Non-organic Disorders Research Articles

Articulation Assessment for Tongue Cancer Patients: Using Consonant Production Performance to Capture Speech Deficits.

The purpose of this study was to thoroughly analyze postoperative consonant errors by tongue cancer (TC) patients with speech disorders and also to investigate the correlation between the pathological factors and the speech performance using our Consonant-based Articulation Assessment Battery (CAAB). The participants were 57 monolingual Mandarin TC patients (26 women, 31 men) after surgery (aged 20-80 years). All participants were literate and had normal vision and hearing, enabling them to comprehend and comply with our instructions. In order to quickly evaluate their articulation performance based on the place and manner of articulation, they were instructed to pronounce the characters in CAAB. The analysis removed speech samples impacted by speakers' dialects, while recording and documenting all other responses. The study uncovered a significant correlation between pathological factors (e.g., size of tongue resection, specific resection site, and tumor size) and the accuracy of consonant articulation. Furthermore, tongue damage predominantly impacts the place of articulation (63.85%) than the manner of articulation (20.78%). The damage in the anterior part of the tongue has the most prominent influence on consonant production. CAAB can fast capture the idiosyncratic characteristics of speech production by TC patients, and the articulation deficits are quite different from other types of organic or nonorganic speech disorders, for example, cleft lip and cleft palate. Hence, CAAB can be designated as an assessment tool for articulation disorders caused by stomatognathic damages. Our findings also shed light on the possible oral cancer surgery plan and the postoperative speech rehabilitation training.

Microbiome and metabolomic profiling in humans with functional anorectal pain: Identifying key players in disease pathogenesis

Functional Anorectal Pain (FARP) is a chronic, functional, nonorganic disorder of the anorectal region, often misdiagnosed as various types of anorectal organic diseases in clinical practice. However, the pathogenesis and diagnostic markers of FARP remain poorly understood. In this study, we recruited 45 FARP patients and 35 healthy subjects to investigate the microbial and metabolomic profiles associated with FARP progression. Anorectal manometry was utilized to determine changes in anal pressure, revealing a significant decrease in FARP patients' anal resting pressure and maximum anal squeeze pressure. Through 16S rRNA gene sequencing and metabolomics analysis, we identified specific microbial genera, including Propionibacterium, Ruminococcus2, and Bilophila, and specific metabolite profiles, including Gentisic acid, 2-Naphthalenethiol, 2-Furancarboxaldehyde, Benzoic acid, Allose, and (S)-3-Amino-5-methylhexanoic acid, that were closely correlated with FARP. In-depth analysis revealed that the Phospholipase D (PLD) signaling pathway exhibited significant differences in FARP. Additionally, serum cortisol levels were found to be significantly elevated in FARP patients. These findings provide new insights into the anorectal manometry features, gut microbiota, and serum metabolome associated with FARP, potentially contributing to improved clinical diagnosis and therapeutic strategies for FARP.

Causal Relationship Between Micronutrient and Sleep Disorder: A Mendelian Randomization Study.

Sleep played an important part in human health, and COVID-19 led to a continuous deterioration of sleep. However, the causal relationship between micronutrient and sleep disorder was not yet fully understood. In this research, the genetic causal relationship between micronutrient and sleep disorder was analyzed utilizing a two-sample Mendelian randomization (MR). Single nucleotide polymorphisms (SNPs) were used as instrumental variables. The analyses were conducted using the MR-Egger, inverse variance weighted, weighted mode, weighted median, simple mode, Cochran's Q test and leave-one-out. Our results suggested that 8 genetically predicted micronutrients participated in sleep disorders, including liver iron (L-iron) and iron in sleeping too much, spleen iron (S-iron) in sleeplessness/insomnia, trouble falling or staying asleep, sleep duration (undersleepers) and nonorganic sleeping disorders, iron metabolism disorder (IMD) and vitamin B12 deficiency anaemia (VB12DA) in narcolepsy, urine sodium (uNa) in narcolepsy, sleep apnea syndrome and sleep disorder, vitamin D (VD) in sleep duration (oversleepers), 25-Hydroxyvitamin D (25(OH)D) in trouble falling or staying asleep. Our study used Mendelian randomization methods at the SNP level to explore the potential causal relationship among L-iron, iron, S-iron, IMD, uNa, 25(OH)D, VD, VB12DA with certain sleep disorder subtypes. Our results uncovered a micronutrient-based strategy for alleviating sleep disorder symptoms.

