Innovations in interventional cardiology: Pioneering techniques for a new era.

Interventional cardiology is on the cusp of a significant transformation as we approach 2050, driven by emerging trends and groundbreaking technological innovations. This mini review explores the pivotal developments shaping the field, focusing on three key areas: Emerging Trends in Interventional Cardiology, Technological Innovations: The Next Frontier, and the Future Era of Intervention Cardiology from 2024 to 2050. Emerging trends, including advancements in imaging and artificial intelligence, are revolutionizing diagnosis and treatment, allowing for more precise and personalized interventions. Technological innovations, such as robotic-assisted procedures and bioresorbable stents, are redefining the landscape, enhancing procedural accuracy, and expanding access to care through remote interventions. Looking ahead to 2050, we anticipate a future where interventional cardiology is increasingly driven by minimally invasive techniques, AI-driven decision-making, and personalized medicine, offering unprecedented improvements in patient outcomes and reshaping the way cardiovascular diseases are managed.

Application of solid waste materials in cold bitumen emulsion mixtures for cleaner pavement industry: a comprehensive review.

There is a global concern with continuous waste production, and efforts are underway to use these wastes in the construction sector. The negative effects of excessive waste production and the use of virgin materials and energy in Hot Mix Asphalt (HMA) construction are challenging and require attention. The right step towards developing resilient road infrastructure is using cold bitumen emulsion mixtures (CBEMs), a cold mix asphalt (CMA). A long-term fix to issues with waste generation and the creation of flexible pavements with HMA can be found by incorporating wastes into CMA. This work reviews the utilization of numerous wastes from different sectors (agricultural, industrial, construction and demolition, and municipal) that are well-known but underutilized and could be used as potential fillers in cold asphalt mixtures. Focus is given to the critical analysis of wastes' physiochemical characteristics and how these affected the effectiveness of mixtures against primary distresses like stability, stiffness, rutting, cracking, fatigue, and moisture susceptibility. Almost all waste materials incorporation reported enhancement in the mechanical performance of CBEM mixes concerning conventional CBEM mixes. The paper sums up the impact on various mechanical properties of CBEM mixes utilizing waste material filler, presents research gaps and a way forward to inspire researchers, and serves as a guideline for using waste materials as fillers in CBEM mixes. This will improve environmental quality and promote sustainability in the paving industry.

Mild Hyperthermia Enhanced Liposomal Doxorubicin Delivery and CD8+ T cell Infiltration in Triple Negative Breast Cancer.

Mild hyperthermia (MHTh) is often used in combination with chemotherapy and radiotherapy for cancer treatment. In the current study, the effect of MHTh on the enhanced uptake of the FDA-approved chemotherapy drug, liposomal doxorubicin (dox) in syngeneic 4T1 tumors was investigated. Doxorubicin has inherent fluorescence properties having an emission signal at 590 nm upon excitation with a 480 nm laser. A group of mice administered with doxorubicin (dox) were exposed to MHTh (42 °C) for 30 minutes whereas control group given dox did not receive MHTh. Ex vivo optical imaging of harvested tumors confirmed higher uptake of dox in treated versus the control untreated tumors. Confocal microscopy of tumor sections indicates higher fluorescent intensity due to increased accumulation of dox in MHTh-treated compared to untreated tumors. We examined the effect of MHTh to enhance CD8 tumor infiltration, production of interferon-γ (IFN-γ) and expression of programmed death ligand-1 (PD-L1). mRNA in situ hybridization was performed to test for transcripts of CD8, IFN-γ and PD-L1. Results showed that higher expression of CD8 mRNA was observed in MHTh-administered tumors versus untreated cohorts. The signal for IFN-γ and PD-L1 in both groups were not significantly different. Taken together, our findings imply that MHTh can improve tumor uptake of dox. Importantly, our data suggests that MHTh can boost CD8+ T cell infiltration.

Development of Magnesium Aluminate (MgAl2O4) Nanoparticles for refractory crucible application.

