Categories Of Illness Research Articles

A Comparison of Dizziness Handicap Inventory Scores by Categories of Vestibular Diagnoses.

The Dizziness Handicap Inventory (DHI) is a 25-item self-report quantifying dizziness-related physical and emotional symptoms and restrictions in daily activities. DHI scores do not correlate with severity of structural vestibular deficits; thus, high DHI scores may reflect other causes of morbidity. This study investigated the relationship between total DHI scores and the presence of structural, functional, and psychiatric disorders in tertiary neurotology patients. Retrospective. Tertiary center. Eighty-five patients who underwent multidisciplinary neurotologic evaluations. Diagnostic. Active illnesses identified by a multidisciplinary neurotology team were abstracted from medical records, cataloged as structural, functional, or psychiatric disorders, and used to group patients into diagnostic categories: structural (structural disorders only), functional (functional disorders with/without structural disorders), and psychiatric (psychiatric disorders with/without other conditions). DHI scores were compared across diagnostic categories. Sensitivities and specificities of DHI scores for identifying structural versus functional or psychiatric disorders were calculated. Mean DHI scores differed significantly by diagnostic category (structural 35 ± 18, functional 64 ± 15, and psychiatric 65 ± 19), before and after adjusting for age and sex (p < 0.001, Hedges' g>1.62 for structural versus functional and psychiatric categories). DHI≤30 (mild handicap) had specificity = 0.98 for structural disorders alone, whereas DHI>60 (severe handicap) had specificity = 0.88 for functional or psychiatric disorders. In this tertiary cohort, categories of illnesses had large effects on total DHI scores. Patients with scores ≤30 were likely to have structural disorders alone, whereas those with scores >60 were likely to have functional or psychiatric disorders, with or without coexisting structural conditions.

Abstract 150: Effect of Amplitude Spectral Area on Termination of Fibrillation and Outcomes in Pediatric Cardiac Arrest

Introduction: Amplitude spectral area (AMSA) predicts termination of fibrillation (TOF) with return of spontaneous circulation (ROSC) and hospital survival in adults, but has not been studied during pediatric cardiac arrest (pCA). Hypothesis: We characterized AMSA during pCA from a pediatric resuscitation quality (pediRES-Q) collaborative and hypothesized that AMSA would be associated with TOF and ROSC. Methods: Children &lt;18 years of age with pCA and VF were studied. AMSA was measured for 2 seconds prior to each shock and also averaged for each subject (AMSA-avg). TOF was defined as termination of VF 10 secs after defibrillation (DF) to any rhythm other than VF. ROSC was defined as &gt;20 mins without chest compressions. Univariate and multivariable logistic regression analyses controlling for weight, current, and illness category (cardiac vs non-cardiac) were performed. Primary endpoints were TOF and ROSC without ECMO. Secondary endpoints were 24-hr survival and survival to hospital discharge. Results: Between 2015-2019, 50 children from 14 hospitals (median age 3.7 years [IQR 0.6, 13.1]; median weight 16.3 kgs [IQR 6.9, 37.2]; 46% male; 73% cardiac illness category) were identified. IHCA occurred in 47 children and OHCA in 3 children. We analyzed 111 shocks with median number of DFs 1.0 [IQR 1.0, 3.0], median DF energy dose 3.27 J/kg [IQR 2.65,5.01], median DF current 0.64 A/kg [IQR 0.38,0.96], median AMSA 12.21 [IQR 7.17,17.03], and median AMSA-avg 14.6 [IQR 8.6,19.2]. TOF was achieved in 72 DFs (65%), ROSC without ECMO in 31 (62%), ROC with ECMO in 11 (22%), 24-hr survival in 40 (80%), and survival to hospital discharge in 26 (52%). Weight (OR 0.91 [0.84, 0.99] P=0.025) and DF current (OR 1.44 [0.97, 2.2] P=0.07), but not AMSA, were significantly associated with TOF for the first shock. Controlling for DF current and illness category, there was a significant association between AMSA-avg (OR 1.11 [1.0, 1.24] P=0.044) and ROSC without ECMO. There was no significant association between AMSA-avg and 24-hr survival or survival to hospital discharge. Conclusions: In pediatric patients, TOF was associated with weight and DF current, but not AMSA, whereas AMSA-avg was associated with ROSC without ECMO, but not 24-hr survival or survival to hospital discharge.

