Posttraumatic Stress, Anxiety, and Depression in COVID-19 Survivors.

OBJECTIVES: This study aims to examine the rates of anxiety, depression, and posttraumatic stress disorder (PTSD) after hospital discharge among COVID-19 survivors and to determine the associated risk factors. METHODS: Adult COVID-19 survivors discharged from hospitals between March 2020 and March 2021 were asked to complete a questionnaire at 4 weeks after discharge. The Chinese version of the 22-item Impact of Event Scale - Revised (IES-R) was used to measure symptoms of PTSD. The 9-item Patient Health Questionnaire (PHQ-9) was used to assess symptoms of major depressive disorder. The 7-item Generalised Anxiety Disorder Scale (GAD-7) was used to measure symptoms of generalised anxiety disorder. The rates of anxiety, depression, and PTSD among discharged patients were determined, as were associations between psychosocial factors and outcome measures and predictors for moderate-tosevere symptoms of anxiety, depression, and PTSD. RESULTS: 96 men and 103 women aged 18 to 81 years returned the completed questionnaire. 12.1% to 20.1% of them reported symptoms of PTSD, anxiety, or depression. Higher symptom severity was associated with higher perceived life threat, lower emotional support, lower disease severity upon admission, and longer hospital stay. Women had more PTSD symptoms than men, particularly when knowing someone under quarantine. CONCLUSION: COVID-19 survivors with higher perceived life threat, lower emotional support, lower disease severity upon admission, and longer hospital stay were associated with higher severity of symptoms of PTSD, anxiety, and depression. Timely intervention should provide to at-risk survivors.

Correlating spacing in the primary dentition and caries experience in preschool children.

PURPOSE: To evaluate the correlation between spacing in the primary dentition and caries experience. METHODS: One hundred seventy-four clinical records, including photographs during 2017-2019 were assessed for primate, generalised and interdental spaces. The mean of decayed, missing or filled teeth and surfaces (dmft and dmfs) were recorded to quantify the caries experience. Linear regression analyses were used to ascertain correlations between spacing and dental caries. The strength of the associations was quantified using odds ratio (OR) and 95% confidence interval (CI). RESULTS: Ninety-seven boys and 77 girls were included in the final analysis. Approximately 41% of children had primate space in all four quadrants, and 15% of children had no primate spaces in all four quadrants. 50% of children did not exhibit generalised spacing, while 39% of children showed interdental spacing. Children with no primate space had approximately five surfaces higher dmfs score compared to those with primate space in all four quadrants (95% CI - 9.27 to - 1.23; p < 0.05). Similarly, children with no primate space in the mandible had 6.12 surfaces higher dmfs score compared to those with primate space in the mandibular arch (95% CI - 10.07 to - 2.17; p < 0.05). CONCLUSIONS: Preschool children with no primate space exhibited a 50% increase in dmfs scores compared to children with primate space.

Posttraumatic Stress after Treatment in an Intensive Care Unit.

OBJECTIVE: To study posttraumatic stress in patients after treatment in an intensive care unit (ICU). METHODS: This prospective cohort study included 136 adult patients with critical medical and surgical problems who were discharged from the ICU of the Caritas Medical Centre, Hong Kong. Their occurrence of posttraumatic stress disorder (PTSD), anxiety, and depression after ICU treatment were measured using the Impact of Event Scale-Revised and Hospital Anxiety and Depression Scale. Patient ICU experience was measured using the ICU Memory Tool. Multivariable analyses were conducted to examine the predictors of PTSD symptoms, anxiety, and depression. RESULTS: Symptoms of PTSD, anxiety, and depression were reported in 10% to 17% of patients. Symptom severity was associated with less factual memory, more vivid memory of feelings about and more delusional memory of the ICU experience, low emotional support, and high perceived life threat. CONCLUSIONS: Symptoms of posttraumatic stress, anxiety, and depression may occur after ICU treatment. Early identification and appropriate intervention for PTSD are important for rehabilitation.

Massively parallel sequencing of the mouse exome to accurately identify rare, induced mutations: an immediate source for thousands of new mouse models.

Accurate identification of sparse heterozygous single-nucleotide variants (SNVs) is a critical challenge for identifying the causative mutations in mouse genetic screens, human genetic diseases and cancer. When seeking to identify causal DNA variants that occur at such low rates, they are overwhelmed by false-positive calls that arise from a range of technical and biological sources. We describe a strategy using whole-exome capture, massively parallel DNA sequencing and computational analysis, which identifies with a low false-positive rate the majority of heterozygous and homozygous SNVs arising de novo with a frequency of one nucleotide substitution per megabase in progeny of N-ethyl-N-nitrosourea (ENU)-mutated C57BL/6j mice. We found that by applying a strategy of filtering raw SNV calls against known and platform-specific variants we could call true SNVs with a false-positive rate of 19.4 per cent and an estimated false-negative rate of 21.3 per cent. These error rates are small enough to enable calling a causative mutation from both homozygous and heterozygous candidate mutation lists with little or no further experimental validation. The efficacy of this approach is demonstrated by identifying the causative mutation in the Ptprc gene in a lymphocyte-deficient strain and in 11 other strains with immune disorders or obesity, without the need for meiotic mapping. Exome sequencing of first-generation mutant mice revealed hundreds of unphenotyped protein-changing mutations, 52 per cent of which are predicted to be deleterious, which now become available for breeding and experimental analysis. We show that exome sequencing data alone are sufficient to identify induced mutations. This approach transforms genetic screens in mice, establishes a general strategy for analysing rare DNA variants and opens up a large new source for experimental models of human disease.

Development of a psychological well-being scale for family caregivers in palliative care.

OBJECTIVE: A Psychological Well-being Scale for Caregivers (PWS-C) was developed to screen for psychological distress among family caregivers in a Palliative Care Unit for patients with advanced cancer. METHODS: To study the psychometric properties of the 11-item PWS-C which consisted of 5 subscales; 132 family caregivers completed the PWS-C, of whom 70 also answered the Hospital Anxiety and Depression Scale (HADS) questionnaire. Results of 15 caregivers who had received psychological intervention and completed the PWS-C before and after treatment were compared. RESULTS: The internal consistency and test-retest reliability of the scale were found to be satisfactory. A 4-factor structure was identified. Items for Life Meaning and Social Support subscales were accounted for by 1 factor. The subscales of Emotional Distress, Caregiving Inadequacy, and Hospital Care were accounted for by 3 other factors. The PWS-C subscale scores were moderately correlated with HADS scores. Significant changes in the subscales of Social Support and Life Meaning of the PWS-C were identified in pre-post treatment comparisons, which indicated the potential utility of the scale as an outcome measure. CONCLUSIONS: The PWS-C could be a reliable and valid tool useful for screening and measuring the outcome of psychological interventions for psychological well-being / distress reduction, for caregivers of patients receiving palliative care.