Tobacco smoking and nicotine dependence in first episode and established psychosis

Aim People with psychotic disorders have increased premature mortality in comparison with the general population, with high rates of cigarette use a contributing factor. We aimed to describe the prevalence of cigarette use and nicotine dependence (ND) in first episode psychosis (FEP), and established psychosis; and to investigate associations between clinical symptoms and ND. Methodology Smoking and clinical data were collected from two cohorts: 181 people with FEP recruited as part of the Physical Health and Substance Use Measures in First Onset Psychosis (PUMP) study and from 432 people with established psychosis recruited as part of the Improving physical health and reducing substance use in psychosis randomised controlled trial (IMPaCT RCT). Results The prevalence of cigarette smoking was 78% in FEP and 62% in established psychosis. Forty nine percent (n=60) of smokers in the FEP cohort and 69% (n=183) of smokers with established psychosis were highly nicotine dependent. Being a highly nicotine dependent smoker was significantly associated with higher PANSS positive symptom scores (F= 5.480 p= 0.004), and with decreased scores on the Rosenberg self-esteem scale (F=3.261, p=0.039) in established psychosis. There was no diagnostic specificity identified in relation to smoking or ND in both groups. Conclusion High rates of cigarette usage and nicotine dependence are problems from the early stages of psychosis. ND is higher in people with established psychosis. Smoking cessation strategies as part of comprehensive management of psychotic disorders at every stage require further development and evaluation

Management of acute diverticulitis with pericolic free gas (ADIFAS). an international multicenter observational study

Background: There are no specific recommendations regarding the optimal management of this group of patients. The World Society of Emergency Surgery suggested a nonoperative strategy with antibiotic therapy, but this was a weak recommendation. This study aims to identify the optimal management of patients with acute diverticulitis (AD) presenting with pericolic free air with or without pericolic fluid. Methods: A multicenter, prospective, international study of patients diagnosed with AD and pericolic-free air with or without pericolic free fluid at a computed tomography (CT) scan between May 2020 and June 2021 was included. Patients were excluded if they had intra-abdominal distant free air, an abscess, generalized peritonitis, or less than a 1-year follow-up. The primary outcome was the rate of failure of nonoperative management within the index admission. Secondary outcomes included the rate of failure of nonoperative management within the first year and risk factors for failure. Results: A total of 810 patients were recruited across 69 European and South American centers; 744 patients (92%) were treated nonoperatively, and 66 (8%) underwent immediate surgery. Baseline characteristics were similar between groups. Hinchey II-IV on diagnostic imaging was the only independent risk factor for surgical intervention during index admission (odds ratios: 12.5, 95% CI: 2.4-64, P =0.003). Among patients treated nonoperatively, at index admission, 697 (94%) patients were discharged without any complications, 35 (4.7%) required emergency surgery, and 12 (1.6%) percutaneous drainage. Free pericolic fluid on CT scan was associated with a higher risk of failure of nonoperative management (odds ratios: 4.9, 95% CI: 1.2-19.9, P =0.023), with 88% of success compared to 96% without free fluid ( P <0.001). The rate of treatment failure with nonoperative management during the first year of follow-up was 16.5%. Conclusion: Patients with AD presenting with pericolic free gas can be successfully managed nonoperatively in the vast majority of cases. Patients with both free pericolic gas and free pericolic fluid on a CT scan are at a higher risk of failing nonoperative management and require closer observation

An In Situ Evaluation of Different CAM Plants as Plant Microbial Fuel Cells for Energy Recovery in the Atacama Desert

Excess energy derived from photosynthesis can be used in plant microbial fuel cell (PMFC) systems as a sustainable alternative for the generation of electricity. In this study, the in situ performance of CAM (Crassulacean acid metabolism) plants in Calama, in the Atacama Desert, was evaluated for energy recovery using PMFCs with stainless steel AISI 316L and Cu as electrodes. The plant species evaluated included Aloe perfoliata, Cereus jamacaru, Austrocylindropuntia subulata, Agave potatorum, Aloe arborescens, Malephora crocea, and Kalanchoe daigremontiana. Among the plant species, Kalanchoe daigremontiana demonstrated significant potential as an in situ PMFC, showing a maximum cell potential of 0.248 V and a minimum of 0.139 V. In addition, the cumulative energy for recovery was about 9.4 mWh m−2 of the electrode. The use of CAM plants in PMFCs presents a novel approach for green energy generation, as these plants possess an inherent ability to adapt to arid environments and water-scarce areas such as the Atacama Desert climate