Comparison of hyperspectral imaging and spectrometers for prediction of cheeses composition.

Artisanal cheeses are part of the heritage and identity of different countries or regions. In this work, we investigated the spectral variability of a wide range of traditional Brazilian cheeses and compared the performance of different spectrometers to discriminate cheese types and predict compositional parameters. Spectra in the visible (vis) and near infrared (NIR) region were collected, using imaging (vis/NIR-HSI and NIR-HSI) and conventional (NIRS) spectrometers, and it was determined the chemical composition of seven types of cheeses produced in Brazil. Principal component analysis (PCA) showed that spectral variability in the vis/NIR spectrum is related to differences in color (yellowness index) and fat content, while in NIR there is a greater influence of productive steps and fat content. Partial least squares discriminant analysis (PLSDA) models based on spectral information showed greater accuracy than the model based on chemical composition to discriminate types of traditional Brazilian cheeses. Partial least squares (PLS) regression models based on vis/NIR-HSI, NIRS, NIR-HSI data and HSI spectroscopic data fusion (vis/NIR + NIR) demonstrated excellent performance to predict moisture content (RPD > 2.5), good ability to predict fat content (2.0 < RPD < 2.5) and can be used to discriminate between high and low protein values (∼1.5 < RPD < 2.0). The results obtained for imaging and conventional equipment are comparable and sufficiently accurate, so that both can be adapted to predict the chemical composition of the Brazilian traditional cheeses used in this study according to the needs of the industry.

Evaluating Moisture Content in Immersion Vacuum-Cooled Sausages with Citrus Peel Extracts Using Hyperspectral Imaging.

The moisture content of immersion vacuum-cooled sausages with modified casings containing citrus fruit extracts under different storage conditions was studied using hyperspectral imaging (HSI) associated with chemometrics. Different pre-processing combinations were applied to improve the robustness of the model. The partial least squares regression model, employing the full reflectance spectrum with pre-treatment of the standard normal variate, showed calibration coefficients of determination (Rc2) of 0.6160 and a root mean square error of calibration (RMSEC) of 2.8130%. For the first time, prediction maps developed via HSI visualized the distribution of moisture content in the immersion vacuum-cooled sausages with unique modified casings in response to fluctuating storage conditions. The prediction maps showed exact parts with high water content, which will help us to monitor and prevent mold growth. The combination of HSI with multivariate analysis not only quantifies changes in moisture content but also visually represents them in response to various casing treatments under different storage conditions, illustrating the significant potential for real-time inspection and early mold detection in sausages within the processed meat industry.

Inter-species Transcriptomic Analysis Reveals a Constitutive Adaptation Against Oxidative Stress for the Highly Virulent Leptospira Species.

Transcriptomic analyses across large scales of evolutionary distance have great potential to shed light on regulatory evolution but are complicated by difficulties in establishing orthology and limited availability of accessible software. We introduce here a method and a graphical user interface wrapper, called Annotator-RNAtor, for performing interspecies transcriptomic analysis and studying intragenus evolution. The pipeline uses third-party software to infer homologous genes in various species and highlight differences in the expression of the core-genes. To illustrate the methodology and demonstrate its usefulness, we focus on the emergence of the highly virulent Leptospira subclade known as P1+, which includes the causative agents of leptospirosis. Here, we expand on the genomic study through the comparison of transcriptomes between species from P1+ and their related P1- counterparts (low-virulent pathogens). In doing so, we shed light on differentially expressed pathways and focused on describing a specific example of adaptation based on a differential expression of PerRA-controlled genes. We showed that P1+ species exhibit higher expression of the katE gene, a well-known virulence determinant in pathogenic Leptospira species correlated with greater tolerance to peroxide. Switching PerRA alleles between P1+ and P1- species demonstrated that the lower repression of katE and greater tolerance to peroxide in P1+ species was solely controlled by PerRA and partly caused by a PerRA amino-acid permutation. Overall, these results demonstrate the strategic fit of the methodology and its ability to decipher adaptive transcriptomic changes, not observable by comparative genome analysis, that may have been implicated in the emergence of these pathogens.

Neuropsychological functioning and its correlates at 1 year follow-up of severe COVID-19.

