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Bronchopulmonary dysplasia (BPD) is a multifactor pathology. Animal studies and cohort studies suggest that poor nutrient intake after birth increases the risk of BPD. The objective of the present study was to determine the existence of association between BPD in very low birth weight (VLBW) and energy intake during the first week of life. We recorded in a retrospective cohort study the intake of enteral and parenteral macronutrients during this period by examining the nutritional and clinical history of 450 VLBW newborns admitted to the neonatal intensive care unit. After applying the relevant exclusion criteria, data for 389 VLBW infants were analysed, of whom 159 developed some degree of BPD. Among the newborns with BPD, energy and lipid intake was significantly lower and fluid intake was significantly higher. The energy intake for the 25th percentile in the group without BPD was 1778·2 kJ/kg during the first week of life. An energy intake <1778·2 kJ/kg in this period was associated with a 2-fold increase in the adjusted risk of BPD (OR 2·63, 95 % CI 1·30, 5·34). The early nutrition and the increase of energy intake in the first week of life are associated in our sample with a lower risk of BPD developing.
A platina sample brought to Spain in the last quarter of the 18th century is nowadays exhibited at the National Museum of Natural Sciences in Madrid. It originated from the ancient Mineralogical Museum of the School of Applied Chemistry at El Turco Street in Madrid and most probably corresponds to the material used by François Chabaneau for his experiments to purify platinum metal in the late 18th century. The sample is a heavy-mineral concentrate consisting of Pt–Fe alloys and gold nuggets associated with ilmenite–hematite, chromian spinel, goethite and minor quartz, sphene, rutile, magnetite, hornblende, garnet, calcite, pyrite, native bismuth and bismite. The Pt–Fe alloys exhibit a characteristic composition (81.97–90.75 wt.% Pt and 5.08–10.81 wt.% Fe with minor amounts of Cu, Os, Ir, Ru, Rh and Pd) and mineralogy of solid inclusions (abundant inclusions of Ir alloy as well as Os alloy, laurite–erlichmanite, bowieite, tulameenite and undetermined Pt–Pd–Ir–Rh antimonides and tellurides) that are very similar to those Pt–Fe alloys currently mined in western Colombia (the Chocó Department). These features allow us to discuss the provenance of the sample (probably from the proximal or medial reaches of any of the Chocó rivers) and evaluate the suitability of the Chabaneau's method for purifying platina. Our results show that the method became effective only with platina samples depleted or lacking iridium.
Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as important peripheral inflammatory biomarkers. Recent data suggest a possible role of the immune system in the pathophysiology of suicidal behavior (SB). The aim of this study is to evaluate the association among NLR, MLR, and PLR and SB in patients with major depressive disorder (MDD), and to test its validity as a biomarker for suicidality.
We evaluated 538 patients with MDD (mean age [standard deviation] = 43.87 [14.36] years; females: 68.8%). A logistic regression model was estimated to determine the independent factors associated with suicide risk in patients with and without a history of suicide attempt (SA).
Three hundred ninety-three patients (74.7%) had a personal history of SA. Patients with a previous SA were more frequently female (71.9% vs. 59.6%; p = 0.007), significantly younger (41.20 vs. 51.77 years; p < 0.001), had lower depression severity at enrolment (15.58 vs. 18.42; p < 0.000), and significantly higher mean NLR and PLR ratios (2.27 vs. 1.68, p = 0.001; 127.90 vs. 109.97, p = 0.007, respectively). In the final logistic regression model, after controlling for age, sex, and depression severity, NLR was significantly associated with SB (β = 0.489, p = 0.000; odds ratio [95% confidence intervals] = 1.631 [1.266–2.102]). We propose a cut-off value of NLR = 1.30 (sensitivity = 75% and specificity = 35%).
Our data suggest that NLR may be a valuable, reproducible, easily accessible, and cost-effective strategy to determine suicide risk in MDD.
Neuroanatomical abnormalities in first-episode psychosis (FEP) tend to be subtle and widespread. The vast majority of previous studies have used small samples, and therefore may have been underpowered. In addition, most studies have examined participants at a single research site, and therefore the results may be specific to the local sample investigated. Consequently, the findings reported in the existing literature are highly heterogeneous. This study aimed to overcome these issues by testing for neuroanatomical abnormalities in individuals with FEP that are expressed consistently across several independent samples.
