bluuebunny/crossref_metadata_2025 huggingface dataset:
Lung cancer screening: where do we stand?
Authors: Hardavella Georgia , Frille Armin , Sreter Katherina Bernadette , Atrafi Florence , Yousaf-Khan Uraujh , Beyaz Ferhat , Kyriakou Fotis , Bellou Elena , Mullin Monica L. , Janes Sam M.
Published: August 2024

Lung cancer screening (LCS) programmes have emerged over recent years around the world. LCS programmes present differences in delivery, inclusion criteria and resource allocation. On a national scale, only a few LCS programmes have been fully established, but more are anticipated to follow. Evidence has shown that, in combination with a low-dose chest computed tomography scan, smoking cessation should be offered as part of a LCS programme for improved patient outcomes. Promising tools in LCS include further refined risk prediction models, the use of biomarkers, artificial intelligence and radiomics. However, these tools require further study and clinical validation is required prior to routine implementation.
Hemoglobin homeostasis in abdominal aortic aneurysm: diagnostic and prognostic potential of hemoglobin/heme and scavenger molecules
Authors: Vats Sakshi , Sundquist Kristina , Grundberg Anton , Sundquist Jan , Wang Xiao , Zarrouk Moncef , Gottsäter Anders , Memon Ashfaque A
Published: August 2024

Background

There is increasing evidence implicating hemoglobin/heme and their scavengers in oxidative stress-mediated pathologies, but information is limited in abdominal aortic aneurysm (AAA).

Methods and results

In this case-control study, we assessed heme/heme-related markers in 142 men with AAA and 279 men with a normal aortic diameter consecutively recruited from an ultrasound screening program in Sweden. Enzyme-linked immunosorbent assays (ELISAs) were used to measure heme oxygenase-1 (HO-1) and hemopexin (Hpx) plasma levels, colorimetric assays for cell-free heme and whole blood hemoglobin (Hb) levels, and droplet digital PCR (ddPCR) and real-time PCR to determine haptoglobin (Hp) (pheno)type and genotype, respectively. Hpx and heme plasma levels at baseline were elevated, while HO-1 levels were lower in men with AAA (p < 0.001) and were significantly associated with AAA prevalence independently of potential confounders. A combination of heme and HO-1 showed the best diagnostic potential based on the area under the curve (AUC): 0.76, sensitivity: 80%, specificity: 48%. Additionally, when previously described inflammatory biomarker interleukin-6 (IL-6), was added to our model it significantly improved the diagnostic value (AUC: 0.87, sensitivity: 80%, specificity: 79%) compared to IL-6 alone (AUC: 0.73, sensitivity: 80%, specificity: 49%). Finally, Hb (positively) and Hpx (negatively) levels at baseline were associated with AAA growth rate (mm/year), and their combination showed the best prognostic value for discriminating fast and slow-growing AAA (AUC: 0.76, sensitivity: 80%, specificity: 62%).

Conclusions

This study reports the distinct disruption of heme and related markers in both the development and progression of AAA, underscoring their potential in aiding risk stratification and therapeutic strategies.
Developing a validated methodology for identifying clozapine treatment periods in electronic health records
Authors: Segev Aviv , Govind Risha , Oloyede Ebenezer , Morrin Hamilton , Jewell Amelia , Jones Rowena , Mangiaterra Laura , Bonora Stefano , Iqbal Ehtesham , Stewart Robert , Broadbent Matthew , MacCabe James H.
Published: August 2024

Background

Clozapine is the only recommended antipsychotic medication for individuals diagnosed with treatment-resistant schizophrenia. Unfortunately, its wider use is hindered by several possible adverse effects, some of which are rare but potentially life threatening. As such, there is a growing interest in studying clozapine use and safety in routinely collected healthcare data. However, previous attempts to characterise clozapine treatment have had low accuracy.

Aim

To develop a methodology for identifying clozapine treatment dates by combining several data sources and implement this on a large clinical database.

Methods

Non-identifiable electronic health records from a large mental health provider in London and a linked database from a national clozapine blood monitoring service were used to obtain information regarding patients' clozapine treatment status, blood tests and pharmacy dispensing records. A rule-based algorithm was developed to determine the dates of starting and stopping treatment based on these data, and more than 10% of the outcomes were validated by manual review of de-identified case note text.

Results

A total of 3,212 possible clozapine treatment periods were identified, of which 425 (13.2%) were excluded due to insufficient data to verify clozapine administration. Of the 2,787 treatments remaining, 1,902 (68.2%) had an identified start-date. On evaluation, the algorithm identified treatments with 96.4% accuracy; start dates were 96.2% accurate within 15 days, and end dates were 85.1% accurate within 30 days.

