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Little evidence exists about suicidal acts in eating disorders and its relation with personality. We explored the prevalence of lifetime suicide attempts (SA) in women with bulimia nervosa (BN), and compared eating disorder symptoms, general psychopathology, impulsivity and personality between individuals who had and had not attempted suicide. We also determined the variables that better correlate with of SA.
Five hundred sixty-six BN outpatients (417 BN purging, 47 BN non-purging and 102 subthreshold BN) participated in the study.
Lifetime prevalence of suicide attempts was 26.9%. BN subtype was not associated with lifetime SA (p = 0.36). Suicide attempters exhibited higher rates on eating symptomatology, general psychopathology, impulsive behaviors, more frequent history of childhood obesity and parental alcohol abuse (p < 0.004). Suicide attempters exhibited higher scores on harm avoidance and lower on self-directedness, reward dependence and cooperativeness (p < 0.002). The most strongly correlated variables with SA were: lower education, minimum BMI, previous eating disorder treatment, low self-directedness, and familial history of alcohol abuse (p < 0.006).
Our results support the notion that internalizing personality traits combined with impulsivity may increase the probability of suicidal behaviors in these patients. Future research may increase our understanding of the role of suicidality to work towards rational prevention of suicidal attempts.
Tuberous sclerosis complex is a rare genetic disorder leading to the growth of hamartomas in multiple organs, including cardiac rhabdomyomas. Children with symptomatic cardiac rhabdomyoma require frequent admissions to intensive care units, have major complications, namely, arrhythmias, cardiac outflow tract obstruction and heart failure, affecting the quality of life and taking on high healthcare cost. Currently, there is no standard pharmacological treatment for this condition, and the management includes a conservative approach and supportive care. Everolimus has shown positive effects on subependymal giant cell astrocytomas, renal angiomyolipoma and refractory seizures associated with tuberous sclerosis complex. However, evidence supporting efficacy in symptomatic cardiac rhabdomyoma is limited to case reports. The ORACLE trial is the first randomised clinical trial assessing the efficacy of everolimus as a specific therapy for symptomatic cardiac rhabdomyoma.
ORACLE is a phase II, prospective, randomised, placebo-controlled, double-blind, multicentre protocol trial. A total of 40 children with symptomatic cardiac rhabdomyoma secondary to tuberous sclerosis complex will be randomised to receive oral everolimus or placebo for 3 months. The primary outcome is 50% or more reduction in the tumour size related to baseline. As secondary outcomes we include the presence of arrhythmias, pericardial effusion, intracardiac obstruction, adverse events, progression of tumour reduction and effect on heart failure.
ORACLE protocol addresses a relevant unmet need in children with tuberous sclerosis complex and cardiac rhabdomyoma. The results of the trial will potentially support the first evidence-based therapy for this condition.
Introduced species can have strong ecological, social and economic effects on their non-native environment. Introductions of megafaunal species are rare and may contribute to rewilding efforts, but they may also have pronounced socio-ecological effects because of their scale of influence. A recent introduction of the hippopotamus Hippopotamus amphibius into Colombia is a novel introduction of a megaherbivore onto a new continent, and raises questions about the future dynamics of the socio-ecological system into which it has been introduced. Here we synthesize current knowledge about the Colombian hippopotamus population, review the literature on the species to predict potential ecological and socio-economic effects of this introduction, and make recommendations for future study. Hippopotamuses can have high population growth rates (7–11%) and, on the current trajectory, we predict there could be 400–800 individuals in Colombia by 2050. The hippopotamus is an ecosystem engineer that can have profound effects on terrestrial and aquatic environments and could therefore affect the native biodiversity of the Magdalena River basin. Hippopotamuses are also aggressive and may pose a threat to the many inhabitants of the region who rely upon the Magdalena River for their livelihoods, although the species could provide economic benefits through tourism. Further research is needed to quantify the current and future size and distribution of this hippopotamus population and to predict the likely ecological, social and economic effects. This knowledge must be balanced with consideration of social and cultural concerns to develop appropriate management strategies for this novel introduction.
Two preferred textures were observed in the Alhama de Murcia Fault rocks: (a) foliated bands (>100 µm thick) rich in well-crystallized dioctahedral micas, quartz, hematite and dolomite; and (b) ultrafine-grained bands (<100 µm thick) made of patches composed of small mica crystals (<15 µm) and dispersed Fe-oxides. In both textures, kaolinite forms intergrowths or patches of randomly oriented crystals filling gaps or opening layers of presumably inherited detrital mica crystals, which is interpreted as an epitaxial growth from fluids. The Na/K ratio of mica crystals in the thin ultrafine-grained bands shows a wider range than the micas from the foliated bands including muscovitic, intermediate Na/K and paragonitic compositions. The absence of the 0.98 nm intermediate peak in the diffractograms indicates that the small micas are submicroscopically paragonite and phengite intergrowths. The d001 values of the K-dioctahedral micas in the <2 µm and whole fractions are clearly different from each other. The d001 values of micas of the <2 µm fraction are larger, indicating a higher K and lower Na content in the small micas. Their composition corresponds to lower temperatures, suggesting their growth during a genetic episode in the fault. The textural relationships indicate a late growth of kaolinite, probably due to the fluid–rock interaction along fault planes and fractures. The neoformed clay minerals might alter the stability of the fault plane. The absence of expandable clay minerals and the relatively high frictional strength of kaolinite under wet conditions might explain the observed velocity-neutral behaviour of this gouge and earthquake propagation towards the surface.
