Panic States Research Articles

Clinical features of depressive states in eating disorders

IntroductionEating disorders (ED) are one of the most pressing problems of modern society. Eating disorders, due to their heterogeneity, can be considered both an independent form of mental disorders and as part of the manifestations of other mental illnesses. In the vast majority of cases within these pathologies, eating disorder coexists with depressive symptoms, which significantly worsens the prognosis of the disease.ObjectivesIdentification of the association of depressive disorders with eating disorders to improve the criteria for nosological diagnosis, prognosis and therapeutic approaches.MethodsA total of 74 patients aged from 15 to 25 years old (all female, average age 16.2), who were on outpatient and inpatient observation of the clinic were studied.ResultsThe study made it possible to establish the characteristics of depressive disorders and the nature of the current course of depression associated with eating disorders. In eating disorders with a predominance of anorexia nervosa, the structure of depression was more dominated by the asthenia radical with symptoms of apathy, melancholia, anhedonia, irritability, episodes of anxiety after eating, and sleep disturbances. Patients noted a decrease in performance, mental activity, and a narrowing of their range of interests and communication. Depression became severe as exhaustion progressed. For eating disorders with bulimia nervosa. depressive states varied in the severity and polymorphism of their manifestations. Their structure was largely dominated by the apatho-adynamic radical of affect, along with asthenia and anxiety, which often reached the level of panic states. Often, along with this, there were pronounced a guilt feeling and low self-esteem ideas with self-deprecation and self-hatred, which led to the manifestation of auto-aggressive behavior (both non-suicidal and suicidal). Depression reached a severe degree as exhaustion progressed, as well as against the background of more frequent attacks of overeating and vomiting.ConclusionsThe identified associations between depressive disorders and eating disorders allow us to form a clearer picture of the expected course of psychiatric disease and optimize therapeutic intervention algorithms.Disclosure of InterestNone Declared

Panic Detection Using Machine Learning and Real-Time Biometric and Spatiotemporal Data

It is common sense that immediate response and action are among the most important terms when it comes to public safety, and emergency response systems (ERS) are technology components strictly tied to this purpose. While the use of ERSs is increasingly adopted across many aspects of everyday life, the combination of them with real-time biometric and location data appears to provide a different perspective. Panic is one of the most important emergency indicators. Until now, panic events of any cause tend to be treated in a local manner. Various attempts to detect such events have been proposed based on traditional methods such as visual surveillance technologies and community engagement systems. The aim of this paper is twofold. First, it presents an innovative multimodal dataset containing biometric and spatiotemporal data associated with the detection of panic state in subjects that perform various activities during a certain period. For this purpose, time-enabled location data are combined with biometrics coming from wearables and smartphones that are analyzed in real-time and produce data indicating possible panic events that are geospatially described. Second, the proposed dataset is used to train various machine learning models, and their applicability to correctly distinguish panic states from normal behavior is thoroughly examined. As a result, the Gaussian SVM classifier ranked first among seven classifiers, achieving an accuracy score of 94.5%. The dataset was also tested in a deep learning framework, achieving an accuracy level of 93.4%. A long short-term memory approach was also used, which reached a top accuracy of 94%. Moreover, the contribution of the various biometric and geospatial features is analyzed in-depth to determine their partial importance in the overall panic detection process. This is moving towards the creation of a smart geo-referenced ERS that could be used to inform the authorities regarding a potentially unpleasant event by detecting possible crowd panic patterns and helping to act accordingly, getting the information right from the source of the event, the human body. The proposed dataset is freely distributed to the scientific community under the third version of GNU General Public License (GPL v3) through the GitHub platform.

THEORETICAL FOUNDATIONS AND PRACTICAL APPROACHES TO PREVENTING AND OVERCOMING THE NEGATIVE MENTAL CONSEQUENCES OF CRISIS SITUATIONS IN THE POPULATION DURING THE WAR

