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Liver transplantation is the standard of care for end-stage liver disease in children and the vast majority of transplant recipients experience successful outcomes. Better preoperative care, enhanced surgical techniques, and improved immunosuppression strategies have led to the appropriate expectation of good short- and long-term outcomes. Increased indications for liver transplant have led to an ever-increasing number of liver transplant candidates and evaluation of past policies and practices has necessitated changes in allocation policy. Collaboration has also led to better outcomes. Fortunately, continued efforts to expand the use of the donor pool through varied surgical techniques and advanced technology allows more children to benefit from this life-saving and enhancing procedure.
The destabilization of a dielectric film flow due to an electrostatic surface force is investigated. A weighted residuals integral boundary-layer (WIBL) model is derived and validated against full numerical simulations. The equations of the WIBL model indicate that the electrostatic surface force contributes to the evolution equations in a similar mathematical way as the volumetric gravitational force. Contrary to gravity, an additional electrostatic contribution (
) arises, whose impact increases nonlinearly with decreasing capacitor plate distance. This nonlinear contribution causes a fold of the branch of solutions of the dynamical system and, thus, the co-existence of a low amplitude solution that is stable against infinitesimal disturbances and an unstable high amplitude solution. In time-dependent simulations, the fold coincides with the limit in the parameter space beyond which a finite-time blow-up occurs with an unsaturated growth of the main wave hump leading to wave pinch-off and drop formation. Thus, a phase diagram can be constructed by tracking this fold. The shape of the main wave prior to blow-up depends on the electrostatic parameter
. If this parameter is zero, the force is equivalent to a hanging film flow configuration and dripping occurs with a drop-shaped structure. With an increasing contribution of the parameter
, Taylor-cone waves occur prior to finite-time blow-up, leading to jetting. Finally, the transition from stable to unstable waves is investigated in terms of the two dimensionless electric parameters, the Reynolds, and viscous dissipation numbers. Imposing the most amplified wavelength, a transition border between stable solutions and jetting is identified.
There is evidence that environmental and genetic risk factors for schizophrenia spectrum disorders are transdiagnostic and mediated in part through a generic pathway of affective dysregulation.
We analysed to what degree the impact of schizophrenia polygenic risk (PRS-SZ) and childhood adversity (CA) on psychosis outcomes was contingent on co-presence of affective dysregulation, defined as significant depressive symptoms, in (i) NEMESIS-2 (n = 6646), a representative general population sample, interviewed four times over nine years and (ii) EUGEI (n = 4068) a sample of patients with schizophrenia spectrum disorder, the siblings of these patients and controls.
The impact of PRS-SZ on psychosis showed significant dependence on co-presence of affective dysregulation in NEMESIS-2 [relative excess risk due to interaction (RERI): 1.01, p = 0.037] and in EUGEI (RERI = 3.39, p = 0.048). This was particularly evident for delusional ideation (NEMESIS-2: RERI = 1.74, p = 0.003; EUGEI: RERI = 4.16, p = 0.019) and not for hallucinatory experiences (NEMESIS-2: RERI = 0.65, p = 0.284; EUGEI: −0.37, p = 0.547). A similar and stronger pattern of results was evident for CA (RERI delusions and hallucinations: NEMESIS-2: 3.02, p < 0.001; EUGEI: 6.44, p < 0.001; RERI delusional ideation: NEMESIS-2: 3.79, p < 0.001; EUGEI: 5.43, p = 0.001; RERI hallucinatory experiences: NEMESIS-2: 2.46, p < 0.001; EUGEI: 0.54, p = 0.465).
The results, and internal replication, suggest that the effects of known genetic and non-genetic risk factors for psychosis are mediated in part through an affective pathway, from which early states of delusional meaning may arise.
