Functional Consequences Research Articles

Experience of using robot-assisted (da Vinci) operations in the treatment of common endometriosis

Background. Currently, genital endometriosis is considered as one of the most severe conditions in women of reproductive age, which has detrimental consequences for social, professional and psychological functioning. It ranks third in the structure of gynecological diseases after inflammatory diseases of the female reproductive system and uterine fibroids. Because of this, it acquires a more pronounced social significance and ceases to be only a medical problem. Aim. To study the results of surgical treatment of patients with severe forms of genital endometriosis using the da Vinci surgical robotic complex.Materials and methods. A retrospective analysis of the treatment results of 51 patients operated on at the N.I. Pirogov National Medical and Surgical Center for the period from January 2015 to July 2024, who underwent robot-assisted (da Vinci) operations for deep endometriosis involving neighboring organs. The duration of surgery and hospital stay, the amount of blood loss, the frequency of intra- and postoperative complications, the clinical course of the disease in the long-term postoperative period, the frequency of detection of residual infiltration in the postoperative period, and the implementation of reproductive plans were analyzed.Results. The duration of the surgical intervention was 220.8 ± 21.87 minutes. The postoperative bed-day was 6.9 ± 1.5 bed days. The average blood loss was 160.2 ± 67.58 ml. There were no intraoperative complications. Postoperative complications accounted for 7.8 %. Residual infiltration occurred in 11.7 % of cases. 94.1 % of the patients had no clinical symptoms of endometriosis in the long-term postoperative period. The pregnancy rate was 31.9 %.Conclusion. Surgical treatment of deep endometriosis using da Vinci surgical robotic complex in the amount of radical removal of endometrioid infiltrate has a positive effect on both the clinical course of the disease and the reproductive potential of a woman. Real-time fluorescence navigation has demonstrated additional imaging capabilities in robotic surgery for deep endometriosis, potentially increasing the radicalism of surgical treatment of infiltrating endometriosis and may lead to a reduction in recurrence rates.

The challenge of toxic leadership in realising Sustainable Development Goals: A scoping review

Orientation: Best human resource management (HRM) practices can play a crucial role in addressing unethical leadership in the form of toxic leadership by fostering organisational cultures where trust, integrity, and accountability are prioritised.Research purpose: The paper addresses how the HRM function can contribute to eliminating toxic leadership and its associated norms and thereby meet the objectives of Sustainable Development Goals 8 and 16.Motivation for the study: The prevalence of toxic leadership and the extent of the detrimental consequences for employees and organisational functioning is a key challenge in realising SDGs 8 and 16.Research approach/design and method: To conduct the scoping review, the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed, and selected databases were searched for peer reviewed empirical articles between 2014 and 2024. Results were summarised and thematically categorised with regard to the objectives of the paper.Main findings: Ethical leadership behaviours are presented as a key mechanism for offsetting the impact of toxic behaviours of organisational leaders. In order to achieve SDGs 8 and 16, the support and commitment from HRM practitioners are essential.Practical/managerial implications: Promoting ethical leadership and a conducive work environment demands attention in the following five areas of HRM practice: recruitment and selection; training and development; performance management; employee engagement and wellbeing; and organisational culture.Contribution/value-add: The review of existing literature on toxic leadership offers a succinct summary of different mechanisms and strategies that can be employed to counter these forms of leadership behaviours in organisations.

Rove beetle species diversity and the patterns of interactions with their host plants in primary and secondary tropical forests

In tropical disturbed forests, it is relatively unknown the extent insect communities are experiencing shifts in species diversity and the consequences for ecosystem functions and services. In southern Mexico, we used the rove beetle community associated to Heliconia wagneriana bracts, as a model system, to investigate differences in community attributes and feeding habits between old-growth and human induced secondary forests. We tested if the beta diversity components of rove beetle communities were influenced by forest type and bract traits. Furthermore, we described the topology of individual-based heliconia-rove beetle ecological networks. Overall, we recorded 26 rove beetle species with significantly greater abundance in secondary forests. High compositional dissimilarity between forest types was observed with saprophagous species being more likely detected in old-growth forests; whereas predatory species in secondary forests. Heliconia-rove beetle networks showed a significant nested pattern with incidence data for old-growth forests and incidence and abundance data for secondary forests. Compared to old-growth forests, the rove beetle community in secondary forests showed strong shifts in species composition, diversity and differences in the detection probability of feeding habits, with consequences for ecosystem functioning. We further discuss these findings according to the forest disturbance and phytotelm systems. Implications for insect conservation: Individuals of H. wagneriana represent biodiversity reservoirs for invertebrates, especially in human-modified landscapes.

