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Individuals with schizophrenia are more likely to smoke and less likely to quit smoking than those without schizophrenia. Because task persistence is lower in smokers with than without schizophrenia, it is possible that lower levels of task persistence may contribute to greater difficulties in quitting smoking observed among smokers with schizophrenia.
To develop a feasible and acceptable intervention for smokers with schizophrenia.
Participants (N = 24) attended eight weekly individual cognitive behavioral therapy sessions for tobacco use disorder with a focus on increasing task persistence and received 10 weeks of nicotine patch.
In total, 93.8% of participants rated the intervention as at least a 6 out of 7 regarding how ‘easy to understand’ it was and 81.3% rated the treatment as at least a 6 out of 7 regarding how helpful it was to them. A total of 62.5% attended at least six of the eight sessions and session attendance was positively related to nicotine dependence and age and negatively related to self-efficacy for quitting.
This intervention was feasible and acceptable to smokers with schizophrenia. Future research will examine questions appropriate for later stages of therapy development such as initial efficacy of the intervention and task persistence as a mediator of treatment outcome.
Impairments in social cognition contribute significantly to disability in schizophrenia patients (SzP). Perception of facial expressions is critical for social cognition. Intact perception requires an individual to visually scan a complex dynamic social scene for transiently moving facial expressions that may be relevant for understanding the scene. The relationship of visual scanning for these facial expressions and social cognition remains unknown.
In 39 SzP and 27 healthy controls (HC), we used eye-tracking to examine the relationship between performance on The Awareness of Social Inference Test (TASIT), which tests social cognition using naturalistic video clips of social situations, and visual scanning, measuring each individual's relative to the mean of HC. We then examined the relationship of visual scanning to the specific visual features (motion, contrast, luminance, faces) within the video clips.
TASIT performance was significantly impaired in SzP for trials involving sarcasm (p < 10−5). Visual scanning was significantly more variable in SzP than HC (p < 10−6), and predicted TASIT performance in HC (p = 0.02) but not SzP (p = 0.91), differing significantly between groups (p = 0.04). During the visual scanning, SzP were less likely to be viewing faces (p = 0.0001) and less likely to saccade to facial motion in peripheral vision (p = 0.008).
SzP show highly significant deficits in the use of visual scanning of naturalistic social scenes to inform social cognition. Alterations in visual scanning patterns may originate from impaired processing of facial motion within peripheral vision. Overall, these results highlight the utility of naturalistic stimuli in the study of social cognition deficits in schizophrenia.
To examine how household food insecurity is related to adolescent weight status and disordered eating.
Cross-sectional, population-based study. Adolescents self-reported unhealthy weight control behaviours, binge eating and meal frequency; weight status was measured. Household food insecurity was assessed by asking parents to respond to the validated six-item US Household Food Security Survey Module.
Adolescents surveyed within Minneapolis/St. Paul public middle and high schools completed surveys at school, and their parents/guardians were surveyed by mail during the 2009–2010 academic year.
Ethnically/racially diverse, primarily low-income adolescents (mean age: 14·4 years, range: 10–22 years) and their parents/guardians (n 2285 dyads).
More than one-third (38·9 %) of the adolescents experienced past-year household food insecurity, 43·2 % reported disordered eating and 39·6 % were overweight. Generalised regression models showed that food insecure (FI) compared with food secure (FS) adolescents had higher prevalence of overweight (FI: 42·3 % v. FS: 37·9 %, P = 0·039), lower breakfast consumption (FI: 4·1 times/week v. FS: 4·4 times/week, P = 0·005) and greater use of unhealthy weight control behaviours (FI: 49·0 % v. FS: 39·5 %, P < 0·001) in unadjusted models. Models adjusted for parental education, ethnicity/race, sex and age found that food insecurity was associated with higher prevalence of unhealthy weight control behaviours (FI: 44·5 % v. FS: 37·8 %, P = 0·007), but not with weight status or other eating behaviours.
These results suggest that food insecurity may be an independent risk factor for unhealthy weight control behaviours, indicating a need to approach these intersecting issues in a comprehensive manner.
