Inflammation contributes to numerous neuropsychiatric disorders, especially those that first appear in childhood. Maternal intrauterine environment, including the placenta, has a role in brain ...development and risk for neuropsychiatric disorders. This study examines the link between fetal inflammatory syndrome (FIRS), which is placental inflammation in the peri-partem period, and neuropsychiatric disorders during childhood.This is a retrospective cohort study using data from electronic medical records over a 19-year period at one women's hospital. The study includes 4851 children born with placentas meeting criteria for and 31,927 controls identified with normal placentas born during the same period. To be diagnosed with FIRS placenta must contain chorionic vasculitis and/or funisitis. Children had to be in study period for at least 5 years. The primary outcome of the study is incidence of neuropsychiatric disorders during childhood. The secondary outcomes were psychiatric medications prescribed, and psychiatric hospitalizations and treatment. Children born to placentas meeting criteria for FIRS were more likely to be diagnosed with neuropsychiatric disorders (OR = 1.21, CI 95% 1.09,1.35). Specifically, they were more likely to be diagnosed with autism spectrum disorder (OR = 1.35, CI 95% 1.08, 1.67), ADHD (OR = 1.27, CI 95% 1.07, 1.49), conduct disorder (OR = 1.50, CI 95% 1.24, 1.81), PTSD (OR = 2.46. CI 95% 1.21, 5.04), adjusting for maternal history of psychiatric disorders, intra-partem substance use, and prescriptions of anti-inflammatory drugs. Children born with placental inflammation are at an increased risk to develop neuropsychiatric disorders. This has profound implications for future research, and early detection, monitoring, and treatment in these children.
In this study, a novel quality control strategy was proposed, aiming to establish a multivariate specification for the processing step by exploring the correlation between colors, chemical ...components, and hemostatic effects of the carbonized Typhae pollen (CTP) using multivariate statistical analysis. The CTP samples were stir‐fried at different durations. Afterward, the colorimeter and LC–MS techniques were applied to characterize the CTP samples, followed by the determination of bleeding time and clotting time using mice to evaluate their hemostatic effect. Then, principal component analysis, hierarchical cluster analysis, and multi‐block partial least squares were used for data analysis on colors, chemical components, and their correlation with the hemostatic effect. Consequently, 13 critical quality attributes (CQAs) of CTP were identified via multivariate statistical analysis—L*, a*, b*, 3,4‐dihydroxybenzoic acid, 4‐hydroxybenzoic acid, 3‐hydroxybenzoic acid, quercetin‐3‐O‐glucoside, azelaic acid, kaempferol‐3‐O‐glucoside, quercetin, naringenin, kaempferol, and isorhamnetin. The multivariate specification method involving the 13 CQAs was developed and visualized in the latent variable space of the partial least squares model, indicating that the proposed method was successfully applied to assess the quality of CTP and the degree of carbonization. Most importantly, this study offers a novel insight into the control of processing for carbonized Chinese herbal medicines.
Abstract
Background
Evidence-based practice in medicine and social policy relies heavily on evidence synthesis. To translate evidence into practical guidelines for low- and middle-income countries, ...local expertise is essential. The objectives of this study are to assess the change in capacity for conducting evidence synthesis in Africa and to identify key African institutions for regional capacity-building. We take on a network perspective, considering that the position of an institution in the African evidence ecosystem is one constituent of its research capacity.
Methods
We systematically identified 3548 evidence synthesis publications between 2008 and 2019 with at least one author in Africa from the Web of Science Core Collection. These articles involved 3769 institutions. Longitudinal institution-level collaboration network data were constructed based on co-authorship information. We used social network analysis to examine the institutions’ connectivity and tendency for intra- and interregional collaboration. We also identified the degree- and betweenness-central African institutions and explored the structure and composition of their local network neighbourhoods.
Results
The number of African institutions involved in evidence synthesis has increased substantially over the last decade, from 31 in 2008 to 521 in 2019, and so has the number of evidence synthesis publications with authors in Africa. African institutions in the evidence ecosystem have also become more connected during this period. Although the amount of intercontinental collaboration continues to exceed that of regional collaboration, the tendency for African institutions to collaborate with partners in Africa is increasing. We identified seven institutions—in South Africa, Egypt and Uganda—as central to the collaboration networks between 2008 and 2019, all of whom showed a tendency to collaborate across sectors.
