Development and characterisation of mgTHP-1, a novel in vitro model for neural macrophages with microglial characteristics

Neuroinflammation is primarily characterised by activation of the brain's resident macrophages - the microglia. However, other central nervous system (CNS) cells also contribute to this response, including the astrocytes and endothelial cells. In addition, there is infiltration into the CNS of peripherally derived immune cells. Together these cells mediate inflammation by the production of cytokines, chemokines, reactive oxygen species, and secondary messengers, and enacting of the appropriate response to those signals. However, deciphering the specific contributions of each cell type has been challenging. Studying CNS cell biology is often challenging, as the isolation of primary cells is not always feasible, and differentiation towards microglia-like cells is complex. Here, we demonstrate a novel method whereby THP-1 monocytic cells are differentiated into neural macrophage cells with microglia-like cell characteristics. The cells, designated mgTHP-1, show typical morphological and gene expression patterns of resident CNS macrophages and functionally respond to inflammatory stimuli by producing inflammatory cytokines. Furthermore, with the addition of Vicenin-2 (an anti-inflammatory flavonoid) such responses can be reversed. This novel cell model will allow further investigations, and hence insights, into the neuroinflammatory mechanisms associated with CNS diseases.

First Measurement of the Nuclear-Recoil Ionization Yield in Silicon at 100 eV

We measured the nuclear-recoil ionization yield in silicon with a cryogenic phonon-sensitive gram-scale detector. Neutrons from a monoenergetic beam scatter off of the silicon nuclei at angles corresponding to energy depositions from 4 keV down to 100 eV, the lowest energy probed so far. The results show no sign of an ionization production threshold above 100 eV. These results call for further investigation of the ionization yield theory and a comprehensive determination of the detector response function at energies below the keV scale.

“I rather talk on the phone”: Factors affecting compliance with outpatient visits during COVID-19 Pandemic

Introduction

The COVID-19 pandemic presented a global public-health crisis that demanded healthcare to adapt at an unprecedented pace. While challenging, it also created opportunities for the advancement of novel electronic-treatment-modalities. Telepsychiatry has emerged as an effective method to ensure continuity of care and ensure social distancing.1 Studies indicate that mental-health patients have higher rates of noncompliance to follow-up, 1 thus finding means to increase compliance is critical.

Objectives

The objectives of this study are to determine the impact of telepsychiatry on compliance to follow-up and to identify numbers of psychiatric/medical emergency-room visits, most common contributing factors for admission, and compliance in terms of diagnosis.

Methods

This IRB approved study is a retrospective chart-review, that aims to study children/adolescents (5-18 years) who presented to the Child&Adolescent-Psychiatry Outpatient-clinic from July-December 2020 and engaged in telepsychiatry, compared to a group of patients presented in July-December 2019-Pre-Covid19-Pandemic. A review of clinical characteristics including diagnosis, demographic information, medication, and treatment compliance will be compared as well as admissions to inpatient-psychiatry/emergency-room visits.

Results

Our total sample (N=252) included patients from 2019-Pre-COVID19 (N=111) and 2020 Telehealth during COVID19-Pandemic (N=141). Our data analysis using SPSF and T-test has shown that Telehealth has significantly increased follow-up compliance (Two-tailed P-value=0.04); 2019-Pre-COVID outreach mean=0.06, 2020-Telehealth-during COVID outreach mean=0.02); significantly decreased ER/CPEP visits (P-value=0.02), and decreased In-patient-unit admissions (P-value=0.02).

Conclusions

According to the presented study, the incorporation of telepsychiatry has increased the compliance to psychiatric-care in outpatient and decreased the emergency-room visits and inpatient admission. Sufficient resources and steps need to be taken to further strengthen telehealth services.

Disclosure

No significant relationships.

