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During menopause, women undergo a series of physiological changes that include a redistribution of fat tissue. This study was designed to investigate the effect of adding 10 g of cocoa-rich chocolate to the habitual diet of postmenopausal women daily on body composition. We conducted a 6-month, two-arm randomised, controlled trial. Postmenopausal women (57·2 (sd 3·6) years, n 132) were recruited in primary care clinics. Participants in the control group (CG) did not receive any intervention. Those of the intervention group (IG) received 10 g daily of 99 % cocoa chocolate in addition to their habitual diet for 6 months. This quantity comprises 247 kJ (59 kcal) and 65·4 mg of polyphenols. The primary outcomes were the between-group differences in body composition variables, measured by impendancemetry at the end of the study. The main effect of the intervention showed a favourable reduction in the IG with respect to the CG in body fat mass (–0·63 kg (95 % CI –1·15, –0·11), P = 0·019; Cohen’s d = –0·450) and body fat percentage (–0·79 % (95 % CI –1·31, –0·26), P = 0·004; Cohen’s d = –0·539). A non-significant decrease was also observed in BMI (–0·20 kg/m2 (95 % CI –0·44, 0·03), P = 0·092; Cohen’s d = –0·345). Both the body fat mass and the body fat percentage showed a decrease in the IG for the three body segments analysed (trunk, arms and legs). Daily addition of 10 g of cocoa-rich chocolate to the habitual diet of postmenopausal women reduces their body fat mass and body fat percentage without modifying their weight.
To evaluate the safety and tolerability of olanzapine in the treatment of elderly patients with schizophrenia.
A total of 135 outpatients with schizophrenia ≥60 years of age were treated with olanzapine (n = 105) or another antipsychotic (n = 30) and followed up for 6 months. Safety measures included the recording of spontaneous adverse events and extrapyramidal symptoms (EPS). Clinical status and effectiveness of the medications were measured using the Clinical Global Impressions-Severity of Illness and the Global Assessment of Function (GAF) scales. Quality of life was assessed by means of the Spanish version of the EuroQol. The Awad scale was applied to evaluate patients’ subjective attitude towards medication.
The incidence of overall adverse events and EPS was non-significantly lower in patients treated with olanzapine than in patients treated with other antipsychotics. The use of anticholinergic drugs was significantly lower (P = 0.04) in patients treated with olanzapine. Both groups of patients experienced similar improvements in Clinical Global Impressions-Severity and GAF scores. Non-significantly greater improvement in the acceptance of medication occurred at endpoint in olanzapine-treated patients than in control patients as measured by the Awad scale. The improvement in the EuroQol quality of life scale achieved at the end of study did not differ between both treatment groups.
Results from this naturalistic study showed that olanzapine was as safe and effective as other antipsychotic drugs in the treatment of elderly patients with schizophrenia.
Motor abnormalities (MAs) are the primary manifestations of schizophrenia. However, the extent to which MAs are related to alterations of subcortical structures remains understudied.
We aimed to investigate the associations of MAs and basal ganglia abnormalities in first-episode psychosis (FEP) and healthy controls. Magnetic resonance imaging was performed on 48 right-handed FEP and 23 age-, gender-, handedness-, and educational attainment-matched controls, to obtain basal ganglia shape analysis, diffusion tensor imaging techniques (fractional anisotropy and mean diffusivity), and relaxometry (R2*) to estimate iron load. A comprehensive motor battery was applied including the assessment of parkinsonism, catatonic signs, and neurological soft signs (NSS). A fully automated model-based segmentation algorithm on 1.5T MRI anatomical images and accurate corregistration of diffusion and T2* volumes and R2* was used.
FEP patients showed significant local atrophic changes in left globus pallidus nucleus regarding controls. Hypertrophic changes in left-side caudate were associated with higher scores in sensory integration, and in right accumbens with tremor subscale. FEP patients showed lower fractional anisotropy measures than controls but no significant differences regarding mean diffusivity and iron load of basal ganglia. However, iron load in left basal ganglia and right accumbens correlated significantly with higher extrapyramidal and motor coordination signs in FEP patients.
