Formation of Testosterone\u27s 5alpha-Reduced, Versus Aromatized, Products Can Have Beneficial Cognitive and Anti-Anxiety Effects Without Negative Effects on Prostate or Sexual Behavior of Male Rats

Testosterone (T) can alter sexual, social, anxiety-like, and/or cognitive behavior of male rodents and exert trophic effects on the prostate. However, whether these effects are due to actions of T, or its 5-reduced and/or aromatized metabolites, is of interest. We tested the hypothesis that T’s effects to enhance prostate proliferation, sexual, social, cognitive and/or anti-anxiety-like behavior require formation of 5-reduced and/or aromatized metabolites. Gonadectomized (GDX) or gonadally-intact rats were administered T-containing, or empty, silastic capsules in conjunction with a 5-reductase inhibitor (finasteride; Experiment 1) or an aromatase inhibitor (formestane; Experiment 2). The performance of rats in sexual, cognitive (object recognition, object placement, water maze), anxiety-like (open field, elevated plus maze, light–dark transition, mirror maze, social interaction) tasks were examined. Prostate mass and concentrations of T and its metabolites were assessed. Rats that were GDX, compared to intact rats, had lower androgen levels, smaller prostates, longer latencies to initiate sexual contacts, had poorer cognitive performance in the object placement and water maze tasks, and demonstrated more anxiety-like behavior in the light/dark transition task and the mirror maze. Finasteride produced effects similar to GDX to decrease prostate weight and inhibit sexual behavior and spatial cognition, but not affective behaviors. Formestane did not alter prostate mass or sexual behavior, but did enhance cognitive performance in the object recognition task and tended to increase central entries in the open field, an indication of anti-anxiety behavior. Thus, shunting T’s metabolism from aromatization to favor 5-reduction had beneficial cognitive and anti-anxiety effects without negative effects on prostate or sexual behavior

Development of a tool to support person-centred medicine-focused consultations with stroke survivors

Objective: To develop a tool to support medicine-focused person-centred consultations between community pharmacists and stroke survivors. Method: Semi-structured interviews with 15 stroke survivors and 16 community pharmacists were conducted. Thematic analysis of the data was performed and emerging themes examined to determine their relevance to the principles of delivering person-centred care. Findings were used to generate a framework from which a consultation tool was created. Face validity and the feasibility of using the tool in practice were explored with participating pharmacists. Results: Three major themes were identified; personal, process and environmental factors. A tool, in two parts, was developed, A ‘Getting to know me’ form which would help the pharmacist to appreciate the individual needs of the stroke survivor and a consultation guide to facilitate the consultation process. Pharmacists considered that both were useful and would support a person-centred medicine-focussed consultation. Conclusion: A consultation tool, reflecting the needs of stroke survivors, has been developed and is feasible for use within community pharmacy practice. Practice implications: Pharmacists must recognise the individual needs of stroke survivors to ensure that they provide consultations which are truly person-centred. The tool developed could support medicine-related consultations with patients with other long term conditions

A Deep Learning Model to Predict Traumatic Brain Injury Severity and Outcome from MR Images

For Many Neurological Disorders, Including Traumatic Brain Injury (TBI), Neuroimaging Information Plays a Crucial Role Determining Diagnosis and Prognosis. TBI is a Heterogeneous Disorder that Can Result in Lasting Physical, Emotional and Cognitive Impairments. Magnetic Resonance Imaging (MRI) is a Non-Invasive Technique that Uses Radio Waves to Reveal Fine Details of Brain Anatomy and Pathology. Although MRIs Are Interpreted by Radiologists, Advances Are Being Made in the Use of Deep Learning for MRI Interpretation. This Work Evaluates a Deep Learning Model based on a Residual Learning Convolutional Neural Network that Predicts TBI Severity from MR Images. the Model Achieved a High Sensitivity and Specificity on the Test Sample of Subjects with Varying Levels of TBI Severity. Six Outcome Measures Were Available on TBI Subjects at 6 and 12 Months. Group Comparisons of Outcomes between Subjects Correctly Classified by the Model with Subjects Misclassified Suggested that the Neural Network May Be Able to Identify Latent Predictive Information from the MR Images Not Incorporated in the Ground Truth Labels. the Residual Learning Model Shows Promise in the Classification of MR Images from Subjects with TBI

Impact of Cluster B Personality Disorders in Drugs Therapeutic Community Treatment Outcomes: A Study Based on Real World Data

