Intracortical myelin in individuals with alcohol use disorder: An initial proof-of-concept study

Introduction Disruption of cortical gray matter and white matter tracts are well-established markers of alcohol use disorder (AUD), but less is known about whether similar differences are present in intracortical myelin (ICM, i.e., highly myelinated gray matter in deeper cortical layers). The goal of this study was to provide initial proof-of-concept for using an optimized structural magnetic resonance imaging (MRI) sequence to detect differences in ICM in individuals with AUD compared to control participants reporting drinking within recommended guidelines. Methods This study used an optimized 3T MRI sequence for high intracortical contrast to examine ICM-related MRI signal in 30 individuals with AUD and 33 healthy social drinkers. Surface-based analytic techniques were used to quantify ICM-related MRI signal in 20 bilateral a priori regions of interest based on prior cortical thickness studies, and exploratory vertex-wise analyses were examined using Cohen's d effect size. Results The global distribution of ICM-related signal was largely comparable between groups. Region of interest analysis indicated that AUD group exhibited greater ICM-related MRI signal in precuneus, ventromedial prefrontal cortex, posterior cingulate, middle anterior cingulate, middle/posterior insula, and dorsolateral prefrontal cortex (Cohen's ds = 0.50–0.75). Four regions (right precuneus, ventromedial prefrontal cortex, posterior cingulate and left dorsolateral prefrontal cortex) remained significant (p < .05) after covarying for smoking status. Conclusion These findings provide initial evidence of ICM differences in a moderately sized sample of individuals with AUD compared to controls, although the inflation of type 1 error rate necessitates caution in drawing conclusions. Robustly establishing these differences in larger samples is necessary. The cross-sectional design cannot address whether the observed differences predate AUD or are consequences of heavy alcohol consumption

Volumetric MRI Analysis of a Case of Severe Ventriculomegaly

We present a case of a 60-year-old male referred to a tertiary psychiatric facility for diagnostic assessment due to low mood and behavioral changes. Neurological examination of the patient was unremarkable. Magnetic resonance imaging (MRI) indicated overt ventriculomegaly with gross dilatation of lateral and third ventricles. Manual segmentation of gray matter, white matter and cerebrospinal fluid demonstrated that the patient had a ventricular volume almost 46 times greater than that of healthy volunteers in the same age range. Despite his striking degree of ventriculomegaly and cortical thinning, he presented primarily with psychiatric and cognitive complaints. These represented a major neurocognitive disorder. His behavior improved with a structured environment and routine instituted by the treating team. This is a dramatic example of the brain’s response to extreme structural remodeling. Elements of pluripotentiality may counteract degeneracy to preserve functions in cases of serious structural stress in the brain. Changes in the neural circuitry of emotional processing, and/or disruption in signaling pathways important for synaptogenesis may influence depression pathophysiology. How this circuitry is modified in cases of extreme structural stress such as long-standing overt ventriculomegaly, is unclear. This case demonstrates the ability of the brain to generate a normal phenotype despite structural changes that seem incompatible with advanced cognitive function, illustrating the substantial potential for adaptability and plasticity in the brain

Challenges and Potential Solutions for Physician\u27s Suicide risk factors in the COVID-19 Era: Psychiatric Comorbidities, Medicine Judicialization, and Burnout

INTRODUCTION: Suicide in physicians outlines a public health problem that deserves more consideration. A recently performed meta-analysis and systematic review evaluated suicide mortality in physicians by gender and investigated several related risk factors. It showed a post-1980 suicide mortality ratio 46% higher in female physicians than women in the general population and a 33% lower risk in male physicians than men in general, despite an overall contraction in physicians\u27 mortality rates in both genders. METHODS: This narrative review was conducted through a search and analysis of relevant articles/databases to address questions raised by the meta-analysis, and how they may be affected by COVID-19. The process included unstructured searches on physician suicide, burnout, medicine judicialization, healthcare organization and COVID-19 on Pubmed, and Google searches for relevant databases, medical society, expert and media commentaries on these topics. We focus on three factors critical to address physician suicides: epidemiological data limitations, psychiatric comorbidities, and professional overload. RESULTS: We found relevant articles on suicide reporting, physician mental health, effects of healthcare judicialization and organization on physician and patient health, and how COVID-19 may impact such factors. This review addresses information sources, underreporting/misreporting of physicians\u27 suicide rates, inadequate diagnosis and management of psychiatric comorbidities and chronic effects on physicians\u27 work capacity, and finally, medicine judicialization and organization failure increasing physician burnout . We discuss these factors in general and in relation to the COVID-19 pandemic. CONCLUSIONS: We describe an overview of the above factors, discuss possible solutions, and specifically address how COVID-19 may impact such factors

Tamanho do tubérculo na produção de batata-semente das cultivares Ágata e Asterix em sistema aeropônico

A busca por tubérculos de batata (Solanum tuberosum L.) com maior qualidade genética e livres de doenças tem se intensificado cada vez mais, para isto, formas alternativas de produção tem surgido ao decorrer dos anos, e o sistema aeropônico é um dos que se destacam. Os tamanhos de tubérculo-semente bem como as cultivares podem gerar influência sobre os índices de produção, e assim, este trabalho objetivou avaliar a influência da cultivar e do tamanho do tubérculo nos índices agronômicos da batata-semente. O ensaio foi conduzido no município de Palotina, estado do Paraná, entre os meses de março a junho de 2019, em delineamento inteiramente casualisado, utilizando de esquema fatorial 2 x 2, sendo os fatores, duas cultivares (Ágata e Asterix) e duas classes de tubérculo semente (Tipo I e IV). Foram avaliadas as características de massa média de tubérculos, número de hastes formadas, número de tubérculos produzidos e diâmetro de tubérculos produzidos. Os dados foram submetidos a análise de variância e teste de Tukey a 5% de probabilidade. Os fatores não apresentaram interação estatisticamente significativa. Independentemente do tamanho de tubérculo, a cultivar Ágata apresentou a maior massa e diâmetro de tubérculos, mas menor número de hastes e de tubérculos formados por planta. Quanto ao tamanho de tubérculo utilizado, o tratamento de tipo I evidenciou maiores índices agronômicos, mesmo não apresentando diferença significativa para formação de hastes em função do tamanho de tubérculo

