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Background and Purpose: Growth differentiation factor 11 (GDF11) and myostatin (growth differentiation factor 8) are related to most diseases and chronic disorders in elderly population. Even though these two factors have similar structural and signaling pathways, they can have different functions, and the available information about their effects on the regeneration of degenerated muscles during old age is contradictory. GDF11 plays a role in skeletal muscle regeneration, combating aging-induced muscle loss, and regulating metabolic homeostasis and energy balance. On the other hand, myostatin, mainly secreted by skeletal muscles, plays a role in inhibiting muscle hypertrophic response (negative regulation of muscle mass) and modulating metabolic processes. Also, its increased expression is related to obesity and insulin resistance. Considering the beneficial effect of resistance training on these variables, the present study aimed to investigate the effect of 12 weeks of elastic band resistance training on the serum levels of growth differentiation factor 11, myostatin, and insulin resistance in overweight elderly women.Materials and Methods: Twenty-eight overweight elderly women with an average age of 74.04 ± 4.69 years and a body mass index of 28.21 ± 3.35 kg/m2 were selected based on the inclusion criteria and then randomly divided into exercise (n = 14) and control (n = 14) groups. Subjects in training group performed 12 weeks of Elastic band resistance training, 3 days per week. Blood samples were taken 24 hours before the first training session and 48 hours after the last training session; and were analyzed for serum levels of GDF11, myostatin, insulin, and glucose. All data were analyzed by two-way repeated-measures of ANOVA and using SPSS version 25 software at a significance level of P0.05), though, the serum levels of myostatin (P=0.027), insulin resistance index (P=0.045) and body fat percentage (P=0.023) decreased significantly.Conclusion: It seems that the decrease in the level of myostatin following elastic band training, which was associated with a reduction in insulin resistance and body fat percentage, can have a positive effect on the muscle mass and energy homeostasis of overweight elderly women. Also, in future studies related to GDF11, it is necessary to select the type, duration, and intensity of exercise as well as measurement methods with more scrutiny and accuracy.

Group therapy is a scalable and effective treatment for anxiety disorders. However, when performed online, the reduced ability to identify with group members and the reduced interactivity can limit its appeal and effectiveness. Extended reality (XR) technology, including virtual reality and augmented reality, may help address these limitations, thereby enhancing the reach of online group therapy and the benefits that can be drawn from it. To understand how the incorporation of XR technology may improve online group therapy for anxiety disorders, this viewpoint paper examines evidence related to the treatment of anxiety disorders using offline group therapy, online group therapy, and virtual reality, as well as ways to increase social identification and interactivity with the platform, the therapist, and other users. This viewpoint paper suggests ways to integrate these research streams to leverage the strengths of XR platforms and improve group therapeutic offerings.

As artificial intelligence (AI) technologies occupy a bigger role in psychiatric and psychological care and become the object of increased research attention, industry investment, and public scrutiny, tools for evaluating their clinical, ethical, and user-centricity standards have become essential. In this paper, we first review the history of rating systems used to evaluate AI mental health interventions. We then describe the recently introduced Framework for AI Tool Assessment in Mental Health (FAITA-Mental Health), whose scoring system allows users to grade AI mental health platforms on key domains, including credibility, user experience, crisis management, user agency, health equity, and transparency. Finally, we demonstrate the use of FAITA-Mental Health scale by systematically applying it to OCD Coach, a generative AI tool readily available on the ChatGPT store and designed to help manage the symptoms of obsessive-compulsive disorder. The results offer insights into the utility and limitations of FAITA-Mental Health when applied to “real-world” generative AI platforms in the mental health space, suggesting that the framework effectively identifies key strengths and gaps in AI-driven mental health tools, particularly in areas such as credibility, user experience, and acute crisis management. The results also highlight the need for stringent standards to guide AI integration into mental health care in a manner that is not only effective but also safe and protective of the users’ rights and welfare.

