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BackgroundThe impact of adopting a race-free estimated glomerular filtration rate (eGFR) creatinine (eGFRcr) equation on racial differences in chronic kidney disease (CKD) progression among people with human immunodeficiency virus (PWH) is unknown.MethodsWe defined eGFR stages using the original race-adjusted Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) eGFRcr equation and the new race-free CKD-EPI eGFRcr equation. We then estimated 5-year probabilities of transitioning from baseline kidney function to more advanced eGFR stages and examined the association of race (black vs white) with rates of CKD progression using Markov models.ResultsWith the race-adjusted eGFRcr equation, black participants (n = 31 298) had a lower risk of progressing from eGFR stage 1 to 2 (hazard ratio [HR], 0.77; 95% confidence interval [CI], .73-.82), an equal risk of progressing from stage 2 to 3 (1.00; .92-.07) and a 3-fold risk of progressing from stage 3 to 4 or 5 (3.06; 2.60-3.62), compared with white participants (n = 27 542). When we used the race-free eGFRcr equation, 16% of black participants were reclassified into a more severe eGFR stage at baseline. The reclassified black individuals had a higher prevalence of CKD risk factors than black PWH who were not reclassified. With the race-free eGFRcr equation, black participants had a higher risk of disease progression across all eGFR stages than white participants.ConclusionsThe original eGFRcr equation systematically masked a subgroup of black PWH who are at high-risk of CKD progression. The new race-free eGFRcr equation unmasks these individuals and may allow for earlier detection and management of CKD.

A care cascade is a critical tool for evaluating delivery of care for chronic infections across sequential stages, starting with diagnosis and ending with viral suppression. However, there have been few data describing the hepatitis B virus (HBV) care cascade among people living with HIV infection who have HBV coinfection. We conducted a cross-sectional study among people living with HIV and HBV coinfection receiving care between January 1, 2012 and December 31, 2016 within 13 United States and Canadian clinical cohorts contributing data to the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). We evaluated each of the steps in this cascade, including: 1) laboratory-confirmed HBV infection, 2) tenofovir-based or entecavir-based HBV therapy prescribed, 3) HBV DNA measured during treatment, and 4) viral suppression achieved via undetectable HBV DNA. Among 3,953 persons with laboratory-confirmed HBV (median age, 50 years; 6.5% female; 43.8% were Black; 7.1% were Hispanic), 3,592 (90.9%; 95% confidence interval, 90.0-91.8%) were prescribed tenofovir-based antiretroviral therapy or entecavir along with their antiretroviral therapy regimen, 2,281 (57.7%; 95% confidence interval, 56.2-59.2%) had HBV DNA measured while on therapy, and 1,624 (41.1%; 95% confidence interval, 39.5-42.6) achieved an undetectable HBV DNA during HBV treatment. Our study identified significant gaps in measurement of HBV DNA and suppression of HBV viremia among people living with HIV and HBV coinfection in the United States and Canada. Periodic evaluation of the HBV care cascade among persons with HIV/HBV will be critical to monitoring success in completion of each step.

BackgroundThe updated Veterans Aging Cohort Study (VACS) Index 2.0 combines general and human immunodeficiency virus (HIV)-specific biomarkers to generate a continuous score that accurately discriminates risk of mortality in diverse cohorts of persons with HIV (PWH), but a score alone is difficult to interpret. Using data from the North American AIDS Cohort Collaboration (NA-ACCORD), we translate VACS Index 2.0 scores into validated probability estimates of mortality.MethodsBecause complete mortality ascertainment is essential for accurate calibration, we restricted analyses to cohorts with mortality from the National Death Index or equivalent sources. VACS Index 2.0 components were ascertained from October 1999 to April 2018. Mortality was observed up to March 2019. Calibration curves compared predicted (estimated by fitting a gamma model to the score) to observed mortality overall and within subgroups: cohort (VACS/NA-ACCORD subset), sex, age 500 copies/mL, CD4 count

Information technology (IT) is transforming the world. Therefore, exposing students to computing at an early age is important. And, although computing is being introduced into schools, students from a low socio-economic status background still do not have such an opportunity. Furthermore, existing computing programs may need to be adjusted in accordance to the specific characteristics of these students in order to help them to achieve the learning goals. Aiming at bringing computing education to all middle and high-school students, we performed a systematic literature review, in order to analyze the content, pedagogy, technology, as well as the main findings of instructional units that teach computing in this context. First results show that these students are able to learn computing, including concepts ranging from algorithms and programming languages to artificial intelligence. Difficulties are mainly linked to the lack of infrastructure and the lack of pre-existing knowledge in using IT as well as creating computing artifacts. Solutions include centralized teaching in assistive centers as well as a stronger emphasis on unplugged strategies. However, there seems to be a lack of more research on teaching computing to students from a low socio-economic status background, unlocking their potential as well to foster their participation in an increasing IT market.

