bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of early maturing elite genotypes based on MTSI and MGIDI indexes: an illustration in upland cotton (Gossypium hirsutum L.)
Authors: D S Raj Supritha , Patil Rajesh S. , Patil Bhuvaneshwara R. , Nayak Spurthi N. , Pawar Kasu N.
Published: August 2024

Background

Globally, the cultivation of cotton is constrained by its tendency for extended periods of growth. Early maturity plays a potential role in rainfed-based multiple cropping system especially in the current era of climate change. In the current study, a set of 20 diverse Gossypium hirsutum genotypes were evaluated in two crop seasons with three planting densities and assessed for 11 morphological traits related to early maturity. The study aimed to identify genotype(s) that mature rapidly and accomplish well under diverse environmental conditions based on the two robust multivariate techniques called multi-trait stability index (MTSI) and multi-trait genotype-ideotype distance index (MGIDI).

Results

MTSI analysis revealed that out of the 20 genotypes, three genotypes, viz., NNDC-30, A-2, and S-32 accomplished well in terms of early maturity traits in two seasons. Furthermore, three genotypes were selected using MGIDI method for each planting densities with a selection intensity of 15%. The strengths and weaknesses of the genotypes selected based on MGIDI method highlighted that the breeders could focus on developing early-maturing genotypes with specific traits such as days to first flower and boll opening. The selected genotypes exhibited positive genetic gains for traits related to earliness and a successful harvest during the first and second pickings. However, there were negative gains for traits related to flowering and boll opening.

Conclusion

The study identified three genotypes exhibiting early maturity and accomplished well under different planting densities. The multivariate methods (MTSI and MGIDI) serve as novel approaches for selecting desired genotypes in plant breeding programs, especially across various growing environments. These methods offer exclusive benefits and can easily construe and minimize multicollinearity issues.
Atrial fibrillation fact sheet in Korea 2024: part 2—stroke prevention in Korean patients with atrial fibrillation
Authors: Yang Pil-sung , Kim Ju Youn , Kim Bong-Seong , Han Kyung-Do , Park Junbeom , Cho Min Soo , Lee Jung Myung , Park Jong Sung , Lee Ki Hong
Published: August 2024

Objective

Atrial fibrillation (AF) increases the risk of thromboembolic events, making oral anticoagulants (OACs) essential for high-risk patients. This fact sheet provides nationwide statistics on AF management for stroke prevention in Korea. We aimed to evaluate current anticoagulation treatment trends and strategies in Korea.

Method

The Korean national health claims database from the National Health Insurance Service was used. AF patients aged ≥ 18 years from 2013 to 2022 were included. OAC use, including warfarin and non-vitamin K antagonist OACs (NOACs), was tracked through prescription data. The rates of OAC use were calculated based on continued use, considering prescription dates and amounts. For patients with multiple encounters, the last encounter was used for analysis.

Results

During the study, 20.4% of strokes were accompanied by AF, with AF diagnosed within 6 months before or after the stroke. The number of patients diagnosed with AF after a stroke increased from 4893 in 2013 to 6978 in 2022. Among newly diagnosed AF patients requiring OACs, 51% were not prescribed OACs within 6 months. OAC treatment rates for high-risk AF patients increased from 44.6% in 2013 to 77.5% in 2022, with NOAC prescriptions rising significantly after 2015. Regional variations in OAC prescription rates were observed, with lower rates in suburban/rural areas than in urban regions (76.0% vs. 79.6%, p < 0.001).

Conclusions

Considerable strokes could have been prevented with earlier AF detection and OAC treatment through more intensive electrocardiogram screening.
Multidisciplinary lifestyle interventions for neurological disorders during the Silent phase (MINDS) study: a multi-omics randomized controlled trial protocol
Authors: Taylor Sara , Sachdeva Seerat , Darling Sandra , Arrotta Kayela , Gallagher Lisa , Supan Alexis , Shipta Gabrielle , Perko Jim , Bar Judi , James Joe , Petschek Iris , Lioi Anthony , Kundu Suman , Ellison Lisa , Bekris Lynn M. , Willard Belinda , Sangwan Naseer , Mata Ignacio , Fernandez Hubert , Katzan Irene , Conway Devon , Pillai Jagan , Leverenz James , Busch Robyn M. , Floden Darlene , Saper Robert , Barnard John , Machado Andre , Najm Imad , Punia Vineet
Published: August 2024

Introduction

Given the prevalence and staggering cost of neurological disorders, there is dire need for effective early detection and intervention tools. Emerging evidence suggests that multidisciplinary lifestyle interventions (MLI) may mitigate the risk and progression of neurological disorders. The objectives of this protocol are (1) to test the impact of MLI on the progression of neurological disorders and (2) to identify multi-omic biomarkers for early stages of neurological disease and the impact of MLIs on these biomarkers.

