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Psychosis with onset prior to 18 years of age, or early-onset psychosis (EOP), have a poorer prognosis than adult-onset psychosis. Further, a worse functional outcome of patients with EOP has been related to diagnosis of schizophrenia, severity of negative symptoms, behavioral problems, premorbid functioning, childhood onset, and insidious onset. We aim to examine the functional outcome of patients with EOP over a two-year follow-up.
A total of 24 patients with first episode psychosis were enrolled. Subjects underwent a cross-sectional evaluation at the baseline visit that consisted of collecting sociodemographic data, including parental socioeconomic status as measured by the Hollingshead-Redlich Scale. Psychotic symptoms were assessed using the Spanish version of the Positive and Negative Syndrome Scale (PANSS). Social disability was measured with the Global Assessment of Functioning disability scale (GAF). Patients were assessed at a two-year follow-up. A linear regression analysis was used to predict the level of functioning (based on GAF scores) over the two-year follow-up. Variables entered into this equation were: GAF at two-year follow-up (as dependent variable), and gender, age at first onset, parental socioeconomic status, diagnosis, positive symptoms at baseline, and negative symptoms at baseline (as independent variables).
Negative symptoms at baseline were the only significant variable that predict the functional outcome at the two-year follow-up (p= 0.010).
Functional prognosis of early-onset psychosis depends on the severity of negative symptoms, independently of diagnosis.
Autism Spectrum Disorders (ASD) and psychosis share deficits in social cognition. The insular region has been associated with awareness of self and reality, which may be basic for proper social interactions.
Total and regional insular volume and thickness measurements were obtained from a sample of 30 children and adolescents with ASD, 29 with early onset first-episode psychosis (FEP), and 26 healthy controls (HC). Total, regional, and voxel-level volume and thickness measurements were compared between groups (with correction for multiple comparisons), and the relationship between these measurements and symptom severity was explored.
Compared with HC, a shared volume deficit was observed for the right (but not the left) anterior insula (ASD: p = 0.007, FEP: p = 0.032), and for the bilateral posterior insula: (left, ASD: p = 0.011, FEP: p = 0.033; right, ASD: p = 0.004, FEP: p = 0.028). A voxel-based morphometry (VBM) conjunction analysis showed that ASD and FEP patients shared a gray matter volume and thickness deficit in the left posterior insula. Within patients, right anterior (r = −0.28, p = 0.041) and left posterior (r = −0.29, p = 0.030) insular volumes negatively correlated with the severity of insight deficits, and left posterior insular volume negatively correlated with the severity of ‘autistic-like’ symptoms (r = −0.30, p = 0.028).
The shared reduced volume and thickness in the anterior and posterior regions of the insula in ASD and FEP provides the first tentative evidence that these conditions share structural pathology that may be linked to shared symptomatology.
During an earthquake, vulnerable populations, especially those with chronic conditions, are more susceptible to adverse, event-induced exacerbation of chronic conditions such as limited access to food and water, extreme weather temperatures, and injury. These circumstances merit special attention when health care facilities and organizations prepare for and respond to disasters.
This study explores the relationship between pre-earthquake burden of illness and postearthquake health-related and preparedness factors in the US. Data from a cohort of male veterans who were receiving care at the Sepulveda Veterans Affairs Medical Center (VAMC) in Los Angeles, California USA during the 1994 Northridge earthquake were analyzed.
Veterans with one or more chronic conditions were more likely to report pain lasting two or more days, severe mental/emotional stress for more than two weeks, broken/lost medical equipment, having difficulty refilling prescriptions, and being unable to get medical help following the quake compared to veterans without chronic conditions. In terms of personal emergency preparedness, however, there was no association between burden of illness and having enough food or water for at least 24 hours after the earthquake.
The relationship that exists between health care providers, including both individual providers and organizations like the US Department of Veterans Affairs (VA), and their vulnerable, chronically-ill patients affords providers the unique opportunity to deliver critical assistance that could make this vulnerable population better prepared to meet their postdisaster health-related needs. This can be accomplished through education about preparedness and the provision of easier access to medical supplies. Disaster plans for those who are burdened with chronic conditions should meet their social needs in addition to their psychological and physical needs.
Der-MartirosianC, RiopelleD, NaranjoD, YanoE, RubensteinL, DobalianA. Pre-earthquake Burden of Illness and Postearthquake Health and Preparedness in Veterans. Prehosp Disaster Med. 2014;29(3):1-7.