Epidemiological study on seroprevalence of syphilis in patients with mental diseases.

The objective of this study was to investigate the seroprevalence of syphilis and its possible influencing factors in patients with mental illness. A total of 24,414 patients with mental illness from 2019 to 2021 were included. Serum syphilis antibody test results and available demographic data were collected. Chi-square test and regression analysis were used to analyze the data. The seroprevalence of syphilis was 0.59% (95% CI 0.49-0.69%) in patients with mental illness in the study area. There were significant differences in the seroprevalence of syphilis in age, marital status, occupation, urban region, and mental disease classification. The seroprevalence of syphilis increased with age (p < 0.01). The seroprevalence of syphilis was higher in patients with "Nonorganic sleep disorders" and "Reaction to severe stress, and adjustment disorders". Adjusted logistic regression analysis showed that the seroprevalence of syphilis in patients with mental illness was associated with age, region, and psychiatric classification. Older age group was a risk factor for syphilis seropositivity. Compared with schizophrenia, "bipolar affective disorder" (OR = 1.707, 95% CI: 1.017-2.864, p = 0.043) and "severe stress response and adjustment disorders"(R = 4.912, 95% CI: 1.138-21.204, p = 0.033) were risk factors for syphilis antibody positivity. The patients with "nonorganic sleep disorders" and "reaction to severe stress, and adjustment disorders" had a high seroprevalence of syphilis. Age and psychosis types became the influencing factors of the positive rate of serum syphilis antibody in patients with mental illness.

Current Status of Research on the Treatment of Insomnia with Acupuncture

Insomnia is a non-organic sleep disorder that currently affects the quality of life of people around the globe, and has received widespread attention at home and abroad. Current treatments such as psychotherapy, medication, and physical therapy can improve patients' sleep quality, but they have drawbacks such as high price, drug resistance, and easy to damage the skin, whereas acupuncture has significant efficacy, few side effects, low price, and ease of use in the treatment of insomnia. Acupuncture is widely recognised in the treatment of insomnia, and research on different acupuncture therapies is increasing year by year. By searching the Chinese Journal Full Text Database (CNKI), Wanfang Database and PubMed Database, relevant clinical randomised controlled trials of acupuncture for insomnia in the past 6 years were included for generalisation and summary, aiming to provide clinicians with new ideas and methods for the treatment of insomnia.

Vividness of visual imagery is associated with the effect of relaxation response meditation training in elderly people with nonorganic insomnia: A randomized, double-blind, multi-center clinical trial

BackgroundThis study aims to explore the efficacy of Relaxation Response Meditation Training (RRMT) on elderly individuals with different levels of vividness of visual imagery. MethodsIn this randomized controlled, double-blind, multi-center clinical trial, we recruited a total of 136 elderly individuals who were over 60 years with nonorganic sleep disorders to participate in a 4-week RRMT intervention from October 2020 to October 2022. The intervention occurred twice a week, totaling eight times. These individuals were divided into high and low groups based on the vividness of visual imagery, and then randomly assigned to either the control or intervention groups, as follows: low-visualizers intervention group (LI group); low-visualizers control group (LC group); high-visualizers intervention group (HI group); high-visualizers control group (HC group). Their social and psychological parameters were assessed before and after the intervention by the Pittsburgh Sleep Quality Index (PSQI), the Revised Piper's fatigue scale (RPFS), General well-being scale (GWB), and Satisfaction rating. The alpha waves of patients were also collected through electroencephalogram to assess their level of relaxation. ResultsCompared to the LI group, the HI group had a greater reduction rate in the PSQI score [25.2 % (18.8 % to 31.7 %), P < 0∙001], shorter sleep latency (P = 0.001), lower frequency of sleep medication (P < 0.001), lower PSQI scores (P < 0.001), and higher GWB scores (P < 0.001). There were significant differences in all indicators in the HI group vs. HC group and in the LI group vs. LC group. In the first five relaxation training sessions, there was no statistically significant difference in the proportion of α waves between the LI group and the LC group; however, from the sixth session onward, we observed a statistically significant difference (t = 2.86, P = 0.019)，while The HI group and HC group showing significant differences in the first relaxation training session (t = 4.464, P < 0.001). There was a statistically significant difference in subjective satisfaction between the intervention group and the control group (x2 = 49.605, P < 0.001). ConclusionIn this study, we found that most elderly people benefitted from RRMT regardless of their vividness of visual imagery. However, low-visualizers experienced slower and less effective results, so these patients may benefit more from alternative approaches.

