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Private equity-backed companies are ubiquitous and economically significant. Consequently, the corporate governance of these companies matters to all of us, and – not surprisingly – is coming under increasing scrutiny. Simon Witney, a practicing private equity lawyer, positions private equity portfolio companies within existing academic theory and examines the laws that apply to them in the UK. He analyses the actual governance frameworks that are put in place and identifies problems created by the legal rules – as well as the market's solutions to them. This book not only explains why these governance mechanisms are established, but also what they are expected to achieve. Witney suggests that private equity owners have both the incentives and the capability to focus on responsible investment practices. Good governance, he argues, is a critical success factor for the private equity industry.
In this work, a Ti–29Nb–13Ta–4.6Zr–xO Gum Metal with two significantly different oxygen levels (388 and 3570 ppm) was investigated during deformation. The alloys were compressed during in situ high-energy X-ray diffraction using three different strain rates, 10−4, 10−3, and 10−1 s−1, in order to evaluate their influence on phase stability and mechanical properties. The influence of oxygen on the deformation process was also studied. Deformation takes place by twinning, stress-induced, and reverse martensitic transformation and was observed, for some samples, a spinodal decomposition of the β-phase during elastic deformation. The mechanical properties were similar for the different rates employed when considering the same oxygen level. The alloy with a higher amount of oxygen, however, showed a substantial increase in mechanical strength, with a yield strength of around 680 MPa, which is more than three times higher than for the specimen with 388 ppm of oxygen.
Identifying the mechanisms linking early experiences, genetic risk factors, and their interaction with later health consequences is central to the development of preventive interventions and identifying potential boundary conditions for their efficacy. In the current investigation of 412 African American adolescents followed across a 20-year period, we examined change in body mass index (BMI) across adolescence as one possible mechanism linking childhood adversity and adult health. We found associations of childhood adversity with objective indicators of young adult health, including a cardiometabolic risk index, a methylomic aging index, and a count of chronic health conditions. Childhood adversities were associated with objective indicators indirectly through their association with gains in BMI across adolescence and early adulthood. We also found evidence of an association of genetic risk with weight gain across adolescence and young adult health, as well as genetic moderation of childhood adversity's effect on gains in BMI, resulting in moderated mediation. These patterns indicated that genetic risk moderated the indirect pathways from childhood adversity to young adult health outcomes and childhood adversity moderated the indirect pathways from genetic risk to young adult health outcomes through effects on weight gain during adolescence and early adulthood.
Right cerebellar-left frontal (RC-LF) white matter integrity (WMI) has been associated with working memory. However, prior studies have employed measures of working memory that include processing speed and attention. We examined the relationships between the RC-LF WMI and processing speed, attention, and working memory to clarify the relationship of RC-LF WMI with a specific cognitive function. Right superior longitudinal fasciculus II (SLF II) WMI and visual attention were included as a negative control tract and task to demonstrate a double dissociation.
Adult survivors of childhood brain tumors [n = 29, age: M = 22 years (SD = 5), 45% female] and demographically matched controls were recruited (n = 29). Tests of auditory attention span, working memory, and visual attention served as cognitive measures. Participants completed a 3-T MRI diffusion-weighted imaging scan. Fractional anisotropy (FA) and radial diffusivity (RD) served as WMI measures. Partial correlations between WMI and cognitive scores included controlling for type of treatment.
A correlational double dissociation was found. RC-LF WMI was associated with auditory attention (FA: r = .42, p = .03; RD: r = −.50, p = .01) and was not associated with visual attention (FA: r = −.11, p = .59; RD: r = −.11, p = .57). SLF II FA WMI was associated with visual attention (FA: r = .44, p = .02; RD: r = −.17, p = .40) and was not associated with auditory attention (FA: r = .24, p = .22; RD: r = −.10, p = .62).
The results show that RC-LF WMI is associated with auditory attention span rather than working memory per se and provides evidence for a specificity based on the correlational double dissociation.
I present a rationale for two different types of in-patient child psychiatric unit: 24/7 intensive units and 24/5 child and family units. Intensive units address safety requirements. The developing personality of young people is at the centre of in-patient approaches on the child and family units. This requires attachment-informed practice. Families must always be involved and placement of units must facilitate their participation. The primary skill characterising these units is use of the milieu for therapy and combining this with family therapy. In other words, nurses and allied professionals need to be the dominant force in unit development, under the reflective guidance of consultants and clinical psychologists.