BACKGROUND: Short-term cognitive impairment is associated with SARS-CoV-2 infection but the long-term impact is yet to be examined in detail. We aim to study the evolution of these symptoms in severe COVID-19 patients admitted to the intensive care unit (ICU) between April and December 2020 1 year after hospital discharge and to analyze its clinical correlates. METHOD: A total of 58 patients agreed to participate in the 6 months follow-up and 30 at 1 year after hospital discharge. Demographic, clinical and laboratory data were collected and a comprehensive neuropsychological battery including validated tests for the main cognitive domains was administered. To test the magnitude of neurocognitive sequelae, two standard deviations below normative group were considered. To compare the neuropsychological performance at 6 and 12 months follow-up we used repeated measures tests. Finally, regression analyses were performed to test the main effects of medical and psychological factors on multiple cognition. RESULTS: Almost half of the sample continued to have impaired performance on neuropsychological tests at 12 months follow-up. In comparison with the results obtained at 6 months, significant improvements were found in immediate recall (d = 0.49), delayed recall (d = 0.45), and inhibitory control (d = 0.53). Medical variables predicted cognitive performance at 6 months but not at 12 months follow-up, while anxiety and depression predicted cognitive deficits in the long-term. CONCLUSIONS: A generalised improvement was observed in severe COVID-19 patients at follow-up. This improvement was particularly notable in verbal memory and executive functioning. However, a considerable proportion of the sample continued to present deficits at 1 year follow-up.

Assessment of adenosine triphosphate content in sausages stuffed in different modified casing treatments added with orange extracts, utilising hyperspectral imaging combined with multivariate analysis.

Introduction: An investigation was conducted using a hyperspectral imaging (HSI) system to non-invasively estimate adenosine triphosphate (ATP) content in vacuum packaged sausages in different modified casing treatments added with orange extracts after a year of storage at 4°C. Methods: Various pre-processing combinations were applied to the spectra to enhance the performance of partial least squares regression (PLSR). Results and discussion: PLSR models, utilising the full absorbance spectrum with pre-treatment of standard normal variate combined with 1st derivative,exhibited prediction coefficients of determination (Rp2) reaching up to 0.6629. A distribution map developed through MATLAB was employed to display the location and concentration of ATP content in these unique sausages for the first time. The integration of HSI and multivariate analysis not only quantifies but also visually represents the changes in ATP content response to the different casing treatments, demonstrating the significant potential for real-time inspection in the processed meat industry.

Characterization and bioaccessibility assessment of bioactive compounds from camu-camu (Myrciaria dubia) powders and their food applications.

Camu-camu (Myrciaria dubia) is a tropical fruit known for its content of bioactive compounds. This study aimed to evaluate physicochemically, morphologically, andsensorialpowders from camu-camu obtained by spray-drying at two inlet temperatures (150 °C and 180 °C) with three encapsulating agents (maltodextrin, whey protein and a 50:50 mixture of both) and by freeze-drying of whole fruit. The use of maltodextrin protected bet anthocyanins (cyanidin-3-glucoside (C3G) and delphinidin-3-glucoside (D3G)), but whey protein showed a better protective effect on ascorbic and malic acids. These facts were confirmed during the storage stability test, finding that relative humidity is a critical variable in preserving the bioactive compounds of camu-camu powders. The powders with the highest content of bioactive compounds were added to a yogurt and a white grape juice, and then sensory evaluated. The bioaccessibility studies in gastric and intestinal phases showed better recovery percentages of bioactive compounds in camu-camu powders (up to 60.8 %) and beverages (up to 90 %) for C3G, D3G, ascorbic acid, and malic acid than in the fruit juice. Dehydration of camu-camu (M. dubia) is a strategy to increase the bioactive compounds stability, modulate the fruit sensory properties, and improve their bioavailability after incorporation in food matrices.

Social cognition and emotional rehabilitation in participants with schizofrenia.

