bluuebunny/crossref_metadata_2025 huggingface dataset:
An experimental investigation on the damage mechanisms of red glutenite in the Mount Wuyi cultural and natural heritage site subject to acid rain and wet-dry cycles: a macro-to-micro approach
Authors: Dong Qi , Sun Xiang , Sheng Jianlong , Lei Nengzhong
Published: August 2024

The safety of rock landscapes in Mount Wuyi is significantly impacted by acid rain and wet-dry cycles. In this paper, the decay characteristics of the physical–mechanical properties of red glutenite were investigated under acidic wet-dry cycles. A systematic approach, including cold field emission scanning electron microscopy (CFE-SEM), image processing techniques, and X-ray diffraction (XRD), was proposed to investigate the damage mechanism of red glutenite under acidic wet-dry cycles. The results indicate that with increasing solution acidity and wet-dry cycles, dry density (DD), longitudinal wave velocity (LWV), uniaxial compressive strength (UCS), and elastic modulus (EM) of red glutenite significantly decrease. Under different acidic conditions, DD, LWV, and UCS exhibit exponential decay with wet-dry cycles, while EM exhibits linear decay. A regression fitting was employed to establish a prediction model for UCS, which exhibited a better capability in predicting the correlation between UCS, pH, and the number of wet-dry cycles. Microscopic comprehensive analysis reveals that the interaction between rock dissolution and desiccation is the primary factor leading to changes in the microstructure and mineral composition of red glutenite, culminating in the decay of its physical–mechanical properties. This study holds significant guidance implications for the preservation of cultural and natural heritage in Mount Wuyi.
Maternal hypothyroidism and the risk of preeclampsia: a Danish national and regional study
Authors: Lundgaard Maja Hjelm , Sinding Marianne Munk , Sørensen Anne Nødgaard , Handberg Aase , Andersen Stig , Andersen Stine Linding
Published: August 2024

Background

Maternal hypothyroidism in pregnancy has been proposed to increase the risk of preeclampsia, but uncertainties persist regarding the underlying causal mechanisms. Thus, it remains unclear if an increased risk of preeclampsia in hypothyroid pregnant women is caused by the lack of thyroid hormones or by the autoimmunity per se.

Methods

We conducted a retrospective study of two pregnancy cohorts in the Danish population. The nationwide cohort (n = 1,014,775) was register-based and included all singleton pregnancies in Denmark from 1999–2015. The regional cohort (n = 14,573) included the biochemical measurement of thyroid stimulating hormone (TSH), thyroid peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (Tg-Ab) (ADVIA Centaur XPT, Siemens Healthineers) among pregnant women in The North Denmark Region from 2011–2015 who had a blood sample drawn in early pregnancy as part of routine prenatal screening for chromosomal anomalies. The associations between diagnosed and biochemically assessed hypothyroidism and a diagnosis of preeclampsia were evaluated using logistic regression (adjusted odds ratio (aOR) with 95% confidence interval (CI)) adjusting for potential confounders, such as maternal age, diabetes, and parity.

Results

In the nationwide cohort, 2.2% of pregnant women with no history of hypothyroidism (reference group (ref.)) were diagnosed with preeclampsia, whereas the prevalence was 3.0% among pregnant women with hypothyroidism (aOR 1.3 (95% CI: 1.2–1.4)) and 4.2% among women with newly diagnosed hypothyroidism in the pregnancy (aOR 1.6 (95% CI: 1.3–2.0)). In the regional cohort, 2.3% of women with early pregnancy TSH < 2.5 mIU/L (ref.) were diagnosed with preeclampsia. Among women with TSH ≥ 6 mIU/L, the prevalence was 6.2% (aOR 2.4 (95% CI: 1.1–5.3)). Considering thyroid autoimmunity, preeclampsia was diagnosed in 2.2% of women positive for TPO-Ab (> 60 U/mL) or Tg-Ab (> 33 U/mL) in early pregnancy (aOR 0.86 (95% CI: 0.6–1.2)).

Conclusions

In two large cohorts of Danish pregnant women, maternal hypothyroidism was consistently associated with a higher risk of preeclampsia. Biochemical assessment of maternal thyroid function revealed that the severity of hypothyroidism was important. Furthermore, results did not support an association between thyroid autoimmunity per se and preeclampsia.
Successful thoracoscopic enucleation of a calcifying fibrous tumor of the lower mediastinum in a young woman
Authors: Yokota Ryo , Matsutani Takeshi , Mishima Keisuke , Yamagiwa Ryo , Kubokura Hirotoshi , Motoda Norio , Taniai Nobuhiko , Yoshida Hiroshi
Published: August 2024

Background

Calcifying fibrous tumor (CFT) arising from the pleura is a relatively rare benign lesion in young and middle-aged adults. We report a 31-year-old woman with pleural CFT who underwent successful complete thoracoscopic enucleation.

