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Bipolar disorder (BD) is related to high prevalence of somatic comorbidities, health care costs, and premature mortality . Some evidence supports the view of BD as chronic, progressive and multisystem disorder in which not only mental system, but also somatic systems are involved .
To investigate differences in physical health in patients with bipolar disorder at different stages (early vs. late) of the disease.
Cross-sectional, naturalistic, multicenter study. Sample: 110 outpatients with BD [68 early stage (diagnosed at least 5 years earlier) and 42 late stage (at least 20 years earlier)]. Assessment: demographic and clinical variables; psychopathology: HDRS, YMRS and CGI; biological information: anthropometric, vital signs and lab results.
Early stage group: mean age 40.1 (11.9), 66.2% females and CGI = 3.6 (1.4). Late stage group: mean age 55.8 (8.2), 69.0% females and CGI = 4.0 (1.4). Patients in early stage have significantly higher levels of glucose (t = −4.007, P < 0.001), urea (t = −2.724, P = 0.008), creatinine (F = 0.560, P = 0.022), triglycerides (t = −3.501, P = 0.001), Fe (t = 2.871, P = 0.005) and insulin (t = −3.223, P = 0.002). Moreover, they have higher Body Max Index (BMI) (t = −3.728, P < 0.000), abdominal circumference (t = −4.040, P < 0.000) and greater number of somatic comorbidities (t = −2.101, P = 0.041).
– patients with bipolar disorders in late stages have worse physical health than those in early stage.
– these results could be an indication that bipolar disorder might better viewed as a multisystem disorder.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Immune-inflammatory processes have been implicated in schizophrenia (SCH), but their specificity is not clear.
To identify potential differential intra-/intercellular biochemical pathways controlling immune-inflammatory response and their oxidative-nitrosative impact on SCH patients, compared with bipolar disorder (BD) patients and healthy controls (HC).
Cross-sectional, naturalistic study of a cohort of SCH patients (n=123) and their controls [BD (n=102) and HC (n=80)].
ANCOVA (or Quade test) controlling for age and gender when comparing the three groups, and controlling for age, gender, length of illness, cigarettes per day, and body mass index (BMI) when comparing SCH and BD.
Pro-inflammatory biomarkers: Expression of COX-1 was statistically higher in SCH and BD than HC (P<0.0001; P<0.0001); NFκB and PGE2 were statistically higher in SCH compared with BD (P=0.001; P<0.0001) and HC (P=0.003; P<0.0001); NLRP3 was higher in BD than HC (P=0.005); and CPR showed a gradient among the three groups. Anti-inflammatory biomarkers: BD patients had lower PPARγ and higher 15d-PGJ2 levels than SCH (P=0.005; P=0.008) and HC (P=0.001; P=0.001). Differences between SCH and BD: previous markers of SCH (NFκB and PGE2) and BD (PPARγ and 15d-PGJ2) remained statistically significant and, interestingly, iNOS and COX-2 (pro-inflammatory biomarkers) levels were statistically higher in SCH than BD (P=0.019; P=0.040).
This study suggests a specific immune-inflammatory biomarker pattern for established SCH (NFκB, PGE2, iNOS, and COX-2) that differentiates it from BD and HC. In future, their pharmacological modulation may constitute a promising therapeutic target.
Some food bioactives potentially exert anti-obesity effects. Anthocyanins (ACN), catechins, β-glucan (BG) and n-3 long chain PUFA (LCPUFA) are among the most promising candidates and have been considered as a strategy for the development of functional foods counteracting body weight gain. At present, clinical trials, reviews and meta-analyses addressing anti-obesity effects of various bioactives or bioactive-rich foods show contradictory results. Abdominal obesity is an important criterion for metabolic syndrome (MetS) diagnosis along with glucose intolerance, dyslipidaemia and hypertension. Food bioactives are supposed to exert beneficial effects on these parameters, therefore representing alternative therapy approaches for the treatment of MetS. This review summarises outcomes on MetS biomarkers in recent clinical trials supplementing ACN, catechins, BG and n-3 LCPUFA, focusing mainly on anti-obesity effects. Overall, it is clear that the level of evidence for the effectiveness varies not only among the different bioactives but also among the different putative health benefits suggested for the same bioactive. Limited evidence may be due to the low number of controlled intervention trials or to inconsistencies in trial design, i.e. duration, dose and/or the method of bioactive supplementation (extracts, supplements, rich or enriched food). At present, the question ‘Are bioactives effective in weight management and prevention of metabolic syndrome?’ remains inconclusive. Thus, a common effort to harmonise the study design of intervention trials focusing on the most promising bioactive molecules is urgently needed to strengthen the evidence of their potential in the treatment of obesity, MetS and related diseases.
