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Intranasal esketamine has recently been approved for the treatment of treatment-resistant depression in adults, with different studies showing its efficacy and tolerability. However, the real-world tolerability of this treatment is still unclear.
Objectives
Evaluate the tolerability of intranasal esketamine in a case series of 15 patients.
Methods
Our case series includes 15 patients, who received treatment with intranasal esketamine during 2022-2023. In order to evaluate the tolerability of intranasal esketamine, patients were asked to complete the TSQM and a side effect questionnaire on different moments of the treatment (one week, six weeks and six months after the beginning of the treatment).
Results
The most common adverse effects were dissociation, dizziness, and somnolence, which resolved within the hours following the administration. All of them were mild or moderate in severity, having a minor impact on the patient, so none of the patients discontinued the treatment due to adverse effects. Other adverse effects noticed were: transitory increment of blood pressure in several patients, and worsening of obsessions in a patient with previous obsessive-compulsive symptoms.
Conclusions
Our data suggests that intranasal esketamine is well tolerated, with transient and mild adverse effects. In all cases the risk-benefit ratio must be evaluated, but until more studies are done, it seems to be a safe treatment for treatment-resistant depression.
Verbal fluency tests are quick and easy to administer neuropsychological measures and are regularly used in neuropsychological assessment. Additionally, phonological fluency is a widely used paradigm that is sensitive to cognitive impairment. This paper offers normative data of phonological verbal fluency (letters P, M, R) for Spanish middle- and older-aged adults, considering sociodemographic factors, and different measures such as the total number of words, errors (perseveration and intrusions), and 15 sec-segmented scores.
Method:
A total of 1165 cognitively unimpaired participants aged between 50 and 89 years old, participated in the study. Data for P were obtained for all participants. Letters M and R were also administered to a subsample of participants (852) aged 60 to 89 years. In addition, errors and words produced every 15 seconds were collected in the subsample. To verify the effect of sociodemographic variables, linear regression was used. Adjustments were calculated for variables that explained at least 5% of the variance (R2 ≥ .05).
Results:
Means and standard deviations by age, scaled scores, and percentiles for all tests across different measures are shown. No determination coefficients equal to or greater than .05 were found for sex or age. The need to establish adjustments for the educational level was only found in some of the measures.
Conclusions:
The current norms provide clinically useful data to evaluate Spanish-speaking natives from Spain aged from 50 to 89 years. Specific patterns of cognitive impairment can be analyzed using these normative data and may be important in neuropsychological assessment.
Two independent temporal-spatial clusters of hospital-onset Rhizopus infections were evaluated using whole-genome sequencing (WGS). Phylogenetic analysis confirmed that isolates within each cluster were unrelated despite epidemiological suspicion of outbreaks. The ITS1 region alone was insufficient for accurate analysis. WGS has utility for rapid rule-out of suspected nosocomial Rhizopus outbreaks.
The present study aimed to determine the prevalence of adiposity-based chronic disease (ABCD) and its association with anthropometric indices in the Mexican population. A cross-sectional study was conducted in 514 adults seen at a clinical research unit. The American Association of Clinical Endocrinology/AACE/ACE criteria were used to diagnose ABCD by first identifying subjects with BMI ≥ 25 kg/m2 and those with BMI of 23–24·9 kg/m2 and waist circumference ≥ 80 cm in women or ≥ 90 cm in men. The presence of metabolic and clinical complications associated with adiposity, such as factors related to metabolic syndrome, prediabetes, type 2 diabetes, dyslipidaemia and arterial hypertension, were subsequently evaluated. Anthropometric indices related to cardiometabolic risk factors were then determined. The results showed the prevalence of ABCD was 87·4 % in total, 91·5 % in men and 86 % in women. The prevalence of ABCD stage 0 was 2·4 %, stage 1 was 33·7 % and stage 2 was 51·3 %. The prevalence of obesity according to BMI was 57·6 %. The waist/hip circumference index (prevalence ratio (PR) = 7·57; 95 % CI 1·52, 37·5) and the conicity index (PR = 3·46; 95 % CI 1·34, 8·93) were better predictors of ABCD, while appendicular skeletal mass % and skeletal muscle mass % decreased the risk of developing ABCD (PR = 0·93; 95 % CI 0·90, 0·96; and PR = 0·95; 95 % CI 0·93, 0·98). In conclusion, the prevalence of ABCD in our study was 87·4 %. This prevalence increased with age. It is important to emphasise that one out of two subjects had severe obesity-related complications (ABCD stage 2).
Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in neonatal intensive care units (NICU) that confers significant morbidity and mortality.
Objective:
Improving our understanding of MRSA transmission dynamics, especially among high-risk patients, is an infection prevention priority.
Methods:
We investigated a cluster of clinical MRSA cases in the NICU using a combination of epidemiologic review and whole-genome sequencing (WGS) of isolates from clinical and surveillance cultures obtained from patients and healthcare personnel (HCP).
Results:
Phylogenetic analysis identified 2 genetically distinct phylogenetic clades and revealed multiple silent-transmission events between HCP and infants. The predominant outbreak strain harbored multiple virulence factors. Epidemiologic investigation and genomic analysis identified a HCP colonized with the dominant MRSA outbreak strain who cared for most NICU patients who were infected or colonized with the same strain, including 1 NICU patient with severe infection 7 months before the described outbreak. These results guided implementation of infection prevention interventions that prevented further transmission events.
Conclusions:
Silent transmission of MRSA between HCP and NICU patients likely contributed to a NICU outbreak involving a virulent MRSA strain. WGS enabled data-driven decision making to inform implementation of infection control policies that mitigated the outbreak. Prospective WGS coupled with epidemiologic analysis can be used to detect transmission events and prompt early implementation of control strategies.
Branched-chain amino acids (BCAA) are considered markers of insulin resistance (IR) in subjects with obesity. In this study, we evaluated whether the presence of the SNP of the branched-chain aminotransferase 2 (BCAT2) gene can modify the effect of a dietary intervention (DI) on the plasma concentration of BCAA in subjects with obesity and IR. A prospective cohort study of adult subjects with obesity, BMI ≥ 30 kg/m2, homeostatic model assessment-insulin resistance (HOMA-IR ≥ 2·5) no diagnosed chronic disease, underwent a DI with an energy restriction of 3140 kJ/d and nutritional education for 1 month. Anthropometric measurements, body composition, blood pressure, resting energy expenditure, oral glucose tolerance test results, serum biochemical parameters and the plasma amino acid profile were evaluated before and after the DI. SNP were assessed by the TaqMan SNP genotyping assay. A total of eighty-two subjects were included, and fifteen subjects with a BCAT2 SNP had a greater reduction in leucine, isoleucine, valine and the sum of BCAA. Those subjects also had a greater reduction in skeletal muscle mass, fat-free mass, total body water, blood pressure, muscle strength and biochemical parameters after 1 month of the DI and adjusting for age and sex. This study demonstrated that the presence of the BCAT2 SNP promotes a greater reduction in plasma BCAA concentration after adjusting for age and sex, in subjects with obesity and IR after a 1-month energy-restricted DI.
Clearfield™ (CL) rice (Oryza sativa L.) is a weedy rice (Oryza spp.; synonym = red rice) control tool that has been used in Brazil since 2003. This system includes the use of an imidazolinone (IMI)-tolerant cultivar and the application of IMI herbicides. In this review article, Brazilian weed scientists evaluate the challenges and lessons learned over 18 yr of CL use. CL system benefits include selective weedy rice control, better crop establishment during the most advantageous period of the year, and more efficient fertilizer use. In Rio Grande do Sul state, the CL system, in conjunction with other improvements, has contributed to rice grain yield gains from 5,500 kg ha−1 before 2002 to around 8,400 kg ha−1 currently. In contrast, the main problem that has arisen over this period is the rapid evolution of IMI-resistant weedy rice, caused by gene flow from CL rice cultivars. The off-label use (rate and continuous use) of IMI herbicides has contributed to the evolution of resistance in Echinochloa spp. and other weeds. IMI herbicide carryover has also affected susceptible crops grown after CL rice. Crop rotation with soybean [Glycine max (L.) Merr.] is increasing, ensuring system sustainability. The importance of minimum tillage has also become apparent. Such cultivation includes applying nonselective herbicides before sowing or just before crop emergence (at the spiking stage to eliminate as much weedy rice as possible and other weeds at an early growth stage). It also includes the use of certified seeds free of weedy rice, following label instructions for IMI herbicides, applying the herbicide PRE followed by POST, and complementary weedy rice management practices, such as roguing of surviving weedy rice plants.
We report the nearly complete mitochondrial genome of Rhabdosynochus viridisi – the first for this genus – achieved by combining shotgun sequencing of genomic and cDNA libraries prepared using low-input protocols. This integration of genomic information leads us to correct the annotation of the gene features. The mitochondrial genome consists of 13,863 bp. Annotation resulted in the identification of 12 protein-encoding genes, 22 tRNA genes and two rRNA genes. Three non-coding regions, delimited by three tRNAs, were found between the genes nad5 and cox3. A phylogenetic analysis grouped R. viridisi with three other species of diplectanid monogeneans for which mitochondrial genomes are available.
