New Origins of Yeast, Plant and Bacterial-Derived Extracellular Vesicles to Expand and Advance Compound Delivery.

Extracellular vesicles (EVs) constitute a sophisticated molecular exchange mechanism highly regarded for their potential as a next-generation platform for compound delivery. However, identifying sustainable and biologically safe sources of EVs remains a challenge. This work explores the emergence of novel sources of plant and bacterial-based EVs, such as those obtained from food industry by-products, known as BP-EVs, and their potential to be used as safer and biocompatible nanocarriers, addressing some of the current challenges of the field. These novel sources exhibit remarkable oral bioavailability and biodistribution, with minimal cytotoxicity and a selective targeting capacity toward the central nervous system, liver, and skeletal tissues. Additionally, we review the ease of editing these recently uncovered nanocarrier-oriented vesicles using common EV editing methods, examining the cargo-loading processes applicable to these sources, which involve both passive and active functionalization methods. While the primary focus of these novel sources of endogenous EVs is on molecule delivery to the central nervous system and skeletal tissue based on their systemic target preference, their use, as reviewed here, extends beyond these key applications within the biotechnological and biomedical fields.

Empathy and big five personality model in medical students and its relationship to gender and specialty preference: a cross-sectional study.

BACKGROUND: Given the influence that personality can have on empathy, this study explores the relationship between empathy and personality, using three different measures of empathy, and taking into account gender and specialty preference. METHODS: Cross-sectional study. One hundred and ten medical students completed the Jefferson Scale of Physician Empathy, the Interpersonal Reactivity Index, the Empathy Quotient, and the NEO-FFI Big Five personality model. Multivariable linear regression was performed to assess the association between personality traits and empathy. RESULTS: Empathy scales showed weak and moderate correlation with personality. The strongest correlations were observed between IRI-Fantasy and Openness, and between IRI-Personal Distress and Neuroticism. Gender and specialty preference can modify this relationship. The extreme groups of Empathy Quotient had significant differences in most personality traits. CONCLUSIONS: This study confirmed that empathy is related to personality. Using three empathy scales allows personalizing the evaluation of different empathy models and its relation with personality. These results can help to design programs to study if some personalized intervention strategies could improve the empathy in medical students.

Short- and Long-Term Outcomes of an Adventure Therapy Programme on Borderline Personality Disorder: A Pragmatic Controlled Clinical Trial.

Adventure Therapy (AT) is a therapeutic intervention utilizing the natural environment and adventure activities as tools for psychotherapeutic interventions. It has been demonstrated to be appropriate for the intervention of patients with borderline personality disorder (BPD). This study aims to evaluate the response to AT treatment compared with the response to treatment as usual (TAU), based on cognitive behavioural therapy, in the short and long term, assessing clinical, psychosocial, and functional outcomes; quality of life; and physical health levels. This study extends the sample of and is a follow-up to a pilot study published in 2021, with a sample of 30 patients in the AT group and 10 in the control group. It does not allow us to affirm that AT provides better outcomes than TAU, as the positive effects observed immediately after therapy seem to be attenuated in the long term. Therefore, the effectiveness of long-term psychotherapy did not show differences between AT and TAU therapies in the treatment of BPD patients. However, the effects of intangibles observed during therapy by professionals and patients were not reflected in the measurements collected. Therefore, we believe it is necessary to increase the programme duration, complement treatment with a specific physical health programme, assess results with more specific instruments, and/or move towards a qualitative methodology to measure perceived changes in clinical improvement. New studies are needed to evaluate the results of the proposed changes.

Next-Generation Proteomics of Brain Extracellular Vesicles in Schizophrenia Provide New Clues on the Altered Molecular Connectome.