Abstract Routine sampling of pregnant women at first antenatal care (ANC) visits could make Plasmodium falciparum genomic surveillance more cost-efficient and convenient in sub-Saharan Africa. We compare the genetic structure of parasite populations sampled from 289 first ANC users and 93 children from the community in Mozambique between 2015 and 2019. Samples are amplicon sequenced targeting 165 microhaplotypes and 15 drug resistance genes. Metrics of genetic diversity and relatedness, as well as the prevalence of drug resistance markers, are consistent between the two populations. In an area targeted for elimination, intra-host genetic diversity declines in both populations (p = 0.002-0.007), while for the ANC population, population genetic diversity is also lower (p = 0.0004), and genetic relatedness between infections is higher (p = 0.002) than control areas, indicating a recent reduction in the parasite population size. These results highlight the added value of genomic surveillance at ANC clinics to inform about changes in transmission beyond epidemiological data.

Abstract Geographic atrophy is an eye disease that greatly interferes with the daily lives of patients and their families, posing a serious threat to the aging European demographic. Over the past 30 months, this initiative has assembled leading experts in the field of ophthalmology to share insights on the necessary policy steps that need to be taken to overcome this challenge on an EU-wide scale. Through analyzing best practices in Germany, Italy, France, and Spain, this consensus paper sets out a series of policy recommendations, which, if implemented, could greatly benefit all individuals affected by geographic atrophy. Amongst other features, these countries have provided valuable examples of awareness campaigns and an overall commitment to inclusive and comprehensive policies. The policy recommendations emerging from this paper include the adoption of comprehensive screening programs, retinal disease screening in the EU Driving License Directive, the development of a white paper at the European Commission, and the creation of Council recommendations on eye health screening. Given the significant improvements made at the national level throughout the EU, countries will require unitary support at the European level to further develop their policies and successfully address the burden of geographic atrophy.

Abstract Background Delirium is one of the most common adverse events in older people during hospitalization, especially in the emergency department. Reliable, easy-to-use instruments are necessary to properly manage delirium in this setting. This study aims to evaluate the diagnostic validity of the Spanish version of the 4 ‘A’s Test (4AT) in the ED. Methods A diagnostic accuracy study was conducted in patients over 65 years old admitted to the Emergency Department who did not have a formal diagnosis of dementia or a severe mental health disorder. Face and content validity were evaluated by an expert panel. Emergency nurses performed the evaluation with 4AT, whilst blinded and trained researchers assessed patients with the Revised Delirium Rating Scale as the gold standard. The content validity index, sensitivity, specificity, positive and negative predictive values, likelihood ratios, Youden’s Index and ROC curves were calculated to evaluate the diagnostic accuracy of the instrument. Results Of 393 eligible patients, 380 were finally analyzed. Content validity yielded a median content validity index of 4 (interquartile range: 0). The Spanish 4AT sensitivity (95.83%; 95% ECI: 78.9–99.9%), specificity (92.98%; 95% CI: 89.8–95.4%), positive predictive value (47.92%) and negative predictive value (99.7%) were satisfactory. Youden’s index was 0.89. Positive likelihood ratio was 13.65, and negative likelihood ratio 0.045. The area under the curve was 0.97. Conclusions The Spanish version of the 4AT for use in the Emergency Departments is easy-to-use and applicable. The validation results indicate that it is a valid instrument with sufficient predictive validity to identify patients at risk of delirium in the Emergency Departments. Moreover, it is a tool that facilitates the management of an adverse event that is associated with increased mortality and morbidity.

The coronavirus disease 2019 (COVID-19) pandemic prompted tens of thousands of people worldwide to migrate from cities in its early stages, leading to an increased spread of the virus. Understanding the factors driving relocation during a pandemic is crucial for effective outbreak control. We investigated how the pandemic influenced people’s aspirations and preparations to move, both domestically and internationally, surveying individuals in Greece, India, Italy, Kenya, Nigeria, Portugal, Serbia, Spain, and the United States of America. Out of 4448 eligible responses, 765 participants (17.2%) had a strong aspiration to move due to COVID-19, and 155 (3.5%) had already prepared. Those considering relocation were statistically significantly more likely to perceive moving to an area with fewer COVID-19 cases as protective against the virus (OR = 1.3, p < 0.05) or to know others who intended to relocate because of COVID-19 (OR = 1.5, p < 0.05). Conversely, a strong sense of being ‘at home’ reduced statistically significantly the strength of mobility aspirations (OR = 0.7, p < 0.01). Social alienation, social imitation, and the perceived efficacy of mobility increased aspirations to move due to COVID-19. This study emphasizes the rapid population movements at pandemic onset and their potential contribution to disease transmission, urging future pandemic planning to take account of such mobility dynamics.