Purpose - to present an analysis of the theoretical foundations and practical approaches to preventing and overcoming the negative mental consequences of crisis situations in the population during the war.
 Material and methods -The study used the bibliographic method, as well as the method of analysis and synthesis of scientific materials from scientific sources.
 Results and discussion. The results of our study showed that it is important for specialists involved in the organization and provision of crisis psychological assistance to take into account that in traumatic situations, victims and their relatives are in dire need of information, social, medical and other types of assistance. Orientation is towards an integrated approach in providing assistance contributes to a more rapid recovery of the pre-crisis functional state of a person, his ability to adequately perceive reality, greater self-control of behavior in a crisis situation and a decrease in the likelihood of mental disorders and psychosomatic diseases as a result of a traumatic experience.
 Of particular importance in the provision of emergency psychological assistance are theoretical ideas about mental (cognitive, emotional, behavioral, etc.) changes caused by the influence of extreme, crisis situations. In the cognitive-cognitive sphere of a person, there are violations of perception, attention, thinking, memory. There are serious negative changes in volitional actions (decision-making, control, self-regulation). On the part of the emotional sphere, there are anxiety, panic states, fear, horror, aggression, anger, guilt, shame, depression, apathy, etc. Among somatovegetative disorders there are loss of appetite, sleep disturbance, a sharp weight decrease (or increase), a decrease in the overall tone of the body, flabbiness, muscle tension, trembling, etc. are observed. In behavioral manifestations, there is a general disorganization, which manifests itself in the loss of purposefulness of behavior, its controllability by a person; aimless increased activity prevails or, on the contrary, passivity, lethargy. In the sphere of social interaction, aggressive behavior, conflict, the search for the perpetrators and blaming others, alienation, social isolation, etc. are often observed.
 Conclusion. Being in crisis conditions and experiencing the traumatic consequences of war, a person experiences a whole range of negative emotional states. Mental processes and states experienced by a person as a result of a crisis event are characterized by the obsessive reproduction of the traumatic experience, which is embodied in symptomatic behavior, and is caused by the desire to avoid repeating the emotional experiences that took place during the traumatic event. The central idea of ​​the vast majority of theoretical and practical approaches to overcoming the traumatic consequences of crisis events is that the use of certain psychotechniques should deprive a person of experiencing negative emotional manifestations and behavior aimed at avoiding everything that can remind of the experience, or at least weaken these symptoms.

Influence of physical activity on psychological states in adults during the covid-19 pandemic

Introduction: Long periods of home confinement may lead to fear, panic, anxiety, and depression states, which, in turn, could drive to a reduction of active lifestyles. Objetive: To determine the association between the characteristics of the physical activity performed and the risk of experiencing mental health issues among peopleduring confinement. Methods: A multicenter, cross-sectional, and observational study design was conducted in Iberoamerican countries with a sample of 4,948 participants, selected through a snowball sampling technique. The study started on March 15th, 2020, and was completed in August 2020 through an online survey that includeddemographic and medical data, mental health status, and physical activity characteristics. Results: Brazilianwomen aged between 18 and 29 who stayed at home more than 19 hours per day presented a relevant higher risk for all the mental health problems analyzed in this study. A low level of physical activity during the isolation period presents the highest probability of depression compared to higher levels (OR = 1.317). In addition, using a no professional resource to do physical activity is a predictive factor of adverse mental health status (OR Anxiety= 1.396, OR Depression = 1.452, and OR Stress = 1.220). Conclusions: A low level of physical activity during a long isolation period is associated with a higher prevalence of depression, and the use of professional resources for physical activity may be a protective factor for mental health disorders.

Post-Covid-19 mental health issues in Obstetrics & Gynecology health care professionals of Lady Reading Hospital, Peshawar

Introduction: Pandemics and Epidemics are usually known for acute anxiety and even panic states, yet it has been documented that psychological effects remain in the post-pandemic period as well. These effects can impact not only the working capacity of individuals, but also their general and social wellbeing.
 Objective: To assess the mental health in terms of anxiety and depression in health care professionals (HCP) who have recovered from COVID 19.
 Materials & Methods: A descriptive study was conducted in the department of Obstetrics & Gynecology of Lady Reading Hospital, Peshawar from March to August 2020 on 34 health care workers who had confirmed COVID 19 (positive PCR on nasopharyngeal swab) and recovered by repeat negative PCR on nasopharyngeal swab, had joined their duties, and were 3 months post-covid. Persons with prior mental health issues and on psychiatric medication were excluded. After permission from Hospital Ethical Board, informed consent for inclusion in the study was taken from subjects. The Hospital Anxiety Depression Scale (HADS), was filled by all subjects; they were categorized as either suffering from anxiety/depression or normal based on the inbuilt scoring system. Data were analyzed using SPSS version 20 for descriptive statistics.
 Results: Anxiety and depression scores based on HADS questionnaire were calculated and following are the percentages of participants with borderline anxiety score (32.5%), abnormal anxiety score (23.4%), borderline depression score (26.5%), and abnormal depression scores (32.4%).
 Conclusion: Post-covid mental health assessment is likely to reveal a sizeable number of health care workers showing long term effects of Covid-19, who could be candidates for rehabilitation psychotherapy.