Structural Magnetic Resonance Imaging data were acquired from a total of 572 FEP and 502 age and gender comparable healthy controls at five sites. Voxel-based morphometry was used to investigate differences in grey matter volume (GMV) between the two groups. Statistical inferences were made at p < 0.05 after family-wise error correction for multiple comparisons.
FEP showed a widespread pattern of decreased GMV in fronto-temporal, insular and occipital regions bilaterally; these decreases were not dependent on anti-psychotic medication. The region with the most pronounced decrease – gyrus rectus – was negatively correlated with the severity of positive and negative symptoms.
This study identified a consistent pattern of fronto-temporal, insular and occipital abnormalities in five independent FEP samples; furthermore, the extent of these alterations is dependent on the severity of symptoms and duration of illness. This provides evidence for reliable neuroanatomical alternations in FEP, expressed above and beyond site-related differences in anti-psychotic medication, scanning parameters and recruitment criteria.
‘Hey boss, we have a real challenging case tomorrow. She is a 94-year-old lady with carcinoma of the stomach needing a laparoscopic resection for recurrent bleeding. She could move around the house ok six months ago but has lost a lot of weight over the past few months. On a load of medications for hypertension, diabetes and has atrial fibrillation. Family said she took ages waking up from her last GA. The family reckon the last anaesthetist overdosed her but the doctor said he gave her the usual dose at one MAC. I guess you want to use TIVA… what should I read up on tonight?’
Name generators (NGs) and position generators (PGs) have been used to measure resources embedded in personal relationships, namely social support and social capital, respectively. Comparisons of these measures adopted NGs that only elicit a small number of alters (max. 5). In this paper we explore whether the measurement of social capital with NGs eliciting larger personal networks (say 15 to 20 alters) gives more comparable results to the PG in terms of occupational prestige. To address this issue, we designed a personal network questionnaire that combined a multiple name generator (MNG) and a PG and enquired about alter characteristics and alter-alter ties for the two sets of nominations simultaneously, allowing their integrated analysis. The questionnaire was implemented in the software EgoNet to collect data from social/environmental entrepreneurs in Spain (N = 30) and Mexico (N = 30. The analysis shows that the two approaches capture mostly non-overlapping sets of personal network members, suggesting that the PG measured in this case available, but not accessed social capital. Remarkably the NG led to a higher average prestige for this occupational group than the PG, but also a lower heterogeneity in prestige. The consequences of using one or another approach and their interpretations are discussed.
First-degree relatives of patients with psychotic disorder have higher levels of polygenic risk (PRS) for schizophrenia and higher levels of intermediate phenotypes.
We conducted, using two different samples for discovery (n = 336 controls and 649 siblings of patients with psychotic disorder) and replication (n = 1208 controls and 1106 siblings), an analysis of association between PRS on the one hand and psychopathological and cognitive intermediate phenotypes of schizophrenia on the other in a sample at average genetic risk (healthy controls) and a sample at higher than average risk (healthy siblings of patients). Two subthreshold psychosis phenotypes, as well as a standardised measure of cognitive ability, based on a short version of the WAIS-III short form, were used. In addition, a measure of jumping to conclusion bias (replication sample only) was tested for association with PRS.
In both discovery and replication sample, evidence for an association between PRS and subthreshold psychosis phenotypes was observed in the relatives of patients, whereas in the controls no association was observed. Jumping to conclusion bias was similarly only associated with PRS in the sibling group. Cognitive ability was weakly negatively and non-significantly associated with PRS in both the sibling and the control group.
The degree of endophenotypic expression of schizophrenia polygenic risk depends on having a sibling with psychotic disorder, suggestive of underlying gene–environment interaction. Cognitive biases may better index genetic risk of disorder than traditional measures of neurocognition, which instead may reflect the population distribution of cognitive ability impacting the prognosis of psychotic disorder.
To investigate whether adherence to the adapted Mediterranean Diet Score for Adolescents (MDS_A) and the adapted Mediterranean Diet Quality Index for Adolescents (KIDMED_A) is associated with better food/nutrient intakes and nutritional biomarkers.
