bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of KP‐1199: a novel acetaminophen analog for hemostatic function and antinociceptive effects
Authors: Reddoch‐Cardenas Kristin M. , Cheppudira Bopaiah P. , Garza Thomas , Hopkins Chad D. , Bunker Kevin D. , Slee Deborah H. , Cap Andrew P. , Bynum James A. , Christy Robert J.
Published: July 2021

Background

Acetaminophen (APAP) is a widely self‐prescribed analgesic for mild to moderate pain, but overdose or repeat doses can lead to liver injury and death. Kalyra Pharmaceuticals has developed a novel APAP analog, KP‐1199, currently in Phase 1 clinical studies, which lacks hepatotoxicity. In this study, the authors evaluated the antinociceptive effect of KP‐1199 on thermal injury‐induced nociceptive behaviors as well as hemostatic parameters using human blood samples.

Methods

Full‐thickness thermal injury was induced in anesthetized adult male Sprague–Dawley rats. On day 7 post‐injury, KP‐1199 (30 and 60 mg/kg) or APAP (60 mg/kg) was administered orally. Antinociception of KP‐1199 and APAP were assessed at multiple time points using Hargreaves' test. In separate experiments, human whole blood was collected and treated with either KP‐1199, APAP, or Vehicle (citrate buffer) at 1× (214 μg/ml) and 10× (2140 μg/ml) concentrations. The treated blood samples were assessed for: clotting function, thrombin generation, and platelet activation.

Results

APAP did not produce antinociceptive activity. KP‐1199 treatment significantly increased the nociceptive threshold, and the antinociceptive activity persisted up to 3 h post‐treatment. In human samples, 10× APAP caused significantly prolonged clotting times and increased platelet activation, whereas KP‐1199 had caused no negative effects on either parameter tested.

Conclusion

These results suggest that KP‐1199 possesses antinociceptive activity in a rat model of thermal injury. Since KP‐1199 does not induce platelet activation or inhibit coagulation, it presents an attractive alternative to APAP for analgesia, especially for battlefield or surgical scenarios where blood loss and blood clotting are of concern.
Platelet aggregation in whole blood is not impaired by a platelet‐sparing leukoreduction filter and instead depends upon the presence of leukocytes
Authors: Rice Joseph , Bill Jerome R. , Razatos Anna , Marschner Susanne
Published: July 2021

Background

Recent studies characterizing in vitro hemostatic properties of whole blood (WB) leukoreduced (LR) with a platelet‐sparing filter have described subtle, if any, changes to viscoelastic clotting; however, reductions in platelet (PLT) content and impedance aggregometry (IA) responses have been noted. The effects of filtration of WB (i.e., filter‐contact effects, reduction in platelet and leukocyte count) have not been rigorously investigated as to their individual impacts on platelet IA responses.

Study Design and Methods

WB units from healthy donors were collected and characterized to assess the effects of platelet‐sparing leukoreduction (LR) upon the in vitro hemostatic measures of platelet IA and thromboelastometry. Further characterization of platelet IA responses was carried out in WB samples to delineate the effects of platelet count and leukocyte presence/absence upon the response.

Results

WB filtration reduced the platelet count and IA responses but had no impact on viscoelastic clotting measures in fresh WB. Experiments revealed that IA responses have a linear correlation with platelet count in both apheresis platelets and WB and that passage of platelets through the WB‐LR filter has no impact upon the strength of this response. Further experiments in LR WB showed that addition of autologous leukocytes back to the platelets fully restored the platelet aggregation response to pre‐filtration levels.

Conclusion

WB filtration results in platelet count reduction and leukocyte removal; however, platelet IA is not degraded by passage through the filter. Apparent declines in platelet IA responses can be fully attributed to the reduction in platelet count and the removal of leukocytes.
A Retrospective Account of Seminal Research by H. M. Zbib
Authors: Hirth J. P.
Published: July 2021

Throughout his career, Zbib was innovative, originating models in seminal papers that anticipated areas of subsequent increased interest. These include strain-gradient plasticity, discrete dislocation dynamics, multiscale modeling, arrays of Somigliana ring dislocations and nanoscale plasticity. We comment here on these aspects of his work. Many of the papers in this volume represent applications of these ideas.
Impact of the Unit Cell Choice on the Efficiency of Dispersion Curve Calculations Using Generalized Bloch Mode Synthesis
Authors: Cool Vanessa , Van Belle Lucas , Claeys Claus , Deckers Elke , Desmet Wim
Published: July 2021

Recently, the potential of metamaterials and phononic crystals to cope with conflicting requirements for obtaining lightweight structures with desirable noise and vibration properties has been demonstrated. These, often periodic, structures are commonly studied based on their representative unit cell (UC) of which the vibro-acoustic performance is examined by means of their wave propagation, visualized by dispersion curves. Typically, the UC is discretized using a finite element technique to capture the possibly complex geometry. This leads to a high computation cost for the dispersion curve calculation which can be strongly reduced by applying modal-based model order reduction techniques such as the (generalized) Bloch mode synthesis (GBMS). In this paper, the choice of the UC is shown to have an impact on the dispersion curve calculation time. Moreover, the efficiency of GBMS strongly depends on the UC choice. The highest reduction in computation time is accomplished when the number of boundary degrees-of-freedom is limited.
Mean acoustic fields exerted on a subwavelength axisymmetric particle
Authors: Lima Everton B. , Silva Glauber T.
Published: July 2021

