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Objectives Recent genome-wide association studies (GWASs) have identified numerous putative genetic polymorphisms associated with bipolar disorder (BD) and/or schizophrenia (SC). We hypothesized that a portion of these polymorphisms would also be associated with BD in the Latino American population. To identify such regions, we tested previously identified genetic variants associated with BD and/or SC and ancestral haploblocks containing these single nucleotide polymorphisms (SNPs) in a sample of Latino subjects with BD. Methods A total of 2254 Latino individuals were genotyped for 91 SNPs identified in previous BD and/or SC GWASs, along with selected SNPs in strong linkage disequilibrium with these markers. Family-based single marker and haplotype association testing was performed using the PBAT software package. Empirical P-values were derived from 10 000 permutations. Results Associations of eight a priori GWAS SNPs with BD were replicated with nominal (P≤.05) levels of significance. These included SNPs within nuclear factor I A (NFIA), serologically defined colon cancer antigen 8 (SDCCAG8), lysosomal associated membrane protein 3 (LAMP3), nuclear factor kappa B subunit 1 (NFKB1), major histocompatibility complex, class I, B (HLA-B) and 5′-nucleotidase, cytosolic II (NT5C2) and SNPs within intragenic regions microRNA 6828 (MIR6828)—solute carrier family 7 member 14 (SLC7A14) and sonic hedgehog (SHH)—long intergenic non-protein coding RNA 1006 (LINC01006). Of the 76 ancestral haploblocks that were tested for associations with BD, our top associated haploblock was located in LAMP3; however, the association did not meet statistical thresholds of significance following Bonferroni correction. Conclusions These results indicate that some of the gene variants found to be associated with BD or SC in other populations are also associated with BD risk in Latinos. Variants in six genes and two intragenic regions were associated with BD in our Latino sample and provide additional evidence for overlap in genetic risk between SC and BD.

We previously identified bipolar disorder (BD) susceptibility loci on 8q24, 14q32, and 2q12-14 in a genome-wide nonparametric linkage screen in a Latino cohort. We now perform a fine mapping analysis using a dense map of additional SNPs to identify BD susceptibility genes within these regions. One thousand nine hundred and thirty-eight individuals with Latino ancestry (880 individuals with BD Type I or Schizoaffective, Bipolar Type) from 416 Latino pedigrees from the United States, Mexico, Costa Rica, and Guatemala were genotyped with 3,074 SNPs to provide dense coverage of the 8q24 (11.5 cM), 14q32 (7.5 cM), and 2q12-14 (6.5 cM) chromosomal loci. Single-marker association tests in the presence of linkage were performed using the LAMP software. The top linkage peak (rs7834818; LOD = 5.08, p = 3.30E - 5) and associated single marker (rs2280915, p = 2.70E - 12) were located within FBXO32 on 8q24. On chromosome 2, the top linkage peak (rs6750326; LOD = 5.06, p = 3.50E - 5) and associated single marker (rs11887088, p = 2.90E - 6) were located in intragenic regions near ACTR3 and DPP10. None of the additional markers in the region around chromosome 14q32 met significance levels for linkage or association. We identified six SNPs on 2q12-q14 and one SNP in FBXO32 on 8q24 that were significantly associated with BD in this Latino cohort.

Objective Presentation of 5 clinical cases of Merkel cell carcinoma of the eyelid, highlighting the clinical, histopathological, management, and monitoring features. Review of related literature. Methods Retrospective review of clinical records and telephone interview of the 5 patients treated for Merkel cell carcinoma between 2006 and 2013, in the Orbit and Oculoplastic Department, Clinical Hospital of the University of Chile. Results Five patients (2 men, 3 women); 79.2 years (range 64–94 years), with a mean onset of 10 weeks (range 5–16 weeks), tumor size reaching a mean of 2.5 × 2 × 2.1 cm at the time of surgery. Described as a nodular mass, exophytic, solid, reddish colored. With no infiltrated lymph nodes or metastases in the first match. Staging as T2N0M0, after the first surgery with oncological criteria. Two lymph node recurrences detected during monitoring. Distant metastasis was found in one patient. The histopathological diagnosis was confirmed by immunohistochemical study of the biopsy. The surgical strategy was full excision, control of surgical margins in the intraoperative period, and eyelid reconstruction with Hughes flap, Cutler–Beard flap or primary closure, depending on the case. Conclusions Early diagnosis, wide excision of the tumor with intraoperative control of clear margins with conventional or Mohs surgery, and proper eyelid reconstruction are adequate for a good survival in elderly patients with this eyelid tumor. The study of sentinel lymph node biopsy in primary intervention is recommended; with subsequent radiotherapy to decrease the recurrence and increase survival.

Resumen Objetivo Estudio descriptivo de 5 casos clinicos de carcinoma de Merkel a nivel palpebral, destacando las caracteristicas clinicas, histopatologicas, el manejo y seguimiento. Revision de literatura asociada. Metodos Revision retrospectiva de fichas clinicas y entrevista telefonica a 5 pacientes tratados por carcinoma de celulas de Merkel entre los anos 2006-2013, en el Departamento de Orbita y Oculoplastica del Hospital Clinico de la Universidad de Chile. Resultados Cinco pacientes (2 hombres, 3 mujeres), de 79,2 anos (rango 64-94 anos), con una evolucion de 10 semanas (rango 5-16 semanas), con un tamano tumoral de 2,5 × 2 x 2,1 cm en promedio al momento de la cirugia. Descritos como una masa nodular, exofitica, solida, de color rojizo. Sin adenopatias sospechosas ni metastasis en el primer enfrentamiento. Tipificados como T2N0M0, tras la primera cirugia con criterios oncologicos. Se observo, durante el seguimiento, 2 recurrencias en nodulo linfoide. Encontramos metastasis a distancia en un paciente. El diagnostico histopatologico se confirmo mediante biopsia corriente mas inmunohistoquimica. La estrategia quirurgica fue con extirpacion completa, control de margenes libres y reconstruccion palpebral con colgajo de Hughes, Cutler-Beard o cierre primario. Conclusiones El diagnostico precoz, la extirpacion amplia del tumor con control de margenes libres intraoperatorio con cirugia convencional o tecnica de Mohs y una adecuada reconstruccion palpebral permiten una supervivencia en pacientes anosos portadores de este tumor a nivel palpebral. Se recomienda el estudio de ganglio centinela y biopsia en la intervencion primaria, junto a una radioterapia posterior, que disminuye la recurrencia y aumentaria la supervivencia.

