bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment Adherence and Long-Term Outcomes
Authors: Kane John M.
Published: August 2016

The successful management of schizophrenia is an enormous public health issue. Although antipsychotic medications can be very helpful in reducing rates of relapse and rehospitalization, nonadherence to medication is a frequent cause of exacerbations in psychopathology, psychotic relapse, and rehospitalization. Relapses can have devastating consequences in a variety of clinical and functional domains. Nonadherence can result from a variety of factors that vary from patient to patient and vary over time in individual patients. A number of strategies have been developed to assess and facilitate adherence. The first critical step is clinician awareness of the scope of the problem and consideration of appropriate strategies to address it.
Impact of Drug Tolerability on the Selection of Antidepressant Treatment in Patients With Major Depressive Disorder
Authors: Ginsberg Lawrence D.
Published: August 2016

Despite significant progress in the development of antidepressant therapies, tolerability remains an important factor associated with the selection of appropriate antidepressant treatment. Side effects commonly reported by depressed patients taking antidepressants include weight gain, sexual dysfunction, and gastrointestinal effects. Tolerability issues associated with antidepressants can negatively impact treatment outcomes for patients with major depressive disorder. In addition, a drug's tolerability profile substantially influences a physician's choice of specific antidepressant therapy. Despite the availability of many antidepressants, empirical clinical evidence to guide physicians in making the best choice is limited and not always clear. Thus, it is key for clinicians to understand the short- and long-term outcomes and side effect profiles of the available antidepressants.
Treatment of Rapid-Cycling Bipolar Disorder
Authors: Post Robert M. , Chang Kiki D. , Suppes Trisha , Ginsberg David L.
Published: August 2016

Approximately 40% of bipolar patients experience rapid cycling, and half of these suffer from ultra-rapid or ultradian cycling. These patterns are also common in children. Rapid-cycling bipolar disorder is difficult to bring to remission and often requires treatment with four or more classes of psychotropic medications. Lithium, even in combination with anticonvulsants or antidepressants, is often associated with residual episodic depressions. Concerns with adjunctive antidepressant treatment include their low response and remission rates and their tendency to cause switch into mania. Atypical antipsychotics and selected agents within the anticonvulsant class are becoming increasingly important in the treatment of rapid cycling. In the absence of clear treatment guidelines, the use and sequencing of drugs in complex combination treatment remains exploratory, but should be individualized based on careful prospective mood charting by the patient. Use of several drugs below their side-effect thresholds may prevent certain side effects. In children, long-term safety considerations are particularly important in the absence of a strong controlled clinical trials database.
Rapid Cycling in Children
Authors: Chang Kiki D.
Published: August 2016

Presence of rapid cycling appears to be the rule rather that the exception in children with bipolar disorder, although there is not much data to support this clinical notion. Geller and colleagues studied 93 pediatric patients with bipolar disorder, mean age 10.9 years. They found that 87% had rapid cycling defined as ≥4 episodes/year and 77% had ultradian cycling, defined as >365 episodes/year. In addition, Findling and colleagues studied 90 bipolar patients with a mean age of 10.8 years and found that 50% had rapid cycling by veteran CV criteria. (The study did not look at ultra-rapid or ultradian cycling.) Finally, using clinical interviews to study children with affective illness, Schraufnagel and colleagues found that 41% experienced >365 cycles/year (Slide 6).

It is difficult to figure out the difference between a cycle and an episode when children are cycling so quickly. Tillman and Geller proposed that any kind of mood switching constitutes a cycle. An episode, they proposed, is defined as having ≥2 weeks of mood symptoms with either onset and offset of one mood state within that 2 weeks, or onset and offset of a period of ultra-rapid or ultradian cycling. It appears that with younger age comes more rapid cycling and more mixed states, which can be confused with ultra-rapid cycling. In turn, the older the child gets, the less rapid cycling occurs, and the more episodic the disorder becomes with more euphoria and less irritability. However, this tendency has not been well studied.
Understanding the Results of CATIE in the Context of the Field
Authors: Glick Ira D.
Published: August 2016

The Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study was undertaken to provide a valid assessment of the differences between conventional and atypical antipsychotics and among the atypicals themselves in patients with schizophrenia. The CATIE investigators reported that while none of the study medications were ideal, olanzapine was the most effective in terms of treatment discontinuation, and there were no significant differences in effectiveness between the conventional antipsychotic perphenazine and the atypicals quetiapine, risperidone, and ziprasidone. Each drug differed slightly in rates of side effects, with more patients discontinuing perphenazine due to extrapyramidal side effects and more patients discontinuing olanzapine due to weight gain and metabolic effects. In order for data from phase 1 of the CATIE study to be interpreted within the appropriate context, physicians must understand how aspects of study design and statistical methods affect interpretation, and how this trial weighs against other data in the literature. This article enumerates the factors that complicate our understanding of the CATIE results and compares these findings with those from previously published meta-analyses. It is clear that therapeutic and side effects of antipsychotics vary from person to person. The goal of schizophrenia management is to maintain pharmacotherapeutic efficacy and tolerability over the long-term in order to maximize treatment adherence and benefits. What should emerge from CATIE is a renewed commitment to tailor schizophrenia treatment to the individual patient for long-term management.
Neurobiology of Sexual Response in Men and Women
Authors: Rowland David L.
Published: August 2016

