An evaluation of continuous positive airway pressure (CPAP) therapy in the treatment of hypernasality following traumatic brain injury - A report of 3 cases

Objective: To evaluate the effectiveness of continuous positive airway pressure (CPAP) therapy in the treatment of hypernasality following traumatic brain injury (17111). Design: An A-B-A experimental research design. Assessments were conducted prior to commencement of the program, midway, immediately posttreatment, and 1 month after completion of the CPAP therapy program. Participants: Three adults with dysarthria and moderate to severe hypernasality subsequent to TBI. Outcome Measures: Perceptual evaluation using the Frenchay Dysarthria Assessment, the Assessment of Intelligibility of Dysarthric Speech, and a speech sample analysis, and instrumental evaluation using the Nasometer. Results: Between assessment periods, varying degrees of improvement in hypernasality and sentence intelligibility were noted. At the 1-month post-CPAP assessment, all 3 participants demonstrated reduced nasalance values, and 2 exhibited increased sentence intelligibility. Conclusions: CPAP may be a valuable treatment of impaired velopharyngeal function in the TBI population.

Vitamin A intake and factors influencing it amongst children and caretakers in Kosrae, Micronesia

A cross-sectional study was undertaken in Kosrae, Federated States of Micronesia to assess preschool children and caretaker dietary intake of vitamin A (VA) (including provitamin A carotenoids) and other nutrients contributing to VA status and to investigate relationships between VA intake and factors affecting dietary intake. Ethnography, food sample analysis, two dietary assessment methods (7-day food frequency questionnaire and quantitative 24-hour recall for three nonconsecutive days) administered by trained interviewers to a random sample group, and cultivar difference specification (yellow-fleshed versus white-fleshed bananas) contributed to the richness of the study. Vitamin A intake was low, approximately half of the estimated requirements for children (n = 65) and caretakers (n = 65), whereas protein intake was high. There were no clear significant relationships associated with gender, caretaker education, caretaker occupation, and socio-economic status with VA intake, indicating that a broad-based intervention over all population segments is needed to change dietary behavior, The ethnographic approach was critical for survey instrument development and data analysis.

Monounsaturated fatty acid, carbohydrate intake, and diabetes status are associated with arterial pulse pressure

Background Diabetes is a global epidemic. Cardiovascular disease (CVD) is one of the most prevalent consequences of diabetes. Nutrition is considered a modifiable risk factor for CVD, particularly for individuals with diabetes; albeit, there is little consensus on the role of carbohydrates, proteins and fats for arterial health for persons with or without diabetes. In this study, we examined the association of macronutrients with arterial pulse pressure (APP), a surrogate measure of arterial health by diabetes status and race. Methods Participants were 892 Mexican Americans (MA), 1059 Black, non-Hispanics (BNH) and 2473 White, non-Hispanics (WNH) with and without diabetes of a weighted sample from the National Nutrition and Health Examination Survey (NHANES) 2007-2008. The cross-sectional analysis was performed with IBM-SPSS version 18 with the complex sample analysis module. The two-year sample weight for the sub-sample with laboratory values was applied to reduce bias and approximate a nationally, representative sample. Arterial stiffness was assessed by arterial pulse pressure (APP). Results APP was higher for MA [B = 0.063 (95% CI 0.015 to 0.111), p = 0.013] and BNH [B = 0.044 (95% CI 0.006 to 0.082), p = 0.018] than WNH, controlling for diabetes, age, gender, body mass index (BMI), fiber intake, energy intake (Kcal) and smoking. A two-way interaction of diabetes by carbohydrate intake (grams) was inversely associated with APP [B = -1.18 (95% CI -0.178 to -0.058), p = 0.001], controlling for race, age, gender, BMI, Kcal and smoking. BNH with diabetes who consumed more mono-unsaturated fatty acids (MUFA) than WNH with diabetes had lower APP [B = -0.112 (95%CI-0.179 to -0.045), p = 0.003] adjusting for saturated fatty acids, Kcal, age, gender, BMI and smoking. Conclusion Higher MUFA and carbohydrate intake for persons with diabetes reflecting lower APP may be due to replacement of saturated fats with CHO and MUFA. The associations of APP with diabetes, race and dietary intake need to be confirmed with intervention and prospective studies. Confirmation of these results would suggest that dietary interventions for minorities with diabetes may improve arterial health.

