Cognition and functionality in delusional disorder.

BACKGROUND: Even if neurocognition is known to affect functional outcomes in schizophrenia, no previous study has explored the impact of cognition on functionality in delusional disorder (DD). We aimed to assess the effect of clinical characteristics, symptom dimensions and neuropsychological performance on psychosocial functioning and self-perceived functional impairment in DD. METHODS: Seventy-five patients with a SCID-I confirmed diagnosis of DD underwent neurocognitive testing using a neuropsychological battery examining verbal memory, attention, working memory and executive functions. We assessed psychotic symptoms with the Positive and Negative Syndrome Scale, and calculated factor scores for four clinical dimensions: Paranoid, Cognitive, Affective and Schizoid. We conducted hierarchical linear regression models to identify predictors of psychosocial functioning, as measured with the Global Assessment of Functioning scale, and self-perceived functional impairment, as measured with the Sheehan's Disability Inventory. RESULTS: In the final linear regression models, higher scores in the Paranoid (β= 0.471, p < .001, r2 = 0.273) and Cognitive (β = 0.325, p < .001, r2 = 0.180) symptomatic dimensions and lower scores in verbal memory (β = -0.273, p < .05, r2 = 0.075) were significantly associated with poorer psychosocial functioning in patients with DD. Lower scores in verbal memory (β= -0.337, p < .01, r2 = 0.158) and executive functions (β= -0.323, p < .01, r2 = 0.094) were significantly associated with higher self-perceived disability. CONCLUSIONS: Impaired verbal memory and cognitive symptoms seem to affect functionality in DD, above and beyond the severity of the paranoid idea. This suggests a potential role for cognitive interventions in the management of DD

Brave new world: expanding home care in stem cell transplantation and advanced therapies with new technologies

Hematopoietic stem cell transplantation and cell therapies like CAR-T are costly, complex therapeutic procedures. Outpatient models, including at-home transplantation, have been developed, resulting in similar survival results, reduced costs, and increased patient satisfaction. The complexity and safety of the process can be addressed with various emerging technologies (artificial intelligence, wearable sensors, point-of-care analytical devices, drones, virtual assistants) that allow continuous patient monitoring and improved decision-making processes. Patients, caregivers, and staff can also benefit from improved training with simulation or virtual reality. However, many technical, operational, and above all, ethical concerns need to be addressed. Finally, outpatient or at-home hematopoietic transplantation or CAR-T therapy creates a different, integrated operative system that must be planned, designed, and carefully adapted to the patient's characteristics and distance from the hospital. Patients, clinicians, and their clinical environments can benefit from technically improved at-home transplantation.Funding: The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article. Acknowledgments: The authors thank Jonathan McFarland for his invaluable help with the English version of the manuscript

Anàlisi de les accions defensives del porter en el futbol 7

L’anàlisi de la competició serà un mitjà per millorar el coneixement del joc del porter des d’una perspectiva física i tecnicotàctica. A més a més, suposarà una font d’informació per a l’organització i el disseny de les tasques específiques per a l’entrenament del porter, que han d’assegurar un treball en què es realitzin situacions semblants a la mateixa competició. Per tal de desenvolupar el joc defensiu, el porter ha de coordinar les seves accions amb la defensa del seu equip i, alhora, el joc defensiu de l’equip estarà condicionat per l’atac de l’equip contrari. Per això, per analitzar l’aportació del porter en el joc defensiu de l’equip, es va valorar l’atac contrari, l’acció tècnica defensiva, l’acció física i la zona d’intervenció on realitza l’acció el porter. La mostra de l’estudi la formaven 34 porters de les seleccions nacionals participants en 56 partits del Mundial de Corea i el Japó 2002. L’instrument d’observació que es va utilitzar va ser el sistema de categories. Abans de la recollida de les dades es va realitzar l’entrenament dels observadors, per a la qual cosa es va fer servir la metodologia exposada per Behar (1993). Es van utilitzar 5 observadors i es va establir un índex de confiança (Coeficient de Correlació Intraclasse o Índex de Kappa) del 0,95. Es va realitzar una anàlisi estadística de caràcter descriptiu, dintre de la qual es van calcular les mitjanes, desviacions típiques, mínims i màxims dels comportaments efectuats pels diferents porters; es va utilitzar el programa estadístic SPSS.11.5

