Categories Of Illness Research Articles

Intensive Short-Term Dynamic Psychotherapy for Complex, Chronic, and Treatment-Resistant Conditions.

Over the past 50 years, intensive short-term dynamic psychotherapy (ISTDP) has been developed, implemented, and evaluated with respect to the treatment of a broad spectrum of complex, chronic, and treatment-resistant conditions. This therapy was developed specifically to treat a range of patients, including those who are highly defensive, those who experience the repression of emotions, and those who have cognitive-perceptual disruptions along with primitive defenses. These three groups of patients are characterized by patterns of attachment trauma and deficits related to neglect. Among the many categories of mental illness with these features that ISTDP can treat, personality disorders, treatment-resistant depression, and somatic symptoms have been the most frequently studied. In this article, the authors provide an overview of the ISTDP treatment method with regard to complex, chronic, and treatment-resistant conditions and summarize evidence for its effectiveness for diverse patient populations. On the basis of the available evidence, ISTDP warrants consideration as a tool for the management of diverse populations who have chronic and complex conditions and have not responded to other treatments.

Practice patterns for acquiring neuroimaging after pediatric in-hospital cardiac arrest.

To determine which patient and cardiac arrest factors were associated with obtaining neuroimaging after in-hospital cardiac arrest, and among those patients who had neuroimaging, factors associated with which neuroimaging modality was obtained. Retrospective cohort study of patients who survived in-hospital cardiac arrest (IHCA) and were enrolled in the ICU-RESUS trial (NCT02837497). We tabulated ultrasound (US), CT, and MRI frequency within 7 days following IHCA and identified patient and cardiac arrest factors associated with neuroimaging modalities utilized. Multivariable models determined which factors were associated with obtaining neuroimaging. Of 1000 patients, 44% had ≥1 neuroimaging study (US in 31%, CT in 18%, and MRI in 6% of patients). Initial USs were performed a median of 0.3 [0.1,0.5], CTs 1.4 [0.4,2.8], and MRIs 4.1 [2.2,5.1] days post-arrest. Neuroimaging timing and frequency varied by site. Factors associated with greater odds of neuroimaging were cardiac arrest in CICU (versus PICU), longer duration CPR, receiving ECMO post-arrest, and post-arrest care with targeted temperature management or EEG monitoring. US performance was associated with congenital heart disease. CT was associated with age ≥1-month, greater pre-arrest disability, and receiving CPR for ≥16 minutes. MRI utilization increased with pre-existing respiratory insufficiency and respiratory decompensation as arrest cause, and medical cardiac and surgical non-cardiac or trauma illness category. Overall, if neuroimaging was obtained, US was more common in CICU while CT/MRI were utilized more in PICU. Practice patterns for acquiring neuroimaging after IHCA are variable and influenced by patient, cardiac arrest, and site factors.

Non-suicidal self-injury disorder as a possible mental illness category and the Hungarian adaptation of a questionnaire developed to measure

Non-suicidal self-injury disorder as a possible mental illness category and the Hungarian adaptation of a questionnaire developed to measure

Choroid plexus-targeted viral gene therapy for alpha-mannosidosis, a prototypical neurometabolic lysosomal storage disease.

The choroid plexuses (CP) are highly vascularized structures that project into the ventricles of the vertebrate brain. The polarized epithelia of the CP produce cerebrospinal fluid by transporting water and ions into the ventricles from the blood and normally secrete a large number of proteins. We assessed the feasibility of selective CP transduction with recombinant adeno-associated virus (rAAV) gene therapy vectors for treatment of lysosomal storage disease (LSD), a broad category of neurometabolic illness associated with significant burdens to affected patients and their families. There are no ideal or complete therapeutic options currently available, especially for the central nervous system manifestations of LSDs. Alpha-mannosidosis (AMD) is an autosomal recessive prototypical LSD caused by deficiency of lysosomal alpha-mannosidase and characterized by cerebellar ataxia, neurocognitive disability, facial and skeletal abnormalities, hearing impairment, and mild immune deficiency. In a murine model of AMD, we compared the biochemical effects of CSF-directed rAAV serotypes 1, 4, 5, 6, and 9. Recombinant AAV1 and rAAV6, two closely related serotypes whose capsid sequences differ by only six amino acids, showed the most robust transduction of CP in mouse brain, consistent with their transduction of CPE in nonhuman primates and cats, as well as in other structures. We found restoration of LAMAN enzyme activity comparable to or higher than AMD heterozygote levels in the brain globally (olfactory bulb, cortex, cerebellum, brainstem). Further IND-generating preclinical experiments will advance rAAV6-LAMAN, which appears to be the most promising choroid plexus-targeting candidate serotype for future clinical translation to treat AMD.

