Loudness (annoyance), prediction procedure for steady sounds

Method has been devised to predict loudness level of any steady sound solely from its measured power spectrum level. Method is based on assumption that, with respect to loudness sensation, the human auditory system acts as open-loop transmission system with transmittance function determined from measured tone curves

The contribution of epidemiology to defining the most appropriate approach to genetic research on schizophrenia

AbstractPsychosis is thought to have a strong genetic component, but many efforts to discover the underlying putative schizophrenia genes have yielded disappointing results. In fact, no strong associations emerged in the first genome-wide association studies in psychiatry and weakly observed associations were not related to the candidate genes identified in previous studies. These partially successful findings may be explained by the fact that genetic research in psychiatry suffers from confounding issues related to phenotype definition, the considerable degree of phenotypic variability and diagnostic uncertainty, absence of specific neuropathological features and environmental influences. To make progress it is first necessary to deconstruct psychosis based on symptomatology, and then to correlate particular phenotypes with genetic variants. Moreover, it is time to conduct studies that define persistent aspects of the schizophrenic profile that are more likely to represent an underlying biological pathogenesis, as opposed to fluctuating symptoms that are possibly environmentally mediated. In fact, progress in understanding the etiology of schizophrenia will depend upon the availability of good measures of genetic liability as well as relevant environmental exposures during critical periods of an individual's life. If environmental and/or genetic factors are not precisely measured, it is impossible to study their independent effects or interactions

Failure of an Embankment on Soft Clay

The failure of an embankment during its construction on soft clay foundation is investigated. Field and laboratory data are used in conventional slope stability analyses to explain the cause of the failure and to evaluate the in-situ undrained shear strength of the clay which was later used in the design of the replacement dike. The results indicate that whereas the stiff embankment having a well compacted core was initially stable on the soft clay, subsequent cracking of the core due to undrained deformations reduced the shearing resistance of the dike thus, initiating the failure. The dike was eventually reconstructed in stages allowing enough time between stages for the foundation clay to consolidate and increase its shear strength. In the new dike a granular material was used in order to provide flexibility and to prevent cracking of the dike. In addition, long berms were placed on both sides of the dike to increase its stability. Field instruments including piezometers and inclinometers were used to monitor the rate of the stage construction of the new dike

Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care?

Background: Similar to other health care sectors, mental health has moved towards the secondary prevention, with the effort to detect and treat mental disorders as early as possible. However, converging evidence sheds new light on the potential of primary preventive and promotion strategies for mental health of young people. We aimed to reap- praise such evidence. Methods: We reviewed the current state of knowledge on delivering promotion and preventive interventions addressing youth mental health. Results: Half of all mental disorders start by 14 years and are usually preceded by non-specific psychosocial distur- bances potentially evolving in any major mental disorder and accounting for 45% of the global burden of disease across the 0\u201325 age span. While some action has been taken to promote the implementation of services dedicated to young people, mental health needs during this critical period are still largely unmet. This urges redesigning preven- tive strategies in a youth-focused multidisciplinary and trans-diagnostic framework which might early modify possible psychopathological trajectories. Conclusions: Evidence suggests that it would be unrealistic to consider promotion and prevention in mental health responsibility of mental health professionals alone. Integrated and multidisciplinary services are needed to increase the range of possible interventions and limit the risk of poor long-term outcome, with also potential benefits in terms of healthcare system costs. However, mental health professionals have the scientific, ethical, and moral responsibility to indicate the direction to all social, political, and other health care bodies involved in the process of meeting mental health needs during youth years

A Comparison of PCA-LDA and PLS-DA Techniques for Classification of Vibrational Spectra