Abstract 345: Resuscitation Quality in the Intensive Care Unit- A Retrospective, Observational Study

Background: Adherence to quality metrics during in-hospital cardiac arrest (IHCA) have been associated with improved outcomes, however, quality metric adherence in the intensive care unit (ICU) has not been well described. In this study, we assessed trends in adherence to time to epinephrine ≤ 5 min, time to defibrillation ≤ 2 min, and confirmation of endotracheal airway device placement during IHCA in the ICU and identified potential predictors of adherence failure. Methods: This was an observational study using the Get With The Guidelines® - Resuscitation registry, a United-States based IHCA registry. Adult patients (&gt;18 years) with an index cardiac arrest in adult ICUs between 2006 and 2018 in the US were included. Generalized estimation equations were used for the analyses. Results: We included 75668 patients. From 2006-2018, adherence to time to epinephrine ≤ 5 min increased from 93% (95%CI, 93%-94%) to 98% (95%CI, 97%-98%), time to defibrillation ≤ 2 min went from 71% (95%CI, 68%-75%) to 74% (95% CI, 71%-77%) and confirmation of airway device placement increased from 93% (95%CI, 91%-94%) to 97% (95% CI, 96%-98%). Significant predictors of defibrillation &gt;2 min included a non-cardiac (RR, 1.35; 95%CI, 1.25-1.46) and traumatic (RR, 1.67; 95%CI, 1.34-2.09) illness category, a prior history of renal insufficiency (RR, 1.13; 95%CI, 1.06-1.22), no myocardial infarction (RR, 1.09; 95%CI, 1.00-1.19), no metabolic abnormality (RR, 1.10; 95%CI, 1.01-1.20), events occurring at nighttime (RR, 1.08; 95%CI, 1.01-1.14), an initial PVT as opposed to VF rhythm (RR, 1.10; 95%CI, 1.03-1.16), no arterial line in place at time of event (RR, 1.20; 95%CI, 1.09-1.32), and events occurring at a small hospital (RR, 1.17; 95%CI, 1.02-1.34). Conclusions: Overall, quality metric adherence was high in the ICU, with the exception of time to defibrillation ≤ 2 min. Predictors associated with defibrillation &gt;2 min, included a non-cardiac and traumatic illness category and nighttime arrests.

Abstract 124: Chest Compression Pause Duration is Associated with Worse Survival Outcomes Following Pediatric In-hospital Cardiac Arrest

Introduction: The association between chest compression (CC) pause duration and pediatric in-hospital cardiac arrest (IHCA) survival outcomes is unknown. We hypothesized that longer maximum CC pause durations are associated with worse survival and neurological outcomes. Methods: Cohort study of all index pediatric IHCAs (&lt;18 years of age) ≥1 min in the Pediatric Resuscitation Quality (PediRES-Q) Network from July 2015 through December 2019. We used multivariate logistic regression with mixed effects and robust standard errors to analyze association of 5-sec increments of longest CC pause duration with survival and neurologic outcomes. Favorable neurological outcome was defined as Pediatric Cerebral Performance Category (PCPC) at discharge ≤3 or no change from baseline. Results: We identified 371 index IHCAs: median [Q1,Q3] age 2.6 [0.6,9.4] years, female 46%, shockable rhythm 13%, CPR duration 23 [9,47] min. Median length of the longest pause was 17 [8,27] sec. Each 5 sec increase in longest CC pause duration was associated with 6% lower odds for survival with favorable neurological outcome, even after adjusting for age, defibrillation, intubation, extracorporeal CPR, illness category, hypotension as etiology for arrest, CC depth, and clustering by site (aOR 0.94 [95% CI:0.88-0.99], p=0.04). Analyses controlling for the same factors demonstrated an association of longest pause duration with lower odds for survival to hospital discharge (aOR 0.94 [95% CI: 0.90-0.99, p=0.02) and return of spontaneous circulation (aOR 0.91 [(95% CI: 0.86-0.96], p=0.001). Conclusions: Longest CC pause duration is associated with favorable neurological outcome, survival to hospital discharge, and return of spontaneous circulation following pediatric IHCA, even when controlling for known confounders and clustering by site. Each 5 sec. increment in longest CC pause duration was associated with 6% lower odds for survival with favorable neurological outcome.

