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To describe validation process of the new apathy scale for institutionalized dementia patients (APADEM-NH).
100 elderly, institutionalized patients with diagnosis of probable Alzheimer Disease (AD) (57%), possible AD (13%), AD with cerebral vascular disease (CVD) (17%), Lewy Bodies Dementia (11%) and Parkinson associated to dementia (PDD) (2%). All stages of the disease severity according to the Global Deterioration Scale (GDS) and Clinical Dementia Rating (CDR) were assessed. The Apathy Inventory (AI), Neuropsychiatric Inventory (NPI), Cornell scale for depression, and the tested scale were applied. Re-test and inter-rater reliability was carried out in 50 patients. The feasibility and acceptability, reliability, validity, and measurement precision were analyzed.
APADEM-NH final version consists of 26 items and 3 dimensions: Deficit of Thinking and Self-Generated behaviors (DT): 13 items, Emotional Blunting (EB): 7 items, and Cognitive Inertia (CI): 6 items. Mean application time was 9.56 minutes and 74% of applications were fully computable. All subscales showed floor and ceiling effect lower than 15%. Internal consistency was excellent for each dimension (Cronbach’s α DT = 0.88, α EB = 0.83, α CI= 0.88);Test-retest reliability for the items was kW=0,48-0,92; Inter-rater reliability reached kW values 0.84-1.00; The APADEM-NH total score showed a low/moderate correlation with apathy scales (Spearman ρ, AI =0.33; NPI-Apathy= 0,31), no correlation with depression scales (NPI-Dementia = -0.003; Cornell= 0,10), and high internal validity (ρ =0.69 0.80).
APADEM-NH is a brief, psychometrically acceptable, and valid scale to assess apathy in patients from mild to severe dementia and discerning between apathy and depression.
A critical review of current models of clinical staging of depressive disorders and their potential contribution to routine clinical practice will be presented.
The main objective was to establish the correlation between the clinical staging model proposed by Hetrick and McGorry (modified by our group) with the severity of depression, the associated disability and the treatment resistance degree.
It is a descriptive cross-sectional study carried out in a sample of 135 patients, 15 or more years old, with a diagnosis of DSM-IV-Major Depression (single or recurrent episode) that were in contact with the outpatient and inpatient Units of the Institute of Psychiatry of the San Carlos Clínico Hospital in Madrid. Socio-demographic and clinical variables were collected: diagnosis, global impression of illness, severity of depressive symptoms, functionality and disability degrees and resistanceto treatment.
In spite the sample size limitations, it can clearly note that clinical stage model correlates in a statistically significant way with the scores of the Clinical Global Impression (CGI), and especially with the Global Assessment of Function (GAF) and the resistance to treatment degree.
We will discuss the utility of clinical staging model in the clinical practice and the interest to study the correlations between this proposed model and the established biomarkers of Major Depression.
Diagnosis of schizophrenia spectrum disorders (SSD) may be difficult in clinical practice, particularly during the first episodes of early-onset psychosis (FE-EOP).
To develop a Support Vector Machine (SVM) algorithm as a predictive tool for diagnostic outcome in patients with FE-EOP, based on clinical and biomedical data at the emergence of the illness.
Two-year, prospective longitudinal study, where 81 patients (9-17 years of age) with a FE-EOP and stable diagnosis at follow-up and 41 age and sex-matched healthy controls (HC) were included. Structured diagnostic interviews, clinical and cognitive scales, a MRI scan and biochemical tests were conducted at baseline. Three SVM classification algorithms were developed (SSD vs HC group, non-SSD vs HC group, and SSD vs non-SSD group). Jackknifing was used to validate the algorithms and to calculate performance estimates. Enhanced-Recursive Feature Elimination was performed in order to gain information about the predictive weight for diagnosis of each variable.
The SSD-versus-non-SSD classifier achieved an overall accuracy of 83.1%, sensitivity of 86.6% and specificity of 77.8%. The variables during a FE-EOP with higher predictive value for a diagnosis of SSD were clinical variables such as negative symptoms preceding or during the psychotic onset, poor insight and duration of illness until first psychiatric contact. Biochemical, neuroimaging, and cognitive variables at baseline did not provide any additional predictive value.
