Dream-Reality confusion: differential psychiatric diagnosis in narcoleptic subjects

Dream-reality confusion (DRC) is the consequence of hypnagogic content confusion with real events and memories. Narcoleptic subjects eventually have DRC and can be misdiagnosed as schizophrenic or with another disorder with delusional or hallucinatory symptoms. Although dream-related experiences and hallucinatory perception share neurophysiological pathways, they are phenomenologically distinct. The lack of phenomenological intentionality in Dreamrelated perceptions, the different cognitive pathways for delusion generation, and other differences between mental disorders psychopathology, and DRC-related phenomena are here discussed. The lived world and awake experience interpretation, and dream neurobiology in narcoleptic subjects related to DRC, might indicate some hints for the mind-brain gap issue that still exists in neurology and psychiatry

Mental State Examination and Its Procedures—Narrative Review of Brazilian Descriptive Psychopathology

Background: Mental State Examination (MSE) is compared with physical examination as a reliable method of objective data investigation. There is a growing concern with psychiatric clinics, nosology, and the reliability of diagnostic interview methods as a source of valid diagnostic strategy. Efforts to achieve an international diagnosis protocol have been unsuccessful or polemical. This paper focuses on psychopathology, MSE, and mental function development within Brazilian psychiatry over the last few decades.Methods: Searches, interviews, and narrative reviews were done to look for systematic ways in which to conduct MSE, mental functions, symptom clusters, orientations about data observation and records. Brazilian psychopathology textbooks were examined, if they provided access to consolidated knowledge on psychopathology examination.Results: Sixteen textbooks were selected from a 49 year span. Descriptive psychopathology with phenomenological orientation was the primary trend in the MSE. Concepts derived from different traditions, most lacking common terminology, suggested some divergence among authors. Recommendations for patient observation and how to collect objective data was clear, but MSE standardization efforts were missing. A detailed description of mental function abnormalities was the main MSE record strategy, without consensus about ways to summarize and record this data. In an examination summary, mental strata was divided into “mental functions,” and MSE subsets were frequent. All authors considered the following mental functions: consciousness, perception, thought, memory, attention, orientation, and volition.Discussion: Psychiatric competence demands MSE proficiency. Official documents are not clear about performance and recording standards. MSE data was usually recorded through descriptive psychopathology. A shift from detailed descriptive findings, to an array of observed pathological elements, described through a mental function checklist was observed over time. Clinical practice and research guidelines should consider the development of reliable MSE practices; however, it has been neglected by modern psychiatry/neuroscience through the excessive emphasis on interview protocols. Better MSE practices, and the improvement of bedside skill in psychiatry are necessary and depend on the recovery of psychopathological debates and semiological reasoning, which will allow the return of phenomenology-oriented “observational” techniques

Ulcerações Labiais Associadas a Comportamento Obsessivo-Compulsivo: Relato de Caso.

Self-inflicted lesions include skin alterations caused by an abnormal behavior. They demand interdisciplinary involvement of health professionals. They are most common among middle-aged women. We report the case of a 42-year-old man with a diagnosis of an ulcerated lesion on the upper and lower lips, secondary to obsessive-compulsive behavior. Histopathological findings were non-specific and the results of laboratory tests performed showed no alterations. Joint evaluation by Psychiatry and Dermatology was initiated, with follow-up sessions of psychotherapy. Patient chose to abandon treatment. The importance of recognizing psychodermatoses for the dermatologist is emphasized, aiming at the early diagnosis and therapeutics, which will allow the prevention of destructive and mutilating lesions.As lesões auto-infligidas compreendem modificações cutâneas induzidas por um desvio do comportamento e demandam o envolvimento de diferentes profissionais da saúde. São mais comuns entre as mulheres de meia idade. Relata-se o caso clínico de um homem de 42 anos com diagnóstico de lesão ulcerada nos lábios superior e inferior, secundária a comportamento obsessivo-compulsivo. Os achados histopatológicos foram inespecíficos e os resultados de exames laboratoriais realizados não apresentaram alterações. Optou-se pelo acompanhamento conjunto entre a Psiquiatria e a Dermatologia, com seguimento de sessões de psicoterapia, mas o paciente acabou por abandonar o tratamento. Ressalta-se a importância do conhecimento das psicodermatoses pelo dermatologista, visando o diagnóstico e a terapêutica precoces, o que permitirá a prevenção de lesões destrutivas e mutiladoras

