A combined VBM and DTI study of schizophrenia: bilateral decreased insula volume and cerebral white matter disintegrity corresponding to subinsular white matter projections unlinked to clinical symptomatology

PURPOSE:Grey matter and white matter changes within the brain are well defined in schizophrenia. However, most studies focused on either grey matter changes or white matter integrity separately; only in limited number of studies these changes were interpreted in the same frame. In addition, the relationship of these findings with clinical variables is not clearly established. Here, we aimed to investigate the grey matter and white matter changes in schizophrenia patients and exhibit the relation of these imaging findings with clinical variables.METHODS:A total of 20 schizophrenia patients and 16 matched healthy controls underwent magnetic resonance imaging to investigate the grey matter and white matter alterations that occur in schizophrenia patients using voxel-based morphometry (VBM) and whole brain voxel-wise analysis of diffusion tensor imaging (DTI) parameters with SPM8, respectively. While the preprocessing steps of VBM were performed with the default parameters of VBM8 toolbox, the preprocessing steps of DTI were carried out using FSL. Additionally, VBM results were correlated with clinical variables.RESULTS:Bilateral insula showed decreased grey matter volume in schizophrenia patients compared with healthy controls (P < 0.01). The opposite contrast did not show a significant difference. Psychiatric scores, duration of illness, and age were not correlated with the decreased grey matter volume of insula in schizophrenia patients. DTI analysis revealed a significant increase in mean, radial, and axial diffusivity, mainly of the fibers of bilateral anterior thalamic radiation and superior longitudinal fasciculus with left predominance, which intersected with bilateral subinsular white matter (P < 0.05).CONCLUSION:Our findings suggest that insula may be the main affected brain region in schizophrenia, which is also well supported by the literature. Our results were independent of disease duration and schizophrenia symptoms. White matter alterations were observed within bilateral anterior thalamic radiation and superior longitudinal fasciculus that intersects with subinsular white matter. Studies with larger sample sizes and more detailed clinical assessments are required to understand the function of insula in the neurobiology of schizophrenia

Programmable RNA Shredding by the Type III-A CRISPR-Cas System of Streptococcus thermophilus

Immunity against viruses and plasmids provided by CRISPR-Cas systems relies on a ribonucleoprotein effector complex that triggers the degradation of invasive nucleic acids (NA). Effector complexes of type I (Cascade) and II (Cas9-dual RNA) target foreign DNA. Intriguingly, the genetic evidence suggests that the type III-A Csm complex targets DNA, whereas biochemical data show that the type III-B Cmr complex cleaves RNA. Here we aimed to investigate NA specificity and mechanism of CRISPR interference for the Streptococcus thermophilus Csm (III-A) complex (StCsm). When expressed in Escherichia coli, two complexes of different stoichiometry copurified with 40 and 72 nt crRNA species, respectively. Both complexes targeted RNA and generated multiple cuts at 6 nt intervals. The Csm3 protein, present in multiple copies in both Csm complexes, acts as endoribonuclease. In the heterologous E. coli host, StCsm restricts MS2 RNA phage in a Csm3 nuclease-dependent manner. Thus, our results demonstrate that the type III-A StCsm complex guided by crRNA targets RNA and not DNA. Highlights • Streptococcus thermophilus type III-A Csm (StCsm) complex targets RNA •Multiple cuts are introduced in the target RNA at 6 nt intervals •Csm3 protein subunits are responsible for endoribonuclease activity of the complex •StCsm complex offers a programmable tool for RNA degradatio

Reconsidering nationalism and feminism: the Kurdish political movement in Turkey

Feminist scholars have documented with reference to multiple empirical contexts that feminist claims within nationalist movements are often side‐lined, constructed as ‘inauthentic’ and frequently discredited for imitating supposedly western notions of gender‐based equality. Despite these historical precedents, some feminist scholars have pointed to the positive aspects of nationalist movements, which frequently open up spaces for gender‐based claims. Our research is based on the recognition that we cannot discuss and evaluate the fraught relationship in the abstract but that we need to look at the specific historical and empirical contexts and articulations of nationalism and feminism. The specific case study we draw from is the relationship between the Kurdish women's movement and the wider Kurdish political movement in Turkey. We are exploring the ways that the Kurdish movement in Turkey has politicised Kurdish women's rights activists and examine how Kurdish women activists have reacted to patriarchal tendencies within the Kurdish movement

Explaining the decline in coronary heart disease mortality in Turkey between 1995 and 2008.

