Strengthening Mental Health Diagnostic Detection in Integrated Primary Care

Primary care behavioral health (PCBH) is crucial for providing mental health treatment to underserved, minority, and uninsured populations. There is a lack of knowledge about accurate mental health diagnoses at PCBH. Underdetection of mental health symptoms has the potential to worsen racial and socioeconomic disparities. Using an expert review process, I developed an abbreviated diagnostic clinical interview (ADCI) for integrated primary care. Next, patients (N = 82) completed the interview after attending PCBH appointments. According to the interview, 63.4% of participants met criteria for a diagnosis, while 64.7% received a diagnosis from their provider. A large portion of patients met criteria for a somatic symptom disorder (25.8%), likely associated with data collection occurring during the COVID pandemic. Kappa agreement between the ADCI and providers’ diagnosis of mood disorders (i.e., depression, anxiety, or both) was significant but in the fair range. The pattern of disagreement demonstrated that the ADCI was significantly more likely to detect comorbid depression and anxiety than providers. Overall, results suggest that the ADCI might be capturing comorbid psychopathology that is underdetected due to the brief PCBH model. For example, referrals from providers often focus on more behavioral health concerns, and the brevity of services does not always allow for in-depth assessment. The ADCI represents an opportunity to improve mental health service in primary care by offering a quick mechanism for identifying a more complete picture of a patient’s mental health concerns

For I Know the Plans I Have for You: God Locus of Control, Spiritual Change, and Death Anxiety in Primary Brain Tumor Patients

Background/Purpose. Primary brain tumor (PBT) patients risk experiencing death anxiety given the high mortality rate of their diagnosis. In line with Terror Management Theory (TMT), many diagnosed with cancer utilize religion as a method of coping with the disease. However, previous literature on the relation between death anxiety and religion in cancer patients indicates mixed findings of either a negative relationship or no association. To the authors’ knowledge, no study has analyzed these two constructs together in PBT patients. The current study sought to address this gap by investigating the relationship between religiosity and death anxiety in an understudied population. Methods. Adult PBT patients (N = 56, Mage = 49.38, 51.8% female, 71.4% Caucasian, Mmonths since diagnosis = 55.34) completed measures of religiosity and death anxiety at their routine medical appointment at an academic medical center, including: The God Locus of Health Control Scale (GLHCS), Posttraumatic Growth Inventory (PTGI), Death and Dying Distress Scale (DADDS), and the Death Distress Scale (DDS). Descriptives and Pearson correlations were utilized. Results. The results revealed that while the GLHCS was not significantly related to either measure of death anxiety, the Spiritual Change subscale of the PTGI was positively correlated to both the DADDS (r = .56, p \u3c .001) and the DDS (r = .41, p = .01). Conclusions and Implications. Results suggest that certain proxies of religiosity may be more closely associated with death anxiety than others. Although there was no evidence in our sample that PBT patient’s God locus of control was related to death anxiety, those who reported higher levels of death anxiety endorsed greater spiritual change (i.e., I have a stronger religious faith). Considering TMT, perhaps feelings of death anxiety prompt one to strengthen their religious beliefs. Future longitudinal analyses addressing the direction and course of these relationships are warranted. Acknowledgement of Funding: The current study was funded on behalf of Virginia Commonwealth University School of Medicine. Learning Objective. Participants will learn about the relationship between religiosity and death anxiety in oncology patients. Further, participants will consider how these findings may or may not differ for PBT patients and across various measures of religiosity.https://scholarscompass.vcu.edu/gradposters/1049/thumbnail.jp

Screening for Cognitive Impairment in Primary Brain Tumor Patients: A Preliminary Investigation with the MMSE and RBANS

Introduction: The prevalence of mild cognition impairment (MCI) among older adults (≥65) is estimated to range between 10-20% (Langa & Levine, 2014). Integrated primary care allows opportunities for interdisciplinary consultation, screening, and intervention. The aim of this study is to explore the percentage of older adults reporting cognitive concerns during their first primary care psychology visits. It is hypothesized that these rates will mirror prevalence rates in other older adult community dwelling samples in primary care settings. Methods: A patient sample of older adults (≥60) was introduced to services following a referral from their primary care physician. Clinicians then identified problems that were discussed in session, including “cognitive concerns.” Descriptive statistics will be used to assess the percentage of older adults with “cognitive concerns” in this sample, compared to other community dwelling samples. Results: 267 older adults were identified within a larger sample of patients who received primary care psychology services. The percentage of older adults who were referred for “cognitive concerns” was 10.5% (n = 28), with 12.7% (n = 34) reporting “cognitive concerns” during their visit. Interestingly of the 28 older adults referred by their provider for “cognitive concerns,” less than 50% (n = 13) of those patients reported “cognitive concerns” as one of their problems in session. Discussion: This sample of older adults reported cognitive concerns in primary care psychology sessions at a rate that falls within the range identified in other community dwelling samples. Future research could further improve upon identification and screening of older adults with cognitive concerns by psychologists in primary care settings, as intervention for MCI can improve quality of life and may delay progression of dementia (Campbell et al., 2018; Eshkoor et al., 2015).https://scholarscompass.vcu.edu/gradposters/1088/thumbnail.jp