Abstract 285: Resuscitation Practices of Cardiac Arrest in Children with Cardiac Disease in Cardiac Intensive Care Units Compared to Pediatric Intensive Care Units

Introduction: Hospitalized children with critical cardiac disease experience cardiac arrest more than any other disease type. Varying models are devoted to caring for this population, including pediatric intensive care units (PICU) and dedicated cardiac intensive care units (CICU). The process of CPR delivery has not been evaluated in CICUs in comparison to PICUs. Hypothesis: There will be no difference in cardiac arrest resuscitation practices between unit types. Methods: We analyzed patients &lt;18 years from the American Heart Association Get with the Guidelines-Resuscitation database (GWTG-R) with an illness category of medical or surgical cardiac disease who received CPR in a CICU or PICU from 2014 to 2018. Events were assessed for compliance with GWTG-R achievement measures of time to first chest compressions ≤ 1 minute, time to IV/IO epinephrine ≤ 5 minutes, time to first shock ≤ 2 minutes for VF/pulseless VT first documented rhythm, and confirmation of endotracheal tube (ETT) placement in trachea. Results: CPR practices were evaluated on 866 patients, 687 CICU and 179 PICU (55% male and 65% neonatal). Surgical cardiac disease was present in 56%. Cardiac malformations were present in 81% (45% cyanotic 29% acyanotic). Pulseless arrest was the initial event in 41% with a shockable rhythm in 14%. Return of spontaneous circulation occurred in 86% and survival to hospital discharge in 58%. Univariate analysis comparing resuscitation practice is shown in Table 1. ECPR use was the only variable noted to be significantly different between units (CICU 22% vs PICU 6%, P&lt;0.01). On multivariate analysis, there were no differences in GWTG-R achievement measures between ICU types for ETT placement confirmation, time to IV/IO epinephrine dose, time to first chest compression to first shock (P&gt;0.05). Conclusion: Despite differences in infrastructure, process, and provider expertise, there were no differences in cardiac arrest resuscitation practice between CICUs and PICUs.

The tired hero and her (il)legitimation: Reworking Parsons to analyse experiences of burnout within the Dutch employment system and lifeworld.

Burnout is an illness label, and in some healthcare systems a diagnostic category, which has received growing attention and usage. Despite its ubiquity and widespread media coverage, the medical sociological literature on the condition remains small and the wider sociological literature tends to treat the rise of burnout as a straightforward reflection of changing working environments. Very few studies have critically reflected on the nature of burnout, its diagnosis and lived experiences of the condition. This neglect is surprising given the relative legitimacy of burnout as an illness category in several national healthcare contexts, not least in the Netherlands. Drawing on in-depth qualitative interviews with a range of burnout sufferers (n=18) and diagnosing professionals (n=12) in the Netherlands, we explore participants' narrated understandings of the condition in light of a reworked Parsonian framework. Narratives suggested sufferers of burnout generally received legitimation, often being understood as hardworking, diligent and altruistic. Experiences of (partial) acceptance through a medical label, and the relative lack of stigma were important to sense-making and coping. This recognition of burnout was particularly striking, given several features burnout shares with conditions commonly associated with ontological doubt, moral suspicion and stigma. Yet recognition of commitment and strength sat in tension with psychological assistance, which sought to correct tendencies for working too hard for too long. Drawing on insights from Habermas's extensive reformulation of Parsons's work, we understand the legitimation and tensions around burnout care in light of meanings, metaphors and manipulation which, in turn, we locate in relation to the functioning of wider socio-cultural lifeworlds and political-economic systems, including the sediments of earlier political-economic and cultural structures.