Abstract Background Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease that commonly results from a high-calorie diet and sedentary lifestyle, leading to insulin resistance and glucose homeostasis perturbation. Physical activity is recommended as one first-line treatment in T2DM, but it leads to contrasted results. We hypothesized that, instead of applying standard exercise protocols, the prescription of personalized exercise programs specifically designed to reverse the potential metabolic alterations in skeletal muscle could result in better results. Methods To test this hypothesis, we drew the metabolic signature of the fast-twitch quadriceps muscle, based on a combined unbiased NMR spectroscopy and RT-qPCR study, in several T2DM mouse models of different genetic background (129S1/SvImJ, C57Bl/6J), sex and aetiology (high-fat diet (HFD) or HFD/Streptozotocin (STZ) induction or transgenic MKR (FVB-Tg Ckm-IGF1R*K1003R)1Dlr/J) mice. Three selected mouse models with unique muscular metabolic signatures were submitted to three different swimming-based programs, designed to address each metabolic specificity. Results We found that depending on the genetic background, the sex, and the mode of T2DM induction, specific muscular adaptations occurred, including depressed glycolysis associated with elevated PDK4 expression, shift to β-oxidation, or deregulation of amino-acid homeostasis. Interestingly, dedicated swimming-based exercises designed to restore specific metabolic alterations in muscle were found optimal in improving systemic T2DM hallmarks, including a significant reduction in insulin resistance, the improvement of glucose homeostasis, and a delay in sensorimotor function alterations. Conclusion The muscle metabolism constitutes an important clue for the design of precision exercises with potential clinical implications for T2DM patients.

Abstract Background Online pornography use, an ever more common activity, has raised myriad psychosocial and clinical concerns. While there is a need to screen for and measure its problematic dimension, there is a debate about the adequacy of existing assessment tools. Objective The study compares two instruments for measuring pathological online pornography use (POPU) that are based on different theoretical frameworks—one in line with DSM-5 criteria and the six-component addiction model and one in line with ICD-11 criteria. Methods An international sample of 1,823 adults (Mean age = 31.66, SD = 6.74) answered an online questionnaire that included the Short Version of the Problematic Pornography Consumption Scale (PPCS-6) and the Assessment of Criteria for Specific Internet-Use Disorders (ACSID-11). Factorial, correlational, and network analyses were conducted on the data. Results Both tools adequately screened for online “addictive” behavior, but the ACSID-11 was superior in assessing the degree of clinical risk. Conclusion Depending on the specific aim of the assessment (screening vs. clinical diagnostics), both online pornography measurement tools may be useful.

Objectives: To identify factors associated with prolonged postoperative length of stay (LOS) after VATS lobectomy (VATS-L), explore potential intersurgeon variation in LOS and ascertain whether or not early discharge influences hospital readmission rates. Methods: We conducted a retrospective analysis of patients who underwent VATS-L at a single academic center between 2018 and 2021. Each VATS lobectomy procedure was performed by 1 of 7 experienced thoracic surgeons. The primary end point of interest was prolonged LOS, defined as an index LOS >3 days. Results: Among 1006 patients who underwent VATS lobectomy, 632 (63%) had a prolonged LOS. On multivariate analysis, the factors independently associated with prolonged LOS were: surgeon (P 3, and prior ipsilateral thoracic surgery or sternotomy. There was no association between LOS ≤3 days and hospital readmission (20 [5.3%] vs 39 [5.9%]; OR, 0.88; 95% CI, 0.50-1.53). Conclusions: An intersurgeon variation in postoperative LOS after VATS-L exists and is independent of patient baseline characteristics or perioperative complications. This variation seems to be more closely related to differences in postoperative management and discharge practices rather than to surgical quality. Postoperative discharge within 3 days is safe and does not increase hospital readmissions.

Abstract Background Geolocation apps have radically transformed dating practices around the world, with profound sociocultural implications. Few studies, however, have explored their addictive potential or factors that are associated with their misuse. Objective The present study aimed to assess the level of problematic Tinder use (PTU) in an adult sample, using a machine learning algorithm to determine, among 29 relevant variables, the most important predictors of PTU. Methods 1,387 users of Tinder (18–74 years-old; male = 50.3%; female = 49.1%) completed an online questionnaire, and a machine learning tool was used to analyze their responses. Results On 5-point scale, participants’ mean PTU score was 1.91 (SD = 0.70), indicating a relatively low overall level of problematic app use. Among the most important predictors of Problematic use were the use of Tinder for enhancement (reduce boredom and increase positive emotions), coping with psychological problems, and increasing social connectedness. The number of “matches” (when two users show mutual interest), the number of online contacts on Tinder, and the number of resulting offline dates were also among the top predictors of PTU. Depressive mood and loneliness were among the middle-ranked predictors of PTU. Conclusion In accordance with the Interaction of Person-Affect-Cognition-Execution model of problematic internet use, the results suggest that PTU relates to how individual experience on the app interacts with dispositional and situational characteristics. However, variables that seemed to relate to PTU, including lack of self-esteem, negative mood states and loneliness, are not problems that online dating services as currently designed can be expected to resolve. This argues for increased digital services to identify and address potential problems helping drive the popularity of dating apps.

