Systemic relations among the variables involved in occupational accidents of the nursing team in a psychiatric hospital.

BACKGROUND: The occupational activities carried out in hospital environments pose occupational risks to professionals. In psychiatric hospitals, due to the characteristics of the patients treated, professionals are also subjected to other risks, such as physical aggression. OBJECTIVE: This research aimed to identify the systemic context, highlighting the cause-and-effect relationships that culminate in occupational accidents that occurred with the nursing staff in a psychiatric hospital in Brazil. METHODS: The current study is an applied research and was divided into three stages. First, the collection of data related to the case study was made and accidents were analyzed and occupational hazards were identified. In the second stage, from the collected information, occupational safety indicators were defined. Lastly, in the third stage, the qualitative aspect of System Dynamics was applied to perform the systemic analysis and to identify how the different variables were related. RESULTS: The results showed that physical aggression was the main cause of accidents. Regarding safety indicators, while both the level of use of Personal Protective Equipment (PPE) by professionals and the high level of PPE protection were positive aspects, the level of training of professionals to use PPE was a negative aspect. The Causal Link Diagram (CLD) showed that the perception of risk influenced the level of use of PPE and those organizational measures influenced the accident rate. CONCLUSION: In conclusion, the systemic analysis of the system dynamics can optimize the diagnostic process of occupational accidents in psychiatric hospitals, and especially help to identify the cause and effect among the variables involved.

Stimuli in 3 Acts: A normative study on action-statements, action videos and object photos.

The study of action observation and imagery, separately and combined, is expanding in diverse research areas (e.g., sports psychology, neurosciences), making clear the need for action-related stimuli (i.e., action statements, videos, and pictures). Although several databases of object and action pictures are available, norms on action videos are scarce. In this study, we validated a set of 60 object-related everyday actions in three different formats: action-statements, and corresponding dynamic (action videos) and static (object photos) stimuli. In Study 1, ratings of imageability, image agreement, action familiarity, action frequency, and action valence were collected from 161 participants. In Study 2, a different sample of 115 participants rated object familiarity, object valence, and object-action prototypicality. Most actions were rated as easy to imagine, familiar, and neutral or positive in valence. However, there was variation in the frequency with which participants perform these actions on a daily basis. High agreement between participants' mental image and action videos was also found, showing that the videos depict a conventional way of performing the actions. Objects were considered familiar and positive in valence. High ratings on object-action prototypicality indicate that the actions correspond to prototypical actions for most objects. 3ActStimuli is a comprehensive set of stimuli that can be useful in several research areas, allowing the combined study of action observation and imagery.

Memory updating after retrieval: when new information is false or correct.

We conducted three experiments testing the malleability of memory in incorporating new information following retrieval. All experiments used associative lists typical of the DRM paradigm [Deese, J. (1959). On the prediction of occurrence of particular verbal intrusions in immediate recall. Journal of Experimental Psychology, 58(1), 17-22; Roediger, H. L., & McDermott, K. B. (1995). Creating false memories: Remembering words not presented in lists. Journal of Experimental Psychology: Learning, Memory, and Cognition, 21(4), 803-814]. This paradigm enabled the evaluation of the integration of false information and correct information with the original information. In Experiment 1, participants studied DRM lists, and in a later phase either retrieved or restudied the lists and were presented with never-presented critical lures. The results of Experiment 1 showed that compared to restudy, retrieval enhanced the integration of subsequent false information, as measured by later recall in a follow-up test. In Experiments 2 and 3, after initial study, participants retrieved or studied incorrect information and received corrective feedback. The results showed that retrieval led to more error correction than restudy, when feedback was presented immediately. In general, this research suggests retrieval facilitates incorporation of new, related information, regardless of whether it is false or correct.

Memory illusions and category malleability: False recognition for goal-derived reorganizations of common categories.

