Evolution of children diagnosed with attention deficit/hyperactivity disorder. Follow-up study in a Spanish simple.

BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is a chronic condition with long-term associated risks. OBJECTIVE: To analyze the clinical status, occupation, and daily life difficulties of two cohorts of children diagnosed with ADHD (2004 and 2009) after five and 10 years. MATERIAL AND METHOD: Descriptive, longitudinal study using the WOMI database corresponding to Oviedo, Asturias, Spain. Children with ADHD detected by their primary care pediatrician were included. A voluntary follow-up telephone interview was requested. Outcome variables were current clinical and occupational status, ADHD symptoms according to SNAP-IV, and Strengths and Difficulties Questionnaire (SDQ). RESULTS: The interviewed sample consisted of 95 subjects, out of whom 71 answered the SNAP-IV and SDQ questionnaires; 60.70% of the sample did not receive treatment at the time of follow-up, 4.7% had no occupation, 25.40% still had ADHD global symptoms above the clinical cutoff point, and 66.2% had difficulties with moderate interference. CONCLUSIONS: ADHD symptoms decline as people grow up. Mental health comorbidities and academic dropout were not confirmed in the sample.

ANTECEDENTES: El trastorno de déficit de atención e hiperactividad (TDAH) constituye una condición crónica con riesgos asociados a largo plazo. OBJETIVO: Analizar el estado clínico, la ocupación y las dificultades de la vida diaria de dos cohortes de niños con diagnóstico de TDAH (2004 y 2009) después cinco y 10 años. MATERIAL Y MÉTODO: Estudio descriptivo y longitudinal de la base de datos WOMI correspondiente a Oviedo, Asturias, España. Se incluyeron niños detectados con TDAH por su pediatra de atención primaria. Se solicitó una entrevista telefónica voluntaria de seguimiento. Las variables de resultado fueron estado clínico y ocupacional al momento de la entrevista, síntomas de TDAH según SNAP-IV y Cuestionario de Fortalezas y Dificultades (SDQ). RESULTADOS: La muestra entrevistada estuvo formada por 95 sujetos, de los cuales 71 respondieron a los cuestionarios SNAP-IV y SDQ; 60.7 % de la muestra no recibía tratamiento en el momento del seguimiento, 4.7 % no tenía ninguna ocupación, 25.4 % mantenía síntomas globales de TDAH en nivel superior al punto de corte clínico y 66.2 % presentaba dificultades con interferencia moderada. CONCLUSIONES: Los síntomas del TDAH disminuyen conforme las personas crecen. Las comorbilidades de salud mental y el abandono académico no se confirmaron en la muestra.

Evolución de menores diagnosticados con trastorno de déficit de atención e hiperactividad. Estudio de seguimiento en una muestra española / Evolution of children diagnosed with attention deficit/hyperactivity disorder. Follow-up study in a Spanish sample

Resumen Antecedentes: El trastorno de déficit de atención e hiperactividad (TDAH) constituye una condición crónica con riesgos asociados a largo plazo. Objetivo: Analizar el estado clínico, la ocupación y las dificultades de la vida diaria de dos cohortes de niños con diagnóstico de TDAH (2004 y 2009) después cinco y 10 años. Material y método: Estudio descriptivo y longitudinal de la base de datos WOMI correspondiente a Oviedo, Asturias, España. Se incluyeron niños detectados con TDAH por su pediatra de atención primaria. Se solicitó una entrevista telefónica voluntaria de seguimiento. Las variables de resultado fueron estado clínico y ocupacional al momento de la entrevista, síntomas de TDAH según SNAP-IV y Cuestionario de Fortalezas y Dificultades (SDQ). Resultados: La muestra entrevistada estuvo formada por 95 sujetos, de los cuales 71 respondieron a los cuestionarios SNAP-IV y SDQ; 60.7 % de la muestra no recibía tratamiento en el momento del seguimiento, 4.7 % no tenía ninguna ocupación, 25.4 % mantenía síntomas globales de TDAH en nivel superior al punto de corte clínico y 66.2 % presentaba dificultades con interferencia moderada. Conclusiones: Los síntomas del TDAH disminuyen conforme las personas crecen. Las comorbilidades de salud mental y el abandono académico no se confirmaron en la muestra.

