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Vitamin D deficiency is highly prevalent in the UK (1-2). Low exposure to the sun in winter months, as well as higher risk of deficiency amongst some ethnic minority populations (1), means that fortification of food and beverages remains an important potential route to ensure optimal vitamin D status. However, it is unclear as to whether type of fortified food affects ability to raise vitamin D status. Animal foods (e.g. dairy foods) would be expected to lead to higher vitamin D absorption than would non-animal-based foods (e.g. bread, juice), due to their higher fat content. The primary aim of this systematic review and meta-analysis was to investigate the effectiveness of animal and non-animal-based vitamin D fortified foods on raising serum 25-hydroxyvitamin D (25(OH)D).
The literature search was conducted using PubMed on 23 January 2024. Inclusion criteria were as follows: data on non-pregnant/non-lactating adults or data on children, randomised controlled trial; data for 25(OH)D measurement. Initial search results retrieved 701 publications, and 593 ineligible records were removed. Next, 108 records were screened by title and abstract, with 63 records excluded, for the following reasons: off topic (n=54); pregnant or breastfeeding (n=6); non-human (n=1); preterm infants (n=1) and duration <4 weeks (n=1). After full text eligibility screening, 28 publications remained for systematic review and meta-analysis. Ethical approval was not required as this was a literature review.
The end point data meta-analysis showed (for all studies combined) a significant increase in 25(OH)D (+23.4 (95% CI 17.0, 29.7) nmol/L (24 studies)). For specific food types, results were as follows: ‘animal’ +21.7 (95% CI 14.1, 29.3) nmol/L (17 studies); mixture of ‘animal’ and ‘non-animal’ +26.1 (95% CI 10.8, 41.4) nmol/L (1 study); ‘non-animal’ +28.1 (95% 12.0, 44.2) nmol/L (6 studies).
Contrary to what would be expected, non-animal mode of fortification (e.g. bread, juice) had a similar effect size to animal modes (e.g. dairy), so can be considered equivalent in effectiveness in raising 25(OH)D concentration. Differences in dose, duration and population groups between the non-animal and animal modes (in terms of health and baseline vitamin D status) mean the results should be taken with caution, and future studies where these factors are standardised could be useful to provide further evidence of effectiveness.
Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.
Methods
T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and controls, performed subgroup analyses considering the trauma exposure of the controls, and examined associations between regional brain volumes and clinical variables including PTSD (CAPS-4/5, PCL-5) and depression severity (BDI-II, PHQ-9).
Results
PTSD patients exhibited smaller GM volumes across the frontal and temporal lobes, and cerebellum, with the most significant effect in the left cerebellum (Hedges’ g = 0.22, pcorrected = .001), and smaller cerebellar WM volume (peak Hedges’ g = 0.14, pcorrected = .008). We observed similar regional differences when comparing patients to trauma-exposed controls, suggesting these structural abnormalities may be specific to PTSD. Regression analyses revealed PTSD severity was negatively associated with GM volumes within the cerebellum (pcorrected = .003), while depression severity was negatively associated with GM volumes within the cerebellum and superior frontal gyrus in patients (pcorrected = .001).
Conclusions
PTSD patients exhibited widespread, regional differences in brain volumes where greater regional deficits appeared to reflect more severe symptoms. Our findings add to the growing literature implicating the cerebellum in PTSD psychopathology.
Aims: We aimed to determine differences in subgenual anterior cingulate cortex (sgACC) resting-state functional connectivity (rsFC) in Major Depressive Disorder (MDD) vs. healthy volunteers (HV) using 7-Tesla functional magnetic resonance imaging (fMRI). Abnormalities in the sgACC are linked to MDD, but the sgACC is anatomically and functionally diverse, including Brodmann area (BA) 25 (Cg25) and the subgenual portion of area 32 (Cg32). The differences in rsFC between Cg25 and Cg32 in MDD compared with HVs have not been directly examined. High-resolution 7T fMRI offers an unrivalled opportunity to measure differences in rsFC between these two subregions which otherwise suffer from signal dropout.