Background: Variations in circadian genes can impact biological rhythms. Given the rhythm disturbances that characterize bipolar disorder (BD), genes encoding components of molecular clocks are good candidate genes for the illness. Methods: A family based association analysis of circadian gene single nucleotide polymorphisms (SNPs) and BD was conducted in Latino pedigrees. 884 individuals from 207 pedigrees (473 BP phenotype and 411 unaffected family members) were genotyped. Family based single marker association testing was performed. Ancestral haplotypes (SNPs found to be in strong LD defined using confidence intervals) were also tested for association with BD. Results: Multiple suggestive associations between circadian gene SNPs and BD were noted. These included CSNK1E (rs1534891, p= 0.00689), ARNTL (rs3789327, p= 0.021172), CSNK1D (rs4510078, p=0.022801), CLOCK (rs17777927, p=0.031664). Individually, none of the SNPs were significantly associated with BD after correction for multiple testing. However, a 4-locus CSNK1E haplotype encompassing the rs1534891 SNP (Z-score=2.685, permuted p=0.0076) and a 3-locus haplotype in ARNTL (Z-score=3.269, permuted p=0.0011) showed a significant association with BD. Limitations: Larger samples are required to confirm these findings and assess the relationship between circadian gene SNPs and BD in Latinos. Conclusions: The results suggest that ARNTL and CSKN1E variants may be associated with BD. Further studies are warranted to assess the relationships between these genes and BD in Latino populations. National Institute of Mental Health/[RO1-MH0698567]/NIMH/Estados Unidos Cancer Center Support Grant/[P30-CA54174]/CCSG/Estados Unidos Brain and Behavior Research Foundation/[]/Brain and Behavior Research Foundation/Estados Unidos UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigación en Biología Celular y Molecular (CIBCM)

A genome-wide nonparametric linkage screen was performed to localize Bipolar Disorder (BP) susceptibility loci in a sample of 3757 individuals of Latino ancestry. The sample included 963 individuals with BP phenotype (704 relative pairs) from 686 families recruited from the US, Mexico, Costa Rica, and Guatemala. Non-parametric analyses were performed over a 5 cM grid with an average genetic coverage of 0.67 cM. Multipoint analyses were conducted across the genome using non-parametric Kong & Cox LOD scores along with Sall statistics for all relative pairs. Suggestive and significant genome-wide thresholds were calculated based on 1000 simulations. Single-marker association tests in the presence of linkage were performed assuming a multiplicative model with a population prevalence of 2%. We identified two genome-wide significant susceptibly loci for BP at 8q24 and 14q32, and a third suggestive locus at 2q13-q14. Within these three linkage regions, the top associated single marker (rs1847694, P = 2.40 × 10(-5)) is located 195 Kb upstream of DPP10 in Chromosome 2. DPP10 is prominently expressed in brain neuronal populations, where it has been shown to bind and regulate Kv4-mediated A-type potassium channels. Taken together, these results provide additional evidence that 8q24, 14q32, and 2q13-q14 are susceptibly loci for BP and these regions may be involved in the pathogenesis of BP in the Latino population.

articulo -- Universidad de Costa Rica. Centro Investigacion en Biologia Molecular y Celular, 2013

artículo -- Universidad de Costa Rica. Centro Investigación en Biología Molecular y Celular, 2010. Este documento es privado debido a limitaciones de derechos de autor. Objectives:The aims of this study were to estimate the frequency and course of substances use disorders in Latino patients with schizophrenia and to ascertain risk factors associated with substance use disorders in this population. Method: We studied 518 subjects with schizophrenia recruited for a genetic study from the Southwest United States, Mexico, and Central America (Costa Rica and Guatemala). Subjects were assessed using structured interviews and a best estimate consensus process. Logistic regression, χ 2 , ttest, Fisher's exact test, and Yates' correction, as appropriate, were performed to assess the sociodemographic variables associated with dual diagnosis. We defined substance use disorder as either alcohol or substance abuse or dependence. Results: Out of 518 patients with schizophrenia, 121 (23.4%) had substance use disorders. Comorbid substance use disorders were associated with male gender, residence in the United States, immigration of Mexican men to the United States, history of depressive syndrome or episode, and being unemployed. The most frequent substance use disorder was alcohol abuse/ dependence, followed by marijuana abuse/dependence, and solvent abuse/dependence. Conclusion: This study provides data suggesting that depressive episode or syndrome, unemployment, male gender, and immigration of Mexican men to the United States were factors associated with substance use disorder comorbidity in schizophrenia. Binary logistic regression showed that country of residence was associated with substance use disorder in schizophrenic patients. The percentage of subjects with comorbid substance use disorders was higher in the Latinos living in the United States compared with subjects living in Central America and Mexico. Universidad de Costa Rica. This research was supported by the following grants from the National Institute of Mental Health: MH60881 and MH60875. Dr. Jimenez-Castro was supported by a fellowship of grant D43 TW06152-01 from the National Institute of Mental Health, the National Institute of Drug Abuse and the Fogarty Institute. These institutions had no further role in the study design, in the collection, analysis and interpretation of data, in writing of the report, and in the decision to submit the paper for publication UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigación en Biología Celular y Molecular (CIBCM)

Depression and suicidal behavior are frequently observed in patients with schizophrenia. The serotonin transporter protein regulates serotonergic signaling at synapses and is encoded by a single gene (SLC6A4; Locus Link ID: 6532), located at 17q11.1-q12 with two polymorphic variants (the short and the long allele). The short allele of serotonin transporter gene has been associated with depression and suicidality in individuals who suffered negative life events and with depression in individuals with chronic psychosis.. Subjects were recruited from a genetic study of schizophrenia conducted in Costa Rica. The authors replicated their previous research, using a more narrow phenotype (only schizophrenic subjects) and a more ethnically homogenous sample (only Costa Rican schizophrenic individuals who were not included in the previous study). The authors hypothesized that subjects with at least one copy of the serotonin transporter promoter gene polymorphism (5-HTTLPR) "s" allele would have a greater history of lifetime depression and suicidability rate than those who had an "l/l" genotype. The authors analyzed 155 subjects with a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) diagnosis of schizophrenia (73% male, age at interview 38.3, SD = 11.23). The genotype distribution was "ss" 58 (37%), "sl" 69 (45%), and "ll" 28 (18%). In the secondary analysis, the authors explored association of the "s" allele with lifetime history of suicide behavior in 173 subjects (18 more subjects than primary analysis because schizophrenic individuals were included regardless of history of depression). The authors found that subjects carrying at least one short allele had a significant increased lifetime risk for depressive syndromes (chi(2) = 5.4, df = 1, P = 0.02; odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.15-6.3). No association was found for suicidal behavior in the same sample (chi(2) = 0.928, P = 0.629). In conclusion, the genotype at the 5-HTTLPR promoter polymorphic locus increases the risk of developing major depression but not suicidal behavior during the course of the schizophrenia in these patients. Due to the small sample size, these results should be followed by definitive replication.

The present study deals with a multiple reaction system in both gas and liquid phases considering the effect of gas-liquid mass transfer limitations in a trickle-bed reactor where the catalytic hydrotreating of gas oil reaction is being carried out. The hydrodesulfurization (HDS) and hydrogenation (HYD) of aromatics reactions over NiMo and CoMo catalysts are taken into account in the model. The reactor model was codified as a user-added unit operation in PROvision process simulator (V 5,0), in FORTRAN language. This model is used to predict reactant conversion and product distribution as a function of inlet condition. The differential equations are solved by the LSODE program. The PROvision process simulator provides the database for physical and thermodynamics properties of the components through appropriate liquid-vapor equilibrium models.

