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Michelle N Levitan,1,2 Marcelo Papelbaum,2 Mauro G Carta,3 Jose C Appolinario,1 Antonio E Nardi1 1Psychiatry Institute/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 2Eating Disorders Department/Sheba Medical Center, Ramat Gan, Israel; 3Dipartimento di Scienze Mediche e Sanità Pubblica, Università Degli Studi di Cagliari, Cagliari, ItalyCorrespondence: Michelle N Levitan Email milevitan@gmail.comAbstract: Binge eating disorder (BED) affects a significant rate of the general population causing a negative impact on their quality of life, weight, and self-esteem. Besides psychological treatments that compose the majority of the studies, pharmaceuticals have contributed to improve a host of clinical parameters, thus being an important component of the treatment. We opted to target the latest results by performing a review of the literature on the pharmacology for BED from the last 5 years. To achieve this goal, the terms: “binge eating disorder” and “treatment” were added to the PubMed database and the website clinicaltrials.gov. At least five drugs were either being tested or had already been recognized to improve BED symptoms – although only lisdexamfetamine is currently approved by the FDA to treat this condition. However, due to a better understanding of BED psychopathology in the last decade, it is notorious that improvement of eating-related symptoms is not the only desired target. Due to the significant comorbidity percentage (30%), weight loss is highly pursued, as well as the amelioration of clinical parameters which highlights the importance of having new agents combining both objectives.Keywords: binge eating disorder, treatment, pharmacological treatment

Media and intercultural education are being increasingly recognised as a fundamental competence for teachers of the 21st century. Digital literacy and civic competence are facing several new challenges in response to the intensification of migratory phenomena and the unprecedented spread of fake news, especially among adolescents at risk of social exclusion, but teachers’ professional development is still far from coping with this emerging need. Intercultural understanding and a critical use of media among adolescents have now become primary goals for the promotion of active citizenship. This article intends to provide some recommendations on how to support teachers’ professional development in the field of media and intercultural education. To this purpose, it presents and discusses the results of an action-research project aimed at teachers’ improvement of teaching skills about the media in multicultural public schools. The results are part of a larger European project “Media Education for Equity and Tolerance” (MEET) (Erasmus Plus, KA3), an initiative promoted in 2016–2018 by the University of Florence (Italy).

Goal: Organ perfusion is a vast subject with several techniques, the most common being Hypothermic Machine Perfusion (HMP) and Normothermic Machine Perfusion (NMP). In this paper, a new machine developed at the Biolab of the University of Florence has been tested to validate its capability to perform a well-controlled Oxygenated Rewarming (COR) phase and maintain stability during the NMP phase. Methods: The tests (n = 5) were conducted on fresh porcine livers and evaluated according to liver perfusion standards. The developed machine is based on a previous version, with an integrated control and sensor system and a complete mechanical and electronic redesign. Results: The results demonstrate the excellent usability of the machine and its ability to effectively maintain the organs in good condition. The new system performed well, and the measures made on the livers were satisfactory for good preservation of the organ. Conclusion: This study showed the effectiveness of the developed machine. Future development of the system will include a more sophisticated control system to ensure the correct parameters for perfusion.

Abstract The correlation between circulating microbes and sepsis as well as proinflammatory diseases is increasingly gaining recognition. However, the detection of microbes’ cell-free DNA (cfDNA), which exist at concentrations of a billion times lower than blood proteins, poses a significant challenge for early disease detection. Here, we present Nano mechanics combined with highly sensitive readout sequences to address the challenges of ultralow counts of disease biomarkers, thus enabling robust quantitative monitoring of chronic medical conditions at different stages of human disease progression. To showcase the effectiveness of our approach, we employ fragments of cfDNA and human cell secretory proteins as models with predictive capabilities for human diseases. Notably, our method reveals a reliable representation over an impressive three to four orders of magnitude in the detection limit and dynamic range, surpassing commercially available quantitative polymerase chain reaction (qPCR) commonly used in routine clinical practice. This concept underpins a highly sensitive and selective medical device designed for the early detection of circulating microbes in patients undergoing intensive cancer therapy. This will help pinpoint individuals at risk of complications, including damage to the intestinal barrier and development of neutropenic fever/Sirsa/Sepsis. Moreover, this approach introduces new avenues for stratifying antibiotic prophylaxis in proinflammatory diseases.

Head and neck cancer represents the seventh most common neoplasm worldwide, with squamous cell carcinoma being the most represented histologic variant. The rising incidence of the neoplastic pathology of this district, coupled with the drastic changes in its epidemiology over the past decades, have posed significant challenges to physicians worldwide in terms of diagnosis, prognosis, and treatment. In order to meet these challenges, a considerable amount of effort has been spent by the authors of the recent literature to explore new technologies and their possible employment for the better diagnostic and prognostic definition of head and neck squamous cell carcinoma (HNSCC). Among these technologies, a growing interest has been gathering around the possible applications of dual-energy computed tomography (DECT) in head and neck pathology. Dual-energy computed tomography (DECT) utilizes two distinct X-ray energy spectra to obtain two datasets in a single scan, allowing for material differentiation based on unique attenuation profiles. DECT offers key benefits such as enhanced contrast resolution, reduced beam-hardening artifacts, and precise iodine quantification through monochromatic reconstructions. It also creates material decomposition images, like iodine maps, aiding in tumor characterization and therapy assessment. This paper aims to summarize recent findings on the use of DECT in HNSCC, providing a comprehensive overview to aid further research and exploration in the field.

Abstract We study tetraquarks in large N QCD with heavy quarks, in the domain where non-relativistic quantum mechanics offers an adequate approximation. Within the regime of validity of the Born-Oppenheimer approximation, we systematically study and explicitly construct tetraquark states. At leading order in the 1/N expansion, the bound spectrum consists of free mesons, while the 1/N corrections give rise to a Born-Oppenheimer potential that can bind the mesons into tetraquarks. We find two different types of tetraquarks, each endowed with distinct color-spatial wavefunctions. These states arise in the presence of an O $$ \mathcal{O} $$ (N) mass hierarchy between the quarks and the antiquarks. We provide a quantitative argument indicating that only for such a hierarchy is the ground state of the system a tetraquark. We discuss what the extrapolation of our results to realistic values of the parameters may imply for the QCD tetraquark states.

Michelle Nigri Levitan,1 Marcelo Papelbaum,1,2 Antonio Egidio Nardi1 1Laboratory of Panic and Respiration, Institute of Psychiatry of the Federal University of Rio de Janeiro, 2State Institute of Diabetes and Endocrinology of Rio de Janeiro, Rio de Janeiro, Brazil Background: Although many generalized anxiety disorder (GAD) patients respond to the available pharmacological treatments, nearly half of them do not present the expected results. Besides, the side effects associated to some drugs have a negative impact on treatment adherence. Therefore, the aim of this review was to report the clinical profile of agomelatine, a selective melatonergic MT1/MT2 receptor agonist with serotonin 5-HT2c receptor antagonist activities, as a potential pharmacological option in the treatment of GAD.Methods: We performed a literature review regarding studies that evaluated the use of agomelatine in GAD treatment. Results: Two short-term, double-blinded studies and one prevention-treatment trial evaluated the efficacy of agomelatine in the treatment of GAD. Agomelatine was associated with higher rates of clinical response and remission, when compared to placebo. In addition, the long-term use of agomelatine decreased the risk of relapse of anxiety symptoms, even for the severely ill patients. Besides, the tolerability was satisfactory with the absence of discontinuation symptoms, as observed in previous studies.Conclusion: The efficacy and tolerability profiles of agomelatine in the treatment of GAD were good. However, the scarce number of trials, the small sample sizes, and the use of patients without any comorbid conditions were some limitations that impaired the generalization of the results in the general population. Nevertheless, agomelatine is an attractive off-label option in the treatment of GAD that needs more conclusive evidences to establish its role in future guidelines. Keywords: agomelatine, generalized anxiety disorder, pharmacological treatment

