Associations between disturbed sleep and attenuated psychotic experiences in people at clinical high risk for psychosis.

BACKGROUND: Pre-diagnostic stages of psychotic illnesses, including 'clinical high risk' (CHR), are marked by sleep disturbances. These sleep disturbances appear to represent a key aspect in the etiology and maintenance of psychotic disorders. We aimed to examine the relationship between self-reported sleep dysfunction and attenuated psychotic symptoms (APS) on a day-to-day basis. METHODS: Seventy-six CHR young people completed the Experience Sampling Methodology (ESM) component of the European Union Gene-Environment Interaction Study, collected through PsyMate® devices, prompting sleep and symptom questionnaires 10 times daily for 6 days. Bayesian multilevel mixed linear regression analyses were performed on time-variant ESM data using the brms package in R. We investigated the day-to-day associations between sleep and psychotic experiences bidirectionally on an item level. Sleep items included sleep onset latency, fragmentation, and quality. Psychosis items assessed a range of perceptual, cognitive, and bizarre thought content common in the CHR population. RESULTS: Two of the seven psychosis variables were unidirectionally predicted by previous night's number of awakenings: every unit increase in number of nightly awakenings predicted a 0.27 and 0.28 unit increase in feeling unreal or paranoid the next day, respectively. No other sleep variables credibly predicted next-day psychotic symptoms or vice-versa. CONCLUSION: In this study, the relationship between sleep disturbance and APS appears specific to the item in question. However, some APS, including perceptual disturbances, had low levels of endorsement amongst this sample. Nonetheless, these results provide evidence for a unidirectional relationship between sleep and some APS in this population.

The relationship between subjective sleep disturbance and attenuated psychotic symptoms after accounting for anxiety and depressive symptoms.

BACKGROUND AND HYPOTHESES: Sleep disturbances are increasingly recognized as cooccurring with psychotic symptoms. The potential importance of this relationship is complicated when considering the effects of anxiety and depressive symptoms which commonly present in early-stage illness states. This study aimed to investigate the relationship between self-reported sleep disturbance on the development of attenuated psychotic symptoms (APS) cross-sectionally and longitudinally while adjusting for roles of anxiety and depressive symptoms. DESIGN: Eight-hundred and two help-seeking young people aged 12 to 25 years who engaged with our Australian early intervention services were included in the study (the "Transitions" cohort). Cross sectional mediation and cross-lagged longitudinal (12-month) mediation models were developed with outcomes being different APS domains. RESULTS: Only baseline excessive daytime sleepiness predicted later APS when accounting for previous APS, anxiety and depressive symptomatology. Cross sectionally, self-reported sleep disturbance showed both direct and indirect predictive relationships with all APS domains. Partial mediation through anxiety and depression was shown for unusual thought content, perceptual abnormalities, and disorganised speech, while full mediation through depression was shown for non-bizarre ideas. CONCLUSIONS: The specificity of the relationship between self-reported sleep disturbance on APS highlights the potential for different roles in mechanistic models of psychotic symptom expression. This further indicates the need for further experimental research to illuminate potential causal pathways. Future research should continue to use continuous, symptom level approaches across a range of timeframes to more accurately model the complex dynamics present in the sleep-psychosis relationship.

Child, parent, and family mental health and functioning in Australia during COVID-19: comparison to pre-pandemic data.

The COVID-19 pandemic presents significant risks to population mental health. Despite evidence of detrimental effects for adults, there has been limited examination of the impact of COVID-19 on parents and children specifically. We aim to examine patterns of parent and child (0-18 years) mental health, parent substance use, couple conflict, parenting practices, and family functioning during COVID-19, compared to pre-pandemic data, and to identify families most at risk of poor outcomes according to pre-existing demographic and individual factors, and COVID-19 stressors. Participants were Australian mothers (81%) and fathers aged 18 years and over who were parents of a child 0-18 years (N = 2365). Parents completed an online self-report survey during 'stage three' COVID-19 restrictions in April 2020. Data were compared to pre-pandemic data from four Australian population-based cohorts. Compared to pre-pandemic estimates, during the pandemic period parents reported higher rates of parent depression, anxiety, and stress (Cohen's d = 0.26-0.81, all p < 0.001), higher parenting irritability (d = 0.17-0.46, all p < 0.001), lower family positive expressiveness (d = - 0.18, p < 0.001), and higher alcohol consumption (22% vs 12% drinking four or more days per week, p < 0.001). In multivariable analyses, we consistently found that younger parent age, increased financial deprivation, pre-existing parent and child physical and mental health conditions, COVID-19 psychological and environmental stressors, and housing dissatisfaction were associated with worse parent and child functioning and more strained family relationships. Our data suggest wide-ranging, detrimental family impacts associated with the COVID-19 pandemic; and support policy actions to assist families with financial supports, leave entitlements, and social housing.

