The Zurich Adjustment Disorder Study: Diagnostics and Risk Factors of ICD-11 Adjustment Disorder Following Involuntary Job Loss

As part of the trauma and stress-related disorders’ category, adjustment disorder is a frequently occurring mental disorder that develops after stressful life events. Preoccupation and failure to adapt are the core symptoms of adjustment disorder in ICD-11. As this is a new definition, we conducted a large-scale study to gain a deeper understanding of the validity and applicability of the revised diagnostic criteria. N=334 individuals who experienced involuntary job loss were interviewed three times one to nine months after the last day at work (immediately, six- and twelve-months follow-up). For measuring adjustment disorder symptoms, a newly developed structured diagnostic interview and a self-report questionnaire evidenced satisfying psychometric properties. Approximately six months after discharge, the prevalence of a tentative diagnosis of adjustment disorder was 27.3% and decreased to 10.5% over the course of 12 months. We identified several event-/person-related, intra- and interpersonal correlates and predictors of adjustment disorder symptoms. The more specific definition of adjustment disorder, which leads to an improved detection of adjustment disorder cases, is in line with WHO's aim of improved ease of use of the disorder

The Course of Adjustment Disorder Following Involuntary Job Loss and Its Predictors of Latent Change

Adjustment disorders (AjDs) usually resolve after the precipitating life event and its consequences are terminated. However, they bear the risk for the development of severe mental illness. The present study investigates the natural course of AjD as defined for International Classification of Diseases, 11th version (ICD-11). A total of 303 individuals who involuntarily lost their jobs were assessed initially after the job loss and 6 months later. Latent class latent change analysis and multinomial logistic regression were performed. Two groups showed low (n = 149, 49.2%) and medium (n = 108, 35.6%) symptom severity at initial assessment that declined over time. The third group (n = 46, 15.2%) showed a high initial response and a small effect of worsening of symptoms. Female gender, higher age, first dismissal, impaired social functioning, dysfunctional disclosure, less social support, and less social acknowledgment were associated with belonging to the latter group. It might be beneficial to target individuals at high risk with interventions that aim at the improvement of skills relevant for stress management

Steps into a Small World: First glimpses on everyday moment-to-moment decision making in an ecologically meaningful multi-choice system for assessing animal preferences

The behaviour shown by an animal at any one time is the consolidated output of its behavioural control mechanism. Moreover, what animals “want” is viewed as (the most) important component for individual welfare. Accordingly, studying the motivation of animals helps understanding basic mechanisms and welfare related needs. However, studying wants of animals is notoriously difficult and many previous studies on the preferences of animals have been restricted in the sense that only two choice options were presented in an artificial test environment. Here, an extended approach, the “Small World” is presented, in which the choices of animals between eight ecologically relevant resources can be observed in a long-term test to reach conclusions with respect to everyday moment-to-moment decisions. In this sense, the system offers a quasi-natural environment. The approach was tested in three experiments with observations of individual female rats, small groups of female rats (Long Evans, Rattus norvegicus) and small groups of female chickens (Lohmann Brown, Gallus gallus domesticus). The animals oriented themselves quickly in the system and it was possible to collect multifaceted data on the use of the resources. These data included the faecal and urinary markings in the Small World cages, the daily frequency and duration of visits to these cages, the sequential analyses of the choices for and decisions among the resources, and the synchrony of the animals in the groups. Given the richness of these data and the lack of a stress response in the tested animals, the use of the Small World approach seems to be highly promising as an extension to previously used procedures. To further improve the approach and more directly reflect the subjective value of the different resources from the animals' point of view, the distances between the resources in a quasi-natural landscape shall be manipulated in future studies

An empirical assessment of adjustment disorder as proposed for ICD-11 in a general population sample of Israel

