[State-dependent motivational interviewing for people with schizophrenia and substance use: results of a randomised controlled trial]. / Motivationsbehandlung für Patienten mit der Doppeldiagnose Psychose und Sucht : Ergebnisse einer randomisierten Studie.

BACKGROUND: Comorbid substance use disorder in patients with schizophrenia is associated with poor clinical and social outcome and low compliance with integrated outpatient treatment programs. For the first time the present trial compares the efficacy of four sessions of motivational interviewing (MI) and four sessions of supportive therapy (ST). The primary outcome was compliance with integrated outpatient treatment post-intervention. Secondary outcomes were substance use, psychopathology, compliance with medication and stage of change in psychotherapy. METHODS: Sixty inpatients with schizophrenia and substance use disorder were randomised to receive either four sessions of MI or four sessions of ST. Masked assessments took place at baseline, post-treatment and 3- and 6-month follow-ups. RESULTS: The integrated outpatient program was attended by 70.0% of the MI (n=30) and 40.0% of the ST patients (n=30; p=0.020). There were no differences regarding secondary outcome between MI and ST groups. CONCLUSION: The study design allows one for the first time to attribute the findings to the specific effects of MI and thereby emphasizes the effectiveness of this particular treatment approach. In summary, these findings show that the integration of short-term MI for people with both psychosis and substance abuse could significantly improve their chances of attending appropriate outpatient settings and thereby improve their well-being.

Coupled order-parameter system on a scale-free network.

The system of two scalar order parameters on a complex scale-free network is analyzed in the spirit of Landau theory. To add a microscopic background to the phenomenological approach, we also study a particular spin Hamiltonian that leads to coupled scalar order behavior using the mean-field approximation. Our results show that the system is characterized by either of two types of ordering: either one of the two order parameters is zero or both are nonzero but have the same value. While the critical exponents do not differ from those of a model with a single order parameter on a scale-free network, there are notable differences for the amplitude ratios and the susceptibilities. Another peculiarity of the model is that the transverse susceptibility is divergent at all T

Pseudo-knots in helical structures.

It is generally accepted that physical entanglements are essential to explain some mechanical properties of polymers, like viscoelasticity. The current view is that entanglements behave as dynamic links that are destroyed and created in time. It is less clear whether entanglements could alternatively produce local and stable links, with similar effects to chemical bonds. Here we show that local and stable entanglements, that we call physical pseudo-knots, exist and are formed with high probability in helical structures. The energies required to create and destroy physical pseudo-knots can differ by at least one order of magnitude. Together with their localized nature this makes them controllable, opening the possibility for a wide range of applications in material science, nano- and biotechnology. Physical pseudo-knots can also have implications in living systems, that may use them, or try to avoid them and hence be related to disease.

Universal shape characteristics for the mesoscopic star-shaped polymer via dissipative particle dynamics simulations.

In this paper we study the shape characteristics of star-like polymers in various solvent quality using a mesoscopic level of modeling. The dissipative particle dynamics simulations are performed for the homogeneous and four different heterogeneous star polymers with the same molecular weight. We analyse the gyration radius and asphericity at the poor, good and θ-solvent regimes. Detailed explanation based on interplay between enthalpic and entropic contributions to the free energy and analyses on of the asphericity of individual branches are provided to explain the increase of the apsphericity in θ-solvent regime.

Entropy-induced separation of star polymers in porous media.

We present a quantitative picture of the separation of star polymers in a solution where part of the volume is influenced by a porous medium. To this end, we study the impact of long-range-correlated quenched disorder on the entropy and scaling properties of f-arm star polymers in a good solvent. We assume that the disorder is correlated on the polymer length scale with a power-law decay of the pair correlation function g(r) approximately r-a. Applying the field-theoretical renormalization group approach we show in a double expansion in epsilon=4-d and delta=4-a that there is a range of correlation strengths delta for which the disorder changes the scaling behavior of star polymers. In a second approach we calculate for fixed space dimension d=3 and different values of the correlation parameter a the corresponding scaling exponents gammaf that govern entropic effects. We find that gammaf-1, the deviation of gammaf from its mean field value is amplified by the disorder once we increase delta beyond a threshold. The consequences for a solution of diluted chain and star polymers of equal molecular weight inside a porous medium are that star polymers exert a higher osmotic pressure than chain polymers and in general higher branched star polymers are expelled more strongly from the correlated porous medium. Surprisingly, polymer chains will prefer a stronger correlated medium to a less or uncorrelated medium of the same density while the opposite is the case for star polymers.