End to End Leaf Detection Using Convolutional Neural Network

Global food security is seriously threatened by crop diseases, yet in many places, it is still difficult to identify them quickly because of a lack of infrastructure. In tackling this problem, recent developments in leaf-based image categorization methods have produced encouraging outcomes. This study investigates how to differentiate between healthy and unhealthy leaves using curated datasets using the Random Forest algorithm. The development of the dataset, feature extraction, classifier training, and classification are the various stages of the implementation process. To efficiently distinguish between diseased and healthy samples, the Random Forest classifier is used to train the dataset, which includes pictures of both diseased and healthy leaves. A significant obstacle to agricultural production, plant diseases have an impact on crop yield and quality. Precision farming and sustainable agriculture depend on the timely and precise identification of leaf diseases. In this work, we present a complete system that automatically detects and classifies leaf diseases using Convolutional Neural Networks (CNN), starting with picture capture. The technology offers a quicker method of identifying leaf illnesses and does away with the requirement for manual feature engineering. Our tests, carried out on several public datasets, show the model's efficacy and achieve high accuracy for a range of illness categories. These results underline the practical uses that might improve crop management and early intervention techniques. Using machine learning on massive datasets that are accessible to the public, this approach offers a scalable solution for detecting plant diseases on a large scale.

Mitigating neurodegenerative diseases: the protective influence of baicalin and baicalein through neuroinflammation regulation.

Neurodegenerative diseases (NDDs) represent a category of serious illnesses characterized by the progressive deterioration of neuronal structure and function. The exploration of natural compounds as potential therapeutic agents has gained increasing attention in recent years owing to their wide range of pharmacological activities and minimal side effects. Baicalin (BAI) and baicalein (BE), polyphenolic flavonoids, derived from the root of Scutellaria baicalensis, evidently show potential in treating NDDs. This review provides an overview of the current understanding of the roles of BAI and BE in alleviating neuroinflammation, a pivotal pathological process implicated in various NDDs. Studies conducted prior to clinical trials have shown that BAI and BE exert protective effects on the nervous system in different animal models of NDDs. Furthermore, mechanistic studies indicate that BAI and BE exert anti-inflammatory effects by inhibiting pro-inflammatory cytokines, suppressing microglial activation, and regulating microglial phenotypes. These effects are mediated through the modulation of inflammatory signaling cascades, including Toll-like receptor 4 (TLR4), mitogen-activated protein kinase (MAPK), amp-activated protein kinase (AMPK), NOD-like receptor thermal protein domain-associated protein 3 (NLRP3) inflammasome, and nuclear factor erythroid 2-related factor 2 (Nrf2)/hemoglobin oxygenase-1 (HO-1). Overall, BAI and BE exhibit promising potential as natural compounds with anti-inflammatory properties and offer innovative therapeutic approaches for managing NDDs.

Trends in cardiac arrest outcomes & management in children with cardiac illness category compared to non-cardiac illness category: An analysis from the AHA get with the guidelines®-resuscitation registry

