Efficacy of cognitive behavioral therapy in reducing psychiatric symptoms in patients with implantable cardioverter defibrillator: an integrative review

This article is a systematic review of the available literature on the benefits that cognitive behavioral therapy (CBT) offers patients with implanted cardioverter defibrillators (ICDs) and confirms its effectiveness. After receiving the device, some patients fear that it will malfunction, or they remain in a constant state of tension due to sudden electrical discharges and develop symptoms of anxiety and depression. A search with the key words “anxiety”, “depression”, “implantable cardioverter”, “cognitive behavioral therapy” and “psychotherapy” was carried out. The search was conducted in early January 2013. Sources for the search were ISI Web of Knowledge, PubMed, and PsycINFO. A total of 224 articles were retrieved: 155 from PubMed, 69 from ISI Web of Knowledge. Of these, 16 were written in a foreign language and 47 were duplicates, leaving 161 references for analysis of the abstracts. A total of 19 articles were eliminated after analysis of the abstracts, 13 were eliminated after full-text reading, and 11 articles were selected for the review. The collection of articles for literature review covered studies conducted over a period of 13 years (1998-2011), and, according to methodological design, there were 1 cross-sectional study, 1 prospective observational study, 2 clinical trials, 4 case-control studies, and 3 case studies. The criterion used for selection of the 11 articles was the effectiveness of the intervention of CBT to decrease anxiety and depression in patients with ICD, expressed as a ratio. The research indicated that CBT has been effective in the treatment of ICD patients with depressive and anxiety symptoms. Research also showed that young women represented a risk group, for which further study is needed. Because the number of references on this theme was small, further studies should be carried out.

Evaluation of 99mTc-HYNIC-βAla-Bombesin(7-14) as an agent for pancreas tumor detection in mice

Pancreatic adenocarcinoma is important in oncology because of its high mortality rate. Deaths may be avoided if an early diagnosis could be achieved. Several types of tumors overexpress gastrin-releasing peptide receptors (GRPr), including pancreatic cancer cells. Thus, a radiolabeled peptide derivative of gastrin-releasing peptide (GRP) may be useful as a specific imaging probe. The purpose of the present study was to evaluate the feasibility of using99mTc-HYNIC-βAla-Bombesin(7-14)as an imaging probe for Capan-1 pancreatic adenocarcinoma. Xenographic pancreatic tumor was developed in nude mice and characterized by histopathological analysis. Biodistribution studies and scintigraphic images were carried out in tumor-bearing nude mice. The two methods showed higher uptake by pancreatic tumor when compared to muscle (used as control), and the tumor-to-muscle ratio indicated that99mTc-HYNIC-βAla-Bombesin(7-14)uptake was four-fold higher in tumor cells than in other tissues. Scintigraphic images also showed a clear signal at the tumor site. The present data indicate that99mTc-HYNIC-βAla-Bombesin(7-14)may be useful for the detection of pancreatic adenocarcinoma.

Potential of quixaba (Sideroxylon obtusifolium) latex as a milk-clotting agent

There are several obstacles to the use of chymosin in cheese production. Consequently, plant proteases have been studied as possible rennet substitutes, but most of these enzymes are unsuitable for the manufacture of cheese. The aim of this study was to evaluate the potential of latex from Sideroxylon obtusifolium as a source of milk-clotting proteases and to partially characterize the enzyme. The enzyme extract showed high protease and coagulant activities, with an optimal pH of 8.0 and temperature of 55 °C. The enzyme was stable in wide ranges of temperature and pH. Its activity was not affected by any metal ions tested; but was inhibited by phenylmethanesulfonyl fluoride and pepstatin. For the coagulant activity, the optimal concentration of CaCl2 was 10 µmol L- 1. Polyacrylamide gel electrophoresis showed four bands, with molecular weights between 17 and 64 kDa. These results indicate that the enzyme can be applied to the cheese industry.