Improving quality of life with nutritional supplementation in Schizophrenia: A literature review

Introduction

Schizophrenia is a chronic and severe mental health disorder, affecting 20 million people worldwide. Diet is a social determinant of health and is among one of the modifiable prognostic factors for schizophrenics. Previous research in nutritional psychiatry has shown that a balanced and healthy diet in this patient population has the potential to improve cognition, decrease positive and negative symptoms of the disease, and improve the overall metabolic profile.1,3

Objectives

To understand the evidence on the role that nutritional supplements play in improving quality of life in Schizophrenia by improving cognitive symptoms and decrease mortality by decreasing chances of metabolic syndrome and CVD. Demonstrate how certain supplements can improve cognitive symptoms, and decrease positive and negative symptoms in schizophrenics

Methods

PubMed was used to search for articles within the past 10 years

Results

A total of 29 articles were initially generated, of which only 5 fit the search criteria. Each specific search produced more articles, and after carefully reading each, a total of 14 articles was determined to fit the criteria. All, but two articles included PANSS score assessment. The studies on vitamin D, cycloserine and omega 3’s produced conflicting

Conclusions

Supplementation of vitamin D, Konjac powder, D-cycloserine, sarcosine, and omega 3’s have the potential to improve symptomatology and enhance the quality of life of schizophrenics. D-serine and sodium benzoate have not been shown to be effective adjunctive treatments in schizophrenia. Due to a limited number of studies for each, more research is indicated to truly determine the public health significance.

Disclosure

No significant relationships.

Effect of risperidone on the cravings of patients with methamphetamine use disorder

Introduction

Methamphetamine associated psychosis has increased globally because of the increased usage of the substance. The use of risperidone is noted to reduce the cravings of methamphetamine in patients who have methamphetamine use disorder. This becomes relevant because the number of patients who are being treated with MAP tends to have high relapse rates. MAP is being treated with different antipsychotics and the treatment protocol is made usually for alleviating the symptoms, a formal treatment regimen for patients with MAP is yet to be developed (Chiang et al 2018; Srisurapanont 2021; Edwards and Mooney 2014)

Objectives

The purpose of this review is to highlight the use of risperidone in reducing the cravings of methamphetamine in patients who have methamphetamine use disorder

Methods

PubMed, SCOPUS and Web of Science literature databases were screened and filtered.With established Inclusion and exclusion criteria, obtained a total of 15578 hits which was refined to 133articles. A total of 10papers were reviewed in detail

Results

Multiple clinical trials have shown that risperidone was effective in lowering drug cravings in methamphetamine use disorder. Along with the effects on craving, risperidone has also been studied for its effect on positive symptoms in patients with MAP (Samei 2016). Risperidone was noted to be effective in reducing positive symptoms.

Conclusions

Risperidone can be effectively used in the acute setting for psychosis and future cravings in the patients. Considering the limited clinical trials and research on risperidone and the cravings of methamphetamine use disorder, studies are needed with longer follow-ups and more samples in the future.

Disclosure

No significant relationships.

Tolerability of Ziprasidone Use in Children and Adolescents: A Prisma Model: Systematic Review and Meta-Analysis

Introduction

Studies have demonstrated that Ziprasidone use may be beneficial in children. Determining its potential risks and benefits when used in children is therefore important.

Objectives

To examine the tolerability of Ziprasidone, an atypical antipsychotic, in children and adolescents.

Methods

We conducted a literature search of open label or randomized control trials that report on Ziprasidone use in children on three databases: Embase, PsychInfo and PubMed using the PRISMA guidelines of Systematic review and Meta-analysis. Out of 1690 articles, 11 studies met inclusion criteria. Outcome measures included adverse effects such as weight gain, increase in BMI, QTc prolongation, changes in metabolic parameters, sedation, and dizziness. We conducted a random effects meta-analysis and meta-regression of potential moderators. Publication bias was assessed with funnel plots.

Results

Data from Eleven studies was meta-analyzed (Total n= 474, mean age=12.87 years, male= 68..37%) that reported the use of Ziprasidone in children and adolescents with Psychosis, Bipolar, Autism spectrum disorders and Tourettes syndrome. Mean Ziprasidone dose = 84.40 mg and mean study duration = 2.85 months). We found that Ziprasidone was not found to cause any significant weight gain (1.72, p>0.05) or change in BMI (0.58 , p>0.05). QTc prolongation was found to be significant (11.9 , p<0.05). Most common side effects were sedation (42.44%), Nausea(19.32%), Headache (22.92%), fatigue (16.67%) and Dizziness (16.96 %).

Conclusions

Results demonstrate that Ziprasidone does not cause significant weight gain, however QTc prolongation and sedation were found to be significant side effects of Ziprasidone use. Therefore, baseline EKG and thorough history must be obtained before prescribing Ziprasidone in children and adolescents.

Disclosure

No significant relationships.

