Reduction in ionic permeability of a silicone hydrogel contact lenses after one month of daily wear

[EN] Purpose. To compare the ionic permeability using the ionoflux method of new and worn samples of a silicone hydrogel contact lens material. Methods. An ionoflux experimental setup was established to measure the ionic permeability (NaCl) of soft contact lenses. Samples of a silicone hydrogel lens (Comfilcon A, Coopervision, Pleasanton, CA) with optical powers of -1.00, -1.50 and -4.75 diopters (D) were used in this study. Three samples of each power were measured after being worn for one month on a daily wear basis. Lenses were cleaned and disinfected every night using multipurpose disinfecting solutions. Three samples of new lenses from the same batch and the same optical power were also measured to evaluate the effect of lens wear on the ionic permeability of the lens material. Before measurement, the lenses were equilibrated with a 1 M NaCl solution during one week before of each measurement. Results. Lens power had minimal effect on the ionic permeability of a modern silicone hydrogel contact lens with the -1.00 lens having a 15% lower permeability compared to the other two lenses. After one month of lens wear the apparent ionic permeability for lenses with -1.50 D decreased by 15%. In the case of -1.00 and -4.75 D lenses there was a decrease of 26%. Conclusions. The ionic permeability of silicone hydrogel lenses of different optical powers was not significantly different. Worn lenses present a significant reduction of the ionic permeability after a month of wear. The potential effect this reduction on lens movement and discomfort associated to lens wear should be further evaluated.The authors have no proprietary interest in any of the materials mentioned in this article. This work was funded in part by FEDER through the COMPTETE Program and by the Portuguese Foundation for Science and Technology (FCT) in the framework of projects PTDC/SAU-BEB/098391/2008, PTDC/SAU-BEB/098392/2008 and the Strategic Project PEST-C/FIS/UI607/2011.Ferreira Da Silva, AR.; Compañ Moreno, V.; Gonzalez-Meijome, JM. (2015). Reduction in ionic permeability of a silicone hydrogel contact lenses after one month of daily wear. Materials Research Express. 2(6). https://doi.org/10.1088/2053-1591/2/6/065007S26Yoon, S. C., & Jhon, M. S. (1982). The transport phenomena of some model solutes through postcrosslinked poly(2-hydroxyethyl methacrylate) membranes with different tactic precursors. Journal of Applied Polymer Science, 27(8), 3133-3149. doi:10.1002/app.1982.070270834Yasuda, H., Lamaze, C. E., & Ikenberry, L. D. (1968). Die Makromolekulare Chemie, 118(1), 19-35. doi:10.1002/macp.1968.021180102MURPHY, S., HAMILTON, C., & TIGHE, B. (1988). Synthetic hydrogels: 5. Transport processes in 2-hydroxyethyl methacrylate copolymers. Polymer, 29(10), 1887-1893. doi:10.1016/0032-3861(88)90407-7Nicolson, P. C., & Vogt, J. (2001). Soft contact lens polymers: an evolution. Biomaterials, 22(24), 3273-3283. doi:10.1016/s0142-9612(01)00165-xMonticelli, M. V., Chauhan, A., & Radke, C. J. (2005). The Effect of Water Hydraulic Permeability on the Settling of a Soft Contact Lens on the Eye. Current Eye Research, 30(5), 329-336. doi:10.1080/02713680590934085Guan, L., Jiménez, M. E. G., Walowski, C., Boushehri, A., Prausnitz, J. M., & Radke, C. J. (2011). Permeability and partition coefficient of aqueous sodium chloride in soft contact lenses. Journal of Applied Polymer Science, 122(3), 1457-1471. doi:10.1002/app.33336Cheng, M.-L., & Sun, Y.-M. (2005). Observation of the solute transport in the permeation through hydrogel membranes by using FTIR-microscopy. Journal of Membrane Science, 253(1-2), 191-198. doi:10.1016/j.memsci.2005.01.017CHHABRA, M., PRAUSNITZ, J., & RADKE, C. (2007). A single-lens polarographic measurement of oxygen permeability (Dk) for hypertransmissible soft contact lenses. Biomaterials, 28(30), 4331-4342. doi:10.1016/j.biomaterials.2007.06.024González-Méijome, J. M., López-Alemany, A., Almeida, J. B., & Parafita, M. A. (2009). Surface AFM microscopy of unworn and worn samples of silicone hydrogel contact lenses. Journal of Biomedical Materials Research Part B: Applied Biomaterials, 88B(1), 75-82. doi:10.1002/jbm.b.31153González-Méijome, J. M., López-Alemany, A., Almeida, J. B., & Parafita, M. A. (2008). Dynamic in vitro dehydration patterns of unworn and worn silicone hydrogel contact lenses. Journal of Biomedical Materials Research Part B: Applied Biomaterials, 90B(1), 250-258. doi:10.1002/jbm.b.31279Pozuelo, J., Compañ, V., González-Méijome, J. M., González, M., & Mollá, S. (2014). Oxygen and ionic transport in hydrogel and silicone-hydrogel contact lens materials: An experimental and theoretical study. Journal of Membrane Science, 452, 62-72. doi:10.1016/j.memsci.2013.10.010Wolffsohn, J. S., Hunt, O. A., & Basra, A. K. (2009). Simplified recording of soft contact lens fit. Contact Lens and Anterior Eye, 32(1), 37-42. doi:10.1016/j.clae.2008.12.00