Abstract Background: Attention deficit/hyperactivity disorder (ADHD) is a chronic condition with long-term associated risks. Objective: To analyze the clinical status, occupation, and daily life difficulties of two cohorts of children diagnosed with ADHD (2004 and 2009) after five and 10 years. Material and method: Descriptive, longitudinal study using the WOMI database corresponding to Oviedo, Asturias, Spain. Children with ADHD detected by their primary care pediatrician were included. A voluntary follow-up telephone interview was requested. Outcome variables were current clinical and occupational status, ADHD symptoms according to SNAP-IV, and Strengths and Difficulties Questionnaire (SDQ). Results: The interviewed sample consisted of 95 subjects, out of whom 71 answered the SNAP-IV and SDQ questionnaires; 60.70% of the sample did not receive treatment at the time of follow-up, 4.7% had no occupation, 25.40% still had ADHD global symptoms above the clinical cutoff point, and 66.2% had difficulties with moderate interference. Conclusions: ADHD symptoms decline as people grow up. Mental health comorbidities and academic dropout were not confirmed in the sample.

3D-Printed Ceramic-Demineralized Bone Matrix Hyperelastic Bone Composite Scaffolds for Spinal Fusion.

Although numerous spinal biologics are commercially available, a cost-effective and safe bone graft substitute material for spine fusion has yet to be proven. In this study, "3D-Paints" containing varying volumetric ratios of hydroxyapatite (HA) and human demineralized bone matrix (DBM) in a poly(lactide-co-glycolide) elastomer were three-dimensional (3D) printed into scaffolds to promote osteointegration in rats, with an end goal of spine fusion without the need for recombinant growth factor. Spine fusion was evaluated by manual palpation, and osteointegration and de novo bone formation within scaffold struts were evaluated by laboratory and synchrotron microcomputed tomography and histology. The 3:1 HA:DBM composite achieved the highest mean fusion score and fusion rate (92%), which was significantly greater than the 3D printed DBM-only scaffold (42%). New bone was identified extending from the host transverse processes into the scaffold macropores, and osteointegration scores correlated with successful fusion. Strikingly, the combination of HA and DBM resulted in the growth of bone-like spicules within the DBM particles inside scaffold struts. These spicules were not observed in DBM-only scaffolds, suggesting that de novo spicule formation requires both HA and DBM. Collectively, our work suggests that this recombinant growth factor-free composite shows promise to overcome the limitations of currently used bone graft substitutes for spine fusion. Impact Statement Currently, there exists a no safe, yet highly effective, bone graft substitute that is well accepted for use in spine fusion procedures. With this work, we show that a three-dimensional printed scaffold containing osteoconductive hydroxyapatite and osteoinductive demineralized bone matrix that promotes new bone spicule formation, osteointegration, and successful fusion (stabilization) when implemented in a preclinical model of spine fusion. Our study suggests that this material shows promise as a recombinant growth factor-free bone graft substitute that could safely promote high rates of successful fusion and improve patient care.

Unlocking preservation bias in the amber insect fossil record through experimental decay.

Fossils entombed in amber are a unique resource for reconstructing forest ecosystems, and resolving relationships of modern taxa. Such fossils are famous for their perfect, life-like appearance. However, preservation quality is vast with many sites showing only cuticular preservation, or no fossils. The taphonomic processes that control this range are largely unknown; as such, we know little about potential bias in this important record. Here we employ actualistic experiments, using, fruit flies and modern tree resin to determine whether resin type, gut microbiota, and dehydration prior to entombment affects decay. We used solid phase microextraction gas chromatography-mass spectrometry (SPME GC-MS) to confirm distinct tree resin chemistry; gut microbiota of flies was modified using antibiotics and categorized though sequencing. Decay was assessed using phase contrast synchrotron tomography. Resin type demonstrates a significant control on decay rate. The composition of the gut microbiota was also influential, with minor changes in composition affecting decay rate. Dehydration prior to entombment, contrary to expectations, enhanced decay. Our analyses show that there is potential significant bias in the amber fossil record, especially between sites with different resin types where ecological completeness and preservational fidelity are likely affected.