Automatic identification of charcoal origin based on deep learning

The differentiation between the charcoal produced from (Eucalyptus) plantations and native forests is essential to control, commercialization, and supervision of its production in Brazil. The main contribution of this study is to identify the charcoal origin using macroscopic images and Deep Learning Algorithm. We applied a Convolutional Neural Network (CNN) using VGG-16 architecture, with preprocessing based on contrast enhancement and data augmentation with rotation over the training set images. on the performance of the CNN with fine-tuning using 360 macroscopic charcoal images from the plantation and native forests. The results pointed out that our method provides new perspectives to identify the charcoal origin, achieving results upper 95 % of mean accuracy to classify charcoal from native forests for all compared preprocessing strategies

ANÁLISE EPIDEMIOLÓGICA DAS TAXAS DE INTERNAÇÃO POR DOENÇAS CEREBROVASCULARES NO ESTADO E MUNICÍPIO DO RIO DE JANEIRO EM 2021

Cerebrovascular Diseases were responsible for the third leading cause of mortality in Brazil in 2021, behind only COVID-19 and cardiovascular diseases, generating high costs for the health system and loss of quality of life for the population. The objective of the present study was to describe, in a quantitative and qualitative way, the hospitalization rates for cerebrovascular diseases in the State and municipality of Rio de Janeiro, in the year 2021. The methodology used was an observational, cross-sectional design, with data collected from the Hospital Information System of the Unified Health System (SIH-SUS) and the State Health Department of Rio de Janeiro, with data referring to the months of January to December 2021. A total of 101.4 hospitalizations for Cerebrovascular Diseases by gender per 100,000 inhabitants in the state, while the municipality of Rio de Janeiro had a total of 74.7 hospitalizations per 100,000 inhabitants. When the analysis was carried out by age groups, a growth profile was observed as the age group became older, with 685.2 hospitalizations per 100,000, in the age group of 80 years or more, in the State, and 391.6 hospitalizations per 100,000, in the same previous age group, in the municipality. Cerebrovascular diseases have high morbidity and mortality. Analyzing the hospitalization profile for this specific cause helps in the creation of public health policies aimed at reducing its effects on the population.Las Enfermedades Cerebrovasculares fueron responsables de la tercera causa de mortalidad en Brasil en 2021, solo detrás de la COVID-19 y las enfermedades cardiovasculares, generando altos costos para el sistema de salud y pérdida de calidad de vida para la población. El objetivo del presente estudio fue describir, de forma cuantitativa y cualitativa, las tasas de hospitalización por enfermedades cerebrovasculares en el Estado y municipio de Rio de Janeiro, en el año 2021. La metodología utilizada fue un diseño observacional, transversal, con datos recopilados del Sistema de Información Hospitalaria del Sistema Único de Salud (SIH-SUS) y de la Secretaría de Estado de Salud de Rio de Janeiro, con datos referentes a los meses de enero a diciembre de 2021. Un total de 101,4 hospitalizaciones por Enfermedades Cerebrovasculares por género por 100.000 habitantes en el estado, mientras que el municipio de Río de Janeiro tuvo un total de 74,7 hospitalizaciones por 100.000 habitantes. Cuando el análisis se realizó por grupos de edad, se observó un perfil de crecimiento a medida que se envejecía el grupo de edad, con 685,2 hospitalizaciones por 100.000, en el grupo de edad de 80 años y más, en el Estado, y 391,6 hospitalizaciones por 100.000, en el mismo grupo de edad anterior, en el municipio. Las enfermedades cerebrovasculares tienen una alta morbimortalidad. Analizar el perfil de hospitalización por esta causa específica ayuda en la creación de políticas públicas de salud dirigidas a reducir sus efectos en la población.As Doenças Cerebrovasculares foram responsáveis pela terceira maior causa de mortalidade no Brasil em 2021, atrás somente de COVID-19 e doenças cardiovasculares, gerando altos custos para o sistema