The acoustic radiation force produced by ultrasonic waves is the “workhorse” of particle manipulation in acoustofluidics. Nonspherical particles are also subjected to a mean torque known as the acoustic radiation torque. Together they constitute the mean acoustic fields exerted on the particle. Analytical methods alone cannot calculate these fields on arbitrarily shaped particles in actual fluids and are no longer fit for purpose. Here, a semi-analytical approach is introduced for handling subwavelength axisymmetric particles immersed in an isotropic Newtonian fluid. The obtained mean acoustic fields depend on the scattering coefficients that reflect the monopole and dipole modes. These coefficients are determined by numerically solving the scattering problem. Our method is benchmarked by comparison with the exact result for a subwavelength rigid sphere in water. Besides, a more realistic case of a red blood cell immersed in blood plasma under a standing ultrasonic wave is investigated with our methodology.
Simple methods for obtaining flow reversal conditions in Couette–Poiseuille flows
Authors: Kwak Hyungyeol , Nam Jaewook
Published: July 2021

Couette–Poiseuille (C–P) flow, which is driven by drag from a moving wall and a pressure gradient, can exist in different states depending on the relative strengths of the two above-mentioned factors. Of particular interest is the onset of flow reversal, which is characterized kinematically by a zero shear rate on the stationary wall. This study presents two different methods for obtaining the critical conditions for the onset of flow reversal in C–P flows. In the first method, exact values of the critical flow rate and pressure gradient are computed by solving a pair of algebraic equations derived from the Weissenberg–Rabinowitsch relation. Using this method, the difficulty in solving the nonlinear differential equation is avoided. In the second method, estimates of the critical conditions are obtained analytically by locally approximating the given fluid as a power-law fluid. To evaluate the prediction accuracy, the methods are applied to the C–P flows of Carreau–Yasuda and Bingham–Carreau–Yasuda fluids. It is demonstrated that the relative errors remained reasonably low in most system parameter ranges, except in cases where the flow curve in the log–log scale is highly nonlinear.
Poststretch Isometric Contractions of the Hamstrings: Just a Brief Stretch to Achieve Supramaximal Isometric Force
Authors: Chapman Neil , William Whitting John , Broadbent Suzanne , Crowley-McHattan Zachary , Meir Rudi
Published: July 2021

Hamstring strain injuries are common in sport. Supramaximal eccentric or high-intensity isometric contractions are favored in hamstring strain injury prevention. The effect of combining these contraction modes in such prevention programs as a poststretch isometric contraction is unknown. Poststretch isometric contractions incorporate an active stretch and result in greater final isometric force than isometric contractions at comparable joint angles. This study compared torque and muscle activation levels between maximal voluntary isometric contraction and maximal poststretch isometric contractions of the knee flexors. Participants (n = 9) completed baseline maximal voluntary isometric contraction at 150° knee flexion and maximal poststretch isometric contractions at 120° knee flexion actively stretching at 60°/s to 150° knee flexion for final isometric contraction. Torque of the knee flexors and surface electromyography root mean square (sEMGRMS) of biceps femoris long head were simultaneously recorded and compared between baseline and poststretch isometric at 150° knee flexion. Torque was 14% greater in the poststretch isometric condition compared with baseline maximal voluntary isometric contraction (42.45 [20.75] N·m, 14% [22.18%], P < .001) without increase in sEMGRMS of biceps femoris long head (−.03 mV, ±.06, P = .130, d = .93). Poststretch isometric contractions resulted in supramaximal levels of poststretch isometric torque without increased activation of biceps femoris long head.
Exploring pain interference with motor skill learning in humans: a protocol for a systematic review
Authors: Matthews David , Elgueta Cancino Edith , Falla Deborah , Khatibi Ali
Published: July 2021

Introduction

Motor skill learning is intrinsic to living. Pain demands attention and may disrupt non-pain-related goals such as learning new motor skills. Although rehabilitation approaches have used motor skill learning for individuals in pain, there is uncertainty on the impact of pain on learning motor skills.

Methods and analysis

The protocol of this systematic review has been designed and is reported in accordance with criteria set out by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Web of Science, Scopus, MEDLINE, Embase and CINAHL databases; key journals; and grey literature will be searched up until March 2021, using subject-specific searches. Two independent assessors will oversee searching, screening and extracting of data and assessment of risk of bias. Both behavioural and activity-dependent plasticity outcome measures of motor learning will be synthesised and presented. The quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.

Ethics and dissemination

No patient data will be collected, and therefore, ethical approval was not required for this review. The results of this review will provide further understanding into the complex effects of pain and may guide clinicians in their use of motor learning strategies for the rehabilitation of individuals in pain. The results of this review will be published in a peer-reviewed journal and presented at scientific conferences.

