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Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
Bipolar disorder (BD) is associated with premature death and ischemic heart disease is the main cause of excess mortality. The predictive power of heart rate variability (HRV) for mortality has been confirmed in patients with or without cardiovascular disease. While several studies have analyzed the association between HRV and BD, their results are incongruent; and none has analyzed the effect of the clinical factors characterizing illness burden on HRV.
To assess the association between HRV and the following factors characterizing illness burden: illness duration, number and type of previous episode(s), duration of the most severe depressive or hypomanic/manic episode, severity of episodes, co-morbid psychiatric disorders, family history of BD or suicide, and duration and polarity of current episode in participants experiencing one.
We used a wearable device in 53 BD participants to assess the association between HRV using 4 measures (RMSSD, SDANN, SDNN and RR Triangular Index) and the abovementioned clinical factors characterizing illness burden. For each of the 4 HRV measures we ran 11 models, one for each burden of illness clinical factor as an independent variable.
Longer illness duration, higher number of depressive episodes, and family history of suicide were negatively correlated with HRV; in the 14 participants experiencing a depressive episode, the MADRS score was negatively correlated with HRV
Our study analyzed the association between burden of illness and HRV in BD, while controlling for functional cardiovascular status, age, sex, BMI, education, and treatment. Our results showed that high illness burden is associated with reduced HRV.
Previous research has found that candidates for bariatric surgery usually present anxiety, depression, personality disorders and/or a tendency to binge eating. The situation related with the pandemic and the lockdowns during the 2020 are possible aggravating factors for these characteristics.
To study the more important psychological characteristics presented by candidates for bariatric surgery.
40 people between 29 and 65 years old (M=46.4, SD=9.1; 37.5% male, 62.5% female) were evaluated between July and December of 2020. The assessment consisted in an interview carried out by a clinical psychologist, and a pool of questionnaires to evaluate depression and anxiety symptoms (Beck Depression Inventory, BDI; and the Goldberg Anxiety and Depression Scale, GADS) the existence of a binge eating pattern (the Binge Eating Scale; BES) and personality traits (the Salamanca Screening Test).
The 25% of the sample had previous mental health antecedents. Eight people disclosed to feel stress in relation with the COVID-19, and 18 presented an emotional regulation strategy using food during the lockdown. 62.5% scored above the cut-off point on the BDI (mild=27.5%, moderate=20%, severe=15%) and a 40% and a 47.5% did it for the anxiety and the depression (respectively) GADS subscales. 20% presented a binge eating pattern according with the BES. Most common personality traits were histrionic (50%), emotionally unstable impulsive type (45%), and anxious (42.5%).
These findings support the previous scientific literature. Psychological intervention programs may be considered to guarantee the surgery’s success, especially when adverse contextual circumstances are presented.
Trichomonas vaginalis causes trichomoniasis, an inflammatory process related to an increased rate of HIV transmission. In order to study T. vaginalis infection response in a microorganism-free environment, an infection model was established providing a host–parasite interaction system useful to study the interplay between immune cells and the parasite. Infected mice peritoneal cells were immunophenotyped at different times after infection using flow cytometry. Neutrophils and macrophages showed the most relevant increase from third to 12th day post-infection. A high number of B lymphocytes were present on 15th day post-infection, and an increase in memory T cells was observed on sixth day post-infection. The levels of NO increased at day 10 post-infection; no significant influence was observed on T. vaginalis clearance. Increased viability of T. vaginalis was observed when the NETs inhibitors, metformin and Cl− amidine, were administrated, highlighting the importance of this mechanism to control parasite infection (43 and 86%, respectively). This report presents a comprehensive cell count of the immune cells participating against trichomoniasis in an in vivo interaction system. These data highlight the relevance of innate mechanisms such as specific population changes of innate immune cells and their impact on the T. vaginalis viability.
