bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative genomic analysis of Flavobacteriaceae: insights into carbohydrate metabolism, gliding motility and secondary metabolite biosynthesis.
Authors: Gavriilidou Asimenia , Gutleben Johanna , Versluis Dennis , Forgiarini Francesca , Passel Mark WJ van , Ingham Colin J , Smidt Hauke , Sipkema Detmer
Published: March 2020

BackgroundMembers of the bacterial family Flavobacteriaceae are widely distributed in the marine environment and often found associated with algae, fish, detritus or marine invertebrates. Yet, little is known about the characteristics that drive their ubiquity in diverse ecological niches. Here, we provide an overview of functional traits common to taxonomically diverse members of the family Flavobacteriaceae from different environmental sources, with a focus on the Marine clade. We include seven newly sequenced marine sponge-derived strains that were also tested for gliding motility and antimicrobial activity. ResultsComparative genomics revealed that genome similarities appeared to be correlated to 16S rRNA gene phylogeny, while differences were mostly associated with nutrient acquisition, such as carbohydrate metabolism and gliding motility. The high frequency and diversity of genes encoding polymer-degrading enzymes support the capacity of marine Flavobacteriaceae to utilize diverse carbon sources. Homologs of gliding proteins were widespread among all studied Flavobacteriaceae in contrast to members of other phyla, highlighting the particular presence of this feature within the Bacteroidetes. Notably, not all gliding bacteria formed spreading colonies. Genome mining uncovered a diverse secondary metabolite biosynthesis arsenal of Flavobacteriaceae with high prevalence of gene clusters encoding pathways for the production of antimicrobial, antioxidant and cytotoxic compounds. Antimicrobial activity tests showed, however, that the phenotype differed from the genome-derived predictions for the seven tested strains.ConclusionsOur study elucidates the functional repertoire of marine Flavobacteriaceae and highlights the need to combine genomic and experimental data while using the appropriate stimuli to unlock their uncharted metabolic potential.
Comparative genomic analysis of Bacillus mycoides Gnyt1 strain
Authors: Xiaomei Yang , Yao Tuo
Published: March 2020

This study focused on the comparative genomic analyses of five carrying Bacillus strains which might give us insights on the difference and similarity in the genomic evolutionary kinships and contexts of Bacillus mycoides Gnyt1.Comparative genomic analyses of the carrying Bacillus strains genomes with emphasis on their antimicrobial resistance genes and virulence factors were performed.Most nitrogen-fixing genes and the phosphate-dissolving genes of the comparative genomic strain existed and the gene type was significantly different. And the action to nitrogen-fixing gene and phosphate-dissolving gene are dependent on different genes. Sharing some adherence, similarity, and the Bacillus mycoides strain Gnyt1 developed evolution is consistent with other Bacillus. Related functions absorb different gene-specific acquisitions, pigments, proteases, regulatory, secretory systems and functional factors associated with nitrogen-fixing phosphorus.Sharing most 16S rDNA analysis, Mauve-based genome-wide, Gene family analysis and phylogenetic tree, the Bacillus strain Gnyt1 and Bacillus mycoides strain AH621 differ in composition gene expression and expression cause conditions and factors.
Knowledge and Attitudes Towards Contraceptives Among Adolescents and Young Adults
Authors: Sharma Aanchal , McCabe Edward , Jani Sona , Gonzalez Anthony , Demissie Seleshi , Lee April
Published: March 2020

Background : Despite endorsements supporting the use of intrauterine devices (IUDs) for adolescents and young adult women (AYA), they have limited knowledge about them Male partners can influence contraceptive decisions, however their perceived knowledge about IUDs is lower than their objective knowledge. We aim to establish current AYA baseline contraceptive knowledge and attitudes so providers can better target their sexual health educational interventions.Methods Females and males, aged 13- 23, from our suburban adolescent clinic, completed an anonymous survey that assessed their knowledge and attitudes towards methods of contraception, with an emphasis on the IUD.Results Completed surveys totaled 130 (99 females/31 males). Demographics: Black/African-American (31.3%), Latino/Hispanic (30.5%), White (17.6%), Asian (3%), and Other (14.5%). 80% of participants were sexually active. 69.5% stated they/their partner were currently using a contraceptive method; only 2.6% used IUDs. 56.6% of females and 10.1% of males had heard of IUDs. Despite this, male and female participants lacked knowledge regarding specific IUD facts. 6.4% who had used EC knew the copper IUD could be used for EC.Conclusion: Contraceptive knowledge deficits, especially regarding the IUD, continue to exist for AYA patients. Many participants stated they required EC despite “satisfaction” with their birth control method and most were unaware that the copper IUD could be used as EC. These discrepancies highlight the importance of comprehensive contraceptive education for AYA patients. Enhanced and consistent contraceptive options counseling can help providers ensure that their AYA patients make well-informed decisions about family planning, thus improving their quality of life.
Associations Between I/ D polymorphism in the ACE gene and lung cancer: an updated systematic review and a meta-analysis
Authors: Xu Junping , Tong Xiang
Published: March 2020