PROSPERO registration number

CRD42020213240.
#3122 Is subjective cognitive decline (SCD) a better marker of susceptibility to functional cognitive disorder (FCD) than to neurodegeneration?: The caerphilly prospective study
Authors: Ball Harriet A , Bayer Antony , Coulthard Elizabeth , Fish Mark , Gallacher John , Ben-Shlomo Yoav
Published: July 2021

Objective/Aims

Does Subjective Cognitive Decline (SCD) indicate susceptibility to Functional Cognitive Disorder (FCD) more often than it indicates neurodegeneration? Prior research has focused on clinical populations where FCD is increasingly identified, but associations could differ at the community level. A clinical diagnosis of FCD requires cognitive symptoms, internal inconsistency, the absence of another explanatory disorder, and significant impairment; but we know little about its aetiology and prevalence. Cognitive internal inconsistency has not been systematically studied.

Methods

1,143 men were followed in the Caerphilly Prospective Study. Their subjective experience of cognitive change at average age 73 years was compared to their previous rate of objective cognitive change (using the Cambridge Cognition Examination). Logistic regression models examined potential predictors of SCD (measured in the preceding decade) including sociodemographic factors, vascular risk markers (ischaemic heart disease, vascular medications, smoking history), alcohol exposure, sleep problems, depression, anxiety trait, and objective cognition. We also looked for markers of cognitive internal inconsistency (delayed recall proportionately better than immediate recall, using the Rivermead Behavioural Memory Test). Finally, subjective and objective cognition at average age 73 were used to predict change in objective cognition nine years later.

Results

SCD was common (30%), and only weakly related to prior objective cognitive decline (sensitivity 36% [95% CI 30-42], specificity 72% [95% CI 68-75]). Longitudinal independent predictors of SCD were older age, poor sleep quality and higher trait anxiety: rate of decline in objective cognition did not independently predict subsequent SCD (adjusted OR 1.18 [95% CI 0.72 1.95]). Those with SCD (compared to those without) had mildly worse scores on immediate recall, but their delayed recall was in proportion to their immediate recall, i.e., there was no evidence of cognitive internal inconsistency. SCD did not predict future objective cognitive change (p=0.84). Important limitations include the male-only sample and the possibility of survivor bias.

Conclusions

SCD is common, but is only weakly associated with prior objective cognitive decline, is not predicted by vascular risk markers (aside from age), and does not predict future objective cognitive decline. The high community prevalence of SCD is instead driven partly via sleep difficulties and anxiety. Our results suggest those with SCD may have a mild deficit in attentional processes but relatively intact memory for the items they do encode. Subjectively experiencing cognitive decline in the absence of an objective decline appears to be a highly prevalent example of poor meta-cognition, which could be a driver to later FCD.
#3097 Temporal and spectral dynamics of reward and risk processing in the amygdala revealed with stereo-EEG recordings in epilepsy
Authors: Manssuer Luis , Qiong Ding , Zhao Yijie , Yang Rocky , Zhang ChenCheng , Zhan Shikun , Sun Bomin , Voon Valerie
Published: July 2021

Objectives/Aims

To examine the temporal and spectral characteristics of local field potentials recorded from the amygdala in epilepsy in the context of the anticipation and receipt of rewards and losses using an incentive learning task and a risky decision-making task.

Methods

16 Epilepsy patients completed two tasks. In the monetary incentive delay (MID) task, patients saw reward and loss cues which indicated whether money could be won or lost depending on whether a subsequent response was or was not quick/accurate enough, respectively. This was compared with neutral cues where responses were neither rewarded nor punished regardless of response.

In the risk task, patients were presented with two face down cards with values ranging from 1 to 10. When the first card is revealed, patients have to choose whether to bet or not bet that the second card is higher. After the card is revealed, patients receive a monetary reward if it is higher and a loss if it is lower. If patients do not bet, they receive nothing.

Results

In both tasks, patients showed larger left amygdala theta band oscillatory activity to the receipt of monetary rewards compared to no money. In contrast, there were no significant responses to monetary losses. During the decision phase of the risk task, there was increased theta activity when patients chose to bet instead of not betting and when the decision had low risk (card <= 5) compared to high risk (card above 5). There were no effects of uncertainty.

Conclusions

The combined results of these two studies embellish our understanding of the role of the amygdala in motivation and decision-making processes and lend further support for its role in reward related processes rather than its often cited fear-related functions (Baxter & Murray, 2002; Murray, 2007). Theta activation is linked to cognitive processes in frontal cortices and coupled to MTL activity (Helfrich & Knight, 2016). As left amygdala theta activation was only recruited when patients were making their bet and not just anticipating reward, the pattern of results lend support to its role in cognition-emotion interactions specific to risk and reward but not uncertainty. Indeed, the hemispheric asymmetry is highly consistent with EEG studies showing left prefrontal dominance in reward processing (Manssuer et al., 2021).
#3080 A systematic review of extra-motor symptom evaluation in clinical trials for amyotrophic lateral sclerosis
Authors: Beswick Emily , Forbes Deborah , Hassan Zachary , Wong Charis , Chandran Siddharthan , Newton Judith , Carson Alan , Abrahams Sharon , Pal Suvankar
Published: July 2021

Background

Amyotrophic lateral sclerosis (ALS) is increasingly recognised as a multi-system disorder, presenting with extra-motor symptoms which arise secondary to motor degeneration or are indicative of wider pathophysiology. Extra-motor symptoms such as cognitive impairment, behavioural change, neuropsychiatric symptoms, sleep disturbances, fatigue, sialorrhea, and pain are common in, and impactful upon, people with ALS.

