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Major depressive disorder (MDD) is a complex disorder with a significant public health burden. Depression remission is often associated with weight gain, a major risk factor for metabolic syndrome (MetS). The primary objective of our study was to assess prospectively the impact of response to antidepressant treatment on developing MetS in a sample of MDD patients with a current major depressive episode (MDE) and who are newly initiating their treatment.
Methods
In the 6-month prospective METADAP cohort, non-overweight patients, body mass index <25 kg/m2, with MDD and a current MDE were assessed for treatment response after 3 months of treatment, and incidence of MetS after 3 and 6 months of treatment. Outcome variables were MetS, number of MetS criteria, and each MetS criterion (high waist circumference, high blood pressure, high triglyceridemia, low high-density lipoprotein-cholesterolemia, and high fasting plasma glucose).
Results
In total, 98/169 patients (58%) responded to treatment after 3 months. A total of 2.7% (1/38) developed MetS out of which 12.7% (10/79) (p value < 0.001) had responded to treatment after 3 months. The fixed-effect regression models showed that those who responded to treatment after 3 months of follow-up had an 8.6 times higher odds of developing MetS (odds ratio = 8.58, 95% confidence interval 3.89–18.93, p value < 0.001).
Conclusion
Compared to non-responders, non-overweight patients who responded to treatment after 3 months of antidepressant treatment had a significantly higher risk of developing MetS during the 6 months of treatment. Psychiatrists and nurses should closely monitor the metabolic profile of their patients, especially those who respond to treatment.
The tryptophan pathway along with its two branches of metabolism to serotonin and kynurenine seems to be affected in major depression. In depressed patients, peripheral levels of tryptophan, serotonin, kynurenine and their metabolite remain unclear.
Objectives
Therefore, peripheral tryptophan and metabolites of serotonin and kynurenine were investigated extensively in 173 patients suffering from a current major depressive episode (MDE) and compared to 214 healthy controls (HC).
Methods
Fasting plasma levels of 11 peripheral metabolites were quantified: tryptophan, serotonin pathway (serotonin, its precursor 5-hydroxy-tryptophan and its metabolite the 5-hydroxy-indole acetic acid), and kynurenine pathway (kynurenine and six of its metabolites including anthranilic acid, kynurenic acid, nicotinamide, picolinic acid, xanthurenic acid and 3-hydroxy-anthranilic acid).
Results
60 (34.7%) patients were antidepressant drug free. Tryptophan levels did not differ between MDE patients and HC. Serotonin and its precursor (5-hydroxy-tryptophan) levels were lower in MDE patients than HC. Whereas, its metabolite (5-hydroxy-indole acetic acid) levels were within the standard range. Kynurenine and four of its metabolites (kynurenic acid, nicotinamide, picolinic acid and xanthurenic acid) were lower in MDE patients.
Conclusions
This study uses the largest ever sample of MDE patients, with an extensive assessment of peripheral tryptophan metabolism in plasma. These findings provide new insights into the peripheral signature of MDE. The reasons for these changes should be further investigated. These results might suggest a better stratification of patients and different therapeutic strategies therapeutic strategies.
Nitric oxide synthase (NOS) activity, an enzyme potentially involved in the major depressive episodes (MDE), could be indirectly measured by the L-Citrulline/L-Arginine ratio (L-Cit/L-Arg). The aim of this study was: (1) to compare the NOS activity of patients with a MDE to that of healthy controls (HC); (2) to assess its change after antidepressant treatment.
Methods
A total of 460 patients with a current MDE in a context of major depressive disorder (MDD) were compared to 895 HC for NOS activity (L-Cit/L-Arg plasma ratio). L-Arg and L-Cit plasma levels were measured using a MS-based liquid chromatography method. Depressed patients were assessed at baseline, and after 3 and 6 months of antidepressant treatment for depression severity and clinical response.