Aging is associated with cognitive decline. The extant literature suggests that exercise positively impacts multiple cognitive domains or at least attenuates the rate of decline among nondemented older adults, but less is known about the broader cognitive impact of daily physical activity (that may or may not fall under the definition of exercise). Evolving technologies have ushered a new wave of research that objectively measures physical activity, providing a metric that is more precise and avoids some of the limitations of self-report data. In this chapter, we briefly review studies examining the relationship between objectively measured physical activity and cognition among older adults. We highlight the current state of the literature on aging, cognition, and wearable technologies that objectively assess physical activity. Our review revealed several cross-sectional studies that show a significant and positive association between overall and specific intensities of physical activity and cognition among older adults. Longitudinal studies indicated that physical activity positively impacts cognitive performance and thus support the notion that physical activity may protect against age-related cognitive decline. Moreover, the extant literature suggests that physical activity may preferentially benefit executive function, processing speed, and episodic memory. Further research on the objective assessment of physical activity and cognition will help identify the precise amount and intensity of daily physical activity that confers optimal cognitive benefits and may inform activity prescriptions for optimal cognitive aging.
Sanislow and Hector (this volume) provided a comprehensive review of the Cluster C personality disorders (PDs) with an emphasis on articulating anxious-fearful pathology and avoidance behavior. The authors provided historical context for the Cluster C PDs within the DSM and reviewed relevant research findings with a particular focus on how Cluster C pathology can be understood within NIMH RDoC domains. There is much to appreciate in their chapter and this commentary offers points intended to augment their review of Cluster C pathology. It is suggested that interpersonal theory provides a useful framework for understanding personality pathology and a review of relevant research investigating interpersonal functioning in Cluster C PDs is provided.
Leukocyte telomere length (LTL) is a widely hypothesized biomarker of biological aging. Persons with shorter LTL may have a greater likelihood of developing dementia. We investigate whether LTL is associated with cognitive function, differently for individuals without cognitive impairment versus individuals with dementia or incipient dementia.
Enrolled subjects belong to the Long Life Family Study (LLFS), a multi-generational cohort study, where enrollment was predicated upon exceptional family longevity. Included subjects had valid cognitive and telomere data at baseline. Exclusion criteria were age ≤ 60 years, outlying LTL, and missing sociodemographic/clinical information. Analyses were performed using linear regression with generalized estimating equations, adjusting for sex, age, education, country, generation, and lymphocyte percentage.
Older age and male gender were associated with shorter LTL, and LTL was significantly longer in family members than spouse controls (p < 0.005). LTL was not associated with working or episodic memory, semantic processing, and information processing speed for 1613 cognitively unimpaired individuals as well as 597 individuals with dementia or incipient dementia (p < 0.005), who scored significantly lower on all cognitive domains (p < 0.005).
Within this unique LLFS cohort, a group of families assembled on the basis of exceptional survival, LTL is unrelated to cognitive ability for individuals with and without cognitive impairment. LTL does not change in the context of degenerative disease for these individuals who are biologically younger than the general population.
Our understanding of ice algal responses to the recent changes in Arctic sea ice is impeded by limited field observations. In the present study, environmental characteristics of the landfast sea-ice zone as well as primary production and macromolecular composition of ice algae and phytoplankton were studied in the Kitikmeot Sea near Cambridge Bay in spring 2017. Averaged total chlorophyll-a (Chl-a) concentration was within the lower range reported previously for the same region, while daily carbon uptake rates of bottom-ice algae were significantly lower in this study than previously reported for the Arctic. Based on various indicators, the region's low nutrient concentrations appear to limit carbon uptake rates and associated accumulation of bottom-ice algal biomass. Furthermore, the lipids-dominant biochemical composition of bottom-ice algae suggests strong nutrient limitation relative to the distinctly different carbohydrates-dominant composition of phytoplankton. Together, the results confirm strong nitrate limitation of the local marine system.
Levels of serotonin in the body are regulated by the serotonin transporters (SERT), which are predominantly located on the presynaptic terminals of serotonin-containing neurons. Alterations in the density of SERT have been implicated in the pathophysiology of many neuropsychiatric disorders.
To evaluate 123-I mZIENT (2(S)-[(S)-2b-carbomethoxy-3b-[3′-((Z)-2-iodoethenyl)phenyl]nortropane), a novel radiopharmaceutical for imaging SERT. The bio-distribution of the radiopharmaceutical in humans was investigated and dosimetry performed.
The study includes three healthy volunteers and three patients receiving SSRIs. Whole body images obtained on a gamma camera at 10 minutes, 1, 2, 3, 6, 24 and 48 hours post administration. Dosimetry was performed. ROIs were drawn over the brain, heart, kidneys, liver, lungs, salivary glands, spleen, thyroid and intestines. Blood was sampled at 5, 15, & 30 minutes and 1, 2, 3, 6, 24 and 48 hours post administration. Urine was collected at 1, 2, 3, 4, 6, 24 and 48 hours. Brain SPECT images were obtained using a neuroSPECT scanner at 4 hours, evaluated visually and analysed using ROI analysis.