Dynamic and Transdiagnostic Risk Calculator Based on Natural Language Processing for the Prediction of Psychosis in Secondary Mental Health Care: Development and Internal-External Validation Cohort Study

BackgroundAutomatic transdiagnostic risk calculators can improve the detection of individuals at risk of psychosis. However, they rely on assessment at a single point in time and can be refined with dynamic modeling techniques that account for changes in risk over time. MethodsWe included 158,139 patients (5007 events) who received a first index diagnosis of a nonorganic and nonpsychotic mental disorder within electronic health records from the South London and Maudsley National Health Service Foundation Trust between January 1, 2008, and October 8, 2021. A dynamic Cox landmark model was developed to estimate the 2-year risk of developing psychosis according to the TRIPOD (Transparent Reporting of a multivariate prediction model for Individual Prognosis or Diagnosis) statement. The dynamic model included 24 predictors extracted at 9 landmark points (baseline, 0, 6, 12, 24, 30, 36, 42, and 48 months): 3 demographic, 1 clinical, and 20 natural language processing–based symptom and substance use predictors. Performance was compared with a static Cox regression model with all predictors assessed at baseline only and indexed via discrimination (C-index), calibration (calibration plots), and potential clinical utility (decision curves) in internal-external validation. ResultsThe dynamic model improved discrimination performance from baseline compared with the static model (dynamic: C-index = 0.9; static: C-index = 0.87) and the final landmark point (dynamic: C-index = 0.79; static: C-index = 0.76). The dynamic model was also significantly better calibrated (calibration slope = 0.97–1.1) than the static model at later landmark points (≥24 months). Net benefit was higher for the dynamic than for the static model at later landmark points (≥24 months). ConclusionsThese findings suggest that dynamic prediction models can improve the detection of individuals at risk for psychosis in secondary mental health care settings.

Melatonin in infants—physiology, pathophysiology and intervention options

AbstractThe effectiveness of melatonin in nonorganic sleep disorders in children and adolescents has been examined in 33 randomised controlled studies [1]. This review presents the current state of knowledge on the physiology, pharmacokinetics, pathophysiology and toxicity of melatonin in infancy based on well-documented studies. Up to the third month of life, premature and full-term babies cannot produce their own melatonin, so they are dependent on exogenous supply via their own mother’s breast milk, non-pooled breast milk or non-pooled formula. Non-pooled means that a distinction should be made between melatonin-rich night milk and melatonin-poor day milk. A number of intervention studies indicate that administration of melatonin to infants may have analgesic and antioxidant effects related to ophthalmological examinations, prevention of bronchopulmonary dysplasia, and the treatment of hypoxic ischaemic encephalopathies. Since melatonin concentrations in the mother’s blood, in breast milk and, e.g., also in cow’s milk show regular day–night fluctuations, and since breastfed infants have a more stable melatonin supply and fewer sleep disorders, infants who cannot be breastfed by their own mother should preferably have chrononutrition made from non-pooled human or cow’s milk. There has recently been evidence that infantile colic is a disorder with delayed development of chronobiological rhythms.

Acting and Dancing during the COVID-19 Pandemic as Art Therapy for the Rehabilitation of Children with Behavioural Disorders Living in Socially Disadvantaged Environments.

Art therapy is employed in numerous ways in rehabilitation. This study focuses on an art and movement therapy project carried out during the COVID-19 pandemic. Acting and dancing methods were adapted to produce a short musical film series for ten children from disadvantaged social backgrounds displaying nonorganic behavioural disorders. The aim was to acquire novel ways of expression on the part of the participants to release painful emotions in a safe setting using the method of catharsis through acting and dancing, triggering relaxation as a physiological response and improving their attitude. This study retrospectively analyses the changes in the children's behaviour and their active participation in the project through quantitative and qualitative research. The children improved their attention and self-esteem, their behaviour became less aggressive and impulsive, and half showed increased empathy. The active participation rate during the project was 82%.