Conclusions

The algorithm produced a reliable database of clozapine treatment periods. Beyond underpinning future observational clozapine studies, we envisage it will facilitate similar implementations on additional large clinical databases worldwide.
Preventing overdoses involving stimulants: the POINTS study protocol
Authors: Hughto Jaclyn M. W. , Rich Josiah D. , Kelly Patrick J. A. , Vento Stephanie A. , Silcox Joseph , Noh Madeline , Pletta David R. , Erowid Earth , Erowid Fire , Green Traci C.
Published: August 2024

Background

In recent years, overdoses involving illicit cocaine, methamphetamine, and other stimulants have increased in the U.S. The unintentional consumption of stimulants containing illicit fentanyl is a major risk factor for overdoses, particularly in Massachusetts and Rhode Island. Understanding the drug use patterns and strategies used by people who use stimulants (PWUS) to prevent overdose is necessary to identify risk and protective factors for stimulant and opioid-involved overdoses. Mixed-methods research with people who distribute drugs (PWDD) can also provide critical information into the mechanisms through which fentanyl may enter the stimulant supply, and the testing of drug samples can further triangulate PWUS and PWDD perspectives regarding the potency and adulteration of the drug supply. These epidemiological methods can inform collaborative intervention development efforts with community leaders to identify feasible, acceptable, and scalable strategies to prevent fatal and non-fatal overdoses in high-risk communities.

Methods

Our overall objective is to reduce stimulant and opioid-involved overdoses in regions disproportionately affected by the overdose epidemic. To meet this long-term objective, we employ a multi-pronged approach to identify risk and protective factors for unintentional stimulant and opioid-involved overdoses among PWUS and use these findings to develop a package of locally tailored intervention strategies that can be swiftly implemented to prevent overdoses. Specifically, this study aims to [1] Carry out mixed-methods research with incarcerated and non-incarcerated people who use or distribute illicit stimulants to identify risk and protective factors for stimulant and opioid-involved overdoses; [2] Conduct drug checking to examine the presence and relative quantity of fentanyl and other adulterants in the stimulant supply; and [3] Convene a series of working groups with community stakeholders involved in primary and secondary overdose prevention in Massachusetts and Rhode Island to contextualize our mixed-methods findings and identify multilevel intervention strategies to prevent stimulant-involved overdoses.

Discussion

Completion of this study will yield a rich understanding of the social epidemiology of stimulant and opioid-involved overdoses in addition to community-derived intervention strategies that can be readily implemented and scaled to prevent such overdoses in two states disproportionately impacted by the opioid and overdose crises: Massachusetts and Rhode Island.
Prevalence and associated risk factors of stunting, wasting/thinness, and underweight among primary school children in Kandahar City, Afghanistan: a cross-sectional analytical study
Authors: Rahimi Bilal Ahmad , Khalid Aziz Ahmad , Lali Wais Mohammad , Khalid Wahid Ahmad , Rahimi Javed Ahmad , Taylor Walter R.
Published: August 2024

Background

Undernutrition, which includes stunting, wasting, and underweight, is a global problem, especially among children of low- and middle-income countries. To our knowledge, this study is first of its type from Afghanistan. Its main objectives were to estimate the prevalence and associated risk factors of stunting, wasting/thinness, and underweight among urban primary school children in Kandahar city of Afghanistan.

Methods

This school-based cross-sectional study was conducted among 1205 primary school children aged 6–12 years during a period of six months (October 2022–March 2023). Anthropometric measurements and other data were collected from all the participants. Data were analyzed by using descriptive statistics, Chi square test (using crude odds ratio or COR), and multivariate logistic regression (using adjusted odds ratio or AOR).

Results

Among the 1205 enrolled government school students, 47.4%, 19.5%, and 25.6% had stunting, wasting/thinness, and underweight, respectively. Statistically significant factors associated with stunting were age group 6–9 years (AOR 1.3, 95% CI 1.1–1.7), being girl (AOR 2.3, 95% CI 1.8–3.0), poverty (AOR 2.2, 95% CI 1.5–3.2), large family (AOR 3.0, 95% CI 2.4–3.9), illiterate mother (AOR 1.6, 95% CI 1.0–2.6), jobless head of the family (AOR 3.3, 95% CI 2.3–4.8), and skipping breakfasts (AOR 1.7, 95% CI 1.2–2.3). Main factor associated with wasting/thinness were age group 6–9 years (AOR 30.5, 95% CI 11.8–78.7), skipping breakfasts (AOR 22.9, 95% CI 13.9–37.8), and history of sickness during the past two weeks (AOR 17.0, 95% CI 6.6–43.8). Also, main factors associated with underweight were age group 6–9 years (AOR 2.6, 95% CI 1.6–4.1), skipping breakfasts (AOR 2.6, 95% CI 1.8–3.6), and poor sanitation (AOR 1.9, 95% CI 1.1–3.2).

Conclusions

Stunting, wasting/thinness, and underweight are highly prevalent among primary school children (both girls and boys) in Kandahar city. It is recommended that local government (Afghanistan Ministry of Education and Ministry of Public Health) with the help of international organizations and donor agencies should implement comprehensive school-based feeding programs especially for girls. Health and nutrition education programs should be conducted with emphasis on nutrition of children aged 6–9 years as well as importance of healthy breakfast and good sanitation.
MicroRNA mediated suppression of airway lactoperoxidase by TGF-β1 and cigarette smoke promotes airway inflammation
Authors: Santiago Maria J. , Chinnapaiyan Srinivasan , Panda Kingshuk , Rahman Md. Sohanur , Ghorai Suvankar , Lucas Joseph H. , Black Stephen M. , Rahman Irfan , Unwalla Hoshang J.
Published: August 2024

