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Background: Diagnosis of schizophrenia lacks reliable medical diagnostic tests and robust biomarkers applied to clinical practice. Schizophrenic patients undergoing treatment with antipsychotics suffer reduced life expectancy due to metabolic disarrangements that co-exist with their mental illness and predispose them to develop metabolic syndrome, which is also exacerbated by medication. Metabolomics is an emerging and potent technology able to accelerate this biomedical research. Aim: This review focus on a detailed vision of the molecular mechanisms involved both in schizophrenia and antipsychotic-induced metabolic syndrome, based on innovative metabolites that consistently change in nascent metabolic syndrome, drug-naïve, first episode psychosis and/or schizophrenic patients compared to healthy subjects. Main Lines: Supported by metabolomic approaches, although not exclusively, noteworthy variations are reported mainly through serum samples of patients and controls in several scenes: 1) alterations in fatty acids, inflammatory response indicators, amino acids and biogenic amines, biometals, and gut microbiota metabolites (schizophrenia); 2) alterations in metabolites involved in carbohydrate and gut microbiota metabolism, inflammation and oxidative stress (metabolic syndrome), some of them shared with schizophrenia; 3) alterations of cytokines secreted by adipose tissue, phosphatidylcholines, acylcarnitines, Sirtuin 1, orexin-A, and changes in microbiota composition (antipsychotic-induced metabolic syndrome). Conclusion: Novel insights into the pathogenesis of schizophrenia and metabolic side-effects associated with its antipsychotic treatment represent an urgent request for scientists and clinicians. Leptin, carnitines, adiponectin, insulin, or interleukin-6 represent some examples of candidate biomarkers. Cutting-edge technologies like metabolomics have the power to strengthen research for achieving preventive, diagnostic, and therapeutical solutions for schizophrenia.

The massification of the Electric Vehicles (EVs) brings as a consequence that adequacy is made in the power systems, due to this, optimization of these systems must be made through the strengthening in the operational and planning process of the network, which can make the technological plans of distributors more flexible while maintaining the criteria of safety and reliability of the networks. According to the above, this article aims to build recommendations for the reliable, safe, and agile integration of EV in the Colombian interconnected power system, in response to technological, and regulatory challenges. To achieve this objective, a research tool was implemented to some companies in the sector, seeking to clarify their point of view on issues related to the integration of electric vehicles, charging infrastructure, and the impact of EVs in the operation of the grid. This research tool yielded results such as the lack of standardization in the connection of electric vehicles generates electrical risks for both users and infrastructure. The massification of charging infrastructure, especially the public ones, encourages the acquisition of electric vehicles by users. There are pilot projects in the installation of charging infrastructure, especially by public utilities. The contribution of this article is therefore to generate strategic guidelines grouped into 5 themes such as EV connection, communication and/or control, charging infrastructure business models, incentives for massification, and customer relations.

To analyse the diagnostic concordance index between Primary Care and Mental Health.

Purpose To assess the safety and efficacy of embolization for spontaneous bleeding in anticoagulated patients with COVID-19. Material and Methods Single center retrospective study in 9 patients with COVID-19 who experienced bleeding complications following anticoagulation. The study included 8 men and 1 woman aged from 48 to 80 years (mean 69.7 years), who had a total of 10 soft tissue haematomas: 1 in the thigh, 1 in the anterior abdominal wall, 6 retroperitoneal and 2 thoracic haematomas. All patients were referenced for vascular embolization, mostly with Onyx-18. Results A total of 10 haematomas were embolized in 9 patients. Technical success was achieved in all patients. No complications or adverse events were noted. One patient required percutaneous drainage of an infected haematoma 88 days after embolization. The mean hemoglobin level before embolization was 8,64 mg/dL and increased to 9,08 mg/dL after embolization (p = 0,3). After embolization all patients recovered haemodynamic stability and blood pressure levels improved. Seven patients resumed anticoagulation therapy after embolization. There were no recurrences or new bleedings in all treated patients. No patients required any additional invasive therapies or surgery. Mean intensive unit care and hospital stay was 6.7 and 35.2 days, respectively. All patients were discharged and were well at follow-up clinic visits 2–7 months after embolization. Seven patients performed a control CT scan 1–6 months after embolization, showing complete resolution of the haematoma. Conclusion Embolization is safe and effective to treat spontaneous haematomas in anticoagulated patients with COVID-19, allowing to resume anticoagulation therapy. Level of evidence IV Level 4, case-series.

The objective of the present study was to evaluate whether declarative memory deficits are related to executive function deficits (EF), since they could be a consequence of a poor organization of the material to memorize. This interaction between both cognitive processes can be studied simultaneously in a single task such as the Test of Memory Strategies (TSM). 23 patients with paranoid schizophrenic disorder, 11 with bipolar disorder with psychotic symptoms, 13 with bipolar disorder without psychotic symptoms and 15 healthy subjects were evaluated with the TSM; with the memory test Texts A and B (subtest of the Barcelona neuropsychological assessment battery), which assesses short-term and immediate recall without the influence of EF; and with the Trail Making Test (TMT): Part A (sustained attention) and Part B (executive control). The patients groups and the control group showed an improvement in memory performance across each of the TSM conditions. However, this facilitating effect of the strategies differed among the groups (the patients with higher EF deficits showed less improvement). Regarding these results, we conclude that this cognitive process cannot be independent of EF. However, due to the pilot nature of this study, it would be recommended to replicate these findings in new studies.

