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Oncological diagnosis is considered to be a major traumatic event and results in post-traumatic stress disorder (PTSD) in a percent of patients ranging between 34 and 80. The aim of the study was to investigate for the first time the functional evidence of possible PTSD in a large cohort of Hodgkin Disease patients (HD).
Forty-nine HD underwent metabolic positron emission tomography (18F- FDG-PET) within a week from diagnosis (PET0) and after two 28-days adriamycin, bleomycin, vinblastine, dacarbazine (ABVD) cycles (PET2). Thirty-five patients were examined after further four 28-days ABDV cycles (PET6). FDG uptake was compared between conditions by paired t-test implemented in statistical parametric mapping.
As compared to PET0, PET2 showed a highly significant increase in 18F-FDG distribution in right superior temporal gyrus and right inferior parietal lobule (Brodmann area 39). When PET2 data were subtracted to PET0 a highly significant hypometabolic area including a large portion of the prefrontal and orbitofrontal cortex (BAs 10, 11 and 32), bilaterally, was found. The 18F-FDG uptake distribution changes found at PET2 disappeared at PET6 in which no significant changes were found.
After the first two months of chemotherapy, we found in HD a significant reduction of brain glucose metabolism in prefrontal and orbitofrontal cortex, typical neurobiological correlate of PTSD. Such finding was not present any more after four months in those HD in which chemotherapy was completed suggesting that acute PTSD disappeared in this cohort of patients following the improvement of general physical and psychological conditions due to successful therapy.
The electroconvulsive therapy (ECT) is an effective treatment used for several psychiatric disorders. However, there are multiple enigmas about the mechanisms of action and factors that improve its results. Some frequent questions are if the anesthetic drug makes a difference in the time of convulsion and blood pressure.
Our principal aim is to describe the utilization of anesthetic drugs among the patients that are being treated with ECT in hospital del Mar. We also want to know the differences in the time of convulsion and systolic arterial pressure for every anesthetic drug (propofol, thiopental and etomidate).
Material and methods
We have used the database of ECT in hospital del Mar. It contains information like age, principal diagnosis, medical background and pharmacological treatment at the moment of starting ECTs; it also contains information of each individual ECT session as basal, 2 and 5 minutes arterial pressure; the anesthetic drug used, and convulsion duration.
We made an analysis of general conditions of the population, the differences of convulsion time and arterial pressure between the three anesthetic drugs.
Propofol was used in 1140 sessions, thiopental in 61 sessions and etomidate in 54 sessions. The differences in the means of convulsion times between propofol and etomidate are statistically significant (“P” value < 0.05). Etomidate or thiopental increases the difference of arterial pressure more than propofol.
Further research about the factors that improve convulsion duration and minimize adverse effects on blood pressure is needed.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
In 2017 Zagreb faced the largest outbreak of haemorrhagic fever with renal syndrome (HFRS) to date. We investigated to describe the extent of the outbreak and identify risk factors for infection. We compared laboratory-confirmed cases of Hantavirus infection in Zagreb residents with the onset of illness after 1 January 2017, with individually matched controls from the same household or neighbourhood. We calculated adjusted matched odds ratios (amOR) using conditional logistic regression. During 2017, 104 cases were reported: 11–81 years old (median 37) and 71% (73) male. Compared with 104 controls, cases were more likely to report visiting Mount Medvednica (amOR 60, 95% CI 6–597), visiting a forest (amOR 46, 95% CI 4.7–450) and observing rodents (amOR 20, 95% CI 2.6–159). Seventy per cent of cases (73/104) had visited Mount Medvednica prior to infection. Among participants who had visited Mount Medvednica, cases were more likely to have drunk water from a spring (amOR 22, 95% CI 1.9–265), observed rodents (amOR 17, 95% CI 2–144), picked flowers (amOR 15, 95% CI 1.2–182) or cycled (amOR 14, 95% CI 1.6–135). Our study indicated that recreational activity around Mount Medvednica was associated with HFRS. We recommend enhanced surveillance of the recreational areas during an outbreak.
