Future Episodes Research Articles

A comparison of risk factors for cryptosporidiosis and non-cryptosporidiosis diarrhoea: A case-case-control study in Ethiopian children.

Cryptosporidiosis is a major cause of diarrhoea in young children in low-and-middle-income countries. New interventions should be informed by evidence pertaining to risk factors and their relative importance. Inconsistencies in the literature may to some extent be explained by choice of methodology, furthermore, most previous risk factor studies compared cryptosporidiosis cases to diarrhoea cases of other aetiologies rather than with controls without diarrhoea. We investigated a broad set of factors in under-2-year-olds presenting with diarrhoea to a hospital and a health center in southwestern Ethiopia. We applied quantitative cut-offs to distinguish between cryptosporidiosis and incidental Cryptosporidium infection or carriage, a hierarchical causal framework to minimize confounding and overadjustment, and a case-case-control design, to describe risk factors for both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Moderate and severe acute malnutrition were strongly associated with both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Previous healthcare attendance and low maternal education were only associated with cryptosporidiosis, whereas unsafe child stool disposal, prematurity and early cessation of exclusive breastfeeding were significantly associated with non-cryptosporidiosis diarrhoea only. By estimation of population attributable fractions, socioeconomic factors-specifically low maternal education-and public tap water use, were apparently more important risk factors for cryptosporidiosis than for non-cryptosporidiosis diarrhoea. Nutritional management of moderate acute malnutrition may be an effective intervention against cryptosporidiosis, particularly if combined with targeted therapy for cryptosporidiosis which, again, may mitigate nutritional insult. Focused caregiver education in healthcare settings and follow-up of children with acute malnutrition may prevent or improve outcomes of future episodes of cryptosporidiosis.

Long-acting new generation antipsychotics in the maintenance treatment of bipolar disorders

IntroductionMaintaining remission, preventing from future episodes, better treatment adherence and improving the quality of life are main aims of long-term treatment in bipolar disorders (BD). In recent years, new generation long-acting injectable (LAI) antipsychotics have been frequently used in maintenance treatment for bipolar disorders.ObjectivesWe aimed to review socio-demographic and clinical characteristics of bipolar patients taking LAI treatment for maintenance treatment.MethodsClinical records of 44 bipolar patients who are on LAI treatment and followed in Mazhar Osman Mood Clinic (MOMC) of Selcuk University Medical Faculty were evaluated.ResultsNearly half of the patients were male (n:24, 54%). 43,2% of the patients were married. The mean age was 36.6±11.9 years and the mean duration of education was 11.5±3.9 years. All of the patients were diagnosed with bipolar 1 disorder. Most of the patients (65.9%) was on aripiprazole LAI while remaining was receiving paliperidone LAI for maintenance treatment. Ten of the patients discontinued the treatment due to the side effects and extrapyramidal side effects was the most common side effect. Relapse was observed in 25% of the patients and there was no difference between aripiprazole and paliperidone in terms of relapse rate.ConclusionsLAI new generation antipsychotics are taking place in long-term treatment of bipolar disorder via improving treatment adherence. Side effect profile of aripiprazole and paliperidone are different. However, we could not find any difference between two drugs in terms of side effects and relapse rates. Small sample size and shorter duration of follow-up should be considered as limitations.DisclosureNo significant relationships.

