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Acute respiratory infection is one of the main causes of morbidity in children. Some studies have suggested that pulmonary hypertension and congenital heart disease with haemodynamic repercussion increase the severity of respiratory infections, but there are few publications in developing countries.
This was a prospective cohort study evaluating the impact of pulmonary hypertension and congenital heart disease (CHD) with haemodynamic repercussion as predictors of severity in children under 5 years of age hospitalised for acute respiratory infection.
Altogether, 217 children hospitalised for a respiratory infection who underwent an echocardiogram were evaluated; 62 children were diagnosed with CHD with haemodynamic repercussion or pulmonary hypertension. Independent predictors of admission to intensive care included: pulmonary hypertension (RR 2.14; 95% CI 1.06–4.35, p = 0.034), respiratory syncytial virus (RR 2.52; 95% CI 1.29–4.92, p = 0.006), and bacterial pneumonia (RR 3.09; 95% CI 1.65–5.81, p = 0.000). A significant difference was found in average length of hospital stay in children with the cardiovascular conditions studied (p = 0.000).
Pulmonary hypertension and CHD with haemodynamic repercussion as well as respiratory syncytial virus and bacterial pneumonia were predictors of severity in children with respiratory infections in this study. Early recognition of cardiovascular risks in paediatric populations is necessary to lessen the impact on respiratory infections.
Verbal working memory span is decreased in patients with schizophrenia, and this might contribute to impairment in higher cognitive functions as well as to the formation of certain clinical symptoms. Processing speed has been identified as a crucial factor in cognitive efficiency in this population. We tested the hypothesis that decreased processing speed underlies the verbal working memory deficit in patients and mediates the associations between working memory span and clinical symptoms.
Forty-nine schizophrenia inpatients recruited from units for chronic and acute patients, and forty-five healthy participants, were involved in the study. Verbal working memory span was assessed by means of the letter-number span. The Digit Copy test was used to assess motor speed, and the Digit Symbol Substitution Test to assess cognitive speed.
The working memory span was significantly impaired in patients (F(1,90) = 4.6, P < 0.05). However, the group difference was eliminated when either the motor or the cognitive speed measure was controlled (F(1,89) = 0.03, P = 0.86, and F(1,89) = 0.03, P = 0.88). In the patient group, working memory span was significantly correlated with negative symptoms (r = –0.52, P < 0.0001) and thought disorganisation (r = –0.34, P < 0.025) scores. Regression analyses showed that the association with negative symptoms was no longer significant when the motor speed measure was controlled (β = –0.12, P = 0.20), while the association with thought disorganisation was no longer significant when the cognitive speed measure was controlled (β = –0.10, P = 0.26).
Decrement in motor and cognitive speed plays a significant role in both the verbal working memory impairment observed in patients and the associations between verbal working memory impairment and clinical symptoms.
Cannabis consumption is known to be increased in both schizophrenic and first psychotic episode patients. Contrary to what has been reported in studies with healthy people, all published studies so far have reported no impairments or even beneficial effects on neurocognition associated with cannabis consumption in schizophrenia and first psychotic episode patients. However, these studies did not address the effects of very high cannabis consumption.
Our aim in this study was to assess the effects on neurocognition of regular and heavy cannabis consumption in first psychotic episode patients.
A total of 74 patients were included in the study and assigned to 3 different groups according to their mean cannabis consumption during the last year (non-users, regular users, and heavy users). Participants were administered verbal memory, attention, processing speed, working memory, vocabulary, arithmetic and spatial orientation tasks.
Our results showed the heavy cannabis group of first psychotic episode patients to be significantly impaired in all the verbal memory measures with respect to the non-users group. There were no significant differences between regular users and non-users. Moreover, regular cannabis consumption was associated with an improvement in some attention and processing speed measures.
Our data showed heavy cannabis consumption to impair verbal memory in first psychotic episode patients and suggest a dose-related effect of cannabis consumption, since regular consumption did not impair verbal memory and may be beneficial for other tasks.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The personality disorders are defined according to the DSM-5 like “an enduring maladaptive patterns of behavior, cognition and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's cultures. These patterns develop in adolescence and the beginning of adulthood, and are associated with significant distress or disability”. The personality disorders can be a risk factor for different processes of the psychiatric pathology like suicide. The personality disorders are classified in 3 groups according to the DSM-5:
– cluster A (strange subjects): paranoid, schizoid and schizotypal;
– cluster B (immature subjects): antisocial, bordeline, histrionic and narcissistic;
– cluster C (frightened subjects): avoidant, dependent and obsessive-compulsive.
To describe the influence of personality disorders in suicide attempts.