To investigate the role of the apolipoprotein E (APOE) gene in schizophrenia, the authors analyzed 60 families with this mental disorder. An association in the presence of linkage test (APL) and haplotypes analysis were undertaken using the APL v1.1 software. A global allelic transmitted was significant for APOE-epsilon3 (chi(2)=6.24, p=0.01); this allele is mainly carried by female patients (chi(2)=8.33, p=0.003), whereas APOE-219G is preferentially transmitted in males (p=0.02). Furthermore, our results show that haplotypes APOE-epsilon3/APOE-219G are associated with schizophrenia (chi(2)=11.61, p=0.01). These results provide evidence that the APOE gene may play a significant role in the etiology of schizophrenia in the Mexican population.

artículo (arbitrado)--Universidad de Costa Rica, Centro de Investigación en Biología Celular y Molecular. 2009. Este documento es privado debido a limitaciones de derechos de autor. We determined the rates of agreement between diagnoses, using the Diagnostic Interview for Genetic Studies (DIGS) and diagnoses arrived at, using additional sources of information, to establish whether there are differences in agreement between direct interview diagnoses at US and non-US sites in comparison best estimate consensus process and to identify diagnoses that could increase diagnostic error when only the DIGS is used. DIGS diagnoses were compared with consensus diagnoses that used the same DIGS interview, plus Family Interview for Genetic Studies (FIGS) and review of medical records in 342 psychotic subjects. We found similar numbers of subjects diagnosed with schizophrenia (225 by direct interview, and 232 by consensus process). The majority of those “misdiagnosed” by direct interview had mood disorder by the consensus. Over 10% of the total subjects diagnosed by direct interview as not meeting criteria for schizophrenia had schizophrenia by consensus. There were no statistically significant differences between countries (US vs. non-US sites) in the agreement rate between direct interview diagnosis and consensus diagnosis. In conclusion, a final best-estimate process is essential to make diagnostic distinctions and to reduce diagnostic misclassifications for both research studies and in clinical practice Universidad de Costa Rica UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigación en Biología Celular y Molecular (CIBCM)

artículo (arbitrado). Universidad de Costa Rica, Centro de Investigación en Biología Celular y Molecular, 2008. Este artículo es privado debido a limitaciones de derechos de autor. This study attempted to replicate evidence for association of the Epsin 4 gene (which encodes enthoprotin, a protein involved in vesicular transport) to schizophrenia in a new sample of families segregating schizophrenia drawn from the Latin American population. 1423 subjects (767 with a history of psychosis) from 337 Latino families were genotyped using three single nucleotide polymorphisms (SNPs) spanning the Epsin 4 gene. A family based association test was utilized to test for association of these SNPs to the phenotypes of psychosis and schizophrenia. Haplotypes defined by these three SNPs showed significant association to the phenotype of psychosis in this sample (global p value=0.014, bi-allelic p value=0.047). Variation in the Epsin 4 gene is significantly associated with psychotic disorder in this Latino population. This provides additional support for the involvement of enthoprotin in the pathogenesis of schizophrenia and other psychotic disorders. Universidad de Costa Rica UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigación en Biología Celular y Molecular (CIBCM)

Biodiesel can be produced from a number of natural, renewable sources, but vegetable oils are the main feedstocks. Most existing biodiesel plants currently rely upon the use of a homogeneous catalyst in a continuous reactor system, using the transesterification of soybean or rapeseed oil with methanol into alkyl esters. A key differentiation characteristic among the existing processes is that of the mixing pattern employed in the system. The present study compares reactor performances in terms of biodiesel yields for plug flow and complete mixing behaviors, along with the use of interstage phase separation. It is concluded that plug flow pattern shows a distinctive benefit in terms of yields and reactor volume reduction compared to complete mixing. Interstage separation improves the reacting system yields when proper phase separation can be achieved, maximizing glycerine removal from the downstream system. Staged mechanically stirred tank reactors can reach similar performances as plug flow behavior syste...

Justificación y objetivo: la esquizofrenia es una enfermedad crónica con importantes repercusiones sociales que afecta al 1% de la población mundial. Se describe las características de la esquizofrenia en una muestra de pacientes del Valle Central de Costa Rica. Métodos: estudio descriptivo, transversal en esquizofrénicos diagnosticados a través del proceso de mejor estimado diagnostico según la cuarta edición del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSMIV). Resultados: de 260 esquizofrénicos, 186 (71.5%) son varones y 74 (28.5%) mujeres, la edad promedio de entrevista es 38.95 años (Desviación Standard (DS): 11.37), menor en los varones (37.54 años, DS: 10.46) que en las mujeres (42.49 (DS: 12.81, p0.05). El número de hospitalizaciones es en promedio 5.49 (DS: 5.24), (p>0.05), los sujetos solteros presentan tendencia a un mayor número de ingresos (17.25 internamientos). El 49.6% ha sufrido al menos un síndrome depresivo mayor, 7.5% de los varones presenta abuso y el 22.0% dependencia al alcohol; 7.7% de sujetos presenta abuso y el 7.3% dependencia a sustancias (p>0.05). Discusión: Nuestros pacientes presentaron características clínicas y demográficas similares a lo observado en otras poblaciones. Más de la mitad de los individuos tenían antecedente de síntomas afectivos siendo los depresivos los más frecuentes. Los varones solteros constituyeron el grupo con peor pronóstico, mayor desempleo y mayor tendencia a presentar reingresos hospitalarios. Sin embargo, dicho hallazgo podría ser explicado por la organización económica de los hogares y el rol social del varón en nuestra sociedad. Conclusión: los varones y las mujeres EZ del VCCR muestran una misma edad de inicio de enfermedad, el subtipo predominante en ambos grupos es el indiferenciado con el antecedente de síntomas depresivos. Los varones presentan un mayor índice de desempleo, mayor consumo de sustancias lícitas e ilícitas y mayor número de hospitalizaciones que las mujeres.