IntroductionContemporary rates of survival after pediatric in-hospital CPR events and trends in survival over the last 20 years have not been compared based on illness category. We hypothesized that survival to hospital discharge for surgical-cardiac category is higher than the non-cardiac category, and rates of survival after in-hospital CPR increased over time in all categories. MethodsThe AHA Get With The Guidelines®-Resuscitation registry was queried for index CPR events in children < 18 years of age from 2000 to 2021. Categories were surgical-cardiac (in-hospital CPR event following cardiac surgery); medical-cardiac (CPR event in non-surgical cardiac disease); and non-cardiac (CPR event in patients without cardiac disease). The primary outcome was survival to hospital discharge. We compared eras 2000–2004, 2005–2009, 2010–2014, and 2015–2021 with mixed logistic regression models, including event year as a continuous predictor and site as a random effect. ResultsOf 16,241 index events, in-hospital CPR event rates by illness category were: 19 % surgical-cardiac, 18 % medical-cardiac, and 63 % non-cardiac. Surgical-cardiac category had the highest rate of survival to hospital discharge compared to medical-cardiac and non-cardiac categories (56 % vs. 44 % vs. 46 %; p < 0.001). After controlling for age, location of event, and hospital size, the odds of survival were highest for surgical-cardiac category (aOR 1.28, 95 % CI 1.17–1.41) and lower for medical-cardiac category (aOR 0.90, 0.82–0.98), compared to the non-cardiac category. Odds of survival increased for all illness categories from the 2000–2004 era to the 2015–2021 era. Rates of improvement differed among illness categories with medical-cardiac having the lowest increased odds per era. Surgical-cardiac patients had the highest rates of extracorporeal resuscitation (ECPR) (20 % across the cohort), though the greatest increase in ECPR utilization was in the non-cardiac population (52 % increased odds per era). ConclusionsOver the last 20 years, both survival to hospital discharge and ECPR use has increased in all in-hospital CPR event illness categories. Children with surgical-cardiac CPR event have higher odds of survival to hospital discharge compared to non-cardiac CPR event categories, whereas odds of survival were lowest with medical-cardiac CPR events.

Evaluating post-cardiac arrest blood pressure thresholds associated with neurologic outcome in children: Insights from the pediRES-Q database.

Current Pediatric Advanced Life Support Guidelines recommend maintaining blood pressure (BP) above the 5th percentile for age following return of spontaneous circulation (ROSC) after cardiac arrest (CA). Emerging evidence suggests that targeting higher thresholds, such as the 10th or 25th percentiles, may improve neurologic outcomes. We aimed to evaluate the association between post-ROSC BP thresholds and neurologic outcome, hypothesizing that maintaining mean arterial pressure (MAP) and systolic blood pressure (SBP) above these thresholds would be associated with improved outcomes at hospital discharge. This retrospective, multi-center, observational study analyzed data from the Pediatric Resuscitation Quality Collaborative (pediRES-Q). Children (<18 years) who achieved ROSC following index in-hospital or out-of-hospital cardiac arrest and survived ≥ 6 h were included. Multivariable logistic regression was preformed to analyze the association between the pre-defined BP thresholds (5th, 10th, and 25th percentiles) and favorable neurologic outcome, controlling for illness category (surgical-cardiac), initial rhythm (shockable), arrest time (weekend or night), age, CPR duration, and clustering by site. There were 787 patients with evaluable MAP data and 711 patients with evaluable SBP data. Fifty-four percent (N = 424) of subjects with MAP data and 53 % (N = 380) with SBP data survived to hospital discharge with favorable neurologic outcome. MAP above the 5th, 10th, and 25th percentile thresholds was associated with significantly greater odds of favorable outcome compared to patients with MAP below target (aOR, 1.81 [95 % CI, 1.32, 2.50]; 1.50 [95 % CI, 1.10, 2.05]; 1.40 [95 % CI, 1.01, 1.94], respectively). Subjects with lowest SBP above the 5th percentile also had greater odds of favorable outcome (aOR, 1.44 [95 % CI, 1.04, 2.01]). Associations between lowest SBP above the 10th percentile and 25th percentile did not reach statistical significance (aOR 1.33 [95 % CI, 0.96, 1.86]; 1.23 [95 % CI, 0.87, 1.75], respectively). After pediatric CA, maintaining MAP above the 5th, 10th, and 25th percentiles and SBP above the 5th percentile during the first 6 h following ROSC was significantly associated with improved neurologic outcomes.

Insights on the Genetic and Phenotypic Complexities of Optic Neuropathies.

