Training in neuropsychiatry: views of early career psychiatrists from across the world.

BACKGROUND: Training and practice in neuropsychiatry varies across the world. However, little is known about the experiences and opinions of early career psychiatrists (ECPs) across different countries regarding neuropsychiatry. AIMS AND METHOD: To investigate neuropsychiatry training experiences, practices and opinions among ECPs across different countries. An online survey was distributed to ECPs in 35 countries across the world. RESULTS: A total of 522 participants took part in this study. Responses show that neuropsychiatry is integrated to a variable extent in psychiatric training curricula across the world. Most respondents were not aware of the existence of neuropsychiatric training or of neuropsychiatric units. Most agreed that training in neuropsychiatry should be done during or after the psychiatry training period. Lack of interest among specialty societies, lack of time during training, and political and economic reasons are regarded as the main barriers. CLINICAL IMPLICATIONS: These findings call for an improvement in the extent and in the quality of neuropsychiatry training across the world.

Workplace violence and risk for psychiatric morbidity among health workers in a tertiary health care setting in Nigeria: Prevalence and correlates.

The objectives were to evaluate the workplace violence and risk for psychiatric morbidity, as well as their correlates, among health workers in a tertiary healthcare setting in Nigeria. A stratified random sampling technique was used to recruit the health workers. Each participant was administered a socio-demographic questionnaire, the ILO/ICN/WHO/PSI Workplace Violence Questionnaire and the 12- item General Health Questionnaire. A total of 380 health workers were recruited, with a mean age of 36.4 (±7.64) years. The prevalence rates of workplace violence and risk of psychiatric morbidity were 39.9% and 38.5%. Factors with independent associations with workplace violence included young age, female sex and worry about workplace violence while a widowed, separated or divorced marital status and being victim of workplace violence independently increased risk for developing psychiatric morbidity. This study therefore showed that workplace violence is common in the health care setting, and significant proportion of workers are at risk for developing psychiatric morbidity. These observations suggest need for the regular mental health screening of health workers, as well as the need for programmes aimed at preventing workplace violence in this setting.

Sleep Hygiene Index: Psychometric Characteristics and Usefulness as a Screening Tool in a Sample of Nigerian Undergraduate Students.

STUDY OBJECTIVES: The objectives of this study were to investigate the psychometric properties of the Sleep Hygiene Index (SHI) and determine its capacity to screen for poor sleep quality in a nonclinical sample of Nigerian university students. METHODS: A total of 348 students appropriately completed the SHI, the Morningness-Eveningness Questionnaire (MEQ), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS). RESULTS: The internal consistency (Cronbach alpha) of the SHI was .64 and its construct validity was modestly satisfactory. It had a significant negative correlation with the MEQ (r = -.170, P < .001) and positive correlations with global PSQI (r = .289, P < .001) and ESS (r = .219, P < .001) scores. Prior to the factor analysis, our sample was randomly divided into two. In one half of the sample (sample 1), exploratory factor analysis of the SHI items yielded a three-factor model. Confirmatory factor analysis on the other half (sample 2) corroborated this model with satisfactory indices of fitness (c2 = 67.805; df = 55; c2/df = 1.233; P = .115; goodness of fit index = .943; Tucker-Lewis index = .958; incremental fit index = .972; comparative fit index = .970; root mean square error of approximation = .037). A cutoff total score of 16 on the SHI had the best sensitivity (77.0%) and specificity (47.5%) to identify students who were categorized as experiencing poor sleep quality, according to the PSQI (area under the curve = 0.65, 95% confidence interval = 0.59-0.71). CONCLUSIONS: The SHI exhibited satisfactory psychometric properties as a self-rated assessment instrument in the evaluation of sleep hygiene and as a screening instrument for poor sleep quality among Nigerian undergraduate students.

Dehydroepiandrosterone Heightens Aggression and Increases Androgen Receptor and Aromatase mRNA Expression in the Brain of a Male Songbird.