Objectives Previous studies have shown that the insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme (ACE) gene was associated with lung cancer susceptibility, but there have been conflicts in previously reported results. Therefore, this study has evaluated the association between the I/D polymorphism in the ACE gene and lung cancer risk by constructing a meta-analysis. Methods The study was performed in Web of Science, Pubmed, Cochrane Library, Embase, China Nationa Knowledge Infrastructure (CNKI) electronic database, covering relevant studies published until June 31, 2019. The heterogeneity in the study was tested by the Q-test and I2, and then the random ratio or fixed effect was utilized to merge the odds ratios (OR) and 95% confidence interval (CI). To estimate the strength of the association between ACE polymorphisms and susceptibility to lung cancer. We have performed Sensitivity analysis. Using funnel plot and begger’s regression test investigated the publication bias. All data Statistical analyses were performed using Stata 12.0 and Revman 5.3. Results A total of 4307 participants (2181 patients; 2126 controls) were included in twelve case-control studies selected. No significant association was found between the ACE I/D polymorphism and lung cancer risks (II vs ID + DD: OR = 1.22, 95% CI = 0.89–1.68; II + ID vs DD: OR = 1.21, 95% CI = 0.90–1.63; I vs D: OR =1.15, 95% CI = 0.95–1.39). In the subgroup analysis by ethnicity, no significant association between this polymorphism and lung cancer risks was also found among Asia and Caucasian populations for the comparison of II vs ID + DD, II + ID vs DD and I vs D genetic models. Conclusion Our study indicated that the ACE I/D polymorphism was not associated with the risk of lung cancer.
Auto titrating versus fixed EPAP intelligent volume-assured pressure support (iVAPS) Ventilation in Patients with COPD and Hypercapnic Respiratory Failure
Authors: Magdy Doaa Mohamed , Metwally Ahmed Metwally
Published: March 2020

Intelligent volume-assured pressure support (iVAPS) is new noninvasive ventilation (NIV) modes can automatically adjust pressure support to deliver effective ventilation.The objectives are to compare treatment efficacy and level of satisfaction between auto-titrating expiratory positive airway pressure (Auto EPAP) and fixed (Fixed-EPAP) during (iVAPS) treatment in stable hypercapnic chronic obstructive pulmonary disease (COPD) patients.Patients & methods:In this prospective single-blinded, randomized study, 50 patients with chronic stable hypercapnic (COPD) who met the study criteria; patients were randomized into group I treated with Auto-EPAP and group II who received Fixed EPAP during iVAPS treatment for 5 consecutive days. Patient's characteristics, Arterial blood gases, and lung function test were recorded. Numeric rating scale (NRS), dyspnea and comfort scale were obtained. The patients were evaluated and followed up after initiating therapy for 5 consecutive days. Outcome measures were recorded at baseline (T0) and after three (T1) and five (T2) days of each consecutive period. All parameters were collected and statistically analyzed.Results: No significant differences were found regarding age, sex, and BMI. It was noted that daytime PaCO2 decreased significantly over the follow-up period in group I patients treated with (Auto-EPAP) as compared with (Fixed EPAP). Regarding patient comfort and dyspnea during iVAPS treatment, dyspnea sensation was significantly lower with Auto –EPAP (7.9±1.8 (T0) vs. 3.5±1.1 (T2), p-=0.001) and Fixed – EPAP (7.7±1.9 (T0) vs. 3.4±1.6 (T2), p=0.001), but no significance was reached between both groups. However, Auto EPAP demonstrated significant improvement in comfort when compared with Fixed-EPAP modality. However, the overall satisfaction in patients receiving Auto EPAP modality was significantly increased. Mean tidal volume tended to be higher in Auto EPAP (698±213 ml) compared with (628±178 ml) in fixed EPAP (P =0.001*). The air leak was significantly lower in auto adjusting mode (2.5 ± 1.3 vs.3.7 ± 2.2 L/ min) in fixed EPAP modality.Conclusion: This new auto-titrating NIV mode may provide additional benefit in decreasing PaCO2 more efficiently and improve patient ̍s comfort and satisfaction.
Plasmodium falciparum histidine-rich protein 2 (PfHRP2) diversity in Ghana
Authors: Addai-Mensah Otchere , Dinko Bismarck , Noagbe Mark , Ameke Selassie Louis , Annani-Akollor Max Efui , Owiredu Eddie-Williams , Mensah Kofi , Tackie Richmond , Togbe Eliezer , Agyare-Kwabi Comfort , Gyasi Charles , Adu-Gyamfi Constance , Debrah Alexander Yaw
Published: March 2020

Background: In the absence of microscopy, Plasmodium falciparum histidine-rich proteins 2 (PfHRP2)-based rapid diagnostic tests (RDTs) are recommended for the diagnosis of falciparum malaria, particularly in endemic regions. However, genetic variability of the PfHRP2 gene threatens the usefulness of the test. This study aimed to investigate the diversity of PfHRP2 in malaria cases among children in Ghana.Methods: A cross-sectional study was conducted at the Adidome Government Hospital in the Volta Region of Ghana. A total of 50 children with mean age of 6.6±3.5 years and diagnosed of falciparum malaria were included. Blood samples were collected for complete blood count, malaria parasite identification and counting. DNA samples were amplified and sequenced. Nucleotide sequences were translated in silico to corresponding amino acids and the deduced amino acids sequences were analyzed for diversity.Results: The number of repeats and number of each repeat within PfHRP2 varied between isolates. Twelve rare PfHRP2 repeat types, two of which are previously unreported, were identified in this study. Our HRP2 sequence shared high similarity with isolates from Kenya. Using Baker’s regression model, Group B was the highest occurring type (58.0%). Screening of all sequences for epitopes recognized by PfHRP2-specific monoclonal antibodies (mAbs), we found the predominant motif to be AHHAADAHH, which is recognized by the C1-13 mAbs.Conclusion: This study reports diversity of P. falciparum histidine-rich proteins 2 in samples from Ghanaian children with symptomatic malaria. We highlight the existence of extra amino acid repeat types which adds to the PfHRP2 antigenic variability. The findings of this study will contribute to the understanding of the performance of PfHRP2-based RDTs in the Ghanaian setting.
Transgelin interacts with PARP1 and affects Rho signaling pathway in human colon cancer cells
Authors: Lew Zhen-xian , Zhou Hui-min , Fang Yuan-yuan , Ye Zhen , Zhong Wa , Yang Xin-yi , Yu Zhong , Chen Dan-yu , Luo Si-min , Chen Li-fei , Lin Ying
Published: March 2020