Background/Objectives: Optic neuropathies are a category of illnesses that ultimately cause damage to the optic nerve, leading to vision impairment and possible blindness. Disorders such as dominant optic atrophy (DOA), Leber hereditary optic neuropathy (LHON), and glaucoma demonstrate intricate genetic foundations and varied phenotypic manifestations. This narrative review study seeks to consolidate existing knowledge on the genetic and molecular mechanisms underlying ocular neuropathies, examine genotype-phenotype correlations, and assess novel therapeutic options to improve diagnostic and treatment methodologies. Methods: A systematic literature review was performed in October 2024, utilizing PubMed, Medline, the Cochrane Library, and ClinicalTrials.gov. Search terms encompassed "optic neuropathy", "genetic variants", "LHON", "DOA", "glaucoma", and "molecular therapies". Studies were chosen according to established inclusion criteria, concentrating on the genetic and molecular dimensions of optic neuropathies and their therapeutic ramifications. Results: The results indicate that DOA and LHON are mostly associated with the mitochondrial dysfunction resulting from pathogenic variants in nuclear genes, mainly OPA1, and mitochondrial DNA (mtDNA) genes, respectively. Glaucoma, especially its intricate variants, is linked to variants in genes like MYOC, OPTN, and TBK1. Molecular mechanisms, such as oxidative stress and inflammatory modulation, are pivotal in disease progression. Innovative therapeutics, including gene therapy, RNA-based treatments, and antioxidants such as idebenone, exhibit promise for alleviating optic nerve damage and safeguarding vision. Conclusions: Genetic and molecular investigations have markedly enhanced our comprehension of ocular neuropathies. The amalgamation of genetic and phenotypic data is essential for customized medical strategies. Additional research is required to enhance therapeutic strategies and fill the gaps in our understanding of the underlying pathophysiology. This interdisciplinary approach shows potential for enhancing patient outcomes in ocular neuropathies.

Spontaneous breathing trials should be adapted for each patient according to the critical illness. A new individualised approach: the GLOBAL WEAN study.

Spontaneous breathing trials (SBT) evaluate the patient's capacity to maintain inspiratory effort after extubation. SBT practices are heterogeneous and not individualised. The objective of this study was to assess which SBT best reproduces inspiratory effort after extubation in five critical illnesses. In this multicentre randomized cross-over study, adult intensive care unit patients under invasive mechanical ventilation for at least 24-h and ready for extubation, underwent three 15-min SBTs in random order: pressure support ventilation level of 7-cmH2O with positive end-expiratory pressure (PEEP) level of 0-cmH2O (PSV7PEEP0), PSV 0-cmH2O with PEEP 0-cmH2O (PSV0PEEP0) and T-piece trial. Primary outcome was the variation of pressure-time-product per minute (PTPmin) between each SBT and 20-min after extubation. Five categories of critical illnesses were selected: abdominal surgery, brain injury, chest trauma, chronic obstructive pulmonary disease (COPD) and miscellaneous. Five hundred measures of effort from 100 patients were analysed. PTPmin (cmH2O s/min, median and interquartile range, IQR) was 256 (208-321) after extubation, 192 (127-281) at the end of PSV7PEEP0 (p < 0.001 in comparison to after extubation), 291 (235-347) at the end of PSV0PEEP0 and 262 (198-338) at the end of T-piece (both no different from after extubation). One method of SBT in patients with brain injury (PSV0PEEP0), two in abdominal surgery (PSV0PEEP0 and T-piece) and miscellaneous patients (PSV7PEEP0 and T-piece) and all three methods in chest trauma and COPD exacerbation patients replicated reasonably accurately the postextubation effort to breathe. Unassisted SBTs, namely PSV0PEEP0 and T-piece trial, are the most appropriate to replicate the postextubation effort to breathe.

Ill persons and capable workers: Constructing work ability in return-to-work negotiations after sickness absence.

