Experience of clinical services shapes attitudes to mental health data sharing: findings from a UK-wide survey.

BACKGROUND: Routinely-collected mental health data could deliver novel insights for mental health research. However, patients' willingness to share their mental health data remains largely unknown. We investigated factors influencing likelihood of sharing these data for research purposes amongst people with and without experience of mental illness. METHODS: We collected responses from a diverse sample of UK National Health Service (NHS) users (n = 2187) of which about half (n = 1087) had lifetime experience of mental illness. Ordinal logistic regression was used to examine the influence of demographic factors, clinical service experience, and primary mental illness on willingness to share mental health data, contrasted against physical health data. RESULTS: There was a high level of willingness to share mental (89.7%) and physical (92.8%) health data for research purposes. Higher levels of satisfaction with the NHS were associated with greater willingness to share mental health data. Furthermore, people with personal experience of mental illness were more willing than those without to share mental health data, once the variable of NHS satisfaction had been controlled for. Of the mental illnesses recorded, people with depression, obsessive-compulsive disorder (OCD), personality disorder or bipolar disorder were significantly more likely to share their mental health data than people without mental illness. CONCLUSIONS: These findings suggest that positive experiences of health services and personal experience of mental illness are associated with greater willingness to share mental health data. NHS satisfaction is a potentially modifiable factor that could foster public support for increased use of NHS mental health data in research.

Effect of sex on torque, recovery, EMG, and MMG responses to fatigue.

OBJECTIVE: The purpose of the present investigation was to examine the effect of sex on maximal voluntary isometric contraction (MVIC) torque and the EMG and MMG responses as a result of fatiguing, intermittent, submaximal (65% of MVIC), isometric elbow flexion muscle contractions. METHODS: Eighteen men and women performed MVIC trials before (pretest), after (posttest), and 5-min after (5-min recovery) performing 50 intermittent, submaximal isometric muscle contractions. Surface electromyographic (EMG) and mechanomyographic (MMG) signals were simultaneously recorded from the biceps brachii muscle. RESULTS: As a result of the fatiguing workbout torque decreased similarly from pretest to posttest for both the men (24.0%) and women (23.3%). After 5-min of recovery, torque had partially recovered for the men, while torque had returned to pretest levels for the women. For both sexes, from pretest to posttest EMG mean power frequency and MMG amplitude decreased, but returned to pretest levels after 5-min of recovery. CONCLUSIONS: In the present study, there were sex-related differences in muscle fatigue that were not associated with the EMG or MMG responses.

Effects of fatiguing constant versus alternating intensity intermittent isometric muscle actions on maximal torque and neuromuscular responses.

OBJECTIVE: To determine the effects of constant versus alternating applications of torque during fatiguing, intermittent isometric muscle actions of the leg extensors on maximal voluntary isometric contraction (MVIC) torque and neuromuscular responses. METHODS: Sixteen subjects performed two protocols, each consisting of 50 intermittent isometric muscle actions of the leg extensors with equal average load at a constant 60% MVIC or alternating 40 then 80% (40/80%) MVIC with a work-to-rest ratio of 6-s on and 2-s off. MVIC torque as well as electromyographic signals from the vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) and mechanomyographic signals from the VL were recorded pretest, immediately posttest, and 5-min posttest. RESULTS: The results indicated that there were no time-related differences between the 60% MVIC and 40/80% MVIC protocols. The MVIC torque decreased posttest (22 to 26%) and remained depressed 5-min posttest (9%). There were decreases in electromyographic frequency (14 to 19%) and mechanomyographic frequency (23 to 24%) posttest that returned to pretest levels 5-min posttest. There were no changes in electromyographic amplitude and mechanomyogrpahic amplitude. CONCLUSIONS: These findings suggested that these neuromuscular parameters did not track the fatigue-induced changes in MVIC torque after 5-min of recovery.

Electromyographic Responses from the Vastus Medialis during Isometric Muscle Actions.

This study examined the electromyographic (EMG) responses from the vastus medialis (VM) for electrodes placed over and away from the innervation zone (IZ) during a maximal voluntary isometric contraction (MVIC) and sustained, submaximal isometric muscle action. A linear electrode array was placed on the VM to identify the IZ and muscle fiber pennation angle during an MVIC and sustained isometric muscle action at 50% MVIC. EMG amplitude and frequency parameters were determined from 7 bipolar channels of the electrode array, including over the IZ, as well as 10 mm, 20 mm and 30 mm proximal and distal to the IZ. There were no differences between the channels for the patterns of responses for EMG amplitude or mean power frequency during the sustained, submaximal isometric muscle action; however, there were differences between channels during the MVIC. The results of the present study supported the need to standardize the placement of electrodes on the VM for the assessment of EMG amplitude and mean power frequency. Based on the current findings, it is recommended that electrode placements be distal to the IZ and aligned with the muscle fiber pennation angle during MVICs, as well as sustained, submaximal isometric muscle actions.

Physiological Responses during Cycle Ergometry at a Constant Perception of Effort.

13 subjects performed an incremental test to exhaustion, 4, 8-min submaximal rides, and a 1-h ride at the rating of perceived exertion (RPE) that corresponded to the physical working capacity at the OMNI threshold (PWC(OMNI)) to examine: 1) the oxygen consumption (V̇O2), heart rate (HR), minute ventilation (+V̇(E)), respiratory frequency (FR), and power output responses during 1-h work bouts at a constant RPE that corresponded to the PWC(OMNI); and 2) the ability of current models to explain the responses for physiological and perceptual parameters during the 1-h work bouts. The RPE that corresponded to the PWC(OMNI) represented a sustainable exercise intensity (56±5% (V̇O(2Peak)) within the moderate-intensity domain. The mean, normalized slope coefficients for the V̇O2, +V̇(E), and power output vs. time relationships during the 1-h rides were significantly less than zero. The mean, normalized slope coefficient for the FR vs. time relationship during the 1-h rides, however, was not significantly different from zero. Thus, RPE most clearly tracked FR responses during the 1-h rides. It was hypothesized that afferent feedback from respiratory muscles may have mediated the perception of effort during cycle ergometry at a constant RPE in the moderate-intensity domain.