Real-time biosensor for the assessment of nanotoxicity and cancer electrotherapy

Knowledge of cell electronics has led to their integration to medicine either by physically interfacing electronic devices with biological systems or by using electronics for both detection and characterization of biological materials. In this dissertation, an electrical impedance sensor (EIS) was used to measure the electrode surface impedance changes from cell samples of human and environmental toxicity of nanoscale materials in 2D and 3D cell culture models. The impedimetric response of human lung fibroblasts and rainbow trout gill epithelial cells when exposed to various nanomaterials was tested to determine their kinetic effects towards the cells and to demonstrate the biosensor's ability to monitor nanotoxicity in real-time. Further, the EIS allowed rapid, real-time and multi-sample analysis creating a versatile, noninvasive tool that is able to provide quantitative information with respect to alteration in cellular function. We then extended the application of the unique capabilities of the EIS to do real-time analysis of cancer cell response to externally applied alternating electric fields at different intermediate frequencies and low-intensity. Decreases in the growth profiles of the ovarian and breast cancer cells were observed with the application of 200 and 100 kHz, respectively, indicating specific inhibitory effects on dividing cells in culture in contrast to the non-cancerous HUVECs and mammary epithelial cells. We then sought to enhance the effects of the electric field by altering the cancer cell's electronegative membrane properties with HER2 antibody functionalized nanoparticles. An Annexin V/EthD-III assay and zeta potential were performed to determine the cell death mechanism indicating apoptosis and a decrease in zeta potential with the incorporation of the nanoparticles. With more negatively charged HER2-AuNPs attached to the cancer cell membrane, the decrease in membrane potential would thus leave the cells more vulnerable to the detrimental effects of the applied electric field due to the decrease in surface charge. Therefore, by altering the cell membrane potential, one could possibly control the fate of the cell. This whole cell-based biosensor will enhance our understanding of the responsiveness of cancer cells to electric field therapy and demonstrate potential therapeutic opportunities for electric field therapy in the treatment of cancer.

Mobility and toxicity of heavy metal(loid)s arising from contaminated wood ash application to a pasture grassland soil

The authors acknowledge the financial support the Scottish Government’s Rural and Environmental Sciences and Analytical Services (RESAS) in order to complete some of the soil and pore water sample analysis as well as the Czech Ministry of Education, Youth and Sports (COST CZ LD13068), the Czech Science Foundation (GAČR 14-02183P) and EU COST actionFP1407 (‘ModWoodLife’) short term scientific mission grant in order to complete the column leaching test.

Validation of PigBal model predictions for pig manure production

PigBal is a mass balance model that uses pig diet, digestibility and production data to predict the manure solids and nutrients produced by pig herds. It has been widely used for designing piggery effluent treatment systems and sustainable reuse areas at Australian piggeries. More recently, PigBal has also been used to estimate piggery volatile solids production for assessing greenhouse gas emissions for statutory reporting purposes by government, and for evaluating the energy potential from anaerobic digestion of pig effluent. This paper has compared PigBal predictions of manure total, volatile, and fixed solids, and nitrogen (N), phosphorus (P) and potassium (K), with manure production data generated in a replicated trial, which involved collecting manure from pigs housed in metabolic pens. Predictions of total, volatile, and fixed solids and K in the excreted manure were relatively good (combined diet R2 ≥ 0.79, modelling efficiency (EF) ≥ 0.70) whereas predictions of N and P, were generally less accurate (combined diet R2 0.56 and 0.66, EF 0.19 and –0.22, respectively). PigBal generally under-predicted lower N values while over-predicting higher values, and generally over-predicted manure P production for all diets. The most likely causes for this less accurate performance were ammonium-N volatilisation losses between manure excretion and sample analysis, and the inability of PigBal to account for higher rates of P uptake by pigs fed diets containing phytase. The outcomes of this research suggest that there is a need for further investigation and model development to enhance PigBal’s capabilities for more accurately assessing nutrient loads. However, PigBal’s satisfactory performance in predicting solids excretion demonstrates that it is suitable for assessing the methane component of greenhouse gas emission and the energy potential from anaerobic digestion of volatile solids in piggery effluent. The apparent overestimation of N and P excretion may result in conservative nutrient application rates to land and the over-prediction of the nitrous oxide component of greenhouse gas emissions.

