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To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress.
This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP).
Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4–95.6%) and work-related stressful experiences (PARP range 76.8–86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety.
TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.
Large, conglomerate caves in north-eastern Iberia have been significant places since the Neolithic through to historical times; however, their significance during the Palaeolithic has barely been explored. This project is the first systematic study of the use of these iconic geological landmarks among Pleistocene hunter-gatherers.
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.
We present a fast method to prepare hybrid materials of polyaniline (PAni) with carbon nanotubes (CNTs, both undoped and nitrogen-doped) by ball milling without solvents or strong oxidants. PAni forms nanoparticles, attached to CNTs in a nanocomposite structure, with the nanotubes well dispersed among the polymer. This is achieved with only a few minutes of ball milling. Raman spectroscopy confirms that PAni was synthesized in its conductive state and suggests a good CNT–PAni interaction, particularly with nitrogen-doped CNTs. We found that water increased polymer yield, which we optimized, together with the nanocomposite conductivity, as function of amount of water and of oxidant (FeCl3). The nanocomposite conductivity is four orders of magnitude higher than that of PAni, for both types of nanotubes. Scanning electron microscopy and X-ray diffraction both show negligible damage to the CNT during this mechanosynthesis procedure, while dry milling and milling CNT in water without aniline does damage nanotubes, indicating that the reaction absorbs most of the mechanical energy.
The well-exposed marine Eocene units from southwestern Patagonia, Argentina, contain useful information for reconstructing regional climate and oceanographic patterns in an area adjacent to the Drake Passage. The aim of this paper is to integrate dinoflagellate cyst data from three sections of the southwestern Austral Basin (Río Turbio Formation) to propose a zonation scheme, which can be applied to other southwestern Atlantic Ocean sites. Assemblages of organic walled dinoflagellate cysts have been analysed in different cropping-out sections and cores, showing the high potential of this fossil group as biostratigraphic markers. Comparison of dinoflagellate cyst events of the upper member of the Río Turbio Formation with calibrated biostratigraphic ranges in the Palaeogene South Pacific Ocean allowed us to date and correlate these sedimentary sections. The resulting zonation consists of four dinoflagellate cyst zones labelled RTF 1 to RTF 4, between the middle Lutetian and late Priabonian. As a final point, we applied dinoflagellate cyst species with importance as palaeoenvironmental markers to assess long-term climatic and oceanographic evolution for the area. This study shows that the endemic–Antarctic dinoflagellate cyst assemblage is dominant during the middle to late Eocene (RTF 1 to RTF 3), while a significant replacement of these taxa by cosmopolitan species characterizes the upper part of the upper member of the Río Turbio Formation (RTF 4). This turnover seems to be a consequence of changes in the ocean circulation patterns forced by deepening of the southern Atlantic gateways (the Drake Passage and the Tasman Gateway).
Glass-ceramics of eutectic composition in the wollastonite [W, CaO⋅SiO2]- tricalcium phosphate [TCP, β-Ca3(PO4)2] binary system were synthesized by using the glass-crystallization method. The parent glass was crystalized at 800-1300 °C for 0.5-5 h. The in vitro bioactivity of the synthesized glass-ceramics was tested in Kokubo’s Simulated Body Fluid (SBF) for 7-21 days, at pH = 7.4 and 37 °C. All materials were characterized by X-Ray Diffraction (XRD) and Scanning Electron Microscopy (SEM/EDS). The results showed that metastable Apatite phase [Ap, Ca10(PO4)6O], plus W and TCP phases expected according to the binary phase diagram, were formed. Ap was the first phase formed at 900 °C/0.5 h, which was followed by formation of W phase at 900 °C/2 h and of TCP phase at 1200 °C/0.5 h. The relative proportion of the formed crystalline phases was a function of heat treatment temperature and time. A eutectic microstructure was obtained for the materials heat-treated at 1300 °C for 2 or 5 h. All glass-ceramics showed the formation of a hydroxyapatite (HAp)-like layer during the in vitro bioactivity tests. After 21 days of soaking in SBF, the samples treated at 1300 °C/5 h showed a behavior similar to that typically shown by Bioeutectic® material, while the materials heat-treated at lower temperatures tended to form denser HAp-like layers, with similar thicknesses but with higher Ca/P molar ratios.