0662 Comparative efficacy of digital CBT-I versus stepped-care CBT-I to prevent depression

Abstract Introduction Insomnia is a robust risk factor for depression. Treating insomnia with digital CBT-I (dCBT-I) has been shown to prevent future episodes of depression; however, remission rate of insomnia following dCBT-I is lower compared to face-to-face CBT-I (fCBT-I), which may reduce the effect on depression prevention. A stepped-care model can optimize care by starting with a least resource intensive intervention (step 1: dCBT-I) and stepping-up non-remitters to specialized treatment (step 2: face-to-face CBT-I). This study examined the efficacy of a stepped-care approach to prevent depression. Methods 341 individuals with DSM-5 insomnia and no depression were randomized into two conditions at step 1: dCBT-I (n=161), or an online sleep education control (n=188). Participants in the dCBT-I condition who did not show remission for insomnia (ISI>9) were further randomized to either face-to-face CBT-I (n=40) or sleep education (n=47). Rates of clinically significant depression was assessed post-step 2. Results Insomnia remission rates were higher in the dCBT-I group (46%) compared to the control group (22%); however, 54% remained symptomatic after dCBT-I and were rerandomized to step 2 treatments (fCBT-I or sleep education control). Insomnia remission rates following fCBT-I was 70% compared to 23% in the step 2 control.Rate of depression in those who received step 2 control (following non-remission to dCBT-I in step 1; 15%) was not significantly different from the step 1 control group (20%). In contrast, those who received step 2 fCBT-I reported significantly lower rates of depression (5%, OR=.22, p < .05) compared to the step 1 control. Those who remitted to dCBT-I in step 1 also reported comparably low rates of depression (8%, OR=.36, p < .05) Conclusion Preliminary evidence from this study provide supported that a stepped-care approach may produce greater protection against incident depression than dCBT-I alone. Support (If Any) R01MH122636

A probabilistic epidemiological model for infectious diseases: The case of COVID-19 at global-level.

This study has developed a probabilistic epidemiological model a few weeks after the World Health Organization declared COVID‐19 a pandemic (based on the little data available at that time). The aim was to assess relative risks for future scenarios and evaluate the effectiveness of different management actions for 1 year ahead. We quantified, categorized, and ranked the risks for scenarios such as business as usual, and moderate and strong mitigation. We estimated that, in the absence of interventions, COVID‐19 would have a 100% risk of explosion (i.e., more than 25% infections in the world population) and 34% (2.6 billion) of the world population would have been infected until the end of simulation. We analyzed the suitability of model scenarios by comparing actual values against estimated values for the first 6 weeks of the simulation period. The results proved to be more suitable with a business‐as‐usual scenario in Asia and moderate mitigation in the other continents. If everything went on like this, we would have 55% risk of explosion and 22% (1.7 billion) of the world population would have been infected. Strong mitigation actions in all continents could reduce these numbers to, 7% and 3% (223 million), respectively. Although the results were based on the data available in March 2020, both the model and probabilistic approach proved to be practicable and could be a basis for risk assessment in future pandemic episodes with unknown virus, especially in the early stages, when data and literature are scarce.

US Sanctions and Foreign Lobbying of the US Government

Previous research has explored how US sanctions affect subsequent behavior by sanctioned states as well as third parties, with particular attention to whether states change the policies that led to US sanctions. In this paper, we argue that US sanctions also affect lobbying of the US government. States experiencing US sanctions over security and political issues will lobby the US government less than other states because this scenario suggests that lobbying is unlikely to influence US policies. States experiencing sanctions over economic issues, on the other hand, will lobby the US more as these targets would see a negotiated settlement as more feasible. We also maintain that third-party states that are similar to US sanction targets will lobby the US government more than dissimilar third parties, as lobbying in this scenario could be aimed at preempting future episodes of US sanctions—regardless of the issue that led to sanctions. We find support for our expectations in auto-regressive models spanning 1975–2005. Our findings suggest that sanctions in some cases lead states to find means other than policy concessions by which to satisfy US policy-makers.

Hitting a New Low: The Unique 28 hr Cessation of Accretion in the TESS Light Curve of YY Dra (DO Dra)

We present the Transiting Exoplanet Surveying Satellite light curve of the intermediate polar YY Draconis (YY Dra, also known as DO Dra). The power spectrum indicates that while there is stream-fed accretion for most of the observational period, there is a day-long, flat-bottomed low state at the beginning of 2020 during which the only periodic signal is ellipsoidal variation and there is no appreciable flickering. We interpret this low state to be a complete cessation of accretion, a phenomenon that has been observed only once before in an intermediate polar. Simultaneous ground-based observations of this faint state establish that when accretion is negligible, YY Dra fades to g = 17.37 ± 0.12, which we infer to be the magnitude of the combined photospheric contributions of the white dwarf and its red dwarf companion. Using survey photometry, we identify additional low states in 2018–2019 during which YY Dra repeatedly fades to—but never below—this threshold. This implies relatively frequent cessations in accretion. Spectroscopic observations during future episodes of negligible accretion can be used to directly measure the field strength of the white dwarf by Zeeman splitting. Separately, we search newly available catalogs of variable stars in an attempt to resolve the long-standing dispute over the proper identifier of this system.