Fluvastatin protects cochleae from damage by high-level noise.

Exposure to noise and ototoxic drugs are responsible for much of the debilitating hearing loss experienced by about 350 million people worldwide. Beyond hearing aids and cochlear implants, there have been no other FDA approved drug interventions established in the clinic that would either protect or reverse the effects of hearing loss. Using Auditory Brainstem Responses (ABR) in a guinea pig model, we demonstrate that fluvastatin, an inhibitor of HMG-CoA reductase, the rate-limiting enzyme of the mevalonate pathway, protects against loss of cochlear function initiated by high intensity noise. A novel synchrotron radiation based X-ray tomographic method that imaged soft tissues at micrometer resolution in unsectioned cochleae, allowed an efficient, qualitative evaluation of the three-dimensional internal structure of the intact organ. For quantitative measures, plastic embedded cochleae were sectioned followed by hair cell counting. Protection in noise-exposed cochleae is associated with retention of inner and outer hair cells. This study demonstrates the potential of HMG-CoA reductase inhibitors, already vetted in human medicine for other purposes, to protect against noise induced hearing loss.

Auditory Neural Activity in Congenitally Deaf Mice Induced by Infrared Neural Stimulation.

To determine whether responses during infrared neural stimulation (INS) result from the direct interaction with spiral ganglion neurons (SGNs), we tested three genetically modified deaf mouse models: Atoh1-cre; Atoh1 f/f (Atoh1 conditional knockout, CKO), Atoh1-cre; Atoh1 f/kiNeurog1 (Neurog1 knockin, KI), and the Vglut3 knockout (Vglut3 -/-) mice. All animals were exposed to tone bursts and clicks up to 107 dB (re 20 µPa) and to INS, delivered with a 200 µm optical fiber. The wavelength (λ) was 1860 nm, the radiant energy (Q) 0-800 µJ/pulse, and the pulse width (PW) 100-500 µs. No auditory responses to acoustic stimuli could be evoked in any of these animals. INS could not evoke auditory brainstem responses in Atoh1 CKO mice but could in Neurog1 KI and Vglut3 -/- mice. X-ray micro-computed tomography of the cochleae showed that responses correlated with the presence of SGNs and hair cells. Results in Neurog1 KI mice do not support a mechanical stimulation through the vibration of the basilar membrane, but cannot rule out the direct activation of the inner hair cells. Results in Vglut3 -/- mice, which have no synaptic transmission between inner hair cells and SGNs, suggested that hair cells are not required.

Irradiated recycled plastic as a concrete additive for improved chemo-mechanical properties and lower carbon footprint.

Concrete production contributes heavily to greenhouse gas emissions, thus a need exists for the development of durable and sustainable concrete with a lower carbon footprint. This can be achieved when cement is partially replaced with another material, such as waste plastic, though normally with a tradeoff in compressive strength. This study discusses progress toward a high/medium strength concrete with a dense, cementitious matrix that contains an irradiated plastic additive, recovering the compressive strength while displacing concrete with waste materials to reduce greenhouse gas generation. Compressive strength tests showed that the addition of high dose (100kGy) irradiated plastic in multiple concretes resulted in increased compressive strength as compared to samples containing regular, non-irradiated plastic. This suggests that irradiating plastic at a high dose is a viable potential solution for regaining some of the strength that is lost when plastic is added to cement paste. X-ray Diffraction (XRD), Backscattered Electron Microscopy (BSE), and X-ray microtomography explain the mechanisms for strength retention when using irradiated plastic as a filler for cement paste. By partially replacing Portland cement with a recycled waste plastic, this design may have a potential to contribute to reduced carbon emissions when scaled to the level of mass concrete production.