Four studies explore semantic memory intrusions for goal-derived subcategories (e.g., "sports good for backache") embedded in taxonomic categories (e.g., "sports"). Study 1 presented hybrid lists (composed of typical items from both representations: taxonomic categories and subcategories) together with names of subcategories, names of taxonomic categories, or with no names. Subcategory names produced levels of false recognitions for critical lures from subcategories comparable with critical lures from taxonomic categories. Study 2 presented lists of exemplars either from taxonomic categories or subcategories (between participants). Lists of subcategories paired with their names produced higher levels of false recognition for subcategories lures compared with taxonomic lures. Study 3 replicated this result and showed that even though distinctiveness of taxonomic lures in a subcategory context (i.e., subcategory list with a subcategory name) may facilitate rejection of these lures, subcategory lures were still more falsely recognized than were taxonomic lures when retrieval monitoring was hindered through speeded recognition. Study 4 replicated the results with lists in which production frequency was better controlled and with a larger sample allowing for increased power of the test. Although confirming the critical role of preexistent categorical structures in the generation of false memories, results show that false memories for goal-derived subcategories can occur with the same frequency as false memories stemming from better established taxonomic categories. Such results broaden the scope of occurrence of false memories to goal-derived semantic organizations, which are often closer to categorizations used in real-world environments.

The effect of unsuccessful retrieval on children's subsequent learning.

It is well known that successful retrieval enhances subsequent adults' learning by promoting long-term retention. Recent research has also found benefits from unsuccessful retrieval, but the evidence is not as clear-cut when the participants are children. In this study, we employed a methodology based on guessing-the weak associate paradigm-to test whether children can learn from generated errors or whether errors are harmful for learning. We tested second- and third-grade children in Experiment 1 and tested preschool and kindergarten children in Experiment 2. With slight differences in the method, in both experiments children heard the experimenter saying one word (cue) and were asked to guess an associate word (guess condition) or to listen to the correspondent target-associated word (study condition), followed by corrective feedback in both conditions. At the end of the guessing phase, the children undertook a cued-recall task in which they were presented with each cue and were asked to say the corrected target. Together, the results showed that older children-those in kindergarten and early elementary school-benefited from unsuccessful retrieval. Older children showed more correct responses and fewer errors in the guess condition. In contrast, preschoolers produced similar levels of correct and error responses in the two conditions. In conclusion, generating errors seems to be beneficial for future learning of children older than 5years.

Continuous Flow Homolytic Aromatic Substitution with Electrophilic Radicals: A Fast and Scalable Protocol for Trifluoromethylation.

We report an operationally simple and rapid continuous flow radical C-C bond formation under Minisci-type reaction conditions. The transformations are performed at or below room temperature employing hydrogen peroxide (H2 O2 ) and dimethylsulfoxide (DMSO) as reagents in the presence of an FeII catalyst. For electron-rich aromatic and heteroaromatic substrates, C-C bond formation proceeds satisfactorily with electrophilic radicals including . CF3 , . C4 F9 , . CH2 CN, and . CH2 CO2 Et. In contrast, electron-poor substrates exhibit minimal reactivity. Importantly, trifluoromethylations and nonafluororobutylations using CF3 I and C4 F9 I as reagents proceed exceedingly fast with high conversion for selected substrates in residence times of a few seconds. The attractive features of the present process are the low cost of the reagents and the extraordinarily high reaction rates. The direct application of the protocol to dihydroergotamine, a complex ergot alkaloid, yielded the corresponding trifluoromethyl ergoline derivative within 12 seconds in a continuous flow microreactor on a 0.6 kg scale. The trifluoromethyl derivative of dihydroergotamine is a promising therapeutic agent for the treatment of migraines.

Explaining the persistence of false memories: a proposal based on associative activation and thematic extraction.

This study aimed to analyse the effect of retention intervals on associative and thematic false memories. Two experiments, using two types of critical items that were either associatively or thematically related to studied material, were conducted. In both experiments, one group of participants performed a recognition test immediately after the presentation of lists, and another group performed the task one week later. In Experiment 1, the recognition test consisted of pairs of items with four response alternatives (both items had been presented, only the left item had been presented, only the right item had been presented or none of the items had been presented). Critical items were also manipulated so that they were either presented in or absent from the list. In Experiment 2, a standard recognition test that differed in the mode of presentation was used: self-paced or speeded response. Both experiments showed that associative critical items were more recognised than thematic critical items in the immediate condition. However, whereas associative critical items decayed after a one-week delay, thematic critical items were similarly recognised at both retention intervals. The findings of the present study suggest that each type of process - associative and thematic - behave differently over time.