Extracellular vesicles (EVs) are tiny membranous structures that mediate intercellular communication. The role(s) of these vesicles have been widely investigated in the context of neurological diseases; however, their potential implications in the neuropathology subjacent to human psychiatric disorders remain mostly unknown. Here, by using next-generation discovery-driven proteomics, we investigate the potential role(s) of brain EVs (bEVs) in schizophrenia (SZ) by analyzing these vesicles from the three post-mortem anatomical brain regions: the prefrontal cortex (PFC), hippocampus (HC), and caudate (CAU). The results obtained indicate that bEVs from SZ-affected brains contain region-specific proteins that are associated with abnormal GABAergic and glutamatergic transmission. Similarly, these vesicles from the analyzed regions were implicated in synaptic decay, abnormal brain immunity, neuron structural imbalances, and impaired cell homeostasis. Our findings also provide evidence, for the first time, that networks of molecular exchange (involving the PFC, HC, and CAU) are potentially active and mediated by EVs in non-diseased brains. Additionally, these bEV-mediated networks seem to have become partially reversed and largely disrupted in the brains of subjects affected by SZ. Taken as a whole, these results open the door to the uncovering of new biological markers and therapeutic targets, based on the compositions of bEVs, for the benefit of patients affected by SZ and related psychotic disorders.

Lithium management of periodic mood fluctuations in behavioural frontotemporal dementia: a case report.

The behavioural variant of Frontotemporal Dementia (bvFTD) is a neurodegenerative condition characterized by behavioural and cognitive symptoms. Mood disturbances, including manic-like episodes, can occur in bvFTD, posing diagnostic and therapeutic challenges. This case report presents a 62-year-old male with bvFTD exhibiting weekly mood fluctuations alternating between manic and depressive-like states. While initial treatment with quetiapine and trazodone showed partial improvement, the periodicity of mood fluctuations persisted. Subsequently, lithium was introduced, resulting in a notable reduction in symptom severity for both manic and depressive episodes. This report highlights the potential use of lithium as a mood stabilizer in bvFTD patients with periodic mood fluctuations, refractory to standard treatments. Further research is needed to elucidate the mechanisms underlying lithium's efficacy in bvFTD and to establish treatment guidelines.

Mental Health Day Hospitals and Lockdown Due to COVID-19 in Spain.

Introduction: The COVID-19 pandemic has forced changes in patient care in Mental Health Day Hospitals (MHDHs). Objectives: To study the interventions performed in MHDHs during the pandemic in comparison with those performed in other facilities and to analyze the new hospital admissions in both groups. Method: A retrospective multicenter cohort study comparing the interventions received by a group of 161 patients admitted in MHDHs during the lockdown period in Spain with the interventions of another group of 109 patients who were treated at other facilities during lockdown. Results: MHDHs reduced their face-to-face interventions during lockdown just as much as other facilities but implemented telematic intervention methods to a greater extent. Patients attached to MHDHs during lockdown were admitted significantly less and presented fewer urgent consultations in the following 6 months. Conclusion: The use of telepsychiatry made it feasible to adapt MHDHs to periods of lockdown, being useful to improve the continuity of care during the pandemic. In addition, it was possible to maintain a reduction in hospital admissions in patients treated at MHDHs.

A pilot study of the efficacy of an adventure therapy programme on borderline personality disorder: A pragmatic controlled clinical trial.

Adventure therapy (AT) is a therapeutic intervention that has demonstrated effectiveness in different populations, but there are no studies on this therapy in borderline personality disorder (BPD). The objective of this study was to assess the response to AT in comparison with treatment as usual (based on cognitive-behavioural therapy) in patients with BPD. Regarding the comparison of the differences post-therapy-pre-therapy between both groups, some metabolic variables improved more in the AT group, with medium-large effect sizes. Almost all psychometric variables evolved better in the AT group, with negligible effects. AT could be considered in BPD treatment because it results in healthier lifestyle habits and increases functionality and quality of life in patients who are prone to self-destruction. © 2021 John Wiley & Sons, Ltd.

Corrigendum: Method for Improving EEG Based Emotion Recognition by Combining It with Synchronized Biometric and Eye Tracking Technologies in a Non-invasive and Low Cost Way.

[This corrects the article on p. 85 in vol. 10, PMID: 27594831.].

Brain Structural Correlates of Emotion Recognition in Psychopaths.

