Search

Objective: Nonalcoholic fatty liver disease (NAFLD) comprises a spectrum ranging from hepatosteatosis to progressive nonalcoholic steatohepatitis that can lead to cirrhosis. Humans with low levels of prohormone thyroxine (T4) have a higher incidence of NAFLD, and thyroid hormone treatment is very promising in all patients with NAFLD. Deiodinase type 1 (Dio1) is a hepatic enzyme that converts T4 to the bioactive T3 and therefore regulates thyroid hormone availability within hepatocytes. We investigated the role of this intrahepatic regulation during the progression of NAFLD. Methods: We investigated hepatic thyroid hormone metabolism in two NAFLD models: wild-type mice fed a Western diet with fructose and Leprdb mice fed a methionine- and choline-deficient diet. AAV8-mediated liver-specific Dio1 knockdown was employed to investigate the role of Dio1 during the progression of NAFLD. Intrahepatic thyroid hormone levels, deiodinase activity, and metabolic parameters were measured. Results: Dio1 expression and activity were increased in the early stages of NAFLD and were associated with an increased T3/T4 ratio. Prevention of this increase by AAV8-mediated liver-specific Dio1 knockdown increased hepatic triglycerides and cholesterol and decreased the pACC/ACC ratio and acylcarnitine levels, suggesting there was lower β-oxidation. Dio1 siRNA KD in hepatic cells treated with fatty acids showed increased lipid accumulation and decreased oxidative phosphorylation. Conclusion: Hepatic Dio1 gene expression was modulated by dietary conditions, was increased during hepatosteatosis and early NASH, and regulated hepatic triglyceride content. These early adaptations likely represent compensatory mechanisms that reduce hepatosteatosis and prevent NASH progression.

Central congenital hypothyroidism (CH) is defined as thyroid hormone (TH) deficiency at birth due to insufficient stimulation by the pituitary of the thyroid gland. The incidence of central CH is currently estimated at around 1:13,000. Central CH may occur in isolation, but in the majority of cases (60%) it is part of combined pituitary hormone deficiencies (CPHD). In recent years several novel genetic causes of isolated central CH have been discovered (IGSF1, TBL1X, IRS4), and up to 90% of isolated central CH cases can be genetically explained. For CPHD the etiology usually remains unknown, although pituitary stalk interruption syndrome does seem to be the most common anatomic pituitary malformation associated with CPHD. Recent studies have shown that central CH is a more severe condition than previously thought, and that early detection and treatment leads to good neurodevelopmental outcome. However, in the neonatal period the clinical diagnosis is often missed despite hospital admission because of feeding problems, hypoglycemia and prolonged jaundice. This review provides an update on the etiology and prognosis of central CH, and a practical approach to diagnosis and management of this intriguing condition.

The role of loneliness in the bereavement experience has been reported as substantial, with the death of a close person leaving a considerable void in the life of the bereaved. Yet, there is lack of agreement about its precise role and, notably, whether loneliness should be included as a core symptom for diagnosis of grief complications. The ongoing threat of heightened social isolation due to the COVID-19 pandemic underlines the need to understand the impact of loneliness, and to accurately chart its prevalence, intensity, duration, and associated difficulties in the context of bereavement. Assessment issues are central to this endeavor. In this article, we review the scientific literature to examine how loneliness after bereavement has been operationalized and measured. Sixty-three articles analyzing 51 independent datasets were reviewed. Results show major disparities: approximately half of the projects assessed loneliness by means of one of two validated scales (spanning different versions); the remainder included only single- or few-item measures. Diverse instructions, content and answer categories were used. While one size does not fit all, awareness of assessment options and dis/advantages may aid selection of the most appropriate measure, to suit the goals of a particular study and the specific groups under investigation. Our conclusion is that, in selecting a loneliness measure, health care professionals should come to their own well-informed decision, aided by the information provided in our review.