Assessment of barriers to effective use of psychiatric advance directives: Providers' knowledge and attitudes.

Psychiatric advance directives, or directives for mental health treatment (DMHTs), are consistent with the principles of psychiatric rehabilitation, self-determination, and a recovery orientation. DMHTs have promise as a consumer-empowering part of a relapse prevention plan. In the context of state psychiatric hospitals, where successful community reintegration is crucial, they have particular relevance. However, DMHTs tend to be underutilized, despite the existence of consumer-friendly laws and consumer interest. Mental health providers (n = 225) were surveyed to assess knowledge of and attitudes toward more comprehensive implementation of DMHTs to test the hypothesis that at least an initial barrier to implementation is provider familiarity with DMHTs. Results of the survey indicate a lack of familiarity with DMHTs, which was addressed by a brief educational intervention embedded in the survey. Prior to education, providers demonstrated a sense of futility and low confidence in their ability to help families plan ahead for future episodes of psychosis. After brief education, they reported more confidence in their ability to effectively intervene and more confidence a DMHT would be a useful intervention. Furthermore, they reported attitudes more supportive of DMHT use as well as an increased likelihood to use DMHTs in their own practice. These findings suggest that an initial barrier to implementation of DMHTs may often be provider familiarity and understanding. Future directions, including broader interventions to increase familiarity, and limitations are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Assessment of Neuromuscular and Psychological Function in People with Recurrent Neck Pain during a Period of Remission: Cross-Sectional and Longitudinal Analyses.

The aim of this study was to examine for the presence of differences in neuromuscular and psychological function in individuals with recurrent neck pain (RNP) or chronic neck pain (CNP) following a whiplash trauma compared to healthy controls. A secondary aim was to examine whether neuromuscular characteristics together with psychological features in people with RNP were predictive of future painful episodes. Multiple features were assessed including neck disability, kinesiophobia, quality of life, cervical kinematics, proprioception, activity of superficial neck flexor muscles, maximum neck flexion and extension strength, and perceived exertion during submaximal contractions. Overall, those with RNP (n = 22) and CNP (n = 8) presented with higher neck disability, greater kinesiophobia, lower quality of life, slower and irregular neck movements, and less neck strength compared to controls (n = 15). Prediction analysis in the RNP group revealed that a higher number of previous pain episodes within the last 12 months along with lower neck flexion strength were predictors of higher neck disability at a 6-month follow-up. This preliminary study shows that participants with RNP presented with some degree of altered neuromuscular features and poorer psychological function with respect to healthy controls and these features were similar to those with CNP. Neck flexor weakness was predictive of future neck disability.

Prevalence of Diarrhea and Associated Factors Among Children Under 5 Years in Baghdad

A cross sectional study has been conducted at primary health center in Baghdad for the period of 6 months to assess the diarrhea disease occurring among children under 5 years. The sample size was 120. Data collection was carried out by direct interview with the mother of the children and filling a questionnaire including: age, sex, residence, level of mother education, occupation of mother, etc….). The results shows that the 41.7% of children were in the age group <1 years, 51.7% were female and 48.3% were male. (47.5%) of mothers had primary education, 80% of mothers had moderate socioeconomic status. Tap 77.5% was the main source of water. Highly significant differences had been found between the age and type of feeding P <0.000. we need to advice the mothers to increase the fluids and continue feeding during future episodes

Paroxysmal Atrial Fibrillation Associated With the Trigger Sequence of Strenous Exercise Followed By Cold Water Ingestion