Wind tunnel experiments are described in this paper, aiming to examine the global dynamics of heavy inverted flags, with a specific focus on the underlying mechanism of large-amplitude flapping, which occurs at sufficiently high flow velocities. This problem is of interest because no consensus exists as to the mechanism, specifically whether it is a vortex-induced vibration or a self-excited vibration – the answer being not only of fundamental interest, but also important for energy harvesting applications. The effect of vortex shedding from both leading and trailing edges was investigated via experiments with flags modified by serrations to the leading edge and a long rigid splitter plate at the trailing edge, so as to disrupt leading- and trailing-edge vortices and to inhibit interactions between counter-rotating leading-edge vortices, if they exist. The relatively small quantitative changes in the critical flow velocity, amplitude and frequency of oscillations, as well as the near-identical qualitative behaviour, of plain and modified flags suggests that the global qualitative dynamics of heavy inverted flags is independent of vortex shedding from the leading and trailing edges, i.e. periodic vortex shedding is not the cause but an effect of large-amplitude flapping. Additional experiments showed that the dominant frequencies of flapping and the lift force on the flag are generally not synchronized, and multiple frequencies occur in the lift signal, reinforcing the conclusion that vortex shedding is not the cause of flapping. Our experimental results suggest that self-excited vibration through a fluid-elastic instability, i.e. flutter, is the underlying mechanism for the flapping of heavy inverted flags.
This study attempted to replicate whether a bias in probabilistic reasoning, or ‘jumping to conclusions’(JTC) bias is associated with being a sibling of a patient with schizophrenia spectrum disorder; and if so, whether this association is contingent on subthreshold delusional ideation.
Data were derived from the EUGEI project, a 25-centre, 15-country effort to study psychosis spectrum disorder. The current analyses included 1261 patients with schizophrenia spectrum disorder, 1282 siblings of patients and 1525 healthy comparison subjects, recruited in Spain (five centres), Turkey (three centres) and Serbia (one centre). The beads task was used to assess JTC bias. Lifetime experience of delusional ideation and hallucinatory experiences was assessed using the Community Assessment of Psychic Experiences. General cognitive abilities were taken into account in the analyses.
JTC bias was positively associated not only with patient status but also with sibling status [adjusted relative risk (aRR) ratio : 4.23 CI 95% 3.46–5.17 for siblings and aRR: 5.07 CI 95% 4.13–6.23 for patients]. The association between JTC bias and sibling status was stronger in those with higher levels of delusional ideation (aRR interaction in siblings: 3.77 CI 95% 1.67–8.51, and in patients: 2.15 CI 95% 0.94–4.92). The association between JTC bias and sibling status was not stronger in those with higher levels of hallucinatory experiences.
These findings replicate earlier findings that JTC bias is associated with familial liability for psychosis and that this is contingent on the degree of delusional ideation but not hallucinations.
In Europe, the incidence of psychotic disorder is high in certain migrant and minority ethnic groups (hence: ‘minorities’). However, it is unknown how the incidence pattern for these groups varies within this continent. Our objective was to compare, across sites in France, Italy, Spain, the UK and the Netherlands, the incidence rates for minorities and the incidence rate ratios (IRRs, minorities v. the local reference population).
The European Network of National Schizophrenia Networks Studying Gene–Environment Interactions (EU-GEI) study was conducted between 2010 and 2015. We analyzed data on incident cases of non-organic psychosis (International Classification of Diseases, 10th edition, codes F20–F33) from 13 sites.
The standardized incidence rates for minorities, combined into one category, varied from 12.2 in Valencia to 82.5 per 100 000 in Paris. These rates were generally high at sites with high rates for the reference population, and low at sites with low rates for the reference population. IRRs for minorities (combined into one category) varied from 0.70 (95% CI 0.32–1.53) in Valencia to 2.47 (95% CI 1.66–3.69) in Paris (test for interaction: p = 0.031). At most sites, IRRs were higher for persons from non-Western countries than for those from Western countries, with the highest IRRs for individuals from sub-Saharan Africa (adjusted IRR = 3.23, 95% CI 2.66–3.93).
Incidence rates vary by region of origin, region of destination and their combination. This suggests that they are strongly influenced by the social context.
We study the stability of the differential process of Rochberg and Weiss associated with an analytic family of Banach spaces obtained using the complex interpolation method for families. In the context of Köthe function spaces, we complete earlier results of Kalton (who showed that there is global bounded stability for pairs of Köthe spaces) by showing that there is global (bounded) stability for families of up to three Köthe spaces distributed in arcs on the unit circle while there is no (bounded) stability for families of four or more Köthe spaces. In the context of arbitrary pairs of Banach spaces, we present some local stability results and some global isometric stability results.