Ceramics are the oxides of metals and nonmetals with excellent compressive strength. Ceramics usually exhibit inert behavior at high temperatures. Magnesium aluminate (MgAl2O4), a member of the ceramic family, possesses a high working temperature up to 2000°C, low thermal conductivity, high strength even at elevated temperatures, and good corrosion resistance. Moreover, Magnesium Aluminate Nanoparticles (MANPs) can be used in the making of refractory crucible applications. This study focuses on the thermal behavior of Magnesium Aluminate Nanoparticles (MANPs) and their application in the making of refractory crucibles. The molten salt method is used to obtain MANPs. The presence of MANPs is seen by XRD peaks ranging from 66° to 67°. The determination of the smallest crystallite size of the sample is achieved by utilizing the Scherrer formula and is found to be 15.3 nm. The SEM micrographs provided further information, indicating an average particle size of 91.2 nm. At 600°C, DSC curves show that only 0.05 W/g heat flows into the material, and the TGA curve shows only 3% weight loss, which is prominent for thermal insulation applications. To investigate the thermal properties, crucibles of pure MANPs and the different compositions of MANPs and pure alumina are prepared. During the sintering, cracks appear on the crucible of pure magnesium aluminate. To explore the reason for crack development, tablets of MgAl2O4 are made and sintered at 1150°C. Ceramography shows the crack-free surfaces of all the tablets. Results confirm the thermal stability of MANPs at high temperatures and their suitability for melting crucible applications.

P-wave indices and left atrial mechanics as predictors of atrial cardiopathy in embolic stroke of undetermined source.

Recent research has shed light on the culpability of LA (left atrial) abnormality, in the form of atrial cardiopathy, as an independent risk factor for the development of atrial fibrillation, LA thrombus and subsequent stroke. The aim of this study was to measure LA electromechanical dissociation (EMD), LA volumes, P-wave dispersion (PWD) and P-wave terminal force in V1 (PTFV1) as markers of atrial cardiopathy in patients with ESUS (embolic stroke of undetermined source), to determine whether atrial cardiopathy is an integral part in the causal pathway of ESUS. 28 patients presenting with ischemic stroke and fulfilling the criteria for ESUS were enrolled into this cross-sectional, observational study along with a control group of 28 age- and gender-matched apparently healthy individuals. On ECG, PWD and PTFV1 were measured. On echocardiography, LA EMD and LA volumes were recorded. Increased PWD (34.14 ± 9.89 ms vs. 27.32 ± 8.95 ms; p = 0.01), atrial EMD (73.32 ± 16.31 ms vs. 63.63 ± 13.59 ms; p = 0.02) and LA volumes were observed in patients with ESUS as compared to controls. A significant correlation was also found between these parameters (p < 0.01). According to the results of our study, PWD, atrial EMD and LA volumes may be novel predictors for ESUS. Our results support the notion that atrial cardiopathy is a distinct mechanism of thrombosis in ESUS patients. Further research is required to clarify its function in the causation of stroke, ESUS in particular.

MDMA-Based Psychotherapy in Treatment-Resistant Post-Traumatic Stress Disorder (PTSD): A Brief Narrative Overview of Current Evidence.

Post-traumatic stress disorder (PTSD) is a debilitating mental health disorder that causes significant dysfunction in individuals. Currently, there are many approved pharmacotherapy and psychotherapy treatment options for PTSD, but unfortunately, half of the patients do not respond to traditional therapies. In this article, we review clinical trials and research on 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy in PTSD patients, its pharmacokinetics, and current treatment guidelines for PTSD. Our findings are based on the results of the efficacy of MDMA-assisted psychotherapy from six phase II randomized controlled trials. MDMA-assisted psychotherapy for PTSD has received the "breakthrough therapy" designation from the FDA. MDMA can reduce PTSD symptoms even in treatment-resistant cases by increasing certain neurohormones, i.e., dopamine, serotonin, norepinephrine, and oxytocin. It also modulates activities in the brain regions involved in fear and anxiety. Future research is needed to show whether the advantages outweigh the disadvantages and whether its use can be integrated into available treatment options for PTSD.