Transforming Growth Factor Beta1 (TGF-β1) signaling is upregulated in Chronic Obstructive Pulmonary disease (COPD), smokers, and people living with HIV. Cigarette smoking and HIV are also independent risk factors for COPD. Chronic inflammation is a hallmark of COPD. However, the underlying mechanisms remain unknown. Previous research has suggested that TGF-β1 alters the airway epithelial microRNAome and transcriptome, potentially contributing to lung inflammation. The Lactoperoxidase (LPO) system is an integral component of innate immunity within the airway. LPO plays a crucial role in host defense by catalyzing the oxidation of thiocyanate to hypothiocyanite in the presence of hydrogen peroxide (H2O2), generating a potent antibacterial and antiviral agent. Additionally, the LPO system potentially aids in maintaining cellular redox balance by reducing the levels of H2O2, thus mitigating oxidative stress within the airway epithelium. LPO dysfunction can impair immune responses and exacerbate inflammatory processes in respiratory diseases.

In this study, primary bronchial epithelial cells and bronchial cell lines were treated with TGF-β1 and exposed to cigarette smoke to characterize the effect of these factors on LPO and their downstream effects. RT-qPCR and Western Blot were applied to quantify mRNA and proteins’ expression. The levels of H2O2 were detected using the Amplex Red Assay. Magnetofection and transfection were applied to probe the effect of miR-449b-5p. Staining procedures using the MitoTracker Green and C12FDG dyes were used to establish mitochondria mass and senescence. The levels of pro-inflammatory cytokines were measured via Luminex assays.

We found that TGF-β1 and cigarette smoke suppressed airway LPO expression, increasing H2O2 levels. This increase in H2O2 had downstream effects on mitochondrial homeostasis, epithelial cellular senescence, and the pro-inflammatory cytokine response. We demonstrate for the first time that airway LPO is regulated by TGF-β1-induced miRNA-mediated post-transcriptional silencing through miR-449b-5p in the lungs. Further, we identify and validate miR-449-5p as the candidate miRNA upregulated by TGF-β1, which is involved in LPO suppression. This paper demonstrates a new mechanism by which TGF-β1 can lead to altered redox status in the airway.
Testing for finite variance with applications to vibration signals from rotating machines
Authors: Skowronek Katarzyna , Zimroz Radosław , Wyłomańska Agnieszka
Published: August 2024

In this paper we propose an algorithm for testing whether the independent observations come from finite-variance distribution. The preliminary knowledge about the data properties may be crucial for its further analysis and selection of the appropriate model. The idea of the testing procedure is based on the simple observation that the empirical cumulative even moment (ECEM) for data from finite-moments distribution tends to some constant whereas for data coming from heavy-tailed distribution, the ECEM exhibits irregular chaotic behavior. Based on this fact, in this paper we parameterize the regular/irregular behavior of the ECEM and construct a new test statistic. The efficiency of the testing procedure is verified for simulated data from three heavy-tailed distributions with possible finite and infinite variances. The effectiveness is analyzed for data represented in time domain. The simulation study is supported by analysis of real vibration signals from rotating machines. Here, the analyses are provided for data in both the time and time-frequency domains.
Maximum radial pattern matching for minimum star map identification
Authors: Fu Jingneng , Li Qiang , Lin Ling , Wei Honggang
Published: August 2024

This paper proposes an all-sky star map identification algorithm that can simultaneously achieve high identification probability, low algorithm complexity, and small databases for well photometric and intrinsic parameters-calibrated star sensors. The proposed algorithm includes three main steps. First, a binary radial pattern table is constructed offline. Then, the maximum value matching of the radial pattern is performed between the star spots and the guide stars, and the star pairs (i.e., the minimum star map) after radial pattern matching undergo a coarse matching through angular distance cross-validation. Finally, a reference star map is designed based on the identified star pairs, and the matching of all the star spots in the field of view is realized. Simulation and analysis results show that the database required by the proposed algorithm for 5,000 guide stars is not larger than 200 KB. Also, when false and missing star spots account for 50% of all guide stars and the star spot extraction error is 0.5 pixel (the corresponding pointing error is 26″), the average star map identification time of the proposed algorithm is less than 2 ms, and its identification probability is higher than 98%. The results demonstrate that the proposed algorithm performs better than similar algorithms.
Development of national specialization in 5G technologies within the European Union
Authors: Rastvortseva Svetlana , Kameneva Elena
Published: August 2024

