To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Our purpose was to determine the intensive care units’ (ICU’s) medical staff surge capacity during the coronavirus disease 2019 (COVID-19) outbreak in Spring 2020 in Spain.
A multicenter retrospective survey was performed addressing the medical specialties present in the ICUs and the increase in bed capacity during this period.
Sixty-seven centers (62.04%) answered the questionnaire. The ICU bed capacity during the pandemic outbreak increased by 160% (95% confidence interval [CI], 128.97-191.03%). The average number of beds per intensive care medicine (ICM) specialist was 1.5 ± 0.60 and 3.71 ± 2.44 beds/specialist before and during the COVID-19 outbreak, respectively. Non-ICM specialists and residents were present in 50 (74.63%) and 23 (34.3%) ICUs during the outbreak, respectively. The number of physicians (ICM and non-ICM residents and specialists) in the ICU increased by 89.40% (95% CI, 64.26114.53%). The increase in ICM specialists was, however, 4.94% (95% CI, −1.35-11.23%). Most non-ICM physicians were anesthetists, followed by pediatricians and cardiologists.
The majority of ICUs in our study were able to rapidly expand critical care capacity by adapting areas outside of the normal ICU to manage critically ill patients, and by extending the critical care staff with noncritical care physicians working as force multipliers.
To explore the association between behavioural characteristics with the prevalence of abdominal obesity (AO) among a population of Southern Brazilian shift working women.
A cross-sectional study was conducted. AO was estimated using waist circumference (WC), and it was used to classify women as having AO (WC ≥ 88 cm). Prevalence ratios were estimated using Poisson regression with robust variance.
A large plastic utensils company in Southern Brazil.
450 female shift workers.
The prevalence of the AO in the women shift workers was 44·5 % (95 % CI 40·0, 49·2 %). In night shift workers, the prevalence of AO was 56·1 % compared with 40·9 % among hybrid shift workers. After adjustments for covariates, women who were current smokers had a decrease in the prevalence of AO compared with those who never smoked. Women who had three or fewer meals per day had a 46 % increase in the AO prevalence compared with those eating more frequent meals. Night shift work was associated with increase in AO prevalence compared with hybrid shift (PR 1·33; 95 % CI: 1·08, 1·64).
Our findings indicate that behavioural characteristics are associated with a high prevalence of AO in female shift workers, thus suggesting that behavioural modifications among women working shifts, such as increase in meal frequency and physical activity, may reduce AO.
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.
The aim of the present study is to see if the changes in the regional cerebral blood flow (rCBF) experienced by restrictive anorexia nervosa (AR) and bulimia nervosa (BN) patients, following the exposure to their own body image, persist at follow-up.
Three single photon emission computed tomography (SPECT) were performed on nine patients with a DSM-IV diagnosis of AR, 13 with BP, and 12 controls: at rest, following a neutral stimulus, and after exposure to their previously filmed whole body image. Body dissatisfaction was measured by means of the Body Dissatisfaction Questionnaire (BSQ). One year later the same assessment was repeated.
Following the exposure to their own body image, BN showed an increase in body dissatisfaction, which was associated with the increase in the rCBF of the Right Temporal Area. Those changes persisted at follow-up.
More specific long term therapies are needed for the treatment of the averse response showed by ED patients to their own body image exposure that is associated with the hyperactivation of the right temporal area when they are confronted with their whole body image.
Motor abnormalities (MAs) are the primary manifestations of schizophrenia. However, the extent to which MAs are related to alterations of subcortical structures remains understudied.
We aimed to investigate the associations of MAs and basal ganglia abnormalities in first-episode psychosis (FEP) and healthy controls. Magnetic resonance imaging was performed on 48 right-handed FEP and 23 age-, gender-, handedness-, and educational attainment-matched controls, to obtain basal ganglia shape analysis, diffusion tensor imaging techniques (fractional anisotropy and mean diffusivity), and relaxometry (R2*) to estimate iron load. A comprehensive motor battery was applied including the assessment of parkinsonism, catatonic signs, and neurological soft signs (NSS). A fully automated model-based segmentation algorithm on 1.5T MRI anatomical images and accurate corregistration of diffusion and T2* volumes and R2* was used.
