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Objectives/Goals: Pregnancy increases vulnerability to stress and mental health symptoms, particularly among Hispanic women in Puerto Rico (PR), a population with unique socioenvironmental adversities, such as poverty and natural disasters. This study examined the relationships between life adversities and psychological distress in this at-risk population. Methods/Study Population: Participants (n = 50) in this cross-sectional study were recruited from an obstetrician’s office in Southern PR. All participants provided written consent and completed the Adverse Life Experiences Scale (ALES, Cronbach’s alpha = 0.71) to identify lifelong adversities faced and the overall duration (chronicity). Measures of psychological distress included the Perinatal Anxiety Screening Scale (PASS, Cronbach’s alpha = 0.96), the Edinburg Postnatal Depression Scale (EDPS, Cronbach’s alpha = 0.87), the Perceived Stress Scale (PSS, Cronbach’s alpha = 0.79), and the Brief Resilience Scale (BRS, Cronbach’s alpha = 0.86). Descriptive and Spearman’s rho correlation analyses were conducted. Results/Anticipated Results: The mean age of the participants was 27.90 years (SD = 6.05), with most in the first trimester (66.0%). On average, participants reported 4.32 (SD = 3.1) out of 23 lifetime adversities. The most common adversities were natural disasters (60.0%), loss of a beloved (58.0%), and financial difficulties (38.0%). Nearly half (44.0%) experienced five or more adversities. A significant number of participants met the clinical threshold for anxiety (38.0%, PASS), depression risk (22.0%, EPDS), moderate-to-severe perceived stress (52.0%, PSS), and low resilience (24.0%, BRS). The overall duration of adversities was significantly associated with anxiety (rs = 0.50, p = 0.001) and stress (rs = 0.50, p = 0.007). Discussion/Significance of Impact: Hispanic pregnant women in PR face high levels of adversity and distress, which can negatively affect both maternal health and fetal development, influencing long-term child outcomes. Early identification and targeted interventions addressing adversities, can improve maternal mental health and child health-development outcomes.
Objectives/Goals: A limited number of Hispanic researchers compete successfully for NIH career development and research grants. We adapted an established K Club model from the University of Pittsburgh with high success rates to Hispanics in Puerto Rico (PR). The K to R Club’s goal is to increase the successful submission of K- and R-type NIH grants in the HCTRECD Program. Methods/Study Population: K to R Club is an inviting environment that exposes scholars to established funded investigators in PR from all career stages. It creates a forum to discuss different grant mechanisms and explains the selection, submission, and review process. The Club promotes the right mentor selection and mentoring team. It facilitates networking with principal investigators local/external to share their success stories, career development experiences, and grant submission tips. It offers mock review sessions of sections of the grant proposal to provide feedback from invited established investigators during the grant writing process. The Club meets 1–2 times per month in-person or virtual for 1 hour and anonymous evaluations were submitted after each session. Results/Anticipated Results: K to R Club 1st year had 11 sessions with 15 invited speakers. Sessions included: 1 Kickoff, 2 funding opportunities, 2 coaching, 7 successful stories of Diversity Supplement, and F99/K00, K22, K23, K99/R00, R01, and R21 awardees. The highest attendance was for the Kickoff (48). Evaluations response rates ranged from 15 to 62 with the highest participation from women (78% vs. 22% men). Most respondents were PhD (45%) and MD (29%). K to R Club sessions were rated as excellent (84%), 74% agreed that the sessions changed their knowledge very much, and 78% reported it changed their ability to apply for funding very much. Interest in submitting NIH supplements in 12 months was higher (68%) vs. 6 months (48%). Interest in requesting mock reviews for K or R grants in 6 months (91%) vs. 12 months (17%). Discussion/Significance of Impact: The 1st year of the K to R Club had an active attendance and increased the interest in submission of NIH grants. We are working on strategies to increase evaluations’ response rates to improve and address future session needs due to the low response rates recorded. Currently, the semester is full of mock review sessions for grant applications (4 Ks and 1 R01).