Aim/Hypothesis

We aimed to systematically review historical clinical trials in ALS to identify if extra-motor features of ALS were explored as outcome measures and if so describe the tools used. We hypothesise that assessment of extra-motor symptoms has been largely neglected in trial design and that where evaluated, it has been with assessment tools which are not designed to evaluate these symptoms in people with ALS.

Methods

We reviewed clinical trials of investigative medicinal products in ALS, since the licensing of riluzole. Trial registry databases including WHO International Trials Registry, European Clinical Trials Register, clinicaltrials.gov, and PubMed were systematically searched for Phase II, III or IV trials registered, completed or published between 01/01/1994 and 16/09/2020. No language restrictions were applied. We evaluated the use of assessment tools to investigate extra-motor symptom as outcome measures.

Results

237 clinical trials were included in this review for use of outcome measures. These trials evaluated cognitive impairment (16 trials, 6.8%), behavioural change (38, 16%), neuropsychiatric symptoms (75, 32%), sleep disturbances (12, 5%), fatigue (18), 8%, saliva (182, 77%) and pain (55, 23%). 29 trials (12%) did not include any assessment of extra-motor symptoms. 51 versions or combinations of assessment tools were utilised in these trials. The most commonly used primary outcome measure in ALS trials, the ALS-FRS(R), is a physical functioning assessment with one sub-domain item assessing saliva. The ALS-FRS accounted for the full number of trials assessing saliva in this review. 6 instruments used were ALS-specific (designed and validated specifically for people with ALS), 14 were symptom-specific, 4 were both, and 9 were generic (evaluated the symptom within a general measure, eg QoL).

Conclusions

Extra-motor symptoms have been under-evaluated in trials for people with ALS. Where evaluated, this has been primarily using assessment tools which are not specific to ALS or the extra-motor symptom, which may affect the validity of conclusions drawn regarding the impact of candidate drugs.
#3113 Evaluating the PCL-C as a measure of trauma and PTSD symptoms in patients with functional neurological symptom disorder
Authors: Yusufi Umamah
Published: July 2021

Aims

Functional Neurological Symptom Disorder (FNSD) is common and disabling. Historically trauma was considered an essential aetiological factor, but the precise contribution of trauma to the disorder, and resulting disability, remains controversial. The PCL-C is a self-reported screening tool for PTSD symptoms based on DSM-IV criteria. A previous study in patients with FNSD demonstrated high scores on the PCL-C, with a reduction in scores following psychotherapy. However strong correlations with other psychological co-morbidities raised the possibility that the PCL-C may be capturing non-specific distress rather than indicators of previous traumatisation. The present study aimed to investigate (i) whether underlying factors measured by the PCL-C can distinguish specific trauma-memory-related symptoms from less specific emotion-regulation-related symptoms, (ii) the extent to which individual factors correlate with other psychopathology and health-related quality of life (HRQoL) measures and (iii) whether different factors change with psychotherapy, all in patients with FNSD.

Methods

An exploratory factor analysis of PCL-C responses from 473 FNSD patients pre-and post-psychotherapy was performed to generate1-4 factor models. The final factor model was determined through confirmatory factor analysis. Relationships between PCL-C factors, measures of comorbidities (depression, somatisation and anxiety) and HRQoL were assessed using regression analysis. Pre- and post-psychotherapy scores were compared.

Results

The best model for the PCL-C comprised of two-factors: factor 1 (intrusive symptoms) explained 55.2% of the variance, whilst factor 2 (emotional dysregulation) explained 7.8% of the variance. Both factors reduced in severity after psychotherapy, but factor 2 reduced by more and correlated more strongly with a decrease in depression and anxiety than factor 1. Changes in depression, anxiety, somatic symptoms and mental HRQoL predicted 61.9% of the change in factor 2, but only 49.2% in factor 1. Improvements in mental HRQoL were strongly associated with a decrease in factor 2, but less so in factor 1.

Discussion

The factor analysis revealed the PCL-C represents two correlated but distinguishable symptom clusters in patients with FNSD: intrusive symptoms and emotional dysregulation. Both were elevated in our patient sample. The high level of intrusive symptoms suggests many patients with FNSD experience classical post-traumatic symptoms, which may indicate that subjective traumatic experiences contribute to pathogenesis and resulting disability. These symptoms showed some reduction with psychotherapy, but the greater reduction in emotional dysregulation symptoms and associated improvements in mental HRQoL suggest that psychotherapy may be more effective in reducing the burden of comorbidities and providing better coping strategies than in addressing core symptoms of the underlying disorder.
#3085 Relationship between variant connective tissue (hypermobility) and autism sensory processing: externally oriented thinking as a mediator
Authors: Savage GK , Csecs JLL , Davies G , Critchley HD , Eccles JA
Published: July 2021

Objectives/Aims

Autism is a neurodevelopmental condition characterised by differences in sensory processing, social communication and restricted/repetitive behaviors. Joint hypermobility is a common connective tissue variant, reportedly overrepresented in Autism. Alexithymia is a personality construct characterised by altered emotional awareness which has notably high rates of overlap with autism spectrum disorder. This study tested whether hypermobility was associated with autistic traits and examined alexithymia as a mediator of this association.

