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Cincinnati Reds make playoff history; eliminated by Braves with 0 runs
By Adrian Woody on October 2, 2020
Sports Pulse: USA TODAY Reporters discuss the future of the MLB
ATLANTA – When Ronald Acuña Jr. reached second base, he raised his arms above his head as his teammates in the Atlanta Braves dugout waved towels, pounded their hands on the railing and pointed toward at him.
Acuña, arguably the top rising star in the sport, did something the Cincinnati Reds couldn't do in two postseason games. Acuña drilled a full-count slider into the left-field gap, scoring Austin Riley from first base in the fifth inning, to take a one-run lead.
One run is all it took to end the Reds' season after a 5-0 Game 2 loss at Truist Park. The Reds didn't score a single run across 22 innings in the best-of-three Wild Card Series, the longest scoreless streak to start the playoffs in MLB postseason history.
The Reds haven't won a playoff series since 1995, winless in their last four appearances.
"I felt like we had as good of a team as anybody coming into this," Tucker Barnhart said. "Our pitching staff pitched amazing. Just as an offense, we couldn't do anything."
Oct 1, 2020; Cumberland, Georgia, USA; Cincinnati Reds left fielder Jesse Winker (33) loses his bat against the Atlanta Braves during the second inning at Truist Park. Mandatory Credit: Dale Zanine-USA TODAY Sports (Photo: Dale Zanine, Dale Zanine-USA TODAY Sports)
Marcell Ozuna and Adam Duvall added a two-run homers to left field in the eighth inning against Reds closer Raisel Iglesias. Ozuna's was a no-doubter as the Braves dugout erupted with cheers. Ozuna held a pose, taking a fake selfie, halfway down the first-base line. It was the first time Iglesias allowed an earned run since Sept. 6.
The Reds became the first team in MLB postseason history to fail to score a run in a series that lasted more than one game. The 1921 New York Giants had a 20-inning scoreless streak to begin their playoff run, according to Elias Sports Bureau, and the 2018 Atlanta Braves were shutout in their first two games.
"There was a little bit of pressing because you want to score runs, and you can't score runs," Eugenio Suárez said. "You start being frustrated. For me personally, I started thinking about why wouldn't I score runs, why you're not hitting base hits or whatever, why you're not getting better at-bats to help my team score runs."
When the Braves celebrated around the first-base line after the final out, several Reds players watched from their own dugout before retreating to the clubhouse. The last player to walk away was Sonny Gray, who was scheduled to start in Game 3.
The story of the Reds' loss in Game 1 of the Wild Card Series was all their missed opportunities, stranding 13 runners on base, but they didn't have many chances Thursday. In a must-win playoff game, the Reds produced a measly two hits and drew two walks against rookie right-hander Ian Anderson and Atlanta's bullpen.
"Clearly, it sucks not scoring any runs, but losing is losing, no matter how you take it, especially at this point in the year," Barnhart said. "Obviously, we would've loved to get our (pitchers) some runs. They deserved it. They earned it. It just didn't happen."
The Reds were last in the Majors with a .212 batting average, but they joined the 1906 Chicago White Sox (.210) and 2007 Arizona Diamondbacks (.250) as the only teams to finish with the league's worst batting average and qualify for the playoffs.
Improving the offense was the front office's top priority last winter. The Reds committed nearly $150 million to add Mike Moustakas, Nick Castellanos and Shogo Akiyama. With their pitching, Joey Votto called the Reds a "(bleeping) nightmare" entering the playoffs. Other players called them "dangerous" and "scary."
"I meant what I said going into the playoffs," Votto said. "I think both starting pitchers and the bullpen showed. We obviously didn't do our part offensively. Kudos to the Braves. I thought they were tenacious and steady. Their pitching, I don't want to say it was better than I thought it would be because it would be disrespectful, but they were very, very good."
Cincinnati Reds' Shogo Akiyama of Japan, heads to the dugout after grounding out during the eighth inning against the Atlanta Braves in Game 2 of a National League wild-card baseball series, Thursday, Oct. 1, 2020, in Atlanta. (Photo: John Bazemore, AP)
In a pitcher's duel between two starters that throw excellent changeups, Luis Castillo had trouble against one player: Acuña. With Riley on first base and two outs in the fifth inning, Castillo gave up the go-ahed hit on an 87-mph slider at the bottom of the strike zone. Acuña's hit rolled to the wall, scoring Riley without a throw to the plate.
Castillo shook off Barnhart once before that pitch, wanting to throw his changeup to Acuña. Barnhart signaled slider again. Barnhart felt it was the right pitch and said it was something they talked about a lot before the game.
"It's a tough game to play when you're trying not to give up any runs," Barnhart said. "Clearly, that's the way you play the game anyway, but when you know the offense is struggling and that we're struggling to string any at-bats together, hits together or anything positive, it feels like you can't give up any runs.
"It's a really damn tough game to play from a pitch calling standpoint and I can't even imagine how it feels from a pitching standpoint."
Acuña had three hits in three at-bats against Castillo. He hit an infield single to short in the first inning and he golfed a changeup way below the strike zone back up the middle for a two-out single in the third inning. Castillo appeared to smile at Acuña at the third-inning single after it whizzed past him on the mound.
Following Acuña's run-scoring hit in the fifth inning, the Reds intentionally walked Freddie Freeman to bring up Ozuna. Castillo struck out Ozuna in a 10-pitch at-bat in the first inning with a 98-mph fastball at the top of the strike zone and struck him out again in the fourth inning. Castillo won another battle when Ozuna flew out on the first pitch to strand two runners on base.
"Our pitching was unbelievable," manager David Bell said. "Unbelievable. I mean, against a great lineup. There are no words for the credit that our pitching staff deserves. It was unbelievable."
Castillo, who would walk up to the chalk on the third-base line and then hop over it each inning, wasn't as dominant as the two pitchers in Game 1, but he gave the Reds every chance to win. Castillo allowed six hits and one run in 5 ⅓ innings, striking out seven and issuing zero non-intentional walks.
He received fist bumps from all his infielders when he was replaced by Lucas Sims with one out in the sixth inning. Sims pitched 1 ⅔ scoreless innings, striking out four of the five batters he faced.
"I don't care how great of a Major League hitter you are," Braves manager Brian Snitker said. "Everybody we saw in this series, it was something pretty special."
Cincinnati Reds starting pitcher Luis Castillo, center left, is relieved by manager David Bell during the sixth inning against the Atlanta Braves in Game 2 of a National League wild-card baseball series, Thursday, Oct. 1, 2020, in Atlanta. (Photo: John Bazemore, AP)
Anderson, the No. 3 overall pick in the 2016 MLB Draft, was making just his seventh big-league start, but he was in control all afternoon. He reached 97 mph with his fastball and fooled hitters with his 87-mph changeup.
"Nobody really comes to mind as far as the guys that are so over the top like him, almost like an Iron Mike pitching machine," Barnhart said. "His fastball and changeup look exactly the same."
Said Bell: "What makes his fastball elite is the way it has that rising effect, so he can do it up in the zone and down in the zone."
The Reds loaded the bases in the second inning after Suárez opened with a single to left in a 10-pitch at-bat. Jesse Winker and Freddy Galvis drew walks.
Braves pitching coach Rick Kranitz made a mound visit as Anderson ticked above 30 pitches in the inning. With the bases loaded and two outs, Barnhart fell into a 0-2 count and grounded into a fielder's choice to end the inning.
(Wednesday), we did a lot of good things, just couldn't get anything across," Barnhart said. "Not a lot of positives happened today and it's a shame."
Anderson retired eight straight, including a stretch of four consecutive strikeouts, before Galvis hit a routine ground ball that deflected off the first-base bag for a hit. Suárez tried to fire up his teammates in the dugout, yelling, "Come on!" and waving his arms to the Reds' small cheering section near the suites.
The lively dugout didn't change their offensive fortune. Anderson struck out the next two hitters and the Reds didn't have another batter reach base.


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redpajama_set_name: RedPajamaGithub


The Apple CarPlay , automotive interface integrated into the iPhone that will allow drivers to control various functions of the smartphone via a touch screen and / or voice controls, has not yet reached any vehicle, but is already generating concerns.
The main problem of technology, shown during the Geneva Motor Show , it would be driver distraction. "The idea that people want to be on their phones, not puts safety first, but the desire to be in touch," said Bruce Hamilton, manager of research and communications for the Foundation for Traffic Safety AAA, the United States, the CNN Money website.
The distraction in automobile driving is a major concern in modern roads, more vehicles, allowing drivers to use their smartphonespor via Bluetooth or infotainment systems. A study from Texas A & M found that the reaction time of the driver doubled as said text messages, according to the publication. Ie, new technology certainly is not making drivers pay more attention to the traffic.
