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Antipsychotic treatment is known to be associated with secondary sexual dysfunction (SD). Recognition and treatment of this adverse effect has received growing attention. Until now, all antipsychotic agents were thought to potentially cause SD mediated by increased prolactin. Our aim was to observe whether aripiprazole modifies SD in patients with schizophrenia after 3 months of treatment.
Material and Methods:
Multicenter, observational, open-label, prospective, three-month study with single group of aripiprazole treated patients. Sexual activity was assessed using CGI-S and CGI-I for SD; SALSEX scale, validated for Spanish, 3 times after initiating study drug. Patient's clinical status was evaluated by CGI-S and CGI-I for psychotic disorders, and by BPRS Scale.
Result: 42 patients (70% men), 38 completed the study. Incidence of SD at 3 months was null for all patients studied. As period of treatment advanced, the Salsex score decreased, showing a mean overall reduction of –5 points (SD 3.6). Largest reduction was observed in subgroup of patients with SD in baseline visit, who exhibited a mean reduction of –6 points (SD 3.1).
Men with SD in baseline evaluation showed more marked improvement than women at 40 days of treatment (p=0.0447). However, recovery was similar for both groups at 90 days of treatment.
In schizophrenia, SD secondary studies to antipsychotics are important in establishing effectiveness of these agents in chronic treatment. After 3 months of aripiprazole treatment, no SD was observed in patients. Patients who presented SD at study initiation improved over course of 3 months treatment with aripiprazole.
After the commercialization of Aripiprazole in Spain, two observational studies were proposed, one was conducted when the drug was first launched, and the other when the starting dose of Aripiprazole was modified, in order to understand the switching strategies, the effectiveness, tolerability and adherence to treatment in standard use conditions.
Patients and Methods:
Two multicenter, retrospective, observational studies were carried out involving 200 psychiatrists throughout Spain with approximate 1000 patients treated with Aripiprazole during the previous four months in each one of the studies during 2005 and 2006 respectively.
Both groups of patients had a very similar demographic profile that matches with the general schizophrenic population. In the first study, the main reasons for switching medication were low efficacy (56% of cases) and intolerance (35%), and 44% and 43% respectively in the second study. Despite the poor response to previous treatment, clinical evaluation of effectiveness and tolerability with Aripiprazole was very positive: In the first study, 76% of patients had very good or good effectiveness and tolerability was very good or good in 90%. In the second study, these values were 75% and 93%, respectively. Patterns of change from the previous treatment were switching in 75% of cases in the first study and in 60% in the second study.
Effectiveness of treatment with Aripiprazole is good in patients who had a poor response to their previous antipsychotic treatments. The most frequent and effective pattern for change patients to Aripiprazole treatments is switching.
S-Metolachlor is commonly used by soybean and cotton growers, especially with POST treatments for overlapping residuals, to obtain season-long control of glyphosate- and acetolactate synthase (ALS)–resistant Palmer amaranth. In Crittenden County, AR, reports of Palmer amaranth escapes following S-metolachlor treatment were first noted at field sites near Crawfordsville and Marion in 2016. Field and greenhouse experiments were conducted to confirm S-metolachlor resistance and to test for cross-resistance to other very-long-chain fatty acid (VLCFA)–inhibiting herbicides in Palmer amaranth accessions from Crawfordsville and Marion. Palmer amaranth control in the field (soil <3% organic matter) 14 d after treatment (DAT) was ≥94% with a 1× rate of acetochlor (1,472 g ai ha–1; emulsifiable concentrate formulation) and dimethenamid-P (631 g ai ha–1). However, S-metolachlor at 1,064 g ai ha–1 provided only 76% control, which was not significantly different from the 1/2× and 1/4× rates of dimethenamid-P and acetochlor (66% to 85%). In the greenhouse, Palmer amaranth accessions from Marion and Crawfordsville were 9.8 and 8.3 times more resistant to S-metolachlor compared with two susceptible accessions based on LD50 values obtained from dose–response experiments. Two-thirds and 1.5 times S-metolachlor at 1,064 g ha–1 were the estimated rates required to obtain 90% mortality of the Crawfordsville and Marion accessions, respectively. Data collected from the field and greenhouse confirm that these accessions have evolved a low level of resistance to S-metolachlor. In an agar-based assay, the level of resistance in the Marion accession was significantly reduced in the presence of a glutathione S-transferase (GST) inhibitor, suggesting that GSTs are the probable resistance mechanism. With respect to other VLCFA-inhibiting herbicides, Marion and Crawfordsville accessions were not cross-resistant to acetochlor, dimethenamid-P, or pyroxasulfone. However, both accessions, based on LD50 values obtained from greenhouse dose–response experiments, exhibited reduced sensitivity (1.5- to 3.6-fold) to the tested VLCFA-inhibiting herbicides.
Field experiments were conducted in 2012 and 2013 across four locations for a total of 6 site-years in the midsouthern United States to determine the effect of growth stage at exposure on soybean sensitivity to sublethal rates of dicamba (8.8 g ae ha−1) and 2,4-D (140 g ae ha−1). Regression analysis revealed that soybean was most susceptible to injury from 2,4-D when exposed between 413 and 1,391 accumulated growing degree days (GDD) from planting, approximately between V1 and R2 growth stages. In terms of terminal plant height, soybean was most susceptible to 2,4-D between 448 and 1,719 GDD, or from V1 to R4. However, maximum susceptibility to 2,4-D was only between 624 and 1,001 GDD or from V3 to V5 for yield loss. As expected, soybean was sensitive to dicamba for longer spans of time, ranging from 0 to 1,162 GDD for visible injury or from emergence to R2. Likewise, soybean height was most affected when dicamba exposure occurred between 847 and 1,276 GDD or from V4 to R2. Regarding grain yield, soybean was most susceptible to dicamba between 820 and 1,339 GDD or from V4 to R2. Consequently, these data indicate that soybean response to 2,4-D and dicamba can be variable within vegetative or reproductive growth stages; therefore, specific growth stage at the time of exposure should be considered when evaluating injury from off-target movement. In addition, application of dicamba near susceptible soybean within the V4 to R2 growth stages should be avoided because this is the time of maximum susceptibility. Research regarding soybean sensitivity to 2,4-D and dicamba should focus on multiple exposure times and also avoid generalizing growth stages to vegetative or reproductive.
Palmer amaranth accessions resistant to protoporphyrinogen oxidase (PPO), 5-enolpyruvyl-shikimate-3-phosphate synthase, and acetolactate synthase (ALS)-inhibitor herbicides are widespread in the Midsouth, making control difficult. Field experiments were conducted in Marion and Crawfordsville, AR, in 2016 and 2017 to assess PRE and POST herbicides labeled for use in corn, cotton, or soybean for control of multiresistant Palmer amaranth. Accessions at both locations were resistant to glyphosate and ALS inhibitors and segregating for both the R128 and ΔG210 PPO resistance mechanisms. Of the 15 herbicide treatments tested, only atrazine (1,120 g ai ha−1), pyroxasulfone (149 g ha−1), and flumioxazin (144 g ha−1) provided 85% or greater Palmer amaranth control 14 days after treatment (DAT). Visible control ratings at 35 DAT declined sharply, with no treatment providing more than 84% control, suggesting POST applications should be made no later than 28 DAT. Glufosinate (594 and 818 g ha−1), dicamba (560 g ae ha−1), 2,4-D plus glyphosate (784 g ae ha−1 plus 834 g ae ha−1), and paraquat (700 g ha−1) applied POST to 7- to 10-cm plants reduced Palmer amaranth density 83% or more 14 DAT. Both glyphosate (1,266 g ha−1) and pyrithiobac sodium (73 g ha−1) provided less than 7% Palmer amaranth control. Although flumioxazin alone at a labeled rate controlled Palmer amaranth 82% in the PRE experiment, PPO inhibitors by themselves applied POST provided no more than 37% control at 14 DAT. Effective foliar herbicides applied POST, including residual herbicides, should be made when Palmer amaranth are less than 10-cm tall for optimal control of these multiresistant Palmer amaranth accessions.
40% of people with dementia have disturbed sleep but there are currently no known effective treatments. Studies of sleep hygiene and light therapy have not been powered to indicate feasibility and acceptability and have shown 40–50% retention. We tested the feasibility and acceptability of a six-session manualized evidence-based non-pharmacological therapy; Dementia RElAted Manual for Sleep; STrAtegies for RelaTives (DREAMS-START) for sleep disturbance in people with dementia.
We conducted a parallel, two-armed, single-blind randomized trial and randomized 2:1 to intervention: Treatment as Usual. Eligible participants had dementia and sleep disturbances (scoring ≥4 on one Sleep Disorders Inventory item) and a family carer and were recruited from two London memory services and Join Dementia Research. Participants wore an actiwatch for two weeks pre-randomization. Trained, clinically supervised psychology graduates delivered DREAMS-START to carers randomized to intervention; covering Understanding sleep and dementia; Making a plan (incorporating actiwatch information, light exposure using a light box); Daytime activity and routine; Difficult night-time behaviors; Taking care of your own (carer's) sleep; and What works? Strategies for the future. Carers kept their manual, light box, and relaxation recordings post-intervention. Outcome assessment was masked to allocation. The co-primary outcomes were feasibility (≥50% eligible people consenting to the study) and acceptability (≥75% of intervention group attending ≥4 intervention sessions).
