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Suicide is a serious public health problem. In the international literature there is evidence to support the notion that certain temperaments and personality traits are often associated with suicidal behavior. In this study, 150 psychiatric inpatients were investigated using the TEMPS-A, the MMPI-2 and the Beck Hopelessness Scale (BHS) and evaluated for suicide risk through the critical items of the Mini International Neuropsychiatric Interview (MINI). Statistical analysis, including linear regression analysis and multiple regression analysis, showed that suicide risk contributed to the prediction of hopelessness. Among the temperaments, only the Hyperthymic temperament, as a protective factor, and the Dys/Cyc/Anx temperament contributed significantly to the prediction of hopelessness. Irritable temperament and Social Introversion were protective factors for suicidal risk. Hopelessness and depression were associated with higher suicidal behavior and ideation, but, unexpectedly, depression as measured by the MMPI did not contribute significant to the multiple regression.. The present study indicated that, although suicidal psychiatric patients have MMPI-2’s profiles in the pathologic range, they exhibit several differences from nonsuicidal patients. Patients at risk of suicide have specific temperaments as well as personality and defense mechanism profiles. They are more social introverted, depressed and psychasthenic, and use hysterical and schizoid mechanisms more often. Generalizability of the findings was limited by the small sample size, mix of BPD-I, BPD-II, MDD and psychotic disorder patients.
Pharmacoresistant depression is a challenging clinical condition faced daily by psychiatrists. Although several strategies have been tried to optimize the outcome of this condition, depressive symptoms management remains difficult. Serotonin is regarded as the target neurotransmitter of mood regulation while other monoamines are considered as secondary characters in symptoms management although their role has not been fully explored.
Verify the role of dopaminergic modulation in management of pharmacoresistant depression.
Aim of our study is to evaluate the role of a dopaminergic treatment in pharmacoresistant depression management by administration of transdermal rotigotine.
Pharmacoresistant depressed patients, with a stabilized antidepressant treatment and in lack of symptomatic improvement in last six weeks, underwent a clinical trial with transdermal rotigotine, up to 4 mg/day. Symptoms were evaluated at the beginning of treatment and after one month by three validated scales: Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Global Assessment of Functioning (GAF).
Ten patients (9 F / 1 M; mean age 48,1 yrs) fulfilled inclusion criteria in the roll-in period. The mean scores before rotigotine treatment were: 22.80±5.8 for HAMD, 25.9±4.9 for HAMA and 41.4±11.62 for GAF. After one month of treatment with rotigotine, scores respectively changed in 11.3±3.3 (t=5.76; p< 0.001), 17.2±1.5 (t=6.37; p< 0.001) and 58.3±4.7 (t=-4.24; p=0.002).
Dopaminergic modulation achieved by rotigotine improved mood, motor and anxiety and global functioning scores, in lack of any side effect. In particular, transdermal administration avoided drug plasmatic peacks related to side effects
Social anxiety (SA) is a dimensional psychological trait that unfolds as a continuum from normality to pathology. While studies have focused on brain response when individuals are exposed to social situations, little is known about neural correlates of trait SA in the absence of any social triggering.
To test the hypothesis that brain resting state activity is modulated by trait SA, we measured the Hurst Exponent (HE), an index of complexity of time series, in healthy individuals.
Resting-state fMRI time series were recorded in 36 subjects (16 F; mean age±S.D. = 26±3 years). All volunteers were healthy without any psychiatric, medical and neurological disorders. Each subject completed the Liebowitz Social Anxiety Scale (LSAS).
HE was estimated by using the discrete second-order derivative approach and its relationship with social anxiety was tested across the whole brain.
LSAS scores predicted HE in the posterior cingulate/precuneus (significant positive correlation).
Our results indicate that the brain pattern of spontaneous activity is influenced by the degree of social anxiety, as a continuum. Moreover, as this relationship between the degree of SA and brain activity was found at rest in the absence of any relevant social stimuli, our findings suggest that social anxiety may be a trait characteristic that shapes brain activity and predisposes to abnormal reactions to social contexts.
Few studies have investigated alterations of olfactory neuroepithelium (ONE) as a biomarker of schizophrenia, and none its association with cognitive functioning.