Sexual desire, arousal, and orgasm are mediated by complex—and as yet not fully understood—interactions of the somatic and autonomic nervous systems, operating at cerebral, spinal, and peripheral levels. Furthermore, neural activity within these systems is modulated by the presence of steroid and peptide hormones, which affect male and female response differentially. At the central level, dopaminergic and serotonergic systems appear to play a significant role in various components of sexual response, although adrenergic, cholinergic, nitergic, γ-aminobutyric acidergic, and other neuropeptide transmitter systems may contribute as well. At the peripheral level, adrenergic, cholinergic, and nitergic activation mechanisms control vascular changes that underlie vaginal lubrication and penile erection. In addition, these systems respond to descending brain and spinal influences that generate orgasmic response. Disruption of endocrine, neural, or vascular response—caused by aging, disease, surgery, or medication—has the potential to lead to sexual inadequacy. At the same time, psychological and relationship factors play an important role in healthy sexual response and may enhance or impair sexual functioning.
Pharmacologic Treatment Strategies for Sexual Dysfunction in Patients with Epilepsy and Depression
Authors: Stimmel Glen L. , Gutierrez Mary A.
Published: August 2016

Sexual dysfunction is a frequently encountered comorbid condition in patients with many medical and psychiatric conditions, such as epilepsy and depression. Most depressed patients experience some type of sexual dysfunction, decreased sexual desire being the most common. The association of sexual dysfunction with epilepsy is less clear. Changes in sex hormone levels are common in patients with epilepsy and may be attributable to the disease or to antiepileptic drugs (AEDs). Sexual dysfunction associated with depression or epilepsy is generally treated according to standard guidelines for the management of sexual disorders, since data from special populations are not available. The most common forms of female sexual dysfunction are lack of sexual desire and difficulty achieving orgasm. There are no approved pharmacotherapies for female hypoactive sexual desire disorder or female orgasmic disorder. Female sexual arousal disorder is treated with estrogen replacement therapy when indicated or vaginal lubricants. The most common male sexual dysfunction disorders are premature ejaculation and erectile dysfunction.  Phosphodiesterase type-5 inhibitor drugs are now the first-line treatment for erectile dysfunction, and selective serotonin reuptake inhibitors and topical anesthetic creams are nonapproved but effective treatments for premature ejaculation. Testosterone and aromatase inhibitors have been used investigationally to treat sexual dysfunction in men taking AEDs. Patient education and follow-up appointments are essential to ensure optimal outcomes of pharmacologic treatments for sexual dysfunction.
The Significance, Assessment, and Management of Nonrestorative Sleep in Fibromyalgia Syndrome
Authors: Moldofsky Harvey
Published: August 2016

People with fibromyalgia syndrome (FMS) experi-ence unrefreshing sleep, aches, hypersensitivity, and cognitive and emotional difficulties. Although no specific causative factor or biological agent is known to account for all of the features of FMS and these related diagnoses, the generalized hypersensitivity of the body is considered to be affected by disturbances in cen-tral nervous system (CNS) functions. Such CNS dis-turbances are intrinsic to the sleeping-waking brain, where the common symptom elements in all these illnesses are poor quality of sleep, nonspecific pain, fatigue, and psychological distress in the absence of known disease pathology.
Current State of Immunotherapy for Alzheimer’s Disease
Authors: Relkin Norman R.
Published: August 2016

There are currently over two dozen agents targeting β-amyloid (Aβ) in human clinical trials. More than a dozen of these are forms of anti-amyloid immunotherapy. Although other anti-amyloid interventions are further along in the development process, thus far only immunotherapy has provided post-mortem evidence that it can alter elements of the underlying pathology of Alzheimer’s disease (AD) in actual patients.

In the past 30 years, there have been many attempts to develop treatments for AD. Early therapies were developed based on a limited understanding of the disease (Slide 1). Prior to the 1980s, a clear pathophysiologic mechanism for AD was not known; instead, symptomatic therapies targeted associated symptoms, such as agitation, insomnia, and psychosis. In the 1970s, several preclinical studies pointed toward synaptic transmission abnormalities, particularly neurochemical abnormalities, as the root cause of AD, and treatments with cholinesterase inhibitors grew out of that theory. Today, the cholinergic hypothesis has been largely discredited in the primary pathogenesis of AD. Another theory based on neurotransmitter abnormalities, the glutaminergic hypothesis, has also gone out of favor as a causal explanation for AD. This did not stop medications based on these mechanisms from finding a meaningful place in the clinical pharmacopeia for treatment of AD.

