The posttraumatic stress disorder diagnosis in preschool- and elementary school-age children exposed to motor vehicle accidents

Objective: Increasingly, children are being diagnosed with psychiatric disorders, including preschool-age children. These diagnoses in young children raise questions pertaining to 1) how diagnostic algorithms for individual disorders should be modified for young age groups, 2) how psychopathology is best detected at an early stage, and 3) how to make use of multiple informants. The authors examined these issues in a prospective longitudinal assessment of preschool- and elementary school-age children who were exposed to a traumatic event. Method: Participants were 114 children (age range: 2-10 years) who had experienced a motor vehicle accident. Parents and older children (age range: 7-10 years) completed structured interviews 2-4 weeks (initial assessment) and 6 months (6-month follow-up) after the traumatic event. A recently proposed alternative symptom algorithm for diagnosing posttraumatic stress disorder (PTSD) was utilized and compared with the standard DSM-IV algorithms for diagnosing PTSD and acute stress disorder. Results: At the 2- to 4-week assessment, 11.5% of the children met conditions for a diagnosis of PTSD based on the alternative algorithm criteria per parent report, and 13.9% met criteria for this diagnosis at the 6-month follow-up. These percentages were much higher than those for DSM-IV diagnoses of acute stress disorder and PTSD. Among 7- to 10-year-old subjects, the use of combined parent- and child-reported symptoms to derive a diagnosis resulted in an increased number of children in this age group who were identified with psychiatric illness relative to the use of parent report alone. Agreement between parent and child on symptoms for 1) a diagnosis of PTSD based on the alternative algorithm criteria and 2) diagnoses of DSM-IV acute stress disorder and PTSD in this age group was poor. Among 2- to 6-year-old subjects, the alternative algorithm PTSD diagnosis per parent report was a more sensitive predictor of later onset psychopathology relative to a diagnosis of DSM-IV acute stress disorder or PTSD per parent report. However, among 7- to 10-year-old subjects, a combined symptom report (from both parent and child) was optimal in predicting posttraumatic psychopathology. Conclusions: These findings support the use of the proposed alternative algorithm for assessing PTSD in young children and suggest that the diagnosis of PTSD based on the alternative algorithm criteria is stable from the acute phase onward. When both parent- and child-reported symptoms are utilized for the assessment of PTSD among 7- to 10-year-old children, the alternative algorithm and DSM-IV criteria have broad comparable validity. However, in the absence of child-reported symptoms, the alternative algorithm criteria per parent report appears to be an optimal diagnostic measure of PTSD among children in this age group, relative to the standard DSM-IV algorithm for diagnosing the disorder

Maladaptive Cognitive Appraisals Mediate the Evolution of Posttraumatic Stress Reactions:A 6-Month Follow-Up of Child and Adolescent Assault and Motor Vehicle Accident Survivors

A prospective longitudinal follow-up study (n = 59) of child and adolescent survivors of physical assaults and motor vehicle accidents assessed whether cognitive processes predicted posttraumatic stress symptomatology (PTSS) at 6 months posttrauma in this age group. In particular, the study assessed whether maladaptive posttraumatic appraisals mediated the relationship between initial and later posttraumatic stress. Self-report measures of PTSS, maladaptive appraisals, and other cognitive processes, as well as structured interviews assessing for acute stress disorder and posttraumatic stress disorder (PTSD), were completed at 2-4 weeks and 6 months posttrauma. PTSS and PTSD at 6 months were associated with maladaptive appraisals and other cognitive processes but not demographic or objective trauma severity variables. Only maladaptive appraisals were found to associate with PTSS/PTSD after partialing out initial symptoms/diagnosis and to mediate between initial and later PTSS. It was argued that, on this basis, maladaptive appraisals are involved in the development and maintenance of PTSS over time, whereas other cognitive processes (e.g., subjective threat, memory processes) may have an effect only in the acute phase. The implications of this study for the treatment of PTSS in youths are discussed

Examining the shared and unique features of self-concept content and structure in Borderline Personality Disorder and Depression