Functional alterations of components of the endogenous cannabinoid system, in particular of the cannabinoid receptor 1 protein (CB1), are hypothetical contributors to many of the symptoms seen in schizophrenia. Variants within the cannabinoid receptor 1 gene (CNR1) have been shown to be directly associated with the hebephrenic form of schizophrenia in a Japanese population. This finding, however, has yet to be replicated. In the present study we sought to study the same (AAT)n-repeat microsatellite of the CNR1 gene which showed association to hebephrenic schizophrenia in Japan, and to investigate whether this microsatellite showed association to a hebephrenic type of schizophrenia in a family-based association study in a population of the Central Valley of Costa Rica. The Lifetime Dimensions of Psychosis Scale and a best estimate consensus process were utilized to identify subjects with schizophrenia who had an elevated lifetime dimensional score for negative and disorganized symptoms, which we used as a proxy for “hebephrenia.” Using the Family Based Association Test we found association of these hebephrenic subjects and the (AAT)n-repeat marker of the CNR1 (multi-allelic P = 0.0368). Our hypothesis that an association with the (AAT)n-repeat marker of CNR1 would not be found with the more general type of schizophrenia was also confirmed. Schizophrenic subjects with prominent lifetime scores for disorganization and negative symptoms (dimension for hebephrenia) are associated with the CNR1 gene and present a type of symptomatology that resembles chronic cannabinoid-induced psychosis. The current finding points to the possibility of different genetic and pathophysiologic mechanisms underlying different types of schizophrenia. © 2008 Wiley-Liss, Inc.

Schizophrenia (SC) and bipolar disorder (BP) share many clinical features, among them psychosis. We previously identified a putative gene locus for psychosis on chromosome 18p in a sample from the Central Valley of Costa Rica (CVCR) population. The present study replicated the association to a specific allele of microsatellite marker D18S63 on 18p11.3, using a newly collected sample from the CVCR. A combined analysis of both samples, plus additional subjects, showed that this specific allele on D18S63, which lies within an intron on the TGFB-induced factor (TGIF) gene, is strongly associated (P-value=0.0005) with psychosis. Eleven additional SNP markers, spanning five genes in the region, were analyzed in the combined sample from the CVCR. Only the four SNPs within the TGIF gene were in strong linkage disequilibrium with D18S63 (D'=1.00). A specific haplotype for all five markers within the TGIF gene showed evidence of association (P-value=0.011) to psychosis. A second, distinct haplotype, containing a newly identified nonsynonymous polymorphism in exon 5 of the TGIF gene, showed a nonsignificant trend towards association to psychosis (P-value=0.077). TGIF is involved in neurodevelopment, neuron survival and controls the expression of dopamine receptors. Altogether, our results point to the possible involvement of TGIF in the pathophysiology of psychotic disorders in the CVCR population.

Schizophrenia is a complex psychiatric disorder, likely to be caused in part by multiple genes. In this study, linkage analyses were performed to identify chromosomal regions most likely to be associated with schizophrenia and psychosis in multiplex families of Mexican and Central American origin. Four hundred and fifty-nine individuals from 99 families, containing at least two siblings with hospital diagnoses of schizophrenia or schizoaffective disorder, were genotyped. Four hundred and four microsatellite markers were genotyped for all individuals and multipoint non-parametric linkage analyses were performed using broad (any psychosis) and narrow (schizophrenia and schizoaffective disorder) models. Under the broad model, three chromosomal regions (1pter-p36, 5q35, and 18p11) exhibited evidence of linkage with non-parametric lod (NPL) scores greater than 2.7 (equivalent to empirical P values of less than 0.001) with the peak multipoint NPL = 3.42 (empirical P value = 0.00003), meeting genomewide evidence for significant linkage in the 1pter-p36 region. Under the narrow model, the same three loci showed (non-significant) evidence of linkage. These linkage findings (1pter-p36, 18p11, and 5q35) highlight where genes for psychosis and schizophrenia are most likely to be found in persons of Mexican and Central American ancestry, and correspond to recent linkages of schizophrenia or psychosis in other populations which were formed in part from emigrants from the Spanish empire of the 15th and 16th centuries. © 2006 Wiley-Liss, Inc.

Linkage studies using multiplex families have repeatedly implicated chromosome 8 as involved in schizophrenia etiology. The reported areas of linkage, however, span a wide chromosomal region. The present study used the founder population of the Central Valley of Costa Rica and phenotyping strategies alternative to DSM-IV classifications in attempts to further delimitate the areas on chromosome 8 that may harbor schizophrenia susceptibility genes. A linkage disequilibrium screen of chromosome 8 was performed using family trios of individuals with a history of psychosis. Four discrete regions showing evidence of association (nominal P values less than 0.05) to the phenotype of schizophrenia were identified: 8p23.1, 8p21.3, 8q13.3 and 8q24.3. The region of 8p23.1 precisely overlaps a region showing strong evidence of linkage disequilibrium for severe bipolar disorder in Costa Rica. The same chromosomal regions were identified when the broader phenotype definition of all individuals with functional psychosis was used for analyses. Stratification of the psychotic sample by history of mania suggests that the 8q13.3 locus may be preferentially associated with non-manic psychosis. These results may be helpful in targeting specific areas to be analyzed in association-based or linkage disequilibrium-based studies, for researchers who have found evidence of linkage to schizophrenia on chromosome 8 within their previous studies.

Objective: This study used the population of the Central Valley of Costa Rica (CVCR) and phenotyping strategies alternative to DSMIV classifications to investigate the association of neuregulin 1 with schizophrenia. Method: Using 134 family trios with a history of psychosis, we genotyped six of the seven markers originally identified to be associated with schizophrenia in Iceland. Results: The neuregulin Icelandic haplotype was not associated with schizophrenia in the CVCR population. However, a novel haplotype was found to be overrepresented in subjects with functional psychosis (global P-value > 0.05). Stratification of the sample by history of mania suggests that this haplotype may be preferentially over-transmitted to persons with a history of manic psychosis. Conclusion: These results suggest that the neuregulin 1 gene is unlikely to play a major role in predisposing to schizophrenia in the CVCR. Further studies in the CVCR and other Latin American populations should be performed in order to corroborate these findings.

The long-standing concept that schizophrenia (SC) and bipolar disorder (BP) represent two distinct illnesses has been recently challenged by findings of overlap of genetic susceptibility loci for these two diseases. We report here the results of a linkage disequilibrium (LD) analysis of chromosome 18 utilizing subjects with SC from the Central Valley of Costa Rica. Evidence of association (P < 0.05) was obtained in three chromosomal regions: 18p11.31 (D18S63), 18q12.3 (D18S474), and 18q22.3-qter (D18S1161, D18S70), all of which overlap or are in close proximity with loci previously shown to be in LD with BP, type I in this population. Since both the SC and bipolar samples contained cases with a history of mania and almost all cases of SC and BP had a history of psychosis, we performed an alternative phenotyping strategy to determine whether presence or absence of mania, in the context of psychosis, would yield distinct linkage patterns along chromosome 18. To address this issue, a cohort of psychotic patients (including a range of DSMIV diagnoses) was divided into two groups based on the presence or absence of mania. Regions that showed association with SC showed segregation of association when the sample was stratified by history of mania. Our results are compared with previous genetic studies of susceptibility to SC or BP, in Costa Rica as well as in other populations. This study illustrates the importance of detailed phenotype analysis in the search for susceptibility genes influencing complex psychiatric disorders in isolated populations and suggests that subdivision of psychoses by presence or absence of past mania syndromes may be useful to define genetic subtypes of chronic psychotic illness.

