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Lithium neurotoxicity – a case report and review of the literature
- C. Almeida Rodrigues, A. Carvalho, F. Martins Costa, V. Silva de Melo
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1006-S1007
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Introduction
Lithium, a mood stabilizer, is a commonly prescribed and effective treatment for bipolar affective disorder. It´s excreted almost exclusively by the kidneys with a half-life primarily determined by renal function. Chronic intoxication results from an insidious accumulation of lithium in a chronically medicated patient (due to a reduction in renal function secondary to volume depletion, a new medication, et cetera). Patients often present with neurologic findings, including tremor, ataxia, dysarthria, confusion and neuromuscular excitability.
ObjectivesThe objective of this report is to describe a clinical case of lithium neurotoxicity (myoclonus and encephalopathy), along with a review of the literature on the topic.
MethodsWe describe a case of lithium neurotoxicity, along with a brief non-systematic review of the literature on lithium toxicity. We conducted a PubMed bibliographic search using keywords such as “lithium intoxication”, “lithium neurotoxicity”, “lithium encephalopathy” and “lithium intoxication treatment”.
ResultsA women aged 81 was brought to the emergency department by her daughter following 1 week of asthenia, diarrhoea, periods of confused speech and involuntary movements. In the previous week, the patient had been diagnosed with COVID-19. Her past medical history is significant for bipolar affective disorder, hypertension, diabetes mellitus, dyslipidemia and asthma. The patient has been treated with following drugs: lithium carbonate (no recent change of dose and previous serum levels around 1mmol/L), quetiapine, lisinopril, metformin, simvastatin, formoterol and budesonide. On the first examination, she had an exuberant multifocal myoclonus. Posteriorly, she became somnolent, with language impairment (verbal perseveration, echolalia) and dysarthria. Investigations revealed renal impairment (creatinine 1,5 mg/dL, blood urea nitrogen 42 mg/dL) and supratherapeutic lithium levels (lithium serum level 1,7 mmol/L). Computed tomography scan of the brain was negative for acute injuries. The electroencephalogram showed triphasic waves (1-1,5 Hz). Encephalopathy secondary to lithium intoxication was diagnosed (probably in the context of acute kidney injury precipitated by hypovolaemia – diarrhoea). Lithium was stopped and intravenous isotonic fluids were given. After 1 week, her myoclonus resolved and over the following week the other signs resolved as well. The patient was later discharged to her daughter’s home, with follow-up neurology and psychiatry visits.
ConclusionsBoth reversible and irreversible neurotoxicity related to lithium have been reported, specially occurring alongside chronic intoxication. If not addressed, impaired consciousness can lead to coma and death. A high clinical suspicion is needed for prompt diagnosis and treatment (intravenous fluids and sometimes haemodialysis are warranted).
Disclosure of InterestNone Declared
An experimental guide to vehicles in the park
- Noel Struchiner, Ivar R. Hannikainen, Guilherme da F. C. F. de Almeida
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- Journal:
- Judgment and Decision Making / Volume 15 / Issue 3 / May 2020
- Published online by Cambridge University Press:
- 01 January 2023, pp. 312-329
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Prescriptive rules guide human behavior across various domains of community life, including law, morality, and etiquette. What, specifically, are rules in the eyes of their subjects, i.e., those who are expected to abide by them? Over the last sixty years, theorists in the philosophy of law have offered a useful framework with which to consider this question. Some, following H. L. A. Hart, argue that a rule’s text at least sometimes suffices to determine whether the rule itself covers a case. Others, in the spirit of Lon Fuller, believe that there is no way to understand a rule without invoking its purpose — the benevolent ends which it is meant to advance. In this paper we ask whether people associate rules with their textual formulation or their underlying purpose. We find that both text and purpose guide people’s reasoning about the scope of a rule. Overall, a rule’s text more strongly contributed to rule infraction decisions than did its purpose. The balance of these considerations, however, varied across experimental conditions: In conditions favoring a spontaneous judgment, rule interpretation was affected by moral purposes, whereas analytic conditions resulted in a greater adherence to textual interpretations. In sum, our findings suggest that the philosophical debate between textualism and purposivism partly reflects two broader approaches to normative reasoning that vary within and across individuals.