The Depression Sensitivity Index: Initial Development and Tests of Convergent and Construct Validity

Background: Depression and suicide are prominent and increasing U.S. public health issues, which suggests novel assessment and treatment approaches are needed. Reiss’ Expectancy Model of Fear, Anxiety, and Panic states that fear is based on two classes of variables, expectations and sensitivities, which has led to much research on anxiety sensitivity as a significant risk factor for later anxiety psychopathology. Major depressive disorder also includes biased expectations and sensitivities; however, a depression sensitivity rooted in Expectancy Theory has never been formalized. Uncovering depression-related sensitivities may lead to earlier risk detection and prevention before mood disorders develop. Method: The goal of the paper was to create a Depression Sensitivity Index using exploratory factor analysis and item response theory and then conduct tests of convergent and construct validity using structural equation modeling using three independent samples. Results: indicated two lower order factors: 1) physical and cognitive concerns (DSPCC) and 2) social concerns (DSSC). Factors showed incremental associations with depression (DSPCC), social anxiety (both) and suicidal thoughts and behaviors (DSPCC), above and beyond anxiety sensitivity cognitive concerns. Both factors together predicted depressive disorder diagnoses Limitations: Mostly self-report data, large percentage of non-Hispanic White participants in Study 1. Conclusions: The results offer initial evidence that expectancy theory applies beyond “fear, anxiety, and panic” and that with further development depression sensitivity could be an important intervention target for prevention of major depressive disorder and suicidal thoughts and behaviors.

COVID-19 Epidemic and Its Impact on Economy and Society

The COVID-19 epidemic has had a huge impact on nations particularly the nationwide lockdowns that have brought social and economic life to a standstill. An environment that has once buzzed with events has fallen silent and all the resources have been redirected to face the unprecedented crisis. Although lockdown and social distancing lead, on the one hand, to a loss of competitiveness, they lead, on the other hand, to a dramatic drop in consumer demand for products and services in the economy, leading to a fall in economic activity. However, the only cost-effective methods available for preventing the spread of COVID-19 are lockdown and social distancing. This research therefore aimed to examine the influence of COVID-19 on the life of the person as a whole.The key objectives of the research are as follows:1. To study the impact on the economy of the COVID-19 epidemic2. Identifying the effects on fishermen and migratory labour of the COVID-19 epidemic3. To highlight the epidemic of COVID-19 and to influence society and family life4. To evaluate the effect of epidemic preparations and preventive measures for COVID-19 in India.This research is focused on secondary information obtained from multiple sources such as journal articles, magazines, the internet, newspapers, books and studies published and unpublished by different governmental bodies, non-governmental organisations and the Commission.The Corona virus pandemic severely affects the lives of individuals as a whole. The serious effects of this condition are directly or indirectly faced by everyone in the world. Unprecedented lockdowns and emergencies have been declared by many nations. The government shuts down schools, colleges, universities, the market for pubs, the mall, the shopping centre, etc. In developed and emerging societies, an atmosphere of fear, anxiety and stress has been established. This disorder, however, causes many other problems due to its intense isolation and lockdown steps, including social anxiety, panic states due to instability, economic recessions and extreme mental stress. Coordinated measures are needed to contain this virus, and individuals need to make uncomfortable but important adjustments to their everyday routine in compliance with the government and WHO's advice and suggestions. This would provide medical personnel with more opportunities to intervene efficiently with the limited resources available to them and to purchase considerable time to position additional resources for the managed management of this current epidemic.

Investigation of people’s behavior and psychology during the COVID-19 epidemic in Deyang, Sichuan

