Towards a Standard Psychometric Diagnostic Interview for Subjects at Ultra High Risk of Psychosis: CAARMS versus SIPS

Background. Several psychometric instruments are available for the diagnostic interview of subjects at ultra high risk (UHR) of psychosis. Their diagnostic comparability is unknown. Methods. All referrals to the OASIS (London) or CAMEO (Cambridgeshire) UHR services from May 13 to Dec 14 were interviewed for a UHR state using both the CAARMS 12/2006 and the SIPS 5.0. Percent overall agreement, kappa, the McNemar-Bowker χ (2) test, equipercentile methods, and residual analyses were used to investigate diagnostic outcomes and symptoms severity or frequency. A conversion algorithm (CONVERT) was validated in an independent UHR sample from the Seoul Youth Clinic (Seoul). Results. There was overall substantial CAARMS-versus-SIPS agreement in the identification of UHR subjects (n = 212, percent overall agreement = 86%; kappa = 0.781, 95% CI from 0.684 to 0.878; McNemar-Bowker test = 0.069), with the exception of the brief limited intermittent psychotic symptoms (BLIPS) subgroup. Equipercentile-linking table linked symptoms severity and frequency across the CAARMS and SIPS. The conversion algorithm was validated in 93 UHR subjects, showing excellent diagnostic accuracy (CAARMS to SIPS: ROC area 0.929; SIPS to CAARMS: ROC area 0.903). Conclusions. This study provides initial comparability data between CAARMS and SIPS and will inform ongoing multicentre studies and clinical guidelines for the UHR psychometric diagnostic interview.

Social and spatial heterogeneity in psychosis proneness in a multilevel case-prodrome-control study

OBJECTIVE

To test whether spatial and social neighbourhood patterning of people at ultra-high risk (UHR) of psychosis differs from first-episode psychosis (FEP) participants or controls and to determine whether exposure to different social environments is evident before disorder onset.

METHOD

We tested differences in the spatial distributions of representative samples of FEP, UHR and control participants and fitted two-level multinomial logistic regression models, adjusted for individual-level covariates, to examine group differences in neighbourhood-level characteristics.

RESULTS

The spatial distribution of controls (n = 41) differed from UHR (n = 48; P = 0.04) and FEP participants (n = 159; P = 0.01), whose distribution was similar (P = 0.17). Risk in FEP and UHR groups was associated with the same neighbourhood-level exposures: proportion of single-parent households [FEP adjusted odds ratio (aOR): 1.56 95% CI: 1.00-2.45; UHR aOR: 1.59; 95% CI: 0.99-2.57], ethnic diversity (FEP aOR: 1.27; 95% CI: 1.02-1.58; UHR aOR: 1.28; 95% CI: 1.00-1.63) and multiple deprivation (FEP aOR: 0.88; 95% CI: 0.78-1.00; UHR aOR: 0.86; 95% CI: 0.76-0.99).

CONCLUSION

Similar neighbourhood-level exposures predicted UHR and FEP risk, whose residential patterning was closer to each other's than controls. Adverse social environments are associated with psychosis before FEP onset.

High prevalence of bla OXA-23 in Acinetobacter spp. and detection of bla NDM-1 in A. soli in Cuba: report from National Surveillance Program (2010-2012)

As a first national surveillance of Acinetobacter in Cuba, a total of 500 Acinetobacter spp. isolates recovered from 30 hospitals between 2010 and 2012 were studied. Acinetobacter baumannii–calcoaceticus complex accounted for 96.4% of all the Acinetobacter isolates, while other species were detected at low frequency (A. junii 1.6%, A. lwoffii 1%, A. haemolyticus 0.8%, A. soli 0.2%). Resistance rates of isolates were 34–61% to third-generation cephalosporins, 49–50% to β-lactams/inhibitor combinations, 42–47% to aminoglycosides, 42–44% to carbapenems and 55% to ciprofloxacin. However, resistance rates to colistin, doxycycline, tetracycline and rifampin were less than 5%. Among carbapenem-resistant isolates, 75% harboured different bla_OXA genes (OXA-23, 73%; OXA-24, 18%; OXA-58, 3%). The bla_NDM-1 gene was identified in an A. soli strain, of which the species was confirmed by sequence analysis of 16S rRNA gene, rpoB, rpoB–rpoC and rpoL–rpoB intergenic spacer regions and gyrB. The sequences of bla_NDM-1 and its surrounding genes were identical to those reported for plasmids of A. baumannii and A. lwoffi strains. This is the first report of bla_NDM-1 in A. soli, together with a high prevalence of OXA-23 carbapenemase for carbapenem resistance in Acinetobacter spp. in Cuba.

