Applicability and Psychometric Properties of General Mental Health Assessment Tools in Autistic People: A Systematic Review

In recent years, there has been a proliferation of instruments for assessing mental health (MH) among autistic people. This study aimed to review the psychometric properties of broadband instruments used to assess MH problems among autistic people. In accordance with the PRISMA guidelines (PROSPERO: CRD42022316571) we searched the APA PsycINFO via Ovid, Ovid MEDLINE, Ovid Embase and the Web of Science via Clarivate databases from 1980 to March 2022, with an updated search in January 2024, to identify very recent empirical studies. Independent reviewers evaluated the titles and abstracts of the retrieved records (n = 11,577) and full-text articles (n = 1000). Data were extracted from eligible studies, and the quality of the included papers was appraised. In all, 164empirical articles reporting on 35 instruments were included. The review showed variable evidence of reliability and validity of the various instruments. Among the instruments reported in more than one study, the Aberrant Behavior Checklist had consistently good or excellent psychometric evidence. The reliability and validity of other instruments, including: the Developmental Behavior Checklist, Emotion Dysregulation Inventory, Eyberg Child Behavior Inventory, Autism Spectrum Disorder-Comorbid for Children Scale, and Psychopathology in Autism Checklist, were less documented. There is a need for a greater evidence-base for MH assessment tools for autistic people.

Effectiveness of combined local therapy with antibiotics and fibrin vs. vacuum-assisted wound therapy in soft tissue infections: a retrospective study

PURPOSE

Soft tissue infections can be severe and life-threatening. Their treatment consists currently in radical surgical wound debridement and combined systemic antimicrobial therapy. Different side effects are possible. Local antibiotic therapy represents a new approach to reduce side effects and improve healing. The aim of this study is to assess the effectiveness of the local sprayed use of antibiotics with fibrin sealing compared with negative pressure wound therapy as an established treatment of soft-tissue infections.

METHODS

In this retrospective study, patients with soft tissue infections who underwent surgical treatment were analysed. One group consists of patients, who received local fibrin-antibiotic spray (FAS) (n = 62). Patients treated by vacuum-assisted wound therapy (VAWT) as the established treatment were the control group (n = 57). Main outcomes were differences in the success of healing, the duration until healing and the number of needed operations.

RESULTS

Clinical healing could be achieved for 55 patients (98.21%) in the FAS group vs. 47 patients (92.16%) in the VAWT group (p = 0.19). Time to require this was 10.65 ± 10.38 days in the FAS group and 22.85 ± 14.02 days in the VAWT group (p < 0.001). In the FAS group, patients underwent an average of 1.44 ± 0.72 vs.3.46 ± 1.66 operations in the VAWT group (p < 0.001).

CONCLUSION

Compared to vacuum-assisted wound therapy in soft tissue infections, local fibrin-antibiotic spray shows faster clinical healing and less needed operations. Leading to shorter hospital stays and more satisfied patients. The combination of sprayed fibrin and antibiotics can be seen as a promising and effective method.

User satisfaction with antenatal care in Norway

BACKGROUND

In Norway, antenatal care is delivered free of charge in the municipality. Satisfaction with care is considered to be an important predictor of utilization of health care. The aim of this study was to examine women's satisfaction with antenatal care, and to identify factors that predict overall satisfaction with the service.

METHODS

A total of 611 women completed a survey that collected information on demographic variables, pregnancy variables, and aspects of antenatal care; it also contained one open-ended question. A hierarchical multiple regression analysis was conducted to predict Overall Satisfaction with antenatal care based on four specific scales: User Participation, Accessibility, Information, and Midwife, adjusted for demographic variables.

RESULTS

Survey responses showed that 95% of women were satisfied with antenatal care in general. The expectant mother's age, having Norwegian as the native language, and the scales User Participation, Information, and Midwife were all significant predictors of Overall Satisfaction with antenatal care. The open-ended user comments underlined the important role of midwifes in antenatal care.

CONCLUSIONS

The results of this study indicate that women who attended antenatal care in Norway were satisfied with the care they received. Midwives had an important role, and their relational and professional competence was highly valuated by expectant mothers. The findings also suggest that there are still opportunities to improve satisfaction with antenatal care, for example, by increasing the focus on mental health during antenatal consultations.

Exploring Adolescents' Attitudes Toward Mental Health Apps: Concurrent Mixed Methods Study

BACKGROUND

Adolescence is a critical time in which many psychological disorders develop. Mental health promotion is important, especially during this period. In recent years, an increasing number of mobile apps geared toward mental health promotion and preventing mental illness have been developed specifically for adolescents, with the goal of strengthening their mental health and well-being.

OBJECTIVE

This study aims to explore adolescents' attitudes toward mental health apps, as well as the perceived usefulness of mental health apps.

METHODS

In this mixed methods study, a total of 183 adolescents (mean age 15.62, SD 3.21 years) answered a cross-sectional questionnaire, with 10 questions (eg, "What do you think about mental health apps in general?"). To complement the quantitative findings, individual interviews were conducted with 9 adolescents, during which they could elaborate on their opinions about mental health apps.