"To-be-forgotten" statements become less true: Memory processes involved in selection and forgetting lead to truthfulness changes of ambiguous sentences.

What happens when people try to forget something? What are the consequences of instructing people to intentionally forget a sentence? Recent studies employing the item-method directed forgetting paradigm have shown that to-be-forgotten (TBF) items are, in a subsequent task, emotionally devaluated relative to to-be-remembered (TBR) items, an aftereffect of memory selection (Vivas, Marful, Panagiotidou & Bajo, 2016). As such, distractor devaluation by attentional selection generalizes to memory selection. In this study, we use the item-method directed forgetting paradigm to test the effects of memory selection and inhibition on truth judgments of ambiguous sentences. We expected the relative standing of an item in the task (i.e., whether it was instructed to be remembered or forgotten) to affect the truthfulness value of that item, making TBF items less valid/truthful than TBR items. As predicted, ambiguous sentences associated with a "Forget" cue were subsequently judged as less true than sentences associated with a "Remember" cue, suggesting that instructions to intentionally forget a statement can produce changes in the validity/truthfulness of that statement. To our knowledge, this is the first study to show an influence of memory processes involved in selection and forgetting on the perceived truthfulness of sentences.

Insight into and Computational Studies of the Selective Synthesis of 6H-Dibenzo[b,h]xanthenes.

Starting from 2-hydroxy-1,4-naphthoquinone (lawsone), we synthesized eight new 6H-dibenzo[b,h]xanthene derivatives selectively under solvent-free conditions. Spectroscopic investigations confirmed that only the isomer 6H-dibenzo[b,h]xanthene was obtained in all eight cases. Computational studies provide a rationalization for the selective appearance of these isomers having as an intermediate an addition product.

Epoxy-α-lapachone has in vitro and in vivo anti-leishmania (Leishmania) amazonensis effects and inhibits serine proteinase activity in this parasite.

Leishmania (Leishmania) amazonensis is a protozoan that causes infections with a broad spectrum of clinical manifestations. The currently available chemotherapeutic treatments present many problems, such as several adverse side effects and the development of resistant strains. Natural compounds have been investigated as potential antileishmanial agents, and the effects of epoxy-α-lapachone on L. (L.) amazonensis were analyzed in the present study. This compound was able to cause measurable effects on promastigote and amastigote forms of the parasite, affecting plasma membrane organization and leading to death after 3 h of exposure. This compound also had an effect in experimentally infected BALB/c mice, causing reductions in paw lesions 6 weeks after treatment with 0.44 mM epoxy-α-lapachone (mean lesion area, 24.9 ± 2.0 mm(2)), compared to untreated animals (mean lesion area, 30.8 ± 2.6 mm(2)) or animals treated with Glucantime (mean lesion area, 28.3 ± 1.5 mm(2)). In addition, the effects of this compound on the serine proteinase activities of the parasite were evaluated. Serine proteinase-enriched fractions were extracted from both promastigotes and amastigotes and were shown to act on specific serine proteinase substrates and to be sensitive to classic serine proteinase inhibitors (phenylmethylsulfonyl fluoride, aprotinin, and antipain). These fractions were also affected by epoxy-α-lapachone. Furthermore, in silico simulations indicated that epoxy-α-lapachone can bind to oligopeptidase B (OPB) of L. (L.) amazonensis, a serine proteinase, in a manner similar to that of antipain, interacting with an S1 binding site. This evidence suggests that OPB may be a potential target for epoxy-α-lapachone and, as such, may be related to the compound's effects on the parasite.

Adapting to test structure: letting testing teach what to learn.