Nowadays the efforts of not only companies, but also governments in different countries are aimed at the development of 5G technologies. On the one hand, the introduction of 5G is an expensive process that requires investments in the development, deployment and maintenance of infrastructure, the involvement of a large number of market participants and service providers, the creation of a stimulating and regulatory legislative framework, the provision of radio frequencies of a more efficient spectrum, the solution of patenting issues. On the other hand, the introduction of 5G technologies will be aimed at developing the economy of many industries, creating social benefits, reducing energy intensity, and will create new opportunities for companies. Currently, the benefits of the digital economy can be most used by the United States, the Republic of Korea and China, which have the highest rates of 5G adoption in the world. The countries of the European Union are also interested in the development of 5G technologies. We analysed key 5G technologies for 74,940 related patents for 23 EU countries for the period 2012–2021. It is shown that the leaders in the number of 5G patents were Sweden, Germany, Finland, France, the Netherlands and Ireland. It is noteworthy that countries can either focus on developing a small number of technologies, or develop a wide range of them. Since 2018, France, Estonia and Germany demonstrate the greatest number of technological specializations primarily creating inventions related to 5G data processing. At the same time, the USA, the Republic of Korea and China still retain their competitive advantages in fields of basic electric elements and electric communication technique for fifth generation networks. To improve positions in the global technology market the EU countries need to specialize in rarer and more complex technologies and develop national policies in this area.
Correlation between gut microbiota characteristics and non-small cell lung cancer based on macrogenomics sequencing
Authors: Zeng GuiLin , Zeng LiRong , Wang Ying , Cao Zhi , Zeng XiangHua , Xue ZhiHong , Liu ShiLan , Li YaMao , He Lang
Published: August 2024

Objective

Non-small cell lung cancer (NSCLC) patients undergoing chemotherapy and immunotherapy experience disturbances in the gut microbiota. This study intends to find out the correlation between gut microbiota and clinical indices before and after radiotherapy for NSCLC.

Methods

Ten patients with primary NSCLC were screened, and plasma and fecal samples were collected before and after radiotherapy, respectively. Inflammatory indices in plasma were detected. Genomic DNA was extracted from fecal specimens and sequenced on on Illumina HiSeq2000 sequencing platform. Thee sequenced data were subjected to Metagenome assembly, gene prediction, species annotation, and gene function analysis to study and analyze gut microbiota and metabolic functions. The correlation between the diversity of gut microbiota and the clinical indicators of NSCLC patients was evaluated, and the changes of gut microbiota before and after radiotherapy were observed.

Results

The diversity of gut microbiota in NSCLC patients did not correlate with smoking, pathology, and inflammatory markers. The abundance of phylum (p)_Bacteroidetes increased; p_Firmicutes and p_Bacteroidetes accounted for the highest proportion in NSCLC patients, and the abundance of both was dominantly exchanged after radiotherapy. There was a decrease in genus (g)_Bifidobacterium after radiotherapy in NSCLC patients. There was no significant correlation between the diversity of gut microbiota after radiotherapy and radiotherapy sensitivity, and the structural composition and abundance of gut microbiota remained stable.

Conclusion

The diversity of gut microbiota is altered after radiotherapy in NSCLC patients, showing an increase in harmful bacteria and a decrease in beneficial bacteria.
The celebrity effect on gaze following in older and young adults
Authors: Chen Airui , Yuan Zhaojun , Zhou Sihan , Yu Qingqing , Zhang Fangyuan , Dong Bo
Published: August 2024

Background

In daily life, people often follow others’ gaze direction to infer their attention and mental state. This phenomenon is known as gaze following.

Objective

This study aimed to explore whether gaze following in different age groups is influenced by celebrity identity.

Methods

We recruited 70 participants, including 35 older adults and 35 young adults. The experimental materials consisted of three faces with different identity information (a political leader, a movie star, and an ordinary person). Each face had left and right gaze conditions. Targets and cues were presented with both longer and shorter stimulus onset asynchrony (SOA) conditions.

Results

Both older adults and young adults exhibited similar gaze following behaviors. Importantly, the celebrity effect on gaze following was observed in both groups, with stronger effects induced by the leader’s and star’s gazes compared to the ordinary person’s gaze. Older adults showed a larger facilitation effect under the longer SOA condition compared to the shorter SOA, while no such SOA-related facilitation effect was found for young adults.

Conclusion

These findings suggest that older adults can integrate social information from others’ faces (celebrity identity) into the process of gaze following as effectively as young adults.
Lowering vector competence in insects: a review
Authors: Olagunju Emmanuel Ajibola
Published: August 2024

Background

Insects act as disease vectors, spreading disease-causing organisms between plants and animals. There have been studies devoted to determining ways to control these pests. One of the most effective ways to accomplish this is to reduce their vector competency. This review article explains how these factors can reduce vector competency.

Main body

The major ways by which vector competence can be reduced were reviewed. Entomopathogens are organisms that cause disease in arthropods like insects, mites, and ticks. Wolbachia is a genus of intracellular bacteria that mostly infects arthropods, including a significant number of insects. It is one of the most frequent insect reproductive parasites that kill or severely disables insects. Entomopathogenic nematodes are a type of worm that attacks insects and kills them. Insect-specific viruses are a relatively new class of viruses with a variety of intriguing traits that could be used to better understand and possibly inhibit arbovirus transmission. Entomopathogenic fungi are a type of fungus that kills insects by attacking and infecting their insect hosts. Disrupting the environment and nutrition of insects could also help to reduce their ability to spread diseases to humans, animals, and plants.