Individuals with psychopathy present deficits in the recognition of facial emotional expressions. However, the nature and extent of these alterations are not fully understood. Furthermore, available data on the functional neural correlates of emotional face recognition deficits in adult psychopaths have provided mixed results. In this context, emotional face morphing tasks may be suitable for clarifying mild and emotion-specific impairments in psychopaths. Likewise, studies exploring corresponding anatomical correlates may be useful for disentangling available neurofunctional evidence based on the alleged neurodevelopmental roots of psychopathic traits. We used Voxel-Based Morphometry and a morphed emotional face expression recognition task to evaluate the relationship between regional gray matter (GM) volumes and facial emotion recognition deficits in male psychopaths. In comparison to male healthy controls, psychopaths showed deficits in the recognition of sad, happy and fear emotional expressions. In subsequent brain imaging analyses psychopaths with better recognition of facial emotional expressions showed higher volume in the prefrontal cortex (orbitofrontal, inferior frontal and dorsomedial prefrontal cortices), somatosensory cortex, anterior insula, cingulate cortex and the posterior lobe of the cerebellum. Amygdala and temporal lobe volumes contributed to better emotional face recognition in controls only. These findings provide evidence suggesting that variability in brain morphometry plays a role in accounting for psychopaths' impaired ability to recognize emotional face expressions, and may have implications for comprehensively characterizing the empathy and social cognition dysfunctions typically observed in this population of subjects.

Modulatory effects of psychopathy on Wisconsin Card Sorting Test performance in male offenders with Antisocial Personality Disorder.

Neuropsychological deficits in executive functions (EF) have been linked to antisocial behavior and considered to be cardinal to the onset and persistence of severe antisocial and aggressive behavior. However, when psychopathy is present, prior evidence suggests that the dorsolateral prefrontal cortex is unaffected leading to intact EF. Ninety-one male offenders with Antisocial Personality Disorder (ASPD) and 24 controls completed the Wisconsin Card Sorting Test (WCST). ASPD individuals were grouped in three categories according to Psychopathy Checklist-Revised (PCL-R) scores (low, medium and high). We hypothesized that ASPD offenders with high PCL-R scores will not differ from healthy controls in EF and will show better EF performance in comparison with subjects with low PCL-R scores. Results showed that ASPD offenders with low PCL-R scores committed more perseverative errors and responses than controls and offenders with high PCL-R scores, which did not differ from healthy controls. Moreover, scores on Factor 1 and the interpersonal facet of the PCL-R were predictors of better WCST performance. Our results suggest a modulatory role of psychopathy in the cognitive performance of ASPD offenders, and provide further evidence supporting that offenders with ASPD and psychopathy are characterized by a cognitive profile different from those with ASPD without psychopathy.

Shadowing patients: experimentar empatía en estudiantes de Medicina / Shadowing patients: Experiencing empathy in medical students

INTRODUCCIÓN: Shadowing patients es una de las propuestas educativas para mantener y experimentar empatía en estudiantes de Medicina. Se trata de observar, sin intervenir, a un paciente durante una visita médica. El objetivo de este estudio piloto es analizar las emociones percibidas y observadas en los pacientes durante la experiencia de shadowing patients y su relación con la empatía médica. MÉTODOS: Veintitrés estudiantes de quinto de Medicina (69,6% mujeres, edad 22,6 ± 1,1 años) participaron en el taller teórico-práctico basado en la observación e identificación de las emociones de los pacientes en una sala de espera hospitalaria. Se aplicó la Jefferson Scale of Physician Empathy (Hojat, 2002) y la Self-Assessment Manikin (Bradley y Lang, 1994) RESULTADOS: La mayoría de los estudiantes experimentaron tristeza (87%) y observaron en los pacientes tristeza (87%) e impaciencia (8,7%). No se objetivó correlación estadísticamente significativa entre empatía médica y valencia/arousal de las emociones experimentadas. DISCUSIÓN: El taller de shadowing patients es de bajo coste y de fácil implementación, consigue estimular la capacidad de observación para identificar las emociones de los pacientes y ayuda al estudiante de Medicina a ser más consciente de sus habilidades empáticas, por lo que complementa la formación teórica de este

INTRODUCTION: Shadowing patients is one of the educational proposals to maintain and experience empathy in medical students. It is about observing, from the sidelines, a patient during a medical visit. The objective of this pilot study is to analyze the perceived and observed patients' emotions during the experience of shadowing patients, and their relationship with medical empathy. METHODS: Twenty-three fifth-year medical students (69.6% women, aged 22.6±1.1 years) participated in the theoretical-practical workshop based on the observation and identification of patients' emotions in a hospital waiting room. The Jefferson Scale of Physician Empathy (Hojat, 2002) and the Self-Assessment Manikin (Bradley and Lang, 1994) were applied. RESULTS: Most students experienced sadness (87%), and observed sadness (87%) and impatience (8.7%) in the patients. No statistically significant correlation between medical empathy and valence/arousal of experienced emotions was observed. DISCUSSION: The workshop of shadowing patient was low cost and easy to implement, stimulated the observation ability to identify the patients' emotions, helped medical student to be more aware of their empathic skills, and complemented the theoretical training of medical students

Functional Connectivity Bias in the Prefrontal Cortex of Psychopaths.

