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A novel underwater vehicle configuration with an operating principle as the Sepiida animal is presented and developed in this paper. The mathematical equations describing the movements of the vehicle are obtained using the Newton–Euler approach. An analysis of the dynamic model is done for control purposes. A prototype and its embedded system are developed for validating analytically and experimentally the proposed mathematical representation. A real-time characterization of one mass is done to relate the pitch angle with the radio of displacement of the mass. In addition, first validation of the closed-loop system is done using a linear controller.
Methane (CH4) is a greenhouse gas (GHG) produced and released by eructation to the atmosphere in large volumes by ruminants. Enteric CH4 contributes significantly to global GHG emissions arising from animal agriculture. It has been contended that tropical grasses produce higher emissions of enteric CH4 than temperate grasses, when they are fed to ruminants. A number of experiments have been performed in respiration chambers and head-boxes to assess the enteric CH4 mitigation potential of foliage and pods of tropical plants, as well as nitrates (NO3−) and vegetable oils in practical rations for cattle. On the basis of individual determinations of enteric CH4 carried out in respiration chambers, the average CH4 yield for cattle fed low-quality tropical grasses (>70% ration DM) was 17.0 g CH4/kg DM intake. Results showed that when foliage and ground pods of tropical trees and shrubs were incorporated in cattle rations, methane yield (g CH4/kg DM intake) was decreased by 10% to 25%, depending on plant species and level of intake of the ration. Incorporation of nitrates and vegetable oils in the ration decreased enteric CH4 yield by ∼6% to ∼20%, respectively. Condensed tannins, saponins and starch contained in foliages, pods and seeds of tropical trees and shrubs, as well as nitrates and vegetable oils, can be fed to cattle to mitigate enteric CH4 emissions under smallholder conditions. Strategies for enteric CH4 mitigation in cattle grazing low-quality tropical forages can effectively increase productivity while decreasing enteric CH4 emissions in absolute terms and per unit of product (e.g. meat, milk), thus reducing the contribution of ruminants to GHG emissions and therefore to climate change.
The giant gypsum crystals of Naica cave have fascinated scientists since their discovery in 2000. Human activity has changed the microclimate inside the cave, making scientists wonder about the potential environmental impact on the crystals. Over the last 9 years, we have studied approximately 70 samples. This paper reports on the detailed chemical–structural characterization of the impurities present at the surface of these crystals and the experimental simulations of their potential deterioration patterns. Selected samples were studied by petrography, optical and electronic microscopy, and laboratory X-ray diffraction. 2D grazing incidence X-ray diffraction, X-ray μ-fluorescence, and X-ray μ-absorption near-edge structure were used to identify the impurities and their associated phases. These impurities were deposited during the latest stage of the gypsum crystal formation and have afterward evolved with the natural high humidity. The simulations of the behavior of the crystals in microclimatic chambers produced crystal dissolution by 1–4% weight fraction under high CO2 concentration and permanent fog, and gypsum phase dehydration under air and CO2 gaseous environment. Our work suggests that most surface impurities are of natural origin; the most significant anthropogenic damage on the crystals is the extraction of water from the caves.
Tuberculosis (TB) in children is a critical public health issue. In Bohol, Philippines, we found a high tuberculin skin test (TST)-positive prevalence (weighted prevalence = 6.4%) among 5476 children (<15 years) from 184 villages, with geographically isolated communities having prevalence as high as 29%. Therefore, we conducted a geospatial and hot spot analysis to examine the association between villages with high TST-positive prevalence (⩾6.5%) and access to medical care (distance (in kilometres and minutes of travel time) to the municipal Rural Health Units (RHU)), access to healthcare resources (distance to Provincial Health Office (PHO)) and socioeconomic determinants of health. Hot spot analysis revealed significant clusters of TST-positive prevalence in villages farthest from the PHO. Based on univariate analysis, the following variables associated with high prevalence were included in the multivariate model: minutes of travel time to the PHO, distance to the PHO, island villages and total deprivation based on socioeconomic indicators. In the final model, only distance to PHO in minutes was significant (P = 0.005). When evaluated further, greater than 1-hour drive significantly increased risk for TST-positivity (P = 0.003). Distance to healthcare resources likely increases the risk of TB transmission within the community. Expanding TB control efforts to geographically isolated areas is critical.