GP.5 Identifying clinically relevant prognostic epigenetic subtypes of chordoma and their non-invasive detection in plasma
- JA Zuccato, V Patil, S Mansouri, JC Liu, F Nassiri, Y Mamatjan, A Chakravarthy, S Karimi, J Almeida, A Bernat, M Hasen, O Singh, S Khan, T Kislinger, N Sinha, S Froelich, H Adle-Biassette, KD Aldape, DD De Carvalho, G Zadeh
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 49 / Issue s1 / June 2022
- Published online by Cambridge University Press:
- 24 June 2022, p. S2
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Background: Chordomas are rare malignant skull-base/spine cancers with devastating neurological morbidities and mortality. Unfortunately, no reliable prognostic factors exist to guide treatment decisions. This work identifies DNA methylation-based prognostic chordoma subtypes that are detectable non-invasively in plasma. Methods: Sixty-eight tissue samples underwent DNA methylation profiling and plasma methylomes were obtained for available paired samples. Immunohistochemical staining and publicly available methylation and gene expression data were utilized for validation. Results: Unsupervised clustering identified two prognostic tissue clusters (log-rank p=0.0062) predicting disease-specific survival independent of clinical factors (Multivariable Cox: HR=16.5, 95%CI: 2.8-96, p=0.0018). The poorer-performing cluster showed immune-related pathway promoter hypermethylation and higher immune cell abundance within tumours, which was validated with external RNA-seq data and immunohistochemical staining. The better-performing cluster showed higher tumour cellularity. Similar clusters were seen in external DNA methylation data. Plasma methylome-based models distinguished chordomas from differential diagnoses in independent testing sets (AUROC=0.84, 95%CI: 0.52-1.00). Plasma methylomes were highly correlated with tissue-based signals for both clusters (r=0.69 & 0.67) and leave-one-out models identified the correct cluster in all plasma cases. Conclusions: Prognostic molecular chordoma subgroups are for the first time identified, characterized, and validated. Plasma methylomes can detect and subtype chordomas which may transform chordoma treatment with personalized approaches tailored to prognosis.
Physico-chemical and sensory interactions of arabica coffee genotypes in different water regimes
- D. S. Ferreira, J. F. T. do Amaral, L. L. Pereira, J. M. S. Ferreira, R. C. Guarçoni, T. R. Moreira, A. C. de Oliveira, W. N. Rodrigues, S. L. H. de Almeida, W. R. Ribeiro, M. A. Tomaz, D. T. Castanheira, T. Lima Filho
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- Journal:
- The Journal of Agricultural Science / Volume 159 / Issue 1-2 / January 2021
- Published online by Cambridge University Press:
- 31 March 2021, pp. 50-58
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The production of specialty coffee has several factors and parameters that are added up in the course of production, so that the quality is expressed in the act of consumption. Based on this scenario, this study included the analysis of ten genotypes of arabica coffee, the materials being subjected to irrigated and rainfed water regimes, in a low altitude region, to identify responses for sensory and physical–chemical quality. The genotypes were evaluated in a split-plot scheme with a randomized block design, with three replications. Arabica coffee fruits were harvested with 80% cherry seeds and processed by the wet method. Subsequently, the characteristics related to physical–chemical and sensory analyses were evaluated. The genotypes of the Paraíso group showed great variability for the physical–chemical and sensory variables for rainfed and irrigated regimes. The genotypes of the Catuaí group, however, showed less variability for sensory characteristics in both cultivation environments and for physical–chemical characteristics in the irrigated regime. In the sensorial data set, the genotypes Catuaí 144 CCF and Catuaí 144 SFC (when irrigated) and Paraíso H 419-3-3-7-16-2, Paraíso H 419-3-3-7-16-11 and Catucaí 24-137 (rainfed cultivation), are more favourable to the production of specialty coffee at low altitude.
Use of stable isotopes in the evaluation of fish trophic guilds from a tropical hypersaline lagoon
- Marcos A. L. Franco, Alejandra F. G. N. Santos, Abílio S. Gomes, Marcelo G. de Almeida, Carlos E. de Rezende
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- Journal of the Marine Biological Association of the United Kingdom / Volume 100 / Issue 6 / September 2020
- Published online by Cambridge University Press:
- 29 October 2020, pp. 979-988
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Environmental factors, size-related isotopic changes of the most abundant species and isotopic niche overlap were investigated using stable isotopes in order to evaluate spatial changes of fish trophic guilds in the Araruama Lagoon. Based on 440 muscle samples, 17 fish species were grouped into five trophic guilds. Mean salinity was above 40 at both sites sampled and a significant spatial difference was observed. The highest δ13C mean value was observed for an omnivorous species, whereas the lowest carbon signatures were found for the three fish species belonging to the planktivorous guild. Analysis of the carbon signature of fish species in lower trophic levels showed influence of salinity variation, whilst size appeared to play a role for others. A narrow δ15N difference was observed, but the piscivorous fish species showed the highest δ15N values. The Standard Ellipses Analysis (SEA) detected spatial differences and varying degrees of isotopic niche overlap among trophic guilds, but the percentages of most overlaps (<60%) suggest that, to some extent, the guilds had a unique isotopic niche space. These results are in agreement with data previously reported for the Araruama Lagoon, that found the same prey items with varying relative importance among the most abundant species. Further studies are necessary to understand how the interaction between salinity and other factors, such as migration patterns, changes in prey availability, changes in contribution of primary sources and changes in baseline isotopic signatures could affect the stable isotope signatures shown here.
