DERSR-B. A Brief Scale for Detection of Emotional Dysregulation Risk / DERSR-B. Una Escala Breve para la Detección del Riesgo de Desregulación Emocional

Abstract Emotional dysregulation (ED) is related to problems in understanding, perceiving, and regulating emotions. The aim is to find the psychometric properties of an instrument that measures ED and classifies the high/low ED group membership with the least possible error. For statistical purposes (factor analysis), two independent samples of males and females (n1 = 476) and (n2 = 562) were obtained, with ages sample 1 (15 -19 years; M= 15.8; SD=0.71) and sample 2 (15-19 years; M=15.6; SD= 0.69). Three factors were formed by sex, males with 14 items and females with 13 items, each loading on a single factor (total α=0.71 - 0.78 ɷ =0.67- 0.79 females; α= 0.70 - 0.79 ɷ=0.73 - 0.75 males) and good fit indices. In sum, a validated cut version instrument (DERSR-B), a risk screening instrument, was obtained.

Resumen La desregulación emocional (DE) se relaciona con problemas para comprender, percibir y regular las emociones. Determinar las propiedades psicométricas de un instrumento que mide DE y que clasifica con el menor error posible la pertenencia de grupo alto/bajo de DE se propuso como el objetivo de este estudio. Para propósitos estadísticos (análisis factoriales) se obtuvieron dos muestras independientes de hombres y mujeres (n1 = 476) y (n2 = 562) respectivamente, con edades para muestra 1 (15-19 años; M= 15.8; DE= 0.71) y muestra 2 (15-19 años; M=15.6; DE= 0.69). Se obtuvieron tres factores por sexo, hombres con 14 ítems y mujeres con 13 ítems cada uno cargando en un solo, un único factor (total α =0.71 - 0.78 ɷ =0.67- 0.79 mujeres; α=0.70 - 0.79 ɷ=0.73-0.75 hombres) y con índices de ajuste aceptables. Se obtuvo un instrumento válido en versión corta de detección rápida de riesgo de Desregulación Emocional (DERSR-B).

Enfermedades autoinmunes asociadas a inmunodeficiencias primarias / Autoimmune diseases associated with primary immunodeficiencies

Introducción: Las enfermedades y manifestaciones autoinmunes ocupan el segundo lugar de las enfermedades por inmunodeficiencia primaria, después de las infecciones. Objetivo: Determinar el comportamiento de las enfermedades autoinmunes en los pacientes con inmunodeficiencias primarias. Métodos: Se realizó estudio de caso control en el servicio de Alergia e Inmunología de Bayamo, Granma entre los años 2013 y 2022. El grupo de estudio fue de 38 pacientes con diagnóstico de inmunodeficiencia primaria y el grupo control de 76 pacientes sin compromiso del sistema inmune. Se empleó el programa estadístico SPSS 25, las frecuencias absolutas y relativas, odds ratio y Chi cuadrado. Resultados: Las manifestaciones sugerentes de autoinmunidad en los pacientes con inmunodeficiencias primarias fue 39,47 % y en los controles 3,95 %, OR = 15,869 y p= 0,000. Las más frecuentes fueron: dolor monoarticular en 6 pacientes (33,33 %); poliartralgia, dermatitis y alopecia en 3 casos (16,67 %) cada uno; dolor en la columna vertebral y nódulos subcutáneos, un paciente (5,56 %) cada uno. Las enfermedades autoinmunes asociadas a inmunodeficiencias primarias fueron: enfermedad celiaca (30,71 %), vitíligo (23,07 %), fibromialgia (15,38 %), eritema nodoso, la gastritis eosinofílica, anemia perniciosa y vasculitis con 7,69 % cada uno. Conclusiones: Las manifestaciones y enfermedades autoinmunes prevalecieron en pacientes con inmunodeficiencias primarias; en ambos casos fueron más frecuentes en los pacientes mayores de 18 años de edad. Las inmunodeficiencias más frecuentemente asociadas a los trastornos autoinmunes fueron las deficiencias predominantemente de anticuerpos y los defectos desregulatorios.

Introduction: Autoimmune diseases are in second place, after infections to suspect primary immunodeficiency diseases. Objective: To determine the behavior of autoimmune diseases in patients with primary immunodeficiencies. Methods: A case control study was carried out in the allergy and immunology service of Bayamo, Granma between 2013 and 2022. The universe was studied as a whole, the study group with 38 patients diagnosed with primary immunodeficiency and the control group with 76 patients without immune system compromise. The SPSS 25 statistical program, absolute and relative frequencies, odds ratio and chi-square were used. Results: The manifestations suggestive of autoimmunity in patients with PID was 39.47% and in controls 3.95%, OR = 15.869 and p = 0.000 and the most frequent were: monoarticular pain in 6 patients (33.33%), polyarthralgia, dermatitis and alopecia with 3 cases (16.67%) each one, pain in dorsal spine and subcutaneous nodule, one patient (5.56%) each one. Immune diseases associated with PID were: celiac disease (30.71%), vitiligo (23.07%), fibromyalgia (15.38%), erythema nodosum, eosinophilic gastritis, pernicious anemia and vasculitis with 7.69% each. Conclusions: Autoimmune manifestations and diseases prevailed in patients with PID, in both cases were more frequent in patients older than 18 years. The immunodeficiencies most frequently associated with autoimmune disorders were those of antibodies and those with some dysregulation component.

