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The El Salt site (Alcoi, Alicante, Spain) is one of the latest Neanderthal sites in the south-eastern Iberian Peninsula. The disappearance of this human group is controversial and needs detailed studies from different research areas. Taphonomy is essential to establish how representative is a fossil assemblage of the past living organisms that produced it and to interpret the formation process of the fossil site. In the case of El Salt, we have analyzed the micromammal assemblages of Units X and V, which contain fossils of Neanderthals and/or evidence of their activity. In contrast with previous identifications of the little owl (Athene noctua), our detailed taphonomic study shown here allows us to conclude that the main predator involved in the production of the micromammal assemblages was the European eagle owl (Bubo bubo). This is an opportunistic predator whose feeding preferences and behavior reflect the abundance of local micromammalian species, which can therefore provide a representation of past ecosystems near El Salt. The taphonomic information provided by this study also indicates the absence of transport and reworking processes, and reinforces previous paleoecological interpretations, suggesting an increase of aridity at the top of El Salt sequence that coincided with the local disappearance of Neanderthals.
ABSTRACT IMPACT: Summarize the burden of diabetes comorbidities and its impact in healthcare utilization in Puerto Rico OBJECTIVES/GOALS: To estimate the prevalence of common comorbidities and describe the healthcare utilization patterns in patients with type 2 diabetes mellitus (T2DM) in Puerto Rico. METHODS/STUDY POPULATION: This is a descriptive study using healthcare claims data from patients with T2DM (based on ICD-9 diagnosis code) from most public and private healthcare insurance companies providing services in Puerto Rico in 2013 (representing more than 90% of insured population). Descriptive analyses by age, sex, type of insurance, health region, and type of medical encounter were done using frequency and percent for categorical data or means or median (with corresponding standard deviation or interquartile range) for continuous variables RESULTS/ANTICIPATED RESULTS: A total of 3,100,636 claims were identified from 485,866 adult patients with T2DM. Most patients were women (276,400; 57%), older than 65 years (235,390; 48%), from the Puerto Rico health regions of Caguas (79,604; 16%), Metro (66,280; 14%), or Bayamon (62,673; 13%) with private health insurance (371,806; 77%). The number of claims per patient ranged from 1 to 339. A mean of 6.3 claims (SD ±9.99) and a median of 3 claims (Q1 1- Q3 8) per subject were identified. Most (74%) were related to the diagnosis of diabetes (1,829,2015; 59%) or to cardiovascular diseases (458,219; 15%) and associated to outpatient services (2,722,727; 88%). The most prevalent comorbidities were hypertension (235,277; 48%), hyperlipidemia (197,449; 41%), neuropathy (100,471; 21%); renal disease (71,517; 15%), and retinopathy (61,837; 13%) DISCUSSION/SIGNIFICANCE OF FINDINGS: A high prevalence of comorbidities and use of healthcare services were identified in patients with T2DM, especially in older adults. Most comorbidities were due to diabetes-related conditions, highlighting the importance of early diagnosis and adequate management of T2DM patients to avoid preventable burden to the patient and the healthcare system
Healthcare workers (HCWs) not fulfilling the coronavirus disease 2019 (COVID-19) case definition underwent severe acute respiratory coronavirus virus 2 (SARS-CoV-2) screening. Risk of exposure, adherence to personal protective equipment (PPE), and symptoms were assessed. In total, 2,000 HCWs were screened: 5.5% were positive for SARS-CoV-2 by polymerase chain reaction (PCR). There were no differences in PPE use between SARS-CoV-2–positive and –negative HCWs (adherence, >90%). Nursing and kitchen staff were independently associated with positive SARS-CoV-2 results.
