bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of phyto-phenolic compounds on ammonia production by select amino acid fermenting bacteria
Authors: Lakes Jourdan E , Ramos Leah I , Cardenas Maedean L , Mast Natasha L , Flythe Michael D
Published: January 2025

Bacteria that ferment amino acids to ammonia can be categorized as generalists or specialist hyper-ammonia-producing bacteria. In the rumens of ruminant animals, most of the ammonia produced is eventually excreted as urea in urine. This process can be controlled with off-label use of antibiotics, but the practice can lead to antibiotic resistance; therefore, discovery of antibiotic alternatives is pertinent. Plant-derived phenolic compounds have demonstrated antimicrobial efficacy for such purposes. This study investigated the antimicrobial and metabolic suppressive potential of six phenolic compounds on five amino acid fermenting bacteria: Clostridium sporogenes MD1, C. aminophilum F, Acetoanaerobium sticklandii SR, Peptostreptococcus sp. BG1, and Prevotella bryantii B14. Inhibitory action of the compounds was determined using a 10% v/v serial dilution method in basal media. Carvacrol (1 mM), thymol (1 mM), and eugenol (10 mM) demonstrated the greatest antimicrobial potential, where carvacrol and eugenol inhibited growth of all five species and thymol four species except BG1. The cinnamic acids (trans and hydro) demonstrated variable activity against all organisms. Suppression of metabolic activity was determined via colorimetric assay quantifying ammonia in washed stationary phase culture supernatant after 24 h of metabolism on fresh substrate. Carvacrol and eugenol yielded the greatest reduction of ammonia by all organisms except B14, which produced no ammonia under the growth conditions. Thymol greatly reduced ammonia production of four organisms except F. These data demonstrate that eugenol, carvacrol, and thymol may be worthy antimicrobial candidates for the control of ammonia-producing organisms.
Extreme smells—microbial production of volatile organic compounds at the limits of life
Authors: Salinas-García Miguel Ángel , Fernbach Jonas , Rinnan Riikka , Priemé Anders
Published: January 2025

Microbial volatile organic compounds (MVOCs) are diverse molecules produced by microorganisms, ranging from mere waste byproducts to important signalling molecules. While the interest in MVOCs has been increasing steadily, there is a significant gap in our knowledge of MVOCs in extreme environments with e.g. extreme temperatures or acidity. Microorganisms in these conditions are subjected to additional stress compared to their counterparts in moderate environments and in many cases have evolved unique adaptations, including the production of specialized MVOCs. This review highlights the diversity of MVOCs identified in extreme environments or produced by isolated extremophiles. Furthermore, we explore potential applications already investigated and discuss broader implications for biotechnology, environmental biology, and astrobiology.
Systematic bias in malaria parasite relatedness estimation
Authors: Mehra Somya , Neafsey Daniel E , White Michael , Taylor Aimee R
Published: January 2025

Genetic studies of Plasmodium parasites increasingly feature relatedness estimates. However, various aspects of malaria parasite relatedness estimation are not fully understood. For example, relatedness estimates based on whole-genome-sequence (WGS) data often exceed those based on sparser data types. Systematic bias in relatedness estimation is well documented in the literature geared towards diploid organisms, but largely unknown within the malaria community. We characterise systematic bias in malaria parasite relatedness estimation using three complementary approaches: theoretically, under a non-ancestral statistical model of pairwise relatedness; numerically, under a simulation model of ancestry; and empirically, using data on parasites sampled from Guyana and Colombia. We show that allele frequency estimates encode, locus-by-locus, relatedness averaged over the set of sampled parasites used to compute them. Plugging sample allele frequencies into models of pairwise relatedness can lead to systematic underestimation. However, systematic underestimation can be viewed as population-relatedness calibration, i.e., a way of generating measures of relative relatedness. Systematic underestimation is unavoidable when relatedness is estimated assuming independence between genetic markers. It is mitigated when relatedness is estimated using WGS data under a hidden Markov model (HMM) that exploits linkage between proximal markers. The extent of mitigation is unknowable when a HMM is fit to sparser data, but downstream analyses that use high relatedness thresholds are relatively robust regardless. In summary, practitioners can either resolve to use relative relatedness estimated under independence, or try to estimate absolute relatedness under a HMM. We propose various tools to help practitioners evaluate their situation on a case-by-case basis.
Inferring demographic and selective histories from population genomic data using a two-step approach in species with coding-sparse genomes: an application to human data
Authors: Soni Vivak , Jensen Jeffrey D
Published: January 2025

