To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Psychotic experiences may emerge in more severe cases of common mental disorders (CMD). Previous work identified that 30% of patients treated by mental health services in primary healthcare, specifically the Improving Access to Psychological Therapies (IAPT) programme in England, reported psychotic experiences, began treatment with more severe CMD and were less likely to reach recovery.
To replicate our previous assessment of psychotic experiences in the IAPT programme using a more sensitive threshold and determine its impact on the prevalence of psychotic experience and likelihood of recovery. Additionally, to compare recovery rates between patients with and without psychotic experiences at the end of therapy.
The Community Assessment of Psychic Experiences (CAPE-P15) with a cut-off of 1.30 was used to determine the prevalence of psychotic experiences. Recovery rates were determined using measures collected in the IAPT programme for depression (PHQ-9) and anxiety (GAD-7). Multi-group growth models estimated improvement trajectories.
In total, 2042 patients with CMD completed the CAPE-P15. The mean age was 39.8. The prevalence of psychotic experiences was 18% higher when using a lower threshold. The recovery rate for patients with psychotic experiences was lower (36%) than for those without (64%). Despite sharing similar improvement trajectories, the higher initial severity of CMD among patients with psychotic experiences impeded likelihood of recovery.
As psychotic experiences may be a marker of severity in CMD, the benefits of identifying these in IAPT populations may also apply to patients with milder experiences. Further investigation of the consequential demands on service provision and how this would affect clinical practice is recommended.
Pulses such as peas, beans or lentils are one of the most complete foods at the nutritional level; however, they are one of the most often neglected foods in the diets of university students. Entrance to university translates into a major lifestyle change for many young people, and the habits acquired or cemented at this time will remain into adulthood. The objective of this study is to analyse the association between personal/sociodemographic factors, dietary intake of other food groups and the consumption of pulses in first-year university students. This cross-sectional study is part of the UniHcos project, a multicentre study of multipurpose prospective cohorts in eleven Spanish universities. Data from 9862 university students were collected through an online self-questionnaire completed by all students who met the selection criteria and agreed to participate in the project during the 2011–2018 academic years. Of students, 75·8 % presented an inadequate (≤2 times/week) consumption of pulses. Living outside the family home in either a student residence (OR 0·76; 95 % CI 0·69, 0·84) or rental (OR 0·81; 95 % CI 0·70, 0·95) decreased the compliance with recommendations on the consumption of pulses. Low consumption of pulses is seemingly not restricted to a specific profile or dietary pattern among university students, and no specific focus group for intervention can be identified. Policies promoting the consumption of pulses among the university population as a whole are necessary to increase compliance rates with the dietary recommendations.
We evaluated the effects of fermentation time and acid casein content on the microbial rennet obtained by solid-state fermentation using wheat bran as the carbon source. The experiments used two fermentation times (72 and 96 h), while acid casein content was 1.5, 2.0, 2.5, and 3.0 g. Rennet strength from eight enzymatic extracts was measured using pasteurized whole milk. Rennet strength of samples from 72 h of fermentation showed an increase when acid casein content increased. The rennet strength increased at 96 h of fermentation with increasing amount of casein (up to 2.5 g), and then decreased with the largest addition (3.0 g) of casein. Coagulation time for the sample with highest rennet strength was 420 s.
OBJECTIVES/GOALS: The glucocorticoid receptor (GR) is a ubiquitous steroid hormone receptor that is emerging as a mediator of breast cancer metastasis. We aim to better understand the biology associated with phospho-GR species in TNBC and their contribution to tumor progression. METHODS/STUDY POPULATION: To better understand how p-S134 GR may impact TNBC cell biology, we probed GR regulation by soluble factors that are rich within the tumor microenvironment (TME), such as TGFβ. TNBC cells harboring endogenous wild-type or S134A-GR species were created by CRISPR/Cas knock-in and subjected to in vitro assays of advanced cancer behavior. RNA-Seq was employed to identify pS134-GR target genes that are uniquely regulated by TGFβ in the absence of exogenously added GR ligands. Direct regulation of selected TGFβ-induced pS134-GR target genes was validated accordingly. Bioinformatics tools were used to probe publicly available TNBC patient data sets for expression of a pS134-GR 24-gene signature. RESULTS/ANTICIPATED RESULTS: In the absence of GR ligands, GR is transcriptionally activated via p38-MAPK-dependent phosphorylation of Ser134 upon exposure of TNBC cells to TME-derived agents (TGFβ, HGF). The ligand-independent pS134-GR transcriptome primarily encompasses gene sets associated with TNBC cell survival and migration/invasion. Accordingly, pS134-GR was essential for TGFβ-induced TNBC cell migration, anchorage-independent growth in soft-agar, and tumorsphere formation, an in vitro readout of breast cancer stemness properties. Finally, a 24-gene pSer134-GR-dependent signature induced by TGFβ1 predicts shortened survival in breast cancer. We expect to find similar results using an in-house tissue microarray. DISCUSSION/SIGNIFICANCE OF IMPACT: Phospho-S134-GR is a critical downstream mediator of p38 MAPK signaling and TNBC migration, survival, and stemness properties. Our studies define GR as a required effector of TGFβ1 signaling and nominate pS134-GR as a biomarker of elevated risk of breast cancer dissemination.
