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The intentional use of drugs before or during sexual intercourse (chemsex), due to its impact on mental health, is a phenomenon of high importance in men who have sex with men. The main drugs usually described in chemsex related research are methamphetamine, mephedrone and GHB/GBL.
We present a narrative review of the evidence about the mechanisms of action of different drugs used in chemsex context.
Different drugs have been associated with chemsex use: stimulants such as cocaine, stimulants with empathogenic properties such as mephedrone, methamphetamine, MDMA; stimulants with a psychedelic effect such as 2C-B; depressants such as GHB/GBL and ethyl chloride; and dissociative hallucinogens such as ketamine.
Classical chemsex research includes only mephedrone, metanphetamine and GHB as “chemsex drugs”. Recently, different drugs have been described associated with chemsex practice. Clinicians may encounter polydrug chemsex users and the different mecanisms of action, mental health problems related to every drug and polydrug use must be takek into account.
The intentional use of drugs before or during sexual intercourse (chemsex), due to its impact on mental health, is a phenomenon of high importance in men who have sex with men.
We report the case of a patient with polysubstance acute intoxication, including 2C-B, in order to review the evidence about the mechanisms of action of 2C-B, its efects on sexual pleasure, toxicity, patterns of abuse and somatic and mental health related consequences it may present.
Case report and narrative review.
We present the case of a patient using 2C-B as a substance in chemsex practice. As the patient presented in our emergency with psychotic symptoms, he was diagnosed with “stimulant acute intoxication” and “acute psychotic symptoms induced by stimulants”. 2C-B increases dopamine (DA) serotonin (5-HT) and norepinephrine (NE) and cause stimulating and hallucinogenic effects.
MSM is a group vulnerable to the problematic use of drugs in a sexual context. Several mental health problems have been associated with chemsex users such as psychotic sypmptoms, suicidal ideation, encephalopaty, delirium. Polysubstance use is common in chemsex practice and it can be difficult to identify the drugs used in states of acute intoxication but psychiatrists must explore the use of differents drugs from the “classic chemsex drugs” (mephedrone, GHB and metanphetamine) including 2C-B and other substances such as cocaine, MDMA, ketamine, and other cathinones different from mephedrone.
Asymptomatic sudden death is the principal cause of mortality in Chagas disease. There is little information about molecular mechanisms involved in the pathophysiology of malignant arrhythmias in Chagasic patients. Previous studies have involved Trypanosoma cruzi secretion proteins in the genesis of arrhythmias ex vivo, but the molecular mechanisms involved are still unresolved. Thus, the aim was to determine the effect of these secreted proteins on the cellular excitability throughout to test its effects on catecholamine secretion, sodium-, calcium-, and potassium-conductance and action potential (AP) firing. Conditioned medium was obtained from the co-culture of T. cruzi and Vero cells (African green monkey kidney cells) and ultra-filtered for concentrating immunogenic high molecular weight parasite proteins. Chromaffin cells were assessed with the parasite and Vero cells control medium. Parasite-secreted proteins induce catecholamine secretion in a dose-dependent manner. Additionally, T. cruzi conditioned medium induced depression of both calcium conductance and calcium and voltage-dependent potassium current. Interestingly, this fact was related to the abolishment of the hyperpolarization phase of the AP produced by the parasite medium. Taken together, these results suggest that T. cruzi proteins may be involved in the genesis of pro-arrhythmic conditions that could influence the appearance of malignant arrhythmias in Chagasic patients.
The aim of this study was to test the appearance of negative dominance in coronavirus disease (COVID-19) vaccine-related information and activity online. We hypothesized that if negative dominance appeared, it would be a reflection of peaks in adverse events related to the vaccine, that negative content would attract more engagement on social media than other vaccine-related posts, and posts referencing adverse events related to COVID-19 vaccination would have a higher average toxicity score.
We collected data using Google Trends for search behavior, CrowdTangle for social media data, and Media Cloud for media stories, and compared them against the dates of key adverse events related to COVID-19. We used Communalytic to analyze the toxicity of social media posts by platform and topic.