Case presentation

An asymptomatic woman presented with a mass in the right lower lung field that was incidentally detected on a chest X-ray during a routine medical checkup. Chest computed tomography showed a well-defined mass in the lower mediastinum, with a maximum diameter of approximately 5.5 cm. Esophagogastroduodenoscopy showed no abnormal findings in the esophagus. An endoscopic ultrasonography (EUS) revealed a well-defined tumor with no internal blood flow. EUS-fine needle aspiration failed to establish a definitive diagnosis. Therefore, thoracoscopic tumor enucleation was performed for diagnostic and therapeutic purposes. Based on the histopathological findings of the resected specimen, the presence of a tumor with a high fibrous component in a young woman, and the identification of granulomatous calcifications, a diagnosis of CFT was established.

Conclusions

Complete thoracoscopic tumor enucleation was successfully performed for CFT arising from the pleura in a young adult woman.
Obstructive sleep apnea and hypertension; critical overview
Authors: Kwon Younghoon , Tzeng William S , Seo Jiwon , Logan Jeongok Gang , Tadic Marijana , Lin Gen-Min , Martinez-Garcia Miguel Angel , Pengo Martino , Liu Xiaoyue , Cho Yeilim , Drager Luciano F. , Healy William , Hong Geu-Ru
Published: August 2024

Obstructive sleep apnea (OSA) and hypertension are two important modifiable risk factors for cardiovascular disease and mortality. Numerous studies have highlighted the interplay between these two conditions. We provide a critical review of the current literature on the role of the OSA as a risk factor for hypertension and its effect on blood pressure (BP). We discuss several key topics: the effect of OSA on nocturnal BP, BP response to continuous positive airway pressure (CPAP) treatment, CPAP effect on BP in refractory hypertension, the role of OSA in BP variability (BPV), and maladaptive cardiac remodeling mediated by OSA’s effect on BP. Finally, we discuss the unique aspects of ethnicity and social determinants of health on OSA with a focus on Asian populations and the disparity in BP control and cardiovascular outcomes.
The effect of physical activity intervention on blood pressure in 18 low and middle-income countries: a systematic review and meta-analysis of randomized controlled trials
Authors: Monfared Vahid , Hashemi Mohtaram , Kiani Fatemeh , Javid Reyhane , Yousefi Mahsa , Hasani Mahdis , Jafari Ali , Vakili Mohammad Ali , Hasani Motahareh
Published: August 2024

Background

In especially, low and middle-income nations (LMICs), where healthcare access may be restricted, high blood pressure (BP) is a major risk factor for cardiovascular disease and stroke, both of which can even lead to death. Altering one's lifestyle, in conjunction with medical therapy, has been demonstrated to be effective in lowering BP. Recent research has shown that physical activity (PA), in a variety of guises and to varying degrees, can be an effective means of lowering BP.

Objective

The purpose of this meta-analysis and systematic review was to evaluate the impact that PA plays in the development of hypertension in LMICs nations.

Methods

An exhaustive search of the available research was carried out in order to locate studies that were pertinent. We searched a number of online databases, such as SCOPUS, Medline, and Web of Science, looking for clinical trials that were published before March of 2023. Studies were only considered for inclusion if they were randomized controlled trials (RCTs), reported on the association between PA and BP, and were carried out in LMICs countries.

Results

This meta-analysis incorporated a comprehensive collection of 60 studies, encompassing a total of 11,002 people, consisting of 5,630 cases and 5372 controls. The findings indicate that engaging in PA had a notable impact on decreasing systolic blood pressure (SBP), as seen by a weighted mean difference (WMD) of -7.70 mmHg, with a 95% confidence interval (CI) ranging from -9.50 to -5.91 (p < 0.001). Additionally, PA was found to have a significant influence on reducing diastolic blood pressure (DBP), as indicated by a WMD of -3.60 mmHg, with a 95% CI ranging from -4.48to -2.73(p < 0.001). The findings from subgroup analysis indicate that the observed results remained statistically significant when considering individuals with baseline SBP of 120 mmHg or lower and DBP of 80 mmHg or lower.

Conclusion

The incorporation of PA can significantly contribute to the mitigation of high BP within LMICs nations. Additional investigation is required to ascertain the most effective form and amount of PA in order to mitigate BP levels within these specific individuals.

Graphical Abstract
Reproducibility of CT-based opportunistic vertebral volumetric bone mineral density measurements from an automated segmentation framework
Authors: Bodden Jannis , Prucker Philipp , Sekuboyina Anjany , El Husseini Malek , Grau Katharina , Rühling Sebastian , Burian Egon , Zimmer Claus , Baum Thomas , Kirschke Jan S.
Published: August 2024

Background

To investigate the reproducibility of automated volumetric bone mineral density (vBMD) measurements from routine thoracoabdominal computed tomography (CT) assessed with segmentations by a convolutional neural network and automated correction of contrast phases, on diverse scanners, with scanner-specific asynchronous or scanner-agnostic calibrations.

Methods

We obtained 679 observations from 278 CT scans in 121 patients (77 males, 63.6%) studied from 04/2019 to 06/2020. Observations consisted of two vBMD measurements from Δdifferent reconstruction kernels (n = 169), Δcontrast phases (n = 133), scan Δsessions (n = 123), Δscanners (n = 63), or Δall of the aforementioned (n = 20), and observations lacking scanner-specific calibration (n = 171). Precision was assessed using root-mean-square error (RMSE) and root-mean-square coefficient of variation (RMSCV). Cross-measurement agreement was assessed using Bland-Altman plots; outliers within 95% confidence interval of the limits of agreement were reviewed.

