Clinical Disorders Research Articles

Mobile cognitive behavioral therapy for insomnia: analysis of factors affecting treatment prognosis

This study aims to explore the factors that affect the prognosis of patients with insomnia who are treated with mobile cognitive behavioral therapy. Patients with insomnia who visited the sleep disorders clinic were selected and completed mobile Cognitive behavioral therapy. Patients completed at least three evaluations (including baseline, monthly evaluations thereafter, and a final evaluation at the end of one year) and responded well to treatment within one year of follow-up. Insomnia, anxiety, and depression symptoms were evaluated using the Pittsburgh Sleep Quality Index (PSQI), the Generalized Anxiety Disorder 7-item (GAD-7) scale, and the 9-item Patient Health Questionnaire (PHQ-9), respectively. Treatment prognosis including relapse, recurrence, and remission group. These 339 patients were divided into three groups: 160 patients who remission, 100 patients who relapsed, and 79 patients who experienced recurrence after remission. Demographic characteristics of the 339 patients showed no significant difference in gender between the three groups (P = 0.978). However, significant differences were found in age (P = 0.006) and onset time (P = 0.000) among the three groups. The remission group had a higher average age than the recurrence group and the relapse group, and the onset time was slower than the other two groups. Multivariate logistic regression analysis showed that age and delayed onset time were protective factors for good treatment prognosis, while low educational level and high GAD-7 scores were independent risk factors for poor prognosis. There are many factors that affect the treatment prognosis of insomnia. Age, low educational level, high GAD-7 scores, and delayed onset time can be used to predict the prognosis of insomnia treatment.

Factors associated with anxiety during the first two years of the COVID-19 pandemic in the United States: An analysis of the COVID-19 Citizen Science study.

COVID-19 increased the prevalence of clinically significant anxiety in the United States. To investigate contributing factors we analyzed anxiety, reported online via monthly Generalized Anxiety Disorders-7 (GAD-7) surveys between April 2020 and May 2022, in association with self-reported worry about the health effects of COVID-19, economic difficulty, personal COVID-19 experience, and subjective social status. 333,292 anxiety surveys from 50,172 participants (82% non-Hispanic white; 73% female; median age 55, IQR 42-66) showed high levels of anxiety, especially early in the pandemic. Anxiety scores showed strong independent associations with worry about the health effects of COVID-19 for oneself or family members (GAD-7 score +3.28 for highest vs. lowest category; 95% confidence interval: 3.24, 3.33; p<0.0001 for trend) and with difficulty paying for basic living expenses (+2.06; 1.97, 2.15, p<0.0001) in multivariable regression models after adjusting for demographic characteristics, COVID-19 case rates and death rates, and personal COVID-19 experience. High levels of COVID-19 health worry and economic stress were each more common among participants reporting lower subjective social status, and median anxiety scores for those experiencing both were in the range considered indicative of moderate to severe clinical anxiety disorders. In summary, health worry and economic difficulty both contributed to high rates of anxiety during the first two years of the COVID-19 pandemic in the US, especially in disadvantaged socioeconomic groups. Programs to address both health concerns and economic insecurity in vulnerable populations could help mitigate pandemic impacts on anxiety and mental health.

Creation of a shortened version of the Sleep Disorders Questionnaire (SDQ).