Increased Levels of Circulating Methylglyoxal Have No Consequence for Cerebral Microvascular Integrity and Cognitive Function in Young Healthy Mice.

Diabetes and other age-related diseases are associated with an increased risk of cognitive impairment, but the underlying mechanisms remain poorly understood. Methylglyoxal (MGO), a by-product of glycolysis and a major precursor in the formation of advanced glycation end-products (AGEs), is increased in individuals with diabetes and other age-related diseases and is associated with microvascular dysfunction. We now investigated whether increased levels of circulating MGO can lead to cerebral microvascular dysfunction, blood-brain barrier (BBB) dysfunction, and cognitive impairment. Mice were supplemented or not with 50mM MGO in drinking water for 13weeks. Plasma and cortical MGO and MGO-derived AGEs were measured with UPLC-MS/MS. Peripheral and cerebral microvascular integrity and inflammation were investigated. Cerebral blood flow and neurovascular coupling were investigated with laser speckle contrast imaging, and cognitive tests were performed. We found a 2-fold increase in plasma MGO and an increase in MGO-derived AGEs in plasma and cortex. Increased plasma MGO did not lead to cerebral microvascular dysfunction, inflammation, or cognitive decline. This study shows that increased concentrations of plasma MGO are not associated with cerebral microvascular dysfunction and cognitive impairment in healthy mice. Future research should focus on the role of endogenously formed MGO in cognitive impairment.

Eating Problems in Young Adults: The Role of Unbalanced Family Cohesion and Difficulties in Emotion Regulation

Strong emotional bonds with the family often result in many positive consequences for human functioning, including emotional regulation and eating patterns. The study aimed to determine the relationship between unbalanced family cohesion, emotion regulation, and eating problems in young adults. A correlation research design was used with a non-probability purposive sampling technique to recruit a sample consisting of 300 university students, 50% men and 50% women, with an age range from 18 to 25 years ( M = 21.60, SD = 1.95) from the four universities of Lahore. Demographic performa, Family Cohesion Scale (FCS), Difficulties in Emotion Regulation Scale (DERS), and Eating Problem Scale (EPS) were used to explore the study variables. Data was analyzed using SPSS 21. Pearson product-moment correlation indicated a significant positive relationship between unbalanced family cohesion, difficulties in emotion regulation, and eating problems. It also revealed that a positive relationship was found among unbalanced family cohesion, difficulties in emotion regulation, and eating problems in young adults. Mediation analysis shows that emotion regulation fully mediates the relationship between unbalanced family cohesion and eating problems in young adults. The findings will help students and family counselors identify risk factors of eating problems and its impact on their transition into marriage life. They will contribute to a deeper understanding of unbalanced family dynamics, difficulties in emotion regulation, and eating problems.

