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Objective: To compare persons with epilepsy (PWE) to those with psychogenic non-epileptic seizures (PNES) on measures of depression, anxiety, and alexithymia subscales (i.e., difficulty identifying emotions, difficulty describing emotions, and external-oriented thinking)., Material and Methods: In this retrospective study, 235 epilepsy patients and 90 patients with PNES were evaluated between 2012 and 2020 at the Northeast Regional Epilepsy Group. These patients had completed the Toronto Alexithymia Scale (TAS-20), The Center for Epidemiologic Studies - Depression Scale (CES-D) and The State-Trait Anxiety Inventory (STAI). Background information was collected regarding work/student/disability status at the time of the evaluation history of psychiatric diagnosis; psychological trauma; and involvement in psychotherapy either at the time of the evaluation or prior., Results: Significant differences between PWEs and those with PNES were found not only in historical data (e.g., Psychiatric History, History of Trauma, and History of Therapy) (p < .001) but also on measures of Depression (p = .002) and Anxiety (p < .001). ANOVA analysis also revealed significant differences in the distribution of the TAS-Total score, TAS-Describing emotions, and TAS-Identifying emotions. Using logistic regression (stepwise model) the optimal set of predictors for a differential diagnosis of epilepsy and PNES was combination of TAS-Identifying emotions score, history of psychological trauma, and history of therapy. The accuracy of the prediction was determined to be 80.2 %., Conclusions: Although higher alexithymia rates are present in PNES and PWEs, clinicians may find a combination of TAS-Identifying Emotion score, history of trauma, and history of psychotherapy useful in supporting a differential diagnosis. Also, a subgroup may exist among those with PNES with high levels of alexithymia, depression, and anxiety that may require a different treatment approach focused on addressing difficulties in identifying and describing their emotions and their other symptomatology., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Background: Temporal self-appraisal (TSA) theory, reflected appraisal theory, and their clinical applications have previously been explored as independent constructs. This study investigates how TSA corresponds to temporal reflected appraisal (TRA), and how the relationship between them differs in the presence of depression., Methods: 273 adults (57 % female), recruited using Amazon Mechanical Turk, filled out a series of measures of mood and self-appraisal assessments (TSA and TRA versions of the Me/Not Me task). Repeated measures MANOVAs were used to assess between group differences., Results: The TSA trajectory of depressed individuals replicated the 'V' shape found in previous research, whereas the TRA of depressed individuals did not decline from past to present. There was little difference between TSA and TRA "past" and "future" appraisals, though there was a significant difference in appraisal of the "present." Individuals with depression believe that others perceive them as doing much better currently than the way they view themselves. By contrast, euthymic individuals had no significant differences between the TSA and TRA appraisals of their present selves, indicating they think their self-perception matches how others view them., Limitations: We assessed depression using online self-reports. Cross-sectional data limits causality determination but suffices for studying mood-related self-perceptions over time., Conclusions: Temporal self-appraisal and temporal reflected appraisal have varying relationships among euthymic and depressed individuals. This more precise characterization of depressed individuals' identity can further aid clinicians in understanding the nature of identity development and treating identity disruption among depressed individuals., Competing Interests: Conflict of interest The authors report no conflict of interest., (Published by Elsevier B.V.)

Adoption of health-protective behaviors, including social distancing measures, are a mainstay of mitigating pandemics, so it is important to understand the characteristics associated with those who use them or not. We aimed to delineate local and personal factors associated with self-reported use of health-protective behaviors (HPB) in response to COVID-19, among adults across 4 economically developed countries. We conducted an exploratory, cross-sectional, representative, on-line survey of adults in Canada, Germany, U.K., or the U.S. during the COVID-19 pandemic (June-July 2020) with two and eight month follow-ups. All countries were experiencing the initial waves of the COVID-19 pandemic. We obtained N = 6,990 participants, who reported 20 specific health-protective behaviors (dependent measure), along with locally mandated health measures, individual characteristics and psychological scales. Using health-protective behaviors (HPB-Quartile score) was significantly associated with 28 of 35 variables studied. In stepwise logistic regression, 21 variables predicted 23.51 % of the variance in HPB-Q scores (p <.000). The strongest predictors were locally mandated protective measures, immature defense mechanisms, COVID-fears, age, moving due to COVID-19, domestic violence, and perceived emotional support from significant others. HPB-Q predicted vaccination hesitancy/willingness (OR = 4.61, CI-95 %: 2.66-8.00) and adoption 8 months later. During the early pandemic, HPB use was most strongly associated with locally mandated measures, followed by psychiatric, demographic, and other personal factors. Considering these empirically derived characteristics may improve public health approaches to optimize HPB and vaccination adoption, mitigating SAR-CoV-2 transmission. Findings may also inform public health responses to future epidemics/pandemics., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Vera Bekes and Claire J. Starrs have no competing interests. J. Christopher Perry owns common stock in the following health-care related companies: Biogen, Evolus, Hologic, Illumina, Moderna, Thermo-Fischer, Veeva Systems., (© 2022 The Authors.)