Background: A new diagnostic concept of Adjustment Disorder (AjD) was proposed for inclusion in the International Classification of Diseases, 11th version (ICD-11). However, the symptom structure of AjD is poorly understood. The aim of the present study was to investigate the dimensionality of AjD as a stress-response syndrome. Methods: A general population sample of the Israeli population (N = 1003) completed the Adjustment Disorder – New Module 20 and the WHO-5 Wellbeing Scale. We compared seven alternative models of AjD using confirmatory factor analysis (CFA). A latent profile analysis (LPA) was performed to determine if subtypes of AjD were present. The performance of the unidimensional and multidimensional models of AjD were evaluated using regression analyses. Results: CFA results supported a unidimensional model of AjD. The LPA identified three quantitatively distinct classes (low, medium, and high) with no evidence of any subtypes of AjD. The criterion validity of AjD was superior when treated as unidimensional. AjD was associated with lower levels of psychological wellbeing (β = −.32, p < .001). Conclusions: Our results suggest that AjD is better conceptualised as a unidimensional construct. Future work should focus on a reduction of required symptoms in order to improve clinical utility and validity of the diagnosis

Utilization of consumer electronics for an economically affordable motorized wheelchair

[EN] A design (sketch) of a prototype electric scooter adaptable to a wheelchair is proposed. A mechanism that allows adapting an electric power unit to a conventional wheelchair is presented. The aim of this design is to create an economic solution to motorize a wheelchair and support the independent mobility of wheelchair users. This is especially relevant as the number of wheelchair users is increasing. The device consists of a self-balancing scooter, serving as the power unit, which is replacing the main wheels of the wheelchair and a metal link, connecting it to the wheelchair. The steering is controlled with two sticks, which directly exerts pressure on the sensor pad and steering unit of the self-balancing scooter. By using a self-balancing scooter and hardware store materials the costs can be kept low and accessible to many people.Prusas, B.; Mansoor, K.; Engelhardt, L.; Pirtilä, SI.; Walgers, B.; Lukoschek, L.; Lengua Lengua, I.... (2020). Utilization of consumer electronics for an economically affordable motorized wheelchair. Editorial Universitat Politècnica de València. 363-369. https://doi.org/10.4995/INN2019.2019.10224OCS36336

Design of an add-on device for transform a standard wheelchair on an affordable and motorized

[EN] In the following article a design to adapt a low-cost power unit to a conventional wheelchair is presented. The adaptation is carried out looking for a simple, low cost solution that does not involve any modification or structural alteration of the wheelchair itself. In this work we present a proposal of a mechanical adaptation that will allow connecting a self-balancing scooter to a wheelchair and be controlled by the user as well as by another person. So that the pushing effort is eliminated.Prusas, B.; Mansoor, K.; Engelhardt, L.; Walgers, B.; Pirtilä, SI.; Lukoschek, L.; Defez Garcia, B.... (2020). Design of an add-on device for transform a standard wheelchair on an affordable and motorized. Editorial Universitat Politècnica de València. 371-380. https://doi.org/10.4995/INN2019.2019.10226OCS37138

Translation and psychometric evaluation of the Chinese Adjustment Disorder – New Module 20

The Adjustment Disorder – New Module 20 (ADNM-20) was developed for the assessment of adjustment disorder symptoms. The aim of the present study was to translate and conduct psychometric testing of the Chinese version of the ADNM-20. The English version was translated into traditional Chinese in an iterative process with an expert panel of mental health professionals. A total of 433 university students in Hong Kong between ages 18-24 completed the Chinese ADNM-20 and the Hospital Anxiety and Depression Scale via an online survey; 32 were retested after two weeks. The content validity indices were excellent for most of the items. Confirmatory factor analysis supported a unidimensional first-order structure with excellent composite reliability. The test-retest reliability of the Chinese version was below satisfactory for the individual items; the intra-class correlation for the overall scale was moderate. The Chinese version of the ADNM-20 also indicated a moderate positive correlation with anxiety and depression symptoms. Initial results support the content, factorial, and discriminant validity of the translated scale. More research is needed to assess its reliability in this cultural context. The ADNM-20 can be quickly employed for the assessment of adjustment disorder as proposed for ICD-11