English syllable confusion and imitation in Korean bilingual and monolingual children and adults

In the present study, Korean-English bilingual (KEB) and Korean monolingual (KM) children, between the ages of 8 and 13 years, and KEB adults, ages 18 and older, were examined with one speech perception task, called the Nonsense Syllable Confusion Matrix (NSCM) task (Allen, 2005), and two production tasks, called the Nonsense Syllable Imitation Task (NSIT) and the Nonword Repetition Task (NRT; Dollaghan & Campbell, 1998). The present study examined (a) which English sounds on the NSCM task were identified less well, presumably due to interference from Korean phonology, in bilinguals learning English as a second language (L2) and in monolinguals learning English as a foreign language (FL); (b) which English phonemes on the NSIT were more challenging for bilinguals and monolinguals to produce; (c) whether perception on the NSCM task is related to production on the NSIT, or phonological awareness, as measured by the NRT; and (d) whether perception and production differ in three age-language status groups (i.e., KEB children, KEB adults, and KM children) and in three proficiency subgroups of KEB children (i.e., English-dominant, ED; balanced, BAL; and Korean-dominant, KD). In order to determine English proficiency in each group, language samples were extensively and rigorously analyzed, using software, called Systematic Analysis of Language Transcripts (SALT). Length of samples in complete and intelligible utterances, number of different and total words (NDW and NTW, respectively), speech rate in words per minute (WPM), and number of grammatical errors, mazes, and abandoned utterances were measured and compared among the three initial groups and the three proficiency subgroups. Results of the language sample analysis (LSA) showed significant group differences only between the KEBs and the KM children, but not between the KEB children and adults. Nonetheless, compared to normative means (from a sample length- and age-matched database provided by SALT), the KEB adult group and the KD subgroup produced English at significantly slower speech rates than expected for monolingual, English-speaking counterparts. Two existing models of bilingual speech perception and production—the Speech Learning Model or SLM (Flege, 1987, 1992) and the Perceptual Assimilation Model or PAM (Best, McRoberts, & Sithole, 1988; Best, McRoberts, & Goodell, 2001)—were considered to see if they could account for the perceptual and production patterns evident in the present study. The selected English sounds for stimuli in the NSCM task and the NSIT were 10 consonants, /p, b, k, g, f, θ, s, z, ʧ, ʤ/, and 3 vowels /I, ɛ, æ/, which were used to create 30 nonsense syllables in a consonant-vowel structure. Based on phonetic or phonemic differences between the two languages, English sounds were categorized either as familiar sounds—namely, English sounds that are similar, but not identical, to L1 Korean, including /p, k, s, ʧ, ɛ/—or unfamiliar sounds—namely, English sounds that are new to L1, including /b, g, f, θ, z, ʤ, I, æ/. The results of the NSCM task showed that (a) consonants were perceived correctly more often than vowels, (b) familiar sounds were perceived correctly more often than unfamiliar ones, and (c) familiar consonants were perceived correctly more often than unfamiliar ones across the three age-language status groups and across the three proficiency subgroups; and (d) the KEB children perceived correctly more often than the KEB adults, the KEB children and adults perceived correctly more often than the KM children, and the ED and BAL subgroups perceived correctly more often than the KD subgroup. The results of the NSIT showed (a) consonants were produced more accurately than vowels, and (b) familiar sounds were produced more accurately than unfamiliar ones, across the three age-language status groups. Also, (c) familiar consonants were produced more accurately than unfamiliar ones in the KEB and KM child groups, and (d) unfamiliar vowels were produced more accurately than a familiar one in the KEB child group, but the reverse was true in the KEB adult and KM child groups. The KEB children produced sounds correctly significantly more often than the KM children and the KEB adults, though the percent correct differences were smaller than for perception. Production differences were not found among the three proficiency subgroups. Perception on the NSCM task was compared to production on the NSIT and NRT. Weak positive correlations were found between perception and production (NSIT) for unfamiliar consonants and sounds, whereas a weak negative correlation was found for unfamiliar vowels. Several correlations were significant for perceptual performance on the NSCM task and overall production performance on the NRT: for unfamiliar consonants, unfamiliar vowels, unfamiliar sounds, consonants, vowels, and overall performance on the NSCM task. Nonetheless, no significant correlation was found between production on the NSIT and NRT. Evidently these are two very different production tasks, where immediate imitation of single syllables on the NSIT results in high performance for all groups. Findings of the present study suggest that (a) perception and production of L2 consonants differ from those of vowels; (b) perception and production of L2 sounds involve an interaction of sound type and familiarity; (c) a weak relation exists between perception and production performance for unfamiliar sounds; and (d) L2 experience generally predicts perceptual and production performance. The present study yields several conclusions. The first is that familiarity of sounds is an important influence on L2 learning, as claimed by both SLM and PAM. In the present study, familiar sounds were perceived and produced correctly more often than unfamiliar ones in most cases, in keeping with PAM, though experienced L2 learners (i.e., the KEB children) produced unfamiliar vowels better than familiar ones, in keeping with SLM. Nonetheless, the second conclusion is that neither SLM nor PAM consistently and thoroughly explains the results of the present study. This is because both theories assume that the influence of L1 on the perception of L2 consonants and vowels works in the same way as for production of them. The third and fourth conclusions are two proposed arguments: that perception and production of consonants are different than for vowels, and that sound type interacts with familiarity and L2 experience. These two arguments can best explain the current findings. These findings may help us to develop educational curricula for bilingual individuals listening to and articulating English. Further, the extensive analysis of spontaneous speech in the present study should contribute to the specification of parameters for normal language development and function in Korean-English bilingual children and adults.

