Miracle-dz/UniFAR-FTUs huggingface dataset:
Severe mental illness: Managing the boundary of a CMHT

A qualitative methodology was used to investigate the process through which a multi-disciplinary Community Mental Health Team focused its services on people with severe and enduring mental health problems. Different team members' perceptions of what constitutes severe mental illness, of the interpretation and implementation of the prioritisation process, and of the impact of this on the functioning of the team were explored. The team appeared to use the term 'severe mental illness' (SMI) in two contrasting ways. First, as a strict medical category serving the function of an effective gate criterion for prioritising referral access to the team and secondly as a descriptive term used to guide its clinical practice and informed by the team's broader perception of what constitute severe and enduring mental health problems. The co-existence of these two differing perceptions of SMI resulted from, and further contributed to, the tension between the team's need to manage referral pressure, comply with strategic demands, and its members' clinical experience and valued practice. A range of idiosyncratic practices had evolved in the process of accepting and allocating referrals to manage this tension. These were perceived to have had an important effect on case-load composition, on the clinical work conducted, and on inter-professional relationships in the team. discussed in the context of CMHTs' competing tasks of efficiently managing a service delivery while effectively attending to the complexity of the needs of people with severe mental health problems.
The association between treatment adherence and antipsychotic dose among individuals with bipolar disorder

Claims data were examined to evaluate the association between antipsychotic dose and treatment adherence among individuals with predominantly manic/mixed or depressed symptoms of bipolar disorder. Two measures of treatment adherence were used, intensity (medication possession ratio) and treatment duration (uncensored treatment episodes). Effects of higher antipsychotic doses on adherence were evaluated using multiple regression analysis. Dose effects on adherence intensity in subsequent (3-month) treatment stages were examined over 15 months. Antipsychotic treatment episodes (13 921) were analyzed. For manic/mixed individuals, risperidone, olanzapine, and typical antipsychotics showed reduced adherence intensity with higher doses in all treatment stages (P<0.05). Among depressed individuals, higher doses of olanzapine and typical antipsychotics were associated with reduced adherence intensity in all stages, with most associations reaching significance (P<0.05). Higher doses of quetiapine and risperidone were associated with increased adherence intensity in months 4–6 (P<0.05), but risperidone showed reduced intensity in months 7–9 (P<0.001). For all risperidone-treated or quetiapine-treated individuals, higher doses were associated with longer treatment durations (P<0.05). Higher doses of olanzapine and typical antipsychotics (and in manic/mixed individuals, risperidone as well) seem to adversely impact adherence intensity. Among depressed individuals, higher doses of quetiapine and risperidone are initially associated with increased adherence intensity.
Phosphorus physiological ecology and molecular mechanisms in marine phytoplankton

Phosphorus (P) is an essential nutrient for marine phytoplankton and indeed all life forms. Current data show that P availability is growth‐limiting in certain marine systems and can impact algal species composition. Available P occurs in marine waters as dissolved inorganic phosphate (primarily orthophosphate [Pi]) or as a myriad of dissolved organic phosphorus (DOP) compounds. Despite numerous studies on P physiology and ecology and increasing research on genomics in marine phytoplankton, there have been few attempts to synthesize information from these different disciplines. This paper is aimed to integrate the physiological and molecular information on the acquisition, utilization, and storage of P in marine phytoplankton and the strategies used by these organisms to acclimate and adapt to variations in P availability. Where applicable, we attempt to identify gaps in our current knowledge that warrant further research and examine possible metabolic pathways that might occur in phytoplankton from well‐studied bacterial models. Physical and chemical limitations governing cellular P uptake are explored along with physiological and molecular mechanisms to adapt and acclimate to temporally and spatially varying P nutrient regimes. Topics covered include cellular Pi uptake and feedback regulation of uptake systems, enzymatic utilization of DOP, P acquisition by phagotrophy, P‐limitation of phytoplankton growth in oceanic and coastal waters, and the role of P‐limitation in regulating cell size and toxin levels in phytoplankton. Finally, we examine the role of P and other nutrients in the transition of phytoplankton communities from early succession species (diatoms) to late succession ones (e.g., dinoflagellates and haptophytes).
Identification of CHRNA5 rare variants in African-American heavy smokers