A brazilian nationwide multicenter study on deficiency of deaminase-2 (DADA2)

Abstract Introduction The deficiency of ADA2 (DADA2) is a rare autoinflammatory disease provoked by mutations in the ADA2 gene inherited in a recessive fashion. Up to this moment there is no consensus for the treatment of DADA2 and anti-TNF is the therapy of choice for chronic management whereas bone marrow transplantation is considered for refractory or severe phenotypes. Data from Brazil is scarce and this multicentric study reports 18 patients with DADA2 from Brazil. Patients and methods This is a multicentric study proposed by the Center for Rare and Immunological Disorders of the Hospital 9 de Julho - DASA, São Paulo - Brazil. Patients of any age with a confirmed diagnosis of DADA2 were eligible for this project and data on clinical, laboratory, genetics and treatment were collected. Results Eighteen patients from 10 different centers are reported here. All patients had disease onset at the pediatric age (median of 5 years) and most of them from the state of São Paulo. Vasculopathy with recurrent stroke was the most common phenotype but atypical phenotypes compatible with ALPS-like and Common Variable Immunodeficiency (CVID) was also found. All patients carried pathogenic mutations in the ADA2 gene. Acute management of vasculitis was not satisfactory with steroids in many patients and all those who used anti-TNF had favorable responses. Conclusion The low number of patients diagnosed with DADA2 in Brazil reinforces the need for disease awareness for this condition. Moreover, the absence of guidelines for diagnosis and management is also necessary (t).

Emotional eating in women with generalized anxiety disorder

Abstract Introduction Individuals diagnosed with generalized anxiety disorder (GAD) seek pleasurable foods to avoid their negative emotional experiences. Ineffective regulation of negative emotions may be a risk factor for emotional eating (EE), leading to suffering, dysfunctional behaviors, and weight gain. Objectives The aim of this study is to understand the relationship between emotional dysregulation and EE, investigating potential mediators such as the intensity of the worry, avoidance of internal experiences, mindfulness, and self-compassion in female patients with anxiety. Methods In this cross-sectional study, participants from a randomized clinical trial diagnosed with GAD answered the following instruments at baseline: the Difficulties in Emotion Regulation Scale (DERS), the Three Factor Eating Questionnaire (TFEQ-R21), the Penn State Worry Questionnaire (PSWQ), the Action and Acceptance Questionnaire (AAQ), the Five Facet Mindfulness Questionnaire (FFMQ), and the Self-Compassion Scale (SCS). We estimated Pearson correlation coefficients and performed mediation analyses. Results We evaluated 51 female individuals, 34 of whom completed all the questionnaires. Our data showed that EE was positively correlated with emotional dysregulation (r = 0.593; p < 0.001), worry trait (r = 0.402; p = 0.018), and avoidance of internal experiences (r = 0.565; p < 0.001), whereas it was negatively correlated with self-compassion (r = -0.590; p < 0.001) and mindful state (r = -0.383; p = 0.026). Moreover, we demonstrated that self-compassion mediates the relationship between emotional dysregulation and EE (ab product estimate = 0.043, 95% confidence interval [95%CI] 0.003-0.084). Conclusion Our findings contribute to the literature by identifying psychological factors that could mediate the association between emotional dysregulation and EE, enabling identification of more effective eating behavior intervention targets for patients with GAD.

Desregulación emocional y nivel de riesgo por consumo de sustancias psicoactivas en universitarios colombianos / Emotional dysregulation and risk level for consumption of psychoactive substances in Colombian university students

Resumen El consumo de sustancias psicoactivas [SPA] es un problema de salud pública, y constituye uno de los principales factores de riesgo para la salud. Se ha observado que el consumo de SPA está mediado por diferentes variables, una de ellas es la desregulación emocional, y se requiere mayor investigación del comportamiento de esta variable y su relación con los niveles de riesgo asociado al consumo. El objetivo del presente estudio fue determinar si existen diferencias en la desregulación emocional según el nivel de riesgo asociado al consumo de sustancias en una muestra de universitarios. Para tal efecto se adelantó un estudio descriptivo por comparación de grupos con una muestra de 721 estudiantes. Los resultados indicaron altas prevalencias de consumo de SPA; diferencias en los puntajes de desregulación emocional según el nivel de riesgo para tranquilizantes y cocaína, y que, a nivel general, aquellos universitarios con menor nivel de riesgo son quienes presentan menores puntajes de desregulación emocional, lo que sugiere que la desregulación emocional es una variable predictora de un mayor nivel de riesgo asociado al consumo de SPA.

Abstract The use of psychoactive substances is a public health problem, and it is one of the main health risk factors. It has been observed that the use of drugs is mediated by different variables, one of them is the emotional dysregulation, and more research is required on the behavior of this variable and its relationship with the levels of risk in the consumption. The aim of this study was to determine whether there are differences in emotional dysregulation according to the level of risk associated with substance use in a sample of 721 university students. For this purpose, a descriptive study was carried out by comparing groups. The results indicated high prevalence of PAS consumption, differences in emotional dysregulation scores according to the risk level for tranquilizer pills and cocaine. In general, the students with a lower risk level are those who present lower emotional dysregulation scores, suggesting that emotional dysregulation is a predictor variable of a higher level of risk associated with PAS consumption.