Investigations of the Proyecto Arqueológico Tlajinga Teotihuacan (PATT) in 2019 focused on the southern neighborhood center of this cluster of non-elite residences in the southern periphery of the ancient Mexican metropolis. Our objective was to better understand the social infrastructure of public space within the district and how it tied its inhabitants together. Our methods included excavations at two large architectural complexes, geophysical prospection of these and adjacent structures and plazas, and chemical residue analysis of floors and sediments. They revealed architecturally elaborate complexes decorated with mural painting that appear to have been the loci of civic-ceremonial activities. Materials from the excavated portions of the complexes are inconsistent with residential uses, although it is possible that local elites lived elsewhere in the complexes or in others located nearby. The investigations therefore demonstrate that the semipublic spaces of neighborhood centers were distributed as distantly as this periphery of Teotihuacan and could be as elaborate as those in the urban epicenter, underscoring the city's more muted social inequality.
As racialized and gendered structures, organizations can reinforce complex inequalities, especially with regard to emotional labor. While the literature on emotional labor is established, little is known about how race and sexual orientation shape feeling rule enforcement. Interviewing staff at university LGBTQ resource centers, we argue that feeling rules have a sexual orientation-based dimension and are experienced and enforced differently based on race. White LGBTQ staff find that they can express anger strategically to bring awareness to issues of race, but do not confront racism in their work for fear of alienating other Whites, which they believe would harm their center. LGBTQ staff of color experience organizational consequences for their anger, which is directed toward the racism they and students of color experience in the university. Lacking the credential of Whiteness (Ray 2019), staff of color find they cannot reach the benchmark set by Whites’ enthusiastic performance of emotional labor. These feeling rules operate in service of what James M. Thomas (2018) calls diversity regimes, which are performances of a benign commitment to racial equality, that retrench racial inequality by failing to redistribute resources along racial lines. By sanctioning anger toward the university—as an institution that reproduces racism—feeling rules have organizational consequences: Whites can advance through compliance and enthusiasm; staff of color are terminated or denied opportunities; and critiques of racism are silenced. While created to address diversity, LGBTQ centers are purposely not structurally positioned to radically shift resources in a way to combat racism, and feeling rules maintain these arrangements while allowing universities to claim a commitment to equality. These findings hold implications for broader concerns of racism, sexual orientation, and inequality within work organizations, especially manifestations of worker control within diversity work.
Food security status is a continuum ranging from high to very low food security. While marginal food security falls next to high food security on the spectrum, new quantitative research indicates marginal food security status is associated with negative health outcomes and poor academic performance among college students. Qualitative research focusing on college students experiencing marginal food security has not been conducted. The current study aims to qualitatively explore experiences of college students with marginal food security and to identify themes to better understand and provide context regarding how marginal food security impacts students.
Students were recruited for semi-structured interviews with questions designed to study the challenges associated with students’ food situations. All interviews were recorded and transcribed with themes identified via an inductive approach.
A large public university on the US west coast.
Thirty college students.
Key themes that emerged: purchasing cheap unhealthy foods, insufficient time to prepare and eat meals on a regular basis, stress and anxiety around the inability to eat healthy food and future health issues, self-perception of health when eating poorly along with physical symptoms and low academic motivation by not fully participating in their courses due to few healthy food options or missing meals.
Marginal food security can potentially diminish students’ health and their capacity to learn and succeed in their coursework. The results emphasise that students experiencing marginal food security should not be grouped with students experiencing high food security.
Healthcare workers (HCWs) not fulfilling the coronavirus disease 2019 (COVID-19) case definition underwent severe acute respiratory coronavirus virus 2 (SARS-CoV-2) screening. Risk of exposure, adherence to personal protective equipment (PPE), and symptoms were assessed. In total, 2,000 HCWs were screened: 5.5% were positive for SARS-CoV-2 by polymerase chain reaction (PCR). There were no differences in PPE use between SARS-CoV-2–positive and –negative HCWs (adherence, >90%). Nursing and kitchen staff were independently associated with positive SARS-CoV-2 results.