We propose that we encode and store information as a function of the particular ways we have used similar information in the past. More specifically, we contend that the experience of retrieval can serve as a powerful cue to the most effective ways to encode similar information in comparable future learning episodes. To explore these ideas, we did two studies in which all participants went through study-test cycles of single category lists while we manipulated the nature of the recognition tests. The recognition tests either included only same-category lures or only different-category lures. The experience of repeated testing leads participants to avoid conceptual-based strategies but only when conceptual knowledge was poorly diagnostic for recognition (i.e., in the same-category lures condition). In a second study with a similar manipulation, we showed that repeated testing with lures from the same category as study items improved performance in a final recall surprise test compared to conditions in which different-category lures were used. Such a difference is akin to the one obtained when encoding instructions focus on distinctive item features compared to cases in which the focus is on relational processing. We suggest that testing requirements lead to adaptive changes at encoding.

Influence of Curing Units and Indirect Restorative Materials on the Hardness of Two Dual-curing Resin Cements Evaluated by the Nanoindentation Test.

PURPOSE: To evaluate the hardness of a dual-curing self-adhesive resin cement (RelyX U200) and a conventional dual-curing resin cement (RelyX ARC) cured with different light curing units of different wavelengths (Elipar Freelight 2 LED [430 to 480 nm, conventional], Bluephase LED [380 to 515 nm, polywave], AccuCure 3000 Laser [488 nm]) by means of the nanoindentation test. MATERIALS AND METHODS: Bovine incisors were cleaned and then sectioned at the cementoenamel junction to remove the crown. After embedding in acrylic, dentin surfaces of the specimens were exposed and ground flat to standardize the surfaces. To simulate clinically placing indirect restorations, ceramic (IPS e.maxPress/Ivoclar Vivadent) or indirect composite resin (SR Adoro/Ivoclar Vivadent) slabs were cemented on dentin surfaces. The specimens were sectioned longitudinally at low speed under constant irrigation and then polished. In the positive control group, the cement was light cured without the interposition of indirect restorative material; in the negative control group, after the indirect restorative material was cemented, no light curing was performed, allowing only chemical polymerization of the cement. All specimens were stored in distilled water at 37°C for 7 days. Nanoindentadion hardness of the cement layer was measured under a 100-mN load. Data were statistically analyzed using ANOVA and Tukey's test (p < 0.05). RESULTS: Although the self-adhesive cement is technically simple, conventional cement showed the best polymerization performance. The polywave LED technology did not differ significantly from other light-curing units. The hardness of the resin cements evaluated was negatively influenced by the interposition of an indirect restorative material; only the LEDs were able to maintain the same degree of cement polymerization when an indirect restorative material was used. CONCLUSION: The photoactivation step is required during the cementation of indirect restorations to ensure adequate polymerization of dual-curing resin cements.

Evidences for leishmanicidal activity of the naphthoquinone derivative epoxy-α-lapachone.

In this work, we analyze the leishmanicidal effects of epoxy-α-lapachone on Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis. Promasigotes and amastigotes (inhabiting human macrophages) from both species were assayed to verify the compound's activity over the distinct morphological stages. The incubation with epoxy-α-lapachone led to a significant decrease in the numbers of promastigotes from both species in the cultures, in a dose-and time-dependent fashion. The survival of amastigotes inhabiting human macrophages was also drastically affected by the compound, as shown by the variations in the endocytic index. Our results indicate that the epoxy-α-lapachone has an antiparasitic effect over Leishmania in both morphological stages and may potentially affect a range of species in two distinct subgenera of this parasite.

Both associative activation and thematic extraction count, but thematic false memories are more easily rejected.

The main aim of this study was to analyse the roles played by associative activation and thematic extraction in the explanation of false memories using the Deese, Roediger, McDermott (DRM) paradigm. Associative lists with two different types of critical items (CIs) were used: one, the associative CI, corresponded to the word most strongly primed by the associates in the list and another, the thematic CI, was the word that best described the theme of the list. Following three different types of encoding instructions (standard, warning or strategic), false recognition for these two types of CIs was analysed in either self-paced or speeded response recognition tests. The results showed considerable levels of false memories for both types of CIs. Even without the quality of being "good themes", associative CIs produced high levels of false recognition, which suggests that associative activation plays a prominent role in false memory formation. More interestingly, thematic CIs were more prone to be edited out, reinforcing the argument that thematic identifiability has a major role in the rejection of false memories.

