Investigating the relationship between low serum cholesterol and suicide in attempters with depression

Background & Objective: It has been postulated that depressed individuals with low total cholesterol levels may be more likely to die prematurely from suicide. This study aimed to examine the association between low serum cholesterol and suicide in depressed attempters. Materials & Methods: In this cross-sectional study, 180 suicide attempters, who met the inclusion criteria and were willing to participate in the study, were recruited in 2017. The data was collected using a demographic questionnaire and the Beck Depression Inventory-Second Edition (BDI-II). The blood cholesterol level was measured via an auto-analyzer. Results: The mean age was 26.39±10.75 years. The average cholesterol level in the moderate, severe, and serious depression groups was 151.30±35.23, 145.89±36.32, and 145.15±33.33, respectively. The mean age was higher in the group with a higher depression level, though the difference was not significant (P=0.06). The percentage of suicide attempts in single individuals was significantly higher (P=0.02). The mean cholesterol level in the group with the highest level of depression was the lowest, but the difference was insignificant (r=-.01, P=0.85). Only in females, the level of blood cholesterol showed a nearly significant difference between groups with different severities of depression (P=0.05). Cholesterol had a significant correlation with suicide frequency (P=0.008, r=0.28). Conclusion: Our results revealed no significant association between low serum cholesterol and suicide in attempters with depression; but low total serum cholesterol may be associated with depression and suicide in depressed subjects. Yet, more studies are required for verification of this causality. © 2020, Journal of Advances in Medical and Biomedical Research. All rights reserved

Ischemic heart disease risk factors in lead exposed workers: Research study

Background: Review of other epidemiological studies reveal inconsistent results of relationships between high blood lead level and risk of hypertension, hyperlipidemia and hyperglycemia. In this study we wanted to find if there is a relationship between blood lead level and these ischemic heart disease risk factors. Methods. This cross-sectional study was conducted in a battery recycling plant, and 497 male workers with the mean age of 41.7 (±6.50) years were recruited from all over the plant (those from the products and maintenance sections were classed as "high lead exposed group" and those from amongst the office, laboratory, security services and food services sections as "low lead exposed group"). Personal information such as demographics and work history was obtained through a questionnaire. Mean (±Standard deviation) for quantitative variables, Frequency (Percent) for qualitative variables, and Odd's ratio (OR) with 95 confidence interval (95 CI) for estimating the effect of blood lead level on lipid profiletriglyceride (TG), cholesterol(CHOL), low density lipoprotein - Cholesterol(LDL-C),high density lipoprotein -Cholesterol(HDL-C), hypertension(HTN) and fasting blood sugar (FBS) level. Logistic regression modeling was used for multivariate analysis and adjusting the effect of different variables (age, body mass index(BMI), eating habits, cigarette smoking). Results: The mean Blood Lead Level (BLL) was >40 μg/dl in 281 (56.6%) subjects, �40 μg in 216 (43.4%) subjects and the mean BLL was 43.3 μg/dl (n = 497). The mean job experience involving lead exposure was 13 years. There was no significant correlation between BLL and FBS (p = 0.68), between BLL and TG (P = 0.32), between BLL and HDL-C (p = 0.49), between BLL and LDL-C (p = 0.17), between BLL and CHOL(p = 0.96), between BLL and systolic blood pressure (p = 0.12). The adjusted Odd's ratio for the effect of BLL >40.0 μg/dl on diastolic blood pressure was1.03 (95% CI: 1.01-1.05) with p = 0.05. Conclusion: This study showed an association of high BLL with diastolic blood pressure but not with TG, FBS, and HDL-C, LDL-C and CHOL. This result persisted even after adjustment was made for age, BMI and job experience, smoking and eating habits. Attention to health-protective policies, individual behavioral changes and regular periodic medical examination with focus on diastolic blood pressure in lead exposed workers is likely to decrease the public health burden of ischemic heart disease. © 2013 Ghiasvand et al.; licensee BioMed Central Ltd

Value of prominent flow voids without cord edema in the detection of spinal arteriovenous fistulae

Purpose: To determine the prevalence of spinal dural arteriovenous fistulae (SDAVF) in patients presenting with prominent vascular flow voids on imaging without other imaging findings suggestive of SDAVF. Methods: We retrospectively identified patients from January 1, 2005 to March 1, 2012 who underwent spinal angiography for suspected SDAVF with prominent vascular flow voids on prior imaging. We excluded patients with other major spinal pathology or other imaging findings of SDAVF including cord hyperintensity, enhancement, or expansion. We calculated the proportion of patients with positive findings for SDAVF on angiography and evaluated the prevalence of SDAVF for this finding alone and in correlation with clinical findings. Results: 18 patients underwent spinal angiography for prominent flow voids on imaging without other spinal pathology or imaging findings of SDAVF. Three had a SDAVF detected on angiography. The prevalence of SDAVF in this population was low, only 17% (95% CI 6-39%). All of the patients with positive angiography findings had myelopathy, increasing the prevalence to 100% if the additional clinical finding of myelopathy was present. Conclusions: Prominent flow voids without other imaging findings suggestive of SDAVF is poorly predictive of the presence of a SDAVF, unless myelopathy is present clinically. © 2014 Alhilali et al

