Somatic Conditions Research Articles

Epidemiology of comorbid hazardous alcohol use and insomnia in 19 185 women and men attending the population-based Troms\xf8 Study 2015\u20132016

BackgroundHazardous alcohol use is known to be comorbid with insomnia problems. The present study examined the prevalence of insomnia and if the odds of insomnia differed between women and men with a hazardous alcohol use.MethodsCross-sectional data from the seventh survey of the Norwegian population-based Tromsø Study 2015–2016 (participation 65%). The sample included 19 185 women and men 40–96 years. Hazardous alcohol use was defined by the Alcohol Use Disorder Identification Test (AUDIT) and insomnia by the Bergen Insomnia Scale. Covariates included socio-demographics, shift work, somatic conditions and mental distress defined by Hopkins Symptom Check List-10 (HSCL-10). Mental distress was also included as a moderator.ResultsInsomnia was more prevalent among participants with a hazardous alcohol use (24.1%) than without (18.9%), and participants who had hazardous alcohol use had higher odds of insomnia (odds ratio = 1.49, 95% CI = 1.20, 1.85). The association turned non-significant after adjustment for mental distress. Adding mental distress as a moderator variable revealed a higher odds of insomnia among hazardous alcohol users having no or low-to-medium levels of mental distress, but not among participants with high levels of mental distress.ConclusionInsomnia was more prevalent among women and men reporting hazardous alcohol use. When mental distress was treated as a moderator, hazardous alcohol use did not yield higher odds for insomnia among those with high levels of mental distress. This suggests that mental distress may play an important role in the association between hazardous alcohol use and insomnia. And that the impact of alcohol on insomnia may differ depending on the severity of mental distress.

The role of ADHD genetic risk in mid-to-late life somatic health conditions

Growing evidence suggests that ADHD, an early onset neurodevelopmental disorder, is associated with poor somatic health in adulthood. However, the mechanisms underlying these associations are poorly understood. Here, we tested whether ADHD polygenic risk scores (PRS) are associated with mid-to-late life somatic health in a general population sample. Furthermore, we explored whether potential associations were moderated and mediated by life-course risk factors. We derived ADHD-PRS in 10,645 Swedish twins born between 1911 and 1958. Sixteen cardiometabolic, autoimmune/inflammatory, and neurological health conditions were evaluated using self-report (age range at measure 42–88 years) and clinical diagnoses defined by International Classification of Diseases codes in national registers. We estimated associations of ADHD-PRS with somatic outcomes using generalized estimating equations, and tested moderation and mediation of these associations by four life-course risk factors (education level, body mass index [BMI], tobacco use, alcohol misuse). Results showed that higher ADHD-PRS were associated with increased risk of seven somatic outcomes (heart failure, cerebro- and peripheral vascular disease, obesity, type 1 diabetes, rheumatoid arthritis, and migraine) with odds ratios ranging 1.07 to 1.20. We observed significant mediation effects by education, BMI, tobacco use, and alcohol misuse, primarily for associations of ADHD-PRS with cardiometabolic outcomes. No moderation effects survived multiple testing correction. Our findings suggests that higher ADHD genetic liability confers a modest risk increase for several somatic health problems in mid-to-late life, particularly in the cardiometabolic domain. These associations were observable in the general population, even in the absence of medical treatment for ADHD, and appear to be in part mediated by life-course risk factors.

Predicting subjective well-being in a high-risk sample of Russian mental health app users

