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AimsTo map studies assessing both clinical high risk for psychosis (CHR-P) and borderline personality disorder (BPD) in clinical samples, focusing on clinical/research/preventive paradigms and proposing informed research recommendations.MethodsWe conducted a PRISMA-ScR/JBI-compliant scoping review (protocol: https://osf.io/8mz7a) of primary research studies (cross-sectional/longitudinal designs) using valid measures/criteria to assess CHR-P and BPD (threshold/subthreshold) in clinical samples, reporting on CHR-P/psychotic symptoms and personality disorder(s) in the title/abstract/keywords, identified in Web of Science/PubMed/(EBSCO)PsycINFO until 23/08/2023.Results33 studies were included and categorized into four themes reflecting their respective clinical/research/preventive paradigm: (i) BPD as a comorbidity in CHR-P youth (k = 20), emphasizing early detection and intervention in psychosis; (ii) attenuated psychosis syndrome (APS) as a comorbidity among BPD inpatients (k = 2), with a focus on hospitalized adolescents/young adults admitted for non-psychotic mental disorders; (iii) mixed samples (k = 7), including descriptions of early intervention services and referral pathways; (iv) transdiagnostic approaches (k = 4) highlighting “clinical high at risk mental state” (CHARMS) criteria to identify a pluripotent risk state for severe mental disorders.ConclusionThe scoping review reveals diverse approaches to clinical care for CHR-P and BPD, with no unified treatment strategies. Recommendations for future research should focus on: (i) exploring referral pathways across early intervention clinics to promote timely intervention; (ii) enhancing early detection strategies in innovative settings such as emergency departments; (iii) improving mental health literacy to facilitate help-seeking behaviors; (iv) analysing comorbid disorders as complex systems to better understand and target early psychopathology; (v) investigating prospective risk for BPD; (vi) developing transdiagnostic interventions; (vii) engaging youth with lived experience of comorbidity to gain insight on their subjective experience; (viii) understanding caregiver burden to craft family-focused interventions; (ix) expanding research in underrepresented regions such as Africa and Asia, and; (x) evaluating the cost-effectiveness of early interventions to determine scalability across different countries.Systematic Review Registrationhttps://osf.io/8mz7a.

Abstract We investigated the vasodilatory effects of Hymenaea rubriflora Ducke stem bark extract (HR- HAc). Vascular reactivity of the aortic rings of Wistar rats was tested by in vitro cumulative doses (0.1 - 729 μg/mL). Rats (n=5) were treated with 25 (G25), 50 (G50) and 100 (G100) mg/ kg of HR-HAc or saline (control group - CG) for four weeks. An in vitro assay resulted in dose-dependent relaxation of the aortic rings with functional endothelium, which was inhibited in the presence of L-NAME. Rings of the treated animals increased acetylcholine relaxing potency at all doses, with a greater effect on G50 (pD2 = 7.8±0.1, Emax = 95.6±1.1) and a decreased contractile potency to phenylephrine in G25 (pD2 = 6.9±0.06, Emax = 61.5±6.0%) and G50 (pD2= 6.6±0.06, Emax = 71.0±8.5%) when compared to the CG in the presence and absence of endothelium (pD2= 6.4± 0.1, 6.4±0.1 and 6.9±0.1, respectively). Cumulative doses of nitroprusside resulted in increased relaxing potency in all treated groups and maintained Emax at 100%. It is concluded that HR-HAc has vasorelaxant capacity and inhibitory vascular contraction activity applied either directly to aortic rings or after treatment with in vivo supplementation, which places this extract as a potential nutraceutical or pharmacological agent for treating diseases associated with vascular dysfunction.