de saúde e perda de qualidade de vida para a população. O objetivo do presente trabalho foi descrever, de forma quantitativa e qualitativa, as taxas de internação por doenças cerebrovasculares no Estado e município do Rio de Janeiro, no ano de 2021. A metodologia utilizada se tratou de um desenho de natureza observacional, do tipo transversal, com dados coletados do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS) e da Secretaria Estadual de Saúde do Rio de Janeiro, com dados referentes aos meses de janeiro a dezembro de 2021. Foi encontrado um total de 101,4 internações por Doenças Cerebrovasculares por sexo a cada 100 mil habitantes no estado, enquanto  o município do Rio de Janeiro apresentou um total de 74,7 internações a cada 100 mil habitantes. Quando a análise foi por grupos de faixas etárias, observou-se um perfil de crescimento à medida que a faixa etária se tornava mais elevada, com 685,2 internações a cada 100 mil, na faixa de 80 anos ou mais, no Estado, e 391,6 internações a cada 100 mil, na mesma faixa etária anterior, no município. As doenças cerebrovasculares apresentam alta morbimortalidade. Analisar o perfil de internação por essa causa específica auxilia na criação de políticas públicas de saúde voltadas para a redução dos seus efeitos na população.As Doenças Cerebrovasculares foram responsáveis pela terceira maior causa de mortalidade no Brasil em 2021, atrás somente de COVID-19 e doenças cardiovasculares, gerando altos custos para o sistema de saúde e perda de qualidade de vida para a população. O objetivo do presente trabalho foi descrever, de forma quantitativa e qualitativa, as taxas de internação por doenças cerebrovasculares no Estado e município do Rio de Janeiro, no ano de 2021. A metodologia utilizada se tratou de um desenho de natureza observacional, do tipo transversal, com dados coletados do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH-SUS) e da Secretaria Estadual de Saúde do Rio de Janeiro, com dados referentes aos meses de janeiro a dezembro de 2021. Foi encontrado um total de 101,4 internações por Doenças Cerebrovasculares por sexo a cada 100 mil habitantes no estado, enquanto  o município do Rio de Janeiro apresentou um total de 74,7 internações a cada 100 mil habitantes. Quando a análise foi por grupos de faixas etárias, observou-se um perfil de crescimento à medida que a faixa etária se tornava mais elevada, com 685,2 internações a cada 100 mil, na faixa de 80 anos ou mais, no Estado, e 391,6 internações a cada 100 mil, na mesma faixa etária anterior, no município. As doenças cerebrovasculares apresentam alta morbimortalidade. Analisar o perfil de internação por essa causa específica auxilia na criação de políticas públicas de saúde voltadas para a redução dos seus efeitos na população

The Eighth Data Release of the Sloan Digital Sky Survey: First Data from SDSS-III

The Sloan Digital Sky Survey (SDSS) started a new phase in August 2008, with new instrumentation and new surveys focused on Galactic structure and chemical evolution, measurements of the baryon oscillation feature in the clustering of galaxies and the quasar Ly alpha forest, and a radial velocity search for planets around ~8000 stars. This paper describes the first data release of SDSS-III (and the eighth counting from the beginning of the SDSS). The release includes five-band imaging of roughly 5200 deg^2 in the Southern Galactic Cap, bringing the total footprint of the SDSS imaging to 14,555 deg^2, or over a third of the Celestial Sphere. All the imaging data have been reprocessed with an improved sky-subtraction algorithm and a final, self-consistent photometric recalibration and flat-field determination. This release also includes all data from the second phase of the Sloan Extension for Galactic Understanding and Evolution (SEGUE-2), consisting of spectroscopy of approximately 118,000 stars at both high and low Galactic latitudes. All the more than half a million stellar spectra obtained with the SDSS spectrograph have been reprocessed through an improved stellar parameters pipeline, which has better determination of metallicity for high metallicity stars.Comment: Astrophysical Journal Supplements, in press (minor updates from submitted version