Evidence indicates that children with autism spectrum disorder (ASD) suffer from an ongoing neuroinflammatory process in different regions of the brain involving microglial activation. When microglia remain activated for an extended period, the production of mediators is sustained longer than usual and this increase in mediators contributes to loss of synaptic connections and neuronal cell death. Microglial activation can then result in a loss of connections or underconnectivity. Underconnectivity is reported in many studies in autism. One way to control neuroinflammation is to reduce or inhibit microglial activation. It is plausible that by reducing brain inflammation and microglial activation, the neurodestructive effects of chronic inflammation could be reduced and allow for improved developmental outcomes. Future studies that examine treatments that may reduce microglial activation and neuroinflammation, and ultimately help to mitigate symptoms in ASD, are warranted.
Glass-ceramics based on hypo-eutectic (GC1) and hyper-eutectic (GC2) compositions of the Wollastonite (W, CaSiO3) - Tricalcium Phosphate [TCP, Ca3(PO4)2] binary system, which are saturated with SiO2 during the glass melting stage, are synthesized by the petrurgic method, using cooling rates of 0.5, 1 or 2°C/h. All synthesized materials are subjected to in vitro bioactivity tests using Kokubo's Simulated Body Fluid (SBF). Primary a-Cristobalite is formed in all cases. Metastable Apatite [Ap, Ca10(PO4)6O] and W phases are additionally formed, in general, in the GC1 glass-ceramics, as well as in the GC2 material obtained at a cooling rate of 0.5°C/h. However, at faster cooling rates, TCP is formed instead of Ap phase in the latter composition. During the bioactivity tests, a hydroxyapatite [HAp, Ca10(PO4)6(OH)2]-like surface layer is formed in all materials. It is proposed that GC2 glass-ceramics cooled at a rate of 1°C/h have the potential to show good in vivo osseointegration properties.
Ti-coated AISI 316L stainless steel, for potential biomedical applications, is obtained by thermal decomposition of TiH2 under vacuum. The presence of hydrogen in the coating material facilitates the sintering process of Ti particles, with simultaneous formation of several inter-diffusion layers at the substrate/coating interface, whose thickness and chemical composition depend mainly on the treatment temperature. Coatings prepared at 1100°C exhibit formation of a wide zone at the substrate/coating interface, which is associated with the appearance of cracks, and which consists of a mixture of λ + χ + α-Fe phases. Formation of abundant microporosity is also observed in this region, which is attributed to the Kinkerdall effect.
There is a relationship between the fatty acid profile in skeletal muscle phospholipids and peripheral resistance to insulin in adults, but similar data have not been reported in infancy and childhood. The objective of this study was to investigate the fatty acid composition of skeletal muscle and adipose tissue across the paediatric age range. The fatty acid profile of skeletal muscle phospholipids and adipose tissue triacylglycerols was analysed in ninety-three healthy Spanish infants and children distributed into four groups: group 1 (0 to <2 years, n 10); group 2 (2 to <5 years, n 41); group 3 (5 to <10 years, n 24); group 4 (10 to 15 years, n 18). In skeletal muscle phospholipids, oleic acid (18: 1n-9cis) content decreased significantly whereas that of linoleic (18: 2n-6) acid increased significantly with age (P for trend <0·01). In adipose tissue, the contents of triacylglycerol and linoleic acid increased significantly across the paediatric age range (P for trend <0·01), whereas dihomo-γ-linolenic (20: 3n-6) and arachidonic (20: 4n-6) showed significant differences between groups. The variations in fatty acid composition observed with age indicated an imbalance in dietary n-3/n-6 long-chain PUFA.