Results
Depressed patients had a lower NOS activity than HC at baseline [0.31 ± 0.09 v. 0.38 ± 0.12; 95% confidence interval (CI) −0.084 to −0.062, p < 0.0001]. Lower NOS activity at baseline predicted a higher response rate [odds ratio (OR) = 29.20; 95% CI 1.58–536.37; p = 0.023]. NOS activity in depressed patients increased significantly up to 0.34 ± 0.08 after antidepressant treatment (Est = 0.0034; 95% CI 0.0002–0.0067; p = 0.03).
Conclusions
Depressed patients have a decreased NOS activity that improves after antidepressant treatment and predicts drug response. NOS activity may be a promising biomarker for MDE in a context of MDD.
Suicide is the second most frequent cause of death among the youth and its rates among adolescents have recently risen. Up to 30% of adolescents who attempt suicide will try it again within a year. Our objective is to analyze how previous attempts and diagnosed psychiatric disorder behave as markers of risk of reattempts and their statistical interaction. We include every underage patient treated by an emergency room psychiatrist after a suicide attempt in a General Hospital between years 2010 and 2015. Patients free of relapse after 1000 days are censored. We obtain Kaplan–Meier estimates for the risk of a new attempt as a time-dependant variable, dividing them by the presence of previous suicide attempts, diagnosed psychiatric disorder or both at a time, checking the differences by using log-rank tests. Then, we perform Cox proportional risk models including both variables and a factor of their interaction and adjust them by sex and age in a non-automatically driven multivariate analysis, thus obtaining HR estimates. We present 150 cases (118 female; mean[SD] age in years: 15.8 [1.6]). Overall, 22.6% of them relapse during follow-up time. Multivariate models show interaction of previous attempts and diagnosed psychiatric disorder is associated with relapse with an HR of 1.27 × 108 (95% CI: 5.51 × 107 – 2.9 × 108). Interaction of both factors is an outstanding risk marker of relapse after an attempted suicide and should thus be given clinical importance in tertiary prevention.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The willow sawfly, Nematus oligospilus (Förster), is a pest in Salix commercial forests and has been reported worldwide. Female adults must recognize a suitable host plant to oviposit, since her offspring lack the ability to move to another host. We evaluated the effect of conspecific herbivory on the oviposition choices of N. oligospilus females by providing damaged (DP) and undamaged (UP) plants of Salix humboldtiana, a native willow from South America, as oviposition substrates. Local and systemic effects were studied. For the local treatment, a twig from the DP with damaged leaves was contrasted to a twig from a UP in dual choice experiments. For systemic treatment, a twig from the DP with intact leaves was contrasted to a twig from a UP. We estimated the use of olfactory and contact cues by comparing volatile emission of DP and UP, and by analysing the behaviour of the females during host recognition after landing on the leaf surface. In the context of the preference–performance hypothesis (PPH), we also tested if oviposition site selection maximizes offspring fitness by evaluating neonate hatching, larval performance and survival of larvae that were born and bred on either DP or UP. Our results demonstrate that previous conspecific herbivory on S. humboldtiana has a dramatic impact on female oviposition choices and offspring performance of the sawfly N. oligospilus. Females showed a marked preference for laying eggs on UP of S. humboldtiana. This preference was found for both local and systemic treatments. Volatile emission was quantitatively changed after conspecific damage suggesting that it could be related to N. oligospilus avoidance. In the dual choice preference experiments, the analysis of the behaviour of the females once landing on the leaf surface suggested the use of contact cues triggering egg laying on leaves from UP and avoidance of leaves from DP. Furthermore, 48 h of previous conspecific feeding was sufficient to dramatically impair neonate hatching, as well as larval development and survival, suggesting a rapid and effective reaction of the induced resistance mechanisms of the tree. In agreement with the PPH, these results support the idea that decisions made by colonizing females may result in optimal outcomes for their offspring in a barely studied insect model, and also opens the opportunity for studying tree-induced defences in the unexplored South American willow S. humboldtiana.
