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Treatment of medical catatonia sometimes requires management of presenting psychiatric syndrome as well as treatment of causative medical illnesses. Treatment response to these approaches may, however, differ even in the same patient suffering a relapse of a similar clinical picture, and this presents a therapeutic challenge for physicians. We therefore report a case of medical catatonia due to Graves’ disease which responded to antithyroid therapy in the first episode but required electroconvulsive therapy (ECT) when relapsed, then discuss the possible mechanism which caused different treatment response.
We describe the clinical course with the laboratory findings of recurrent catatonic episodes of a patient with Graves’ disease.
A 25-year-old woman manifested stupor, catalepsy and echolalia accompanying goiter, proptosis and tachycardia. Laboratory findings on thyroid function were consistent with Graves’ disease. Treated with thyamazole (TMZ), her psychiatric and physical symptoms gradually subsided. She had remained euthyroid and symptom free for 10 years on TMZ 5 mg every other day. However, at age 35, she exhibited stupor with mannerism and stereotypy. Laboratory findings revealed mild exercerbation of thyroid function. Though antithyroid therapy regained euthyroid, her psychiatric symptoms persisted. Further treatment with neuroleptics did not ameliorate her symptoms. She was thus administered bitemporal ECT and recovered after 7th trial.
Aggravation of thyroid function associated with catatonic symptoms when relapsed was milder compared to the first episode. This suggested that dysregulation of thyroid homeostasis in the central nervous system might have persisted despite the peripheral euthyroid and could affect the treatment response.
The deviation from thermodynamic equilibrium of the ion velocity distribution functions (VDFs), as measured by the Magnetospheric Multiscale (MMS) mission in the Earth’s turbulent magnetosheath, is quantitatively investigated. Making use of the unprecedented high-resolution MMS ion data, and together with Vlasov–Maxwell simulations, this analysis aims at investigating the relationship between deviation from Maxwellian equilibrium and typical plasma parameters. Correlations of the non-Maxwellian features with plasma quantities such as electric fields, ion temperature, current density and ion vorticity are found to be similar in magnetosheath data and numerical experiments, with a poor correlation between distortions of ion VDFs and current density, evidence that questions the occurrence of VDF departure from Maxwellian at the current density peaks. Moreover, strong correlation has been observed with the magnitude of the electric field in the turbulent magnetosheath, while a certain degree of correlation has been found in the numerical simulations and during a magnetopause crossing by MMS. This work could help shed light on the influence of electrostatic waves on the distortion of the ion VDFs in space turbulent plasmas.
The giant Hii region W 31 hosts the populous star cluster W 31-CL and others projected on or in the surroundings. The most intriguing object is the stellar cluster SGR 1806-20, which appears to be related to a Luminous Blue Variable (LBV)—a luminous supergiant star. We used the deep VVV J-, H-, and
-band photometry combined with 2MASS data in order to address the distance and other physical and structural properties of the clusters W 31-CL, BDS 113, and SGR 1806-20. Field-decontaminated photometry was used to analyse colour–magnitude diagrams (CMDs) and stellar radial density profiles, using procedures that our group has developed and employed in previous studies. We conclude that the clusters W 31-CL and BDS 113 are located at 4.5 and 4.8 kpc and have ages of 0.5 and 1 Myr, respectively. This result, together with the pre-main sequence distribution in the CMD, characterises them as members of the W 31 complex. The present photometry detects the stellar content, addressed in previous spectroscopic classifications, in the direction of the cluster SGR 1806-20, including the LBV, Wolf–Rayet, and foreground stars. We derive an age of
and a distance of
. The cluster is extremely absorbed, with
. The present results indicate that SGR 1806-20 is more distant by a factor 1.8 with respect to the W 31 complex, and thus not physically related to it.
The VISCACHA (VIsible Soar photometry of star Clusters in tApii and Coxi HuguA†) Survey is an ongoing project based on deep and spatially resolved photometric observations of Magellanic Cloud star clusters, collected using the SOuthern Astrophysical Research (SOAR) telescope together with the SOAR Adaptive Module Imager. So far we have used >300h of telescope time to observe ∼150 star clusters, mostly with low mass (M < 104M⊙) on the outskirts of the LMC and SMC. With this high-quality data set, we homogeneously determine physical properties using deep colour-magnitude diagrams (ages, metallicities, reddening, distances, mass, luminosity and mass functions) and structural parameters (radial density profiles, sizes) for these clusters which are used as a proxy to investigate the interplay between the Magellanic Clouds and their evolution. We present the VISCACHA survey and its initial results, based on our first two papers. The project’s long term goals and expected legacy to the community are also addressed.
Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.
Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.
Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?
Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.
Documenting past changes in the East Antarctic surface mass balance is important to improve ice core chronologies and to constrain the ice-sheet contribution to global mean sea-level change. Here we reconstruct past changes in the ratio of surface mass balance (SMB ratio) between the EPICA Dome C (EDC) and Dome Fuji (DF) East Antarctica ice core sites, based on a precise volcanic synchronization of the two ice cores and on corrections for the vertical thinning of layers. During the past 216 000 a, this SMB ratio, denoted SMBEDC/SMBDF, varied between 0.7 and 1.1, being small during cold periods and large during warm periods. Our results therefore reveal larger amplitudes of changes in SMB at EDC compared with DF, consistent with previous results showing larger amplitudes of changes in water stable isotopes and estimated surface temperature at EDC compared with DF. Within the last glacial inception (Marine Isotope Stages, MIS-5c and MIS-5d), the SMB ratio deviates by up to 0.2 from what is expected based on differences in water stable isotope records. Moreover, the SMB ratio is constant throughout the late parts of the current and last interglacial periods, despite contrasting isotopic trends.
We report our systematic survey observations of protostellar sources with the SubMillimeter Array (SMA) and Atacama Large Millimeter/submillimeter Array (ALMA). The purpose of our survey is to investigate formation mechanism of protoplanetary disks, precursors of planetary systems, out of ~1000 AU-scale protostellar envelopes surrounding the protostars. We found that in the early protostars (B335, NGC1333 IRAS 4B), the envelopes do not show significant rotating motions but infalling motions toward the central protostars. In more evolved protostars (L1527 IRS, L1448-mm, L1551 IRS 5), the envelopes are infalling and rotating with the conserved specific angular momenta (that is, vrot ∝ r−1). In most evolved sources (L1551 NE, TMC-1A, L1489 IRS) large-scale (≳100 AU) disks in Keplerian rotation or protoplanetary disks are evident. These results demonstrate a systematic evolutionary trend of envelope gas motions toward the disk formation.
We present high resolution molecular line observations of dusty AGN and starburst in nearby luminous infrared galaxies (LIRGs), VV 114 (band 3/4/7) and NGC 1614 (band 3/6/7/9), with ALMA. Multi-frequency imaging from 4.8 GHz to 691 GHz of NGC 1614 allows us to study spatial properties of the radio-to-FIR continuum and multiple CO transitions, and we find the CO excitation up to Jupp = 6 can be explained by a single ISM model powered by nuclear starbursts. Our processing line imaging survey for VV 114 detected at least 30 molecular lines which show different chemical composition from region to region. Multi-molecule imaging helps us to diagnose the chemical differences of dusty ISM, while multi-transition imaging allows us to investigate gas physical conditions affected by nuclear activities directly.
Evidence is lacking on the preventive effect of oral care on healthcare-associated pneumonia in hospitalized patients and nursing home residents who are not mechanically ventilated. The primary aim of this review was to assess the effectiveness of oral care on the incidence of pneumonia in nonventilated patients.
We searched 8 databases (MEDLINE, Embase, CENTRAL, CINAHL, Web of Science, LILACS, ICHUSHI, and CiNii), in addition to trial registries and a manual search. Eligible studies were published and unpublished randomized controlled trials examining the effect of any method of oral care on reported incidence of pneumonia and/or fatal pneumonia. Relative risks (RR) and 95% confidence intervals were calculated. Risk of bias was assessed for eligible studies.
We identified 5 studies consisting of 1,009 subjects that met the inclusion criteria. Of these, 2 trials assessed the effect of chlorhexidine in hospitalized patients; 3 studies examined mechanical oral cleaning in nursing home residents. A meta-analysis could only be done on 4 trials; this analysis showed a significant risk reduction in pneumonia through oral care interventions (RRfixed, 0.61; 95% CI, 0.40–0.91; P=.02). The effects of mechanical oral care alone were significant when pooled across studies. (RRfixed, 0.61; 95% CI, 0.40–0.92; P=.02). Risk reduction for fatal pneumonia from mechanical oral cleaning was also significant (RRfixed, 0.41; 95% CI, 0.23–0.71; P=.002). Most studies had a high risk of bias.
This analysis suggests a preventive effect of oral care on pneumonia in nonventilated individuals. This effect, however, should be interpreted with caution due to risk of bias in the included trials.
