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Research has consistently documented the significance of severe life events for the onset and course of major depression. However, no research has been done on whether social and clinical characteristics differ in depressed primary care attendees who have experienced stressful life events compared to those who have not.
We investigated whether social and clinical characteristics differ in depressed primary care attendees who have experienced stressful life events compared to depressed primary care attendees who have not.
We undertook a prospective cohort study involving 5,442 consecutive primary care attendees with evaluations at baseline and at 6 months. Patients aged 18-75 years were recruited in six Spanish provinces between October 2005 and February 2006. The incidence of major depression was assessed at 6 months with the Depression Section of the Composite International Diagnostic Interview (CIDI). Stressful life events were measured with the List of Threatening Experiences (LTE).
3,804 (70%) were interviewed at 6 months of follow-up. Among 200 attendees with a first episode of major depression, 24.5% had experienced no stressful life events, 30.5% had suffered one, 20.5% had experienced two and 24% had suffered three or more in the 6 months prior to the onset of depression. Depressed primary care attendees who had experienced three or more stressful life events differed from depressed patients with no stressful life events in the following variables: economic difficulties, dissatisfaction with unpaid work, relational variables, psychiatric co-morbidity and family history.
Stress-related major depression differs from non-stress-related depression in primary care.
The treatment of anxiety disorders is subject to multiple factors (biological and environmental), this creates a complex situation while trying to achieve effective treatment of anxiety disorders.
This is the reason why in the current study, we decided to evaluate the effectiveness of specific relaxation techniques as an additional therapeutic measure.
To determine whether there is therapeutic benefit in the application of relaxation techniques among patients undergoing Pharmacological and psychological anxiety disorder treatment in comparison with patients with anxiety disorders receiving only the latter.
Firstly the process involved a pre and post intervention assessment using a psychometric equipment the Hamilton rating Scale for -HARS anxiety (HARS), the anxiety Inventory-STAI State (STAI-S) and Trait (STAI-T), which allowed us to perform an objective assessment of anxiety levels
Significant reductions in post intervention levels were obtained in comparison with pre anxiety levels, in HARS (30.56 and 22.75), in STAI-S (64.93 and 46.62) and in STAI-T (83.75 and 63.56).
Additionally the size effect (SE) was considerable, in the HARS (SE= 0,70), en STAI-S (SE=0.59) and STAI-T (SE =0.69).
From the obtained results, we can affirm there are benefits of introducing therapeutic relaxation techniques as a complement to pharmacological / psychological treatment in patients with anxiety disorders.
However more studies should be carried out to evaluate the maintenance of these results in the Long-term.
To review the current knowledge about Diogenes symptoms and organic personality disorder through systematic review of the literature and the analysis of a case.
Case report. Review. Literature sources were obtained through electronic search in PubMed.gov database of 10 last years.
Background: Diogenes syndrome is a behavioral disorder characterized by severe self-neglect, hoarding, domestic dirt, and lack of shame regarding one's living state. Patients may present due to a range of reasons, few studies has been described hoarding symptoms secondary to brain injury. Early management could reduce their high-mortality condition.
We present a case of a 67-year-old Caucasian female known with a organic personality disorder secondary to a head trauma with obsessive hoarding symptoms. After being hospitalizated, we were authorized to explore her personal items trough photographs. Her handbag and her house were filled with rubbish and rotting food. Our patient had no insight into any self-hygiene or public health problems.
Information of the characteristics of Diogenes syndrome can help in earlier recognition of such persons, in order to decrease their morbidity and mortality.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Anorexia nervosa is a disorder of eating behavior that is a major health problem on our society. It is characterized by three main criteria: self-induced starvation, desire for thinness or fear of obesity, and the presence of medical signs and symptoms due to improper feeding. This work is focused on its treatment. The biopsychosocial approach allows the design and application of effective therapeutic strategies and a multidisciplinary team collaboration is essential.
Research of current pharmacological and psychotherapy treatments options of the disease.
Material and methods
Literature review based on articles and publications on this topic.
In anorexia nervosa, it is necessary to establish a therapeutic alliance between doctor and patient. Patient usually feels no motivation to improve. The different treatments options to combine, in terms of the patient status, are: nutritional rehabilitation, cognitive-behavioral, family and interpersonal psychotherapies and pharmacological treatment. It can be carried out at the ambulatory, at the day-hospital or by medical stay, even beyond patient will.