Despite recent achievements in predicting personality traits and some other human psychological features with digital traces, prediction of subjective well-being (SWB) appears to be a relatively new task with few solutions. COVID-19 pandemic has added both a stronger need for rapid SWB screening and new opportunities for it, with online mental health applications gaining popularity and accumulating large and diverse user data. Nevertheless, the few existing works so far have aimed at predicting SWB, and have done so only in terms of Diener’s Satisfaction with Life Scale. None of them analyzes the scale developed by the World Health Organization, known as WHO-5 – a widely accepted tool for screening mental well-being and, specifically, for depression risk detection. Moreover, existing research is limited to English-speaking populations, and tend to use text, network and app usage types of data separately. In the current work, we cover these gaps by predicting both mentioned SWB scales on a sample of Russian mental health app users who represent a population with high risk of mental health problems. In doing so, we employ a unique combination of phone application usage data with private messaging and networking digital traces from VKontakte, the most popular social media platform in Russia. As a result, we predict Diener’s SWB scale with the state-of-the-art quality, introduce the first predictive models for WHO-5, with similar quality, and reach high accuracy in the prediction of clinically meaningful classes of the latter scale. Moreover, our feature analysis sheds light on the interrelated nature of the two studied scales: they are both characterized by negative sentiment expressed in text messages and by phone application usage in the morning hours, confirming some previous findings on subjective well-being manifestations. At the same time, SWB measured by Diener’s scale is reflected mostly in lexical features referring to social and affective interactions, while mental well-being is characterized by objective features that reflect physiological functioning, circadian rhythms and somatic conditions, thus saliently demonstrating the underlying theoretical differences between the two scales.

Genomics Driving Diagnosis and Treatment of Inborn Errors of Immunity With Cancer Predisposition

Inborn errors of immunity (IEI) are genetically and clinically heterogeneous disorders that, in addition to infection susceptibility and immune dysregulation, can have an enhanced cancer predisposition. The increasing availability of upfront next-generation sequencing diagnostics in immunology and oncology have uncovered substantial overlap of germline and somatic genetic conditions that can result in immunodeficiency and cancer. However, broad application of unbiased genetics in these neighboring disciplines still needs to be deployed, and joined therapeutic strategies guided by germline and somatic genetic risk factors are lacking. We illustrate the current difficulties encountered in clinical practice, summarize the historical development of pathophysiological concepts of cancer predisposition, and review select genetic, molecular, and cellular mechanisms of well-defined and illustrative disease entities such as DNA repair defects, combined immunodeficiencies with Epstein-Barr virus susceptibility, autoimmune lymphoproliferative syndromes, regulatory T-cell disorders, and defects in cell intrinsic immunity. We review genetic variants that, when present in the germline, cause IEI with cancer predisposition but, when arising as somatic variants, behave as oncogenes and cause specific cancer entities. We finally give examples of small molecular compounds that are developed and studied to target genetically defined cancers but might also proof useful to treat IEI.

The Use of Telehealth for Psychological Counselling of Vulnerable Adult Patients With Rheumatic Diseases or Diabetes: Explorative Study Inspired by Participatory Design.

BackgroundVideo consultation is increasingly used in different health care settings to reach patients. However, little is known about telehealth in psychological counselling for vulnerable patients with somatic and chronic conditions such as rheumatoid arthritis and diabetes.ObjectiveThis study aimed to develop and pilot test a telepsychology module for inclusion in the app My Hospital (Mit Sygehus) to provide remote psychological counselling to vulnerable adults with either rheumatic diseases or diabetes.MethodsWith inspiration from participatory design, the content of the telepsychology module was developed through user involvement and evaluated by individual interviews with patients and psychologists as well as questionnaires.ResultsWe developed a module with our patient partners that targeted patients with rheumatic diseases and diabetes in relation to the psychological challenges of living with chronic diseases. The module included information, tools, exercises, and videoconferencing. In total, 16 patients and 3 psychologists participated in the pilot test. Psychological counselling was described by 4 themes: “The good relation despite physical distance,” “The comfort of being at home,” “The pros of saving time on transport and energy,” and “A therapeutic alliance at a distance.”ConclusionsPsychological counselling in relation to somatic care can be provided by videoconferencing supported by web-based or mobile delivery of tailored information, tools, and exercises without compromising on the quality of care. To ensure a good alliance between the patient and psychologist, a first face-to-face meeting is important. The home location provided patients with a safe environment and increased accessibility and reduced travel time to the hospital.

