Biomarkers in autism Goldani, Andre A S; Downs, Susan R; Widjaja, Felicia ...
Frontiers in psychiatry,
08/2014, Letnik:
5
Journal Article
Recenzirano
Odprti dostop
Autism spectrum disorders (ASDs) are complex, heterogeneous disorders caused by an interaction between genetic vulnerability and environmental factors. In an effort to better target the underlying ...roots of ASD for diagnosis and treatment, efforts to identify reliable biomarkers in genetics, neuroimaging, gene expression, and measures of the body's metabolism are growing. For this article, we review the published studies of potential biomarkers in autism and conclude that while there is increasing promise of finding biomarkers that can help us target treatment, there are none with enough evidence to support routine clinical use unless medical illness is suspected. Promising biomarkers include those for mitochondrial function, oxidative stress, and immune function. Genetic clusters are also suggesting the potential for useful biomarkers.
Time-geographic density estimation (TGDE) is a method of movement pattern analysis that generates a continuous intensity surface from a set of tracking data. TGDE has recently been proposed as a ...method of animal home range estimation, where the goal is to delineate the spatial extents that an animal occupies. This paper tests TGDE's effectiveness as a home range estimator using simulated movement data. First, an agent-based model is used to simulate tracking data under 16 movement scenarios representing a variety of animal life history traits (habitat preferences, homing behaviour, mobility) and habitat configurations (levels of habitat fragmentation). Second, the accuracy of TGDE is evaluated for four temporal sampling frequencies using three adaptive velocity parameters for 30 sample data sets from each scenario. Third, TGDE accuracy is compared to two other common home range estimation methods, kernel density estimation (KDE) and characteristic hull polygons (CHP). The results demonstrate that TGDE is the most effective at estimating core areas, home ranges and total areas at high sampling frequencies, while CHP performs better at low sampling frequencies. KDE was ineffective across all scenarios explored.
Aim
This systematic review aimed to identify the most important social, environmental, biological, and/or genetic risk factors for intellectual disability (ID).
Methods
Eligible were published ...prospective or retrospective comparative studies investigating risk factors for ID in children 4–18 years. Exclusions were single group studies with no comparator without ID and a sample size <100. Electronic databases (Medline, Cochrane Library, EMBASE, PsycInfo, Campbell Collaboration, and CINAHL) were searched for eligible publications from 1980 to 2020. Joanna Briggs Institute critical appraisal instruments, appropriate for study type, were used to assess study quality and risk of bias. Descriptive characteristics and individual study results were presented followed by the synthesis for individual risk factors, also assessed using GRADE.
Results
Fifty-eight individual eligible studies were grouped into six exposure topics: sociodemographic; antenatal and perinatal; maternal physical health; maternal mental health; environmental; genetic or biological studies. There were few eligible genetic studies. For half the topics, the certainty of evidence (GRADE) was moderate or high.
Conclusion
Multiple studies have examined individual potential determinants of ID, but few have investigated holistically to identify those populations most at risk. Our review would indicate that there are vulnerable groups where risk factors we identified, such as low socioeconomic status, minority ethnicity, teenage motherhood, maternal mental illness, and alcohol abuse, may cluster, highlighting a target for preventive strategies. At-risk populations need to be identified and monitored so that interventions can be implemented when appropriate, at preconception, during pregnancy, or after birth. This could reduce the likelihood of ID and provide optimal opportunities for vulnerable infants.
Systematic review registration
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=120032
, identifier CRD42019120032.
Mycobacterial spindle cell pseudotumor (MSP) is a rare benign spindle cell lesion containing acid-fact mycobacteria. These lesions are most commonly identified in the lymph nodes, skin, spleen, or ...bone marrow of immunocompromised patients and only rarely involve the lungs. We report 3 cases of pulmonary MSP, which include 2 patients who are known to be HIV-positive. The histopathological diagnosis of MSP in the lung lends itself to many challenges due to its rare incidence and its spindled tumor-like appearance. The differential diagnosis is broad and includes both benign and malignant entities. We highlight the importance of the clinical context in which these lesions typically present and the morphologic spectrum of features seen, and we offer a practical approach to the workup of pulmonary mycobacterial pseudotumor. Appropriate recognition of this entity should lead to an accurate diagnosis of a treatable benign condition despite the clinical presentation often favoring malignancy.
Participant recruitment and retention (R&R) are well-documented challenges in longitudinal studies, especially those involving populations historically underrepresented in research and vulnerable ...groups (e.g., pregnant people or young children and their families), as is the focus of the HEALthy Brain and Child Development (HBCD) birth cohort study. Subpar access to transportation, overnight lodging, childcare, or meals can compromise R yet, guidance on how to overcome these "logistical barriers" is sparse. This study's goal was to learn about the HBCD sites' plans and develop best practice recommendations for the HBCD consortium for addressing these logistical barriers.
The HBCD's workgroups developed a survey asking the HBCD sites about their plans for supporting research-related transportation, lodging, childcare, and meals, and about the presence of institutional policies to guide their approach. Descriptive statistics described the quantitative survey data. Qualitative survey responses were brief, not warranting formal qualitative analysis; their content was summarized.
Twenty-eight respondents, representing unique recruitment locations across the U.S., completed the survey. The results indicated substantial heterogeneity across the respondents in their approach toward supporting research-related transportation, lodging, childcare, and meals. Three respondents were aware of institutional policies guiding research-related transportation (10.7%) or childcare (10.7%).