The demographic history of a population, and the distribution of fitness effects (DFE) of newly arising mutations in functional genomic regions, are fundamental factors dictating both genetic variation and evolutionary trajectories. Although both demographic and DFE inference has been performed extensively in humans, these approaches have generally either been limited to simple demographic models involving a single population, or, where a complex population history has been inferred, without accounting for the potentially confounding effects of selection at linked sites. Taking advantage of the coding-sparse nature of the genome, we propose a 2-step approach in which coalescent simulations are first used to infer a complex multi-population demographic model, utilizing large non-functional regions that are likely free from the effects of background selection. We then use forward-in-time simulations to perform DFE inference in functional regions, conditional on the complex demography inferred and utilizing expected background selection effects in the estimation procedure. Throughout, recombination and mutation rate maps were used to account for the underlying empirical rate heterogeneity across the human genome. Importantly, within this framework it is possible to utilize and fit multiple aspects of the data, and this inference scheme represents a generalized approach for such large-scale inference in species with coding-sparse genomes.
Genomes reveal pervasive distant hybridization in nature among cyprinid fishes
Authors: Ren Li , Tu Xiaolong , Luo Mengxue , Liu Qizhi , Cui Jialin , Gao Xin , Zhang Hong , Tai Yakui , Zeng Yiyan , Li Mengdan , Wu Chang , Li Wuhui , Wang Jing , Wu Dongdong , Liu Shaojun
Published: January 2025

Background

Genomic data have unveiled a fascinating aspect of the evolutionary past, showing that the mingling of different species through hybridization has left its mark on the histories of numerous life forms. However, the relationship between hybridization events and the origins of cyprinid fishes remains unclear.

Results

In this study, we generated de novo assembled genomes of 8 cyprinid fishes and conducted phylogenetic analyses on 24 species. Widespread allele sharing across species boundaries was observed within 7 subfamilies of cyprinid fishes. Based on a systematic analysis of multiple tissues, we found that the testis exhibited a conserved pattern of divergence between the herbivorous Megalobrama amblycephala and the carnivorous Culter alburnus, suggesting a potential link to incomplete reproductive isolation. Significant differences in the expression of 4 genes (dpp2, ctrl, psb7, and ppce) in the liver and intestine, accompanied by variations in enzyme activities, indicated swift divergence in digestive enzyme secretion. Moreover, we identified introgressed genes linked to organ development in sympatric fishes with analogous feeding habits within the Cultrinae and Leuciscinae subfamilies.

Conclusions

Our findings highlight the significant role played by incomplete reproductive isolation and frequent gene flow events, particularly those associated with the development of digestive organs, in driving speciation among cyprinid fishes in diverse freshwater ecosystems.
Relationship between COVID-19 cases and monthly mortality from all causes, cancer, cardiovascular diseases and diabetes in 16 countries, 2020–21
Authors: Pizzato Margherita , Santucci Claudia , Islam Nazrul , La Vecchia Carlo , Alicandro Gianfranco
Published: January 2025

Background

During the COVID-19 pandemic, mortality from some chronic diseases increased. In this study, we evaluated monthly excess mortality from all causes, cancer, cardiovascular diseases (CVD) and diabetes during the months of 2020 and 2021, examining its relationship with COVID-19 cases.

Methods

Monthly cause-specific mortality data were downloaded from public repositories of national statistics offices or directly requested from them, and population data were obtained from the United Nations archives. Excess deaths were estimated as the difference between observed and expected deaths. Monthly expected deaths for 2020 and 2021 were calculated using a quasi-Poisson regression model trained on 2010–19 data (or a shorter timespan if the full decade of data was not available). To quantify the correlation between COVID-19 cases and monthly excess mortality, we used the Spearman’s correlation coefficient (rs).

Results

The study included 16 countries that provided monthly national data on causes of death (Argentina, Austria, Brazil, Switzerland, Chile, the Czech Republic, Germany, Georgia, Hungary, Italy, Lithuania, Latvia, Mexico, Serbia, Slovakia and the USA). A positive correlation was found between COVID-19 cases and monthly excess mortality from all causes in all countries (rs ranging from 0.61 to 0.91), from CVD in 11 countries (rs ranging from 0.45 to 0.85) and for diabetes in 13 countries (rs ranging from 0.42 to 0.79). Excess mortality above 5% was estimated from all causes in 14 countries for both 2020 and 2021, from CVD in seven countries for 2020 and in nine countries for 2021, and from diabetes in 11 countries for 2020 and in 12 countries for 2021. No excess above 5% was estimated for cancer mortality in any of the countries considered.

Conclusions

Excess mortality from CVD and diabetes persisted in several countries throughout 2021. These increases coincide with COVID-19 peaks, supporting a short-term impact of the COVID-19 pandemic on mortality from these causes.
Host-response testing with MeMed BV in community-acquired pneumonia: an economic evaluation from the UK NHS perspective
Authors: Gregg Emily , Graziadio Sara , Green William , Afonso Daniela , Garrett Monica , Watts Karina , Watkins Deborah , Carrol Enitan D , Cooke Jonathan , Felton Tim
Published: January 2025

Background

Community-acquired pneumonia (CAP) remains a leading cause of hospital admissions and mortality. A novel host-response test, MeMed BV (MMBV), has been developed for discriminating between bacterial and viral infection that could improve the clinical management of CAP.

Objectives

To evaluate the cost-effectiveness of using MMBV to guide antibiotic decisions in the clinical management of CAP in the UK.

Methods

An economic model was developed to understand the incremental cost per person associated with the implementation of MMBV from the UK NHS perspective. A qualitative care pathway analysis was performed to inform the standard of care (SOC) and SOC plus MMBV (SOC + MMBV) clinical pathways captured in the model.

