Starkgraversen8891

Effectiveness of evidence-based psychotherapy (EBP) for PTSD can vary based on gender and trauma type, with poorer outcomes for men and sexual traumas. Among veterans receiving EBPs for PTSD, the effects of the interaction between gender and military sexual trauma (MST) on treatment outcome are unclear. This study examined how gender and MST impact PTSD symptoms following cognitive processing therapy (CPT) and prolonged exposure (PE).

We conducted a national, retrospective cohort study of all post 9/11 veterans who had a PTSD diagnosis from 10/2001-9/2017at VHA facilities and >1 psychotherapy visit. Inclusion criteria included completion of ≥8 CPT/PE sessions and pre- and post-treatment PCL (N=9711). Mixed-effects linear regression models were conducted, separately by treatment, to examine associations between changes in PTSD symptoms and gender, MST, and their interactions with time.

For both treatments, there were no significant differences in pre-treatment PCL by gender or MST, and PCL decreased st. Both CPT and PE may thus be effective for veterans irrespective of MST history.High levels of aldosterone appear to be related to depressive and anxiety related behavior as demonstrated in therapy refractory depression and primary aldosteronism (PA). We analyzed data from a large register of patients with PA in order to clarify mediators and moderators of this influence. Up to 624 subjects were analyzed, however not all subjects had a complete dataset. Due to the known gender differences in subjects with PA we performed the analyses adjusted for gender. We compared subjects with (PHQ-9 ≥ 5) vs. no depressive symptomatology. 56% of men and 61% of women met this depression criterion. In women aldosterone concentration was significantly higher in depressed patients and renin levels were significantly increased with higher anxiety scores. This was not found in men. Depressive symptoms in men and women were significantly associated to BMI (men dep vs non-dep 29.6 vs. 28.4, p less then 0.05; women 26.9 vs. 24.5) and body weight (p less then 0.05). Neither blood pressure nor electrolytes were different between depression groups. The relationship of these parameters to anxiety was less pronounced and partially unexpected only in men higher anxiety (GAD ≥ 5) was related to lower systolic blood pressure. In conclusion, higher aldosterone appears to be associated with depressive symptoms in women, but less so in men with PA. BMI appears to be strongly and independently associated with depressive symptoms in patients with PA, independent of gender. Further studies are required to clarify the causal relationship.The psychomotor retardation that may be seen in major depression represents an interesting parallel to bradykinesia, a core feature of Parkinson's disease. Psychomotor retardation has been correlated with the severity of depression and is a predictor of response to electroconvulsive therapy (ECT). Psychomotor retardation has typically been assessed by subjective clinical judgement including clinical rating scales. Gross activity levels have also been measured with actigraphy previously. The Parkinson's KinetiGraph (PKG) was developed to assess bradykinesia, dyskinesia and tremor in Parkinson's disease and allows for an objective assessment of motor symptoms over time. It has not been used previously to assess motor symptoms in depression. The aim of the current pilot study was to use the PKG to objectively measure both bradykinesia and immobility in depressed inpatients undergoing ECT before, during and at the end of therapy and review correlations with depressive symptomatology and treatment response. The majority of patients (9/12) had PKG defined bradykinesia at baseline and 7/9 of these improved with ECT. All patients with bradykinesia who remitted clinically demonstrated improvements in bradykinesia scores. PKG defined immobility was present at baseline in 11/12 total patients and improved in the majority of these patients (9/11) post ECT. Correlations between clinically assessed melancholia and PKG measures were significant (r = 0.701, p 0.011 at baseline to rs = 0.655, p 0.021 at end). A strong association between bradykinesia and immobility scores and depression severity was not seen. The PKG is a potentially useful wearable technology to objectively assess motor symptoms in depression.This paper focuses on the social hallmarks of aging including low lifetime socioeconomic status, adversity in childhood and adulthood, being a member of a minority group, adverse health behaviors, and adverse psychological states. The "Social Hallmarks of Aging" are analogous to the "Geroscience Hallmarks of Aging" in reflecting a set of underlying and interrelated social causes of multiple age-related health outcomes. The paper presents empirical work incorporating the social hallmarks of aging with indicators of multiple biological hallmarks of aging as well as downstream biology in explaining a range of health outcomes. Results show the relative strength of the associations of social and biological measures with important health outcomes. Social factors are strongly related to physical and cognitive functioning and multimorbidity in this older population; this remains true when the significant number of biological measures are controlled. These results can be interpreted to mean that a significant amount of the social variance in age-related health outcomes is not explained by these measures of biology. Indicators of the geroscience hallmarks of aging only relate modestly to the variability in human health outcomes. Attention to the social hallmarks related to human aging can usefully be incorporated into work on the biological hallmarks of aging to make greater progress in understanding human aging.

