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Treatment Resistant Depression is a challenging condition with a poor outcome and limited therapeutic options. Esketamine is the enantiomer of Ketamine and has recently been approved and marketed for treating depression. Questions remain about its short- and long-term benefit, as well as its usefulness in suicide risk. Hopelessness is one of the symptoms most closely associated with suicide risk.
Objectives
The aim of this paper is to evaluate the effect of this drug on hopelessness after one month of treatment with Esketamine.
Methods
The Beck Hopelessness Scale (BHS) was administered to patients receiving Esketamine at the Doctor Negrín University Hospital of Gran Canaria, who provided informed consent and exhibited suicidal ideations and depressive symptoms at the beginning of treatment. This scale was administered before the intranasal administration of Esketamine and after one month of treatment.
Results
Participants (n=5) had an average age of 54,4 years (median 56). We observed variability in the results among the evaluated patients, although the overall trend was a decrease in scores. On average, the patients’ scores decreased from 14,6 to 7,4 points (with a median change from 14 to 8 points).
Conclusions
Hopelessness improved in the BHS after one month of treatment with Esketamine. These results could be of clinical significance. Hopelessness is associated with suicide risk, so we hypothesize that the improvement could have an impact on it. Nevertheless, we must exercise caution with these results: the sample size is small, patients were taking different medications, and they have diverse medical histories.
Interest in the co-occurrence of gender dysphoria and autism spectrum disorder has gained prominence in recent years. Gender dysphoria refers to the distress experienced when there is an incongruence between gender identity and sex assigned at birth. On the other hand, autism spectrum disorder is characterized by difficulties in communication and social interaction, as well as restrictive and repetitive patterns of behavior.
Objectives
The aim of this paper is to review the current available literature in order to expand our knowledge about gender identity and dysphoria in the population with autism spectrum disorder.
Methods
A qualitative review was conducted over the last 20 years, using the Medline database through PubMed. Combinations of MeSH terms related to gender identity and people with autism spectrum disorder were used, selecting those studies in English, French or Spanish that met the objectives of the review, excluding references in other languages. The scientific evidence obtained was analyzed and synthesized.
Results
The development of gender identity of people with autism spectrum disorder can be a complex process. Comparing the general population with the population with autism spectrum disorder, a higher prevalence of gender dysphoria has been evidenced in the population with autism spectrum disorder, and within this group when segmented by gender, greater in women than in men.
Conclusions
This review highlights the importance of increasing knowledge about sexuality and gender dysphoria in people with autism spectrum disorder in order to facilitate the development, understanding and acceptance of their gender identity and sexual orientation of these people.
The surface and charge characteristics of 6 allophanic clays originating from a climatosequence of Andisols have been studied by titration, ion retention, surface area, and reactivity measurements. Several properties of these clays, such as the pH of zero charge, the magnitude of the surface area, and the reactivity of structural hydroxyl groups, appear to be governed by their chemical composition, especially by their silica content. A similar relationship between the above properties and silica content also exists for synthetic aluminosilicate gels (often quoted in the literature as possible models of allophanes), despite their different structure to the natural clays. An explanation is that as desilication proceeds, octahedral polymeric units of aluminum progressively individualize in both the synthetic and natural samples. The surface areas of the aUophanic clays, based on the slope of the titration curve at pH 7, are closely related to the amounts of structural hydroxyl that can react with fluoride at about the same pH. The permanent negative charges are always very low, even for silica-rich, allophane-bearing samples. It is therefore suggested that all of these clays should be virtually free of tetrahedral aluminum.
