bluuebunny/crossref_metadata_2025 huggingface dataset:
The Neandertal Progesterone Receptor
Authors: Zeberg Hugo , Kelso Janet , Pääbo Svante
Published: May 2020

The hormone progesterone is important for preparing the uterine lining for egg implantation and for maintaining the early stages of pregnancy. The gene encoding the progesterone receptor (PGR) carries introgressed Neandertal haplotypes with two missense substitutions and a mobile Alu element. These Neandertal gene variants have reached nearly 20% frequency in non-Africans and have been associated with preterm birth. Here, we show that one of the missense substitutions appears fixed in Neandertals, while the other substitution as well as the Alu insertion were polymorphic among Neandertals. We show that two Neandertal haplotypes carrying the PGR gene entered the modern human population and that present-day carriers of the Neandertal haplotypes express higher levels of the receptor. In a cohort of present-day Britons, these carriers have more siblings, fewer miscarriages, and less bleeding during early pregnancy suggesting that the Neandertal progesterone receptor alleles promote fertility. This may explain their high frequency in modern human populations.
Evolution of the Insecticide Target Rdl in African Anopheles Is Driven by Interspecific and Interkaryotypic Introgression
Authors: Grau-Bové Xavier , Tomlinson Sean , O’Reilly Andrias O , Harding Nicholas J , Miles Alistair , Kwiatkowski Dominic , Donnelly Martin J , Weetman David ,   and The Anopheles gambiae 1000 Genomes Consortium
Published: May 2020

The evolution of insecticide resistance mechanisms in natural populations of Anopheles malaria vectors is a major public health concern across Africa. Using genome sequence data, we study the evolution of resistance mutations in the resistance to dieldrin locus (Rdl), a GABA receptor targeted by several insecticides, but most notably by the long-discontinued cyclodiene, dieldrin. The two Rdl resistance mutations (296G and 296S) spread across West and Central African Anopheles via two independent hard selective sweeps that included likely compensatory nearby mutations, and were followed by a rare combination of introgression across species (from A. gambiae and A. arabiensis to A. coluzzii) and across nonconcordant karyotypes of the 2La chromosomal inversion. Rdl resistance evolved in the 1950s as the first known adaptation to a large-scale insecticide-based intervention, but the evolutionary lessons from this system highlight contemporary and future dangers for management strategies designed to combat development of resistance in malaria vectors.
推进全谷物消费的全球策略
Authors: Toups Kelly E
Published: May 2020

全谷物是健康饮食的重要组成部分已是全球普遍的共识；然而，许多国家居民全谷物摄入量一直尚未达到推荐摄入量。本文目的是评 估拥有不同饮食文化的4 个国家在推进全谷物消费所采取的策略与方 法，即美国、新加坡、菲律宾和丹麦。为此，收集了每个目标国家与 全谷物相关的法规、非政府组织(NGO)举办的活动和推广项目等信 息。这项努力旨在总结出在公共和个人领域促进全谷物消费的最佳实 践方法。
Factors associated with unsuccessful return-to-work following work-related upper extremity injury
Authors: von Schroeder H P , Xue C (R) , Yak A , Gandhi R
Published: May 2020

Background

Returning to work following occupational injury is a key outcome for both workers’ compensation boards and injured workers. Predictive factors for returning remain unclear.

Aims

To describe factors associated with unsuccessful return-to-work (RTW) in a hand injury population to identify target areas through which occupational rehabilitation programmes can help injured workers achieve successful RTW outcomes.

Methods

Demographic data, functional, pain and psychosocial scores were recorded for injured workers discharged between April 2011 and September 2015 from a multidisciplinary upper extremity treatment programme. The primary outcome of RTW status was assessed at programme discharge. Bivariate analyses and multivariable logistic regression were used to identify factors associated with being unable to RTW.

Results

Of 872 participants who met the inclusion criteria, 65% were male and the mean age was 46 (standard deviation [SD] 11) years. In unadjusted bivariate analyses, the group with an unsuccessful RTW outcome had higher mean baseline pain, catastrophizing and QuickDASH scores; a higher baseline prevalence of depression, and reported a high level of pain more frequently than those who were working at discharge. In the adjusted logistic regression model, not working at baseline, higher QuickDASH score and presence of depression at baseline were independently associated with unsuccessful work status outcome.

Conclusions

Negative baseline work status, greater self-reported functional disability and presence of depression were associated with greater odds of unsuccessful RTW following a workplace upper extremity injury. Integrating mental healthcare provision with occupational rehabilitation is a potential programmatic approach to improve RTW.
Doctor of Physical Therapy Education in a Hybrid Learning Environment: Reimagining the Possibilities and Navigating a “New Normal”
Authors: Gagnon Kendra , Young Brian , Bachman Teresa , Longbottom Thomas , Severin Richard , Walker Michael J
Published: May 2020

