The relationship between fine particulate matter (PM2.5) and schizophrenia severity.

PURPOSE: Although particulate matter (PM) is reported to affect the rate of emergency admissions for schizophrenia, no study has examined the relationship between particulate matter less than 2.5 µm in diameter (PM2.5) and the severity of schizophrenia. METHODS: We obtained data on patients with schizophrenia at a psychiatric hospital, and on air pollution in Sakai, Japan between Feb 1, 2013 and April 30, 2016. Multivariate logistic regression analyses were used to estimate the relationship between PM2.5 concentrations and scores on the Brief Psychiatric Rating Scale (BPRS) of schizophrenia patients at admission, with a lag of up to 7 days. RESULTS: During the study period, there were 1193 schizophrenia cases. The odds ratio (OR) for a BPRS score ≥ 50 at admission was 1.05 [95% confidence interval 1.00-1.10] and the effect of PM2.5 concentration was significant for lag period of 2 days. The ORs associated with PM2.5 concentration increased substantially for patients over 65 years of age. CONCLUSIONS: Ambient PM2.5 concentration was associated with exacerbation of schizophrenia. Our results suggest that protection for several days should be considered for controlling PM2.5-related schizophrenia, especially among elderly patients.

Psychological assessment of acute schizophrenia patients who experienced seclusion either alone or in combination with restraint.

Objective Numerous studies on the effects of seclusion and/or restraint in acute psychiatric treatment have reported both positive and negative effects. However, no studies to date have evaluated the effects of seclusion and/or restraint on schizophrenia patients using a rating scale. Thus, to examine the effects of seclusion and/or restraint on schizophrenia patients, we used the Brief Psychiatric Rating Scale and assessed the psychological condition of patients. Methods Factor analysis was conducted to create subscales of Brief Psychiatric Rating Scale, and psychiatric changes were assessed with respect to each subscale using multiple logistic regression analyses. Analyses were performed on three groups (i.e. entire, higher functioning, and lower functioning groups) involving a total of 1559 schizophrenia patients aged 18 to 65 years. Results In the entire and lower functioning groups, seclusion was a significant predictor of improvements related to the "hostility/suspiciousness" subscale. Seclusion combined with restraint was associated with improvements related to the "psychosis/thinking disorder" subscale. In the higher functioning group, there were no significant predictors. Conclusions It is implied that seclusion and/or restraint is related to improved psychiatric symptoms only among patients whose functioning is impaired. To verify the present findings, further studies involving multiple sites and additional psychiatric measures are necessary.

Examination of center of pressure displacement and muscle activity of the hip girdle muscles on lateral movement in the sitting position, focusing on kinematic features before and after the start of exercise.

[Purpose] This study aimed to evaluate the kinematic characteristics at the start of lateral movement in the sitting position, for application in physical therapy. [Subjects and Methods] Eleven healthy male subjects (mean age, 24.8 ± 3.7 years) were included in the study after they provided informed consent. The electromyographic activities of the tensor fascia lata, gluteus medius, and rectus femoris, and the center of pressure (COP) displacement during lateral reach in the sitting position were measured. The task was recorded on video for analysis. [Results] In almost all subjects, before the beginning of the task, the electromyographic activity in the opposite side of each studied muscle was recorded, and the opposite and anterior displacement of the COP was observed. The video analysis revealed that all subjects showed lateral displacement of the thoracic part of the trunk after the start of the task. However, the lumbar region and pelvis maintained their starting positions. [Conclusion] COP displacement occurred in the reverse reaction before the task, and this involved the hip girdle muscles of the opposite side. A reverse reaction displaced the pelvis to the opposite side to ensure instability of posture through side tilting of the trunk at the beginning of the task.

Bone marrow AT1 augments neointima formation by promoting mobilization of smooth muscle progenitors via platelet-derived SDF-1{alpha}.

OBJECTIVE: Bone marrow (BM)-derived endothelial progenitor cells (EPCs) and vascular smooth muscle progenitor cells (VPCs) contribute to neointima formation, whereas the angiotensin II (Ang II) type 1 receptor (AT(1))-mediated action on BM-derived progenitors remains undefined. METHODS AND RESULTS: A wire-induced vascular injury was performed in the femoral artery of BM-chimeric mice whose BM was repopulated with AT(1)-deficient (BM-Agtr1(-/-)) or wild-type (BM-Agtr1(+/+)) cells. Neointima formation was profoundly reduced by 38% in BM-Agtr1(-/-) mice. Although the number of circulating EPCs (Sca-1(+)Flk-1(+)) and extent of reendothelialization did not differ between the 2 groups, the numbers of both circulating VPCs (c-Kit(-)Sca-1(+)Lin(-)) and tissue VPCs (Sca-1(+)CD31(-)) incorporated into neointima were markedly decreased in BM-Agtr1(-/-) mice. The accumulation of aggregated platelets and their content of stromal cell-derived factor-1alpha (SDF-1alpha) were significantly reduced in BM-Agtr1(-/-) mice, accompanied by a decrease in the serum level of SDF-1alpha. Thrombin-induced platelets aggregation was dose-dependently inhibited (45% at 0.1 IU/mL, P<0.05) in Agtr1(-/-) platelets compared with Agtr1(+/+) platelets, accompanied by the reduced expression and release of SDF-1alpha. CONCLUSIONS: The BM-AT(1) receptor promotes neointima formation by regulating the mobilization and homing of BM-derived VPCs in a platelet-derived SDF-1alpha-dependent manner without affecting EPC-mediated reendothelialization.

Predicting the length of hospital stay of psychiatry patients using signal detection analysis.

In Japan, the length of hospital stay (LOS) at psychiatric institutions often exceeds a year, and factors related to such stays have been identified. However, we do not know how multiple patient, hospital, and physician factors interact to determine LOS. Patient data were collected from a psychiatric hospital in Osaka, Japan. We developed subgroups, which were determined by interactions related to LOS using signal detection theory. In acute or emergency wards, five factors related to LOS were identified, and subjects were categorized into six subgroups. The indices obtained by the five factors ranged 2.49-3.47 for odds ratio, 0.47-0.84 for sensitivity, 0.40-0.76 for specificity, and 0.52-0.71 for positive predictive value. In general wards, five factors related to LOS were identified, and subjects were categorized into six subgroups. The indices obtained by the five factors ranged 3.02-5.36 for odds ratio, 0.58-0.86 for sensitivity, 0.37-0.68 for specificity, and 0.85-0.92 for positive predictive value. Psychiatrists who have been practicing longer in acute or emergency wards appear to have significantly longer stay of patients, and older or more severe patients tend to be in need of longer inpatient care. Our results provide findings that may be helpful in decreasing LOS at psychiatric hospitals.