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16 - A New Generation of Worker Cooperatives
- from Part IV - Enterprise
- Edited by Brian D. Christens, Vanderbilt University, Tennessee
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- The Cambridge Handbook of Community Empowerment
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- 18 April 2024
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- 25 April 2024, pp 415-437
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Summary
Worker cooperatives – enterprises owned and operated by their employees – offer the potential for workplace socioeconomic empowerment. Historically they have struggled to capture a significant share of employment in the US and to be fully inclusive of communities confronting the greatest social and economic marginalization. Since the Great Recession, however, worker cooperatives have shown strong growth, with increasing representation from BIPOC, working-class, and immigrant communities. This chapter compares two home care worker cooperatives to discuss the benefits that worker cooperatives bring and some of the challenges they face. One, Golden Steps, operates at the small scale typical of most of the newer worker cooperatives, while the other, Cooperative Home Care Associates, is currently the largest worker cooperative in the US. Focusing on the financial, social, diversity, equity, and inclusion (DEI), and labor dimensions of worker cooperatives, we consider the important role of worker ownership and control within broader discussions of individual and community empowerment.
316 Machine Learning to Predict Fluid Responsiveness in Hypotensive Children
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- Sarah B. Walker, Kyle S. Honegger, Michael S. Carroll, Debra E. Weese-Mayer, L. Nelson Sanchez-Pinto
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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. 97
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OBJECTIVES/GOALS: Fluid boluses are administered to hypotensive, critically ill children but may not reverse hypotension, leading to delay of vasoactive infusion, end-organ damage, and mortality. We hypothesize that a machine learning-based model will predict which children will have sustained response to fluid bolus. METHODS/STUDY POPULATION: We will conduct a single-center retrospective observational cohort study of hypotensive critically ill children who received intravenous isotonic fluid of at least 10 ml/kg within 72 hours of pediatric intensive care unit admission between 2013 and 2023. We will extract physiologic variables from stored bedside monitors data and clinical variables from the EHR. Fluid responsive (FR) will be defined as a MAP increase by 310%. We will construct elastic net, random forest, and a long short-term memory models to predict FR. We will compare complicated course (multiple organ dysfunction on day 7 or death by day 28) between: 1) FRs and non-FRs, 2) predicted FRs and non-FRs, 3), FRs and non-FRs stratified by race/ethnicity, and 4) FRs and non-FRs stratified by sex as a biologic variable. RESULTS/ANTICIPATED RESULTS: We anticipate approximately 800 critically ill children will receive 2,000 intravenous isotonic fluid boluses, with a 60% rate of FR. We anticipate being able to complete all three models. We hypothesize that the model with the best performance will be the long short-term memory model and the easiest to interpret will be the tree-based random forest model. We hypothesize non-FRs will have a higher complicated course than FRs and that predicted non-FRs will have a higher rate of complicated course than FRs. Based on previous adult studies, we hypothesize that there will be a higher rate of complicated course in patients of black race and/or Hispanic ethnicity when compared to non-Hispanic white patients. We also hypothesize that there will be no difference in complicated course when comparing sex as a biologic variable. DISCUSSION/SIGNIFICANCE: We have a critical need for easily-deployed, real-time prediction of fluid response to personalize and improve resuscitation for children in shock. We anticipate the clinical application of such a model will decrease time with hypotension for critically ill children, leading to decreased morbidity and mortality.
Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)
- Konstantinos N. Fountoulakis, Grigorios N. Karakatsoulis, Seri Abraham, Kristina Adorjan, Helal Uddin Ahmed, Renato D. Alarcón, Kiyomi Arai, Sani Salihu Auwal, Michael Berk, Sarah Bjedov, Julio Bobes, Teresa Bobes-Bascaran, Julie Bourgin-Duchesnay, Cristina Ana Bredicean, Laurynas Bukelskis, Akaki Burkadze, Indira Indiana Cabrera Abud, Ruby Castilla-Puentes, Marcelo Cetkovich, Hector Colon-Rivera, Ricardo Corral, Carla Cortez-Vergara, Piirika Crepin, Domenico De Berardis, Sergio Zamora Delgado, David De Lucena, Avinash De Sousa, Ramona Di Stefano, Seetal Dodd, Livia Priyanka Elek, Anna Elissa, Berta Erdelyi-Hamza, Gamze Erzin, Martin J. Etchevers, Peter Falkai, Adriana Farcas, Ilya Fedotov, Viktoriia Filatova, Nikolaos K. Fountoulakis, Iryna Frankova, Francesco Franza, Pedro Frias, Tatiana Galako, Cristian J. Garay, Leticia Garcia-Álvarez, Maria Paz García-Portilla, Xenia Gonda, Tomasz M. Gondek, Daniela Morera González, Hilary Gould, Paolo Grandinetti, Arturo Grau, Violeta Groudeva, Michal Hagin, Takayuki Harada, Tasdik M. Hasan, Nurul Azreen Hashim, Jan Hilbig, Sahadat Hossain, Rossitza