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Patients with schizophrenia spectrum disorders (SSD) tend to lack insight, which is linked to poor outcomes. The effect size of previous treatments on insight changes in SSD has been small. Metacognitive interventions may improve insight in SSD, although this remains unproved.
We carried out a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effects of metacognitive interventions designed for SSD, namely Metacognitive Training (MCT) and Metacognitive Reflection and Insight Therapy (MERIT), on changes in cognitive and clinical insight at post-treatment and at follow-up.
Twelve RCTs, including 10 MCT RCTs (n = 717 participants) and two MERIT trials (n = 90), were selected, totalling N = 807 participants. Regarding cognitive insight six RCTs (n = 443) highlighted a medium effect of MCT on self-reflectiveness at post-treatment, d = 0.46, p < 0.01, and at follow-up, d = 0.30, p < 0.01. There was a small effect of MCT on self-certainty at post-treatment, d = −0.23, p = 0.03, but not at follow-up. MCT was superior to controls on an overall Composite Index of cognitive insight at post-treatment, d = 1.11, p < 0.01, and at follow-up, d = 0.86, p = 0.03, although we found evidence of heterogeneity. Of five MCT trials on clinical insight (n = 244 participants), which could not be meta-analysed, four of them favoured MCT compared v. control. The two MERIT trials reported conflicting results.
Metacognitive interventions, particularly Metacognitive Training, appear to improve insight in patients with SSD, especially cognitive insight shortly after treatment. Further long-term RCTs are needed to establish whether these metacognitive interventions-related insight changes are sustained over a longer time period and result in better outcomes.
Due to the higher costs and selection bias of directly measuring weight, the majority of body weight data are based on survey responses. However, these statements are subject to systematic biases of social desirability; therefore, it is important to evaluate the magnitude of bias through indirect indicators such as rounding of weights. Data from seven rounds of the Spanish National Health Survey from 1995 to 2017 were included in the study, with 113,284 subjects. A general rounding index of weights terminating in 0 and 5, and a partial rounding index that estimated the bias direction, were used to estimate the bias distribution in the self-reporting of body weight. All body weights were systematically rounded, although more strongly in the lower weights and even more so in the higher weights. Lower weights were rounded up, and the higher weights rounded down. Regarding gender, men had higher rounding indices than women. The subjects generally reported a weight closer to the socially desirable weight. Rounding allows estimating the historical evolution of this bias in health and nutrition surveys, having more accurate information by population segments and designing public policies against obesity aimed at the more affected social segments.
Infertility is defined as a failure of spontaneous conception after one year of regular sexual intercourse in the absence of contraceptive measures . This entity represents a rising medical complaint since one out of eight couples find it difficult to conceive a child for the first time, and up to one in six find it difficult to conceive twice. Currently, 70 million couples of reproductive age suffer from infertility worldwide, accounting for an estimated overall prevalence of 15% .
This study assessed psychiatric medications and their potential lethality in a representative sample of suicide attempts.
Materials and methods.
During 1996–98, 563 suicide attempts were studied in a general hospital in Madrid (Spain). Medication overdose was used in 456 suicide attempts (81%). The ratio between dose taken and maximum prescription dose recommended was used to evaluate the medication toxicity.
Benzodiazepines were the drugs most often used in self-poisoning (65% of overdoses), followed by new antidepressants (11%), tricyclic antidepressants (TCAs) (10%), and antipsychotics (8%). An overdose with any of the three latter psychiatric medications was significantly more frequent in patients prescribed those medications. The overdoses for TCA were potentially lethal in 47% of the cases. However, all patients who overdosed on psychiatric medications recovered well and were discharged without any sequelae.
This study suggests that psychiatric medications, particularly benzodiazepines, new antidepressants and antipsychotics, are relatively safe when they are used for self-poisoning. If patients with mental illnesses are under treated, there is a clear and documented higher risk for suicide.
It is better to prescribe psychiatric medications, particularly the new ones, rather than withhold them due to an exaggerated fear of a lethal overdose
Response to SSRIs suggests the implication of the serotonergic system in obsessive-compulsive disorder (OCD). However, biological studies on serotonergic function in OCD have yielded contradictory results. Platelet monoamine oxidase (MAO) activity has been proposed as an index of cerebral serotonin activity.
The aim of this study was to examine platelet MAO activity in 29 OCD patients and 29 healthy controls matched by age, sex and tobacco use. We also explored the relationship between platelet MAO activity and aggressive obsessions in OCD patients.
