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Proton acceleration from optically tailored high-density gas jet targets
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- A. Maitrallain, J.-R. Marquès, K. Bontemps, J. Bonvalet, E.F. Atukpor, V. Bagnoud, T. Carrière, F. Hannachi, J.L. Henares, J. Hornung, A. Huber, E. d'Humières, L. Lancia, P. Loiseau, P. Nicolaï, J. Santos, V. Tikhonchuk, B. Zielbauer, M. Tarisien
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- Journal:
- Journal of Plasma Physics / Volume 90 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 25 April 2024, 965900201
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Laser-driven ion acceleration is well established using solid targets mainly in the target normal sheath acceleration regime. To follow the increasing repetition rate available on high-intensity lasers, the use of high-density gas targets has been explored in the past decade. When interacting with targets reaching densities close to the critical one, the laser pulse can trigger different acceleration mechanisms such as Collisionless Shock Acceleration (CSA) or hole boring. Particle-in-cell simulations using ideal target profiles show that CSA can accelerate a collimated, narrow energy spread and few hundreds of megaelectronvolts ion beam on the laser axis. Nevertheless, in real experiments, the laser will not only interact with an overcritical, thin plasma slab with sharp density gradients, but also with lower density regions surrounding the core of the gas jet, extending to several hundreds of micrometres. The interaction of the laser with these lower density wings will lead to nonlinear effects that will reduce the available energy to drive the shock in the high-density region of the target. Optically tailoring this target could mitigate that issue. Recent experiments conducted on different laser facilities aimed at testing several tailoring configurations. We first tested a scheme with a copropagating picosecond prepulse to create a lower density plasma channel to facilitate the propagation of the main pulse, while the second one was a transverse tailoring driven by nanosecond laser pulses to generate blast waves and form a high-density plasma slab. The main results will be presented here and the methods compared.
Helminth parasites of the Eurasian otter Lutra lutra in southwest Europe
- J. Torres, C. Feliu, J. Fernández-Morán, J. Ruíz-Olmo, R. Rosoux, M. Santos-Reis, J. Miquel, R. Fons
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- Journal of Helminthology / Volume 78 / Issue 4 / December 2004
- Published online by Cambridge University Press:
- 12 April 2024, pp. 353-359
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The helminth fauna in 109 Eurasian otters (Lutra lutra L.) from France, Portugal and Spain was analysed, together with 56 faecal samples collected in Portugal and 23 fresh stools from otters included in a reintroduction programme. Seven helminth species were found in L. lutra in southwest Europe: Phagicola sp. (Trematoda), Aonchotheca putorii, Eucoleus schvalovoj, Strongyloides lutrae, Anisakis (third stage larvae) and Dirofilaria immitis (Nematoda), and Gigantorhynchus sp. (Acanthocephala). Eucoleus schvalovoj was the dominant species throughout southwest Europe. Strongyloides lutrae was significantly more prevalent in the Iberian Peninsula than in France. Apart from these two dominant nematodes and A. putorii, the other helminth species were incidental parasites of L. lutra in southwest Europe. The helminth fauna of L. lutra in southwest Europe is, in general, poorer than that reported in eastern Europe and in all other aquatic mustelids in southwest Europe. Phagicola specimens are reported for the first time in a non-marine wild carnivore in Europe. The prevalences of E. schvalovoj and S. lutrae obtained by necropsy were higher than those observed by coprological analysis using a formalin-ether concentration method (Ritchie). Nevertheless, the culture of fresh faeces appears to be the best method to study infection of L. lutra by Strongyloides.
