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Clinical progression during psychosis has been closely associated with grey matter abnormalities resulting from atypical brain development. However, the complex interplay between psychopathology and heterogeneous maturational trajectories challenges the identification of neuroanatomical features that anticipate symptomatic decline.
Aims
To investigate cortical volume longitudinal deviations in first-episode psychosis (FEP) using normative modelling, exploring their relationship with long-term cognitive and symptomatic outcomes, as well as their cytoarchitectural and neurobiological underpinnings.
Method
We collected magnetic resonance imaging (MRI), cognitive and symptomatic data from 195 healthy controls and 357 drug-naïve or minimally medicated FEP individuals that were followed up 1, 3, 5 and 10 years following the first episode (1209 MRI scans and assessments in total). Using normative modelling, we derived subject-specific centile scores for cortical volume to investigate atypical deviations in FEP and their relationship to long-term cognitive and symptomatic deterioration. The resulting centile association maps were further characterised by examining their cytoarchitectural and neurobiological attributes using normative atlases.
Results
FEP centiles demonstrated a widespread reduction at treatment initiation, with longitudinal analysis showing an increase during treatment time, indicating convergence towards normal maturation trajectories. Interestingly, this effect was reduced in highly medicated individuals. Additionally, we found that cognitive impairments experienced during early FEP stages worsened under long-term medication. Positive symptomatology was negatively associated with regional centiles, and individuals with higher centiles benefited most from treatment. Cytoarchitectural and neurobiological analyses revealed that regional centiles related to FEP, as well as to symptomatology, were associated with specific molecular features, such as regional serotonin and dopamine receptor densities.
Conclusions
Collectively, these findings underscore the potential use of centile-based normative modelling for a better understanding of how atypical cortical development contributes to the long-term clinical progression of neurodevelopmental conditions.
Predicting long-term outcome trajectories in psychosis remains a crucial and challenging goal in clinical practice. The identification of reliable neuroimaging markers has often been hindered by the clinical and biological heterogeneity of psychotic disorders and the limitations of traditional case-control methodologies, which often mask individual variability. Recently, normative brain charts derived from extensive magnetic resonance imaging (MRI) data-sets covering the human lifespan have emerged as a promising biologically driven solution, offering a more individualised approach.
Aims
To examine how deviations from normative cortical and subcortical grey matter volume (GMV) at first-episode psychosis (FEP) onset relate to symptom and functional trajectories.
Method
We leveraged the largest available brain normative model (N > 100 000) to explore normative deviations in a sample of over 240 patients with schizophrenia spectrum disorders who underwent MRI scans at the onset of FEP and received clinical follow-up at 1, 3 and 10 years.
Results
Our findings reveal that deviations in regional normative GMV at FEP onset are significantly linked to overall long-term clinical trajectories, modulating the effect of time on both symptom and functional outcome. Specifically, negative deviations in the left superior temporal gyrus and Broca’s area at FEP onset were notably associated with a more severe progression of positive and negative symptoms, as well as with functioning trajectories over time.
Conclusions
These results underscore the potential of brain developmental normative approaches for the early prediction of disorder progression, and provide valuable insights for the development of preventive and personalised therapeutic strategies.
We investigated which objective language proficiency tests best predict the language dominance, balance, English and Spanish proficiency scores relative to Oral Proficiency Interview (OPI) scores (averaged across 5–6 raters). Eighty Spanish–English bilinguals completed OPIs, picture naming, semantic and letter fluency, lexical decision tests and a language history questionnaire. Except for letter fluency, objective measures explained more variance than self-report variables, which seldom and negligibly improved proficiency prediction beyond objective measures in forward regression models. Picture naming (the Multilingual Naming Test (MINT) Sprint 2.0) was the strongest predictor for most purposes. Lexical decision and category fluency were next best predictors, but the latter was time-consuming to score, while the former was easiest to administer (and does not require bilingual examiners). Surprisingly, self-rated proficiency better predicted the OPI scores when averaged across modalities (i.e., including reading/writing instead of just spoken proficiency), and lexical-decision (a written test) was as powerful as picture naming for predicting spoken Spanish (but not language dominance).