Results

In the base case analysis, the SOC + MMBV strategy for a hypothetical cohort of 1000 patients (adults and children modelled independently) presenting to the emergency department with suspected CAP was estimated to provide total cost savings of £134 018 and £105 750 for adults and children, respectively. Cost savings were associated with reductions in total antibiotic treatment, the number of patients receiving additional diagnostic tests, and hospital admissions. Deterministic sensitivity analysis revealed that the specificity of SOC + MMBV and sensitivity of the SOC were primary drivers of the cost model for adults, whereas the specificity of SOC and SOC + MMBV were primary drivers for paediatrics.

Conclusions

Overall, the model predicts that the introduction of SOC + MMBV has the potential to be cost-saving and promote antimicrobial stewardship for both adult and paediatric CAP patients.
Replication across O6-methylguanine activates futile cycling of DNA mismatch repair attempts assisted by the chromatin-remodelling enzyme Smarcad1
Authors: Shigenobu-Ueno Karin , Sakamoto Reihi , Kanatsu Eiichiro , Kawasoe Yoshitaka , Takahashi Tatsuro S
Published: January 2025

SN1-type alkylating reagents generate O6-methylguanine (meG) lesions that activate the mismatch repair (MMR) response. Since post-replicative MMR specifically targets the nascent strand, meG on the template strand is refractory to rectification by MMR and, therefore, can induce non-productive MMR reactions. The cycling of futile MMR attempts is proposed to cause DNA double-strand breaks in the subsequent S phase, leading to ATR-checkpoint-mediated G2 arrest and apoptosis. However, the mechanistic details of futile MMR cycling, especially how this reaction is maintained in chromatin, remain unclear. Using replication-competent Xenopus egg extracts, we herein establish an in vitro system that recapitulates futile MMR cycling in the chromatin context. The meG–T mispair, but not the meG–C pair, is efficiently targeted by MMR in our system. MMR attempts on the meG-strand result in the meG-to-A correction, whilst those on the T-strand induce iterative cycles of strand excision and resynthesis. Likewise, replication across meG generates persistent single-strand breaks on the daughter DNA containing meG. Moreover, the depletion of Smarcad1, a chromatin remodeller previously reported to facilitate MMR, impairs the retention of single-strand breaks. Our study thus provides experimental evidence that chromatin replication across meG induces futile MMR cycling that is assisted by Smarcad1.
Oncogenic FLT3 internal tandem duplications (ITD) and CD45/PTPRC control osteoclast functions and bone microarchitecture
Authors: Lossius-Cott Carolin , Annoh Akua , Bens Martin , Nietzsche Sandor , Hoffmann Bianca , Figge Marc Thilo , Rauner Martina , Hofbauer Lorenz C , Müller Jörg P
Published: January 2025

Activating internal tandem duplications (ITD) in the juxtamembrane domain of receptor tyrosine kinase FLT3 occur frequently in patients with acute myeloid leukemia (AML). Constitutive active FLT3-ITD mutations induce aberrant signaling and promote leukemic cell transformation. Inactivation of the attenuating receptor protein tyrosine phosphatase CD45 (PTPRC) in FLT3-ITD mice resulted in the development of a severe hematopoietic phenotype with characteristics of AML. In addition, abnormal bone structures and ectopic bone formation were observed in these mice, suggesting a previously unknown role of FLT3 to control bone development and remodeling. While Ptprc knockout and Flt3-ITD mutant mice showed a largely normal bone microarchitecture, micro-CT analysis of femurs from Flt3-ITD Ptprc knockout mice revealed trabecularization of the cortical bone. This resulted in increased trabecular bone volume at the metaphysis, while the cortical bone at the diaphysis was thinner and less dense. In the metaphysis, severely reduced osteoclast and osteoblast numbers were observed. Reduced capacity of ex vivo differentiation of CD11b-positive bone marrow stem cells to mature osteoclast was accompanied by their abnormal morphology and reduced size. Transcriptome analysis revealed reduced expression of osteoclastogenic genes. Unexpectedly, cumulative resorption activity of osteoclasts was increased. Size and structure of resorption pits of differentiated osteoclasts remained similar to those observed in osteoclast cultures derived from control animals. Enhanced proliferation of cells in osteoclast cultures derived from FLT3-ITD–expressing mice was mediated by increased expression of STAT5 target genes. Transcriptome analysis of differentiated osteoclasts showed dysregulated signaling pathways influencing their differentiation as well as the coupling of bone resorption and formation. Taken together, inactivation of attenuating CD45 in mice expressing oncogenic FLT3-ITD resulted in marked abnormalities of the osteo-hematopoietic niche, which can be explained by aberrant STAT5 activation.
Two volatiles from anthracnose-infected blueberries trigger electrophysiological and aversive behavioral responses in Drosophila suzukii (Diptera: Drosophilidae)
Authors: Quadrel Amanda , Ferguson Beth , Rering Caitlin C , Urbaneja-Bernat Pablo , Rodriguez-Saona Cesar
Published: January 2025