Using synchrotron X-ray phase-contrast micro-computed tomography to study tissue damage by laser irradiation.

BACKGROUND AND OBJECTIVE: The aim of this study was to determine if X-ray micro-computed tomography could be used to locate and characterize tissue damage caused by laser irradiation and to describe its advantages over classical histology for this application. STUDY DESIGN/MATERIALS AND METHODS: A surgical CO2 laser, operated in single pulse mode (100 milliseconds) at different power settings, was used to ablate different types of cadaveric animal tissues. Tissue samples were then harvested and imaged with synchrotron X-ray phase-contrast and micro-computed tomography to generate stacks of virtual sections of the tissues. Subsequently, Fiji (ImageJ) software was used to locate tissue damage, then to quantify volumes of laser ablation cones and thermal coagulation damage from 3D renderings of tissue image stacks. Visual comparisons of tissue structures in X-ray images with those visible by classic light microscopy histology were made. RESULTS: We demonstrated that micro-computed tomography could be used to rapidly identify areas of surgical laser ablation, vacuolization, carbonization, and thermally coagulated tissue. Quantification and comparison of the ablation crater, which represents the volume of ablated tissue, and the thermal coagulation zone volumes were performed faster than we could by classical histology. We demonstrated that these procedures can be performed on fresh hydrated and non-sectioned plastic embedded tissue. CONCLUSION: We demonstrated that the application of non-destructive micro-computed tomography to the visualization and analysis of laser induced tissue damage without tissue sectioning is possible. This will improve evaluation of new surgical lasers and their corresponding effect on tissues. Lasers Surg. Med. 48:866-877, 2016. © 2016 Wiley Periodicals, Inc.

The 'Tully monster' is a vertebrate.

Problematic fossils, extinct taxa of enigmatic morphology that cannot be assigned to a known major group, were once a major issue in palaeontology. A long-favoured solution to the 'problem of the problematica', particularly the 'weird wonders' of the Cambrian Burgess Shale, was to consider them representatives of extinct phyla. A combination of new evidence and modern approaches to phylogenetic analysis has now resolved the affinities of most of these forms. Perhaps the most notable exception is Tullimonstrum gregarium, popularly known as the Tully monster, a large soft-bodied organism from the late Carboniferous Mazon Creek biota (approximately 309-307 million years ago) of Illinois, USA, which was designated the official state fossil of Illinois in 1989. Its phylogenetic position has remained uncertain and it has been compared with nemerteans, polychaetes, gastropods, conodonts, and the stem arthropod Opabinia. Here we review the morphology of Tullimonstrum based on an analysis of more than 1,200 specimens. We find that the anterior proboscis ends in a buccal apparatus containing teeth, the eyes project laterally on a long rigid bar, and the elongate segmented body bears a caudal fin with dorsal and ventral lobes. We describe new evidence for a notochord, cartilaginous arcualia, gill pouches, articulations within the proboscis, and multiple tooth rows adjacent to the mouth. This combination of characters, supported by phylogenetic analysis, identifies Tullimonstrum as a vertebrate, and places it on the stem lineage to lampreys (Petromyzontida). In addition to increasing the known morphological disparity of extinct lampreys, a chordate affinity for T. gregarium resolves the nature of a soft-bodied fossil which has been debated for more than 50 years.

Absorption and Phase Contrast X-Ray Imaging in Paleontology Using Laboratory and Synchrotron Sources.

X-ray micro-computed tomography (µCT) is commonly used for imaging of samples in biomedical or materials science research. Owing to the ability to visualize a sample in a nondestructive way, X-ray µCT is perfectly suited to inspect fossilized specimens, which are mostly unique or rare. In certain regions of the world where important sedimentation events occurred in the Precambrian geological time, several fossilized animals are studied to understand questions related to their origin, environment, and life evolution. This article demonstrates the advantages of applying absorption and phase-contrast CT on the enigmatic fossil Corumbella werneri, one of the oldest known animals capable of building hard parts, originally discovered in Corumbá (Brazil). Different tomographic setups were tested to visualize the fossilized inner structures: a commercial laboratory-based µCT device, two synchrotron-based imaging setups using conventional absorption and propagation-based phase contrast, and a commercial X-ray microscope with a lens-coupled detector system, dedicated for radiography and tomography. Based on our results we discuss the strengths and weaknesses of the different imaging setups for paleontological studies.