Precision feeding requires a mathematical model to estimate standardized ileal digestible (SID) lysine (Lys) requirements (SIDLysR) in real time. However, this type of model requires constant calibration updates. The objective of this study was to review the calibration of the model used to estimate the real-time Lys requirements of individual growing-finishing pigs. A digestibility trial (n = 10) was conducted to evaluate amino acids digestibility during the growing and finishing phases. Additionally, 120 pigs were used in two 28-day growth experiments conducted as completely randomized design with growing (25 ± 2.1 kg BW, n = 60; 10 pigs per treatment) or finishing barrows (68.1 ± 6 kg BW, n = 60; 10 pigs per treatment). In each experiment, the pigs were divided into six equal treatment groups and fed 60%, 70%, 80%, 90%, 100% or 110% of their estimated individual SIDLysR. The Lys requirement of each pig was estimated daily using a real-time model. Body composition was measured with dual-energy X-ray densitometry on day 1 and 28 of the experiments. Average daily feed intake increased quadratically (P < 0.05) during both growth phases. Maximum average daily gain (ADG) (0.98 kg) and maximum protein deposition (PD; 170 g/day) were observed in growing pigs fed 100% of the estimated SIDLysR (P < 0.001). During the growing period, PD in BW gain (17% to 19%) and N efficiency (52% to 65%) increased linearly (P < 0.01) with increasing inclusion rates of SID Lys. Finishing pigs had maximum ADG (1.2 kg/day) when they were fed 100% of the requirements. However, the amount of protein in BW gain (13% to 16%) and N efficiency (40% to 55%) increased linearly (P < 0.01) with increasing inclusion rates of SID Lys. In conclusion, the model proposed for precision feeding is correctly calibrated to predict SIDLysR that maximize PD and ADG of average pigs from 25 to 50 kg BW. Still, there is an opportunity to improve the estimation of SIDLysR and N retention in individual pigs by better representing the individual proportion of protein in BW gain and the factors controlling the efficiency of Lys utilization in individual pigs.
Immigrant population has been growing up in Spain in the last decades. The immigration process constitutes a vulnerability factor for the development of psychological issues. Moreover, ethnicity determines a great variability in the symptomatic expression of psychiatric diseases. The objective of this study was to investigate the demographical characteristics and clinical profiles of immigrant patients that visit the emergency services of general hospitals.
An epidemiological study was conducted to evaluate profiles and demographical characteristics of immigrant population attended at the emergency services of the “Hospital 12 de Octubre” Madrid, during 2007. The data were acquired through a protocol developed for this study and applied to all foreign patients attended.
2976 patients were attended during 2007. Immigrant patients were 10% of the sample. There mean age was 29.46 years. 42.1% were men and 57.9% were women. The nationalities of the sample were as follow: 47.8% were Latin American, 23.7% Eastern Europeans, 16.1% were Maghribian and 4.7% were Africans. 48.2% were attended because of suicide attempt (the 59% of Latin Americans and the 54.5% of Eastern Europeans) and 14.3% had psychosis (the 42.9% of Africans and the 36.2% of Maghribians). 30% were diagnosed of a current Substance Use Disorder (the 16.9% of Eastern Europeans).
We found several clinical and demographical differences within the ethnic groups studied. Latin Americans and Eastern Europeans consult for suicide attempt, whereas Maghribians and Africans are attended for psychosis. Psychiatrists should consider cultural and ethnic factors when interviewing foreign population.
