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Corporate law has traditionally assumed that men organize business, men profit from it, and men bring cases in front of male judges when disputes arise. It overlooks or forgets that women are dealmakers, shareholders, stakeholders, and businesspeople too. This lack of inclusivity in corporate law has profound effects on all of society, not only on women's lives and livelihoods. This volume takes up the challenge to imagine how corporate law might look if we valued not only women and other marginalized groups, but also a feminist perspective emphasizing the importance of power dynamics, equity, community, and diversity in corporate law. Prominent lawyers and legal scholars rewrite foundational corporate law cases, and also provide accompanying commentary that situates each opinion in context, explains the feminist theories applied, and explores the impact the rewritten opinion might have had on the development of corporate law, business, and society.
This study aims to evaluate the effects of N-acetylcysteine (NAC) on bovine oocyte maturation, mitochondrial activity and transzonal projections (TZP), as well as on the levels of reactive oxygen species (ROS) and messenger RNA (mRNA) for catalase (CAT) superoxide dismutase (SOD), periredoxin-6 (Prdx6), glutathione peroxidase (GPx), growth and differentiation factor-9 (GDF9), histone H1Foo, cyclin B1 (CCNB1) and c-Mos. Bovine cumulus–oocyte complexes (COC) of medium-sized antral follicles (3.0–6.0 mm) were prematured in TCM-199 for 8 h at 38.5°C in 5% CO2. After prematuration in the presence of forskolin and C-type natriuretic peptide, COCs were matured in TCM-199 alone or with 0.1, 0.5 or 2.5 mM NAC. Then, oocytes were classified according to the stage of chromatin. Furthermore, mitochondrial activity and intracellular levels of ROS and TZP were also evaluated. The levels of mRNAs for CAT, SOD, Prdx6, GPx, GDF9, H1Foo, CCNB1 and c-Mos were evaluated using real-time polymerase chain reaction (RT-PCR). The results showed that NAC significantly increased the percentages of oocytes with resumption of meiosis when compared with those oocytes matured in control medium. Oocytes had homogeneous mitochondrial distribution, and those cultured with 0.1 and 0.5 mM NAC had lower levels of ROS when compared with the control. In addition, 0.5 mM NAC reduced TZP and the levels of mRNA for CCNB1. In contrast, NAC did not influence the expression of CAT, GPx, Prdx6, SOD, GDF9, H1Foo, and c-Mos. In conclusion, 0.5 mM NAC reduced the levels of ROS, TZP and mRNA for CCNB1, and improved in vitro resumption of meiosis in oocytes from medium-sized bovine antral follicles.
Self-Harm (SH) is any act of self-injury carried out by somebody irrespective of motivation. SH most commonly functions to relieve negative affect (NA). Tentative evidence suggests reward processing is altered in SH. NA may trigger reward hypersensitivity and therefore SH. Whether NA influences reward processing in SH remains unclear.
To investigate whether self-harmers differ in motivation to obtain SH stimuli than healthy controls (HCs) following NA induction.
After NA induction, SH participants will have a significantly shorter reaction latency (RL) and greater reaction accuracy (RA) than HCs in the SH condition of the Incentive Delay (ID) task.
16-25-year-old SH (n=35) and HC (n=20) participants were recruited online and underwent the Trier Social Stress Test, to induce NA, followed by the ID task, where participants were cued to respond to a target as quickly as possible. On responding, an image of either a SH act (SH Condition), people socializing (Social Condition) or money (Monetary Condition) appeared. Each condition included control trials showing a neutral image. RA was the percentage of trials responded to within the target’s presentation time. RL was the time (seconds) between target appearance and participants’ response.
There was no significant main effect of group, condition or group x condition interaction for RL. There was a significant main effect of condition (p < 0.05) but not of group nor a group x condition interaction for RA.
Reward processing did not differ in the SH group compared to HCs post-NA induction. Future studies could investigate reward processing in longitudinal and larger SH samples.
