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Previous genetic association studies have failed to identify loci robustly associated with sepsis, and there have been no published genetic association studies or polygenic risk score analyses of patients with septic shock, despite evidence suggesting genetic factors may be involved. We systematically collected genotype and clinical outcome data in the context of a randomized controlled trial from patients with septic shock to enrich the presence of disease-associated genetic variants. We performed genomewide association studies of susceptibility and mortality in septic shock using 493 patients with septic shock and 2442 population controls, and polygenic risk score analysis to assess genetic overlap between septic shock risk/mortality with clinically relevant traits. One variant, rs9489328, located in AL589740.1 noncoding RNA, was significantly associated with septic shock (p = 1.05 × 10–10); however, it is likely a false-positive. We were unable to replicate variants previously reported to be associated (p < 1.00 × 10–6 in previous scans) with susceptibility to and mortality from sepsis. Polygenic risk scores for hematocrit and granulocyte count were negatively associated with 28-day mortality (p = 3.04 × 10–3; p = 2.29 × 10–3), and scores for C-reactive protein levels were positively associated with susceptibility to septic shock (p = 1.44 × 10–3). Results suggest that common variants of large effect do not influence septic shock susceptibility, mortality and resolution; however, genetic predispositions to clinically relevant traits are significantly associated with increased susceptibility and mortality in septic individuals.
Monolayer (ML) molybdenum disulfide (MoS₂) is a novel 2-dimensional (2D) semiconductor whose properties have many applications in devices. Despite its potential, ML MoS₂ is limited in its use due to its degradation under exposure to ambient air. Therefore, studies of possible degradation prevention methods are important. It is well established that air humidity plays a major role in the degradation. In this paper, we investigate the effects of substrate hydrophobicity on the degradation of chemical vapor deposition (CVD) grown ML MoS2. We use optical microscopy, atomic force microscopy (AFM), and Raman mapping to investigate the degradation of ML MoS2 grown on SiO2 and Si3N4 that are hydrophilic and hydrophobic substrates, respectively. Our results show that the degradation of ML MoS₂ on Si3N4 is significantly less than the degradation on SiO2. These results show that using hydrophobic substrates to grow 2D transition metal dichalcogenide ML materials may diminish ambient degradation and enable improved protocols for device manufacturing.
This study examines how human capital develops in response to early-life weather and pollution exposures in the Philippines. Both pollution and weather are examined in relation to short- and long-term human capital outcomes. We combine a three-decade longitudinal survey measuring human capital development, a database of historical weather, and multiple databases characterizing carbon monoxide and ozone in the Philippines during the 1980s. We find evidence that extreme precipitation and temperature affect short-term anthropometric outcomes, but long-term outcomes appear unaffected. For long-term cognitive outcomes, we find that early-life pollution exposures negatively affect test scores and schooling. These long-term responses to early-life pollution exposures extend to the labor market with reduced hours worked and earnings. The implication is that a 25 per cent reduction in early-life ozone exposure would increase per person discounted lifetime earnings by $1,367, which would scale to $2.05 billion at the national level (or 2 per cent of 2005 GDP).
Cohorting patients who are colonized or infected with multidrug-resistant organisms (MDROs) protects uncolonized patients from acquiring MDROs in healthcare settings. The potential for cross transmission within the cohort and the possibility of colonized patients acquiring secondary isolates with additional antibiotic resistance traits is often neglected. We searched for evidence of cross transmission of KPC+ Klebsiella pneumoniae (KPC-Kp) colonization among cohorted patients in a long-term acute-care hospital (LTACH), and we evaluated the impact of secondary acquisitions on resistance potential.
Genomic epidemiological investigation.
A high-prevalence LTACH during a bundled intervention that included cohorting KPC-Kp–positive patients.
Whole-genome sequencing (WGS) and location data were analyzed to identify potential cases of cross transmission between cohorted patients.