Background: The impact of dual pathology on treatment outcomes is unclear, with the literature reporting both favorable and unfavorable evidence. The main aim of this study was to determine how dual pathology affects treatment outcomes using real world data obtained from inpatients that began treatment in therapeutic communities. Method: The data of 2458 inpatients were used. Clinical information was obtained from electronic medical records. Reliability of diagnosis was checked and revealed a mean kappa value of 0.88. Results: Of the sample, 41.8% were discharged after achieving the therapeutic objectives. Patients diagnosed with Cluster B personality disorders were found to have a higher risk of dropping out of treatment (HR = 1.320; z = 2.61; p = 0.009). Conclusions: Personality traits exhibited by Cluster B patients can interfere with treatment in therapeutic communities. There is a need to develop specific interventions for these inpatient groups, which could be implemented in therapeutic communities

Connecting Phenotype To Genotype: PheWAS-inspired Analysis Of Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is extremely heterogeneous clinically and genetically. There is a pressing need for a better understanding of the heterogeneity of ASD based on scientifically rigorous approaches centered on systematic evaluation of the clinical and research utility of both phenotype and genotype markers. This paper presents a holistic PheWAS-inspired method to identify meaningful associations between ASD phenotypes and genotypes. We generate two types of phenotype-phenotype (p-p) graphs: a direct graph that utilizes only phenotype data, and an indirect graph that incorporates genotype as well as phenotype data. We introduce a novel methodology for fusing the direct and indirect p-p networks in which the genotype data is incorporated into the phenotype data in varying degrees. The hypothesis is that the heterogeneity of ASD can be distinguished by clustering the p-p graph. The obtained graphs are clustered using network-oriented clustering techniques, and results are evaluated. The most promising clusterings are subsequently analyzed for biological and domain-based relevance. Clusters obtained delineated different aspects of ASD, including differentiating ASD-specific symptoms, cognitive, adaptive, language and communication functions, and behavioral problems. Some of the important genes associated with the clusters have previous known associations to ASD. We found that clusters based on integrated genetic and phenotype data were more effective at identifying relevant genes than clusters constructed from phenotype information alone. These genes included five with suggestive evidence of ASD association and one known to be a strong candidate

Changes in the Care Activity in Addiction Centers with Dual Pathology Patients during the COVID-19 Pandemic

Background: Health care provision during the COVID-19 pandemic and confinement has led to significant changes in the activity of addiction centers. These changes in healthcare activity may have had a greater impact on patients with dual pathology. The aim of this study is to compare the treatment indicators of patients with dual pathology in addiction centers during the preconfinement, confinement, and post-confinement periods. Methods: A retrospective observational study was conducted for the period between 1 February 2019 and 30 June 2021. A total of 2785 patients treated in specialized addiction services were divided into three periods according to their time of admission: pre-confinement, confinement, and post-confinement. Results: During the prepandemic period, the addiction centers attended to an average of 121.3 (SD = 23.58) patients, decreasing to 53 patients during confinement (SD = 19.47), and 80.69 during the post-confinement period (SD = 15.33). The number of appointments scheduled monthly for each patient decreased during the confinement period, although this number increased after confinement. There was a reduction in the number of toxicological tests carried out both during and after confinement (except for alcohol). Conclusions: The results show a reduction in the number of patients seen and the care activity delivered to dual diagnosis patients. These results, which were caused by the COVIDpreventive measures, may affect the progress and recovery of dual patients. A greater investment is needed to bring the care activity up to the standards of the years prior to confinementThis work was supported by the grant “COMPARA: Psychiatric Comorbidity in Addictions and Outcomes in Andalusia. Modelización a través de Big Data”, project P20-00735 of the Andalusian Research, Development, and Innovation Plan, provided by Fondo Europeo de Desarrollo Regional (EU) and Junta de Andalucía (Spain). This study has been carried out thanks to the transfer of data by the Department of Equality, Social Policies, and Conciliation of the Junta de Andalucí

Monitoring adherence and abstinence of cannabis use disorder patients: profile identification and relationship with long term treatment outcomes

Background: Patients with cannabis use disorder (CUD) show heterogeneous sociodemographic and consumption patterns. Although previous studies, focused on identifying subgroups of CUD patients using input variables, have yielded useful results for planning individualized treatments, no published research has analyzed the profiles of CUD patients according to their therapeutic progress. This study therefore aims to identify subgroups of patients using adherence and abstinence indicators and to explore whether these profiles are associated with sociodemographic characteristics, consumption variables, and long-term therapeutic outcomes. Methods: This was a retrospective observational study with a multisite sample of 2055 CUD outpatients who were beginning treatment. The study monitored patient data at two-year follow-up. We conducted latent profiles analysis on the appointment attendance ratio and percentage of negative cannabis tests. Results: A three profile solution emerged: i) moderate abstinence/moderate adherence (n = 997); ii) high abstinence/moderate adherence (n = 613); and iii) high abstinence/high adherence (n = 445). The study found the most marked differences at the beginning of treatment for education level (chi2 (8) = 121.70, p < .001), source of referral (chi2 (12) = 203.55, p < .001), and frequency of cannabis use (chi2 (10) = 232.39, p < .001). Eighty percent of patients from the “high abstinence/high adherence” group were relapse-free at two year follow- up. This percentage decreased to 24.3 % in the “moderate abstinence/moderate adherence” group. Conclusions: Research has shown adherence and abstinence indicators to be useful for identifying subgroups of patients with different prognoses regarding long-term success. Recognizing the sociodemographic and con- sumption variables associated with these profiles at the beginning of treatment could help to inform the design of more individualized interventionsFunding for open access charge: Universidad de Huelva / CBU