Dealing with low access to harm reduction: a qualitative study of the strategies and risk environments of people who use drugs in a small Swedish city

BackgroundThe development of harm reduction has been limited in many areas of Sweden. This study aims to understand the implications that this has for the life circumstances and risk management of people who use drugs in areas of low access.MethodsEleven qualitative, semi-structured interviews were undertaken with people who use drugs in a small urban centre with no needle and syringe exchange program (NSP) or Housing First policy.ResultsParticipants reported many solutions to lack of NSP, including travel to an external NSP, creating bridging distribution networks, stealing, borrowing, reusing, ordering online, and smuggling injection equipment. They were at risk of having their equipment confiscated by police. Participants were mostly homeless, and to address exclusion from housing services, were forced to frequently find new temporary solutions, sheltering themselves in public places, with friends, in cars, among others. Participants felt the lack of services reflected stigmatized notions of drug use and heightened their exclusion from general society. For example, they avoided accessing other health care services for fear of discrimination. These issues caused high levels of stress and anxiety, in addition to serious risk for many somatic and psychological health conditions, including HIV and HCV transmission.ConclusionLack of harm reduction services placed a great burden on study participants to develop strategies due to gaps in official programming. It also contributes to a vicious cycle of exclusion from services. The implementation of such evidence-based programs will reduce this burden, as well as provide the indirect, symbolic effect of inclusion.

Risk of severe COVID-19 infection in individuals with severe mental disorders, substance use disorders, and common mental disorders

ObjectiveTo evaluate the risk of severe COVID-19 in individuals with severe mental disorders, substance use disorders, and common mental disorders in the total adult population of Region Stockholm (N = 1,516,270), and to explore possible underlying mechanisms to the increased risk. MethodsIn this prospective cohort study, we examined the risk of hospitalization and treatment in an intensive care unit (ICU) with COVID-19, and death from COVID-19 for individuals with mental disorders. Associations were step by step adjusted for (1) sociodemographic/economic factors, (2) indicators of virus exposure, (3) somatic conditions, and (4) psychopharmacological treatment. ResultsIn model 1 (adjusted for age, sex and living in a care home for elderly people), people with a mental disorder had increased risks for inpatient care (HR = 1.5), ICU care (HR = 1.5), and mortality (HR = 1.4) from COVID-19. There was an increased risk of dying from COVID-19 in all subgroups of mental disorders, particularly in people with a severe mental disorder (HR = 1.9). Different covariates had different effects on the association depending on the outcome and on sex, age, or psychiatric diagnosis of the participants. ConclusionPeople with mental disorders have an increased risk of severe COVID-19, including mortality. The increased risk was partly explained by the examined covariates.

Drug Combinations for Mood Disorders and Physical Comorbidities That Need Attention: A Cross-Sectional National Database Survey.

This study investigated combined prescriptions of drugs for mood disorders and physical comorbidities that need special attention in the light of frequent physical comorbidities in patients with mood disorders. We used the claims sampling data of 581,990 outpatients in January 2015 from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Fisher's exact test was performed to compare the prescription rates of non-steroidal anti-inflammatory drugs (NSAIDs), loop/thiazide diuretics, angiotensin-converting enzyme inhibitors, and/or angiotensin II receptor blockers between lithium users and age- and sex-matched non-lithium users; NSAIDs, antiplatelet drugs, and/or anticoagulants between selective serotonin reuptake inhibitor (SSRI)/serotonin-noradrenaline reuptake inhibitor (SNRI) users and non-users; warfarin between mirtazapine users and non-users; and the proportions of patients in the two groups with a diagnosis of somatic conditions for which these medications were indicated and actually received them. A Bonferroni corrected p-value of<0.05/3 was considered statistically significant. Prescriptions of the above-mentioned medications were less frequent in lithium and mirtazapine users and comparable in SSRI/SNRI users, compared to non-users (18.3 vs. 31.9%, p=7.6×10-10; 0.78 vs. 1.65%, p=0.01; 23.1 vs. 24.1%, p=0.044). In a subgroup of patients with somatic diseases for which these medications were indicated, the prescription rates were comparable in lithium and mirtazapine users and higher in SSRI/SNRI users compared to non-users (28.0 vs. 29.4%, p=0.73; 4.7 vs. 7.4%, p=0.28; 35.6 vs. 33.4%, p=0.0026). Pharmacotherapy with drugs for mood disorders and physical comorbidities that require attention was commonly observed in clinical practice.