Secondary KPC-Kp isolates from 19 of 28 admission-positive patients were more closely related to another patient’s isolate than to their own admission isolate. Of these 19 cases, 14 showed strong genomic evidence for cross transmission (<10 single nucleotide variants or SNVs), and most of these patients occupied shared cohort floors (12 patients) or rooms (4 patients) at the same time. Of the 14 patients with strong genomic evidence of acquisition, 12 acquired antibiotic resistance genes not found in their primary isolates.
Acquisition of secondary KPC-Kp isolates carrying distinct antibiotic resistance genes was detected in nearly half of cohorted patients. These results highlight the importance of healthcare provider adherence to infection prevention protocols within cohort locations, and they indicate the need for future studies to assess whether multiple-strain acquisition increases risk of adverse patient outcomes.
Through imagining possible actions and considering their consequences, we are able to reason about the morality of behavior – judging whether an action is morally right or wrong. Neuroscience research indicates that moral reasoning depends on a complex, broadly distributed network of brain regions that interact in a both cooperative and competitive manner. Understanding the underlying neurobiology that governs how these regions dynamically interact to produce patterns of behavior is therefore of interest to the field. Currently, prominent theories suggest that moral judgments (consequentialist or deontological) are the product of two distinct cognitive systems (i.e. a dual-process framework). Network neuroscience, an emerging field that measures and interprets brain activity through the framework of modern network science, is positioned to expand our understanding of this dual-process framework by examining how topological properties of networks influence consequentialist and deontological reasoning, and how these two processing systems interact in order to imagine hypothetical scenarios during complex deontological reasoning tasks. In this chapter, we review evidence from neuroscience that bears on our understanding of the dual-process moral reasoning framework and advance a network neuroscience perspective on the neurobiological substrates that underlie it.
We investigate the turbulence statistics in a multiphase plume made of heavy particles (particle Reynolds number at terminal velocity is 450). Using refractive-index-matched stereoscopic particle image velocimetry, we measure the locations of particles whose buoyancy drives the formation of a multiphase plume, together with the local velocity of the induced flow in the ambient salt–water. Measurements of the mean axial flow in the plume centreplane follow Gaussian profiles and that of the mean radial flow is consistent with integral plume theory. The turbulence characteristics resemble those measured in a bubble plume, including strong anisotropy in the normal Reynolds stresses. However, we observe structural differences between the two multiphase plumes. First, the skewness of the probability density function of the axial velocity fluctuations is not that which would be predicted by simply reversing the direction of a bubble plume. Second, in contrast to a bubble plume, the particle plume has a non-negligible fluid-shear production term in the turbulent kinetic energy (TKE) budget. Third, the radial decay of all measured terms in the TKE budget is slower than those in a bubble plume. Despite these dissimilarities, a bigger picture emerges that applies to both flows. The TKE production by particles (or bubbles) roughly balances the viscous dissipation, except near the plume centreline. The one-dimensional power spectra of the velocity fluctuations show a
power law that puts both the particle and bubble plume in a category different from single-phase shear-flow turbulence.
OBJECTIVES/GOALS: Primary graft dysfunction (PGD) is acute lung injury in the first three days after lung transplant. Patients that experience PGD have increased mortality and an increased risk of chronic lung allograft dysfunction. The pathogenesis is thought to be an ischemia-reperfusion injury but is incompletely understood and there are no specific therapies. We investigated the role of the microbiome in PGD and associations with inflammation and markers of aspiration. METHODS/STUDY POPULATION: We collected airway lavage samples from lung transplant donors before procurement and recipients after reperfusion. We extracted DNA, amplified the bacterial 16S rRNA gene, and sequenced on the Illumina MiSeq platform. QIIME2 and Deblur were used for bioinformatic analysis. R packages were used for downstream analysis and visualizations. The host response was quantified using the Milipore 41-plex Luminex and an ELISA for pepsin. Clinical data was collected by the Penn Lung Transplant Outcomes Group. PGD was assessed by degree of hypoxemia and chest X-ray findings in the 72 hours after transplant. RESULTS/ANTICIPATED RESULTS: There was no significant difference in alpha diversity (Shannon index, p = 0.51), biomass (via comparison of 16S amplicon PicoGreen, p = 0.6), or beta diversity (Weighted UniFrac, p = 0.472, PERMANOVA) between subjects with PGD grade 3 (n = 36) and those that did not (n = 96). On taxonomic analysis, we found an enrichment of Prevotella in donor and recipient lungs that went on to develop PGD (p = 0.05). To follow up this finding we measured immune response and pepsin concentrations in recipient lungs. We found elevated levels in 35/41 cytokines measured in subjects that developed PGD as well as an elevation in pepsin and a correlation between pepsin concentration and Prevotella relative abundance (Figure 1). Additionally, Prevotella relative abundance had statistically significant positive correlations with multiple cytokines such as IL-6 (Pearson’s = 0.26, p = 0.009) and eotaxin (Pearson’s = 0.24, p = 0.016). DISCUSSION/SIGNIFICANCE OF IMPACT: There is an enrichment of oral anerobes in lung allografts that eventually develop PGD. This is associated with elevated levels of pepsin and markers of inflammation. These lines of evidence suggest aspiration contributes to priming the allograft for PGD.
