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Pictorial irony is another example of nonverbal irony. This chapter addresses the need for experimental work on these topics in light of the view that irony is deeply tied to human cognition and not just language. Katz examines different ways of distinguishing between irony and sarcasm, particularly in terms of “vector space theory,” which suggests that sarcasm is more aggressive, dark, and mocking than is irony. Additional empirical analyses note important distinctions in defining the notions of verbal vs. situational irony. Katz then applies his “constraint-satisfaction” model to create an open-ended list of visual features that likely signal the presence of irony or sarcasm in visual, including pictorial, displays. Katz argues that basic psychological processes involved in scene perception, which have deep evolutionary roots, are employed when people infer either sarcastic or ironic intents in pictures (including pictures with and without accompanying words). At the same time, similar psychological processes used in detecting pretense or echoic mention within language can also be adopted for understanding visual scenes as conveying sarcasm or irony. Expertise with some visual medium, such as painting, may enhance people’s abilities to readily interpret these as expressing irony in different ways.
The COVID-19 outbreak is a serious global public health issue with wide-ranging negative effects on people’s lives, which is reflected in steadily rising mental health problems. In order to appropriately respond to the increased occurrence of psychiatric illness, protect mental health and strengthen resilience it is necessary to include new technologies, such as extended reality (XR) or socially assistive robots (SAR) in not only psychiatric treatment but also in the prevention of psychiatric diseases. In this context, the use of new technologies offers innovative ways to strengthen resilience, self-efficacy and stress coping skills and plays an important role in improving psychological wellbeing.
Objectives
Preliminary results from studies at the Clinical Department of Psychiatry and Psychotherapeutic Medicine in Graz, Austria, dealing with new technologies in psychiatry, show new options for psychiatric settings.
Methods
Project AMIGA: The aim of this study is to test the effectiveness of a cognitive training session, conducted with the SAR named Pepper. In this randomized controlled trial, the effectiveness of SAR on depressive symptoms and correlates is evaluated in a sample of 60 individuals with major depression. While the intervention group will receive cognitive training with the SAR Pepper, the control group will receive “treatment-as-usual” therapy with a common PC software. Participants will receive 30 minutes of training 2 times per week over a period of 3 weeks.
Project XRes4HEALTH: The aim of this study is to develop an XR resilience training to increase resilience and stress coping mechanisms in healthcare workers. A total of 40 people will be included. To test the effectiveness of the resilience training, 3 XR training sessions of 15 minutes each will be held. A pre-post measurement will test the effectiveness of the training on wellbeing and stress levels as well as the acceptance and satisfaction with the training.
Project AI-REFIT: The overall goal of this study is to explore key information to increase resilience in healthy individuals who are at increased risk for mental health problems. Through a usability study, the artificial intelligence-based prototype app of the resilience training will be tested for acceptance, usability, functionality, and efficiency. During the resilience training, participants are wearing a smartwatch which measures psychophysiological parameters. Conclusions about the success of the therapy can be drawn based on digital data acquisition.
Results
New technologies including XR and SAR support classical psychiatric treatment in the topics of resilience and cognitive training as an add-on therapy in times of reduced availability of healthcare workers.
Conclusions
The rapid development of new technologies holds a lot of potential in the treatment of psychiatric disorders, which is why it is important to scientifically evaluate those innovative tools.
Obsessive Compulsive Disorder (OCD) and Tic Disorder (TD) are two highly disabling, comorbid and difficult-to-treat conditions. DSM-5 acknowledged a new “tic-related” specifier for OCD, i.e., Obsessive-Compulsive Tic-related Disorder (OCTD), which may show poor treatment response.
Objectives
The aim of the present study was to evaluate rates and clinical correlates of response, remission and resistance to treatment in a large multicentre sample of OCD patients with versus without tics.
Methods
398 patients with a DSM-5 diagnosis of OCD with and without comorbid TD was assessed from ten psychiatric departments across Italy. Treatment response profiles in the whole sample were analysed comparing the rates of response, remission and treatment-resistance as well as related clinical features. Multivariate logistic regressions were performed to highlight possible treatment response related factors.
Results
Later ages of onset of TD and OCD were found in the remission group. Moreover, significantly higher rates of psychiatric comorbidities, TD, and lifetime suicidal ideation and attempts were associated to the treatment-resistant group, with larger degrees of perceived worsened quality of life and family involvement.
Conclusions
While remission was related to later ages of OCD and TD onset, specific clinical factors, such as early onset and presence of psychiatric comorbidities and concomitant TD, predicted a worse treatment response, with a significant impairment in quality of life for both patients and their caregivers. These findings suggest a worse profile of treatment response for patients with OCTD.