Native to Southeast Asia, the spotted-wing drosophila (Drosophila suzukii Matsumura) is an economically important invasive pest of thin-skinned fruits such as raspberries, blueberries, and strawberries worldwide. To reduce the reliance on insecticides for managing this pest, alternative strategies like behavioral manipulation are needed. Previous studies have shown that D. suzukii adults avoid blueberry fruits infected with the fungal pathogen Colletotrichum fioriniae Marcelino & Gouli, which causes anthracnose fruit rot, leading to the identification of 9 potential repellent compounds. In this study, we further investigated the two most potent of these compounds—ethyl butanoate and ethyl (E)-but-2-enoate—to assess their repellent properties on the antennal and behavioral responses of D. suzukii. Electroantennogram (EAG) assays revealed that both esters elicited similar dose-dependent responses in male and female D. suzukii, which were often stronger than those triggered by 2-pentylfuran, a known repellent of this species. Additionally, we examined the behavioral responses of adult D. suzukii to these 3 repellent compounds under semi-field and field conditions using outdoor cages containing potted and planted blueberry bushes, respectively. Results from the cage studies showed that all 3 tested compounds can significantly reduce D. suzukii oviposition and adult emergence from blueberry fruits, with ethyl (E)-but-2-enoate sometimes outperforming the other compounds. Our findings indicate that the esters ethyl butanoate and ethyl (E)-but-2-enoate, which are induced from C. fioriniae-infected blueberries, elicit dose-dependent effects on D. suzukii antennae and act as effective oviposition deterrents. This supports their potential as promising tools for managing this pest through behavioral strategies.
Predictive variables for intraoperative blood loss and surgical time in resection of malignant soft tissue tumors without reconstruction
Authors: Nakamura Tomoki , Kobayashi Eisuke , Takenaka Satoshi , Endo Makoto , Hayashi Katsuhiro , Nakata Eiji , Ohshika Shusa , Kawashima Hiroyuki , Hamada Tetsuya , Horiuchi Keisuke , Nishida Yoshihiro , Hasegawa Masahiro , Morii Takeshi
Published: January 2025

Background

Procedural techniques such as dissection and separation of blood vessels or nerves from the tumor for preserving limbs and functions involves high surgical difficulty. We hypothesized the relation of vessel and/or nerve preservation to surgical time and blood loss, accurately reflecting surgical difficulty. In this study, we elucidated the variables affecting surgical time and intraoperative bleeding in patients with malignant soft tissue tumors who did not undergo any reconstruction after tumor resection.

Methods

We included 153 patients with malignant oft tissue tumors in the trunk (n = 72), thigh (n = 68), and upper arm (n = 13) at nine institutions. We analyzed the possible predictive variables affecting surgical time and intraoperative bleeding.

Results

Overall, the study included 153 patients (85 men and 68 women) with a mean age of 65 years. The tumors were primary soft tissue sarcoma (STS) (n = 114), local recurrent STS (n = 25), and soft tissue metastasis (n = 14). The median number of participating surgeons was three. The mean and median surgical time were 144.6 and 123 min, respectively. The mean and median intraoperative bleeding were 157.1 and 55 mL, respectively. Tumor size, depth, dissection and separation of blood vessels from the tumor, dissection and separation of nerve from the tumor, and the number of participating surgeons were significantly related to the surgical time and intraoperative bleeding.

Conclusions

The procedure of dissection and separation of blood vessels and nerves from the tumor were related to surgical time and intraoperative bleeding in patients with malignant soft tissue tumors, especially large and deep tumors.
Phenotypic and genomic characterization of Levilactobacillus brevis YT108: a potential probiotic strain capable of metabolizing xylo-oligosaccharides
Authors: Chen Yang , Zhou Jun , Li Xin , Li Xin-yao , Qiu Shi-xiu , Xu Zhen-ying , Yang Jian-xia , Zhu Yuan-ting , Zhang Xin-rui , Yan Lang
Published: January 2025

Levilactobacillus brevis YT108, identified for its ability to metabolize prebiotic xylo-oligosaccharides (XOS), emerges as a candidate for probiotic use in synbiotic food formulations. This study aimed to investigate the metabolic and genomic traits associated with XOS metabolism in YT108 and to assess its probiotic attributes through whole genome sequencing and in vitro assays. Strain YT108 exhibited robust growth kinetics on XOS as the sole carbon source, with a growth profile comparable to that on glucose, achieving a pH reduction to 4.68 and an OD600nm of 1.603 after 48 h. Three key gene clusters (xylCDEPFRT, xylHTG, and xylABT) and key enzymes (1,4-β-xylosidase) were identified as potentially involved in XOS metabolism. In vitro assays confirmed the strain’s remarkable physiological properties, including tolerance to acid, bile, heat, and NaCl, as well as resistance to simulated gastrointestinal juices and antioxidant capacity. Furthermore, strain YT108 was sensitive to five commonly used antibiotics and lacked transferable resistance genes. Taken together, these results highlight the potential of L. brevis YT108 as a probiotic candidate with beneficial traits for XOS utilization, suggesting its promising application in the formulation of next-generation synbiotic products.
Synaptic Plasticity in the Hippocampus
Authors: Bliss Tim , Collingridge Graham , Cooke Sam , Georgiou John , Morris Richard
Published: January 2025