Case report: Three characteristics of tyrosine kinase inhibitor-associated cerebrovascular stenosis. High threshold for infarction, atypical infarct area, and vascular recoverability under the use of ponatinib

While tyrosine kinase inhibitors (TKI)-associated cerebral vascular stenosis (CVS) exhibit distinct mechanisms compared to conventional stroke in basic research, the clinical strategy remains nearly the same other than TKI-switching. We present the case of a 22-year-old female with chronic myeloid leukemia without stroke risk factors, who developed ponatinib-associated CVS. Three potential characteristics of TKI-associated CVS were identified: a heightened threshold for infarction, an atypical infarct area, and vascular recoverability. Specifically, brain computed tomography remained normal despite 20 h of severe hemiplegia. The ischemic distribution was confined in gray matter and the anterior cerebral artery territory on magnetic resonance imaging, despite severe stenosis of the internal carotid artery. Ischemic changes resolved within 10 days and arterial stenosis improved after ponatinib withdrawal. These unique features, distinct from typical stroke, could lead to misdiagnosis as non-organic neurological disorders or other conditions in ponatinib-treated patients.

The results of a study of the causes and correlations between stress and sleep disorders by medical professionals

IntroductionProlonged exposure to stress can adversely affect mental health and lead to mental illness, which can adversely affect the provision of medical care. It has been determined that sleep disturbances affect physical and mental health and negatively affect daily activities. Therefore, we conducted this study with the assumption that it is an opportunity to improve health care by examining the prevalence of stress in the medical profession and identifying its causes.ObjectivesTo study the prevalence of stress and sleep disorders among doctors and medical professionals in Selenge Province General Hospital2. Identify some factors affecting stress and sleep disorders and their relationshipMethodsUsing SRQ20, PHQ9, GAD7, and sleep disturbance questionnaires issued by WHO for doctors of primary health care institutions, according to the analytical research model, the ethics committee with the informed consent form, and the research was conducted.ResultsDoctors and medical professionals aged 23-65 participated in the study, the average life expectancy was 37.05 years. 44.44% are stressed. 8% of stressed people had severe stress, 18.89% had no sleep disorder and 81.11% had a sleep disorder. 46.67% of those with sleep disturbances had mild sleep disturbances. But 34.44% had sleep disorders. 30% had a non-organic sleep disorder, 5.56% had lucid dreaming disorder, and 3.33% had non-organic insomnia. According to the correlation analysis, the SRQ20 stress score GAD7 anxiety score is r=0.76, the PHQ9 score is r=0.74, the sleep disturbance score is r=0.68, the satisfaction score is r=-0.44, the sleep disturbance score GAD7 score r=0.75, a moderate positive correlation with the PHQ9 depression score r=0.45, and a weak inverse correlation with the satisfaction score r=-0.24 was related. In the composite linear regression analysis, the stress score increased by 116.2% when the stress problem score increased by one, the anxiety problem score increased by 44.34%, the body shape problem screening questionnaire increased by 82.86%, and the depression problem score increased by one. 73.18% per increase of one, and 7.18% per increase of PHQ9 depression score was statistically significant. On the other hand, the sleep disorder score increases by 127.05% when the stress problem score increases by one, the anxiety problem score increases by 120.79% and the body shape problem detection questionnaire score increases by one.ConclusionsDoctors and medical professionals need to increase their coping skills, psychiatric examination and diagnosis, and psychological counseling. Also, by implementing the right lifestyle habits, most of the sleep disorders of doctors and medical professionals can be normalized by themselves. Stress is associated with depression, anxiety, sleep disturbances, years of work, relationship satisfaction, psychological problems, and depression.Disclosure of InterestNone Declared

Psychiatric disorders and mortality due to external causes following diagnosis of endometriosis at a young age: a longitudinal register-based cohort study in Finland

