Feasibility and efficacy of an acceptance and mindfulness-based group intervention for young people with early psychosis (Feel-Good group)

Background: Over the last decade, researchers have sought for alternative interventions that have better treatment effects than Cognitive Behavioral Therapy (CBT) when treating psychotic symptoms. Mindfulness-based interventions have been a proposed alternative to CBT, yet research regarding its feasibility, acceptance and effectiveness is lacking when treating individuals with early psychosis in inpatient settings. Objective: Before conducting a large-scale randomized-controlled trial (RCT), this pilot study evaluated the feasibility and the potential efficacy of a mindfulness-based inpatient group intervention that targets emotion regulation in patients with early psychosis, and thus indirectly improving psychotic symptoms. Methods: A pre–post study was performed. Thirty-six patients with early psychosis treated at the specialized inpatient treatment “Frühinterventionsund Therapiezentrum; FRITZ” (early intervention and therapy center) received eight group therapy sessions. Assessments were performed at baseline, after 8 weeks post treatment and at follow-up after 16 weeks. Results: Rates of patients who participated in the study suggests that a mindfulness-based group therapy is highly accepted and feasible for patients with early psychosis being treated in an inpatient ward. Friedman analyses revealed significant changes in the primary outcomes of emotional goal attainment (Goal 1: W = 0.79; Goal 2: W = 0.71) and psychotic symptoms (PANSS-T: W = 0.74). Significant, albeit small, effect sizes were found in patients’ self-perception of emotion regulation skills (ERSQ: W = 0.23). Discussion: We found favorable findings regarding the feasibility and acceptance of the Feel-Good mindfulness-based intervention. Results of the study provide a basis for an estimation of an adequate sample size for a fully powered RCT that needs to be conducted to test whether Feel-Good is effective in the inpatient treatment of psychotic symptoms for individuals with early psychosis

EOS: Atmospheric Radiative Transfer in Habitable Worlds with HELIOS

We present EOS, a procedure for determining the outgoing longwave radiation (OLR) and top-of-atmosphere (TOA) albedo for a wide range of conditions expected to be present in the atmospheres of rocky planets with temperate conditions. EOS is based on HELIOS and HELIOS-K, which are novel and publicly available atmospheric radiative transfer (RT) codes optimized for fast calculations with GPU processors. These codes were originally developed for the study of giant planets. In this paper we present an adaptation for applications to terrestrial-type, habitable planets, adding specific physical recipes for the gas opacity and vertical structure of the atmosphere. To test the reliability of the procedure, we assessed the impact of changing line opacity profile, continuum opacity model, atmospheric lapse rate, and tropopause position prescriptions on the OLR and the TOA albedo. The results obtained with EOS are in line with those of other RT codes running on traditional CPU processors, while being at least one order of magnitude faster. The adoption of OLR and TOA albedo data generated with EOS in a zonal and seasonal climate model correctly reproduces the fluxes of the present-day Earth measured by the CERES spacecraft. The results of this study disclose the possibility to incorporate fast RT calculations in climate models aimed at characterizing the atmospheres of habitable exoplanets

Helpers influence on territory use and maintenance in Alpine marmot groups

In social mammals, territory size and shape vary according to the number and strength of neighbour individuals competing for resources. Two main theories have been proposed to explain this variability: the Group Augmentation (GA) and the realized Resource Holding Potential (rRHP) hypotheses. The first states that the outcome of the interactions among groups depends on the total number of individuals in the group while the second states that only the number of animals directly involved in intergroup competition determines this outcome. We collected data on space use of individually tagged Alpine marmots ( Marmota marmota), a cooperative breeding species that overlaps part of its territory with neighbouring groups. In accordance with the rRHP hypothesis, we found that groups having higher proportion of helpers, rather than higher total number of individuals, had lower percentage of the territory overlapping with neighbouring groups and a larger area available for individual exclusive use

Specialized inpatient treatment for young people with early psychosis: acute-treatment and 12-month results