High quality SPECT images can be obtained after 100–150 MBq 123-ImZEINT. Regional brain uptake was observed in midbrain and basal ganglia in healthy volunteers, consistent with the known distribution of SERT. Biodistribution images demonstrated highest uptake in the lungs, brain, liver and intestines. The effective dose was within range of other commonly used ligands and is acceptable for clinical imaging.
123-ImZIENT is a promising agent for imaging SERT in humans with acceptable dosimetry.
Activation of microglial cells is currently explored in schizophrenia pathophysiology. Post-mortem immunohistochemistry remains the most accurate method to investigate microglial morphology and function, since high microglial plasticity limits extrapolation of in vitro and animal research results to the human brain.
To investigate microglial morphology and activation patterns, we performed immunohistochemistry with specific microglial markers: Iba1 (marker of resting and activated microglia), CD68 (marker of microglial lysosomes, indicative of phagocytic microglia) and CD64 (FcγRI, binds IgG) on formalin fixed paraffin embedded brain tissue from the Corsellis Collection (BRAIN UK), in 15 schizophrenia cases and 15 nonneurological controls. Immunostaining was quantified by image capture and analysis (Image J, NIH, US) to provide a measure of protein load. We also reviewed existing literature on microglial immunostaining in schizophrenia using Pubmed.
Few studies have examined post-mortem microglia in schizophrenia, mostly with HLA-DP/DQ/DR markers. Although frequently studied in neurological disorders Iba1, but also CD64 were never previously investigated in schizophrenia patients. Two studies explored CD68, but results were misinterpreted for resting state tissue macrophages. Our pilot study shows Iba1, CD68 and CD64 can detect microglial cells in schizophrenia brain tissue, but considerable heterogeneity exists both in patients and controls, probably due to confounding by clinical variables, e.g. age and cause of death.
Future research needs careful selection of cases and controls to minimize heterogeneity due to confounding clinical variables. Highly specific microglial markers such as Iba1, CD64 and CD68 are very useful and ought to be introduced into schizophrenia research.
The opioid epidemic has led to the wide-spread distribution of naloxone to emergency personnel and to the general public. Recommended storage conditions based on prescribing information are between 15°C and 25°C (59°F and 77°F), with excursions permitted between 4°C and 40°C (39°F and 104°F). Actual storage likely varies widely with potential exposures to extreme temperatures outside of these ranges. These potentially prolonged extreme temperatures may alter the volume of naloxone dispensed from the nasal spray device, which could result in suboptimal efficacy.
The aim of this study was to assess the naloxone volume deployed following nasal spray device storage at extreme temperatures over an extended period of time.
Naloxone nasal spray devices were exposed to storage temperatures of −29°C (−20°F), 20°C (68°F), and 71°C (160°F) to simulate extreme temperatures and a control for 10 hours. First, the density was measured under each temperature condition. Following the density calculation part of the experiment, the mass of naloxone dispensed from each nasal spray device at each temperature was captured and used to calculate volume: calculated volume (microliter, µl) = spray mass (mg converted to g)/mean density (g/mL). Measurements and calculations are reported as means with standard deviation and standard error, and a one-way ANOVA was used to evaluate mean dispensed volume differences at different temperatures.
There was no difference in the mean volume deployed at −29°C (−20°F), 20°C (68°F), and 71°C (160°F), and measurements were 101.44µl (SD = 9.56; SE = 5.52), 99.01µl (SD = 6.31; SE = 3.64), and 108.28µl (SD = 2.04; SE = 1.18), respectively; P value = .289, F-statistic value = 1.535.
The results of this study suggest that naloxone nasal spray devices will dispense the appropriate volume, even when stored at extreme temperatures outside of the manufacturer’s recommended range.
Lymphopenia is common in adults who have had a Fontan operation although its aetiology and clinical implications remain unknown. Previous work suggests an association between lymphopenia and both liver disease and splenomegaly. The objective of this study was to assess the prevalence of lymphopenia in adults with a Fontan circulation and evaluate its associations with risk factors and clinical outcomes. Using a retrospective cohort study design, we studied 73 adult Fontan patients (age 25.0 ± 8.4 years) who had a complete blood count and abdominal imaging performed. Patients with protein-losing enteropathy were excluded. Clinical data were extracted from hospital records. The mean white blood cell count was 6580 ± 220/ml with a mean lymphocyte count of 1223 ± 508/ml. Lymphopenia, defined as lymphocyte count <1000/ml, was present in 23 (32%) patients. Patients with lymphopenia had a lower total white blood cell count (5556 ± 2517 versus 7136 ± 1924/ml, p = 0.009) and a lower platelet count (162 ± 69 versus 208 ± 69 k/ml, p = 0.008). Lymphopenia was also associated with findings of portal hypertension, including splenomegaly (36 versus 14%, p = 0.04), varices (22 versus 6%, p = 0.04), and ascites (39 versus 14%, p = 0.02). Lymphopenia did not correlate with any cardiac imaging, haemodynamic or exercise testing variables. In conclusion, lymphopenia is common in adult Fontan patients and is associated with markers of portal hypertension. Larger studies are needed to better define the relationship between lymphopenia and clinical outcomes.