SVM may serve as a predictive tool for early diagnosis of SSD during a FE-EOP. The most discriminative variables during a FE-EOP for a future diagnosis of SSD are clinical variables.
The use of antipsychotics in children is controversial, one of the considerations to take into account is the possible effect on the values of fasting glucose, prolactin or weight gain are very important.
To study the effect of these drugs on metabolic rate in children.
We measured the weight, waist circumference, fasting glucose and basal prolactin in 6 children at Children's Hospital in the province of Huelva, diagnosed with bipolar disorder and early schizophrenia, atypical antipsychotics before starting treatment and 6 months later.
In the provisional results it is found that a there is not a significant weight gain (less than 3%), no impairment of glucose and only in one case basal prolactin was elevated.
The use of atypical antipsychotics in children should be reserved when strictly necessary. Once established, keep tight control of metabolic parameters, although the data of our study coincide with the literature, do not produce significant alterations.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Emerging drugs are a growing problem, of which we have little information and clinical experience and pose a challenge in everyday clinical practice because many are not detectable with the test at our disposal and its effect on cognition and behavior are not well known.
Conduct a thorough literature review of all the material in this regard has been published both in high impact journals and in the last International Congress of Dual Pathology.
There are many and varied new substances used for harmful/abuse consumption mainly for their sedative effects and/or hallucinogens, easily accessible since many are easily purchased online or can even be easily obtained at any pharmacy without a prescription.
There are more and more often consumed new substances with high harmful potential and very easy to obtain. It is therefore essential knowledge to identify, treat and educate not only our patients but to the general population.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The hormonal imbalance produced by antipsychotics can be detected by symptoms, such as: infertility, acne, hirsutism, sexual dysfunction and galactorrhea. We consider especially important the study of women's diseases, which may develop due to hyperprolactinemia, specifically: breast cancer, endometrial cancer and osteoporosis.
To undertake a systematic review about the relationship between hyperprolactinemia as a result of the treatment with antipsychoticsand endometrial and breast cancer.
An exhaustive search was performed on PUBMED and COCHRANE (from 2006 to 2015).
Fifteen papers were selected including comparative studies, clinical trials and clinical reviews.
With respect to endometrial carcinoma, there is no direct relationship with the use of antipsychotics. However, most papers have suggested that the blood prolactin elevation is a risk factor in the development of endometrial engrossment, which could lead to endometrial hyperplasia, polyps and endometrial cancer. Related to the use of antipsychotics as a treatment for schizophrenic women and breast carcinoma, a significant association was found and this association is strengthened through the interaction of other factors like the fact that women with schizophrenia are less worried about going to the clinical screening reviews in their health centre, smoking, and lower physical activity than healthy women.
Aripiprazolis associated with a low prevalence of hyperprolactinemia. Menopausal women, the obese, and women who smoke receiving antipsychotics that produce hyperprolactinemia have the greatest risk of developing endometrial pathology. Schizophrenic women with hyperprolactinemia due to antipsychotics and loss of motivation to go to screening activities have a greater risk of breast cancer. Sexual dysfunction could be a non-adherence treatment factor.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
AGB stars are important contributors of processed matter to the ISM. However, the physical and chemical mechanisms involved in its ejection are still poorly known. This process is expected to have remarkable effects in the innermost envelope, where the dust grains are formed, the gas is accelerated, the chemistry is active, and the radiative excitation becomes important. A good tracer of this region in C-rich stars is SiS, an abundant refractory molecule that can display maser lines, very sensitive to changes in the physical conditions. We present high angular resolution interferometer observations (HPBW ≳0.″.25) of the v = 0 J = 14 – 13 and 15 – 14 SiS maser lines towards the archetypal AGB star IRC+10216, carried out with CARMA and ALMA to explore the inner 1” region around the central star. We also present an ambitious monitoring of these lines along one single pulsation period carried out with the IRAM 30 m telescope.