This paper presents the design and application of a research tool developed to identify preferences of users to participate in demand response (DR) programs. The proposed research tool was applied to the Colombian case discriminated in five different regions for industrial, commercial and residential uses. The results of the research tool evidenced the willingness of users to engage in DR programs if they are given the appropriate incentives (the most wanted incentive being a reduction of the electricity bill). The time of the day at which they would participate in such programs is mainly at night, in the range of 18h to 24h. It was also found that pedagogic programs would be needed since a high percentage of surveyed users do not even check their electricity meters, or only do it every month when the electricity bill comes.

Objective This study explores whether an Experiential Training Programme (ETP) in communication skills (CS) improves students' ability to identify patients clues compared to those who follow a non-experiential training throughout their medical studies. Method Intervention Group (IG): 85 4th-year medical students who received the ETP and Control Group (CG): 67 recently graduated students who did not receive it. Their immediate (written) response was requested to three expressions offered by patients containing communicative clues. The answers were grouped into 2 categories: Clue recognised and response patient-centred and the opposite. Three researchers analysed the answers. Results Responses 366 (65 from the CG and 77 from the IG): 280 did not recognise clues: 131 (62%) in IG and 149 (96%) in CG and 86 recognised them: 80 (37.9%) in IG and 6 (3.9%) in CG (p = 0.000). Some clues were more elusive than others (p = 0,003). Conclusions The students who received the ETP in CS showed greater ability to explore patients perspective taking advantage of different types of communicative clues than those who did not receive it in a non-relational context. Practice implications Further research is needed to assess whether this ability is maintained in simulated or real clinical situations. pre-print 222 KB

The implementation of a centralized transmission expansion plan is a complex task when several investors compete and bid to build a new transmission asset, as is the case now in Chile. The assessment of a transmission project depends on the number of competitors, where the project is subject to risks, such as delays, penalties, and cost overruns. The risk faced by an investor is measured using the Conditional Value at Risk (CVaR), which can be interpreted as the risk of not reaching an expected return on investment, depending on the tolerance to risk and the real income obtained with the investor's portfolio. This risk comes from the difference between the regulated income (investor's bid) and the real cost during the implementation and operation of the transmission project. The difference is the “surplus” profit that the investor obtains by participating in the tender, considering their risk tolerance. The goal is to determine the optimal value of a risky investor's portfolio made up of several transmission projects. The optimal portfolio may allow the central planner to improve the efficiency of the project allocation process. To test the methodology, two case studies are analyzed: the IEEE 24-bus Reliability Test System and a predefined expansion plan of Chile's Central Interconnected System (SIC).

BACKGROUND Regarding the treatment of patients with resistant schizophrenia, different options exit, although they are supported by limited evidence. In this study, antipsychotic polypharmacy, comprising 1200 mg of amisulpride and 600 mg of quetiapine, was used. Clinical change evaluation was performed using neurocognitive evaluations. STUDY QUESTION The use of amisulpride and quetiapine will imply a clinical improvement in patients affected by schizophrenia, which will be specially reflected in a cognitive improvement. STUDY DESIGN Naturalistic and prospective study. Twenty-six patients were applied and assessed by a battery of neurocognitive evaluations since the pretreatment baseline until 6-month treatment. The patients had no biological response to medication, high social maladjustment, and a long clinical history of the disease. Kane and Brenner criteria for treatment-resistant schizophrenia were applied to choose the subjects. MEASURES AND OUTCOMES The cognitive improvement will imply a significant betterment, from the pretreatment baseline until 6-month treatment, in the following cognitive tests: Stroop Test, WAIS Coding Subtest, and Comprehensive Trail Making Test (CTMT). An improvement in the Calgary Depression Scale, Simpson-Angus Scale, and Visual Analogue Scale (EVA) will also be observed. This scales were been used during the baseline, 3 months after, and then, 6 months. RESULTS Subjects, after 6-month treatment with amisulpride and quetiapine, did show statistically significant differences in the assessed areas: WAIS Coding Subtest (P < 0.001), CTMT A and B (CTMT A P < 0.034; CTMT B P < 0.000), and Stroop Tests: Word (P < 0.001), Word-Color (P < 0.007), and Interference (P < 0.039). Furthermore, they showed a statistically significant difference in the Calgary Depression Scale (P < 0.002), Simpson-Angus Scale (P < 0.019), and EVA (P < 0.001). CONCLUSIONS The results of this report show a cognitive and clinical improvement in refractory patients after the administration of amisulpride and quetiapine.

Since Classical Antiquity numerous authors have linked the origin of some mental disorders to physical and functional changes in the pineal gland because of its attributed role in humans as the connection between the material and the spiritual world. The pineal organ was seen as a valve-like structure that regulated the flow of animal spirits through the ventricular system, a hypothesis that took on more vigour during the Middle Ages and the Renaissance. The framework for this theory was "the three cells of the brain", in which the pineal gland was even called the "appendix of thought". The pineal gland could also be associated with the boom, during this period, of certain legends about the "stone of folly". But the most relevant psychopathological role of this organ arrived with Descartes, who proposed that it was the seat of the human soul and controlled communications between the physical body and its surroundings, including emotions. After a period of decline during which it was considered as a mere vestigial remnant of evolution, the link between the pineal gland and psychiatric disorders was definitively highlighted in the 20th century, first with the use of glandular extracts in patients with mental deficiency, and finally with the discovery of melatonin in 1958. The physiological properties of melatonin reawakened interest in the relationship between the pineal gland and mental disorders, fundamentally the affective and sleep disorders, which culminated in the development of new pharmacological agents acting through melatonergic receptors (ramelteon and agomelatine).