Results

Repeated measurements from Δdifferent reconstruction kernels were highly precise (RMSE 3.0 mg/cm3; RMSCV 1.3%), even for consecutive scans with different Δcontrast phases (RMSCV 2.9%). Measurements from different Δscan sessions or Δscanners showed decreased precision (RMSCV 4.7% and 4.9%, respectively). Plot-review identified 12 outliers from different scan Δsessions, with signs of hydropic decompensation. Observations with Δall differences showed decreased precision compared to those lacking scanner-specific calibration (RMSCV 5.9 and 3.7, respectively).

Conclusion

Automatic vBMD assessment from routine CT is precise across varying setups, when calibrated appropriately. Low precision was found in patients with signs of new or worsening hydropic decompensation, what should be considered an exclusion criterion for both opportunistic and dedicated quantitative CT.

Relevance statement

Automated CT-based vBMD measurements are precise in various scenarios, including cross-session and cross-scanner settings, and may therefore facilitate opportunistic screening for osteoporosis and surveillance of BMD in patients undergoing routine clinical CT scans.

Key Points

Artificial intelligence-based tools facilitate BMD measurements in routine clinical CT datasets.

Automated BMD measurements are highly reproducible in various settings.

Reliable, automated opportunistic osteoporosis diagnostics allow for large-scale application.

Graphical Abstract
Growth inhibition of P. aeruginosa by methanol extract of Bridelia stipularis and identification of active components using in silico studies
Authors: Sini A. , Bindu T. K. , Raphael Vinod P. , Shaju K. S. , Sebastian Sherry
Published: August 2024

Background

Antimicrobial resistance among pathogens is an emerging problem, gaining significant importance recently. Pharmaceutical scientists are constantly exploring innovative and effective antibacterial agents. Pseudomonas aeruginosa (P. aeruginosa) is a bacterium primarily responsible for pneumonia and infections in the liver, kidneys, and other body parts. It is a Gram-negative bacterium that can be controlled by antibiotics such as ciprofloxacin and levofloxacin. However, this pathogen sometimes exhibits resistance to these antibacterial agents.

Methods

Recognizing the well-known potential of plants as sources of medicinal compounds, our study focused on the ethyl acetate, acetone and methanol extract of the leaves of Bridelia stipularis and its impact on the growth of P. aeruginosa using well diffusion method. To gain insight into the composition of the extract, we conducted GC–MS analysis. After identifying the components present in the extract, we assessed the drug-likeness, absorption, distribution, metabolism, and excretion (ADME) and conducted docking studies of the molecules with the selected structural receptors of P. aeruginosa to find out the active component present in the extract.

Results

Remarkably, only methanol extract of Bridelia stipularis demonstrated significant antibacterial activity against this pathogen. In silico investigations revealed that two compounds, namely ethyl iso-allocholate and toluene sulfonylhydrazone derivative, exhibited high inhibition potencies. All structural receptors of the pathogen taken for this study were well inhibited by ethyl iso-allocholate while the receptors such as laconizing lipase and penicillin-binding protein of the bacterium were bound well with the 4-phenyl-3-penten-2-one p-toluene sulfonylhydrazone.

Conclusions

Observations of this study clearly establish that the two phytochemicals present in the methanolic extract, i.e., ethyl iso-allocholate and toluene sulfonylhydrazone derivative of Bridelia stipularis leaves are highly active against the growth of the opportunistic pathogen P. aeruginosa.

Graphical abstract
Assessing the acceptance of cultural policies among heritage homeowners: a study of Ahmedabad’s heritage TDR implementation, capacity building, and satisfaction
Authors: Routh Rajdeep , Bhavsar Dhruma
Published: August 2024

This paper examines the influence of the Heritage Transfer of Development Rights (HTDR) among heritage property owners and explores how its successful implementation has been hampered based on the study of two indicators—policy awareness and implementation efficiency—which are vital for generating initial interest among stakeholders and leading them to use the policy.

The HTDR policy at Ahmedabad, introduced in 2015 as an incentive program supporting the conservation of privately owned properties within the old city of Ahmedabad, has failed to generate much interest among the local community. As per the documents available online on the website of Ahmedabad Municipal Corporation, in the last 9 years, only 81 properties with TDR certificates. It is thus very pertinent to identify the reasons for its lack of influence and acceptance. In this study, a mixed method was adopted involving a closed-ended survey and semi structured interviews. The inferences are based on the responses gathered from heritage property owners currently living in heritage properties and those living elsewhere. The heritage properties were identified based on a random sampling method from the listed heritage properties spread across the 13 wards of the walled city. Based on the research findings, although most property owners are aware of the HTDR policy and find it an essential tool for conserving heritage in Ahmedabad, awareness of the whole mechanism and application process is significantly limited.

