Nevin Manimala

J Psychiatr Res. 2021 Jul 8;141:287-292. doi: 10.1016/j.jpsychires.2021.06.033. Online ahead of print.

ABSTRACT

INTRODUCTION: Cytokines might play a key role in the pathophysiology of major depressive disorder (MDD). The speed of onset of depressive episodes has been discussed as an important clinical parameter in MDD. The aim of this study was to investigate a potential influence of the speed of onset of the depressive episode on cytokine serum levels.

METHOD: Serum level of the cytokines interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor alpha (TNF-α), interferon-gamma (IFN-γ) granulocyte and monocyte colony stimulating factor (GM-CSF) were measured in a total of 92 patients with MDD that did not respond to at least one previous antidepressant treatment. Patients were retrospectively divided in two groups: Faster (≤4 weeks) and slower (>4 weeks) onset of the depressive episode defined as the time passing from the first depressive symptoms to a full-blown depressive episode by using information from a clinical interview.

RESULTS: We found significantly lower serum levels of IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ in patients with a faster onset compared to patients with a slower onset of the depressive episodes. Furthermore, lower cytokine serum levels of IL-2, IL-8, IL-10 and IFN-γ were found in patients with a shorter duration (less than 6 months) compared to a longer duration (6-24 months) of the current depressive episode. This effect on cytokines was independent from the effect of the speed of onset of the depressive episode.

CONCLUSIONS: Patients with faster onset of the depressive episode might represent a biological subtype of MDD with lower serum levels of IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ.

PMID:34271459 | DOI:10.1016/j.jpsychires.2021.06.033

J Psychiatr Res. 2021 Jul 6;141:276-286. doi: 10.1016/j.jpsychires.2021.07.001. Online ahead of print.

ABSTRACT

BACKGROUND: Re-establishing societal norms in the wake of the COVID-19 pandemic will be important for restoring public mental health and psychosocial wellbeing as well as economic recovery. We investigated the impact on post-pandemic adjustment of a history of mental disorder, with particular reference to obsessive-compulsive (OC) symptoms or traits.

METHODS: The study was pre-registered (Open Science Framework; https://osf.io/gs8j2/). Adult members of the public (n = 514) were surveyed between July and November 2020, to identify the extent to which they reported difficulties re-adjusting as lockdown conditions eased. All were assessed using validated scales to determine which demographic and mental health-related factors impacted adjustment. An exploratory analysis of a subgroup on an objective online test of cognitive inflexibility was also performed.

RESULTS: Adjustment was related to a history of mental disorder and the presence of OC symptoms and traits, all acting indirectly and statistically-mediated via depression, anxiety and stress; and in the case of OC symptoms, also via COVID-related anxiety (all p < 0.001). One hundred and twenty-eight (25%) participants reported significant adjustment difficulties and were compared with those self-identifying as “good adjusters” (n = 231). This comparison revealed over-representation of those with a history or family history of mental disorder in the poor adjustment category (all p < 0.05). ‘Poor-adjusters’ additionally reported higher COVID-related anxiety, depression, anxiety and stress and OC symptoms and traits (all p < 0.05). Furthermore, history of mental disorder directly statistically mediated adjustment status (p < 0.01), whereas OC symptoms (not OC traits) acted indirectly via COVID-related anxiety (p < 0.001). Poor-adjusters also showed evidence of greater cognitive inflexibility on the intra-extra-dimensional set-shift task.

CONCLUSION: Individuals with a history of mental disorder, OC symptoms and OC traits experienced greater difficulties adjusting after lockdown-release, largely statistically mediated by increased depression, anxiety, including COVID-related anxiety, and stress. The implications for clinical and public health policies and interventions are discussed.

PMID:34271458 | DOI:10.1016/j.jpsychires.2021.07.001

Musculoskelet Sci Pract. 2021 Jul 10;55:102429. doi: 10.1016/j.msksp.2021.102429. Online ahead of print.

ABSTRACT

BACKGROUND: Since the contribution of the lumbar multifidus(LM) is not well understood in relation to non-specific low back pain(LBP), this may limit physiotherapists in choosing the most appropriate treatment strategy.

OBJECTIVES: This study aims to compare clinical characteristics, in terms of LM function and morphology, between subacute and chronic LBP patients from a large clinical practice cohort compared to healthy controls.

