bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-bleached colonies of massive Porites may attract fishes for selective grazing during mass bleaching events
Authors: Ikeuchi Eri , Ohno Yoshikazu , Iguchi Akira , Nakamura Takashi
Published: June 2017

In this study we investigated the variation in grazing scar densities between bleached and non-bleached colonies of massive Porites species in Sekisei Lagoon (Okinawa, southwestern Japan) during a mass bleaching event in 2016. The grazing scar densities and bleaching susceptibility varied among neighboring colonies of massive Porites spp. However, non-bleached colonies had significantly more surface scars than bleached colonies. One explanation for these variations is that corallivorous fishes may selectively graze on non-bleached, thermally tolerant colonies. This is the first report of a relationship between grazing scars and the bleaching status of massive Porites spp. colonies during a mass bleaching event.
Avaliação da sessão temática “Estado, Planejamento e Política” do XVI ENANPUR
Authors: Teixeira Alex Volnei , Rezende Denis Alcides , Ribeiro Sergio Silva , Araujo Roberson Cesar
Published: June 2017

A gestão urbana pode se beneficiar de estudos de infometria para contribuir com seus pesquisadores. O objetivo neste artigo é identificar e analisar o perfil informacional da produção cientifica, publicada nos Anais da XVI ENANPUR, especificamente, a sessão temática dois: Estado, Planejamento e Política. Trata-se de uma pesquisa informacional, de natureza quantitativa, para identificar padrão de preferência por temas e seus reflexos quantitativos. Como procedimentos metodológicos foram utilizados a Infometria e o acoplamento bibliográfico. Os resultados obtidos apontaram para uma distribuição homogênea das temáticas, restando como tendência de preferência os temas: “Teorias do Estado e do Planejamento” e “Gestão e Governança Urbana”. A conclusão também aponta para uma dispersão de temporalidade nas citações e no acoplamento bibliográfico.Código JEL | I23; O18; R19.
Perforated Goblet Cell Carcinoid Tumors of the Appendix: Navigating the Management Conundrum
Authors: Koganti Suman B. , Gilchrist Brian F. , Bell Tresara C.
Published: June 2017

Appendix is the most common site of occurrence for a goblet cell carcinoid tumor. A diagnosis of an appendiceal goblet cell carcinoid is made in retrospect the majority of the time. These tumors are best treated with a right hemicolectomy and adjuvant therapies tailored according to the presence or absence of residual disease. Presentation as a perforated appendix is seen in 16% of these tumors. The natural history and the ideal management strategy in such a scenario are not well described. In those with peritoneal spread cytoreductive surgery with HIPEC (hyperthermic intraperitoneal chemotherapy) offers the best disease-free and progression-free survival. Close follow-up with cross-sectional imaging helps in identifying recurrences at the earliest. Multimodality management involving patient participation in every aspect of care accomplishes high-value care in the treatment of these tumors.
LITTORAL PROCESSES ON SANDY COASTS
Authors: Eaton Richard O.
Published: June 2017

From the standpoint of geological processes, a sandy beach is an interim phase in the ultimate development of a coastline, principally because a sandy beach can survive only if it receives nourishment at the rate of depletion. Depending upon its stage of maturity, a particular coastal segment may be advancing, retreating or in a state of approximate equilibrium. Its precise status in any phase is dependent upon material balance, that is, the rate at which sediments are delivered to the littoral zone compared with the rate at which they are removed therefrom. The ultimate stage of development may be described as a state in which the littoral forces are incapable of transporting materials which form the littoral berm, and erosive forces acting upon the land mass are incapable of delivering sediments to or from the coastal shores.
MOBILE BREAKWATERS
Authors: Carr John H.
Published: June 2017

A mobile breakwater may be defined as a structure or device which combines the ability to appreciably reduce the height of ocean waves in its lee with a degree of mobility sufficient to permit its ready transportation for considerable distances and its speedy installation when arrived at the site. Such a device would find application wherever wave protection is necessary for but limited periods, as in offshore drilling operations, or where an installation is required to be completed in a very short time, as in amphibious military operations.
NUMERICAL STUDY ON THE INFLUENCE OF INFILTRATION ON SWASH HYDRODYNAMICS AND SEDIMENT TRANSPORT IN THE SWASH ZONE
Authors: Hammeken Alejandro M. , Simons Richard R.
Published: June 2017

Infiltration and exfiltration processes have a significant influence on the hydrodynamics of the swash zone. Such processes need to be taken into account in the modelling of cross-shore sediment transport and the prediction of beach profile evolution. This paper presents a numerical study of the swash hydrodynamics using a 2D Volume-Averaged Reynolds-Averaged Navier-Stokes model, which was calibrated and validated against new experimental data. The model was used to simulate wave run-up from regular waves over permeable and impermeable fixed slopes. Swash flow velocities and water depth data were obtained from the simulations and used to estimate bed shear stresses at three different locations on the beach slope. The results show that infiltration can have opposing effects on the bed shear stress when compared to equivalent swash on an impermeable slope. During the uprush phase, stresses are directly increased due to boundary layer thinning, whereas, during the backwash phase, there is a significant reduction of flow leading to a decrease in the bed shear stresses.
TSUNAMI INDUCED FORCES IN BRIDGES: LARGE-SCALE EXPERIMENTS AND THE ROLE OF AIR-ENTRAPMENT
Authors: Istrati Denis , Buckle Ian G , Lomonaco Pedro , Yim Solomon , Itani Ahmad
Published: June 2017