Abstract When the available collision energy is much above the mass of the particles involved, scattering amplitudes feature kinematic configurations that are enhanced by the much lower virtuality of some intermediate particle. Such configurations generally factorise in terms of a hard scattering amplitude with exactly on-shell intermediate particle, times universal factors. In the case of real radiation emission, such factors are splitting amplitudes that describe the creation or the annihilation — for initial or final state splittings — of the low-virtuality particle and the creation of the real radiation particles. We compute at tree-level the amplitudes describing all the splittings that take place in the Standard Model when the collision energy is much above the electroweak scale. Unlike previous results, our splitting amplitudes fully describe the low-virtuality kinematic regime, which includes the region of collinear splitting, of soft emission, and combinations thereof. The splitting amplitudes are compactly represented as little-group tensors in an improved bi-spinor formalism for massive spin-1 particles that automatically incorporates the Goldstone Boson Equivalence Theorem. Simple explicit expressions are obtained using a suitably defined infinite-momentum helicity basis representation of the spinor variables. Our results, combined with the known virtual contributions, could enable systematic predictions of the leading electroweak radiation effects in high-energy scattering processes, with particularly promising phenomenological applications to the physics of future colliders with very high energy such as a muon collider.

Abstract Background Diabetes mellitus (DM) is associated with premature atherosclerotic disease, coronary artery disease (CAD) and chronic heart failure (HF), leading to increased morbidity and mortality. Sodium-Glucose Co-transporter 2 Inhibitors (SGLT2i) exhibit cardioprotective benefits beyond glucose lowering, reducing the risk of major cardiovascular events (MACE) and HF hospitalizations in patients with DM and CAD. Endothelial progenitor cells (EPCs) are bone marrow-derived cells involved in vascular repair, mobilized in response to vascular injury. The number and function of circulating EPCs (cEPCs) are negatively affected by cardiovascular risk factors, including DM. This study aimed to examine the response of cEPCs to SGLT2i treatment in DM patients with stable CAD. Methods A prospective single-center study included patients with DM and stable CAD who were started on an SGLT2i (empagliflozin). Peripheral blood samples were collected at baseline, 1 month, and 3 months to evaluate cEPC levels and function by flow cytometry, immunohistochemistry and MTT assays. Results Eighteen patients were included in the study (median age 73, (IQR 69, 77) years, 67% male). After 1 month of treatment with empagliflozin, there was no significant change in cEPCs level or function. However, following 3 months of treatment, a significant increase was observed both in cell levels (CD34(+)/VEGFR-2(+): from 0.49% (IQR 0.32, 0.64) to 1.58% (IQR 0.93, 1.82), p = 0.0006; CD133(+)/VEGFR-2(+): from 0.38% (IQR 0.27, 0.6) to 0.82% (IQR 0.7, 1.95), p = 0.0001) and in cell function (from 0.25 CFUs (IQR 0, 0.5) at baseline, to 2 CFUs (IQR 1, 2) at 3 months, p = 0.0012). Conclusions Empagliflozin treatment in patients with DM and stable CAD increases cEPC levels and function, implying a cardioprotective mechanism. These findings highlight the potential of SGLT2i in treating cardiovascular diseases, warranting further research to explore these effects and their long-term implications. Graphical Abstract

The complete mitochondrial genome of the shining leaf chafer Mimela junii was sequenced and is herein described. The mitogenome consists of a circular molecule of 16,805 bp, with an overall AT content of 75.7%. It encodes for 13 protein-coding genes (PCGs), 22 transfer RNA genes (tRNAs), two ribosomal RNA genes (rRNAs) and contains a non-coding Control Region (CR) characterized by the presence of tandem repeats. The gene order corresponds to the ancestral Pancrustacea model and mitogenome characteristics are congruous with those of hexapods. In the phylogenetic analysis, M. junii is nested within a paraphyletic Anomala with high support, and is herein associated with Anomala corpulenta with medium/low support.

Abstract Atmospheric rivers are important transport vehicles for Earth’s water cycle. Using a high-resolution, eddy-resolving Earth System Model, atmospheric river impacts on the upper ocean are investigated by analyzing historical and climate change simulations. For atmospheric rivers along the North American coastline, strong winds cause significant dynamic and thermodynamic upper ocean responses. They push ocean water towards the coast, measured by sea surface height, a process that is amplified under climate change. Mixed layers are deeper upstream of atmospheric rivers, and shallower downstream, however for climate change, shoaling downstream is subdued. Air-sea heat fluxes tend to promote ocean cooling upstream and warming downstream, although different regions have different climate change heat flux signals. Southern California heat flux changes due to warming are driven by evaporative processes and strengthen the ocean responses seen in historical simulations. The regions north are primarily dominated by sensible heat flux changes and counter the historical patterns.

(1) Background: Musculoskeletal disorders of the upper limbs are a common medical condition among dental hygienists and dentists, making them a common occupational risk for dental professionals. The purpose of the work was to collect information about the dental professions and their habits to highlight what can be good practices to be carried out to prevent any musculoskeletal disorders. (2) Methods: To identify habits and problems inherent in the professional activity of dental hygienists and dentists, a questionnaire was formulated on the use of enlarging systems. (3) Results: The questionnaire was completed by 241 dental professionals. As for the use of magnifiers, 72.6% of participants use them: among dental hygienists, 67.8% use magnifiers, among dentists, 80.9% use magnifiers; there is a statistically significant difference. There is no statistically significant difference between professions regarding muscle disorders. (4) Conclusions: For a clearer assessment, it would be appropriate to submit the questionnaire to a wider sample of professionals, to define better the correlation between musculoskeletal disorders, work activity and the type of enlarging systems used.

Abstract Background Hybrids are expected to show greater phenotypic variation than their parental species, yet how hybrid phenotype expression varies with genetic distances in closely-related parental species remains surprisingly understudied. Here, we investigate pelage and morphometric trait variation in anthropogenic hybrids between four species of Brazilian Callithrix marmosets, a relatively recent primate radiation. Marmoset species are distinguishable by pelage phenotype and morphological specializations for eating tree exudates. In this work, we (1) describe qualitative phenotypic pelage differences between parental species and hybrids; (2) test whether significant quantitative differences exist between parental and hybrid morphometric phenotypes; and (3) determine which hybrid morphometic traits show heterosis, dysgenesis, trangression, or intermediacy relative to the parental trait. We investigated cranial and post-cranial morphometric traits, as most hybrid morphological studies focus on the former instead of the latter. Finally, we estimate mitogenomic distances between marmoset species from previously published data. Results Marmoset hybrid facial and overall body pelage variation reflected novel combinations of coloration and patterns present in parental species. In morphometric traits, C. jacchus and C. penicillata were the most similar, while C. aurita was the most distinct, and C. geoffroyi trait measures fell between these species. Only three traits in C. jacchus x C. penicillata hybrids showed heterosis. We observed heterosis and dysgenesis in several traits of C. penicillata x C. geoffroyi hybrids. Transgressive segregation was observed in hybrids of C. aurita and the other species. These hybrids were also C. aurita-like for a number of traits, including body length. Genetic distance was closest between C. jacchus and C. penicillata and farthest between C. aurita and the other species. Conclusion We attributed significant morphometric differences between marmoset species to variable levels of morphological specialization for exudivory in these species. Our results suggest that intermediate or parental species-like hybrid traits relative to the parental trait values are more likely in crosses between species with relatively lesser genetic distance. More extreme phenotypic variation is more likely in parental species with greater genetic distance, with transgressive traits appearing in hybrids of the most genetically distant parental species. We further suggest that fewer developmental disturbances can be expected in hybrids of more recently diverged parental species, and that future studies of hybrid phenotypic variation should investigate selective pressures on Callithrix cranial and post-cranial morphological traits.