The identification of more reliable diagnostic or prognostic biomarkers in age-related neurodegenerative diseases, such as Amyotrophic Lateral Sclerosis (ALS), is urgently needed. The objective in this study was to identify more reliable prognostic biomarkers of ALS mirroring neurodegeneration that could be of help in clinical trials. A total of 268 participants from three cohorts were included in this study. The muscle and blood cohorts were analyzed in two cross-sectional studies, while the serial blood cohort was analyzed in a longitudinal study at 6-monthly intervals. Fifteen target genes and fourteen proteins involved in muscle physiology and differentiation, metabolic processes and neuromuscular junction dismantlement were studied in the three cohorts. In the muscle biopsy cohort, the risk for a higher mortality in an ALS patient that showed high Collagen type XIX, alpha 1 (COL19A1) protein levels and a fast progression of the disease was 70.5% ( P < 0.05), while in the blood cohort, this risk was 20% ( P < 0.01). In the serial blood cohort, the linear mixed model analysis showed a significant association between increasing COL19A1 gene levels along disease progression and a faster progression during the follow-up period of 24 months ( P < 0.05). Additionally, higher COL19A1 levels and a faster progression increased 17.9% the mortality risk ( P < 0.01). We provide new evidence that COL19A1 can be considered a prognostic biomarker that could help the selection of homogeneous groups of patients for upcoming clinical trial and may be pointed out as a promising therapeutic target in ALS.

Introduction: Polypharmacy, defined as the use of 5 or more medications is associated with multiple adverse outcomes in older adults, including falls and slow gait velocity. However, the relationship between polypharmacy and cortical control of locomotion has not been reported. The purpose of this study was to examine the relationship between polypharmacy and activation patterns in the prefrontal cortex (PFC), a brain region involved in higher order control of locomotion during attention-demanding conditions., Methods: Using Functional Near Infrared Spectroscopy (fNIRS) to quantify PFC oxygenated hemoglobin (HbO 2 ) levels, we performed a cross sectional analysis of 325 community dwelling adults age ≥65 years, and examined HbO 2 levels during single tasks (Single-Task-Walk (STW), (talking, cognitive interference (Alpha)) and Dual-Task Walk (DTW))., Results: The prevalence of polypharmacy was 33% (n = 104) amongst the 325 participants (mean age 76.4 ± 6.7 years, 56% women). Among the 221 participants with no polypharmacy there was an increase in HbO 2 levels from STW to DTW (estimate = -0.625; p = <0.001) and from Alpha to DTW (estimate=-0.079; p = 0.031). Polypharmacy status, however, moderated the change in HbO 2 levels comparing the two single tasks to the dual-task walking condition. Specifically, the presence of polypharmacy was associated with an attenuated increase in HbO 2 levels from STW to DTW (estimate = 0.149; p = 0.027) and with a decline in HbO 2 levels from Alpha to DTW (estimate = 0.169; p = 0.009) after adjustments for potential confounders including medical comorbidities and the use of high-risk medications., Conclusion: The results of this study further support the need for clinicians to reduce polypharmacy in older adults, given its significant association with the PFC hemodynamic response during attention-demanding locomotion., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The present study was to evaluate the diagnostic value of salivary total and oligomeric α-synuclein levels in PD. Furthermore, we sought to explore the relationship between salivary total α-synuclein and α-synuclein SNP variants levels. 201 PD patients and 67 controls were recruited, of which there also had the genetic information of two positive α-synuclein (SNCA) loci. Salivary total α-synuclein was assayed using a highly sensitive Luminex assay and oligomeric α-synuclein was quantified by the combination of Gel filtration chromatography and Western blot, respectively. From our analysis,No difference in salivary total α-synuclein levels was found between PD patients and healthy controls, it decreased with age in PD patients, and was closely associated with genotypic distribution of rs11931074 and rs894278 in PD, respectively. After controlled for age and genders, G allele of rs11931074 was correlated with lower salivary total α-synuclein levels, while G allele of rs894278 was also correlated with the higher levels. Simultaneously, the further study was shown that salivary oligomeric α-synuclein in PD patients significantly increased comparing to healthy controls. In conclusions,our study firstly demonstrated that salivary total α-synuclein levels could be manipulated by different α-synuclein SNPs and salivary oligomeric α-synuclein could be a potential diagnostic indicator of PD.

