Fair Insight Research Articles

Deficit of perineuronal oligodendrocytes in the inferior parietal lobule is associated with lack of insight in schizophrenia

Background and Objectives: Previously we reported a significant reduction in the numerical density of oligodendrocytes and oligodendrocyte clusters in the inferior parietal lobule (IPL) in schizophrenia that was associated with lack of insight. We also found a significant decrease in the number of perineuronal oligodendrocytes (PnOl) in the prefrontal cortex in schizophrenia and therefore we hypothesized that there may also be a deficit of PnOl in the IPL in schizophrenia and that it could be associated with poor insight. Methods: We estimated the number of PnOl adjacent to pyramidal neurons in layer 3 of BA39 and BA40 in Nissl stained sections from 24 males with schizophrenia and 24 nor- mal male controls from the Stanley Parietal Collection. The schizophrenia group was di- vided into three subgroups based on level of insight: poor, fair or good. Results : We found a significant deficit of PnOl in layer 3 of BA39 and BA40 in the schizophrenia group as compared to the control group (p<0.01). In the control group but not in the schizophrenia group in BA39 the number of PnOl was significantly higher in the left hemisphere compared to the right hemisphere. In schizophrenia, in BA39 the number of PnOl was decreased in the subgroup with poor insight vs. controls. In BA40 the sub- groups with both poor and fair insight were decreased vs. controls (p<0.01). In BA40 the subjects with fair insight also differed from those with good insight (p<0.01). Conclusions: The reduction of PnOl in the IPL in schizophrenia is associated with im- paired insight and lack of hemispheric asymmetry.

English

There is wide range of pathological neck masses from benign inflammatory conditions to frankly malignant lesions, which may be congenital or acquired. These neck mass may be an incidental finding on the general physical examination. The close proximity of various structures in the neck creates a diagnostic problem. The precise anatomical location and imaging appearances are important for accurate diagnosis and formulating the differential diagnoses of neck masses. Ultrasonography (US) and computed tomography (CT) enable radiological characterization of normal and diseased structures in the neck in ways that were previously not possible. With the advent of high frequency ultrasound (US) probes, superficial structures are visualized very conveniently and with great spatial solution. Ability of CT to give tissue attenuation values gives a fair insight into the nature of the lesion. AIMS & OBJECTIVE: In this study we planned to evaluate palpable neck masses with US and CT, and comparing their efficacy. MATERIAL & METHOD: The present study was conducted in the Department of Radio-diagnosis, TMMC & RC, TMU, Moradabad. Patients under study were referred from the department of Surgery, ENT, Medicine and Pediatrics. Patients included for study were evaluated by Clinical and Radiological examination .The age range in the present study was from 3 to 80 years and total number of patients were 40 (including both male and females). RESULT: 1. On examination distribution of lesions was found to be Inflamatory- 17.5%, Developmental- 7.5%, Thyroid masses-30%, Mesenchymal-10%, Neural 5%, Vascular-5%, Bone5%, Lymph nodes-10%, & Salivary gland mass-10%. 2. The Male to Female ratio in the present study = 1.22:1 CONCLUSION: Ultrasound complimented coupled with Computed Tomography is of immense help in the diagnosis and better management of palpable neck masses.

Depression and insight in schizophrenia: Comparisons of levels of deficits in social cognition and metacognition and internalized stigma across three profiles

While research has paradoxically linked insight to greater emotional distress and depression in schizophrenia, little is known why and for whom insight can result in depression. One possibility is that internalized stigma and deficits in social cognition and metacognition are risk factors for insight to convert to depression. To explore this possibility we assessed insight, depression, internalized stigma, social cognition and metacognition for sixty five persons with schizophrenia spectrum disorders. We then performed a cluster analysis based on insight and depression scores. Three groups were produced by the cluster analysis: Good insight/Mild depression (n=22); Fair insight/Moderate depression (n=26) and Poor insight/Minimal depression (n=17). As predicted, ANOVA comparing groups revealed the three groups differed in social cognition, and the metacognitive mastery aspect of metacognition. Those with fair insight and moderate depression reported more internalized stigma than those with poor insight and minimal depression. Persons with good insight and mild depression had higher levels of social cognition and metacognitive mastery than the other two groups. These differences persisted when controlling for neurocognition and symptom severity. These findings point to the possibility that future research should examine whether bolstering metacognitive and social cognitive capacities may have a protective effect as persons are assisted to achieve insight.