Abstract Rates of nitrogen transformations support quantitative descriptions and predictive understanding of the complex nitrogen cycle, but measuring these rates is expensive and not readily available to researchers. Here, we compiled a dataset of gross nitrogen transformation rates (GNTR) of mineralization, nitrification, ammonium immobilization, nitrate immobilization, and dissimilatory nitrate reduction to ammonium in terrestrial ecosystems. Data were extracted from 331 studies published from 1984–2022, covering 581 sites. Globally, 1552 observations were appended with standardized soil, vegetation, and climate data (49 variables in total) potentially contributing to the observed variations of GNTR. We used machine learning-based data imputation to fill in partially missing GNTR, which improved statistical relationships between theoretically correlated processes. The dataset is currently the most comprehensive overview of terrestrial ecosystem GNTR and serves as a global synthesis of the extent and variability of GNTR across a wide range of environmental conditions. Future research can utilize the dataset to identify measurement gaps with respect to climate, soil, and ecosystem types, delineate GNTR for certain ecoregions, and help validate process-based models.

Abstract Background Doxorubicin (DOX) has been widely used in the treatment of breast cancer, but it is directly associated with late-onset cardiovascular disease (CVD). Whether anthropometric, food intake or other risk factors together with DOX-based chemotherapy can increase the risk of developing cardiotoxicity remains uncertain. We examined the association between anthropometric variables with doxorubicin-induced cardiotoxicity in women with breast cancer. Methods Twenty-six women (53.7 ± 9.6 y) undergoing DOX-based chemotherapy (408.3 ± 66.7 mg/m2) participated in the study. We collected data on body composition (bioimpedance), dietary intake (24 h) and cardiac function (echocardiographic assessment of left ventricular ejection fraction, LVEF). All measurements were taken at baseline, one month of treatment completion and one-year follow-up after start of treatment. DOX-induced cardiotoxicity was defined as ≥ 10% absolute decrease in LVEF. Thus, the participants were then grouped as DOX-induced (DIC) or non-DOX-induced (non-DIC) cardiotoxicity. Data are shown as mean ± SD (standard deviation). We performed comparisons between the two groups using Student’s t-test for independent samples or Generalized Estimating Equations (groups + 3 evaluation time points) with Bonferroni post-hoc test. Lastly, the correlations were analyzed using Pearson correlation; p

Abstract Background SmithRNAs (Small MITochondrial Highly-transcribed RNAs) are a novel class of small RNA molecules that are encoded in the mitochondrial genome and regulate the expression of nuclear transcripts. Initial evidence for their existence came from the Manila clam Ruditapes philippinarum, where they have been described and whose activity has been biologically validated through RNA injection experiments. Current evidence on the existence of these RNAs in other species is based only on small RNA sequencing. As a preliminary step to characterize smithRNAs across different metazoan lineages, a dedicated, unified, analytical workflow is needed. Results We propose a novel workflow specifically designed for smithRNAs. Sequence data (from small RNA sequencing) uniquely mapping to the mitochondrial genome are clustered into putative smithRNAs and prefiltered based on their abundance, presence in replicate libraries and 5′ and 3′ transcription boundary conservation. The surviving sequences are subsequently compared to the untranslated regions of nuclear transcripts based on seed pairing, overall match and thermodynamic stability to identify possible targets. Ample collateral information and graphics are produced to help characterize these molecules in the species of choice and guide the operator through the analysis. The workflow was tested on the original Manila clam data. Under basic settings, the results of the original study are largely replicated. The effect of additional parameter customization (clustering threshold, stringency, minimum number of replicates, seed matching) was further evaluated. Conclusions The study of smithRNAs is still in its infancy and no dedicated analytical workflow is currently available. At its core, the SmithHunter workflow builds over the bioinformatic procedure originally applied to identify candidate smithRNAs in the Manila clam. In fact, this is currently the only evidence for smithRNAs that has been biologically validated and, therefore, the elective starting point for characterizing smithRNAs in other species. The original analysis was readapted using current software implementations and some minor issues were solved. Moreover, the workflow was improved by allowing the customization of different analytical parameters, mostly focusing on stringency and the possibility of accounting for a minimal level of genetic differentiation among samples.

Background: A wide range of conditions, including mixed depressive symptoms, hyperactivity, cognitive impairment (CI) might be expressions of Bipolar Spectrum Disorder (BSD) according to the neo-Kraepelinian perspective, even in advanced age. CI, which has a high prevalence in the elderly population, when it occurs in comorbidity with depression further hinders therapy response and functional ability. The present study aims to explore risk factors associated with CI in elderly individuals experiencing a depressive episode during lockdown a period marked by significant stressors and rhythm disruption. Methods: A case-control study analyzed data from a previous RCT (secondary analyses) on elderly individuals living at home, assessing depressive symptoms, cognitive performance, hyperactivity, and hypertension before (T0) and during lockdown (T1). Results: Participants with lower pre-pandemic cognitive performance were more prone to lockdown depression compared to those with higher baseline function (F = 6.074; p = 0.016). Among those experiencing lockdown depression without prior depression, those with low cognitive performance were more prevalent than the control group without depression (OR = 11.8; p = 0.015). Conclusion: This study highlights a potentially vulnerable subgroup within the elderly population that requires targeted interventions and support during stressful events. Future research should explore the underlying mechanisms linking cognitive decline and depression in older adults, particularly those with a possible bipolar spectrum predisposition.

Baited traps are a basic component of both specific and generic surveillance programs targeting wood-boring beetles at risk of introduction to new habitats because of global trade. Among the numerous protocols developed over the years for generic surveillance of longhorn beetles, jewel beetles, and bark and ambrosia beetles is the simultaneous use of black multi-funnel traps set up in the understory and green multi-funnel traps set up in the canopy of forested areas surrounding ports and other entry points. These traps are commonly baited with multi-lure blends of pheromones and host volatiles. In this study, we tested this trapping protocol in areas surrounding eight entry points located in Europe and North America to determine: i) the relative performance of black-understory traps and green-canopy traps among the targeted taxa; and ii) whether the dissimilarity among communities of beetles collected by the understory vs. canopy traps was affected by taxon and amount of forest cover in the traps’ surroundings. A total of 96,963 individuals belonging to 358 species of wood-boring beetles were collected, including 21 non-native species. Black-understory multi-funnel traps were generally more efficient than green-canopy multi-funnel traps for detecting longhorn beetles and bark and ambrosia beetles, whereas the opposite trend was observed for jewel beetles. Differences between beetle communities caught in black-understory and green-canopy traps were mainly attributed to differences in species richness in jewel beetles, while both differences in species richness and species turnover contributed to the dissimilarity between communities of longhorn beetles and bark and ambrosia beetle. The difference in the number of jewel beetle species caught by the two trapping methodologies decreased with increasing forest cover, whereas species turnover increased when moving from an urban-dominated to a forest-dominated landscape. Overall, these results suggest that the simultaneous use of both black-understory and green-canopy multi-funnel traps can be considered a very efficient approach for generic surveillance of longhorn beetles, jewel beetles and bark and ambrosia beetles in both urban-dominated and forest-dominated areas surrounding entry points.

