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Well-defined Ga(III) sites on SiO2 are highly active, selective, and stable catalysts in the propane dehydrogenation (PDH) reaction. In this contribution, we evaluate the catalytic activity toward PDH of tricoordinated and tetracoordinated Ga(III) sites on SiO2 by means of first-principles calculations using realistic amorphous periodic SiO2 models. We evaluated the three reaction steps in PDH, namely, the C-H activation of propane to form propyl, the ß-hydride (ß-H) transfer to form propene and a gallium hydride, and the H-H coupling to release H2, regenerating the initial Ga-O bond and closing the catalytic cycle. Our work shows how Brønsted-Evans-Polanyi relationships are followed to a certain extent for these three reaction steps on Ga(III) sites on SiO2 and highlights the role of the strain of the reactive Ga-O pairs on such sites of realistic amorphous SiO2 models. It also shows how transition-state scaling holds very well for the ß-H transfer step. While highly strained sites are very reactive sites for the initial C-H activation, they are more difficult to regenerate. The corresponding less strained sites are not reactive enough, pointing to the need for the right balance in strain to be an effective site for PDH. Overall, our work provides an understanding of the intrinsic activity of acidic Ga single sites toward the PDH reaction and paves the way toward the design and prediction of better single-site catalysts on SiO2 for the PDH reaction.
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OBJECTIVE: A growing literature indicates that unipolar depression and bipolar depression are associated with alterations in grey matter volume. However, it is unclear to what degree these patterns of morphometric change reflect symptom dimensions. Here, we aimed to predict depressive symptoms and hypomanic symptoms based on patterns of grey matter volume using machine learning. METHOD: We used machine learning methods combined with voxel-based morphometry to predict depressive and self-reported hypomanic symptoms from grey matter volume in a sample of 47 individuals with unmedicated unipolar and bipolar depression. RESULTS: We were able to predict depressive severity from grey matter volume in the anteroventral bilateral insula in both unipolar depression and bipolar depression. Self-reported hypomanic symptoms did not predict grey matter loss with a significant degree of accuracy. DISCUSSION: The results of this study suggest that patterns of grey matter volume alteration in the insula are associated with depressive symptom severity across unipolar and bipolar depression. Studies using other modalities and exploring other brain regions with a larger sample are warranted to identify other systems that may be associated with depressive and hypomanic symptoms across affective disorders.
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Transtorno Bipolar/fisiopatologia , Córtex Cerebral/patologia , Transtorno Depressivo Maior/fisiopatologia , Substância Cinzenta/patologia , Aprendizado de Máquina , Adulto , Transtorno Bipolar/diagnóstico por imagem , Transtorno Bipolar/patologia , Córtex Cerebral/diagnóstico por imagem , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/patologia , Feminino , Substância Cinzenta/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Índice de Gravidade de Doença , Adulto JovemRESUMO
BACKGROUND: Atypical depression may show lowered rather than raised short-term cortisol levels. Atypical major depressive episodes (A-MDE) may also be more closely linked to environmental factors and show overlap with somatic symptom disorders. Hair specimens allow measuring long-term cortisol levels. METHODS: Twenty-seven A-MDE and 44 NA-MDE patients and 40 matched controls were tested. Measures of hair cortisol concentration [HCC] covering the previous 3 months and short-term cortisol parameters (six saliva specimens to assess the cortisol awakening response [CAR] and total daily cortisol output calculated as the area under the curve [AUCg]) were taken alongside measures of environmental factors and clinical variables. RESULTS: There were no differences in HCC between the three groups (P = 0.8), and no difference in the CAR (P = 0.95). However, A-MDE showed lowered short-term cortisol output (AUCg) compared to controls (P = 0.04). A-MDE patients also reported a higher number of daily hassles, and higher levels of fatigue and impaired concentration than NA-MDE. CONCLUSIONS: Normal long-term (HCC) and reduced short-term (AUCg) cortisol levels in A-MDE could suggest a disrupted long-term cortisol rhythm, perhaps affected by environmental factors or by certain symptoms, such as mid-nocturnal insomnia. However, other underlying explanations for these findings should also be investigated in the future.