Even knowing the statistics, Apple said that "CarPlay lets drivers use their iPhone in the car with minimized distractions."


text:
Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 12
Correlation between fractional exhaled nitric oxide and sputum eosinophilia in exacerbations of COPD
Authors Gao J, Zhang M, Zhou LQ, Yang X, Wu HG, Zhang JF, Wu F
Received 17 February 2017
Accepted for publication 27 March 2017
Published 27 April 2017 Volume 2017:12 Pages 1287—1293
DOI https://doi.org/10.2147/COPD.S134998
Editor who approved publication: Dr Richard Russell
Jie Gao,1 Min Zhang,2 Liqin Zhou,1 Xing Yang,1 Haigui Wu,1 Jianfang Zhang,1 Feng Wu1
1Department of Respiratory Medicine, 2Internal Medicine-Cardiovascular Department, The Third People's Hospital, Guangzhou Medical College, Huizhou, People's Republic of China
Introduction: Measurements of eosinophils in induced sputum and fractional exhaled nitric oxide (FeNO) are noninvasive biomarkers for assessing airway inflammation phenotypes in chronic obstructive pulmonary disease (COPD). Nevertheless, the clinical application of the correlation between FeNO levels and sputum eosinophilia is controversial. The study aimed to investigate the correlation and predictive relationship between FeNO levels and sputum eosinophils in patients with COPD exacerbation. It also examined the relationship between FeNO levels and blood eosinophil percentage.
Methods: A total of 163 patients with COPD exacerbation were included in the cross-sectional study. All patients underwent the following on the same day: FeNO test, spirometry, bronchodilator reversibility test, induced sputum, and routine blood test. They were classified as eosinophilic group or noneosinophilic group based on sputum eosinophilic percentage (=2.5%)/FeNO levels (=32 parts per billion [ppb]).
Results: FeNO levels and blood eosinophilic percentage were higher in patients with sputum eosinophilia (n=62) compared to those without (31.35 ppb versus 21.43 ppb, P=0.015; 2.71% versus 0.98%, P<0.0001, respectively). Sputum eosinophilic percentage was higher with raised FeNO (n=34) compared to those with FeNO <32 ppb (5.12% versus 3.12%, P=0.007). Eosinophils in induced sputum correlated with both FeNO levels (ρ=0.221, P=0.005) and blood eosinophilic percentage (ρ=0.399, P<0.001). There was no relationship between FeNO and blood eosinophilic percentage. Blood eosinophilic percentage was predictive of sputum eosinophilia (95% confidence interval [CI] =0.65–0.81, P<0.001) at a cutoff point of 0.65% (sensitivity =73%, specificity =61.3%). FeNO levels were predictive of sputum eosinophilia (95% CI =0.53–3,071, P=0.012) at a cutoff point of 17.5 ppb (sensitivity =65.1%, specificity =56.4%).
Conclusion: The clinical relevance of this study provides evidence that inflammatory biomarkers, including sputum eosinophilic percentage, FeNO level, and blood eosinophilic percentage, can be used to positively diagnose eosinophilic COPD. The FeNO level and blood eosinophilic counts/percentage, which determine an optimal cutoff for sputum eosinophilia, need more studies.
Keywords: fractional exhaled nitric oxide, eosinophils in induced sputum, blood eosinophil percentage, chronic obstructive pulmonary disease
Assessment of airway inflammation is normally recognized as an important aspect in the diagnosis and clinical control of asthma, but is not considered for chronic obstructive pulmonary disease (COPD). Both of them are considered as chronic airway inflammatory diseases, typically associated with Th2-mediated immune response in asthma and related to the characteristic of Th1-mediated immunity in COPD.1 Subsequently, while eosinophilic airway inflammation is the hallmark feature of airway inflammation in asthma, COPD is typically associated with a neutrophilic response in airway inflammation, which is often because of bacterial colonization. However, this classical pathway probably represents only half of the patients with COPD, and in up to 10%–40% mixed inflammatory pattern with increased eosinophils (defined as sputum eosinophils >3%) is a feature, especially where there is clinical overlap with asthma.2,3
Measurement of airway eosinophilia is a reliable predictive index of responsiveness to inhaled corticosteroid (ICS) and oral corticosteroid therapies in patients with COPD. Eosinophilic airway inflammation can be measured through the airway noninvasively by induced sputum analysis and fractional exhaled nitric oxide (FeNO).4 Both are considered as a direct, reliable, sensitive, simple, and repeatable method of assessing inflammatory phenotypes, widely used in clinical practice. And the 2017 Global Initiative for Chronic Obstruction Lung Disease (GOLD) recently published an evidence-based clinical research guideline that sputum eosinophils and blood eosinophilic counts/percentage can predict the risk of exacerbations.5 In 2016, the normal reference values of induced sputum cytology in China, defined as sputum eosinophils ≥2.5%%, and increases in FeNO levels (≥32 ppb), were identified as airway eosinophilia.6 Nevertheless, the clinical application of the correlation between FeNO levels and sputum eosinophilia or peripheral blood eosinophilic percentage is controversial.
The aim of this study was to assess the correlation between sputum eosinophils, FeNO levels, and peripheral blood eosinophilic percentage in patients with COPD and to determine the accuracy of these biomarkers as indicators of airway inflammatory phenotypes in these patients.
The aim of the study was to discuss the correlation between eosinophilic percentage in induced sputum, peripheral blood eosinophilic percentage, and FeNO levels in patients with COPD exacerbation. Data were collected during regular clinical practice and medical procedures.
Patients diagnosed to have acute exacerbations of COPD visiting The Third People's Hospital of Guangzhou Medical College in Huizhou from March 2016 to January 2017 were retrospectively enrolled in the study. The severity and GOLD stage of COPD were defined according to the 2017 recommendation of GOLD. We excluded patients if they had a pulmonary infection within 4 weeks; had used any oral corticosteroid in the previous 4 weeks; had a confounding pulmonary comorbidity such as a pulmonary tuberculosis, an interstitial lung disease, a lung cancer, or a possible overlap with asthma; had a cognitive impairment that may affect the collaboration or comprehension of the study.
The Institutional Review Board of the Third People's Hospital of Guangzhou Medical College in Huizhou approved the study protocol and absolved the need for written informed consent from patients as the study was a retrospective study, personal identification data were anonymized.
Assessments and study procedures
On the same day the following tests or determinations were performed: FeNO test, pulmonary function test (PFT), bronchodilator reversibility test, induced sputum, and routine blood test. Clinical variables were recorded for the participants.
Measurement of FeNO: FeNO level was measured before PFT according to the guidelines in the user manual training on the NO electrochemical equipment (NIOX VERO; Aerocrine AB, Solna, Sweden). Patients were required to refrain from eating, drinking, and smoking for at least 1 hour prior to the FeNO measurement. Patients were instructed to inhale NO-free air to total lung capacity and immediately exhale fully into the device at a sustained flow rate of 50 mL/s for 6 or 10 seconds, which resulted in display of FeNO value.6 A significant increase in FeNO was considered if the FeNO value was equal to or higher than 32 parts per billion (ppb).7
PFT: Airway limitation was performed using Lung Function Machine (MS-pneumo + aps; JAEGER; German) by the experienced technician in accordance with the 2014 recommendations of the Chinese National Guidelines of Pulmonary Function Test. Percentage predicted values (%pred) were calculated based on the reference values for healthy Chinese adults. All patients were required to undergo PFT in a reproducible way, and the best values were retained.8
Bronchodilator reversibility test: patients were asked to inhale 400 μg salbutamol through a metered dose inhaler after baseline evaluation, and PFT was repeated in not <20 minutes. Three forced expiratory maneuvers were recorded. Postbronchodilator forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) <70% and the negative response, defined as FEV1 <200 mL and FEV1 <12% after salbutamol inhalation, were obtained.8
Sputum induction: After bronchodilator reversibility test, sputum was induced with hypertonic saline inhalation through ultrasonic atomizer. A single hypertonic saline (3% NaCl) was used. Patients were asked to inhale 400 μg salbutamol through a metered dose inhaler at 20 minutes before induction. The collected lower respiratory (trachea and bronchi), except nasal cavity, pharynx, larynx and oral cavity were dispersed using 0.1% dithiothreitol with water bath and oscillator at 15 minutes before 300 mesh nylon mesh filter, and subsequently, total cell count was centrifuged, smeared, and stained (hematoxylin-eosin). A differential cell count was obtained from 400 cells with a 400× microscope to identify the severity and type of airway inflammation in patients with COPD. Squamous cell count <10% in each sample was deemed adequate for further analysis. We defined the sputum eosinophilic percentage ≥2.5 as abnormal.7
Blood collection and analysis: Peripheral venous blood was measured using Automated Hematology Blood Analyzer (ABX Pentra DF120–1; ABX, France). The results of blood eosinophilic count/ratio, defined as normal number of white blood cells in peripheral blood (4–10×109/L), were obtained.