Recent trends in multimedia technologies indicate the need for richer imaging modalities to increase user engagement with the content. Among other alternatives, point clouds denote a viable solution that offers an immersive content representation, as witnessed by current activities in JPEG and MPEG standardization committees. As a result of such efforts, MPEG is at the final stages of drafting an emerging standard for point cloud compression, which we consider as the state-of-the-art. In this study, the entire set of encoders that have been developed in the MPEG committee are assessed through an extensive and rigorous analysis of quality. We initially focus on the assessment of encoding configurations that have been defined by experts in MPEG for their core experiments. Then, two additional experiments are designed and carried to address some of the identified limitations of current approach. As part of the study, state-of-the-art objective quality metrics are benchmarked to assess their capability to predict visual quality of point clouds under a wide range of radically different compression artifacts. To carry the subjective evaluation experiments, a web-based renderer is developed and described. The subjective and objective quality scores along with the rendering software are made publicly available, to facilitate and promote research on the field.
In a randomized trial, a gown designed to allow easy removal at the neck and with increased skin coverage and snugness of fit at the wrist significantly reduced contamination of personnel during personal protective equipment (PPE) removal. Our results suggest that simple modifications of PPE can reduce contamination of personnel.
Consecutive, adult, non–intensive care unit (non-ICU) inpatients triggering an institutional clinical sepsis pathway from May to August 2015.
All patients reviewed by an ID Fellow within 24 hours of sepsis pathway trigger underwent case review and clinic file documentation of recommendations. Those not reviewed by an ID Fellow were considered controls and received standard sepsis pathway care. The primary outcome was antibiotic appropriateness 48 hours after sepsis trigger.
In total, 164 patients triggered the sepsis pathway: 6 patients were excluded (previous sepsis trigger); 158 patients were eligible; 106 had ID intervention; and 52 were control cases. Of these 158 patients, 91 (58%) had sepsis, and 15 of these 158 (9.5%) had severe sepsis. Initial antibiotic appropriateness, assessable in 152 of 158 patients, was appropriate in 80 (53%) of these 152 patients and inappropriate in 72 (47%) of these patients. In the intervention arm, 93% of ID Fellow recommendations were followed or partially followed, including 53% of cases in which antibiotics were de-escalated. ID Fellow intervention improved antibiotic appropriateness at 48 hours by 24% (adjusted risk ratio, 1.24; 95% confidence interval, 1.04–1.47; P=.035). The appropriateness agreement among 3 blinded ID staff opinions was 95%. Differences in intervention and control group mortality (13% vs 17%) and median length of stay (13 vs 17.5 days) were not statistically significant.
Sepsis overdiagnosis and delayed antibiotic optimization may reduce sepsis pathway effectiveness. Early ID AMS improved antibiotic management of non-ICU inpatients with suspected sepsis, predominantly by de-escalation. Further studies are needed to evaluate clinical outcomes.
The local electrode atom probe (LEAP) has become the primary instrument used for atom probe tomography measurements. Recent advances in detector and laser design, together with updated hit detection algorithms, have been incorporated into the latest LEAP 5000 instrument, but the implications of these changes on measurements, particularly the size and chemistry of small clusters and elemental segregations, have not been explored. In this study, we compare data sets from a variety of materials with small-scale chemical heterogeneity using both a LEAP 3000 instrument with 37% detector efficiency and a 532-nm green laser and a new LEAP 5000 instrument with a manufacturer estimated increase to 52% detector efficiency, and a 355-nm ultraviolet laser. In general, it was found that the number of atoms within small clusters or surface segregation increased in the LEAP 5000, as would be expected by the reported increase in detector efficiency from the LEAP 3000 architecture, but subtle differences in chemistry were observed which are attributed to changes in the way multiple hit detection is calculated using the LEAP 5000.
An ethanol-based spray disinfectant significantly reduced bacteriophage MS2 contamination on material from gowns meeting ASTM standard 1671 for resistance to blood and viral penetration and on a cover gown worn by personnel. Effectiveness of disinfection was affected by the type of gown material and the correctness of fit.
Hospital floors are frequently contaminated with pathogens, but it is not known whether floors are a potential source of transmission. We demonstrated that a nonpathogenic virus inoculated onto floors in hospital rooms disseminated rapidly to the hands of patients and to high-touch surfaces inside and outside the room.
Urological problems are extremely common in older adults. The prevalence of many urological disorders increases with advancing age in both men and women. Estimates indicate that approximately 20% of all primary care visits include some type of urological complaint. In fact, the specialty of urology ranks third, behind only ophthalmology and cardiology, in the total annual number of outpatient clinical visits by older Medicare recipients in the United States. These trends hold steady even when stratifying for ages older than either 75 or 85 years. There is a critical need for more clinicians across all specialties focused on care of older adults, including providers skilled in the evaluation and management of many of the common urological conditions seen in the geriatric population.