Adverse effects of antipsychotics are important determinants of patient attitudes towards medications, adherence to treatment, and quality of life. A discussion of adverse effects is therefore a crucial element of treatment and offers a unique opportunity for dialogue between the patient and the clinician. Unfortunately, clinicians in routine clinical practice have had very limited guidance regarding how best to initiate this discussion. In fact, despite the recognition of the importance of adverse effects, their systematic assessment has been, for the most part, confined to research settings, where the main focus has been on extrapyramidal symptoms (EPS). Furthermore, until recently, clinicians tended to discount patient subjective experiences with antipsychotic medications, focusing on the evaluation of objective severity. However, ignoring the subjective experience of patients results in inadequate communication between the patient and the clinician. The Approaches to Schizophrenia (Communication ASC) Steering Group, comprised of psychiatrists from the US, Canada and the UK, identified the need to develop a tool that could be used in routine clinical care settings to facilitate the communication between patients and clinicians regarding adverse effects. In order to be useful the instrument needed to be brief, clinically focused and easy to administer. As for the content, it needed to include the patients’ subjective experiences with antipsychotics and to assess a broad adverse effect profile (i.e. both EPS and non-EPS effects). To address these needs, the Steering Group designed two checklists: the ASC-Self-Report (ASC-SR) and the ASC-Clinic (ASC-C). The ASC-SR is a self-report checklist completed by the patient. It contains a list of common problems experienced by patients receiving antipsychotics. The ASC-C is a clinician-administered version that is designed to be completed by the clinician and the patient together during a regular clinic visit. The experience with the ASC-SR and ASC-C checklists across sites and countries has been encouraging. The vast majority of respondents in a pilot study of the ASC checklists found the ASC-SR user friendly and helpful in their communication with the healthcare team. Likewise, almost half of the healthcare professionals reported that the ASC-C assisted them in identifying previously unrecognized adverse effects. Additional experience in the UK and the US has provided further support for clinical use of the checklists.

Stangeland's kinetic model for predicting hydrocracker yields was modified to explicitly account for the mass balance closure in each individual hydrocracking reaction and for the effect of hydrogen partial pressure on the hydrocracking reaction rate. This improved kinetic model has two additional parameters. The model was applied to the modeling of a fixed bed reactor for mild hydrocracking of vacuum gas oils in the framework of the Aspen Plus® process simulator. The kinetic parameters were regressed using the algorithm of Levenberg-Marquardt such that the mass balance in each individual hydrocracking reaction is satisfied. The reactor model assumed gas-liquid equilibrium and was used to quantify the effect upon conversion of the operating variables--liquid hourly spatial velocity, reactor pressure, and hydrogen-to-feed ratio--showing that both the kinetic and reactor models predict the appropriate trends compared to the reference data. The practical implications of explicitly introducing the mass balanc...

In a previous study, we found that cognitive adaptation training (CAT)--a manual-driven program of environmental supports designed to bypass cognitive deficits--improved multiple domains of outcome in schizophrenia patients recently discharged from a State psychiatric facility. The present study examined the efficacy of CAT in a sample of patients who had been in the community at least 3 months. Forty-five medicated schizophrenia patients were randomly assigned for 9 months to one of three conditions: (1) CAT, (2) a condition that controlled for therapist time and provided environmental changes unrelated to cognitive deficits, or (3) follow-up only. Comprehensive assessments were conducted every 3 months by blinded raters. Results of repeated measures analyses of covariance for mixed models indicated that patients participating in CAT had better adaptive function and quality of life, and fewer positive symptoms than those in the two non-CAT conditions. Results indicate that compensatory strategies may improve various outcomes in schizophrenia outpatients.

Presentation of 5 clinical cases of Merkel cell carcinoma of the eyelid, highlighting the clinical, histopathological, management, and monitoring features. Review of related literature.Retrospective review of clinical records and telephone interview of the 5 patients treated for Merkel cell carcinoma between 2006 and 2013, in the Orbit and Oculoplastic Department, Clinical Hospital of the University of Chile.Five patients (2 men, 3 women); 79.2 years (range 64-94 years), with a mean onset of 10 weeks (range 5-16 weeks), tumour size reaching a mean of 2.5×2×2.1cm at the time of surgery. Described as a nodular mass, exophytic, solid, reddish coloured. With no infiltrated lymph nodes or metastases in the first match. Staging as T2N0M0, after the first surgery with oncological criteria. Two lymph node recurrences detected during monitoring. Distant metastasis was found in one patient. The histopathological diagnosis was confirmed by immunohistochemical study of the biopsy. The surgical strategy was full excision, control of surgical margins in the intraoperative period, and eyelid reconstruction with Hughes flap, Cutler/Beard flap or primary closure, depending on the case.Early diagnosis, wide excision of the tumour with intraoperative control of clear margins with conventional or Mohs surgery, and proper eyelid reconstruction are adequate for a good survival in elderly patients with this eyelid tumour. The study of sentinel lymph node biopsy in primary intervention is recommended; with subsequent radiotherapy to decrease the recurrence and increase survival.

Objectives. We examined the association of posttraumatic stress disorder (PTSD), traumatic brain injury, and chronic pain—the polytrauma clinical triad (PCT)—independently and with other conditions, with suicide-related behavior (SRB) risk among Operation Enduring Freedom (OEF; Afghanistan) and Operation Iraqi Freedom (OIF) veterans. Methods. We used Department of Veterans Affairs (VA) administrative data to identify OEF and OIF veterans receiving VA care in fiscal years 2009–2011; we used International Classification of Diseases, Ninth Revision, Clinical Modification codes to characterize 211 652 cohort members. Descriptive statistics were followed by multinomial logistic regression analyses predicting SRB. Results. Co-occurrence of PCT conditions was associated with significant increase in suicide ideation risk (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.5, 2.4) or attempt and ideation (OR = 2.6; 95% CI = 1.5, 4.6), but did not exceed increased risk with PTSD alone (ideation: OR = 2.3; 95% CI = 2.0, 2.6; attempt: OR = 2.0; 95% CI = 1.4, 2.9; ideation and attempt: OR = 1.8; 95% CI = 1.2, 2.8). Ideation risk was significantly elevated when PTSD was comorbid with depression (OR = 4.2; 95% CI = 3.6, 4.8) or substance abuse (OR = 4.7; 95% CI = 3.9, 5.6). Conclusions. Although PCT was a moderate SRB predictor, interactions among PCT conditions, particularly PTSD, and depression or substance abuse had larger risk increases.