Gender is an important social determinant of health, but gender has played only a marginal role in the geriatric and gerontology research and practice. The aim of this study was to examine the relevance of gender to the psychological well-being of older adults.
A cross-sectional study was conducted.
The study was carried out in Spain.
A total of 1,201 people aged between 65 and 94.
The participants completed sociodemographic data and four questionnaires: The Bem sex role inventory, the Ryff’s psychological well-being scale, the York self-esteem inventory, and the Social support scale.
Men scored higher than women in self-acceptance, autonomy, purpose in life, and environmental mastery. Hierarchical multiple regression analyses showed that, although the most important predictors of psychological well-being in both women and men were self-esteem and social support, both masculine/instrumental and feminine/expressive traits were associated with higher psychological well-being, although the effect size was higher for the masculine/instrumental trait. Furthermore, education was associated with psychological well-being in the case of females.
Gender plays an important role in the psychological well-being of older adults. The results of this research are relevant for healthcare providers and policy-makers interested in promoting successful aging and increasing the well-being of older people.
Previous literature supports antipsychotics’ (AP) efficacy in acute first-episode psychosis (FEP) in terms of symptomatology and functioning but also a cognitive detrimental effect. However, regarding functional recovery in stabilised patients, these effects are not clear. Therefore, the main aim of this study is to investigate dopaminergic/anticholinergic burden of (AP) on psychosocial functioning in FEP. We also examined whether cognitive impairment may mediate these effects on functioning.
A total of 157 FEP participants were assessed at study entry, and at 2 months and 2 years after remission of the acute episode. The primary outcomes were social functioning as measured by the functioning assessment short test (FAST). Cognitive domains were assessed as potential mediators. Dopaminergic and anticholinergic AP burden on 2-year psychosocial functioning [measured with chlorpromazine (CPZ) and drug burden index] were independent variables. Secondary outcomes were clinical and socio-demographic variables.
Mediation analysis found a statistical but not meaningful contribution of dopaminergic receptor blockade burden to worse functioning mediated by cognition (for every 600 CPZ equivalent points, 2-year FAST score increased 1.38 points). Regarding verbal memory and attention, there was an indirect effect of CPZ burden on FAST (b = 0.0045, 95% CI 0.0011–0.0091) and (b = 0.0026, 95% CI 0.0001–0.0006) respectively. However, only verbal memory post hoc analyses showed a significant indirect effect (b = 0.009, 95% CI 0.033–0.0151) adding premorbid IQ as covariate. We did not find significant results for anticholinergic burden.
CPZ dose effect over functioning is mediated by verbal memory but this association appears barely relevant.
The ‘jumping to conclusions’ (JTC) bias is associated with both psychosis and general cognition but their relationship is unclear. In this study, we set out to clarify the relationship between the JTC bias, IQ, psychosis and polygenic liability to schizophrenia and IQ.
A total of 817 first episode psychosis patients and 1294 population-based controls completed assessments of general intelligence (IQ), and JTC, and provided blood or saliva samples from which we extracted DNA and computed polygenic risk scores for IQ and schizophrenia.
The estimated proportion of the total effect of case/control differences on JTC mediated by IQ was 79%. Schizophrenia polygenic risk score was non-significantly associated with a higher number of beads drawn (B = 0.47, 95% CI −0.21 to 1.16, p = 0.17); whereas IQ PRS (B = 0.51, 95% CI 0.25–0.76, p < 0.001) significantly predicted the number of beads drawn, and was thus associated with reduced JTC bias. The JTC was more strongly associated with the higher level of psychotic-like experiences (PLEs) in controls, including after controlling for IQ (B = −1.7, 95% CI −2.8 to −0.5, p = 0.006), but did not relate to delusions in patients.
Our findings suggest that the JTC reasoning bias in psychosis might not be a specific cognitive deficit but rather a manifestation or consequence, of general cognitive impairment. Whereas, in the general population, the JTC bias is related to PLEs, independent of IQ. The work has the potential to inform interventions targeting cognitive biases in early psychosis.