Introduction: People with schizophrenia have deficits in social cognition, emotion and social perception, as well as attributional style. The purpose of this study was to evaluate the efficacy of a multicomponent social cognition training program, e-Motional Training® (ET), in people with schizophrenia and to compare its efficacy with people who did not receive it. Therefore, a single-blind RCT was conducted in participants with a diagnosis of schizophrenia. Methods: A randomized, single-blind, clinical trial was conducted with 50 stable outparticipants with schizophrenia (registry number CHUC_2019_109). All participants (control and intervention) were treated with pharmacotherapy, case management and were on Individual Placement and Support methodology for competitive employment. The intervention group was treated with ET, an online program designed for social cognition rehabilitation. Pre and post assessment was performed using different battery of tests. General mixed models with subject identification and repeated measures over time were used. Results: Different pre and post measurements were performed in the two groups. No significant differences were found in sociodemographic characteristics between the control and intervention groups. Improvements were obtained in the intervention group in the Ekman test (p = 0.009), mainly enhanced by the improvement shown in three emotions: fear, sadness and disgust (p = 0.041, p = 0.021 and p = 0.038 respectively). Conclusion: ET is a promising online training tool for social cognition deficits in schizophrenia, in particular, for the improvement of emotions.Clinical Trial Registration: https://beta.clinicaltrials.gov, NCT05866328.

An In-Vitro Experimental Investigation of Oscillatory Flow in the Cerebral Aqueduct.

Background: The cerebrospinal fluid filling the ventricles of the brain moves with a cyclic velocity driven by the transmantle pressure, or instantaneous pressure difference between the lateral ventricles and the cerebral subarachnoid space. This dynamic phenomenon is of particular interest for understanding ventriculomegaly in cases of normal pressure hydrocephalus (NPH). The magnitude of the transmantle pressure is small, on the order of a few Pascals, thereby hindering direct in vivo measurements. To complement previous computational efforts, we perform here, for the first time, in vitro experiments involving an MRI-informed experimental model of the cerebral aqueduct flow. Methods: Dimensional analysis is used in designing a scaled-up model of the aqueduct flow, with physical similarity maintained by adjusting the flow frequency and the properties of the working fluid. High-resolution MRI images are used to generate a 3D-printed anatomically correct aqueduct model. A programmable pump is used to generate a pulsatile flow rate signal measured from phase-contrast MRI. Extensive experiments are performed to investigate the relation between the cyclic fluctuations of the aqueduct flow rate and the transmantle pressure fluctuation over the range of flow conditions commonly encountered in healthy subjects. The time-dependent pressure measurements are validated through comparisons with predictions obtained with a previously derived computational model. Results: Parametric dependences of the pressure-fluctuation amplitude and its phase lag relative to the flow rate are delineated. The results indicate, for example, that the phase lag is nearly independent on the stroke volume. A simple expression relating the mean amplitude of the interventricular pressure difference (between third and fourth ventricle) with the stroke volume of the oscillatory flow is established. Conclusions: MRI-informed in-vitro experiments using an anatomically correct model of the cerebral aqueduct and a realistic flow rate have been used to characterize transmantle pressure. The quantitative results can be useful in enabling quick clinical assessments of transmantle pressure to be made from noninvasive phase contrast MRI measurements of aqueduct flow rates. The scaled-up experimental facility provides the ability to conduct future experiments specifically aimed at investigating altered CSF flow and associated transmantle pressure, as needed in connection with NPH studies.

Hyperspectral Imaging Combined with Chemometrics Analysis for Monitoring the Textural Properties of Modified Casing Sausages with Differentiated Additions of Orange Extracts.

The textural properties (hardness, springiness, gumminess, and adhesion) of 16-day stored sausages with different additions of orange extracts to the modified casing solution were estimated by response surface methodology (RSM) and a hyperspectral imaging system in the spectral range of 390-1100 nm. To improve the model performance, normalization, 1st derivative, 2nd derivative, standard normal variate (SNV), and multiplicative scatter correction (MSC) were applied for spectral pre-treatments. The raw, pretreated spectral data and textural attributes were fit to the partial least squares regression model. The RSM results show that the highest R2 value achieved at adhesion (77.57%) derived from a second-order polynomial model, and the interactive effects of soy lecithin and orange extracts on adhesion were significant (p < 0.05). The adhesion of the PLSR model developed from reflectance after SNV pretreatment possessed a higher calibration coefficient of determination (0.8744) than raw data (0.8591). The selected ten important wavelengths for gumminess and adhesion can simplify the model and can be used for convenient industrial applications.

Evaluation of pH in Sausages Stuffed in a Modified Casing with Orange Extracts by Hyperspectral Imaging Coupled with Response Surface Methodology.