Abstract In this paper, we consider an integrated sensing and communications system assisted by a reconfigurable intelligent surface (RIS). A small number of sparsely placed active sensors are applied in the RIS to perform effective channels and, thereby, enable optimized beamforming for both communications and sensing objectives, namely, establishing reliable communication links with communication users (CUs) and effectively localize targets. The time-varying multipath channels between the RIS and the CU as well as the time-varying channel between the RIS and the targets are estimated by exploiting an interpolated Hermitian and Toeplitz covariance matrix followed by direction-of-arrival estimation using the MUSIC algorithm. Based on such results, we jointly optimize the transmit beamformer at the base station and the unit-modulus RIS passive beamformer. The RIS beamformer is optimized to maximize its minimum beam-pattern gain towards the desired sensing angles subject to the minimum signal-to-noise ratio requirement at the CU. Simulation results verify the effectiveness of the proposed approach, and the performance of different sparse array configurations is compared.

IntroductionSpinal muscular atrophy (SMA) is a fatal neurodegenerative disorder, characterized by motor neuron (MN) degeneration and severe muscular atrophy and caused by Survival of Motor Neuron (SMN) depletion. Therapies aimed at increasing SMN in patients have proven their efficiency in alleviating SMA symptoms but not for all patients. Thus, combinational therapies are warranted. Here, we investigated the involvement of NADPH oxidase 4 (NOX4) in SMA-induced spinal MN death and if the modulation of Nox4 activity could be beneficial for SMA patients.MethodsWe analysed in the spinal cord of severe type SMA-like mice before and at the disease onset, the level of oxidative stress and Nox4 expression. Then, we tested the effect of Nox4 inhibition by GKT137831/Setanaxib, a drug presently in clinical development, by intrathecal injection on MN survival and motor behaviour. Finally, we tested if GKT137831/Setanaxib could act synergistically with FDA-validated SMN-upregulating treatment (nusinersen).ResultsWe show that NOX4 is overexpressed in SMA and its inhibition by GKT137831/Setanaxib protected spinal MN from SMA-induced degeneration. These improvements were associated with a significant increase in lifespan and motor behaviour of the mice. At the molecular level, GKT137831 activated the pro-survival AKT/CREB signaling pathway, leading to an increase in SMN expression in SMA MNs. Most importantly, we found that the per os administration of GKT137831 acted synergistically with a FDA-validated SMN-upregulating treatment.ConclusionThe pharmacological inhibition of NOX4 by GKT137831/Setanaxib is neuroprotector and could represent a complementary therapeutic strategy to fight against SMA.

Abstract The C-type lectin-related protein, Clr-f, encoded by Clec2h in the mouse NK gene complex (NKC), is a member of a family of immune regulatory lectins that guide immune responses at distinct tissues of the body. Clr-f is highly expressed in the kidney; however, its activity in this organ is unknown. To assess the requirement for Clr-f in kidney health and function, we generated a Clr-f-deficient mouse (Clr-f −/−) by targeted deletions in the Clec2h gene. Mice lacking Clr-f exhibited glomerular and tubular lesions, immunoglobulin and C3 complement protein renal deposits, and significant abdominal and ectopic lipid accumulation. Whole kidney transcriptional profile analysis of Clr-f −/− mice at 7, 13, and 24 weeks of age revealed a dynamic dysregulation in lipid metabolic processes, stress responses, and inflammatory mediators. Examination of the immune contribution to the pathologies of Clr-f −/− mouse kidneys identified elevated IL-12 and IFNγ in cells of the tubulointerstitium, and an infiltrating population of neutrophils and T and B lymphocytes. The presence of these insults in a Rag1 −/− Clr-f −/− background reveals that Clr-f −/− mice are susceptible to a T and B lymphocyte-independent renal pathogenesis. Our data reveal a role for Clr-f in the maintenance of kidney immune and metabolic homeostasis.