There were no differences in platelet MAO activity between OCD patients and healthy controls. We found a significant correlation between platelet MAO activity and Y-BOCS scores in the group of patients with Y-BOCS scores >15.
OCD patients with aggressive obsessions had significantly lower levels of platelet MAO activity than patients without aggressive obsessions.
Our results suggest that platelet MAO activity may be a marker of OCD severity, and that low platelet MAO activity may be associated with aggressive obsessions in OCD patients.
The need to achieve a uniform distribution of concentrated solar flux in the photovoltaic, thermal or any other receivers is a common problem; therefore, the optical characterization of the concentration system is necessary to determinate the physical characteristics of the receptors. In this work, a parabolic dish concentrator of 1.65x1.65 m2, developed by research from the University of Arizona, is optically characterized under normal operating conditions, also known as environmental conditions that refer to non-controlled conditions as solar radiation, environmental temperature and wind velocity that could affect slightly, by thermal and mechanical efforts, the distribution profiles of the concentrated solar radiation. The set used for the evaluation consisted of the parabolic mirror and Chilled Lambertian Flat Surface installed in the focal point on the optical axis of the mirror. The evaluation was divided into two parts: a theoretical part that consist on using ray tracing simulation and an experimental part that corresponds to image analysis. The used methodology in this work has been stablish in many researches, so this is a reliable method. The global optical error was 2.3 mrad under normal operating conditions.
The Bay of Málaga is located in a high biodiversity and productivity area that harbours a wide variety of commercial species exploited by different fishing fleets. Benthic and demersal fauna from circalittoral soft bottoms have been studied using a benthic dredge (BD) (8 sampling stations) and an otter trawl (OT) (8 sampling stations on a seasonal basis). Some sediment and water column variables, as well as the trawling activity, have also been studied and used for analysing their linkage with the fauna. A total of 287 species have been found in these bottoms and fish, molluscs and crustaceans represented the most diverse and abundant faunistic groups. A new record of the decapod Hippolyte leptometrae for Spanish waters is also included in this study. Some multivariate analyses using BD samples indicated the presence of three assemblages, but these seem to represent different facies of a single benthic community due to the absence of acute sediment changes and significant differences in the fauna. OT samples only displayed differences related to seasons but not to sediment types or depth. These seasonal differences seem to be linked to biological and ecological features of both dominant and/or commercial species. Mud and organic matter contents (%OM) in sediment, as well as the temperature, were the main variables linked to the spatial distribution of the benthic community identified with BD, whereas medium and coarse sand as well as gravel contents were the main variables linked to the changes of the epibenthic and demersal assemblage resulting from OT samples. The information of this study is of importance for improving the knowledge on the biodiversity of circalittoral soft bottoms of the Mediterranean and Alboran Sea as well as for the potential creation of a Marine Fisheries Reserve in the Bay of Málaga.
Ceramic–metal composites are an important group of materials that have gained interest recently because of their peculiar properties. There have been numerous studies on the reinforcement of alumina through the incorporation of various ductile metals in it. However, these studies have been limited to determining the effect of the addition of metals on the mechanical properties of ceramics, without determining the effect of these metal additions on other physical properties of the resulting composite. In this way, in agreement with the obtained results, we have that because of the conductive nature of metals, there is a considerable decrease in the electrical resistivity of alumina, mainly when copper is added to it. However, in terms of optical performance, alumina matrix composites showed significant changes in absorbance in the visible spectra. The addition of iron, titanium, and yttrium enhanced the absorbance of alumina, whereas manganese addition significantly decreased the optical absorption.
We aimed to study the correlation between neck circumference (NC) and anthropometric adiposity indicators, and to determine cut-off points of NC for both sexes to identify elevated central adiposity in schoolchildren in western Mexico.
Rural settings in western México.
Children from a convenience sample of six schools in Acatlán, Jalisco, Mexico (n 1802).
NC showed a strong positive correlation with all anthropometric adiposity indicators in both sexes, which were notably higher in boys regardless of age. Noteworthy, waist circumference displayed the highest significant correlation when analysed by both age and sex. As age increased, NC cut-off points to identify elevated central adiposity ranged from 25·7 to 30·1 cm for girls and from 27·5 to 31·7 cm for boys.
NC could be used as a simple, inexpensive and non-invasive indicator for central obesity assessment in Mexican schoolchildren.
A newborn with prenatally diagnosed dysplasia of both atrioventricular valves presented after birth with signs and symptoms of low cardiac output, severe regurgitation of both mitral and tricuspid valves. This combination is as rare as challenging, since it regards both the timing and management of this complex cardiac malformation. We report an early surgical repair of both atrioventricular valves in a symptomatic newborn, which improved his clinical status and, so far, delayed valve replacement.