The 176-item Sleep Disorders Questionnaire (SDQ) was initially developed using canonical discriminant function analysis on 4 groups of sleep disorder patients, but it was never studied by factor analysis in its entirety. Several authors have criticized 2 of its subscales as being confounded with each other, and its narcolepsy scale as substantially over-diagnosing narcolepsy. This study describes its first exploratory factor analysis (EFA), the intent of which was to reassess item membership on the 4 existing subscales and to derive new scales to improve differential diagnosis between patient groups. It was also hoped that EFA could reduce the total number of questions, to increase speed of completion. The EFA was performed on the anonymized SDQ results from a retrospective review of the charts of 2131 persons from 7 sleep disorders clinics and research centers. Factors were assessed via scree plots and eigenvalues. The EFA identified four main factors: insomnia, daytime sleepiness, substance use, and sleep-disordered breathing. The insomnia factor had 3 subfactors: psychological symptoms of insomnia, subjective description of insomnia, and insomnia due to periodic limb movements. The sleepiness factor had two subfactors: daytime sleepiness and neurological symptoms of narcolepsy. The novel substance use factor was homogeneous, as was the sleep-disordered breathing factor. Importantly, the EFA reassigned items from the original SDQ's NAR, PSY, and PLM subscales to five of the new subscales. The Sleep Apnea (SA) subscale emerged mostly unchanged. The 7 resulting factors comprised only 66 items of the original 176-item SDQ. These results have allowed the creation of a new shorter questionnaire, to be called the SDQ-2. External validation of the SDQ-2 is currently underway. It will likely prove to be a superior differential diagnostic instrument for sleep disorders clinics, compared to the original SDQ.

Genetic Clustering Algorithm-Based Feature Selection and Divergent Random Forest for Multiclass Cancer Classification Using Gene Expression Data

AbstractComputational identification and classification of clinical disorders gather major importance due to the effective improvement of machine learning methodologies. Cancer identification and classification are essential clinical areas to address, where accurate classification for multiple types of cancer is still in a progressive stage. In this article, we propose a multiclass cancer classification model that categorizes the five different types of cancers using gene expression data. To perform efficient analysis of the available clinical data, we propose feature selection and classification methods. We propose a genetic clustering algorithm (GCA) for optimal feature selection from the RNA-gene expression data, consisting of 801 samples belonging to the five major classes of cancer. The proposed feature selection method reduces the 1621 gene expressions into a cluster of 21 features. The optimum feature set acts as input data to the proposed divergent random forest. Based on the features computed, the proposed classifier categorizes the data samples into 5 different classes of cancers, including breast cancer, colon cancer, kidney cancer, lung cancer, and prostate cancer. The proposed divergent random forest provided performance improvisation in terms of accuracy with 95.21%, specificity with 93%, and sensitivity with 94.29% which outperformed all the other existing multiclass classification algorithms.

Telemedicine in the management of temporomandibular disorders: A literature review

Background: Temporomandibular disorders are clinical disorders involving the muscles of mastication, temporomandibular joints, and related structures. There are several treatments, such as self-help exercises, that can be done at home using remote care, often called telemedicine, after the patient has been directed to do so by a practitioner and evaluated during regular visits. Along with advancement of the times and technology, as well as with the prevention of COVID-19, telemedicine may currently be the main means of self-care for patients at home without losing the supervision of a doctor. Purpose: The purpose of this study is to determine the effect of using telemedicine in the management of temporomandibular disorders. Methods: A systematic literature review was undertaken using literature search methods in electronic databases: PubMed, ProQuest, and Google Scholar. The keywords were “(Telemedicine OR Teledentistry) AND (Temporomandibular disorder) AND (Effect).” The inclusion criteria for selection of the scientific articles were publication from 2012 to 2022, publication in English, and the full paper being available. Results: Seven articles have been included in this review. Based on the results of this systematic study, using telemedicine is considered able to assist the management of temporomandibular disorders by conducting consultation, follow-up, and treatment remotely via telephone, smartphone application, or internet-based or website-based applications. Conclusion: Telemedicine makes it easier for patients who do not have access to a health center to receive consultations and treatments from home, minimizing time and costs.

Diagnostic machine learning applications on clinical populations using functional near infrared spectroscopy: a review.