While our first hypothesis was partially supported, with peaks in search behavior for image and YouTube videos driven by adverse events, we did not find negative dominance in other types of searches or patterns of attention by news media or on social media.
We did not find evidence in our data to prove the negative dominance of adverse events related to COVID-19 vaccination on social media. Future studies should corroborate these findings and, if consistent, focus on explaining why this may be the case.
The COVID-19 pandemic is a global challenge for humanity, in which a large number of resources are invested to develop effective vaccines and treatments. At the same time, governments try to manage the spread of the disease while alleviating the strong impact derived from the slowdown in economic activity. Governments were forced to impose strict lockdown measures to tackle the pandemic. This significantly changed people’s mobility and habits, subsequently impacting the economy. In this context, the availability of tools to effectively monitor and quantify mobility was key for public institutions to decide which policies to implement and for how long. Telefonica has promoted different initiatives to offer governments mobility insights throughout many of the countries where it operates in Europe and Latin America. Mobility indicators with high spatial granularity and frequency of updates were successfully deployed in different formats. However, Telefonica faced many challenges (not only technical) to put these tools into service in a short timing: from reducing latency in insights to ensuring the security and privacy of information. In this article, we provide details on how Telefonica engaged with governments and other stakeholders in different countries as a response to the pandemic. We also cover the challenges faced and the shared learnings from Telefonica’s experience in those countries.
This is the first report on the association between trauma exposure and depression from the Advancing Understanding of RecOvery afteR traumA(AURORA) multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience.
We focus on participants presenting at EDs after a motor vehicle collision (MVC), which characterizes most AURORA participants, and examine associations of participant socio-demographics and MVC characteristics with 8-week depression as mediated through peritraumatic symptoms and 2-week depression.
Eight-week depression prevalence was relatively high (27.8%) and associated with several MVC characteristics (being passenger v. driver; injuries to other people). Peritraumatic distress was associated with 2-week but not 8-week depression. Most of these associations held when controlling for peritraumatic symptoms and, to a lesser degree, depressive symptoms at 2-weeks post-trauma.
These observations, coupled with substantial variation in the relative strength of the mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated in more in-depth analyses of the rich and evolving AURORA database to find new targets for intervention and new tools for risk-based stratification following trauma exposure.
The purpose of this study was to demonstrate the use of social network analysis to understand public discourse on Twitter around the novel coronavirus disease 2019 (COVID-19) pandemic. We examined different network properties that might affect the successful dissemination by and adoption of public health messages from public health officials and health agencies.
We focused on conversations on Twitter during 3 key communication events from late January to early June of 2020. We used Netlytic, a Web-based software that collects publicly available data from social media sites such as Twitter.
We found that the network of conversations around COVID-19 is highly decentralized, fragmented, and loosely connected; these characteristics can hinder the successful dissemination of public health messages in a network. Competing conversations and misinformation can hamper risk communication efforts in a way that imperil public health.
Looking at basic metrics might create a misleading picture of the effectiveness of risk communication efforts on social media if not analyzed within the context of the larger network. Social network analysis of conversations on social media should be an integral part of how public health officials and agencies plan, monitor, and evaluate risk communication efforts.
Sardinella aurita has become an important source of fish protein-intake in NW African countries, where one stock is considered from Morocco to south Senegal, performing seasonal reproductive migrations along the coast. Although data are limited for the fisheries involved and for life-history knowledge of the species in the area, a precautionary approach is recommended to avoid overexploitation. Commercial landings of round sardinella produced by the European freezer-pelagic trawlers operating in Mauritanian waters were analysed between May 2004 and February 2012. The length-weight relationships (LWRs) (N = 40,725) did not show significant differences between sexes. Ripening round sardinellas were present throughout the year, but spawning effort rose between June and December. The length at first maturity for males and females was estimated at 27.7 cm TL (2.1 years) and 28.1 cm TL (2.2 years), respectively. Ages were interpreted from otoliths, varying from 0 to 8 years. Von Bertalanffy growth parameters resulted in non-statistically significant differences between sexes (P = 0.28). Natural mortality was estimated at ~0.63 year–1. The results provide important biological information for fisheries assessment of a species that plays an important key role in the current climate change scenario and for the economies of the riparian countries.
