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The current investigation examined the self-concept and temporality in institutionalized and non-institutionalized elderly. Sixty-two participants divided into two groups according to their place of residence participated in the study. The analysis focused on psychopathological scales, on self-concept assessment, its positive or negative valence, its development and the time perspective. The results showed that the institutionalized group was defined more with descriptive evaluations, emotional states, and peripheral information. The non-institutionalized group described themselves more with traits and specific attributes. For some identity statements, the emotional valence between the two groups was significantly different. The institutionalized group is not turned towards a particular temporal perspective, unlike the non-institutionalized who is more forward-looking. Findings suggest that there are differences in self-expression and temporality in our sample. This exploratory study emphasizes the importance of taking into account the self of institutionalized elderly and the temporality in which they are projected upon entering an institution. [ABSTRACT FROM AUTHOR]

Background: A 10-day dexamethasone regimen has emerged as the internationally adopted standard-of-care for severe COVID-19 patients. However, the immune response triggered by SARS-CoV-2 infection remains a complex and dynamic phenomenon, leading to various immune profiles and trajectories. The immune status of severe COVID-19 patients following complete dexamethasone treatment has yet to be thoroughly documented. Results: To analyze monocyte HLA-DR expression (mHLA-DR) and CD4 + T lymphocyte count (CD4) in critically ill COVID-19 patients after a dexamethasone course and evaluate their association with 28-day ICU mortality, adult COVID-19 patients (n = 176) with an ICU length of stay of at least 10 days and under dexamethasone treatment were included. Associations between each biomarker value (or in combination) measured at day 10 after ICU admission and 28-day mortality in ICU were evaluated. At day 10, the majority of patients presented decreased values of both parameters. A significant association between low mHLA-DR and 28-day mortality was observed. This association remained significant in a multivariate analysis including age, comorbidities or pre-existing immunosuppression (adjusted Hazard ratio (aHR) = 2.86 [1.30–6.32], p = 0.009). Similar results were obtained with decreased CD4 + T cell count (aHR = 2.10 [1.09–4.04], p = 0.027). When combining these biomarkers, patients with both decreased mHLA-DR and low CD4 presented with an independent and significant elevated risk of 28-day mortality (i.e., 60%, aHR = 4.83 (1.72–13.57), p = 0.001). Conclusions: By using standardized immunomonitoring tools available in clinical practice, it is possible to identify a subgroup of patients at high risk of mortality at the end of a 10-day dexamethasone treatment. This emphasizes the significance of integrating immune monitoring into the surveillance of intensive care patients in order to guide further immumodulation approaches. [ABSTRACT FROM AUTHOR]

Self-defining future projections (SDFPs) have never been explored across lifespan. The present study aimed to characterize those self-relevant narratives in three age groups matched for sex and education level: young (mean age = 23.0 years), middle-aged (mean age = 41.7 years), and young-old (mean age = 68.2 years) adults. All participants first completed the Hospital Anxiety and Depression Scale followed by two tests assessing executive functions : a phonemic verbal fluency task and the Similarities subtest of the WAIS-IV. Finally, participants were asked to collect three SDFPs. Results highlighted that thematic contents of SDFPs varied with advancing age: percentage of achievement events decreased whereas percentage of leisure or dependence events increased. No significant difference in specificity and meaning-making was observed between the three groups. Compared to the SDFPs of young and middle-aged adults, older participants' SDFPs were closer to the present time. Moreover, young-old adults provided fewer words to describe their narratives than young individuals. [ABSTRACT FROM AUTHOR]