A Unique Case of Atrial Fibrillation Secondary to Squamous Cell Lung Carcinoma.

Atrial fibrillation (AF) is widely considered to be the most prevalent cardiac arrhythmia with an incidence of roughly 1%-2% in the United States alone. The incidence of AF has been known to increase with advancing age and thus presents a significant burden on healthcare systems across the globe. AF arises as a result of several mechanisms including structural changes that occur in the heart over time. Here, we present a case in which a 63-year-old male with no past medical history except heavy tobacco use presented to the emergency department complaining of shortness of breath. He also endorsed having palpations and a productive cough for several weeks prior to presenting to the emergency department. An EKG revealed AF with a rapid ventricular response. His chest x-ray revealed an irregular opacification of the left lung; however, a chest computed tomography unveiled a left hilar mass extending to the left upper lobe. The mass was causing obstruction of the left upper lobe and encasement of the left main pulmonary artery and left atrium. This case highlights a rare etiology of AF. While many causes of AF have been elucidated, including hypertension and valvular heart disease, a much lesser-known cause includes lung carcinoma resulting in a mass effect on the heart. Representing almost 19% of all cancer deaths, lung cancer is the leading cause of cancer death. Although lung cancer screenings are recommended for certain populations, the majority of lung cancer cases present at an advanced stage, limiting treatment options. Our patient presents a unique case involving a lung mass causing AF due to the mass effect on the left heart. Although the patient had other risk factors for AF including advanced age and cigarette smoking, we propose that due to the anatomical location of his lung mass, his AF was a consequence of the squamous cell carcinoma of the lung. Although the mortality for lung cancer remains high, new treatments, including pembrolizumab, have the potential to drastically alter the way these cancers are treated.

Molybdenum disulfide (MoS2) along with graphene nanoplatelets (GNPs) utilized to enhance the capacitance of conducting polymers (PANI and PPy).

Hybrid composites of molybdenum disulfide (MoS2), graphene nanoplatelets (GNPs) and polyaniline (PANI)/polypyrrole (PPy) have been synthesized as cost-effective electrode materials for supercapacitors. We have produced MoS2 from molybdenum dithiocarbamate by a melt method in an inert environment and then used a liquid exfoliation method to form its composite with graphene nanoplatelets (GNPs) and polymers (PANI and PPy). The MoS2 melt/GNP ratio in the resultant composites was 1 : 3 and the polymer was 10% by wt. of the original composite. XRD (X-ray diffraction analysis) confirmed the formation of MoS2 and SEM (scanning electron microscopy) revealed the morphology of the synthesized materials. The electrochemical charge storage performance of the synthesized composite materials was assessed by cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS) and galvanostatic charge/discharge (GCCD) measurements. Resultant composites showed enhanced electrochemical performances (specific capacitance = 236.23 F g-1, energy density = 64.31 W h kg-1 and power density = 3858.42 W kg-1 for MoS2 melt 5 mPP at a current density of 0.57 A g-1 and had 91.87% capacitance retention after 10 000 charge-discharge cycles) as compared to the produced MoS2; thus, they can be utilized as electrode materials for supercapacitors.

An Unusual Case of Bleeding: Acquired Hemophilia A.

Acquired hemophilia A (AHA) is a bleeding disorder, autoimmune in nature, in which the body produces IgG antibody inhibitors that attack coagulation factor VIII, causing deficiency. It is largely seen in the elderly, but most cases are idiopathic. Cases of acquired hemophilia A can occur in the presence of neutrophilia, infection, acute physiological stress, medication effect, tissue necrosis, various inflammatory disorders, and/or malignancy, which presents a formidable challenge with clinical workup. This case illustrates the potential for a masked bleeding disorder in a complex elderly male patient and the value of a thorough history-taking and workup. Although rare, acquired hemophilia recognition is essential for appropriate therapies to be started as early as possible and for cases to not easily be confused for another bleeding disorder in an acute care setting after ruling out other acute/common causes of similarly presenting symptoms.

