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Virtual reality is an effective therapeutic tool in many psychiatric disorders. However, some patients are not very sensitive to these new treatments due to a difficulty in considering these virtual environments as plausible. The aim of this study is to evaluate the influence of conceptual priming on the perception of virtual environments in healthy participants. We primed participants with a pro-social, non-social or anti-social priming. The participants then had to present themselves for 2 min to an audience of avatars in a virtual amphitheater. We used the ITC-SOPI and the Presence scale to assess participants' perception of the environments. Our results suggest that there are significant differences between the three priming conditions concerning the perception scale (F.sub.(2,75) = 4.579; p = 0.013). More specifically, the pro-social condition significantly favours the positive perception of a virtual audience compared to the anti-social condition (respectively: Mean = 33.31 / SD = 8.76; Mean = 25.38 / SD = 9.26; t = 3.249; p = 0.005). This study shows that an experimental priming task can influence the perception of an environment in virtual reality. Experimental priming can become a very interesting tool for maximizing the therapeutic effects of virtual reality in patients who are not very sensitive to digital tools., Author(s): Lisa Cerda [sup.1] , Jonathan Del-Monte [sup.1] [sup.2] , Pierluigi Graziani [sup.1] [sup.2] Author Affiliations: (1) Social Psychology Laboratory, , 29, avenue Robert-Schuman, 13621, Aix-en-Provence, cedex 1, France (2) [...]

Abstract Background Individuals infected with SARS-CoV-2 vary greatly in their disease severity, ranging from asymptomatic infection to severe disease. The regulation of gene expression is an important mechanism in the host immune response and can modulate the outcome of the disease. miRNAs play important roles in post-transcriptional regulation with consequences on downstream molecular and cellular host immune response processes. The nature and magnitude of miRNA perturbations associated with blood phenotypes and intensive care unit (ICU) admission in COVID-19 are poorly understood. Results We combined multi-omics profiling—genotyping, miRNA and RNA expression, measured at the time of hospital admission soon after the onset of COVID-19 symptoms—with phenotypes from electronic health records to understand how miRNA expression contributes to variation in disease severity in a diverse cohort of 259 unvaccinated patients in Abu Dhabi, United Arab Emirates. We analyzed 62 clinical variables and expression levels of 632 miRNAs measured at admission and identified 97 miRNAs associated with 8 blood phenotypes significantly associated with later ICU admission. Integrative miRNA-mRNA cross-correlation analysis identified multiple miRNA-mRNA-blood endophenotype associations and revealed the effect of miR-143-3p on neutrophil count mediated by the expression of its target gene BCL2. We report 168 significant cis-miRNA expression quantitative trait loci, 57 of which implicate miRNAs associated with either ICU admission or a blood endophenotype. Conclusions This systems genetics study has given rise to a genomic picture of the architecture of whole blood miRNAs in unvaccinated COVID-19 patients and pinpoints post-transcriptional regulation as a potential mechanism that impacts blood traits underlying COVID-19 severity. The results also highlight the impact of host genetic regulatory control of miRNA expression in early stages of COVID-19 disease.

Abstract The objective of this study was to characterize frailty and resilience in people evaluated for Post-Acute COVID-19 Syndrome (PACS), in relation to quality of life (QoL) and Intrinsic Capacity (IC). This cross-sectional, observational, study included consecutive people previously hospitalized for severe COVID-19 pneumonia attending Modena (Italy) PACS Clinic from July 2020 to April 2021. Four frailty-resilience phenotypes were built: “fit/resilient”, “fit/non-resilient”, “frail/resilient” and “frail/non-resilient”. Frailty and resilience were defined according to frailty phenotype and Connor Davidson resilience scale (CD-RISC-25) respectively. Study outcomes were: QoL assessed by means of Symptoms Short form health survey (SF-36) and health-related quality of life (EQ-5D-5L) and IC by means of a dedicated questionnaire. Their predictors including frailty-resilience phenotypes were explored in logistic regressions. 232 patients were evaluated, median age was 58.0 years. PACS was diagnosed in 173 (74.6%) patients. Scarce resilience was documented in 114 (49.1%) and frailty in 72 (31.0%) individuals. Predictors for SF-36 score

