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People with serious mental illness exhibit higher morbidity and mortality rates of chronic diseases than the general population.
The aim of this study was to establish a dedicated clinic for patients with chronic mental illness to monitor physical health in accordance with best practice guidelines.
Patients were invited to attend the metabolic clinic. The following areas were examined: Personal and family history of cardiovascular disease, diet, exercise, smoking. Mental state examination, waist circumference, BP, pulse, ECG and BMI. Laboratory tests including U+E, LFTs, HbA1c, Lipid profile and other tests as appropriate such as serum lithium. AIMS scale, HoNOS and WHOQOL-BREF scales as additional indicators of global health.
A total of 80 patients attended during 3.5 years of clinic. Mean age was 54.9 years (SD:13.81) at first contact and 45% were females. Mean years in the service was 19.66 (SD:11.54) and mean number of previous hospital admissions was 4.4 (SD:5.63). Metabolic syndrome was present in 42% at first assessment and 20% had at least one new physical abnormality identified during the clinic. A statistically significant difference was found for the psychological domain of the WHOQOL-BREF and the HoNOs particularly at third assessment. (β=4.64, Wald x2=7.38, df:1, p=0.007, CI:1.3-8.1, β
=-.889, Wald x2=4.08, df:1, p=0.043, CI: -1.752 to-.026) respectively.
The results show a high prevalence of physical health conditions in this cohort, some of which represent a new diagnosis. This implicates better allocation of existing resources for screening and early detection, and potential to run joint clinics with primary care.
Depression is characterized by a pattern of specific changes in the network organization of brain functioning.
We researched a graph structure specificity in a depressive student sample by analyzing resting-state EEG. All possible combinations of graph metrics, frequency bands, and sensors/sources levels of networks were examined.
We recorded resting-state EEG in fourteen participants with high Beck Depression Inventory score (24.4 ± 9.7; 20.4 ± 1.5 y.o.; 14 females; 1 left-handed) and fourteen participants with a low score (6.8 ± 3.7; 21.3 ± 2.0 y.o.; 8 females; 1 left-handed). We applied weighted phase-lag index (wPLI) to construct functional networks at sensors and sources levels and computed characteristic path length (CPL), clustering coefficient (CC), index of modularity (Q), small-world index (SWI) in 4-8, 8-13, 13-30, and 4-30 Hz frequency bands. We used Mann-Whitney U-test (p < 0.05) to investigate between-group differences in the graph metrics.
The depressive sample was characterized by increased CC and Q in the 4-30 Hz band networks and decreased CPL in the beta-band network (sensors-level for CPL and CC, and sources-level for Q).
Elevated CC and Q may relate to an increase of intramodular connectivity, and CPL reduction reflects the global connectivity increasing. We hypothesize that intramodular hyperconnectivity could explain the rise of global functional connectivity in participants with depressive symptoms. Funding: This research has been supported by the Interdisciplinary Scientific and Educational School of Lomonosov Moscow State University ‘Brain, Cognitive Systems, Artificial Intelligence’.
Recent studies mostly focus on the links between measures of alpha-band EEG networks and intelligence. However, associations between wide frequency range EEG networks and general intelligence level remain underresearched.
In this study in a student sample we aimed to correlate the intelligence level and graph metrics of the sensors/sources-level networks constructed in different frequency EEG bands.
We recorded eyes-closed resting-state EEG in 28 healthy participants (21.4±2.1 y.o., 18 females, 1 left-handed). The Raven’s Standard Progressive Matrices Plus (‘SPM Plus’, 60 figures) was used as an intelligence measure. We constructed networks for all possible combinations of sensors/sources-level and 4-8, 8-13, 13-30, or 4-30 Hz frequency bands using Weighted Phase-Lag Index (wPLI), and calculated four graph metrics (Characteristic Path Length, Clustering Coefficient, Modularity, and Small World Index) for each network. Spearman correlation (with Holm-Sidak correction) was applied to characterize the relations between the SPM Plus scores and all the network metrics.
SPM Plus scores varied from 35 to 57 (mean 45.3±4.2), and the intelligence level negatively correlated with Modularity in beta-band (r = -0.63, pcorr = 0.0253).