The study evaluated forage and livestock performance in different grazing systems over two years. Treatments were three contrasting grazing systems: (I) N-fertilized bahiagrass (Paspalum notatum Flüggé) in the summer overseeded during the winter by N-fertilized ryegrass (Lolium multiflorum) and oat (Avena sativa L.) (Grass + N); (II) unfertilized bahiagrass during the summer overseeded with ryegrass + oat and a blend of clovers (Trifolium spp.) in the winter (Grass + Clover); (III) unfertilized bahiagrass and rhizoma peanut (RP; Arachis glabrata Benth.) mixture during summer, overseeded during winter by ryegrass + oat + clovers mixture (Grass + Clover + RP). Average daily gain (ADG), gain per area (GPA), and stocking rate (SR) in the winter did not differ across treatments and averaged 0.87 kg/d (P = 0.940), 303 kg/ha, and 2.72 AU/ha. In the summer, Grass + Clover + RP had greater ADG than Grass + N (0.34 vs. 0.17 kg/d, respectively). During the summer, the GPA of Grass + Clover + RP was superior to Grass + N (257 vs. 129 kg/ha, respectively), with no difference in SR among treatments at 3.19 AU/ha. Over the entire year, ADG and GPA tended to be greater for Grass + Clover + RP. Annual SR differed between treatments, where Grass + N was greater (3.37 AU/ha) than the other treatments, which averaged 2.76 AU/ha. Integration of legumes into pasture systems in the summer and winter contributes to developing a sustainable grazing system, reducing N fertilizer use by 85% while tending to increase livestock productivity even though SR was decreased by 18%.
Maghemite (γ-Fe2O3) is a ferrimagnetic Fe oxide commonly found in tropical and subtropical soils, especially in the topsoil where it is usually a product of burning. Isomorphic substitution (IS) of the Fe in maghemite by different metals (mainly Al3+) can modify its mineralogical and chemical attributes, and these modifications may be important to understanding the formation and properties of this mineral in soils and sediments. The objective of this work was to evaluate the crystallochemical alterations of synthetic, Al-substituted maghemites prepared by the precipitation of magnetites from alkaline aqueous media containing FeSO4·7H2O with increasing amounts of Al2(SO4)3·7H2O to obtain hypothetical Al3+ for Fe3+ substitutions ranging from 0.0 to 40.0 mol %. The Al-substituted magnetites were washed and dried, and then heated to 250ºC for 4 h to form yellowish red maghemites that were characterized by total chemical analysis, X-ray diffraction, specific surface area (SSA), mass-specific magnetic susceptibility, infrared spectroscopy, transmission electronic microscopy, and color. Increasing Al3+ substitution to an experimental maximum of 15.9 mol % decreased both the a0 dimension of the cubic unit cell (a0 = 0.8339 − 396.157 × 10−16 Al, r2 = 0.99) and the mean crystallite dimension (MCD = 76.4–3.15Al, r2 = 0.79) of the maghemites. With the decrease in MCD came a more yellowish color, an increase in SSA, and a decrease in crystallinity as measured through extraction of the samples with acid ammonium oxalate. The mass-specific magnetic susceptibility of the maghemites increased with Al3+ substitution up to 5.3 mol % and then decreased with further replacement of Fe by Al. Solid-phase aluminum in excess of 16 mol % substitution appeared to occur as a separate, poorly crystalline phase that was X-ray amorphous.
Mercury ion removal from waste-waters has been the subject of extensive research. The aim of the present investigation was to report the incorporation of the n-alkylamine molecules onto a bentonite surface and the capacities of these new chelating moieties on this modified bentonite surface for mercury removal from water. Bentonite collected from the Amazon region, Brazil, was used in an intercalation process with polar n-alkylamine molecules of general formula H3C(CH2)n-NH2 (n = 1 to 4) in 1,2-dichloroethane. The natural and modified bentonite samples were characterized by elemental analysis, Xray diffraction, helium picnometry, mercury porosimetry, and 29Si, 27Al, and 13C nuclear magnetic resonance spectroscopy. Because of the increasing size of the molecules attached to the pendant chains, the metal-adsorption capability of the final chelating materials was measured in each case. The adsorption of Hg(II) on natural and modified bentonites was determined under different conditions. The effects of concentration of Hg(II), contact time, and pH were investigated; batch and dynamic adsorption experiments of Hg(II) were conducted on bentonite samples under various conditions. The ability of these materials to remove Hg(II) from aqueous solution was assessed by means of a series of adsorption isotherms at room temperature and pH 4.0. In order to evaluate the bentonite samples as adsorbents in a dynamic system, a glass column was filled with clay samples (1.0 g each) and fed with 1.8 × 10−4 mol dm−3 Hg(II) at pH 4.0. The energetic effects caused by adsorption of metal cations were determined by means of calorimetric titrations. Thermodynamics indicated the existence of favorable conditions for such Hg(II)-nitrogen interactions.
