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Schizophrenia is notoriously becoming one of the world's most debilitating mental disorders, affecting 1 in 100 people. There is increasing evidence that neuroinflammation plays a part in the pathogenesis of schizophrenia and other psychotic disorders; microglial activity acting as a marker for neuroinflammatory reactions in the brain. Furthermore, cannabis is an illicit substance that also evokes a similar response in the neuroimmune activity. This project explores how cannabis exposure influences an elevation in neuroinflammatory responses through TSPO levels, and whether this information can help us determine if cannabis use and increased TSPO levels can be associated with a risk factor for developing psychosis.
55 participants (36 males and 19 females) were recruited from the community by the IRIS (Inflammatory Reaction in Schizophrenia) team at the IoPPN, King's College London, from which 34 patients with a diagnosis of schizophrenia and 21 healthy controls took part in the study. The eligible participants underwent clinical assessments and PET scanning, from which cannabis use history and PET data were collected. Participant neuroinflammatory levels are represented by [18F]DPA-714 volume and different regions of grey matter in the brain were analysed through multivariate analyses, the confounding variables being age and TSPO genotype.
A statistically significant association is shown between participants who have had exposure to cannabis and participants who have not had any exposure in their lifetime. The differences across the prioritised brain regions of interest were robust, the association appearing more apparent and statistically significant in the total (p = .00) and temporal grey matter (p = .00) regions of the brain. This may suggest that cannabis exposure influences the [18F]DPA-714 VT in the significant regions of interest. However, a negative association is seen with current use, the quantity of use, and the frequency of use.
The initial findings for cannabis exposure show us a positive association with increased TSPO levels, however, limitations must be taken into account. Although we cannot readily establish that elevated TSPO levels in cannabis users can presently act as a risk factor marker for developing psychosis from this particular study, we can utilise this data to continue our research in disclosing a new system to predict the occurrence of psychosis.
We aimed to develop and validate a new simple decision support tool (U-TEST) for diagnosis of sarcopenia in orthopaedic patients. We created seventeen candidate original questions to detect sarcopenia in orthopaedic patients with sarcopenia through expert opinions and a semi-structured interview. To derive a decision support tool, a logistic regression model with backward elimination was applied to select variables from the seventeen questions, age and underweight (BMI < 18·5 kg/m2). Sarcopenia was defined by Asian Working Group for Sarcopenia 2019 criteria. After assigning a score to each selected variable, the sum of scores was calculated. We evaluated the diagnostic performance of the new tool using a logistic regression model. A bootstrap technique was used for internal validation. Among a total of 1334 orthopaedic patients, sixty-five (4·9 %) patients were diagnosed with sarcopenia. We succeeded in developing a ‘U-TEST’ with scores ranging from 0 to 11 consisting of values for BMI (Underweight), age (Elderly) and two original questions (‘I can’t stand up from a chair without supporting myself with my arms’ (Strength) and ‘I feel that my arms and legs are thinner than they were in the past’ (Thin)). The AUC was 0·77 (95 % CI 0·71, 0·83). With the optimal cut-off set at 3 or greater based on Youden’s index, the sensitivity and the specificity were 76·1 and 63·6 %, respectively. In orthopaedic patients, our U-TEST scoring with two questions and two simple clinical variables can help to screen for sarcopenia.
During the COVID-19 pandemic, the use of telemedicine as a way to reduce COVID-19 infections was noted and consequently deregulated. However, the degree of telemedicine regulation varies from country to country, which may alter the widespread use of telemedicine. This study aimed to clarify the telepsychiatry regulations for each collaborating country/region before and during the COVID-19 pandemic.
We used snowball sampling within a global network of international telepsychiatry experts. Thirty collaborators from 17 different countries/regions responded to a questionnaire on barriers to the use and implementation of telepsychiatric care, including policy factors such as regulations and reimbursement at the end of 2019 and as of May 2020.
Thirteen of 17 regions reported a relaxation of regulations due to the pandemic; consequently, all regions surveyed stated that telepsychiatry was now possible within their public healthcare systems. In some regions, restrictions on prescription medications allowed via telepsychiatry were eased, but in 11 of the 17 regions, there were still restrictions on prescribing medications via telepsychiatry. Lower insurance reimbursement amounts for telepsychiatry consultations v. in-person consultations were reevaluated in four regions, and consequently, in 15 regions telepsychiatry services were reimbursed at the same rate (or higher) than in-person consultations during the COVID-19 pandemic.
