DeepSea is an efficient deep-learning model for single-cell segmentation and tracking in time-lapse microscopy.

Time-lapse microscopy is the only method that can directly capture the dynamics and heterogeneity of fundamental cellular processes at the single-cell level with high temporal resolution. Successful application of single-cell time-lapse microscopy requires automated segmentation and tracking of hundreds of individual cells over several time points. However, segmentation and tracking of single cells remain challenging for the analysis of time-lapse microscopy images, in particular for widely available and non-toxic imaging modalities such as phase-contrast imaging. This work presents a versatile and trainable deep-learning model, termed DeepSea, that allows for both segmentation and tracking of single cells in sequences of phase-contrast live microscopy images with higher precision than existing models. We showcase the application of DeepSea by analyzing cell size regulation in embryonic stem cells.

Extrasinus zygomatic implant placement in the rehabilitation of the atrophic maxilla: three-dimensional finite element stress analysis.

Placement of zygomatic implants lateral to the maxillary sinus, according to the extrasinus protocol, is one of the treatment options in the rehabilitation of severely atrophic maxilla or following maxillectomy surgery in patients with head and neck cancer. The aim of this study was to investigate the mechanical behavior of a full-arch fixed prosthesis supported by 4 zygomatic implants in the atrophic maxilla under occlusal loading. Results indicated that maximum von Mises stresses were significantly higher under lateral loading compared with vertical loading within the prosthesis and its supporting implants. Peak stresses were concentrated at the prosthesis-abutments interface under vertical loading and the internal line angles of the prosthesis under lateral loading. The zygomatic supporting bone suffered significantly lower stresses. However, the alveolar bone suffered a comparatively higher level of stresses, particularly under lateral loading. Prosthesis displacement under vertical loading was higher than under lateral loading. The zygomatic bone suffered lower stresses than the alveolar bone and prosthesis-implant complex under both vertical and lateral loading. Lateral loading caused a higher level of stresses than vertical loading.

A comparison of the life goals program and treatment as usual for individuals with bipolar disorder.

OBJECTIVE: This randomized controlled study of 164 outpatients with bipolar disorder in a community mental health center who received standardized psychoeducation (Life Goals Program [LGP]) or treatment as usual sought to determine whether there were differences between the groups in medication adherence attitudes and behaviors. METHODS: Patients were randomly assigned to treatment as usual (N=80) or treatment as usual plus LGP (N=84) and were assessed at baseline and at the three-, six-, and 12-month follow-up. Primary outcomes were change in score from baseline on the Drug Attitude Inventory (DAI) and on self-reported treatment adherence behaviors (SRTAB). RESULTS: At baseline, there were no significant differences between the two groups. Slightly less than half (N=41, 49%) of the LGP group participated in most or all (four to six) LGP sessions, 14% (N=12) participated in one to three sessions, and 37% (N=31) did not participate in any sessions. At the 12-month follow-up there was improvement among all patients, with no significant differences between the two groups, in DAI scores, SRTAB, symptoms, psychopathology, and functional status. Greater depressive severity at baseline was associated with more negative attitudes toward treatment over time, although this finding was not significant (p=.056). Secondary analysis of persons in the LGP group found that compared with those who did not go to any LGP sessions, those with partial or full participation in LGP sessions had improved attitudes toward medication at the three- and six-month follow-up, but no difference was found between the three LGP subgroups by the 12-month follow-up. CONCLUSIONS: There were no differences between two groups in treatment attitudes at the 12-month follow-up. Low attendance rates mitigated effects on primary outcomes. Effects of LGP may become lost over time without ongoing intervention, and individuals with depression may have reduced response to LGP.

Aripiprazole therapy in 20 older adults with bipolar disorder: a 12-week, open-label trial.

OBJECTIVE: Bipolar disorder in older adult populations has gained increasing attention due to the growing proportion of elderly in the United States and worldwide. A continuing unmet need is the identification of agents that are generally well-tolerated and effective in later life bipolar disorder. Aripiprazole is an atypical antipsychotic compound that is approved by the U.S. Food and Drug Administration for the treatment of bipolar mania and for the long-term treatment of bipolar disorder. This study is an open-label, prospective trial of aripiprazole therapy in 20 older adult patients with bipolar disorder. METHOD: Older adults with bipolar I disorder (confirmed by the Mini-International Neuropsychiatric Interview) who were currently suboptimally responsive to their prescribed medication treatments received 12 weeks of open-label aripiprazole added on to existing mood stabilizer medication treatment. Aripiprazole was initiated at 5 mg daily and increased as tolerated. Efficacy outcomes included psychopathology measures (the Young Mania Rating Scale [YMRS] and the Hamilton Rating Scale for Depression [HAM-D]), extrapyramidal symptoms, and a level of functioning measure (the Global Assessment Scale [GAS]). The study was conducted from April 2004 to June 2005. RESULTS: Twenty older adults (mean age = 59.6 years, range 50-83 years) received aripiprazole therapy. Compared to baseline, individuals had significant reductions in mean depression scores (HAM-D baseline = 13.8, HAM-D end point = 6.1, p < .001), as well as mania scores (YMRS baseline = 8.6, YMRS end point = 3.9, p < .03). There were also significant improvements in functional status as measured by the GAS (p < .001). The mean +/- SD daily dose of aripiprazole was 10.26 +/- 4.9 mg/day. Overall, aripiprazole was adequately tolerated in this older adult population. CONCLUSION: Aripiprazole therapy may reduce symptoms in bipolar older adults, and it appears to be reasonably tolerated. However, larger, controlled trials are needed to confirm these preliminary findings.