Objectives: We tested the hypothesis that adjunctive rosiglitazone treatment would reduce levels of circulating angiopoietin-2 (Angpt-2) and improve outcomes of Mozambican children with severe malaria. Methods: A randomized, double-blind, placebo-controlled trial of rosiglitazone vs placebo as adjunctive treatment to artesunate in children with severe malaria was conducted. A 0.045 mg/kg/dose of rosiglitazone or matching placebo were administered, in addition to standard of malaria care, twice a day for 4 days. The primary endpoint was the rate of decline of Angpt-2 over 96 hours. Secondary outcomes included the longitudinal dynamics of angiopoietin-1 (Angpt-1) and the Angpt-2/Angpt-1 ratio over 96 hours, parasite clearance kinetics, clinical outcomes, and safety metrics. Results: Overall, 180 children were enrolled; 91 were assigned to rosiglitazone and 89 to placebo. Children who received rosiglitazone had a steeper rate of decline of Angpt-2 over the first 96 hours of hospitalization compared to children who received placebo; however, the trend was not significant (P = 0.28). A similar non-significant trend was observed for Angpt-1 (P = 0.65) and the Angpt-2/Angpt-1 ratio (P = 0.34). All other secondary and safety outcomes were similar between groups (P >0.05). Conclusion: Adjunctive rosiglitazone at this dosage was safe and well tolerated but did not significantly affect the longitudinal kinetics of circulating Angpt-2.

Background: Nursing students need to acquire knowledge through active methods that promote critical thinking and decision making. The purpose of this study is to analyze whether there are differences in the acquisition of knowledge by nursing students between active face-to-face or virtual teaching methods. Methods: In this comparative study, nursing students enrolled in the psychology course were divided into two groups: a face-to-face group that received active teaching methods and a virtual group. The virtual group was exposed to the Effective Learning Strategy (ELS), which included seminars based on video content through the Virtual Campus and answering questions using the H5P tool. In addition, participants engaged in reflection tasks on the content. Covariate data were collected, and knowledge tests were administered to both groups before and after the course. After three months, subjects were re-evaluated with a final exam to assess content retention. Results: A total of 280 students were randomized. No differences were found in students’ scores at the end of the knowledge test or in their final grades in the subject. Having study habits (b = 0.12, p = 0.03) and social support from relevant people (b = 0.09; p = 0.03) were associated with better post-intervention scores, and inversely with social support from friends (b = −0.12, p < 0.01). Final grades were inversely associated with digital safety literacy (b = −0.101, p = 0.01). No factors were associated with the scores of each group separately. Conclusions: The ELS virtual active learning model is as effective as face-to-face active learning methods for teaching psychology to first-year nursing students. This study was not registered.

Abstract The yeast Saccharomyces cerevisiae is widely used as a host cell for recombinant protein production due to its fast growth, cost-effective culturing, and ability to secrete large and complex proteins. However, one major drawback is the relatively low yield of produced proteins compared to other host systems. To address this issue, we developed an overlay assay to screen the yeast knockout collection and identify mutants that enhance recombinant protein production, specifically focusing on the secretion of the Trametes trogii fungal laccase enzyme. Gene ontology analysis of these mutants revealed an enrichment of processes including vacuolar targeting, vesicle trafficking, proteolysis, and glycolipid metabolism. We confirmed that a significant portion of these mutants also showed increased activity of the secreted laccase when grown in liquid culture. Notably, we found that the combination of deletions of OCA6, a tyrosine phosphatase gene, along with PMT1 or PMT2, two genes encoding ER membrane protein-O-mannosyltransferases involved in ER quality control, and SKI3, which encode for a component of the SKI complex responsible for mRNA degradation, further increased secreted laccase activity. Conversely, we also identified over 200 gene deletions that resulted in decreased secreted laccase activity, including many genes that encode for mitochondrial proteins and components of the ER-associated degradation pathway. Intriguingly, the deletion of the ER DNAJ co-chaperone gene SCJ1 led to almost no secreted laccase activity. When we expressed SCJ1 from a low-copy plasmid, laccase secretion was restored. However, overexpression of SCJ1 had a detrimental effect, indicating that precise dosing of key chaperone proteins is crucial for optimal recombinant protein expression. This study offers potential strategies for enhancing the overall yield of recombinant proteins and provides new avenues for further research in optimizing protein production systems.