Methods and analysis

We present the Multidisciplinary lifestyle Interventions for Neurological Disorders during the Silent phase (MINDS) protocol, a randomized controlled trial of MLI in neurologically healthy older adults (≥ 50 years old) exhibiting elevated risk for common neurological disorders: stroke, epilepsy, Parkinson’s Disease, or Alzheimer’s disease and related dementias. Participants will be randomly assigned to intervention (n = 100) or control (n = 100) groups. The intervention group will receive 3 months of weekly 2-hour sessions on diet education, yoga, music therapy, and cognitive skills training. The participants’ neurological health and engagement in relevant lifestyle practices will be assessed at regular intervals for 12 months. Neuroimaging and samples for multi-omic analyses will be collected at baseline, and at 3 months and 12 months after enrollment. Primary outcomes will be signs of progression of the neurological disorder risk that qualified them for study enrollment or a clinical diagnosis of the disorder. Secondary and exploratory outcomes will be based on self-reported health and multi-omic data. Data analysis will include between-group and longitudinal within-group analyses.

Perspectives

The MINDS protocol and trial aims to clarify the impact of MLI on the progression of neurological disorder risk or diagnosis in older adults and to identify biomarkers that can be used to confirm MLI efficacy. The ability to validate the impact of MLI on neurological disorder progression based on biomarker data allows the identification of individuals most likely to benefit from such therapies in the early stages of neurological disease.

Trial registration

The trial is registered on the National Institutes of Health (NIH) ClinicalTrials.gov (NCT05984056) site. It was registered on August 2nd, 2023. The trial has full approval of the Cleveland Clinic Internal Review Board.
Electroclinical characteristics and therapies of tonic spasms
Authors: Peng Xi , Chen Yangmei , Wang Zezhi , Zhang Xinbo , Wang Bi , Jin Lang , Wang Xiaoli , Yuan Na , Hu Xiaojing , Wang Xiaomu , Liu Yonghong
Published: August 2024

Backgroud

Epileptic spasms followed by a tonic component have been frequently observed in patients with late-onset spasms (LOS). However, there is a lack of comprehensive analysis and summary of clinical data related to tonic spasms (TS), including seizures, video-electroencephalogram (V-EEG), synchronous electromyography (EMG) and follow-up data.

Methods

To investigate the characteristics of TS, we prospectively collected the clinical data, including 24-h V-EEG and synchronous EMG data of 32 enrolled patients who suffered from epileptic spasms followed by a TS onset at least once during the 24-h V-EEG in the epilepsy center of Xijing Hospital between June 2015 and July 2020. The patients were prescribed anti-seizure medications (ASMs) and followed up for 2–7 years.

Results

The average age of epilepsy onset was 48.06 ± 16.07 months (range: 25 to 88 months). Among the enrolled patients, 22 patients presented with mild intellectual deficits. During the 24-h video-EEG monitoring, an average of 6.94 TS events (range: 3 to 21) were recorded, and these TS seizures often occurred in clusters. In addition to TS, 26 patients experienced generalized tonic-clonic seizures (GTCS), atypical absence seizures, myoclonic seizure, and epileptic spasms. None of the 32 patients with TS displayed hypsarrhythmia during the 24-h video-EEG recording. A total of 28 patients showed normal EEG backgrounds. Interictal epileptic discharges, including slow waves (SW), spike/sharp slow waves (SSW), and spikes, often displayed multifocally. Notably, two patients achieved seizure freedom for more than 2 years through monotherapy with oxcarbazepine (OXC), which was associated with normalization of the EEG.

Conclusions

It is difficult to classify the patients with TS as any existing epileptic syndromes, which were distinct from West syndrome or Lennox-Gastaut syndrome. TS might be an underreported seizure type and further studies are needed to gain a more comprehensive understanding of the electro-clinical features and appropriate choice of ASMs for treating tonic spasms.
Premenstrual syndrome among medical versus non-medical workers and its association with work-related quality of life
Authors: Mahmoud Nesma A. , Frere Noha O. , Zaitoun Nahla A. , Zaitoun Mai M. , Elshamy Raghda A.
Published: August 2024

Background

Premenstrual syndrome (PMS) is a commonly underestimated disorder that negatively impacts a woman’s life. Medical workers, who live a more stressful life, may report an increased rate of PMS. Studies on the relationship between PMS and work-related quality of life for medical professionals are scarce, particularly in the Arab world. This study aimed to compare the frequency of PMS among medical versus non-medical workers at Zagazig University and to assess the association between PMS and their work-related quality of life.

Methods

A comparative cross-sectional study was conducted. The sample population consisted of 48 medical and 48 non-medical female workers aged 18–45 years from Zagazig University. The two groups filled out a questionnaire with 3 parts: sociodemographic and occupational data, the Premenstrual Symptoms Screening Tool (PSST), and the Work-Related Quality of Life Scale (WRQL).