Nowadays, the nutritional rehabilitation is the best treatment established and it is the core treatment. About the psychotherapies, the cognitive-behavioral is the most used because it has exposed better results in all different studies proved and in clinical practices, followed by the family therapy which is the responsible of the patient family's treatment. Pharmacological treatment should not be used systematically and its exclusive use is not enough to resolve anorexia nervosa as there are needed also other treatments combined.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
This paper is a review of literature about the relation in some cases between psychotic symptoms and NMDA antibodies. Most of these cases are early observed and treated by psychiatry, observing torpid evolution and symptoms that are rarely observed in Psychiatry patients, like visual hallucinations or rapid fluctuations of symptoms.
Make a review of psychotic symptoms and NMDA antibodies, to think about other options when we are in front of some unusual cases in psychiatry, and it seems that “nothing is working”
Systematic review of pub med literature, applying the keywords: “psychotic” and “NMDA antibodies” of last 5 years.
We found that in most of cases the patients presents Opisthotonus, catatonia, and rhythmic and non-rhythmic involuntary movements of the mouth and jaw, and most of them had a psychiatric evaluation for those symptoms. There was no response to antipsicotic treatment. The treatment with corticoids and rituximab was effective.
In psychiatry we have to think in some cases that maybe “the patient could have something else than a psychiatric disease”, most when we found that the symptoms has a rare presentation and the treatment is not effective.
We encourage our colleagues to “think outside the box” when something like this occurs, and hesitate about our own valuations of the patients, when the case is atypical strange.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
This paper reviews the neurocognitive particularities of subjects with sustained experience in simultaneous interpreting, a highly demanding form of bilingual processing. The literature converges into three broad empirical patterns. First, significant neurocognitive differences, including behavioral enhancements in verbal and executive domains, are observable after only one or two years of training. Second, such effects, both in interpreting students and/or professional interpreters, seem robust for crucial linguistic (e.g., translation) and executive (e.g., working memory) aspects of the activity, but not for more marginally relevant ones (e.g., conflict resolution) – suggesting that they are non-generalizable beyond directly taxed functions. Third, though more tentatively, some of the observed verbal and executive effects seem to be mutually independent and uninfluenced by other bilingual-experience-related factors (e.g., L2 competence), which could highlight their distinctive relation with interpreting practice. In sum, this particular model of expertise sheds novel light on the adaptive capacity of cognitive systems in bilinguals.
The present work aims to explore the tribological behavior of the laser texturing process with different patterns on a Co based alloy using a pulsed Nd: YAG laser. Different parameters such as peak power, speed and spot diameter of the laser were explored for the experimental setting. The microstructural analysis was performed using scanning electron microscopy (SEM) with energy dispersive spectroscopy (EDS), X-ray diffraction (XRD), and nanoindentation tests. The influence of the different textured patterns of the tribological performance tested with a pin-on-disc tribometer under lubricated sliding condition was evaluated. The results showed that typical interdendritic structures in the as-cast CoCr alloy condition were refined due to the heat input and fast cooling rate during the laser treatment. The refined microstructure showed less volumetric loss resulting in a increment of wear resistance and a better tribological performance than as-cast alloy. The correlation among laser parameters, microstructural effect and their influence in wear resistance is discussed.
The study of the mechanisms of radiocarbon (14C) release from different types of radioactive waste in final disposal conditions (organic, inorganic species, liquid, or gaseous phase) is an important aspect for the definition of waste acceptance criteria in a repository. The goal of this work is to determine the behavior of activated stainless steel, under standard leaching tests performed at El Cabril laboratory, with the aim of determining the retention capacity of the activated stainless steel, and therefore to assess the treatment and the potential additional barriers necessary for the fulfillment of waste acceptance criteria relevant to the El Cabril surface repository, Spain.
Extinct Hydrochoerinae traditionally included within ‘Cardiomyinae’ (Cavioidea, Caviidae) are caviomorph rodents well represented in the late Miocene to late Pliocene of Argentina, but their paleobiology has received little scientific attention. The postcranium of these rodents is poorly known and has not been considered in morphofunctional or systematic studies. Here, we provide the first description of the postcranium of the basal hydrochoerine Cardiomys Ameghino, 1885, based on a well-preserved specimen from the late Miocene of Central Argentina, and evaluate its paleobiological and systematic implications. A morphofunctional study and a character mapping analysis were performed. We concluded that most of its postcranial features are neither adaptations to a specialized cursoriality, as in some extant cavioids, nor major modifications associated with swimming, as in extant capybaras. Cardiomys exhibits several features (high humeral distal articular surface, perforated olecranon fossa, proximal portion of radius cranially located with respect to the ulna, subrectangular-shaped radial head with flattened ulnar facet, calcaneocuboid joint distally located with respect to the astragalonavicular joint) that allow us to interpret it as an ambulatory caviid. Among cavioids, some features of Cardiomys are more similar to those of Hydrochoerus Brisson, 1762 (lateral coronoid process reduced, humeral capitular tail well differentiated, capitular tail facet of the radial head well developed and relatively short craniodistally, plantar process of the navicular massive and short). Other postcranial features (relatively longer and more gracile third metatarsal and phalanges, straight caudal border of the ulna) suggest that Cardiomys would have been a generalized hydrochoerine, as also indicated by its dental and cranial characters.