The objective of the study was to investigate the development of clinical outcomes of young people with early psychosis in a specialized inpatient treatment and assess the feasibility of such an intervention in an inpatient setting. The study was a prospective cohort study of patients with early psychosis treated at the specialized inpatient treatment Fuhinterventions-und Therapiezentrum, FRITZ (early intervention and therapy center) in Berlin, Germany. The primary outcomes were attitudes towards psychiatric medication and patient satisfaction with treatment after 6 weeks. Secondary outcomes were clinical symptoms, functioning, remission, recovery, all-cause treatment discontinuation, and rehospitalisation at 6 and 12 months after inpatient treatment. We recruited 95 inpatients with early psychosis. Attitudes towards psychiatric medication (Delta(6weeks) = 3.00, d(6weeks) = 0.55; Delta(6mo) = 2.15, d(6mo) = 0.35; Delta(12mo) = 3.03, d(12mo) = 0.52) and patient satisfaction (Delta(6weeks) = 0.21, d(6weeks) = 0.40; Delta(6mo) = 0.32, d(6mo) = 0.43; Delta(12mo) = 0.13, d(12mo) = 0.17) changed with medium effect sizes at six weeks up to a 6- and 12-month follow-up. Clinical outcomes changed significantly with medium-to-large-effect sizes over 12 months CGI(Delta 12mo) = 1.64, d(12mo) = -1.12; PANSS total(Delta 12mo) = 20.10, d(12mo) = -0.76; GAF(Delta 12mo) = 19.58, d(12mo) = 1.25). The all-cause treatment discontinuation rate was 13.69% (n = 13) at a 6-month and 35.79% (n = 34) at a 12-month follow-up. The rehospitalization rate was 30.53% (n = 29) at a 6-month and 43.16% (n = 41) at a 12-month follow-up. Patients with specialized inpatient treatment for early psychosis showed improvements in attitude towards psychiatric medication, patient satisfaction, symptoms, and functioning for up to 12 months

Treatment decision satisfaction and regret after focal HIFU for localized prostate cancer

Purpose: Focal therapies (FTs) are investigated within prospective studies on selected patients treated for localized prostate cancer (PCa). Benefits are preservation of genitourinary function and reduced complications, but follow-up is elaborate and is associated with uncertainty as cancer-free survival appears to be lower compared to standard radical treatments. The aim of this study was to analyse patient-reported acceptance of FT and evaluate factors associated with treatment decision regret. Methods: 52 patients who received focal high-intensity focused ultrasound for low- to intermediate-risk PCa between 2014 and 2019 within two prospective trials were eligible for a survey regarding PCa-related treatment regret and quality-of-life (Clark's scale) and the following potential predictors: sociodemographic variables, Charlson Comorbidity Index, subjective aging (AARC-10 SF), and general health-related quality-of-life (SF-12). Cancer persistence/recurrence (multiparametric MRI and fusion biopsy after 12 months) and functional outcomes (EPIC-26 UI/UIO/S) data were also included in this study. Results: The overall survey response rate was 92.3% (48/52 patients). Median follow-up was 38 months (interquartile range = 25-50 months). In total, ten patients (20.8%) reported treatment decision regret. In univariable analyses, a clinically meaningful increase in urinary incontinence showed a significant association (OR 4.43; 95% CI 0.99-20.53;p = 0.049) with regret. Cancer recurrence (OR 12.31; 95% CI 1.78-159.26;p = 0.023) and general health worry as a domain of Clark's scale (OR 1.07; 95% CI 1.03-1.14;p < 0.01) were predictors of regret in a multivariable logistic regression model (AUC = 0.892). Conclusion: Acceptance of FT is comparable to standard treatments. Extensive follow-up including regular PSA testing does not cause additional regret but careful patient selection and information before FT is crucial

Table_1_Feasibility and efficacy of an acceptance and mindfulness-based group intervention for young people with early psychosis (Feel-Good group).DOCX

BackgroundOver the last decade, researchers have sought for alternative interventions that have better treatment effects than Cognitive Behavioral Therapy (CBT) when treating psychotic symptoms. Mindfulness-based interventions have been a proposed alternative to CBT, yet research regarding its feasibility, acceptance and effectiveness is lacking when treating individuals with early psychosis in inpatient settings.ObjectiveBefore conducting a large-scale randomized-controlled trial (RCT), this pilot study evaluated the feasibility and the potential efficacy of a mindfulness-based inpatient group intervention that targets emotion regulation in patients with early psychosis, and thus indirectly improving psychotic symptoms.MethodsA pre–post study was performed. Thirty-six patients with early psychosis treated at the specialized inpatient treatment “Frühinterventions- und Therapiezentrum; FRITZ” (early intervention and therapy center) received eight group therapy sessions. Assessments were performed at baseline, after 8 weeks post treatment and at follow-up after 16 weeks.ResultsRates of patients who participated in the study suggests that a mindfulness-based group therapy is highly accepted and feasible for patients with early psychosis being treated in an inpatient ward. Friedman analyses revealed significant changes in the primary outcomes of emotional goal attainment (Goal 1: W = 0.79; Goal 2: W = 0.71) and psychotic symptoms (PANSS-T: W = 0.74). Significant, albeit small, effect sizes were found in patients’ self-perception of emotion regulation skills (ERSQ: W = 0.23).DiscussionWe found favorable findings regarding the feasibility and acceptance of the Feel-Good mindfulness-based intervention. Results of the study provide a basis for an estimation of an adequate sample size for a fully powered RCT that needs to be conducted to test whether Feel-Good is effective in the inpatient treatment of psychotic symptoms for individuals with early psychosis.Clinical trial registration[https://clinicaltrials.gov/ct2/show/NCT04592042], identifier [NCT04592042].</p