During the 1990s significant changes took place in the practice of psychiatry, particularly in the treatment of schizophrenia and related disorders (1). These changes were the result of a combination of factors, including deinstitutionalization, the availability of new medications, and managed care. Managed care has prompted the need to demonstrate the efficacy and effectiveness of new medications and other evidence-based interventions to support their incorporation in clinical practice. Published guidelines for the treatment of schizophrenia (2,3) provide a framework of reference that includes expert consensus and research evidence supporting a rational approach to disease management. Most guidelines are general, and their implementation has been left up to practitioners and organizations. The extent to which clinical sites conform to guidelines varies, partly because of differences in financial support and the availability of other resources (4). This column describes the experience of clinicians working in a publicsector institution in implementing best-practice guidelines for schizophrenia. Setting

Home care of a chronically mentally ill relative exerts substantial physical and emotional demands on a family member. Yet, little work has examined the perspective about caregiving voiced by individuals from different ethnic groups and the comparison of this perspective with objective measures of caregiver burden. This article reviews findings from a study of 251 Mexican American and European American family caregivers of severely mentally ill relatives living in South Texas. Significant multivariate interaction effects of residence (rural/urban) and level of acculturation were found on caregiver stresses and coping responses, even when controlling for income. Analyses suggest differential vulnerability patterns for caregiver burden: In urban areas, Spanish-speaking Mexican Americans reported higher stress and greater coping efforts; whereas in rural areas, this was true instead for more acculturated Mexican Americans and European Americans. Discussion addresses differences in report of burden between standardized scaled approaches and open-ended responses and explores how the nature of caregiver burden may vary along contextual lines.

Applying research findings to community mental health practices is slowed by provider concerns that research participants often differ from community populations in duration of illness, comorbid conditions, and illness severity. Selecting participants from community settings makes research results demonstrably relevant, but researchers and community providers can be mistrustful of one another, feeling that the other has little understanding of their needs and work. This mistrust impedes patient referrals for research. This column describes a program to increase researcher knowledge of community clinic procedures through structured interactions with clinic personnel. Follow-up interviews indicate improved attitudes and cooperation of researchers and community providers.

The present study examined the concurrent and predictive validity of the Allen Cognitive Levels (ACL) Assessment in a sample of 110 medicated patients with schizophrenia who received the ACL at discharge from a state psychiatric facility. Subsamples within this group of patients had received an Activities of Daily Living assessment (n = 64) and a comprehensive neuropsychological test battery (n = 48) at discharge, or a battery of community follow-up measures (n = 30) 1-3.5 years following discharge as part of other investigations. Positive correlations were found between the ACL and concurrent measures of adaptive and cognitive function. With respect to cognitive variables, stepwise multiple regression analysis revealed that the majority of the variance in ACL scores was predicted by neuropsychological test scores assessing higher level cognitive processes, such as visual organization, manipulation of information in working memory, and ability to inhibit a response to a prepotent stimulus. Finally, results revealed positive relationships between the ACL obtained at discharge and community functioning at follow-up. The results of this study provide some evidence for the concurrent and predictive validity of the ACL for patients with schizophrenia and suggest that further study of this assessment tool would be important to pursue in future investigations.

Data from a random sample of 164 Anglo, 168 African American, and 149 Mexican American male regular drinkers compare the use of cross-sectional data on current consumption patterns versus retrospective lifetime drinking history data in studying ethnic differences in "maturing out" of heavy drinking among male drinkers. Crosssectional analyses among males in their 20s, 30s, and 40s on current consumption indexes suggest that maturing out of heavy drinking may be more of an Anglo phenomenon. Drinking history analyses suggest that the process takes place in both majority and minority male drinkers in their 20s, although slightly earlier among Anglos. Although Mexican Americans were less likely to report heavy or problem drinking stages, heavy drinkers in this ethnic group reported heavy drinking earlier and for longer periods of time than did otherdrinkers. Analyses suggest that ethnic differences in the maturing out phenomenon may be more subtle than is suggested in the cross-sectional analysis.

One parameter models have been extensively used for three-phase reactor simulation when backmixing is present in the liquid phase. Axial dispersion and cell models are among the most commonly employed, using the dispersion coefficient and the number of cells, respectively, as parameters that account for the liquid backmixing. Because of the mathematical complexity of the system usually at hand some symplifying assumptions are made to obtain a tractable problem. Some of them involve the thermodynamics or physical property estimation. This work introduces a modified cell model (MCM) for three-phase reactors with significant backmixing in the liquid phase. Different phenomena are accounted for in the model: interfacial mass transfer limitations, adiabatic operation, phase distributions. All these effects are evaluated sequentially within a repetitive cell unit, following the criterion that numerical complexity is proportional to the number of equations and to the degree of coupling among them. In the case of MCM, the number of cells determines the degree of coupling among the effects and it is not related to the extent of backmixing as in classical models. Liquid phase mixing is introduced by considering a macroscopic recycle in the corresponding phase between the first and last cell. The numerical solution of this model is accomplished through an adequate computer program and the use of a commercial process simulator that provides an important link to thermodynamics and transport properties estimation packages. This is a new technique that allows the user to build a complex conceptual model with little development effort. The present work is focused in bubble column slurry reactors. In most cases the chemical reaction occurs between a gas reactant dissolved in the liquid phase and a liquid reactant in the surface of a solid catalyst suspended in the slurry. One of such applications is the hydrocracking of heavy oil fractions. Its adiabatic operation is modeled as a function of the global gas-liquid mass transfer coefficient for the reacting gaseous species, particle diameter, inlet solids concentration, superficial gas velocity and recycle ratio that accounts for liquid backmixing.

The purpose of this study was to assess ethnic differences in the negative symptom profile of 25 Anglo American and 26 Mexican American subjects with schizophrenia. Subjects were rated at the end of a 1-2-week medication washout period (time 1) and at discharge (time 2) with the Negative Symptoms Assessment (NSA), Brief Psychiatric Research Scale, (BPRS), the [Diagnostic and Statistical Manual of Mental Disorders (4th edition)] DSM-IV negative factor score and LAECA acculturation scale. Total NSA scores were significantly higher among Mexican Americans both at time 1 and time 2. Among the five subscales of the NSA, ethnic differences were significant only for the Cognition subscale at time 1. Results indicate no ethnic differences in core negative symptoms (alogia, avolition, flat affect), but do suggest that a cognition-related factor differs between Mexican American and Anglo American schizophrenic patients.

In an effort to improve our understanding of perceived treatment barriers among veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) relative to other era veterans, the current study examined veteran attitudes and beliefs about mental health treatment and treatment-seeking, and perceived patient and institution-level logistical barriers to care.A survey was conducted among 434 Combat veterans seeking care in nine Veterans Affairs mental health care outpatient clinics.When compared to Vietnam and Gulf War veterans, OEF/OIF veterans were significantly more likely to endorse negative treatment attitudes as possible barriers to care. OEF/OIF veterans were also more likely than Vietnam veterans to endorse conflicting work demands as a potential barrier, although this was the only logistical barrier for which OEF/OIF veterans' responses differed significantly from those of veterans of other eras. Among OEF/OIF veterans, older veterans were more likely than younger veterans to endorse barriers related to cost and time commitments.These findings suggest an important role for outreach and engagement strategies that address attitudinal barriers to treatment utilization among veteran populations.