Functional near-infrared spectroscopy (fNIRS) and its interaction with machine learning (ML) is a popular research topic for the diagnostic classification of clinical disorders due to the lack of robust and objective biomarkers. This review provides an overview of research on psychiatric diseases by using fNIRS and ML. Article search was carried out and 45 studies were evaluated by considering their sample sizes, used features, ML methodology, and reported accuracy. To our best knowledge, this is the first review that reports diagnostic ML applications using fNIRS. We found that there has been an increasing trend to perform ML applications on fNIRS-based biomarker research since 2010. The most studied populations are schizophrenia (n=12), attention deficit and hyperactivity disorder (n=7), and autism spectrum disorder (n=6) are the most studied populations. There is a significant negative correlation between sample size (>21) and accuracy values. Support vector machine (SVM) and deep learning (DL) approaches were the most popular classifier approaches (SVM=20) (DL=10). Eight of these studies recruited a number of participants more than 100 for classification. Concentration changes in oxy-hemoglobin (ΔHbO) based features were used more than concentration changes in deoxy-hemoglobin (ΔHb) based ones and the most popular ΔHbO-based features were mean ΔHbO (n=11) and ΔHbO-based functional connections (n=11). Using ML on fNIRS data might be a promising approach to reveal specific biomarkers for diagnostic classification.

Naloxone access in perinatal substance use disorder

BackgroundRisk of fatal drug overdose is higher in pregnant and postpartum people with substance use disorder (SUD) than for nonpregnant women of reproductive age. It is recommended that naloxone is prescribed for pregnancies complicated by opioid or stimulant use disorder. ObjectiveThe purpose of this study was to assess the rates of naloxone coprescribing with buprenorphine in a perinatal SUD (PSUD) specialty clinic and identify opportunities for pharmacist-led interventions to improve communication and documentation surrounding naloxone access to achieve a rate of 100% coprescribing of naloxone with buprenorphine. Practice descriptionA clinical pharmacist practitioner is embedded on the Project CARA (Care that Advocates Respect/Resilience/Recovery for All) team, which provides outpatient SUD care integrated with perinatal care in Western North Carolina. Practice innovationThe clinical pharmacist practitioner assessed baseline rates of naloxone coprescribing with medications for opioid use disorder. Interventions to improve rates of coprescribing include provider education, electronic health record (EHR) documentation templates, and direct patient outreach. Evaluation methodsBaseline rates of naloxone coprescribing were assessed and then re-evaluated after different interventions to measure pharmacist impact. ResultsEach intervention improved rates of naloxone coprescribing in a PSUD clinic. EHR documentation templates had the largest impact on baseline efforts, although the long-term benefits derived from these efforts have not yet been demonstrated. Substantial time investment from the pharmacist was required to address patients’ barriers to obtaining naloxone after their visits. ConclusionFurther process improvement should address barriers to naloxone access for both patients and providers. This may include proactive identification of patients in need of naloxone and a “meds-to-beds” pilot to assist patients in navigating logistical challenges.

Perceptions of reproductive healthcare providers regarding their involvement in offering expanded carrier screening in fertility clinics: a qualitative study

Research questionWhat are the main arguments of reproductive healthcare providers in favour or against their involvement in offering expanded carrier screening (ECS) for recessive disorders in fertility clinics in the Netherlands? DesignSemi-structured interview study with 20 reproductive healthcare providers between May 2020 and January 2021. Participants included 11 gynaecologists, 7 fertility doctors, one nurse practitioner and one clinical embryologist, recruited in academic medical centres (N=13), peripheral facilities associated with academic centres (N=4), and independent fertility treatment centres (N=3) in the Netherlands. An interview guide was developed, and thematic content analysis was performed using ATLAS.ti software. ResultsArguments of reproductive healthcare providers in favour of their potential involvement in offering ECS included: (1) opportunities offered by the setting; (2) motivation to assist in reproduction and prevent suffering; and (3) to counter unwanted commercialization offers. Arguments against involvement included: (1) lack of knowledge and familiarity with offering ECS; (2) insufficient staff and resources and potential high costs for clinics and/or couples; (3) the emotional impact it might have on couples; (4) perceived complexity of counselling and expected elongation of waiting lists; and (5) expected low impact on reducing the burden of diseases. Participants believed that more evidence and research is needed prior to their involvement on the costs-benefits, implications, and demand. ConclusionWhile agreeing that the field of medically assisted reproduction provides a unique opportunity for offering ECS, reproductive health care workers feel a lack of capability and limited motivation to offer ECS to all or a selection of couples in their fertility clinic.