The recent developments in applications that have been designed to increase road safety require reliable and trustworthy sensors. Keeping this in mind, the most up-to-date research in the field of automotive technologies has shown that LIDARs are a very reliable sensor family. In this paper, a new approach to road obstacle classification is proposed and tested. Two different LIDAR sensors are compared by focusing on their main characteristics with respect to road applications. The viability of these sensors in real applications has been tested, where the results of this analysis are presented.
Some new Advanced Driver Assistance Systems (ADAS) need on-the-lane vehicle positioning on accurate digital maps, but current applications of vehicle positioning do not justify the surcharge of very accurate equipment such as DGPS or high-cost inertial systems. For this reason, the performance of GPS in autonomous mode is analyzed. Although satisfactory results can be found, in some areas the GPS signal is lost or degraded so it is necessary to know the positioning error when using only inertial system data. A theoretical approach based on the uncertainty propagation law is used to estimate the upper limit of distance that can be travelled fulfilling the specifications of an assistance system. Test results support the conclusions of this approach. Finally, the combination of GPS and inertial systems is studied, with the conclusion that the theoretical approach is valid when inertial measurements are used right from the start of GPS signal degradation, without waiting for a complete loss of signal.
On 13 November 2009, the authorities of Flemish Brabant, Belgium, received an alert concerning a potential outbreak of Shigella sonnei at a public institution. A study was conducted to assess the extent, discover the source and to implement further measures. We performed a matched case-control study to test an association between shigellosis and canteen-food consumption. Water samples and food handlers' faecal samples were tested. The reference laboratory characterized the retrospectively collected Shigella specimens. We found 52 cases distributed over space (25/35 departments) and time (2 months). We found a matched odds ratio of 3·84 (95% confidence interval 1·02–14·44) for canteen-food consumption. A food handler had travelled to Morocco shortly before detection of the first laboratory-confirmed case. Water samples and food handlers' faecal samples tested negative for Shigella. Confirmed cases presented PFGE profiles, highly similar to archived isolates from Morocco. Foodborne transmission associated with the canteen was strongly suspected.
We present the adaptive optics assisted, near-infrared VLTI instrument GRAVITY for precision narrow-angle astrometry and interferometric phase referenced imaging of faint objects. With its two fibers per telescope beam, its internal wavefront sensors and fringe tracker, and a novel metrology concept, GRAVITY will not only push the sensitivity far beyond what is offered today, but will also advance the astrometric accuracy for UTs to 10 μas. GRAVITY is designed to work with four telescopes, thus providing phase referenced imaging and astrometry for 6 baselines simultaneously. Its unique capabilities and sensitivity will open a new window for the observation of a wide range of objects, and — amongst others — will allow the study of motion within a few times the event horizon size of the Galactic Center black hole.
The Iberian lynx (Lynx pardinus) is the most endangered felid in the world. Only about 160 individuals remain in 2 separate metapopulations in Southern Spain (Sierra Morena and Doñana). We obtained blood samples of 20 lynxes captured from 2004 to 2006, and determined the prevalence of infection and genetic diversity of Cytauxzoon spp. using 18S rRNA PCR and sequence analysis. Prevalence of infection was 15% (3 of 20). Cytauxzoon sp. was only detected in Sierra Morena. For phylogenetic analysis, we used the sequences reported in the present study and those characterized in different domestic and wild felids and ticks from North and South America, Asia and Europe. Three different Cytauxzoon sp. sequences were obtained. They were closely related to that obtained from a Spanish cat, but diverged in up to 1·0% with respect to the only previously reported sequence from an Iberian lynx. Conversely, the latter sequence clustered together with C. manul sequences obtained from Pallas cats (Otocolobus manul) in Mongolia. Our analysis yields a separate cluster of C. felis sequences from cats, wild felids and ticks in the United States and Brazil. These results suggest that at least 2 different Cytauxzoon spp. may be present in Iberian lynx. The apparent absence in one of the areas, together with the possibility of fatal cytauxzoonosis in lynxes makes necessary disease risks to be taken into account in management conservation strategies, such as translocations and re-introductions.
