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"Bryant, R."
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Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications
ABSTRACTRheumatoid arthritis is a systemic autoimmune disease characterized by excess morbidity and mortality from cardiovascular disease. Mechanisms linking rheumatoid arthritis and cardiovascular disease include shared inflammatory mediators, post-translational modifications of peptides/proteins and subsequent immune responses, alterations in the composition and function of lipoproteins, increased oxidative stress, and endothelial dysfunction. Despite a growing understanding of these mechanisms and their complex interplay with conventional cardiovascular risk factors, optimal approaches of risk stratification, prevention, and treatment in the context of rheumatoid arthritis remain unknown. A multifaceted approach to reduce the burden posed by cardiovascular disease requires optimal management of traditional risk factors in addition to those intrinsic to rheumatoid arthritis such as increased disease activity. Treatments for rheumatoid arthritis seem to exert differential effects on cardiovascular risk as well as the mechanisms linking these conditions. More research is needed to establish whether preferential rheumatoid arthritis therapies exist in terms of prevention of cardiovascular disease. Ultimately, understanding the unique mechanisms for cardiovascular disease in rheumatoid arthritis will aid in risk stratification and the identification of novel targets for meaningful reduction of cardiovascular risk in this patient population.
Journal Article
التكنولوجيا المساندة للأشخاص ذوي الحاجات الخاصة
يتحدث الكتاب عن التكنولوجيا المساندة للأشخاص ذوي الحاجات الخاصة حيث يتناول مقدمة إلى خدمات وأجهزة التكنولوجيا المساندة والاعتبار والاختيار والتقييم في التكنولوجيا المساندة وتقاييم التكنولوجيا المساندة وأجهزة التكنولوجيا المساندة المستخدمة في تحسين الحركة للأفراد ذوي الإعاقات الجسدية والتكنولوجيا المساندة لتحسين التواصل اللغوي وأجهزة التكنولوجية المساندة لتحسين الوصول للمعلومات وتوظيف التعديلات للتكنولوجيا المساندة في التدريس الأكاديمي وأجهزة التكنولوجيا المساندة لتحسين العيش باستقلالية.
BOOK
Workplace interventions for common mental disorders: a systematic meta-review
Depression and anxiety disorders are the leading cause of sickness absence and long-term work incapacity in most developed countries. The present study aimed to carry out a systematic meta-review examining the effectiveness of workplace mental health interventions, defined as any intervention that a workplace may either initiate or facilitate that aims to prevent, treat or rehabilitate a worker with a diagnosis of depression, anxiety or both. Relevant reviews were identified via a detailed systematic search of academic and grey literature databases. All articles were subjected to a rigorous quality appraisal using the AMSTAR assessment. Of the 5179 articles identified, 140 studies met the inclusion criteria, of which 20 were deemed to be of moderate or high quality. Together, these reviews analysed 481 primary research studies. Moderate evidence was identified for two primary prevention interventions; enhancing employee control and promoting physical activity. Stronger evidence was found for CBT-based stress management although less evidence was found for other secondary prevention interventions, such as counselling. Strong evidence was also found against the routine use of debriefing following trauma. Tertiary interventions with a specific focus on work, such as exposure therapy and CBT-based and problem-focused return-to-work programmes, had a strong evidence base for improving symptomology and a moderate evidence base for improving occupational outcomes. Overall, these findings demonstrate there are empirically supported interventions that workplaces can utilize to aid in the prevention of common mental illness as well as facilitating the recovery of employees diagnosed with depression and/or anxiety.
Journal Article
Changes in circulating microRNA levels associated with prostate cancer
Background:
The aim of this study was to investigate the hypothesis that changes in circulating microRNAs (miRs) represent potentially useful biomarkers for the diagnosis, staging and prediction of outcome in prostate cancer.
Methods:
Real-time polymerase chain reaction analysis of 742 miRs was performed using plasma-derived circulating microvesicles of 78 prostate cancer patients and 28 normal control individuals to identify differentially quantified miRs.
Results:
A total of 12 miRs were differentially quantified in prostate cancer patients compared with controls, including 9 in patients without metastases. In all, 11 miRs were present in significantly greater amounts in prostate cancer patients with metastases compared with those without metastases. The association of miR-141 and miR-375 with metastatic prostate cancer was confirmed using serum-derived exosomes and microvesicles in a separate cohort of patients with recurrent or non-recurrent disease following radical prostatectomy. An analysis of five selected miRs in urine samples found that miR-107 and miR-574-3p were quantified at significantly higher concentrations in the urine of men with prostate cancer compared with controls.
Conclusion:
These observations suggest that changes in miR concentration in prostate cancer patients may be identified by analysing various body fluids. Moreover, circulating miRs may be used to diagnose and stage prostate cancer.
Journal Article
Group problem management plus (PM+) to decrease psychological distress among Syrian refugees in Turkey: a pilot randomised controlled trial
Background
Syrian refugees resettled in Turkey show a high prevalence of symptoms of mental disorders. Problem Management Plus (PM+) is an effective psychological intervention delivered by non-specialist health care providers which has shown to decrease psychological distress among people exposed to adversity. In this single-blind pilot randomised controlled trial, we examined the methodological trial procedures of Group PM+ (gPM+) among Syrian refugees with psychological distress in Istanbul, Turkey, and assessed feasibility, acceptability, perceived impact and the potential cost-effectiveness of the intervention.