Diversity of respiratory viruses present in nasal swabs under influenza suspicion in respiratory disease cases of weaned pigs

Respiratory diseases in weaned pigs are a common problem, with a complex etiology involving both viruses and bacteria. In the present study, we investigated the presence of eleven viruses in nasal swabs, collected from nurseries (55 cases) under the suspicion of swine influenza A virus (swIAV) and submitted by swine veterinarians for diagnosis. The other ten viruses included in the study were influenza B (IBV) and D (IDV), Porcine reproductive and respiratory syndrome virus (PRRSV), Porcine respiratory coronavirus (PRCV), Porcine cytomegalovirus (PCMV), Porcine circovirus 2 (PCV2), 3 (PCV3) and 4 (PCV), Porcine parainfluenza 1 (PPIV1) and Swine orthopneumovirus (SOV). Twenty-six swIAV-positive cases and twenty-nine cases of swIAV-negative respiratory disease were primarily established. While IBV, IDV, PCV4 and PPIV1 were not found in any of the cases, PRCV, SOV, and PCMV were more likely to be found in swIAV-positive nurseries with respiratory disease (p < 0.05). Overall, PCV3, PRRSV, and PCMV were the most frequently detected agents at herd level. Taken individually, virus prevalence was: swIAV, 48.6%; PRCV, 48.0%; PRRSV, 31.6%; SOV, 33.8%; PCMV, 48.3%, PCV2, 36.0%; and PCV3, 33.0%. Moreover, low Ct values (<30) were common for all agents, except PCV2 and PCV3. When the correlation between pathogens was individually examined, the presence of PRRSV was negatively correlated with swIAV and PRCV, while was positively associated to PCMV (p < 0.05). Also, PRCV and SOV were positively correlated between them and negatively with PCMV. Besides, the analysis of suckling pig samples, collected in subclinically infected farrowing units under an influenza monitoring program, showed that circulation of PRCV, PCMV, SOV, and PCV3 started during the early weeks of life. Interestingly, in those subclinically infected units, none of the pathogens was found to be correlated to any other. Overall, our data may contribute to a better understanding of the complex etiology and epidemiology of respiratory diseases in weaners. This is the first report of SOV in Spain and shows, for the first time, the dynamics of this pathogen in swine farms

Brave new world: expanding home care in stem cell transplantation and advanced therapies with new technologies

Hematopoietic stem cell transplantation and cell therapies like CAR-T are costly, complex therapeutic procedures. Outpatient models, including at-home transplantation, have been developed, resulting in similar survival results, reduced costs, and increased patient satisfaction. The complexity and safety of the process can be addressed with various emerging technologies (artificial intelligence, wearable sensors, point-of-care analytical devices, drones, virtual assistants) that allow continuous patient monitoring and improved decision-making processes. Patients, caregivers, and staff can also benefit from improved training with simulation or virtual reality. However, many technical, operational, and above all, ethical concerns need to be addressed. Finally, outpatient or at-home hematopoietic transplantation or CAR-T therapy creates a different, integrated operative system that must be planned, designed, and carefully adapted to the patient’s characteristics and distance from the hospital. Patients, clinicians, and their clinical environments can benefit from technically improved at-home transplantation