People presenting first-episode psychosis (FEP) benefit from early intervention programmes, although they are scarce in low- and middle-income countries (LMICs). In Brazil, there are just a few of them unequally distributed across the country.
We aimed to describe the workings of the Ribeirão Preto Early Intervention for Psychosis Programme (Ribeirão Preto-EIP) – an outpatient service for first-episode psychosis patients residents in the Ribeirão Preto catchment area in Southeastern Brazil.
A retrospective cohort of all patients attended throughout four years (2015-2018) was analysed. We excluded patients who attended only the first consultation and those with an initial diagnosis other than a psychotic disorder. Data was obtained through retrospective analysis of medical records.
Our service had 358 new referrals during the four-year period, and 237 patients were followed on average (median) by 14 months. Most of the patients were male (64.1%), single (84.8%), with a median age of 23.5 years (age ranged from 9 to 86 years). Schizophrenia was the main diagnosis (43.4%), followed by substance-induced (25.7%) and affective psychosis (18.6%). Taking follow-up diagnoses as gold-standard, initial diagnoses of bipolar disorder and schizophrenia spectrum disorders had the highest positive predictive values, 83% and 81% respectively. Most referrals to our programme were made by tertiary care (63.7%), followed by secondary (28.5%) and primary care (7.8%).
Here we presented a large sample of FEP patients in a representation as trustworthy to the reality of our programme as possible. Our analysis suggest that Early Intervention Programmes can be successfully implemented in LMICs.
Entrepreneurship may entail innovation and disruption, but ideas need businesses to effectuate them, and businesses require financing. Financing inevitably entails regulation – securities regulation. Securities law has never been static, but it has evolved rapidly and in a complex dynamic between Congress and the Securities and Exchange Commission (SEC). These two bodies create the rules of the road for entrepreneurs who grapple with the challenges of raising capital. Entrepreneurs being entrepreneurial, they naturally will seek to disrupt the regulatory status quo. What should Ms. Entrepreneur seek when she goes to Washington? History makes clear that as important as getting legislation passed is knowing the optimal shape of that legislation. In this chapter I’ll use the history of financial regulation to articulate the distinction between legislation that dictates and legislation that delegates – and explain why the former is more attractive to the entrepreneur than the latter.
In this study, we compared the richness of ground-dwelling ants among three different sugarcane management systems (with the application of the insecticide fipronil and the addition of vinasse; with fipronil and no vinasse; and with vinasse and no fipronil, i.e., an organic production system) to evaluate whether the feeding/foraging types vary according to the management system. We tested the hypothesis that organic management increases species diversity because there is no use of chemical inputs. Estimated species richness was significantly higher in the organic management system than in the systems that used fipronil with vinasse. Generalists species were prevalent in all sugarcane fields, regardless of the production system, whereas predatory and fungivorous species were infrequent. However, the organically managed field had many predatory species. Our results suggest that fipronil with vinasse in sugarcane cultivation alters the ant community, possibly disrupting the functions performed by the edaphic fauna, such as control of arthropod crop pests, due to reduced predator species richness.
The coronavirus disease 2019 (COVID-19) pandemic has caused a global health crisis and may have affected healthcare-associated infection (HAI) prevention strategies. We evaluated the impact of the COVID-19 pandemic on HAI incidence in Brazilian intensive care units (ICUs).
In this ecological study, we compared adult patients admitted to the ICU from April through June 2020 (pandemic period) with the same period in 2019 (prepandemic period) in 21 Brazilian hospitals. We used the Wilcoxon signed rank-sum test in a pairwise analysis to compare the following differences between the pandemic and the prepandemic periods: microbiologically confirmed central-line–associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) incidence density (cases per 1,000 central line and ventilator days, respectively), the proportion of organisms that caused HAI, and antibiotic consumption (DDD).
We detected a significant increase in median CLABSI incidence during the pandemic: 1.60 (IQR, 0.44–4.20) vs 2.81 (IQR, 1.35–6.89) (P = .002). We did not detect a significant difference in VAP incidence between the 2 periods. In addition, we detected a significant increase in the proportion of CLABSI caused by Enterococcus faecalis and Candida spp during the pandemic, although only the latter retained statistical significance after correction for multiple comparisons. We did not detect a significant change in ceftriaxone, piperacillin–tazobactam, meropenem, or vancomycin consumption between the studied periods.