The study investigated antioxidant effects of Se on resilience to diquat-induced oxidative stress in nursery pigs. Thirty-five weaned pigs were individually housed and randomly assigned to one of the five treatments. Pigs were (1) fed a basal diet and intraperitoneally injected with sterile saline (negative control), (2) fed the basal diet and injected with diquat solution (positive control, PC), or fed the basal diet supplemented with 0·3 mg Se/kg as (3) sodium selenite (SS), (4) soyabean protein-chelated Se (SC) or (5) selenised yeast (SY) and intraperitoneally injected with diquat. Pigs were fed the experimental diets for 17 d and injected with diquat at 10 mg/kg body weight or saline on the 11th day of the study (day 0 post-injection (PI)). Diquat exposure induced acute stress and innate immune activation (P < 0·05) at 6 h PI and compromised (P < 0·05) plasma glutathione peroxidase activity on day 2 PI, which was accompanied by an increase in plasma malondialdehyde at 6 h and day 2 PI (P < 0·10). Organic Se, particularly SY, enhanced (P < 0·05) endogenous antioxidant activity in various aspects compared with the PC group. The growth rate and feed intake from day 0 to day 7 PI were significantly lower in the PC, SS and SC groups than the NC group (P < 0·05). Untargeted metabolomics analysis revealed that twenty-two hepatic metabolites (false discovery rate < 0·15) associated with lipid and cellular antioxidant metabolism were altered by diquat. SY restored hepatic metabolic profiles in some but not all samples.
We present the analysis of global sympagic primary production (PP) from 300 years of pre-industrial and historical simulations of the E3SMv1.1-BGC model. The model includes a novel, eight-element sea ice biogeochemical component, MPAS-Seaice zbgc, which is resolved in three spatial dimensions and uses a vertical transport scheme based on internal brine dynamics. Modeled ice algal chlorophyll-a concentrations and column-integrated values are broadly consistent with observations, though chl-a profile fractions indicate that upper ice communities of the Southern Ocean are underestimated. Simulations of polar integrated sea ice PP support the lower bound in published estimates for both polar regions with mean Arctic values of 7.5 and 15.5 TgC/a in the Southern Ocean. However, comparisons of the polar climate state with observations, using a maximal bound for ice algal growth rates, suggest that the Arctic lower bound is a significant underestimation driven by biases in ocean surface nitrate, and that correction of these biases supports as much as 60.7 TgC/a of net Arctic PP. Simulated Southern Ocean sympagic PP is predominantly light-limited, and regional patterns, particularly in the coastal high production band, are found to be negatively correlated with snow thickness.
Seed dispersal is an important ecological process that structures plant communities and influences ecosystem functioning. Loss of animal dispersers therefore poses a serious threat to forest ecosystems, particularly in the tropics where zoochory predominates. A prominent example is the near-total extinction of seed dispersers on the tropical island of Guam following the accidental introduction of the invasive brown tree snake (Boiga irregularis), negatively impacting seedling recruitment and forest regeneration. We investigated frugivory by a remnant population of Såli (Micronesian starling – Aplonis opaca) on Guam and two other island populations (Rota, Saipan) to evaluate their ecological role as a seed disperser in the Mariana archipelago. Using a combination of behavioural observations, nest contents and fecal samples, we documented frugivory of 37 plant species. Native plants comprised the majority (66%) of all species and 90% of all seeds identified in fecal and nest contents. Diet was highly similar across age classes and sampling years. In addition, plant species consumed by Såli comprised 88% of bird-dispersed adult trees and 54% of all adult trees in long-term forest monitoring plots, demonstrating the Såli’s broad diet and potential for restoring native forests. Overall, we provide the most comprehensive assessment to date of frugivory by the Såli and confirm its importance as a seed disperser on Guam and throughout the Marianas.
