163 results
Proton and helium ions acceleration in near-critical density gas targets by short-pulse Ti:Sa PW-class laser
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- J.L. Henares, P. Puyuelo-Valdes, C. Salgado-López, J.I. Apiñaniz, P. Bradford, F. Consoli, D. de Luis, M. Ehret, F. Hannachi, R. Hernández-Martín, A. Huber, L. Lancia, M. Mackeviciute, A. Maitrallain, J.-R. Marquès, J.A. Pérez-Hernández, C. Santos, J.J. Santos, V. Stankevic, M. Tarisien, V. Tomkus, L. Volpe, G. Gatti
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- Journal of Plasma Physics / Volume 89 / Issue 6 / December 2023
- Published online by Cambridge University Press:
- 28 December 2023, 965890601
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The ability to quickly refresh gas-jet targets without cycling the vacuum chamber makes them a promising candidate for laser-accelerated ion experiments at high repetition rate. Here we present results from the first high repetition rate ion acceleration experiment on the VEGA-3 PW-class laser at CLPU. A near-critical density gas-jet target was produced by forcing a 1000 bar H$_2$ and He gas mix through bespoke supersonic shock nozzles. Proton energies up to 2 MeV were measured in the laser forward direction and 2.2 MeV transversally. He$^{2+}$ ions up to 5.8 MeV were also measured in the transverse direction. To help maintain a consistent gas density profile over many shots, nozzles were designed to produce a high-density shock at distances larger than 1 mm from the nozzle exit. We outline a procedure for optimizing the laser–gas interaction by translating the nozzle along the laser axis and using different nozzle materials. Several tens of laser interactions were performed with the same nozzle which demonstrates the potential usefulness of gas-jet targets as high repetition rate particle source.
Advocacy at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery
- Bistra Zheleva, Amy Verstappen, David M. Overman, Farhan Ahmad, Sulafa K.M. Ali, Zohair Y. Al Halees, Joumana Ghandour Atallah, Isabella E. Badhwar, Carissa Baker-Smith, Maria Balestrini, Amy Basken, Jonah S. Bassuk, Lee Benson, Horacio Capelli, Santo Carollo, Devyani Chowdhury, M. Sertaç Çiçek, Mitchell I. Cohen, David S. Cooper, John E. Deanfield, Joseph Dearani, Blanca del Valle, Kathryn M. Dodds, Junbao Du, Frank Edwin, Ekanem Ekure, Nurun Nahar Fatema, Anu Gomanju, Babar Hasan, Lewis Henry, Christopher Hugo-Hamman, Krishna S. Iyer, Marcelo B. Jatene, Kathy J. Jenkins, Tara Karamlou, Tom R. Karl, James K. Kirklin, Christián Kreutzer, Raman Krishna Kumar, Keila N. Lopez, Alexis Palacios Macedo, Bradley S. Marino, Eva M. Marwali, Folkert J. Meijboom, Sandra S. Mattos, Hani Najm, Dan Newlin, William M. Novick, Sir Shakeel A. Qureshi, Budi Rahmat, Robert Raylman, Irfan Levent Saltik, Craig Sable, Nestor Sandoval, Anita Saxena, Emma Scanlan, Gary F. Sholler, Jodi Smith, James D. St Louis, Christo I. Tchervenkov, Koh Ghee Tiong, Vladimiro Vida, Susan Vosloo, Douglas J. “DJ” Weinstein, James L. Wilkinson, Liesl Zuhlke, Jeffrey P. Jacobs
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- Cardiology in the Young / Volume 33 / Issue 8 / August 2023
- Published online by Cambridge University Press:
- 24 August 2023, pp. 1277-1287
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The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS) will be held in Washington DC, USA, from Saturday, 26 August, 2023 to Friday, 1 September, 2023, inclusive. The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery will be the largest and most comprehensive scientific meeting dedicated to paediatric and congenital cardiac care ever held. At the time of the writing of this manuscript, The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery has 5,037 registered attendees (and rising) from 117 countries, a truly diverse and international faculty of over 925 individuals from 89 countries, over 2,000 individual abstracts and poster presenters from 101 countries, and a Best Abstract Competition featuring 153 oral abstracts from 34 countries. For information about the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery, please visit the following website: [www.WCPCCS2023.org]. The purpose of this manuscript is to review the activities related to global health and advocacy that will occur at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery.
Acknowledging the need for urgent change, we wanted to take the opportunity to bring a common voice to the global community and issue the Washington DC WCPCCS Call to Action on Addressing the Global Burden of Pediatric and Congenital Heart Diseases. A copy of this Washington DC WCPCCS Call to Action is provided in the Appendix of this manuscript. This Washington DC WCPCCS Call to Action is an initiative aimed at increasing awareness of the global burden, promoting the development of sustainable care systems, and improving access to high quality and equitable healthcare for children with heart disease as well as adults with congenital heart disease worldwide.
Evaluation of sperm and hormonal assessments in Wagyu, Nellore, and Angus bulls
- A. R. Moura, A. R. Santos, Jr, J. D. A. Losano, A. F. P. Siqueira, T. R. S. Hamilton, R. Zanella, K. C. Caires, R. Simões
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Wagyu bulls are known to have a highly exacerbated libido, as shown by the intense sexual interest of young calves. Therefore we believe that Wagyu male animals have specialized Sertoli and Leydig cells that are directly involved with the sexual precocity in this breed as mature bulls have a small scrotal circumference. This study aimed to evaluate whether there were differences in the hormone and sperm characteristics of Wagyu bulls compared with the same characteristics of subspecies Bos indicus and Bos taurus sires. Frozen–thawed semen from Wagyu, Nellore, and Angus sires were analyzed for sperm kinetics (computer-assisted sperm analysis), plasma membrane integrity, chromatin integrity, acrosome status, mitochondrial activity, lipid peroxidation and hormone [luteinizing hormone (LH) and testosterone] serum concentration. The results showed that Wagyu had lower total motility and an increased number of sperm with no motility when compared with Nellore and Angus bulls. Wagyu breed did not differ from those breeds when considering plasma and acrosome membranes integrity, mitochondrial potential, chromatin resistance, sperm lipid peroxidation or hormone (LH and testosterone) concentrations. We concluded that Wagyu sires had lower total motility when compared with Nellore and Angus bulls. Wagyu breed did not differ from these breeds when considering plasma and acrosome membranes integrity, mitochondrial potential, chromatin resistance, sperm lipid peroxidation, or hormone (LH and testosterone) concentrations.