Epipaleolithic hunter-gatherers are often interpreted as playing an important role in the development of early cereal cultivation and subsequent farming economies in the Levant. This focus has come at the expense of understanding these people as resilient foragers who exploited a range of changing micro habitats through the Last Glacial Maximum. New phytolith data from Ohalo II seek to redress this. Ohalo II has the most comprehensive and important macrobotanical assemblage in Southwest Asia for the entire Epipaleolithic period. Here we present a phytolith investigation of 28 sediment samples to make three key contributions. First, by comparing the phytolith assemblage to a sample of the macrobotanical assemblage, we provide a baseline to help inform the interpretation of phytolith assemblages at other sites in Southwest Asia. Second, we highlight patterns of plant use at the site. We identify the importance of wetland plant resources to hut construction and provide evidence that supports previous work suggesting that grass and cereal processing may have been a largely “indoor” activity. Finally, drawing on ethnographic data from the American Great Basin, we reevaluate the significance of wetland plant resources for Epipaleolithic hunter-gatherers and argue that the wetland-centered lifeway at Ohalo II represents a wider Levantine adaptive strategy.
By applying a display ecology to the Deeper, Wider, Faster proactive, simultaneous telescope observing campaign, we have shown a dramatic reduction in the time taken to inspect DECam CCD images for potential transient candidates and to produce time-critical triggers to standby telescopes. We also show how facilitating rapid corroboration of potential candidates and the exclusion of non-candidates improves the accuracy of detection; and establish that a practical and enjoyable workspace can improve the experience of an otherwise taxing task for astronomers. We provide a critical road test of two advanced displays in a research context—a rare opportunity to demonstrate how they can be used rather than simply discuss how they might be used to accelerate discovery.
In autumn 2014, enterovirus D68 (EV-D68) cases presenting with severe respiratory or neurological disease were described in countries worldwide. To describe the epidemiology and virological characteristics of EV-D68 in England, we collected clinical information on laboratory-confirmed EV-D68 cases detected in secondary care (hospitals), between September 2014 and January 2015. In primary care (general practitioners), respiratory swabs collected (September 2013–January 2015) from patients presenting with influenza-like illness were tested for EV-D68. In secondary care 55 EV-D68 cases were detected. Among those, 45 cases had clinical information available and 89% (40/45) presented with severe respiratory symptoms. Detection of EV-D68 among patients in primary care increased from 0.4% (4/1074; 95% CI 0.1–1.0) (September 2013–January 2014) to 0.8% (11/1359; 95% CI 0.4–1.5) (September 2014–January 2015). Characterization of EV-D68 strains circulating in England since 2012 and up to winter 2014/2015 indicated that those strains were genetically similar to those detected in 2014 in USA. We recommend reinforcing enterovirus surveillance through screening respiratory samples of suspected cases.
In 2013–2014, the Public Health Agency of Sweden developed a web-based participatory surveillance system, Hӓlsorapport, based on a random sample of individuals reporting symptoms weekly online, to estimate the community incidence of self-reported acute gastrointestinal (AGI), acute respiratory (ARI) and influenza-like (ILI) illnesses and their severity. We evaluated Hӓlsorapport's acceptability, completeness, representativeness and its data correlation with other surveillance data. We calculated response proportions and Spearman correlation coefficients (r) between (i) incidence of illnesses in Hӓlsorapport and (ii) proportions of specific search terms to medical-advice website and reasons for calling a medical advice hotline. Of 34 748 invitees, 3245 (9·3%) joined the cohort. Participants answered 81% (139 013) of the weekly questionnaires and 90% (16 351) of follow-up questionnaires. AGI incidence correlated with searches on winter-vomiting disease [r = 0·81, 95% confidence interval (CI) 0·69–0·89], and ARI incidence correlated with searches on cough (r = 0·77, 95% CI 0·62–0·86). ILI incidence correlated with the web query-based estimated incidence of ILI patients consulting physicians (r = 0·63, 95% CI 0·42–0·77). The high response to different questionnaires and the correlation with other syndromic surveillance systems suggest that Hӓlsorapport offers a reasonable representation of AGI, ARI and ILI patterns in the community and can complement traditional and syndromic surveillance systems to estimate their burden in the community.