This study assessed whether bilingual memory is susceptible to the extreme processing demands of professional simultaneous interpreters (PSIs). Seventeen PSIs and 17 non-interpreter bilinguals completed word production, lexical retrieval, and verbal fluency tasks. PSIs exhibited enhanced fluency in their two languages, and they were faster to translate words in both directions. However, no significant differences emerged in picture naming or word reading. This suggests that lexical enhancements in PSIs are confined to their specifically trained abilities (vocabulary search, interlingual reformulation), with no concomitant changes in other word-processing mechanisms. Importantly, these differences seem to reflect specifically linguistic effects, as both samples were matched for relevant executive skills. Moreover, only word translation performance correlated with the PSIs’ years of interpreting experience. Therefore, despite their tight cooperation, different subcomponents within bilingual memory seem characterized by independent, usage-driven flexibility.
The purpose of this work is to study the effect of SiO2- and Al2O3-NPs on the microstructure and mechanical properties of the weld bead (WB) created by a process of Submerged Arc Welding (SAW) between two AISI 1025 steel plates. Also it was necessary consider the chemical compositions of slags and burned fluxes, in order to determine the elements that are deposited and contribute in the final microstructure of WB. The welding materials to form each WB were a M12K electrode, a commercial fused flux (CFF) and AISI 1025 steel plates bevelled at 45°. In addition SiO2- or Al2O3-NPs an ethylic alcohol mixture were applied directly to the beveled surfaces, just before the SAW process, which was carried out according to the AWS A5.17 norm. Microstructural and phase changes at the Heat Affected Zone (HAZ) and Welding Zone (WZ) were analysed by metallographic Optical and Scanning Electron Microscopies. The mechanical properties of the WBs were determined through Tensile, Charpy impact and Vickers Hardness tests. By means of metallography of WBs, it was determined that the length of the AF needles increases in 113 and 183 % when adding SiO2- or Al2O3-NPs, respectively. Related to the mechanical properties of the WB, the tensile and yield strength decreases with both additions, SiO2- or Al2O3-NPs. The microhardness at WZ was found to decrease by adding such oxide-NPs. Moreover, the impact energy absorbed by the WBs increases approximately by 83 or 57% due to SiO2- or Al2O3-NPs addition, respectively.
The Brangus breed was developed to combine the superior characteristics of both of its founder breeds, Angus and Brahman. It combines the high adaptability to tropical and subtropical environments, disease resistance, and overall hardiness of Zebu cattle with the reproductive potential and carcass quality of Angus. It is known that the major histocompatibility complex (MHC, also known as bovine leucocyte antigen: BoLA), located on chromosome 23, encodes several genes involved in the adaptive immune response and may be responsible for adaptation to harsh environments. The objective of this work was to evaluate whether the local breed ancestry percentages in the BoLA locus of a Brangus population diverged from the estimated genome-wide proportions and to identify signatures of positive selection in this genomic region. For this, 167 animals (100 Brangus, 45 Angus and 22 Brahman) were genotyped using a high-density single nucleotide polymorphism array. The local ancestry analysis showed that more than half of the haplotypes (55.0%) shared a Brahman origin. This value was significantly different from the global genome-wide proportion estimated by cluster analysis (34.7% Brahman), and the proportion expected by pedigree (37.5% Brahman). The analysis of selection signatures by genetic differentiation (Fst) and extended haplotype homozygosity-based methods (iHS and Rsb) revealed 10 and seven candidate regions, respectively. The analysis of the genes located within these candidate regions showed mainly genes involved in immune response-related pathway, while other genes and pathways were also observed (cell surface signalling pathways, membrane proteins and ion-binding proteins). Our results suggest that the BoLA region of Brangus cattle may have been enriched with Brahman haplotypes as a consequence of selection processes to promote adaptation to subtropical environments.
