Effects of antipsychotic medications in glucose and lipid metabolism at the fasted state in drug-naïve first episode patients with psychosis after six months and three years of treatment.

Diabetes and dyslipidemia are common in patients with psychosis and may be related to adverse effects of antipsychotic medications. Metabolic disturbances in first-episode patients with psychosis are common, even prior to any antipsychotic treatment, and antipsychotic medications are implicated in the development of metabolic syndrome, at least in the long run. We therefore aimed to follow a group of drug-naïve, first-episode patients with psychosis at different time points (baseline, six months, and 36 months after the initiation of antipsychotic treatment) in order to evaluate the progression of metabolic abnormalities after antipsychotic therapy and the time-course of their onset. We assessed glucose and lipid metabolism during the fasted state in 54 drug-naïve patients with first-episode psychosis (FEP) before the initiation of any antipsychotic treatment and compared them with matched controls. The same parameters were assessed in the patient group (n=54) after six months of antipsychotic treatment and in a subgroup of patients (n=39) after three years of continuous and stable treatment in comparison to baseline. Measurements were obtained for fasting serum concentrations of total cholesterol, triglycerides, high density lipoprotein (HDL), glucose, insulin, connecting peptide (C-peptide), homeostatic model assessment index (HOMA-IR), glycated hemoglobin (HbA1c) and body mass index (BMI). Insulin, C-peptide, triglyceride levels, and HOMA-IR index were significantly higher compared to controls. Total cholesterol, triglyceride levels and BMI, increased significantly in the patient group after six months of antipsychotic treatment. After three years of continuous antipsychotic treatment, we found statistically significant increases in fasting glucose, insulin, total cholesterol, triglyceride levels, HbA1c, HOMA-IR index, and BMI compared to baseline. In conclusion, FEP patients developed significant increases in BMI and serum lipid levels as soon as six months after antipsychotic treatment. These metabolic abnormalities persisted following 36 months of treatment and in addition, increases in fasting glucose, insulin, HbA1c and HOMA-IR were observed compared to baseline.

Promoting Linguistically Based Health Literacy in Doctors for Better Cancer Healthcare in Cyprus.

This paper explores a novel approach in cancer healthcare, underscoring the significance of fostering health literacy among doctors by enhancing their ability to employ linguistically oriented strategies to extract and interpret the linguistic behavior of patients. The focus is on the Greek-Cypriot context, where research on health literacy is still in its nascent stages.

Discrimination of Second Language Vowel Contrasts and the Role of Phonological Short-Term Memory and Nonverbal Intelligence.

Although extensive research has focused on the perceptual abilities of second language (L2) learners, a significant gap persists in understanding how cognitive functions like phonological short-term memory (PSTM) and nonverbal intelligence (IQ) impact L2 speech perception. This study sets out to investigate the discrimination of L2 English monophthongal vowel contrasts and to assess the effect of PSTM and nonverbal IQ on L2 speech perception. The participants consisted of adult monolingually-raised Greek speakers, who completed an AX discrimination test, a digit span test, and a nonverbal intelligence test. A control group of English speakers also completed the AX test. Data were analyzed using Bayesian regression models. The results revealed that Greek speakers exhibited below chance discrimination for the majority of L2 vowel contrasts, consistently underperforming in comparison to the control group. Intriguingly, the study did not provide substantial evidence in favor of more accurate discrimination of L2 contrasts by Greek participants with high PSTM compared to those with low PSTM. However, the study yielded compelling evidence indicating that Greek participants with higher IQ demonstrated superior accuracy in discriminating most L2 contrasts compared to their lower IQ counterparts. The limited influence of PSTM on speech perception suggests the need for further exploration, considering the potential impact of test methodologies and the intricate interplay of other confounding factors. Furthermore, the study uncovers a noteworthy relationship between nonverbal IQ and L2 speech perception, likely linked with the association of high IQ with enhanced attentional capacities, information processing abilities, and learning skills-all of which are pivotal for accurate speech perception.

Comparison of the prediction accuracy of machine learning algorithms in crosslinguistic vowel classification.