Análisis factorial confirmatorio de la Escala de Dificultades en la Regulación Emocional Estado en una muestra argentina / Confirmatory Factor Analysis of State Difficulties in Emotion Regulation Scale in an Argentine Sample

Resumen La desregulación emocional es un constructo multidimensional determinado por formas poco adaptativas de responder frente a las emociones. Las personas adultas emergentes (i.e., entre 18 y 25/30 años de edad), particularmente universitarias, son vulnerables a involucrarse en comportamientos riesgosos en contextos emocionales. La Escala de Dificultades en la Regulación Emocional Estado (S-DERS) resulta adecuada para medir dimensiones de desregulación emocional momentánea en esta población; sin embargo, no se conocen estudios confirmatorios de su estructura factorial ni estudios de adaptación al idioma español. El objetivo del presente estudio fue examinar las propiedades psicométricas de la S-DERS. Se evaluaron 178 adultos emergentes universitarios argentinos (18-28 años; 53.9% mujeres; Medad= 22.03; DE ±2.06). Se analizó la estructura y la consistencia interna del modelo original (S-DERS; cuatro factores: aceptación, conciencia, claridad y modulación) y un modelo alternativo (S-DERS-R; 3 factores) sin el factor claridad. Ambos modelos presentaron un ajuste satisfactorio de su estructura factorial y valores aceptables de consistencia interna, a excepción de la subescala claridad. Mayormente, para las subescalas aceptación y modulación y puntajes totales de ambos modelos, se obtuvieron evidencias de validez convergente con dos escalas de desregulación emocional rasgo concurrente con una escala de afecto positivo y negativo y predictiva con una medida de activación emocional. Los resultados muestran propiedades psicométricas adecuadas. S-DERS-R, que prescinde del factor claridad, mejora el ajuste y mantiene valores de consistencia interna aceptables respecto a S-DERS. Se espera que este instrumento sea útil en estudios transversales y longitudinales de la desregulación emocional estado en universitarios.

Abstract: Emotion dysregulation is a multidimensional construct determined by maladaptive ways of responding to emotions. Emerging adults (i.e., aged from 18 to 25/30), particularly college students, are vulnerable to involvement in risky behaviors under emotions. The State Difficulties in Emotion Regulation Scale (S-DERS) became suitable to measure facets of momentary emotion dysregulation in this population; however, there are no confirmatory studies or studies of adaptation to the Spanish language. The aim of this study was to examine psychometric properties of S-DERS. A sample of 178 Argentine emerging college-age adults was evaluated (18-28 years old; 53.9% women; Mage= 22.03; DE ± 2.06). Internal structure and consistency of the original model (i.e., S-DERS; four factors: Nonacceptance, Awareness, Clarity, Modulation) and an alternative model without Clarity (i.e., S-DERS-R; three factors) was analyzed. Both models presented a factor structure with satisfactory fit and acceptable values of internal consistency, with the exception of the Clarity subscale. Mainly to Nonacceptance and Modulation subscales, we observed evidence of convergent validity with two-trait emotion dysregulation scales, concurrent validity with a positive and negative affect scale, and predictive validity with an emotion arousal measure. Results show suitable sychometric properties. The S-DERS-R model (i.e., without Clarity factor) improves the model fit and maintains acceptable internal consistency values with respect to the S-DERS model. This instrument is expected to be useful in cross-sectional and longitudinal studies of state emotion dysregulation in college students.

Clinical and Genetic Spectrum of Inborn Errors of Immunity in a Tertiary Care Center in Southern India

Objectives To study the incidence, clinical manifestations, and genetic spectrum of primary immunodefciency diseases (PID)/inborn errors of immunity (IEI) in a tertiary care hospital in Southern India. Methods A retrospective analysis of all patients with a clinical suspicion of PID/IEI seen at a tertiary care hospital was performed. All patients had at least one or more warning signs of PID. Serum immunoglobulin levels and other targeted investigations were performed as warranted by the clinical presentation. All families with suspected PID were counseled and ofered genetic testing. Results A total of 225 children were evaluated for PID during the study period of 6 y. Fifty-six of them did not meet the European Society of Immunodefciencies (ESID) criteria (working defnition of clinical diagnosis) and were excluded. An IEI was found in 30/49 (61.2%) patients. The most frequent reason for referral was recurrent/unusual or serious infections (28%), or cytopenia (16%). Group IV diseases of immune dysregulation was the most common category (19%), followed by group III predominant antibody defciencies in 23/163 (14%), as per the International Union of Immunological Societies (IUIS) classifcation. Conclusions This study highlights the heterogeneity of the present cohort, the underuse of genetic tests, and eforts to provide optimal care for children with possible IEI in this center.

The effect of ribophagy on lipopolysaccharide-induced apoptosis of dendritic cells / 中华急诊医学杂志