The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study is a cross-sectional study aiming to obtain comparable data on a variety of nutritional and health-related parameters in European adolescents aged 12·5–17·5 years.
Nine European countries.
European adolescents (n 2330) recruited to the HELENA study. Dietary intake was obtained with 24 h dietary recalls, an FFQ and a Food Choices and Preferences questionnaire. MDS_A was calculated as a categorical variable using cut-offs (MDS_A), as a continuous variable (zMDS_A) and with energy adjustments (zEnMDS_A). The KIDMED_A score was also calculated.
Multilevel linear regression analysis showed positive associations for zMDS_A and KIDMED_A with serum levels of vitamin D, vitamin C, plasma folate, holo-transcobalamin, β-carotene and n-3 fatty acids, while negative associations were observed with trans-fatty acid serum levels. For categorical indices, blood biomarkers showed few significant results. zMDS_A and KIDMED_A showed positive associations with vegetables and fruits intake, and negative associations with energy-dense and low-nutritious foods. zMDS_A and KIDMED_A were positively associated with all macronutrients, vitamins and minerals (all P < 0·0001), except with monosaccharides and PUFA for KIDMED_A and cholesterol for both indices (P < 0·05).
zMDS_A and KIDMED_A have shown the strongest associations with the dietary indicators and biomarkers that have been associated with the Mediterranean diet before, and are therefore considered the most appropriate and valid Mediterranean diet scores for European adolescents.
To determine whether (-)-epicatechin (Epi) could decrease visceral adipose tissue and improve the metabolic profile of male offspring rats, after maternal obesity was induced by a high-fat diet (HFD).
Maternal obesity in albino Wistar rats was induced with a HFD, whereas male offspring were fed with chow diet throughout the study. Eight male offspring per group, from different litters, were randomly assigned to the experimental or to the control groups. In the experimental group, Epi was administered at a dose of 1 mg/kg of body weight to the male offspring twice daily for two weeks, beginning at postnatal day (PND).
Weight of visceral adipose tissue, adipocyte size, and several metabolic parameters.
Epi administration in the male offspring induced a significant decrease in the amount of visceral fat (11.61 g less, P < 0.05) and in the size of adipose cells (28% smaller, P < 0.01). Besides, Epi was able to decrease insulin, leptin, and Homeostasis Model Assessment -Insulin Resistance (HOMA-IR) (P < 0.05), as well as triglycerides, when the experimental group was compared to the untreated male offspring of obese rats (P < 0.01).
Epi administration can reverse the negative effects that maternal obesity has on the male offspring. This could be because Epi reduces the amount of visceral fat and improves metabolic profile.
Little is known about changes in brain functioning after first-episode psychosis (FEP). Such knowledge is important for predicting the course of disease and adapting interventions. Functional magnetic resonance imaging has become a promising tool for exploring brain function at the time of symptom onset and at follow-up.
A systematic review of longitudinal fMRI studies with FEP patients according to PRISMA guidelines. Resting-state and task-activated studies were considered together.
Eleven studies were included. These reported on a total of 236 FEP patients were evaluated by two fMRI scans and clinical assessments. Five studies found hypoactivation at baseline in prefrontal cortex areas, two studies found hypoactivation in the amygdala and hippocampus, and three others found hypoactivation in the basal ganglia. Other hypoactivated areas were the anterior cingulate cortex, thalamus and posterior cingulate cortex. Ten out of eleven studies reported (partial) normalization by increased activation after antipsychotic treatment. A minority of studies observed hyperactivation at baseline.
This review of longitudinal FEP samples studies reveals a pattern of predominantly hypoactivation in several brain areas at baseline that may normalize to a certain extent after treatment. The results should be interpreted with caution given the small number of studies and their methodological and clinical heterogeneity.
Emergency physicians play a frontline role in hospital disaster responses and require appropriate training.
The aim of the current study was to pilot and compare the effectiveness of two emergency preparedness teaching interventions: the first employing traditional lecture-based instruction (LEC) and the second utilizing interactive simulation/game-based teaching (SIM).