Introduction: The combination of antipsychotic drugs is a therapeutic resource in clinical practice. This study aimed to evaluate the efficacy and security of adding amisulpride in patients who at least partially responded to risperidone. Methods: A 3-month, open, observational study was undertaken to evaluate the effectiveness of adding amisulpride in subjects who scored at least 25 on the brief psychiatric rating scale (BPRS) after risperidone monotherapy. Patients were evaluated with BPRS, the Clinical Global Impressions Severity of Illness scale (CGI-S) and the Udvalg for Kliniske Undersogelser Side Effect Rating Scale (UKU) at baseline, 1 and 3 months. Results: Coadjuvant treatment with amisulpride achieves a statistically significant improvement in mental status over a period of 3 months when measured with BPRS, CGI and UKU scales. The response rate was 70 (45%) in the oral risperidone and 74 (28%) in the parenteral risperidone groups. Discussion: The addition of amisulpride could lead to an improvement in schizophrenia symptoms in patients that do not, or only partially, respond to risperidone. Further research is required into alternative therapies for poor responders.

To describe if there are differences in the prescription of psychodrug at discharge between bipolar disorder patients with or without addiction.We review all the psychotropic drugs dispensed to inpatients of a brief hospitalization psychiatric unit diagnosed as having bipolar disorder at time of discharge. We recluted 225 patients over 18 years old on their last manic episode, between the year 2000 and 2010. We classify them according to the comorbid presence or not of a substance abuse or dependence disorder.Prevalence of addiction was 24%. We found no differences between groups in the number of psychotropic drugs prescribed at discharge. The prescription pattern of mood stabilizers and benzodiazepines was similar in both groups. We detect differences in the total daily dose of antipsychotic, expressed as risperidone equivalents (5.86 ± 4.62 mg in addictions group versus 4.67 ± 3.20 mg in control group, p=0.042) and in the total daily dose of biperideno (4.80 ± 1.78 mg in addictions group versus 3.20 ± 1.03 mg in the control group, p=0.044).Contrary to our expectations, both groups were similar in psychopharmacological prescription patterns at discharge. However, those patients with substance abuse disorder had higher doses of antipsychotics and higher dose biperiden at discharge.

Bipolar depression, underdiagnosed in relation to unipolar depression, affects both the individual’s affective as well as cognitive areas. On the other hand, its manifestation is more frequent than hypomania/mania, despite which there has been less research into its treatment than manic phases.

The concept of “resistant schizophrenia” is linked to the development of antipsychotic drugs. Although there were previous attempts, the first definition acknowledged in the scientific literature, was closely linked to the development of clozapine in dichotomic terms of response/no response to previous drug. This article reviews the influence of the psychopharmacologic treatment of schizophrenia on the evolving definition of treatment-resistance. It also addresses other concepts of interest, such as remission and recovery, as well as definitions of schizophrenia in which deterioration is an integral part of the psychopathology, thereby implicitly ruling out the possibility of a complete remission of symptoms. Instead of treatment-resistance, we are suggesting the term “lack of adequate response,” which is closer to operational dimensional models that integrate the idea of a continuum with response levels related to an individual’s life expectations, and which allow different pharmacological approaches to be integrated.

Introduction: The anatomic seat of the human soul has been a controversial matter of discussion in the philosophical, theological and scientific fields throughout history. One of the more known hypotheses on this subject was proposed by Descartes, for whom the soul would host in the pineal gland, a brain body with a special location that would adequately address the functionalism of the human body. Development: In this work, we discuss the historical influences which made possible the Cartesian model of the relationship between spirit (res cogitans) and body-machine (res extensa) and the technical bases of his dualism doctrine. In philosophical terms, Descartes supported Augustine approaches and in physiological and anatomical terms adopted some theories of the classical Antiquity, essentially the proposals of Alexandrian pneumatic school (Herophilos, Erasistratus) in relation to the animal spirits. Descartes might also have known the hypotheses of some contemporary anatomists (Diemerbroeck) which established the location of sensorium commune in the pineal gland. Conclusions: Although Cartesian theories had strong criticism even in his time, some aspects of these postulates remained up to mid 19th century. Resumen: Introducción: La ubicación anatómica del alma humana ha constituido un controvertido motivo de discusión en los ámbitos filosófico, teológico y científico a lo largo de la historia. Una de las hipótesis más conocidas sobre este tema fue propuesta por Descartes, para quien el alma se alojaría en la glándula pineal, órgano cerebral cuya especial localización le permitiría dirigir adecuadamente el funcionamiento del cuerpo humano. Desarrollo: En el presente trabajo, analizaremos las influencias históricas que posibilitaron el modelo cartesiano de relación entre el pensamiento (res cogitans) y la extensión (cuerpo-máquina) y las bases técnicas de su principio de dualismo espíritu-materia. En materia filosófica, Descartes se apoyó en los planteamientos de San Agustín y en materia fisiológica y anatómica adoptó gran parte de las teorías vigentes desde la Antigüedad clásica, fundamentalmente las propuestas de la escuela neumática alejandrina (Herófilo, Erasístrato) en relación con los espíritus animales. Asimismo, también podría conocer las hipótesis de algunos anatomistas coetáneos (Diemerbroeck), que establecían la localización del sensorium commune en la glándula pineal. Conclusiones: Aunque desde el primer momento las teorías de Descartes tuvieron serios detractores, algunos aspectos de éstas perduraron hasta mediados el siglo xix. Keywords: Pineal gland, Soul, Descartes, Dualism, Animal spirits, History of neuroscience, Palabras clave: Glándula pineal, Alma, Descartes, Dualismo, Espíritus animales, Historia de la neurociencia