RESULTS

A total of 30% (56/183) of the adolescents in the quantitative study had used a mental health app. Over half of the respondents (77/126, 61.1%) reported that they would use a mental health app if they had a mental health problem as well as that they thought mental health apps were somewhat or very useful (114/183, 62.3%). Availability was the most frequently reported advantage of mental health apps (107/183, 58.8%). Possible associated costs of mental health apps were the most frequently mentioned barrier to their use (87/183, 47.5%). Findings from the interviews also pointed to the importance of the availability of mental health apps as well as their credibility and potential to provide adolescents with autonomy when seeking mental health advice and help.

CONCLUSIONS

Overall, the results indicate that adolescents have a positive attitude toward and an interest in mental health apps. However, adolescents are also more or less unaware of such apps, which might be one reason why they are often not used. The findings of this study have important implications for future research on mental health apps and for developers of mental health apps that target young people. The insights gained from this study can inform the development of more effective mental health apps that better meet the needs and preferences of adolescents.

Examining the psychometric properties of the Norwegian version of the Social Aptitudes Scale in two clinical samples

BACKGROUND

Few studies have examined the psychometric properties of the Social Aptitudes Scale (SAS). The study aims of the current paper were to examine the internal consistency and the validity of the Norwegian SAS.

METHODS

Parents of children from a clinical neuropediatric sample (N = 257) and from a clinical sample from child and adolescent's mental health services (N = 804) filled in the SAS.

RESULTS

Internal consistency for the SAS were good in both samples and correlations between the SAS and different scales were in the expected directions. The results from the Confirmatory Factor Analyses indicated poor model fit.

CONCLUSIONS

Future validity studies should investigate whether SAS is suitable as a screening instrument for detecting autism spectrum disorder.

Neural bases of reward anticipation in healthy individuals with low, mid, and high levels of schizotypy

A growing body of research has placed the ventral striatum at the center of a network of cerebral regions involved in anticipating rewards in healthy controls. However, little is known about the functional connectivity of the ventral striatum associated with reward anticipation in healthy controls. In addition, few studies have investigated reward anticipation in healthy humans with different levels of schizotypy. Here, we investigated reward anticipation in eighty-four healthy individuals (44 females) recruited based on their schizotypy scores. Participants performed a variant of the Monetary Incentive Delay Task while undergoing event-related fMRI.Participants showed the expected decrease in response times for highly rewarded trials compared to non-rewarded trials. Whole-brain activation analyses replicated previous results, including activity in the ventral and dorsal striatum. Whole-brain psycho-physiological interaction analyses of the left and right ventral striatum revealed increased connectivity during reward anticipation with widespread regions in frontal, parietal and occipital cortex as well as the cerebellum and midbrain. Finally, we found no association between schizotypal personality severity and neural activity and cortico-striatal functional connectivity. In line with the motivational, attentional, and motor functions of rewards, our data reveal multifaceted cortico-striatal networks taking part in reward anticipation in healthy individuals. The ventral striatum is connected to regions of the salience, attentional, motor and visual networks during reward anticipation and thereby in a position to orchestrate optimal goal-directed behavior.

Adolescents' Assessment of Two Mental Health-Promoting Mobile Apps: Results of Two User Surveys

BACKGROUND

The importance of mental health promotion is irrevocable and is especially important at a young age. More mental health-promoting mobile apps have been developed in the last few years. However, their usability and quality have been rarely assessed.

OBJECTIVE

The aim of this study is to investigate how adolescents assess the usability, quality, and potential goal achievement of Opp and NettOpp. Opp is a universal mental health-promoting mobile app aimed at 13- to 19-year-olds, and NettOpp is a mobile app for children and adolescents between 11 to 16 years of age that have experienced negative incidents online.

METHODS

A total of 45 adolescents tested either Opp (n=30) or NettOpp (n=15) for a period of 3 weeks and answered a questionnaire. The System Usability Scale (SUS) was used to measure the usability of the apps. A SUS score above 70 indicates acceptable usability. Items from the Mobile Application Rating Scale were adapted for study purposes and used to measure the quality and perceived goal achievement that Opp and NettOpp might have on adolescents' knowledge, attitudes, and intention to change behavior. Furthermore, adolescents could answer an open comment question.

RESULTS

Opp had a mean SUS score of 80.37 (SD 9.27), and NettOpp's mean SUS score was 80.33 (SD 10.30). In the overall evaluation, Opp and NettOpp were given a mean score of 3.78 (SD 0.42) and 4.20 (SD 0.56), respectively, on a 5-point scale, where 5 was best. Most adolescents who evaluated Opp rated that the app would increase knowledge about mental health and help young people deal with stress and difficult emotions or situations. Most adolescents who evaluated NettOpp agreed that the app would increase awareness and knowledge about cyberbullying, change attitudes toward cyberbullying, and motivate them to address cyberbullying. Some adolescents stated that Opp was difficult to navigate and consisted of too much text. Some of the adolescents that tested NettOpp stated that the app had crashed and that the design was a bit childish.

CONCLUSIONS

All in all, this study indicates that Opp and NettOpp have good usability and that adolescents are satisfied with both apps. It also indicates that the potential goal achievement of the apps, for example, increasing knowledge about mental health (Opp) or cyberbullying (NettOpp) is promising. While there are some comments from the users that are more difficult to solve (eg, Opp is too text-based), some comments helped improve the apps (eg, that the app crashed). Overall, the user evaluation provided valuable knowledge about how adolescents assess Opp and NettOpp. However, more extensive effectiveness studies are necessary to measure their actual goal achievement.