This chapter provides an overview of activity-dependent synaptic plasticity in the hippocampus. It outlines the basic properties of long-term potentiation (LTP) and long-term depression (LTD) in the pathways that form the core hippocampal trisynaptic circuit, notably the Schaffer collateral/commissural (SCC) pathway connecting CA3 to CA1 pyramidal cells. Other significant pathways include the projections from medial and later entorhinal cortex (EC) to the distal dendrites of principal cells in all hippocampal subfields and the mossy fiber projection from dendate granule cells to CA3 pyramidal cells. The chapter then delves into the physiological and cell biological mechanisms of hippocampal synaptic plasticity and its contribution to hippocampus-dependent memory, including the relationship of synaptic plasticity to engrams. Another major focus is the role of dysregulated synaptic plasticity in synaptopathies, with a particular emphasis on neurodevelopmental, psychiatric and neurodegenerative brain disorders.
Hippocampal Physiology in the Behaving Animal
Authors: Krupic Julija , O’Keefe John
Published: January 2025

This chapter tackles the electrophysiological activity of the hippocampus in the behaving animal. It elaborates on the hippocampal local field potential (LFP) and its role in organizing hippocampal cellular activity. The LFP represents the state of the hippocampus as it shifts from an active mode in which the hippocampus controls the behavior of the animal to a more passive state with large amplitude irregular activity (LIA) and sharpwave ripples (SWRs). Moreover, hippocampal theta activity dominates the local field potential when the animal is actively attending to and moving around the environment. The chapter discusses the different cell types in the hippocampal formation and the properties of spatial cells.
Functions of the Human Hippocampus
Authors: Barry Daniel N. , Maguire Eleanor A.
Published: January 2025

This chapter describes the journey of signals once they enter the brain, and the roles played by the human hippocampus in their processing. This includes perception, short-term maintenance of information, replay, consolidation, and how representations are transformed or lost over time. The reconstruction of representations during retrieval is then considered, along with other flexible applications of hippocampal representations such as future planning, imagination, navigating through physical, conceptual and social space, and decision making. Coming full circle, we outline how prior experiences influence subsequent perception, attention and memory. The chapter ends by discussing hippocampal theories and whether they can account for extant data, identifying where knowledge gaps remain, and how they might be bridged in the future using new technologies.
Computational Models of Hippocampal Cognitive Function
Authors: Bush Daniel , Burgess Neil
Published: January 2025

Computational models of the hippocampus are invaluable in exploring the link between neurons and behavior, enabling hypothetical mechanisms to be defined precisely and examined quantitatively. This chapter reviews many of these, including models of spatial and mnemonic function, models that stress feedforward processing through the hippocampal system, and those stressing recurrent processing within it. It reviews the spatial models first, then those of associative or episodic memory function. Finally, it reviews recent proposals to unify the spatial and mnemonic functions of the hippocampus. These models are based on two related considerations: the correspondence between place or index-like representations in spatial or mnemonic models and low dimensional latent variables that efficiently describe the underlying causes of sensory input; and the benefit of finding representations that capture common relational structure across multiple contexts for prediction and generalization. Overall, these models instantiate cognitive maps of states or concepts and the relationships between them.
Alzheimer’s Disease
Authors: Chan Dennis , Spires-Jones Tara , Provenzano Frank , Glennon Elizabeth BC , Duff Karen
Published: January 2025

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that results in cognitive decline and is the leading cause of dementia worldwide. Very early in the disease, AD affects the hippocampal formation before spreading to other brain regions. The high prevalence of AD, along with its significant social and economic costs, highlights the need to understand hippocampal dysfunction. In this chapter, we will first review the current knowledge of AD pathobiology, particularly focusing on hippocampal dysfunction and cognitive impairment, then explore the molecular mechanisms underlying the disease, and finally discuss the implications for early diagnosis and treatment.
Beyond Shades of Gray: Depression and the Bipolar Spectrum
Authors: Fogel Barry S. , Jiang Xiaoling
Published: January 2025

Many patients who present with depression have an undiagnosed disorder in the bipolar spectrum. Bipolarity is associated with more frequent depressive episodes, increased suicide risk, a higher prevalence of comorbid substance use disorders, and several general medical conditions (e.g., migraine and hypothyroidism). Antidepressant treatment of bipolar depression without mood stabilization often has a poor outcome. Cultural issues complicate the diagnosis of depression with mixed features and mild bipolar disorder. Systematic screening with rating scales like the 32-item Hypomania Checklist, the Mood Disorder Questionnaire, and the Clinically Useful Depression Outcome Scale supplemented with questions for Diagnostic and Statistical Manual of Mental Disorders, fifth edition, mixed features facilitate identification of bipolarity in depressed patients; but the utility of specific questionnaire items and optimal cut points vary by culture and gender. Social class and life stage matter: Specific manifestations of hypomania might be tolerated or even normalized among adolescents and members of the upper class. Biomarkers might soon aid in identifying bipolarity in depressed patients.
Cultural Identity and Personal Biography
Authors: Fogel Barry S. , Jiang Xiaoling
Published: January 2025