Professional physical therapist education has experienced a transformation over the last few decades, moving to a doctoring profession with more autonomy and a broader scope of practice. These changes have occurred in parallel with systemic and structural changes in health care and higher education, both of which have experienced challenges with improving access and controlling costs, and have become a centerpiece of legislative and political discourse. At the same time, advances in technology have introduced new possibilities in education, with the emergence of online, blended, and “flipped” learning models that supplement or replace face-to-face instruction with distance learning. Hybrid education is a type of blended learning, utilizing both face-to-face and online instructional strategies. In a hybrid learning environment, online content may be delivered synchronously or asynchronously, replacing traditional face-to-face instructional time and reducing “seat time” for students. Recent attention has been brought to online and hybrid/blended learning in physical therapist education in the wake of the COVID-19 pandemic, as programs have been required to abruptly move from face-to-face to remote instruction. Hybrid and other forms of blended learning strategies have been described at the physical therapist education course level. However, there is no literature describing hybrid learning implementation at the physical therapist education program “levels,” and there has been limited discussion on best practices for delivering hybrid, blended, and online instruction in physical therapist education. This perspective provides an overview of hybrid education, describes theoretical frameworks that guide implementation of a hybrid education curriculum, and discusses future directions for hybrid physical therapist education and educational research.
Juvenile Paget’s disease: Report of a family with a novel missense mutation and unique radiological manifestations in a heterozygote
Authors: Khalifa O , Ramzan K , Moustafa A S , AlMane K , Abdelfattah M , Abuharb G , Hegde M , Alsayed M
Published: May 2020

Juvenile Paget’s disease (JPD) is a rare, generalized skeletal disorder characterized by markedly increased bone turnover secondary to enhanced osteoclastic activity. The patients with JPD develop progressive, widespread skeletal involvement and non-skeletal manifestations.

Objectives

To identify the characteristic molecular, biochemical, radiological, and audiological findings in three siblings with JPD associated with intrafamilial phenotypic variability.

Patients and Methods

A Saudi family with 3 affected siblings was recruited. Biochemical measurement of serum alkaline phosphatase and markers of bone turnover were performed. Genetic testing and sequencing of a panel of 22 known genes for skeletal dysplasia with increase bone density were performed by next generation sequencing (NGS). Radiological and audiological assessment were also performed.

Results

Patients showed marked elevation of serum alkaline phosphatase and markers of bone turnover. A novel homozygous mutation c.433T>G (p.Cys145Gly) in exon 3 of TNFRSF11B gene was identified in the 3 affected siblings. Both parents were heterozygous for the mutation. The heterozygote father had thickening of calvarium, a radiological manifestation of JPD. The eldest child (index case) had a unique striking distortion of the skull bones as evidenced by 3-D computed tomography of skull. He had also bilateral inner ear structural deformity and severe sensorineural hearing loss.

Conclusions: JPD is a rare disorder that can be highly overlooked due to phenotypic overlap with other disorders of skeletal dysplasia. Mutations affecting cysteine residues result in the most severe JPD phenotypes. NGS is useful for early diagnosis of JPD, a prerequisite for successful treatment strategy.
Role of PET/CT in Assessment of Recurrent Ovarian Tumors
Authors: Kadry S , Haggag A , Ekbal A
Published: May 2020

Background

Ovarian cancer remains a major health problem worldwide, with over 225,000 new cases and 140,000 deaths reported annually. Despite high response after initial treatment, 20-30% of patients with early-stage disease and up to 75% of patients with advanced disease present with recurrence within two years. Early diagnosis of recurrence is crucial for determination of the best treatment.

Aim of the Work

is to detect the significance of PET/CT in the early detection of recurrent ovarian tumors.

Patients and Method

The study included 25 patients who have been diagnosed with ovarian cancer, received treatment and achieved complete response. All of the 25 patients had suspected recurrence either due to elevated tumor markers or suspicious clinical findings. The 25 patients have been referred for PET/CT scan at ElDemerdash university hospital from July 2017 to August 2018.

Results

Total of 25 patients were included in the study. 18 of 25 patients had high tumor marker (CA 125) level. The remaining 7 patients had suspected recurrence with normal tumor marker levels. Recurrence was confirmed by histopathology or clinical and imaging follow up in 19 patients of the 25 patients. Recurrent disease was not shown in 5 of 19 patients on CECT imaging and 1 of 19 patients on PET/CT imaging. PET/CT had a sensitivity of (94.74%), specificity of (100%) and accuracy of (96%). CECT has been reported with sensitivity of (73.68), specificity of (83.33%) and accuracy of (76%).

Conclusion

PET/CT is a useful tool and has a higher sensitivity, specificity and accuracy than CECT in detection of recurrent ovarian cancer.
Ultrasound Elastography and TI- Rads (Thyroid Imaging Reporting and Data System) in the Diagnostic Evaluation of Thyroid Nodules
Authors: Ali M A , Abdelrahman A S , Khalaf A M
Published: May 2020

Background

Thyroid nodules refers to an abnormal growth of thyroid cells that forms a lump within the thyroid gland. Although the vast majority of thyroid nodules are benign , a small percent is presenting as a thyroid cancer.

Objective

To quantify the sensitivity & the specifity of ultrasound elastography and TI-RAADS in evaluation of thyroid nodules among study population in Ain Shams university hospitals.

Patients and Methods

Type of study: cross sectional study. Study setting: it was conducted at Ain Shams University hospitals. Study period: March2018 to September 2018. Sample size: 41 patients were included in this study.

Results

There is a significant increase in the hyperechoic and isoechoic echogenicity in benign groups while no significant difference in hypoechogenicity and a significant difference in very hypoechogenicity in malignant group P- value=0.002.

Conclusion

Finally both the use of TI- RADS and elastography are methods to evaluate thyroids nodules according to US features and scoring systems that they are easy to perform, not invasive, informative, not costy and can be combined together to increase the accuracy of evaluation.
Value of transcranial ultrasound screening for the preterm in the neonatal ICU
Authors: Ali S B , Abdelrahman A S , Hassan M I
Published: May 2020

Background

preterm neonates less than 37 weeks of gestational age are more liable to hemorrhagic and ischemic brain lesions due to the immaturity of capillary bed, cerebral auto-regulation and vascular anastomosis, with consequent adverse outcome, poor cognitive development, and cerebral palsy. Cranial ultrasound is a safe imaging modality with no need to radiation exposure or sedation.

