Characteristics of hospital-treated intentional drug overdose in Ireland and Northern Ireland

OBJECTIVES This study compared the profile of intentional drug overdoses (IDOs) presenting to emergency departments in Ireland and in the Western Trust Area of Northern Ireland between 2007 and 2012. Specifically the study aimed to compare characteristics of the patients involved, to explore the factors associated with repeated IDO and to report the prescription rates of common drug types in the population. METHODS We utilised data from two comparable registries which monitor the incidence of hospital-treated self-harm, recording data from deliberate self-harm presentations involving an IDO to all hospital emergency departments for the period 1 January 2007 to 31 December 2012. RESULTS Between 2007 and 2012 the registries recorded 56,494 self-harm presentations involving an IDO. The study showed that hospital-treated IDO was almost twice as common in Northern Ireland than in Ireland (278 vs 156/100,000, respectively). CONCLUSIONS Despite the overall difference in the rates of IDO, the profile of such presentations was remarkably similar in both countries. Minor tranquillisers were the drugs most commonly involved in IDOs. National campaigns are required to address the availability and misuse of minor tranquillisers, both prescribed and non-prescribed.

Musculoskeletal effects and injury risk in collegiate Indian classical and ballet dancers

Dancers of all forms often engage in aesthetic yet challenging movements. Their training, choreography, and performances require strength, stamina, flexibility, grace, passion, and emotion. Ballet and Bharatanatyam (an Indian classical dance form) dancers utilize two movements in each of their dance forms that are similar—a half-sitting pose and a full-sitting pose, both requiring external rotation of the legs and bending at the knee joints. The purpose of this study was to examine and compare the biomechanics of joint reaction forces and knee angles in both styles of dance for these particular poses. The study included nine female ballet dancers and seven female Bharatanatyam dancers. Hamstring and gastrocnemius flexibility were measured for each dancer. Knee angles, vertical peak forces, and moments were determined for dancers at the lowest point of their bending positions. Mann-Whitney U tests found significant differences in hamstring flexibility, right gastrocnemius flexibility, and knee angles for the full-sitting poses between ballet and Bharatanatyam dancers. No significant difference was found in the vertical peak forces as a ratio to total body weight and moments between the two styles of dance. Further research can be done to more directly assess a difference in injury risk between the ballet and Bharatanatyam dancers.

Withdrawal of Antidementia Drugs in Older People: Who, When and How?

The evidence base to guide withdrawal of antidementia medications in older people with dementia is limited; while some randomised controlled studies have considered discontinuation of cholinesterase inhibitors, no such studies examining discontinuation of the N-Methyl-D-aspartate receptor antagonist memantine have been conducted to date. The purpose of this opinion article was to summarise the existing evidence on withdrawal of cholinesterase inhibitors and memantine, to highlight the key considerations for clinicians when making these prescribing decisions and to offer guidance as to when and how treatment might be discontinued. Until the evidence-base is enhanced by the findings of large scale randomised controlled discontinuation trials of ChEIs and memantine which use multiple, clinically relevant cognitive, functional and behavioural outcome measures, clinicians’ prescribing decisions involve balancing the risks of discontinuation with side-effects and costs of continued treatment. Such decisions must be highly individualised and patient-centred.

The detection of contaminating clonal cells in apheresis products is related to response and outcome in multiple myeloma undergoing autologous peripheral blood stem cell transplantation.

In the present paper, we report on the use of the heteroduplex PCR technique to detect the presence of clonally rearranged VDJ segments of the heavy chain immunoglobulin gene (VDJH) in the apheresis products of patients with multiple myeloma (MM) undergoing autologous peripheral blood stem cell (APBSC) transplantation. Twenty-three out of 31 MM patients undergoing APBSC transplantation with VDJH segments clonally rearranged detected at diagnosis were included in the study. Samples of the apheresis products were PCR amplified using JH and VH (FRIII and FRII) consensus primers and subsequently analyzed with the heteroduplex technique, and compared with those obtained at diagnosis. 52% of cases yielded positive results (presence of clonally rearranged VDJH segments in at least one apheresis). The presence of positive results in the apheresis products was not related to any pretransplant characteristics with the exception of response status at transplant. Thus, while no one patient with positive apheresis products was in complete remission (CR), negative immunofixation, before the transplant, five cases (46%) with negative apheresis were already in CR at transplant (P = 0.01). The remaining six cases with heteroduplex PCR negative apheresis were in partial remission before transplant. Patients with clonally free products were more likely to obtain CR following transplant (64% vs 17%, P= 0.02) and a longer progression-free survival, (40 months in patients transplanted with polyclonal products vs 20 with monoclonal ones, P = 0.03). These results were consistent when the overall survival was considered, since it was better in those patients with negative apheresis than it was in those with positive (83% vs 36% at 5 years from diagnosis, P= 0.01). These findings indicate that the presence of clonality rearranged VDJH segments is related to the response and outcome in MM transplanted patients.