The role of edaphic factors on plant species richness and diversity along altitudinal gradients in the Brazilian semi-arid region
- Maiara B. Ramos, Fabricio C. Diniz, Humberto A. de Almeida, Gilbevan R. de Almeida, Anderson S. Pinto, Jorge A. Meave, Sérgio de F. Lopes
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- Journal:
- Journal of Tropical Ecology / Volume 36 / Issue 5 / September 2020
- Published online by Cambridge University Press:
- 25 September 2020, pp. 199-212
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Unlike well-known global patterns of plant species richness along altitudinal gradients, in the mountainous areas of the Brazilian Caatinga, species richness and diversity reach their maxima near mountain tops. The causes of this unusual pattern are not well understood, and in particular the role of edaphic factors on plant community assembly along these gradients has not been investigated. Our goal was to assess the role of edaphic factors (fertility and soil texture) on plant community composition and structure on two mountains of the Brazilian semi-arid region. In 71 plots (Bodocongó site, twenty-one 200-m2 plots, 401–680 m asl; Arara site, fifty 100-m2 plots, 487–660 m asl) we recorded 3114 individuals representing 61 plant species; in addition, at each plot we collected composite soil samples from 0–20 cm depth. Significant altitude-related changes were observed both for community structure and composition, and edaphic variables. A canonical correspondence analysis allowed the distinction of two groups of plots according to species abundances, indicating a preferential habitat distribution of species depending both on altitude and soil variables. Although soil fertility was lowest at the highest altitudes, these areas had high richness and diversity. Conversely, the more fertile foothills were characterized by the dominance of generalist pioneer species. Despite the relatively short altitudinal range that characterizes the studied mountains, this study elucidates the role of edaphic factors on the floristic composition and species richness patterns on the mountains of the Brazilian semi-arid region.
Comorbidity within mental disorders: a comprehensive analysis based on 145 990 survey respondents from 27 countries
- J. J. McGrath, C. C. W. Lim, O. Plana-Ripoll, Y. Holtz, E. Agerbo, N. C. Momen, P. B. Mortensen, C. B. Pedersen, J. Abdulmalik, S. Aguilar-Gaxiola, A. Al-Hamzawi, J. Alonso, E. J. Bromet, R. Bruffaerts, B. Bunting, J. M. C. de Almeida, G. de Girolamo, Y. A. De Vries, S. Florescu, O. Gureje, J. M. Haro, M. G. Harris, C. Hu, E. G. Karam, N. Kawakami, A. Kiejna, V. Kovess-Masfety, S. Lee, Z. Mneimneh, F. Navarro-Mateu, R. Orozco, J. Posada-Villa, A. M. Roest, S. Saha, K. M. Scott, J. C. Stagnaro, D. J. Stein, Y. Torres, M. C. Viana, Y. Ziv, R. C. Kessler, P. de Jonge
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 29 / 2020
- Published online by Cambridge University Press:
- 12 August 2020, e153
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Aims
Epidemiological studies indicate that individuals with one type of mental disorder have an increased risk of subsequently developing other types of mental disorders. This study aimed to undertake a comprehensive analysis of pair-wise lifetime comorbidity across a range of common mental disorders based on a diverse range of population-based surveys.
MethodsThe WHO World Mental Health (WMH) surveys assessed 145 990 adult respondents from 27 countries. Based on retrospectively-reported age-of-onset for 24 DSM-IV mental disorders, associations were examined between all 548 logically possible temporally-ordered disorder pairs. Overall and time-dependent hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. Absolute risks were estimated using the product-limit method. Estimates were generated separately for men and women.
ResultsEach prior lifetime mental disorder was associated with an increased risk of subsequent first onset of each other disorder. The median HR was 12.1 (mean = 14.4; range 5.2–110.8, interquartile range = 6.0–19.4). The HRs were most prominent between closely-related mental disorder types and in the first 1–2 years after the onset of the prior disorder. Although HRs declined with time since prior disorder, significantly elevated risk of subsequent comorbidity persisted for at least 15 years. Appreciable absolute risks of secondary disorders were found over time for many pairs.