Olanzapine and its use for methamphetamine-induced psychosis

Introduction

Over time the prevalence of methamphetamine associated psychosis (MAP) has increased globally including Asia and Europe. Shoptaw et al looked at an RCT and concluded that olanzapine is superior to haloperidol in terms of tolerability and the side effect profile as it causes fewer extrapyramidal symptoms. Another study by Xue et al compared the efficacy of olanzapine and haloperidol and found that they had comparable effects but the onset time in the olanzapine group was significantly earlier than the haloperidol group. Srisurapanont et al analyzed 6 RCTs and concluded that quetiapine and olanzapine are probably superior than aripiprazole and risperidone.

Objectives

The purpose of this review is to find out if olanzapine is better than other antipsychotics in treating methamphetamine-induced psychosis.

Methods

PubMed, SCOPUS, and Web of Science literature databases were screened and filtered by using specific search terms, inclusion/exclusion criteria. Texts of the selected articles and trials were reviewed and the search terms generated a total of 248 results from the databases. After applying the criteria 200 citations were left and 15 papers were reviewed.

Results

The literature review concluded that olanzapine can be used as an effective treatment for methamphetamine-induced psychosis. Olanzapine can help to reduce the psychotic symptoms in MAP with a quicker onset and lesser side effects.

Conclusions

Olanzapine can help in the treatment of methamphetamine-associated psychosis and can be considered as the first-line therapy. Research is further needed with a higher pool of candidates in the future to compare the efficacy and tolerability of different typical and atypical antipsychotics.

Disclosure

No significant relationships.

Effect of different dietary fiber-rich extenders on the quality attributes of functional restructured buffalo meat fillets

Background

The ever-increasing market of functional meat products demanded especially by modern health conscious consumers has prompted researchers to develop healthier meat products.

Aims

This experiment was conducted to improve the dietary fiber-deficient buffalo meat with natural functional fiber-rich extenders.

Methods

Meat obtained from the carcass of adult female buffalo (>10 years of age) was procured from the local market within 5-6 h of slaughter, conditioned for 24 h, and then processed by incorporating the dietary fiber-rich extenders at their optimum levels viz. 12% barley flour, 12% maize flour, 10% pea hull powder, and 8% wheat bran (hydrated as 1:1, w/w) for the development of functional restructured buffalo meat fillets (FRBMF).

Results

Results revealed higher cooking yield, pH, moisture content, lower protein, and fat percentage for most of the treated samples compared with the control group. The ash percentage of FRBMF prepared with the optimum level of pea hull powder and wheat bran was significantly higher (P<0.05) than in control and other treatments. Shear force values for FRBMF were lower than the control. Total dietary fiber (TDF) percentage of all the treatment products was significantly higher (P<0.05) than the control. Texture profile analysis revealed no significant differences (P>0.05) between FRBMF and the control. The sensory scores for most of the attributes of FRBMF incorporated with the optimum level of extenders were lower but comparable to the control.

Conclusion

It was concluded that the functionality of the product had improved, especially in terms of total dietary fiber, as compared to the control. Pea hull powder and wheat bran proved to be excellent sources of dietary fibers, followed by barley and maize flours, respectively.

Supplementing rabbit diets with butylated hydroxyanisole affects oxidative stress, growth performance, and meat quality

Butylated hydroxyanisole (BHA) is a synthetic antioxidant analogous of vitamin E. It is used as a preservative to prevent free radical-mediated oxidation in high-fat foods, and this study's objective was to investigate the effects of BHA on oxidative stress and apoptosis in addition to delineating its efficacy as a growth-promoting feed additive. 60 weaned male rabbits (V-line) were randomly divided into four equal groups: BHA0.0 (control), BHA50, BHA100, and BHA150, administered basal diets with 0.0, 50, 100, and 150 mg BHA/kg of feed for 60 days. Animals were examined for growth performance, markers of oxidative stress and apoptosis, and meat characteristics. Compared to the control group, rabbits receiving BHA-supplemented diets exhibited increases in BW and average daily gain (P < 0.01), where BHA50 and BHA100 groups showed increased muscle content of methionine aspartic acid, serine, and glutamine (P < 0.05). These two groups also exhibited elevated catalase and superoxide dismutase activities and diminished malondialdehyde levels in the liver. Butylated hydroxyanisole upregulated fatty acid synthase gene (FASN), especially in BHA100 animals. Bcl-2-associated X/B-celllymphoma-2 (Bax/Bcl-2) ratio significantly increased in animals receiving higher doses of BHA, and the weight of the liver significantly increased following BHA treatment. Supplementing growing rabbits with lower doses of dietary BHA may promote growth performance and meat quality via maintaining the redox balance. Hence, the 50-100 mg/kg may be recommended as a safe and still effective feed additive as well as an oxidative stress attenuator.