Objective To understand Deyang people’s knowledge, behavior changes and psychological state during coronavirus disease 2019 (COVID-19) pandemic, and provide scientific basis for the government and individuals to take effective measures. Methods A total of 1 380 people in Jingyang District of Deyang City were investigated by online questionnaire. SPSS 23.0 software was used for statistical analysis. Results People’s mode of acquiring relevant knowledge through traditional TV, radio and newspaper has changed to TV, Internet, WeChat, and Tik Tok. In addition to ventilation and panic buying mask and disinfectant, the general public has positive behavior for COVID-19 pandemic, especially those with higher education and higher education level. The differences are statistically significant (all P <0.01). In terms of people’s psychological state, those who feel fear and pessimism and disappointment have lower education background than those of high school and below; those who are worried about infection, worried about family health, depressed mood, irritable and angry have higher education background than those of high school and below, with statistical significance (all P <0.05). There are seven main reasons for residents′ fear, the proportion of college degree or above is higher than that of high school degree or below in fear reasons of strong infectivity, long incubation period and infectivity, increasing number of suspected cases, lack of medicines and protective substances (all P <0.05). Conclusion During the epidemic period, there are panic, anxiety, pessimism and other psychological states in Deyang people. It is very important to take targeted health education strategies and measures to effectively prevent and control the spread of disease, and pay attention to the prevention and control of psychological diseases caused by the epidemic. 摘要：目的 了解新型冠状病毒肺炎流行期间德阳市民众掌握相关知识的情况、行为变化及心理状态，为政府和 个体采取有效的措施提供科学依据。 方法 采用网上问卷的方式调查德阳地区民众 1 380 人，利用 SPSS 23.0 软件进行 统计分析。 结果 人们由传统的电视、广播、报纸等途径获得相关知识发展为以电视、网络、微信、抖音等获得；除了通 风及抢购口罩和消毒液以外，普遍大众都持积极行为表现，尤其是大专及以上文化程度者明显高于高中及以下文化程 度者，差异有统计学意义（ P <0.01）;人们心理状态方面：感到恐惧和悲观失望者大专及以上学历低于高中及以下学历； 担心传染、担心家人健康、心情压抑、易怒发脾气者大专及以上学历均高于高中及以下学历，差异有统计学意义（ P < 0.05）；居民产生恐惧心理的主要原因有 7 项，其中传染性强、潜伏期长且具传染性、疑似病例增多、药品及防护物质缺 乏等项目上大专及以上学历者所占比例均高于高中及以下学历者，差异有统计学意义（ P <0.05）。 结论 疫情期间，德 阳民众普遍存在恐慌、焦虑、悲观等心理状态，应采取有针对性的健康教育策略和措施，对有效预防控制疾病传播非常 重要，同时还要注重防止因疫情引起的心理疾病发生。

Momentum crashes and variations to market liquidity

AbstractWe document that the variation in market liquidity is an important determinant of momentum crashes that is independent of other known explanations. This relationship is driven by the asymmetric large return sensitivity of short‐leg of momentum portfolio to changes in market liquidity that increases the tail risk of the momentum strategy in panic states. Identifying this partly explains the forecasting ability of known predictors of tail risk of the momentum strategy. The contemporaneous increase in market liquidity explains, to some extent, the documented negative relationship between predictors and future momentum returns. Our findings are robust to the use of alternative measures of market liquidity that share a common source of variation in aggregate liquidity.

Study of anxiety and intrapersonal fears in persons with panic disorder when exposed to the method of formation and activation of artificially stable functional connections

Relevance. It is justified by the need to study panic states in healthy and sick individuals, the difficulty correcting acute and chronic anxiety disorders, and the search for modern, effective and safe methods of correction. Intention . To study intrapersonal fears and anxiety as components of the current mental state in people with panic disorder when exposed to the method of formation and activation of artificial stable functional connections (ASFC). Methodology. The sample consisted of 60 individuals with panic disorder (F 41.0 according to ICD-10) in the interattack period, 18 of them participated in the correction program, while 20 healthy individuals were examined as a control group. The dynamics of indicators of the current mental state of the subjects was studied using Taylor questionnaires, questionnaire of current personal fears and Lusher test, and a standardized personality inventory. Formation and activation of ASFC was conducted using rhythmic photostimuli with given frequencies. The results and discussion . The study of the current mental state of 60 people with panic disorder showed significant excess of normative indicators of anxiety and fears. At the same time, undirected paroxysmal fear was the leading symptom in 100% of cases. The division of the total sample into male (42 %) and female (58 %) subgroups showed a gender difference in the structure of actual intrapersonal fears. Heterogeneous anxiety was revealed in people with panic disorder. 18 patients underwent a course of correction by the method of formation and activation of ASFC. There were significant positive changes in the clinical picture and in indicators of anxiety and intrapersonal fears, also when compared with the control group. The correlation analysis showed disconnection between the indicators of anxiety and fears after the correction course. Conclusion. Changes in the main components of the current mental state in people with panic disorder are shown: a decrease in the level of anxiety and fears, loss of correlation between them and indicators of the SMIL scale. The positive experience of using the method of formation and activation of ASFC via photostimulation of a given frequency in persons with panic disorder in the interattack period in connection with the correction tasks was revealed.