The author present several results of some different European Project about the the call "Smart Cities and Communitiesin Europe". The main objective of these projects is to develop a replicable strategy for the design, construction and management of entire residential neighborhoods with "almost zero" consumption. The experience, both in the competition participation and in the course of the phases of the project, it is particularly significant, especially for the synergy that has necessarily developed at international level, including Municipality, researchers, industries, non-profit companies and finance companies. Regarding the role of the University is evident the contribution in terms of knowledge and strength of cohesion between the different actors involved.

Through recent genome-wide association studies (GWASs), several groups have reported significant association between variants in the calcium channel, voltage-dependent, L-type, alpha 1C subunit (CACNA1C) and bipolar disorder (BP) in European and European-American cohorts. We performed a family-based association study to determine whether CACNA1C is associated with BP in the Latino population. This study included 913 individuals from 215 Latino pedigrees recruited from the USA, Mexico, Guatemala, and Costa Rica. The Illumina GoldenGate Genotyping Assay was used to genotype 58 single-nucleotide polymorphisms (SNPs) that spanned a 602.9-kb region encompassing the CACNA1C gene including two SNPs (rs7297582 and rs1006737) previously shown to associate with BP. Individual SNP and haplotype association analyses were performed using Family-Based Association Test (version 2.0.3) and Haploview (version 4.2) software. An eight-locus haplotype block that included these two markers showed significant association with BP (global marker permuted p = 0.0018) in the Latino population. For individual SNPs, this sample had insufficient power (10%) to detect associations with SNPs with minor effect (odds ratio = 1.15). Although we were not able to replicate findings of association between individual CACNA1C SNPs rs7297582 and rs1006737 and BP, we were able to replicate the GWAS signal reported for CACNA1C through a haplotype analysis that encompassed these previously reported significant SNPs. These results provide additional evidence that CACNA1C is associated with BP and provides the first evidence that variations in this gene might play a role in the pathogenesis of this disorder in the Latino population.

This demonstration project examined whether medication management coordinators enhanced continuity of care from inpatient facilities to an outpatient public mental health clinic.From 2004 to 2008, patients (N=325) hospitalized with schizophrenia or schizoaffective or bipolar disorder enrolled in a medication management program before discharge or at their first clinic appointment. Medication management coordinators supplemented existing clinic practices by identifying recently hospitalized patients, providing inpatient and outpatient prescribing clinicians with patients' complete medication history, meeting with patients for six months postdischarge to assess clinical status and provide medication education, and advocating guideline-concordant prescribing. Recently discharged patients (N=345) assigned to a different outpatient clinic within the same agency served as the comparison group. Intent-to-treat, repeated-measures analyses for mixed models compared the groups' number of hospital admissions, hospital days, and medication appointments kept and use of nurse or case manager contact hours and emergency or crisis services during the 12 months before enrollment, the six-month intervention, and the six-month follow-up period.After discharge, individuals enrolled in medication management were more likely than comparison patients to attend outpatient appointments, and they had more medication visits and nurse or case manager treatment hours than the comparison group. Use of hospital and crisis or emergency services by all patients decreased. Almost one-third of patients never attended an outpatient appointment after hospital discharge.Although this program succeeded in improving continuity of care, additional interventions may be required to reduce rehospitalization and crisis care.

We developed an intervention to improve compliance with guidelines for monitoring metabolic syndrome and compared compliance prior to intervention and three times post-intervention at three community mental health clinics in Texas. One test clinic received intervention and two other clinics served as controls. Fifty random charts were reviewed from each clinic for three specific, 1–2 weeks periods over the course of 18 months. There were significant improvements in the ordering of labs, the presence of lab results in the chart, and documentation of blood pressure, body mass index and waist circumference in the intervention clinic over time in comparison to the control clinics. Documented evidence of physician action with respect to out of range values remained low. Metabolic monitoring is a multi-step process. Removing barriers, creating specific procedures, and dedicating staff resources can improve compliance with monitoring.

A 2004 consensus statement by the American Psychiatric Association and other groups noted that metabolic side effects of second-generation antipsychotics require monitoring. To reduce risk, prescribers may consider factors differentially associated with development of metabolic abnormalities, such as age, gender, and race-ethnicity. As part of a study of older patients with schizophrenia (50-102 years), this study evaluated factors associated with antipsychotic switches and switches that incurred a greater or lesser metabolic risk.Administrative data were analyzed for a national cohort of 16,103 Veterans Health Administration patients with schizophrenia receiving second-generation antipsychotics. Multinomial logistic regression predicted the likelihood of switches from 2002 to 2003 and again from 2004 to 2005.At baseline nearly half the patients (45%) had a diagnosis of hypertension, a third (34%) had dyslipidemia, and 15% had a diagnosis of obesity. In both periods diabetes was associated with switches to lower-risk antipsychotics, and older patients were likely to experience neutral or no switches. Women were more likely to experience switches to higher-risk antipsychotics in 2004-2005.General medical conditions potentially associated with antipsychotic-related metabolic concerns were common; however, half of these patients were prescribed medication that made them liable to developing metabolic problems. Modest evidence suggests that metabolic considerations became a higher priority during the study. Future research should investigate the differential impact of antipsychotics on metabolic dysregulation for women and elderly patients. Findings underscore the need to monitor metabolic parameters of older patients taking antipsychotics.

The aim of the study was to evaluate ethnic and gender differences in the diagnostic profiles of patients first admitted to the alcohol/drug rehabilitation unit of a state hospital. The majority of the patients (66%) had more than one diagnosis. African-American patients were significantly more likely to have a single diagnosis, however. In terms of primary diagnosis, Mexican Americans were more likely to have an alcoholrelated disorder while African-Americans were more likely to have a drug related disorder Drug-related disorders also complicate the diagnostic profile of African-American patients who had a primary diagnosis of an alcohol-related disorder Ethnic differences in type of drug abused were observed. African Americans were more likely to use stimulants/hallucinogens, and Mexican Americans were more likely to use depressants. A drug-related disorder was the most common diagnosis among females across all ethnic groups. Findings pointto the need of developing gender/ethnic-sensitive treatment programs. Potential ethnic and gender biases in the diagnostic evaluation of substance abuse patients are discussed.

Research involving community mental health center clients, resources, or both can affect clinical care, administrative processes, and costs. To help agencies identify and quantify these effects, a stakeholder group examined and discussed a range of protocols and then developed questionnaires and rating scales for agency use. The purpose of these materials is to make explicit the risks, costs, and benefits of a research protocol so an agency can make informed decisions about protocol approval and implementation. The goal of this work was to promote the conduct of appropriate research in community mental health settings while reducing risks to the agency and its clientele.