Reduced oligodendroglial density in the inferior parietal lobule and lack of insight in schizophrenia

Background and Objectives: Alterations and deficits of oligodendrocytes reported in the grey and white matter in schizophrenia may contribute to neuronal disconnectivity. Prefrontal-parietal functional disconnections have been implicated in diverse clinical symptoms of schizophrenia, including poor insight. We studied the effects of schizophrenia diagnosis and insight on numerical density (Nv) of oligodendrocytes in the inferior parietal lobule (IPL). Methods: Nissl-stained sections from the Stanley �Parietal Collection� from male schizophrenia subjects (n = 24) having poor, fair, or good insight and healthy matched controls (n = 24) were examined. The Nv of oligodendrocytes was estimated in layer 3 of BA 39 and BA 40 of the IPL and in white matter underlying layer 6 by optical dissector method. Results: In BA 39 we found a significant 15% decrease in the Nv of oligodendrocytes in layer 3 in the schizophrenia group. Nv of oligodendrocytes in the poor+fair insight subgroup was 20% lower compared to controls (p< 0.05) and to good insight subgroup (p = 0.055). Nv of oligodendrocytes in the good insight subgroup did not differ from the control group. A significant lateralization of oligodendrocyte density was detected in layer 3 (L>R) only in the control group. There were no significant group differences in the Nv of oligodendrocytes in BA 40 or in the white matter underlying BA 39/40 areas. Conclusions: Lack of insight in schizophrenia may be associated with a deficit of oligodendroglia in the grey matter of IPL.

Histopathological spectrum of lesions in nephrectomy specimens: A five-year experience in a tertiary care hospital

Context: Nephrectomy is a common procedure in surgical practice. It is indicated in patients presenting with a wide range of clinical conditions ranging from symptomatic chronic infections, obstruction, calculus disease, and severe traumatic injury to renal cell carcinomas. It is performed increasingly in the context of end-stage renal disease and to treat renovascular hypertension from non-correctable renal artery disease, or for severe unilateral parenchymal damage resulting from nephrosclerosis, pyelonephritis, vesicoureteric reflux, and congenital dysplasia. Objective: This study aimed to assess the patterns and morphology of lesions in nephrectomy specimens in a tertiary care hospital, observe variations if any from the conventional pattern, and clinico-morphological correlation for proper postoperative management. Materials and Methods: A hospital-based five-year study included all nephrectomy specimens received in the department over a period of five years (November 1, 2005 to October 31, 2010). Results: A total of 140 cases over a period of five years were studied. A wide range of lesions were found on histopathological examination. The histopathological analysis correlated well with the clinical diagnosis; however, few benign lesions like xanthogranulomatous pyelonephritis may be misdiagnosed clinically as malignant. Similarly, cases of cystic diseases of kidney, renal sarcomas, renal squamous cell carcinomas, and angiomyolipomas were confirmed on histopathological analysis only. Conclusions: The present study provides a fair insight into the histological patterns of lesions in nephrectomy specimens at our institution. In conclusion, a wide range of lesions are encountered on histopathology of nephrectomy specimens, many of which may be misdiagnosed clinically and radiologically; therefore, it is mandatory that every nephrectomy specimen be subjected to detailed histopathological examination for a clinico-morphological correlation to ensure proper management.