Objectives: The main objective of this study was to determine the directions of the relationships between apathy, cognitive deficits and lack of awareness. Methods: One hundred and twenty‐one older persons living in nursing homes, aged between 65 and 99 years old, participated in the study. Cognitive functioning, autonomy, depressive and anxious symptoms, general self‐efficacy, self‐esteem and apathy were evaluated through tests and questionnaires. Lack of awareness was calculated using the patient‐caregiver discrepancy method. The sample was divided into two groups (n1 = 60, n2 = 61) depending on cognitive functioning level (Dementia Rating Scale < median score: 120). We first explored the characteristics of each group. Then, we compared the mode of evaluation of apathy. Finally, we investigated the direction of relationships by applying mediation analyses. Results: Older persons in the low cognitive functioning group were less autonomous, had a lower cognitive functioning level, higher caregiver‐rated apathy and higher lack of awareness than the high cognitive functioning group (ps < 0.05). Evaluation differences were found only in the low cognition group. Caregiver‐rated apathy totally mediated the relationship between cognitive functioning (predictor) and lack of awareness (dependent variable) for the whole sample (90%) and for the low cognitive functioning group (100%). Conclusions: Cognitive deficits should be taken into account when evaluating apathy. Interventions should combine cognition training and emotion intervention to reduce lack of awareness. Future research should develop a therapy dedicated to apathy among older persons without pathologies. [ABSTRACT FROM AUTHOR]

The present web-based study (N = 840) aimed to illuminate the cognitive mechanisms underlying self-disorders in autism. Initially, participants selected three self-defining memories. Then, we assessed their capacity to give meaning to these events (i.e., meaning making), their tendency to scrutinize autobiographical memory to better understand themselves (i.e., self-continuity function of autobiographical memory) and their clarity of self-concept. The results showed that individuals with high autistic traits (ATs) had a lower clarity of self-concept than control participants. Meaning making was also reduced in AT individuals and mediated the relation between AT and self-concept clarity. Our results suggest that the reduced clarity of self-concept in AT individuals is related to an impaired capacity to make meaning of important past life events., Author(s): Fabrice Berna[sup.1] , Anja S. Goritz[sup.2] , Johanna Schroder[sup.1] , Romain Coutelle[sup.3] [sup.4] , Jean-Marie Danion[sup.3] [sup.4] , Christine V. Cuervo-Lombard[sup.5] [sup.6] , Steffen Moritz[sup.1] Author Affiliations: (1) Department [...]

Previous studies have reported the major role of apathy in awareness assessment among Alzheimer's patients using the patient-caregiver discrepancy method, whatever the awareness dimension assessed. Using the Apathy Evaluation Scales among other awareness scales, we report that apathy is the sole awareness dimension distinguishing healthy controls (25), mild (57) and moderate-to-moderately-severe (11) Alzheimer's patients. A linear regression showed that the Mini-Mental State Examination score used as a risk factor for non-awareness was the only factor associated with awareness of apathy and was the best predictor. This suggests that apathy is the most discriminant dimension for awareness assessment in Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Nostalgia is an efficient coping strategy that helps elders overcome major life transitions. To better explore the protective functions of nostalgia, we set out to adapt a short-form nostalgia scale to French elders and examine its convergent and divergent validity in terms of self-esteem, depression, and wellbeing. Participants were 175 institutionalized French elders. After providing their written informed consent, they were asked to complete a demographic information form and respond to four questionnaires probing self-esteem, nostalgia, depression, and wellbeing. Principal component analyses and fit indices were used to explore convergent validity. An 8-item version showed acceptable psychometric properties and measured two dimensions of nostalgia. Spearman correlations were conducted to explore divergent validity. In our sample, the first dimension was negatively associated with global cognitive functioning, while the second dimension was positively associated with self-esteem and wellbeing, and negatively associated with depression. The negative relationship between depression and nostalgia supports the idea that nostalgia is a positive concept. Future research should explore factors liable to impact nostalgia, such as cultural differences and reminiscence therapy. [ABSTRACT FROM AUTHOR]