In this study large scale hydraulic experiments of tsunami waves impacting a straight composite I-girder bridge were conducted in the LWF at Oregon State University. Both solitary waves and turbulent bores were tested and the experimental results revealed the existence of 4 different phases in the vertical force histories, among which is (i) a phase with a large applied moment and bridge rotation at the time of the first impact of the tsunami bore on the bridge, and (ii) a phase with a governing uplift mode of the bridge during the passage of the wave through the bridge. The first phase introduced the largest tensile forces in the offshore bearings and must be considered in order to prevent the progressive damage of bearings. In addition, the air-entrapment occurring in bridges with diaphragms was seen to (a) alter significantly the pattern of the applied pressures on the girders and below the deck in the internal chambers, (b) consistently increase the total uplift forces for all examined wave heights, and (3) cause a complex nonlinear wave-air interaction phenomenon with significant 3D effects.
VARIATION IN GREAT LAKES LEVELS IN RELATION TO ENGINEERING PROBLEMS
Authors: McDonald W. E.
Published: June 2017

Throughout the recorded history of the Great Lakes, the fluctuation in their water levels has created engineering problems generally unique in relation to coastal engineering. In periods of low water, demands are heard from navigation and power interests to raise the levels. In periods of high water appeals are made by shore property owners to lower the levels. Such conflicting interests present major engineering problems, the nature of which during a given period of time reflect the long-range upward and downward trend in lake levels due to natural phenomena.
STATISTICAL ANALYSIS OF WAVE RECORDS
Authors: Putz R. R.
Published: June 2017

The establishment of quantitative relationships between recorded wave-system characteristics and other phenomena requires numerical description of the wave record. Current concepts applied to time histories of wave activity at a point are discussed. Characteristic statistical regularities found in wave measurements are described. Examples given show the application of statistical techniques' to the description of wave systems in terms of the distribution of spectral energy as well as the distributions of "individual" wave heights and periods. Results from the prediction, from one point to another, of surface time histories illustrate the application of approximate spectral information.
SHOCK PRESSURE OF BREAKING WAVES
Authors: Ross Culbertson W.
Published: June 2017

Most of you have observed waves breaking against rocks or structures, and have noted that water is frequently thrown high in the air. The pressure required to project water in a vertical direction is about one half pound per square inch for each foot of height. We may therefore expect to find substantial pressure involved in the mechanics of a wave breaking against a structure.
THE MOTION OF SEDIMENT ALONG THE SOUTH SHORE OF LAKE ERIE
Authors: Pincus Howard J.
Published: June 2017

Much of Lake Erie' s southern shoreline displays fairly uniform properties with respect to shore processes. However, detailed studies of selected stripe of shore areas often reveal characteristics which are so distinctive that problems of control require special attention to local characteristics. The purpose of this paper is to present some generalizations and some detailed comments on the motion of sediment along the south shore of Lake Erie, to outline the results of some detailed studies of small areas, and to evaluate the types of evidence used in such studies.
LITTORAL DRIFT FORMATION OF SPITS AND TOMBOLOS
Authors: Sauvage M. G. , Vincent M. G.
Published: June 2017

This paper, entirely devoted to the study of phenomena connected with the evolution of sand banks, is introduced by a rapid survey of a few basic ideas about littoral drift; we point out the fundamental role of wave currents and more particularly of the currents caused by breaking waves.

We have attempted to determine the influence on littoral drift of such factors as: the wave characteristics, the wave steepness, the inclination of the wave crests breaking onto the beach, the nature of the beach material. The few experimental results given need to be completed and then compared with figures resulting from observations in nature; it is unfortunate that these latter are difficult and expensive to obtain.

After these general remarks on littoral drift, we consider a few aspects of the-development of sand banks such as the birth and evolution of littoral spits and tombolos, both of which are littoral formations presenting an obvious practical interest for the engineer responsible for the construction of ports on sandy coasts.
DUNE FORMATION AND STABILIZATION BY VEGETATION AND PLANTINGS
Authors: Davis John H.
Published: June 2017

Plantings of appropriate native and introduced plants and the management of extant vegetation are often very effective in promoting the development and maintenance of dunes that serve to protect shores against some types of erosion. The importance of dunes as barriers, the formation of dunes, and the role of plants and vegetation are considered. The types of vegetation of the three zones usually present over dune fields are described, and the general management to maintain such vegetation is discussed. Methods of making plantings on natural and artificial dunes by selecting, seeding, and transplanting the species that are most effective in building and stabilizing dunes are given.
WAVE RUN-UP ON COMPOSITE SLOPES
Authors: Saville, Jr. Thorndike
Published: June 2017

A method is presented for determining wave run-up on composite slopes from laboratory- derived curves for single slopes. The method is one of successive approximations and involves replacement of the actual composite slope with a hypothetical single slope obtained from the breaking depth and an estimated run-up value. Comparison of predicted values is made with actual laboratory data.
MOUVEMENTS DES MATERIAUX DE FOND SOUS L'ACTION DE LA HOULE
Authors: Lhermitte P.
Published: June 2017

Hous exposerons dans cet article, les resultats d'experiences que nous avons obtenues, relativement aux mouvemen des materiaux de fond sous 1'action des houles progressives, et nous tenterons de fournir des schemas d'explication des differenph^ nomenes observes. Certains aspects des mouvements. de materiaux sous 1*action des houles, n© peuvent s'expliquer que par 1*extension de certains phenomenes hydrauliques lies a. la propagation des houles progressives : repartition des courants d'entrainement, effet de viscosite des fluides, developpement de la eouche-limit* pres du fond, etc ....