Iakimova, Mona Ibrahim, Felicia Iftene, Yulia Ignatenko, Matias Irarrazaval, Zaliha Ismail, Jamila Ismayilova, Asaf Jakobs, Miro Jakovljević, Nenad Jakšić, Afzal Javed, Helin Yilmaz Kafali, Sagar Karia, Olga Kazakova, Doaa Khalifa, Olena Khaustova, Steve Koh, Svetlana Kopishinskaia, Korneliia Kosenko, Sotirios A. Koupidis, Illes Kovacs, Barbara Kulig, Alisha Lalljee, Justine Liewig, Abdul Majid, Evgeniia Malashonkova, Khamelia Malik, Najma Iqbal Malik, Gulay Mammadzada, Bilvesh Mandalia, Donatella Marazziti, Darko Marčinko, Stephanie Martinez, Eimantas Matiekus, Gabriela Mejia, Roha Saeed Memon, Xarah Elenne Meza Martínez, Dalia Mickevičiūtė, Roumen Milev, Muftau Mohammed, Alejandro Molina-López, Petr Morozov, Nuru Suleiman Muhammad, Filip Mustač, Mika S. Naor, Amira Nassieb, Alvydas Navickas, Tarek Okasha, Milena Pandova, Anca-Livia Panfil, Liliya Panteleeva, Ion Papava, Mikaella E. Patsali, Alexey Pavlichenko, Bojana Pejuskovic, Mariana Pinto Da Costa, Mikhail Popkov, Dina Popovic, Nor Jannah Nasution Raduan, Francisca Vargas Ramírez, Elmars Rancans, Salmi Razali, Federico Rebok, Anna Rewekant, Elena Ninoska Reyes Flores, María Teresa Rivera-Encinas, Pilar Saiz, Manuel Sánchez de Carmona, David Saucedo Martínez, Jo Anne Saw, Görkem Saygili, Patricia Schneidereit, Bhumika Shah, Tomohiro Shirasaka, Ketevan Silagadze, Satti Sitanggang, Oleg Skugarevsky, Anna Spikina, Sridevi Sira Mahalingappa, Maria Stoyanova, Anna Szczegielniak, Simona Claudia Tamasan, Giuseppe Tavormina, Maurilio Giuseppe Maria Tavormina, Pavlos N. Theodorakis, Mauricio Tohen, Eva Maria Tsapakis, Dina Tukhvatullina, Irfan Ullah, Ratnaraj Vaidya, Johann M. Vega-Dienstmaier, Jelena Vrublevska, Olivera Vukovic, Olga Vysotska, Natalia Widiasih, Anna Yashikhina, Panagiotis E. Prezerakos, Daria Smirnova
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- Journal:
- CNS Spectrums / Volume 29 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 25 January 2024, pp. 126-149
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Background
The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.
MethodsThe sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.
ResultsAbout 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.
ConclusionsThe finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.
32 Effects of Emotion Regulation and Emotional Lability/Negativity on Academic Achievement Among Youth With and Without ADHD
- Kathleen E. Feeney, Stephanie S. J. Morris, Karissa DiMarzio, Rosario Pintos Lobo, Katherine Schmarder, Garcia Susana, Erica D. Musser
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 821-822
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Objective:
Youth with attention-deficit/hyperactivity disorder (ADHD), characterized by symptoms of inattention and hyperactivity, often experience challenges with emotion regulation (ER) and/or emotional lability/negativity (ELN).1-3 Prior work has shown that difficulties with ER and ELN among young children contribute to lower academic achievement.4-6 To date, research examining associations between ADHD and academic achievement have primarily focused on the roles of inattentive symptoms and executive functioning.7-8 However, preliminary work among youth with ADHD suggests significant associations between disruptions in emotional functioning and poor academic outcomes.9-10 The current study will examine associations between ER, ELN, and specific subdomains of academic achievement (i.e., reading, spelling, math) among youth with and without ADHD.
Participants and Methods:Forty-six youth (52% male; Mage=9.52 years; 76.1% Hispanic/Latino; 21 with ADHD) and their parents were recruited as part of an ongoing study. Parents completed the Disruptive Behavior Disorders Rating Scale11 and Emotion Regulation Checklist12 about their child. Youth completed the Wechsler Abbreviated Scale of Intelligence-II13 and three subtests [Spelling (SP), Numerical Operations (NO), Word Reading (WR)] of the Wechsler Individual Achievement Test-III.14 Univariate analysis of variance assessed differences in emotional functioning and academic achievement among youth with and without ADHD. Correlation and regression analyses were conducted to examine the association between emotional factors and the three subtests of academic achievement.
Results:Youth with ADHD exhibited significantly higher ELN (M=30.7, SD=8.7) compared to their peers (M=23.2, SD=5.8), when controlling for child age, sex, and diagnoses of conduct disorder and/or oppositional defiant disorder [F(1,41)=8.96, p<.01, ŋp2=.18]. With respect to ER, youth with (M=24.8, SD=4.2) and without ADHD (M=25.8, SD=4.3) did not differ [F(1,41)=.51, p=.48]. Surprisingly, within this sample, ADHD diagnostic status was not significantly associated with performance on any of the academic achievement subtests [WR: F(1,41)=.29, p=.59; NO: F(1,41)=.91, p=.35; SP: F(1,41)=2.14, p=.15]. Among all youth, ER was significantly associated with WR (r=.31, p=.04) and SP (r=.35, p=.02), whereas ELN was associated with performance on NO (r=-.30, p=.04). When controlling for child age, sex, IQ, and ER within the full sample, higher ELN was associated with lower scores on the NO subtest (b=-.56, SE=.26, p=.04). The associations between higher ER and WR scores (b=1.12, SE=.51, p=.03), as well as higher ER and SP scores (b=1.47, SE=.56, p=.01), were significant when controlling for child age and sex, but not ELN and IQ (p=.73 and p=.64, respectively).
