Clinical management and burden of bipolar disorder: a multinational longitudinal study (WAVE-bd Study)

BACKGROUND: Studies in bipolar disorder (BD) to date are limited in their ability to provide a whole-disease perspective--their scope has generally been confined to a single disease phase and/or a specific treatment. Moreover, most clinical trials have focused on the manic phase of disease, and not on depression, which is associated with the greatest disease burden. There are few longitudinal studies covering both types of patients with BD (I and II) and the whole course of the disease, regardless of patients' symptomatology. Therefore, the Wide AmbispectiVE study of the clinical management and burden of Bipolar Disorder (WAVE-bd) (NCT01062607) aims to provide reliable information on the management of patients with BD in daily clinical practice. It also seeks to determine factors influencing clinical outcomes and resource use in relation to the management of BD. METHODS: WAVE-bd is a multinational, multicentre, non-interventional, longitudinal study. Approximately 3000 patients diagnosed with BD type I or II with at least one mood event in the preceding 12 months were recruited at centres in Austria, Belgium, Brazil, France, Germany, Portugal, Romania, Turkey, Ukraine and Venezuela. Site selection methodology aimed to provide a balanced cross-section of patients cared for by different types of providers of medical aid (e.g. academic hospitals, private practices) in each country. Target recruitment percentages were derived either from scientific publications or from expert panels in each participating country. The minimum follow-up period will be 12 months, with a maximum of 27 months, taking into account the retrospective and the prospective parts of the study. Data on demographics, diagnosis, medical history, clinical management, clinical and functional outcomes (CGI-BP and FAST scales), adherence to treatment (DAI-10 scale and Medication Possession Ratio), quality of life (EQ-5D scale), healthcare resources, and caregiver burden (BAS scale) will be collected. Descriptive analysis with common statistics will be performed. DISCUSSION: This study will provide detailed descriptions of the management of BD in different countries, particularly in terms of clinical outcomes and resources used. Thus, it should provide psychiatrists with reliable and up-to-date information about those factors associated with different management patterns of BD. TRIAL REGISTRATION NO: ClinicalTrials.gov: NCT01062607.

Comparison of Setting Time Measured Using Ultrasonic Wave Propagation with Saw-Cutting Times on Pavements, TR-675, 2015

At present, there is little fundamental guidance available to assist contractors in choosing when to schedule saw cuts on joints. To conduct pavement finishing and sawing activities effectively, however, contractors need to know when a concrete mixture is going to reach initial set, or when the sawing window will open. Previous research investigated the use of the ultrasonic pulse velocity (UPV) method to predict the saw-cutting window for early entry sawing. The results indicated that the method has the potential to provide effective guidance to contractors as to when to conduct early entry sawing. The aim of this project was to conduct similar work to observe the correlation between initial setting and conventional sawing time. Sixteen construction sites were visited in Minnesota and Missouri over a two-year period. At each site, initial set was determined using a p-wave propagation technique with a commercial device. Calorimetric data were collected using a commercial semi-adiabatic device at a majority of the sites. Concrete samples were collected in front of the paver and tested using both methods with equipment that was set up next to the pavement during paving. The data collected revealed that the UPV method looks promising for early entry and conventional sawing in the field, both early entry and conventional sawing times can be predicted for the range of mixtures tested.

Are Simple Signatures So Easy to Simulate?

Is it possible to perfectly simulate a signature, in the particular and challenging case where the signature is simple? A set of signatures of six writers, considered to be simple on the basis of highlighted criteria, was sampled. These signatures were transferred to forgers requested to produce freehand simulations. Among these simulations, those capable of reproducing the features of the reference signatures were submitted for evaluation to forensic document experts through proficiency testing. The results suggest that there is no perfect simulation. With the supplementary aim of assessing the influence of forger's skills on the results, forgers were selected from three distinct populations, which differ according to professional criteria. The results indicate some differences in graphical capabilities between individuals. However, no trend could be established regarding age, degrees, years of practice and time dedicated to the exercise. The findings show that simulation is made easier if a graphical compatibility exists between the forger's own writing and the signature to be reproduced. Moreover, a global difficulty to preserve proportions and slant as well as the shape of capital letters and initials has been noticed.