Weedy rice (WR) (Oryza spp.) is the most troublesome weed infesting rice paddies in Brazil. Several changes have occurred in this region regarding crop management, especially WR control based on the Clearfield® (CL) rice production system launched in 2003. This survey’s objective was to evaluate the WR infestation status by assessing the producers’ perception and the management practices used in southern Brazil after 18 yr of CL use in Brazil. Rice consultants and extension agents distributed a questionnaire to 213 producers in the Rio Grande do Sul (RS) and Santa Catarina (SC) states in the 2018 to 2019 growing season. In RS, most farms are larger than 150 ha, and farmers have adopted the CL system for more than 2 yr and use minimal or conventional tillage, permanent flooding, clomazone PRE tank-mixed with glyphosate at the rice spiking stage, and crop rotation with soybean [Glycine max (L.) Merr.] or pasture. In SC, rice farms are small, averaging from 20 to 30 ha, farmers predominantly plant pre-germinated rice and do not rotate rice with other crops, and roguing is practiced. Comparing both states, the CL system is used in 99.5% and 69.3% of the total surveyed rice areas in RS and SC, respectively. Imidazolinone-resistant WR is present in 68.4% and 26.6% of rice farms in RS and SC, respectively. Rice cultivation in Brazil is currently coexisting with WR with minimal integration of control methods. However, integrated practices can control this weed and are fundamental to the sustainability of systems based on herbicide-resistant rice cultivars.
We report the bivariate
$\rm HI$
- and
$\rm H_{2}$
-stellar mass distributions of local galaxies in addition of an inventory of galaxy mass functions, MFs, for
$\rm HI$
,
$\rm H_{2}$
, cold gas, and baryonic mass, separately into early- and late-type galaxies. The MFs are determined using the
$\rm HI$
and
$\rm H_{2}$
conditional distributions and the galaxy stellar mass function (GSMF). For the conditional distributions we use the results from the compilation presented in Calette et al. [(2018) RMxAA, 54, 443.]. For determining the GSMF from
$M_{*}\sim3\times10^{7}$
to
$3\times10^{12}\ \text{M}_{\odot}$
, we combine two spectroscopic samples from the Sloan Digital Sky Survey at the redshift range
$0.0033<z<0.2$
. We find that the low-mass end slope of the GSMF, after correcting from surface brightness incompleteness, is
$\alpha\approx-1.4$
, consistent with previous determinations. The obtained
$\rm HI\,$
MFs agree with radio blind surveys. Similarly, the
$\rm H_{2}\,$
MFs are consistent with CO follow-up optically-selected samples. We estimate the impact of systematics due to mass-to-light ratios and find that our MFs are robust against systematic errors. We deconvolve our MFs from random errors to obtain the intrinsic MFs. Using the MFs, we calculate cosmic density parameters of all the baryonic components. Baryons locked inside galaxies represent 5.4% of the universal baryon content, while
$\sim\! 96\%$
of the
$\rm HI$
and
$\rm H_{2}$
mass inside galaxies reside in late-type morphologies. Our results imply cosmic depletion times of
$\rm H_{2}$
and total neutral H in late-type galaxies of
$\sim\!1.3$
and 7.2 Gyr, respectively, which shows that late type galaxies are on average inefficient in converting
$\rm H_{2}$
into stars and in transforming
$\rm HI$
gas into
$\rm H_{2}$
. Our results provide a fully self-consistent empirical description of galaxy demographics in terms of the bivariate gas–stellar mass distribution and their projections, the MFs. This description is ideal to compare and/or to constrain galaxy formation models.
Helminthological studies may contribute with valuable information on host biology and conservation. Herein, we provide new data on helminths infecting the lizard Norops fuscoauratus, testing one of the factors considered most important in parasitic ecology: host size. We analysed 25 specimens of N. fuscoauratus from three highland marshes in the Brazilian semi-arid. Eight taxa of helminths belonging to Nematoda, Trematoda and Acanthocephala were found. Physaloptera sp. showed the higher prevalence (40%), with a mean intensity of infection of 3.3 ± 1.46 (1–16) and mean abundance 1.32 ± 0.65 (0–16). Norops fuscoauratus represents four new host records for the helminths Cyrtosomum sp., Pharyngodon travassosi, Strongyloides sp. and Centrorhynchus sp. There is no relationship of host body size (P = 0.79) and mass (P = 0.50) with parasite richness. In addition, the present study contributes to the knowledge of the parasitic fauna of N. fuscoauratus and the Neotropical region.