Taken together, iron load in left basal ganglia may have a role in the emergence of extrapyramidal signs and NSS of FEP patients and in consequence in the pathophysiology of psychosis.
This paper examines the joint impact of infrastructure capital and institutional quality on economic growth using a large panel dataset covering 99 countries and spanning the years 1980–2015. The empirical strategy involves estimating a simple growth model where, in addition to standard controls, infrastructure, institutional quality, and their interaction are included as explanatory variables. Potential endogeneity concerns are addressed by employing generalized method of moments estimators that utilize internal instruments. We find that the interaction terms between infrastructure capital and institutional quality show a positive and significant impact on economic growth. These results are robust to a variety of alternative specifications and institutional quality measures. Hence, our results suggest that maximizing returns from infrastructure capital requires improving the quality of institutions.
Polyurethane/cellulose composites were synthesized from castor-oil-derived polyols and isophorone diisocyanate using dibutyltin dilaurate (DBTDL) as the catalyst. Materials were obtained by adding 2% cellulose in the form of either microcrystals (20 μm) or nanocrystals obtained by acid hydrolysis. The aim was to assess the effects of filler particle size and the use of a catalyst on the physicochemical properties and biological response of these composites. The addition of the catalyst was found to be essential to prevent filler aggregations and to enhance the tensile strength and elongation at break. The cellulose particle size influenced the composite properties, as its nanocrystals heighten hydrogen bond interactions between the filler surface and polyurethane domains, improving resistance to hydrolytic degradation. All hybrids retained cell viability, and the addition of DBTDL did not impair their biocompatibility. The samples were prone to calcification, which suggests that they could find application in the development of bioactive materials.
The aim of this study was to develop and to assess a specific Multi-Criteria Decision Analysis (MCDA) framework to evaluate new drugs in an hospital pharmacy and therapeutics committee (P&TC) setting.
A pilot criteria framework was developed based on the EVIDEM (Evidence and Value: Impact on DEcisionMaking) framework, together with other relevant criteria, and assessed by a group of P&TC's members. The weighting of included criteria was done using a 5-point weighting technique. Two drugs were chosen by evaluation: an orphan-drug for Gaucher disease, and a nonorphan drug for the treatment of inflammatory bowel disease. Evidence matrices were developed, and value contribution of each drug was evaluated by P&TC's members. An agreed final framework was obtained through a discussion between the P&TC's members.
After criteria assessment, the pilot framework included eight quantitative criteria: “disease severity,” “unmet needs,” “comparative efficacy/effectiveness,” “comparative safety/tolerability,” “comparative patient-reported outcomes,” “comparative cost consequences-cost of treatment,” “comparative cost consequences-other medical costs,” and “quality of evidence”; and one contextual criterion: “opportunity costs and affordability.” The most valued criteria were: “comparative safety/tolerability,” “disease severity,” and “comparative efficacy/effectiveness.” When assessing the drugs most valued characteristics of the MCDA were the possibility that all team may contribute to drug assessment by means of scoring the matrices and the discussion to reach a consensus in drug positioning and value decision making.
The reflective MCDA would integrate quantitative and qualitative criteria relevant for a P&TC setting, allowing reflective discussions based on the criteria weighting score.
Polyurethane-based bioadhesive was synthesized with polyols derived from castor oil (chemically modified and unmodified) and hexamethylene diisocyanate with chitosan addition as a bioactive filler. The objective was to evaluate the effect of type of polyols with the incorporation of low-concentrations of chitosan on the mechanical and biological properties of the polymer to obtain suitable materials in the design of biomaterials. The results showed that increasing physical crosslinking increased the mechanical and adhesive properties. An in vitro cytotoxic test of polyurethanes showed cellular viability. The biocompatibility of the polyurethanes favors the adhesion of L929 cells at 6, 24, and 48 h. The polyurethanes showed bacterial inhibition depending on the polyol and percentage of chitosan. The antibacterial effect of the polyurethanes for Escherichia coli decreased 60–90% after 24 h. The mechanical and adhesive properties together with biological response in this research suggested these polyurethanes as external application tissue bioadhesives.
