bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clozapine in first episode psychosis – the experience of a Portuguese center
Authors: Soares Da Costa I. , Santos Martins F. , Silveira C. 
Published: August 2023

IntroductionAntipsychotics are the standard in the treatment of first psychotic episodes. Although the majority of patients respond to the established treatment, it is currently known that there is a subgroup of patients whose response is not satisfactory. In this group, the subsequent response to a new antipsychotic is generally poor. Clozapine is an antipsychotic with a unique profile, with demonstrated efficacy and approval in the treatment of treatment-resistant schizophrenia. Its role in the first psychotic episodes remains unclear and its use is, to say the least, controversial.ObjectivesThis work aims to analyze and evaluate the use of clozapine in patients with a first psychotic episode, taking into account the experience of a Portuguese Hospital Center.MethodsWe carried out a retrospective study, including all patients admitted to the inpatient clinic of adults with a first psychotic episode, in the Department of Psychiatry of Centro Hospitalar Universitário of São João, in Oporto, between 2007 and 2020. Clinical and socio-demographic data were collected.We performed a retrospective analysis of patients who, at discharge, were medicated with clozapine, proceeding to a descriptive analysis.ResultsIn this case series, we intended to describe the cases of patients in whom the use of clozapine in the first psychotic episode was initiated. All patients were discharged with the diagnosis of Schizophrenia. Prior to the introduction of clozapine, patients were treated with other antipsychotics, normally two. Patients taking clozapine were younger and had a longer duration of untreated psychosis. They had also longer length of hospital stay. The pattern of prescribing antipsychotics in the first and subsequent episodes has generally been extensively studied. However, the use of clozapine in the first episodes remains unclear.In the literature, and despite clozapine being considered one of the most effective antipsychotics, there is a high prevalence of polypharmacy and a significant delay in its use in the first episodes.Notwithstanding the unfavorable metabolic and hematological profile of clozapine, compared to other antipsychotics, in terms of hospitalization, mortality and discontinuation rates for all causes, it demonstrates a pattern of superiority.ConclusionsThe superiority in effectiveness of clozapine is well established, despite its underutilization and frequent delay in its introduction.The clinicians attitude remains a significant barrier to the commencement of clozapine, although it is important to define and characterize better potential groups of eligible patients. Education resources for clinicians as well as services specifically dedicated to early identification and management of eligible patients would be beneficial.Disclosure of InterestNone Declared
The suitability of zebrafish (danio rerio) as an optimal organism to further investigate the associated schizophrenia-like phenotype
Authors: Nita I. B. , Ilie O. D. , Ciobica A. S. , Hritcu L. D. , Solcan C. , Dobrin R. P. 
Published: August 2023

