The COVID-19 pandemic has triggered a global mental health crisis. Yet, we know little about the lasting effects of COVID-19 infection on mental health. This prospective longitudinal study aimed to ...investigate the trajectories of mental health changes in individuals infected with COVID-19 and to identify potential predictors that may influence these changes.
A web-survey that targeted individuals that had been infected with COVID-19 was used at three time-points: T0 (baseline), T1 (six months), and T2 (twelve months). The survey included demographics, questions related to COVID-19 status, previous psychiatric diagnosis, post-COVID impairments, fatigue, and standardized measures of depression, anxiety, insomnia. Linear mixed models were used to examine changes in depression, anxiety, and insomnia over time and identify factors that impacted trajectories of mental health outcomes.
A total of 236 individuals completed assessments and was included in the longitudinal sample. The participants' age ranged between 19 and 81 years old (M = 48.71, SD = 10.74). The results revealed notable changes in mental health outcomes over time. The trajectory of depression showed significant improvement over time while the trends in anxiety and insomnia did not exhibit significant changes over time. Younger participants and individuals who experienced severe COVID-19 infection in the acute phase were identified as high-risk groups with worst mental ill-health. The main predictors of the changes in the mental health outcomes were fatigue and post-COVID impairments.
The findings of our study suggest that mental health outcomes following COVID-19 infection exhibit a dynamic pattern over time. The study provides valuable insights into the mental health trajectory following COVID-19 infection, emphasizing the need for ongoing assessment, support, and interventions tailored to the evolving mental health needs of this population.
Scalable and effective treatments are needed for children with functional abdominal pain disorders (FAPDs). We performed a randomized controlled trial of the efficacy and cost effectiveness of ...cognitive behavioral therapy delivered online (Internet-CBT) compared with usual therapy.
We studied children (age, 8–12 y) diagnosed with FAPDs, based on the Rome IV criteria, in Sweden from September 2016 through April 2017. The patients were assigned randomly to groups that received 10 weeks of therapist-guided, internet-delivered cognitive behavioral therapy (Internet-CBT, n = 46) or treatment as usual (treatments within the health care and school systems, including medications and visits to doctors and other health care professionals; n = 44). The primary outcome was global child-rated gastrointestinal symptom severity assessed using the Pediatric Quality of Life Gastrointestinal Symptom scale. All outcomes were collected from September 2016 through January 2018. Secondary outcomes included quality of life, gastrointestinal-specific anxiety, avoidance behaviors, and parental responses to children’s symptoms. Societal costs and costs for health care consumption were collected during the treatment.
Children who received Internet-CBT had a significantly larger improvement in gastrointestinal symptom severity with a medium effect size (Cohen’s d = 0.46; 95% CI, 0.05–0.88; number needed to treat, 3.8) compared with children who received the treatment as usual. The children’s quality of life, gastrointestinal-specific anxiety, avoidance behaviors, and parental responses to children’s symptoms also improved significantly in the Internet-CBT group compared with the treatment as usual group. The effects of Internet-CBT persisted through 36 weeks of follow-up evaluation. Children who received Internet-CBT had significantly less health care use than children who received treatment as usual, with an average cost difference of US $137 (P = .011). We calculated a cost savings of US $1050 for every child treated with Internet-CBT compared with treatment as usual.
In a randomized trial of pediatric patients with FAPDs, we found Internet-CBT to be clinically cost effective compared with treatment as usual. Internet-CBT has the potential to increase the availability of treatment for a number of patients and reduce health care costs. ClinicalTrials.gov: NCT02873078.
Current breast cancer risk prediction scores and algorithms can potentially be further improved by including molecular markers. To this end, we studied the association of circulating plasma proteins ...using Proximity Extension Assay (PEA) with incident breast cancer risk.
In this study, we included 1577 women participating in the prospective KARMA mammographic screening cohort.
In a targeted panel of 164 proteins, we found 8 candidates nominally significantly associated with short-term breast cancer risk (P < 0.05). Similarly, in an exploratory panel consisting of 2204 proteins, 115 were found nominally significantly associated (P < 0.05). However, none of the identified protein levels remained significant after adjustment for multiple testing. This lack of statistically significant findings was not due to limited power, but attributable to the small effect sizes observed even for nominally significant proteins. Similarly, adding plasma protein levels to established risk factors did not improve breast cancer risk prediction accuracy.
Our results indicate that the levels of the studied plasma proteins captured by the PEA method are unlikely to offer additional benefits for risk prediction of short-term overall breast cancer risk but could provide interesting insights into the biological basis of breast cancer in the future.
The link between DNA methylation, obesity, and adiposity-related diseases in the general population remains uncertain.
We conducted an association study of body mass index (BMI) and differential ...methylation for over 400,000 CpGs assayed by microarray in whole-blood-derived DNA from 3,743 participants in the Framingham Heart Study and the Lothian Birth Cohorts, with independent replication in three external cohorts of 4,055 participants. We examined variations in whole blood gene expression and conducted Mendelian randomization analyses to investigate the functional and clinical relevance of the findings. We identified novel and previously reported BMI-related differential methylation at 83 CpGs that replicated across cohorts; BMI-related differential methylation was associated with concurrent changes in the expression of genes in lipid metabolism pathways. Genetic instrumental variable analysis of alterations in methylation at one of the 83 replicated CpGs, cg11024682 (intronic to sterol regulatory element binding transcription factor 1 SREBF1), demonstrated links to BMI, adiposity-related traits, and coronary artery disease. Independent genetic instruments for expression of SREBF1 supported the findings linking methylation to adiposity and cardiometabolic disease. Methylation at a substantial proportion (16 of 83) of the identified loci was found to be secondary to differences in BMI. However, the cross-sectional nature of the data limits definitive causal determination.