Prospective studies assessing the association between fibre intake or fibre-rich food consumption and the risk of CVD have often been limited by baseline assessment of diet. Thus far, no study has used yearly repeated measurements of dietary changes during follow-up. Moreover, previous studies included healthy and selected participants who did not represent subjects at high cardiovascular risk. We used yearly repeated measurements of diet to investigate the association between fibre intake and CVD in a Mediterranean cohort of elderly adults at high cardiovascular risk. We followed-up 7216 men (55–80 years) and women (60–80 years) initially free of CVD for up to 7 years in the PREvención con DIeta MEDiterránea study (registered as ISRCTN35739639). A 137-item validated FFQ was repeated yearly to assess diet. The primary end point, confirmed by a blinded ad hoc Event Adjudication Committee, was a composite of cardiovascular death, myocardial infarction and stroke. Time-dependent Cox’s regression models were used to estimate the risk of CVD according to baseline dietary exposures and to their yearly updated changes. We found a significant inverse association for fibre (Pfor trend=0·020) and fruits (Pfor trend=0·024) in age-sex adjusted models, but the statistical significance was lost in fully adjusted models. However, we found a significant inverse association with CVD incidence for the sum of fruit and vegetable consumption. Participants who consumed in total nine or more servings/d of fruits plus vegetables had a hazard ratio 0·60 (95 % CI 0·40, 0·96) of CVD in comparison with those consuming <5 servings/d.
Little is known about the clustering patterns of lifestyle behaviours in adult populations. We explored clusters in multiple lifestyle behaviours including physical activity (PA), smoking, alcohol use and eating habits in a sample of adult population. A cross-sectional and multi-centre study was performed with six participating groups distributed throughout Spain. Participants (n 1327) were part of the Lifestyles and Endothelial Dysfunction (EVIDENT) study and were aged between 20 and 80 years. The lifestyle and cardiovascular risk (CVR) factors were analysed using a clustering method based on the HJ-biplot coordinates to understand the variables underlying these groupings. The following three clusters were identified. Cluster 1: unhealthy, 677 subjects (51 %), with a slight majority of men (58·7 %), who were more sedentary and smokers with higher consumption of whole-fat dairy products, bigger waist circumference as well as higher TAG levels, systolic blood pressure (SBP) and CVR. Cluster 2: healthy/PA, 265 subjects (20 %), including 24·0 % of males with high PA. Cluster 3: healthy/diet, including 29 % of the participants, with a higher consumption of olive oil, fish, fruits, nuts, vegetables and lower alcohol consumption. Using the unhealthy cluster as a reference, and after adjusting for age and sex, the multiple regression analysis showed that belonging to the healthy/PA cluster was associated with a lower waist circumference, body fat percentage, SBP and CVR. In summary, the three clusters were identified according to lifestyles. The ‘unhealthy’ cluster had the least favourable clinical parameters, the ‘healthy/PA’ cluster had good HDL-cholesterol levels and low SBP and the ‘healthy/diet’ cluster had lower LDL-cholesterol levels and clinical blood pressure.
High-frequency filters are essential components in the radio frequency (RF) front-ends for telecommunications and remote-sensing systems. They enable to properly suppress out-of-band additive noise, external – i.e., out-of-system – and internal – i.e., inter-channel – interferences, and nonlinear distortion perturbations in the transmitter and receiver modules of the overall transceiver. Thus, a proper emitted RF signal which does not contaminate other co-channel services can be assured in the transmitter part, whereas a certain quality for the detected signal or “sensitivity” is guaranteed at the receiver end.
