Proposed Recommendations for the Management of Depression in Adults with Epilepsy: An Expert Consensus.

INTRODUCTION: Experts agree that there is a need for protocols to guide health professionals on how to best manage psychiatric comorbidities in patients with epilepsy (PWE). We aimed to develop practical recommendations for key issues in the management of depression in PWE. METHODS: This was a qualitative study conducted in four steps: (1) development of a questionnaire on the management of depression in PWE to be answered; (2) literature review and, if evidence from guidelines/consensus or systematic reviews was available, drafting initial recommendations; (3) a nominal group methodology for reviewing initial recommendations and formulating new recommendations on those issues without available evidence; and (4) drafting and approving the final recommendations. A scientific committee (one neurologist and one psychiatrist) was responsible for the development of the project and its scientific integrity. The scientific committee selected a panel of experts (nine neurologists and nine psychiatrists with experience in this field) to be involved in the nominal group meetings and to formulate final recommendations. RESULTS: Fifteen recommendations were formulated. Four on the screening and diagnosis: screening and diagnosis of depression, evaluation of the risk of suicide, and diagnosis of depression secondary to epilepsy; nine on the management of depression: referral to a psychiatrist, selection of the antiseizure medication, change of antiseizure medication, antidepressant treatment initiation, selection of antidepressant, use of antidepressants during pregnancy, use of psychotherapy, antidepressant treatment duration, and discontinuation of antidepressant treatment; two on the follow-up: duration of the follow-up under usual conditions, and follow-up of patients at risk of suicide. CONCLUSION: We provide recommendations based on expert opinion consensus to help healthcare professionals assess depression in PWE. The detection and treatment of major depressive disorders are key factors in improving epilepsy outcomes and avoiding suicide risk.

A Novel, Simple and Highly Efficient Route to Obtain PrBaMn2O5+δ Double Perovskite: Mechanochemical Synthesis.

In this work, a mechanochemical route was proposed for the synthesis of the PrBaMn2O5+δ (PMBO) double layered perovskite phase. The mechanochemical reaction between Pr6O11, BaO2, and MnO powders with cationic stoichiometric ratios of 1/1/2 for Pr/Ba/Mn was performed using high-energy milling conditions in air. After 150 min of milling, a new phase with perovskite structure and cubic symmetry consistent with the A-site disordered Pr0.5Ba0.5MnO3 phase was formed. When this new phase was subsequently annealed at a high temperature in an inert Ar atmosphere, the layered PrBaMn2O5+δ phase was obtained without needing to use a reducing atmosphere. At 1100 °C, the fully reduced layered PrBaMn2O5 phase was achieved. A weight gain was observed in the 200-300 °C temperature range when this fully reduced phase was annealed in air, which was consistent with the transformation into the fully oxidized PrBaMn2O6 phase. The microstructural characterization by SEM, TEM, and HRTEM ascertained the formation of the intended PrBaMn2O5+δ phase. Electrical characterization shows very high electrical conductivity of layered PBMO in a reducing atmosphere and suitable in an oxidizing atmosphere, becoming, therefore, excellent candidates as solid oxide fuel cell (SOFC electrodes).

Effect of the Processing Parameters on the Porosity and Mechanical Behavior of Titanium Samples with Bimodal Microstructure Produced via Hot Pressing.

Commercially pure (c.p.) titanium grade IV with a bimodal microstructure is a promising material for biomedical implants. The influence of the processing parameters on the physical, microstructural, and mechanical properties was investigated. The bimodal microstructure was achieved from the blends of powder particles with different sizes, while the porous structure was obtained using the space-holder technique (50 vol.% of ammonium bicarbonate). Mechanically milled powders (10 and 20 h) were mixed in 50 wt.% or 75 wt.% with c.p. titanium. Four different mixtures of powders were precompacted via uniaxial cold pressing at 400 MPa. Then, the specimens were sintered at 750 °C via hot pressing in an argon gas atmosphere. The presence of a bimodal microstructure, comprised of small-grain regions separated by coarse-grain ones, was confirmed by optical and scanning electron microscopies. The samples with a bimodal microstructure exhibited an increase in the porosity compared with the commercially available pure Ti. In addition, the hardness was increased while the Young's modulus was decreased in the specimens with 75 wt.% of the milled powders (20 h).

Development by Mechanochemistry of La0.8Sr0.2Ga0.8Mg0.2O2.8 Electrolyte for SOFCs.

In this work, a mechanochemical process using high-energy milling conditions was employed to synthesize La0.8Sr0.2Ga0.8Mg0.2O3-δ (LSGM) powders from the corresponding stoichiometric amounts of La2O3, SrO, Ga2O3, and MgO in a short time. After 60 min of milling, the desired final product was obtained without the need for any subsequent annealing treatment. A half solid oxide fuel cell (SOFC) was then developed using LSGM as an electrolyte and La0.8Sr0.2MnO3 (LSM) as an electrode, both obtained by mechanochemistry. The characterization by X-ray diffraction of as-prepared powders showed that LSGM and LSM present a perovskite structure and pseudo-cubic symmetry. The thermal and chemical stability between the electrolyte (LSGM) and the electrode (LSM) were analyzed by dynamic X-ray diffraction as a function of temperature. The electrolyte (LSGM) is thermally stable up to 800 and from 900 °C, where the secondary phases of LaSrGa3O7 and LaSrGaO4 appear. The best sintering temperature for the electrolyte is 1400 °C, since at this temperature, LaSrGaO4 disappears and the percentage of LaSrGa3O7 is minimized. The electrolyte is chemically compatible with the electrode up to 800 °C. The powder sample of the electrolyte (LSGM) at 1400 °C observed by HRTEM indicates that the cubic symmetry Pm-3m is preserved. The SOFC was constructed using the brush-painting technique; the electrode-electrolyte interface characterized by SEM presented good adhesion at 800 °C. The electrical properties of the electrolyte and the half-cell were analyzed by complex impedance spectroscopy. It was found that LSGM is a good candidate to be used as an electrolyte in SOFC, with an Ea value of 0.9 eV, and the LSM sample is a good candidate to be used as cathode.