Adjunct extended-release valproate semisodium in late life schizophrenia.

OBJECTIVE: Adjunctive anticonvulsant medications may benefit some individuals with schizophrenia, however data on adjunct anticonvulsants in older adults with schizophrenia is limited. This prospective, 12-week open label study evaluated adjunct extended-release valproate semisodium (divalproex) in 20 older adults with schizophrenia. METHODS: The study was conducted at an academic psychiatry clinic in the mid-western United States. Participants were self-referred from posted advertisements or referred by clinic practitioners. Extended-release valproate semisodium was added onto antipsychotic treatment. Individuals with active substance use disorders or active significant medical comorbidity were excluded. Primary outcome measures included the Positive and Negative Syndrome Scale (PANSS), Geriatric Depression Scale (GDS) and Global Assessment Scale (GAS). Tolerability was evaluated via patient self-reported side effects, change from baseline in body weight and change on abnormal movement scales. RESULTS: Patients (mean age 61 years, range 49.8-79.2 years) had significant reductions in psychosis scores as measured by the Positive and Negative Syndrome Scale (PANSS) p<0.01, as well as in global functioning as measured by the Global Assessment Scale (GAS) p<0.01 and depression as measured by the Geriatric Depression Scale (GDS) p<0.05. Mean dose of extended-release valproate semisodium was 587.50 mg/day SD+/-247.02. Extended-release valproate semisodium was well tolerated in this older adult population. The primary adverse effect was sedation, which appeared to be relatively dose and titration-speed dependent. Weight change was not significant. CONCLUSION: While extended-release valproate semisodium appears efficacious and well tolerated in older adults with schizophrenia, data from larger, controlled trials is needed.

How should HIV vaccine efficacy trials be conducted? Diverse U.S. communities speak out.

Developing an effective vaccine remains a critical long-term approach to HIV prevention. Every efficacy trial should be responsive to the concerns of participating communities because the successful development of an HIV preventive vaccine will require long-term involvement of people who have been marginalized and who distrust the government and biomedical research. Using qualitative interviews and purposive sampling, we elicited recommendations regarding how vaccine efficacy trials should be conducted from 90 members of communities that have been disproportionately affected by HIV/AIDS: injection drug users, gay men, and African Americans. The most common recommendation was for complete disclosure of all aspects of the trial. Other themes included participant and community education, who to include in trials, preventing harm, trust, community involvement, researcher attributes, and respect for participants. Developing positive, respectful and collaborative experiences with community members will facilitate vaccine research because negative experiences and unfavorable community reactions can greatly impede success in future trials.

Menopause knowledge and subjective experience among peri- and postmenopausal women with bipolar disorder, schizophrenia and major depression.

This study examined concerns regarding menopause among women with schizophrenia/schizoaffective disorder (N = 30), women with bipolar disorder (N = 25), and women with major depression (N = 36). The three groups were compared regarding knowledge of menopause, expectations of effect of menopause, and menopause-related quality of life. All women had deficits in fund of knowledge regarding menopause. More than half (53.8%) agreed that they felt more stressed due to menopause or approaching menopause, and 51.6% felt that menopause has had a negative effect on their emotional state. Perceptions of menopause effect on emotional states between the three groups were similar. The top five symptoms experienced by women with serious mental illness were all problems related to psychological issues: feeling depressed (88%, N = 80), feeling anxious (88%, N = 80), feeling tired or worn out (87%, N = 79), feeling a lack of energy (86%, N = 78), and experiencing poor memory (84%, N = 76). Larger-scale studies evaluating the effects of menopause on serious mental illness are needed to clarify how menopause affects illness outcomes in women with serious mental illness.

Attitudes regarding the collaborative practice model and treatment adherence among individuals with bipolar disorder.