At present, analysis of diet and bladder cancer (BC) is mostly based on the intake of individual foods. The examination of food combinations provides a scope to deal with the complexity and unpredictability of the diet and aims to overcome the limitations of the study of nutrients and foods in isolation. This article aims to demonstrate the usability of supervised data mining methods to extract the food groups related to BC. In order to derive key food groups associated with BC risk, we applied the data mining technique C5.0 with 10-fold cross-validation in the BLadder cancer Epidemiology and Nutritional Determinants study, including data from eighteen case–control and one nested case–cohort study, compromising 8320 BC cases out of 31 551 participants. Dietary data, on the eleven main food groups of the Eurocode 2 Core classification codebook, and relevant non-diet data (i.e. sex, age and smoking status) were available. Primarily, five key food groups were extracted; in order of importance, beverages (non-milk); grains and grain products; vegetables and vegetable products; fats, oils and their products; meats and meat products were associated with BC risk. Since these food groups are corresponded with previously proposed BC-related dietary factors, data mining seems to be a promising technique in the field of nutritional epidemiology and deserves further examination.
A group of schizophrenic patients perform well in known theory of mind (ToM) tasks. Still most of them have difficulties to understand social situations in real life.
We used a new test of ToM to find out if this group of patients really have the ability to understand other people´s mental states or they might use some compensatory strategies.
49 schizophrenic patients and 38 matched control inviduals were evaluated. Participants were asked to read short stories and answer simple yes/no comprehension questions. We used three experimental conditions: “false-irony” condition (FI), “control” condition (C), and “false-irony with linguistic help” condition (FIH).
P atients with schizophrenia performed sinificantly worse than control subjects in each of the three conditions (FI:p=0.01;C:p=0.04;FIH:p=0.01). Among the 49 patients 22 did well the FIH tasks (44.89%). Among these 22 patients 12 did the FI tasks well (24.48%) and the other 10 did the FIH tasks well (20.4%).
P atients with schizophrenia performed a sinificant impairment in the new ToM test. Beside a group of patients is able to understand other people´s mental states. To understand these situations some patients probably use real mentalisation strategies, some of them can use the given linguistic help as a compensatory strategy, and some patients have difficulties in representing of the mental states of others.
Irony is a form of speech used to convey feelings in an indirect way. Patients with schizophrenia demonstrated an impaired irony processing, associated with poor theory of mind.
We used fMRI to examine neural circuitry underlying deficits in understanding irony in schizophrenia.
11 right-handed patients with paranoid schizophrenia and 11 right-handed healthy subjects were studied. Participants were asked to listen short scenarios. The 15 irony condition consisted an ironic statement, and the 15 control condition was physical causality. We used an event-related design. Every scenario started with a two sentences long context, followed by a 2-4 s (jittered) inter-stimulus interval. The third, critical ironic sentence appeared next, and finally a simple yes/no comprehension question followed. Between trials an inter-trial interval of 5-7 s (jittered) were used.
The schizophrenic group performed significantly worse in the irony condition than the control group (p=0.0008). Ironic statements resulted in significant activations in the left inferior frontal gyrus (IFG) and insula, right superior and medial frontal gyrus, left postcentral gyrus, posterior division of right superior and left middle temporal gyrus, left lingual gyrus, left cuneus and right inferior parietal lobule in the schizophrenic group. The control group showed significantly greater activity in the left IFG and insula compared to the schizophrenic group.
Among schizophrenic patients we found a significant underactivation in the left IFG and insula during irony comprehension, which may contribute to the impairements of social behavior in schizophrenia.
Theory of mind (ToM) has been proved to play a crucial role in social cognition and functioning. In our study, higher order mentalization performance of euthymic bipolar I patients were compared with that of healthy controls. The impact of demographic data, course of the disorder and patients’ current functioning were also considered while interpreting mentalization data.
The mentalizing performance (computerized faux pas task and false irony task), neurocognitive functioning, and IQ of twenty-three euthymic bipolar I patients and 31 matched (IQ, age) healthy controls were examined. In the patients group, the age at onset, the occurrence of psychotic symptoms, age, education, current employment status, and global functioning were also taken into account.
