Neuropsychological profiles in first-episodes psychosis and their relationship with clinical, metacognition and social cognition variables.

An increasing interest in the assessment of neuropsychological performance variability in people with first-episode psychosis (FEP) has emerged. However, its association with clinical and functional outcomes requires further study. Furthermore, FEP neuropsychological subgroups have not been characterized by clinical insight or metacognition and social cognition domains. The aim of this exploratory study was to identify specific groups of patients with FEP based on neuropsychological variables and to compare their sociodemographic, clinical, metacognition and social cognition profiles. A sample of 149 FEP was recruited from adult mental health services. Neuropsychological performance was assessed by a neuropsychological battery (WAIS-III; TMT; WSCT; Stroop Test; TAVEC). The assessment also included sociodemographic characteristics, clinical, functional, metacognition and social cognition variables. Two distinct neuropsychological profiles emerged: one neuropsychological impaired cluster (N = 56) and one relatively intact cluster (N = 93). Significant differences were found between both profiles in terms of sociodemographic characteristics (age and level of education) (p = 0.001), clinical symptoms (negative, positive, disorganized, excitement and anxiety) (p = 0.041-0.001), clinical insight (p = 0.038-0.017), global functioning (p = 0.014), as well as in social cognition domains (emotional processing and theory of mind) (p = 0.001; p = 0.002). No significant differences were found in metacognitive variables (cognitive insight and 'jumping to conclusions' bias). Relationship between neurocognitive impairment, social cognition and metacognition deficits are discussed. Early identifying of neuropsychological profiles in FEP, characterized by significant differences in clinical and social cognition variables, could provide insight into the prognosis and guide the implementation of tailored early-intervention.

Efficacy of a transdiagnostic internet-based program for adolescents with emotional disorders: A randomized controlled trial.

OBJECTIVE: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is a well-established transdiagnostic cognitive-behavioral therapy (T-CBT) intervention. The aim of the present study was to examine the efficacy of the program Learn to Manage your Emotions [Aprende a Manejar tus Emociones] (AMtE), a self-applied transdiagnostic internet-delivered program based on the Spanish version of the UP-A. This is the first transdiagnostic internet-based program designed for the treatment of emotional disorders in adolescents. METHOD: A sample of Spanish adolescents with a primary diagnosis of an anxiety and/or depressive disorder (n = 58; age range = 12-18 years; 78.3% girls; 90% Caucasian) were randomly allocated to receive AMtE (n = 28) or the UP-A via videocall (n = 30). Pre-treatment, post-treatment and 3-month follow-up data were collected using self-reports and clinician-rated measures of anxiety, depression, positive and negative affect, anxiety sensitivity and emotional avoidance. RESULTS: Based on generalized estimating equations (GEE) models, both intervention programs were effective in significantly reducing self-reported anxiety and depressive disorder symptoms and clinician-rated severity of anxiety and depression, as well as self-reported transdiagnostic outcome variables. CONCLUSIONS: Data provide empirical support for the efficacy of AMtE as a transdiagnostic online CBT treatment for anxiety and depressive disorders in adolescents. No marked nor consistent differences were observed between the UP-A and AMtE, highlighting the potential usefulness of the online self-administered AMtE program.

Effectiveness of family metacognitive training in mothers with psychosis and their adolescent children: a multicenter study protocol.

Background: More than half of women with psychosis take care of their children despite the difficulties caused by the disease. Additionally, these kids have a higher risk of developing a mental health disorder. However, no interventions have been developed to meet these needs. Metacognitive Training (MCT) is a psychological intervention that has demonstrated its efficacy in improving cognitive insight, symptom management and social cognition in people with first-episode psychosis (FEP). Additionally, MCT has shown better results in women than men with FEP. This study aims to adapt and evaluate the efficacy of MCT-F in mothers and adolescent children in an online group context with the main purpose of improving family relationships, cognitive awareness and symptoms in women with psychosis and increase their children's knowledge of the disease and their functioning. As secondary objectives, it also aims to evaluate improvements in metacognition, social cognition, symptoms, protective factors and self-perception of stigma. Materials and methods: A quasi-experimental design with participants acting as their own control will be carried out. Forty-eight mothers with psychosis and their adolescent children (between 12 and 20 years old) recruited from a total of 11 adult mental health care centers will receive MCT-F. Participants will be evaluated 11 weeks before the intervention (T1), at baseline (T2), and post-intervention (T3) with a cognitive insight scale, as a primary outcome. Measures of metacognitive and social cognition, symptoms, cognitive functioning, family and social functioning, protective factors (self-esteem, resilience, and coping strategies) and self-perceived stigma will be addressed as secondary outcomes. Assessment will also address trauma and attachment in mothers and, lastly, the feasibility and acceptability of MCT-F in both participant groups. Discussion: This will be the first investigation of the efficacy, acceptability, and viability of the implementation of MCT-F. The results of this study may have clinical implications, contributing to improving mothers' with psychosis and adolescents' functioning and better understanding of the disease, in addition to the possible protective and preventive effect in adolescents, who are known to be at higher risk of developing severe mental disorders.Clinical trial registration:https://clinicaltrials.gov/, identifier [NCT05358457].