Los macroútiles han sido habitualmente marginados de los estudios, debido al peso que ha tenido la industria lítica tallada para la observación de los cambios y continuidades cronológicos y culturales. Sin embargo, estos elementos aparecen en yacimientos arqueológicos asociados a diferentes contextos geográficos y cronológicos, lo cual les confiere un valor como marcadores de la adaptación y de la evolución técnica desarrollada por los grupos humanos. En este trabajo se presentan los resultados del análisis detallado de un objeto procedente del yacimiento de Hort de Cortés-Volcán del Faro (València), asociado a niveles gravetienses. La singularidad de su morfología, de la materia prima y la presencia de huellas de uso apreciables a nivel macroscópico motivaron la aplicación de diferentes metodologías de estudio sobre la pieza para su comprensión. El análisis de las huellas de uso apunta a que esta roca carbonatada fue utilizada en actividades asociadas con el tratamiento de la piel. La diferenciación de dos grupos de huellas de uso ha determinado la distinción de dos tareas desarrolladas con el objeto. La presencia de residuos que se pueden correlacionar con el uso de la pieza se ha evaluado aplicando una aproximación multianalítica y no destructiva. Además, se han aplicado técnicas de espectroscopía atómica y molecular junto con estadística multivariante, con el objetivo de identificar la potencial fuente de materia prima. El interés de este estudio reside en la combinación de aproximaciones para el estudio de un macroútil. Todo ello ha permitido ampliar la limitada información que se tiene sobre este tipo de materiales, y abrir el debate sobre el conocimiento del nivel tecnológico alcanzado por los grupos humanos.

Background: A family of less invasive glaucoma procedures has been developed to provide moderate reductions in intraocular pressure and medication burden in eyes with therapeutic needs that may not warrant the risks associated with trabeculectomy and tube shunt implantation. This study aims to compare the effectiveness and clinical outcomes of pediatric goniotomy using minimally invasive glaucoma surgery techniques to manage primary congenital glaucoma. Materials and methods: Using a computer-generated set of random numbers, the patients were randomized into three groups: Kahook blade group, microvitreoretinal blade group, and 23G needle group. Each group contained 22 eyes. All patients underwent anesthesia for intraocular pressure measurement, corneal diameter evaluation, and fundoscopy. Preoperative intraocular pressure at presentation and postoperative intraocular pressure were recorded during a one-year follow-up period. Outcome measures included decreases in corneal diameter from preoperative size, mean postoperative reduction in intraocular pressure for each minimally invasive glaucoma surgery technique and absence of intraoperative or postoperative complications. Surgical success was defined as a postoperative intraocular pressure of ≤20 mmHg without antiglaucoma medications or reoperation, based on the last recorded intraocular pressure during postoperative follow-up. Results: A total of 66 eyes were diagnosed with primary congenital glaucoma and underwent goniotomy surgeries during the study period in 2022. The majority (89%) were bilateral cases. Among the patients, there were 26 males and 9 females, which makes up an 8: 2 male-to-female ratio, with an average age range of 2 months to 2 years. After a one-year postoperative follow-up, a significant reduction in intraocular pressure was achieved of ≤18 mmHg. In terms of surgical success with minimally invasive glaucoma surgery techniques, goniotomy with a 23-gauge needle had the most postoperative intraocular pressure, followed by the microvitreoretinal blade and the Kahook blade. On average, the 23-gauge needle had a corneal diameter of 13.8 mm, while the microvitreoretinal blade was 13.9 mm and the Kahook blade recorded 14 mm. Conclusions: Goniotomy using minimally invasive glaucoma surgery techniques has been proven to be an effective surgical technique for the management of childhood glaucoma among Nigerian patients. A reduction in postoperative intraocular pressure, corneal diameter, and absence of complications provide clinical evidence of successful glaucoma management and preservation of outcomes of visual function in patients. Level of evidence: Level 1 (Prospective study)

