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The ability to generate memory strategies is a key factor in performance of episodic memory tests. There is evidence about the inefficient use of memory strategies in old adults. However, a question remains unresolved: Worse performance on memory test in the older people is due to an inability to mobilize cognitive strategies or to an episodic memory deficit? In this study we tried to answer it by using the Test of Memory Strategies (TMS), which parametrically reduces the need of executive functions on memory tests. The test consists of five experimental conditions (TMS1–5) where a progressive external organization of the material reduces the need to mobilize memory strategies. TMS was applied to a sample of 180 participants (n = 180) divided into three age groups (25–45; 46–65; 66–85). The results showed an increased performance in all groups groups (F(2, 177) = 14.79, p < .001) across conditions (F(3.88,674.04) = 292.48, p < .001), without group differences in those conditions with a maximum reduction of the need of executive functions (F(7.61,674.04) = 1.95, p = .053). However, middle age and older adults showed more difficulties in establishing cognitive strategies, in the initial conditions. These results lead to the conclusion that the typical pattern of low performance on episodic memory tasks in the older population may be due to the deterioration of executive functions and not mainly to a primary decline of memory process.
In cases of mass-casualty incidents (MCIs), triage represents a fundamental tool for the management of and assistance to the wounded, which helps discriminate not only the priority of attention, but also the priority of referral to the most suitable center.
The objective of this study was to evaluate the capacity of different prehospital triage systems based on physiological parameters (Shock Index [SI], Glasgow-Age-Pressure Score [GAP], Revised Trauma Score [RTS], and National Early Warning Score 2 [NEWS2]) to predict early mortality (within 48 hours) from the index event for use in MCIs.
This was a longitudinal prospective observational multi-center study on patients who were attended by Advanced Life Support (ALS) units and transferred to the emergency department (ED) of their reference hospital. Collected were: demographic, physiological, and clinical variables; main diagnosis; and data on early mortality. The main outcome variable was mortality from any cause within 48 hours.
From April 1, 2018 through February 28, 2019, a total of 1,288 patients were included in this study. Of these, 262 (20.3%) participants required assistance for trauma and injuries by external agents. Early mortality within the first 48 hours due to any cause affected 69 patients (5.4%). The system with the best predictive capacity was the NEWS2 with an area under the curve (AUC) of 0.891 (95% CI, 0.84-0.94); a sensitivity of 79.7% (95% CI, 68.8-87.5); and a specificity of 84.5% (95% CI, 82.4-86.4) for a cut-off point of nine points, with a positive likelihood ratio of 5.14 (95% CI, 4.31-6.14) and a negative predictive value of 98.7% (95% CI, 97.8-99.2).
Prehospital scores of the NEWS2 are easy to obtain and represent a reliable test, which make it an ideal system to help in the initial assessment of high-risk patients, and to determine their level of triage effectively and efficiently. The Prehospital Emergency Medical System (PhEMS) should evaluate the inclusion of the NEWS2 as a triage system, which is especially useful for the second triage (evacuation priority).
First-degree relatives of patients with psychotic disorder have higher levels of polygenic risk (PRS) for schizophrenia and higher levels of intermediate phenotypes.
We conducted, using two different samples for discovery (n = 336 controls and 649 siblings of patients with psychotic disorder) and replication (n = 1208 controls and 1106 siblings), an analysis of association between PRS on the one hand and psychopathological and cognitive intermediate phenotypes of schizophrenia on the other in a sample at average genetic risk (healthy controls) and a sample at higher than average risk (healthy siblings of patients). Two subthreshold psychosis phenotypes, as well as a standardised measure of cognitive ability, based on a short version of the WAIS-III short form, were used. In addition, a measure of jumping to conclusion bias (replication sample only) was tested for association with PRS.
In both discovery and replication sample, evidence for an association between PRS and subthreshold psychosis phenotypes was observed in the relatives of patients, whereas in the controls no association was observed. Jumping to conclusion bias was similarly only associated with PRS in the sibling group. Cognitive ability was weakly negatively and non-significantly associated with PRS in both the sibling and the control group.
The degree of endophenotypic expression of schizophrenia polygenic risk depends on having a sibling with psychotic disorder, suggestive of underlying gene–environment interaction. Cognitive biases may better index genetic risk of disorder than traditional measures of neurocognition, which instead may reflect the population distribution of cognitive ability impacting the prognosis of psychotic disorder.
