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Clergy as a frontline mental health service:a UK survey of medical practitioners and clergy

General Psychiatry 2020年第6期33卷 413-422页

作者： William Heseltine-Carp Mathew Hoskins School of medicine Cardiff University School of MedicineCardiffUK Cardiff University Institute of psychological medicine and clinical neurosciences CardiffUK

Background Christian clergy have often been identified as'frontline mental health workers'and gatekeepers to mental health ***,despite this,collaboration between clergy and mental health services remains poor,with some US clergy referring on as little as 10%of *** In this study,we aimed to evaluate the collaborative relationship between UK clergy and medical practitioners,with the purpose of identifying key issues that should be addressed to improve such collaboration between the two *** We surveyed 124 clergy,48 general practitioners and 13 psychiatrists in *** 1 of the survey covered four main themes:demographics;types of mental health cases seen by clergy and practitioners;referral rates between clergy and mental health services;attitude and relationship between clergy and mental health *** 2 was directed at clergy only and assessed how sensitive clergy were in identifying and referring on mental health disorders by using seven virtual case *** Clergy frequently encountered mental health cases and around 60%-80%regularly referred on to a healthcare *** appeared very effective at identifying and referring on high risk scenarios,such as psychosis,suicidal ideation and substance misuse,however were less effective at identifying and referring on clinical depression and *** rarely received referrals from medical *** medical professionals and clergy felt they needed to engage in a more collaborative relationship,and around of onethird of practitioners were prepared to offer training to *** Most clergy in Wales regularly encounter mental health cases and appear effective at recognising and referring on mental health disorders;however,a large minority do not(20%-40%).Clergy generally do not receive referrals from mental health professionals,despite the proven ***,improving collaboration,developing spiritual training for mental health prof

关键词： Wales survey service

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Understanding the pathophysiology of postpartum psychosis: Challenges and new approaches

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World Journal of Psychiatry 2017年第2期7卷 77-88页

作者： William Davies Medical Research Council Centre for Neuro-psychiatric Genetics and Genomics and division of psychological medicine and clinical neurosciences School of Medicine Cardiff University School of Psychology Cardiff University Neuroscience and Mental Health Research Institute Cardiff University

Postpartum psychosis is a severe psychiatric condition which affects 1-2 of every 1000 mothers shortly after childbirth. Whilst there is convincing evidence that the condition is precipitated by a complex combination of biological and environmental factors, as yet the pathophysiological mechanisms remain extremely poorly defined. Here, I critically review approaches that have been, or are being, employed to identify and characterise such mechanisms; I also review a recent animal model approach, and describe a novel biological risk model that it suggests. Clarification of biological risk mechanisms underlying disorder risk should permit the identification of relevant predictive biomarkers which will ensure that "at risk" subjects receive prompt clinical intervention if required.

关键词： CCN3 Immune system Steroid sulfatase Nephroblastoma-overexpressed Mouse Animal model Risk factor

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Pathophysiological significance of increased α-synuclein deposition in sympathetic nerves in Parkinson’s disease: a post-mortem observational study

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Translational Neurodegeneration 2022年第1期11卷 737-746页

作者： Risa Isonaka Patti Sullivan David S.Goldstein Autonomic medicine Section Clinical Neurosciences ProgramDivision of Intramural ResearchNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMD 20892USA

Background: Parkinson’s disease (PD) is characterized by intra-neuronal deposition of the protein α-synuclein (α-syn) and by deficiencies of the catecholamines dopamine and norepinephrine (NE) in the brain and heart. Accumulation of α-syn in sympathetic noradrenergic nerves may provide a useful PD biomarker;however, whether α-syn buildup is pathophysiological has been unclear. If it were, one would expect associations of intra-neuronal α-syn deposition with catecholaminergic denervation and with decreased NE contents in the same samples. Methods: We assayed immunoreactive α-syn and tyrosine hydroxylase (TH, a marker of catecholaminergic innerva-tion) concurrently with catecholamines in coded post-mortem scalp skin, submandibular gland (SMG), and apical left ventricular myocardial tissue samples from 14 patients with autopsy-proven PD and 12 age-matched control subjects who did not have a neurodegenerative disease. Results: The PD group had increased α-syn in sympathetic noradrenergically innervated arrector pili muscles (5.7 times control, P < 0.0001), SMG (35 times control, P = 0.0011), and myocardium (11 times control, P = 0.0011). Myocar-dial TH in the PD group was decreased by 65% compared to the control group (P = 0.0008), whereas the groups did not differ in TH in either arrector pili muscles or SMG. Similarly, myocardial NE was decreased by 92% in the PD group (P < 0.0001), but the groups did not differ in NE in either scalp skin or SMG. Conclusions: PD entails increased α-syn in skin, SMG, and myocardial tissues. In skin and SMG, augmented α-syn deposition in sympathetic nerves does not seem to be pathogenic. The pathophysiological significance of intra-neuronal α-syn deposition appears to be organ-selective and prominent in the heart.