“O Código Penal em seu artigo 65, III, c, diz que é circunstância sempre atenuante da imposição da pena, ter o agente cometido o crime sob a influência da violenta emoção, provocado por ato injusto da vítima” (Parentoni, 2014). Tal prática, no entanto, gera insatisfação por acabar culpabilizando a vítima ao sugerir que o comportamento criminoso é originado a partir de respostas por ela emitidas. Apesar de uma série de alterações na sociedade contemporânea, frequentemente crimes passionais ainda são descritos como aqueles cometidos sob “violenta emoção”, e com responsabilidades atribuídas também à vítima a partir de seu comportamento. Questionamentos sobre tal argumentação se intensificam quando o caso tem suas contingências analisadas a partir da ótica behaviorista, expressa através da ciência do comportamento. Este estudo tem como objetivo problematizar a utilização do atenuante: "violenta emoção" através da análise de crimes passionais. Para atingir o objetivo deste trabalho, a partir do levantamento de literatura, foi realizada uma busca pelos termos 'crimes passionais' e 'violenta emoção' em noticiários online. Foi eleito o caso: 'Eloá Cristina' como agente catalisador, capaz de fomentar uma discussão sobre a concessão do atenuante 'violenta emoção'. O caso: 'Eloá Cristina' se refere ao mais longo sequestro passional registrado pela polícia do Estado de São Paulo que adquiriu grande repercussão nacional e internacional ao ter sua ocorrência e consequente desdobramento transmitido ao vivo por redes televisivas do Brasil e do Mundo. Inconformado com o fim do namoro de três anos, Lindemberg Fernandes Alves rendeu Eloá e outras três pessoas (Folha Online, 2008). A temática jurídica que tange aos crimes passionais rotineiramente revive um termo bastante conhecido pelos defensores, o atenuante: 'violenta emoção' e propositalmente, tal termo foi revivido pela advogada, Ana Lúcia Assad, que exercendo seu papel de defensora, buscou demonstrar que seu cliente foi uma vítima do ambiente, que o homicídio ali cometido não foi premeditado e nem culpa de Lindemberg e que talvez até pudesse haver culpado, mas este não era o seu cliente. Os culpados seriam a imprensa e a própria Eloá, vítima do crime. Ao afirmar sua defesa, Assad permite à ciência do comportamento invalidar a atual utilização do atenuante: 'violenta emoção'. Acontece que tal termo, quando utilizado no referido contexto, carrega consigo, todo um complexo de passividade há muito desmentido pela ciência do comportamento. Enquanto sujeitos, não podemos acatar que apenas respondemos a estímulos provenientes do meio, como se fossemos uma espécie de autômato. Enquanto humanos precisamos nos sujeitar e aceitar nossa posição ativa gerada e mantida por consequências de nossas próprias ações no meio. Logo designar que a origem de um crime passional está na vítima, não passa de uma defesa risível. Entretanto, o que encontramos no atual cenário judiciário é uma falta de padronização dentro dos tribunais do Júri. Quando ocorre um julgamento, Juiz e Júri estão abertos a uma livre interpretação de cada caso e podem ser ludibriados. A veracidade do caso é velada pela melhor performance teatral, seja ela da defesa ou da acusação e tal jogo artístico unido ao despreparo científico dos membros dos tribunais do Júri pode acarretar numa falta de rigor na aplicabilidade de atenuantes, como o: 'violenta emoção'. A ciência do comportamento possibilita uma análise objetiva do fenômeno ocorrido e sua junção com o Direito pode propiciar uma grande contribuição no julgamento de crimes, que ao menos por enquanto, repousam sobre a total responsabilidade de mãos sem padrão de condenação do agente criminoso. Entretanto, tal contribuição exige uma conversa entre os saberes. Exige transdisciplinaridade