Tailoring the Band Gap in the ZnS/ZnSe System: Solid Solutions by a Mechanically Induced Self-Sustaining Reaction.

The complete ZnS xSe1- x solid solution was successfully obtained by the mechanochemical process denoted as a mechanically induced self-sustaining reaction. Excellent control of the chemical stoichiometry of the solid solution was possible by adjusting the atomic ratio of the starting Zn/S/Se elemental mixture subjected to milling. A mixture of both wurtzite-2H (hexagonal) and zinc blende (cubic) structures was always obtained, although for a similar milling time the proportion of the zinc blende structure increased with the Se content in the solid solution. However, wurtzite was the major phase for S-rich compositions when milling was stopped just after ignition. It was demonstrated that milling induces the wurtzite-to-zinc blende phase transition. The 8H hexagonal polytype was also observed in samples subjected to long milling times. Variation of the lattice parameters for both structures with the x value in the solid solution presented an excellent linearity, confirming the validity of Vegard's law. However, variation of the band-gap energy ( Eg) with x was not perfectly linear, and a small bowing parameter of 0.34 was obtained. It was possible to tune the Eg value between those of the end members of the solid solution in a continuous manner by adjusting the stoichiometry of the solid solution. The morphology and crystalline domain size can also be controlled by adjusting, in this case, the postignition milling time of the mechanochemical process.

A novel, simple and rapid route to the synthesis of boron cabonitride nanosheets: combustive gaseous unfolding.

The ternary compound boron carbonitride (BCN) was synthesized in the form of few-layer nanosheets through a mechanically induced self-sustaining reaction (MSR). Magnesium was used to reduce boron trioxide in the presence of melamine in a combustive manner. The process to form the nanostructured material was very rapid (less than 40 min). The prepared powder was investigated by various techniques such as X-ray diffraction (XRD), Fourier Transform infrared (FTIR), Micro-Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), high-resolution transmission electron microscopy (HRTEM), and electron energy loss spectroscopy (EELS). The thermal stability and the optical behavior of the BCN nanosheets were also studied by thermal analysis and UV-vis spectroscopy, respectively. The formation mechanism of the nanosheet morphology was described in detail.

Hallmarks of mechanochemistry: from nanoparticles to technology.

The aim of this review article on recent developments of mechanochemistry (nowadays established as a part of chemistry) is to provide a comprehensive overview of advances achieved in the field of atomistic processes, phase transformations, simple and multicomponent nanosystems and peculiarities of mechanochemical reactions. Industrial aspects with successful penetration into fields like materials engineering, heterogeneous catalysis and extractive metallurgy are also reviewed. The hallmarks of mechanochemistry include influencing reactivity of solids by the presence of solid-state defects, interphases and relaxation phenomena, enabling processes to take place under non-equilibrium conditions, creating a well-crystallized core of nanoparticles with disordered near-surface shell regions and performing simple dry time-convenient one-step syntheses. Underlying these hallmarks are technological consequences like preparing new nanomaterials with the desired properties or producing these materials in a reproducible way with high yield and under simple and easy operating conditions. The last but not least hallmark is enabling work under environmentally friendly and essentially waste-free conditions (822 references).

A comparative study of the sexual function of institutionalized patients with schizophrenia.

INTRODUCTION: Sexual dysfunction occurs frequently in patients with schizophrenia. AIM: To assess the sexual function of institutionalized patients with schizophrenia and compare it to both that of noninstitutionalized schizophrenic patients as well as patients without any mental illness. METHODS: A cross-sectional comparative analysis between three groups: Group A: 75 patients with schizophrenia and/or schizoaffective disorder according to the International Classification of Diseases, 10th Edition (ICD-10) criteria, admitted into public psychiatric residential facilities; Group B: 41 patients with the same diagnosis who live in the community; Group C: 152 patients with no mental illness attended to by a Primary Care Medical Center. MAIN OUTCOME MEASURES: The Mini-International Neuropsychiatric Interview, Positive and Negative Syndrome Scale for Schizophrenia and Changes in Sexual Function Questionnaire were used to complete the study. RESULTS: When institutionalized patients were compared to the control group, the impairment of sexual function was identified in all areas except Arousal in women and the percentage of dysfunction in Desire-Interest for both sexes. The results for noninstitutionalized schizophrenic males indicated a deficit in Pleasure and Orgasm and in Pleasure and Desire-Frequency for females, when compared with the control group. The overall subscale indicated that 71.2% of males and 57.1% of females in the institutionalized group experienced sexual dysfunction compared with 10% of males and 50% of females in the noninstitutionalized group, and only 12.7% of women in the control group. CONCLUSIONS: Most areas of sexual function are impaired among patients with schizophrenia, especially among institutionalized patients. However, their percentage of sexual dysfunction associated with sexual thoughts or fantasies was similar to that of patients without mental illness.