Hormonal changes related to paternal and alloparental care in common marmosets (Callithrix jacchus)

The physiological mechanisms of parental and alloparental care in cooperatively breeding nonhuman primate species such as the common marmoset (Callithrix jacchus) are poorly known. In this study, we examined prolactin and cortisol plasma levels of fathers and older offspring of both sexes, with and without previous experience in infant carrying, around parturition and during infant carrying. Blood samples were collected from fathers and older offspring and prolactin and cortisol were measured by RIA and EIA, respectively. Prolactin levels of both caretakers were not influenced by infant’s birth, previous experience or proximity to parturition. However, prolactin levels increased in both caretakers while in physical contact with infants and also with the number of infants being carried in older offspring. These findings suggest that increased prolactin seems to be mainly due to physical effort rather than a physiological trigger of paternal and alloparental care in common marmosets. Cortisol levels were higher for experienced fathers shortly before parturition which could act to reinforce affiliative bonds between breeding males and females at this time or in the ability of males to detect the proximity of the parturition or both

Biomass, quality traits and methane production of extensive grassland: biodiversity effects and sensor approaches

Energy policies around the world are mandating for a progressive increase in renewable energy production. Extensive grassland areas with low productivity and land use limitations have become target areas for sustainable energy production to avoid competition with food production on the limited available arable land resources and minimize further conversion of grassland into intensively managed energy cropping systems or abandonment. However, the high spatio-temporal variability in botanical composition and biochemical parameters is detrimental to reliable assessment of biomass yield and quality regarding anaerobic digestion. In an approach to assess the performance for predicting biomass using a multi-sensor combination including NIRS, ultra-sonic distance measurements and LAI-2000, biweekly sensor measurements were taken on a pure stand of reed canary grass (Phalaris aruninacea), a legume grass mixture and a diversity mixture with thirty-six species in an experimental extensive two cut management system. Different combinations of the sensor response values were used in multiple regression analysis to improve biomass predictions compared to exclusive sensors. Wavelength bands for sensor specific NDVI-type vegetation indices were selected from the hyperspectral data and evaluated for the biomass prediction as exclusive indices and in combination with LAI and ultra-sonic distance measurements. Ultrasonic sward height was the best to predict biomass in single sensor approaches (R² 0.73 – 0.76). The addition of LAI-2000 improved the prediction performance by up to 30% while NIRS barely improved the prediction performance. In an approach to evaluate broad based prediction of biochemical parameters relevant for anaerobic digestion using hyperspectral NIRS, spectroscopic measurements were taken on biomass from the Jena-Experiment plots in 2008 and 2009. Measurements were conducted on different conditions of the biomass including standing sward, hay and silage and different spectroscopic devices to simulate different preparation and measurement conditions along the process chain for biogas production. Best prediction results were acquired for all constituents at laboratory measurement conditions with dried and ground samples on a bench-top NIRS system (RPD > 3) with a coefficient of determination R2 < 0.9. The same biomass was further used in batch fermentation to analyse the impact of species richness and functional group composition on methane yields using whole crop digestion and pressfluid derived by the Integrated generation of solid Fuel and Biogas from Biomass (IFBB) procedure. Although species richness and functional group composition were largely insignificant, the presence of grasses and legumes in the mixtures were most determining factors influencing methane yields in whole crop digestion. High lignocellulose content and a high C/N ratio in grasses may have reduced the digestibility in the first cut material, excess nitrogen may have inhibited methane production in second cut legumes, while batch experiments proved superior specific methane yields of IFBB press fluids and showed that detrimental effects of the parent material were reduced by the technical treatment

In vitro efficacy of selected medicinal plants from Cholistan desert, Pakistan, against gastrointestinal helminths of sheep and goats