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Transtorno Bipolar/metabolismo , Transtorno Bipolar/fisiopatologia , Transtorno Depressivo Maior/metabolismo , Transtorno Depressivo Maior/fisiopatologia , Cabelo/metabolismo , Hidrocortisona/metabolismo , Saliva/metabolismo , Adulto , Biomarcadores/metabolismo , Transtorno Bipolar/classificação , Transtorno Depressivo Maior/classificação , Feminino , Humanos , Masculino , Fatores de Tempo , Adulto JovemRESUMO
Employment precariousness is a social determinant that affects the health of workers, families, and communities. Its recent popularity has been spearheaded by three main developments: the surge in "flexible employment" and its associated erosion of workers' employment and working conditions since the mid-1970s; the growing interest in social determinants of health, including employment conditions; and the availability of new data and information systems. This article identifies the historical, economic, and political factors that link precarious employment to health and health equity; reviews concepts, models, instruments, and findings on precarious employment and health inequalities; summarizes the strengths and weaknesses of this literature; and highlights substantive and methodological challenges that need to be addressed. We identify two crucial future aims: to provide a compelling research program that expands our understanding of employment precariousness and to develop and evaluate policy programs that effectively put an end to its health-related impacts.
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Emprego/psicologia , Emprego/estatística & dados numéricos , Estudos Epidemiológicos , Disparidades nos Níveis de Saúde , Determinantes Sociais da Saúde/estatística & dados numéricos , Recessão Econômica/estatística & dados numéricos , Emprego/métodos , Projetos de Pesquisa Epidemiológica , Saúde Global , Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Humanos , Saúde Mental/estatística & dados numéricos , Política , Assistência Pública/estatística & dados numéricosRESUMO
Housing is a pressing problem worldwide and a key determinant of health and wellbeing. The right to adequate housing, as a pillar of the right to an adequate standard of living, means more than a roof to live under. Adequate means the dwelling must fulfill material functions and psychosocial functions, thus contributing to dwellers health and wellbeing. Social housing policies aim to fulfill the right to housing, but frequently fail in fulfilling the right to it being adequate. This study capitalizes on the implementation of a national urban regeneration program in two social housing villas in central Chile (one in Santiago, in the central valley, the other in Viña del Mar, a coastal city) to run a natural experiment assessing the impact of dwelling renovation on several dimensions of perceived habitability and housing satisfaction among the -mostly female-household homemakers. We use 5 waves of survey data collected with a step-wedge design to estimate the association between a time-varying exposure status (the intervention) and 7 binary outcomes for habitability and 5 for housing dissatisfaction, including overall housing satisfaction. We use Poisson regression models with robust variance and a random intercept at the respondent level. At baseline, reports of poor habitability and dissatisfaction across all features were markedly high, the highest levels of dissatisfaction being with acoustic insulation and dwelling size in both villas, and with indoor temperature in Santiago. The intervention resulted in statistically significant and markedly large improvements in reported habitability and dissatisfaction relative to those housing components targeted by the intervention, as well as with overall dwelling satisfaction in both study cases. Implications are, first, that the policy response to quantitative housing deficits must not overlook housing quality; second, that housing renovation appears as a promising intervention for qualitative housing crises; third, that while improvements in habitability and satisfaction are specific to the interventions in place, overall housing satisfaction can improve in more limited, tailored, dwelling renovation interventions. Social housing renovation in Latin America appears as a promising intervention to improve quality of life among the urban poor dwellers and reduce inequalities in health related to housing conditions.
