The International Mood Network (IMN) Nosology Project: differentiating borderline personality from bipolar illness

OBJECTIVE

The differential diagnosis of bipolar illness vs. borderline personality is controversial. Both conditions manifest impulsive behavior, unstable interpersonal relationships, and mood symptoms. This study examines whether and which mood clinical features can differentiate between both conditions.

METHOD

A total of 260 patients (mean ± standard deviation age 41 ± 13 years, 68% female) attending to a mood clinic were examined for diagnosis of bipolar illness and borderline personality disorder using SCID-I, SCID-II, and clinical mood criteria extracted from Mood Disorder Questionnaire (MDQ). They were analyzed using diagnoses as dependent variables. Predictors of bipolar and borderline diagnoses were identified by multivariable logistic regressions, and predictive validity of models was assessed using ROC curve analysis.

RESULTS

Bipolar illness was strongly predicted by elevated mood (OR = 4.02, 95% CI: 1.80-9.15), increased goal-directed activities (OR = 3.90, 95% CI: 1.73-8.96), and episodicity of mood symptoms (OR = 3.48, 95% CI 1.49-8.39). This triad model predicted bipolar illness with 88.7% sensitivity, 81.4% specificity, and obtained an auROC of 0.91 (95% CI: 0.76-0.96) and a positive predictive value of 85.1%. For borderline personality disorder, only female gender was a statistically significant predictor (OR = 3.41, 95% CI: 1.29-13.7), and the predictive model obtained an auROC of 0.67 (95% CI: 0.53-0.74).

CONCLUSION

In a mood disorder clinic setting, manic criteria and episodic mood course distinguished bipolar illness from borderline personality disorder.

Expression of acute phase proteins by bone marrow stromal cells

The current work examines the expression of acute phase genes in a murine-derived bone marrow stromal cell model (BMS2) which exhibits adipocyte and osteoblast characteristics and supports lymphopoiesis in vitro. Each of these physiologic processes is responsive to inflammatory events such as endotoxemia. Exposure of BMS2 cells to pro-inflammatory cytokines induced the expression of the serum amyloid A and complement factor B. During adipocyte differentiation, expression of complement C3, complement factor D (adipsin), and angiotensinogen increased in a time dependent manner. The bone metabolic steroid, 1,25 dihydroxy vitamin D3, specifically induced complement C3 expression in a time- and dose-dependent manner. Based on gel retention analysis, BMS2 nuclear extract contained proteins recognizing specific response elements from the complement C3, angiotensinogen, and complement factor B promoters. These results suggest that the bone marrow's repertoire of acute phase proteins is dependent on the stromal cell's phenotype or activation state.

Effects of Offenders' and Victims' Characteristics on Severity of Punishment

244 undergraduates read a transcript of a murder case, then made recommendations for treatment of the offender. In Exp. 1, length of sentence for a convicted murderer was unrelated to his mode of attire. In Exp. 2, sentences were unrelated to intention but were longer with than without a motive. In Exp. 3, punishment was not consistently related to the victim's gender. Suggestions for research are given.

Urinary VMA, dopamine and the likelihood of neuroblastoma: a preferred way of reporting laboratory results?

Background: Neuroblastoma patients may be classified as normal or abnormal depending on reference interval and decision points for urine catecholamine metabolites. We therefore evaluated the utility of positive likelihood ratios (LR+) based on data from patients in whom the diagnosis was suspected.

Methods: Urine samples from 249 patients (122 male, 127 female) suspected of neuroblastoma were assayed for VMA by spectrophotometry and dopamine by HPLC. Ratios of VMA to creatinine (VMA/Cr) and dopamine to creatinine (DA/Cr) were calculated and age-related median scores derived relative to patients without neuroblastoma. Receiver operator characteristic (ROC) curve analysis was undertaken for the ability of median scores to identify neuroblastoma.

