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Antarctica's ice shelves modulate the grounded ice flow, and weakening of ice shelves due to climate forcing will decrease their ‘buttressing’ effect, causing a response in the grounded ice. While the processes governing ice-shelf weakening are complex, uncertainties in the response of the grounded ice sheet are also difficult to assess. The Antarctic BUttressing Model Intercomparison Project (ABUMIP) compares ice-sheet model responses to decrease in buttressing by investigating the ‘end-member’ scenario of total and sustained loss of ice shelves. Although unrealistic, this scenario enables gauging the sensitivity of an ensemble of 15 ice-sheet models to a total loss of buttressing, hence exhibiting the full potential of marine ice-sheet instability. All models predict that this scenario leads to multi-metre (1–12 m) sea-level rise over 500 years from present day. West Antarctic ice sheet collapse alone leads to a 1.91–5.08 m sea-level rise due to the marine ice-sheet instability. Mass loss rates are a strong function of the sliding/friction law, with plastic laws cause a further destabilization of the Aurora and Wilkes Subglacial Basins, East Antarctica. Improvements to marine ice-sheet models have greatly reduced variability between modelled ice-sheet responses to extreme ice-shelf loss, e.g. compared to the SeaRISE assessments.
To explore tolerability, safety and treatment response of flexible doses of paliperidone ER in adult non-acute patients with schizophrenia previously unsuccessfully treated with oral antipsychotics.
International prospective 6-month open-label study. Endpoints were the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity Scale (CGI-S), patient satisfaction, adverse events (AEs), extrapyramidal symptoms (Extrapyramidal Symptom Rating Scale; ESRS) and weight change.
1812 patients were included (59.9% male, mean age 40.1±12.6 years, 75.8% paranoid schizophrenia); most were enrolled because of lack of efficacy (n=1026) or lack of tolerability (n=490) with prior antipsychotic treatment. The median mode dose of paliperidone ER was 6 mg/day. 70.7% of patients completed the 6-month study. Most frequent reasons for early discontinuation were patient choice (8.8%), lack of efficacy or adverse event (5.1% each) independent of the reason for switching. Mean total PANSS decreased significantly from 79.4±20.4 at baseline to 66.1±21.5 at endpoint (mean change -13.3±19.7; 95% confidence interval -14.2;-12.3, p< 0.0001). The percentage of patients rated mildly ill or less in CGI-S increased from 27.0% to 52.2% at endpoint, and the rate of patients with mild functional impairment increased from 15.8% to 34.9%. AEs reported in greater-than-or-equal-to 5% of patients were insomnia (9.2%) and anxiety (7.2%). Extrapyramidal symptoms in ESRS decreased significantly from 3.5±5.8 to 2.1±4.6 (p< 0.0001). Mean weight gain from baseline to endpoint was 0.3±4.8kg.
These data support results from recent randomized controlled studies that paliperidone ER is safe, well tolerated and effective in patients previously unsuccessfully treated with other oral antipsychotics.
Data about quality of life (QoL) are important to estimate the impact of diseases on functioning and well-being. The present study was designed to assess the association of different aspects of panic disorder (PD) with QoL and to examine the relationship between QoL and symptomatic outcome following brief cognitive-behavioral group therapy (CBGT).
The sample consisted of 55 consecutively recruited outpatients suffering from PD who underwent CBGT. QoL was assessed by the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) at baseline, post-treatment and six months follow-up. SF-36 baseline scores were compared with normative data obtained from a large German population sample.
Agoraphobia, disability, and worries about health were significantly associated with decreased QoL, whereas frequency, severity and duration of panic attacks were not. Treatment responders showed significantly better QoL than non-responders. PD symptom reduction following CBGT was associated with considerable improvement in emotional and physical aspects of QoL. However, the vitality subscale of the SF-36 remained largely unchanged over time.