The pH values of sausages stuffed in natural hog casings with different modifications (soy lecithin, soy oil, orange extracts (OE) from waste orange peels, lactic acid in slush salt, and treatment time) after 16-day 4 °C storage were evaluated for the first time by hyperspectral imaging (350−1100 nm) coupled with response surface methodology (RSM). A partial least squares regression (PLSR) model was developed to relate the spectra to the pH of sausages. Spectral pretreatment, including first derivative, second derivative, multiplicative scatter correction (MSC), standard normal variate (SNV), normalization, and normalization, with different combinations was employed to improve model performance. RSM showed that only soy lecithin and OE interactively affected the pH of sausages (p < 0.05). The pH value decreased when the casing was treated with a higher concentration of soy lecithin with 0.26% OE. As the first and second derivatives are commonly used to eliminate the baseline shift, the PLSR model derived from absorbance pretreated by the first derivative in the full wavelengths showed a calibration coefficient of determination (R2) of 0.73 with a root mean square error of calibration of 0.4283. Twelve feature wavelengths were selected with a comparable R2 value compared with the full wavelengths. The prediction map enables the visualization of the pH evolution of sausages stuffed in the modified casings added with OE.

Evolution of longitudinal division in multicellular bacteria of the Neisseriaceae family.

Rod-shaped bacteria typically elongate and divide by transverse fission. However, several bacterial species can form rod-shaped cells that divide longitudinally. Here, we study the evolution of cell shape and division mode within the family Neisseriaceae, which includes Gram-negative coccoid and rod-shaped species. In particular, bacteria of the genera Alysiella, Simonsiella and Conchiformibius, which can be found in the oral cavity of mammals, are multicellular and divide longitudinally. We use comparative genomics and ultrastructural microscopy to infer that longitudinal division within Neisseriaceae evolved from a rod-shaped ancestor. In multicellular longitudinally-dividing species, neighbouring cells within multicellular filaments are attached by their lateral peptidoglycan. In these bacteria, peptidoglycan insertion does not appear concentric, i.e. from the cell periphery to its centre, but as a medial sheet guillotining each cell. Finally, we identify genes and alleles associated with multicellularity and longitudinal division, including the acquisition of amidase-encoding gene amiC2, and amino acid changes in proteins including MreB and FtsA. Introduction of amiC2 and allelic substitution of mreB in a rod-shaped species that divides by transverse fission results in shorter cells with longer septa. Our work sheds light on the evolution of multicellularity and longitudinal division in bacteria, and suggests that members of the Neisseriaceae family may be good models to study these processes due to their morphological plasticity and genetic tractability.

Las personas con trastorno mental grave en un programa de alojamiento supervisado por un Equipo Comunitario Asertivo / People with severe mental disorders in a housing program supervised by an Assertive Community Team

El objetivo de este trabajo es evaluar la actitud y satisfacción de 182 pacientes con trastorno mental grave alojados en pisos y residencias supervisadas, sus redes sociales, las necesidades de atención y los cambios clínicos. Se recogieron datos sociodemográficos y clínicos. Se aplicaron los cuestionarios de Actitudes del Usuario (CAU), de Red Social (CURES) y la Escala ENAR-CPB de Valoración de los Niveles de Atención Residencial, con repetición a los dos años. El 86% refirieron mejoría en su vida, 77% en su enfermedad y 50% en sus relaciones sociales. Se observó una reducción significativa en las necesidades de atención a los dos años. Un 86% no tuvo ingresos hospitalarios, frente al 99% del año previo. En general, encontramos una buena aceptación de los alojamientos, con mejoría en las relaciones sociales, la estabilidad clínica y hospitalizaciones. Gracias al tratamiento asertivo comunitario, la mayoría consideraba que había habido una mejoría en su enfermedad y en sus vidas. (AU)

The aim of this work was to evaluate the attitude and satisfaction of 182 patients with severe mental disorder in supervised accommodation, their social networks, their care needs and clinical changes. Sociodemographic and clinical data were collected. The User Attitudes Questionnaire (CAU), the Social Network Questionnaire (CURES) and the Scale of Assessment of the Levels of Residential Attention for people with Severe Mental Disorder (ENAR-CPB) were administered with repetition at two years. 86% of them reported improvement in their life, 77% in their illness, and 50% in their social relationships. There was a significant reduction in care needs at two years. 86% of the participants did not have hospital admissions, compared to 99% the previous year. In general, we found a good acceptance of the accommodations, as well as an improvement in their social relationships, clinical stability, and hospitalizations. Thanks to the assertive community treatment, the majority considered that there was an improvement both in their disease and in their lives. (AU)

Proteomic and computational characterisation of 11S globulins from grape seed flour by-product and its interaction with malvidin 3-glucoside by molecular docking.