There was an increase in CLABSI incidence in Brazilian ICUs during the first months of COVID-19 pandemic. Additionally, we detected an increase in the proportion of CLABSI caused by E. faecalis and Candida spp during this period. CLABSI prevention strategies must be reinforced in ICUs during the COVID-19 pandemic.
The presence of the prostate in female mammals has long been known. However, pieces of information related to its development are still lacking. The aim of this study was to explore the budding dynamic during the initial prostate development in female gerbils. Pregnant females were timed, the fetuses were euthanized, and the urogenital sinus was dissected out between the embryonic days 20 and 24 (E20–E24 groups). Newborn pups (1-day-old; P1 group) underwent the same procedures. The female prostate development was based on epithelial buds which arose far from the paraurethral mesenchyme (PAM). The epithelial buds reached the PAM at prenatal day 24, crossing a small gap in the smooth muscle layer between the periurethral mesenchyme (PEM) and the PAM. Steroid nuclear receptors such as the androgen receptor and estrogen receptor alpha were localized in the PEM through the urethral wall, although some epithelial labeling was also present in the urogenital sinus epithelium (UGE). P63-positive cells were found only in the UGE, becoming restricted to the basal compartment after the 23rd prenatal day. The results showed that the gerbil female prostate exhibits a distinct budding pattern as compared to the male prostate development.
Polycystic echinococcosis (PE) is a zoonosis endemic in the Neotropical region of the Americas. It is caused by the larval stage of the cestode Echinococcus vogeli, which develops as harmful cysts that slowly grow in the liver, lungs and other organs of humans and other host species. Human PE diagnosis is usually based on clinical and epidemiological aspects and imaging techniques, often requiring confirmation by immunological assays. The currently available serological tests for detecting antibodies against Echinococcus spp. are mostly based on complex, variable and poorly characterized mixtures of native parasite antigens, which impairs specificity and/or sensitivity. In this scenario, the evaluation of well-characterized alternative antigens is urgently needed for the improvement of PE diagnosis. Here, two subunits (AgB8/1 and AgB8/2) of the major secretory antigen from Echinococcus granulosus (antigen B (AgB)), of diagnostic value for cystic echinococcosis, were validated for PE diagnosis. These antigens, produced as pure recombinant proteins (rAgB8/1 and rAgB8/2) in Escherichia coli, allowed detecting specific immunoglobulin G antibodies in sera from PE patients in an enzyme-linked immunosorbent assay, with sensitivities of 83.72% and 81.40%, respectively, and specificities of 83.12% and 80.09%, respectively. The use of recombinant proteins overcomes difficulties to obtain parasite material and reduced non-specific reactions and costs. Our results demonstrated reproducibility and accuracy high enough to be considered valid according to the acceptance criteria for Food and Drug Administration assay validation. This qualifies rAgB8/1 and rAgB8/2 as potential substitutes for the currently used parasite crude or partially purified antigens.
The objective of this study is to provide approaches to determine the mature weight of intact male hair sheep using body composition data. To estimate empty body weight (EBW) at maturity, we used information from eight independent studies comprising a total of 250 intact males in growing and finishing phases. The quantitative data used for each animal were body weight (BW), EBW, water-free EBW protein content, water-free EBW fat content, water-free EBW ash content and EBW water content. The water, protein, fat and ash contents in the EBW and water-free EBW were predicted by non-linear regressions. The best model was chosen considering the achievement of convergence and capacity for biological explanation. The standard deviation of the asymptotic EBW was computed using a simulation method based on a Monte Carlo approach. Among the non-linear evaluations, only the allometric function converged with the parameters within the expected biological limits. To estimate mature EBW, only protein and fat were suitable to predict estimates with the capacity to biological explanation. The water and protein contents in the EBW were closely associated. Animal maturity can be estimated mathematically using body composition. Maturity was reached at an EBW of 47.3 and 57.5 kg when protein and fat were used as a predictor, respectively. We conclude that protein is a good predictor of maturity for intact male hair sheep.