Objective Despite the availability of thousands of mental health applications, the extent to which they are used and the factors associated with their use remain largely unknown. The present study aims to (a) assess in a representative US-based population sample the use of smartphone apps for mental health and wellbeing (SAMHW), (b) determine the variables predicting the use of SAMHW, and (c) explore how a set of variables related to mental health, smartphone use, and smartphone “addiction” may be associated with the use of SAMHW. Methods Data was collected via online questionnaire from 1989 adults. The data gathered included information on smartphone use behavior, mental health, and the use of SAMHW. Latent class analysis was used to categorize participants. Machine learning and logistic regression analyses were used to determine the most important predictors of SAMHW use and associations between predictors and outcome variables. Results While two-thirds of participants had a statistically high probability for using SAMHW, nearly twice more had high probability for using them to improve wellbeing compared to using them to address mental health problems (43% vs. 18%). In both groups, these participants were more likely to be female and in the younger adult age bracket than male and in the adult or older adult age bracket. According to the machine learning model, the most important predictors for using the relevant smartphone apps were variables associated with smartphone problematic use, COVID-19 impact, and mental health problems. Conclusion Findings from the present study confirm that the use of SAMHW is growing, particularly among younger adult and female individuals who are negatively impacted by problematic smartphone use, COVID-19, and mental health problems. These individuals tend to bypass traditional care via psychotherapy or psychopharmacology, relying instead on smartphones to address mental health conditions or improve wellbeing. Advising users of these apps to also seek professional help and promoting efforts to prove the efficacy and safety of SAMHW would seem necessary.

BackgroundProblematic smartphone use, like problematic internet use, is a condition for which treatment is being sought on the web. In the absence of established treatments, smartphone-provided tools that monitor or control smartphone use have become increasingly popular, and their dissemination has largely occurred without oversight from the mental health field. ObjectiveWe aimed to assess the popularity and perceived effectiveness of smartphone tools that track and limit smartphone use. We also aimed to explore how a set of variables related to mental health, smartphone use, and smartphone addiction may influence the use of these tools. MethodsFirst, we conducted a web-based survey in a representative sample of 1989 US-based adults using the crowdsourcing platform Prolific. Second, we used machine learning and other statistical tools to identify latent user classes; the association between latent class membership and demographic variables; and any predictors of latent class membership from covariates such as daily average smartphone use, social problems from smartphone use, smartphone addiction, and other psychiatric conditions. ResultsSmartphone tools that monitor and control smartphone use were popular among participants, including parents targeting their children; for example, over two-thirds of the participants used sleep-related tools. Among those who tried a tool, the highest rate of perceived effectiveness was 33.1% (58/175). Participants who experienced problematic smartphone use were more likely to be younger and more likely to be female. Finally, 3 latent user classes were uncovered: nonusers, effective users, and ineffective users. Android operating system users were more likely to be nonusers, whereas younger adults and females were more likely to be effective users. The presence of psychiatric symptoms did not discourage smartphone tool use. ConclusionsIf proven effective, tools that monitor and control smartphone use are likely to be broadly embraced. Our results portend well for the acceptability of mobile interventions in the treatment of smartphone-related psychopathologies and, potentially, non–smartphone-related psychopathologies. Better tools, targeted marketing, and inclusive design, as well as formal efficacy trials, are required to realize their potential.

Abstract. Introduction:. Chronic pain (pain lasting ≥3 months) co-occurs with internalizing mental health issues, such as posttraumatic stress symptoms (PTSS), at high rates in youth. The mechanisms underlying these relationships remain unclear. Posttraumatic stress symptoms, including re-experiencing (eg, intrusive memories), alterations in cognition and mood, hyperarousal, and avoidance could lead to altered neuronal processing, pain sensitization, and greater reports of pain. However, the relationships between PTSS and pain sensitization in youth with chronic pain are not known. Methods:. Youth (n = 165) aged 10 to 18 years were recruited from outpatient multidisciplinary chronic pain programs. Symptoms of PTSS were assessed using psychometrically sound questionnaires. Youth also underwent a cold-pressor task, the most commonly used experimental pain induction technique. During this task, they reported on their expected pain, actual pain intensity, and pre- and post-state pain catastrophizing. Their pain threshold was recorded. A multivariate general linear model was used to examine the relationships between PTSS, ratings of pain intensity, state pain catastrophizing, and pain threshold, controlling for age, gender, ethnicity, anxiety, and depressive symptoms. Results:. Higher PTSS were associated with greater pain thresholds (P = 0.03) and higher pre- and post-state pain catastrophizing (P ≤ 0.05). Conclusions:. Individuals with higher PTSS may avoid or dissociate from pain-inducing stimuli, thus leading to higher pain thresholds. However, individuals with higher PTSS also tend to catastrophize prior to and following exposure to pain. Avoidant and pain catastrophizing behaviors may serve to perpetuate chronic pain conditions. Future research is needed to determine how PTSS are related to pain sensitization prior to the development of chronic pain in at-risk youth.