Steringotrema microacetabularis Suriano & Martorelli, 1983 (Fellodistomidae) was described from the flounder Paralichthys orbignyanus. Later, it was redescribed, based on new material from the same host and type locality, and reconsidered as Bacciger microacetabularis (Baccigeridae). The main difference noted in the redescription was the presence of spines on the body. However, the lack of DNA data made confirming the true affiliation of this digenean challenging. New specimens sampled from P. orbignyanus allowed us to sequence the 28S, ITS, and COI genes. Fresh specimens were stained to compare their morphology with the holotype and voucher specimens. The digeneans found correspond with those reported from Mar Chiquita, described as B. microacetabularis (=S. microacetabularis). Genetic analyses clustered the newly sequenced individuals within the Cryptogonimidae, showing relationships with Oligogonotylus manteri, Tabascotrema verai, and Caecincola parvulus (28S); T. verai, Lobosorchis spp., Euryakaina manilensis, and Metadena marina (ITS); and Siphoderina spp. (COI). After comparing the species with cryptogonimids lacking spines in the oral sucker, a new genus, Surianotrema n. gen., is described. This genus increases the number of cryptogonimid genera known in South America to seven – three in freshwater and four in marine environments – with Surianotrema n. gen. being the first to be sequenced. New sequences from other South American cryptogonimids are necessary to better understand the phylogenetic relationships between genera within this family, particularly in South America.
To develop and evaluate the validity and reliability of the Street Food and Beverage Tool (SFBT).
Design:
This methodological study contains two phases: (a) tool development, which involves conducting a systematic review followed by expert evaluation of the items, the creation of a nutritional healthfulness index (NH), and pilot testing; and (b) evaluation of the Tool’s Validity and Reliability. Content validity was judged by an external technical group, which evaluated the adequacy and pertinence of each tool item. Construct validity was evaluated around schools by testing the hypothesis: In high-income areas, there will be greater availability of healthy food and beverages at street food outlets (SFO), as measured by the NH index. Inter-rater and test–retest reliabilities were assessed outside subway stations. Pearson’s correlation, Cohen’s kappa and Content validity Indexes were used for reliability and validation. A multinomial regression model was used to estimate construct validity.
Setting:
Mexico City, Mexico.
Participants:
80 SFO at subway station exits and 1066 around schools from diverse income areas.
Results:
The SFBT content validity index was satisfactory. The construct validity of the NH index indicated higher values in higher-Social Development Index areas. The NH index showed a positive linear correlation between raters and across the first and second evaluations. The majority of item availability (>60 %) showed moderate to strong kappa values for inter-rater and test–retest reliability.
Conclusions:
The SFBT is a reliable and valid tool for assessing the availability of foods and beverages. Compared to other tools, it can measure the nutritional quality of SFO expressed as an NH index.
Latinx populations are underrepresented in clinical research. Asking Latinx research participants about their research experiences, barriers, and facilitators could help to improve research participation for these populations.
Methods:
The Salud Estres y Resilencia (SER) Hispano cohort study is a longitudinal cohort study of young adult Latinx immigrants whose design and conduct were tailored for their study population. We administered the Research Participant Perception Survey (RPPS) to SER Hispano participants to assess their experiences in the study. We describe overall results from the RPPS and compare results of surveys administered to SER Hispano participants via email versus telephone.
Results:
Of 340 participants who were contacted with the RPPS, 142 (42%) responded. Among respondents, 53 (37%) responded by initial email contact; and 89 (63%) responded by subsequent phone contact. The majority of respondents were between 35 and 44 years of age (54%), female (76%), and of Cuban origin (50%). Overall, research participants expressed high satisfaction with their research experience; 84% stated that they would “definitely” recommend research participation to friends and family, with no significant difference by method of survey administration (P = 0.45). The most common factor that was chosen that would influence future research participation was having summary results of the research shared with them (72%).
Conclusion:
We found that culturally tailored studies can be good experiences for Latinx research participants; and we found that use of the RPPS can be administered successfully, particularly when administered by more than one method, including telephone, to evaluate and to improve research experiences for this population.