Exhibition of clinical cases.
In this case report, we exhibit three clinical cases of suicide attempts which correspond to a type of personality disorder belonging to each of the three big groups of the DSM-5 classification, specifically the paranoid disorder of the cluster A, the disorder borderline of cluster B and the obsessive compulsive of cluster C.
The personality disorders have a clear relation with the suicide attempts, increasing this influence in some of them, especially the borderline personality disorder.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Psychiatric patients tend to have severe metabolic alterations of multifactorial causes, lifestyle, diet, drug use and psychopharmacological treatment, especially antipsychotic drugs which act as risk factors for cardiovascular disease, strokes, infections and complications of diseases basal negatively influencing its evolution and prognosis.
Rating the profile lipid and the prevalence of obesity in patients registered as disorder mental severe in treatment with antipsychotics.
A descriptive study was performed taking as variables to take into account levels of cholesterol, triglycerides, weight and size.
Of the 28 patients included in the study 7 refused to perform the corresponding measurements. Of the 21 remaining, 3 showed values higher than 150 mg/dl triglycerides and cholesterol figures higher than 200 mg/dl. Other 3 patients presented hypercholesterolemia without alteration of triglycerides and 2 hypertriglyceridemia without elevation of the cholesterol. Concerning the IMC, found that 7 patients presented overweight (BMI > 25 and < 30) and 5 patients obesity (BMI > 30). Of the 8 patients with lipid disorders, 2 had prescribed treatment with risperidone (oral or injectable) more quetiapine, 2 oral risperidone as monotherapy, risperidone1 more amisulpride, 1 quetiapine more aripiprazole, quetiapine 1 in monotherapyand 1 injection invega more oxcarbamacepina.
We found lipid alterations in a 38.1% of patients and a BMI greater than 25 in a 57.14% of 21 patients who agreed to the study. The most prescribed antipsychoticamong these patients were risperidone (5 patients) followed closely by quetiapine (4 patients).
Disclosure of interest
The authors have not supplied their declaration of competing interest.
He income hospital represents a rupture in the continuity of life of the patient. It would be advisable to determine those variables that help to reduce them. Some studies are running to a paper protector of the treatment injection in the relapses and number of hospitalizations.
Compare the risk of decompensation, measured in terms of income hospital or consultations to emergency, between patients to treatment injection versus oral.
He is a descriptive study which assesses the number of hospital admissions and consultations to emergency departments in the period of one year (between September 2015 and September 2016) of a sample of 28 patients registered as TMS and the results are compared with the type used for antipsicotivo treatment via.
We start from a sample of 28 patients, of which 17 are still a treatment intramuscular and 11 have all your guideline prescribed in oral. Patients injection treatment group needed to be admitted to a psychiatric inpatient unit at least on one occasionin the past year, 7 patients and 11 patients to oral treatment, only 2 patients wereadmitted and other 2 came once to your referral hospital emergency department.
Of the 17 patients to treatment with injectable ingresason or needed care urgently a 41.18%, facing the 36.36% of those patients to treatment by via oral. These results do not have a protective role of injectable treatment compared with decompensation measures according to need hospitalization or urgent attention.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Although multiple studies have been conducted in the adult population, there is a vast knowledge gap regarding the epidemiologic characteristics of cardiomyopathies in the paediatric population. This issue is even more crucial when the precarious situation of medical research in Latin America is considered. Given the potential impact that these disorders could have on Latin American health systems, a comprehensive epidemiologic study regarding the clinical profile and sociodemographic characteristics of these patients will influence the way we approach paediatric cardiomyopathies.
An observational retrospective study was conducted at a tertiary referral centre for Colombian and Latin American paediatric cardiology. We analysed all cases of primary cardiomyopathies in children younger than 18 years of age who presented at our institution between 2010 and 2016. Cases of cardiomyopathies were classified according to World Health Organization guidelines.
From a total of 29,533 children who attended our institution during the study period, 89 new cases of primary cardiomyopathies were identified. The median age at diagnosis was 11 years (interquartile range 4–9). Dilated cardiomyopathy accounted for 57.3% (n = 51) of cases; hypertrophic cardiomyopathy, 12.3% (n = 11); restrictive cardiomyopathy, 8.9% (n = 8); non-compacted cardiomyopathy, 7.8% (n = 7); arrhythmogenic ventricular cardiomyopathy, 6.7% (n = 6); and unspecified cardiomyopathy, 6.7% (n = 6). Heart failure was observed in 53.93% of the patients. The overall mortality was 12.36% (n = 11), which included two of eight patients who underwent cardiac transplantation.