Cultural identity strongly influences the personal meaning of common life events like marriage or retirement and the probability of adverse childhood events (ACEs) or intimate partner violence (IPV). Some cultures normalize ACEs and IPV. Life events can require adaptation to a new identity or environment, involving acculturative stress and sometimes family distancing. These include not only immigration but also migration within countries, changes in socioeconomic class, the onset of major illness or disability, changes in family composition, and aging. Acculturation is most successful when people become bicultural, integrating old and new identities. Depression risk is greatest when people feel isolated: disconnected from both their native culture and that of their new environment. Second-generation immigrants can experience “acculturative family distancing.” Effective psychotherapy of depression often requires addressing acculturation-related issues and recognition of traumas and stresses normalized by a patient’s native culture.
Unnatural Deaths
Authors: Fogel Barry S. , Jiang Xiaoling
Published: January 2025

Suicide and other “unnatural deaths” are the most dramatic expression of the mortality of depression, and more deaths from depression and bipolar spectrum disorders can be attributed to self-neglect and careless risk-taking. A framework for relating culture to suicide combines Joiner’s interpersonal theory of suicide with neuropsychiatric and existential considerations and the availability of highly lethal means: an interpersonal-neuropsychiatric model. Collectivist culture accentuates thwarted belongingness in those ostracized or bullied. A shame culture and/or “face” culture can contribute to perceived burdensomeness. Cultural normalization, rationalization, or romanticization of suicide increases acquired capacity for suicide. Activation and inhibition, pain and pleasure can relate to culture and its structural correlates. Mediators include formal education and informal acculturation, normalized trauma, lifestyle-related and occupation-related illness and injury, and culturally sanctioned substance use. Religious and spiritual perspectives and national, regional, and ethnic cultures are associated with hope and with reasons to live.
Depression and Social Class: A Four-Dimensional View
Authors: Fogel Barry S. , Jiang Xiaoling
Published: January 2025

A simple correlation of income, social class, and depression risk is misleading. Education, occupation, wealth, and heritage can be as important as income in determining social status. The practical and social meaning of a nominal numerical income varies by place of residence. Relevant mediators are a place’s cost of living, distribution of income and wealth, and public policies related to housing, healthcare, and income support. Within racial groups in the United States, median household wealth and income vary greatly by national origin. Open expression of depressive emotions is more likely to be acceptable in upper classes, and somatic expression is especially common in lower classes. Non-irritable presentations of hypomania sometimes are normalized in the upper class. A change in social class in either direction can entail loneliness and a loss of social capital that contributes to depression. Effective treatment of depression can require adaptation to class-related circumstances.
Ancient Wisdom Meets Modern Science: Depression in Traditional Medicine
Authors: Fogel Barry S. , Jiang Xiaoling
Published: January 2025

The phenomenology and treatment of depression and the bipolar spectrum are described in three systems of traditional medicine, two of which are currently practiced: classical Greco-Roman medicine, traditional Chinese medicine (TCM), and traditional Arabic and Islamic medicine. These and other traditional systems (e.g., Ayurvedic medicine) contribute content to modern complementary, alternative, and integrative medicine (CAIM). The three systems conceive of depression as a mind–body illness, in a comprehensive, holistic, non-stigmatized, and dimensional (rather than categorical) way. Depression phenotypes described and distinguished by TCM have been correlated with distinct biomarkers. Traditional holistic treatments include changes in diet, activity, and environment as well as herbal medicaments and physical treatments like acupuncture and massage. CAIM includes evidence-based alternatives and complements to mainstream medicine that many patients find acceptable. They can help depressed patients reach and maintain remissions.
China: Confucian Harmony and Dissonance
Authors: Fogel Barry S. , Jiang Xiaoling
Published: January 2025

Conflicts of China’s traditional Confucian culture with modern realities contribute to depression and to suicide in Chinese immigrants to Western countries, Chinese international students, and rural Chinese including internal migrants and their “left-behind” family members. Traditions include authoritarian parenting, extreme emphasis on academic success, obligations of filial piety, and rigid gender roles. Immigrants experience acculturative stress and acculturative family distancing. In Chinese culture, depression is heavily stigmatized, and its overt expression is discouraged. Negative emotions often are expressed metaphorically. Treatment can be complicated by fear of medications and reluctance to self-disclose in psychotherapy. Clinicians can address this by eliciting patients’ personal illness narratives, disclosing a diagnosis in stages using language compatible with their illness models and beliefs, and negotiating a personalized treatment plan.
South Korea: Han and Passionate Intensity
Authors: Fogel Barry S. , Jiang Xiaoling
Published: January 2025

