The Effects of Mindfulness-Based Interventions on Suicide Outcomes: A Meta-Analysis

Although mindfulness-based interventions (MBIs) have been shown to be effective in treating several psychological difficulties, to date, no review has systematically examined their effectiveness in treating or preventing suicide. The goals of the present study were to (1) evaluate the effectiveness of MBIs in treating suicide and (2) understand how individual characteristics and characteristics of MBIs influence treatment outcomes through a systematic meta-analysis. A search of PubMed, MEDLINE, PsychINFO, and ProQuest Dissertations and Theses was conducted in February 2019. A total of 12 publications (13 studies, n = 627) were included. MBIs demonstrated significant moderate effects on suicidal ideation in pre-post studies and small effects in controlled studies. In addition, MBIs demonstrated significant moderate effects in both samples of individuals with histories of depression and histories of suicidal ideation or attempts. Moreover, MBIs led to clinically significant reductions in suicidal ideation and depression. Female participants, older samples, and longer treatments showed greater treatment effects, although these relationships were weak. Results suggest that MBIs may be promising treatments for suicidal ideation; however, more research is needed to establish the effects of these treatments as well as the mechanisms through which MBIs reduce suicide.

Leptin receptor-expressing nucleus tractus solitarius neurons suppress food intake independently of GLP1 in mice

Leptin receptor-expressing (LepRb-expressing) neurons of the nucleus tractus solitarius (NTS; LepRbNTS neurons) receive gut signals that synergize with leptin action to suppress food intake. NTS neurons that express preproglucagon (Ppg) (and that produce the food intake-suppressing PPG cleavage product glucagon-like peptide-1 [GLP1]) represent a subpopulation of mouse LepRbNTS cells. Using Leprcre, Ppgcre, and Ppgfl mouse lines, along with Designer Receptors Exclusively Activated by Designer Drugs (DREADDs), we examined roles for Ppg in GLP1NTS and LepRbNTS cells for the control of food intake and energy balance. We found that the cre-dependent ablation of NTS Ppgfl early in development or in adult mice failed to alter energy balance, suggesting the importance of pathways independent of NTS GLP1 for the long-term control of food intake. Consistently, while activating GLP1NTS cells decreased food intake, LepRbNTS cells elicited larger and more durable effects. Furthermore, while the ablation of NTS Ppgfl blunted the ability of GLP1NTS neurons to suppress food intake during activation, it did not impact the suppression of food intake by LepRbNTS cells. While Ppg/GLP1-mediated neurotransmission plays a central role in the modest appetite-suppressing effects of GLP1NTS cells, additional pathways engaged by LepRbNTS cells dominate for the suppression of food intake.

Calcitonin Receptor Neurons in the Mouse Nucleus Tractus Solitarius Control Energy Balance via the Non-aversive Suppression of Feeding

To understand hindbrain pathways involved in the control of food intake, we examined roles for calcitonin receptor (CALCR)-containing neurons in the NTS. Ablation of NTS Calcr abrogated the long-term suppression of food intake, but not aversive responses, by CALCR agonists. Similarly, activating Calcr^NTS neurons decreased food intake and body weight but (unlike neighboring Cck^NTS cells) failed to promote aversion, revealing that Calcr^NTS neurons mediate a non-aversive suppression of food intake. While both Calcr^NTS and Cck^NTS neurons decreased feeding via projections to the PBN, Cck^NTS cells activated aversive CGRP^PBN cells while Calcr^NTS cells activated distinct non-CGRP PBN cells. Hence, Calcr^NTS cells suppress feeding via non-aversive, non-CGRP PBN targets. Additionally, silencing Calcr^NTS cells blunted food intake suppression by gut peptides and nutrients, increasing food intake and promoting obesity. Hence, Calcr^NTS neurons define a hindbrain system that participates in physiological energy balance and suppresses food intake without activating aversive systems.

Mindfulness-based interventions for weight loss: a systematic review and meta-analysis

BACKGROUND

An increasing number of studies are investigating the efficacy of mindfulness-based interventions (MBIs) for weight loss and obesity-related eating behaviours. However, the results of past reviews are inconsistent.

OBJECTIVE

To clarify these inconsistencies, we conducted a comprehensive effect-size analysis to evaluate the efficacy of MBIs on weight loss and eating behaviours.

DATA SOURCE

Data sources were identified through a systematic review of studies published in journals or as dissertations in PsychINFO, PubMed, CINAHL, Web of Science, Medline and Scopus, ProQuest or OATD from the first available date to March 10, 2017.