Suppressing Endoplasmic Reticulum Stress Alleviates LPS-Induced Acute Lung Injury via Inhibiting Inflammation and Ferroptosis.

Acute lung injury (ALI) is a life-threatening clinical disorder with high mortality rate. Ferroptosis is a new type of programmed cell death with lipid peroxidation and iron ion overloading as the main characteristics. Endoplasmic reticulum (ER) stress and ferroptosis play pivotal roles in the pathogenesis of ALI. The study aimed to investigate the underlying relationship between ER stress and ferroptosis in ALI. The ER stress inhibitor 4-phenylbutyric acid (4-PBA) alleviated LPS-induced inflammation, and decreased IL-1β, IL-6, and TNF-α levels in BALF and lungs. The increased MDA and decreased GSH induced by LPS were partially reversed by 4-PBA, which also inhibited the expressions of ferroptosis-related protein ACSL4, COX-2, and FTH1. TEM further confirmed the ferroptosis within airway epithelia cells was ameliorated by 4-PBA. Moreover, 4-PBA reduced the production of ROS and lipid ROS in LPS-exposed BEAS-2B cells in a concentration-dependent way. Meanwhile, 4-PBA mitigated LPS-induced cell apoptosis in vivo and in vitro. Mechanistically, the MAPK signaling pathway activated by LPS was downregulated by 4-PBA. Collectively, these findings suggested that 4-PBA protected against ALI by inhibiting inflammation and ferroptosis through downregulating ER stress, thus providing a potential intervention for ALI and revealing the possible interaction between ER stress and ferroptosis in ALI.

Cannabis sativa – A matter of physical, mental, and social health

Several studies show that chronic marijuana use opens doors to several disorders, especially neuropsychiatric disorders. Others consider cannabinoids to be promising in therapeutic practice. Here, we present a literature review, based on selected publications on the Medline and Scielo databases, on health and cannabis use. This review aims to assist health professionals and students in understanding the growing number of marijuana users who look for help in outpatient clinics and offices. Therefore, there is an increase in the frequency of hospital admissions for psychotic disorders in clinics and specific treatment institutions. Research over the past 35 years has shown that marijuana use promotes only momentary anxiolysis. This drug alone or in combination with cigarette, when consumed for a long term, can deteriorate the user’s intellectual capacity, academic performance, and professional achievements and finally results in social isolation. The current situation demonstrates that cannabis usage is a public health issue that needs to be addressed in health policy because the majority of users get sick and lose their ability to work.

Emotion-focused Therapy for youth: clinical outcomes of a single-site, randomized waitlist-controlled trial

ABSTRACT Although there is considerable evidence to support Emotion Focused Therapy (EFT) in the adult population, it has not been empirically studied in youth. EFT does not rely on an individual’s adherence to manualized strategies or between-session homework tasks, focusing instead on within-session processes. These processes activate and transform core emotions that are often linked to experiences with primary caregivers, family members, and other significant relationships. This novel study reports on an adaptation of EFT for youth. Building upon the evidence base for EFT with adults, we examined the impact of an 8-session EFT-Y intervention on clinical disorders in youth (n = 43). Using a single-site randomized waitlist-controlled design, outcomes from a treatment group (n = 22) were compared to a waitlist control group (n = 21), similar in age and presenting problems. In comparison to youth in the waitlist control group, the treatment group reported a significant decrease in their emotion dysregulation and depression scores at the end of treatment. Youth in the treatment group also demonstrated a decrease in their emotion difficulties, conduct problems, and overall difficulties, with baseline scores controlled for. These findings provide preliminary evidence that EFT-Y is an efficacious therapeutic approach for common child and adolescent psychopathology.