Results

Severe PMS was reported in 45.8% of medical workers versus 20.8% of non-medical workers with a statistically significant difference between both groups (p = 0.009). Binary logistic regression showed that being a medical worker, clinical specialty, ≥ 8 years of work, ≥ 24 working hours per week, and having a non-set hourly schedule were predictors for severe PMS. PMS was found to be a statistically significant predictor of poor WRQL (p < 0.001). There was a highly significant negative correlation between the PMS score and the WRQL score (r =  − 0.302, p < 0.001).

Conclusion

Among medical workers, PMS is more common and more severe, and WRQL is worse and negatively correlated with PMS. We suggest further studies with larger samples to prove this association and planning for public health programs to screen for and manage PMS among medical workers in our community.
Dairy farmer, engagement and understanding of One Health and antimicrobial resistance - a pilot survey from the lower north island of Aotearoa New Zealand
Authors: Arden Kurt , Rosanowski Sarah M. , Laven Richard A , Mueller Kristina R.
Published: August 2024

Background

Reducing antimicrobial resistance (AMR) requires a multidisciplinary One Health approach, which necessitates buy-in from all stakeholders. In Aotearoa New Zealand, where the dairy industry is one of the largest users of antimicrobials, there are ongoing efforts to optimise antimicrobial usage (AMU) to minimise the development of AMR. These include regulations around the veterinary authorisation of the use of antibiotics by farmers without the need for a specific prescription (“the RVM process”) and programmes such as the New Zealand Veterinary Association’s antibiotic ‘Traffic Light System’. The goal of this pilot survey was to develop and trial a questionnaire to determine how much Aotearoa dairy farmers understand about One Health, AMR, the RVM process and how their actions regarding AMU affect the wider environment.

Methods

A 55-question semi-structured questionnaire was piloted on 15 dairy farms in the Lower North Island of Aotearoa New Zealand via an in-person semi-structured interview between September and November 2021.

Results

None of the interviewed farmers could define the term One Health. However, the majority found the RVM process to be of use on their farm, although admitted they generally felt frustration regarding AMR, seeing it as a blockage to productivity, and lacked awareness regarding how their actions were related to its development. Of the farmers interviewed over half had not heard of the traffic light system, and of those who had, one admitted they refused to adhere to it.

Conclusions

This survey’s novel findings have highlighted that there are notable gaps within dairy farmer understanding of AMU, AMR and One Health as well as highlighting that veterinarians could do more to keep their clients informed of their important role within One Health. There is still a lot more work to do with regards to vets, farmers and industry representatives working together to embrace One Health. Simple solutions would be to encourage farmers returning unused drugs to their veterinarians for correct disposal and to actively engage farmers further regarding AMU and AMR, so that these end-product users do not feel disconnected from the process.
Superamphiphilic aerogels with 2D lamellar structure of gelatin-tuned 3D supramolecular network of collagen fibers for high-performance separation of surfactant-stabilized emulsified oily wastewater
Authors: Liu Honglian , Xiao Hanzhong , Hao Baicun , Zheng Wan , Wang Yujia , Huang Xin , Shi Bi
Published: August 2024

Superwetting aerogel is a promising alternative for the remediation of emulsified oily wastewater for its high porosity combined with extreme wettability enabled high separation performances to emulsion wastewater. However, it remains challenging for superwetting aerogels to accomplish high-performance dual separation to surfactant-stabilized oil-in-water (O/W) and water-in-oil (W/O) emulsions with high stability. Herein, an environmentally benign superamphiphilic composite aerogel was prepared by a green synthesis route that relied on the utilization of natural amphiphilic biomass. Collagen fibers (CFs) were utilized to construct the three-dimensional (3D) supramolecular skeleton of aerogel to provide high storage capacity of water/oil and outstanding capillary effect to boost the mass transfer. The two-dimensional (2D) lamellar structure of gelatin (Gel) was further grown on the skeleton of CFs aerogel to play the role for simultaneously enhanced demulsifying capability and spreading of emulsions. The as-prepared superamphiphilic aerogel enabled the separation of highly stable surfactant-stabilized O/W and W/O emulsions with high separation efficiency and flux. Excellent recycling performances and anti-fouling performance were also confirmed. Our investigations therefore demonstrated that the structural engineering of superamphiphilic aerogel is a promising way to realize high-performance dual separation of surfactant-stabilized O/W and W/O emulsion wastewater.

Graphical Abstract
OCD in children: phenomenology, impairment, and psychiatric co-morbidity—an experience from Kashmir
Authors: Raj Rajnish , Hussain Syed Karrar , Wani Zaid Ahmad
Published: August 2024

Introduction

Obsessions are recurrent ego-dystonic thoughts, images, or urges followed by compulsion to reduce them. The phenomenology of obsessive–compulsive disorder (OCD) along with comorbidities is essential for understanding treatment response. This study aimed to assess phenomenology, impairment, and psychiatric co-morbidity associated with OCD in children and adolescents.

Methodology

A cross-sectional study was done among 36 patients suffering from OCD. Socio-demographic and clinical details were collected with the application of Children’s Yale-Brown Obsessive Compulsive Scale for severity of illness, Children’s Global Assessment Scale for impairment assessment, and Kiddie-Sads-Present and Lifetime Version for comorbidity.