High-speed feedback based wavefront shaping for spatiotemporal enhancement of incoherent light through dynamic scattering media.

Feedback-based wavefront shaping is a promising and versatile technique for enhancing the contrast of a target signal for both coherent and incoherent light through a highly scattering medium. However, this technique can fail for a dynamic sample with a short correlation time. So far, most proposed methods for high-speed wavefront shaping can only directly enhance the intensity of coherent light but not incoherent light. Here we try to fill this gap to directly enhance incoherent light with high speed, such as fluorescence, which is essential in extending wavefront shaping to biomedical applications. For this purpose, we develop a technique based on a single acousto-optic deflector (AOD) with field-programmable gate array (FPGA) acceleration for spatiotemporal focusing within milliseconds. With the digital time gating of the feedback signal, spatiotemporal focusing of laser light with high contrast can be formed behind dynamic scattering media in milliseconds resulting in fluorescence enhancement. Furthermore, FPGA-based wavefront shaping is shown to effectively enhance fluorescence directly behind dynamic samples with short correlation times.

A synthesis on utilization of waste glass and fly ash in cold bitumen emulsion mixtures.

The generation of waste materials is a global concern and attempts are being made to utilize these wastes in the construction industry. The development of road infrastructure everywhere is going at a fast pace which increases the environmental degradation, fossil fuel consumption, global warming, and depletion of natural materials because of hot mix asphalt (HMA) usage. The detrimental effects of generation of waste in large quantities at a global scale and virgin material/energy consumption in HMA construction are of prime concern and need to be addressed. The construction/maintenance of pavement must be environmentally, economically, and socially sustainable. Use of cold bitumen emulsion mixtures (CBEMs), a type of cold mix asphalt (CMA), is a way forward for development of sustainable road infrastructure. The incorporation of wastes in CMA can be a sustainable solution to problems linked to waste generation and development of flexible pavements with HMA. This work summarizes the staging evaluation of CBEMs incorporated with waste glass (WG) and fly ash (FA) utilizing mechanical characteristics, water sensitivity and environmental impact, critical gaps in the literature, and recommendations to address those gaps. A detailed analysis on CBEMs using WG as a replacement of fine aggregate showed comparable stability/stiffness and multifold resistance to rutting than HMA. Fly ash filler in CBEMs reported extraordinary increase in stability, stiffness, rutting resistance, and water sensitivity than reference CBEM/HMA. The focus of the research area should continue on the exploration of waste materials for use in CBEMs to achieve a better environment for society and to promote sustainability in the pavement industry.

Effects of CYP2B6 Genetic Variants on the Propofol Dose and Response among Jordanian Arabic Patients Undergoing General Anesthesia.

BACKGROUND: Propofol is the most commonly used general anesthetic drug in many countries, including Jordan. However, there is a wide variation in the propofols' dose and response among the patients. Genetic variation in the cytochrome (CYP) 2B6 gene affects propofol metabolism and might affect propofol dose and response. AIMS: This study aimed to determine the influence of major genetic alleles of the CYP2B6 gene, CYP2B6*2A, *6A, *3, *4A, and *5A, on the required propofol dose and response among Jordanian Arabic patients attending The University of Jordan Hospital. METHODS: A total of 155 patients were administrated propofol. The propofol response was evaluated by monitoring the time to reach the bispectral index of 60 (BIS60) for every patient. The CYP2B6 genetic variants were genotyped by polymerase chain reaction followed by restriction through specific enzymes for CYP2B6 variants. RESULTS: It is found that patients with variant CYP2B6*2A and *4A alleles required significantly (P < 0.05) lower propofol doses, while patients with variant CYP2B6*6A, *3, and *5A alleles required higher propofol doses in comparison with patients carrying the wild CYP2B6 alleles. Patients with variant CYP2B6*2A and *3 alleles needed a significantly (P < 0.05) shorter while patients with variant CYP2B6*5A allele needed longer time of BIS60 than patients with wild CYP2B6*2A, *3, and *5A alleles. CONCLUSION: It is concluded that CYP2B6 genetic variants affect propofol dose and can explain, at least partly, the inter-individual variation in the propofol response. Further clinical studies with a larger sample size are needed to confirm the findings of this study.