The implementation of the HTDR policy is highly inefficient, and more awareness must be generated among owners. Moreover, more training or technical assistance needs to be provided to them to help them access the incentive program. The lack of a proper and comprehensible policy brief or document further hinders the situation. Overall, property owners are not completely satisfied with the HTDR policy and suggest critical revisions, such as reducing the file clearance time, calculating a new TDR amount, and modifying the stages of fund disbursement.
Outcome of novel combination of graphene nanoparticles and Moringa methyl ester fueled engine working under varying loads and compression ratios
Authors: Das Akkur Neele Gowda Mohan , Riyazuddin Haseebuddin Mohammad , Nagaraj Shreyas , Hebbal Umamaheshwar , Siddesh Jatin , Kamath Aditya
Published: August 2024

The widespread use of petroleum products in modern times has led to a search for alternative resources. Biofuel is a promising alternative to petroleum fuel, but biodiesel has a lower calorific value and is slightly more denser than diesel. To address this, a novel combination of GNA emulsified MME20 fuel is being investigated. This study aims to analyze the impact of a novel Nano additive blended biodiesel on engine performance and optimize the best compression ratio for the selected blend. The novelty of the study lies in the production of novel GNA emulsified MME fuel and its influence on a conventional CI engine. To achieve the objectives of the study, MME was produced using a two-phase transesterification method, and GNA was added to the MME20 at concentrations of 30, 60, and 90 ppm using the ultrasonication method. Engine experiments were then conducted using the prepared samples at CRs of 16, 17.5, and 19, and the results were compared with the standard diesel and MME20 blend. The results showed that the CP of the MME20 + GNA30 fuel at a CR 19 revealed a 14% increase compared to diesel. The ID of the fuel decreased by 20% compared to diesel at CR19, and there was a 23.5% increase in the CD for the MME20 + GNA30 blend compared to diesel at CR19. The BTHE for the MME20 + GNA30 fuel showed increases of 2.64% and BSFC and EGT decreases of 3.6% and 3.9%, respectively, at CR19 compared to the other blends. In summary, the study found that MME20 with GNA30, along with VCR, significantly enhanced the engine attributes compared to the pure diesel-operated standard CI engine conditions.
Correlation between worsening pneumonitis and right ventricular systolic function in critically ill patients with COVID-19
Authors: Lashin Hazem , Aron Jonathan , Lee Shaun , Fletcher Nick
Published: August 2024

Background

The pneumonitis associated with coronavirus disease 2019 (COVID-19) infection impacts the right ventricle (RV). However, the association between the disease severity and right ventricular systolic function needs elucidation.

Method

We conducted a retrospective study of 108 patients admitted to critical care with COVID-19 pneumonitis to examine the association between tricuspid annular plane systolic excursion (TAPSE) by transthoracic echocardiography as a surrogate for RV systolic function with PaO2/FiO2 ratio as a marker of disease severity and other respiratory parameters.

Results

The median age was 59 years [51, 66], 33 (31%) were female, and 63 (58%) were mechanically ventilated. Echocardiography was performed at a median of 3 days [2, 12] following admission to critical care. The PaO2/FiO2 and TAPSE medians were 20.5 [14.4, 32.0] and 21 mm [18, 24]. There was a statistically significant, albeit weak, association between the increase in TAPSE and the worsening of the PaO2/FiO2 ratio (r2 = 0.041, p = 0.04). This association was more pronounced in the mechanically ventilated (r2 = 0.09, p = 0.02). TAPSE did not correlate significantly with FiO2, PaO2, PaCO2, pH, respiratory rate, or mechanical ventilation. Patients with a TAPSE ≥ 17 mm had a considerably worse PaO2/FiO2 ratio than a TAPSE < 17 mm (18.6 vs. 32.1, p = 0.005). The PaO2/FiO2 ratio predicted TAPSE (OR = 0.94, p = 0.004) with good area under the curve (0.72, p = 0.006). Moreover, a PaO2/FiO2 ratio < 26.7 (moderate pneumonitis) predicted TAPSE > 17 mm with reasonable sensitivity (67%) and specificity (68%).

Conclusion

In patients admitted to critical care with COVID-19 pneumonitis, TAPSE increased as the disease severity worsened early in the course of the disease, especially in the mechanically ventilated. A TAPSE within the normal range is not necessarily reassuring in early COVID-19 pneumonitis.
Digital Interventions to reduce hospitalization and hospital readmission for chronic obstructive pulmonary disease (COPD) patient: systematic review
Authors: Mishra Vineet , Stuckler David , McNamara Courtney L.
Published: August 2024

Background

The high readmission rate following chronic obstructive pulmonary disease (COPD) has created a significant global health challenge, with high healthcare costs and a growing burden of care. Digital interventions, including telemonitoring, Telehealth, web, or mobile-based, can address these challenges, but there has yet to be a systematic review of the impact of digital interventions on reducing hospital readmission for patients with COPD. The aim of this systematic review was to assess the effectiveness of digital interventions in lowering hospitalization and rehospitalization for patients with COPD.

Methods

We conducted a systematic literature search from PubMed and Scopus to identify randomized controlled trials (RCTs) published in English with outcomes related to hospital admission or readmission within 30 days of hospital discharge.