Data analysis were performed by using SPSS 19. Continuous variables were expressed as mean ± standard deviation (SD), and categorical variables as frequencies and percentages. Data were analyzed with the Student's t-test for quantitative variables and the chi-square test for categorical variables. The relationship between FeNO, eosinophil ratios in induced sputum, and eosinophil ratios in peripheral blood was assessed with the Spearman's correlation coefficient. The correlation between tests was performed by constructing receiver operating characteristic (ROC) curve. The optimal cutoff value was determined from the highest sum of sensitivity and specificity. Statistical significance was defined as P<0.05.
Characteristics of the patients
Patient demographic information is presented in Table 1. A total of 163 patients with COPD exacerbation were included in this study. The mean age was 72.2 years with a range between 47 and 96 years. There were 147 (89.63%) men. Smokers accounted for 74.8% of patients. All participants were Chinese.
Table 1 Patient demographics and baseline characteristics
Notes: N refers to the total population; n refers to the subgroup population.
Abbreviation: SD, standard deviation.
PFT results are reported in Table 2. Patients with COPD had a mean FEV1/FVC percentage of 48.87±12.08 and a mean FEV1% predicted of 45.81±21.43. FEV1% predicted values indicated severe degree of obstructive lung disease. As expected in this study, the patients in such a state have severe impairment.
Table 2 Spirometry results for the patients
Abbreviations: FVC, forced vital capacity; FEV1, forced expiratory volume in 1 second; PEF, peak expiratory flow; MMEF, maximum midexpiratory flow; MEF, maximal expiratory flow.
Sputum induction
Eosinophilic airway inflammation (sputum eosinophilia ≥2.5%) was present in 62 (38.04%) participants. The characteristics of patients are shown in Table 3. Patients in eosinophilica group as compared with patients in noneosinophilicb group showed significantly higher FeNO values (mean [SD] 31.35 [37] versus 21.43 [22.4], P=0.015), eosinophil ratios in peripheral blood (mean [SD] 2.71 [2.9] versus 0.98 [1.37], P<0.001), and eosinophil count in peripheral blood (mean [SD] 0.18 [0.19] versus 0.07 [0.11], P<0.001).
Table 3 FeNO levels and peripheral blood eosinophilic percentage/counts
Notes: aRefers to sputum eosinophil count ≥2.5%; bRefers to sputum eosinophil count <2.5%. Bold figures indicate P<0.05.
Abbreviations: FeNO, fractional exhaled nitric oxide; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; SD, standard deviation.
FeNO levels equal to or higher than 32 ppb were present in 34 (20.86%). The characteristics of patients are shown in Table 4. Patients in eosinophilica group as compared with patients in noneosinophilicb group showed a nonsignificant result in eosinophilic cell in peripheral blood ratios and count, but significantly higher eosinophil ratios in induced sputum (mean [SD] 5.12 [7.15] versus 3.12 [5.8], P=0.007).
Table 4 Eosinophilic percentage in induced sputum and peripheral blood eosinophilic percentage/counts
Notes: aRefers to FeNO levels ≥32 ppb; bRefers to FeNO levels <32 ppb. Bold figure indicates P<0.05.
Abbreviations: FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; SD, standard deviation.
Peripheral blood eosinophil
Eosinophilic percentage in peripheral blood ≥1 was present in 71 (43.56%) patients. The characteristics of patients are shown in Table 5. Patients in eosinophilica group as compared with patients in noneosinophilicb group showed a significantly higher eosinophil count in induced sputum (mean [SD] 5.72 [7.54] versus 1.97 [4.17], P<0.001) and eosinophil count in peripheral blood (mean [SD] 0.23 [0.17] versus 0.02 [0.04], P<0.001). Nonetheless, FeNO level was with a nonsignificant result.
Table 5 FeNO levels and eosinophilic percentage in induced sputum
Notes: aRefers to peripheral blood eosinophilic percentage ≥1%; bRefers to peripheral blood eosinophilic percentage <1%. Bold figures indicate P<0.05.
Correlation between FeNO levels, eosinophil in induced sputum, and eosinophil in peripheral blood
A significant correlation was found between sputum eosinophils and FeNO values (ρ=0.221; P=0.005; Figure 1A) and blood eosinophil ratio (ρ=0.399; P<0.001) (Figure 1B). No significant association was observed between FeNO values and blood eosinophil ratio (ρ=0.094; P=0.233).
Figure 1 Scatter plots for correlations among FeNO levels, eosinophilic percentage in induced sputum, and eosinophilic percentage in peripheral blood.
Notes: (A) Correlation between percentage sputum eosinophils and FeNO levels (ppb). (B) Correlation between percentage sputum eosinophils and percentage blood eosinophils.
Abbreviations: FeNO, fractional exhaled nitric oxide; ppb, parts per billion.
ROC curve analysis demonstrated that 17.5 ppb was the best diagnostic cutoff value of FeNO level for sputum eosinophilia (area under the curve [AUC] 0.617; 95% confidence interval [CI] 0.53–0.71). Sensitivity and specificity of 17.5 ppb for the diagnosis of sputum eosinophils were 64.5% and 56.4%, respectively. In addition, ROC curve analysis showed that 0.65% was the best diagnostic cutoff value of blood eosinophil ratio for sputum eosinophilia (AUC 0.729; 95% CI 0.65–0.81). Sensitivity and specificity at a cutoff point of 0.65% for the diagnosis of sputum eosinophils were 74.2% and 61.4%, respectively (Figure 2).
Figure 2 Receiver operating characteristic (ROC) curve for FeNO level and blood eosinophilic percentage to predict sputum eosinophilia (≥2.5%).
Abbreviation: FeNO, fractional exhaled nitric oxide.
This cross-sectional analytical study assessed the correlation of FeNO levels and sputum eosinophilia in exacerbations of COPD. One hundred sixty-three patients had an increase in cough, sputum/purulent sputum, and dyspnea beyond normal day-to-day variation, and it was acute in onset and necessitated a change in regular medication.5 All the people in the study were Chinese.
Following the 2015 recommendations of the Chinese National Guidelines on Diagnosis and Management of Cough,7 eosinophilic airway inflammation was defined as percentage of eosinophil count ≥2.5 in induced sputum. As shown in Table 3, the FeNO level, peripheral blood eosinophil percentage, and counts between eosinophilica group and noneosinophilicb group were significantly different. Although induced sputum has been considered the "gold standard" for phenotyping airway inflammation, measurement of FeNO has achieved wide acceptance in routine clinical practice because it is easy to perform and readily available readout. The 2014 recommendation also suggested that a significant increase in eosinophil sputum (≥2.5%) was considered if the FeNO value was ≥32 ppb. As shown in Table 4, the percentage of eosinophil count between eosinophilica group and noneosinophilicb group was significantly different; however, the difference in peripheral blood eosinophilic percentage/count was not statistically significant. According to the 2017 recommendation of GOLD, which recently published an evidence-based clinical research guideline, eosinophils, such as in induced sputum or peripheral venous blood, can predict the risk of exacerbations.5 We predicted that a sputum eosinophilia (≥2.5%) was considered if the peripheral blood eosinophil percentage was ≥1. As shown in Table 5, the eosinophil sputum percentage and peripheral blood eosinophil count of eosinophilica group and noneosinophilicb group were significantly different; however, the difference between the FeNO levels in the two groups was not statistically significant.
Our study was performed in a larger sample of patients with COPD exacerbations and it provided an evidence of a positive correlation between FeNO, sputum eosinophilia, and eosinophilic percentage in the peripheral blood. Soter et al reported that FeNO levels (19 ppb) can help correctly identify the presence or absence of sputum eosinophilia (≥3%) (AUC 0.89, sensitivity =90%, specificity =74%).9 Our present optimal cutoff point (17.5 ppb) is similar to this optimal cutoff point (19 ppb) in COPD with exacerbations, but the sensitivity and specificity in this study are different (sensitivity =65.1%, specificity =56.4%). These results showed that FeNO value was to distinguish the patients with COPD at exacerbations with sputum eosinophilia from those without, thereby indicating its potential use as a diagnostic biomarker for eosinophilic COPD. However, the cutoff value has been a question in dispute because normal or low FeNO levels do not exclude the presence of disease. Optimal cutoff points by calculating sensitivity and specificity on an ROC curve to assess diagnostic biomarkers of eosinophilic airway inflammation may not be clinically applicable, given that their sensitivity and/or specificity is often suboptimal compared to that of reference standard tests.10 In view of this, we have evaluated the sensitivity and specificity of FeNO levels at different cutoff points (Table 6): at cutoff points of 26 ppb or 32 ppb, sensitivity and specificity of 2.5% for the diagnosis of sputum eosinophils were 39.7% and 75.2%, and 28.5% and 84.2%, respectively.
Table 6 Sensitivity and specificity for different FeNO levels cutoff points for detecting sputum eosinophilia
Abbreviations: FeNO, fractional exhaled nitric oxide; ppb, parts per billion; LR, likelihood ratio.
The 2017 GOLD recently published an evidence-based clinical research guideline that blood eosinophilic counts/percentage may be a biomarker of exacerbation risk in patients with a history of exacerbation and can predict the effects of ICS on exacerbation prevention.5 One study in stable COPD has shown that peripheral blood eosinophil count (≥0.3×109/L) can serve as a diagnostic biomarker of sputum eosinophilia (≥3%) (AUC 0.76 [95% CI =0.67–7.84], sensitivity =76%, specificity =60%).11 This AUC is similar to our present AUC in COPD at exacerbations.
This finding also indicates that blood eosinophil percentage has a higher relevance than FeNO level with eosinophil sputum in patients with COPD. However, there was no correlation between FeNO level and blood eosinophil ratios/count. In clinical practice, there is a tendency to generalize the correlation between FeNO level and eosinophilic percentage in induced sputum. Although the two methods are useful to assess the eosinophilic airway inflammation,12–14 there are confounding factors that may affect FeNO values in many cases.6 Furthermore, FeNO has a limited value to assess the neutrophilic airway inflammation, and bronchial induced sputum cytology provides a more accurate approximation of airway inflammation phenotypes in COPD patients than FeNO.
The clinical relevance of this study provides evidence that inflammatory biomarkers, including sputum eosinophilia, FeNO value, and blood eosinophil percentage/counts, can be used to positively diagnose eosinophilic COPD. These data may be useful for identifying patients with airway inflammation phenotypes who will have a beneficial response to treatment with an ICS, and it is important to help guide treatment and management of COPD patients. However, further studies are required to validate the use of FeNO levels and blood eosinophilic counts/percentage to determine an optimal cutoff for sputum eosinophilia that predicts future exacerbation risk in patients with COPD exacerbation history and the cutoff values that could be used in clinical practice.
We would like to thank Dr Ziwen Zhao for his comments and discussion.
Eltboli O, Brightling CE. Eosinophils as diagnostic tools in chronic lung disease. Expert Rev Respir Med. 2013;7(1):33–42.
Brightling CE, Bleecker ER, Panettieri RA Jr, et al. Benralizumab for chronic obstructive pulmonary disease and sputum eosinophilia: a randomised, double-blind, placebo-controlled, phase 2a study. Lancet Respir Med. 2014;2(11):891–901.
Eltboli O, Bafadhel M, Hollins F, et al. COPD exacerbation severity and frequency is associated with impaired macrophage efferocytosis of eosinophils. BMC Pulm Med. 2014;9(14):112.
Donohue JF, Herje N, Crater G, Rickard K. Characterization of airway inflammation in patients with COPD using fractional exhaled nitric oxide levels: a pilot study. Int J Chron Obstruct Pulmon Dis. 2014;16(9):745–751.
The Global Strategy for the Diagnosis, Management and Prevention of COPD [webpage on the Internet]. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017. Available from: http://www.goldcopd.org/. Accessed October 16, 2016.
Dweik RA, Boggs PB, Erzurum SC, et al. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med. 2011;184(5):602–615.
The Chinese national guidelines on diagnosis and management of cough (2015). Chin Med J. 2016;39(5):321–339.
The Chinese national guidelines of pulmonary function test (2014). Chin Med J. 2014;37(9):655–658.
Soter S, Barta I, Antus B. Predicting sputum eosinophilia in exacerbations of COPD using exhaled nitric oxide. Inflammation. 2013;36(5):1178–1185.
Korevaar DA, Westerhof GA, Wang J, et al. Diagnostic accuracy of minimally invasive markers for detection of airway eosinophilia in asthma: a systematic review and meta-analysis. Lancet Respir Med. 2015;3(4):290–300.
Negewo NA, McDonald VM, Baines KJ, et al. Peripheral blood eosinophils: a surrogate marker for airway eosinophilia in stable COPD. Int J Chron Obstruct Pulmon Dis. 2016;1(11):1495–1504.
Berry MA, Shaw DE, Green RH, Brightling CE, Wardlaw AJ, Pavord ID. The use of exhaled nitric oxide concentration to identify eosinophilic airway inflammation: an observational study in adults with asthma. Clin Exp Allergy. 2005;35(9):1175–1179.
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Find Your Core and Never Let Go!
In the world of health and fitness, there is an obsession with appearances. Looking good, flaunting your muscles and most of all building those six-pack abs are often the goals. It is perhaps this skewed view of fitness that makes yoga appear more complicated than say, doing sit-ups, crunches or other exercises that focus on the abdomen.
In a yoga class, you will often hear the teacher telling you to 'engage your core.' This is a highly debated subject and rightly so. One way of looking at it is the physical which involves identifying those muscles such as Rectus Abdominis, Transverse Abdominis, the Obliques and so on. Another way of looking at it is holistically. This means to be aware of your central source of strength and energy. It involves the spine, the trunk, the abdominal and the pelvic muscles but it also involves the depth of your awareness in maintaining spine stability, balance and posture.
How to find the elusive core?
Initially when I started yoga, the core was a constantly shifting concept. The six-pack ab ideal in my mind did not help because that was merely scratching the surface. By the way, if you are looking for a six-pack in a yoga studio, you are looking for it in the wrong place. Secondly, you are in all probability looking for the wrong thing because you are compromising on flexibility and inner stability by being obsessed with something as superficial as six-pack abs.
It is only by regular practice that you will find your core and when you find it, it may not come as a revelation. It is rarely as dramatic as a moment of epiphany. You discover it slowly but surely, sometimes when you are doing a side plank pose or a dolphin plank pose, the locust pose or an inversion such as a shoulder stand or a headstand. And then, you slowly become aware of it all through your practice. As the celebrated Ashtanga yoga teacher, Pattabhi Jois used to say, "Yoga is 99% practice and 1% theory." So, no matter how much you analyse and identify your different muscles and focus on them, it is only through regular practice of the yoga asanas or physical postures that you will be able to find your core.
Take it beyond the mat and the studio.
Once you find your core, you will not let go. It is like breathing. Yoga makes you aware of your breath even when you are not in a studio. Whether you are running, walking, at work or relaxing watching a movie or reading a book, you become aware of your breath and on a deeper level prana or life. Indeed, the term for breathing techniques in yoga which is called pranayama, is derived from the term prana which means life or life-breath. Similarly, once you find your core, you will be aware of it in your everyday life. It will establish correct posture when you, walk, sit or stand and imparting grace and balance to every movement that you make, whether on or off the mat. Real yoga practice goes beyond the physical, beyond what we can see, it becomes an awareness of how we live.
Yogasync Me! Access quick fix core activation yoga here and now.