Fresh ONE cells from twelve patients with schizophrenia and thirteen healthy controls were collected by nasal brushing, cultured in proper media and passed twelve times. Markers of cell proliferation (BrdU incorporation, Cyclin-D1 and p21 protein level) were quantified.Cognitive function was measured using Brief Neuropsychological Examination-2. Primary outcome: proliferation of ONE cells from schizophrenic patients at passage 3. Secondary outcome: association between alteration of cell proliferation and cognitive function.
Fresh ONE cells from patients showed a faster cell proliferation than those from healthy controls at passage 3. An opposite trend was observed at passage 9, ONE cells of patients with schizophrenia showing slower cell proliferation as compared to healthy controls. In schizophrenia, overall cognitive function (Spearman’s rho -0.657, p < 0.01), verbal memory – immediate recall, with interference at 10 s and 30 s (Spearman’s rho from -0.676 to 0.697, all p < 0.01) were inversely associated with cell proliferation at passage 3.
Fresh ONE cells collected by nasal brushing might eventually represent a tool for diagnosing schizophrenia based upon markers of cell proliferation, which can be easily implemented as single-layer culture. Cell proliferation at passage 3 can be regarded as a promising proxy of cognitive functioning in schizophrenia. Future studies should replicate these findings, and may assess whether ONE alterations are there before onset of psychosis, serving as an early sign in patients with at risk mental state.
Objectives: This study aimed to evaluate the influence of lower limb loss (LL) on mental workload by assessing neurocognitive measures in individuals with unilateral transtibial (TT) versus those with transfemoral (TF) LL while dual-task walking under varying cognitive demand. Methods: Electroencephalography (EEG) was recorded as participants performed a task of varying cognitive demand while being seated or walking (i.e., varying physical demand). Results: The findings revealed both groups of participants (TT LL vs. TF LL) exhibited a similar EEG theta synchrony response as either the cognitive or the physical demand increased. Also, while individuals with TT LL maintained similar performance on the cognitive task during seated and walking conditions, those with TF LL exhibited performance decrements (slower response times) on the cognitive task during the walking in comparison to the seated conditions. Furthermore, those with TF LL neither exhibited regional differences in EEG low-alpha power while walking, nor EEG high-alpha desynchrony as a function of cognitive task difficulty while walking. This lack of alpha modulation coincided with no elevation of theta/alpha ratio power as a function of cognitive task difficulty in the TF LL group. Conclusions: This work suggests that both groups share some common but also different neurocognitive features during dual-task walking. Although all participants were able to recruit neural mechanisms critical for the maintenance of cognitive-motor performance under elevated cognitive or physical demands, the observed differences indicate that walking with a prosthesis, while concurrently performing a cognitive task, imposes additional cognitive demand in individuals with more proximal levels of amputation.
Objectives: A growing body of research suggests that regular participation in long-term exercise is associated with enhanced cognitive function. However, less is known about the beneficial effects of acute exercise on semantic memory. This study investigated brain activation during a semantic memory task after a single session of exercise in healthy older adults using functional magnetic resonance imaging (fMRI). Methods: Using a within-subjects counterbalanced design, 26 participants (ages, 55–85 years) underwent two experimental visits on separate days. During each visit, participants engaged in 30 min of rest or stationary cycling exercise immediately before performing a Famous and Non-Famous name discrimination task during fMRI scanning. Results: Acute exercise was associated with significantly greater semantic memory activation (Famous>Non-Famous) in the middle frontal, inferior temporal, middle temporal, and fusiform gyri. A planned comparison additionally showed significantly greater activation in the bilateral hippocampus after exercise compared to rest. These effects were confined to correct trials, and as expected, there were no differences between conditions in response time or accuracy. Conclusions: Greater brain activation following a single session of exercise suggests that exercise may increase neural processes underlying semantic memory activation in healthy older adults. These effects were localized to the known semantic memory network, and thus do not appear to reflect a general or widespread increase in brain blood flow. Coupled with our prior exercise training effects on semantic memory-related activation, these data suggest the acute increase in neural activation after exercise may provide a stimulus for adaptation over repeated exercise sessions. (JINS, 2019, 25, 557–568)
The Hamilton Depression Rating Scale (HAMD) and the Beck Depression Inventory (BDI) are the most frequently used observer-rated and self-report scales of depression, respectively. It is important to know what a given total score or a change score from baseline on one scale means in relation to the other scale.