Result

Thirty-six patients, comprising 20 male and 16 female subjects, with a mean age ± SD of 11 ± 3.4 years and a mean duration of illness of 12.30 months, were included in the study. A positive family history was noted in 30.6% of subjects. Mean C-YBOCS score was 24.44 (moderate to severe OCD) and the mean C-GAS score was 47.86, with 55.6% of subjects suffering from other comorbidities. Fear of contamination with washing and cleaning was among the most common themes in the population. Data was analyzed and presented as mean ± SD, frequencies, and percentages.

Conclusion

Considering the increased prevalence of OCD in children and adolescent populations, a thorough symptom evaluation and any co-morbidities related to OCD should be considered by clinicians.
Metabolic syndrome among Egyptian children with Familial Mediterranean Fever: a case–control study
Authors: Atef Shimaa , Marzouk Huda , El-khity Mariam Mahmoud , Abu Shady Hend Mohamed
Published: August 2024

Background

Familial Mediterranean fever (FMF) is the most prevalent inherited autoinflammatory disease globally. Metabolic syndrome (MetS) is a cluster of interrelated risk factors; insulin resistance, obesity, dyslipidemia, and hypertension are the main constituents of MetS.

Aim

This study aimed to investigate components of metabolic syndrome among Egyptian children with FMF during the attack-free period.

Patients and methods

This is a case–control study that was conducted in the Pediatric Rheumatology Outpatient Clinic and Pediatric Endocrinology Clinic, Children’s Hospital, Faculty of Medicine, Cairo University. It was conducted on 40 patients with FMF. The patients included were of both sexes and aged 10 years or older, during the FMF attack-free period; they were compared to 40 apparently healthy age- and sex-matched children as controls. All subjects in this study were subjected to detailed history taking, anthropometric measurements, general and systemic examinations. Laboratory evaluation (at the time of the study) was done at time of study, in the form of CBC with differential, BUN, creatinine, ESR, serum amyloid A, urine analysis, serum insulin, fasting blood glucose, and lipid profile. FMF gene mutations were collected from patients’ files.

Results

The mean ± SD age of FMF patients was 12.65 ± 1.82 (10–17) years, while the mean ± SD age of the control group was 12.6 ± 1.82 (10–16) years. Among FMF patients, 50% were males, and 50% were females (F:M = 1:1), while in the control group, 47.5% were females, and 52.5% were males. All FMF patients were during the attack-free period. There was a statistically significant difference between both groups regarding insulin resistance, being more frequent among the FMF patients’ group, with a p-value of 0.025.

Conclusion

None of our FMF patients met the criteria for the definition of metabolic syndrome, but there was a significant difference between cases and control regarding insulin resistance with higher frequency among FMF patients, probably due to the ongoing subclinical inflammation. This indicates that children with FMF may be at a higher risk of getting metabolic syndrome later on in life.
The contribution of stakeholder engagement to cultural significance assessment: the case of values-based conservation management planning for the Ocean Swimming Pool, Portugal
Authors: Cunha Ferreira Teresa , Freitas Pedro Murilo , Frigolett Constanza , Mendonça Hugo , Silva Ana Tarrafa
Published: August 2024

Introduction

Values-based approaches are among the best practices for management and conservation planning. However, cultural significance assessments (of the attributes and values of cultural heritage) have generally been performed by experts (top-down) instead of including expert and nonexpert communities (top-down and bottom-up).

Objectives

This paper presents a multitechnique approach in which different strategies are applied to assess the perceptions of cultural significance held by several actors (users, managers, staff, experts, children, students, virtual community) within the framework of the Keeping It Modern Grant awarded by the Getty Foundation (2020–2023) for the Ocean Swimming Pool (1960–1966) designed by Álvaro Siza in Matosinhos, Portugal.

Method

Interviews, surveys, social media analysis, and workshops with children, students, and experts were adopted for the method, and, whenever possible, the ‘Imagine Ballarat’ Love, Change and Imagine questions were utilised as a resourceful instrument for assessing the significance attributed by multiple stakeholders.

Results

Based on the results, stakeholders’ opinions and values regarding the heritage site could be compared, which revealed the relationship between the values and the groups of actors, thereby deepening the complexity of heritage sites as National Monuments.