The Ninth Data Release of the Sloan Digital Sky Survey: First Spectroscopic Data from the SDSS-III Baryon Oscillation Spectroscopic Survey

The Sloan Digital Sky Survey III (SDSS-III) presents the first spectroscopic data from the Baryon Oscillation Spectroscopic Survey (BOSS). This ninth data release (DR9) of the SDSS project includes 535,995 new galaxy spectra (median z=0.52), 102,100 new quasar spectra (median z=2.32), and 90,897 new stellar spectra, along with the data presented in previous data releases. These spectra were obtained with the new BOSS spectrograph and were taken between 2009 December and 2011 July. In addition, the stellar parameters pipeline, which determines radial velocities, surface temperatures, surface gravities, and metallicities of stars, has been updated and refined with improvements in temperature estimates for stars with T_eff<5000 K and in metallicity estimates for stars with [Fe/H]>-0.5. DR9 includes new stellar parameters for all stars presented in DR8, including stars from SDSS-I and II, as well as those observed as part of the SDSS-III Sloan Extension for Galactic Understanding and Exploration-2 (SEGUE-2). The astrometry error introduced in the DR8 imaging catalogs has been corrected in the DR9 data products. The next data release for SDSS-III will be in Summer 2013, which will present the first data from the Apache Point Observatory Galactic Evolution Experiment (APOGEE) along with another year of data from BOSS, followed by the final SDSS-III data release in December 2014.Comment: 9 figures; 2 tables. Submitted to ApJS. DR9 is available at http://www.sdss3.org/dr

Erratum: “The eighth data release of the Sloan Digital Sky Survey: first data from SDSS-III” (2011, ApJS, 193, 29)

Section 3.5 of Aihara et al. (2011) described various sources of systematic error in the astrometry of the imaging data of the Sloan Digital Sky Survey (SDSS). In addition to these sources of error, there is an additional and more serious error, which introduces a large systematic shift in the astrometry over a large area around the north celestial pole. The region has irregular boundaries but in places extends as far south as declination δ ≈ 41◦. The sense of the shift is that the positions of all sources in the affected area are offset by roughly 250 mas in a northwest direction. We have updated the SDSS online documentation to reflect these errors, and to provide detailed quality information for each SDSS field

SDSS-III: Massive Spectroscopic Surveys of the Distant Universe, the Milky Way Galaxy, and Extra-Solar Planetary Systems

Building on the legacy of the Sloan Digital Sky Survey (SDSS-I and II), SDSS-III is a program of four spectroscopic surveys on three scientific themes: dark energy and cosmological parameters, the history and structure of the Milky Way, and the population of giant planets around other stars. In keeping with SDSS tradition, SDSS-III will provide regular public releases of all its data, beginning with SDSS DR8 (which occurred in Jan 2011). This paper presents an overview of the four SDSS-III surveys. BOSS will measure redshifts of 1.5 million massive galaxies and Lya forest spectra of 150,000 quasars, using the BAO feature of large scale structure to obtain percent-level determinations of the distance scale and Hubble expansion rate at z<0.7 and at z~2.5. SEGUE-2, which is now completed, measured medium-resolution (R=1800) optical spectra of 118,000 stars in a variety of target categories, probing chemical evolution, stellar kinematics and substructure, and the mass profile of the dark matter halo from the solar neighborhood to distances of 100 kpc. APOGEE will obtain high-resolution (R~30,000), high signal-to-noise (S/N>100 per resolution element), H-band (1.51-1.70 micron) spectra of 10^5 evolved, late-type stars, measuring separate abundances for ~15 elements per star and creating the first high-precision spectroscopic survey of all Galactic stellar populations (bulge, bar, disks, halo) with a uniform set of stellar tracers and spectral diagnostics. MARVELS will monitor radial velocities of more than 8000 FGK stars with the sensitivity and cadence (10-40 m/s, ~24 visits per star) needed to detect giant planets with periods up to two years, providing an unprecedented data set for understanding the formation and dynamical evolution of giant planet systems. (Abridged)Comment: Revised to version published in The Astronomical Journa

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt