Acute Myocardial Injury Assessed by High-Sensitivity Cardiac Troponin I Levels in Adult Patients with Early Sepsis at a Tertiary Referral Center in Mexico: An Exploratory Study.

The objective of the study was to describe the frequency of acute myocardial injury (AMI) assessed by high-sensitivity cardiac troponin I (hs-cTnI) levels and to determine the possible initial risk factors (related to the characteristics of the patient, the disease, and the initial management) in a population of adult patients with early sepsis (within the first 72 h of diagnosis) in a single tertiary hospital center in western Mexico. For the inferential statistics, the proportions of the categorical dichotomous variables were compared using the chi-square test. In all analyses, p values less than 0.05 with a 95% confidence interval were considered significant. We included a total of 64 patients diagnosed with early sepsis, of whom 46 presented elevated hs-cTnI and were classified as having AMI. In our study, the frequency of AMI in patients with early sepsis was 71.87%, and no significant differences were found in all of the characteristics of patients with early sepsis with and without AMI, nor was any significant association found with any of the variables analyzed. In the population of western Mexico, the frequency of AMI in patients with early sepsis, assessed by hs-cTnI levels, is high and similar to that reported in other populations worldwide.

Clinical features associated with neurosyphilis in people living with HIV and late latent syphilis.

BACKGROUND: The diagnosis of neurosyphilis is a challenge, and the criteria for deciding when to perform a lumbar puncture are still controversial, especially in people living with HIV with a late latent syphilis diagnosis. METHODS: Retrospective analysis of demographic, clinical, and laboratory data of people with HIV and documented late latent syphilis or syphilis of unknown duration with a cerebrospinal fluid VDRL test. RESULTS: 122 patients were evaluated, of whom 52 had the diagnosis of neurosyphilis. Patients with and without neurosyphilis presented a similar viral load and lymphocyte CD4+ T-cell count. Neurological symptoms (OR 6.4, 95% CI 2.1-22.4; p < 0.01), serum VDRL titers of 1:32 (p<0.01), 1:64 (p = 0.055), and ≥1:128 (p < 0.001) were associated with neurosyphilis. Furthermore, serum VDRL ≥1:32 were associated with (OR 24.9, 95% CI 5.45-154.9; p < 0.001) or without (OR 6.5, 95% CI 2.0-29.2; p = 0.004) neurological symptoms with neurosyphilis; however, VDRL ≤1:16 with neurological symptoms can be associated with neurosyphilis (OR 7.6, 95% CI 1.03-64.3; p = 0.046). CONCLUSION: Neurological symptoms, particularly headache, were predictors of neurosyphilis in people with HIV irrespective of their viral load and lymphocyte CD4+ T-cell count in late latent syphilis. A serum VDRL ≥1:32 increased the risk of neurosyphilis in patients with or without any symptoms.

Threat cues and attentional bias in blood-injection-injury phobia and snake phobia / Señales de amenaza y sesgo atencional en la fobia a la sangre, inyecciones y heridas y en la fobia a las serpientes

The aim of this research was to study the effect of a cue signalling the upcoming of a phobic picture on the electrocortical activity provoked by the disorder-relevant stimulus in in blood-injection-injury (BII) phobia and snake phobia. A sample of 13 BII phobia participants, 12 snake phobia individuals and 14 non-phobic controls underwent an S1-S2 task, where S1 was a word that described the content of a subsequent picture (blood-related, snake and neutral) that appeared 2 seconds later (S2). We obtained the P200 and P300 ERP amplitudes provoked by the pictures. Our results reveal that P200 did not differentiate between picture contents in BII phobia while, in contrast, snake and blood-related pictures provoked the largest responses in snake phobia participants. Both blood-related and snake pictures provoked greater P300 amplitudes than neutral pictures in all the groups. Threat cues reduced the electrocortical reaction of the BII phobia participants, possibly by the elicitation of anticipatory or regulatory responses. These results are indicative of a low automatic, exogenous attention towards the feared stimuli in BII phobia, as revealed by P200, probably related to a lack of attentional bias to the phobic object.(AU)