The water balance and urinary parameters of lambs fed diets containing cactus cladodes varieties were evaluated. Thirty-six uncastrated male Santa Inês lambs (22.0 ± 2.9 kg initial body weight) were distributed in a completely randomized design, with three treatments and 12 replicates. The animals were fed a control diet (Tifton-85 hay as exclusive roughage), Miúda or Orelha de Elefante Mexicana (OEM) cactus-based diets. Urine samples were collected 45 days after the introduction of the tested diets, and voluntary water intake was measured over 10 days, during the experimental period. Diets containing Miúda or OEM cactus caused a reduction of 68.35 and 77.03% in voluntary water intake, respectively. In addition, the Miúda cactus cladodes caused urinary alkalinization (pH = 8.14) and reduction in the urinary excretion index (UEI) and on the fractional excretion rate (FER) of total calcium (Ca). The diets with OEM cactus cladodes caused higher oxalates intake (6.21 g/day) and increase in urinary volume. Regardless of the variety, there was a reduction in the urinary concentrations of urea, creatinine, total proteins, Ca, phosphorus (P), UEI of urea and P, as well as in FER of P, compared to the control diet. Urinary Mg content and UEI of uric acid and Mg increased and FER of P decreased by diets supplemented with different varieties of cactus cladodes. In conclusion, the cactus cladodes increased water intake and retention, and diuresis in lambs, altered urine parameters, without compromising kidney function.
ADHD is a risk factor for impulsive/compulsive eating problems (EP). In, bulimia nervosa and compulsive eating disorder, EP are frequently preceded by negative affect and experienced as loss of control. Clarifying the underlying causes (eg., ADHD symptoms and/or psychological distress) of EP in ADHD would allow the development of targeted interventions.
Objectives
To a) compare levels of EP between ADHD patients and a community sample, and b) test if ADHD symptoms and psychological distress predict EP, in ADHD patients.
Methods
Adults with ADHD (n=32; age=23.78+/-6.12; 69% males) from the Neurodevelopmental Outpatient Unit of Coimbra and healthy participants (n=30; age=36.90+/-13.23; 57% males) answered an online survey including the Portuguese versions of the Adult ADHD Self-Report Scale Symptom Checklist, the Parkinson’s Disease Impulsive-Compulsive Disorders Questionnaire-Current Short and the Depression, Anxiety and Stress Scale.
Results
The ADHD group reported experiencing more EP than healthy individuals (18/32 vs. 4/30; χ2=12.458, p<.001). ADHD patients with EP suffered from severer ADHD inattentive, hyperactive, and global symptoms and higher levels of psychological distress (p<.001 to p=.027). Logistic regression model testing if ADHD and psychological distress symptoms predicted EP, in ADHD, explained 38.8% of the variance and showed that the only significant predictor was ADHD symptoms (B=.121, SE=.051, p=.017).
Conclusions
Our results indicate that EP are associated with severer ADHD clinical pictures. EP arose secondarily to ADHD symptoms, instead of serving as means to alleviate psychological distress. Clinicians should be mindful that, in ADHD patients, EP follow specific motivations, i.e., impulsivity and inattention, and may respond to combined cognitive-behavioural/executive training strategy.
