Alcohol Use Disorder and Chronic Pain: An Overlooked Epidemic.

Alcohol use disorder (AUD) and chronic pain disorders are pervasive, multifaceted medical conditions that often co-occur. However, their comorbidity is often overlooked, despite its prevalence and clinical relevance. Individuals with AUD are more likely to experience chronic pain than the general population. Conversely, individuals with chronic pain commonly alleviate their pain with alcohol, which may escalate into AUD. This narrative review discusses the intricate relationship between AUD and chronic pain. Based on the literature available, the authors present a theoretical model explaining the reciprocal relationship between AUD and chronic pain across alcohol intoxication and withdrawal. They propose that the use of alcohol for analgesia rapidly gives way to acute tolerance, triggering the need for higher levels of alcohol consumption. Attempts at abstinence lead to alcohol withdrawal syndrome and hyperalgesia, increasing the risk of relapse. Chronic neurobiological changes lead to preoccupation with pain and cravings for alcohol, further entrenching both conditions. To stimulate research in this area, the authors review methodologies to improve the assessment of pain in AUD studies, including self-report and psychophysical methods. Further, they discuss pharmacotherapies and psychotherapies that may target both conditions, potentially improving both AUD and chronic pain outcomes simultaneously. Finally, the authors emphasize the need to manage both conditions concurrently, and encourage both the scientific community and clinicians to ensure that these intertwined conditions are not overlooked given their clinical significance.

Alpine glacier algal bloom during a record melt year.

Glacier algal blooms dominate the surfaces of glaciers and ice sheets during summer melt seasons, with larger blooms anticipated in years that experience the greatest melt. Here, we characterize the glacier algal bloom proliferating on Morteratsch glacier, Switzerland, during the record 2022 melt season, when the Swiss Alps lost three times more ice than the decadal average. Glacier algal cellular abundance (cells ml-1), biovolume (µm3 cell-1), photophysiology (Fv/Fm, rETRmax), and stoichiometry (C:N ratios) were constrained across three elevations on Morteratsch glacier during late August 2022 and compared with measurements of aqueous geochemistry and outputs of nutrient spiking experiments. While a substantial glacier algal bloom was apparent during summer 2022, abundances ranged from 1.78 × 104 to 8.95 × 105 cells ml-1 of meltwater and did not scale linearly with the magnitude of the 2022 melt season. Instead, spatiotemporal heterogeneity in algal distribution across Morteratsch glacier leads us to propose melt-water-redistribution of (larger) glacier algal cells down-glacier and presumptive export of cells from the system as an important mechanism to set overall bloom carrying capacity on steep valley glaciers during high melt years. Despite the paradox of abundant glacier algae within seemingly oligotrophic surface ice, we found no evidence for inorganic nutrient limitation as an important bottom-up control within our study site, supporting our hypothesis above. Fundamental physical constraints may thus cap bloom carrying-capacities on valley glaciers as 21st century melting continues.

Demystifying the 'hidden curriculum' for minoritized graduate students.

Graduate programs in the biomedical sciences dedicate considerable resources to recruiting students from underrepresented racial and ethnic groups. However, students from these minoritized groups have decreased access to the 'hidden curriculum' that must be navigated in order to be successful in graduate school. Here, we describe a student-led initiative at Johns Hopkins University, the Hidden Curriculum Symposium, that is organized to help prepare new students from underrepresented groups for graduate school. Preliminary evidence from surveys suggests that the initiative does increase the preparedness of minoritized students, and we believe this approach could also prove useful at other academic institutions.

Policy for Equity: Associations Between Community Mental Health Agency Policies and Clinicians' Cultural Competence.