Prolonged pleural effusions are common post Fontan operation and are associated with morbidity. Fontan pleural effusions have elevated proinflammatory cytokines. Little is known about the chest tube drainage after a superior cavopulmonary connection. We examined the chest tube drainage and the inflammatory profiles in post-operative superior cavopulmonary connection patients.
Methods:
This prospective cohort study enrolled 25 patients undergoing superior cavopulmonary connection and 10 age-similar controls. Data are also compared to 25 previously published Fontan patients and their 15 age-similar controls. Chest tube samples were analysed with a 17-cytokine BioPlex Assay. Descriptive statistics and univariate comparisons were made between groups.
Results:
Duration of chest tube drainage was significantly shorter in superior cavopulmonary connection patients (median 4 days, [interquartile range 3–5 days]) versus Fontan patients (10 days, [7–11 days], p < 0.0001). Cytokine concentrations were higher on post-operative day 1 in superior cavopulmonary connection patients versus Fontan patients (all p ≤ 0.01), however levels were comparable to age-similar controls. While proinflammatory IL 8, MIP-1β, and TNF-α concentrations increased in chest tube drainage of Fontan patients from post-operative day 1 to last chest tube day (all p < 0.0001), there was no change in these biomarkers in superior cavopulmonary connection patients, their controls, or Fontan controls.
Conclusions:
Our study demonstrates that after superior cavopulmonary connection, proinflammatory cytokines in the chest tube drainage remain similar to biventricular controls of both age groups, unlike the significant rise over time observed in Fontan patients. Inflammation within the chest tube drainage is likely not innate to single ventricle patients.
This book offers an empirically-based view on Europeans’ interconnections in everyday life. It looks at the ways in which EU residents have been getting closer across national frontiers. The book considers how people reconcile their increasing cross-border interconnections and a politically separating Europe of nation states and national interests.
Cognitive deficits may be characteristic for only a subgroup of first-episode psychosis (FEP) and the link with clinical and functional outcomes is less profound than previously thought. This study aimed to identify cognitive subgroups in a large sample of FEP using a clustering approach with healthy controls as a reference group, subsequently linking cognitive subgroups to clinical and functional outcomes.
Methods
204 FEP patients were included. Hierarchical cluster analysis was performed using baseline brief assessment of cognition in schizophrenia (BACS). Cognitive subgroups were compared to 40 controls and linked to longitudinal clinical and functional outcomes (PANSS, GAF, self-reported WHODAS 2.0) up to 12-month follow-up.
Results
Three distinct cognitive clusters emerged: relative to controls, we found one cluster with preserved cognition (n = 76), one moderately impaired cluster (n = 74) and one severely impaired cluster (n = 54). Patients with severely impaired cognition had more severe clinical symptoms at baseline, 6- and 12-month follow-up as compared to patients with preserved cognition. General functioning (GAF) in the severely impaired cluster was significantly lower than in those with preserved cognition at baseline and showed trend-level effects at 6- and 12-month follow-up. No significant differences in self-reported functional outcome (WHODAS 2.0) were present.
Conclusions
Current results demonstrate the existence of three distinct cognitive subgroups, corresponding with clinical outcome at baseline, 6- and 12-month follow-up. Importantly, the cognitively preserved subgroup was larger than the severely impaired group. Early identification of discrete cognitive profiles can offer valuable information about the clinical outcome but may not be relevant in predicting self-reported functional outcomes.
This article reports on a new project to investigate the activities of early Homo sapiens in the area of the Chotts ‘megalake’ in southern Tunisia. Excavations in 2015 and 2019 at Oued el Akarit revealed one of a number of Middle Stone Age (MSA) horizons near the top of a long sequence of Upper Pleistocene deposits. The site identified as Oued el Akarit (Sondage 8) consists of lithic artefacts, bone fragments of large ungulates and pieces of ostrich eggshell. Many of the objects are burnt. Excavation of about nine square metres revealed that these were associated with a lightly trampled and combusted occupation surface. Amongst the identified artefacts were Levallois flakes some of which could be refitted, thereby indicating the generally undisturbed nature of the occupation. The lithic finds also included side scrapers and other tools diagnostic of the MSA but significantly no bifacial or tanged tools. OSL (Optically Stimulated Luminescence) dating of the sediments and AMS (Accelerator Mass Spectrometry) radiocarbon dating of ostrich eggshell have produced uncalibrated age determinations in the range 37,000–40,000 years ago, one of the youngest ages for MSA sites in the region. This is the first example of a securely dated later MSA occupation in a riparian environment in south-eastern Tunisia.