We show that high-efficiency and low-degradation hydrogenated amorphous silicon (a-Si:H) p-i-n solar cells can be obtained by depositing absorber layers in a triode-type plasma-enhanced chemical vapor deposition (PECVD) process. Although the deposition rate is relatively low (0.01-0.03 nm/s) compared to the conventional diode-type PECVD process (∼0.2 nm/s), the light-induced degradation in conversion efficiency of single-junction solar cell is substantially reduced (Δη/ηini∼10%) due to the suppression of light-induced metastable defects in the a-Si:H absorber layer. So far, we have attained an independently-confirmed stabilized efficiency of 10.11% for a 220-nm-thick a-Si:H solar cell which was light soaked under 1 sun illumination for 1000 hours at cell temperature of 50°C. We further demonstrate that stabilized efficiencies as high as 10% can be maintained even when the solar cell is thickened to >300 nm.
The Vista Variables in the Vía Láctea (VVV) ESO Public Survey is an ongoing time-series, near-infrared (IR) survey of the Galactic bulge and an adjacent portion of the inner disk, covering 562 square degrees of the sky, using ESO's VISTA telescope. The survey has provided superb multi-color photometry in 5 broadband filters (Z, Y, J, H, and Ks), leading to the best map of the inner Milky Way ever obtained, particularly in the near-IR. The main part of the survey, which is focused on the variability in the Ks-band, is currently underway, with bulge fields observed between 34 and 73 times, and disk fields between 34 and 36 times. When the survey is complete, bulge (disk) fields will have been observed up to a total of 100 (60) times, providing unprecedented depth and time coverage in the near-IR. Here we provide a first overview of stellar variability in the VVV data.
Ten ice-sheet models are used to study sensitivity of the Greenland and Antarctic ice sheets to prescribed changes of surface mass balance, sub-ice-shelf melting and basal sliding. Results exhibit a large range in projected contributions to sea-level change. In most cases, the ice volume above flotation lost is linearly dependent on the strength of the forcing. Combinations of forcings can be closely approximated by linearly summing the contributions from single forcing experiments, suggesting that nonlinear feedbacks are modest. Our models indicate that Greenland is more sensitive than Antarctica to likely atmospheric changes in temperature and precipitation, while Antarctica is more sensitive to increased ice-shelf basal melting. An experiment approximating the Intergovernmental Panel on Climate Change’s RCP8.5 scenario produces additional first-century contributions to sea level of 22.3 and 8.1 cm from Greenland and Antarctica, respectively, with a range among models of 62 and 14 cm, respectively. By 200 years, projections increase to 53.2 and 26.7 cm, respectively, with ranges of 79 and 43 cm. Linear interpolation of the sensitivity results closely approximates these projections, revealing the relative contributions of the individual forcings on the combined volume change and suggesting that total ice-sheet response to complicated forcings over 200 years can be linearized.
Periodically textured back reflectors with hexagonal dimple arrays are applied to thin-film microcrystalline silicon (μc-Si:H) solar cells for enhancing light trapping. The period and aspect ratio of the honeycomb textures have a big impact on the photovoltaic performance. When the textures have a moderate aspect ratio, the optimum period for obtaining a high short circuit current density (JSC) is found to be equal to or slightly larger than the cell thickness. If the cell thickness exceeds the texture period, the cell surface tends to be flattened and texture-induced defects are generated, which constrain the improvement in JSC. Based on these findings, we have fabricated optimized μc-Si:H cells achieving a high active-area efficiency exceeding 11% and a JSC of 30 mA/cm2.
Using open-field behaviour as an experimental paradigm, we demonstrated a complex interaction between the rewarding/stimulating effects and the anxiogenic/stressful effects of both novelty and acute or chronic amphetamine in mice. As a consequence of this interaction, acute amphetamine-induced hyperlocomotion was inhibited, whereas the expression of its sensitization was facilitated in a novel environment. In the present study, we aimed to investigate the interactions between exposure to a novel environment and the acute and chronic effects of ethanol (Eth), a drug of abuse known to produce anxiolytic-like behaviour in mice. Previously habituated and non-habituated male Swiss mice (3 months old) were tested in an open field after receiving an acute injection of Eth or following repeated treatment with Eth. Acute Eth administration increased locomotion with a greater magnitude in mice exposed to the apparatus for the first time, and this was thought to be related to the attenuation of the stressful effects of novelty produced by the anxiolytic-like effect of acute Eth, leading to a subsequent prevalence of its stimulant effects. However, locomotor sensitization produced by repeated Eth administration was expressed only in the previously explored environment. This result might be related to the well-known tolerance of Eth-induced anxiolytic-like behaviour following repeated treatment, which would restore the anxiogenic effect of novelty. Our data suggest that a complex and plastic interaction between the emotional and motivational properties of novelty and drugs of abuse can critically modify the behavioural expression of addiction-related mechanisms.