An imbalance in energy expenditure can be the main cause of overweight and obesity. Some factors that increase it are the raise in the consumption of hypercaloric foods and the tendency to decrease physical activity. The aim of this study was to determine the association of physical activity by number of steps with the nutritional status of adolescents in Mexico City. A sample of 1457 first-grade adolescents from high school was obtained. To measure the number of steps in the adolescents, a Tanita® FB-731 pedometer was used. For the determination of physical activity, the cut points proposed by Tudor and Bassett were used. Likewise, anthropometric measures were taken and through the use of Who Anthro Plus program, the nutritional status diagnosis was obtained. The obtained data was analyzed with the statistical package IBM SPSS Statistics® version 20.0 for Windows. It was found that highly active and active adolescents have a lower prevalence of obesity (8.0% and 6.3%, respectively), in comparison with adolescents who classify on a typical day (28.5%), or slightly active (14.2%), finding a high significant difference (p < 0.01). In the present study it was found that adolescents with greater physical activity have lower prevalence of obesity, results that agree with the literature, which highlight the importance of encourage adolescents to be more active to reduce the prevalence of overweight and obesity.
Parasites inflict many costs on their hosts. Understanding host–parasite relationship eco-evolutionary dynamics needs appreciation of how parasites affect individual fitness, survival and reproductive potential, and how they combine to influence population demography, dynamics and viability; also, how these processes drive microevolutionary processes that define natural and sexual selection. We synthesise work on the relationship between the red grouse and its main parasite, a gastrointestinal nematode. At individual level, we show how parasites impose a physiological cost, measured by immunosuppression and increased oxidative stress, and how their impact varies depending on contexts. We describe how parasite infection constrains expression of sexually selected traits and summarise how relationships between parasite, host and environment shape host population demography and dynamics. Genetic analyses in red grouse suggest nematode burden is moderately heritable, underpinned by a potentially large array of genes involved in the immune system, energy balance and broader homeostatic processes. There is no clear association between allele frequencies among populations and differences in nematode burdens. Possibly, beneficial alleles for parasite resistance cannot spread through the population due to the strong diversifying e?ects of gene ?ow and genetic drift.
Psychiatry's most recent foray into the area of risk and prevention has been spear-headed by work on at-risk mental states for psychotic disorders. Twenty-five years' research and clinical application have led us to reformulate the clinical evolution of these syndromes, blurred unhelpful conceptual boundaries between childhood and adult life by adopting a developmental view and has changed the shape of many mental health services as part of a global movement to increase quality. But there are problems: fragmentary psychotic experiences are common in young people but transition from risk-state to full syndrome is uncommon away from specialist clinics with rarefied referrals and can, anyway, be subtle; diagnostic over-shadowing by the prospect of schizophrenia and other psychotic disorders may divert clinical attention from the kaleidoscopic and disabling range of probably treatable psychopathology with which people with risk syndromes present. We use a 19th Century lyric poem, The Lady of Shallot, as an allegory for Psychiatry warning us against regarding these mental states only as pointers towards diagnoses that probably will not occur. Viewed from the fresh perspective of common mental disorders they tell us a great deal about the psychopathological crucible of the second and third decades, the nature of diagnosis, and point towards new treatment paradigms.