Background The common CHRNA5 mis-sense coding single-nucleotide polymorphism (SNP) rs16969968:G>A (D398N) has repeatedly been shown to confer risk for heavy smoking in individuals who carry the ‘A’ allele (encoding the 398N amino acid). The mis-sense SNP has a minor allele frequency of ∼40% in European-Americans, but only ∼7% in African-Americans (http://www.ncbi.nlm.nih.gov/projects/SNP/). We reasoned that there might be other mis-sense variants among African-Americans that could confer the heavy smoking phenotype (defined here as ≥20 cigarettes per day), perhaps in a manner similar to that of the D398N polymorphism in Europeans. Materials and methods As such, we resequenced 250 African-American heavy smokers, most of whom were homozygous ‘G’ at rs16969968:G>A (minor allele frequency of 9.6% within the population). Results Although many novel coding SNPs were not observed, we report an interesting, although rare (perhaps personal), variant in CHRNA5 that could result in nonsense-mediated decay of the aberrant transcript. Conclusion We conclude that, in African-Americans, variants (common or rare) in genes other than CHRNA5 most likely contribute toward the nicotine-dependent phenotype, either independently or in combination with variants in CHRNA5. The functional significance, on CHRNA5 expression or protein function, of the variants found here should be determined in future studies.
A comparison of molecular markers and morphology for Neidium taxa (Bacillariophyta) from eastern North America

Historically, a morphological species concept has applied shape subjectively in the delimitation of diatom species. This has led to confusion between taxa within the benthic diatom genus Neidium. Samples from Ontario, Quebec, Nova Scotia, Newfoundland (Canada) and New York (USA) were examined for Neidium taxa under LM and SEM. Fourier shape analysis showed that shape as a taxonomic character was not able to discern all species. Isolated individuals from the samples were amplified and sequenced for three chloroplast molecular markers (rbcL, psbC, and psbA) and one nuclear ribosomal molecular marker (18S). Phylogenetic reconstructions were completed with the concatenated chloroplast and 18S dataset using Maximum Likelihood and Bayesian analyses. The concatenated chloroplast dataset exhibited a species‐level resolution phylogeny of Neidium taxa. The 18S dataset had a lower level of sequence divergence and was unable to differentiate between Neidium taxa. We present emended species descriptions and sequence data for four previously described species: Neidium sacoense, N. longiceps, N. fossum, and N. affine. We describe three novel species (Neidium lowei, N. promontorium, and N. potapovae) and identify two forms with unique molecular signatures. The distinguishing features of N. lowei are its size, valve shape, and longitudinal canal structure. Distinguishing features of N. promontorium are its valve shape, longitudinal canal and apex formation, and surface depression along the axial area. Neidium potapovae is distinguished by its size, formation of valve and apices and single longitudinal canal. This paper demonstrates how future phylogenetic treatments using single cell multigene sequencing can help resolve taxonomic confusion within diatoms.
Relationship among Glutamine, γ-Aminobutyric Acid, and Social Cognition in Autism Spectrum Disorders.

OBJECTIVE An imbalance of excitatory and inhibitory neurotransmission in autism spectrum disorder (ASD) has been proposed. We compared glutamate (Glu), glutamine (Gln), and γ-aminobutyric acid (GABA) levels in the anterior cingulate cortex (ACC) of 13 males with ASD and 14 typically developing (TD) males (ages 13-17), and correlated these levels with intelligence quotient (IQ) and measures of social cognition. METHODS Social cognition was evaluated by administration of the Social Responsiveness Scale (SRS) and the Reading the Mind in the Eyes Test (RMET). We acquired proton magnetic resonance spectroscopy ((1)H-MRS) data from the bilateral ACC using the single voxel point resolved spectroscopy sequence (PRESS) to quantify Glu and Gln, and Mescher-Garwood point-resolved spectroscopy sequence (MEGA-PRESS) to quantify GABA levels referenced to creatine (Cr). RESULTS There were higher Gln levels (p=0.04), and lower GABA/Cre levels (p=0.09) in the ASD group than in the TD group. There was no difference in Glu levels between groups. Gln was negatively correlated with RMET score (rho=-0.62, p=0.001) and IQ (rho=-0.56, p=0.003), and positively correlated with SRS scores (rho=0.53, p=0.007). GABA/Cre levels were positively correlated with RMET score (rho=0.34, p=0.09) and IQ (rho=0.36, p=0.07), and negatively correlated with SRS score (rho=-0.34, p=0.09). CONCLUSIONS These data suggest an imbalance between glutamatergic neurotransmission and GABA-ergic neurotransmission in ASD. Higher Gln levels and lower GABA/Cre levels were associated with lower IQ and greater impairments in social cognition across groups.
Towards School Mental Health in Nigeria: Baseline Knowledge and Attitudes of Elementary School Teachers

There is a shortage of child and adolescent mental health (CAMH) professionals all over the world, and this shortage is especially critical in most parts of the developing world. Schools have been identified as ideal settings to reach needy children in the community, and training teachers in CAMH issues can help improve early identification and appropriate referrals of children with mental health problems. As part of a needs assessment for developing a training programme, selected Nigerian elementary school teachers were asked to complete confidential questionnaires to determine their perceptions of mental health problems in school children. Teachers indicated that they had no previous CAMH training. Baseline assessments revealed that teachers' knowledge of CAMH was deficient, and attitudes to children with mental health problems revealed intolerance. Incorporation of CAMH care into teacher education curricula is a critical next step towards integrating school teachers as mental health collaborators in school mental health programmes in Nigeria.
Mobile Device-Based Applications for Childhood Anxiety Disorders.