Type of feeding during early life influences growth trajectory and metabolic risk at later ages. Modifications in infant formula composition have led to evaluate their effects on growth and energetic efficiency (EE) compared with breast-feeding. Main goal was to analyse type of feeding potential effects during first months of life, plus its EE, on growth patterns in healthy formula fed (standard infant formula (SF) vs. experimental infant formula enriched with bioactive nutrients (EF)) and breastfed (BF) infants participating in the COGNIS RCT (http://www.ClinicalTrials.gov, Identifier: NCT02094547) up to 18 months of age. Infants follow-up to 18 months of age (n 141) fed with a SF (n 48), EF(n 56), or BF (n 37), were assessed for growth parameters using WHO standards. Growth velocity (GV) and catch-up were calculated to identify growth patterns. EE of breast milk/infant formula was also estimated. Infants’ growth at 6 months showed higher length and lower head circumference gains in SF and EF infants than BF infants. Both weight-for-length and weight-for-age catch-up growth showed significant differences in formula fed groups compared with the BF. No significant differences in GV or catch-up were found at 6–12 and 12–18 months. Regarding EE, infant formula groups showed significantly lower weight and length gains/g of milk protein, and higher weight and length gains/g of milk lipids, than the BF infants. GV during first 6 months, which may be influenced by feeding, seems to be the main predictor of subsequent growth trajectory. Breast-feeding may have positive effects on growth programming due to its nutrients’ EE.
The aim of this study is to test the psychometric properties of the Spanish validation of the Fear of COVID-19 Scale (FCV-19S) in a Paraguayan population.
Participants were recruited through an Internet-based survey. All participants whose scores in the Hospital Anxiety and Depression Scale (HADS) and The Fear Questionnaire (FQ) were greater than zero were included. 1245 subjects responded voluntarily: 1077 subjects, scoring >0, were considered.
To establish construct validity of the FCV-19S, an exploratory factor analysis was performed using the KMO test, which was adequate, and the Bartlett sphericity test, which was significant (p <.0001). The CFI, NFI, GFI, TLI and RMSEA indices were used to evaluate the model and showed good adjustment. Cronbach’s α showed valid internal consistency (α = 0.86). This validation was supported by significant correlation (p <.001) with the HADS scale for anxiety and depression and with the FQ scale for specific phobia.
The Spanish version of the FCV-19S is a 7-item scale with two dimensions, psychological symptoms and physiological symptoms, which demonstrated robust psychometric properties in a Paraguayan population.
Previous research has shown that individuals suffering from depression and generalized anxiety disorder (GAD) seem to have inhibitory control deficits compared with healthy controls. However, few studies have been conducted in Spanish-speaking countries. Thus, this study aims to analyze the performance on the Stroop Color and Word Test (SCWT) between groups of Colombian participants with clinical levels of depression and GAD symptoms and a nonclinical control group. According to previous research, we expected to find significant differences in inhibitory control among groups. An ex post facto design was implemented. The SCWT was administered to a total sample of 105 individuals (64.8% women, M = 22.94 years, SD = 4.62), including 27 depressed and 15 anxious participants according to their scores on the Personal Health Questionnaire–9 and the Generalized Anxiety Disorder–7, respectively. Bayesian t-tests showed that depressed participants showed the same processing speed but lower scores on inhibitory control than healthy controls, BF = 13.70, δ = 0.50, 95% CI [0.08, 0.94]. Conversely, anxious participants showed deficits in processing speed, SCWT-Word: BF = 16.19, δ = 0.68, 95% CI [0.15, 1.24]; SCWT-Color: BF = 5.98, δ = 0.50, 95% CI [–0.01, 1.04], but not in inhibitory control compared with the nonanxious counterparts. This study provides preliminary evidence concerning the inhibitory control deficits in Colombian depressed individuals and processing speed deficits in those experiencing clinical levels of GAD symptoms.
Molecular genetics are key to understanding current and historical relationships between isolated populations, including species’ colonizations during glacial–interglacial cycles, to determine viability of local populations, needs for habitat corridors, and other aspects of population management, especially where bears are harvested for sport, etc. As natural habitats shrink, some bear species will inevitably require high levels of management, perhaps combining captive and wild populations following the IUCN’s One Plan Approach. In this chapter we review the systematics of the Ursidae and its relationships with other Carnivora, the molecular phylogenetic of extant ursid species, the phylogeography of and morphological variation within each species, and the use of molecular genetics to monitor bear populations for management and conservation.
This chapter comprises the following sections: names, taxonomy, subspecies and distribution, descriptive notes, habitat, movements and home range, activity patterns, feeding ecology, reproduction and growth, behavior, parasites and diseases, status in the wild, and status in captivity.