El objetivo de esta investigación fue estudiar el efecto de una señal que indica la aparición de una imagen fóbica sobre la actividad electrocortical provocada por el estímulo fóbico en personas con fobia a la sangre, inyecciones y heridas (SIH) y en fóbicos a las serpientes. Una muestra de 13 participantes con fobia SIH, 12 con fobia a las serpientes y 14 controles no fóbicos se sometieron a una tarea S1-S2, donde S1 era una palabra que describía el contenido de una imagen posterior (relacionada con sangre, serpientes o neutra) que aparecía 2 segundos después (S2). Obtuvimos las amplitudes de los potenciales evocados P200 y P300 provocados por las imágenes. Nuestros resultados revelaronn que P200 no diferenciaba entre el contenido de las imágenes en la fobia SIH mientras que, por el contrario, las imágenes relacionadas con serpientes y con sangre provocaron las mayores respuestas en los participantes con fobia a las serpientes. Tanto las imágenes relacionadas con sangre como las relacionadas con serpientes provocaron amplitudes de P300 mayores que las imágenes neutras en todos los grupos. Las señales de amenaza redujeron la reacción electrocortical de los fóbicos SIH, posiblemente porque desencadenaron respuestas anticipatorias o reguladoras. Estos resultados indican una baja atención exógena hacia los estímulos temidos en la fobia SIH, como lo revela P200, probablemente relacionada con una pérdida del sesgo atencional hacia su objeto fóbico.(AU)

Silicon Nanoparticles Improve the Shelf Life and Antioxidant Status of Lilium.

The production of ornamentals is an economic activity of great interest, particularly the production of Lilium. This plant is very attractive for its color and shapes; however, the quality of its flower and its shelf life can decrease very fast. Therefore, it is of the utmost importance to develop techniques that allow for increasing both flower quality and shelf life. Nanotechnology has allowed for the use of various materials with unique characteristics. These materials can induce a series of positive responses in plants, among which the production of antioxidant compounds stands out. The objective of this study was to determine the impact of the application of silicone nanoparticles (SiO2 NPs) on the quality, shelf life, and antioxidant status of Lilium. For this, different concentrations of SiO2 NPs (0, 200, 400, 600, 800, and 1000 mg L-1) were applied in two ways, foliar and soil, as two independent experiments. The contents of enzymatic (superoxide dismutase, glutathione peroxidase, catalase, ascorbate peroxidase, and phenylalanine ammonia lyase) and non-enzymatic (phenols, flavonoids, and glutathione) antioxidant compounds, the mineral content, flower quality, and shelf life were analyzed. The results showed that the application of SiO2 NPs through the foliar method induced a greater flowers' shelf life (up to 21.62% more than the control); greater contents of Mg, P, and S (up to 25.6%, 69.1%, and 113.9%, respectively, compared to the control); more photosynthetic pigment (up to 65.17% of total chlorophyll); more glutathione peroxidase activity (up to 69.9%); more phenols (up to 25.93%); and greater antioxidant capacity as evaluated by the DPPH method (up to 5.18%). The use of SiO2 NPs in the production of Lilium is a good alternative method to increase flower quality and shelf life.

Does Social Content Influence the Subjective Evaluation of Affective Pictures?

This study explored the effect of the perceived social content of affective pictures on the subjective evaluation of affective valence and arousal. For this purpose, we established three categories of social content (pictures without people, with one person and with two or more people). A sample of 161 subjects rated 200 pictures varying in affective valence (unpleasant, neutral, and pleasant), arousal and social content. Results of two-factor analysis of variance, F(4, 157) = 71.7, p < .001, ηp2 = .31, showed that perceived social content influenced the ratings of affective valence, specially for unpleasant pictures, with the greatest social content (two or more people) leading subjects to rate unpleasant pictures with the lowest ratings (all pairwise comparisons' p < .001). Regarding arousal, F(4, 157) = 64.0, p < .001, ηp2 = .29), the higher the social content, the higher the arousal ratings, but only for pleasant (all pairwise comparisons' p < .007) and unpleasant (all pairwise comparisons' p < .001) pictures. Overall, this study demonstrated an effect of the perceived social content on the subjective evaluation of affective valence and arousal of emotional stimuli.

Does social content influence the subjective evaluation of affective pictures?