ConclusionsSurvey data from a range of sites confirms that comorbidity between mental disorders is common. Understanding the risks of temporally secondary disorders may help design practical programs for primary prevention of secondary disorders.
Differences in clinical and needs assessment between inmates with high versus low risk of suicide
- A.M. Cardoso, M. Talina, F. Fortes, T. Leal, J.M. Caldas de Almeida, M. Xavier
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- European Psychiatry / Volume 26 / Issue S2 / March 2011
- Published online by Cambridge University Press:
- 16 April 2020, p. 769
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Introduction
Drugs addiction, suicide and mental health disorders are the major problems of inmates health. In Portugal the suicide is the second cause of death and is increasing in a panorama of general decreased mortality in prisons.
ObjectivesTo characterize and compare the inmate population with high versus low risk of suicidality, according several variables including the needs for care.
MethodsA descriptive study of a non-probabilistic sample constituted by all male inmates referenced to a forensic psychiatric clinic in Lisbon region, during a year (April 2009–2010), was performed. The data was collect from user and professional interviews and user file. The instruments, besides a specific questionnaire, includes MINI; BPRS and the Camberwell Assessment of Need, Forensic Version (CANFOR). The suicide risk was defined by C section from MINI and defined as a dichotomic variable: null/low or moderate/high suicide risk.
ResultsThe sample was composed of seventy nine inmates (median age 36). Major depression was the only diagnostic significantly associated with suicide risk. There was a significant association between moderate/high risk of suicide and the unmet needs rated by users in psychological distress, safety to self, drugs and company domains and unmet needs rated by staff in daytime activities, psychological distress, safety to self and drugs domains.
ConclusionThe suicide prevention is a crucial issue in prisons. The assessment of suicide risk, psychiatric care and care delivery in unmet needs domains may have a positive impact in self harm and suicide incidence.
1992 – Late Onset Bipolar Disorder: Challenges In Diagnosis And Treatment
- F. Araújo, J.D. Rodrigues, T. Falcão de Almeida, A. Venâncio, A. Horta, G. Lapa
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- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E1217
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Introduction
Mania has been estimated to represent the cause of 4.6% to 18.5% of all geriatric psychiatric admissions and 10% of new-onset mania cases have been found to occur in individuals over the age of 50. Age of onset can have a significant impact on the nature and course of bipolar illness.
ObjectivesReview the current literature of pharmacologic management of late-life bipolar disorder and discuss the differential diagnosis.
AimsBrief literature review.
MethodsCase report and literature review.
ResultsWe describe a case of a 76-years-old female with elevated mood, verbosity, distractibility, irritability, inadequate social behavior, reduced requirement of sleep, increased physical activity, impulsive business investments. Several tests were made: analytical study, CT scan and neuropsychological evaluation, none with significant alterations. She was treated with an antipsychotic drug with improvement of symptoms.
ConclusionThere is a limited evidence base for treatment of bipolar disorder in the elderly and further controlled studies are needed. Current data suggest that valproate and lamotrigine may be better tolerated as mood stabilizers than lithium. Preliminary reports suggest a role for the use of atypical antipsychotic in older adults with bipolar disorder although potential benefit must be balanced against the potential risks of treatment. In treating elderly bipolar patients, one has to keep in mind that pharmacokinetic and pharmacodynamic changes that occur with ageing, associated with frequent concomitant medical illnesses and their treatments, are likely to increase the risk of adverse events and drug interactions.
1963 – Difficulty In The Psychopharmacological Approach Of Fronto-temporal Dementia- Case Report
- F. Araújo, T. Falcão de Almeida, J.D. Rodrigues, A. Venâncio, A. Horta, G. Lapa
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- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E1191
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Introduction
The clinical syndromes related to fronto-temporal lobar degeneration are the second most common cause of pre-senile primary dementia. There are three distinct clinical variants: behavioral-variant fronto-temporal dementia (BvFTD), semantic dementia and progressive non-fluent aphasia. BvFTD is characterized by a significant change in the patients personality and social behavior, and impaired executive function.
ObjectivesReview the current literature on both the pharmacologic and nonphar- macologic management of fronto-temporal dementia.
AimsBrief literature review.
MethodsCase report and literature review.