Our results confirm that, due to COVID-19, the majority of countries surveyed are altering telemedicine regulations that had previously restricted the spread of telemedicine. These findings provide information that could guide future policy and regulatory decisions, which facilitate greater scale and spread of telepsychiatry globally.
Patients with schizophrenia show a significantly higher frequency of hyperbilirubinemia the patients suffering from other psychiatric disorders and the general healthy population. The objective of the current study was to determine whether patients with schizophrenia-associated idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome, GS) have specific changes in signal intensities on fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) images.
Axial 5-mm-thick FLAIR MR images from schizophrenia patients with GS (n = 18) and schizophrenia patients without GS (n = 18), all diagnosed according to DSM-IV criteria, were compared with age- and sex-matched non-psychiatric controls (n = 18). Signal intensities in the hippocampus, amygdala, caudate, putamen, thalamus, cingulate gyrus, and insula were graded relative to cortical signal intensity in the frontal lobe.
Compared to both schizophrenia patients without GS and normal controls, the schizophrenia patients with GS showed significantly increased signal intensities in almost all regions studied.
Patients with schizophrenia-associated GS have specific changes of signal intensities on FLAIR MR images, suggesting that schizophrenia with GS produces changes in the fronto-temporal cortex, limbic system, and basal ganglia.
John Hughlings Jackson, an English neurologist of the 19th century, proposed that the nervous system was organised as a hierarchical system of three anatomical layers corresponding to a functional hierarchy. The concepts introduced in this description, for the most part in antinomic form, turned out to be fruitful for psychology and psychopathology: psychic evolution/dissolution, simplicity/complexity, organisation/disorganisation, stability/instability, automatism/intentionality, inhibition/disinhibition, brain topology, and Darwinian selection of the most stable states. Henri Ey's adaptation of this architectonic model to the psyche and conscience, which he called organodynamics, required making modifications such as including the intervention of nerve connections between the various brain areas, designated by the term “transanatomical sets”. The most recent synaptic and neuronal models of conscience (J-P Changeux, G Edelman) are presented briefly and include the “selective stabilisation of synapses”. Neurotransmitter anomalies in psychopathy; immunity, inflammatory and synaptic anomalies of certain acute psychoses; and the modifications of synaptic connections after electrical stimulation of the brain are also presented. The convergence of this theoretical and experimental data leads to a discussion of the hypothesis according to which mental diseases might be “synaptic diseases”.
Morphological abnormalities of extensive nerve cell death have been mainly observed in cerebral cortex, hippocampus and cerebellum with a long-term use of alcohol.
Objectives & Aims
We try to to investigate the mechanism of the brain atrophy in alcoholics.
We reviewed consecutive CT examinations in 170 patients and 17 controls (from 23 to 85 years old) with symmetrical intracranial ventricular system and normal density of the white and gray matter.
There was a significant difference (p<0.05) in the BCI between controls and patients of all ages. There was no significant difference of the BCI in ages between 20s, 30s and 40s of patients. And there was a significant difference (p<0.05) in each generation between the young ages (20s, 30s and 40s) and the older ages (the 50's, 60s, 70s and 80s). There was no significant difference of the BCI between the generation of 20s, 30s and 40s. But the significant difference (p<0.05) between the young and the older generations was observed. And the generation of 50s is considered as the start point of the physiological brain atrophy. We consider that the spasmodic drinking might be due to the abnormal excitation of neural circuit. It has been reported that there is a correlation between the progression of brain atrophy and the seizure frequency and its lateralization in temporal lobe epilepsy.
We hypothesized that the spasmodic drinking might be caused by abnormal excitation of neural circuit and the higher the frequency, the more brain atrophy progresses.
Traditional classifications confuse etiologic factors with symptomatic ones, making it difficult to treat psychosis.
Objectives, aims and method
Traditional and Henri Ey's classifications of mental illness are discussed. And the theory of neo-organo-dynamism is proposed.
The acute phase of disease may only be a temporary modification of the basic mental illness and the nature of the latter can be expressed in terms of the depth of the organic degeneration. The psychotic state consists of the basic disorder and its acute aggregative phase that is in proportion to the degree of abnormal neuronal excitations. In my classification, mental illness is classified from a normal stage N or N+ to a stage X and the degree of acute aggravation is staged from 0 to 7. By applying this classification to diagnosis, we can accurately represent the conditions of psychiatric patients that change organo-dynamically over time. At the same time, clinical comparative research, such as the effects of medicine and of biochemical changes becomes possible. The principle of the accessory pathway is also proposed. Mental pressures or ritual acts promote construction and the reorganization of neural network, and it is fixed by repeating itself. Coding to the subconsciousness of a new neural network namely bypass will be made, and it is immobilized as an accessory pathway like the bundle of Kent of the Wolff-Parkinson-White syndrome.