This study explored the effect of the perceived social content of affective pictures on the subjective evaluation of affective valence and arousal. For this purpose, we established three categories of social content (pictures without people, with one person and with two or more people). A sample of 161 subjects rated 200 pictures varying in affective valence (unpleasant, neutral, and pleasant), arousal and social content. Results of two-factor analysis of variance, F(4, 157) = 71.7, p < .001, ηp2 = .31, showed that perceived social content influenced the ratings of affective valence, specially for unpleasant pictures, with the greatest social content (two or more people) leading subjects to rate unpleasant pictures with the lowest ratings (all pairwise comparisons' p < .001). Regarding arousal, F(4, 157) = 64.0, p < .001, ηp2 = .29), the higher the social content, the higher the arousal ratings, but only for pleasant (all pairwise comparisons' p < .007) and unpleasant (all pairwise comparisons' p < .001) pictures. Overall, this study demonstrated an effect of the perceived social content on the subjective evaluation of affective valence and arousal of emotional stimuli

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Time Course of the Neural Activity Related to Behavioral Decision-Making as Revealed by Event-Related Potentials.

Objective: To study the time course of the electrocortical activity evoked by gains and losses in the Iowa Gambling Task (IGT), the brain sources of this electrical activity, and its association with behavioral parameters of task performance in order to achieve a better knowledge of decision-making processes. Method: Event-related potentials (ERPs) were obtained from a 64-channel EEG in 25 participants when performing the IGT. Brain source localization analyses of the ERP components were also assessed. Results: ERP amplitudes were sensitive to gains and losses. An early fronto-central negativity was elicited when feedback was provided for both gains and losses, and correlated with the number of gains at FCz and with the number of both gains and losses at Cz. The P200 component had larger amplitudes to losses and correlated positively with the number of losses. Feedback related negativity (FRN) was higher at frontal, temporal and occipital electrodes in trials with monetary losses. In addition, trials with monetary losses elicited larger P300 magnitudes than trials with monetary gains at all electrode localizations. Conclusions: All ERP components (except P300) were related to participants' performance in the IGT. Amplitudes of P200 and P300 were associated with the conscious recognition of the error during the decision-making. Performance data and source analysis underline the importance of the medial prefrontal cortex when processing feedback about monetary losses in the IGT.

Head Motion Elicited by Viewing Affective Pictures as Measured by a New LED-Based Technique.

The complex sensory input and motor reflexes that keep body posture and head position aligned are influenced by emotional reactions evoked by visual or auditory stimulation. Several theoretical approaches have emphasized the relevance of motor reactions in emotional response. Emotions are considered as a tendency or predisposition to act that depends on two motivational systems in the brain - the appetitive system, related to approach behaviours, and the defensive system, related to withdrawal or fight-or-flight behaviours. Few studies on emotion have been conducted employing kinematic methods, however. Motion analysis of the head may be a promising method for studying the impact of viewing affective pictures on emotional response. For this purpose, we presented unpleasant, neutral and pleasant affective pictures. Participants were instructed to view the pictures and to remain still. Two light-emitting diodes (LEDs) were attached to the foreheads of participants, and a Wii Remote controller, positioned 25 cm away, detected the position of the LEDs in the medial-lateral and anterior-posterior axes. We found more sway in response to unpleasant pictures. In addition, unpleasant pictures also provoked faster movements than both neutral and pleasant pictures. This response to unpleasant pictures, in contrast to pleasant ones, might reflect the readiness or predisposition to act. Our data also revealed that men moved faster than women, which is in accordance with previous findings related to gender differences.

Effects of social and affective content on exogenous attention as revealed by event-related potentials.

The social content of affective stimuli has been proposed as having an influence on cognitive processing and behaviour. This research was aimed, therefore, at studying whether automatic exogenous attention demanded by affective pictures was related to their social value. We hypothesised that affective social pictures would capture attention to a greater extent than non-social affective stimuli. For this purpose, we recorded event-related potentials in a sample of 24 participants engaged in a digit categorisation task. Distracters were affective pictures varying in social content, in addition to affective valence and arousal, which appeared in the background during the task. Our data revealed that pictures depicting high social content captured greater automatic attention than other pictures, as reflected by the greater amplitude and shorter latency of anterior P2, and anterior and posterior N2 components of the ERPs. In addition, social content also provoked greater allocation of processing resources as manifested by P3 amplitude, likely related to the high arousal they elicited. These results extend data from previous research by showing the relevance of the social value of the affective stimuli on automatic attentional processing.