Methods: We used resting state 7T fMRI to compare rsFC between Cg25 and Cg32 in 40 patients with MDD, and 38 HVs. Within the MDD group, we correlated rsFC changes with anhedonia (SHAPS) and anxiety (STICSA) scores together with baseline high-sensitivity C-reactive protein (hsCRP) measures.
Results: Across all 78 participants, Cg25 and Cg32 showed regionally distinct rsFC patterns despite their proximity. Cg25 had increased rsFC to the orbitofrontal cortex, amygdala, hippocampus and dorsolateral (dl)PFC/BA46, while Cg32 showed increased rsFC to the perigenual (pg) and dorsal (d)ACC, dlPFC/BA9, posterior cingulate cortex (PCC), ventral striatum, and ventral tegmental area. When comparing MDD patients to HV, both Cg25 and Cg32 exhibited increased rsFC to the anterior (ant)PFC/BA10, amygdala and hypothalamus, together with key nodes of the default mode network (DMN), including pgACC, rostral ventromedial prefrontal cortex (vmPFC) and the PCC. rsFC to nodes of the central executive and salience networks, such as the right dlPFC/BA46 and the bilateral insula, was decreased. Within the MDD group, Cg32-antPFC/BA10 and Cg32-dlPFC/BA9 rsFC was positively correlated with anhedonia scores; additionally, subthreshold clusters were identified in the ventral striatum, pgACC and hypothalamus. Cg25-antPFC/BA10 and Cg25-PCC rsFC was negatively correlated with anxiety scores. Cg32 rsFC to the insula, dlPFC/BA9 and and dmPFC/BA10 showed negative correlations with hsCRP measures.
Conclusion: These findings suggest that sgACC subregions have distinct rsFC patterns which are altered in MDD. rsFC changes are differentially related to symptoms of anhedonia and anxiety, together with inflammatory status. This has important implications for the development of targeted neuromodulation treatment strategies.
We undertake a comprehensive investigation into the distribution of in situ stars within Milky Way-like galaxies, leveraging TNG50 simulations and comparing their predictions with data from the H3 survey. Our analysis reveals that 28% of galaxies demonstrate reasonable agreement with H3, while only 12% exhibit excellent alignment in their profiles, regardless of the specific spatial cut employed to define in situ stars. To uncover the underlying factors contributing to deviations between TNG50 and H3 distributions, we scrutinise correlation coefficients among internal drivers (e.g. virial radius, star formation rate [SFR]) and merger-related parameters (such as the effective mass-ratio, mean distance, average redshift, total number of mergers, average spin-ratio, and maximum spin alignment between merging galaxies). Notably, we identify significant correlations between deviations from observational data and key parameters such as the median slope of virial radius, mean SFR values, and the rate of SFR change across different redshift scans. Furthermore, positive correlations emerge between deviations from observational data and parameters related to galaxy mergers. We validate these correlations using the Random Forest Regression method. Our findings underscore the invaluable insights provided by the H3 survey in unravelling the cosmic history of galaxies akin to the Milky Way, thereby advancing our understanding of galactic evolution and shedding light on the formation and evolution of Milky Way-like galaxies in cosmological simulations.
Guideline-based tobacco treatment is infrequently offered. Electronic health record-enabled patient-generated health data (PGHD) has the potential to increase patient treatment engagement and satisfaction.
Methods:
We evaluated outcomes of a strategy to enable PGHD in a medical oncology clinic from July 1, 2021 to December 31, 2022. Among 12,777 patients, 82.1% received a tobacco screener about use and interest in treatment as part of eCheck-in via the patient portal.
Results:
We attained a broad reach (82.1%) and moderate response rate (30.9%) for this low-burden PGHD strategy. Patients reporting current smoking (n = 240) expressed interest in smoking cessation medication (47.9%) and counseling (35.8%). As a result of patient requests via PGHD, most tobacco treatment requests by patients were addressed by their providers (40.6–80.3%). Among patients with active smoking, those who received/answered the screener (n = 309 ) were more likely to receive tobacco treatment compared with usual care patients who did not have the patient portal (n = 323) (OR = 2.72, 95% CI = 1.93–3.82, P < 0.0001) using propensity scores to adjust for the effect of age, sex, race, insurance, and comorbidity. Patients who received yet ignored the screener (n = 1024) compared with usual care were also more likely to receive tobacco treatment, but to a lesser extent (OR = 2.20, 95% CI = 1.68–2.86, P < 0.0001). We mapped observed and potential benefits to the Translational Science Benefits Model (TSBM).
