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Recent theories have implicated inflammatory biology in the development of psychopathology and maladaptive behaviors in adolescence, including suicidal thoughts and behaviors (STB). Examining specific biological markers related to inflammation is thus warranted to better understand risk for STB in adolescents, for whom suicide is a leading cause of death.
Method:
Participants were 211 adolescent females (ages 9–14 years; Mage = 11.8 years, SD = 1.8 years) at increased risk for STB. This study examined the prospective association between basal levels of inflammatory gene expression (average of 15 proinflammatory mRNA transcripts) and subsequent risk for suicidal ideation and suicidal behavior over a 12-month follow-up period.
Results:
Controlling for past levels of STB, greater proinflammatory gene expression was associated with prospective risk for STB in these youth. Similar effects were observed for CD14 mRNA level, a marker of monocyte abundance within the blood sample. Sensitivity analyses controlling for other relevant covariates, including history of trauma, depressive symptoms, and STB prior to data collection, yielded similar patterns of results.
Conclusions:
Upregulated inflammatory signaling in the immune system is prospectively associated with STB among at-risk adolescent females, even after controlling for history of trauma, depressive symptoms, and STB prior to data collection. Additional research is needed to identify the sources of inflammatory up-regulation in adolescents (e.g., stress psychobiology, physiological development, microbial exposures) and strategies for mitigating such effects to reduce STB.
Edited by
Daniel Benoliel, University of Haifa, Israel,Peter K. Yu, Texas A & M University School of Law,Francis Gurry, World Intellectual Property Organization,Keun Lee, Seoul National University
The Nagoya Protocol to the Convention on Biological Diversity (CBD) has threatened to impede access to genetic resources and related data for cross-border scientific research. In principle, every use of genetic resources would require a set of contracts under the CBD, in a “bilateral” regime. The related transaction costs could overwhelm many transnational research undertakings, affecting even public health responses to outbreaks and epidemics. However, the Nagoya Protocol also offers a unique opportunity to resolve this dilemma, despite struggles to define the meaning and coverage of “digital sequence information.” The coverage of genetic sequence data under the CBD remains controversial mainly because users do not know what the potential consequences of such coverage might ultimately entail. This chapter’s objective is to outline a type of coverage devised specifically for pathogens that would promote science, public health, and commercial applications while also protecting the interests of provider countries, supporting innovation, and addressing inequalities. The authors envision an agreed waiver for pathogen sequence data used for upstream scientific research purposes under the Nagoya Protocol, without compromising the duty of users to share benefits. This waiver should help alleviate the problems of definition and subject-matter coverage that have stymied multilateral action.
The aim of this study was to determine whether there was a significant change in cardiac [123I]-metaiodobenzylguanidine uptake between baseline and follow-up in individuals with mild cognitive impairment with Lewy bodies (MCI-LB) who had normal baseline scans. Eight participants with a diagnosis of probable MCI-LB and a normal baseline scan consented to a follow-up scan between 2 and 4 years after baseline. All eight repeat scans remained normal; however, in three cases uptake decreased by more than 10%. The mean change in uptake between baseline and repeat was −5.2% (range: −23.8% to +7.0%). The interpolated mean annual change in uptake was −1.6%.
We present the second data release for the GaLactic and Extragalactic All-sky Murchison Widefield Array eXtended (GLEAM-X) survey. This data release is an area of 12 892-deg$^2$ around the South Galactic Pole region covering 20 h40 m$\leq$RA$\leq$6 h40 m, -90$^\circ$$\leq$Dec$\leq$+30$^\circ$. Observations were taken in 2020 using the Phase-II configuration of the Murchison Widefield Array (MWA) and covering a frequency range of 72–231 MHz with twenty frequency bands. We produce a wideband source finding mosaic over 170–231 MHz with a median root-mean-squared noise of $1.5^{+1.5}_{-0.5}$ mJy beam$^{-1}$. We present a catalogue of 624 866 components, including 562 302 components which are spectrally fit. This catalogue is 98% complete at 50 mJy, and a reliability of 98.7% at a 5 $\sigma$ level, consistent with expectations for this survey. The catalogue is made available via Vizier, and the PASA datastore and accompanying mosaics for this data release are made available via AAO Data Central and SkyView.
Maternal vitamin-D and omega-3 fatty acid (DHA) deficiencies during pregnancy have previously been associated with offspring neurodevelopmental traits. However, observational study designs cannot distinguish causal effects from confounding.