Autonomic reactivity in blood-injection-injury and snake phobia.

OBJECTIVE: This research aimed to study the salivary flow and other autonomic reactions -heart rate (HR) and skin conductance response (SCR)- in blood-injection-injury (BII) phobia and snake phobia participants, under the assumption that exposure to blood-related pictures in BII phobia will provoke an increase in parasympathetic activity that, in turn, will lead to a greater saliva production than other affective contents. METHODS: We selected 18 BII phobia and 14 snake phobia participants along with 22 non-phobia individuals. All participants were exposed to 3 blocks of pictures (12 pictures per block) depicting either mutilations, snakes or neutral, household objects. Saliva samples were taken in the 2-min interval before and after each block. RESULTS: In comparison to other contents, blood-related pictures provoked an increase in salivary flow in BII phobia participants, as well as an increase in the number of SCRs. In the snake phobia group, snake pictures provoked HR acceleration, but the SCRs they elicited did not differ from the SCRs provoked by the blood-related pictures. CONCLUSION: BII phobia individuals react to their phobic object with a series of physiological changes resulting from a sympathetic-parasympathetic co-activation. This is in contrast with other specific phobias (e.g., small animal phobias) that usually show a sympathetically mediated, defensive reactivity when exposed to their disorder-relevant stimuli. These data support the use of therapeutic interventions in BII phobia that may differ in some respect from those used in other specific phobias.

Social stimuli increase physiological reactivity but not defensive responses.

Emotional reactions are crucial in survival because they provide approach and withdrawal behaviors. However, an unsolved question is whether the social content of the affective stimuli has a specific effect on emotional responses. We studied whether the social content of affective pictures influenced the defensive response and response mobilization. For this purpose, we recorded startle blink reflex (a defensive response) and skin conductance responses (a measure of unspecific physiological reactivity or arousal) in 73 participants while they viewed a series of 81 pictures of varying affective valence and social content. Our results revealed that defense response, as indicated by increases in the magnitude of the startle blink reflex, was mainly dependent on threatening or unpleasant cues, but was unrelated to the social content of the pictures. The social content, however, had an influence on pleasant stimuli, provoking an increase in resource mobilization, as reflected by changes in electrodermal activity. Hence, the social content of the affective stimuli may increase the physiological arousal elicited by pleasant stimuli, and it appears to be unrelated to the defense reactivity provoked by unpleasant stimuli.

Suboptimal decision making in borderline personality disorder: effect of potential losses

This research explored the underlying processes mediating risky decisions for individuals with Borderline Personality Disorder (BPD). We tested whether BPD patients were more apt to take risks compared to a matched comparison group. We used two controlled tasks designed to assess risky decision-making, both to achieve gains and to avoid losses. Overall, BPD patients showed increased risk-taking compared to the comparison group (p = .011, η2 = .224), and were especially likely to be risk-seeking when the decision was framed as a potential loss (p < .0001, d = 1.77). When the outcome involved pure losses, BPD patients were insensitive to the relative expected value between choice options resulting in suboptimal decision making (p = .004, d = 1.24), but did not differ from the comparison group when taking risks to achieve gains (p = .603, d = 0.21). We discuss these results in the context of behavioral and neuropsychiatric research suggesting abnormalities BPD patients’ ability to effectively regulate affect (AU)

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Suboptimal decision making in borderline personality disorder: effect of potential losses.

This research explored the underlying processes mediating risky decisions for individuals with Borderline Personality Disorder (BPD). We tested whether BPD patients were more apt to take risks compared to a matched comparison group. We used two controlled tasks designed to assess risky decision-making, both to achieve gains and to avoid losses. Overall, BPD patients showed increased risk-taking compared to the comparison group (p = .011, η2 = .224), and were especially likely to be risk-seeking when the decision was framed as a potential loss (p < .0001, d = 1.77). When the outcome involved pure losses, BPD patients were insensitive to the relative expected value between choice options resulting in suboptimal decision making (p = .004, d = 1.24), but did not differ from the comparison group when taking risks to achieve gains (p = .603, d = 0.21). We discuss these results in the context of behavioral and neuropsychiatric research suggesting abnormalities BPD patients' ability to effectively regulate affect.