Hous nous bornerons d'ailleurs dans cette etude, a la description des mouvements de materiaux, qui dependent directemer des caracteristiques hydrauliques du mouvement du fluide, et plus .particulierement des caracteristiques de la couche limite, mais nous ne nous attacherons pas a, 1* etude de 1'influence des caracteres geologiques ou sedimentologiqu.es du materiau sur le comportement de ce dernier, l'etude detaill^e de ces phenomenes sortani du cadre de cette etude.

Sans exposer de facon complete et rigoureuse les phenc menes hydrauliques, il nous a semble" utile, pour la comprdhensior du texte, d'indiquersommairement certains aspects shhematiques d€ ces phenomenes. £es lecteurs desirant approfondir ces questions pourront se reporter aux ouvrages citds en bibliographie -(6) (7) pour les courants d'entrainement, (5) et (4) pour les phenomenes de couche limite.
LITTORAL TRANSPORT IN THE GREAT LAKES
Authors: Bajorunas L.
Published: June 2017

The Great Lakes Superior, Michigan, Huron, Erie, and Ontario extend almost to the middle of the North American Continent. With their 95,000 square miles of water surface and their three navigable connections with the Atlantic Ocean and Gulf of Mexico, they affect the well-being of about 4.0 million people living within their vicinity in Canada and the United States. Possessing a shoreline of 6,600 miles, these waters have been called the fourth coast of the continent along with the Atlantic, Gulf, and Pacific coasts. This paper analyzes one of the many problems of the Great Lakes, the littoral transport problem.

Littoral transport has been defined as the movement of material along the shore in the littoral zone by waves and currents. The material thus transported is referred to as the littoral drift. The littoral drift originates from the beach material, being picked up by the water and transported along the shore and deposited in another location. Shore erosion, littoral transport, and deposition of drift are all factors in the littoral process.

A knowledge of the littoral process is important for many engineering projects including the construction and maintenance of shoreline harbors. The harbor breakwater extending from the shore into deep water forms a littoral barrier, and by stopping the transport action causes the depositio of drift on the updrift side. If the breakwater does not entirely stop the transport, or when the storage area on the updrift side is filled, the drift will bypass the breakwater and fill the dredged navigation channel causing frequent and expensive maintenance dredging. This problem is especially important in the small harbors on the Great Lakes planned every 25 to 30 miles as refuge for fishing and pleasure boats. These harbors have a rather small capacity for littoral drift, and the costs of maintenan dredging of so many entrance channels would be almost prohibitive.

In order to provide data required for the design and economic evaluation of the small refuge harbors on the Great .Lakes, the United States Lake Survey, Corps of Engineers, conducted a study of the best method of estimating the rate of littoral transport along the shores of the Great Lakes. Although much of the data used in this paper was taken from the above study, the views and
Death by translation: ribosome‐assisted degradation of mRNA by endonuclease toxins
Authors: Belasco Joel G.
Published: June 2017

Read the Original article at doi: 10.1002/1873-3468.12705
Fusing Dicarbollide Ions with N‐Heterocyclic Carbenes
Authors: Estrada Jess , Lavallo Vincent
Published: June 2017

Discovered by Hawthorne in 1965, dicarbollide ions are an intriguing class of nido‐carboranes that mimic the behavior of the cyclopentadienyl anion. Herein, we show that it is possible to directly link the dicarbollide ion to an N‐heterocyclic carbene (NHC) to form an isolable N‐dicarbollide‐substituted NHC dianion. This molecule can be accessed by the sequential double deprotonation of a mono‐nido‐carboranyl imidazolium zwitterion. As revealed by a single‐crystal X‐ray diffraction study, the first deprotonation leads to a monoanionic dicarbollide ion that adopts a bis(dicarbollide) structure in the solid state. Subsequent deprotonation of this monoanion leads to the first N‐dicarbollide NHC, which was fully characterized by multinuclear NMR spectroscopy as well as single‐crystal X‐ray diffraction.
Unusual Lipid A from a Cold‐Adapted Bacterium: Detailed Structural Characterization
Authors: Casillo Angela , Ziaco Marcello , Lindner Buko , Parrilli Ermenegilda , Schwudke Dominik , Holgado Aurora , Verstrepen Lynn , Sannino Filomena , Beyaert Rudi , Lanzetta Rosa , Tutino Maria Luisa , Corsaro Maria Michela
Published: June 2017