Aim of the Work

to evaluate the usefulness of universal cranial ultrasound screening in preterm neonates in the neonatal ICU with gestational age between 28 and 37 weeks to detect the different intra cranial pathologies in this pediatric group.

Patients and Methods

After taking approval by the Radiology Department Committee of the Faculty of Medicine, Ain shams University, the current study was performed on all preterm neonates (50) admitted to neonatal ICU in Ain shams hospital between 28 and 37 weeks of gestational age, between the third and seventh day of life, from July 1, 2017 to April 1, 2018 were included in the study.

Results

The study showed normal transcrainal ultrasound (72.0%), Germinal matrix hemorrhage (10.0%), Intraventricular hemorrhage (6.0%), Periventricular leukomalacia (6.0%), Congenital anomalies is Dandy walker malformation (2.0%), Chiari malformation (0.0%), Agenesis of corpus callosum (2.0%) and Porencephalic cyst (2.0%) of finding of ultrasound.

Conclusion

The importance of preterm screening by cranial ultrasound is sustained by the observation that most preterm neonates with abnormal CUS are usually asymptomatic. Only occasionally these patients develop symptoms.Linear high frequency probe of ultrasound was of great benefit in better visualization of anatomical details and mild pathological lesions.
Left Gastric Artery Embolization for Weight Loss
Authors: Shaker M , Elhemeily M , Gamal M , Elgogary A , Zidan H , Gobara Z , Abogamra S
Published: May 2020

Purpose

To conduct a prospective clinical trial to evaluate the feasibility, safety and efficacy of left gastric artery embolization as a minimally-invasive way for the treatment of obesity.

Materials & Methods

Patients were recruited with respect to detailed inclusion and exclusion criteria. A baseline clinical history taking and physical examination including anthropometric measurements was undertaken. A baseline EGD was performed to rule out any pre-existing pathology in the esophagus, stomach or duodenum. Baseline serum Ghrelin level was assessed. Embolization was performed using non-spherical polyvinyl alcohol particles sized 355–500 µm (Bearing nsPVA®, Merit Medical) until complete stasis of flow within the LGA and its branches. Patients were followed up weekly for 1 month then monthly for 6 months by anthropometric measurements by the clinical nutritionists from the Physical Medicine department. At 1 month, EGD was repeated to assess for any complications or adverse effects. Another blood sample was withdrawn to assess the change in serum Ghrelin level.

Results

Left gastric artery embolization was performed on six obese to morbidly obese patients (four women and two men; average age, 44 years; range, 24–62 years), with a mean weight of 113.67 kg (range 86–133 kg), a mean BMI of 44.45 kg/m2 (range 33.6–51.2 kg/m2) Technical success rate was 100%. There was one minor adverse event in the form of a small asymptomatic superficial gastritis in the fundus/lesser curvature. There were no major adverse events. Mean excess weight loss of 5.58% and 2.91% was noted at 1 month and at 6 months, respectively. Mean change in serum ghrelin was −35.57% at 1 month.

Conclusion

LGA embolization is technically feasible and safe. There is considerable drop in serum ghrelin level at 1 month. However, the weight loss appears to be transient. Future studies can opt for smaller-sized particles and probably embolization of the right gastro-epiploic artery together with the left gastric artery.

Abbreviations

BMI = Body Mass Index, EGD = Esophagogastroduodenoscopy, LGA = Left Gastric Artery, NSAID = Non-steroidal anti-inflammatory drugs, PPI = Proton pump inhibitors, WHO = World Health Organization.
Role of DWI in differentiation between cholestatoma and recurrent otitis media
Authors: Geneidi E A S , Hanaa S R R , Kamal A M M
Published: May 2020

Background

Cholesteatoma and otitis media are common middle ear pathologies. They may cause serious complication such as hearing loss, facial nerve paralysis or intra-cranial complications in advanced cases. They are mainly diagnosed by otoscope yet CT examination is essential to confirm the diagnosis in some cases as well as assess its extensions for proper surgical excision. However, CT is poor in differentiation of cholesteatoma from other middle ear pathologies. Between the two diseases, there are a grey zone. Depending on CT images in differentiation between cholestatoma and otitis media, radiologist will be susptable for misdiagnosis.

Objective

To determine the diagnostic accuracy of DWI and the difference between the ADCs of middle ear cleft cholestatoma and those of non-cholesteatomatous tissue especially recurrent otitis media on single-shot echo planar DW images. In a case of cholestatoma, the results will be confirmed by intra-operative findings and histopathological data. In a case of otitis media, we will follow up the patients clinically if signs and symptoms resolve or not; or follow up by CT examination.

Methods

This study was conducted on patient with suspected cholesteatoma suspected clinically or by CT examination or known patients and patient also with suspected otitis media recurrence who underwent already surgery or preparing to that; at Ain Shams university hospitals. The patients referred from the otolaryngology department at Ain Shams university hospitals and from other private clinics. The patients was investigated using magnetic resonance imaging (MRI).