Agile project management (APM) can be defined as an iterative approach that promotes satisfying customer requirements, adjusts to change, and develops a working product in rapidly changing environments. Managers usually apply agile management as the project management approach in projects requiring extraordinary speed and flexibility in their processes. Earned value management (EVM) is a fundamental part of project management to establish practical measures. Often, managers use a task board to visually represent the work on a project and the path to completion. Still, managing an agile project can be a challenging endeavor. In this paper, we propose an agent-based model describing the management of tasks within a project using earned value assessment and a task board. Our model illustrates how EVM yields an efficient method to measure a project’s performance by comparing actual progress against planned activities, thus facilitating the formulation of more accurate predicted estimations. As proof of concept, we leverage our implementation to calculate EVM performance indexes according to a performance measurement baseline (PMB) in a task board fashion.

Na Amazônia colonial, os rios eram os caminhos por excelência. Interligavam vilas e lugares através de canoas. Dinâmicas específicas da região implicaram a participação indispensável de índios como remeiros, pilotos, guerreiros e informantes. Este texto procura compreender, a partir da análise de diversas fontes, o protagonismo indígena em canoas de comércio e de guerra na Amazônia do século XVIII. Palavras-chave: Amazônia colonial; índios; canoas e rios.

The authors present an in vitro gut microbiome model that maintains the functional and compositional profiles of individual gut microbiomes, as assessed by metaproteomics. Gut microbiome responses to metformin in this model correlate with those shown in mice fed a high-fat diet.

We report the case of a biological female with gender identity-related doubts that were misconstrued as suggesting obsessive-compulsive disorder (OCD). The patient's parent seemed to favor an OCD explanation for the gender-based self-questioning over acceptance of possible transgender identity. We discuss what OCD is and what it is not in the context of gender identity-based doubt; analogy with the better studied sexual orientation-related OCD; cultural flashpoints around sex and gender that can become the object of OCD; how confusion about biological sex, assigned gender and gender identity can lead to clinical harm; and the role of mental health professionals in fighting the stigma faced by gender minorities.

Objective This study assessed the prevalence of refractive error (RE) and its associated factors among elementary school children in Hawassa, Ethiopia. Methods In this school-based cross-sectional study, a random selection technique with proportional allocation was used to ensure a representative sample of students. Survey questionnaires were used to collect sociodemographic, environmental, and family history data. Clinical examinations were performed to assess RE and ocular health. Associations between dependent and independent variables were computed using adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Results Overall, 529 children participated in this study, with a response rate of 95.5% (529/554). Most participants were aged ≥12 years (337 [63.7%]), in grade levels 5 to 8 (307 [58%]), and attended public schools (366 [69.2%]). RE prevalence was 12.9% (95% CI: 10.0–16.1). Higher grade level (AOR=3.18, 95% CI: 1.68–5.97), positive family history of RE (AOR=3.69, 95% CI: 1.57–8.67), lack of paternal formal education (AOR=3.25, 95% CI: 1.20–8.77), and public school attendance (AOR=3.33, 95% CI: 1.52–7.27) were factors significantly associated with RE. Conclusions RE prevalence among elementary school children in Hawassa was higher than in previous reports. Grade level, family history, paternal education level, and school type significantly influenced RE status.

Objective To assess the strabismus prevalence and associated factors among children aged ≤15 years. Methods This hospital-based cross-sectional study was conducted from March 2017 to October 2017 in the Department of Ophthalmology & Optometry, Hawassa University Comprehensive Specialized Hospital. Interviewer-administered questionnaires were used to collect relevant data and clinical examinations were performed for patient diagnosis. Results Overall, 582 children participated in the study (response rate, 97%). The prevalence of childhood strabismus was 17.9% [95% confidence interval: 14.6–21.1]. Additionally, 9.6%, 16.7%, and 9.6% of the children had anisometropia, amblyopia, and dense cataract, respectively. Among the 16.7% of children with amblyopia, 56.7% had strabismus; among the 22.5% of children with clinically significant refractive error, 52.7% had strabismus. Moreover, among the 9.6% of children with anisometropia, 58.9% had strabismus. The presence of amblyopia (adjusted odds ratio [95% confidence interval]: 3.9, 1.7–8.6), age

The electrocardiogram (ECG) is the most common tool used to predict left ventricular hypertrophy (LVH). However, it is limited by its low accuracy (