482 Improvement of health outcomes and quality of life of Hispanic older adults in Puerto Rico through participation in a Physical Activity (PA) Community-based Program
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- Felix J. Roman - Hernandez, Maria Danet Lapiz - Bluhm, Abdiel Gomez – Santos, Wilnelys M. Montalvo – Caraballo
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- Journal:
- Journal of Clinical and Translational Science / Volume 8 / Issue s1 / April 2024
- Published online by Cambridge University Press:
- 03 April 2024, p. 142
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OBJECTIVES/GOALS: The proposed study aims to improve physical and mental health outcomes among Hispanic older adults who live alone in a low-income San Juan, Puerto Rico community through weekly PA groups. Specific outcomes include measures of loneliness, social isolation, depression, physical mobility, metabolic indicators, and other health indicators. METHODS/STUDY POPULATION: Data will be collected at three time points: Pre (Week 1), Mid (Week 6), and Post (Week 12) intervention. Currently, the community has 50 residents over 65 years old who live under the poverty index and receive multiple social benefits. Various tools will be implemented to measure loneliness (University of California Los Angeles – Loneliness Scale-10 items), social isolation (Lubben Social Network Scale-6 items), depression (Geriatric Depression Scale-10 items), physical mobility (Time Up and Go Test), metabolic health indicators (hemoglobin A1c and glucose) and other health indicators (i.e., blood pressure, cholesterol, as well as body mass index (BMI)). These measurements will determine if participation in PA groups is associated with improvement of the variables measured. RESULTS/ANTICIPATED RESULTS: It is expected that the baseline scores of older Hispanic adults in terms of loneliness, social isolation, depression, physical mobility, metabolic indicators (i.e., cholesterol level and hemoglobin A1c), and other health indicators (blood pressure or BP and BMI) will be lower compared to those after participation in the Physical Activity Program. More frequent participation will be associated with more significant improvement in measured variables. DISCUSSION/SIGNIFICANCE: Results from this study will determine the effectiveness of community-based PA interventions in addressing loneliness, social isolation, depression, physical mobility, and metabolic factors (hemoglobin A1c and glucose) in elderly minority Hispanic populations as a means of improving their health outcomes and quality of life.
403 Epithelial hypoxia maintains colonization resistance against Candida albicans
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- Derek J. Bays, Hannah P. Savage, Connor Tiffany, Mariela A. F. Gonzalez, Eli. J. Bejarano, Henry Nguyen, Hugo L. P. Masson, Thaynara P. Carvalho, Renato L. Santos, Andrew Tritt, Suzanne M. Noble, George R. Thompson, Andreas J. Bäumler
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- Journal:
- Journal of Clinical and Translational Science / Volume 8 / Issue s1 / April 2024
- Published online by Cambridge University Press:
- 03 April 2024, pp. 119-120
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OBJECTIVES/GOALS: Antibiotic treatment sets the stage for intestinal domination by Candida albicanswhich is necessary for development of invasive disease, but the resources driving this bloom remain poorly defined. We sought to determine these factors in order to design novel prophylaxis strategies for reducing gastrointestinal (GI) colonization. METHODS/STUDY POPULATION: We initially developed a generalizable framework, termed metabolic footprinting to determine the metabolites C. albicanspreferentially uses in the mouse GI tract. After identifying the metabolites C. albicansutilizes, we usedin vitro growth assays in the presence and absence of oxygen to validate out metabolomics findings. We next determined if a probiotic E. coli that utilizes oxygen would reduce C. albicanscolonization compared to a mutant E. coli that could not respire oxygen. Finding that oxygen was a necessary resource, we utilized germ-free mice to determine if Clostridiaspp. known to reduce GI oxygen would prevent C. albicanscolonization. Lastly, we sought to see if 5-aminosalicylic acid (5-ASA) could prevent C. albicanscolonization. RESULTS/ANTICIPATED RESULTS: We found that C. albicans preferentially utilizes simple carbohydrates including fructo-oligosaccharides (e.g., 1-kestose), disaccharides (e.g., β-gentiobiose), and alcoholic sugars (e.g., sorbitol) and is able to grow in vitro on minimal media supplemented with either of these nutrients. However, in the hypoxic environment that is found in the “healthy” colon, C. albicans cannot utilize these nutrients. We next found that pre-colonization in a mouse model with a probiotic E. coli significantly reduced C. albicanscolonization, but the mutant E. coli had no effect on colonization. We next showed that Clostridia supplementation restored GI hypoxia and reduced C. albicanscolonization. Remarkably, we found that 5-ASA significantly reduced GI colonization of C. albicans. DISCUSSION/SIGNIFICANCE: We have shown that C. albicans requires oxygen to colonize the GI tract. Importantly, we found that 5-ASA can prevent an antibiotic mediated bloom of C. albicans by restoring GI hypoxia, which warrants additional studies to determine if 5-ASA can be used as an adjunctive prophylactic treatment in high risk patients.