Colwellia psychrerythraea 34H is a Gram‐negative cold‐adapted microorganism that adopts many strategies to cope with the limitations associated with the low temperatures of its habitat. In this study, we report the complete characterization of the lipid A moiety from the lipopolysaccharide of Colwellia. Lipid A and its partially deacylated derivative were completely characterized by high‐resolution mass spectrometry, NMR spectroscopy, and chemical analysis. An unusual structure with a 3‐hydroxy unsaturated tetradecenoic acid as a component of the primary acylation pattern was identified. In addition, the presence of a partially acylated phosphoglycerol moiety on the secondary acylation site at the 3‐position of the reducing 2‐amino‐2‐deoxyglucopyranose unit caused tremendous natural heterogeneity in the structure of lipid A. Biological‐activity assays indicated that C. psychrerythraea 34H lipid A did not show an agonistic or antagonistic effect upon testing in human macrophages.
Amaryllidaceae alkaloids: Absolute configuration and biological activity
Authors: Cimmino Alessio , Masi Marco , Evidente Marco , Superchi Stefano , Evidente Antonio
Published: June 2017

Plants belonging to the Amaryllidaceae family are well known for their ornamental and medicinal use. Plant members of this group are distributed through both tropical and subtropical regions of the world and are dominant in Andean South America, the Mediterranean basin, and southern Africa. Amaryllidaceae plants have been demonstrated to be a good source of alkaloids with a large spectrum of biological activities, the latter being strictly related to the absolute stereochemistry of the alkaloid scaffold. Among them, great importance for practical applications in medicine has galanthamine, which has already spawned an Alzheimer's prescription drug as a potent and selective inhibitor of the enzyme acetylcholinesterase. Furthermore, lycorine as well as its related isocarbostyryl analogs narciclasine and pancratistatine have shown a strong anticancer activity in vitro against different solid tumors with malignant prognosis. This review addresses the assignment of the absolute configuration of several Amaryllidaceae alkaloids and its relationship with their biological activities.
Hot carrier solar cell as thermoelectric device
Authors: Konovalov Igor , Emelianov Vitali
Published: June 2017

Improvement of solar cell efficiency beyond the Shockley–Queisser limit requires introduction of new physical concepts. One such concept is hot carrier solar cell, proposed more than three decades ago and still not impressively demonstrated in experiment. Here we show that hot carrier solar cell may be considered as thermoelectric device based on Seebeck effect. This enables one to describe the operation of hot carrier solar cell in a simple way. We fabricated a prototype of the hot carrier solar cell showing open circuit voltage at room temperature larger than the band gap in the absorber material. Extrapolation of open circuit voltage to absolute zero temperature results in barrier height depending on light intensity, interpreted by splitting of quasi‐Fermi levels between the regions of different carrier temperature. Properties of the prototype solar cell may be described by kinetic transport theory as well as from the point of view of the thermoelectric theory.
The impact of extrahepatic disease among patients undergoing liver‐directed therapy for neuroendocrine liver metastasis
Authors: Ejaz Aslam , Reames Brad N. , Maithel Shishir , Poultsides George A. , Bauer Todd W. , Fields Ryan C. , Weiss Matt , Marques Hugo Pinto , Aldrighetti Luca , Pawlik Timothy M.
Published: June 2017

Introduction

Management of neuroendocrine liver metastasis (NELM) in the presence of extrahepatic disease (EHD) is controversial. We sought to examine outcomes of patients undergoing liver‐directed therapy (resection, ablation, or both) for NELM in the presence of EHD using a large international cohort of patients.

Methods

612 patients who underwent liver‐directed therapy were identified from eight institutions. Postoperative outcomes, as well as and overall (OS) were compared among patients with and without EHD.

Results

Most primary tumors were located in the pancreas (N = 254;41.8%) or the small bowel (N = 188;30.9%). Patients underwent surgery alone (N = 471;77.0%), ablation alone (N = 15;2.5%), or a combined approach (N = 126;20.6%). Patients with EHD had more high‐grade tumors (EHD: 44.4% vs no EHD: 16.1%; P < 0.001). EHD was often the peritoneum (N = 29;41.4%) or lung (N = 19;27.1%). Among 70 patients with EHD, 20.0% (N = 14) underwent concurrent resection for EHD. After median follow‐up of 51 months, 174 (28.4%) patients died with a median OS of 140.4 months. Patients with EHD had a shorter median OS versus patients who did not have EHD (EHD: 87 months vs no EHD: not reached; P = 0.002). EHD was independently associated with an increased risk of death (HR: 2.56, 95%CI 1.16‐5.62; P = 0.02).

Conclusion

Patients with NELM and EHD had more aggressive tumors, conferring a twofold increased risk of death. Surgical treatment of NELM among patients with EHD should be individualized.
Prognostic factors for recurrence of locally advanced differentiated thyroid cancer
Authors: Kim Bo‐Young , Choi Ji‐Eun , Lee Eunkyu , Son Young‐Ik , Baek Chung‐Hwan , Kim Sun Woo , Chung Man Ki
Published: June 2017

Background and Objectives To present treatment outcomes and prognostic factors for surgical management of locally advanced differentiated thyroid cancer (DTC).

Methods

Retrospective review of 70 patients in a single, tertiary referral institution was done. Clinical pathology characteristics were analyzed to investigate prognosticators, based on primary endpoints; locoregional recurrence alone (LRR), total recurrence (LRR or distant metastasis (DM)), and recurrence‐free survival.