Issues in traditional cross-section sampling of paintings and other cultural artifacts with a scalpel, such as crumbling, delamination and paint compression, can deter conservators from sampling fragile paint layers. Often, such sampling carries the risk of causing further damage from a scalpel, which outweighs the benefits of scientific investigation. Here, we show that femtosecond lasers offer a viable alternative to obtaining cross-sections with minimal damage to the surrounding artwork. A Regenerative Ti:Sapphire amplifier system with a pulse duration of 70 femtoseconds, a few milliwatts of average power and a repetition rate of 1 kHz (1000 pulses/sec) was used for the study. Tests were performed on oil paintings ranging in age from the 19th century to late 20th century. Effective settings were determined to be 2 mW of power at a speed of 10mm/sec using an 800nm laser. Preliminary results suggest femtosecond lasers could be a viable alternative for obtaining paint cross-sections when traditional sampling methods cause unnecessary damage to fragile materials.
Radio survey datasets comprise an increasing number of individual observations stored as sets of multidimensional data. In large survey projects, astronomers commonly face limitations regarding: 1) interactive visual analytics of sufficiently large subsets of data; 2) synchronous and asynchronous collaboration; and 3) documentation of the discovery workflow. To support collaborative data inquiry, we present encube, a large-scale comparative visual analytics framework. encube can utilise advanced visualization environments such as the CAVE2 (a hybrid 2D and 3D virtual reality environment powered with a 100 Tflop/s GPU-based supercomputer and 84 million pixels) for collaborative analysis of large subsets of data from radio surveys. It can also run on standard desktops, providing a capable visual analytics experience across the display ecology. encube is composed of four primary units enabling compute-intensive processing, advanced visualisation, dynamic interaction, parallel data query, along with data management. Its modularity will make it simple to incorporate astronomical analysis packages and Virtual Observatory capabilities developed within our community. We discuss how encube builds a bridge between high-end display systems (such as CAVE2) and the classical desktop, preserving all traces of the work completed on either platform – allowing the research process to continue wherever you are.
Crowdsourcing platforms offer a source of inexpensive data for research. At their fingertips, researchers have a round-the-clock workforce to fill out surveys, participate in experiments, and content-analyze text, among other tasks that generate social science data and help support research. Thanks to its low cost and convenience, crowdlabor has quickly and uncritically become a mainstream tool in our discipline. While such platforms have been evaluated on their aptness to generate high-quality data, surprisingly little has been said about the economic or political implications of their usage. Among other aspects, this article problematizes the “state of legal exception” in which crowdlabor markets operate, their tendency to rely on a pool of economically vulnerable workers and the asymmetrical employment relations they create. Rather than offer an easy solution, I aim to open up a conversation about this unique set of challenges in order to acknowledge and address them.
Fiber optic temperature sensors are used in a variety of harsh environment applications. We have explored use of such temperature sensors in commercial gas turbines to measure the temperature at various regions of interest within the turbine system. More specifically, fiber optic temperature rakes were designed and installed on a commercial gas turbine under full load conditions. This work will focus on failure mechanisms observed at multiple length scales that impact the performance of high temperature optical fiber sensors. It was found that Au-coated silica fibers, which are a standard in the industry, undergo various failure modes when subjected to combinations of high temperature and high vibration. More specifically, the Au coating became soft/ductile as the temperature is increased. We also observed that the Au coating was not well bonded to the silica fiber, as expected since there were no adhesion layers present. These effects led to significant damage of the fiber optic under high vibrations. We also found that vibrations from the gas turbine coupled into fundamental modes of the fiber optic probe assembly, which were analyzed by detailed dynamic mechanical analysis. This led to the fiber impacting the internal wall of the probe assembly, which caused further damage and failure of the fiber and the Au coating. The silica fibers returned from the field also exhibited significant twisting throughout most of their length. This suggests the fibers reached temperatures above their strain point (about 1000 C for pure silica glass), which is explained by either a) the strain point had been significantly reduced by the presence of the Ge dopant, or b) the temperature was higher than expected in the gas turbine exhaust region. It was also hypothesized that complex anelastic effects may play a role under the high temperature, high vibration environment experienced by the probes. Detailed structural analysis of the fiber optic temperature sensors by scanning electron microscopy, ToF-SIMS, and X-ray microscopy will be presented to corroborate the above simulations and proposed damage mechanisms. Finally, we note that the fiber Bragg gratings (FBG) present within the temperature probes provided promising temperature data, and were in fact not damaged/erased by the high temperature environment.