Nutritional composition of ultra-processed plant-based foods in the out-of-home environment: a multi-country survey with plant-based burgers
- R. E. Vellinga, H. L. Rippin, B. G. Gonzales, E. H. M. Temme, C. Farrand, A. Halloran, B. Clough, K. Wickramasinghe, M. Santos, T. Fontes, M. J. Pires, A. C. Nascimento, S. Santiago, H. E. Burt, M. K. Brown, K. H. Jenner, R. Alessandrini, A. M. Marczak, R. Flore, Y. Sun, C. Motta
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- Journal:
- British Journal of Nutrition , First View
- Published online by Cambridge University Press:
- 15 January 2024, pp. 1-8
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Ultra-processed plant-based foods, such as plant-based burgers, have gained in popularity. Particularly in the out-of-home (OOH) environment, evidence regarding their nutritional profile and environmental sustainability is still evolving. Plant-based burgers available at selected OOH sites were randomly sampled in Amsterdam, Copenhagen, Lisbon and London. Plant-based burgers (patty, bread and condiment) (n 41) were lab analysed for their energy, macronutrients, amino acids and minerals content per 100 g and serving and were compared with reference values. For the plant-based burgers, the median values per 100 g were 234 kcal, 20·8 g carbohydrates, 3·5 g dietary fibre and 12·0 g fat, including 0·08 g TFS and 2·2 g SFA. Protein content was 8·9 g/100 g, with low protein quality according to amino acid composition. Median Na content was 389 mg/100 g, equivalent to 1 g salt. Compared with references, the median serving provided 31% of energy intake based on a 2000 kcal per day and contributed to carbohydrates (17–28%), dietary fibre (42%), protein (40%), total fat (48%), SFA (26%) and Na (54%). One serving provided 15–23% of the reference values for Ca, K and Mg, while higher contributions were found for Zn, Mn, P and Fe (30–67%). The ultra-processed plant-based burgers provide protein, dietary fibre and essential minerals and contain relatively high levels of energy, Na and total fats. The amino acid composition indicated low protein quality. The multifaceted nutritional profile of plant-based burgers highlights the need for manufacturers to implement improvements to better support healthy dietary habits, including reducing energy, Na and total fats.
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:
- 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.
Water use efficiency and yield responses of Cenchrus purpureus genotypes under irrigation
- R. E. P. Ribeiro, A. C. L. Mello, M. V. Cunha, M. V. F. Santos, S. B. M. Costa, J. J. Coelho, R. O. Carvalho, V. J. Silva
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- The Journal of Agricultural Science / Volume 161 / Issue 4 / August 2023
- Published online by Cambridge University Press:
- 07 September 2023, pp. 572-580
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In tropical regions, water stress is one of the main causes of the reduction in forage productivity, and irrigation strategies can mitigate the problem, especially for highly productive species. The objective of this study was to evaluate the effects of irrigation, genotype and plant size on productive responses and water use efficiency (WUE) of elephant grass (Cenchrus purpureus [Schumach.] Morrone), in the rainy and dry season. The experimental design was randomized in blocks, arranged in split plots, the main plots were established based on the use of irrigation and the subplots were the tall-sized genotypes (IRI 381 and Elephant B) and dwarfs (Taiwan A-146 2.37 and Mott). The genotypes were evaluated for two years and harvested every 60 days. Water use efficiency, total forage accumulation per year and harvest, forage accumulation rate and forage density were evaluated. There was a significant difference between the genotypes in terms of total forage accumulated (P < 0.05). The most productive genotype was IRI 381, which showed the greatest total forage accumulation (42 168 kg of DM/ha in two years) in the irrigated plots. During the rainy seasons, IRI 381 stood out in terms of forage accumulated (24 667 kg of DM/ha). Irrigation favoured increases in forage accumulation around 60%, in both years of evaluation. Irrigation and plant size influenced the productivity and WUE of elephant grass harvested in 60-day intervals. Tall genotypes and Taiwan A-146 2.37 (dwarf size) stood out in most of the productive traits analysed, while Mott was highlighted by its forage density.