Diversity of Mycorrhizal Types Along Altitudinal Gradients in the Tropical Andes

ABSTRACTAimMycorrhizal fungi play key roles in the functioning of terrestrial ecosystems. The main types of mycorrhizal associations are arbuscular mycorrhizae, ectomycorrhizae, ericoid mycorrhizae and orchid mycorrhizae. Previous studies have shown that the abundance of plants with different types of mycorrhizal associations change gradually along latitudinal and altitudinal gradients driven by the effects of climate and soil nutrients. We aimed to understand how altitude and climatic and soil variables shape the distribution patterns of tropical plant mycorrhizal types and nitrogen‐fixing plants along altitudinal gradients in the Andes.LocationColombian Andean mountain range.Time PeriodPresent day.Major Taxa StudiedPlants (vascular and non‐vascular).MethodsWe used a herbarium plant records database and assigned mycorrhizal type to each plant species based on the available literature. Bioclimatic and soil variables were also compiled at a resolution of 10 km. We calculated the proportion of each mycorrhizal association type per grid cell and created a diversity index to explore their spatial distribution and association with abiotic factors based on LMs.ResultsThe diversity of mycorrhizal associations increased with altitude and peaked around 3000 m, in an ecotone belt known as the subpáramo recognised by the high abundance of Ericaceae species. Soil carbon stock and soil total nitrogen were also positively correlated with the diversity of mycorrhizal types. Moreover, the abundance of arbuscular mycorrhizal plants was highest at low elevations and increased with the proportion of nitrogen‐fixing plants per cell.Main ConclusionsOur results indicate that mycorrhizal associations gradually change along altitudinal gradients in the tropical Andes. Climatic factors and the interactions between climatic and edaphic factors have the greatest explanatory power to predict the distribution of types of mycorrhizal associations along the altitudinal gradient. Based on these results we expect that climate change could potentially alter the distribution of mycorrhizal types in tropical mountains with unknown consequences for ecosystem functions.

Narcissism and Problematic Social Media Use: A Moderated Mediation Analysis of Fear of Missing out and Trait Mindfulness in Youth

Social media use has increased worldwide, facilitating social relationships as well as the widespread exchange of information, images, and ideas. However, some individuals may develop a compulsive and unregulated engagement with social media platforms, known as problematic social media use (PSMU), which can result in adverse consequences for personal, social, and professional functioning. This scenario leads to considering which factors are implicated in PSMU and how they can affect the disposition toward PSMU. The present study aimed to explore the mediating role of fear of missing out (FoMO) in the association between both grandiose and vulnerable facets of narcissism and PSMU while also investigating the moderating effect of trait mindfulness. The research was conducted with 208 youth participants from 19 to 28 years old through an online cross-sectional design. Participants completed the Narcissistic Personality Inventory-13, the Hypersensitive Narcissism Scale, the Fear of Missing Out Scale, the Cognitive and Affective Mindfulness Scale-Revised, the Bergen Social Media Addiction Scale, and a short socio-demographic questionnaire. Results revealed that FoMO mediated the association between both facets of narcissism and PSMU, while trait mindfulness moderated the interplay between FoMO and PSMU, dampening the effect of FoMO. These findings provide theoretical insights into the main mechanisms underlying PSMU as well as promising practical implications for the development of mindfulness-based interventions aimed at mitigating PSMU. Limitations and future research directions are also discussed.

Effects of Climate, Soil, Topography and Disturbance on Liana Prevalence.

Lianas (woody vines and climbing monocots) are increasing in abundance in many tropical forests with uncertain consequences for forest functioning and recovery following disturbances. At a global scale, these increases are likely driven by disturbances and climate change. Yet, our understanding of the environmental variables that drive liana prevalence at regional scales is incomplete and geographically biased towards Latin America. To address this gap, we present a comprehensive study evaluating the combined effects of climate, soil, disturbance and topography on liana prevalence in the Australian Wet Tropics. We established 31 20 × 20 m vegetation plots along an elevation gradient in low disturbance (canopy closure ≥ 75%) and high disturbance (canopy closure ≤ 25%) forest stands. In these plots, all tree and liana (defined as all woody dicot vines and climbing monocots, i.e., rattans) stems ≥ 1 cm DBH were measured and environmental data were collected on climate, soil and topography. Generalised linear models were used with multi-model averaging to quantify the relative effects of the environmental variables on measures of liana prevalence (liana-tree basal area ratio, woody vine basal area and stem density and rattan stem density). Liana prevalence decreased with elevation but increased with disturbance and mean annual precipitation. The increase in the liana-tree ratio with precipitation was more pronounced for highly disturbed sites. Like other tropical regions, disturbance is an important driver of liana prevalence in Australian rainforests and appears to interact with climate to increase liana-tree ratios. The observed increase in liana-tree ratio with precipitation contrasts findings from elsewhere but is confounded by correlated changes in elevation and temperature, which highlights the importance of regional studies. Our findings show that forests with high disturbance and climatic conditions favourable to lianas are where lianas most likely to outcompete trees and impede forest recovery.