Results

Recurrent laryngeal nerve (n = 31) and trachea (n = 30) were most commonly invaded organs by tumor. At the mean follow‐up of 81.7 months, LRR occurred in 15 patients and/or DM was detected in 15 patients (10 developed LRR and DM). By multivariate analysis, R1 resection (positive margin) and pN1b stage increased risk of LRR with a fold of 3.16 [95%CI 1.08‐9.24, P = 0.03] and 5.92 [1.61‐21.7, P = 0.007], respectively. Also, they increased risk of total recurrence with a fold of 3.04 [95%CI 1.26‐7.31, P = 0.01] and 3.42 [95%CI 1.16‐10.0, P = 0.02], respectively. Patients with pN1b stage showed better LRR‐free survival than pN0/N1a stage (P = 0.03).

Conclusions

Along with careful preoperative evaluation of the extent of primary and neck disease, obtaining negative resection margin and aggressive neck management is critical to improve oncologic outcomes of locally advanced DTC.
Factors associated with thromboembolic events following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy
Authors: Rottenstreich Amihai , Kalish Yosef , Kleinstern Geffen , Yaacov Almog Ben , Dux Joseph , Nissan Aviram
Published: June 2017

Background and Objectives

We investigated the risk factors, incidence, and role of thromboprophylaxis in the development of thrombosis following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC).

Methods

We reviewed data of patients with CRS/HIPEC in three hospitals.

Results

Overall, 192 patients underwent CRS/HIPEC during 2007‐2016. Mechanical (thigh‐length pneumatic compression stockings) and pharmacologic thromboprophylaxis (40 mg enoxaparin daily, starting 12 h before surgery until discharge) was provided for all patients; and 116 (60.4%) also received an extended course of enoxaparin for 2‐4 weeks after discharge. Twenty‐six patients experienced thrombotic complications (13.5%) including portal‐splenic‐mesenteric venous thrombosis (n = 11, 5.7%), pulmonary embolism (n = 10, 5.2%), and deep vein thrombosis (n = 5, 2.6%); most (n = 21, 80.8%) occurred after hospital discharge. Univariate analysis identified Peritoneal Cancer Index, intraoperative transfusion requirement, operative blood loss, operative time, lengths of hospital, and intensive care unit stay, and lack of administration of anticoagulation at discharge as significantly associated with thrombosis. With multivariate analysis, only the lack of anticoagulation therapy at discharge remained significantly associated with thrombosis (P = 0.0001).

Conclusions

Thromboembolic complications are common following CRS/HIPEC. As significantly lower rates of thrombosis were found in patients who received an extended course of anticoagulation, we support its use for at least 2 weeks after discharge.
US‐guided core‐needle biopsy versus US‐guided fine‐needle aspiration of suspicious cervical lymph nodes for staging workup of non‐head and neck malignancies: A propensity score matching study
Authors: Ryu Kyeong Hwa , Lee Jeong Hyun , Jang Seung Won , Kim Hwa Jung , Lee Ji Ye , Chung Sae Rom , Chung Mi Sun , Kim Hyo Weon , Choi Young Jun , Baek Jung Hwan
Published: June 2017

Background and Objectives

To compare US‐guided core‐needle biopsy (USCNB) and US‐guided fine‐needle aspiration (USFNA) of suspicious cervical lymph nodes for staging workup of malignancies in locations other than the head and neck using propensity score matching (PSM).

Methods

This retrospective cohort study included 108 patients who underwent USFNA and 1058 who underwent USCNB for suspicious cervical lymph nodes detected by imaging modalities during the staging workup for malignancies located in regions other than the head and neck. The primary outcome was defined as the inconclusive results. To evaluate the procedures according to the outcome, we performed univariate and multivariate logistic regression analyses and a 1:1 PSM of USCNB and USFNA.

Results

There was no complication for both USFNA and USCNB. The inconclusive results were 6.5% (7/108) for USFNA and 1.6% (17/1058) for USCNB. A significantly lower rate of the inconclusive results in USCNB than in USFNA before matching was maintained after a 1:1 PSM of 103 patients from each group (before PSM, odds ratio (OR) = 4.489, 95% confidence interval (CI) [1.803‐11.177], P = 0.001; after PSM, OR = 1.060, 95%CI [1.013‐1.109], P = 0.012).

Conclusions

Because USCNB can reduce inconclusive results compared to USFNA, it could be more helpful for staging workup of malignancies in locations other than the head and neck in patients with suspicious cervical lymph nodes.
Do multidose compliance aids do more harm than good?
Authors: Chaplin Steve
Published: June 2017

Use of multidose compliance aids (MCAs) is becoming more widespread, yet there is little evidence for their benefit and a recent UK study suggests that they are associated with a high rate of potentially inappropriate medication use and drug interactions.
The NHS GP Health Service: providing mental health support
Authors: Dowden Angela
Published: June 2017

GPs with mental ill health will rarely admit their emotional vulnerabilities to colleagues and therefore find it difficult to access existing local mental health services. This article discusses the NHS GP Health Service, a new England‐wide service that offers confidential help for GPs experiencing mental health issues.
Addressing the problem of undressing
Authors: Delvin David
Published: June 2017