Results

The search and selection process followed PRISMA guidelines and resulted in a final sample of 12 RCTs. We found mixed results. Of the 12 included studies, only four studies [mobile-based (n=1), Telehealth (n=1), Telemonitoring (n=2)] found positive effect of a digital intervention on hospital readmission. Seven studies [mobile-based (n=1), Telehealth (n=1), Telemonitoring (n=3), Web-based (n=2)] did not demonstrate clear evidence of a significant reduction in hospitalization rate. Based on these findings, the primary factors contributing to the outcome variation were differences in intervention components used and their operator, COPD severity, patient age, and sample size.

Conclusions

Systematic review provides the first insight into the impact of digital intervention on hospital readmission among patients with COPD . While some studies showed positive results, the evidence is mixed, and further research is needed. COVID-19 has accelerated the use of digital intervention and created the opportunity for comprehensive research and investigation with more updated information and further impact on readmission.
Multiphysics framework for cost-effective, long-term monitoring of carbon storage in a carbonate reservoir
Authors: Alyousuf Taqi , Colombo Daniele , Turkoglu Ersan , Almajid Muhammad , Shawaf Mohammed , Ali Mohammed
Published: August 2024

We evaluate an effective and cost-efficient multiphysics approach for long-term monitoring of carbon storage in carbonate reservoirs. A key focus of our study is to advocate for a cost-effective, long-term monitoring strategy for carbon storage projects through the integration of surface and borehole multiphysics measurements. By leveraging technologies related to electromagnetic (EM) and gravity methods, we present a framework that addresses the monitoring of the dynamic behavior of injected CO2 over an extended period. The modeling setup integrates realistic static reservoir models with simulated dynamic saturation models to provide results as close as possible to real experimental conditions. Results demonstrate the high sensitivity of EM fields to changes in reservoir CO2 saturation, especially when surface-to-reservoir acquisition configurations are adopted. Additionally, gravity simulations, employing three-axis vector surface gravity measurements and borehole vector gravity, effectively capture density variations over time. Our proposed framework highlights the sequential use of seismic imaging for preinjection site characterization and the transition to EM and gravity surveys for continuous monitoring during and after the injection phases. The multiphysics simulation results performed on realistic carbon storage conditions contribute to the evolving landscape of effective geophysical CO2 monitoring technology for reliable long-term reservoir management.
Isolating and Characterizing the Translatome From Human Alzheimer's Disease (AD) Brains
Authors: Ali Bangash Muhammad , Lin Julie Qiaojin
Published: August 2024

Aims

Local protein synthesis at the synapse is a key determinant of learning and memory and is predicted to be severely disrupted in Alzheimer's disease (AD). Omics approaches have played a key role in deciphering molecular mechanisms underlying AD pathology. However, isolating the transcriptome may be biased due to inherent variations in transcript levels, or by transcription-on-demand models employed by several genes, whereas mass-spec based proteomics approaches fail to capture low abundance peptides. The translatome bypasses these inherent limitations of other omics methods by capturing actively translating mRNA species trapped inside ribosomes and subjecting them to unbiased RNA-seq analysis capturing even very low abundance transcripts.

Methods

Isolating the neuronal ribosomes from human post-mortem brains without interference from non-neuronal cells remains a challenge. We used frozen brain tissue from Alzheimer's patients and healthy controls obtained from the Cambridge Brain Biobank. Synaptoneurosomal fractions were prepared using sucrose gradients in non-denaturing buffers with RNAse inhibitors to preserve ribosomal composition and trapped mRNA. We isolated functional ribosomes on affinity columns following recombinant RNAse digestion. Finally, actively translating ribosome-trapped mRNAs were sequenced using RNA-seq, aligned to human genome using STAR alignment and analysed for differential expression using DeSeq2 followed by pathway analysis.

Results

We have successfully isolated ribosome-associated RNA transcripts in the dendritic spines from cortical neurons of postmortem Alzheimer's brains with little interference from glial and non-neuronal material. The novel AD translatome disruptions identified by isolating endogenous ribosome bound mRNA will help detect downstream molecular targets. We will also integrate targeted translatome data with published transcriptome and GWAS DNA variant data to identify novel biomarkers.

Conclusion

This is the first successful isolation of the dendritic translatome from human postmortem AD brains. Future studies will verify functional significance of key targets using gain- and loss-of-function studies in animal models of AD and human iPSCs.
Stakeholders’ Experience of Postpartum Psychosis Recovery in UK Mother and Baby Units: A Systematic Review and Conceptual Framework
Authors: Barry Jillian
Published: August 2024

Aims

•

Identify themes in experience of Postpartum Psychosis (PP) recovery in Mother and Baby Units (MBUs) from the perspective of mothers, partners and MBU professionals.

•

Develop a Conceptual Framework of recovery from PP in the MBU setting.

Methods

Systematic review using published and unpublished literature identified through database searches and grey literature sources. A narrative synthesis approach was taken and used to form a Conceptual Framework of recovery from PP in the MBU setting.

Results

Four databases were searched, yielding 8 includable studies. A further 3 grey literature sources met the inclusion criteria. Most of the sources focussed on the womens' experience of recovery.

