To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The aim of this study is to investigate the impact of anatomical changes in prostate cancer patients on the target coverage when using 6 MV beams-VMAT therapy and to propose strategies that allow us to evaluate the dose or correct it by normalization without having to perform a new simulation.
Methods and materials:
Ten patients of high-risk prostate cancer were chosen for the study. All test plans were delivered using the same isocenter and monitor units as the original plan and compared against the original unedited plan. The expansion and contraction of body contours due to size changes was mimicked by increasing and decreasing the body contour with depths of −2, −1·5, …, 1·5, 2 cm, in the anterior, and both lateral directions of the patient. A total of 90 plans were evaluated, 9 for each patient. Dose-volume histogram statistics were extracted from each plan and normalized to prescription dose.
Weight changes resulted in considerable dose modifications to the target and critical structures. Plans were found to be varied with 2·9% ± 0·3% per cm SSD change for VMAT treatment with a correlation index close to one. Therefore, doses variations were linear to the changes of depth. Gamma index evaluation was performed for the 10 renormalized plans. All of them passed criteria of 3%/3 mm in at least 98.2% of points. Eight of them passed criteria in 99% points. Gamma index 4%/4 mm passed 100% points in all patients for the chosen region of interest.
The dosimetry estimation presented in this study shows important data for the radiation oncology staff to justify whether a CT rescan is necessary or not when a patient experiences weight changes during treatment. Based on the results of our study, discrepancies between real dose and planned dose were >5% for 1·7 cm of difference in external contour in the anterior and both lateral directions of the patient.
Previous work has identified associations between psychotic experiences (PEs) and general medical conditions (GMCs), but their temporal direction remains unclear as does the extent to which they are independent of comorbid mental disorders.
In total, 28 002 adults in 16 countries from the WHO World Mental Health (WMH) Surveys were assessed for PEs, GMCs and 21 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders. Discrete-time survival analyses were used to estimate the associations between PEs and GMCs with various adjustments.
After adjustment for comorbid mental disorders, temporally prior PEs were significantly associated with subsequent onset of 8/12 GMCs (arthritis, back or neck pain, frequent or severe headache, other chronic pain, heart disease, high blood pressure, diabetes and peptic ulcer) with odds ratios (ORs) ranging from 1.3 [95% confidence interval (CI) 1.1–1.5] to 1.9 (95% CI 1.4–2.4). In contrast, only three GMCs (frequent or severe headache, other chronic pain and asthma) were significantly associated with subsequent onset of PEs after adjustment for comorbid GMCs and mental disorders, with ORs ranging from 1.5 (95% CI 1.2–1.9) to 1.7 (95% CI 1.2–2.4).
PEs were associated with the subsequent onset of a wide range of GMCs, independent of comorbid mental disorders. There were also associations between some medical conditions (particularly those involving chronic pain) and subsequent PEs. Although these findings will need to be confirmed in prospective studies, clinicians should be aware that psychotic symptoms may be risk markers for a wide range of adverse health outcomes. Whether PEs are causal risk factors will require further research.
One important aspect of the societal burden of mental disorders is the extent to which these problems cause disability.
To assess days out of role associated with commonly occurring mental disorders in comparison with physical disorders in Portugal.
National cross-sectional survey, with home interviews carried out with 3849 adult (aged 18+) respondents (57.3% response rate).
Twelve-month prevalence for any mental disorder was 21.8%, any physical disorder 55.1% and any disorder 63.1%, with an average of 2.3 disorders per respondent with a disorder. Close to one out of every 10 respondents (9.2%) reported at least one day totally out of role in the past month (median of 6.4 days/any). The 18 conditions accounted for 78.2% of all days out of role, with 20.2% because of mental disorders and 59.2% because of physical disorders.
Mental disorders account for a substantial proportion of all role disability in the Portuguese population. Early detection and intervention would have a positive societal effect. Owing to highly frequent comorbidity, simultaneous management of mental and physical disorder comorbidities is advised for greater effect.