We obtained individual participant data from the randomised controlled trials of psychological and pharmacological treatments for major depressive disorders. We then identified corresponding scores of the HAMD and the BDI (369 patients from seven trials) or the BDI-II (683 patients from another seven trials) using the equipercentile linking method.
The HAMD total scores of 10, 20 and 30 corresponded approximately with the BDI scores of 10, 27 and 42 or with the BDI-II scores of 13, 32 and 50. The HAMD change scores of −20 and −10 with the BDI of −29 and −15 and with the BDI-II of −35 and −16.
The results can help clinicians interpret the HAMD or BDI scores of their patients in a more versatile manner and also help clinicians and researchers evaluate such scores reported in the literature or the database, when scores on only one of these scales are provided. We present a conversion table for future research.
This paper describes a method to analyze open or closed elliptical structures with constant axial ratio by a Body-of-Revolution (BoR) Finite Element Method (FEM). The method is based on Transformation Optics, a coordinate transformation that maps the elliptical shape to a circular shape, for which BoR-FEM represents a greatly efficient tool for the analysis.
Perinatal exposure to sucrose or high-fructose corn syrup-55 (HFCS-55) in rats has previously been associated with altered hepatic fat content and composition post-weaning, although the effects on hepatic metabolism are unknown. The current study aimed to determine the sex-specific effects of maternal consumption of sucrose or HFCS-55 on the expression of hepatic lipogenic genes in the offspring. Liver samples were collected from offspring of albino Wistar rats provided with ad libitum access to either water (control), 10% sucrose or 10% HFCS-55 solution during pregnancy and lactation at 3 weeks (control n=16, sucrose n=22, HFCS-55 n=16) and 12 weeks (control n=16, sucrose n=10, HFCS-55 n=16) of age. Hepatic expression of the transcription factors such as carbohydrate response element-binding protein, sterol regulatory element-binding protein-1c and downstream genes was determined by quantitative real-time PCR. Sucrose-exposed offspring had higher hepatic SREBP-1c messenger RNA expression compared with control and HFCS-55 groups at both 3 weeks (P=0.01) and 12 weeks (P=0.03) of age. There were no differences in the expression of other hepatic lipogenic genes between groups at either 3 or 12 weeks. Thus, perinatal exposure to sucrose may be more detrimental to offspring hepatic metabolism compared with HFCS-55, independent of sex, and it will be important to evaluate the longer-term effects of perinatal sucrose exposure in future studies.
Sponsorship bias has never been investigated for non-pharmacological treatments like psychotherapy.
We examined industry funding and author financial conflict of interest (COI) in randomised controlled trials directly comparing psychotherapy and pharmacotherapy in depression.
We conducted a meta-analysis with subgroup comparisons for industry v. non-industry-funded trials, and respectively for trial reports with author financial COI v. those without.
In total, 45 studies were included. In most analyses, pharmacotherapy consistently showed significant effectiveness over psychotherapy, g = −0.11 (95% CI −0.21 to −0.02) in industry-funded trials. Differences between industry and non-industry-funded trials were significant, a result only partly confirmed in sensitivity analyses. We identified five instances where authors of the original article had not reported financial COI.
Industry-funded trials for depression appear to subtly favour pharmacotherapy over psychotherapy. Disclosure of all financial ties with the pharmaceutical industry should be encouraged.
The effects of cognitive behavioural therapy of anxiety disorders on depression has been examined in previous meta-analyses, suggesting that these treatments have considerable effects on depression. In the current meta-analysis we examined whether the effects of treatments of anxiety disorders on depression differ across generalized anxiety disorder (GAD), social anxiety disorder (SAD) and panic disorder (PD). We also compared the effects of these treatments with the effects of cognitive and behavioural therapies of major depression (MDD).
We searched PubMed, PsycINFO, EMBASE and the Cochrane database, and included 47 trials on anxiety disorders and 34 trials on MDD.