Healthy lifestyle habits are the cornerstone in the management of familial hypercholesterolaemia (FH). Nevertheless, dietary studies on FH-affected populations are scarce. The present study analyses dietary habits, adherence to a Mediterranean diet pattern and physical activity in an adult population with FH and compares them with their non-affected relatives.
Data came from SAFEHEART, a nationwide study in Spain.
Individuals (n 3714) aged ≥18 years with a genetic diagnosis of FH (n2736) and their non-affected relatives (n 978). Food consumption was evaluated using a validated FFQ.
Total energy intake was lower in FH patients v. non-affected relatives (P<0·005). Percentage of energy from fats was also lower in the FH population (35 % in men, 36 % in women) v. those non-affected (38 % in both sexes, P<0·005), due to the lower consumption of saturated fats (12·1 % in FH patients, 13·2 % in non-affected, P<0·005). Consumption of sugars was lower in FH patients v. non-affected relatives (P<0·05). Consumption of vegetables, fish and skimmed milk was higher in the FH population (P<0·005). Patients with FH showed greater adherence to a Mediterranean diet pattern v. non-affected relatives (P<0·005). Active smoking was lower and moderate physical activity was higher in people with FH, especially women (P<0·005).
Adult patients with FH report healthier lifestyles than their non-affected family members. They eat a healthier diet, perform more physical activity and smoke less. However, this patient group’s consumption of saturated fats and sugars still exceeds guidelines.
Chagas disease is a complex tropical pathology caused by the kinetoplastid Trypanosoma cruzi. This parasite displays massive genetic diversity and has been classified by international consensus in at least six Discrete Typing Units (DTUs) that are broadly distributed in the American continent. The main clinical manifestation of the disease is the chronic chagasic cardiomyopathy (CCC) that is lethal in the infected individuals. However, one intriguing feature is that only 30–40% of the infected individuals will develop CCC. Some authors have suggested that the immune response, host genetic factors, virulence factors and even the massive genetic heterogeneity of T. cruzi are responsible of this clinical pattern. To date, no conclusive data support the reason why a few percentages of the infected individuals will develop CCC. Therefore, we decided to conduct a systematic review analysing the host genetic factors, immune response, cytokine production, virulence factors and the plausible association of the parasite DTUs and CCC. The epidemiological and clinical implications are herein discussed.
A computational model for the evaluation of the thermomechanical effects that give rise to the catastrophic optical damage of laser diodes has been devised. The model traces the progressive deterioration of the device running in continuous wave conditions. The local heating of the active layer locally leads to the onset of the plastic regime. As a result, dislocations and threads of dislocations grow across the active layers and lead to rapidly growing temperatures in the quantum well. The poor power dissipation under these conditions has been identified as the key factor driving the final degradation of the laser.
The present study compares the patterns of growth of beginning reading skills (i.e., phonemic awareness, phonics, fluency, vocabulary and comprehension) of Spanish speaking monolingual students who received a Tier 2 reading intervention with students who did not receive the intervention. All the students in grades K-2 were screened at the beginning of the year to confirm their risk status. A quasi-experimental longitudinal design was used: the treatment group received a supplemental program in small groups of 3 to 5 students, for 30 minutes daily from November to June. The control group did not receive it. All students were assessed three times during the academic year. A hierarchical linear growth modeling was conducted and differences on growth rate were found in vocabulary in kindergarten (p < .001; variance explained = 77.0%), phonemic awareness in kindergarten (p < .001; variance explained = 43.7%) and first grade (p < .01; variance explained = 15.2%), and finally we also find significant growth differences for second grade in oral reading fluency (p < .05; variance explained = 15.1%) and retell task (p < .05; variance explained = 14.5%). Children at risk for reading disabilities in Spanish can improve their skills when they receive explicit instruction in the context of Response to Intervention (RtI). Findings are discussed for each skill in the context of implementing a Tier 2 small group intervention within an RtI approach. Implications for practice in the Spanish educational context are also discussed for children who are struggling with reading.