ResultsWe describe case of a 65-years-old male with hyperactivity, desinhibition, aggressive, stereotyped and persevering behaviors with continuous walking and changes in eating habits (hyperphagia). He also presented distractibility, poor speech with loss of spontaneity, an indifferent attitude, mental rigidity, inflexibility, and lack of insight for his condition. This condition developed within one year, with a change in his personality and the appearance of an inadequate social conduct, with an insidious onset and gradual progression. He has family history of dementia. Computerized Tomography scan shows lobar fronto-temporal atrophy. During hospitalization no drugs has had effect, apart from paroxetine (partial response).
ConclusionConcerning therapy, several drugs were used without proved effect in controlling the symptoms, highlighting the difficulty in the psychopharmacological approach of this disorder. The selective serotonin reuptake inhibitors have shown some effect on behavior.
Renal developmental disturbances and their long-term consequences in female pups from vitamin D-deficient mothers: involved mechanisms
- L. F. Almeida, H. D. C. Francescato, R. S. Silva, C. G. A. Silva, J. Antunes-Rodrigues, F. J. A. de Paula, T. M. Coimbra
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- Journal:
- Journal of Developmental Origins of Health and Disease / Volume 10 / Issue 4 / August 2019
- Published online by Cambridge University Press:
- 06 February 2019, pp. 497-501
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The mechanisms involved in kidney disturbances during development, induced by vitamin D3 deficiency in female rats, that persist into adulthood were evaluated in this study. Female offspring from mothers fed normal (control group, n=8) or vitamin D-deficient (Vit.D-, n=10) diets were used. Three-month-old rats had their systolic blood pressure (SBP) measured and their blood and urine sampled to quantify vitamin D3 (Vit.D3), creatinine, Na+, Ca+2 and angiotensin II (ANGII) levels. The kidneys were then removed for nitric oxide (NO) quantification and immunohistochemical studies. Vit.D- pups showed higher SBP and plasma ANGII levels in adulthood (P<0.05) as well as decreased urine osmolality associated with increases in urinary volume (P<0.05). Decreased expression of JG12 (renal cortex and glomeruli) and synaptopodin (glomeruli) as well as reduced renal NO was also observed (P<0.05). These findings showed that renal disturbances in development in pups from Vit.D- mothers observed in adulthood may be related to the development of angiogenesis, NO and ANGII alterations.
Complementary and alternative medicine contacts by persons with mental disorders in 25 countries: results from the World Mental Health Surveys
- P. de Jonge, K. J. Wardenaar, H. R. Hoenders, S. Evans-Lacko, V. Kovess-Masfety, S. Aguilar-Gaxiola, A. Al-Hamzawi, J. Alonso, L. H. Andrade, C. Benjet, E. J. Bromet, R. Bruffaerts, B. Bunting, J. M. Caldas-de-Almeida, R. V. Dinolova, S. Florescu, G. de Girolamo, O. Gureje, J. M. Haro, C. Hu, Y. Huang, E. G. Karam, G. Karam, S. Lee, J.-P. Lépine, D. Levinson, V. Makanjuola, F. Navarro-Mateu, B.-E. Pennell, J. Posada-Villa, K. Scott, H. Tachimori, D. Williams, B. Wojtyniak, R. C. Kessler, G. Thornicroft
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 27 / Issue 6 / December 2018
- Published online by Cambridge University Press:
- 28 December 2017, pp. 552-567
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Aims.
A substantial proportion of persons with mental disorders seek treatment from complementary and alternative medicine (CAM) professionals. However, data on how CAM contacts vary across countries, mental disorders and their severity, and health care settings is largely lacking. The aim was therefore to investigate the prevalence of contacts with CAM providers in a large cross-national sample of persons with 12-month mental disorders.
Methods.In the World Mental Health Surveys, the Composite International Diagnostic Interview was administered to determine the presence of past 12 month mental disorders in 138 801 participants aged 18–100 derived from representative general population samples. Participants were recruited between 2001 and 2012. Rates of self-reported CAM contacts for each of the 28 surveys across 25 countries and 12 mental disorder groups were calculated for all persons with past 12-month mental disorders. Mental disorders were grouped into mood disorders, anxiety disorders or behavioural disorders, and further divided by severity levels. Satisfaction with conventional care was also compared with CAM contact satisfaction.
Results.An estimated 3.6% (standard error 0.2%) of persons with a past 12-month mental disorder reported a CAM contact, which was two times higher in high-income countries (4.6%; standard error 0.3%) than in low- and middle-income countries (2.3%; standard error 0.2%). CAM contacts were largely comparable for different disorder types, but particularly high in persons receiving conventional care (8.6–17.8%). CAM contacts increased with increasing mental disorder severity. Among persons receiving specialist mental health care, CAM contacts were reported by 14.0% for severe mood disorders, 16.2% for severe anxiety disorders and 22.5% for severe behavioural disorders. Satisfaction with care was comparable with respect to CAM contacts (78.3%) and conventional care (75.6%) in persons that received both.