F. Manuel Montalbán, Francisco M. Llorente and Evelina Zurita apply key ideas from critical assessments of study abroad contexts when they examine the effects of academic mobility on exchange students’ intercultural competence. Their chapter draws on comments from Spanish and South Korean students within joint internationalization programmes led by the University of Malaga and South Korean universities to analyse how exactly international students construct their cultural experiences. In particular, they discover three interpretative repertoires, which focus on fundamental aspects of these experiences: mastery and interest in the language, counter-stereotypic otherness and differentiation at the individual level. Some student comments demonstrate that progress in intercultural competence is frequently left to the spontaneous development of informal and personal interactions.
Previous studies have found a relationship between job-related stress and depressive symptoms in different occupational groups, and that personality may modify the risk of developing depressive symptoms. We aimed to examine the association of personality and other individual and work conditions with depressive symptoms.
A sample of 498 teachers answered a questionnaire concerning individual and work characteristics, some job-related perceptions, and the wish to change jobs. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression scale (CES-D) and personality was measured by the Temperament and Character Inventory (TCI-125).
Depressive symptoms were associated with female gender, age, low job satisfaction, high job stress, the wish to change jobs, working at a public school, and with higher scores on harm avoidance and novelty seeking and lower scores on self-directedness.
Our results underline the influence of personality traits on the development of depressive symptoms independently of other individual characteristics and the occupational context.
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.
North African knapweed (Centaurea diluta Aiton) is an annual weed that is widespread in southern Spain and is of increasing concern in dryland cropping systems. Despite its expanding range in Spain, there is limited information on the emergence timing and pattern of this species, knowledge of which is critical for developing more timely and effective management strategies. Therefore, there is a need to develop simple and reliable models to predict the timing and emergence of this annual weed under dryland conditions. A multi-location field experiment was established across Spain in 2016 to 2017 to assess the emergence of C. diluta. At each of 11 locations, seeds were sown in the fall, and emergence was recorded. Overall emergence averaged 39% in the first year across all sites and 11% in the second year. In both years, the main emergence flush occurred at the beginning of the growing season. A three-parameter Weibull function best described seedling emergence of C. diluta. Emergence models were developed based on thermal time (TT) and hydrothermal time (HTT) and showed high predictability, as evidenced by root mean-square error prediction values of 10.8 and 10.7, respectively. Three cardinal points were established for TT and HHT at 0.5, 10, and 35 C for base, optimal, and ceiling temperatures, respectively, while base water potential was estimated at −0.5 MPa.
The first episode of psychosis is a crucial period when early intervention can alter the trajectory of the young person's ongoing mental health and general functioning. Cognitive abilities are nuclear for the social recovery. Stress impairs higher cognitive processes, dependent on the prefrontal cortex (PFC) and that involve maintenance and integration of information over extended periods, including working memory and attention. Different mechanism are involved such as HPA-Axis hyperactivity, affecting PFC. Recently, investigations show the different evolution of cognitive abilities between different sex in WM.
A sample of 41 FEPs and 39 healthy subjects were evaluated. The variables assessed were verbal and visual memory, attention, working memory, processing speed, mental flexibility, verbal fluency, motor coordination, planning ability and intelligence.
We found an interaction between age (< 16 years and > 16 years) and group (psychosis vs. controls) in working memory (P = 0.04). There were no difference in men < 16 years old control group and men with same age plus psychosis (5.87 ± 1.57 vs. 5.83 ± 1; P = 0.1) in WM. However, this work was found to be significantly different in the univariant analysis of working memory in the group < 16 years old women control (7.30 ± 1.56) and women psychosis group (5.61 ± 1.91).
Social cognition and stress seem to be directly relation. Some studies show that stress enhance cognition performance in men while impairing it in women. Stress affect a variety of cognitive processes such attention and working memory. Deficit in social cognition are present in the prodromal phases of psychosis.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Ethnic minority groups in Western countries face an increased risk of psychotic disorders. Causes of this long-standing public health inequality remain poorly understood. We investigated whether social disadvantage, linguistic distance and discrimination contributed to these patterns.