Conclusion
The development of more regionally based network-building initiatives would help to foster communities of practice and inter-institutional collaboration, strengthening regional research capacity. Moreover, the analysis in this study adds depth beyond a simple bibliometric analysis and illustrates that network analysis could provide a useful tool to evaluate the effectiveness of capacity-building strategies and programmes in the future.
Assessment for risks associated with acute stable COVID-19 is important to optimize clinical trial enrollment and target patients for scarce therapeutics. To assess whether healthcare system ...engagement location is an independent predictor of outcomes we performed a secondary analysis of the ACTIV-4B Outpatient Thrombosis Prevention trial.
A secondary analysis of the ACTIV-4B trial that was conducted at 52 US sites between September 2020 and August 2021. Participants were enrolled through acute unscheduled episodic care (AUEC) enrollment location (emergency department, or urgent care clinic visit) compared to minimal contact (MC) enrollment (electronic contact from test center lists of positive patients).We report the primary composite outcome of cardiopulmonary hospitalizations, symptomatic venous thromboembolism, myocardial infarction, stroke, transient ischemic attack, systemic arterial thromboembolism, or death among stable outpatients stratified by enrollment setting, AUEC versus MC. A propensity score for AUEC enrollment was created, and Cox proportional hazards regression with inverse probability weighting (IPW) was used to compare the primary outcome by enrollment location.
Among the 657 ACTIV-4B patients randomized, 533 (81.1%) with known enrollment setting data were included in this analysis, 227 from AUEC settings and 306 from MC settings. In a multivariate logistic regression model, time from COVID test, age, Black race, Hispanic ethnicity, and body mass index were associated with AUEC enrollment. Irrespective of trial treatment allocation, patients enrolled at an AUEC setting were 10-times more likely to suffer from the adjudicated primary outcome, 7.9% vs. 0.7%; p < 0.001, compared with patients enrolled at a MC setting. Upon Cox regression analysis adjustment patients enrolled at an AUEC setting remained at significant risk of the primary composite outcome, HR 3.40 (95% CI 1.46, 7.94).
Patients with clinically stable COVID-19 presenting to an AUEC enrollment setting represent a population at increased risk of arterial and venous thrombosis complications, hospitalization for cardiopulmonary events, or death, when adjusted for other risk factors, compared with patients enrolled at a MC setting. Future outpatient therapeutic trials and clinical therapeutic delivery programs of clinically stable COVID-19 patients may focus on inclusion of higher-risk patient populations from AUEC engagement locations.
ClinicalTrials.gov Identifier: NCT04498273.
Suicide is a leading cause of death in the young adult population, with few biological markers identified thus far to be associated with suicidality. Cytokines (including IL-6 and TNFα) may ...contribute to increased risk for depression and suicidality. Few studies have examined the associations of cytokine mRNA expression with depression and suicidal ideation and behavior. This study examines these associations and whether cytokine signaling networks differentiate suicide attempters (SA), suicide ideators (SI), and healthy controls (HC).
Cytokine pathway marker (CPM; e.g. cytokines and proteins in cytokine signaling pathways) mRNA gene expression in whole blood was examined in suicide attempters (n = 38), suicide ideators (n = 38), and healthy controls (n = 36). Between-group differences in CPM gene expression were examined. We also examined association of the mRNA of these genes with the severity of depression and suicidal ideation. Novel Gaussian Graphical Model (GGM) techniques were utilized to examine between-network partial correlation differences in cytokine signaling networks relevant to IL-6 and TNFα signaling pathways.
The severity of depression symptoms was positively associated with TNFα mRNA levels and negatively associated with IL-10 mRNA levels, but CPM expression was not associated with suicidal ideation severity. There were no between-group differences in CPM markers among healthy controls, SI and SA groups after correcting for multiple comparisons. In network analyses, we found suggestive results of between-group network differences between SI and control groups in gene pairs with IL-6R and STAT3 as common nodes.
In a cohort of suicide attempters and ideators, TNFα and IL-10 mRNA levels appear to be associated with depressive symptomology, consistent with elevation of pro-inflammatory cytokine production and reduction of anti-inflammatory cytokine production. Additionally, cytokine signaling networks may differentiate suicide ideators from healthy controls based on between-network differences, with differences possibly related to relationships of IL6R or STAT3 with other components of cytokine signaling networks.