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 objective of the study was to characterize small-scale dairy production systems to identify the technological preferences according to the farmer and farm characteristics and to analyze the importance and role of the information communication technologies (ICTs) in the dissemination of information related to management and livestock activities. To collect the data, a survey was applied to 170 small-scale dairy farmers from central Mexico. To characterize the farms, a factor analysis (FA) and cluster analysis (CA) were performed. To compare and identify differences between groups, a Kruskal–Wallis test was conducted. Four factors that explain 70.93% of the accumulated variance were identified; these factors explain the use of technology, production characteristics, social connections, and use of ICTs. The cluster analysis identified four groups. Group 1 was integrated by farmers with more experience and the largest farms. Group 2 had higher studies and use of ICTs. Group 3 was formed by young farmers but had a low use of technology. Group 4 contained older farmers with a low use of technology. The young farmers with higher studies have begun to incorporate ICTs into their daily activities on the farm, as observed in Group 2. Smartphones were the most used and were considered important by the farmers of the four groups, since they enable interaction with other farmers and the dissemination of topics of interest related with the farm. In conclusion, four group of farmers were differentiated; therefore, different extension approaches should be implemented to take into account the preferences and the technologies considered most important for each group. The ICTs are emerging technologies among small-scale dairy farmers to communicate information related to livestock management, mainly by young farmers with studies of secondary, as observed in Group 2.
Hydrogen cyanide (HCN) is considered a fundamental molecule in prebiotic chemistry experiments due to the fact that it could have an important role as raw material to form more complex molecules, as well as it could be an intermediate molecule in chemical reactions. However, the primitive scenarios in which this molecule might be available have been widely discussed. Hydrothermal systems have been considered as abiotic reactors and ideal niches for chemical evolution. Nevertheless, several experiments have shown that high temperatures and pressures could be adverse to the stability of organic molecules. Thus, it is necessary to carry out systematic experiments to study the synthesis, stability and fate of organic molecules in hydrothermal scenarios. In this work, we performed experiments focused on the stability and fate of HCN under a simple hydrothermal system scenario: the thermolysis of HCN at 100°C, at acidic and basic pH and in the presence of Mg-montmorillonite. Furthermore, we analysed the products from HCN thermolysis and highlighted the role of these chemical species as prebiotic molecules under a hydrothermal scenario.
Mixed Bipolar patients are those who have co-existing depressive symptoms during mania. These patients are supposed to have a worse evolution.
The objective of this study was to compare the long-term outcomes of patients who had at least one mixed episode with those who experienced only pure manic episodes.
169 outpatients diagnosed of Bipolar I disorder and treated at least during two years were included. 120 patients (71%) complited the follow-up over 10 years. Baseline demographic and clinical variables were included.
The patients with mixed episodes (37%) had a significantly younger mean age at onset comparing with those with manic episodes (25.3 years vs. 30.8 years; p=0.025) they also had more previous mood- incongruent psychotic symptoms χ2= 6.77, p=0.034), more number of hospitalizations (OR= 1.36, 95% CI = 1.14; -1.63; p< 0.001), and more number of episodes (OR= 1.21, 95% CI = 1.10-1.31; p< 0.001). There were no significant differences relating to depressive episodes, alcohol use, drug abuse, suicidal behaviour and suicide attempts.
Age at onset differed significantly between the mixed episode and pure mania groups, with mixed episode patients having a younger age of onset. This is interesting as one of the major results of the study we have found that age at onset mediates some of the factors classically related to outcome in mixed episodes like alcohol abuse and suicide attempts. However, independently of age at onset, these patients represent a especially severe type of bipolar disorder.
Sexuality is a crucial area of human life. A proper examination to assess and detect problems in this field, it seems imperative to intervene when transsexual patients. Therefore accurately known, the sexual practices of these patients, allows us to work directly on possible alterations in the functioning of sexual life during the therapeutic process.
Describe patterns of sexual behavior in patients diagnosed with transsexualism
Gender and Identity Disorder Unit (GIDU)
Selected by consecutive sampling, 200 transsexuals treated at GIDU Malaga, aged between 20 and 40 years and who agreed to participate in the study. Comprising 142 transgender male-to-woman (MtW) and 58 women-to-man (WtM).
