Emotional theory of mind in eating disorders

The general aim of this ex post facto study was to investigate the emotional component of theory of mind (eToM) in a sample of 97 female patients with eating disorders (ED), considering all the diagnostic subtypes. Empirical research on this matter in ED is limited, specially focused on anorexia nervosa (AN), and results have been contradictory. The Reading the Mind in the Eyes test was administered to the patients and to 39 healthy controls. The emotional valence of the items was also examined. Patients with bulimia nervosa (BN) and ED-not otherwise specified (EDNOS) showed a poorer eToM ability compared to controls, especially in relation to positive emotions and non-emotional cognitive states. AN patients showed no differences in relation to controls. These results suggest that BN and EDNOS may show a specific pattern of difficulties inferring complex emotions, while AN patients would have no relevant difficulties in this regard. These deficits may need to be targeted in psychological treatmentEl objetivo general del presente estudio ex post facto fue investigar el componente emocional de la teoría de la mente (eToM) en una muestra de 97 mujeres con trastornos de la conducta alimentaria (TCA), considerando todos los subtipos diagnósticos. La investigación empírica realizada a este respecto en los TCA es limitada, enfocada especialmente en anorexia nerviosa (AN), y los resultados encontrados han sido contradictorios. Se administró el 'Test de los Ojos' a las pacientes y a 39 controles sanos. La valencia emocional de los ítems también se examinó. Las pacientes con bulimia nerviosa (BN) y TCA no especificado (TCANE) mostraron una peor habilidad en eToM que las controles, especialmente en relación a las emociones positivas y a los estados cognitivos no emocionales. No se encontraron diferencias entre las pacientes con AN y el grupo control. Los resultados sugieren que las pacientes con BN y TCANE podrían mostrar un patrón específico de dificultades a la hora de inferir emociones complejas en los otros, mientras el grupo de AN no presentaría ninguna dificultad relevante. Estos déficits necesitarían ser tenidos en cuenta en el tratamiento psicológic

Coordinated ultrastructural and phylogenomic analyses shed light on the hidden phycobiont diversity of Trebouxia microalgae in Ramalina fraxinea

[EN] The precise boundary delineations between taxa in symbiotic associations are very important for evolutionary and ecophysiological studies. Growing evidence indicates that in many cases, the use of either morphological characters or molecular markers results in diversity underestimation. In lichen symbioses. Trebouxia is the most common genus of lichen phycobionts, however, the diversity within this genus has been poorly studied and as such there is no clear species concept. This study constitutes a multifaceted approach incorporating aspects of ultrastructural characterization by TEM and phylogenomics to evaluate the morphological and genetic diversity of phycobionts within the sexually reproducing lichen Ramalina fraxinea in the context of Mediterranean and temperate populations. Results reveal an association with at least seven different Trebouxia lineages belonging to at least two species. T. decolorans and T. jamesii, and diverse combinations of such lineages coexisting within the same thallus depending on the analysed sample. Some of these lineages are shared by several other non-related lichen taxa. Our findings indicate the existence of a highly diverse assemblage of Trebouxia algae associating with R. fraxinea and suggest a possible incipient speciation within T. decolorans rendering a number of lineages or even actual species. This study stresses the importance of coordinated ultrastructural and molecular analyses to improve estimates of diversity and reveal the coexistence of more than one Trebouxia species within the same thallus. lt is also necessary to have clearer species delimitation criteria within the genus Trebouxia and microalgae in general.This study was funded by the Ministerio de Economia y Competitividad (MINECO CGL2012-40058-0O2-01/02), FEDER, the Generalitat Valenciana (PROMETEOII2013/021, GVA) and the Direccion General de Universidades e Investigacion de la Consejeria de Educacion de la Comunidad de Madrid - Universidad de Alcala (CCG10-UAH/GEN-5904). Drs. Arantxa Matins and Patricia Moya (Universitat de Valencia) made helpful comments on the manuscript.Català, S.; Campo, ED.; Barreno, E.; García-Breijo, F.; Reig Armiñana, J.; Casano, L. (2016). Coordinated ultrastructural and phylogenomic analyses shed light on the hidden phycobiont diversity of Trebouxia microalgae in Ramalina fraxinea. Molecular Phylogenetics and Evolution. 94:765-777. https://doi.org/10.1016/j.ympev.2015.10.021S7657779