Members of the genus Maritrema Nicoll, 1907 include endoparasites of aquatic birds and mammals, distributed worldwide. Adult specimens were collected from the intestines of three bird species (the great black hawks, Buteogallus urubitinga Gmelin; laughing gull, Leucophaeus atricilla Linnaeus; and the willet, Tringa semipalmata Gmelin) in three localities along the Gulf of Mexico. Photogenophores were sequenced for the large subunit (LSU) from nuclear rDNA, and the new sequences were aligned with other microphalloid sequences available in GenBank. The maximum likelihood and Bayesian inference analyses revealed three independent lineages, one corresponding to a previously described species, Maritrema corai Hernández-Orts, Pinacho-Pinacho, García-Varela & Kostadinova, 2016, and two representing two undescribed species. These two new species are described in the current study. Maritrema itzamnai n. sp. can be morphologically differentiated from its four congeneric species occurring in coastal areas of Mexico by having smaller oral (20–29 × 20–38 μm) and ventral (20–39 × 19–33 μm) suckers. In addition, Maritrema itzamnai n. sp. possess annular vitellarium instead of a horseshoe-shaped vitellarium. Maritrema kukulkanni n. sp. can be distinguished from its congeneric species reported from Mexico by possessing a larger oesophagus (44–117μm) and by having a vitellarium distributed in both the hindbody and forebody. Maritrema corai is the third species recorded in this study parasitizing the great black hawk (Buteogallus urubitinga); this represents a new host and locality record, expanding its distribution range from the Mexican Pacific Ocean to the Gulf of Mexico.
Migrants and refugees face elevated risks for mental health problems but have limited access to services. This study compared two strategies for training and supervising nonspecialists to deliver a scalable psychological intervention, Group Problem Management Plus (gPM+), in northern Colombia. Adult women who reported elevated psychological distress and functional impairment were randomized to receive gPM+ delivered by nonspecialists who received training and supervision by: 1) a psychologist (specialized technical support); or 2) a nonspecialist who had been trained as a trainer/supervisor (nonspecialized technical support). We examined effectiveness and implementation outcomes using a mixed-methods approach. Thirteen nonspecialists were trained as gPM+ facilitators and three were trained-as-trainers. We enrolled 128 women to participate in gPM+ across the two conditions. Intervention attendance was higher in the specialized technical support condition. The nonspecialized technical support condition demonstrated higher fidelity to gPM+ and lower cost of implementation. Other indicators of effectiveness, adoption and implementation were comparable between the two implementation strategies. These results suggest it is feasible to implement mental health interventions, like gPM+, using lower-resource, community-embedded task sharing models, while maintaining safety and fidelity. Further evidence from fully powered trials is needed to make definitive conclusions about the relative cost of these implementation strategies.
Staphylococcus aureus nasal carriers were randomized (1:1) to XF-73 or placebo nasal gel, administered 5x over ∼24hrs pre-cardiac surgery. S. aureus burden rapidly decreased after 2 doses (–2.2log10 CFU/mL; placebo –0.01log10 CFU/mL) and was maintained to 6 days post-surgery. Among XF-73 patients, 46.5% received post-operative anti-staphylococcal antibiotics versus 70% in placebo (P = 0.045).
Empathy is an essential skill in the doctor-patient relationship since it contributes to improve aspects of health care and patient satisfaction. Nevertheless, burnout research projects have been developed in recent years.
Objectives
To examine the predictive capacity that empathy has on burnout syndrome in health professionals.
Methods
A non-experimental, cross-sectional design was proposed. The type of study was correlational-descriptive since it was sought out to explore a functional relation through the prognosis of a criterion variable. Sample: 200 (100 female and 100 male).
Results
First, the variance of cognitive and Affective Empathy was dug out in the emotional exhaustation criterion scale. Results accounted for 15% of variability in emotional exhaustation. (Corrected R 2 = .15, F = 17,56, p = 0,00). The best predictor of emotional exhaustation refers to Cognitive Empathy. (B = -.27, p = 0.00). It does not seem that Affective Empathy acts as a predictor variable of Emotional Exhaustation. (Table 1).Table 1
Multiple linear regression analysis considering Emotional Exhaustation as a criterion.
TECA
Corrected R2
F
B
p
Cognitive Empathy
.15
17,5
-.27**
0,00
Affective Empathy
-.14
.13
The predictive capacity of Empathy in relation to Depersonalization was estimated (Corrected R 2 = .20, F = 25,4, p = 0.00). Cognitive and affective empathy were included as predictor variables and MBI as a criterion variable (Table 2). On one hand, the best predictor of Depersonalization is the Cognitive Empathy. On the other hand, regarding Affective Empathy, it does not act as a predictor of Depersonalization.Table 2
Multiple linear regression analysis considering Depersonalization as a criterion.