Psychometric properties of the Chinese version of procrastination assessment scale for students.

The procrastination assessment scale for students (PASS) has been used widely in evaluating the patterns of university students' procrastination on academic tasks and their procrastination behavior. The present study validated the psychometric properties of a Chinese version of the PASS (PASS-C) by recruiting two representative independent sample of Hong Kong Chinese university students (S1 used in the EFA study: 506; S2 used in the CFA study: 506). The results confirmed that this modified Chinese version is a valid and appropriate tool to assess university students' procrastination tendencies in Chinese educational settings.

Subchondral bone alterations in a novel model of intermediate post traumatic osteoarthritis in mice.

In Post Traumatic Osteoarthritis (PTOA), hypomineralization and increased remodeling of the Subchondral bone (SB) are the first stages of tissue alterations. Although these alterations are well depicted and one of the main targets in OA intervention, the link between SB compositional and mechanical properties alterations during OA progression remains scarce in the literature. Here, we hypothesized that SB shows - right after the first sign of gait pattern changes - a decrease in SB tissue formation depicted by (i) a decrease in thickness, (ii) a lower nanoscopic stiffness, and (iii) a decrease in mineral and collagen maturity. To test our hypothesis, we investigated PTOA in female C57Bl6 mice's right knee (n = 13 control group [CL] and n = 27 PTOA group) by using Gait Analysis, Histomorphometry, Nanoindentation, and Raman Spectroscopy (RS). We showed (i) an increased OA histological grade, (ii) a decrease in Cartilage and SB thickness, and (ii) an increase of stance time and stride length on both limbs. The lateral condyle - where the main forces were applied - of mice with PTOA decreased in the degree of mineralization and crystal size and presented a lower Modulus of Elasticity (E). However, while no difference was observed regarding collagen or mineral-related compositional RS properties, we depicted higher crystallinity in the medial condyle than the lateral condyle in the PTOA group, which we did not observe in the control group. Our study depicts an early onset of intermediate PTOA where SB nanoscopic stiffness decreases while the degree of mineralization is not severely altered yet.

Online psychological interventions to reduce symptoms of depression, anxiety, and general distress in those with chronic health conditions: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Over the past 15 years, there has been substantial growth in web-based psychological interventions. We summarize evidence regarding the efficacy of web-based self-directed psychological interventions on depressive, anxiety and distress symptoms in people living with a chronic health condition. METHOD: We searched Medline, PsycINFO, CINAHL, EMBASE databases and Cochrane Database from 1990 to 1 May 2019. English language papers of randomized controlled trials (usual care or waitlist control) of web-based psychological interventions with a primary or secondary aim to reduce anxiety, depression or distress in adults with a chronic health condition were eligible. Results were assessed using narrative synthases and random-effects meta-analyses. RESULTS: In total 70 eligible studies across 17 health conditions [most commonly: cancer (k = 20), chronic pain (k = 9), arthritis (k = 6) and multiple sclerosis (k = 5), diabetes (k = 4), fibromyalgia (k = 4)] were identified. Interventions were based on CBT principles in 46 (66%) studies and 42 (60%) included a facilitator. When combining all chronic health conditions, web-based interventions were more efficacious than control conditions in reducing symptoms of depression g = 0.30 (95% CI 0.22-0.39), anxiety g = 0.19 (95% CI 0.12-0.27), and distress g = 0.36 (95% CI 0.23-0.49). CONCLUSION: Evidence regarding effectiveness for specific chronic health conditions was inconsistent. While self-guided online psychological interventions may help to reduce symptoms of anxiety, depression and distress in people with chronic health conditions in general, it is unclear if these interventions are effective for specific health conditions. More high-quality evidence is needed before definite conclusions can be made.

A peer coach intervention in childcare centres enhances early childhood physical activity: The Active Early Learning (AEL) cluster randomised controlled trial.