Establishing Disorder-Specific and Transdiagnostic Neural Features of Psychiatric Disorders Through Large-Scale Functional Magnetic Resonance Imaging Meta-Analyses
- C. H. Miller, E. Pritchard, S. Saravia, M. Duran, S. L. Santos, J. P. Hamilton, D. W. Hedges, I. H. Gotlib, M. D. Sacchet
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S547-S548
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Introduction
Meta-analyses of functional magnetic resonance imaging (fMRI) studies have been used to elucidate the most reliable neural features associated with various psychiatric disorders. However, it has not been well-established whether each of these neural features is linked to a specific disorder or is transdiagnostic across multiple disorders and disorder categories, including mood, anxiety, and anxiety-related disorders.
ObjectivesThis project aims to advance our understanding of the disorder-specific and transdiagnostic neural features associated with mood, anxiety, and anxiety-related disorders as well as to refine the methodology used to compare multiple disorders.
MethodsWe conducted an exhaustive PubMed literature search followed by double-screening, double-extraction, and cross-checking to identify all whole-brain, case-control fMRI activation studies of mood, anxiety, and anxiety-related disorders in order to construct a large-scale meta-analytic database of primary studies of these disorders. We then employed multilevel kernel density analysis (MKDA) with Monte-Carlo simulations to correct for multiple comparisons as well as ensemble thresholding to reduce cluster size bias to analyze primary fMRI studies of mood, anxiety, and anxiety-related disorders followed by application of triple subtraction techniques and a second-order analysis to elucidate the disorder-specificity of the previously identified neural features.
ResultsWe found that participants diagnosed with mood, anxiety, and anxiety-related disorders exhibited statistically significant (p < .05 – 0.0001; FWE-corrected) differences in neural activation relative to healthy controls throughout the cerebral cortex, limbic system, and basal ganglia. In addition, each of these psychiatric disorders exhibited a particular profile of neural features that ranged from disorder-specific, to category-specific, to transdiagnostic.
ConclusionsThese findings indicate that psychiatric disorders exhibit a complex profile of neural features that vary in their disorder-specificity and can be detected with large-scale fMRI meta-analytic techniques. This approach has potential to fundamentally transform neuroimaging investigations of clinical disorders by providing a novel procedure for establishing disorder-specificity of observed results, which can be then used to advance our understanding of individual disorders as well as broader nosological issues related to diagnosis and classification of psychiatric disorders.
Disclosure of InterestNone Declared
Do we have an “anti-stigmotic”? – Addressing Mental-Illness Related Stigma as the main issue
- C. Cabaços, J. Andrade, F. Pocinho, M. Carneiro, G. Santos, D. Loureiro, A. Macedo
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1031
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Introduction
For people with mental illness, internalized stigma, also referred to as self-stigma, is characterized by a subjective perception of devaluation, marginalization, secrecy, shame, and withdrawal. It has many adverse effects on individual’s psychological well-being and clinical outcomes. The iatrogenic effects it has during psychotherapeutic treatment can significantly reduce utilization of mental health care services, reduce quality of life and increase avoidant coping. Overall, internalized stigma is considered a risk factor for poorer mental health prognosis. Although some interventions have recently been developed to specifically intervene on this target as part of psychological recovery goals over the course of treatment, most clinicians are not yet aware or empowered to correctly address this.
ObjectivesDescription of a clinical case illustrating the relevance on addressing internalized mental illness related stigma during the recovery process.
MethodsClinical case report and review of the literature on the subject.
ResultsWe present the case of a 47-year-old female patient, C.S., single, graduated in social work (currently unemployed), who was admitted at the Psychiatry Day Hospital, where she was referred by her Psychiatry Assistant because of abulia, social withdrawal and isolation, depressed mood, thoughts of shame, guilt and self-devaluation and work incapacity. She had been admitted in the Psychiatry ward one year earlier for a first psychotic breakthrough, presenting persecutory and grandiose delusions and auditory hallucinations. After three weeks of inpatient treatment with antipsychotics, a full remission of the symptoms was achieved, without any posterior relapse. Before that first psychotic episode, the patient had been taking anti-depressive medication (escitalopram 20 mg id) for many years, prescribed by her General Practitioner, for mild to moderate depressive symptoms. After being discharged from the Psychiatry ward, C. kept following an outpatient treatment with anti-depressives and behavioural activation-based psychotherapy. She started to believe she was mentally ill and therefore weak, uncapable, and less deserving than her peers or her previous self. These self-stigmatizing ideas were enhanced by the lack of family support and the beliefs that were fostered by her mother, with whom she started to live after the hospitalization. These factors led to a dysfunctional internalization of an illness behaviour, jeopardizing the patient’s ability to reach full recovery.
ConclusionsThis case reinforces the importance of targeting mental illness related stigma during the recovery process. Also, involving the family is of extreme importance to achieve support and address shared beliefs and the interchange between social and internalized stigma.