Introduction: In public discourse and media, as well as in medical settings, dementia is often portrayed as a tragedy, a perspective that contributes to stigma. Descriptions using metaphors like decaying fruit, or statements labeling dementia as death in life’’ and a tsunami for healthcare systems,’’ not only perpetuate negative emotions like fear and helplessness, but also promote social distance. These dehumanizing expressions can intensify the suffering of those living with dementia and those around them, besides complicating understanding of the condition, exacerbating social isolation, and hindering timely medical attention. Questioning the narrative of dementia as a tragedy does not imply denying or underestimating the challenges and suffering associated with this condition. However, diagnosis should not hinder the recognition of moments of pleasure, the potential for internal growth of the person living with dementia and those around them, as well as the persistence of connection and dignity. The philosophy of ambiguity offers a useful framework for countering a stigmatizing narrative and addressing dementia with a more compassionate and nuanced approach. The philosophy of ambiguity, primarily expounded by Simone de Beauvoir, invites us to recognize the coexistence of multiple realities and the simultaneous presence of contradictions. This is reflected in the complex contradictions and paradoxes present in our experiences, both personal and social. Health itself is an ambiguous concept, representing not only the absence of illness but also a dynamic and multifaceted state, culturally and contextually influenced. By focusing on preserved abilities, we can contribute to the well-being of those living with dementia, reinforcing their dignity and self-esteem. The success of this approach depends on having adequate social support and an effective healthcare system. Understanding dementia in a broad social and cultural context allows us to overcome the traditional Manichean view that categorizes it strictly as either tragedy or well-being. It is crucial for medical personnel to use empathetic and respectful communication to maintain dignity and foster hope in those living with dementia. Listening carefully and avoiding stigmatizing language are fundamental to recognizing individual worth and creating a more compassionate and humane care environment.
Suicidal behavior constitutes a multi-cause phenomenon that may also be present in people without a mental disorder. This study aims to analyze suicidal behavior outcomes in a sample of attempters, from a symptom-based approach.
Methods
The sample comprised 673 patients (72% female; M = 40.9 years) who attended a hospital emergency department due to a suicide attempt. A wide range of clinical factors (e.g., psychopathology symptoms, psychiatric diagnoses, impulsivity, acquired capability), was administered within 15 days after the index attempt. Nine psychopathology domains were explored to identify the profile of symptoms, using latent profile analysis. The relationship between the profile membership and suicide outcome (i.e., intensity of suicidal ideation, number of suicide behaviors, and medical injury derived from index attempt) was also studied, using linear and logistic regression.
Results
Three psychopathology profiles were identified: high-symptom profile (45.02% of participants), moderate-symptom profile (42.50%), and low-symptom profile (12.48%). High-symptom profile members were more likely to show higher risk of non-suicidal self-injury, acquired capability for suicide, and more severe suicide behavior and ideation. On the other hand, a more severe physical injury was associated with low-symptom profile membership in comparison to membership from the other profiles (OR < 0.45, p < .05).
Conclusions
A symptom-based approach may be useful to monitor patients and determine the risk of attempt repetition in the future and potential medical injury, and to optimize prevention and intervention strategies.
The relevance of family relationships in the outcome of various disorders has been highlighted from different domains. Specifically, empirical studies on the relationship between the outcome of schizophrenia and various affective dimensions of family relationships have allowed the identification of particularly relevant aspects: criticism, hostility, and over-protection.
Aims:
The present study aims to adapt and validate an abbreviated Spanish version of the Influential Relationship Questionnaire (IRQ), an instrument that measures the patient’s own perception of the affective dimensions of family relationships.
Method:
Participants were 188 patients (63.8% male) of the Public Health Service in Andalusia (Spain) with a diagnosis of schizophrenia or a related disorder. One hundred and thirty-six participants provided data related to both father and mother, and 52 only related to mother or father, so the analyses were carried out with a total of 324 questionnaires. Simultaneously, in 130 participants, the Perceived Criticism Scale was applied, and in 50 cases, relatives were asked to complete the Family Attitudes Scale.
Results:
Principal component analysis allowed for the identification of four factors that explained 61.53% of the total variance (criticism, over-protection, restriction, and care). The values of Cronbach’s alpha coefficient, as well as the omega coefficient, showed high consistency. The temporal reliability for an interval of 3 months was high. The correlations between the IRQ dimensions and the other variables included in the study were significant and in the expected direction.
Conclusions:
The results support the reliability and validity of the abbreviated version of the IRQ.