Objectives: Functional losses are common in healthy and cognitively impaired older adults. However, subtle declines in instrumental activities of daily living (IADLs) are not always detected in self-reports. Performance IADL measurements are financially and time burdensome, restricting their use in varied settings. To address these limitations, we developed the Brief Everyday Activities Measure (BEAM), a short (< 5 minutes) objective IADL measure that assesses medication and finance management., Design and Participants: The BEAM was administered to 209 cognitively non-demented community-dwellers (ages 65 - 95 years)., Measurements: Participants completed standardized motor, neuropsychological, psychological, and self-report functional assessments., Results: BEAM completion time ranged from 54.16 to 259.31 seconds. Interclass correlations (ICC) for total BEAM completion time was moderate (0.65, 95% CI [.43 -.78]). Accuracy for total BEAM performance was in the low-moderate range (Kappa = 0.38, p < .001, 95% CI [.18 -.54]). As predicted, lower accuracy and longer time to complete the BEAM were both associated with worse executive functions, attention, and processing speed., Conclusions: Medication and finance management can be efficiently assessed within five minutes. The BEAM may be a valuable screening tool to evaluate these functional abilities.

Catechol-O-methyltransferase (COMT) is one of the cardinal enzymes that metabolize dopamine and other catecholamine neurotransmitters in the central and peripheral nervous system. Recent studies have shown that the impact of COMT haplotypes on the development of wearing-off phenomenon is in dispute, while the relationship between COMT haplotypes and wearing-off phenomenon in ethnic Chinese population is lacking. The purpose of this study was to characterize the correlation between the Val158Met polymorphism in the COMT gene and the motor complication "wearing-off" in Chinese PD patients. We have sequenced the COMT gene in 259 PD patients and 257 healthy controls. Our results demonstrated that Met/Met homozygosity of the COMT Val158Met polymorphism was related to a decreased risk of developing wearing-off. This finding suggests that COMT Val158Met may affect susceptibility to wearing-off in PD., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Purpose: To evaluate dose plans for head and neck organs at risk (OARs) for classical Hodgkin lymphoma (HL) patients using involved node radiotherapy (INRT) delivered as 3D conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), and intensity modulated proton therapy (PT), in comparison to the past mantle field (MF)., Materials and Methods: Data from 37 patients with cervical lymph node involvement were used. All patients originally received chemotherapy followed by 3DCRT-INRT (30.6 Gy). A VMAT-INRT, PT-INRT (both 30.6 Gy), and a MF plan (36 Gy) were simulated. Doses to head and neck OARs were compared with cumulative DVHs and repeated measures ANOVA., Results: The estimated median mean doses were 15.3, 19.3, 15.4, and 37.3 Gy (thyroid), 10.9, 12.0, 7.9, and 34.5 Gy (neck muscles), 2.3, 11.1, 1.8, and 37.1 Gy (larynx), 1.7, 5.1, 1.3, and 23.8 Gy (pharynx), 0.5, 0.8, 0.01, and 32.3 Gy (ipsilateral parotid), and 2.4, 3.8, 0.7, and 34.7 Gy (ipsilateral submandibular) with 3DCRT, VMAT, PT, and MF (all p<0.0001), respectively., Conclusion: The use of INRT significantly lowered the estimated radiation dose to the head and neck OARs. VMAT appeared suboptimal compared to 3DCRT and PT, and for some patients, PT offered an additional gain., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Background: Compromised learning and cognitive fatigue are critical clinical features in multiple sclerosis., Objectives: This study was designed to determine the effect of repeated exposures within and across study visits on performance measures of learning and cognitive fatigue in relapsing-remitting multiple sclerosis (RRMS)., Methods: Thirty patients with RRMS and 30 controls were recruited. Using a burst measurement design (i.e. repeated assessments within and across study visits) the oral version of the Symbol Digit Modalities Test (SDMT) was administered three times during the baseline and two consecutive monthly follow-up visits for a total of nine test administrations. Learning was assessed within and across study visits whereas cognitive fatigue was assessed during the course of each test administration that was divided into three 30-second intervals., Results: Linear mixed-effect models revealed compromised learning within (95% CI: 2.6355 to 3.9867) and across (95% CI: 1.3250 to 3.1861) visits and worse cognitive fatigue (95% CI: -2.1761 to -0.1720) in patients with RRMS compared with controls. Among patients with RRMS, worse self-rated cognitive dysfunction predicted poor learning within (95% CI: -0.1112 to -0.0020) and across (95% CI: -0.0724 to -0.0106) visits., Conclusions: Burst design is optimal to study learning and cognitive fatigue. This methodology, using the SDMT or other time-efficient tests as outcome measures, can be successfully implemented in longitudinal studies and clinical trials.