Fiction films offer unexplored opportunities of rehabilitation for schizophrenia and other psychoses. Schizophrenia produces deficits y distortions in the perception and comprehension of reality, also expressed in the perception and comprehension of films. After a year of an “ad hoc” experience, the following technique was developed:
1) Selecting a fiction film for its narrative, affective, cognitive and social cognitive content
2) Briefly presenting of the film to a group of 8-16 patients with diverse psychosis.
3) Screening of the film to the patients and the therapeutic team.
4) Summarizing of the plot by a patient. Group correcting of distortions and deficits caused by problems of attention and working memory, as well as positive, negative, affective and social cognitive symptoms (emotional perception, theory of mind, attributive style)
5) Selecting 1-2 sequences by each patient, and group commenting using the same technique.
6) Field recording of all the commentaries obtained.
7) Second screening of the film two days after, repeating points 2 to 6.
8) Comparing both field records.
An experimental study using this technique is presented. 8 patients with schizophrenia and other psychoses watched 4 fiction films (“The 39 Steps”, “Charade”, “M”, “The General”). The differences founded in both viewings by two external evaluators (using CGI and analogical scales of the main variables) are presented and commented. An evaluation of the perceived usefulness and satisfaction of the participants was included.
Comorbidity between Substance Use Disorder (SUD) and other psychiatric disorders, known as Dual Diagnosis, is an issue of growing interest in Mental Health. The high association between Personality Disorders (PD) and substance use is reported in scientific literature. However, not many studies have been published regarding the prevalence of this disorder in a psychiatric unit. AIMSTo determine the prevalence of substance abuse among patients with a Personality Disorder in a psychiatric unit.
A retrospective descriptive study was carried out among all patients admitted to our psychiatric unit during one year. The data collected from the discharge clinical records of patients were: demographic variables, personal psychiatric history and substance use, urine tests and clinical diagnoses at discharge.
We obtained a sample of 334 patients. There was comorbidity between Mental Disorder and SUD in 10.17% of subjects; including 4% diagnosed with Personality Disorder (80% belong to Cluster B). 53.3% of patients with PD substance abuse was reported. Excluding nicotine dependence and benzodiazepines, the most common substances used were cannabis (50%), alcohol (37.5%) and cocaine (25%).
This study shows that Personality Disorder is the Mental Disorder most commonly associated with SUD, among inpatients in our psychiatric unit. In order to detect cases of Dual Diagnosis, we suggest optimize recording in clinical history substance use and systematic urine tests in all patients admitted, which would benefit from specific treatment for their condition.
Fiction films offer unexplored support for rehabilitation in patients with schizophrenia and other psychoses. Schizophrenia produces deficits and distortions in perception and understanding of reality, also expressed in the perception and comprehension of films. After two years of experience “ad hoc” we have designed an experimental case-control study in order to study the effectiveness of the proposed technique compared with conventional “cinema-forum”
20 patients treated at the Psychiatric Day Hospital in Puerta de Hierro Hospital (Majadahonda) will participate in the study. Initially, the researcher will collect information on socio-demographic and clinical data of all participants, as well as a written informed consent. There will be an initial assessment using the following instruments:
- SCIP (schizophrenia cognitive screening)
- Scale GEOPTE (social cognition in schizophrenia)
- Social Functioning Scale (SOFAS, PSP)
- Scale of disease awareness
- IPDE (TP)
- Hamilton Scale (anxiety-depression)
The material used will be the 12 chapters of the first season of TV series “The Sopranos” by David Chase (2004). Specific techniques of cognitive and affective work are compared against a “cinema-forum”. For the evaluation of the effectiveness of the proposed technique, it will be used a measurement tool designed specifically for the activity, which includes:
1. 60 item-Scale, specific on each chapter, evaluating:
Psychotic symptoms in depression are indicators of severity and poor prognosis. It usually requires psychopharmacotherapy with antidepressants and antipsychotic agents and it may even require electroconvulsive therapy (ECT).
To review the indications of ECT in major depression through the study of a clinical case of a patient admitted in an indoor psychiatric unit.