We construct inhomogeneous isoparametric families of hypersurfaces with non-austere focal set on each symmetric space of non-compact type and rank ${\geq }3$. If the rank is ${\geq }4$, there are infinitely many such examples. Our construction yields the first examples of isoparametric families on any Riemannian manifold known to have a non-austere focal set. They can be obtained from a new general extension method of submanifolds from Euclidean spaces to symmetric spaces of non-compact type. This method preserves the mean curvature and isoparametricity, among other geometric properties.
Understanding the evolution of negative symptoms in first-episode psychosis (FEP) requires long-term longitudinal study designs that capture the progression of this condition and the associated brain changes.
Aims
To explore the factors underlying negative symptoms and their association with long-term abnormal brain trajectories.
Method
We followed up 357 people with FEP over a 10-year period. Factor analyses were conducted to explore negative symptom dimensionality. Latent growth mixture modelling (LGMM) was used to identify the latent classes. Analysis of variance (ANOVA) was conducted to investigate developmental trajectories of cortical thickness. Finally, the resulting ANOVA maps were correlated with a wide set of regional molecular profiles derived from public databases.
Results
Three trajectories (stable, decreasing and increasing) were found in each of the three factors (expressivity, experiential and attention) identified by the factor analyses. Patients with an increasing trajectory in the expressivity factor showed cortical thinning in caudal middle frontal, pars triangularis, rostral middle frontal and superior frontal regions from the third to the tenth year after the onset of the psychotic disorder. The F-statistic map of cortical thickness expressivity differences was associated with a receptor density map derived from positron emission tomography data.
Conclusions
Stable and decreasing were the most common trajectories. Additionally, cortical thickness abnormalities found at relatively late stages of FEP onset could be exploited as a biomarker of poor symptom outcome in the expressivity dimension. Finally, the brain areas with less density of receptors spatially overlap areas that discriminate the trajectories of the expressivity dimension.
The Francoist regime constructed the Valley of the Fallen between 1940 and 1959, allegedly as a monument to reconciliation after the civil war (1936–1939). The dictator continued repressing Republicans and portraying them as an alliance of forces to destroy Spain, while simultaneously using the Valley to declare peace and impose a narrative of fraternity. Hence, the Valley became the centralized artifact of the civil war’s commemoration, to which all other memorials around the country would ultimately refer because of its central location and concentration of burials: almost thirty-four thousand bodies of people killed during the civil war were transferred from mass graves all around the country to the Valley’s ossuaries, in most cases without the consent, or even awareness, of their families.
Upon Franco’s death in 1975, the dictator’s tomb was placed in the Valley as well, occupying the most prominent location near the basilica’s main altar, alongside Falange’s founder José Antonio Primo de Rivera. Despite the pro-Franco demonstrations and the philo-Fascist mass services it has regularly hosted, the Valley has remained under the care of National Patrimony, funded by Spanish taxpayers, and this state of affairs went mostly uncontested until the first few years of the twenty-first century. By the turn of the millennium, the grassroots Association for the Recovery of Historical Memory (ARHM) had started mapping and exhuming mass graves, as well as raising awareness about the need to intervene in the Valley by identifying the bodies buried there against the victims’ and their families’ will, exhuming the dictator’s body, and resignifying the space.
This work by ARHM triggered in Spain what has been called “the memory boom” of the 2000s, in which collective and individual memory was used as an alternative, even a counter-narrative, for telling the story of the war and the post-war through literature, the visual arts, activism, and academia. Eventually, this new sensibility materialized in legislation. José Luis Rodríguez Zapatero’s socialist government (2004–2011) passed the 52/2007 Law, commonly known as the Historical Memory Law, which obliged the removal of Francoist monuments, toponymy, and other symbols that eulogized the dictatorship. This included the Valley of the Fallen, although its physical removal is not possible: the memorial is excavated out of the rock; the basilica and cross is composed of many tons of granite; and it hosts thousands of bodies, mostly of Republicans.