L'alpha 1-antitrypsine (AAT) est une glycoprotéine synthétisée principalement par les hépatocytes ; son rôle est de protéger le parenchyme pulmonaire en inhibant les protéases pro-inflammatoires, notamment l'élastase libérée par les poly-nucléaires neutrophiles lors de l'inflammation. Le déficit sévère en AAT est une des maladies génétiques les plus courantes. Il peut se manifester par une atteinte pulmonaire avec un emphysème, une atteinte hépatique pouvant évoluer vers une cirrhose et plus rarement par une panniculite ; sa traduction biologique est une diminution de sa concentration circulante sérique. Nous rapportons ici le cas d'un déficit sévère découvert chez un nouveau-né présentant un ictère néonatal. Alpha 1-antitrypsin is a glycoprotein mainly produced by hepatocytes; the main role is the protection of pulmonary parenchyma by inhibiting pro-inflammatory proteases like elastase released by neutrophils during inflammation. One of the most common genetic diseases is severe AAT deficiency. The clinical manifestation are pulmonary involvement with emphysema, liver disease, which may progress to cirrhosis and more rarely panniculitis; its biological translation is a decrease of AAT serum level. We report here the case of a severe deficit discovered in a newborn with neonatal jaundice. [ABSTRACT FROM AUTHOR]

Torque Teno Virus (TTV) is a small, non-enveloped, single-stranded and circular DNA virus that infects the majority of the population worldwide. Increased levels of plasma TTV viral load have been observed in various situations of immune deficiency or dysregulation, and several studies have suggested that TTV levels may be inversely correlated with immune competence. The measurement of TTV viremia by qPCR has been proposed as a potential biomarker for the follow-up of functional immune competence in immunosuppressed individuals, particularly hematopoietic stem cell transplant recipients. We hypothesized that TTV viral load could be used as a prognostic marker of immune checkpoint inhibitor (ICI) efficacy, and therefore investigated the TTV viral load in melanoma patients treated with nivolumab or pembrolizumab before and after 6 months of treatment. In the present study, TTV viral load was not different in melanoma patients before anti-PD-1 introduction compared to healthy volunteers, was not modified by ICI treatment and did not allowed to distinguish patients with treatment-sensitive tumor from patients with treatment-resistant tumor. [ABSTRACT FROM AUTHOR]

Objectives: Impairment of type I interferon (IFN‐I) immunity has been reported in critically ill COVID‐19 patients. This defect can be explained in a subset of patients by the presence of circulating autoantibodies (auto‐Abs) against IFN‐I. We set out to improve the detection and the quantification of IFN‐I auto‐Abs in a cohort of critically ill COVID‐19 patients, in order to better evaluate the prevalence of these Abs as the pandemic progresses, and how they correlate with the clinical course of the disease. Methods: The concentration of anti‐IFN‐α2 Abs was determined in the serum of 84 critically ill COVID‐19 patients who were admitted to ICU in Hospices Civils de Lyon, France, using a commercially available kit (Thermo Fisher, Catalog #BMS217). Results: A total of 21 of 84 (25%) critically ill COVID‐19 patients had circulating anti‐IFN‐α2 Abs above cut‐off (> 34 ng mL−1). Among them, 15 of 21 had Abs with neutralising activity against IFN‐α2, that is 15 of 84 (18%) critically ill patients. In addition, we noticed an impairment of the IFN‐I response in the majority of patients with neutralising anti‐IFN‐α2 Abs. There was no significant difference in the clinical characteristics or outcome of with or without neutralising anti‐IFN‐α2 auto‐Abs. We detected anti‐IFN‐α2 auto‐Abs in COVID‐19 patients' sera throughout their ICU stay. Finally, we also found auto‐Abs against multiple subtypes of IFN‐I including IFN‐ω. Conclusions: We reported that 18% of critically ill COVID‐19 patients were positive for IFN‐I auto‐Abs, whereas all mild COVID‐19 patients were negative, confirming that the presence of these antibodies is associated with a higher risk of developing a critical COVID‐19 form. [ABSTRACT FROM AUTHOR]

We compared SimoaTM and EllaTM immunoassays to assess serum neurofilament‐light chain levels in 203 multiple sclerosis patients from the OFSEP HD study. There was a strong correlation (ρ = 0.86, p < 0.0001) between both platforms. The EllaTM instrument overestimated values by 17%, but as the data were linear (p = 0.57), it was possible to apply a correction factor to EllaTM results. As for SimoaTM, serum neurofilament‐light chain levels measured by EllaTM were correlated with age and EDSS and were significantly higher in active multiple sclerosis, suggesting that these assays are equivalent and can be used in routine clinical practice. [ABSTRACT FROM AUTHOR]