In the 1990s, many clinical trials followed up on epidemiologic studies suggesting systemic causes of AD. These clinical trials focused on anti-inflammatories, hormone replacement, and antioxidants. The trials performed have largely failed, with the possible exception of the trials of vitamin E, an antioxidant. None of these agents have proven useful as disease-modifying therapies for symptomatic AD.
Food and Drug Administration Regulation
Authors: Katz Russell
Published: August 2016

As disease-modifying therapies near realization, there are concerns about the criteria by which these therapies will be judged. It is not yet clear what kind of evidence (clinical, biomarker, or otherwise) will be required to support a disease-modifying claim. When such a drug is approved, regulators must be certain that the claims in the label are factual and unambiguous, yet a definition for “disease modification” remains to be established. One strong potential definition is: “a therapy that affects the underlying pathology and structure of the disease”. However, this is only one possibility, and a consensus definition must be codified before criteria to evaluate it can be determined.

There is room for informed speculation, however. Criteria to evaluate disease-modifying effects have been proposed, and typically involve one of two approaches (neither of which has yet been endorsed by regulators). The first is a clinical approach, in which clinical designs are employed that would ideally force a conclusion that a drug has a disease-modifying effect. In one proposed design, patients would be randomized to drug or placebo for an appropriate duration. At the end of that period, and if a difference in outcome between drug and placebo on an appropriate clinical measure or measures has been achieved, patients originally randomized to drug would then be treated with placebo, while patients originally treated with placebo would remain on placebo.
Pharmacologic Treatments for Anxiety
Authors: Pollack Mark H.
Published: August 2016

While the public health perspective prioritizes large populations of affected individuals, our job as clinicians is to help one patient at a time. Over the last 10–20 years, there has been marked improvement in pharmacologic and psychosocial interventions available for patients with anxiety disorders (Slide 8).

The use of antidepressants, particularly the serotonergic and serotonergic noradrenergic agents, have received increased attention as first-line treatment for most of the anxiety disorders, including panic disorder, social phobia, posttraumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). Antidepressants are often used as first-line therapy for anxiety disorders because of their broad spectrum of efficacy against common comorbidities, especially depression, and because of concern about benzodiazepine-associated dependence, abuse liability, and lack of efficacy for depression and other comorbidities (Slide 9).

These newer antidepressants have advantages over the older antidepressants, particularly the tricyclics and the monoamine oxidase inhibitors, in that they are generally better tolerated and more appropriate for use in potentially suicidal patients because they are less lethal in overdose. However, there are some side effects that may limit their use in some patients. In the case of the serotonergic antidepressants, many patients are hesitant to initiate or maintain treatment due to concerns about sexual dysfunction.
Improving the Recognition of Anxiety Disorders in Depressed Patients
Authors: Chelminski Iwona
Published: August 2016

There is considerable symptom overlap and high levels of comorbidity between anxiety disorders and depression. The recognition of this comorbidity has both academic interest and clinical significance. Epidemiological studies have demonstrated that depressed individuals with a history of anxiety disorders are at increased risk for hospitalization, suicide attempt, and greater impairment from the depression. These individuals also tend to have a more chronic course of depression, as observed in psychiatric patients, primary care patients, and epidemiological samples. Van Valkenberg and colleagues reported that depressed patients with anxiety had poorer outcome and greater psychosocial impairment than those without an anxiety disorder. In the National Institute of Mental Health Collaborative Depression Study, the presence of panic attacks predicted a lower rate of recovery during the first 2 years of the follow-up interval. Similarly, Grunhaus found poorer outcome in depressed patients with comorbid panic disorder than in depressed patients without panic. In an 8-month follow-up study, depressed primary care patients with a history of generalized anxiety disorder (GAD) or panic disorder were less likely to have recovered from their depressive episode.

Gaynes and colleagues prospectively followed primary care patients with major depressive disorder (MDD) every 3 months for 1 year after their initial diagnostic evaluation. At baseline, half of the original 85 patients had a coexisting anxiety disorder, the most frequent being social phobia (n=38). Twelve months after intake, 68 of the patients were available for the final interview. Those with a comorbid anxiety disorder were significantly more likely to still be in an episode of depression (82% vs 57%; risk ratio=1.44; 95% CI 1.02-2.04), and they experienced more disability days during the course of the 12 months than the depressed patients without an anxiety disorder (67.1 days vs 27.5 days).
Cooling Core Body Temperature May Slow Down Neurodegeneration
Authors: Salerian Alen J. , Saleri Nansen G.
Published: August 2016

Reduction of core body temperature has been proposed to contribute to the increased lifespan and the anti-aging effects conferred by caloric restriction in mice and higher primates. Cooler biologically compatible core body temperatures have also been hypothesized to combat neurodegenerative disorders. Yet, validation of these hypotheses has been difficult until recently, when it demonstrated that transgenic mice engineered to have chronic low core body temperature have longer lifespan independent of alteration in diet or caloric restriction. This article reviews the literature and highlights the potential influence of core body temperature's governing role on aging and in the pathophysiology of neurodegenerative disorders in humans. What makes recent findings more significant for humans is the existence of several methods to lower and maintain low core body temperatures in human subjects. The therapeutic potential of “cooler people” may also raise the possibility that this could reverse the adverse-health consequences of elevations in core body temperature.
Gender-related Differences in Individuals Seeking Treatment for Kleptomania
Authors: Grant Jon E. , Potenza Marc N.
Published: August 2016

Objective: Understanding variations in disease presentation in men and women is clinically important as differences may reflect biological and sociocultural factors and have implications for prevention and treatment strategies. Few empirical investigations have been performed in kleptomania, particularly with respect to gender-related influences.