Disclosure of InterestNone Declared
Neural Abnormalities Associated with Generalized Anxiety Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation Studies
- S. K. Kahlon, Z. Ali, E. Pritchard, S. Saravia, C. Baten, A. M. Klassen, J. H. Shepherd, G. Zamora, J. Jordan, M. Duran, S. L. Santos, D. W. Hedges, J. P. Hamilton, M. D. Sacchet, C. H. Miller
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S452
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Introduction
Generalized anxiety disorder (GAD) is a highly prevalent mental illness that is associated with clinically significant distress, functional impairment, and poor emotional regulation. Primary functional magnetic resonance imaging (fMRI) studies of GAD report neural abnormalities in comparison to healthy controls. However, many of these findings in the primary literature are inconsistent, and it is unclear whether they are specific to GAD or shared transdiagnostically across related disorders.
ObjectivesThis meta-analysis seeks to establish the most reliable neural abnormalities observed in individuals with GAD, as reported in the primary fMRI activation literature.
MethodsWe conducted an exhaustive literature search in PubMed to identify primary studies that met our pre-specified inclusion criteria and then extracted relevant data from primary, whole-brain fMRI activation studies of GAD that reported coordinates in Talairach or MNI space. We then used multilevel kernel density analysis (MKDA) with ensemble thresholding to examine the differences between adults with GAD and healthy controls in order to identify brain regions that reached statistical significance across primary studies.
ResultsPatients with GAD showed statistically significant (α=0.05–0.0001; family-wise-error-rate corrected) neural activation in various regions of the cerebral cortex and basal ganglia across a variety of experimental tasks.
ConclusionsThese results inform our understanding of the neural basis of GAD and are interpreted using a frontolimbic model of anxiety as well as specific clinical symptoms of this disorder and its relation to other mood and anxiety disorders. These results also suggest possible novel targets for emerging neurostimulation therapies (e.g., transcranial magnetic stimulation) and may be used to advance our understanding of the effects of current pharmaceutical treatments and ways to improve treatment selection and symptom-targeting for patients diagnosed with GAD.
Disclosure of InterestNone Declared
Major Depressive Disorder Across Development and Course of Illness: A Functional Neuroimaging Meta-Analysis
- C. Baten, A. M. Klassen, J. H. Shepherd, G. Zamora, E. Pritchard, S. Saravia, Z. Ali, J. Jordan, S. K. Kahlon, G. Maly, M. Duran, S. Santos, A. F. Nimarko, D. W. Hedges, P. Hamilton, I. H. Gotlib, M. D. Sacchet, C. H. Miller
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S345-S346
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Introduction
Functional magnetic resonance imaging (fMRI) has been used to identify the neural activity of both youth and adults diagnosed with major depressive disorder (MDD) in comparison to healthy age-matched controls. Previously reported abnormalities in depressed youth appear to mostly align with those found in depressed adults; however, some of the reported aberrant brain activity in youth has not been consistent with what is observed in adults, and to our knowledge there has not yet been a formal, quantitative comparison of these two groups. In addition, it is not known whether these observed differences between youth and adults with depression are attributable to developmental age or length-of-illness.
ObjectivesThe aim of this study is to elucidate the similarities and differences in patterns of abnormal neural activity between adults and youth diagnosed with MDD and to then determine whether these observed differences are due to either developmental age or length-of-illness.
MethodsWe used multilevel kernel density analysis (MKDA) with ensemble thresholding and triple subtraction to separately determine neural abnormalities throughout the whole brain in primary studies of depressed youth and depressed adults and then directly compare the observed abnormalities between each of those age groups. We then conducted further comparisons between multiple subgroups to control for age and length-of-illness and thereby determine the source of the observed differences between youth and adults with depression.
ResultsAdults and youth diagnosed with MDD demonstrated reliable, differential patterns of abnormal activation in various brain regions throughout the cerebral cortex that are statistically significant (p < .05; FWE-corrected). In addition, several of these brain regions that exhibited differential patterns of neural activation between the two age groups can be reliably attributed to either developmental age or length-of-illness.
ConclusionsThese findings indicate that there are common and disparate patterns of brain activity between youth and adults with MDD, several of which can be reliably attributed to developmental age or length-of-illness. These results expand our understanding of the neural basis of depression across development and course of illness and may be used to inform the development of new, age-specific clinical treatments as well as prevention strategies for this disorder.
Disclosure of InterestNone Declared
Effects of cognitive rehabilitation interventions on non-central nervous system cancer survivors: A meta-analysis
- A. F. Oliveira, J. D. Reis, I. M. Santos, A. Torres
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S116-S117
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Introduction
Cancer treatments can have a detrimental impact on cancer survivors’ cognitive function. Cognitive rehabilitation is considered the first-line intervention to address cognitive difficulties of cancer survivors. Nevertheless, its efficacy remains unclear.
ObjectivesThis meta-analysis aimed to understand the effects of cognitive rehabilitation in non-central system (non-CNS) cancer survivors, through the assessment of the overall efficacy on subjective cognitive outcomes.
MethodsThis meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. An electronic search on the databases PubMed, Scopus, and Web of Science was conducted in May 2021, considering the past 15 years, by two independent authors. Studies were eligible if they included cancer survivors (excluding CNS cancers) who were exposed to cognitive rehabilitation interventions, in which the subjective cognitive effects were measured through self-report questionnaires. The quality of studies was assessed using the Cochrane Risk of Bias Tool for Randomized Trials. The effect size was the standardized mean difference in the cognitive assessment, between baseline and post-intervention. Statistical heterogeneity was assessed using I2 Statistic. Publication bias was evaluated with Egger’s test. P<0.05 was considered statistically significant. The meta-analysis was performed using R software.
ResultsAmong 14 studies, with 1115 cancer survivors, one study included a pediatric population, other young adult survivors, and the remaining adult population. The most used scale for measuring cognitive changes was the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) and, as recommended, the Perceived Cognitive Impairments (PCI) subscale was used as the primary measure of subjective cognitive function. Results indicated beneficial effects following cognitive rehabilitation, with an overall standard mean difference between pre- and post-treatment of 3.4447, with CI95% [1.5543; 5.3350], p-value<0.0004. The subgroup analysis between the measures of cognitive outcomes showed that the heterogeneity is Group=Other 0.00% (I2) and for the Group=FACT-Cog PCI is 86% (I2). Analyzing the FACT-Cog PCI, the CI95% [-2.93; 6.43] includes 0, meaning that the overall effect in this subgroup is non-significant. The meta-analysis does not demonstrate publication bias (p-value of the Egger test=0.3220).