The nematode Angiostrongylus cantonensis is the most common cause of neuroangiostrongyliasis (manifested as eosinophilic meningitis) in humans. Gastropod molluscs are used as intermediate hosts and rats of various species are definitive hosts of this parasite. In this study, we identified several environmental factors associated with the presence and abundance of terrestrial gastropods in an impoverished urban region in Brazil. We also found that body condition, age and presence of co-infection with other parasite species in urban Rattus norvegicus, as well as environmental factors were associated with the probability and intensity of A. cantonensis infection. The study area was also found to have a moderate prevalence of the nematode in rodents (33% of 168 individuals). Eight species of molluscs (577 individuals) were identified, four of which were positive for A. cantonensis. Our study indicates that the environmental conditions of poor urban areas (presence of running and standing water, sewage, humidity and accumulated rain and accumulation of construction materials) influenced both the distribution and abundance of terrestrial gastropods, as well as infected rats, contributing to the maintenance of the A. cantonensis transmission cycle in the area. Besides neuroangiostrongyliasis, the presence of these hosts may also contribute to susceptibility to other zoonoses.
Gender differences in psychosis have been investigated, and the results have contributed to a better understanding of the disease, but many questions are unanswered. In clinical terms, women and men with psychosis differ in terms of access to social support, tendency of substance abuse, level of functioning and symptom patterns. We aimed to investigate how gender differences at onset of psychosis develop during the first 5 years of treatment.
Method
A total of 578 patients with a first-episode psychosis in the schizophrenia spectrum were included in the Danish OPUS trial – a randomized clinical trial comparing 2 years of intensive early-intervention programme with standard treatment. All patients were assessed with validated instruments at inclusion, and after 2 and 5 years. Data were analysed for significant gender differences.
Results
Males have significantly higher levels of negative symptoms at all times, and are more likely to live alone and suffer from substance abuse. Females reach higher levels of social functioning at follow-up, and show a greater tendency to be employed or in education than males. Markedly more women than men live with children. More women than men reach a state of recovery and are more compliant with medication.
Conclusion
There are significant gender differences at 2- and 5-year follow-up in this large cohort of first-episode psychotic patients. Males and females show different symptomatology and different levels of social functioning.
Early Intervention services with team-based intensive case management and family involvement are superior to standard treatment in reducing psychotic and negative symptoms and comorbid substance abuse and improving social functioning and user satisfaction. The results of the OPUS-trial will be presented together with meta-analyses based on similar trials. The implementation of OPUS all over Denmark will be presented together with the Danish OPUS-fidelity study. Specialized elements are being are being developed such as inclusion of new methods in CBT for psychotic and negative symptoms, neurocognitive and social cognitive training programs, interventions for supported employment and focus on physical health. Results of long term follow-up studies indicate that the prognosis of first episode psychosis is very diverse with the extremes represented by one group being well functioning and able to quit medication without relapse; and another group having a long term chronic course of illness with a need for support to maintain daily activities. The Danish TAILOR-trial–testing dose reduction versus maintenance therapy will be presented. It will be of immense value to be able to intervene in risk groups identified in the premorbid phase, and there are few examples of ongoing trial for children of parent with schizophrenia and bipolar disorder.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Surface modification of Engelhard titanosilicate (ETS-10) with silver (Ag) was carried out in efforts to promote the photocatalytic activity of ETS-10 towards the degradation of methylene blue (MB) under visible light irradiation. The core-shell heterostructure encapsulates the Ag nanoparticles, which would otherwise dislodge from the surface of ETS-10. The Ag@ETS-10 core-shell heterostructured photocatalyst was prepared by the photodeposition of Ag nanoparticles onto ETS-10 crystals to form the Ag-ETS-10 core, followed by secondary growth of ETS-10 shell using the Ag-ETS-10 as seeds. Ag@ETS-10 showed absorption in the visible light region, as well as a red shift in the UV region, compared to the unmodified ETS-10. The extent of shell growth depended on the seeding level. Increasing the seeding level from 1 wt.% to 50 wt.% resulted in a decreased mode of the particle size distribution of the products, and thus a decreased shell thickness. The Ag@ETS-10 photocatalyst grown using 50 wt.% seeding level (i.e., ∼0.1 μm shell) showed higher photocatalytic activity in the photodegradation of MB under visible light irradiation (k = 0.0159 min-1) than the unmodified ETS-10 sample (k = 0.007 min-1). However, the Ag@ETS-10 photocatalyst grown using 1 wt. % seeding levels (i.e., ∼ 0.8 μm shell) showed lower photocatalytic activity compared to the Ag@ETS-10 photocatalyst grown using 50 wt.% seeding level (i.e., ∼ 0.1 μm shell). This was attributed to the suppression of the plasmon resonance peak when a thicker ETS-10 shell was grown around the Ag-ETS-10 core.