When designing passive filters, the obtaining of filtering transfer functions featuring high selectivity and low-power insertion loss in compact-size circuits is a major concern . In the case of active filters, some other relevant factors, such as linearity, noise performance, and power transmission gain must also be considered . Regarding the technologies commonly employed for their practical realization, the choice is mainly driven by the application intended for the filtering device that is to be developed. For example, bulky waveguide and air-/dielectric-cavity resonators are preferred in bandpass filters and multiplexers for satellite communications, where small power insertion loss and high power-handling capability are mandatory issues , . Integrated implementations in gallium-arsenide (GaAs) and silicon-germanium (SiGe) processes have been in great demand for portable mobile terminals , .
The aim of this study was to explore the association between pathological gambling (PG) and anger by assessing whether psychopathology and personality are related to PG and to evaluate gender differences. The sample comprised 71 PGs and 37 healthy controls. Anger, psychopathology and personality were assessed with the STAXI-2, SCL-90-R and TCI-R respectively. Gender did not affect anger expression after stratifying by diagnostic condition (p > .05). Among PG patients, anger, psychopathology and personality measures were correlated with good effect-size (r > .30). Scores in the Anger Temperament (B = 0.21, p = .038) and Anger External-Expression (B = 0.27, p = .029) scales were positively associated with PG severity scores. Anger expression in PG should be considered in future treatment programs.
Patella ferruginea is the most threatened macroinvertebrate in the western Mediterranean, where it is at serious risk of extinction. There is little information on the status of the various populations and most data were published more than 25 years ago. This study provides updated information on the global status of this species, and implications for management and conservation, and tests the hypothesis that population structure can be influenced by collection by people and by the type of substrate. Fifty-five localities were surveyed in Corsica, Sardinia, Tuscany and Sicily, on the islands of Egadi and Pantelleria, and on the Zembra archipelago and Tunisian coasts. The species is extinct on mainland Italy and Sicily but isolated individuals can be found on Egadi and Pantelleria. Populations on Corsica and Sardinia have declined dramatically during the last 25 years. The population in the Zembra archipelago is well preserved, although more widely on Tunisian coasts the species is highly threatened. The information provided here, combined with information from the literature, indicates a strong decline and/or extinction of many populations throughout the western Mediterranean and the presence of healthy populations only in some locations along the north African coast. The species exhibits an increase in density and mean size in areas free of human pressure but the type of substrate (natural or artificial) has no strong influence.
We study the space of commuting elements in the central product Gm,p of m copies of the special unitary group SU(p), where p is a prime number. In particular, a computation for the number of path-connected components of these spaces is given and the geometry of the moduli space Rep(ℤn, Gm,p) of isomorphism classes of flat connections on principal Gm,p-bundles over the n-torus is completely described for all values of n, m and p.
The present study analysed the effects of the flavanol ( − )-epicatechin in rats after chronic inhibition of NO synthesis with NG-nitro-l-arginine methyl ester (l-NAME), at doses equivalent to those achieved in the studies involving human subjects. Wistar rats were randomly divided into four groups: (1) control-vehicle, (2) l-NAME, (3) l-NAME-epicatechin 2 (l-NAME-Epi 2) and (4) l-NAME-epicatechin 10 (l-NAME-Epi 10). Rats were daily given by oral administration for 4 weeks: vehicle, ( − )-epicatechin 2 or 10 mg/kg. Animals in the l-NAME groups daily received l-NAME 75 mg/100 ml in drinking-water. The evolution in systolic blood pressure and heart rate, and morphological and plasma variables, proteinuria, vascular superoxide, reactivity and protein expression at the end of the experiment were analysed. Chronic ( − )-epicatechin treatment did not modify the development of hypertension and only weakly affected the endothelial dysfunction induced by l-NAME but prevented the cardiac hypertrophy, the renal parenchyma and vascular lesions and proteinuria, and blunted the prostanoid-mediated enhanced endothelium-dependent vasoconstrictor responses and the cyclo-oxygenase-2 and endothelial NO synthase (eNOS) up-regulation. Furthermore, ( − )-epicatechin also increased Akt and eNOS phosphorylation and prevented the l-NAME-induced increase in systemic (plasma malonyldialdehyde and urinary 8-iso-PGF2α) and vascular (dihydroethidium staining, NADPH oxidase activity and p22phox up-regulation) oxidative stress, proinflammatory status (intercellular adhesion molecule-1, IL-1β and TNFα up-regulation) and extracellular-signal-regulated kinase 1/2 phosphorylation. The present study shows for the first time that chronic oral administration of ( − )-epicatechin does not improve hypertension but reduced pro-atherogenic pathways such as oxidative stress and proinflammatory status of the vascular wall induced by blockade of NO production.