In return-to-work (RTW) negotiations after sickness absence, the work ability of an individual employee becomes a shared interest for the multiple stakeholders representing both the healthcare sector and working life. In practice, the employee, employer and occupational health professionals need to reach a shared understanding of the employee's work ability to enable shared decision-making concerning the plans for sustainable RTW. Drawing on 14 video-recorded RTW negotiations, we used conversation analysis-informed membership categorization analysis to examine how the participants of RTW negotiations discuss the work ability of an employee to pursue a shared understanding of the situation. Work ability was constructed in a very situational way, using illness categories to both explain the work ability of the employee and argue for or against their ability or inability to work. Our study contributes to research on RTW by introducing a new perspective to work ability. We show how work ability is realized during RTW negotiations through interaction, and how participants leverage their cultural understanding of illness and capability when negotiating work ability. We also demonstrate how membership categorization analysis can reveal the situational and consequential aspects of illness and work ability categories.

Welcome To #Spoonietok: Understanding and Supporting Disability Expertise, Storytelling Abilities, and Collective Information Practices on Tiktok and Beyond

ABSTRACTThis poster reports developing dissertation research, exploring the individual and collective storytelling practices of people experiencing difficult to diagnose chronic pain and fatigue (CSSs) on TikTok to understand and ultimately support these embodied, creative, and collective storytelling abilities on and off‐app. Ongoing data collection and analysis using constant comparison, guided by critical disability studies sensitizing concepts, of 150 videos and their top‐20 comments, and interviews with 6 community members indicate that people with CSSs are using TikTok affordances to tell and scaffold complex micro‐stories sharing disabled expertise; creatively visualize invisible illness; use intimate, documentary cinematography; tell composite stories using skits and collapsed time; and make audio, visual, and community/collective mimetic alterations. This poster shares a pragmatic sampling approach using algorithm training, and results from visualization activities during interviews which indicate a messy overlapping landscape of what I call algorithmically mediated online health communit(ies) (AMOHCs), which have slippery boundaries, where health information is found serendipitously, and people connect across specific chronic illness categories. This dissertation‐in‐progress is developing a set of disability‐specific storytelling abilities, which interview participants indicate are transferable to off‐app settings; and upcoming codesign workshops creating storytelling support materials with community members will further distill disability storytelling support needs.

Comparison of Predictive Models for Severe Dengue: Logistic Regression, Classification Tree, and the Structural Equation Model.

This study aimed to compare the predictive performance of 3 statistical models-logistic regression, classification tree, and structural equation model (SEM)-in predicting severe dengue illness. We adopted a modified classification of dengue illness severity based on the World Health Organization's 1997 guideline. We constructed predictive models using demographic factors and laboratory indicators on the day of fever occurrence, with data from 2 hospital cohorts in Thailand (257 Thai children). Different predictive models for each category of severe dengue illness were developed employing logistic regression, classification tree, and SEM. The model's discrimination abilties were analyzed with external validation data sets from 55 and 700 patients not used in model development. From external validation based on predictors on the day of presentation to the hospital, the area under the receiver operating characteristic curve was from 0.65 to 0.84 for the regression models from 0.73 to 0.85 for SEMs. Classification tree models showed good results of sensitivity (0.95 to 0.99) but poor specificity (0.10 to 0.44). Our study showed that SEM is comparable to logistic regression or classification tree, which was widely used for predicting severe forms of dengue.

Tinea capitis and its associated factors among school children in Gondar town northwest, Ethiopia

IntroductionTinea capitis is a global public health concern with a unique therapeutic challenge and mostly affects children. The burden is double in developing countries. There is no study on school-going children from the urban residence in Ethiopia.ObjectiveTo determine the prevalence of Tinea capitis and its associated factors among school children in Gondar town northwest, Ethiopia 2021.MethodsAn institution-based cross-sectional study was conducted among school children in Gondar town from November 20 to December 20, 2021. Data was collected through an interviewer-administered structured questionnaire. A stratified simple random sampling technique was employed. Then data were entered into EPI Info version 7.22 and transferred to Statistical package for social science (SPSS) version 22 for further analysis. The binary logistic regression model was employed to identify factors associated with tinea capitis, and the strength of association and statistical significance was declared using the adjusted odds ratios with its corresponding 95% CI, and p-value ≤ 0.05 respectively.ResultThe prevalence of tinea capitis among school children in Gondar town was found to be 29.4%. Public school student (AOR = 2.79 95% CI: 1.34–5.87), widowed mother (AOR = 6.09, 95% CI: 1.83–11.23), students in the age group of 5–8 years (AOR = 3.79 95% CI: 1.68–8.55), animal contact (AOR = 2.61 95% CI: 1.15–5.90), and family similar illness category (AOR = 8.49 95% CI: 3.73–11.39) have risen the likelihood of tinea capitis among school children.ConclusionsThe prevalence of tinea capitis was higher. Young age, children from widowed marital status, illiterate mother, history of share blades, animal contact, a family similar illness, and lower number of living rooms are important factors contributing to tinea capitis among school children. Health education for the mother on the mode of transmission, prevention, and improve the low socioeconomic status of the parent is crucial.Key termsChildren, Ethiopia, Gondar, School age, Tinea capitis