Conclusions:As expected, youth with ADHD had higher ELN, although they did not differ from their peers in terms of ER. Results identified distinct associations between ER and higher reading/spelling performance, as well as ELN and lower math performance across all youth. Thus, findings suggest that appropriate emotional coping skills may be most important for reading and spelling, while emotional reactivity appears most salient to math performance outcomes. In particular, ELN may be a beneficial target for intervention, especially with respect to improvement in math problem-solving skills. Future work should account for executive functioning skills, expand the academic achievement domains to include fluency and more complex academic skills, and assess longitudinal pathways within a larger sample.
57 Association Between Adverse Childhood Experiences on Depression and Anxiety in Adulthood: Examining the Role of Cognitive Flexibility
- Rosario Pintos Lobo, Alexandria G. Nuccio, Zachary T. Goodman, Stacy S. Merritt, Xiaoyan Sun, Katalina F. McInerney, Bonnie E. Levin
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 842-843
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Objective:
The association between adverse childhood experiences (ACEs) and adult depression and anxiety has been well described (Aafjes-van Doorn et al., 2020; Dolbier et al., 2021; Herzog & Schmahl, 2018). However, cognitive flexibility, as a potential moderating factor of this relationship, has been underreported (Kalia et al., 2021). We hypothesize that increased ACEs will be associated with increased symptoms of depression and anxiety, and cognitive flexibility will exhert a moderating role in this relationship.
Participants and Methods:Participants from the Evelyn F. McKnight University of Miami Frailty Registry were included in the study. 224 adults (Mage= 66.30, SD = 11.63; 59.4% female; 62.1% Hispanic/Latinx) without primary neurological disorders were recruited from University of Miami clinics and community centers. Participants completed a demographic questionnaire and neuropsychological evaluation including the Adverse Childhood Experiences inventory, Beck Depression Inventory, Beck Anxiety Inventory, and the Wisconsin Card Sorting Test (WCST). Current data were initially analyzed using descriptive statistics and correlations among variables. A series of hierarchical multiple linear regressions (HLR) were conducted to examine the effect that age has on cognitive flexibility (measured by number of perseverative errors on the WCST), as well as the association between number of ACEs endorsed on symptoms of depression and anxiety in late life.
Results:Correlation analyses revealed a negative correlation between total ACE score and cognitive flexibility (r=-.16, p=0.03); a positive correlation between age and cognitive flexibility (r=0.19, p=0.01); and positive relationships between ACE score and both BDI (r=0.35, p<0.001) and BAI (r=0.28, p<0.001) scores. Correlations further revealed a negative correlation between cognitive flexibility and both BDI (r=-0.18, p=0.014) and BAI (r=-0.14, p=0.048) scores. A series of hierarchical multiple linear regressions revealed that total number of ACEs had a statistically significant effect on both depression (f=7.24, p<.001, ΔR2=0.072) and anxiety (f=4.57, p<.001, ΔR2=0.044) symptoms, in models adjusted for demographic correlates (i.e., age, sex, race, ethnicity). While the overall moderation model examining the effect of cognitive flexibility on the relationship between ACEs and psychopathology was significant (f=6.04, p<.001, ΔR2=0.191), the interaction was not significant (p=.4199). However, HLRs further revealed a statistically significant effect of age on cognitive flexibility (f=6.77, p=0.01, ΔR2=0.034).
Conclusions:Current findings support past research showing higher number of ACEs are associated with more symptoms of depression and anxiety in later life. However, cognitive flexibility did not moderate the relationship between ACEs and symptoms of depression and anxiery. This suggests cognitive flexibility might not play a significant role in the association between childhood trauma and symptoms of depression and anxiety in later life. Alternatively present results could be attributed to a small sample size, or the specific measure of cognitive flexibility used. This study expands on prior research highlighting the role of cognitive flexibility on age, with age serving as a prominent feature in the association between ACEs and adult depression and anxiety. Further research examining the role of cognitive flexibility in younger and middle years and its association with ACEs and psychopathology may provide unique insights on how to intervene earlier in the life course before cognitive flexibility begins to decline.
14 Prevalence of Mid-Range Visual Functions and their Relationship to Higher-order Visual Functions after Stroke
- Edward H.F. de Haan, Nils S. van den Berg, Nikki A. Lammers, Selma Lugtmeijer, Anouk R. Smits, Yaïr Pinto
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 697-698
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Objective:
Visual deficits are common after stroke and are powerful predictors for the chronic functional outcome. However, while basic visual field and recognition deficits are relatively easy to assess with standardized methods, selective deficits in visual primitives, such as shape or motion, are harder to identify, as they often require a symmetrical bilateral posterior lesion in order to provoke full field deficits. We aimed to investigate the prevalence and co-occurrence of hemifield “mid-range” visual deficits. In addition, we looked at the repercussions of these mid-range deficits on higher-order visual cognitive functions, such as visuoconstruction and memory. At a more theoretical level, we investigated whether associations between deficits in 'mid-range’ visual functions and deficits in higher-order visual cognitive functions are in line with a hierarchical, two-pathway model of the visual brain.