Coronavirus disease 2019 is associated with long-term depressive symptoms in Spanish older adults with overweight/obesity and metabolic syndrome
- Sangeetha Shyam, Carlos Gómez-Martínez, Indira Paz-Graniel, José J. Gaforio, Miguel Ángel Martínez-González, Dolores Corella, Montserrat Fitó, J. Alfredo Martínez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque, Dora Romaguera, José López-Miranda, Ramon Estruch, Francisco J. Tinahones, José Manuel Santos-Lozano, J. Luís Serra-Majem, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín Sánchez, Xavier Pintó, María Ortiz Ramos, Josep Vidal, Maria Mar Alcarria, Lidia Daimiel, Emilio Ros, Fernando Fernandez-Aranda, Stephanie K. Nishi, Oscar García Regata, Estefania Toledo, Jose V. Sorli, Olga Castañer, Antonio Garcia-Rios, Rafael Valls-Enguix, Napoleon Perez-Farinos, M. Angeles Zulet, Elena Rayó-Gago, Rosa Casas, Mario Rivera-Izquierdo, Lucas Tojal-Sierra, Miguel Damas-Fuentes, Pilar Buil-Cosiales, Rebeca Fernández-Carrion, Albert Goday, Patricia J. Peña-Orihuela, Laura Compañ-Gabucio, Javier Diez-Espino, Susanna Tello, Ana González-Pinto, Víctor de la O, Miguel Delgado-Rodríguez, Nancy Babio, Jordi Salas-Salvadó
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- Journal:
- Psychological Medicine / Volume 54 / Issue 3 / February 2024
- Published online by Cambridge University Press:
- 05 September 2023, pp. 620-630
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Background
The coronavirus disease 2019 (COVID-19) has serious physiological and psychological consequences. The long-term (>12 weeks post-infection) impact of COVID-19 on mental health, specifically in older adults, is unclear. We longitudinally assessed the association of COVID-19 with depression symptomatology in community-dwelling older adults with metabolic syndrome within the framework of the PREDIMED-Plus cohort.
MethodsParticipants (n = 5486) aged 55–75 years were included in this longitudinal cohort. COVID-19 status (positive/negative) determined by tests (e.g. polymerase chain reaction severe acute respiratory syndrome coronavirus 2, IgG) was confirmed via event adjudication (410 cases). Pre- and post-COVID-19 depressive symptomatology was ascertained from annual assessments conducted using a validated 21-item Spanish Beck Depression Inventory-II (BDI-II). Multivariable linear and logistic regression models assessed the association between COVID-19 and depression symptomatology.
ResultsCOVID-19 in older adults was associated with higher post-COVID-19 BDI-II scores measured at a median (interquartile range) of 29 (15–40) weeks post-infection [fully adjusted β = 0.65 points, 95% confidence interval (CI) 0.15–1.15; p = 0.011]. This association was particularly prominent in women (β = 1.38 points, 95% CI 0.44–2.33, p = 0.004). COVID-19 was associated with 62% increased odds of elevated depression risk (BDI-II ≥ 14) post-COVID-19 when adjusted for confounders (odds ratio; 95% CI 1.13–2.30, p = 0.008).
ConclusionsCOVID-19 was associated with long-term depression risk in older adults with overweight/obesity and metabolic syndrome, particularly in women. Thus, long-term evaluations of the impact of COVID-19 on mental health and preventive public health initiatives are warranted in older adults.
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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- Journal:
- 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.
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
Searching for bridges between psychopathology and real-world functioning in first-episode psychosis: a network analysis from the OPTiMiSE trial
- F. Dal Santo, E. Fonseca-Pedrero, M. P. García-Portilla, L. González-Blanco, P. A. Sáiz, S. Galderisi, G. M. Giordano, J. Bobes
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S262-S263
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Introduction
Network analysis has been used to explore the interplay between psychopathology and functioning in psychosis, but no study has used dedicated statistical techniques to focus on the bridge symptoms connecting these domains.
ObjectivesThe current study aims to estimate the network of depressive, negative, and positive symptoms, general psychopathology, and real-world functioning in people with first-episode schizophrenia or schizophreniform disorder, focusing on bridge nodes.
MethodsBaseline data from the OPTiMiSE trial were analysed. The sample included 446 participants (age 40.0±10.9 years, 70% males). The network was estimated with a Gaussian graphical model (GGM), using scores on individual items of the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), and the Personal and Social Performance (PSP) scale. Stability, strength centrality, expected influence (EI), predictability, and bridge centrality statistics were computed. The top 20% scoring nodes on bridge strength were selected as bridge nodes.
ResultsNodes from different rating scales assessing similar psychopathological and functioning constructs tended to cluster together in the estimated network (Fig. 1). The most central nodes (EI) were Delusions, Emotional Withdrawal, Depression, and Depressed Mood. Bridge nodes included Depression, Conceptual Disorganisation, Active Social Avoidance, Delusions, Stereotyped Thinking, Poor Impulse Control, Guilty Feelings, Unusual Thought Content, and Hostility. Most of the bridge nodes belonged to the general psychopathology subscale of the PANSS. Depression (G6) was the bridge node with the highest value.