Pneumonia is a respiratory condition with complex etiology. Host genetic variation is thought to contribute to individual differences in susceptibility and symptom manifestation. Here, we analyze pneumonia data from the UK Biobank (14,780 cases and 439,096 controls) and FinnGen (9980 cases and 86,519 controls) and perform a genomewide association study meta-analysis. We use gene-based tests, colocalization, genetic correlation, latent causal variable (LCV) and polygenic prediction in an independent Australian sample (N = 5595) to draw insights into the etiology of pneumonia risk. We identify two independent loci on chromosome 15 (lead single-nucleotide polymorphisms rs2009746 and rs76474922) to be associated with pneumonia (p < 5e−8). Gene-based tests revealed 18 genes in chromosomes 15, 16 and 9, including IL127, PBX3, ApoB receptor (APOBR) and smoking related genes CHRNA3/5, statistically associated with pneumonia. We observed genetic correlations between pneumonia and cardiorespiratory, psychiatric and inflammatory related traits. LCV analysis suggests a strong genetic causal relationship with cardiovascular health phenotypes. Polygenic risk scores for pneumonia significantly predicted self-reported pneumonia in an independent sample, albeit with a small effect size (OR = 1.11 95% CI [1.04, 1.19], p < .05). Sensitivity analyses suggested the associations in chromosome 15 are mediated by smoking history, but the associations in chromosomes 16 and 9, and polygenic prediction were robust to adjustment for smoking. Altogether, our results highlight common genetic variants, genes and potential pathways that contribute to individual differences in susceptibility to pneumonia, and advance our understanding of the genetic factors underlying heterogeneity in respiratory medical outcomes.
More and more studies indicate that leisure plays a fundamental role in active ageing. Our study describes the current leisure patterns of older adults, comparing them with other age groups. Consequently, 445 adults, stratified by age (young, middle-aged and older adults), were selected and subsequently administered a set of tests. The results indicate that older people claim having more time for their leisure activities; however, the diversity of activities performed is lower, showing a negative gradient based on age. The leisure patterns of older people reflect a predominance of passive leisure, little cultural leisure time and moderate levels of social and physical leisure activities. Older people’s leisure seems to be influenced by ageist stereotypes and attribution biases. Our findings imply that these results could be used to design and implement programs aimed at promoting leisure styles that contribute to increase active ageing.
Data on short-term peripheral intravenous catheter–related bloodstream infections per 1,000 peripheral venous catheter days (PIVCR BSIs per 1,000 PVC days) rates from Latin America are not available, so they have not been thoroughly studied.
Methods:
International Nosocomial Infection Control Consortium (INICC) members conducted a prospective, surveillance study on PIVCR BSIs from January 2010 to March 2018 in 100 intensive care units (ICUs) among 41 hospitals, in 26 cities of 9 countries in Latin America (Argentina, Brazil, Colombia, Costa Rica, Dominican-Republic, Ecuador, Mexico, Panama, and Venezuela). The Centers for Disease Control and Prevention (CDC) National Health Safety Network (NHSN) definitions were applied, and INICC methodology and INICC Surveillance Online System software were used.
Results:
In total, 10,120 ICU patients were followed for 40,078 bed days and 38,262 PVC days. In addition, 79 PIVCR BSIs were identified, with a rate of 2.06 per 1,000 PVC days (95% confidence interval [CI], 1.635–2.257). The average length of stay (ALOS) of patients without a PIVCR BSI was 3.95 days, and the ALOS was 5.29 days for patients with a PIVCR BSI. The crude extra ALOS was 1.34 days (RR, 1.33; 95% CI, 1.0975–1.6351; P = .040).
The mortality rate in patients without PIVCR BSI was 3.67%, and this rate was 6.33% in patients with a PIVCR BSI. The crude extra mortality was 1.70 times higher. The microorganism profile showed 48.5% gram-positive bacteria (coagulase-negative Staphylococci 25.7%) and 48.5% gram-negative bacteria: Acinetobacter spp, Escherichia coli, and Klebsiella spp (8.5% each one), Pseudomonas aeruginosa (5.7%), and Candida spp (2.8%). The resistances of Pseudomonas aeruginosa were 0% to amikacin and 50% to meropenem. The resistance of Acinetobacter baumanii to amikacin was 0%, and the resistance of coagulase-negative Staphylococcus to oxacillin was 75%.
Conclusions:
Our PIVCR BSI rates were higher than rates from more economically developed countries and were similar to those of countries with limited resources.