The Strengths and Difficulties Questionnaire self-report-, parent-, and teacher version in children with intellectual and developmental disabilities

BACKGROUND

The Strengths and Difficulties Questionnaire (SDQ) is a frequently used behavioral screening instrument. However, its psychometric properties have been rarely examined among children with intellectual and developmental disabilities (IDD).

AIMS

The main aims of this study were to examine the internal consistency (i.e., McDonald's Omega), the convergent validity (by correlating the Total difficulties score with the Aberrant Behavior Checklist [ABC]), the divergent validity (by correlating the Total difficulties score with the Vineland Adaptive Behavior Composite; VABS-II Total) and the factorial validity (by the means of confirmatory factor analyses [CFA]) of the SDQ self-report-, parent-, and teacher version in a sample of children with IDD.

METHOD

Participants were 365 children and adolescents (males n = 238; 65 %) aged 4-18 years (M = 10.11, SD = 3.82) referred for a developmental/neurological assessment to the neuropediatric outpatient clinics in the specialist health services. The SDQ was filled inn by 115 children, 337 parents, and 248 teachers.

RESULTS

McDonald's Omega was overall lowest for the self-report version. Correlations of the SDQ Total difficulties score and the ABC subscales were strongest for the parent version. The results of the CFA indicated best model fit for the six-factor model that included a method factor for all three versions of the SDQ, however, model fit was overall not good.

CONCLUSIONS

Further research that examines the psychometric properties of the SDQ among multiple informants in large samples of children with IDD is needed.

Erytra blood group analyser and kode technology testing of SARS-CoV-2 antibodies among convalescent patients and vaccinated individuals

Surveillance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic requires tests to monitor antibody formation and prevalence. We detected SARS-CoV-2 antibodies using red cells coated by Kode technology with short peptides derived from the SARS-CoV-2 spike protein (SP). Such modified red cells, called C19-kodecytes, can be used as reagent cells in any manual or automated column agglutination assay. We investigated the presence of SARS-CoV-2 antibodies in 130 samples from COVID-19 convalescent plasma donors using standard manual technique, two FDA-authorized enzyme-linked immunosorbent assay (ELISA) assays and a virus neutralisation assay. The sensitivity of the C19-kodecyte assay was 88%, comparable to the anti-SP and anti-nucleocapsid protein (NCP) ELISAs (86% and 83%) and the virus neutralisation assay (88%). The specificity of the C19-kodecyte assay was 90% (anti-SP 100% and anti-NCP 97%). Likewise, 231 samples from 73 vaccinated individuals were tested with an automated analyser, and we monitored the appearance and persistence of SARS-CoV-2 antibodies. The C19-kodecyte assay is a robust tool for SARS-CoV-2 antibody detection. Automated blood group analyser use enables large-scale SARS-CoV-2 antibody testing for vaccination monitoring in population surveys.

An App-Based Intervention for Adolescents Exposed to Cyberbullying in Norway: Protocol for a Randomized Controlled Trial

BACKGROUND

Adolescents exposed to negative online events are at high risk to develop mental health problems. Little is known about what is effective for treatment in this group. NettOpp is a new mobile app for adolescents who have been exposed to cyberbullying or negative online experiences in Norway.

OBJECTIVE

The aim of this paper is to provide a description of the content of the intervention and about a randomized controlled trial that will be conducted to examine the effectiveness of NettOpp. This protocol is written in accordance with the Spirit 2013 Checklist.

METHODS

An effectiveness study with a follow-up examination after 3 months will be conducted to evaluate the mobile app. Adolescents will be recruited through schools and will be randomly assigned to the intervention (NettOpp) group and a waiting-list control group. The adolescents (aged 11 to 16 years) will respond to self-report questionnaires on the internet. Primary outcomes will be changes in mental health assessed with the Strengths and Difficulties Questionnaire, the WHO-Five Well-being Index, and the Child and Adolescent Trauma Screen.

RESULTS

Recruitment will start in January 2022. The results from this study will be available in 2023.

CONCLUSIONS

There are few published evaluation studies on app-based interventions. This project and its publications will contribute new knowledge to the field.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04176666; https://clinicaltrials.gov/ct2/show/NCT04176666.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/31789.

Erytra Blood Group Analyser and Kode Technology testing of SARS-CoV-2 antibodies among convalescent patients and vaccinated individuals

Surveillance of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic requires tests to monitor antibody formation and prevalence. We detected SARS-CoV-2 antibodies using red cells coated by Kode technology with short peptides derived from the SARS-CoV-2 spike protein. Such modified red cells, called C19-kodecytes, can be used as reagent cells in any manual or automated column agglutination assay. We investigated the presence of SARS-CoV-2 antibodies in 130 samples from COVID-19 convalescent plasma donors using standard manual technique, two FDA authorized ELISA assays and a virus neutralisation assay. The sensitivity of the C19-kodecyte assay was 88%, comparable to the anti-SP and anti-NCP ELISAs (86% and 83%) and the virus neutralisation assay (88%). The specificity of the C19-kodecyte assay was 90% (anti-SP 100% and anti-NCP 97%). Likewise, 231 samples from 73 vaccinated individuals were tested with an automated analyser and we monitored the appearance and persistence of SARS-CoV-2 antibodies. The C19-kodecyte assay is a robust tool for SARS-CoV-2 antibody detection. Automated blood group analyser use enables large-scale SARS-CoV-2 antibody testing for vaccination monitoring in population surveys.