Universal shape characteristics for the mesoscopic polymer chain via dissipative particle dynamics.

In this paper we study the shape characteristics of a polymer chain in a good solvent using a mesoscopic level of modelling. The dissipative particle dynamics simulations are performed in 3D space at a range of chain lengths N. The scaling laws for the end-to-end distance and gyration radius are examined first and found to hold for [Formula: see text] yielding a reasonably accurate value for the Flory exponent ν. Within the same interval of chain lengths, the asphericity, prolateness and some other shape characteristics of the chain are found to become independent of N. Their mean values are found to agree reasonably well with the respective theoretical results and lattice Monte Carlo (MC) simulations. We found the probability distribution for a wide range of shape characteristics. For the asphericity and prolateness they are quite broad, resembling in form the results of lattice MC simulations. By means of the analytic fitting of these distributions, the most probable values for the shape characteristics are found to supplement their mean values.

[Lung function in patients with diabetes mellitus]. / Fonction pulmonaire du patient diabétique.

INTRODUCTION: Diabetes mellitus is a disease affecting a lot of organs. One of the little known diabetes complication is impairment of pulmonary function. The aim of this study was to compare pulmonary function in two groups: diabetic individuals and obese non-diabetic individuals and to investigate predictive factors of alteration of diffusing capacity of lung for carbon monoxide (DLCO). PATIENTS AND METHOD: We retrospectively included all patients hospitalized in department of endocrinology between 1st July 2013 and 31 December 2013 and who underwent pulmonary function tests. All these medical charts of patients were reviewed and patients were classified in two groups: diabetic and obese non-diabetic individuals. RESULTS: Overall, 89 patients were included, 62 diabetic patients and 27 obese non-diabetic patients. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), medium expiratory flow, expiratory residual volume, total lung capacity (TLC) and DLCO were significantly lower in patients with diabetes mellitus compared to obese non-diabetic patients. A low DLCO was significantly associated with diabetic neuropathy, macrovascular complication (carotid atheroma), impairment of renal function, and insulin treatment. CONCLUSION: Respiratory function is impaired in diabetes mellitus, with a significant decrease in FVC, FEV1, TLC and DLCO.

Purification and characterisation of polygalacturonases from a commercial Aspergillus niger preparation.

The polygalacturonase (poly(1,4-alpha-D-galacturonide) glycanohydrolase, EC 3.2.1.15) activity of Pectinol is resolved into two fractions (E1 and E2) of about equal total activity on DEAE-cellulose. These fractions are purified from other pectinolytic enzyme activity by Sephadex G-75 chromatography. Both E1 and E2 reduce the viscosity of polygalacturonate by 50% after 7% of the glycosidic bonds are hydrolysed. Their activities are not affected by iodoacetate (1 mM) or EDTA (10 mM). E1 and E2 have different molecular weights (35 000 and 85 000, respectively) and different electrophoretic mobilities on sodium dodecyl sulphate polyacrylamide gels. Their pH (4.1 and 3.8 respectively) and ionic strength optima and specific activities also differ. Both enzymes are inhibited at similar rates by diethyl pyrocarbonate at pH 6 but only E2 is protected from this inhibition by 2% (w/v) polygalacturonate. The rate of change of protein absorbance at 250 nm accompanying this inhibition, and the residues are essential for the activities of both E1 and E2. About 2 molecules of carbethoxyhistidine per subunit of E2 and 0.6 molecules per subunit of E1 are present in the completely inhibited enzymes.20

Increased serotonin platelet uptake after tianeptine administration in depressed patients.