Shared decision-making denotes a structured process that encourages full participation by patient and provider in making complex medical decisions. There has been extensive and growing interest in its application to long-term illnesses but surprisingly not in severe psychiatric disorders, such as schizophrenia. However, the great majority of schizophrenics are capable of understanding treatment choices and making rational decisions. Although the main justification for shared decision-making is ethical, several randomized controlled trials support its effectiveness in improving the quality of decisions, but robust evidence in objective health outcomes is needed.
Aims and objectives
Of the study: to demonstrate the effectiveness, measured as treatment adherence and readmissions at 3, 6 and 12 months, of shared decision making in the choice of antipsychotic treatment at discharge.
Of the oral presentation: to present the study design; to make an interim report of the data obtained at the moment of the congress.
Randomized controlled trial, prospective, two parallel groups, not masked, comparing two interventions (shared decision making and treatment as usual). Study population: Inpatients diagnosed of schizophrenia and schizoaffective disorders (ICD-10/DSM-IV-R: F20 y F25) at Adult Acute Hospitalization Unit at Jerez General Hospital.
Currently in the recruiting phase with 55 patients included in the study. An interim analysis of at least half of the target sample size.
We will show the study design and decision tools employed. Conclusions in relation to the effectiveness (adherence and readmissions) and subjective perception.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Effectiveness of shared decision making in treatment planning at discharge of inpatient with schizophrenia: interim analysis.
Shared decision-making denotes a structured process that encourages full participation by patient and provider in making complex medical decisions. Hamann et al. conducted a few years ago a randomized controlled trial with schizophrenic inpatients and found increased knowledge and perceived involvement in decisions about antipsychotic treatment at discharge by the experimental group, but not clear beneficial effects on long term outcomes. The present communication introduces the DECIDE study.
Aims and objectives
Of the study: to demonstrate the effectiveness, measured as treatment adherence and readmissions at 3, 6 and 12 months, of shared decision making in the choice of antipsychotic treatment at discharge in a simple of schizophrenics hospitalized after an acute episode of their disorder. Of the oral presentation: to present preliminary conclusions with more of the half of the sample.
Randomized controlled trial, prospective, two parallel groups, not masked, comparing two interventions (shared decision making and treatment as usual). Study population: inpatients diagnosed of schizophrenia and schizoaffective disorders (ICD-10/DSM-IV-R: F20 y F25) at Adult Acute Hospitalization Unit at Jerez General Hospital.
At discharge, increased scale score COMRADE, both subscales (Satisfacción in communication and trust in the decision) statistically significant. At 3 months follow-up, intensification of these differences in effect size and statistical significance and shows trends in health outcomes. We will present results for 6 and 12 months.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The aim of the present poster is to describe an initial complex case of schizoaffective disorder with other clinical adverse conditions (metabolic disorders) in a young adult male, which gradually went into a positive treatment way from polipharmacy to monoteraphy. His psychiatric history started when he was 25-year-old, he was diagnosed of heroine dependence, hypercholesterolemia and hypertrigliceridemia. In 2000 he had a suicide attempt in a context of depressive mood and delusions. He needed a psychiatric hospitalization for the first time in his life and he received anti-psychotics for the first time too. Drug abuse was detected in that hospitalization (cannabis and alcohol). In 2001 was diagnosed of paranoid schizophrenia. In 2007 the diagnosis was modified to schizoaffective disorder and also was detected high blood pressure, Diabetes Mellitus II and overweight. From 2007 to the present he passed from a scheme treatment composed by four or more psychotropic drugs to monotherapy (only one psychotropic drug, an anti-psychotic), he stayed clinically stable and all his metabolic parameters remained equal or improved.