Adolescents' experiences of the information they received about the coronavirus (Covid-19) in Norway: a cross-sectional study

BACKGROUND

In the first months of the coronavirus (Covid-19) pandemic, many countries took radical prevention measures. Authorities had to communicate with the public regularly to explain and ensure compliance with these measures and promote safety. The information given by authorities was mainly developed for adults, but children and adolescents may have different needs when it comes to information. This study examined how adolescents perceived information about Covid-19 provided by the media and other sources, and about what topics adolescents reported they lacked information during the first months of the Covid-19 pandemic.

METHODS

Three hundred seventy-seven adolescents in 11th, 12th, and 13th grade in Norwegian upper secondary schools (67% girls) completed an online questionnaire. Analyses included descriptive statistics, in addition to Generalized Linear Mixed Models analyses to examine gender differences in adolescents' satisfaction with the information provided about Covid-19, to what extent the pandemic affected their everyday life, and to what extent they were concerned about becoming infected with Covid-19.

RESULTS

The results showed that the majority of adolescents used the internet as the main source of information about Covid-19, followed by (online) newspapers. About half (49%) reported that they were satisfied with the information available, while 39% were neither satisfied nor dissatisfied, and 12% were dissatisfied. Adolescents wanted more information about the school situation, as well as virus- and future-related topics. A total of 21% reported that they were concerned about becoming infected with Covid-19. There was no significant gender difference in overall satisfaction with the information provided about Covid-19. Girls reported being significantly more affected by the pandemic than boys, and that they were significantly more concerned than boys about becoming infected with Covid-19.

CONCLUSIONS

This survey provides important knowledge to professionals working with adolescents, as well as to authorities, about what information channels can be used to reach adolescents, and what information they lacked about the Covid-19 pandemic.

Apathy in patients with schizophrenia: Treatment perspectives

Apathy occurs in many neuropsychiatric disorders and is a central negative symptom of schizophrenia. Apathy has severe functional consequences for patients with schizophrenia and the development of evidence-based treatments is a major challenge. There is now increasing evidence that dysfunctions in reward processing underly apathy, in particular regarding reward anticipation, cost-benefit computation and reward learning. In addition, metacognitive processes such as defeatist performance beliefs modulate reward processing. Psychological interventions for negative symptoms target these processes. While the evidence for cognitive-behavioral therapy for negative symptoms remains limited, recent findings suggest that specifically targeting reward-related dysfunctions may improve efficacy of these interventions. On the neurobiological level, there is now considerable evidence that a dysregulation of the dopaminergic reward system is related to reward processing dysfunctions. Regarding pharmacological treatment approaches, psychostimulants have successfully been used for apathy in dementia to target the reward system. Pro-dopaminergic drugs to target apathy in schizophrenia seem to be safer than anticipated, but their efficacy remains to be established. At the current state of knowledge, there is no evidence-based treatment that specifically targets apathy in patients with schizophrenia today. However, there are encouraging results from research inspired by basic research in neuroscience and clinical research in patients with other neuropsychiatric disorders.

EPA guidance on treatment of negative symptoms in schizophrenia

Negative symptoms of schizophrenia remain a major therapeutic challenge. The progress in the conceptualization and assessment is not yet fully reflected by treatment research. Nevertheless, there is a growing evidence base regarding the effects of biological and psychosocial interventions on negative symptoms. The importance of the distinction between primary and secondary negative symptoms for treatment selection might seem evident, but the currently available evidence remains limited. Good clinical practice is recommended for the treatment of secondary negative symptoms. Antipsychotic treatment should be optimized to avoid secondary negative symptoms due to side effects and due to positive symptoms. For most available interventions, further evidence is needed to formulate sound recommendations for primary, persistent, or predominant negative symptoms.

However, based on currently available evidence recommendations for the treatment of undifferentiated negative symptoms (including both primary and secondary negative symptoms) are provided. Although it has proven difficult to formulate an evidence-based recommendation for the choice of an antipsychotic, a switch to a second-generation antipsychotic should be considered for patients who are treated with a first-generation antipsychotic. Antidepressant add-on to antipsychotic treatment is an option. Social skills training is recommended as well as cognitive remediation for patients who also show cognitive impairment. Exercise interventions also have shown promise. Finally, access to treatment and to psychosocial rehabilitation should be ensured for patients with negative symptoms. Overall, there is definitive progress in the field, but further research is clearly needed to develop specific treatments for negative symptoms.

EPA guidance on assessment of negative symptoms in schizophrenia

Background

During the last decades, a renewed interest for negative symptoms (NS) was brought about by the increased awareness that they interfere severely with real-life functioning, particularly when they are primary and persistent.

Methods

In this guidance paper, we provide a systematic review of the evidence and elaborate several recommendations for the conceptualization and assessment of NS in clinical trials and practice.

Results

Expert consensus and systematic reviews have provided guidance for the optimal assessment of primary and persistent negative symptoms; second-generation rating scales, which provide a better assessment of the experiential domains, are available; however, NS are still poorly assessed both in research and clinical settings.

This European Psychiatric Association (EPA) guidance recommends the use of persistent negative symptoms (PNS) construct in the context of clinical trials and highlights the need for further efforts to make the definition of PNS consistent across studies in order to exclude as much as possible secondary negative symptoms. We also encourage clinicians to use second-generation scales, at least to complement first-generation ones.