FEP patients showed significant local atrophic changes in left globus pallidus nucleus regarding controls. Hypertrophic changes in left-side caudate were associated with higher scores in sensory integration, and in right accumbens with tremor subscale. FEP patients showed lower fractional anisotropy measures than controls but no significant differences regarding mean diffusivity and iron load of basal ganglia. However, iron load in left basal ganglia and right accumbens correlated significantly with higher extrapyramidal and motor coordination signs in FEP patients.
Taken together, iron load in left basal ganglia may have a role in the emergence of extrapyramidal signs and NSS of FEP patients and in consequence in the pathophysiology of psychosis.
Food phytochemicals are increasingly considered to play a key role in the cardiometabolic health effects of plant foods. However, the heterogeneity in responsiveness to their intake frequently observed in clinical trials can hinder the beneficial effects of these compounds in specific subpopulations. A range of factors, including genetic background, gut microbiota, age, sex and health status, could be involved in these interindividual variations; however, the current knowledge is limited and fragmented. The European network, European Cooperation in Science and Technology (COST)-POSITIVe, has analysed, in a systematic way, existing knowledge with the aim to better understand the factors responsible for the interindividual variation in response to the consumption of the major families of plant food bioactives, regarding their bioavailability and bioefficacy. If differences in bioavailability, likely reflecting differences in human subjects’ genetics or in gut microbiota composition and functionality, are believed to underpin much of the interindividual variability, the key molecular determinants or microbial species remain to be identified. The systematic analysis of published studies conducted to assess the interindividual variation in biomarkers of cardiometabolic risk suggested some factors (such as adiposity and health status) as involved in between-subject variation. However, the contribution of these factors is not demonstrated consistently across the different compounds and biological outcomes and would deserve further investigations. The findings of the network clearly highlight that the human subjects’ intervention studies published so far are not adequate to investigate the relevant determinants of the absorption/metabolism and biological responsiveness. They also emphasise the need for a new generation of intervention studies designed to capture this interindividual variation.
The implications of cannabis use in the onset of early psychosis and the severity of psychotic symptoms have resulted in a proliferation of studies on this issue. However, few have examined the effects of cannabis use on the cognitive symptoms of psychosis (i.e., neurocognitive functioning) in patients with first-episode psychosis (FEP). This systematic review and meta-analysis aim to assess the neurocognitive functioning of cannabis users (CU) and nonusers (NU) with FEP.
Of the 110 studies identified through the systematic review of 6 databases, 7 met the inclusion criteria, resulting in 14 independent samples and 78 effect sizes. The total sample included 304 CU with FEP and 369 NU with FEP. The moderator variables were age at first use, duration of use, percentage of males, and age.
Effect sizes were not significantly different from zero in any neurocognitive domain when users and NU were compared. Part of the variability in effect sizes was explained by the inclusion of the following moderator variables: (1) frequency of cannabis use (β = 0.013, F = 7.56, p = 0.017); (2) first-generation antipsychotics (β = 0.019, F = 34.46, p ≤ 0.001); and (3) country where the study was carried out (β = 0.266, t = 2.06, p = 0.043).
This meta-analysis indicates that cannabis use is not generally associated with neurocognitive functioning in patients with FEP. However, it highlights the deleterious effect of low doses of cannabis in some patients. It also stresses the importance of the type of antipsychotic prescription and cannabis dose as moderator variables in the neurocognitive functioning of CU with FEP.
Although it is known that certain emotion regulation processes produce a buffering effect on the relationship between life events and well-being, this issue has been poorly studied in the elderly population. Thus, the aim of the present study is to test and confirm a comprehensive model of the impact that past life events have on older adults’ psychological distress, exploring the possible mediating roles of emotion regulation processes. These include rumination, experiential avoidance, and personal growth.
In this cross-sectional study, 387 people over 60 years old residing in the community were assessed on life events, physical functioning, emotion regulation variables, psychological well-being, as well as symptoms of anxiety and depression.
The structural model tested achieved a satisfactory fit to the data, explaining 73% of the variance of older adults’ psychological distress. In addition, the main results suggest possible mediation effects of both the physical functioning and the emotional variables: rumination, experiential avoidance, and personal growth in the face of hardship.
