Depression in internal medicine inpatients at the time of hospital discharge and referral to primary care

Background and objectives. This is the first multi-center study intended to document the prevalence, characteristics, and associations of depression in Medicine patients at the time of hospital discharge and their referral to Primary Care (PC). Methods. Adult patients randomly selected among consecutive admissions to Medicine wards in 8 hospitals in Spain, covering health districts, were examined in a two-phase 'case-finding' procedure. Standardized, Spanish versions of instruments were used, including the Standardized Polyvalent Psychiatric Interview (SPPI) and Cumulative Illness Rating Scale (CIRS). Cases of depression were diagnosed according to ICD-10 general hospital research criteria. Results. Three hundred and twelve patients with treatable depression and 777 non-depressed controls were identified. In a conservative estimate, the global prevalence of major depression was 7.1%, dysthymia 4.2% and adjustment depression 7.1%, and 51.9% of cases were of moderate/ severe intensity. Depression was more frequent in women, the differences being significant in all categories of depression. The prevalence of depression was lower in individuals aged 85 or more years, the differences being significant in cases of both dysthymia and adjustment depression. A clear pattern of decreasing prevalence with age was observed in women. The depressed had as an average five medical systems affected, and higher CIRS scores compared with the controls, the differences being significant in cases of both major depression and dysthymia. Conclusions. This is the first report showing a considerable prevalence of treatable cases of depression in Medicine patients at the time of hospital discharge and referral to PC. Depression is associated with the severity of the medical condition, and differences observed by age and sex have clinical implications. Paper read at the 3rd Annual Meeting of the European Association of Psychosomatic Medicine, Nuremberg 2015.

Variables related to chronic immune thrombocytopenia: experience from a single center and comparison to a meta-analysis.

Classically, several variables have been related to the disease course of chronic primary immune thrombocytopenia (cITP), though to date, there is no consensus on their clinical relevance. In a recent systematic review, a meta-analysis was made and confirmed the existence of certain cITP-related variables that may be related to prognosis in pediatric patients. We retrospectively analyzed a cohort of patients diagnosed with ITP, identified prognostic variables, and compared our results to the variables described by the authors. A multivariate study revealed that older age at diagnosis and higher platelet count were the only independent variables related to cITP. Children up to age 4 years and those with lower platelet counts (below 20 × 109/L) were at lower risk for cITP.Conclusion: We therefore concluded that only age and platelet count at diagnosis are independent variables that should be considered when evaluating the risk of developing cITP. What is Known: • Around 20% of patients with immune thrombocytopenia progress to chronic disease as determined by a sustained platelet count below 100×109/L for more than 12 months. • A number of variables potentially related to the development of cITP are being studied, such as age, sex, cell count, and previous treatment. What is New: • This is a new group of patients diagnosed with ITP in which the platelet count and age at diagnosis are the only independent variables closely related to cITP. • In this new series, we could not confirm other variables previously related to cITP such as total leukocyte count or the absence of treatment at diagnosis.

Over What Length Scale Does an Inorganic Substrate Perturb the Structure of a Glassy Organic Semiconductor?

While the bulk structure of vapor-deposited glasses has been extensively studied, structure at buried interfaces has received little attention, despite being important for organic electronic applications. To learn about glass structure at buried interfaces, we study the structure of vapor-deposited glasses of the organic semiconductor DSA-Ph (1,4-di-[4-(N,N-diphenyl)amino]styrylbenzene) as a function of film thickness; the structure is probed with grazing incidence X-ray scattering. We deposit on silicon and gold substrates and span a film thickness range of 10-600 nm. Our experiments demonstrate that interfacial molecular packing in vapor-deposited glasses of DSA-Ph is more disordered compared to the bulk. At a deposition temperature near room temperature, we estimate ∼8 nm near the substrate can have modified molecular packing. Molecular dynamics simulations of a coarse-grained representation of DSA-Ph reveal a similar length scale. In both the simulations and the experiments, deposition temperature controls glass structure beyond this interfacial layer of a few nanometers.

Multivalent counterions diminish the lubricity of polyelectrolyte brushes.