A 64-year-old woman diagnosed as bipolar affective disorder 20 years ago. Her first manic episode required hospitalization. Afterwards, she remained clinically stable for 18 years with pharmacotherapy with lithium. Lately she was admitted due to a major depressive episode with psychotic features (injury delusions, ruin and catastrophe). Antidepressant and antipsychotic treatment was added, improving her symptoms. However, she had to be readmitted two months later with severe psychotic symptoms that did not improve with pharmacological treatment. ECT was added to her treatment. She improved after a few sessions. During the last years, she has presented depressive episodes with psychotic symptoms at least once a year, and all of them have required ECT.
ECT is an alternative to pharmacological therapy in depression with psychotic symptoms in patients with no response to drugs. According to studies and clinical practice, ETC has been effective as we see in this case. Therefore, ECT is a technique to consider in major depression, not only in patients who do not respond to drug therapy but also in those who do not tolerate psychopharmacological, who suffer from severe or psychotic symptoms, suicide thoughts or those, psychomotor agitation or stupor.
Obsessive compulsive disorder (OCD) in childhood was first described by Legrand du Saulle in late XIX century, however, a systematic study in pediatric population was not made until 1986, by Rapoport. It is has been documented in scientific literature that younger patients usually hide their symptoms because of shame or that they do not find their obsessions and compulsions excessive, so that they feel them in an egosyntonic way, delaying diagnosis until several years after their first symptoms.
Aims and methodology
To highlight the specific symptoms in Pediatric OCD and review its treatment and approach through the study of a case report.
A 11-year-old boy was referred by his paediatrician to a child mental outpatient service for behavioural disturbances in the last few months. For the last three years, he had been performing rituals of cleaning, order and checking, increasingly complex and with a significant impact on his life, to the point of not being able to go to school and have other members of his family involved. He also had religious and catastrophic obsessions that generated him important distress. He was treated with high doses of sertraline and low doses of risperidone, and cognitive-behavioral psychotherapy with exposure response prevention and training in relaxation techniques were associated to the treatment. The patient improved partially.
This case illustrates the delay in the diagnosis of Pediatric OCD itself as well as the complexity when treating this disorder.
There is a growing interest in establishing a relationship between several mental disorders and traumatic life events in childhood and adolescence.
It has been seen a high prevalence of these traumatic events when reviewing the clinical history of patients with mental illness.
Measuring the prevalence of traumatic events in a sample of patients with a diagnosis of psychotic disorder.
A retrospective descriptive study was made. The sample comprised 50 patients admitted to our psychiatric inpatient unit. These patients were separated into different categories according to clinical diagnosis and demographic variables. Data was obtained through clinical interview before their hospital discharge. We tried to detect the presence or absence of real or imaginary memories of traumatic events during their childhood or adolescence.
52% of patients had a diagnosis of paranoid schizophrenia. 64% reported a history of substance abuse in their family. 20% referred the experience of having suffered sexual abuse by a member of their family, and up to 44% of them by someone other than family. 22% reported having suffered some kind of physical abuse by their parents, and more than 70% reported having suffered some type of traumatic event in the school environment.
There is an important amount of traumatic events in childhood and adolescence in this sample of patients. However, concluding that such traumatic events could eventually produce severe psychiatric disorders is still quite controversial. In order to understand better the association between childhood trauma and severe mental illnesses more research is needed.
Late-onset psychoses are a heterogeneous group of disorders whose nosology has been controversial throughout history. Several methodological limitations have made difficult the comparison among studies and, as a consequence, the research interest has been little, leading to the absence of late-onset schizophrenia and paraphrenia in current official classifications.
Aims and methodology
To highlight the specific symptoms of late-onset schizophrenia as well as its differences with other psychoses though the study of a case report.