ConclusionsImprovement of cognitive function in non-CNS survivors throughout cognitive rehabilitation appears to be effective. The findings of this meta-analysis can help inform clinical practice and assist practitioners in recommending and developing interventions of cognitive rehabilitation and deciding how to evaluate them. Further research is required to strengthen this evidence.
Disclosure of InterestNone Declared
Major Depressive Disorder in Youth: A Meta-Analysis of Functional Magnetic Resonance Imaging Studies
- G. Zamora, C. Baten, A. M. Klassen, J. H. Shepherd, E. Pritchard, S. Saravia, Z. Ali, J. Jordan, S. K. Kahlon, G. Maly, M. Duran, S. L. Santos, A. F. Nimarko, D. W. Hedges, J. P. Hamilton, I. H. Gotlib, M. D. Sacchet, C. H. Miller
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S219-S220
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Introduction
Major depressive disorder (MDD) is a highly prevalent mental illness that frequently originates in early development and is pervasive during adolescence. Despite its high prevalence and early age of onset, our understanding of the potentially unique neural basis of MDD in this age group is still not well understood, and the existing primary literature on the topic includes many new and divergent results. This limited understanding of MDD in youth presents a critical need to further investigate its neural basis in youth and presents an opportunity to also improve clinical treatments that target its neural abnormalities.
ObjectivesThe present study aims to advance our understanding of the neural basis of MDD in youth by identifying abnormal functional activation in various brain regions compared with healthy controls.
MethodsWe conducted a meta-analysis of functional magnetic resonance imaging (fMRI) studies of MDD by using a well-established method, multilevel kernel density analysis (MKDA) with ensemble thresholding, to quantitatively combine all existing whole-brain fMRI studies of MDD in youth compared with healthy controls. This method involves a voxel-wise, whole-brain approach, that compares neural activation of patients with MDD to age-matched healthy controls across variations of task-based conditions, which we subcategorize into affective processing, executive functioning, positive valence, negative valence, and symptom provocation tasks.
ResultsYouth with MDD exhibited statistically significant (p<0.05; FWE-corrected) hyperactivation and hypoactivation in multiple brain regions compared with age-matched healthy controls. These results include significant effects that are stable across various tasks as well as some that appear to depend on task conditions.
ConclusionsThis study strengthens our understanding of the neural basis of MDD in youth and may also be used to help identify possible similarities and differences between youth and adults with depression. It may also help inform the development of new treatment interventions and tools for predicting unique treatment responses in youth with depression.
Disclosure of InterestNone Declared
How sexuality is affected and managed in patients under antipsychotic drugs
- F. Ribeirinho Soares, B. Mesquita, A. M. Fraga, M. Albuquerque, J. O. Facucho, P. E. Santos, D. E. Sousa, N. Moura, P. Cintra
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1057
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Introduction
Sexual dysfunction (SD) is a prevalent side effect of antipsychotic drugs (AP), and it impairs patients’ quality of life. Because of the distress caused by it, it should be borne in mind when prescribed since it is responsible for treatment nonadherence or discontinuation. SD affects about 45- 80% of males and 30-80% of females that take it. In SD, all phases of the sexual response cycle may be compromised.
ObjectivesThis non-systematic review of the literature aims to better understand the antipsychotic-induced SD and its management to better compliance of AP-treated patients without compromising their quality of life.
MethodsA semi-structured review on PubMed linking SD as a side effect of AP drugs.
ResultsAll AP drugs can cause SD. It seems related to their mechanism of activity at receptors D2, 5-HT2, α1, H1, and M, which are also involved in sexual function. They do it by diminishing arousal, decreasing libido by blocking motivation and reward system and orgasm indirectly, provoking erectile dysfunction by vasodilatation, and decreasing woman lubrification. Hyperprolactinemia is a significant cause of sexual dysfunctions. Haloperidol, Risperidone, and Amisulpride (prolactin elevating AP) are more likely to cause SD than Olanzapine, Clozapine, Quetiapine, and Aripiprazole (prolactin sparing AP). Although psychotic disorders (Schizophrenia and other psychotic disorders) can impact sexual functioning, according to evidence, there is no denying the role of AP in this issue. Aripiprazole, a D2 partial agonist, has been associated with lower rates of SD and seems to reduce the rates of SD in patients previously treated with other AP. Other AP with the same potential dopamine agonist activity, such as Cariprazine and Brexpiprazole, can probably have the same effect. The management of SD induced by AP drugs should include measuring serum prolactin and modifying risk factors like hypertension, smoking, hyperglycemia, and hypercholesterolemia. In that regard, waiting for spontaneous remission, reducing the dose of the AP prescribed, or switching to Aripiprazole are all viable strategies, if possible. Although the evidence supporting the addition of symptomatic therapies is weak, adding dopaminergic drugs (amantadine, bromocriptine, cabergoline) or drugs with specific effects on sexual functioning (such as phosphodiesterase inhibitors or yohimbine) may be helpful in selected cases.
ConclusionsAlthough all AP drugs can cause sexual dysfunction, it is difficult to determine its true prevalence accurately. AP-induced sexual dysfunction can adversely affect compliance and is one of the factors that must be considered when selecting treatment. In summarizing, Aripiprazole has shown to be the AP with the most favorable profile concerning SD. Cariprazine and Brexpiprazole, being also D2 partial agonists, may cause less SD.
Disclosure of InterestNone Declared
I don’t know where I’m going or where I come from. Self-disorders in schizophrenia.