关键词： Synuclein Tyrosine hydroxylase Norepinephrine Immunofluorescence Parkinson Post-mortem

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How random is the random forest ? Random forest algorithm on the service of structural imaging biomarkers for Alzheimer's disease: from Alzheimer's disease neuroimaging initiative(ADNI) database

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Neural Regeneration Research 2018年第6期13卷 962-970页

作者： Stavros I.Dimitriadis Dimitris Liparas division of psychological medicine and clinical neurosciences School of Medicine Cardiff University Cardiff University Brain Research Imaging Centre School of Psychology Cardiff University School of Psychology Cardiff University Neuroinformatics Group Cardiff University Brain Research Imaging Centre School of Psychology Cardiff University Neuroscience and Mental Health Research Institute Cardiff University MRC Centre for Neuropsychiatric Genetics and Genomics School of Medicine Cardiff University High Performance Computing Center Stuttgart (HLRS) University of Stuttgart Department of Informatics Aristotle University of Thessaloniki

Neuroinformatics is a fascinating research field that applies computational models and analytical tools to high dimensional experimental neuroscience data for a better understanding of how the brain functions or dysfunctions in brain diseases. Neuroinformaticians work in the intersection of neuroscience and informatics supporting the integration of various sub-disciplines（behavioural neuroscience, genetics, cognitive psychology, etc.） working on brain research. Neuroinformaticians are the pathway of information exchange between informaticians and clinicians for a better understanding of the outcome of computational models and the clinical interpretation of the analysis. Machine learning is one of the most significant computational developments in the last decade giving tools to neuroinformaticians and finally to radiologists and clinicians for an automatic and early diagnosis-prognosis of a brain disease. Random forest（RF） algorithm has been successfully applied to high-dimensional neuroimaging data for feature reduction and also has been applied to classify the clinical label of a subject using single or multi-modal neuroimaging datasets. Our aim was to review the studies where RF was applied to correctly predict the Alzheimer＇s disease（AD）, the conversion from mild cognitive impairment（MCI） and its robustness to overfitting, outliers and handling of non-linear data. Finally, we described our RF-based model that gave us the 1 ^（st） position in an international challenge for automated prediction of MCI from MRI data.

关键词： random forest Alzheimer's disease mild cognitive impairment neuroimaging classification machine learning biomarker magnetic resonance imaging

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Altered thermal sensitivity in facial skin in chronic whiplash-associated disorders

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International Journal of Oral Science 2013年第3期5卷 150-154页

作者： Birgitta Hggman-Henrikson Ewa Lampa Erik Nordh Department of Odontology Clinical Oral Physiology Umea University Department of Pharmacology and clinical neurosciences Division of Clinical Neurophysiology Ume University

There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash *** of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such *** present study investigated facial thermal thresholds in patients with chronic whiplash-associated disorders（WADs）with both a qualitative method and quantitative sensory testing（QST）.Ten women with pain and dysfunction following a whiplash injury were compared to 10 healthy age-matched *** detection thresholds were assessed by qualitative chair-side testing and by QST according to the *** test sites in the facial skin（overlying each trigeminal branch bilaterally,and the midpoint of the chin）were *** detection warm and cold thresholds were defined as the mean values of 10 individual *** the WAD patients,the qualitative assessment demonstrated both reduced and increased sensitivity compared to the healthy,whereas QST systematically showed significantly higher detection thresholds（i.e.,decreased sensitivity）for both cold and warm *** the individuals who were assessed as having increased sensitivity in the qualitative assessment,the QST displayed either normal or higher thresholds,i.e.,decreased *** results suggest that QST is more sensitive for detecting thermal sensory disturbances in the face than a qualitative *** impaired thermal sensitivity among the patients corroborates the notion of altered thermal detection capacity induced by WAD-related pain.