ARMAZENAMENTO ESPARSO NO PRÉ-CONDICIONAMENTO PARA O MÉTODO ITERATIVO GMRES, APLICADO À SOLUÇÃO DE FLUXO DE POTÊNCIA

Com a crescente expansão dos sistemas elétricos de energia, cada vez mais aumenta-se as dificuldades em manter o estado seguro das redes de energia elétrica e seu continuo funcionamento, que ao sofrer perturbações podem acarretar no seu desligamento parcial ou total. Portanto é de extrema relevância para os órgãos responsáveis pela coordenação e controle da operação da transmissão de energia elétrica, contar com simuladores computacionais que agreguem modelos matemáticos complexos e métodos numéricos eficientes com o intuito de garantir a segurança do Sistema Elétrico de Potência. Este trabalho busca integralizar e aproveitar adequadamente os avanços na área de métodos numéricos usufruindo de suas características e testando-os no problema de fluxo de potência. Propondo novas estratégias para o pré-condicionamento com intuito de melhorar significativamente o desempenho do método iterativo. Com o uso destas estratégias, também deverá ser possível solucionar sistemas lineares relativos ao subproblema linear de fluxo de potência que envolve matrizes mal-condicionadas, próximas da singularidade e/ou indefinidas, decorrentes de cenários de condições operacionais adversas, que comumente os solucionadores diretos não conseguem solucionar. Para tanto, o algoritmo realiza o armazenamento da matriz Jacobiana de forma esparsa. Em seguida, com intuito de minimizar as operações e melhorar a estabilidade numérica durante fatoração, efetua-se o reordenamento. Subsequente realiza-se a decomposição em fatores triangulares (LU) e por fim, a solução do sistema. O processo é repetido para cada iteração Newton-Raphson do algoritmo de fluxo de potência. Novas estratégias numéricas são propostas e testadas tanto no processo de armazenamento como na fatoração triangular esparsa

Diferencias de género en el trastorno delirante.

El objetivo de nuestro estudio fue explorarlas diferencias de género en trastorno delirante (TD)comparando aspectos sociodemográficos, factores deriesgo, correlatos clínicos y características del curso deltrastorno. La muestra se compuso de 50 pacientes conprimer ingreso psiquiátrico y con diagnóstico de TD(según SCID-I para criterios DSM-IV). Los casos fueronevaluados retrospectivamente mediante la revisiónde historia clínicas mediante el cuestionario OPCRIT4.0 y un inventario diseñado por los autores que comprendiódistintos aspectos clínicos no recogidos en elanterior instrumento. La proporción mujer-hombre fuede 1.27:1. La edad del primer ingreso psiquiátrico fuemás alta en mujeres. Respecto a los potenciales factoresde riesgo, los hombres presentaron mayor prevalenciade Trastornos por uso de sustancias premórbido mientraslas mujeres más retraimiento social y síntomasdepresivos previos al inicio del trastorno. En relacióna la sintomatología delirante, los hombres presentaronmayor frecuencia de delirios generalizados, de grandiosidad,de celos y persecución; mientras que las mujerespresentaron mayor frecuencia de delirio erotomaniacoasí como percepciones y humor delirantes. Los hombrespresentaron mayor frecuencia de aumento de laestima del Self y las mujeres insomnio inicial y de medianoche. No se observaron diferencias de género enotros factores sociodemográficos, potenciales factoresde riesgo, correlatos clínicos y características del cursode la enfermedad

Depresión en adultos mayores con enfermedades crónicas en un hospital general del Perú*