Stakeholders experienced MBUs as providing a positive therapeutic milieu for recovery. The broad themes identified for improvement encompassed: knowledge of PP, accessibility of services and discharge practises.

Conclusion

This review provides valuable insights into the experience of recovery from PP within UK MBUs from the perspectives of multiple stakeholders. Areas for improvement identified include antenatal education on PP, knowledge of PP amongst non-specialist healthcare professionals, partner involvement in care, and discharge processes.

The outcomes of this review have the potential to shape the design, implementation, and expansion of MBUs and their practices both nationally and internationally.
An fMRI Based Study of the Neural Correlates of OCD Sub-Types
Authors: Chahal Shagun , Sharan Pratap , Kumaran Senthil , Hans Gagan
Published: August 2024

Aims

1.

To study the neural correlates of OCD using functional MRI.

2.

To compare the neural correlates of the pure washer dimension of OCD with other dimensions of OCD and healthy controls.

Methods

It was a cross-sectional, case-control study conducted from 2018 to 2021. OCD patients were recruited with purposive sampling from outpatient attendance at All India Institute of Medical Sciences, New Delhi following the inclusion and exclusion criteria. The patients were divided into two groups i.e. washing sub-type and non-washing/other sub-type based on dimensional YBOCS score. The healthy control group consisted of age and sex-matched healthy individuals. Each group had 10 individuals. The participants underwent functional MRI with resting fMRI and activation task-based MRI. Activation tasks included a cognitive task i.e. Stroop test and an affective task which included trigger words for OCD tailored according to the patient's triggers for OCD.

The results were studied for significance within a group and also compared among the three groups and between OCD patients and healthy controls as well.

Results

In OCD-specific task using trigger words, the right frontal gyrus, right medial frontal gyrus, and left cingulate gyrus showed hyperactivation in the washer OCD subtype group. After correction for family-wise error, p-FWE (<0.05) corrected < 0.05, there was so significant result. The non-washing subtype had no significant areas of activity on the OCD specific task.

But the combined OCD patient group (compared with controls), had hypoactivation of the right inferior frontal gyrus and fusiform gyrus at p-unc (<0.001) in the OCD task.

In the Incongruent part of the Stroop task, the non-washer subtype had hypoactivation of the right caudate body compared with healthy controls at p-FWE (<0.05).

In the congruent Stroop task, washer OCD subtype, the right insula was found to be hyperactive at p-FWE (<0.05).

Conclusion

Previous studies comparing activation on cognitive tasks in OCD patients and healthy controls have revealed differences in CSTC circuits as well as cerebellum and parietal areas. The washing symptom dimension is associated with insular hyperactivity in both emotional and cognitive tasks. It is associated with stimuli related to disgust. The role of the insula is being researched in functions like attention and response inhibition. Our study, with all its limitations, could replicate the insular findings in washing-subtype of OCD. With a better sample size, we may be able to explore further the findings that have not attained levels of significance in our study.
Adherence to a Mediterranean Diet and Impact on Mental Health Outcomes in Adolescents and Adults With Severe Mental Illness: A Systematic Review
Authors: Chavda Seetal , Sarwar Amina , Batchelor-Parry Holly , Pankhania Kishan , Upthegrove Rachel
Published: August 2024

Aims

The Mediterranean diet has shown to improve mental health outcomes in people with depressive disorder. However, little is known of the impact of the Mediterranean diet on severe mental illness. The aim of this systematic review was to evaluate the impact of a Mediterranean diet on mental health and quality of life outcomes in adolescents and adults with severe mental illness (as defined by schizophrenia spectrum disorders, at risk mental states for psychosis, bipolar affective disorder and severe depression with psychosis).

Methods

The following databases were systematically searched: MEDLINE and EMBASE via Ovid, CINAHL via EBSCO, PsychInfo via ProQuest, PubMed and Clinicaltrials.gov, using relevant subject headings and free text search terms to encompass severe mental illness and the Mediterranean diet. Screening, data extraction and quality assessment were completed by two independent reviewers. Eligible study designs included randomised controlled trials, other non-controlled or controlled interventional or experimental studies, cohort studies, case-control studies and cross-sectional studies that included adults and adolescents. The search was not limited to a specific time frame or language. The Mediterranean diet and mental health and quality of life outcomes were defined by primary paper author definitions.

Results

Thirteen eligible studies were identified: 4 interventional, 2 cohort, 2 case-control and 4 cross-sectional studies and 1 mixed methods (interventional and observational) study. Diagnoses in most studies were psychotic illness, schizophrenia, schizoaffective disorder, bipolar affective disorder and depression with psychosis. There was a lack of studies found that included adolescents or participants with at-risk mental states for psychosis. A range of Mediterranean diet adherence scoring systems were used across studies, indicating a notable heterogeneity in the way adherence was evaluated. Most studies included other lifestyle exposures or interventions alongside the Mediterranean diet. There was a marked heterogeneity between studies in how mental health and quality of life outcomes were assessed. Although there was an overall trend towards improved mental health or quality of life outcomes in some studies, others reported no change or a negative association with the dietary/lifestyle exposure or intervention.