Use of a cytotoxic peptide as an immunotherapeutic agent in the treatment of metastatic breast cancer (VAC13P.1134)

Breast cancer is a challenge for immunotherapy because of its genetic heterogeneity and decreased immunogenicity, which impedes the use of immune checkpoint blockade. A promising approach is to generate dying cancer cells that operate like a vaccine to induce a tumor-specific immune response and eradicate residual cancer cells. This is termed immunogenic cell death (ICD) and is characterized by a unique molecular signature that stimulates immunity. To develop a novel ICD agent for cancer immunotherapy, our group discovered a therapeutic peptide, CT20p, and a nanotechnology-based platform to concentrate CT20p in breast tumors. Treatment of mice with nanomolar amounts of CT20p caused tumor regression, and dying breast cancer cells expressed markers characteristic of ICD: calreticulin (Crt) and heat shock protein (HSP)-70. The intracellular target of CT20p is a protein called chaperonin-containing T-complex (CCT) that folds actin and tubulin. CCT was overexpressed in breast cancer cells susceptible to CT20p. In contrast, normal epithelial cells, macrophages or NK cells, which have low levels of CCT, were unaffected by CT20p. Breast cancer cells treated with CT20p displayed alterations in IRE1 and PERK, mediators of the unfolded protein response (UPR) that are upstream drivers of ICD signals. Hence, CT20p-treated breast cancer cells were more effectively killed by NK cells and ingested by phagocytes, demonstrating that CT20p is a robust stimulator of innate immunity.

Mood, anxiety and psychotic phenomena measure a common psychopathological factor

BACKGROUND

Psychotic phenomena are common in the general population but are excluded from diagnostic criteria for mild to moderate depression and anxiety despite their co-occurrence and shared risk factors. We used item response theory modelling to examine whether the co-occurrence of depressive, anxiety and psychotic phenomena is best explained by: (1) a single underlying factor; (2) two separate, uncorrelated factors; (3) two separate yet linked factors; or (4) two separate domains along with an underlying 'common mental distress' (CMD) factor. We defined where, along any latent continuum, the psychopathological items contributed most information.

METHOD

We performed a secondary analysis of cross-sectional, item-level information from measures of depression, anxiety and psychotic experiences in 6617 participants aged 13 years from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort and 977 participants aged 18 years from the ROOTS schools-based sample. We replicated results from one sample in the other and validated the latent factors against an earlier parental measure of mental state.

RESULTS

In both cohorts depression, anxiety and psychotic items were best represented as a bi-factor model with a single, unitary CMD factor on which psychotic items conveyed information about the more severe end (model 4); residual variation remained for psychotic items. The CMD factor was significantly associated with the prior parental measure.

CONCLUSIONS

Psychotic phenomena co-occur with depression and anxiety in teenagers and may be a marker of severity in a single, unitary dimension of CMD. Psychotic phenomena should be routinely included in epidemiological assessments of psychiatric morbidity, otherwise the most severe symptomatology remains unmeasured.

Enhanced apatite precipitation on a biopolymer-coated bioactive glass

In this work, sintered pellets of a silica-based bioactive glass were dip-coated with a biocompatible natural-derived polymer in order to investigate the influence of the organic coating on the glass bioactivity. After the sintering process optimization, uncoated and coated pellets have been characterized by means of scanning electron microscopy with energy dispersive spectroscopy (SEM, EDS), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR) and pH measurements, after the immersion in a simulated body fluid (SBF). An increased apatite forming ability and a better control of the pH during soaking of the samples in SBF were observed in the presence of the biopolymer. This result opens a new insight on the simple fabrication of highly bioactive hybrid inorganic-organic materials for medical applications.