Korea has the highest suicide rate of all high-income countries: 28.91 per 100,000 population in 2019—with disproportionally high rates in women and in older adults. Cultural features contributing to suicide, and to often-undiagnosed depression, include normalization of traumatic experiences, including family and intimate partner violence; transgenerational effects of historical trauma; widespread binge drinking; intense academic, occupational, and romantic competition that produces many “losers”; preoccupation with “face” and external appearance; and high gender inequality. Korea has two “national emotions”—han and jeong. Han is a form of righteous anger with grim resolve and yearning for vengeance. Jeong is a form of attachment that entails both protective social capital and a risk of unhealthy dependency. Hwa-byung, a distinctive expression of depression most common in women in midlife, reflects an excess of han. The interpersonal dimension of depression deserves special attention in Koreans.
American Regional Cultures and Geography of Mood
Authors: Fogel Barry S. , Jiang Xiaoling
Published: January 2025

Regions of the United States have distinctive cultures, demographics, economies, and institutions relevant to depression’s epidemiology, expression, and consequences. Comparisons between regions and within regions illustrate this phenomenon. The implications of race and of Hispanic ethnicity vary greatly between regions, because of different distributions of national origin and socioeconomic class among Whites, Blacks, and Asians. The female-to-male ratio of depression prevalence reflects regional differences in gender inequality. Geographical differences in altitude and in local gun culture explain much of the interstate difference in suicide rates. Social capital—especially institutional trust—is protective against depression and suicide; it is high in Minnesota and Massachusetts and low in Mississippi and Montana. Stigmatization of depression and its treatment is greater in states with “tighter” (more traditional and conformist) cultures and less educated populations.
Physicians in Pain: Depression in the Medical Profession
Authors: Fogel Barry S. , Jiang Xiaoling
Published: January 2025

The medical profession has a high prevalence of depression, and women physicians are at increased risk of suicide. A high proportion of physicians at times experience burnout, and many experience moral injury. These problems have become more prevalent during the COVID-19 pandemic. Internal, external, and institutional stigma can discourage depressed physicians from seeking treatment. Occupational identity often is primary for female and/or minority physicians. Others’ responses to their non-professional identities can at times involve microaggressions, harassment, mistrust, or interpersonal conflict. A professional culture of prioritizing others’ needs can lead to physicians’ neglecting their own health and/or worsen painful work–life conflicts. Most physicians now work in institutional settings with organizational cultures that conflict with the traditional “doctor culture.” While personalized treatment can address some barriers to treatment of depressed physicians, a full solution will require changes in organizational culture and wider recognition of cultural and structural contributions to the problem.
Prolonged PTT in a Healthy Patient
Authors: Verdecchia Nicole , Nguyen Khoa
Published: January 2025

Tonsillectomies are one of the most commonly performed surgeries in the United States. The surgery is performed for several indications in patients of all types. There is a known risk of post-tonsillectomy hemorrhage, and thus many surgeons request preoperative laboratory values including partial thromboplastin time (PTT) for preoperative hemostatic assessment. Most patients have unremarkable laboratory values but there are few who return with abnormal values. There is no consensus about management of patients with abnormal preoperative laboratory values. This case study discusses the value of preoperative testing for tonsillectomy patients as well as the current literature supporting the management of these patients.
Elevated Glucose on Admission Fingerstick
Authors: Carafone Lindsay E. , Bauer Colin E. , Miller Joshua D. , Wittlin Steven D.
Published: January 2025

Diabetes mellitus (DM) is an increasingly prevalent chronic disease that can result in acute and long-term complications. Uncontrolled DM contributes significantly to increased morbidity and mortality among all patients undergoing surgery. Preoperative evaluation of patients with DM is critical to mitigate the risks of surgical complications. Attention to glycemic control and related comorbidities is key to ensuring safe, high-quality care to patients with DM undergoing surgery.
Pheochromocytoma and MEN Syndromes
Authors: Carr Zyad J. , Farela Andrea , Oprea Adriana D.
Published: January 2025

Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors that present unique challenges for anesthesiologists. Definitive surgical management of PPGLs is contingent on excellent preoperative medical management because the resection of pheochromocytoma remains a high-risk procedure due to the possibility of tumor-mediated sympathetic storm, which may result in hypertensive crises and potentially lethal ventricular dysrhythmias. Diligent postoperative care of PPGL resection patients also is mandated since the postoperative period can be fraught with potential complications, including postoperative bleeding, persistent vasoplegia requiring vasopressor support, or refractory hypertension from inadequate surgical resection. With advancement of anesthesia techniques and improved preoperative optimization, mortality has substantially decreased. In this chapter, the authors review perioperative considerations for resection of PPGLs as well as for multiple endocrine neoplasia (MEN) syndromes.
Introduction to somatization across cultures: Somatization, a cry for help—different wails from different cultures
Authors: Chaturvedi Santosh K.
Published: January 2025

The introduction of this volume on somatization across cultures discusses the nosological changes in the concept of neurosis and somatization. The concepts in current classificatory systems are mentioned. The chapter also elaborates on biological, genetic, psychosocial, and cultural factors underlying somatization. The relationship between somatization and the erstwhile concept of neurosis is highlighted. Further, the intricate association between somatization and idiom of distress is described. Somatization is a complex and common problem, and invariably, it is a ‘cry for help’. It needs to be handled with care and caution. It needs proper nomenclature and classification. By recategorizing somatization in other groups and changing the name, it would not go away. Different societies have their unique forms of expressing their ‘cry for help’ and their unique presentations.
Culture and somatization
Authors: Poulter Daniel , Gnanapragasam Sam , Bhugra Dinesh
Published: January 2025