Conclusions

Chemical control has been one of the most widely used methods for controlling disease vectors, but there have been reports of insect resistance, environmental degradation, and a variety of other side effects. Instead of chemical control, there are a variety of techniques that can be used, including targeting insects' endosymbionts (bacteria, viruses, fungi, nematodes, and protozoa), changing insects' nutrition, manipulating their environment, and many others. This paper discussed the alternative ways to reduce vectors’ competence without the use of synthetic chemical.
Effect of nano-fluorapatite filler particles on surface microhardness and mineralization capacity of an experimental oral film
Authors: Zaki Dalia Y. , Safwat Engie M. , Salem Haidy N. , Nagi Shaymaa M. , Hamdy Tamer M. , Moharam Lamiaa M. , Hassan Mohammad L. , Sherief Marwa A.
Published: August 2024

Background

The objective of the study was to prepare and assess novel remineralizing oral films loaded with fluorapatite powder and composed of a combination of hydroxyethyl cellulose (HC) and cellulose nanofibers (CF).

Methods

Three concentrations of the prepared nano-fluorapatite were tried and tested after loading in the cellulose blends and films were prepared using solvent cast technique. Along with SEM, measurements of thickness of film, bending tolerance, time of disintegration, surface pH and release of ions were made. The produced film’s ability to remineralize demineralized teeth in vitro was investigated.

Results

The findings showed that the films’ thicknesses were uniform, their folding endurance exceeded 300, and their disintegration times exceeded 24 h. High amounts of fluoride and calcium ions were released, and nearly neutral pH values were observed. The distribution of fluorapatite powder particles was uniform, as demonstrated by SEM. The Vickers microhardness (VHN) of enamel and morphological analysis results showed that in comparison with the demineralized specimens, there was a substantial microhardness value increase following 15 and 30 days remineralization.

Conclusions

Newly developed prepared films are a successful method for remineralizing early-stage demineralized tooth lesions.
How bureaucracies interact with Indigenous Fire Stewardship (IFS): a conceptual framework
Authors: Nikolakis William , Ross Russell Myers , Steffensen Victor
Published: August 2024

Background

Indigenous Fire Stewardship (IFS) is contested within settler-colonial contexts, where its development is shaped by complex and dynamic socio-cultural, legal, and political factors. This manuscript draws from the policy sciences to sketch out a “zone of interaction” between IFS and the state’s wildfire policy system. Drawing from the strategies of bureaucracies, our goal is to illustrate the patterns in this “zone of interaction,” and to identify the implications for IFS, as well as for Indigenous Peoples and landscapes.

Results

Drawing insights from the Australian and Canadian contexts where governments are restoring lands and reconciling with the laws and governance of Indigenous Peoples, we illustrate how IFS interacts with the state. We do this in two ways. Figure 1 shows that the state has three general strategies for dealing with IFS: avoidance (ignoring IFS), coping strategies (carefully considering and sometimes accommodating IFS), and learning (embracing and accommodating IFS). We document that post-wildfire, there are affective drivers that move the state’s approach from avoidance to learning; however, over time, as public attention shifts away from alternatives, the strategy moves back to either avoidance or coping strategies (where the state is required to engage with IFS, but cannot fully embrace it because of institutional, tenure, or jurisdictional issues, among other constraints). Figure 2 documents the six coping strategies available to bureaucracies in dealing with IFS, which either institutionalize, partially institutionalize, or do not institutionalize IFS. Each of these pathways has implications for IFS, and the manuscript details the effects on IFS practices, and the impacts for people and landscapes.

Conclusions

To better support IFS, we must look beyond the institutionalization of IFS within the state, and nest IFS within Indigenous laws and governance. An Indigenous-led IFS approach can operate in parallel with the state, and develop innovative land-access arrangements and Tribal Parks to apply IFS to landscapes. New structures of engagement must be designed for this parallel space, grounded in the principle of free prior and informed consent (FPIC), and with explicit focus on deconstructing power differences.
Metadata recommendations for light logging and dosimetry datasets
Authors: Spitschan Manuel , Hammad Grégory , Blume Christine , Schmidt Christina , Skene Debra J. , Wulff Katharina , Santhi Nayantara , Zauner Johannes , Münch Mirjam
Published: August 2024

Background

Light exposure significantly impacts human health, regulating our circadian clock, sleep–wake cycle and other physiological processes. With the emergence of wearable light loggers and dosimeters, research on real-world light exposure effects is growing. There is a critical need to standardize data collection and documentation across studies.

Results

This article proposes a new metadata descriptor designed to capture crucial information within personalized light exposure datasets collected with wearable light loggers and dosimeters. The descriptor, developed collaboratively by international experts, has a modular structure for future expansion and customization. It covers four key domains: study design, participant characteristics, dataset details, and device specifications. Each domain includes specific metadata fields for comprehensive documentation. The user-friendly descriptor is available in JSON format. A web interface simplifies generating compliant JSON files for broad accessibility. Version control allows for future improvements.

Conclusions

Our metadata descriptor empowers researchers to enhance the quality and value of their light dosimetry datasets by making them FAIR (findable, accessible, interoperable and reusable). Ultimately, its adoption will advance our understanding of how light exposure affects human physiology and behaviour in real-world settings.
Is bipolar mixed depression associated with a good response to psychotropic augmentation?
Authors: Rihmer Z.
Published: August 2024

Is bipolar mixed depression associated with a good response to psychotropic augmentation? Zoltán Rihmer Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest and at the National Institute of Mental Helath, Neurology and Neurosurgery, Budapest, Hungary.