Background: Since the onset of the pandemic, only few studies focused on longitudinal immune monitoring in critically ill COVID-19 patients with acute respiratory distress syndrome (ARDS) whereas their hospital stay may last for several weeks. Consequently, the question of whether immune parameters may drive or associate with delayed unfavorable outcome in these critically ill patients remains unsolved.Methods: We present a dynamic description of immuno-inflammatory derangements in 64 critically ill COVID-19 patients including plasma IFNα2 levels and IFN-stimulated genes (ISG) score measurements.Results: ARDS patients presented with persistently decreased lymphocyte count and mHLA-DR expression and increased cytokine levels. Type-I IFN response was initially induced with elevation of IFNα2 levels and ISG score followed by a rapid decrease over time. Survivors and non-survivors presented with apparent common immune responses over the first 3 weeks after ICU admission mixing gradual return to normal values of cellular markers and progressive decrease of cytokines levels including IFNα2. Only plasma TNF-α presented with a slow increase over time and higher values in non-survivors compared with survivors. This paralleled with an extremely high occurrence of secondary infections in COVID-19 patients with ARDS.Conclusions: Occurrence of ARDS in response to SARS-CoV2 infection appears to be strongly associated with the intensity of immune alterations upon ICU admission of COVID-19 patients. In these critically ill patients, immune profile presents with similarities with the delayed step of immunosuppression described in bacterial sepsis. [ABSTRACT FROM AUTHOR]

L'électrophorèse permet la séparation des protéines sériques en différentes fractions pour en étudier les variations et les interpréter. La zone des gammaglobulines, dans laquelle migre une grande proportion des immunoglobulines (Ig), donne une image de la réponse immunitaire. L'allure normale de cette zone est une répartition gaussienne des immunoglobulines, correspondant à une synthèse polyclonale des Ig. D'autres aspects peuvent être observés, restriction d'hétérogénéité, oligoclonalité et monoclonalité. La restriction d'hétérogénéité est l'aspect le plus difficile à interpréter, faut-il identifier les Ig ? Faut-il contrôler régulièrement cet aspect ? Il apparaît que dans certains cas, discuter du contexte clinique avec le médecin soit essentiel. Cet article aborde la problématique de la définition, de la perception des aspects de restriction d'hétéro-généité et de leur interprétation, illustrée par des exemples de contextes cliniques concrets. Electrophoresis allows the separation of serum proteins into different fractions in order to study their variations and to interpret them. The gamma globulin zone, in which a large proportion of immunoglobulins (Ig) migrate, gives a picture of the immune response. The normal pattern of this zone is a Gaussian distribution of immunoglobulins, corresponding to a polyclonal synthesis of Ig. Other aspects can be observed, restriction of heterogeneity, oligoclonality and monoclonality. Heterogeneity restriction is the most difficult aspect to interpret, should Ig be identified? Is it necessary to check this aspect regularly? It appears that in some cases it is essential to discuss the clinical context with the physician. This article addresses the problem of defining and perceiving the aspects of heterogeneity restriction and their interpretation, illustrated by examples of concrete clinical contexts. [ABSTRACT FROM AUTHOR]

This study aimed to provide a model of awareness in Alzheimer's disease using the stage of the disease as a risk factor. Awareness was assessed using three methods (patient-caregiver discrepancy, prediction-performance discrepancy, clinical rating). Twenty-five healthy control subjects and sixty-one patients participated, with measures of cognition, apathy, depression, and awareness. These measures were introduced into a manual backward regression. Confounding factors impacting at least 15% of the exposure factor estimate were maintained in the model. Except for the prediction performance discrepancy, also presenting cognitive associations, the other awareness assessments suggested a major role of depression and apathy as impacting factors. [ABSTRACT FROM AUTHOR]