Objective:To investigate the role and significance of NUFIP-1-mediated ribophagy in apoptosis of dendritic cells (DCs) stimulated by lipopolysaccharide (LPS).Methods:Cultured mouse dendritic cell line DC2.4 were divided into the blank control group and LPS stimulation groups for 6, 12, 24, 48 and 72 h ( n=5). LPS subgroups were consistently cultured with 1 μg/mL LPS for the corresponding incubation time. Western blot was adopted to detect the expression levels of NUFIP-1 and autophagy-related proteins p62 and LC3B across groups. Laser scanning confocal microscopy (LSCM) was applied to detect the expression and cellular localization of NUFIP-1, with its co-localization with Lyso-tracker and LC3B, respectively. The silencing blank vector NS and silencing virus vector NUFIP-1 siRNA were transferred into DC2.4 ( n=3) and stimulated with 1 μg/mL LPS for 24 h. The apoptosis of DC2.4 was measured by flow cytometry analysis. The expression levels of apoptosis-related proteins were determined using Western blot, including cleaved caspase-3 and Bcl-2. One-way analysis of variance (ANOVA) was applied for comparison among multiple groups, and LSD-t method was used for subsequent pairwise comparison. A P<0.05 was considered statistically significant. Results:The results of Western blot showed that expression level of NUFIP-1 in DC2.4 revealed a trend of first increasing and subsequent decreasing upon LPS stimulation for different times (6, 12, 24, 48 and 72 h), and the expression level of NUFIP-1 in the LPS 24 h group was significantly higher than that in the blank control group [blank control group: (0.6786 ± 0.0820); LPS 24 h group: (1.4830 ± 0.1170); P<0.01]. Meanwhile, p62 expression in the LPS 24 h group was significantly lower than that in the blank control group [blank control group: (0.9087 ± 0.1235); LPS 24 h group: (0.3113 ± 0.5571); P<0.01]. Moreover, the conversion from LC3B-I to LC3B-II in the LPS 24 h group was significantly higher than that in the blank control group [blank control group: (0.5542 ± 0.1248); LPS 24 h group: (2.5310 ± 0.3119); P<0.01]. LSCM indicated that NUFIP-1 was predominantly located in the nucleus and perinuclear area in DC2.4. The fluorescence intensity of NUFIP-1 increased in a time-dependent manner from 6 h to 24 h after LPS stimulation, whereas a significant reduction could be observed at 48 h and 72 h after LPS stimulation. Meanwhile, the co-localization of NUFIP-1 with Lyso-tracker and LC3B was substantially reinforced in comparison with the blank control group. Transfection of NUFIP-1 siRNA through lentivirus transfection technology significantly down-regulated the expression level of NUFIP-1 in DC2.4, with statistical differences compared with the blank control group and empty vector group [blank control group: (0.6627 ± 0.1707); empty vector group: (0.6966 ± 0.1107); siRNA group: (0.1428 ± 0.0296); P<0.05]. Flow cytometry analysis revealed that the apoptotic rate of LPS-stimulated DC2.4 was significantly higher in the NUFIP-1 siRNA transfection group than that in the blank control group and empty vector group [blank control LPS 24 h group: (47.91% ± 1.006%); empty vector LPS 24 h group: (70.26% ± 1.011%); siRNA LPS 24 h group: (80.23% ± 2.094); P<0.01]. Western blot analysis of apoptosis-related protein further confirmed that the expression level of cleaved caspase-3 was significantly elevated in the NUFIP-1 siRNA transfection group compared to those of the blank control group and empty vector group under LPS challenge [blank control LPS 24 h group: (0.4748 ± 0.0876); empty vector LPS 24 h group: (0.2849 ± 0.0418); siRNA LPS 24 h group: (0.9733 ± 0.0525); P<0.01]. Likewise, expression of Bcl-2, an anti-apoptotic protein was significantly down-regulated in the siRNA LPS 24 h group [blank control LPS 24 h group: (0.7810 ± 0.0490); empty vector LPS 24 h group: (0.8292 ± 0.0729); siRNA LPS 24 h group: (0.3957 ± 0.0838); P<0.05]. Conclusions:NUFIP-1-mediated ribophagy is significantly activated in DC2.4 upon LPS stimulation, exerting an underlying protective effect on apoptosis.

Progress in differentiation regulation and subpopulation typing of exhausted CD8 + T cells / 中华微生物学和免疫学杂志

Exhausted CD8 + T cells (CD8 + Tex) are a distinct subpopulation formed from naive CD8 + T cells under conditions of sustained high antigen stimulation. Initially, naive CD8 + T cells can differentiate into functional cytotoxic cells and exert anti-infective and anti-tumor effects upon short-term antigen stimulation. However, sustained high antigen stimulation will make effector CD8 + T cells progressively differentiate into terminally CD8 + Tex cells and irreversibly lose effector function. Unlike memory and effector T cells, CD8 + Tex cells have a unique transcriptional program. Numerous studies are attempting to map a detailed differentiation landscape of CD8 + Tex cell subsets, aiming to maximize the number of effector T cells in the future by targeting individual subsets or individual differentiation stages in CD8 + Tex cells without damaging the effector cells. This article reviewed the progress in CD8 + Tex cells from the aspects of transcriptional dysregulation, metabolic reprogramming, subpopulation typing and clinical application, aiming to provide more CD8 + T cell-based therapeutic strategies for tumor.

Spondyloenchondrodysplasia with immune dysregulation caused by ACP5 gene mutation: a case report and literature review / 中华实用儿科临床杂志

Objective:To summarize the clinical features and gene phenotype of children with spondyloenchondrodysplasia with immune dysregulation (SPENCDI) caused by ACP5 gene mutation. Methods:The medical data and genetic phenotype of a child diagnosed with SPENCDI in the Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University in February 23, 2017 were analyzed retrospectively.Besides, " spondyloenchondrodysplasia" were taken as the search terms to perform the retrieval in CNKI, Wanfang Data, and PubMed, in an attempt to conduct the literature review.χ 2 test was used to compare the factors among children with different mutations. Results:The 4.5-year-old girl was admitted to hospital for complaint of " fever and chilblain-like rash" when she was 2 years old.She was diagnosed with systemic lupus erythematosus (SLE) concomitant with lupus nephritis.Methylprednisolone combined with cyclophosphamide, mycophenolate mofetil was used for the treatment.However, she experienced multiple infections, thrombocytopenia, limp, and growth retardation during the treatment.Genetic detection identified ACP5 gene compound hybrid mutation: c.779C>A and c. 770T>C.She was diagnosed with SPENCDI, and was subjected to follow-up.A total of 78 SPENCDI patients were retrieved from the databases, with various clinical manifestations of SPENCDI, commonly with skeletal involvement and immune phenotypes; 73.08% of the cases were positive for antinuclear antibodies, 57.69% of cases were positive for anti-double stranded-DNA antibodies and 34.62% of cases had neurological symptoms.In 58 cases, ACP5 gene mutations were detected, including 44 homozygous mutations and 14 compound heterozygous mutations.Patients with ACP5 gene homozygous mutation had a higher probability of consanguineous marriage in parents [56.82% (25/44 cases) vs.14.29% (2/14 cases)]; patients with ACP5 gene heterozygous mutation were more likely to develop SLE [64.29% (9/14 cases) vs.34.09% (15/44 cases)]( χ2=7.722, 3.992; all P<0.05). Conclusions:The majority of the ACP5 gene mutations are homozygous mutations in patients with SPENCDI, and heterozygous mutations are rare.The clinical manifestations of SPENCDI are various and complex, it is prone to develop autoimmune diseases, and there was no clear correlation between clinical features and gene phenotype in SPENCDI patients.