The bottom of the pyramid (BoP) consists of 1.4 billion people living less than 1.25 USD per day. Fulfilling unmet needs of BoP people involves the design of products as a main activity. Designing products for the BoP faces two main problems. First, there is a general lack of understanding of the needs of users and second, traditional design methods may be limited in addressing the BoP context. Frugal innovation is positioned as a very interesting approach with the potential to adequately respond to the design challenges of the products for the BoP. However, studies in engineering design based on frugal innovation are still limited. In response to these issues, through an analysis and review of the literature, an exploratory mapping of the proposals in frugal innovation and the characteristics of the BoP was conducted. On the basis of the results, this paper defines a set of eight frugal criteria design and an identification of three dimensions that characterize a BoP context and two roles of BoP people. Finally, an association of BoP dimensions and roles with the key criteria of frugal design is proposed.
It is crucial to identify people at risk for type 2 diabetes mellitus (T2DM) and gestational diabetes mellitus (GDM) to implement preventive interventions in order to address these pandemics. A simple score exclusively based on dietary components, the Dietary-Based Diabetes-Risk Score (DDS) showed a strong inverse association with incident T2DM. The objective was to assess the association between DDS and the risk of GDM in a cohort of Spanish university graduates. The ‘Seguimiento Universidad de Navarra’ project is a prospective and dynamic cohort which included data of 3455 women who notified pregnancies between 1999 and 2012. The diagnosis of GDM is self-reported and further confirmed by physicians. A validated 136-item semi-quantitative FFQ was used to assess pre-gestational dietary habits. The development of the DDS was aimed to quantify the association between the adherence to this a priori dietary score and T2DM incidence. The score exclusively included dietary components (nine food groups with reported inverse associations with T2DM incidence and three food groups which reported direct associations with T2DM). Three categories of adherence to the DDS were assessed: low (11–24), intermediate (25–39) and high (40–60). The upper category showed an independent inverse association with the risk of incident GDM compared with the lowest category (multivariate-adjusted OR 0·48; 95 % CI 0·24, 0·99; P for linear trend: 0·01). Several sensitivity analyses supported the robustness of these results. These results reinforce the importance of pre-gestational dietary habits for reducing GDM and provide a brief tool to practically assess the relevant dietary habits in clinical practice.
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.
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.
A thermoset polymer can be used for specific applications by creating a unique chemical composition that is designed for certain characteristic environments. To know the behavior of a thermoset polymer, it is necessary to thermally analyze its behavior during the curing process, as well as its mechanical behavior under certain loads that are applied in its field of application. In this study, the epoxy resin X was created at high temperatures, which there was no record of its thermal or mechanical behavior; the resin was analyzed to determine if it was possible to make a reduction in its curing cycle that was at temperature of 425° F with a time of 24 hours. As a result, through thermal analysis such as Differential Scanning Calorimetry (DSC), rheometry, Thermogravimetric Analysis (TGA) and Dynamic Mechanical Thermal Analysis (DMTA); as well as mechanical analysis, such as stress, hardness and planar cutting tests; it was possible to reduce the curing cycle of resin X, which is used in aerospace generators, from 24 hours at 425 ° F to 8 hours at 425 ° F. In the same way, this reduction of the cure cycle was verified by means of a qualification of a product that involved the reduction of the curing cycle of the epoxy resin obtaining very similar results to the original ones, verifying that the change of curing in the epoxy resin did not affected the functioning of the component. This methodology can be used and applied for the study of thermoset polymers that are used in several industries such as aerospace, automotive, among others.
In January 2006, the Spanish government enacted a tobacco control law that banned smoking in bars and restaurants, with exceptions depending on the floor space of the premises. In January 2011, further legislation in this area was adopted, removing these exceptions. We analyse the effect produced on cigarette sales by these two bans. We approach this problem using an interrupted time series analysis while accounting for the potential effects of autocorrelation and seasonality. The data source used was the official data on legal sales of tobacco in Spain, from January 2000 to December 2015 (excluding the Canary Islands and the autonomous cities of Ceuta and Melilla). As confounder variables, we use the log-transformed average prices for manufactured and hand-rolled cigarettes (or the average minimum excise tax as a proxy), and log-transformed real-household disposable income. The implementation of a total smoke-free ban in Spain was associated with an immediate reduction in cigarette sales between 9% to 11%. In contrast, in the period immediately following the partial ban, no such reduction was detected, beyond the trend already present. Our results indicate that, in Spain, partial bans on smoking in public places failed, and that only a total tobacco ban worked.
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.
