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Epidemiological studies have reported that the increased risk of developing psychosis in cannabis users is dose related. In addition, experimental research has shown that the active constituent of cannabis responsible for its psychotogenic effect is Delta-9-Tetrahydrocannabinol (THC) (Murray et al, 2007). Recent evidence has suggested an increased in potency (% TCH) in the cannabis seized in the UK (Potter et al, 2007).
We predicted that first episode psychosis patients are more likely to use higher potency cannabis and more frequently than controls.
We collected information concerning socio-demographic, clinical characteristics and cannabis use (age at first use, frequency, length of use, type of cannabis used) from a sample of 191 first-episode psychosis patients and 120 matched healthy volunteers. All were recruited as part of the Genetic and Psychosis (GAP) study which studied all patients who presented to the South London and Maudsley Trust.
There was no significant difference in the life-time prevalence of cannabis use or age at first use between cases and controls. However, cases were more likely to be regular users (p=0.05), to be current users (p=0.04) and to have smoked cannabis for longer (p=0.01). Among cannabis users, 86.8% of 1st Episode Psychosis Patients preferentially used Skunk/Sinsemilla compared to 27.7% of Controls. Only 13.2 % of 1st Episode psychosis Patients chose to use Resin/Hash compared to 76.3% of controls. The concentration of TCH in these in South East London, ranges between 8.5 and 14 % (Potter et al, 2007). Controls (47%) were more likely to use Hash (Resin) whose average TCH concentration is 3.4% (Potter et al, 2007).
Patients with first episode psychosis have smoked higher potency cannabis, for longer and with greater frequency, than healthy controls.
We report here three clinical cases as exemples of our rich and frequent collaboration between the department of psychiatry and the department of medecine, nephrology and hemodialysis. This work can serve as a basis for further reflection in order to improve mutual demands. We based our description on three patients chosen for their homogeneity in demand, rapidity of evaluation, the same clinician who evaluated the demand. Either case: a 42-year-old woman, who was admitted for alteration of general state, severe headaches and chronic addiction to alcohool, 71-year-old woman sufferring from recurrent unipolar depression who came for somatic exploration and severe weight loss or 55-year-old man who was transferred from cardio-pulmonary intensive care unit after a volontary ingestion of neuroleptic- were reevaluated by the psychiatrist and the special follow-up was indicated as the patient was discharded from internal medecine department. We were interested in studying how important to the patient this indication turned to be on time.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Background: SMA is characterized by reduced levels of survival of motor neuron (SMN) protein from deletions and/or mutations of the SMN1 gene. While SMN1 produces full-length SMN protein, a second gene, SMN2, produces low levels of functional SMN protein. Risdiplam (RG7916/RO7034067) is an investigational, orally administered, centrally and peripherally distributed small molecule that modulates pre-mRNA splicing of SMN2 to increase SMN protein levels. Methods: FIREFISH (NCT02913482) is an ongoing, multicenter, open-label operationally seamless study of risdiplam in infants aged 1–7 months with Type 1 SMA and two SMN2 gene copies. Exploratory Part 1 (n=21) assesses the safety, tolerability, pharmacokinetics and pharmacodynamics of different risdiplam dose levels. Confirmatory Part 2 (n=40) is assessing the safety and efficacy of risdiplam. Results: In a Part 1 interim analysis (data-cut 09/07/18), 93% (13/14) of babies had ≥4-point improvement in CHOP-INTEND total score from baseline at Day 245, with a median change of 16 points. The number of infants meeting HINE-2 motor milestones (baseline to Day 245) increased. To date (data-cut 09/07/18), no drug-related safety findings have led to patient withdrawal. No significant ophthalmological findings have been observed. Conclusions: In FIREFISH Part 1, risdiplam improved motor function in infants with Type 1 SMA.