Introduction Schizotypal disorder is associated with a high level of disability at an individual level and high societal costs. However, clinical recommendations for the treatment of schizotypal disorder are scarce and based on limited evidence. This review aims to synthesise the current evidence on treatment for schizotypal disorder making recommendations for clinical practice.Methods and analysis This systematic review protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic literature search will be performed in PsychArticles, Embase, Medline and Cochrane Central Register of Controlled Trials. Additionally, we will search for relevant articles manually. Inclusion criteria are published studies including individuals diagnosed with schizotypal personality disorder according to Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria, or schizotypal disorder according to International Classification of Diseases (ICD) criteria. We will include interventional studies comprising any pharmacological and non-pharmacological treatment trials for patients with schizotypal disorder, and all relevant outcome measures will be reported. Risk of bias will be assessed by Cochrane risk-of-bias tools. Data will be synthesised using narrative or thematic analysis and, if suitable, through meta-analysis.Ethics and dissemination No original data will be collected as part of this study and ethics approval is, therefore, not applicable. The results will be disseminated through peer-reviewed publication and presented at international scientific meetings. We will aim at submitting the final paper for publication within 4 months of completion of analyses. Furthermore, this systematic review will inform clinicians and researchers on the current state of evidence on treatment for schizotypal disorder. Findings may guide proposals for further research and potentially guide recommendations for clinical practice using the Grading of Recommendations Assessment, Development and Evaluation.PROSPERO registration number CRD42022375001.

Abstract The diagnosis of inflammatory bowel diseases (IBD) may be challenging and their clinical course, characterized by relapses and spontaneous or drug-induced remissions, is difficult to predict. Novel prognostic biomarkers are needed. Keratin 7 (K7) is a cytoskeletal intermediate filament protein which is not normally expressed in the colonic epithelium. It was recently shown that K7 expression in the colonic epithelium is associated with ulcerative colitis and Crohn’s disease, the two main subtypes of IBD. Here we investigated IBD associated K7 neo-expression in different regions of colon and terminal ileum. The correlation of the K7 expression with the inflammatory activity of the epithelium was analyzed in each region. The prognostic value of K7 was estimated by comparing the clinical disease activity after 3 years with the K7 expression at the time of enrollment. Our data shows that the level of K7 expression in inflamed epithelium varies depending on the anatomical region and it is the most pronounced in ascending and descending colon, but it did not predict the severity of IBD for the following 3 years. These results warrant future studies focusing on the biological role of K7 in colon and its utilization as potential IBD biomarker.

Abstract The clinical course of IBD, characterized by relapses and remissions, is difficult to predict. Initial diagnosis can be challenging, and novel disease markers are needed. Keratin 7 (K7) is a cytoskeletal intermediate filament protein not expressed in the colonic epithelium but has been reported in IBD-associated colorectal tumors. Our aim was to analyze whether K7 is expressed in chronic colonic inflammatory diseases and evaluate its potential as a novel biomarker. K7 was analyzed in two patient cohorts using immunohistochemistry-stained colon samples and single-cell quantitative digital pathology methods. K7 was correlated to pathological changes and clinical patient characteristics. Our data shows that K7 is expressed de novo in the colonic epithelium of ulcerative colitis and Crohn’s disease IBD patients, but not in collagenous or lymphocytic colitis. K7 mRNA expression was significantly increased in colons of IBD patients compared to controls when assessed in publicly available datasets. While K7 increased in areas with inflammatory activity, it was not expressed in specific crypt compartments and did not correlate with neutrophils or stool calprotectin. K7 was increased in areas proximal to pathological alterations and was most pronounced in drug-resistant ulcerative colitis. In conclusion, colonic epithelial K7 is neo-expressed selectively in IBD patients and could be investigated for its potential as a disease biomarker.