Bipolar patients scored significantly lower in false irony tasks than healthy controls (p< 0,02). The deficit in irony tasks positively correlated with the number of episodes. Among the examined variables, the performance in the faux pas task predicted most closely the functional outcome in bipolar I disorder. No correlation was found between the ToM and irony deficits and the occurrence of psychotic symptoms, the length of the bipolar disorder or neurocognitive functioning.
Our results showed impaired performance in faux pas and irony tasks, which correlates with the number of previous episodes. Additionally, the impairment of ToM functions predicts a worse functional outcome.
Deficits of social cognition are a relevant predictor of functioning and outcome. Several studies have found that euthymic bipolar patients perform worse in social cognition tasks than healthy controls. Some data show a higher relapse risk in bipolar patients with concomitant mentalization deficits. However, relatively little is known about the neurobiological base of these deficits.
12 euthymic bipolar I patients and 14 age- and IQ-matched healthy controls underwent event-related functional MRI study while performing 15 irony, and 15 control tasks (auditory stimulus) in the scanner. Both within group (irony versus control task) and random effects between group analyses were performed on fMRI data.
Bipolar patients were significantly compromised in their ability to appropriately answer irony tasks. Bipolar patients showed a reduced activation in right cingulate, right anterior paracingulate cortex, right precuneus, left superior parietal lobule, left hippocampus, left insula in comparison to healthy controls. However, bipolar patients brain activation was significantly increased in the left inferior frontal gyrus, left superior temporal gyrus, and left secondary somatosensory cortex.
The findings of this neuroimaging study suggest that euthymic bipolar patients are restricted in their ability to mentalize fully. They show less activation in brain regions involved in mental imaginery, emotional processing and self-representation. Therefore, bipolar patients have difficulties in understanding others’ intentions and emotions, which impacts on interpersonal relationships and the functional outcome.
The objective of the present study was to examine the association of insight into the illness with demographic variables and symptomatology in a sample of 1213 patients with schizophrenia.
Data were collected with the Psychosis Evaluation tool for Common use by Caregivers (PECC), a semi-structured interview evaluating five symptom domains of schizophrenia and the insight items ‘awareness of having a mental disorder’ and ‘attributing symptoms to a mental disorder’.
Insight was positively associated with educational level and inversely with overall symptom severity, and the positive, negative, excitatory and cognitive symptom domains. At symptom level, the items ‘delusions’, ‘grandiosity’, ‘poor rapport’, ‘social withdrawal’ and ‘guilt feelings’ showed the strongest associations with both insight items. Overall, correlations between insight and symptomatology were modest, explaining less than 30% of the variance in insight.
Lack of insight in schizophrenia is partially explained by clinical symptoms and demographic measures.
Irony is a form of speech used to convey feelings in an indirect way. Schizophrenic patients usually demonstrate impaired irony processing, associated with poor theory of mind.
We used fMRI to examine neural circuitry underlying deficits in understanding irony in schizophrenia.
21 schizophrenic patients and 24 healthy subjects were studied. Short scenarios and three conditions were used: irony condition (IC), irony with linguistic help condition (IHC), and control condition (CC). We used event-related design. Scenarios started with a contextual part, followed by a 2–4s ISI. The ironic sentence appeared next, and a question followed. Between trials an ITI of 5–7s were used.
Patients performed significantly worse in the conditions (IC:p = 0.0003;IHC:p = 0.0034;CC:p = 0.0036). In the IC: patients activated the left insula, left anterior cingulum, right and left superior frontal gyrus (SFG), right middle frontal gyrus (MFG) during the contextual part, and activated the left inferior frontal gyrus (IFG), left middle temporal gyrus (MTG) and right superior temporal gyrus during the statement. In the IHC: patients activated the left precuneus, left IFG, left SFG, left and right MFG, right cuneus and left MTG during the context, and activated right SFG and left posterior cingulum during the statement.
Patients probably have an abnormal contextual processing and a missing activation of the theory of mind network during the interpretation of ironic statements. The given linguistic help proved to be efficient help for many patients in processing the context correctly, and in understanding ironic situations more successfully.
This pooled analysis evaluated the predictors of clinical outcome in the short-term treatment of panic disorder.