Although resilience varies depending on the specific type of adverse situation faced by the individual, to date resilience questionnaires do not consider its situational character. This study aims to develop and validate the Situated Subjective Resilience Questionnaire for Adults (SSRQA), which assesses resilience in five different adverse contexts. A total of 584 Spanish adults (including general population and clinical samples individuals) completed the SSRQA and other measures of resilience, optimism, and self-efficacy. Confirmatory factor analysis showed that the SSRQA structure fitted the situational model better (χ2/df = 1.90; CFI = .96; TLI = .95; RMSEA = .07) than the non-situational version (χ2/df = 4.99; CFI = .79; TLI = .76; RMSEA = .15). The SSRQA was shown to be reliable (α = .90) and to be significantly and positively correlated with other resilience measures (p < .001) and, to a lower degree, with optimism and self-efficacy (p < .001). Degree of exposure to each adverse situation was negatively correlated with resilience in the face of that situation (p < .05), supporting a vulnerability to stress model. The SSRQA has been demonstrated to be a reliable and valid situated measure for resilience towards different adverse contexts.
The aim of this study is to provide an overview of the development of premature children, including attachment, child psychological adjustment and parental variables. 130 children < 1,500 g or < 32 weeks at birth from two public hospitals, assessed at two years corrected age, together with their parents. Parental socio-demographic data was collected. Infant development, attachment and child psychological adjustment were evaluated, as was parental stress. The percentage of preterm children with developmental delays ranged from 5% to 21%. Girls tend to show higher levels of development than boys with effect sizes ranging from small, η2p = .02, to medium, η2p = .07. Secure attachment was the most frequent pattern in the sample. No significant differences, p < .05, between preterm children and the normative population were found on children´s behavioral problems and maternal stress levels. Despite the fact prematurity is considered to be a risk factor for a child´s development, a significant proportion of these children do not show problems in terms of developmental levels, attachment pattern and maternal stress. However, socio-emotional and affective domains, as well as psychological support programs for parenthood, should be followed up from a multidisciplinary perspective.
This paper addresses the feasibility of cross-lingual parsing with Universal Dependencies (UD) between Romance languages, analyzing its performance when compared to the use of manually annotated resources of the target languages. Several experiments take into account factors such as the lexical distance between the source and target varieties, the impact of delexicalization, the combination of different source treebanks or the adaptation of resources to the target language, among others. The results of these evaluations show that the direct application of a parser from one Romance language to another reaches similar labeled attachment score (LAS) values to those obtained with a manual annotation of about 3,000 tokens in the target language, and unlabeled attachment score (UAS) results equivalent to the use of around 7,000 tokens, depending on the case. These numbers can noticeably increase by performing a focused selection of the source treebanks. Furthermore, the removal of the words in the training corpus (delexicalization) is not useful in most cases of cross-lingual parsing of Romance languages. The lessons learned with the performed experiments were used to build a new UD treebank for Galician, with 1,000 sentences manually corrected after an automatic cross-lingual annotation. Several evaluations in this new resource show that a cross-lingual parser built with the best combination and adaptation of the source treebanks performs better (77 percent LAS and 82 percent UAS) than using more than 16,000 (for LAS results) and more than 20,000 (UAS) manually labeled tokens of Galician.
Major depressive disorder (MDD) is a leading cause of disability worldwide.
To examine the: (a) 12-month prevalence of DSM-IV MDD; (b) proportion aware that they have a problem needing treatment and who want care; (c) proportion of the latter receiving treatment; and (d) proportion of such treatment meeting minimal standards.
Representative community household surveys from 21 countries as part of the World Health Organization World Mental Health Surveys.
Of 51 547 respondents, 4.6% met 12-month criteria for DSM-IV MDD and of these 56.7% reported needing treatment. Among those who recognised their need for treatment, most (71.1%) made at least one visit to a service provider. Among those who received treatment, only 41.0% received treatment that met minimal standards. This resulted in only 16.5% of all individuals with 12-month MDD receiving minimally adequate treatment.
Only a minority of participants with MDD received minimally adequate treatment: 1 in 5 people in high-income and 1 in 27 in low-/lower-middle-income countries. Scaling up care for MDD requires fundamental transformations in community education and outreach, supply of treatment and quality of services.