DESIGN: Multicenter case control study.

METHOD: Subacute and chronic LBP patients and healthy controls between 18 and 65 years of age were included. Several clinical tests were performed: primary outcomes were the LM thickness from ultrasound measurements, trunk range of motion(ROM) from 3D kinematic tests, and median frequency and root mean square values of LM by electromyography measurements. The secondary outcomes Numeric Rating Scale for Pain(NRS) and the Oswestry Disability Index(ODI) were administered. Comparisons between groups were made with ANOVA, p-values<0.05, with Tukey’s HSD post-hoc test were considered significant.

RESULTS: A total of 161 participants were included, 50 healthy controls, 59 chronic LBP patients, and 52 subacute LBP patients. Trunk ROM and LM thickness were significantly larger in healthy controls compared to all LBP patients(p < 0.01). A lower LM thickness was found between subacute and chronic LBP patients although not significant(p = 0.11-0.97). All between-group comparisons showed no statistically significant differences in electromyography outcomes (p = 0.10-0.32). NRS showed no significant differences between LBP subgroups(p = 0.21). Chronic LBP patients showed a significant higher ODI score compared to subacute LBP patients(p = 0.03).

CONCLUSIONS: Trunk ROM and LM thickness show differences between LBP patients and healthy controls.

PMID:34271415 | DOI:10.1016/j.msksp.2021.102429

Int J Paleopathol. 2021 Jul 13;34:155-162. doi: 10.1016/j.ijpp.2021.06.010. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyse the oral conditions of pre-Hispanic mummies from Gran Canaria (5th-11th centuries AD), comparing the results with published data from the non-mummified population.

MATERIALS: 440 teeth and 764 alveoli of 30 adult mummies.

METHODS: Macroscopic examination of pathological and non-pathological features of the oral cavity, using standardized criteria.

RESULTS: The mummies reveal frequent dental caries (11.8%), especially affecting molars (27.6%), a high prevalence of calculus (66.3%) and periodontal disease (34.9%). The average wear is characterized by extensive dentine exposure. Periapical lesions (10.6%) and antemortem tooth loss (AMTL) (15.9%) are common. A high percentage of individuals exhibit linear enamel hypoplasia (LEH) (84%). Except for periodontitis, the data indicate the absence of significant statistical differences between the mummies and the skeletonized sample.

CONCLUSIONS: The profile of the dental pathologies of the mummies indicates a carbohydrate-rich diet that contained abrasive grit from the stone querns used to grind cereals. Comparison of the oral conditions of mummified and skeletonized remains shows no differences in access to food resources, reinforcing the recent rejection of the traditional interpretation of the mummies as the pre-eminent status group of Canarian society.

SIGNIFICANCE: This is the first study to delve into the oral conditions of pre-Hispanic mummified remains from Gran Canaria. The results have implications for the framing of research questions based on the social status of these mummies.

LIMITATION: The preserved sample of mummified remains of ancient Canarians is small.

SUGGESTION FOR FURTHER RESEARCH: Comparative analysis from a diachronic perspective would improve understanding of the historical development of ancient Canarians.

PMID:34271409 | DOI:10.1016/j.ijpp.2021.06.010

Soc Sci Med. 2021 Jul 2;284:114196. doi: 10.1016/j.socscimed.2021.114196. Online ahead of print.

ABSTRACT

This paper examines the interrelationship between suicide, health, socioeconomic, and psychosocial factors in contributing to suicide in older adults in rural Australia. Drawing on a coronial dataset of suicide cases and a mixed methods sociological autopsy approach, our study integrated a quantitative analysis of 792 suicide cases with a qualitative analysis of medico-legal reports from 30 cases. The sociological autopsy provided novel insights into the entanglement of policy and service provision at the state-level with individual end-of-life decisions. Particular attention is drawn to age and gendered dimensions of suicide, especially in relation to health and social issues. The study showed a continuity between suicide and the patterning of an individual’s life course, including experiences and consequences of inequality and marginality; a desire to meet culturally-normative ideals of autonomy; and a fragmented, under-funded, and intimidating social care system that offered limited options.

PMID:34271402 | DOI:10.1016/j.socscimed.2021.114196

Sci Total Environ. 2021 Jul 10;796:148950. doi: 10.1016/j.scitotenv.2021.148950. Online ahead of print.