In this paper the space of almost commuting elements in a Lie group is studied through a homotopical point of view. In particular a stable splitting after one suspension is derived for these spaces and their quotients under conjugation. A complete description for the stable factors appearing in this splitting is provided for compact connected Lie groups of rank one. By using symmetric products, the colimits Rep(ℤn, SU), Rep(ℤn, U) and Rep(ℤn, Sp) are explicitly described as finite products of Eilenberg–MacLane spaces.
TiO2nanoparticles were synthesized by the Sol-Gel method by using 2-propanol as solvent in acid medium (pH1). The samples were annealed at 200 and 500°C and were characterized by BET, XRD-Rietveld refinements, TEM and FTIR. The activity was evaluated by the acetaldehyde photodecomposition in an isolated chamber with an initial concentration of contaminant of 300 ppmv with oxygen (2%) assisted with a 365-nm UV lamp. The test results were compared with those obtained with a commercial catalyst (P25). Improved photoactivity (≍100 % of acetaldehyde in 150 min) was obtained with catalysts annealed at 200°C (TiO2-P-200°C), that showed nanoparticles (≍7 nm) and abundant anatase phase (≍ 63 %) coexist with the brookite phase (≍ 37 %), as well as irregular equiaxial morphology. The samples annealed at 500°C (TiO2-P-500°C), showed an increment in nanoparticles (≍22 nm), different ratio and phase composition (anatase-brookite-rutile), and therefore less activity (≍80 %). This high activity could be explained by the special ratio of anatase-brookite and the dimension of nanometric crystal size. The aforementioned characteristics could be useful in the degradation of reactive organic gases like acetaldehyde either in confined spaces or in the open air.
The mollusc Patella ferruginea, endemic to the Mediterranean, is presently in serious risk of extinction. Although the species was formerly distributed in the western Mediterranean Basin, today its Mediterranean range has contracted to a few restricted areas. This paper reports on the finding of a range extension of the historical distribution of this species in the Iberian Peninsula. The implication of the Marine Protected Areas (MPAs) effect is discussed.
High blood pressure (BP) has been ranked as the most important risk factor worldwide regarding attributable deaths. Dietary habits are major determinants of BP. Among them, frequent intake of low-fat dairy products may protect against hypertension. Our aim was to assess the relationship between low-fat dairy product intake and BP levels and their changes after 12-month follow-up in a cohort of asymptomatic older persons at high cardiovascular risk recruited into a large-scale trial assessing the effects of Mediterranean diets on cardiovascular outcomes. Data from 2290 participants, including 1845 with hypertension, were available for analyses. Dairy products were not a specific part of the intervention; thus, data were analysed as an observational cohort. Dietary information was collected with validated semi-quantitative FFQ and trained personnel measured BP. To assess BP changes, we undertook cross-sectional analyses at baseline and at the end of follow-up and longitudinal analyses. A statistically significant inverse association between low-fat dairy product intake and systolic BP was observed for the 12-month longitudinal analysis. In the longitudinal analysis, the adjusted systolic and diastolic BP were significantly lower in the highest quintile of low-fat dairy product intake ( − 4·2 (95% CI − 6·9, − 1·4) and − 1·8 (95% CI − 3·2, − 0·4) mmHg respectively), whereas the point estimates for the difference in diastolic BP indicated a modest non-significant inverse association. Intake of low-fat dairy products was inversely associated with BP in an older population at high cardiovascular risk, suggesting a possible protective effect against hypertension.
