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Cities have suffered from three years of the COVID-19 pandemic and are increasingly experiencing exacerbated heatwaves, floods, and droughts due to climate change. Going forward, cities need to address both climate and public health crises effectively while reducing poverty and inequity, often in the context of economic pressure and declining levels of trust in government. The COVID-19 pandemic has revealed gaps in city readiness for simultaneous responses to pandemics and climate change, particularly in the Global South. However, these concurrent challenges to cities present an opportunity to reformulate current urbanization patterns and the economies and dynamics they enable. This Element focuses on understanding COVID-19's impact on city systems related to climate change mitigation and adaptation, and vice versa, in terms of warnings, lessons learned, and calls to action. This title is also available as open access on Cambridge Core.
The Mini-Mental State Examination (MMSE) is a composite scale that is included in diagnostic algorithms and in procedures to assess severity of cognitive impairment and efficacy of therapeutic interventions. It is unclear, however, whether the MMSE provides information about the same deficits in different diseases.
Aims
To assess patterns of MMSE scores in patients with confirmed diagnosis of Alzheimer's disease or depressive disorder.
Method
We used data from a previously published cross-sectional retrospective observational clinical cohort study. The final analysis included only patients in whom biomarker analysis showed results characteristic of Alzheimer's disease (n = 167) and patients with depressive disorder in whom Alzheimer's disease had been ruled out by analysis of biomarkers (n = 69).
Results
A three-point decline in MMSE score from 30 to 27 reflected impairment of memory recall in patients with Alzheimer's disease, whereas it reflected impairments in calculation and memory recall in patients with depressive disorder. A further three-point decline in MMSE score from 27 to 24 predominantly reflected additional calculation impairment in patients with Alzheimer's disease.
Conclusions
Our results indicate that memory performance is the most important measure of disease severity and the main contributor to the decline in MMSE score at onset of clinical manifestation of Alzheimer's disease. In general, this suggests that memory should be the primary measure used in routine clinical care and the primary endpoint in clinical trials involving patients with Alzheimer's disease at onset of clinical manifestation. Changes in other measures of cognition should prompt consideration of possible comorbidities as a cause, rather than the impact of Alzheimer's disease itself.
Parental warmth during the transition from childhood to adolescence is a key protective factor against a host of adolescent problems, including substance use, maladjustment, and diminished well-being. Moreover, adolescents and parents often disagree in their perceptions of parenting quality, and these discrepancies may confer risk for problem outcomes. The current study applies latent profile analysis to a sample of 687 mother–father–6th grade adolescent triads to identify patterns of adolescent–parent convergence and divergence in perceptions of parental warmth. Five profiles were identified, and associations with adolescent positive well-being, substance use, and maladjustment outcomes in 9th grade were assessed. Patterns of divergence in which adolescents had a pronounced negative perception of parental warmth compared to parents, as well as those wherein pronounced divergence was present in only one adolescent–parent dyad, were associated with diminished positive well-being compared to adolescents who had more positive perceptions of warmth than parents. Having more negative perceptions of warmth compared to parents was also associated with elevated risk for alcohol and marijuana initiation, but only when the divergence was pronounced rather than more moderate. These findings add nuance to findings from previous between-family investigations of informant discrepancies, calling for further family-centered methods for investigating multiple perspectives.
The transmission, control and the relationship between Dicrocoelium dendriticum and its definitive (sheep and cattle) and intermediate (molluscs and ants) hosts under natural and experimental conditions are described. Eleven species of molluscs and four of ants were found infected with larval D. dendriticum in León province, north-west Spain. Infected ants were observed between April and November and in tetania at 7.5–26.9°C. The highest shedding of eggs by sheep and cattle was detected in winter. Two treatments applied in November and January were the most effective. In experimentally infected molluscs, the parasite was not visible under the stereomicroscope, at least until 50 days post-infection (p.i.). The prepatent period in experimentally infected lambs was 49–79 days p.i. The number of eggs per gram increased with the days p.i. and the parasite burden. The aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transpeptidase, leukocyte and neutrophil values of infected lambs increased, but those of lymphocytes decreased. Using the enzyme-linked immunosorbert assay technique, the IgG antibody response to excretory–secretory and somatic antigens of D. dendriticum was positive from day 30 p.i., although the maximum antibody levels were observed on day 60 p.i. The number of worms per lamb ranged between 30 and 2063. Cholangitis and cholangiectasia of the septal bile and hepatic ducts were observed. The best enzymatic systems for adult and larval D. dendriticum characterization were lactate dehydrogenase, glucose phosphate isomerase and phosphoglucomutase. Genetic variability of adult D. dendriticum was high using the random amplified polymorphic DNA technique.