ABSTRACT

Boundary layer height (BLH) plays an important role in regulating global weather/climate, as well as the dispersion and transportation of pollutants. Until now, however, the attribution and contributions of different controlling factors to BLH long-term variability and trends have not been quantified on a global scale. The long-term radiosonde dataset was used in this study to retrieve global BLH climatology; seasonal, diurnal, long-term variation and trends were analyzed over a 39-year period (1980-2018). Statistical results show that the global distribution of the BLH and its trend have apparent day-night differences. BLH during daytime is deeper during clear-sky conditions compared to cloudy sky conditions, indicating a significant effect of clouds; BLH during nighttime is deeper under cloudy conditions. BLH was also found to vary over different land types; dry and hot soil exhibits a deeper BLH than those of wet and cool soil. The long-term variation and trend of BLH are highly influenced by near-surface meteorological parameters. In particular, based on multiple linear stepwise regression models and the contribution calculation method, this investigation initiatively quantifies the influences of meteorological parameters on global BLH long-term variation and trend. Our results emphasized that a 10 m wind speed (WS) and low tropospheric stability (LTS) have significant contributions to long-term BLH variation; WS and LTS anomalies alternately dominated the contribution of the diurnal cycle of the BLH anomaly. Annual BLH recorded an average increasing trend (38.9-42.1 m/decade), and LTS is more dominant than WS from a contribution perspective, especially for increased BLH anomaly. Contributions from near-surface temperature (T) and relative humidity (RH) also play important roles. However, a decreasing WS trend dominated the decreased trends of BLH anomaly, accounting for nearly 40% of the total contribution.

PMID:34271389 | DOI:10.1016/j.scitotenv.2021.148950

Psychiatry Res. 2021 Jul 9;303:114107. doi: 10.1016/j.psychres.2021.114107. Online ahead of print.

ABSTRACT

Disadvantaged populations have an increased risk of suicide and suicide attempts because of the Covid-19 pandemic. To date, few studies focused on people living in detention, who have a high burden of mental health problems and are exposed to severe control measures. Our study investigated whether there was an increase in suicide attempts in prison. Data were collected in the largest Swiss pre-trial prison (Champ-Dollon) for the pre-pandemic and the pandemic periods. We identified a statistically significant 57%-increase of suicide attempts. Mitigation measures, access to mental health care, and access to vaccination are needed to protect this vulnerable population.

PMID:34271371 | DOI:10.1016/j.psychres.2021.114107

Eur J Obstet Gynecol Reprod Biol. 2021 Jun 24;264:25-30. doi: 10.1016/j.ejogrb.2021.06.025. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study was to measure the impact of innovative pelvic floor muscle training (iPFMT) on Quality-Adjusted Life Years (QALYs) in women with stress urinary incontinence (SUI) treated by duloxetine.

STUDY DESIGN: This analysis is part of the DULOXING study conducted between February 2019 and 2020. The control group received oral duloxetine treatment (40 mg BID), and the experimental group received oral duloxetine treatment (40 mg BID) and iPFMT with lumbopelvic stabilization. SUI was analysed at baseline and in the final period according to the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). The QALYs gained were calculated by multiplying life expectancy (LE) by a weighting factor (QALYs = LE * WF).

RESULTS: The study included 158 women, of whom 129 were fully analysed (81.6%). The mean life expectancy was 26.3 ± 11.8 years for the control group and 29.0 ± 11.7 years for the experimental group. The mean baseline ICIQ-UI SF scores were 15.2 ± 1.7 vs 15.1 ± 1.5, and the final ICIQ-UI SF scores were 9.8 ± 4.2 vs 8.3 ± 3.8, in the control vs the experimental group, respectively (p < 0.05). The mean baseline WF was 0.27 ± 0.08 vs 0.28 ± 0.07, and the final WF was 0.53 ± 0.20 vs 0.60 ± 0.18, in the control vs the experimental group, respectively (p < 0.05). Before treatment, the number of QALYs during life expectancy in the control vs the experimental group was 7.53 ± 4.24 vs 8.30 ± 4.01. The number of QALYs during life expectancy in control vs the experimental group increased following treatment: 15.03 ± 7.63 vs 17.90 ± 7.86 (p < 0.05).

