The impact of psychiatric diagnosis on treatment adherence and duration among victimized children and adolescents in São Paulo, Brazil

OBJECTIVE: Despite the high prevalence of substance abuse and mood disorders among victimized children and adolescents, few studies have investigated the association of these disorders with treatment adherence, represented by numbers of visits per month and treatment duration. We aimed to investigate the effects of substance abuse and mood disorders on treatment adherence and duration in a special program for victimized children in São Paulo, Brazil. METHODS: A total of 351 participants were evaluated for psychiatric disorders and classified into one of five groups: mood disorders alone; substance abuse disorders alone; mood and substance abuse disorders; other psychiatric disorders; no psychiatric disorders. The associations between diagnostic classification and adherence to treatment and the duration of program participation were tested with logistic regression and survival analysis, respectively. RESULTS: Children with mood disorders alone had the highest rate of adherence (79.5%); those with substance abuse disorders alone had the lowest (40%); and those with both disorders had an intermediate rate of adherence (50%). Those with other psychiatric disorders and no psychiatric disorders also had high rates of adherence (75.6% and 72.9%, respectively). Living with family significantly increased adherence for children with substance abuse disorders but decreased adherence for those with no psychiatric disorders. The diagnostic correlates of duration of participation were similar to those for adherence. CONCLUSIONS: Mood and substance abuse disorders were strong predictive factors for treatment adherence and duration, albeit in opposite directions. Living with family seems to have a positive effect on treatment adherence for patients with substance abuse disorders. More effective treatment is needed for victimized substance-abusing youth

Impact of ocean acidification on phytoplankton growth and aggregation

Since the industrial revolution, the ocean has absorbed around one third of the anthropogenic CO2, which induced a profound alteration of the carbonate system commonly known as ocean acidification. Since the preindustrial times, the average ocean surface water pH has fallen by 0.1 units, from approximately 8.2 to 8.1 and a further decrease of 0.4 pH units is expected for the end of the century. Despite their microscopic size, marine diatoms are bio-geo-chemically a very important group, responsible for the export of massive amount of carbon to deep waters and sediments. The knowledge of the potential effects of ocean acidification on the phytoplankton growth and on biological pump is still at its infancy. This study wants to investigate the effect of ocean acidification on the growth of the diatom Skeletonema marinoi and on its aggregation, using a mechanistic approach. The experiment consisted of two treatments (Present and Future) representing different pCO2 conditions and two sequential experimental phases. During the cell growth phase a culture of S. marinoi was inoculated into transparent bags and the effect of ocean acidification was studied on various growth parameters, including DOC and TEP production. The aggregation phase consisted in the incubation of the cultures into rolling tanks where the sinking of particles through the water column was simulated and aggregation promoted. Since few studies investigated the effect of pH on the growth of S. marinoi and none used pH ranges that are compatible with the OA scenarios, there were no baselines. I have shown here, that OA does not affect the cell growth of S. marinoi, suggesting that the physiology of this species is robust in respect to the changes in the carbonate chemistry expected for the end of the century. Furthermore, according to my results, OA does not affect the aggregation of S. marinoi in a consistent manner, suggesting that this process has a high natural variability but is not influenced by OA in a predictable way. The effect of OA was tested over a variety of factors including the number of aggregates produced, their size and sinking velocity, the algal, bacterial and TEP content. Many of these variables showed significant treatment effects but none of these were consistent between the two experiments.

The impact of ice crystals on radiative forcing and remote sensing of arctic boundary-layer mixed-phase clouds