Coincidence of paroxysmal supraventricular tachycardia and panic disorder: two case reports

Panic disorder (PD) is characterised by sudden attacks of intense fear with somatic symptoms including palpitations and tachycardia. Reciprocally, palpitations caused by paroxysmal supraventricular tachycardia (PSVT) are commonly associated with anxiety and may therefore be misdiagnosed as PD. As demonstrated by two case reports, PSVT and PD can occur comorbidly in a chronological sequence, with PSVT possibly precipitating and maintaining PD via interoceptive processes or, alternatively, with PD increasing the risk for PSVT by elevating stress levels. As both PSVT and PD require different treatments, potentially helpful differential clinical diagnostic criteria are proposed

converging evidence from an intermediate phenotype approach

Representing a phylogenetically old and very basic mechanism of inhibitory neurotransmission, glycine receptors have been implicated in the modulation of behavioral components underlying defensive responding toward threat. As one of the first findings being confirmed by genome-wide association studies for the phenotype of panic disorder and agoraphobia, allelic variation in a gene coding for the glycine receptor beta subunit (GLRB) has recently been associated with increased neural fear network activation and enhanced acoustic startle reflexes. On the basis of two independent healthy control samples, we here aimed to further explore the functional significance of the GLRB genotype (rs7688285) by employing an intermediate phenotype approach. We focused on the phenotype of defensive system reactivity across the levels of brain function, structure, and physiology. Converging evidence across both samples was found for increased neurofunctional activation in the (anterior) insular cortex in GLRB risk allele carriers and altered fear conditioning as a function of genotype. The robustness of GLRB effects is demonstrated by consistent findings across different experimental fear conditioning paradigms and recording sites. Altogether, findings provide translational evidence for glycine neurotransmission as a modulator of the brain’s evolutionary old dynamic defensive system and provide further support for a strong, biologically plausible candidate intermediate phenotype of defensive reactivity. As such, glycine-dependent neurotransmission may open up new avenues for mechanistic research on the etiopathogenesis of fear and anxiety disorders

Generalization of Conditioned Contextual Anxiety and the Modulatory Effects of Anxiety Sensitivity

Anxiety patients overgeneralize fear responses, possibly because they cannot distinguish between cues never been associated with a threat (i.e., safe) and threat-associated cues. However, as contexts and not cues are discussed as the relevant triggers for prolonged anxiety responses characterizing many anxiety disorders, we speculated that it is rather overgeneralization of contextual anxiety, which constitutes a risk factor for anxiety disorders. To this end, we investigated generalization of conditioned contextual anxiety and explored modulatory effects of anxiety sensitivity, a risk factor for anxiety disorders. Fifty-five participants underwent context conditioning in a virtual reality paradigm. On Day 1 (acquisition), participants received unpredictable mildly painful electric stimuli (unconditioned stimulus, US) in one virtual office (anxiety context, CTX+), but never in a