In recent decades, concern about rabbit welfare and sustainability has increased. The housing system is a very important factor for animal welfare. However, information about how different available housing types for female rabbits affect their health status is scarce, but this is an important factor for their welfare. Hence, the objective of this study was to evaluate the health status of female rabbits in five common housing systems: three different single-housing systems with distinct available surfaces and heights; a single-housing system with a platform; a collective system. Female rabbits in the collective and platform cages had greater cortisol concentrations in hair than those in the single-housing system with no platform. Haptoglobin concentrations and kit mortality rates during lactation were greater for the collective-cage female rabbits. The collective group had more culled females and more lesions than in the other groups. The main reasons for culling in all the groups were reproduction problems and presence of abscesses, and the collective group of females was the most affected. In conclusion, it appears that keeping females together in collective systems negatively affects their health status and welfare, while single-housing systems imply lower kit mortality rates during lactation and cortisol concentrations, and fewer lesions in female rabbits.
Although executive and other cognitive deficits have been found in patients with borderline personality disorder (BPD), whether these have brain functional correlates has been little studied. This study aimed to examine patterns of task-related activation and de-activation during the performance of a working memory task in patients with the disorder.
Sixty-seven DSM-IV BPD patients and 67 healthy controls underwent fMRI during the performance of the n-back task. Linear models were used to obtain maps of within-group activations and areas of differential activation between the groups.
On corrected whole-brain analysis, there were no activation differences between the BPD patients and the healthy controls during the main 2-back v. baseline contrast, but reduced activation was seen in the precentral cortex bilaterally and the left inferior parietal cortex in the 2-back v. 1-back contrast. The patients showed failure of de-activation affecting the medial frontal cortex and the precuneus, plus in other areas. The changes did not appear to be attributable to previous history of depression, which was present in nearly half the sample.
In this study, there was some, though limited, evidence for lateral frontal hypoactivation in BPD during the performance of an executive task. BPD also appears to be associated with failure of de-activation in key regions of the default mode network.
This article undertakes the first systematic examination of Frank’s (1979, 1981, 1987, 1990, 2007b, 2008) claim that Old Norse influence is discernible in the language of Beowulf. It tests this hypothesis first by scrutinizing each of the alleged Nordicisms in Beowulf, then by discussing various theoretical considerations bearing on its plausibility. We demonstrate that the syntactic, morphological, lexical, and semantic peculiarities that Frank would explain as manifestations of Old Norse influence are more economically and holistically explained as consequences of archaic composition. We then demonstrate that advances in the study of Anglo-Scandinavian language contact provide strong reasons to doubt that Old Norse could have influenced Beowulf in the manner that Frank has proposed. We conclude that Beowulf is entirely devoid of Old Norse influence and that it was probably composed ca. 700, long before the onset of the Viking Age.
The single intradermal comparative cervical tuberculin (SICCT) test and post-mortem examination are the main diagnostic tools for bovine tuberculosis (bTB) in cattle in the British Isles. Latent class modelling is often used to estimate the bTB test characteristics due to the absence of a gold standard. However, the reported sensitivity of especially the SICCT test has shown a lot of variation. We applied both the Hui–Walter latent class model under the Bayesian framework and the Bayesian model specified at the animal level, including various risk factors as predictors, to estimate the SICCT test and post-mortem test characteristics. Data were collected from all cattle slaughtered in abattoirs in Northern Ireland in 2015. Both models showed comparable posterior median estimation for the sensitivity of the SICCT test (88.61% and 90.56%, respectively) using standard interpretation and for post-mortem examination (53.65% and 53.79%, respectively). Both models showed almost identical posterior median estimates for the specificity (99.99% vs. 99.80% for SICCT test at standard interpretation and 99.66% vs. 99.86% for post-mortem examination). The animal-level model showed slightly narrower posterior 95% credible intervals. Notably, this study was carried out in slaughtered cattle which may not be representative for the general cattle population.