ESCV/PASCV Membership

Occult HBV infection (OBI) is of great concern due to their complicated diagnosis and potential for public transmission.The study aimed to determine the clinical prevalence of OBI and if viral immune escape-associated mutations contribute to the occurrence of OBI.A total of 91,037 HBV-infected patients with different related illnesses who were admitted to the Fifth Medical Center of Chinese PLA General Hospital from January 2005 to December 2017 were tested for OBI. Serum samples from 62 patients with OBI manifestations (OBI patients) and 124 matched non-OBI patients were sequenced for possible immune escape-associated mutations within the major hydrophilic region of HBV S protein. HBsAg and HBV DNA levels in representative viral strains were measured.Of the 91,037 tested patients, 487 (0.53 %) were negative for HBsAg but positive for HBV DNA and were defined as OBI patients. The prevalence in different illness categories varied. Immune escape-associated mutations were more frequently detected in OBI patients than in non-OBI patients (59.68 % vs. 35.48 %, P < 0.01), as did the coexistence of multiple mutations (43.55 % vs. 22.58 %, P < 0.01). Specifically, the prevalence rates of sT118 K, sK122R, and sV168A were increased in OBI patients. Strains with sK122R mutants (sK122R, sK122R + D144E, sK122R + C121R + D144E, and sK122R + F134L + D144E) from a follow-up OBI patient all showed significantly lower levels of HBsAg production than a wild-type strain.The study clarified the clinical prevalence of OBI, verified the influence of immune escape-associated mutations, and identified the role of the sK122R mutation in multiple OBI patients.

Neurologic Manifestations of Systemic Disease: Sleep Disorders.

Purpose of reviewSleep is intimately involved in overall health and wellbeing. We provide a comprehensive report on the interplay between systemic diseases and sleep to optimize the outcomes of systemic disorders.Recent findingsSpanning the categories of endocrinologic disorders, metabolic/toxic disturbances, renal, cardiovascular, pulmonary, gastrointestinal, infectious diseases, autoimmune disorders, malignancy, and critical illness, the review highlights the prevalent coexisting pathology of sleep across the spectrum of systemic disorders. Although it is rare that treating a sleep symptom can cure disease, attention to sleep may improve quality of life and may mitigate or improve the underlying disorder. Recent controversies in assessing the cardiovascular relationship with sleep have called into question some of the benefits of treating comorbid sleep disorders, thereby highlighting the need for an ongoing rigorous investigation into how sleep interplays with systemic diseases.SummarySystemic diseases often have sleep manifestations and this report will help the clinician identify key risk factors linking sleep disorders to systemic diseases so as to optimize the overall care of the patient.

Two Case Studies of Delusions Leading to Suicide, a Selective Review.

Many questions pertaining to delusional disorder (DD) remain unanswered. It is unclear what syndromes to include under this category of psychotic illness and when to treat with antidepressants, cognitive therapy, or antipsychotic medication. DD is associated with psychiatric comorbidity, especially depression, and rates of suicidal behavior are high when the two conditions co-exist. In this selective review, we present two instances of suicide in the context of DD, one illustrating risks for the somatic subtype and the second, risks for the persecutory subtype. The frequency of suicidal behaviour in these two subtypes of DD is estimated at 8-21%. The literature suggests a prominent role for social emotions (shame, humiliation) in the pathway leading to suicide. In addition, risk factors found in our two patients point to factors such as poverty, living alone, vulnerable risk periods, stigma, and lack of trust in mental health services. Building trust may be the most effective preventive measure.