- M. D. C. Vallecillo Adame, L. Rodríguez Andrés, C. de Andrés Lobo, T. Jimenez Aparicio, M. Queipo de Llano de la Viuda, G. Guerra Valera, A. A. Gonzaga Ramirez, M. Fernández Lozano, M. J. Mateos Sexmero, N. Navarro Barriga, B. Rodríguez Rodríguez, M. P. Pando Fernández, M. Calvo Valcárcel, P. Martínez Gimeno, M. A. Andreo Vidal, I. D. L. M. Santos Carrasco
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1069-S1070
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Introduction
In the early stages of schizophrenia the person experiences feelings of strangeness about themselves, difficulty in making sense of things and difficulty in interacting with their environment. Based on this, self-disorder assessment instruments have been developed and empirical studies have been conducted to assess people at risk of developing a schizophrenia spectrum disorder. These studies show that self-disorders are found in pre-psychotic stages and that their manifestation can predict the transition to schizophrenia spectrum disorders.
ObjectivesWe present the case of a patient with multiple diagnoses and mainly dissociative symptoms who, after years of evolution, was diagnosed with schizophrenia.
MethodsBibliographic review including the latest articles in Pubmed about self-disorders and schizophrenia.
ResultsWe present the clinical case of a 51-year-old woman with a long history of follow-up in mental health consultations and with multiple hospital admissions to the psychiatric unit, with several diagnoses including: dissociative disorder, histrionic personality disorder, adaptive disorder unspecified psychotic disorder and, finally, schizophrenia. The patient during the first hospital admissions showed a clinical picture of intense anxiety, disorientation and claiming to be a different person. The patient related these episodes to stressors she had experienced, and they improved markedly after a short period of hospital admission. Later, psychotic symptoms appeared in the form of auditory and visual hallucinations and delusional ideation, mainly of harm, so that after several years of follow-up and study in mental health consultations and in the psychiatric day hospital, she was diagnosed with schizophrenia and treatment with antipsychotics was introduced, with a marked clinical improvement being observed.
ConclusionsIt is important to take into account this type of symptoms (self-disorders), as they allow the identification of individuals in the early stages of the disorder and create the opportunity for early therapeutic interventions.
Disclosure of InterestNone Declared
Relationship between CAINS negative symptoms and cognition, psychosocial functioning and quality of life in patients with a first psychotic episode of schizophrenia
- R. Rodriguez-Jimenez, L. García-Fernández, V. Romero-Ferreiro, M. Valtueña García, A. I. Aparicio, J. M. Espejo-Saavedra, L. Sánchez-Pastor, A. Nuñez-Doyle, M. Dompablo, O. Jiménez-Rodríguez, D. Rentero, P. Fernández-Sotos, I. Martínez-Gras, J. L. Santos
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S641-S642
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Introduction
Negative symptoms has been classically associated with cognition, psychosocial functioning and quality of life in patients with schizophrenia. But negative symptoms are not a unitary construct, encompassing two different factors: diminished expression, and motivation and pleasure. Few works have studied the relationship between these two different negative symptoms factors and cognition (neuro and social cognition), psychosocial functioning and quality of life, jointly, in patients with a first psychotic episode of schizophrenia.
ObjectivesThe objective of the present work was to study, in a sample of patients with a first psychotic episode of schizophrenia, the relationship between the negative symptoms (diminished expression and motivation and pleasure) and neurocognition, social cognition, functioning and quality of life.
MethodsThe study was carried out with 82 outpatients with a first psychotic episode of schizophrenia from two Spanish hospitals (“12 de Octubre” University Hospital, Madrid and “Virgen de la Luz” Hospital, Cuenca). The patients were assessed with the Clinical Assessment Interview for Negative Symptoms (CAINS) for evaluating diminished expression (EXP) and motivation and pleasure (MAP) symptoms, the MATRICS Consensus Cognitive Battery (MCCB) for evaluating neurocognition and social cognition, the Social and Occupational Functioning Assessment Scale (SOFAS), and the Quality of Life Scale (QLS).
ResultsA negative correlation was found between neurocognition and the two negative symptoms subscales: CAINS-EXP (r=-0.458, p<0.001) and CAINS-MAP (r=-0.374, p<0.001); but with social cognition only CAINS-EXP was correlated (r=-0.236, p=0.033). Also, it was found a high negative correlation between SOFAS scores and CAINS-MAP (r=-0.717, p<0.001); and a medium negative correlation with CAINS-EXP (r=-0.394, p<0.001). Finally, QLS score was high correlated with both CAINS subscales: CAINS-EXP (r=-0.681, p<0.001) and CAINS-MAP (r=-0.770, p<0.001).
ConclusionsThis study found a relationship between negative symptoms and neurocognition, social cognition, functioning and quality of life in a sample of patients with a first psychotic episode of schizophrenia. But the two different negative symptom factors, diminished expression, and motivation and pleasure, are associated differently with psychosocial functioning, but especially with social cognition where the relationship was only found with diminished expression symptoms.
Disclosure of InterestNone Declared
Late diagnosis of attention deficit hyperactivity disorder and cocaine abuse
- C. De Andrés Lobo, C. Vallecillo Adame, T. Jiménez Aparicio, M. Queipo de Llano de la Viuda, G. Guerra Valera, A. A. Gonzaga Ramírez, M. Fernández Lozano, N. Navarro Barriga, M. J. Mateos Sexmero, B. Rodríguez Rodríguez, M. Calvo Valcárcel, M. Andreo Vidal, M. P. Pando Fernández, P. Martínez Gimeno, I. D. L. M. Santos Carrasco, J. I. Gonçalves Cerejeira, A. Rodríguez Campos
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S335-S336
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Introduction
Adult ADHD diagnosis sometimes represents a challenge for the clinician, due to the comorbid psychiatric diseases that are often associated and which complicate de recognition of the primary symptoms of ADHD. The prevalence of ADHD in adult populations is 2’5% and it is a relevant cause of functional impairment.