Validation of PigBal model predictions for pig manure production

PigBal is a mass balance model that uses pig diet, digestibility and production data to predict the manure solids and nutrients produced by pig herds. It has been widely used for designing piggery effluent treatment systems and sustainable reuse areas at Australian piggeries. More recently, PigBal has also been used to estimate piggery volatile solids production for assessing greenhouse gas emissions for statutory reporting purposes by government, and for evaluating the energy potential from anaerobic digestion of pig effluent. This paper has compared PigBal predictions of manure total, volatile, and fixed solids, and nitrogen (N), phosphorus (P) and potassium (K), with manure production data generated in a replicated trial, which involved collecting manure from pigs housed in metabolic pens. Predictions of total, volatile, and fixed solids and K in the excreted manure were relatively good (combined diet R2 ≥ 0.79, modelling efficiency (EF) ≥ 0.70) whereas predictions of N and P, were generally less accurate (combined diet R2 0.56 and 0.66, EF 0.19 and -0.22, respectively). PigBal generally under-predicted lower N values while over-predicting higher values, and generally over-predicted manure P production for all diets. The most likely causes for this less accurate performance were ammonium-N volatilisation losses between manure excretion and sample analysis, and the inability of PigBal to account for higher rates of P uptake by pigs fed diets containing phytase. The outcomes of this research suggest that there is a need for further investigation and model development to enhance PigBal's capabilities for more accurately assessing nutrient loads. However, PigBal's satisfactory performance in predicting solids excretion demonstrates that it is suitable for assessing the methane component of greenhouse gas emission and the energy potential from anaerobic digestion of volatile solids in piggery effluent. The apparent overestimation of N and P excretion may result in conservative nutrient application rates to land and the over-prediction of the nitrous oxide component of greenhouse gas emissions. © CSIRO 2016.

Determinación de la frecuencia de infección por helicobacter pylori y parasitosis en preescolares de 2 a 4 años que acuden a los centros de desarrollo infantil del municipio de la ciudad de Cuenca julio, 2015

El presente estudio se enfocó en la determinación de la frecuencia de Helicobacter pylori y parasitosis intestinal en los niños y niñas de 2 a 4 años que asisten a los Centros de Desarrollo Infantil del Municipio de la ciudad de Cuenca. Las muestras de heces fueron receptadas en los Centros de Desarrollo Infantil con la colaboración de los padres de familia y los educadores. Los exámenes coprológicos se llevaron a cabo en el Laboratorio Clínico del Centro de Diagnóstico de la Facultad de Ciencias Médicas de la Universidad de Cuenca cumpliendo normas de control de calidad y bioseguridad. La identificación de los parásitos intestinales se realizó a través del examen coproparasitario en fresco y la técnica inmunocromatográfica se empleó para la determinación cualitativa de Helicobacter pylori. Los resultados del estudio evidenciaron una prevalencia de 26,1% de infección por Helicobacter pylori y de 19,3% para parasitosis intestinal en los Centros. En las parasitosis infantiles, el quiste de Entamoeba histolytica se identificó como el agente etiológico en el 58,8% de los casos.

Explora: Infrastructure for Scaling Up Software Visualisation to Corpora

Visualisation provides good support for software analysis. It copes with the intangible nature of software by providing concrete representations of it. By reducing the complexity of software, visualisations are especially useful when dealing with large amounts of code. One domain that usually deals with large amounts of source code data is empirical analysis. Although there are many tools for analysis and visualisation, they do not cope well software corpora. In this paper we present Explora, an infrastructure that is specifically targeted at visualising corpora. We report on early results when conducting a sample analysis on Smalltalk and Java corpora.