BackgroundEndometriosis diagnosed in adults is associated with increased risk of various psychiatric disorders. However, little is known concerning psychiatric comorbidity and mortality due to external causes associated with endometriosis diagnosed at a young age. Objective(s)In this longitudinal cohort study, we investigated the link between surgical diagnosis of endometriosis at a young age, and subsequent psychiatric disorders and mortality due to external causes. Additionally, we compared the occurrence of the most common psychiatric disorders between different sites of surgically confirmed endometriosis (ovarian versus other) due to possible different pain manifestations. Study DesignWe conducted a retrospective register-based cohort study. Altogether 4532 women with surgically confirmed diagnosis of endometriosis before the age of 25 in 1987–2012 were identified from the Finnish Hospital Discharge Register and matched with women without surgically diagnosed endometriosis for age and municipality on the index day (n=9014). Women were followed from the index day until the end of 2019 for the outcomes of interest, which included nine groups of psychiatric disorders (inpatient episodes since 1987, outpatient episodes since 1998) and death due to external causes, including deaths due to accidents, suicides, and violence (Finnish Register of Causes of Death). Cox proportional hazard models were applied to assess the crude and parity-adjusted hazard ratios and 95% confidence intervals. ResultsThe cohort’s median age was 22.9 years (interquartile range: 21.3–24.1) at the beginning and 42.5 years (36.7–48.3) after a median follow-up time of 20.0 years (14.5–25.7). We observed a higher hazard of depressive, anxiety, and bipolar disorders in women with endometriosis compared to the reference cohort. These differences appeared early and remained the same during the entire follow-up, irrespective of whether assessed from the data on inpatient episodes only, or using data on both in- and outpatient episodes. The corresponding adjusted hazard ratios were 2.57 (95% confidence interval 2.11–3.14) and 1.87 (1.65–2.12) for depressive disorders, 2.40 (1.81–3.17) and 2.09 (1.84–2.37) for anxiety disorders, 1.71 (1.30–2.26) and 1.66 (1.28–2.15) for bipolar disorders, respectively. A higher hazard was seen for nonorganic sleeping disorders for the first ten years only (3.83, 2.01–7.30) when assessed using the data on both in- and outpatient episodes. When based on inpatient records, a higher hazard for alcohol/drug dependence after 15 years of follow-up (2.07, 1.21–3.54) was observed. The difference in hazard for personality disorders tended to increase during follow-up (<10 years 2.12, 1.28–3.52; 10 years or more 3.08, 1.44–6.57). Depressive and anxiety disorders occurred more frequently in women with other than ovarian endometriosis. No difference in deaths due to external causes was observed between the endometriosis and reference cohorts. Conclusion(s)Surgical diagnosis of endometriosis at young age associated with increased incidence for several psychiatric disorders. Moreover, within the endometriosis population, psychiatric comorbidity was more common in women with other than ovarian endometriosis. We speculate that chronic pain is essential in the development of these psychiatric disorders, and that early and effective pain management is important in reducing the risk of psychiatric morbidity in young women. More research concerning the associations and management of endometriosis and associated psychiatric disorders is warranted.

Impact of lipodystrophy on health-related quality of life: the QuaLip study

BackgroundLipodystrophy is a rare disease characterized by loss of adipose tissue. Natural history studies have demonstrated significant burden of disease; however, there is limited data on the impact of lipodystrophy on quality of life (QoL) and psychoemotional well-being. The QuaLip study is a prospective observational real-world study that aims to determine the impact of lipodystrophy on QoL and psychoemotional well-being and explore subjective burden of the disease. Sixty-seven adult patients and eight pediatric patients with lipodystrophy were included. Patients were followed up for 24 months and assessments were repeated every three months. Patients were examined by licensed psychiatrists at baseline, and at year 1 and year 2 visits.ResultsEighteen (27.69%) of 65 adult patients (two subjects refused psychiatric assessment) were diagnosed with a psychiatric disorder (e.g., depressive episodes, mixed anxiety and depressive disorder, anxiety disorder, adjustment disorder, recurrent depression, panic disorder, generalized anxiety disorder, unspecified mood disorder, nonorganic sleep disorder, post-traumatic stress disorder, depressive episode comorbidity, social phobia and obsessive–compulsive disorder comorbidity). Lipodystrophy disease and QoL questionnaires revealed a significant disease burden over the study period. More than one-third of patients reported depression symptoms on the Beck Depression Inventory and more than one-fourth of the patients reported significant hunger throughout the study period. Physical appearance, fatigue, and pain contributed to the disease burden. QoL scores were lower in patients with psychiatric disease and in those with poor metabolic control. Attention deficit hyperactivity disorder, depressive disorder, sub-threshold depressive symptoms, obsessive–compulsive disorder, appetite problems, and issues with physical appearance were identified in selected pediatric subjects.ConclusionsLipodystrophy has a significant impact on QoL and psychoemotional well-being. Psychiatric disorders seem to be underdiagnosed among patients with lipodystrophy.