Abstract Objectives In March 2020, France faced a health crisis due to the COVID-19 outbreak that, like previous infectious disease crises, involved high psychological and emotional stress, a series of factors that influenced the ongoing mental health crisis. Methods We recruited 384 respondents to complete an online questionnaire during the second month of isolation: 176 psychotherapy recipients (68 were currently attending psychiatric care) and 208 healthy controls. We measured demographic characteristics, impulsivity, aggression, hopelessness, suicidal risk, and the global level of anxiety and depression in order to estimate potential discrepancies in clinical measures across these populations. Results Our results indicate that the group currently undergoing psychiatric care was prone to loneliness and social isolation. Regarding clinical and nonclinical population, there were differences in suicidal risk, depression, anxiety, and hopelessness but mainly in aggression. Regression analysis also demonstrated that aggression surprisingly influenced anxiety levels. Patients undergoing therapy compared with patients who were not displayed differences only in suicidal risk, anxiety, and hopelessness, with those undergoing therapy having higher scores. The outpatient group undergoing therapy had a significantly lower level of impulsivity. Moreover, the regression to predict anxiety and depression levels from correlated factors highlighted the potentially heightened role of aggression in predicting anxiety in the clinical group. Conclusion New research into stress reactions should assess other clinical signals, such as aggression, and examine preventive mental health interventions in times of crisis.

Cushing’s syndrome due to ectopic adrenocorticotropic hormone (ACTH) secretion (EAS) by a pheochromocytoma is a challenging condition. A woman with hypertension and an anamnestic report of a ‘non-secreting’ left adrenal mass developed uncontrolled blood pressure (BP), hyperglycaemia and severe hypokalaemia. ACTH-dependent severe hypercortisolism was ascertained in the absence of Cushingoid features, and a psycho-organic syndrome developed. Brain imaging revealed a splenial lesion of the corpus callosum and a pituitary microadenoma. The adrenal mass displayed high uptake on both 18F-FDG PET/CT and 68Ga-DOTATOC PET/CT; urinary metanephrine levels were greatly increased. The combination of antihypertensive drugs, high-dose potassium infusion, insulin and steroidogenesis inhibitor normalized BP, metabolic parameters and cortisol levels; laparoscopic left adrenalectomy under intravenous hydrocortisone infusion was performed. On combined histology and immunohistochemistry, an ACTH-secreting pheochromocytoma was diagnosed. The patient's clinical condition improved and remission of both hypercortisolism and catecholamine hypersecretion ensued. Brain magnetic resonance imaging showed a reduction of the splenial lesion. Off-therapy BP and metabolic parameters remained normal. The patient was discharged on cortisone replacement therapy for post-surgical hypocortisolism. EAS due to pheochromocytoma displays multifaceted clinical features and requires prompt diagnosis and multidisciplinary management in order to overcome the related severe clinical derangements.

We present the first X-ray spectropolarimetric results for Cygnus X-1 in its soft state from a campaign of five IXPE observations conducted during 2023 May–June. Companion multiwavelength data during the campaign are likewise shown. The 2–8 keV X-rays exhibit a net polarization degree PD = 1.99% ± 0.13% (68% confidence). The polarization signal is found to increase with energy across the Imaging X-ray Polarimetry Explorer’s (IXPE) 2–8 keV bandpass. The polarized X-rays exhibit an energy-independent polarization angle of PA = −25.°7 ± 1.°8 east of north (68% confidence). This is consistent with being aligned to Cyg X-1’s au-scale compact radio jet and its parsec-scale radio lobes. In comparison to earlier hard-state observations, the soft state exhibits a factor of 2 lower polarization degree but a similar trend with energy and a similar (also energy-independent) position angle. When scaling by the natural unit of the disk temperature, we find the appearance of a consistent trend line in the polarization degree between the soft and hard states. Our favored polarimetric model indicates that Cyg X-1’s spin is likely high ( a _* ≳ 0.96). The substantial X-ray polarization in Cyg X-1's soft state is most readily explained as resulting from a large portion of X-rays emitted from the disk returning and reflecting off the disk surface, generating a high polarization degree and a polarization direction parallel to the black hole spin axis and radio jet. In IXPE’s bandpass, the polarization signal is dominated by the returning reflection emission. This constitutes polarimetric evidence for strong gravitational lensing of X-rays close to the black hole.