Background: Transgelin, an actin-binding protein, is associated with the cytoskeleton remodeling. Our previous studies found that transgelin was up-regulated in node-positive colorectal cancer versus in node-negative disease. Over-expression of TAGLN affected the expression of 256 downstream transcripts and increased the metastatic potential of colon cancer cells in vitro and in vivo. This study aims to explore the mechanisms that transgelin participates in the metastasis of colon cancer cells.Methods: Immunofluorescence and immunoblotting analysis were used to determine the cellular localization of the endogenous and exogenous transgelin in colon cancer cells. Co-immunoprecipitation and subsequent high performance liquid chromatography/tandem mass spectrometry were performed to identify the proteins potentially interacting with transgelin. Bioinformatics methods were used to analyze the 256 downstream transcripts regulated by transgelin to discriminate the specific key genes and signaling pathways. By analyzing the promoter region of these key genes, GCBI tools were used to predict the potential transcription factor(s) for these genes. The predicted transcription factors were matching to the proteins that have been identified to potentially interact with transgelin. The interaction between transgelin and these transcription factors was verified by co-immunoprecipitation and immunoblotting.Results: Transgelin was found to localize both in the cytoplasm and the nucleus of colon cancer cells. 297 proteins have been identified to interact with transgelin by co-immunoprecipitation and subsequent high performance liquid chromatography/mass spectrometry. Over-expression of TAGLN could lead to differential expression of 184 downstream genes. By constructing the network of gene-encoded proteins, 7 genes (CALM1, MYO1F, NCKIPSD, PLK4, RAC1, WAS and WIPF1) have been discriminated as key genes using network topology analysis. They are mostly involved in the Rho signaling pathway. Poly ADP-ribose polymerase-1 (PARP1) was predicted as the unique transcription factor for the key genes and concurrently matching to the DNA-binding proteins potentially interacting with transgelin. Immunoprecipitation validated that PARP1 interacted with transgelin in human RKO colon cancer cells.Conclusions: The results of this study suggest that transgelin binds to PARP1 and regulates the expression of the downstream key genes mainly involving Rho signaling pathway, thus participates in the metastasis of colon cancer.
Perspectives from a Psychiatric outpatient Service for Immigrants and Refugees in São Paulo, Brazil in a 15 year period.
Authors: Carvalho Luciana de Andrade , Andrade Laura Helena , Ang Patrícia Lin , Santana Carmen Lucia de Albuquerque , Albertin Paula de Vries , Neto Francisco Lotufo , Junior Claudinei Eduardo Biazoli
Published: March 2020

Background Immigrants and refugees have specific mental health needs. Studies of immigrant psychiatric patients in Latin America are scarce. This article presents the profile of patients from an outpatient psychiatric service in Sao Paulo (Brazil) in order to better inform mental health service planning for immigrants and refugees.Methods Exploratory study to characterize demographic and mental health profile of refugees and immigrants attending service from 2003 to 2018. Chi-square tests and logistic regressions were used to examine the association of demographic variables, exposure to violence, and immigrant status with psychiatric diagnosis. Cluster Analysis was used to identify sub-groups within the sample. Results A total of 162 immigrants and refugees referred to the service obtained treatment, being 57·4% men, 59·8% refugees/asylum seekers, 51·9% black, 48·8% single, mean age of 35.9, 64·2% with ten years of education, 57·4% unemployed. Half of the sample (52·5%) were exposed to violence. The most common diagnosis was depression (54·2%) followed by PTSD (16·6%). Around 34% of the participants sought psychiatric care in six months upon arrival. Logistic regressions showed men were had decreased odds to present depression (OR= 0·34). Patients with PTSD were more likely to be refugees (OR= 3·9) and not having university degree (OR= 3·1). In cluster analysis, a cluster of patients with PTSD were almost all black refugee men exposed to violence. Most patients diagnosed with psychotic disorders were also black refugee men.Interpretation Data raises questions regarding sex differences and mental health care access. Refugees in Brazil are mainly black men, what might contribute to the profile found in the present study. Further investigation is needed to better understand treatment adherence and clarify the role of patient-health professional relationship in mental health outcomes.
Relationships between abnormal neural activities and cognitive impairments in patients with drug-naive first-episode schizophrenia
Authors: Yan Wei , Zhang Rongrong , Zhou Min , Lu Shuiping , Li Wenmei , Xie Shiping , Zhang Ning
Published: March 2020