Introduction

Suboptimal response to antidepressant pharmacotherapy (nonresponse or partial response but no remisson) is the most challenging issue in the treatment of depressive disorders. Open and controlled clinical studies show that augmentation of the given antidepressant with lithium, atypical antipsychotics, antiepileptics and thyroid hormones are effective in 30-40% in such cases.

Objectives

To explore the possiblity wether bipolar mixed depression is the ideal subject of good response to psychotroic augmentation.

Method

Literature review.

Results

Studies consistently indicate that in contrast to unipolar MDE (=MDD) the rate of antidepressant-resistant depression is higher not only in bipolar I and II depression but also in MDE with subthreshold bipolarity (bipolar mixed depression). However, lithium, atypical antipsychotic and antiepileptic (but not thyroid) augmentation works much better in bipolar depression and in unipolar MDE with subthreshold bipolarity (mixed depression) tjan in unipolar MDE without subthreshold bipolar features. In addition to this, almost all clinical predictors of good response to lithium/atypical antipsychotics/antiepileptics are classical bipolar markers (familial bipolarity, eraly onset, intradepressive hypomanic symptoms, agitation, cyclothymic tempermanent, shorter episodes, more than three depressive episodes, and suicidality).

Conclusion

Considering that lithium, atyipcal antipsychotics and antiepileptics, but not thyroid stimulating drugs have more and less antimanic effect, these results suggst that tretating intradecpressive hypomanic symptoms in bipolar mixed depression is a new (if not the only) explanation among the several previously proposed mechanisms of action of successful psychotropic augmentation of antidepressants in patients with MDE.

Disclosure of Interest

None Declared
Prevalence of Low Self-Esteem Among Patients Treated in the Craniofacial Surgery Department of an international Reference Hospital
Authors: Pereira Bernd G. , Dall Agnol Bouvier V. , Brusa da Costa Linn T. , Cho de Almeida I. , de Oliveira de Marchi B. , Guinter Muccillo L. , Menezes Chaves Barcellos C. G. , Paz Portinho C. , Martins Collares M. V. , Ribas Leite R.
Published: August 2024

Introduction

Craniofacial surgery is a specialized field that addresses congenital and acquired deformities of the head and face. While the physical outcomes of craniofacial surgery are well-documented, less attention has been given to the psychological well-being of adult patients. This abstract aims to explore self-esteem issues among adult patients treated at the Craniofacial Surgery Sector of HCPA (Hospital de Clínicas de Porto Alegre), where a substantial proportion of adult patients have reported self-esteem problems.

Objectives

1.

To assess the prevalence of self-esteem issues among adult patients (≥18 years old) attending the HCPA Craniofacial Surgery Sector.

2.

To examine potential contributing factors to self-esteem problems in this specific patient population.

3.

To evaluate the impact of self-esteem on the mental health and psychosocial functioning of adult craniofacial surgery patients.

4.

To propose recommendations for psychosocial support and intervention strategies tailored to the needs of adult patients in this context.

Methods

This cross-sectional study involved 132 adult patients who had undergone or were scheduled for craniofacial surgery at HCPA. Participants reported self-esteem issues in their talk with the hospital’s physicians, and their medical records were reviewed to collect demographic and clinical data. Additionally, participants provided information about their mental health status and psychosocial functioning.

Results

Among the 39 adult patients included in the study, 37 (94.9%) reported experiencing self-esteem issues, such as lack of confidence or feeling unattractive. The most commonly reported contributing factors were visible facial differences, social interactions, and prior surgical experiences. Patients with lower self-esteem had a higher likelihood of reporting symptoms of depression and anxiety and reported lower overall psychosocial functioning compared to those with higher self-esteem.

Conclusions

This reveals a strikingly high prevalence of self-esteem issues among adult patients attending the Craniofacial Surgery Sector at HCPA. These findings underscore the importance of recognizing and addressing the psychological well-being of adult craniofacial surgery patients. Comprehensive psychosocial support, including counseling, peer support, and interventions to enhance self-esteem, should be integrated into the care of these patients. By addressing self-esteem concerns, healthcare providers can improve the mental health and overall quality of life of adult craniofacial surgery patients.

Disclosure of Interest

None Declared
The emergence of new obsessions and compulsions after COVID-19: a case report
Authors: Abdelkefi M. , Feki R. , Gassara I. , Smaoui N. , Omri S. , Charfi N. , Zouari L. , Ben Thabet J. , Maalej Bouali M. , Maalej M.
Published: August 2024

Introduction

The coronavirus pandemic has affected mental health since its outbreak in 2019 and several studies have revealed that obsessive-compulsive disorder (OCD) patients were adversely affected.

Objectives

The aim of our present report is to study the impact of the coronavirus infection on OCD.

Methods

We illustrate a case of new emerging obsessions and compulsions after a COVID-19 infection in a patient consulting at the Psychiatry C department of the Hedi Chaker University Hospital.