This article reviews the evolution of nuclear medicine in the evaluation of the musculoskeletal system over the past hundred years, from autoradiography and Geiger counters and rectilinear scanners to sophisticated imaging devices that provide both functional and morphological information. Initially synonymous with bone scanning, radionuclide evaluation of musculoskeletal disorders now includes gallium, labeled leukocytes, FDG, and fluourine-18, indications and applications of which are reviewed.

Behavioral medicine is based on the biopsychosocial theory that biological, psychological, and environmental factors all play significant roles in human functioning. This article reviews empirically supported and efficacious behavioral approaches to the treatment and management of migraine including cognitive behavioral therapy and biobehavioral training (ie, biofeedback, relaxation training, and stress management). These techniques have demonstrated efficacy when learned and practiced correctly and may be used individually or in conjunction with pharmacologic and other interventions. Data are also reviewed regarding patient education, support groups, psychological comorbidities, modifiable risk factors for headache progression, strategies for enhancing adherence and motivation, and strategies for effective medical communication.

Three competing models of cognitive aging (neural compensation, capacity limitations, neural inefficiency) were examined in relation to working memory for novel non-verbal material. To accomplish this goal young (n=25) and old (n=25) participants performed a delayed item recognition (DIR) task while being scanned with bold fMRI. The stimuli in the DIR task consisted of computer-generated closed-curve shapes with each shape presented only once in the testing conditions of each participant. This ensured that both the novelty and appearance of the shapes maximized visual demands and limited the extent of phonologic processing. Behaviorally, as expected, the old participants were slower and less accurate compared to the young participants. Spatial patterns of brain activation that corresponded to load-dependent (stimulus set size ranged from 1 to 3) fMRI signal during the three phases of the DIR task (memory set presentation, retention delay, probe presentation) were evaluated in both age groups. Support for neural compensation and capacity limitation was evident in retention delay and the probe phase, respectively. Data were inconsistent with the neural inefficiency model. The process specific support for the theories we examined is consistent with a large corpus of research showing that the substrates underlying the encoding, retention and probe phases are different. That is, cognitive aging theories can be specific to the neural networks/regions underlying the different phases of working memory. Delineating how these theories work in concert can increase knowledge of age-related effects on working memory.

The current study examined the relationship between cognitive function and falls in older people who did not meet criteria for dementia or mild cognitive impairment (N = 172). To address limitations of previous research, the authors controlled for the confounding effects of gait measures and other risk factors by means of associations between cognitive function and falls. A neuropsychological test battery was submitted to factor analysis, yielding 3 orthogonal factors (Verbal IQ, Speed/Executive Attention, Memory). Single and recurrent falls within the last 12 months were evaluated. The authors hypothesized that Speed/Executive Attention would be associated with falls. Additionally, the authors assessed whether associations between different cognitive functions and falls varied depending on whether single or recurrent falls were examined. Multivariate logistic regressions showed that lower scores on Speed/Executive Attention were associated with increased risk of single and recurrent falls. Lower scores on Verbal IQ were related only to increased risk of recurrent falls. Memory was not associated with either single or recurrent falls. These findings are relevant to risk assessment and prevention of falls and point to possible shared neural substrates of cognitive and motor function., ((PsycINFO Database Record (c) 2007 APA, all rights reserved).)