Conclusions.CAM contacts are common in persons with severe mental disorders, in high-income countries, and in persons receiving conventional care. Our findings support the notion of CAM as largely complementary but are in contrast to suggestions that this concerns person with only mild, transient complaints. There was no indication that persons were less satisfied by CAM visits than by receiving conventional care. We encourage health care professionals in conventional settings to openly discuss the care patients are receiving, whether conventional or not, and their reasons for doing so.
Supplementation of grazing beef cows during gestation as a strategy to improve skeletal muscle development of the offspring
- D. C. Marquez, M. F. Paulino, L. N. Rennó, F. C. Villadiego, R. M. Ortega, D. S. Moreno, L. S. Martins, D. M. de Almeida, M. P. Gionbelli, M. R. Manso, L. P. Melo, F. H. Moura, M. S. Duarte
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The appropriate supply of nutrients in pregnant cows has been associated with the optimal development of foetal tissues, performance of their progeny and their meat quality. The aim of this study was to evaluate supplementation effects of grazing cows in different stages of gestation on skeletal muscle development and performance of the progeny. Thereby, 27 Nellore cows were divided into three groups (n=9 for each group) and their progeny as follows: UNS, unsupplemented during gestation; MID, supplemented from 30 to 180 days of gestation; LATE, supplemented from 181 to 281 days of gestation. The percentage composition of the supplement provided for the matrices was the following: ground corn (26.25%), wheat bran (26.25%) and soya bean meal (47.5%). The supplement was formulated to contain 30% CP. Supplemented matrices received 150 kg of supplement (1 and 1.5 kg/day for cows in the MID and LATE groups, respectively). After birth, a biopsy was performed to obtain samples of skeletal muscle tissue from calves to determine number and size of muscle fibres and for messenger RNA (mRNA) expression analysis. The percentage composition of the supplement provided for the progeny was the following: ground corn grain (30%), wheat bran (30%), soya bean meal (35%) and molasses (5%). The supplement was formulated to contain 25% CP and offered in an amount of 6 g/kg BW. Performance of the progeny was monitored throughout the suckling period. Means were submitted to ANOVA and regression, and UNS, MID and LATE periods of supplementation were compared. Differences were considered at P<0.10. Birth weight, average daily gain and weaning weight of the offspring did not differ among treatments (P>0.10). Similarly, no differences were observed between calves for nutrient intake (P>0.10). However, greater subcutaneous fat thickness (P=0.006) was observed in the calves of LATE group. The ribeye area (P=0.077) was greater in calves born from supplemented compared with UNS cows. The supplementation of pregnant cows did not affect the muscle fibre size of their progeny (P=0.208). On the other hand, calves born from dams supplemented at mid-gestation had greater muscle fibre number (P=0.093) compared with calves from UNS group. Greater mRNA expression of peroxysome proliferator-activated receptor α (P=0.073) and fibroblast growth factor 2 (P=0.003) was observed in the calves born from MID cows. Although strategic supplementation did not affect the BW of offspring, it did cause changes in carcass traits, number of myofibres, and mRNA expression of a muscle hypertrophy and lipid oxidation markers in skeletal muscle of the offspring.
Herbage intake, methane emissions and animal performance of steers grazing dwarf elephant grass v. dwarf elephant grass and peanut pastures
- E. A. Andrade, E. X. Almeida, G. T. Raupp, M. F. Miguel, D. M. de Liz, P. C. F. Carvalho, C. Bayer, H. M. N. Ribeiro-Filho
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Management strategies for increasing ruminant legume consumption and mitigating methane emissions from tropical livestock production systems require further study. The aim of this work was to evaluate the herbage intake, animal performance and enteric methane emissions of cattle grazing dwarf elephant grass (DEG) (Pennisetum purpureum cv. BRS Kurumi) alone or DEG with peanut (Arachis pintoi cv. Amarillo). The experimental treatments were the following: DEG pastures receiving nitrogen fertilization (150 kg N/ha as ammonium nitrate) and DEG intercropped with peanut plus an adjacent area of peanut that was accessible to grazing animals for 5 h/day (from 0700 to 1200 h). The animals grazing legume pastures showed greater average daily gain and herbage intake, and shorter morning and total grazing times. Daily methane emissions were greater from the animals grazing legume pastures, whereas methane emissions per unit of herbage intake did not differ between treatments. Allowing animals access to an exclusive area of legumes in a tropical grass-pasture-based system can improve animal performance without increasing methane production per kg of dry matter intake.