Methods: From 2001–2007, 95 adult subjects (n = 27 [28.4%] males) withDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined kleptomania were assessed on sociodemographics and clinical characteristics, including symptom severity, comorbidity, and functional impairment, to identify gender-related differences.

Results: Men and women showed substantial symptom severity and functional impairment. Compared with affected men, women with kleptomania were more likely to be married (47.1% vs 25.9%;P= .039), have a later age at shoplifting onset (20.9 vs 14 years of age;P= .001), steal household items (P<.001), hoard stolen items (P=.020), and have an eating disorder (P= .017) and less likely to steal electronic goods (P< .001) and have another impulse-control disorder (P= .018).

Conclusion: Kleptomania is similarly associated with significant impairment in women and men. Gender-related differences in clinical features and co-occurring disorders suggest that prevention and treatment strategies incorporate gender considerations.
Single-Isomer Science: The Phenomenon and Its Terminology
Authors: Gal Joseph
Published: August 2016

Single-isomer drugs are of great importance in modern therapeutics. In this article, the basics of the underlying phenomenon are explained. Some molecules are chiral, ie, their mirror image is not superposable on the original. The most common element producing molecular chirality is a chiral center, typically a carbon atom carrying four different groups. The mirror-image molecules are termed enantiomers, but the less specific terms stereoisomers and isomers are also used. A substance consisting of only one of the two enantiomers is a single enantiomer or single isomer, and the 1:1 mixture of the enantiomers is the racemic mixture or racemate. A graphical convention that conveys the three-dimensional aspects of chiral molecules drawn in two dimensions, as well as two nongraphical conventions, based on optical rotation and configuration, are used to identify enantiomers. Optical rotation is a physical property of single enantiomers and involves rotation of the plane of plane-polarized light, each pure enantiomer rotating with equal magnitude but in the opposite direction (dextro and levo). Configuration is the actual arrangement in space of the atoms of chiral molecules. Two systems of indicating configuration are in use. One employs D and L to denote the respective enantiomers, and is applicable only to α-amino acids and carbohydrates. The other is a universal system using R and S as descriptors for the two possible arrangements, respectively, of the atoms around the chiral center. Interest in chiral drugs stems from the frequently observed biological differences between enantiomers. Such enantioselectivity is the result of different interactions of the drug enantiomers with target receptors that are themselves chiral and single-enantiomeric.
Factors that Enhance Treatment Outcome of Cognitive-Behavioral Therapy for Anxiety Disorders
Authors: Foa Edna B. , Cahill Shawn P. , Pontoski Kristin
Published: August 2016

Effective cognitive-behavioral therapy (CBT) programs have been developed for aU of the anxiety disorders. Common elements ofCBTfor these disorders include exposure to feared objects, situations, activities, thoughts, memories, and sensations; cognitive restructuring of dysfunctional beliefs; and training in anxiety management skills, such as controlled breathing and relaxation. This article describesCBTprocedures for anxiety disorders and summarizes the research documenting its efficacy. Next, the article discusses the factors that influence the efficacy of these treatment program. Finally, emotional-processing theory is discussed to explain the efficacy of CBT for anxiety and how this theory can assist in selecting optimal treatment brocedures.
Valutazione del carico familiare in un campione di parenti di pazienti con diagnosi di schizofrenia paranoide: risultati preliminari
Authors: Veltro Franco , Magliano Lorenza , Lobrace Silvana , Morosini Pierluigi , Maj Mario
Published: August 2016

Objective - assessment of the burden perceived by a sample of key-relatives of schizophrenic patients. Design - Observational study of key-relatives of patients with a PSE-CATEGO diagnosis of active paranoid schizophrenia. Assessment of possible correlations between the family burden, the patients' symptoms and disabilities, as well as the relatives attitude of overinvolvement and criticism. Setting - Inpatient and outpatient psychiatric units of the Department of Psychiatry of the First Medical School, University of Naples. Subjects - 25 patients, with a diagnosis of active paranoid schizophrenia, according to ICD-9 diagnostic criteria, minimun illness history 1 year, at least one previous admission, living with at least one adult relative. Main outcome measures - Standardized assessment of patients clinical status and social disability and of relatives clinical status attitude and perceived burden. Results - The burden, both objective and subjective, was found to be present to a marked or very marked degree in more than 50% of the inteviewed relatives. A marked effect of the patients illness was observed especially on relatives social contacts and leisure activities. Also the attitudes of criticism and overinvolvement were detected in the great majority of the relatives. 52% of the relatives, when assessed by the PSE-9, received a psychiatric diagnosis. The objective burden was found to be associated with some «negative» symptoms and deficits of social functioning in the patients. Finally, significant correlations were observed between the objective and subjective dimensions of the burden and the relatives attitudes of hypercriticism toward the patients. Conclusions - The present study seems to be relevant both from the epidemiological point of view and for psychiatric care planning.
Il contributo dell'epidemiologia alla valutazione dei servizi psichiatrici
Authors: Biggeri Annibale
Published: August 2016