Cutaneous leishmaniasis (CL) is a spectrum of clinical manifestations characterized by severe skin ulcerations that leads to social stigma. There are limited treatment options for CL, and the available drugs are becoming less efficacious due to drug resistance. More efficacious and safer antileishmanial drugs are needed. In this study, the biological effect of seven synthetically accessible nitroaromatic compounds was evaluated in vitro against amastigotes of Leishmania amazonensis, followed by in vivo evaluation using mouse models of CL. Two compounds (6 and 7) were active against amastigotes in vitro [half-maximal effective concentration (EC50): 4.57 ± 0.08 and 9.19 ± 0.68 μm, respectively], with selectivity indexes >50, and the other compounds were not selective. In vivo, compounds 6 and 7 (10 mg kg−1, twice a day for 14 days) failed to reduce skin lesion sizes and parasite loads determined by light microscopy of lesion imprints and quantitative polymerase chain reaction. Nevertheless, the in vitro leishmanicidal efficacy sustained their use as templates for nitroimidazole-based antileishmanial drug discovery programmes focusing on analogues with more suitable properties.
The population dynamics of the stout reef octopus, Octopus insularis fished with longlines of pots in mid-shelf waters of north-eastern Brazil was studied based on fishermen's logbooks and onboard monthly fishing trips from September 2009 to August 2010. Specimens marked with oxytetracycline kept in tanks for up to 21 days provided evidence of the daily deposition of growth increments in the lateral wall of the upper beaks. Sampled specimens weighed 50–1280 g and had 43–172 daily growth increments. Compared with congeneric species from higher latitudes, O. insularis grows faster and has a shorter longevity in the north-eastern Brazil tropical environment. Total catches and catch-per-unit effort were substantially higher in the dry season, with less wind and cooler temperatures. The presence of larger specimens was seasonal, correlated with the chlorophyll-a levels recorded six months earlier. The year-round presence of mature females and males, spawned females, and egg masses attached to the pots, were considered evidence of migration of small and young specimens from coastal areas towards the 20–40 m depth range for reproduction. Annual landings attained ~200 tonnes (2005–2010). Although recent landing statistics are missing, fishermen interviewed in 2021 claimed that the fishery was still profitable. It is suggested that, despite the lack of management, the fast growth, year-round reproduction and limited market for this relatively small octopus, prevented the fishery from collapse and reinforces the current view of the high resilience of cephalopod fisheries.
Corticosteroids may induce psychiatric symptoms (agitation, fear, hypomania, insomnia, irritability, labile mood, pressured speech and restlessness) with incidence rates ranging from 1,8% to 57%. We present a case of corticosteroid-induced mania and psychosis.
Objectives
Non-systematic review on corticosteroid therapy induced psychiatric symptoms. Analysis and comparison of a patient’s case with the existing literature.
Methods
Case report and a non-systematic review through databases as Pubmed, UpToDate, Medscape, between 2000 and 2020.
Results
We present a female 70 year-old patient without psychiatric background, diagnosed with Rhizomelic Pseudopolyarthritis, who started treatment with prednisone 20 mg. During the third month of treatment the patient started progressively worse behavior changes (such as destruction of the neighbor’s property), developed persecutory delusions, decreased sleep and increased energy. The patient was committed to our psychiatric ward and started on diazepam 10 mg and olanzapine 15 mg per day. Despite introduction of antipsychotics, which has evidence for mood stabilization, the patient maintained the symptoms, so it was necessary to gradually reduce corticosteroids until symptomatic control.
Conclusions
Psychosis (24%), hypomania and mania (35%), are the most common psychiatric reactions to corticosteroid therapy. Several studies show that even a low dosage may induce psychiatric disturbances, most frequently during the first two weeks of treatment. However, as reported in this case, symptoms may occur at any time. Thus, a multidisciplinary team, as well as training of professionals from different specialties, such as psychiatry, rheumatology and endocrinology, are needed, since these syndromes may be confused with pure psychiatric conditions and consequently delay treatment and compromise prognosis.