Prognoses Associated With Palliative Performance Scale Scores in Modern Palliative Care Practice

The Palliative Performance Scale (PPS) is one of the most widely used prognostic tools for patients with serious illness. However, current prognostic estimates associated with PPS scores are based on data that are over a decade old. To generate updated prognostic estimates by PPS score, care setting, and illness category, and examine how well PPS predicts short- and longer-term survival. This prognostic study was conducted at a large academic medical center with robust inpatient and outpatient palliative care practices using electronic health record data linked with data from California Vital Records. Eligible participants included patients who received a palliative care consultation between January 1, 2018, and December 31, 2020. Data analysis was conducted from November 2022 to February 2024. Palliative care consultation with a PPS score documented. The primary outcomes were predicted 1-, 6-, and 12-month mortality and median survival of patients by PPS score in the inpatient and outpatient settings, and performance of the PPS across a range of survival times. In subgroup analyses, mortality risk by PPS score was estimated in patients with cancer vs noncancer illnesses and those seen in-person vs by video telemedicine in the outpatient setting. Overall, 4779 patients (mean [SD] age, 63.5 [14.8] years; 2437 female [51.0%] and 2342 male [49.0%]) had a palliative care consultation with a PPS score documented. Of these patients, 2276 were seen in the inpatient setting and 3080 were seen in the outpatient setting. In both the inpatient and outpatient settings, 1-, 6-, and 12-month mortality were higher and median survival was shorter for patients with lower PPS scores. Prognostic estimates associated with PPS scores were substantially longer (2.3- to 11.7-fold) than previous estimates commonly used by clinicians. The PPS had good ability to discriminate between patients who lived and those who died in the inpatient setting (integrated time-dependent area under the curve [iAUC], 0.74) but its discriminative ability was lower in the outpatient setting (iAUC, 0.67). The PPS better predicted 1-month survival than longer-term survival. Mortality rates were higher for patients with cancer than other serious illnesses at most PPS levels. In this prognostic study, prognostic estimates associated with PPS scores were substantially longer than previous estimates commonly used by clinicians. Based on these findings, an online calculator was updated to assist clinicians in reaching prognostic estimates that are more consistent with modern palliative care practice and specific to the patient's setting and diagnosis group.

Virtual Reality Therapy Could be a Promising Alternative for Anxiety – A Review

Anxiety disorders are the major mental illnesses globally, characterized by a persistent and variable clinical course. These disorders probably have a severe impact on a person’s ability to function personally, socially, and professionally. A person suffering from such disorders could affect the standard of living. Anxiety disorders are classified within the vague category of neurotic illnesses. General disorders such as apprehension, fearfulness, restlessness, and agoraphobia are among the current categories of anxiety disorders. Anxiety is advantageous from an evolutionary standpoint since it promotes survival by motivating individuals to avoid hazardous environments. The frequency of symptoms associated with anxiety that are associated with each other is around 2 to 4% in the general population, and it may rise up to 20% with non-psychotic conditions. Then present systematic review aims to assess virtual reality therapy’s (VRT) effectiveness in treating anxiety disorders. Our aim is to highlight the existing research to ascertain the effectiveness of VRT in alleviating symptoms of anxiety as well as its possible advantages and constraints in comparison to conventional therapeutic approaches. The review will further explore the fundamental mechanics of VRT and pinpoint any lacuna in the existing literature that necessitates more attention. Furthermore, these reviews are significant because they provide insightful information about how VRT could be used to treat anxiety and evaluate the effectiveness of VRT as a therapeutic intervention.