Experimental studies have reported on the anti-inflammatory properties of polyphenols. However, results from epidemiological investigations have been inconsistent and especially studies using biomarkers for assessment of polyphenol intake have been scant. We aimed to characterise the association between plasma concentrations of thirty-five polyphenol compounds and low-grade systemic inflammation state as measured by high-sensitivity C-reactive protein (hsCRP). A cross-sectional data analysis was performed based on 315 participants in the European Prospective Investigation into Cancer and Nutrition cohort with available measurements of plasma polyphenols and hsCRP. In logistic regression analysis, the OR and 95 % CI of elevated serum hsCRP (>3 mg/l) were calculated within quartiles and per standard deviation higher level of plasma polyphenol concentrations. In a multivariable-adjusted model, the sum of plasma concentrations of all polyphenols measured (per standard deviation) was associated with 29 (95 % CI 50, 1) % lower odds of elevated hsCRP. In the class of flavonoids, daidzein was inversely associated with elevated hsCRP (OR 0·66, 95 % CI 0·46, 0·96). Among phenolic acids, statistically significant associations were observed for 3,5-dihydroxyphenylpropionic acid (OR 0·58, 95 % CI 0·39, 0·86), 3,4-dihydroxyphenylpropionic acid (OR 0·63, 95 % CI 0·46, 0·87), ferulic acid (OR 0·65, 95 % CI 0·44, 0·96) and caffeic acid (OR 0·69, 95 % CI 0·51, 0·93). The odds of elevated hsCRP were significantly reduced for hydroxytyrosol (OR 0·67, 95 % CI 0·48, 0·93). The present study showed that polyphenol biomarkers are associated with lower odds of elevated hsCRP. Whether diet rich in bioactive polyphenol compounds could be an effective strategy to prevent or modulate deleterious health effects of inflammation should be addressed by further well-powered longitudinal studies.
Development of biomaterials with primary amine surfaces is very important for the study of some cells of the immune systemuch as macrophages. Currently, the modification can be carried out by physical or chemical methods with several disadvantages due to the presence of additives or subproducts in the system. To overcome this problem, modified polypropylene (PP) films were synthesized by gamma radiation. In this work, radiation grafting of acryloyl chloride onto PP has been employed to form an acyl chloride. Then, the radiation-grafted films were reacted with ethylenediamine in several solvents to obtain the different concentration of the primary amine. The surface amine concentration was determined by derivatization with 4-trifluoromethyl benzaldehyde and characterized by x-ray photoelectron spectroscopy (N/C ratios), Fourier transform infrared spectroscopy with attenuated total reflection, contact angle, scanning electron microscopy, atomic force microscopy, and elementary analysis. The stability of the amines was measured up to 90 days, without the occurrence of aging as was found by plasma modification.
The elastic constants, elastic modulus, anisotropy, Debye temperature, and sound velocity properties of Mo0.85Nb0.15B3 were investigated by first-principles calculations under pressure based on the generalized gradient approximation (GGA) proposed by Perdew–Burke-Ernzerhof (PBE). Employing the stress-strain method and the Voigt-Reuss-Hill approximations, were calculated the elastic properties of single and polycrystalline crystals; Bulk modulus (B), Young modulus (E), Poisson ratio (ν), Pugh ratio (G/B), Debye temperature and the Cauchy pressure terms. The calculated ν, Cauchy pressure, and Pugh ratio G/B values indicate that Mo0.85Nb0.15B3 shows a transition from brittle to ductile under pressure. Finally, the Density of States decreases as pressure increases.
New therapeutic strategies have been established in chronic wound healing procedures, such as the use of platelet-rich plasma (PRP). There is currently still uncertainty about the effectiveness, cost-effectiveness and real safety of PRP in promoting chronic wound healing and what specific types of chronic wounds can benefit most from its use.
We conducted a systematic review of available scientific literature on the effectiveness, safety and cost-effectiveness of PRP compared to placebo, standard care or alternative topical therapies for the treatment of chronic wounds in adults. Overall effect size was estimated through a meta-analysis. A cost-effectiveness analysis was conducted using a Markov model which simulates the costs and health outcomes of individuals for a 5-year horizon, from the perspective of the Spanish National Health Service (NHS) for the PRP versus standard treatment in patients with diabetic foot ulcers. The effectiveness measure was quality-adjusted life years (QALYs). We ran extensive sensitivity analyses, including a probabilistic sensitivity analysis.