Feasibility and short-term outcomes in liver-first approach: a Spanish snapshot study (the RENACI project)

Producción CientíficaSimple Summary: Current evidence does not provide enough information for selecting a tailored approach pathway in patients with colorectal cancer and synchronous liver metastases. There are no randomized clinical trials or prospective series comparing the classical approach with the liver-first approach. In addition, information on the proportion of patients who actually complete the therapeutic regimen is limited. The RENACI Project was a prospective National Registry performed on patients with colorectal cancer and synchronous liver metastases undergoing the liver-first approach. This study aimed to present the data of feasibility and short-term outcomes of the Spanish National Registry of Liver First Approach (the RENACI Project).(1) Background: The liver-first approach may be indicated for colorectal cancer patients with synchronous liver metastases to whom preoperative chemotherapy opens a potential window in which liver resection may be undertaken. This study aims to present the data of feasibility and short-term outcomes in the liver-first approach. (2) Methods: A prospective observational study was performed in Spanish hospitals that had a medium/high-volume of HPB surgeries from 1 June 2019 to 31 August 2020. (3) Results: In total, 40 hospitals participated, including a total of 2288 hepatectomies, 1350 for colorectal liver metastases, 150 of them (11.1%) using the liver-first approach, 63 (42.0%) in hospitals performing <50 hepatectomies/year. The proportion of patients as ASA III was significantly higher in centers performing ≥50 hepatectomies/year (difference: 18.9%; p = 0.0213). In 81.1% of the cases, the primary tumor was in the rectum or sigmoid colon. In total, 40% of the patients underwent major hepatectomies. The surgical approach was open surgery in 87 (58.0%) patients. Resection margins were R0 in 78.5% of the patients. In total, 40 (26.7%) patients had complications after the liver resection and 36 (27.3%) had complications after the primary resection. One-hundred and thirty-two (89.3%) patients completed the therapeutic regime. (4) Conclusions: There were no differences in the surgical outcomes between the centers performing <50 and ≥50 hepatectomies/year. Further analysis evaluating factors associated with clinical outcomes and determining the best candidates for this approach will be subsequently conducted.Asociación Española de Cirujanos - (grant Research Projects 2020

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Search for electroweak production of charginos and neutralinos in multilepton final states in proton-proton collisions at root s=13 TeV

Results are presented from a search for the direct electroweak production of charginos and neutralinos in signatures with either two or more leptons (electrons or muons) of the same electric charge, or with three or more leptons, which can include up to two hadronically decaying tau leptons. The results are based on a sample of protonproton collision data collected at p s = 13TeV, recorded with the CMS detector at the LHC, corresponding to an integrated luminosity of 35.9 fb1. The observed event yields are consistent with the expectations based on the standard model. The results are interpreted in simpli ed models of supersymmetry describing various scenarios for the production and decay of charginos and neutralinos. Depending on the model parameters chosen, mass values between 180GeV and 1150 GeV are excluded at 95% CL. These results signi cantly extend the parameter space probed for these particles in searches at the LHC. In addition, results are presented in a form suitable for alternative theoretical interpretations.Sponsoring Consortium for Open Access Publishing in Particle Physic

A 10-year longitudinal study of sustained attention across adolescence in a community sample : neurocognitive, personality, and biobehavioural correlates /