Tianeptine is a new antidepressant drug reported to enhance serotonin (5-hydroxytryptamine [5-HT]) uptake in rat brain. The effect of tianeptine on 5-HT platelet uptake was studied in 10 depressed patients treated for 28 days. Tianeptine increases Vmax of 5-HT platelet uptake during treatment without inducing any change in Km. As early as 2 hr after the first administration, Vmax increased significantly (+23%, alpha = 0.01). Although of a lesser magnitude, 5-HT platelet uptake remains increased after chronic administration (+14% on day 10 and +13% on day 28). This suggests that tianeptine affects 5-HT platelet uptake sites, either directly or via an action on modulators of 5-HT uptake. These results, in contrast with the action of other tricyclic antidepressants, confirm the original action of tianeptine on 5-HT platelet metabolism.

Factors related to sleep apnea syndrome in sleep clinic patients.

We examined 129 patients recruited from two sleep clinics to study the sleep apnea syndrome (SAS), defined by the apnea-hypopnea index (AHI) > or = 10. Information was registered from a self-administered questionnaire, basal physical measurements, and polysomnography. In 68 subjects recorded for two consecutive nights, a high correlation was found between first- and second-night AHIs (r = 0.89). Habitual loud snoring and breathing arrests during sleep were associated with AHI > or = 10. A model including these two variables, sex, age, and body mass index was created in order to predict AHI > or = 10 and with which it was possible to successfully classify almost three of four patients. Among subjective sleep questionnaire items, only daytime sleepiness was related to drops of transcutaneous oxygen tension. These discrepancies in the observed relationship between sleep parameters and subjective sleep items reduce the questionnaire value in epidemiologic settings where it aimed to detect SAS, as defined solely by the AHI value.

Naltrexone improves blood gas patterns in obstructive sleep apnoea syndrome through its influence on sleep.

Endogenous opiates have been shown to depress ventilation, and could therefore play a role in sleep apnoea syndrome (SAS). Hence, opiate antagonists have been used to treat SAS. The improvement they seem to give in blood-gas monitoring could derive either from a direct blocking of endorphins that inhibit respiration or else, indirectly, through an influence on sleep patterns. The present study used a double blind cross-over protocol to investigate the relationships between the effects on blood-gas and on sleep patterns of the oral opiate antagonist naltrexone in obstructive SAS. Sleep patterns and transcutaneous blood gas (tcPO2 and tcPCO2) were recorded in parallel. Control recordings, without treatment, were carried out over two nights, followed by two nights of recording after administration either of naltrexone followed by a placebo or of a placebo followed by naltrexone. The number of obstructive apnoea and hypopnoea events per hour of sleep (Apnoea-Hypopnoea Index: AHI), of hypoxic events (defined as a tcPO2 fall of at least 10, 15 or 20 mm Hg) and of hypercapnic events (defined as a tcPCO2 increase of at least 5 mm Hg) were counted. A Metabolic Suffering Index (MSI) was calculated, defined as the product of the number, duration and magnitude of hypoxic and hypercapnic events. Compared to placebo, naltrexone resulted in significant improvements in blood-gas patterns for the duration and MSI of hypoxic events and for the number, duration and MSI of hypercapnic events. Likewise, compared to placebo, naltrexone induced significant decreases in total sleep time, slow-wave sleep and rapid eye movement (REM) sleep, and, on the other hand, significant increases in total wake time and in the number of wakenings per hour of sleep (Nw h-1). Certain naltrexone-linked blood-gas improvements were closely correlated with certain of the sleep pattern changes: the decrease in number and duration of hypoxic events correlated with REM-time decrease and the decrease in number and duration of hypercapnic events correlated with the increase in Nwh-1. These findings suggest that the improvement in blood-gas patterns induced by naltrexone in SAS may be mediated by sleep pattern effects: i.e. a decrease in REM-time and an increase in intra-sleep wakening.

Development of cochlear active mechanisms in humans differs between gender.

Despite onset of function early during the third term of gestation, the human auditory system demonstrates continued maturation, thought previously to occur primarily at the neural level. The electromotile properties of outer hair cells appear to contribute substantially to hearing sensitivity and frequency selectivity and lead to the generation of otoacoustic emissions (OAEs). This report demonstrates continued development of cochlear active mechanisms (i.e. end-organ level) after onset of cochlear function, as reflected by OAEs. Significant gender differences also are reported, corresponding to recently observed intersex differences in cochlear length and precursory to gender differences observed in the adult.