Polyelectrolyte brushes provide wear protection and lubrication in many technical, medical, physiological, and biological applications. Wear resistance and low friction are attributed to counterion osmotic pressure and the hydration layer surrounding the charged polymer segments. However, the presence of multivalent counterions in solution can strongly affect the interchain interactions and structural properties of brush layers. We evaluated the lubrication properties of polystyrene sulfonate brush layers sliding against each other in aqueous solutions containing increasing concentrations of counterions. The presence of multivalent ions (Y3+, Ca2+, Ba2+), even at minute concentrations, markedly increases the friction forces between brush layers owing to electrostatic bridging and brush collapse. Our results suggest that the lubricating properties of polyelectrolyte brushes in multivalent solution are hindered relative to those in monovalent solution.

A molecular view of the role of chirality in charge-driven polypeptide complexation.

Polyelectrolyte molecules of opposite charge are known to form stable complexes in solution. Depending on the system conditions, such complexes can be solid or liquid. The latter are known as complex coacervates, and they appear as a second liquid phase in equilibrium with a polymer-dilute aqueous phase. This work considers the complexation between poly(glutamic acid) and poly(lysine), which is of particular interest because it enables examination of the role of chirality in ionic complexation, without changes to the overall chemical composition. Systematic atomic-level simulations are carried out for chains of poly(glutamic acid) and poly(lysine) with varying combinations of chirality along the backbone. Achiral chains form unstructured complexes. In contrast, homochiral chains lead to formation of stable ß-sheets between molecules of opposite charge, and experiments indicate that ß-sheet formation is correlated with the formation of solid precipitates. Changes in chirality along the peptide backbone are found to cause "kinks" in the ß-sheets. These are energetically unfavorable and result in irregular structures that are more difficult to pack together. Taken together, these results provide new insights that may be of use for the development of simple yet strong bioinspired materials consisting of ß-rich domains and amorphous regions.

Effects of enhanced denitrification on hydrodynamics and microbial community structure in a soil column system.

Enhanced heterotrophic denitrification by adding glucose was investigated by means of a soil column experiment which simulated the groundwater flow. The carbon-to-nitrogen ratio was the main factor determining denitrification potential under experimental conditions. The influence of stimulated denitrification on the autochthonous microbial community was investigated by quantitative PCR (qPCR), and denaturing gradient gel electrophoresis (DGGE). The qPCR detection of the nosZ genes encoding nitrous oxide reductase, and the comparison of the abundances of 16S rRNA genes revealed that the addition of glucose enhanced denitrification leading to an increase in both the total eubacteria and, in particular, in the ratio of denitrifying bacteria, which represented the 21% of the total native eubacteria on the basis of nosZ/16S rRNA gene ratio. Microbial community profiling by DGGE indicated that ribotypes closely related to the genera Acidovorax and Hydrogenophaga (Comamonadaceae family) became enriched in the soil column. The effects of biomass occurrence in the column system on soil hydrodynamics, assessed by tracer studies, revealed a reduction of porosity and a significant increase of dispersivity that could be caused by the appearance of new functional microbial biomass in the aquifer material under enhanced denitrifying conditions. The importance of investigating the microbial growth in relation to the hydrodynamic effects, during enhanced denitrification, has been revealed in the column system experiments associated with the bioremediation. Combining microbial characterisation and hydrodynamic data in a soil column system permits us to gain an insight to the limiting factors of different stimulation strategies that can be applied in the field.

Smooth pursuit eye movements and schizophrenia: literature review.

OBJECTIVE: To review the scientific literature about the relationship between impairment on smooth pursuit eye movements and schizophrenia. METHODS: Narrative review that includes historical articles, reports about basic and clinical investigation, systematic reviews, and meta-analysis on the topic. RESULTS: Up to 80% of schizophrenic patients have impairment of smooth pursuit eye movements. Despite the diversity of test protocols, 65% of patients and controls are correctly classified by their overall performance during this pursuit. The smooth pursuit eye movements depend on the ability to anticipate the target's velocity and the visual feedback, as well as on learning and attention. The neuroanatomy implicated in smooth pursuit overlaps to some extent with certain frontal cortex zones associated with some clinical and neuropsychological characteristics of the schizophrenia, therefore some specific components of smooth pursuit anomalies could serve as biomarkers of the disease. Due to their sedative effect, antipsychotics have a deleterious effect on smooth pursuit eye movements, thus these movements cannot be used to evaluate the efficacy of the currently available treatments. CONCLUSION: Standardized evaluation of smooth pursuit eye movements on schizophrenia will allow to use specific aspects of that pursuit as biomarkers for the study of its genetics, psychopathology, or neuropsychology.