ObjectivesPresentation of a clinical case of a male cocaine user diagnosed with adult ADHD.
MethodsLiterature review on adult ADHD and comorbid substance abuse.
ResultsA 43-year-old male who consulted in the Emergency Department due to auditory hallucinosis in the context of an increase in his daily cocaine use. There were not delusional symptoms associated and judgment of reality was preserved. Treatment with olanzapine was started and the patient was referred for consultation. In psychiatry consultations, he did not refer sensory-perceptual alterations anymore, nor appeared any signals to suspect so, and he was willing to abandon cocaine use after a few appointments. He expressed some work concerns, highlighting that in recent months, in the context of a greater workload, he had been given several traffic tickets for “distractions.” His wife explained that he had always been a inattentive person (he forgets important dates or appointments) and impulsive, sometimes interrupting conversations. In the Barkley Adult ADHD Rating Scale he scored 32 points.
He was diagnosed with adult ADHD and treatment with extended-release methylphenidate was started with good tolerance and evolution, with improvement in adaptation to his job and social environment. Since then, the patient has moderately reduced the consumption of drugs, although he continues to use cocaine very sporadically.
ConclusionsEarly detection of ADHD and its comorbidities has the potential to change the course of the disorder and the morbidity that will occur later in adults. Comorbidity in adult ADHD is rather the norm than the exception, and it renders diagnosis more difficult. The most frequent comorbidities are usually mood disorders, substance use disorders, and personality disorders. Treatment of adult ADHD consists mainly of pharmacotherapy supported by behavioral interventions. When ADHD coexists with another disorder, the one that most compromises functionality will be treated first and they can be treated simultaneously. The individual characteristics of each patient must be taken into account to choose the optimal treatment.
Disclosure of InterestNone Declared
European Journal of Psychiatric Trainees - a new scientific peer-reviewed Journal in Psychiatry
- F. Santos Martins, M. J. Santos, L. Afonso Fernandes, D. Cavaleri, M. Pinto da Costa, N. Žaja, K. Markin, L. Tomašić, H. Ryland, J. D King, L. E Stirland, A. Seker
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1118-S1119
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Introduction
Psychiatry training programs vary in the degree to which they offer trainees with an opportunity to get involved in research. Exposure to research during the training period is critical, as this is usually when trainees start their own scientific research projects and gain their first experiences in academic publishing.
ObjectivesWe present the European Journal of Psychiatric Trainees (EJPT) (ejpt.scholasticahq.com), the official journal of the European Federation of Psychiatric Trainees (EFPT), including its scope, mission and vision and practical considerations.
MethodsReflecting on the foundation and operation of the European Journal of Psychiatric Trainees.
ResultsThe European Journal of Psychiatric Trainees is an Open Access, double blind peer-reviewed journal which aims to publish original and innovative research as well as clinical, theory, perspective and policy articles, and reviews in the field of psychiatric training, psychiatry and mental health. Its mission is to encourage research on psychiatric training and inspire scientific engagement by psychiatric trainees. Work conducted by psychiatric trainees and studies of training in psychiatry are prioritized. The journal is open to submissions, and while articles from psychiatric trainees are prioritized, submissions within scope from others are also encouraged. The article processing fee is very low and waivable. It is planned to publish two issues yearly.
The first article was published in July 2022, titled “Fluoxetine misuse by snorting in a teenager: a case report” and it received 218 views as of 17 October 2022, which confirms the journal’s potential for visibility.
ConclusionsThe European Journal of Psychiatric Trainees is a non-profit initiative designed to offer psychiatric trainees a platform to publish and gain experience in publishing. Thanks to its robust double blind peer reviewing system, it has the potential to contribute to scientific excellence.
Disclosure of InterestNone Declared
“We weren’t used to seeing our colleagues hospitalized”: A clinical-qualitative study on reports from an intensivist clinical team at a Brazilian university public hospital
- E. R. Turato, F. S. Santos, L. M. Guerra, A.-P. D.-C. Gasparotto, R. N. Aoki, J. M. Cavalcante
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S787
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Introduction
The care relationships of physicians and nurses with patients with Covid-19 had pointed to a scenario explorable from a psychological point of view due to the peculiarities of this pandemic. How do clinicians feel, when caring for their co-workers, in a context that was not so common to see colleagues occupy the patient’s place? What emotional experiences arise from this reality? The results of the present study sought to point out how to handle this caring relationship, in an exceptional context.
ObjectivesTo interpret emotional meanings reported by physicians and nurses on their experiences of working at COVID-19 intensive care units during the height of the pandemic.
MethodsClinical-qualitative design of Turato. Data collection with semi-directed interviews with open-ended questions in-depth applied to a sample of six professionals, closed by theoretical information saturation according to Fontanella, in a Brazilian university general hospital. Trigger question: “Talk about the psychological meanings of your experience in face of management of patients with COVID-19 at ICU”. Data treatment by the Seven Steps of the Clinical-Qualitative Content Analysis of Faria-Schützer. Theoretical framework from Medical Psychology using Balintian concepts.
ResultsWe raised initially 4 categories. Three categories were presented preliminarily in this congress, version last year. In this opportunity, we show this special category of analysis that emerged during the deepened discussion of the final results: “The feeling of insecurity: from technique to affective dimension”.
ConclusionsThe care relationships between the health professional and the patient hospitalized in the Covid-19 ICU pointed to peculiar transference and countertransference psychodynamic mechanisms between both. Before the pandemic, the care relationship seemed pragmatic and protocolar. During the pandemic, this relationship seemed “more subjective”, building a strongly emotional dimension, as health professionals also began to care for their colleagues in the profession. The egoic defense mechanisms, such as projective and introjective identification were reported as intense.