Dehydroepiandrosterone (DHEA) is a testosterone/oestrogen precursor and known modulator of vertebrate aggression. Male song sparrows (Melospiza melodia morphna) show high aggression during breeding and nonbreeding life-history stages when circulating DHEA levels are high, and low aggression during molt when DHEA levels are low. We previously showed that androgen receptor and aromatase mRNA expression are higher during breeding and/or nonbreeding in brain regions associated with reproductive and aggressive behaviour, although the potential role of DHEA in mediating these seasonal changes remained unclear. In the present study, nonbreeding male song sparrows were captured and held in the laboratory under short days (8 : 16 h light/dark cycle) and implanted with s.c. DHEA-filled or empty (control) implants for 14 days. DHEA implants increased aggression in a laboratory-based simulated territorial intrusion. Brains of DHEA-implanted birds showed higher aromatase mRNA expression in the preoptic area (POA) and higher androgen receptor mRNA expression in the periventricular nucleus of the medial striatum (pvMSt) and ventromedial nucleus of the hypothalamus. The DHEA-induced increases in aromatase expression in the POA and androgen receptor expression in the pvMSt are consistent with previously reported seasonal increases in these markers associated with naturally elevated DHEA levels. This suggests that DHEA facilitates seasonal increases in aggression in nonbreeding male song sparrows by up-regulating steroid signalling/synthesis machinery in a brain region-specific fashion.

Cavity-Enhanced Room-Temperature Broadband Raman Memory.

Broadband quantum memories hold great promise as multiplexing elements in future photonic quantum information protocols. Alkali-vapor Raman memories combine high-bandwidth storage, on-demand readout, and operation at room temperature without collisional fluorescence noise. However, previous implementations have required large control pulse energies and have suffered from four-wave-mixing noise. Here, we present a Raman memory where the storage interaction is enhanced by a low-finesse birefringent cavity tuned into simultaneous resonance with the signal and control fields, dramatically reducing the energy required to drive the memory. By engineering antiresonance for the anti-Stokes field, we also suppress the four-wave-mixing noise and report the lowest unconditional noise floor yet achieved in a Raman-type warm vapor memory, (15±2)×10^{-3} photons per pulse, with a total efficiency of (9.5±0.5)%.

Efeitos da acupuntura nos acupontos Shenmen (C-7) e Neiguan (PC-6) sobre a frequência cardíaca, a variabilidade da frequência cardíaca e o ritmo cardíaco em cães saudáveis / Effects of acupuncture at Shenmen (C-7) and Neiguan (PC-6) acupoints on the heart hate, heart rate variability and cardiac rhythm in healthy dogs

Acupuncture derives from traditional Chinese medicine, which aims to restore homeostasis. The action mechanism of this technique involves stimulation of certain points on the skin by inserting a needle. The aim of this study was to evaluate the influence of stimulation of acupoints C7 and PC6 on the heart rate variability, heart rate and heart rhythm in healthy dogs. 30 male and female adult dogs were used, with no breed restriction. The animals were analyzed at two different times in weekly intervals. Firstly were applied needles in the true acupoints, and on the second time we applied needles in false acupoints. Previously to the acupuncture an ECG with 2 minutes of recorder was performed, and after an insertion of needles the electrocardiographic recording was maintained during the 30 minutes of acupuncture. Results showed no significant difference between the HR when comparing true and false acupoints (p = 0.890). For heart rate variability a small difference was observed between the groups (p = 0.0051), however, when comparing the baseline with 15 and 25 minutes of monitoring in the false acupoint group, no significant results were found when compared with true acupoint. In conclusion, it is suggested that the stimulation of acupoints C-7 and PC-6 in healthy dogs does not promote change in sympathovagal balance, specifically on the heart rate variability, heart rate and heart rhythm on healthy dogs.(AU)

Estudo comparativo da eletrocardiografia convencional e computadorizada em equinos das raças Quarto de Milha e Mangalarga Marchador / Comparative study of computerized and conventional electrocardiography in Quarter Horse and Mangalarga Marchador

A eletrocardiografia computadorizada é mais precisa e prática quando comparada à convencional e por essa razão vem ganhando espaço na rotina clínica. No entanto os valores de referência devem diferir para os dois métodos. O objetivo desse trabalho foi analisar e comparar o exame eletrocardiográfico computadorizado com o exame obtido pelo método convencional em equinos. O estudo demonstrou diferenças na amplitude da onda P (P<0,0001) com valor médio de 0,21 mV para o método convencional e 0,17 mV para o computadorizado; duração do intervalo PR (p=0,0005), tendo o valor médio de 260,49 ms para o método convencional e 242,37 ms para o informatizado e duração do complexo QRS (p=0,0003), sendo a média de valores para o método convencional de 75,61ms e 84,83 ms para o computadorizado. Essas diferenças devem ser levadas em consideração com o intuito de evitar equívocos na interpretação da eletrocardiografia na espécie equina.