Method

Forty-two people underwent eligibility assessment for a study of joint hypermobility and anxiety (ISRCTN17018615). Hypermobility was assessed using both the Brighton Criteria for Joint Hypermobilty Syndrome (JHS) and 2017 Hypermobile Ehlers Danlos Syndrome (hEDS) Criteria. Participants completed the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS R: sensory/motor, language, social relatedness and circumscribed interest domains) to quantify autistic traits. No participant had a prior diagnosis of Autism. Participants also completed the Toronto Alexithymia Scale (TAS-20) to measure alexithymia. The TAS-20 has three domains: difficulty describing feelings, difficulty identifying feelings and externally oriented thinking.

Results

All 42 participants met criteria for JHS, 26 participants also met criteria for hEDS. Strikingly, 22/42 (52.4%) scored above threshold for suspected Autism (26/42 in the sensory/motor domain; 22/42 in language domain; 22/42 in social relatedness domain; 17/42 in circumscribed interests domain). There were no significant differences in RAADS-R scores depending on hypermobility diagnosis. The number of connective tissue features (hEDS Criterion 2A) correlated with RAADS-R sensory/motor score (r = 0.418, p = 0.006) but not social relatedness nor circumscribed interests sub-scores. Full mediation of the relationship between the number of connective tissue features and RAADs sensory/motor score by TAS-20 externally oriented thinking was found using the method of Baron-Kenny (1986) and estimation of indirect effects (Hayes, 2018; bootstrapped confidence intervals (n = 5000, do not cross zero)). Difficulty identifying feelings and difficulty describing feelings domains did not mediate this relationship.

Conclusion

These results add to evidence linking variant connective tissue to neurodevelopmental conditions (including Autism) and interestingly, specifically to sensory processing differences. Our study provides a strong rationale for screening for neurodevelopmental conditions in people with hypermobility and motivates further to understand symptom expression in this group. Our results also provide an insight into the processes underlying this relationship, which maybe important for informing interventions for people with hypermobility and autistic traits.
#3031 Outcome and evaluation of an outpatient multidisciplinary group-based rehabilitative therapy programme for functional neurological disorder
Authors: Guy Lisette , Gorman Sean , Wilson Jennifer , Jackson Temeika , Petty Demelza , Harrison Simon , Pick Susannah
Published: July 2021

Aims

We report findings from an eight-week rehabilitative therapy programme, delivered in a neuropsychiatric outpatient setting, with co-primary aims to (1) reduce symptom severity, and (2) improve functional mobility, in selected adults with a diagnosis of Functional Neurological Disorder (FND). Effectiveness of the programme was assessed in regard to outcome data routinely collected throughout the programme, and at three-month follow-up.

Method

Following appropriate referral, criteria screening and initial assessment, suitable individuals attended as day patients for two days per week over an eight-week period, and a follow-up session provided at three months. The programme comprised individual sessions of Physiotherapy (PT), Cognitive Behavioural Therapy (CBT) and self-management, as well as group physiotherapy workshops and psycho-educational sessions. Outcome measures included the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-ii), Work and Social Adjustment Scale (WSAS), and clinician-rated observation of mobility-aid requirement. Mobility-aid requirement was categorised as follows: unaided, walking-aid, and wheelchair user. Analyses included only data from individuals completing both treatment and follow-up (n = 31). Friedmans ANOVA assessed overall change in outcome measure scores over time. Dunn-Bonferroni post-hoc tests were used to compare pairs of time-points (Weeks 1, 8, three-month follow-up).

Results

There were statistically significant overall improvements on the BAI,χ2(2) = 15.35, p <.001,BDI-ii,χ2(2) = 24.61, p <.001,WSAS,χ2(2) = 24.61, p =.001, and in category of mobility-aid requirement, χ2(2) = 19.50, p <.001.Descriptive statistics indicated that 45% of patients could mobilise unaided prior to programme attendance, with 84%able to mobilise unaided at follow-up. Post-hoc Dunn-Bonferroni tests indicated that reductions in scores were significant between Week 1 and Week 8 for the BAI, p =.004, BDI-ii, p <.001, and WSAS, p =.004, and between Week 1 and three-month follow-up for the BAI, p =.002, BDI-ii, p =.001, and WSAS, p =.006.

Conclusions

These findings suggest that an outpatient rehabilitative therapy programme can be a beneficial treatment approach, as patients reported reduced symptom severity in terms of anxiety, depression, and functional impairment, as demonstrated by scores on the BAI, BDI-ii and WSAS, and displayed improvements in mobility, as determined by reduced mobility-aid requirement. Although further evaluation would be encouraged to address limitations of these findings, they serve as a positive indication of an effective alternative to inpatient treatment.
#3119 Diagnosis and management of functional neurological symptoms: Saudi Arabia experience
Authors: Khoja Lujain , Khoja Abeer , Shaaban Saeed , Tayeb Haythum
Published: July 2021

Objectives

To explore the opinion of todays neurologist and psychiatrist in the kingdom of Saudi Arabia regarding pathogenesis, diagnosis, treatment and outcome. It is a replication for Dutch experience with Functional Neurological symptoms Disorder (FND).

Methods

A multi-centres Cross-sectional study was conducted in Saudi Arabia started from November 2019 and still ongoing. The target populations were a qualified psychiatrists or neurologists. Data were collected through an electronic questionnaire.