Scientific literature from the last two decades indicates that, when it comes to mental health, technology is presented either as panacea or anathema. This is partly because researchers, too frequently, have planted themselves either in the field of digital mental health interventions (variably called “telepsychiatry”, “digital therapeutics”, “computerized therapy”, etc.), or in that of the problems arising from technology, with little cross-fertilization between the two. Yet, a closer look at the two fields reveals unifying themes that underpin both the advantages and dangers of technology in mental health. This article discusses five such themes. First, the breakneck pace of technology evolution keeps digital mental health interventions updated and creates more potentially problematic activities, leaving researchers perennially behind, so new technologies become outdated by the time they are studied. Second, the freedom of creating and using technologies in a regulatory vacuum has led to proliferation and choice, but also to a Wild-West online environment. Third, technology is an open window to access information, but also to compromise privacy, with serious implications for online psychology and digital mental health interventions. Fourth, weak bonds characterize online interactions, including those between therapists and patients, contributing to high attrition from digital interventions. Finally, economic analyses of technology-enabled care may show good value for money, but often fail to capture the true costs of technology, a fact that is mirrored in other online activities. The article ends with a call for collaborations between two interrelated fields that have been—till now—mutually insular.

Purpose: The best adjuvant treatment in high-risk endometrial cancer remains unclear. Although adjuvant chemotherapy seems to improve overall survival (OS) in locally advanced disease, the role of adding radiotherapy is not certain. We evaluated the outcomes of patients with high-risk endometrial cancer treated with adjuvant chemotherapy followed by radiotherapy. Patients and Methods: We performed a retrospective analysis of patients with high-risk endometrial cancer (endometrioid histology stages III to IVA or carcinosarcoma, clear cell, or serous histology stages I to IVA) treated with adjuvant carboplatin and paclitaxel, followed by radiotherapy, from 2010 to 2017 at a Brazilian cancer center. The Kaplan-Meier method was used for survival analysis, and prognostic factors were analyzed using the Cox proportional hazards model. Results: One hundred forty-six consecutive patients were evaluated. The OS rates were 86.2% at 3 years and 75.4% at 5 years. OS was significantly affected by pelvic lymphadenectomy (P = .001) and positive peritoneal cytology (P < .001). Three- and 5-year disease-free survival (DFS) rates were 78.3% and 69.5%, respectively. The initial site of recurrence was limited to the pelvis in 4.1% of patients, within the abdomen in 1.3%, and extra-abdominal in 11.6%. Patients with grade 1 or 2 endometrioid carcinoma had better prognosis than patients with endometrioid carcinoma grade 3 or nonendometrioid histology (3-year DFS, 93.67% v 68.5%, respectively; P = .0017). Conclusion: Adjuvant carboplatin and paclitaxel, followed by radiotherapy, is effective in high-risk endometrial cancer and associated with low rates of pelvic recurrence, which might be explained by the addition of radiotherapy. The high-risk group is heterogeneous, and the benefit of adjuvant treatment in patients with grade 1 or 2 endometrioid carcinoma is less clear.

The objective of this paper is to provide an update to psychiatrists regarding the new Brazilian Law for the Inclusion of People with Disabilities (BLI, Law 13,146 of 2015), and, specifically, to discuss potential implications of situations in which examination by a forensic psychiatrist points toward civil incompetence, while the above-mentioned law mandates full civil capacity for disabled persons. A study of Law 13,146/2015 was conducted, including a comparative analysis of legal and psychiatric approaches on the subject. This analysis revealed that the BLI has generated differences of opinion among legislators. However, the greatest difference seems to arise between the justice system and psychiatric expertise in relation to the difference of criteria adopted in the two approaches. The BLI is very recent; it should be revised in response to debates among psychiatrists and the criminal justice system, and especially as jurisprudence is formed over time.

In recent years, the readiness potential (RP), a type of pre-movement neural activity, has been investigated for asynchronous electroencephalogram (EEG)-based brain-computer interfaces (BCIs). Since the RP is attenuated for involuntary movements, a BCI driven by RP alone could facilitate intentional control amid a plethora of unintentional movements. Previous studies have mainly attempted binary single-trial classification of RP. An RP-based BCI with three or more states would expand the options for functional control. Here, we propose a ternary BCI based on single-trial RPs. This BCI classifies amongst an idle state, a left hand and a right hand self-initiated fine movement. A pipeline of spatio-temporal filtering with per participant parameter optimization was used for feature extraction. The ternary classification was decomposed into binary classifications using a decision-directed acyclic graph (DDAG). For each class pair in the DDAG structure, an ordered diversified classifier system (ODCS-DDAG) was used to select the best among various classification algorithms or to combine the results of different classification algorithms. Using EEG data from 14 participants performing self-initiated left or right key presses, punctuated with rest periods, we compared the performance of ODCS-DDAG to a ternary classifier and four popular multiclass decomposition methods using only a single classification algorithm. ODCS-DDAG had the highest performance (0.769 Cohen's Kappa score) and was significantly better than the ternary classifier and two of the four multiclass decomposition methods. Our work supports further study of RP-based BCI for intuitive asynchronous environmental control or augmentative communication.