Grape seed flour by-product (GSBP) is an economic and renewable source of proteins, increasingly being explored due to interesting technological application such as colour protection in rich-anthocyanins beverages. Globulin-like proteins from GSBP were characterised by proteomic and computational studies. MALDI TOF/TOF analysis revealed the presence of two 11S globulins (acid and basic), whose 3D structures have been elucidated for the first time in Vitis vinifera L. grape seeds by using homology models and molecular dynamics. The secondary structure showed 11 α-helices and 25 ß-sheets for acid and 12 α-helices and 24 ß-sheets for basic 11S globulins. Molecular docking results indicate that both grape seed 11S globulins could establish different types of non-covalent interactions (π-π) with malvidin 3-O-glucoside (wine anthocyanin), which suggest a possible colour protection similar to that occurring in copigmentation phenomenon. These findings provide valuable information of globulin family proteins that could be relevant in food industry applications.

Neuropsychological functioning in post-ICU patients after severe COVID-19 infection: The role of cognitive reserve.

BACKGROUND: Cognitive manifestations associated with Severe Acute Respiratory Syndrome by Coronavirus 2 (SARS-CoV-2) are yet to be described in the existing literature. The aim of this exploratory study is to analyze the impact of severe SARS-CoV-2 infection on neuropsychological performance 6 months following hospital discharge, and to identify which medical variables predict worse outcome. In this context, we study if cognitive reserve (CR) may play a protective role on cognitive impairment. METHODS: We enrolled a cohort of 102 severe SARS-CoV-2 survivors who had been admitted to the Intensive Care Unit (ICU) and were contacted 6-months post discharge. A total of 58 agreed to participate in this 6-month follow-up study. Patients with previously known cognitive impairment were excluded. Demographic, clinical and laboratory data were collected. Firstly, to test the magnitude of neurocognitive sequalae two standard deviations below normative group were considered. Secondly, to analyze the main effects of medical variables on cognition and the interaction with cognitive reserve, ANCOVA analyses were performed. RESULTS: 53.4% obtained a score below the cutoff point (<26) in the screening test MOCA. ICU variables including mechanical ventilation, days of sedation or high CRP days were related with cognition. Cognitive Reserve (CR) interacted with delirium (F â€‹= â€‹6.8, p â€‹= â€‹0.01) and sedation days (F â€‹= â€‹9.40, p â€‹= â€‹0.003) to predict verbal memory and interacted with high CRP to predict phonemic fluency (F â€‹= â€‹6.47, p â€‹= â€‹0.01). Finally, no differences in neuropsychological performance were found depending on subjective cognitive impairment (SCI). However, patients with SCI had a higher score in the HAD anxiety subscale (t â€‹= â€‹-2.2; p â€‹< â€‹0.05). CONCLUSIONS: In our cohort, cognitive dysfunction was related with ICU variables such as delirium, mechanical ventilation, and inflammation. CR modulated the impact of these variables on cognition. Cognitive complaints were related with anxiety but not with cognitive performance. Despite some limitations, including the need of replication of the findings with larger samples and control groups, our study suggests that high CR may be protective for severe COVID-19-related cognitive impairment.

Research Progress in Imaging Technology for Assessing Quality in Wine Grapes and Seeds.

The chemical composition of wine grapes changes qualitatively and quantitatively during the ripening process. In addition to the sugar content, which determines the alcohol content of the wine, it is necessary to consider the phenolic composition of the grape skins and seeds to obtain quality red wines. In this work, some imaging techniques have been used for the comprehensive characterisation of the chemical composition of red grapes (cv. Tempranillo and cv. Syrah) grown in a warm-climate region during two seasons. In addition, and for the first time, mathematical models trained with laboratory images have been extrapolated for using in field images, obtaining interesting results. Determination coefficients of 0.90 for sugars, 0.73 for total phenols, and 0.73 for individual anthocyanins in grape skins have been achieved with a portable hyperspectral camera between 400 and 1000 nm, and 0.83 for total and individual phenols in grape seeds with a desktop hyperspectral camera between 900 and 1700 nm.