2020 was to be a landmark year for setting targets to stop biodiversity loss and prevent dangerous climate change. However, COVID-19 has caused delays to the 15th Conference of the Parties (COP) of the UN Convention on Biological Diversity and the 26th COP of the UN Framework Convention on Climate Change. Negotiations on the Global Biodiversity Framework and the second submission of Nationally Determined Contributions under the Paris Agreement were due to take place at these COPs. There is uncertainty as to how the COVID-19 disruption will affect the negotiations, whether parties will pursue more ambitious actions or take a weaker stance on issues. Our policy analysis shows there are broad opportunities for climate and biodiversity frameworks to better respond to COVID-19, by viewing future pandemics, biodiversity loss, and climate change as interconnected problems. Importantly, there needs to be greater focus on agriculture and food systems in discussions, establishing safeguards for carbon markets, and implementing nature-based solutions in meeting the Paris Agreement goals. We can no longer delay action to address the biodiversity and climate emergencies, and accelerating sustainable recovery plans through virtual spaces may help keep discussions and momentum before the resumption of in-person negotiations.
High ambition needed at UN biodiversity and climate conferences to address pandemics, biodiversity, climate change, and health.
This study aims to determine the relationship between physico-chemical variables on a seasonal basis and wild fish assemblages beneath sea-cage fish farms. Assemblages of wild fish were counted monthly on two separate days at each of six fish farms between August 2015 and July 2017, by six rapid visual counts (RVC) in 5 minutes with scuba by two divers. Seawater samples were simultaneously taken by a Nansen bottle during the RVC from the fish farm barge. SST (°C), salinity (ppm), dissolved oxygen (mg l−1) and pH were measured by YSI multiparameter, while Secchi disk was also used for light transmittance. Wild fish species richness went up with increasing temperature and salinity in the Izmir region, however, this stopped at about 26°C and about 39 ppm. Wild fish richness increased when the DO was at a level of 7 mg l−1 and the pH at about 7.9 in Izmir. Between 10 and 20 m, light transmittance showed greater wild fish species richness in Izmir region. In contrast, the wild fish species richness of the Muğla region fluctuated more. In terms of wild fish species richness, these fluctuations increased with salinity and DO, while they decreased with SST, pH and light transmittance. However, the range of variation of the recorded physico-chemical variables is rather narrow. The results of the correlation matrix indicate that the relationship between wild fish species richness and pH and SST was statistically significant in Izmir region (P < 0.05).
Spreading of pruning waste over the soil surface may increase soil organic carbon, thus improving soil physical properties and serving as a source of nutrients and energy for microbial populations. The aim of this study was to test the effect of the environmental conditions and the biochemical composition of pruning waste from avocado, cherimoya, mango and gardens on their decomposition process in a Mediterranean subtropical climate. Bagged pruning and garden waste were placed on the ground at a distance of 1 m around the trunk of the three trees from each crop. The concentrations in C, N, lignin, cellulose, hemicellulose, other extracts and ash were determined at the beginning of the experiment (T0), after six (T6) and 24 (T24) months in the field. Initially, significant differences were detected for all types of waste, especially in lignin, hemicellulose, cellulose and other extracts. No significant differences were found in the N content and the C content in mango pruning waste was significantly lower than that in avocado. The greatest weight loss recorded at T24 (63.2%) was related to the lower content in lignin, cellulose and other extracts. Weight losses and C concentrations showed negative correlations with lignin content. Despite the intense decomposition of all the waste, between 55 and 36.8% of the original weights were recorded at the end of the experiment. Recalcitrant C could be the result of the lignin concentrating in the case of the garden waste applied to the different crops.
We extend the classical notion of standardly stratified k-algebra (stated for finite dimensional k-algebras) to the more general class of rings, possibly without 1, with enough idempotents. We show that many of the fundamental results, which are known for classical standardly stratified algebras, can be generalized to this context. Furthermore, new classes of rings appear as: ideally standardly stratified and ideally quasi-hereditary. In the classical theory, it is known that quasi-hereditary and ideally quasi-hereditary algebras are equivalent notions, but in our general setting, this is no longer true. To develop the theory, we use the well-known connection between rings with enough idempotents and skeletally small categories (ringoids or rings with several objects).
Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.
The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.
We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.
We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.
A new species of gopher, Gregorymys mixtecorum n. sp., is described from the Arikareean 1 (early Oligocene) of Oaxaca, southern Mexico. Phylogenetic analysis indicates that it is the sister species of G. veloxikua, which was also recently described from southern Mexico. Both species were collected from sediments of the Chilapa Formation that crop out in northwestern Oaxaca. Gregorymys mixtecorum n. sp. and G. veloxikua show differences in size and proportions that possibly reduced competition for resources, exploiting different microhabitats. Both Mexican species represent the oldest and the most southern records of Gregorymys in North America. The Mexican record of Gregorymys suggests that at least some entoptychine rodents diversified in southern Mexico or Central America, and that Geomyidae has had a wide geographic distribution in North America since the early Oligocene.
Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear.
We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed.
This is a multicentre study of magnetic resonance imaging in patients with schizophrenia and controls from six Latin American cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model.
A total of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (P = 0.006). Controls showed a positive correlation between total grey matter volume and income (R = 0.14, P = 0.02). Surprisingly, this relationship was not present in patients with schizophrenia (R = −0.076, P = 0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure.
Our results highlight the interplay between environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as low- and middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments.
The concept of emotional labor or emotion work, first introduced by Hochschild (1983), has received enormous attention among researchers in recent decades (e.g. Grandey, 2000; Grandey & Gabriel, 2015; Holman, Martínez-Iñigo, & Totterdell, 2008; Hülsheger & Schewe, 2011; Rafaeli & Sutton, 1987; Zapf, 2002). It refers to emotional job requirements that service employees are exposed to when interacting with customers or clients. Social interaction with customers is one of the core aspects of service work. Here, as in any social interaction, requirements about regulating one’s emotions play a central role. Hochschild (1983), who coined the term “emotional labor” for this requirement, investigated the work of flight attendants and demonstrated that a substantial part of the job involved dealing with passengers and their emotions, and that displaying emotions that were not felt had a negative effect on both the health and the performance of service providers. As this finding was of high theoretical and practical importance, it stimulated research in the field.
Until now, no reliable biological markers of risk and relapse in substance-dependent patients have been identified. The yawn-inducing test with apomorphine has been proposed as a marker of the functional status of the dopaminergic system and therefore a predictor of suffering an addiction or predisposition to relapse.
Studying the safety and efficacy of apomorphine test as a predictor of relapse in intranasal cocaine dependent, diagnosed according to DSM-IV-TR.
We performed the test of apomorphine at the beginning (day 1) and end (day 11/12) of a detoxification program in 33 patients (29 men). The majority of patients relapsed after 22 weeks of follow up (87% relapse). The average yawns in the sample were 10.9 ± 9.3 in the initial test (Apo 1) and 10.2 ± 10.2 in the final test (Apo 2). The 42% of patients relapsed early (before 4 weeks) and 45% late (afther 4 weeks). 58% of the sample (N = 19), which did not fall belatedly filled an average of 8.0 yawns in Apo1 and 8.1 on Apo2 and 42% who did so early (N = 14), 14,8 in Apo1 and 14.6 in Apo2. Therefore there are an increased number of yawns in patients with early relapse. No important side effects were reported.
Patients with early relapse have a higher number of yawns that those falling late or abstainers The apomorphine test is a safe test and it is a readily applicable tool in clinical practice and may be a biological marker of risk.
Drug substance abuse has been related with chronic insomnia and other sleep disorders that are thought to interfere in detoxification treatment and relapse induction. These disorders can persist after drug detoxification.
To describe sleep disorders refered by drug dependents patients in an inpatient detoxification unit.
We prospectively studied drug dependents patients admitted to our Detoxification Unit from January 2005 to March 2009. The first night, patients were asked to complete an 11-item questionnaire measure designed to assess the relationship between sleep disorders and drug use. Responses ranged from 1 to 7. The questionnaire measured the following:
a) insomnia before hospitalization;
b) patients’ beliefs about the relationship between insomnia and drug use;
c) insomnia in previous detoxifications;
d) patients’ worry about insomnia;
e) treatment of sleep disorder with benzodiazepines.