The Imaging X-ray Polarimetry Explorer measured with high significance the X-ray polarization of the brightest Z-source, Sco X-1, resulting in the nominal 2–8 keV energy band in a polarization degree of 1.0% ± 0.2% and a polarization angle of 8° ± 6° at a 90% confidence level. This observation was strictly simultaneous with observations performed by NICER, NuSTAR, and Insight-HXMT, which allowed for a precise characterization of its broadband spectrum from soft to hard X-rays. The source has been observed mainly in its soft state, with short periods of flaring. We also observed low-frequency quasiperiodic oscillations. From a spectropolarimetric analysis, we associate a polarization to the accretion disk at

Supernova remnants (SNRs) provide insights into cosmic-ray acceleration and magnetic field dynamics at shock fronts. Recent X-ray polarimetric measurements by the Imaging X-ray Polarimetry Explorer (IXPE) have revealed radial magnetic fields near particle acceleration sites in young SNRs, including Cassiopeia A, Tycho, and SN 1006. We present here the spatially resolved IXPE X-ray polarimetric observation of the northwestern rim of SNR RX J1713.7–3946. For the first time, our analysis shows that the magnetic field in the particle acceleration sites of this SNR is oriented tangentially with respect to the shock front. Because of the lack of precise Faraday rotation measurements in the radio band, this was not possible before. The average measured polarization degree (PD) of the synchrotron emission is 12.5% ± 3.3%, lower than the one measured by IXPE in SN 1006, comparable to the Tycho one, but notably higher than the one in Cassiopeia A. On subparsec scales, localized patches within RX J1713.7–3946 display a PD of up to 41.5% ± 9.5%. These results are compatible with a shock-compressed magnetic field. However, in order to explain the observed PD, either the presence of a radial net magnetic field upstream of the shock or partial reisotropization of the turbulence downstream by radial magnetohydrodynamical instabilities can be invoked. From comparison of PD and magnetic field distribution with γ -rays and ^12 CO data, our results provide new inputs in favor of a leptonic origin of the γ -ray emission.

How astrophysical systems translate the kinetic energy of bulk motion into the acceleration of particles to very high energies is a pressing question. SS 433 is a microquasar that emits TeV γ -rays indicating the presence of high-energy particles. A region of hard X-ray emission in the eastern lobe of SS 433 was recently identified as an acceleration site. We observed this region with the Imaging X-ray Polarimetry Explorer and measured a polarization degree in the range 38%–77%. The high polarization degree indicates the magnetic field has a well-ordered component if the X-rays are due to synchrotron emission. The polarization angle is in the range −12° to +10° (east of north), which indicates that the magnetic field is parallel to the jet. Magnetic fields parallel to the bulk flow have also been found in supernova remnants and the jets of powerful radio galaxies. This may be caused by interaction of the flow with the ambient medium.

Cir X-1 is a neutron star X-ray binary characterized by strong variations in flux during its eccentric ∼16.6 day orbit. There are also strong variations in the spectral state, and it has historically shown both atoll and Z state properties. We observed the source with the Imaging X-ray Polarimetry Explorer during two orbital segments, 6 days apart, for a total of 263 ks. We find an X-ray polarization degree in these segments of 1.6% ± 0.3% and 1.4% ± 0.3% at polarization angles of 37° ± 5° and −12° ± 7°, respectively. Thus, we observed a rotation of the polarization angle by 49° ± 8° along the orbit. Because variations of accretion flow, and then of the hardness ratio, are expected during the orbit, we also studied the polarization binned in hardness ratio and found the polarization angle differing by 67° ± 11° between the lowest and highest values of the hardness ratio. We discuss possible interpretations of this result that could indicate a possible misalignment between the symmetry axes of the accretion disk and the Comptonizing region caused by the misalignment of the neutron star’s angular momentum with respect to the orbital one.

Resumo Fundamento: As doenças crônicas não transmissíveis (DCNT), também conhecidas como doenças crônicas de longa duração, são consideradas a principal causa de morte e incapacidade em todo o mundo, e os seis pilares da medicina do estilo de vida (nutrição, exercício, controle de tóxicos, manejo do estresse, saúde do sono e conexão social) desempenham um papel importante na gestão holística da sua prevenção e tratamento. Além disso, as diretrizes médicas são os documentos mais aceitos com recomendações para o manejo das DCNT. Objetivo: O presente estudo tem como objetivo analisar a ausência de pilares de estilo de vida nas principais diretrizes médicas brasileiras sobre as DCNT e identificar evidências na literatura que possam justificar sua inclusão nos documentos. Método: As diretrizes brasileiras foram selecionadas de acordo com as causas de morte mais relevantes no Brasil, informadas pelo Sistema de Informações sobre Mortalidade publicado pelo Ministério da Saúde em 2019. Os periódicos foram selecionados na biblioteca PUBMED de acordo com a doença e os pilares do estilo de vida não mencionados. Resultados: Causas relevantes de mortes no Brasil são o infarto agudo do miocárdio (IAM), o diabetes mellitus (DM) e as doenças pulmonares obstrutivas crônicas (DPOC). Foram identificadas seis diretrizes relacionadas a essas DCNT e todas abordam aspectos do estilo de vida, mas apenas uma, referente à prevenção cardiovascular, destaca todos os seis pilares. Apesar disso, uma pesquisa bibliográfica envolvendo mais de 50 artigos mostrou que há evidências de que todos os pilares podem ajudar no controle de cada uma dessas DCNT. Conclusão: Raramente os seis pilares do estilo de vida são contemplados nas diretrizes brasileiras para IAM, DM e DPOC. A revisão da literatura identificou evidências de todos os pilares do estilo de vida para oferecer uma abordagem holística para a gestão e prevenção das DCNT.