High-throughput luminescent reporter of insulin secretion for discovering regulators of pancreatic Beta-cell function

Defects in insulin secretion play a central role in the pathogenesis of type 2 diabetes, yet the mechanisms driving beta-cell dysfunction remain poorly understood, and therapies to preserve glucose-dependent insulin release are inadequate. We report a luminescent insulin secretion assay that enables large-scale investigations of beta-cell function, created by inserting Gaussia luciferase into the C-peptide portion of proinsulin. Beta-cell lines expressing this construct cosecrete luciferase and insulin in close correlation, under both standard conditions or when stressed by cytokines, fatty acids, or ER toxins. We adapted the reporter for high-throughput assays and performed a 1,600-compound pilot screen, which identified several classes of drugs inhibiting secretion, as well as glucose-potentiated secretagogues that were confirmed to have activity in primary human islets. Requiring 40-fold less time and expense than the traditional ELISA, this assay may accelerate the identification of pathways governing insulin secretion and compounds that safely augment beta-cell function in diabetes.

First-rank symptoms and premorbid adjustment in young individuals at increased risk of developing psychosis

BACKGROUND

Individuals at clinical high risk (CHR) for psychosis represent a heterogeneous group with a high rate of comorbid psychiatric disorders. There is little information on whether certain qualitative aspects of psychotic symptoms among CHR individuals may be predictive of future psychosis. This study focused on describing the prevalence of first-rank symptoms (FRS) among a sample of CHR individuals and its association with future transition to psychosis and, from a neurodevelopmental perspective, the level of adjustment of individuals at CHR during their childhood was also analysed.

SAMPLING AND METHODS

Participants comprised 60 individuals at CHR (according to the Comprehensive Assessment of At-Risk Mental States, CAARMS) at the time of their referral to an early intervention service and 60 healthy volunteers (HVs). All subjects were assessed by senior research clinicians using the Mini International Neuropsychiatric Interview (MINI), and the Positive and Negative Syndrome Scale (PANSS). FRS were defined according to Kurt Schneider's original classification, and information was collected from PANSS, CAARMS and clinical reports. Early premorbid functioning was measured using the Premorbid Adjustment Scale (PAS). We grouped individuals by number and type of FRS and analysed transitions to full-blown psychosis over a 2-year follow-up period. We also correlated the general social and functional adjustment of these individuals during their childhood (6-11 years of age) with the future development of mental states at CHR and FRS.

RESULTS

Over 69% of CHR individuals had more than one DSM-IV psychiatric diagnosis, mainly within the affective and anxiety diagnostic spectra. At least one FRS was present in 43.3% of CHR individuals, and 21.6% of these had more than one. Auditory hallucinations and passivity experiences were the most commonly reported. Only 10% of individuals at CHR made a transition to first-episode psychosis (FEP) over 2 years and, except for passivity experiences, the presence of one or more FRS was not significantly associated with the transition to FEP. CHR individuals, especially those with FRS, had poorer premorbid functioning and adjustment as children across educational, social and peer relationship domains than HVs. However, this was not associated with FEP 2 years later.

CONCLUSIONS

FRS might not be indicators of psychosis alone but of different psychiatric disorders. In line with the neurodevelopmental model of psychosis, individuals at CHR might be exhibiting several vulnerability traits and manifestations of abnormal developmental processes that might predict a future psychiatric disorder and/or long-term impairment.