The study sample included 150 patients (75.3% men). 39% of the patients suffered from alcohol abuse, 34.67% from cocaine abuse, 22.67% from opiod abuse, 21% from cannabis abuse, 18% from benzodiazepine abuse, and 12.67% of patients were polydrug users.Lifetime prevalence of sleep disorders was 68.1%. 64% had suffered insomnia the months previous to detoxification. 80.1% of patients’ refered sleep disorders in relationship with substance abuse. 69.4% were worried about insomnia during detoxification. 75.4% of patients took benzodiazepines without prescription.
Sleep disorders in patients with drug abuse are frequent. A high prevalence of patients having worries about insomnia during the detoxification treatment and believing in a relationship between their sleep disorders and the drug abuse was found.
Functional brain activity has been only studied marginally in schizoaffective disorder (SAD), a disorder whose nosological status is controversial. The present study investigated the prefrontal cortex (PFC) activity of schizomanic patients during performance of a working memory task.
13 schizoaffective patients, with current schizomanic episode (Young> 18); and 26 sex- and age-matched healthy controls underwent functional magnetic resonance imaging (fMRI) while performing baseline, 1-back and 2-back versions of the n-back task. Linear models were used to obtain maps of activations and deactivations in the groups.
During performance of the n-back task, controls showed activation in a cluster of frontal areas and de-activation in the medial orbitofrontal and anterior cingulate cortex. The SAD patients showed significantly less activation in prefrontal areas than the controls. They also showed a marked failure to de-activate in medial frontal cortex. The SAD patients’ impaired task performance was associated with both reduced activation of the dorsolateral PFC and reduced de-activation of the medial frontal areas.
Schizomanic patients show failure of activation in a network of cortical regions, and also a failure to de-activate the ventromedial PFC and anterior cingulate cortex. This latter area corresponds to the one of the components of the 'default mode network´. This pattern of abnormality is similar to that found by our group to characterise schizophrenia (failure to activate and failure to de-activate), but different from that which characterises manic patients (failure to de-activate only).
To describe validation process of the new apathy scale for institutionalized dementia patients (APADEM-NH).
100 elderly, institutionalized patients with diagnosis of probable Alzheimer Disease (AD) (57%), possible AD (13%), AD with cerebral vascular disease (CVD) (17%), Lewy Bodies Dementia (11%) and Parkinson associated to dementia (PDD) (2%). All stages of the disease severity according to the Global Deterioration Scale (GDS) and Clinical Dementia Rating (CDR) were assessed. The Apathy Inventory (AI), Neuropsychiatric Inventory (NPI), Cornell scale for depression, and the tested scale were applied. Re-test and inter-rater reliability was carried out in 50 patients. The feasibility and acceptability, reliability, validity, and measurement precision were analyzed.
APADEM-NH final version consists of 26 items and 3 dimensions: Deficit of Thinking and Self-Generated behaviors (DT): 13 items, Emotional Blunting (EB): 7 items, and Cognitive Inertia (CI): 6 items. Mean application time was 9.56 minutes and 74% of applications were fully computable. All subscales showed floor and ceiling effect lower than 15%. Internal consistency was excellent for each dimension (Cronbach’s α DT = 0.88, α EB = 0.83, α CI= 0.88);Test-retest reliability for the items was kW=0,48-0,92; Inter-rater reliability reached kW values 0.84-1.00; The APADEM-NH total score showed a low/moderate correlation with apathy scales (Spearman ρ, AI =0.33; NPI-Apathy= 0,31), no correlation with depression scales (NPI-Dementia = -0.003; Cornell= 0,10), and high internal validity (ρ =0.69 0.80).
APADEM-NH is a brief, psychometrically acceptable, and valid scale to assess apathy in patients from mild to severe dementia and discerning between apathy and depression.