Machine learning algorithms can be used for the prediction of nonnative sound classification based on crosslinguistic acoustic similarity. To date, very few linguistic studies have compared the classification accuracy of different algorithms. This study aims to assess how well machines align with human speech perception by assessing the ability of three machine learning algorithms, namely, linear discriminant analysis (LDA), decision tree (C5.0), and neural network (NNET), to predict the classification of second language (L2) sounds in terms of first language (L1) categories. The models were trained using the first three formants and duration of L1 vowels and fed with the same acoustic features of L2 vowels. To validate their accuracy, adult L2 speakers completed a perceptual classification task. The results indicated that NNET predicted with success the classification of all L2 vowels with the highest proportion in terms of L1 categories, while LDA and C5.0 missed only one vowel each. Furthermore, NNET exhibited superior accuracy in predicting the full range of above chance responses, followed closely by LDA. C5.0 did not meet the anticipated performance levels. The findings can hold significant implications for advancing both the theoretical and practical frameworks of speech acquisition.

Perception of Dutch vowels by Cypriot Greek listeners: To what extent can listeners' patterns be predicted by acoustic and perceptual similarity?

There have been numerous studies investigating the perception of non-native sounds by listeners with different first language (L1) backgrounds. However, research needs to expand to under-researched languages and incorporate predictions conducted under the assumptions of new speech models. This study aimed to investigate the perception of Dutch vowels by Cypriot Greek adult listeners and test the predictions of cross-linguistic acoustic and perceptual similarity. The predictions of acoustic similarity were formed using a machine-learning algorithm. Listeners completed a classification test, which served as the baseline for developing the predictions of perceptual similarity by employing the framework of the Universal Perceptual Model (UPM), and an AXB discrimination test; the latter allowed the evaluation of both acoustic and perceptual predictions. The findings indicated that listeners classified each non-native vowel as one or more L1 vowels, while the discrimination accuracy over the non-native contrasts was moderate. In addition, cross-linguistic acoustic similarity predicted to a large extent the classification of non-native sounds in terms of L1 categories and both the acoustic and perceptual similarity predicted the discrimination accuracy of all contrasts. Being in line with prior findings, these findings demonstrate that acoustic and perceptual cues are reliable predictors of non-native contrast discrimination and that the UPM model can make accurate estimations for the discrimination patterns of non-native listeners.

Abilities of children with developmental language disorders in perceiving phonological, grammatical, and semantic structures.

This study aims to investigate the perception of phonological, grammatical, and semantic structures by 8 children (age range: 8;2-9;5) with developmental language disorders (DLD). Another 8 age-matched (age range: 8;4-10;0) typically developing (TD) children served as controls. The results demonstrated that children with DLD had lower performance than children with TD in the phonology and grammar tests, corroborating earlier findings, which reported difficulties of children with DLD in discriminating voicing contrasts and perceiving grammatical structures. However, both groups had similar performance in the semantic test. The absence of semantic atypicality can be explained possibly due to the simplicity of the sentences included in the test. The study offers important clinical implications for the identification and treatment of the disorder.

Identification of Native Vowels in Normal and Whispered Speech by Individuals with Autism Spectrum Disorder.

The present study aims to investigate the identification of native vowel categories by adult individuals with Autism Spectrum Disorder (ASD) and estimate their reaction times in both normal and whisper registers; their responses were compared with those of typically developing individuals. The results demonstrated that there was no deficit for individuals with ASD in normal speech, but their responses in the whispered speech were impaired. Also, individuals with ASD responded quicker than controls in normal speech but slower in the whispered speech; still, their responses were quicker than the responses of the controls in the whispered mode. The findings can have implications for the understanding of auditory sensitivities and auditory processing time in individuals with ASD as well as for clinical practice.

Comprehension of complex syntax by non-English-speaking children with developmental language disorder: A scoping review.