ObjectiveYouths at clinical high risk for psychosis (CHR-P) are characterized by a high prevalence of anxiety and depressive disorders. The present study aimed at developing and analyzing a network structure of CHR-P symptom domains (i.e., positive, negative, disorganization, and general subclinical psychotic symptoms), depressive and anxiety symptoms, and general functioning.MethodsNetwork analysis was applied to data on 111 CHR-P children and adolescents (Mage = 14.1), who were assessed using the Structured Interview for Prodromal Syndromes, the Children’s Depression Inventory, the Children’s Global Assessment Scale, and the Multidimensional Anxiety Scale for Children.ResultsIn the network, negative and disorganization symptoms showed the strongest association (r = 0.71), and depressive and anxiety symptoms showed dense within-domain connections, with a main bridging role played by physical symptoms of anxiety. The positive symptom cluster was not associated with any other node. The network stability coefficient (CS) was slightly below 0.25, and observed correlations observed ranged from 0.35 to 0.71.ConclusionThe lack of association between subclinical positive symptoms and other network variables confirmed the independent nature of subclinical positive symptoms from comorbid symptoms, which were found to play a central role in the analyzed network. Complex interventions should be developed to target positive and comorbid symptoms, prioritizing those with the most significant impact on functioning and the most relevance for the young individual, through a shared decision-making process. Importantly, the results suggest that negative and disorganization symptoms, as well as depressive and anxiety symptoms, may be targeted simultaneously.

Purpose: Inflammatory bowel disease (IBD) can be imaged with positron emission tomography (PET), but existing PET radiopharmaceuticals have limited diagnostic accuracy. Vascular adhesion protein-1 (VAP-1) is an endothelial cell surface molecule that controls leukocyte extravasation into sites of inflammation. However, the role of inflammation-induced VAP-1 expression in IBD is still unclear. Therefore, this study investigated the utility of VAP-1-targeted [68Ga]Ga-DOTA-Siglec-9 positron emission tomography/computed tomography (PET/CT) for assessing inflammation in two mouse models of IBD. Procedures: Studies were performed using K8−/− mice that develop a chronic colitis-phenotype and C57Bl/6NCrl mice with acute intestinal inflammation chemically-induced using 2.5% dextran sodium sulfate (DSS) in drinking water. In both diseased and control mice, uptake of the VAP-1-targeting peptide [68Ga]Ga-DOTA-Siglec-9 was assessed in intestinal regions of interest using in vivo PET/CT, after which ex vivo gamma counting, digital autoradiography, and histopathological analyses were performed. Immunofluorescence staining was performed to determine VAP-1-expression in the intestine, including in samples from patients with ulcerative colitis. Results: Intestinal inflammation could be visualized by [68Ga]Ga-DOTA-Siglec-9 PET/CT in two murine models of IBD. In both models, the in vivo PET/CT and ex vivo studies of [68Ga]Ga-DOTA-Siglec-9 uptake were significantly higher than in control mice. The in vivo uptake was increased on average 1.4-fold in the DSS model and 2.0-fold in the K8−/− model. Immunofluorescence staining revealed strong expression of VAP-1 in the inflamed intestines of both mice and patients. Conclusions: This study suggests that the VAP-1-targeting [68Ga]Ga-DOTA-Siglec-9 PET tracer is a promising tool for non-invasive imaging of intestinal inflammation. Future studies in patients with IBD and evaluation of the potential value of [68Ga]Ga-DOTA-Siglec-9 in diagnosis and monitoring of the disease are warranted. [ABSTRACT FROM AUTHOR]

Aim: Basic self disturbance is a putative core vulnerability marker of schizophrenia spectrum disorders. The primary aims of the Self, Neuroscience and Psychosis (SNAP) study are to: (1) empirically test a previously described neurophenomenological self‐disturbance model of psychosis by examining the relationship between specific clinical, neurocognitive, and neurophysiological variables in UHR patients, and (2) develop a prediction model using these neurophenomenological disturbances for persistence or deterioration of UHR symptoms at 12‐month follow‐up. Methods: SNAP is a longitudinal observational study. Participants include 400 UHR individuals, 100 clinical controls with no attenuated psychotic symptoms, and 50 healthy controls. All participants complete baseline clinical and neurocognitive assessments and electroencephalography. The UHR sample are followed up for a total of 24 months, with clinical assessment completed every 6 months. Results: This paper presents the protocol of the SNAP study, including background rationale, aims and hypotheses, design, and assessment procedures. Conclusions: The SNAP study will test whether neurophenomenological disturbances associated with basic self‐disturbance predict persistence or intensification of UHR symptomatology over a 2‐year follow up period, and how specific these disturbances are to a clinical population with attenuated psychotic symptoms. This may ultimately inform clinical care and pathoaetiological models of psychosis. [ABSTRACT FROM AUTHOR]

