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Introduction: Although deficits in neurocognitive functioning and emotional recognition impact treatment outcomes in schizophrenia since the development of the first psychotic episode (FEP), there is still a lack of longer follow-up studies showing the course of these deficits over time. Objectives: Our objective is to investigate the changes of cognitive functioning over years in a cohort of patients, since their FEP. Methods: This study is developed as a follow-up of the project Biomarkers in schizophrenia- integration of complementary methods in longitudinal follow-up of FEP, that was conducted in several Croatian psychiatric clinics during the period from 2014 to 2019. A cohort of patients with FEP took part in the project with psychopathology, neurocognitive functioning and emotional recognition assessment at two time points- at baseline, during the subacute phase of a psychotic episode, and after 18 months of follow-up. In this study, patients with FEP who completed the baseline assessment of the project (n=159), will be contacted and included in the follow- up. Follow-up assessment will consist of sociodemographic data including information of their treatment so far, battery of neurocognitive tests (Rey Auditory Verbal Learning Test, Rey–Osterrieth complex figure Test, Wechsler paired memory, trail making test a & b, Digit symbol, Digit span, Semantic & Phonetic Fluency, Stroop 1, 2, 3 and Block design test), emotional recognition test (Penn Emotion Recognition Task) and several scales assessing psychopathology (Positive and Negative Syndrome Scale, Self-evaluation of Negative Symptoms, Scale for the Assessment of Negative Symptoms), functioning (Global Assessment of Functioning, WHO Disability Assessment Scale 2.0), quality of life and recovery. The study is funded by the University of Zagreb programmes (Project No. 10106-23-2394). Results: We plan to analyze the differences between the three time points (baseline, 18 months, 5 years), taking in account possible correlations with psychopathology, functioning, quality of life and different treatment options. Conclusions: Identifying specific deficits can help in providing more effective treatment plan including various interventions that can improve treatment outcomes in schizophrenia. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]

The effects of natural gas prices on the households and economy of Moldova are presented. The methods to reduce these prices are also discussed.

Introduction: Different studies have tried to identify possible genetic biomarkers of treatment outcomes in schizophrenia. Methylenetetrahydrofolate reductase (MTHFR) gene was previously associated with schizophrenia, metabolic risk and side-effects as well as with neurocognitive functions and treatment response in schizophrenia. Objectives: The objective of this study was to investigate the association of MHTFR 1298 polymorphisms with treatment response measured by changes in facial emotional recognition (FER) and psychopathology in patients with first-episode psychosis (FEP). Methods: We conducted a prospective study including 159 patients with FEP recruited from two Croatian psychiatric hospitals. We performed assessment two weeks upon admittance to hospital and after 18 months of follow-up. We assessed psychopathology with the Positive and Negative Syndrome Scale (PANSS) and FER with Penn Emotional Recognition Test. Genotyping of blood samples was preformed according to usual practice. Statistical analysis included ANOVA. Results: Our results did not show statistically significant association of MHTFR genotypes and correct recognition of presented emotions. However, we found significant associations with initial general (F=3.36, p=0.04) and overall PANSS scores (F=3.14, p=0.05) as well as with changes of negative (F=-1.562, p=0.012), general (F=-2.686, p=0.005) and overall PANSS scores (F=-5.417, p=0.006). In all cases, the carriers of the CC alleles had better scores. Conclusions: While we did not find association of specific MHTFR genotypes and FER, they showed strong association with both initial and changes of psychopathology scores after 18 months of follow-up which opens the possibility of their role as potential marker for treatment outcomes. [ABSTRACT FROM AUTHOR]

Introduction As programs for prodromal states of psychosis emerge, part of our focus naturally shifts from first psychotic episodes and early course psychotic disorders. Clinical practice will, however, always confront us primarily with psychosis after its onset, and ample evidence still confirms specificity and importance of early stages of psychosis. Aim Authors aim to present experience and data from Zagreb First Psychosis Unit, only such unit in Croatia and one of rare units of that type in the region, discussing wider role of stationary units in integrative care of first and early psychoses. Methods Ten-year data from the unit is analyzed. Demographics and illness specificities are presented, along with duration of hospitalization, involuntary treatment rates, diagnoses, rehospitalization rates, subsequent treatment and other variables. Examples of organic causes and specific clinical presentations are presented in the context of necessary first psychotic episodes differential diagnostic process. Results In the 10-year period Zagreb First Psychosis Unit had over 2000 hospitalizations, 61% of which were first psychotic episodes and the rest cases in early stages of psychosis; 6.8% of first episode cases required involuntary hospitalization; 71.4% of first psychotic episode cases were not re-hospitalized following the diagnostic process and treatment. Conclusion First psychotic episodes present especially vulnerable periods that might determine following stages of illness and functioning. It is vital to consider role of specialized first psychosis units that initiate structured specific diagnostic, evaluation, and treatment protocols for first episode patients requiring hospitalization, and present a bridge towards equally specialized and congruent outpatient programs. [ABSTRACT FROM AUTHOR]