Diagnostic psychiatric and somatic comorbidity in patients with depression in the Western Balkan countries.

This paper aims to examine the frequency and significance of diagnostic comorbidity of psychiatric disorders and somatic diseases in a sample of patients with depression as well as present current psychopharmacological treatment of the patients in the sample. The subjects in this study sample were 489 patients from the four Western Balkan countries with current primary diagnosis of major depression according to ICD 10. Comorbid psychiatric disorders and non-psychiatric illnesses were noted according to ICD 10 criteria during the diagnostic interview and analysed later. Additionally, the pharmacological treatment (existing and newly introduced) for each patient was noted and analysed later. At least one comorbid psychiatric disorder was present in 72.5% of patients. The most frequent were anxiety disorders (53.6%), specifically generalized anxiety disorder (20.2%); non-organic sleep disorders (50.7%), specifically insomnia (48.4%); and sexual dysfunctions (21.4%), specifically lack of sexual desire (20.2%). Comorbidity with any non-psychiatric illness was present in 80.3% of patients. The most frequent were circulatory system diseases (55.9%), specifically hypertension (45.9%); endocrine, nutritional and metabolic disorders (51.3%), specifically hyperlipidaemia (24.0%); and other non-psychiatric disorders (60.7%), specifically low back pain (22.7%). All patients received pharmacological treatment with different medications. Most patients received monotherapy or combination therapy of antidepressants, anxiolytics, antipsychotics and antiepileptics. The most frequently used antidepressants were escitalopram, sertraline, and duloxetine. The most frequently used anxiolytics were alprazolam and diazepam, the most used antiepileptic was pregabalin, and the most used antipsychotics were olanzapine, quetiapine, and aripiprazole. The results of the study confirm the results of previous research studies about the high prevalence of psychiatric and non-psychiatric comorbidities in patients with depression that were conducted in the past. It would be important if future studies could prove the importance of those comorbidities on clinical severity, choice of treatment, and its outcome in patients with depression.

Mortality Among Psychiatric Inpatients in a Nigerian Teaching Hospital: A 40-year review

Background: Regularly monitoring mortality rates among psychiatric inpatients is essential for evaluating the effectiveness of healthcare services and subsequently improving healthcare delivery. Prior research in Nigeria focused on psychiatric hospitals, and no published data exist on inpatient psychiatric mortality in Nigerian teaching hospitals. This study aimed to investigate mortality and its associated factors among inpatients admitted to the psychiatric unit of a teaching hospital in Nigeria. Methods: A register-based descriptive retrospective design was used for this study. Review of the records of all patients who died while on admission between 1977 and 2017 was carried out. Results: Among 6490 admissions to the psychiatric unit over 40 years, 46 patients (0.71%) died during their admission, resulting in a mortality rate of 1.15 deaths per year. The age of death ranged from 18 to 90 years, with an average of 48.8 years (standard deviation 18.5). Females comprised a larger proportion of deaths (76.1%, M ratio = 1:3.2). Psychotic disorders were the most frequent diagnoses (35.0%), with acute psychosis being the most common (25.0%), followed by depression (20.0%). Notably, a higher proportion of patients with organic disorders (75.0%) died within two weeks of admission compared to those with non-organic disorders (61.5%). Conclusion: This 40-year study at a Nigerian teaching hospital revealed a low mortality rate (0.71%) for psychiatric patients. Females had a higher mortality rate than males, and most deaths occurred within the first two weeks of admission, particularly for patients with organic diagnoses. Psychotic disorders were the most prevalent diagnoses, followed by depression and bipolar disorder. These findings highlight the need for enhanced early identification and intervention strategies for high-risk patients.