Objective: The association of antipsychotics is a widespread therapeutic resource in clinical practice. The purpose of the present work was to evaluate the effi cacy and safety of amisulpride augmentation in patients responding at least partially to olanzapine. Methods: In this observational 3-months open-label investigation, we evaluated the eff ec- tiveness of the addition of amisulpride to 49 subjects, after having scored at least 25 on the brief psychiatric rating scale (BPRS) following olanzapine monotherapy for 6 weeks. Patients were assessed at baseline, 1 and 3 months using the BPRS, the clinical global impression severity of illness (CGI-S) scale and the Udvalg for Kliniske Undersogelser side eff ect rating scale (UKU). Results: In subjects who were at least partially responsive to monotherapy with olanzapine, coadjuvant treatment with amisulpride achieved a statistically signifi cant improvement in mental status over a 3 month period as measured by the BPRS, CGI and UKU scales. The response rate ( > 20 % reduction in BPRS score) was 75.51 % . Conclusions: Amisulpride augmentation, in a group of patients partially or non-responsive to olanzapine, may lead to an improvement in schizoprenic symptoms. However, these results are subject to several limitations making it dif- fi cult to derive fi rm clinical recommendations, and underscoring the need for future research into the value of these therapeutic alternatives in poor responders.

German psychiatry and pharmacology both enjoyed an extraordinary international reputation prior to the promulgation of the Third Reich. However, with the triumph of eugenic ideas and the imposition of a "racial hygiene" policy by the Nazi regime, various organs of the German health system saw themselves involved in a perverse system of social control, in which the illicit use of psychopharmacological tools became customary. In the present work, we review, from the historical perspective, the factors that helped to bring about this situation and we analyze the abuses (known and documented) committed through the specific use of psychotropic drugs during the Nazi period. Among such abuses we can identify the following illegitimate activities: the use of psychoactive drugs, mainly sedatives from the barbiturates family, in the different euthanasia programmes implemented by the Nazi authorities, in police activity and various types of repression, and for purely criminal and extermination purposes within the so-called "Final Solution"; psychopharmacological research on the mentally ill, without the slightest ethical requirements or legal justification; and the use of psychotropic agents in research on healthy subjects, recruited from concentration camps. Finally, we refer to the role of poisonous nerve agents (tabun, sarin and soman) as instruments of chemical warfare and their development by the German authorities. Many of these activities, though possibly only a small portion of the total - given the destruction of a great deal of documentation just before the end of World War II - came to light through the famous Nuremberg Trials, as well as through other trials in which specific persons were brought to justice unilaterally by individual Allied nations or by the authorities of the new German government after the War.

El desarrollo de la neuropsiquiatria biologica en Espana se inicio a principios del siglo XX siguiendo las corrientes somaticistas europeas y bajo la gran influencia de Cajal, en torno a cuya figura se gesto una escuela de discipulos caracterizada por su orientacion germanica, su componente mixto neuropsiquiatrico y su afinidad hacia la histopatologia. Uno de sus mas prestigiosos representantes fue Gonzalo Rodriguez Lafora. Tras formarse en el campo de la neuropatologia y de la psiquiatria en Alemania, al lado de Alzheimer, Kraepelin, Rothmann y Minkowski, Lafora se ocupo, en 1910, de la direccion del Laboratorio de Histopatologia del Government Hospital for Insane de Washington, donde realizo algunos de los descubrimientos mas relevantes de su carrera cientifica, como la descripcion histopatologica de 2 de los primeros 10 casos de enfermedad de Alzheimer en Estados Unidos y de un tipo de epilepsia mioclonica, conocida a partir de entonces como “enfermedad de Lafora”. En este campo, Lafora estudio tambien la histopatologia de la placa senil, el paludismo cerebral, la neurosifilis, la paralisis agitante, etc., mientras en el ambito de la neurologia estudio las funciones del cuerpo calloso, la corea y atetosis, la fisiopatologia del sueno, las encefalitis y meningitis, etc. Finalmente, en el marco estrictamente psiquiatrico, se ocupo del estudio de las psicosis paranoides, las alucinaciones auditivas, las celotipias, los sindromes obsesivos, la ereutofobia y, sobre todo, las bases morfologicas de la esquizofrenia, y postulo incluso una hipotesis sobre su origen endocrino. La relevancia de los trabajos de Lafora en estos campos trascendio ampliamente las fronteras de nuestro pais, y se puede considerar el gran pionero de la neuropsiquiatria biologica espanola.