Looking deep inside tissue with photoacoustic molecular probes: a review.

Significance: Deep tissue noninvasive high-resolution imaging with light is challenging due to the high degree of light absorption and scattering in biological tissue. Photoacoustic imaging (PAI) can overcome some of the challenges of pure optical or ultrasound imaging to provide high-resolution deep tissue imaging. However, label-free PAI signals from light absorbing chromophores within the tissue are nonspecific. The use of exogeneous contrast agents (probes) not only enhances the imaging contrast (and imaging depth) but also increases the specificity of PAI by binding only to targeted molecules and often providing signals distinct from the background. Aim: We aim to review the current development and future progression of photoacoustic molecular probes/contrast agents. Approach: First, PAI and the need for using contrast agents are briefly introduced. Then, the recent development of contrast agents in terms of materials used to construct them is discussed. Then, various probes are discussed based on targeting mechanisms, in vivo molecular imaging applications, multimodal uses, and use in theranostic applications. Results: Material combinations are being used to develop highly specific contrast agents. In addition to passive accumulation, probes utilizing activation mechanisms show promise for greater controllability. Several probes also enable concurrent multimodal use with fluorescence, ultrasound, Raman, magnetic resonance imaging, and computed tomography. Finally, targeted probes are also shown to aid localized and molecularly specific photo-induced therapy. Conclusions: The development of contrast agents provides a promising prospect for increased contrast, higher imaging depth, and molecularly specific information. Of note are agents that allow for controlled activation, explore other optical windows, and enable multimodal use to overcome some of the shortcomings of label-free PAI.

Marshall Stability Prediction with Glass and Carbon Fiber Modified Asphalt Mix Using Machine Learning Techniques.

Pavement design is a long-term structural analysis that is required to distribute traffic loads throughout all road levels. To construct roads for rising traffic volumes while preserving natural resources and materials, a better knowledge of road paving materials is required. The current study focused on the prediction of Marshall stability of asphalt mixes constituted of glass, carbon, and glass-carbon combination fibers to exploit the best potential of the hybrid asphalt mix by applying five machine learning models, i.e., artificial neural networks, Gaussian processes, M5P, random tree, and multiple linear regression model and further determined the optimum model suitable for prediction of the Marshall stability in hybrid asphalt mixes. It was equally important to determine the suitability of each mix for flexible pavements. Five types of asphalt mixes, i.e., glass fiber asphalt mix, carbon fiber asphalt mix, and three modified asphalt mixes of glass-carbon fiber combination in the proportions of 75:25, 50:50, and 25:75 were utilized in the investigation. To measure the efficiency of the applied models, five statistical indices, i.e., coefficient of correlation, mean absolute error, root mean square error, relative absolute error, and root relative squared error were used in machine learning models. The results indicated that the artificial neural network outperformed other models in predicting the Marshall stability of modified asphalt mix with a higher value of the coefficient of correlation (0.8392), R2 (0.7042), a lower mean absolute error value (1.4996), and root mean square error value (1.8315) in the testing stage with small error band and provided the best optimal fit. Results of the feature importance analysis showed that the first five input variables, i.e., carbon fiber diameter, bitumen content, hybrid asphalt mix of glass-carbon fiber at 75:25 percent, carbon fiber content, and hybrid asphalt mix of glass-carbon fiber at 50:50 percent, are highly sensitive parameters which influence the Marshall strength of the modified asphalt mixes to a greater extent.