Stigma against mental illness and the mentally ill is well known. However, stigma against psychiatrists and mental health professionals is known but not discussed widely. Public attitudes and also those of other professionals affect recruitment into psychiatry and mental health services. The reasons for this discriminatory attitude are many and often not dissimilar to those held against mentally ill individuals. In this Guidance paper we present some of the factors affecting the image of psychiatry and psychiatrists which is perceived by the public at large. We look at the portrayal of psychiatry, psychiatrists in the media and literature which may affect attitudes. We also explore potential causes and explanations and propose some strategies in dealing with negative attitudes. Reduction in negative attitudes will improve recruitment and retention in psychiatry. We recommend that national psychiatric societies and other stakeholders, including patients, their families and carers, have a major and significant role to play in dealing with stigma, discrimination and prejudice against psychiatry and psychiatrists.
The Time to Change (TTC) anti-stigma campaign, launched in January 2009 in England, intends to make fundamental improvements across England in: public knowledge, attitudes and discriminatory behaviour in relation to people with mental illness. To be effective and valid the campaign must reach a wide range of diverse audiences. This study explores attitudes of people from ethnic minority communities in relation to mental health.
The study investigates:
1) General attitudes and perceptions about mental illness in ethnic minority communities
2) How we might increase awareness about mental wellbeing and decrease stigma in ethnic minority communities.
Ten focus groups with members of ethnic minority groups were conducted. Five groups consisted of service users and five were composed of non-service users. Two groups comprised participants from an Indian origin, two Somali origin, two Afro-Caribbean origin and the other groups were mixed.
We will present findings regarding the ways in which traditional perceptions of mental health and personal experiences of ethnic minority service users affect their perceptions of sources of support such as family, friends, medical staff and religion and how this feedback could inform ant-stigma interventions.
The study suggests that in order to maximise the impact of anti-stigma campaigns, attention should be given to sources of discrimination and traditional perceptions of mental illness which are emphasised by ethnic minority groups. When planning anti-stigma campaigns it is important to incorporate experiences and perceptions from a wide range of audiences.
Les femmes en attente de don d’ovocytes sont confrontées à diverses difficultés peu explorées dans la littérature : vécu subjectif douloureux, échecs des FIV précédentes, long délai d’attente d’un don, dissociation de la filiation génétique et gestationnelle… L’objectif principal est de déterminer si l’« attente d’un don d’ovocytes » est anxio-dépressiogène, et si le locus de contrôle externe constitue un facteur protecteur.
Les 3 groupes de femmes inclus sont en attente d’un don d’ovocytes (n = 10), en cours d’une première FIV (FIV1 ; n = 34) ou d’une deuxième FIV ou plus (FIV2+ ; n = 39). Elles ont été évaluées sur l’anxiété (State-Trait Anxiety Inventory), la dépression (Beck Depression Inventory), les locus de contrôle, la réaction à l’infertilité.
