Makoto Kawahito, Keitaro Murayama, Hirofumi Tomiyama
et al.
IntroductionSensory phenomena (SP) are subjective experiences, such as feelings of discomfort or incompleteness, which often precede repetitive behaviors in patients with obsessive-compulsive disorder (OCD). Although previous studies have shown that SP are common in early-onset OCD, the relationship between age at onset and SP severity remains unclear.MethodsThis cross-sectional study included 30 drug-naive patients with OCD, without comorbid psychiatric or medical/neurological disorders, and with at least one lifetime SP. SP severity was assessed using the University of São Paulo Sensory Phenomena Scale (USPSPS). Multiple regression analysis was conducted to examine the association between age at onset and SP severity, controlling for sex, autistic traits, and obsessive-compulsive symptom severity. Sensitivity analyses evaluated illness duration and anxiety and used a two-part analysis to address the floor at USPSPS = 0. Robustness was assessed using bias-corrected (BC) bootstrap 95% confidence intervals and influence diagnostics.ResultsEarlier age at onset was associated with greater SP severity (B = −0.171, p = 0.007; BC bootstrap 95% CI −0.300 to −0.064). Sensitivity analyses, including models additionally adjusting for illness duration or anxiety, and influence diagnostics, supported the robustness of this association. In a two-part analysis, autistic traits were associated with the presence of current SP, whereas earlier onset was associated with greater SP severity.DiscussionEarlier onset of OCD was associated with more severe SP after adjustment for clinical covariates. These findings may be consistent with a neurodevelopmental contribution to SP severity in OCD. Further longitudinal and qualitative studies on SP are warranted.
Elise M. Martin, Matthew J. Morales, Niki Y. Li
et al.
Air pollution and maternal stress during pregnancy are both risk factors for neurodevelopmental disorders and often converge on the same communities. Epidemiological and animal studies suggest that maternal psychosocial stress may worsen the effects of air pollutants on neurodevelopmental outcomes. Previous work utilizing a mouse model of combined prenatal exposure to diesel exhaust particles (DEP) and maternal stress (MS) has found numerous sex-specific effects of DEP/MS exposure on neuroimmune outcomes, dopamine receptors, the gut-brain axis, and social behavior. However, it is unclear how broadly the immune landscape is shifted in the brain and intestinal epithelium following DEP/MS. Here, we analyzed immune gene expression in 5 brain regions important for social behavior and in 3 regions of the intestinal epithelium in both male and female offspring at ∼postnatal day 50, following either DEP/MS or control exposure. We found several interesting overall patterns. First, changes in expression of immune genes such as CD11b and Tlr4 were concentrated in the nucleus accumbens and hippocampus. Tlr4 and Il-17ra mRNA also increased in the jejunum and colon following DEP/MS, but only in females. Second, in the nucleus accumbens, catecholamine-O-methyltransferase (Comt) and dopamine transporter 1 (Slc6a3) gene expression were increased following DEP/MS, indicating increased dopamine degradation at and reuptake from the synapse, respectively. Additionally, dopamine D2 receptor (Drd2) mRNA was decreased following DEP/MS in males. Finally, we observed numerous sex differences in immune gene expression regardless of treatment in both the brain and gut. Together, these findings suggest the nucleus accumbens is a key site for neuroimmune and dopaminergic changes following DEP/MS exposure and indicate female-specific changes in intestinal immunity in young adulthood following these prenatal exposures.
Kira DiClemente-Bosco, Caroline Kuo, Goodman Sibeko
et al.
Background In South Africa, rates of HIV and alcohol use are among the highest globally, with a detrimental synergistic relationship. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based, cost-effective approach to identifying people at risk of alcohol-related problems to deliver early intervention. We developed and deployed a cascading train-the-trainer model to promote SBIRT implementation in a large nongovernmental organization offering HIV services across South Africa. Method Between 2021 and 2022, we completed preparatory activities including designing scalable training resources prior to rolling out the train-the-trainer model across two South African provinces. We conducted a comprehensive assessment of outcomes at the trainer- (knowledge, fidelity), provider- (attitudes, confidence, perceived implementation potential, adoption), and client-encounter (reach) levels over approximately one year. Results We trained 12 novice trainers who then trained 206 providers to implement SBIRT. Trainer SBIRT knowledge increased pre- to posttraining, and fidelity of training delivery was high (99.0% of elements covered across sessions). Provider attitudes, confidence, and perceived implementation potential increased over time, and 64% of providers adopted SBIRT. Reach of the model varied by component, with 41,793 clients screened by trained providers. Of those screening positive for risky alcohol use, 86% received brief intervention (BI) and 53% received referral to treatment (RT). Additionally, 15,353 clients who did not screen as having risky alcohol use received BI and 1,122 received RT. Conclusion Results indicated that the cascading training model was delivered with high fidelity, associated with improvements in all provider outcomes, and reached high numbers of clients for the screening component of the model. Rates of BI and RT delivery were moderate to high, though data suggested over-application of these elements with some clients, highlighting the tension between reach and fidelity. Lessons learned will inform future scale-out of this model in HIV service settings in low- and middle-income countries.
