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C8H15NO4S, orthorhombic, P212121 (no. 19), a = 5.0215 (3) Å, b = 7.0392 (5) Å, c = 28.0593 (19) Å, V = 991.82 (11) Å3, Z = 4, R gt(F) = 0.0462, wR ref(F 2) = 0.0899, T = 100 K.

Anwar E Ahmed,1 Michael H Yim,1 Jimmy Dawood,2 Cara H Olsen,1 Andrew J Waters,3 Darrell E Singer,1 James D Mancuso1 1Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA; 2School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA; 3Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USACorrespondence: Anwar E Ahmed, Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA, Email anwar.ahmed@usuhs.eduBackground: This study aimed to 1) determine the prevalence of past-year suicidal ideation (SI) and attempts (SA) among active-duty SMs; 2) determine whether differences exist by age, sex, and race; and 3) assess whether prevalence estimates vary by risk profiles of mental health conditions and substance use.Methods: Data were from the 2018 Health-Related Behavior Survey (HRBS), a cross-sectional survey of active-duty SMs (n = 17,166). We used the logistic model to identify the factors of SI and SA and latent class analysis (LCA) to identify the risk profiles.Results: Among active duty SMs, 8.26% had SI and 1.25% had SA in the past year. Gender and age have been shown to influence how race might contribute to suicidal behaviors. Mental health conditions were associated with higher odds of SI and SA, as were younger ages; LGB identity; being separated, divorced, or widowed; use of e-cigarettes, dual use of e-cigarettes and cigarettes, or drugs; and history of deployment of less than 12 months. Frequencies of cigarette and e-cigarette use were also associated with SI and SA, indicating the odds were increasing by 0.3% for every additional cigarette or e-cigarette used. Five risk profiles were identified: class 1 (illegal drug use), class 2 (mental health needs with tobacco and alcohol use), class 3 (mental health conditions only), class 4 (“low risk” SMs with low levels of illegal drug use, mental health visits, tobacco use, and alcohol use), and class 5 (alcohol use). Compared to class 4 (“low risk”), all other risk profiles were associated with increased odds of suicidal behaviors.Conclusion: Despite the resources and increased access provided for mental health support, the prevalence of SI among active-duty SMs is greater than in the general population of the same age, likely due to additional military exposures and stressors.Keywords: suicide, ideation, attempts, mental health, e-cigarette, active-duty service member

Dana DiBenedetti,1 Katherine Kosa,1 Heidi C Waters,2 Dorothee Oberdhan2 1Patient-Centered Outcomes Assessment, RTI Health Solutions, Research Triangle Park, NC, USA; 2Global Value & Real-World Evidence, Otsuka Pharmaceutical Development & Commercialization, Inc, Rockville, MD, USACorrespondence: Dorothee Oberdhan, Otsuka Pharmaceutical Development & Commercialization, Inc, Rockville, MD, 20850, USA, Email Dorothee.Oberdhan@otsuka-us.comBackground: Patient perspectives of living with borderline personality disorder (BPD) are not traditionally captured in the literature. To overcome this gap, we explored participants’ experiences with BPD to gain a better understanding of symptoms and impacts related to the condition.Methods: Two experienced researchers conducted semistructured interviews with a subset of participants from a randomized controlled trial evaluating a BPD treatment. The interview study was independent from the trial. Interviews focused on participants’ experiences with BPD prior to the trial, including the symptoms and impacts of BPD. Interview transcripts were analyzed to identify dominant trends and generate patterns in the way participants described their experiences with BPD.Results: A total of 50 adults with BPD participated in the interview study. The mean age of the participants was 28.5 years (range, 18– 53 years) and 72.0% were female. All participants described having difficulties with extreme emotional responses and interpersonal relationships, and most participants reported experiencing issues with self-image, impulsivity, suspiciousness/distrust, feelings of emptiness, and anger. The symptoms that were most bothersome to participants were extreme moods or emotional responses and a pattern of unstable personal relationships. All participants remarked that their BPD-related symptoms negatively impacted their interpersonal relationships, and nearly two-thirds of the sample reported that the impact of BPD on their relationships was the most bothersome. Additionally, more than half of the participants discussed impacts on work or school, memory or thinking, self-care, and financial and legal issues.Conclusion: Participants reported that the most bothersome symptoms of BPD were those related to extreme moods or emotional responses and interpersonal relationships. Participants similarly described the impact of BPD on their interpersonal relationships as the most bothersome. Overall, participant perspectives from this study indicate that the burden of BPD is significant and new treatments tailored to patients’ real-world needs are warranted.Keywords: borderline personality disorder, patient experience, symptoms, impacts, patient perception