Methods
First, we conducted Mendelian randomisation (MR) using genetic instruments for vitamin-D and DHA identified in independent genome-wide association studies (GWAS). Outcomes were (1) GWAS for traits related to autism and ADHD, generated in the Norwegian mother, father, and child cohort study (MoBa) from 3 to 8 years, (2) autism and ADHD diagnoses. Second, we used mother–father–child trio-MR in MoBa (1) to test causal effects through maternal nutrient levels, (2) to test effects of child nutrient levels, and (3) as a paternal negative control.
Results
Associations between higher maternal vitamin-D levels on lower ADHD related traits at age 5 did not remain after controlling for familial genetic predisposition using trio-MR. Furthermore, we did not find evidence for causal maternal effects of vitamin-D/DHA levels on other offspring traits or diagnoses. In the reverse direction, there was evidence for a causal effect of autism genetic predisposition on lower vitamin-D levels and of ADHD genetic predisposition on lower DHA levels.
Conclusions
Triangulating across study designs, we did not find evidence for maternal effects. We add to a growing body of evidence that suggests that previous observational associations are likely biased by genetic confounding. Consequently, maternal supplementation is unlikely to influence these offspring neurodevelopmental traits. Notably, genetic predisposition to ADHD and autism was associated with lower DHA and vitamin-D levels respectively, suggesting previous associations might have been due to reverse causation.
Considering the ethnic, racial, and cultural diversity in the U.S., we aim to explore the experiences of healthcare chaplains as they provide culturally sensitive care to diverse patients and their families.
Methods
This is a qualitative study. Individual interviews were conducted with 14 healthcare chaplains recruited from 3 U.S. chaplaincy organizations.
Results
Thematic analysis with constant comparison yielded 6 themes in the chaplains’ experiences: (1) the diverse roles of chaplains; (2) their high levels of comfort in working with diverse populations, attributed to cultural sensitivity and humility training; (3) cues for trust-building; (4) common topics of diversity, equity, and inclusion discussed; (5) gaps in chaplaincy training; and (6) the importance of collaboration and negotiation with healthcare professionals to accommodate cultural needs.
Significance of results
This research highlights the valuable role of chaplains in providing culturally sensitive care and suggests areas for improving chaplaincy training and education to better serve diverse patient populations.
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
Collaborative psychiatric management is founded on a person-centred, holistic assessment leading to a diagnostic formulation that guides decision making. Formulation around the individual person, including their unique history and worldview, can be described with presenting, precipitating, predisposing, perpetuating and protective factors as well as the life context for the individual patient. Allied with this, diagnosis – in which the patient’s unique presentation can be evaluated as sharing characteristics and patterns with other patients – can allow for the individual plan to be guided by a wider frame of reference and knowledge. Such diagnostic frameworks have been developed over millennia and across cultures. As well as being important for individual patient care, they are essential for research and service planning. The development of these diagnostic frameworks is discussed with particular reference to the main international classifications of ICD-11 and DSM-5. It is common for people to have more than one diagnosis, and diagnostic hierarchies are considered. Criticisms of the construct of psychiatric diagnosis are reviewed, and an approach to conducting and describing collaborative psychiatric assessment is described.
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
Psychiatry, according to Johann Christian Reil (1759–1813), the German anatomist who first coined the term, consists of the meeting of two minds, the mind of the patient with the mind of the doctor. As the patient’s story unfolds, the doctor’s task is to recognise the pattern and to do so with compassion. Pattern recognition lies at the heart of the diagnostic process throughout medicine and none more so than in psychiatry, which lacks almost all the special investigations that help clarify diagnosis in other medical specialities. Thus, detailed knowledge of the key features of all the psychiatric disorders, both common and rare, is the core body of information that the psychiatrist will need to acquire during their training years. Because of this, we have provided detailed descriptions of each and every disorder as well as their diagnostic criteria according to DSM-5 and ICD-11.
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
This long-awaited third edition of Seminars in General Adult Psychiatry provides a highly readable and comprehensive account of modern general adult psychiatry. The text has been fully updated throughout by leading figures in modern psychiatry. This new edition covers developments in the understanding of mental disorders, service delivery, changes to risk assessment and management, collaborate care plans and 'trauma-informed' care. Coverage will also be given to the implementation of the ICD-11 and DSM-5 classification systems, and the impact on diagnosis and treatment. Key features of the previous edition that have been updated include the detailed clinical descriptions of psychiatric disorders and historical sections with access to the classic studies of psychiatry. Additional topics include autism, ADHD and physical health. This is a key text for psychiatric trainees studying for their MRCPsych exams, and a source of continuing professional development for psychiatrists and other mental health professionals.