The effect of shared decision-making on recovery from non-chronic aspecific low back pain in primary care; a post-hoc analysis from the patient, physician and observer perspectives

BackgroundAlthough shared decision-making (SDM) is increasingly accepted in healthcare and has demonstrated merits for several psychological outcomes, the effect on recovery from somatic conditions is still subject to debate. The objective of this study is to measure the effect of SDM on recovery from non-chronic aspecific low back pain (LBP).MethodsThis study is a post-hoc analysis of data from a cluster-randomised trial that evaluated the effectiveness of SDM on recovery in patients with non-chronic aspecific LBP. In this analysis, we re-evaluate the impact of SDM from three perspectives: that of external observers, participating GPs and participating patients. Recovery was measured with the Visual Analogue Scale (VAS) for pain and with the Roland Morris Disability questionnaire (RMD) and defined as a VAS < 30 and an RMD < 4. Logistic regression was used to analyse the effect of SDM on recovery at 6 and 26 weeks.ResultsAt 26 weeks, 105 (74%) of all 176 included patients had recovered. No significant effect of SDM on recovery at 6 or 26 weeks after the consultation was found when considering SDM from an observer perspective or a patient perspective. From a GP perspective SDM had a significant effect on recovery, but at 26 weeks only, and with the lowest probability of recovery observed at a medium level of GP-perceived SDM.ConclusionsWe found no evidence that SDM as perceived by the patient or by external observation improves recovery from non-chronic aspecific low back pain. The long-term recovery may be better for patients in whom the GP perceives SDM during their consultations. Further research should highlight the hierarchy and the relation between the perspectives, which is needed to come to an integral effect evaluation of SDM.Trial registrationThe Netherlands National Trial Register (NTR) number: NTR1960.

With Medicine in Mind? Exploring the Relevance of Having Recreational Experience When Becoming a Medicinal Cannabis User

Background: Beyond the legal use of medical cannabis in Denmark for selected patient groups, a large unregulated use of medicinal (non-prescribed) cannabis occurs. However, little is known about the paths to becoming a medicinal cannabis user and the role that previous recreational experience plays in this process. Aim: Inspired by Becker’s social learning approach to becoming a cannabis user, this study explores sources of inspiration for medicinal cannabis use, the social control factors related to use, and the relevance of recreational experience (RE) with cannabis. Methods: An anonymous survey was made available online to a convenience sample of 2,281 adults (≥18 years) who self-medicate with non-prescribed cannabis. Logistic regression analysis compared users with no RE (46.1%) to users with occasional RE (27.4%) and regular RE (26.5%) in terms of user characteristics, initiation of medicinal use, and experiences with social control factors. Results: Compared to users with RE, users with no RE were significantly more likely to be women, older, more frequent users, and to treat somatic conditions and use low potency CBD-oil. Users with no RE were more likely to rely on social networks for information on medicinal cannabis, use online sources for supply, and find supply stable. Moreover, users with no RE were less likely to keep use secret and find use problematic. Also, when medicinal use develops on a gradual transition from recreational use it is associated with increased odds of treating mental health conditions and with use of smoking as form of intake. Conclusion: The heterogeneity among medicinal cannabis users in Denmark, in terms of demographics, motives for use, and patterns of use, is related to the level of previous recreational experience and to whether medicinal use developed on a gradual transition from recreational use.

Eating disorders in the U.S. Medicare population.