A discussion of epidemiologic researches for the evaluation of psychiatric care is presented. With regard to the Italian context the author stresses the importance of analytical studies over the descriptive ones. The main design options for the evaluation of quality of care are then considered in the psychiatric framework.
Il progetto dell'Istituto ≪Mario Negri≫: salute mentale in America Latina
Authors: Saraceno Benedetto
Published: August 2016

Objective - To describe the cooperation in mental health that, since ten years, the Institute for Pharmacological Research ≪Mario Negri≫, Milan, is carrying out in Latin America. The project has developed along three main lines: the training of the mental health services personnel, the promotion of an epidemiological approach to the mental health care, and the assistance to the local health authorities in the field of mental health policy. Results - The most relevant goals of the project have been the Caracas Conference on the Latin American psychiatric hospitals and the constitution of an European Consortium for the technical cooperation with Latin America in mental health. Most of the activities have been done in cooperation with WHO regional office (Organización Panamericana de la Salud). Furthemore the paper outlines the main results of two epidemiologic studies carried out in Central America. Conclusions - The psychiatric hospitals phasing out, the setting up of mental health community-based services and the close cooperation between psychiatric services and primary health care services are the main objectives of a project of cooperation in mental health; training and epidemiological research must be the methodological tools of this type of cooperation.
La mortalità e le cause di morte fra i pazienti psichiatrici
Authors: Aguglia Eugenio , Pagnanelli Roberto , Clocchiatti Marco , de Vanna Maurizio
Published: August 2016

Objective - Gathering, comparing and, if possible, commenting on datas and experimental evidences which have emerged in the principal literary works about mortality and psychiatric patients' causes of death. Particularly finding an answer (and a possible explanation) to some of the most important questions about these matters: does a psychiatric patient die easier than a healthy man? Does a correlation exist between nosographic diagnosis and causes of death? Finally do factors of risk, which are connected with death, exist? Method - The principal bibliographies which exist in national and international literature, from the middle of the last century until present days, have been consulted. Results - Essential agreement among existing dates in literature have emerged. Psychiatric patients dies easier than healthy man: rates of mortality have fallen from 6-7 (SMR), value of the middle of 1800 to 1,5-3 which is the value of present days. Respiratory, cardiovascular and, still, infectious diseases are the most important causes of death. There is not agreement about deaths caused by cancer. Some researchers affirm the protective action of psychiatric disease against the rising and diffusion of cancer. Non natural deaths (in primis suicide and accidental deaths) are rapresented too. All diagnostic categories (from alcholism to homosexuality, from organic brain disorders to schizophrenia) have a high risk of death while affective disorders have to be studied further. Young people have the highest risk. Conclusions - The frequency of physical beside psychic disease suggests to pay more attention to patient's general conditions even by some diagnostic ascertainments (TAC, RMN, etc) which are able to identify the most disabling conditions for the prognosis (diabetes, arterial hypertension, organic cerebral syndromes, etc).
Causes and psychosocial consequences of schizophrenia: the opinions of Mental Health services' staff
Authors: Magliano Lorenza , de Rosa Corrado , Guarneri Manuela , Cozzolino Pasquale , Malangone Claudio , Marasco Cecilia , Fiorillo Andrea , Maj Mario ,   Gruppo di Lavoro
Published: August 2016

Objective– Description of the opinions about causes and psychosocial consequences of schizophrenia in a sample of psychiatric professionals, recruited in 29 Italian Mental Health Centres (MHC).Design– Each professional was asked to read a case-vignette describing a patient who met the ICD-10 criteria for schizophrenia. Referring to case-vignette, he/she was asked to fill the Questionnaire on the Opinions about Mental Illness – Professionals' version (QO-P). Professionals' opinions were explored in relation to: a) their socio-demographic variables and professional background; b) geographic location of the MHC.Setting– 29 MHC stratified by geographic area (Northern, Central, Southern Italy) and population density of their catchment areas (> 100000 inhabitants; between 100000 and 25000 inhabitants; < 25000 inhabitants) and randomly selected.Results– Data on 465 professionals were collected. 75% of the sample identified in the vignette a case of schizophrenia, 22% of depression/anxiety disorder. Factors most frequently mentioned as causes of the detected disorder were heredity (68%), stress (61%), family difficulties (46%). More pessimistic opinions about psychosocial consequences of schizophrenia were found among nurses and among professionals of Southern Italy, among those with lower educational level, older age and among those working longer in psychiatry. No statistical difference in the opinions about psychosocial consequences of schizophrenia was found among staff who referred the case-vignette to schizophrenia and those who did not.Conclusions– The results of this study outline the need to: a) include issues such as disability and psychosocial consequences of mental disorders in the basic training of professionals; b) increase the number of professionals trained in evidence-based psychosocial interventions.
Disability in schizophrenia. Intrinsic factors and prediction of psychosocial outcome. An analysis of literature
Authors: Carpiniello Bernardo , Carta Mauro G.
Published: August 2016