The TaqIA polymorphism linked to the DRD2 gene has been associated with alcoholism. The aim of this work is to study attention and inhibitory control as per the continuous performance test and the stop task in a sample of 50 Spanish male alcoholic patients split into two groups according to the presence of the TaqIA1 allele in their genotype. Our results show that alcoholics carrying the TaqIA1 allele present lower sustained attention and less inhibitory control than those patients without such allele.
Different types of behavioural impulsivity have been associated with the development of substance use disorders but little is know about what type of impulsivity is provoked by the effect of chronic use of substances.
Objectives:
Determine what type of behavioural impulsivity was associated with the use of alcohol and cocaine.
Design and measurements:
A prospective cohort study was conducted to identify changes on behavioural impulsivity. Non-dependent heavy drinkers (N=471) were recruited from primary care centres. The following assessments were used at baseline and at the end of the 4-year follow-up period: The continuous performance test (CPT) and stop-signal task (SST) assessed behavioural inhibition. Differential reinforcement for low-rate responding (DRLR) was used to evaluate the delay discounting dimension. Diagnoses were rendered using the Structured Interview for DSM-IV.
Results:
Amounts on alcohol and cocaine consumption during follow-up correlated positively with changes on all impulsivity measures. Logistic regression analysis indicated that cocaine used was associated specifically with poor performance on CPT and SST and amount of alcohol used during follow-up was related to changes on DRLR.
Conclusions:
Substances provoke different pattern of behavioural impulsivity: chronic cocaine use provokes changes mainly on behavioural inhibition dimension and alcohol use induces changes on delay discounting paradigm.
The link between impulsivity and alcohol use disorders has been established in longitudinal and cross-sectional studies, but little is know about the role of behavioural impulsivity in the development of substance use disorders.
Objectives:
Determine the role of behavioural measures of impulsivity in the development of alcohol use disorders.
Design and measurements:
A prospective cohort study was conducted to identify the risk factors associated with alcohol dependence. Non-dependent heavy drinkers (N=471) and healthy controls (N=149) were recruited from primary care centres. They were assessed at the end of the 4-year follow-up period. Diagnoses were rendered using the Structured Interview for DSM-IV. The continuous performance test (CPT) and stop-signal task (SST) assessed behavioural inhibition. Differential reinforcement for low-rate responding (DRLR) was used to evaluate the delay discounting dimension.
Results:
HD participants have significant impairments on all laboratory measures of impulsivity. In the logistic regression model, impairment on DRLR (delay discounting dimension) was the only measure that classified accurately HD. Baseline behavioural measures of impulsivity correlated positively with amount of alcohol consumption during the follow-up period. Logistic regression analysis indicated that performance on inhibitory control (SST) (behavioural inhibition dimension) was a significant predictor (odds=1.52[1.08-2.31]) for developing alcohol dependence.
Conclusions:
Our data support the link between behavioural measures of impulsivity and alcohol use disorders. Delay discounting dimension may be a risk factor for begin alcohol use heavily and behavioural inhibition impairment is more involved in the development of dependence.
Suicide is a serious public health problem. In 2005, 793 people were hospitalized in Madrid due to suicide attempt. However, most of the attempts do not require hospitalization and patients are discharged after the intervention in the emergency units. With the aim to implement local policies to prevent suicide, it is important to know the whole spectrum of suicide attempts that contact emergency units in Madrid.
Aims:
To explore the incidence of suicide attempts assisted in the public health system in Madrid and to analyze their characteristics and the response of the health system.
Method:
Clinical reports of all patients attempting suicide were analyzed during 4 months in 4 general public hospitals (covering 44.7% of the whole population) in the Community of Madrid.
Results:
1009 suicide attempts committed by 921 people (66.2% women) were collected, with an incidence of 34.3 people per 100.000 in 4 months. 57 people (6.2%) committed more than one attempt (range 2 to 10, mean=2.5 ± 1.3). After the emergency intervention 71.9% of the patients were discharged, 25.3% hospitalized, 2.6% fled, and 0.2% died. Regarding suicidal ideation, 7.5% presented very high levels during evaluation, while 13.1% had high levels, 20.3% moderate and 47.3% had no suicidal ideation.
Conclusion:
Compared with other European countries, our findings show moderate incidence of suicide attempts, most of which were mild, treated in the emergency units and derived to outpatient psychiatric follow-up. These results suggest places to develop and implement prevention measures.