Impulse control disorders (ICDs) are an adverse effect of dopamine agonists (DAAs) that affects the quality of life and can lead to legal, criminal and familiar problems.
Presenting a review of the mechanisms, prevalence and factors associated with the development of an ICD due to DAA use.
Search on Pubmed database with combination of the following keywords were used: “Impulse control disorders”, “dopamine agonist” or “therapy”. We focused on data from studies published between 2015 and 2020. The articles were selected by the author according to their relevance.
DAAs are mainly indicated in the treatment of Parkinson’s Disease (PD), and are also used on symptoms of restless legs syndrome (RLS) and prolactinoma or lactation inhibition. Dopamine replacement therapy act on dopamine receptors in the nigrostriatal and the reward pathways, which plays a role in addictive behavior. The prevalence of ICDs ranged from 2.6 to 34.8% in PD patients and a lower prevalence in RLS patients. Some of the ICDs reported were pathological gambling, hypersexuality, compulsive shopping, obsessive hobbying, punding, and compulsive medication use. The factors associated with the development include the type of DAAs, dosage, male gender, younger age, history of psychiatric symptoms, earlier onset of disease, longer disease duration, and motor complications in PD.
Further studies are needed to clarify the pathophysiology of the ICD in DAA therapy and determinate premorbid risk factors. The percentage of patients with ICDs is underrated, so it’s important to improve the patient’s evaluation, using validated and consensual assessment tools.
Frontotemporal dementia (FTD) is a group of neurodegenerative disorders characterized by behavioral or language changes with progressive executive dysfunction. It´s subdivided into two variants, the behavioral and language variants. The phenocopy syndrome of frontotemporal dementia (phFTD) mimics the behavioral variant, but doesn´t show frontotemporal atrophy in neuroimaging and doesn´t progress to frank dementia over the years.
Presenting a review of phenocopy syndrome of frontotemporal dementia.
Search on Pubmed® and Medscape® databases with the following keywords: “frontotemporal dementia and phenocopy” or “FTD phenocopy”. We focused on data from systematic reviews and meta-analyzes published in the last five years. The articles were selected by the authors according to their relevance.
Mutations in GRN and MAPT gens and genetic expansion of C9orf72 have been identified. The discovery of the C9orf72 expansion in psychiatric disorders (psychosis, bipolar disorder or depressive disorder), for some authors, represents that phFTD is a psychiatric pathology. In fact, there’s a higher frequency of psychiatric and psychological symptoms in phFTD compared to the variants of FTD. Usually are male patients who don´t have significant cognitive deficits, with preservation of executive functions and episodic memory. Until now, there are no definitive biomarkers of the disease. The prognosis is more benigne, unlike FTD, which has an average survival of 3 years since diagnosis.
phFTD is a clinical and scientific challenge. The neurobiological bases remain unknown, requiring further studies in this field. The identification of markers that can differentiate patients with typical FTD and phFTD can facilitate prognosis orientation and pharmacological an non-pharmacological treatment.
Any outbreak of pandemic dimension will most likely produce a serious amount of distress and prejudice to anyone, in particular when it comes to mental health. The pandemic impact in primary care and in the psychiatric emergency department are some of the topics discussed in this review.
It aims to review, evaluate and reflect over the impact of a deadly coronavirus pandemic on mental health, as well as presenting possible long-term challenges and potential ways to approach it.
A non-systematic literary review was performed on the Pubmed, PsycInfo and Cochrane databases using the key words “covid-19”, “psychiatry”, “self-isolation” and “telepsychiatry”.
Globally and, as expected, there has been a general increase in need for psychiatric assessment and treatment due to the COVID-19 pandemic.
The role of psychiatry has faced quite some challenges in such a short period of time: the rise of telepsychiatry; the management of patients with both a psychiatric disorder and an infection with the new coronavirus and the need to provide an adequate psychiatric assistance in the emergency room has become the new normal.
