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Little is known about touch hunger (longing for physical contact) during the COVID-19 pandemic, particularly for people with pre-existing mental health disorders.
Objectives
We aim to investigate the dynamics of touch hunger in people with and without depressive, anxiety, or obsessive-compulsive disorders during the COVID-19 pandemic, and the potential predictors for touch hunger during lockdown.
Methods
Data were aggregated from three Dutch ongoing prospective cohorts with similar methodology for data collection. We included participants with pre-pandemic data gathered during 2006–2016, and who completed up to 9 online questionnaires between October 2020 and February 2022. We compared trajectories between subgroups with different pre-pandemic chronicity of disorders and healthy controls using linear mixed models. Sociodemographic, clinical (number and type of mental health disorders, personality traits) and COVID-19-related variables were analysed as predictors of touch hunger using multivariate linear regression analyses.
Results
We included 1061 participants with (n = 811) and without (n = 250) mental health disorders. In all groups, touch hunger increased during lockdown (Fig. 1). Extraversion (β = 0.256, P <0.001), social distancing due to COVID-19 anxiety (β = 0.122, P = 0.001) and death of a close contact from COVID-19 (β = 0.073, P = 0.02) predicted higher touch hunger, while living with a partner (β = -0.109, P = 0.004) or with a partner and children (β = -0.147, P <0.001) were protective factors for touch hunger. Remarkably, pre-pandemic mental disorders did not predict touch hunger during lockdown.
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Conclusions
Social distancing measures have important psychological and emotional implications, as our study showed an increase in touch hunger during lockdown, which did not differ between people with and without mental health disorders. Extroverted individuals may benefit most from interventions aimed at addressing their need for physical contact during times of crisis.
Pain following surgery for cardiac disease is ubiquitous, and optimal management is important. Despite this, there is large practice variation. To address this, the Paediatric Acute Care Cardiology Collaborative undertook the effort to create this clinical practice guideline.
Methods:
A panel of experts consisting of paediatric cardiologists, advanced practice practitioners, pharmacists, a paediatric cardiothoracic surgeon, and a paediatric cardiac anaesthesiologist was convened. The literature was searched for relevant articles and Collaborative sites submitted centre-specific protocols for postoperative pain management. Using the modified Delphi technique, recommendations were generated and put through iterative Delphi rounds to achieve consensus
Results:
60 recommendations achieved consensus and are included in this guideline. They address guideline use, pain assessment, general considerations, preoperative considerations, intraoperative considerations, regional anaesthesia, opioids, opioid-sparing, non-opioid medications, non-pharmaceutical pain management, and discharge considerations.
Conclusions:
Postoperative pain among children following cardiac surgery is currently an area of significant practice variability despite a large body of literature and the presence of centre-specific protocols. Central to the recommendations included in this guideline is the concept that ideal pain management begins with preoperative counselling and continues through to patient discharge. Overall, the quality of evidence supporting recommendations is low. There is ongoing need for research in this area, particularly in paediatric populations.
Pathological gambling is a behavioural addiction with negative economic, social, and psychological consequences. Identification of contributing genes and pathways may improve understanding of aetiology and facilitate therapy and prevention. Here, we report the first genome-wide association study of pathological gambling. Our aims were to identify pathways involved in pathological gambling, and examine whether there is a genetic overlap between pathological gambling and alcohol dependence.
Methods
Four hundred and forty-five individuals with a diagnosis of pathological gambling according to the Diagnostic and Statistical Manual of Mental Disorders were recruited in Germany, and 986 controls were drawn from a German general population sample. A genome-wide association study of pathological gambling comprising single marker, gene-based, and pathway analyses, was performed. Polygenic risk scores were generated using data from a German genome-wide association study of alcohol dependence.
Results
No genome-wide significant association with pathological gambling was found for single markers or genes. Pathways for Huntington's disease (P-value = 6.63 × 10−3); 5′-adenosine monophosphate-activated protein kinase signalling (P-value = 9.57 × 10−3); and apoptosis (P-value = 1.75 × 10−2) were significant. Polygenic risk score analysis of the alcohol dependence dataset yielded a one-sided nominal significant P-value in subjects with pathological gambling, irrespective of comorbid alcohol dependence status.
Conclusions
The present results accord with previous quantitative formal genetic studies which showed genetic overlap between non-substance- and substance-related addictions. Furthermore, pathway analysis suggests shared pathology between Huntington's disease and pathological gambling. This finding is consistent with previous imaging studies.