TECA
Corrected R2
F
B
p
Cognitive Empathy
.20
25,4
-.32**
0,00
Affective Empathy
-.15
.84
Lastly, the predictive capacity of Empathy in relation to Personal Achievement was figured out. (Corrected R 2 = .19, F = 23,4, p = 0.00). Cognitive Empathy is the best predictor for Personal Fulfillment (Table 3).Table 3
Multiple linear regression analysis considering Personal Fullfilment as a criterion.
TECA
Corrected R2
F
β
p
Cognitive Empathy
.20
25,4
.43**
0,00
Affective Empathy
.00
.96
Conclusions
It was noticed that through a linear multiple regression analysis, the variable that best explains Emotional Exhaustation is Cognitive Empathy. Those results are replicated for Depersonalization and Personal Fullfilment.
Short-chain fatty acids (SCFA) are bacterial metabolites that, within microbiome-gut-brain axis, make a promising research line on etiopathology of mental diseases like schizophrenia (SZ) and major depression disorder. Besides, depressive symptoms are frequent clinical features of SZ.
Objectives
- Describe fecal SCFA concentrations in SZ patients.
Cross-sectional study of 67 outpatients [mean age=43.52±12.42, range=22-67; males=40 (59.7%)] with diagnosis (DSM-5) of SZ recruited from their mental health clinics in Oviedo (Spain).
- Chlorpromazine equivalent doses (CPZ-ED), use of antidepressants.
- MetS (ATP-III), body mass index (BMI; kg/cm2).
- Statistics: Spearman correlation, U Mann-Whitney, ANCOVA.
Results
14 patients showed clinical depression (CDS≥5). There were no differences in age or sex between groups. 36 patients (53.7%) showed systemic low-grade inflammation (CPR≥0.3mg/dL) and 32 (30.8%) MetS.Table 1 shows fecal SCFA levels by depressive state. Means (SD) are ahown.Table 1
CDS≤4
CDS≥5
Total
U Mann-Whitney(p-value)
Acetate
21.449(12.823)
12.911(7.189)
19.665(12.328)
221.000(0.021)
Propanoate
9.170(6.819)
6.848(6.036)
8.685(6.687)
268.500(0.114)
Butyrate
8.529(6.436)
7.875(8.232)
8.392(6.787)
320.000(0.432)
Total SCFA
39.148(23.770)
31.415(24.526)
36.742(23.549)
250.000(0.062)
Correlations were found in Age with Butyrate (r=-0.248,p=0.043) and weekly alcohol units with Propanoate (r=0.250,p=0.041) plus trend to significance with Butyrate (r=0.232,p=0.059). It also showed a trend towards statistical relation for CPZ-ED with Propanoate (r=-0.253,p=0.039) and Total SCFA (r=-0.253,p=0.039). We found no correlation in SCFA with MetS, CGI, PANSS-N, BMI, IPAQ, MEDAS and other toxic habits.
ANCOVA was performed to Acetate and Total SCFA using depression state as independent variable and Age and CPZ-ED as covariates. There was a trend towards statistical significance for Acetate (F=3.937,p=0.052,η2=0.059) whereas Total SCFA showed no difference (F=1.350,p=2.250,η2=0.021).
Conclusions
There seems to be lower levels of fecal Acetate in SZ patients with depressive symptoms, considering age and antipsychotic intake. In our sample there was no relation between SFCA and clinical severity, lifestyle, comorbidities or antidepressant use.
Cannabinoid hyperemesis syndrome (CHS) is an underrecognized condition characterized by acute episodes of intractable nausea and vomiting, colic abdominal pain and restlessness related to chronic cannabis use. Antiemetics commonly fail to alleviate the severe nausea and vomiting. A very particular finding is the symptomatic relief with hot water. Antipsychotics (such as haloperidol), benzodiazepines and/or capsaicin cream appear to be the most efficacious in the treatment of this unique disorder. Precisely, it has been studied that transient relief of symptoms with topic capsaicin or hot water share the same pathophysiology. Nevertheless, abstinence from cannabis remains the most effective way of mitigating morbidity associated with CHS.