AcceptedArticleCopyright © Springer Science+Business Media New York 2015The online version of this article (doi:10.1007/s10608-015-9695-3) contains supplementary material, which is available to authorized users.A number of clinical theories emphasise self-concept disturbance as central to borderline personality disorder (BPD). To date, however, there has been limited empirical examination of exactly how BPD changes the content and structure of self-concept. Moreover, it is unclear if patterns of self-concept disturbance are unique to BPD or are driven by axis-I comorbidities such as depression. To examine this issue, the present study adopted a dimensional design, examining how performance on a novel adaptation of a well-validated measure of self-concept (the Psychological Distance Scaling Task) was related to BPD and depression symptoms in a sample of 93 individuals with a wide range of symptom severity. While greater BPD severity was associated with less positive and more negative content of self-concept, this was driven by depression symptoms. Similarly, positive content was more diffuse and negative content more interconnected at higher levels of BPD severity, but for positive content, this was most clearly linked to comorbid depression features. In contrast, BPD severity (over and above depression symptoms) was uniquely associated with greater ‘clustering’ for positive and negative content (i.e. a more fragmented self-concept). This pattern of results lends support to clinical theories arguing that self-concept fragmentation is core to BPD and also supports the utility of dimensional analyses to identify patterns of cognitive-affective disturbance unique to BPD versus those shared with comorbid conditions like depression.MR

NCBI Reference Sequences (RefSeq): current status, new features and genome annotation policy

The National Center for Biotechnology Information (NCBI) Reference Sequence (RefSeq) database is a collection of genomic, transcript and protein sequence records. These records are selected and curated from public sequence archives and represent a significant reduction in redundancy compared to the volume of data archived by the International Nucleotide Sequence Database Collaboration. The database includes over 16 000 organisms, 2.4 × 106 genomic records, 13 × 106 proteins and 2 × 106 RNA records spanning prokaryotes, eukaryotes and viruses (RefSeq release 49, September 2011). The RefSeq database is maintained by a combined approach of automated analyses, collaboration and manual curation to generate an up-to-date representation of the sequence, its features, names and cross-links to related sources of information. We report here on recent growth, the status of curating the human RefSeq data set, more extensive feature annotation and current policy for eukaryotic genome annotation via the NCBI annotation pipeline. More information about the resource is available online (see http://www.ncbi.nlm.nih.gov/RefSeq/)

A phase II study of continuous-infusion 5-fluorouracil with cisplatin and epirubicin in inoperable pancreatic cancer.

Carcinomas of the exocrine pancreas respond poorly to most chemotherapy regimens. Recently continuous infusional 5-fluorouracil (200 mg m-(2)day-1) with 3 weekly cisplatin (60 mg m-2) and epirubicin (50 mg m-2) (the ECF regimen) has proven to be an active regimen in gastric and breast cancer and consequently worthy of further study in pancreatic cancer. Thirty-five patients were treated with the ECF regimen as above, of whom 29 were evaluable for response and 32 were evaluable for toxicity. The mean age was 59 years (range 37-75). Sixteen patients had locally advanced disease at presentation and 19 had metastases. Objective tumour responses were documented in five (17.3%) patients who achieved a partial response; in 18 (62%) patients there were no change and six (20.7%) patients progressed on therapy. Patients with either stable disease or partial response had a significantly improved overall survival (median = 253 days) compared with patients who progressed (median = 170 days; P = 0.01). Grade 3/4 (WHO) toxicity (all cycles) included alopecia in 18 (56%) patients, nausea/vomiting in eight (25%) stomatitis in three (9%) and diarrhoea in seven (22%) patients, with rhinorrhoea and excessive lacrimation in one patient each. Neutropenic sepsis occurred in 13 cycles in ten patients, and there was one toxic death due to sepsis. There were eight other episodes of non-neutropenic sepsis requiring hospital admission. Fourteen patients (40%) experienced complications with their Hickman lines, including thrombotic episodes (six patients) or their line falling out (five patients). ECF can prolong survival in patients with locally advanced or metastatic pancreatic cancer who demonstrate a response or stabilisation of their disease. However, this is associated with considerable toxicity

Performance considerations for continuous-wave and pulsed laser line scan (LLS) imaging systems

Extended range underwater optical imaging techniques can be classified into one of two broad categories; those which use synchronously scanned narrow source and receiver paths to restrict both back-scattered and forward-scattered light reaching the receiver (continuous-wave laser line scan); and those which use pulsed sources and time-gating to remove back-scatter noise (pulsed laser line scan and pulse-gated laser line scan). Laser line scan systems are observed to perform at up to 5 to 6 optical attenuation lengths, but greater standoff distances are desirable for seabed imaging using the growing fleet of autonomous underwater vehicles (AUVs). Currently, a moderate physical separation between laser and receiver is necessary to reject near-field multiple back-scatter, which imposes restrictions on AUV miniaturization. Recent experiments and theoretical modeling reveal that significant imaging improvements are possible over the existing continuous-wave laser line scan systems (LLS), by using a pulsed-gated version of the LLS (PG-LLS). However, the use of such a technique has a greater advantage in reducing the overall form factor over conventional LLS imaging system, as well as providing greater depth-of-field. In this paper, we present experimental results comparing both LLS and PG-LLS systems for several source-receiver separations and standoff distances. These results compare favorably with images obtained from validated LLS image simulation tools, and indicate the potential for reducing the source-receiver separation and therefore the system size