Background: Prior resting state functional magnetic resonance imaging studies via the regional homogeneity (ReHo) method have demonstrated inconsistent and conflicting results because of several confounding factors, such as small sample size, medicinal influence, and illness duration. Relationships between ReHo measures and cognitive impairments in patients with drug-naive first-episode schizophrenia (dn-FES) are rarely reported. This study was conducted to explore the correlations between ReHo measures, cognitive deficits, and clinical symptoms in patients with dn-FES. Methods: A total of 69 patients with dn-FES and 74 healthy controls were recruited. MATRICS Consensus Cognitive Battery (MCCB), Wechsler Adult Intelligence Scale (WAIS), and Positive and Negative Syndrome Scale (PANSS) were used to assess cognitive function, intelligence quotient (IQ), and clinical symptoms, respectively. The correlations between ReHo map and cognitive deficits, the severity of symptoms were examined using strict correlation analyses within brain areas.Results: The ReHo values in the right middle frontal gyrus (MFG) and the superior frontal gyrus (SFG) increased in the dn-FES group, whereas the ReHo values in the right cuneus decreased. Correlation analysis showed that the ReHo values in the right MFG were positively correlated with attention/vigilance impairments, social cognition deficits, the severity of clinical manifestations. Conclusions: These findings suggested that abnormal spontaneous activities in the right MFG reflect the illness severity and cognitive deficits, which serves as a basis for establishing the objective diagnostic markers and might be a clinical intervention target for patients with schizophrenia.
Adverse event reports in patients taking psychiatric medication during pregnancy from spontaneous reports in Japan and the United States: an approach using latent class analysis
Authors: Anzai Tatsuhiko , Takahashi Kunihiko , Watanabe Michiko , Mochizuki Mayumi , Murashima Atsuko
Published: March 2020

Background: Little is known regarding the association between adverse events (AEs) and psychiatric medications administered to pregnant women in clinical trials during the pre-marketing period. This study analyzes reports of AE association with psychiatric medication administrated during pregnancy using post-marketing spontaneous reports of AE from the Japanese Adverse Drug Event Report (JADER) database and Food and Drug Administration Adverse Event Reporting System in the United States (FAERS-US). Methods: We summarized AE reports of psychiatric medication administrated during pregnancy by comparing data obtained from JADER and FAERS-US databases with medication patterns determined as classes via latent class analysis. The odds ratios (ORs) of AE reports categorized into system organ classes in which each class was compared with those without psychiatric medications. Results: The proportions of AE reports under psychiatric medication in pregnancy among all AE reports were 22.0% and 16.6% in JADER and FAERS-US, respectively. The 10,389 reports of psychiatric medication during pregnancy were classified into 11 classes. The proportion of patients receiving four or more psychiatric drugs in JADER was larger than that in FAERS-US. The maximum number of reports in combinations of AE and medication pattern in JADER was 169, for ‘general disorders and administration site conditions’ from the class of four or more medications (OR = 9.1), while that in FAERS-US was 1,654, for ‘injury, poisoning, and procedural complications’ from the class of single psychiatric medication (OR = 2.8). Conclusions: The main AE reports and associated AE differed depending on medication patterns in pregnant women taking psychiatric medication. This study may provide a prediction of AEs that are likely to be reported with each medication pattern. Our findings of the association between AE reports and medication patterns could help improve the administration of psychiatric medications during pregnancy, though further research on additional datasets is needed to clarify these results.
A Systematic Review of Validated Screening Tools for Anxiety Disorders and PTSD in Low to Middle Income Countries
Authors: Mughal Anisa , Devadas Jackson , Ardman Eric , Levis Brooke , Go Vivian F , Gaynes Bradley N
Published: March 2020

Background: Anxiety and post-traumatic stress disorder (PTSD) contribute significantly to disability adjusted life years in low- to middle-income countries (LMICs). Screening has been proposed to improve identification and management of these disorders, but little is known about the validity of screening tools for these disorders. We conducted a systematic review of validated screening tools for detecting anxiety and PTSD in LMICs. Methods: MEDLINE, EMBASE, Global Health and PsychINFO were searched (inception-January 10, 2019). Eligible studies (1) screened for anxiety disorders and/or PTSD; (2) reported sensitivity and specificity for a given cut-off value; (3) were conducted in LMICs; and (4) compared screening results to diagnostic classifications based on a reference standard. Screening tool, cut-off, disorder, region, country, and clinical population were extracted for each included study. We assed quality using a modified version of Greenhalgh’s ten item checklist. Accuracy results were organized based on screening tool, cut-off, and specific disorder. Accuracy estimates for the same cut-off for the same screening tool and disorder were combined via meta-analysis.ResultsOf 5343 unique citations identified, 57 articles including 75 screening tools were included. There were 44, 20 and 11 validations for anxiety, PTSD, and combined depression and anxiety, respectively. Continentally, Asia had the most validations (34). Regionally, South Asia (10) had the most validations, followed by West Asia (9) and South Africa (9). The Kessler-10 (7) and the Generalized Anxiety Disorder-7 item scale (GAD-7) (6) were the most commonly validated tools for anxiety disorders, while the Harvard Trauma Questionnaire (3) and Posttraumatic Diagnostic Scale (3) were the most commonly validated tools for PTSD. Most studies (27) had the lowest quality rating (unblinded) followed by good (21). Due to incomplete reporting, we combined only two sets of accuracy values in meta-analysis (GAD-7 cut-off ≥10; sensitivity: 76%, specificity: 64%).ConclusionUse of brief screening instruments can bring much needed attention and research opportunities to various at-risk LMIC populations, yet many have been validated in inadequately designed studies. Locally validated screening tools for anxiety and PTSD need further evaluation and well-designed studies, including clinical trials, to determine whether their use can reduce the burden of disease. PROSPERO registry number: CRD42019121794
Association of serum uric acid levels with suicide risk in female patients with major depressive disorder: a comparative cross-sectional study
Authors: Chen Jing-Xu , Feng Jun-Hui , Zhang Li-Gang , Liu Yan , Yang Fu-De , Wang Shao-Li , Tan Yun-Long , Su Yun-Ai
Published: March 2020