Objetivo: Comparar o tempo necessário para realizar escolhas alimentares com diferentes modelos de rotulagem nutricional frontal entre adultos brasileiros. Métodos: Foram realizadas entrevistas com 150 participantes, que foram orientados a escolher o produto mais saudável entre dois alimentos, sendo apresentados oito pares de imagens. Um dos produtos de cada par apresentava advertências (alto em açúcares, sódio ou gordura saturada), testados em formatos diferentes de acordo com o grupo no qual o indivíduo era alocado: lupa, octógono, círculo, triângulo e semáforo. Foram contabilizados o número de acertos do produto mais saudável em cada par e o tempo para escolha correta do produto mais saudável. Resultados: Observou-se menor número de acertos do produto mais saudável entre os pares com semáforo, em comparação com qualquer outro modelo (p

A mangaba apresenta grande potencial para elaboração de fermentados alcoólicos, sendo de extrema importância o acompanhamento do processo fermentativo para obtenção dessa bebida, assim como de outras. Assim, objetivou-se acompanhar e avaliar o processo cinético de fermentação e os parâmetros fermentativos de bebidas fermentadas de mangaba. Foram elaboradas quatro formulações de fermentados com variação do teor de sólidos solúveis inicial e concentração de leveduras conforme etapas e concentrações descritas no processo de pedido de patente BR 10 2018 075834 9. Durante a fermentação, retirou-se alíquotas para o acompanhamento da cinética de fermentação e parâmetros fermentativos. Verificou-se que o comportamento cinético, com exceção do tempo de fermentação, não sofreu interferência pelas variáveis estudadas, e que a formulação 3 (maior teor de sólidos solúveis e menos concentração de levedura) e formulação 4 (maior teor de sólidos solúveis e maior concentração de levedura) apresentaram melhores resultados principalmente no tocante a teor alcoólico, concentração de etanol experimental e teórico, rendimento do processo e em produto. Conclui-se que não houve diferença no comportamento cinético, mas existiu nos parâmetros fermentativos das bebidas de mangaba.

Moisture and fat content, fatty acid profile, and volatile terpenes were measured for the first time for ‘Kalehghouchi’, ‘Pete 1’, and ‘Lost Hills’ pistachios grown at two California microclimates: Lost Hills and Parlier. ‘Kalehghouchi’ had the highest moisture content, followed by ‘Pete 1’ and ‘Lost Hills’, respectively. While the moisture content of ‘Kalehghouchi’ was not significantly affected by location, it was lower for ‘Pete 1’ grown at Parlier (40.8 vs. 40.8 g/100 g) and higher for ‘Lost Hill’ grown there (48.2 vs. 45.2 g/100 g). ‘Pete 1’ grown at the Parlier site had a higher fat content compared with ‘Lost Hills’ (47.7 vs. 43.0 g/100 g). ‘Kalehghouchi’ had a lower fat content at Parlier compared with Lost Hills (42.0 vs. 44.9 g/100 g), and ‘Lost Hills’ was unaffected by location. The main fatty acid measured in the pistachio samples was oleic acid (52% to 58%), followed by linoleic (26% to 33%) and palmitic acids (11% to 13%). While oleic acid content of ‘Lost Hills’ and ‘Kalehghouchi’ was higher for pistachios grown in Parlier, no impact of location was observed for ‘Pete 1’. The fatty acid profiles of all three cultivars appeared to be more dependent on genotype and less affected by microclimate. α-pinene (95–1682 ng/kg), limonene (37–741 ng/kg), and α-terpinolene (1–368 ng/kg) were the most abundant volatiles among all the cultivars and locations. Microclimate was the primary factor in determining volatile terpenes concentration in pistachio kernels.