Eficacia de la terapia de aceptación y compromiso en personas con trastorno mental crónico. Un ensayo aleatorizado / No disponible

El presente estudio analizó el impacto de un tratamiento basado en la aceptación(Terapia de Aceptación y Compromiso; ACT) en personas con trastorno mental crónico. Esta intervención enseña a los pacientes a aceptar aquellos eventos privados que son inevitables y a identificar y centrarse en acciones dirigidas hacia objetivos valiosos para ellos.23 participantes con un alto nivel de cronificación fueron asignados al azar al tratamiento habitual (TAU) o a un protocolo de siete sesiones de ACT más TAU. Los participantes del grupo de ACT mostraron cambios en la dirección deseada tanto en las conductas de evitación como en el nivel de actividades realizadas en dirección a los objetivos valorados. Estos cambios se mantuvieron y fueron aún más significativos a largo plazo, tal y como cabía esperar de una intervención basada en la aceptación. Destacan los resultados en el seguimiento a los ocho meses respecto a la sintomatología, a pesar de que esta no era el objetivo de la intervención. Los resultados obtenidos son de gran relevancia habida cuenta de la alta cronicidad y disfuncionalidad social de los participantes (AU)

This study examined the impact of a treatment based on the acceptance (Acceptance and Commitment Therapy, ACT)in people with chronic mental disorder. This intervention teaches patients to accept these private events that are inevitable and to identify and focus on actions directed toward valued goals for them. Twenty-three participants with a high-level of chronicity were randomized to treatment as usual (TAU) protocol or 7 sessions of ACT plus TAU. The ACT group participants showed changes in the desired direction both in avoidance behavior and the level of activities toward valued goals. These changes were maintained and were even more significant in the long term, as might be expected of an intervention based on acceptance. Notable results at 8 months follow-up regarding the symptoms, even though it was not the aim of the intervention. The results are of great importance given the high chronicity and social dysfunctionality of the participants (AU)

Thrips pollination of Mesozoic gymnosperms.

Within modern gymnosperms, conifers and Ginkgo are exclusively wind pollinated whereas many gnetaleans and cycads are insect pollinated. For cycads, thrips are specialized pollinators. We report such a specialized pollination mode from Early Cretaceous amber of Spain, wherein four female thrips representing a genus and two species in the family Melanthripidae were covered by abundant Cycadopites pollen grains. These females bear unique ring setae interpreted as specialized structures for pollen grain collection, functionally equivalent to the hook-tipped sensilla and plumose setae on the bodies of bees. The most parsimonious explanation for this structure is parental food provisioning for larvae, indicating subsociality. This association provides direct evidence of specialized collection and transportation of pollen grains and likely gymnosperm pollination by 110-105 million years ago, possibly considerably earlier.

Una visión posmoderna de la vejez en la comunidad susqueña: construcción de sentido de la vejez desde la perspectiva de los adultos mayores / A post-modern vision of old age in susques community: construction of meaning of old age from the point of view of older adults