These findings confirm the importance of emotion regulation processes in the final stages of life. They reveal the various adaptive and maladaptive mechanisms that underlie the relationship between life events and psychological distress. The findings suggest – both in the explanatory models of psychological well-being and in psychotherapeutic interventions – the importance of emotion regulation in the elderly population’s health.
The increasing prevalence of overweight and obesity has developed into an epidemic public health problem worldwide. In this regard, in the last years several investigations have suggested that water intake and water balance could have important implications for both weight management and body composition. The aim of this study was to analyse the association between fluid intake, water balance and body composition in a sample of healthy young adults from Spain.
Material and methods
A total of 358 healthy subjects (121 males; 237 females) aged 18–39 years participated in the current study. The validated questionnaire entitled “The hydration status questionnaire” was used to assess fluid intake, elimination, and water balance. Anthropometric measurements (height, weight and waist circumference) were performed according to the recommendations of the International Standards for Anthropometric Assessment (ISAK). The estimates of total body water (TBW), fat mass (FM) and fat free mass (FFM) were acquired by bioelectrical bioimpedance analysis. Physical activity was estimated through the Short form of the International Physical Activity Questionnaire (IPAQ-SF). Differences in anthropometric and body composition variables were assessed through the ANOVA test and considered significant at p < 0.05.
Fluid intake was correlated with body water content in females (r = 0.180, p = 0.006) and males (r = 0.266, p = 0.003). An inverse association between water consumption per weight (ml/kg) with body weight (females (f): r = -0.318, p = 0.000; males (m): r = -0.220, p = 0.015), body fat mass (f: r = -0.320, p = 0.000; m: r = -0.200, p = 0.028), and waist circumference (f: r = -0.237, p = 0.000; m: r = -0.215, p = 0.018) was found. Finally, significant differences in body water content in females according to water balance were observed (p = 0.04).
Higher fluid intake seems to be related with a better body composition, therefore the improvement of water intake and water balance could be useful in weight management and in the prevention of overweight and obesity in healthy young adults.
Impulsivity and cognitive distortions are hallmarks of gambling disorder (GD) but it remains unclear how they contribute to clinical phenotypes. This study aimed to (1) compare impulsive traits and gambling-related distortions in strategic versus non-strategic gamblers and online versus offline gamblers; (2) examine the longitudinal association between impulsivity/cognitive distortions and treatment retention and relapse.
Participants seeking treatment for GD (n = 245) were assessed for gambling modality (clinical interview), impulsive traits (Urgency, Premeditation, Perseverance and Sensation Seeking [UPPS] scale) and cognitive distortions (Gambling Related Cognitions Scale) at treatment onset, and for retention and relapse (as indicated by the clinical team) at the end of treatment. Treatment consisted of 12-week standardized cognitive behavioral therapy, conducted in a public specialized clinic within a general public hospital.
Strategic gamblers had higher lack of perseverance and gambling-related expectancies and illusion of control than non-strategic gamblers, and online gamblers had generally higher distortions but similar impulsivity to offline gamblers. Lack of perseverance predicted treatment dropout, whereas negative urgency and distortions of inability to stop gambling and interpretative bias predicted number of relapses during treatment.
Individuals with online and strategic GD phenotypes have heightened gambling related biases associated with premature treatment cessation and relapse. Findings suggest that these GD phenotypes may need tailored treatment approaches to reduce specific distortions and impulsive facets.
The aim of this study was to analyze the psychometric properties of the Brief Resilient Coping Scale (BRCS). 57 stable severe mental disorder patients (42 men, 73.7%, and 15 women, 26.3%), ranging in age between 23 and 64 years, (M = 46.25; SD = 7.52) answered to the BRCS and the World Health Organization Quality of Life Assessment (WHOQOL-BREF). Descriptive analyses, estimations of internal consistency, and confirmatory factor analysis were conducted, and correlations between the BRCS and the WHOQOL-BREF were calculated. The factorial validity of the scale was tested using confirmatory factor analysis, with a single dimension of resilience. The BRCS showed acceptable internal consistency (alpha of .69). Correlations between the BRCS and WHOQOL-BREF were positive, r(PhH-R) = .42, r(PsH-R) = .40, r(SR-R) = .33, r(E-R) = .35, and significant (p < .01). In conclusion, the Spanish adaptation of the BRCS seems to be a reliable and valid measure of resilience in stable severe mental disorder patients.