The social and economic burden of eating disorders is significant and often financially devastating. Medicare is the largest public insurer in the United States and provides coverage for older adults and some disabled individuals. This study explores prevalence, sociodemographic and clinical characteristics, and health care spending for Medicare enrollees with eating disorders. A cross-sectional study was conducted with the nationally representative 20% sample of 2016 Medicare inpatient, outpatient, carrier, and home health fee-for-service claims and Medicare Advantage encounter records. Sociodemographic characteristics and comorbid somatic conditions were compared between individuals with versus without an eating disorder diagnosis. Mean spending was compared overall and separately for inpatient, outpatient, home health, and pharmacy claims. The sample included 11,962,287 Medicare enrollees of whom 0.15% had an eating disorder diagnosis. Compared to those without a 2016 eating disorder diagnosis, a greater proportion of individuals with an eating disorder were female (73.8% vs. 54.3%), under age 65 (41.6% vs. 15.5%), and dually eligible for Medicaid due to disability or low-income qualification (48.0% vs. 19.6%). Individuals with eating disorders had higher rates of comorbid conditions, with the greatest differences in cardiac arrythmias (35.3% vs. 19.9%), arthritis (40.1% vs. 26.6%), and thyroid conditions (32.2% vs. 19.4%). Spending was higher for enrollees with eating disorders compared to those without overall ($29,456 vs. $7,418) and across settings. The findings establish that eating disorders occur in the Medicare population, and that enrollees with these illnesses have risk factors associated with significant healthcare spending and adverse health outcomes.

Associations of Neighborhood Socioeconomic Disadvantage With Chronic Conditions by Age, Sex, Race, and Ethnicity in a Population-Based Cohort

ObjectiveTo determine the association of socioeconomic status at the census block group level with chronic conditions and to determine whether the associations differ by age, sex, race, or ethnicity. MethodsAdults aged 20 years and older on April 1, 2015, from 7 counties in southern Minnesota were identified using the Rochester Epidemiology Project records-linkage system. We estimated the prevalence of 19 chronic conditions (7 cardiometabolic, 7 other somatic, and 5 mental health conditions) at the individual level and a composite measure of neighborhood socioeconomic disadvantage (the area deprivation index [ADI]) at the census block group level (n=249). ResultsAmong the 197,578 persons in our study, 46.7% (92,373) were male, 49.5% (97,801) were aged 50 years and older, 12.3% (24,316) were of non-White race, and 5.3% (10,546) were Hispanic. The risk of most chronic conditions increased with increasing ADI. For each cardiometabolic condition and most other somatic and mental health conditions, the pattern of increasing risk across ADI quintiles was attenuated, or there was no association across quintiles of ADI in the oldest age group (aged ≥70 years). Stronger associations between ADI and several cardiometabolic, other somatic, and mental health conditions were observed in women. ConclusionHigher ADI was associated with increased risk of most chronic conditions, with more pronounced associations in younger persons. For some chronic conditions, the associations were stronger in women. Our findings underscore the importance of recognizing the overall and potentially differential impact of area-level deprivation on chronic disease outcomes for diverse populations.

Dissociative stupor in young adults. Challenges in differential diagnosis and treatment management

Dissociative stupor is a rare psychiatric condition, included in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) among Other Specified Dissociative Disorders, as an acute dissociative reaction to a stressful event. Like other acute pathological dissociative presentations, it is primarily related to traumatic experiences. Aim. This article aims at presenting the case of dissociative stupor in a 21-year-old male who presented firstly with mixed symptoms of tonic seizures and catatonia. Method. Before the present admission, the patient had two previous emergency department presentations, upon which he presented altered consciousness, muscular rigidity, unresponsiveness to external stimuli, alternated with episodes of psychomotor agitation and visual hallucinations, symptoms partially remitted after the administration of propofol, levetiracetam and solumedrol. During the presentation, the patient’s mother revealed that the patient may have seen the dead body of his grandfather, with whom he had a previously close relationship, and found out in this manner that he passed away during the previous night. Urinary tox-screen was positive for tetrahydrocannabinol (THC). Also, complete blood count (CBD), basic metabolic panel (BMP), cerebrospinal fluid (CSF) analysis, cerebral magnetic resonance imaging (MRI), both native and angiographic sequence, and electroencephalogram (EEG) were performed, with results within normal range. The treatment with selective serotonin reuptake inhibitors (SSRI’s; sertraline) and second-generation antipsychotics (SGA; olanzapine) was initiated. Discussion. From a psychiatric point of view, the patient needs to be reevaluated periodically regarding the psychopharmacologic therapy; also, cognitive-behavioral therapy (CBT) or hypnosis may be an option in this case. Conclusions. The diagnosis and therapeutic management of dissociative stupor represents a real challenge due to the need of excluding other psychiatric or somatic conditions and the fact that there are no available data regarding the psychopharmacological treatment. However, there is much ongoing research in the neurobiology of trauma-related altered states of consciousness and the promising results of them are the basis of future psychopharmacological strategies.