Our results are encouraging for cognitive-behavior therapists who treat patients suffering from PD in groups, since decrease of PD symptoms appears to be associated with considerable improvements in QoL. Nevertheless, additional interventions designed to target specific aspects of QoL, in particular vitality, may be useful to enhance patients’ well-being.
The aim of the study was to analyse EEG investigation to diagnose the tic disorders in children and adolescents.
Material and Methods
The analysis was conducted on a group of 76 patients admitted to the Department of Developmental Neurology between 2000-2005 years to diagnose the tic disorders. The average of children's age was 11,4 +/- 3,7 years. In investigated group of patients there were 62 boys (81,6%) and 14 girls (18,4%). The video-EEGs were carried out at 7 patients (22,4%).
There were recorded a single sharp waves in 37 patients (47,4%) and the groups of sharp waves in 21 cases (27,6%). Accordingly there were registered the spike and wave complexes in 7 cases (9,2%) and the sharp and wave complexes in 4 cases (5,3%) in EEG. The generalized paroxysmal activity was recorded in 7 patients (9,1%). The abnormal activity appeared in the temporal part of cerebral hemispheres in 41 children (53,9%). The hiperventilation activated EEG recording of 33 children (43,4%). In 18 cases (23,7%) the abnormal graphoelements didn't appeare in EEG recording. The video recording and the clinical observations during EEG invstigation didn't revealed any coincidence between changes in EEG recording and the involuntary movements presented by patients.
The resting, routine EEG revealed abnormalities in most cases. Therefore video-EEG recording enabled to differentiate tics from epileptic seizure by finding any corelation between the occurrence of involuntary movements and abnormal graphoelements recorded during in EEG investigation.
Some studies have shown that alexithymic patients respond poorly to pharmacotherapy and that alexithymia may have a negative impact on the naturalistic course of psychiatric illnesses. The view that alexithymic patients are also less responsive to psychotherapy is often described in the literature, but few empirical studies have examined this issue, with inconsistent results.
We conducted two prospective studies (pre/post/follow-up) with patients with panic disorder and obsessive-compulsive disorder, to evaluate alexithymia as a potential predictor of the outcome of cognitive-behavioral therapy (CBT) including exposure response management. A further aim was to examine the absolute and relative stability of alexithymia.
Regression analyses revealed that alexithymia, as measured with the 20-item Toronto Alexithymia Scale, was related neither to the post-treatment nor to the follow-up outcome. The repeated measures ANOVA showed a significant decrease of alexithymia over time, even after controlling for depression. The high test-retest correlations of alexithymia total and factor scores indicated relative stability of this construct, suggesting that it is a stable personality trait rather than a state-dependent phenomenon in these patients.
The results are encouraging for cognitive-behavior therapists working with alexithymic patients with panic disorder and obsessive-compulsive disorder, since the CBT outcome of these patients does not appear to be negatively affected by alexithymia. Furthermore, some alexithymic characteristics may decrease during CBT, even when the therapy program is not specifically directed to alexithymia. Future controlled studies should examine whether these improvements of alexithymia are due to psychotherapeutic interventions, in particular exposure therapy.
The aim of the study was to analyze the clinical symptoms of the tic disorder in children and adolescents and verify the diagnosis of the Tourette's syndrome.
The analysis was conducted on a group of 123 patients at the age of 11.1 +/- 3.2 years, admitted to the Chair and Department of Developmental Neurology to diagnose and treatment of the tic disorder.
Variable tics symptomatology were observed in 53 patients (43,1%). The simple motor tics occurred in 121 patients from the researched group (98,4%), the complex motor tics in 7 cases (5,7%) and the vocal tics in 55 cases (44,7%). The dominant symptoms of simple motor tics in the researched group included: blinking occurring in 67 patients (54,5%) and the head movements occurring in 62 children (50,4%). The complex motor tics were the most frequently manifested by jumping - 4 patients (3,3%). The vocal tics manifested as throat cleaning were observed in 40 patients (32,5%). Coprolalia was observed only in 4 children (3.3%). The obsessive – compulsive disorders occurred in 3 patients (2,4%). In 41 examined patients (33,3%) the co-existence of tics with ADHD symptoms was observed.