To what extent meditation techniques (which incorporate practices to regulate attention, construct individual values, or deconstruct self-related assumptions), are more or less effective than relaxation therapy in the treatment of anxiety, is not clear. The aim of this study was to examine the effectiveness of meditation compared to relaxation in reducing anxiety. A systematic review from PubMed, Embase, PsycInfo and the Cochrane Central was conducted. A meta-analysis of 14 RCTs (n = 862 participants suffering from anxiety disorders or high trait anxiety) was performed. Effect sizes (ESs) were determined by Hedges’ g. Heterogeneity, risk of publication bias, quality of studies/interventions, and researcher allegiance, were evaluated. Meditation techniques incorporated attentional elements, and five of them also added constructive practices. No studies were found using deconstructive exercises. The overall ES was g = −0.23 [95% confidence interval (CI) −0.40 to −0.07], favouring meditation (number needed to treat = 7.74). Heterogeneity was low (I2 = 2; 95% CI 0 to 56). There was no evidence of publication bias, but few studies and interventions were of high quality, and allegiance might be moderating results. Meditation seems to be a bit more effective than relaxation in the treatment of anxiety, and it might also remain more effective at 12-month follow-up. However, more research using the full spectrum of meditation practices to treat different anxiety disorders, including independent studies to avoid researcher allegiance, is needed if we are to have a precise idea of the potential of these techniques compared to relaxation therapy.
Preliminary evidence suggests that hoarding disorder (HD) and obsessive-compulsive disorder (OCD) may show distinct patterns of brain activation during executive performance, although results have been inconclusive regarding the specific neural correlates of their differential executive dysfunction. In the current study, we aim to evaluate differences in brain activation between patients with HD, OCD and healthy controls (HCs) during response inhibition, response switching and error processing.
We assessed 17 patients with HD, 18 patients with OCD and 19 HCs. Executive processing was assessed inside a magnetic resonance scanner by means of two variants of a cognitive control protocol (i.e. stop- and switch-signal tasks), which allowed for the assessment of the aforementioned executive domains.
OCD patients performed similar to the HCs, differing only in the number of successful go trials in the switch-signal task. However, they showed an anomalous hyperactivation of the right rostral anterior cingulate cortex during error processing in the switch-signal task. Conversely, HD patients performed worse than OCD and HC participants in both tasks, showing an impulsive-like pattern of response (i.e. shorter reaction time and more commission errors). They also exhibited hyperactivation of the right lateral orbitofrontal cortex during successful response switching and abnormal deactivation of frontal regions during error processing in both tasks.
Our results support that patients with HD and OCD present dissimilar cognitive profiles, supported by distinct neural mechanisms. Specifically, while alterations in HD resemble an impulsive pattern of response, patients with OCD present increased error processing during response conflict protocols.
The potential of a mass asteroid impact on Earth to disturb the chemosynthetic communities at global scale is discussed. Special emphasis is made on the potential influence on anammox communities and their implications in the nitrogen biogeochemical cycle. According to our preliminary estimates, anammox communities could be seriously affected as a consequence of global cooling and the large process of acidification usually associated with the occurrence of this kind of event. The scale of affectations could vary in a scenario like the Chicxulub as a function of the amount of soot, depth of the water column and the deposition rate for sulphates assumed in each case. The most severe affectations take place where the amount of soot and sulphates produced during the event is higher and the scale of time of settlements for sulphates is short, of the order of 10 h. In this extreme case, the activity of anammox is considerably reduced, a condition that may persist for several years after the impact. Furthermore, the impact of high levels of other chemical compounds like sulphates and nitrates associated with the occurrence of this kind of event are also discussed.
The effectiveness of Early Intervention in Psychosis (EIP) services for individuals with a first episode of psychosis (FEP) could be thwarted by high rates of early disengagement.
To investigate which factors predict disengagement with EIP services.
Using data from a naturalistic cohort of 786 EIP clients in East Anglia (UK), we investigated the association between sociodemographic and clinical predictors and disengagement using univariable and multivariable Cox proportional hazards models.
Over half (54.3%) of our sample were discharged before receiving 3 years of EIP care, with 92 (11.7%) participants discharged due to disengagement. Milder negative symptoms, more severe hallucinations, not receiving an FEP diagnosis, polysubstance use and being employed were associated with greater disengagement.
Our findings highlight heterogeneous reasons for disengagement with EIP services. For some patients, early disengagement may hinder efforts to sustain positive long-term EIP outcomes. Efforts to identify true FEP cases and target patients with substance use problems and more severe positive symptoms may increase engagement.
Following the introduction of new standards for early intervention in psychosis (EIP) in England, EIP services are accepting referrals for people aged 35–65. The Cambridgeshire and Peterborough EIP service (CAMEO) aimed to explore the immediate implications for the service, especially with regards to referral numbers and sources. Data were collected from April 2016 to June 2017.