Alterations of attention and emotional processing following childhood-onset damage to the prefrontal cortex.

The prefrontal cortex (PFC), especially the medial sector, plays a crucial role in emotional processing. Damage to this region results in impaired processing of emotional information, perhaps attributable to an inability to initiate and maintain attention toward emotional materials, a process that is normally automatic. Childhood onset damage to the PFC impairs emotional processing more than adult-onset PFC damage. The aim of this work was to study the involvement of the PFC in attention to emotional stimuli, and to explore how age at lesion onset affects this involvement. To address these issues, we studied both the emotional and attentional modulation of the startle reflex. Our sample was composed of 4 patients with childhood-onset PFC damage, 6 patients with adult-onset PFC damage, and 10 healthy comparison participants. Subjects viewed 54 affective pictures; acoustic startle probes were presented at 300 ms after picture onset in 18 pictures (as an index of attentional modulation) and at 3,800 ms after picture onset in 18 pictures (as an index of emotional modulation). Childhood-onset PFC patients did not show attentional or emotional modulation of the response, in contrast to adult-onset PFC damage and comparison participants. Early onset damage to the PFC results, therefore, in more severe dysfunction in the processing of affective stimuli than adult-onset PFC damage, perhaps reflecting limited plasticity in the neural systems that support these processes.

Salivary alpha-amylase changes promoted by sustained exposure to affective pictures.

We studied the changes in salivary alpha-amylase (sAA) and other psychophysiological indices (heart rate, skin conductance, and corrugator supercilii activity) elicited by sustained exposure to affective pictures. Thirty-nine subjects viewed five blocks of pictures depicting mutilations, human attack, neutral scenes, sport/adventure, and erotica. Each block comprised 12 pictures of the same content. Saliva samples were collected before and after each block of pictures. The results showed that mutilation pictures promoted the greatest increase in sAA activity and output, as well as greater corrugator supercilii activity than pleasant pictures. Skin conductance response did not differ among high arousal picture contents. Changes in sAA varied with the affective valence but not with the arousal ratings of the pictures. Our results point to sAA as an index directly related to the unpleasantness elicited by sustained exposure to affective stimuli.

Preattentive processing of feared stimuli in blood-injection-injury fearful subjects.

This research aimed to study the defence responses of blood-injection-injury (BII) fearful subjects elicited by the preattentive processing of their feared objects and by an abrupt acoustic stimulus. We selected 21 BII fearful subjects and 25 non-fearful controls from an initial sample of 128 women, according to their scores on the Fear Survey Scale (damage subscale) and the Mutilation Questionnaire. Subjects were exposed to a burst of white noise to promote a defence response, and to 48 pictures, depicting mutilations, as well as other affective contents, displayed through a backward masking procedure. Heart rate (HR), skin conductance response (SCR) and corrugator supercilii activity were continuously recorded throughout the task. Both groups showed similar SCRs, EMG activity and cardiac defence responses to the acoustic stimulus, though fearful subjects showed greater initial HR deceleration than controls. While BII fearful subjects displayed the usual defence response when exposed to a non-feared threatening stimulus, the preattentive processing of the pictures did not reveal autonomic differences between fearful subjects and controls. Mutilation pictures, however, evoked the greatest EMG activity, but only in the fearful group. These data further extend previous research on conscious perception of blood-related stimuli in BII fearful subjects, by showing a failure to recruit autonomic defence responses when blood-related pictures appear outside of conscious awareness.

Altered associative learning and emotional decision making in fibromyalgia.