A new ghrelin receptor antagonist, agrelax, reduces emotional overeating caused by the stimulation of the lateral hypothalamus reward zone in well-fed rats

BACKGROUND: Ghrelin receptor antagonists hold promise for the treatment of eating disorders. The reward zone of the lateral hypothalamus has been proposed as a target for mediating the effects of the ghrelin system in emotional overeating.&#x0D; AIM: This study aimed to evaluate the effects of a new ghrelin receptor antagonist, agrelax, on emotional overeating induced by the stimulation of the reward zone of the lateral hypothalamus in well-fed rats.&#x0D; MATERIALS AND METHODS: Male Wistar rats were trained to self-stimulate in a Skinner box. After training, a feeder was placed in the Skinner box, and a food-conditioned reflex was developed in the rats for 5 days. Then, the reaction of food self-deprivation, i.e., behavior under conditions of choice of self-stimulation or food intake, was assessed.&#x0D; RESULTS: The reaction of food self-deprivation when the animals did not approach the feeder was 10% of the threshold current. Self-stimulation of the lateral hypothalamus with a threshold current caused numerous approaches to the feeder and food intake. Sulpiride, a dopamine D2/D3 antagonist (5 and 20 mg/kg ip), administered to well-fed rats reduced both feeding behavior and the intensity of self-stimulation in the food self-deprivation test at threshold currents. The ghrelin receptor antagonists [D-LYS3]-GHRP-6 and the novel antagonist agrelax (1 µg/µL, 20 µL intranasally) also reduced both feeding behavior and the intensity of self-stimulation under these conditions.&#x0D; CONCLUSIONS: Ghrelin and dopamine receptors are involved in emotional overeating. Agrelax, a novel ghrelin receptor antagonist, reduces emotional overeating induced by the activation of the lateral hypothalamic reward system. Because emotional overeating is strongly associated with clinical eating disorders such as bulimia and binge-eating disorder, the use of ghrelin antagonists to treat and prevent this problem is promising.

Circulating miR-206, miR-181b, and miR-21 as promising biomarkers in hypothyroidism and their relationship to related hyperlipidemia and hepatic steatosis.

Background: Thyroid hormones (THs) signaling has profound effects on many physiological processes. The regulation of THs signaling in various tissues involves the action of microRNAs (miRNAs) on thyroid deiodinases and receptors. THs regulate the expression of certain miRNAs and their target messenger RNAs (mRNAs) in various tissues and cells. The modulation of miRNA levels by THs affects their functions in processes such as liver lipid metabolism, skin physiology, and muscle and heart performance. Aim: This research aimed to investigate miR-181b, miR-206, and miR-21 in the serum of patients with subclinical and overt hypothyroidism to determine their possible role in the diagnosis of the disease and their relationship to clinical disorders related to hypothyroidism. Methods: This study included ninety participants, divided evenly into three groups as follows: patients with overt hypothyroidism diagnosed clinically, radiologically, and by investigation, subclinical hypothyroid patients, and healthy volunteers. The patients had a thorough medical history and underwent a clinical examination. Laboratory tests included plasma cholesterol, LDL, HDL, TGs, liver and renal function tests, CBC, fasting insulin, HOMA-IR, HbA1c, TSH, and free T4. The serum levels of miR-21, miR-206, and miR-181b were measured using qRT-PCR. Results: miR-206 and miR-181b levels were higher in the subclinical group, followed by the hypothyroid and control groups. For miR-21, there was a significantly lower mean value in both the hypothyroid and subclinical groups than in the control group, with no difference between the two groups. Both miR-206 and miR-181b showed a significant negative association with albumin and free T4 levels and a significant direct association with GGT, ALT, AST, creatinine, uric acid, TGs, TC, LDL, TSH, thyroid volume, and CAP score. The same correlation pattern was observed for miR-181b, except that it was not significantly correlated with the TGs. For miR-21 levels, there was a significant positive correlation with albumin, free T4 level, and kPa score and a negative correlation with GGT, ALT, AST, creatinine, uric acid, HOMA-IR, HbA1c, TC, LDL, TSH, and CAP score. Cases with F1 kPa score and S2 CAP scores had significantly higher averages for miR-206 and miR-181b, with a p-value of 0.05. Moreover, miR-21 levels were significantly lower in the S2 CAP score group. Conclusion: These miRNAs (miR-206, miR-181b, and miR-21) may be used as diagnostic biomarkers for hypothyroidism. They may be used as therapeutic targets to control dyslipidemia and hepatic steatosis during hypothyroid disease.