The nanos translational control element represses translation in somatic cells by a Bearded box-like motif

AbstractDevelopmental control of translation is frequently mediated by regulatory elements that reside within 3′ untranslated regions (3′ UTRs). Two stem-loops within the nanos 3′ UTR translational control element (TCE) act independently to direct translational repression of maternal nanos mRNA in the ovary or embryo. We have previously shown that the nanos TCE can also function in select somatic sites. Using an ectopic expression screen, we now identify a new site of TCE function, the dorsal pouch epithelium. Analysis of TCE mutants reveals that TCE activity in the dorsal pouch does not depend on either of the stem-loops required for maternal TCE function, but instead requires a third feature—a sequence that closely matches the Bearded box, a regulatory motif found in the 3′ UTRs of several Notch pathway genes. In addition, we identify pleiohomeotic mRNA as an endogenous candidate for regulation by Bearded box-like motifs in the dorsal pouch. Together, these results suggest that the TCE has appropriated a conserved regulatory motif to expand its function to somatic tissues

Sustained proliferation in cancer: mechanisms and novel therapeutic targets

Proliferation is an important part of cancer development and progression. This is manifest by altered expression and/or activity of cell cycle related proteins. Constitutive activation of many signal transduction pathways also stimulates cell growth. Early steps in tumor development are associated with a fibrogenic response and the development of a hypoxic environment which favors the survival and proliferation of cancer stem cells. Part of the survival strategy of cancer stem cells may manifested by alterations in cell metabolism. Once tumors appear, growth and metastasis may be supported by overproduction of appropriate hormones (in hormonally dependent cancers), by promoting angiogenesis, by undergoing epithelial to mesenchymal transition, by triggering autophagy, and by taking cues from surrounding stromal cells. A number of natural compounds (e.g., curcumin, resveratrol, indole-3-carbinol, brassinin, sulforaphane, epigallocatechin-3-gallate, genistein, ellagitannins, lycopene and quercetin) have been found to inhibit one or more pathways that contribute to proliferation (e.g., hypoxia inducible factor 1, nuclear factor kappa B, phosphoinositide 3 kinase/Akt, insulin-like growth factor receptor 1, Wnt, cell cycle associated proteins, as well as androgen and estrogen receptor signaling). These data, in combination with bioinformatics analyses, will be very important for identifying signaling pathways and molecular targets that may provide early diagnostic markers and/or critical targets for the development of new drugs or drug combinations that block tumor formation and progression

Artifacts In Magnetic Resonance Imaging and Computed Tomography Caused By Dental Materials

BACKGROUND: Artifacts caused by dental restorations, such as dental crowns, dental fillings and orthodontic appliances, are a common problem in MRI and CT scans of the head and neck. The aim of this in-vitro study was to identify and evaluate the artifacts produced by different dental restoration materials in CT and MRI images. METHODS: Test samples of 44 materials (Metal and Non-Metal) commonly used in dental restorations were fabricated and embedded with reference specimens in gelatin moulds. MRI imaging of 1.5T and CT scan were performed on the samples and evaluated in two dimensions. Artifact size and distortions were measured using a digital image analysis software. RESULTS: In MRI, 13 out of 44 materials produced artifacts, while in CT 41 out of 44 materials showed artifacts. Artifacts produced in both MRI and CT images were categorized according to the size of the artifact. SIGNIFICANCE: Metal based restoration materials had strong influence on CT and less artifacts in MRI images. Rare earth elements such as Ytterbium trifluoride found in composites caused artifacts in both MRI and CT. Recognizing these findings would help dental materials manufacturers and developers to produce materials which can cause less artifacts in MRI and CT images

GLUT 5 Is Not Over-Expressed in Breast Cancer Cells and Patient Breast Cancer Tissues

F18 2-Fluoro 2-deoxyglucose (FDG) has been the gold standard in positron emission tomography (PET) oncologic imaging since its introduction into the clinics several years ago. Seeking to complement FDG in the diagnosis of breast cancer using radio labeled fructose based analogs, we investigated the expression of the chief fructose transporter-GLUT 5 in breast cancer cells and human tissues. Our results indicate that GLUT 5 is not over-expressed in breast cancer tissues as assessed by an extensive immunohistochemistry study. RT-PCR studies showed that the GLUT 5 mRNA was present at minimal amounts in breast cancer cell lines. Further knocking down the expression of GLUT 5 in breast cancer cells using RNA interference did not affect the fructose uptake in these cell lines. Taken together these results are consistent with GLUT 5 not being essential for fructose uptake in breast cancer cells and tissues