Abstract Atrial fibrillation (AF) is more common in patients with malignancies than in general population. The pathophysiological processes include the pro-inflammatory condition and the exaggerated inflammatory reaction to chemotherapy, radiotherapy, and surgery interventions. Thus, it is pivotal to decrease morbidity and mortality in this group by providing appropriate care and prevention. In this subset, the risk of thromboembolic and bleeding events is high and the common risk score such as CHA2DS2-VASc and HAS-BLED employed in non-oncologic patients have limited evidence in cancer patients. A paucity of evidence in the setting in individuals having both malignancies and atrial fibrillation entangle the clinician when it comes to therapeutic management. Tailored management is recommended of anticoagulation treatment could be difficult, and there is. In this review, we try to explain the mechanism of AF in cancer patients as well as its management in this setting.

Juliana Bittencourt,1–4 Bruna Velasques,1–3,5 Silmar Teixeira,1,2,4 Luis F Basile,6,7 José Inácio Salles,5,8 Antonio Egídio Nardi,9 Henning Budde,10 Mauricio Cagy,11 Roberto Piedade,1 Pedro Ribeiro1,2,12 1Brain Mapping and Sensory Motor Integration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, 2Institute of Applied Neuroscience, Rio de Janeiro, 3Neurophysiology and Neuropsychology of Attention, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, 4Laboratory of Physical Therapy, Veiga de Almeida University, Rio de Janeiro, 5Neuromuscular Research Laboratory, National Institute of Traumatology and Orthopaedics, Rio de Janeiro, 6Division of Neurosurgery, University of São Paulo Medical School, São Paulo, 7Laboratory of Psychophysiology, Department of Psychology and Phonoaudiology, Universidade Metodista do Estado de São Paulo (UMESP), São Paulo, 8Brazilian Volleyball Confederation, Rio de Janeiro, 9Panic and Respiration Laboratory, Federal University of Rio de Janeiro, Instituto Nacional de Ciência e Tecnologia (INCT) e Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Rio de Janeiro, Brazil; 10Department of Sport Science and Physical Education, School of Science and Engineering, Reykjavik University, Reykjavik, Iceland; 11Biomedical Engineering Program, Coordenação dos Programas de Pós-Graduação em Engenharia (COPPE), Federal University of Rio de Janeiro, Rio de Janeiro; 12School of Physical Education, Bioscience Department Escola de Educação Física e Desportos da Universidade Federal do Rio de Janeiro (EEFD/UFRJ), Rio de Janeiro, Brazil Objective: The study presented here analyzed the patterns of relationship between oculomotor performance and psychopathology, focusing on depression, bipolar disorder, schizophrenia, attention-deficit hyperactivity disorder, and anxiety disorder. Methods: Scientific articles published from 1967 to 2013 in the PubMed/Medline, ISI Web of Knowledge, Cochrane, and SciELO databases were reviewed. Results: Saccadic eye movement appears to be heavily involved in psychiatric diseases covered in this review via a direct mechanism. The changes seen in the execution of eye movement tasks in patients with psychopathologies of various studies confirm that eye movement is associated with the cognitive and motor system. Conclusion: Saccadic eye movement changes appear to be heavily involved in the psychiatric disorders covered in this review and may be considered a possible marker of some disorders. The few existing studies that approach the topic demonstrate a need to improve the experimental paradigms, as well as the methods of analysis. Most of them report behavioral variables (latency/reaction time), though electrophysiological measures are absent. Keywords: depression, bipolar disorder, attention-deficit hyperactivity disorder, schizophrenia, anxiety disorder

É apresentado o caso de um indivíduo com diagnóstico de esquizofrenia que cometeu um delito sexual e foi submetido a perícia psiquiátrica para avaliação de responsabilidade penal, sendo considerado inimputável. São discutidos fatores que podem contribuir para delitos dessa natureza, em indivíduos com transtornos psicóticos. Parecer CEP: Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, IPUB - Número do Parecer: 1.334.993

Background: COVID-19 has put a huge strain on the healthcare systems worldwide, requiring unprecedented intensive care resources. There is still an unmet clinical need for easily available biomarkers capable of predicting the risk for severe disease. The main goal of this prospective multicenter study was to identify biomarkers that could predict ICU admission and in-hospital mortality. Methods: We prospectively recruited COVID-19 PCR positive patients in two hospitals, in Belgium and Italy. Blood samples were collected at hospital admission and 20 potential biomarkers were measured with the Luminex technology. Logistic regression models were performed to identify the biomarkers that, alone or together, were associated with patient disease severity. Results: Our study demonstrates that elevated levels of circulating inflammatory cytokines were associated with disease severity in COVID-19 hospitalized patients. CXCL10, IL-4, IL-6 and MCP-1 values were predictive of ICU admission. Elevated levels of IL-6 and MCP-1 were also associated with in hospital death in COVID-19 hospitalized patients. Conclusion: Altogether, elevated and correlated inflammatory cytokines in the blood of COVID-19 patients at hospital admission are predictive of disease severity and suggest a dysregulated inflammation induced by SARS-CoV-2 infection.

Summary: Alpha-synuclein (α-Syn) is an important molecule in the pathogenesis of Parkinson’s and Alzheimer’s disease-related dementias such as Lewy body dementia, forming multiple pathological species. In vitro disease models, including human neurons and α-Syn-transfected cells, are instrumental to understand synucleinopathies or test new therapies. Here, we provide a detailed protocol to generate human neurons derived from induced pluripotent stem cells (iPSCs), and HEK cells, with α-Syn mutations. We also describe multiple assays to determine the various α-Syn forms. : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Introdução As infecções por Clostridiodes difficile (C. difficile) vêm sofrendo aumento global e estão entre infecções relacionadas a assistência à saúde mais prevalentes nas instituições de saúde. Estão diretamente relacionadas ao uso de antimicrobianos, em particular os de amplo espectro, podendo desencadear diversas complicações. A recorrência é caracterizada por novo episódio da infecção em um período de até dois meses, após o fim do tratamento do primeiro episódio. Embora diretrizes internacionais apontem como primeira linha de tratamento para os casos recorrentes o uso de fidaxomicina ou vancomicina oral e o transplante de microbiota fecal (TMF), no Brasil, devido à falta de registro e comercialização de fidaxomicina e vancomicina oral, o tratamento é realizado principalmente com metronidazol e uso off label de vancomicina oral preparada a partir do pó liofilizado para administração endovenosa. Considerando as limitações de tratamento da infecção recorrente no cenário brasileiro, o transplante de microbiota fecal, uma terapia mais efetiva em comparação ao tratamento com metronidazol e vancomicina para os casos recorrentes, pode ser um recurso terapêutico de grande relevância para o Sistema Único de Saúde (SUS). Portanto, o objetivo desse trabalho foi realizar uma análise de impacto orçamentário para avaliar a factibilidade da incorporação do TMF no SUS. Métodos Foi realizada análise de impacto orçamentário, sob a perspectiva do SUS, comparando o tratamento atual de infecções recorrentes por C. difficile no Brasil realizado com vancomicina e/ou metronidazol com o cenário alternativo, através da incorporação do TMF com fezes frescas por colonoscopia. O horizonte temporal considerado foi de cinco anos, englobando os anos de 2024 a 2028, com taxa de difusão inicial de 5% em 2024, seguida de 10, 20, 40 e 80% no último ano, 2028. A população foi determinada a partir da abordagem epidemiológica, com aplicação da taxa de incidência e recorrência na população brasileira geral. O levantamento de custos foi realizado por método de microcusteio, sendo considerados todos os custos diretos associados ao tratamento atual e custos diretos do TMF, incluindo custos relacionados ao doador, receptor e processamento das fezes. Foi realizada análise de sensibilidade determinística para os seguintes parâmetros: custo do metronidazol oral e endovenoso, custo da vancomicina, custo do transplante, taxa de absorção, taxa de incidência e taxa de recorrência. Todos os dados utilizados no estudo são de domínio público. Resultados A análise do impacto orçamentário da incorporação do TMF no SUS, na estimativa pontual, evidenciou economia de R$ 27.084,72 acumulada nos cinco anos considerados. Os valores da análise de sensibilidade variaram de R$ -187.041,31 à R$ 357.176,64. Com relação à variação dos parâmetros na análise de sensibilidade, apenas a variação do custo de metronidazol injetável para o limite inferior e a variação do custo do transplante para o limite superior resultaram em maior custo para o SUS com a incorporação do TMF. O TMF se mostrou a opção mais econômica para todos os demais parâmetros variados na análise de sensibilidade. Discussão e conclusões Nenhum estudo brasileiro avaliou, até o momento, o impacto orçamentário da incorporação do TMF no Brasil. A análise de impacto orçamentário realizada demonstrou que a incorporação do TMF no SUS não só é factível como é capaz de gerar economia, o que pode contribuir para a sustentabilidade do sistema de saúde público. Para além do aspecto econômico, a incorporação da tecnologia possibilitaria a redução do consumo de antimicrobianos sistêmicos, o que poderia impactar positivamente na redução da resistência antimicrobiana, uma emergência global em saúde. Considerando a relevância do TMF para o SUS, espera-se que pesquisas futuras sobre o tema, incluindo a avaliação de aspectos regulatórios, éticos e processuais possam ser realizadas, de modo que, em futuro próximo, usuários do SUS com infecções recorrentes por C. difficile tenham o TMF como opção terapêutica segura, eficaz e econômica.