Background: Individuals with major depressive disorder (MDD) have a high suicide risk. Some evidence suggests that uric acid (UA) may be involved in the pathophysiology of MDD. The purpose of this study was to evaluate whether serum UA levels were associated with suicide risk in MDD patients.Methods: One hundred four female patients with MDD (52 patients with suicide risk and 52 patients without suicide risk) and 52 healthy individuals were included in this study. The suicide risk was evaluated by Mini International Neuropsychiatric Interview (M.I.N.I). Fasting serum levels of UA, as well as glucose, lipid and renal function indicators were measured.Results: Serum UA levels in MDD patients with suicide risk (245.01 ± 55.44 μmol/L) were significantly lower than those in MDD patients without suicide risk (274.17 ± 72.65 μmol/L) (p = 0.017) and healthy controls (271.42 ± 55.25 μmol/L) (p = 0.030). There was no difference in serum UA levels between the MDD patients without suicide risk and healthy controls (p = 0.821). Binary logistic regression analysis revealed a significant relationship between suicide risk and decreased serum UA levels (OR = 0.989, p = 0.010) in MDD patients.Conclusion: Decreased serum UA levels were associated with suicide risk in MDD patients. Purinergic system dysfunction may be involved in the neurobiological basis of suicide risk in these patients.
The underlying dimensions of major depressive symptoms in a sample of Chinese earthquake survivor
Authors: Bi Yajie , Wang Li , Cao Chengqi , Fang Ruojiao , Li Gen , Liu Ping , Luo Shu , Hall Brian , Yang Haibo
Published: March 2020

Background: Experiencing natural disasters is associated with common mental disorders including major depressive disorder (MDD). However, the latent structure of MDD is widely debated, and few studies examined the structure of MDD in Chinese natural disaster survivors. Therefore, this study aimed to evaluate the factorial validity of the Patient Health Questionnaire-9 (PHQ-9) for DSM-5 major depressive disorder (MDD) symptoms in Chinese earthquake survivors.Method: Participants were 1058 Chinese earthquake survivors. Self-reported measures included the PHQ-9 and the Short-Form Health Survey (SF-36). Confirmatory factor analysis (CFA) and structural equation modelling (SEM) was used to examine the latent structure of MDD and the associations between latent factors of MDD and different aspects of health-related quality of life, respectively.Results: The model comprised of somatic and non-somatic factors demonstrated significantly better fit than the other competing MDD models in the current sample. Further structural equation modeling analyses indicated that the non-somatic factor was significantly associated with both physical and psychosocial health-related quality of life, while the somatic factor was a uniquely predictor of physical health-related quality of life. Furthermore, the somatic factor was found to partially mediate the relationship between the non-somatic factor and physical health-related quality of life.Conclusions: The MDD symptoms was best captured by a two-factor model comprised of somatic and non-somatic factors in Chinese natural disaster survivors. The two MDD factors were differentially associated with physical and psychosocial health-related quality of life, and the non-somatic factor associated physical health-related quality of life partially through the somatic factor. The current findings add to extant knowledge of latent structure of MDD symptoms, and carry implications for assessment and intervention of post-disaster mental health problems.
Cognitive behavioral group therapy for panic disorder in a general clinical setting: a prospective cohort study with 24-year follow-up
Authors: Bilet Truls , Olsen Thorbjørn , Andersen John Roger , Martinsen Egil W
Published: March 2020

Background: The long-term prognosis after cognitive behavioral therapy (CBT) in outpatient groups for panic disorder and agoraphobia is not well known. The purpose of this study was to assess long-term outcomes in terms of psychological health, health-related quality of life (HRQoL), quality of life (QoL) and treatment satisfaction after CBT for panic disorder and agoraphobia.Methods: The sample consisted of 68 patients (61% response rate), who were assessed at pretreatment; at the start and end of treatment; and after 3 months, after one year, and over the long term (M= 24 years; SD = 5.3). The main outcome was the total score on the Phobic Avoidance Rating Scale (PARS-total). At long-term follow-up, HRQoL was measured with the RAND-12 questionnaire, and QoL was measured with two questions from the “Study on European Union Statistics on Income and Living Conditions”. Patient experiences and treatment satisfaction were assessed by the Generic Short Patient Experiences Questionnaire. A marginal longitudinal model was applied to study the main outcome.Results: The effect size of the change (mean change/SD of pretreatment) in the PARS-total score was (-1.19, p <0.001) at the end of treatment and remained stable thereafter. A PARS-total score reduction of 50% was found in 98% of patients at the long-term follow-up. The patients’ HRQoL and QoL were similar to the expected scores for the general Norwegian population. Of the patients, 95% reported high to very high satisfaction with the CBT, and 93% reported large treatment benefits.Conclusions: To the best of our knowledge, this study has the longest follow-up after group CBT for panic disorder and agoraphobia, showing a good prognosis in ≥ 93% of the participating patients.
Use of sequence analysis for classifying individual antidepressant trajectories to monitor population mental health
Authors: Cherrie Mark , Curtis Sarah , Baranyi Gergő , McTaggart Stuart , Cunningham Niall , Licence Kirsty , Dibben Chris , Bambra Clare , Pearce Jamie
Published: March 2020

