Τρίτη 26 Απριλίου 2022

Disclosure of suicidal thoughts and behaviors: The impact of suicide event type

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Abstract

Objectives

Despite its importance, limited work has investigated the nuances of suicidal thoughts and behavior self-disclosure. The present study aimed to examine potential differences in self-disclosure based on whether an individual has disclosed suicidal thinking versus behavior.

Methods

Two hundred and four participants having disclosed their suicidal thoughts or behaviors completed a battery of online questionnaires assessing several key aspects of disclosure (i.e., disclosure recipient, perceived helpfulness of disclosure, impact on treatment seeking), as it pertained to both one's first and overall disclosure experiences.

Results

Individuals who disclosed a suicide attempt, versus ideation, were more likely to have disclosed to a formal support (i.e., health professional) and to seek professional help following disclosure. No significant group differences in perceived helpfulness of experiences were found.

Conclusion

It may be beneficial to increase opportunities for disclosure of suicidal thinking. Overall, disclosures were perceived as helpful and may not impede future help-seeking behavior.

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The response of dual‐species bacterial biofilm to 2% and 5% NaOCl mixed with etidronic acid: a laboratory real‐time evaluation using optical coherence tomography.

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Abstract

Aim

The addition of etidronic acid (HEDP) to sodium hypochlorite (NaOCl) could increase the antibiofilm potency of the irrigant, while maintaining the benefits of continuous chelation. Studies conducted so far have shown that mixing HEDP with NaOCl solutions of relatively low concentration does not compromise the antibiofilm efficacy of the irrigant. However, the working lifespan of NaOCl may decrease resulting in a reduction of its antibiofilm efficacy over time (efficiency). In this regard, continuous irrigant replenishment needs to be examined. This study investigated the response of a dual-species biofilm when challenged with 2% and 5% NaOCl mixed with HEDP for a prolonged timespan and under steady laminar flow.

Methodology

Dual-species biofilms comprised of Streptococcus oralis J22 and Actinomyces naeslundii T14V-J1 were grown on human dentine discs in a constant depth film fermenter (CDFF) for 96 h. Biofilms were treated with 2% and 5% NaOCl, alone or mixed with HEDP. Irrigants were applied under steady laminar flow for 8 min. Biofilm response was evaluated by means of optical coherence tomography (OCT). Biofilm removal, biofilm disruption, rate of biofilm loss and disruption as well as bubble formation were assessed. One-way ANOVA, Wilcoxon's signed-rank test and Kruskal-Wallis H test were performed for statistical analysis of the data. The level of significance was set at a ≤ 0.05.

Results

Increasing NaOCl concentration resulted in increased biofilm removal and disruption, higher rate of biofilm loss and disruption and increased bubble formation. Mixing HEDP with NaOCl caused a delay in the antibiofilm action of the latter, without compromising its antibiofilm efficacy.

Conclusions

NaOCl concentration dictates the biofilm response irrespective of the presence of HEDP. The addition of HEDP resulted in a delay in the antibiofilm action of NaOCl. This delay affects the efficiency, but not the efficacy of the irrigant over time.

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Edaravone dexborneol protects cerebral ischemia reperfusion injury through activating Nrf2/HO‐1 signaling pathway in mice

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Abstract

Stroke is the leading cause of disability and death. When blood flow is restored after prolonged ischemia and hypoxia, it leads to excessive production of reactive oxygen species (ROS), increased local inflammation and apoptosis, which are the cause of most cerebral ischemia reperfusion injury (CIRI), leading to secondary brain tissue damage. Edaravone dexborneol is a novel neuroprotective agent consisting of edaravone and borneol. Studies have shown that it has synergistic antioxidant and anti-inflammatory effects. However, whether Edaravone dexborneol stimulates the Nrf2/HO-1 pathway to regulate NADPH oxidase 2 (NOX2) remains unclear. In this study, wild type (WT) mice and Nrf2 knockout (KO) mice were used to investigate the antioxidant, anti-inflammatory and anti-apoptotic effects of Edaravone dexborneol on CIRI and its mechanism. The cognitive function of mice was evaluated with the Morris Water Maze (MWM) test and the cell structures of hippocampus were observed by HE stainin g. Nrf2, HO-1 and NOX2 proteins and apoptosis-related proteins Bcl-2, Bax and Caspase 3 were detected by Western blotting. Nrf2, HO-1, NOX2 and inflammatory factors TNF-α, IL-1β, IL-4 and IL-10 were detected by real time polymerase chain reaction. The results showed that Edaravone dexborneol treatment improved learning and memory performance, neuronal damage, and enhanced antioxidant, inflammation, and apoptosis in CIRI mice. In addition, Edaravone dexborneol induced the activation Nrf2/HO-1 signaling pathway activation while inhibiting NOX2 expression. Overall, these results indicate that Edaravone dexborneol ameliorates CIRI-induced memory impairments by activating Nrf2/HO-1 signaling pathway and inhibiting NOX2.