Patients often present to the emergency department with paroxysmal atrial fibrillation. There is increasing recognition that, in a subset of patients, certain clinical triggers mediated via the autonomic nervous system may precipitate episodes of atrial fibrillation. Although identification of these triggers may be critical for prevention of future episodes, they may be overlooked by treating physicians. We describe an otherwise healthy 64-year-old physician who presented on two separate occasions to the emergency department with atrial fibrillation. He was electrically cardioverted successfully into normal sinus rhythm and discharged without medications both times. The patient ultimately recognized that both episodes occurred in the setting of strenuous exercise followed soon after by ingestion of cold water. Since avoiding this sequence he has not had any episodes of atrial fibrillation in the ensuing 7 years. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians often encounter patients who present with paroxysmal atrial fibrillation, some of whom may have autonomic triggers or trigger sequences that precipitated it. Although our single case report cannot prove that the sequence described caused the atrial fibrillation, we hope the case can serve to highlight the increasing awareness that, in a subset of patients with paroxysmal atrial fibrillation, identification of specific triggers could be critical in prevention and should be sought.

Schema-related eye movements support episodic simulation

Recent work indicates that eye movements support the retrieval of episodic memories by reactivating the spatiotemporal context in which they were encoded. Although similar mechanisms have been thought to support simulation of future episodes, there is currently no evidence favoring this proposal. In the present study, we investigated the role of eye movements in episodic simulation by comparing the gaze patterns of individual participants imagining future scene and event scenarios to across-participant gaze templates for those same scenarios, reflecting their shared features (i.e., schemas). Our results provide novel evidence that eye movements during episodic simulation in the face of distracting visual noise are (1) schema-specific and (2) predictive of simulation success. Together, these findings suggest that eye movements support episodic simulation via reinstatement of scene and event schemas, and more broadly, that interactions between the memory and oculomotor effector systems may underlie critical cognitive processes including constructive episodic simulation.

Episodic Past, Future, and counterfactual thinking in Relapsing-Remitting Multiple sclerosis

Multiple sclerosis (MS) is a progressive disease characterized by widespread white matter lesions in the brain and spinal cord. In addition to well-characterized motor deficits, MS results in cognitive impairments in several domains, notably in episodic autobiographical memory. Recent studies have also revealed that patients with MS exhibit deficits in episodic future thinking, i.e., our capacity to imagine possible events that may occur in our personal future. Both episodic memory and episodic future thinking have been shown to share cognitive and neural mechanisms with a related kind of hypothetical simulation known as episodic counterfactual thinking: our capacity to imagine alternative ways in which past personal events could have occurred but did not. However, the extent to which episodic counterfactual thinking is affected in MS is still unknown. The current study sought to explore this issue by comparing performance in mental simulation tasks involving either past, future or counterfactual thoughts in relapsing-remitting MS. Diffusion weighted imaging (DWI) measures were also extracted to determine whether changes in structural pathways connecting the brain’s default mode network (DMN) would be associated with group differences in task performance. Relative to controls, patients showed marked reductions in the number of internal details across all mental simulations, but no differences in the number of external and semantic-based details. It was also found that, relative to controls, patients with relapsing-remitting MS reported reduced composition ratings for episodic simulations depicting counterfactual events, but not so for actual past or possible future episodes. Additionally, three DWI measures of white matter integrity—fractional anisotropy, radial diffusivity and streamline counts—showed reliable differences between patients with relapsing-remitting MS and matched healthy controls. Importantly, DWI measures associated with reduced white matter integrity in three association tracts on the DMN—the right superior longitudinal fasciculus, the left hippocampal portion of the cingulum and the left inferior longitudinal fasciculus—predicted reductions in the number of internal details during episodic counterfactual simulations. Taken together, these results help to illuminate impairments in episodic simulation in relapsing-remitting MS and show, for the first time, a differential association between white matter integrity and deficits in episodic counterfactual thinking in individuals with relapsing-remitting MS.