OP0074 A FRAMEWORK OF POTENTIAL INTERVENTIONS TO ACCELERATE GENDER-EQUITABLE CAREER ADVANCEMENT IN ACADEMIC RHEUMATOLOGY

Background:

A growing number of professional societies in clinical and medically related disciplines investigate evidence, make recommendations, and take action to advance gender equity. Evidence on women’s advancement and leadership in the context of the European Alliance of Associations for Rheumatology, EULAR, is limited [1].

Objectives:

The objective of the EULAR Task Force on Gender Equity in Academic Rheumatology was to establish the extent of the unmet need for support of female rheumatologists, health professionals and non-clinical scientists in academic rheumatology and develop a framework to address this through EULAR and Emerging EULAR Network (EMEUNET).

Methods:

Potential interventions to accelerate gender-equitable career advancement in academic rheumatology were gathered from a narrative review of the relevant literature, expert opinion of a multi-disciplinary Task Force (comprised of 23 members from 11 countries), data from the surveys of EULAR scientific member society leaders, EULAR and EMEUNET members, and EULAR Executive Committee members. These interventions were rated by Task Force members, who ranked each according to perceived priority on a five-point numeric scale from 1 = very low to 5 = very high.

Results:

A framework of 29 potential interventions was formulated, which covers six thematic areas, namely, EULAR policies, advocacy and communication, EULAR Congress and associated symposia, training courses, mentoring/peer support, and EULAR funding (Figure 1).

Figure 1.

A framework of potential interventions with the levels of priority, mean and standard deviation (SD)

Conclusion:

The framework provides structured interventions for accelerating gender-equitable career advancement in academic rheumatology.

References:

[1]Andreoli L, Ovseiko PV, Hassan N, et al. Gender equity in clinical practice, research and training: Where do we stand in rheumatology? Joint Bone Spine 2019;86(6):669-72.

Acknowledgements:

The task force is grateful to EULAR for funding this activity under project number EPI 024.

Disclosure of Interests:

None declared

Prevalence and Pattern of Musculoskeletal Injuries Among Malaysian Hockey League Players

Introduction

Hockey is a team sport that involves running, sprinting, and making sudden changes in directions of movement to control a ball against the opposing team. Therefore, due to its nature of fast movement, hockey players may be at risk of various musculoskeletal injuries. This study aimed to identify the prevalence and pattern of musculoskeletal injuries sustained among Malaysian Hockey League players.

Materials and Method

Data were collected from 84 field hockey players that participated in the Malaysian Hockey League competition from June 2016 until December 2016. All injuries were recorded by the participating medical team using a structured questionnaire. A descriptive statistical analysis and Chi-Square test were used to explore the prevalence of the injury.

Result

More than half of the players were reported to have lower limb injuries (51.6%). Sprain and strain were the most prevalent injuries (63%) and mostly affected the ankle (29%). Male players sustained more injuries (50.8%) compared to female players (49.2%).

Conclusion

This study suggests that a guideline is needed for injury prevention strategies that will benefit the hockey players in preventing injuries.

Predicting infection and sepsis; what predictors have been used to train machine learning algorithms? A systematic review

Introduction

Sepsis is a life-threatening condition that is associated with increased mortality. Artificial intelligence tools can inform clinical decision making by flagging patients who may be at risk of developing infection and subsequent sepsis and assist clinicians with their care management.

Aim

To identify the optimal set of predictors used to train machine learning algorithms to predict the likelihood of an infection and subsequent sepsis and inform clinical decision making.

Methods

This systematic review was registered in PROSPERO database (CRD42020158685). We searched 3 large databases: Medline, Cumulative Index of Nursing and Allied Health Literature, and Embase, using appropriate search terms. We included quantitative primary research studies that focused on sepsis prediction associated with bacterial infection in adult population (&gt;18 years) in all care settings, which included data on predictors to develop machine learning algorithms. The timeframe of the search was 1st January 2000 till the 25th November 2019. Data extraction was performed using a data extraction sheet, and a narrative synthesis of eligible studies was undertaken. Narrative analysis was used to arrange the data into key areas, and compare and contrast between the content of included studies. Quality assessment was performed using Newcastle-Ottawa Quality Assessment scale, which was used to evaluate the quality of non-randomized studies. Bias was not assessed due to the non-randomised nature of the included studies.