The implications of American chestnut reintroduction on landscape dynamics and carbon storage

In the eastern United States, American chestnut (Castanea dentata) was historically a major component of forest communities, but was functionally extirpated in the early 20th century by an introduced pathogen, chestnut blight (Cryphonectria parasitica). Because chestnut is fast-growing, long-lived, and resistant to decay, restoration of American chestnut using blight-resistant stock could have the potential to increase carbon sequestration or storage in forested landscapes. However, carbon dynamics are also affected by interspecific competition, succession, natural disturbance, and forest management activities, and it is unknown how chestnut restoration might interact with these other processes. We used the PnET-Succession extension of the LANDIS-II forest landscape model to study the implications of chestnut restoration on forest composition and carbon storage in the context of other disturbances, including timber harvest and insect pest outbreaks. Our results imply that it could take a millennium or more for chestnut to fully occupy landscapes without aggressive restoration efforts. When successful, chestnut restoration activities displaced other species approximately in proportion to their abundance on the landscape, rather than replacing a single species or genus (e.g., Quercus). Insect pests increased the rate of chestnut colonization by reducing the abundance of competitors, and also had a dominant effect on carbon dynamics. Although chestnut is fast-growing, moderately shade-tolerant, and decomposes very slowly, our results suggest that it can only modestly increase the carbon storage potential of eastern forests. However, our results also demonstrate that compositional changes in forest communities can have noticeable effects on biomass accumulation, even with the large uncertainties introduced by invasive pests

Novel thalidomide analogues display anti-angiogenic activity independently of immunomodulatory effects

The anti-tumour effects of thalidomide have been associated with its anti-angiogenic properties. Second generation thalidomide analogues are distinct compounds with enhanced therapeutic potential. Although these compounds are beginning to enter trials for the treatment of cancer there is very little information regarding the anti-angiogenic activity of these clinically relevant compounds. Furthermore, it is not known how the various immunomodulatory activities of these compounds relate to anti-angiogenic activity. In this study we assessed the anti-angiogenic activity of compounds from both IMiD™ and SelCID™ classes of analogues using a novel in vitro multicellular human assay system and the established rat aorta assay. Our results show that both the IMiDs and SelCIDs tested are significantly more potent than thalidomide. The anti-angiogenic potency of the analogues was not related to inhibition of endothelial cell proliferation, nor their TNF-α/PDE type 4 inhibitory properties. However, anti-migratory effects in vitro and inhibition of tumour growth in vivo was observed with the analogue IMiD-1 (clinically known as REVIMID™). Our results show that anti-angiogenic activity spans both currently defined classes of thalidomide analogue and is not related to their previously described immunomodulatory properties. Identification of the differential effects of these compounds will enable targeting of such compounds into the appropriate clinical setting

Transcriptional response of ovine lung to infection with jaagsiekte sheep retrovirus

Jaagsiekte sheep retrovirus (JSRV) is the etiologic agent of ovine pulmonary adenocarcinoma (OPA), a neoplastic lung disease of sheep. OPA is an important economic and welfare issue for sheep farmers and a valuable naturally-occurring animal model for human lung adenocarcinoma. Here, we used RNA sequencing to study the transcriptional response of ovine lung tissue to infection by JSRV. We identified 1,971 ovine genes differentially-expressed in JSRV-infected lung compared to non-infected lung, including many genes with roles in carcinogenesis and immunomodulation. The differential expression of selected genes was confirmed using immunohistochemistry and RT-qPCR. A key finding was the activation of anterior-gradient-2, yes-associated protein-1 and amphiregulin in OPA tumor cells, indicating a role for this oncogenic pathway in OPA. In addition, there was differential expression of genes related to innate immunity including genes encoding cytokines, chemokines and complement system proteins. In contrast, there was little evidence for upregulation of genes involved in T-cell immunity. Many genes related to macrophage function were also differentially expressed, reflecting the increased abundance of these cells in OPA-affected lung tissue. Comparison of the genes differentially regulated in OPA with transcriptional changes occurring in human lung cancer revealed important similarities and differences between OPA and human lung adenocarcinoma. This study provides valuable new information on the pathogenesis of OPA and strengthens the use of this naturally occurring animal model for human lung adenocarcinoma

Astronomers for planet Earth: engaging with the public to forge a sustainable future

Science Communication and Societ