BACKGROUND: Psychopathy is characterized by a distinctive interpersonal style that combines callous-unemotional traits with inflexible and antisocial behavior. Traditional emotion-based perspectives link emotional impairment mostly to alterations in amygdala-ventromedial frontal circuits. However, these models alone cannot explain why individuals with psychopathy can regularly benefit from emotional information when placed on their focus of attention and why they are more resistant to interference from nonaffective contextual cues. The present study aimed to identify abnormal or distinctive functional links between and within emotional and cognitive brain systems in the psychopathic brain to characterize further the neural bases of psychopathy. METHODS: High-resolution anatomic magnetic resonance imaging with a functional sequence acquired in the resting state was used to assess 22 subjects with psychopathy and 22 control subjects. Anatomic and functional connectivity alterations were investigated first using a whole-brain analysis. Brain regions showing overlapping anatomic and functional changes were examined further using seed-based functional connectivity mapping. RESULTS: Subjects with psychopathy showed gray matter reduction involving prefrontal cortex, paralimbic, and limbic structures. Anatomic changes overlapped with areas showing increased degree of functional connectivity at the medial-dorsal frontal cortex. Subsequent functional seed-based connectivity mapping revealed a pattern of reduced functional connectivity of prefrontal areas with limbic-paralimbic structures and enhanced connectivity within the dorsal frontal lobe in subjects with psychopathy. CONCLUSIONS: Our results suggest that a weakened link between emotional and cognitive domains in the psychopathic brain may combine with enhanced functional connections within frontal executive areas. The identified functional alterations are discussed in the context of potential contributors to the inflexible behavior displayed by individuals with psychopathy.

Disrupted neural processing of emotional faces in psychopathy.

Psychopaths show a reduced ability to recognize emotion facial expressions, which may disturb the interpersonal relationship development and successful social adaptation. Behavioral hypotheses point toward an association between emotion recognition deficits in psychopathy and amygdala dysfunction. Our prediction was that amygdala dysfunction would combine deficient activation with disturbances in functional connectivity with cortical regions of the face-processing network. Twenty-two psychopaths and 22 control subjects were assessed and functional magnetic resonance maps were generated to identify both brain activation and task-induced functional connectivity using psychophysiological interaction analysis during an emotional face-matching task. Results showed significant amygdala activation in control subjects only, but differences between study groups did not reach statistical significance. In contrast, psychopaths showed significantly increased activation in visual and prefrontal areas, with this latest activation being associated with psychopaths' affective-interpersonal disturbances. Psychophysiological interaction analyses revealed a reciprocal reduction in functional connectivity between the left amygdala and visual and prefrontal cortices. Our results suggest that emotional stimulation may evoke a relevant cortical response in psychopaths, but a disruption in the processing of emotional faces exists involving the reciprocal functional interaction between the amygdala and neocortex, consistent with the notion of a failure to integrate emotion into cognition in psychopathic individuals.

Empathy and specialty preference in medical students. Follow-up study and feedback / Empatía y preferencia de especialidad en estudiantes de medicina. Estudio de seguimiento y feedback

INTRODUCTION: The evolution of empathy among medical students according to gender and specialty preference is explored using several validated scales. The value of our feedback to the medical students at the end of the study is also assessed. MATERIALS AND METHODS: A total of 151 students completed the initial questionnaire, including the following scales: Jefferson Scale of Physician Empathy (JSPE), Interpersonal Reactivity Index (IRI), and Empathy Quotient (EQ). The final questionnaire was completed by 99 of them. RESULTS: According to the EQ classification, it was found that 7.3% of students had low empathy, 49.7% average, 36.4% above average, and 6.6% very high. Empathy was higher among women in IRI-FS, IRI-EC, and EQ. Students who preferred people-oriented specialties score higher in JSPE and EQ. The IRI-Fantasy Scale was the only scale that shows increased scores on follow-up and in students with preference for people-oriented specialties. DISCUSSION: This study shows that most of the medical students in our sample had a good level of empathy. Empathy was unchanged throughout the follow-up. Medical students had different profiles of empathy. In extreme profiles, feedback could offer advice in the process of choosing a specialty to best suit their empathic skills

