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Patients with schizophrenia spectrum disorders (SSD) tend to lack insight, which is linked to poor outcomes. The effect size of previous treatments on insight changes in SSD has been small. Metacognitive interventions may improve insight in SSD, although this remains unproved.
We carried out a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effects of metacognitive interventions designed for SSD, namely Metacognitive Training (MCT) and Metacognitive Reflection and Insight Therapy (MERIT), on changes in cognitive and clinical insight at post-treatment and at follow-up.
Twelve RCTs, including 10 MCT RCTs (n = 717 participants) and two MERIT trials (n = 90), were selected, totalling N = 807 participants. Regarding cognitive insight six RCTs (n = 443) highlighted a medium effect of MCT on self-reflectiveness at post-treatment, d = 0.46, p < 0.01, and at follow-up, d = 0.30, p < 0.01. There was a small effect of MCT on self-certainty at post-treatment, d = −0.23, p = 0.03, but not at follow-up. MCT was superior to controls on an overall Composite Index of cognitive insight at post-treatment, d = 1.11, p < 0.01, and at follow-up, d = 0.86, p = 0.03, although we found evidence of heterogeneity. Of five MCT trials on clinical insight (n = 244 participants), which could not be meta-analysed, four of them favoured MCT compared v. control. The two MERIT trials reported conflicting results.
Metacognitive interventions, particularly Metacognitive Training, appear to improve insight in patients with SSD, especially cognitive insight shortly after treatment. Further long-term RCTs are needed to establish whether these metacognitive interventions-related insight changes are sustained over a longer time period and result in better outcomes.
The coronavirus disease 2019 (COVID-19) pandemic has induced a reinforcement of infection control measures in the hospital setting. Here, we assess the impact of the COVID-19 pandemic on the incidence of nosocomial Clostridioides difficile infection (CDI).
We retrospectively compared the incidence density (cases per 10,000 patient days) of healthcare-facility–associated (HCFA) CDI in a tertiary-care hospital in Madrid, Spain, during the maximum incidence of COVID-19 (March 11 to May 11, 2020) with the same period of the previous year (control period). We also assessed the aggregate in-hospital antibiotic use (ie, defined daily doses [DDD] per 100 occupied bed days [BD]) and incidence density (ie, movements per 1,000 patient days) of patient mobility during both periods.
In total, 2,337 patients with reverse transcription-polymerase chain reaction–confirmed COVID-19 were admitted to the hospital during the COVID-19 period. Also, 12 HCFA CDI cases were reported at this time (incidence density, 2.68 per 10,000 patient days), whereas 34 HCFA CDI cases were identified during the control period (incidence density, 8.54 per 10,000 patient days) (P = .000257). Antibiotic consumption was slightly higher during the COVID-19 period (89.73 DDD per 100 BD) than during the control period (79.16 DDD per 100 BD). The incidence density of patient movements was 587.61 per 1,000 patient days during the control period and was significantly lower during the COVID-19 period (300.86 per 1,000 patient days) (P < .0001).
The observed reduction of ~70% in the incidence density of HCFA CDI in a context of no reduction in antibiotic use supports the importance of reducing nosocomial transmission by healthcare workers and asymptomatic colonized patients, reinforcing cleaning procedures and reducing patient mobility in the epidemiological control of CDI.
In animal models, exposure to excess testosterone during gestation induces polycystic ovary syndrome (PCOS)-like reproductive and metabolic traits in female offspring, suggesting that the hyperandrogenemic intrauterine environment may have a role in the etiology of PCOS. Additionally, few studies have also addressed metabolic and reproductive outcomes in male offspring. In the present study, the intravenous glucose tolerance test (IGTT) was used to assess the insulin–glucose homeostasis at various ages during sexual development in male sheep born to testosterone-treated ewes. To further analyze the programming effect of testosterone on insulin–glucose homeostasis, indexes of insulin sensitivity were assessed in orchidectomized post-pubertal males born to testosterone-treated ewes (Torq-males) and orchidectomized post-puberal controls (Corq-males) before and 48 h after a testosterone injection. There was no difference in insulin sensitivity indexes between males born to testosterone-treated ewes (T-males) and control males born to control ewes (C-males) at 5, 10, 20 and 30 weeks of age, representing the infantile, early and late pre-pubertal, and early post-pubertal stage of sexual development, respectively. In orchidectomized males, basal levels of insulin and glucose were not different between both groups before and after the testosterone injection; however, Torq-males released more insulin before and after T challenge during the first 20 min of the test. Despite this, plasma glucose concentrations were not different in both groups during IVGTT, resulting in an insulin sensitivity index composite similar between groups. We concluded that the effect of prenatal exposure to excess testosterone may reprogram the pancreatic β-cells insulin release in ovine males, with effects more evident in castrated males versus intact males.