Results

Fifteen articles met our inclusion criteria (Figure 1). We identified 194 predictors that were used to train machine learning algorithms to predict infection and subsequent sepsis, with 13 predictors used on average across all included studies. The most significant predictors included age, gender, smoking, alcohol intake, heart rate, blood pressure, lactate level, cardiovascular disease, endocrine disease, cancer, chronic kidney disease (eGFR&lt;60ml/min), white blood cell count, liver dysfunction, surgical approach (open or minimally invasive), and pre-operative haematocrit &lt; 30%. These predictors were used for the development of all the algorithms in the fifteen articles. All included studies used artificial intelligence techniques to predict the likelihood of sepsis, with average sensitivity 77.5±19.27, and average specificity 69.45±21.25.

Conclusion

The type of predictors used were found to influence the predictive power and predictive timeframe of the developed machine learning algorithm. Two strengths of our review were that we included studies published since the first definition of sepsis was published in 2001, and identified factors that can improve the predictive ability of algorithms. However, we note that the included studies had some limitations, with three studies not validating the models that they developed, and many tools limited by either their reduced specificity or sensitivity or both. This work has important implications for practice, as predicting the likelihood of sepsis can help inform the management of patients and concentrate finite resources to those patients who are most at risk. Producing a set of predictors can also guide future studies in developing more sensitive and specific algorithms with increased predictive time window to allow for preventive clinical measures.

A survey of the knowledge and attitudes of Egyptian healthcare professionals towards the application of Health Information Technology to optimize antibiotic therapy

Introduction

Antimicrobial resistance is a global health problem, especially in developing countries. Antimicrobial Stewardship Programmes (AMS) have been shown to be effective at reducing antimicrobial resistance and hospital patient stays. Health information technology (HIT) can support Outpatient Parenteral Antimicrobial Therapy (OPAT) through more accurate diagnosis and management of infectious diseases.

Aim

To evaluate the knowledge and attitude of Egyptian healthcare professionals towards the application of HIT to optimize OPAT.

Methods

Healthcare professionals who worked in either private or public sectors of Egyptian healthcare system were emailed and asked if they would be willing to complete an electronic questionnaire (using google forms). One reminder was sent by email each week for two weeks (two in total) from the first invitation. The survey was laid out in four sections. The first section included specific details about the healthcare professional’s current employment and role, the second related to HIT services available in their organisations, the third covered their training in HIT and antimicrobial stewardship programmes, and the fourth included their use of HIT to optimize OPAT. Ethical approval was obtained from National Heart Institute, Egypt. Descriptive analysis was carried out for all the variables. One-way ANOVA testing at level of significance P-value &lt;0.05, was used to compare numerical variables. SPSS version 26 was used for statistical analysis.

Results

Three hundred and eighty-five healthcare professionals were invited to respond to the questionnaire. (The response rate was 75.34% (290)). Of these, 152 (52.6%) were pharmacists, 134 (46.4%) physicians, and 3 (1%) nurses, and many participants (30.8%) had between 6 to 10 years of experience working in either outpatient or in-patient units. Only 15.2% of respondents mentioned that they have access to OPAT in their organizations, 51.2% did not have the service, while 33.6% responded that they did not know if the service was available. However, 27.3% had a training on ASP and 18.3% had a training on HIT. Mean scores for both knowledge (14.31±5.49) and attitude (14.67±2.53) were significantly higher in professionals who had received training in HIT (p = 0.003 & 0.006 respectively). However, scores for attitude were better than scores for knowledge.

Conclusions

In developing countries, HIT applications in OPAT are still in their infancy with only a few organisations adopting them. Egyptian healthcare professionals showed positive attitudes towards HIT use, especially when their knowledge was improved through training. Two strengths of this study include our high response rate and the wide breadth of different healthcare professionals who responded from both private and public healthcare settings. However, being a questionnaire, some questions were left unanswered and some respondents may not have been aware of their reasons for a particular answer. That said, this study has important implications for practice, with more awareness amongst healthcare professionals required on the availability of HIT services in their hospitals and how further training may be needed on the applications of HIT in optimizing OPAT.