Discussion:
PGHD via patient portal appears to be a feasible, acceptable, scalable, and cost-effective approach to promote patient-centered care and tobacco treatment in cancer patients. Importantly, the PGHD approach serves as a real world example of cancer prevention leveraging the TSBM.
Surfactant transport is central to a diverse range of natural phenomena with numerous practical applications in physics and engineering. Surprisingly, this process remains relatively poorly understood at the molecular scale. Here, we use non-equilibrium molecular dynamics (NEMD) simulations to study the spreading of sodium dodecyl sulphate on a thin film of liquid water. The molecular form of the control volume is extended to a coordinate system moving with the liquid–vapour interface to track surfactant spreading. We use this to compare the NEMD results to the continuum description of surfactant transport on an interface. By including the molecular details in the continuum model, we establish that the transport equation preserves substantial accuracy in capturing the underlying physics. Moreover, the relative importance of the different mechanisms involved in the transport process is identified. Consequently, we derive a novel exact molecular equation for surfactant transport along a deforming surface. Close agreement between the two conceptually different approaches, i.e. NEMD simulations and the numerical solution of the continuum equation, is found as measured by the surfactant concentration profiles, and the time dependence of the so-called spreading length. The current study focuses on a relatively simple specific solvent–surfactant system, and the observed agreement with the continuum model may not arise for more complicated industrially relevant surfactants and anti-foaming agents. In such cases, the continuum approach may fail to predict accompanying phase transitions, which can still be captured through the NEMD framework.
Polygenic scores (PGSs) have garnered increasing attention in the clinical sciences due to their robust prediction signals for psychopathology, including externalizing (EXT) behaviors. However, studies leveraging PGSs have rarely accounted for the phenotypic and developmental heterogeneity in EXT outcomes. We used the National Longitudinal Study of Adolescent to Adult Health (analytic N = 4,416), spanning ages 13 to 41, to examine associations between EXT PGSs and trajectories of antisocial behaviors (ASB) and substance use behaviors (SUB) identified via growth mixture modeling. Four trajectories of ASB were identified: High Decline (3.6% of the sample), Moderate (18.9%), Adolescence-Peaked (10.6%), and Low (67%), while three were identified for SUB: High Use (35.2%), Typical Use (41.7%), and Low Use (23%). EXT PGSs were consistently associated with persistent trajectories of ASB and SUB (High Decline and High Use, respectively), relative to comparison groups. EXT PGSs were also associated with the Low Use trajectory of SUB, relative to the comparison group. Results suggest PGSs may be sensitive to developmental typologies of EXT, where PGSs are more strongly predictive of chronicity in addition to (or possibly rather than) absolute severity.
Accurate diagnosis of bipolar disorder (BPD) is difficult in clinical practice, with an average delay between symptom onset and diagnosis of about 7 years. A depressive episode often precedes the first manic episode, making it difficult to distinguish BPD from unipolar major depressive disorder (MDD).
Aims
We use genome-wide association analyses (GWAS) to identify differential genetic factors and to develop predictors based on polygenic risk scores (PRS) that may aid early differential diagnosis.
Method
Based on individual genotypes from case–control cohorts of BPD and MDD shared through the Psychiatric Genomics Consortium, we compile case–case–control cohorts, applying a careful quality control procedure. In a resulting cohort of 51 149 individuals (15 532 BPD patients, 12 920 MDD patients and 22 697 controls), we perform a variety of GWAS and PRS analyses.
Results
Although our GWAS is not well powered to identify genome-wide significant loci, we find significant chip heritability and demonstrate the ability of the resulting PRS to distinguish BPD from MDD, including BPD cases with depressive onset (BPD-D). We replicate our PRS findings in an independent Danish cohort (iPSYCH 2015, N = 25 966). We observe strong genetic correlation between our case–case GWAS and that of case–control BPD.