High modularity may reflect relatively high segregation, but not integration, of networks (Girn, Mills, Christoff, 2019). Accordingly, our findings may shed light on the neural mechanisms of the general inefficiency of global cognitive processing in the case of intellectual decline related to different mental disorders. Funding: This research has been supported by the Interdisciplinary Scientific and Educational School of Lomonosov Moscow State University ‘Brain, Cognitive Systems, Artificial Intelligence’.
Background: Eye movements reveal neurodegenerative disease processes due to overlap between oculomotor circuitry and disease-affected areas. Characterizing oculomotor behaviour in context of cognitive function may enhance disease diagnosis and monitoring. We therefore aimed to quantify cognitive impairment in neurodegenerative disease using saccade behaviour and neuropsychology. Methods: The Ontario Neurodegenerative Disease Research Initiative recruited individuals with neurodegenerative disease: one of Alzheimer’s disease, mild cognitive impairment, amyotrophic lateral sclerosis, frontotemporal dementia, Parkinson’s disease, or cerebrovascular disease. Patients (n=450, age 40-87) and healthy controls (n=149, age 42-87) completed a randomly interleaved pro- and anti-saccade task (IPAST) while their eyes were tracked. We explored the relationships of saccade parameters (e.g. task errors, reaction times) to one another and to cognitive domain-specific neuropsychological test scores (e.g. executive function, memory). Results: Task performance worsened with cognitive impairment across multiple diseases. Subsets of saccade parameters were interrelated and also differentially related to neuropsychology-based cognitive domain scores (e.g. antisaccade errors and reaction time associated with executive function). Conclusions: IPAST detects global cognitive impairment across neurodegenerative diseases. Subsets of parameters associate with one another, suggesting disparate underlying circuitry, and with different cognitive domains. This may have implications for use of IPAST as a cognitive screening tool in neurodegenerative disease.
Frontal sinus obliteration is often performed using fat, autologous bone or a range of synthetic materials. This paper reports the long-term clinical and radiological outcomes of frontal sinus obliteration using beta-tricalcium phosphate putty.
A retrospective audit was performed of patients who underwent frontal sinus obliteration with beta-tricalcium phosphate putty. Patient-, disease- and procedure-related data were collected. Pre- and post-operative computed tomography scans were reviewed to assess bone integration.
Four patients underwent frontal sinus obliteration using beta-tricalcium phosphate putty for treatment of a cerebrospinal leak, mucocele and recalcitrant frontal sinusitis. All patients had disease resolution, with no intra- or post-operative complications reported in the 16.5-month follow up. Post-operative computed tomography scans confirmed native bone obliteration of the frontonasal ducts in all patients.
Beta-tricalcium phosphate putty is a safe and effective option for bone obliteration of the frontal sinus in a range of pathologies, including cerebrospinal fluid leak.
The process of identifying and connecting with clinical trial study teams can be challenging and difficult for members of the public. The national volunteer community registry, ResearchMatch, and the public clinical trials search tool, Trials Today, work in tandem to bridge this connection by providing a streamlined process for potential participants to identify clinical trials which may be of interest.
Building on the existing infrastructure of ResearchMatch and Trials Today, we created a mechanism by which the public can request that their basic contact information (e.g., email/phone) be securely shared with any actively recruiting clinical trial, including trials with no existing relationship with ResearchMatch.
Within the first 2 years of use (July 2019–July 2021), ResearchMatch Volunteers sent 12,251 requests to study teams. On average, 20% of these requests were accepted by the study teams.
The utilization of this tool indicates that there is active interest among members of the public to independently contact study teams about trials of interest. Additionally, research teams unaffiliated with ResearchMatch are willing to at minimum accept contact information. This allows ResearchMatch to successfully serve as a medium, connecting members of the public with actively recruiting trials.
Background: Medulloblastoma (MB) is the most common solid malignant pediatric brain neoplasm. Group 3 (G3) MB, particularly MYC amplified G3 MB, is the most aggressive subgroup with the highest frequency of children presenting with metastatic disease, and is associated with a poor prognosis. To further our understanding of the role of MSI1 in MYC amplified G3 MB, we performed an unbiased integrative analysis of eCLIP binding sites, with changes observed at the transcriptome, the translatome, and the proteome after shMSI1 inhibition. Methods: Primary human pediatric MBs, SU_MB002 and HD-MB03 were kind gifts from Dr. Yoon-Jae Cho (Harvard, MS) and Dr. Till Milde (Heidelberg) and cultured for in vitro and in vivo experiments. eCLIP, RNA-seq, Polysome-seq, and TMT-MS were completed as previously described. Results:MSI1 is overexpressed in G3 MB. shRNA Msi1 interference resulted in a reduction in tumour burden conferring a survival advantage to mice injected with shMSI1 G3MB cells. Robust ranked multiomic analysis (RRA) identified an unconventional gene set directly perturbed by MSI1 in G3 MB. Conclusions: Our robust unbiased integrative analysis revealed a distinct role for MSI1 in the maintenance of the stem cell state in G3 MB through post-transcriptional modification of multiple pathways including identification of unconventional targets such as HIPK1.