Data were pooled from 4 randomized, placebo-controlled studies of venlafaxine XR in adult outpatients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) panic disorder with or without agoraphobia (n=1595). Patients were randomly assigned to 10 to 12 weeks' treatment with either placebo or venlafaxine (fixed or flexible dosing, range from 75 mg/d to 225 mg/d). The primary efficacy measure was the proportion of patients free of full-symptom panic attacks at end point. Predictors included panic severity (<8 or ≥8 full-symptom panic attacks during each 2 week period in the 4 weeks prior to baseline) and gender. Other predictors included panic disorder, clinical global impressions, anxiety, somatic and psychic anxiety, depression, mood, phobias, fear, and avoidance.
In both the active treatment and placebo groups, males (65% and 50%, respectively) and those with low symptom severity (69% and 53%, respectively) were significantly (P<0.05) more likely to be panic-free at end point. For nearly all baseline ratings on clinical measures, greater symptom severity was associated with lower proportions of patients who were free from full-symptom panic attacks at end point. Change scores showing improvement in symptom severity following treatment were associated with higher proportions of patients who were free from full-symptom panic attacks at end point.
Panic-free status at end point was predicted by gender, panic disorder severity, and most baseline and change scores of clinical ratings scales.
Post-Traumatic Stress Disorder (PTSD) affects nearly 10% of soldiers leaved waging war. So far, there is no standard treatment for PTSD. The selective serotonin reuptake inhibitors (SSRIs) are considered the first-line pharmacological treatment for PTSD. However, response rates rarely exceed 60% and less than 20-30% of the patients achieve full remission. Excessive brain responsiveness to norepinephrine appears to play a significant role in the onset of PTSD. A brain active alpha- 1 adrenergic receptor antagonist used to treat benign prostatic hypertrophy and hypertension, prazosin, is of major interest and might become the main therapeutic treatment for PTSD.
Objective and methods
In order to further assess the therapeutic efficacy of prazosin, the present review analyzes the results of Medline-referenced outcome studies conducted.
Confirm the therapeutic efficacity of prazosin in the PTSD.
These studies concern 99 patients included in five clinical trials ran from 2004 to 2008. 24% of the patients have been exposed to civilian trauma and 76% to war trauma. Prazosin significantly (p< 0.05 versus controls) decreases trauma nightmares, distressed awakening, avoidance, sleep disturbance, hyper-arousal, re-experiencing and improves global clinical status in all studies. From a statistical point of view, any significant difference of blood pressure was observed at the end of trials.
Beyond the methodological biases, the present review confirms the effectiveness of prazosin in reducing overall PTSD illness severity and distress. Studies of longer duration in larger samples are necessary to confirm these preliminary findings.
The endophenotype concept of schizophrenia represents an important approach in the exploration of the neurobiology of the illness. An important characteristic of an endophenotype, that it can be found among the healthy, first-degree relatives of patients with schizophrenia.
We evaluated two systematic reviews of studies on two potential endophenotypes (theory of mind and informative morphogenetic variants) to confirm the possibility of them as biological and cognitive markers of the illness.
We planned to explore data from theory of mind and informative morphogenetic variant studies among the relatives of schizophrenia patients.
We evaluated two researches of studies published in PubMed, Medline,Web of Science and PsycINFO between the period of 1968 and 2014 (informative morphogenetic variants studies) and 1980 and 2014 (theory of mind studies).
11 studies on the appearence of informative morphogenetic variants in the relatives of schizophrenia patients were found with mixed results, while 15 studies and two meta-analyses were analysed on theory of mind studies among the first-degree relatives of patients with schizophrenia,the exploration of the latter studies showed also diverse findings.
Futher research is needed to clarify theory of mind and informative morphogentic variant alternations as endophenotypic markers of schizophrenia.
Acknowledgement: This study was supported by the National Brain Research Program Grant no. NAP KTIA NAP-A-II/12.
In the United States of America, lifetime prevalence of the post-traumatic stress disorder (PTSD) varies between 8 and 11 %. The pathophysiology of PTSD is complex, involving the prefrontal cortex, the limbic system which amygdala and the locus coeruleus. We don’t have a specific treatment for this pathology but just a symptomatic treatment.
Objectives and methods
The present review analyzes the results of referenced outcome studies in Medline. The efficacity of prazosin, an alpha-1 adrenergic antagonistis is an evidence to this deregulation.
Confirm the hypothesis of a noradrenergic dysregulation in PTSD.