Conclusion

By using this integrated perspective, we could define the cultural significance of a modern heritage site through an inclusive methodology while also establishing the grounds for conservation policies within a more broadly participative management of change.
Influence of aging on opioid dosing for perioperative pain management: a focus on pharmacokinetics
Authors: Mercadante Sebastiano
Published: August 2024

The older population continues to grow in all countries, and surgeons are encountering older patients more frequently. The management of postoperative pain in older patients can be a difficult task. Opioids are the mainstay of perioperative pain control. This paper assesses some pharmacokinetic age-related aspects and their relationship with the use of opioids in the perioperative period. Changes in body composition and organ function, and pharmacokinetics in older patients, as well as characteristics of opioids commonly used in the perioperative period are described. Specific problems, dose titration, and patient-controlled analgesia in the elderly are also reviewed. Opioids can be safety used in perioperative period, even in the elderly. The choice of drugs and doses can be individualized according to the surgery, opioid pharmacokinetics, comorbidities, and routes of administration.
Expanding molecular diagnostic coverage for tuberculosis by combining computer-aided chest radiography and sputum specimen pooling: a modeling study from four high-burden countries
Authors: Codlin Andrew James , Vo Luan Nguyen Quang , Garg Tushar , Banu Sayera , Ahmed Shahriar , John Stephen , Abdulkarim Suraj , Muyoyeta Monde , Sanjase Nsala , Wingfield Tom , Iem Vibol , Squire Bertie , Creswell Jacob
Published: August 2024

Background

In 2022, fewer than half of persons with tuberculosis (TB) had access to molecular diagnostic tests for TB due to their high costs. Studies have found that the use of artificial intelligence (AI) software for chest X-ray (CXR) interpretation and sputum specimen pooling can each reduce the cost of testing. We modeled the combination of both strategies to estimate potential savings in consumables that could be used to expand access to molecular diagnostics.

Methods

We obtained Xpert testing and positivity data segmented into deciles by AI probability scores for TB from the community- and healthcare facility-based active case finding conducted in Bangladesh, Nigeria, Viet Nam, and Zambia. AI scores in the model were based on CAD4TB version 7 (Zambia) and qXR (all other countries). We modeled four ordinal screening and testing approaches involving AI-aided CXR interpretation to indicate individual and pooled testing. Setting a false negative rate of 5%, for each approach we calculated additional and cumulative savings over the baseline of universal Xpert testing, as well as the theoretical expansion in diagnostic coverage.

Results

In each country, the optimal screening and testing approach was to use AI to rule out testing in deciles with low AI scores and to guide pooled vs individual testing in persons with moderate and high AI scores, respectively. This approach yielded cumulative savings in Xpert tests over baseline ranging from 50.8% in Zambia to 57.5% in Nigeria and 61.5% in Bangladesh and Viet Nam. Using these savings, diagnostic coverage theoretically could be expanded by 34% to 160% across the different approaches and countries.

Conclusions

Using AI software data generated during CXR interpretation to inform a differentiated pooled testing strategy may optimize TB diagnostic test use, and could extend molecular tests to more people who need them. The optimal AI thresholds and pooled testing strategy varied across countries, which suggests that bespoke screening and testing approaches may be needed for differing populations and settings.
How Are FOMO and Nomophobia Linked to Symptoms of Depression, Anxiety and Stress Among University Students?
Authors: Alhaj Hamid , Muthana Abdelraouf , Abdalla Asia , Marouf Menna , Awad Nisreen
Published: August 2024

Aims

Nomophobia, defined as the fear of being without one's mobile phone, and FOMO (Fear of Missing Out) are on the rise and are thought to be linked to increased mental health problems. In the information era, being separated from smartphones may cause anxiety, while the expectation of continuous updates on social media may increase feelings of inadequacy and distress when comparing one's life with selected highlights of others. The extent of nomophobia and FOMO in the Middle East and whether these experiences are associated with psychiatric disorders are yet to be ascertained. The purpose of this study was to determine the prevalence of nomophobia and FOMO among university students in the UAE and the relationship between these phenomena and depression, anxiety and stress levels.

Methods

232 female and 103 male undergraduate students in four Emirates (Abu Dhabi, Dubai, Sharjah, and Ajman) took part in the study. An online questionnaire was developed and piloted. Nomophobia and FOMO were measured using validated questionnaires, namely NMP-Q and FoMOs. Symptoms of depression, anxiety and stress were assessed using the DASS-21 scale. Data were analysed using SPSS 22. Significance level was set at p < 0.05.

Results

The data revealed that 28.6% of respondents exhibited severe, 47.7% moderate, and 23.7% mild nomophobia symptoms. 52.5% of participants reported moderate to extreme fear that others have more rewarding experiences than them, with the median FoMO score being (25.62). Higher nomophobia, stress, anxiety, and depression levels correlated with elevated FOMO scores (p < 0.001). Variations in FOMO scores were noted across university, gender, and college. Strong associations existed between severe nomophobia and heightened stress, anxiety, and depression (p < 0.001). The findings underscored contextual influences on nomophobia intensity among diverse individuals.