The main aim of this study was to confirm the relationship between executive performance and salivary alpha-amylase (SAA) activity in a sample of 64 healthy children (39 boys), and compare it to the association of SAA output and salivary flow rate (SFR). Executive functioning was assessed via fluency, trail-making, rings and inhibition tasks from the Batería de Evaluación Neuropsicológica de la Función Ejecutiva en Niños [Battery of Neuropsychological Assessment for Executive Function in Children] (ENFEN), merged into an ENFEN total score. SAA activity, output, and SFR were measured at baseline, one minute before, and one minute after the end of a neuropsychological testing session. Our results confirmed a direct, linear and significant association between SAA activity and executive functioning, r(64) = .351, p < .05, and extended it to SAA output, r(64) =.431, p < .05. The mean level of SAA output was the best predictor of executive functioning (β = .431, p < .05) and explained 18.2 % of the variance in ENFEN total score. In sum, and compared to SAA activity, measuring SAA output may be a more precise and indirect marker to assess executive functioning in children.
This study aimed to evaluate the associations between the muscle mass to visceral fat (MVF) ratio and cardiometabolic risk factors in a large population of college students in Colombia and to propose cut-off points of this index for the metabolic syndrome (MetS). A total of 1464 young adults recruited from the FUPRECOL (Asociación de la Fuerza Prensil con Manifestaciones Tempranas de Riesgo Cardiovascular en Jóvenes y Adultos Colombianos) study were categorised into four groups based on their MVF ratio. Muscle mass and visceral fat level of the participants were measured using a bioelectrical impedance analysis. Cardiometabolic risk factors including lifestyle characteristics, anthropometry, blood pressure and biochemical parameters were assessed. The prevalence of moderate to severe obesity, hypertension and the MetS was higher in subjects in quartile (Q)1 (lower MVF ratio) (P <0·001). ANCOVA revealed that the subjects in Q1 had higher cardiometabolic disturbances, including altered anthropometry, blood pressure, muscle strength and biochemical parameters after adjusting for age and sex compared with young adults in higher MVF ratio quartiles (P <0·001). Muscular mass and physical activity levels were significantly lower in subjects with a lower MVF ratio (P <0·001). The receiver operating characteristic curve analyses indicated that in men the best MVF ratio cut-off point for detecting the MetS was 18·0 (AUC 0·83, sensitivity 78 % and specificity 77 %) and for women, the MVF ratio cut-off point was 13·7 (AUC 0·85, sensitivity 76 % and specificity 87 %). A lower MVF ratio is associated with a higher risk cardiometabolic profile in early adulthood, supporting that the MVF ratio could be used as a complementary screening tool that may help clinicians identify young adults at high cardiometabolic risk.
In December 2010, a major storm erupted in Saturn’s northern hemisphere near 37° planetographic latitude. This rather surprising event, occurring at an unexpected latitude and time, is the sixth “Great White Spot” (GWS) storm observed over the last century and a half. Such GWS events are extraordinary, planetary-scale atmospheric phenomena that dramatically change the typically bland appearance of the planet. Occurring while the Cassini mission was on orbit at Saturn, the Great Storm of 2010–2011 was well suited for intense scrutiny by the suite of sophisticated instruments onboard the Cassini spacecraft as well by modern instrumentation on ground-based telescopes and onboard the Hubble Space Telescope. This GWS erupted on 5 December close to the peak of a westward jet and generated a major dynamical disturbance that affected the whole latitude band from 25° to 48°N. At the upper cloud level, following the rapid growth of the bright outbreak spot, a blunt aerodynamic-shaped head formed due to interaction of the spot with the westward zonal jet, with the winds reaching velocities of 160 m s−1 along the periphery of the arc. Eastward of the head, the disturbance progressed in the following months forming a turbulent wake or tail with growing vortices, one of them a major enduring anticyclone (called AV) with a size of ~11,000 km. Lightning events were prominent and detected as outbursts and flashes at the head and along the disturbance at both optical and radio wavelengths. The activity of the head ceased after about seven months when AV reached it, leaving the cloud structure and ambient winds perturbed. The tops of the optically dense clouds of the head reached the 300-mbar altitude level (~50 km below tropopause), where a mixture of ices was detected, including (1) a component of water ice lofted over 200 km altitude from its 10-bar condensation level, (2) ammonia ice as the predominant component and (3) a component that might be ammonium hydrogen sulfide ice. The energetics of the frequency and power of lightning, as well as the estimated power generated by the latent heat released in the water-based convection to create the observed dynamical three-dimensional flows, both indicate that the power released for much of the 7-month lifetime of the storm (~1017 Watts) was a significant fraction of Saturn’s total radiated power (~2.2 1017 W). A post-storm depletion of ammonia vapour was also measured in the upper troposphere. The effects of the storm propagated into the stratosphere, forming two warm air masses at the ~0.5- to 5-mbar pressure level altitude that later merged into a so-called “beacon” because of its 80 K temperature excess relative to its surroundings. Related to the stratospheric disturbance, hydrocarbon composition excesses were found, in particular for ethylene (C2H4), in the high stratosphere at the ~0.1- to 0.5-mbar altitude level. Numerical models of the storm dynamics explain the major observed features that essentially result from two processes: (1) a huge and sustained, moist, convective storm at the water clouds (altitude level 10–12 bar, or ~250–275 km below the tropopause) and (2) the interaction of the updraft columns with the ambient winds that generates the turbulent wake consisting of vortices and waves. Model simulations of the GWS require a low vertical shear of the zonal winds and low static stability across the weather layer where the disturbance develops. Its upward propagation into the stratosphere involves Rossby waves and their breaking and energy deposition to form the beacon and induce chemical changes.