Introduction: Insufficient analgesia affects around 50% of emergency department patients. The use of a protocol helps to reduce the risk of oligoanalgesia in this context. Our objective was to describe the feasibility and efficacy of a multimodal analgesia protocol (combining paracetamol, oxycodone, and inhaled low-dose methoxyflurane) initiated by triage nurse. Methods: We performed a prospective, observational study in the emergency department at Grenoble Alpes University Hospital (Grenoble, France) between October 2017 and April 2018. Non severe adult trauma patients with a numerical pain rating scale (NRS) score ≥4 and receiving MEOF were included. The primary efficacy criterion was the proportion of patients with an NRS score ≤3 at 15min post-administration. Pain intensity was measured for 60 min as well as during radiography. Data on adverse events and satisfaction were also recorded. Data are presented as median [interquartile (IQR)] and were compared using non parametric tests. Results: A total of 200 adult patients were included (age: 32 [IQR: 23–49] years; 126 men (63%)). Patients presented at triage with a pain score of 7 [IQR: 6-8]. Sixty-six patients (33%) reported an NRS score ≤3 at 15 min post-administration. The time required to achieve a decrease of at least 2 points in the NRS score was 10 [IQR 5–20] min. The pain intensity was 4 [IQR: 2–5] before radiography and 4 [IQR: 2–6] during radiography. Adverse events were frequent (n = 128, 64%), mainly dizziness. No serious adverse events were reported and 89% of minor adverse events resolved at one hour. Both patients and health care providers reported good levels of satisfaction. Conclusion: The administration of a nurse-driven multimodal analgesia protocol combining paracetamol, oxycodone, and low-dose methoxyflurane was feasible on triage. It rapidly produced long-lasting analgesia in adult trauma patients.
The acoustics of a straight annular lined duct containing a swirling mean flow is considered. The classical Ingard–Myers impedance boundary condition is shown not to be correct for swirling flow. By considering behaviour within the thin boundary layers at the duct walls, the correct impedance boundary condition for an infinitely thin boundary layer with swirl is derived, which reduces to the Ingard–Myers condition when the swirl is set to zero. The correct boundary condition contains a spring-like term due to centrifugal acceleration at the walls, and consequently has a different sign at the inner (hub) and outer (tip) walls. Examples are given for mean flows relevant to the interstage region of aeroengines. Surface waves in swirling flows are also considered, and are shown to obey a more complicated dispersion relation than for non-swirling flows. The stability of the surface waves is also investigated, and as in the non-swirling case, one unstable surface wave per wall is found.
This paper gives a modified Myers boundary condition in swirling inviscid flow, which differs from the standard Myers boundary condition by assuming a small but non-zero boundary layer thickness. The new boundary condition is derived and is shown to have the correct quadratic error behaviour with boundary layer thickness and also to agree with previous results when the swirl is set to zero. The boundary condition is initially derived for swirling flow with constant azimuthal velocity, but easily extends to radially varying swirling flow, with terms depending on the boundary layer model. The modified Myers boundary condition is then given in the time domain rather than in the frequency domain. The effect of the boundary layer profile is then considered, and shown to be small compared to the boundary layer thickness. The boundary condition is then used to analyse the eigenmodes and Green’s function in a realistic flow. Modelling the thickness of the boundary layer properly is shown to be essential in order to get accurate results.
Documenting past changes in the East Antarctic surface mass balance is important to improve ice core chronologies and to constrain the ice-sheet contribution to global mean sea-level change. Here we reconstruct past changes in the ratio of surface mass balance (SMB ratio) between the EPICA Dome C (EDC) and Dome Fuji (DF) East Antarctica ice core sites, based on a precise volcanic synchronization of the two ice cores and on corrections for the vertical thinning of layers. During the past 216 000 a, this SMB ratio, denoted SMBEDC/SMBDF, varied between 0.7 and 1.1, being small during cold periods and large during warm periods. Our results therefore reveal larger amplitudes of changes in SMB at EDC compared with DF, consistent with previous results showing larger amplitudes of changes in water stable isotopes and estimated surface temperature at EDC compared with DF. Within the last glacial inception (Marine Isotope Stages, MIS-5c and MIS-5d), the SMB ratio deviates by up to 0.2 from what is expected based on differences in water stable isotope records. Moreover, the SMB ratio is constant throughout the late parts of the current and last interglacial periods, despite contrasting isotopic trends.
Thin GaAs photovoltaic heterostructures are grown by MOCVD with various p-GaAs
base thicknesses. The total n/p absorbing thickness is varied systematically.
Output voltages up to ∼1.155V were obtained for individual n/p
junctions at an average illumination intensity of ∼8W/cm2.