•The severity of depression symptoms is associated with TNFα and IL-10 mRNA levels.•Associations between SI severity and cytokine mRNA levels were not detected.•Cytokine networks may be different between patients with suicidal ideation and controls.
Chronic stress is associated with increased risk for maladaptive psychological responses during childhood, adolescence, and young adulthood. Adults exposed to chronic stress during childhood exhibit ...dysregulation of hypothalamic-pituitary-adrenal (HPA) axis activity and inflammation. There are no studies examining the impact of stress on biological stress responses and functional impairment in adolescents and young adults early after the onset of a stressor.
The sample consisted of 59 offspring, aged 11-25 years, 33 of parents diagnosed with cancer and 26 controls from families with no cancer or severe chronic illness in parents or siblings. Cancer patients and their families were recruited within an average of 62 days (SD = 35.9) and followed at 6 and 9 months later. Functional impairment was assessed and hair cortisol concentrations (HCC), salivary cortisol, and inflammatory markers were measured. Mixed regression analyses were conducted.
The stress group showed higher functional impairment (β = -5.5, 95% CI (-10.4, -0.06),
= 0.03, d= -0.40) and HCC (β = 10.5, 95% CI (-5.5, -0.50),
< 0.001, d = 1.43). However, HCC were reduced over time in the stress group (β= -0.3, 95% CI (-0.04, -0.01),
< 0.001, d = -1.08). Higher total cortisol output was associated with increased functional impairment over time (β = -3.0, 95% CI (-5.5, -0.5),
= 0.02, d = -0.60).
Parental cancer is associated with early increase in cortisol, which was associated with increased functional impairment in offspring. Clinicians need to assess and monitor psychiatric symptoms and functioning in these offspring early on following parental cancer diagnosis.
Background
The COVID‐19 pandemic is the most serious global public health crisis since the 1918 influenza pandemic. This study is the first to assess its mental health impact across the lifespan in ...the United States in adolescents, adults, and health care workers.
Methods
We recruited 4909 participants through an online survey advertising on Facebook and Instagram to assess exposure to COVID‐19 and psychiatric symptoms from April 27 to July 13. We also recruited through the University of Pittsburgh, University of Pittsburgh Medical Center, and other health care systems around Pittsburgh. The primary outcomes were clinically significant depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms, suicidal ideation or behavior, and grief reactions since COVID‐19.
Results
Adolescents were significantly more likely to report moderate to severe symptoms of depression (55% vs. 29%; χ2 = 122, df = 1; p < .001), anxiety (48% vs. 29%; χ2 = 73; df = 1; p < .001), PTSD (45% vs. 33%; χ2 = 12; df = 1; p < .001), suicidal ideation or behavior (38% vs. 16%; χ2 = 117; df = 1; p < .001), and sleep problems (69% vs. 57%; χ2 = 26; df = 1; p < .001) compared to adults. The rates of intense grief reactions among those who lost someone to COVID‐19 was 55%. Loneliness was the most common predictor across outcomes and higher number of hours spent on social media and exposure to media about COVID‐19 predicted depression symptoms and suicidal ideation or behavior in adolescents.
Conclusions
The COVID‐19 pandemic is associated with increased rates of clinically significant psychiatric symptoms. Loneliness could put individuals at increased risk for the onset of psychiatric disorders.
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•Identify the authentic and adulterated medicinal AR by DD-SIMCA and PLS-DA.•Determine the concentration of adulteration in the adulterated AR by PLS and SVM.•The NIR-based method ...proved to be effective for quality control of medicinal AR.