An emerging literature suggests that a collaborative care model, in which patients are active managers of their illness within a supportive social environment, is a beneficial approach for individuals with bipolar disorder. One aspect of treatment that is often suboptimal among individuals with bipolar disorder is treatment adherence. Establishing an ideal collaborative model may offer an opportunity to enhance treatment adherence among individuals with bipolar disorder. This paper presents results from a qualitative exploration of patients' attitudes towards the collaborative care model and how individuals with bipolar disorder perceive treatment adherence within the context of the collaborative care model. All participants were actively enrolled in outpatient treatment at a Community Mental Health Center and part of a larger study that evaluated the Life Goals Program, a manual-driven structured group psychotherapy for bipolar disorder that is based on the collaborative practice model. The Life Goals Program is designed to assist individuals to participate more effectively in the management of their bipolar illness and to improve their social and work-related problems. Individuals were queried regarding their opinions on the ingredients for an effective client-provider relationship. Quantitative data were collected on baseline treatment adherence as well. Individuals treated for bipolar disorder in a community mental health clinic identified 12 key elements that they felt were critical ingredients to a positive collaborative experience with their mental health care provider. The authors conceptualized these elements around 3 emerging themes: patient-centered qualities, provider-centered qualities, and interactional qualities. Individuals with bipolar disorder perceived the ideal collaborative model as one in which the individual has specific responsibilities such as coming to appointments and sharing information, whereas the provider likewise has specific responsibilities such as keeping abreast of current "state-of-the-arf" prescribing practices and being a good listener. Treatment adherence was identified as a self-managed responsibility within the larger context of the collaborative model. Individuals with bipolar disorder in this study placed substantial emphasis on the interactional component within the patient-provider relationship, particularly with respect to times when the individual may be more symptomatic and more impaired. It is important that clinicians and care providers gather information related to patients' perceptions of the patient-provider relationship when designing or evaluating services aimed at enhancing treatment adherence.

Menopause-related quality of life in chronically mentally ill women.

OBJECTIVE: Menopause is an important life event that has not yet been well characterized among women with severe mental illness. Our goal was to evaluate menopause-related quality of life among severely mentally ill women. METHOD: We conducted a cross-sectional assessment of perimenopausal and postmenopausal women, ages 45-55, diagnosed with schizophrenia/schizoaffective disorder, bipolar disorder, or major depression, who were receiving inpatient or outpatient psychiatric care. Women were compared regarding menopausal symptoms and quality of life using the Menopause Specific Quality of Life Scale (MENQOL). RESULTS: Women with severe mental illnesses who were peri- and post-menopausal experienced considerable vasomotor, physical, sexual, and psychosocial symptoms related to menopause. On seven of 29 MENQOL items, women with major depression reported problems significantly more often than women with other serious mental illnesses. CONCLUSIONS: This preliminary study indicates that psychiatrists and other physicians should consider the frequency and overlap of menopausal and psychiatric symptoms among women with serious mental illness in this age group.

The Mpowerment Project: community-building with young gay and bisexual men to prevent HIV1.

The Mpowerment Project is a community-level HIV prevention intervention for young gay and bisexual men ages 18-27. The program seeks to build a strong, supportive young gay and bisexual men's community where young gay and bisexual men nurture and protect each other, particularly with regard to HIV prevention. The program's theoretical framework draws from the areas of diffusion of innovations, community organizing, peer influence, and personal empowerment. The Mpowerment Project promotes a norm for safer sex through a variety of social, outreach and small group activities. The project is run by a "Core Group" of 12-15 young gay and bisexual men who, with volunteers, design and carry out all project activities. Implemented in 4 communities (Eugene, OR; Santa Barbara, CA; Albuquerque, NM; Austin, TX), the Mpowerment Project has proven to be effective in reducing high risk sex. This paper discusses the development and implementation of the program and various challenges encountered.

Differential seed predation on two species of Arctostaphylos (Ericaceae).

The fire-prone California chaparral contains two sympatric species of shrubs: Arctostaphylos glauca and A. glandulosa. A previous study showed that in a stand where both species had similar amounts of coverage, A. glauca had fewer seeds in the soil. We attempt to answer the questions: 1) Could ground-foraging seed predators produce the lower population of A. glauca seeds in the soil? 2) Do predators select fruits randomly with respect to fruit size? 3) Do the fruits of the two species differ in the proportions of fruit components (i.e. seeds, endocarp, mesocarp, and exocarp) in ways that could be important to seed predators? Predation was measured on artificial caches of fruits, for 17 weeks. Selection by predators was examined by comparing weights of fruits recovered from soil samples with newlymatured fruits on the shrubs. Fruits components were characterized by dividing fruits into 3 fractions and weighing. More fruits of A. glauca were removed from the caches. Fruits of both species recovered from the soil were lighter than those on the shrubs. The weights of seeds, stony and fleshy fruit layers were all larger in A. glauca. Within fruits of A. glandulosa, the weights of the three components, various combinations, and ratios were all significantly correlated, while in A. glauca no other component, combination of components, or ratio examined was significantly correlated with the weights of the seeds.