Children with developmental language disorder (DLD) are characterised by impaired language abilities both in comprehension and production. Complex syntax is a specific domain which is often considered challenging for children with DLD. Research regarding complex syntax is mostly concerned with the production patterns of speakers and usually employs English-speaking populations. This scoping review aims to systematically map the abilities of non-English-speaking children with DLD to comprehend complex syntactic structures, comparing these results with the broader literature on English-speaking children with DLD. It also aims to consider the account (i.e. grammatical vs processing) by which these abilities can be explained. Four online databases were used to extract original research articles published between 2011 and 2021. Of the 264 studies initially identified, 20 studies were included in the review. The results demonstrated that children with DLD present with difficulties in comprehending object relative clauses, wh-questions, sentences with non-canonical word order, passives, and other types of complex syntax. All of these challenges are also evident in English-speaking children with DLD and can be mainly attributed either to the inability of children to assign thematic roles, their restricted working memory capacities, or a combination thereof. It is concluded that the comprehension of complex syntax might be a universal marker of DLD, which can be explained on the basis of either a grammatical or a processing account, or both. Common challenges in certain structures across languages can be used to design a comprehension assessment tool that can be applied in several languages.

The Acquisition of /ɪ/-/iː/ Is Challenging: Perceptual and Production Evidence from Cypriot Greek Speakers of English.

This study aims to investigate the perception and production of the English /ɪ/-/iː/ vowel contrast by Cypriot Greek speakers of English as a second language (L2). The participants completed a classification test in which they classified the L2 vowels in terms of their first language (L1) categories, a discrimination test in which they distinguished the members of the vowel contrast, and a production test in which they produced the target vowels. The results showed that they classified both L2 /ɪ/-/iː/ mostly in terms of L1 /i/, which denotes the formation of a completely overlapping contrast according to the theoretical framework of the Universal Perceptual Model (UPM), and that they could hardly distinguish the vowel pair. In addition, their productions deviated in most acoustic parameters from the corresponding productions of English controls. The findings suggest that /ɪ/-/iː/ may carry a universal marker of difficulty for speakers with L1s that do not possess this contrast. This distinction is difficult even for experienced L2 speakers probably because they had never been exposed to naturalistic L2 stimuli and they do not use the L2 that much in their daily life. Finally, the study verifies UPM's predictions about the discriminability of the contrast and extends the model's implications to speech production; when an L2 vowel contrast is perceived as completely overlapping, speakers activate a (near-) unified interlinguistic exemplar in their vowel space, which represents both L2 vowels.

Clinical Validation of EndoPredict in Pre-Menopausal Women with ER-Positive, HER2-Negative Primary Breast Cancer.

PURPOSE: The EndoPredict prognostic assay is validated to predict distant recurrence and response to chemotherapy primarily in post-menopausal women with estrogen receptor-positive (ER+), HER2- breast cancer. This study evaluated the performance of EndoPredict in pre-menopausal women. EXPERIMENTAL DESIGN: Tumor samples from 385 pre-menopausal women with ER+, HER2- primary breast cancer (pT1-3, pN0-1) who did not receive chemotherapy in addition to endocrine therapy were tested with EndoPredict to produce a 12-gene EP molecular score and an integrated EPclin score that includes pathologic tumor size and nodal status. Associations of molecular and EPclin scores with 10-year distant recurrence-free survival (DRFS) were evaluated by Cox proportional hazards models and Kaplan-Meier analysis. RESULTS: After a median follow-up of 9.7 years, both the EP molecular score and the molecular-clinicopathologic EPclin score were associated with increased risk of distant recurrence [HR, 1.33; 95% confidence interval (CI), 1.18-1.50; P = 7.2 × 10-6; HR, 3.58; 95% CI, 2.26-5.66; P = 9.8 × 10-8, respectively]. Both scores remained significant after adjusting for clinical factors in multivariate analysis. Patients with low-risk EPclin scores (64.7%) had significantly improved DRFS compared with high-risk patients (HR, 4.61; 95% CI, 1.40-15.17; P = 4.2 × 10-3). At 10 years, patients with low-risk and high-risk EPclin scores had a DRFS of 97% (95% CI, 93%-99%) and 76% (95% CI, 67%-82%), respectively. CONCLUSIONS: The EPclin score is strongly associated with DRFS in pre-menopausal women who received adjuvant endocrine therapy alone. On the basis of these data, pre-menopausal women with EPclin low-risk breast cancer may be treated with endocrine therapy only and safely forgo adjuvant chemotherapy.

Delusions with content related to COVID-19 pandemic, in non-infected psychiatric hospitalized patients: a six-case series.