Computerized electrocardiography has been gaining space in clinic routines because it is more practical and precise when compared to the conventional method. However, their reference values may differ from each other. The aim of this paper was to analyze and compare computerized and conventional electrocardiography in horses. Differences were observed between P wave amplitude (P<0001) with a mean of 0.21mV in the conventional method and 0.17mV in the computerized method, PR interval duration (p=0.0005) with a mean of 260.49 ms and 242.37 ms in the conventional and computerized methods respectively, and QRS complex duration (p=0.0003) with a mean of 75.61 ms in the conventional method and 84.83 ms in the computerized method. These differences should be taken into consideration in order to avoid misunderstandings in the interpretation of the electrocardiogram in equine species.

Cor triatriatum sinister e hipertensão arterial pulmonar secundária em cão / Cor triatriatum sinister and secondary pulmonary arterial hypertension in a dog

This paper describes the occurrence of cor triatriatum sinister, a rare cardiac malformation in dogs, associated with pulmonary edema and pulmonary hypertension in a 5-year-old Poodle female with history of acute dyspnea and cyanosis. The animal presented acute respiratory failure, heart failure with low cardiac output, progressing to acute tubular necrosis and death. The diagnosis was made posmortem due to the clinical instability of the dog. This malformation was diagnosed by the subdivision of the left atrium into two compartments separated by an abnormal fibromuscular membrane, absence of structural abnormalities of the mitral valve and thickening of pulmonary artery tunica media associated with renal tubular degeneration. The occurrence of cor triatriatum in dogs is most common in the right atrium, defined as cor triatriatum dexter. Additionally, pulmonary arterial hypertension associated with this malformation is described only in humans with this heart defect.

Enhancing multiphoton rates with quantum memories.

Single photons are a vital resource for optical quantum information processing. Efficient and deterministic single photon sources do not yet exist, however. To date, experimental demonstrations of quantum processing primitives have been implemented using nondeterministic sources combined with heralding and/or postselection. Unfortunately, even for eight photons, the data rates are already so low as to make most experiments impracticable. It is well known that quantum memories, capable of storing photons until they are needed, are a potential solution to this "scaling catastrophe." Here, we analyze in detail the benefits of quantum memories for producing multiphoton states, showing how the production rates can be enhanced by many orders of magnitude. We identify the quantity ηB as the most important figure of merit in this connection, where η and B are the efficiency and time-bandwidth product of the memories, respectively.

Multipulse addressing of a Raman quantum memory: configurable beam splitting and efficient readout.

Quantum memories are vital to the scalability of photonic quantum information processing (PQIP), since the storage of photons enables repeat-until-success strategies. On the other hand, the key element of all PQIP architectures is the beam splitter, which allows us to coherently couple optical modes. Here, we show how to combine these crucial functionalities by addressing a Raman quantum memory with multiple control pulses. The result is a coherent optical storage device with an extremely large time bandwidth product, that functions as an array of dynamically configurable beam splitters, and that can be read out with arbitrarily high efficiency. Networks of such devices would allow fully scalable PQIP, with applications in quantum computation, long distance quantum communications and quantum metrology.

Entangling macroscopic diamonds at room temperature.

Quantum entanglement in the motion of macroscopic solid bodies has implications both for quantum technologies and foundational studies of the boundary between the quantum and classical worlds. Entanglement is usually fragile in room-temperature solids, owing to strong interactions both internally and with the noisy environment. We generated motional entanglement between vibrational states of two spatially separated, millimeter-sized diamonds at room temperature. By measuring strong nonclassical correlations between Raman-scattered photons, we showed that the quantum state of the diamonds has positive concurrence with 98% probability. Our results show that entanglement can persist in the classical context of moving macroscopic solids in ambient conditions.

Effects of topical levobunolol or fixed combination of dorzolamide-timolol or association of dorzolamide-levobunolol on intraocular pressure, pupil size, and heart rate in healthy cats / Efeitos da aplicação tópica do levobunolol, da combinação fixa de dorzolamidatimolol ou da associação de dorzolamida com levobunolol sobre a pressão intra-ocular, o diâmetro pupilar e a freqüência cardíaca em gatos saudáveis

The effects of topical levobunolol with the fixed combination of 2 percent dorzolamide-0.5 percent timolol and the association of 2 percent dorzolamide with 0.5 percent levobunolol on intraocular pressure (IOP), pupil size (PS), heart rate (HR), and conjunctival hyperemia in eighteen halthy cats were investigated and compared. IOP, PS, HR, and conjuntival hyperemia were daily recorded at three times (9a.m., 2p.m., and 6p.m.). Three groups were formed (n=6), and one eye of each animal was randomly selected and treated with topical levobunolol (L), or commercial combination of dorzolamide-timolol (DT), or the association of dorzolamide with levobunolol (DL). The first day (0) consisted of recording of baseline values. On the next four consecutive days, drugs were instilled at 8a.m. and 8p.m. and measurements were taken at the same times fore cited. Comparing with the baseline values, all evaluated parameters significantly decreased (P<0.001). Conjuntival hyperemia was not seen. Levobunolol significantly declined IOP, PS, and HR in normal cats, and showed a stronger effect in lowering HR, when compared to dorzolamide-timolol effect. No synergistic effect in IOP declining was noted when levobunolol dorzolamide was added to levobunolol.