The aim of this descriptive study was to investigate the Self-Defining Memories (SDMs) in a large sample of 181 older adults (65–90 years; mean age = 73.0 years) and to target the relationships between their different dimensions. The sampling method was nonprobabilistic, based on voluntary participation. Participants were asked to recall three SDMs. They also completed the Mini-Mental State Examination, the Hospital Anxiety and Depression Scale, and a Self-esteem Scale. Almost half of the SDMs were specific and more than a quarter were integrated. Specificity, tension, redemption, contamination sequences, and affective response varied regarding thematic content. Specificity was positively correlated to tension whereas autobiographical reasoning was positively correlated to redemption and negatively linked to emotional response and depression. This research highlighted that identity is constituted by the main types of events that make up a life: interpersonal relationships, life-threatening events, achievement, and leisure. [ABSTRACT FROM AUTHOR]

Little research has examined changes in personal identity over different periods of adult development. The aim of the present cross-sectional study was to target these changes through the characterization of the main dimensions in self-defining memories (SDMs; thematic content, specificity, integrative meaning, tension, contamination/redemption, and emotion) and their interactions. Our final sample was composed of 652 healthy French adults aged from 18 to 97 years, divided into four age groups: young adults (n = 163, M = 23.7 years), middle-aged adults (n = 135, M = 44.0 years), young-old adults (n = 178, M = 64.5 years), and old-old adults (n = 176, M = 79.6 years). Participants were asked to recollect three SDMs. A similar pattern of thematic content was observed throughout adulthood, except for relationship narratives were more frequent in the two younger groups. The findings highlighted that specific and integrated SDMs decreased with age and that tension and contaminative sequences were the most frequent in young adults. Redemptive memories did not significantly differ whatever the age of participants. No clear positivity effect was observed with aging. Finally, an analysis of the correlations among the main SDMs' dimensions showed that specificity correlated positively with tension in young adults and integrative meaning with redemption in young and middle-aged participants. We found no significant correlation between specificity and integration in any age group. For the first time, this study sheds new light on lifelong identity adjustments. Public Significance Statement: The current study explored the development of personal identity through the comparison of four French age groups of adults: young, middle-aged, young-old, and old-old. It provides insights into a few developmental trends of the self. Thus, we found that some characteristics of memories supporting the sense of identity and called self-defining memories are differently influenced by age. [ABSTRACT FROM AUTHOR]

Aim of the study Evaluate the added value of screening anti-ZnT8 antibodies (ZnT8A) in addition to the classical anti-GAD (GADA) and anti-IA-2 (IA-2A) antibodies for the diagnosis of type-1 diabetes (T1D) within a large cohort of both children and adults. Materials and methods Retrospective 2-year study including 516 patients (215 children, 301 adults) who had blood tests at diabetes onset and/or for diabetes classification. ZnT8A, GADA, and IA-2A were analyzed in all samples. Results Among those individuals included, 142 (28%) were ZnT8A-positive. A total of 228/516 suffered from T1D, of whom 110 (48%) were ZnT8A-positive and 166 (73%) GADA and/or IA-2A positive. When adding ZnT8A to GADA/IA-2A, 184 (81%) patients were positive for ≥ 1 Ab. Regarding the 122 patients at T1D onset, 75 (61%) were positive for ZnT8A and the proportion of patients with T1D with ≥ 1 Ab reached 89%. The highest prevalence of ZnT8A was observed in children aged 6–10 years. Fourteen of the 124 patients positive for ZnT8A with a known clinical diagnosis suffered from a disease other than T1D. Conclusions ZnT8A should be included in routine evaluation at diabetes onset and is a valuable biological marker to classify newly-diagnosed diabetics. The predictive value in our high-risk subjects has to be confirmed. [ABSTRACT FROM AUTHOR]