We briefly present a case series of six patients hospitalized in the Department of Psychiatry, University General Hospital of Ioannina, between the first (starting March 23, 2020) and the second (starting November 7, 2020) lockdown in Greece who presented with COVID-19 - related delusional ideas. All patients had negative PCR prior to admission and no history of COVID-19 infection.The first three of our cases were admitted during the first lockdown, between March 23 and May 4, one involuntary and the other two voluntary. The first one was diagnosed with acute and transient psychosis (F23 - First Episode Psychosis) and the other two with psychotic depression (F32.3). Three additional patients were admitted voluntary after the end of the first lockdown. One was diagnosed with acute and transient psychosis (F23-First Episode Psychosis) and the other two were relapses of a known psychiatric disorder (Bipolar disorder F31.5 and Psychotic depression F32.3). At follow-up six months after discharge all patients were in remission following antipsychotic medication, among other medicines. These cases reveal that COVID-19 pandemic may have an impact on the delusional content of new or preexisting psychotic disorders during the COVID-19 pandemic.

GSK3ß and mTORC1 Represent 2 Distinct Signaling Markers in Peripheral Blood Mononuclear Cells of Drug-Naive, First Episode of Psychosis Patients.

BACKGROUND AND HYPOTHESIS: Schizophrenia is characterized by a complex interplay between genetic and environmental risk factors converging on prominent signaling pathways that orchestrate brain development. The Akt/GSK3ß/mTORC1 pathway has long been recognized as a point of convergence and etiological mechanism, but despite evidence suggesting its hypofunction, it is still not clear if this is already established during the first episode of psychosis (FEP). STUDY DESIGN: Here, we performed a systematic phosphorylation analysis of Akt, GSK3ß, and S6, a mTORC1 downstream target, in fresh peripheral blood mononuclear cells from drug-naive FEP patients and control subjects. STUDY RESULTS: Our results suggest 2 distinct signaling endophenotypes in FEP patients. GSK3ß hypofunction exhibits a promiscuous association with psychopathology, and it is normalized after treatment, whereas mTORC1 hypofunction represents a stable state. CONCLUSIONS: Our study provides novel insight on the peripheral hypofunction of the Akt/GSK3ß/mTORC1 pathway and highlights mTORC1 activity as a prominent integrator of altered peripheral immune and metabolic states in FEP patients.

Acoustic markers of vowels produced with different types of face masks.

The wide spread of SARS-CoV-2 led to the extensive use of face masks in public places. Although masks offer significant protection from infectious droplets, they also impact verbal communication by altering speech signal. The present study examines how two types of face masks affect the speech properties of vowels. Twenty speakers were recorded producing their native vowels in a /pVs/ context, maintaining a normal speaking rate. Speakers were asked to produce the vowels in three conditions: (a) with a surgical mask, (b) with a cotton mask, and (c) without a mask. The speakers' output was analyzed through Praat speech acoustics software. We fitted three linear mixed-effects models to investigate the mask-wearing effects on the first formant (F1), second formant (F2), and duration of vowels. The results demonstrated that F1 and duration of vowels remained intact in the masked conditions compared to the unmasked condition, while F2 was altered for three out of five vowels (/e a u/) in the surgical mask and two out of five vowels (/e a/) in the cotton mask. So, both types of masks altered to some extent speech signal and they mostly affected the same vowel qualities. It is concluded that some acoustic properties are more sensitive than other to speech signal modification when speech is filtered through masks, while various sounds are affected in a different way. The findings may have significant implications for second/foreign language instructors who teach pronunciation and for speech therapists who teach sounds to individuals with language disorders.

Adiponectin, leptin and resistin levels in first-episode, drug-naïve patients with psychosis before and after short-term antipsychotic treatment.