Participants and Methods:In 220 stroke patients and a healthy control group (N=49), we assessed the perception of colour (isoluminant stimuli in the red-green range), shape (Efron shapes), location (dot in a circle), orientation (lines at different angles), contrast (bars with converging grey-level differences), texture (from Brodatz grayscale texture album) and correlated motion (different percentages of dots moving in the same direction). All tasks started with a fixation dot presented at the centre of the screen. After one second, a target stimulus was presented on the horizontal midline at either 5° to the left or at 5° to the right side of the fixation. Then, after 1.5 seconds, two response items appeared in addition to the target stimulus for three seconds. To control for eye movements, we used an eye-tracker to present the target in a gaze contingent fashion. Thus, the target always remained in the correct retinal position independent of eye movements. In a subset of 182 ischemic stroke patients, we also assessed visuoconstruction (Copy Rey-Complex Figure Test), visual emotion recognition (FEEST test) and visual memory (Doors-test).
Results:The results showed that deficits in motion-perception were most prevalent (26%), followed by colour (22%), texture (22%), location (21%), orientation (18%), contrast (14%), shape (14%) and glossiness (13%). 63% of the stroke patients showed one or more mid-range visual deficits. Overlap of deficits was small; they mostly occurred in isolation or co-occurred with only one or two other deficits. Impairments in mid-range visual functions could not predict performance on higher-order visual cognitive tasks. Impaired visuoconstruction and visual memory were only modestly predicted by a worse location perception. Impaired emotion perception was modestly predicted by a worse orientation perception. In addition, double dissociations were found: there were patients with selective deficits in 'mid-range’ visual functions without higher-order visual deficits and vice versa.
Conclusions:First, deficits in “mid-range” visual functions are very prevalent. Since we found no strong patterns of co-occurrences, we suggest that an assessment of deficits at this level of visual processing requires screening the full range of visual functions. Second, the relationship between mid-range visual tasks and higher-order visual cognitive tasks is weak. Finally, our findings are not supportive of the hierarchical, two-pathway model but more in line with an alternative patchwork model.
The impact of self-stigma in people with diagnosis of severe mental illness: a cross-sectional pilot study from a community psychiatry unit in Porto, Portugal
- A. S. Pinto, M. Almada, I. Fonseca, A. Sousa, A. Lopes
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S866-S867
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Introduction
Self-stigma refers to the process in which a person internalizes negative stereotypes, beliefs, and prejudices about their mental illness, adopting a stigmatized view of themselves. Severe mental illness is one of the most socially exclusive stigmata and is associated with poor clinical and functional outcomes and social withdrawal.
ObjectivesIn Portugal, investigation regarding self-stigma is scarce. In this study, we aim to evaluate the impact of self-stigma among people with diagnosis of severe mental illness (SMI). For this goal we assess the prevalence of self-stigma of psychiatric patients with diagnosis SMI; and investigate the correlates of elevated self-stigma levels.
MethodsFifty-one outpatients with SMI, were recruited from a community psychiatry unit from Porto, Portugal. After informed consent, evaluations included sociodemographic data, illness characteristics, and self-reported standardized scales. Self-stigma (ISMI), self-esteem (RSES) and quality of life (WHO-QoL) were assessed. Data analyses were performed using the SPSS version 28.0 (IBM Corp., Armonk, NY). p-values<0.05 were considered significant.
ResultsFrom the study sample, 66.7% were male, with mean age of 44.8±11.0 and 56.9% were single. 33.3% reported living with their parents while 31.4% were living with a partner/spouse. The majority of participants had a diagnosis of schizophrenia (60.8%). Concerning the level of education, 58.8% completed basic education, but most patients were retired due to illness (62.7%). In this study, moderate to high self-stigma levels was found in 31.4% participants. Proportion of elevated self-stigma was significantly higher in unemployed/retired patients vs. those who were active (39.0% vs. 0%; P=0.021). No significant correlations were found with age, level of education, age at diagnosis, duration of illness, and number of hospitalizations. In the correlations analysis, a negative correlation between self-stigma and self-esteem (rho=-0.745; P<0.001), as well as self-stigma and quality of life (rho=-0.585; P<0.001) was found. A positive relationship between self-esteem and quality of life (rho=0.551; P<0.001) was found.
ConclusionsThis study investigates, for the first time, the prevalence of self-stigma among outpatients with SMI in a community psychiatric unit from Porto. Our findings suggest a high prevalence of elevated levels of self-stigma among these patients. A significant association with being unemployed/retired was also found. Our results support previous evidence that internalized stigma is strongly associated with diminished self-esteem and impaired quality of life, in particular those aspects related to physical and psychological complaints. Targeting internalized stigma and self-esteem among patient with SMI will likely improve their quality of life, besides improving their clinical and functional outcomes.
Disclosure of InterestNone Declared
Psychopharmacology In Myasthenia Gravis Patients: A Case Study
- T. M. Afonso, F. Ferreira, C. Cativo, S. Martins, A. Ramos, M. Pinto
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S274
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Introduction
Myasthenia gravis (MG) is an autoimmune disease that affects the neuromuscular junction. It causes generalized muscle weakness that may include the respiratory muscles, potentially leading to a medical emergency known as a myasthenic crisis. Several medications, including some antipsychotics, have been shown to worsen myasthenia gravis symptoms.
ObjectivesWe aim to summarize the current knowledge on the use of psychopharmacological treatments in patients with MG.
MethodsNon-systematic review of the literature was performed in PubMed/Medscape database. Case report of a patient who was admitted and treated in our inward patient unit.