Introduction: The effectiveness of intravenous alteplase is highly time dependent, and very short door-to-needle times (DNT) of 30 minutes or less have been reported in single centre hospitals, but never in an entire population. QuICR (Quality Improvement and Clinical Research) Alberta Stroke Program aimed to reduce DNT to a median of 30 minutes across the Canadian province of Alberta. Methods: We used the Improvement Collaborative Methodology from early 2015 to September 2016 with participation from all 17 Stroke Centres in Alberta. This methodology included 4 face-to-face workshops, site visits, webinars, data collection, data feedback, intensive process mapping, and process improvements. We compared data in the pre-intervention period from 2009-2014 (collected during the Alberta Provincial Stroke Strategy) to data in the post-intervention period from March 2016-February 2017 (collected during the QuICR DTN Collaborative). Data from January 2015-February 2016 were excluded, as improvements were being implemented during this time. Results: There were a total of 2,322 treated cases in the pre- and post-intervention periods. The results show that the median DNT dropped from 68 minutes (n=1846) in the pre-intervention period to 36 minutes (n=476) in the post-intervention period (p<0.001). There were reductions in DNT across all hospital types: median DNT dropped from 63 to 32 minutes in Urban Tertiary Centres (p<0.001), from 73 to 32 minutes in Community with 24/7 neurology (p<0.001), from 85 to 62 minutes in Community with limited/no neurology (p<0.001), and from 74 to 52.5 minutes in rural centres (p<0.001). Conclusion: There were 21.5 to 41 minute reductions in median DNT across all hospital types including smaller rural and community hospitals. A targeted multi-site improvement collaborative can be an effective intervention to reduce DNT across an entire population.
Studies were conducted in 2003 and 2004 over seven environments evaluating rice root growth inhibition (RGI) and foliar injury from penoxsulam at 30 and 60 g ai/ha and bispyribac-sodium at 30 g ai/ha applied to four- to five-leaf rice at three flood timings, 1, 7, and 14 d after herbicide treatment (DAT), for five rice cultivars, ‘Bengal’, ‘Cypress’, ‘Wells’, ‘Cocodrie’, and ‘XP712’. Flooding at 1 and 7 DAT resulted in greater RGI compared with flood at 14 DAT when evaluated 1 wk after flood (WAF). By 2 WAF, RGI was greater with flooding at 1 DAT compared with flooding at 7 DAT for cultivars Bengal, Cypress, and Wells. Analyzing flood timing 1 DAT, bispyribac-sodium reduced root growth of Bengal and Cypress compared with penoxsulam at 30 g/ha at 1 week after treatment (WAT). At 2 WAT, RGI for Cocodrie was higher following penoxsulam at 60 g/ha when compared with bispyribac-sodium. By 3 WAT, RGI was higher following penoxsulam at 60 g/ha when compared with penoxsulam at 30 g/ha for Cocodrie and greater than bispyribac-sodium and penoxsulam at 30 g/ha for Cypress. Foliar injury following penoxsulam at both rates was less than injury following bispyribac-sodium for all cultivars except XP712 at 1 WAT. XP712 resulted in < 5% RGI and < 6% foliar injury at each evaluation. Rice grain yield was not affected by herbicide treatment for any cultivar compared with the standard treatment of propanil plus quinclorac.
Medulloblastoma (MB) is the most common malignant pediatric brain tumour, and is categorized into four molecular subgroups, with Group 3 MB having the worst prognosis due to the highest rate of metastatic dissemination and relapse. In this work, we describe the epigenetic regulator Bmi1 as a novel therapeutic target for treatment of recurrent Group 3 MB. Through comparative profiling of primary and recurrent MB, we show that Bmi1 defines a treatment-refractory cell population that is uniquely targetable by a novel class of small molecule inhibitors. We have optimized an in vivo mouse-adapted therapy model that has the advantage of generating recurrent, human, treatment-refractory MBs. Our preliminary studies showed that although chemoradiotherapy administered to mice engrafted with human MB showed reduction in tumour size, Bmi1 expression was enriched in the post-treatment residual tumour. Furthermore, we found that knockdown of Bmi1 in human recurrent MB cells decreases proliferation and self-renewing capacities of MB cells in vitro as well as both tumour size and extent of spinal leptomeningeal metastases in vivo. Oral administration of a potent Bmi1 inhibitor, PTC 028, resulted in a marked reduction in tumour burden and an increased survival in treatment cohort. Bmi1 inhibitors showed high specificity for MB cells and spared normal human neural stem cells, when treated with doses relevant for MB cells. As Group 3 medulloblastoma is often metastatic and uniformly fatal at recurrence, with no current or planned trials of targeted therapy, an efficacious agent such as Bmi1 inhibitor could be rapidly transitioned to clinical trials.