Early impacts of the COVID-19 pandemic on mental health care and on people with mental health conditions: framework synthesis of international experiences and responses

PURPOSE: The COVID-19 pandemic has many potential impacts on people with mental health conditions and on mental health care, including direct consequences of infection, effects of infection control measures and subsequent societal changes. We aimed to map early impacts of the pandemic on people with pre-existing mental health conditions and services they use, and to identify individual and service-level strategies adopted to manage these. METHODS: We searched for relevant material in the public domain published before 30 April 2020, including papers in scientific and professional journals, published first person accounts, media articles, and publications by governments, charities and professional associations. Search languages were English, French, German, Italian, Spanish, and Mandarin Chinese. Relevant content was retrieved and summarised via a rapid qualitative framework synthesis approach. RESULTS: We found 872 eligible sources from 28 countries. Most documented observations and experiences rather than reporting research data. We found many reports of deteriorations in symptoms, and of impacts of loneliness and social isolation and of lack of access to services and resources, but sometimes also of resilience, effective self-management and peer support. Immediate service challenges related to controlling infection, especially in inpatient and residential settings, and establishing remote working, especially in the community. We summarise reports of swiftly implemented adaptations and innovations, but also of pressing ethical challenges and concerns for the future. CONCLUSION: Our analysis captures the range of stakeholder perspectives and experiences publicly reported in the early stages of the COVID-19 pandemic in several countries. We identify potential foci for service planning and research

New eutectoid materials in the system dicalcium silicate-tricalcium phosphate as acaffolds for bone tissue engineering = Nuevos materiales eutectoides en el sistema fosfato tricálcico-silicato dicálcico para regeneración ósea

Las células mesenchymales adultas de medula ósea (ahMSCs) son células multipotentes capaces de diferenciación osteogenica. Tres materiales eutectiodes en el sistema dicalcio silicato-tricalcio fosfato se estudiaron como matrices para la bioingeniería del hueso: su habilidad para suportar el crecimiento celular y el diferenciamiento osteogenico de las ahMSCs, con o sin suplementos osteogenicos. Cuando los biomateriales son puestos en medio de crecimiento, una capa de apatita se forma en su superficie, esta favorece la adhesión de las ahMSCs, pero solo EC2 aumentó la proliferación significativamente. EC1 y EC2 aumentan la expresión de genes osteoblasticos. Las proteínas de la matriz extracelular, como osteopontina y osteonectina, se detectaron a partir del día 21 para los tres biomateriales. A 21 días hubo mineralización especialmente con el EC2 en medio osteogenico. La disminución del anfígeno CD105 en las células sembradas con EC2 sugiere diferenciación. EC2 es el mejor candidato para ulteriores estudios de ingeniería tisular. Adult human bone marrow mesenchymal stem cells (ahMSCs) are multipotent stromal cells capable of osteogenic differentiation. Three eutectoid materials in the system dicalcium silicate-tricalcium phosphate were investigated as scaffolds for bone bioengineering: their ability to support cell growth and ahMSC osteogenic differentiation with or without osteogenic supplements. When biomaterials are placed in culture medium an apatitic layer forms on their surfaces, ahMSCs are therefore able to adhere, but only EC2 strongly increments ahMSC proliferation. EC1 and EC2 augment the expression of osteoblastic lineage typical genes Extracellular matrix proteins, such as osteocalcin and osteopontin, are detected from 21th day of incubation with the three materials. At 21 days, mineralization occurs specially in samples incubated with EC2 with osteogenic medium. Moreover, the decrease of CD105 antigen expression in cells seeded on EC2 suggests differentiation. EC2 seems to be the best candidate for further investigations concerning its application in bone tissue engineering

Effects of a competition of mountain biking on the state of hydration in amateur cyclists