Climate bistability of Earth-like exoplanets

Before about 500 million years ago, most probably our planet experienced temporary snowball conditions, with continental and sea ices covering a large fraction of its surface. This points to a potential bistability of Earth's climate that can have at least two different (statistical) equilibrium states for the same external forcing (i.e. solar radiation). Here, we explore the probability of finding bistable climates in Earth-like exoplanets and consider the properties of planetary climates obtained by varying the semimajor orbital axis (thus, received stellar radiation), eccentricity and obliquity, and atmospheric pressure. To this goal, we use the Earth-like planet surface temperature model (ESTM), an extension of one-dimensional Energy Balance Models developed to provide a numerically efficient climate estimator for parameter sensitivity studies and long climatic simulations. After verifying that the ESTM is able to reproduce Earth climate bistability, we identify the range of parameter space where climate bistability is detected. An intriguing result of this work is that the planetary conditions that support climate bistability are remarkably similar to those required for the sustenance of complex, multicellular life on the planetary surface. The interpretation of this result deserves further investigation, given its relevance for the potential distribution of life in exoplanetary systems

Biallelic variants in TMEM222 cause a new autosomal recessive neurodevelopmental disorder

Purpose: To elucidate the novel molecular cause in families with a new autosomal recessive neurodevelopmental disorder. Methods: A combination of exome sequencing and gene matching tools was used to identify pathogenic variants in 17 individuals. Quantitative reverse transcription polymerase chain reaction (RT-qPCR) and subcellular localization studies were used to characterize gene expression profile and localization. Results: Biallelic variants in the TMEM222 gene were identified in 17 individuals from nine unrelated families, presenting with intellectual disability and variable other features, such as aggressive behavior, shy character, body tremors, decreased muscle mass in the lower extremities, and mild hypotonia. We found relatively high TMEM222 expression levels in the human brain, especially in the parietal and occipital cortex. Additionally, subcellular localization analysis in human neurons derived from induced pluripotent stem cells (iPSCs) revealed that TMEM222 localizes to early endosomes in the synapses of mature iPSC-derived neurons. Conclusion: Our findings support a role for TMEM222 in brain development and function and adds variants in the gene TMEM222 as a novel underlying cause of an autosomal recessive neurodevelopmental disorder

Multisystem Inflammation and Susceptibility to Viral infections in Human ZNFX1 Deficiency

Background: Recognition of viral nucleic acids is one of the primary triggers for a type I interferon–mediated antiviral immune response. Inborn errors of type I interferon immunity can be associated with increased inflammation and/or increased susceptibility to viral infections as a result of dysbalanced interferon production. NFX1-type zinc finger–containing 1 (ZNFX1) is an interferon-stimulated double-stranded RNA sensor that restricts the replication of RNA viruses in mice. The role of ZNFX1 in the human immune response is not known. Objective: We studied 15 patients from 8 families with an autosomal recessive immunodeficiency characterized by severe infections by both RNA and DNA viruses and virally triggered inflammatory episodes with hemophagocytic lymphohistiocytosis-like disease, early-onset seizures, and renal and lung disease. Methods: Whole exome sequencing was performed on 13 patients from 8 families. We investigated the transcriptome, posttranscriptional regulation of interferon-stimulated genes (ISGs) and predisposition to viral infections in primary cells from patients and controls stimulated with synthetic double-stranded nucleic acids. Results: Deleterious homozygous and compound heterozygous ZNFX1 variants were identified in all 13 patients. Stimulation of patient-derived primary cells with synthetic double-stranded nucleic acids was associated with a deregulated pattern of expression of ISGs and alterations in the half-life of the mRNA of ISGs and also associated with poorer clearance of viral infections by monocytes. Conclusion: ZNFX1 is an important regulator of the response to double-stranded nucleic acids stimuli following viral infections. ZNFX1 deficiency predisposes to severe viral infections and a multisystem inflammatory disease.</p