The Emergence of the ‘Dealing With the Past’ Agenda: Sociological Thoughts on its Negative Impact on the Ground

In this short piece, I trace the emergence of the ‘dealing with the past’ agenda which entered the public sphere from the 1970s, briefly describing how it has gradually disseminated worldwide. Consequently, the ‘dealing with the past’ approach, where remembering was intimately tied to a preventative vision of ‘never again!’, became deeply embedded in human rights-led memorialization processes around the world. However, though this approach gave voice to long-silenced historical injustices and mass human rights abuses from the past, the erroneous assumption that ‘proper remembrance’ can heal nations also produced numerous troubling ‘side-effects’: the application of Western(ized) medical diagnostic categories of mental illness; hierarchies of victimhood; and new social inequalities, which are briefly discussed in the second part of this article.

The sK122R mutation of hepatitis B virus (HBV) is associated with occult HBV infection: Analysis of a large cohort of Chinese patients.

Occult HBV infection (OBI) is of great concern due to their complicated diagnosis and potential for public transmission. The study aimed to determine the clinical prevalence of OBI and if viral immune escape-associated mutations contribute to the occurrence of OBI. A total of 91,037 HBV-infected patients with different related illnesses who were admitted to the Fifth Medical Center of Chinese PLA General Hospital from January 2005 to December 2017 were tested for OBI. Serum samples from 62 patients with OBI manifestations (OBI patients) and 124 matched non-OBI patients were sequenced for possible immune escape-associated mutations within the major hydrophilic region of HBV S protein. HBsAg and HBV DNA levels in representative viral strains were measured. Of the 91,037 tested patients, 487 (0.53 %) were negative for HBsAg but positive for HBV DNA and were defined as OBI patients. The prevalence in different illness categories varied. Immune escape-associated mutations were more frequently detected in OBI patients than in non-OBI patients (59.68 % vs. 35.48 %, P < 0.01), as did the coexistence of multiple mutations (43.55 % vs. 22.58 %, P < 0.01). Specifically, the prevalence rates of sT118 K, sK122R, and sV168A were increased in OBI patients. Strains with sK122R mutants (sK122R, sK122R + D144E, sK122R + C121R + D144E, and sK122R + F134L + D144E) from a follow-up OBI patient all showed significantly lower levels of HBsAg production than a wild-type strain. The study clarified the clinical prevalence of OBI, verified the influence of immune escape-associated mutations, and identified the role of the sK122R mutation in multiple OBI patients.

Mothers' and Fathers' Perspectives on the Causes of Their Child's Disorder.

Parental beliefs about the cause of their child's illness are thought to affect parents' help-seeking behaviors, treatment decisions, and the child's health outcomes. Yet, research on parental beliefs about disease causation is still scarce. While a small number of studies assesses parental cause attributions for singular disorders (e.g., neurodevelopmental disorders), no study has compared disorders with differing physical versus mental conditions or with mixed comorbidities in children and adolescents or their caregivers. Furthermore, most pediatric research suffers from a lack of data on fathers. Hence, the objective of the current study was to test for possible differences in mothers' and fathers' perceptions about the etiology of their child's illness. Forty-two parent couples (overall N = 84) whose child had been diagnosed either with Attention Deficit Hyperactivity-Disorder (ADHD) or Autism Spectrum Disorder (ASD) (category "neurodevelopmental disorder") or with a primary physical illness and a comorbid mental disorder, e.g. depression (category "psychosomatic disorder") were asked to rate possible causes of their child's illness using a modified version of the revised Illness Perception Questionnaire (IPQ) Cause scale. A two-way ANOVA showed that psychosomatic disorders were significantly more strongly attributed to be caused by medical and environmental stressors than neurodevelopmental disorders. A significant parent × illness category interaction revealed that this effect was more pronounced in fathers. By providing first insights into parental beliefs about the etiology of their children's neurodevelopmental versus psychosomatic disorders, this study paves ground for future research and tailored counseling of affected families.