REVIEW METHODS

A total of 18 publications (19 studies, n = 1,160) were included.

RESULTS

Mean weight loss for MBIs at post-treatment was 6.8 and 7.5 lb at follow-up. In pre-post comparisons, effect-size estimates suggest that MBIs are moderately effective for weight loss (n = 16; Hedge's g = .42; 95% CI [.26, .59], p < .000001) and largely effective in reducing obesity-related eating behaviours (n = 10; Hedge's g = .70; CI 95% [.36, 1.04], p < .00005). Larger effects on weight loss were found in studies that used a combination of informal and formal meditation practice (n = 6; Hedge's g = .55; CI 95% [.32, .77], p < .00001) compared with formal meditation practice alone (n = 4; Hedge's g = .46; CI [.10, .83], p < .05).

CONCLUSION

Results suggest that MBIs are effective in reducing weight and improving obesity-related eating behaviours among individuals with overweight and obesity. Further research is needed to examine their efficacy for weight loss maintenance.

In vivo near-infrared imaging of ErbB2 expressing breast tumors with dual-axes confocal endomicroscopy using a targeted peptide

ErbB2 expression in early breast cancer can predict tumor aggressiveness and clinical outcomes in large patient populations. Accurate assessment with physical biopsy and conventional pathology can be limited by tumor heterogeneity. We aim to demonstrate real-time optical sectioning using a near-infrared labeled ErbB2 peptide that generates tumor-specific contrast in human xenograft breast tumors in vivo. We used IRDye800CW as the fluorophore, validated performance characteristics for specific peptide binding to cells in vitro, and investigated peak peptide uptake in tumors using photoacoustic tomography. We performed real-time optical imaging using a handheld dual-axes confocal fluorescence endomicroscope that collects light off-axis to reduce tissue scattering for greater imaging depths. Optical sections in either the vertical or horizontal plane were collected with sub-cellular resolution. Also, we found significantly greater peptide binding to pre-clinical xenograft breast cancer in vivo and to human specimens of invasive ductal carcinoma that express ErbB2 ex vivo. We used a scrambled peptide for control. Peptide biodistribution showed high tumor uptake by comparison with other organs to support safety. This novel integrated imaging strategy is promising for visualizing ErbB2 expression in breast tumors and serve as an adjunct during surgery to improve diagnostic accuracy, identify tumor margins, and stage early cancers.

Angiology of the Plantar Plate

Category:

Basic Sciences/Biologics, Lesser Toes, Midfoot/Forefoot

Introduction/Purpose:

Hammertoes, crossover toes, and claw toes are common deformities and can be a major source of pain and dysfunction. These deformities result from instability of the metatarsophalangeal (MTP) joint due to incompetence of the plantar plate and/or collateral ligaments. Non-operative management is the first line of treatment. When non-operative treatment is unsuccessful, surgical interventions have been described. Newer surgical techniques focus on performing anatomic repairs of plantar plates. The vasculature of the foot has been well studied, but the vascular supply of the plantar plate has not been described. This study presents a new technique for imaging the microvasculature of the lesser toe plantar plates through micro- computed tomography (micro-CT) in order to better understand tear pathology and the capacity of healing with plantar plate repairs.

Methods:

The posterior tibial and dorsalis pedis arteries of a fresh frozen human cadaver foot were dissected and cannulated at the ankle for perfusion distally. After administration of an anticoagulant, each artery was perfused with Microfil® Silicone Rubber, a contrast agent. The compound was then allowed to cure, and the foot was fixed in formalin. The foot was sectioned through the metatarsal shafts for imaging, and imaging of the lesser toe MTP joints was performed using a Bruker Skyscan 1176 micro-CT scanner at 18 micron slices. Computerized reconstruction of the images was performed for three dimensional visualization of the vasculature.

Results:

Post-perfusion imaging of the lesser toe MTP joints using micro-CT allows for visualization of the plantar plate microvasculature. Preliminary imaging suggests that micro-CT is a useful modality for analysis of the blood supply of the plantar plate.

Conclusion:

Anatomic repair of the plantar plate has become a viable treatment option for MTP joint instability. One important question that remains to be answered is whether plantar plate tears have the capacity to heal. We present a novel technique for imaging of lesser toe plantar plate microvascularity using micro-CT. Preliminary results of post-perfusion imaging of the plantar plate are promising for developing a better understanding of its blood supply. Further definition of the plantar plate vascular supply will help clinicians understand the capacity for healing after repairs and may provide some insight to the biological causes plantar plate tears.

