O Primeiro Atendimento Clinico no Imaginario de Estudantes de Psicologia

Considering the academic development of the psychologist as a complex process which articulates the transmission of scientific knowledge and changes in imaginative activity, we psychoanalytically investigate the collective imaginary of Psychology students regarding the first clinical consultation. We conducted a group interview with 52 undergraduate students, using the Thematic Story-Drawing Procedure as a way to open a dialogical field. The material obtained, through the psychoanalytical method, resulted in the creation/gathering of four affective-emotional meaning fields: “I came, I saw and I conquered”, “I know that I (do not) know”, “I survived and I will save” and “I am and I do”, from which we see an emotionally immature imaginary about the meeting with the patient, since students are more self-centered than concerned with the patient. The overall situation indicates the need for care regarding student academic development, in order to encourage a more mature approach toward the suffering of the other.Considerando la formación académica del psicólogo como un proceso complejo, que articula transmisión de conocimientos científicos con cambios en la actividad imaginativa, investigamos psicoanalíticamente el imaginario colectivo de estudiantes de Psicología sobre la primera experiencia de la práctica clínica. Realizamos una entrevista grupal, que incluyó 52 estudiantes universitarios, utilizando el Procedimiento Dibujos-Cuentos con Tema para favorecer la apertura de un campo dialógico. El material obtenido fue considerado a través del método psicoanalítico, resultando en la creación/encuentro de cuatro campos de sentido afectivo-emocional: “vino, vio, conquistó”, “Yo sé que (no) lo sé”, “sobreviví e salvaré” y “soy y hago”. Percibimos un imaginario emocionalmente inmaduro sobre el encuentro con el paciente, puesto que los alumnos están más centrados en sí mismo que preocupados por el paciente. El panorama general indica la necesidad de atención a la educación de los estudiantes, para facilitar un enfoque más maduro del sufrimiento de otro.Considerando a formação do psicólogo como um processo complexo, que articula transmissão de conhecimentos científicos e mudanças na atividade imaginativa, investigamos psicanaliticamente o imaginário coletivo de estudantes de Psicologia sobre o primeiro atendimento clínico. Realizamos entrevista grupal, da qual participaram 52 graduandos, usando o Procedimento de Desenho-Estória com Tema como favorecedor da abertura de um campo dialógico. O conjunto das produções foi considerado através do método psicanalítico, resultando na criação/encontro de quatro campos de sentido afetivo-emocional: “vim, vi e venci”, “sei que (não) sei”, “sobrevivi e salvarei” e “sou e faço”, a partir dos quais percebemos um imaginário emocionalmente imaturo sobre o encontro com o paciente, uma vez que os alunos se mostram mais centrados em si mesmos, do que preocupados com o paciente. O quadro geral indica a necessidade de cuidados em relação à formação do aluno, no sentido de facilitar uma aproximação mais amadurecida do sofrimento do outro

Bone Marrow Foot Oedema in Adolescents: The Role of Vitamin D

BACKGROUND: Bone marrow oedema (BMO) in children/adolescents is a rare clinical condition without an etiologic cause. It is associated with typical increased signal intensity on T2-weighted magnetic resonance images (MRI) and an increase in bone turnover in which vitamin D plays a pivotal role. No treatment guidelines for these young patients are to date available. METHODS: We performed a retrospective study in a pediatric setting of 13 patients with diagnosis of primary BMO of the foot on the basis of clinical and radiological findings. Data collection included sex, age, patient history, symptoms at presentation, clinical examination, laboratory bone turnover markers, vitamin D levels, MRI, treatment, and outcome. RESULTS: Vitamin D deficiency or insufficiency was found in 76.9% of cases. All patients were treated with adequate vitamin D daily intake, a short course of analgesic therapy, physical therapy, avoiding detrimental feet and ankle immobilization. All fully recovered in 3-month lag period. CONCLUSIONS: Our data highlight that environmental factors, such as underestimated articular or bone microtraumatisms, as well as joint hyper mobility, in a bone turnover milieu of vitamin D deficiency could be the cause of this clinical conditions. Adequate vitamin D supplementation, associated with physical and analgesic therapy, is crucial in the management of BMO

Stage of Change and Motivation to a Healthier Lifestyle before and after an Intensive Lifestyle Intervention