Background and PurposeFor patients with severe spontaneous intracerebral hemorrhage on antiplatelet therapy (patients with APT-SICH), postoperative rebleeding (PR) is an important cause of poor outcomes after surgery. As impacted by coagulation disorder caused by APT, patients with APT-SICH are likely to suffer from PR. This study aimed to assess the risk of PR in patients with APT-SICH receiving emergency surgery using a novel coagulation classification.MethodsThis prospective, multicenter cohort study consecutively selected patients with APT-SICH between September 2019 and March 2021. The preoperative coagulation factor function was recorded, and the platelet function was assessed using thrombelastography. Based on platelet and coagulation factor function, a novel four-type coagulation classification, i.e., Type I (severe coagulation disorder), Type IIa (low platelet reserve capacity), Type IIb (normal coagulation), and Type III (hypercoagulation), was presented. The primary outcome was PR, defined as the rebleeding in the operative region or new intracerebral hemorrhage correlated with the operation.ResultsOf the included 197 patients with APT-SICH, PR occurred in 40 patients (20.3%). The novel coagulation classification categorized 28, 32, 122, and 15 patients into Type I, Type IIa, Type IIb, and Type III, respectively. The Type I patients had the highest incident rate of PR (39.3 per 100 persons), followed by the Type IIa patients (31.3 per 100 persons). In the PR-related analysis, the large hematoma volume (hazard ratio (HR): 1.02; 95% CI: 1.02–1.03; p < 0.001), Type I (HR: 9.72; 95% CI: 1.19–79.67; p = 0.034), and Type IIa (HR: 8.70; 95% CI: 1.09–69.61; p = 0.041) were correlated with the highest risk of PR. The coagulation classification could discriminate the PR patients from no PR (NPR) patients (p < 0.001), and it outperformed the conventional coagulation assessment (only considering platelet count and coagulation factor function) (c-statistic, 0.72 vs. 0.55).ConclusionThe novel coagulation classification could discriminate the patients with APT-SICH with the highest risk of PR preoperatively. For the Type I and Type IIa patients, emergency surgery should be performed carefully.
J. Koniukhovskaia, E. Pervichko, V. Petrenko
et al.
Introduction
Dysfunctional breathing is a breathing patterns that do not correspond to the physiological needs of the body, provoke many poly-systemic symptoms. Dysfunctional breathing is experienced as a feeling of “difficulty in breathing”, which in the conditions of the COVID-19 pandemic may be similar to the symptoms of coronavirus infection (Taverne et al., 2021).
Objectives
To examine the role of socio-demographic predictors in the prevalence of dysfunctional breathing in the Russian population during the COVID-19 pandemic.
Methods
The author’s socio-demographic questionnaire, the Naimigen Questionnaire (Van Dixhoorn, Duivenvoordent, 1985), the STAI (Spielberger et al., 1983) and the “Perceived Stress Scale-10” (Cohen,Kamarck,Mermelstein,1983) were used. The study was conducted online from April 27 to December 28, 2020. It was attended by 1,362 people from all regions of Russia (38.3 ±11.4 y.o.).
Results
In men, the average values for NQ (11.19±7.74) are lower than among women (18.73±9.96, p=0.000). Persons with incomplete higher education have a higher score on NQ (N=103,NQ=20.44±11.8) than persons with higher education (N=1051,NQ= 17.40±9.63,p=0.048) and candidates/doctors of sciences (N=97,NQ= 15.34±11.20,p=0.005). There was also a connection between the severity of dysfunctional breathing and the level of income, which is associated with a negative correlation between income level and perception of stress (r=-0.215,p=0.000), state (r=-0.165,p=0.000) and trait anxiety (r=-0.127,p=0.000).
Conclusions
The severity of dysfunctional breathing is associated with gender, income levels and education, what can be used to identify a group of people who are most susceptible to the occurrence of dysfunctional breathing during the pandemic COVID-19. The study was supported of the Russian Science Foundation, project No.21-18-00624.
Disclosure
The study was supported of the Russian Science Foundation, project No. 21-18-00624.