The Bay of Málaga is located in a high biodiversity and productivity area that harbours a wide variety of commercial species exploited by different fishing fleets. Benthic and demersal fauna from circalittoral soft bottoms have been studied using a benthic dredge (BD) (8 sampling stations) and an otter trawl (OT) (8 sampling stations on a seasonal basis). Some sediment and water column variables, as well as the trawling activity, have also been studied and used for analysing their linkage with the fauna. A total of 287 species have been found in these bottoms and fish, molluscs and crustaceans represented the most diverse and abundant faunistic groups. A new record of the decapod Hippolyte leptometrae for Spanish waters is also included in this study. Some multivariate analyses using BD samples indicated the presence of three assemblages, but these seem to represent different facies of a single benthic community due to the absence of acute sediment changes and significant differences in the fauna. OT samples only displayed differences related to seasons but not to sediment types or depth. These seasonal differences seem to be linked to biological and ecological features of both dominant and/or commercial species. Mud and organic matter contents (%OM) in sediment, as well as the temperature, were the main variables linked to the spatial distribution of the benthic community identified with BD, whereas medium and coarse sand as well as gravel contents were the main variables linked to the changes of the epibenthic and demersal assemblage resulting from OT samples. The information of this study is of importance for improving the knowledge on the biodiversity of circalittoral soft bottoms of the Mediterranean and Alboran Sea as well as for the potential creation of a Marine Fisheries Reserve in the Bay of Málaga.
With the aim of performing perimeter surveillance of high-speed railway networks, this paper presents the design of a passive multistatic radar system based on the use of Long-Term Evolution (LTE) downlink signals as the illumination of opportunity. Taking into account the specifications and standard of the LTE system, the ambiguity function of measured downlink signals is analyzed in terms of range and Doppler resolution, ambiguities, and sidelobe level. The deployment of the proposed passive radar is flexible and scalable, and it is based on multichannel software defined radio receivers that obtain the reference and surveillance signals by means of digital beamforming. The signal processing and data fusion are based, respectively, on the delay-Doppler cross-correlation with the reconstructed reference signals and a two-stage tracking at sensor and central level. Finally, the performance of the proposed system is estimated in terms of its maximum detection range and simulation results of the detection of moving targets are presented, demonstrating its technical feasibility for the short-range detection of pedestrians, vehicles, and small drones.
The design of mixed-technology quasi-reflectionless planar bandpass filters (BPFs), bandstop filters (BSFs), and multi-band filters is reported. The proposed quasi-reflectionless filter architectures comprise a main filtering section that determines the power transmission response (bandpass, bandstop, or multi-band type) of the overall circuit network and auxiliary sections that absorb the reflected radio-frequency (RF) signal energy. By loading the input and output ports of the main filtering section with auxiliary filtering sections that exhibit a complementary transfer function with regard to the main one, a symmetric quasi-reflectionless behavior can be obtained at both accesses of the overall filter. The operating principles of the proposed filter concept are shown through synthesized first-order BPF and BSF designs. Selectivity-increase techniques are also described. They are based on: (i) cascading in-series multiple first-order stages and (ii) increasing the order of the filtering sections. Moreover, the RF design of quasi-reflectionless multi-band BPFs and BSFs is discussed. A hybrid integration scheme in which microstrip-type and lumped-elements are effectively combined within the filter volume is investigated for size miniaturization purposes. For experimental validation purposes, two quasi-reflectionless BPF prototypes (one- and two-stage architectures) centered at 2 GHz and a second-order BSF prototype centered at 1 GHz were designed, manufactured, and measured.