An Old English Poetics of Comfort

Despite the robust tradition of consolatio in medieval writing, historians of the senses have argued that the idea of physical comfort developed from post-medieval commodity cultures. This article considers the ways in which the reading scripted or supported by Old English poems might have enabled feelings of physical comfort and its related somatic conditions: health, ease, and balance. I first discuss Classical and monastic ideas about reading as a form of exercise that facilitates homeostasis before exploring how the Exeter Book Riddles and other cryptic poems encourage readerly exertion. I'm especially intrigued by the possibility of thinking about hermeneutically difficult works as prompts for heat-generating somatic regimens.

Impact of Somatic Conditions and Lifestyle Behaviours on Depressive Symptoms and Low Life Satisfaction among Middle-Aged and Older Adult Men in South Africa.

The purpose of this study was to assess the association between somatic disorders, lifestyle factors, incident and persistent depressive symptoms, and low life satisfaction in a longitudinal study in South Africa. We analyzed longitudinal data from two consecutive waves, 2346 men aged 40 years or older in 2014/2015 in wave 1 and 1864 men of wave 1 in 2018/2019 in wave 2 of the "Health and Ageing in Africa: A Longitudinal Study of an International Network for the Demographic Evaluation of Populations and their Health (INDEPTH) Community in South Africa (HAALSI)". In total, 360 of 1932 male participants without depressive symptoms in wave 1 (24.3%) had incident depressive symptoms in wave 2 and 77 of 349 men had depressive symptoms in both waves 1 and 2 (persistent depressive symptoms). In all, 457 of 1258 male participants without low life satisfaction in Wave 1 (47.6%) had incident low life satisfaction in Wave 2, and 360 of 998 men had low life satisfaction at both Wave 1 and 2 (persistent low life satisfaction). In the unadjusted logistic regression analysis, having kidney disease and living with HIV had greater odds of incident depressive symptoms. In adjusted analysis, alcohol dependence (Adjusted Odds Ratio-AOR: 4.54, 95% Confidence Interval-CI: 1.05-19.66) was positively correlated and 1-7 and 8-11 years of education (AOR: 0.45, 95% CI: 0.27-0.74, and AOR: 0.20, 95% CI: 0.07-0.54, respectively) were negatively associated with persistent depressive symptoms. Increasing age increased the odds (AOR: 1.03, 95% CI: 1.01-1.04), while higher education (≥12 years) (AOR: 0.50, 95% CI: 0.33-0.76), and high physical activity (AOR: 0.68, 95% CI: 0.52-0.89) decreased the odds of incident low life satisfaction. Increasing age (AOR: 1.03, 95% CI: 1.02-1.04) and tobacco use (AOR: 1.64, 95% CI: 1.23-2.19) increased the odds and high physical activity (AOR: 0.73, 95% CI: 0.56-0.96) decreased the odds of persistent low life satisfaction. Of the seven chronic conditions and five lifestyle factors evaluated, alcohol dependence increased the odds of persistent depressive symptoms and low physical activity, and tobacco use increased the odds of incident and/or persistent low life satisfaction among men in rural South Africa.