The effect of workplace smoking bans on heart rate variability and pulse wave velocity of non-smoking hospitality workers

OBJECTIVES: To investigate the effect of a change in second-hand smoke (SHS) exposure on heart rate variability (HRV) and pulse wave velocity (PWV), this study utilized a quasi-experimental setting when a smoking ban was introduced. METHODS: HRV, a quantitative marker of autonomic activity of the nervous system, and PWV, a marker of arterial stiffness, were measured in 55 non-smoking hospitality workers before and 3-12 months after a smoking ban and compared to a control group that did not experience an exposure change. SHS exposure was determined with a nicotine-specific badge and expressed as inhaled cigarette equivalents per day (CE/d). RESULTS: PWV and HRV parameters significantly changed in a dose-dependent manner in the intervention group as compared to the control group. A one CE/d decrease was associated with a 2.3 % (95 % CI 0.2-4.4; p = 0.031) higher root mean square of successive differences (RMSSD), a 5.7 % (95 % CI 0.9-10.2; p = 0.02) higher high-frequency component and a 0.72 % (95 % CI 0.40-1.05; p < 0.001) lower PWV. CONCLUSIONS: PWV and HRV significantly improved after introducing smoke-free workplaces indicating a decreased cardiovascular risk.

Predicting spinor condensate dynamics from simple principles

We study the spin dynamics of quasi-one-dimensional F=1 condensates both at zero and finite temperatures for arbitrary initial spin configurations. The rich dynamical evolution exhibited by these nonlinear systems is explained by surprisingly simple principles: minimization of energy at zero temperature and maximization of entropy at high temperature. Our analytical results for the homogeneous case are corroborated by numerical simulations for confined condensates in a wide variety of initial conditions. These predictions compare qualitatively well with recent experimental observations and can, therefore, serve as a guidance for ongoing experiments.

A simple halide-to-anion exchange method for heteroaromatic salts and ionic liquids

A broad and simple method permitted halide ions in quaternary heteroaromatic and ammonium salts to be exchanged for a variety of anions using an anion exchange resin (A− form) in non-aqueous media. The anion loading of the AER (OH− form) was examined using two different anion sources, acids or ammonium salts, and changing the polarity of the solvents. The AER (A− form) method in organic solvents was then applied to several quaternary heteroaromatic salts and ILs, and the anion exchange proceeded in excellent to quantitative yields, concomitantly removing halide impurities. Relying on the hydrophobicity of the targeted ion pair for the counteranion swap, organic solvents with variable polarity were used, such as CH3OH, CH3CN and the dipolar nonhydroxylic solvent mixture CH3CN:CH2Cl2 (3:7) and the anion exchange was equally successful with both lipophilic cations and anions.

Brazilian maize genotypes sensitivity to water deficit estimated through a simple crop yield model

The objective of this work was to determine the sensitivity of maize (Zea mays) genotypes to water deficit, using a simple agrometeorological crop yield model. Crop actual yield and agronomic data of 26 genotypes were obtained from the Maize National Assays carried out in ten locations, in four Brazilian states, from 1998 to 2006. Weather information for each experimental location and period were obtained from the closest weather station. Water deficit sensitivity index (Ky) was determined using the crop yield depletion model. Genotypes can be divided into two groups according to their resistance to water deficit. Normal resistance genotypes had Ky ranging from 0.4 to 0.5 in vegetative period, 1.4 to 1.5 in flowering, 0.3 to 0.6 in fruiting, and 0.1 to 0.3 in maturing period, whereas the higher resistance genotypes had lower values, respectively 0.2-0.4, 0.7-1.2, 0.2-0.4, and 0.1-0.2. The general Ky for the total growing season was 2.15 for sensitive genotypes and 1.56 for the resistant ones. Model performance was acceptable to evaluate crop actual yield, whose average errors estimated for each genotype ranged from -5.7% to +5.8%, and whose general mean absolute error was 960 kg ha-1 (10%).

IOWATER Sustaining the Wave

Summary of the IOWATER Program and workshops offered.

Wave-height hazard analysis in Eastern Coast of Spain : Bayesian approach using generalized Pareto distribution

Standard practice of wave-height hazard analysis often pays little attention to the uncertainty of assessed return periods and occurrence probabilities. This fact favors the opinion that, when large events happen, the hazard assessment should change accordingly. However, uncertainty of the hazard estimates is normally able to hide the effect of those large events. This is illustrated using data from the Mediterranean coast of Spain, where the last years have been extremely disastrous. Thus, it is possible to compare the hazard assessment based on data previous to those years with the analysis including them. With our approach, no significant change is detected when the statistical uncertainty is taken into account. The hazard analysis is carried out with a standard model. Time-occurrence of events is assumed Poisson distributed. The wave-height of each event is modelled as a random variable which upper tail follows a Generalized Pareto Distribution (GPD). Moreover, wave-heights are assumed independent from event to event and also independent of their occurrence in time. A threshold for excesses is assessed empirically. The other three parameters (Poisson rate, shape and scale parameters of GPD) are jointly estimated using Bayes' theorem. Prior distribution accounts for physical features of ocean waves in the Mediterranean sea and experience with these phenomena. Posterior distribution of the parameters allows to obtain posterior distributions of other derived parameters like occurrence probabilities and return periods. Predictives are also available. Computations are carried out using the program BGPE v2.0

Rapid LC-MS/MS quantification of the major benzodiazepines and their metabolites on dried blood spots using a simple and cost-effective sample pretreatment.