Botulinum Toxin Injections to the Obliquus Capitis Inferioris Muscle for Dynamic Cervical Dystonia Improves Subjective Patient Outcomes.

The obliquus capitis inferioris (OCI) muscle is a significant driver of cervical dystonia with torticaput movements and a no-no head tremor. Limited data are available on the efficacy of OCI injections on patient outcomes. Our study aims to determine whether the botulinum toxin injection into OCI improves subjective patient quality of life in those with dystonic head tremors. A retrospective chart review was performed for 25 patients receiving injections into the OCI for a dystonic head tremor at the London Movement Disorders Clinic between January 2020 and January 2022. Toronto Western Spasmodic Torticollis Scale-2 (TWSTRS-2) subscale scores for disability and pain, TWSTRS-PSYCH scores, and the global impression of severity were extracted. The average TWSTRS-2 disability subscale change was -2.8 points (p < 0.003). The average TWSTRS-2 pain subscale change was -4.6 points (p < 0.003). The average TWSTRS-PSYCH score prior to injection was 5.6. After injection, the average score was 3.7 (p < 0.004). The patient self-reported average global impression of severity before injection was 7.0; after this, it was 4.2 (p < 0.0003). The OCI injection showed significant improvement in retrospective patient self-reported outcomes; it should be considered early in the treatment plan for cervical dystonia with a no-no head tremor.

The Effect of Light on Negative Emotion and Cognitive Regulation in Individuals with Depressive Tendencies

ABSTRACT Light has been demonstrated to influence transient mood states in healthy populations and can be used as a treatment for clinical mood disorders. However, it is still interesting to know whether stimulus with relatively low light levels can moderate the transient mood state of people with depressive tendencies, and what are the effects respectively from light levels and light color. In this study, 10 subjects with depressive tendencies were recruited and screened to receive a typical lighting intervention, including five crossover conditions with the 300 l×-isoluminance groups (red, 6500 K-white, blue) and 6500 K-isospectral groups (50 lx, 300 lx, and 1500 lx). Negative cognitive bias, high-frequency heart rate variability, and subjective emotion were measured at different stages during the lighting intervention. Statistical results demonstrated that the lighting condition of 1500 lx-6500 K was associated with a transient positive mood state (p < 0.001) and had a significant positive moderating effect on the negative cognitive biases compared with the other groups (p = .017). Colored lights are more likely to trigger negative emotions and negative cognitive biases.

Sexual victimisation, peer victimisation, and mental health outcomes among adolescents in Burkina Faso: a prospective cohort study