To determine histopathological changes in nasal mucosa associated with duration of nasal packing with Merocel tampons.
This study included 24 healthy rabbits, 6 rabbits per group. In group A, no tampon was applied. In group B, Merocel nasal tampons were applied and removed after 24 hours. In group C, the tampons were removed after 48 hours. In group D, the tampons were removed after 5 days. Specimens were obtained from the septum of each rabbit, including cartilage. Histopathological examination was performed.
Significant differences were observed in terms of inflammatory infiltration and loss of cilia between groups A and B. Significant differences were also observed in terms of inflammatory infiltration, haematoma, cilia loss, epithelium dysplasia and cartilage degeneration between groups B and C. There were significant differences in terms of cilia loss, epithelium dysplasia and subepithelial fibrosis between groups C and D. Cartilage degeneration was mild in one animal in group B and in two animals in group C, and was moderate in four animals in group C.
It is recommended that Merocel nasal tampons are removed within 48 hours to preserve nasal mucosal function. Keeping the pack longer may cause cartilage degeneration and other complications.
The chapter examines current trends in the prevalence of mental health issues for American college students. The use of mental health services is discussed, along with insights into barriers to treatment and harm-reduction efforts. The chapter closes with recommendations for future directions in addressing mental health challenges across campuses in the United States.
To assess current demographics and duties of physicians as well as the structure of paediatric cardiac critical care in the United States.
REDCap surveys were sent by email from May till August 2019 to medical directors (“directors”) of critical care units at the 120 United States centres submitting data to the Society of Thoracic Surgeons Congenital Heart Surgery Database and to associated faculty from centres that provided email lists. Faculty and directors were asked about personal attributes and clinical duties. Directors were additionally asked about unit structure.
Measurements and main results:
Responses were received from 66% (79/120) of directors and 62% (294/477) of contacted faculty. Seventy-six percent of directors and 54% of faculty were male, however, faculty <40 years old were predominantly women. The majority of both groups were white. Median bed count (n = 20) was similar in ICUs and multi-disciplinary paediatric ICUs. The median service expectation for one clinical full-time equivalent was 14 weeks of clinical service (interquartile range 12, 16), with the majority of programmes (86%) providing in-house attending night coverage. Work hours were high during service and non-service weeks with both directors (37%) and faculty (45%).
Racial and ethnic diversity is markedly deficient in the paediatric cardiac critical care workforce. Although the majority of faculty are male, females make up the majority of the workforce younger than 40 years old. Work hours across all age groups and unit types are high both on- and off-service, with most units providing attending in-house night coverage.
Whereas Phillips and colleagues argue that knowledge representations are more basic than belief representations, we argue that an accurate analysis of what is fundamental to theory of mind may depend crucially on the context in which mental-state reasoning occurs. Specifically, we call for increased study of the developmental trajectory of mental-state reasoning within socially evaluative contexts.