Objectives: The worldwide spread of Parkinson’s disease (PD) calls for sensitive and specific measures enabling its early (or, ideally, preclinical) detection. Here, we use language measures revealing deficits in PD to explore whether similar disturbances are present in asymptomatic individuals at risk for the disease. Methods: We administered executive, semantic, verb-production, and syntactic tasks to sporadic PD patients, genetic PD patients with PARK2 (parkin) or LRRK2 (dardarin) mutation, asymptomatic first-degree relatives of the latter with similar mutations, and socio-demographically matched controls. Moreover, to detect sui generis language disturbances, we ran analysis of covariance tests using executive functions as covariate. Results: The two clinical groups showed impairments in all measures, most of which survived covariation with executive functions. However, the key finding concerned asymptomatic mutation carriers. While these subjects showed intact executive, semantic, and action-verb production skills, they evinced deficits in a syntactic test with minimal working memory load. Conclusions: We propose that this sui generis disturbance may constitute a prodromal sign anticipating eventual development of PD. Moreover, our results suggest that mutations on specific genes (PARK2 and LRRK2) compromising basal ganglia functioning may be subtly related to language-processing mechanisms. (JINS, 2017, 23, 150–158)
Two metal fillers with TiC nanoparticles (TiC NPs) of less than 100 nm for the overlay process is an alternative to hardfacing for treating surfaces subjected to severe wear. In this work, the effect of tribological behavior for TiC NPs addition on two Co-based filler materials, as well as the dilutions, was studied. Mixtures of Co-based filler metals without and with 0.5% and 2% TiC NPs were deposited onto D2 steel plates using PTA (Plasma Transferred Arc). The BET surface area was 0.17 m2 g-1 and 0.31 m2 g-1, respectively, for Stellite 6 and 12. The distribution of ca 23% macroporous for Stellite 6 was sufficient to get inside the TiC NPs, as well as in the case of Stellite 12, with a pore distribution of ca 13%. Stellite 12 has an increase in the dilutions (70%) and enthalpies showed endothermic reactions. Stellite 6 with NPs was determined to be most effective in increasing the wear resistance.
Different aging heat treatments were performed in a Titanium alloy using as aging media metallic baths in comparison to typical furnace aging. As a first step, a Duplex Aging (DA) consisted of solubilization followed by quenching to room temperature after aging heat treatment in different metallic baths (Zn, Sn and Bi). A second procedure was Alternative Aging (AA) which consisted of solubilization and direct aging inside three different aforementioned baths. Microstructural aging variations begins at half hour until 30 h at 550°C inside metallic bath of Zn, Sn or Bi. Both kinds of aging promoted a microstructural variation and so on microhardness values. Microstructural analysis by Optical Microscopy showed a structural refinement after AA treatment. The highest hardness value of 375 HVN was achieved in Alternative Aging with Zn bath, which was found to be dependent on laminar α phase refining. Moreover, after AA treatment for 0.5, 1, 2, 3, 4, 10 and 30 h at 550°C in the metallic bath of Zn and Sn, the results indicated similar hardness values in different times, resulting in the fastest kinetic for Sn metallic bath at 2 h compared to that 4 h in Zn metallic bath. The observed increase in micro-hardness is not very attractive, it is recommended to use large aging times in order to stabilize final spacing of microstructural features in AA treatment.
I deficiency is still a worldwide public health problem, with children being especially vulnerable. No nationwide study had been conducted to assess the I status of Spanish children, and thus an observational, multicentre and cross-sectional study was conducted in Spain to assess the I status and thyroid function in schoolchildren aged 6–7 years. The median urinary I (UI) and thyroid-stimulating hormone (TSH) levels in whole blood were used to assess the I status and thyroid function, respectively. A FFQ was used to determine the consumption of I-rich foods. A total of 1981 schoolchildren (52 % male) were included. The median UI was 173 μg/l, and 17·9 % of children showed UI<100 μg/l. The median UI was higher in males (180·8 v. 153·6 μg/l; P<0·001). Iodised salt (IS) intake at home was 69·8 %. IS consumption and intakes of ≥2 glasses of milk or 1 cup of yogurt/d were associated with significantly higher median UI. Median TSH was 0·90 mU/l and was higher in females (0·98 v. 0·83; P<0·001). In total, 0·5 % of children had known hypothyroidism (derived from the questionnaire) and 7·6 % had TSH levels above reference values. Median TSH was higher in schoolchildren with family history of hypothyroidism. I intake was adequate in Spanish schoolchildren. However, no correlation was found between TSH and median UI in any geographical area. The prevalence of TSH above reference values was high and its association with thyroid autoimmunity should be determined. Further assessment of thyroid autoimmunity in Spanish schoolchildren is desirable.