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It is surprising to see how much a young monkey clings to an abusing surrogate mother whatever the bad treatment « she » keeps giving it [Harry F. Harlow]. Another manoeuvre that is possible after the initial despair stage is to create a « false symbiosis » with the mother. Thus, body isolation is the very current first solution found in the heavy disorders produced by the early isolation of the child. When a child with Asperger'sbecomes paranoid, he fails to make a distinction between accidental and deliberate acts. ASD traits and neuropsychological functioning may precipitate and perpetuate paranoia. The vitality pushes. Seven cross-sectional studies have examined paranoia in ASD. This is the last possible outcome of this fight for survival. A systematic search of English-language peer-reviewed publications was undertaken to synthesise empirical research about paranoia in ASD. Most of the structural paranoid types come from an evolution of one of the psychotic series case. research on autism, psychosis, and addiction. It calms me for the first 5 minutes or so after I've taken a couple of hits, the beginning is great. [see B. L. Whorff, Language, Thought and Reality, 1956; Ludwig Von Bertalanffy, General System Theory, 1968; Piera Aulagnier, L'apprenti historien et le maître sorcier, 1993, pp. Increasingly, it is recognised that there is a spectrum of severity of excessive mistrust across the general population. This prohibition to think is done by negative methods, such as « do not do that » or do not say so and so » etc;, but also by positive methods such as the imposition to think in a certain way. This audiobook addresses anxiety, depression, psychosis, and paranoia. He is indifferent to speech or other human stimuli. Psychosocial factors may render individuals with ASD vulnerable to developing paranoia. Thus we have in this type of history both a sacrifice of the child on the altar of conformity, and a sacrificial resignation of the child attempting a redemption of the parent. This is the usual guise of destructive process : ideology named good. ASD traits and neuropsychological functioning may precipitate and perpetuate paranoia. This is the onset of the early delirium which is very common to babies although it seems to have passed unnoticed in many instances. The urge to kill the mother is but the mother's urge to kill the child transferred into the child's psyche and acted out by him. Cette pathologie psychologique est exaltée par une consommation excessive l'alcool, de substances toxiques telles que la cocaïne. Paranoia, defined as the unfounded or exaggerated idea that something or someone is deliberately trying to psychologically, physically or financially harm you, is not an uncommon transient sentiment among the general population at one time or another. In order not to complicate the vocabulary, we here use the standard names of autism, psychosis and paranoia to describe the various psychic structures generated from early traumas. Many mothers during therapy talk about these feelings not understanding them and how they were born to them. Third, the mother also can be used as an addictive object and help sustain a state currently bordering decompensation. The nonsense of the originary trauma will also produce a difficulty to make sense of life, motivation, others, and community. How do we then come to ignore such early disasters leaving a so unbearable suffering that it cannot be even slightly touched without creating those special ways of managing the pain that we call crisis, depression or delirium? https://doi.org/10.1016/j.rasd.2016.02.002. Here is a chart showing the canonical of heavy disorders and of their genesis by impeding correct imprinting. Effective social programs teach a child early communication and social interaction skills. In some occurrences, the baby is shocked or stunned by an especially difficult labour, and the call for contact may not come at once and has to be solicited or favoured by the mother. This provokes an abandonment perfectly felt by the child, in the loss of the necessary synergetic effort of the mother, and a panic which may result in stopping the expelling frenzy. Your voice is missing! Therapy such as CBT, may help in this regard - especially if it involves 'themes', or recurrent patterns that are seen as threats from other people. Postpartum depression is the regular consequence of the lack of symbiosis, or rather of the rupture of the pregnancy symbiosis without its natural extension during the first months of the infant's life. A framework to guide further investigation is outlined. With all mammals, any slight intervention on the mother or on the offspring during and right after delivery (like touching the new-born, preventing smelling, touching or seeing the small one), causes rejection, destruction of the offspring by the mother, or its abandonment to the predators. One of the reasons why getting a correct autism diagnosis is so very important is because it's easy for autistic behaviours and responses to be interpreted as expressions of mental health problems, which can lead to all sorts of over-medicating and worse. Yet, the contractions are essential in triggering the onset of the freeing frenzy, and of the whole vitalisation reflex. Typically, the paranoid type is in a negative symbiosis or parasitosis with the world where the original aggressor or persecutor is the whole environment. We hypothesise, however, that core ASD characteristics and associated neurocognitive impairments also serve to precipitate and perpetuate paranoia. Relatively little is known about paranoia in individuals with autism spectrum disorders (ASD), but rates could be expected to be higher given both difficulties in understanding others' mental states and frequent experiences of negative social interactions. Skin to skin contact of the new-born with the breast draws with it the touch, the smell, the vivacity of the child which are all part of the shock necessary to produce the continuity between the feelings of the foetus and those of the new-born, and the bonding reflex. Only at the end of my career(s) was my autism identified. He is scared and has a reaction of retraction when one closes on him. This is precisely the reason why very little work on the real events generating psychosis has been done, few professionals have devised methods to reach the core of our structure, or that little attention has been paid to the testimonies of those who have undertaken reliving their archaic lives in specific therapeutic settings. The paranoid series is the type of disorders one has when the two first imprints have been correctly had, but separation from the mother has not taken place, owing to the absence of a real role active father or the absence of a symbolic or social father. Help for adults with Asperger's and High-Functioning Autism who struggle in relationships... https://www.AdultAspergersChat.com The psychotic series is the type of disorders one has when the child is vitalised but has lost or has been refused the natural symbiosis. There are numerous examples of all these forms of attack with consequences ranging from severe disorders (autism, psychoses and their derivatives) to actual death. Death often comes unexpected after the despair phase if the suffering is too high and the hope too weak. In 2012, Pinkham and Sasson evaluated paranoia, a common experience in people with either condition. In children with Asperger's, paranoia–or misreading the motives of others–is an aspect that can be disheartening to patients and to the parents of children with the syndrome. London fundraiser. We shall show that psychoses originate mainly from the impeding of the course of the early essential ethological imprints or their prevention. But they do not come back whole, a good part or the totality of their vitality is gone, and they usually live passively and driven by the other's motives, with sometimes a certain awareness of being « behind a glass », in an other world than the others who appear to move on their own drive. The autistic series is the type of disorders one has when the first imprint, vitalisation, has not been had, and the child is unborn, or has regressed to a prenatal stage, the child is born, vitalised but shelled in, or has regressed to a previtalisation stage, the child is vitalised but deactivated. Then despair and emergency procedures will start. Swine Flu and Paranoia, North of the Border Chantal Sicile-Kira May 1, 2009 Recently I traveled to Mexico (see Autism and Hope, South of the Border) and came back really sick, so sick that I visited my medical clinic three times in two weeks. Here is a selection of them: A mother prevented to bond to her baby is also in a state of distress which may easily pass unobserved. The innumerable variations in the outcomes of faulty imprinting can be thus classified by the type of imprinting which had been had early in life. Actual absence or isolation would recall the originary event with full pain; struggling with a toxic object is the opposite of such a re-living and therefore actively sought as a saving device. If the contact with her body is refused by the mother , if the child is taken away, or if the mother is anaesthetised, or numbed, or shocked, or indifferent, or even rejecting for some reason, the absence of the proper response is a catastrophe to the child. The absence of drive entrains the absence of call for bonding (very remarkable in therapy), the absence of feelings and elementary reactions, and the absence of psychic work on the sensory inputs. the American colloquial phrase, "Everyone is out to get me"). In order to recognise the outer baby as the same as the inner one, a number of steps have to be taken into account. Paranoia is characterized by intense, fearful feelings and is often related to thoughts of conspiracy, persecution, and threats. Thus, in the normal state, the psyche remains blocked or split, avoids the risk of stalling, facing the blank behind which lies the terrifying recording left by the event, and in a state of acute tension. This is a very thorough look at Autism from all angles. The urge to kill the unresponsive mother so often found in therapy settings is part of the rage to survive by killing the destructive object, and also the mother's unconscious urge to kill the child transferred to it's psyche and acted out (since the child cannot hold nor repress that motion). Relatively little is known about paranoia in individuals with autism spectrum disorders (ASD), but rates could be expected to be higher given both difficulties in understanding others' mental states and frequent experiences of negative social interactions. Since in this originary register there are no fantasies nor words to elaborate on the purely body event and release tensions (no primary nor secondary register yet), the response is a `body delirium' (or a delirious acting out). Continuity is ensured by feelings, principally that of mastering the whole process from the early contractions to the contact on the breast, and by sensations, especially those of helping the baby during his efforts to come out and those of the progression of the new-born in the tractus. Then, emergency procedures appear, and when they fail, havoc; more and more drastic procedures attempt to preserve a form of psychic life, then biological life to the detriment of the psychic life, then death. One has to lift the veil of his own infancy before accrediting the actuality of the terrible events which have taken place at the dawn of life, and this can be done only by procedures which are contra-variant to the enforced mainstream knowledge and methods which were all designed to produce oblivion and false sense. This is an actual psychic death implying renouncing to life in the outer real world and growth. The child is actively closed to the world, shelled in, and hard. When the call for imprinting has not been responded to, a disastrous process begins. The absence of the mother's body has no pre-established meaning in the child's psyche and the child cannot make sense of an event for which he has no built-in program. ), due to false birth process theories, from unconscious/conscious male aggressiveness towards women attempting to prevent feminine functioning, rejection of children, sadism, search for profit, search for fame, etc. Seven cross-sectional studies have examined paranoia in ASD. Copyright © 2016 Elsevier Ltd. All rights reserved. However, the mutual parasitic scheme is an unstable system and oscillates between attempts of destruction of the other and protection against destruction. Levels of paranoia are higher in ASD, compared to typically-developing samples. Another surprising feature found by many clinicians is that of attempting to love and repair the mother, that is a sacrificial attitude of the child in the hope that the mother will eventually come to milder terms. ), 3-similar problems due to the failure of the society to cope with the essential imprints (for example the psychological father which gives the right environment for the woman to transform into a