OBJECTIVES/SPECIFIC AIMS: By combining clinical knowledge of hoarding disorder (HD) with qualitative methods from cultural anthropology, we hope to build a patient-centered approach that will allow us to better understand the clinician perspectives on patient motivations and explanatory models of individuals with HD, and improve treatment outcomes. We describe the ways that these methodologies are productively merged in this project as a result of TL1 collaboration, and present a preliminary picture of methodological and theoretical issues uncovered as part of this processes. We further describe the analytical methods used for this project, and explore issues raised through the combination of psychological and anthropological data and insights. METHODS/STUDY POPULATION: This study represents an attempt to combine the qualitative methodologies of cultural anthropology with the clinical knowledge of psychology and psychiatry in order to better understand gaps between provider and patient beliefs and knowledge about hoarding disorder. This study will present preliminary methodological issues arising from interviews with hoarding experts. RESULTS/ANTICIPATED RESULTS: This study will discuss preliminary issues including shared language, strengths and limitations of both disciplines, and factors for consideration when combining these disparate methodologies. It will close with recommendations for consideration when moving forward with similar collaborations. DISCUSSION/SIGNIFICANCE OF IMPACT: This project seeks to unite psychological and social factors that may contribute to the lived experience of individuals with HD in order to better understand the way that HD is manifested. It also unites disparate methodologies to provide us with a more holistic and complete picture of the experience of HD. While HD has been studied within psychiatry, it has never been assessed using the qualitative methods of anthropology. These methods provide the possibility of expanding knowledge about the ways that this disorder is experienced by individuals and their families, and potentially impacted by shared beliefs and cultures. Furthermore, qualitative data of this nature provides a patient perspective on the experience of HD as a psychiatric illness. This patient perspective can be used to better inform treatment, improve patient outcomes, and to allow providers and researchers to gain a fuller understanding of this complex population.
This study was aimed to investigate associations between birth weight and multiple adiposity indicators in youth, and to examine potential mediating effects by biological maturation. This was a school-based study involving 981 Brazilian adolescents aged between 10 and 17 years. Birth weight was reported retrospectively by mothers. Maturation was estimated by age of peak height velocity. Adiposity indicators included body mass index (BMI), waist circumference and percent body fat estimated from triceps and subscapular skinfolds. Multilevel mediation analyses were performed using the Sobel test, adjusted for chronological age, gestational age, cardiorespiratory fitness and socio-economic status. Except for body fat in girls, biological maturation partly or fully mediated (P<0.05) positive relationships between birth weight with all other obesity indicators in both sexes with their respective values of indirect effects with 95% confidence intervals: BMI [boys: 0.44 (0.06–0.82); girls: 0.38 (0.13–0.64)], waist circumference [boys: 1.14 (0.22–2.05); girls: 0.87 (0.26–1.48)] and body fat [boys: 0.60 (0.13–1.07)]. To conclude, birth weight is associated with elevated obesity risk in adolescence and biological maturation seems to at least partly mediate this relationship.
The study of the evolution of organic matter subjected to space conditions, and more specifically to Solar photons in the vacuum ultraviolet range (120–200 nm) has been undertaken in low-Earth orbit since the 1990s, and implemented on various space platforms. This paper describes a photochemistry experiment called AMINO, conducted during 22 months between 2009 and 2011 on the EXPOSE-R ESA facility, outside the International Space Station. Samples with relevance to astrobiology (connected to comets, carbonaceous meteorites and micrometeorites, the atmosphere of Titan and RNA world hypothesis) have been selected and exposed to space environment. They have been analysed after return to the Earth. This paper is not discussing the results of the experiment, but rather gives a general overview of the project, the details of the hardware used, its configuration and recent developments to enable long-duration exposure of gaseous samples in tight closed cells enabling for the first time to derive quantitative results from gaseous phase samples exposed in space.
UGIB remains a common disease affecting 100 to 170 adults per year, with an associated mortality ranging from 5 to 14%, causing thereby an important burden to healthcare resources. UGIB in children is uncommon (1–2/10,000 per year) but potentially life threatening. Since various specialists (general practitioners, emergency physicians, gastroenterologists and hepatologists, pediatricians, intensivists, radiologists and surgeons) may be involved and given the absence of evidence-based medical (EBM) recommendations - for adults as well as for children - there is considerable variability in the management of UGIB. Moreover, as even RCTs on the management of UGIB in children are lacking, many treatment strategies are simply deducted from the management of adult UGIB.