Implementation of Educational-Interactive-Psychiatric Management Software for Patients with Bipolar Disorder

Background: Bipolar disorder is considered a psychiatric disease without any effective screening questionnaire to monitor and manage Iranian patients. This study aims to implement a researcher-made questionnaire in the form of educational interactive software for better management of patients with bipolar disorder and prevent further complications. Methods: The present cross-sectional study evaluated the efficacy of psychoeducational-interactive-therapeutic software for patients with bipolar disorder, which is a network-based software providing a researcher-made questionnaire in a planned manner. This software can predict the occurrence of future bipolar episodes for each patient by using artificial intelligence algorithms after the occurrence of two mood episodes as the training phase. The patients with bipolar disorder were asked to use the software for a year and their mood episodes were compared before and after using the software. We evaluate the reliability of the questionnaires in the software with internal consistency using alpha Cronbach test and test-retest analysis. Face validity and content validity were also evaluated. Results: The content validity index of the instrument was 93%, and the Cronbach's alpha coefficient of the whole questionnaire was 0.955. Also, the ICC coefficient for this questionnaire is above 0.70, and the correlation coefficient of the answers in all constructs of the questionnaire is more than 0.8. Thirty male patients with bipolar disorder who experienced four episodes of mood swings per year experienced an average of 2 mood episodes per year following the use of this software. Conclusion: Our Psychoeducational-interactive-therapeutic software is the first Persian language software based on artificial intelligence to monitor clinical symptoms in patients with bipolar disorder, which uses a standard questionnaire to predict the incidence of episodes of depression and mania in these patients.

Reviewing clinical considerations and guideline recommendations of C1 inhibitor prophylaxis for hereditary angioedema.

BackgroundHereditary angioedema (HAE), a rare disease that is characterized by painful and recurring non‐allergic swelling episodes, is caused by the deficiency or dysfunction of C1 inhibitor (C1INH) protein. A comprehensive HAE management plan may require long‐term prophylaxis (LTP) in addition to on‐demand treatment to help “normalize” patients' lives so that they may fully engage in work, school, family, and leisure activities.AimThe main objective of this narrative review is to provide an overview of updated guideline recommendations specific to LTP of HAE and discuss clinical considerations and pharmacologic management options, with a focus on C1INH.Materials and MethodsThe authors reviewed relevant HAE literature for current recommendations regarding LTP and the role of C1NH.ResultsAcute HAE attacks are treated with on‐demand medication; however, there is a consensus that LTP should routinely be considered for risk reduction and prevention of future episodes. The 2017 World Allergy Organization/European Academy of Allergy and Clinical Immunology guidelines recommend that all patients with HAE be evaluated for LTP routinely and the 2020 HAE Association (HAEA) guidelines emphasize that the decision to use LTP should not be based on rigid criteria, but rather should be based on individual patient needs. Both guidelines recommend C1INH as first‐line/preferred therapy for LTP in a range of patient types including adults, children/adolescents, and pregnant/lactating patients. The HAEA also recommends the kallikrein inhibitor, lanadelumab, as a first‐line option for LTP. HAE pathway‐specific agents for LTP have not been associated with notable safety concerns.DiscussionPlasma‐derived C1INH has been available for 40+ years in Europe and impacts multiple targets within the HAE pathway. C1INH has been used for on‐demand treatment and LTP. A subcutaneous formulation of plasma‐derived C1INH is approved for LTP and produces functional C1INH activity levels consistently above the threshold needed for protection from HAE attacks. Other pathway‐specific options for LTP include the plasma kallikrein inhibitors, lanadelumab‐flyo and berotralstat, approved for adults and pediatric patients aged ≥12 years. C1INH is approved for adults and pediatric patients aged ≥6 years.ConclusionAssessing the need for LTP is vital in the ongoing dialogue between clinicians and patients, as both disease‐related factors and patient preferences may change over time. Among available options for LTP, plasma‐derived C1INH is the broadly recommended first‐line option for LTP in patients with HAE, including pregnant/lactating women and pediatric patients (≥6 years).