El propósito del presente trabajo fue valorar los cambios en el estado de hidratación en ciclistas amateurs de la disciplina mountain bike (Rally) durante una prueba de un día. Método: Se obtuvieron dos muestras de orina, una PRE y otra POST competición en 13 varones de nivel amateur en esta disciplina, en las que se analizó la gravedad específica de la orina (USG) mediante refractómetro. Se registró igualmente el cambio en la masa corporal PRE-POST y se controló el volumen de líquido ingerido durante la competición ad libitum. Resultados: Se observó una USG media PRE competición de 1034,33 ±6,8 y POST de 1034 ± 6,6. Una pérdida de masa corporal relativa del 2,6 ± 0,7 % y una tasa de sudoración media de 707,5 ml/h ± 277,9. Conclusiones: Los resultados obtenidos indican que los ciclistas evaluados comenzaron y terminaron la competición en estado de deshidratación severa (i.e., USG> 1.020). No obstante, a pesar de comenzar en este estado de deshidratación y disponer de avituallamiento líquido y sólido ad libitum, los ciclistas experimentaron una pérdida de masa corporal superior a un 2% durante el evento competitivo.ABSTRACT: The purpose of this study was to assess the changes in the state of hydration in amateur cyclists of the discipline mountain biking (Rally) during a race of one day. Method: PRE and POST urine samples were obtained, in 13 amateur cyclists of this discipline, and urine specific gravity (USG) was analyzed by refractometer. Change in body mass was also registered and the volume of liquid ingested ad libitum during the competition was controlled. Results: The average pre-competition USG was 1034,33 ±6,8 and post-competition 1034 ± 6,6. The loss of body mass was 2.6 ± 0.7% and the average sweating rate was 707,5 ml/h ± 277,9. Conclusions: The results obtained indicate that the cyclists evaluated began and ended the competition in a severe dehydration state (i.e., USG> 1.020). However, despite starting in state of dehydration and having liquid and solid supplies ad libitum, the cyclists experienced a body mass loss higher than 2% during the competitive event

Human mesenchymalstemcellviability,proliferationanddifferentiation potential inresponsetoceramicchemistryandsurfaceroughness

We investigatedtheeffectoftheceramicchemistryandsurfaceroughnessofpure α-tricalcium phosphate,andalso αTCP dopedwitheither 1.5 wt%or3.0wt%ofdicalciumsilicate(C2S), ontheresponseofadulthumanmesenchymalstemcells(ahMSCs). AhMSCs wereplatedonto ceramic discs,preparedbyasolid-statereaction.Afterbeingsintered,somesampleswerepolishedupto1 μm, whileotherswerekeptas manufactured, whichresultedintwosurfaceroughnessgrades.Viability,proliferationandosteoinductivecapacityweredeterminedfollowing various incubationperiods. The resultsshowedanon-cytotoxiceffectafteranindirectapoptosistest.Celladhesionandproliferationweresurfaceroughness-sensitiveand increased proportionallytotheroughnessofmaterials.Theseobservationsbecamemoreevidentintheunpolished αTCP ceramicdopedwith 1.5 wt%C2S, whichinducedosteoblasticdifferentiationasaresultoftheroughnessandincreasedconcentrationoftheC2S solidsolution in αTCP

The chemokine CXCL12 mediates the anti-amyloidogenic action of painless human nerve growth factor

Nerve growth factor is a therapeutic candidate for Alzheimer's disease. Due to its pain-inducing activity, in current clinical trials nerve growth factor is delivered locally into the brain by neurosurgery, but data on the efficacy of local nerve growth factor delivery in decreasing amyloid-β deposition are not available. To reduce the nerve growth factor pain-inducing side effects, thus avoiding the need for local brain injection, we developed human painless nerve growth factor (hNGFp), inspired by the human genetic disease hereditary sensory and autonomic neuropathy type V. hNGFp has identical neurotrophic potency as wild-type human nerve growth factor, but a 10-fold lower pain sensitizing activity. In this study we first mimicked, in the 5xFAD mouse model, the intraparenchymal delivery of hNGFp used in clinical trials and found it to be ineffective in decreasing amyloid-β plaque load. On the contrary, the same dose of hNGFp delivered intranasally, which was widely biodistributed in the brain and did not induce pain, showed a potent anti-amyloidogenic action and rescued synaptic plasticity and memory deficits. We found that hNGFp acts on glial cells, modulating inflammatory proteins such as the soluble TNFα receptor II and the chemokine CXCL12. We further established that the rescuing effect by hNGFp is mediated by CXCL12, as pharmacological inhibition of CXCL12 receptor CXCR4 occludes most of hNGFp effects. These findings have significant therapeutic implications: (i) we established that a widespread exposure of the brain is required for nerve growth factor to fully exert its neuroprotective actions; and (ii) we have identified a new anti-neurodegenerative pathway as a broad target for new therapeutic opportunities for neurodegenerative diseases