A novel role of sphingosine 1-phosphate receptor S1pr1 in mouse thrombopoiesis

Millions of platelets are produced each hour by bone marrow (BM) megakaryocytes (MKs). MKs extend transendothelial proplatelet (PP) extensions into BM sinusoids and shed new platelets into the blood. The mechanisms that control platelet generation remain incompletely understood. Using conditional mutants and intravital multiphoton microscopy, we show here that the lipid mediator sphingosine 1-phosphate (S1P) serves as a critical directional cue guiding the elongation of megakaryocytic PP extensions from the interstitium into BM sinusoids and triggering the subsequent shedding of PPs into the blood. Correspondingly, mice lacking the S1P receptor S1pr1 develop severe thrombocytopenia caused by both formation of aberrant extravascular PPs and defective intravascular PP shedding. In contrast, activation of S1pr1 signaling leads to the prompt release of new platelets into the circulating blood. Collectively, our findings uncover a novel function of the S1P-S1pr1 axis as master regulator of efficient thrombopoiesis and might raise new therapeutic options for patients with thrombocytopenia

Plasmacytoid dendritic cells control homeostasis of megakaryopoiesis

Platelet homeostasis is essential for vascular integrity and immune defence1, 2. Although the process of platelet formation by fragmenting megakaryocytes (MKs; thrombopoiesis) has been extensively studied, the cellular and molecular mechanisms required to constantly replenish the pool of MKs by their progenitor cells (megakaryopoiesis) remains unclear3, 4. Here we use intravital imaging to track the cellular dynamics of megakaryopoiesis over days. We identify plasmacytoid dendritic cells (pDCs) as homeostatic sensors that monitor the bone marrow for apoptotic MKs and deliver IFNα to the MK niche triggering local on-demand proliferation and maturation of MK progenitors. This pDC-dependent feedback loop is crucial for MK and platelet homeostasis at steady state and under stress. pDCs are best known for their ability to function as vigilant detectors of viral infection5. We show that virus-induced activation of pDCs interferes with their function as homeostatic sensors of megakaryopoiesis. Consequently, activation of pDCs by SARS-CoV-2 leads to excessive megakaryopoiesis. Together, we identify a pDC-dependent homeostatic circuit that involves innate immune sensing and demand-adapted release of inflammatory mediators to maintain homeostasis of the megakaryocytic lineage

Translocator protein (18kDA) (TSPO) marks mesenchymal glioblastoma cell populations characterized by elevated numbers of tumor-associated macrophages

TSPO is a promising novel tracer target for positron-emission tomography (PET) imaging of brain tumors. However, due to the heterogeneity of cell populations that contribute to the TSPO-PET signal, imaging interpretation may be challenging. We therefore evaluated TSPO enrichment/expression in connection with its underlying histopathological and molecular features in gliomas. We analyzed TSPO expression and its regulatory mechanisms in large in silico datasets and by performing direct bisulfite sequencing of the TSPO promotor. In glioblastoma tissue samples of our TSPO-PET imaging study cohort, we dissected the association of TSPO tracer enrichment and protein labeling with the expression of cell lineage markers by immunohistochemistry and fluorescence multiplex stains. Furthermore, we identified relevant TSPO-associated signaling pathways by RNA sequencing.We found that TSPO expression is associated with prognostically unfavorable glioma phenotypes and that TSPO promotor hypermethylation is linked to IDH mutation. Careful histological analysis revealed that TSPO immunohistochemistry correlates with the TSPO-PET signal and that TSPO is expressed by diverse cell populations. While tumor core areas are the major contributor to the overall TSPO signal, TSPO signals in the tumor rim are mainly driven by CD68-positive microglia/macrophages. Molecularly, high TSPO expression marks prognostically unfavorable glioblastoma cell subpopulations characterized by an enrichment of mesenchymal gene sets and higher amounts of tumor-associated macrophages.In conclusion, our study improves the understanding of TSPO as an imaging marker in gliomas by unveiling IDH-dependent differences in TSPO expression/regulation, regional heterogeneity of the TSPO PET signal and functional implications of TSPO in terms of tumor immune cell interactions