Engineering of thermoelectric materials requires an understanding of thermal conduction by lattice and electronic degrees of freedom. Filled skutterudites denote a large family of materials suitable for thermoelectric applications where reduced lattice thermal conduction attributed to localized low-frequency vibrations (rattling) of filler cations inside large cages of the structure. In this work, a multi-wavelength method of exploiting x-ray dynamical diffraction in single crystals of CeFe4P12 is presented and applied to resolve the atomic amplitudes of vibrations. The results suggest that the vibrational dynamics of the whole filler-cage system is the actual active mechanism behind the optimization of thermoelectric properties.
Introduced species can have strong ecological, social and economic effects on their non-native environment. Introductions of megafaunal species are rare and may contribute to rewilding efforts, but they may also have pronounced socio-ecological effects because of their scale of influence. A recent introduction of the hippopotamus Hippopotamus amphibius into Colombia is a novel introduction of a megaherbivore onto a new continent, and raises questions about the future dynamics of the socio-ecological system into which it has been introduced. Here we synthesize current knowledge about the Colombian hippopotamus population, review the literature on the species to predict potential ecological and socio-economic effects of this introduction, and make recommendations for future study. Hippopotamuses can have high population growth rates (7–11%) and, on the current trajectory, we predict there could be 400–800 individuals in Colombia by 2050. The hippopotamus is an ecosystem engineer that can have profound effects on terrestrial and aquatic environments and could therefore affect the native biodiversity of the Magdalena River basin. Hippopotamuses are also aggressive and may pose a threat to the many inhabitants of the region who rely upon the Magdalena River for their livelihoods, although the species could provide economic benefits through tourism. Further research is needed to quantify the current and future size and distribution of this hippopotamus population and to predict the likely ecological, social and economic effects. This knowledge must be balanced with consideration of social and cultural concerns to develop appropriate management strategies for this novel introduction.
We present the main results from the analysis of the Hα-[NII] emission lines with integral field spectroscopy observations gathered with MEGARA at the GTC of the nearby Seyfert 1.5 galaxy NGC7469. We obtained maps of the ionised gas in the inner 12.5 arcsec × 11.3 arcsec, at spatial scales of 0.62 arcsec, with an unprecedented spectral resolution (R ˜ 20 000). We characterized the kinematics and ionisation mechanism of the distinct kinematic components (Cazzoli et al.2019).
To determine infection prevention and control (IPAC) practices for carbapenemase-producing Enterobacteriaceae (CPE), an emerging threat, at acute-care hospitals in Ontario, Canada.
A descriptive cross-sectional survey.
We surveyed IPAC directors and managers at all acute-care hospitals in Ontario, Canada, to gather information on IPAC practices related to CPE, including admission screening, other patient screening, environmental testing, use of precautions to prevent transmission, and outbreak management.
Of 116 acute-care hospitals, 105 (91%) responded. Admission screening included patients previously colonized or infected with CPE (n = 64, 61%), patients recently hospitalized outside of Canada (Indian subcontinent, n = 62, 59%; other countries, n = 56, 53%), and patients recently hospitalized in Canada (n = 22, 21%). Fifty-one hospitals (49%) screened patients for colonization during an outbreak. Almost all hospitals (n = 101, 96%) used precautions to prevent transmission from patients with CPE colonization or infection; most hospitals (n = 54, 53%) continued precautions indefinitely. Few hospitals (n = 19, 18%) performed environmental cultures. Eight hospitals (8%) reported at least 1 outbreak, and 6 hospitals (6%) reported transmission from sink or shower drains to patients.
Variability in practices may result from lack of evidence and challenges in updating guidelines as evidence emerges. A coordinated approach to slow the emergence of CPE should be considered in our population.
To determine whether (-)-epicatechin (Epi) could decrease visceral adipose tissue and improve the metabolic profile of male offspring rats, after maternal obesity was induced by a high-fat diet (HFD).
Maternal obesity in albino Wistar rats was induced with a HFD, whereas male offspring were fed with chow diet throughout the study. Eight male offspring per group, from different litters, were randomly assigned to the experimental or to the control groups. In the experimental group, Epi was administered at a dose of 1 mg/kg of body weight to the male offspring twice daily for two weeks, beginning at postnatal day (PND).
Weight of visceral adipose tissue, adipocyte size, and several metabolic parameters.