Objectives
The objective is to study this phenomenom in our hospital and to alert of its existence in order to avoid a suspected misdiagnosis and overdiagnosis.
Methods
We report a case series of seven patients who attended the Emergency Room (ER) of a third level hospital located in Cantabria (Spain) where a psychiatric evaluation was demanded.
Results
The reasons for consultation were agitation and/or compulsive vomit provocation and showers. They were all women, with a median age of 29 years (range 21 to 38), who all smoked cannabis and in probable high doses (seven to up to twenty joints per day, information was missing in three of the patients) and probable long duration of consumption (more than nine years up to twenty-three, information was missing in three of the patients).
One of the most striking findings is the time to diagnosis, being the median of years of more than eight (range from two to twenty-one). In all of the cases there is a hyperfrequentation to the ER for this reason (not counting other emergency centres we have in Cantabria which we don´t have access to), being the average of almost twenty-two times (thirteen up to thirty times), not diagnosing it until last visits. Another interesting fact is that Psychiatric evaluation is done approximately in a third of the visits, being the department that makes all of the diagnosis except in one case. In all of the cases there are a lot of diagnostic orientation doubts from different medical departments, being the two most common psychiatric misdiagnosis: Other Specified Anxiety Disorder and Other Specified Feeding or Eating Disorder. Two of the patients were hospitalized in an acute psychiatric unit for this reason, one of them nine times and the other patient, twice.
Conclusions
CHS has a very particular presentation which makes its recognition very simple. From our experience, it is an unknown entity for most of the doctors, something that needs to change in order to make a correct therapeutic management. Larger studies need to be done to make this findings more solid and for further information.
Hospital at home for psychiatric patients is a new emerging resource of delivering acute mental health care in the community. The main objective of this program is to provide intense care to patients with severe mental disorders at home as an alternative to acute admission.
Although home hospitalisation has begun to develop widely in recent years there is a notable lack of studies
The CAEM Psychiatric Home Hospitalization Unit (HAD-CAEM) has been operating since 2018 and takes place in Santa Coloma de Gramenet; and from March 2022 also in a part of Badalona. Both are sociodemographically depressed areas near Barcelona.
Objectives
The aim of this study is to describe the characteristics of patients attended at the Psychiatric Home Hospitalization Unit of our hospital and to study differences according to area and place of referral.
Methods
Socio-demographic and clinical data were collected retrospectively at admission and discharge of all patients treated at HAD-CAEM between March 2022 to february 2023.
Statistical analysis was performed by using SPSS program.
Results
85 patients were included in the study. 45.9% were women. The mean age was 45.5 years (SD 15.58 years). The main diagnoses of the sample were psychosis and schizophrenia (38.8%), Bipolar disorder (23.53%), Depressive disorder (21.18%), schizoaffective disorder (8.24%) and others (8,24%).
54 (63.53%) patients were from Santa Coloma area and 35 (41.18%) from Badalona area.
The total mean duration of admission was 40.22 days (SD 26.18 days), with a mean follow-up of 10.09 visits (SD 5.39 visits) and 2.41 teleassistence (SD 2.62).
The mean duration of admission for Santa Coloma patients was 43.98 days (SD 28.59), and for Badalona patients 33.68 days (SD 20.13). Trend without significance is observed (t= 1.77, p=0.08)
We found differences in the mean duration of admission according to referral location. Acute psychiatric unit 33.25 days (SD 18.06), Mental health Center 51.93 days (SD 33.45), Emergencies 34.28 days (SD 19.69) (F=5.1, p=0.008).
Conclusions
Sociodemografic and clinical característics obtained in our study are consistent with those reported in previous studies. The duration of admission of patients referred from the mental health center is longer than those referred from the acute psychiatric or emergency unit. Home hospitalization teams have been increasing in recent years, being an alternative to traditional hospitalization.
The scientific literature widely acknowledges the multitude of factors contributing to suicide, emphasizing the intricate and dynamic interplay among genetic, biological, psychological, and social dimensions (Van Heeringen, 2001). Despite this consensus, each suicide case is unique, shaped by an exclusive combination of these factors. One relatively underexplored risk factor in the realm of suicidal behavior is attachment style. As posited by attachment theorists, avoidant and anxious/insecure attachment styles may hold predictive value for suicide attempts (Sheftall et al., 2014).