Results

MRI examination was advocated to differentiate between cholesteatoma from other middle ear pathologies. Delayed post contrast T1 images were used but showed low sensitivity for smaller lesions as well as patient inconvenience due to delayed imaging after 30-45 minutes. In recent years, diffusion weighted sequences have been used in diagnosis of cholesteatoma due to its bright signal on DWIs. In our study we used thin cut multi-shot EPI diffusion weighted images in the assessment of cholesteatoma and otitis media suspected clinically or by CT examination or known patients. It showed very good sensitivity and excellent specificity in detection of diffusion restriction of cholestatoma compared to chronic otits media which appear as a facilitated diffusion. The use of multi-shot techniques improved its sensitivity compared to single shot images yet it is still relatively less than non-EPI techniques.

Conclusion

DWI is a beneficial tool in the evaluation of cholesteatoma and differentiate between it and otitis media with excellent specificity that reduces the need of second look surgeries in multiple cases. The use of multi-shot diffusion weighted techniques improved its sensitivity significantly compared to single shot techniques. It still could not detect lesions smaller than 4 mm.
Potential implications of six American Indian patients with myopathy, statin exposure and anti-HMGCR antibodies
Authors: Close Ryan M , Close Laura M , Galdun Patrick , Gerstberger Stefanie , Rydberg Matthew , Christopher-Stine Lisa
Published: May 2020

Objectives

Statin-associated autoimmune myopathy is a rare condition associated with the formation of autoantibodies to 3-hydroxy-3-methylglutaryl-coenzyme A reductase. Underlying environmental and genetic risk factors remain poorly understood. American Indians have high rates of cardiovascular disease and associated co-morbidities that require lipid-lowering therapies. We observed this autoimmune myopathy in a series of American Indian statin users in rural Arizona.

Methods

We reviewed the charts of six American Indian patients with statin-associated autoimmune myopathy. We provide an illustrative case in addition to summaries of clinical presentations and treatment courses.

Results

This is the first report of statin-associated autoimmune myopathy in American Indians. These cases were all identified at the same geographically isolated hospital that exclusively serves an American Indian population with only 1800 statin users. There is relatively low migration. Each case was consistent with the previously described classical presentations for the disease. All six of our cases had diabetes and developed myopathy on high-dose atorvastatin, often with a recent change in statin type or dose.

Conclusion

Providers serving American Indians need to be aware of the possibility of statin-associated autoimmune myopathy and familiar with its presentation. Larger, inclusive, population-based investigations are needed to elucidate risk factors for this condition, in particular the potential interactions between predisposing HLA alleles, diabetes and specific statin exposures. This is necessary to identify effective and safe lipid-lowering medications.
In context: emotional intent and temporal immediacy of contextual descriptions modulate affective ERP components to facial expressions
Authors: Rischer Katharina M , Savallampi Mattias , Akwaththage Anushka , Salinas Thunell Nicole , Lindersson Carl , MacGregor Oskar
Published: May 2020

In this study, we explored how contextual information about threat dynamics affected the electrophysiological correlates of face perception. Forty-six healthy native Swedish speakers read verbal descriptions signaling an immediate vs delayed intent to escalate or deescalate an interpersonal conflict. Each verbal description was followed by a face with an angry or neutral expression, for which participants rated valence and arousal. Affective ratings confirmed that the emotional intent expressed in the descriptions modulated emotional reactivity to the facial stimuli in the expected direction. The electrophysiological data showed that compared to neutral faces, angry faces resulted in enhanced early and late event-related potentials (VPP, P300 and LPP). Additionally, emotional intent and temporal immediacy modulated the VPP and P300 similarly across angry and neutral faces, suggesting that they influence early face perception independently of facial affect. By contrast, the LPP amplitude to faces revealed an interaction between facial expression and emotional intent. Deescalating descriptions eliminated the LPP differences between angry and neutral faces. Together, our results suggest that information about a person’s intentions modulates the processing of facial expressions.
T94. VIRTUAL REALITY STRESS REDUCTION FOR PATIENTS WITH PSYCHIATRIC DISORDERS: CROSS-OVER RANDOMIZED CONTROLLED TRIAL
Authors: Veling Wim , Lestestuiver Bart , Jongma Marieke , Hoenders Rogier , van Driel Catheleine
Published: May 2020

Background

Psychosocial stress is associated with onset and relapse of psychosis, and stress-reactivity is high in patients with psychotic disorder. Stress management is an important part of treatment, but stress-reducing interventions are challenging for people with psychotic or other psychiatric disorder. We developed a virtual reality self-management relaxation tool (VRelax; 360o nature videos with interactive elements) and investigated its immediate effects on stress level, mood states and symptoms in patients with a psychotic or other psychiatric disorder, compared to standard relaxation exercises.

Methods

A randomized cross-over trial was conducted in 50 patients receiving ambulatory treatment for psychotic, anxiety, depressive or bipolar disorder. Participants were randomly assigned to start with VRelax or standard relaxation, and used both interventions for 10 days at home. They completed Visual Analogue Scales (VAS) of stress level and mood states before and after each session. Global perceived stress and psychiatric symptoms were measured before and after both intervention periods. Treatment effects were analyzed with multilevel repeated-measures regression models and two-way ANOVA.

Results

Both VRelax and standard relaxation exercises reduced subjective stress and improved momentary mood states. Compared to standard relaxation, VRelax resulted in a significantly greater immediate improvement of anxiety (B=-4.30, 95%CI=-5.86;-2.73), sadness (B=-3.65, 95%CI =-5.39;-1.91), cheerfulness (B=3.67, 95%CI=2.15;5.18), overall positive mood (B=7.59, 95%CI=2.28;12.89), and overall negative mood (B=10.88, 95%CI=5.89;15.87). There were no significant differences between short-term effects of the two treatments on symptoms and global perceived stress.