There are numerous challenges pertaining to epilepsy care across Ontario, including Epilepsy Monitoring Unit (EMU) bed pressures, surgical access and community supports. We sampled the current clinical, community and operational state of Ontario epilepsy centres and community epilepsy agencies post COVID-19 pandemic. A 44-item survey was distributed to all 11 district and regional adult and paediatric Ontario epilepsy centres. Qualitative responses were collected from community epilepsy agencies. Results revealed ongoing gaps in epilepsy care across Ontario, with EMU bed pressures and labour shortages being limiting factors. A clinical network advising the Ontario Ministry of Health will improve access to epilepsy care.
Floating, mixed-valent Fe films have been observed worldwide in wetlands, ferrous iron-rich seeps, and in seasonally reduced soils, but are usually misidentified as oil or biofilms. There has been little characterization or explanation of their formation. Along the Oregon coast such films were found on ephemeral pools where Fe(II)-rich groundwater (∼100 µM Fe) has been discharged at the base of Pleistocene sand dunes. Fe(II) oxidized to Fe(III) at the air-water interface to form ∼100–300 nm thick films. Analyses indicated that the films contained both Fe(III) and Fe(II) in a ratio of 3:1; Si was the other main cation; OH was the main anion and some C was also identified. The film morphology was flat under optical and electron microscopy with some attached floccules having a string-like morphology. Energy-filtered electron diffraction patterns showed three diffraction rings at 4.5, 2.6 and 1.4 Å in some places and two rings (2.6 and 1.4 Å) in others. Upon further oxidation the films became 2-line ferrihydrite. We are proposing the name ‘schwimmeisen’ for the floating, mixed-valent Fe film.
The COVID-19 pandemic created barriers to healthcare that necessitated changes in services to meet needs of individuals. With these changes, technological advances in computerized cognitive testing became critical. As researchers and clinicians accelerated adaptation of computerized testing formats, considerations for development and interpretation of such tools have proved imperative. One such computerized tool, RC21X, utilizes performance measurement software comprising 15 modules to evaluate an individual’s processing speed, memory, executive functions, and neuromotor coordination. Although initial data has revealed strong psychometric properties (Saganis et al., 2020), a need to explore various attributes of this web-based tool has emerged. The current study examined impact of dominant handedness on an RC21X neuromotor task.
Participants and Methods:
The sample consisted of 602 participants: 553 (91.86%) were right-hand dominant and 49 (8.14%) were left-hand dominant. Of participants who identified their sex, 81.2% were male, 18.3% were female; 0.5% chose not to identify. Age ranged from 7-95 years (M = 41.21, SD = 18.81). This study focused on the RC21X Eye-Hand Coordination subtest. Using a Fitts’ Law paradigm, the module provided instruction for participants to alternately press the “A” and “L” keys on a keyboard as quickly and accurately as possible using only one upper extremity (UE) at a time (tested separately for right then left UE). We computed a one-way between groups multivariate analysis of variance (MANOVA) to investigate handedness differences on task performance. Dependent variables were individuals’ performances on right- and left-UE tasks; the independent variable was dominant handedness. We conducted preliminary assumption testing with no serious violations noted. We also separated the sample by dominant handedness to compare right versus left-hand performance using paired samples t-tests within each group. There were no significant differences between the two groups on either age or sex.
Results:
There was a statistically significant difference between right-hand dominant and left-hand dominant participants on the dependent variables, F (2, 599) = 8.84, p < .001, Wilks’ Lambda = .971. Mean scores indicated that right-hand dominant participants (M = 52.87, SD = 20.42) outperformed their left-hand dominant counterparts (M = 46.30, SD = 12.79) when using their right UE, though both groups performed similarly when using their left UE (right-hand dominant M = 48.55, SD = 17.81; left-hand dominant M = 49.70, SD = 14.13). These findings were present despite expected results from paired samples t-tests that revealed individuals performed best with their dominant hand.
Conclusions:
Results revealed that handedness is necessary to consider in design and utilization of computerized neuropsychological tests. The large proportion of right-hand dominant individuals may have affected our results; however, our sample is representative of handedness distribution in the general population. Although our paired samples t-tests support validity of RC21X, continued investigation of computerized performance measurement tools is necessary. Future research must explore the possibility of an ordering effect (i.e., right-handed participants starting with their dominant UE, but left-handed participants starting with their nondominant UE) or due to construction of everyday items (e.g., computer keyboards) primarily for right-hand dominant people.
Many large-scale land acquisition studies focus on the role of powerful transnational corporations, foreign and domestic governments. Instead, we shift the focus to the role of local actors, in this case, pastoralists in Samburu County, Kenya. Here, we apply the concept of ‘intimate exclusion’ and show that pastoralist elites' desire and ability to maximise productive and financial gains from customary land, coupled with their privileged understanding of land-related laws and regulations and ability to use or threaten others with violence, enables the control of extensive customary lands and the exclusion of weaker pastoralists. These processes, we find, are rooted in the country's capitalist development trajectory traceable to colonial rule. Overall, the paper highlights local ‘homegrown’ actors’ role in large-scale land acquisition, how social intimacy provides space and opportunity for unequal benefits and how historical gains offer unique opportunities to gain from new political and economic developments.