Transition between adolescence and adulthood represents the most important challenge for personal development and involves several transformations: physical, psychological and social. It is a complex age bracket, concurring the transition from youth psychiatric units to adult ones, with an increased risk for the appearance of mental disorders and risky behaviours. TRANVIA program, developed in Avilés, provides psychiatric assistance to patients between 15 and 25 years old, diagnosed with a severe psychiatric disorder or with an increased risk of having one.
Objectives
Our objectives are: ensuring clinical continuity assistance, promoting communication among professionals and the empowerment of our patients to improve their functionality and quality of life.
Methods
Descriptive study including patients involved in TRANVIA program from November 2019 to November 2021.
Results
During this two-years period there have been 44 referrals to the program, 11 of them were rejected for failure to comply with diagnostic criteria. In November 2021 there were 33 patients included in the TRANVIA program with an average age of 17 years old (range: 15-22). 70% of them were men and 30% women. All of them had psychiatric assistance from different sources: youth mental health units, neuropediatrics… About 75% of the patients were diagnosed with autistic spectrum disorder and approximately three-quarters of the sample needed pharmacological treatment. Risperidone was the most prescribed drug. We have also developed other assistance alternatives as home-based care, relaxation sessions, social worker interventions and coordination with schools.
Conclusions
TRANVIA program has allowed us to provide continual attention to vulnerable patients that shift from youth psychiatric units to adult ones. Patients that meet inclusion criteria were enrolled independently the type of assistance they have previously received. Accessibility and flexibility were our priority. During the described period there was only one dropout, three patients required psychiatric hospitalization and two others visited the emergency department. There have been no cases of completed suicide.
We compared the individual-level risk of hospital-onset infections with multidrug-resistant organisms (MDROs) in hospitalized patients prior to and during the coronavirus disease 2019 (COVID-19) pandemic. We also quantified the effects of COVID-19 diagnoses and intrahospital COVID-19 burden on subsequent MDRO infection risk.
Design:
Multicenter, retrospective, cohort study.
Setting:
Patient admission and clinical data were collected from 4 hospitals in the St. Louis area.
Patients:
Data were collected for patients admitted between January 2017 and August 2020, discharged no later than September 2020, and hospitalized ≥48 hours.
Methods:
Mixed-effects logistic regression models were fit to the data to estimate patients’ individual-level risk of infection with MDRO pathogens of interest during hospitalization. Adjusted odds ratios were derived from regression models to quantify the effects of the COVID-19 period, COVID-19 diagnosis, and hospital-level COVID-19 burden on individual-level hospital-onset MDRO infection probabilities.
Results:
We calculated adjusted odds ratios for COVID-19–era hospital-onset Acinetobacter spp., P. aeruginosa and Enterobacteriaceae spp infections. Probabilities increased 2.64 (95% confidence interval [CI], 1.22–5.73) times, 1.44 (95% CI, 1.03–2.02) times, and 1.25 (95% CI, 1.00–1.58) times relative to the prepandemic period, respectively. COVID-19 patients were 4.18 (95% CI, 1.98–8.81) times more likely to acquire hospital-onset MDRO S. aureus infections.
Conclusions:
Our results support the growing body of evidence indicating that the COVID-19 pandemic has increased hospital-onset MDRO infections.
OBJECTIVES/GOALS: The study aims to identify and measure metabolites in irradiation-induced senescent pre-adipocytes induced by the increased secretion of pro-inflammatory cytokines. Through untargeted metabolomics, we seek to understand the alterations to metabolism and mitochondrial activity that occur during irradiation-induced senescence. METHODS/STUDY POPULATION: First, commercially available human primary subcutaneous pre-adipocytes were cultured in vitro, and irradiated to induce senescence. To confirm senescence, cells were stained for beta-galactosidase, which was positive in senescent pre-adipocytes. The cells and their conditioned cultured media were then collected and frozen for untargeted metabolomics to profile metabolites. The sample analysis is currently underway and will be conducted using central carbon isotope tracing and chromatograph mass spectrometry. Principal Component Analysis, fold change analysis, and heat maps will be used to detect and report the changes in metabolite signals. Oxygen consumption rate and extracellular acidification rate measurements are in progress at present using the Agilent Seahorse XF Cell Mito Stress Test. RESULTS/ANTICIPATED RESULTS: We expect that metabolites of central carbon metabolism and oxidative phosphorylation will be upregulated. The concentrations of metabolites of pathways altered by the pro-inflammatory cytokines that have been identified to be secreted by senescent cells are expected to be altered. The metabolites measured in conditioned culture media will provide insight into the changes to the cellular microenvironment caused by senescence. Finally, we anticipate that mitochondrial function, and both aerobic and anaerobic metabolism will be altered in senescent pre-adipocytes compared to controls. Through the present study, we will achieve a better understanding the metabolic alterations that occur as part of cell senescence in pre-adipocytes. DISCUSSION/SIGNIFICANCE: Adipose tissue dysfunction due to the accumulation of senescent cells has been linked to chronic diseases such as diabetes and insulin resistance, and inflammaging. Through this study, we expect to provide new insight into the metabolic alterations of senescence and offer a backbone for prospective translational human studies and clinical trials.