Here, we expose planar and plasmonic Ag surfaces to a low-power O2/Ar
plasma to form an ultrathin surface oxide layer. We study the chemical state and
morphology of the plasma-treated Ag surfaces using X-ray photoelectron
spectroscopy, scanning electron microscopy, and dark-field microscopy. We
observe the formation of an ultrathin layer (< 10 nm) composed of both AgOx and Ag2CO3 for a plasma exposure time of 1 s by
investigating shifts in the Ag3d, O1s, and C1s core level binding energies. For
an exposure time of 1 s, the surface structure of the planar and plasmonic Ag
surfaces remains unchanged. For exposure times of 5 - 30 s, the planar Ag
surfaces become porous and exhibit increased surface roughness. We demonstrate
that the plasma-treated planar and plasmonic Ag surfaces lead to improvements in
the excited-state population of a polymer:fullerene coating through ultrafast
Recent scholarship has identified problems in the measurement of party
system instability. To limit the conflation of different sources of
instability in party systems (e.g., electoral shifts between stable parties
and instability in parties, such as mergers, splinters or new parties), this
article introduces a new indicator of electoral instability in parties,
tests its robustness and construct validity and demonstrates its usefulness
empirically. The indicators of party instability and the accompanying data
of 27 European democracies, 1987–2011, will be valuable resources in
comparative research on the interplay between elite and mass behavior, party
and electoral systems, and democratic consolidation.
The aim of this study was to assess the effect of sulfamethoxazole/trimethoprim (ST) supplemented with diphenyl diselenide and sodium selenite in experimental toxoplasmosis, on oxidant/antioxidant biomarkers and cytokine levels. Eighty-four BALB/c mice were divided in seven groups: group A (negative control), and groups B to G (infected). Blood and liver samples were collected on days 4 and 20 post infection (p.i.). Levels of thiobarbituric acid (TBA) reactive substances and advanced oxidation protein products (AOPP) were assessed in liver samples. Both biomarkers were significantly increased in infected groups on day 4 p.i., while they were reduced on day 20 p.i., compared with group A. Glutathione reductase (GR) activity significantly (P<0·01) increased on day 4 p.i., in group G, compared with group A. INF-γ was significantly increased (P<0·001) in both periods, day 4 (groups B, C, F and G) and 20 p.i. (groups C, F and G). IL-10 significantly reduced (P<0·001) on day 4 p.i. in group B; however, in the same period, it was increased (P<0·001) in groups C and G, compared with group A. On day 20 p.i., IL-10 increased (P<0·001) in groups F and G. Therefore, our results highlighted that these forms of selenium, associated with the chemotherapy, were able to reduce lipid peroxidation and protein oxidation, providing a beneficial immunological balance between the production of pro- and anti-inflammatory cytokines.
During catastrophic disasters, government leaders must decide how to efficiently and effectively allocate scarce public health and medical resources. The literature about triage decision making at the individual patient level is substantial, and the National Response Framework provides guidance about the distribution of responsibilities between federal and state governments. However, little has been written about the decision-making process of federal leaders in disaster situations when resources are not sufficient to meet the needs of several states simultaneously. We offer an ethical framework and logic model for decision making in such circumstances. We adapted medical triage and the federalism principle to the decision-making process for allocating scarce federal public health and medical resources. We believe that the logic model provides a values-based framework that can inform the gestalt during the iterative decision process used by federal leaders as they allocate scarce resources to states during catastrophic disasters. (Disaster Med Public Health Preparedness. 2014;0:1–10)
Our retrospective analysis of the Michigan Keystone intensive care unit (ICU) collaborative demonstrated that adult ICUs could achieve and sustain a zero rate of ventilator-associated pneumonia (VAP) for a considerable number of ventilator and calendar months. Moreover, the results highlight the importance of adjustment for ventilator-days before comparing VAP-free time among ICUs.