IntroductionZebrafish (Danio rerio) has evolved over the years as a preferred organism due to its vast repertoire in research fields that mimic a targeted phenotype, particularly behavioral typologies and specific attributes comparable to murine models and relatively high homology with humans. Considering this consideration, different pharmacological treatments have been tested and proven that under different concentrations may trigger schizophrenia (SCZ)-like symptoms.ObjectivesStarting from the actual stage of knowledge according to which agents used as N-methyl-D-aspartate (NMDA) inhibitors (MK-801, ketamine, and phencyclidine) alongside psychedelic (mescaline, lysergic acid diethylamide), psychoactive substances (amphetamine), and non- and essential amino acids (proline and methionine), we aimed to reunite and review all existing evidence. This approach may offer an updated and critical overview regarding the possible future directions surrounding these compounds regarding the pharmaco-dynamics/kinetics.MethodsTo ensure the coverage of all relevant literature, we performed searches in four databases (PubMed/Medline, ISI Web of Knowledge, Scopus, and ScienceDirect) per combinations of keywords: “schizophrenia” with “MK-801”, “ketamine”, “phencyclidine”, “mescaline”, “lysergic acid diethylamide”, “amphetamine”, “proline”, “methionine”, and “zebrafish”. Eligible studies had to be “research article(s)” written in English.ResultsA total of n = 246 studies were returned during the established interval (2010 – 2022). Precisely, n = 16 were identified in PubMed/Medline, n = 16 in ISI Web of Knowledge, n = 17 in Scopus, and n = 197 in ScienceDirect per database. If taken per year, n = 13 were published in 2010, n = 12 in 2011, n = 15 in 2012, n = 24 in 2013, n = 21 in 2014, n = 21 in 2015, n = 32 in 2016, n = 8 in 2017, n = 12 in 2018, n = 9 in 2019, n = 17 in 2020, n = 34 in 2021, and n = 28 in 2022. Depending on the combination of keywords, we had the following situation: n = 65 for “schizophrenia+MK-801+zebrafish”, n = 42 for “schizophrenia+ketamine+zebrafish”, n = 21 for “schizophrenia+phencyclidine+zebrafish”, n = 4 for “schizophrenia+mescaline+zebrafish”, n = 5 for “schizophrenia+lysergic acid diethylamide+zebrafish”, n = 36 for “schizophrenia+amphetamine+zebrafish”, n = 37 for “schizophrenia+proline+zebrafish”, n = 36 for “schizophrenia+ methionine+zebrafish”.ConclusionsThere can be seen an uprising trend in the current literature of studies focused on the administration of MK-801, ketamine, amphetamine, proline, methionine, and phencyclidine aiming to trigger SCZ-like symptoms as opposed to mescaline and lysergic acid diethylamide. Most of the data is contradicting, with either a decrease/increase in behavior (locomotion, aggression, sociability, circling behavior, and memory deficits), which is why additional studies are mandatory.Disclosure of InterestNone Declared
Sleep disorders in patients with a first psychotic episode: a case-control study
Authors: Abdellatif M. , Nefzi H. , Nasri J. , Methni M. , Rania K. , Karoui M. , Ellouze F. 
Published: August 2023

Introduction
Patients with chronic schizophrenia experience significant disturbances in the quality
and quantity of their sleep and it had been mainly attributed to severity of symptoms and
antipsychotic use. Recent studies suggested that antipsychotic-naïve early course patients
with schizophrenia and their non-psychotic first-degree relatives also show altered sleep
quality.

Objectives
In this study we aimed to compare sleep parameters in antipsychotic-naive
first-episode schizophrenia patients to their healthy siblings and age- and sex-matched
healthy controls.

Methods
We conducted a cross-sectional, descriptive case-control study in the Psychiatry « G »
department at Razi Hospital, for a period of six months. Our sample consisted of three
groups: a group of schizophrenic patients, a group of their healthy siblings and a group of
healthy controls. The three groups were matched by age and sex. The Positive and Negative
Syndrome Scale (PANSS) was used to assess the severity of symptoms in patients with
schizophrenia. The Morningness-Eveningness Questionnaire (MEQr), Epworth Sleepiness Scale
(ESS), and Pittsburgh Sleep Quality Index (PSQI) were used in the three groups to assess
Circadian preference, daytime sleepiness and sleep quality.

Results
There was no significant difference between the groups regarding the chronotype.
Patients had significantly higher daytime sleepiness compared to siblings (p=0.001) and
controls (p<0.001). Patients also had poorer quality sleep (PSQI total score) than
siblings (p<0.001) and controls (p<0.001), longer sleep latency than siblings (p=0.003)
and controls (p<0.001); lower habitual sleep efficiency than siblings (p=0.003) and
controls (p<0.001). Siblings had poorer sleep quality (p=0.001), longer sleep latency
(p=0.006) and shorter sleep duration (p=0.033) compared to control subjects.

Conclusions
Our results joined those of the literature concerning the significant prevalence of
sleep disorders in early psychosis. In addition, the alteration of sleep quality in
unaffected siblings compared to healthy controls supports the hypotheses suggested in the
literature that sleep disorders may be markers of genetic susceptibility to schizophrenia and
serve as a potential endophenotype of the disease.