IntroductionWith the growing older adult population, the European Union emphasizes the need to promote research in healthy aging trough multidisciplinary and innovative approaches, including the integration of advanced technologies like virtual reality (VR) in cognitive rehabilitation. This reflects the increasing awareness of the importance of addressing challenges related to neurodegenerative diseases in the older adult population. Our study aims to present a protocol that will assess the feasibility and provide a preliminary measure of effectiveness for an intervention using immersive CR technology for cognitive remediation (CR) in individuals with Mild Cognitive Impairment (MCI).MethodsA feasibility randomized controlled clinical study will involve 30 individuals who are over 65 years old, both sex, who meet the diagnostic criteria for MCI from the University Hospital of Cagliari, randomly assigned to either the experimental condition or control group. Both groups will continue to receive standard pharmacological therapy. The experimental group will undergo a 3-months cognitive remediation program using fully immersive VR with two sessions per week. Each session will last a maximum of 60 min and will be supervised by expert health professionals. In contrast, the control group will continue with standard care. The intervention program will be carried out by s psychiatric rehabilitation technicians and speech therapists, emphasizing a comprehensive framework aligned with healthcare needs. Feasibility will be assessed based on tolerability, including dropout rates and acceptability, which considers the proportion of recruited participants among those considered eligible and on side effects and level of satisfaction. The preliminary measures of effectiveness will be evaluated on quality of life, cognitive functions, biological and social rhythms, depressive symptoms and anxiety.ResultsThe trial findings will be submitted for publication in international peer-reviewed journals and shared at international meetings and conferences.DiscussionThis study aiming to assess the feasibility and preliminary effectiveness of a fully immersive VR/CR program for MCI in order to give data for a subsequent confirmatory trial. The results of the pilot RCT are expected to significantly contribute to research on the prevention of neurocognitive degeneration, with a specific emphasis on enhancing the application of technologies. The strengths of this work are the high technological innovation program for mental health treatments for healthy aging and multidisciplinary approach emphasizing a holistic framework aligned with health needs.

BackgroundEarly palliative care (EPC) is a recommended model for improving the quality of life for patients with advanced cancer and their caregivers. However, limited research has focused on the role of psychological evaluation within EPC. The Veneto Institute of Oncology (IOV), a Comprehensive Cancer Centre, employs an interdisciplinary team to assess patients with advanced-stage disease. This study aims to assess the psychological needs of these patients, investigate any correlations between psychological symptoms (PSs) and factors such as awareness of diagnosis and prognosis, symptoms detected using the Edmonton Symptom Assessment System (ESAS), as well as the patient’s gender, age, social issues, and survival and to clarify the psychologist’s role within the interdisciplinary team.MethodsData were retrieved from a prospectively maintained database. From 1st January 2018 to 31st December 2021, 819 consecutive patients were evaluated during EPC consultations, with 753 participants enrolled in the study. The ESAS was administered to each patient before the consultation.ResultsMore than half of the patients (385, 57.1%) reported at least one PS, with an ESAS score of ≥4. Specifically, 34.9% reported depression, 28.7% reported anxiety, and 43.2% indicated feeling “not well.” Referring oncologists tended to overestimate the presence of PSs compared to patient self-reports (51.8% versus 41.3%). According to the psychologists’ assessment, 29.2% of participants were found to have depression, and 10.8% of participants had anxiety. Additionally, 31 patients (10.8%) with psychological disorders were diagnosed with an adaptation disorder related to a physical condition. The psychology service engaged 47% of patients, while 18.5% declined psychological support. Patients exhibiting other ESAS symptoms with scores of ≥4 had an increased odds ratio for reporting PSs of ≥4. However, multivariable analysis revealed no significant relationship between PSs and awareness of diagnosis and prognosis.ConclusionThe systematic use of self-assessment in EPC is essential for understanding patient’s experience, determining whether PSs stem from physical disorders, and prioritizing interventions. Awareness of prognosis does not correlate with increased anxiety and depression in patients. Therefore, EPC is an ideal opportunity to discuss prognosis and facilitate patients’ end-of-life choices early in their care journey.

The results of archaeological excavations, when compared with iconography and medieval texts, provide multiple intersections that facilitate a better understanding of material civilization, with the perspective of obtaining a comprehensive and evolving vision. While historians and archaeologists have long downplayed "illustrations", these are now recognized as full-fledged documentary sources. In the case of Cencelle, an italian medieval city, a study that integrates texts, images and excavation results is necessary. Cencelle has been the subject of extensive archaeological excavations for over three decades, yielding a substantial corpus of data pertaining to the daily lives of its inhabitants. The Italian Middle Ages are particularly rich in iconographic sources that reflect various aspects of urban life, rendering Cencelle a particularly compelling case study. The utilisation of iconography allows us to better understand certain aspects related to the social and economic context of the city, such as its leisure activities or beliefs. For instance, the article will conclude with a discussion of beliefs related to funeral rites.

Abstract In 2022, two new classifications of myeloid neoplasms and acute leukemias were published: the 5th edition WHO Classification (WHO-HAEM5) and the International Consensus Classification (ICC). As with prior classifications, the WHO-HAEM5 and ICC made updates to the prior classification (revised 4th edition WHO Classification, WHO-HAEM4R) based on a consensus of groups of experts, who examined new evidence. Both WHO-HAEM5 and ICC introduced several new disease entities that are based predominantly on genetic features, superseding prior morphologic definitions. While it is encouraging that two groups independently came to similar conclusions in updating the classification of myeloid neoplasms and acute leukemias, there are several divergences in how WHO-HAEM5 and ICC define specific entities as well as differences in nomenclature of certain diseases. In this review, we highlight the similarities and differences between the WHO-HAEM5 and ICC handling of myeloid neoplasms and acute leukemias and present a practical approach to diagnosing and classifying these diseases in this current era of two divergent classification guidelines.