Insight, Self-esteem, and Coping Skills among Patients with Alcohol Addiction

Purpose: This study was conducted to investigate the related factors of insight, self-esteem, and coping skills and the relationships among them in patients with alcohol addiction. Methods: The participants enrolled in this study were 106 patients from two alcohol treatment hospitals in Gyeonggi Province. Data were collected from May, 12 to 20, 2010 using self-report questionnaires. The instruments were the Hanil Alcohol Insight Scale, Rosenberg Self-esteem Scale, and the Ways of Coping Checklist. Data were analyzed using the SPSS-Win 12.0 program. Results: Among the participants, 24.5% had poor insight, 45.3% fair insight, and 30.2% good insight. Insights of participants who had experienced withdrawal symptoms (t=-3.79, p<.001) and of those not living with family (t=-2.07, p=.041) were higher than those who had not experienced the symptoms and who were not living with family. Self-esteem of participants living with family (F=3.60, p<.001) and of those with better academic backgrounds (F=3.39, p=.021) were higher than those of the other groups. Also, self-esteem showed a positive relation with active coping (r=.34, p<.001). Conclusion: The results of the present study suggest that mental health practitioners need to focus on insight and self-esteem enhancement, coping skill development when treating patients with alcohol addiction.

Mathematical Model for Shelf-life of Chickpea Sprouts under Modified Atmospheric Packaging

Simulation study compared predicted in-pack gaseous composition of O2 and CO2 with the actual experimental data and predicted in-pack water vapour and temperature as well as the appropriate shelf life of chickpea sprouts. The actual and simulated results for in-pack gaseous composition O2/CO2 was 14.46; 8.45 % and 14.99; 7.92 % for PP package (100g) and 14.22; 8.85 % and 14.21; 10.57 % for 100g of LDPE package containing chickpea sprout under MAP. Verification of developed model considered the prediction of in-pack gaseous composition and storage period packed under PP and LDPE polymeric films with the experimental value and showed a near proximity. A model with the selected quality attribute (lightness of hypocotyl) thus could provide a fair insight into the shelf life of chickpea sprout under modified atmospheric packaging.

Probabilistic reasoning in patients with body dysmorphic disorder

Background and ObjectivesMany patients with body dysmorphic disorder (BDD) have poor insight into their condition. Indeed, their conviction in their ugliness is often delusional. Perhaps the most robust information-processing abnormality associated with delusions is a jumping to conclusions (JTC) reasoning bias such that delusional individuals request significantly less information before making a decision relative to healthy controls. We investigated whether patients with BDD (n = 20) demonstrate a JTC reasoning style relative to patients with OCD (n = 20) and healthy controls (n = 20). MethodsParticipants completed a clinician-rated measure of delusionality and two tests of probabilistic reasoning: the beads task and the survey task. ResultsPatients with BDD did exhibit higher delusionality than the patients with OCD. They did not, however, exhibit a JTC reasoning bias relative to the patients with OCD or the healthy controls. Patients with poor insight BDD requested significantly less information before making a decision than did patients with fair insight BDD. LimitationsThe clinical groups were characterized by multiple comorbidities and concomitant medications. The BDD group had relatively good insight as compared to other studies examining delusionality in BDD. ConclusionsTaken together, our results suggest that although a JTC reasoning bias was not present in all patients with BDD, a modest JTC reasoning bias may be present among patients with poor insight BDD. Future studies could provide additional information on this hypothesis.

Effects of Insight Level on the Sensitivity of Alcoholism Screening Tests in Alcohol Dependent Patients

Results: In good insight group, the sensitivity of AUDIT and CAGE identified 96.9% and 96.9% of the participants as alcohol dependence, respectively. In fair insight group, those were 92.7% and 96.4%, respectively. However, in poor insight group, these decreased substantially to 62.9% and 65.7%, respectively. After adjusting for general characteristics on the basis of good insight group, we found that the possibility of positive on the AUDIT was significantly lower in poor insight group (Odd ratios [OR], 0.025; 95% confidence interval [CI], 0.002 to 0.411). Also, the possibility of positive on the CAGE was significantly lower in poor insight group (OR, 0.016; 95% CI, 0.001 to 0.358). Conclusion: Alcohol-dependent patients with poor insight showed a high rate of false negatives in alcoholism screening tests. These suggest that primary care physicians should be careful in interpreting the results of alcoholism screening tests.