Discussion

If the results of this trial are replicated and extended, VRelax may provide a much needed effective self-management stress intervention to enhance treatment of patients with psychotic and other psychiatric disorders.
T115. PERSONALITY ACROSS THE PSYCHOSIS CONTINUUM: A FINE-GRAINED PERSPECTIVE
Authors: Begemann Marieke , Boyette Lindy-Lou , Kwast Aimo , Sommer Iris
Published: May 2020

Background

Personality is associated with the etiology, course and outcome of psychosis. Previous research has mainly focused on the global domains within the Five-Factor Model of personality. Moreover, little is known on the personality profile of individuals who report frequent psychosis-like experiences (PE) including auditory hallucinations, but do not fulfill criteria for a Cluster A personality disorder or psychotic disorder.

Methods

We included 134 individuals with non-clinical PE, 40 patients with a psychotic disorder and 126 healthy controls. Participants completed the Dutch NEO-PI-R. ANOVAs were performed to compare personality profiles across the three groups.

Results

The domains of Neuroticism, Openness and Conscientiousness showed significant group differences. Together with intermediate levels of Neuroticism, individuals with non-clinical PE on average showed high Openness compared to healthy controls and patients (trend-level). The patient group scored high on Neuroticism and low on Conscientiousness compared to both individuals with non-clinical PE and controls. Furthermore, facet-level analyses showed intermediate levels of Depression and Anxiety (N) in individuals with non-clinical PE, as well as high Fantasy, Aesthetics and Ideas (O) relative to controls. The group with non-clinical PE also displayed similar high Angry Hostility (N) and Feelings (O), along with low Trust (A) and Gregariousness (E), as seen in the patient group. Patients showed high Vulnerability and Self-Conscientiousness (N), and also low Competence and Self-discipline (C) compared to both other groups.

Discussion

This is the first study to provide an analysis of both domain and facet-level data across the psychosis continuum. Our findings underline the added value of a more fine-grained evaluation of personality. We address how certain facets may be related to general PE proneness, both in non-clinical and clinical individuals alike, while other traits may differentiate individuals with non-clinical PE from patients. Current results encourage intervention strategies targeting coping and social skills for youth at risk for psychosis.
T127. GENDER DIFFERENCES IN CLINICAL PRESENTATION AND ILLICIT SUBSTANCE USE DURING FIRST EPISODE PSYCHOSIS: AN ELECTRONIC CASE REGISTER NATURAL LANGUAGE PROCESSING ANALYSIS
Authors: Irving Jessica , Colling Craig , Shetty Hitesh , Pritchard Megan , Stewart Robert , Fusar-Poli Paolo , McGuire Philip , Patel Rashmi
Published: May 2020

Background

Gender differences in the clinical presentation of first episode psychosis (FEP) and its relationship to illicit substance use are inconclusive and underexplored. We conducted an electronic health record (EHR) study applying natural language processing (NLP) techniques to investigate gender differences in psychiatric symptoms when controlling for age, ethnicity, and illicit substance use.

Methods

Data were extracted from EHRs of 3,340 people presenting to the South London and Maudsley (SLaM) NHS Trust between April 2007 and March 2017 with FEP. Logistic regression was used to examine gender differences in presentation of 42 psychiatric symptoms, grouped into positive, negative, depressive, mania and disorganisation symptoms. We controlled for age of onset, ethnicity and illicit substance use (cocaine, amphetamine, MDMA or cannabis) and adjusted p-values for multiple comparisons.

Results

Patients were predominantly male (62%). Eight symptoms were more prevalent in males (poverty of thought, negative symptoms, social withdrawal, poverty of speech, aggression, grandiosity, paranoia and agitation), and thirteen in females (tearfulness, low energy, reduced appetite, low mood, pressured speech, mood instability, flight of ideas, guilt, mutism, insomnia, poor concentration, tangentiality and elation), before adjustment for age, ethnicity and substance use. Male patients were significantly more likely to experience negative symptoms than females (e.g. poverty of thought, OR 1.85, 95% CI 1.33 to 2.62); female patients showed increased likelihood of depressive and manic symptoms (e.g. tearfulness, 0.30, 0.26 to 0.35). Male patients were significantly more likely to misuse amphetamines, cannabis and cocaine (e.g. cannabis, OR 3.18, 2.75 to 3.70). All significant differences survived controls for age and ethnicity. After adjustment for illicit substance use gender differences in aggression, agitation, paranoia and grandiosity became insignificant (p > 0.05). However, adjustment for illicit substance use resulted in increased strength of gender associations with negative, manic and depression symptoms.

Discussion

There are clear gender differences in the clinical presentation of FEP which are modified by exposure to illicit substances. These findings highlight a need to better understand the impact of gender on clinical presentation and treatment outcomes in psychosis, and to ensure that clinicians are aware of how gender differences in presentation could be modified by illicit substance use.
T132. RETINAL GANGLION CELLS DYSFUNCTIONS IN SCHIZOPHRENIA PATIENTS
Authors: Bernadin Florent , Schwitzer Thomas , Laprevote Vincent , Schwan Raymund
Published: May 2020

Background

Structural and functional retinal anomalies are documented in neurologic, substance use and psychiatric disorders. In schizophrenia, flash electroretinogram (fERG) measures have revealed photoreceptors, bipolar cells and retinal ganglion cells (RGC) dysfunctions. To date, no study has explored RGC using a pattern electroretinogram (pERG) protocol as recommended by the International Society for Clinical Electrophysiology of Vision (ISCEV) standards for RGC measurements. We aim to study retinal functional responses of the photoreceptors and RGC in schizophrenia patients in comparison with healthy controls.