Effect of Incorporating Computerized Insulin Dose Adjustment Algorithms into a Remote Patient Monitoring Program on HbA1c Levels in Patients with Type 2 Diabetes

Aims: To evaluate the effect of Federal Drug Administration-cleared computerized insulin dose adjustment algorithms (CIDAAs) incorporated into a Remote Patient Monitoring (RPM) program on HbA1c levels. Material & Methods: Type 2 patients receiving insulin for >6 months with HbA1c levels ≥8.0% enrolled in a Medicare Advantage plan were recruited into 3 arms; Group A (RPM plus CIDAAs, N=40), Group B (RPM but no CIDAAs, N=42), and Group C (usual care with no RPM or CIDAAs, N=33). In Groups A and B, glucose readings of >200 mg/dL and <70 mg/dL triggered alerts and health educators contacted patients for counseling to avoid future episodes. Results: Baseline HbA1c levels (% ± SD) were not statistically different among Groups A (9.5 ± 1.5), B (9.2 ± 1.1) and C (9.0 ± 0.9). At 6 months, HbA1c levels fell twice as much in Group A (-1.5 ± 1.0) as in Groups B (-0.7 ±1.5) and C (-0.7 ± 1.2) (P <0.001). Alerts >200 mg/dl were significantly less in Group A (N=942) than in B (N=1111) (P = 0.002) but alerts <70 mg/dL were not significantly different (235 vs 209). In Group A, baseline per patient daily insulin doses of 78 units rose 40% to 109 units. Six patients in Group C had emergency room visits for hypoglycemia but none in Groups A and B. Conclusions: The RPM program lessened clinical hypoglycemic risk but required CIDAAs to markedly increase insulin doses effectively and safely to significantly lower HbA1c levels twice as much as either RPM alone or usual care.

AVALIAÇÃO DAS CONSEQUÊNCIAS DO GALGAMENTO COSTEIRO DE 10/11 DE DEZEMBRO DE 2013 NA FRENTE URBANA DO CONCE-LHO DE SANTA CRUZ, ILHA DA MADEIRA

The expansion and consolidation of urban areas along the coast lead to the exposure of a large number of anthropic elements to sea storm events. It is with the aim of identifying and classifying the consequences of coastal overtopping that we analyse the recent storm surge of 10/11 December of 2013 which affected the urban coastal fringe of the city of Santa Cruz, on the south coast of Madeira Island. Therefore, the atmospheric conditions of wind intensity and atmospheric pressure are analysed and is characterised the direction of the waves and their maximum height, as well as the tide variation. After the oceanographic and meteorological characterization, it´s identified and evaluated the structural damage on the coastal zone and classified the functional consequences on the port structures affected by overtopping. The quantitative analysis of atmospheric and oceanographic data supports that this overtopping is a green water type resulting from an extratropical storm arising from the rapid reduction of atmospheric pressure and an average wind velocity of 30 km/h, affecting approximately 1600 meters of the coastal area of Santa Cruz. The qualitative analysis of the consequences shows that the port structures suffered severe to catastrophic consequences and dysfunction of their normal activities. The most affected areas are at the extremes of the urban front, registering reduced to insignificant consequences, in the intermediate area. Thus, it shows areas of greatest exposure, and areas that had presented seriously to severe damages, which can be highlighted in future episodes.

Evaluation and Correlation of Pulpal Calcification in the Patients with Cardiovascular Diseases in Vidarbha Region, India

Background: The dental pulp is soft tissue enclosed in the hard tissues of teeth. Calcification occurring in the body affects the dental pulp too. Pulp undergoes calcification as whole or in discrete masses known as denticles or pulp stones. Pulp stones are nodular, calcified masses seen more frequently in coronal pulp than radicular pulp. Pulp stones can vary from small structures embedded in pulp tissue to large masses.
 Aim: To evaluate and correlate the pulpal calcification with cardiovascular diseases in the patients using radiograph in Vidarbha region.
 Objectives:
 
 To evaluate the presence of pulpal calcification in the patients with cardiovascular disease using Ortho-pantomogram images.
 To co-relate the radiological findings with the cardiovascular disorders.
 