Gastrointestinal helminths are a major constraint to small ruminants in extensive husbandry systems of tropical regions. Yet, unavailability, high prices, side effects, and development of parasite resistance often limit the use of synthetic anthelmintics. Traditional medicinal plants might be an effective low-cost alternative. Therefore the in vitro anthelmintic activity of leaf extracts of the ligneous plants Capparis decidua, Salsola foetida, Suaeda fruticosa, Haloxylon salicornicum, and Haloxylon recurvum from Cholistan, Pakistan, was investigated against adult worms of Haemonchus contortus, Trichuris ovis, and Paramphistomum cervi. Various concentrations (from 7.8 to 500 mg dry matter ml^(−1)) of three extracts (aqueous, methanol, and aqueous-methanol) of each plant were tested at different time intervals for their anthelmintic activity via adult motility assay. Plant species (p<=0.01), extract type (p<=0.001), parasite species (p<=0.001), extract concentration (p<=0.001), time of exposure (p<=0.001) and their interactions (p<=0.001) affected the number of immobile or dead helminths. The 50% lethal concentration (LC_(50)) values indicated that the methanol and aqueous-methanol extracts of C. decidua, H. recurvum, and H. salicornicum as well as the methanol extract of S. fruticosa have the potential to be developed into plant-based remedies against the studied helminths. Further studies are needed to investigate the in vivo anthelmintic activity of these extracts, in order to develop effective, cheap and locally available anthelmintics for pastoralists in Cholistan and neighbouring desert regions.

Predicting Muscularity-Related Behavior, Emotions, and Cognitions in Men: The Role of Psychological Need Thwarting, Drive for Muscularity, and Mesomorphic Internalization

We examine the relationships that internalization, need thwarting (NT), and drive for muscularity (DFM), along with their interactions, had with weightlifting, muscle dissatisfaction (MD), and muscle-related-worry (MRW). A sample of 552 men (MAGE = 20.5 years, SD = 3.1) completed the Psychological Need Thwarting Scale, the Internalization subscale of the male version of the Sociocultural Attitudes Towards Appearance Questionnaire, the Drive for Muscularity Scale-Attitudes subscale, the Male Body Attitudes Scale-Muscularity subscale, the Body Change Inventory-Worry subscale, and an inventory assessing weightlifting behavior. DFM significantly predicted weightlifting, MRW, and MD. Internalization significantly predicted weightlifting and MRW. NT significantly predicted weightlifting and MD, and its relationship with MRW approached significance. The interaction terms did not predict weightlifting or MRW. The NT/DFM and NT/Internalization interaction terms predicted MD. These results highlight the role of NT in predicting appearance variables in men.

Omega-3 Fatty Acids are Inversely Related to Callous and Unemotional Traits in Adolescent Boys with Attention Deficit Hyperactivity Disorder

A number of research studies have reported abnormal plasma fatty acid profiles in children with ADHD along with some benefit of n−3 to symptoms of ADHD. However, it is currently unclear whether (lower) long chain-polyunsaturated fatty acids (LC-PUFAs) are related to ADHD pathology or to associated behaviours. The aim of this study was to test whether (1) ADHD children have abnormal plasma LC-PUFA levels and (2) ADHD symptoms and associated behaviours are correlated with LC-PUFA levels. Seventy-two, male children with (n=29) and without a clinical diagnosis of ADHD (n=43) were compared in their plasma levels of LC-PUFA. Plasma DHA was higher in the control group prior to statistical correction. Callous–unemotional (CU) traits were found to be significantly negatively related to both eicosapentaenoic acid (EPA), and total omega-3 in the ADHD group. The findings unveil for the first time that CU and anti-social traits in ADHD are associated with lower omega-3 levels.

A critical appraisal of clinical trials conducted and subsequent drug approvals in India and South Africa

Objectives: To assess the relation between the number of clinical trials conducted and respective new drug approvals in India and South Africa. Design: Construction and analysis of a comprehensive database of completed randomised controlled clinical trials based on clinicaltrials.gov from 1 January 2005 to 31 December 2010 and drug approval data from 2006 until 2013 for India and South Africa. Setting: USA, the EU, India and South Africa. Main outcome measures: Percentage of completed randomised clinical trials for an Investigational Medicinal Product (IMP) leading to new drug approval in India and South Africa. Results: A total of 622 eligible randomised controlled trials were identified as per search criteria for India and South Africa. Clustering them for the same sponsor and the same Investigational New Drug (IND) resulted in 453 eligible trials, that is, 224 for India and 229 for South Africa. The distribution of the market application approvals between the EU/USA as well as India and South Africa revealed that out of clinical trials with the participation of test centres in India and/or South Africa, 39.6% (India) clinical trials and 60.1% (South Africa) clinical trials led to market authorisation in the EU/USA without a New Drug Application (NDA) approval in India or South Africa. Conclusions: Despite an increase in clinical trial activities, there is a clear gap between the number of trials conducted and market availability of these new drugs in India and South Africa. Drug regulatory authorities, investigators, institutional review boards and patient groups should direct their efforts to ensuring availability of new drugs in the market that have been tested and researched on their population.