Entre as diversas definições, o envelhecimento pode ser entendido como a consequência da passagem do tempo pelo qual um indivíduo se torna mais velho. Nos seres humanos ocorre um desgaste de sua saúde, com o aumento do risco de morte. As políticas desenvolvidas ao público idoso têm contribuído para o aumento da longevidade e qualidade de vida. No Brasil, este processo vem se concretizando de modo marcante na Estratégia Saúde da Família, através de iniciativas voltadas para a educação em saúde como mediadora de uma vida mais saudável. Diante desse contexto, o presente trabalho teve como objetivo investigar como os cuidados em saúde têm sido praticados, de modo a contribuir para um envelhecimento saudável e com a melhoria do estilo de vida de idosos, na atenção básica da cidade de João Pessoa - PB. Tratou-se de uma pesquisa qualitativa, exploratória, descritiva realizada mediante aplicação de um formulário , sobre as condições de saúde e de vida, a idosos assistidos pela USF-Ipiranga, do bairro do Valentina em João Pessoa-PB, os quais fazem parte de um programa de extensão da Faculdade de Medicina Nova Esperança. Os resultados das entrevistas foram analisados e convertidos em gráficos e estatísticas. Evidenciouse uma predominância de mulheres, com faixa etária entre 50 a mais de 80 anos, sendo mais de 61% aposentados e que mesmo nessa condição não se sentiam sozinhos. Verificou-se que os idosos têm se preocupado com sua saúde física e mental, apresentando cuidado com a alimentação, visita regular ao médico e busca pelo lazer. Desta forma, percebe-se que é possível envelhecer com saúde e ativo na sociedade, mas para isso faz-se necessário a disponibilidade de uma série de condições e ações para que essa população envelheça com qualidade.

Introduction: While the majority of young people who meet the criteria for being considered at increased risk of psychosis do not go on to develop a psychotic disorder, young people are currently being identified and treated in early intervention services. Ethical concerns have been raised concerning the decision about whether or not to provide treatment, and if so, what type of treatment. This study sought to support young people themselves to make these decisions with support from their clinician through a shared decision-making approach, facilitated by an online decision aid.Methods: This project used the International Patient Decision Aid Standards (IPDAS) to guide the development and piloting of an online decision aid across two phases: (1) qualitative, semi-structured focus groups with young people who were past clients and clinicians from an early psychosis service; and (2) pilot testing of the decision aid with clinicians and young people who were current clients to finalize the development.Results: Issues discussed by clinicians in the focus group were grouped into three main areas: (1) engagement phase; (2) assessment and priorities for treatment; and (3) initial and ongoing decision making. Clients focused on the context in which the decisions were made, including as they experienced initial feelings of resistance, and then acceptance of efforts made to describe and treat their mental health challenges. Clients highlighted the need for collaboration between themselves and their clinician, and the need to be equipped with the knowledge and tools to take care of themselves. These focus group data were used to refine the online decision aid. Pilot testing revealed that while it was overall useful and relevant, important limitations were noted by both clients and clinicians.Discussion: The use of a decision aid to facilitate shared decision making (SDM) in this area is feasible and has utility for both clients and clinicians. Use of such a tool can help to address the need to uphold the rights of young people as decision makers about their own care. Future efforts should embed decision aids within complex SDM interventions, and research to understand issues relating to implementation of these interventions.