BACKGROUND: As numbers of children and time spent in childcare centres increase, so does the potential influence of these centres on early childhood physical activity (PA). However, previous reports indicate little success of interventions aimed at improving PA. The Active Early Learning (AEL) program is a multi-component pragmatic intervention designed to imbed PA into the daily curriculum. Delivered by childcare centre staff, it is directed and supported by a peer coach who works across a network of centres. The objective of the study is to investigate the effect of the AEL program on children's PA. METHODS: Fifteen childcare centres (8 intervention, 7 control centres; 314 children, 180 boys, 4.3y ± 0.4) participated in a 22-week stratified cluster randomised controlled trial. To be eligible to participate, centres needed to have ≥15 preschool children aged 3 to 5-years. The primary outcome was PA measured by accelerometer (Actigraph GT3X) during childcare centre hours over a 3-day period, calculated in min/h of Total PA and moderate-to-vigorous PA (MVPA). The effect of the intervention was evaluated using linear mixed models adjusted for age, sex, accelerometer wear time and centre clustering. RESULTS: There was an intervention effect for Total PA (+ 4.06 min/h, 95% CI [2.66 to 5.47], p < .001) and MVPA (+ 2.33 min/h, 95% CI [1.31 to 3.34] p < .001). On average, a child taking part in the intervention attending a childcare centre from 8 am to 3 pm performed 28 min more Total PA and 16 min more MVPA per day than children receiving usual practice care. CONCLUSION: In contrast with the findings of previous pragmatic trials in early childcare centres, this study shows that a peer-coach facilitated program, focussed on integrating PA into the daily childcare routine, can elicit increases in preschool children's PA of practical as well as statistical significance. TRIAL REGISTRATION: Australian New Zealand Clinical Trials registry: ACTRN12619000638134 . Registered 30/04/2019.

Psychological distress leads to reduced physical activity and fitness in children: the Australian longitudinal LOOK study.

Stress and depression can affect an individual's level of physical activity and fitness, which may place them at risk of developing cardiovascular disease. This study investigates the longitudinal effects of stress and depression on physical activity and cardiorespiratory fitness among youth. Six hundred and seventy-six children, initially aged 8 years, from the LOOK study completed a modified version of the Children's Depression Inventory, the Children's Stress Questionnaire, and objective physical activity and cardiorespiratory fitness assessments on three occasions, every 4 years. Depressive symptoms had a direct effect (longitudinal) on the cardiorespiratory fitness of girls, with a similar trend for boys. In cross-sectional analyses, a child who identified with more symptoms of depression and stress was likely to be less fit and less physically active, which in girls extended to less moderate-to-vigorous physical activity. Our findings, that both physical activity and fitness are impacted by depression and stress may contribute to strategies directed towards achieving enhanced physical activity and reductions in obesity.

Benefits of early development of eye-hand coordination: evidence from the LOOK longitudinal study.

We investigated longitudinal and cross-sectional relationships between eye-hand coordination (EHC) and cardiorespiratory fitness (multistage run), physical activity (pedometers), percent body fat (%BF, dual energy x-ray absorptiometry), body image, and organized sport participation (questionnaires) in 406 boys and 384 girls at 8 and 10 years of age. EHC was measured by a throw and wall-rebound catch test involving 40 attempts of increasing difficulty. Median EHC improved during two years from 18 to 32 (boys) and 9 to 24 (girls), and gender differences and improvements were both significant (P < 0.001). Cross-sectional analyses showed that boys and girls with better EHC were fitter (P < 0.001), and a longitudinal relationship showed that girls who improved their EHC over the two years became fitter (P < 0.001). There was also evidence that children with better EHC possessed a more positive body image (P = 0.05 for combined sex data), but there was no evidence of any relationships between EHC and %BF or PA (both P > 0.3). Finally, even at age 8 years, boys and girls participating in organized sport possessed better EHC than non-participants. These data provide evidence for the premise that early acquisition of this single motor skill promotes the development of a child's fitness, body image, and participation in sport.

[Implant insertion in distracted bone for reconstruction after gunshot injury]. / Pose d'implants en os distracté chez les patients reconstruits après traumatisme balistique.

Distraction osteogenesis is a tissue engineering technique with two clinical applications in maxillofacial surgery: alveolar distraction and basal bone distraction. Even if it appears to be a binding and major surgery, distraction osteogenesis applied to facial bone, and especially to the mandible, has the great advantage of producing a pluritissular reconstruction of ideal quality and quantity, suitable for the ultimate goal of dental implant rehabilitation management. This technique had some drawbacks due to technical constraints related to the material. Distraction osteogenesis is well placed in the armamentarium of reconstructive surgery techniques for bone defects caused by trauma or tumor. It allows rapid restoration of adequate physiological conditions for mandibular dental implant placement. We reviewed the various modifications of this technique.

Contribución a la patogénesis de la endometriosis desde la histeroscopia quirúrgica / Contribution to the endometriosis pathogenesis since the surgical histeroscopy

La teoría más aceptada en la patogénesis de la endometriosis, propuesta en 1920, es que esta alteración se origina desde un flujo menstrual retrógrado de tejido endometrial a través de las trompas de Falopio a la cavidad peritoneal. Aportamos dos casos clínicos en los que una resección endometrial incompleta originó un aumento del flujo menstrual, por persistir endometrio funcional en los ostium y una oclusión de la cavidad endometrial. Estas pacientes desarrollaron una endometriosis grado IV al año de la intervención, habiéndose verificado que no existía previo a la misma

The most widely accepted theory on the pathogenesis of endometriosis, proposed in the 1920s, is that the disorder originates from retrograde menstruation of endometrial tissue sloughed through patent fallopian tubes into the peritoneal cavity. We contribute two clinical cases in which an incomplete endometrial resection originated an increase of retrograde menstrual flow by persist functional endometrium in the ostium and occlusion of the endometrial cavity. Theses patients developed an endometriosis degree IV in a year postintervention, having verified that did not exist previously to the one

[Anhidrotic ectomermal dysplasia (AED): four cases]. / La dysplasie ectodermique anhydrotique: présentation de quatre observations.