Optimum design for buckling of arbitrary shaped ribs under uncertain loadings
- A. C. Conrado, A. R. de Faria, S. F. M. de Almeida
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- Journal:
- The Aeronautical Journal / Volume 109 / Issue 1102 / December 2005
- Published online by Cambridge University Press:
- 03 February 2016, pp. 609-618
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Typically, aircraft wing structural panels are designed against buckling for a very large number of possible loadings that may occur during the operation of the aircraft. If the optimisation procedure accounts only for a limited number of design loads, the structure may be vulnerable to a specific type of loading that may cause the structure to fail. A novel approach for the optimisation of ribs or plates of arbitrary shapes under uncertain loads is proposed. The geometry of the rib is defined by a single closed spline or several connected splines. The loading distribution is not considered to be uniform but it is allowed to vary within an admissible set, conferring uncertainty to the applied loads. The admissible load space comprises distributed normal and shear loadings that can be represented through a collection of piecewise linear functions defined along the plate boundary. A special procedure is applied to handle the constraint that the loading must be self equilibrating. A minimax strategy is used to deal with the loading variability such that the resulting optimal design is able to withstand an entire class of linear piecewise loadings along the rib boundary. The refinement of the loading representation may be completely independent of the refinement of finite element mesh. The validity of the proposed approach is assessed by applying it to an aeronautical wing rib.
The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium
- C. Benjet, E. Bromet, E. G. Karam, R. C. Kessler, K. A. McLaughlin, A. M. Ruscio, V. Shahly, D. J. Stein, M. Petukhova, E. Hill, J. Alonso, L. Atwoli, B. Bunting, R. Bruffaerts, J. M. Caldas-de-Almeida, G. de Girolamo, S. Florescu, O. Gureje, Y. Huang, J. P. Lepine, N. Kawakami, Viviane Kovess-Masfety, M. E. Medina-Mora, F. Navarro-Mateu, M. Piazza, J. Posada-Villa, K. M. Scott, A. Shalev, T. Slade, M. ten Have, Y. Torres, M. C. Viana, Z. Zarkov, K. C. Koenen
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- Journal:
- Psychological Medicine / Volume 46 / Issue 2 / January 2016
- Published online by Cambridge University Press:
- 29 October 2015, pp. 327-343
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Background
Considerable research has documented that exposure to traumatic events has negative effects on physical and mental health. Much less research has examined the predictors of traumatic event exposure. Increased understanding of risk factors for exposure to traumatic events could be of considerable value in targeting preventive interventions and anticipating service needs.
MethodGeneral population surveys in 24 countries with a combined sample of 68 894 adult respondents across six continents assessed exposure to 29 traumatic event types. Differences in prevalence were examined with cross-tabulations. Exploratory factor analysis was conducted to determine whether traumatic event types clustered into interpretable factors. Survival analysis was carried out to examine associations of sociodemographic characteristics and prior traumatic events with subsequent exposure.
ResultsOver 70% of respondents reported a traumatic event; 30.5% were exposed to four or more. Five types – witnessing death or serious injury, the unexpected death of a loved one, being mugged, being in a life-threatening automobile accident, and experiencing a life-threatening illness or injury – accounted for over half of all exposures. Exposure varied by country, sociodemographics and history of prior traumatic events. Being married was the most consistent protective factor. Exposure to interpersonal violence had the strongest associations with subsequent traumatic events.
ConclusionsGiven the near ubiquity of exposure, limited resources may best be dedicated to those that are more likely to be further exposed such as victims of interpersonal violence. Identifying mechanisms that account for the associations of prior interpersonal violence with subsequent trauma is critical to develop interventions to prevent revictimization.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
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- 27 April 2015, pp ix-xxx
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Ectoparasites and endoparasites of fish form networks with different structures
- S. BELLAY, E. F. DE OLIVEIRA, M. ALMEIDA-NETO, M. A. R. MELLO, R. M. TAKEMOTO, J. L. LUQUE
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- Parasitology / Volume 142 / Issue 7 / June 2015
- Published online by Cambridge University Press:
- 16 March 2015, pp. 901-909
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Hosts and parasites interact with each other in a variety of ways, and this diversity of interactions is reflected in the networks they form. To test for differences in interaction patterns of ecto- and endoparasites we analysed subnetworks formed by each kind of parasites and their host fish species in fish–parasite networks for 22 localities. We assessed the proportion of parasite species per host species, the relationship between parasite fauna composition and host taxonomy, connectance, nestedness and modularity of each subnetwork (n = 44). Furthermore, we evaluated the similarity in host species composition among modules in ecto- and endoparasite subnetworks. We found several differences between subnetworks of fish ecto- and endoparasites. The association with a higher number of host species observed among endoparasites resulted in higher connectance and nestedness, and lower values of modularity in their subnetworks than in those of ectoparasites. Taxonomically related host species tended to share ecto- or endoparasites with the same interaction intensity, but the species composition of hosts tended to differ between modules formed by ecto- and endoparasites. Our results suggest that different evolutionary and ecological processes are responsible for organizing the networks formed by ecto- and endoparasites and fish.