Disclosure of InterestNone Declared
The Neural Basis of Major Depressive Disorder in Adults: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation Studies
- A. M. Klassen, C. Baten, J. H. Shepherd, G. Zamora, S. Saravia, E. Pritchard, Z. Ali, J. Jordan, S. K. Kahlon, G. Maly, M. Duran, S. L. Santos, A. F. Nimarko, D. W. Hedges, J. P. Hamilton, I. H. Gotlib, M. D. Sacchet, C. H. Miller
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S158
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Introduction
Major depressive disorder (MDD) is a highly prevalent mental illness that often first occurs or persists into adulthood and is considered the leading cause of disability and disease burden worldwide. Unfortunately, individuals diagnosed with MDD who seek treatment often experience limited symptom relief and may not achieve long-term remission, which is due in part to our limited understanding of its underlying pathophysiology. Many studies that use task-based functional magnetic resonance imaging (fMRI) have found abnormal activation in brain regions in adults diagnosed with MDD, but those findings are often inconsistent; in addition, previous meta-analyses that quantitatively integrate this large body literature have found conflicting results.
ObjectivesThis meta-analysis aims to advance our understanding of the neural basis of MDD in adults, as measured by fMRI activation studies, and address inconsistencies and discrepancies in the empirical literature.
MethodsWe employed multilevel kernel density analysis (MKDA) with ensemble thresholding, a well-established method for voxel-wise, whole-brain meta-analyses, to conduct a quantitative comparison of all relevant primary fMRI activation studies of adult patients with MDD compared to age-matched healthy controls.
ResultsWe found that adults with MDD exhibited a reliable pattern of statistically significant (p<0.05; FWE-corrected) hyperactivation and hypoactivation in several brain regions compared to age-matched healthy controls across a variety of experimental tasks.
ConclusionsThis study supports previous findings that there is reliable neural basis of MDD that can be detected across heterogenous fMRI studies. These results can be used to inform development of promising treatments for MDD, including protocols for personalized interventions. They also provide the opportunity for additional studies to examine the specificity of these effects among various populations-of-interest, including youth vs. adults with depression as well as other related mood and anxiety disorders.
Disclosure of InterestNone Declared
“The cat and the calcium”. A case of delirium secondary to hypercalcaemia.
- T. Jiménez Aparicio, C. Vallecillo Adame, C. de Andrés Lobo, G. Medina Ojeda, M. Queipo de Llano de la Viuda, A. A. Gonzaga Ramírez, G. Guerra Valera, M. Fernández Lozano, M. J. Mateos Sexmero, B. Rodríguez Rodríguez, N. Navarro Barriga, M. A. Andreo Vidal, M. Calvo Valcárcel, P. Martínez Gimeno, M. P. Pando Fernández, I. D. L. M. Santos Carrasco, J. I. Gonçalves Cerejeira
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S946-S947
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Introduction
Interconsultation with the psychiatry service is frequently requested from other specialties for the assessment and treatment of patients who present neuropsychiatric symptoms secondary to organic alterations. On the other hand (and in relation to this case), within the possible causes for the elevation of calcaemia figures, the most frequent are hyperparathyroidism and neoplasms, representing between these two entities 90% of cases (1).
Among the organic mental disorders, Delirium stands out, with an approximate prevalence between 1 and 2% (general population), which increases in hospitalized and elderly patients (2).
ObjectivesPresentation of a clinical case about a patient with delirium secondary to hypercalcemia, with hallucinations and behavioral disturbance.
MethodsBibliographic review including the latest articles in Pubmed about delirium (causes and treatment) and hypercalcaemia secondary to neoplasms.
ResultsWe present a 52-year-old male patient, who went to the emergency room accompanied by his wife, due to behavioral alteration. Two days before, he had been evaluated by Neurology, after a first epileptic crisis (with no previous history) that resolved spontaneously. At that time, it was decided not to start antiepileptic treatment.
The patient reported that he had left his house at midnight, looking for a cat. As he explained, this cat had appeared in his house and had left his entire bed full of insects. His wife denied that this had really happened, and when she told the patient to go to the emergency room, he had become very upset.
As background, the patient used to consume alcohol regularly, so the first hypothesis was that this was a withdrawal syndrome. However, although the consumption was daily, in recent months it was not very high, and at that time no other symptoms compatible with alcohol withdrawal were observed (tremor, tachycardia, sweating, hypertension…).
We requested a general blood test and a brain scan. The only relevant finding was hypercalcaemia 12.9mg/dL (which could also be the origin of the previous seizure). It was decided to start treatment with Diazepam and Tiapride in the emergency room, with serum perfusion, and keep under observation. After several hours, the patient felt better, the hallucinations disappeared, and calcium had dropped to 10.2mg/dL. A preferential consultation was scheduled, due to suspicion that the hypercalcaemia could be secondary to a tumor process.
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ConclusionsIt is important to rule out an organic alteration in those patients who present acute psychiatric symptoms. Hypercalcaemia is frequently associated with tumor processes (1) due to secretion of PTH-like peptide (4), so a complete study should be carried out in these cases.
Delirium has a prevalence between 1 and 2% in the general population (2).
Psychopharmacological treatment is used symptomatically, with antipsychotics (3). For the episode to fully resolve, the underlying cause must be treated.