Background

Over the past decade, antidepressant prescriptions have increased in European countries and the United States, partly due to an increase in the number of new cases of mental illness. This paper demonstrates an innovative approach to the classification of population level change in mental health status, using administrative data for a large sample of the Scottish population. We aimed to identify groups of individuals with similar patterns of change in usage, validate these groups with other indicators of mental illness, and characterise the population most at risk of increasing mental ill health.

Methods

NHS prescription data were linked to the Scottish Longitudinal Study, a 5.3% sample of the Scottish population (N=151,418). Antidepressant prescription status over the previous six months was recorded for every month for which data were available (January 2009-December 2014), and sequence dissimilarity was computed by optimal matching. Hierarchical clustering was used to create groups of participants who had similar patterns of change, with multi-level logistic regression used to understand group membership.

Results

Five distinct prescription pattern groups were observed, indicating: no prescriptions (76%), occasional prescriptions (10%), continuation of prior use of prescriptions (8%), new course of prescriptions started (4%) or ceased taking prescriptions (3%). Young, white, female participants, of low social grade, residing in socially deprived neighbourhoods, living alone, being separated/divorced or out of the labour force, were more likely to have become prescribed a new course of antidepressants.

Conclusions

The use of sequence analysis for classifying individual antidepressant trajectories offers a novel approach for capturing population-level changes in mental health. By classifying individuals into groups based on their anti-depressant medication use we can better identify the determinants of changes in mental health, from compositional, contextual, to macro political and economic factors.
Sinhala translation of Perinatal Anxiety Screening Scale: A valid and reliable tool to detect anxiety among pregnant women
Authors: Priyadarshanie Nirmala , Fernando DMS , Waas MDIA , Senaratna BCV , Goonewardena CSE , Balasuriya A
Published: March 2020

Background Anxiety disorders during pregnancy are not routinely assessed in Sri Lanka despite being common and leading to adverse pregnancy outcomes. A screening tool will help early detection and management of anxiety to improve pregnancy outcomes. Our aim was to determine the validity of Sinhala translation of Perinatal Anxiety Screening Scale (PASS) to detect anxiety among Sri Lankan pregnant women.Methods A cross-sectional study was conducted in antenatal clinics of ateaching hospital in Colombo. PASS was translated to Sinhala language using the standard translation/back-translation method. Pregnant women (n=221) were sequentially recruited and assessed by a psychiatrist until 81 women with anxiety disorder were diagnosed usingInternational Classification of Diseases-10 criteria(gold standard). Sinhala translation of PASS (PASS-S) was administered to all recruited women, including to 139women without anxiety. Receiver-Operator-Characteristics(ROC) analysis was performed, the optimal cut-off score for PASS-S was determined, and its validity was assessed using sensitivity, specificity, predictive values and positive and negative likelihood ratios.Internal consistency was assessed using Cronbach’salpha.Test-retest and inter-rater reliabilityfor PASS-S score and anxiety classification were assessed using intraclass correlation coefficient (ICC) and Cohen’s kappa (k), respectively.Results Mean age( + SD) of women was 30( + 5.8) years. Of them,53.7% were multiparous. Psychiatrist diagnosed anxiety disorder in 37.0% of women while PASS-S at its optimal cut-off of 20 classified 37.5% of women as having anxiety. Area under the ROC curve for PASS-S was 0.96 (95% CI0.94-0.99).Sensitivity, specificity and positive and negative predictive values of PASS-S were 0.93(95%CI 0.84-0.97), 0.90(95%CI0.83-0.94), 0.85(95%CI0.75-0.90)and 0.95(95% CI0.89-0.98),respectively. Positive and negative likelihood ratios were 8.8(95%CI 5.3-14.5) and 0.08(95% CI0.04-0.18), respectively. Internal consistency was high (Cronbach’s alpha 0.95).Four factor structures obtained by exploratory factor analysis were“Generalized anxiety, acute anxiety and adjustment difficulties”,“Social anxiety, excessive worry and specific fears”,”Perfectionism, control andtrauma” and “Generalized anxiety”.Test-retest reliability was high for the PASS-S score (ICC 0.85 [95%CI 0.65-0.96]) and anxiety classification (k0.77 [95%CI 0.34-1.2]).Inter-interviewer reliability was also high(ICC 0.92 [95%CI0.81-0.97] for the PASS-S score and (k0.86 [95%CI0.59-1.1] for anxiety classification).Conclusion Sinhala translation of PASS is a valid and reliable instrument to screen for anxiety disorders among antenatal women in Sri Lanka.
Suicidality and associated social, demographic and clinical factors in Thai patients with acutely treated depressive disorder: a cross-sectional study
Authors: Chiddaycha Mayteewat , Lueboonthavatchai Peeraphon
Published: March 2020