Conclusion

The study identified a high prevalence of nomophobia and FOMO among UAE university students. Significant correlations were observed between these digital-related fears and mental health issues like depression, anxiety, and stress. Our results delineate the necessity for exploring and implementing interventions that address smartphone-related phobias to safeguard the mental well-being of UAE university students, considering their unique cultural context.
The Neurobiology of Depression, Burnout and Resilience Among Healthcare Students
Authors: Alhaj Hamid , Al Midani Abdul Rahman , Alkokhardi Zainab , Abu Helwa Rashid , Al Moukdad Almuzaffar
Published: August 2024

Aims

Adapting to academic and social demands may be challenging for university students. Healthcare students are thought to be at high risk of burnout and Major Depressive Disorder (MDD) due to the demands of their training and emotional toll of caring for patients. This risk extends well into physician years, suggesting the persistence of an abnormal psychological state developed during training years. We aimed to investigate the prevalence and severity of depressive symptoms, burnout, and resilience in healthcare students, examine their correlation with salivary cortisol levels, and assess how these factors change during examination periods.

Methods

This longitudinal study investigated the mental health and salivary cortisol levels of medical, dental, or health science students in the UAE at two distinct periods, at the start of the academic semester, and within one week of the examination period. A total of 147 students (51% females) were included, and their demographics and education variables, including cumulative GPA (cGPA), were assessed. Depression, resilience, and burnout scores were measured using the Patient Health Questionnaire-9, Nicholson-McBride Resilience questionnaire, and Maslach Burnout Inventory-Student-Survey, respectively. Participants who met the criteria for MDD were identified. Time-dependent cortisol levels were modelled using functional data analysis and standardised cortisol levels were calculated. Data analysis was done using mixed effect models in R 4.1.2.

Results

Among participants, 12.2% screened positive for MDD at the beginning of the semester, increasing to 16.6% during the examination period. Depression scores were higher during the examination period (p = 0.011). Female gender was significantly associated with higher levels of depression (median difference = 3.00; p < 0.001) and burnout but lower levels of resilience (mean difference = 3.27; p < 0.001). cGPA below 75% (p = 0.009) and history of mental illness (p = 0.015) were associated with increased levels of depression. High cortisol responders (z-value > 1) developed higher depression scores (p = 0.033) compared with low cortisol responders (z-value < −1). Participants with higher resilience were less likely to develop depression and burnout (p < 0.003).

Conclusion

This study shows relatively high levels of depression among healthcare students in the UAE, particularly in females, students with history of mental illness, students with low cGPA, and students with high cortisol levels. Efforts to promote culturally appropriate resilience skills need to be developed to reduce distress and depression in this population.
Understanding Perceptions of Mental Health Practitioners on Care and Treatment Reviews (CTRs)
Authors: Amiola Ayomipo , Chester Verity , Purandare Kiran , Shankar Rohit , Alexander Regi
Published: August 2024

Aims

NHS England's ‘Transforming Care’ initiative introduced care and treatment reviews (CTRs) for adults with intellectual disabilities and/or autism to avoid inpatient admissions, improve inpatient care quality and support timely discharge. CTRs are completed by an independent panel including an expert by experience, a clinician, and the commissioner. Since 2015, thousands of CTRs have been carried out. In a survey of ID psychiatrists involved in CTRs, many felt that discharge planning was limited by a lack of appropriate community placements. Proposed changes to the Mental Health Act indicate that CTRs should become statutory.

Our aim was to obtain the views of professionals working in intellectual disability services on the proposed reforms to the Mental Health Act and CTRs.

Methods

A mixed methods 34-item questionnaire exploring views of professionals working in ID services (n = 66) on the CTR process, their perception on its usefulness and the proposal to make CTR recommendations statutory. Survey shared with ID MDT professionals working in the UK. Of the respondents, 30% were psychiatrists, 29% psychologists and 21% nurses, with average length of mental health service of 18.2 years. More than 80% work in the NHS and most worked either in inpatient or forensic units.

Results

Although in 80% of CTRs attended, patients have a current risk assessment and management plan, in less than 10% of CTRs attended were people ready for discharge and had a current discharge plan. In terms of CTR actions, 70% of the time, patients were receiving the right care, over 60% of the time, care was person centred, person's health needs are met and 50% of the time key areas of concerns were covered. In less than 40% of CTRs were the person's rights always upheld, family or carers always involved, medications being used appropriately or were there clear, safe and positive approaches to risk. Reasons for delayed discharges included no placement options (68%), no placement profile or community needs assessment (24%), placement funding disputes (23%), no agreed social care responsibility (18%) and no agreed community clinical care responsibility (18%). Only 7% of respondents felt CTRs were always useful, 44% felt they were sometimes useful and 23% often useful. Professionals had mixed views about whether CTRs should become statutory/enforceable (45%) versus those who did not (48%).

Conclusion

This is a survey with a relatively representative sample of MDT professionals involved in CTRs. It gives insight into the typical CTR process, duration, and professionals involved. It summarises the opinions of clinicians towards CTRs and their views on proposed changes.
The Effectiveness of Antipsychotic Drug Therapy for Treating Psychosis in People With Epilepsy – a Systematic Review
Authors: Arora Aryan , Prakash Priya , Rizzo Laura , Rogers Jonathan
Published: August 2024

Aims

Individuals with epilepsy are at risk of developing pre-ictal, ictal, postictal or interictal psychoses. Antipsychotic drugs (APDs) are the main class of drugs used to treat psychosis and schizophrenia. The efficacy and safety of APDs as a treatment for epileptic psychosis is not well understood. Hence, we aimed to conduct a systematic review assessing the effectiveness and adverse effects of antipsychotic drugs to treat psychosis in people with epilepsy.