Montreal Cognitive Assessment (MoCA) no rastreio de comprometimento cognitivo leve (CCL) em pacientes com doença renal crônica (DRC) pré-dialítica

Resumo Introdução: Indivíduos com doença renal crônica (DRC) têm grande risco de desenvolver comprometimento cognitivo (CC), inicialmente leve (CCL), passível de identificação, mas ainda subdiagnosticado e subtratado. O Montreal Cognitive Assessment (MoCA) vem sendo indicado para rastreio de CCL na DRC. Objetivo: Avaliar o CCL em indivíduos com DRC pré-dialítica. Métodos: O estudo foi realizado em 72 indivíduos, não idosos, com DRC nos estágios pré-dialíticos. A avaliação neuropsicológica incluiu: o teste de cognição global MoCA; o teste do relógio (TDR); o Digit Span ordem direta (DOD) e inversa (DOI); o teste de fluência verbal (FV), fonêmica (FAS) e semântica (animais); o punho-borda-mão (PBM); e de memória 10 figuras. Resultados: A média de idade dos participantes foi de 56,74 ± 7,63 anos, com predominância de homens (55,6%), com escolaridade ≥ 4 anos (84,3%), a maioria com DRC 1, 2 e 3a e 3b (67,6%), hipertensa (93,1%) e diabética (52,1%). O CC (MoCA ≤ 24) foi observado em 73,6% dos usuários. Não encontramos associação das variáveis demográficas e clínicas com CC, mas tendência de associação com a idade (p = 0,07), com a escolaridade (p = 0,06) e com o DM (0,06). Os testes de função executiva, TDR, DOI e PBM, isoladamente, apresentaram boa sensibilidade e valor preditivo negativo comparados ao MoCA para a identificação de CC e, em conjunto, foram capazes de predizer o resultado do MoCA. Conclusão: O CCL é frequente em usuários não idosos com DRC pré-dialítica. O TDR, DOI e PBM associados são equivalentes ao MoCA na identificação do CC nessa população, sugerindo comprometimento de funções executivas.

Social control of public expenditures in a multilevel principal-agent approach

ABSTRACTThis study enhances the principal-agent model by incorporating a multilevel perspective and differences among agency situations. A theoretical discussion is developed using a proposed intersection of methodological focuses and a descriptive-exemplificative hypothetical analysis. The analysis is applied to public expenditure social control in representative democracies, and as a result, a principal-agent model unfolds that incorporates a decision-making perspective and focuses on formulation, negotiation, articulation, and implementation competencies. Thus, it is possible to incorporate elements into the principal-agent model to make it more permeable to individual, group, and societal idiosyncrasies with respect to public expenditure social control.

Animal Spirits in Financial Markets: Agent-Based Model

In this work an agent based model (ABM) was proposed using the main idea from the Jabłonska-Capasso-Morale (JCM) model and maximized greediness concept. Using a multi-agents simulator, the power of the ABM was assessed by using the historical prices of silver metal dating from the 01.03.2000 to 01.03.2013. The model results, analysed in two different situations, with and without maximized greediness, have proven that the ABM is capable of explaining the silver price dynamics even in utmost events. The ABM without maximal greediness explained the prices with more irrationalities whereas the ABM with maximal greediness tracked the price movements with more rational decisions. In the comparison test, the model without maximal greediness stood as the best to capture the silver market dynamics. Therefore, the proposed ABM confirms the suggested reasons for financial crises or markets failure. It reveals that an economic or financial collapse may be stimulated by irrational and rational decisions, yet irrationalities may dominate the market.

[1er mai 1920 à Paris, agent cycliste et cavaliers du service d'ordre à l'angle du boulevard Magenta et de la rue La Fayette] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59109

Guide des propriétaires d'hôtels et de maisons meublées / publié avec l'autorisation de leur chambre syndicale, par M. Juge, agent général de leur société...

Etat de collection : N° 1 (s.d.)

Guide des propriétaires d'hôtels et de maisons meublées / publié avec l'autorisation de leur chambre syndicale, par M. Juge, agent général de leur société...

1900 (N1).

[Lettre autographe signée d'Arnaud, agent dramatique, au Duc d'Aumont, 9 mai 1825]

Contre Guilbert de Pixérécourt qui a outrepassé ses droits de directeur