Silicon carbide together with amorphous carbon are the main components of dust grains in the atmospheres of C-rich AGB stars. Small gaseous Si-C bearing molecules (such as SiC, SiCSi, and SiC2) are efficiently formed close to the stellar photosphere. They likely condense onto dust seeds owing to their highly refractory nature at the lower temperatures (i.e., below about 2500 K) in the dust growth zone which extends a few stellar radii from the photosphere. Beyond this region, the abundances of Si-C bearing molecules are expected to decrease until they are eventually reformed in the outer shells of the circumstellar envelope, owing to the interaction between the gas and the interstellar UV radiation field. Our goal is to understand the time-dependent chemical evolution of Si-C bond carriers probed by molecular spectral line emission in the circumstellar envelope of IRC+10216 at millimeter wavelengths.
People who have schizophrenia die earlier from somatic diseases than do people in the general population, but information about cardiovascular deaths in people who have schizophrenia is limited. We analysed mortality in all age groups of people with schizophrenia by specific cardiovascular diseases (CVDs), focusing on five CVD diagnoses: coronary heart disease, acute myocardial infarction, cerebrovascular disease, heart failure and cardiac arrhythmias. We also compared hospital admissions for CVDs in people who had schizophrenia with hospital admissions for CVDs in the general population.
This national register study of 10 631 817 people in Sweden included 46 911 people who were admitted to the hospital for schizophrenia between 1 January 1987 and 31 December 2010. Information from national registers was used to identify people who had schizophrenia and obtain data about mortality, causes of death, medical diagnoses and hospitalisations.
CVDs were the leading cause of death in people who had schizophrenia (5245 deaths), and CVDs caused more excess deaths than suicide. The mean age of CVD death was 10 years lower for people who had schizophrenia (70.5 years) than the general population (80.7 years). The mortality rate ratio (MRR) for CVDs in all people who had schizophrenia was 2.80 (95% confidence interval (CI) 2.73–2.88). In people aged 15–59 years who had schizophrenia, the MRR for CVDs was 6.16 (95% CI 5.79–6.54). In all people who had schizophrenia, the MRR for coronary heart disease was 2.83 (95% CI 2.73–2.94); acute myocardial infarction, 2.62 (95% CI 2.49–2.75); cerebrovascular disease, 2.4 (95% CI 2.25–2.55); heart failure, 3.25 (95% CI 2.94–3.6); and cardiac arrhythmias, 2.06 (95% CI 1.75–2.43). Hospital admissions for coronary heart disease were less frequent in people who had schizophrenia than in the general population (admission rate ratio, 0.88 (95% CI 0.83–0.94). In all age groups, survival after hospital admission for CVD was lower in people who had schizophrenia than in the general population.
People who had schizophrenia died 10 years earlier from CVDs than did people in the general population. For all five CVD diagnoses, mortality risk was higher for those with schizophrenia than those in the general population. Survival after hospitalisation for CVDs in people who had schizophrenia was comparable with that of people in the general population who were several decades older.
Animal health surveillance enables the detection and control of animal diseases including zoonoses. Under the EU-FP7 project RISKSUR, a survey was conducted in 11 EU Member States and Switzerland to describe active surveillance components in 2011 managed by the public or private sector and identify gaps and opportunities. Information was collected about hazard, target population, geographical focus, legal obligation, management, surveillance design, risk-based sampling, and multi-hazard surveillance. Two countries were excluded due to incompleteness of data. Most of the 664 components targeted cattle (26·7%), pigs (17·5%) or poultry (16·0%). The most common surveillance objectives were demonstrating freedom from disease (43·8%) and case detection (26·8%). Over half of components applied risk-based sampling (57·1%), but mainly focused on a single population stratum (targeted risk-based) rather than differentiating between risk levels of different strata (stratified risk-based). About a third of components were multi-hazard (37·3%). Both risk-based sampling and multi-hazard surveillance were used more frequently in privately funded components. The study identified several gaps (e.g. lack of systematic documentation, inconsistent application of terminology) and opportunities (e.g. stratified risk-based sampling). The greater flexibility provided by the new EU Animal Health Law means that systematic evaluation of surveillance alternatives will be required to optimize cost-effectiveness.