Two Cases Orthostatic Dysregulation in which the Effectiveness of Ryokeijutsukanto was Confirmed by Multiple Clinical Indicators / 日本東洋医学雑誌

Ryokeijutsukanto is an herbal medicinal product that is often used for dizziness when standing up, that is, orthostatic dysregulation. This time, we encountered 2 patients with orthostatic dysregulation successfully treated with ryokeijutsukanto, and objectively evaluated the therapeutic effect of ryokeijutsukanto by using Visual Analog Scale (VAS), Vertigo Symptom Scale-short form (VSS-sf) Japanese version and Dizziness Handicap Inventory (DHI) Japanese version. Case 1 is a 17-year-old woman. Dizziness when standing up appeared from 2 month ago. Before treatment, VAS scored 71/100, VSS-sf scored 7 points, and DHI scored 42 points. After 4 weeks of administration of Ryokeijutsukanto, VAS improved to 22/100, VSS-sf improved to 6 points, and DHI improved to 26 points. Case 2 is a 38-year-old woman. Dizziness when standing up appeared from 3 month ago. Before treatment, VAS scored 48/100, VSS-sf scored 18 points, and DHI scored 32 points. After 4 weeks of administration of Ryokeijutsukanto, VAS improved to 9/100, VSS-sf improved to 3 points, and DHI improved to 20 points. In both cases, all the evaluation scales showed sharp improvement after 4 weeks, indicating that ryokeijutsukanto was certainly effective.

Tratamiento de la desregulación emocional en hospitales del área metropolitana de Buenos Aires: una encuesta a profesionales / Treatment of emotional dysregulation in hospitals of the metropolitan area of Buenos Aires: a survey to practitioners

Resumen El proceso de regulación emocional está siendo foco de gran cantidad de investigaciones en la actualidad. Se estima que se encuentra asociada al desarrollo y mantenimiento del 75 % de los trastornos mentales del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM, por sus siglas en inglés). En esta línea se han estado estudiando en los últimos años, a nivel global, protocolos transdiagnósticos que tienen, como foco de tratamiento, dicho proceso. El objetivo de este estudio consistió en explorar la familiaridad de los profesionales de la salud mental, de hospitales públicos del área metropolitana de Buenos Aires, con el constructo de la desregulación emocional y los protocolos diseñados para el tratamiento de pacientes con dichas características. A su vez, se buscó conocer el grado de acercamiento de los profesionales clínicos a las investigaciones sobre psicoterapias. A estos fines, se diseñó un cuestionario con 40 preguntas de respuestas abiertas y opción múltiple que fue completado por 75 profesionales (psicólogos y psiquiatras) de hospitales públicos del área metropolitana de Buenos Aires. La mayoría reportó conocer el constructo de desregulación emocional, pero al pedirles que conceptualicen un caso diseñado para este estudio muy pocos utilizaron el constructo. En cuanto a los protocolos transdiagnósticos diseñados para intervenir en la desregulación emocional, son muy poco implementados. Por su parte, menos de la mitad reportó haber leído investigaciones empíricas. Los cursos elegidos para continuar la formación son en su mayoría psicoanalíticos y la participación en congresos internacionales es escasa. Se propone la necesidad de fomentar el uso de intervenciones basadas en evidencia en hospitales públicos y la divulgación de protocolos transdiagnósticos con evidencia para la desregulación emocional.

Abstract A substantial amount of evidence regarding comorbidity among mental disorders has been accumulated during the last years. Moreover, it has been identified that there is a great variability within nosological categories. These limitations of categorical systems lead to the development of the transdiagnostic paradigm which contemplates the existence of underlying processes common to different diagnoses. The process of emotional regulation is currently the focus of many investigations. It is estimated that it is associated with the development and maintenance of 75 % of DSM mental disorders. Emotional dysregulation is being studied particularly as a common factor in depression and anxiety, the two most prevalent disorders in Argentina. Related to this, transdiagnostic protocols aiming this process have been studied in the last years at a global level. The Unified Protocol has been developed by Barlow from a transdiagnostic perspective aiming to offer an evidence-based intervention that could be faithfully used in heterogeneous groups. It was created for emotional disorders with a specific focus on emotional dysregulation, contemplating comorbidity and heterogeneity. This makes the Unified Protocol a proper and valid intervention for the most prevalent disorders in Argentina. The objective of this study was to explore the familiarity of mental health practitioners, of public hospitals in the metropolitan area of ​​Buenos Aires, with the emotional dysregulation construct and protocols designed for the treatment of patients with these characteristics. Moreover, the degree in which clinicians approach psychotherapy research was evaluated. For this purpose, a cross-sectional descriptive study was carried on. A questionnaire was designed with 40 questions (25 with closed answer and 15 with short open answer) that investigated five thematic areas: demographic characteristics, therapeutic approach, knowledge about the emotional dysregulation construct and treatment protocols, knowledge about the transdiagnostic paradigm and approach to empirical research. The questionnaire was completed by 75 practitioners (psychologists and psychiatrists) from public hospitals of the metropolitan area of Buenos Aires. After analyzing the results, it can be said that the most prominent theoretical framework from which practitioners work in public hospitals is psychoanalysis. The most prevalent diagnoses are anxiety and depression and comorbidity is frequent (M = 2.23, SD = .707). When studying the familiarity to the construct of emotional dysregulation, it was observed that even though most of them reported knowing the emotional dysregulation construct (89.3 %), when asked to conceptualize a person with intense and long-lasting emotional distress and difficulty in controlling their behavior and recognizing their emotions, very few mentioned difficulties in the regulation of emotions (13.51 %). Individual format treatment was the most chosen by psychologists for patients with these characteristics (69 %). Psychiatrists reported pharmacotherapy as the most chosen treatment (87.5 %). Group format is not frequently used. In regards to transdiagnostic protocols designed to intervene in emotional dysregulation, they are very poorly implemented. Dialectical Behavioral Therapy was reported to be known by 80 % of the sample, but used by 33.9 %, while the Unified Protocol was referred to be known by 34.7 % and used by 7.69 % of them. On the other hand, the gap between clinical practice and research seems to be wide. Less than half of the practitioners reported reading empirical research (44 %). And the transdiagnostic paradigm is known by 46.7 % of practitioners. When asked to mention the most influential authors in their practice, Freud and Lacan (classical psychoanalytic authors) were mentioned by the majority. The courses chosen to continue their training are mostly psychoanalytic and participation in international congresses is low (10.45 %). These results show the need to look for ways to encourage the use of evidence-based interventions in public hospitals and specifically the dissemination of transdiagnostic protocols with evidence for emotional dysregulation, being emotional disorders the most prevalent.