Resiliency personality factors are supposed to underlie resilience. To get evidence on this supposition, the Prince-Embury scales (PES) for adolescents were adapted to the Spanish population. Then, the relationship between the resiliency variables sense of mastery, sense of relatedness and emotional reactivity -assessed with the PES- with resilience -assessed with the Subjective Resilience Questionnaire (SRQ)- were analyzed, as well as the role of social integration within this relationship. Data from 1083 adolescents were analyzed using confirmatory techniques (CFA, PALV). CFA of PES displayed a good fit to the model (CFI: .95). Path-analysis showed that sense of mastery and emotional reactivity predict resilience as expected, but also that, contrary to expectations based on Prince-Embury’s theory, sense of relatedness and resilience are not related, either directly, or through social integration. Being related and socially integrated probably favors well-being, but it may not favor resilience unless associated to Sense of Mastery, at least in adolescence.
A clinical case is presented. The reason for admission was for behavioral disturbances and agitation piscomotriz episode in the street: she had gone to a library to “denounce” the police for entering the subway without paying several times. The patient was very distraught because she was heavily guarded (someone had tapped her phone, entered her house, changed objects place, she was chased down the street…). In the psychopathological examination revealed the sphere of language, her speech was fluid, with pressured speech, full of details, with loss of thread and highlighted the presence of neologisms and grammatical errors (changes of subject and predicate…) and changes some letters by others in the same word. She often used sayings incorrectly and, when you are exploring about this fact, objectively presenting alteration in abstract thinking. In addition, it presents self-references on television. The diagnostic impression was chronic psychotic process of years of evolution. In this case, it was decided to administer intramuscular antipsychotic treatment because she was not aware of the disease but presenting good tolerability profile because, otherwise, leave the track and also a good social functioning was sought. Currently, she continues in mental health, she has not reported new crisis and a progressive scan objective improvement in the organization of thought and speech, leaving the psychotic symptoms.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
This work presents a series of three-dimensional computational methods with the objective of analyzing and quantifying some important structural characteristics in a collection of low-density polyolefin-based foams. First, the solid phase tortuosity, local thickness, and surface curvature, have been determined over the solid phase of the foam. These parameters were used to quantify the presence of wrinkles located at the cell walls of the foams under study. In addition, a novel segmentation technique has been applied to the continuous solid phase. This novel method allows performing a separate analysis of the constituting elements of this phase, that is, cell struts and cell walls. The methodology is based on a solid classification algorithm and evaluates the local topological dissimilarities existing between these elements. Thanks to this method it was possible to perform a separate analysis of curvature, local thickness, and corrugation ratio in the solid constituents that reveals additional differences that were not detected in the first analysis of the continuous structure. The methods developed in this work are applicable to other types of porous materials in fields such as geoscience or biomedicine.
Compacted bentonite barrier in radioactive waste repositories is expected to prevent radionuclide migration, due to its high sorption capability for many radionuclides. This study analyses whether the addition of Al2O3 nanoparticles (NPs) enhances the sorption properties of bentonite. The study was carried out with 109Cd, highly pollutant heavy metal and divalent fission product. Sorption experiments were conducted in NaClO4 at different ionic strengths (5·10-4 to 10-1 M) and pH (2 to 10), using mixtures of sodium homoionised bentonite and Al2O3 in different proportions.
It has been probed that addition of Al2O3 NPs to bentonite enhances Cd sorption at pH higher than 6. The effect of Al2O3 NPs addition on the surface properties of bentonite colloids was also analyzed by measuring particle size and surface charge in all studied systems.
A number of systems based on synthetic molecules, among them cationic liposomes and poly(ethylene imine)-based polymers, have been proposed as delivery vehicles for nucleic acids. Some of these systems have even reached the market, ensuring efficient and transient transfection levels in a variety of cell types. However, toxicity issues have limited their application in vivo. In this context, chitosan, a biocompatible and biodegradable polysaccharide, has been proposed as a promising alternative for the delivery of nucleic acid-based molecules. Here we present an overview of the state of the art of chitosan-based vectors for nucleic acid delivery and the most recent data on the in vivo testing of the proposed systems. We additionally express our view on the barriers that might be hampering the translation of this knowledge into clinical practice and the challenges that need to be fulfilled for these promising vehicles to reach patients.