Liquid-crystal-mediated self-assembly at nanodroplet interfaces.

Technological applications of liquid crystals have generally relied on control of molecular orientation at a surface or an interface. Such control has been achieved through topography, chemistry and the adsorption of monolayers or surfactants. The role of the substrate or interface has been to impart order over visible length scales and to confine the liquid crystal in a device. Here, we report results from a computational study of a liquid-crystal-based system in which the opposite is true: the liquid crystal is used to impart order on the interfacial arrangement of a surfactant. Recent experiments on macroscopic interfaces have hinted that an interfacial coupling between bulk liquid crystal and surfactant can lead to a two-dimensional phase separation of the surfactant at the interface, but have not had the resolution to measure the structure of the resulting phases. To enhance that coupling, we consider the limit of nanodroplets, the interfaces of which are decorated with surfactant molecules that promote local perpendicular orientation of mesogens within the droplet. In the absence of surfactant, mesogens at the interface are all parallel to that interface. As the droplet is cooled, the mesogens undergo a transition from a disordered (isotropic) to an ordered (nematic or smectic) liquid-crystal phase. As this happens, mesogens within the droplet cause a transition of the surfactant at the interface, which forms new ordered nanophases with morphologies dependent on surfactant concentration. Such nanophases are reminiscent of those encountered in block copolymers, and include circular, striped and worm-like patterns.

Liquid crystal mediated interactions between nanoparticles in a nematic phase.

A continuum theory is used to study the interactions between nanoparticles suspended in nematic liquid crystals. The free energy functional that describes the system is minimized using an Euler-Lagrange approach and an unsymmetric radial basis function method. It is shown that nanoparticle liquid-crystal mediated interactions can be controlled over a large range of magnitudes through changes of the anchoring energy and the particle diameter. The results presented in this work serve to reconcile past discrepancies between theoretical predictions and experimental observations, and suggest intriguing possibilities for directed nanoparticle self-assembly in liquid crystalline media.

Biogenic hydroxyapatite (Apatite II™) dissolution kinetics and metal removal from acid mine drainage.

Apatite II™ is a biogenic hydroxyapatite (expressed as Ca(5)(PO(4))OH) derived from fish bone. Using grains of Apatite II™ with a fraction size between 250 and 500 µm, batch and flow-through experiments were carried out to (1) determine the solubility constant for the dissolution reaction Ca(5)(PO(4))(3)(OH) ⇔ 5Ca(2+) + 3PO(4)(3-) + OH(-), (2) obtain steady-state dissolution rates over the pH range between 2.22 and 7.14, and (3) study the Apatite II™'s mechanisms to remove Pb(2+), Zn(2+), Mn(2+), and Cu(2+) from metal polluted water as it dissolves. The logK(S) value obtained was -50.8±0.82 at 25 °C. Far-from-equilibrium fish-bone hydroxyapatite dissolution rates decrease by increasing pH. Assuming that the dissolution reaction is controlled by fast adsorption of a proton on a specific surface site that dominates through the pH range studied, probably ≡PO(-), followed by a slow hydrolysis step, the dissolution rate dependence is expressed in mol m(-2) s(-1) as where Rate(25 °C) = -8.9 × 10(-10) × [9.96 × 10(5) × a(H+)]/[1 + 9.96 × 10(5) × a(H+)] where a(H+) is the proton activity in solution. Removal of Pb(2+), Zn(2+), Mn(2+) and Cu(2+) was by formation of phosphate-metal compounds on the Apatite II™ substrate, whereas removal of Cd(2+) was by surface adsorption. Increase in pH enhanced the removal of aqueous heavy metals. Using the kinetic parameters obtained (e.g., dissolution rate and pH-rate dependence law), reactive transport simulations reproduced the experimental variation of pH and concentrations of Ca, P and toxic divalent metal in a column experiment filled with Apatite II™ that was designed to simulate the Apatite II™-metal polluted water interaction.

Determination of the equilibrium formation constants of two U(VI)-peroxide complexes at alkaline pH.