Epi administration in the male offspring induced a significant decrease in the amount of visceral fat (11.61 g less, P < 0.05) and in the size of adipose cells (28% smaller, P < 0.01). Besides, Epi was able to decrease insulin, leptin, and Homeostasis Model Assessment -Insulin Resistance (HOMA-IR) (P < 0.05), as well as triglycerides, when the experimental group was compared to the untreated male offspring of obese rats (P < 0.01).
Epi administration can reverse the negative effects that maternal obesity has on the male offspring. This could be because Epi reduces the amount of visceral fat and improves metabolic profile.
Several studies have documented associations between social isolation and poor physical health or well-being. However, little is known of the importance of social support among older adults on specific topics about their quality of life. The purpose of the present study was to determine the relationship between social isolation and quality of life among older adults.
A cross-sectional study.
1,252 subjects aged ≥ 60 years living at home.
We used the Abbreviated Version of the Lubben Social Network Scale (LSNS-6) to assess social isolation and the World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-Old) to assess quality of life. Socio-demographic and health factors were collected through face-to-face interviews. A series of linear regression analyses were used to investigate relationship between social isolation and quality of life. The statistical models were controlled for socio-demographic and health factors.
A total of 750 women (60%) and 502 men (40%) participated in the study. According to their LSNS-6 scores, 426 participants (34.0%) were classified into the highest group of isolation (range 0-10 points). Older adults with higher scores of social isolation exhibited lower quality of life. Regression analyses indicated that social isolation correlated with lower levels of global quality of life, autonomy, intimacy, and past, present, and future activities.
Coping with life from a socially isolated situation entails serious difficulties concerning quality of life. Interventions that foster environments where older adults can forge social bonds might improve their quality of life.
The rate coefficients, k(T= 11.7 – 64.4 K), for the gas-phase reaction between OH radicals and acetone, CH3C(O) CH3, have been measured using the pulsed CRESU (French acronym for Reaction Kinetics in a Uniform Supersonic Flow) technique, the most suitable one to cool down gases below the freezing point without gas condensation. The experimental k(T) was found to increase as temperature was lowered and is several orders of magnitude higher for low temperature than k(300 K). No pressure dependence of k(20 K) and k(64 K) was observed, while k(50 K) at the largest gas density is twice higher than the average values found at lower gas densities. The obtained values of k(11.7 K) and k(21.1 K) were 2.45’10-10 and 1.39’10-10 cm3 molecule-1 s-1, respectively.
Two main elements characterize a country as federal and the development of its federal system. The first one is directly connected to competences and how regions may or may not have powers over public policies. The second one focuses on the fiscal arena, and how regions generate their own income and share it with the central government. This paper describes from a historical point of view the different phases that the Spanish federal process has followed since its beginning in 1978 up to the last reform in 2016. These phases are related to the composition of both the regional and the national governments. It is therefore is important to investigate the connection between changes in these compositions and how they may have affected the phases of decentralization. Employing the new institutionalism paradigm and seeking for critical junctures in the different moments, we show how national governments are more important in shaping this process than regional ones.
Newly discovered archaeological sites in the Uribe Kosta region of northern Spain are illuminating the establishment of late prehistoric coastal farming settlements and specialised tool-production activities.
The polychaete Gallardoneris iberica was described in soft-bottom benthic habitats from the Atlantic Iberian Peninsula coasts in 2012. Since then, successive studies have found this species in Spain, Italy and Croatia. The present study is the first to report G. iberica for Greece and Cyprus (42 new records) confirming its wide geographic distribution on southern European coasts. Taxonomic accounts and ecological preferences based on a large survey and review of available literature are being presented. The species was frequently found in habitats characterized by infralittoral muddy sands with variable organic matter and ‘Moderate’ ecological quality status; nevertheless it was also recorded in coarser and finer sediments, circalittoral mixed sediments, phytal substrates and undisturbed sites. Its relative abundance per sample was always lower than 2%. A review of the available ecological and geographic data of the other Gallardoneris species and a worldwide taxonomic key to Gallardoneris species are provided.