Results

Mr. HB first presented in our outpatient unit of the Psychiatry C department at the age of 32. His medical history was unremarkable except for a COVID-19 infection in June 2022 that did not cause any organic complications. His family history was negative without neurological and psychiatric diseases. Further history revealed that OCD symptoms already started before his infection with COVID-19. At that time, he suffered from compulsions with the urge to constantly wash his hands and check rituals, but his symptoms were not severe enough to make him seek a psychiatric consult or treatment. However, since July 2022, soon after his infection with COVID-19, he suffered from new obsessions and compulsions, he would spend hours calculating all the numbers he sees and counting the number of letters in the words he came across. Non-surprisingly, OCD symptoms caused relevant problems in social life, and at work, he had difficulties concentrating and working. Due to his symptoms, he had neglected hobbies, avoided social contact, spent less time with his family, and even had suicidal thoughts. Therefore, pharmacotherapy with clomipramine was initiated with a maximal dose of 150 mg/d. Because of adverse events and lack of efficacy, he stopped medication and decided to consult our department to seek a different treatment. Therefore, sertraline was started at the dose of 50 mg/d along with psychotherapy.

Conclusions

People with OCD are likely to be more susceptible to the mental health impact of COVID-19. Responses to the pandemic are not only associated with an increase in all Obsessive-Compulsive (OC) symptoms and their severity but also the emergence of new types of obsessions and compulsions. Consequently, therapists should consider the effects of the pandemic on all OC symptom dimensions and adjust their treatment plans accordingly.

Disclosure of Interest

None Declared
The fundamental beliefs held by individuals living with HIV and university students during the challenges posed by the second wave of the COVID-19 pandemic in Russia
Authors: Titova V. V. , Rozhdestvenskiy V. I. , Gorkovaya I. A. , Ivanov D. O. , Aleksandrovich Y. S.
Published: August 2024

Introduction

Baseline beliefs, as conceptualized by R. Janoff-Bulman in her cognitive theory of mental trauma, represent an inherent internal framework that shapes how individuals perceive and assess traumatic events. It is widely acknowledged that the pandemic has had a profound impact on the global economy and the living conditions of individuals. Consequently, it is reasonable to assume that during a pandemic, one’s ability to adapt to these altered circumstances is influenced by their foundational beliefs. Consequently, exploring these fundamental beliefs in two at-risk groups, namely university students and individuals with confirmed HIV, becomes a subject of significant interest.

Objectives

This study aims to examine the fundamental beliefs of patients with HIV and university students in the context of the second wave of the new coronavirus pandemic in Russia.

Methods

Data collection took place from January to July 2021 using a custom-developed Google form. The study involved 35 Russian university students majoring in humanities and 59 HIV-positive patients. We employed the WAS-37 methodology, adapted for use in Russia, to assess their baseline beliefs.

Results

We found that on the scales “Fairness” (M = 21.00±3.73 - students, M = 20.53±4.63 - patients, p = 0.616), “Luck” (M = 31.74±5.06 vs M = 29.59±7.33, p = 0.129) and “Control beliefs” (M = 26.66±4.80 vs M = 27.12±4.42, p = 0.636) students did not differ from patients. Scores on the Environment Benevolence scale were higher in students (M = 35.46±7.33 vs M = 30.50±7.09, p = 0.002) and on the Self Image scale were higher in HIV patients (M = 26.63±6.97 vs M = 30.03±5.41, p = 0.010).

Conclusions

During the latter stages of the COVID-19 pandemic in Russia, individuals living with HIV, when compared to students, tended to perceive the world around them as being more perilous and unfriendly, while simultaneously viewing themselves as possessing greater integrity. From our perspective, this latter observation could be interpreted as a means of self-defence against the perceived hostility of the external world. In such pandemic circumstances, it may be advisable to consider the use of supportive psychotherapy for individuals living with HIV.

Disclosure of Interest

None Declared
The connection between professional burnout of medical workers and the self-help methods during the COVID-19 pandemic
Authors: Deshchenko E. V. , Koniukhovskaia J. E. , Stepanova O. B. , Shishkova I. M. , Pervichko E. I. , Mitina O. V. , Irgashev N. R.
Published: August 2024

Introduction

Many medical workers suffered from severe professional burnout while working in the conditions of the COVID-19 pandemic, but few of them had the opportunity to find psychological help.

Objectives

The aim of the research was to study the relationship between emotional burnout and self-help strategies in medical professionals during the pandemic.

Methods

The Maslach Burnout Inventory (MBI) was used to measure the level of professional burnout. It was filled out by medical workers from January 2021 to November 2022.

The sample consisted of 314 medical workers (57 men and 255 women), whose average age was 36.97±11.93. According to the level of education, the sample included specialists with secondary general education (4.14%), with secondary special education (19.4%), with incomplete higher education (11.46%), with higher education (59.87%) and PhD (5.1%). 35 people (11%) of the surveyed medical workers worked in the red zone.

Results

When medical workers experience severe Emotional Exhaustion and Depersonalization, they often try to help themselves by drinking alcohol (r=0.156; p=0.005; r=0.184; p=0.001), eating (r=0.227; p=0.000; r=0.151; p=0.007), taking medications (r=0.204; p=0.000; r=0.212; p=0.005), solitude (r=0.204; p=0.000; r=0.133; p=0.019), watching TV series (r=0.173; p=0.002; r=0.146; p=0.01). With an increase in the Reduction of professional skills, medical workers also eat more (r=-0.148; p=0.009) and try to learn something new, engage in self-development (r=-0.137; p=0.015). It is important to note that the desire to seek psychological help is associated only with Emotional Exhaustion (r=0.121, p=0.032), that is, he/she may be aware at an early stage of professional burnout, when the symptoms of depersonalization and reduction of professional skills have not yet occurred.