Results: Of the 249 patients, there were 20 confirmed cases of neuroblastoma, with ages ranging from 0 (congenital tumour) to 8.4 years. From ROC curves, VMA/Cr was found to have an area under the curve 0.96 (95% confidence interval [CI] 0.92-0.98) compared with 0.72 (95% CI 0.66-0.77) for DA/Cr, P=0.001. At the optimal decision point for VMA/Cr, LR+ was 7.2, identifying cases with a sensitivity of 95% and a specificity of 86%, and comparing favourably with published intervals.

Conclusions: VMA/Cr is more accurate than DA/Cr for the diagnosis of neuroblastoma. Reporting LR+ may also be more informative than using reference intervals and decision points.

An evaluation of carbon offset supplementation options for beef production systems on coastal speargrass in central Queensland, Australia

In 2014, the Australian Government implemented the Emissions Reduction Fund to offer incentives for businesses to reduce greenhouse gas (GHG) emissions by following approved methods. Beef cattle businesses in northern Australia can participate by applying the ‘reducing GHG emissions by feeding nitrates to beef cattle’ methodology and the ‘beef cattle herd management’ methods. The nitrate (NO3) method requires that each baseline area must demonstrate a history of urea use. Projects earn Australian carbon credit units (ACCU) for reducing enteric methane emissions by substituting NO3 for urea at the same amount of fed nitrogen. NO3 must be fed in the form of a lick block because most operations do not have labour or equipment to manage daily supplementation. NO3 concentrations, after a 2-week adaptation period, must not exceed 50 g NO3/adult animal equivalent per day or 7 g NO3/kg dry matter intake per day to reduce the risk of NO3 toxicity. There is also a ‘beef cattle herd management’ method, approved in 2015, that covers activities that improve the herd emission intensity (emissions per unit of product sold) through change in the diet or management. The present study was conducted to compare the required ACCU or supplement prices for a 2% return on capital when feeding a low or high supplement concentration to breeding stock of either (1) urea, (2) three different forms of NO3 or (3) cottonseed meal (CSM), at N concentrations equivalent to 25 or 50 g urea/animal equivalent, to fasten steer entry to a feedlot (backgrounding), in a typical breeder herd on the coastal speargrass land types in central Queensland. Monte Carlo simulations were run using the software @risk, with probability functions used for (1) urea, NO3 and CSM prices, (2) GHG mitigation, (3) livestock prices and (4) carbon price. Increasing the weight of steers at a set turnoff month by feeding CSM was found to be the most cost-effective option, with or without including the offset income. The required ACCU prices for a 2% return on capital were an order of magnitude higher than were indicative carbon prices in 2015 for the three forms of NO3. The likely costs of participating in ERF projects would reduce the return on capital for all mitigation options.

Heterogeneous photo-Fenton reaction on hematite (α-Fe2O3){104}, {113} and {001} surface facets

The exposed surface facets play an important role in determining the catalytic performance of nanostructured materials. In this study, we report the synthesis of hematite nanoparticles with three varying morphologies with exposure of well-controlled {104}, {113} and {001} surfaces. The better shape control of hematite particles has provided a direct correlation between the surface facets and the photocatalytic performance. The catalytic photodegradation of MB using hematite nanoparticles reveals that the reaction follows the heterogeneous photo-Fenton process under visible light irradiation. The catalytic performance of hematite surface facets follows the order of {113} > {104} > {001}. Density functional theory (DFT) calculations were conducted to demonstrate the atomic surface structures and the corresponding charge distribution. The results indicate that the catalytic activity depends on surface atom arrangements as well as the number and the type of surface terminated hydroxyl groups bonding to underlying Fe atoms, where low valence states of Fe on {104} and {113} planes have the highest probability to be oxidized by H2O2 and the concurrently generated Fe((3+x)+) sites are more electronegative to accept electrons from activated dye molecules. The findings are of fundamental importance to understand the surface-dependence of photocatalytic properties, thus shedding new light on the catalytic application of hematite particles.