Cultures play a major role in moulding our worldview and how distress is experienced, expressed, and communicated. Cultures and various social factors influence how individuals explain their distress. Depending upon explanatory models, help may be sought from personal, folk, social, or professional sectors. Pathways into care are strongly influenced by cultures, as well as by accessibility and availability of resources. Furthermore, cultures which do not believe in mind–body dualism, or do not follow the Cartesian dichotomy, may influence people to present with physical symptoms, even if they are experiencing psychological distress. This chapter describes the impact of cultures on presentation of symptoms, particularly in somatization, and attempts to explain various reasons which may affect potential intervention strategies.
Understanding somatization from a neuroscience perspective
Authors: de Filippis Renato , Nocera Alessandra
Published: January 2025

A deep understanding of somatization from a neuroscientific point of view is still lacking. In fact, for a long time, somatization disorders have been mostly associated with psychological or psychosocial factors, limiting the influence that neuroscience could have. Only in recent years has research rediscovered the role that neuroanatomy, neurogenetics, and neuroimaging play in this field, with potential diagnostic, clinical, and therapeutic implications. The purpose of this chapter is to review the literature available on the topic, in order to provide a modern, updated, and current picture of an ancient disorder, but with extremely modern implications, still largely to be deciphered.
Somatization in South East Asia
Authors: Jatchavala Chonnakarn , Sidi Hatta
Published: January 2025

Somatization could be attributed to: a cultural idiom of distress—crying for help; the ethnobelief structure of a society; the divergent psycholinguistic representation of emotional states; and an understanding of pathways to access healthcare. Despite the change of terminology into ‘somatic symptom disorder’ in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), the core concept and pathogenesis model of somatization are still the same. There is a strong evidence base indicating that antidepressants, antipsychotic augmentation, and psychotherapies, such as cognitive behavioural therapy and mindfulness psychotherapy, can effectively reduce symptoms of somatization. Furthermore, therapeutic interventions could be enriched via insight and awareness in connection to cultural identity, social context, and the religious beliefs of South East Asians. Social and individual stigma associated with being a psychiatric patient can be a crucial obstacle to recovery and can result into further somatic symptom representation. Therefore, activities designed to alleviate stigma are urgently needed in South East Asian societies, aiming to sustainably destigmatize having psychiatric distress and encouraging people to seek mental health support in good time.
Somatization disorders in central and northern Europe
Authors: Karaliuniene Ruta , Frankova Iryna , Szczegelniak Anna
Published: January 2025

This chapter provides essential information on the cultural and historical background of Central and Northern Europe and the prevalence, clinical manifestations, and treatment opportunities for somatization disorders in the region. The significant impact of historical events such as the World Wars, the fall of the Berlin Wall, and migration from post-Soviet Union countries on the physical and mental health of individuals in the region have been discussed. The lack of unified guidelines and limited access to psychotherapy within the public psychiatric care system in different countries are significant challenges that must be addressed to improve mental healthcare in the region.
Psychopharmacological approaches to somatization with a focus on cross-cultural differences
Authors: Shoib Sheikh , Saeed Fahimeh , Swed Sarya , Ransing Ramdas
Published: January 2025

Due to globalization, multiethnic and multicultural populations are growing across the world. This necessitates that psychiatrists should understand the role of ethnicity and culture when diagnosing and treating patients with an ethnic, culturally and linguistically diverse background. Cross-cultural psychopharmacology assesses and addresses the differences between ethnic groups in their response to psychotropic medications, as well as the reasons for such variations, including genetic, biological, environmental, and psychosocial factors. The discovery of genetic polymorphisms (cytochrome P (CYP) 450 enzyme systems) supports the role of cross-cultural psychopharmacology in clinical practice. However, research on cross-cultural aspects of psychotropic medications is scarce and has often yielded conflicting findings.
Psychotherapeutic models on somatization across cultures
Authors: Mamtani Harkishan , Sudhir Chandna Ateev , Phurailatpam Shivraj , Chaturvedi Santosh K.
Published: January 2025

Somatization disorder presents a complex interplay between culture and symptom manifestation. This chapter examines various cultural explanations for somatic complaints and considers how these explanations may affect psychotherapy techniques. The expression and perception of somatic symptoms are greatly influenced by cultural norms and beliefs; certain cultures place more emphasis on psychological attributions than others do on physiological or social reasons. Explanatory models that emphasise the significance of cultural sensitivity in therapeutic approaches include psychological, biological, and social models. These models influence people's understanding and communication of their experiences with illness. In order to address the particular requirements of various groups, evidence-based psychotherapy modalities such as cognitive behavioural therapy, mindfulness-based interventions, and positive psychology therapies are explored in the context of cultural adaptation. Further research needs to be conducted to improve treatment efficacy and address the global problem of somatization with regard to culture-specific therapies. Mental health practitioners can better support people with somatic symptoms and advance holistic well-being across cultures by recognising and appreciating peculiarities of culture.