Phyto-synthesized facile Pd/NiOPdO ternary nanocomposite for electrochemical supercapacitor applications.

Sustainable and effective electrochemical materials for supercapacitors are greatly needed for solving the global problems of energy storage. In this regard, a facile nanocomposite of Pd/NiOPdO was synthesized using foliar phyto eco-friendly agents and examined as an electrochemical electrode active material for supercapacitor application. The nanocomposite showed a mixed phase of a ternary nano metal oxide phase of rhombohedral NiO and tetragonal PdO confirmed by X-ray diffraction (XRD), scanning electron microscopy (SEM) and XPS (X-rays photoelectron spectroscopy). The optical (direct) energy value of the synthesized nanocomposite was 3.14 eV. The phyto-functionalized nanocomposite was studied for electrochemical supercapacitor properties and revealed a specific capacitance of 88 F g-1 and low internal resistance of 0.8 Ω. The nanoscale and phyto organic species functionalized nanocomposite exhibited enhanced electrochemical properties for supercapacitor application.

Anomalous Origin of the Right Coronary Artery From the Left Coronary Cusp Presenting as a Non-ST-Elevation Myocardial Infarction (NSTEMI).

Coronary artery anomalies are relatively uncommon in the general population with a roughly 1% incidence. Though oftentimes asymptomatic, these anomalies can be detrimental, resulting in myocardial infarction and even sudden cardiac death. Here, we present a case in which a 65-year-old male presented to the emergency room with substernal chest pain that radiated into his left arm. The patient's cardiac enzyme panel revealed a troponin of 10.14 ng/mL and a creatine kinase-myocardial band (CK-MB) of 78.8 ng/mL. Furthermore, the patient's electrocardiogram demonstrated normal sinus rhythm with no significant changes. Upon cardiac catheterization, his right coronary artery was found to originate from the left coronary cusp. Moreover, the anomalous artery demonstrated significant stenosis in its middle portion, which was presumably causing his elevated cardiac enzymes and anginal chest pain. The patient underwent successful percutaneous coronary intervention and was discharged the following day.

Sequency encoding single pixel spectroscopy based on Hadamard transform.

Single pixel spectroscopy based on Hadamard transform (SPS-HT) has been applied widely because of its capability of wavelength multiplexing and associated advantage in signal-to-noise ratio. In this paper, we propose a sequency encoding single pixel spectroscopy (SESPS) based on two-dimensional (2D) masks for concurrent coding of all Hadamard coefficients instead of one-dimensional (1D) Hadamard masks (only coding one coefficient at a time) widely used in the traditional SPS-HT. Moreover, each Hadamard coefficient is coded along the time dimension with a different sequency value such that the alternating current (AC) measurements of the time-domain signal can be used to reconstruct all Hadamard coefficients simultaneously, which reduces the influence of noise and dramatically speeds up data acquisition. We demonstrate that the SESPS with 32 spectral channels can accelerate spectral measurements from white light sources and fluorescence particles by around 14 times and 70 times, respectively, compared to measurements using a commercial spectrometer when the relative root mean square error (RMSE) is around 3% or smaller. The acceleration factors can be boosted by an extra 4 times when only eight spectral channels are used to achieve a compression ratio of 4:1, in which the relative RMSEs change only marginally. Compared to our previous SPS-HT, this new scheme can increase the speed by three orders of magnitude. This technique is expected to be useful in applications requiring high-speed spectral measurements such as the spectral flow cytometry and on-site medical diagnosis using fluorescence or Raman spectroscopy.

Machine Learning Techniques for Evaluating Concrete Strength with Waste Marble Powder.