ResultsWe present a clinical case of a 64-year-old man diagnosed with Bipolar Disease at the age of 18 and recently diagnosed with MG (he was hospitalized in Neurology Department, pyridostigmine was introduced and lithium was reduced to half dose). Three months later he was admitted to the emergency department due to behavior and speech disorganization, persecutory delusional ideas, insomnia and caregiver exhaustion. During his hospitalization lithium was increased to 1200 mg. At day 8 of admission the patient started to show weakness of neck extensor muscles, due to that he was evaluated by neurology, lithium was stopped and haloperidol was increased resulting in clinical improvement.
ConclusionsPsychotropic choice in patients with MG can be challenging due to their anticholinergic properties that can exacerbate MG symptoms with potential deterioration to a myasthenic crisis. There is a great need for evidence-based data on the safety and efficacy of psychotropic medications in MG.
Disclosure of InterestNone Declared
A new cryptic species of Echinostoma (Trematoda: Echinostomatidae) closely related to Echinostoma paraensei found in Brazil
- Marisa C. Valadão, Philippe V. Alves, Danimar López-Hernández, Jordana C. A. Assis, Paulo R. S. Coelho, Stefan M. Geiger, Hudson A. Pinto
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- Journal:
- Parasitology / Volume 150 / Issue 4 / April 2023
- Published online by Cambridge University Press:
- 12 January 2023, pp. 337-347
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Echinostoma paraensei, described in Brazil at the end of the 1960s and used as a biological model for a range of studies, belongs to the ‘revolutum’ complex of Echinostoma comprising species with 37 collar spines. However, molecular data are available only for a few isolates maintained under laboratory conditions, with molecular prospecting based on specimens originating from naturally infected hosts virtually lacking. The present study describes Echinostoma maldonadoi Valadão, Alves & Pinto n. sp., a species cryptically related to E. paraensei found in Brazil. Larval stages (cercariae, metacercariae and rediae) of the new species were found in the physid snail Stenophysa marmorata in the State of Minas Gerais, Brazil, the same geographical area where E. paraensei was originally described. Adult parasites obtained experimentally in Meriones unguiculatus were used for morphological (optical microscopy) and molecular [28S, internal transcribed spacer (ITS), nad1 and cox1] characterization. The morphology of larval and adult parasites (most notable the small-sized dorsal spines in the head collar), associated with low (0–0.1%) molecular divergence for 28S gene or ITS region, and only moderate divergence for the mitochondrial cox1 gene (3.83%), might suggest that the newly collected specimens should be assigned to E. paraensei. However, higher genetic divergence (6.16–6.39%) was found in the mitochondrial nad1, revealing that it is a genetically distinct, cryptic lineage. In the most informative phylogenetic reconstruction, based on nad1, E. maldonadoi n. sp. exhibited a strongly supported sister relationship with E. paraensei, which may indicate a very recent speciation event giving rise to these 2 species.
Sphingolipids and acylcarnitines are altered in placentas from women with gestational diabetes mellitus
- Gabriela D. A. Pinto, Antonio Murgia, Carla Lai, Carolina S. Ferreira, Vanessa A. Goes, Deborah de A. B. Guimarães, Layla G. Ranquine, Desirée L. Reis, Claudio J. Struchiner, Julian L. Griffin, Graham J. Burton, Alexandre G. Torres, Tatiana El-Bacha
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- Journal:
- British Journal of Nutrition / Volume 130 / Issue 6 / 28 September 2023
- Published online by Cambridge University Press:
- 21 December 2022, pp. 921-932
- Print publication:
- 28 September 2023
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Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy and a severe threat to pregnant people and offspring health. The molecular origins of GDM, and in particular the placental responses, are not fully known. The present study aimed to perform a comprehensive characterisation of the lipid species in placentas from pregnancies complicated with GDM using high-resolution MS lipidomics, with a particular focus on sphingolipids and acylcarnitines in a semi-targeted approach. The results indicated that despite no major disruption in lipid metabolism, placentas from GDM pregnancies showed significant alterations in sphingolipids, mostly lower abundance of total ceramides. Additionally, very long-chain ceramides and sphingomyelins with twenty-four carbons were lower, and glucosylceramides with sixteen carbons were higher in placentas from GDM pregnancies. Semi-targeted lipidomics revealed the strong impact of GDM on the placental acylcarnitine profile, particularly lower contents of medium and long-chain fatty-acyl carnitine species. The lower contents of sphingolipids may affect the secretory function of the placenta, and lower contents of long-chain fatty acylcarnitines is suggestive of mitochondrial dysfunction. These alterations in placental lipid metabolism may have consequences for fetal growth and development.
Nitrous Oxide in Treatment Resistant Major Depression: Should We Laugh About It?
- B. Leal, D. Vila-Chã, S. Garcia, I. Pinto, R. Mateiro, M. Avelino, M. Martins, J. Salgado
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- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S716
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Introduction
Nitrous oxide (NO), also known as “laughing gas” is a colorless gas used as an anesthetic, a propellant in some foods, an engine performance enhancer and a recreational drug. When inhaled, it is known to provoke a rapid feeling of euphoria or excitement for a short period of time, dissociative phenomena and sometimes laughter. As its fellow anesthetic agent and NMDA-receptor antagonist, ketamine, NO is being studied for its possible therapeutic profile in treatment resistant major depression (TRMD).