Aim
To provide EBM guidelines for the care of adults and children presenting with bleeding caused by gastro-duodenal ulcer or variceal rupture.
Method and Results
An interuniversity interdisciplinary team of Belgian experts was launched. Statements based on the published literature up to September 2010 were collected and proposed after expert opinions reconciliation and graded accordingly to the class of evidence. The current guidelines for the management of UGIB include recommendations for the diagnosis process, general supportive care, pharmacological therapy aiming at bleeding control, specific and endoscopic treatment of acute bleeding and follow-up for both gastro-duodenal ulcers and portal hypertension induced bleeding. Specificities and differences in the approach to UGIB in children compared to adults are highlighted.
Conclusion
Interdisciplinary guidelines for the management of UGIB based on current standards for EBM will provide an opportunity for clinicians to improve the management of their patients. However, clinical guidelines are not mandatory tenets appropriate for all patients, but should constitute a canon or principle tailored to the individual patient. In addition, EBM might provide quality indicators for the assessment of care to bleeding patients at a local, national or international level.
We describe three space experiments designed to expose to space conditions, and more specifically to solar UV radiation, selected samples of organic and mineral material.
In 1972 more than 20% of boys admitted to a closed community (Junior Detention Centre) developed acute tonsillitis and group-A streptococci were isolated from more than 40% of all boys at some time during their stay of two months. The most common serotype was M-type 5, which has frequently been associated with rheumatic fever in other epidemics; four cases of rheumatic fever occurred between 1972 and 1977. Various methods were tried to eliminate the infection, but only full penicillin prophylaxis (0·25 g oral penicillin 4 times a day for 10 days) to all boys on entry appeared to be effective.
In a sample of cases of acute tonsillitis, group-A haemolytic streptococci were isolated from 31·7% by the use of dry swabs or unenriched transport medium, but with enrichment medium duplicate swabs, 77·0% yielded positive results. We question the current practice in some laboratories of reporting positive cultures only when more than ten colonies of β-haemolytic streptococci are present. In this survey viruses did not appear to be an important cause of acute tonsillitis.
High titres of streptococcal antibodies (antistreptolysin O, anti-desoxyribonuclease B and anti-M associated protein) were found, not only in cases and carriers, but in boys on entry to the centre. This supports epidemiological evidence that adolescent boys on entry to the centre. This supports epidemiological evidence that adolescent boys are particularly prone to streptococcal throat infections.
1. In an endemic area of Q fever in south-east England, two flocks of sheep, with serological evidence of infection by Rickettsia burneti, were examined for excretion of the rickettsia at parturition.
2. R. burneti was isolated from two out of ninety-six placentas collected from 118 ewes which lambed in one flock. The organism was also isolated from ‘wool tags’ obtained from one of the ewes which voided an infected placenta.
3. Infectivity titrations showed that the two placentas contained respectively 104·5 and 101·5 guinea-pig infective doses per gram of cotyledon. The wool tag from the sheep which voided the more highly infected placenta contained 103·25 infective doses per gram.
4. Except for one doubtful result, which could not be confirmed, no isolations were made from 194 placentas collected from 199 ewes in the other flock.
Details of the design of the microblender were supplied by Dr A. P. Goffe and Mr T. Nash of the Central Public Health Laboratory, Colindale, to whom we are much indebted. A gift of Triton X-100 was kindly given to us by the Rohm and Haas Corporation, Philadelphia 5 Pa.
Sensitivity analyses have shown major role of foliar transfer for many radionuclides in the context of radiological impact assessments. A review of the published literature about foliar transfer focusing on translocation factors was carried out in order to constitute an updated database on one hand and to use the appropriate existing values of translocation parameters for modeling on the other. Translocation describes the distribution of radionuclides within the plant after foliar deposition and radionuclide absorption onto the surface of leaves. It mainly depends on elements and the plant growth stage. The collected data was derived from both in-field and greenhouse experiments. It was analysed to select those coming from a contamination simulating sprinkling irrigation or rain.