Momentum Crashes and Variations to Market Liquidity

We document that the variation in market liquidity is an important determinant of momentum crashes that is independent of other known explanations surfaced on this topic. This relationship is driven by the asymmetric large return sensitivity of short-leg of momentum portfolio to changes in market liquidity that flares the tail risk of momentum strategy in panic states. This identification explains the forecasting ability of known predictors of tail risk of momentum strategy such that the contemporaneous increase in market liquidity predominantly sums up the trademark negative relationship between predictors and future momentum returns. Our results are robust using a different momentum portfolio and alternative measures of market liquidity that make a substantial part of the common source of variation in aggregate liquidity.

Panic-aware portfolio optimization

This article provides a portfolio optimization approach that takes into account extreme events. By merging a (downside-only) panic copula with the empirical marginal distributions, panic-awareness is attained for the optimization process. This approach includes the likelihood of highly co-dependent asset movements in panic states of the market—as empirically observed during market crashes. Panic-awareness CVaR optimization translates into robust equity portfolios, empirically exemplified for the UK and German stock market.

Momentum crashes

Despite their strong positive average returns across numerous asset classes, momentum strategies can experience infrequent and persistent strings of negative returns. These momentum crashes are partly forecastable. They occur in panic states, following market declines and when market volatility is high, and are contemporaneous with market rebounds. The low ex ante expected returns in panic states are consistent with a conditionally high premium attached to the option like payoffs of past losers. An implementable dynamic momentum strategy based on forecasts of momentum’s mean and variance approximately doubles the alpha and Sharpe ratio of a static momentum strategy and is not explained by other factors. These results are robust across multiple time periods, international equity markets, and other asset classes.

Heart rate and respiratory response to doxapram in patients with panic disorder

Panic disorder (PD) is characterized by anticipatory anxiety and panic, both causing physiological arousal. We investigated the differential responses between anticipatory anxiety and panic in PD and healthy controls (HC). Subjects (15 PD and 30 HC) received an injection of a respiratory stimulant, doxapram, with a high rate of producing panic attacks in PD patients, or an injection of saline. PD subjects had significantly higher scores in anxiety and panic symptoms during both conditions. Analysis of heart rate variability (HRV) indices showed higher sympathetic activity (LF) during anticipatory anxiety and panic states, an increase in the ratio of LF/HF during the anticipatory and panic states and a decrease in parasympathetic (HF) component in PD patients. During doxapram PD subjects increased their LF/HF ratio while HC had a reduction in LF/HF. Parasympathetic component of HRV was lower during anticipatory anxiety in PD. In general, PD showed greater sympathetic and psychological responses related to anxiety and sensations of dyspnea, reduced parasympathetic responses during anticipatory and panic states, but no differences in respiratory response. This confirms previous studies showing that PD patients do not have an intrinsic respiratory abnormality (either heightened or dysregulated) at the level of the brain stem but rather an exaggerated fear response.

PSYCHOEMOTIONAL STATUS FEATURES IN PATIENTS WITH THYROID GLAND PATHOLOGY

It is now well known that thyroid gland disorder (both excess and lack of thyroid hormones) may signifi­cantly influenced mental status, including emotions and cognition. Both central and peripheral nervous systems are affected. In hyperthyroidism nervous system lesion is associated with thyroid hormone toxic effect, metabo­lism increase and increased sensitivity to catecholamines. This state is manifested in emotional lability, quick transition from depression to euphoria. Different kinds of phobias and panic states may occur. Psychic disorders in hypothyroidism are the result of hypothyroid encephalopathy. Cognitive processes are hindered. Psychiatric diseases following the type of depression and paranoia may occur. In severe hypothyroidism exogenous or­ganic psychosis may develop. And despite all the achievements of euthyreosis patients may continue to have disorders of cognitive functions and emotional-affective distresses.

Electroencephalographic findings in panic disorder.

