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Describe and validate the CHROME (CHemical Restraints avOidance MEthodology) criteria.
Observational prospective longitudinal study.
Single nursing home in Las Palmas de Gran Canaria, Spain.
288 residents; mean age: 81.6 (SD 10.6). 77.4% had dementia.
Multicomponent training and consultancy program to eliminate physical and chemical restraints and promote overall quality care. Clinicians were trained in stringent diagnostic criteria of neuropsychiatric syndromes and adequate psychotropic prescription.
Psychotropic prescription (primary study target), neuropsychiatric syndromes, physical restraints, falls, and emergency room visits were semi-annually collected from December 2015 to December 2017. Results are presented for all residents and for those who had dementia and participated in the five study waves (completer analysis, n=107).
For the study completers, atypical neuroleptic prescription dropped from 42.7% to 18.7%, long half-life benzodiazepines dropped from 25.2% to 6.5%, and hypnotic medications from 47.7% to 12.1% (p<0.0005). Any kind of fall evolved from 67.3 to 32.7 (number of falls by 100 residents per year). Physicians’ diagnostic confidence increased, while the frequency of diagnoses of neuropsychiatric syndromes decreased (p<0.0005).
Implementing the CHROME criteria reduced the prescription of the most dangerous medications in institutionalized people with dementia. Two independent audits found no physical or chemical restraint and confirmed prescription quality of psychotropic drugs. Adequate diagnosis and independent audits appear to be the keys to help and motivate professionals to optimize and reduce the use of psychotropic medication. The CHROME criteria unify, in a single compendium, neuropsychiatric diagnostic criteria, prescription guidelines, independent audit methodology, and minimum legal standards. These criteria can be easily adapted to other countries.
Positive symptoms are a useful predictor of aggression in schizophrenia. Although a similar pattern of abnormal brain structures related to both positive symptoms and aggression has been reported, this observation has not yet been confirmed in a single sample.
To study the association between positive symptoms and aggression in schizophrenia on a neurobiological level, a prospective meta-analytic approach was employed to analyze harmonized structural neuroimaging data from 10 research centers worldwide. We analyzed brain MRI scans from 902 individuals with a primary diagnosis of schizophrenia and 952 healthy controls.
The result identified a widespread cortical thickness reduction in schizophrenia compared to their controls. Two separate meta-regression analyses revealed that a common pattern of reduced cortical gray matter thickness within the left lateral temporal lobe and right midcingulate cortex was significantly associated with both positive symptoms and aggression.
These findings suggested that positive symptoms such as formal thought disorder and auditory misperception, combined with cognitive impairments reflecting difficulties in deploying an adaptive control toward perceived threats, could escalate the likelihood of aggression in schizophrenia.
Leishmaniasis is one of the world's most neglected diseases, and it has a worldwide prevalence of 12 million. There are no effective human vaccines for its prevention, and treatment is hampered by outdated drugs. Therefore, research aiming at the development of new therapeutic tools to fight leishmaniasis remains a crucial goal today. With this purpose in mind, we present 20 arylaminoketone derivatives with a very interesting in vitro and in vivo efficacy against Trypanosoma cruzi that have now been studied against promastigote and amastigote forms of Leishmania infantum, Leishmania donovani and Leishmania braziliensis strains. Six out of the 20 Mannich base-type derivatives showed Selectivity Index between 39 and 2337 times higher in the amastigote form than the reference drug glucantime. These six derivatives affected the parasite infectivity rates; the result was lower parasite infectivity rates than glucantime tested at an IC25 dose. In addition, these derivatives were substantially more active against the three Leishmania species tested than glucantime. The mechanism of action of these compounds has been studied, showing a greater alteration in glucose catabolism and leading to greater levels of iron superoxide dismutase inhibition. These molecules could be potential candidates for leishmaniasis chemotherapy.
As is well known, the corrosion of embedded steel reinforced depends strongly of the concrete resistivity, which is related directly with the water contained into its porous network. Environment plays an important role on resistivity, due to have a direct correspondence with the relative humidity and temperature. In these terms, ingress or output of water is favored or hampered by the environmental parameters, as well as its fluctuations. This work presents a proposal of instrumented system to generate a map of electrical resistivity at concrete samples by using superficial and embedded electrodes. Mathematical analysis of equivalent circuit revealed the importance of the impedance of electrodes utilized, to simplify measures. Concrete samples were exposed to different relative humidity focused to try to obtain the relation between relative humidity and resistivity. An array of two electrodes distributed in a matrix was manufactured to apply a signal of direct current at first electrode and measure the resultant current at second electrode. The system applies a programmed sequence of switch to turn on and turn off to realize measurements over established zone and, in this form, allows identify zones with potentials gradients. Also, do easy the monitoring of concrete resistivity evolution in function of time and humidity conditions.
Current Cherenkov Telescopes for VHE gamma ray astrophysics are pointing instruments with a field of view up to a few tens of deg2. We propose to build an array of two non-steerable telescopes with a FoV of 5×60 deg2 oriented along the meridian. Roughly half of the sky drifts through this FoV in a year. We have performed a MC simulation to estimate the performance of this instrument, which we dub MACHETE. The sensitivity that MACHETE would achieve after 5 years of operation for every source in this half of the sky is comparable to the sensitivity that a current IACT achieves for a specific source after a 50 h devoted observation. The analysis energy threshold would be 150 GeV and the angular resolution 0.1 deg. For astronomical objects that transit over MACHETE for a specific night, it would achieve an integral sensitivity of 12% of Crab in a night. This makes MACHETE a powerful tool to trigger observations of variable sources at VHE or any other wavelengths.