BACKGROUND: Coronary heart disease (CHD) mortality rates have been decreasing in Turkey since the early 1990s. Our study aimed to determine how much of the CHD mortality decrease in Turkey between 1995 and 2008 could be attributed to temporal trends in major risk factors and how much to advances in medical and surgical treatments. METHODS: The validated IMPACT CHD mortality model was used to combine and analyse data on uptake and effectiveness of CHD treatments and risk factor trends in Turkey in adults aged 35-84 years between 1995 and 2008.Data sources were identified, searched and appraised on population, mortality and major CHD risk factors for adults those aged 35-84 years. Official statistics, electronic databases, national registers, surveys and published trials were screened from 1995 onwards. RESULTS: Between 1995 and 2008, coronary heart disease mortality rates in Turkey decreased by 34% in men and 28% in women 35 years and over. This resulted in 35,720 fewer deaths in 2008.Approximately 47% of this mortality decrease was attributed to treatments in individuals (including approximately 16% to secondary prevention, 3% angina treatments, 9% to heart failure treatments, 5% to initial treatments of acute myocardial infarction, and 5% to hypertension treatments) and approximately 42% was attributable to population risk factor reductions (notably blood pressure 29%; smoking 27%; and cholesterol 1%). Adverse trends were seen for obesity and diabetes (potentially increasing mortality by approximately 11% and 14% respectively). The model explained almost 90% of the mortality fall. CONCLUSION: Reduction in major cardiovascular risk factors explained approximately 42% and improvements in medical and surgical treatments explained some 47% of the CHD mortality fall. These findings emphasize the complimentary value of primary prevention and evidence-based medical treatments in controlling coronary heart disease

Contrasting cardiovascular mortality trends in Eastern Mediterranean populations: contributions from risk factor changes and treatments

Background Middle income countries are facing an epidemic of non-communicable diseases, especially coronary heart disease (CHD). We used a validated CHD mortality model (IMPACT) to explain recent trends in Tunisia, Syria, the occupied Palestinian territory (oPt) and Turkey. Methods Data on populations, mortality, patient numbers, treatments and risk factor trends from national and local surveys in each country were collated over two time points (1995–97; 2006–09); integrated and analysed using the IMPACT model. Results Risk factor trends: Smoking prevalence was high in men, persisting in Syria but decreasing in Tunisia, oPt and Turkey. BMI rose by 1–2 kg/m2 and diabetes prevalence increased by 40%–50%. Mean systolic blood pressure and cholesterol levels increased in Tunisia and Syria. Mortality trends: Age-standardised CHD mortality rates rose by 20% in Tunisia and 62% in Syria. Much of this increase (79% and 72% respectively) was attributed to adverse trends in major risk factors, occurring despite some improvements in treatment uptake. CHD mortality rates fell by 17% in oPt and by 25% in Turkey, with risk factor changes accounting for around 46% and 30% of this reduction respectively. Increased uptake of community treatments (drug treatments for chronic angina, heart failure, hypertension and secondary prevention after a cardiac event) accounted for most of the remainder. Discussion CHD death rates are rising in Tunisia and Syria, whilst oPt and Turkey demonstrate clear falls, reflecting improvements in major risk factors with contributions from medical treatments. However, smoking prevalence remains very high in men; obesity and diabetes levels are rising dramatically

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Cas6 specificity and CRISPR RNA loading in a complex CRISPR-Cas system

This research was funded in part by Biotechnology and Biological Sciences Research Council [BB/K000314/1]. The APC was paid through RCUK OA block grant funds.CRISPR-Cas is an adaptive prokaryotic immune system, providing protection against viruses and other mobile genetic elements. In type I and type III CRISPR-Cas systems, CRISPR RNA (crRNA) is generated by cleavage of a primary transcript by the Cas6 endonuclease and loaded into multisubunit surveillance/effector complexes, allowing homology-directed detection and cleavage of invading elements. Highly studied CRISPR-Cas systems such as those in Escherichia coli and Pseudomonas aeruginosa have a single Cas6 enzyme that is an integral subunit of the surveillance complex. By contrast, Sulfolobus solfataricus has a complex CRISPR-Cas system with three types of surveillance complexes (Cascade/type I-A, CSM/type III-A and CMR/type III-B), five Cas6 paralogues and two different CRISPR-repeat families (AB and CD). Here, we investigate the kinetic properties of two different Cas6 paralogues from S. solfataricus. The Cas6-1 subtype is specific for CD-family CRISPR repeats, generating crRNA by multiple turnover catalysis whilst Cas6-3 has a broader specificity and also processes a non-coding RNA with a CRISPR repeat-related sequence. Deep sequencing of crRNA in surveillance complexes reveals a biased distribution of spacers derived from AB and CD loci, suggesting functional coupling between Cas6 paralogues and their downstream effector complexes.Publisher PDFPeer reviewe