Consultable des del TDXTítol obtingut de la portada digitalitzadaIntroducción: Este estudio parte de una aproximación de alto riesgo no genético para el estudio de marcadores de vulnerabilidad a los trastornos del espectro esquizofrénico. Objetivos: a) explorar prospectivamente la relación entre la presencia de un déficit de atención sostenida a inicios de la adolescencia y medidas exofenotípicas de vulnerabilidad a los trastornos del espectro esquizofrénico (neurocognitivas, neurointegrativas, factores de personalidad y psicosociales) a principios de la edad adulta; b) identificar y describir diferentes subgrupos de sujetos en función de su perfil de desarrollo atencional a lo largo de la adolescencia; c) explorar asociaciones a nivel transversal entre la esquizotipia psicométrica y algunas variables endofenotípicas (factores neurocognitivos). Método: Dos cohortes de adolescentes de la población general fueron seleccionadas en 1993 (Fase I) en función de la presencia (n=301 sujetos Índice) o ausencia (n=300 sujetos Control) de un déficit de atención sostenida, según la prueba Continuous Performance Test. Ambas cohortes fueron re-evaluadas en 1997-98 (Fase II) y 2001-03 (Fase III) con una batería de tests neuropsicológicos y de personalidad. La última fase (Fase III) es el objetivo del presente estudio. En Fase III, la mortalidad experimental redujo la muestra drásticamente a n=42 sujetos Índice y n=38 sujetos Control. A ambas cohortes se les administraron varias medidas de funcionamiento neuropsicológico, esquizotipia psicométrica, conducta social, estrategias de afrontamiento, trastornos de personalidad y ajuste general previo. Las cohortes estaban ajustadas en cuanto a género, edad y nivel de educación. Se utilizaron t-tests y análisis de la covarianza (ANCOVA) para comparar ambas cohortes (ajustando por nivel de educación en caso necesario). Se utilizó análisis de conglomerados con el rendimiento atencional a lo largo de la adolescencia como variable de agrupación. Ae aplicaron análisis de la covarianza para comparar los grupos resultantes en cuanto a las medidas tomadas en Fase III. Se usaron correlaciones de Pearson para relacionar la esquizotipia psicométrica con las variables neurocognitivas. Resultados: Los sujetos Índice mostraron un rendimiento neruospicológico y neurointegrativo peor que los sujetos Control en Fase III. Además, mostraron mayor esquizotipia negativa, rasgos neuróticos e inmaduros de personalidad, así como mayor conducta asocial y peor uso de estrategias de afrontamiento que los controles. El análisis de conglomerados identificó 3 grupos de desarrollo atencional: a) desarrollo atencional no lineal y asintótico; b) incremento lineal progresivo de la atención partiendo de un rendimiento deficitario y acabando en un rango normal de ejecución; c) desarrollo no lineal asintótico, al igual que el grupo «a», pero con un déficit de atención estable a lo largo de la adolescencia. El primer grupo mostró puntuaciones normales en todas las medidas. El segundo grupo mostró déficit sutil en funcionamiento ejecutivo, así como rasgos de personalidad del grupo B. El tercer grupo mostró una mala ejecución en general en todas las variables neurocognitivas, conducta social pobre, esquizotipia negativa y desorganizada, estrategias de afrontamiento pobres, mal ajuste previo y mayor alteración emocional. Las correlaciones entre esquizotipia y funcionamiento neuropsicológico revelaron una peor ejecución neurocognitiva a mayores puntuaciones en esquizotipia negativa y desorganizada. Conclusiones: el déficit de atención sostenida a principios de la adolescencia puede asociarse a déficit social y de afrontamiento, esquizotipia negativa y rasgos de personalidad sugerentes de alteraciones de emocionales, así como alteraciones neurocognitivas en edad adulta. El perfil de desarrollo atencional durante la adolescencia muestra correlatos a nivel clínico, psicosocial, caracterial y neurocognitivo. Una aproximación al estudio de la vulnerabilidad a la psicopatología centrada en el desarrollo podría ser más útil que los diseños transversales. Nuestros resultados sugieren que el déficit de atención sostenida en la adolescencia temprana podría ser indicador de psicopatología en edad adulta y dan apoyo a modelos dimensionales de psicopatología.Background: The present study starts from a non-genetic high-risk approach to the study of vulnerability markers for schizophrenia spectrum disorders. Aims: a) to explore prospectively the relationship between the presence of sustained attention deficit in early adolescence, and exophenotypical measures of vulnerability to schizophrenia spectrum disorders (neurocognitive, neurointegrative, personality and psychosocial factors) in early adulthood; b) to identify and describe different subgroups of subjects according to their profile of attentional development through adolescence; and c) to explore cross-sectional associations between psychometric schizotypy and some endophenotypical variables (neurocognitive factors). Methods: Two cohorts of community adolescents were selected in 1993 (Phase I) according to the presence (n=301 Index subjects) or absence (n=300 Control subjects) of a sustained attention deficit, as measured by the Continuous Performance Test. Both cohorts were re-assessed in 1997-98 (Phase II) and 2001-03 (Phase III) with a battery of neuropsychological and personality tests. The last phase (Phase III) was the focus of the present study. In Phase III, attrition reduced the sample to n=42 Index subjects, and n=38 Control subjects. Both cohorts were administered several measures of neuropsychological functions, psychometric schizotypy, social behavior, coping strategies, personality disorders, and previous general adjustment. The cohorts were adjusted for gender, years of education and age. T-tests and ANCOVA tests were used to compare both cohorts (adjusting for education when needed). Cluster analyses were applied by using attentional performance in all three phases as the main variable. ANCOVA tests were used to compare the identified clusters among them in all Phase III measures. In addition, Pearson correlations were used to correlate psychometric schizotypy with neurocognitive variables. Results: Index subjects showed poorer neuropsychological and neurointegrative performance than Control subjects in Phase III. In addition, they showed higher negative schizotypy, neurotic and immature personality traits, as well as more asocial behavior and poorer use of coping resources than Control subjects did. The cluster analysis identified three clusters of attentional development across adolescence: a) asymptotic non-linear developmental function of sustained attention; b) progressive linear increase of attentional scores starting from impaired performance and eventually achieving normal scores; c) non-linear mean developmental function of attention, alike the «a» cluster, but with stable attention deficit through adolescence. First cluster was associated with normal scores in all tests. Second cluster was associated with subtle impairments in executive functioning and Cluster B personality traits. The third cluster was associated with a generally poor performance in neurocognitive variables, negative and disorganized schizotypy, poor coping strategies, poor social behavior, poor previous general adjustment and more emotional disturbance. Correlations between schizotypy scores and neurocognitive variables revealed poorer neurocognitive functioning in relation to higher scores in negative and disorganized schizotypy. Conclusions: A sustained attention deficit in early adolescence may be associated with coping and social deficits, negative schizotypy, and personality traits indicative of emotional disturbance, as well as neurocognitive impairment in adulthood. The profile of attentional development across adolescence shows clinical, personality, psychosocial and neurocognitive correlates. A developmental approach to the study of vulnerability to psychopathology may be more useful than a cross-sectional design. Our results suggest that a sustained attention deficit in early adolescence might be an indicator of psychopathology in adulthood and give support to dimensional models of psychopathology