Methods

fERG conducted in scotopic (dark-adapted 0.01 and dark-adapted 3.0 ERG) and photopic conditions (light-adapted 3.0 ERG) and pERG were recorded in schizophrenia patients (n=29) and healthy controls (n=29). PERG provides the measurements of 2 waves: the P50 wave which arises in RGC with a contribution of bipolar cells and relates to the spatial distribution and density of the RGC bodies and the N95 wave which represents ganglion cell activity.

Results

fERG results showed a decrease in the b-wave amplitude (t(51)=-3.4, p<.05, d=0.63) (dark-adapted 0.01 ERG), a-wave amplitude (t(48)=4.7, p<.001, d =1.33) (dark-adapted 3.0 ERG), b-wave amplitude (t(48)=-2.8, p<.005, d=0.78) (dark-adapted 3.0 ERG), a-wave amplitude (t(52)=2.8, p<.001, d=0.29) (light-adapted 3.0 ERG) in schizophrenia patients compared to controls. We found as well a significant decrease of the a-wave implicit time (t(52)=-2.5, p<.05, d =1.19) (light-adapted 3.0 ERG) in schizophrenia patients compared to controls. pERG results showed a significant increase of the P50 (t(55)=2.1, p<.05, d=0.55) and a significant increase of the N95 implicit time in schizophrenia patients compared with controls (t(55)=4.2; p<.001, d=0.66).

Discussion

Our results replicate previous findings regarding photoreceptors and bipolar cells dysfunction in schizophrenia patients. pERG results demonstrate a delay in transmission of action potentials by the ganglion cells along the visual pathway via the optic nerve and the lateral geniculate nucleus to the visual cortex in schizophrenia patients which could support alterations in cerebral visual processing in schizophrenia.
T152. AZERI RECENT ONSET ACUTE PHASE PSYCHOSIS SURVEY (ARAS COHORT): PRELIMINARY REPORTS FROM AN OBSERVATIONAL COHORT OF FIRST EPISODE PSYCHOSIS IN IRAN
Authors: Farhang Sara , Ghaemmaghami Mehrdad , Noorazar Gholamreza , Veling Wim , Malek Ayyoub , Shafiee-Kandjani Ali Reza , Alizadeh Behrooz Z , Bruggeman Richard
Published: May 2020

Background

Azeri Acute phase/Recent onset psychosis Survey (ARAS) is the first from central Asia to study the course of patients with recent onset psychosis. The aim is to reveal indicators for understanding the risk and resilience factors, and for choosing the best personalized treatment strategy.

Methods

The catchment area is north-west of Iran, with the majority having an Azeri ethnic background. All participants are evaluated for clinical signs and symptoms as well as risk and resilient factors and followed up for outcome in several domains. Here we give report of first 100 registered patients (male/female: 1.6).

Results

Patients are diagnosed with schizophrenia (23), brief psychotic disorder (4), schizophrenifom (9), amphetamine induced psychotic disorder (12), psychotic disorder NOS and schizoaffective (27). The mean score of PANSS was 26.79±20.62.

Their mean age is 29.8±11.5. High school diploma or higher was achieved by 45. While 60 were single, 21 were married at the moment and 35 had children. All of patients were Muslims, 30 scored moderate on religiosity and the remaining scored high. Level of multidimensional perceived social support was moderate and high in 80 patients. Only 4 were living alone. Level of internalized stigma was moderate and high in 16 patients. Metabolic syndrome was diagnosed in 11.

Almost one third of patients had ever used substance including cigarette (20), alcohol (12), opioids (5), amphetamine (15) and cannabis (5). The most prevalent prescribed medication is risperidone (78). Metabolic syndrome criteria were fulfilled in 16 patients.

Discussion

Preliminary reports from ARAS cohort shows few differences between Iranian and European patients. Lower rate of metabolic syndrome, substance use (especially cannabis) and higher rate of religiosity, having social support, married situation and having children are noticed.
T156. FUNCTIONAL CONNECTIVITY AND RISK OF PSYCHOSIS: AN ACTIVATION LIKELIHOOD ESTIMATION (ALE) META-ANALYSIS OF FUNCTIONAL MAGNETIC RESONANCE IMAGING STUDIES
Authors: Del Fabro Lorenzo , Schmidt André , Delvecchio Giuseppe , D’Agostino Armando , Borgwardt Stefan , Brambilla Paolo
Published: May 2020

Background

Disrupted communication involving large-scale neural networks is hypothesized to underlie the pathophysiology of schizophrenia, as demonstrated by impaired resting-state functional connectivity (rsFC). Seed-based functional magnetic resonance imaging (fMRI) studies in subjects at increased risk of developing psychosis have begun to identify abnormalities in rsFC, although reported findings remain mixed. The aim of this study was to conduct a meta-analysis of seed-based resting-state fMRI studies to test whether high-risk subjects show rsFC alterations relative to healthy controls within and between the default mode network (DMN), control executive network (CEN), and salience network (SN).

Methods

A literature search was performed to identify seed-based resting-state fMRI studies comparing subjects with genetic risk factors, psychotic-like experiences, and clinical high-risk for psychosis to healthy controls. Then, coordinates of seed regions were extracted and categorized into networks by their location within a priori templates. Activation likelihood estimate (ALE) analysis examined the reported coordinates for hypo-connectivity and hyper-connectivity with each a priori network.