Context Although genetic influences on bipolar disorder are well established, localization of genes that predispose to the illness has proven difficult. Given that genes predisposing to bipolar disorder may be transmitted without expression of the categorical clinical phenotype, a strategy for identifying risk genes is to identify and map quantitative intermediate phenotypes or endophenotypes. Objective To adjudicate neurocognitive endophenotypes for bipolar disorder. Design All participants underwent diagnostic interviews and comprehensive neurocognitive evaluations. Neurocognitive measures found to be heritable were entered into analyses designed to determine which test results are impaired in affected individuals, are sensitive to the genetic liability for the illness, and are genetically correlated with affection status. Setting Central valley of Costa Rica; Mexico City, Mexico; and San Antonio, Texas. Participants Seven hundred nine Latino individuals participated in the study. Of these, 660 were members of extended pedigrees with at least 2 siblings diagnosed as having bipolar disorder (n = 230). The remaining subjects were community control subjects drawn from each site who did not have a personal or family history of bipolar disorder or schizophrenia. Main Outcome Measure Neurocognitive test performance. Results Two of the 22 neurocognitive variables were not significantly heritable and were excluded from subsequent analyses. Patients with bipolar disorder were impaired on 6 cognitive measures compared with nonrelated healthy controls. Nonbipolar first-degree relatives were impaired on 5 of these, and the following 3 tests were genetically correlated with affection status: Digit Symbol Coding Task, Object Delayed Response Task, and immediate facial memory. Conclusion This large-scale extended pedigree study of cognitive functioning in bipolar disorder identifies measures of processing speed, working memory, and declarative (facial) memory as candidate endophenotypes for bipolar disorder.

Diurnal variations in streamflow (DVS) have been studied in detail by underwater pressure loggers. Some of this equipment requires barometric compensation with a logger or sensor located outside the water. Studies related to this topic have not offered a critical report of the validity of patterns inferred with these instruments. While studying a forested watershed in Southern Chile (40° S), we detected a DVS when the external logger was placed 1.5 m above ground, under a marked diurnal fluctuation in air temperature (amplitude 12.4 °C) and a dampened fluctuation in stream temperature (amplitude 1.4 °C). Synchronization was apparent between air and stream temperature in a direct relationship, but the synchronization between air/stream temperature and streamflow was negative, with some hours of lag time. In laboratory experiments, when the external logger is considerably warmer than the water-level logger, depth measurements can be underestimated by up to 1.5 cm. When the opposite occurs, water depths can be overestimated by up to 0.9 cm and are large instrumental/methodological artifacts compared to the field water diurnal variation of 1.3 cm. Finally, we relocated the external logger in front of the water-level logger and inside a weir, but exposed to the air. Results confirmed the pattern previously detected in the field, but streamflow fluctuations were 19% less accentuated. We conclude that the incorrect placement of the external logger, along with an instrumental artifact, can intensify a DVS pattern.

Schizophrenia (SC) and bipolar disorder (BP) are two of the most severe and incapacitating mental disorders. It has been questioned whether these two conditions designate distinct illnesses with different etiologies or whether they represent different ends of a clinical spectrum with a common etiology. This study compares social and clinical characteristics of 84 SC and 84 BP subjects from the Costa Rican Central Valley (CRCV) using information from the DIGS, FIGS and psychiatric records. Each of these subjects had a best estimate lifetime consensus diagnosis of either bipolar type I or SC. Subjects with SC differed from subjects with BP in social adjustment measures like marital and employment status, and number of children. Both groups were very similar in years of education, age of onset of their illness, history of other psychiatric co-morbidities, and treatment received. The high percentage of psychosis in the BP group (97.6%) may largely explain the similarities found between groups in their clinical characteristics. The differences in social and functional decline support the original dichotomy described by Kraepelin based on chronicity and periodicity between these two psychotic disorders.

Schizophrenia is a genetically complex illness with heterogeneous clinical presentation, including variable age of onset. In this study, the heritability, or proportion of variation in age of onset of psychotic symptoms due to genetic factors, was estimated using a maximum likelihood method. The subjects were 717 members of families with more than one member affected with schizophrenia from Mexican and Central American populations. Age of onset of psychosis was determined by best-estimate consensus diagnosis based on the Diagnostic Interview for Genetic Studies, Family Interview for Genetic Studies, and each subject's medical records. Mean age of onset was 21.44 years (SD 8.07); 20.55 years for males (SD 6.90), and 22.67 for females (SD 9.34). Variance components were estimated using a polygenic model in the SOLAR software package. The sex of the participant was a significant covariate (P = 0.010) accounting for 0.02 of the total variance in age of onset. The heritability of age of onset of psychosis was 0.33 (SE = 0.09; P = 0.00004). These findings suggest that genetic factors significantly contribute to the age of onset of psychotic symptoms in individuals with schizophrenia and that sex influences this trait as well.

A comprehensive mathematical model description of a fixed-bed reactor for catalytic incineration of volatile organic compound is developed for accurate sizing of the commercial reactor from laboratory data

A heterogeneous model for the fast fluidized bed reactor which carries out a gas-solid non catalytic reaction is presented. The hydrodynamics of the fast fluidized bed is characterized by the model of Kwauk et al. (1985) which assumes the existence of two phases; a dense phase and a dilute pneumatic transport phase. For a given solid flowrate, the length of the reactor occupied by each phase depends on gas velocity, particle diameter and density and average voidage within the reactor. The gas-solid reaction is assumed to follow the shrinking core model. The solids are assumed to be completely backmixed in the dense phase and move in plug How in the dilute pneumatic transport phase. The gas phase is assumed to be in plug flow in both phases For given gas and solid flowrates, the transition from the dense phase flow to the fast fluidized bed (containing two regions) as functions of particle size and density is determined using the model of Kwauk et al. (1985). The numerical solution of the governing mass ba...

This paper reports the voidage and mixing of solids measured in a 10-cm-diameter, 6.2-m-tall recirculating fluidized bed column. The solid were alumina with an average particle size of 120 {mu}m, a wide particle size distribution, and a density of 3460 kg/m{sup 3}. For mixing of solids, CaCl{sub 2} impregnated on alumina as a tracer and the carbon- alumina system were examined. The experimental measurements were carried out in the ranges of gas velocities from 3.5 to 4.5 m/s, solid recycle rates from 7 to 11 kg/(m{sup 2} {center dot} s), column inventories from 19 to 24 kg, and average riser voidages from 0.879 to 0.938. The experimental data for the solid fraction were correlated well (mean deviation 26.9%) with an expression similar to Kwauk et al.'s model. Mixing of solids in the riser was well correlated assuming a dilute core region, a wall region with a high concentration of solids, and interchange of solids between these two regions. The mixing model contained two parameters; the mass-exchange coefficient {ital k}{sub m} between the core and wall regions and the effective average residence time for the solids in the return leg, {ital t}{sub pf}. The experimental data obtained in this study weremore » well correlated by the mass-exchange coefficient.« less

The clinical and sociodemographic profile of suicidal and nonsuicidal schizophrenia patients was investigated in 801 patients with this diagnosis seen at a comprehensive psychiatric facility between 1983 and 1987. Suicidal patients tended to exhibit depression, aggressiveness, substance abuse and a severe and progressive impairment in adaptive functioning.