Objectives
This study undertakes a comprehensive review of the relationships between attachment styles, life scripts, parental mandates, and suicidal behavior.
Methods
This study delves into the interconnections between attachment styles, life scripts, parental mandates, and suicide, drawing from an extensive body of research and theory. A comprehensive review of existing literature was conducted to elucidate the intricate relationships among these variables and their potential influence on suicidal behavior.
Results
The synthesis of existing research highlights a compelling link between attachment styles, life scripts, and parental mandates. Attachment styles, formed in early life, profoundly influence an individual’s interpersonal relationships, emotional regulation, and sense of self-worth. These attachment patterns lay the foundation for the development of life scripts—internalized narratives that dictate one’s beliefs, values, and expectations regarding their life course. Parental mandates, often transmitted explicitly or implicitly during childhood, further shape these life scripts by imposing conditions or constraints on the individual’s choices and aspirations.
Crucially, within this framework, suicidal behavior emerges as a possible outcome. Individuals with maladaptive attachment styles, burdened by parental mandates that discourage autonomous living or impose conditional acceptance, may perceive suicide as a way to escape perceived unmet expectations or alleviate emotional distress.
Conclusions
This study underscores the intricate interplay between attachment styles, life scripts, parental mandates, and suicidal behavior. Understanding these complex relationships is pivotal in both prevention and intervention efforts. Recognizing the significance of family history, parental approaches, maladaptive beliefs, attachment patterns, and early caregiver interactions can inform the development of targeted strategies aimed at mitigating suicide risk in diverse contexts, including schools, communities, and clinical settings. By identifying these factors and their influence on suicidal behavior, practitioners and researchers alike can contribute to more effective prevention and intervention initiatives tailored to individual needs.
According to Bisquerra Alzina (2003),competencies are defined as a set of knowledge, capabilities, skills and attitudes, necessary to understand, express and regulate emotional phenomena appropriately and which are fundamental in the teaching profesion since they are closely related to students´performance and mental health.
Objectives
compare socio-emotional skills in two groups of participants: female and male
Methods
A non-experimental,cross-sectional design was proposed for this study. The scope of this research is descriptive, in the sense,that it seeks to establish measures in regard to specific variables. Sample (100 female and 100 male).
Results
Results revealed that the evaluated teachers show average level of socio-emotional competencies, (Table 1).The highest scores were encountered in relation to the optimism competence. It suggests that teachers have the ability to obtain favorable balances from adverse situations presented in their daily lives.Table 1:
Distribution of socio-emotional competency levels in the professionals evaluated
LOW %
MEDIUM %
HIGHT %
EMOTIONAL AWARENESS
19
80
1
SELF EFFICACY
32
66
2
EMOTIONAL REGULATION
17
81
2
EMOTIONAL EXPRESSION
6
85
9
PROSOCIALITY
6
85
9
ASSERTIVENESS
6
82
12
OPTIMISM
0
21
79
EMOTIONAL AUTONOMY
25
71
4
EMPATHY
8
85
7
Findings showed that there exists a statiscally significative difference (P=0,000) in the empathy and self-efficacy dimensions. Women obtained higher scores in these two abilities in regard to men. (Table 2). No differences were observed in the rest of the competences evaluated.Table 2:
Differences according to men and women
FEMALE
MALE
SELF EFFICACY
1,78
1,61
EMPATHY
2,02
1,96
Conclusions
Although teachers´s socio-emotional competences were classified in medium levels, it is necessary to implement an intervention design that allows to streghten those dimensions since they could improve not only the relationships with their students but also teachers´ mental health.
Sodium oxybate, an effective treatment for narcolepsy-associated daytime sleepiness and cataplexy, has been extensively. Despite its therapeutic benefits, sodium oxybate is not without its risks, and adverse psychiatric effects have been documented. This case report highlights a rare manifestation of sodium oxybate-related secondary mania with psychotic symptoms in a patient with narcolepsy, emphasizing the importance of recognizing and managing such adverse events. Additionally, we provide a brief review of similar cases reported in the literature.
Objectives
This report aims to describe the presentation, evaluation, and management of sodium oxybate-induced secondary mania with psychotic symptoms in a patient with narcolepsy. We also discuss the potential mechanisms underlying this adverse reaction and its clinical implications. Furthermore, we summarize findings from previous studies that have reported cases of secondary mania associated with sodium oxybate use.