Memory effects and geometrical considerations in open quantum systems

This thesis discusses memory effects in open quantum systems with an emphasis on the Breuer, Laine, Piilo (BLP) measure of non-Markovianity. It is shown how the calculation of the measure can be simplifed and how quantum information protocols can bene t from memory e ects. The superdense coding protocol is used as an example of this. The quantum Zeno effect will also be studied from the point of view of memory e ects. Finally the geometric ideas used in simplifying the calculation of the BLP measure are applied in studying the amount of resources needed for detecting bipartite quantum correlations. It is shown that to decide without prior information if an unknown quantum state is entangled or not, an informationally complete measurement is required. The first part of the thesis contains an introduction to the theoretical ideas such as quantum states, closed and open quantum systems and necessary mathematical tools. The theory is then applied in the second part of the thesis as the results obtained in the original publications I-VI are presented and discussed.

Hormonal changes related to paternal and alloparental care in common marmosets (Callithrix jacchus)

The physiological mechanisms of parental and alloparental care in cooperatively breeding nonhuman primate species such as the common marmoset (Callithrix jacchus) are poorly known. In this study, we examined prolactin and cortisol plasma levels of fathers and older offspring of both sexes, with and without previous experience in infant carrying, around parturition and during infant carrying. Blood samples were collected from fathers and older offspring and prolactin and cortisol were measured by RIA and EIA, respectively. Prolactin levels of both caretakers were not influenced by infant’s birth, previous experience or proximity to parturition. However, prolactin levels increased in both caretakers while in physical contact with infants and also with the number of infants being carried in older offspring. These findings suggest that increased prolactin seems to be mainly due to physical effort rather than a physiological trigger of paternal and alloparental care in common marmosets. Cortisol levels were higher for experienced fathers shortly before parturition which could act to reinforce affiliative bonds between breeding males and females at this time or in the ability of males to detect the proximity of the parturition or both

Identifying treatment effects and counterfactual distributions using data combination with unobserved heterogeneity

This paper considers identification of treatment effects when the outcome variables and covari-ates are not observed in the same data sets. Ecological inference models, where aggregate out-come information is combined with individual demographic information, are a common example of these situations. In this context, the counterfactual distributions and the treatment effects are not point identified. However, recent results provide bounds to partially identify causal effects. Unlike previous works, this paper adopts the selection on unobservables assumption, which means that randomization of treatment assignments is not achieved until time fixed unobserved heterogeneity is controlled for. Panel data models linear in the unobserved components are con-sidered to achieve identification. To assess the performance of these bounds, this paper provides a simulation exercise.

Distributional effects and individual differences in L2 morphology learning

Second language (L2) learning outcomes may depend on the structure of the input and learners’ cognitive abilities. This study tested whether less predictable input might facilitate learning and generalization of L2 morphology while evaluating contributions of statistical learning ability, nonverbal intelligence, phonological short-term memory, and verbal working memory. Over three sessions, 54 adults were exposed to a Russian case-marking paradigm with a balanced or skewed item distribution in the input. Whereas statistical learning ability and nonverbal intelligence predicted learning of trained items, only nonverbal intelligence also predicted generalization of case-marking inflections to new vocabulary. Neither measure of temporary storage capacity predicted learning. Balanced, less predictable input was associated with higher accuracy in generalization but only in the initial test session. These results suggest that individual differences in pattern extraction play a more sustained role in L2 acquisition than instructional manipulations that vary the predictability of lexical items in the input.

Promotion and diffusion of tha career Bachelor and Licenciature of Mathematics Teaching in rural areas of Costa Rica project: effects and results

This article describes the purpose and activities of the project Promoting Mathematics Education in Rural Areas of Costa Rica. The activity has focused on two objectives. First, supporting and monitoring students who have expressed interest in studying a mathematics teacher. To achieve this, it has been working with students who have an ideal profile for the career, mainly from rural areas. The second objective is to conduct training workshops for high school in-service teachers, to strengthen and improve their knowledge in the area of mathematics. Among the results of the project, it can be highlighted a significant increase in the enrollment of students in the career of Mathematics Education in 2010 and 2011, and the training processes in the field of Real Functions of Real Variable and Geometry at different regional areas mostly rural as Aguirre, Sarapiquí, Coto, Buenos Aires, Limón, Cañas, Pérez Zeledón, Nicoya, Los Santos, Turrialba, Puriscal, Desamparados, San Carlos, Puntarenas, Limón, Liberia, Santa Cruz y Upala.