Blood shizonticidal activities of phenazines and naphthoquinoidal compounds against Plasmodium falciparum in vitro and in mice malaria studies.

Due to the recent advances of atovaquone, a naphthoquinone, through clinical trials as treatment for malarial infection, 19 quinone derivatives with previously reported structures were also evaluated for blood schizonticide activity against the malaria parasite Plasmodium falciparum. These compounds include 2-hydroxy-3-methylamino naphthoquinones (2-9), lapachol (10), nor-lapachol (11), iso-lapachol (12), phthiocol (13) and phenazines (12-20). Their cytotoxicities were also evaluated against human hepatoma and normal monkey kidney cell lines. Compounds 2 and 5 showed the highest activity against P. falciparum chloroquine-resistant blood-stage parasites (clone W2), indicated by their low inhibitory concentration for 50% (IC50) of parasite growth. The therapeutic potential of the active compounds was evaluated according to the selectivity index, which is a ratio of the cytotoxicity minimum lethal dose which eliminates 50% of cells and the in vitro IC50. Naphthoquinones 2 and 5, with activities similar to the reference antimalarial chloroquine, were also active against malaria in mice and suppressed parasitaemia by more than 60% in contrast to compound 11 which was inactive. Based on their in vitro and in vivo activities, compounds 2 and 5 are considered promising molecules for antimalarial treatment and warrant further study.

Anti-titin antibodies in a cohort of myasthenia gravis patients.

Background: Anti-titin antibodies have been previously associated with thymoma-associated myasthenia gravis (MG) and a more clinically severe form of MG. While currently only serving as a disease biomarker, its possible utility as an indicator of underlying thymus malignancy may be of value in clinical practice. Methods: Data was retrospectively collected and analyzed from 2013 to 2022 using an institutional record of MG patients. Anti-titin antibodies were assessed using Line Blot immunoassay. Results: From 130 MG cases, 32 (24.6%) were anti-titin positive. Anti-titin positive cases were associated with older age of disease onset [median (IQR): 63.0 (44.3-70.8) vs. 35.5 (24.8-60.8) years] (P<0.01). Thymectomy was performed in 46 (35.4%) MG patients, 12 of which anti-titin positive (26.1%). Thymectomy samples from anti-titin positive patients comprised 10 (83.3%) cases of thymoma and 2 (16.7%) cases of thymus hyperplasia. There was a tendency towards anti-titin positive patients having more thymoma while anti-titin negative displayed more hyperplasia (P<0.01). Anti-titin positivity correlated with thymoma in patients with age of onset bellow 50 years (P=0.028). Anti-titin positivity was significantly associated with generalized MG in the late-onset group (P=0.005). Conclusions: The presence of anti-titin antibodies appears to correlate with underlying thymoma in early-onset MG cases and with generalized MG in late-onset cases. Prospective studies are needed to further study this association.

Blood and CSF anti-neuronal antibodies testing in psychotic syndromes: a retrospective analysis from a tertiary psychiatric hospital.

A Consensus of Psychoimmunology Experts (Pollak et al., 2019) established a set of red flags and proposed diagnostic criteria for psychosis of autoimmune origin (AIP). Previous studies on AIP are limited by the scarcity of CSF analysis, preventing the valorization of blood anti-neuronal antibodies (Ab). The aims of this study are to determine the relative frequency and characterize AIP in a cohort of psychotic patients that underwent CSF workup. This work is a retrospective study in a tertiary psychiatric hospital. Clinical and paraclinical data were collected from medical records, and patients were classified according to Pollak et al. (2019) criteria. From 68 patients, ten (14.7%) had positive anti-neuronal antibodies (Ab): n = 5 in CSF and blood (n = 4 anti-NMDAr, n = 1 -GAD65), and n = 5 in blood only (n = 1 anti-GABAb, n = 1 -GAD65, n = 1 -SOX1, n = 1 -NMDAr, n = 1 -zic4). After 5- (2-10)-year follow-up, n = 6/68 (8.8%) had AIP diagnosis in context of autoimmune encephalitis (AE), and the remaining (n = 4/10, blood-only Ab) alternative diagnoses (n = 2 dementia, n = 1 schizophrenia, n = 1 intellectual disability). Ten of the 13 patients that fulfilled criteria for possible AIP were mimics, and only three AE had criteria for probable AIP. All AIP developed neurological manifestations (mostly cognitive dysfunction); EEG was usually abnormal (66.7%), and all had normal MRI. We found statistically significant associations between AIP/AE and systemic autoimmune disease, presentation with seizures and EEG abnormalities. All AE developed neurological symptoms alongside psychosis. Ab positivity occurred predominantly in AE but also in other neuropsychiatric disorders. Clinical suspicion based on the knowledge of the described presentations of established Ab is crucial in the psychotic patient approach.