Abstract This systematic review addresses the complex nature of Panic Disorder (PD), characterized by recurrent episodes of acute fear, with a focus on updating and consolidating knowledge regarding neurochemical, genetic, and epigenetic factors associated with PD. Utilizing the PRISMA methodology, 33 original peer-reviewed studies were identified, comprising 6 studies related to human neurochemicals, 10 related to human genetic or epigenetic alterations, and 17 animal studies. The review reveals patterns of altered expression in various biological systems, including neurotransmission, the Hypothalamic-Pituitary-Adrenal (HPA) axis, neuroplasticity, and genetic and epigenetic factors leading to neuroanatomical modifications. Noteworthy findings include lower receptor binding of GABAA and serotonin neurotransmitters in the amygdala. The involvement of orexin (ORX) neurons in the dorsomedial/perifornical region in triggering panic reactions is highlighted, with systemic ORX-1 receptor antagonists blocking panic responses. Elevated Interleukin 6 and leptin levels in PD patients suggest potential connections between stress-induced inflammatory changes and PD. Brain-derived neurotrophic factor (BDNF) and tyrosine receptor kinase B (TrkB) signaling are implicated in panic-like responses, particularly in the dorsal periaqueductal gray (dPAG), where BDNF’s panicolytic-like effects operate through GABAA-dependent mechanisms. GABAergic neurons’ inhibitory influence on dorsomedial and posterior hypothalamus nuclei is identified, potentially reducing the excitability of neurons involved in panic-like responses. The dorsomedial hypothalamus (DMH) is highlighted as a specific hypothalamic nucleus relevant to the genesis and maintenance of panic disorder. Altered brain lactate and glutamate concentrations, along with identified genetic polymorphisms linked to PD, further contribute to the intricate neurochemical landscape associated with the disorder. The review underscores the potential impact of neurochemical, genetic, and epigenetic factors on the development and expression of PD. The comprehensive insights provided by this systematic review contribute to advancing our understanding of the multifaceted nature of Panic Disorder and pave the way for targeted therapeutic strategies.

ABSTRACT Background. This study assessed fidelity and feasibility of the Self-Management of Well-being (SMW) intervention for long-term social assistance recipients (SARs). Methods. Next to evaluation forms and on-site observations, semi-structured interviews with participants and teachers were used, which were recorded and transcribed verbatim. Thematic analysis was performed using ATLAS.ti 23. Results. The intervention was executed with high fidelity, and seems feasible for the target population. Teachers and participants were positive about the intervention, its complexity, facilitation strategies, recruitment, quality of delivery, participant responsiveness, acceptability, and suitability. Participant dropout was relatively high. Discussion. This study contributes to improving the well-being of long-term SARs, as it provides an adequate support tool for this group. Drop-out remains a challenge. The positive results encourage widespread dissemination of the intervention. A study on its effectiveness is underway.

Abstract Most of the intrusion detection datasets to research machine learning-based intrusion detection systems (IDSs) are devoted to cyber-only systems, and they typically collect data from one architectural layer. Often the attacks are generated in dedicated attack sessions, without reproducing the realistic alternation and overlap of normal and attack actions. We present a dataset for intrusion detection by performing penetration testing on an embedded cyber-physical system built over Robot Operating System 2 (ROS2). Features are monitored from three architectural layers: the Linux operating system, the network, and the ROS2 services. The dataset is structured as a time series and describes the expected behavior of the system and its response to ROS2-specific attacks: it repeatedly alternates periods of attack-free operation with periods when a specific attack is being performed. This allows measuring the time to detect an attacker and the number of malicious activities performed before detection. Also, it allows training an intrusion detector to minimize both, by taking advantage of the numerous alternating periods of normal and attack operations.

OBJECTIVE: Our aim was to observe if anxiety disorder patients - DSM-IV - respond in a similar way to the induction of panic attacks by a breath-holding challenge test. METHOD: We randomly selected 29 panic disorder (PD) patients, 27 social anxiety disorder (SAD) patients, 21 generalized anxiety disorder (GAD) patients. They were induced to breath-hold for as long as possible four times with two-minute interval between them. Anxiety scales were applied before and after the test. RESULTS: A total of 44.8% (n=13) PD patients, 14.8% (n=4) SAD patients, 9.5% (n=2) GAD patients had a panic attack after the test (c²= 21.44, df= 2, p=0.001). There was no heart rate or anxiety levels difference among the groups before and after the test. CONCLUSION: In this breath-holding challenge test the panic disorder patients were more sensitive than other anxiety disorder patients.

The panic-respiration connection has been presented with increasing evidences in the literature. We report three panic disorder patients with nocturnal panic attacks with prominent respiratory symptoms, the overlapping of the symptoms with the sleep apnea syndrome and a change of the diurnal panic attacks, from spontaneous to situational pattern. The implication of these findings and awareness to the distinct core of the nocturnal panic attacks symptoms may help to differentiate them from sleep disorders and the search for specific treatment.

Epidemiological and clinical studies have shown a positive correlation between smoking and psychiatric disorders. To investigate the prevalence of cigarette smoking, 277 psychiatric outpatients with anxiety or depressive disorders (DSM-IV) answered a self-evaluation questionnaire about smoking behavior and were compared with a group of 68 control subjects. The diagnoses (N = 262) were: 30.2% (N = 79) major depressive disorder, 23.3% (N = 61) panic disorder, 15.6% (N = 41) social anxiety disorder, 7.3% (N = 19) other anxiety disorders, and 23.7% (N = 62) comorbidity disorders. Among them, 26.3% (N = 69) were smokers, 23.7% (N = 62) were former smokers and 50.0% (N = 131) were nonsmokers. The prevalence of nicotine dependence among the smokers was 59.0% (DSM-IV). The frequency of cigarette smoking did not show any significant difference among the five classes of diagnosis. The social anxiety disorder patients were the heaviest smokers (75.0%), with more unsuccessful attempts to stop smoking (89.0%). The frequency of former smokers was significantly higher among older subjects and nonsmokers were significantly younger (chi² = 9.13, d.f. = 2, P = 0.01). Our data present some clinical implications suggesting that in our psychiatric outpatient sample with anxiety disorder, major depression and comorbidity (anxiety disorder and major depression), the frequency of cigarette smoking did not differ from the frequency found in the control group or in general population studies. Some specific features of our population (outpatients, anxiety and depressive disorders) might be responsible for these results.

OBJECTIVE: We aim to evaluate the psychodymanic model for panic disorder (PD) formulated by Shear et al. (1993), comparing PD patients and major depression (MD) patients. METHOD: We evaluated these parameters in open interviews in 10 PD patients and 10 patients with MD (DSM-IV). The data were recorded on videotape and were examined by 5 diagnostic blind appraisers. RESULTS: The data allowed a comparative analysis that underscores the existence of a psychological model for PD vs MD: 1) the protracted symbiotic phase of development and the existence of problems with separation in PD patients; 2) patients with MD tended to have a particularly negative impression of relationship with the first objects; furthermore, they had remarkable experiences of loss; and 3) while the PD patients tended to be shy and inhibited in childhood, especially showing a clear difficulty in expressing aggressiveness, the depressed patients tended to disclose an impulsive aggressiveness from infancy to adulthood. CONCLUSION: Exposure to parental behaviours that augment fearfulness may result in disturbances in object relations and persistence of conflicts between dependence and independence may predispose to anxiety symptoms and fears of PD.