Disclosure of InterestNone Declared
Neonatal mortality of lambs in production systems in a semi-arid environment: main risk factors
- J. D. C. dos Santos, E. P. Saraiva, E. C. Pimenta Filho, G. C. X. Neta, L. K. C. Morais, H. S. Teti, S. S. Fidelis
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- The Journal of Agricultural Science / Volume 161 / Issue 3 / June 2023
- Published online by Cambridge University Press:
- 24 May 2023, pp. 438-449
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The sheep farming has economic and sociocultural importance in semi-arid regions worldwide. Of the total of 1.2 billion sheep in the world, 0.4 are found in semi-arid regions. In this review, we have discussed the main risk factors for neonatal lamb mortality and its association with the prevailing environmental conditions of tropical semi-arid regions. Over the last decades, the average mortality rate of newborn lambs remained relatively constant (~15%) around the world. This rate is reported to be higher (Up to 30%) in small-scale sheep farming systems from developing countries. Overall, the main risk factors of neonatal mortality include low birth weight, dystocia, adverse weather conditions, inadequate milk, or colostrum supply, competition between siblings in multiple births, and poor expression of maternal behaviour. In tropical semi-arid regions, recent findings revealed that newborn lambs from hair coat sheep breeds are less vigorous to perform the first suckling when even exposed to moderate cold conditions (18–20°C). On the other hand, the high radiant heat load in these areas can also challenge the thermoregulation of ewes and newborn lambs, especially if they are kept in areas without protection against direct short-wave solar radiation. Under such circumstances, newborn lambs were reported to be hyperthermic. The heat stress as risk factor for neonatal lamb mortality is a topic that deserves more investigation, particularly in tropical semi-arid areas, where is expected to be drier and hotter as consequence of rapid advances in climate change.
Tobacco use in first-episode psychosis, a multinational EU-GEI study
- T. Sánchez-Gutiérrez, E. Rodríguez-Toscano, L. Roldán, L. Ferraro, M. Parellada, A. Calvo, G. López, M. Rapado-Castro, D. La Barbera, C. La Cascia, G. Tripoli, M. Di Forti, R. M. Murray, D. Quattrone, C. Morgan, J. van Os, P. García-Portilla, S. Al-Halabí, J. Bobes, L. de Haan, M. Bernardo, J. L. Santos, J. Sanjuán, M. Arrojo, A. Ferchiou, A. Szoke, B. P. Rutten, S. Stilo, G. D'Andrea, I. Tarricone, EU-GEI WP2 Group, C. M. Díaz-Caneja, C. Arango
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- Psychological Medicine / Volume 53 / Issue 15 / November 2023
- Published online by Cambridge University Press:
- 26 April 2023, pp. 7265-7276
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Background
Tobacco is a highly prevalent substance of abuse in patients with psychosis. Previous studies have reported an association between tobacco use and schizophrenia. The aim of this study was to analyze the relationship between tobacco use and first-episode psychosis (FEP), age at onset of psychosis, and specific diagnosis of psychosis.
MethodsThe sample consisted of 1105 FEP patients and 1355 controls from the European Network of National Schizophrenia Networks Studying Gene–Environment Interactions (EU-GEI) study. We assessed substance use with the Tobacco and Alcohol Questionnaire and performed a series of regression analyses using case-control status, age of onset of psychosis, and diagnosis as outcomes and tobacco use and frequency of tobacco use as predictors. Analyses were adjusted for sociodemographic characteristics, alcohol, and cannabis use.
ResultsAfter controlling for cannabis use, FEP patients were 2.6 times more likely to use tobacco [p ⩽ 0.001; adjusted odds ratio (AOR) 2.6; 95% confidence interval (CI) [2.1–3.2]] and 1.7 times more likely to smoke 20 or more cigarettes a day (p = 0.003; AOR 1.7; 95% CI [1.2–2.4]) than controls. Tobacco use was associated with an earlier age at psychosis onset (β = −2.3; p ⩽ 0.001; 95% CI [−3.7 to −0.9]) and was 1.3 times more frequent in FEP patients with a diagnosis of schizophrenia than in other diagnoses of psychosis (AOR 1.3; 95% CI [1.0–1.8]); however, these results were no longer significant after controlling for cannabis use.
ConclusionsTobacco and heavy-tobacco use are associated with increased odds of FEP. These findings further support the relevance of tobacco prevention in young populations.
Radiation use efficiency and canopy structure of contrasting elephant grass varieties grown as monocrops and intercrops with butterfly pea
- P. H. F. Silva, M. V. F. Santos, A. C. L. Mello, T. B. Sales, E. R. Costa, L. M. P. Guimarães, D. E. Simões Neto, J. J. Coêlho, M. V. Cunha
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- The Journal of Agricultural Science / Volume 161 / Issue 1 / January 2023
- Published online by Cambridge University Press:
- 11 January 2023, pp. 88-96
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The objective of this study was to evaluate the radiation use efficiency (RUE) and canopy structure of elephant grass varieties (Cenchrus purpureus Schum.) of contrasting statures, under monocropping or intercropped with butterfly pea (Clitoria ternatea L.) in cut-and-carry systems. Two tall varieties (elephant B and IRI-381), and two dwarf ones (Mott and Taiwan A-146 2.37), were evaluated as monocrops or binary intercrops with the legume in a 2-year trial with eight harvests. Greater annual leaf biomass accumulation was observed in the monocrops of the tall variety elephant B (7.76 t/ha per year) and dwarf Mott (8.08 t/ha per year). Greater herbage bulk density (59 kg/ha per cm) and leaf area index (3.83) were recorded in canopies of dwarf Mott than in those composed of IRI-381 (37 kg/ha per cm and 3.48, respectively). In the first year, dwarf varieties Mott and Taiwan A-146 2.37 showed less RUE (0.89 and 0.84 g dry matter (DM)/MJ, respectively) than the elephant B (1.46 g DM/MJ). Higher non-fibre carbohydrate (NFC) contents were found in dwarf Mott under monocrop (180 g/kg) and in the intercrop systems. Tall varieties elephant B and IRI-381 showed greater efficiency in intercepting the radiation to accumulate herbage via stem accumulation. Dwarf Mott variety exhibited short stems and great leaf biomass accumulation that favoured denser canopies with higher content of NFCs in vegetal tissue. Planting butterfly pea into rows of elephant grass varieties can be adopted with no significant losses in RUE caused by light extinction, regardless of the grass stature.