Results

The meta-analysis included 15 studies (774 subjects at risk, 628 healthy controls) on clinical high-risk for psychosis, 6 studies (123 subjects at risk, 147 healthy controls) on psychotic-like experiences, and 5 studies (173 subjects at risk, 256 healthy controls) on genetic risk factors of developing psychosis. We found specific patterns of hypo- and hyper-connectivity within and between large-scale networks. Our results showed that subjects with high-risk for psychosis were characterized by hypo-connectivity within the SN and CEN and hyper-connectivity within the DMN and CEN. Network seeds in the DMN, CEN, and SN displayed hyper-connectivity with regions in other networks. The DMN seeds displayed hypo-connectivity with regions in the CEN, while CEN and SN seeds displayed hypo-connectivity with regions in the DMN.

Discussion

This meta-analysis provides evidence that subjects at risk for psychosis present distinctive abnormalities of hyper- and hypo-connectivity within and between the DMN, CEN and SN, particularly implicating network dys-connectivity as a core deficit underlying the psychopathology of psychosis in the preclinical phase. More studies are needed to investigate whether subjects at risk to develop psychosis present patterns of dysfunction between the rsFC of healthy subjects and that of patients with established psychosis.
T169. SEMANTIC PROCESSING IN RELATION TO ANATOMICAL INTEGRITY OF THE VENTRAL LANGUAGE STREAM IN SCHIZOPHRENIA SPECTRUM DISORDERS
Authors: Surbeck Werner , Hänggi Jürgen , Viher Petra , Schmidt André , Seifritz Erich , Homan Philipp , Borgwardt Stefan , Quednow Boris , Walther Sebastian
Published: May 2020

Background

Semantic processing anomalies, clinically reflected by disorganized speech are a core symptom of schizophrenia. In the light of accumulating evidence on its prominent role in semantic processing, aberrant structural integrity of the ventral language stream may reflect impaired semantic processing in schizophrenia spectrum disorders (SSD).

Methods

Comparison of white matter tract integrity in SSD patients and healthy controls using diffusion tensor imaging combined with probabilistic fiber tractography. For the ventral language stream, we assessed the inferior fronto-occipital fasciculus [IFOF], inferior longitudinal fasciculus, and uncinate fasciculus. The arcuate fasciculus and corticospinal tract

were used as control tracts. In SSD patients, the relationship between semantic processing impairments and tract integrity was analyzed separately. Three-dimensional tract reconstructions were performed in 45/44 SSD patients/controls (“Bern sample”) and replicated in an independent sample of 24/24 SSD patients/controls (“Basel sample”).

Results

Multivariate analyses of fractional anisotropy, mean, axial, and radial diffusivity of the left IFOF showed significant differences between SSD patients and controls (p<0.001, ηp2=0.23) in the Bern sample. In SSD, axial diffusivity of the left IFOF was inversely correlated with semantic processing impairments (r=-0.579, p<0.0001). In the Basel sample, significant group differences for the left IFOF were replicated (p<0.01, ηp2=0.29), while the correlation between axial diffusivity of the left IFOF and semantic processing decline (r=-0.376, p=0.09) showed a statistical trend. No significant effects were found for the dorsal language stream.

Discussion

This work provides direct evidence for the importance of the integrity of the ventral language stream, in particular the left IFOF, in semantic processing deficits in SSD.
T176. INSIGHTS INTO THE ROLE OF ORAL AND GUT MICROBIOME IN THE PATHOGENESIS OF SCHIZOPHRENIA
Authors: Ghorbani Mahin , Benedict Gerard , Mei Mei Tew , Syahril bin Mod Yusub Muhamad , SalwaRamly Siti , Arif bin Muhamad Rasat Muhamad , Loke Stella , Croft Lawrence , Parimannan Sivachandran , SuYin Lee , Rajandas Heera
Published: May 2020

Background

The role of oral and gut microbiomes in the pathogenesis of schizophrenia has recently come to light with the advancement of sequencing technology. Recent studies have shown that schizophrenia patients have different gut and oral microbiome profiles than healthy people. The interaction of oral and gut microbiota with the brain is facilitated through the gut-brain axis. Several studies have profiled the gut microbiomes in the Malaysian population, however none has investigated its relationship with etiology of schizophrenia. The aim of this preliminary study is to therefore investigate the relationship between oral and gut microbiomes in pathogenesis of schizophrenia in the Malaysian population based on the total transcriptome profiles.

Methods

In this study, 15 schizophrenia patients and 15 healthy people (control) were recruited from the three major ethnic groups in Malaysia, namely Malay, Chinese and Indian. Throat swabs and stool samples were collected and subjected to total RNA extraction. Following this, ribosomal RNA depletion and cDNA conversion were performed prior to sequencing using Illumina platform. Bioinformatic tools will be used to analyse and compare the transcriptome profiles of microbiomes from schizophrenia and healthy subjects. Brain derived neurotrophic factor, serotonin and dopamine assays will be performed using their blood samples too. The results of the bioassays will be then correlated with the transcriptome profiles to identify possible mechanisms by which microbiota could promote schizophrenia

Results

The RNA sequencing results will reveal differences in gene expression profiles between the microbiomes of schizophrenic and healthy subjects. Based on the transcriptome profiles and bioassay results, the possible pathways and mechanisms by which these microbiota can cause schizophrenia will be identified. In addition, candidate biomarkers from the oral and/or gut microbiomes for diagnosis of schizophrenia can be identified.