The formation of uranyl-peroxide complexes was studied at alkaline media by using UV-Visible spectrophotometry and the STAR code. Two different complexes were found at a H(2)O(2)/U(VI) ratio lower than 2. A graphical method was used in order to obtain the formation constants of such complexes and the STAR program was used to refine the formation constants values because of its capacity to treat multiwavelength absorbance data and refining equilibrium constants. The values obtained for the two complexes identified were: UO(2)(2+) + H(2)O(2) + 4OH(-) <−> UO(2)(O(2))(OH)(2)(2-) + 2H(2)O: log ß°(1,1,4) = 28.1 ± 0.1 (1). UO(2)(2+) + 2H(2)O(2) + 6OH(-) <−> UO(2)(O(2))(2)(OH)(2)(4-) + 4H(2)O: log ß°(1,2,6) = 36.8 ± 0.2 (2). At hydrogen peroxide concentrations higher than 10(-5) mol dm(-3), and in the absence of carbonate, the UO(2)(O(2))(2)(OH)(2)(4-) complex is predominant in solution, indicating the significant peroxide affinity of peroxide ions for uranium and the strong complexes of uranium(VI) with peroxide.

Estudio de contactos en niños y adolescentes usando el QuantiFERON-TB® gold in-tube / Study of contacts in children and adolescents using the QuantiFERON®-TB Gold in-tube

Objetivo: Comparar el comportamiento de la prueba de la tuberculina (PT) y el QuantiFERONTB® gold in-tube (QFT-GIT) en una población infantil integrada por contactos. Material y métodos: Estudio con recogida de datos prospectivo realizado en un distrito sanitario del País Vasco (España) de 300.000 habitantes, en niños y adolescentes (edad < 17 años)reclutados en un estudio de contactos durante un periodo de casi 3 años. El estudio incluyó la prueba de la tuberculina (PT), realizada con la técnica de Mantoux (con 2-TU de PPD RT23 con Tween 80), y el QFT-GIT simultáneamente y la recogida de datos demográficos y clínicos. Resultados: Entre los 160 niños incluidos, el 14% tenía una PT positiva (≥ 5mm) y 11% un QFTGIT positivo. La concordancia entre las pruebas fue del 95-96%, dependiendo del punto de corte de la PT elegido y fue mayor en los niños no vacunados (100%) y en los niños menores de 5 años (100%). Se observó una asociación significativa entre el resultado positivo de ambas pruebas con la exposición en el domicilio. El uso del QFT-GIT en el cribado de la infección tuberculosa latente supondría reducir entre el 28-34% de tratamientos preventivos con respecto al cribado convencional con la PT. Conclusiones: El comportamiento del QFT-GIT fue comparable a la PT en la identificación de niños con infección tuberculosa por lo que podría potencialmente reemplazar a la PT (AU)

Objective: To compare the results of the Mantoux Tuberculin Test (TT) and the QuantiFERONTB® Gold In-Tube (QFT-GIT) in a population of children and adolescents with TB contacts. Material and methods: A prospective study using data collected on children and adolescents (< 17 years) from a Health District of 300,000 inhabitants in the Basque Country (Spain) recruited into a TB contact study over a period of almost three years. The study included performing theTuberculin Test using the Mantoux technique (with 2-TU of RT-23 PPD RT23 and Tween 80), and the QFT-GIT simultaneously, and collecting the demographic and clinical data. Results: Of the 160 children included in the study, 14% had a positive TT (≥ 5mm) and 11% a positive QFT-GIT. There was 95%-96% agreement between the tests, depending on the TT cutoff point chosen, and was higher in non-vaccinated children (100%) and in children less than5 years-old (100%). A significant relationship was observed between a positive result for both tests with exposure in the home. The use of QFT-GIT in the screening of latent TB infection could reduce preventive treatments by 28%-34% compared with conventional screening with the TT. Conclusions: The behaviour of QFT-GIT was comparable to the TT in identifying children with a tuberculosis infection; therefore it could potentially replace the TT (AU)

Evolution of glassy gratings with variable aspect ratios under surface diffusion.