Estudaram-se e compararam-se os efeitos do levobunolol, da combinação fixa de dorzolamida 2 por cento-timolol 0,5 por cento e da associação de dorzolamida 2 por cento com levobunolol 0,5 por cento sobre a pressão intra-ocular (PIO), o diâmetro pupilar (DP), a freqüência cardíaca (FC) e a hiperemia conjuntival em 18 gatos saudáveis. PIO, DP, FC e hiperemia conjuntival foram aferidos diariamente, em três horários distintos (9h, 14h e 18h). Três grupos foram formados (n=6) e um olho de cada animal recebeu, aleatoriamente, uma gota de levobunolol (L), ou a combinação comercial à base de dorzolamida-timolol (DT), ou a associação de dorzolamida com levobunolol (DL). Parâmetros basais foram aferidos no primeiro dia (dia 0). Nos quatro dias consecutivos, os fármacos foram instilados às 8h e 20h e os parâmetros aferidos nos mesmos horários. Todos os parâmetros decresceram significativamente em relação aos valores basais (P<0,001) e não se observou hiperemia conjuntival. O levobunolol reduziu significativamente a PIO, o DP e a FC e o foi o fármaco que mais reduziu a FC. Não se observou efeito sinérgico na redução da PIO quando a dorzolamida foi adicionada ao levobulol.

Penfigóide bolhoso. Relato de caso

O artigo não apresenta resumo.

Artrite séptica em cão. Relato de caso

O artigo não apresenta resumo.

Stability and CTL activity of N-terminal glutamic acid containing peptides.

Several cytotoxic T lymphocyte peptide-based vaccines against hepatitis B, human immunodeficiency virus and melanoma were recently studied in clinical trials. One interesting melanoma vaccine candidate alone or in combination with other tumor antigens, is the decapeptide ELA. This peptide is a Melan-A/MART-1 antigen immunodominant peptide analog, with an N-terminal glutamic acid. It has been reported that the amino group and gamma-carboxylic group of glutamic acids, as well as the amino group and gamma-carboxamide group of glutamines, condense easily to form pyroglutamic derivatives. To overcome this stability problem, several peptides of pharmaceutical interest have been developed with a pyroglutamic acid instead of N-terminal glutamine or glutamic acid, without loss of pharmacological properties. Unfortunately compared with ELA, the pyroglutamic acid derivative (PyrELA) and also the N-terminal acetyl-capped derivative (AcELA) failed to elicit cytotoxic T lymphocyte (CTL) activity. Despite the apparent minor modifications introduced in PyrELA and AcELA, these two derivatives probably have lower affinity than ELA for the specific class I major histocompatibility complex. Consequently, in order to conserve full activity of ELA, the formation of PyrELA must be avoided. Furthermore, this stability problem is worse in the case of clinical grade ELA, produced as an acetate salt, like most of the pharmaceutical grade peptides. We report here that the hydrochloride salt, shows higher stability than the acetate salt and may be suitable for use in man. Similar stability data were also obtained for MAGE-3, another N-terminal glutamic acid containing CTL peptide in clinical development, leading us to suggest that all N-terminal glutamic acid and probably glutamine-containing CTL peptide epitopes may be stabilized as hydrochloride salts.

Identification and characterisation of multiple linear B cell protectopes in the respiratory syncytial virus G protein.

Respiratory syncytial virus (RSV) is an important respiratory pathogen in man, against which no vaccine is available. However, recent evidence suggests that antibodies to the RSV F and G proteins may play an important role in disease prevention. We previously demonstrated that BBG2Na, a subunit vaccine candidate including residues 130-230 of the Long strain G protein, protects rodents against RSV challenge. Using a panel of monoclonal antibodies (MAb) and synthetic peptides, five linear B cell epitopes were identified that mapped to residues 152-163, 165-172, 171-187 (two over-lapping epitopes) and 196-204. Antibody passive transfer and peptide immunisation studies revealed that all were protective. Pepscan analyses of anti-RSV-A and BBG2Na murine polyclonal sera suggested stronger immunogenicity of some protective epitopes (protectopes) in the context of BBG2Na compared with live virus. However, all the identified murine B cell protectopes were conserved in RSV seropositive humans. Should these protectopes correspond with protection in humans, BBG2Na may constitute a very interesting vaccine candidate against RSV.