The diagnostic criteria of the Tourette's syndrome according to DSM-IV were met by 44 patients (35,8%).
The symptomatology of the tics in children and adolescents are exceptionally rich and the symptoms are highly variable. The Tourette's syndrome is still too seldom recognised as the reason of tics in children and teenagers, despite the patients meeting the diagnostic criteria.
The aim of this study was to monitor the use of electroconvulsive therapy (ECT) in the Czech Republic for the purpose of harmonizing national practice.
A 13-item questionnaire was sent to all Czech inpatient psychiatric facilities. This questionnaire assessed technical background of ECT, indications for the treatment, procedure in detail, way of documentation and monitoring of side effects.
ECT is used 23 centers (10 psychiatric hospitals, 5 university psychiatric departments and 8 psychiatric wards) across the Czech Republic. There is no special legal act regulating the use of ECT in the CR, but there are guidelines issued by the Czech Psychiatric Society available. All centers use instruments delivering brief pulse stimuli. All patients have to be indicated for this treatment and have to sign inform consent form/excluding situation when patient's life is endangered/. Somatic state is assessed/EKG, blood tests, eye check-up regularly and other examinations in individual cases/. Thiopenthal and succinylcholine are used most often for anesthesia and myorelaxation. Bitemporal electrode placement is the preferred option in all centers. The ECT is provided 2–4 times a week in special ECT rooms in the presence of staff team/psychiatrist, anesthetist, psychiatric and anesthesiological nurses/. Continuation ECT and outpatient ECT is not used. The procedure including side effects is documented in individual patient's documentation, but summarizing documentation is conducted only in some centers.
ECT is widely used in the Czech Republic. Procedures in all centers follow national guidelines. There is need to improve documentation system to harmonize national practice.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
We present some results from the DRAGON simulations, a set of four direct N-body simulations of globular clusters (GCs) with a million stars and five percent initial (primordial) binaries. These simulations were undertaken with the NBODY6++GPU code, which allowed us to follow dynamical and stellar evolution of individual stars and binaries, formation and evolution of white dwarfs, neutron stars, and black holes, and the effect of a galactic tidal field. The simulations are the largest existing models of a realistic globular cluster over its full lifetime of 12 billion years. In particular we will show here an investigation of the population of binaries including compact objects (such as white dwarfs - cataclysmic variables and merging black hole binaries in the model as counterparts of LIGO/Virgo sources); their distribution in the cluster and evolution with time.
Background: Focal cortical dysplasias (FCDs) are congenital structural abnormalities of the brain, and represent the most common cause of medication-resistant focal epilepsy in children and adults. Recent studies have shown that somatic mutations (i.e. mutations arising in the embryo) in mTOR pathway genes underlie some FCD cases. Specific therapies targeting the mTOR pathway are available. However, testing for somatic mTOR pathway mutations in FCD tissue is not performed on a clinical basis, and the contribution of such mutations to the pathogenesis of FCD remains unknown. Aim: To investigate the feasibility of screening for somatic mutations in resected FCD tissue and determine the proportion and spatial distribution of FCDs which are due to low-level somatic mTOR pathway mutations. Methods: We performed ultra-deep sequencing of 13 mTOR pathway genes using a custom HaloPlexHS target enrichment kit (Agilent Technologies) in 16 resected histologically-confirmed FCD specimens. Results: We identified causal variants in 62.5% (10/16) of patients at an alternate allele frequency of 0.75–33.7%. The spatial mutation frequency correlated with the FCD lesion’s size and severity. Conclusions: Screening FCD tissue using a custom panel results in a high yield, and should be considered clinically given the important potential implications regarding surgical resection, medical management and genetic counselling.