Significant Links Between Photosynthetic Capacity, Atmospheric CO2 and the Diversification of C3 Plants During the Last 80 Million Years.

Changing CO2 concentrations will continue to affect plant growth with consequences for ecosystem functioning. The adaptive capacity of C3 photosynthesis to changing CO2 concentrations is, however, insufficiently investigated so far. Here, we focused on the phylogenetic dynamics of maximum carboxylation rate (Vcmax) and maximum electron transport rate (Jmax)-two key determinants of photosynthetic capacity in C3 plants-and their relation to deep-time dynamics in species diversification, speciation and atmospheric CO2 concentrations during the last 80 million years. We observed positive relationships between photosynthetic capacity and species diversification as well as speciation rates. We furthermore observed a shift in the relationships between photosynthetic capacity, evolutionary dynamics and prehistoric CO2 fluctuations about 30 million years ago. From this, we deduce strong links between photosynthetic capacity and evolutionary dynamics in C3 plants. We furthermore conclude that low CO2 environments in prehistory might have changed adaptive processes within the C3 photosynthetic pathway.

Thyroid, neurodevelopmental, and kidney toxicities of common organic UV filters in embryo-larval zebrafish (Danio rerio), and their potential links

Organic UV filters (OUVFs) have been commonly used in sunscreen and many consumer products. Following dermal application, these compounds can enter circulation and may cause systemic effects in humans. In the present study, we chose four OUVFs frequently detected in the environment, i.e., avobenzone (AVB), benzophenone-3 (BP-3), octocrylene (OC), and octyl methoxycinnamate (OMC), and evaluated their thyroid, neurodevelopmental, and kidney toxicities. For this purpose, zebrafish embryos (<4 h post fertilization, hpf) were exposed to sublethal concentrations of AVB, BP-3, OC, or OMC until 120 hpf. Exposure to all OUVFs decreased thyroid hormone (TH) levels, probably by enhanced metabolism and excretion of THs (ugt1ab and/or sult1 st5) in the larval fish. Exposure to the OUVFs also induced hypoactivities and/or anxiety-like behaviors: Regulatory changes of mbp, gfap, c-fos, syn2a, sty1a, and stxbp1b genes, support the changes in normal neurobehavior of the larval fish. Moreover, the OUVFs exposure caused increased proteinuria in the fish, along with transcriptional changes of wt1, nephrin, podocin, and cdh17 genes, which could explain the observed reduction in kidney functions. Principal component analysis (PCA) implied the potential interplay of THs with neurogenesis, or podocyte differentiation of the larval fish. Toxicological consequences of altered TH homeostasis, neurobehavior, and kidney function at the early life stage warrant further investigations not only in humans but also in aquatic ecosystems.

Impact of naphthalene on soil fauna diversity: Consequences for ecosystem functioning and carbon cycling in grasslands

Soil fauna, key indicators of grassland ecosystem health, face significant threats from the vast amounts of chemical pollutants released by human activities. These organisms are crucial for fundamental processes such as litter decomposition and carbon cycling. However, the response of soil animal communities and their functional dynamics to environmental chemical stress remains poorly understood. To investigate this, we conducted a naphthalene addition and litterbag experiment in the Bashang Grassland, located on the southern Inner Mongolia Plateau, to analyze its effects on soil fauna and litter decomposition. The investigated soil fauna groups included Arachnida (Arachnids), Insecta (Insects), Collembola (Springtails), Enoplea (enopleans), and Chromadorea (chromadoreans). The litter composition included Leymus chinensis, Stipa krylovii, Artemisia, Saussurea amara, and Artemisia giraldii. The findings indicated that a high diversity of soil fauna enhanced the decomposition of litter and the release of organic carbon from the litter. While the addition of naphthalene decreased both the abundance of soil fauna and the rate of litter decomposition, it specifically increased the relative proportion of Collembola (Springtails). Microfauna and mesofauna (0.1–2.0 mm) contributed more to the loss of litter mass and the release of organic carbon from the litter than macrofauna (2.0–4.0 mm). The effects of diverse soil fauna on litter decomposition and soil organic carbon accumulation were diminished by naphthalene exposure. This study further reveals the relationship between composite soil fauna diversity, litter decomposition, and soil organic carbon under chemical stress, highlighting the threat of environmental pollution to ecosystem health. It also enriches our understanding of the complexity of grassland ecosystems, especially in response mechanisms under chemical pollution stress.