OBJECTIVE Given that childhood anxiety disorders are common and frequently undertreated, novel treatment platforms are needed. The current article explores the potential for mobile device-based (m-health) applications, to expand access to evidence-based treatment. METHODS This article reviews the relevant literature regarding barriers to disseminating evidence-based treatment, the potential benefits of the m-health platform, standards for evaluating m-health interventions, and currently available applications. RESULTS Although a large number of m-health applications for anxiety are available, the vast majority of them are inconsistent with therapy protocols supported by the child anxiety treatment literature. The relatively few m-health applications based on evidence-based practice have not yet been examined empirically. CONCLUSIONS Realizing the potential of m-health for child anxiety will require addressing the uncertainty around the necessary and sufficient components of cognitive-behavioral therapy (CBT), as well as the common challenges associated with delivering interventions via information and communication technology. Mayo Clinic Anxiety Coach is an m-health application designed by the author and colleagues to be consistent with exposure-based CBT and principles for effective intervention delivery via information and communication technology. Recommendations for identifying, using, and developing m-health applications for childhood anxiety disorders are presented.
An Alternative Approach to Scoring the MTA-SNAP-IV to Guide Attention-Deficit/Hyperactivity Disorder Medication Treatment Titration towards Symptom Remission: A Preliminary Consideration.

OBJECTIVE The Multimodal Treatment Study for Attention-Deficit/Hyperactivity Disorder Swanson, Nolan, and Pelham, Version IV (MTA-SNAP-IV) is a common rating scale to measure attention-deficit/hyperactivity disorder (ADHD) symptoms during medication treatment. Relying on the traditional scoring approach for this instrument to identify symptom remission, however, may leave a child with significant residual symptoms. The objective of this study was to examine an alternative scoring approach for this instrument to identify the extent of residual symptoms for children completing ADHD medication treatment. METHODS Parent and teacher ratings on the ADHD symptom component of the MTA-SNAP-IV were extracted from medical records of 80 children completing medication treatment at a specialty clinic in Canada. Data were scored in two ways. 1) Traditional scoring based on assigning a value ranging from 0 to 3 for response options: "Not at all," "Just a little," "Pretty much," or "Very much," for each symptom and then determining a mean across items, and 2) alternative scoring based on assigning values of 0, 0, 0.5, and 1 across the same response options and summing the total across items. Symptom remission based on the former is defined as a mean value ≤ 1, and for the latter it is defined as a summed value equal to 0. RESULTS Children were significantly less likely to be classified as symptom remitted under the alternative scoring method based on parent, teacher, and combined parent-teacher ratings. Using the alternative scoring approach, residual symptoms were identified for 25%, 39%, and 70% of children classified as symptom remitted (under traditional scoring rules) by parents, teachers, and parents/teachers combined, respectively. CONCLUSIONS Potential "residual" ADHD symptoms were identified in many children attaining symptom remission using the traditional scoring approach; however, further scrutiny of this alternative scoring approach is required. Although it may improve the ability to detect residual symptoms that could signal the need for further intervention to achieve symptom remission, it may increase the risk of over treatment.
Analysis of hemodynamic responses to resistance exercise performed with different intensities and recovery intervals

This aim of the present study was to analyze the hemodynamic responses during resistance exercise performed at different intensities and with different recovery intervals. This study was conducted on twenty-four apparently healthy male individuals (25.50 ± 3.72 years and 76.50 ± 4.50 kg) experienced in strength training. The volunteers performed a 1RM test to determine the training load for the study. Blood pressure and Rate Pressure Product were measured before and at the end of the exercise training. The only significant difference observed was in SBP during strength training at 70% intensity (121.7 ± 8.68, p = 0.039), which was lower than SBP at the remaining intensities of 80% (126.3 ± 7.11) and 90% (127.1 ± 7.51). It was concluded that strength training performed at different intensities and recovery intervals did not significantly alter most variables, changing only the SBP due to the intensity employed.
Variation in the genes encoding vesicular monoamine transporter 2 and beta-1 adrenergic receptor and antidepressant treatment outcome