Концепция болезни как ценности в романах Идиот Федора Достоевского и Волшебная гора Томаса Манна

The article is an attempt to analyse the novels The Idiot by Fyodor Dostoyevsky and The Magic Mountain by Thomas Mann in the context of the category of illness. The author undertakes a comparison of the characters suffering from turberculosis: Hans Castorp and Ippolit Terentyev. It is claimed that in both of the works illness acquires the status of a value and opens before the characters a path to self-knowledge. However, while Castorp’s illness develops in comfortable conditions and he finally decides to cease his fascination with death, for the terminally ill Terentyev it is far too late to fight for his life. For this reason, the sacralisation of death is alien to Dostoyevsky’s character. In his case, death can be perceived as the Lacanian Real that interrupts the self-narrative. The noted phenomenon can be attributed to Dostoevsky’s maximalism that urges the Russian novelist to bring the disease to the limits, and take it out of control. Mann, in turn, portrays the disease as a kind of safety valve, keeping the fascination with the dark sides of life in a healthy framework.

Mobile health applications for mental illnesses: An Asian context.

Advances in digital technologies have created unprecedented opportunities to assess and improve health behavior and health outcomes. Evidence indicates that a majority of the world's population, including traditionally underserved populations and low- and middle-income countries, has access to mobile technologies (phones, tablets, mobile devices). Given the widespread access to mobile technology worldwide, health behavior-change tools delivered on mobile platforms enable broader reach and scalability of evidence-based assessment and interventions, especially for addressing the growing burden of mental health disorders globally. The purpose of this article was to present a qualitative review of mobile mental health applications in an Asian context. We searched on-line databases and included 22 articles in this review. We have identified mobile health applications that address eight categories of mental illnesses. These applications were developed in only six countries and regions in Asia. Future studies from more diverse countries for diverse cultures should be conducted to examine the advantages and disadvantages of mobile health technology.

Early Rise in CRP is Associated with Progression to Respiratory Failure and Intubation in COVID-19 Patients

During the course of hospitalization, it is often unclear which COVID-19 patients will progress from non-critical to critical illness. Predicting disease trajectory is crucial for resource allocation and therapeutic intervention. In our single-center retrospective cohort analysis of the first 66 patients admitted for COVID-19 infection, we examined biomarkers of inflammation to distinguish non-critically ill inpatients who remained stable from those that had progressive respiratory failure requiring intubation and ICU transfer. Unlike the typical approach where patients are grouped into the two categories of non-critical and critical illness, COVID-19 patients in our study were classified into three cohorts by severity and stability of respiratory failure: stable non-critical illness (“mild”, 38 [58%]); non-critical illness at admission that progressed to critical illness (“progressive”, 21 [32%]); and critical illness at admission (“severe”, 7 [11%]). We found that while CRP level at admission was weakly associated with future progressive respiratory failure and appeared to have limited clinical utility. The progressive cohort showed modestly increased levels of CRP compared to the mild cohort, with significant overlap (125.0 ± 74 vs. 81.3 ± 57 mg/L, P = 0.05). Despite the limited predictive value of admission CRP levels, these measurements were indeed clinically relevant as they correlated with SOFA score (ρ = 0.41, P aO2/FiO2, r = -0.58, P P = 0.03; 48-72h post-admission: 185.0 ± 92 vs. 81.6 ± 63 mg/L, P = 0.002). Trends of inflammatory biomarkers, rather than absolute value at admission, may have most value for clinical triage and targeting therapeutic immunomodulation. Further, COVID-19 patients that are aggregated as “critically ill” in cross-sectional studies could represent two distinct inflammatory biomarker profiles and clinical presentations ( i.e., progressive versus severe cohorts).Funding: This work was supported by the American Heart Association Award 2014D007100 (E.Y.K.) and NIAMS T32 AR007530-35 (A.A.M.).Conflict of Interest: The authors declare no competing interests.Ethical Approval: This investigation was approved by the Partners Healthcare Institutional Review Board (Protocol 2014D007100). Opt-out consent was designated for the study.