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Immunosuppressants contribute to a reduced risk of Parkinson’s disease in rheumatoid arthritis

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Abstract
Background
Observational studies have suggested a decreased risk of Parkinson's disease (PD) in patients with rheumatoid arthritis (RA). However, the results are controversial and the biological mechanism underlying this effect remains largely unknown.
Methods
T he effect sizes of five observational studies were summarized to determine the association between RA and PD. A two-step Mendelian randomization (TSMR) analysis was conducted using genome-wide association studies data sets of RA, PD and prescription of non-steroidal anti-inflammatory drugs (NSAIDs), immunosuppressants (IS) and glucocorticoids (GC). A multivariable MR (MVMR) was also performed to verify the impact of prescription history on PD risk.
Results
Integrated data from observational studies showed that RA was associated with a decreased risk of PD in the European population (effect size = –0.38, P = 0.004). We found that genetically predicted RA was correlated with a decreased risk of PD [odds ratio (OR)=0.91, P = 0.007]. In the TSMR, RA patients tended to have an increased prescription of GC (OR = 1.16, P = 2.96e − 07) and IS (OR = 1.77, P = 5.58e − 64), which reduced the risk of PD (GC: OR = 0.86, P = 0.0270; IS: OR = 0.82, P = 0.0277), respectively. Further MVMR analysis demonstrated that only IS was linked to a decreased risk of PD (OR = 0.86, P = 0.004).
Conclusion
This work clarified that patients with RA had a decreased risk of PD, which was partially attributed to the use of IS in RA patients but not GC or NSAIDs.
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Comparison of 68Ga-FAPI and 18F-FDG PET/CT in Dermatofibrosarcoma Protuberans

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imageDermatofibrosarcoma protuberans is a rare soft tissue sarcoma with a high recurrence rate. Herein, we present 68Ga-FAPI and 18F-FDG PET/CT findings of dermatofibrosarcoma protuberans in a 45-year-old man. Dermatofibrosarcoma protuberans only shows limited FDG uptakes on 18F-FDG PET/CT, but demonstrated intense tracer uptakes on 68Ga-FAPI PET/CT. In this case, 68Ga-FAPI was superior to 18F-FDG PET/CT in detecting dermatofibrosarcoma protuberans.
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Bone Scan With SPECT/CT Demonstrated C1 to C2 Involvement in Rheumatic Arthritis

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imageAn 80-year-old man was treated with rituximab for active rheumatoid arthritis until 2019, now controlled with Salazopyrin, prednisolone, methotrexate, and folic acid. However, laboratory data showed elevated C-reactive protein and erythrocyte sedimentation rate. Whole-body bone scan showed bony and joint destruction to the upper cervical vertebra (C spine), bilateral shoulders, wrists, finger joints, ankles, and left knee. SPECT/CT localized the upper C spine uptake to the C1/C2 joint and adjacent C1 and C2 with C1/C2 subluxation. C spine CT showed vertical atlantoaxial subluxation and bony erosions.
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Dual-Phase 18F-FP-CIT PET in 2 Different Clinical Phenotypes of Sporadic Creutzfeldt-Jakob Disease

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imageEarly diagnosis of Creutzfeldt-Jakob disease (CJD) patients is often challenging due to the low sensitivity of the current clinical diagnostic criteria. We describe MRI and dual-phase 18F-FP-CIT PET findings in 2 cases of sporadic CJD presenting different clinical phenotypes (Heidenhain variant and corticobasal syndrome). Our case series suggest that dual-phase FP-CIT-PET findings may improve the diagnosis of CJD by combining the perfusion patterns in early phase with the dopamine transporter density in delayed phase. Familiarity with these dual-phase FP-CIT PET findings is helpful for early correct diagnosis of CJD.
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68Ga-PSMA-11 and 18F-FDG PET/CT in a Case of Ductal Adenocarcinoma of the Prostate