The structural evolution of surface gratings on a glassy material is investigated by means of molecular simulations. The gratings provide a means to probe surface diffusion in the vicinity of the glass transition temperature. A theory by Mullins [J. Appl. Phys. 30, 77 (1959)] is used to extract qu-antitative measures of surface diffusivity that rely on calculation of grating amplitude as a function of time. The simulations are implemented in the context of a model binary glass mixture [S. S. Ashwin and S. Sastry, J. Phys.: Condens. Matter 15, S1253 (2003)]. We find that surface diffusion is faster than bulk diffusion by several orders of magnitude, consistent with recent experimental data for an organic glass former. The diffusivities extracted by the grating-decay approach are consistent with those estimated on the basis of mean-squared particle displacements. The grating-decay approach, however, is more efficient than traditional techniques based on Einstein's diffusion equation. Grating decay is also more versatile and is shown to be applicable in a variety of sample geometries.

[Study of contacts in children and adolescents using the QuantiFERON®-TB Gold In-Tube]. / Estudio de contactos en niños y adolescentes usando el QuantiFERON-TB(®) gold in-tube.

OBJECTIVE: To compare the results of the Mantoux Tuberculin Test (TT) and the QuantiFERON TB® Gold In-Tube (QFT-GIT) in a population of children and adolescents with TB contacts. MATERIAL AND METHODS: A prospective study using data collected on children and adolescents (< 17years) from a Health District of 300,000 inhabitants in the Basque Country (Spain) recruited into a TB contact study over a period of almost three years. The study included performing the Tuberculin Test using the Mantoux technique (with 2-TU of RT-23 PPD RT23 and Tween 80), and the QFT-GIT simultaneously, and collecting the demographic and clinical data. RESULTS: Of the 160 children included in the study, 14% had a positive TT (≥ 5mm) and 11% a positive QFT-GIT. There was 95%-96% agreement between the tests, depending on the TT cut-off point chosen, and was higher in non-vaccinated children (100%) and in children less than 5 years-old (100%). A significant relationship was observed between a positive result for both tests with exposure in the home. The use of QFT-GIT in the screening of latent TB infection could reduce preventive treatments by 28%-34% compared with conventional screening with the TT. CONCLUSIONS: The behaviour of QFT-GIT was comparable to the TT in identifying children with a tuberculosis infection; therefore it could potentially replace the TT.

Effects of ionizing radiation and temperature on uranyl silicates: soddyite (UO2)2(SiO4)(H2O)2 and Uranophane Ca(UO2)2(SiO3OH)2·5H2O.

The stability of soddyite under electron irradiation has been studied over the temperature range of 25-300 °C. At room temperature, soddyite undergoes a crystalline-to-amorphous transformation (amorphization) at a total dose of 6.38 × 10(8) Gy. The electron beam irradiation results suggest that the soddyite structure is susceptible to radiation-induced nanocrystallization of UO(2). The temperature dependence of amorphization dose increases linearly up to 300 °C. A thermogravimetric and calorimetric analysis (TGA-DSC) combined with X-ray diffraction (XRD) indicates that soddyite retains its water groups up to 400 °C, followed by the collapse of the structure. Based on thermal analysis of uranophane, the removal of some water groups at relatively low temperatures provokes the collapse of the uranophane structure. This structural change appears to be the reason for the increase of amorphization dose at 140 °C. According to the results obtained, radiation field of a nuclear waste repository, rather than temperature effects, may cause changes in the crystallinity of soddyite and affect its stability during long-term storage.

Numerical simulation of Gaussian chains near hard surfaces.

We present a coarse grain representation for Gaussian chains in the presence of hard surfaces. Whereas a Gaussian chain in the bulk can be represented by a bead-spring model with a quadratic potential between adjacent beads, the presence of a surface reduces the number of allowed chain configurations and modifies the effective potential between the beads. We derive the corrected potentials for several surface geometries: a single wall, two parallel walls (slit), and a spherical or cylindrical object (nanoparticle). Those potentials can be used in any model that includes a Gaussian chain, regardless of the simulation method. As an illustration, we consider a coarse grain model of a polymeric melt and, using Monte Carlo simulations, we compute the density profiles for (i) a melt confined in a slit and (ii) a melt in the vicinity of a nanoparticle. The case of a polymeric solution confined within a slit is also addressed, and the proposed approach is shown to yield results in qualitative agreement with those obtained with field-theoretic simulations.

Denitrification in presence of acetate and glucose for bioremediation of nitrate-contaminated groundwater.