Methods
We present the case of Mr. X, a 48-year-old male diagnosed with “Narcolepsy with cataplexy,” who had been receiving sodium oxybate treatment for 11 years. He was admitted to the hospital following a mild head injury and the emergence of a manic episode with psychotic features. Comprehensive clinical evaluation, including medical history, toxicology screening, and neuroimaging, was conducted.
Results
Upon evaluation, Mr. X exhibited hyperactivity, restlessnes, grandiose delusions, paranoid delusions related to hospital staff, and decreased need for sleep. Notably, he had been consuming sodium oxybate excessively. Sodium oxybate was discontinued, and low-dose olanzapine was initiated. Within 24 hours, his manic and psychotic symptoms resolved. He admitted to overusing his medication, and his family reported a recent increase in his activity level. A review of the literature revealed similar cases of sodium oxybate-induced secondary mania with psychotic symptoms.
Conclusions
This case underscores the importance of vigilance for psychiatric side effects of sodium oxybate, particularly in patients with a history of substance abuse or potential overuse. Secondary mania associated with medications is a rare but significant clinical entity. Prompt recognition and intervention are crucial for patient safety and well-being. Further research is needed to elucidate the mechanisms underlying such reactions and to establish guidelines for their prevention and management.
The glucagon-like peptide-1 (GLP-1) receptor agonist Semaglutide has been widely used to manage type 2 diabetes due to its favourable effects on glycemic control and weight reduction. Proved to be safe in adults and elderly patients with renal or hepatic disorders demanding no dose modification. Affective symptoms are not listed as side effects in the product information. However, there is a recent investigation going on by the European Medicines Agency (EMA) after three flagged cases of suicidal thoughts in Iceland. In contrast, the Food and Drug Administration (FDA) recommend that patients with this treatment are monitored for suicidal thoughts or behaviour.
Objectives
This case study explores the possible relationship between Semaglutide treatment and the onset of a manic episode in a 57-year-old male with no history of psychiatric disorders.
Methods
We present a 57-year-old male with no psychiatric history of interests, with a previous good functioning. A one-week history of disruptive behaviours started, characterized by excessive cheerfulness, heightened euphoria, and reduced need for sleep. Family members describe a complex situation at home, with frequent outings by the patient, engaging in conversations with strangers, getting lost, and becoming more irritable with them. The patient and family relate this mood change after initiating Semaglutide for diabetes control, starting at 7mg doses. The temporal relationship between the initiation of Semaglutide therapy, precisely a dose escalation to 7mg, and the onset of manic symptoms prompted family members to notify the patient’s endocrinologist. Due to the inability to manage the patient at home and his unpredictability, they sought help at the emergency department, resulting in a psychiatric admission. Imaging and analytical tests show no significant abnormalities.
Results
During his stay in the psychiatry department, semaglutide dosage was reduced, and treatment with Aripiprazole was initiated at doses of 5mg, given the metabolic profile associated with medical comorbidities (obesity, chronic renal failure and diabetes). Subsequent clinical observations showed a gradual resolution of manic symptoms and an improvement in the patient’s overall mental state.
Conclusions
This case highlights the importance of monitoring and recognizing potential neuropsychiatric side effects associated with Semaglutide therapy, particularly in individuals without a prior psychiatric history. Further research is warranted to elucidate the underlying mechanisms linking Semaglutide with mood disturbances and to identify risk factors that may predispose certain patients to develop manic states in response to this GLP-1RA. Clinicians should remain vigilant and consider alternative treatment options if such side effects occur, ensuring comprehensive management of patients receiving Semaglutide for diabetes control.