Austromegabalanus psittacus is a large (normally up to 30 cm high) sessile balanomorph barnacle from the coast of Chile and South Peru. Its hard shell is composed of twelve calcareous side plates, six parietes and six radii, joined in the form of a truncated cone opened at the top. Plates rest on a basal disk firmly cemented to the substratum. Although the crystalline microstructure of barnacle's shell has been studied to some extent, its organic composition and the mechanisms governing the biomineralization of such highly ordered nanocomposite have remained obscure. By using X-ray diffraction, infrared spectrometry, SEM and TEM electron microscopy, histochemistry, immuno-histochemistry and -ultrastructure, biochemistry and a crystallization assay, we have studied the cell-shell interactions, the crystalline microstructure of the inorganic moiety and the localization of particular macromolecules, and tested their influence on crystallization.The mineral of the plates and basal disk was calcite showing a (104) preferential orientation. Plates were not solid but porous. While parietes have longitudinal canals (from the base to the apex), radii have transversal canals arranged parallel to the base. These canals are not in the center of the plates but displaced to the outside of the shell delimiting a thinner solid outer lamina and a thicker inner one. The inner lamina consisted of parallel calcified layers separated by organic sheets. These sheets showed autofluorescence and consisted of chitin surrounded by proteoglycans and other minor proteins, which seems to be responsible for the fluorescent behaviour. These organic sheets were also organized as several concentric rings around the canals. The shell matrix obtained after decalcification, which surrounded the crystals, also contained a loose net of such proteoglycans. Mantle epithelial cells covered the entire surface of the inner side of the inner lamina and extend to the plate canals. While isolated chitin did not promote or alter calcite crystallization, the proteoglycan-rich fraction dramatically modified crystal morphology and size. As we have demonstrated in another model of biomineralization, such as the eggshell, hereby we suggest that these structured polyanionic proteoglycan moieties could also be part of the regulatory mechanisms of the barnacle shell mineralization.
The enterococci have traditionally been used as
indicators of faecal contamination
because they are common inhabitants of the human and
animal intestinal tract. In
addition, some strains are well documented as opportunistic
pathogens, and have
been implicated in endocarditis, infant diarrhoea and
other conditions. However,
other strains are widespread in foods, particularly in
milk and dairy products, where
they are considered desirable microflora. In fact, through
their proteolytic and
lipolytic abilities, they play an important role in cheese
ripening, contributing to the
development of the organoleptic properties characteristic
of certain cheeses (Villani et al. 1993).
Production of antimicrobial substances is one of the
mechanisms by which
microorganisms can exert a probiotic effect in a host.
In this context, a significant
number of bacteriocin-producing enterococci of dairy
origin have been isolated in
recent years (Giraffa, 1995). Production of these
antimicrobial peptides or proteins
is a common phenotype among lactic acid bacteria, and
this is the application of
enterococcal bacteriocins of special interest in dairy
systems. Firstly, they show
activity against a broad spectrum of spoilage and
pathogenic organisms of concern
in dairy industries, such as Listeria monocytogenes.
Secondly, they are inactivated by
human gastric enzymes but not by some enzymes that, like
rennet, are frequently
used in dairy plants. Finally, their marked heat stability
enables them to be used in
a wide variety of dairy products (Giraffa, 1995).
The genes that encode the biosynthesis of some enterocins
or enterococcins, such
as enterocin AS-48 (Martínez-Bueno et al. 1994),
have been sequenced, allowing their
rapid detection by molecular biology techniques such as
the polymerase chain
reaction (PCR) (Joosten et al. 1997). Enterococcal
bacteriocins that have been
genetically characterized have been shown to be
plasmid-encoded (Clewell, 1993).
In this paper, we report a simple method for the isolation
of plasmid DNA from
dairy enterococci, using a combination of lysozyme and
glass beads (Frère, 1994;
Reinkemeier et al. 1996) to achieve cell lysis.
Plasmid DNA was used in dot-blot and
Southern hybridization analyses to identify enterocin
enterococci by using a specific PCR-generated probe. In
addition, a more rapid
detection method based on colony hybridization was also developed.
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