In this study, we investigate the changes in the crystalline structure of MBE-deposited SrTiO3 layers on Si with different deviations from Sr/Ti stoichiometry as deposited but also after annealing at high temperatures (>600 °C). We show that as-grown 15 nm thick non-stochiometric SrTiO3 layers present surprisingly lower FWHM values of the (002) omega diffraction peak compared to fully stoichiometric layers of similar thickness. This can misleadingly point to superior crystalline quality of such non-stochiometric layers. However, thermal post-deposition anneals of these layers at temperatures up to 850 °C in oxygen show strong detrimental effects on the crystalline structure, surface and interface with the Si (001) substrate. On the contrary, the post-deposition anneals applied to the stoichiometric samples strongly improve the physical, optical and electrical properties of the epitaxial SrTiO3 thin films. [ABSTRACT FROM AUTHOR]

Savoring beliefs refer to people's beliefs about their ability to generate, increase, and prolong enjoyment from positive experiences. The role of these beliefs in affecting responses to negative events is largely unexplored. This study aimed to increase knowledge about the role of savoring beliefs in symptoms of posttraumatic stress (PTS) following negative life events and the incremental role of these beliefs beyond the impact of worry, depressive rumination, and neuroticism. A two-wave longitudinal survey. Two-hundred and five students completed the Savoring Beliefs Inventory, measuring one's ability to generate pleasure from past, present, and anticipated experiences at Time 1 (T1). Six months later (at T2), they rated adverse life-events experienced between T1 and T2 and completed measures of PTS (associated with the most distressing event experienced in this time-frame) and depression. Savoring beliefs at T1 were correlated with PTS total scores and PTS clusters and depression at T2. Regression analyses indicated that savoring beliefs regarding present and future (but not past) events were associated with some, but not all T2-outcomes, above and beyond worry, depressive rumination, and neuroticism. This study confirms that increased savoring beliefs could mitigate the impact of confrontation with adverse events. [ABSTRACT FROM AUTHOR]

The invasion of epithelial tumours often depends on the epithelial-mesenchymal transition. Here, the authors report that intracellular activation of thyroid hormone by the D2 deiodinase enzyme promotes invasion and progression of squamous cell carcinoma by transcriptionally up-regulating ZEB-1.

Abstract Objectives Relatives of long-term missing persons need to deal with uncertainties related to the disappearance. These uncertainties may give rise to ruminative thinking about the causes and consequences of the loss. Focusing on tolerating uncertainties in treatment of relatives of missing persons might foster recovery. Adding mindfulness to cognitive behavioural therapy might serve this aim. The feasibility and potential effectiveness of cognitive behavioural therapy with mindfulness were evaluated in a pilot study. We aimed to detect changes in symptom levels and mindfulness from pre-treatment to 1 week, 12 weeks, and 24 weeks post-treatment. Method Dutch adults who experienced the disappearance of a significant other more than 3 months earlier and scored above clinical thresholds for psychological distress were eligible to participate. Participants were recruited from January 2015 to July 2016. Participants in the immediate treatment group started treatment after 1 week after randomization, whereas waiting list controls started the treatment after 12 weeks of waiting. Data from self-report measures as well as clinical diagnostic interviews (tapping persistent complex bereavement disorder, major depressive disorder, and posttraumatic stress disorder) were gathered among 17 relatives of missing persons with elevated symptom levels. Results The response rate (31.7%) was low, and dropout rate (47.1%) high. Cognitive behavioural therapy with mindfulness coincided with changes in psychopathology levels (Hedges’ g 0.35–1.09) and mindfulness (Hedges’ g − 0.10–0.41). Participants completing the treatment were satisfied with treatment quality and reported high treatment compliance. Conclusions Because of the limited research about effective treatments for relatives of missing persons and promising results of small and/or uncontrolled trials examining the effect of mindfulness-based treatment to target grief-related complaints, it seems valuable to continue investigating the effects of cognitive behavioural therapy with mindfulness on reducing post-loss psychopathology in future research. However, in order to increase the feasibility of future trials among relatives of missing persons, we recommend collaborating internationally and/or extending duration of recruitment phase, to maximize the sample size. Trial registration The Netherlands National Trial Register, NTR4732.