Objective– Many different factors, both related to the individual and illness (“intrinsic” factors) and to the environment (“extrinsic” factors), contribute in different ways to the development of disability. Basing on data of literature, this review focuses the main “intrinsic” factors predicting disability in schizophrenia.Method– A systematic search on Mediline of all papers published during the period 1965-2001 was performed, using “schizophrenia”, “outcome”, “psychosocial outcome”, “social disability” and “social adjustment” as key words. Only papers reporting specifically data about predictive factors and psychosocial outcome variables were considered; prospective follow-up studies were considered, but retrospective and cross-sectional studies were also taken into account when data deriving from prospective studies were inconsistent.Results– Male sex predicts a higher disability among demographic factors; lower social and occupational adjustment are premorbid personality factors associated with higher disability; among factors related to illness, younger age at onset of illess, “nuclear”, “non paranoid” and in particular “deficit” forms of schizophrenia seem to predict more disability. The latter seems to be predicted also by higher levels of negative symptoms and neuropsychological deficits ; the role of depressive symptoms seems to be less supported by follow-up data; a continuous course of the illness predicts more disability, although some evidences show a progressive reduction of disability, at least in the long term.Conclusions– Disability shows a largely autonomous course respect to symptoms and has to be considered an independent parameter of outcome. Few intrinsic factors show a predictive role also in the long term.
Schizofrenia e intervento psicosociale sulle famiglie. Indagine sulle caratteristiche dell'utenza e follow-up ad un anno
Authors: Carrà Giuseppe , Clerici Massimo , Cazzullo Carlo L.
Published: August 2016

Aims- Evaluating socio-demographic characteristics of a sample of 102 schizophrenic patients and their relatives which got in touch with a facility with different psychoeducational treatments. Checking differential characteristics among subsamples according to the engaging to different treatment programs. Longitudinally evaluating both patient's psychosocial course and relative's perception 1 year after the end of such a treatment.Design- Assessment of patients and relatives sociodemographic characteristics, according to engaging in 2 different psychoeducative groups (informative and support) or not engaging (early drop-outs), matching Vs. an external control sample of «no-treated» families. One year follow-up study on patients and relatives both for «objective» and «subjective» conditions.Setting-A private social organization of voluntary psychiatrists, the Association for Research on Schizophrenia in Milan.Main outcome measures- Survey on characteristics of patients and relatives in different stage of treatment collected by standardized records and contrasted with those of comparison groups. Follow-up study by structured questionary. Student's two tailed t tests were used to compare some socio-demographic data. Chi-square analyses were used to compare nominal data. Mc Nemar test is used to follow significative changes.Results- Some preliminar differences in sociodemographic features, between different groups, are to be confirmed by increasing sample while there are interesting evidences for different course and outcome in a group following a particular kind of treatment (informative group) for both patient's objective performance and family subjective well-being.Conclusions- Psychoeducational family treatment shows good prospects for families interested to coping with schizophrenia and which are able to look for information and support. Longitudinal evaluation shows interesting changes in the relationship with public facilities and in the occupational status overall in the informative group. It proves its importance for «acute» schizophrenia, while a supportive treatment retains an usefulness in chronic ilnesses reducing the burden of care.
The association between diet quality and subclinical inflammation among children aged 6–18 years in the Eastern Cape, South Africa
Authors: Oldewage-Theron Wilna , Kruger Rozanne
Published: August 2016

Objective

The study aimed to investigate, for the first time, the association between diet quality (food variety and dietary diversity), intakes of anti-inflammatory nutrients and food groups, and subclinical inflammation as assessed by categories of high-sensitivity C-reactive protein (hs-CRP).

Design

Cross-sectional study.

Setting

Resource-poor, rural children in the Eastern Cape, South Africa.

Subjects

A sample size formula determined a representative sample of 235. Five schools were purposively selected and cluster sampling used to select 240 participants. Measurements included 24 h recall and dietary diversity questionnaires, anthropometric and biochemical measurements.

