A definition of bioinks and their distinction from biomaterial inks.

Biofabrication aims to fabricate biologically functional products through bioprinting or bioassembly (Groll et al 2016 Biofabrication 8 013001). In biofabrication processes, cells are positioned at defined coordinates in three-dimensional space using automated and computer controlled techniques (Moroni et al 2018 Trends Biotechnol. 36 384-402), usually with the aid of biomaterials that are either (i) directly processed with the cells as suspensions/dispersions, (ii) deposited simultaneously in a separate printing process, or (iii) used as a transient support material. Materials that are suited for biofabrication are often referred to as bioinks and have become an important area of research within the field. In view of this special issue on bioinks, we aim herein to briefly summarize the historic evolution of this term within the field of biofabrication. Furthermore, we propose a simple but general definition of bioinks, and clarify its distinction from biomaterial inks.

Evaluation of 3D printed PCL/PLGA/ß-TCP versus collagen membranes for guided bone regeneration in a beagle implant model.

Here, we compared 3D-printed polycaprolactone/poly(lactic-co-glycolic acid)/ß-tricalcium phosphate (PCL/PLGA/ß-TCP) membranes with the widely used collagen membranes for guided bone regeneration (GBR) in beagle implant models. For mechanical property comparison in dry and wet conditions and cytocompatibility determination, we analyzed the rate and pattern of cell proliferation of seeded fibroblasts and preosteoblasts using the cell counting kit-8 assay and scanning electron microscopy. Osteogenic differentiation was verified using alizarin red S staining. At 8 weeks following implantation in vivo using beagle dogs, computed tomography and histological analyses were performed after sacrifice. Cell proliferation rates in vitro indicated that early cell attachment was higher in collagen than in PCL/PLGA/ß-TCP membranes; however, the difference subsided by day 7. Similar outcomes were found for osteogenic differentiation, with approximately 2.5 times greater staining in collagen than PCL/PLGA/ß-TCP, but without significant difference by day 14. In vivo, bone regeneration in the defect area, represented by new bone formation and bone-to-implant contact, paralleled those associated with collagen membranes. However, tensile testing revealed that whereas the PCL/PLGA/ß-TCP membrane mechanical properties were conserved in both wet and dry states, the tensile property of collagen was reduced by 99% under wet conditions. Our results demonstrate in vitro and in vivo that PCL/PLGA/ß-TCP membranes have similar levels of biocompatibility and bone regeneration as collagen membranes. In particular, considering that GBR is always applied to a wet environment (e.g. blood, saliva), we demonstrated that PCL/PLGA/ß-TCP membranes maintained their form more reliably than collagen membranes in a wet setting, confirming their appropriateness as a GBR membrane.

Protective effects of Orostachys japonicus A. Berger (Crassulaceae) on H2O2-induced apoptosis in GT1-1 mouse hypothalamic neuronal cell line.

Oxidative stress is a major cause of neurodegenerative diseases, so the protection of neuronal cells from reactive oxygen species can be beneficial for the prevention and treatment of these diseases. Methanol extract of Orostachys japonicus A. Berger (Crassulaceae), a traditional oriental medical herb, was shown to have a protective effect on H2O2-induced apoptosis in GT1-1 mouse hypothalamic neuronal cell line which was detected by flow cytometry after propidium iodide staining. Among fractions of O. japonicus, chloroform fraction had the highest protective effect, and water fraction had no protective effect suggesting that the active ingredients might be hydrophobic compounds.

Reliability and validity of the interview and self-report versions of the BASIS-32.

The psychometric properties of the interview and self-report versions of the BASIS-32 were compared. A total of 120 severely mentally ill adults enrolled in psychosocial rehabilitation were randomly assigned to either a self-report or an interview condition. The BASIS-32 had good internal consistency and test-retest reliability on most subscales; coefficients were higher in the self-report condition. Only the interview version of the psychosis subscale had unacceptable internal consistency. Validity correlations were generally good for the symptom subscales but disappointing for the functional domains. The subscale scores did not discriminate between diagnostic subgroups.

Predicting length of stay in an acute psychiatric hospital.