Novel phototransducer devices are then achieved with a vertical epitaxial
heterostructure architecture, monolithically integrating 5 or more such thin n/p
junctions. Around the design wavelength, the stacked heterostructure design is
yielding an optimal external quantum efficiency approaching unity divided by the
number of junctions. The modeled and measured conversion efficiencies are
exceeding 60%. The photocarrier extraction properties are simulated for
different junction thicknesses using a model based on a 3-dimensional (3D)
radially-symmetric TCAD implementation of the heterostructures. The study
clearly demonstrates that for such thin n/p junctions the photocarrier
extraction can still be efficient due to the operation at reduced current
densities and higher voltages in heterostructures enhancing electrical power
extraction. With the supplementary add-on of a window layer with a reduced sheet
resistance for the stacked structure, we demonstrate the possible efficient
operation of phototransducers for optical inputs exceeding 150 W/cm2,
even for the case of devices designed without gridlines.
Defect structures in Rubidium Titanyl Phosphate (RTP) crystals (non-doped and doped) grown by the Top Seeded Solution Growth (TSSG) method were characterized using Synchrotron White Beam X-ray Topography. Main defects observed in non-doped crystals are growth sector boundaries while both growth sector boundaries and growth striations are observed in the Nb single doped and (Nb,Yb)-codoped crystals with relatively few linear defects such as dislocations. Results show that the overall crystalline quality is lowered as more doping elements are incorporated. Details of defect distributions are correlated with the growth process to facilitate high quality growth of doped RTP.
The origin of solar energetic particle (SEP) events is an issue for the understanding of particle acceleration and transport in astrophysics, as well as for space weather. We outline some recent studies addressing from the observational viewpoint the relationship between interacting and escaping particles, conditions for particle escape from the Sun, and the interplanetary magnetic field configurations where the particles propagate.
Early Intervention in Psychosis Services (EIS) for young people in England experiencing first-episode psychosis (FEP) were commissioned in 2002, based on an expected incidence of 15 cases per 100 000 person-years, as reported by schizophrenia epidemiology in highly urban settings. Unconfirmed reports from EIS thereafter have suggested higher than anticipated rates. The aim of this study was to compare the observed with the expected incidence and delineate the clinical epidemiology of FEP using epidemiologically complete data from the CAMEO EIS, over a 6-year period in Cambridgeshire, for a mixed rural–urban population.
A population-based study of FEP (ICD-10, F10–39) in people aged 17–35 years referred between 2002 and 2007; the denominator was estimated from mid-year census statistics. Sociodemographic variation was explored by Poisson regression. Crude and directly standardized rates (for age, sex and ethnicity) were compared with pre-EIS rates from two major epidemiological FEP studies conducted in urban English settings.
A total of 285 cases met FEP diagnoses in CAMEO, yielding a crude incidence of 50 per 100 000 person-years [95% confidence interval (CI) 44.5–56.2]. Age- and sex-adjusted rates were raised for people from black ethnic groups compared with the white British [incidence rate ratio (IRR) 2.1, 95% CI 1.1–3.8]. Rates in our EIS were comparable with pre-EIS rates observed in more urban areas after age, sex and ethnicity standardization.
Our findings suggest that the incidence observed in EIS is far higher than originally anticipated and is comparable to rates observed in more urban settings prior to the advent of EIS. Sociodemographic variation due to ethnicity and other factors extend beyond urban populations. Our results have implications for psychosis aetiology and service planning.
Airborne 137Cs level in France is not decreasing significantly anymore (mean yearly value around 0,25 µ Bq.m-3 contrarily to what was noticed in the past decades. This observation points out the role of processes that delay the atmospheric cleaning and participate to the persistence of radionuclide in the air at ground-level after a deposit, in the frame of medium as well as long-dated post-accidental contexts. The current background level also yields to consider 137Cs in the atmosphere as a tracer of atmospheric processes like resuspension and re-emission from biomass burnings. This allows us to explain 2/3 of the peaks observed over the last six years. The remaining 1/3 is mainly noticed in winter when spreading of pollutants in the atmosphere is often weak due to temperature gradient inversion. On average, continental air masses are responsible for increases by a factor of 3 while oceanic air masses are characterised by levels 3 times lower, compared to the mean value. Feeding of 137Cs in air at ground-level is the result of both local resuspension that signs 137Cs activity levels in soils to which is added a remote contribution from time to time (resuspension of Saharan dust or re-emission from fires occurring in eastern territories with high 137Cs deposition level). Finally, 137Cs activity levels in air masses crossing over France can be described on average by a longitudinal gradient.