Conclusions
We find that MDD and BPD, including BPD-D are genetically distinct. Our findings support that controls, MDD and BPD patients primarily lie on a continuum of genetic risk. Future studies with larger and richer samples will likely yield a better understanding of these findings and enable the development of better genetic predictors distinguishing BPD and, importantly, BPD-D from MDD.
We use the 529 college savings plan setting to investigate whether and why households make suboptimal choices to invest in local assets. We estimate that 67% of open accounts between 2010 and 2020 were located suboptimally due to the plans’ tax inefficiencies and high expenses. Over the accounts’ projected lifetimes, such investments yielded expected losses of 8% on average or $15.6 billion in 2020 alone. We then investigate why suboptimal investment is so prevalent. Consistent with households’ lack of understanding of state-level tax benefits, we find that a meaningful proportion of households does not account for the potential tax benefits and costs of local versus nonlocal 529 investment. Household financial literacy and plan disclosure complexity appear to explain suboptimal investment patterns, which further supports the role of information-processing frictions. Our study presents novel evidence on individuals’ preferences for local assets and how information-processing frictions shape their investment decisions, reducing their financial well-being.
The aim of this paper is to discuss nonparametric item response theory scores in terms of optimal scores as an alternative to parametric item response theory scores and sum scores. Optimal scores take advantage of the interaction between performance and item impact that is evident in most testing data. The theoretical arguments in favor of optimal scoring are supplemented with the results from simulation experiments, and the analysis of test data suggests that sum-scored tests would need to be longer than an optimally scored test in order to attain the same level of accuracy. Because optimal scoring is built on a nonparametric procedure, it also offers a flexible alternative for estimating item characteristic curves that can fit items that do not show good fit to item response theory models.
The association between cannabis and psychosis is established, but the role of underlying genetics is unclear. We used data from the EU-GEI case-control study and UK Biobank to examine the independent and combined effect of heavy cannabis use and schizophrenia polygenic risk score (PRS) on risk for psychosis.
Methods
Genome-wide association study summary statistics from the Psychiatric Genomics Consortium and the Genomic Psychiatry Cohort were used to calculate schizophrenia and cannabis use disorder (CUD) PRS for 1098 participants from the EU-GEI study and 143600 from the UK Biobank. Both datasets had information on cannabis use.
Results
In both samples, schizophrenia PRS and cannabis use independently increased risk of psychosis. Schizophrenia PRS was not associated with patterns of cannabis use in the EU-GEI cases or controls or UK Biobank cases. It was associated with lifetime and daily cannabis use among UK Biobank participants without psychosis, but the effect was substantially reduced when CUD PRS was included in the model. In the EU-GEI sample, regular users of high-potency cannabis had the highest odds of being a case independently of schizophrenia PRS (OR daily use high-potency cannabis adjusted for PRS = 5.09, 95% CI 3.08–8.43, p = 3.21 × 10−10). We found no evidence of interaction between schizophrenia PRS and patterns of cannabis use.
Conclusions
Regular use of high-potency cannabis remains a strong predictor of psychotic disorder independently of schizophrenia PRS, which does not seem to be associated with heavy cannabis use. These are important findings at a time of increasing use and potency of cannabis worldwide.
Hybrid whole genome sequencing was used to investigate if nosocomial Verona integron-encoded metallo-β-lactamase (VIM) carbapenemase transmission occurred between two patients without epidemiological links or common pathogens. Challenges in genomic methodology and appropriate analytical depth for mobile carbapenemase outbreaks are described including how inappropriate choices can mislead results and impact infection control practices.