OBJECTIVES/GOALS: Motivations and hesitations about participating in genetic research among those at risk of inherited conditions are unclear. We aim to understand perceptions, perspectives, and concerns of these individuals regarding genetic research studies, especially for hard-to-diagnose diseases. METHODS/STUDY POPULATION: Mix method study of 150 Hispanics individuals in Puerto Rico (PR) at risk for in heriting a condition. These individuals, with limited diagnostic data, are attending genetics clinics or invited to a genetics study at the University of Puerto Rico Medical Sciences Campus. Structured surveys and interviews will be conducted. Surveys will gauge general perceptions and feelings toward genetic research, while interviews will provide a deeper understanding of participants’ personal narratives and experiences. All sessions will be recorded, transcribed, and analyzed using NVivo qualitative analysis software. Thematic analysis will be employed to identify recurring themes and sentiments. RESULTS/ANTICIPATED RESULTS: Weanticipatevaried responses: some enthusiastic about genetic research benefits, others having reservations due to privacy, cultural beliefs, or past experiences. A significant portion may express concerns about genetic research’s impact on insurance and potential discrimination. We also expect to uncover systemic challenges that hinder participation among Hispanics living in PR, such as a lack of information or misconceptions about genetic research. This study will overview factors, both encouraging and inhibitory, influencing decisions to join genetic research. Quantitative genetic literacy survey data will undergo descriptive analysis and multivariate logistic regression. DISCUSSION/SIGNIFICANCE: Hispanics in PR exhibit a rich tapestry of genetic variations being a focal point for genetic research. Understanding perceptions is vital among those at risk for inherited conditions. Insights can shape outreach and education strategies, ensuring participants are informed, concerns met, and empowered to make decisions alignined their views.
The diffusion of exchanged Yb, Ho, and Eu from interlayer positions in montmorillonite was studied using infrared spectroscopy (IR), X-ray powder diffraction, and cation-exchange measurements. Dehydration of exchanged montmorillonite between 100° and 280°C caused the ions to diffuse into the hexagonal rings of surface oxygens. Subsequent migration into vacant octahedral sites was small regardless of the radius of the cation. Considerable ion fixation in excess of the cation-exchange capacity of the clay was observed at 20°C in both water and a 1:1 water:95% ethanol mixture. Evidence for hydrolysis as a possible mechanism for cation fixation was obtained by observing frequency shifts for deuterated hydroxyl groups using IR spectroscopy. A major IR band centered at 2680 cm−1 was observed for all three lanthanide-exchanged montmorillonites studied and assigned to the OH-stretching frequency of a lanthanide hydroxide. This band intensified on heating at 300°C for 1 hr. An IR band between 690 and 710 cm−1 also was observed for all three lanthanide-exchanged montmorillonites and was assigned to a lanthanide-hydroxyl deformation mode. No hydrolysis was observed for Na-montmorillonite, as expected from the very low hydration energy of Na+.
X-ray diffraction, infrared, and cation-exchange capacity measurements of the reaction products of montmorillonites with YbCl3.6H2O show that at 1 atm irreversible sorption of Yb3+ increases with increasing temperature in the range 20° to 280°C, whereas at 110 atm it decreases with increasing temperature. Above 100°C, less irreversible sorption occurs at 110 atm than at 1 atm. The decreased sorption at high pressure is attributed to reduced cation hydrolytic fixation and to rapid expulsion of interlayer Yb3+ by interlayer water at higher temperatures, with a concomitant decrease in Yb3+ migration to octahedral sites. At 110 atm, 160° and 200°C treatments cause changes in infrared absorption bands (884 cm-1, 848 cm-1) suggesting that sorbed Yb3+ is charge compensated by the deprotonation of Fe3+- and Mg2+-hydroxyl groups. At 290°C deprotonation is restricted to Fe3+-hydroxyl groups.
Tight focusing with very small f-numbers is necessary to achieve the highest at-focus irradiances. However, tight focusing imposes strong demands on precise target positioning in-focus to achieve the highest on-target irradiance. We describe several near-infrared, visible, ultraviolet and soft and hard X-ray diagnostics employed in a ∼1022 W/cm2 laser–plasma experiment. We used nearly 10 J total energy femtosecond laser pulses focused into an approximately 1.3-μm focal spot on 5–20 μm thick stainless-steel targets. We discuss the applicability of these diagnostics to determine the best in-focus target position with approximately 5 μm accuracy (i.e., around half of the short Rayleigh length) and show that several diagnostics (in particular, 3$\omega$ reflection and on-axis hard X-rays) can ensure this accuracy. We demonstrated target positioning within several micrometers from the focus, ensuring over 80% of the ideal peak laser intensity on-target. Our approach is relatively fast (it requires 10–20 laser shots) and does not rely on the coincidence of low-power and high-power focal planes.