Emotional theory of mind in eating disorders

The general aim of this ex post facto study was to investigate the emotional component of theory of mind (eToM) in a sample of 97 female patients with eating disorders (ED), considering all the diagnostic subtypes. Empirical research on this matter in ED is limited, specially focused on anorexia nervosa (AN), and results have been contradictory. The Reading the Mind in the Eyes test was administered to the patients and to 39 healthy controls. The emotional valence of the items was also examined. Patients with bulimia nervosa (BN) and ED-not otherwise specified (EDNOS) showed a poorer eToM ability compared to controls, especially in relation to positive emotions and non-emotional cognitive states. AN patients showed no differences in relation to controls. These results suggest that BN and EDNOS may show a specific pattern of difficulties inferring complex emotions, while AN patients would have no relevant difficulties in this regard. These deficits may need to be targeted in psychological treatmentEl objetivo general del presente estudio ex post facto fue investigar el componente emocional de la teoría de la mente (eToM) en una muestra de 97 mujeres con trastornos de la conducta alimentaria (TCA), considerando todos los subtipos diagnósticos. La investigación empírica realizada a este respecto en los TCA es limitada, enfocada especialmente en anorexia nerviosa (AN), y los resultados encontrados han sido contradictorios. Se administró el 'Test de los Ojos' a las pacientes y a 39 controles sanos. La valencia emocional de los ítems también se examinó. Las pacientes con bulimia nerviosa (BN) y TCA no especificado (TCANE) mostraron una peor habilidad en eToM que las controles, especialmente en relación a las emociones positivas y a los estados cognitivos no emocionales. No se encontraron diferencias entre las pacientes con AN y el grupo control. Los resultados sugieren que las pacientes con BN y TCANE podrían mostrar un patrón específico de dificultades a la hora de inferir emociones complejas en los otros, mientras el grupo de AN no presentaría ninguna dificultad relevante. Estos déficits necesitarían ser tenidos en cuenta en el tratamiento psicológic

Development of a Mobile Application for People with Obesity

Peer ReviewedPostprint (author's final draft