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imageProstatic ductal adenocarcinoma is an uncommon variant of prostatic carcinoma with aggressive behavior and worse prognosis. We describe 68Ga-PSMA-11 and FDG PET/CT findings in a case of prostatic ductal adenocarcinoma with pelvic lymph node metastases. The majority of the prostate tumor and all the metastatic lesions showed no significant PSMA uptake but intense FDG uptake. The role of PSMA and FDG PET in the management of prostatic ductal adenocarcinoma needs to be investigated in a large number of patients.
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Nivolumab Immunotherapy–Related Skin Reactions Detected on 18F-FDG PET/CT in Renal Cell Cancer

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imageNivolumab, a fully human immunoglobulin G4 anti–programmed cell death 1 antibody, provides a novel therapy option for patients with metastatic cancers. Immunotherapy agents have been associated with immune-related adverse events (irAEs), which may be detected on 18F-FDG PET/CT. Cutaneous toxicities are one of the most common irAEs in the form of maculopapular rash (eczema-like spongiotic dermatitis) and pruritus. These irAEs may lead to false-positive findings on PET/CT done during the treatment. One should be aware of the potential irAEs while interpreting PET/CT to avoid misinterpretation.
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18F-FDG PET/CT Uptake in Acute Pontine Infarct Mimicking Intracranial Metastasis

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imageInfarcts are generally nonviable and are not avid on an 18F-FDG PET/CT. Here, we discuss a 53-year-old man who presented with chest pain and raised d-dimer. CT pulmonary angiogram was performed to exclude pulmonary embolism, which identified incidental lung nodules. 18F-FDG PET/CT was performed for the assessment of lung nodules, which showed incidental focal FDG uptake in the pons. This was concluded as an acute infarct on subsequent MR scan. This highlights the importance of not interpreting all focal FDG uptakes as malignant. In rare circumstances, false-positive benign causes should be considered, such as in this rare case of an acute pontine infarct.
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Neonatal Intensive Care Workflow Analysis Informing NEC-Zero Clinical Decision Support Design

alexandrossfakianakis shared this article with you from Inoreader
imageDecision support in neonatal ICUs is needed, especially for prevention and risk awareness of the devastating complication of necrotizing enterocolitis, a major cause of emergency surgery among fragile infants. The purpose of this study was to describe the current clinical workflow and sociotechnical processes among clinicians for necrotizing enterocolitis risk awareness, timely recognition of symptoms, and treatment to inform decision support design. A qualitative descriptive study was conducted. Focus groups were held in two neonatal ICUs (five groups in Unit A and six in Unit B). Transcripts were analyzed using content analys is and compared with field notes. Clinicians (N = 27) included nurses (37%), physicians (30%), neonatal nurse practitioners (19%), and other staff (16%). Workflow processes differed for nurses (who see necrotizing enterocolitis signs and notify providers to order diagnostic tests and treatments) and providers (who receive notification of necrotizing enterocolitis concern and then decide how to act). Clinicians desired (1) a necrotizing enterocolitis-relevant dashboard to support nutrition tracking and necrotizing enterocolitis recognition; (2) features to support decision-making (eg, necrotizing enterocolitis risk and adherence scoring); (3) breast milk tracking and feeding clinical decision support; (4) tools for necrotizing enterocolitis surveillance and quality reporting; and (5) general EHR optimizations to improve user experience.
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Developing a Multimodal Monitoring System for Geriatric Depression: A Feasibility Study

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imageThe Internet of Medical Things is promising for monitoring depression symptoms. Therefore, it is necessary to develop multimodal monitoring systems tailored for elderly individuals with high feasibility and usability for further research and practice. This study comprised two phases: (1) methodological development of the system; and (2) system validation to evaluate its feasibility. We developed a system that includes a smartphone for facial and verbal expressions, a smartwatch for activity and heart rate monitoring, and an ecological momentary assessment application. A sample of 21 older Koreans aged 65 years and more was r ecruited from a community center. The 4-week data were collected for each participant (n = 19) using self-report questionnaires, wearable devices, and interviews and were analyzed using mixed methods. The depressive group (n = 6) indicated lower user acceptance relative to the nondepressive group (n = 13). Both groups experienced positive emotions, had regular life patterns, increased their self-interest, and stated that a system could disturb their daily activities. However, they were interested in learning new technologies and actively monitored their mental health status. Our multimodal monitoring system shows potential as a feasible and useful measure for acquiring mental health information about geriatric depression.
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