Recent epidemiological data suggest a link between the consumption of bovine offal products and Shiga toxin-producing Escherichia coli (STEC) infection in Japan. This study thus examined the prevalence of STEC in various types of these foods. PCR screened 229 bovine offal products for the presence of Shiga toxin (stx) gene. Thirty-eight (16·6%) samples were stx positive, of which eight were positive for rfbEO157 and three were positive for wzyO26. Four O157 and one O26 STEC isolates were finally obtained from small-intestine and omasum products. Notably, homogenates of bovine intestinal products significantly reduced the extent of growth of O157 in the enrichment process compared to homogenates of beef carcass. As co-incubation of O157 with background microbiota complex from bovine intestinal products in buffered peptone water, in the absence of meat samples, tended to reduce the extent of growth of O157, we reasoned that certain microbiota present in offal products played a role. In support of this, inoculation of generic E. coli from bovine intestinal products into the homogenates significantly reduced the extent of growth of O157 in the homogenates of bovine intestinal and loin-beef products, and this effect was markedly increased when these homogenates were heat-treated prior to inoculation. Together, this report provides first evidence of the prevalence of STEC in a variety of bovine offal products in Japan. The prevalence data herein may be useful for risk assessment of those products as a potential source of human STEC infection beyond the epidemiological background. The growth characteristic of STEC O157 in offal products also indicates the importance of being aware when to test these food products.
In order to measure precisely the polarization of Crab Nebula and Cygnus X-1, we have been developing a hard X-ray polarimeter for balloon-borne experiments called PHENEX (Polarimetry of High ENErgy X-rays). It consists of several detectors called unit counters. The unit counter has a detection efficiency of 20% and a modulation factor of 53% at 80 keV. Up to now, we have finished the installation of eight unit counters to the polarimeter, that will be launched in Spring 2009 to observe the Crab Nebula. If the polarization of this source is more than 30%, the PHENEX polarimeter will be able to measure the degree and the direction of the polarization with errors less than 10% and 10°, respectively.
X-ray astronomy has been much advanced by three observations: spectroscopy, timing, and imaging. Also in the hard X-ray region, these three observations will be realized by ASTRO-H and XEUS. However, the observation of the polarization is at the moment left out in spite of its potential usefulness. This is because of the difficulty of developing polarimeters with high sensitivity. Since the origin of the polarization is often due to nonthermal radiation processes such as synchrotron radiation, observations in the hard X-ray region are possibly more important than those in the soft X-ray region: it is expected that the degree of polarization in the hard X-ray region would be higher than that at lower energies.
Adrenomedullin is a potent vasodilatory peptide. The mechanisms of adrenomedullin-induced responses are via guanine nucleotide guanosine 5′-triphosphate-binding protein (G-protein)-coupled receptor activation and are similar to those of calcitonin gene-related peptide (CGRP). Previously, we reported that sevoflurane and isoflurane inhibit CGRP-induced haemodynamic responses. The effects of volatile anaesthetics on adrenomedullin-induced haemodynamic responses, however, are unclear. We hypothesized that the volatile anaesthetic isoflurane inhibits adrenomedullin-induced haemodynamic responses. We studied the effects of isoflurane on adrenomedullin-induced haemodynamic responses in pithed rats, which enables us to evaluate the direct cardiovascular effects of drugs without interference from centrally mediated circulatory reflexes.
Male Wistar rats were pithed by inserting a stainless-steel rod into the spinal cord. Following median sternotomy, a flow probe was placed around the ascending aorta to measure aortic blood flow. Mean arterial pressure and cardiac output were maintained at approximately 100 mmHg and 50 mL min−1, respectively, with continuous infusion of norepinephrine. After 30 min inhalation of isoflurane (1%, or 2%) in oxygen, or only oxygen, adrenomedullin (1, 3, 10 or 30 μg kg−1) was administered intravenously.
Adrenomedullin administration induced a transient increase followed by a persistent decrease in mean arterial pressure and cardiac output. Isoflurane (2%) significantly inhibited the initial increase in mean arterial pressure and the later decrease in mean arterial pressure and systemic vascular resistance.
Isoflurane inhibits adrenomedullin-induced vasodilation and positive inotropic effect in pithed rats. Isoflurane might inhibit the adrenomedullin receptor-mediated response, which is a common pathway for both actions.