Complete genomes of HPV101 and HPV103 were PCR amplified and cloned from cervicovaginal cells of a 34-year-old female with cervical intraepithelial neoplasia grade 3 (CIN 3) and a 30-year-old female with a normal Pap test, respectively. HPV101 and HPV103 contain 4 early genes (E7, E1, E2, and E4) and 2 late genes (L2 and L1), but both lack the canonical E6 ORF. Pairwise alignment similarity of the L1 ORF nucleotide sequences of HPV101 and HPV103 indicated that they are at least 30% dissimilar to each other and all known PVs. However, similarities of the other ORFs (E7, E1, E2, and L2) indicated that HPV101 and HPV103 are most related to each other. Phylogenetic analyses revealed that these two types form a monophyletic clade, clustering together with the gamma- and pi-PV groups. These data demonstrated that HPV genomes closely related to papillomaviruses identified from cutaneous epithelia can be isolated from the genital mucosal region. Moreover, this is the first report of HPVs lacking an E6 ORF and phylogenetic evidence suggests this occurred subsequent to their emergence from the gamma-/pi-PVs.

Objective: To evaluate the diagnostic performance of 18F-2-deoxy-2-fluoro-D-glucose-positron emission tomography (FDG-PET) in the evaluation of breast cancer recurrence and metastases., Data Sources: Articles published in medical journals during January 1995-June 2004 were identified by a systematic Medline search, supplemented by a manual search of the references listed in original and review articles., Study Selection: Studies that evaluated FDG-PET with a dedicated camera for the diagnosis of breast cancer recurrence or metastases, and reporting sufficient data to permit calculation of sensitivity and specificity, were included in the analysis., Data Extraction: Two reviewers independently reviewed the eligibility and abstracted data regarding the sample population, technical imaging characteristics of FDG-PET, and the number of true positives, true negatives, false positives and false negatives. Differences between readers were resolved by consensus., Data Synthesis: We used meta-analytic methods to estimate the pooled sensitivity, false positive rate, and the maximum joint sensitivity and specificity. Eighteen studies met the inclusion criteria. Sixteen studies included patient-based data, comprising a sample size of 808 subjects, and eight studies included lesion-based data, totaling 1013 lesions. Among the studies with patient-based data, the median sensitivity was 92.7%, and the median specificity was 81.6%. The pooled sensitivity was 90% [95% confidence interval (86.8-93.2)], and the pooled false positive rate was 11% [95% confidence interval (7.8-14.6)], after the exclusion of outliers. The maximum joint sensitivity and specificity, was 88% [95% confidence interval (86.0-90.6)]., Conclusion: These results indicate that FDG-PET is a valuable tool for detecting breast cancer recurrence and metastases.

Functional analysis, a variation of the time study technique, was used to examine how HIV/AIDS case managers in the tri-county region of New York State spend their time-the actual tasks and activities they choose to perform relative to the total universe of activities and tasks subsumed in the general category of case management. The picture developed was of a system operating primarily in a crisis mode, spending relatively brief amounts of time completing a range of activities and providing an extensive scope of services for or on behalf of clients. The bulk of the work was client centered, not administrative, and involved providing disease management and essential services (e.g., family and mental health). The implications of these findings are discussed, with particular attention paid to the potential influence of client profiles and worker demographics.

33 adolescents were tested for signs of dissociation and somatization as these processes relate to histories of physical and sexual abuse, a characteristic of over half of patients admitted for acute psychiatric disorder. Analysis suggested that the 19 adolescents having histories of abuse were more likely to score higher on dissociation and somatization.

24 psychotic-spectrum adolescents were compared with 23 conduct-disordered adolescents on a self-other drawing differentiation task. Of the 24 psychotic-spectrum disordered adolescents, 14 received the diagnosis of Psychotic Disorder NOS (Group 1) and the remaining 10 had diagnoses of Schizophrenia, Bipolar Disorder with Psychotic Features, and Schizoaffective Disorder (Group 2). Interestingly, less impaired adolescents (Groups 1 and 3, the conduct-disordered group) showed significantly more difficulty than the more impaired adolescents (Group 2) on self-other differentiation as measured by their differentiated drawings.

Results obtained from a questionnaire regarding termination criteria in psychotherapy, revealed significant differences between the public and private sector. Additional differences were also found for: length of sessions, frequency of sessions, length of treatment, hospitalizations, medication usage, ethnicity, diagnosis, degree of perceived improvement, and degree of clinical improvement.