Bovine sex-sorted sperm have been commercialized and successfully used for the production of transgenic embryos of the desired sex through the sperm-mediated gene transfer (SMGT) technique. However, sex-sorted sperm show a reduced ability to internalize exogenous DNA. The interaction between sperm cells and the exogenous DNA has been reported in other species to be a CD4-like molecule-dependent process. The flow cytometry-based sex-sorting process subjects the spermatozoa to different stresses causing changes in the cell membrane. The aim of this study was to elucidate the relationship between the redistribution of CD4-like molecules and binding of exogenous DNA to sex-sorted bovine sperm. In the first set of experiments, the membrane phospholipid disorder and the redistribution of the CD4 were evaluated. The second set of experiments was conducted to investigate the effect of CD4 redistribution on the mechanism of binding of exogenous DNA to sperm cells and the efficiency of lipofection in sex-sorted bovine sperm. Sex-sorting procedure increased the membrane phospholipid disorder and induced the redistribution of CD4-like molecules. Both X-sorted and Y-sorted sperm had decreased DNA bound to membrane in comparison with the unsorted sperm; however, the binding of the exogenous DNA was significantly increased with the addition of liposomes. Moreover, we demonstrated that the number of sperm-bound exogenous DNA was decreased when these cells were preincubated with anti-bovine CD4 monoclonal antibody, supporting our hypothesis that CD4-like molecules indeed play a crucial role in the process of exogenous DNA/bovine sperm cells interaction.
The Spanish National Network (REDETS) is a group of eight agencies, units and services, depending on National and Regional Governments that coordinate their work within a common methodological framework, guided by the principles of mutual recognition and cooperation. The necessity of considering a Quality Management System has been detected and, consequently, a common tool for all the members needs to be developed. We describe in this study the process to achieve that goal.
Based on both a review of previous literature and the proposal for a self-evaluating tool, a group of experts from each agency through consensus have developed a tool for self-evaluation in Health Technology Assessment (HTA) agencies. Through the structure described in the handbook of the Andalusian Agency for Healthcare Quality (ACSA), each standard should have a statement or proposal that needs to also include evidence or good practices, and the corresponding evaluation questions. In separate workgroups, the definition of these proposals, evidence and evaluation questions were developed. One face-to-face meeting and two meetings via teleconference were necessary to achieve a final document with all the quality standards.
From a proposed structure of sixty-six standards, the titles, definitions, statements and evidence as well as good practices and evaluation questions were established in workgroups with consensus among all of the members (1 - 3). The final version of the self-assessment tool was composed of sixty-eight standards, grouped in twelve quality criteria structured in four dimensions: I Responsibility, II Clients and Stakeholders, III Production Process, and IV Resources.
Quality management requires an evaluation tool and this version, based on a systematic review and consensus, is a useful and practical instrument for developing a handbook by each member of REDETS. An online version of the tool is in process of development.
In this work, the molecular interaction of the amino acid glycine and the mineral pyrite was performed to gain insight into the potential role of the mineral as a precursor of chemical complexity in the presence of ultraviolet (UV) radiation. Glycine samples were self-assembled on pyrite with and without exposure to UV radiation and subsequently characterized by scanning electron microscopy, infrared spectroscopy (with the second-derivative method), and AM1 and PM3 semi-empirical molecular computational simulations. In this work, our molecular modelling results suggest that pyrite acts as a template for self-assembly of glycine, and it is a potential catalyst for the glycine dimerization of relevance in interstellar space and ancient Earth conditions. A change in the structural complexity of glycine from the α to its γ polymorph when irradiated with UV radiation can be a condition for chemical evolution towards living forms.
Tetrao urogallus cantabricus is the most endangered capercaillie subspecies and unlike the others it inhabits deciduous forests in the Cantabrian Mountains (north-west Spain). Its southernmost distribution occurs in Mediterranean forests outside conservation areas where wind farm construction is increasing. We surveyed Cantabrian Capercaillie presence in a wintering site one year before and four years after wind farm construction. Sign abundance greatly decreased after wind farm construction indicating a likely negative effect on Cantabrian Capercaillie habitat use. According to the precautionary principle, in order to conserve Cantabrian Capercaillie, all its range should be legally protected to avoid further wind farm construction and human disturbance.
Based on a combined three locus analysis two new genera, Charcotiana and Amundsenia, are proposed in the lichen family Teloschistaceae, subfamily Xanthorioideae. Charcotiana includes the new species C. antarctica, which is known only from continental Antarctica. The bipolar genus Amundsenia includes the new species A. austrocontinentalis, which is also known only from continental Antarctica, and the Arctic species Caloplaca approximata which is here combined into the new genus. The two new genera are phylogenetically distinct, but poor in morphological characters; the new species consist mainly of minute apothecia in cracks of rocks located in the climatically harshest regions of the Antarctic. They are somewhat similar to another continental Antarctic species, Austroplaca frigida, which is described as a new name based on the illegitimate name Caloplaca frigida Søchting. The distribution of the four species is mapped.