BACKGROUND: Dried blood spots (DBS) sampling has gained popularity in the bioanalytical community as an alternative to conventional plasma sampling, as it provides numerous benefits in terms of sample collection and logistics. The aim of this work was to show that these advantages can be coupled with a simple and cost-effective sample pretreatment, with subsequent rapid LC-MS/MS analysis for quantitation of 15 benzodiazepines, six metabolites and three Z-drugs. For this purpose, a simplified offline procedure was developed that consisted of letting a 5-µl DBS infuse directly into 100 µl of MeOH, in a conventional LC vial. RESULTS: The parameters related to the DBS pretreatment, such as extraction time or internal standard addition, were investigated and optimized, demonstrating that passive infusion in a regular LC vial was sufficient to quantitatively extract the analytes of interest. The method was validated according to international criteria in the therapeutic concentration ranges of the selected compounds. CONCLUSION: The presented strategy proved to be efficient for the rapid analysis of the selected drugs. Indeed, the offline sample preparation was reduced to a minimum, using a small amount of organic solvent and consumables, without affecting the accuracy of the method. Thus, this approach enables simple and rapid DBS analysis, even when using a non-DBS-dedicated autosampler, while lowering the costs and environmental impact.

Simple and multiple resistances to viruses in cowpea genotypes

The objective of this work was to identify new sources of simple and multiple resistances to Cowpea severe mosaic virus (CPSMV), Cowpea aphid-borne mosaic virus (CABMV) and Cucumber mosaic virus (CMV) isolates in cowpea (Vigna unguiculata). Thirty-three genotypes from the germplasm bank of Universidade Federal do Ceará were tested as to their resistance to four CPSMV isolates, two CABMV isolates and one CMV isolate. Twenty-five days after the first virus inoculations, all inoculated plants, including the asymptomatic ones, were tested by serology. Genotypes were classified as: immune, plants without symptoms and negative serology; resistant, plants with mild mosaic and positive serology; susceptible, plants with mosaic and positive serology; and highly susceptible, plants with severe mosaic, other systemic symptoms, including systemic necrosis, and positive serology. Simple and multiple resistances to viruses were identified among the evaluated genotypes, but none of them showed multiple immunities to all isolates. Four genotypes showed immunity to all CPSMV isolates, two were immune to CABMV and two showed immunity to CMV. Eleven genotypes showed multiple resistances to two viruses, allowing for the development of new cultivars with more stable and broader resistance. Genotypes Purple Knuckle Hull-55, MNC-03-731C-21 and CNCx284-66E show resistance to CABMV, even when inoculated with CMV.

Seismic Wave Velocity as a Means of In-Place Density Measurement, Part 1, HR-114

Velocity-density tests conducted in the laboratory involved small 4-inch diameter by 4.58-inch-long compacted soil cylinders made up of 3 differing soil types and for varying degrees of density and moisture content, the latter being varied well beyond optimum moisture values. Seventeen specimens were tested, 9 with velocity determinations made along two elements of the cylinder, 180 degrees apart, and 8 along three elements, 120 degrees apart. Seismic energy was developed by blows of a small tack hammer on a 5/8-inch diameter steel ball placed at the center of the top of the cylinder, with the detector placed successively at four points spaced 1/2-inch apart on the side of the specimen involving wave travel paths varying from 3.36 inches to 4.66 inches in length. Time intervals were measured using a model 217 micro-seismic timer in both laboratory and field measurements. Forty blows of the hammer were required for each velocity determination, which amounted to 80 blows on 9 laboratory specimens and 120 blows on the remaining 8 cylinders. Thirty-five field tests were made over the three selected soil types, all fine-grained, using a 2-foot seismic line with hammer-impact points at 6-inch intervals. The small tack hammer and 5/8-inch steel ball was, again, used to develop seismic wave energy. Generally, the densities obtained from the velocity measurements were lower than those measured in the conventional field testing. Conclusions were reached that: (1) the method does not appear to be usable for measurement of density of essentially fine-grained soils when the moisture content greatly exceeds the optimum for compaction, and (2) due to a gradual reduction in velocity upon aging, apparently because of gradual absorption of pore water into the expandable interlayer region of the clay, the seismic test should be conducted immediately after soil compaction to obtain a meaningful velocity value.