Molière’s depiction of marriage and the struggle between parents and children over the choice of a spouse uses the framework of civil law to shape his treatment of the comedy in these quarrels. While Molière explores human folly to drive the action in plays such as Le Bourgeois gentilhomme and L’École des femmes, legal requirements for arranging a valid marriage in early modern France also form part of these stories. Only the Catholic Church could declare a marriage valid, but the French monarchy promulgated laws giving fathers the right to punish disobedient children with penalties ranging from disinheritance to criminal charges. However, Moliere’s works mock the men entrusted with this power, showing them to be vain and superficial patriarchs who seek partners that will elevate family status rather than providing for the happiness of their children. Mothers and servants step in to undermine these foolish plans and help children marry for love and happiness rather than social concerns. Despite their subordinate roles in their families and in French society, these figures understand how to get round the requirements of French law and the wishes of men to conclude happy partnerships for the young people in their midst.
En Latinoamérica, la transición demográfica se desarrolla, en general, de la misma manera en la que se desarrolló en Europa. No obstante, los efectos demográficos del proceso de modernización son muy variados, especialmente en grupos indígenas. Desde los años treinta las poblaciones indígenas del Gran Chaco Argentino comenzaron un proceso de modernización. El objetivo de este trabajo fue analizar los cambios demográficos en una población toba del norte de Argentina. Se utilizaron los censos de los años 1985 y 2002, registros de nacimientos y defunción de agentes sanitarios toba, del centro médico, del Registro Civil y entrevistas a mujeres tobas. Se estimó la tasa de crecimiento poblacional; se analizaron pirámides poblaciones y se obtuvo el índice de masculinidad, la tasa de mortalidad infantil y la tasa global de fecundidad. El crecimiento poblacional fue similar al provincial, se evidenció un rejuvenecimiento de la población, un moderado descenso de la mortalidad infantil y un aumento de la fecundidad. Se discute la necesidad de desarrollar modelos más integradores que consideren las variaciones demográficas de estos grupos.
This Crisis Intervention Team was born in October 2018 with the aim of intensifying the treatment of people in psychiatric crisis situation.
Objectives
Provide an intensive and early assessment and approach in a timely manner. It also provides home care if necessary.
Methods
The team intensively performs scheduled visits, emergencys, telephone interventions and home care. It is in constant coordination with other structures of the mental health and socio-health network.
Results
A total of 83 patients have been included in our team since its inception. The youngest was 17 years old and the oldest 83 years old (exceptional case in evaluation). The mean age was 45.6 years. 67.4% were female (56 women) and 32.5% male (27 men). The delay in care did not exceed 48 hours.
200 patients were evaluated into suicide protocol, with ages ranging from 15 to 85 years, with a mean age of 45.4 years. The delay in care does not exceed 10 days.
Conclusions
This is a team that offers a rapid response, dedicates the necessary time for a correct evaluation of the risk, of the evolution and tries to establish a therapeutic alliance in record time. It is able to tolerate a certain degree of uncertainty, manage and tolerate the level of risk. He stands out for being flexible and dynamic in order to be able to adapt to the patients and theirs circumstances. This requires empathy, closeness and commitment.
The new mineral marchettiite (IMA2017-066) is the natural equivalent of ammonium hydrogen urate. It has a simple molecular formula C5H7N5O3 and can be alternatively written as (NH4)C5H3N4O3. Marchettiite was found in a cleft at Mount Cervandone, Devero Valley, Piedmont, Italy, where it occurs as aggregates of opaque pale pink to white, platy prismatic crystals. This mineral has a white streak, dull and opaque lustre, it is not fluorescent and has a hardness of 2–2.5 (Mohs’ scale). The tenacity is brittle and crystals have a good cleavage parallel to {001}. The calculated density is 1.69 g/cm3. Marchettiite is biaxial (–) with 2V of 47.24°; the optical properties of marchettiite were determined by periodic-DFT methods providing the following values: α = 1.372, β = 1.681 and γ = 1.768. No twinning was observed. Electron microprobe analyses gave the following chemical formula: C4.99H6.97N4.91O3.00. Although the small crystal size did not allow refinement of structural data by single-crystal diffraction, we were able to refine the structure by powder micro X-ray diffraction. Marchettiite has space group P$\bar{1}$ and the following unit-cell parameters: a = 3.6533(2) Å, b = 10.2046(7) Å, c = 10.5837(7) Å, α = 113.809(5)°, β = 91.313(8)°, γ = 92.44(1)° and V = 360.312 Å3. The strongest lines in the powder diffraction pattern [d in Å (I)(hkl)] are: 9.784(50)(001); 8.663(80)(01$\bar{1}$); 5.659(100)(011); 3.443(100)(10$\bar{1}$); 3.241(70)(003) and 3.158(100)(1$\bar{1}\bar{1})$. Marchettiite is named after Gianfranco Marchetti, the mineral collector who found this mineral.