Madde Kullanımı ile İlgili İnançlar Ölçeği (MKİÖ) Türkçe Uyarlamasının Alkol BağımlılarındaGeçerlik ve Güvenilirliği

Amaç: Bu çalışmada özgün formu Wrigt (1993) tarafından geliştirilen Madde Kullanımı ile İlgili İnançlar Ölçeği (MKİÖ) Türkçe uyarlamasının geçerlik ve güvenilirliğinin değerlendirilmesi amaçlanmıştır. Yöntem: Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi kliniğine yatırılarak tedavi edilen 70 alkol bağımlısı hasta, 31 hiç alkol kullanmayan sağlıklı gönüllü ve 33 sosyal alkol kullanıcısı incelenmiştir. Bütün gruplarda Madde Kullanımı ile İlgili İnançlar Ölçeği (MKİÖ) ve Alkol Kullanma İsteği ile İlgili İnançlar Ölçeği (AKİÖ), hasta grubunda Beck Anksiyete Envanteri (BAE), Alkol Çekilme Değerlendirme Skalası (AÇDS), Fonksiyonel Olmayan Tutumlar Ölçeği (FOTÖ) ve Otomatik Düşünce Ölçeği (ODÖ) değerlendirme araçları olarak kullanılmıştır. Ölçekler arasındaki bağıntılar ve farklılıklar incelenmiştir.Bulgular: Hasta grubunun, sağlıklı kontrol grubunun ve sosyal alkol kullanıcılarının yaş ortalamaları sırasıyla 42,37,0, 33,59,9 ve 33,28,9 idi. Hasta grubunda BSU ortalama puanı 46,4 21,2 idi. Alkol bağımlıları için MKİÖ içtutarlılığı yeterli düzeyde bulundu (Cronbach alfa0.89) ve madde-toplam puan bağıntıları 0.33 ile 0.69 arasındaydı. Temel eleman analizleri tek bir ana faktörü gösterdi. MKİÖ, AKİÖ ve ODÖ arasında pozitif bağıntı bulundu. FOTÖ toplam puanları ya da alt ölçekleri, AÇDS, BAÖ ve MKİÖ toplam puanları arasında bağıntı bulunmadı. Geçerlilik incelemesinde MKİÖ ortalama puanları, alkol bağımlılarında sağlıklı kontrol grubuna ve sosyal alkol kullanıcılarına göre anlamlı olarak yüksek bulundu.Sonuç: Bulgularımız MKİÖ'nün Türkçe uyarlamasının alkol bağımlısı hastalarda madde kullanımıyla ilgili inançların değerlendirilmesi için yeterli bir araç olduğunu desteklemektedirObjective: In this study, it is aimed to evaluate the validity and reliability of the Beliefs About Substance Use Questionnaire (BSU) which was originally developed by Wright (1993). Method: Seventy alcohol addicted inpatients, who were admitted to Ankara Dışkapı Yıldırım Beyazıt Education and Research Hospital Psychiatry Clinic, 31 healthy volunteers who had never used alcohol and 33 social drinkers were evaluated. For all groups, BSU and Craving Beliefs Questionnaire (CBQ), for the patient groups, Beck Anxiety Inventory (BAI), Clinical Institute Withdrawal Assessment (CIWA), Dysfunctional Attitudes Questionnaire (DAS) and Automatic Thoughts Questionnaire (ATQ) were used as the assessment tools. The correlations and differences between the questionnaires were studied. Results: Mean age of the addicted patients, healthy controls and social drinkers were 42,3&plusmn; 7,0, 33,5&plusmn; 9,9 and 33,2&plusmn; 8,9, respectively. In patient group, mean BSU score was 46,4 &plusmn; 21,2. For alcohol addicts, internal reliability of BSU was found to be adequate (Cronbach alfa0.91) and item-total score correlations were between 0.33 and 0.69. Basic component analysis showed one basic factor. A positive correlation has been found between BSU and CBQ, and ATQ scores. No correlations have been found between total and subscale scores of DAS and total scores of CIWA, BAI and BSU. In evaluation of validity, BSU mean scores of alcohol addicts were found to be significantly higher than healthy controls and social drinkers. Conclusion: Our findings support that Turkish version of BSU is an adequate tool that can be used to evaluate alcohol addicted patients cognitive believes about alcohol use