Baseline depression severity was somewhat lower in anxiety disorders than in MDD, but still mild to moderate in most studies. Baseline severity differed across the three anxiety disorders. The effect sizes found for treatment of the anxiety disorders ranged from g = 0.47 for PD, g = 0.68 for GAD and g = 0.69 for SAD. Differences between these effect sizes and those found in the treatment of MDD (g = 0.81) were not significant in most analyses and we found few indications that the effects differed across anxiety disorders. We did find that within-group effect sizes resulted in significantly (p < 0.001) larger effect sizes for depression (g = 1.50) than anxiety disorders (g = 0.73–0.91). Risk of bias was considerable in the majority of studies.
Patients participating in trials of cognitive behavioural therapy for anxiety disorders have high levels of depression. These treatments have considerable effects on depression, and these effects are comparable to those of treatment of primary MDD.
Clinical studies have reported beneficial effects of a maternal low glycaemic index (GI) diet on pregnancy and neonatal outcomes, but the impact of the diet on the offspring in later life, and the mechanisms underlying these effects, remain unclear. In this study, Albino Wistar rats were fed either a low GI (n=14) or high GI (n=14) diet during pregnancy and lactation and their offspring weaned onto either the low or high GI diet. Low GI dams had better glucose tolerance (AUC[glucose], 1322±55 v. 1523±72 mmol min/l, P<0.05) and a lower proportion of visceral fat (19.0±2.9 v. 21.7±3.8% of total body fat, P<0.05) compared to high GI dams. Female offspring of low GI dams had lower visceral adiposity (0.45±0.03 v. 0.53±0.03% body weight, P<0.05) and higher glucose tolerance (AUC[glucose], 1243±29 v. 1351±39 mmol min/l, P<0.05) at weaning, as well as lower hepatic PI3K-p85 mRNA at 12 weeks of age. No differences in glucose tolerance or hepatic gene expression were observed in male offspring, but the male low GI offspring did have reduced hepatic lipid content at weaning. These findings suggest that consuming a low GI diet during pregnancy and lactation can improve glucose tolerance and reduce visceral adiposity in the female offspring at weaning, and may potentially produce long-term reductions in the hepatic lipogenic capacity of these offspring.
Background: To identify differences in the recurrence pattern of surgically-resected skull base meningiomas compared with superficial intra-cranial meningiomas Methods: A retrospective hospital-based study of all patients referred to our institution from 1990 to 2014 for surgical resection of meningiomas was conducted (both primary and recurrent cases). Survival analysis was performed using IBM SPSS v22.0. Results: Overal, 398 intra-cranial meningiomas –129 (32%) skull base - were reviewed. Skull base tumors had a lower MIB-1 index (p = 0.001) and were more likely to be WHO I (p = 0.003). Meningiomas in all locations demonstrated a recurrence rate of 30% at 100 months of follow-up. Afterwards, the recurrence of skull base meningiomas plateaued (longest follow-up: 250 months) whereas superficial lesions had a recurrence rate of 80% at 230 months (p = 0.02). In multivariable analysis, patients with a first-time diagnosis (p = 0.02), those with WHO I or II tumors (p= 0.02 and 0.05), and those with a total resection (p < 0.01) were less likely to experience a recurrence. Conclusions: Skull base meningiomas are less aggressive than superficial lesions and may not need to be followed beyond 100 months. The WHO grade, complete resection, and prior recurrence are predictive factors of recurrence.
Introduction: Surgical removal is the standard treatment for Cushing’s disease. Although endoscopic transsphenoidal surgical (ETS) approach has grown in popularity, its efficacy has not yet been established. Furthermore, achieving long-term remission remains challenging. Methods: We conducted a retrospective chart review of 39 consecutive patients who underwent ETS for Cushing’s disease at our institution between 2005 and 2014. Univariate analysis using Pearson’s χ2 test was carried out on variables of patient demographics, radiology, pathology, biochemical markers versus recurrence. Results: The mean age was 40, with 82% females. Average length of follow-up was 44.8 months. Based on serum cortisol level, 28 patients (71%) achieved mid to long-term remission after ETS. Of them, 25 experienced an immediate remission, and 3 achieved a delayed remission as long as 4 months postoperatively. MRI findings of (1) microadenomas or no detectable abnormality, (2) adjacency to the cavernous sinus wall were associated with significantly higher recurrence rate (p<0.05). Histologically, MIB-1 >5% was not a significant variable (p=0.55). Conclusion: We found ETS resection to be an effective and safe procedure for majority of the ACTH-secreting adenomas, with remission rates >70%. Additionally, patients with microadenomas, negative preoperative MR, and cavernous sinus adjacency were less likely to achieve remission.