OBJECTIVE: Multivariate statistical methods were used to identify patient-related variables that predicted length of stay in a single psychiatric facility. The study investigated whether these variables remained stable over time and could be used to provide individual physicians with data on length of stay adjusted for differences in clinical caseloads and to detect trends in the physicians' practice patterns. METHODS: Data on all patients discharged over two six-month periods were collected at an acute psychiatric inpatient facility. Stepwise multiple regression analyses were conducted on the two datasets. RESULTS: The results from both analyses revealed that five variables significantly predicted length of stay and were stable over time. They were a primary diagnosis of schizophrenia, the number of previous admissions, a primary diagnosis of a mood disorder, age, and a secondary diagnosis of an alcohol- or other drug-related disorder. For some physicians, the mean length of stay of their patients differed significantly from the length predicted by the regression model--generally, it was shorter. CONCLUSIONS: The results demonstrate that patient-related predictors of length of stay in a single psychiatric hospital can be identified using relatively simple statistical procedures and can be consistent across a large dataset and over time.

An outcome study of Missouri's CSTAR alcohol and drug abuse programs.

The Comprehensive Substance Abuse Treatment and Rehabilitation (CSTAR) program is described, and a study of its services is presented. The CSTAR program is a community program with wrap-around services and intensive case management. Eleven domains typically affected by substance abuse were measured, plus satisfaction with treatment services. A retrospective study of 280 clients at 10 facilities was done, and results analyzed separately by General Programs. Women with Children programs, and Adolescent programs. A small sample of clients who were early in their treatment was re-interviewed 90 days later. Data were also examined according to length of stay in the program. Results were consistently positive, and increased with length of time in the program.

Missouri's statewide outcomes study: lessons and surprises from the public sector.

Demand is increasing for statewide outcomes initiatives and greater focus on studies of treatment effects for publicly funded patients. Such initiatives pose enormous challenges in management--to involve key stakeholders, to protect confidentiality, and to comply with methodological standards. The state of Missouri is taking a leadership role in this direction.

A psychiatric hospital 100 years ago: I. A comparative study of treatment outcomes then and now.

OBJECTIVE: The authors' goal was to compare distribution of diagnoses, length of stay, and readmission rates for every 16th patient admitted to the St. Louis County Insane Asylum (now St. Louis State Hospital) between 1886 and 1904 with those for every 16th patient admitted to the hospital between 1978 and 1980. METHODS: A sample of 369 cases was drawn from the archival admission records, and 380 cases were selected from recent admissions. Descriptive data from the archival records were used to make DSM-III diagnoses. Data on length of stay and number of readmissions were collected from case records. RESULTS: The historical sample had fewer cases of major mental illness, longer mean lengths of stay, and fewer mean readmissions than the modern sample. CONCLUSIONS: Differences in the clinical characteristics of the two samples may be explained by differences between the two periods in treatment philosophies, admitting policies, and presence of alternative resources for accommodating long-term chronic patients.

Identifying psychiatric suicides for research purposes.

Unusual accidental deaths recorded for former public psychiatric patients during a 3-year period in Missouri were compared with data previously published on suicide and undetermined deaths. Demographic and diagnostic data suggested that undetermined deaths resemble suicides, while the remaining unusual accidents do not. For purposes of estimating incidence or prevalence, it is recommended that "undetermined deaths" might well be combined with suicides, while the remaining accidents should not.

The Missouri Inpatient Behavior Scale.

The Missouri Inpatient Behavior Scale (MIBS) is described, and data are presented from the Missouri automated mental health information system (N = 12,106). The factor structure for MIBS was replicated and shown to be robust. Data on intrascale consistency and interscale correlations are presented, as well as a validity study that showed MIBS to be sensitive to changes on acute-receiving services and a comparison of MIBS and NOSIE-30 scores.

Mortality variations among public mental health patients.