Awareness of Illness and Insight Into Obsessive-Compulsive Symptoms in Schizophrenia Patients With Obsessive-Compulsive Disorder

Obsessive-compulsive symptoms (OCS) have been revealed in a substantial proportion of schizophrenia patients. We sought to evaluate insight into OCS in schizo-obsessive patients. We evaluated insight into OCS and awareness of schizophrenia, using the Brown Assessment of Beliefs Scale (BABS) and the Scale to Assess Unawareness of Mental Disorder (SUMD), respectively. Fifty-seven inpatients that met DSM-IV criteria for both schizophrenia and OCD were recruited. To determine a possible modifying effect of OCS on the awareness of schizophrenia, we included a comparison group of non-OCD schizophrenia patients (N = 80). Nine (15.8%) schizo-obsessive patients revealed lack of insight into OCS, whereas a majority (48 patients, 84.2%) exhibited good or fair insight. In the schizo-obsessive group, insight into OCS positively correlated with awareness of schizophrenia but not with awareness of delusions. Roughly 40% of the schizo-obsessive and non-OCD schizophrenia patients revealed unawareness of schizophrenia. Our findings indicate that OCS in schizophrenia represent an identifiable dimension of psychopathology independent of core schizophrenia symptoms.

Insight into Obsessive-Compulsive Symptoms and Awareness of Illness in Adolescent Schizophrenia Patients with and without OCD

A substantial proportion of adolescent schizophrenia patients also has obsessive-compulsive disorder (OCD). As the reliability of OCD identification in schizophrenia has been challenged, we evaluated insight into OCD symptoms and awareness of schizophrenia, using the Brown Assessment of Beliefs Scale and the Scale to Assess Unawareness of Mental Disorder respectively, in 22 adolescent inpatients who met DSM-IV criteria for both schizophrenia and OCD. Awareness of illness was also assessed in a comparison group of 22 non-OCD adolescent schizophrenia patients. Nineteen (86.3%) schizo-obsessive patients exhibited good or fair insight into OCD, while only 3 patients revealed lack of insight. Roughly 30% of patients in the two schizophrenia groups with and without OCD exhibited unawareness of schizophrenia, indicating that the presence of OCD does not substantially modify global awareness of illness. The effect size of the correlation between insight into OCD and awareness of schizophrenia in the schizo-obsessive group was small and not statistically significant. Our findings support the notion that OCD in adolescent schizophrenia patients represent an identifiable dimension of psychopathology independent of core schizophrenia symptoms. Early identification of this potentially treatable syndrome is imperative for appropriate diagnosis and treatment of this unique subset of schizophrenia patients.

Treatment of a 50-Year-Old African American Woman Whose Chronic Posttraumatic Stress Disorder Went Undiagnosed for Over 20 Years

Treatment of a 50-Year-Old African American Woman Whose Chronic Posttraumatic Stress Disorder Went Undiagnosed for Over 20 Years