INTRODUCCIÓN: Se explora la evolución de la empatía en estudiantes de medicina utilizando a la vez varias escalas validadas, teniendo en cuenta el sexo y la preferencia de especialidad. Al final del estudio se realizó feedback de los resultados a los estudiantes. MATERIALES Y MÉTODOS: Ciento cincuenta y un estudiantes de medicina completaron el cuestionario inicial con las siguientes escalas: Jefferson Scale of Physician Empathy, Interpersonal Reactivity Index (IRI), Empathy Quotient (EQ) y Systemizing Quotient. Noventa y nueve de ellos finalizaron el estudio de seguimiento. RESULTADOS: Según la clasificación de la EQ encontramos un 7,3% de estudiantes con baja empatía, un 49,7% media, un 36,4% por encima de la media y un 6,6% muy alta. La empatía fue mayor en mujeres en IRI-Fantasy Scale, IRI-Empathetic Concern y EQ. En los estudiantes con preferencia de especialidad orientada a las personas la empatía fue mayor en Jefferson Scale of Physician Empathy y EQ. IRI-Fantasy Scale fue la única escala que aumentó durante el seguimiento y en los estudiantes con orientación a las personas. DISCUSIÓN: Este estudio mostró que la mayoría de los estudiantes de medicina de nuestra muestra tenían un buen nivel de empatía, y que la empatía apenas se modificó durante el período de seguimiento. Los estudiantes de medicina tenían diferentes perfiles de empatía, algunos de ellos con valores extremos. En estos perfiles el feedback permite ofrecer asesoramiento en el proceso de elegir una especialidad para adaptarse mejor a sus habilidades empáticas

Experimentar empatía en estudiantes de medicina: deprivación sensorial / Experiencing empathy in medical students: sensorial deprivation

Objetivo: Identificar las emociones que experimentan los estudiantes de medicina en el contexto de deprivación sensorial para mejorar la empatía. Sujetos y métodos: Se presenta el programa del taller (deprivación visual, auditiva y discapacidad física). Se identifican y se miden las emociones mediante la escala Self-Assessment Manikin, y se mide la empatía médica mediante la escala de empatía médica de Jefferson. Resultados y conclusiones: La deprivación sensorial permite experimentar diferentes tipos de emociones. Identificarlas permite al estudiante de medicina ser más sensible a las personas con discapacidad y aumentar la empatía

To identify emotions experienced by medical students in a workshop of sensory deprivation to enhance empathy. Subjects and methods: The workshop program (visual deprivation, auditory deprivation and physical disabilities) is presented. Emotions are identified and measured by Self-Assessment Manikin scale. Medical empathy is measured by Jefferson Scale of Physician Empathy. Results and conclusions: Sensory deprivation can experience different types of emotions. Identify them allows medical students to be more sensitive to people with disabilities and increase empathy

Breakdown in the brain network subserving moral judgment in criminal psychopathy.

Neuroimaging research has demonstrated the involvement of a well-defined brain network in the mediation of moral judgment in normal population, and has suggested the inappropriate network use in criminal psychopathy. We used functional magnetic resonance imaging (fMRI) to prove that alterations in the brain network subserving moral judgment in criminal psychopaths are not limited to the inadequate network use during moral judgment, but that a primary network breakdown would exist with dysfunctional alterations outside moral dilemma situations. A total of 22 criminal psychopathic men and 22 control subjects were assessed and fMRI maps were generated to identify (i) brain response to moral dilemmas, (ii) task-induced deactivation of the network during a conventional cognitive task and (iii) the strength of functional connectivity within the network during resting-state. The obtained functional brain maps indeed confirmed that the network subserving moral judgment is underactive in psychopathic individuals during moral dilemma situations, but the data also provided evidence of a baseline network alteration outside moral contexts with a functional disconnection between emotional and cognitive elements that jointly construct moral judgment. The finding may have significant social implications if considering psychopathic behavior to be a result of a primary breakdown in basic brain systems.