A 70-year-old woman developed psychotic symptoms during the last seven years, consisting of auditory and olfactory hallucinations, telepathic phenomena and injury delusions, erotomania and thought control, with a high level of systematization and fantasy. She was admitted in an inpatient unit. She was treated with risperidone and the psychotic symptoms got better. At the time of hospital discharge, hallucinations and delusional thoughts had disappeared and no behavioral or emotional disorder was observed. Some weeks later, risperidone had to be substituted by paliperidone due to side effects, such as tremor, sialorrhea and parkinsonism.
Late-onset schizophrenic psychosis is not as exceptional as it has been traditionally considered. One of the main problems is that current classifications do not include specific diagnostic categories for cases of late or very-late-onset psychoses. It would be necessary that future ICD-11 and DSM-V classifications will include different-age criteria when diagnosing mental disorders.
The studies about the comorbidity of major depressive disorder (MDD) and bipolar disorder (BD) have increased in the last years. The comorbidity with Axis I psychiatric disorders complicates the diagnosis, prognosis and treatment.
To analyze the prevalence of affective disorders associated with another Axis I psychiatric disorders to treat correctly from the beginning of the diagnosis and to improve the course of the disorder and the quality of life of these patients
The subjects who participated in the study were diagnosed of bipolar I disorder, bipolar II disorder and MDD, according to DSM-IV-TR criteria. The sample (n = 114) was divided into three groups: MDD (n = 58), BD (n = 31) and a control group of healthy subjects (n = 25). The diagnosis and stability were assessed using the MINI International Neuropsyquiatric Interview and the Hamilton Depression Rating Scale (HDRS).
BD had a significantly association with risk of suicide (38%), anxiety disorder (3.3%) and social phobia (12.9%). It was also reported a significant association between MDD and risk of suicide (71%), manic/hypomanic episodes (25.9%), anxiety disorder (37.9%), social phobia (25.9%) and generalized anxiety disorder (37.9%).
It is necessary for clinical practice an integrative model which takes into account the comorbidity of affective disorders to improve the response to treatment and the prognosis of these mental disorders
Insight in schizophrenia shows critical implications for adherence. Non-adherence is particularly relevant in first-episode patients. Few studies have examined insight in early schizophrenia. The aim of this study is to examine relationship between insight, adherence and outcome in patients with early schizophrenia.
Observational study in patients diagnosed for schizophrenia, schizophreniform, or schizoaffective disorder for less than 5 years. Data are collected retrospectively from first psychotic episode to study start, and prospectively (1 year). Association of demographic data, clinical measures, remission, relapses, and adherence with level of insight (Scale to Assess Unawareness of Mental Disorder and G12 item of PANSS) was evaluated. Adherence was assessed interviewing patients and family. Remission was defined according to Remission in Schizophrenia Working Group criteria. Preliminary data are shown.
575 patients have been analyzed. Duration of illness was 3.9±1.6 years. According to G12 item of PANSS, almost 50% of patients had moderate to extreme impairment in baseline insight, while this percentage was 15.8% at 12 mo. (N=291). At baseline, 50% of patients showed good adherence to medication (>80%), and adherence rose to 78% at 12 mo. (N=291). Remission (severity criteria) significantly increased from baseline (23.9%, N=574) to 12 mo. (59.5%, N=291; p<0.0001). A significant relationship between insight and remission at baseline (p<0.001) was found. Among patients who reached 12 mo. visit (N=289), hospitalization was more frequent in those with poor baseline insight.
Lack of insight is common in early schizophrenia and may be a relevant predictor of poor outcome.
One of the problems of many studies and clinical trials is that don’t reflect the patient's opinion about the medication that they receive and their satisfaction.
Objetive and aims
The aim of this study was to assess the degree of outpatients satisfaction with antipsychotic treatment in four outpatients clinics in Mallorca. The adherence rates was estimated from information provided by the patients and their psychiatrists.