Bone structure and function in male C57BL/6 mice: Effects of a high-fat Western-style diet with or without trace minerals

PURPOSE

Osteoporosis occurs in both women and men, but most of what we know about the condition comes from studies in females. The present study examined bone structure and function over an 18-month period in male C57BL/6 mice maintained on either a rodent chow diet (AIN76A) or a high-fat, Western-style diet (HFWD). Effects of mineral supplementation were assessed in both diets.

METHODS

Trabecular and cortical bone structure in femora and vertebrae were assessed by micro-CT analysis. Following this, bone stiffness and strength measurements were made. Finally, bone levels of several cationic trace elements were quantified, and serum biomarkers of bone metabolism evaluated.

RESULTS

Bone loss occurred over time in both diets but was more rapid and extensive in mice on the HFWD. Dietary mineral supplementation reduced bone loss in both diets and increased bone stiffness in the femora and bone stiffness and strength in the vertebrae. Bone content of strontium was increased in response to mineral supplementation in both diets.

CONCLUSIONS

Bone loss was more severe in mice on the HFWD and mineral supplementation mitigated the effects of the HFWD. In comparison to previous findings with female C57BL/6 mice, the present studies indicate that males are more sensitive to diet and benefited from a healthy diet (AIN76A), while females lost as much bone on the healthy diet as on the HFWD. Male mice benefited from mineral supplementation, just as females did in the previous study.

Changes in Skeletal Integrity and Marrow Adiposity during High-Fat Diet and after Weight Loss

The prevalence of obesity has continued to rise over the past three decades leading to significant increases in obesity-related medical care costs from metabolic and non-metabolic sequelae. It is now clear that expansion of body fat leads to an increase in inflammation with systemic effects on metabolism. In mouse models of diet-induced obesity, there is also an expansion of bone marrow adipocytes. However, the persistence of these changes after weight loss has not been well described. The objective of this study was to investigate the impact of high-fat diet (HFD) and subsequent weight loss on skeletal parameters in C57Bl6/J mice. Male mice were given a normal chow diet (ND) or 60% HFD at 6 weeks of age for 12, 16, or 20 weeks. A third group of mice was put on HFD for 12 weeks and then on ND for 8 weeks to mimic weight loss. After these dietary challenges, the tibia and femur were removed and analyzed by micro computed-tomography for bone morphology. Decalcification followed by osmium staining was used to assess bone marrow adiposity, and mechanical testing was performed to assess bone strength. After 12, 16, or 20 weeks of HFD, mice had significant weight gain relative to controls. Body mass returned to normal after weight loss. Marrow adipose tissue (MAT) volume in the tibia increased after 16 weeks of HFD and persisted in the 20-week HFD group. Weight loss prevented HFD-induced MAT expansion. Trabecular bone volume fraction, mineral content, and number were decreased after 12, 16, or 20 weeks of HFD, relative to ND controls, with only partial recovery after weight loss. Mechanical testing demonstrated decreased fracture resistance after 20 weeks of HFD. Loss of mechanical integrity did not recover after weight loss. Our study demonstrates that HFD causes long-term, persistent changes in bone quality, despite prevention of marrow adipose tissue accumulation, as demonstrated through changes in bone morphology and mechanical strength in a mouse model of diet-induced obesity and weight loss.

Region-specific variation in the properties of skeletal adipocytes reveals regulated and constitutive marrow adipose tissues

Marrow adipose tissue (MAT) accumulates in diverse clinical conditions but remains poorly understood. Here we show region-specific variation in MAT adipocyte development, regulation, size, lipid composition, gene expression and genetic determinants. Early MAT formation in mice is conserved, whereas later development is strain dependent. Proximal, but not distal tibial, MAT is lost with 21-day cold exposure. Rat MAT adipocytes from distal sites have an increased proportion of monounsaturated fatty acids and expression of Scd1/Scd2, Cebpa and Cebpb. Humans also have increased distal marrow fat unsaturation. We define proximal 'regulated' MAT (rMAT) as single adipocytes interspersed with active haematopoiesis, whereas distal 'constitutive' MAT (cMAT) has low haematopoiesis, contains larger adipocytes, develops earlier and remains preserved upon systemic challenges. Loss of rMAT occurs in mice with congenital generalized lipodystrophy type 4, whereas both rMAT and cMAT are preserved in mice with congenital generalized lipodystrophy type 3. Consideration of these MAT subpopulations may be important for future studies linking MAT to bone biology, haematopoiesis and whole-body metabolism.