Fine-mapping genomic loci refines bipolar disorder risk genes.

Bipolar disorder (BD) is a heritable mental illness with complex etiology. While the largest published genome-wide association study identified 64 BD risk loci, the causal SNPs and genes within these loci remain unknown. We applied a suite of statistical and functional fine-mapping methods to these loci, and prioritized 17 likely causal SNPs for BD. We mapped these SNPs to genes, and investigated their likely functional consequences by integrating variant annotations, brain cell-type epigenomic annotations, brain quantitative trait loci, and results from rare variant exome sequencing in BD. Convergent lines of evidence supported the roles of genes involved in neurotransmission and neurodevelopment including SCN2A, TRANK1, DCLK3, INSYN2B, SYNE1, THSD7A, CACNA1B, TUBBP5, PLCB3, PRDX5, KCNK4, CRTC3, AP001453.3, TRPT1, FKBP2, DNAJC4, RASGRP1, FURIN, FES, DPH1, GSDMB, MED24 and THRA in BD. These represent promising candidates for functional experiments to understand biological mechanisms and therapeutic potential. Additionally, we demonstrated that fine-mapping effect sizes can improve performance of BD polygenic risk scores across diverse populations, and present a high-throughput fine-mapping pipeline (https://github.com/mkoromina/SAFFARI).

Fractional Hermite–Hadamard, Newton–Milne, and Convexity Involving Arithmetic–Geometric Mean-Type Inequalities in Hilbert and Mixed-Norm Morrey Spaces ℓq(·)(Mp(·),v(·)) with Variable Exponents

Function spaces play a crucial role in the study and application of mathematical inequalities. They provide a structured framework within which inequalities can be formulated, analyzed, and applied. They allow for the extension of inequalities from finite-dimensional spaces to infinite-dimensional contexts, which is crucial in mathematical analysis. In this note, we develop various new bounds and refinements of different well-known inequalities involving Hilbert spaces in a tensor framework as well as mixed Moore norm spaces with variable exponents. The article begins with Newton–Milne-type inequalities for differentiable convex mappings. Our next step is to take advantage of convexity involving arithmetic–geometric means and build various new bounds by utilizing self-adjoint operators of Hilbert spaces in tensorial frameworks for different types of generalized convex mappings. To obtain all these results, we use Riemann–Liouville fractional integrals and develop several new identities for these operator inequalities. Furthermore, we present some examples and consequences for transcendental functions. Moreover, we developed the Hermite–Hadamard inequality in a new and significant way by using mixed-norm Moore spaces with variable exponent functions that have not been developed previously with any other type of function space apart from classical Lebesgue space. Mathematical inequalities supporting tensor Hilbert spaces are rarely examined in the literature, so we believe that this work opens up a whole new avenue in mathematical inequality theory.

Strategies to Maintain Redox Homeostasis in Yeast Cells with Impaired Fermentation-Dependent NADPH Generation.

Redox homeostasis is the balance between oxidation and reduction reactions. Its maintenance depends on glutathione, including its reduced and oxidized form, GSH/GSSG, which is the main intracellular redox buffer, but also on the nicotinamide adenine dinucleotide phosphate, including its reduced and oxidized form, NADPH/NADP+. Under conditions that enable yeast cells to undergo fermentative metabolism, the main source of NADPH is the pentose phosphate pathway. The lack of enzymes responsible for the production of NADPH has a significant impact on yeast cells. However, cells may compensate in different ways for impairments in NADPH synthesis, and the choice of compensation strategy has several consequences for cell functioning. The present study of this issue was based on isogenic mutants: Δzwf1, Δgnd1, Δald6, and the wild strain, as well as a comprehensive panel of molecular analyses such as the level of gene expression, protein content, and enzyme activity. The obtained results indicate that yeast cells compensate for the lack of enzymes responsible for the production of cytosolic NADPH by changing the content of selected proteins and/or their enzymatic activity. In turn, the cellular strategy used to compensate for them may affect cellular efficiency, and thus, the ability to grow or sensitivity to environmental acidification.