OBJECTIVE: Alzheimer's disease (AD) is commonly accompanied by aggressive behavior. In the elderly, effective and safe antiaggressive treatment is lacking. Risks of antipsychotics in this population demand therapeutic alternatives. This randomized, double-blind, pilot trial examined the efficacy and safety of cyproterone in the treatment of agitated AD. METHOD: The subjects were 27 elderly patients referred to the University Hospital of Guadalajara Psychogeriatric Clinic diagnosed with AD and associated aggressive behavior (mean Staff Observation Aggression Scale [SOAS] score >or=2). Each patient underwent a 15-day washout for psychotropics and then was randomly assigned to receive stable doses of either cyproterone (100 mg/day) or haloperidol (2 mg/day) for 90 days. The primary outcome measure was the SOAS score. This trial was conducted between October 27, 1993, and March 24, 1998. RESULTS: Of the 27 patients, 19 (70.4%) were women, and the mean age was 80.7 years. The trial was completed by 24 (88.9%) of the subjects (13 in the cyproterone group and 11 in the haloperidol group for 90 days). Three patients (11.1%) dropped out, all after adverse effects in the haloperidol group. Baseline aggression level in the sample was mild (mean SOAS score of 4.48 [SD = 2.04]). Efficacy analyses for all intent-to-treat patients showed that 9 (69.2%) in the cyproterone group achieved complete elimination of aggression at endpoint, in contrast to 2 patients (14.2%) in the haloperidol group (p = .012). Ten patients (71.4%) taking haloperidol had adverse events, compared with 4 (30.7%) taking cyproterone (p = .035). CONCLUSION: Cyproterone showed significantly better efficacy and safety than haloperidol in controlling mild aggression associated with AD. Additional research is needed to confirm if these results can be ratified in a larger study and generalized to patients whose aggression is more severe. Language: en

Objective: We performed a bibliometric study on scientific publications on atypical antipsychotic drugs (AADs) from Australia. Methods: Using the EMBASE and MEDLINE databases, we chose those documents produced in Australia between 1993 and 2011, whose title included the descriptors atypic* (atypical*), antipsychotic*, second-generation antipsychotic*, clozapine, risperidone, olanzapine, ziprasidone, quetiapine, sertindole, aripiprazole, paliperidone, amisulpride, zotepine, asenapine, iloperidone, lurasidone, perospirone and blonanserin. We applied bibliometric indicators of production as well as dispersion. Results: We identified 438 relevant publications. The most widely studied AADs were clozapine (162 documents), olanzapine (103), risperidone (77) and quetiapine (42). There was a lack of exponential growth in publications over time, indicated by non-fulfilment of Price’s Law (correlation coefficient r=0.9195 after exponential adjustment vs. r=0.9253 after linear adjustment). Publications appeared in 148 different journals, with four of the top nine journals having an impact factor greater than 3; 84 of the articles appeared in the Australian and New Zealand Journal of Psychiatry. Conclusion: Despite Australian publications on AADs appearing in reasonably high impact journals, most were confined to a single Australian psychiatry journal and overall publications did not show exponential growth over the period studied. This might reflect, inter alia, the relative paucity of medication trials being performed in Australia.

IntroductionPorphyrias are rare inherited disorders due to specific enzyme abnormalities of heme biosynthesis. Among the hepatic forms, three of them are clinically characterized by acute abdominal pain and neuropathy, sometimes associated with psychiatric disorders like mood changes, organic brain syndrome and psychosis.Case reportHere, we present a 38-year-old male patient with intermittent porphyria and chronic psychosis who was hospitalized. He had been treated by benzodiacepines and neuroleptic medication for several years. Exposure to certain drugs, dieting, starvation and infection may precipitate AIP attacks.DiscussionUnderlying organic causes of psychiatric disorders such as psychosis should be considered among patients with atypical symptoms and/or resistance to standard therapy.ConclusionIt is important to increase awareness amongst psychiatric and neurological professionals with regard to certain inborn errors of metabolism. Early detection of porphyria may diminish morbidity and mortality rates, and perhaps heal some chronic atypical psychiatric illnesses.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Objective To estimate the predictive value of the 30-question Geriatric Depression Scale (GDS) in Spanish and calculate the most adequate cut-point for its use in Primary Health Care consultations. Method 218 patients over the age of 64 treated at three health centers of Area 10 in Madrid were selected. In the first phase, the subjects completed the GDS, the Mini-Mental State Examination (MMSE) and a questionnaire on health and socio-demographic variables. They were later interviewed using the Geriatric Mental Schedule (GMS), used as the gold standard by doctors who were unaware of the results of the GDS. Two categories were contemplated according to the results of the GMS: cases of depression (diagnosis of psychotic or neurotic depression) and non-psychiatric cases (no psychiatric diagnosis, although isolated symptoms could be present). Results 192 aged subjects were interviewed using the GDS and the GMS. Of these, 103 were considered ‘non-cases of depression’ and 60 others made up the ‘cases of psychotic/neurotic depression’ group. For the most effective cut-point (9/10), sensitivity was 86.7% and specificity 63.1%. Considering a prevalence of depression of 30%, the predictive value for positives was 50.2% and for negatives 91.7%. The Cronbach alpha coefficient was 0.82, and the area below the ROC curve obtained was 0.85. Those patients with cognitive deterioration had a mean GDS score similar to those that did not present deterioration (11.16 vs 10.52; p > 0.05). Conclusions The Geriatric Depression Scale is valid as a screening test in Primary Care consultations due to its high sensitivity and negative predictive value. The most effective Spanish GDS cut-point (9/10) is lower than that obtained in the original English version (10/11). Copyright © 2002 John Wiley & Sons, Ltd.