Vibrational spectroscopies provide information about the biochemical and structural environment of molecular functional groups inside samples. Over the past few decades, Raman and infrared-absorption-based techniques have been extensively used to investigate biological materials under different pathological conditions. Interesting results have been obtained, so these techniques have been proposed for use in a clinical setting for diagnostic purposes, as complementary tools to conventional cytological and histological techniques. In most cases, the differences between vibrational spectra measured for healthy and diseased samples are small, even if these small differences could contain useful information to be used in the diagnostic field. Therefore, the interpretation of the results requires the use of analysis techniques able to highlight the minimal spectral variations that characterize a dataset of measurements acquired on healthy samples from a dataset of measurements relating to samples in which a pathology occurs. Multivariate analysis techniques, which can handle large datasets and explore spectral information simultaneously, are suitable for this purpose. In the present study, two multivariate statistical techniques, principal component analysis-linear discriminate analysis (PCA-LDA) and partial least square-discriminant analysis (PLS-DA) were used to analyse three different datasets of vibrational spectra, each one including spectra of two different classes: (i) a simulated dataset comprising control-like and exposed-like spectra, (ii) a dataset of Raman spectra measured for control and proton beam-exposed MCF10A breast cells and (iii) a dataset of FTIR spectra measured for malignant non-metastatic MCF7 and metastatic MDA-MB-231 breast cancer cells. Both PCA-LDA and PLS-DA techniques were first used to build a discrimination model by using calibration sets of spectra extracted from the three datasets. Then, the classification performance was established by using test sets of unknown spectra. The achieved results point out that the built classification models were able to distinguish the different spectra types with accuracy between 93% and 100%, sensitivity between 86% and 100% and specificity between 90% and 100%. The present study confirms that vibrational spectroscopy combined with multivariate analysis techniques has considerable potential for establishing reliable diagnostic models

Randomized phase II clinical trial of chemo-immunotherapy in advanced nonsmall cell lung cancer

The purpose of this study was to compare chemotherapy-naive patients with stage IV nonsmall cell lung cancer patients treated with chemotherapy or chemoimmunotherapy. We tested doxetacel plus cisplatinum as chemotherapy protocol. An immunomodulatory adjuvant system was added as chemoimmunotherapy to the previously mentioned protocol. This system contains three well-known and complementary conditioners of protective immune-responses: cyclophosphamide low-dose, granulocyte macrophage-colony stimulant factor and magnesium silicate granuloma. Eighty-eight patients were randomly assigned to receive every 3-weeks one of the treatments under comparison. Patients received four cycles of treatment unless disease progression or unacceptable toxicity was documented. The maximum follow-up was one year. In each arm, tumor response (rate,duration), median survival time, 1-year overall survival, safety, and immunity modifications were assessed. Immunity was evaluated by submitting peripheral blood mononuclear cells to laboratory tests for nonspecific immunity: a) phytohemaglutinin-induced lymphocyte proliferation, b) prevalence of T-Regulatory (CD4+CD25+) cells and for specific immunity: a) lymphocyte proliferation induced by tumor-associated antigens (TAA) contained in a previously described autologous thermostable hemoderivative. The difference (chemotherapy vs. chemoimmunotherapy) in response rate induced by the two treatments (39.0% and 35.0%) was not statistically significant. However, the response duration (22 and 31 weeks), the median survival time (32 and 44 weeks) and 1-year survival (33.3% and 39.1%) were statistically higher with chemoimmunotherapy. No difference in toxicity between both arms was demonstrated. A switch in the laboratory immunity profile, nonspecific and specific, was associated with the chemoimmunotherapy treatment: increase of proliferative lymphocyte response, decrease of tolerogenic T-regulatory cells and eliciting TAA-sensitization