With the current increasing interest in aquifer denitrification, recent attention has been given to cost-effective in-situ treatments such as Enhanced In-Situ Biological Denitrification (EISBD), which intends to stimulate the indigenous bacterial activity by injecting an external organic substrate and/or nutrients to the aquifer matrix. Within this context, laboratory batch assays have been conducted to develop a strategy for in-situ denitrification of a nitrate-contaminated aquifer in Argentona, Catalonia (Spain). The assays were run under aerobic and anaerobic conditions at a temperature of 17 degrees C to better simulate the conditions of the aquifer. Acetate and glucose were added to assess their potential to promote heterotrophic denitrifying bacteria activity. Overall, the results revealed that indigenous micro-organisms had the potential of reducing nitrate under appropriate conditions. Nitrate removal was complete and faster under anaerobic conditions, though high nitrate removals were also attained under initial aerobic conditions when a readily organic compound was amended at a sufficient dosage. The results also revealed that a significant amount of the available organic carbon was consumed by processes other than denitrification, namely aerobic oxidation and other microbial oxidation processes. To sum up, the results of this study demonstrated that addition of organic compounds into the groundwater is a promising method for in-situ bioremediation of nitrate in the Argentona aquifer. This approach could potentially be applied to a number of situations in which nitrate concentration is elevated and where indigenous micro-organisms with potential to reduce nitrate are present within the aquifer material.

In situ removal of arsenic from groundwater by using permeable reactive barriers of organic matter/limestone/zero-valent iron mixtures.

In this study, two mixtures of municipal compost, limestone and, optionally, zero-valent iron were assessed in two column experiments on acid mine treatment. The effluent solution was systematically analysed throughout the experiment and precipitates from both columns were withdrawn for scanning electron microscopy, energy-dispersive X-ray spectroscopy, X-ray diffractometry analysis and, from the column containing zero-valent iron, solid digestion and sequential extraction analysis. The results showed that waters were cleaned of arsenic, metals and acidity, but chemical and morphological analysis suggested that metal removal was not due predominantly to biogenic sulphide generation but to pH increase, i.e. metal (oxy)hydroxide and carbonate precipitation. Retained arsenic and metal removal were clearly associated to co-precipitation with and/or sorption on iron and aluminum (oxy)hydroxides. An improvement on the arsenic removal efficiency was achieved when the filling mixture contained zero-valent iron. Values of arsenic concentrations were then always below 10 microg/L.

Uncovering pathways in DNA oligonucleotide hybridization via transition state analysis.

DNA hybridization plays a central role in biology and, increasingly, in materials science. Yet, there is no precedent for examining the pathways by which specific single-stranded DNA sequences interact to assemble into a double helix. A detailed model of DNA is adopted in this work to examine such pathways and to determine the role of sequence, if any, on DNA hybridization. Transition path sampling simulations reveal that DNA rehybridization is prompted by a distinct nucleation event involving molecular sites with approximately four bases pairing with partners slightly offset from those involved in ideal duplexation. Nucleation is promoted in regions with repetitive base pair sequence motifs, which yield multiple possibilities for finding complementary base partners. Repetitive sequences follow a nonspecific pathway to renaturation consistent with a molecular "slithering" mechanism, whereas random sequences favor a restrictive pathway involving the formation of key base pairs before renaturation fully ensues.

Effect of trehalose on amyloid beta (29-40)-membrane interaction.

A growing body of experimental evidence indicates that the interaction between amyloid beta peptide and lipid bilayer membranes plays an important role in the development of Alzheimer disease. Recent experimental evidence also suggests that trehalose, a simple disaccharide, reduces the toxicity of amyloid beta peptide. Molecular simulations are used to examine the effect of trehalose on the conformational stability of amyloid beta peptide in aqueous solution and its effect on the interaction between amyloid beta peptide and a model phospholipid bilayer membrane. It is found that, in aqueous solution, the peptide exhibits a random coil conformation but, in the presence of trehalose, it adopts an alpha helical conformation. It is then shown that the insertion of amyloid beta peptide into a membrane is more favorable when the peptide is folded into an alpha-helix than in a random coil conformation, thereby suggesting that trehalose promotes the insertion of alpha-helical amyloid beta into biological membranes.