Determinación de la frecuencia de infección por helicobacter pylori y parasitosis en preescolares de 2 a 4 años que acuden a los centros de desarrollo infantil del municipio de la ciudad de Cuenca. Julio, 2015

El presente estudio se enfocó en la determinación de la frecuencia de Helicobacter pylori y parasitosis intestinal en los niños y niñas de 2 a 4 años que asisten a los Centros de Desarrollo Infantil del Municipio de la ciudad de Cuenca. Las muestras de heces fueron receptadas en los Centros de Desarrollo Infantil con la colaboración de los padres de familia y los educadores. Los exámenes coprológicos se llevaron a cabo en el Laboratorio Clínico del Centro de Diagnóstico de la Facultad de Ciencias Médicas de la Universidad de Cuenca cumpliendo normas de control de calidad y bioseguridad. La identificación de los parásitos intestinales se realizó a través del examen coproparasitario en fresco y la técnica inmunocromatográfica se empleó para la determinación cualitativa de Helicobacter pylori. Los resultados del estudio evidenciaron una prevalencia de 26,1% de infección por Helicobacter pylori y de 19,3% para parasitosis intestinal en los Centros. En las parasitosis infantiles, el quiste de Entamoeba histolytica se identificó como el agente etiológico en el 58,8% de los casos

Real-time Biosensor for the Assessment of Nanotoxicity and Cancer Electrotherapy

Knowledge of cell electronics has led to their integration to medicine either by physically interfacing electronic devices with biological systems or by using electronics for both detection and characterization of biological materials. In this dissertation, an electrical impedance sensor (EIS) was used to measure the electrode surface impedance changes from cell samples of human and environmental toxicity of nanoscale materials in 2D and 3D cell culture models. The impedimetric response of human lung fibroblasts and rainbow trout gill epithelial cells when exposed to various nanomaterials was tested to determine their kinetic effects towards the cells and to demonstrate the biosensor’s ability to monitor nanotoxicity in real-time. Further, the EIS allowed rapid, real-time and multi-sample analysis creating a versatile, noninvasive tool that is able to provide quantitative information with respect to alteration in cellular function. We then extended the application of the unique capabilities of the EIS to do real-time analysis of cancer cell response to externally applied alternating electric fields at different intermediate frequencies and low-intensity. Decreases in the growth profiles of the ovarian and breast cancer cells were observed with the application of 200 and 100 kHz, respectively, indicating specific inhibitory effects on dividing cells in culture in contrast to the non-cancerous HUVECs and mammary epithelial cells. We then sought to enhance the effects of the electric field by altering the cancer cell’s electronegative membrane properties with HER2 antibody functionalized nanoparticles. An Annexin V/EthD-III assay and zeta potential were performed to determine the cell death mechanism indicating apoptosis and a decrease in zeta potential with the incorporation of the nanoparticles. With more negatively charged HER2-AuNPs attached to the cancer cell membrane, the decrease in membrane potential would thus leave the cells more vulnerable to the detrimental effects of the applied electric field due to the decrease in surface charge. Therefore, by altering the cell membrane potential, one could possibly control the fate of the cell. This whole cell-based biosensor will enhance our understanding of the responsiveness of cancer cells to electric field therapy and demonstrate potential therapeutic opportunities for electric field therapy in the treatment of cancer.