OBJECTIVES/GOALS: Ambulatory methods are useful tools to study physical and mental health in everyday life. While many studies show daily activity improves mood, the effects of daily light exposure on mood remain unknown. This study evaluated the effects of daily natural light exposure and activity on daily mood and evaluate whether depression moderate effects. METHODS/STUDY POPULATION: 82 adults with lifetime major depression disorder (25 current) and 49 healthy controls were recruited from the greater Chicago community (N = 131, 62% female, age M = 30.15, SD = 9.94). At baseline, participants completed the Inventory of Depression and Anxiety Symptoms to measure depression symptoms of anhedonia, or loss of pleasure. Positive and negative affect were then measured 3x daily for 14-days via self-report using smartphones while light exposure and activity were continuously recorded from a wrist-worn actigraphy device. Following prior studies, daily natural light exposure was measured as the total number of white light samples greater than 1000 lux each day. Multilevel models were used to separate within-person (daily level) from between-person (subject level) effects. RESULTS/ANTICIPATED RESULTS: Results revealed daily within-person activity (p < .001) and natural light exposure duration (p = .035) were independently associated with increased positive affect. Effects were significantly moderated by baseline anhedonia symptoms (3-way interaction: p = .004). Natural light exposure duration only increased positive affect on lower activity days for high anhedonia and higher activity days for low anhedonia (ps < .018). Significant results remained controlling for between-person light and activity, time of year, age, sex, negative affect, and baseline general depression symptoms. Compared to one’s own daily averages, daily activity and natural light exposure may be independent pathways to boost positive affect, especially for individuals with high anhedonia symptoms. DISCUSSION/SIGNIFICANCE: Results suggest daily natural light exposure may be an accessible, low-cost alternative to independently increase positive affect in depression on days when activity is low. Translational applications are discussed focusing on transdiagnostic implications for physical and mental health conditions that disrupt mood and limit activity.
This study investigates the impact of primary care utilisation of a symptom-based head and neck cancer risk calculator (Head and Neck Cancer Risk Calculator version 2) in the post-coronavirus disease 2019 period on the number of primary care referrals and cancer diagnoses.
Methods
The number of referrals from April 2019 to August 2019 and from April 2020 to July 2020 (pre-calculator) was compared with the number from the period January 2021 to August 2022 (post-calculator) using the chi-square test. The patients’ characteristics, referral urgency, triage outcome, Head and Neck Cancer Risk Calculator version 2 score and cancer diagnosis were recorded.
Results
In total, 1110 referrals from the pre-calculator period were compared with 1559 from the post-calculator period. Patient characteristics were comparable for both cohorts. More patients were referred on the cancer pathway in the post-calculator cohort (pre-calculator patients 51.1 per cent vs post-calculator 64.0 per cent). The cancer diagnosis rate increased from 2.7 per cent in the pre-calculator cohort to 3.3 per cent in the post-calculator cohort. A lower rate of cancer diagnosis in the non-cancer pathway occurred in the cohort managed using the Head and Neck Cancer Risk Calculator version 2 (10 per cent vs 23 per cent, p = 0.10).
Conclusion
Head and Neck Cancer Risk Calculator version 2 demonstrated high sensitivity in cancer diagnosis. Further studies are required to improve the predictive strength of the calculator.
The International Design Engineering Annual (IDEA) Challenge is a virtually hosted hackathon for Engineering Design researchers with aims of: i) generating open access datasets; ii) fostering community between researchers; and, iii) applying great design minds to develop solutions to real design problems. This paper presents the 2022 IDEA challenge and elements of the captured dataset with the aim of providing insights into prototyping behaviours at virtually hosted hackathons, comparing it with the 2021 challenge dataset and providing reflections and learnings from two years of running the challenge. The dataset is shown to provide valuable insights into how designers spend their time at hackathon events and how, why and when prototypes are used during their design processes. The dataset also corroborates the findings from the 2021 dataset, demonstrating the complementarity of physical and sketch prototypes. With this paper, we also invite the wider community to contribute to the IDEA Challenge in future years, either as participants or in using the platform to run their own design studies.
Childhood adversity and cannabis use are considered independent risk factors for psychosis, but whether different patterns of cannabis use may be acting as mediator between adversity and psychotic disorders has not yet been explored. The aim of this study is to examine whether cannabis use mediates the relationship between childhood adversity and psychosis.