Background Some depressed people die by suicide although they are in treatment. The aims of this study were to examine the prevalence of suicidality and to identify the associated social, demographic and clinical factors in Thai patients with acutely treated depressive disorders.Patients and methods A sample of 178 in- and outpatients with depressive disorders who were treated within the six-month period of being diagnosed or of a recurrent episode were recruited from a tertiary hospital during November 2017 to April 2018. The associations between suicide risks assessed using the suicidality module of the Mini-International Neuropsychiatric Interview (MINI) and various factors including demographic data, depressive severity, interpersonal problems, social support, family relationships, and life stress events were analyzed by chi-square test. Logistic regression was used for identification of the potential predictors of moderate-to-high suicide risk.Results Most of the subjects were single (80.9%), female (68%), and in early adulthood (mean age 28.9, SD 11.2). The prevalence of suicidal ideation, suicide attempt within one month, and previous history of suicide attempt during lifetime were 62.4%, 35.4% and 41%, respectively. The prevalence of suicidality (76.4%) and moderate-to-high suicide risk (48.4%) were high. The factors associated with moderate-to-high suicide risk were lower age, no religion, unemployment, history of substance use within one year, moderate-to-severe level of depression, being an in-patient, short duration of treatment, receiving benzodiazepines, having interpersonal role disputes, having interpersonal deficits, low social support, poor family relationships and functioning, and high severity level of health stress events. Potential predictors of moderate-to-high suicide risk were moderate-to-severe levels of depression, poor family relationships and functioning, age of 20 or lower, being an in-patient, and receiving benzodiazepines.Conclusion The prevalence of suicidality in patients with acutely treated depressive disorder was found to be high. Depressive severity and social factors such as poor family relationships were highly associated with suicide risk. Knowledge of these factors may raise awareness of suicide prevention during the course of treatment of depression.
Classification of vulnerability levels using multivariate biomarkers in schizophrenia: a machine-learning approach
Authors: Caldani Simona , Vialatte François-Benoît , Baelde Aurélien , Bucci Maria Pia , Bendjemaa Narjes , Mam-Lam-Fook Célia , Gaillard Raphaël , Krebs Marie-Odile , Amado Isabelle
Published: March 2020

Background Schizophrenia is a heterogeneous neurodevelopmental disease involving cognitive and motor impairments. Motor dysfunctions, such as eye movements or neurological soft signs (NSS), are proposed as endophenotypic markers. Methods Machine-learning method applied on oculomotor performances using comprehensive testing with prosaccades, antisaccades, memory-guided saccade tasks and smooth pursuit, as well as NSS assessment, was used to discriminate patients with schizophrenia (SZ), full siblings of patients (FS) and healthy volunteers (C). Results The most reliable classification was between C and SZ, with only 15% and 12% of error rates for validation and test, whereas the SZ vs . FS classification provided the highest error rates (32% of error rate in both validation and test). Interestingly, NSS were selected as the best predictor, together with a combination of measures, for the two classifications: C vs . SZ, SZ vs . FS. In addition, memory-guided saccades were consistently selected among the best two multimodal features for the classifications involving the control group (C vs. SZ or FS). Conclusions Taken together, these results emphasize the importance of neurological soft signs and sensitive oculomotor parameters, especially memory-guided saccades. This classification provides promising avenues for improving early detection of / early intervention in psychosis.
Prevalence and Distribution Pattern of Mood Swings in Thai Adolescents: School-based Survey
Authors: Angsukiattitavorn Suleemas , Seeherunwong Acharaporn , Panitrat Rungnapa , Tipayamongkholgul Mathuros
Published: March 2020

Background: Mood Swings (MS) is a condition widely discussed as a prominent feature with psychiatric patients. However, there is a lack of research related MS. Methods: This school-based, cross-sectional study aimed to investigate the prevalence and distribution pattern of mood swings on personal and contextual determinants in Thai adolescent. The participants were 2,598 students in high school and vocational school in Bangkok and central region of Thailand. Results : the prevalence of mood swings was 26.4%. It was most frequent among the vocational students in Bangkok, there was 37.1%. The distribution of mood swings could be found in adolescents who had risk behaviors and who resided in hazardous situation. The probabilities of MS by characteristic in those 15 – 24 years old were: bullying involvement 36.9% (n=1293), problematic social media use 55.9%(n=127), high expressed emotion in family 36.6% (n=1256), and studying in vocational program 29.5%(n=1,216) and school located in Bangkok 32.4%(n=561). Also, substance use was a risk to MS as with cannabis 41.8%(n=55) and heroin users 48.0%(n=25). Hierarchical logistic regression analysis showed that being female, the family history of mental problems, bullying involvement, problematic social media use, high expressed emotion in family, and the interaction between vocational programs and metropolitan/urban residence were impacted adolescent mood swings (p < .05). Conclusions: our ﬁndings indicate that the pattern of mood swings was associated with signiﬁcant bullying involvement, social media use, family circumstance and school characteristics. The public needs greater awareness of mood swings patterns and the positive implications of MS screening. Moreover, early preventive interventions which may stem later mental illness are needed. Keywords : Mood swings, Adolescent, Prevalence, Distribution
Cultural adaptation of the mental health first aid guidelines for assisting a person at risk of suicide to China: a Delphi expert consensus study
Authors: Lu Shurong , Li Wenjing , Oldenburg Brian , Wang Yan , Jorm Anthony F. , He Yanling , Reavley Nicola J.
Published: March 2020