Giant miscanthus has the potential to move beyond cultivated fields and invade noncrop areas, but this can be overshadowed by aesthetic appeal and monetary value as a biofuel crop. Most research on giant miscanthus has focused on herbicide tolerance for establishment and production rather than terminating an existing stand. This study was conducted to evaluate herbicide options for control or terminating a stand of giant miscanthus. In 2013 and 2014, field experiments were conducted on established stands of the giant miscanthus cultivars ‘Nagara’ and ‘Freedom.’ Herbicides evaluated in both years included glyphosate, hexazinone, imazapic, imazapyr, clethodim, fluazifop, and glyphosate plus fluazifop. All treatments were applied in summer (June or July) and September. For both years, biomass reduction ranged from 85% to 100% when glyphosate was applied in June or July at 4.5 or 7.3 kg ae ha−1. No other treatment applied at this timing provided more than 50% giant miscanthus biomass reduction 1 yr after application. September applications of glyphosate were not consistent: treatments in 2013 reduced biomass by 40% or less, whereas in 2014, at all rates provided at least 78% biomass reduction. Glyphosate applied in June or July was the only treatment that provided effective and consistent control of giant miscanthus 1 yr after treatment.
Employment is a crucial part of adult life and is associated with improved health outcomes. However, despite the several advantages of hiring individuals with intellectual and development disabilities (IDD), the employment rate for this population is still low. An employment conference was organised to inform participants of successful employment initiatives, and to increase our understanding of local employer challenges regarding the recruitment, hire, and retention of employees with IDD. Descriptive statistics were used to assess common methods of recruitment, potential helpful hiring strategies, and recruitment, hire, and retention challenges, and an ordinal logistic regression was conducted to examine whether responses differed based on demographic variables. The conference was evaluated by gathering data on several facets of participant satisfaction. Findings brought to light several key challenges that can be used to create more targeted interventions and supports. Responses to several questions differed by demographics (such as company size and industry type), which represent important areas for future research to examine. Participants reported being satisfied with the conference, and many indicated that their attitudes had changed towards disability and that they were more likely to employ individuals with IDD in the future. Systematically addressing barriers to employment is essential in order to reduce the employment gap and improve outcomes for individuals with IDD. Ultimately, conferences that aim to educate participants about successful programs and strategies represent a promising practice that can increase employment opportunities for individuals with IDD.
The personality traits of neuroticism, openness, and conscientiousness are relevant factors for cognitive aging outcomes. The present study examined how these traits were associated with cognitive abilities and corresponding resting-state functional connectivity (RSFC) of the default mode network (DMN) in an older and predominantly minority sample. A sample of 58 cognitively unimpaired, largely African-American, older adults (M age = 68.28 ± 8.33) completed a standard RSFC magnetic resonance imaging sequence, a Big Five measure of personality, and delayed memory, Stroop, and verbal fluency tasks. Personality trait associations of within-network connectivity of the posterior cingulate cortex (PCC), a hub of the DMN, were examined using a seed-based approach. Trait scores were regressed on cognitive performance (delayed memory for neuroticism, Stroop for conscientiousness, and verbal fluency for openness). Greater openness predicted greater verbal fluency and greater RSFC between the PCC and eight clusters, including the medial prefrontal cortex, left middle frontal gyrus, and precuneus. Greater PCC–precuneus connectivity predicted greater verbal fluency. Neuroticism and conscientiousness did not significantly predict either cognitive performance or RSFC. Although requiring replication and elaboration, the results implicate openness as a contributing factor to cognitive aging via concomitant cognitive performance and connectivity within cortical hubs of the DMN and add to the sparse literature on these variables in a diverse group of older adults.
In the present study, we aimed to compare anthropometric indicators as predictors of mortality in a community-based setting.
We conducted a population-based longitudinal study nested in a cluster-randomized trial. We assessed weight, height and mid-upper arm circumference (MUAC) on children 12 months after the trial began and used the trial’s annual census and monitoring visits to assess mortality over 2 years.
Children aged 6–60 months during the study.
Of 1023 children included in the study at baseline, height-for-age Z-score, weight-for-age Z-score, weight-for-height Z-score and MUAC classified 777 (76·0 %), 630 (61·6 %), 131 (12·9 %) and eighty (7·8 %) children as moderately to severely malnourished, respectively. Over the 2-year study period, fifty-eight children (5·7 %) died. MUAC had the greatest AUC (0·68, 95 % CI 0·61, 0·75) and had the strongest association with mortality in this sample (hazard ratio = 2·21, 95 % CI 1·26, 3·89, P = 0·006).
MUAC appears to be a better predictor of mortality than other anthropometric indicators in this community-based, high-malnutrition setting in Niger.