Objective. Lifestyle modification programs are different but typically include both nutritional aspects and physical activity as main domains with different behavioral and/or psychological strategies designed to affect change. A fundamental role in modifying unhealthy habits is played by personal motivation for change. The present study sought to investigate, in a group of 100 overweight/obese outpatients with and/or without TMD2, treatment seeking, the effect of an intensive lifestyle program on medical measures and motivational profile for physical activity (PA) and healthy nutrition (NUTR). Method. Subjects participated in an intensive multidisciplinary lifestyle intervention at C.U.R.I.A.MO. Before and after the intervention, patients received a comprehensive evaluation of their clinical, anthropometric, and metabolic states and motivation to lifestyle changes. Results. Data showed differences before and after intervention in both medical and motivational measures. Before the intervention patients reported to be ready, open, and determined to change and gave importance to healthy habits. After the intervention patients continued to be determined but increased the actions toward the change showing a higher degree of maintenance and of acquisition of habits especially in the physical domain of the new lifestyle. Conclusion. Data support the notion that the motivation should be followed during all the lifestyle interventions to support the change on both domains of the lifestyle program

Development of a High Oleic Cardoon Cell Culture Platform by SAD Overexpression and RNAi-Mediated FAD2.2 Silencing

The development of effective tools for the sustainable supply of phyto-ingredients and natural substances with reduced environmental footprints can help mitigate the dramatic scenario of climate change. Plant cell cultures-based biorefineries can be a technological advancement to face this challenge and offer a potentially unlimited availability of natural substances, in a standardized composition and devoid of the seasonal variability of cultivated plants. Monounsaturated (MUFA) fatty acids are attracting considerable attention as supplements for biodegradable plastics, bio-additives for the cosmetic industry, and bio-lubricants. Cardoon (Cynara cardunculus L. var. altilis) callus cultures accumulate fatty acids and polyphenols and are therefore suitable for large-scale production of biochemicals and valuable compounds, as well as biofuel precursors. With the aim of boosting their potential uses, we designed a biotechnological approach to increase oleic acid content through Agrobacterium tumefaciens-mediated metabolic engineering. Bioinformatic data mining in the C. cardunculus transcriptome allowed the selection and molecular characterization of SAD (stearic acid desaturase) and FAD2.2 (fatty acid desaturase) genes, coding for key enzymes in oleic and linoleic acid formation, as targets for metabolic engineering. A total of 22 and 27 fast-growing independent CcSAD overexpressing (OE) and CcFAD2.2 RNAi knocked out (KO) transgenic lines were obtained. Further characterization of five independent transgenic lines for each construct demonstrated that, successfully, SAD overexpression increased linoleic acid content, e.g., to 42.5%, of the relative fatty acid content, in the CcSADOE6 line compared with 30.4% in the wild type (WT), whereas FAD2.2 silencing reduced linoleic acid in favor of the accumulation of its precursor, oleic acid, e.g., to almost 57% of the relative fatty acid content in the CcFAD2.2KO2 line with respect to 17.7% in the WT. Moreover, CcSADOE6 and CcFAD2.2KO2 were also characterized by a significant increase in total polyphenolic content up to about 4.7 and 4.1 mg/g DW as compared with 2.7 mg/g DW in the WT, mainly due to the accumulation of dicaffeoyl quinic and feruloyl quinic acids. These results pose the basis for the effective creation of an engineered cardoon cells-based biorefinery accumulating high levels of valuable compounds from primary and specialized metabolism to meet the industrial demand for renewable and sustainable sources of innovative bioproducts