We present robust associations of BMI with differential DNA methylation at numerous loci in blood cells. BMI-related DNA methylation and gene expression provide mechanistic insights into the relationship between DNA methylation, obesity, and adiposity-related diseases.
Given current uncertainties in the cratering rates and geological histories of icy objects in the outer solar system, it is worth considering how the ages of icy surfaces could be constrained with ...measurements from future landed missions. A promising approach would be to determine cosmic-ray exposure ages of surface deposits by measuring the amounts of cosmogenic Lithium, Beryllium and Boron at various depths within a few meters of the surface. Preliminary calculations show that ice that has been exposed to cosmic radiation for one billion years should contain these cosmogenic nuclei at concentrations of a few parts per trillion, so any future experiment that might attempt to perform this sort of measurement will need to meet stringent sensitivity requirements.
•Surface ages of icy worlds in the outer solar system are uncertain.•Cosmic-ray exposure ages are a promising method of measuring surface ages.•Such ages require measuring Li, Be or B concentrations at parts-per-trillion level.
ABSTRACT
Effective training of mental health professionals is crucial for bridging the gap between research and practice when delivering cognitive behavioural therapy (CBT) and motivational ...interviewing (MI) within community settings. However, previous research has provided inconclusive evidence regarding the impact of training efforts. The current study aimed to systematically search, review and synthesize the literature on CBT and MI training to assess its effect on practitioner behavioural outcomes. Following prospective registration, a literature search was conducted for studies where mental health practitioners were exposed to training in face‐to‐face CBT or MI, reporting on at least one quantitative practitioner behavioural outcome. A total of 116 studies were eligible for the systematic review, and 20 studies were included in four meta‐analyses. The systematic review highlights the need to establish psychometrically valid outcome measures for practitioner behaviour. Results of the meta‐analyses suggest that training has a greater effect on practitioner behaviour change compared to receiving no training or reading a treatment manual. Training combined with consultation/supervision was found to be more effective than training alone, and no differences were found between face‐to‐face and online training. Results should be interpreted with caution due to methodological limitations in the primary studies, large heterogeneity, and small samples in the meta‐analyses. Future directions are discussed.
Obesity is an important component of the pathophysiology of chronic diseases. Identifying epigenetic modifications associated with elevated adiposity, including DNA methylation variation, may point ...to genomic pathways that are dysregulated in numerous conditions. The Illumina 450K Bead Chip array was used to assay DNA methylation in leukocyte DNA obtained from 2097 African American adults in the Atherosclerosis Risk in Communities (ARIC) study. Mixed-effects regression models were used to test the association of methylation beta value with concurrent body mass index (BMI) and waist circumference (WC), and BMI change, adjusting for batch effects and potential confounders. Replication using whole-blood DNA from 2377 White adults in the Framingham Heart Study and CD4+ T cell DNA from 991 Whites in the Genetics of Lipid Lowering Drugs and Diet Network Study was followed by testing using adipose tissue DNA from 648 women in the Multiple Tissue Human Expression Resource cohort. Seventy-six BMI-related probes, 164 WC-related probes and 8 BMI change-related probes passed the threshold for significance in ARIC (P < 1 × 10(-7); Bonferroni), including probes in the recently reported HIF3A, CPT1A and ABCG1 regions. Replication using blood DNA was achieved for 37 BMI probes and 1 additional WC probe. Sixteen of these also replicated in adipose tissue, including 15 novel methylation findings near genes involved in lipid metabolism, immune response/cytokine signaling and other diverse pathways, including LGALS3BP, KDM2B, PBX1 and BBS2, among others. Adiposity traits are associated with DNA methylation at numerous CpG sites that replicate across studies despite variation in tissue type, ethnicity and analytic approaches.
The D68 ringlet is the innermost narrow feature in Saturn's rings. Prior to 2014, the brightness of this ringlet did not vary much with longitude, but sometime in 2014 or 2015 a series of bright ...clumps appeared within D68. These clumps were up to four times brighter than the typical ringlet, occurred within a span of ∼ 120° in corotating longitude, and moved at an average rate of 1751.7°/day during the last year of the Cassini mission. The slow evolution and relative motions of these clumps suggest that they are composed of particles with a narrow (sub-kilometer) spread in semi-major axis. The clumps therefore probably consist of fine material released by collisions among larger (up to 20 m wide) objects orbiting close to D68. The event that triggered the formation of these bright clumps is still unclear, but it could have some connection to the material observed when the Cassini spacecraft passed between the planet and the rings.
•Several bright clumps appeared in the D68 ringlet near the Cassini Mission's end.•The evolution of these clumps implies their material spans <1 km in semi-major axis.•These clumps are probably debris from collisions among larger objects near D68.
Jupiter’s icy moon, Europa, harbors a subsurface liquid water ocean; the prospect of this ocean being habitable motivates further exploration of the moon with the upcoming NASA Europa Clipper ...mission. Key among the mission goals is a comprehensive assessment of the moon’s composition, which is essential for assessing Europa’s habitability. Through powerful remote sensing and
in situ
investigations, the Europa Clipper mission will explore the composition of Europa’s surface and subsurface, its tenuous atmosphere, and the local space environment surrounding the moon. Clues on the interior composition of Europa will be gathered through these assessments, especially in regions that may expose subsurface materials, including compelling geologic landforms or locations indicative of recent or current activity such as potential plumes. The planned reconnaissance of the icy world will constrain models that simulate the ongoing external and internal processes that act to alter its composition. This paper presents the composition-themed goals for the Europa Clipper mission, the synergistic, composition-focused investigations that will be conducted, and how the anticipated scientific return will advance our understanding of the origin, evolution, and current state of Europa.
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