Systemic reform is needed to address racism as a root cause of mental health inequities, such as understanding how community mental health (CMH) agencies' practices and policies may impact care provided to racially minoritized populations. This study described and examined associations between CMH clinicians' multicultural knowledge and awareness and agency practices and policies to improve care for Clients of Color. CMH clinicians (N = 119) across Washington State reported on their multicultural competence and agencies' practices and policies in an online survey. Multicultural competence was assessed with the Multicultural Counseling Knowledge and Awareness Scale (MCKAS), which assesses respondents' knowledge of multicultural counseling frameworks and awareness of multicultural counseling issues. Agency policies were examined with an adapted version of the Multiculturally Competent Service System (MCSS) Assessment Guide, which asked respondents to endorse the degree to which their agencies had taken specific steps to better serve racially and ethnically minoritized populations across 11 domains, including policies, linguistic diversity in services, and quality monitoring and improvement. Multicultural knowledge and awareness were generally high across the sample. Clinicians commonly endorsed that their agencies had mission statements that were committed to cultural competence. Endorsement of concrete steps to improve services for non-English speaking clients was associated with greater multicultural knowledge and awareness, and practices to monitor and improve care provided to Clients of Color were associated with lower scores. Addressing mental health inequities requires multifaceted solutions. Results highlight the potential of examining agency practices and policies as one solution to improve care for Clients of Color.

Artificial intelligence and machine learning in cardiotocography: A scoping review.

INTRODUCTION: Artificial intelligence (AI) is gaining more interest in the field of medicine due to its capacity to learn patterns directly from data. This becomes interesting for the field of cardiotocography (CTG) interpretation, since it promises to remove existing biases and improve the well-known issues of inter- and intra-observer variability. MATERIAL AND METHODS: The objective of this study was to map current knowledge in AI-assisted interpretation of CTG tracings and thus, to present different approaches with their strengths, gaps, and limitations. The search was performed on Ovid Medline and PubMed databases. The Preferred Reporting Items for Systematic Reviews and meta-Analysis for Scoping Reviews (PRISMA-ScR) guidelines were followed. RESULTS: We summarized 40 different studies investigating at least one algorithm or system to classify CTG tracings. In addition, the Oxford Sonicaid system is presented because of its wide use in clinical practice. CONCLUSIONS: There are several promising approaches in this area, but none of them has gained big acceptance in clinical practice. Further investigation and refinement of the algorithms and features are needed to achieve a validated decision-support system. For this purpose, larger quantities of curated and labeled data may be necessary.

Finding landmarks - An investigation of viewing behavior during spatial navigation in VR using a graph-theoretical analysis approach.

Vision provides the most important sensory information for spatial navigation. Recent technical advances allow new options to conduct more naturalistic experiments in virtual reality (VR) while additionally gathering data of the viewing behavior with eye tracking investigations. Here, we propose a method that allows one to quantify characteristics of visual behavior by using graph-theoretical measures to abstract eye tracking data recorded in a 3D virtual urban environment. The analysis is based on eye tracking data of 20 participants, who freely explored the virtual city Seahaven for 90 minutes with an immersive VR headset with an inbuild eye tracker. To extract what participants looked at, we defined "gaze" events, from which we created gaze graphs. On these, we applied graph-theoretical measures to reveal the underlying structure of visual attention. Applying graph partitioning, we found that our virtual environment could be treated as one coherent city. To investigate the importance of houses in the city, we applied the node degree centrality measure. Our results revealed that 10 houses had a node degree that exceeded consistently two-sigma distance from the mean node degree of all other houses. The importance of these houses was supported by the hierarchy index, which showed a clear hierarchical structure of the gaze graphs. As these high node degree houses fulfilled several characteristics of landmarks, we named them "gaze-graph-defined landmarks". Applying the rich club coefficient, we found that these gaze-graph-defined landmarks were preferentially connected to each other and that participants spend the majority of their experiment time in areas where at least two of those houses were visible. Our findings do not only provide new experimental evidence for the development of spatial knowledge, but also establish a new methodology to identify and assess the function of landmarks in spatial navigation based on eye tracking data.

Lipid Biomarkers From Microbial Mats on the McMurdo Ice Shelf, Antarctica: Signatures for Life in the Cryosphere.