Lessons Learned In North Sea Oil Field Developments

Abstract Continued progress in matters of frontier resource development is dependent on avoidance of past errors. The development of oil and gas fields in the hostile North Sea environment represents a major pioneering effort which has witnessed the successful introduction of many new technologies. Evaluation of the success of North Sea ventures has, however, been confused by the impact of inflation and currency realignments.A recent analysis by Castle) of North Sea field Economic performance suggests that these fields would have been ‘underwater’ (due to technical under performance) if they had not been "bailed out" by the crude oil price increases, particularly of 1979. Examined are the technical factors responsible for Castle's observation for certain fields and it is concluded that greater care is needed in relating reservoir performance uncertainty to pre-development appraisal well data. Attempts are made to highlight some of the potential problem areas encountered when defining a development plan with the help of reservoir simulationmodels. Analyzed are published data for two typical North Sea fields: Thistle and Beatrice, which are amplified with observations from personal experience. Introduction Table 1 is partly extracted from a recent article by Castle(l) where an attempt was made to estimate how profitable 19 North Sea fields would have been if prices had remained flat from the time development was initiated. These "proforma" rate-of-return estimates, which ignore petroleum revenue tax as well as corporate taxes, and only deduct the 12 ? % royalty, indicated that only 14 fields in fact yielded a positive cash flow and of these only 7 yielded a rate of return in excess of 15%. At first glance Castle's analysis leads one to conclude that the performance of the oil industry in the North Sea was, in real terms, an economic disappointment. Table 1 has been enlarged with technical performance data extracted from the United Kingdom Brown Book(2). It is well known that the oil industry and various northwestern European National Treasuries have derived much benefit from the North Sea Oil Province. In terms of money of the day, the rates-of-return have been more than adequate to permit rapid payback of loans, a very large government "take", as well as to fund further developments. This is due, as Castle points out, to inflation and currency fluctuations ‘bailing out’ the North Sea projects most of which suffered from construction delays, cost overruns and production shortfalls. In this paper an attempt is made to identify the main technical reasons for under-performance of two of Castle's fields: Thistle and Beatrice (Fig. 1), These fields are rather well documented (see reference list) and thus provide much study material. This sample moreover includes a typical "Brent Province" Jurassic field representing one of the pioneering developments, as well as a later, non-Brent "marginal discovery" benefitting from five years of offshore technological progress. It is, therefore, a representative sample, and gives a fair insight into the technical risks inherent in offshore developments. Within the context of U.K offshore developments, both fields are successful.

The crystal structure of non-stoichiometric Eu-anorthite: an explanation of the Eu-positive anomaly

AbstractSynthetic Eu-anorthite of the alkali feldspar structure type has been refined toRw= 4.7% using 3-D counter diffractometer data and full-matrix least-squares methods. The chemical composition of the feldspar is Eu0.92Al1.76Si2.24O8, based on both occupancy refinement of the Eu atom site and estimation of the Al/Si distribution calculated from the meanT-Obond length. The unit cell parameters area= 8.373(1),b= 12.959(1),c= 7.124(1) Å, and β = 115.51(1)° and the symmetry is enhanced toC2/m. Mean bond lengths areT(1)-O = 1.677 Å,T(2)-O = 1.668 Å, and Eu-O = 2.721 Å. The average Al/Si distribution over theT(1) andT(2) sites calculated from the meanT-Obond length is in fairly good agreement with an estimate of the Al content from the bond strength calculation; the Al partition is calculated ast1= 0.47 andt2= 0.41 respectively. Summing the bond strengths of these Eu and partially disordered Al/Si cations approximates to electrostatic neutrality for the anion content of the feldspar structure, indicating that this synthetic Eu feldspar can be non-stoichiometric, signifying vacancies on the alkali cation site.Plagioclase and melilite generally show a positive Eu anomaly. A fair insight into the driving force of this anomaly can be afforded by the crystallo-chemical affinities of Eu2+and Eu3+cations to the crystal structures of their host minerals; (1) ioinic radius, (2) electrostatic charge balance and (3) tolerance for non-stoichiometry of the crystal structure.

Causes of Blindness in Indiana

The following report, based on the physical ocular examinations of 2,657 applicants for blind pension in the state °f Indiana, gives a fair insight into the common causes of blindness in the midwestern part of the United States. The examinations were made by physicians Practicing in or near the county in which the applicant resided, and the examiner was either an oculist or an eye, ear, nose, and throat specialist, as required by the Welfare Act of Indiana for 1936. As a standard qualifying requirement, the central vision of the better eye of the applicant had to be reduced to 20/200 or less. All of the individuals included l n this analysis were so handicapped. All applicants were adults. However, not ah applicants were eligible for blind Pension because of other considerations ; usually financial support from other sources. Through the cooperation of the National Society for the Prevention of blindness, a standard form of the causes ()f blindness, prepared by the Committee on Statistics of the Blind, was obtained. proceeding w i t h this chart, which has a Retailed cross-classification of topograph_al listings—such as, glaucoma, cataract, ' r ' t is, and comcal opacity—along its upper o der, and etiological factors—such as, ophthalmia neonatorum, syphilis, trach> a n d diabetes—on the side margin, a Pographical and an etiological factor was listed on each of the 2,657 individual r e c o r d s After this was accomplished, it