Causal hierarchy within the thalamo-cortical network in spike and wave discharges

Background: Generalised spike wave (GSW) discharges are the electroencephalographic (EEG) hallmark of absence seizures, clinically characterised by a transitory interruption of ongoing activities and impaired consciousness, occurring during states of reduced awareness. Several theories have been proposed to explain the pathophysiology of GSW discharges and the role of thalamus and cortex as generators. In this work we extend the existing theories by hypothesizing a role for the precuneus, a brain region neglected in previous works on GSW generation but already known to be linked to consciousness and awareness. We analysed fMRI data using dynamic causal modelling (DCM) to investigate the effective connectivity between precuneus, thalamus and prefrontal cortex in patients with GSW discharges. Methodology and Principal Findings: We analysed fMRI data from seven patients affected by Idiopathic Generalized Epilepsy (IGE) with frequent GSW discharges and significant GSW-correlated haemodynamic signal changes in the thalamus, the prefrontal cortex and the precuneus. Using DCM we assessed their effective connectivity, i.e. which region drives another region. Three dynamic causal models were constructed: GSW was modelled as autonomous input to the thalamus (model A), ventromedial prefrontal cortex (model B), and precuneus (model C). Bayesian model comparison revealed Model C (GSW as autonomous input to precuneus), to be the best in 5 patients while model A prevailed in two cases. At the group level model C dominated and at the population-level the p value of model C was ∼1. Conclusion: Our results provide strong evidence that activity in the precuneus gates GSW discharges in the thalamo-(fronto) cortical network. This study is the first demonstration of a causal link between haemodynamic changes in the precuneus - an index of awareness - and the occurrence of pathological discharges in epilepsy. © 2009 Vaudano et al

GABAergic Neuron Deficit As An Idiopathic Generalized Epilepsy Mechanism: The Role Of BRD2 Haploinsufficiency In Juvenile Myoclonic Epilepsy

Idiopathic generalized epilepsy (IGE) syndromes represent about 30% of all epilepsies. They have strong, but elusive, genetic components and sex-specific seizure expression. Multiple linkage and population association studies have connected the bromodomain-containing gene BRD2 to forms of IGE. In mice, a null mutation at the homologous Brd2 locus results in embryonic lethality while heterozygous Brd2+/− mice are viable and overtly normal. However, using the flurothyl model, we now show, that compared to the Brd2+/+ littermates, Brd2+/− males have a decreased clonic, and females a decreased tonic-clonic, seizure threshold. Additionally, long-term EEG/video recordings captured spontaneous seizures in three out of five recorded Brd2+/− female mice. Anatomical analysis of specific regions of the brain further revealed significant differences in Brd2+/− vs +/+ mice. Specifically, there were decreases in the numbers of GABAergic (parvalbumin- or GAD67-immunopositive) neurons along the basal ganglia pathway, i.e., in the neocortex and striatum of Brd2+/− mice, compared to Brd2+/+ mice. There were also fewer GABAergic neurons in the substantia nigra reticulata (SNR), yet there was a minor, possibly compensatory increase in the GABA producing enzyme GAD67 in these SNR cells. Further, GAD67 expression in the superior colliculus and ventral medial thalamic nucleus, the main SNR outputs, was significantly decreased in Brd2+/− mice, further supporting GABA downregulation. Our data show that the non-channel-encoding, developmentally critical Brd2 gene is associated with i) sex-specific increases in seizure susceptibility, ii) the development of spontaneous seizures, and iii) seizure-related anatomical changes in the GABA system, supporting BRD2's involvement in human IGE

Analyzing Stakeholder Water Source Preference Based upon Social Capital: a Case Study of the Fajr Jam Gas Refinery in Iran

Gas refineries are among the most water-intensive industries in the world. The Fajr Jam gas refinery is one such example, located in the southern Iran. The indiscriminate use of aquifer resources for this highly profitable industry creates tragedy of the commons effects, causing significant environmental controversy and threatening the long-term water security of the region. It behooves decision makers, therefore, to examine a broad range of adaptive water management strategies for this industry. The implementation of such strategies requires understanding the preferences and potential conflicts that may emerge among competing stakeholder interests. This quantitative social scientific study examines stakeholder preferences among water management options through the lens of social capital. Elite stakeholder representatives (including agricultural organizations, governmental organizations, the Water, and Power Authority, Department of Health, Bureau of Water and Wastewater) were canvassed through a survey instrument using paired comparisons. Data were analyzed using Expert Choice software and an analytic hierarchy process technique. The results show that accountability is the main criterion for selecting the best water sources and ranked first with the Eigenvector 0.62. Also, the results show that the least important criterion was social cohesion with the Eigenvalue 0.033. The criteria of partnership and trust ranked as two and three with Eigenvalues 0.215 and 0.133, respectively. The results indicate that the construction of salt water transmission from the sea (A = 0.240) is the preferred option among other alternatives, and this is confirmed by sensitivity analysis