Improved survival to hospital discharge in pediatric in-hospital cardiac arrest using 2 Joules/kilogram as first defibrillation dose for initial pulseless ventricular arrhythmia

The American Heart Association (AHA) recommends first defibrillation energy dose of 2 Joules/kilogram (J/kg) for pediatric cardiac arrest with ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT). However, optimal first energy dose remains unclear. MethodsUsing AHA Get With the Guidelines-Resuscitation® (GWTG-R) database, we identified children ≤12 years with IHCA due to VF/pVT. Primary exposure was energy dose in J/kg. We categorized energy doses: 1.7–2.5 J/kg as reference (reflecting 2 J/kg intended dose), <1.7 J/kg and >2.5 J/kg. We compared survival for reference doses to all other doses. We constructed models to test association of energy dose with survival; adjusting for age, location, illness category, initial rhythm and vasoactive medications. ResultsWe identified 301 patients ≤12 years with index IHCA and initial VF/pVT. Survival to discharge was significantly lower with energy doses other than 1.7–2.5 J/kg. Individual dose categories of <1.7 J/kg or >2.5 J/kg were not associated with differences in survival. For patients with initial VF, doses >2.5 J/kg had worse survival compared to reference. For all patients ≤18 years (n = 422), there were no differences in survival between dosing categories. However, all ≤18 with initial VF receiving >2.5 J/kg had worse survival. ConclusionsFirst energy doses other than 1.7–2.5 J/kg are associated with lower rate of survival to hospital discharge in patients ≤12 years old with initial VF/pVT, and first doses >2.5 J/kg had lower survival rates in all patients ≤18 years old with initial VF. These results support current AHA guidelines for first pediatric defibrillation energy dose of 2 J/kg.

Analisis Beban Kerja Mental Pada Mekanik Menggunakan Metode SWAT dan Metode QNBM

Mental workload is the difference between the demands of a task workload with the maximum capacity of a person's mental capability in a motivated state. The purpose of this study was to determine the level of the mental burden of mechanics using the SWAT and QNBM methods. The results of the Subjective Workload Assessment Technique method for heavy service workload showed that the mechanics were 56.6% burdened. Mental workload dimensions for mechanics 1 and 3 are effort load, for mechanic 2 is time load. The category for light service is 11.11%, unburdened in the time load dimension for all mechanics. Nordic Body Map Questionnaire Method was 67%, with illness category included.

The supramammillary nucleus controls anxiety-like behavior; key role of GLP-1R

Anxiety disorders are among the most prevalent categories of mental illnesses. The gut-brain axis, along with gastrointestinally-derived neuropeptides, like glucagon-like peptide-1 (GLP-1), are emerging as potential key regulators of emotionality, including anxiety behavior. However, the neuroanatomical substrates from which GLP-1 exerts its anxiogenic effect remain poorly characterized. Here we focus on a relatively new candidate nucleus, the supramammillary nucleus (SuM), located just caudal to the lateral hypothalamus and ventral to the ventral tegmental area. Our focus on the SuM is supported by previous data showing expression of GLP-1R mRNA throughout the SuM and activation of the SuM during anxiety-inducing behaviors in rodents. Data show that chemogenetic activation of neurons in the SuM results in an anxiolytic response in male and female rats. In contrast, selective activation of SuM GLP-1R, by microinjection of a GLP-1R agonist exendin-4 into the SuM resulted in potent anxiety-like behavior, measured in both open field and elevated plus maze tests in male and female rats. This anxiogenic effect of GLP-1R activation persisted after high-fat diet exposure. Importantly, reduction of GLP-1R expression in the SuM, by AAV-shRNA GLP-1R knockdown, resulted in a clear anxiolytic response; an effect only observed in female rats. Our data identify a new neural substrate for GLP-1 control of anxiety-like behavior and indicate that the SuM GLP-1R are sufficient for anxiogenesis in both sexes, but necessary only in females.

M171. THE GENE-SHARING RELATIONSHIP OF SCHIZOPHRENIA WITH OTHER MENTAL OR SYSTEMIC DISORDERS: A DISEASE-SIMILARITY NETWORK ANALYSIS FOCUSED ON EGOCENTRIC NETWORK

BackgroundSchizophrenia is an archetypal example that a psychiatric illness may not merely be a mental or a brain disorder but rather a systemic illness. It can be glimpsed from a wide range of biomarkers that span all the imaginable body systems, and from higher co-morbidity with other systemic illnesses. However, quantitative analysis of schizophrenia’s relationship with other diseases are not yet satisfactory. Genome-wide association studies have identified more than hundreds of genetic loci associated with schizophrenia. In turn, these loci are associated with a wide variety of other diseases. From this gene-disease relationship, a bipartite network can be built which, after appropriate projection, could help to map a complex disease-similarity network. In case of schizophrenia, it would reveal the position of schizophrenia among the broader categories of systemic illnesses.MethodsDisGeNET is a discovery platform which contains one of the largest collections of gene-disease association data. The major source of the integrated data is the automatized curation from MEDLINE abstract. Therefore, it contains the timestamp of reported gene-disease association. Gene-disease-timestamp (year of publication) triplet was fed into a Neo4J graph database platform. From this, disease-disease relationships with shared gene count and Jaccard similarity score was extracted. The network structure of level 1.5 egocentric network centered upon schizophrenia was inspected. Louvain community detection algorithm was applied to expose underlying group structure among the 1st order alters. For comparison, similar ego-networks centered upon several major psychiatric illnesses were also inspected. Finally, the yearly variation of Jaccard score which reflected the accumulation of research data were monitored.ResultsThe diseases which showed the highest Jaccard score (j) were bipolar disorder (j=0.203) and depressive disorder (j=0.190) as expected. Other diseases with meaningful similarity could be grouped into three communities: 1) psychiatric illness including bipolar/depressive disorder, 2) a variety of malignancies including neuroblastoma (j=0.083), stomach cancer (j=0.070) and pancreatic cancer (j=0.065) 3) other systemic illnesses including multiple sclerosis (j=0.088), metabolic syndrome (j=0.076), myocardial infarction (j=0.073), rheumatoid arthritis (j=0.070), lupus erythematosus (0.056). The gene-sharing relationship with systemic illnesses (malignancies and other) began to be revealed after 2005. Since then, more and more evidences were accumulated to solidify the schizophrenia’s link with systemic illnesses.DiscussionRecently, a couple of large-scale epidemiological studies verified the significant correlation between prevalence of schizophrenia and cancer/autoimmune disorders. The present study results may augment these epidemiological data and thus strongly support the concept of schizophrenia as a systemic illness. Gene-sharing and its reflection in prevalence data would indicate deeper link at the level of pathogenesis with systemic illnesses. Recently, many authors contemplated the possible link between schizophrenia and cancer in terms of cell cycle regulation and control of apoptosis. Likewise, others suspected immunological disturbance as the fundamental mechanism of schizophrenia. In this vein, the need for extending the concept of mental disorders as a focused manifestation of systemic illness seems gaining impetus.

Computational Analysis of Network Model Based Relationship of Mental Disorder with Depression

In this study, we present the network relationship of anxiety, eating and mood disorder with depression. Different computational network models have been demonstrated using different ongoing technologies. One of the most common mental illnesses can be classified as anxiety disorders. These are observable psychological conditions or a category of mental illnesses believed to be caused either by genetic weakness or by causes of environmental sensitivity. A wide range of psychological chronic conditions is often correlated with eating disorders (ED). However, the increasing role of lipid metabolism in ED pathogenesis has been highlighted by recent research studies. Depression (DE) acknowledgement is traced back to the ancient Greeks, who called it melancholia. The word depression has originated with the Greeks who used it to identify a specific condition, a God-given spiritual state, or a response involving rage or excitement, in different ways. Throughout drug research and development, finding innovative mechanisms is a massive challenge. In this field, structure-based design is a basic methodology and has become an essential part of developing drugs. The detailed three-dimensional structure of the protein is shown for a significant number of drug targets. While simulation docking and similar biotechnology have progressed in recent times, a suitable set of docking simulations for simulation performance is difficult to identify.