We prove a Torelli theorem for the moduli space of semistable parabolic Higgs bundles over a smooth complex projective algebraic curve under the assumption that the parabolic weight
systemis generic. When the genus is at least two, using this result we also prove a Torelli theoremfor the moduli space of semistable parabolic bundles of rank at least two with generic parabolic weights.
The key input in the proofs is a method of J.C. Hurtubise.
In an experimental study, the frequency of contamination of healthcare personnel during removal of contaminated personal protective equipment (PPE) was similar for bacteriophage MS2 and a novel reflective marker visualized using flash photography. The reflective marker could be a useful tool to visualize and document personnel contamination during PPE removal.
To determine the effect of variation in test methods on performance of an ultraviolet-C (UV-C) room decontamination device.
We compared the efficacy of 2 UV-C room decontamination devices with low pressure mercury gas bulbs. For 1 of the devices, we evaluated the effect of variation in spreading of the inoculum, carrier orientation relative to the device, type of organic load, type of carrier, height of carrier, and uninterrupted versus interrupted exposures on measured UV-C killing of methicillin-resistant Staphylococcus aureus and Clostridium difficile spores.
The 2 UV-C room decontamination devices achieved similar log10 colony-forming unit reductions in the pathogens with exposure times ranging from 5 to 40 minutes. On steel carriers, spreading of the inoculum over a larger surface area significantly enhanced killing of both pathogens, such that a 10-minute exposure on a 22-mm2 disk resulted in greater than 2 log reduction in C. difficile spores. Orientation of carriers in parallel rather than perpendicular with the UV-C lamps significantly enhanced killing of both pathogens. Different types of organic load also significantly affected measured organism reductions, whereas type of carrier, variation in carrier height, and interrupted exposure cycles did not.
Variation in test methods can significantly impact measured reductions in pathogens by UV-C devices during experimental testing. Our findings highlight the need for standardized laboratory methods for testing the efficacy of UV-C devices and for evaluations of the efficacy of short UV-C exposure times in real-world settings.
Within the context of the transition from junior-to-senior sport, this study aims in first place to explore differences in young Spanish elite soccer players based on the importance given to getting different achievements in their future (including sport, studies and private life) and, in second place, to explore differences among those players in levels of passion, motivation and basic psychological need. 478 elite youth soccer filled out a questionnaire based on the presented theoretical models. A cluster analysis shows a sport oriented group (N = 98) only interested in becoming a professional, a life spheres balance group (N = 288) characterized by balancing the importance of achievements in the sport sphere, as well as in education and a private life and a group (N = 91) only interested in private life achievements. The life spheres balance group shows higher levels of harmonious passion (η2 = .06, F(2, 475) = 9.990, p < .001) than the players of the other groups. The life spheres balance group shows higher levels of autonomous motivation (η2 = .10, F(2, 475) = 13.597, p < .001), autonomy (η2 = .07, F(2, 475) = 6.592, p < .01) and relatedness satisfaction (η2 = .07, F(2, 475) = 5.603, p < .01) than the sport oriented group as well as lower levels of amotivation (η2 = .04, F(2, 475) = 6.665, p < .01) than the private life oriented group. This study suggests players who perceive equal future importance in their life spheres appear to be more resourceful than the other two groups regarding athletes’ internal resources, such as passion and motivation, to cope with the transition to professional soccer.
Decontamination of gloves before removal could reduce the risk for contamination of hands of personnel caring for patients with Clostridium difficile infection. We demonstrated that a novel sporicidal formulation of ethanol rapidly reduced C. difficile spores on gloved hands without adverse odor, respiratory irritation, or staining of clothing.
Infect. Control Hosp. Epidemiol. 2016;37(3):337–339
A portable booth designed to disinfect full-body coverage protective equipment before removal using ultraviolet-C radiation resulted in at least 3 log reductions in bacteriophage MS2 and methicillin-resistant Staphylococcus aureus within 3 minutes. The booth could be useful for disinfection of contaminated protective equipment before removal during care of Ebola patients.
Infect Control Hosp Epidemiol 2015;36(10):1226–1228
We used a colorimetric assay to determine the presence of chlorhexidine on skin, and we identified deficiencies in preoperative bathing and daily bathing in the intensive care unit. Both types of bathing improved with an intervention that included feedback to nursing staff. The assay provides a simple and rapid method of monitoring the performance of chlorhexidine bathing.
Infect. Control Hosp. Epidemiol. 2015;36(9):1095–1097