Absorption of electrical energy provided to a metal wire in an exploding wire system is thought to be terminated or greatly diminished when the plasma is formed, after the joule heating of the metallic wire by the electrical current. Accordingly, it is common to account for the electrical energy delivered to the wire that the integration of current and voltage signals is halted when the voltage peak changes its slope. Usually, this moment is synchronized with the plasma appearance, as detected by optical sensors. In this work, experimental evidence of a two-step electrical energy absorption in an exploding wire surrounded by atmospheric air is presented. During the first step of the energy absorption the plasma is not formed, indicating that the delivered energy is not enough for ionizing the wire, giving place to a dark pause that lasts until a second energy absorption produces a plasma. The delay between the two steps can reach ≈2.2 µs for copper wires of 50 µm diameter charged at an initial voltage of 10 kV. Experimental investigation of variation of the delay between the two steps with different metals, charging voltages, and wire diameters are presented. A relation of the current density with the initial kinetic energy of the plasma and the electrical current rate is devised as a possible explanation of the observed phenomena.
We gathered a multiwavelength dataset of two well-known LBVs. We found a complex mass-loss, with evidence of variability, such as has been seen previously. In addition, our data reveal signatures of collimated stellar winds. We propose a new scenario for these two stars where the nebula shaping is influenced by the presence of a companion star and/or fast rotation.
In this globalized world, the spread of new, exotic and re-emerging diseases has become one of the most important threats to animal production and public health. This systematic review analyses conventional and novel early detection methods applied to surveillance. In all, 125 scientific documents were considered for this study. Exotic (n = 49) and re-emerging (n = 27) diseases constituted the most frequently represented health threats. In addition, the majority of studies were related to zoonoses (n = 66). The approaches found in the review could be divided in surveillance modalities, both active (n = 23) and passive (n = 5); and tools and methodologies that support surveillance activities (n = 57). Combinations of surveillance modalities and tools (n = 40) were also found. Risk-based approaches were very common (n = 60), especially in the papers describing tools and methodologies (n = 50). The main applications, benefits and limitations of each approach were extracted from the papers. This information will be very useful for informing the development of tools to facilitate the design of cost-effective surveillance strategies. Thus, the current literature review provides key information about the advantages, disadvantages, limitations and potential application of methodologies for the early detection of new, exotic and re-emerging diseases.
To design and develop a questionnaire that can account for an individual’s adherence to a Mediterranean lifestyle including the assessment of diet and physical activity patterns, as well as social interaction.
The Mediterranean Lifestyle (MEDLIFE) index was created based on the current Spanish Mediterranean food guide pyramid. MEDLIFE is a twenty-eight-item derived index consisting of questions about food consumption (fifteen items), traditional Mediterranean dietary habits (seven items) and physical activity, rest and social interaction habits (six items). Linear regression models and Spearman rank correlation were fitted to assess content validity and internal consistency.
A subset of participants in the Aragon Workers’ Health Study cohort (Zaragoza, Spain) provided the data for development of MEDLIFE.
Participants (n 988) of the Aragon Workers’ Health Study cohort in Spain.
Mean MEDLIFE score was 11·3 (sd 2·6; range: 0–28), and the quintile distribution of MEDLIFE score showed a significant association with each of the individual items as well as with specific nutrients and lifestyle indicators (intra-validity). We also quantified MEDLIFE correspondence with previously reported diet quality indices and found significant correlations (ρ range: 0·44–0·53; P<0·001) for the Alternate Healthy Eating Index, the Alternate Mediterranean Diet Index and Mediterranean Diet Adherence Screener.
MEDLIFE is the first index to include an overall assessment of lifestyle habits. It is expected to be a more holistic tool to measure adherence to the Mediterranean lifestyle in epidemiological studies.