Of share its projections with the amygdale, the hippocampus and the prefrontal cortex and the reticular formation, the locus coeruleus is one of the main brain noradrenergic structure. It regulates the vigilance and attention in the alert situations and regulates the fear and anxiety. The locus coeruleus regulates the wakefulness-sleep cycle with this projection with the raphe nuclei and the paraventricular nuclei of hypothalamus. During a stress, activation of locus coeruleus causes a release of norepinephrine responsible for symptoms of avoidance, hyper-arousal, re-experiencing and trauma nightmares. Prazosin, significantly decreases the main clinical symptoms of PTSD and improve global clinical status to placebo in all studies. This results constitutes a harmul evidence to the implication of norepinephrine in the PTSD.
Norepinephrenine is a major actor in the pathophysiology of PTSD. The prazosin is led to become the first-line treatment of PTSD but longer studies in larger samples are necessary to confirm these preliminary findings.
Social functioning is often impaired in patients with chronic schizophrenia and contribute to the poor outcome of the illness. It is unclear how much of this social impairment can be attributed to residual symptomatology and how much to cognitive impairment, often present in patients with schizophrenia. In the present study, the relationships between social functioning, psychopathological remission and cognitive deficits were investigated in 148 subjects with chronic schizophrenia or schizoaffective disorder.
A comprehensive neuropsychological battery was used to assess general cognitive abilities, attention, secondary verbal and visuospatial memory and executive functions. To assess social functioning we used four indices for global social disability, interpersonal relationships, intrapsychic functions and work functioning. Patients were divided in remitted or not remitted according to the criteria proposed by Andreasen. Multiple regressions analyses were carried out, in which the dependent variables were the indices of social functioning while independent variables were remission status, neuropsychological indices, duration of illness, age and education.
The results of multiple regression analyses showed that secondary memory explained 10.6% of the variance for the global disability index, 8% for “intrapsychic functions” 5.8% for “interpersonal relationships” and 4% for “work functioning”; the index of attention explained 2.6% of the variance for the global disability index; the remission status explained 4.6% of the variance for the “intrapsychic functions” index.
Our findings suggest that cognitive impairment is an important feature of schizophrenia and that its relationship with social functioning is independent from and stronger than those between psychopathology and social functioning.
Les effets cliniques de l’intoxication alcoolique aiguë seraient liés à une modulation des systèmes de neurotransmission du GABA et du glutamate. Les caractéristiques longitudinales de cette modulation et l’impact de la dose d’éthanol absorbée restent mal connus. Nous avons voulu étudier in vivo les effets aigus de l’éthanol sur les niveaux de GABA et de glutamate du cortex préfrontal en spectroscopie par résonance magnétique (SRM).
Matériel et méthodes
Après une première acquisition de SRM (zone préfrontale), trois groupes de rats Wistar mâles (363 ± 27 g) ont reçu par voie intrapéritonéale (IP) :
– éthanol 1 g/kg (n = 6) ;
– éthanol 2 g/kg (n = 8) ;
– sérum physiologique (n = 5).
Des acquisitions répétées de SRM ont été réalisées jusque 300 minutes post-injection. Une cinétique de l’éthanolémie a également été réalisée dans des groupes similaires de rats Wistar. Après alcoolisation par voie IP, des prélèvements sanguins successifs ont été réalisés jusque 180 minutes pour le groupe 1 g/kg (n = 6) et 300 minutes pour le groupe 2 g/kg (n = 14). Pour la SRM, des analyses statistiques inter- et intragroupes ont été effectuées à l’aide d’un modèle linéaire mixte visant à étudier la variation des taux de GABA et glutamate.
La cinétique de l’éthanolémie était superposable à celle de la cinétique cérébrale. En SRM, une diminution significative du GABA, de 11,4 % ± 3,8 % (p < 0,0059) dans le groupe 1 g/kg et du glutamate de 13,8 % ± 2,6 % dans le groupe 2 g/kg (p < 0,0001) ont été observées, sans modification significative dans les autres groupes. La variation du ratio GABA/glutamate s’est montrée différente entre les deux groupes éthanol avec une augmentation dans le groupe 2 g/kg et une diminution dans le groupe 1 g/kg (p < 0,01).
La dose d’éthanol détermine les variations des niveaux de GABA et de glutamate du cortex préfrontal, pouvant expliquer les différents effets cliniques induits par l’alcool selon la dose.