Was conducted through a heterocompleted questionnaire that included questions about sexuality, personality traits and demographic characteristics. These were filled in the consultation and were anonymous.
11.6% of MtW transsexuals have never had sex. 26.8% of the MtW and 29% of WtM are more than 3 months without masturbating. 54.1% of the MtW avoid having sex due to the rejection of his genitals, lack of sexual desire and previous traumatic experience. Transgender respondents had secondary education, stable jobs and they were single.
It is vital that we explore the sex lives of transsexual patients. This information must be integrated in a systematic and rigorous evaluation process. According to the results presented, the hyposexuality would be the most significant feature that describes sexuality for this population.
Response to SSRIs suggests the implication of the serotonergic system in obsessive-compulsive disorder (OCD). However, biological studies on serotonergic function in OCD have yielded contradictory results. Platelet monoamine oxidase (MAO) activity has been proposed as an index of cerebral serotonin activity.
The aim of this study was to examine platelet MAO activity in 29 OCD patients and 29 healthy controls matched by age, sex and tobacco use. We also explored the relationship between platelet MAO activity and aggressive obsessions in OCD patients.
There were no differences in platelet MAO activity between OCD patients and healthy controls. We found a significant correlation between platelet MAO activity and Y-BOCS scores in the group of patients with Y-BOCS scores >15.
OCD patients with aggressive obsessions had significantly lower levels of platelet MAO activity than patients without aggressive obsessions.
Our results suggest that platelet MAO activity may be a marker of OCD severity, and that low platelet MAO activity may be associated with aggressive obsessions in OCD patients.
Looking for a substantial increase in the reliability and validity of voice analysis measurements in depression, we have developed a new experimental paradigm. The paradigm is based on two vocal tasks with different levels of cognitive processing and a baseline verbal task. It has been applied to 40 subjects, 20 patients with affective disorders and 20 normal individuals. We have found that an important set of vocal parameters, at different intervals, discriminates patients from normal subjects. Here, we discuss four of them – those that have been especially consistent; the patients had longer reaction times, a higher proportion of relative spectral energy (at a very low frequency band), narrower fundamental frequency range and higher proportion of omissions. Under the proposed paradigm, the acoustic analysis could be a promising instrument for the development of quantitative indicators of depression.
Chronic Fatigue Syndrome (CFS) is characterized by severe fatigue associated with pain, sleep disturbance, attentional impairment and headaches. Evidence points towards a prominent role for Central Nervous System in its pathogenesis, and alterations in serotoninergic and dopaminergic neurotransmission have been described.
Attention-deficit Hyperactivity Disorder (ADHD) courses with inattention, impulsivity, and hyperactivity. It affects children and persists into adulthood in 50% of patients. Dopamine transporter abnormalities lead to impaired neurotransmission of catecholaminergic frontal-subcortical-cerebellar circuits.
To describe the prevalence of ADHD in a sample of CFS patients, and the clinical implications of the association.
To study the relationship between CFS and ADHD.
The initial sample consisted of 142 patients, of whom 9 were excluded because of severe psychopathology or incomplete evaluation. All the patients (age 49 ± 87; 94,7 women) received CFS diagnoses according to Fukuda criteria. ADHD was assessed with a diagnostic interview (CAADID), ADHD Rating Scale and the scale WURS, for childhood diagnose. The scales FIS-40, HAD, STAI and Pluthik Risk of Suicide (RS) were administrated.
38 patients (28,8%) were diagnosed of childhood ADHD (4 combined, 22 hyperactive-impulsive, 12 inattentive) and persisted into adulthood in 28 (21,1%; 5 combined, 4 hyperactive-impulsive, 19 inattentive). There were no differences in Fukuda criteria profile and FIS-40 between groups. ADHD patients scored higher in HAD-Anxiety (9,88 ± 4,82 vs. 12,57 ± 3,49; p = 0,007), HAD-Depression (9,69 ± 4,84 vs. 12,04 ± 4,53; p = 0,023), STAI-E (30,55 ± 14,53 vs. 38,41 ± 11,35; p = 0,012), and RS (6,13 ± 3,48 vs. 8,49 ± 3,07; p = 0,002).
ADHD is frequent in CFS patients and it is associated with more severe clinical profile.