When it comes to asking reluctant patients to undress for an examination, Dr David Delvin opts for a straightforward, no‐nonsense approach.
Winter and summer weather modulate the demography of wild turkeys at the northern edge of the species distribution
Authors: Lavoie Maxime , Blanchette Pierre , Larivière Serge , Tremblay Jean‐Pierre
Published: June 2017

Temperate species occupying habitats at the northern limit of their geographical distribution are limited by weather and climatic conditions. Such conditions often directly affect population dynamics, and thus, influence shifts in distribution via changes in demographic parameters. We examined this question by following three distinct populations of wild turkeys inhabiting areas exposed to a gradient of meteorological conditions at the northern limit of the species distribution. Four years of radio‐telemetry on 181 birds and monitoring of 95 nests revealed that population demographics of wild turkeys were influenced by snow depth, winter temperature and summer rainfall. During winter, survival of turkeys decreased drastically when snow depth remained >30 cm for >10 days and also decreased as temperatures got colder. In the spring, snow persistence delayed nest initiation, whereas nest survival was negatively affected by rainfall. Our findings show that the effects of critical meteorological factors such as snow and temperature can be compounded when both reach the limit of a species tolerance simultaneously.
The Impact of Screening Psychiatric Comorbidity and High-risk Feedback on Liaison Psychiatric Consultation Rates and Clinicians’ Attitudes on a Neurology Ward
Authors: Van Damme R. , Portzky G. , Boon P. , Lemmens G.M.D.
Published: June 2017

Introduction

Lifetime prevalence of psychiatric comorbidity in neurological patients is as high as 55%, but it remains often undetected and therefore untreated in hospital settings. Further, clinicians tend to make little use of the consultative and liaison psychiatric team for detection and treatment of anxiety and mood disorders in neurological patients. The current study aimed to investigate whether the implementation of a stepped screening protocol with high risk feedback to the clinician had an influence on the use of consultative and liaison psychiatric services.

Method

All patients admitted to the neurological ward were assessed using a stepped screening protocol for depression, anxiety and substance use during 15 months. Positive screening resulted in feedback to the clinicians depending on the study phase (e.g. feedback vs. no feedback).

Results

No differences were found in the use of consultative and liaison psychiatric services during the non-feedback and feedback phase.

Conclusion

Screening and high risk feedback of psychiatric comorbidity in neurological patients does not increase psychiatric referral rates. It points to the necessity of a more integrated collaborative care model for detection and treatment of psychiatric comorbidity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Structural Brain Abnormalities in Early Onset Psychosis: Results from Nhe norment eop Cohort
Authors: Lonning V. , Nerland S. , Smelror R.E. , Gurholt T.P. , Agartz I.
Published: June 2017

Introduction

Cortical brain abnormalities are frequently observed in adults with psychotic disorders, but few studies have investigated adolescents with early-onset psychosis (EOP). A previous magnetic resonance imaging (MRI) study from the NORMENT group in Norway, found widespread cortical thinning and smaller subcortical volumes in adult patients with psychotic disorders, particularly schizophrenia, compared to healthy controls.

Methods

Participants from the ongoing NORMENT adolescent EOP-study, 30 patients (age: 13.3–18.3 years, mean age: 16.5, 66% female) and 45 healthy adolescents (age: 13.6–18.8 years, mean age: 16.2, 58% female), underwent 3 T MRI on the same scanner. Surface-based morphometric analyses were performed using FreeSurfer version 5.3.0. Group differences in vertex-wise cortical volume, thickness and surface area were investigated by fitting general linear models at each vertex on the surface. Age, sex and group were entered as covariates, and a non-parametric cluster-wise correction method for multiple comparisons was applied and cluster-forming and cluster-wise threshold set at 0.05.

Results

Preliminary results show thinner cortex in the left medial frontal lobe and smaller surface area in the left temporoparietal junction in EOP patients compared to healthy controls after correction for multiple comparisons.

Conclusion

Surface-based analysis is sensitive to alterations in cortical morphology in an adolescent EOP sample. The regions exhibiting reduced cortical thickness and area in EOP overlap with findings in an adult psychosis sample. Large-scale studies are warranted to better identify the pattern of abnormalities and clarify effects of age, diagnosis and medication.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Insulin Resistance and Telomere Length in Treatment of Depressive Disorders
Authors: Rasgon N. , McEwen B. , Lin K.W.
Published: June 2017

Insulin resistance and markers of Allostatic load in depression

Introduction

Among patients with major depression, increased inflammatory markers at baseline may predict an anti-depressant response. Reducing inflammation may augment response to psychotropic medications. Few studies have investigated an association between Leukocyte Telomere Length (LTL) and therapeutic response in depression, reporting mixed results. No studies assessed LTL and treatment response with PPAR-γ agonists.

Objectives

(1) LTL as a predictor of anti-depressant response to PPAR-γ agonist in patients with unremitted depression.

(2) the correlation between LTL and insulin resistance (IR) status.

Aims

We aimed to assess LTL as a predictor of antidepressant response to Pioglitazone in groups of insulin resistant and insulin-sensitive subjects using surrogate markers of IR.