CONCLUSIONS: Combination treatment with duloxetine and iPFMT statistically significantly increased the number of QALYs and reduced the degree of urinary incontinence in women with stress urinary incontinence.

PMID:34271362 | DOI:10.1016/j.ejogrb.2021.06.025

Vet Parasitol. 2021 Jul 3;298:109516. doi: 10.1016/j.vetpar.2021.109516. Online ahead of print.

ABSTRACT

On the Northern Tablelands of New South Wales, Australia, endemic Theileria orientalis infection of cattle has been reported on farms where no ticks have been observed, raising the question of how Theileria is transmitted in these areas. To investigate the potential role of mechanical transmission by insects, the present study investigated the seasonal dynamics of biting fly species trapped between December 2017 and May 2019 on six cattle farms in the region where the presence of Theileria was confirmed. These flies, sucking lice collected from these farms and pools of Culicoides species affecting cattle also trapped in the region were subjected to qPCR detection of T. orientalis. Eleven species from eight genera of biting flies were collected using unbaited Nzi traps. Tabanid species were present in all farms, with Dasybasis oculata (43.6 %) and D. circumdata (27.6 %) being the most abundant and widespread species. The effect of season on the mean count per trapping event was statistically significant and highest in the summer months for Lilaea fuliginosa and D. oculata, and the autumn months for D. circumdata, with no seasonal effect on the abundance of the undescribed Dasybasis spp. No biting flies were trapped during the winter months. Sucking (Linognathus vituli and Haematopinus eurysternus) and biting (Bovicola bovis) cattle lice were also collected from all farms with the latter detected in only one farm. PCR screening for T. orientalis of trapped hematophagous insects resulted in parasite detection in the tabanid and Stomoxyini flies, biting midges and sucking lice with the highest proportion of positive samples for Haematopinus eurysternus (4/4 pools) and H. irritans exigua (6/15 individuals). The detection of the parasite in these potential vectors indicates a possible role in the mechanical transmission of T. orientalis and may partly explain the ubiquitous presence of Theileria in areas where ticks are absent.

PMID:34271315 | DOI:10.1016/j.vetpar.2021.109516

ESMO Open. 2021 Jul 13;6(4):100217. doi: 10.1016/j.esmoop.2021.100217. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with advanced gastrointestinal stromal tumours (GISTs) resistant to the tyrosine kinase inhibitors imatinib and sunitinib may be treated with regorafenib, which resulted in a median progression-free survival (PFS) of 4.8 months in the GRID trial. Also, pazopanib, another tyrosine kinase inhibitor, has been studied in a randomized, placebo-controlled trial (PAZOGIST) in the third line, which showed a PFS of 45.2% 4 months after study entry, but patients intolerant to sunitinib were also included. We designed another trial evaluating pazopanib, enrolling only patients with progression on both imatinib and sunitinib.

PATIENTS AND METHODS: Since all eligible patients had progressive disease, we preferred a non-randomized, phase II multicentre trial so that all patients could receive a potentially active drug. Patients had a progressive metastatic or locally advanced GIST and were ≥18 years of age, with a performance status of 0-2, and sufficient organ functions. The primary endpoint was disease control rate (defined as complete remission + partial remission + stable disease) at 12 weeks on pazopanib. A Simon’s two-stage analysis was used with an interim analysis 12 weeks after enrollment of the first 22 patients, and if passed, there was a full enrolment of 72 patients. GIST mutational analysis was done, and most patients had pazopanib plasma concentration measured after 12 weeks.

RESULTS: Seventy-two patients were enrolled. The disease control rate after 12 weeks was 44%, and the median PFS was 19.6 weeks (95% confidence interval 12.6-23.4 weeks). Pazopanib-related toxicity was moderate and manageable. No statistically significant differences were found related to mutations. Plasma concentrations of pazopanib had a formal but weak correlation with outcome.

CONCLUSION: Pazopanib given in the third line to patients with GIST progressing on both imatinib and sunitinib was beneficial for about half of the patients. The PAGIST trial confirms the results from the PAZOGIST trial, and the median PFS achieved seems comparable to the PFS achieved with regorafenib in the third-line setting.

PMID:34271307 | DOI:10.1016/j.esmoop.2021.100217