The decades-long interval between storms is probably related to the insolation cycle and the long radiative time constant of Saturn’s atmosphere, and several theories for temporarily storing energy have been proposed.
The primary objectives of the ExoplANETS-A project are to: establish new knowledge on exoplanet atmospheres; establish new insight on influence of the host star on the planet atmosphere; disseminate knowledge, using online, web-based platforms. The project, funded under the EU’s Horizon-2020 programme, started in January 2018 and has a duration ∼3 years. We present an overview of the project, the activities concerning the host stars and some early results on the host stars.
Hii regions in galaxy disks can be used as a powerful tool to trace the radial distribution of several of their properties and shed some light on the different relevant processes on galaxy formation and evolution. Among the properties that can be extracted from the study of the ionized gas are the metallicity, the excitation and the hardness of the ionizing field of radiation. In this contribution we focus on the determination of both the ionization parameter (U) and the effective temperature of the ionizing clusters (T⋆) by means of a bayesian-like comparison between the observed relative fluxes of several emission-lines with the predictions from a set of photoionization models. We also show the implications that the use of our method has for the study of the radial variation of both U and T⋆ in some very well-studied disk galaxies of the Local Universe.
During the INDEMARES/CHICA 0610, 0211 and 0412 expeditions, carried out in the northern Spanish sector of the Gulf of Cádiz (Spain), samples were collected with a box-corer in 11 mud volcanoes and their adjacent bottoms. Chemoautotrophic communities were found in nine mud volcanoes. Among Decapoda, a rare eucalliacid, belonging to the genus Calliax and related to the Mediterranean infralittoral species C. lobata (de Gaillande and Lagardère 1966), was present in three of them. Data on its morphology, biogeographic distribution, vertical distribution within the burrows, sediment composition, pH and redox potential values (each in 5 cm intervals) are given; information on the chemoautotrophic communities associated with this species are also provided.
Non-suicidal self-injury (NSSI) behaviors are self-injurious behaviors inflicted without intending death. Literature has shown the relationship between stressful life events (SLE) and NSSI behaviors. The Strengths and Difficulties Questionnaire-Dysregulation Profile (SDQ-DP) is defined as an index of self-regulatory problems, related to higher risk for suicidal ideation and attempts in adolescents. In this study the relationship between SDQ-DP and NSSI behaviors, mediated by SLE in a clinical sample of children and adolescents is analyzed. A cross-sectional study was conducted on 239 subjects (aged from 11 to 17) to test the mediation model. SDQ-DP significantly correlates with NSSI behaviors (Wald = 6.5477, p = .0105); SDQ-DP significantly correlates with SLE (T = 5.7229, p < .001); SLE significantly correlates NSSI behaviors, and the relation remains significant whilst controlling for SDQ-DP (Wald = 4.1715, p = .041); the relation between SDQ-DP and NSSI behaviors stops being significant whilst controlling for the potential mediator (SLE) (Wald = 2.9951, p = .0835). Study of indirect effect supports the mediation model (.0585 CI [.0016, .1266]). Findings are compatible with the complete mediation scenario. These results point out the importance of self-regulatory problems in coping strategies with regards to SLE and the development of NSSI behaviors.