The transmission asset expansion in Colombia evidences constraints that affect the transmission planning and implementation of the optimal expansion plans. Therefore, it is required to analyse the transmission sector experiences to assess the evolution of the transmission asset expansion and the challenges it faces to achieve a balance between social, sustainable and technical-economic goals.

Introduction A bibliometric study was carried out to ascertain the volume and impact of scientific literature published on second-generation antipsychotic drugs (SGAs) in Singapore from 1997 to 2011. Method s A search of the EMBASE and MEDLINE databases was performed to identify articles originating from Singapore that included the descriptors ‘atypic* antipsychotic*’, ‘second-generation antipsychotic*’, ‘clozapine’, ‘risperidone’, ‘olanzapine’, ‘ziprasidone’, ‘quetiapine’, ‘sertindole’, ‘aripiprazole’, ‘paliperidone’, ‘amisulpride’, ‘zotepine’, ‘asenapine’, ‘iloperidone’, ‘lurasidone’, ‘perospirone’ and ‘blonanserin’ in the article titles. Certain bibliometric indicators of production and dispersion (e.g. Price’s Law on the increase of scientific literature, and Bradford’s Law) were applied, and the participation index of various countries was calculated. The bibliometric data was also correlated with some social and health data from Singapore, such as the total per capita expenditure on health and gross domestic expenditure on research and development. Results From 1997 to 2011, a total of 51 articles on SGAs in Singapore were published. Our results suggested non-fulfilment of Price’s Law (r = 0.0648 after exponential adjustment vs. r = 0.2140 after linear adjustment). The most widely studied drugs were clozapine (21 articles), risperidone (16 articles) and olanzapine (8 articles). Division into Bradford zones yielded a nucleus occupied by the Journal of Clinical Psychopharmacology (6 articles) and the Singapore Medical Journal (4 articles). The analysed material was published in a total of 30 journals, with the majority from six journals. Four of these six journals have an impact factor greater than 2. Conclusion Publications on SGAs in Singapore are still too few to confirm an exponential growth of scientific literature.

Genetic differences in non-human primates and the context where they were reared are important in the determination of their behaviors. Some studies suggest that Self-Injurious Behavior results from stress or anxiety, but some macaques appear to be more vulnerable to acquiring Self-Injurious Behavior. Vulnerability and risk for socially reared macaques of developing Self-Injurious Behavior increased when they experienced early adverse events and suffered from consequent stress. Stressful events can cause alterations in the neuroendocrine and neuropeptide systems associated with the regulation of stress and anxiety. Dysregulation in these systems contributes to the occurrence of anxious episodes that lead to self-harm. This could be used by those animals to counteract the effects of anxiety, causing euphoria by releasing endogenous opioids. In developing an integrative approach of Self-Injurious Behavior, we propose the diathesis-stress model to illustrate how the environment and genetics are influenced as well, taking rhesus monkeys as an example. Rhesus macaques and humans have essentially the same gene 5-HTT as well as functional polymorphism. The allelic variation in the region promoting the serotonin transporter gene (5-HTT) was associated with significant differences in the number of depressive symptoms and contributions to social reward and punishment. Growing up without the mother and the rearing environment are important risk factors for developing abnormal behaviors. The main idea is that monkeys who carry short 5-HTT allele and are reared with their peers (without their mother) suffer from neurobiological developmental delay, deteriorated serotonergic functioning and act more aggressively. Monkeys who carry short 5-HIAA allele and are reared with their mothers, though, show normal behavioral patterns. We could conclude that carrying the short allele of gene 5-HTT leads to a psychopathological tendency in macaques with a poor parenting history, but it may be adaptive for those who establish an attached relationship with their mothers. Stressful early experiences result in impaired 5-HTT expression as well. There are both specific genetic and environmental factors which pose a risk in the development of adverse responses to stress and environment. Rhesus macaques, as well as humans, show big individual differences in their responses to environmental stress. Some are very fearful and anxious, others are aggressive and impulsive. It is possible to identify genetic and environmental patterns that contribute to these differen

We carried out a bibliometric study on the scientific publications in relation to atypical antipsychotic drugs (AADs) in Spain.We used the EMBASE and MEDLINE databases and we applied some bibliometric indicators of paper production and dispersion (Price's law and Bradford's law, respectively). We also calculated the participation index of the different countries and correlated the bibliometric data with some social and health data (total per capita expenditure on health and gross domestic expenditure on research and development).We collected 656 original papers published between 1988 and 2011. Our study results fulfilled Price's law with scientific production on AADs showing exponential growth (correlation coefficient r = 0.9693, vs. r = 0.9177 after linear adjustment). The most widely studied drugs were risperidone (181 papers), olanzapine (143), clozapine (94), and quetiapine (74). Division into Bradford zones yielded a nucleus occupied by the European Psychiatry and European Neuropsychopharmacology (70 articles). Totally 194 different journals were published, with 5 of the first 10 used journals having an impact factor being greater than 4.The publications on AADs in Spain have undergone exponential growth over the studied period, without evidence of reaching a saturation point.