For aerobic human pathogens, adaptation to hypoxia is a critical factor for the establishment of persistent infections, as oxygen availability is low inside the host. The two-component system RegB/A of Brucella suis plays a central role in the control of respiratory systems adapted to oxygen deficiency, and in persistence in vivo. Using an original “in vitro model of persistence” consisting in gradual oxygen depletion, we compared transcriptomes and proteomes of wild-type and ΔregA strains to identify the RegA-regulon potentially involved in the set-up of persistence. Consecutive to oxygen consumption resulting in growth arrest, 12% of the genes in B. suis were potentially controlled directly or indirectly by RegA, among which numerous transcriptional regulators were up-regulated. In contrast, genes or proteins involved in envelope biogenesis and in cellular division were repressed, suggesting a possible role for RegA in the set-up of a non-proliferative persistence state. Importantly, the greatest number of the RegA-repressed genes and proteins, including aceA encoding the functional IsoCitrate Lyase (ICL), were involved in energy production. A potential consequence of this RegA impact may be the slowing-down of the central metabolism as B. suis progressively enters into persistence. Moreover, ICL is an essential determinant of pathogenesis and long-term interactions with the host, as demonstrated by the strict dependence of B. suis on ICL activity for multiplication and persistence during in vivo infection. RegA regulates gene or protein expression of all functional groups, which is why RegA is a key regulator of B. suis in adaptation to oxygen depletion. This function may contribute to the constraint of bacterial growth, typical of chronic infection. Oxygen-dependent activation of two-component systems that control persistence regulons, shared by several aerobic human pathogens, has not been studied in Brucella sp. before. This work therefore contributes significantly to the unraveling of persistence mechanisms in this important zoonotic pathogen.

The aim of this study was to identify the ideal maize seed harvest moment by different characteristics, as black layer formation, milk line development, seed moisture content and seed dry matter accumulation. Three simple hybrids from Syngenta Company were used in this work; ears from plants in the same development stage were collected, the first harvesting began 40 days after flowering, at four days interval until all seeds in an ear had the black layer formation. The characteristics evaluated were: black layer formation, milk line development, seed moisture content and seed dry matter. Seed physiological quality was evaluated by germination test, cold test, accelerated ageing and electrical conductivity. Results obtained in this study showed that the best indicative to identify the ideal maize seeds harvest moment is milk line stage 4 (75% of solidified endosperm). This stage occurs at different time for each genotype studied, 60DAF to hybrids 1 and 3, and 52DAF to hybrid 2, due to genetic differences among the hybrids.

O sistema radicular das plantas necessita de condições físicas, químicas e biológicas favoráveis para o seu crescimento. Tecnologias têm sido propostas com intuito de minimizar condições adversas a esse crescimento, aumentando o rendimento das plantas. O objetivo deste trabalho foi avaliar os efeitos de manejos de solo sobre as propriedades físicas do solo e da utilização de bioestimulantes sobre o rendimento de grãos de trigo. O experimento constou de três manejos de solo (plantio direto − PD, plantio direto escarificado – PDE, e solo arado − SA) e o uso de dois tipos de bioestimulantes aplicados via tratamento de sementes. De modo geral, os preparos de solo com escarificador e arado melhoraram as propriedades físicas do solo em relação ao solo não mobilizado sob plantio direto. O intervalo hídrico ótimo (IHO) para uma mesma densidade foi maior no PDE quando comparado aos manejos arado e PD. O rendimento de grãos de trigo não foi afetado pelo uso de bioestimulantes, mas na média produziu menos no PD do que no PDE e SA.