In total, 63out of 95 (66%; 95% CI: 56–76%) eligible referrals consented between 04/08/2016 and 24/03/2017; 62 (65%; 95% CI: 55–75%) were randomized, and 37 out of 42 (88%; 95% CI: 75–96%) adhered to the intervention.
DREAM-START for sleep disorders in dementia is feasible and acceptable.
Two new species of Oreocharis, O. tribracteata and O. rufescens, are described and a key to the species in Vietnam is provided. The new species have distinct features not previously, or rarely, observed in the genus, both showing the partial fusion of the calyx lobes into a tube, and the presence of three bracts in Oreocharis tribracteata.
Coinfection with human immunodeficiency virus (HIV) and viral hepatitis is associated with high morbidity and mortality in the absence of clinical management, making identification of these cases crucial. We examined characteristics of HIV and viral hepatitis coinfections by using surveillance data from 15 US states and two cities. Each jurisdiction used an automated deterministic matching method to link surveillance data for persons with reported acute and chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections, to persons reported with HIV infection. Of the 504 398 persons living with diagnosed HIV infection at the end of 2014, 2.0% were coinfected with HBV and 6.7% were coinfected with HCV. Of the 269 884 persons ever reported with HBV, 5.2% were reported with HIV. Of the 1 093 050 persons ever reported with HCV, 4.3% were reported with HIV. A greater proportion of persons coinfected with HIV and HBV were males and blacks/African Americans, compared with those with HIV monoinfection. Persons who inject drugs represented a greater proportion of those coinfected with HIV and HCV, compared with those with HIV monoinfection. Matching HIV and viral hepatitis surveillance data highlights epidemiological characteristics of persons coinfected and can be used to routinely monitor health status and guide state and national public health interventions.
Pachyonychia congenita is a rare keratinising disorder, which typically presents during the first three years of life and usually affects the nails and palmoplantar surfaces. It can involve the larynx and potentially result in life-threatening airway obstruction.
A case report is presented and the findings of a literature review are reported. The review involved a PubMed search using the keywords ‘pachyonychia congenita’ together with ‘larynx’, ‘laryngeal involvement’, ‘laryngeal obstruction’, ‘airway obstruction’, ‘hoarseness’ and/or ‘stridor’.
A five-year-old boy, with confirmed pachyonychia congenita, presented with complications of laryngeal involvement over a four-year period. He required three intubations and a tracheostomy for acute airway obstruction. Treatment with potassium titanyl phosphate laser laryngoscopy stabilised the progression of laryngeal disease.
Patients with pachyonychia congenita and laryngeal involvement can have a varied presentation, ranging from hoarseness to acute airway obstruction. Management can be a challenge, requiring early evaluation, regular surveillance and aggressive treatment. This paper reports our experience in managing and treating the laryngeal complications of a child with pachyonychia congenita.
Field studies were conducted in Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, and Tennessee during 2010 and 2011 to determine the effect of glufosinate application rate on LibertyLink and WideStrike cotton. Glufosinate was applied in a single application (three-leaf cotton) or sequential application (three-leaf followed by eight-leaf cotton) at 0.6, 1.2, 1.8, and 2.4 kg ai ha−1. Glufosinate application rate did not affect visual injury or growth parameters measured in LibertyLink cotton. No differences in LibertyLink cotton yield were observed because of glufosinate application rate; however, LibertyLink cotton treated with glufosinate yielded slightly more cotton than the nontreated check. Visual estimates of injury to WideStrike cotton increased with each increase in glufosinate application rate. However, the injury was transient, and by 28 d after the eight-leaf application, no differences in injury were observed. WideStrike cotton growth was adversely affected during the growing season following glufosinate application at rates of 1.2 kg ha−1 and greater; however, cotton height and total nodes were unaffected by glufosinate application rate at the end of the season. WideStrike cotton maturity was delayed, and yields were reduced following glufosinate application at rates of 1.2 kg ha−1 and above. Fiber quality of LibertyLink and WideStrike cotton was unaffected by glufosinate application rate. These data indicate that glufosinate may be applied to WideStrike cotton at rates of 0.6 kg ha−1 without inhibiting cotton growth, development, or yield. Given the lack of injury or yield reduction following glufosinate application to LibertyLink cotton, these cultivars possess robust resistance to glufosinate. Growers are urged to be cautious when increasing glufosinate application rates to increase control of glyphosate-resistant Palmer amaranth in WideStrike cotton. However, glufosinate application rates may be increased to maximum labeled rates when making applications to LibertyLink cotton without fear of reducing cotton growth, development, or yield.