Sixteen RCTs and four observational studies were included for the effectiveness and safety meta-analysis. The primary outcome was the proportion of chronic wounds completely healed: 143 patients out of 334 (42.8 percent) were cured in the standard treatment arm and 251 patients out of 375 (66.9 percent) in the PRP arm, relative risk (RR) 1.68 (95% CI: 1.22–2.31). It was unclear whether there was a difference in the risk of infection (RR 0.53, 95% CI: 0.10–2.71) or adverse events (RR 1.05, 95% CI: 0.29–3.88) between PRP and standard care. Three studies were considered for the cost-effectiveness analysis. In the base case analysis, PRP led to higher QALYs and healthcare costs with an estimated incremental cost-effectiveness ratio (ICER) of EUR 41,767 (USD 48,323)/QALY.
PRP treatment is more expensive and more effective than standard treatment. The estimated ICER is above the acceptability threshold in Spain.
In the present work the kinetic growth is analyzed for a hard coating applied on a low carbon steel AISI 8620. A thermochemical treatment of bored with dehydrated paste at temperatures of 900, 950 and 1000 °C with a residence time of 2, 4, 6 and 8 h. The morphology and types of borides formed on the surface of the steel were evaluated by optical microscopy, scanning electron microscopy (SEM) and X-ray diffraction (XRD). The layer formed has a size of 20 to 113 μm which will be dependent on the process temperature, the treatment time and the alloy elements of the substrate. Hardness of 1493-1852 HV are presented for treatment times and temperatures established in this study. The kinetics of growth were determined and analyzed using a mathematical model of diffusion, evaluating the penetration of the biphasic layer that is determined as a function of the time and temperature of the thermochemical treatment (TCT). The results show the increase in the growth constants (k) with respect to the bored temperatures. The activity energy (Q) of the material AISI 8620 was also obtained.
In order to understand how galaxies form and evolve, the measurement of the parameters related to their morphologies and also to the way they interact is one of the most relevant requirements. Due to the huge amount of data that is generated by surveys, the morphological and interaction analysis of galaxies can no longer rely on visual inspection. For dealing with such issue, new approaches based on machine learning techniques have been proposed in the last years with the aim of automating the classification process. We tested Deep Learning using images of galaxies obtained from CANDELS to study the accuracy achieved by this tool considering two different frameworks. In the first, galaxies were classified in terms of their shapes considering five morphological categories, while in the second, the way in which galaxies interact was employed for defining other five categories. The results achieved in both cases are compared and discussed.
Establishing accurate morphological measurements of galaxies in a reasonable amount of time for future big-data surveys such as EUCLID, the Large Synoptic Survey Telescope or the Wide Field Infrared Survey Telescope is a challenge. Because of its high level of abstraction with little human intervention, deep learning appears to be a promising approach. Deep learning is a rapidly growing discipline that models high-level patterns in data as complex multilayered networks. In this work we test the ability of deep convolutional networks to provide parametric properties of Hubble Space Telescope like galaxies (half-light radii, Sérsic indices, total flux etc..). We simulate a set of galaxies including point spread function and realistic noise from the CANDELS survey and try to recover the main galaxy parameters using deep-learning. We compare the results with the ones obtained with the commonly used profile fitting based software GALFIT. This way showing that with our method we obtain results at least equally good as the ones obtained with GALFIT but, once trained, with a factor 5 hundred time faster.
We present an autonomous visual landmark recognition and pose estimation algorithm designed for use in navigation of spacecraft around small asteroids. Landmarks are selected as generic points on the asteroid surface that produce strong Harris corners in an image under a wide range in viewing and illumination conditions; no particular type of morphological feature is required. The set of landmarks is triangulated to obtain a tightly fitting mesh representing an optimal low resolution model of the natural asteroid shape, which is used onboard to determine the visibility of each landmark and enables the algorithm to work with highly concave bodies. The shape model is also used to estimate the centre of brightness of the asteroid and eliminate large translation errors prior to the main landmark recognition stage. The algorithm works by refining an initial estimate of the spacecraft position and orientation. Tests with real and synthetic images show good performance under realistic noise conditions. Using simulated images, the median landmark recognition error is 2m, and the error on the spacecraft position in the asteroid body frame is reduced from 45m to 21m at a range of 2km from the surface. With real images the translation error at 8km to the surface increases from 107m to 119m, due mainly to the larger range and lack of sensitivity to translations along the camera boresight. The median number of landmarks detected in the simulated and real images is 59 and 44 respectively. This algorithm was partly developed and tested during industrial studies for the European Space Agency’s Marco Polo-R asteroid sample return mission.