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Satisfação Pessoal , Habitação Popular , Humanos , Chile , Feminino , Masculino , Habitação Popular/estatística & dados numéricos , Habitação Popular/normas , Adulto , Pessoa de Meia-Idade , Reforma Urbana , Habitação/estatística & dados numéricos , Habitação/normas , Inquéritos e QuestionáriosRESUMO
The co-adsorption of CO and OH on two Pt stepped surfaces vicinal to the (111) orientation has been evaluated by means of density functional theory (DFT) calculations. Focusing on Pt(533) and Pt(221), which contain (100) and (111)-steps, respectively, we find that (111)-steps should be more reactive towards CO oxidation than surfaces containing (100)-steps. The DFT results are compared with electrochemical experiments on the CO adsorption and oxidation on these vicinal surfaces.
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From the beginning of 2007 until the end of 2011, 146 cases of lymphogranuloma venereum (LGV) were notified to the Barcelona Public Health Agency. Some 49% of them were diagnosed and reported in 2011, mainly in men who have sex with men. Almost half of them, 32 cases, were reported between July and September. This cluster represents the largest since 2004. This article presents the ongoing outbreak of LGV in Barcelona.
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Chlamydia trachomatis/isolamento & purificação , Homossexualidade Masculina , Linfogranuloma Venéreo/diagnóstico , Linfogranuloma Venéreo/epidemiologia , Adulto , Doenças Transmissíveis Emergentes/diagnóstico , Doenças Transmissíveis Emergentes/epidemiologia , Surtos de Doenças , Humanos , Linfogranuloma Venéreo/prevenção & controle , Linfogranuloma Venéreo/transmissão , Masculino , Vigilância da População , Parceiros Sexuais , Espanha/epidemiologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Occupational mutual insurance companies (OMICs), in collaboration with the Spanish Social Security System, provide healthcare and manage the economic benefits for the workers in Spain. They have ambulatory care centers that attend outpatient trauma pathology, although most of the studies published have focused on surgical and hospital activity. The aim of this study was to detect adverse events (AEs) in outpatient trauma care in the context of an OMIC. METHODS: A cohort study designed to identify harmful safety incidents (adverse events, AEs) in 2017 was conducted. A random sample of 313 medical records among patients who were visited more than 3 medical and nursing attendances during their outpatient process. The AEs detected were classified according to category, severity and preventability. RESULTS: We identified 48 AEs (15.3% of medical records, 95% CI 11.3-19.3), most of them procedure-related, while 27 (56.2%) were preventable and 46 mild (95.8%). CONCLUSIONS: The AEs identified are double than those found in primary care general consultations in Spain and are close to the lower range of studies on surgical AEs in traumatology and orthopedics. Preventable AEs were within expected limits. Over half of AEs are preventable, within that group, the mild AEs have an increased rate of preventability. These results highlight the relevance of research of patient safety in the outpatient care of trauma and orthopaedic procedures in an OMIC for patient safety and contribute to introduce improvements in outpatient care.
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Seguro , Erros Médicos , Assistência Ambulatorial , Estudos de Coortes , Humanos , EspanhaRESUMO
Nonoxidative dehydrogenation of light alkanes has seen a renewed interest in recent years. While PtGa systems appear among the most efficient catalyst for this reaction and are now implemented in production plants, the origin of the high catalytic performance in terms of activity, selectivity, and stability in PtGa-based catalysts is largely unknown. Here we use molecular modeling at the DFT level on three different models: (i) periodic surfaces, (ii) clusters using static calculations, and (iii) realistic size silica-supported nanoparticles (1 nm) using molecular dynamics and metadynamics. The combination of the models with experimental data (XAS, TEM) allowed the refinement of the structure of silica-supported PtGa nanoparticles synthesized via surface organometallic chemistry and provided a structure-activity relationship at the molecular level. Using this approach, the key interaction between Pt and Ga was evidenced and analyzed: the presence of Ga increases (i) the interaction between the oxide surface and the nanoparticles, which reduces sintering, (ii) the Pt site isolation, and (iii) the mobility of surface atoms which promotes the high activity, selectivity, and stability of this catalyst. Considering the complete system for modeling that includes the silica support as well as the dynamics of the PtGa nanoparticle is essential to understand the catalytic performances.