COVID-19 in patients with thymic epithelial tumors with or without Good’s syndrome: a single-center retrospective study

IntroductionThymic epithelial tumors (TETs) are rare neoplasms often associated with immune-related disorders. Patients with Good’s syndrome (GS), an adult-acquired TET-related immunodeficiency, are at a high risk of mortality due to infectious diseases. This study aims to examine COVID-19 occurrence and severity in TET patients, with or without GS.MethodsClinical records of TET patients referred to the Regional Coordinating Center for Rare Tumors of Campania Region were retrospectively collected. During the observation period, elapsing from March 2020 to April 2023, the following data were collected: occurrence of SARS-CoV-2 infection; COVID-19 severity, according to the National Institute of Health (NIH) illness categories; COVID-19 treatment. COVID-19 occurrence and severity were assessed in the overall population and correlated with the presence of GS and/or other immune-related dysregulations.ResultsOverall, 47 TET patients were included in the study; 27 of these (57.4%) had GS. All participants had received a full cycle of mRNA vaccine for SARS-CoV2., Thirty-one patients (66.0%) experienced COVID-19, of whom 18 (58.0%) had previously received a diagnosis of GS. No significant association of GS and/or other immune-related dysregulations with SARS-CoV-2 infection occurrence was detected (Fisher’s exact test p = 1 and p = 0.3587, respectively). Among patients with GS, 8 (45.0%) reported a COVID-19 severity score of ≥ 3; whereas, only 1 of the 13 patients without GS (7.7%) had a severity score of ≥ 3. The correlation between presence of GS and COVID-19 severity (score 1 or 2 vs. ≥ 3) was statistically significant (p = 0.0448). No statistically significant association between COVID-19 severity and other immune-related syndromes were found (p = 1). Of note, all the hospitalized patients for NIH 4 and 5 COVID-19 had GS.ConclusionsOur data suggest that TET patients, especially those with GS, require a careful multidisciplinary monitoring for SARS-CoV-2 infection, in order to establish tailored treatments and prophylactic protocols.

Association of EEG characteristics with outcomes following pediatric ICU cardiac arrest: A secondary analysis of the ICU-RESUScitation trial

Background and ObjectivesThere are limited tools available following cardiac arrest to prognosticate neurologic outcomes. Prior retrospective and single center studies have demonstrated early EEG features are associated with neurologic outcome. This study aimed to evaluate the prognostic value of EEG for pediatric in-hospital cardiac arrest (IHCA) in a prospective, multicenter study. MethodsThis cohort study is a secondary analysis of the ICU-Resuscitation trial, a multicenter randomized interventional trial conducted at 18 pediatric and pediatric cardiac ICUs in the United States. Patients who achieved return of circulation (ROC) and had post-ROC EEG monitoring were eligible for inclusion. Patients < 90 days old and those with pre-arrest Pediatric Cerebral Performance Category (PCPC) scores > 3 were excluded. EEG features of interest included EEG Background Category, and presence of focal abnormalities, sleep spindles, variability, reactivity, periodic and rhythmic patterns, and seizures. The primary outcome was survival to hospital discharge with favorable neurologic outcome. Associations between EEG features and outcomes were assessed with multivariable logistic regression. Prediction models with and without EEG Background Category were developed and receiver operator characteristic curves compared. ResultsOf the 1129 patients with an index cardiac arrest who achieved ROC in the parent study, 261 had EEG within 24 h of ROC, of which 151 were evaluable. The cohort included 57% males with a median age of 1.1 years (IQR 0.4, 6.8). EEG features including EEG Background Category, sleep spindles, variability, and reactivity were associated with survival with favorable outcome and survival, (all p < 0.001). The addition of EEG Background Category to clinical models including age category, illness category, PRISM score, duration of CPR, first documented rhythm, highest early post-arrest arterial lactate improved the prediction accuracy achieving an AUROC of 0.84 (CI 0.77–0.92), compared to AUROC of 0.76 (CI 0.67–0.85) (p = 0.005) without EEG Background Category. ConclusionThis multicenter study demonstrates the value of EEG, in the first 24 h following ROC, for predicting survival with favorable outcome after a pediatric IHCA.