Results

There were 70 respondents, 37.1% were female and 62.9% males. A 15.5% were Neurologists and 72.4% psychiatrists. Three questionnaires were taken out due to incompletion error. Most neurologists and psychiatrists believed that FND is a disorder of functioning of the nervous system together with psychogenic factors. However, 100% of psychiatrist believed that a prior psychological stress is a cause of the disorder (among other causes) while 86.84% of neurologists. Also found that, a 71% of patients who referred to neurologist were evaluated initially by a general practitioner, while 85% of the patients who referred to psychiatrist; were evaluated by neurologists. Eventually, most of the neurologists and the psychiatrists diagnosed patients by conversion disorder (13/38 of neurologist and 13/20 of psychiatrists).

Conclusion

Our preliminary conclusion is comparable for Dutch experience that is not considered purely a psychiatric disorder and counted disordered brain functioning together with psychogenic factors responsible for FNS. However, the majority of the psychiatrists in our study diagnose FND as conversion disorder.
#3115 Systematic review into the effects of sleep disorders on the development of PTSD
Authors: Millar Samuel J , Miorelli Ana
Published: July 2021

Objectives

To examine if sleep problems act as a risk factor for future PTSD development in military, child, and general adult demographics. We will also be examining specific sleep disorders, such as nightmares and insomnia, as well as examining general sleep complaints in a series of sub-sections (REM sleep, Sleep duration, quality, latency, and maintenance) to see if it is possible with the current literature to discover potential hints into the development of PTSD.

Methods

Six databases (Medline, Embase, Web of Science, Psych info, AMED, and OpenGray) were searched with a standardised search strategy. The papers were then screened for relevance and quality controlled using the Ottowa-Newcastle Scale and the CASP cohort checklist by two reviewers until only relevant and high quality cohort studies remained. Relevant information and data was extracted from published sources and information on insomnia, nightmares, REM sleep, and 4 specific sleep subcategories (sleep duration, quality, latency, and maintenance) were gathered and examined. Nometa-analysis was planned.

Results

Out of the 1813 documents gathered from the various databases, 25 papers were deemed fit for narrative synthesis. 19 discussed insomnia or general sleep complaints, and found that those tended to correlate with development of future PTSD, with little distinction between if the insomnia appeared pre or post-trauma. 6 discussed nightmares and found that those too were predictive, and 2 discussed REM sleep and found that REM theta waves were potentially predictive.

Conclusion

It is almost certain that complaints of poor sleep predict future PTSD development, with insomnia being predictive of many psychiatric conditions not just PTSD, and nightmares being more specific to the development of just PTSD. It has also been suggested that only subjectively (not objectively) poor sleep predicts PTSD. This would explain why specific sleep categories all have mostly mixed results, but the idea is not backed completely in the literature.
#3121 Adapting the queen square guided self help (QGSH) for functional neurological disorders as a stand-alone intervention: an exonian pilot study
Authors: Sachdeva Jasjeet , Selai Caroline , Moutoussis Michael
Published: July 2021

Aim

Functional neurological disorders (FND) are one of the most common presentation in neurology clinics, causing a significant disability and economic burden. Cognitive behavioural therapy (CBT) has one of the best available evidence in managing FND, although access remains limited. Queen Square, London neuropsychiatry experts have established an excellent model for a CBT based, Guided Self Help (GSH) programme, which is preparatory to a multidisciplinary inpatient treatment. It has been shown to have good outcomes. This study was designed to ascertain the feasibility and acceptance of this QGSH model, in an Exonian cohort of FND patients, whilst piloting its stand-alone version, without the inpatient component. Additionally, the study explores the need and types of modifications required for the stand-alone adaptation of QGSH.

Method

Consecutive patients referred to Exeter FND Service, between February to June 2020, who had internet access, were offered the QGSH pilot. Patients with a primary mental disorder concurrent drug/alcohol misuse or risk of self-harm or suicide were excluded. Ethics approval was not required. The QGSH intervention constitutes of 11 modules focussing on specific elements crucial to FND management along with homework tasks, delivered by the author, under supervision by QGSH experts. Patients completed Pre and Post-intervention questionnaires as well as structured feedback.

Results

Three successive patients with varied FND symptoms were recruited to the pilot between February and June 2020. The baseline health status of these patients was worse as compared to EQ-5D-5L population norms with significant baseline psychiatric comorbidity. Outcome measures used before and after QGSH intervention included PHQ 9, GAD 7, EQ-5D-5L and a locally devised symptom severity questionnaire. Necessary modifications were made to the program based on the patients informal feedback and structured formal feedback was sought in the end.