Short gamma-ray bursts (GRBs) are an extremely elusive family of cosmic explosions. They are thought to be related to the violent merger of compact objects (such as a neutron stars or black holes). Their optical counterparts were not discovered until 2005, and since then, there had been no successful spectroscopic observations. Here we present the first spectra of a short GRB, which we use to study the environment and derive implications on the progenitors of these cosmic explosions. This poster is based on the work by de Ugarte Postigo et al. (2014).
Recent advances in bird tracking technologies are revealing that migratory birds use temporal staging sites other than breeding and wintering areas, and these areas deserve conservation efforts. Eleonora’s Falcon Falco eleonorae is a long-distance migratory raptor that breeds colonially on islands and is considered a priority species for conservation. Anecdotal observations indicate that during the pre-breeding period, Eleonora’s Falcons stay in inland areas far away from the colonies, but, to date there are no detailed data concerning the connectivity between these areas and breeding colonies. Using satellite telemetry, we analysed data from four summering events belonging to three individuals breeding in two colonies in the Western Mediterranean (Spain). All of them made inland movements in areas up to c.400 km distant from the respective breeding colonies, visiting several habitats, from forests to arable lands, probably taking advantage of high densities of insects. Perturbations occurring in these areas could threaten Eleonora’s Falcons with serious consequences at the population level. We suggest that conservation measures implemented at breeding and wintering grounds may not suffice and that temporary staging areas should be identified at a larger scale and deserve protection as well.
The Calar Alto Legacy Integral Field Area (CALIFA) project is an ongoing 3D spectroscopic survey of 600 nearby galaxies of all kinds. This pioneer survey is providing valuable clues on how galaxies form and evolve. Processed through spectral synthesis techniques, CALIFA datacubes allow us to, for the first time, spatially resolve the star formation history of galaxies spread across the color-magnitude diagram. The richness of this approach is already evident from the results obtained for the first ~ 1/6 of the sample. Here we show how the different galactic spatial sub-components (“bulge” and “disk”) grow their stellar mass over time. We explore the results stacking galaxies in mass bins, finding that, except at the lowest masses, galaxies grow inside-out, and that the growth rate depends on a galaxy's mass. The growth rate of inner and outer regions differ maximally at intermediate masses. We also find a good correlation between the age radial gradient and the stellar mass density, suggesting that the local density is a main driver of galaxy evolution.
In this work we study the nonlinear complementarity problem on the
nonnegative orthant. This is done by approximating its equivalent
variational-inequality-formulation by a sequence of variational
inequalities with nested compact domains. This approach yields
simultaneously existence, sensitivity, and stability results. By
introducing new classes of functions and a suitable metric for
performing the approximation, we provide bounds for the asymptotic
set of the solution set and coercive existence results, which extend
and generalize most of the existing ones from the literature. Such
results are given in terms of some sets called coercive existence
sets, which we also employ for obtaining new sensitivity and
stability results. Topological properties of the
solution-set-mapping and bounds for it are also established.
Finally, we deal with the piecewise affine case.
In this work we study the multivalued complementarity problem on
the non-negative orthant. This is carried out by describing
the asymptotic behavior of the sequence of approximate
solutions to its multivalued variational inequality formulation.
By introducing new classes of multifunctions we provide several
existence (possibly allowing unbounded solution set), stability as well as
sensitivity results which extend and
generalize most of the existing ones in the literature.
We also present some kind of robustness results regarding existence
of solution with respect to certain perturbations.
Topological properties of the solution-set multifunction are
established and some notions of approximable multifunctions are
also discussed. In addition,
some estimates for the solution set and its
asymptotic cone are derived, as well as the existence of solutions for
perturbed problems is studied.
Transplantation of olfactory ensheathing cells (OECs) into the injured spinal cord has been shown to exert neuroprotective effects and promote functional recovery. In the present study, we investigated the potential modulatory effects of OECs on the inflammatory reaction developed after photochemical injury to the spinal cord. OEC cultures were obtained from olfactory bulbs of adult Sprague-Dawley rats. Photochemical spinal cord injury was induced in adult rats at T8. Thirty minutes after the insult, either a suspension of OECs (180 000 cells in 12 µl DMEM) or DMEM alone was injected into the lesioned spinal cord. At 3, 7 and 14 days post-operation (dpo), five animals from each group were processed for histology. Double-fluorescent labeling of transverse sections of the cord were made by combination of immunohistochemistry for inflammatory markers, interleukin 1β (IL-1β) and inducible nitric oxide synthase (iNOS), and for selective markers of astrocytes (glial fibrillar acidic protein; GFAP) and microglia/macrophages (tomato lectin; LEC). Differences in the intensity and time course of glial response, and IL-1β and iNOS expression were found between the two groups of rats. The reactivity grade against IL-1β, iNOS, GFAP and LEC in OEC-transplanted rats was higher at 7 dpo and lower at 14 dpo compared with DMEM-injected rats. These results indicate that the mechanisms underlying neuroprotection by OECs might be caused by earlier, higher and shorter duration of microglia/macrophage and astrocyte responses after injury.
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