Quasi-monoenergetic electron beams of energies 12 MeV to over 200 MeV are generated from both nitrogen and helium gas targets with 7TW laser pulses. Typically nitrogen gas interactions lead to electron bunches in the range of 12 to 50 MeV varying from shot to shot. Helium gas leads to higher energy electron bunches from 25 to 100 MeV. Occasionally exceptionally high energy bunches of electrons up to 200 MeV are observed from nitrogen and helium. Initial full two-dimensional simulations indicate the production of 20–30 MeV electron energy bunches for the typical interaction conditions as the electrons are injected from wave breaking in the plasma wake behind the laser pulse and injected into the strong electric field gradient propagating with the optical pulse. This is consistent with the experimental observations from the majority of shots. Pulse compression during propagation in the high density plasma does not allow the threshold conditions for the full bubble regime to be reached. However, the electric acceleration field in the wakefield cavity is still sufficient to lead to the formation of a bunch of electrons with an energy peak in the range of 20 to 30 MeV. In order to explain the occasional high energy shots most likely a lower density channel created by the laser prepulse may occasionally form a natural low density electron guide channel giving ideal conditions for acceleration over much longer lengths leading to the high energies observed.
The purpose of this paper is to give a rapid overview of the recent developments in the field of X-ray diffraction on polycrystalline materials from the viewpoint of the instruments. After a brief historical report, the main types of laboratory diffractometers are presented. At the end of the twentieth century the apparition of position sensitive detectors and artificial crystal monochromators have induced the conception of new diffractometer often based on old geometrical arrangements. Those modern diffractometers are described with respect to the more conventional ones. Among the experimental parameters which can characterize a given diffractometer, the instrumental resolution function and the acquisition time of the pattern are of primary importance. The different apparatus are compared with respect to those two parameters.
The experimental determination of the iron losses created
in a localized zone of an electric machine is a difficult operation. We try
to verify and to valid by local thermal measurements the sum of local iron
losses. To realize our verification, we determine the optimal measurement
conditions by calculation and simulation before the realization of a
prototype specially designed for this operation. This structure represents a
part of an electric machine, with emphasis on inhomogeneous flux
distribution areas. This device permits to obtain an experimental
temperature mapping which is compared to the calculated temperature
distribution obtained by finite elements modelling.
Les longues séries temporelles d'observation de la radioactivité dans l'atmosphère
(au niveau du sol) permettent d'étudier l'évolution de ce réservoir après les injections des expérimentations nucléaires militaires, de l'activité industrielle, ou suite
aux accidents tel que celui de Tchernobyl (1986). Conjointement à l'observation des
radionucléides d'origine artificielle, les radionucléides formés par l'interaction du
rayonnement cosmique dans la haute atmosphère, comme 7Be, sont quantifiés. La
corrélation entre les composantes naturelles et artificielles permet de mieux comprendre l'évolution globale de la radioactivité dans l'atmosphère. L'observatoire de
la radioactivité dans l'atmosphère de l'Institut de radioprotection et de sûreté
nucléaire (IRSN) a débuté en 1959. Actuellement les aérosols sont prélevés dans
6 stations localisées en Métropole et dans 2 stations en Outre-mer (hémisphère sud).
Les concentrations de 137Cs dans les aérosols en 2002 sont de l'ordre de 0,4 μBq m-3
en métropole et 10 fois moins à Tahiti. Les activités du 7Be, de l'ordre de
3 200 μBq m-3, sont similaires en métropole et à Tahiti.