Computed tomography and magnetic resonance diagnosis of variations in the anatomical location of the major salivary glands in 1680 dogs and 187 cats

During assessment of routine clinical magnetic resonance imaging (MRI) of the heads of dogs, variations in the location of mandibular and zygomatic salivary glands (SGs) were observed incidentally. The aims of this retrospective study were to describe anatomical variations of the major SGs found on MRI and computed tomography (CT) studies of the head in dogs and cats and to investigate possible clinical relevancy. No anatomical variation of the SGs was seen in cats, but in dogs, although variation of the parotid SG was not identified, that of the mandibular SG was found in 33/1680 animals (2%), either unilaterally (6/33 right-sided, 13/33 left-sided) or bilaterally (14/33). The Border terrier breed (19/33, 58%) was over-represented. Each atypically located mandibular SG was positioned medial to the digastric muscle and rostral to the retropharyngeal lymph node. The sublingual glands were difficult to delineate from the mandibular glands. Anatomical variation of one zygomatic gland (3/4 left-sided) was identified in four small-breed dogs (0.2%). Each atypically located zygomatic gland was tilted at the ventrorostral aspect of the masseter muscle underneath the skin surface. MRI and CT characteristics were not different between typically and atypically located SGs. None of the dogs had clinical signs related with SG disease. It was concluded that, with suspected breed predispositions, incidental unilateral or bilateral anatomical variations of mandibular and zygomatic SGs can be encountered in dogs and an awareness of these possible variations may be important in pre-surgical planning.

Evaluation of the ventro 20° rostral-dorsocaudal oblique radiographic projection for the investigation of canine nasal disease

OBJECTIVE

To assess the ventro 20° rostral-dorsocaudal oblique projection for canine nasal disease as an alternative to the dorsoventral intra-oral view.

MATERIALS AND METHODS

Thirty-one dogs with nasal disease underwent radiography and computed tomography with a final diagnosis of underlying cause achieved through rhinoscopy, biopsy or cytology. Three independent observers, blinded to diagnosis, reviewed the nasal radiographs on two separate occasions. Intra- and inter-observer agreement and level of confidence on radiographic diagnosis were evaluated and radiographic diagnosis was compared with computed tomography and definitive diagnosis.

RESULTS

The ventro 20° rostral-dorsocaudal oblique projection of canine nasal cavities was feasible in anaesthetised dogs and gave diagnostic quality images in most dogs. Assessment of this view showed moderate to substantial agreement with computed tomography diagnosis but gave lower confidence in diagnosis. Interpretation of this radiographic projection had substantial to almost perfect repeatability but moderate reproducibility.

CLINICAL SIGNIFICANCE

The ventro 20° rostral-dorsocaudal oblique projection may be used as a valuable initial screening tool for canine nasal pathology in practices without access to advanced imaging, although computed tomography is still likely to provide greater diagnostic information.

Abstract P4-11-02: Mammary tumor formation induced by N-methyl-N-nitrosourea (MNU) is accelerated by natural and synthetic progesterone but suppressed by an anti-progesterone CDB4124

Background: CDB4124, anti-progesterone suppresses the development of carcinogen-induced ER+/PR+ mammary tumors in rats, and may have implications for prevention and treatment of human breast cancer. We hypothesize that progesterone (P4) and medroxyprogesterone acetate (MPA) will accelerate mammary carcinogenesis induced by MNU, however CDB4124 will efficiently suppress tumor formation stimulated by progesterone.

Methods: ovary intact female Sprague Dawley rats received a single intraperitoneal injection of 50mg/kg MNU at 4-5 weeks of age. 30mg of CDB4124 and 25mg of P4 or MPA (90 release pellets, Innovative research of America, Inc) were implanted in dorsal area at 3 weeks and 4 weeks after MNU injection, respectively. 10-11 rats were used for each treatment group. Tumor incidence, latency, multiplicity, and burden were recorded weekly. 9 weeks after MNU injection all the mice were euthanized and mammary tumors and glands were fixed in 10% (v/v) neutral buffered formalin. Plasma concentrations of CDB4124 and its metabolite CDB4453 were determined by LC-MS/MS.