mother or to wean the child properly has a social component lacking in many industrialised societies). has become an organ of hers; disinvested, i.e. He could be watching Spongebob videos on his iPad, but he just doesn't want me to see what he's doing. It is the loss of the ordinary set of sensations of the body (section of the body) and a raise into a supersensitive state where much refined feelings come directly to the psyche from the surroundings and tell much more than the ordinary senses. Last Friday, I actually got to see my regular doctor, but that was before we knew the swine flu existed. Before autism had its own entry in the Diagnostic and Statistical Manual of Mental Disorders, people with autism were diagnosed with childhood-onset schizophrenia. These points were missed partly from the lack of evidence of these mechanisms at this pioneering period of the art, and partly owing to the strong ideology that birth methods and early education were good and not to be discussed. Fast and free shipping free returns cash on delivery available on eligible purchase. The vitalisation reflex is thus suppressed and the baby is taken out in an impotent and helpless condition. In some occurrences, it will handicap other types of intelligence out of fear and unfulfilled narcissistic needs. We use cookies to help provide and enhance our service and tailor content and ads. Published on 12, July, 2020. This is due to the large benefit both gain from this detrimental, even in some cases lethal, arrangement. What was not expected in this arrangement is that either repetitively or slowly building up in time, the original event will be reactivated, replayed and re-enacted, owing to the natural tendency to relive the originary trauma seeking the freeing of the associated tensions. Am J Psychiatry. In children under 3 years of age, these interventions usually take place at home and they target specific deficits in learning, language, imitation, attention, motivation, compliance, and initiative of interaction. Reliving the original scene leaves no doubt that at the same time these crippling events were taking place a disposition of the environment was creating a veil on the recording. Attachment between father and child, although of a different kind from that of the mother, also necessitates proper childbirth procedures to happen. They did not differ in self-concept and causal attributions, contrary to the attributional model of paranoia. Welcome to Autism Forums, a friendly forum to discuss Aspergers Syndrome, Autism, High Functioning Autism and related conditions. Subjugation of the mother and father in a moment of emotional importance conducing to the enforcement of irrational and inadequate childbirth methods is often a cause of faulty imprinting. We have found a number of cases where the child is numbed during labour, probably as a result of the partial or total anaesthesia of the mother: the anaesthetic is a light molecule and diffuses easily through the placenta, in sufficient quantities to produce a significant change of state in a highly sensitive baby of 3 kilograms. oscillating between disintegration and suicide, fits of violence and depression. Distraction of the mother from the natural needs for proper labour and delivery by psychological means also occur: pressure to deliver rapidly, induction of pushing hard, the presence of males, an unsuitable and distressing position such as lying on the back with legs wide open in the presence of unknown masculine staff, imposition by force or by seduction of unknown or non-accepted methods or products, authoritative attitudes producing fear and submission, imposing and pressuring, are attitudes of the staff generally detrimental to the already present link between mother and child, to the natural course of the labour, to the synergy between the contraction rhythm and the vitalisation reflex, and to the subsequent smooth passage from the inner womb to the outer womb, and to the construction of this external womb. There's an excellent analysis of this in Tony Attwood's Aspergers and Girls book. As in typically-developing populations, causal and maintaining mechanisms for paranoia in ASD, against a background of genetic and environmental risk, most likely include cognitive and affective processes interacting with social factors. It has also been shown that a female who has been isolated or has not been raised with peers during childhood is likely to ignore the young after its birth, step on it like inanimate objects, or treat it with brutality [Harry F. Harlow]. A systematic search of English-language peer-reviewed publications was undertaken to synthesise empirical research about paranoia in ASD. In some cases, the indifference or hate which arises at birth has been present in the history of the mother since infancy, or cumulates on her previous unconscious contempt or hate of males, of authorities, or on early self-hate and/or envy projected onto babies. People with paranoid schizophrenia appear to have an automatic, delusional and omnipresent sense of being under threat. This is done by the lack of certain forms in the language which, in our occidental system, prevents the expression of some modes which would be useful in exposing in particular inner events or early events or relational events. report that genetic variation in the single-nucleotide polymorphism (SNP) rs850807 was strongly and exclusively associated with expression of paranoia symptoms … J Autism Child Schizophr. No affective development will happen until the onset of vitality is worked on by triggering the self-expelling frenzy in a specialised setting. Each presented the theory that the measles-mumps-rubella (MMR) vaccine in combination with thimerosal, a mercury-based ingredient contained … Therefore, such an event will be recorded as unaccountable for, an out of the human range horror, a sheer destruction without meaning. In the following presentation, we use the simplifying on/off binary description of imprinting, thus leaving us with only a few canonical cases. These are secondary issues that can affect people with autism. This is completed by the absence in the vocabulary of words pertaining to notions that the whole of the society does not want to hear about. Our Autism Inpatient Mental Health service offers information and support to families whose loved ones have been detained in a mental health hospital, or are at imminent risk of detention or re-detention. First, she does not know or make sense of what is happening, feels disoriented if the baby is taken from her, she may loses her notions, or he ability to reason or to call for help or to express her distress. By continuing you agree to the use of cookies. Environmental problems are numerous, especially in clinical situations where the woman loses the power on herself and on the baby, and where the intimacy which should more or less correspond to the intimacy of the conception moments is broken. The absence of bonding has left an immense void in the child that is better filled by a fight for life than nothing. Progression may try to occur even without having had a correct imprint: this is the reason why we meet seemingly advanced stages which bear heavy disturbances. Since she is not transformed by imprinting into a natural mother, true symbiosis is not possible, but the creation of a mutual parasitic bond is sometimes possible (a dual parasitosis). A framework outlining causal and maintaining factors for paranoia in ASD is proposed. Paranoia is an instinct or thought process which is believed to be heavily influenced by anxiety or fear, often to the point of delusion and irrationality. Second, it maintains a slight hope that she will changed and that the future might be fairer than the present. Basically, my whole family have said I have A LOT of traits of Autism and my mother spoke to a specialist and she confirmed it. The attachment with the father comes into play later on when dissolving the symbiosis is needed. The child is (sometimes from the conception) just felt and used as a supplementary organ of her. The early infant death, usually around 2-3 months, when not of biological origin, is fully accounted for by the above described process and is actually a suicide under forced conditions, very similar to the post-traumatic deaths. Based on the heartless and coldly smug reaction at the last employer on sharing that information, I'd say you cannot … These attacks may not be unconscious: they sometimes form a part of the theory of good medicine or of good mothering, or of good education. If it does not happen in the first weeks of life, it very often reappears in the course of adolescence as a attempt to suicide, or later in life when circumstances recall the originary event, which is more or less bound to happen. Second, she may lose the emotional capacity of recognising the baby she is presented to later as the one she had in her belly a few moments ago. Clients testimony of loss of the hold to the normal state, a fall without possible stop in a black void, and a state of a horrible no-command. Conversely to the symbiosis where a phase of separation and mutual independence is reached relatively easily during the second year, the parasitic bond seem to be very resistant to the forces of separation and independence which may grow in each. In the new-born, if attachment has not taken place, a double process sets on: try and restart the imprinting processes (absent or faulty) when an occasion seems possible; cope with the situation as it is without the skeleton of the imprints. The third one may also have been problematic, but in the majority of the cases as a consequence of problems in the first or the second. systematic attack of the natural delivery process (rhythm and duration, position, environment, etc. What failed to Freud was twofold: 1-he ignored the mechanisms of the early instincts of the foetus, neonate or infant, and of the mother during the perinatal and early feeding period, the psychic work of the originary register; 2-he ignored the disturbances due to the environment, namely the parents, the family, and the clinical staff besides them. While often occurring in many different mental disorders, paranoia is often not present in several psychotic disorders. I have Aspergers (along with depression, anxiety and PTSD) and I have found that marjuana just does not agree with me. If no response is had, rage will set on, to try release the enormous amount of tension and keep potent. creating a doubt as to whether that real horror has been actually lived, with opposite words such as « normal », « everything has been all right », thus making the infant doubt of his sensations, reactions and recording of the events, by attacking constantly the vitality process, thus the power input weakening or extinguishing all reactions, and later emotions and words which tend to reveal the truth. The other affective functions are not possible, since all the vitality is used to annihilate the body-based functions. The sensory outputs appear to be normal at the level of the sense organs, but there is no psychic work done to transform them into feelings, hence the no-feeling state and coldness of body usually reported. But we do not relate them to symptoms, following the theorem that symptoms are the product of a definite structure and of the situation, principally the transferential situation, so that symptoms refer as much to the observer as to the person under study, and can not be used as a testimony of the structure. For the mother, she gains the appearance of a good mother and the parasitic bond is a good part of the mask she badly needs. It has a strong similarity to the environment of antisocial personalities, and it is possible that what we call primary paranoia (at least in some forms) is akin to psychopathic personality. Again, they saw different mechanisms at work. Our modern chat room. Useful Links. The mother usually respond by disinvesting the former established relation with the child and safeguarding herself by concentrating on her pain. … As for the mother, anaesthetics can produce a hold in the labour and irregular or absent contractions. Copyright © 2020 Elsevier B.V. or its licensors or contributors. He is passive and soft and has no will, being subject to outbursts of violence if constrained or put into danger. What was not said at this time was that a « normal » mother, ready for symbiosis and children care, may very easily become a rejecting mother if the maternity staff, the father's behaviour, or other environmental circumstances, interfere with the bonding and symbiotic process. Rational Paranoia Rational Paranoia. by attacking the freedom to move and to express, by suppressing the schemes and inhibiting the process by which the infant gains his independence during the second year; by preventing this third imprint to happen, one creates specifically disorders of the third paranoid series on a background of psychosis; if not sufficient, preventing the fourth imprint of freedom at the age of seven and of passage at adolescence will complete the masking task; by imposing raising and educational methods