Disclosure of Interest
None Declared
Google trend analysis and lockdown impact on mental health during the COVID-19 pandemic
Authors: Mastelić T. , Borovina Marasović T. , Kozina S. , Glavina T. 
Published: August 2023

IntroductionThe COVID-19 pandemic has affected the mental health of the world’s population in numerous ways. One of the methods are certainly lockdown measures. The countries of the European Union (EU) were affected by the pandemic in different ways, but their response was partly coordinated. Google trend analysis has so far proven to be a useful tool for monitoring the reactions of the population and the state of their mental health.ObjectivesThe aim of our research was to examine the impact of lockdown measures on the state of mental health through an internet search for terms related to mental health.MethodsWe observed three countries of the European Union in the period from February 1, 2020. until May 17, 2021. According to the average value of the CSI (covid stringency index), as an indicator of the strength of the lockdown measures, we chose Estonia, Belgium and Italy. CSI uses nine indicators (such as school closures, travel bans, …) to assess the strength of the lockdown. Italy is the country that, according to the average value of the CSI, had the strongest closure measures in the mentioned period (average CSI 69.19468). In Estonia, the measures were the mildest (CSI 42.87324895), and Belgium represents the average (CSI 57.6381). We observed to what extent, in the mentioned countries, changing the CSI, i.e. the strength of lockdown measures, correlates with the search for terms in the field of mental health. We used Google trends data for the terms: tension, anxiety, depression, insomnia, concern. We also compared Croatia with the mentioned countries.ResultsIn Estonia, there is no significant correlation between lockdown measures and searches for mental health terms. In Belgium, there is a correlation between CSI and searches for the term “anxiety” (r=0.31, p<0.01). In Italy, there is a correlation between CSI and searches for the terms “concern” (r=0.22, p=0.067 ), “tension” (r=0.33, p<0.01), “anxiety” (r=0.55, p<0.001). In Croatia, which is the 4th country with the weakest lockdown measures (CSI 46.90232), there is only a correlation between the strength of lockdown measures and searches for the term “tension” (r=0.27, p<0.05).ConclusionsIn countries with a higher CSI, i.e., stronger lockdown measures, there is a stronger correlation, i.e., a greater influence on the search for terms related to the state of mental health. We can assume that at some point the lockdown measures start to have a negative effect on the state of mental health.Disclosure of InterestNone Declared
Anxio-depressive disorders among healthcare workers in COVID-19 department
Authors: Fendri M. N. , Brahim D. , Youssef I. , Ayed W. , Mechergui N. , Ernez S. , Mersni M. , Ladhari N. 
Published: August 2023

IntroductionThe COVID pandemic has troubled the world and disrupted the professional and personal lives of healthcare workers, putting their mental health at risk.ObjectivesDetermine the prevalence of anxiety-depressive disorders among health personnel assigned to the COVID-19 circuit.MethodsCross-sectional study carried out on healthcare personnel assigned to departments dedicated to the care of patients hospitalized for a SARS-COV2 infection. The study took place between March and September 2021. Data collection was done from a pre-established sheet. Anxiety-depressive disorders were screened using the HAD scale.ResultsThe study included 140 health personnel. The sex ratio (M/W) was 0.62 with 54 men and 86 women. The mean age was 36.4±9 years. Nurses represented the largest professional category (64.6%). Professional seniority was 10 ± 9 years. Staff had been caring for patients with COVID for an average of 9 ±5 months. They worked an average of 4 days a week. The number of patients ranged from 1 to 55 per department. Psychiatric history was found in 29 participants, depression in 7% and anxiety in 2%. The workload was rated very hard at 42.1% and hard at 37.1%. Thirty percent of the population declared having received the moral support necessary to face the wave. The prevalence of anxiety and depression were 75.7% and 72.9% respectively. With 48.6% of patients presenting with definite anxiety and 27.1% with probable anxiety. Depression was certain in 40% of cases and doubtful in 32.9% of cases.ConclusionsAnxio-depressive disorders are common among healthcare staff assigned to the COVID circuit. Setting up listening cells with regular monitoring of these staff is very important to avoid psychologic impactDisclosure of InterestNone Declared
The EXPERIENCE system for the investigation of behavioral differences between depressed and healthy-control participants in Virtual Reality
Authors: Sutori S. , Todorov I. , Hadlaczky G. , Carli V. 
Published: August 2023