The theory of the neo-organo-dynamism is proposed as a minimum clinical classification of mental illness for psychiatrists.
Particle acceleration induced by fast magnetic reconnection may help to solve current puzzles related to the interpretation of the very high energy (VHE) and neutrino emissions from AGNs and compact sources in general. Our general relativistic-MHD simulations of accretion disk-corona systems reveal the growth of turbulence driven by MHD instabilities that lead to the development of fast magnetic reconnection in the corona. In addition, our simulations of relativistic MHD jets reveal the formation of several sites of fast reconnection induced by current-driven kink turbulence. The injection of thousands of test particles in these regions causes acceleration up to energies of several PeVs, thus demonstrating the ability of this process to accelerate particles and produce VHE and neutrino emission, specially in blazars. Finally, we discuss how reconnection can also explain the observed VHE luminosity-black hole mass correlation, involving hundreds of non-blazar sources like Perseus A, and black hole binaries.
Upcoming VLBI observations will resolve nearby supermassive black holes, most notably Sagittarius A* and M87, on event horizon-scales. Recent observations of Sagittarius A* with the Event Horizon Telescope have revealed horizon-scale structure. Accordingly, the detection and measurement of the back hole “shadow” is expected to enable the existence of astrophysical black holes to be verified directly. Although the theoretical description of the shadow is straightforward, its observational appearance is largely determined by the properties of the surrounding accretion flow, which is highly turbulent. We introduce a new polarised general-relativistic radiative transfer code, BHOSS, which accurately solves the equations of polarised radiative transfer in arbitrary strong-gravity environments, providing physically-realistic images of astrophysical black holes on event horizon-scales, as well as also providing insight into the fundamental properties and nature of the surrounding accretion flow environment.
Health-related quality of life (HRQOL) is significantly affected in individuals with schizophrenia or bipolar I disorder (BD-I). The current study investigated whether symptomatic remission and resilience might differently impact HRQOL in these patients.
Fifty-two patients with schizophrenia and 60 patients suffering from BD-I from outpatient mental health services as well as 77 healthy control subjects from the general community were included into a cross-sectional study. HRQOL and resilience were assessed using the WHOQOL-BREF and the Resilience Scale. In patients, psychopathology was quantified by the Positive and Negative Syndrome Scale or the Montgomery Asberg Depression Rating Scale and the Young Mania Rating Scale, respectively.
Notably, both patient groups showed lower HRQOL and resilience compared to control subjects, non-remitted patients indicated lower HRQOL than remitted ones. The effect of remission on HRQOL was significantly larger in patients with BD-I than in those with schizophrenia but did not explain the difference in HRQOL between groups. Resilience predicted HRQOL in all three groups. When accounting for the effect of resilience among remitted patients, only the difference in HRQOL between schizophrenia patients and control subjects was significant.
These findings demonstrate the impact of symptomatic remission and resilience on HRQOL of both patients suffering from schizophrenia and BD-I and indicate that these factors are especially relevant for HRQOL of patients with BD-I.
This study investigated subjective memory complaints in older adults and the roles of setting, response bias, and personality.
Cognitively normal older adults from two settings completed questionnaires measuring memory complaints, response bias, and personality.
(A) Neuroimaging study with community-based recruitment and (B) academic memory clinic.
Cognitively normal older adults who (A) volunteer for research (N = 92) or (B) self-referred to a memory clinic (N = 20).
Neuropsychological evaluation and adjudication of normal cognitive status were done by the neuroimaging study or memory clinic. This study administered self-reports of subjective memory complaints, response bias, five-factor personality, and depressive symptoms. Primary group differences were examined with secondary sensitivity analyses to control for sex, age, and education differences.
There was no significant difference in over-reporting response bias between study settings. Under-reporting response bias was higher in volunteers. Cognitive complaints were associated with response bias for two cognitive complaint measures. Neuroticism was positively associated with over-reporting in evaluation-seekers and negatively associated with under-reporting in volunteers. The relationship was reversed for Extraversion. Under-reporting bias was positively correlated with Agreeableness and Conscientiousness in volunteers.