A two-group randomized pre- and post-test design was implemented into the didactic curriculum of the Emergency Medicine (EM) Residency Training Program at the San Lucas Episcopal Hospital in Ponce, Puerto Rico. Residents (n=23) completed either a LEC (control) or SIM teaching module (single day, one to two hours) focusing on emergency preparedness concepts, disaster-related clinical decision-making, and physician responsibilities during hospital disaster protocols. Knowledge-based multiple-choice exams and scenario-based competency exams were administered at three different time points: one-week pre-intervention, immediately post-training, and two-weeks post-training. Test scores were compared between groups at each time point using the Mann-Whitney U test.
Following the teaching interventions, no significant differences were found between the LEC group versus the SIM group in knowledge-based exam performance (LEC 81.1%[9.4] vs. SIM 74.9%[12.1]; U=42.50, p=0.15) and scenario-based exam performance (LEC 80.0%[9.7] vs. SIM 80.2%[9.2]; U=62.00, p=0.83), suggesting both teaching methods were similarly effective. Indeed, knowledge-based exam scores improved two-fold and scenario-based exam scores improved by over 50% immediately following training relative to baseline exam scores. Two-weeks post-training, a significant decrease in scenario-based exam performance was found in the LEC group relative to the SIM group (LEC 63.1%[11.6] vs. SIM 75.4%[11.5]; U=91.50, p=0.036), suggesting residents who train with simulations show greater retention of scenario-based concepts compared to those who train with lecture-based training alone.
The current study highlights the potential dual value of incorporating simulation training in EM emergency preparedness curriculums in improving both knowledge and concept retention of physician disaster responsibilities.
Trichomonas vaginalis induces cellular damage to the host cells (cytotoxicity) through the proteolytic activity of multiple proteinases of the cysteine type (CPs). Some CPs are modulated by environmental factors such as iron, zinc, polyamines, etc. Thus, the goal of this study was to assess the effect of glucose on T. vaginalis cytotoxicity, proteolytic activity and the particular role of TvCP2 (TVAG_057000) during cellular damage. Cytotoxicity assays showed that glucose-restriction (GR) promotes the highest HeLa cell monolayers destruction (~95%) by trichomonads compared to those grown under high glucose (~44%) condition. Zymography and Western blot using different primary antibodies showed that GR increased the proteolytic activity, amount and secretion of certain CPs, including TvCP2. We further characterized the effect of glucose on TvCP2. TvCP2 increases in GR, localized in vesicles close to the plasma membrane and on the surface of T. vaginalis. Furthermore, pretreatment of GR-trichomonads with an anti-TvCP2r polyclonal antibody specifically reduced the levels of cytotoxicity and apoptosis induction to HeLa cells in a concentration-dependent manner. In conclusion, our data show that GR, as a nutritional stress condition, promotes trichomonal cytotoxicity to the host cells, increases trichomonad proteolytic activity and amount of CPs, such as TvCP2 involved in cellular damage.
After the recent detection, by both morphology and DNA barcodes, of the larval stages of an unknown species of pea crab (Pinnotheres sp.) in European waters, adults of this crab are herein reported and described as a new species. The current known geographic distribution of the species comprises the Gulf of Cádiz in the eastern Atlantic and the adjacent Mediterranean waters of the south of the Iberian Peninsula (Alboran Sea), where this crab is well-established inside the anomiid bivalve Anomia ephippium. In the Gulf of Cádiz, the species displayed a relatively high prevalence: on average, 55.6–77.7%, in A. ephippium samples. The dominant demographic categories of the new species were soft females (61.8–77.0%) with fewer males (17.7–21.10%). Most of the host bivalves carried only one crab; in bivalves harbouring two crabs, heterosexual pairs were collected more frequently than expected by chance, which suggests that they could be mated pairs. A strong correlation between host size and soft female size was found (r = 0.73, P < 0.01) indicating that space availability within hosts seems to be relevant in determining the size of the sedentary phase of the new crab species.