IntroductionThe EXPERIENCE project aims to enable the creation and sharing of extended-personal realities in virtual reality (VR). Currently, software and hardware technology are under development, that will automatically generate VR environments based on neurophysiological, psychological, cognitive, and behavioral data to support not only the recording of personal experiences but the transmission as well to another user. Potential use cases include enhanced treatment and the assessment of symptom severity of affective disorders.ObjectivesThe objective is to design and create a virtual reality environment that enables the identification of between-group differences in behavioral measures when comparing depressed and healthy-control participants.MethodsWe conducted a literature review to identify measures that can be implemented in VR and have the potential to show differences between depressed and healthy-control participants. PubMed and ResearchGate databases were screened to identify potential cognitive tasks. A selection protocol was developed considering effect size, homogeneity of results, risk for cybersickness, cognitive demand, domain heterogeneity, and VR compatibility to choose 4 out of the 47 initial tasks. In addition to the cognitive tasks, behavior measures were considered as well and a virtual environment has been equipped to assess (1) exploratory behavior; (2) engagement with emotionally valenced stimuli (via eye-tracking); (3) metacognitive sensitivity, (4) persistence/grit, and (5) possible effects of mood induction.ResultsBased on the above review, a virtual environment has been developed which is composed of four rooms and a hallway where the starting point is. After an initial tutorial on how the environment/controllers work participants are free to explore and instructions are only provided for the specific cognitive tasks which have to be solved to open the doors and move between rooms. The rooms are equipped with numerous interactive objects and images with varying emotional valence. The engagement with the environment and general activity are continuously recorded and can be retrieved for analyses after participants exit the environment.ConclusionsIf the controlled VR environment will be proven effective for the assessment of depressive symptoms in future studies, the EXPERIENCE system could incorporate direct and objective behavioral measures into the assessment depressive symptoms. Consequently, the system has the potential to support the clinical diagnosis of affective disorders.AcknowledgementThe EXPERIENCE project is funded by the European Commission H2020 Framework Program with the Grant No. 101017727.Disclosure of InterestNone Declared
Effectiveness of an e-health system on depression among patients with somatic disorders
Authors: Vitcheva T. , Hadlaczky G. , Petros N. G. , Carli V. 
Published: August 2023

IntroductionPatients with severe somatic conditions frequently develop depressive symptoms, with a reduction in quality of life, sleep disturbances and suicide as some of the most serious consequences. However, there is a lack of evidence-based interventions to reduce this comorbidity. The NEVERMIND system aims to address this issue by collecting biomedical and psychometric data through a smart shirt and questionnaires, which are used to predict patients’ depressive symptoms. Based on the predictions, patients are offered personalised feedback to self-manage their mental health symptoms in the form of lifestyle behavioural advice, mindfulness-based therapy, and cognitive behavioural therapy.ObjectivesThe primary objective was to assess the effectiveness of the NEVERMIND system in reducing depressive symptoms in patients with somatic conditions in comparison to treatment as usual. Some of the secondary objectives were to examine the NEVERMIND system’s effectiveness in preventing new depressive symptoms, sustaining the effects of the intervention at 24 weeks post-baseline, and reducing suicide ideation.MethodsFor this pragmatic randomised controlled trial, 425 patients diagnosed with myocardial infarction, breast or prostate cancer, kidney failure, or lower limb amputation were recruited from hospitals in Turin, Pisa and Lisbon. Data from clinical interviews and structured questionnaires was collected at baseline, 12 weeks, and 24 weeks. The primary outcome was depressive symptoms at week 12 as measured by the Beck Depression Inventory II (BDI-II), while secondary outcomes included prevention of depressive symptoms, suicide ideation, self-reported general interest, satisfaction with daily life, illness perception, self-compassion, and the sustainability of the system’s effect at 24 weeks post-baseline. The intention-to-treat analyses included all patients, while the per-protocol analyses included 333 patients.ResultsThe intervention group included 213 and the control group 212 patients, with the sample’s mean age being 59.41 (SD=10.70). Those who used the system had statistically significant lower depressive symptoms at 12 weeks (mean difference=-3.05, p=0.004; 95%CI -5.12 to -0.99) compared to controls, with a clinically relevant effect size (Cohen’s d=0.41). Notable significant reductions included suicide ideation (mean difference =-0.61, p=0.020; 95%CI -1.13 to -0.10) and incidence of depressive symptoms at week 12 (OR=0.43, p=0.019; 95%CI 0.22 to 0.87). The improvements in depressive symptoms were sustained at week 24 (mean difference =-1.34, p=0.015; 95%CI -2.41 to -0.26). No significant differences were observed for other secondary outcomes.ConclusionsThe NEVERMIND system was shown to be superior to standard care in reducing and preventing depressive symptoms among the studied sample.Disclosure of InterestNone Declared
Enhanced human periodontal ligament stem cell viability and osteogenic differentiation on two implant materials: An experimental in vitro study
Authors: El Shafei Sara F. , Raafat Shereen N. , Farag Engy A. 
Published: August 2023