Stability and CTL-activity of P40/ELA melanoma vaccine candidate.

The decapeptide ELA (ELAGIGILTV), a Melan-A/MART-1 antigen immunodominant peptide analogue, is an interesting melanoma vaccine candidate alone or in combination with other tumour antigens. P40, the recombinant outer membrane protein A of Klebsiella pneumoniae (kpOmpA), was recently shown to target dendritic cells and to induce peptide-specific CTLs. Here we investigated the adjuvant role of P40 mixed or chemically conjugated to ELA. This compound is an N-terminal glutamic acid-containing peptide. However, it has been reported that the amino group and the gamma-carboxylic group of glutamic acids easily condense to form pyroglutamic derivatives. Usually, to overcome this stability problem, peptides of pharmaceutical interest were developed with a pyroglutamic acid instead of N-terminal glutamic acid, without loss of pharmacological properties. Unfortunately, the pyroglutamic acid derivative (PyrELA) as well as the N-terminal acetyl capped derivative (AcELA) failed to elicit CTL activity when mixed with P40 adjuvant protein. Despite the apparent minor modifications introduced by PyrELA and AcELA, these two derivatives have probably lower affinity than ELA for the class I Major Histocompatibility Complex. Furthermore, this stability problem is worse in the case of clinical grade ELA, produced as an acetate salt, like most of the pharmaceutical grade peptides. We report here that the hydrochloride shows a higher stability than the acetate and may be suitable for use in man.

Influence of live respiratory syncytial virus priming on the immune response generated by a recombinant vaccine candidate, BBG2Na.

Respiratory syncytial virus is one of the major respiratory pathogens for infants and immunocompromized children. With the exception of young children, all the population has encountered RSV and is seropositive. Recent reports have demonstrated however that the virus also affects the elderly and represents a major cause of illness associated with an excess of morbidity and mortality. We have generated a recombinant RSV vaccine, BBG2Na, which is highly protective in rodents against RSV infection. The aim of this study was to evaluate the ability of the vaccine to increase anti-RSV protection in RSV-primed mice and to characterize the induced immune responses. Immunization with BBG2Na increased the anti-RSV-A serum antibody titers of RSV-primed mice with induction of both IgG1 and IgG2a antibodies attesting for a mixed Th response. Moreover, the level of the induced anti-G2Na antibodies was greater in seropositive mice. Finally, sera from RSV-primed mice displayed a higher protective efficacy after transfer into naive mice following subsequent immunization with BBG2Na than sera of mice immunized with RSV-A only. Our results demonstrate that BBG2Na is immunogenic and increases the protective efficacy of serum antibodies in RSV-primed mice; they support the possibility of performing clinical trials in the seropositive human population.

Influence of administration dose and route on the immunogenicity and protective efficacy of BBG2Na, a recombinant respiratory syncytial virus subunit vaccine candidate.

The immunogenicity and protective efficacy of BBG2Na, a novel recombinant respiratory syncytial virus subunit vaccine candidate, was assessed in BALB/c mice under various conditions of dose, administration route and number of immunisations. A single intra-peritoneal (i.p.) dose of 2 microg, or two doses of 0.2 microg, were sufficient to induce elevated RSV-A serum antibodies and sterilising lung protective immunity. Serum antibody titres were significantly boosted following second immunisations, but not a third. Of three routes of immunisation, i.p. induced the highest RSV-A antibody titres, followed in efficacy by the intra-muscular (i. m.) and subcutaneous (s.c.) routes. Nonetheless, all three routes induced comparable and sterilising lung protection. In contrast, upper respiratory tract protection was observed only after i.p. vaccination, although significant viral titre reductions were evident following i.m. or s.c. immunisations. Interestingly, Pepscan analyses indicated that antibody epitope usage was highest in i.p. and lowest in i.m. immunised mice, respectively. Nonetheless, all routes resulted in antibody responses to known lung protective epitopes (protectopes). Thus, the prevention of serious lower respiratory tract disease, the principle goal of a RSV vaccine, but not URT infection, is dose dependent but unlikely to be influenced by the route of BBG2Na administration.