Bounds of Different Integral Operators in Tensorial Hilbert and Variable Exponent Function Spaces

In dynamical systems, Hilbert spaces provide a useful framework for analyzing and solving problems because they are able to handle infinitely dimensional spaces. Many dynamical systems are described by linear operators acting on a Hilbert space. Understanding the spectrum, eigenvalues, and eigenvectors of these operators is crucial. Functional analysis typically involves the use of tensors to represent multilinear mappings between Hilbert spaces, which can result in inequality in tensor Hilbert spaces. In this paper, we study two types of function spaces and use convex and harmonic convex mappings to establish various operator inequalities and their bounds. In the first part of the article, we develop the operator Hermite–Hadamard and upper and lower bounds for weighted discrete Jensen-type inequalities in Hilbert spaces using some relational properties and arithmetic operations from the tensor analysis. Furthermore, we use the Riemann–Liouville fractional integral and develop several new identities which are used in operator Milne-type inequalities to develop several new bounds using different types of generalized mappings, including differentiable, quasi-convex, and convex mappings. Furthermore, some examples and consequences for logarithm and exponential functions are also provided. Furthermore, we provide an interesting example of a physics dynamical model for harmonic mean. Lastly, we develop Hermite–Hadamard inequality in variable exponent function spaces, specifically in mixed norm function space (lq(·)(Lp(·))). Moreover, it was developed using classical Lebesgue space (Lp) space, in which the exponent is constant. This inequality not only refines Jensen and triangular inequality in the norm sense, but we also impose specific conditions on exponent functions to show whether this inequality holds true or not.

Diminishing warming effects on plant phenology over time.

Plant phenology, the timing of recurrent biological events, shows key and complex response to climate warming, with consequences for ecosystem functions and services. A key challenge for predicting plant phenology under future climates is to determine whether the phenological changes will persist with more intensive and long-term warming. Here, we conducted a meta-analysis of 103 experimental warming studies around the globe to investigate the responses of four phenophases - leaf-out, first flowering, last flowering, and leaf coloring. We showed that warming advanced leaf-out and flowering but delayed leaf coloring across herbaceous and woody plants. As the magnitude of warming increased, the response of most plant phenophases gradually leveled off for herbaceous plants, while phenology responded in proportion to warming in woody plants. We also found that the experimental effects of warming on plant phenology diminished over time across all phenophases. Specifically, the rate of changes in first flowering for herbaceous species, as well as leaf-out and leaf coloring for woody species, decreased as the experimental duration extended. Together, these results suggest that the real-world impact of global warming on plant phenology will diminish over time as temperatures continue to increase.

Estimating biofilm activity on biofilter elements in recirculating aquaculture systems (RAS) for rearing Atlantic salmon parr (Salmo salar) during operation with ozone and peracetic acid

Chemical disinfection in a recirculating aquaculture system (RAS) may affect biofilm-associated bacteria and the nitrification performance in the biofilter units. The biofilm response to chemical disinfectants in RAS remains unclear, but it can be understood using methods to quantify biofilm activity. Here, we compared the effects of two disinfection strategies, continuous ozone at 0.06 mg/L Cl2 equivalent (Ozone group) and peracetic acid (PAA) at 1 mg/L (PAA group) to control group without disinfectant, on biofilm activity on biofilter elements from nine identical experimental RAS with Atlantic salmon parr (Salmo salar) during a four-week trial. Biofilm activities on biofilter elements from the three groups were examined by measuring oxygen consumption rates (OCR) following sequential spiking with pure tap water, and tap water spiked with nitrite or ammonium, as well as oxygen release rate (kor) following hydrogen peroxide (H2O2) addition, to estimate metabolic activities of biofilm related to endogenous respiration and substrate turnover. The results show that the applied PAA dose increased the endogenous respiration activity of biofilm by 39–133%, stimulated the rate of biofilm enzymatic decomposition of H2O2 by 135%, and partially impaired the biofilm metabolism for nitrite oxidation (decrease by 36%), resulting in a significant nitrite accumulation (rise by 59%) in the cultured water, compared to control over experimental period. Ozone treatment caused an enhanced endogenous respiration activity of biofilm at the beginning of the experiment (increase by 45–74%), but dropped to control levels at the end of the experiment. The results indicate that chronic exposure to PAA can alter the metabolic state of biofilm, which can have consequences for biofilter functions, while chronic exposure to ozone improved water clarity without compromising the metabolic status of biofilm. The investigations provided insights into biofilm response to chemical disinfectant in RAS, which would benefit the optimization of an effective and safe use of disinfectants in RAS.