Results

The sample consisted of 50·4 % (n 118) girls and 49·6 % (n 116) boys. No obesity was found, but overweight was prevalent in 4·2 % of the children. The hs-CRP concentration (median (25th, 75th percentile)) of the low, medium and high risk inflammatory categories was 0·6 (0·4, 0·7), 1·6 (1·2, 2·2) and 4·2 (3·4, 6·4) mg/l, respectively. Body composition parameters did not differ between hs-CRP groups. Most of the anti-inflammatory nutrient intakes (dietary Fe, Zn, Mg, vitamin C, folate, linolenic acid, linoleic acid, MUFA and PUFA) differed significantly between the hs-CRP groups, with intakes increasing from low to high hs-CRP groups, with similar results for linolenic acid (P=0·022) intake. No significant relationships between hs-CRP and any of the food groups could be established, but significant relationships were established between hs-CRP levels and the high density of living arrangements and unhygienic ablution facilities.

Conclusions

Although no link could be established between overnutrition and hs-CRP levels, an association was found between hs-CRP and dietary quality, as well as socio-economic status.
Vitamin D deficiency, behavioral atypicality, anxiety and depression in children with chromosome 22q11.2 deletion syndrome
Authors: Kelley L. , Sanders A. F. P. , Beaton E. A.
Published: August 2016

Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a complex developmental disorder with serious medical, cognitive and emotional symptoms across the lifespan. This genetic deletion also imparts a lifetime risk for developing schizophrenia that is 25–30 times that of the general population. The origin of this risk is multifactorial and may include dysregulation of the stress response and immunological systems in relation to brain development. Vitamin D is involved in brain development and neuroprotection, gene transcription, immunological regulation and influences neuronal signal transduction. Low levels of vitamin D are associated with schizophrenia, depression and anxiety in the general population. Yet, little is known about how vitamin D levels in children with 22q11.2DS could mediate risk of psychosis in adulthood. Blood plasma levels of vitamin D were measured in children aged 7–16 years with (n=11) and without (n=16) 22q11.2DS in relation to parent reports of children’s anxiety and atypicality. Anxiety and atypicality in childhood are risk indicators for the development of schizophrenia in those with 22q11.2DS and the general population. Children with 22q11.2DS had lower vitamin D levels, as well as elevated anxiety and atypicality compared with typical peers. Higher levels of anxiety, depression and internalizing problems but not atypicality were associated with lower levels of vitamin D. Vitamin D insufficiency may relate to higher levels of anxiety and depression, in turn contributing to the elevated risk of psychosis in this population. Further study is required to determine casual linkages between anxiety, stress, mood and vitamin D in children with 22q11.2DS.
Non-equilibrium 8π Josephson effect in atomic Kitaev wires
Authors: Laflamme C. , Budich J. C. , Zoller P. , Dalmonte M.
Published: August 2016

The identification of fractionalized excitations, such as Majorana quasi-particles, would be a striking signal of the realization of exotic quantum states of matter. While the paramount demonstration of such excitations would be a probe of their non-Abelian statistics via controlled braiding operations, alternative proposals exist that may be easier to access experimentally. Here we identify a signature of Majorana quasi-particles, qualitatively different from the behaviour of a conventional superconductor, which can be detected in cold atom systems using alkaline-earth-like atoms. The system studied is a Kitaev wire interrupted by an extra site, which gives rise to super-exchange coupling between two Majorana-bound states. We show that this system hosts a tunable, non-equilibrium Josephson effect with a characteristic 8π periodicity of the Josephson current. The visibility of the 8π periodicity of the Josephson current is then studied including the effects of dephasing and particle losses.
High-order species interactions shape ecosystem diversity
Authors: Bairey Eyal , Kelsic Eric D. , Kishony Roy
Published: August 2016

Classical theory shows that large communities are destabilized by random interactions among species pairs, creating an upper bound on ecosystem diversity. However, species interactions often occur in high-order combinations, whereby the interaction between two species is modulated by one or more other species. Here, by simulating the dynamics of communities with random interactions, we find that the classical relationship between diversity and stability is inverted for high-order interactions. More specifically, while a community becomes more sensitive to pairwise interactions as its number of species increases, its sensitivity to three-way interactions remains unchanged, and its sensitivity to four-way interactions actually decreases. Therefore, while pairwise interactions lead to sensitivity to the addition of species, four-way interactions lead to sensitivity to species removal, and their combination creates both a lower and an upper bound on the number of species. These findings highlight the importance of high-order species interactions in determining the diversity of natural ecosystems.
Spectral descriptors for bulk metallic glasses based on the thermodynamics of competing crystalline phases
Authors: Perim Eric , Lee Dongwoo , Liu Yanhui , Toher Cormac , Gong Pan , Li Yanglin , Simmons W. Neal , Levy Ohad , Vlassak Joost J. , Schroers Jan , Curtarolo Stefano
Published: August 2016