Creative music therapy (CMT) has been shown to promote the development of brain function and structure in preterm infants. We aimed to investigate the effect of CMT on cerebral oxygenation and perfusion to examine how the brain reacts to CMT. Absolute levels of cerebrovascular oxygen saturation (StO 2 ) were measured in clinically stable preterm-born neonates (n = 20, gestational age: ≥30 weeks and < 37 weeks) using two near-infrared spectroscopy (NIRS)-based tissue oximeters over the right prefrontal cortex and left auditory cortex. We applied the systemic physiology augmented functional NIRS approach. Each CMT session lasted 55 min and involved 9 intervals, including two 10-minute intervals during which the music therapist hummed and held the neonate. We found that CMT-induced changes in cerebrovascular StO 2 , perfusion and systemic physiology (i) could be classified into two groups (group 1: increase in StO 2 during the first singing interval, group 2: decrease in StO 2 ), (ii) differed in female neonates compared to male neonates, and (iii) correlated with individual blood haematocrit levels. Our exploratory study (i) demonstrates the impact of CMT on the neonate's physiology and (ii) highlights the need to analyze functional NIRS measurements in neonates separately according to their response pattern to avoid erroneous conclusions, e.g. when only the group average of the signal change is determined., Competing Interests: Declarations Competing interests F.H., T.K., T.R., T.R., B.C.H.V., E.O., H.Z, H.U.B., U.W. and D.B. declare no conflict of interest. D.O. and S.K. are affiliated with and MW is co-founder and president of the board of OxyPrem AG (a University of Zurich spin-off that produces an improved version of the near-infrared spectroscopy oximeters employed in the study). S.K., D.O., and M.W. had no influence on how the data were analyzed by F.S. F. S. provided scientific consulting for companies producing fNIRS devices (NIRx GmbH, Berlin, Germany; Kernel, Culver City, Los Angeles, USA)., (© 2024. The Author(s).)

To understand the complex nature of heterogeneous psychiatric disorders, scientists and clinicians are required to employ a wide range of clinical, endophenotypic, neuroimaging, genomic, and environmental data to understand the biological mechanisms of psychiatric illness before this knowledge is applied into clinical setting. Machine learning (ML) is an automated process that can detect patterns from large multidimensional datasets and can supersede conventional statistical methods as it can detect both linear and non-linear relationships. Due to this advantage, ML has potential to enhance our understanding, improve diagnosis, prognosis and treatment of psychiatric disorders. The current review provides an in-depth examination of, and offers practical guidance for, the challenges encountered in the application of ML models in psychiatric research and clinical practice. These challenges include the curse of dimensionality, data quality, the 'black box' problem, hyperparameter tuning, external validation, class imbalance, and data representativeness. These challenges are particularly critical in the context of psychiatry as it is expected that researchers will encounter them during the stages of ML model development and deployment. We detail practical solutions and best practices to effectively mitigate the outlined challenges. These recommendations have the potential to improve reliability and interpretability of ML models in psychiatry., Competing Interests: Declaration of competing interest All authors declare that they have no conflicts of interest., (Copyright © 2024. Published by Elsevier B.V.)