Role of the ES-62 protein derived from Acanthocheilonema viteae in regulation of immune dysregulation diseases: a review / 中国血吸虫病防治杂志

ES-62 is a phosphorylcholine-containing, 62 kDa glycoprotein derived from the excretory-secretory product of Acanthocheilonema viteae, which is effective for the prevention and treatment of immune dysregulation diseases through triggering activation of immune cells, such as dendritic cells, mononuclear macrophages and regulatory B cells and mediating immune responses. Recently, the role of the ES-62 protein in the management of allergic, autoimmune and metabolic diseases has been paid much attention. This review summarizes the regulatory role of the ES-62 protein in immune dysregulation diseases and the underlying mechanisms, so as to provide insights into future experimental studies.

Recent Progress in Non-motor Features of Parkinson’s Disease with a Focus on Circadian Rhythm Dysregulation / 神经科学通报·英文版

Parkinson’s disease (PD) is the second most common neurodegenerative disease, which manifests with both motor and non-motor symptoms. Circadian rhythm dysregulation, as one of the most challenging non-motor features of PD, usually appears long before obvious motor symptoms. Moreover, the dysregulated circadian rhythm has recently been reported to play pivotal roles in PD pathogenesis, and it has emerged as a hot topic in PD research. In this review, we briefly introduce the circadian rhythm and circadian rhythm-related genes, and then summarize recent research progress on the altered circadian rhythm in PD, ranging from clinical features to the possible causes of PD-related circadian disorders. We believe that future comprehensive studies on the topic may not only help us to explore the mechanisms of PD, but also shed light on the better management of PD.

Analysis of components of proteins from Echinococcus granulosus cyst fluid / 中国血吸虫病防治杂志

Objective To analyze the components of proteins from Echinococcus granulosus cyst fluid using the shotgun method, and to identify the active components with potential regulatory effects for immune dysregulation diseases. Methods The E. granulosus cyst fluid was collected aseptically from the hepatic cysts of patients with cystic echinococcosis, and characterized by liquid chromatography (LC) tandem mass spectrometry (MS/MS) following digestion with trypsin. The protein data were searched using the software MaxQuant version 1.6.1.0 and the cellular components, molecular functions, and biological processes of the identified proteins were analyzed using the Gene Ontology (GO) method. Results The E. granulosus cyst fluid separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) had a relative molecular mass of 25 to 70 kDa. LS-MS/MS analysis identified 37 proteins, including 32 known proteins and 5 unknown proteins. At least 4 proteins were preliminarily found to exhibit potential regulatory effects for immune dysregulation diseases, including antigen B, glutathione-S-transferase (GST), thioredoxin peroxidase (TPX) and malate dehydrogenase (MDH). GO enrichment analysis showed that the identified proteins had 149 molecular functions and were involved in 341 biological processes. Conclusions E. granulosus cyst fluid has a variety of protein components, and four known proteins are preliminarily identified to be associated with immune dysregulation diseases.

A chain mediating model of emotion dysregulation and trait anger in the relationship between childhood abuse and aggressive behavior within the undergraduate students / 中华行为医学与脑科学杂志

Objective:To explore the chain mediating effect of emotion dysregulation and trait anger between childhood trauma and aggressive behavior in adolescents.Methods:A sample of 1 333 undergraduates were recruited to complete the questionnaires about childhood trauma, aggressive behavior, emotion dysregulation, trait anger.The SPSS 23. 0 and Mplus 8.3 software were used to analysis data and test intermediate effect.Results:The scores of childhood trauma, aggressive behavior, difficulties in emotion regulation and trait anger were (33.624±8.211), (53.995±12.307), (91.781±17.518), (23.352±5.477), respectively. Correlation analysis showed that childhood trauma, aggressive behavior, emotion dysregulation and trait anger were positively correlated with each other( r=0.209-0.614; all P<0.01). Mediation modeling analysis showed that childhood trauma had a significant direct effect on aggressive behavior. The direct effect value was 0.121, accounting for 35.8% of the total effect. The total indirect effect of childhood trauma on aggressive behavior was 0.217, accounting for 64.2% of the total effect. The mediating effect of emotion dysregulation as mediator between childhood trauma and aggressive behavior was 0.035, accounting for 10.4% of the total effect. The mediating effect of trait anger as mediator between childhood trauma and aggressive behavior was 0.108, accounting for 31.9% of the total effect. The chain mediating effect of emotion dysregulation and trait anger was 0.074, accounting for 21.9% of the total effect. Conclusion:Emotion dysregulation and trait anger exert a multiple mediating effect on the relationship between childhood trauma and aggressive behavior.