Among several potential animal models that can be used for adipogenic studies, Wagyu cattle is the one that presents unique molecular mechanisms underlying the deposit of substantial amounts of intramuscular fat. As such, this review is focused on current knowledge of such mechanisms related to adipose tissue deposition using Wagyu cattle as model. So abundant is the lipid accumulation in the skeletal muscles of these animals that in many cases, the muscle cross-sectional area appears more white (adipose tissue) than red (muscle fibers). This enhanced marbling accumulation is morphologically similar to that seen in numerous skeletal muscle dysfunctions, disease states and myopathies; this might indicate cross-similar mechanisms between such dysfunctions and fat deposition in Wagyu breed. Animal models can be used not only for a better understanding of fat deposition in livestock, but also as models to an increased comprehension on molecular mechanisms behind human conditions. This revision underlies some of the complex molecular processes of fat deposition in animals.
The thermal conductivity, bulk modulus, thermal expansion and heat capacity for
bulk β-Ga2O3 are calculated from lattice
dynamics using both a quasi-harmonic approximation and an anharmonic
force-constant approach involving a solution of the linearized Boltzmann
transport equation. The role of anharmonicity in
β-Ga2O3 is determined to be small, which
leads to the weak volume dependence of the calculated thermal conductivity. The
negligible anharmonic contribution to the overall thermal conductivity is
consistent with both thermal expansion measurements and also with comparisons
between the quasi-harmonic and anharmonic methods. Phonon-mode-dependent
Grüneisen parameters are found to be weakly dependent on temperature.
Negative values of the mode Grüneisen parameters are found for certain
low energy optical modes, but their net effect on the overall thermal expansion
is insignificant. Bulk modulus as well as heat capacity are also given and found
to be in agreement with experimental results.
Direct numerical simulations of flows in cylinders subjected to both rapid rotation and axial precession are presented and analysed in the context of a stability theory based on the triadic resonance of Kelvin modes. For a case that was chosen to provide a finely tuned resonant instability with a small nutation angle, the simulations are in good agreement with the theory and previous experiments in terms of mode shapes and dynamics, including long-time-scale regularization of the flow and recurrent collapses. Cases not tuned to the most unstable triad, but with the nutation angle still small, are also in quite good agreement with theoretical predictions, showing that the presence of viscosity makes the physics of the triadic-resonance model robust to detuning. Finally, for a case with
nutation angle for which it has been suggested that resonance does not occur, the simulations show that a slowly growing triadic resonance predicted by theory is in fact observed if sufficient evolution time is allowed.
A review is presented of Synchrotron X-ray Topography and KOH etching studies carried out on n type 4H-SiC offcut substrates before and after homo-epitaxial growth to study defect replication and strain relaxation processes and identify the nucleation sources of both interfacial dislocations (IDs) and half-loop arrays (HLAs) which are known to have a deleterious effect on device performance. We show that these types of defects can nucleate during epilayer growth from: (1) short segments of edge oriented basal plane dislocations (BPDs) in the substrate which are drawn by glide into the epilayer; and (2) segments of half loops of BPD that are attached to the substrate surface prior to growth which also glide into the epilayer. It is shown that the initial motion of the short edge oriented BPD segments that are drawn from the substrate into the epilayer is caused by thermal stress resulting from radial temperature gradients experienced by the wafer whilst in the epi-chamber. This same stress also causes the initial glide of the surface half-loop into the epilayer and through the advancing epilayer surface. These mobile BPD segments provide screw oriented segments that pierce the advancing epilayer surface that initially replicate as the crystal grows. Once critical thickness is reached, according to the Mathews-Blakeslee model , these screw segments glide sideways under the action of the mismatch stress leaving IDs and HLAs in their wake. The origin of the mismatch stress is shown to be associated with lattice parameter differences at the growth temperature, arising from the differences in doping concentration between substrate and epilayer.