Conclusion

All patients derived some benefit from QGSH and certain modifications were suggested in patient feedback to improve engagement. Despite study limitations, especially small size and the impact of Covid 19 pandemic during the intervention; QGSH model appears acceptable and feasible in an Exonian cohort, however, some modifications are recommended for the stand-alone version to succeed. The recommendations will be presented.
5 Sex, bugs & microwave attacks: how bad science, mating insects & psychogenic illness created an international incident with cuba
Authors: Bartholomew Robert E
Published: July 2021

The National Academic of Sciences recently concluded that the most likely explanation for a cluster of health complaints among American diplomats stationed in Cuba between 2016 and 2018, was microwave energy. A considerable amount of misinformation continues to circulate in the media about this episode. The author will refute the NAS report and make the case that the preponderance of evidence supports a psychogenic explanation.
Increased risk of subsequent chlamydia infection among women not tested at the anorectal anatomical location
Authors: Visser Maartje , Dvorakova Milada , van Aar Fleur , Heijne Janneke C M
Published: July 2021

Background

Universal anorectal testing for Chlamydia trachomatis (chlamydia) among women is not recommended in many countries, while anorectal chlamydia infections are common. Missed anorectal infections might cause sequelae at the genital site if autoinoculation from the anorectum is possible, but evidence is limited. This study investigates the association between potentially missed anorectal infections and subsequent genital chlamydia infections in women, using not being tested at the anorectal site as a proxy for having a potentially missed anorectal infection.

Methods

We included all women with a repeat chlamydia test within 1 year (with at least a genital test) from the Dutch sexual health centre surveillance between 2014 and 2019. Multilevel logistic regression analyses were used to identify determinants of genital chlamydia infection at the repeat test, with anorectal testing at the previous chlamydia test as the main determinant.

Results

A total of 40 217 women were included in the analyses, of whom 15.4% tested chlamydia-positive genitally at their second test. Not being tested anorectally at the first test was an independent risk factor for genital chlamydia infection at the repeat test (adjusted OR 1.24, 95% CI 1.15 to 1.33). This association was in the same range as most other significant risk factors in the model: low education level, no condom use, STI symptoms and previous STI diagnosis. Young age (<20 years) (2.67, 2.39–2.98) and those who received partner notification (3.11, 2.91–3.31) showed stronger associations. The findings were robust; correcting for interactions and a sensitivity analysis stratifying by chlamydia infection at first visit did not show significant differences in the adjusted OR of not being tested anorectally at first test.

Conclusion

The results are suggestive of an autoinoculation process from the anorectal to the genital anatomical site in women. To enhance chlamydia control, future studies on the role of extragenital testing and autoinoculation in chlamydia transmission are needed.
Low-strain dynamic characterization of undisturbed Leda clay
Authors: Irfan Muhammad , Cascante Giovanni , Basu Dipanjan , LeBoeuf Denis
Published: July 2021

The low-strain dynamic behavior of Leda clays is investigated using resonant column (RC) and bender element (BE) tests. Four undisturbed, lightly overconsolidated Leda clay samples, collected from two sites near the St. Lawrence River valley, are tested at different strains, confining stresses, and frequencies. To evaluate the effect of excitation frequency, simultaneous measurements of shear wave velocity using RC and BE tests are performed. The results show that the samples from the different sites behave differently. The high sensitivity of the Leda clays does not have a significant effect on the modulus degradation curves. However, the measured degradation curves are similar to those of soft clays with high plasticity, which is contrary to the expected behavior of these low plasticity (Ip= 6.2–20) specimens. Likewise, the measured damping ratios are on the lower end of the typical values reported for soils of high plasticity. Low values of damping ratio make the amplification of small seismic events more likely in Leda clay deposits. The difference in the shear wave velocity measurements from RC and BE tests ranges from 17% to 26% depending on the confinement, likely because of the strong influence of P-waves observed in the BE tests for these soils.
Variations in phytochemistry, morphology, and population structure inTrillium govanianum(Melanthiaceae)
Authors: Chauhan Harsh Kumar , Gallacher David , Bisht Anil Kumar , Bhatt Indra Dutt , Bhatt Arvind , Dhyani Praveen , Kewlani Pushpa
Published: July 2021

As habitats change, species with higher intraspecific variation have more resources to adapt. Medicinal plants in the Himalayas are increasingly threatened by climate change and other anthropogenic influences. The intraspecific variation within and among 17 populations of the high-elevation herb Trillium govanianum Wall. ex D.Don was studied as an indicator of adaptability. The variation in 19 traits of population structure, morphology, and phytochemistry was assessed across habitats that varied in elevation (2452–3432 m a.s.l.), aspect, latitude (30.1–31.7°N), and arboreal community. The morphology and population structure were conserved among populations but varied among regions. The populations in the lower elevation mixed forests of Tirthan Valley produced smaller rhizomes but larger plant densities, such that plant biomass per square metre was conserved. The phytochemistry varied among regions and populations within regions, indicating significant variation among habitats. The aboveground morphology of the species masks considerable variations in belowground morphology and phytochemistry. The observed variations can help the species to adapt to the changing environmental conditions by provoking a functional response.
Pathogenicity, anastomosis groups, host range, and genetic diversity of Rhizoctonia species isolated from soybean, pea, and other crops in Alberta and Manitoba, Canada
Authors: Yu Haitian , Zhou Qixing , Hwang Sheau-Fang , Ho Andrew J. , Chang Kan-Fa , Strelkov Stephen E. , He Yuhua , Conner Robert L. , Harding Michael W.
Published: July 2021