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder characterized by neuropsychiatric symptoms before progressing to seizures, complex movement disorder, autonomic dysfunction and hypoventilation.
Presenting a review of the psychiatric manifestations of anti-NMDAR encephalitis.
Search on Pubmed® and Medscape® databases with the following keywords: “psychiatric”, “anti-NMDA receptor encephalitis” and “anti-NMDAR encephalitis”. We focused on data from systematic reviews and meta-analyzes. The articles were selected by the authors according to their relevance.
Studies show that 77% to 95% of patients with anti-NMDAR encephalitis initially present psychiatric manifestations. Age and sex distribution are young women, and the frequency of cases is lower after 40 years of age. The most common psychiatric symptoms are agitation (59%) and psychotic symptoms (54%). The psychotic symptoms more common are visual (64%), auditory (59%) hallucinations and persecutory delusions (73%). Catatonia is described in 42% of patients. Antipsychotic treatment induces an adverse drug reaction (33%), the neuroleptic malignant syndrome represents 22% of the cases. Delays in distinguishing this disease from a psychiatric disorder can have serious complications, with a mortality of up to 25% in patients receiving limited or delayed immunotherapy.
It’s important to consider anti-NMDAR encephalitis in the differential diagnosis of patients with an acute onset psychosis or unusual psychiatric symptoms. Antipsychotic treatment should be use with caution when suspected or confirmed anti-NMDAR encephalitis. Without appropriate treatment, patients may suffer a protracted course with significant long-term disability or death. A clinical index of suspicion is required to identify patients who would benefit from cerebrospinal fluid testing and immunotherapies.
Individuals with schizophrenia have a shortened average life expectancy, with a lifetime risk of suicide around 5%.
Here we present a case of a patient diagnosed with schizophrenia who developed depressive symptoms with suicidal ideation, reactive to psychotic symptoms. Considering this specific case, the factors that contribute to the increased risk of suicide in these patients are reviewed.
Relevant clinical information was extracted from the patient’s clinical process. In addition, we searched PubmedR database with the terms “Schizophrenia”, “Hopelessness” and “Suicide”.
A 40-year-old male patient, single and unemployed presents a progressive psychotic condition, with 20 years of evolution, with an impact on social and work behaviour. As a background he has a history of depressive episodes with suicidal ideation at the age of 36, following psychotic symptoms. This is a patient with preserved cognitive functioning combined with a high level of education, who understands the impact of his reality on his functioning. In this context, he develops feelings of hopelessness, that are the risk factor for suicide, most consistently reported in patients with schizophrenia.
This case assesses a patient with schizophrenia who has several factors, that contribute to an increased risk of suicide, focusing on hopelessness. In the future, it may be interesting to study in more detail the individual weight of each factor, so that it is possible to accurately predict the individual risk of each patient and, consequently, it is possible to implement preventive strategies.
To investigate the associations of maternal excess weight before pregnancy with (1) weaning at 3 months of age, (2) duration of exclusive breast-feeding at 6 months of age, (3) duration of any breast-feeding at 12 months of age and (4) to compare the magnitude of these associations over four decades. Data were from participants in the Pelotas (Brazil) Birth Cohorts born in 1982 (n 5334), 1993 (n 1442), 2004 (n 4092) and 2015 (n 4102). Maternal pre-pregnancy weight was collected after the delivery and breast-feeding status was assessed when children were 3 and 12 months old. Only in the most recent cohort (2015), women with excess weight (BMI ≥ 25 kg/m2) before pregnancy had higher risk of discontinuing exclusive breast-feeding within the first 6 months postpartum than women with normal weight (hazard ratio = 1·22 (95 % CI 1·15, 1·30)). Duration of any type of breast-feeding until 12 months of age was not affected by pre-pregnancy weight. Excess weight before pregnancy is associated with exclusive breast-feeding only in the most recent birth cohort coinciding with increases in excess weight and breast-feeding over time.