A cross.-sectional and descriptive study was conducted during one month, from May to June 2010, by administering several questionnaires to outpatients with psychotic disorders. It was designed a case report data which recorded the following variables: age, gender, diagnosis (schizophreniform, schizophrenia, schizoaffective disorder, delusional, psychotic disorder not otherwise specified), time since diagnosis, substance use, number of antipsychotic drugs, type of antipsychotic (oral and / or im), number of doses per day and number of tablets, via of administration (buttocks or deltoid). The psychometric instruments used were: the Morisky-Green test, Haynes-Sacket test, the MSQ (Medication Satisfaction Questionnaire) and CGI (Clinical Global Impression).
The sample was of 92 patients with a mean age of 42.1 years (SD 12.2): 57.6% male and the most frequent diagnosis was schizophrenia in 65.2%. The duration of treatment from diagnosis was more than 5 years in 66.3%.
The patients on maintenance monotherapy with RLAI showed better adherence rates and more insight, evaluated by their psychiatrits.
78% of patients receiving antipsychotic medication injections were satisfied with the treatment.
Patients with RLAI administrating in deltoid were satisfied in 65.7%.
Recent epidemiological studies suggest that the prevalence of bipolar disorder might be misdiagnosed initially as unipolar depression due to the difficulty to detect episodes of hypomania. The Hypomania Checklist (HCL-32), validated in Spanish, is a self-report questionnaire with 32 hypomania items designed to screen for hypomanic episodes.
To examine the prevalence of hypomania in patients with unipolar depression. Corroborate the efficacy of the HCL-32 to detect symptoms of hypomania.
The presence of hypomanic symptoms was assessed by the HCL-32 in a sample of 128 subjects diagnosed with bipolar I disorder (n = 30), bipolar II disorder (n = 1), unipolar depression (n = 57), and anxiety disorder (n = 15) according to DSM-IV-TR criteria. A control group of healthy subjects was selected (n = 25).
The discriminative capacity was analyzed by the ROC curve. The AUC was 0.65 which did not indicate a good capacity. The sensitivity (S), specificity (E) and prevalence (P) of hypomania in unipolar patients for the following cut-off points were :14: S = 81.6%,95%CI(69.8, 93.5); E = 30.1%,95%CI(19.7,40.6); P = 74.1%; 15: S = 77.6%,95%CI(64.9,90.3); E = 37.4%,95%CI(26.3,48.4); P = 67.2%; 16: S = 59.2%,95%CI(44.4,73.9); E = 55.4%,95%CI(44.1,74.0); P = 51.7%; 17: S = 55.1%,95%CI(40.2,70.1); E = 57.8%,95%CI(46.6,69.1); P = 48.3%.
The HCL-32 has a high sensitivity but a low specificity as screening instrument. This might explain the high proportion of hypomania found in this study. The difference with previous studies is that our sample was heterogeneous, unstable and serious. This suggests that the HCL-32 is not valid for any psychiatric sample. Future research should develop more specific instruments with better external validity.
EUREGENAS (European Regions Enforcing Against Suicide) is a project which has received funding from the European Union under the Public Health Programme 2008–2013. The overall objective of the project is to contribute to the prevention of suicidality (suicidal ideation, suicide attempts and suicide) in Europe through the development and implementation of strategies for suicide prevention at regional level that can be of use to the European Community as examples of good practice.
The project has several workpackages (WP). Our region, Andalusia (Spain) is one of the eleven selected regions associated partners and has been selected for piloting three WPs (number 6, 7 and 8) in a high rate of suicide local area. The aims of the WP's are :
- WP 6: to develop general guidelines for suicide prevention strategies as well as specific prevention packages for the awareness raising on suicide prevention for the identified target groups.
- WP 7: to develop a training package targeting GPs and to pilot the training package in five selected regions/local areas. The main goal of the training is to provide GPs with relevant information related to the early detection/recognition and referral of suicide risk.
- WP8: to develop a specific tool for survivor support groups to support facilitators in ensuring an on-going monitoring of the group processes. This tool will be used in order to map the group status and to adjust the management of the group accordingly.
In our communication we want to show the experience and results of the project in our area.