FINANCIAL IMPACT OF MENTAL ILLNESS AND HOW TO MEASURE THE CONSEQUENCES

This article shows the economic impact of mental illness, as well as various cost-estimating approaches. To assess the burden of mental diseases, there are three different ways: the human capital, the economic growth and the value of statistical life approach. The first focuses on indirect and direct costs. Moreover, the effect of mental illness on economic development can only be approximated implicitly. Thus, the lack of production is primary estimated for somatic conditions compared to their corresponding quantity of disability-adjusted life years (DALYs). The total economic productivity drop associated with mental illnesses between 2011 and 2030 is rated to be US$16.3 trillion globally. Furthermore, the value of statistical life (VSL) method suggests that trade-offs between risks and capital should be used to assess the probability of injury or death due to psychiatric illness. This computation is equivalent to that of cardiovascular disease and bigger than that of cancer. However, greater activism is required to better the existing condition.

Fundamental Clock of Biological Aging: Convergence of Molecular, Neurodegenerative, Cognitive and Psychiatric Pathways: Non-Equilibrium Thermodynamics Meet Psychology.

In humans, age-associated degrading changes, widely observed in molecular and cellular processes underly the time-dependent decline in spatial navigation, time perception, cognitive and psychological abilities, and memory. Cross-talk of biological, cognitive, and psychological clocks provides an integrative contribution to healthy and advanced aging. At the molecular level, genome, proteome, and lipidome instability are widely recognized as the primary causal factors in aging. We narrow attention to the roles of protein aging linked to prevalent amino acids chirality, enzymatic and spontaneous (non-enzymatic) post-translational modifications (PTMs SP), and non-equilibrium phase transitions. The homochirality of protein synthesis, resulting in the steady-state non-equilibrium condition of protein structure, makes them prone to multiple types of enzymatic and spontaneous PTMs, including racemization and isomerization. Spontaneous racemization leads to the loss of the balanced prevalent chirality. Advanced biological aging related to irreversible PTMs SP has been associated with the nontrivial interplay between somatic (molecular aging) and mental (psychological aging) health conditions. Through stress response systems (SRS), the environmental and psychological stressors contribute to the age-associated “collapse” of protein homochirality. The role of prevalent protein chirality and entropy of protein folding in biological aging is mainly overlooked. In a more generalized context, the time-dependent shift from enzymatic to the non-enzymatic transformation of biochirality might represent an important and yet underappreciated hallmark of aging. We provide the experimental arguments in support of the racemization theory of aging.

Effectiveness of Videoconference-Delivered Cognitive Behavioral Therapy for Adults With Psychiatric Disorders: Systematic and Meta-Analytic Review.

BackgroundCognitive behavioral therapy (CBT) is the gold standard of psychotherapy for psychiatric disorders. However, the format of delivering CBT in person limits access to the intervention. The advancements in information and communication technology, especially the internet, present an opportunity for cognitive behavioral therapists to service patients or clients in remote areas through videoconferencing. Although many randomized controlled trials of videoconference-delivered cognitive behavioral therapy (VCBT) have already been conducted, the overall estimated effect size of VCBT for psychiatric disorders has not been examined by systematic reviews and meta-analyses.ObjectiveThis study attempts to evaluate the effectiveness of VCBT for psychiatric disorders through a systematic and meta-analytic review.MethodsA systematic review and meta-analysis of studies in which VCBT was directly compared to control groups (such as treatment as usual, attention control, wait-list control, and other minimal supports) was carried out. To identify previous studies that meet our study objective, 2 independent reviewers undertook a systematic search through seven databases: MEDLINE (via PubMed), Web of Science, Science Direct, PsycINFO, CINAHL, LILACS, and SciELO. Other databases (ClinicalTrials.gov and Cochrane Central Resister of Controlled Trials) were also checked. All studies included in the review were assessed using the quality criteria of the Cochrane Collaboration. Statistical analysis was performed by using Cochrane Review Manager (RevMan, version 5.4.0). Standardized mean difference was used in major meta-analyses where a P value of .05 or less was the threshold for statistical significance. A heterogeneity test and the chi-square test were performed to assess the presence and extent of statistical heterogeneity with significance set at P<.10. Funnel plots were visually inspected to assess the risk of bias. Subgroup analyses were conducted for each disorder to estimate intervention effects.ResultsThe systematic search resulted in 16 studies (total N=1745) that met the criteria for this study and were included in the review. There were 10 studies on depressive symptoms, 3 on chronic pain, 1 on generalized anxiety disorder, 1 on obsessive-compulsive disorder, and 1 on hypochondriasis. The quality and risk of bias was also assessed. Results showed a pooled effect size (Hedge g) post treatment of −0.49 (95% CI –0.68 to –0.29), indicating that VCBT is effective for clients with psychiatric disorders. Study quality did not affect outcomes.ConclusionsWhile the overall results indicate the effectiveness of VCBT, there are still only a limited number of studies on specific psychiatric and somatic conditions. Therefore, more randomized controlled trials are needed to establish the effectiveness of VCBT for different disorders.Trial RegistrationInternational Prospective Register of Systematic Reviews (PROSPERO) CRD42021224832; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=224832

