Dimensions of emotional distress among Brazilian workers in a COVID-19 reference hospital:A factor analytical study

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic is an unprecedented challenge for public health and has caused the loss of millions of lives worldwide.Hospital workers play a key role in averting the collapse of the health system,but the mental health of many has deteriorated during the pandemic.Few studies have been devoted to identifying the needs of workers on frontline duty.AIM To investigate dimensions of common emotional symptoms and associated predictors among Brazilian workers in a COVID-19 reference hospital.METHODS This is an observational study of the mental health of professionals in a COVID-19 hospital in the city of São Paulo.We invited all hospital employees to respond to an online survey between July and August 2020,during the first peak of the pandemic.Data of 1000 participants who completed the survey were analyzed(83.9%were women and 34.3%were aged 30 to 40).Hospital workers selfreported the presence of symptoms of depression,anxiety,trauma-related stress,and burnout through the Patient Health Questionnaire-9,the Generalized Anxiety Disorder-7,the Impact of Event Scale-Revised and the Mini-Z Burnout Assessment respectively.Responses were assembled and subjected to exploratory factor analysis to reveal workers’core emotional distress.Multiple linear regression models were subsequently carried out to estimate the likelihood of dimensions of distress using questions on personal motivation,threatening events,and institutional support.RESULTS Around one in three participants in our sample scored above the threshold of depression,anxiety,post-traumatic stress disorder,and burnout.The factor analysis revealed a three-factor structure that explained 58%of the total data variance.Core distressing emotional domains were avoidance and re-experience,depression-anxiety,and sleep changes.Regression analysis revealed that institutional support was a significant protective factor for each of these dimensions(βrange=-0.41 to-0.20,P<0.001).However,participants’personal motivation to work in healthcare service was not associated with these emotional domains.Moreover,the likelihood of presenting the avoidance and re-experience dimension was associated with having a family member or close friend be hospitalized or die due to COVID-19 and having faced an ethical conflict.CONCLUSION Distressing emotional domains among hospital workers were avoidance and re-experience,depression and anxiety,and sleep changes.Improving working conditions through institutional support could protect hospital workers'mental health during devastating public health crises.

Oxytocin structure and function in New World monkeys:from pharmacology to behavior

Oxytocin(OT)is a hypothalamic nonapeptide that mediates a host of physiological and behavioral processes in-cluding reproductive physiology and social attachments.While the OT sequence structure is highly conserved among mammals,New World monkeys(NWMs)represent an unusual“hot spot”in OT structure variability among mammals.At least 6 distinct OT ligand variants among NWMs exist,yet it is currently unclear whether these evolved structural changes result in meaningful functional consequences.NWMs offer a new area to explore how these modifications to OT and its canonical G-protein coupled OT receptor(OTR)may mediate specific cellular,physiological and behavioral outcomes.In this review,we highlight relationships between OT ligand and OTR structural variability,specifically examining coevolution between OT ligands,OTRs,and physiological and behavioral phenotypes across NWMs.We consider whether these evolved modifications to the OT structure alter pharmacological profiles at human and marmoset OTRs,including changes to receptor binding,intracellular signaling and receptor internalization.Finally,we evaluate whether exogenous manipulation using OT variants in marmoset monkeys differentially enhance or impair behavioral processes involved in social relationships between pairmates,opposite-sex strangers,and parents and their offspring.Overall,it appears that changes to OT ligands in NWMs result in important changes ranging from cellular signaling to broad measures of social behavior.

Deciphering lipid dysregulation in ALS:from mechanisms to translational medicine

Lipids,defined by low solubility in water and high solubility in nonpolar solvents,can be classified into fatty acids,glycerolipids,glycerophospholipids,sphingolipids,and sterols.Lipids not only regulate integrity and fluidity of biologi-cal membranes,but also serve as energy storage and bioactive molecules for signaling.Causal mutations in SPTLC1(serine palmitoyltransferase long chain subunit 1)gene within the lipogenic pathway have been identified in amyo-trophic lateral sclerosis(ALS),a paralytic and fatal motor neuron disease.Furthermore,lipid dysmetabolism within the central nervous system and circulation is associated with ALS.Here,we aim to delineate the diverse roles of different lipid classes and understand how lipid dysmetabolism may contribute to ALS pathogenesis.Among the different lipids,accumulation of ceramides,arachidonic acid,and lysophosphatidylcholine is commonly emerging as detri-mental to motor neurons.We end with exploring the potential ALS therapeutics by reducing these toxic lipids.