The wealth effects of commercial bank securities issuances announcement

Banks are often excluded in corporate finance research mainly because of the regulatory concerns. Compares to non-bank firms, banks are heavily regulated due to its special economic role of money and the uncertainty. Heavy regulation on banks could reduce the information asymmetry between the managers and investor by limiting the behaviour of banks at the time of the Seasoned Equity Offering (SEO), and by increasing the incentive for banks to avoid excessive risk-taking. Therefore, the market may be less likely to assume that bank issued securities signal information that the bank is overvalued compared to their non-bank counterparts. The objective of this thesis is therefore to examine commercial banks issued securities announcement effect. Three interrelated research questions are addressed in this thesis: 1) What is the difference in convertible bond announcement effect between banks and non-banks firm? 2) What is the difference in SEO announcement effect between banks and non-banks? 3) How do the stringency levels of bank regulation impact on the announcement effects of bank issued SEO? By using the U.S. convertible bond and SEO data from 1982 to 2012, I find that the bank issued a convertible bond and SEO announcement experience higher cumulative abnormal return than non-bank. This is consistent with the view that bank regulation reveals positive information about banks. Since banks are heavily regulated, the market is less likely to assume that the issuance of the convertible bond and SEO by banks signals information that is overvalued. These results are robust after controlling for a number of firm-, issue-, and market-specific characteristics. These results are robust by considering the different categories of non-bank industries by undertaking tests in relation to the differences in the CARS upon convertible bond/ SEO across industries, as well as the unbalanced sample between banks and non-banks by using the matched sample analysis. However, the relation between the stringency level of bank regulation and bank issued securities announcement effect may be nonlinear. As hypothesised, I find that bank regulation has an inverted U-shaped relation with the announcement effect of bank SEO by using the SEO data across 21 countries from 2001 to 2012. Under a less bank regulation environment, the market reacts more positively to the bank SEO announcement for an increase in the level of bank regulation. However, the bank SEO announcement effects become more negative if the bank regulation becomes too stringent. This inverted U-shaped relationship is robust after I use the exogenous cross-country, cross-year variation in the timing of the Basel II adoption as the instrument to assess the causal impact of bank regulation on SEO announcement effects. However, the stringency of regulation does not have a significant impact on the announcement effects of involuntary bank equity issuance.

DOMESTIC VIOLENCE IN PERSPECTIVE OF WOMEN WHO LIVED IT

Introduction: Knowing the experience of abuse, contextual determinants that led to the rupture of the situation and attempts to build a more harmonious future, it is essential to work sensitivities and better understand victims of domestic violence. Objectives: To understand the suffering of women victims of violence. Methods: This is an intentional sample of 21 women who were at shelter home or in the community. The data were collected by in- Documento descargado de http://www.elsevier.es el 13-10-2016 3rd World Congress of Health Research 21 terviews, guided by a script organized into four themes. The interviews were conducted with audio record, the permission of the participants were fully passed the text and analyzed as two different corpuses, depending on the context in which they occurred. The analysis was conducted using the ALCESTE computer program. The study obtained a favorable opinion of the Committee on Health and Welfare of the University of Évora. Results: From the irst sample analysis emerged ive classes. The association of the words gave the meaning of each class that we have appointed as Class 1 - Precipitating Events; Class 2 - Experience of abuse; Class 3 - Two feet in the present and looking into the future; Class 4 - The present and learning from the experience of abuse; and Class 5 - Violence in general. From the analysis of the sample in the community four classes emerged that we have appointed as Class 1 - Violence in general; Class 2 - Precipitating Events; Class 3 - abuse of experience; and class 4 - Support in the process. Conclusions: Women who are at shelter home have this experience of violence and its entire context a lot are very focused on their experiences and the future is distant and unclear. Women in the community have a more comprehensive view of the phenomenon of violence as a whole, they can decentralize to their personal experiences and recognize the importance of support in the future construction process.

Latent class analysis of manic and depressive symptoms in a population-based sample in Sao Paulo, Brazil

Background: Current diagnostic criteria cannot capture the full range of bipolar spectrum. This study aims to clarify the natural co-segregation of manic-depressive symptoms occurring in the general population. Methods: Using data from the Sao Paulo Catchment Area Study, latent class analysis (LCA) was applied to eleven manic and fourteen depressive symptoms assessed through CIDI 1.1 in 1464 subjects from a community-based study in Sao Paulo, Brazil. All manic symptoms were assessed, regardless of presence of euphoria or irritability, and demographics, services used, suicidality and CIDI/DSM-IIIR mood disorders used to external validate the classes. Results: The four obtained classes were labeled Euthymics (EU; 49.1%), Mild Affectives (MA; 31.1%), Bipolars (BIP; 10.7%), and Depressives (DEP; 9%). BIP and DEP classes represented bipolar and depressive spectra, respectively. Compared to DEP class, BIP exhibited more atypical depressive characteristics (hypersomnia and increase in appetite and/or weight gain), risk of suicide, and use of services. Depressives had rates of atypical symptoms and suicidality comparable to oligosymptomatic MA class subjects. Limitations: The use of lay interviewers and DSM-IIIR diagnostic criteria, which are more restrictive than the currently used DSM-IV TR. Conclusions: Findings of high prevalence of bipolar spectrum and of atypical symptoms and suicidality as indicators of bipolarity are of great clinical importance, due to different treatment needs, and higher severity. Lifetime sub-affective and syndromic manic symptoms are clinically significant, arguing for the need Of revising DSM bipolar spectrum categories. (C) 2009 Elsevier B.V. All rights reserved.