Methods
Refugees with psychological distress (Kessler Psychological Distress Scale, K10 > 15) and impaired psychosocial functioning (World Health Organization Disability Assessment Schedule, WHODAS 2.0 > 16) were recruited from the community and randomised to either gPM+ and enhanced care as usual (E-CAU) (
n
= 24) or E-CAU only (
n
= 22). gPM+ comprised of five weekly group sessions with eight to ten participants per group. Acceptability and feasibility of the intervention were assessed through semi-structured interviews. The primary outcome at 3-month follow-up was symptoms of depression and anxiety (Hopkins Symptoms Checklist-25). Psychosocial functioning (WHODAS 2.0), symptoms of posttraumatic stress disorder and self-identified problems (Psychological Outcomes Profiles, PSYCHLOPS) were included as secondary outcomes. A modified version of the Client Service Receipt Inventory was used to document changes in the costs of health service utilisation as well as productivity losses.
Results
There were no barriers experienced in recruiting study participants and in randomising them into the respective study arms. Retention in gPM+ was high (75%). Qualitative analyses of the interviews with the participants showed that Syrian refugees had a positive view on the content, implementation and format of gPM+. No adverse events were reported during the implementation. The study was not powered to detect an effect. No significant difference between gPM+ and E-CAU group on primary and secondary outcome measures, or in economic impacts were found.
Conclusions
gPM+ delivered by non-specialist peer providers seemed to be an acceptable, feasible and safe intervention for Syrian refugees in Turkey with elevated levels of psychological distress. This pilot RCT sets the stage for a fully powered RCT.
Trial registration
ClinicalTrials.gov
Identifier
NCT03567083
; date: 25/06/2018.
Journal Article
Wild cards III : Jokers Wild
\"The journey into high adventure soars on! Let the secret history of the world be told--of the alien virus that struck Earth after World War II, and of the handful of survivors who found they now possessed superhuman powers. Some were called Aces, endowed with powerful mental and physical prowess. The others were Jokers, tormented by bizarre mind or body disfigurements. Some served humanity. Others wreaked terror. Now, forty years later, under the streets of Manhattan an evil genius unleashes the powers of darkness--and Aces and Jokers alike must fight for their lives. Here, in the third volume of the Wild Cards series, seven of science fiction's most gifted writers take you on a journey of wonder and excitement.Includes stories by:Edward Bryant, Leanne C. Harper, George R. R. Martin, John J. Miller, Lewis Shiner ,Walter Simons, Melinda M. Snodgrass\"-- Provided by publisher.
Book
Interactions between BDNF Val66Met polymorphism and early life stress predict brain and arousal pathways to syndromal depression and anxiety
Individual risk markers for depression and anxiety disorders have been identified but the explicit pathways that link genes and environment to these markers remain unknown. Here we examined the explicit interactions between the brain-derived neurotrophic factor (BDNF)
Val66Met
gene and early life stress (ELS) exposure in brain (amygdala–hippocampal–prefrontal gray matter volume), body (heart rate), temperament and cognition in 374 healthy European volunteers assessed for depression and anxiety symptoms. Brain imaging data were based on a subset of 89 participants. Multiple regression analysis revealed main effects of ELS for body arousal (resting heart rate,
P
=0.005) and symptoms (depression and anxiety,
P
<0.001) in the absence of main effects for BDNF. In addition, significant BDNF–ELS interactions indicated that BDNF Met carriers exposed to greater ELS have smaller hippocampal and amygdala volumes (
P
=0.013), heart rate elevations (
P
=0.0002) and a decline in working memory (
P
=0.022). Structural equation path modeling was used to determine if this interaction predicts anxiety and depression by mediating effects on the brain, body and cognitive measures. The combination of Met carrier status and exposure to ELS predicted reduced gray matter in hippocampus (
P
<0.001), and associated lateral prefrontal cortex (
P
<0.001) and, in turn, higher depression (
P
=0.005). Higher depression was associated with poorer working memory (
P
=0.005), and slowed response speed. The BDNF Met–ELS interaction also predicted elevated neuroticism and higher depression and anxiety by elevations in body arousal (
P
<0.001). In contrast, the combination of
BDNF
V/V genotype and ELS predicted increases in gray matter of the amygdala (
P
=0.003) and associated medial prefrontal cortex (
P
<0.001), which in turn predicted startle-elicited heart rate variability (
P
=0.026) and higher anxiety (
P
=0.026). Higher anxiety was linked to verbal memory, and to impulsivity. These effects were specific to the
BDNF
gene and were not evident for the related 5HTT-LPR polymorphism. Overall, these findings are consistent with the correlation of depression and anxiety, yet suggest that partially differentiated gene–brain cognition pathways to these syndromes can be identified, even in a nonclinical sample. Such findings may aid establishing an evidence base for more tailored intervention strategies.
Journal Article