Dor cortante: sofrimento emocional de meninas adolescentes

This research aims at investigating the experience lived by teenage girls who cut themselves, a symptom of emotional distress that has had social visibility nowadays and caused concern among mental health professionals. This is a qualitative research that uses the psychoanalytic method to study some blog posts signed by eight teenage girls who identify themselves as practitioners of self-injurious acts. The reading and the re-reading of the material, in a state of floating attention, allowed the production of two fields of affective-emotional meaning: “Devoid of affection” and “Crime and punishment”. The general picture indicates that these people inhabit an imaginary hostile world, marked by the experience of a persecutory guilty caused by the lack of affection, care, and consideration, pointing out that fundamental requirements in the constitution of the personality are not being satisfactorily contemplated.Keywords: self-harm, suffering, teenager.Esta pesquisa objetiva investigar a experiência vivida por meninas adolescentes que se autolesionam, sintoma de sofrimento emocional que vem ganhando maior visibilidade social e motivando preocupação entre profissionais de saúde mental. O trabalho articula-se como pesquisa qualitativa mediante uso do método psicanalítico, pelo estudo de postagens em blogs assinados por oito meninas adolescentes que se identificam como praticantes de atos autolesivos. Leituras e releituras do material, em estado de atenção flutuante, permitiram a produção interpretativa de dois campos de sentido afetivo-emocional: “Desprovidas de afeto” e “Crime e castigo”. O quadro geral indica que essas pessoas habitam, imaginariamente, um mundo hostil, marcado pela experiência de culpa persecutória pela privação de afeto, cuidado e consideração, apontando que exigências fundamentais na constituição da pessoalidade não estão sendo satisfatoriamente contempladas.Palavras-chave: autolesão, sofrimento, adolescência

Use of Machine Learning to Investigate the Quantitative Checklist for Autism in Toddlers (Q-CHAT) towards Early Autism Screening.

In the past two decades, several screening instruments were developed to detect toddlers who may be autistic both in clinical and unselected samples. Among others, the Quantitative CHecklist for Autism in Toddlers (Q-CHAT) is a quantitative and normally distributed measure of autistic traits that demonstrates good psychometric properties in different settings and cultures. Recently, machine learning (ML) has been applied to behavioral science to improve the classification performance of autism screening and diagnostic tools, but mainly in children, adolescents, and adults. In this study, we used ML to investigate the accuracy and reliability of the Q-CHAT in discriminating young autistic children from those without. Five different ML algorithms (random forest (RF), naïve Bayes (NB), support vector machine (SVM), logistic regression (LR), and K-nearest neighbors (KNN)) were applied to investigate the complete set of Q-CHAT items. Our results showed that ML achieved an overall accuracy of 90%, and the SVM was the most effective, being able to classify autism with 95% accuracy. Furthermore, using the SVM-recursive feature elimination (RFE) approach, we selected a subset of 14 items ensuring 91% accuracy, while 83% accuracy was obtained from the 3 best discriminating items in common to ours and the previously reported Q-CHAT-10. This evidence confirms the high performance and cross-cultural validity of the Q-CHAT, and supports the application of ML to create shorter and faster versions of the instrument, maintaining high classification accuracy, to be used as a quick, easy, and high-performance tool in primary-care settings

Case Series and DARS2 Variant Analysis in Early Severe Forms With Unexpected Presentations

Objective: Leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation (LBSL) is regarded a relatively mild leukodystrophy, diagnosed by characteristic long tract abnormalities on MRI and biallelic variants in DARS2, encoding mitochondrial aspartyl-tRNA synthetase (mtAspRS). DARS2 variants in LBSL are almost invariably compound heterozygous; in 95% of cases, 1 is a leaky splice site variant in intron 2. A few severely affected patients, still fulfilling the MRI criteria, have been described. We noticed highly unusual MRI presentations in 15 cases diagnosed by WES. We examined these cases to determine whether they represent consistent novel LBSL phenotypes. Methods: We reviewed clinical features, MRI abnormalities, and gene variants and investigated the variants' impact on mtAspRS structure and mitochondrial function. Results: We found 2 MRI phenotypes: early severe cerebral hypoplasia/atrophy (9 patients, group 1) and white matter abnormalities without long tract involvement (6 patients, group 2). With antenatal onset, microcephaly, and arrested development, group 1 patients were most severely affected. DARS2 variants were severer than for classic LBSL and severer for group 1 than group 2. All missense variants hit mtAspRS regions involved in tRNAAsp binding, aspartyl-adenosine-5'-monophosphate binding, and/or homodimerization. Missense variants expressed in the yeast DARS2 ortholog showed severely affected mitochondrial function. Conclusions: DARS2 variants are associated with highly heterogeneous phenotypes. New MRI presentations are profound cerebral hypoplasia/atrophy and white matter abnormalities without long tract involvement. Our findings have implications for diagnosis and understanding disease mechanisms, pointing at dominant neuronal/axonal involvement in severe cases. In line with this conclusion, activation of biallelic DARS2 null alleles in conditional transgenic mice leads to massive neuronal apoptosis