The influence of gender in cognitive insight and cognitive bias in people with first-episode psychosis: an uncontrolled exploratory analysis.

PURPOSE: Previous studies have investigated the role of gender in clinical symptoms, social functioning, and neuropsychological performance in people with first-episode psychosis (FEP). However, the evidence of gender differences for metacognition in subjects with FEP is still limited and controversial. The aim of the present study was to explore gender differences in cognitive insight and cognitive biases in this population. METHODS: Cross-sectional study was carried out in a sample of 104 patients with FEP (35 females and 69 males) recruited from mental health services. Symptoms were assessed with the Positive and Negative Syndrome Scale, cognitive insight with the Beck Cognitive Insight Scale, and cognitive bias by the Cognitive Biases Questionnaire for Psychosis. The assessment also included clinical and sociodemographic characteristics. RESULTS: After controlling for potential confounders (level of education, marital status, and duration of psychotic illness) analysis of covariance revealed that males presented greater self-reflectiveness (p = 0.004) when compared to females. However, no significant differences were found in self-certainty and composite index of the cognitive insight scale, as in the cognitive biases assessed. CONCLUSIONS: Gender was an independent influence factor for self-reflectiveness, being better for males. Self-reflectiveness, if shown to be relatively lacking in women, could contribute to the design of more gender-sensitive and effective psychotherapeutic treatments, as being able to self-reflect predicts to better treatment response in psychosis.

Family Metacognitive Training (MCT-F): Adapting MCT to Mothers with Psychosis and Their Adolescent Children.

Over half of women with psychosis are mothers. Research suggests that mothers with psychosis face unique challenges affecting both their mental health prognosis and their relationship with their children. Moreover, those children have a higher risk of developing a mental disorder. Notwithstanding, interventions specifically tailored to these families remain largely uncovered. Metacognitive Training (MCT) has demonstrated its efficacy in improving cognitive insight, symptom management, and social cognition in people with psychosis. However, there is no evidence of the efficacy of MCT in a family setting (MCT-F). This study describes the first adaptation of MCT for mothers with psychosis and their adolescent children in an online group setting. The phases (assessment, decision, adaptation, production, topical experts' integration) of the ADAPT-ITT model were systematically applied through a participatory approach (n = 22), including a first-person perspective and involving qualitative (e.g., topical expert literature review and consensus groups, interviews, thematic analyses) and quantitative methods. While MCT's core components were retained, participants guided adaptations both in content and delivery. The findings suggest the importance of community engagement and sharing decision-making processes to demonstrate the acceptability and feasibility of the adapted intervention. Employing a structured approach such as the ADAPT-ITT model ensures readiness of the new training for efficacy trials.

Generación de un inoculante acelerador del compostaje / Production of a compost accelerator inoculant

Se realizó el compostaje de una mezcla de estiércol de ovino más paja. Se extrajo inóculo de 5 diferentes fases del proceso de compostaje (a los 18, 23, 28, 33 y 38 días de iniciado) y se evaluó su efecto en la reducción del tiempo de biotransformación de un compost de estiércol de ovino. Las muestras se conservaron en un ultracongelador, después se liofilizaron para obtener el inóculo y se agregaron 50 g a cada tratamiento en la segunda fase experimental. En dicha fase se establecieron seis tratamientos: C = paja (P) + estiércol de ovino (E), T1= P+E +inóculo de 18 días de iniciado el proceso de compostaje (I18), T2= P + E+I23, T3= P + E +128, T4= P + E + I33, T5= P + E + I38, con 3 repeticiones. Estos tratamientos se colocaron en una cámara de ambiente controlado con 45% de humedad relativa y a 30°C. Al mismo tiempo, se colocaron frascos con 50 g de material para medir la producción diaria y la acumulación de CO2, la temperatura, el pH, la conductividad eléctrica, la materia orgánica, el nitrógeno (N), el carbono total, la relación C:N, el tamaño de partícula y la densidad aparente. La producción de CO2 en los tratamientos T2 y T5 mostró diferencia significativa (p < 0,05) de respecto de los demás tratamientos, lo que demuestra que el inóculo de estos tratamientos aceleró la dinámica de los microorganismos y el proceso de compostaje. La calidad y la madurez del compost se garantizan a medida que disminuye la cantidad de CO2.