A violência é nítida na sociedade atual e há uma infinita diversidade de motivos que a caracterizam, assim como suas manifestações podem ocorrer também de diferentes formas. Uma das maneiras pelas quais essa violência vem sendo sistematicamente estudada na contemporaneidade é aquela que se manifesta na forma dos chamados crimes passionais – aqueles cometidos contra o objeto de amor a partir de uma situação de abandono ou rejeição. Objetivos: Investigar e discutir as características que levam alguns indivíduos a atacarem e até mesmo, assassinarem seu objeto de amor, seja de forma direta ou indireta. Metodologia: Levantamento de literatura. Resultados: No passado, crimes passionais eram considerados como aqueles crimes que ocorriam supostamente em defesa da honra, o que rendia ao agressor uma pena mais branda, além de argumentações no sentido de que tal comportamento poderia ser justificado por forte emoção. Após uma série de mudanças na sociedade e também na legislação civil e penal, tal justificativa não é mais aceita. Quando se trata de um ato criminoso, pensa-se de duas formas, não sendo diferente disso no que se refere aos crimes passionais: como um ato de impulso, que ocorre quando não há o controle da violência, permitindo assim que a paixão se sobreponha à razão e a pessoa perca, naquele momento, a capacidade de controlar seus atos. Porém, existe ainda o criminoso passional que planeja o ato previamente, contra a vítima ou pessoa próxima, de forma detalhada e, em muitos casos, extremamente fria. O crime passional geralmente ocorre quando a pessoa se sente ferida pela conduta de seu parceiro e sente a necessidade de reagir a essa situação. É importante destacar que não necessariamente ocorre uma situação de rejeição, mas ao imaginar a possibilidade de abandono, o criminoso passa a desenvolver pensamentos disfuncionais que tem como principal característica confirmar sua crença. A ideia de atingir e ferir o suposto objeto de amor começa a tomar características próprias, com o desejo de ferir este indivíduo da mesma forma que se está sofrendo. Essa reação nem sempre atinge o parceiro diretamente, mas pode atingir alguém que seja extremamente importante para a vítima, fato que teria força suficiente para causar imenso sofrimento. Essas duas características podem ser observadas em dois eventos: o conhecido caso da “Fera da Penha” e o recente caso da manicure de Barra do Piraí. Ambos são casos de crimes planejados sistematicamente que tiveram por principal objetivo atingir seu objeto de suposto amor através da agressão a quem lhe é mais caro – os filhos. É notório, em ambos os casos, a premeditação dos crimes e os atos de barbárie em nome do que os criminosos tinham como idealização de amor, porém, também houve a garantia de que a dor sentida fosse a do luto, causando assim o mesmo sentimento de perda vivenciado pelo autor do crime. Conclusões: O crime passional apresenta aspectos próprios e seu intento é sempre causar dor e profundo sofrimento no objeto de amor, seja sob a forma do assassinato e/ou tortura do mesmo, ou de alguém ou algo de extrema importância na vida do indivíduo, fato que, por si só, possui força suficiente para gerar infinita dor. Tal ato pode ser cometido impulsivamente, porém a literatura vem sistematicamente apontando para crimes que são planejados e executados com requintes de crueldade.

Previous research suggests that exposure to accent variability can affect toddlers' familiar word recognition and word comprehension. The current preregistered study addressed the gap in knowledge on early language development in infants exposed to two dialects from birth and assessed the role of dialect similarity in infants' word recognition and comprehension. A 12-month-old Norwegian-learning infants, exposed to native Norwegian parents speaking the same or two Norwegian dialects, took part in two eye-tracking tasks, assessing familiar word form recognition and word comprehension. Their parents' speech was assessed for similarity by native Norwegian speakers. First, in contrast to previous research, our results revealed no listening preference for words over nonwords in both monodialectal and bidialectal infants, suggesting potential language-specific differences in the onset of word recognition. Second, the results showed evidence for word comprehension in monodialectal infants, but not in bidialectal infants, suggesting that exposure to dialectal variability impacts early word acquisition. Third, perceptual similarity between parental dialects tendentially facilitated bidialectal infants' word recognition and comprehension. Forth, the results revealed a strong correlation between the raters and parents' assessment of similarity between dialects, indicating that parental estimations can be reliably used to assess infants' speech variability at home. Finally, our results revealed a strong relationship between word recognition and comprehension in monodialectal infants and the absence of such a relationship in bidialectal infants, suggesting that either these two skills do not necessarily align in infants exposed to more variable input, or that the alignment might occur at a later stage.

Abstract Ancient lakes are hotspots of species diversity, posing challenges and opportunities for exploration of the dynamics of endemic diversification. Lake Baikal in Siberia, the oldest lake in the world, hosts a particularly rich crustacean fauna, including the largest known species flock of harpacticoid copepods with some 70 species. Here, we focused on exploring the diversity and evolution within a single nominal species, Harpacticella inopinata Sars, 1908, using molecular markers (mitochondrial COI, nuclear ITS1 and 28S rRNA) and a set of qualitative and quantitative morphological traits. Five major mitochondrial lineages were recognized, with model‐corrected COI distances of 0.20–0.37. A concordant pattern was seen in the nuclear data set, and qualitative morphological traits also distinguish a part of the lineages. All this suggests the presence of several hitherto unrecognized cryptic taxa within the baikalian H. inopinata, with long independent histories. The abundances, distributions and inferred demographic histories were different among taxa. Two taxa, H. inopinata CE and H. inopinata CW, were widespread on the eastern and western coasts, respectively, and were largely allopatric. Patterns in mitochondrial variation, that is, shallow star‐like haplotype networks, suggest these taxa have spread through the lake relatively recently. Three other taxa, H. inopinata RE, RW and RW2, instead were rare and had more localized distributions on either coast, but showed deeper intraspecies genealogies, suggesting older regional presence. The rare taxa were often found in sympatry with the others and occasionally introgressed by mtDNA from the common ones. The mitochondrial divergence between and within the H. inopinata lineages is still unexpectedly deep, suggesting an unusually high molecular rate. The recognition of true systematic diversity in the evaluation and management of ecosystems is important in hotspots, as it is everywhere else, while the translation of the diversity into a formal taxonomy remains a challenge.