Assessment of Sensory and Texture Profiles of Grape Seeds at Real Maturity Stages Using Image Analysis.

The usefulness of digital image analysis in estimating sensory attributes of grape seeds in relation to maturation level was evaluated for the first time. Seeds from Syrah grapes harvested throughout the ripening period were grouped according to maturity using the DigiEye® system. The discriminant ability, homogeneity, repeatability, and uniformity of a sensory panel were assessed after training on grape seeds. The aim was to evaluate the use of digital image techniques in order to accurately establish the maturity level of grape seeds, based on sensory and textural features. All sensory attributes (color, hardness, cracking, vegetal, bitterness and astringency) showed significant (p < 0.05) correlations with the chemical maturity stage. Color and vegetal (sensory attributes), together with deformation energy (instrumental texture parameter) (De), allowed for the classification of the seeds into four real maturity stages, hence their usefulness as grape seed ripening indicators. Significant (p < 0.05) and high-correlation factors were also found between instrumental and sensory attributes. Therefore, digital analysis can be a useful tool to better define the maturity stage in the vineyard, and to dispose of grape seeds with well-defined sensory profiles for specific oenological applications. This could help to determine the optimal harvest date to manage winemaking, in order to produce high quality wines in warm climates.

A Study of Overripe Seed Byproducts from Sun-Dried Grapes by Dispersive Raman Spectroscopy.

Overripe seeds from sun-dried grapes submitted to postharvest dehydration constitute a scarcely investigated class of vinification byproduct with limited reports on their phenolic composition and industrial applications. In this study, Raman spectroscopy was applied to characterize a selection of overripe seed byproducts from different white grapes (cv. Moscatel, cv. Pedro Ximénez and cv. Zalema) submitted to postharvest sun drying. The Raman measurements were taken using a 1064 nm excitation laser in order to mitigate the fluorescent effect and the dispersive detection scheme allowed a compactness of the optical system. Spectroscopic data were processed by a principal component analysis to reduce the dimensionality and partner recognition. The evolution of the Raman spectrum during the overripening process was compared with the phenolic composition of grape seeds, which was determined by rapid resolution liquid chromatography/mass spectrometry (RRLC/MS). A multivariate processing of the spectroscopic data allowed the classification of overripe seeds according to the grape variety and the monitoring of stages of the postharvest sun drying process.

Reduction of the Number of Samples for Cost-Effective Hyperspectral Grape Quality Predictive Models.

Developing chemometric models from near-infrared (NIR) spectra requires the use of a representative calibration set of the entire population. Therefore, generally, the calibration procedure requires a large number of resources. For that reason, there is a great interest in identifying the most spectrally representative samples within a large population set. In this study, principal component and hierarchical clustering analyses have been compared for their ability to provide different representative calibration sets. The calibration sets generated have been used to control the technological maturity of grapes and total phenolic compounds of grape skins in red and white cultivars. Finally, the accuracy and precision of the models obtained with these calibration sets resulted from the application of the selection algorithms studied have been compared with each other and with the whole set of samples using an external validation set. Most of the standard errors of prediction (SEP) in external validation obtained from the reduced data sets were not significantly different from those obtained using the whole data set. Moreover, sample subsets resulting from hierarchical clustering analysis appear to produce slightly better results.

Cognitive remediation to improve the vocational outcomes of people with severe mental illness.

The present study investigates the effects of cognitive remediation (CR) training with Individual Placement and Support (IPS) in people suffering from severe mental illness in European population (Spanish). Sixty-five participants (83% with schizophrenia or bipolar disorder) were recruited from community mental health teams. Fifty-seven met the criteria and agreed to participate in the study. The conditions of cognitive rehabilitation were assigned randomly with support employment CR + IPS (n = 28) and IPS alone (n = 29). Two groups were followed at 8 and 12 months after the baseline. Participants in the CR + IPS group improved more than the IPS only group during the follow-up period in measures of cognitive functioning (significantly higher in executive functions, verbal learning and memory) and obtained higher employment percentages during the follow-up period, including people who got a job after 8 months (52.2% versus 29.2%, p = .023) and after 1 year (60.9% versus 37.5%, p = .025), as well as, in the weekly hours worked (37.2 versus 26.7 h, p = .023). Retention in the CR + IPS program was high (82.14%). The calculated global cognitive score showed that the evolution over time differed significantly between groups (p < .001).