The rate of torque development: a unique, non-invasive indicator of eccentric-induced muscle damage?

This study examined the time courses of recovery for isometric peak torque and rate of torque development (RTD) after eccentric-induced muscle damage. 18 men completed 6 sets of 10 maximal eccentric isokinetic muscle actions at 30° · s(-1). Peak torque, peak RTD and RTD at 10 (RTD10), 50 (RTD50), 100 (RTD100) and 200 ms (RTD200), serum creatine kinase and lactate dehydrogenase were measured before (PRE), immediately after (POST), 24, 48 and 72 h after eccentric exercise. Creatine kinase and lactate dehydrogenase increased from 139 to 6 457 and from 116 to 199 IU · L(-1) from PRE to 72 h, respectively. Peak torque and all RTDs decreased at POST. Peak torque and RTD200 remained lower than PRE through 72 h. Peak RTD remained lower than PRE through 48 h, but was not different from PRE at 72 h. RTD10 and RTD100 were lower than PRE through 24 h, but were not different from PRE at 48 and 72 h. RTD50 decreased at POST, but was not different from PRE at 24 h. Early phase RTDs recovered more quickly than PT and RTD200. Early phase RTDs may reflect neural mechanisms underlying eccentric-induced force decrements, while late RTDs may describe the same physiological mechanisms as PT.

Association between Longitudinal Cerebrospinal Fluid Alzheimer's Biomarkers and the Lifestyle for Brain Health (LIBRA) Index: Findings from the European Prevention of Alzheimer's Dementia Cohort Study (EPAD LCS).

BACKGROUND: In the absence of preventative pharmacological interventions for Alzheimer's Disease dementia, there is a growing interest in modifiable risk factors associated with AD. Such risk factors are thought to contribute up to 40% of the risk of dementia. The Lifestyle for Brain Health (LIBRA) index, a dementia risk score which focuses exclusively on modifiable factors, has been found to be associated with increased risk of dementia and cognitive decline. It is currently unclear how the LIBRA index relates to cerebrospinal fluid (CSF) biomarkers of Alzheimer's Disease. OBJECTIVES: To examine the association between LIBRA index scores and trajectories of phospho-tau 181 and total tau in the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study (EPAD LCS), and to examine whether these trajectories differ between participants with high and low CSF amyloid-beta 1-42 (Aß42). DESIGN: Analysis of CSF biomarker and LIBRA index scores from the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study. SETTING: The European Prevention of Alzheimer's Dementia Longitudinal Cohort Study is a multi-centre, pan-European study. MEASUREMENTS: Cerebrospinal fluid samples were taken by lumbar puncture and analysed using electrochemiluminescence. LIBRA index scores were calculated from self-reported variables, questionnaires, and physiological measurements. RESULT: In the total sample (n = 1715; mean age = 66.0, 56.4% female), there were no significant associations between LIBRA scores (mean = 0.73 points) and rate of change in cerebrospinal fluid biomarkers. In participants with high Aß, reflecting less deposition in the brain, (n = 1134), LIBRA scores were significantly associated with the rate of change in total tau, where higher LIBRA scores (denoting higher dementia risk) were associated with increases in t-tau. There were no significant associations between LIBRA scores and change in cerebrospinal biomarkers in participants with low Aß. CONCLUSION: We found an association between modifiable risk factors and total tau accumulation in participants without dementia and without Aß accumulation. This suggests that increasing levels of total tau may be driven by factors other than Aß accumulation and highlights the need for developing and examining tau-targeting drugs in Alzheimer's Disease development.

Genetic Polymorphisms in ADORA2A and CYP1A2 Influence Caffeine's Effect on Postprandial Glycaemia.

The liver enzyme cytochrome P450 1A2 (CYP1A2) is responsible for 90% of caffeine metabolism, while caffeine exerts many of its effects via antagonist binding to adenosine A2a receptors (ADORA2A). This study aimed to examine whether functional single nucleotide polymorphisms (SNPs) in 1976T > C (ADORA2A; rs5751876) and -163C > A (CYP1A2; rs762551) influence the effect of caffeine on the postprandial glucose (GLU) response to a carbohydrate meal. We report that individuals with the 1976T > C CC, but not CT/TT genotypes display elevated GLU levels after consuming caffeine and carbohydrate (CHO + CAFF) versus carbohydrate only (CHO). The GLU area under the curve (AUC) was also greater during the CHO + CAFF condition compared to the CHO condition in CC, but not the CT/TT genotypes. The -163C > A AC/CC, but not AA, genotypes displayed greater GLU concentrations 60-min post meal during CHO + CAFF versus CHO. Our data suggest that caffeine-induced impairments in postprandial glycaemia are related to 1976T > C and -163C > A SNPs.

Relationship between superoxide dismutase and melanin in a pathogenic fungus.

Since melanin is considered a virulence factor in Cryptococcus neoformans, its suppression at 37 degrees C has been perplexing. We now show an opposite thermal regulation of superoxide dismutase (SOD), consistent with a compensatory mechanism. Moreover, we demonstrate normal SOD and catalase levels in albino, oxygen-sensitive mutants. These results suggest that melanin is an antioxidant factor comparable in importance to SOD.