This study highlighted heterogeneity in approaches and scarcity of institutional policies regarding research-related transportation, lodging, childcare, and meals, underscoring the need for guidance in this area to ensure equitable support of participant R&R across different settings and populations, so that participants are representative of the larger community, and increase research result validity and generalizability.
Objective
A growing body of literature documents high rates of burnout, depression, and suicidal ideation among physicians and medical students. Barriers to seeking mental health treatment in this ...group include concerns about time, stigma, confidentiality, and potential career impact. The authors describe a 4-year trial of the Healer Education Assessment and Referral (HEAR) program, designed to increase mental health services utilization (MHSU) and decrease suicide risk (SR) as assessed by an Interactive Screening Program (ISP)at one US medical school.
Methods
Over a 4-year period, medical students were engaged in face-to-face, campus-wide, educational group programs and were invited to complete an individual, online, and anonymous survey. This survey contained the 9-item Patient Health Questionnaire (PHQ-9) scale to assess depression and items to identify suicidal thoughts and behaviors, substance use, distressing emotional states, and the use of mental health treatment. Students who engaged in this ISP by corresponding electronically with a counselor after completing the survey were assessed and when indicated, referred to further treatment.
Results
The HEAR program was delivered to 1,008 medical students. Thirty-four percent (343/1,008) completed the online screening portion. Almost 8 % of respondents met the criteria for high/significant SR upon analysis of the completed screens. Ten out of 13 of the students with SR who dialogued with a counselor were not already receiving mental health treatment, indicating that this anonymous ISP identified a high proportion of an untreated, at risk, and potentially suicidal population. MHSU among medical students who completed the survey was 11.5 % in year 1 and 15.0 % by year 4. SR among medical students was 8.8 % in year 1 and 6.2 % in year 4 as assessed by the ISP.
Conclusions
This novel interventional program identified at risk, potentially suicidal medical students at one institution. Based on this single-site experience, we suggest that future multisite studies incorporate a comparison group, acquire baseline (prematriculation) data regarding MHSU and SR, and use an individualized yet anonymous identification system to measure changes in individual participants’ mental health status over time.
Medical students and physicians in training and in practice are at risk for excessive alcohol use and abuse, potentially impacting the affected individuals as well as their family members, trainees, ...and patients. However, several roadblocks to care, including stigma, often keep them from seeking treatment.
We analyzed data from anonymous questionnaires completed by medical students, house staff, and faculty from 2009 to 2014 as part of a depression awareness and suicide prevention program at a state-supported medical school in the United States. The authors explored associations between self-reported "drinking too much" and depression, suicidal ideation, substance use, intense affective states, and mental health treatment.
Approximately one-fifth of the respondents reported "drinking too much." "Drinking too much" was associated with more severe depression and impairment, past suicide attempts and current suicidal ideation, intense affective states, and other substance use. Those who were "drinking too much" were more likely than others to accept referrals for mental health treatment through the anonymous interactive screening program, suggesting that this program may be effective in skirting the stigma barrier for accessing mental health care for this at-risk population.
The self-reported prevalence of "drinking too much" among medical students, house staff, and faculty is high and associated with negative mental health outcomes. Targeted, anonymous screenings may identify at-risk individuals and provide mental health care referrals to those in need.
Physicians are among the highest risk groups for suicide, and emerging data suggest this risk begins early in medical training. We describe a screening program at one medical center for identifying ...and referring physicians and students who may be at risk for suicide, and we explore differences between groups with respect to depressive symptoms, suicidal ideation (SI) and behaviors, and utilization of mental health resources. Over a 5-year period (May 2009–August 2014), we invited 1,134 medical students, 1,380 house staff (residents and fellows), and 1,922 faculty to complete an anonymous web-based “stress” questionnaire including items about depression symptoms, SI and behaviors, emotional distress features, drinking and drug-use behaviors, problematic eating, and utilization of treatments for depression and anxiety. Response rates among each group ranged from 17% (house staff) to 33% (students). Overall, 7% to 10% of respondents met criteria for a current major depressive syndrome, and 9% to 11% of respondents endorsed current SI. Similarities in depression severity and SI between groups far outweighed differences. The following were the four unique predictors of SI: presence of moderately severe or severe depressive symptoms, impairment, hopelessness, and past attempts. Only 17% of those endorsing current SI were taking antidepressant medication, and only 12% were receiving psychotherapy. However, 16% accepted referrals provided through this program. Increased efforts at education and destigmatization, outreach, assessment, and treatment at medical schools are essential. Our educational and screening program is one model others might employ to work toward this goal, though it is likely that additional outreach methods are needed.
Quasi-periodic, fast-mode, propagating wave trains (QFPs) are a new observational phenomenon recently discovered in the solar corona by the Solar Dynamics Observatory with extreme ultraviolet (EUV) ...imaging observations. They originate from flares and propagate at speeds up to ~2000 km/s within funnel-shaped waveguides in the wakes of coronal mass ejections (CMEs). QFPs can carry sufficient energy fluxes required for coronal heating during their occurrences. They can provide new diagnostics for the solar corona and their associated flares. We present recent observations of QFPs focusing on their spatio-temporal properties, temperature dependence, and statistical correlation with flares and CMEs. Of particular interest is the 2010-Aug-01 C3.2 flare with correlated QFPs and drifting zebra and fiber radio bursts, which might be different manifestations of the same fast-mode wave trains. We also discuss the potential roles of QFPs in accelerating and/or modulating the solar wind.
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