This PhD thesis is embedded into the Arctic Study of Tropospheric Aerosol, Clouds and Radiation (ASTAR) and investigates the radiative transfer through Arctic boundary-layer mixed-phase (ABM) clouds. For this purpose airborne spectral solar radiation measurements and simulations of the solar and thermal infrared radiative transfer have been performed. This work reports on measurements with the Spectral Modular Airborne Radiation measurement sysTem (SMART-Albedometer) conducted in the framework of ASTAR in April 2007 close to Svalbard. For ASTAR the SMART-Albedometer was extended to measure spectral radiance. The development and calibration of the radiance measurements are described in this work. In combination with in situ measurements of cloud particle properties provided by the Laboratoire de M¶et¶eorologie Physique (LaMP) and simultaneous airborne lidar measurements by the Alfred Wegener Institute for Polar and Marine Research (AWI) ABM clouds were sampled. The SMART-Albedometer measurements were used to retrieve the cloud thermodynamic phase by three different approaches. A comparison of these results with the in situ and lidar measurements is presented in two case studies. Beside the dominating mixed-phase clouds pure ice clouds were found in cloud gaps and at the edge of a large cloud field. Furthermore the vertical distribution of ice crystals within ABM clouds was investigated. It was found that ice crystals at cloud top are necessary to describe the observed SMART-Albedometer measurements. The impact of ice crystals on the radiative forcing of ABM clouds is in vestigated by extensive radiative transfer simulations. The solar and net radiative forcing was found to depend on the ice crystal size, shape and the mixing ratio of ice crystals and liquid water droplets.

The impact of swine welfare on some qualitative traits of meat and long cured animal derived products

The present dissertation collects the results of three different research trials which have the common aim to understand the effects of swine welfare (both at farm level and during transport) on the main fresh and dry-cured meat characteristics. The first trial was carried out in order to compare the effects of illumination regimes differing in light duration or light intensity on meat and ham quality of Italian heavy pigs. The results of this trial support the conclusion that, within a moderate range of light intensity and given an appropriate dark period for animal rest, an increase of light duration or intensity above the minimum mandatory levels has no negative impact on carcass composition, meat or long-cured hams quality. The second trial was designed with the aim to investigate the effects of water restriction on growth traits, animal welfare and meat and ham quality of liquid-fed heavy pigs. Overall, the parameters analyzed as concerns growth rate, behavioural traits, blood, as well as carcass, fresh meat and cured hams quality were not affected by the absence of fresh drinking water. However, since liquid feeding did not suppress drinker use or drinker manipulation in the experimental groups, water restriction does not appear to be an applicable method to obtain a reduction of water waste. The third trial, which was carried out in Canada, tested the effectiveness of water sprinkling market-weight pigs (115±10Kg BW) before and after transport in reducing the heat stress experienced under commercial transport conditions. Our results show that the water sprinkling protocol proposed may reduce heat stress during transport and improve pork quality, particularly in specific trailer compartments. This body of research supports the general conclusion that swine welfare could be improved in different scenarios through simple and cost-effective means, without negatively affecting the quality of the main animal-derived products.

The impact of cardiac rehabilitation on lifestyles, psychological correlates and the clinical course of cardiac disease

Objectives: The aim of this research was to evaluate the impact of Cardiac Rehabilitation (CR) on risky lifestyles, quality of life, psychopathology, psychological distress and well-being, considering the potential moderating role of depression, anxiety and psychosomatic syndromes on lifestyles modification. The influence of CR on cardiac morbidity and mortality was also evaluated. Methods: The experimental group (N=108), undergoing CR, was compared to a control group (N=85) of patients affected by cardiovascular diseases, not undergoing CR, at baseline and at 1-month, 6- and 12-months follow-ups. The assessment included: the Structured Clinical Interview for DSM-IV, the structured interview based on Diagnostic Criteria for Psychosomatic Research (DCPR), GOSPEL questionnaire on lifestyles, Pittsburgh Sleep Quality Index, Morisky Medication Adherence Scale, MOS 36-Item Short Form Health Survey, Symptom Questionnaire, Psychological Well-Being Scale and 14-items Type D Scale. Results: Compared to the control group, CR was associated to: maintenance of the level of physical activity, improvement of correct dietary behaviors and stress management, enhancement of quality of life and sleep; reduction of the most frequently observed psychiatric diagnoses and psychosomatic syndromes at baseline. On the contrary, CR was not found to be associated with: healthy dietary habits, weight loss and improvement on medications adherence. In addition, there were no relevant effects on sub-clinical psychological distress and well-being, except for personal growth and purpose in life (PWB). Also, CR did not seem to play a protective role against cardiac recurrences. The presence of psychosomatic syndromes and depressive disorders was a mediating factor on the modification of specific lifestyles. Conclusions: The findings highlight the need of a psychosomatic assessment and an evaluation of psychological sub-clinical symptomatology in cardiac rehabilitation, in order to identify and address specific factors potentially associated with the clinical course of the heart disease.