Psychosocial Factors Associated With Long-Term Cognitive Impairment Among COVID-19 Survivors: A Cross-Sectional Study.

COVID-19 survivors complained of the experience of cognitive impairments, which also called "brain fog" even recovered. The study aimed to describe long-term cognitive change and determine psychosocial factors in COVID-19 survivors. A cross-sectional study was recruited 285 participants from February 2020 to April 2020 in 17 hospitals in Sichuan Province. Cognitive function, variables indicative of the virus infection itself, and psychosocial variables were collected by telephone interview. Univariate logistic regression and Lasso logistic regression models were used for variable selection which plugged into a multiple logistics model. Overall prevalence of moderate or severe cognitive impairment was 6.3%. Logistic regression showed that sex, religion, smoking status, occupation, self-perceived severity of illness, sleep quality, perceived mental distress after COVID-19, perceived discrimination from relatives and friends, and suffered abuse were associated with cognitive impairment. The long-term consequences of cognitive function are related to multiple domains, in which psychosocial factors should be taken into consideration.

Psychoeducation for Pathologic Narcissism and Narcissistic Personality Disorder: A Review and Proposal for a Good Psychiatric Management-based Six-week Group Program.

Pathologic narcissism (PN) and narcissistic personality disorder (NPD) are 2 common and stigmatized clinical constructs that are known to have large consequences for patients' functioning and mental health-related outcomes. To date, no treatment for these conditions has been empirically validated, but there is a relative consensus about the importance of psychoeducation. Here we present a model for a psychoeducational intervention for patients with PN or NPD. We start with a review of the current evidence on the role of psychoeducation in different treatment models for PN, and we discuss several aspects regarding the content and format of this type of intervention. Based on this review, we outline a 6-week Good Psychiatric Management-based psychoeducation group program that we developed. We also describe how such a psychoeducational intervention can be implemented individually, with fewer resources, in general care settings. Finally, we discuss the strengths and limitations of our approach and elaborate on the rationale for our proposal. We believe that this program proposal is a first step in the development of psychoeducational programs for PN and NPD that can be further corrected and enhanced.

Separation of Channels Subserving Approach and Avoidance/Escape at the Level of the Basal Ganglia and Related Brainstem Structures.

The basal ganglia have the key function of directing our behavior in the context of events from our environment and/or our internal state. This function relies on afferents targeting the main input structures of the basal ganglia, entering bids for action selection at the level of the striatum or signals for behavioral interruption at the level of the subthalamic nucleus, with behavioral reselection facilitated by dopamine signaling. Numerous experiments have studied action selection in relation to inputs from the cerebral cortex. However, less is known about the anatomical and functional link between the basal ganglia and the brainstem. In this review, we describe how brainstem structures also project to the main input structures of the basal ganglia, namely the striatum, the subthalamic nucleus and midbrain dopaminergic neurons, in the context of approach and avoidance (including escape from threat), two fundamental, mutually exclusive behavioral choices in an animal's repertoire in which the brainstem is strongly involved. We focus on three particularly well-described loci involved in approach and avoidance, namely the superior colliculus, the parabrachial nucleus and the periaqueductal grey nucleus. We consider what is known about how these structures are related to the basal ganglia, focusing on their projections toward the striatum, dopaminergic neurons and subthalamic nucleus, and explore the functional consequences of those interactions.