enforcing oblivion of the early hours of life such as: impeding reactions (which are attempts to re-live the originary scene and let go of the tensions thereof and make revelation and sense of it); impeding emotions later in life; depreciating the emotional life; enforcing a mental life and an intellectual education which compels investment in the function opposite to that which will bring revelation and release; favouring passivity and control instead of agitation and release attitudes, even to the point of utilising punishment of chemical suppressers of vitality; enforcing standard language and knowledge where all trace of these type of events are absent; enforcing a discourse reputed with the higher cultural value such as « rational » or « scientific » where all reference to this type of events and to methods of retrieval of those events has been thoroughly erased. Buy Autism Anxiety Depression Psychosis and Paranoia by Breeding, Travis online on Amazon.ae at best prices. The result is virtually the same as in the previous case, but since vitality has set on, and is active, the womb effect is obtained by creating a sensory and muscular barrier to external stimuli, by active disinvestment and repulsion. In some births, oxytocin is used to accelerate contractions, but produces abnormal ones, largely excessive and painful. They have trouble conceptualizing the beliefs, thoughts, feelings, and kn… We have actually found in most cases that the response to the isolation or rejection of the new-born is of delirious type. DSM: the Psychiatric Bible and the Creation of Mental Disorders, 1997]. La maladie est plus importante à partir de 40 ans. It is also done by creating specific names of adjectives used for the degradation, the depreciation or even the removal and suppression of the individual from the social stage. These survival schemes are different whether they stem from the first or second imprint. It is important to note that some of these attacks function by rebound: some actors impede the natural functioning of another. Volkmar FR, Cohen DJ. fear of the delivery, anticipated rejection due to a fear of the infant to come, inaptitude of the mother to form a symbiosis with the child, sexual difficulties in the couple, etc. If one attempts to make a logic of the nonsense of sheer inhuman destruction, which is the originary experience, one will end mad since we have no built-in program to account for non-instinctual behaviour. cutting the vitality to prevent sensing and reacting. Coping with the absence of the mother's body in the first place amounts to cope with torture. The distinction between the two disorders remained unclear for nearly 30 years, until DSM-II included children with autism under the diagnostic umbrella of schizophrenia… Autism Anxiety Depression Psychosis and Paranoia, Travis Breeding, Smashwords Edition. The excess of pain to be managed instantly provokes a tentative reduction of the sensations which can be done in two steps: cutting the sensations, which amounts to separating from the body and thus from the reality of the outer world The child's first reflex is to get the body of the mother, the warmth, the heartbeat (already known) and the breast, for safety and continuity. Furthermore, the initial evidence indicates that paranoia in ASD may be linked with theory of mind performance, negative affect, and jumping to conclusions, but not to attributional style. Keep up to date with all the great things we're doing Subscribe for updates. All what is foreign to mammal and human built-in instinctual programs (including the ability to cope with natural catastrophes and predators) will meet a void of ready elementary « explanation » (here in the originary, ethological, and instinctual response range). The present study investigated this attributional model of paranoia in Asperger syndrome. This is a highly defensive state. Here, autism, psychosis, and paranoia refer to definite missing or faulty imprint, therefore to a definite structure. 1991;148:1705-1707. an outer object necessary to maintain her frail balance on the verge of rupture (incipient decompensation)[see Addictions]. 232-363 ; Kutchins and Kirk, Making Us Crazy. The child benefits from this by rendering his mother less terrible than if she does not use him as a crutch, since she would then probably decompensate and he will lose her or face a rougher treatment than he now has. We have an absolute necessity of making sense of what is happening, which will then be at a loss and the psychic process will eventually stop and shatter into pieces. It is caused by the loss of the child (this is how it is felt when bonding has not taken place), by the repression of the rejection of the child, and by guilt or remorse and the feeling of being a bad mother. The child is then either: deprived of major functions, the feeling and reaction ability, the integrity, or the drive; alienated to the mother, i.e. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concerning a perceived threat towards oneself (i.e. Achetez et téléchargez ebook Autism Anxiety Depression Psychosis and Paranoia (English Edition): Boutique Kindle - Mental Health : Amazon.fr The difference was autism had higher levels of social anxiety and self-consciousness that was then tied to paranoia. And in this respect both the originary trauma of the child and that of the mother. In some cases, the self-expelling frenzy has partially or fully taken place, but the conditions met during delivery (unnatural induction during labour), during the bonding critical period (removal of the neonate, abandon or rejection by the mother), or during the beginning of the symbiosis (aggressive behaviour from staff or parents, lack of external womb and protection against dangerous stimuli), create such a danger that the child seeks by regression a safer environment, occludes the external and reverts to a stage before delivery or even before vitalisation. Therefore, there are bridges between elementary disorders, in either direction: worsening and regression to a former state, bettering and progression to a more advanced state. The external world does not exist, for want of a psychic disposition to make sense of the inputs, itself for want of an investment of the drive, which here does not exist, in the functions used to elaborate on the sensory inputs. 237-263; La violence de l'interprétation, 1991, pp. Third, the openness and receptivity to the contact of the new-born she is in just after delivery (the critical bonding window) soon fades away and she is left in a somewhat insensitive and indifferent state (due also to the shock of having « lost » her baby). the structural theory of autism, psychosis, and paranoia; addictions, bulimia-anorexia, alcoholism, drug abuse and other addictions; depression, violence, and delirium; note on the therapy of severe disorders autistic, psychosis, paranoic series, eating disorders, alcoholism and other addictive element It will remain in later life as a lack of sensitivity, a lack of response, an impossibility of building up the natural emotional response and relational communication schemes and a confused or inadequate function of sentiment (which is body based). ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Conceptualising paranoia in ASD: A systematic review and development of a theoretical framework. We have seen above that in very adverse conditions, the psyche will seek to revert to the much safer condition it had before birth. Therefore, the child lives a uterus life and does not require nor wishes external contact. 4. The absence of the bonding reflex in the mother may have many reasons: personal emotional problems, inadequate environment, or detrimental practice during labour. Similarly, Anna Freud pointed out the strength of the bond of children being abused, or being alternatively abused and cuddled. Event. Forum; Files; Members; Mentions; Sub-Groups; Tags; More; Cancel; New; Adulthood and Autism requires membership for participation - click to join. Crespi et al. The hormonal changes for labour and for lactation are also part of the transformation which ensures the continuity foetus – infant. A relatively small number of mothers are unable to face the call for bonding, owing to their own psychological resonance, or could face it only with the assistance of a specialised psychologist. Depending on the welcoming of the child, some mental development can take place, since this is the only function that can work. Travis provides real-life examples from his life and talks about how anxiety, depression, psychosis, and paran… October 25, 2018 Patrick Dwyer Comments 1 comment. It is easy to show, from our therapy notes, and from many cases of perinatal therapy [Sandra Lantzman], and also from other analyses [for instance: Stanislav Grof, the perinatal matrixes] that in each case of autism/psychosis, when we face the root cause of the disorder, we come upon a distressing event during precisely the first or the second essential imprinting process. For example, we have many instances where the neonate is taken away from the mother by the staff precisely at the critical period of bonding, thus impeding the transformation of the woman into a mother at the contact of the new-born, and producing the surge of the instinct of destruction of the unattached child in her associated with depression at its loss. The other source of variation is that of the subsequent history after the faulty imprinting has taken place. You will need to register to get access to the following site features: Reply to discussions and create your own threads. Comorbid association of autism and schizophrenia. Replies 51 replies Subscribers 480 subscribers Views 7765 views Users 0 members are here Options Share; More; Cancel; Related Autism Spectrum and Paranoia. In those cases where chemical manipulation is used to modify the rhythm and the strength of the contractions, heavy defects of the vitality may occur, and sometimes leads to its complete absence. Thirdly, the child can be a addictive object, i.e. Then, in the approximate severity sequence, the child experiences: The absence of the bonding reflex in the child points in most cases to the lack of vitalisation. Levels of paranoia are higher in ASD, compared to typically-developing samples. Autism and schizophrenia share a convoluted history. I have yet to be diagnosed formally, but I was wondering if paranoia is linked to this as I get very paranoid about certain things. The affective and relational functions are nil, since all the body-based functions, not being fed by vitality, are non-existent. 1972;2:315-337. Furthermore, the third imprint, the dissolving of the symbiosis, is a complex stretched in time motion, already cumulating on the preceding imprints, so that typical features are more difficult to isolate. Autism Anxiety Depression Psychosis and Paranoia: Travis Breeding, Betty Johnston, Travis Breeding: Amazon.fr: Livres At this point the psyche explodes from the incapability to process so much pain. How they have survived to that death and came to a surrogate life then is usually not known. A number of mothers would have easily bonded to their new-born and entered the symbiotic state with happiness and reward had the medical staff not prevented it. In the aetiology of the psychoses, it is therefore important to assess what set of motivations is behind the destructive act and what is its mask. [see Therapy of the Psychoses]. The same sort of feelings may occur to the father if he is taken away from the birth scene or do not play the correct role. [see Therapy of the Psychoses]. This reflex is automatically triggered by the contact with the outside when the vitality is on. Autism Anxiety Depression Psychosis and Paranoia, ISBN 1792850506, ISBN-13 9781792850509, Brand New, Free shipping in the US So-called technical reasons or non-psychologically evaluated current practices are especially numerous in the inhibition of the bonding reflex of the mother. reading others' intentions resembling paranoia, difficulties in expressive communication resembling thought disorder, and 'melt downs' resembling catatonia.6 Third, these psychopathological alternatives might simply be epiphenomena of different constructs and language from separate literatures applied to the same mental phenomena. Individuals with ASD were consistently found to have higher levels of paranoia compared to non-clinical controls, and lower levels than individuals with current psychotic experiences manifesting in the context of schizophrenia. 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autism and paranoia
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autism and paranoia 2020


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Home Blog Pope speaks as a pastor in call to protect earth, USCCB president says
Pope speaks as a pastor in call to protect earth, USCCB president says
By Dennis Sadowski
Archbishop Joseph E. Kurtz of Louisville, Ky., president of the U.S. Conference of Catholic Bishops, addresses media at the National Press Club in Washington June 18 about the U.S. perspective on Pope Francis' encyclical on the environment.