Les femmes receveuses étaient significativement plus âgées. Elles étaient significativement plus anxieuses mais pas plus dépressives que les groupes FIV. Leur anxiété actuelle était en partie expliquée par une internalité plus marquée. Pourtant, chez les femmes infertiles en général, c’est l’externalité de type « Autre toutpuissant » qui expliquait en partie la diminution de l’anxiété et la diminution du vécu négatif émotionnel de l’infertilité.
Ces résultats sur le locus de contrôle des femmes infertiles éclairent la réflexion sur le mode relationnel médecin malade, chez des patientes anxieuses sans maîtrise de leur fécondité et devant faire confiance aux équipes soignantes.
Social contact is one of the most effective strategies for improving inter-group relations and is supported by decades of positive evidence. Several studies specifically support social contact interventions as a way of reducing stigma against people with mental health problems. Despite the effectiveness of this approach, some social groups have few opportunities for social contact in the real world.
Using the England Time to Change anti-stigma campaign as an example, we investigate the feasibility and effectiveness of delivering social contact interventions at the mass population level to reduce stigma and discrimination against people with mental health problems.
To investigate: (i) the feasibility of scaling up social contact interventions to reduce stigma and discrimination against people with mental health problems and (ii) the effectiveness of mass population social contact interventions to: improve intended stigmatising behaviour, increase willingness to disclose mental health problems and to promote engagement in antistigma activities.
Two types of mass participation social contact programmes within England's Time to Change campaign were evaluated via self-report questionnaire. Participants at social contact events were asked about the occurrence and quality of contact, attitudes, readiness to discuss mental health, and intended behaviour towards people with mental health problems.
Findings on feasibility and effectiveness of social contact programmes will be presented.
This study suggests that social contact interventions can be used by anti-stigma campaigns to reduce stigma and discrimination against people with mental health problems. Further investigation is needed regarding the maintenance of these changes
Previous research demonstrates various associations between depression, cardiovascular disease (CVD) incidence and mortality. Differences between studies may occur as a result of different methodologies.
This work investigated the impact of using two different methods to measure depression and two different methods of analysis to establish relationships.
The work investigated the association between depression, CVD incidence (CVDI) and mortality from coronary heart disease (MCHD), smoking related conditions (MSRC), and all causes (MALL), in a major population study using depression measured from a validated scale and a depression measure derived by factor analysis, and analyses based on continuous data and grouped data.
Data from the PRIME Study (N=9,798 men) on depression and ten year CVD incidence and mortality were analysed using Cox proportional hazards models.
Using continuous data, no relationships with CVDI were found, but both measures of depression resulted in the emergence of positive associations between depression and mortality (MCHD, MSRC, MALL). Using grouped data, no associations with CVDI or MCVD were found, and associations between the measure derived from factor analysis and MSRC and MALL were also lost. Positive associations were only found between depression measured using validated items, MSRC and MALL.
These data demonstrate a possible association between depression and mortality but detecting this association is dependent on the methodology used. Different findings based on methodology present clear problems for the determination of relationships. The differences here suggest the preferential use of validated scales and suggest against over-reduction via factor analysis and grouping.
Stigma and social exclusion related to mental health are of substantial public health importance for Europe. As part of ROAMER (ROAdmap for MEntal health Research in Europe), we used systematic mapping techniques to describe the current state of research on stigma and social exclusion across Europe. Findings demonstrate growing interest in this field between 2007 and 2012. Most studies were descriptive (60%), focused on adults of working age (60%) and were performed in Northwest Europe—primarily in the UK (32%), Finland (8%), Sweden (8%) and Germany (7%). In terms of mental health characteristics, the largest proportion of studies investigated general mental health (20%), common mental disorders (16%), schizophrenia (16%) or depression (14%). There is a paucity of research looking at mechanisms to reduce stigma and promote social inclusion, or at factors that might promote resilience or protect against stigma/social exclusion across the life course. Evidence is also limited in relation to evaluations of interventions. Increasing incentives for cross-country research collaborations, especially with new EU Member States and collaboration across European professional organizations and disciplines, could improve understanding of the range of underpinning social and cultural factors which promote inclusion or contribute toward lower levels of stigma, especially during times of hardship.