Results: The first tumor appeared in the control group at 5 weeks, and in the P4 and MPA treated groups at 6 weeks after MNU injection. 7 weeks after MNU injection, mammary tumor incidence of MPA and P4 treated groups were 80% and 50%, respectively compared to 30% in the control group. 9 weeks after MNU injection all MPA treated mice, 80% of P4 treated mice, and 60% of control mice developed tumors. Tumor incidence, latency, multiplicity, and tumor weight were summarized as mean ± SD in Table 1.

[Table 1] Tumor latency, incidence, multiplicity, and burden in mammary tumorsTreatmentsLatency (days)Incidence(%)MultiplicityBurden (g)Control53.7 ± 12.9602.34.25 ± 7.02P453.6 ± 9.6802.64.11 ± 5.32MPA50.8 ± 7.71002.56.02 ± 4.85P4 + CDB412459.3 ± 11.53621.38 ± 0.61MPA + CDB412454.3 ± 10.7732.84.19 ± 4.39

Tumor latency of CDB4124 treated groups was increased; tumor incidence and burden (g) of CDB4124 treated groups were decreased compared to P4 and MPA treated groups. In particular, tumor incidence and burden of CDB4124 + P4 treated group were significantly lower than those of the control group. Plasma CDB4124 and CDB4453 were 11.6 ±5.88 ng/mL and 3.4±1.68 ng/mL, respectively. Histopathology of tumors and mammary glands and immuno-histochemical evaluations of Ki67, activated caspase-3, CD34, ER, and PR are currently underway.

Conclusions: Our results indicated that natural progesterone promotes MNU- induced mammary tumor formation similar to synthetic progesterone, MPA in rats. Under this tumor permissive environment, CDB4124 provided excellent prevention efficacy, suggesting good potential as breast cancer prevention agent.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-11-02.

Identifying environmental drivers of insect phenology across space and time: Culicoides in Scotland as a case study

Interpreting spatial patterns in the abundance of species over time is a fundamental cornerstone of ecological research. For many species, this type of analysis is hampered by datasets that contain a large proportion of zeros, and data that are overdispersed and spatially autocorrelated. This is particularly true for insects, for which abundance data can fluctuate from zero to many thousands in the space of weeks. Increasingly, an understanding of the ways in which environmental variation drives spatial and temporal patterns in the distribution, abundance and phenology of insects is required for management of pests and vector-borne diseases. In this study, we combine the use of smoothing techniques and generalised linear mixed models to relate environmental drivers to key phenological patterns of two species of biting midges, Culicoides pulicaris and C. impunctatus, of which C. pulicaris has been implicated in transmission of bluetongue in Europe. In so doing, we demonstrate analytical tools for linking the phenology of species with key environmental drivers, despite using a relatively small dataset containing overdispersed and zero-inflated data. We demonstrate the importance of landcover and climatic variables in determining the seasonal abundance of these two vector species, and highlight the need for more empirical data on the effects of temperature and precipitation on the life history traits of palearctic Culicoides spp. in Europe.

An outburst from a massive star 40 days before a supernova explosion

Some observations suggest that very massive stars experience extreme mass-loss episodes shortly before they explode as supernovae, as do several models. Establishing a causal connection between these mass-loss episodes and the final explosion would provide a novel way to study pre-supernova massive-star evolution. Here we report observations of a mass-loss event detected 40 days before the explosion of the type IIn supernova SN 2010mc (also known as PTF 10tel). Our photometric and spectroscopic data suggest that this event is a result of an energetic outburst, radiating at least 6 × 10(47) erg of energy and releasing about 10(-2) solar masses of material at typical velocities of 2,000 km s(-1). The temporal proximity of the mass-loss outburst and the supernova explosion implies a causal connection between them. Moreover, we find that the outburst luminosity and velocity are consistent with the predictions of the wave-driven pulsation model, and disfavour alternative suggestions.