Conclusion

The association between Mediterranean diet adherence and mental health outcomes and quality of life in adults and adolescents with severe mental illness remains inconsistent. Lifestyle-based interventions for the treatment of mental illness are cost-effective and relatively easy to implement with less concern about side effects. Therefore, this area requires further research.
Integrating Spirituality Into Mental Health Care
Authors: Barber Joanna , Cook Christopher
Published: August 2024

Aims

To find how best to integrate religion/spirituality (R/S) into clinical care.

Methods

This was a qualitative study. 41 mental health patients of varying diagnoses in secondary care underwent semi-structured interviews describing their mental health and spiritual journeys and how these have interacted, before, during and after a period of acute illness. Grounded theory was used. Detailed coding was carried out and themes extracted.

Results

Preliminary results from this project have already been reported, (submitted for publication). 5 main processes by which R/S interacted positively or negatively with mental health recovery were identified:

•

R/S experiences, (+ve or -ve),

•

Existential crisis, (-ve),

•

Influence of faith community, (+ve or -ve),

•

Finding a personally meaningful faith, (+ve),

•

Changing priorities to a more spiritual outlook, (+ve).

Further analysis has allowed a comparison between our different participants who were at different stages of recovery:

1.

Those who described themselves most as being in recovery tended to have more positive R/S experiences, support from a faith community, a personally meaningful faith and have changed their priorities. Most have also found clinical care helpful. However, often R/S was considered more helpful both for personal recovery and symptom relief. For others in this group, R/S enables living a satisfying life despite limitations of illness partially controlled by medication.

2.

Those who described themselves most as struggling with mental illness were much less likely to have a personally meaningful faith or had changed their priorities. They tended to have negative R/S experiences, persistent existential crisis and/or rejection from a faith community. Most of these people find both clinical care and R/S issues unhelpful. Some people were finding clinical care helpful but R/S barriers were blocking their recovery.

Many people at all stages of recovery said they wanted more help with R/S issues. They often regard their illness as a spiritual problem and consider positive R/S experiences a key to recovery.

Conclusion

Spiritual health may be important for recovery from many mental health problems and needs to be addressed according to the 5 themes.

•

Possible R/S barriers identified, even if symptoms seem to be responding to clinical treatment.

•

Positive R/S experiences and/or support from a faith community used to help overcome R/S barriers.

•

Support made available to find a personally meaningful faith and change priorities.

•

Referral to spiritual care offered more frequently.

Clinical care will be most effective if combined with facilitating spiritual health.
The Influence of Social Media on the Body Image of First Year Female Medical Students of University of Khartoum, 2022
Authors: Farah Razan
Published: August 2024

Aims

Facebook, Instagram, TikTok and other social media applications have become an integral component of everyone's social life, particularly among younger generations and adolescents. These social apps have been changing a lot of conceptions and beliefs in the population by representing public figures and celebrities as role models. The social comparison theory, which says that people self-evaluate based on comparisons with similar others, is commonly used to explore the impact of social media on body image. There is a need to study the influence of those social platforms on the body image as there has been an increase in body dissatisfaction in the recent years.

Methods

This was a cross sectional study that used a self administered questionnaire on a simple random sample of 133 female medical students of the first year. Data were analyzed using SPSS.

Results

Finding shows that the response rate was 75%. There was an association between social media usage and noticing how the person looks (p value = 0.022), but no significant association between social media use and body image influence or dissatisfaction was found.

Conclusion

This study implies more research under this topic in Sudan as the literature are scarce.
The Role of Rare Copy Number Variants in the Functional Outcomes of Individuals With Neurodevelopmental Conditions
Authors: Flanagan Maria , Dennison Charlotte , Martin Joanna , Thapar Anita
Published: August 2024

Aims

Copy number variants (CNVs) are large changes in the structure of DNA. Certain rare CNVs are associated with elevated chance of neurodevelopmental conditions and difficulties (NDs), including autism spectrum disorder (ASD) and intellectual disability, alongside various physical health complications. Currently, CNV testing in children with NDs is only recommended under limited circumstances, in part because their impact on outcomes and prognosis remains unknown. We aimed to investigate whether individuals with NDs in childhood, with and without rare pathogenic CNVs, differ in terms of functional outcomes in early adulthood.

Methods

Pathogenic CNV carriers were identified in the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK birth cohort of individuals born in 1991–1992. Individuals with the following childhood NDs were identified through parent-reported diagnostic interviews and questionnaires, and assessment with the child: Attention Deficit Hyperactivity-Disorder (ADHD), ASD, reading difficulties, coordination difficulties, language difficulties, and chronic tics. Outcomes were measured at age 25 and included: presence of an emotional disorder, being in receipt of sickness/disability benefit, ability to make and maintain friendships, not being in education, employment, or training (NEET), and self-reported life satisfaction. We will use logistic regression to measure the association between carrying a pathogenic CNV and each functional outcome in ALSPAC. Sensitivity analyses will be conducted on all large (>250kb), rare (<1%) CNVs, as opposed to only pathogenic CNVs.