Evaluation of sciatic nerve function after ultrasonic and electrocautery muscle dissection: an electromyographic study

BACKGROUND

Minimally invasive surgery has been developed with various innovative surgical tools. Ultrasonic (US) blades have been introduced as an alternative to conventional electrocautery (EC) monopolar device. The purpose of the present study was to evaluate the effects of surgical devices used for muscle dissection close to peripheral nerves on motor nerve function using electromyographic (EMG) recordings.

MATERIALS AND METHODS

A total of 24 rats were used in this study. The rats were assigned to the following three groups: Control (n = 8), EC (n = 8), and US (n = 8). A stimulus electrode was placed under the sciatic nerve at a sciatic notch. A pair of recording electrodes was implanted into the midbelly regions of the gastrocnemius muscle. To evoke compound muscle action potentials (CMAPs), 3-V stimuli with 0.3-ms duration were applied to the sciatic nerve at a frequency of 1 Hz. After the recording of the baseline, a monopolar surgical device (EC or US) was applied to cut the muscle 10 mm in length and 2 mm away on both sides of the sciatic nerve. Amplitude and latency of the evoked CMAPs were measured. CMAPs were monitored until 3 hours after the device application.

RESULTS

The EC device caused a marked drop in the amplitude of CMAP with no recovery at the end of the experiment. In the US group, the amplitude of CMAP was stable and constant CMAP over 3 hours, similar to the control group could be measured. In all three groups, the latency of CMAP showed no significant changes through the experiment.

CONCLUSION

The study showed that the EC device resulted in injury to several motor units in the sciatic nerve. The US device may be a safe tool for muscle dissection around peripheral nerves.

Postoperative pulmonary complications after gynecologic surgery

OBJECTIVE

Investigate the frequency of, and risks for postoperative pulmonary complications after surgery for non-malignant gynecologic disorders.

METHOD

A retrospective component included medical record data for one year. A prospective component enrolled 300 patients consecutively who were scheduled for gynecologic surgeries.

RESULT

Postoperative pulmonary complications occurred in 1.22% of 328 open abdominal procedures in the retrospective study, and 2.16% of 232 in the prospective study. Pooling the data yielded a frequency estimate of 1.61%. Mean hospital length of stay (pooled data) increased 1.75 days in those with postoperative pulmonary complications. Smoking was the only significant risk factor (relative risk=3.9 using pooled data).

CONCLUSION

Postoperative pulmonary complications after surgery for non-malignant gynecologic disorders are infrequent but increase hospital length of stay. Smokers are at increased risk.

National character does not reflect mean personality trait levels in 49 cultures

Most people hold beliefs about personality characteristics typical of members of their own and others' cultures. These perceptions of national character may be generalizations from personal experience, stereotypes with a "kernel of truth," or inaccurate stereotypes. We obtained national character ratings of 3989 people from 49 cultures and compared them with the average personality scores of culture members assessed by observer ratings and self-reports. National character ratings were reliable but did not converge with assessed traits. Perceptions of national character thus appear to be unfounded stereotypes that may serve the function of maintaining a national identity.

Nucleic acid spot hybridization with nonradioactive labeled probes in screening for human papillomavirus DNA sequences

We examined 161 human tissue samples using the spot hybridization technique with nonradioactive labeled DNA probes of human papillomavirus (HPV). Whole cells were spotted on nitrocellulose filters; DNA of the cells was denatured and fixed to the filter. Then the DNA spots were hybridized to nonradioactive labeled DNA and monitored by a sandwich immunoenzymatic reaction. This technique is simple, sensitive, specific, requires no special equipment, and can be used in clinical settings. HPV DNA was found in 92% of samples in which, on the basis of histologic and colposcopic criteria, its presence was suspected, as well as in 31 samples where it was not suspected.

[Current methods in the diagnosis of Chlamydia infections]

The pathogenicity of Chlamydia species is no longer questioned and most figures indicate that these organisms are the leading cause of sexually transmitted diseases. Diagnosis by direct examination of a stained slide is not acceptable due to inadequate sensitivity. The use of monoclonal antibodies conjugated to ITCF, however, is a good method to detect chlamydial particles. Cultures are made from specimens of heavily infected cells, centrifuged with cells from the McCoy cell line treated with cycloheximide. The inclusions are visualized using immunological techniques (immunofluorescence or staining with a peroxidase-antiperoxidase reaction). By using wells of microplates, this method is less expensive and can also be used for antimicrobial susceptibility testing. Serology (by MIF or ELISA) is very helpful, especially to investigate complications originating from a lower genital tract infection. Both techniques are useful in routine screening.