During the INDEMARES/CHICA 0610, 0211 and 0412 expeditions, carried out in the northern Spanish sector of the Gulf of Cádiz (Spain), samples were collected with a box-corer in 11 mud volcanoes and their adjacent bottoms. Chemoautotrophic communities were found in nine mud volcanoes. Among Decapoda, a rare eucalliacid, belonging to the genus Calliax and related to the Mediterranean infralittoral species C. lobata (de Gaillande and Lagardère 1966), was present in three of them. Data on its morphology, biogeographic distribution, vertical distribution within the burrows, sediment composition, pH and redox potential values (each in 5 cm intervals) are given; information on the chemoautotrophic communities associated with this species are also provided.
The Panic Disorder Severity Scale (PDSS) is a well-established measure of panic symptoms but few data exist on this instrument in non north-American samples. Our main goal was to assess the psychometric properties (internal consistency, test re-test reliability, inter-rater reliability, convergent and divergent validity) and the factor structure of the Spanish version. Ninety-four patients with a main diagnosis of panic disorder were assessed with the Spanish version of PDSS, the Anxiety Sensitivity Index–3 (ASI-3), the Panic and Agoraphobia Scale (PAS), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-II (BDI-II) the PDSS self-rating form and the Clinical Global Impression-Severity scale (CGI). The Spanish PDSS showed acceptable internal consistency (α = .74), excellent test-retest (total score and items 1–6: α > .58, p < .01) and inter-rater reliability (most intraclass correlation coefficient values for the total score were > .90) and medium to large convergent validity (r = .68, 95% CI [.54, .79], p < .01; r = .80, 95% CI [.70, .87], p < .01; r = .48, 95% CI [.28, .67], p < .01; BAI, PAS and ASI–3 total scores respectively). Data on divergent validity (BDI-II total score: r = .52, 95% CI [.34, .67], p < .01) suggest some need for refinement of the PDSS. The confirmatory factor analysis suggested a two-factor modified model for the scale (nested χ2 = 14.01, df = 12, p < .001). The Spanish PDSS has similar psychometric properties as the previous versions and is a useful instrument to assess panic symptoms in clinical settings in Spanish-speaking populations.
The bryozoan genus Aspidostoma Hincks, 1881 has been regarded as the only representative of the Aspidostomatidae Jullien, 1888 in Argentina to date. Its type species, Aspidostoma giganteum (Busk, 1854), is presently distributed in the Magellanic Region (Argentina and Chile) and has been recorded in Oligocene and Miocene fossil deposits of Santa Cruz and Chubut, respectively. New material from San Julián (late Oligocene), Monte León (early Miocene), Chenque (early to middle Miocene), and Puerto Madryn (late Miocene) formations suggests, however, that A. giganteum is not represented in the fossil record. Material from Puerto Madryn Formation previously regarded as A. giganteum is here recognized as Aspidostoma roveretoi new species. Aspidostoma ortmanni Canu, 1904 is revalidated for the species from the San Julián Formation. Aspidostoma armatum new species and Aspidostoma tehuelche new species are introduced for material from the Monte León and Chenque formations, respectively. Aspidostoma incrustans Canu, 1908, from the early Miocene, is redescribed. Melychocella Gordon and Taylor, 1999, which differs from Aspidostoma in having vicarious avicularia and lacking a median ridge and a quadrangular process proximal to the opesia-orifice, is so far represented by three Paleogene species from the Chatham Islands (Southwest Pacific). The material from Monte León allowed us to transfer Aspidostoma flammulum Canu, 1908 to Melychocella, resulting in the new combination Melychocella flammula (Canu, 1908). Melychocella biperforata new species is described from the lower Miocene Monte León and Chenque formations. The presence of Melychocella in the Neogene of Patagonia extends its geographic distribution and its temporal range.
We present a construction that enables one to find Banach spaces
of norm attaining functionals do not contain two-dimensional subspaces and such that, consequently,
does not contain proximinal subspaces of finite codimension greater than one, extending the results recently provided by Read [Banach spaces with no proximinal subspaces of codimension 2, Israel J. Math. (to appear)] and Rmoutil [Norm-attaining functionals need not contain 2-dimensional subspaces, J. Funct. Anal.272 (2017), 918–928]. Roughly speaking, we construct an equivalent renorming with the requested properties for every Banach space
where the set
for the original norm is not “too large”. The construction can be applied to every Banach space containing
and having a countable system of norming functionals, in particular, to separable Banach spaces containing
. We also provide some geometric properties of the norms we have constructed.