Obsessive-Compulsive Disorder: An Open-Label Pilot Trial of Escitalopram
- Amanda Galvão-de Almeida, Lucas C. Quarantini, Cristianne R. Góis, Rogério Santos-Jesus, Ângela M.A. Miranda-Scippa, Irismar R. de Oliveira, Helena da Silva Prado, James F. Leckman, Maria C. Rosário
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- CNS Spectrums / Volume 12 / Issue 7 / July 2007
- Published online by Cambridge University Press:
- 07 November 2014, pp. 519-524
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Introduction: Selective serotonin reuptake inhibitors are considered the most effective and well-established pharmacotherapy for the treatment of obsessive-compulsive disorder (OCD), a chronic and disabling condition. However, ~40% of patients do not have a significant improvement, suggesting that new medications are needed. This study was designed to investigate the treatment response to escitalopram in OCD patients.
Methods: This open-label study involved 11 adult OCD outpatients diagnosed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders. Data were collected and the treatment response was assessed by an experienced psychiatrist by using the Yale-Brown Obsessive-Compulsive Scale. Subjects received escitalopram 30 mg/day for 12 weeks starting at 10 mg/day. Dosage adjustments were made within 2 weeks, depending on the tolerability of the patient.
Results: Six of the 11 patients (54.5%) presented a reduction of at least 40% in the baseline total Yale-Brown Obsessive-Compulsive Scale scores.
Conclusion: Despite the small sample size and the open-label nature of this trial, these data suggest that escitalopram may be a useful option for patients with OCD.
Effect of dietary lipids on circulating adiponectin: a systematic review with meta-analysis of randomised controlled trials
- Anize D. von Frankenberg, Flávia M. Silva, Jussara C. de Almeida, Vanessa Piccoli, Filipe V. do Nascimento, Mônica M. Sost, Cristiane B. Leitão, Luciana L. R. Remonti, Daniel Umpierre, André F. Reis, Luis H. Canani, Mirela J. de Azevedo, Fernando Gerchman
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- Journal:
- British Journal of Nutrition / Volume 112 / Issue 8 / 28 October 2014
- Published online by Cambridge University Press:
- 05 September 2014, pp. 1235-1250
- Print publication:
- 28 October 2014
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Different dietary interventions have been identified as potential modifiers of adiponectin concentrations, and they may be influenced by lipid intake. We identified studies investigating the effect of dietary lipids (type/amount) on adiponectin concentrations in a systematic review with meta-analysis. A literature search was conducted until July 2013 using databases such as Medline, Embase and Scopus (MeSH terms: ‘adiponectin’, ‘dietary lipid’, ‘randomized controlled trials (RCT)’). Inclusion criteria were RCT in adults analysing adiponectin concentrations with modification of dietary lipids. Among the 4930 studies retrieved, fifty-three fulfilled the inclusion criteria and were grouped as follows: (1) total dietary lipid intake; (2) dietary/supplementary n-3 PUFA; (3) conjugated linoleic acid (CLA) supplementation; (4) other dietary lipid interventions. Diets with a low fat content in comparison to diets with a high-fat content were not associated with positive changes in adiponectin concentrations (twelve studies; pooled estimate of the difference in means: − 0·04 (95 % CI − 0·82, 0·74) μg/ml). A modest increase in adiponectin concentrations with n-3 PUFA supplementation was observed (thirteen studies; 0·27 (95 % CI 0·07, 0·47) μg/ml). Publication bias was found by using Egger's test (P= 0·01) and funnel plot asymmetry. In contrast, CLA supplementation reduced the circulating concentrations of adiponectin compared with unsaturated fat supplementation (seven studies; − 0·74 (95 % CI − 1·38, − 0·10) μg/ml). However, important sources of heterogeneity were found as revealed by the meta-regression analyses of both n-3 PUFA and CLA supplementation. Results of new RCT would be necessary to confirm these findings.