OBJECTIVE: The present study examines the possibility that a chronic pain condition, such as fibromyalgia, was associated with deficits in decision making and associative learning. METHODS: Fifteen patients with fibromyalgia (aged 42-59 years) and 15 healthy controls (aged 39-61 years) participated in the experiment. Subjects completed anxiety (STAI) and depression (BDI) questionnaires, as well as standardized neuropsychological tests (Stroop and WAIS subscales). In addition, an emotional decision-making task (Iowa Gambling Task) and a conditional associative learning task (CALT) were administered to all participants. RESULTS: Results indicated that fibromyalgia had a poorer performance than healthy controls in both tasks, showing more perseveration errors in the learning task, and more disadvantageous decisions, as well as a more random behavior in the gambling task. Moreover, we observed that poor performance on the associative learning task was mediated by depression, whereas performance on the gambling task was not influenced by depression. No group differences were found on the standardized neuropsychological tests. CONCLUSION: These findings indicate that pain and depressive symptoms in fibromyalgia might lead to significant deficits in emotionally charged cognitive tasks. Furthermore, it suggests that chronic pain might impose a high cost on executive control, undermining mainly affective processes involved in learning, memory, attention, and decision-making.

Revisan los mecanismos cerebrales que intervienen en la toma de decisiones: [revisión] / A distributed brain system for decision making: [review]

Se revisa la investigación reciente sobre los mecanismos cerebrales de la toma de decisiones a partir de los trabajos que emplean la Iowa Gambling Task y tareas relacionadas, llevada a cabo en pacientes con lesión cerebral y en controles normales mediante neuroimágenes funcionales. Estos estudios muestran que la corteza prefrontal ventromedial y su sector orbital, especialmente en el hemisferio derecho, participan de forma crucial en la toma de decisiones. Sin embargo, las lesiones en la corteza prefrontal dorsolateral y en otras regiones cerebrales también la perjudican. Así, otras estructuras que desempeñan un papel relevante son la corteza cingulada anterior, relacionada con la anticipación y selección de la conducta a realizar; la corteza insular, asociada a la asignación de valor afectivo a las señales somáticas que forman parte de la anticipación de las consecuencias afectivas de las decisiones; la amígdala, que interviene en un sistema de alerta ante estímulos significativos, particularmente de carga afectiva negativa, y el estriado ventral, cuando se espera un estímulo reforzante. Así pues, puede hablarse de un sistema cerebral distribuido que interviene de forma dinámica en los procesos de toma de decisiones.

Revisan los mecanismos cerebrales que intervienen en la toma de decisiones: [revisión] / A distributed brain system for decision making: [review]

Se revisa la investigación reciente sobre los mecanismos cerebrales de la toma de decisiones a partir de los trabajos que emplean la Iowa Gambling Task y tareas relacionadas, llevada a cabo en pacientes con lesión cerebral y en controles normales mediante neuroimágenes funcionales. Estos estudios muestran que la corteza prefrontal ventromedial y su sector orbital, especialmente en el hemisferio derecho, participan de forma crucial en la toma de decisiones. Sin embargo, las lesiones en la corteza prefrontal dorsolateral y en otras regiones cerebrales también la perjudican. Así, otras estructuras que desempeñan un papel relevante son la corteza cingulada anterior, relacionada con la anticipación y selección de la conducta a realizar; la corteza insular, asociada a la asignación de valor afectivo a las señales somáticas que forman parte de la anticipación de las consecuencias afectivas de las decisiones; la amígdala, que interviene en un sistema de alerta ante estímulos significativos, particularmente de carga afectiva negativa, y el estriado ventral, cuando se espera un estímulo reforzante. Así pues, puede hablarse de un sistema cerebral distribuido que interviene de forma dinámica en los procesos de toma de decisiones.(AU)

Psychophysiological, behavioral, and cognitive indices of the emotional response: a factor-analytic study.

Previous research on the components of the emotional response employing factor analytic studies has yielded a two-factor structure (Lang, Greenwald, Bradley, & Hamm, 1993; Cuthbert, Schupp, Bradley, Birbaumer, & Lang, 2000). However, the startle blink reflex, a widely employed measure of the emotional response, has not been considered to date. We decided to include two parameters of the startle reflex (magnitude and latency) in order to explore further how this response fits into the two-factor model of emotion. We recorded the acoustic startle blink response, skin conductance response, heart rate, free viewing time, and picture valence and arousal ratings of 45 subjects while viewing 54 pictures from the International Affective Picture System (IAPS; 18 unpleasant, 18 neutral, and 18 pleasant). Factorizations of all measures gave a two-factor solution (valence and arousal) that accounted for 70% of the variance. Although some measurements, including heart rate change, did not behave as predicted, our results reinforce the two-dimension model of the emotion, and show that startle fits into the model.