Illegal killing/taking of birds is a growing concern across the Mediterranean. However, there are few quantitative data on the species and countries involved. We assessed numbers of individual birds of each species killed/taken illegally in each Mediterranean country per year, using a diverse range of data sources and incorporating expert knowledge. We estimated that 11–36 million individuals per year may be killed/taken illegally in the region, many of them on migration. In each of Cyprus, Egypt, Italy, Lebanon and Syria, more than two million birds may be killed/taken on average each year. For species such as Blackcap Sylvia atricapilla, Common Quail Coturnix coturnix, Eurasian Chaffinch Fringilla coelebs, House Sparrow Passer domesticus and Song Thrush Turdus philomelos, more than one million individuals of each species are estimated to be killed/taken illegally on average every year. Several species of global conservation concern are also reported to be killed/taken illegally in substantial numbers: Eurasian Curlew Numenius arquata, Ferruginous Duck Aythya nyroca and Rock Partridge Alectoris graeca. Birds in the Mediterranean are illegally killed/taken primarily for food, sport and for use as cage-birds or decoys. At the 20 worst locations with the highest reported numbers, 7.9 million individuals may be illegally killed/taken per year, representing 34% of the mean estimated annual regional total number of birds illegally killed/taken for all species combined. Our study highlighted the paucity of data on illegal killing/taking of birds. Monitoring schemes which use systematic sampling protocols are needed to generate increasingly robust data on trends in illegal killing/taking over time and help stakeholders prioritise conservation actions to address this international conservation problem. Large numbers of birds are also hunted legally in the region, but specific totals are generally unavailable. Such data, in combination with improved estimates for illegal killing/taking, are needed for robustly assessing the sustainability of exploitation of birds.
Este libro reúne un número significativo de artículos suponen una aportación ciertamente notable a la bibliografía disponible hasta la fecha. Juan de Mena: de letrado a poeta recoge dieciséis trabajos en los que se estudia su figura y su obra desde perspectivas distintas pero complementarias que abren nuevas líneas de investigación o bien enriquecen otras ya existentes. El libro está estructurado en tres grandes bloques temáticos: El primero de ellos se dedica al contexto histórico de Juan de Mena. El segundo bloque gira en torno a la configuración del poeta, atendiendo a la conciencia autorial de Mena y a los recursos literarios que emplea. El tercer y último bloque está dedicado a la transformación del 'famosíssimo poeta Juan de Mena' en un clásico. Cristina Moya García es profesora en la Universidad de Córdoba. This book contains several studies reviewing the two facets of Juan de Mena's life as lawyer and poet. These contributions open up new lines of research on this important early-fifteenth-century Castilian writer and enrich some existing ones, studying Juan de Mena from different perspectives. The book is structured into three thematic blocks: The first is devoted to the historical context of Juan de Mena. The second section focuses on the configuration of the poet. The third and final part is dedicated to the transformation of "famosíssimo poeta Juan de Mena" into a classic author. Cristina Moya García is a profesor at the Universidad de Córdoba.Contributors: Federica Accorsi, Carlos Alvar, Linde M. Brocato, Daniel Capra, Juan Luis Carriazo Rubio, Antonio Cortijo, Sila Gómez Álvarez, Ángel Gómez Moreno, Daniel Hartnett, Julián Jiménez Heffernan, Maxim Kerkhof, Françoise Maurizi, Cristina Moya García, Francisco de Paula Cañas Gálvez, Pedro Ruiz Pérez.
This study was designed to find out whether a person’s relationship with his voices and the negative affect he suffers from are mediated by beliefs about the voices. Research done to date shows contradictory results (Sorrell, Hayward, & Meddings, 2010, Vaughan & Fowler, 2004). A cross-sectional study was done to study the associations among variables, and a multiple mediation model (Preacher & Hayes, 2008) in which the beliefs about voices were the mediating variables was tested. Sixty subjects who heard voices participated. The VAY (Hayward, Denney, Vaughan, & Fowler, 2008), BAVQ (Chadwick & Birchwood, 1995), BAI (Beck & Steer, 1993) and BDI-II (Beck, Steer & Brown, 1996) were given. We found a significant positive correlation between perception of voices as dominant and intrusive and maintaining a position of distance from them on one hand, and negative affect [anxiety (r = .57, p < .001; r = .40, p < .001; r = .34, p < .01 respectively) and depression (r = .58, p < .001; r = .37, p < .01; r = .38, p < .001 respectively)] on the other. We also found that beliefs of malevolence and omnipotence mediated between relating style and negative affect (anxiety and depression). The theoretical implications of the results and clinical implications of the mediating relationships found are discussed.
A multidisciplinary study from a number of drilled cores in the Guadalquivir estuary has made possible to identify as many as three extreme wave events and their facies in the 4th millennium BP (A: ~ 4000 cal yr BP, B: ~ 3550 cal yr BP, and C: ~ 3150 cal yr BP). These events, which caused strong erosion in the Guadalquivir sandy barrier and in the neighboring aeolian systems of El Abalario, brought about significant paleogeographical changes that may have affected human settlements established in the area during the Neolithic and Copper Age periods and during the Middle Bronze Age. The three events can be spatially correlated and their facies differentiated from more proximal to more distal from the coastline. The most proximal facies is characterized by a massive accumulation of shells, a sandy or sandy–muddy matrix, an erosive base, a highly diverse mixture of species (marine and estuarine), and lithoclasts. The most distal facies presents a muddy–sandy matrix, dominance of estuarine fauna, shell accumulation, presence of terrestrial species, mudpebbles, pebbles in a clayey matrix, and bioturbation. The evidence presented will further advance scientific knowledge about the impact of extreme wave events on coastal areas in SW Iberia and NW Africa.