OBJECTIVE: There is increasing evidence that adiponectin, resistin and leptin may be implicated in the pathophysiology of neuropsychiatric disorders, including schizophrenia. The results of the studies so far remain controversial. Our aim was to compare serum adiponectin, leptin and resistin levels between drug-naïve, first -episode patients with psychosis and healthy controls and in the same group of patients after six weeks of antipsychotic treatment. METHODS: Forty first-episode patients with psychosis and 40 matched controls were included in the study. Serum levels of adiponectin, resistin and leptin were measured by enzyme linked immunosorbent assay (ELISA) in both groups. In the patient group, the same adipokines were also measured six weeks after the initiation of antipsychotic treatment. RESULTS: Log-transformed serum levels of adiponectin (mean difference = 1.68, 95% confidence interval [CI] = 1.30 to 2.06, U = 157, p < 0.0001), resistin (0.48, 95% CI = 0.36 to 0.59, t = 8.00, p < 0.0001) and leptin (0.66, 95% CI = 0.52 to 0.80, U = 160, p < 0.0001) were significantly higher to the patient group compared to controls. Leptin levels were significantly decreased in the patient group six weeks after the initiation of antipsychotic treatment (mean change = -0.40, 95% CI = -0.59 to -0.21, W = 666; p < 0.0001) while those of adiponectin and resistin levels did not change significantly. CONCLUSION: In our study we found higher levels of adiponectin, leptin and resistin in drug-naïve, first-episode patients with normal Body Mass Index (BMI) compared to controls. After six weeks of antipsychotic treatment, there was no change in adiponectin and resistin levels, while leptin levels were reduced compared to baseline.

Silent severe myocardial ischemia in a past illicit drug user imaged with myocardial perfusion scintigraphy.

Patients with illicit drug use may have deleterious acute and chronic cardiac effects. We present a case of a 42-year-old man, former alcohol and various illicit drugs user, who was admitted to the psychiatric unit for management of psychosis. Because of his previous drug and alcohol history, a cardiological evaluation was performed which revealed silent severe myocardial ischemia detected by myocardial perfusion imaging (MPI). The myocardial ischemia was attributed to coronary microvascular dysfunction, occurring several years after quitting the illicit drugs. This study highlights the potential myocardial ischemia that may occur in patients with previous alcohol and illicit drug use, and the role of MPI, a non-invasive test that can provide important information regarding the myocardial status of such patients, even without obvious cardiac symptoms or findings.

The PTW microSilicon diode: Performance in small 6 and 15 MV photon fields and utility of density compensation.

PURPOSE: We have experimentally and computationally characterized the PTW microSilicon 60023-type diode's performance in 6 and 15 MV photon fields ≥5 × 5 mm2 projected to isocenter. We tested the detector on- and off-axis at 5 and 15 cm depths in water, and investigated whether its response could be improved by including within it a thin airgap. METHODS: Experimentally, detector readings were taken in fields generated by a Varian TrueBeam linac and compared with doses-to-water measured using Gafchromic film and ionization chambers. An unmodified 60023-type diode was tested along with detectors modified to include 0.6, 0.8, and 1.0 mm thick airgaps. Computationally, doses absorbed by water and detectors' sensitive volumes were calculated using the EGSnrc/BEAMnrc Monte Carlo radiation transport code. Detector response was characterized using k Q c l i n , 4 cm f c l i n , 4 cm , a factor that corrects for differences in the ratio of dose-to-water to detector reading between small fields and the reference condition, in this study 5 cm deep on-axis in a 4 × 4 cm2 field. RESULTS: The greatest errors in measurements of small field doses made using uncorrected readings from the unmodified 60023-type detector were over-responses of 2.6% ± 0.5% and 5.3% ± 2.0% determined computationally and experimentally, relative to the reading-per-dose in the reference field. Corresponding largest errors for the earlier 60017-type detector were 11.9% ± 0.6% and 11.7% ± 1.4% over-responses. Adding even the thinnest, 0.6 mm, airgap to the 60023-type detector over-corrected it, leading to under-responses of up to 4.8% ± 0.6% and 5.0% ± 1.8% determined computationally and experimentally. Further, Monte Carlo calculations indicate that a detector with a 0.3 mm airgap would read correctly to within 1.3% on-axis. The ratio of doses at 15 and 5 cm depths in water in a 6 MV 4 × 4 cm2 field was measured more accurately using the unmodified 60023-type detector than using the 60017-type detector, and was within 0.3% of the ratio measured using an ion chamber. The 60023-type diode's sensitivity also varied negligibly as dose-rate was reduced from 13 to 4 Gy min-1 by decreasing the linac pulse repetition frequency, whereas the sensitivity of the 60017-type detector fell by 1.5%. CONCLUSIONS: The 60023-type detector performed well in small fields across a wide range of beam energies, field sizes, depths, and off-axis positions. Its response can potentially be further improved by adding a thin, 0.3 mm, airgap.