Results

983 individuals with probable NDs (39.4% female, n = 387) were identified in ALSPAC, including 495 people with ASD, 163 with ADHD, 16 with Tourette's syndrome, 210 with reading difficulties, 295 with language difficulties, and 166 with coordination difficulties. Many individuals met criteria for more than one ND.

43 (4.4%) of individuals with an ND carried a pathogenic CNV. CNV carrier status amongst individuals with a ND was not associated with sex (4.4% of females vs 4.4% of males, OR = 1.007 [0.539–1.882] p = 0.981). Analysis of CNV carrier status on outcomes in NDs will be conducted between February and April 2024.

Conclusion

Evidence in support of poorer outcomes in CNV carriers could suggest that neurodiverse young people with CNVs may benefit from intervention to improve outcomes, and thus more individuals may benefit from genetic testing. Conversely, evidence indicating that CNVs do not impact outcomes may suggest that current clinical guidelines are appropriate within the current research landscape, and that further research is needed to understand the impact of carrying a pathogenic CNV in young people with NDs.
What Is the Evidence for Cognitive Behavioural Therapy for Insomnia (CBTI) in Improving Sleep in People With Mild Cognitive Impairment or Dementia?
Authors: Forbes Charlotte , Butterworth Jo , Fox Chris , Allan Louise
Published: August 2024

Aims

There is a well-established association between sleep disturbance and cognitive decline. Poor sleep can have a significant effect on patient and carer wellbeing and is a potentially modifiable risk factor for dementia. Sleep medications are problematic in cognitive impairment due to the increased risk of adverse events such as falls and confusion. There is good evidence for Cognitive Behavioural Therapy for Insomnia (CBTI) in older adults but its effectiveness in cognitive impairment is unclear. In 2021, only one RCT on CBTI in cognitive impairment was identified (Cassidy-Eagle et al. 2018). This review seeks to establish if there is any new evidence.

Methods

Ovid Medline (1946 to present) and clinicaltrials.gov were searched for all interventional trials testing CBTI including RCTs, single-arm studies and protocols, written in English. Inclusion criteria:

1.

Adults with a diagnosis of MCI or Alzheimer's dementia;

2.

Sleep as a primary outcome, using a validated outcome measure.

Systematic reviews were tracked for references.

Results

172 citations were screened by the first author and 26 underwent full text review. Eight papers were eligible for inclusion. Four of these studied MCI, three looked at people living with dementia (PLWD) and caregivers as a dyad and one combined MCI and Alzheimer's (protocol only).

The search found two pilot RCTs and two protocols for MCI. Cassidy-Eagle et al. (2018) found a highly significant positive effect on four of five sleep outcome measures with large effect sizes. The Insomnia Severity Index (ISI) decreased from 15.29 to 3.25 (p < 0.001; Cohen's d −4.22). Mattos et al. (2021) also found significant improvements on all sleep outcome measures; ISI decreased from 13.5 to 8.3 (p < 0.01).

Three papers study joint CBTI for PLWD and their care partners (one pilot RCT and two protocols). Song et al. (2024) reported improvements in sleep parameters for both participants in the dyad but were not statistically significant. They are recruiting for a larger trial.

Conclusion

This review identified 7 new RCTs in progress. In MCI, new data continue to show a significant association between CBTI and improved sleep. Published data for people with dementia have not found a significant relationship, although the data set remains very limited. It is not yet possible to synthesise the results and future systematic reviews are needed. If effective, CBTI could offer a lower risk alternative to medications in managing sleep disturbance in people with cognitive impairment.
Disparities in Access to Group Parenting Training Programmes: A Cross-Sectional Analysis of Local Authorities Across England
Authors: Gorringe Rosemary , Woods Peter , Giardino Manuel , Solano Juan Luque , Hodson Nathan
Published: August 2024

Aims

To compare the funding, courses and delivery modalities of parenting training delivered across London borough councils, metropolitan district councils, and county councils in England.

Methods

Freedom of Information requests were piloted on 5 local authorities. Following optimisation, requests were sent out to 74 local authorities across England requesting information on funding for parenting training programmes (26 London Borough Councils, 16 County Councils, and 29 Metropolitan Borough Councils). 26/32 London Boroughs, 16/21 County Councils, and 29/36 Metropolitan Boroughs were sent requests. No follow-up emails were sent chasing responses; however, clarification was provided where necessary. Data were analysed on Excel to observe patterns and disparities.

Results

We received responses from 74 local authorities, and 50 were usable. The mean amount of funding spent across local authorities was £881,254 (standard deviation 1,627,921). There were 18 parenting programmes used, the most common was Triple-P. The average number of parents supported by parenting programmes per local authority was 949 (standard deviation 1410). Local authorities reported spending an average of £27,430 (standard deviation 41005) on digital parenting programmes. The mean number of parenting staff was 36 (standard deviation 59).

Conclusion

We found wide disparities in spending, staffing, and programme choices representing a fragmented landscape of parenting training provision. Several local authorities could not separate spending on parenting training, and parental engagement was not reported consistently. We recommend more consistent reporting of parental initiation, engagement, and completion of training programmes to ensure equitable access and provision of parenting training nationwide.