Soon Nan Wee,1,* Christian Liman,1,* Heidi C Waters,2 Christy R Houle,3 Miguel Renteria,1 Sankha S Mukherjee,1 Subina Surendran,1 Joshua Marcovici,1 Malaak Brubaker,2 Stine Rasmussen Meehan,4 Anne de Jong-Laird,2 A John Rush,5– 7 Joydeep Sarkar1 1Holmusk Technologies, Inc, New York, NY, USA; 2Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, NJ, USA; 3Lundbeck, Deerfield, IL, USA; 4H. Lundbeck A/S, Valby, Denmark; 5Department of Psychiatry, Duke-National University of Singapore, Singapore, Singapore; 6Department of Psychiatry, Duke University School of Medicine, Durham, NC, USA; 7Health Sciences Center, Texas Tech University, Odessa, TX, USA*These authors contributed equally to this workCorrespondence: Heidi C Waters, Otsuka Pharmaceutical Development & Commercialization, Inc, 508 Carnegie Center Drive, Princeton, NJ, 08540, USA, Tel +1 609 535 9626, Email heidi.waters@otsuka-us.comPurpose: Life engagement encompasses concepts such as life fulfillment, well-being, and participation in meaningful activities, encompassing cognitive, physical, social, and emotional dimensions. Patients with MDD experience impaired functioning across multiple domains of life engagement and have ranked concepts related to life engagement and fulfillment as important predictors of treatment success. Post-hoc analyses of three clinical trials of patients with MDD treated adjunctively with brexpiprazole have reported a significantly greater improvement in life engagement. This study investigated improvements in life engagement among patients with MDD following initiation of brexpiprazole treatment using a real-world dataset.Patients and Methods: Information was extracted from semi-structured clinical notes of the Mental Status Examination (MSE) of patients in a real-world setting to develop an outcome measure for quantifying life engagement of psychiatric patients. Measures of life engagement and its four sub-domains (emotional, physical, social, and cognitive) were calculated at each clinical visit for 624 adult patients with MDD during the 6 months following brexpiprazole initiation. Paired t-tests assessed differences between the index event and time periods within 6 months of the index event. Kaplan–Meier survival analyses were used to quantify the improvement in life engagement scores following brexpiprazole initiation.Results: The study identified 54 clinical features associated with life engagement. Statistically significant improvements were observed from as early as 1 month following brexpiprazole initiation, with 20.6%, 37.9%, and 53.9% of the patients demonstrating improved life engagement scores within 1, 3, and 6 months, respectively. The improvements were particularly apparent for the emotional and social sub-domains.Conclusion: The results of this study provide evidence of improved life engagement following brexpiprazole initiation in a real-world dataset.Keywords: brexpiprazole, major depressive disorder, real-world evidence, mental status examination, life engagement

The structures of regional economies play a critical role in determining both a region’s productivity and its resilience to shocks. We extend previous work on the regional occupation and skills structure by analyzing the effect of a region’s industry structure. We operationalize the concept of economic structure by constructing a network of interdependent economic components, employing ecological techniques of co-occurrence analysis to infer interactions between industries. For each U.S. metropolitan statistical area, we create an aggregate measure of economic tightness that captures the degree of interconnectedness among a region’s industries. We find that industry tightness, which we find is partly driven by rare industry pairs, is positively correlated with a region’s economic productivity, negatively correlated with a region’s change in productivity following the Great Recession. This study contributes to an understanding of the tradeoff between productivity and resilience, which is intended to help policy makers that face similar real-world tradeoffs.

Gabrielle Pogge,1 Erika A Waters,2 Gregory D Webster,1 Sreekala Prabhakaran,3 Jean M Hunleth,2 David A Fedele,4 James A Shepperd1 1University of Florida, Department of Psychology, Gainesville, FL, 32603, USA; 2Washington University School of Medicine, Department of Surgery – Public Health Sciences, Saint Louis, MO, USA; 3University of Florida, Department of Pediatrics, Gainesville, FL, 32603, USA; 4University of Florida, Department of Clinical and Health Psychology, Gainesville, FL, 32603, USACorrespondence: Gabrielle Pogge, Department of Psychology, University of Florida, PO Box 112250, Gainesville, FL, 32611-2250, USA, Tel +1757-642-0396, Email gcm0402@ufl.eduPurpose: Although several indicators suggest that pediatric asthma control in the United States improved early in the pandemic, other indicators suggest not. Missing are reports from caregivers of the experiences of their children with asthma early in the pandemic.Methods: Using the PP-ACT and other measures that we specifically constructed for our research, we conducted a cross-sectional national survey of US caregivers of children with asthma (N=595) to examine perceived change in their child’s asthma control and changes in reports of ED visits and use of emergency relief medicine and controller medicine pre-pandemic (January to March 2020) versus early-pandemic (June to September 2020).Results: Caregivers fell into three groups: most caregivers perceived that their child’s asthma control was improved (50.3%) or unchanged (41.2%), and few reported worse control (8.5%). Surprisingly, all three groups of caregivers reported similar frequencies of early-pandemic and pre-pandemic ED visits and use of emergency relief medicine. Also surprising, caregivers who perceived their child’s asthma as more controlled (compared with the other two groups) reported more frequent ED visits and use of emergency relief medicine, yet also more use of controller medicine at both early-pandemic and pre-pandemic.Conclusion: The mismatch between caregivers’ perceptions of their child’s early-pandemic asthma control and their reports of ED visits and use of emergency relief medicine suggests that caregivers may rely on a gist (a global evaluation that can include nonbiomedical evidence) when estimating their child’s asthma control. Caregivers and their families could benefit from help from clinicians in understanding the discrepancy between subjective asthma control and asthma control indicators and in understanding what well-controlled asthma looks and feels like.Keywords: PP-ACT, childhood asthma, ED admissions, coronavirus 19 pandemic, asthma caregivers, United States, perceptions