Transition metal nitrides containing metal ions in high oxidation states are a significant goal for the discovery of new families of semiconducting materials. Most metal nitride compounds prepared at high temperature and high pressure from the elements have metallic bonding. However amorphous or nanocrystalline compounds can be prepared via metal-organic chemistry routes giving rise to precursors with a high nitrogen:metal ratio. Using X-ray diffraction in parallel with high pressure laser heating in the diamond anvil cell this work highlights the possibility of retaining the composition and structure of a metastable nanocrystalline precursor under high pressure-temperature conditions. Specifically, a nanocrystalline Hf3N4 with a tetragonal defect-fluorite structure can be crystallized under high-P,T conditions. Increasing the pressure and temperature of crystallization leads to the formation of a fully recoverable orthorhombic (defect cottunite-structured) polymorph. This approach identifies a novel class of pathways to the synthesis of new crystalline nitrogen-rich transition metal nitrides.
Involuntary soil intake by cows on pasture can be a potential route of entry for pollutants into the food chain. Therefore, it appears necessary to know and quantify factors affecting soil intake in order to ensure the food safety in outside rearing systems. Thus, soil intake was determined in two Latin square trials with 24 and 12 lactating dairy cows. In Trial 1, the effect of pasture allowance (20 v. 35 kg dry matter (DM) above ground level/cow daily) was studied for two sward types (pure perennial ryegrass v. mixed perennial ryegrass–white clover) in spring. In Trial 2, the effect of pasture allowance (40 v. 65 kg DM above ground level/cow daily) was studied at two supplementation levels (0 or 8 kg DM of a maize silage-based supplement) in autumn. Soil intake was determined by the method based on acid-insoluble ash used as an internal marker. The daily dry soil intake ranged, between treatments, from 0.17 to 0.83 kg per cow in Trial 1 and from 0.15 to 0.85 kg per cow in Trial 2, reaching up to 1.3 kg during some periods. In both trials, soil intake increased with decreasing pasture allowance, by 0.46 and 0.15 kg in Trials 1 and 2, respectively. In Trial 1, this pasture allowance effect was greater on mixed swards than on pure ryegrass swards (0.66 v. 0.26 kg reduction of daily soil intake between medium and low pasture allowance, respectively). In Trial 2, the pasture allowance effect was similar at both supplementation levels. In Trial 2, supplemented cows ate much less soil than unsupplemented cows (0.20 v. 0.75 kg/day, respectively). Differences in soil intake between trials and treatments can be related to grazing conditions, particularly pre-grazing and post-grazing sward height, determining at least in part the time spent grazing close to the ground. A post-grazing sward height lower than 50 mm can be considered as a critical threshold. Finally, a dietary supplement and a low grazing pressure, that is, high pasture allowance increasing post-grazing sward height, would efficiently limit the risk for high level of soil intake, especially when grazing conditions are difficult. Pre-grazing and post-grazing sward heights, as well as faecal crude ash concentration appear to be simple and practical tools for evaluating the risk for critical soil intake in grazing dairy cows.
Twenty Assaf lambs fed barley straw plus a concentrate alone (CONTROL group) or enriched with naringin (1.5 g/kg DM, NARINGIN group) were used to assess the effect of this polyphenolic compound on meat quality attributes. Serum samples were collected for 7 weeks, then the animals were slaughtered and the livers and longissimus thoracis et lumborum muscles extracted for analysis. Triacylglycerol levels in the serum samples tended to show (P = 0.087) lower average values for the NARINGIN group when compared with the CONTROL, but no differences were observed when the meat was analysed for the intramuscular fat content. Lower thiobarbituric acid-reactive substances procedure (TBARS) values (P < 0.001) in the liver of the NARINGIN group were detected, probably as a consequence of naringenin accumulation in this organ. No significant differences were observed in the meat samples concerning TBARS or colour evolution during refrigerated storage, as not enough naringenin would have reached the muscle. Independent of naringin administration, the low levels of the most atherogenic oxysterols must be highlighted as the most important quality score in the lamb meat samples studied.
The Catalina Real-time Transient Survey (CRTS) currently covers 33,000 deg2 of the sky in search of transient astrophysical events, with time base-lines ranging from 10 minutes to ~7 years. Data provided by the Catalina Sky Survey provide an unequalled base-line against which > 4,000 unique optical transient events have been discovered and openly published in real-time. Here we highlight some of the discoveries of CRTS.