Comparison between a bulk-fill resin-based composite and three luting materials on the cementation of fiberglass-reinforced posts.

Objectives: This study verified the possibility of cementing fiberglass-reinforced posts using a flowable bulk-fill composite (BF), comparing its push-out bond strength and microhardness with these properties of 3 luting materials. Materials and Methods: Sixty endodontically treated bovine roots were used. Posts were cemented using conventional dual-cured cement (CC); self-adhesive cement (SA); dual-cured composite (RC); and BF. Push-out bond strength (n = 10) and microhardness (n = 5) tests were performed after 1 week and 4 months of storage. Two-way repeated measures analysis of variance (ANOVA), 1-way ANOVA, t-test, and Tukey post-hoc tests were applied for the push-out bond strength and microhardness results; and Pearson correlation test was applied to verify the correlation between push-out bond strength and microhardness results (α = 0.05). Results: BF presented higher push-out bond strength than CC and SA in the cervical third before aging (p < 0.01). No differences were found between push-out bond strength before and after aging for all the luting materials (p = 0.84). Regarding hardness, only SA presented higher values measured before than after aging (p < 0.01). RC and BF did not present 80% of the maximum hardness at the apical regions. A strong positive correlation was found between the luting materials' push-out bond strength and microhardness (p < 0.01, R2 = 0.7912). Conclusions: The BF presented comparable or higher push-out bond strength and microhardness than the luting materials, which indicates that it could be used for cementing resin posts in situations where adequate light curing is possible.

Distinct phenotypes in a cohort of anti-CASPR2 associated neurological syndromes.

INTRODUCTION: Anti-contactin-associated protein-like 2 (CASPR2) is classically associated with limbic encephalitis (LE), Morvan syndrome and peripheral nerve hyperexcitability (PNH). Additional clinical features have been previously recognized. OBJECTIVE: To describe a cohort of patients with anti-CASPR2-associated neurological syndromes from a tertiary referral centre. METHODS: Retrospective analysis of patients with positive serum anti-CASPR2 antibodies in the period between 2014 and 2021. RESULTS: Nineteen patients were identified, 11 (57.9%) male, with a median age at symptom onset of 49.0 (31.3-63.0) years and a median time to diagnosis of 1.0 (0.0-1.8) years. The most common clinical syndromes were LE (7 cases, 36.8%), Morvan syndrome (4, 21.1%) and PNH (2, 10.5%). Six patients presented with atypical phenotypes (31.6%), comprising dysautonomia (orthostatic hypotension and Adie's Pupil), motor tics/stereotypies, obsessive-compulsive disorder, and brainstem involvement. The most common presenting symptoms were seizures (31.6%), PNH (21.1%) and cognitive dysfunction (15.8%). One LE patient had a disease duration of 2,5 years and was initially diagnosed with dementia. CSF was normal in most cases. Brain MRI showed temporal lobe hyperintensities in 4 LE cases (57.1%). All PNH cases had myokymic discharges of fasciculations in the electromyography. Two patients had associated thymoma and 1 had lung adenocarcinoma. Eight patients (42.1%) received treatment during the acute phase and 26.3% maintenance treatment. Approximately half of the treated cases improved or stabilised, with 4 (21.1%) deaths in the whole cohort. CONCLUSION: Anti-CASPR2-associated neurological disorders may present with isolated atypical phenotypes, a slowly progressive clinical course, and with normal CSF or imaging findings.