The COVID-19 pandemic negatively influenced individuals' physical activity levels (PALs) and particularly the PAL of the elderly. However, few studies have examined the correlates of PALs in this population during the pandemic. This study aimed to evaluate the residence-specific correlates of PALs in elderly people from Croatia and Bosnia and Herzegovina during the COVID-19 pandemic. The participants were 211 persons older than 65 years (101 females), of whom 111 were community-dwelling residents, and 110 were nursing home residents (71.11 ± 3.11 and 72.22 ± 4.01 years of age, respectively; t -test = 0.91, p < 0.05). The variables included health status, residential status sociodemographic factors, anthropometrics (body mass, height, and body mass index), and PAL. PAL was evaluated using a translated version of the Physical Activity Scale for the Elderly (PASE), and was validated in this study. PASE showed good test-retest reliability (51% of the common variance) and validity (57% of the common variance, with the step count measured using pedometers). Apart from participants' health status and age, PAL was positively correlated with (i) community-dwelling residence (OR = 1.93, 95% CI: 1.60-2.23), and (ii) a lower BMI (OR = 0.85, 95% CI = 0.71-0.98). The pre-pandemic physical activity was positively correlated with the PAL of the nursing home residents (OR = 1.2, 95% CI: 1.02-1.45). A higher education level was positively correlated with the PAL of community-dwelling residents (OR = 1.31, 95% CI: 1.04-1.66). This study evidenced the residence-specific correlates of PALs, and enabled the identification of specific groups that are at risk of having low PALs during the pandemic. Future studies examining this problem during a non-pandemic period are warranted.

Background and objectives: The risk of low energy availability is related to various health problems in sports. This cross-sectional study aimed to identify a possible association between various dance factors, anthropometrics/body build, and energy availability with injury occurrence in contemporary dancers. Materials and Methods: The participants were 50 female competitive dancers (19.8 ± 4.1 years of age). The independent variables included age, dance factors (amount of training and competitions per week-exposure time, experience in dance), anthropometrics/body composition (body height, mass, BMI, body fat percentage (BF%), and fat-free mass (FFM)), and energy availability score (EAS; evaluated by accelerometer-based measurement of energy expenditure and Dance Energy Availability Questionnaires). The dependent variables were the occurrence of (i) soft-tissue injuries and (ii) bone injuries. The measurements were obtained by experienced technicians during the pre-competition period for each specific dance discipline. Univariate and multivariate logistic regressions were calculated to identify the associations between independent variables and injury prevalence. Results: The results showed that EAS (OR = 0.81, 95% CI:0.65-0.91), age (OR = 1.65, 95% CI: 1.1-2.46), higher BF% (OR = 1.23, 95% CI: 1.04-1.46) and BMI (OR = 1.61, 95% CI: 1.05-2.47) were correlated with soft-tissue injuries. Dancers who suffered from bone injuries reported higher exposure time (OR = 1.21, 95% CI: 1.05-1.37) and had lower values of FFM (OR = 0.73, 95% CI: 0.56-0.98). Multivariate regression analyses evidenced a higher likelihood of soft-tissue injuries in older dancers (OR = 1.75, 95% CI: 1.21-2.95) and the ones who had lower EAS (OR = 0.84, 95% CI: 0.71-0.95) while the exposure time was associated with a higher likelihood of bone injuries (OR = 1.21, 95% CI: 1.05-1.39). Conclusions: In order to decrease the injury prevalence among dancers, special attention should be paid to maintaining adequate nutrition that will provide optimal available energy for the demands of training and performing. Additionally, the control of training volume should be considered in order to reduce traumatic bone injuries.

Scholastic factors (academic achievement) are hypothesized to be important determinants of health-related behaviors in adolescents, but there is a lack of knowledge on their influence on physical activity levels (PAL), especially considering the COVID-19 pandemic and the imposed lockdown. This study aimed to investigate the associations between scholastic factors and PAL before and during the pandemic lockdown. The participants were adolescents form Bosnia and Herzegovina ( n = 525, 46% females), who were observed prospectively at the baseline (before the pandemic lockdown) and during the lockdown in 2020 (follow-up). The scholastic factors (grade point average, behavioral grade, school absences, unexcused absences) were evidenced at the baseline (predictors). The outcome (PAL) was evaluated using the Physical Activity Questionnaire for Adolescents at the baseline and the follow-up. Gender, age, parental/familial conflict, and sport participation were observed as confounders. No significant influence of the predictors on PAL were evidenced at the baseline or at the follow-up. The scholastic variables were significantly associated with the changes of PAL which occurred due to pandemic lockdown, with a lower risk for negative changes in PAL among adolescents who were better in school (OR = 0.56, 95%CI: 0.34-0.81, and OR = 0.66, 95%CI: 0.34-0.97, for the grade point average and behavioral grade, respectively). Students who do well in school are probably more aware of the health benefits of proper PAL, and therefore are devoted to the maintenance of their PAL even during the home-confinement of lockdown. Public health authorities should focus more on helping adolescents to understand the importance and benefits of proper PAL throughout the school system.