Objetivo: Determinar la frecuencia y características asociadas a la depresión en adultos mayores con enfermedades crónicas que acuden a un hospital del segundo nivel de atención. Material y métodos: Se desarrolló un estudio observacional, descriptivo y transversal en pacientes adultos mayores con enfermedades crónicas que acudían a los servicios de Medicina, Cardiología y Neurología del Hospital Santa María del Socorro durante el mes de enero 2015. La muestra estuvo constituida por 117 pacientes hombres y mujeres de 60 a más años de edad con enfermedad crónica, que hablaban español, con capacidad de decisión y que aceptaron participar del estudio mediante la firma del consentimiento informado. Se usó el cuestionario de Yesavage para evaluar la depresión. Resultados: La frecuencia de depresión fue 64,96% (76 casos), 47 (40,17%) pacientes con depresión leve y 29 (24,79%) con depresión establecida. Estuvo presente en 53 (74,65%) de las mujeres (p=0,023); en 52 (98,11%) de los soltero(a)/viudo(a)/divorciado(a) (p&lt;0,00); en 23 (100%) de los que vivían solos (p&lt;0,00); en 53 (75, 71%) de los que no trabajaban (p=0,005); en 33 (85,71%) de los pacientes con hipertensión arterial (p&lt;0,00); en 41 (77,36%) de los pacientes con diabetes mellitus tipo 2 (p=0,031); y en 32 (54,24%) de los pacientes con deterioro cognitivo leve (p=0,016). Conclusiones: La frecuencia de depresión en pacientes adultos mayores con enfermedad crónica es elevada y está relacionada al sexo, estado civil, convivencia, actividad laboral, presencia de hipertensión arterial, diabetes mellitus tipo 2 y deterioro cognitivo en el paciente adulto mayor. *&nbsp;Basado en la Tesis " DEPRESION EN ADULTOS MAYORES CON ENFERMEDADES CRÓNICAS EN UN HOSPITAL GENERAL DEL PERÚ, 2015" -presentada y sustentada por los(as) bachilleres Claudia Yesenia Consuelo De la Cruz Mitac, Enory Elvira Lizarzaburu Córdova y Miguel Angel Portugal Medrano para optar el título de Médico Cirujano en la Facultad de Medicina Humana – UNSLG (Ica, Perú)

Calidad de vida y su relación con la malnutrición en el adulto mayor de la provincia de Ica: Quality of life and its relationship with malnutrition in the elderly adult of the province of Ica

Objetive: To determine the relationship between the quality of life and malnutrition of the elderly in the province of Ica in the year 2015.&nbsp;Methods: An observational, descriptive and prospective study was conducted in a population of 29 937 senior citizens of the province of Ica. The sample consisted of 138 older adults (60 to more years of age) who agreed to participate in the study by consent informed or informed consent of the relative. They were used; the WHOQOL-OLD survey and the Mini Nutritional Assessment to assess quality of life and nutritional status, respectively.&nbsp;Results: The unweighted total score obtained through the WHOQOL-OLD instrument was 87.0 or less in 50% of older adults. When older adults presented malnutrition, the score was 68.63 ± 3.40, when there was a risk of malnutrition it was 82.15 ± 1.34 and 90.08 ± 1.32 in the presence of satisfactory nutrition (p = 0.000).&nbsp;Conclusion: The quality of life of the elderly is related to the nutritional status. In the presence of malnutrition there is a lower overall quality of life and in its domains: functioning of the sensory, autonomy, past, present and future activities, social participation, privacy. DOI 10.25176/RFMH.v18.n4.1734Objetivo: Determinar la relación entre la calidad de vida y la malnutrición del adulto mayor en la provinciade Ica en el año 2015.&nbsp;Métodos: Se realizó un estudio observacional, descriptivo y prospectivo, en unapoblación de 29 937 adultos mayores de la provincia de Ica. La muestra estuvo conformada por 138adultos mayores (60 a más años de edad) que aceptaron participar del estudio mediante consentimientoinformado o asentimiento informado del familiar. Se usaron; la encuesta WHOQOL-OLD y el Mini Nutritional Assessment para valorar la calidad de vida y el estado nutricional, respectivamente.&nbsp;Resultados: El puntaje total no ponderado obtenido a través del instrumento WHOQOL-OLD fue 87,0 o menos en el 50% de los adultos mayores. Cuando los adultos mayores presentaron malnutrición el puntaje fue 68,63±3,40, cuando hubo riesgo de malnutrición fue 82,15±1,34 y 90,08±1,32&nbsp;en presencia de nutrición satisfactoria (p=0,000).&nbsp;Conclusión: La calidad de vida del adulto mayor está relacionada con el estado nutricional.En presencia de malnutrición existe menor calidad de vida global y en sus dominios: funcionamiento delsensorio, autonomía, actividades pasadas, presentes y futuras, participación social, intimidad. DOI 10.25176/RFMH.v18.n4.173