Due to their excellent properties, aerogel has attracted the attention of the scientific community to use it in the biomedical area as a drug delivery system. This work reports on the synthesis and characterization of ZrO2 aerogels and cryogels obtained by the sol-gel method. The influence of different cetyltrimethylammonium bromide (CTAB) and the type of drying on structural, morphological and texture properties of ZrO2 aerogels and cryogels was investigated. SEM images reveal that a porous interconnected three-dimensional network was formed into aerogels due to supercritical drying. Zirconia aerogel sample has a specific surface area (SBET) larger than zirconia cryogels. Therefore, our results indicate that zirconia aerogel is an adequate material for applications in drug delivery systems.
Earlier activities on health technology assessment (HTA) started in Spain around 1984, with the creation of a National Advisory Board on HTA, and the development of national and regional HTA organizations in the early 1990s. In 2012, the Spanish Health Ministry established the Spanish Network for Health Technology Assessment of the National Health System (RedETS); funded at national level and including all public HTA organizations at national and regional levels. RedETSis focused on the assessment of nondrug health technologies to inform the revision (approval and funding or disinvestment) of the Benefit Portfolio of the Spanish NHS. In parallel with European Network for Health Technology Assessment (EUnetHTA), RedETS has been setting-up and sharing common procedures and methodological guidelines to ensure effective cooperation and mutual recognition of the scientific and technical production in HTA. The output of RedETS is fifty to sixty annual reports, including the production of full HTA reports, Clinical Practice Guidelines, methodological guidance reports, relative effectiveness assessments, tools to support shared decision making between patients and healthcare professionals, and monitoring studies. The HTA assessments requested by the Regional Health Authorities are the biggest component of the annual RedETS working plan. These assessment needs are identified according to a yearly process and prioritized by a Commission composed of representatives from all Spanish regions with the aid of the PRITEC tool. The objectives of this study are to report and update the normative and organizational state of HTA in Spain; describing noteworthy advances witnessed over the past 10 years, as well as discussing existing challenges.
Since ancient times, lubricants have been used to reduce friction and wear problems of mechanical systems. However, nowadays, there is a constant effort to improve their performance through additives so that they can accomplish properly in this modern world. In that sense, in this study, it was proposed the use of Poly(ε-Caprolactone) (PCL) as a biodegradable additive in Castor oil. The effect that this additive has on the tribological properties of AISI 4140 steel/Al2O3 tribosystem was analyzed. For this purpose, PCL was dissolved in Castor oil at 65 °C for 15 minutes. Later, once the lubricant formulations got into room temperature, friction tests were conducted with a ball-on-disk configuration. Several experiments were systematically carried out in order to study the factors that could influence the performance of the tribological system, for instance: additive concentration, velocity, temperature, and wear track radius. The kinetic friction coefficient was used to analyze the results as an output variable. The parameters in which the best friction behavior was observed were employed again to compare the efficiency of the polymeric additive by profoundly analyzing and comparing the wear response of the system. The PCL additive showed great results by decreasing friction up to 30% compared to the neat Castor oil. Nevertheless, as the opposite effect, this additive increased the steel wear to almost half an order of magnitude. Given the above, this investigation showed that, with further studies, Poly(ε-Caprolactone) could be used as an additive in vegetable oil-based lubricants for the improvement of friction performance.
A new computerized instrument (the Multimedia Behavioral Avoidance Test, or MBAT) for blood-injury-injection phobia (BII) assessment is presented. Analogous stimuli such as images and videos can also elicit anxiety responses; thus, they can be used for the assessment of phobia. The MBAT was applied to participants via computer, and subjective anxiety responses and time latency were recorded. The MBAT was composed of 30 original images and 30 videos related to blood, injury and injections. The MBAT was compared with other pencil-and-paper questionnaires for BII phobia, and heart rate was also measured with a pulsioximeter. The participants included 160 students and professionals (34.5% males, 65.6% females; mean 28.6 years old). The results showed a high reliability for internal consistency in images and videos (α = .98 both), with a single factor that groups all the items. In addition, the MBAT had high concurrent validity (r = .78 to .85) with the different anxiety scales compared. The MBAT diagnosed 12 participants with possible BII phobia. It is a useful instrument in the assessment of this kind of phobia because it is easier and quicker than pencil-and-paper questionnaires, it uses more objective measurements, and it is useful in planning subsequent exposure with images and videos.