 Methodology: The present study comprises of 30 patients out of whom 15 patients will be in test group and 15 patients in control group. The test group will consist of patients suffering from cardiovascular diseases and control group will consist of healthy patients with no significant medical history. Ortho-pantomogram will be taken of each participant and the anterior and posterior teeth will be assessed for any pulp calcification and obliteration of pulp chamber and root canals.
 Expected Results: Positive correlation is expected between pulp calcification and cardiovascular diseases.
 Conclusion: Positive correlation can be found between the occurrence of pulpal calcifications and cardiovascular disease. Hence the occurrence of pulpal calcifications can be used to predict the future chances of cardiovascular diseases in the otherwise normal person. Early detection of pulp calcification can be used as a tool to predict the disease and will help in taking possible steps to avoid the future episodes of heart diseases.

The Lahars of the South-East slope of Mount Cameroon: geological study, economic interest and impacts of their exploitation on the environment

Mount Cameroon is the site of explosive eruptions with the emission of ash, slag and lava flows. Mudflows, known as Lahars, can also be observed. These Lahars are mainly found in the lower part of the south-eastern slope. The outcrops observed on this flank show that these Lahars are very extensive and are avalanches of volcanic material, which flowed down the slopes of the volcano after the eruptions. The different outcrops observed are separated by pyroclastic products on which the lahars rest. The components of these lahars are generally black or grey basalts. The main granulometric characteristic of the deposits of these lahars is their heterometry. The size of the material varies from a few meters to the clay fraction. Large concentrations of mineable material are found in the watercourses. These materials are exploited in order to produce aggregates for civil engineering. This exploitation has consequences on the immediate environment. In addition to climatic factors, several parameters have influenced the mobilities and emplacement of the lahars on the south-eastern slope of Mount Cameroon: the slope, the volume and thickness of the deposits, the nature and physico-hydric characteristics of the deposits. The persistence of strombolian volcanic eruptions on Mount Cameroon and the particularly rainy context predispose it to other future episodes of lahar flow.

The Temporal Pattern of Arterial Stiffness during Aging: A Large-Scale Cross-Sectional Study.

Brachial-ankle pulse wave velocity (baPWV) is a noninvasive clinical test that provides quantification for the stiffness of both the aorta and peripheral arteries by measuring the brachial and tibial arterial wave velocities. The temporal pattern of baPWV values during aging was investigated in this paper. A gradual increase in baPWV with respect to age was observed, suggesting an increase in the stiffness of arterial vessels as age increases. The ΔbaPWV value, defined as the absolute value of the difference between bilateral baPWV, also showed a positive correlation with aging. Many underlying physiological conditions such as hyperlipidemia, hypertension, diabetes, and hyperglycemia have previously been shown to elevate baPWV and contribute to the decline of arterial function. The effect of factors including biological sex, blood pressure, and blood glucose levels on the baPWV temporal pattern were also investigated. Between the ages of 18 and 50, men in the study had significantly higher baPWV readings than females of comparable age on average. However, after the age of 50, mean baPWV values increased at a greater rate in females than in males. In addition, blood pressure and blood glucose were shown to be associated with baPWV values. The results will improve existing prediction models for future cardiovascular episodes induced by arterial hardening in different age groups.

COVID-19 lockdown in Spain: Psychological impact is greatest on younger and vulnerable children.

In 2020, quarantine home confinement measures were implemented in Spain to control a pandemic for the first time. The objective of this study is to assess both the psychological and social impact of that ‘lockdown’ on different age groups of children and adolescents and also the different strategies adopted by families in that situation. We collected data via an online questionnaire answered by 850 participants, parents of young people aged between 4 and 18, between 24th April and 8th May 2020. Our results show that living in a home smaller than 80 m2 is associated with an increased risk of presenting clinical symptoms of emotional or behavioural distress, with an odds ratio of 2.54 (95% CI: 1.07–6.02), p = 0.034; while increased age is a predictor of better psychological functioning during lockdown: coefficient of 0.25 (95% CI: 0.07–0.41), p = 0.004. Moreover, age is also a marker of higher scores on the scale of psychological symptoms, with a coefficient of 0.02 (95% CI: 0.01–0.04), p = .005. To conclude, younger children present poorer behavioural and emotional functioning and more symptoms of emotional distress than adolescents during lockdown. Living in a small home is a risk factor for presenting clinical symptoms. These findings should be taken into consideration when planning for future home confinement episodes and when considering preventative strategies in the realm of mental health care.