Methods
Data were utilised on 881 first-episode psychosis patients and 1231 controls from the European network of national schizophrenia networks studying Gene–Environment Interactions (EU-GEI) study. Detailed history of cannabis use was collected with the Cannabis Experience Questionnaire. The Childhood Experience of Care and Abuse Questionnaire was used to assess exposure to household discord, sexual, physical or emotional abuse and bullying in two periods: early (0–11 years), and late (12–17 years). A path decomposition method was used to analyse whether the association between childhood adversity and psychosis was mediated by (1) lifetime cannabis use, (2) cannabis potency and (3) frequency of use.
Results
The association between household discord and psychosis was partially mediated by lifetime use of cannabis (indirect effect coef. 0.078, s.e. 0.022, 17%), its potency (indirect effect coef. 0.059, s.e. 0.018, 14%) and by frequency (indirect effect coef. 0.117, s.e. 0.038, 29%). Similar findings were obtained when analyses were restricted to early exposure to household discord.
Conclusions
Harmful patterns of cannabis use mediated the association between specific childhood adversities, like household discord, with later psychosis. Children exposed to particularly challenging environments in their household could benefit from psychosocial interventions aimed at preventing cannabis misuse.
While cannabis use is a well-established risk factor for psychosis, little is known about any association between reasons for first using cannabis (RFUC) and later patterns of use and risk of psychosis.
Methods
We used data from 11 sites of the multicentre European Gene-Environment Interaction (EU-GEI) case–control study. 558 first-episode psychosis patients (FEPp) and 567 population controls who had used cannabis and reported their RFUC.
We ran logistic regressions to examine whether RFUC were associated with first-episode psychosis (FEP) case–control status. Path analysis then examined the relationship between RFUC, subsequent patterns of cannabis use, and case–control status.
Results
Controls (86.1%) and FEPp (75.63%) were most likely to report ‘because of friends’ as their most common RFUC. However, 20.1% of FEPp compared to 5.8% of controls reported: ‘to feel better’ as their RFUC (χ2 = 50.97; p < 0.001). RFUC ‘to feel better’ was associated with being a FEPp (OR 1.74; 95% CI 1.03–2.95) while RFUC ‘with friends’ was associated with being a control (OR 0.56; 95% CI 0.37–0.83). The path model indicated an association between RFUC ‘to feel better’ with heavy cannabis use and with FEPp-control status.
Conclusions
Both FEPp and controls usually started using cannabis with their friends, but more patients than controls had begun to use ‘to feel better’. People who reported their reason for first using cannabis to ‘feel better’ were more likely to progress to heavy use and develop a psychotic disorder than those reporting ‘because of friends’.
This co-authored book examines the implications of the global ascent of China on cross-Strait relations and the identity of Taiwan as a democratic state, offering insights into policies for peaceful relations and prosperity across the Taiwan Strait.
The majority of children with maltreatment histories do not go on to develop depression in their adolescent and adult years. These individuals are often identified as being “resilient”, but this characterization may conceal difficulties that individuals with maltreatment histories might face in their interpersonal relationships, substance use, physical health, and/or socioeconomic outcomes in their later lives. This study examined how adolescents with maltreatment histories who exhibit low levels of depression function in other domains during their adult years. Longitudinal trajectories of depression (across ages 13–32) in individuals with (n = 3,809) and without (n = 8,249) maltreatment histories were modeled in the National Longitudinal Study of Adolescent to Adult Health. The same “Low,” “increasing,” and “declining” depression trajectories in both individuals with and without maltreatment histories were identified. Youths with maltreatment histories in the “low” depression trajectory reported lower romantic relationship satisfaction, more exposure to intimate partner and sexual violence, more alcohol abuse/dependency, and poorer general physical health compared to individuals without maltreatment histories in the same “low” depression trajectory in adulthood. Findings add further caution against labeling individuals as “resilient” based on a just single domain of functioning (low depression), as childhood maltreatment has harmful effects on a broad spectrum of functional domains.
We assessed the efficacy of a culturally competent outreach model with promotoras in raising the coronavirus disease 2019 (COVID-19) first-dose vaccination rates in Chicago’s at-risk ZIP codes from February through May 2021. Utilizing community members from within target communities may reduce barriers, increase vaccination rates, and enhance COVID-19 prevention.