Strenuous physical activity, sleep deprivation and psychological stress are common features of military field training. The present study aimed to evaluate the effects of supplementation with a synbiotic ice cream on salivary IgA, gastrointestinal symptoms, well-being indicators and gut microbiota in young military participants undergoing field training. Sixty-five military completed the study: one group was supplemented for 30 d with synbiotic ice cream containing: 2·1 × 108 CFU/g for Lactobacillus acidophilus LA-5 and 2·7 × 109 CFU/g for Bifidobacterium animalis BB-12 and 2·3 g of inulin in the 60 g of ice cream at manufacture, and the other with a placebo ice cream. Volunteers were evaluated at pre-supplementation (baseline), post-supplementation and after a 5-d military training. Bifidobacterium and Lactobacillus genera were measured in stool samples and both showed a higher differential abundance post-supplementation and training. Salivary IgA and gastrointestinal symptoms decreased at post-training in both groups (P < 0·05; main effect of time); however, supplementation with synbiotic did not mitigate this effect. Tenseness and sleepiness were decreased in the synbiotic-treated group, but not in the placebo group at post-military training (P = 0·01 and 0·009, respectively; group × time effect). The other well-being indicators were not affected by the synbiotic supplementation. In conclusion, 30 d of synbiotic ice cream supplementation containing inulin, L. acidophilus LA-5 and B. animalis BB-12 favourably modulated gut microbiota and improved tenseness and sleepiness in healthy young military undergoing a 5-d field training. These improvements may be relevant to this population as they may influence the decision-making process in an environment of high physical and psychological stress.
To assess the factors associated with overweight and obesity among women of childbearing age in Brazil.
Design:
Cross-sectional study.
Setting:
Using the National Health Survey (PNS) database, from the year 2013. The socio-economic and demographic factors analysed were age, race/skin colour, region, marital status, education level, employment and family income. Concerning health history, diagnoses of hypertension, diabetes mellitus, high cholesterol, heart attack, stroke, chronic kidney disease, menarche, parity and depression were evaluated. For lifestyle information, health status, alcoholic beverage consumption, smoking and physical activity were included. The outcomes were obesity and overweight. The association of excess weight with socio-economic and demographic factors, health history and lifestyle characteristics was investigated according to the appropriate theoretical–conceptual model for the topic.
Participants:
The sample size was 17 109 women aged 18–49 years.
Results:
The prevalence of women with excess weight was 55·20 %, with 33·26 % being overweight and 21·94 % with obesity. The factors associated with excess weight were age, non-white skin colour, having a partner, family income of up to two minimum wages, menarche before the age of 12, multiparity, diabetes mellitus, depression, hypertension, high cholesterol, stroke and heart attack.
Conclusion:
The results showed an association between excess weight and socio-demographic factors, both determinants of general and reproductive health history. Implementation of effective public health policies is necessary to prevent unfavourable outcomes related to the health of women of childbearing age with excess weight.
To evaluate energetic contribution according to the degree of industrial food processing and its association with sociodemographic, anthropometric, biochemical, clinical and behavioural characteristics in adolescents.
Design:
Cross-sectional study (Adolescent Lifestyle Study). Food consumption was assessed using 24-h dietary recalls, with foods classified by degree of industrial progressing. The usual diet was estimated using the Multiple Source Method. In a linear regression model, the energy percentage (E %) was associated with sociodemographic, anthropometric, biochemical, clinical and behavioural characteristics, after adjustment for sex and age.
Setting:
Juiz de Fora, Brazil.
Participants:
Eight hundred and four adolescents, of both sexes, 14–19 years of age, enrolled in public schools.
Results:
The E % of unprocessed or minimally processed foods corresponded to 43·1 %, processed foods to 11·0 % and the ultraprocessed foods to 45·9 %. E % of unprocessed foods was associated with socio-economic stratum (adjusted β = −0·093; P = 0·032), neck circumference (adjusted β = 0·017; P = 0·049), screen time (adjusted β = −0·247; P = 0·036) and HDL-cholesterol (adjusted β = −0·156; P = 0·003). E % of ultraprocessed foods was associated with socio-economic stratum (adjusted β = 0·118; P = 0·011), screen time (adjusted β = 0·375; P = 0·003), BMI (adjusted β = −0·029; P = 0·025), neck circumference (adjusted β = −0·017; P = 0·028) and HDL-cholesterol (adjusted β = 0·150; P = 0·002).
Conclusions:
There was a high E % of ultraprocessed foods in the diet of the adolescents. Actions are needed to raise the awareness of adopting healthy eating habits.