Age-frequency distributions of dead skeletal material on the landscape or seabed—information on the time that has elapsed since the death of individuals—provide decadal- to millennial-scale perspectives both on the history of production and on the processes that lead to skeletal disintegration and burial. So far, however, models quantifying the dynamics of skeletal loss have assumed that skeletal production is constant during time-averaged accumulation. Here, to improve inferences in conservation paleobiology and historical ecology, we evaluate the joint effects of temporally variable production and skeletal loss on postmortem age-frequency distributions (AFDs) to determine how to detect fluctuations in production over the recent past from AFDs. We show that, relative to the true timing of past production pulses, the modes of AFDs will be shifted to younger age cohorts, causing the true age of past pulses to be underestimated. This shift in the apparent timing of a past pulse in production will be stronger where loss rates are high and/or the rate of decline in production is slow; also, a single pulse coupled with a declining loss rate can, under some circumstances, generate a bimodal distribution. We apply these models to death assemblages of the bivalve Nuculana taphria from the Southern California continental shelf, finding that: (1) an onshore-offshore gradient in time averaging is dominated by a gradient in the timing of production, reflecting the tracking of shallow-water habitats under a sea-level rise, rather than by a gradient in disintegration and sequestration rates, which remain constant with water depth; and (2) loss-corrected model-based estimates of the timing of past production are in good agreement with likely past changes in local production based on an independent sea-level curve.
We use excavations of low-status houses to explore Postclassic political and economic transformations in the lower Río Verde Valley, Oaxaca. Following the collapse of Classic period political institutions, commoners experienced greater economic and political autonomy. Residential excavations at Río Viejo indicate that commoners took advantage of the absence of regional authority to gain greater control over surplus craft products, especially cotton thread, as well as access to social valuables and long distance trade. By the Late Postclassic period, the region was once again dominated by powerful rulers. Yet household excavations at Tututepec show that Late Postclassic commoners continued to control some surplus craft production and had access to social valuables like copper and polychrome pottery via market exchange. We argue that Late Postclassic political relations were a product of negotiations among elites and commoners that in part reflect the greater economic autonomy and political power that Early Postclassic people had acquired.
transient ischemic attack (tIA) and minor stroke have a high risk of early neurological deterioration, and patients who experience early improvement are at risk of deterioration. We generated a score for quantifying the worst reported motor and speech deficits and assessed whether this predicted outcome.
510 tIA or minor stroke (NIHSS>4) patients were included. the Historical Stroke Severity Score (HSSS) prospectively quantified the patient's description of the worst motor or speech deficits. the HSSS was rated at the time of first assessment with more severe deficits scoring higher. Motor HSSS included assessments of arm and leg motor power (score total 0-5). Speech HSSS assessed severity of dysarthria and aphasia (total 0-3). the association between motor and speech HSSS and symptom progression was assessed during the 90-day follow-up period.
the proportion of patients in each category of the motor HSSS was 0: 43% (216/510), 1: 22%(110/510), 2: 17% (89/510), 3: 7% (37/510), 4: 5% (28/510) and 5: 6% (30/510). Motor HSSS was associated with symptom progression (p=0.004) but not recurrent stroke. Speech HSSS was not associated with either progression or recurrent stroke. Motor HSSS predicted disability (p=0.002) and intracranial occlusion (p=0.012). Disability increased with increasing motor HSSS.
taking a detailed history about the severity of motor deficits, but not speech, predicted outcome in tIA and minor stroke patients. A score based on the patient's description of the severity of motor symptoms predicted symptom progression, intracranial occlusion and functional outcome, but not recurrent stroke in a tIA and minor stroke population.
We employ intense and short pulses of energetic lithium (Li+) ions to investigate the relaxation dynamics of radiation induced defects in single crystal silicon samples. Ions both create damage and track damage evolution simultaneously at short time scales when we use the channeling effect as a diagnostic tool. Ion pulses, ∼20 to 600 ns long and with peak currents of up to ∼1 A are formed in an induction type linear accelerator, the Neutralized Drift Compression eXperiment at Lawrence Berkeley National Laboratory. By rotating silicon (<100>) membranes of different thicknesses and changing the incident ion energy, the fraction of channeled ions in the transmitted beam could be varied. In preliminary experiments we find that the Li ion intensity is not high enough to generate overlapping cascades (in time and space) that would be necessary to measure a change in the shape of the current waveform of the transmitted ion beam. We discuss the concept of pump-probe type experiments with short ion beam pulses to access defect dynamics in materials and outline a path to increasing damage rates with heavier ions and by the application of longitudinal and lateral pulse compression techniques.
Platinum particles supported in zeolites are used as catalysts for hydrogenation/ dehydrogenation reactions. In this study in situ high energy synchrotron X-ray diffraction was used to study the Pt particle formation under calcination and reduction conditions using time resolved pair distribution function (PDF). Because these particles grow inside the pores of zeolite X, PDF is able to give insight to unique information at the short and medium interatomic distance range that cannot be readily obtained with other techniques. Among the information obtained are the Pt atom interactions during calcination and the evolvement of the Pt particle sizes and average Pt-Pt distances during reduction.