Sexual victimisation and peer victimisation are pervasive and increase risk for mental illness. Longitudinal studies that compare their unique and cumulative effects are scarce and have been done predominantly in high-income countries. The aims of this study were to examine the prevalence, prospective associations, and gender differences in sexual and peer victimisation and mental health in a low-income, African setting. In this prospective cohort study, data were obtained from the 2017 ARISE Adolescent Health Study, a population-representative, two-wave, prospective study of adolescents (aged 12-20 years) from Burkina Faso. A random sample of adolescents was drawn from ten villages, selected to capture the five main ethnic groups, and from one of the seven sectors of Nouna town, Burkina Faso, at two timepoints: Nov 12 to Dec 27, 2017, and Nov 15 to Dec 20, 2018. Standardised interviews were conducted in French or a local language by trained researchers. We measured victimisation exposure as sexual victimisation, peer victimisation, and polyvictimisation, using lifetime frequency of exposure, and we measured mental health symptoms and disorders using the Kutcher Adolescent Depression Scale, the Primary Care Post-Traumatic Stress Disorder screen IV and 5, and a question on lifetime self-harm and number of incidents in the past year. We calculated prevalence of victimisation and mental health symptoms and disorders at the two timepoints, and we used lifetime victimisation at the first timepoint to predict mental health at the second timepoint using logistic and negative binomial regressions. Gender differences were examined using interaction terms. Of 2544 eligible adolescents, 1644 participated at time 1 and 1291 participated at time 2. The final sample with data at both timepoints included 1160 adolescents aged 12-20 years (mean 15·1, SE 0·2), of whom 469 (40·4%) were girls and 691 (59·6%) were boys. The majority ethnic group was Dafin (626 [39·1%]), followed by Bwaba (327 [20·5%]), Mossi (289 [16·0%]), Samo (206 [13·0%]), Peulh (166 [9·7%]), and other (30 [1·6%]). After survey weight adjustment, sexual victimisation (weighted percentages, time 1, 256 [13·8%] of 1620; time 2, 93 [7·2%] of 1264) and peer victimisation (weighted percentages, time 1, 453 [29·9%] of 1620; time 2, 272 [21·9%] of 1264) were common, whereas polyvictimisation was more rare (weighted percentages, time 1, 116 [6·6%] of 1620; time 2, 76 [5·7%] of 1264). Longitudinally, sexual victimisation was associated with probable clinical disorder (adjusted odds ratio 2·59, 95% CI 1·15-5·84), depressive symptoms (adjusted incidence rate ratio [aIRR] 1·39, 95% CI 1·12-1·72), and symptoms of post-traumatic stress disorder (aIRR 2·34, 1·31-4·16). Peer victimisation was associated with symptoms of post-traumatic stress disorder (aIRR 1·89, 1·13-3·17) and polyvictimisation was associated with depressive symptoms (aIRR 1·34, 1·01-1·77). Girls reported more sexual victimisation (weighted percentages, 130 [17·3%] of 681 vs 126 [11·4%] of 939), boys reported more peer victimisation (weighted percentages, 290 [33·1%] of 939 vs 163 [25·2%] of 681), and there was a significant interaction between lifetime victimisation and gender for probable clinical disorder (F [degrees of freedom 7, sample 376] 2·16; p=0·030). Sexual and peer victimisation were common in the study setting and increased risk for mental health problems. Adolescent girls who have been sexually victimised are especially at risk of mental health problems. Interventions targeting sexual and peer violence in low-income settings are needed. Alexander von Humboldt Foundation, the Wellcome Trust, Fondation Botnar, and Harvard TH Chan School of Public Health.

A Novel Home-Based Telerehabilitation Program Targeting Fall Prevention in Parkinson Disease: A Preliminary Trial.

Falls in a person with Parkinson disease (PwP) are frequent, consequential, and only partially prevented by current therapeutic options. Notably, most falls in PwPs occur in the home or its immediate surroundings; however, our current strategies for fall prevention are clinic-centered. The primary objective of this nonrandomized pilot trial was to investigate the feasibility and preliminary efficacy of the novel implementation of home-based PD telerehabilitation (tele-physical/occupational therapy) focusing on fall risk reduction and home-safety modification. Persons with mild-to-moderate PD who were identified as being at risk of falls by their movement disorders neurologist were recruited from a tertiary movement disorders clinic. After an initial in-person evaluation by the study physical and occupational therapists, 15 patients with PD (Hoehn and Yahr Stage 2 (n = 8) and Stage 3 (n = 7)) participated in 4 biweekly PT/OT televisits with care partner supervision over the course of 10 weeks. The Goal Attainment Scale (GAS) was implemented to assess progress toward individualized PT/OT goals established at baseline. Outcomes were assessed at the end of the intervention at 10 weeks and at a six-month follow-up. Participants completed all 120 protocol-defined televisits without dropouts and adverse events. At 10 weeks, mean composite PT and OT-GAS scores showed significant improvement from baseline (PT: p < 0.001, OT: p < 0.008), which continued at 6 months (PT: p < 0.0005, OT: p < 0.0005). Home-modification recommendations made through novel virtual home-safety tours were cumulatively met by participants at 87% at 10 weeks and 91% at 6 months. Home-based telerehabilitation is a promising new strategy toward fall prevention in PD. The GAS has the potential to serve as an effective and patient-driven primary outcome variable for rehabilitation interventions for heterogeneous PwPs to assess progress toward personalized goals. ClinicalTrial.gov identifier: NCT04600011.