The recently discovered massive and stockwork sulphide mineralization of Semblana-Rosa Magra and Monte Branco, situated ESE of the Neves–Corvo volcanogenic massive sulphide (VMS) deposit in the Iberian Pyrite Belt (IPB) is presented. Geological setting and tectonic model is discussed based on proxies such as palynostratigraphy and U–Pb zircon geochronology. The mineralization is found within the IPB Volcano-Sedimentary Complex (VSC) Lower sequence, which includes felsic volcanic rocks (rhyolites) with U–Pb ages in zircons of 359.6 ± 1.6 Ma, and black shales of the Neves Formation of late Strunian age. Massive sulphides are enveloped by these shales, implying that felsic volcanism, mineralization and shale sedimentation are essentially coeval. This circumstance is considered highly prospective, as it represents an important exploration vector to target VMS mineralization across the IPB, in areas where the Lower VSC sequence is present. The Upper VSC sequence, with siliciclastic and volcanogenic sedimentary rocks of middle–late Visean age, shows no massive mineralization but a late Tournaisian (350.9 ± 2.3 Ma) volcanism with disseminated sulphides was also identified. Nevertheless, stratigraphic palynological gaps were found within the Strunian and in the Tournaisian sediments, between the Lower and Upper VSC sequences, reflecting probable erosion and uplift mechanisms linked with extensional tectonics. The Semblana and Monte Branco deposits and the Rosa Magra stockwork are enclosed by tectonic sheets that dismembered the VSC sequence in a fold-and-thrust tectonic complex, characteristic of the NE Neves–Corvo region. The methodologies used allow a geological comparison between Neves–Corvo and other IPB mine regions such as Lousal–Caveira, Herrerias, Tharsis and Aznalcollar.
This study provides a morphological and phylogenetic characterization of two novel species of the order Haplosporida (Haplosporidium carcini n. sp., and H. cranc n. sp.) infecting the common shore crab Carcinus maenas collected at one location in Swansea Bay, South Wales, UK. Both parasites were observed in the haemolymph, gills and hepatopancreas. The prevalence of clinical infections (i.e. parasites seen directly in fresh haemolymph preparations) was low, at ~1%, whereas subclinical levels, detected by polymerase chain reaction, were slightly higher at ~2%. Although no spores were found in any of the infected crabs examined histologically (n = 334), the morphology of monokaryotic and dikaryotic unicellular stages of the parasites enabled differentiation between the two new species. Phylogenetic analyses of the new species based on the small subunit (SSU) rDNA gene placed H. cranc in a clade of otherwise uncharacterized environmental sequences from marine samples, and H. carcini in a clade with other crustacean-associated lineages.
The impact of the diagnosis of an oncologic disease is well-known in terms of psychological adjustment and quality of life. On the other hand it is known that depressive symptoms may also overlap the physical symptoms of cancer and cancer treatment, which may interfere in their detection and appropriate treatment approach.
Objectives
The aim of the current study was to explore the relationship between psychological adjustment to lung cancer, self-compassion, social support and emotional negative states in patients with lung cancer.
Method
Fifty-five patients diagnosed with lung cancer (38 men and 17 women) with ages ranging from 44 to 87 years old participated in the study. A set of self-report instruments was used: the Mini Mental Adjustment to Cancer Scale (MiniMac), the Self-compassion Scale (SCS; Neff, 2003), the Social Support Satisfaction Scale (SSSS) and the Depression, Anxiety and Stress Scale (DASS-21).
Results
Significant correlations were found between psychological adjustment and emotion regulation strategies (self-compassion), social support and psychopathology. The predictive model for depressive symptomatology and psychological adjustment (as assessed by the helpless/hopeless dimension) includes mindfulness as a significant predictor. Regarding the predictive model for stress, the satisfaction level with support from friends revealed to be an important element.
Conclusions
Our findings suggest that these patients may benefit, in their therapeutic approach, from the development of this kind of strategies (new ways of relating themselves with their emotional experiences and quality of their social networks) in order to promote a better psychological adjustment to their clinical condition.