The catastrophic lahars triggered by the 13 November 1985 eruption of the ice-clad Nevado del Ruiz volcano, Colombia, demonstrate that the interaction of hot pyroclasts with snow and ice can release 30–50 millionm3 of meltwater in 30–90 minutes. The 1985 eruption caused a 16% loss in area and a 9% loss in volume of snow, firn and ice. Turbulent pyroclastic density currents mechanically mixed with snow and produced meltwater at a rate of 0.5–1.6mms–1. Laboratory experiments suggest that turbulent, fluidized pyroclastic density currents exert mechanical and thermal scour, thereby efficiently transferring heat from hot pyroclasts to snow. Ice cap loss at Nevado del Ruiz continued between 1985 and 2000, representing a ∽52% decline in area and a ∽30% fall in volume. Ice 60–190m thick caps the east and southeast summit plateau, whereas an ice field < 30m thick and devoid of snow is retreating on the north, northeast and west edges. This asymmetrical distribution of ice reflects combined long-term effects of the 1985 eruption and of the post-1985 ice cap retreat. Should volcanic activity resume, steep-sided glaciers can fail and pyroclastic flows and surges can sweep the snowpack and generate mixed avalanches and lahars. Although the potential source of meltwater has decreased since 1985, extensive debris at the ice cap margins can be incorporated to future lahars.
The genus Anaplasma (Rickettsiales: Anaplasmataceae) includes several pathogens of veterinary and human medical importance. An understanding of the diversity of Anaplasma major surface proteins (MSPs), including those MSPs that modulate infection, development of persistent infections, and transmission of pathogens by ticks, is derived in part, by characterization and phylogenetic analyses of geographic strains. Information concerning the genetic diversity of Anaplasma spp. MSPs will likely influence the development of serodiagnostic assays and vaccine strategies for the control of anaplasmosis.
We report a Raman scattering study of local vibrational modes (LVMs) on Mg-doped GaN grown by molecular beam epitaxy (MBE). Besides Mg:Ga local vibrational modes clearly observed at 262 and 565 cm−1, several peaks were detected in the spectral regions around 2200 cm−1 and 2900 cm−1. The modes in the 2200 cm−1 spectral region correspond to local modes of hydrogen complexes and hydrogen-decorated defects, and indicate the presence of a fairly high concentration of H in the samples. The peaks observed in the 2900 cm−1 region are assigned to carbon-hydrogen local modes and are indicative of the presence of C impurities in the samples. These measurements show that both C and H impurities may be present in sizable amounts not only in metal-organic chemical vapor deposition (MOCVD) samples but also in MBE grown samples, and this may have an effect on the electrical conductivity ofp-type GaN:Mg samples.
A direct comparison of the optical energies of MBE- and MOVPE-grown InxGa1-xN epilayers of similar InN content is performed for the first time. The InN fraction in the 7 MBE samples examined ranged from x ∼ 0.11 to x ∼ 0.35 while the range in available MOVPE epilayers is [0, 0.4]. Wavelength Dispersive X-ray (WDX) and Extended X-ray Absorption Fine Structure (EXAFS) spectroscopies were used to measure composition and local structure (alloy character) of the samples. Cathodoluminescence (CL) spectroscopy in situ, ex situ photoluminescence (PL) mapping and large-area optical absorption spectroscopy were used to measure various optical energies. The composition dependence of the optical energies is determined by the growth method. The absorption bandgap and luminescence peak energies vary linearly with x for both growth methods, suggesting a near-zero value of the bowing parameter. But the energy intercept at zero InN content in MOVPE samples is close to the wurtzite-GaN bandgap of 3.4 eV at room temperature, as expected, while the equivalent for MBE samples falls near 3.2 eV.
Crystal morphology of GaN layers grown on Si(111) evolves from whisker-like microcrystals to compact films as a function of the III/V ratio. Small changes in the III/V ratio (from Ga-rich to N-rich) during the growth of a compact layer result in the appearance of microcrystals on the top of the layer, indicating a sharp transition between the two growth regimes.
Four different morphologies are obtained by increasing the III/V ratio: a) completely columnar whisker-like samples exhibiting a pair of intense excitonic emissions at 3.471−3.478 eV; b) a mixture of compact regions with columnar microcrystals showing two pairs of excitonic emissionsnbsp c) compact layers with very small microcrystals on the top surface with a weaker dominant transition at 3.415 eV (±5meV) and, d) full compact and smooth layers with a single dominant excitonic emission at 3.466 eV. A combination of PL measurements with SEM photographs and CL imaging reveals that both pairs of emissions in samples b) come from the columnar microcrystals. The high energy pair (3.471−3.478eV) is attributed to the free-exciton A and a donor-bound exciton while the low energy pair (3.452−3.458eV) is assigned to acceptor-bound excitons associated to valence bands Γ9v and Γ7uv. Power and temperature dependence together with time-resolved data show that the dominant peak at 3.415eV (± 5meV) present in samples c) correspond to a donor-acceptor transition. CL measurements as a function of electron beam energy (depth) also indicate that this emission is more intense towards the interface between the layer and the sample. Finally, the excitonic emission in samples d) is shifted to lower energies due to residual biaxial tensile strain of thermal origin.