ObjectivesTRMD is a serious illness, that urges for effective alternative treatments. In that regard, we explored the recent studies conducted in these patients, using NO in different dosages when compared to placebo.
MethodsThe authors revised the published literature about this topic, selecting relevant articles with the topic words: “Depression”, “Treatment Resistant Major Depression” and “Nitrous Oxide” in scientific data base.
ResultsSince 2018, at least two randomized clinical trials have demonstrated that NO has considerable antidepressant effects in TRMD, when compared to placebo. Investigators noted that these positive effects where maintained at least for two weeks after a single 1-hour inhalation. In a more recent study, scientists compared different NO concentrations (25% vs. 50%) concluding that the 25% concentration had similar efficacy with a lower risk of adverse effects.
ConclusionsThere appears to be encouraging results when treating patients with TRMD with NO in a 25% concentration. Nonetheless, there is need for further investigation, namely through studies that compare NO with other valid TRMD treatments and not only versus placebo.
DisclosureNo significant relationships.
Altered Executive Function in Suicide Attempts
- J. Fernández, S. Alberich, I. Zorrilla, I. González-Ortega, M.P. López, V. Pérez-Solà, E. Vieta, A.M. González-Pinto, P.A. Saiz
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S124
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Introduction
Executive function organizes and directs behaviour but alterations in this cognitive domain can lead to inaccurate perception, interpretation and response to environmental information, which could be a risk factor for suicide.
ObjectivesTo explore executive function performance of depressed recent suicide attempters in comparison to depressed past suicide attempters, depressed non-attempters and healthy controls.
Methods96 participants from the Psychiatry Department of the Araba University Hospital-Santiago were recruited as follows: 20 patients with a recent suicide attempt (<30days) diagnosed with a Major Depressive Disorder (MDD), 33 MDD patients with history of attempted suicide, 23 non-attempter MDD patients and 20 healthy controls. All participants underwent a clinical interview and neuropsychological assessment on executive function with the Wisconsin Sorting Card Test. Backward multiple regressions were performed adjusting for significant confounding variables. For group comparisons ANOVA test and Bonferroni post hoc test were performed with p<0.05 significance level.
ResultsPatient groups did not differ regarding severity of depression. All patient groups performed significantly worse than healthy controls on executive function. Adjusted comparisons between patient groups indicated that recent suicide attempters had a poorer performance in this cognitive domain in comparison to both depressed lifetime attempters and depressed non-attempters (B=0.296, p=0.019 and B=0.301, p=0.028 respectively).
ConclusionsExecutive function performance is altered in recent suicide attempts. As impaired executive function can be a risk factor for suicide, preventive interventions on suicide should focus on its assessment and rehabilitation.
DisclosureNo significant relationships.
Retinal Thickness as a biomarker of cognitive impairment in bipolar disorder
- E. García-Corres, S. Alberich, L. Rementeria, I. Pérez-Landaluce, A.M. González-Pinto
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, pp. S415-S416
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Introduction
Ocular Coherence Tomography (OCT) to measure retinal thickness is the current method to observe neurological impairment in neurodegenerative diseases [1] and in mental disorders [2] due to the composition of the retina itself as an anatomic extension of the brain.There can be found some factors to improve the resilience like the years of study.
ObjectivesOur aim is to evaluate cognitive and clinical impairment in Bipolar Disorder and see the correlation to the retinal thinning.
MethodsTwenty-seven patients diagnosed with Bipolar Disorder were assessed in the context of the FINEXT programme (3). Selective attention, executive functions and verbal memory were measured among other variables. Using the OCT technique, we measured the thickness of the ppRNFL, the RFNL, GCL and IPL layers in the macula in both eyes through several radial segments. Partial correlations were performed with Bonferroni correction (p≤0.006) adjusted for age and academic status except for the variable years of study which was adjusted for age.
ResultsSignificant direct correlations were observed between: - The study-years and the thickness of the retina in the NO and RFNL. -Selective attention and GCL and RFNL layers. -Executive function and the GCL and IPL.
ConclusionsWe can observe some preliminar results showing a significant correlation between some layers of the retina, upper segments more frequently, and the outcomes of the neurocognitive assessment. We can see a relationship as well between years of study and the thickness of the Retinal Nerve Fibre Layer in the retina and optic nerve head, the axons of the neurons in the eye.
DisclosureNo significant relationships.
Treating Patients with Aripiprazol: A Safe Gamble?
- B. Leal, D. Vila-Chã, S. Garcia, I. Pinto, R. Mateiro, M. Avelino, M. Martins, J. Salgado
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- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S713
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Introduction
Aripiprazole (ARI) is an atypical antipsychotic drug with D2 partial agonist properties, usually prescribed to treat mood disorders (major depression or bipolar disorder) and schizophrenic disorder (schizophrenia or schizoaffective disorder). Dopamine receptor agonists, as is ARI, have been implicated in some cases of impulse-control problems, such as gambling disorder (GD), increased spending, hypersexuality and compulsive eating.
ObjectivesCurrently, it is hypothesized that aripiprazole may cause impulse-control problems because it can produce a hyperdopaminergic state in the mesolimbic pathway (reward system) through its predominant action on dopamine D3 receptors. We intend to do a non-systematic review of the scientific information regarding this subject.
MethodsThe authors revised the published literature about this topic, selecting relevant articles, systematic reviews and case reports, with the topic words: “aripiprazol”, “gambling disorder” and “dopamine receptor” in scientific data base.