The pore structure of vapour deposited ASW is poorly understood, despite its importance to fundamental processes such as grain chemistry, cooling of star forming regions, and planet formation. We studied structural changes of vapour deposited D2O on intra-molecular to 30 nm length scales at temperatures ranging from 18 to 180 K and observed enhanced mobility from 100 to 150 K. An Arrhenius type model describes the loss of surface area and porosity with a common set of kinetic parameters. The low activation energy (428 K) is commensurate with van der Waals forces between nm-scale substructures in the ice. Our findings imply that water porosity will always change with time, even at low temperatures.
To evaluate how rearing programmes could affect resources allocation and reproductive performance of primiparous rabbit females, a total of 118 rabbit females were used to evaluate the effects of five rearing feeding programmes on their performance from 1st to 2nd parturition: CAL, fed ad libitum C diet (11.0 MJ digestible energy (DE), 114 g digestible protein (DP) and 358 g NDF/kg dry matter (DM) until 1st parturition; CR, fed ad libitum with C diet until 12 weeks of age and then C diet restricted (140 g/day) until 1st parturition; F, fed ad libitum with F diet (8.7 MJ DE, 88 g DP and 476 NDF/kg DM) until 1st parturition; FC, fed with F diet ad libitum until 16 weeks of age, and C diet ad libitum until 1st parturition; FCF, fed with F diet ad libitum until 16 weeks of age, then C diet ad libitum until 20 weeks and then F diet ad libitum until 1st parturition. From 1st parturition, C diet was ad libitum offered to all the experimental groups until 2nd parturition. CAL females presented lower feed intake than females of F, FC and FCF groups in the 1st week of lactation (on av. −16.6%; P<0.05). During 1st lactation, the perirenal fat thickness change in CAL females was not different from 0 (+0.02 mm), while in the other four groups it increased (on av. +0.44 mm; P<0.05). Plasma of females fed with F diet during rearing (F, FC and FCF) had lower non-esterified fatty acids content than those exclusively fed with C diet (–0.088 and –0.072 mmol/l compared to CAL and CR, respectively; P<0.05). FCF litters had higher weight than F litters at day 21 of lactation (+247 g; P<0.05), but FCF litter had significantly lower weight than FC litters at weaning (+170 g; P<0.05). CR females had the shortest average interval between the 1st and 2nd parturition (49 days) and FCF females the longest (+ 9 days compared to CR; P<0.05). At 2nd parturition, liveborn litters of F females were larger and heavier than litters of FCF females (+2.22 kits and +138 g; P<0.05), probably due to the lower mortality at birth of F litters (–16.5 percentage points; P<0.05). In conclusion, rearing females on fibrous diets seems to increase the ability of primiparous rabbit females to obtain resources, especially at the onset of lactation.
To compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypes
As part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013. Risk factors for ESBL-EC versus ESBL-KP BSI and for 30-day mortality were examined by bivariate analysis followed by multivariable logistic regression.
The study included 909 patients: 687 with ESBL-EC BSI and 222 with ESBL-KP BSI. ESBL genotype by polymerase chain reaction amplification of 286 isolates was available. ESBL-KP BSI was associated with intensive care unit admission, cardiovascular and neurological comorbidities, length of stay to bacteremia >14 days from admission, and a nonurinary source. Overall, 30-day mortality was significantly higher in patients with ESBL-KP BSI than ESBL-EC BSI (33.7% vs 17.4%; odds ratio, 1.64; P=.016). CTX-M was the most prevalent ESBL subtype identified (218 of 286 polymerase chain reaction-tested isolates, 76%). No differences in clinical characteristics or in mortality between CTX-M and non–CTX-M ESBLs were detected.
Clinical characteristics and risk of mortality differ significantly between ESBL-EC and ESBL-KP BSI. Therefore, all ESBL-producing Enterobacteriaceae should not be considered a homogeneous group. No differences in outcomes between genotypes were detected.