INTRODUCTION: Anhidrotic ectodermal dysplasia (AED) or Christ-Siemens-Touraine syndrome is a rare, hereditary genodermatosis, classically X-linked recessive disorder. MATERIAL AND METHODS: [corrected] We report the cases of 3 children and a male adult. RESULTS: The mode of diagnosis, the clinical signs and the therapeutic option are detailed. DISCUSSION: AED is characterized by a malformative state derived from the ectodermal layer of the embryo which results in the triad: anhidrosis (or hypohidrosis), hypotrichosis, anodontia (or hypodontia). Hypohidrosis causes thermoregulation disorders, which in the infant, can be life threatening. It is important to recognize the affection early to avoid accidents of hyperthermia. Once the diagnosis is established, family investigations are necessary to determine whether it is a family form or a new sporadic case. Carrier mothers must be informed of the high risk recurrence for future male infants. Symptomatic maxillo-facial treatment strives to improve masticatory function and facial growth and thus limit the psychological impact and improve patient comfort.

Gestación y el uso del cinturón de seguridad / Pregnancy and use of the safety belt

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Relation of study strategies to the academic performance of Hong Kong university students.

A revised version of the Learning and Study Strategies Inventory was used to examine the relation of study strategies with academic performance of 100 Hong Kong university students. Analysis indicated the high academic-achieving group differed significantly from the low academic-achieving group in terms of intrinsic disposition factors of motivation, scheduling, concentration, and selecting main ideas.

[Multiple cortical photolesions and penicillin epileptogenic focus. Study of a model in rabbits]. / Photolésions corticales multiples et foyer epileptogène a la pénicilline. Etude d'un modèle chez le lapin.

Inactivation of an epileptogenic focus by dividing it into sub-unities unable to maintain epileptic activity has been demonstrated in animals. Based on these experiments, multiple subpial transections have been performed in patients suffering from partial drug-resistant epilepsies when resection of the epileptogenic cortex was not possible. In order to develop a new surgical technique for such epilepsies, the authors present an initial study of multiple cortical laser photolesions on the rabbit brain. The aim of this study is to assess the histological lesions created on the cortex with a laser at a chronic stage, and to compare the electrical paroxysmal activity of a penicillin focus on the laser irradiated cortex and on the non radiated cortex in the same animal. Twenty-five adult albino rabbits were used for this study. Both hemispheres of 19 rabbits have been exposed; 14 to 35 photolesions in a network were performed on one hemisphere using a 1.064 microns wavelength Nd-YAG laser. Six to twenty-one days later, a penicillin-induced focus was created on both hemispheres, a corticographic study was performed, and each animal was sacrificed for histological study of the brain. For the 6 last animals a high-power 0.805 micron wavelength diode laser was used with the same protocol. Histological study was solely performed in order to compare the effects of both lasers. In 11 animals electrocorticographic control was reliable. Time to first spike occurrence after penicillin application was significantly increased on the treated hemisphere as compared to the untreated one (1' to 14'30" and 10" to 6', respectively; p < 0.01) and the number of spikes per minute at early and late counts was significantly smaller on the treated hemisphere as compared to the untreated one (1 to 29 and 2 to 70, respectively; p < 0.02). Histologically the lesions appeared as cone-shaped coagulation necrosis surrounded by an area of macrophagic reaction, angiogenesis and gliosis. With the diode laser, some lesions included ischemic changes extended in the white matter. This study demonstrated the possibility of creating limited and reproducible photolesions using the laser light energy, without extensive destruction of the cortex. These lesions were reaching from one third to the totality of the cortical depth, depending on laser exposure parameters. This study also demonstrated that these photolesions arranged in a network and at a chronic stage were associated with a significantly reduced paroxysmal activity of a penicillin focus when compared to intact cortex. Since such lesions did not totally isolate cortical sub-unities, spiking was still recorded from the irradiated cortex, but at a lower rate, suggesting a disorganization of the local neuronal network responsible for paroxysmal activity.

Role of Golgi Apparatus in Sorogenesis by the Cellular Slime Mold Fonticula alba.

Aggregating cells of the cellular slime mold Fonticula alba form a volcano-shaped fruiting structure which at maturity bears its spores apically in a globose mucous mass. Numerous dictyosomes forming in the sorogenic cells are involved in the accumulation and deposition of stalk material.