The identification of genetic variants regulating antidepressant response would allow for more individualized, rational, and successful drug treatments. We previously identified a region of mouse chromosome 19 that strongly influences citalopram response in an antidepressant model, the tail suspension test. By virtue of their location in this loci, expression in brain, and involvement in monoamine neurotransmission, we nominated SLC18A2 (encoding vesicular monoamine transporter 2, a.k.a. VMAT2) and ADRB1 (encoding &bgr;-1 adrenergic receptor) as candidate genes for a human pharmacogenetic study. This study tested for an association between SLC18A2 and ADRB1 and treatment outcome in 873 major depressive disorder patients treated with the antidepressant citalopram in the Sequenced Treatment Alternatives to Relieve Depression study. Haplotype-tagging single nucleotide polymorphisms (four in SLC18A2 and two in ADRB1) were chosen to detect the common genetic variation. We failed to detect any significant association between treatment outcome and genotypes or allele frequencies at any of the markers studied. We did, however, detect ethnic differences in the allele frequencies of five out of six markers. These data do not rule out the possible involvement of SLC18A2 or ADRB1 in antidepressant treatment response as these genes may contribute a small effect size or interact epistatically with other genes.
Lipopolysaccharide-induced indoleamine 2,3-dioxygenase expression in the periodontal ligament.

BACKGROUND AND OBJECTIVE Indoleamine 2,3-dioxygenase (IDO) is a tryptophan-oxidizing enzyme with immune-inhibitory effects. The aim of this study was to investigate the expression of IDO by lipopolysaccharide (LPS), a component of gram-negative bacteria, in human periodontal ligament (PDL) cells. MATERIAL AND METHODS Human PDL cells and gingival fibroblasts (GFs) were prepared from explants of human PDLs and from gingival tissues of clinically healthy donors, respectively. Real-time RT-PCR, western blotting and the IDO enzyme assay were performed to determine the expression of IDO following LPS treatment of cells. LPS was injected into mice tail veins to evaluate the effects of LPS in vivo in the maxillary first molar. Immunofluorescence staining and histological analysis were followed to localize IDO in mouse PDL. RESULTS The level of expression of IDO mRNA in primary human PDL cells after LPS treatment was increased in a dose-dependent manner, reaching a peak 8 h after LPS treatment. The expression and activities of IDO protein were significantly increased in comparison with those of the control. In addition, the increased production of kynurenine in culture medium was observed 72 h after LPS treatment. In the immunofluorescence findings, stronger immunoreactivities were shown in PDL than in gingival tissues in the maxillae. In accordance with the immunofluorescence findings, LPS treatment induced a strong up-regulation of IDO mRNA in human PDL cells, whereas human GFs showed only a weak response to LPS. CONCLUSION These results clearly show that IDO was induced by LPS in primary human PDL cells, suggesting that PDL might be involved in the regulation of oral inflammatory disease.
Role of GABRA2 on risk for alcohol, nicotine, and cannabis dependence in the Iowa Adoption Studies

Aim A number of studies have shown that genetic variation at GABRA2 alters vulnerability to alcohol dependence. The exact identity of the causal variant(s), and the relationship of these variants to other forms of substance use and behavioral illness is, however, uncertain. Objective Therefore, we genotyped 516 individuals from the Iowa Adoption Studies, a large longitudinal case and control adoption study of substance use, at 39 single nucleotide polymorphisms encompassing the GABRA2 locus and analyzed them with respect to their lifetime history of three common forms of substance use dependence [alcohol dependence (AD), nicotine dependence (ND), and cannabis dependence (CD)] in the Iowa Adoption Studies and relevant exposure variables. Result Using regression analysis, we found substantial evidence that both GABRA2 genotype and haplotype are significantly related to vulnerability to AD, ND, and CD, with the strongest relationships noted with respect to ND. Consistent with earlier studies suggesting exposure is an important step in the development of substance use, we found the inclusion of substance exposure data in our analytic models markedly increased the strength of the genetic associations of GABRA2 haplotype with substance use. Finally, we report that the genetic effects were markedly more pronounced in females than in males. Conclusion We conclude that genetic variation at or near the GABRA2 locus significantly affects vulnerability not only to AD, but to other forms of substance use including ND and CD, and that the effects may be sex dependent.
Chemical Exploration of the Brain: A Study of Cerebral Excitability and Ion Movement.

The primary objective of this volume is to explore the possible interrelationships of biochemistry and function (or "cerebral excitability") within the nervous system. A considerable portion of this effort is devoted to the chemistry and physiological properties of membranes and their presumed relationship to the problem of ion transport and excitability. Among the topics discussed are the relationship of metabolism to excitation; the role of lipids, phosphoproteins, and enzymes in the maintenance of electrolyte balance and transport; and certain morphological characteristics relating to membrane structure and metabolism. Some effort is devoted to reviewing a few selected theories regarding the problems of ion transport in excitable tissues. Unfortunately much of the discussion of such theories as well as the material as a whole suffer from the bias of the author's views on the subject. This volume is of value in that it exemplifies the kind of thinking and methodology involved in