Surface plasmon enhancement of broadband photoluminescence emission from graphene oxide

The photoluminescence (PL) emission studies of both graphene oxide (GO) and partially reduced graphene oxide (rGO) have been investigated. It has been observed that GO has broadband emission from the green to near infrared range and upon reduction rGO shows blue PL emission. The broadband PL emission is due to the recombination of the electron-hole pair in the sp(2) domain embedded within the sp(3) matrix. The broadband PL emission also suggests the existence of various sizes of the sp(2) domain within the same matrix. Furthermore, PL emission from GO in the presence of an Au metal thin film has been investigated. It has been observed that the entire broadband emission from GO in the green to near infrared wavelength region is enhanced significantly at room temperature. The Au-GO interface exhibits surface plasmon resonance in the visible wavelength region and is responsible for over 10 fold enhancement in the photoluminescence at ∼2.36 eV. The electrical property measurements on the GO and rGO thin films suggested that the rGO exhibits significantly higher electrical conductivity compared to that of the GO thin film. Furthermore, the GO thin film exhibits semiconducting behaviour. These properties make the material quite suitable for fabrication of new generation photonic devices.

A new cytotype of the African pygmy mouse Mus minutoides in Eastern Africa. Implications for the evolution of sex-autosome translocations

The African pygmy mice (genus Mus, subgenus Nannomys) are recognized for their highly conserved morphology but extensive chromosomal diversity, particularly involving sex-autosome translocations, one of the rarest chromosomal rearrangements among mammals. It has been shown that in the absence of unambiguous diagnostic morphological traits, sex-autosome translocations offer accurate taxonomic markers. For example, in Mus minutoides, irrespective of the diploid number (which ranges from 2n = 18 to 34), all specimens possess the sex-autosome translocations (X.1) and (Y.1) that are unique to this species. In this study, we describe a new cytotype that challenges this view. Males are characterized by the translocation (Y.1) only, while females carry no sex-autosome translocation, the X chromosome being acrocentric. Hence, although sex-autosome translocations (X.1) and (Y.1) are still diagnostic when one or both are present, their absence does not rule out M. minutoides. This cytotype has a large distribution, with specimens found in Tanzania and in the eastern part of South Africa. The nonpervasive distribution of Rb(X.1) provides an opportunity to investigate different evolutionary scenarios of sex-autosome translocations using a phylogenetic framework and the distribution of telomeric repeats. The results tend to support a scenario involving a reversal event, i.e., fusion then fission of Rb(X.1), and highlighted the existence of a new X1X1X2X2/X1X2Y sex chromosome system, confirming the remarkable diversity of neo-sex chromosomes and sex determination systems in the African pygmy mice.

A 3'-UTR KRAS-variant is associated with cisplatin resistance in patients with recurrent and/or metastatic head and neck squamous cell carcinoma

BACKGROUND

A germline mutation in the 3'-untranslated region of KRAS (rs61764370, KRAS-variant: TG/GG) has previously been associated with altered patient outcome and drug resistance/sensitivity in various cancers. We examined the prognostic and predictive significance of this variant in recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC).

PATIENTS AND METHODS

We conducted a retrospective study of 103 HNSCCs collected from three completed clinical trials. KRAS-variant genotyping was conducted for these samples and 8 HNSCC cell lines. p16 expression was determined in a subset of 26 oropharynx tumors by immunohistochemistry. Microarray analysis was also utilized to elucidate differentially expressed genes between KRAS-variant and non-variant tumors. Drug sensitivity in cell lines was evaluated to confirm clinical findings.

RESULTS

KRAS-variant status was determined in 95/103 (92%) of the HNSCC tumor samples and the allelic frequency of TG/GG was 32% (30/95). Three of the HNSCC cell lines (3/8) studied had the KRAS-variant. No association between KRAS-variant status and p16 expression was observed in the oropharynx subset (Fisher's exact test, P = 1.0). With respect to patient outcome, patients with the KRAS-variant had poor progression-free survival when treated with cisplatin (log-rank P = 0.002). Conversely, KRAS-variant patients appeared to experience some improvement in disease control when cetuximab was added to their platinum-based regimen (log-rank P = 0.04).

CONCLUSIONS

The TG/GG rs61764370 KRAS-variant is a potential predictive biomarker for poor platinum response in R/M HNSCC patients.

CLINICAL TRIAL REGISTRATION NUMBERS

NCT00503997, NCT00425750, NCT00003809.