Tropical savannas are complex landscapes composed of mainly grasses and a matrix of proportions of discontinuous tree cover. They play an essential role in providing multiple ecosystem services including biodiversity, carbon storage, and socio-economic and cultural values. However, knowledge of sustainable land management practices is still the main challenge, especially to incorporate conservation practices and well-planned fire management. Indonesia is a tropical country with a relatively large area of savannas in the eastern part of the country, in the province of East Nusa Tenggara, with the largest savannas lying in the east of Sumba Island. This study explored the level of knowledge, behaviours, and actions in managing savannas in the east of Sumba Island. The study involved key informant interviews and household surveys among the local population in four villages of Kanatang and Kota Waingapu districts. The communities generally utilized the savanna ecosystems for crop cultivation, plantation farming, and livestock production. This utilization poses a great challenge to explore proper strategies for managing the savanna landscapes sustainably and for conservation. The demands on the land are due to land clearing for farming and livestock, low awareness of conservation practices, and regular drought. Learning from this research, management strategies to sustain savanna ecosystems should focus on: 1) improving knowledge and behaviour on sustainable farming and grazing practices, 2) establishing proper fire management systems to sustain the savanna ecosystem functions and services, 3) designing policies or regulations for managing savanna ecosystems, 4) enhancing networks and coordination for collective community actions.

Introduction Psychic trauma profoundly affects a person’s confidence in himself and others. There is a sudden experience of helplessness, loss of control, fear for one’s own life, and the humiliation of having been violated. The victim may run out of internal and external reference elements. Objectives Describe the factors that influence the development of Post-traumatic stress disorder after experiencing traumatic experiences. Methods Review in the literature of the different factors that influence the subject’s response to the traumatic experience. Results 1) Predisposing and precipitating factors: – characteristics of the traumatic evento: severity of the stressor agent: dose-dependent, Characteristics of the same: sudden, prolonged, repetitive, intentional; decrease the ability to control the situation and develop effective coping strategies; they question basic cognitive schemas; the symbolic meaning of the traumatic evento. – characteristics of the person (predisposing factors of vulnerability): genetic-constitutional vulnerability, adverse experiences in childhood, previous traumatic events: increased vulnerability, personality characteristics, recent stressors or life changes, inadequate support system, use of alcohol, perception locus control more external than internal, pre-existing psychiatric symptoms: neuroticism, anxiety, depression, critical ages of development: time of greatest vulnerability (11-16 years). 2) Perpetuating and empowering factors: sharing traumatic events, seeking the logic of the facts, rupture of affective ties. 3) Elements of Resistance: tendency to selectively remember the positive elements in autobiographical memory, acceptance of a certain dose of uncertainty in life, perceiving themselves as survivors, perception of the stressful stimulus as less threatening, Less physiological reactivity to stress, use of humor, positive emotions counteracting during the traumatic process. 4) Elements of Resilience: ability to extract and assimilate positive elements from negative situations. Conclusions Trauma threatens 3 basic assumptions of life: the world is good, the world has meaning, the self has value. The knowledge of these mentioned factors allow a better psychotherapeutic approach to Psychic Trauma. Disclosure of Interest None Declared

Introduction Negative symptoms are present in more than two thirds of schizophrenic patients throughout the evolution of the disorder. These include symptoms related to reduced motivation or pleasure, such as avolition, anhedonia and asociality, and reduced expressivity, including alogia and blunted affect. We present the case of a 24-year-old man who was admitted to our Psychosis Day Hospital after several psychotic episodes, presenting with prominent negative symptomatology that was imbued with mystical delusional beliefs. Objectives 1) To describe the clinical particularities of this case, focusing on the improvement of negative symptoms during the course of treatment at our Day Hospital. 2) To review the available evidence regarding the pharmacological and psychotherapeutic management of negative symptoms of schizophrenia. Methods A review of the patient’s clinical history and complementary tests were carried out. Likewise, we reviewed the available literature in relation to the management of negative symptoms of schizophrenia in an ambulatory setting. Results The patient was admitted to our Day Hospital after four psychiatric hospitalizations due to mystical delusions, ideas of grandiosity and hyper-spirituality, along with prominent negative symptoms at the moment of inclusion at our centre, including social withdrawal, diminished affective response, lack of interest in the academic sphere and poor social drive. Although previous positive symptoms were present in a lesser degree, the patient interpreted the presence of the negative symptoms described above as a “punishment” or “test” from spiritual creatures. Management of negative symptoms represents a major unmet need in schizophrenia. Modest effect size evidence for pharmacological approaches favours the use of antipsychotic in monotherapy and augmentation of antipsychotic treatment with other agents, such as antidepressants. Scarce evidence regarding psychotherapeutic approaches to these symptoms points to the use of cognitive behaviour therapy and social skills training. Conclusions - Clinical identification and characterization of negative symptoms is crucial when treating patients with schizophrenia, as these are associated with important disability and poorer functional outcomes. - Differentiation of primary and secondary negative symptoms is a key aspect in the evaluation and management of schizophrenic patients. - This case outlines the coexistence of positive and negative symptoms, and illustrates the challenges in the pharmacological and psychotherapeutic management of these symptoms at a Psychosis Day Hospital. Disclosure of Interest None Declared