A PheWAS Model Of Autism Spectrum Disorder

Children with Autism Spectrum Disorder (ASD) exhibit a wide diversity in type, number, and severity of social deficits as well as communicative and cognitive difficulties. It is a challenge to categorize the phenotypes of a particular ASD patient with their unique genetic variants. There is a need for a better understanding of the connections between genotype information and the phenotypes to sort out the heterogeneity of ASD. In this study, single nucleotide polymorphism (SNP) and phenotype data obtained from a simplex ASD sample are combined using a PheWAS-inspired approach to construct a phenotype-phenotype network. The network is clustered, yielding groups of etiologically related phenotypes. These clusters are analyzed to identify relevant genes associated with each set of phenotypes. The results identified multiple discriminant SNPs associated with varied phenotype clusters such as ASD aberrant behavior (self-injury, compulsiveness and hyperactivity), as well as IQ and language skills. Overall, these SNPs were linked to 22 significant genes. An extensive literature search revealed that eight of these are known to have strong evidence of association with ASD. The others have been linked to related disorders such as mental conditions, cognition, and social functioning, Clinical relevance - This study further informs on connections between certain groups of ASD phenotypes and their unique genetic variants. Such insight regarding the heterogeneity of ASD would support clinicians to advance more tailored interventions and improve outcomes for ASD patients

Coping motives for drinking as a mediator between anxiety and depression, and alcohol outcomes in community Spanish young adults

Consistent with the medication hypothesis, drinking to cope with negative affect appears to mediate the relationship between mental health and alcohol-related problems, which has been shown in college students. However, there is a lack of evidence in non-university samples that limits the generalization of results. The present study examines the mediating role of coping motives in the relationship between depression and anxiety and alcohol outcomes (frequency and quantity of alcohol use, binge drinking, and alcohol-related consequences). Prospective design with a baseline assessment and a 2-month follow-up. We recruited 334 young adults in the community (mean = 21.1; SD = 2.21) who completed a questionnaire to measure coping motives for drinking and depression and anxiety (Brief Symptom Inventory) at baseline. Eight mediation models were tested, one for each alcohol outcome (at follow-up) for depression and another four for anxiety. The coping motives for drinking mediated the positive relationships between depression and alcohol outcomes, such that higher levels of depression were associated with higher coping motives, which in turn, were associated with higher alcohol-related outcomes. The same results were found for anxiety, except for the relationship between anxiety and binge drinking, which was not mediated by coping motives. Our findings are consistent with the medication hypothesis that "drinking to cope with negative affect" is a critical mediator of associations between mental health and alcohol-related problems in young adults in the community. Training in healthy coping strategies against negative affect should be useful for interventions aimed at reducing alcohol use and their harms.Fil: González Ponce, Bella. Universidad de Huelva; EspañaFil: Vera, Belén del Valle. Universidad Nacional de Córdoba. Instituto de Investigaciones Psicológicas. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones Psicológicas; ArgentinaFil: Pilatti, Angelina. Universidad Nacional de Córdoba. Instituto de Investigaciones Psicológicas. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones Psicológicas; ArgentinaFil: Pautassi, Ricardo Marcos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigación Médica Mercedes y Martín Ferreyra. Universidad Nacional de Córdoba. Instituto de Investigación Médica Mercedes y Martín Ferreyra; ArgentinaFil: Parrado González, Alberto. Universidad de Huelva; EspañaFil: Dacosta Sánchez, Daniel. Universidad de Huelva. Facultad de Ciencias de la Educación. Departamento de Psicología Clínica, Experimental y Sociale.; EspañaFil: Fernández Calderón, Fermín. Universidad de Huelva. Facultad de Ciencias de la Educación. Departamento de Psicología Clínica, Experimental y Sociale.; EspañaII Virtual Meeting of the Latin American Society for Biomedical Research on AlcoholismCórdobaArgentinaLatin American Society for Biomedical Research on Alcoholis