Methods

Medically stable men and women (n = 42) ages 23–71 with non-remitted depression participated in double-blind placebo controlled add-on of Pioglitazone to treatment-as-usual. Oral glucose tolerance tests were administered at baseline and at 12 weeks.

Results

At baseline, no differences in LTL were detected by depression severity, duration or chronicity. LTL was also not significantly different between insulin-resistant and insulin-sensitive subjects. Subjects with longer telomeres exhibited greater declines in depression severity in the active arm, but not in a placebo arm. LTL also predicted improvement in insulin sensitivity in the group overall and did not differ between the active and placebo arm.

Conclusions

LTL may emerge as a viable predictor of antidepressant response. An association between insulin sensitization and LTL regardless of the baseline IR status points to potential role of LTL as a non-specific moderator of metabolic improvement in these patients.

Disclosure of interest

I, Dr. Natalie Rasgon, am a consultant for Shire Pharmaceuticals and Sunovion Pharmaceuticals.
Conceptual Aspects of Mental Health in its Intersection with Human Rights and Development
Authors: Galderisi S.
Published: June 2017

Introduction

Improving mental health of people is an important goal of the present millennium. Community-based services programs for prevention of mental disorders and promotion of mental health have been implemented in several countries. However, the proportion of people suffering from mental disorders is significantly and persistently high, and psychosocial distress due to migration, natural disasters, and terrorism; in general, feeling of insecurity is unlikely to improve current figures.

Aims

To highlight the interrelatedness of mental health, development and human rights, in particular in women and girls.

Methods

The presentation will consider conceptual aspects of mental health in its intersection with human rights and development, with particular reference to women and girls.

Results

Current definitions of mental health might be misleading and convey the false expectation that mental health coincides with happiness and productivity. An alternative conceptual framework will be presented, in which mental health is a dynamic state of internal equilibrium that enables individuals to use their abilities in harmony with universal values of society. Different factors concur to the dynamic equilibrium, and will be discussed in their intersection with human rights and development, with particular reference to the most frequent violations of human rights (e.g. trafficking, domestic abuse, sexual violence) that contribute to increase the risk of mental disorders in women and girls.

Conclusion

Mental health is rooted in personal development and social context in which the person lives. Strategies aimed to address mental health in women and girls will need to consider gender, country and socio-cultural specificities.

Disclosure of interest

Honoraria or Advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter.
The Needs of Women Users of Mental Health Services and their Families
Authors: Amering M.
Published: June 2017

Aim

Understand the needs of women users of mental health services and their families and discuss consequences.

Method

Non-systematic review of concepts and data regarding the needs of women users of mental health services and their families.

Results

nequity and inefficiency of mental health resources affect men and women all around the globe. Some important mental health needs as well as barriers to care are gender-specific. Women have specific needs in specific phases of life, e.g. the perinatal period, as well as specific risk factors, e.g. interpersonal violence and sexual abuse. Developments of women only services as well as the implementation of gender-specific approaches in routine care are underway and need to be evaluated, amended and expanded. Training as well as research requirements are numerous and urgent. Family carers are an essential mental health resource. A majority is female with significant unmet needs. Family advocacy in mental health is prominently supported by female activists as is the psychiatric user movement. Because of the cumulation and the interaction of gender-based and other forms of discrimination, legislations such as those following the UN-Convention on the rights of persons with disabilities include specific provisions for women and girls with psychosocial disabilities.

Conclusions

Mental health stigma and discrimination interact with gender inequality and the discrimination of women and girls to their mental health detriment. Clinical and scientific responsibilities in mental health essentially include gender-specific attention to the needs of women and girls and their families.

Disclosure of interest

The author has not supplied his declaration of competing interest.
The Role of Long Acting Antipsychotics in Bipolar Disorder
Authors: Vieta E.
Published: June 2017

Antipsychotics are widely used for the short and long-term treatment of bipolar disorder. Depot and long-acting injectable formulations (LAIs) can be particularly useful for certain subgroups of patients. This lecture will discuss the available data from randomized controlled trials of LAIs in bipolar disorder. A recently published meta-analysis and individual studies assessing depot medications, as well as modern LAIs such as risperidone, paliperidone and aripiprazole, will be reviewed, looking carefully into the prevention of either pole of illness and tolerability. Potential indications and patient profile, based on data and clinical experience, will be discussed.

Disclosure of interest

The author has not supplied his declaration of competing interest.
A Pilot Study on Posttraumatic Stress Disorder Prevalence in Asylum Seeker in Primary Reception Setting
Authors: Vaccino N. , Signorelli M.S. , Rodolico A. , Riso M.C. , Aguglia E.
Published: June 2017

Introduction

Social, political and health related effects of “European migrant crisis” are challenging our Old Continent, not always capable to address immigrants’ needs.

Objectives

Our main purpose is to estimate the prevalence of post-traumatic stress disorder among asylum seekers arriving in Italy.

Methods

We designed a cross-sectional study for prevalence estimation in a reception centre where asylum seekers stay for their first period in Italy. They are given hospitality until the possibility of their permanence is verified. We created a survey asking for general information. Participants also received PTSD Checklist (PCL-C). In our analysis, we adopted 45 as cut-off for diagnosis. Questionnaires have been delivered house-to-house and collected when completed.