Introduction: This study sought to determine the overall and disease-specific latency period for radiological appearance of new intracranial metastases for patients with metastatic involvement of the brain. Methods: A retrospective chart review of patients with intracranial metastases between 2008–2010 was conducted. For each patient, the following were recorded: cancer type, gender, age at diagnosis of primary cancer and first intracranial metastases, treatments (chemotherapy, whole-brain-radiotherapy (WBRT), radiosurgery), and latency period for radiological appearance of new intracranial metastases. Results: 137 patients with multiple metastatic tumors were included in our study. Majority (>90%) of patients received chemotherapy and WBRT. The latency periods for appearance of new metastases for different cancer types were (in months): breast 12.7, lung 11.3, colorectal 9.0, melanoma 6.6, renal cell 8.1, other 8.1. The overall average latency period was 10.1 months. There was no relation between latency period for new metastases and the following: age at diagnosis of metastases(p=0.174), age at treatment(p=0.199), and cancer type(p=0.124). The latency period for new metastatic lesions differed significantly between males (8.1 months) and females (11.7 months) (p=0.009). Conclusions: The average latency period for new metastases is approximately 10 months. Our data suggests that males develop new metastatic tumors at a faster rate.
The conservation of species listed in the Bern Convention and European Directive 1992/43/EEC (so-called policy species) is mandatory for European Union (EU) countries. We assessed the conservation status of Italian policy species, based on the IUCN categories and criteria, to evaluate the effectiveness of existing protection measures at the national level. Among the 203 vascular plants, bryophytes and lichens evaluated, 41.9% are categorized as threatened, and one is already extinct, indicating that the protection measures for policy species are inadequate. Our results for the Italian policy species are consistent with those of an assessment at the EU level. Conservation priorities should be established at both the national and regional scales. An effective conservation strategy is needed, and in situ and ex situ actions focused on threatened species should be promoted.
Excess consumption of added sugars, including sucrose and high fructose corn syrup (HFCS-55), have been implicated in the global epidemics of obesity and type 2 diabetes. This study aimed to investigate and compare the impact of maternal consumption of sucrose or HFCS-55 during pregnancy and lactation on the metabolic health of the dam and her offspring at birth. Female Albino Wistar rats were given access to chow and water, in addition to a sucrose or HFCS-55 beverage (10% w/v) before, and during pregnancy and lactation. Maternal glucose tolerance was determined throughout the study, and a postmortem was conducted on dams following lactation, and on offspring within 24 h of birth. Sucrose and HFCS-55 consumption resulted in increased total energy intake compared with controls, however the increase from sucrose consumption was accompanied by a compensatory decrease in chow consumption. There was no effect of sucrose or HFCS-55 consumption on body weight, however sucrose consumption resulted in increased adiposity and elevated total plasma cholesterol in the dam, while HFCS-55 consumption resulted in increased plasma insulin and decreased plasma non-esterified fatty acids (NEFA). Maternal HFCS-55 consumption was associated with decreased relative liver weight and plasma NEFA in the offspring at birth. There was no effect of either treatment on pup weight at birth. These findings suggest that both sucrose and HFCS-55 consumption during pregnancy and lactation have the potential to impact negatively on maternal metabolic health, which may have adverse consequences for the long-term health of the offspring.
This paper presents a new concept for the fine tuning of high-Q bandpass filters to compensate for small response deviations due to manufacturing tolerances and temperature variations. Discrete frequency tuning steps are obtained using a rectangular waveguide resonator loaded with a reconfigurable E-plane circuit. Ohmic micro electromechanical systems (MEMS) switches can be placed along thin E-plane metal strips so as to modify the E-field distribution of the TE101 resonant mode, thus the central frequency of the filter. As an example, 0.1% frequency steps can easily be obtained in a 10 GHz resonant cavity. The use of low-loss substrates ensures high-quality factors of the order of 1000. The feasibility of the proposed approach is demonstrated both by full-wave simulations and by fabricating and measuring an X-band hardwired prototype.