Evaluar la seguridad y tolerabilidad de la olanzapina en el tratamiento de pacientes ancianos con esquizofrenia.
Un total de 135 pacientes ambulatorios de 60 años o más con esquizofrenia recibió tratamiento con olanzapina (n = 105) u otro antipsicótico (n = 30) y seguimiento durante 6 meses. Las medidas de seguridad incluían el registro de los acontecimientos adversos espontáneos y los síntomas extrapiramidales (SEP). El estado clínico y la efectividad de las medicaciones se midieron utilizando las escalas de Impresíon Clínica Global-Gravedad de la Enfermedad y de Evaluacion de la Actividad Global (GAF). La calidad de vida se evaluó por medio de la versión española de EuroQoL. Se aplicó la escala Awad para evaluar la actitud subjetiva de los pacientes hacia la medicación.
La incidencia de acontecimientos adversos y SEP en conjunto fue no significativamente más baja en los pacientes tratados con olanzapina que en los pacientes tratados con otros antipsicóticos. El uso de fármacos anticolinérgicos fue significativamente más bajo (P = 0,04) en los pacientes tratados con olanzapina. Ambos grupos de pacientes experimentaron mejorías similares en las puntuaciones de la Impresión Clínica Global-Gravedad y la GAF. Se produjo una mejoría no significativamente mayor en los pacientes control, en el grado de aceptación de la medicación al final del estudio, tal y como es medida por la escala Awad. La mejoría en la escala de calidad de vida EuroQoL alcanzada al final del estudió no difirio entre ambos grupos de tratamiento.
Los resultados de este estudio naturalista mostraron que la olanzapina era tan segura y efectiva como otros medicamentos antipsicóticos en el tratamiento de los pacientes ancianos con esquizofrenia.
To identify risk factors associated with tuberculin reactivity in healthcare workers (HCWs).
Cross-sectional survey of tuberculin reactivity (2 TU of purified protein derivative (PPD) RT23, using the Mantoux two-step test).
Two general hospitals located in a region with a high prevalence of tuberculosis and high bacille Calmette-Guérin (BCG) coverage.
Volunteer sample of HCWs.
605 HCWs were recruited: 71.2% female; mean age, 36.4 (standard deviation [SD], 8.2) years; 48.9% nurses, 10.4% physicians, 26.8% administrative personnel; mean time of employment, 10.9 (SD, 6.7) years. PPD reactivity (≥10 mm) was found in 390 (64.5%). Multivariate analysis revealed an association of tuberculin reactivity with occupational exposure in the hospital: participation in autopsies (odds ratio [OR], 9.3; 95% confidence interval [CI95], 2.1-40.5; P=.003.), more than 1 year of employment (OR, 2.4; CI95, 1.1-5.0; P=.02), work in the emergency or radiology departments (OR, 2.0; CI95,1.03-3.81; P=.04), being physicians or nurses (OR, 1.5; CI95, 1.04-2.11; P=.03), age (OR, 1.04; CI95, 1.02-1.07 per year of age; P<.001), and BCG scar (OR, 2.1; CI95, 1.2-3.4; P=.005).
Although the studied population has a high baseline prevalence of tuberculosis infection and high coverage of BCG vaccination, nosocomial risk factors associated with PPD reactivity were identified as professional risks; strict early preventive measures must be implemented accordingly.