The EPA guidance further recommends the evidence-based exclusion of several items included in first-generation scales from any NS summary or factor score to improve NS measurement in research and clinical settings. Self-rated instruments are suggested to further complement observer-rated scales in NS assessment.

Several recommendations are provided for the identification of secondary negative symptoms in clinical settings.

Conclusions

The dissemination of this guidance paper may promote the development of national guidelines on negative symptom assessment and ultimately improve the care of people with schizophrenia.

Help-seeking behavior in Norwegian adolescents: the role of bullying and cyberbullying victimization in a cross-sectional study

Background:

Help-seeking is considered a constructive coping style. However, the threshold at which many adolescents seek help is relatively high, and the outcomes are not necessarily always positive.

Objective:

The main aim of this study was to examine if bullying and cyberbullying victimization predicted help-seeking behavior among Norwegian adolescents.

Method:

Help-seeking behavior was predicted using three different Generalized Linear Mixed Models. In addition to demographic characteristics and mental health, these models controlled for bullying and cyberbullying, respectively.

Results:

2054 adolescents answered questions on help-seeking behavior and if they had felt the need to seek outside help with their problems, feelings, behavior, or emotional troubles within the past 6 months. Two hundred (9.7%) reported seeking outside help. Being exposed to bullying increased the likelihood of help-seeking behavior, while being exposed to cyberbullying did not. Only when forms of bullying or cyberbullying, respectively, were added to the models, did the threat of having rumors spread, both in real life and online, increase the likelihood for seeking help.

Conclusions:

Many factors affect whether adolescents seek help for a problem. The fact that adolescents exposed to bullying seek help more often than those not exposed may be considered a success, as this behavior is encouraged by many adults, mental health professionals, and anti-bullying interventions. However, adolescents exposed to cyberbullying did not seem to seek help. Future studies should identify factors that lead to more and successful help-seeking among bullied and cyberbullied adolescents.

Mortality risk reduction differs according to bisphosphonate class: a 15-year observational study

In this prospective cohort of 6120 participants aged 50+, nitrogen-bisphosphonates but not non-nitrogen bisphosphonates were associated with a significant 34% mortality risk reduction compared to non-treated propensity score matched controls. These findings open new avenues for research into mechanistic pathways.

INTRODUCTION

Emerging evidence suggests that bisphosphonates (BP), first-line treatment of osteoporosis, are associated with reduced risks for all-cause mortality. This study aimed to determine the association between different BP types and mortality risk in participants with or without a fracture.

METHODS

A prospective cohort study of users of different BPs matched to non-users by propensity score (age, gender, co-morbidities, fragility fracture status) and time to starting the BP medication from the population-based Canadian Multicentre Osteoporosis Study from nine Canadian centres followed from 1995 to 2013. Mortality risk for bisphosphonate users vs matched non-users was assessed using pairwise multivariable Cox proportional hazards models.

RESULTS

There were 2048 women and 308 men on BP and 1970 women and 1794 men who did not receive medication for osteoporosis. The relationship between BP and mortality risk was explored in three separate 1:1 propensity score-matched cohorts of BP users and no treatment (etidronate, n = 599, alendronate, n = 498, and risedronate n = 213). Nitrogen BP (n-BP) (alendronate and risedronate) was associated with lower mortality risks [pairwise HR, 0.66 (95% CI, 0.48-0.91)] while the less potent non-n-BP, etidronate, was not [pairwise HR: 0.89 (95% CI, 0.66-1.20)]. A direct comparison between n-BP and etidronate (n = 340 pairs) also suggested a better survival for n-BP [paired HR, 0.47 (95%CI, (95% CI, 031-0.70)] for n-BP vs. etidronate].

CONCLUSION

Compared to no treatment, nitrogen but not non-nitrogen bisphosphonates appear to be associated with better survival.

The effects of angiotensin receptor neprilysin inhibition by sacubitril/valsartan on adipose tissue transcriptome and protein expression in obese hypertensive patients

Increased activation of the renin-angiotensin system is involved in the onset and progression of cardiometabolic diseases, while natriuretic peptides (NP) may exert protective effects. We have recently demonstrated that sacubitril/valsartan (LCZ696), a first-in-class angiotensin receptor neprilysin inhibitor, which blocks the angiotensin II type-1 receptor and augments natriuretic peptide levels, improved peripheral insulin sensitivity in obese hypertensive patients. Here, we investigated the effects of sacubitril/valsartan (400 mg QD) treatment for 8 weeks on the abdominal subcutaneous adipose tissue (AT) phenotype compared to the metabolically neutral comparator amlodipine (10 mg QD) in 70 obese hypertensive patients. Abdominal subcutaneous AT biopsies were collected before and after intervention to determine the AT transcriptome and expression of proteins involved in lipolysis, NP signaling and mitochondrial oxidative metabolism. Both sacubitril/valsartan and amlodipine treatment did not significantly induce AT transcriptional changes in pathways related to lipolysis, NP signaling and oxidative metabolism. Furthermore, protein expression of adipose triglyceride lipase (ATGL) (P_time*group = 0.195), hormone-sensitive lipase (HSL) (P_time*group = 0.458), HSL-ser660 phosphorylation (P_time*group = 0.340), NP receptor-A (NPRA) (P_time*group = 0.829) and OXPHOS complexes (P_time*group = 0.964) remained unchanged. In conclusion, sacubitril/valsartan treatment for 8 weeks did not alter the abdominal subcutaneous AT transcriptome and expression of proteins involved in lipolysis, NP signaling and oxidative metabolism in obese hypertensive patients.