Keratins are epithelial intermediate filament proteins that play a crucial role in cellular stress protection, with K8 being the most abundant in the colon. The intestinal epithelial-specific K8-deficient mouse model (K8flox/flox;Villin-Cre) exhibits characteristics of inflammatory bowel disease, including diarrhea, crypt erosion, hyperproliferation, and decreased barrier function. Nevertheless, the order in which these events occur and whether they are a direct cause of K8 loss or a consequence of one event inducing another remains unexplored. Increased knowledge about early events in the disruption of colon epithelial integrity would help to understand the early pathology of inflammatory and functional colon disorders and develop preclinical models and diagnostics of colonic diseases. Here, we aimed to characterize the order of physiological events after Krt8 loss by utilizing K8flox/flox;Villin-CreERt2 mice with tamoxifen-inducible Krt8 deletion in intestinal epithelial cells, and assess stool analysis as a noninvasive method to monitor real-time gene expression changes following Krt8 loss. K8 protein was significantly decreased within a day after induction, followed by its binding partners, K18 and K19 from day 4 onward. The sequential colonic K8 downregulation in adult mice leads to immediate diarrhea and crypt elongation with activation of proliferation signaling, followed by crypt loss and increased neutrophil activity within 6-8 days, highlighting impaired water balance and crypt elongation as the earliest colonic changes upon Krt8 loss. Furthermore, epithelial gene expression patterns were comparable between colon tissue and stool samples, demonstrating the feasibility of noninvasive monitoring of gut epithelia in preclinical research utilizing Cre-LoxP-based intestinal disease models. NEW & NOTEWORTHY: Understanding the order in which physiological and molecular events occur helps to recognize the onset of diseases and improve their preclinical models. We utilized Cre-Lox-based inducible keratin 8 deletion in mouse intestinal epithelium to characterize the earliest events after keratin 8 loss leading to colitis. These include diarrhea and crypt elongation, followed by erosion and neutrophil activity. Our results also support noninvasive methodology for monitoring colon diseases in preclinical models. [ABSTRACT FROM AUTHOR]

O leite humano é de grande importância para recém-nascidos e lactentes, constituindo-se uma fonte de nutrientes em proporções satisfatórias ao crescimento e desenvolvimento da criança. Além disso, tem papel significativo na redução da morbimortalidade infantil. Este estudo trata-se de um relato de experiência de discentes de medicina, a partir de visita técnica ao Banco de Leite Humano (BLH) do Instituto Cândida Vargas. O BLH é definido como um centro especializado responsável por promover o aleitamento materno e executar a coleta, processamento e controle de qualidade de colostro e leite maduro, com objetivo de distribuir para crianças que dele necessitam como fator de sobrevivência. Observou-se um número considerável de mulheres realizando a ordenha e recebendo orientações de profissionais visivelmente capacitadas para aquela função e uma infraestrutura compatível com a que é preconizada pelo Ministério da Saúde. Lactentes que não dispõem de aleitamento diretamente ao seio podem ser beneficiados com o leite adquirido nesses bancos. Entretanto, a quantidade de leite disponível ainda necessita ser ampliada. É preciso que haja melhor divulgação e incentivo para que as mulheres se tornem doadoras, visto que elas também se beneficiam na prevenção de infecções decorrentes do ingurgitamento mamário. Pelo gesto de carinho e solidariedade na condição de doadora de leite humano, a nutriz deve ser valorizada e acolhida com dignidade e respeito.

Most psychiatric disorders develop during adolescence and young adulthood and are preceded by a phase during which attenuated or episodic symptoms and functional decline are apparent. The introduction of the ultra-high risk (UHR) criteria two decades ago created a new framework for identification of risk and for pre-emptive psychiatry, focusing on first episode psychosis as an outcome. Research in this paradigm demonstrated the comorbid, diffuse nature of emerging psychopathology and a high degree of developmental heterotopy, suggesting the need to adopt a broader, more agnostic approach to risk identification. Guided by the principles of clinical staging, we introduce the concept of a pluripotent at-risk mental state. The clinical high at risk mental state (CHARMS) approach broadens identification of risk beyond psychosis, encompassing multiple exit syndromes such as mania, severe depression, and personality disorder. It does not diagnostically differentiate the early stages of psychopathology, but adopts a “pluripotent” approach, allowing for overlapping and heterotypic trajectories and enabling the identification of both transdiagnostic and specific risk factors. As CHARMS is developed within the framework of clinical staging, clinical utility is maximized by acknowledging the dimensional nature of clinical phenotypes, while retaining thresholds for introducing specific interventions. Preliminary data from our ongoing CHARMS cohort study (N = 114) show that 34% of young people who completed the 12-month follow-up assessment (N = 78) transitioned from Stage 1b (attenuated syndrome) to Stage 2 (full disorder). While not without limitations, this broader risk identification approach might ultimately allow reliable, transdiagnostic identification of young people in the early stages of severe mental illness, presenting further opportunities for targeted early intervention and prevention strategies.