关键词： jaw neck quantitative sensory testing thermal thresholds trigeminal whiplash injury

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Outcomes of Medicare beneficiaries hospitalised with transient ischaemic attack and stratification using the ABCD^(2) score

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Stroke & Vascular Neurology 2021年第2期6卷 314-318页

作者： Shreyansh Shah Li Liang Durgesh Bhandary Saga Johansson Eric E Smith Deepak L Bhatt Gregg C Fonarow Naeem D Khan Eric Peterson Janet Prvu Bettger Department of Neurology Duke University School of MedicineDurhamNorth CarolinaUSA Duke clinical Research Institute DurhamNorth CarolinaUSA AstraZeneca UK Ltd CambridgeUK Hotchkiss Brain Institute and Department of clinical neurosciences University of CalgaryCalgaryAlbertaCanada division of Cardiology Brigham and Women's HospitalBostonMassachusettsUSA division of Cardiology Ronald Reagan UCLA Medical CenterLos AngelesCaliforniaUSA

Background Long-term outcomes for Medicare beneficiaries hospitalised with transient ischaemic attack(TIA)and role of ABCD^(2) score in identifying high-risk individuals are not *** We identified 40825 Medicare beneficiaries hospitalised from 2011 to 2014 for a TIA to a Get With The Guidelines(GWTG)-Stroke hospital and classified them using ABCD^(2)s of mortality and rehospitalisation(all-cause,ischaemic stroke,haemorrhagic stroke,myocardial infarction,and gastrointestinal and intracranial haemorrhage)for high-risk versus low-risk groups adjusted for patient and hospital *** Of the 40825 patients,35118(86%)were high risk(ABCD^(2)≥4)and 5707(14%)were low risk(ABCD^(2)=0-3).Overall rate of mortality during 1-year follow-up after hospital discharge for the index TIA was 11.7%,44.3% were rehospitalised for any reason and 3.6%were readmitted due to *** with ABCD^(2) score≥4 had higher mortality at 1 year than not(adjusted HR 1.18,95%CI 1.07 to 1.30).Adjusted risks for ischaemic stroke,all-cause readmission and mortality/all-cause readmission at 1 year were also significantly higher for patients with ABCD^(2) score≥4 vs *** contrast,haemorrhagic stroke,myocardial infarction,gastrointestinal bleeding and intracranial haemorrhage risk were not significantly different by ABCD^(2) *** This study validates the use of ABCD^(2) score for long-term risk assessment after TIA in patients aged 65 years and *** efforts for community-based follow-up care after TIA are needed for ongoing prevention in Medicare beneficiaries who were hospitalised for TIA.

关键词： admitted score prevention

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Associations of cerebrospinal fluid amyloidogenic nanoplaques with cytokines in Alzheimer’s disease

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Translational Neurodegeneration 2021年第2期10卷 230-239页

作者： Mari Aksnes Hans Christian DAass Ann Tiiman Trine Holt Edwin Lars Terenius Nenad Bogdanovic Vladana Vukojevic Anne-Brita Knapskog Department of Geriatric medicine Institute of Clinical MedicineFaculty of MedicineUniversity of OsloOsloNorway Department of Medical Biochemistry Oslo University HospitalOsloNorway Department of clinical neurosciences(CNS) Center for Molecular Medicine CMM L8:01Karolinska InstitutetStockholmSweden Department of Geriatric medicine The Memory ClinicOslo University HospitalOsloNorway Institute of Health and Society Faculty of MedicineUniversity of OsloOsloNorway Norwegian National Advisory Unit on Ageing and Health Vestfold Hospital TrustTonsbergNorway Department of Neurobiology Care Science and Society(NVS)Division of Clinical GeriatricsKarolinska InstitutetHuddingeSweden