En time forut for sin tid. Om kroppen, arkeologien og Anders Nummedal

Anders Nummedal - one hour ahead of his time. Anders Nummedal is considered as an archaeological pioneer. In the 1910s, he developed techniques for surveying landscapes, involving systematic and physical examination of the terrain for Stone Age sites. This was in a sharp contrast to the ordinary procedure of doing Stone Age Archaeology at this time. Nummedal was in many ways different from the average pre-war archaeologist. His social habitus as well as methods for doing archaeology were, however, reproduced by the next generation of archaeologists, being part of the large social transformation of Norway form a peasant and fisher society to a social democratic welfare state. Finally, the analysis is concluded by a present example, intended to show some of the social-material thus somatic conditions that still affect the structure of the discipline.

Abstract 11371: Prevalence of Cardiometabolic, Mental, and Other Somatic Chronic Conditions in Patients Enrolled in Phase II Outpatient Cardiac Rehabilitation

Introduction: Multimorbidity is associated with physical disability, increased health care utilization, reduced quality of life, and mortality. Whereas most literature has focused on the co-occurrence of somatic conditions, we aim to (i) establish the prevalence of combined somatic and mental health multimorbidity (SMM) in cardiac rehabilitation (CR) patients, and (ii) determine the most prevalent co-occurrence of cardio-metabolic conditions (CMC) with other somatic or mental health conditions in CR patients. Methods: Using the Rochester Epidemiology Project records-linkage system, we identified residents of Southern MN and Western WI who attended (≥1) CR sessions from 1995 to 2019. The prevalence of 18 chronic conditions defined by the US Department of Health and Human Services was electronically extracted. Heat maps were created to assess the pairwise prevalence of cardio-metabolic (CMC; n=6) with mental (n=5) and other somatic (n=7) chronic conditions (Table 1) . Results: We included 13,056 patients; 68.5% were male. Patients were 65.5±12.5 years old with 44.7% ≤65 years old. Median number of conditions was 7 (Range 0-18) with 52.6% of patients having ≥7 conditions. Hyperlipidemia (89.3%), hypertension (79.5%), and arrhythmias (72.4%) were the most prevalent CMC. The prevalence of combined SMM (≥2 conditions) was 44.9% and was higher in those &lt;65 years ( p &lt;.0001). Depression (26.8%) and anxiety (24.7%) were the most common mental conditions involved in SMM and frequently co-occurred with CMC. Among other prevalent somatic conditions, arthritis (51.7%), chronic obstructive pulmonary disease (33.5%), and cancer (29.3%) co-occurred with CMC (Figure 1). Conclusions: Half of patients in CR have ≥7 chronic conditions. Somatic and mental health multimorbidity (SMM) is highly prevalent and is more frequent in those younger than 65 years old. Our results highlight the critical need to better understand the clinical burden of SMM in patients undergoing CR.