We used case–control data from the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study, carried out in 16 centres in six countries. We recruited 1130 cases and 1497 population-based controls. Our main outcome measure was first-episode ICD-10 psychotic disorder (F20–F33), and exposures were ethnicity (white majority, black, mixed, Asian, North-African, white minority and other), generational status, social disadvantage, linguistic distance and discrimination. Age, sex, paternal age, cannabis use, childhood trauma and parental history of psychosis were included as a priori confounders. Exposures and confounders were added sequentially to multivariable logistic models, following multiple imputation for missing data.
Participants from any ethnic minority background had crude excess odds of psychosis [odds ratio (OR) 2.03, 95% confidence interval (CI) 1.69–2.43], which remained after adjustment for confounders (OR 1.61, 95% CI 1.31–1.98). This was progressively attenuated following further adjustment for social disadvantage (OR 1.52, 95% CI 1.22–1.89) and linguistic distance (OR 1.22, 95% CI 0.95–1.57), a pattern mirrored in several specific ethnic groups. Linguistic distance and social disadvantage had stronger effects for first- and later-generation groups, respectively.
Social disadvantage and linguistic distance, two potential markers of sociocultural exclusion, were associated with increased odds of psychotic disorder, and adjusting for these led to equivocal risk between several ethnic minority groups and the white majority.
Motor abnormalities (MAs) are the primary manifestations of schizophrenia. However, the extent to which MAs are related to alterations of subcortical structures remains understudied.
We aimed to investigate the associations of MAs and basal ganglia abnormalities in first-episode psychosis (FEP) and healthy controls. Magnetic resonance imaging was performed on 48 right-handed FEP and 23 age-, gender-, handedness-, and educational attainment-matched controls, to obtain basal ganglia shape analysis, diffusion tensor imaging techniques (fractional anisotropy and mean diffusivity), and relaxometry (R2*) to estimate iron load. A comprehensive motor battery was applied including the assessment of parkinsonism, catatonic signs, and neurological soft signs (NSS). A fully automated model-based segmentation algorithm on 1.5T MRI anatomical images and accurate corregistration of diffusion and T2* volumes and R2* was used.
FEP patients showed significant local atrophic changes in left globus pallidus nucleus regarding controls. Hypertrophic changes in left-side caudate were associated with higher scores in sensory integration, and in right accumbens with tremor subscale. FEP patients showed lower fractional anisotropy measures than controls but no significant differences regarding mean diffusivity and iron load of basal ganglia. However, iron load in left basal ganglia and right accumbens correlated significantly with higher extrapyramidal and motor coordination signs in FEP patients.
Taken together, iron load in left basal ganglia may have a role in the emergence of extrapyramidal signs and NSS of FEP patients and in consequence in the pathophysiology of psychosis.
Near-field to far-field transformations constitute a powerful antenna characterization technique for near-field measurement scenarios. In this paper, a near-field to far-field transformation technique based on multiple spherical wave expansions (SWEs) is presented. Thanks to its iterative matrix inversion nature, the approach performs the transformation of fields measured on arbitrary surfaces. Also, irregular sampling schemes can be incorporated. The proposed algorithm is based on modeling the antenna fields with not one, but several SWEs distributed over its geometry. Due to the high number of SWEs, their truncation number can be arbitrarily reduced. Working with expansions of low order allows us to incorporate the probe correction in the transformation in a very simple way, accepting any type of probe and orientation. Only the probe far-field pattern is used, thus working with its full SWE is avoided. The algorithm is validated using simulated field data as well as measurements of real antennas.
This paper examines the joint impact of infrastructure capital and institutional quality on economic growth using a large panel dataset covering 99 countries and spanning the years 1980–2015. The empirical strategy involves estimating a simple growth model where, in addition to standard controls, infrastructure, institutional quality, and their interaction are included as explanatory variables. Potential endogeneity concerns are addressed by employing generalized method of moments estimators that utilize internal instruments. We find that the interaction terms between infrastructure capital and institutional quality show a positive and significant impact on economic growth. These results are robust to a variety of alternative specifications and institutional quality measures. Hence, our results suggest that maximizing returns from infrastructure capital requires improving the quality of institutions.