Investigations on DNA methylation by Dnmt2 and impact of tRNA modifications on TLR7 stimulation

The incorporation of modified nucleotides into ribonucleic acids (RNAs) is important for their structure and proper function. These modifications are inserted by distinct catalytic macromolecules one of them being Dnmt2. It methylates the Cytidine (C) at position 38 in tRNA to 5-methylcytidine (m5C). Dnmt2 has been a paradigm in this respect, because all of its nearest neighbors in evolution are DNA-cytosine C5-methyltransferases and methylate DNA, while its (own) DNA methyltransferase activity is the subject of controversial reports with rates varying between zero and very weak. This work determines whether the biochemical potential for DNA methylation is present in the enzyme. It was discovered that DNA fragments, when presented as covalent RNA:DNA hybrids in the structural context of a tRNA, can be more efficiently methylated than the corresponding natural tRNA substrate. Additional minor deviations from a native tRNA structure that were seen to be tolerated by Dnmt2 were used for a stepwise development of a composite system of guide RNAs that enable the enzyme to perform cytidine methylation on single stranded DNA in vitro. Furthermore, a proof-of-principle is presented for utilizing the S-adenosyl methionine-analog cofactor SeAdoYn with Dnmt2 to search for new possible substrates in a SELEX-like approach.rnIn innate immunity, nucleic acids can function as pathogen associated molecular patterns (PAMPs) recognized by pattern recognition receptors (PRRs). The modification pattern of RNA is the discriminating factor for toll-like receptor 7 (TLR7) to distinguish between self and non-self RNA of invading pathogens. It was found that a 2'-O-methylated guanosine (Gm) at position18, naturally occurring at this position in some tRNAs, antagonizes recognition by TLR7. In the second part of this work it is pointed out, that recognition extends to the next downstream nucleotide and the effectively recognized molecular detail is actually a methylated dinucleotide. The immune silencing effect of the ribose methylation is most pronounced if the dinucleotide motif is composed of purin nucleobases whereas pyrimidines diminish the effect. Similar results were obtained when the Gm modification was transposed into other tRNA domains. Point mutations abolishing base pairings important for a proper tertiary structure had no effect on the immune stimulatory potential of a Gm modified tRNA. Taken together these results suggest a processive type of RNA inspection by TLR7.rn

Neuropsychological impairments and the impact of dystrophin mutations on general cognitive functioning of patients with Duchenne muscular dystrophy

Mutations in the dystrophin gene have long been recognised as a cause of mental retardation. However, for reasons that are unclear, some boys with dystrophin mutations do not show general cognitive deficits. To investigate the relationship between dystrophin mutations and cognition, the general intellectual abilities of a group of 25 boys with genetically confirmed Duchenne muscular dystrophy were evaluated. Furthermore, a subgroup underwent additional detailed neuropsychological assessment. The results showed a mean full scale intelligence quotient (IQ) of 88 (standard deviation 24). Patients performed very poorly on various neuropsychological tests, including arithmetics, digit span tests and verbal fluency. No simple relationship between dystrophin mutations and cognitive functioning could be detected. However, our analysis revealed that patients who lack the dystrophin isoform Dp140 have significantly greater cognitive problems.

The impact of frozen sections on final surgical margins in squamous cell carcinoma of the oral cavity and lips: a retrospective analysis over an 11 years period

Taking intraoperative frozen sections (FS) is a widely used procedure in oncologic surgery. However so far no evidence of an association of FS analysis and premalignant changes in the surgical margin exists. Therefore, the aim of this study was to evaluate the impact of FS on different categories of the final margins of squamous cell carcinoma (SCC) of the oral cavity and lips.

The impact of CpG island methylator phenotype and microsatellite instability on tumour budding in colorectal cancer

In colorectal cancer, tumour budding, a process likened to epithelial mesenchymal transition, is an adverse prognostic factor which is rarely found in tumours with high-level microsatellite instability (MSI-H). Cases with MSI-H or high-level CpG island methylator phenotype (CIMP-H) have similar histomorphological features, yet seemingly opposite prognosis. We hypothesized that tumour budding is related to CIMP, thus partially explaining this prognostic difference.