Current perspectives on endometrial receptivity: A comprehensive overview of etiology and treatment.

Recurrent implantation failure (RIF) remains a challenging problem in assisted reproductive technology (ART). Further insights into uterine abnormalities that can disturb embryo implantation should be obtained. This review provides an overview of the effects of organic and non-organic uterine disorders on endometrial receptivity. The results suggest that various uterine pathologies can lead to defective embryo implantation via multiple mechanisms. In particular, uterine adenomyosis dysregulates molecular and cellular interactions that are vital for successful embryo implantation with a background of chronic inflammation, which may be alleviated by pretreatment with a gonadotropin-releasing hormone agonist. Uterine myomas can cause endometrial deformation and adverse alterations in uterine contractility. Nonetheless, the effectiveness of myomectomy remains debated, and endometrial polyp removal may be considered, particularly in patients with RIF. Chronic endometritis abrogates the appropriate uterine immunological environment critical for embryo implantation. Abnormal endometrial microbiota have been suggested to influence endometrial receptivity; however, supporting evidence is currently scarce. Platelet-rich plasma therapy may be a potential treatment for thin endometria; nevertheless, further validation is required. Endometrial receptivity analysis can detect dysregulation of the window of implantation, and new non-invasive methods for predicting endometrial receptivity have recently been proposed. However, numerous issues still need to be fully clarified. Further clinical and basic studies are necessary to investigate the pathophysiology of defective endometrial receptivity and identify optimal treatments for patients undergoing ART, especially those with RIF.

Nonorganic sleep disorders and sleep quality among the general population of Mongolia

The aim of this study was to determine the prevalence of non-organic sleep disorders and sleep quality, using a structured psychiatric interview following screening through the Pittsburgh Sleep Quality Index (PSQI) among the general population. This nationwide population-based cross-sectional study was carried out between August and October 2020 and involved 964 participants (74% women, mean age: 40.72±14.34) who were randomly selected from 64 clusters in 10 sites of Mongolia. 27.9% of the study participants were evaluated as having non-organic sleep disorders based on the diagnostic guidelines of the International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10). The prevalence of non-organic sleep disorders differed in age (p&lt;0.001). Non-organic sleep disorders were related to age, employment, diastolic blood pressure, sleep quality, and quality of life. The prevalence of non-organic sleep disorders in the general population of Mongolia was calculated as 27.9%, while the prevalence rate of the poor sleep quality was 42.2%.

Levels of Neurospecific Peptides, Neurotransmitters and Neuroreceptor Markers in the Serum of Children with Various Sensory Disorders, Mild Cognitive Impairments and Other Neuropathology

Background. The role of recently discovered neurospecific peptides in the pathogenesis of acute and progressive neurologic disorders, their neuroprotective features, and possibilities to use them as markers for the course and prognosis of certain diseases have been actively studied in recent decades. However, neurospecific peptides are almost not studied in chronic residual diseases. In our study we measured the levels of neurospecific peptides and some other markers to achieve understanding of general neurophysiological trends in congenital and acquired chronic non-progressive brain pathology with reference to the selection of relevant groups — study objects. Objective. The aim of the study is to study patterns of neurospecific peptides, neurotransmitters and neuroreceptor markers distribution in the serum of children with various pathogenetic variants of chronic neuropathology. Methods. The study included children from 3 to 16 years old with different pathologies. The sample was divided into groups by pathology type: no sensory and neurological disorders, congenital sensory deficit due to mutation of genes expressed and not expressed in the brain, early acquired sensory deficit of multifactorial nature, congenital mild and severe organic disorders of central nervous system (CNS) in residual stage without baseline sensory deficit, acquired functional CNS disorders without baseline organic defect and sensory deficit. The following laboratory data (neurophysiological components) was studied: nerve growth factor, brain-derived neurotropic factor, neurotrophin-3, neurotrophin-4, neuregulin-1-beta-1, beta-secretase, sirtuin-1, synaptophysin, neuronal nitric oxide synthase, and anti-NR2 glutamate receptor antibodies. The parameters of cognitive activity, sense of vision, sense of smell, and acoustic sense were also evaluated. Results. The study included 274 participants. Neuropeptides and markers have shown a variable degree and range in the group spectrum of differences from normal levels. The most variable in the examined sample was NO-synthase, as well as levels of both neurotrophins, beta-secretase, and glutamate receptor marker. All visual deficits were associated with increased NO-synthase levels (p &lt; 0.001). Neuroplasticity peptides (beta-secretase, neurotrophin-3 and 4) have been activated in all pathological conditions. Nerve growth factor and brain-derived neurotropic factor were specifically activated in mild organic CNS lesions (mild cognitive impairments), while neuregulin — in congenital genetically determined visual deficits. There was no specific activation of neuropeptides and NO-synthase level tended to decrease in cases of severe CNS lesions. Conclusion. The study results suggest that all types of early visual impairment are associated with increased physiological neuronal activity, and non-organic neurological functional disorders — mainly with increased physiological synaptic activity. General neuroplasticity processes were activated in all cases of visual deficits but more specific. However, more specific and well-studied processes were activated in mild organic CNS lesions, and neuroplasticity processes did not activate adequately in severe organic CNS lesions probably due to the limited neuronal and synaptic resources.