Progress of physiological dysfunctions in autism spectrum disorder / 国际儿科学杂志

Autism spectrum disorder(ASD)is a group of highly heterogeneous neurodevelopmental disorders with different kinds of physiological dysfunctions.Based on the literature reports, physiological dysfunctions of ASD mainly focus on four aspects, including immune dysregulation/ inflammation, oxidative stress, mitochondrial dysfunction and environmental toxin exposure.This review focuses on the main manifestations of the four physiological abnormalities in patients with ASD, aiming to illustrate the relationship between various physiological abnormalities and autism, providing clues for the research, treatment and prevention strategies of ASD.

Pathological Mechanisms of Brain-Heart Mutual Damage and Treatment with Traditional Chinese Medicine: A review / 中国实验方剂学杂志

The brain and heart has a tight relationship upon physiology and pathology during the development of cardiovascular and cerebrovascular diseases with clinical conditions interacting with each other and complex pathological mechanisms. Clinical studies prove that cerebral diseases such as stroke usually happen with cardiac diseases as complications， and cardiac diseases such as atrial fibrillation can also cause cerebral diseases， which can even aggravate brain atrophy and lead to cognitive impairment. Traditional Chinese medicine （TCM） also believes that “the substance of Shenming is located in the brain and the function in the heart.” Specifically， Yuanshen is in the brain and Shishen is in the heart， which thus makes the heart and brain closely related. If Shenming in any of them is impaired， the other one would also be injured. Therefore， the pathological mechanisms of brain-heart mutual damage have become one of the current research hotspots. This paper， combined with the clinical research status of the brain-heart mutual damage， summarized its pathological mechanisms from the perspectives of inflammatory responses， dysregulation of autonomic nervous system， apoptosis， energy metabolism and oxidative stress. The necessity of “brain-heart concurrent regulation” was proposed and the research progress on the treatment of cerebral and cardiac diseases with TCM represented by Naoxintong capsule was profiled in the light of heart and brain function described by TCM and the holistic concept of TCM treating cerebral and cardiac diseases. This paper reviews the pathological mechanisms of brain-heart mutual damage and the research progress on its treatment with TCM， which can provide reference for the prevention and treatment of cardiovascular and cerebrovascular diseases and further research on them.

Kampo Ｍedicine and Its Treatment in 10 Cases Suspected to be Orthostatic Dysregulation / 日本東洋医学雑誌

Orthostatic dysregulation is also a social problem as a disease of puberty today, and its treatment has at­tracted attention. Ten cases suspected to be orthostatic dysregulation based on diagnostic criteria of Society of Pediatric Psychology were diagnosed and treated with Kampo medicine, and all improvements were made. After analyzing 10 cases, Symptom­complex resulting from blood stagnation (血証), Disorders of the body's water metabolism (水毒), Psychosomatic factors (心身症的要因) were found as a background to cause orthostatic dysregulation. In these backgrounds, kamishoyosan, unkeito, and tokishakuyakusan were prescribed for symptom-­complex resulting from blood stagnation. Goreisangokumibinroto and ryokeijutsukanto were prescribed for disorders of the body's water metabolism. Saikokeishito and saibokuto were prescribed for the psychosomatic factors. Therapeutic effect of modern medical treatment is insufficient. It is considered that medical diagnosis and treatment with Kampo medicine is very effective.

Índice de desregulación inmunológica como predictor de evolución hacia síndrome de insuficiencia respiratoria progresiva del adulto en pacientes con neumonía por SARS-CoV-2 / Immune dysregulation index as a predictor of evolution to acute respiratory distress syndrome in patients with SARS-CoV-2 pneumonia / Índice de disregulação imunológica como preditor da evolução da síndrome de insuficiência respiratória progressiva do adultos em pacientes com pneumonia por SARS-CoV-2

Resumen: Introducción: Se han descrito los principios fisiopatológicos de la neumonía secundaria a infección por SARS-CoV-2, en donde se identificó la cascada de citocinas como principal factor para el desarrollo de lesiones orgánicas. Actualmente, se realizan mediciones de marcadores bioquímicos inflamatorios en la búsqueda de su relación con el pronóstico y posibles complicaciones. En un estudio reciente, se realizó un índice relacionando la interleucina 6 y los niveles de linfocitos y su asociación con la mortalidad en los pacientes con neumonía severa por SARS-CoV-2. El índice de desregulación inmunológica (IL-6/linfocitos) podría permitir estimar a los pacientes que evolucionarán hacia síndrome de insuficiencia respiratoria progresiva del adulto (SIRPA). Objetivos: Establecer si existe una relación entre el nivel de índice de desregulación inmunológica y la aparición del síndrome de insuficiencia respiratoria progresiva del adulto, en los pacientes con neumonía por SARS-CoV-2. Material y métodos: Se realizó el estudio observacional y retrolectivo de una cohorte, en el cual se incluyeron pacientes internados en el Centro Médico ABC con el diagnóstico de neumonía por SARS-CoV-2 de marzo a julio del año 2020, en quienes se realizaron mediciones de interleucina 6 y linfocitos de ingreso, se evaluó su progreso y desarrollo de complicaciones. Se efectuó un análisis univariado de los factores seleccionados, el procesamiento estadístico se elaboró en SPSS v 22.1, se determinaron medidas de frecuencia y de los factores de riesgo con pruebas de Fisher y χ2. Resultados: Se analizaron 346 pacientes, el índice de desregulación inmunológica presentó un promedio de 157 en el grupo correspondiente a SIRPA, mientras que en el grupo control el promedio fue de 38. De los pacientes con diagnóstico de SIRPA, el 18.6% fallecieron, mientras que dentro del grupo control sólo 0.47%. La curva ROC para el análisis de la sensibilidad y especificidad del índice como predictor de evolución hacia SIRPA resultó con un hallazgo de sensibilidad de 68.2% y una especificidad de 77% con un punto de corte de 99. Conclusión: La predicción de complicaciones en el contexto de SARS-CoV-2 permitirá tomar medidas oportunas; por lo que la existencia de índices predictivos es una herramienta útil pero que requiere análisis múltiples y validados en distintas poblaciones para contar con un nivel de seguridad alto al tomar decisiones basadas en ellos.En este estudio en particular, el índice de desregulación inmunológica se ha mostrado como un posible predictor de evolución hacia SIRPA; sin embargo, el establecimiento de medidas terapéuticas deberá continuar con relación a hallazgos clínicos, bioquímicos y de imagen.