Examining links between anxiety, reinvestment and walking when talking by older adults during adaptive gait

Falls by older adults often result in reduced quality of life and debilitating fear of further falls. Stopping walking when talking (SWWT) is a significant predictor of future falls by older adults and is thought to reflect age-related increases in attentional demands of walking. We examine whether SWWT is associated with use of explicit movement cues during locomotion, and evaluate if conscious control (i.e., movement specific reinvestment) is causally linked to falls-related anxiety during a complex walking task. We observed whether twenty-four older adults stopped walking when talking when asked a question during an adaptive gait task. After certain trials, participants completed a visual-spatial recall task regarding walkway features, or answered questions about their movements during the walk. In a subsequent experimental condition, participants completed the walking task under conditions of raised postural threat. Compared to a control group, participants who SWWT reported higher scores for aspects of reinvestment relating to conscious motor processing but not movement self-consciousness. The higher scores for conscious motor processing were preserved when scores representing cognitive function were included as a covariate. There were no group differences in measures of general cognitive function, visual spatial working memory or balance confidence. However, the SWWT group reported higher scores on a test of external awareness when walking, indicating allocation of attention away from task-relevant environmental features. Under conditions of increased threat, participants self-reported significantly greater state anxiety and reinvestment and displayed more accurate responses about their movements during the task. SWWT is not associated solely with age-related cognitive decline or generic increases in age-related attentional demands of walking. SWWT may be caused by competition for phonological resources of working memory associated with consciously processing motor actions and appears to be causally linked with fall-related anxiety and increased vigilance.This research was supported by The Royal Society (IE131576) and British Academy (SG132820)

Cost-effectiveness of financial incentives to promote adherence to depot antipsychotic medication: economic evaluation of a cluster-randomised controlled trial

Background: Offering a modest financial incentive to people with psychosis can promote adherence to depot antipsychotic medication, but the cost-effectiveness of this approach has not been examined. Methods: Economic evaluation within a pragmatic cluster-randomised controlled trial. 141 patients under the care of 73 teams (clusters) were randomised to intervention or control; 138 patients with diagnoses of schizophrenia, schizo-affective disorder or bipolar disorder participated. Intervention participants received £15 per depot injection over 12 months, additional to usual acute, mental and community primary health services. The control group received usual health services. Main outcome measures: incremental cost per 20% increase in adherence to depot antipsychotic medication; incremental cost of ‘good’ adherence (defined as taking at least 95% of the prescribed number of depot medications over the intervention period). Findings: Economic and outcome data for baseline and 12-month follow-up were available for 117 participants. The adjusted difference in adherence between groups was 12.2% (73.4% control vs. 85.6% intervention); the adjusted costs difference was £598 (95% CI -£4 533, £5 730). The extra cost per patient to increase adherence to depot medications by 20% was £982 (95% CI -£8 020, £14 000). The extra cost per patient of achieving 'good' adherence was £2 950 (CI -£19 400, £27 800). Probability of cost-effectiveness exceeded 97.5%at willingness-to-pay values of £14 000 for a 20% increase in adherence and £27 800 for good adherence. Interpretation: Offering a modest financial incentive to people with psychosis is cost-effective in promoting adherence to depot antipsychotic medication. Direct healthcare costs (including costs of the financial incentive) are unlikely to be increased by this intervention. Trial Registration: ISRCTN.com 7776928