Abstract Objective Dysfunctional cognitions related to sleep play a major role in insomnia but also in nightmares. Moreover, they are closely related to anxiety. To our knowledge, no study has probed the impact of non-constructive ruminations on these dimensions in their harmful interplay with sleep. The aim of this study is to provide new insights into the processes underlying the dysfunctional cognitions-insomnia relationship. Method Four hundred twenty nine French participants completed an anonymous online survey using Qualtrics® software. For the assessment of variables, we used the Mini Cambridge-Exeter Repetitive Thought Scale, the Nightmare Distress Questionnaire, the Beck Anxiety Inventory and the Sleep Condition Indicator. The frequency of nightmares was assessed subjectively via an item. Participants were divided into two groups according to their score on the insomnia assessment: good sleepers and poor sleepers. Result Anxiety was found to be a common mediator of the relationship between dysfunctional beliefs and attitudes toward sleep and insomnia between good (20.8%) and poor sleepers (24.6%). However, for poor sleepers, nightmare frequency (15.2%) and non-constructive ruminations (16.6%) emerged as mediators of this relationship. Conclusion The results gathered through this study bring interesting perspectives regarding the theoretical and etiological conceptualization of insomnia. We showed a positive association between dysfunctional beliefs and attitudes towards sleep and non-constructive ruminations in their contributory role to insomnia.

Colorectal cancer is preventable and treatable by screening and early detection. Fecal immunochemical tests (FIT) for average risk individuals is an effective strategy for screening. Incidence and mortality in Mexico is increasing and large-scale screening programs do not yet exist. The aim of this study was to evaluate the feasibility of FIT-based colorectal cancer screening program in Mexico City. For more than 15 months, average risk individuals in Mexico City were invited to participate at Mexico's Instituto Nacional de Cancerologia (INCan, Mexico City, Mexico). Participants received an FIT kit for stool collection, results ≥20 ng/mL were referred for high quality colonoscopy. Participants' results were classified according to the most advanced clinical finding as: adenocarcinoma, high-risk adenomas, low-risk adenomas, serrated lesions, hyperplastic polyps, and no polyps. Sequential analyses were performed to assess the positive predictive value (PPV) of FIT. A total of 810 participants were eligible, 737 (91.0%) returned the FIT and 112 (15.2%) had an abnormal result. Of these participants, 87 (77.7%) completed colonoscopy. Clinical findings of participants included: seven (8.1%) adenocarcinomas, 18 (20.7%) high-risk adenomas, 23 (26.4%) low-risk adenomas, one (1.2%) serrated lesions, 14 (16.1%) hyperplasic polyps, and 24 (27.6%) no polyps. The PPV of FIT using the ≥20 ng/mL was 8.1% for cancer and 20.7% for high-risk adenomas. In conclusion, colorectal cancer screening with FIT is feasible at INCan in Mexico City, where resources are available. Further studies are needed to determine feasibility of colorectal cancer screening in other settings, as well as optimal hemoglobin detection cut-off points to maximize the population benefits of colorectal cancer screening with FIT in Mexico.

Abstract The state of Campeche, Mexico, harbors one of the largest green turtle (Chelonia mydas) rookeries of the Wider Caribbean Region. Since the 1970s, harvesting of this population was common practice, but it has since ceased, and the population is rebounding as a consequence. In this rookery, during the past 37 years (1984–2020), the positive relationship between the annual number of nesting females and the number of hatchlings they produce has revealed a long-term population signal that we postulate could be related to environmental factors. To investigate this relationship more deeply, we adopt a stock-recruitment (SR) approach, which is commonly used in fisheries. Regression analysis methods for the SR relationship, including a dynamic version of the model that incorporates the effect of sea surface temperature, show that the number of recruits produced and the number of hatchlings per unit nester were significantly and inversely correlated with a 26-year cycle of the Atlantic Multidecadal Oscillation (AMO) with a three year lag. A possible explanation for this finding is that environmental conditions during warming periods of the 26-year AMO cycle may negatively affect hatchling production by altering the nest moisture content during the incubation period, and increasing embryonic mortality, while the annual female abundance at nesting beaches may decrease due to trophic effects. The time series of abundance corresponding to other population units of green turtles as well as other species of sea turtles in the Gulf of Mexico present a similar behavior to that evaluated here, suggesting a basin-wide environmental effect.