Abstract The parameterization of subgrid‐scale processes such as boundary layer (PBL) turbulence introduces uncertainty in Earth System Model (ESM) results. This uncertainty can contribute to or exacerbate existing biases in representing key physical processes. This study analyzes the influence of tunable parameters in an experimental version of the Cloud Layers Unified by Binormals (CLUBBX) scheme. CLUBB is the operational PBL parameterization in the Community Atmosphere Model version 6 (CAM6), the atmospheric component of the Community ESM version 2 (CESM2). We perform the Morris one‐at‐a‐time (MOAT) parameter sensitivity analysis using short‐term (3‐day), initialized hindcasts of CAM6‐CLUBBX with 24 unique initial conditions. Several input parameters modulating vertical momentum flux appear most influential for various regionally‐averaged quantities, namely surface stress and shortwave cloud forcing (SWCF). These parameter sensitivities have a spatial dependence, with parameters governing momentum flux most influential in regions of high vertical wind shear (e.g., the mid‐latitude storm tracks). We next evaluate several experimental 20‐year simulations of CAM6‐CLUBBX with targeted parameter perturbations. We find that parameter perturbations produce similar physical mechanisms in both short‐term and long‐term simulations, but these physical responses can be muted due to nonlinear feedbacks manifesting over time scales longer than 3 days, thus causing differences in how output metrics respond in the long‐term simulations. Analysis of turbulent fluxes in CLUBBX indicates that the influential parameters affect vertical fluxes of heat, moisture, and momentum, providing physical pathways for the sensitivities identified in this study.

This is the second part of the Brazilian S20 mental health report. The mental health working group is dedicated to leveraging scientific insights to foster innovation and propose actionable recommendations for implementation in Brazil and participating countries. In addressing the heightened mental health challenges in a post-pandemic world, strategies should encompass several key elements. This second part of the S20 Brazilian Mental Health Report will delve into some of these elements, including: the impact of climate change on mental health, the influence of environmental factors on neurodevelopmental disorders, the intersection of serious mental illness and precision psychiatry, the co-occurrence of physical and mental disorders, advancements in biomarkers for mental disorders, the use of digital health in mental health care, the implementation of interventional psychiatry, and the design of innovative mental health systems that integrate principles of innovation and human rights. Reassessing the treatment settings for psychiatric patients in general hospitals, where their mental health and physical needs are addressed, should be prioritized in mental health policy. As the S20 countries prepare for the future, we need principles that can advance innovation, uphold human rights, and strive for the highest standards in mental health care.

A toxoplasmose é causada pelo protozoário Toxoplasma gondii, parasita intracelular obrigatório, coccídeo que infecta animais de sangue quente e humanos. Os felinos são considerados os únicos hospedeiros definitivos por liberarem formas infectantes e os demais hospedeiros são apenas intermediários. Atualmente os cães estão sendo estudados como potenciais sentinelas da contaminação tanto humana quanto ambiental. A grande maioria das infecções são subclínicas havendo um quadro de Toxoplasmose generalizada apenas em imunossupressão. A toxoplasmose clínica causa principalmente sinais inespecíficos que incluem diarreia, febre, vômitos, alterações respiratórias e nervosas como por exemplo tremores, ataxia, paresia, tetraparesia, convulsões, rigidez e fraqueza muscular e disfonia variando de acordo com o local da infecção. O diagnóstico antemortem pode ser realizado baseado na exclusão dos diagnósticos diferenciais, níveis elevados e crescentes de anticorpos, com a junção dos sinais clínicos e a melhora clínica do paciente após o início da terapia anti-Toxoplasma. No presente relato foi atendido um canino, macho, castrado há 3 meses, sem raça definida, com 6 anos de idade que apresentava marcha rígida, atáxica e parética em membros pélvicos. Propriocepção preservada nos quatro membros, porém tônus muscular diminuído. Possuía reflexo perineal e panículo preservados e sem alterações em nervos cranianos, mas esse quadro logo evoluiu para tetraparesia, ausência de diversos reflexos e ventroflexão de pescoço. O paciente possuía o hábito de ingerir fezes de outros animais principalmente de seu coabitante felino que possuía acesso irrestrito à rua. O tratamento medicamentoso instituído foi com sulfadiazina + trimetoprim onde já houve dos sinais clínicos e após resultado positivo do IgM e IgG para toxoplasmose iniciou-se a associação com Clindamicina. Com 28 dias de tratamento o paciente recebeu alta com remissão de todos os sinais clínicos e alterações hematológicas.

Objective: To compare the prevalence of postpartum depression (PPD) symptoms between high-income countries (HIC) and low- and middle-income countries (LMIC) during the COVID-19 pandemic. Methods: The PubMed, Embase, Virtual Health Library, Scopus, Web of Science, PsycINFO, and CINAHL databases were searched until October 2022 for studies that collected data during the pandemic. The metaprop command was used in the Stata statistical software version 12.0 to run a random-effects meta-analysis. Results: A total of 15 studies with 4,788 postpartum women were included. The overall prevalence of PPD symptoms was 31% (95%CI 21.85-40.99). The pooled prevalence of PPD symptoms among women from HIC (30.5% [95%CI 16.95-46.02]) did not differ significantly from that of women from LMIC (31.5% [95%CI 19.26-45.15]). However, studies that analyzed women up to 1 month after childbirth reported a lower prevalence of PPD symptoms (17.5% [95%CI 9.85-26.62]) compared to those that observed them up to 1 year after childbirth (38.3% [95%CI 33.96-42.83]). Conclusions: The prevalence of PPD symptoms was high across countries, regardless of human development index. This condition must be regularly tracked worldwide to assess, discuss, and recommend more assertive steps that may be implemented to address it based on the particular characteristics of each country. Registration number: PROSPERO CRD42022346861.

Background Greenness—or vegetative presence—has been identified as a factor in chronic disease. The present study examines the longitudinal relationship between objective measures of greenness at the residential block level and incidence of 6 cardiovascular disease conditions. Methods and Results Analyses examined the impact of consistently high versus consistently low “precision” greenness at the Census block level on the 5‐year incidence of cardiovascular disease conditions, including acute myocardial infarction, atrial fibrillation, heart failure, ischemic heart disease, stroke/transient ischemic attack, and hypertension, among 229 034 US Medicare beneficiaries in Miami‐Dade County, Florida, USA. Zero‐inflated Poisson regression was used to model the odds of developing any new cardiovascular disease and number of new cardiovascular disease conditions based on greenness tertiles computed across 2011 and 2016 Normalized Difference Vegetation Index values, adjusting for individual age, sex, race, ethnicity, baseline cardiovascular disease conditions, neighborhood income, and walkability in 2011 and 2016. When compared with individuals consistently in the low greenness tertile in 2011 and 2016, those consistently in the high greenness tertile in 2011 and 2016 had a 9% lower odds of having any new cardiovascular conditions (odds ratio [OR], 0.91 [95% CI, 0.84–0.99]; P=0.021). Conclusions Over a 5‐year period, consistently high greenness, when compared with consistently low greenness, was associated with lower odds of any new cardiovascular disease conditions. Identifying the role of greenness exposure in such a small geographic area, the Census block on which the older adult resides, allows for more precise, strategic decisions on where additional trees can be added—by selecting at‐risk blocks rather than entire neighborhoods for tree‐planting interventions.