CNS photo/Tyler Orsburn
WASHINGTON — Pope Francis speaks with a pastor's voice and with deep respect for science in calling the world to address threats to all life on earth through environmental degradation and a the mindset of a "throwaway culture" in his encyclical, the president of the U.S. Conference of Catholic Bishops.
Archbishop Joseph E. Kurtz of Louisville, Ky., said during a June 18 news conference in Washington that the encyclical, "Laudato Si', on Care for Our Common Home," also urges people to remember that "we have a shared responsibility for one another" while calling for "urgent action" to work for the common good and the betterment of the planet.
He said the document is meant to be a valuable teaching tool and moral guide for "generations to come."
"He's painfully aware of what's happening to our world and that we need to grow in solidarity, responsibility and compassionate care," the archbishop said. "He's speaking to all of us now. What does it mean? It's marching orders for advocacy."
Cardinal Donald W. Wuerl of Washington also addressed reporters and said that as he read the encyclical he immediately thought of the magnificence of God's creation and how everyone must take steps to protect it.
"Our Holy Father is speaking out of our Catholic tradition," the cardinal explained. "But if you read the document carefully, he is not saying to individuals whether you are in the economic area or the political area, 'You must do this.' He is saying, 'Here is the moral frame of reference. I would like everyone to work together on this so that we individually would come to the conclusion this is the way things should be.'"
While the pope sounded an urgent call for action is urgent, Cardinal Wuerl told Catholic News Service he interpreted it as a call for conversations to begin on how to address the challenges facing the planet ecologically and economically.
"The urgency is to get started today," he said. "That means it's going to take a little bit of time."
The encyclical provides an opening for people to cross political divides to discuss solutions to the challenges posed by climate change, polluting industries, drought brought on by changing weather and the failure to respect all of human life, Archbishop Kurtz told reporters, saying that solutions are not likely to come quickly.
"We need to give ourselves time, all of us including the bishops, to be able to reflect and read and study (the encyclical)," Archbishop Kurtz said. "Those who take this studying seriously, I think, will find an invitation to dialogue."
Various parish and school study guides, homily aids and online resources have been developed by the USCCB and its partner, the Catholic Climate Covenant. Both prelates said the materials will help initiate those discussions.
Archbishop Kurtz, who was the Diocese of Knoxville's second bishop, said the formation of young people on the environment particularly will be important in the months and years ahead.
"What kind of world are we going to leave to those who come after us?" he asked.
Bishop Richard F. Stika of the Diocese of Knoxville said he prays that people will see the wisdom in Pope Francis' encyclical.
"It is with excitement and joy that we have received Laudato Si, the much anticipated encyclical letter on the environment from Pope Francis. Some will try to place the Holy Father's words into a political framework and limit discussion to just a few talking points. This encyclical is not about politics and taking sides. The pope's message is a moral one, and its meaning and impact go beyond the fractured discourse that seems to consume our society," Bishop Stika said.
"The Holy Father reminds us that the beauty of creation that surrounds us is a gift. His message is meant for all humanity, and its conclusions are based on research and the advice of the Pontifical Academy of Sciences of the Vatican — an organization that includes Nobel Prize- winning scientists. I pray that people everywhere accept its wisdom. I praise God for the beauty of creation, and I give thanks to Him for our planet and our home here in East Tennessee," Bishop Stika added.
Christiana Peppard, assistant professor of theology, science and ethics at Fordham University, described the pope's message as pastoral and poetic, as has been his style since his election, and follows in the footsteps of his predecessors, particularly Pope Benedict XVI, who has been described as the "green pope."
"He is attempting to take a global look at planetary problems," said Peppard, one of three experts who appeared at the news conference to address questions on particulars of the document. "His views are not merely from a North American perspective."
Pope Francis questions "short-term economic yield that leaves a trail of environmental destruction behind, which disproportionately affects the poor and vulnerable," she said. "That's an important part of the idea that the few must not profit at the expense of the many."
She noted that the pope draw upon the words and experiences of people around the world. The encyclical cites documents from the bishops' conferences of Argentina, Bolivia, Paraguay, Southern Africa, Germany, Philippines and the United States.
"The question of whose voices get to be heard is important" to Pope Francis, she explained. "These folks have expertise on how the Gospel looks and the imperative to care for one another."
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Last two of original Sisters of Mercy retire
December 11, 2020 7:36 am | By Emily Booker
The Sisters of Mercy of the Americas have served in East Tennessee since coming to Knoxville in 1896 By Dan McWilliams The retirement of the last two Sisters of Mercy of the Americas in the Diocese of Knoxville ends a tradition of more than 120 years of the community's service in East Tennessee. Sister Patricia "Pat" Soete, RSM, the pastoral associate at St. Jude Parish in Helenwood since September 1994, retired to Mercy Convent in Nashville in late November. In spring of this year, Sister Yvette Gillen, RSM, pastoral associate at Our Lady of Fatima Parish in Alcoa, retired to Nashville. Several Sisters of Mercy have retired in recent years, ending a long run of service that began in 1896 when the first Sisters of Mercy came to East Tennessee to teach at St. Mary School, next door to Immaculate Conception Church in downtown Knoxville. The Sisters of Mercy founded... Read more →
Thoughts on Crucial Voting Decisions
October 28, 2020 1:37 pm | By Emily Booker
By Debbie & Duane Donahoo All Saints Parish As Americans consider their choices in the coming elections, we have a wealth of information on candidates and what their positions are... Read more →
Cathedral dedication stone begins yearlong tour of diocese
December 4, 2016 9:31 am | By Emily Booker
Marble piece blessed by Pope Francis will visit all 51 parishes and missions in lead-up to cathedral opening By Jim Wogan As the new Cathedral of the Sacred Heart of... Read more →
Irish Fest brings out the Irish in everyone
August 10, 2015 2:48 pm | By Bill Brewer
If the weather, crowd size, and smiles are a barometer, then the 2015 edition of Irish Fest on the Hill at Immaculate Conception Church in Knoxville was a rousing success.... Read more →
Fighting hunger is a team affair for parishes
July 30, 2015 9:06 pm | By Bill Brewer
A highly organized assembly line of parishioners from across the Diocese of Knoxville gathered at St. Thomas the Apostle in Lenoir City on July 25 in an effort to help... Read more →
Of prophets and kings
July 10, 2015 11:45 am | By Bill Brewer
By Father Joseph Brando In modern times, the relationship between church and state is complex and difficult. The complication is due to multiple factors, including the migration of peoples, race,... Read more →
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