Background: Tecovirimat (TPOXX) is an antiviral drug only available via an Expanded Access Program (EAP) investigational new drug protocol and is recommended for treatment of select patients with monkeypox (mpox) infection. Alameda County Public Health Department prioritizes health equity but does not have a dedicated public health clinic. Therefore, we partnered closely with local healthcare providers that serve communities disproportionally impacted by mpox to ensure there was access to TPOXX. Using data collected during the outbreak we assessed whether populations in Alameda County most affected by mpox received treatment. Methods: We describe Alameda County patients with confirmed or probable mpox who received TPOXX during June–October 2022. Data were collected from case investigation interviews with patients and state-wide reportable disease database(s), which included demographic, clinical, and behavioral information. Confidence intervals (CIs) were calculated using the exact method for Poisson counts. We compared characteristics of mpox patients who received and did not receive TPOXX using the Pearson χ2 or Fisher exact test. P < .05 was considered significant. Results: Mpox case rates in Alameda County were highest among Black or African-American residents (35.6 per 100,000, 95% CI, 26.7–46.4) and Hispanic or Latinx residents (25.2, 95% CI, 20.2–31.0) compared to Asian residents (3.9, 95% CI, 2.3–6.1) and white residents (10.4, 95% CI, 7.7–13.9) residents. Among 242 mpox patients, 69 patients (28.5%) received TPOXX. The distribution of demographic and clinical characteristics among patients who received TPOXX was not significantly different than among those who did not, including residents aged 31–40 years (36.2% vs 34.7%), Black or African-American residents (20% vs 26.3%), Hispanic or Latinx residents (38.5% vs 41%), male residents (89.9% vs 95.3%), gay, lesbian, or same-gender loving residents (67.2% vs 67.4%) in the city of Oakland (63.2% vs 61.5%), or residents with human immunodeficiency virus infection (43.5% vs 36.6%). Conclusions: During the Alameda County mpox outbreak, nearly one-third of patients received TPOXX. Demographic and clinical characteristics were similar among TPOXX recipients and nonrecipients. A proactive approach to obtaining TPOXX in Alameda County and strong relationships with local providers may have allowed for treatment to be accessible to mpox patients. Regular review of outbreak data can inform public health activities, ensure health equity, and help refine local response efforts.
Glioblastoma (GBM) is the most frequent type of primary brain cancer, having a median survival of only 15 months. The current standard of care includes a combination of surgery, radiotherapy (RT) and chemotherapy with temozolomide, but with limited results. Moreover, multiple studies have shown that tumour relapse and resistance to classic therapeutic approaches are common events that occur in the majority of patients, and eventually leading to death. New approaches to better understand the intricated tumour biology involved in GBM are needed in order to develop personalised treatment approaches. Advances in cancer biology have widen our understanding over the GBM genome and allowing a better classification of these tumours based on their molecular profile.
Methods
A new targeted therapeutic approach that is currently investigated in multiple clinical trials in GBM is represented by molecules that target various defects in the DNA damage repair (DDR) pathway, a mechanism activated by endogenous and exogenous factors that induce alteration of DNA, and is involved for the development of chemotherapy and RT resistance. This intricate pathway is regulated by p53, two important kinases ATR and ATM and non-coding RNAs including microRNAs, long-non-coding RNAs and circular RNAs that regulate the expression of all the proteins involved in the pathway.
Results
Currently, the most studied DDR inhibitors are represented by PARP inhibitors (PARPi) with important results in ovarian and breast cancer. PARPi are a class of tumour agnostic drugs that showed their efficacy also in other localisations such as colon and prostate tumours that have a molecular signature associated with genomic instability. These inhibitors induce the accumulation of intracellular DNA damage, cell cycle arrest, mitotic catastrophe and apoptosis.
Conclusions
This study aims to provide an integrated image of the DDR pathway in glioblastoma under physiological and treatment pressure with a focus of the regulatory roles of ncRNAs. The DDR inhibitors are emerging as an important new therapeutic approach for tumours with genomic instability and alterations in DDR pathways. The first clinical trials with PARPi in GBM are currently ongoing and will be presented in the article. Moreover, we consider that by incorporating the regulatory network in the DDR pathway in GBM we can fill the missing gaps that limited previous attempts to effectively target it in brain tumours. An overview of the importance of ncRNAs in GBM and DDR physiology and how they are interconnected is presented.