Background. Group B Streptococcus is an organism that commonly infects a wide range of hosts including infants in the first week of life, pregnant women, and older age adults as well as adults with underlying medical comorbidities. Case. Large pelvic abscess in a nonpregnant patient found to be caused by Group B Streptococcus was treated successfully with IR guided drainage and antibiotics. Conclusion. Though rare, GBS can still be a cause of invasive infection even in individuals who are nonpregnant and have no underlying comorbidities. Empiric antibiotic coverage for this organism should be kept in mind when treating an abscess.

É desenvolvida uma análise comparativa entre a prática da Psiquiatria Forense na Inglaterra e no Brasil. O objetivo é promover reflexões sobre a condução desta especialidade psiquiátrica nos dois países. Trata-se de um estudo dirigido especificamente para a área criminal e sua abordagem é realizada sob os pontos de vista legal, clínico e ético. As observações realizadas na Inglaterra podem ser aplicadas também ao País de Gales, mas não ao Reino Unido como um todo, uma vez que legislações diferentes são adotadas na Escócia e Irlanda do Norte. Conclui-se que, enquanto no Brasil é necessário um relacionamento mais próximo e integrado entre Psiquiatria e Lei, é igualmente importante ter clareza do alcance e dos limites de cada um desses campos de abordagem para, assim, evitar o risco de se ignorar os limites dessa relação, que parece estar marcada por uma certa confusão no contexto inglês.

Small-cell ovarian carcinoma (SCOC) is a rare and aggressive neoplasia, predominantly affecting young women who are frequently first diagnosed with advanced stage disease. Platinum-based chemotherapy (ChT) can provide high response rates and rapidly ameliorate symptoms in this scenario. However, progression after chemotherapy usually occurs quickly, leading to high mortality rates. In addition, ChT complications, such as tumor lysis syndrome (TLS) can also occur, jeopardizing the patient’s outcome. We present a case of metastatic SCOC in a 47-year-old patient who achieved tumor response after platinum-based chemotherapy and developed TLS, from which she recovered with supportive treatment. After the second ChT cycle, she developed febrile neutropenia and died 8 weeks after the diagnosis of SCOC. Although SCOC is a chemo-sensitive tumor, short-lived responses and frequent chemotherapy complications lead to a dismal prognosis.

Müllerian adenosarcoma is a rare, mixed tumor that can occur throughout the female genital tract, but is most commonly found in the uterus. Ovarian adenosarcoma is rarer and has a poorer prognosis than uterine adenosarcoma. Data on the clinicopathological features of ovarian adenosarcoma are limited, and, due to its rarity, the management is controversial. The authors report a case of a 25-year-old patient who presented with recurrent abdominal pain. Sonography and laparotomy showed an ovarian cyst, and pathologic examination confirmed the diagnosis of cystic low-grade adenosarcoma. The patient remains free of recurrence 6 months after diagnosis. The authors call attention to the differential diagnosis of ovarian masses, especially in young patients, and to the lack of evidence on the management of this neoplasm in the literature.

BACKGROUND: Outcomes of sexual violence care programmes may vary according to the profile of survivors, type of violence suffered, and local context. Analysis of existing sexual violence care services could lead to their better adaptation to the local contexts. We therefore set out to compare the Médecins Sans Frontières sexual violence programmes in the Democratic Republic of Congo (DRC) in a zone of conflict (Masisi, North Kivu) and post-conflict (Niangara, Haut-Uélé). METHODS: A retrospective descriptive cohort study, using routine programmatic data from the MSF sexual violence programmes in Masisi and Niangara, DRC, for 2012. RESULTS: In Masisi, 491 survivors of sexual violence presented for care, compared to 180 in Niangara. Niangara saw predominantly sexual violence perpetrated by civilians who were known to the victim (48%) and directed against children and adolescents (median age 15 (IQR 13-17)), while sexual violence in Masisi was more directed towards adults (median age 26 (IQR 20-35)), and was characterised by marked brutality, with higher levels of gang rape, weapon use, and associated violence; perpetrated by the military (51%). Only 60% of the patients in Masisi and 32% of those in Niangara arrived for a consultation within the critical timeframe of 72 hours, when prophylaxis for HIV and sexually transmitted infections is most effective. Survivors were predominantly referred through community programmes. Treatment at first contact was typically efficient, with high (>95%) coverage rates of prophylaxes. However, follow-up was poor, with only 49% of all patients in Masisi and 61% in Niangara returning for follow-up, and consequently low rates of treatment and/or vaccination completion. CONCLUSION: This study has identified a number of weak and strong points in the sexual violence programmes of differing contexts, indicating gaps which need to be addressed, and strengths of both programmes that may contribute to future models of context-specific sexual violence programmes.