INTRODUCCIÓN A través de la investigación, es posible conocer y comprender las representaciones sociales acerca de la vejez. OBJETIVOS Investigar las representaciones sociales respecto de la vejez en los adultos mayores, la comunidad y las instituciones de la localidad de Susques, perteneciente al departamento homónimo de la provincia de Jujuy. Desentrañar mitos, valores y creencias. Identificar factores protectores o de riesgo. Indagar acerca de las instituciones promotoras de la salud. MÉTODOS Se siguió una estrategia metodológica cualitativa. Las fuentes primarias de recolección de datos fueron dispositivos de grupo focal, la entrevista flash en profundidad y la observación participante. Se estudió a 39 mujeres y 25 varones de tercera edad, 30 adultos, 20 adolescentes y 20 niños. RESULTADOS El estudio mostró que desde la visión del propio anciano la vejez es un desvalor y una desventaja, y que la etapa se minimiza como natural y bella. Como barreras de acceso al sistema de salud en ancianos aparecieron los mitos que generan sentimientos de culpa, naturalizando el sufrimiento. Los factores de riesgo verificados fueron el alcoholismo, la depresión, la influencia de la tecnología y el estrés en familiares; los factores protectores incluyeron la fe en Dios y el uso de hojas de coca. No se encontró ninguna institución promotora de salud. DISCUSIÓN Los resultados indican la necesidad de capacitar profesionales de la salud. El estudio puede contribuir a generar alternativas de trabajo interdisciplinario e intersectorial, y promover políticas dirigidas a mejorar la atención de los ancianos con el fin de lograr el reconocimiento social.

Terapia de Aceptación y Compromiso (ACT) y la importancia de los valores personales en el contexto de la terapia psicológica / ACT and the importance of personal values in the context of psychological therapy

El presente artículo expone la relevancia que tienen los valores personales como componente necesario del tratamiento psicológico y las ventajas que se derivan del abordaje de los valores de forma explícita a lo largo del proceso terapéutico. Se muestra la importancia de analizar los valores del cliente implicados en la práctica de la Psicología Clínica y se describe el lugar que dan a los valores las terapias más relevantes. Se discute además del rol de los valores del cliente, el papel de los valores del terapeuta y la necesidad de que éste aprenda a discriminar cuándo sus propios valores funcionan como barreras en el proceso clínico. En este contexto, se expone la Terapia de Aceptación y Compromiso (ACT) como terapia centrada explícitamente en los valores personales del cliente

ACT and the Importance of Personal Values in the Context of Psychological Therapy. The aims of the article are to show the importance of personal values in the context of psychological treatment. The advantages of an explicit approach to values during the therapeutic process are examined. We analyse the values involved in Clinical Psychology, and how different clinical perspectives address them. Besides the importance of client’svalues, the role of the therapist’s values as an incentive for effective clinical work or as a barrier in the therapeutic change is analysed. All these points are considered in the context of the Acceptance and Commitment Therapy (ACT), as a therapy explicitly centred in client’s personal values

Análisis de los contextos verbales en el trastorno de evitación experiencial y en la terapia de aceptación y compromiso / Analyzing the verbal contexts in experiential avoidance disorder and in acceptance and commitment therapy

El interés por la dimensión funcional diagnóstica del trastorno de evitación experiencial (TEE) se ha extendido rápidamente en los últimos años, a la par que se han generado estrategias clínicas que han evolucionado desde el objetivo de la terapia cognoscitiva de la conducta, centrado en el cambio del contenido cognoscitivo o de eventos privados, hacia un nuevo foco centrado en el cambio de los contextos verbales que mantienen la relación que el paciente establece con esos contenidos cognoscitivos. Esta nueva vía de terapias está siendo conocida como "tercera generación". Los resultados iniciales que se han derivado de estas aproximaciones a la psicopatología y su tratamiento, son prometedores y resaltan la necesidad tanto de un análisis específico de los contextos verbales, base del TEE (la literalidad, la valoración, las razones cognoscitivas como buenas causas de la acción, y, consecuentemente, la acción dirigida a regular o controlar tales eventos privados), como de los contextos verbales que definen los métodos clínicos que llegan a producir la alteración de funciones en la Terapia de Aceptación y Compromiso (ACT). En este artículo se aborda el TEE en un análisis más específico sobre los contextos verbales que le sirven de base. Y se presenta brevemente ACT como terapia dirigida a alterar tales contextos verbales, resaltando los métodos clínicos de cambio contextual orientados a la transformación de funciones y, así, al cambio de la relación funcional entre cognición y acción, es decir, la ruptura de la regulación verbal destructiva