Evaluation-seekers do not show bias toward over-reporting symptoms compared to volunteers. Under-reporting response bias may be important to consider when screening for memory impairment in non-help-seeking settings. The Memory Functioning Questionnaire was less sensitive to reporting biases. Over-reporting may be a facet of higher Neuroticism. Findings help elucidate psychological influences on self-perceived cognitive decline and help seeking in aging and may inform different strategies for assessment by setting.
In this study, direct numerical simulation of the flow around a rotating sphere at high Mach and low Reynolds numbers is conducted to investigate the effects of rotation rate and Mach number upon aerodynamic force coefficients and wake structures. The simulation is carried out by solving the three-dimensional compressible Navier–Stokes equations. A free-stream Reynolds number (based on the free-stream velocity, density and viscosity coefficient and the diameter of the sphere) is set to be between 100 and 300, the free-stream Mach number is set to be between 0.2 and 2.0, and the dimensionless rotation rate defined by the ratio of the free-stream and surface velocities above the equator is set between 0.0 and 1.0. Thus, we have clarified the following points: (1) as free-stream Mach number increased, the increment of the lift coefficient due to rotation was reduced; (2) under subsonic conditions, the drag coefficient increased with increase of the rotation rate, whereas under supersonic conditions, the increment of the drag coefficient was reduced with increasing Mach number; and (3) the mode of the wake structure becomes low-Reynolds-number-like as the Mach number is increased.
The Magellanic Clouds offer the opportunity to obtain a spatially resolved view of external galaxies at reduced metallicity with no distance ambiguity. Our ALMA observations of the active star-forming region N83C in the Small Magellanic Cloud (SMC) revealed subparsec-scale molecular structures in 12CO and 13CO (2-1) emission Muraoka et al. (2017). We found strong CO peaks associated with Young Stellar Objects(YSOs) and derived a typical gas density of ∽104 cm−3 and gas temperature of 40-60 K from the excitation analysis. The high gas density and temperature are presumably due to the effect of the HII region under the low-metallicity environment. We have found that the column density ratios N(CI)/N(CO) are generally high throughout the cloud compared with the Galaxy, ranging from 0.2 to 2.0. A peak of the ratio is observed toward a CO peak associated with a massive protostar.
The author gives the analytic properties of the Rankin–Selberg convolutions of two half-integral weight Maass forms in the plus space. Applications to the Koecher–Maass series associated with nonholomorphic Siegel–Eisenstein series are given.
We propose a robust numerical algorithm for solving the nonlinear eigenvalue problem A(ƛ)x = 0. Our algorithm is based on the idea of finding the value of ƛ for which A(ƛ) is singular by computing the smallest eigenvalue or singular value of A(ƛ) viewed as a constant matrix. To further enhance computational efficiency, we introduce and use the concept of signed singular value. Our method is applicable when A(ƛ) is large and nonsymmetric and has strong nonlinearity. Numerical experiments on a nonlinear eigenvalue problem arising in the computation of scaling exponent in turbulent flow show robustness and effectiveness of our method.
Over the past 20 years, many designer drugs derived from controlled substances have been widely distributed as easily available psychoactive substances and have become a serious problem in Japan. In order to determine the absolute structures of four new designer drugs derived from medicines (methylphenidate and phenmetrazine) X-ray single-crystal structure analyses were performed using the BL26B1 beamline of synchrotron radiation facility SPring-8. The results show that the molecular configuration of these designer drugs (having two asymmetric carbons), which were distributed in the illegal drug market had threo-forms as found for methylphenidate and phenmetrazine.
We aimed to clarify the correlation between the 2011 Great East Japan Earthquake and pregnant women’s awareness of social capital 3 to 9 months after the tsunami disaster.
We analyzed data on responses to a questionnaire by 7451 pregnant women in their second to third trimesters. The proportions of social capital–related items were calculated in the north and south coastal areas of Miyagi Prefecture and were compared with national samples. The factors associated with social capital were estimated by use of multivariate logistic regression analyses.
The proportion of women feeling that they had helpful neighbors was higher (69.0% vs 56.7%, P=0.0005), the proportion of women regarding their communities as safe and secure was lower (51.7% vs 62.4%, P=0.002), and the proportion of women feeling that most people were trustworthy was lower (23.7% vs 32.9%, P=0.006) in the north coastal area than nationwide. Such differences were not observed in the less severely affected south coastal area. Age of 35 years or older, extended family, college or university graduation, and being multiparous were associated with the feeling of having helpful neighbors.
The current status of pregnant women’s awareness of social capital in disaster-affected areas was revealed. Continuous monitoring and support may be necessary to address this issue.(Disaster Med Public Health Preparedness. 2017;11:355–364)