Abstract Background Depression is a common condition among cancer patients, across several points in the disease trajectory. Although presenting higher prevalence rates than the general population, it is often not reported or remains unnoticed. Moreover, somatic symptoms of depression are common in the oncological context and should not be dismissed as a general symptom of cancer. It becomes even more challenging to track psychological distress in the period after the treatment, where connection with the healthcare system typically becomes sporadic. The main goal of the FAITH project is to remotely identify and predict depressive symptoms in cancer survivors, based on a federated machine learning (ML) approach, towards optimization of privacy. Methods FAITH will remotely analyse depression markers, predicting their negative trends. These markers will be treated in distinct categories, namely nutrition, sleep, activity and voice, assessed in part through wearable technologies. The study will include 300 patients who have had a previous diagnosis of breast or lung cancer and will be recruited 1 to 5 years after the end of primary cancer. The study will be organized as a 12-month longitudinal prospective observational cohort study, with monthly assessments to evaluate depression symptoms and quality of life among cancer survivors. The primary endpoint is the severity of depressive symptoms as measured by the Hamilton Depression Rating Scale (Ham-D) at months 3, 6, 9 and 12. Secondary outcomes include self-reported anxiety and depression symptoms (HADS scale), and perceived quality of life (EORTC questionnaires), at baseline and monthly. Based on the predictive models gathered during the study, FAITH will also aim at further developing a conceptual federated learning framework, enabling to build machine learning models for the prediction and monitoring of depression without direct access to user’s personal data. Discussion Improvements in the objectivity of psychiatric assessment are necessary. Wearable technologies can provide potential indicators of depression and anxiety and be used for biofeedback. If the FAITH application is effective, it will provide healthcare systems with a novel and innovative method to screen depressive symptoms in oncological settings. Trial registration Trial ID: ISRCTN10423782 . Date registered: 21/03/2022.

Abstract Background The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. Methods Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. Results A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p

Resumen: Las consultas monográficas de dermatoscopia digital están dirigidas a la población con alto riesgo de melanoma. Conocer los motivos de derivación a estas consultas, así como las características epidemiológicas de los pacientes permite optimizar los recursos sanitarios, y determinar qué pacientes se benefician más de esta técnica. Se analizaron los motivos de derivación y las características epidemiológicas de 413 pacientes atendidos en una consulta monográfica de dermatoscopia en un período de 10 años, y que presentaban al menos un criterio de alto riesgo de melanoma. También se analizó el número necesario de extirpaciones (NNE) por cada melanoma diagnosticado, sus características histológicas y las variables no ambientales se asociaron con su diagnóstico. Los motivos de derivación más frecuentes fueron: antecedentes de melanoma previo (21,5%), cambios detectados por el paciente o su familia (20%), hallazgos clínicos y/o dermatoscópicos sospechosos de malignidad (19,4%) y antecedentes familiares de melanoma (17,4%). Setenta y seis de las 178 lesiones extirpadas fueron melanomas, obteniendo un NNE de 2,34. La edad avanzada fue el único factor de riesgo que se asoció de forma estadísticamente significativa con el desarrollo de melanoma. Abstract: Dedicated dermoscopy units assess individuals at high risk for melanoma. Understanding the reasons for referral to these units and the epidemiological profile of referred patients can help optimize health care resources and determine who benefits most from dermoscopic evaluation. We analyzed reasons for referral and epidemiological characteristics of 413 patients with at least 1 high-risk factor for melanoma seen at a dedicated dermoscopy unit over a period of 10 years. We also analyzed the number of necessary excisions (NNE) for each melanoma diagnosed, histologic features, and associations between nonenvironmental factors and diagnosis. The main reasons for referral were a past history of melanoma (21.5%), changes detected by the patient or a relative (20%), clinical and/or dermoscopic findings suggestive of malignancy (19.4%), and a family history of melanoma (17.4%). Seventy-six of the 178 excised lesions were melanomas (NNE per melanoma detected, 2.34). Older age was the only risk factor significantly associated with the development of melanoma.