Background:The aggregation of amyloidβ(Aβ)is central in the pathogenesis of Alzheimer’s disease(AD).Recently it has been shown that specifically,larger,Thioflavin T-binding Aβaggregates are associated with increased neuroinflammation and cytokine *** study was aimed to quantify fibrillary amyloid aggregates,so-called nanoplaques,and investigate their relationship with cytokines in the cerebrospinal fluid(CSF).Methods:CSF was collected from 111 patients assessed for cognitive complaints at the Oslo University Hospital Memory *** patients were grouped based on their amyloid *** CSF nanoplaque concentration was quantified with the Thioflavin T-fluorescence correlation spectroscopy(ThT-FCS)*** levels of nine cytokines(eotaxin-1,granulocyte stimulating factor,interleukin[IL]-6,IL-7,IL-8,monocyte chemoattractant protein-1,gammainduced protein 10,macrophage inflammatory protein[MIP]-1α,and MIP-1β)were quantified with a magnetic bead-based multiplex assay and read on a Luminex IS 200 ***:There were 49 amyloid-negative and 62 amyloid-positive patients in the cohort;none of the cytokines differed significantly between the amyloid *** increased nanoplaque levels were associated with levels of MIP-1βbelow the lower limit of quantification,and with decreased levels of MIP-1αand *** associations remained significant when adjusted for age,sex,cognitive function,apolipoproteinε4 status and CSF core biomarker ***:The cytokine levels were not associated with amyloid status in this *** nanoplaque levels were negatively associated with MIP-1β,MIP-1αand IL-8,which is in line with recent findings suggesting that the upregulation of some cytokine markers has a protective role and is negatively associated with AD progression.

关键词： Alzheimer's disease Amyloid Amyloid beta peptides Amyloidogenic proteins Biomarkers Cerebrospinal fluid Cytokines Inflammation Fluorescence correlation spectroscopy Thioflavin T

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Diffusion tractography of kidney by high angular resolution diffusion imaging

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Magnetic Resonance Letters 2024年第4期4卷 25-33页

作者： Surendra Maharjan Jie Chen Adrienne Gaughan Neal XChen Nian Wang Department of Radiology and Imaging Sciences Indiana UniversityIndianapolisIN 46202USA division of clinical Transitional Research Institute IndianapolisIN 46202USA division of Nephrology Department of MedicineIndiana UniversityIndianapolisIN 46202USA Stark neurosciences Research Institute Indiana UniversityIndianapolisIN 46202USA Indiana Center for Musculoskeletal Health Indiana UniversityIndianapolisIN 46202USA

Diffusion magnetic resonance imaging(MRI) has been utilized to probe the renal microstructures but investigating the three-dimensional(3D) tubular network still presents significant challenges due to the complicated architecture of kidney. This study aims to assess whether high angular resolution diffusion imaging(HARDI) could improve the reconstruction of 3D tubular architectures. Kidneys from both mice and rats were imaged using 3D diffusion-weighted pulse sequences at 9.4 T. Five healthy mouse kidneys were scanned at an isotropic spatial resolution of 40 μm, with a b value of 1500 s/mm2across 46 diffusion encoding directions. The study employed diffusion tensor imaging(DTI) and generalized Q-sampling imaging(GQI) to examine the tubular orientation distributions and tractography, validated by conventional histology. Fractional anisotropy(FA) and mean diffusivity(MD) were quantified and compared among the inner medullar(IM), outer medullar(OM), and cortex(CO) at different angular resolutions. FA values, estimated with 6 diffusion-weighted images(DWIs), were significantly overestimated by 49.9%(p < 0.001) in IM, 179.4%(p < 0.001) in OM, and 225.5%(p < 0.001) in CO, compared to using 46 DWIs. In contrast, MD exhibited less variations to angular resolution variations(3.4% in IM, 4.2% in OM, and 4.6% in CO). Both DTI and GQI at high angular resolution successfully traced renal tubular structures throughout the kidney, with GQI demonstrating superior performance in generating more continuous tracts. Furthermore, disrupted renal tubule structures were observed in a chronic kidney disease(CKD) rat model. HARDI, especially when combined with the GQI approach, holds promise in tracking complicated 3D tubule architectures and may serve as a potent tool for kidney disease research.