Factors influencing early development such as birth weight, nest competition, and the diet received during rearing have been proposed as elements conditioning the future reproductive performance of European rabbit (Oryctolagus cuniculus) females. To evaluate their effects, we followed the life of 1513 females from birth to time of death, culling or censoring (animals alive at a fixed date). Between 0 and 63 days of age 353 females died. From the remaining 1160 females, 864 were chosen based on their birth weight to be transferred from the selection to the production farm. At this farm, 431 females received the control diet (184 g of CP, 381 g of NDF and 11.8 MJ of DE per kg DM), while the other 433 received the fibrous diet (134 g of CP, 436 g of NDF and 10.0 MJ of DE per kg DM). Throughout the rearing period, we checked for the individual live weight and body condition (perirenal fat thickness) at first artificial insemination. Reproductive lifespan was defined as the number of days between the first parturition and the time of death, culling or censoring. Birth weight affected the survival of newborn females during lactation and the presence of a milk spot at birth (related to nest competition) increased the survivability of newborns weighing <45 g (P<0.001). Rearing diet altered the growth curve of females and their body condition at first insemination. The diet also altered the relative risk of death during the rearing period, which was lower among females fed on the fibrous diet (−12.5%; P<0.001). Therefore, a higher number of females fed with this diet reached their reproductive life, directly affecting the productivity measured per housed female. Fatter females at first insemination had smaller litter sizes and a higher risk of being culled than lean ones (P<0.05). In general, the fibrous diet reduced the risk of leaving the herd at early rearing, and both birth weight and perirenal fat thickness affected female’s reproductive lifespan. An excess of fat (positive change in one unit of perirenal fat) at their first insemination represented an increased the risk of death or elimination of 13%.
Genetic selection and nutrition management have played a central role in the development of commercial rabbitry industry over the last few decades, being able to affect productive and immunological traits of the animals. However, the implication of different energy sources in animals from diverse genetic lines achieving such evolutionary success remains still unknown. Therefore, in this work, 203 female rabbits housed and bred in the same conditions were used from their first artificial insemination until their fifth weaning. The animals belonged to three different genetic types diverging greatly on breeding goals (H line, hyper-prolific (n=66); LP line, robust (n=67) and R line, selected for growth rate (n=67), and were assigned to two experimental diets, promoting major differences in energy source (cereal starch or animal fat)). The aims of this work were to: (1) characterize and describe blood leucocyte populations of three lines of rabbit does in different physiological stages during their reproductive period: first artificial insemination, first weaning, second parturition and fifth weaning; and (2) study the possible influence of two different experimental diets on the leucocyte populations in peripheral blood. Flow cytometry analyses were performed on blood samples taken from females at each different sampling stade. Lymphocyte populations at both weanings were characterized by significantly lower counts of total, CD5+ and CD8+ lymphocytes (–19.8, –21.7 and –44.6%; P<0.05), and higher counts of monocytes and granulocytes (+49.2 and +26.2%; P<0.05) than in the other stages. Females had higher blood counts of lymphocytes B, CD8+ and CD25+ and lower counts of CD4+ at first than at fifth weaning (+55.6, +85.8, +57.5, –14.5%; P<0.05). G/L ratio was higher at both weanings (P<0.05), and CD4+/CD8+ ratio increased progressively from the 1AI to the 5 W (P<0.001). Regarding the effect of genetic type in blood leucocyte counts, LP animals presented the highest counts for total, B, CD5+ and CD8+ lymphocytes (+16.7, +31.8, +24.5 and +38.7; P<0.05), but R rabbits showed the highest counts for monocytes and granulocytes (+25.3 and +27.6; P<0.05). The type of diet given during the reproductive life did not affect the leucocyte population counts. These results indicate that there are detectable variations in the leucocyte profile depending on the reproductive stage of the animal (parturition, weaning or none of them). Moreover, foundation for reproductive longevity criteria allows animals to be more capable of adapting to the challenges of the reproductive cycle from an immunological viewpoint.