Stress resilience during the coronavirus pandemic

The epidemic of the 2019 novel coronavirus SARS-CoV-2, causing the coronavirus disease 2019 (COVID-19) is a global public health emergency with multifaceted severe consequences for people's lives and their mental health. In this article, as members of the European College of Neuropsychopharmacology (ECNP) Resilience, we will discuss the urgent need for a focus on resilience during the current coronavirus pandemic. Resilience is pivotal to cope with stress and vital to stay in balance. We will discuss the importance of resilience at the individual and societal level, but also the implication for patients with a psychiatric condition and health care workers. We not only advocate for an increased focus on mental health during the coronavirus pandemic but also highlight the urgent need of augmenting our focus on resilience and on strategies to enhance it. The epidemic of the 2019 novel coronavirus SARS-CoV-2, causing the coronavirus disease 2019 (COVID-19), first expanded within the Wuhan region in China and quickly spread to Europe and to the rest of the world (Zhou et al., 2020). The outbreak of COVID-19 is a global public health emergency with multifaceted severe consequences for people's lives and their mental health. In this article, as members of the European College of Neuropsychopharmacology (ECNP) Resilience, we will discuss the urgent need for a focus on resilience during the current coronavirus pandemic. Resilience is pivotal to cope with stress and vital to stay in balance. We will discuss the importance of resilience at the individual and societal level, but also the implication for patients with a psychiatric condition and health care workers

Cross validation of bi-modal health-related stress assessment

This study explores the feasibility of objective and ubiquitous stress assessment. 25 post-traumatic stress disorder patients participated in a controlled storytelling (ST) study and an ecologically valid reliving (RL) study. The two studies were meant to represent an early and a late therapy session, and each consisted of a "happy" and a "stress triggering" part. Two instruments were chosen to assess the stress level of the patients at various point in time during therapy: (i) speech, used as an objective and ubiquitous stress indicator and (ii) the subjective unit of distress (SUD), a clinically validated Likert scale. In total, 13 statistical parameters were derived from each of five speech features: amplitude, zero-crossings, power, high-frequency power, and pitch. To model the emotional state of the patients, 28 parameters were selected from this set by means of a linear regression model and, subsequently, compressed into 11 principal components. The SUD and speech model were cross-validated, using 3 machine learning algorithms. Between 90% (2 SUD levels) and 39% (10 SUD levels) correct classification was achieved. The two sessions could be discriminated in 89% (for ST) and 77% (for RL) of the cases. This report fills a gap between laboratory and clinical studies, and its results emphasize the usefulness of Computer Aided Diagnostics (CAD) for mental health care

Depression and anxiety in relation to catechol-O-methyltransferase Val158Met genotype in the general population: The Nord-Trøndelag Health Study (HUNT)

<p>Abstract</p> <p>Background</p> <p>The catechol-O-methyltransferase (COMT) gene contains a functional polymorphism, Val158Met, which has been linked to anxiety and depression, but previous results are not conclusive. The aim of the present study was to examine the relationship between the Val158Met COMT gene polymorphism and anxiety and depression measured by the Hospital Anxiety and Depression Scale (HADS) in the general adult population.</p> <p>Methods</p> <p>In the Nord-Trøndelag Health Study (HUNT) the association between the Val158Met polymorphism and anxiety and depression was evaluated in a random sample of 5531 individuals. Two different cut off scores (≥ 8 and ≥ 11) were used to identify cases with anxiety (HADS-A) and depression (HADS-D), whereas controls had HADS-A <8 and HADS-D <8.</p> <p>Results</p> <p>The COMT genotype distribution was similar between controls and individuals in the groups with anxiety and depression using cut-off scores of ≥ 8. When utilizing the alternative cut-off score HADS-D ≥ 11, Met/Met genotype and Met allele were less common among men with depression compared to the controls (genotype: p = 0.017, allele: p = 0.006). In the multivariate analysis, adjusting for age and heart disease, depression (HADS-D ≥ 11) was less likely among men with the Met/Met genotype than among men with the Val/Val genotype (OR = 0.37, 95% CI = 0.18–0.76).</p> <p>Conclusion</p> <p>In this population-based study, no clear association between the Val158Met polymorphism and depression and anxiety was revealed. The Met/Met genotype was less likely among men with depression defined as HADS-D ≥ 11, but this may be an incidental finding.</p