ObjectiveaaWe have carried out a bibliometric study on the scientific publications in relation to atypical or second-generation antipsychotic drugs (SGAs) in South Korea. MethodsaaWith the EMBASE and MEDLINE databases, we selected those publications made in South Korea whose title included the descriptors atypic* (atypical*) antipsychotic*, second-generation antipsychotic*, clozapine, risperidone, olanzapine, ziprasidone, quetiapine, sertindole, aripiprazole, paliperidone, amisulpride, zotepine, asenapine, iloperidone, lurasidone, perospirone and blonanserin. We applied some bibliometric indicators of paper production and dispersion with Price’s law and Bradford’s law, respectively. We also calculated the participation index (PI) of the different countries, and correlated the bibliometric data with some social and health data from Korea (such as total per capita expenditure on health and gross domestic expenditure on research and development). ResultsaaWe collected 326 original papers published between 1993 and 2011. Our results state fulfilment of fulfilled Price’s law, with scientific production on SGAs showing exponential growth (correlation coefficient r=0.8978, as against an r=0.8149 after linear adjustment). The most widely studied drugs were risperidone (91 papers), aripiprazole (77), olanzapine (53), and clozapine (43). Division into Bradford zones yielded a nucleus occupied by the Progress in Neuro-Psychopharmacology and Biological Psychiatry (36 articles). A total of 86 different journals were published, with 4 of the first 10 used journals having an impact factor being greater than 4. ConclusionaaThe publications on SGAs in South Korea have undergone exponential growth over the studied period, without evidence

Aims:Research on second-generation antipsychotic drugs (SGAs) has experienced great development in last decades.We did a bibliometric study on the scientific publications on SGAs in Japan.Methods: With theEMBASEandMEDLINEdatabases, we chose papers published from Japan with SGA descriptors. Price’s law and Bradford’s law has been used as bibliometric indicators for quantitating production and dispersion, respectively, of published papers on SGAs. We also calculated the participation index of different countries, and correlated those bibliometric data with some social and health data from Japan (such as totalper capitaexpenditure on health and gross domestic expenditure on research and development). Results: A sum of 669 original documents were published from Japan from 1982 to 2011. Those results fulfilled Price’s law, with scientific production on SGAs showing exponential growth (correlation coefficientr= 0.9261, as against anr= 0.8709 after linear adjustment). The most studied SGAs in Japan wererisperidone (n= 192), aripiprazole (n= 109), and olanzapine (n= 106). Division of documents into Bradford zones yielded a nucleus occupied exclusively by theProgress in Neuro-Psychopharmacology and Biological Psychiatry(49 articles). Those publications were in 157 different journals. Seven of the first 10 frequently used journals had an impact factor of being greater than 3. Conclusions: The SGA publications in Japan have been through exponential growth over the studied period, without evidence of reaching a saturation point.

This paper is the second of a two-paper series and presents a model to assess and promote investment projects defined in a plan of expansion of the transmission. We propose a model that consists of three main elements: valuation of a project based on the design of a linear contract, a principal-agent model to assess the optimal effort of an agent, and the right-of-way negotiating cost. We also define a model to evaluate bids by the agents. The value of the project depends on the number of competitors, the incentives to invest, and the right-of-way costs. The right-of-way cost is approached from the perspective of a bilateral bargaining problem.

Defining and making decisions about network investments has become a hard task in a competitive environment. This work defines a methodology to look for expansion alternatives in a transmission system. We propose a Transmission Expansion Game model that consists of four main elements: i) generating transmission expansion plan scenarios, ii) valuation of a project based on the design of a linear contract, bargaining solutions and hidden actions, iii) optimal value of a risky investor's portfolio made up of several projects, and iv) transmission cost allocation with wind energy assets. The results obtained show that the model developed is efficient to solve the combinatorial problem. A principal-agent model obtains the real costs of the bidders and creates incentives for disclosure of information. The private optimal portfolio and bargaining for allocation cost gives evidence for the central planner to adjust the project assignment process and to carry out the proposed expansion plan efficiently. To test the methodology we analyze the Chilean Central Interconnected System.

In this study, we investigated the cognitive effects of combined treatment with amisulpride and quetiapine in a sample of four patients with refractory schizophrenia

Electric energy transmission is essential for the operation of competitive energy markets. Transmission expansion planning has been defined as a complex combinatorial optimization problem. This work puts forward a description of the solution techniques and alternatives to implement the transmission system's expansion. A model that considers Multi-objective Optimization - MOO - criteria is proposed under the concepts of Tabu Search - TS - Ordinal Optimization - OO - and Pareto optimality. The model proposed generates expansion plans under the Pareto optimality approach. It shows acceptable solutions under robustness and algorithmic speed criteria. The results obtained in the test systems show that the model developed is effective to find the solution for the combinatorial problem. Multi-objective optimization defines a set of feasible solutions that establishes expansion plans scenarios.

The relationship between the "passions" (emotions or feelings) and psychopathology has been a constant throughout the history of medicine. In this context, melancholy was considered a perversion of the soul (corruption of the passions). One of the most influential authors on this subject was René Descartes, who discussed it in his work The Treatise on the Passions of the Soul (1649). Descartes believed that "passions" were sensitive movements that the soul experienced due to its union with the body (res extensa). According to this theory, the soul was located in the pineal gland, where it was actively involved in overseeing the functions of the "human machine" and kept its dysfunctions under control, by circulating animal spirits. Descartes described sadness as one of "the six primitive passions of the soul", which leads to melancholy if not remedied. Cartesian theories had a great deal of influence on the way that mental pathologies were considered throughout the entire 17th century (Spinoza, Willis, Pitcairn) and during much of the 18th century (Le Cat, Tissot). From the 19th century onwards, emotional symptomatology finally began to be used in diagnostic criteria for mood disorders. Sadness as a passion of the soul: A psychopathological.... Available from: https://www.researchgate.net/publication/49830961_Sadness_as_a_passion_of_the_soul_A_psychopathological_consideration_of_the_Cartesian_concept_of_melancholy [accessed Jun 06 2018].