Earlier studies of mortality of psychiatric patients are reviewed, and agreements and inconsistencies related to age, sex, diagnosis and cause of death are noted. The authors then analyze 5,268 deaths during a 5-year period of current or former patients in Missouri public psychiatric hospitals and mental health clinics, calculating mortality ratios that are simultaneously age-, sex-, diagnostic-, and cause-specific. The results are used to construct a quantitative model. The ratios vary most with cause, then diagnosis, least with sex. Influenza and pneumonia contribute most to patient mortality; patient death rates for cancer are lower than population rates at all ages. There are substantial interactions of diagnosis with cause and sex. Among those diagnosed organic brain syndrome, who have the highest overall ratios, the ratios are extra high for females and for influenza and pneumonia, relatively low for external causes.

Age group differences in depression on MMPI D scale.

Much of the work that has been done to the present in exploring age differences in the assessment of depression has utilized normally aging populations. This research has indicated that present depression scales may yield many false positives for depression because of the large number of somatic items that these scales contain. An important question is whether this same finding would hold in psychiatric populations, which are the ones most likely to be subject to diagnosis. The present study was designed to supply information in that area. The D-scale responses of the MMPI for 6,964 patients were factor-analyzed. Results indicated significant differences in the expression of depression for three age groups--20-39, 40-59 and 60+ years. A central core of items that accounted for one-half of the variances for all three groups was found. Additional items appeared across the age groups with greater to lesser significance in terms of the variance accounted for producing distinct qualitative differences. Concern over declining physical well-being was not part of the central core of depression for the older group in this psychiatric population.

Suicide rates among public mental health patients.

Age-specific suicide rates are presented, based on 207 white patients of the Missouri Department of Mental Health who were identified as having committed suicide during 1972-74. Results, divided by age, sex, diagnosis and patient status, are compared with other studies. Male inpatients are about five times more likely to commit suicide compared to the general population, while female inpatients are about 10 times more likely to do so. In both sexes, the rate is greatest for the diagnosis of major affective disorder. A history of psychiatric treatment increases the suicide risk more for women than for men, although male patients are still about twice as likely to commit suicide than are female patients. A quantitative model is presented which describes the relative influence of age, sex and diagnosis on suicide rates.

Symptomatology of depression in black and white patients.

This study compares the symptoms of public mental health patients diagnosed as having a depressive disorder, and then relates its findings to the previous literature concerning black-white differences in mental illness. Results of this study corroborate previous observations that a somewhat smaller proportion of black admissions than white admissions are diagnosed with a depressive disorder and that a higher proportion of black admissions are diagnosed with a schizophrenic disorder. Some black-white differences in depressive symptoms were corroborated-notably, slightly higher percentages of hostility, dangerousness, and somatic complaints in blacks-and these appeared to be independent of socio-economic status.

Measuring the relationship of public psychiatric admissions to rising unemployment.

The results of a correlational analysis of the relationship between monthly state unemployment statistics and admissions to eight Missouri Department of Mental Health facilities are presented. Over a period of 100 months, readmissions, rather than new admissions, showed the strongest positive relationship to unemployment. A second study-a retrospective analysis of admissions before and after a major increase in unemployment-supported the results of the correlational analysis. A third analysis of subset of the original sample, comprised of patients unemployed at the time of admission, suggests that public facilities are more accessible to the unemployed during times of economic adversity. The findings on the relationship of readmission rates to the state of the economy have important implications for policy on deinstitutionalization. The planning, development, and evaluation of community care programs should include consideration of employment data.

A computerized mental patient classification system.

This paper presents the detailed logic and flow of a computerized actuarial report system based on the patient's demographic and clinical information routinely collected in a state mental health information system. Probability statements regarding the patient's diagnostic classifications, likelihood of harm to self and others, probable psychotropic drug prescription, likelihood of unauthorized absence, and prediction of length of stay are presented in the report. The multivariate linear discriminant function and linear regression are used in the calculation of the posterior probabilities and the predicted value of length of stay.

Patients of a public state mental health system who commit suicide.

Twelve per cent of suicides in Missouri during a 3-year period were identified as having been patients of the state mental health care system by computer matching of death certificate tapes and a statewide case registry file. The percentage of Missouri suicides who had been patients varied markedly among age groups. Compared to nonpatient suicides, the patient suicides had a more equal male/female ratio and were younger. Diagnostically, schizophrenia, alcoholism (among males), and affective disorder (among females) were prominent. Nonwhites had a low incidence of suicide. The significance of the patient status at the time of death is discussed.