Glyphosate is now the most widely used herbicide; after years of frequent utilization, resistant weeds were selected, mainly due to widespread adoption of glyphosate-resistant crops and no-tillage sowing system. Increasing difficulty in controlling Chloris polydactyla with glyphosate has been noticed in agricultural areas. Here, the susceptibility level of various C. polydactyla accessions from Brazil is examined. Two whole-plant studies were conducted to confirm the presence and extent of glyphosate susceptibility among accessions, which involved the application of seven glyphosate doses on four accessions. The four accessions showed different glyphosate susceptibilities. The “Matão” accession presented major tolerance for glyphosate compared to “Palotina” accessions. “Jaboticabal” plants showed an intermediary susceptibility. The resistance factor (RF) was 3.76 between the “Matão” and “Palotina” accessions. All biotypes died at 2,880 g ae ha−1 glyphosate.
We assessed for vancomycin-resistant Staphylococcus aureus (VRSA) precursor organisms in southeastern Michigan, an area known to have VRSA. The prevalence was 2.5% (pSK41-positive methicillin-resistant S. aureus, 2009–2011) and 1.5% (Inc18-positive vancomycin-resistant Enterococcus, 2006–2013); Inc18 prevalence significantly decreased after 2009 (3.7% to 0.82%). Risk factors for pSK41 included intravenous vancomycin exposure.
Infect Control Hosp Epidemiol 2014;35(12):1531–1534
Making confident statements about the evolution of an ice-sheet–shelf system with a numerical model requires the capability to reproduce the migration of the grounding line. Here we show that the shallow-ice approximation/shallow-shelf approximation hybrid-type Parallel Ice Sheet Model (PISM), with its recent improvements, is capable of modeling the grounding line motion in a perturbed ice-sheet–shelf system. The model is set up according to the three-dimensional Marine Ice-Sheet Model Intercomparison Project (MISMIP3d), and simulations are carried out across a broad range of spatial resolutions. Using (1) a linear interpolation of the grounding line with locally interpolated basal friction and (2) an improved driving-stress computation across the grounding line, the reversibility of the grounding line (i.e. its retreat after an advance forced by a local perturbation of basal resistance) is captured by the model even at medium and low resolutions (∆x > 10 km). The transient model response is qualitatively similar to that of higher-order models but reveals a higher initial sensitivity to perturbations on very short timescales. Our findings support the application of PISM to the Antarctic ice sheet from regional up to continental scales and on relatively low spatial resolutions.
Of the 13 US vancomycin-resistant Staphylococcus aureus (VRSA) cases, 8 were identified in southeastern Michigan, primarily in patients with chronic lower-extremity wounds. VRSA infections develop when the vanA gene from vancomycin-resistant enterococcus (VRE) transfers to S. aureus. Incl8-like plasmids in VRE and pSK41-like plasmids in S. aureus appear to be important precursors to this transfer.
Identify the prevalence of VRSA precursor organisms.
Prospective cohort with embedded case-control study.
Southeastern Michigan adults with chronic lower-extremity wounds.
Adults presenting to 3 southeastern Michigan medical centers during the period February 15 through March 4, 2011, with chronic lower-extremity wounds had wound, nares, and perirectal swab specimens cultured for S. aureus and VRE, which were tested for pSK41-like and Incl8-like plasmids by polymerase chain reaction. We interviewed participants and reviewed clinical records. Risk factors for pSK41-positive S. aureus were assessed among all study participants (cohort analysis) and among only S. aureus-colonized participants (case-control analysis).
Of 179 participants with wound cultures, 26% were colonized with methicillin-susceptible S. aureus, 27% were colonized with methicillin-resistant S. aureus, and 4% were colonized with VRE, although only 17% consented to perirectal culture. Six participants (3%) had pSK41-positive S. aureus, and none had Incl8-positive VRE. Having chronic wounds for over 2 years was associated with pSK41-positive S. aureus colonization in both analyses.
Colonization with VRSA precursor organisms was rare. Having long-standing chronic wounds was a risk factor for pSK41-positive S. aureus colonization. Additional investigation into the prevalence of VRSA precursors among a larger cohort of patients is warranted.