Background Suicide is a significant public health concern in China and there is a need for evidence-based suicide prevention programs to assist people in the community who may be in a position to support those in their social networks who are at risk of suicide. English-language mental health first aid guidelines for this purpose have been developed. However, due to differences in culture, language and health systems, guidelines for English-speaking countries require cultural adaptation for use in China. Methods A Delphi expert consensus study was conducted among mainland Chinese panellists with a diverse range of expertise in suicide crisis intervention (n = 56). Using the mental health first aid guidelines used in English-speaking countries as a basis, a questionnaire containing 141 statements on how to help a person at risk of suicide was developed and translated. Panellists were asked to rate their importance of each item for inclusion in the Chinese guidelines. They were also encouraged to suggest any additional statements that were not included in the original questionnaire. Statements were accepted for inclusion in the adapted guidelines if they were endorsed by at least 80% of panellists as essential or important. Results Consensus was achieved after two survey rounds on 152 statements for inclusion in the adapted guidelines for China, with 141 adopted from the guidelines for English-speaking countries and 11 generated from the comments of panellists. Conclusions While the adapted guidelines were similar to the guidelines for English-speaking countries, they also incorporated actions specific to the Chinese context, including Chinese attitudes towards suicide, the role of families and friends and removal of the means of suicide. Further research is needed to investigate the use of the guidelines by the Chinese public and the implementation of Mental Health First Aid training in appropriate settings in China.
Lifestyle changes and outcomes of elderly people with mild cognitive impairment: a 4-year longitudinal study
Authors: Katayama Osamu , Lee Sangyoon , Bae Seongryu , Makino Keitaro , Shinkai Yohei , Chiba Ippei , Harada Kenji , Shimada Hiroyuki
Published: March 2020

Background Longitudinal studies have shown that mild cognitive impairment (MCI; a precursor of dementia) reverts to normal cognition (NC). However, we couldn’t find any reports that have examined the lifestyle activity change patterns of elderly people diagnosed as having MCI and their outcomes in a longitudinal study. We determined the lifestyle activity change patterns among elderly people with MCI. Methods The participants in this study were 769 community-dwelling elders who were ≥65 years old with MCI at baseline. Four years later, participants were classified into reverters who recovered from MCI to NC, maintainers who maintained MCI, and converters who had global cognitive impairment (GCI) or Alzheimer disease (AD). We used latent class analysis (LCA) to classify changes in instrumental activities of daily living (IADL), and cognitive, social, and productive activities of the participants. Subsequently, we performed a multinomial logistic regression analysis with reversion status as dependent variable (the most typical, converters as reference group) and cluster membership as independent variables. Results The reversion rate of 769 participants was 33.3%. The reverters were maintaining multidomain lifestyle activities, converters had discontinued multidomain lifestyle activity or were inactive, and maintainers were maintaining productive activities. According to logistic regression analysis, the activity pattern of continuing to engage in multidomain lifestyle activities and start activity were more likely to recover from MCI to NC (P <.05). Conclusions Elderly participants with MCI who continued their multidomain lifestyle activities were more likely to recover to NC. Even if it does not lead to NC, continuing productive activities is important to maintaining MCI without converting.
Characterization of Hepatitis C Virus Circulating among Injecting Drug Users (IDU) in Kilifi County, Kenya.
Authors: Mainga Robert Onchong'a , Eddy Odari Okoth , Peter Borus Kimutai , Allan Ole Kwallah , James Murith Gikunda , Vincent Ruttoh Kiplangat , Charles Mwandawiro Smiti , Raphael Lihana Wekesa
Published: March 2020

Background: Hepatitis C virus is a major global health problem estimated to infect over 170 million people globally with the most common route of infection being injecting drug use (IDU). Treatment for HCV infection has traditionally been shown to be genotype specific; however the available drugs are still expensive and out of reach in many developing countries. To improve on monitoring, there is need to continuously document the genotypic burden and epidemiology in different populations arises. Objectives: This study aimed to determine the circulating genotypes and link the data to the socio-demographics of injecting drug users in Kilifi County along the Kenyan coastline. Methods: Using a random sampling method, this was a cross-sectional prospective study conducted among 127 injecting drug users, whereby ethical clearance was sought from Kenyatta National Hospital/ University of Nairobi Ethical and Research review committee (KNH/UON-ERC), and Reference number P366/07/2017 on 25 th September 2017. Serology for HCV was done followed by nucleic acid amplification and eventual genotyping. Socio-demographic data was collected using questionnaire administered at the sites. Results: A total of 28 (23 males and 5 females) samples out of 127 samples were positive for HCV giving a prevalence of 22.1%. The modal age group was 25- 49 years. Of the positive samples, 11 were amplified by PCR, all from the male IDUs. Prevalent genotypes included genotype 1a (13%) and genotype 4a (87%). Both genotype 1a and 4a were only found in males. Conclusion: Although it is the first time to report HCV4a in Kilifi town and Mtwapa as compared to Watamu and Malindi which had both HCV1a and HCV4a. Tourists born in countries where HCV prevalence is high are supposed to be screened before accessing entry to Kilifi County. No clinical trial was conducted. The study reveals the burden of HCV infection among IDUs in Kilifi County. The Government should formulate policies for intervention on testing and treatment of HCV in Kilifi County targeting IDUs in order to minimize spread to other populations.