Lack of association between transiently evoked otoacoustic emission amplitude and experimentation linked-factors (repeated acoustic stimulation, cerebrospinal fluid pressure, supine and sitting positions, alertness level).

Changes in transiently evoked otoacoustic emissions (TEOAEs) occur during sleep and during tasks requiring attention. This can be due to a central nervous system effect on the cochlea. But, an additional or dominant influence by non-controlled factors is possible. In this paper, the effect of click-stimulus repetition, lying and sitting positions, state of alertness (awake or asleep) and CSF pressure variation on TEOAE features were studied. None of these factors affected TEOAE amplitude. In 2 subjects, TEOAE amplitude increased considerably during the night while remaining stable in 7 subjects during daytime sleep. This may be due to circadian variations of TEOAE amplitude.

Spontaneous otoacoustic emissions in preterm neonates: prevalence and gender effects.

A number of lines of evidence indicate that the human cochlea is fully functional as a mature sound transducer by 6 months of age. However, information about the development of the active cochlear mechanisms and notably the development of outer hair cell (OHC) activity is yet incomplete. Recording and analysis of otoacoustic emissions (OAEs), probably generated by the OHCs of the organ of Corti, have led to a better understanding, in humans, of how sounds are analysed in the cochlea by means of active mechanisms. Evoked OAEs (EOAEs) and spontaneous OAEs (SOAEs), when they can be recorded in full-term and preterm neonates, show different characteristics from those in adults, suggesting that maturation of the peripheral auditory system is incomplete at birth. To learn more about this maturation, using the best-established facts concerning SOAEs in adults, such as their greater prevalence in females and also in right ears, SOAEs were studied in more detail in 81 preterm neonates, from 30 to 40 weeks of conceptional age, all presenting bilateral EOAEs according to objective criteria. The first finding of this study was that SOAEs existed and could be recorded as of 30 weeks of conceptional age in humans. Some SOAE characteristics in preterm neonates, such as prevalence, peak number and acoustic frequencies, showed similarity with full-term neonates. Comparison of other criteria between the two populations, such as greater SOAE prevalence in right ears and higher SOAE peak number in females, suggested that these developmental factors emerge around term in humans. Comparison of SOAE characteristics between male and female preterms suggested that male preterms were less advanced in peripheral auditory development than were female preterms.

Development of human cochlear active mechanism asymmetry: involvement of the medial olivocochlear system?

To study the functional development of the medial olivocochlear system, transient-evoked otoacoustic emission suppression experiments were conducted in 73 ears of 38 pre-term and 11 full-term neonates. The continuous contralateral stimulation was a broad band white noise, presented at 70 dB SPL. Efferent suppression was determined by subtracting the without-contralateral stimulation condition from the with-contralateral stimulation condition. Across this population, a mean suppression effect of contralateral stimulation on transient-evoked otoacoustic emissions was found, with most of the suppression effect observed after 8 ms. The amount of suppression is linearly, positively correlated with the conceptional age. In the subgroup of bilaterally tested neonates, the suppression of transient-evoked otoacoustic emissions is similar in the right ear and the left ear in subjects whose conceptional age is less than 36 weeks and significantly higher in the right ear than in the left ear in older neonates. This last observation was seen at frequencies where transient-evoked otoacoustic emission amplitudes became higher in the right ear than in the left ear as the conceptional age increased, a finding already reported in adults. This study shows that the functional adult pattern of the medial efferent system, probably involved in the detection of signals in noise such as speech sounds, seems to appear gradually in neonates and represents one of the several arguments in favor of functional auditory lateralization in humans, with a right ear advantage.

Effects of dexfenfluramine on the feeding behavior of rats foraging in the cold for palatable bait.