Composting was performed using a mixture of ovine manure and straw. Inoculum was extracted at five different phases of the composting process (18, 23, 28, 33 and 38 days after the start of the composting process) and its effect on reducing biotransformation time was evaluated in the composted ovine manure. The samples were preserved in a deep freezer, then lyophilized to obtain the inoculum, 50g of which was added to each treatment in the second experimental phase. Six treatments were established; C = straw (P) + ovine manure (E), T1 = P+ E+ inoculum 18 days after the start of the composting process (I18), T2 = P + E + I23, T3 = P + E +128, T4 = P + E +133, T5 = P + E +138, with three replications. Treatments were placed in a controlled-environment chamber at 45% relative humidity and 30°C along with flasks containing 50 g of material to measure daily production, CO2 accumulation, temperature, pH, electric conductivity (dS/m), organic matter (%), total nitrogen (%), total carbon (%), C: N ratio, particle size (Tp) and bulk density (g/l). CO2 production (mg) showed a significant difference (p <.05) of treatments T2 and T5 with respect to the others, which demonstrated that the inoculum of these treatments accelerated the dynamics of microorganisms and the composting process. The quality and maturity of the compost are guaranteed as the amount of CO2 decreases.

Formulación de mezclas de sustratos mediante programación líneal / Formulation of substrate mixtures by means of lineal programming

El propósito del presente estudio fue formular mezclas de sustratos mediante programación lineal, a partir de las propiedades físicas y químicas de siete sustratos (orgánicos e inorgánicos): Tezontle, Agrolita, Peat-moss®, vermicomposta de desechos de cocina, composta de estiércol de cabra y paja, vermicomposta de bagazo de agave y germinasa (fibra de coco), con el empleo del software BLP88. Se establecieron variables de diseño (balance de volúmenes, materia orgánica, espacio poroso total y capacidad de aire) y valores finales para cada una de las propiedades de la mezcla a diseñar (restricciones). La función objetivo fue minimizar los costos de las mezclas en función de tres niveles de restricción para cada una de las variables de diseño. Las mezclas factibles se obtuvieron a partir de la combinación de las variables de diseño. La programación lineal redujo el número de mezclas posibles en un 93 por ciento. Para evaluar los criterios de diseño, se seleccionó el 25 por ciento de las mezclas factibles, las cuales fueron reconstruidas a partir de los materiales originales en las proporciones definidas en cada caso. Los resultados indicaron que los valores para cada una de las variables evaluadas se encontraron dentro de los límites preestablecidos, por lo que es posible considerar a la programación lineal como un método factible para la formulación de mezclas de sustratos específicos

Técnica de descompresión, una alternativa conservadora para el manejo de grandes lesiones perirradiculares / Decompression technique: A conservative altrnative for the management of large

Las grandes lesiones perirradiculares se pueden desarrollar con o sin síntomas clínicos. Esta situación puede involucrar los ápices de varios dientes adyacentes el del origen de la lesión y a veces localizarse cerca de estructuras anatómicas como seno maxilar, fosas nasales, canal mandibular, foramen mentoniano. La enucleación quirúrgica de tales lesiones podría atentar contra la vitalidad de los dientes adyacentes y puede resultar en una indeseada comunicación y daño de las estructuras anatómicas asociadas. El propósito de este artículo es mostrar tres casos clínicos que explican como una de las opciones más conservadores de tratamiento es la descompresión de grandes lesiones; un procedimiento diseñado para reducir el tamaño de la lesión tal, que se evite la intervención quirúrgica, o que si sea necesaria se limite solo a los tejidos perirradiculares del diente involucrado. Además, otra indicación para este procedimiento puede ser la eliminación de la lesión y la preparación ósea para el lecho de un implante cuando exista una gran lesión en un diente donde esta indicada su extracción...