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OBJECTIVE: This work has aimed to validate the Spanish version of the PHQ-15 questionnaire (Patient Health Questionnaire) for its use in patients with depression and/or and anxiety disorders. MATERIAL AND METHODS: An observational, cross-sectional study in which the PHQ-15 questionnaire (made up of 15 items on somatic symptoms) was administered in the outpatient psychiatric clinics to patients of 18 years or more, diagnosed of depression and/or anxiety disorder according to the DSM-IV criteria. Feasibility (percent of patients without response), reliability (in terms of internal consistency) and convergent/divergent validity compared to the MADRS scale (by correlational analysis), discriminant (with intragroup comparison) and predictive (by logistical regression). RESULTS: A total of 3362 evaluated patients were included. Of these, 65.5% were women, with a mean age of 45.6 years (18.0-90.0). The questionnaire was feasible (9.6% of patients lacking an answer to some item), and showed acceptable internal reliability (Cronbach's Alpha Coefficient =0.78) with adequate validity, with correlations with the MADRS scale between moderate and high (r=0.3-0.7) and differences between groups of patients. The factors associated to the profile type of the patient with relevant physical symptoms were: being a woman, having a background of depression and/or anxiety, anxiety according to the DSM-IV, any concomitant condition in general, and specifically hepatic-digestive and osteoarticular system affectation and, as protective factor, being 70 years of age or older. CONCLUSION: The PHQ-15 questionnaire in its Spanish version has been shown to be feasible, reliable and valid to evaluate somatic symptoms in patients with depression and/ or anxiety disorders in psychiatry.
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Ansiedade/diagnóstico , Depressão/diagnóstico , Transtornos Somatoformes/diagnóstico , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Human papilloma virus (HPV) infection is the most common sexually transmitted infection worldwide. There is a high detection rate in sexually active young people but the risk, in males, persists over years. Currently, the American Center for Disease Control and Prevention does not recommend the evaluation of men for HPV and, the extant bibliography, backs up this stance for several reasons. Objective of the paper was to evaluate the usefulness of HPV detection methods for men; A comprehensive and exhaustive review of the literature was performed. Many are methods for HPV detection used in cervical cancer screening as well as in the study and management of patients with cytological alterations of the lower genital tract. Need for HPV detection methods in men are numerous: screening for both partner/gender; anogenital warts; recurrent respiratory papillomatosis; HPV-related cancer in men; fertility. No HPV test for men has been approved by the FDA, nor has any test been approved for detection of the virus in areas other than the cervix. Many are methods for HPV detection that have shown their usefulness in some of the pathologies associated with male HPV but, despite this, none of them has been approved for man.
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Técnicas de Diagnóstico Molecular , Infecções por Papillomavirus/diagnóstico , Testes de DNA para Papilomavírus Humano , Humanos , MasculinoAssuntos
Busca de Comunicante/métodos , Busca de Comunicante/tendências , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Espanha/epidemiologia , Inquéritos e Questionários , Adulto JovemRESUMO
Major depression is associated with altered static functional connectivity in various brain networks, particularly the default mode network (DMN). Dynamic functional connectivity is a novel tool with little application in affective disorders to date, and holds the potential to unravel fluctuations in connectivity strength over time in major depression. We assessed stability of connectivity in major depression between the medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC), key nodes in the DMN that are implicated in ruminative cognitions. Functional connectivity stability between the mPFC and PCC over the course of a resting-state functional magnetic resonance imaging (fMRI) scan was compared between medication-free patients with major depression and healthy controls matched for age, sex and handedness. We tested replicability of the results in an independent sample using multi-echo resting-state fMRI. The primary sample included 20 patients and 19 controls, while the validation sample included 19 patients and 19 controls. Greater connectivity variability was detected in major depression between mPFC and PCC. This was demonstrated in both samples indicating that the results were reliable and were not influenced by the fMRI acquisition approach used. Our results demonstrate that alterations within the DMN in major depression go beyond changes in connectivity strength and extend to reduced connectivity stability within key DMN regions. Findings were robustly replicated across two independent samples. Further research is necessary to better understand the nature of these fluctuations in connectivity and their relationship to the aetiology of major depression.