Results

In this pilot study, we collected 61 questionnaires. The majority of answers came from male subjects (46). The prevalence of PTSD was 44% (47% among men and 53% among women, not statistically different).

Conclusions

So high rate of PTSD depicts a reality that cannot be left apart. Our attention toward immigrants must focus also on their mental health. European Union should consider new solutions to take care of these critical aspects of those.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Is Borderline Personality Disorder a Neuroendocrine Disease?
Authors: Ferreira C. , Alves S. , Oliveira C. , Avelino M.J.
Published: June 2017

Introduction

Borderline personality disorder (BPD) is a disabling heterogeneous psychiatric disorder characterized by poor affect regulation and impulse control, with a high reactivity and vulnerability to stress. It has been hypothesized that these patients may have a dysregulation of the neuroendocrine system.

Aims

The goal of this work is to systematically review the scientific knowledge regarding the role of the neuroendocrine system in the physiopathology of BPD.

Methods

The literature was reviewed by online searching using PubMed®. The authors selected scientific papers with the words “borderline personality disorder” and “neuroendocrine”/“endocrine” in the title and/or abstract, published in English.

Results and discussion

There is scientific evidence for an enhanced cortisol release and HPA axis hyperactivity in BPD. The dexamethasone suppression test has been used in BPD, finding high rates of non-suppressors in that sample. There also seems to be a reduced volume of the amygdala and anterior cingulate cortex, suggesting an involvement of those regions in the emotional disturbances in BPD. Symptoms of impulsivity, aggression and suicidal behavior seem to be strongly mediated by the serotonergic system. The available research suggests a serotoninergic dysfunction in BPD, with lower levels of serotonin in those patients.

Conclusions

There seems to be several neuroendocrine changes related to BPD, namely a hyperactivity of the HPA axis with stimulated cortisol release together with disturbances of the serotonergic system. Also some brain structural alterations in BPD are scientifically depicted. Further studies are needed to clarify the neurobiology of BPD improving both psychotherapeutic and psychopharmacological treatment in these patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Anxiety and Depression among Elderly Hemodialyzed Patients
Authors: Feki R. , Trigui D. , Abida I. , Baati I. , Sellami R. , Feki I. , Masmoudi J.
Published: June 2017

Introduction

The haemodialysis, one of the main treatment modalities of chronic renal failure, imposes a great psychosocial burden on elderly patients, which may cause many psychological impacts.

Objective

The aim of this study was to screen anxiety and depression in elderly patients on haemodialysis, taking into account factors that may contribute to.

Methods

Our study was transversal, descriptive carried out among 38 elderly patients aged more than 60 years with chronic kidney failure on haemodialysis. The structured questionnaire used in this study was gathered information on socio-demographic and disease characteristics. We used the hospital anxiety and depression scale (HADS) to access anxiety and depression.

Results

The mean age of our sample was 71 years. The sex-ratio (♂/♀) was 1.92.,patients were mainly married (73.7%), and have a low school level (76.3%). The mean haemodialysis duration was 5 years ± 4.68. The most common cause of renal failure was polycystic kidney disease (18.4%), diabetes (15.8%), while in 28.9% the cause was unknown. Anxiety was found in 18.4% of patients and it was associated with both low school (P = 0.02) and socio-economic level (P = 0.04). The prevalence of depressive symptoms was 42.1%. It was correlated to the unknown cause of kidney failure and the short duration haemodialysis (P = 0.03).

Conclusion

These data suggest that depression and anxiety are highly prevalent in elderly patients with renal failure on dialysis. This result shows the need for interdisciplinary teamwork in improving the quality of life of those patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Risk of Suicidal Behaviours in Elderly
Authors: Goretti S. , Sanchéz Sanchéz M.D.C. , Góngora Oliver B. , Sanz Fernández M.D.
Published: June 2017

Introduction

Older adults constitute the age group in which suicide more often reaches its most categorical expression: consummation.

Objective

Identify risk factors for suicide in older people.

Method

Systematic review of the literature on the subject. The databases consulted were Dialnet and Pubmed. The descriptors used have been: “suicide”, “risk factors” and “elderly”, accepting the works found in English and Spanish, with a total of 501 references found after the search, from which 75 have been selected.

Results

As shown in the reviewed studies, there is a progressive increase in suicide rate with age in males. The purpose of dying in the old man is usually characterized by his firm conviction, not infrequently reflexive and premeditated. In the multifactorial etiology of suicidal behaviour in this age group, the main elements to be considered would be psychosocial factors, psychiatric diseases and chronic somatic diseases, resulting in a potentiation among them due to their frequent interaction. The feeling of abandonment, the feeling of emptiness, the despair of the organic collapse and the self-perception of being a useless person, without projects, generates deterioration in the quality of life.

Conclusions

In the multifactorial etiology of the suicidal behaviour of the elderly, they usually play coprotagonic roles, loneliness, isolation, somatic illness and depression. The most likely profile of the suicidal elder would be represented by a man with a history of depressive episode after age 40, who lives alone, with a family history of depression or alcoholism and a recent loss.

Disclosure of interest

The authors have not supplied their declaration of competing interest.