Advances in technology enabled the development of a web-based, pictorial FFQ to collect parent-report dietary intakes of 7-year-old children in the Growing Up in Singapore Towards healthy Outcomes study. This study aimed to compare intakes estimated from a paper-FFQ and a web-FFQ and examine the relative validity of both FFQ against 3-d diet records (3DDR). Ninety-two mothers reported food intakes of their 7-year-old child on a paper-FFQ, a web-FFQ and a 3DDR. A usability questionnaire collected participants’ feedback on the web-FFQ. Correlations and agreement in energy, nutrients and food groups intakes between the dietary assessments were evaluated using Pearson’s correlation, Lin’s concordance, Bland–Altman plots, Cohen’s κ and tertile classification. The paper- and web-FFQ had good correlations (≥ 0·50) and acceptable-good agreement (Lin’s concordance ≥ 0·30; Cohen’s κ ≥ 0·41; ≥ 50 % correct and ≤ 10 % misclassification into same or extreme tertiles). Compared with 3DDR, both FFQ showed poor agreement (< 0·30) in assessing absolute intakes except micronutrients (web-FFQ had acceptable-good agreement), but showed acceptable-good ability to classify children into tertiles (κ ≥ 0·21; ≥ 40 % and ≤ 15 % correct or misclassification). Bland–Altman plots suggest good agreement between web-FFQ and 3DDR in assessing micronutrients and several food groups. The web-FFQ was well-received, and majority (81 %) preferred the web-FFQ over the paper-FFQ. The newly developed web-FFQ produced intake estimates comparable to the paper-FFQ, has acceptable-good agreement with 3DDR in assessing absolute micronutrients intakes and has acceptable-good ability to classify children according to categories of intakes. The positive acceptance of the web-FFQ makes it a feasible tool for future dietary data collection.
Dietary patterns high in fat contribute to the onset of cardiometabolic disease through the accrual of adipose tissue (AT). Lycopene, a carotenoid shown to exert multiple health benefits, may disrupt these metabolic perturbations. The purpose of the present study was to evaluate AT development and obesity-associated metabolic outcomes in the neonate and weanling offspring of Sprague-Dawley mothers fed a high-fat diet (HFD = 50 % fat) with and without lycopene supplementation. Sprague-Dawley rats consumed either a normal fat diet (NFD; 25 % fat) or HFD throughout gestation. Upon delivery, half of HFD mothers were transitioned to an HFD supplemented with 1 % lycopene (HFDL). At postnatal day 14 (P14), P25, and P35, pups were euthanised, body weight was recorded, and visceral white AT (WAT) and brown AT (BAT) mass were determined. Serum redox status, adipokines, glucose and inflammatory biomarkers were evaluated, as well as BAT mRNA expression of uncoupling protein 1 (UCP1). The HFD was effective in inducing weight gain as evident by significantly greater BW and WAT in the HFD group compared to the NFD group across all time points. Compared to HFD, the HFDL group exhibited significantly greater BAT with concomitant reductions in WAT mass, serum lipid peroxides and serum glucose. No significant differences were observed in serum adipokines, inflammatory markers or UCP1 expression despite the aforementioned alterations in AT development. Results suggest that dietary lycopene supplementation may influence metabolic outcomes during the weaning and post-weaning periods. Additional research is warranted to elucidate molecular mechanisms by which lycopene influences AT biology.
Throughout the COVID-19 pandemic, older adults have been disproportionately impacted by both illness and fatalities. Of the nearly 39 million adults over age 65 in the United States, approximately 2.4 million older adults identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ). LGBTQ older adults face unique challenges due to their intersecting identities and histories, including the effects of heterosexism, ageism, and being more likely to live alone, be single, and not have children. As we implement social distancing as a primary COVID-19 prevention method, older adults have faced increased isolation.
We presented a case of a lesbian older adult patient who has experienced increased depression during the COVID-19 pandemic. A table will be added featuring culturally competent recommendations for LGBTQ older adults from a literature review.
A 77-year-old female with history of major depression, attention deficit disorder, hypertension, xerostomia, and polymyalgia rheumatica. The patient has been on multiple trials of medications for depression as well as ECT treatments. She was initially engaged to a man and after some years fell in love with a woman. The patient is currently single and has no children. She typically has a strong support system with her lifelong friend and attends church. She transitioned from independent living to an adult living facility, with the hope of increased social activity and connectedness. However, due to COVID-19, she experienced her move as extremely difficult, and was disappointed that all social activities were canceled. For a period of several months, she was unable to visit her chosen family, was limited to attending church via Zoom, and was restricted from multiple areas of the complex. As a result, she reported increased depression, anxiety, and difficulty sleeping with passive suicidal ideation due to isolation and no direct family support.
Older LGBTQ populations are at disproportionately higher risk for mental health conditions and with the current social distancing measures in place, social isolation and loneliness has been exacerbated.
Connection with accepting family and community are well documented in the literature as key protective factors and sources of resiliency in LGBTQ populations. Culturally competent care is integral to psychiatric treatment of older LGBTQ adults.
This abstract was presented at the American Association of Geriatric Psychiatry 2021 Annual Meeting.