Seasonal patterns of sickness absence due to diagnosed mental disorders: a nationwide 12-year register linkage study.

Although seasonality has been documented for mental disorders, it is unknown whether similar patterns can be observed in employee sickness absence from work due to a wide range of mental disorders with different severity level, and to what extent the rate of change in light exposure plays a role. To address these limitations, we used daily based sickness absence records to examine seasonal patterns in employee sickness absence due to mental disorders. We used nationwide diagnosis-specific psychiatric sickness absence claims data from 2006 to 2017 for adult individuals aged 16-67 (n=636,543 sickness absence episodes) in Finland, a high-latitude country with a profound variation in daylength. The smoothed time-series of the ratio of observed and expected (O/E) daily counts of episodes were estimated, adjusted for variation in all-cause sickness absence rates during the year. Unipolar depressive disorders peaked in October-November and dipped in July, with similar associations in all forms of depression. Also, anxiety and non-organic sleep disorders peaked in October-November. Anxiety disorders dipped in January-February and in July-August, while non-organic sleep disorders dipped in April-August. Manic episodes reached a peak from March to July and dipped in September-November and in January-February. Seasonality was not dependent on the severity of the depressive disorder. These results suggest a seasonal variation in sickness absence due to common mental disorders and bipolar disorder, with high peaks in depressive, anxiety and sleep disorders towards the end of the year and a peak in manic episodes starting in spring. Rapid changes in light exposure may contribute to sickness absence due to bipolar disorder. The findings can help clinicians and workplaces prepare for seasonal variations in healthcare needs.

Prevalence and Treatment Patterns of Sleep Disorders in the Under 20 Population: analysis using a national health insurance claims database.

ObjectivesChild and adolescent sleep is an important factor for brain and physical development. Therefore, it is necessary to investigate the prevalence of sleep disorders and nonorganic sleep disorders in children and adolescents and determine the type of utilization of medical institutions. This study analyzed the prevalence and type of medical institutions in Korean children and adolescents with sleep disorders and nonorganic sleep disorders.MethodsThis study used data recorded in the Health Insurance Review and Assessment-National Patient Sample (HIRA-NPS) database from 2010 to 2017. Details of medical institution type and patient’s sex, age, and treatment type were extracted for patients younger than 20 years with sleep disorders and nonorganic sleep disorders.ResultsAmong 2,536,478 patients under age 20, we identified 3,772 patients with sleep disorders or nonorganic sleep disorders. From 2010 to 2017, the prevalence of sleep disorders in children and adolescents was 0.07% to 0.09%. The utilization rate of Korean medical institutions was 30.47%. The prevalence of nonorganic sleep disorders and the utilization rate of Korean medical institutions were 0.06% to 0.08% and 45.99%, respectively.ConclusionThe prevalence of sleep disorders and nonorganic sleep disorders in the under-20 population was 0.14% to 0.16%. More than 70% of patients with nonorganic sleep disorder who were younger than 9 years used Korean medical institutions.