14-18 Yaş Arası Ergenler için Bozulmuş Yeme Ölçeği’nin Geliştirilmesi

This study aimed to develop a scale for evaluating disordered eating attitudes and behaviors among adolescents aged 14 to 18. The scale’s factor structure was examined with a total of 1379 participants, revealing 14 items and three sub-dimensions that accounted for 58.46% of the total variance. The scale demonstrated good internal consistency (Cronbach’s alpha = .86) and test-retest reliability (r = .90). Regarding criterion validity, the correlation between the Disordered Eating Scale (DES) and the Eating Disorder Examination Questionnaire (EDE-Q) was found to be .86. Receiver operating characteristic (ROC) analysis results indicated a sensitivity of .930 and a specificity of .91 for the ≥31 cut-off point. Confirmatory factor analysis (CFA) was conducted, and the model fit indexes for both applications were as follows: x2 = 287.43, df = 73, x2/df = 3.94, RMSEA = 0.079, CFI = 0.938, TLI = 0.922, and SRMR = 0.045. These findings supported the three-dimensional model, suggesting that disordered eating can be measured through restriction, weight anxiety, and extraction-control behaviors dimensions with a total of 14 items. The DES is deemed suitable for screening and evaluating negative eating behaviors and potential psychopathology in adolescents, including those with and without clinical eating disorder symptoms.

Gut microbiota and metabolite variations in a migraine mouse model.

Migraine is a prevalent clinical disorder characterized by recurrent unilateral throbbing headache episodes accompanied by symptoms such as nausea, vomiting, photophobia, and phonophobia. Despite its common occurrence, the diagnosis, pathophysiology, and treatment of migraine remain controversial. Extensive research has implicated the gut microbiota in various central nervous system disorders, including anxiety disorders, depression, and Parkinson's disease. Some studies have also suggested that migraine may stem from disruptions to neurohormones and metabolism. This study aimed to investigate the disparities in gut microbiota and metabolites between migraine mice model and normal mice to shed light on the underlying mechanisms and potential therapeutic approaches. Distinct differences in gut microbial composition were observed between the migraine mouse model and normal mouse, indicating a potential correlation between these variations and the pathogenesis of migraine. This study provides evidence of differences in gut microbiota composition and metabolites between a migraine mouse model and normal mice, which showed that Akkermansiaceae constituted the most abundant taxon in the sham injection mouse group, while Lachnospiraceae constituted the most prevalent group in the migraine mouse model group. The associations between the abundances of Akkermansia muciniphila and Lachnospiraceae bacteria and metabolites suggested their potential roles in the pathogenesis of migraine. The altered abundance of Lachnospiraceae observed in migraine-afflicted mice and its correlations with changes in metabolites suggest that it may affect the host's health. Thus, probiotic therapy emerges as a possible treatment for migraine. Moreover, significant disparities in gut metabolites were observed between the migraine mouse model and normal mice. These alterations encompass multiple metabolic pathways, suggesting that metabolic disturbances may also contribute to the development of migraines.

41. Feasibility of Snack Provision in a Multidisciplinary Eating Disorder Clinic

41. Feasibility of Snack Provision in a Multidisciplinary Eating Disorder Clinic