Root rot is a common disease in soybean (Glycine max) and field pea (Pisum sativum), which restrain increased production in Canada. Sixty-seven isolates of Rhizoctonia were recovered from various diseased plants in Alberta, Canada along with three isolates from diseased soybean plants in Manitoba, Canada. According to their anastomosis behavior, 23 (32.9%) of the isolates were identified as anastomosis group (AG) 4 (AG4), 7 (10.0%) were AG2-1, 10 (14.3%) were AG2-2, 7 (10.0%) were AG5, 3 (4.3%) were AG-E and the AGs of the remaining 20 (28.6%) isolates could not be determined. Isolates belonging to AG4 produced typical symptoms of stem rot and root rot on seedlings of soybean and pea and were more aggressive than the AG2-1, AG2-2, AG5 and AG-E isolates. Selected isolates of AG4, AG2-1, AG2-2, AG5 and AG-E were to some degree able to infect common crops in Alberta, which included barley, canola, corn, faba bean, flax, lupin, lentil, pea, potato, soybean, and wheat. The genetic variability among these isolates was evaluated using phylogenetic analysis based on the rDNA ITS sequences and inter-simple sequence repeat (ISSR) markers. For the ITS sequence analysis, a neighbour-joining tree was constructed using the PAUP program, which clustered the Rhizoctonia isolates into five groups (Groups I to V). However, no correlation was observed between AGs, locations, aggressiveness or host origins. For the ISSR analysis, 54 polymorphic ISSR patterns were identified, indicating a high level of diversity among the isolates.
Short-term impacts of winter bale grazing beef cows on forage production and soil nutrient status in the eastern Canadian Prairies
Authors: Donohoe Gwen , Flaten Don , Omonijo Faith , Ominski Kim
Published: July 2021

The impact of winter bale grazing on forage productivity and nutrient cycling was determined near Winnipeg, MB, Canada. Variable distribution of nutrients and forage yield within bale-grazed plots on a perennial grass–legume forage field was identified using an intensive grid sampling method. In bale-grazed plots, mean dry matter (DM) yield of forage decreased 68% in year 1 following bale grazing, with no difference in DM yield in year 2 following bale grazing, relative to an untreated control. Decreased yield was attributed to the large mass of waste feed and feces (21% of feed delivered) that remained at the centre of each bale-grazed plot, where each bale was placed. Concentrations of crude protein, total digestible nutrients, phosphorus (P), and potassium in forage increased in the first growing season following winter bale grazing compared with the control, particularly at the centre of each bale-grazed plot. Concentrations of residual nitrate-nitrogen and Olsen P in soil were 15 and 2.5 times greater, respectively, at the centre of the bale-grazed plots compared with untreated control plots. Dispersion of waste feed packs when bale grazing in subhumid climates on clay soils is recommended to minimize smothering and encourage rapid decomposition of waste feed and feces. Long-term studies are needed to determine the potential benefits and risks of bale grazing to forage productivity and soil nutrient status in the eastern Canadian Prairies.
Linear dichroism in few-photon ionization of laser-dressed helium
Authors: Meister Severin , Bondy Aaron , Schnorr Kirsten , Augustin Sven , Lindenblatt Hannes , Trost Florian , Xie Xinhua , Braune Markus , Manschwetus Bastian , Schirmel Nora , Redlin Harald , Douguet Nicolas , Pfeifer Thomas , Bartschat Klaus , Moshammer Robert
Published: July 2021

Ionization of laser-dressed atomic helium is investigated with focus on photoelectron angular distributions stemming from two-color multi-photon excited states. The experiment combines extreme ultraviolet (XUV) with infrared (IR) radiation, while the relative polarization and the temporal delay between the pulses can be varied. By means of an XUV photon energy scan over several electronvolts, we get access to excited states in the dressed atom exhibiting various binding energies, angular momenta, and magnetic quantum numbers. Furthermore, varying the relative polarization is employed as a handle to switch on and off the population of certain states that are only accessible by two-photon excitation. In this way, photoemission can be suppressed for specific XUV photon energies. Additionally, we investigate the dependence of the photoelectron angular distributions on the IR laser intensity. At our higher IR intensities, we start leaving the simple multi-photon ionization regime. The interpretation of the experimental results is supported by numerically solving the time-dependent Schrödinger equation in a single-active-electron approximation.

Graphic abstract
Entanglement in fermionic chains and bispectrality
Authors: Crampé Nicolas , Nepomechie Rafael I. , Vinet Luc
Published: July 2021

Entanglement in finite and semi-infinite free Fermionic chains is studied. A parallel is drawn with the analysis of time and band limiting in signal processing. It is shown that a tridiagonal matrix commuting with the entanglement Hamiltonian can be found using the algebraic Heun operator construct in instances when there is an underlying bispectral problem. Cases corresponding to the Lie algebras [Formula: see text] and [Formula: see text] as well as to the q-deformed algebra [Formula: see text] at [Formula: see text] a root of unity are presented.
Explicit, periodic and dispersive soliton solutions to the conformable time-fractional Wu–Zhang system
Authors: Tariq Kalim U. , Khater Mostafa M. A. , Younis Muhammad
Published: July 2021

In this paper, some new traveling wave solutions to the conformable time-fractional Wu–Zhang system are constructed with the help of the extended Fan sub-equation method. The conformable fractional derivative is employed to transform the fractional form of the system into ordinary differential system with an integer order. Some distinct types of figures are sketched to illustrate the physical behavior of the obtained solutions. The power and effective of the used method is shown and its ability for applying different forms of nonlinear evolution equations is also verified.