An alimentary/thermic conflict of motivation was used to explore the effects of very low doses of dexfenfluramine (dFF), an anorectic serotoninergic agonist, on the parameters of food motivation, drive and incentive (or palatability). Six rats trained to feed 2 hr/day, were given the possibility to feed on chow in a shelter (25 degrees C), and to get a snack of shortcake, a highly palatable bait, from a feeder placed 16 m away in a very cold environment (-15 degrees C). dFF at 0.6 or 1.25 mg/kg decreased neither the chow intake in the shelter, nor the mean duration of the snacks in the cold, which is the parameter believed to be the best indicator of incentive. In contrast, dFF reduced the number of trips to the bait in the cold as well as the total mass of palatable bait ingested and the mean amount ingested by snack. Such an effect was no longer observed after a food restriction had reduced the body weight of the rats to 90% of its initial value. It is concluded that, even at doses too small to reduce the consumption of basic food, dFF decreases the drive to get palatable food.

Effect of sleep stages on transiently evoked oto-acoustic emissions in infants.

Transiently evoked oto-acoustic emissions (TEOAEs) are generated by active contractions of the outer hair cells (OHC) of the organ of Corti. TEOAE are inhibited by the medial efferent olivocochlear system which originates in the brainstem and innervates the OHC. TEOAEs are a rapid non-invasive objective method of auditory screening in infants. Because in infants sleep represents 75% of their time, it was of interest to determine whether sleep stages which are induced in the brainstem could concomitantly affect TEOAEs. Repeated TEOAE recordings during polygraphic recordings of sleep stages were made on seven, 6-week-old infants. Results showed that: (i) TEOAE spectrum frequency components remained stable over sleep stages; (ii) TEOAE amplitude tended to increase during recording sessions; (iii) sleep stages (quiet, active and indeterminate sleep) did not affect TEOAE amplitude. This pilot study reveals that sleep mechanisms seem to have no effect on active OHC micromechanical properties. Therefore, in auditory screening, TEOAEs may serve to study active cochlear mechanisms in infants even during sleep which is the better time to perform recordings because of the quietness required.

Brainstem auditory evoked potentials following meningitis in children.

The report concerns findings for brainstem auditory evoked potentials (BAEPs) recorded in 116 children, aged between a few days and 7 years, having suffered from bacterial meningitis. 26% of cases occurred between birth and 6 months, 55% between 6 months and 2 years, and 19% after 2 years of age. Hemophilus was the most common bacteria (49%), followed by Pneumococcus (22%) and Meningococcus (15%). Neurological complications were found in 30% of the meningitis cases and accounted for 85% of all complications found. 29% of BAEPs were abnormal, of which 47% revealed transmission, 32% endocochlear and 21% retrocochlear impairment. Transmission impairment mainly occurred before the age of 2 years (88%), most frequently in meningococcus meningitis cases (44%), and independently of neurological complications. Retrocochlear impairment was found in association with neurological complications in 71% of cases. Endocochlear BAEP damage was found in 9.5% of cases, half of which were bilateral and total, representing cophosis: it was found at all ages, and without any particular associated neurological complication. Hemophilus was the commonest bacterial agent in endocochlear cases overall, with Pneumococcus underlying 50% of cophosis cases. The study shows BAEP recording in association with a clinical ear examination is useful following childhood bacterial meningitis, screening for definitive endocochlear and deafness, distinguishing total from partial hearing-loss and indicating suitable treatment.

Two-dimensional copolymers and multifractality: comparing perturbative expansions, Monte Carlo simulations, and exact results.

We analyze the scaling laws for a set of two different species of long flexible polymer chains joined together at one of their extremities (copolymer stars) in space dimension D=2. We use a formerly constructed field-theoretic description and compare our perturbative results for the scaling exponents with recent conjectures for exact conformal scaling dimensions derived by a conformal invariance technique in the context of D=2 quantum gravity. A simple Monte Carlo simulation brings about reasonable agreement with both approaches. We analyze the remarkable multifractal properties of the spectrum of scaling exponents.

Amphiphilic hard body mixtures.

In order to study ternary amphiphilic mixtures, we introduce a simplistic model of hard spheres corresponding to water and hard needles corresponding to oil and amphiphilic particles, where the hydrophilic head is modeled as a hard sphere and the hydrophobic tail as an infinitely thin needle attached radially to the sphere. For this system, we construct a geometry-based density functional and perform Monte Carlo computer simulations. The equation of state derived from the theory is found to be in remarkable agreement with our simulation results. We investigate the theoretical demixing phase diagram, and find that the predicted trends strongly support the amphiphilic character of the model.