Introduction The spectrum of neuropsychiatric adverse effects of corticosteroids ranges from unspecific symptoms to structured psychotic or affective episodes. We present the case of a 30-year-old woman admitted to our hospital due to behavioral alterations, coinciding with the initiation of treatment with corticosteroid boluses as part of a chemotherapy regimen for gastric adenocarcinoma. She had a previous diagnose of Addison’s disease, undergoing treatment with supplemental corticosteroids. Objectives 1) To describe the clinical particularities of this case, focusing on the psychopathological aspects and their correlation with the corticoid treatment. 2) To review the available literature regarding the clinical characteristics and management of corticosteroid-induced psychosis, with special interest in patients with adrenal insufficiency that require long term steroid supplementation. Methods A review of the patient’s clinical history and complementary tests were carried out. Likewise, we reviewed the available literature in relation to the clinical presentation of corticosteroid-induced psychosis and its pharmacological management. Results The patient was admitted to our hospital due to acute behavioural alterations, which temporally coincided with the 4th cycle of FOLFOX chemotherapy and corticosteroid boluses. She presented with incoherent speech, with non sequitur answers and glossolalia, as well as dysphoric affect and purposeless behavior. She presented a favorable clinical course after the initiation of treatment with antipsychotics and temporary suspension of corticosteroid treatment. Manic symptoms are the most common presentation of “corticosteroid-induced psychosis”, with the key characteristic being the temporal association with the corticosteroids administration. Although the discontinuation of steroids generally results in a sudden decrease in symptoms, additional treatment with antipsychotics such as haloperidol or olanzapine might be required for a symptomatic control. In patients with adrenal insufficiency, long-term treatment with lithium or anti-seizure treatments are effective strategies in relapse prevention when a higer steroid dose is required. Conclusions - Corticosteroid-induced psychosis is a well described clinical phenomenon, that usually presents with manic symptoms rather than psychotic experiences. - Progressive discontinuation of corticosteroid treatment usually results in complete cessation of symptoms, but additional psychopharmacological treatment might be required, especially in patients with adrenal insufficiency undergoing long-term corticosteroid treatment. - This case outlines the psychopathological richness in the presentation of corticosteroid-induced psychosis, and illustrates the challenges in the pharmacological management in patients with adrenal insufficiency. Disclosure of Interest None Declared

Introduction The relationship between Borderline Personality Disorder and Attention Deficit Hyperactivity Disorder has been highlighted in different studies over the last few years, with an estimated prevalence of around 15-35% of ADHD in adult patients diagnosed with BPD and a 7.4 times higher risk of developing BPD in patients diagnosed with ADHD. Objectives To conduct a pragmatic review of the recent literature on the relationship between ADHD and BPD, so that it serves as a starting point for an in-depth study of the sociodemographic, clinical and cross-sectional dimensional factors of both disorders. Methods A bibliographic review of scientific articles published in recent years, in English and Spanish, extracted from the MEDLINE database, which delve into the relationship between BPD and ADHD, will be carried out. In addition, the common psychopathological dimensions, such as impulsivity or emotional dysregulation, as well as the weight of other dimensional factors related to both disorders, will be studied. Results The results of the selected articles will be grouped, for a better understanding, in the following sections: - Clinical factors and shared comorbidities. - Psychopathological dimensions: impulsivity and emotional dysregulation. - Other common dimensional factors. Conclusions There are common symptoms and etiological or perpetuating factors, as well as comorbidities shared in both conditions, which in many cases make the correct diagnosis and, therefore, the appropriate therapeutic approach to these patients, quite difficult. Taking into account the differential characteristics of BPD and ADHD, it is possible to create different profiles that allow a precise approach to both disorders in those cases in which they coexist in the same patient. Disclosure of Interest None Declared