Coronavirus Pandemic Anxiety Scale (CPAS-11): development and initial validation

The mental health impact of the COVID-19 pandemic will increase as the outbreak continues and persist even after the pandemic passes. We developed an 11-item Coronavirus Pandemic Anxiety Scale (CPAS-11) to measure symptoms of anxiety related to the COVID-19 pandemic to help identify individuals who might need mental health services. In developing the scale items, we considered previous research and theory on anxiety symptoms and symptoms reported by clinically referred cases in the Philippines. The scale was validated in a Filipino sample (N = 925). Exploratory factor analysis indicated two factors corresponding to somatic and non-somatic symptoms; confirmatory factor analysis showed good fit for the two-factor model. CPAS-11 showed good internal consistency, convergent and divergent validity, and screening accuracy. A cutoff score of 15 showed adequate sensitivity and specificity to distinguish GAD-7 screened participants. The results support the viability of CPAS-11 as a screening tool to identify individuals experiencing COVID-19-related anxiety.

Past adult lead exposure is associated with longitudinal decline in cognitive function

OBJECTIVE

To determine whether adults with past exposure to neurotoxicants have progressive declines in cognitive function years after exposure has ceased, and whether tibia lead is a predictor of the magnitude of change.

METHODS

A total of 535 former organolead manufacturing workers with a mean age of 55.6 years, a mean duration of 16 years since last occupational lead exposure, and low blood lead levels at the first study visit and 118 controls were evaluated with neurobehavioral tests two to four times over 4 years. "Peak" tibia lead levels, estimated from current levels measured by X-ray fluorescence, were used to predict changes in cognitive function over time.

RESULTS

In former lead workers, peak tibia lead ranged from -2.2 to 98.7 microg Pb/g bone mineral. Compared to controls, former lead workers performed worse over time for three tests of visuo-constructive ability and verbal memory and learning (p < 0.05). In former lead workers, peak tibia lead predicted declines for six tests of verbal memory and learning, visual memory, executive ability, and manual dexterity (p < 0.05 for four tests and < 0.10 for two additional tests). On average, for these six tests, an increase of 15.7 microg/g of peak tibia lead was equivalent in its effects on annual test decline to 5 more years of age at baseline.

CONCLUSIONS

These are the first data to suggest that cognitive function can progressively decline due to past occupational exposures to a neurotoxicant.

Thy-1 is critical for normal retinal development

In the mammalian retina, Thy-1, the most abundant mammalian neuronal surface glycoprotein, is found predominantly if not exclusively on retinal ganglion cells. We hypothesized that Thy-1 plays a significant role in retinal development. Neurite outgrowth of retinal ganglion cells from Thy-1(-) mice over multiple substrates was compared to that seen with wild-type controls. Adult mouse retinas were histologically compared between Thy-1(-) and three strains of Thy-1 positive mice. Thy-1(-) retinal ganglion cells had significantly less neurite outgrowth than controls. The inner nuclear, inner plexiform, ganglion cell and outer segment/pigment epithelium layers were thinner in Thy-1(-) retinae than in controls. Thy-1 appears to be critical for normal retinal development.

Infection with adeno-associated virus may protect against excitotoxicity

Gene therapy has developed as a promising approach for therapy in a broad variety of conditions. Viral vectors have been developed that may replace a defective gene, prevent expression of a mutant gene, or deliver a protective gene and thereby delay cellular loss. Using adeno-associated virus containing green fluorescent protein (AAV-GFP) we were able to specifically transduce cells located in the inner retina and induce over-expression of GFP in adult rat retinae. The delivery and expression of GFP had no influence themselves on retinal ganglion cell survival. Administration of the reporter vector AAV-GFP provided retinal ganglion cells with slight but significant protection from intravitreal NMDA. This was a locally mediated phenomenon; greater protection was seen in regions with more transduced cells. Any evaluation of the efficacy of a putative viral vector should consider the possible protective or toxic effect of the native virus.

bcl-2 gene therapy exacerbates excitotoxicity

The protooncogene bcl-2 can block neuronal death from both naturally occurring apoptosis and exogenous insults. bcl-2 is therefore a promising candidate for the prevention of excitotoxic neuronal death. Using an adeno-associated viral vector, we delivered the bcl-2 gene to the ganglion cell layer of the rat eye. We hypothesized that infection with bcl-2 would protect ganglion cells against excitotoxic cell death. However, retinal infection with bcl-2 increased ganglion cell susceptibility to both axonal injury and intravitreal NMDA. Our study--intended to explore the possibility of bcl-2 transduction as an in vivo therapeutic approach--revealed a deleterious effect of bcl-2 transduction.