The purpose of the research is to predict the compressive and flexural strengths of the concrete mix by using waste marble powder as a partial replacement of cement and sand, based on the experimental data that was acquired from the laboratory tests. In order to accomplish the goal, the models of Support vector machines, Support vector machines with bagging and Stochastic, Linear regression, and Gaussian processes were applied to the experimental data for predicting the compressive and flexural strength of concrete. The effectiveness of models was also evaluated by using statistical criteria. Therefore, it can be inferred that the gaussian process and support vector machine methods can be used to predict the respective outputs, i.e., flexural and compressive strength. The Gaussian process and Support vector machines Stochastic predicts better outcomes for flexural and compressive strength because it has a higher coefficient of correlation (0.8235 and 0.9462), lower mean absolute and root mean squared error values as (2.2808 and 1.8104) and (2.8527 and 2.3430), respectively. Results suggest that all applied techniques are reliable for predicting the compressive and flexural strength of concrete and are able to reduce the experimental work time. In comparison to input factors for this data set, the number of curing days followed by the CA, C, FA, w, and MP is essential in predicting the flexural and compressive strength of a concrete mix for this data set.

Depression and Anxiety in Patients With a History of Traumatic Brain Injury: A Case-Control Study.

Background The burden of psychiatric illness following a head injury may have implications on the disease prognosis. The present study evaluated the association of depression and anxiety with traumatic brain injury (TBI). Methods A case-control study was conducted in Karachi, Pakistan, from 2nd July 2021 and 30th January 2022, including individuals of age 18 and above of both genders, with or without a mild head trauma history, forming the case and control groups, respectively. Individuals with previous head trauma/congenital neurological dysfunction were excluded. A mental health assessment of the participants was carried out with two scales, the Generalized Anxiety Disorder-7 (GAD-7) scale and the Public Health Questionnaire-9 (PHQ-9) scale. Other parameters like age, gender, socioeconomic status, education status, and comorbidities were also documented. Results A total of 62 participants were enrolled with 31 cases and 31 controls. The majority were males aged between 18 and 39 years. About 29% of the patients with a history of mild TBI had moderate to severe depression while only 22.6% of them did not have depression or had minimal depression. We found that about 29.3% of patients with TBI had severe anxiety as compared to the only two healthy controls. The majority of the control group participants did not have anxiety. Conclusion Traumatic head injuries and their long-term side effects can predispose patients to a myriad of psychiatric comorbidities. In this study, we found definitive evidence that both anxiety and depression had a significantly higher incidence in cohorts that suffered from mild TBI. However, we recommend large-scale and multicenter studies in the future to explore these relationships more thoroughly and comprehensively.

Diabetes self-management during the COVID-19 pandemic and its associations with COVID-19 anxiety syndrome, depression and health anxiety.

INTRODUCTION: The effects of the COVID-19 pandemic on mental health have been profound. Mental health and diabetes self-care are inter-related. We examined whether COVID-19 anxiety, depressive symptoms and health anxiety were associated with domains of diabetes self-management and investigated whether greater COVID-19 anxiety syndrome would independently contribute to suboptimal diabetes self-care. RESEARCH DESIGN AND METHODS: Surveys were sent to people attending diabetes clinics of three London hospitals. Participants completed the Diabetes Self-Management Questionnaire (DSMQ), the COVID-19 Anxiety Syndrome Scale (C-19 ASS), which measures perseveration and avoidant maladaptive coping behaviour, assessed with measures of co-existent depressive symptoms and anxiety, controlling for age, gender and social deprivation. Clinical data, including pre- and post-lockdown HbA1c measures, were obtained from hospital records for 369 respondents, a response rate of 12.8%. RESULTS: Depressive symptom scores were high. Both pre-existing health anxiety and depressive symptoms were independently linked to improvable measures of diabetes care, as was lower socio-economic rank. However, avoidant COVID-19 anxiety responses were independently associated with higher diabetes self-care scores. HbA1c levels improved modestly over the year of UK lockdown in this cohort. CONCLUSION: During the height of lockdown, avoidant coping behaviours characteristic of the COVID-19 anxiety syndrome may in fact work to improve diabetes self-care, at least in the short term. We recommend screening for depressive symptoms and being aware of the significant minority of people with COVID-19 anxiety syndrome who may now find it difficult to re-engage with face-to-face clinic opportunities.