We consider a specific accumulation event that occurred in January 2002 in western Dronning Maud Land, Antarctica. Snow samples were obtained a few days after accumulation. We combine meteorological analyses and isotopic modelling to describe the isotopic composition of moisture during transport. Backward trajectories were calculated, based on European Centre for Medium-Range Weather Forecasts operational archive data so that the history of the air parcels transporting water vapour to the accumulation site could be reconstructed. This trajectory study showed that the air masses were not (super)saturated along most of the transport path, which is in contrast with assumptions in Lagrangian fractionation models and probably true for most precipitation events in Antarctica. The modelled fractionation along the trajectories was too limited to explain the measured isotopic content of the snow. It is shown that the observed isotopic composition of precipitation resulted from fractionation of initially more depleted water. This lower initial isotopic composition of water vapour might result from atmospheric mixing with more depleted air along the trajectory or from earlier condensation cycles, not captured by the trajectories. This is in accordance with isotope fields resulting from general circulation models, indicating a gradient in isotopic composition from the Equator to Antarctica.
The epitaxial growth of KTiOPO4 (KTP) films on different natural faces of KTi1-xGexOPO4 substrates was studied. The growth on faces (100) and (201) is generally of high quality, irrespective of the growth time or concentration of germanium in the substrates. On the other hand, the epitaxial growth on the face (101) is always of poor quality, and the defects are pyramids, even when the germanium content in the substrate is low and the growth time is short. The films on faces (011) and (110) generally have small hillocks as defects and for high concentrations of Ge in the crystals some cracks begin to appear. The film thickness, depending on the growth time and the face considered was measured by scanning electron microscopy (SEM) using backscattered electrons. The diffusion of germanium from the substrate to the film is very low, as demonstrated by electron probe microanalysis measurements and SEM observations. The difference in the refractive indices ny and nz of KTP and KTi0.92Ge0.08OPO4 are on the order of 0.01, which could be enough to produce wave guides. Finally, it was observed that the second harmonic generation response of KTP substituted with Ge decreases as the Ge content in the crystal increases.
The dominant theme that emerges is that there is more than one plausible explanation for any slightly mysterious phenomenon (such as the arrival and spread of cholera or yellow fever), that these contending plausible explanations often have radically different implications for public action, and that societies are reluctant to undertake costly or even inconvenient actions on the basis of contending theories of uncertain merit.
(Cooper, 1989, pp. 180–181).
It is not surprising that the increasing turmoil in global financial markets has stimulated interest in models with multiple equilibria, where the jumps between equilibria are triggered by extraneous events. What has seemed most striking about the crises in the mid– to late 1990s is that their timing and virulence seem quite unrelated to the fundamental problems facing the countries and markets concerned. For instance, though the crisis in Mexico in 1994–1995 seems to have among its causes an overvalued exchange rate and a large current account deficit, the devaluation of December 1994, which should have served to help solve these problems, instead led to a loss of confidence, a free‐fall of the exchange rate, and the prospect of a massive default on exchange–rate– linked foreign debt, the tesobonos.
In addition, crises have triggered severe attacks on other currencies, where the trade and capital flow linkages between countries have been weak. This includes the contagion from Mexico to Argentina and Brazil, the contemporaneous crises in many East Asian countries in 1997, and the rippling effects of the Russian default in August 1998 on many emerging markets and even on U.S. corporate debt and mortgage backed securities spreads, resulting in a severe liquidity crisis that nearly brought down the hedge fund Long–Term Capital Management (LTCM).
Many taxonomic distinctions are made or refined on the basis of herbarium material that is either dried or preserved in spirit medium. Hitherto, examination of internal structure has only been possible by the destructive sectioning of the preserved material. In this paper, the use of nuclear magnetic resonance (NMR) imaging for the non-destructive, non-invasive, complete three-dimensional structural examination of herbarium material is demonstrated for the first time. The experimental materials were the fruiting structures of two species of Southern Hemisphere Podocarpaceae: Acmopyle pancheri and Podocarpus nivalis. Material dried in accordance with standard herbarium techniques was used, as well as material preserved in spirit and freshly gathered fruits. The dried material was subsequently rehydrated using standard techniques, and protocols established for the specimens. Appropriate selection of NMR imaging parameters allowed a variety of anatomical features to be highlighted on a single specimen. Fresh specimens from living material gave the best NMR signals. Dry specimens gave no signal except from the lipid in the seed, but when rehydrated the images yielded almost as much information about internal structure as did a fresh specimen of the same taxon. Thus, NMR imaging has great potential value as a non-invasive method for obtaining details of the internal structure of fruits and seeds and is particularly useful when, as in the case of Acmopyle, the sclerotesta of the seed is too lignified for sectioning by conventional methods.