Background: Surface roughness of dental implants impacts the survival of adult periodontal stem cells and rate of differentiation. This research was conducted to test how human periodontal ligament stem cells behaved on yttria stabilized tetragonal zirconia polycrystals and polyetheretherketone (PEEK) discs with different surface topographies. Methods: Discs roughening was prepared by sandblasting. Stem cells were cultivated on zirconia discs with a polished surface, PEEK discs with a polished surface, sandblasted zirconia discs and sandblasted PEEK discs. Cells viability was assessed after 24, 48, 72 hours. Scanning electron microscopy was used to examine the adherence and attachment of cells. Osteoblastic differentiation capacity was studied by checking the mineralization clusters development through alizarin red S staining and alkaline phosphatase assay. ANOVA and the Tukey post hoc test were used for the statistical analysis. Results: Polished PEEK discs showed lower cell viability, whereas roughened sandblasted zirconia and PEEK discs showed the highest proliferation rates and cell viability percent. The osteogenic differentiation was enhanced for rough surfaces in comparison to polished surfaces. Sandblasted zirconia and PEEK discs showed a markedly increased mineralized nodule development and ALP enzyme activity compared to the polished surface and control. Conclusions: Micro- topographies creation on the PEEK implant surface enhances stem cell attachment, viability, and osteogenic differentiation.
Can Technology Startups Hire Talented Early Employees? Ability, Preferences, and Employee First Job Choice
Authors: Roach Michael , Sauermann Henry 
Published: August 2023

Early stage technology startups rely critically on talented scientists and engineers to commercialize new technologies. And yet these startups compete with established technology firms to hire the best workers. Theories of ability sorting predict that high-ability workers will choose jobs in established firms that offer greater complementary assets and higher pay, leaving low-ability workers to take lower paying and riskier jobs in startups. We propose an alternative view in which heterogeneity in both worker ability and preferences enable startups to hire talented workers who have a taste for a startup work environment even at lower pay. Using a longitudinal survey that follows 2,394 science and engineering PhDs from graduate school into their first industrial employment, we overcome common empirical challenges by observing ability and stated preferences prior to entry into the labor market. We find that both ability and career preferences strongly predict startup employment with high-ability workers who prefer startup employment being the most likely to work in a startup. We show that this partly reflects dual selection effects whereby worker preferences result in a large pool of startup job applicants and startups make job offers to the most talented workers. Additional analyses confirm that startup employees earn approximately 17% lower pay. This gap is greatest for high-ability workers and persists over workers’ early careers, suggesting that they accept a negative compensating differential in exchange for the nonpecuniary benefits of startup employment. Data on job attributes and stated reasons for job choice further support this interpretation. This paper was accepted by Toby Stuart, entrepreneurship and innovation. Funding: This work was supported by the National Science Foundation SciSIP Award [Grant 1262270] and the Ewing Marion Kauffman Foundation (Junior Faculty Fellowship). Supplemental Material: The online appendix and data are available at https://doi.org/10.1287/mnsc.2023.4868 .