The 1988–1990 eruption of Lonquimay Volcano, Chile (38°S) formed a 10.2 km long andesite lava with a volume of 0.23 km3 over a period of 13 months. The lava extrusion rate decreased with time as chamber pressure and vent dimensions decreased. The velocity of the flow front decreased exponentially with distance from vent as a consequence of cooling and the increase of apparent viscosity at the flow front. The lava developed a central channel which decreased in width and depth with time. Three prominent lava levées were formed on each margin and resulted from abandonment as the channel decreased in width as a result of a rapid decrease of flow rate over the first 100 days of activity. A fourth major levée developed in February, during a brief period of flow rate increase down the main channel, but its walls were gradually exposed as the lava depth again decreased due to declining flow rate. The structure of lava levées depended on their age and longevity of the flow in the adjacent channel. Initial levées were formed in the first few days as the lava spread laterally and then retreated, leaving levées of massive lava. More mature rubble levées were formed during the next month by the lava pushing and then shearing aa and blocky breccia which formed on the cooling flow margin. Fragmentation and abrasion formed a characteristic zonation in the levées. A basal zone consists of very poorly sorted matrix-rich breccia with very rounded vesicular clasts and bimodal grain size distribution. The basal breccia zone strongly resembles block and ash flow deposits. This zone passes up into a zone of clast-supported clinker breccia which becomes increasingly matrix-poor and coarser with clasts becoming more angular upwards. The crest of the levée is composed of large (10–100 cm) angular to subangular blocks with no matrix. The zoned levées form after the active lava channel suddenly narrows. Lava depth initially increases and breccias are deposited on the channel margins and acquire the zoned structure by progressive shearing and accretion of clinkery aa breccia. The lava level then drops exposing the steep inner scarp of a levée. The most mature levée type formed in a long-lived channel over several months. The outer wall of the levée consists of zoned breccia, but the inner wall consists of a massive curving wall of strongly foliated lava with well-developed horizontal striations and ductile Reidel shears. The massive foliated facies is a consequence of prolonged flow which coats strongly sheared lava onto the inner levée wall. Scanning electron microscopy shows that the aa clinker clasts and foliated lava from the levée walls form at low melt fractions (⋚ 15%). In the last three months of the eruption the flow front ceased to advance but thickened as lava drained from proximal regions and intruded into the interior of the distal lava. The last stages of lava movement were characterized by updoming in the central channel. A lava surface feature, named here ‘Armadillo structure’, was formed by deformation of the cooler but still ductile lava crust. The deformation caused by underflow produced Reidel shears dipping upstream and doming of the lava due to rotation of the shear planes. The study demonstrates that lava morphology, structure and texture are strongly influenced by variations of effusion rate, local flow rate, channel topography and thermal maturity of the lava, which is reflected in downstream changes in viscosity.
Radiometric dates on specimens of plutons of the Coastal Cordillera of Atacama span the period 300–110 Ma. A group of dates cluster around 190 Ma and evidence is presented which strongly suggests that they represent near crystallization ages. The geographic distribution of these plutons, adjacent to Liassic tuffs and lavas (Pan de Azúcar and Posada de los Hidalgo formations), suggests a genetic relationship between them, and that the plutons were the roots of the Lower Jurassic volcanic chain. The location of these granitoids to the west of the Liassic volcanic rocks, favours a previous idea that the Liassic basin extended eastwards as a back-arc or intra-arc basin. The host rocks to the Lower Jurassic plutons include Palaeozoic granitoids and metasedimentary rocks, indicating that the volcanic chain was founded on continental crust. The distance from the Liassic plutons to the present-day trench is less than 100 km, which indicates the possibility that part of the arc-trench system of that time is missing.
An algorithm for the inference of the external behaviour model of an automaton is given. It uses a sequential learning procedure based on induction-contradiction-correction concepts. The induction is a generalization of relationships between automaton state properties, and the correction consists in a more and more accurate discrimination of the automaton state properties. These properties are defined from the input/output contradictory sequences which are discovered after the observed contradictions between successive predictions and observations.
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