This work not only allowed us to carry out a diagnosis on the values themselves but also enabled us to ascertain missing data needs. In order to compensate for the lack of data on important radionuclides concerning radioactive waste (129I, 36Cl, 79Se), experimental studies have been launched.
Tholins are polymeric hydrogenated carbon nitrides formed from N2:CH4 mixtures exposed to electrical discharges. They are complex disordered solids, and their structural chemistry and formation processes are not yet fully understood. Tholins have been widely adopted as useful analogs of reddish organic solids associated with planetary bodies or in interstellar space (e.g., Titan's aerosols, reddish surfaces of outer objects, interstellar organics, etc.) for fitting astronomical observations. However, there has been little evidence to date that they in fact constitute pertinent model materials, i. e. with chemical structure/composition similar to those presumed to be present in planetary or interstellar organic solids. In this contribution, we first review recent advances made regarding the determination of composition and structure of tholins produced in the laboratory. They point to a high chemical selectivity in the range of functional groups present, the control of unsaturation by nitrogen, and the highly disordered character of the structures. In a second section, we discuss the relationship between chemistry and the optical properties of tholins, and we point out the lack of a unique relationship between the shape and strength of the visible absorption bands and the chemical composition or structure of the model tholins. The tholins exhibit similarities with HCN “polymers”, that are suspected to be present in cometary refractory dust. This points to the existence of possible similar polymerisation processes, and it suggests they could also be used as analogs of N-rich cometary organics. Laboratory-based studies of cometary dust might offer new insights on the “chemical relevancy” of tholins, as combined micro-analytical techniques will allow direct comparison of chemical information between the materials produced. In a third section we present recent results pertaining to the search for such compounds in cometary grains (Stardust grains, interplanetary dust particles - IDPs). We show that some N-rich spots in stratospheric IDPs are rich in cyanide species, but no tholin-like compounds or polymeric HCN have been detected to date.
As a prerequisite to returning their molecular inventory to the gas phase, icy grain mantles must desorb from the refractory core material of the grain. This desorption process can be instigated through interactions with photons or cosmic rays but can equally well be thermally driven. In this invited paper, the application of thermal desorption techniques borrowed from ultrahigh vacuum surface science to problems of astronomical interest will be discussed. The experimental methods employed by surface scientists to probe thermal desorption processes will be described and the analysis of the resulting empirical data outlined. The results of recent laboratory measurements from a number of groups will be highlighted.
Foliar transfer of transuranium elements had not received the same attention as other long-lived radionuclides, such as the well-known classical fission products Cs and Sr. Thus, the aim of this study was to compare the foliar transfer parameters of 241Am and $^{239,240}$Pu with those of 137Cs and 85Sr. Bean plants (Phaseolus vulgaris) at flowering development stage were contaminated by soaking their first two trifoliate leaves for 3 hours in a solution containing 241Am, $^{239,240}$Pu, or 137Cs and 85Sr. Results showed that transuranium elements were more retained by leaves than Cs or Sr. The mean leave-to-pod translocation factor of Am was of the same order as that of Sr, showing that the behaviour of Am was close to the behaviour of Sr. Translocation of Pu was significantly lower than for Cs, Sr or Am and occurred preferentially in leaves. Differential mobility of Am, Pu, Cs and Sr were compared to those used in related studies. Comparison showed that, when specific values of representative radioecological parameters are lacking, the behaviour of Am and Pu towards foliar transfer may be conservatively described as “Sr-like".
Laboratory surface science under ultra-high vacuum (UHV) conditions allows us to simulate the growth of ices in astrophysical environments. Using the techniques of temperature programmed desorption (TPD), reflection-absorption infrared spectroscopy (RAIRS) and micro-balance methods, we have studied binary ice systems consisting of water (H2O) and variety of other species including carbon monoxide (CO), at astrophysically relevant conditions of temperature and pressure. We present results that demonstrate that the morphology of water ice has an important influence on the behavior of such systems, by allowing processes such as diffusion and trapping that can not be understood through a knowledge of the binding energies of the species alone. Through an understanding of the implications of water ice morphology on the behavior of ice mixtures in the interstellar environment, additional constraints can be placed on the thermodynamic conditions and ice compositions during comet formation.