Image:
ConclusionsThe current study provides novel insights for understanding the complex phenotype of psychotic disorders and the mechanisms underlying the development and maintenance of comorbidity and functional impairment after psychosis onset.
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
Characterization of a population of transgender individuals and their perceived negative mental health and life experiences
- M. F. Santos, J. Mota, Z. Figueiredo
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S646
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Introduction
Gender dysphoria (GD) is characterized by a marked incongruence between one’s experienced/expressed gender and gender assigned at birth, associated with clinically significant distress or impairment in important areas of functioning. Persons with GD are a population with specific healthcare needs. In our hospital, psychiatric assessment of these individuals started in 2008.
ObjectivesCharacterization of a population of transgender individuals and their perceived negative mental health and life experiences.
MethodsSince the beginning of evaluations of transgender individuals in our hospital, from 2008 to 2022, they were asked to freely elaborate their “life story”: a report of the most relevant events in their lives, related to their condition. We retrospectively analyzed the content of the reports that were sent and associated with the clinical files.
ResultsWe collected the data of 104 individuals. The gender attributed at birth consisted of 74 (71.2%) females and 30 (28.8%) males. As for the gender identity, the sample consisted of 73 (70.2%) males, 28 (26.9%) females, 2 (1.9%) nonbinary and 1 (1%) person didn’t identify with any of the existent denominations. The medium age in October of 2022 was 27.4 (minimum 18, maximum 60, SD 7.3). The age at first evaluation at consult was 23.6 (minimum 15, maximum 56, SD 7.2). 99 (95.2%) individuals mentioned symptoms of gender non-conformity beginning in childhood, and of those who mentioned their adolescence (n=43, 41.3%), all expressed feelings of anguish relating to their changing bodies. The medium age of recognition of their condition was 17.2 (minimum 11, maximum 30, SD 4.3). Of those who recall their first contact with health practitioners regarding their symptoms (n=31, 29.8%), 32.3% admitted they didn’t feel they were helped. Of those who mentioned early relationships with family and carers (n=65, 62,5%), 35.4% reveal dysfunctional relationships and 79% mention gender expectations from their families. Similarly, 42 (40.4%) individuals reveal experiences of victimization and bullying because of their gender nonconformity. 53 (60.2%) described symptoms of a likely comorbid psychiatric illness throughout their life, particularly depressive symptoms, anxious symptoms, suicide attempts and non-suicidal self-injury.
ConclusionsGD has gained more attention in the recent years, and the scientific community has now developed a more accurate set of criteria for the recognition of this condition. The findings in our study are in accordance with these criteria. Unfortunately, much of the suffering this condition entails is also associated with distress related to stigma and societal gender expectations, and that was evident in this investigation.
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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- Journal:
- 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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- Journal:
- 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
The link between Pos-Traumatic Stress Disorder and Childbirth
- A. M. Fraga, A. Quintão, B. Mesquita, C. Melo Santos, F. Soares, J. Correia, M. Albuquerque, S. Neves, A. Moutinho, P. Cintra
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1124
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Introduction
Childbirth can be experienced as distressing or even traumatic for some women and her partners, which could cause psychological distress, intense fear or helplessness and increases the risk of anxiety, depression and even post-traumatic stress disorder (PTSD). The reported prevalence of post-traumatic stress disorder after childbirth ranges from 1.5% to 6%.
ObjectivesThe current study aimed to elaborate a narrative literature review to identify predictors associated development of PTSD in women and the partners.
MethodsPubMed database searched using the terms “post-traumatic stress disorder” and “childbirth” and “trauma”. Only research conducted in the past 20 years was considered for inclusion.
ResultsSeveral variables were associated with risk to development PTSD after childbirth, including negative experiences and severe fear of childbirth, subjetive distress, previous abortion, psychological difficulties in pregnancy, previous psychiatric problems, history of PTSD and trauma. Futhermore, obstretic and birth-related factors such as pregnancy complications, type of birth could also contribute to PTSD in women and her partners. Additionally, diferent environmental factors like poor interaction between provider and mother, low social support during labour and birth are associated with development of PTSD.
ConclusionsClinicians should be aware that many women and her parterns have a risk to development PTSD following childbirth. We need to research risk factors in routine clinical practice and carefully monitored the patients with high risk.
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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- Journal:
- 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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- Journal:
- 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