Referrals for over-35s represented 25.7% of all new referrals. Fifty per cent of referrals for over-35s were accepted onto caseload (40.2% for under-35s). The over-35s were more likely to be referred from acute and secondary mental health services (P < 0.01) and had longer durations of untreated psychosis than the under-35s (P = 0.02).
CAMEO has received a significantly higher number of referrals as a result of age inclusivity, with an increased proportion of patients suffering from severe, acute psychotic presentations and existing mental health difficulties. This has implications for service planning.
To compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypes
As part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013. Risk factors for ESBL-EC versus ESBL-KP BSI and for 30-day mortality were examined by bivariate analysis followed by multivariable logistic regression.
The study included 909 patients: 687 with ESBL-EC BSI and 222 with ESBL-KP BSI. ESBL genotype by polymerase chain reaction amplification of 286 isolates was available. ESBL-KP BSI was associated with intensive care unit admission, cardiovascular and neurological comorbidities, length of stay to bacteremia >14 days from admission, and a nonurinary source. Overall, 30-day mortality was significantly higher in patients with ESBL-KP BSI than ESBL-EC BSI (33.7% vs 17.4%; odds ratio, 1.64; P=.016). CTX-M was the most prevalent ESBL subtype identified (218 of 286 polymerase chain reaction-tested isolates, 76%). No differences in clinical characteristics or in mortality between CTX-M and non–CTX-M ESBLs were detected.
Clinical characteristics and risk of mortality differ significantly between ESBL-EC and ESBL-KP BSI. Therefore, all ESBL-producing Enterobacteriaceae should not be considered a homogeneous group. No differences in outcomes between genotypes were detected.
In this work, the degradation of methyl orange (MO) was analyzed by direct light with visible radiation (λ > 450 nm) of a dye solution in the presence of silicon nanowires (SiNWs) or silicon nanowires with copper nanoparticles (SiNWs-CuNPs). The SiNWs were synthesized by metal assisted etching from monocrystalline silicon wafers in aqueous HF / AgNO3 solution, and the CuNPs were deposited on the SiNWs via electroless. Discoloration with visible irradiation of aqueous methyl orange solution (C14H14N3NaOS) in the presence of SiNWs showed an efficiency of 71% after 120 min of illumination. The deposition of copper nanoparticles on the nanowires improves the efficiency of the photocatalytic reaction achieving 89% discoloration after 120 min exposure to visible light. The MO photocatalytic degradation with visible radiation in aqueous solution shows to be efficient in discoloration reaching up to 92% in a time of 150 min in the presence of SiNWs-CuNPs.
The work shows the preparation and characterization of composite materials using a polymer as a matrix (ABS) and carbon black or a graphenic material (graphene or graphene foam). The materials were individually mixed with the polymer and the process parameters were established in an extruder with capacity for temperature control starting at laboratory conditions and up to 600 °C. The process parameters were adjusted to form filaments that were subsequently used in a 3D printer. The parameters of the printing process were adjusted to achieve the production of flat prototypes. These prototypes were characterized by Digital Optical Microscopy. The degree of homogeneity of the prototypes and the working ranges for the graphene material concentrations were determined. Even though the characterizations were done in flat samples, 3D printing allows obtaining a great diversity of structure that broadens the diversity of applications for such kind of composite materials.
In the frame of the COST ACTION ‘EMBOS’ (Development and implementation of a pan-European Marine Biodiversity Observatory System), coverage of intertidal macroalgae was estimated at a range of marine stations along the European coastline (Subarctic, Baltic, Atlantic, Mediterranean). Based on these data, we tested whether patterns in macroalgal diversity and distribution along European intertidal rocky shores could be explained by a set of meteo-oceanographic variables. The variables considered were salinity, sea surface temperature, photosynthetically active radiation, significant wave height and tidal range and were compiled from three different sources: remote sensing, reanalysis technique and in situ measurement. These variables were parameterized to represent average conditions (mean values), variability (standard deviation) and extreme events (minimum and maximum values). The results obtained in this study contribute to reinforce the EMBOS network approach and highlight the necessity of considering meteo-oceanographic variables in long-term assessments. The broad spatial distribution of pilot sites has allowed identification of latitudinal and longitudinal gradients manifested through species composition, diversity and dominance structure of intertidal macroalgae. These patterns follow a latitudinal gradient mainly explained by sea surface temperature, but also by photosynthetically active radiation, salinity and tidal range. Additionally, a longitudinal gradient was also detected and could be linked to wave height.