The prevalence of psychiatric disorders in the general population in Portugal is estimated to be 30%. It is already known that many patients who present a psychiatric disorder do not seek a medical doctor, in part because they do not recognise their illness but also because of stigma associated to these disorders. Mental health promotion programs for schools are believed to help overcome these difficulties.
Objectives:
To analyse the knowledge on mental health issues and psychiatric disorders of Portuguese school students from the 7th to the 12th grade, and to assess their contact and interactions with patients who have a psychiatric disorder.
Methods:
Five students from each class at Pedro Alexandrino high school were selected and they were asked to answer to a questionnaire. Data collected from the questionnaires was then statistically analysed.
Results:
The sample collected for this study included a total of 145 students, 60% male and 40% female, with a mean age of 15years-old. Global knowledge about mental health and psychiatric disorders among students was poor and it was primarily acquired through the media. A comparatively high percentage of students in our sample (46%) knew at least one patient with a psychiatric disorder, and in most cases those patients were from their family group or circle of friends.
Conclusions:
Education on mental health and psychiatric disorders should be implemented at schools and within the context of health education, in order to promote mental health and also to help reduce stigma usually associated to psychiatric disorders.
Potentially inappropriate prescribing, is highly prevalent among older patients hospitalized with major psychiatric illness. Inappropriate use of psychotropic medications in elderly patients has become a focus of concern.
Objectives
To determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs), according to STOPP-START, Beers and PRISCUS criteria applied by CheckTheMeds®.
Aims
To identify potentially IP, PPo and the prevalence of contraindications, interactions and precautions in older patients hospitalized with major psychiatric illness.
Methods
Retrospective cross-sectional study with patients over 65 discharged from the Psychiatric acute unit of the university hospital of La Princesa (Madrid) between January 2013 and October 2015 was conducted. The CheckTheMeds® program was used to identify IP.
Results
A total of 104 elders–74 females and 30 males–were included, with a mean age of 76 years (range: 65–91). An average of 5.73 (range: 1–16) was prescribed drugs at discharge. The Ip results STOPP 81.73% (n = 85), START 43.26% (n = 45), Beers 94.23% (n = 98) y PRISCUS 40.38% (n = 42). Contraindications were described in the 21.15% of the patients, precautions in 83.65% and interactions in 83.65%. Psychotropic drugs were the most often inappropriate prescribed medicaments.
Conclusion
Prescribing omissions are twice as prevalent as IP in the elderly. Currently, inappropriate prescription of psychotropic agents is very common for the elderly. Application of such screening tools to prescribing decisions may reduce unnecessary medication, related adverse events, healthcare utilization and cost and nonpharmacological interventions, should be thoroughly explored.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
This paper describes initial experimental results from an extreme ultraviolet (EUV) radiation-pulsed atom probe microscope. Femtosecond-pulsed coherent EUV radiation of 29.6 nm wavelength (41.85 eV photon energy), obtained through high harmonic generation in an Ar-filled hollow capillary waveguide, successfully triggered controlled field ion emission from the apex of amorphous SiO2 specimens. The calculated composition is stoichiometric within the error of the measurement and effectively invariant of the specimen base temperature in the range of 25 K to 150 K. Photon energies available in the EUV band are significantly higher than those currently used in the state-of-the-art near-ultraviolet laser-pulsed atom probe, which enables the possibility of additional ionization and desorption pathways. Pulsed coherent EUV light is a new and potential alternative to near-ultraviolet radiation for atom probe tomography.
Gold nanoparticles (AuNPs) have been classified as one of the most attractive nanotechnologies, thanks to their potential or already implemented applications; therefore, biological methods for their synthesis have been widely investigated. This study explores the synthesis of AuNPs using the extract of Anemopsis californica, and determinates the effect of the solvent used (water, methanol, and isopropanol) to obtain the AuNPs. Biogenic nanoparticles were analysed through UV-Vis spectroscopy and transmission electron microscopy (TEM, HRTEM, and SAED). Significant differences in polydispersity and morphology of AuNPs among the different methods used were found; the aqueous extract and the extract based on methanol formed nanotriangles and polyhedral nanoparticles; the shape of the nanoparticles is predominantly polyhedral when isopropanol is used as the solvent. The as obtained nanoparticles were placed on glass slides to perform Surface-Enhanced Raman Scattering (SERS) experiments, an amplification of the methylene blue Raman signal was observed when triangular nanoparticles cover the biogenic SERS substrate.