Conclusions

Thus, all the considered self-help methods are already used with pronounced symptoms of professional burnout, but do not lead to its pronounced decrease. It is important to note that seeking psychological help is possible with awareness of emotional exhaustion, but not with depersonalization and reduction of professional skills.

Disclosure: Research is supported by the Russian Science Foundation, project No. 21-18-00624.

Disclosure of Interest

None Declared
Hematological impact of COVID-19 mRNA vaccination in patients treated with Clozapine
Authors: Touiti A. , Yaich I. , Ben Said C. , Bram N.
Published: August 2024

Introduction

Clozapine is an atypical antipsychotic that is primarily prescribed for treatment-resistant schizophrenia. Despite its proven efficacy, the prescription of clozapine is sometimes limited by its hematologic side effects, including agranulocytosis. During the SARS-CoV-2 pandemic, schizophrenia is recognized as a risk factor for developing severe forms of the infection. Early and complete vaccination of patients has been recommended. However, there is limited data on the effect of the vaccine on the risk of hematologic abnormalities in patients treated with clozapine.

Objectives

To study the hematologic effect of the mRNA vaccine against COVID-19 in a population of patients with treatment-resistant schizophrenia treated with clozapine.

Methods

Twenty-five patients hospitalized for schizophrenia at the forensic psychiatry department of Razi Hospital in Manouba, Tunisia, were included. Eighteen patients were treated with clozapine, and seven patients were treated with other antipsychotics. Consent from patients and/or their relatives was obtained before vaccination. The results of complete blood counts performed as part of the therapeutic protocol were compared between the two groups before and after administration of the vaccine.

Results

No patient experienced agranulocytosis induced by clozapine after vaccination against COVID-19.Blood cells counts,red blood cells counts,and platelets were within the normal ranges.However,a decrease in the number of WBCs,neutrophils,and lymphocytes was observed in patients treated with clozapine without significant difference compared to the patients treated with other neuroleptics, but there was no severe neutropenia or need to stop treatment.

Conclusions

The prescription of clozapine, the introduction protocol, and treatment administration have been greatly influenced by the COVID-19 pandemic due to the hepatotoxic risk of the drug. Vaccination is essential to prevent severe forms of the infection, especially in at-risk populations such as patients treated for schizophrenia.The potentiation of hematologic side effects induced by clozapine by the vaccine is not documented.The COVID-19 mRNA vaccine is safe even with clozapine

Disclosure of Interest

None Declared
Atypical case of anterograde amnesia after cerebral infarction and anti-NMDA encephalitis post Covid 19 infection: A complex clinical case
Authors: Gebele M.
Published: August 2024

Introduction

Only a few cases of primary anterograde amnesia with confabulation after severe complex brain damage have been described in the literature.

Objectives

To describe a case of anterograde amnesia with confabulation in a patient with severe and extensive brain damage.

Methods

case report

Results

Case presentation: A 48-year-old male patient with a medical history of diabetes mellitus type II, hypertension, presented to a psychiatric clinic for the first time. He was admitted to the hospital due to the manifestation of disruptive aggressive behaviour, aimless wandering, and excessive, impulsive expenditure of financial resources. At the time of hospitalization and during the hospital stay, the patient exhibited a state of elevated mood and anterograde amnesia compounded by the presence of prominent confabulation, easily irritable mood with a tendency to conflict. No physical limitations.

Background: The patient is an active long-distance driver for 15 years. A year before hospitalization in psychiatric clinic, he was travelling to Moscow, he had episode of headache and unconsciousness after which hospitalization. Diagnosed with multiple infarcts of embolic origin in the right frontal lobes, both cortical and subcortical, on the right side at the level of the uncus, in the medial anterior parts of the right occipital lobe, on the left side in the insula and at the level of the capsula externa, in the anterior basal part of the left temporal lobe. After hemodynamic stabilization, he was repatriated to Latvia. Stationary positive SARS-CoV-2 PCR, O2 support therapy required.

The patient develops auditory and visual hallucinations, which do not correct on antipsychotic therapy. Lumbar puncture was performed, which showed positive anti-NMDA antibodies, magnetic resonance - autoimmune limbic encephalitis with damage to the gyrus cinguli of the insula cortex of both temporal lobes and the right subfrontal part with spread throughout the right temporal lobe, bilaterally in the mediobasal structures of the temporal lobes and the right thalamus with progressive changes. The patient receives immunomodulatory therapy, plasma exchange and immune globulin. Hallucinations decrease on the background of therapy. At discharge - moderate ataxia in the legs, disorientation in time, severe short-term memory disorders.

The patient in his mind lives like nothing has happened and the same life continues.

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Conclusions

The long-term prognosis for the patient remains uncertain, given the multifaceted nature of the condition and the extent of brain damage. Continuous monitoring, rehabilitation, and ongoing support will be essential to assess cognitive recovery and improve the patient’s quality of life.

Disclosure of Interest

None Declared