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Encéfalo/fisiopatologia , Transtorno Depressivo Maior/fisiopatologia , Giro do Cíngulo/diagnóstico por imagem , Córtex Pré-Frontal/diagnóstico por imagem , Adulto , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Feminino , Neuroimagem Funcional/métodos , Giro do Cíngulo/fisiopatologia , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Transtornos do Humor/fisiopatologia , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiopatologia , Córtex Pré-Frontal/fisiopatologia , Índice de Gravidade de DoençaRESUMO
The generalization of flexible labour markets, the declining influence of unions and the degradation of social protection has led to the emergence of new forms of employment at the expense of the Standard Employment Relationship, as well as a considerable amount of research across social and scientific disciplines. Years ago we suggested the urgent need to disentangle the consequences of new types of employment for the health and well-being of workers, contending that the study of precarious employment and health is in its infancy. Today, research challenges include clearer, more precise definitions of the original concepts, a more detailed understanding of the pathways and mechanisms through which precarious employment harms worker health, stronger information systems for monitoring the problem and a complex systems approach to employment conditions and health research. All of these must be guided by the theoretical and policy debates linking precarious employment and health, and be geared towards developing better tools for the design, implementation and evaluation of policies intended to minimize precariousness in the labour market and its effects on public health and health inequalities. Our aim in this paper is to outline an agenda for the next decade of research on precarious employment and health, establishing a compelling programme that expands our understanding of complex causes and links.
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Emprego/tendências , Disparidades nos Níveis de Saúde , Saúde Ocupacional/tendências , Determinantes Sociais da Saúde/tendências , Humanos , Medicina do Trabalho , Política Pública , Projetos de PesquisaRESUMO
INTRODUCTION: The aim of this study was to perform a verification of the hematology analyzer Sysmex XN-2000 by comparing with the previous XE-5000. This study assessed the precision and carryover on the XN-2000 and the systematic error between the both counters according to desirable biological variability criterion and a flag comparison study. METHODS: Within-run precision and between-batch precision were measured according to the ICSH guidelines. A comparative study was performed analyzing two hundred and six samples of peripheral blood from patients. The statistical study was conducted using the Passing-Bablok and Bland-Altman analyses. The leucocyte flag comparison was made by measuring the efficiency rate. RESULTS: Between-batch precision was lower than that recommended by the biological variability criterion and manufacturer specifications. The comparison gave nonagreement results for neutrophil and basophil counts according to the criterion of biological variability. Erythroblasts and immature granulocytes showed nonagreement, but there is no available biological variation database for these parameters to compare with. Nevertheless, excellent absolute agreement was found for red blood cell parameters, and for platelet, lymphocyte, monocyte, and eosinophil counts. CONCLUSIONS: The global results obtained for the precision, comparability, and efficiency provide a satisfactory integration of the XN-2000 in the core laboratory routine and accomplish an optimal reliability.