关键词： DTI Kidney Tractography HARDI MRI GQI CKD

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Towards a comprehensive understanding of p75 neurotrophin receptor functions and interactions in the brain

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Neural Regeneration Research 2022年第4期17卷 701-704页

作者： Joel F.Ritala Seán BLyne Antti Sajanti Romuald Girard Janne Koskimäki division of clinical neurosciences Department of NeurosurgeryTurku University Hospital and University of TurkuTurkuFinland Neurovascular Surgery Program Section of NeurosurgeryThe University of Chicago Medicine and Biological SciencesChicagoILUSA Department of Psychiatry Central Hospital of Southern OstrobothniaSeinäjokiFinland Neuroscience Center HiLIFEUniversity of HelsinkiHelsinkiFinland

The role of neurotrophins in neuronal plasticity has recently become a strong focus in neuroregeneration research field to elucidate the biological mechanisms by which these molecules modulate synapses,modify the response to injury,and alter the adaptation ***,the prior studies highlight the role of p75 neurotrophin receptor(p75^(NTR))in various injuries and diseases such as central nervous system injuries,Alzheimer's disease and amyotrophic lateral *** comprehensive elucidation of the mechanisms,and therapies targeting these molecular signaling networks may allow for neuronal tissue regeneration following an *** to a diverse role of the p75^(NTR)in biology,the body of evidence comprising its biological role is diffusely spread out over numerous *** review condenses the main evidence of p75^(NTR)for clinical applications and presents new findings from published literature how data mining approach combined with bioinformatic analyses can be utilized to gain new hypotheses in a molecular and network level.

关键词： bioinformatics brain injury data mining neuron neurotrophins p75^(NTR) plasticity regeneration

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Symposia Report Immunoglobulin G for the Treatment of Chronic Pain：Report of an Expert Workshop

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中国疼痛医学杂志 2014年第11期20卷 769-777页

作者： Stefano Tamburin Kristian Borg Xavier J. Caro Stefano Jann Alexander J. Clark Francesca Magrinelli Gen Sobue Lars Werhagen Giampietro Zanette Haruki Koike Peter J. Spath Angela Vincent Andreas Goebel Department of Neurological and Movement Sciences University of Verona Verona Department of neurosciences Hospital Niguarda Ca Granda Milan Section of Neurology Pederzoli Hospital Peschiera del Garda Verona Italy division of Rehabilitation medicine Department of Clinical Sciences Karolinska Institute at Danderyds Hospital Stockholm Sweden division of Rheumatology David Geffen School of Medicine at UCLA Los Angeles California USA Department of Neurology Nagoya University Graduate School of Medicine Nagoya Japan Department of Anesthesia Pain Management and Perioperative Medicine Dalhousie University Halifax Nova Scotia Canada Institute of pharmacology University of Bern Bern Switzerland Nuffield Department of clinical neurosciences University of Oxford Oxford Pain Research Institute University of Liverpool Clinical Sciences Building University Hospital Aintree Liverpool UK

背景:慢性疼痛的治疗效果仍不理想。尽管现在治疗慢性疼痛的药物种类较多,但许多患者对疗效仍不满意或诉药物的副作用太大。越来越多的证据表明,免疫系统参与了伤害性和神经病理性慢性疼痛的病理过程。设计:在英国利物浦的专题会议上,... 详细信息

背景:慢性疼痛的治疗效果仍不理想。尽管现在治疗慢性疼痛的药物种类较多,但许多患者对疗效仍不满意或诉药物的副作用太大。越来越多的证据表明,免疫系统参与了伤害性和神经病理性慢性疼痛的病理过程。设计:在英国利物浦的专题会议上,专家们出示了免疫系统参与慢性疼痛的证据。近来的研究表明,静脉(IVIg)或皮下(SCIg)注射免疫调节药物——多价免疫球蛋白(Ig G)可缓解外周神经病理性疼痛和其他疼痛性疾病。专题会议讨论了IVIg和SCIg治疗的适应证、效价比及其副作用。结果:Ig G可缓解某些伤害性和神经病理性慢性疼痛,如糖尿病、干燥综合征、纤维肌痛症、复杂性区域疼痛综合征、小儿麻痹后遗症和继发于病理性自身抗体的疼痛。结论:Ig G对某些慢性疼痛具有一定的治疗前景。Ig G是一种相对安全的治疗方法,副作用少而轻,但价格较贵。今后有必要对Ig G治疗顽固性疼痛进行随机对照研究和预测性临床试验。

关键词：慢性疼痛患者临床治疗副作用后遗症

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