Burden of disease of chronic pain in Ecuador

Estimar la carga de enfermedad relacionada con el dolor crónico en el Ecuador. Métodos Utilizamos métodos de carga global de enfermedad (GBD) para estimar los años de vida ajustados por discapacidad (AVAD) relacionados con el dolor crónico en Ecuador relacionado con el dolor lumbar, la osteoartritis, la neuralgia posherpética, la neuropatía diabética, el dolor relacionado con el cáncer y otros dolores musculoesqueléticos. . Estimamos los casos prevalentes por sexo y grupo de edad utilizando datos de la literatura. Solo estimamos los años vividos con discapacidad utilizando ponderaciones de discapacidad obtenidas del GBD, con el supuesto de que ninguna muerte prematura estaría relacionada con el dolor. Utilizamos un enfoque basado en la prevalencia para estimar los casos por sexo y grupo de edad utilizando la literatura, sin descuentos ni ajustes por edad. Calculamos los AVAD totales y los AVAD/100.000 habitantes. Resultados Nuestra estimación arrojó un total de 3.644.108 pacientes con dolor crónico. Producirían 256.090 AVAD o 1.483 AVAD/100.000 habitantes atribuibles al dolor crónico. El dolor lumbar, la osteoartritis y el dolor relacionado con el cáncer fueron los impulsores de la producción de AVAD. Conclusiones El dolor crónico es una fuente importante de carga de enfermedad. Es comparable a otras causas importantes como dolores de cabeza, accidentes cerebrovasculares, diabetes y enfermedad pulmonar obstructiva crónica, entre otras. El dolor lumbar, la osteoartritis y otros dolores musculoesqueléticos fueron los mayores contribuyentes dada su alta prevalencia.Q2Q2Objectives To estimate the burden of disease related to chronic pain in Ecuador. Methods We used Global Burden of Disease (GBD) methods to estimated disability-adjusted life years (DALYs) related to chronic pain in Ecuador related to lumbar pain, osteoarthritis, post-herpetic neuralgia, diabetic neuropathy, cancer-related pain, and other musculoskeletal pain. We estimated the prevalent cases by sex and age group using literature data. We only estimated years lived with disability using disability weights obtained from the GBD, with the assumption that no premature death would be related to pain. We used a prevalence-based approach to estimate cases by sex and age group using literature, without discounting or age adjustment. We calculated total DALYs and DALYs/100,000 inhabitants. Results Our estimated yielded a total of 3,644,108 patients with chronic pain. They would produce 256,090 DALYs or 1,483 DALYs/100,000 inhabitants attributable to chronic pain. Low back pain, osteoarthritis and cancer-related pain were the drivers of DALY production. Conclusions Chronic pain is an important source of burden of disease. It is comparable to other important causes such as headaches, stroke, diabetes and chronic obstructive pulmonary disease, among others. Low back pain, osteoarthritis and other musculoskeletal pain were the biggest contributors given their high prevalence.Revista Internacional - IndexadaS

Should we be concerned about stigma and discrimination in people at risk for psychosis? A systematic review.

AbstractBackgroundPrevious studies have provided initial evidence that people at risk for psychosis (PR) suffer from stigma and discrimination related to their condition. However, no study has systematically reviewed stigma and discrimination associated with being at PR and the potential underlying mechanisms.MethodsThis work aimed to systematically review all studies addressing stigma and discrimination in PR people in order to assess: (1) the occurrence of this phenomenon and its different components (public, internalized, perceived, and labeling-related), (2) whether stigma affects outcomes of the PR state, and (3) whether other factors modulate stigma among PR individuals.ResultsThe reviewed studies (n = 38) widely differ in their design, methodological quality, and populations under investigation, thus limiting direct comparison of findings. However, converging evidence suggests that the general public endorses stigmatizing attitudes towards PR individuals, and that this is more frequent in people with a low educational level or with no direct experience of the PR state. PR individuals experience more internalized stigma and perceive more discrimination than healthy subjects or patients with non-psychotic disorders. Further, PR labeling is equally associated with both positive (e.g. validation and relief) and negative effects (e.g. status loss and discrimination). Moreover, stigma increases the likelihood of poor outcome, transition to full-psychosis, disengagement from services, and family stigma among PR individuals. Finally, very limited evidence awaiting replication supports the efficacy of cognitive therapies in mitigating the negative effects of stigma.ConclusionsEvidence confirms previous concerns about stigma and its negative consequences for PR individuals, thus having important public health implications