Earlier activities on health technology assessment (HTA) started in Spain around 1984, with the creation of a National Advisory Board on HTA, and the development of national and regional HTA organizations in the early 1990s. In 2012, the Spanish Health Ministry established the Spanish Network for Health Technology Assessment of the National Health System (RedETS); funded at national level and including all public HTA organizations at national and regional levels. RedETSis focused on the assessment of nondrug health technologies to inform the revision (approval and funding or disinvestment) of the Benefit Portfolio of the Spanish NHS. In parallel with European Network for Health Technology Assessment (EUnetHTA), RedETS has been setting-up and sharing common procedures and methodological guidelines to ensure effective cooperation and mutual recognition of the scientific and technical production in HTA. The output of RedETS is fifty to sixty annual reports, including the production of full HTA reports, Clinical Practice Guidelines, methodological guidance reports, relative effectiveness assessments, tools to support shared decision making between patients and healthcare professionals, and monitoring studies. The HTA assessments requested by the Regional Health Authorities are the biggest component of the annual RedETS working plan. These assessment needs are identified according to a yearly process and prioritized by a Commission composed of representatives from all Spanish regions with the aid of the PRITEC tool. The objectives of this study are to report and update the normative and organizational state of HTA in Spain; describing noteworthy advances witnessed over the past 10 years, as well as discussing existing challenges.
In the present investigation, biocomposites were synthesized from a polymeric alginate matrix in which the carrot residue and a natural bentonite (ANat / Bio) or an iron-modified clinoptilolite-type zeolite (ZFe / Bio) were supported. Their properties were evaluated adsorbents in contact with aqueous solutions of methylene blue (MB). In the first hour of contact, 46% removal was obtained for the ZFe / Bio biocomposite and 60% for the ANat / Bio biocomposite; reaching 100% removal for the ZFe / Bio biocomposite and 98% for the ANat / Bio biocomposite after 24 hours. The biocomposites were characterized by Scanning Electron Microscopy (SEM) and Fourier Transformed Infrared Spectroscopy (FTIR).
Mechanized dredging impact on discards was assessed along the northern Alboran Sea (W Mediterranean Sea). Data from 101 dredging operations were analysed for contrasting spatial and seasonal variability of damage, with the use of a three-level damage scale. 4.5% of discarded individuals displayed intermediate damage, whereas 11.3% displayed severe damage. Echinoderms displayed the highest level of damage (~75% of total collected individuals) and Echinocardium cf. mediterraneum was the most susceptible discarded species (85% with severe damage), followed by bivalves (7.3%) and crustaceans (3.3%). The target Chamelea gallina showed a low proportion of damaged individuals, probably due to their thick protective shell, which promotes the survival of discarded undersized target individuals. Spatial differences in damage level on discards were linked to some gear characteristics, to the higher amount of gravels and to longer tow durations, whereas damage was generally higher in cold months and partly related to higher quantities of hard shelled molluscs, in both cases increasing the abrasion and damage to retained organisms. Data suggest that dredges with a lower number of narrower iron teeth and towed for a shorter time could decrease the damage rate in discards of this fishery. A spatial management plan based on the type of grounds would be useful in order to improve efficiency of these fisheries and minimize their impact to soft bottoms with different commercial catches and biological communities.
With their sizes larger than 0.7 Mpc, Giant Radio Galaxies (GRGs) are the largest individual objects in the Universe. To date, the reason why they reach such enormous extensions is still unclear. One of the proposed scenarios suggests that they are the result of multiple episodes of jet activity. Cross-correlating the INTEGRAL+Swift AGN population with radio catalogues (NVSS, FIRST, SUMSS), we found that 22% of the sources are GRG (a factor four higher than those selected from radio catalogues). Remarkably, all of the sources in the sample show signs of restarting radio activity. The X-ray properties are consistent with this scenario, the sources being in a high-accretion, high-luminosity state with respect to the previous activity responsible for the radio lobes.
Hii regions in galaxy disks can be used as a powerful tool to trace the radial distribution of several of their properties and shed some light on the different relevant processes on galaxy formation and evolution. Among the properties that can be extracted from the study of the ionized gas are the metallicity, the excitation and the hardness of the ionizing field of radiation. In this contribution we focus on the determination of both the ionization parameter (U) and the effective temperature of the ionizing clusters (T
) by means of a bayesian-like comparison between the observed relative fluxes of several emission-lines with the predictions from a set of photoionization models. We also show the implications that the use of our method has for the study of the radial variation of both U and T in some very well-studied disk galaxies of the Local Universe.
Hands on the Stars is a long-term project developed by the IAU Commission C1 Education and Development of Astronomy and its WG3 Astronomy for Equity and Inclusion with the goal of creating the first international comparative list of astronomical words in as many sign languages as possible.