Conjugation of Functionalized SPIONs with Transferrin for Targeting and Imaging Brain Glial Tumors in Rat Model

Currently, effective and specific diagnostic imaging of brain glioma is a major challenge. Nanomedicine plays an essential role by delivering the contrast agent in a targeted manner to specific tumor cells, leading to improvement in accurate diagnosis by good visualization and specific demonstration of tumor cells. This study investigated the preparation and characterization of a targeted MR contrast agent, transferrin-conjugated superparamagnetic iron oxide nanoparticles (Tf-SPIONs), for brain glioma detection. MR imaging showed the obvious contrast change of brain glioma before and after administration of Tf-SPIONs in C6 glioma rat model in vivo on T2 weighted imaging. Significant contrast enhancement of brain glioma could still be clearly seen even 48 h post injection, due to the retention of Tf-SPIONs in cytoplasm of tumor cells which was proved by Prussian blue staining. Thus, these results suggest that Tf-SPIONs could be a potential targeting MR contrast agent for the brain glioma

Three-dimensional Noninvasive Monitoring Iodine-131 Uptake in the Thyroid Using a Modified Cerenkov Luminescence Tomography Approach

BACKGROUND: Cerenkov luminescence tomography (CLT) provides the three-dimensional (3D) radiopharmaceutical biodistribution in small living animals, which is vital to biomedical imaging. However, existing single-spectral and multispectral methods are not very efficient and effective at reconstructing the distribution of the radionuclide tracer. In this paper, we present a semi-quantitative Cerenkov radiation spectral characteristic-based source reconstruction method named the hybrid spectral CLT, to efficiently reconstruct the radionuclide tracer with both encouraging reconstruction results and less acquisition and image reconstruction time. METHODOLOGY/PRINCIPAL FINDINGS: We constructed the implantation mouse model implanted with a 400 µCi Na(131)I radioactive source and the physiological mouse model received an intravenous tail injection of 400 µCi radiopharmaceutical Iodine-131 (I-131) to validate the performance of the hybrid spectral CLT and compared the reconstruction results, acquisition, and image reconstruction time with that of single-spectral and multispectral CLT. Furthermore, we performed 3D noninvasive monitoring of I-131 uptake in the thyroid and quantified I-131 uptake in vivo using hybrid spectral CLT. Results showed that the reconstruction based on the hybrid spectral CLT was more accurate in localization and quantification than using single-spectral CLT, and was more efficient in the in vivo experiment compared with multispectral CLT. Additionally, 3D visualization of longitudinal observations suggested that the reconstructed energy of I-131 uptake in the thyroid increased with acquisition time and there was a robust correlation between the reconstructed energy versus the gamma ray counts of I-131 (r(2) = 0.8240). The ex vivo biodistribution experiment further confirmed the I-131 uptake in the thyroid for hybrid spectral CLT. CONCLUSIONS/SIGNIFICANCE: Results indicated that hybrid spectral CLT could be potentially used for thyroid imaging to evaluate its function and monitor its treatment for thyroid cancer

In Vivo Serial MR Imaging of Magnetically Labeled Endothelial Progenitor Cells Homing to the Endothelium Injured Artery in Mice

Background: Emerging evidence of histopathological analyses suggests that endothelial progenitor cells (EPCs) play an important role in vascular diseases. Neointimal hyperplasia can be reduced by intravenous transfusion of EPCs after vascular injury in mice. Therefore, it would be advantageous to develop an in vivo technique that can explore the temporal and spatial migration of EPCs homing to the damaged endothelium noninvasively. Methodology/Principal Findings: The left carotid common artery (LCCA) was injured by removal of endothelium with a flexible wire in Kunming mice. EPCs were collected by in vitro culture of spleen-derived mouse mononuclear cells (MNCs). EPCs labeling was carried out in vitro using Fe2O3-poly-L-lysine (Fe2O3-PLL). In vivo serial MR imaging was performed to follow-up the injured artery at different time points after intravenous transfusion of EPCs. Vessel wall areas of injured artery were computed on T2WI. Larger MR signal voids of vessel wall on T2WI was revealed in all 6 mice of the labeled EPC transfusion group 15 days after LCCA injury, and it was found only in 1 mouse in the unlabeled EPC transfusion group (p = 0.015). Quantitative analyses of vessel wall areas on T2WI showed that the vessel wall areas of labeled EPC transfusion group were less than those of unlabeled EPC transfusion group and control group fifteen days after artery injury (p,0.05). Histopathological analyses confirmed accumulation and distribution of transfused EPCs at the injury site of LCCA. Conclusions/Significance: These data indicate that MR imaging might be used as an in vivo method for the tracking of EPC