This essay traces how China's changing presents have been represented in Anglo-American discourse and in China studies from the Cold War to today. It shows how, in popular opinion but also in academia, that discourse has displayed a stubborn tendency to explain—or rather explain away—China's presents, configuring them strictly in relation to pasts that can never be overcome and futures that are either never realized or always dangerously looming. This ideological framing has its roots in Cold War anticommunism, which was foundational to China studies in the US, but lingers on to this day, as China's coevalness is continuously denied.
The COVID-19 pandemic has impacted how we perceive and shape our living environment (Klaus, 2020; Shenker, 2020), questioning economic and social inequalities in cities. As the pandemic spread, reflections proposed in the international debate have suggested three possible effects for the future of cities.
The first – paraphrasing the title of an article by Arundhati Roy, ‘the pandemic is a portal between one world and the next’ (Roy, 2020) – interprets the pandemic as an opportunity for rethinking the urban condition, spatial dimensions, and the forms of conviviality, shedding new light on the social divide. In this perspective, the measures ensuring social distancing tested during the emergency and then in the post-lockdown can be thought of as policies to promote a lasting urban turn. The outcome could be a city that is environmentally sustainable, de-carbonized, and more socially just in terms of the distribution of services.
The second perspective considers the pandemic as an accelerator for innovative projects that could be tested, thus taking advantage of the COVID-19 constraints. Some ‘temporary’ emergency measures implemented to deal with social distancing may become permanent policies to improve urban quality from an environmental and equity point of view.
The third interprets the pandemic as a lesson for addressing future disruptive changes, refining our predictive tools for governing interrelated and complex processes under emergency conditions. The changing conditions impose a reframing of the urban scenarios and their evaluation on a different time horizon that calls into question longer-term planning policy.
The chapter describes three approaches driving a Milan plan adopted in April 2020 to deal with the pandemic (Chapter Twenty also addresses adaptation to the pandemic in Milan). One involves a ‘distribution’ of public space so as to reduce the presence of the car and encourage other uses of road and parking space. The second approach consists in ‘desynchronizing’ activities so as to avoid rush hour crowding. Finally, a ‘digitalizing’ strategy aims at improving access to electronic means of communication. The chapter demonstrates that the plan echoed the orientation of an earlier pre-pandemic document. In this sense, the pandemic is perceived as an accelerator that propelled the implementation of measures that would have otherwise taken much longer to see the day.
Milan 2020 document: tactical strategies to deal with COVID-19
The City of Milan published in April ‘Milano 2020.
Recent reports on the burden of cardiovascular disease (CVD) in the USA indicate that despite significant declines in CVD mortality in the late 20th century, this decline is now decelerating and may be worsened by inequalities in health care. Social factors contribute to most of the cardiovascular health disparities documented to date. Hispanics/Latinos and African-Americans share a higher prevalence of cardiovascular risk factors and experience higher rates of poverty and social stressors than non-Hispanic Whites. We propose that the use of social and behavioral data beyond basic and sometimes loose identifiers of race/ethnicity, educational attainment, and occupation would inform clinical practice and greatly facilitate the provision of adequate guidance and support to patients regarding continuity of care, adherence to medications and treatment plans, and engagement of participants in future research. This perspective briefly highlights factors deemed to be critical for the advancement of Hispanic/Latino health and delineates pathways toward future applications.
Decontamination of N95 respirators is being used by clinicians in the face of a global shortage of these devices. Some treatments for decontamination, such as some vaporized hydrogen peroxide methods or ultraviolet methods, had no impact on respiratory performance, while other treatments resulted in substantial damage to masks.
Purposeful qualitative modelling of embodiment function relations is a challenge in embodiment design. This contribution investigates the applicability and usefulness of the Contact and Channel Approach as a qualitative modelling approach in a survey study. From 23 development and research projects, advantages and challenges regarding applicability and usefulness are identified. A further result is that many different models are used additionally to the Contact and Channel Approach. Based on the findings, research potential for optimization and development of links to other models emerges.