La visée de cette recherche est de mieux comprendre le vécu psychique de l'Insuffisance Ovarienne Précoce (IOP) chez une jeune femme qui souhaite s'engager avec son compagnon dans une grossesse. Après avoir rappelé l'impact de cet événement somatique sur la psychosexualité féminine mais aussi le sentiment d'incomplétude lorsque l'infertilité survient, nous avons présenté un dispositif méthodologique basé sur des entretiens cliniques de recherche, des épreuves projectives (Rorschach, TAT) et un génogramme imaginaire pour analyser comment la participante élabore ses liens filiatifs et affiliatifs depuis l'annonce du diagnostic d'IOP. L'analyse des données cliniques et projectives dans un référentiel métapsychologique a mis en évidence des défenses narcissiques (idéalisation du couple), des marques de retrait relationnel, une élaboration complexe des identifications et notamment de la polarité féminine. Les imagos parentales se sont avérées insuffisantes à soutenir le narcissisme de la participante et donc à déployer les identifications. Quant au génogramme imaginaire, il illustre un fantasme incestuel et une dissociation du conjugal et du parental. Si la maternité pourrait être envisagée comme une sortie de la relation fusionnelle à la mère et soutenir une identité féminine, l'IOP, paradoxalement, maintiendrait la participante comme une éternelle enfant et ferait l'économie de la rivalité adressée à la mère (seule génitrice). The aim of this research is to better understand the psychological experience of premature ovarian failure (POF) in a young woman who desires to become pregnant with her partner. After taking into consideration the impact of this somatic event on female psychosexuality and the feeling of inadequacy in cases of infertility, we present a methodological approach based on clinical research interviews, projective tests (Rorschach, TAT), and an imaginary genogram to analyze how the participant approaches her filial and affiliative links following the announcement of the diagnosis of POF. The research was spread out over almost a month and used the following procedure: first of all, we conducted an initial interview concerning the impact of the announcement of the POF. During a second interview, the instructions were to go back over the salient elements of her life story (relationship with her parents, love life, desire for a child, etc.). Following this interview, the Rorschach and the TAT were administered. A session was devoted to doing the genograms, and finally a last meeting recorded her return on the research. Only the projective tests were carried out in the same session. The analysis of the clinical and projective data in a metapsychological perspective revealed narcissistic defense mechanisms (the idealization of the couple), indications of relational withdrawal, and a complex elaboration of identifications, particularly regarding feminine polarity. The parental imagos proved to be insufficient to support the participant's narcissism and to enforce the identifications. Moreover, the imaginary genogram illustrates an incestual fantasy and a dissociation of the conjugal being from the parental being. If motherhood could be envisaged as a way out of the fusional relationship with the mother and support a feminine identity, it seems that the ovarian failure, paradoxically, would relegate the participant to the status of an eternal child and would avoid the feelings of rivalry toward the mother (who remains the sole genitor). The fact that the partner was not involved in the data collection is one of the limitations of this research and it would seem interesting to include input from the partners in our future. [ABSTRACT FROM AUTHOR]

The article discusses a study on the potential anti-leukemic activity of iron chelation after patients with acute myeloid leukemia (AML) underwent allogeneic hematopoietic stem cell transplantation. The study involved a total of 83 patients who underwent the procedure during the period from 2002 to 2010. The results observed a lower relapse rate in patients who received iron chelation.

Background: In France, women represent approximately 20% of alcohol-dependent subjects. Although general practitioners (GPs) are often these women's first medical contact, GPs may be reluctant to probe for alcohol dependence. Method: In this context, in 1996 and 2006 we conducted a cross-sectional survey using self-completion postal questionnaires sent to all GPs in a French département (administrative area), with the aim to explore and to compare after a ten-year time lapse, expectations and relational difficulties in managing alcohol dependence in women. Results: A total of 300 GPs returned the questionnaire for the two data collection times. According to the GPs, comparing 1996 and 2006, there was less embarrassment among female patient to talk about alcohol consumption and a lesser tendency to break off medical care (33.7% vs. 47.3%, p < 0.001, and 13.3% vs. 23.0%, p = 0.002, respectively). In 2006, more GPs considered they were well informed about specialized care in alcohol dependence than in 1996 (76.8% vs. 59.9%, p < 0.0001), and more often reported referring their female patients to specialized centers (73.0% vs. 52.7%, p < 0.0001), rather than medical or psychiatric wards. Young GPs, aged under 40, seem rather to have had difficulty using the managed care network than lacking medical knowledge related to female alcohol dependence. Conclusions: The results suggest that over ten years there has been a decrease in the tendency among women to deny their alcohol dependence, and that they more readily accept specific care. In the same period, GPs have benefited from better information about specialized management. [ABSTRACT FROM AUTHOR]