The medicinal Arnebia Radix (AR) is one of widely-used Chinese herbal medicines (CHMs), usually adulterated with non-medicinal species that seriously compromise the quality of AR and affect patients’ health. Detection of these adulterants is usually performed by using expensive and time-consuming analytical instruments. In this study, a rapid, non-destructive, and effective method was proposed to identify and determine the adulteration in the medicinal AR by near-infrared (NIR) spectroscopy coupled with chemometrics. 37 batches of medicinal AR samples originated from Arnebia euchroma (Royle) Johnst., 11 batches of non-medicinal AR samples including Onosma paniculatum Bur. et Franch and Arnebia benthamii (Wall. ex G. Don) Johnston, and 72 batches of adulterated AR samples were characterized by NIR spectroscopy. The data driven-soft independent modeling by class analogy (DD-SIMCA) and partial least squares-discriminant analysis (PLS-DA) were separately used to differentiate the authentic from adulterated AR samples. Then the PLS and support vector machine (SVM) were applied to predict the concentration of the adulteration in the adulterated AR samples, respectively. As a result, the classification accuracies of DD-SIMCA and PLS-DA models were 100% for the calibration set, and 96.7% vs. 100% for the prediction set. Moreover, the relative prediction deviation (RPD) values of PLS models reached 11.38 and 7.75 for quantifying two adulterants species, which were obviously superior to the SVM models. It can be concluded that the NIR spectroscopy coupled with chemometrics is feasible to identify the authentic from adulterated AR samples and quantify the adulteration in adulterated AR samples.
Suicide and cardiovascular disease rank among the leading causes of disability and premature mortality worldwide. Young adult suicide attempters are at increased risk of mortality from cardiovascular ...disease even compared to those with major depressive disorder suggesting an increased burden of cardiovascular risk factors. We compared the cardiovascular risk burden between
attempters and other high-risk individuals.
Participants were from the Collaborative Psychiatric Epidemiology Surveys (CPES), a U.S. population-based study, aged 18-30 years suicide attempt (SA):
= 303; suicidal ideation (SI):
= 451; controls:
= 3671; and psychiatric inpatients admitted for a SA (
= 38) or SI (
= 40) and healthy controls (
= 37) aged 15-30 years. We computed a cardiovascular risk score and high- and low-risk latent classes based on risk factors of high blood pressure, obesity, and smoking.
Suicide attempters showed an increased cardiovascular risk score (CPES:
= 0.43, 95% confidence interval (CI) 0.31-0.54,
< 0.001; inpatient sample:
= 1.61, 95% CI 0.53-2.68,
= 0.004) compared to controls. They were also more likely to be classified in the high cardiovascular risk group (CPES: odds ratio (OR) 3.36, 95% CI 1.67-6.78,
= 0.001; inpatient sample: OR 9.89, 95% CI 1.38-85.39,
= 0.03) compared to those with SI (CPES: OR 1.15, 95% CI 0.55-2.39,
= 0.71; inpatient sample: OR 1.91, 95% CI 0.25-15.00,
= 0.53).
Youth attempters show an increased burden for cardiovascular risk compared to other high-risk individuals in inpatient and population-based samples. Clinicians should pay particular attention to cardiovascular risk factors among suicide attempters in order to reduce their risk for cardiovascular events.
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•High pressure reinforces the formation of soy protein-pectin-coumarin complex.•S-P-C complexes (>200 MPa) showed smaller particle sizes and more compact structure.•S-P-C complex ...exhibited excellent thermal stability and UV-light stability.•The hydrogen bonding and hydrophobic interaction were enhanced after HPP treatment.
This study was devoted to explore the synergistic effect of pressure level and pectin addition on the binding and structural properties of soy protein-coumarin (S-C) complexes through multi-spectroscopic approaches to elucidate the protective effect of the complexes on physicochemical stability of coumarin. High pressure processing (HPP) could reinforce the intermolecular hydrogen bonding and hydrophobic interaction between soy protein and coumarin (at a mass ratio of 3:1), resulting in the formation of complexes with smaller particle sizes and more compact structure, the effects were more pronounced as the pressure > 200 MPa. The incorporation of pectin provided a better protection of coumarin against UV and thermal degradation and improved remarkably the physical stability of complex particles during 30 days at 4 °C. In comparison with free coumarin, the coumarin retention of S-P-C (400) was up to 55.3 ± 1.7 % when exposure to UV for 120 min, 61.7 ± 2.9 % under 90 °C heating, and 96 ± 1.5 % after storage. However, the DPPH radical scavenging ability of S-C complexes decreased with HPP treatment and the addition of pectin. The present work revealed that soy protein-pectin-coumarin ternary complexes developed by HPP could be an effective delivery system for bioactive compounds with applications in functional food ingredient.
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