Mating strategy and sexual dimorphism of morphological traits of the leucosiid crab Pyrhila pisum were elucidated by analysing relative growth patterns of chelipeds and abdomen, and gonad development patterns. Male adults had long chelipeds compared with juvenile males and females. Among male adults, two phases with different slopes could be found in the regression lines; their chelipeds growth pattern changed from negative allometry to positive and longer chelipeds developed in large adults. The growth is more markedly expressed in the merus than in the propodus. Female adults had wider abdominal segments and a thicker body compared with juvenile females and males. Abdomen of females was greatly enlarged by a puberty moult. Male adults had well-developed gonads similar to female adults, and the weights of male gonads were often larger than those of females of the same body size. For adult males, a negative correlation was detected between carapace width and the weight ratio of their gonads, but no significant relationship was detected for adult females. Females had large and well-bloated seminal receptacles, whose weight was nearly equal to gonad weight. There was little difference in the amount of seminal receptacles regardless of the body size of females. There is a trade-off relationship in the development between chelipeds and gonads in adult males. Probably young adult males compensate for the disadvantageous condition of guarding by increasing the number of spermatozoids, and old adult males invest more of their energy to their chelae for guarding while decreasing investment in sperm production.
Mating behaviour of the leucosiid crab Pyrhila pisum was studied in the laboratory and tidal flats in Japan. Most males actively approached females. Males started guarding females without any courtship behaviour (pre-copulatory guarding). Males began copulation within several minutes. The copulation continued for about 1–2 h, following which males began post-copulatory guarding. This guarding lasted from almost 0 to over 3 days, but its duration was generally much longer than that prior to copulation. Release of guarding was not linked to ovulation by females. Long-term rearing experiments revealed that both sexes of P. pisum could copulate multiple times with various mates. Developmental stages of the embryos recorded from copulating ovigerous females widely varied; their timing of copulation may not be fixed. In the tidal flat, wandering males frequently contacted with other individuals, but without distinguishing single males, single females and pairs of P. pisum, or Hemigrapsus takanoi. Male P. pisum cannot recognize female conspecifics, and they approach their mates relying only on vision, without using any attractive cues from females. In cases in which males encountered pairing crabs, they successfully stole the females when the guardians were smaller than the challengers, suggesting that effectiveness of guarding depends on male size. Among the mating pairs, males tended to be larger than females, and the tendency of size-assortative mating was weak or absent. Therefore, the mating behaviour of P. pisum is not elaborate, although their guarding behaviour may contribute to improve success to some degree.
Studies of abundance and distribution of organisms are fundamental to ecology. The identity of host species is known to be one of the major factors influencing ectoparasitic flea abundance, but explanations are still needed regarding how host taxa influence abundance parameters of different flea species. This study was carried out at La Malinche National Park (LMNP), Tlaxcala, Mexico, where previously 11 flea species had been recorded on 8 host species. Our aims were to list micromammal flea species, to determine flea infection parameters [flea prevalence (FP) and flea mean abundance (FMA)] and to analyse the influence of host species on these parameters. A total of 16 species of fleas were identified from 1178 fleas collected from 14 species of 1274 micromammals captured with Sherman® traps from March 2014 to December 2015 in 18 sites at LMNP. Some host species influence FP and FMA, in particular, Microtus mexicanus and Peromyscus melanotis showed particularly higher infection values than other host species. Plusaetis aztecus and Plusaetis sibynus were identified as the most abundant flea species.
Plant–animal mutualistic interactions through ecological network systems and the environmental conditions in which they occur, allow us to understand patterns of species composition and the structure and dynamics of communities. We evaluated whether flower morphologies with different pollination syndromes (ornithophilous and non-ornithophilous) are used by hummingbirds and whether these characteristics affect the structure (core-peripheral species) of hummingbird networks. Observations were made in flowering patches, where plant–hummingbird interactions were recorded at three altitudes (300–2500 m) during three seasons (dry, rainy and post-rainy) from 2015 to 2016 at El Triunfo Biosphere Reserve, Chiapas, Mexico. We recorded 15 hummingbird species interacting with 58 plant species, and the greatest number of interacting hummingbird species (11; 14) and plant species (28; 40) were found at middle altitudes and during the dry season, respectively. In all study sites, most of the plant species visited by hummingbirds had an ornithophilous syndrome (67%) at high altitudes (22 plant species) and during the dry season (26 plant species), but more individual hummingbirds visited non-ornithophilous plant species. The hummingbird species at high altitudes exhibited the greatest level of specialization towards plants (H2′ = 0.74), but the networks of plant-hummingbird interactions were generalist (H2′ = 0.25); i.e. visiting plants with both syndromes, at low altitudes. The core generalist hummingbird species remained constant with altitude and season, but the core generalist plant species varied between different altitudes and seasons according to the phenology of the species.