Anhedonia as a Potential Transdiagnostic Phenotype With Immune-Related Changes in Recent-Onset Mental Health Disorders

BackgroundChronic low-grade inflammation is observed across mental disorders and is associated with difficult-to-treat-symptoms of anhedonia and functional brain changes, reflecting a potential transdiagnostic dimension. Previous investigations have focused on distinct illness categories in people with enduring illness, but few have explored inflammatory changes. We sought to identify an inflammatory signal and the associated brain function underlying anhedonia among young people with recent-onset psychosis and recent-onset depression. MethodsResting-state functional magnetic resonance imaging, inflammatory markers, and anhedonia symptoms were collected from 108 (mean [SD] age = 26.2 [6.2] years; female = 50) participants with recent-onset psychosis (n = 53) and recent-onset depression (n = 55) from the European Union/Seventh Framework Programme–funded PRONIA (Personalised Prognostic Tools for Early Psychosis Management) study. Time series were extracted using the Schaefer atlas, defining 100 cortical regions of interest. Using advanced multimodal machine learning, an inflammatory marker model and a functional connectivity model were developed to classify participants into an anhedonic group or a normal hedonic group. ResultsA repeated nested cross-validation model using inflammatory markers classified normal hedonic and anhedonic recent-onset psychosis/recent-onset depression groups with a balanced accuracy of 63.9% and an area under the curve of 0.61. The functional connectivity model produced a balanced accuracy of 55.2% and an area under the curve of 0.57. Anhedonic group assignment was driven by higher levels of interleukin 6, S100B, and interleukin 1 receptor antagonist and lower levels of interferon gamma, in addition to connectivity within the precuneus and posterior cingulate. ConclusionsWe identified a potential transdiagnostic anhedonic subtype that was accounted for by an inflammatory profile and functional connectivity. Results have implications for anhedonia as an emerging transdiagnostic target across emerging mental disorders.

Neuro-stimulating effect of Citri Reticulata Pericarpium Viride essential oil through regulating Glu/NMDAR on olfactory bulb to improve anxiety-like behavior

Ethnopharmacological relevanceCitri Reticulata Pericarpium Viride (also known Qing-Pi or QP) is a plant in the Rutaceae family, QP is a traditional Qi-regulating medicine in Chinese medicine that is compatible with other Chinese medicine components and has extensive clinical practice in treating anxiety and depression. Reports on the pharmacological effects of QP have demonstrated its neuroprotective effects and antioxidant capacities. Numerous pharmacological benefits of QP are attributed to its antioxidant abilities. Anxiety disorders are a broadly defined category of mental illnesses. Oxidative stress and an imbalance in the antioxidant defense system are typical pathological features of these disorders. Aim of the studyThe aim of this study was to evaluate the effects of QP essential oil on anxiety using animal models and investigate the underlying neurobiological mechanisms. Materials and methodsThis study aimed to develop an animal model of anxiety using chronic restraint stress and investigate the effects of inhalation of Citri Reticulata Pericarpium Viride essential oil on anxiety-like behavior, olfactory function, and olfactory bulb neurogenesis in mice with anxiety. ResultsThe results showed that long-term chronic restraint stimulation caused a decrease in olfactory function, significant anxiety-like behavior, and a notable reduction in the number of neurons in the olfactory bulb. However, inhalation of Citri Reticulata Pericarpium Viride essential oil reversed these effects, improving the olfactory function, neuro-stimulating effect, alleviating anxiety-like behavior, and regulating theta (4–12Hz) oscillation in the hippocampus DG area. These effects were associated with changes in the expression levels of glutamate receptor NMDAR and NeuN in olfactory bulb. ConclusionsThe study revealed that mice with anxiety induced by chronic restraint stress exhibited significant olfactory dysfunction, providing strong evidence for the causal relationship between anxiety disorders and olfactory dysfunction. Moreover, QP essential oil has the potential to be developed as a therapeutic drug for anxiety disorders, in addition to its role as a complementary anxiolytic.