Methods

We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE, Embase, PsycInfo and AMED from database inception to 20/06/2023. We contacted experts in the field and performed citation searches to identify additional records. Title, abstract, full-text review, and data analysis were conducted in duplicate, with conflicts resolved by discussion among authors. Given the heterogeneity of study designs, meta-analysis was not deemed appropriate; instead, the results were tabulated in a narrative synthesis. The Joanna Briggs Institute Risk of Bias tool was used to assess study quality.

Results

We identified 13 studies, with a total of 1,180 participants. In the 9 case series included, the psychotic symptoms of all but 3 out of 28 patients treated with APDs partially improved or fully resolved. 3 of the cohort studies reported an association between antipsychotic use and longer duration of psychotic episodes, 2 found similar results in both APD and non-APD groups, and 2 did not report control psychosis outcomes. When reported, seizure frequency was observed to remain unchanged or decrease following APD treatment.

Conclusion

Available evidence does not suggest that antipsychotics increase seizure risk in individuals with epilepsy. However, further data from randomised controlled trials and well-controlled cohort studies are urgently needed to draw more definitive conclusions.
Development and Preliminary Testing of App-Based Culturally-Adapted Psychoeducation for Bipolar Disorder in Pakistan
Authors: Asif Muqaddas , Khoso Ameer B. , Chaudhry Nasim , Chaudhry Imran B. , Husain Muhammad Ishrat
Published: August 2024

Aims

Bipolar disorder (BD) leads to marked disability, morbidity, and premature death. Although pharmacological agents are an essential part of BD treatment, psychosocial interventions have played an important role in enhancing treatment adherence, functioning and quality of life in patients with BD. Building on a successful pilot randomised controlled trial (RCT) of a Culturally adapted PsychoEducation (CaPE) intervention for BD, CaPE is currently being evaluated in a large multicenter RCT for its clinical and cost-effectiveness across Pakistan. However, innovations are urgently needed due to limited human resources and disproportionately high clinical needs to bring effective interventions to scale. This study aims to develop and test a mHealth iteration of CaPE, digital CaPE (dCaPE), to be delivered via a mobile app.

Methods

The study will utilise a two-phased approach to i) develop a user-centred dCaPE mobile application and ii) assess the feasibility and preliminary efficacy of dCaPE for people with BD in a randomised controlled trial in Pakistan. For application development, we have conducted discussion groups with stakeholders i.e., mental health professionals (psychiatrists, psychologists, nurses) (n = 8) and patients and carers (n = 10) to gauge their valuable insights for app design, visual elements, cultural sensitivity, motivational and mood-monitoring features, and app functionality to improve user experience.

Results

The findings from discussion groups informed the importance of visual elements, specifically font size and style. Participants recommended the use of soft and soothing colours like white, grey, and soft shades of pink to prevent overstimulation. Additionally, participants highlighted the need for culturally and linguistically inclusive features, including emojis and audio messages for effective engagement and to address the challenge of low literacy. The mHealth approach was deemed highly valuable, especially given the prevalence of mental health challenges and associated stigma. Endorsed by participants, the dCaPE application will offer customized psychoeducation messages along with daily 5-item (mood, energy, sleep, medication, and irritability) screening, a weekly comprehensive test for manic and depressive episodes based on DSM–5 criteria; weekly reminders to regulate sleep and eating habits, and visual representations of weekly mood monitoring reports with the incentive of badges or rewards for goal achievers.

Conclusion

This research has the potential to enhance clinical outcomes, social and occupational functioning, and the overall quality of life for BD patients while addressing substantial mental health treatment gaps with impact and implications extending to various low-resource settings.
Assessing the Efficacy of a Brief Universal Family Skills Program on Child Behaviour and Family Functioning in Families in Gilgit Baltistan, Pakistan
Authors: Asif Muqaddas , El-Khani Aala , Husain Nusrat , Chaudhry Nasim , Chaudhry Imran B.
Published: August 2024

Aims

The burden of mental health difficulties is a global problem and preventing them from childhood is paramount. Children living in challenged and underserved settings can suffer various harmful lifelong consequences including alcohol and substance abuse, low self-esteem, health issues, poor school performance, self-harm and suicide. This study aims to assess the feasibility, acceptability and efficacy of the culturally adapted Strong Families program in improving child behaviour and family functioning in families living in a challenged setting i.e. Gilgit-Baltistan (GB), Pakistan.

Methods

This is a two-arm, multisite feasibility randomised controlled trial with 90 families (n = 45 in intervention, and n = 45 in waitlist group) including a female primary caregiver (mostly mother) and at least one of their children between the age of 8–15 years in three districts of GB. There will be three raters’ blind assessments: at baseline, week 2, and 6 weeks after Strong Families Program sessions.