The assessment of needs among patients with severe mental disorders is one of the most studied measures in treatment planning and monitoring of mental health services. Nevertheless, studies on this subject are scarce in Brazil, even following the recent expansion of community services.
To investigate the prevalence and correlates of unmet needs among outpatients with psychotic disorders in Brazilian community mental health services.
This is a cross-sectional study with a random sample of 401 outpatients with psychotic disorders in the city of Santos, Brazil. Needs were assessed through interviews with patients using the Camberwell Assessment of Needs (CAN), which investigates 22 clinical, social and basic needs. The Positive and Negative Symptom Scale (PANSS) was used to assess symptoms. Data were analyzed with multiple linear regression, using p < 0.05. Independent variables were introduced in hierarchical levels, as follows: 1) demographic variables; 2) history and severity of illness; and, 3) service utilization.
The most reported needs were psychotic symptoms (67.0%), information needs (55.0%), psychological distress (41.8%) and money (41.5%). The mean number of unmet needs was 2.91 (+-2.56). A greater number of unmet needs was significantly associated to lower education, more negative symptoms and general psychopathology, all with p = 0.001.
The most reported needs were clinical and social. The number of unmet needs was consistent with the results of international studies. Furthermore, the association of greater unmet needs with lower education and higher symptoms severity may indicate the need for further and comprehensive psychosocial interventions.
The unprecedented growth, availability and accessibility of sophisticated image analysis algorithms and powerful computational resources led to the idea of developing web-based computational infrastructures that could meet users’ new requirements. On the other hand the gap between the pace of data generation and the capability to extract clinically or scientifically relevant information is rapidly widening.
Integration of the power of sophisticated mathematical models, efficient computational algorithms and advanced hardware infrastructure provides the necessary sensitivity to detect, extract and analyze subtle, dynamic and distributed patterns distinguishing one brain from another, and a diseased brain from a normal brain.
neuGRID is the leading e-Infrastructure where neuroscientists can find core services and resources for brain image analysis. The neuGRID platform makes use of grid services and computing, and was developed with the final aim of overcoming the hurdles that the average scientist meets when trying to set up advanced experiments in computational neuroimaging, thereby empowering a larger base of scientists. Although originally built for neuroscientists working in the field of AD, the infrastructure is designed to be expandable to services from other medical fields (e.g. multiple sclerosis, psychiatric conditions).
“neuGRID for Users” will provide an e-Science environment by further developing and deploying the neuGRID infrastructure to deliver a Virtual Laboratory offering neuroscientists access to a wide range of datasets and algorithm pipelines, access to computational resources, services, and support. Information from this abstract is intended to make aware researchers working with neuroimaging of all possibilities when it comes to resources.
The Meeting Centre Support Programme (MCSP) is a community-based approach to support people living with dementia and their families. It was developed in the Netherlands and has been implemented in other European Countries (Italy, Poland and the UK) within the JPND-MEETINGDEM project.
To assess the relationship between background characteristics of people with dementia participating in MCSP, mood, quality of life (QoL) and experienced stigma, and to explore if and how the experienced stigma changed after 6 months of participation in MCSP.
A pretest (M1) post-test (M7) control group design with matched groups regarding severity of dementia was applied. In each country, a minimum of 25 participants using MCSP were compared with people with dementia receiving ‘usual care’. Data were collected with the Stigma Impact Scale, Cornell Scale for Depression in Dementia, Global Deterioration Scale and two QoL scales (QoL-AD & DQoL). Differences in background characteristics were taken into account in the analyses.
The preliminary analysis on 116 participants at baseline shows that the level of stigma was low to moderate. People felt more socially rejected in the UK than in Poland and Italy. The level of perceived stigmatization appeared negatively correlated with QoL areas and positively correlated with negative mood. Changes after 6 months will be presented.
It is expected that after 6 months people living with dementia participating in MCSP will experience less stigma, as in contrast with usual care MCSP promotes social integration of people with dementia and person-centered support.
Disclosure of interest
The authors have not supplied their declaration of competing interest.