Abstract: Introduction: The pathophysiological principles of pneumonia secondary to SARS-CoV-2 infection have been described, where the cytokine cascade was identified as the main factor for the development of organic lesions. Measurements of inflammatory biochemical markers are currently being carried out in search of their relationship with prognosis and possible complications. In a recent study, an index was made relating interleukin 6 and lymphocyte levels and their association with mortality in patients with severe SARS-CoV-2 pneumonia. The index of immune dysregulation (IL-6/lymphocytes) could allow estimating the patients that evolve towards acute respiratory distress syndrome. Objectives: To establish whether there is a relationship between the levels of the immune dysregulation index and the appearance of acute respiratory distress syndrome in patients with SARS-CoV-2 pneumonia. Material and methods: We conducted a retrolective, observational cohort study, in which patients admitted to the ABC Medical Center with the diagnosis of pneumonia due to SARS-CoV-2 from March to July of 2020 were included, in them, measurements of interleukin 6 and lymphocytes on admission and their progress and development of complications were evaluated. A univariate analysis of the selected factors was carried out; the statistical analysis was elaborated in SPSS v 22.1, frequency measures were examined and the analysis of the risk factors was carried out with the Fisher and χ2 tests. Results: 346 patients were analyzed, the immune dysregulation index presented an average of 157 in the group corresponding to ARDS, while in the control group the average was 38. Of the patients with a diagnosis of ARDS, 18.6% died, while in the control group only 0.47%. The ROC curve was used for the analysis of the sensitivity and specificity of the index as a predictor of evolution towards ARDS with a sensitivity finding of 68.2% and a specificity of 77% with a cut-off point of 99. Conclusion: The prediction of complications in the context of SARS-CoV-2 will allow timely measures to be taken. The existence of predictive indices is a useful tool but it requires multiple and validated analyses in different populations to have a high level of safety when making decisions based on them. In this study, the immune dysregulation index has been shown as a possible predictor of evolution towards ARDS; however, the establishment of therapeutic measures should continue in relation to clinical, biochemical and imaging findings.

Resumo: Introdução: São descritos os princípios fisiopatológicos da pneumonia secundária à infecção por SARS-CoV-2, onde a cascata de citocinas foi identificada como o principal fator para o desenvolvimento de lesões orgânicas. Medidas de marcadores bioquímicos inflamatórios estão sendo realizadas em busca de sua relação com o prognóstico e possíveis complicações. Em um estudo recente, foi realizado um índice relacionando os níveis de interleucina 6 e de linfócitos e sua associação com a mortalidade em pacientes com pneumonia por SARS-CoV-2 grave. O índice de desregulação imunológica (IL-6/linfócitos) poderia permitir estimar os pacientes que irão evoluir para a síndrome do desconforto respiratório progressivo em adultos (SIRPA). Objetivos: Estabelecer se há uma relação entre o nível do índice de desregulação imunológica e o aparecimento da síndrome de insuficiência respiratória progressiva do adulto em pacientes com pneumonia por SARS-CoV-2. Material e métodos: Foi realizado um estudo de coorte observacional, retroletivo, que incluiu pacientes internados no Centro Médico do ABC com diagnóstico de pneumonia por SARS-CoV-2 de março a julho deste ano, nos quais foram realizadas dosagens de interleucina 6 e linfócitos na admissão, sua evolução e desenvolvimento de complicações. Realizou-se a análise univariada dos fatores selecionados, a análise estatística foi elaborada no SPSS v 22.1, as medidas de frequência e os fatores de risco foram determinados com teste de Fisher e χ2. Resultados: Foram analisados 346 pacientes, o índice de desregulação imunológica apresentou média de 157 no grupo correspondente ao SIRPA, enquanto no grupo controle a média foi de 38. Dos pacientes com diagnóstico de SIRPA 18.6% morreram durante o grupo controle apenas 0.47%. A curva ROC para análise da sensibilidade e especificidade do índice como preditor de evolução para SIRPA com uma de sensibilidade de 68.2% e uma especificidade de 77% com um ponto de corte de 99. Conclusão: A previsão de complicações no contexto da SARS-CoV-2 nos permitirá tomar medidas oportunas; portanto, a existência de índices preditivos é uma ferramenta útil, mas requer análises múltiplas e validadas em diferentes populações para ter um alto nível de segurança ao tomar decisões com base neles. Neste estudo em particular, o índice de desregulação imunológica foi mostrado como um possível preditor de evolução para SIRPA; entretanto, o estabelecimento de medidas terapêuticas deve continuar em relação aos achados clínicos, bioquímicos e de imagem.