Metallic glasses attract considerable interest due to their unique combination of superb properties and processability. Predicting their formation from known alloy parameters remains the major hindrance to the discovery of new systems. Here, we propose a descriptor based on the heuristics that structural and energetic ‘confusion’ obstructs crystalline growth, and demonstrate its validity by experiments on two well-known glass-forming alloy systems. We then develop a robust model for predicting glass formation ability based on the geometrical and energetic features of crystalline phases calculated ab initio in the AFLOW framework. Our findings indicate that the formation of metallic glass phases could be much more common than currently thought, with more than 17% of binary alloy systems potential glass formers. Our approach pinpoints favourable compositions and demonstrates that smart descriptors, based solely on alloy properties available in online repositories, offer the sought-after key for accelerated discovery of metallic glasses.
SALM4 suppresses excitatory synapse development by cis-inhibiting trans-synaptic SALM3–LAR adhesion
Authors: Lie Eunkyung , Ko Ji Seung , Choi Su-Yeon , Roh Junyeop Daniel , Cho Yi Sul , Noh Ran , Kim Doyoun , Li Yan , Kang Hyeyeon , Choi Tae-Yong , Nam Jungyong , Mah Won , Lee Dongmin , Lee Seong-Gyu , Kim Ho Min , Kim Hyun , Choi Se-Young , Um Ji Won , Kang Myoung-Goo , Bae Yong Chul , Ko Jaewon , Kim Eunjoon
Published: August 2016

Synaptic adhesion molecules regulate various aspects of synapse development, function and plasticity. These functions mainly involve trans-synaptic interactions and positive regulations, whereas cis-interactions and negative regulation are less understood. Here we report that SALM4, a member of the SALM/Lrfn family of synaptic adhesion molecules, suppresses excitatory synapse development through cis inhibition of SALM3, another SALM family protein with synaptogenic activity. Salm4-mutant (Salm4−/−) mice show increased excitatory synapse numbers in the hippocampus. SALM4 cis-interacts with SALM3, inhibits trans-synaptic SALM3 interaction with presynaptic LAR family receptor tyrosine phosphatases and suppresses SALM3-dependent presynaptic differentiation. Importantly, deletion of Salm3 in Salm4−/− mice (Salm3−/−; Salm4−/−) normalizes the increased excitatory synapse number. These results suggest that SALM4 negatively regulates excitatory synapses via cis inhibition of the trans-synaptic SALM3–LAR adhesion.
Single Particle and PET-based Platform for Identifying Optimal Plasmonic Nano-Heaters for Photothermal Cancer Therapy
Authors: Jørgensen Jesper Tranekjær , Norregaard Kamilla , Tian Pengfei , Bendix Poul Martin , Kjaer Andreas , Oddershede Lene B.
Published: August 2016

Plasmonic nanoparticle-based photothermal cancer therapy is a promising new tool to inflict localized and irreversible damage to tumor tissue by hyperthermia, without harming surrounding healthy tissue. We developed a single particle and positron emission tomography (PET)-based platform to quantitatively correlate the heat generation of plasmonic nanoparticles with their potential as cancer killing agents. In vitro, the heat generation and absorption cross-section of single irradiated nanoparticles were quantified using a temperature sensitive lipid-based assay and compared to their theoretically predicted photo-absorption. In vivo, the heat generation of irradiated nanoparticles was evaluated in human tumor xenografts in mice using 2-deoxy-2-[F-18]fluoro-D-glucose (18F-FDG) PET imaging. To validate the use of this platform, we quantified the photothermal efficiency of near infrared resonant silica-gold nanoshells (AuNSs) and benchmarked this against the heating of colloidal spherical, solid gold nanoparticles (AuNPs). As expected, both in vitro and in vivo the heat generation of the resonant AuNSs performed superior compared to the non-resonant AuNPs. Furthermore, the results showed that PET imaging could be reliably used to monitor early treatment response of photothermal treatment. This multidisciplinary approach provides a much needed platform to benchmark the emerging plethora of novel plasmonic nanoparticles for their potential for photothermal cancer therapy.
Nanoforging Single Layer MoSe2 Through Defect Engineering with Focused Helium Ion Beams
Authors: Iberi Vighter , Liang Liangbo , Ievlev Anton V. , Stanford Michael G. , Lin Ming-Wei , Li Xufan , Mahjouri-Samani Masoud , Jesse Stephen , Sumpter Bobby G. , Kalinin Sergei V. , Joy David C. , Xiao Kai , Belianinov Alex , Ovchinnikova Olga S.
Published: August 2016

Development of devices and structures based on the layered 2D materials critically hinges on the capability to induce, control and tailor the electronic, transport and optoelectronic properties via defect engineering, much like doping strategies have enabled semiconductor electronics and forging enabled introduction the of iron age. Here, we demonstrate the use of a scanning helium ion microscope (HIM) for tailoring the functionality of single layer MoSe2 locally and decipher associated mechanisms at the atomic level. We demonstrate He+ beam bombardment that locally creates vacancies, shifts the Fermi energy landscape and increases the Young’s modulus of elasticity. Furthermore, we observe for the first time, an increase in the B-exciton photoluminescence signal from the nanoforged regions at the room temperature. The approach for precise defect engineering demonstrated here opens opportunities for creating functional 2D optoelectronic devices with a wide range of customizable properties that include operating in the visible region.