Some studies have reported the importance of electroencephalography (EEG) as a method for investigating abnormal parameters in psychiatric disorders. Different findings in time and frequency domain analysis with regard to central nervous system arousal during acute panic states have already been obtained. This study aimed to systematically review the EEG findings in panic disorder (PD), discuss them having a currently accepted neuroanatomical hypothesis for this pathology as a basis, and identify limitations in the selected studies. Literature search was conducted in the databases PubMed and ISI Web of Knowledge, using the keywords electroencephalography and panic disorder; 16 articles were selected. Despite the inconsistency of EEG findings in PD, the major conclusions about the absolute power of alpha and beta bands point to a decreased alpha power, while beta power tends to increase. Different asymmetry patterns were found between studies. Coherence studies pointed to a lower degree of inter-hemispheric functional connectivity at the frontal region and intra-hemispheric at the bilateral temporal region. Studies on possible related events showed changes in memory processing in PD patients when exposed to aversive stimuli. It was noticed that most findings reflect the current neurobiological hypothesis of PD, where inhibitory deficits of the prefrontal cortex related to the modulation of amygdala activity, and the subsequent activation of subcortical regions, may be responsible to trigger anxiety responses. We approached some important issues that need to be considered in further researches, especially the use of different methods for analyzing EEG signals.

Investor Attention and Stock Market Volatility

We offer a framework to simultaneously study the role played by investors’ attention to news and learning uncertainty in the determination of asset prices. We show that asset return volatility and risk premia increase quadratically with both attention and uncertainty. Our empirical investigation lends support to these theoretical predictions. Moreover, learning yields a lead-lag relation between attention and uncertainty; this relation is found to enable “panic states,” featuring spikes in volatilities and risk premia. During these panic states asset prices are very sensitive to news, consistent with recent empirical findings.

Attachment and self-consciousness: A dynamic connection between schizophrenia and panic

IntroductionAttachment theory offers an evolutionary explanation for the occurrence of panic states. The distance between a mother and child causes the sensation of fear. The experience of feared annihilation, an intense fear reaction (panic), is presented as a threat to the individual’s cohesiveness, disrupting the mental representation of self-consciousness, specifically self-unity. Alterations in self-consciousness in schizophrenia are so important that they are mostly included among Kurt Schneider’s first-ranked symptoms. HypothesesBased on clinical trials, case reports, and brain imaging and pharmacological studies, a paradigm is proposed to explain the relationship between panic anxiety and psychosis. ConclusionThe psychosis-anxiety pathophysiology explanation needs further investigation into the brain areas that integrate self-monitoring with fear areas, but it seems possible to note the importance of the anterior cingulate cortex.

‘Needle with ease’: rapid stress management techniques

For some patients, even looking at a needle is enough to make them feel anxious. Repeated cannulation for bloods and all other intravenous therapies, such as scans and chemotherapy treatment can become so frightening that they escalate to feeling overwhelmed and panicky. If this response persists without any intervention, it may eventually become a phobia (Choy et al, 2007). Four-hundred-thousand patients are treated at The Christie NHS Foundation Trust each year, with many receiving intravenous chemotherapy treatments. The 'CALM' service was initiated over 5 years ago to enable and support patients to achieve a calm state during procedural-related anxieties and panic. Thanks to recent funding from 'Walk the Walk' Breast Cancer Charity, the service has grown, enabling more patients to access the service. Increasing skill has led to development of training courses for health professionals. The training provides easy-to-learn skills, some of which are described here, that can be used to prevent and/or interrupt panic states triggered by medical procedures.

New assay for measuring valproic acid in plasma by conjugation to hydrazides

Valproic acid (VA) is an anticonvulsant used to treat mania, schizophrenia, bipolar disorders, panic states and post‐traumatic stress disorder. Recently, VA has been shown to improve survival to hemorrhagic and septic shock in rats and pigs. However, the measurement of VA in plasma is difficult by standard chromatography and spectroscopy. We have developed a method that extracts VA and an internal standard (2‐phenyl butyric acid) from 10μl plasma after addition of 20μl 1M NaCl, 100μl ethyl acetate and 400μl acetonitrile. Sample is vortexed, centrifuged, and the supernatant removed and dried, and conjugated to 7‐diethylaminocoumarin‐3‐carboxylic acid, hydrazide (DCCH, Invitrogen). The conjugate is measured by Fluorometry (2020 Jasco) with λex=415nm, λem=465nm after separation by Reverse Phase High Pressure Liquid Chromatography (Beckman Coulter). A 2‐parameter exponential non‐ linear regression, y‐a(1‐bx), was fitted (r2=0.991) to the standard curve (0.033 to 10mg/ml VA, or 12.5μg to 41ng/injection). Coefficient of Variation was 3.9 and 1.8% for high and low pools. This method can be used to measure the reported dosage range of VA in human or animal plasma. Supported by the ARMY MRMC.