Results

Strong Families Program is a brief evidence-based prevention programme designed to improve parenting skills, child well-being and family mental health. The primary outcome measures include the feasibility of Strong Families, as determined by families' recruitment, attendance rates, and program completeness (mean number of sessions attended, attrition rates). Additionally, purposefully selected participants, including up to 5 caregivers from each study site, researchers, and facilitators delivering the intervention, will be interviewed. Descriptive statistics will be used to analyse primary and secondary outcomes. The process evaluation will be conducted in terms of program context, reach, fidelity, dose delivered and received, implementation, and recruitment.

Conclusion

The findings from this feasibility trial hold the potential to carry out the large multicentre trial of clinical and cost-effectiveness and scale-up across Pakistan and other similar settings to meaningfully impact child behaviour and family dynamics in culturally diverse contexts.
Knowledge of Psychogenic Polydipsia Within Mental Health Services
Authors: De Leon Ewelina , Dunford Louise , Yorston Graeme
Published: August 2024

Aims

Psychogenic polydipsia (PP) is a term used to describe a repetitive behaviour that characterises compulsivity in psychiatric patients resulting in excessive fluid consumption. It is a common clinical problem in patients with severe mental illness, learning disability, autism and acquired brain injury. Up to 20% of patients with schizophrenia have polydipsia, and many develop hyponatraemia and water intoxication, which can lead to irreversible brain damage or death.

Psychogenic polydipsia may not be obvious to staff in a busy care setting, leading to delayed identification and appropriate care.

The objective of this study is to assess the existing knowledge of psychogenic polydipsia among mental health staff and promote greater awareness of the condition.

Methods

To investigate the understanding of psychogenic polydipsia among healthcare staff, an online survey has been chosen as the research method. This survey will help identify any knowledge deficiencies in this area. It consists of both closed and open-ended questions, allowing for quantitative and qualitative analysis. The open-ended questions are designed to provide an opportunity for participants to share their individual experiences. Additionally, the survey will collect information on participants' age groups, years of experience in mental health services, and level of expertise. The survey was created using Qualtrics online survey software. Participant recruitment will be conducted at St Matthews Healthcare, with an estimated sample size of n = 101. The collected data will be analysed using statistical software such as SPSS, NVivo, or other appropriate tools.

Results

The results of this study will be presented. Data are being collected and analysis will be completed in March. The abstract will be updated. These findings will serve as the basis for future recommendations and suggestions.

Conclusion

Comprehending patients' illnesses is a crucial aspect of providing quality healthcare. However, identifying psychogenic polydipsia has proven to be challenging within mental health settings. Failure to recognize excessive fluid intake can result in ineffective treatment, exacerbation of psychiatric symptoms, and in severe cases, coma or even death. The findings of this study have the potential to contribute to the creation of a training program for healthcare providers. Such a program would enable the development of improved care plans for patients who engage in excessive fluid consumption and are at risk of developing hyponatremia and water intoxication.
Linguistic Creativity and Formal Thought Disorder in Schizophrenia
Authors: Robinson Louise , Archer Dawn , Bartha Alex , Chatzidamianos Gerasimos , Delgaram-Nejad Oliver
Published: August 2024

Aims

The present investigation was interested in whether formal thought disorder (FTD) in schizophrenia was in any way related to linguistic creativity. The project's main aims and research questions were the development of operational definitions of linguistic creativity and FTD in schizophrenia, an investigation of creative language processing in schizophrenia, and an investigation of creative language output in schizophrenia.

Methods

We designed a psycholinguistic experiment and collected natural language data to build a specialised schizophrenia corpus. Recruitment for the psycholinguist experiment was challenged by the COVID pandemic and the technical abilities of clinical participants. Those data are thus underpowered and not reported in the results. We collected sufficient data for the construction of the specialised corpus.

Results

We tested an operational definition of FTD in schizophrenia (the '4TD Framework') against our natural language dataset. There was good support for the framework, with grammatical and discourse tracking features reliably distinguishing clinical and comparison speakers (p < 0.05). We also examined concordance lines and grouped random concordances into error types. Error types were consistently similar across groups, suggesting that speech disturbances in schizophrenia are on a continuum with those of nonclinical speakers. We also conducted a keyness analysis to examine the key terms and semantic categories present in the corpus and noted significant differences in the clinical cohort. Clinical participants found discussion of the topic of linguistic creativity more challenging, deviating from topic more often. They also involved topics of emotional and personal concern at rates of up to 16 to 32 times more often than comparison participants in some cases.

Conclusion

Our results provide support for the dysexecutive and dyssemantic hypotheses of FTD, as well as work on the Thought Language Index (TLI) that also suggests that language disturbances in schizophrenia and FTD are on a continuum with nonclinical speech. Further research is needed to understand how these phenomena are positioned in relation to FTD as a transdiagnostic entity.