Discussion

The first and second generations of schizophrenia treatments mostly are based on controlling the symptoms of the disease, whereas treatment based on microbiome dysbiosis correction can tackle the underlying mechanism leading to a precise treatment of the disease.The findings from this study will enable the identification of distinct schizophrenia associated bacteria, that may help in development of new treatments and novel diagnostics for schizophrenia via microbiome-targeted therapy including probiotics and prebiotic.
T182. DIAGNOSIS INDEPENDENT SYNDROME RELATED GRAY MATTER VOLUME CHANGES IN A LARGE TRANSDIAGNOSTIC COHORT: RESULTS FROM THE FOR2107 STUDY
Authors: Stein Frederike , Lemmer Gunnar , Schmitt Simon , Brosch Katharina , Meller Tina , Nenadic Igor , Dannlowski Udo , Krug Axel , Kircher Tilo
Published: May 2020

Background

More than a century of research on the neurobiological underpinnings of the Major Psychoses (Schizophrenia SZ, Bipolar Disorder BD, Major Depressive Disorder, Schizoaffective Disorder SZA) has been unable to identify diagnostic “markers”. An alternative approach is to study dimensional psychopathological syndromes that cut across categorical diagnoses. Brain imaging studies on the correlates of syndromes are thus far restricted to one diagnosis, however it is unclear, whether structural brain correlates of syndromes are the same across diagnoses. Previously, we have identified 7 syndromes in n=811 patients suffering from major psychoses, applying a confirmatory factor analysis, including depressed mood, negative symptoms, delusions, formal thought disorders, hallucinations, mania and increased appetite. The aim of the current study was to identify gray matter volume correlates of these syndromes across the major psychoses.

Methods

We tested the association of the above 7 psychopathological factors with whole brain GMV (voxel-based morphometry) in a sample of n=713 patients meeting DSM-IV criteria for MDD (n=550), BD (n=79), SZ (n=51) and SZA (n=33) (www.for2107.de). T1 weighted brain images were acquired at a 3-Tesla MRI. Images were pre-processed as implemented in the Cat12 (SPM12) toolbox. We performed multiple regression analyses for each factor separately and used the family wise error correction (FWE) to correct for multiple comparisons. Additionally, we tested if local VBM associations were driven by one diagnosis extracting the beta-volumes of the clusters and then comparing the subgroups using ANCOVA.

Results

The delusion factor was negatively correlated with gray matter volume in the left inferior temporal gyrus/fusiform gyrus (k=138 voxels, x/y/z=-48/-58/-15, t=5.23, p<.05 FWE peak level) and the left amygdala/hippocampus (k=23 voxels, x/y/z=-15/-12/-12, t=4.84, p<.05 FWE peak level). The hallucinatory syndrome was negatively correlated with volume in the right thalamus proper (k=54 voxels, x/y/z=8/-4/-2, t=4.9, p<.05 FWE peak level). Extraction of the beta-volumes revealed no effect of diagnosis (delusions (F (3,708) p=.54; hallucinations (F (3,708) p=.542).

Discussion

Volume changes underlying psychopathological syndromes are independent of diagnosis. We could confirm previous results from much smaller studies which have restricted themselves to single diagnoses or case control designs. Our findings open a new avenue for neurobiological research of the major psychoses, using syndrome based, dimensional approaches rather than DSM or ICD diagnoses.
T206. ANTIPSYCHOTIC EFFECTIVENESS FOCUSING ON INSIGHT
Authors: Stabell Lena , Johnsen Erik , Kroken Rune A , Løberg Else-Marie , Joa Inge , Reitan Solveig Klæbo , Rettenbacher Maria , Gjestad Rolf
Published: May 2020

Background

Impaired insight is common among patients with schizophrenia, and a major obstacle for treatment adherence and improvement. Previous studies have investigated the effect of antipsychotics on insight, but findings are indecisive due to small or homogeneous samples, non-randomized design or short follow- up.

The aim of this study was to investigate if there were differential effects on insight among different antipsychotic medications, and whether the effect was directly related to improvement in insight or indirectly through reduction of psychosis symptoms.

Methods

Data was derived from the Bergen-Stavanger-Innsbruck-Trondheim study (BestIntro). This is a randomized, rater-blinded, naturalistic study with a head- to head comparison of three antipsychotic medications: amisulpride, aripiprazole and olanzapine. Inclusion criteria were adults with a F20-F29 ICD-10 diagnosis being actively psychotic defined as a score of ≥4 on items P1, P3, P5, P6, or G9 on the Positive And Negative Syndrome Scale (PANSS). Insight was measured by PANSS item G12. We used a modified version of PANSS to assess psychosis symptoms (PANSS total score minus item G12, mPANSS). Level and change in insight and psychosis symptoms were estimated in latent growth curve models. The pattern of change indicated a piecewise model with the initial phase from baseline to week six and the long-term phase from week six to one year. The study drugs were used as predictors.

Results

A total of 144 participants were included, 35% female and 61% had previously used antipsychotic medication. Mean insight score at baseline was 3.36. Preliminary findings show differential effects on insight among the three medications, where aripiprazole was the least effective drug. The effect on insight was related to improvement in psychosis symptoms for all study drugs. In addition, we found a direct effect on insight in the long-term phase for amisulpride and olanzapine. In the same phase, the aripiprazole group showed a slight increase in impaired insight.

Discussion

This is the first randomized study with a heterogeneous sample to find an effect of antipsychotics on insight that exceeds the contribution of reduction of psychosis symptoms. Although we have not investigated the association between increased insight and medication adherence, our results imply that patients with impaired insight will benefit from antipsychotic treatment. More specifically, treatment with amisulpride or olanzapine may be more helpful in improving insight over time.