الملخص: أهداف البحث: الهدف من هذا التواصل هو عرض تطوير، وتنفيذ، وتقييم دورة رائدة عبر الإنترنت لبناء قدرات الطاقم الأكاديمي في كليات الطب في منطقة شرق البحر المتوسط حول المحاسبة المجتمعية لكليات الطب. طرق البحث: تم تطوير هذه الدورة المكونة من أربع وحدات باستخدام نهج الخطوات الست لتطوير المناهج. أعطيت الدورة عبر الإنترنت من خلال منصة ''موودل'' إلى الأوساط الأكاديمية المشاركة من قبل ثلاثة من أعضاء هيئة التدريس من ذوي الخبرة في المحاسبة المجتمعية. تم تقويم محتويات ومدى ملاءمة الدورة باستخدام نموذج تقييم ''كيرك باتريك'' من خلال استبانة تعبأ ذاتيا وتقييم آراء المشاركين وتغذيتهم الراجعة. النتائج: تم قبول ١٦ مشاركا من أربعة بلدان في الدورة. أكمل ما يصل إلى ٧٥٪ من المشاركين أربع وحدات. كان متوسط عدد مواضيع المناقشة عبر الإنترنت هو ٣٦ استجابة لكل وحدة. واعتبر جميع المشاركين أن الدورة تحتوي على رسالة واضحة، ووافق الأغلبية على أن الدورة قدمت لهم مفاهيم جديدة وصححت بعض سوء فهمهم بشأن المحاسبة المجتمعية لكليات الطب. كانت المشاكل الرئيسة التي واجهها المشاركين هي ضيق الوقت ومشاكل الإنترنت التقنية. الاستنتاجات: يحتاج تطبيق مفهوم المحاسبة المجتمعية في العمل اليومي لكليات الطب إلى أن يكون أعضاء هيئة التدريس على علم ويتم تدريبهم. توفر الدورة عبر الإنترنت طريقة مرنة لإجراء برامج لتطوير أعضاء هيئة التدريس. Abstract: Objectives: The objective of this communication is to describe the development, implementation, and evaluation of a pioneering online course about the social accountability of medical schools intended to develop the skills of academic staff at medical schools in the eastern Mediterranean region. Methods: This four-module course was developed using a six-step approach for curriculum development. Three faculty members with vast experience in social accountability delivered the course online through the MOODLE platform to participants. The content and appropriateness of the course were evaluated using Kirkpatrick's evaluation model, by offering a self-administered questionnaire that assesses the participants' opinions and feedback besides the analysis of the responses of the participants to the discussion points. Results: Sixteen participants from four countries were admitted to the course. An overall 75% of the participants completed four modules. The mean number of online discussion threads was reported to be 36 responses per module. All participants regarded the course as having a clear take-home message. The majority agreed that the course introduced new concepts and corrected some of their misunderstandings about social accountability in medical schools. The main problems that participants experienced were time constraints and technical Internet problems. Conclusion: The application of the concept of social accountability in the day-to-day work of medical schools requires faculty to be informed and trained. The online course provides a flexible way to conduct faculty development programmes. الكلمات المفتاحية: المحاسبة المجتمعية, التدريب, عبر الإنترنت, شرق البحر المتوسط, Keywords: Eastern Mediterranean, Online, Social accountability, Training

Abstract Background Families applying for asylum have often experienced multiple potentially traumatic events and continue to face stressors during their resettlement. Studies have indicated that traumatic events can negatively impact parenting behaviour and child development. A secondary preventive multi-family intervention programme, called Family Empowerment, was developed. Family Empowerment aims to strengthen parenting skills and prevent exacerbation of emotional problems in asylum-seeker families. This study protocol aims to evaluate the feasibility, acceptability, and potential effectiveness of Family Empowerment to reduce parental mental health problems and improve family functioning. Methods An uncontrolled pre-test-post-test design will be conducted, using a mixed-methods approach. Approximately 60 families living at asylum centres and family locations with children aged 0–18 will be included. All participants will be invited to take part in seven sessions of Family Empowerment. Measurements take place at baseline, during implementation of Family Empowerment and 1 week post-Family Empowerment. Demographic data, the quality of the parent-child interaction, family functioning, parental symptoms of depression and anxiety, and participants’ feedback on progress and the therapeutic alliance will be assessed. A programme integrity list will be filled out during each session. Semi-structured interviews at baseline and post-Family Empowerment will be used to evaluate Family Empowerment. Discussion This is the first study to provide a pilot implementation and evaluation of Family Empowerment. The current study will inform us on how to improve programme elements and the implementation of Family Empowerment. Limitations are discussed. Trial registration Dutch Trial Register, TC = NTR6934. Registered on January 8 2018.