Interaction between perceived maternal care, anxiety symptoms, and the neurobehavioral response to palatable foods in adolescents

Studies in rodents have shown that early life trauma leads to anxiety, increased stress responses to threatening situations, and modifies food intake in a new environment. However, these associations are still to be tested in humans. This study aimed to verify complex interactions among anxiety diagnosis, maternal care, and baseline cortisol on food intake in a new environment in humans. A community sample of 32 adolescents and young adults was evaluated for: psychiatric diagnosis using standardized interviews, maternal care using the Parental Bonding Inventory (PBI), caloric consumption in a new environment (meal choice at a snack bar), and salivary cortisol. They also performed a brain fMRI task including the visualization of palatable foods vs. neutral items. The study found a three-way interaction between anxiety diagnosis, maternal care, and baseline cortisol levels on the total calories consumed (snacks) in a new environment. This interaction means that for those with high maternal care, there were no significant associations between cortisol levels and food intake in a new environment. However, for those with low maternal care and who have an anxiety disorder (affected), cortisol was associated with higher food intake; whereas for those with low maternal care and who did not have an anxiety disorder (resilient), cortisol was negatively associated with lower food intake. In addition, higher anxiety symptoms were associated with decreased activation in the superior and middle frontal gyrus when visualizing palatable vs. neutral items in those reporting high maternal care. These results in humans mimic experimental research findings and demonstrate that a combination of anxiety diagnosis and maternal care moderate the relationship between the HPA axis functioning, anxiety, and feeding behavior in adolescents and young adults

Thrifty-eating behavior phenotype at the food court : programming goes beyond food preferences

Introduction: Prenatal growth impairment leads to higher preference for palatable foods in comparison to normal prenatal growth subjects, which can contribute to increased body fat mass and a higher risk for developing chronic diseases in small-for-gestational-age (SGA) individuals throughout life. This study aimed to investigate the effect of SGA on feeding behavior in children and adolescents, as well as resting-state connectivity between areas related to reward, self-control, and value determination, such as orbitofrontal cortex (OFC), dorsolateral prefrontal cortex (DL-PFC), amygdala and dorsal striatum (DS). Methods: Caregivers and their offspring were recruited from two independent cohorts in Brazil (PROTAIA) and Canada (MAVAN). Both cohorts included anthropometric measurements, food choice tasks, and resting-state functional magnetic resonance imaging (fMRI) data. Results: In the Brazilian sample (17 ± 0.28 years, n=70), 21.4% of adolescents were classified as SGA. They exhibited lower monetary-related expenditure to buy a snack compared to controls in the food choice test. Decreased functional connectivity (n=40) between left OFC and left DL-PFC; and between right OFC and: left amygdala, right DS, and left DS were observed in the Brazilian SGA participants. Canadian SGA participants (14.9%) had non-significant differences in comparison with controls in a food choice task at 4 years old ( ± 0.01, n=315). At a follow-up brain scan visit (10.21 ± 0.140 years, n=49), SGA participants (28.6%) exhibited higher connectivity between the left OFC and left DL-PFC, also higher connectivity between the left OFC and right DL-PFC. We did not observe significant anthropometric neither nutrients’ intake differences between groups in both samples. Conclusions: Resting-state fMRI results showed that SGA individuals had altered connectivity between areas involved in encoding the subjective value for available goods and decision-making in both samples, which can pose them in disadvantage when facing food options daily. Over the years, the cumulative exposure to particular food cues together with the altered behavior towards food, such as food purchasing, as seen in the adolescent cohort, can play a role in the long-term risk for developing chronic noncommunicable diseases

Machine learning and big data analytics in bipolar disorder:A position paper from the International Society for Bipolar Disorders Big Data Task Force

Objectives The International Society for Bipolar Disorders Big Data Task Force assembled leading researchers in the field of bipolar disorder (BD), machine learning, and big data with extensive experience to evaluate the rationale of machine learning and big data analytics strategies for BD. Method A task force was convened to examine and integrate findings from the scientific literature related to machine learning and big data based studies to clarify terminology and to describe challenges and potential applications in the field of BD. We also systematically searched PubMed, Embase, and Web of Science for articles published up to January 2019 that used machine learning in BD. Results The results suggested that big data analytics has the potential to provide risk calculators to aid in treatment decisions and predict clinical prognosis, including suicidality, for individual patients. This approach can advance diagnosis by enabling discovery of more relevant data-driven phenotypes, as well as by predicting transition to the disorder in high-risk unaffected subjects. We also discuss the most frequent challenges that big data analytics applications can face, such as heterogeneity, lack of external validation and replication of some studies, cost and non-stationary distribution of the data, and lack of appropriate funding. Conclusion Machine learning-based studies, including atheoretical data-driven big data approaches, provide an opportunity to more accurately detect those who are at risk, parse-relevant phenotypes as well as inform treatment selection and prognosis. However, several methodological challenges need to be addressed in order to translate research findings to clinical settings.Peer reviewe

Meta-analysis of mould and dampness exposure on asthma and allergy in eight European birth cohorts: an ENRIECO initiative

n/