ResultsOverall, a few cases of ARI-induced pathological gambling as well as ARI-induced hypersexuality have been reported. In one study it was verified that comorbid psychiatric and substance use disorders were common among those who have experienced GD or worsened GD after beginning ARI treatment. In another study, it was verified that the group of patients who reported this alleged side-effect were mostly young (mean age, 33.6 years), mostly men (88.2%) and most lived alone.
ConclusionsAttributing to dopamine agonists the only factor that can explain the onset of GD is simplistic and dangerous. Many other potential risk factors, including individual vulnerability factors (temperament, genetics) as well as environmental factors, must be considered.
DisclosureNo significant relationships.
Hybrid methodology based on computational vision and sensor fusion for assisting autonomous UAV on offshore messenger cable transfer operation
- Gabryel S. Ramos, Milena F. Pinto, Fabricio O. Coelho, Leonardo M. Honório, Diego B. Haddad
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The recent development of new offshore projects in pre-salt deepwater fields has placed offshore loading operations as the main production outflow alternative, increasing the operational complexity and risks. Numerous dangerous situations are associated with oil offloading, such as the messenger line transfer during the mooring stage. Nowadays, this critical task is realized by launching a thin messenger cable using the pneumatic line throwing apparatus. This is a complex and slow process since the operation usually occurs with the ship opposite to the wind. This work proposes a hybrid flight methodology based on computer vision and sensor fusion techniques for autonomous unmanned aerial vehicles (UAVs). The UAV takes off from an oil rig and precisely reaches a specific point in the shuttle tanker without using expensive positioning devices and augmenting UAV’s orientation (yaw) precision since the compass can suffer from severe interference due to naval metallic structures near the vehicle. The proposed framework was tested in a realistic simulated environment considering several practical operational constraints. The results demonstrated both the robustness and efficiency of the methodology.
New non-native ornamental octocorals threatening a South-west Atlantic reef
- N. M. Menezes, C. S. McFadden, R. J. Miranda, J. A. C. C. Nunes, L. Lolis, F. Barros, C. L. S. Sampaio, T. K. Pinto
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- Journal:
- Journal of the Marine Biological Association of the United Kingdom / Volume 101 / Issue 6 / September 2021
- Published online by Cambridge University Press:
- 24 January 2022, pp. 911-917
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Invasive species are leading to ecosystem changes and socioeconomic deterioration around the globe. In 2018, unknown soft corals were noticed forming a massive ‘blue carpet’ on a shallow reef environment at Todos os Santos Bay, South-west Atlantic. In this study we identified the species, quantified their distribution and abundance as a first step for baseline invasion monitoring, and discussed origin, vector and impacts on native competitors. Coral samples were identified based on morphology and a multilocus DNA barcode, and benthic structure was characterized using digital photoquadrats. Our results revealed two new harmful non-native octocorals in this tropical rocky reef, the ‘blue polyps’ genus Sarcothelia (Xeniidae), native to Hawaii but likely an undescribed cryptic species, and Briareum hamrum (Briareidae), native to the Indian Ocean. Sarcothelia sp. was the dominant taxon in the rocky reef (mean cover 23.66% ± 21.46), exhibiting high coverage as well in the sandy and patch reef habitats (15.83% ± 15.81), however, only three colonies of B. hamrum were found, all outside the sampling area. These octocorals were in physical contact with native benthic organisms, mainly with the most abundant group, but apparently avoid turf algae in sandy and patch reef habitats. We suggest that irresponsible marine aquarium releases likely introduced these species to Brazilian reefs. After identifying the aquarium trade as the main vector of octocoral introductions, we reinforce the importance of inspecting marine species importation and the urgent need to implement a government plan to mitigate invasive species' impacts on the natural reefs of Brazil.
Prevalence of herpes zoster virus reactivation in patients diagnosed with Bell's palsy
- R Freire de Castro, D Crema, F C Neiva, R A S R Pinto, F A Suzuki
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- Journal:
- The Journal of Laryngology & Otology / Volume 136 / Issue 10 / October 2022
- Published online by Cambridge University Press:
- 12 January 2022, pp. 975-978
- Print publication:
- October 2022
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Objective
Herpes zoster virus can cause inflammatory neuropathy of the facial nerve. However, studies evaluating the prevalence of this agent in peripheral facial palsy are heterogeneous regarding sample group selection, laboratory analysis method and variables studied. In addition, there are a lack of epidemiological data in the Brazilian population on this serological phenomenon in peripheral facial palsy. This study estimated herpes zoster reactivation prevalence in serological samples through chemiluminescence immunoassay for quantitative determination of specific antibodies directed against the virus.
MethodsThis cross-sectional study sought to determine the prevalence of viral reactivation by herpes zoster in subjects with idiopathic peripheral facial palsy through analysis of serological samples over a year.
ResultsForty-seven patients (32 females and 15 males) participated. Severe paralysis was more common in older patients (p = 0.017). Facial pain (p = 0.02) and vertigo (p = 0.001) were related to a worse evolution of facial palsy. The rate of serological reactivation of the virus was 12.76 per cent.
ConclusionThe rate of serological reactivation of herpes virus in idiopathic peripheral facial palsy in our population is similar to foreign literature data, suggesting similar aetiological mechanisms in the genesis of this morbidity.