This study has two objectives, first, to develop and validate the “Emotion and Motivation Self-regulation Questionnaire” (EMSR-Q), and second, to analyze (in the context of the questionnaire validation process) the relationships between self-regulation styles (SRS) rooted in goal orientations, and classroom motivational climate (CMC). A total of 664 Secondary Education students from Madrid (Spain) formed the sample of the study. It was divided randomly in two groups to perform confirmatory factor analysis and to cross-validate the results. Both analyses supported a five first-order factor structure, organized around two second-order factors, “Learning self-regulation style” (LSR) and “Avoidance self-regulation style” (ASR): (χ2/df = 2.71; GFI = .89; IFI = .84; CFI = .84; RMSEA = .07). Hypotheses concerning the relationships between SRS, goal orientations and expectancies are supported by additional correlation and factor analyses. Moreover, several regression analyses supported for the most part of the remaining hypotheses concerning the role of self-regulation styles as predictors of classroom motivational climate (CMC) perception, of change in self-regulation attributed to teacher work, and of students’ satisfaction with this same work. Theoretical and practical implications are discussed.
Land snail shell δ13C value is often used as a paleovegetation proxy assuming that snails ingest all plants in relation to their abundance, and that plants are the only source of carbon. However, carbonate ingestion and variable metabolic rates complicate these relationships. We evaluate if live-collected snails from Lanzarote (Canary Islands) reflect the abundance of C3 and CAM plants. Snails were collected on either CAM or C3 plants for isotope analysis of shell and body, and shell size. Respective shell and body δ13C values of snails collected on CAM plants averaged − 8.5 ± 1.7‰ and − 22.8 ± 1.6‰, whereas specimens from C3 plants averaged − 10.1 ± 0.7‰ and − 24.9 ± 1.1‰. A flux balance model suggests snails experienced comparable metabolic rates. A two-source mass balance equation implies that snails consumed ~ 10% of CAM, which agrees with their abundance in the landscape. Snails collected on CAM plant were smaller than those on C3 plants. Conclusively: 1) snails consume CAM plants when they are available; 2) migration of snails among C3 and CAM plants is a common phenomenon; and 3) C3 plants may be a more energetic food for growth than CAM plants. This study shows that shell δ13C values offer approximate estimates of plants in C3–CAM mixed environments.
We describe an opinion mining system which classifies the polarity of Spanish texts. We propose an NLP approach that undertakes pre-processing, tokenisation and POS tagging of texts to then obtain the syntactic structure of sentences by means of a dependency parser. This structure is then used to address three of the most significant linguistic constructions for the purpose in question: intensification, subordinate adversative clauses and negation. We also propose a semi-automatic domain adaptation method to improve the accuracy of our system in specific application domains, by enriching semantic dictionaries using machine learning methods in order to adapt the semantic orientation of their words to a particular field. Experimental results are promising in both general and specific domains.
The objective of this study is to develop and validate a scale of subjective resilience for students 12–17 years old. Items covered adverse situations due to parents’, peers’ and teachers’ actions. The validation process included the analysis on the generalizability of the factor structure and of relationships of resilience scores with different kinds of protective and vulnerability factors -goal orientations and learning-oriented classroom motivational climate (CMC)-. A total of 471 students answered four questionnaires. Confirmatory factor analyses, reliability analysis and correlation and regression analyses were carried out. Results showed: (a) that factor structure was well defined; (b) that resilience scale had good reliability; (c) that scores correlated as expected with protective-vulnerability factors such as goal orientations and CMC defined by teachers’ teaching-patterns, and (d) that students’ attribution of perceived change in resilience to teachers’ work depended on the degree in which CMC was learning oriented. Theoretical and practical implications are discussed.
Previous community surveys of the drop out from mental health treatment have been carried out only in the USA and Canada.
To explore mental health treatment drop out in the World Health Organization World Mental Health Surveys.
Representative face-to-face household surveys were conducted among adults in 24 countries. People who reported mental health treatment in the 12 months before interview (n = 8482) were asked about drop out, defined as stopping treatment before the provider wanted.
Overall, drop out was 31.7%: 26.3% in high-income countries, 45.1% in upper-middle-income countries, and 37.6% in low/ lower/middle-income countries. Drop out from psychiatrists was 21.3% overall and similar across country income groups (high 20.3%, upper-middle 23.6%, low/lower-middle 23.8%) but the pattern of drop out across other sectors differed by country income group. Drop out was more likely early in treatment, particularly after the second visit.
Drop out needs to be reduced to ensure effective treatment.