Introduction Wearable cardioverter-defibrillators (WCD) have emerged as a valuable tool in the management of patients at risk for life-threatening arrhythmias. These devices offer a non-invasive and temporary solution, providing continuous monitoring and the potential for prompt defibrillation when needed. In this study, we explore the use of WCD and evaluate arrhythmic events through comprehensive monitoring.Methods From November 2022 to May 2024, we conducted an outpatient follow-up of 41 patients receiving WCD. Regular check-ups, remote monitoring and comprehensive echocardiography were performed to optimise a tailored therapy.Results The average age of the patients was 59.2.4±16.5 years, with 78% being male. Among the cohort, 54% had hypertension, 41% were smokers and 66% had dyslipidaemia, while 27% were diabetic. WCD was assigned according to the Italian Association of Hospital Cardiologists position paper focussing on the appropriate use of WCD and European Society of Cardiology guidelines on ventricular arrhythmias and the prevention of sudden cardiac death: 24 (58%) patients had a de novo diagnosis of heart failure with reduced ejection fraction, 11 (27%) patients had a recent acute coronary syndrome and ejection fraction

Refletir sobre a construção da identidade profissional dos professores é essencial para compreender que os processos formativos, seja na formação inicial ou continuada, representam momentos cruciais para a construção e consolidação dos fundamentos identitários inerentes à classe docente. Nesse contexto, o objetivo desta pesquisa foi investigar os elementos do imaginário de licenciando(a)s em Física sobre o conhecimento científico, o desenvolvimento de saberes para o exercício docente e, por consequência, a formação de suas identidades profissionais. Trata-se de um estudo longitudinal, que acompanhou os participantes desde o início do curso de licenciatura até dois anos após sua conclusão, abrangendo um período de seis anos. A pesquisa se baseou em princípios da Análise de Discurso Pecheutiana e em conceitos relacionados à identidade profissional docente provenientes da área de formação de professores. A partir da análise das produções discursivas, foi evidenciado que o projeto pedagógico do curso e sua matriz curricular, por meio das práticas pedagógicas desenvolvidas, desempenham um papel fundamental na modificação dos imaginários do(a)s participantes, durante o processo de construção de saberes para a docência e na formação de suas identidades profissionais. Além disso, observou-se que os imaginários dos licenciandos sobre a profissão docente estão alinhados com a perspectiva do professor reflexivo. Essa abordagem reforça a constituição de uma identidade profissional docente fundamentada em princípios que naturalizam um modelo de formação auto formativo e orientado para a instrumentalização da reflexão prática.

BackgroundAutistic traits (AT) seem to be particularly frequent among patients with borderline personality disorder (BPD). Moreover, the autism spectrum is considered a vulnerability factor for the development of post-traumatic stress disorder (PTSD) symptoms, increasing the vulnerability of BPD subjects toward the development of a stress-related disorder.AimThe study aimed to investigate the association between AT and trauma-related symptoms in a clinical sample of patients with BPD.MethodsA total of 48 patients with a clinical diagnosis of BPD and 52 healthy control (HC) subjects were recruited and assessed with the Adult Autism Subthreshold Spectrum Self-Report (AdAS Spectrum) questionnaire and the Trauma and Loss Spectrum—Self-Report questionnaire (TALS-SR). The BPD group was divided into two subgroups: BPD with a symptomatological diagnosis of PTSD (pBPD = 25) and BPD not diagnosed with PTSD (No-pBPD = 23).ResultsThe clinical sample scored significantly higher in almost all AdAS domains. Moreover, pBPD groups reported higher AdAS and TALS-SR scores in the total and in various domains than the No-pBPD group, which scored higher in several domains than HC. AdAS Restricted interests and rumination domain scores were positive predictors of BPD presence independently from PTSD, while Inflexibility and adherence to routine domain was a negative predictor. Finally, AdAS Hyper/hyporeactivity to sensory stimuli domain was a positive predictor only for inclusion in the pBPD group.ConclusionOur study confirmed the existence of a statistically significant relationship between the autism spectrum and BPD, while BPD subjects diagnosed with PTSD seem to show a higher autism spectrum burden.

Background Haemodynamic variables like right atrial pressure (RAP), cardiac index (CI), stroke volume index (SVI) and mixed venous oxygen saturation (SvO2) predict survival in patients with pulmonary arterial hypertension (PAH). However, there is the need to identify further prognostic haemodynamic parameters as well as to redefine their role in PAH risk stratification compared to current risk tools and non-invasive parameters. Methods This cohort study includes treatment-naïve patients assessed at baseline and after first-line PAH therapy with clinical, functional, exercise, laboratory and haemodynamic evaluations. Using a stepwise multivariate Cox regression analysis, independent prognostic haemodynamic parameters were identified and stratified according to cut-offs already defined in the European Society of Cardiology (ESC)/European Respiratory Society (ERS) risk table or defined based on the highest Chi-squared of the log-rank test. Their discriminatory power was tested for all-cause death and a combined end-point of death, hospitalisation and need of treatment escalation. Results 794 patients with PAH were enrolled. At first follow-up, RAP and pulmonary artery elastance were independently associated with death. Because of high correlations between haemodynamic parameters, different multivariable analyses were done identifying six other variables (pulmonary arterial compliance, cardiac efficiency, pulmonary vascular resistance, SvO2, CI and SVI). Haemodynamic parameters were of no added prognostic value compared to ESC/ERS risk tools for the all-cause death end-point but they showed additional value to non-invasive parameters for the combined end-point and, when taken alone, had a discriminatory capacity comparable to ESC/ERS risk tools. Conclusion Haemodynamics’ discriminative ability for clinical worsening is comparable to current ESC/ERS risk tools and is of added value to non-invasive parameters.

Abstract Objective In the DSM-III and the DSM-IV, bipolar disorder (BD) is classified as a mood disorder and diagnosis requires presence of a mood change, i.e., euphoria or irritability. In contrast, DSM-5 states that there must be some increase in energy or motor activity in addition to the mood change. Our aim was to identify which types of symptoms (i.e., mood or energy/activity-related symptoms) are the most informative in a manic episode. Methods Symptoms of manic episodes in 106 outpatients with BD were assessed in a naturalistic study using the Young Mania Rating Scale (YMRS) between November 2002 and November 2015. The scale items were divided into three groups according to clinical criteria: mood, energy/activity, and other. For comparisons between groups, the Samejima graded response model from Item Response Theory (IRT) and the Test Information Function (TIF) were computed. Chi-square tests were used to verify the association between the groups of symptoms by comparing the area under the curve of the TIF results. Results The information accounted for by energy/activity represents 77% of the proportion of the total TIF; about 23% is related to mood and other groups of symptoms. These proportions are statistically different (χ2[1] = 30.42, p < 0.001) Conclusion On average, changes in energy/activity tend to be more informative than mood changes during the manic phases of BD.

O estudo tem por objetivo compreender a relação entre política criminal atuarial e biopolítica como instrumentos de segregação e neutralização de determinados grupos sociais, os quais, a partir de prognósticos atuariais, são tidos como grupos de risco. Buscou-se analisar em que consiste e como se dá a política atuarial e os mecanismos de controle da biopolítica. Mediante metodologia analítica e interpretativa, foi possível identificar os efeitos do gerencialismo, sua influência no controle social articulado pelo biopoder e, por fim, verificar que a política atuarial se dá como instrumentalização dos mecanismos da biopolítica para uma higienização social.