Patients with back pain can show one or more features of spinal osteoarthritis (OA), such as morning stiffness, limited or painful range of motion (ROM), and lumbar disc degeneration (LDD). However, it has not been investigated whether these features are prognostic of long-term back pain.

This study assessed whether spinal morning stiffness, ROM and LDD are prognostic factors for back pain after 1 year in older adults with back pain.

This prospective observational study (BACE cohort) included patients aged>55 years visiting a general practitioner for a back-pain episode. Baseline patient-reported morning stiffness, physical examined ROM and radiographic LDD features (i.e., multilevel osteophytes and disc space narrowing) were analysed as potential prognostic factors in unadjusted and adjusted regression models with the outcomes of persistent back pain (yes/no) and back pain severity after 1-year follow-up.

This study included 543 patients with mean (SD) age 67 (8) years, 59% female, and 62% reportiorning stiffness, painful rotation, and multilevel osteophytes are prognostic factors for persistent back pain and back pain severity after 1 year. Evaluating these clinical and radiographic features of spinal OA could help clinicians identify older patients who will experience long-term back pain.Human Coronaviruses (HCoV), periodically emerging across the world, are potential threat to humans such as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) - diseases termed as COVID-19. Current SARS-CoV-2 outbreak have fueled ongoing efforts to exploit various viral target proteins for therapy, but strategies aimed at blocking the viral proteins as in drug and vaccine development have largely failed. In fact, evidence has now shown that coronaviruses undergoes rapid recombination to generate new strains of altered virulence; additionally, escaped the host antiviral defense system and target humoral immune system which further results in severe deterioration of the body such as by cytokine storm. buy Bafilomycin A1 This demands the understanding of phenotypic and genotypic classification, and pathogenesis of SARS-CoV-2 for the production of potential therapy. In lack of clear clinical evidences for the pathogenesis of COVID-19, comparative analysis of previous pandemic HCoVs associated immunological responses can provide insights into COVID-19 pathogenesis. In this review, we summarize the possible origin and transmission mode of CoVs and the current understanding on the viral genome integrity of known pandemic virus against SARS-CoV-2. We also consider the host immune response and viral evasion based on available clinical evidences which would be helpful to remodel COVID-19 pathogenesis; and hence, development of therapeutics against broad spectrum of coronaviruses.Phylogeography is a popular way to analyze virus sequences annotated with discrete, epidemiologically-relevant, trait data. For applied public health surveillance, a key quantity of interest is often the state at the root of the inferred phylogeny. In epidemiological terms, this represents the geographic origin of the observed outbreak. Since determining the origin of an outbreak is often critical for public health intervention, it is prudent to understand how well phylogeographic models perform this root state classification task under various analytical scenarios. Specifically, we investigate how discrete state space and sequence data set influence the root state classification accuracy. We performed phylogeographic inference on several simulated DNA data sets while i) increasing the number of sequences and ii) increasing the total number of possible discrete trait values. We show that phylogeographic models tend to perform best at intermediate sequence data set sizes. Further, we demonstrate that a popular metric used for evaluation of phylogeographic models, the Kullback-Leibler (KL) divergence, both increases with discrete state space and data set sizes. Further, by modeling phylogeographic root state classification accuracy using logistic regression, we show that KL is not supported as a predictor of model accuracy, indicating its limited utility for assessing phylogeographic model performance on empirical data. These results suggest that relying solely on the KL metric may lead to artificially inflated support for models with finer discretization schemes and larger data set sizes. These results will be important for public health practitioners seeking to use phylogeographic models for applied infectious disease surveillance.

Spontaneous hematomas of the umbilical cord are rare and often fatal to the fetus. Little is known about their mechanism or their risk factors. In view of their rarity, the series are limited. No comparative study enabling the identification of factors associated with these hematomas has been published.

This retrospective case-control study of 13 spontaneous histologically confirmed hematomas of the umbilical cord over a consecutive 16-year period compared the characteristics of the case mothers and fetuses to those of a group of 39 control mothers who gave birth the same day as the case mothers.

In utero death was high in the case group (46.2% vs 0.0%, P<0.001). Third-trimester oligohydramnios (30.8 vs 2.6%, OR=16.9, P=0.01), second-trimester amniocentesis (33.3 vs 5.1%, OR=9.3, P=0.02), and a reduction in fetal movements as perceived by the mother (35.7 vs 7.7%, P=0.02) were significantly associated with spontaneous umbilical cord hematomas.

Third-trimester oligohydramnios and second-trimester amniocentesis appear to be associated with the occurrence of a spontaneous hematoma of the umbilical cord.