The comorbidity of personality disorders in eating disorders: a meta-analysis

PURPOSE

The present meta-analysis summarized the proportion of comorbid personality disorders (PDs) in patients with anorexia (AN) and bulimia nervosa (BN), respectively, and examined possible moderating variables.

METHODS

A search of the databases PsychINFO, Embase, and Medline for the period 1980-2016 identified 87 studies from 18 different countries.

RESULTS

The mean proportion of PDs among patients with any type of eating disorder (ED) was .52 compared to .09 in healthy controls. There were no statistically significant differences between AN (.49) and BN (.54) in proportions of any PD or PD clusters except for obsessive-compulsive PD (.23 vs .12 in AN and BN, respectively).

CONCLUSIONS

Both ED diagnoses had a similar comorbidity profile with a high prevalence of borderline and avoidant PDs. Moderator analyses conducted for any ED and any PD yielded significant differences for diagnostic systems with respect to EDs, method for assessing PD as well as patient weight and age.

Reorganisation of healthcare services for children and families: Improving collaboration, service quality, and worker well-being

This study is an evaluation of a reorganisation of different services for children and their families in a Norwegian municipality. The main aim of the reorganisation was to improve interprofessional collaboration through integrating different social services for children and their parents. The evaluation was guided by the Job Demands-Resources Model with a focus on social and healthcare workers' experiences of their work, including job demands and resources, service quality, and well-being at work. The survey of the employees was conducted at three measurement points: before (T₁) and after (T₂, T₃) the reorganisation took place, and included between 87 and 122 employees. A secondary aim was to examine the impact of different job resources and job demands on well-being (burnout, engagement, job satisfaction), and service quality. A one-way ANOVA indicated a positive development on many scales, such as collaboration, work conflict, leadership, and perceived service quality, especially from T₁ to T₂. No changes were detected in burnout, engagement, or job satisfaction over time. Moderated regression analyses (at T₃) indicated that job demands were particularly associated with burnout, and job resources with engagement and job satisfaction. Perceived service quality was predicted by both job demands and resources, in addition to the interaction between workload and collaboration. The reorganisation seems to have contributed to a positive development in how collaboration, work conflict, leadership, and service quality were evaluated, but that other changes are needed to increase worker well-being. The value of the study rests on the findings that support co-locating and merging services for children and their families, and that collaboration is an important resource for healthcare professionals.

Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus

The purpose of this review is to assess the most recent evidence in the management of primary hyperparathyroidism (PHPT) and provide updated recommendations for its evaluation, diagnosis and treatment. A Medline search of "Hyperparathyroidism. Primary" was conducted and the literature with the highest levels of evidence were reviewed and used to formulate recommendations. PHPT is a common endocrine disorder usually discovered by routine biochemical screening. PHPT is defined as hypercalcemia with increased or inappropriately normal plasma parathyroid hormone (PTH). It is most commonly seen after the age of 50 years, with women predominating by three to fourfold. In countries with routine multichannel screening, PHPT is identified earlier and may be asymptomatic. Where biochemical testing is not routine, PHPT is more likely to present with skeletal complications, or nephrolithiasis. Parathyroidectomy (PTx) is indicated for those with symptomatic disease. For asymptomatic patients, recent guidelines have recommended criteria for surgery, however PTx can also be considered in those who do not meet criteria, and prefer surgery. Non-surgical therapies are available when surgery is not appropriate. This review presents the current state of the art in the diagnosis and management of PHPT and updates the Canadian Position paper on PHPT. An overview of the impact of PHPT on the skeleton and other target organs is presented with international consensus. Differences in the international presentation of this condition are also summarized.

Photo-responsive thiol–ene networks for the design of switchable polymer patterns

Photo-patternable thiol–ene networks are prepared by combining versatile o-NBE chemistry with the distinctive advantages of a typical “click” reaction.

Treatment of a periorbital cyst in a dog by creation of a permanent drainage opening

An inflammatory periorbital cyst with secondary pressure atrophy of the maxilla was treated by surgical creation of a drainage opening to the nasal cavity in a 4-year-old Yorkshire Terrier. Following treatment, clinical signs resolved and computed tomography 5 weeks after surgery confirmed the permanence of the drainage opening. Eight months later, the dog showed no clinical abnormalities. Therefore, the procedure described in this report may offer a suitable treatment option in cases where the cyst's size or localization prevents complete excision.

THz-Frequency Modulation of the Hubbard U in an Organic Mott Insulator

We use midinfrared pulses with stable carrier-envelope phase offset to drive molecular vibrations in the charge transfer salt ET-F_{2}TCNQ, a prototypical one-dimensional Mott insulator. We find that the Mott gap, which is probed resonantly with 10 fs laser pulses, oscillates with the pump field. This observation reveals that molecular excitations can coherently perturb the electronic on-site interactions (Hubbard U) by changing the local orbital wave function. The gap oscillates at twice the frequency of the vibrational mode, indicating that the molecular distortions couple quadratically to the local charge density.