Animals destined for meat production are usually exposed to many stressful conditions during production and particularly during preslaughter operations. Handling animals on farm, loading into and unloading from vehicles, transportation, passing through livestock markets, fasting, lairage and stunning can all affect their welfare. How badly welfare can be affected will depend on both the intrinsic factors of the specific type of animal involved and the extrinsic factors of the environment where those animals live or are being handled, including the animal handlers. In South America (SA), it has been part of a strategy for improving animal welfare (AW) to address not only ethical aspects, but to emphasize the close relationship existing between handling ruminants preslaughter and the quantity and quality of the meat they produce. This has resulted not only in improvements in AW, but has also brought economic rewards to producers which in turn can lead to higher incomes for them and hence better human welfare. For producers with a high number of animals, considering AW during production and preslaughter operations can determine the possibility of exporting and/or getting better prices for their products. At smallfarmer level, particularly in some less developed countries, where human welfare is impaired, using this strategy together with education has also been relevant. It is important that education and training in AW are done not only considering global knowledge, but also including specific geographical and climatic characteristics of each country and the cultural, religious and socio-economical characteristics of its people; therefore, research within the context of each country or region becomes relevant. The aim of this review was to show the results of research dealing with AW of ruminant livestock in Chile and some other SA countries. Some of the main problems encountered are related to lack of proper infrastructure to handle animals; long distance transport with high stocking densities in the larger countries; long fasting times due to animals passing through livestock markets and dealers; bad handling of animals by untrained personnel in these and other premises; and finally the lack of knowledge and skills by operators in charge of stunning procedures. Interventions at these stages have considered training animal handlers and transporters by showing them the consequences of bad handling with audiovisual material prepared on site. Research results have helped to improve AW and support the development of new legislation or to make changes in the existent legislation related to AW.
Galaxy morphology is a first-order descriptor of a galaxy and a useful proxy to identify physical processes. The 100 years old Hubble fork describes the structural diversity of galaxies in the local universe. Unveiling the origins of this galaxy zoology is a key challenge in galaxy evolution. In this review talk, I first summarized some key advances in our understanding of the morphological evolution of galaxies from z ~ 0 to z ~ 3, thank you in particular to the SDSS and HST legacies. In the second part, I focused on the classification techniques. With the emergence in the last years of large surveys the samples of study have increased by several orders of magnitude going from a few tens to several millions of objects. This trend will clearly continue in the next decade with coming surveys/missions such as EUCLID and WFIRST. While galaxy classification is still a required step in any survey, visual inspection of galaxies is becoming prohibitively time-consuming. Under these circumstances, the techniques used to estimate galaxy morphologies need to be updated.
A retrospective case-control study of patients who had undergone cataract extraction at a Spanish hospital over a 13-year period was conducted to identify the risk factors for developing post-operative endophthalmitis (POE). During the study period, the type of antibiotic prophylaxis was changed from subconjunctival gentamicin to the addition of both vancomycin and gentamicin to the irrigating solution. The overall incidence of POE was 0·19% (35 cases/18 287 operations). For the period prior to the change in antibiotic prophylaxis, the incidence rate of POE was 3·4 cases/1000 operations while in the latter period the incidence rate decreased to 0·34 cases/1000 operations. All patients who presented a virulent microorganism had a final visual acuity worse than 20/200. The only significant risk factor identified was the type of prophylaxis used (odds ratio 1·97, 95% confidence interval 0·94–4·14, P = 0·07). There were no significant differences between cases and controls although choice of surgeon approached significance.
Health-beneficial effects of adhering to a healthy Nordic diet index have been suggested. However, it has not been examined to what extent the included dietary components are exclusively related to the Nordic countries or if they are part of other European diets as well, suggesting a broader preventive potential. The present study describes the intake of seven a priori defined healthy food items (apples/pears, berries, cabbages, dark bread, shellfish, fish and root vegetables) across ten countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) and examines their consumption across Europe.
Cross-sectional study. A 24 h dietary recall was administered through a software program containing country-specific recipes. Sex-specific mean food intake was calculated for each centre/country, as well as percentage of overall food groups consumed as healthy Nordic food items. All analyses were weighted by day and season of data collection.
Multi-centre, European study.
Persons (n 36 970) aged 35–74 years, constituting a random sample of 519 978 EPIC participants.
The highest intakes of the included diet components were: cabbages and berries in Central Europe; apples/pears in Southern Europe; dark bread in Norway, Denmark and Greece; fish in Southern and Northern countries; shellfish in Spain; and root vegetables in Northern and Central Europe. Large inter-centre variation, however, existed in some countries.
Dark bread, root vegetables and fish are strongly related to a Nordic dietary tradition. Apples/pears, berries, cabbages, fish, shellfish and root vegetables are broadly consumed in Europe, and may thus be included in regional public health campaigns.