RESUMEN: Se propone un modelo para el pronóstico del precio de la energía eléctrica en Colombia mediante el uso de redes neuro-difusas. Se utilizan dos estructuras de redes incluyendo como entradas la serie de precios diarios en la primera y la serie de precios más el nivel medio de los embalses en la segunda. Los resultados son comparados con dos estructuras de redes neuronales y con un modelo Autoregresivo Condicional Heterocedástico Generalizado (GARCH). Los datos históricos fueron obtenidos de la Compañía XM del Grupo ISA; datos para 120 días son usados para entrenamiento y los 31 días siguientes para verificar la capacidad predictiva del modelo. Se encontró ventajas en este último dentro del periodo de muestreo para una variable de entrada, pero un mejor desempeño de las redes neuro-difusas en el periodo fuera de la muestra tanto para una como para dos variables de entrada. ABSTRACT: A forecasting model for the price of electricity in Colombia using neurofuzzy networks is proposed. Two network structures including the price series in the first and the price series plus the reserve water levels in the latter are used. The results are compared with two neural networks structures and a Generalized Autoregressive Conditional Heteroscedasticity model (GARCH). Historical date were supplied by the Company XM of the ISA Group; data for 120 days were used as for training the network and the following 31 days were used for testing the predictive capabilities of the model. The GARCH model shows better adjustment within the training period for the prices series as input, but the neurofuzzy networks have better forecasting performance for one and for two input variables. COL0124235 COL0010477

Transmission has established itself as a natural monopoly, and as such, the prices and remaining access and operating conditions of the transmission system have been regulated. In the regulations existing before the electric sector reform there was a single planner that determined the generation and transmission expansion. However, each time more mechanisms have been implemented that have allowed individualizing the agents of interest and as such, uncoupling planning and investment from the power plants and grids. This has brought a problem based on the optimal and timely investment on grids, mainly when power injection is considered with high uncertainty, as it usually happens with renewable energies.

The debate on which is the best incentive for transmission expansion is still active. Discussions center on economic mechanisms based on game theory to expand transmission. There is a mix of experiences and they vary in function of the level of interaction of market agents. Identifying the agents' strategies will allow a better understanding of the market's dynamics. This article assesses regulatory incentives based on the market for transmission expansion. Game theory fundamentals are developed, namely, the cooperative and non-cooperative games. Four base cases of a bi-nodal model were implemented. It is claimed that given the individual interests (egotistical) and grid characteristics (non-stored energy, circulating flows and variables), the transmission expansion fits better to a non-cooperative model. An alternative analysis is the design of Bayesian mechanisms.

The reforms carried out in various energy markets assign a central place to the transmission and hence this has created a dynamic research area, which is reported in this paper. There are various research topics, so it is required to identify the different areas and scientific advances in the field. Setting the types of assumptions used in the models and the influence of dynamic variables such as generation, demand and flow control will allow a better understanding of market dynamics. A comprehensive literature review is performed and in a context of power markets the most recent and relevant research in the evolution of the transmission is assessed. The paper presents topics of economic regulation and market mechanisms, planning, financial assessment, assignment, network congestion, economic and technical modeling methods and the influence of transmission technologies in the energy market. Research has sought to provide coupling mechanisms between economic and technical concepts, in order to provide feasible solutions to the electricity market. The debate about which is the best mechanism for the regulation of transmission, the planning model and the allocation of transmission costs, are still in force. The new contributions are focused on the impact of transmission on the market and the social benefits of the proposed mechanisms for transmission expansion.

Renewable energy has had a steady growth in power systems worldwide. The high uncertainty about what type of renewable technology meets technical and economic variables of the energy markets and what could be the participation in the energy matrix are important long term energy planning challenges that need to be identified and evaluated. This work assesses different scenarios of future development of the Chilean electricity matrix and the technological contribution of renewables. They are formulated within the Chilean Central Interconnected System and determine the evolution of technological diversity variables, costs, CO2 emissions and energy injection. The scenarios illustrate the need to strengthen the transmission system and the importance of improving and / or incorporating mechanisms to reduce dependence on fossil fuels and the maximization of renewable resources in Chile. Future work will establish the impact of intermittent renewable technologies on power system operation.

A number of authors have provided a useful evolutionary perspective on personality disorders, arguing that personality traits can be conceptualized in terms of evolutionary strategies. If we consider personality traits not as illnesses but as stable evolutionary strategies, the characteristic features of borderline personality disorder may respond to a behavioral pattern which, although deviating from the norm, would be in the service of survival of the species. Early environments involving factors such as childhood physical/sexual abuse may prove useful for explanation of personality traits based on gene-environment interaction, potentially providing a model for understanding borderline personality traits. We also review the question of whether personality traits exist in animals to also provide a translational perspective. We propose that certain traits in borderline personality disorder may derive from evolved mechanisms which in the short-term serve to help respond to adversity, but which when activated in an ongoing way prove maladaptive.