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Basófilos , Contagem de Leucócitos/instrumentação , Neutrófilos , Feminino , Humanos , Contagem de Leucócitos/métodos , Contagem de Leucócitos/normas , MasculinoRESUMO
The objective of the study was to report our results using a porcine small intestinal submucosa graft (Surgisis ES, Cook Medical) for tunica albuginea substitution after plaque incision. We retrospectively evaluated patients surgically treated at our institution for Peyronie's disease (PD) by means of plaque incision and porcine small intestinal submucosa grafting (Surgisis) between 2009 and 2013. At the same time a literature review was conducted, searching for similar reports and results. Forty-four patients were identified who had been diagnosed with PD between 2009 and the beginning of 2013, and had been treated with corporoplasty, plaque incision and grafting with Surgisis for a severe curvature of the penis. Curvature of the penis was dorsal in 40 patients (90%) and laterally on the right in 4 patients (10%). Mean duration of surgery was 165 min (range 90-200). Mean size of the graft was 6.5 cm(2) and the mean follow-up was 19.2 months (range 11-48). In patients with severe curvature of the penis due to PD and the need for corporoplasty with plaque incision and graft placement, Surgisis represents a good option with a low risk of complications, below the rate described with previously investigated graft tissues.
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Mucosa Intestinal/transplante , Intestino Delgado/transplante , Induração Peniana/cirurgia , Transplante Heterólogo/métodos , Adulto , Idoso , Animais , Disfunção Erétil/etiologia , Disfunção Erétil/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pênis/anormalidades , Pênis/cirurgia , Estudos Retrospectivos , SuínosRESUMO
BACKGROUND: Children represent one of the patient groups most affected by constipation. Our objective was to identify and describe the risk factors associated with childhood constipation. PATIENTS AND METHODS: The study had a case-control, retrospective, open and multicenter design. Clinical data on possible risk factors were collected through an ad-hoc questionnaire. Two groups were studied: children with and without constipation. RESULTS: Nine hundred twenty-one children were recruited; of these, 898 (97.6%) were included in the statistical analysis. There were 408 (45.4%) children in the constipated group and 490 (54.5%) in the non-constipated group. Most of the children with constipation (53.6%) had a maternal history of constipation compared with 21.4% of children without constipation (p < 0.05). More than half (53.2%) of the constipated children reported a lack of regularity in their toilet habits while 64.9 % of the children without constipation went to the toilet regularly. Toilet training started slightly earlier (at 3 years) in children without constipation (93.2%) than in those with the disorder (83.8%) (p < 0.05). At school, 57.4% of the children with constipation never used the toilet compared with 26.8% of those without constipation (p < 0.05). A total of 73.4% of children with constipation drank less than four glasses of water per day compared with 47.1% of those without constipation (p < 0.05). Consumption of vegetables and legumes in the diet was significantly lower in children with constipation than in those without (p < 0.05). The risk factors linked to childhood constipation found in this study were a familial history of constipation, irregular toilet habits, low dietary fiber contents and no fruit intake. The main preventive factors against constipation were water and vegetable consumption and training on the use of the toilet at school. CONCLUSIONS: Daily toilet training and dietary changes are needed to prevent constipation among children and to achieve regular defecation. This preventive intervention should be reinforced at school.
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Constipação Intestinal/epidemiologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Fatores de RiscoRESUMO
The depressive state has been characterised as one of elevated inflammation, which holds promise for better understanding treatment-resistance in affective disorders as well as for future developments in treatment stratification. Aiming to investigate alterations in the inflammatory profiles of individuals with depression as putative biomarkers for clinical response, we conducted meta-analyses examining data from 35 studies that investigated inflammation before and after treatment in depressed patients together with a measure of clinical response. There were sufficient data to analyse IL-6, TNFα and CRP. Levels of IL-6 decreased with antidepressant treatment regardless of outcome, whereas persistently elevated TNFα was associated with prospectively determined treatment resistance. Treatment non-responders tended to have higher baseline inflammation, using a composite measure of inflammatory markers. Our findings suggest that elevated levels of inflammation are contributory to treatment resistance. Combining inflammatory biomarkers might prove a useful tool to improve diagnosis and detection of treatment refractoriness, and targeting persistent inflammation in treatment-resistant depression may offer a potential target for the development of novel intervention strategies.