Provider insights on shared decision-making with families affected by CHD
- Nelangi M. Pinto, Angira Patel, Rebecca K. Delaney, Mary T. Donofrio, Bradley S. Marino, Stephen Miller, Elissa M. Ozanne, Susan L. Zickmund, Michelle H. Karasawa, Mandy L. Pershing, Angela Fagerlin
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- Journal:
- Cardiology in the Young / Volume 32 / Issue 9 / September 2022
- Published online by Cambridge University Press:
- 03 November 2021, pp. 1475-1482
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Background and Objectives:
Little data exist on provider perspectives about counselling and shared decision-making for complex CHD, ways to support and improve the process, and barriers to effective communication. The goal of this qualitative study was to determine providers’ perspectives regarding factors that are integral to shared decision-making with parents faced with complex CHD in their fetus or newborn; and barriers and facilitators to engaging in effective shared decision-making.
Methods:We conducted semi-structured interviews with providers from different areas of practice who care for fetuses and/or children with CHD. Providers were recruited from four geographically diverse centres. Interviews were recorded, transcribed, and analysed for key themes using an open coding process with a grounded theory approach.
Results:Interviews were conducted with 31 providers; paediatric cardiologists (n = 7) were the largest group represented, followed by nurses (n = 6) and palliative care providers (n = 5). Key barriers to communication with parents that providers identified included variability among providers themselves, factors that influenced parental comprehension or understanding, discrepant expectations, circumstantial barriers, and trust/relationship with providers. When discussing informational needs of parents, providers focused on comprehensive short- and long-term outcomes, quality of life, and breadth and depth that aligned with parental goals and needs. In discussing resources to support shared decision-making, providers emphasised the need for comprehensive, up-to-date information that was accessible to parents of varying situations and backgrounds.
Conclusions:Provider perspectives on decision-making with families with CHD highlighted key communication issues, informational priorities, and components of decision support that can enhance shared decision-making.
Corticosteroid induced mania with psychotic symptoms
- F. Gomes Tavares, M. Viseu De Carvalho, M. Pinto, C. Solana, S. Batista
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S755-S756
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Introduction
Corticosteroids may induce psychiatric symptoms (agitation, fear, hypomania, insomnia, irritability, labile mood, pressured speech and restlessness) with incidence rates ranging from 1,8% to 57%. We present a case of corticosteroid-induced mania and psychosis.
ObjectivesNon-systematic review on corticosteroid therapy induced psychiatric symptoms. Analysis and comparison of a patient’s case with the existing literature.
MethodsCase report and a non-systematic review through databases as Pubmed, UpToDate, Medscape, between 2000 and 2020.
ResultsWe present a female 70 year-old patient without psychiatric background, diagnosed with Rhizomelic Pseudopolyarthritis, who started treatment with prednisone 20 mg. During the third month of treatment the patient started progressively worse behavior changes (such as destruction of the neighbor’s property), developed persecutory delusions, decreased sleep and increased energy. The patient was committed to our psychiatric ward and started on diazepam 10 mg and olanzapine 15 mg per day. Despite introduction of antipsychotics, which has evidence for mood stabilization, the patient maintained the symptoms, so it was necessary to gradually reduce corticosteroids until symptomatic control.
ConclusionsPsychosis (24%), hypomania and mania (35%), are the most common psychiatric reactions to corticosteroid therapy. Several studies show that even a low dosage may induce psychiatric disturbances, most frequently during the first two weeks of treatment. However, as reported in this case, symptoms may occur at any time. Thus, a multidisciplinary team, as well as training of professionals from different specialties, such as psychiatry, rheumatology and endocrinology, are needed, since these syndromes may be confused with pure psychiatric conditions and consequently delay treatment and compromise prognosis.
DisclosureNo significant relationships.
Autistic traits predict obsessive-compulsive symptoms: Study in a clinical sample
- C. Pinto-Gouveia, A. Araujo, A.T. Pereira, C. Cabaços, S. Renca, A. Macedo
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S417-S418
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Introduction
Co-occurrence of obsessive-compulsive disorder (OCD) and autism spectrum disorder (ASD) features is well stablished. Diagnosis of OCD increases the risk of a later diagnosis of ASD, and vice versa. Moreover, a recent combined genome-wide association study identified a shared polygenic risk between the two disorders. Our preliminary results also indicate that OCD patients have higher levels of autistic traits than individuals from the community.
ObjectivesTo determine which autistic dimensions (social skill, communication, attention switching, attention to detail imagination) are predictors of OC symptoms.
Methods39 OCD patients (52,5% female; 19 to 64 years old) answered the Portuguese versions of the Autism-Spectrum Quotient for Adults and Obsessive Compulsive Inventory – Revised (OCI-R). Spearman correlation and linear multiple regression tests were performed using SPSS.
ResultsThe OCI-R global score showed positive correlations with some AQ dimensions (attention switching, attention to detail and communication). The regression model showed that attention to detail (β = .43, p = .01) and attention switching (β = .33, p = .038) explained 36% of obsessive-compulsive symptoms variance.
ConclusionsOur results are in line with a dimensional perspective of psychopathological continua and indicate that the overlap between OCD and ASD occurs through shared neurocognitive processes. We suggest that, besides being a predisposing factor for social difficulties (e.g.: facial/emotion recognition) in ASD, attention to detail and deficits in attention switching may also lead to difficulties to dismiss repetitive thoughts or extinguish behaviours in OCD. Future studies should investigate the distinctive features and underlying processes between OCD/ASD.