[Severe complications after non-intended usage of octenidine dihydrochloride. A case series with four dogs]

OBJECTIVE

Case series of four dogs in which extensive bite wounds had been treated using octenidine dihydrochloride (Octenivet® or Octenisept®) flushing. The dogs subsequently developed severe local complications.

MATERIAL AND METHODS

Retrospective evaluation of clinical symptoms, diagnostics, therapy and course of the disease.

RESULTS

In four dogs, severe necrosis and persistent edematous changes of the treated area developed after the application of octenidine dihydrochloride. The clinical course was comparable to complications described previously in human medicine. Therapy was protracted and complicated by secondary wound infection.

CONCLUSION AND CLINICAL RELEVANCE

Irrigation of deep wounds, particularly bite wounds, using octenidine dihydrochloride without drainage may lead to persistent edematous changes, inflammatory reactions and necrosis. The inappropriate application of octenidine dihydrochloride for wound irrigation should be avoided in veterinary medicine.

Preparation of monolithic silica-chitin composite under extreme biomimetic conditions

Chitin is a widespread renewable biopolymer that is extensively distributed in the natural world. The high thermal stability of chitin provides an opportunity to develop novel inorganic-organic composites under hydrothermal synthesis conditions in vitro. For the first time, in this work we prepared monolithic silica-chitin composite under extreme biomimetic conditions (80°C and pH 1.5) using three dimensional chitinous matrices isolated from the marine sponge Aplysina cauliformis. The resulting material was studied using light and fluorescence microscopy, scanning electron microscopy, Fourier transform infrared spectroscopy. A mechanism for the silica-chitin interaction after exposure to these hydrothermal conditions is proposed and discussed.

Effectiveness of school-based preventive interventions on adolescent alcohol use: a meta-analysis of randomized controlled trials

BACKGROUND

Preventive interventions for adolescents are an important priority within school systems. Several interventions have been developed, but the effectiveness of such interventions varies considerably between studies. The purpose of this study was to assess the effectiveness of universal school-based prevention programs on alcohol use among adolescents by using meta-analytic techniques.

METHOD

A systematic literature search in the databases, PubMed (Medline), PsycINFO (Ovid), EMBASE (Ovid) and WEB of Science (ISI) was conducted to search for empirical articles published in the period January 1990 to August 2014.

RESULTS

In total, 28 randomized controlled studies with 39,289 participants at baseline were included. Of these 28 articles, 12 studies (N = 16279) reported continuous outcomes (frequency of alcohol use and quantity of alcohol use), and 16 studies (N = 23010) reported categorical data (proportion of students who drank alcohol). The results of the random effects analyses showed that the overall effect size among studies reporting continuous outcomes was small and demonstrated a favorable effect from the preventive interventions (Hedges' g = 0.22, p < .01). The effect size among studies reporting categorical outcomes was not significant (OR = 0.94, p = .25). The level of heterogeneity between studies was found to be significant in most analyses. Moderator analyses conducted to explore the heterogeneity showed neither significant difference between the different school levels (junior high schools and high schools), nor between the varied program intensities (low, medium and high intensity programs). The meta-regression analyses examining continuous moderators showed no significant effects for age or gender.

CONCLUSIONS

The findings from this meta-analysis showed that, overall, the effects of school-based preventive alcohol interventions on adolescent alcohol use were small but positive among studies reporting the continuous measures, whereas no effect was found among studies reporting the categorical outcomes. Possible population health outcomes, with recommendations for policy and practice, are discussed further in this paper.

Optically enhanced coherent transport in YBa2Cu3O6.5 by ultrafast redistribution of interlayer coupling

Nonlinear optical excitation of infrared active lattice vibrations has been shown to melt magnetic or orbital orders and to transform insulators into metals. In cuprates, this technique has been used to remove charge stripes and promote superconductivity, acting in a way opposite to static magnetic fields. Here, we show that excitation of large-amplitude apical oxygen distortions in the cuprate superconductor YBa2Cu3O6.5 promotes highly unconventional electronic properties. Below the superconducting transition temperature (Tc = 50 K) inter-bilayer coherence is transiently enhanced at the expense of intra-bilayer coupling. Strikingly, even above Tc a qualitatively similar effect is observed up to room temperature, with transient inter-bilayer coherence emerging from the incoherent ground state and similar transfer of spectral weight from high to low frequency. These observations are compatible with previous reports of an inhomogeneous normal state that retains important properties of a superconductor, in which light may be melting competing orders or dynamically synchronizing the interlayer phase. The transient redistribution of coherence discussed here could lead to new strategies to enhance superconductivity in steady state.

Antidepressant use and 10-year incident fracture risk: the population-based Canadian Multicentre Osteoporosis Study (CaMoS)

We used data from a large, prospective Canadian cohort to assess the association between selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) and fracture. We found an increased risk of fractures in individuals who used SSRI or SNRI, even after controlling for multiple risk factors.

INTRODUCTION

Previous studies have suggested an association between SSRIs and increasing risk of fragility fractures. However, the majority of these studies were not long-term analyses or were performed using administrative data and, thus, could not fully control for potential confounders. We sought to determine whether the use of SSRIs and SNRIs is associated with increased risk of fragility fracture, in adults aged 50 + .

METHODS

We used data from the Canadian Multicentre Osteoporosis Study (CaMos), a prospective randomly selected population-based community cohort; our analyses focused on subjects aged 50+. Time to event methodology was used to assess the association between SSRI/SNRI use, modeled time-dependently, and fragility fracture.

RESULTS

Among 6,645 subjects, 192 (2.9%) were using SSRIs or/and SNRIs at baseline. During the 10-year study period, 978 (14.7%) participants experienced at least one fragility fracture. In our main analysis, SSRI/SNRI use was associated with increased risk of fragility fracture (hazard ratio (HR), 1.88; 95% confidence intervals (CI), 1.48-2.39). After controlling for multiple risk factors, including Charlson score, previous falls, and bone mineral density hip and lumbar bone density, the adjusted HR for current SSRI/SNRI use remained elevated (HR, 1.68; 95% CI, 1.32-2.14).

CONCLUSIONS

Our results lend additional support to an association between SSRI/SNRI use and fragility fractures. Given the high prevalence of antidepressants use, and the impact of fractures on health, our findings may have a significant clinical impact.

Pressure-dependent relaxation in the photoexcited mott insulator ET-F2TCNQ: influence of hopping and correlations on quasiparticle recombination rates

We measure the ultrafast recombination of photoexcited quasiparticles (holon-doublon pairs) in the one dimensional Mott insulator ET-F(2)TCNQ as a function of external pressure, which is used to tune the electronic structure. At each pressure value, we first fit the static optical properties and extract the electronic bandwidth t and the intersite correlation energy V. We then measure the recombination times as a function of pressure, and we correlate them with the corresponding microscopic parameters. We find that the recombination times scale differently than for metals and semiconductors. A fit to our data based on the time-dependent extended Hubbard Hamiltonian suggests that the competition between local recombination and delocalization of the Mott-Hubbard exciton dictates the efficiency of the recombination.

[Rehabilitation in persons with schizophrenic spectrum disorders: the impact of cognition and cognitive remediation therapy]

Schizophrenia is a chronic disorder, which severely limits the social and occupational functioning. Employment, education, relationships, housing and health are among the most frequently stated life and treatment goals among persons suffering from schizophrenia. Rehabilitation for persons with schizophrenia aims at preservation and improvement of psychosocial functions in areas such as work, social relationship and independent living skills, promotes recovery-oriented interventions and, therefore, serves the central goals of affected persons. Cognitive functioning, education, negative symptoms, social support and skills, age, work history, and rehabilitation service to restore community functioning have proven to be strong predictors for successful psychiatric rehabilitation. It makes sense to concentrate on these predictors when improvement of psychiatric rehabilitation is targeted. Cognitive remediation produces moderate improvements in cognitive performance and, when combined with functional training and embedded in comprehensive psychiatric rehabilitation, also enhances functional outcome. Germany provides a highly differentiated system of psychosocial support for schizophrenic patients. However, the "German disease" with different care providers being in charge in subsequent stages of recovery hampers efficient organisation of psychiatric rehabilitation. Improvement of overall organisation, i.e., configuration of interfaces, understanding of the complex interactions of measures, design of disease specific programmes, research and economic evaluation constitute major challenges in the field of psychiatric rehabilitation.

Optical properties of a vibrationally modulated solid state Mott insulator

Optical pulses at THz and mid-infrared frequencies tuned to specific vibrational resonances modulate the lattice along chosen normal mode coordinates. In this way, solids can be switched between competing electronic phases and new states are created. Here, we use vibrational modulation to make electronic interactions (Hubbard-U) in Mott-insulator time dependent. Mid-infrared optical pulses excite localized molecular vibrations in ET-F2TCNQ, a prototypical one-dimensional Mott-insulator. A broadband ultrafast probe interrogates the resulting optical spectrum between THz and visible frequencies. A red-shifted charge-transfer resonance is observed, consistent with a time-averaged reduction of the electronic correlation strength U. Secondly, a sideband manifold inside of the Mott-gap appears, resulting from a periodically modulated U. The response is compared to computations based on a quantum-modulated dynamic Hubbard model. Heuristic fitting suggests asymmetric holon-doublon coupling to the molecules and that electron double-occupancies strongly squeeze the vibrational mode.

Photoperiodic effects on reproductive development in male cavies (Cavia aperea)

Age at maturity is a particularly important life history parameter, as it predicts potential life time reproductive success in many small mammal species. Animals should therefore optimize the timing of maturation by reacting to environmental stimuli that predict future environmental conditions. Photoperiod often reliably predicts ecological conditions. Animals born into a photoperiod indicating favorable conditions (spring, summer) may mature earlier and at a lower weight than animals born into conditions indicating unfavorable conditions (autumn, winter). So far most work was done on small, altricial rodent species and we still lack knowledge about their precocial relatives. Precocial animals are born much further developed than altricials and might show less plasticity in their ontogenetic trajectory than the latter. We tested the influence of photoperiod simulated by increasing (spring) or decreasing (autumn) light in climate chambers on important life history parameters in a medium sized rodent, the highly precocial cavy (Cavia aperea). We wanted to determine whether photoperiod influences timing of maturation and early growth in male cavies and whether patterns of testosterone in blood are reflected by patterns of testosterone metabolites in feces.Males born into simulated spring grew faster and matured at an earlier age than males born into simulated autumn conditions. Patterns of testosterone in blood correlated with testosterone metabolites measured in feces. Male cavies strongly react to predictive photoperiod cues by adjusting growth and timing of maturation as we found previously for females, corroborating the importance of seasonal cues for adjustments of life history.