Persistent cold temperatures, a paucity of nutrients, freeze-thaw cycles, and the strongly seasonal light regime make Antarctica one of Earth's least hospitable surface environments for complex life. Cyanobacteria, however, are well-adapted to such conditions and are often the dominant primary producers in Antarctic inland water environments. In particular, the network of meltwater ponds on the 'dirty ice' of the McMurdo Ice Shelf is an ecosystem with extensive cyanobacteria-dominated microbial mat accumulations. This study investigated intact polar lipids (IPLs), heterocyte glycolipids (HGs), and bacteriohopanepolyols (BHPs) in combination with 16S and 18S rRNA gene diversity in microbial mats of twelve ponds in this unique polar ecosystem. To constrain the effects of nutrient availability, temperature and freeze-thaw cycles on the lipid membrane composition, lipids were compared to stromatolite-forming cyanobacterial mats from ice-covered lakes in the McMurdo Dry Valleys as well as from (sub)tropical regions and hot springs. The 16S rRNA gene compositions of the McMurdo Ice Shelf mats confirm the dominance of Cyanobacteria and Proteobacteria while the 18S rRNA gene composition indicates the presence of Ochrophyta, Chlorophyta, Ciliophora, and other microfauna. IPL analyses revealed a predominantly bacterial community in the meltwater ponds, with archaeal lipids being barely detectable. IPLs are dominated by glycolipids and phospholipids, followed by aminolipids. The high abundance of sugar-bound lipids accords with a predominance of cyanobacterial primary producers. The phosphate-limited samples from the (sub)tropical, hot spring, and Lake Vanda sites revealed a higher abundance of aminolipids compared to those of the nitrogen-limited meltwater ponds, affirming the direct affects that N and P availability have on IPL compositions. The high abundance of polyunsaturated IPLs in the Antarctic microbial mats suggests that these lipids provide an important mechanism to maintain membrane fluidity in cold environments. High abundances of HG keto-ols and HG keto-diols, produced by heterocytous cyanobacteria, further support these findings and reveal a unique distribution compared to those from warmer climates.

Average stride length and stride rate of Thoroughbreds and Quarter Horses during racing.

The main factors influencing speed in athletes are stride length (SL) and stride rate (SR). However, conflict remains whether SL or SR is the key determinant of higher speeds. Quarter Horses (QH) generally reach higher speeds in their races than do Thoroughbreds (TB). However, the influence of SL and SR on this greater speed is unclear. Therefore, the main objective of this study was to compare SL and SR in QH and TB raced in short (sprint) and long (classic) distances. We hypothesized that QH have a higher SR in comparison to TB, and SR decreases as distance increases. Two race distances were analyzed for each breed: QH races of 100.6 and 402.3 m, and TB races of 1,207.0 and 2,011.7 m. Data from 20 horses were obtained, consisting of five horses from each race distance (10 QH and 10 TB). Five individuals watched recordings of each race three times counting the number of strides taken by each winning horse. The SR was calculated using the average number of strides over a given race duration, and SL was determined by calculating the total number of strides over the distance covered. Speed was calculated by dividing the distance by the time of the winning horse. The PROC Mixed Procedure was used to identify statistical differences between breeds, and between distances within the same breed. Results showed that although the SL of the TB was longer in comparison with the QH (P < 0.001), the average SR in QH was higher than in TB (2.88 vs. 2.34 + 0.03 strides/s; P < 0.001). Furthermore, QH classic distance demonstrated a faster speed than TB at either distance (P < 0.001). In conclusion, QH achieve a higher SR in comparison to TB (between 14% and 20% more than TB), confirming the importance of SR in achieving high racing speeds.

Polar Cryoconite Associated Microbiota Is Dominated by Hemispheric Specialist Genera.

Cryoconite holes, supraglacial depressions containing water and microbe-mineral aggregates, are known to be hotspots of microbial diversity on glacial surfaces. Cryoconite holes form in a variety of locations and conditions, which impacts both their structure and the community that inhabits them. Using high-throughput 16S and 18S rRNA gene sequencing, we have investigated the communities of a wide range of cryoconite holes from 15 locations across the Arctic and Antarctic. Around 24 bacterial and 11 eukaryotic first-rank phyla were observed in total. The various biotic niches (grazer, predator, photoautotroph, and chemotroph), are filled in every location. Significantly, there is a clear divide between the bacterial and microalgal communities of the Arctic and that of the Antarctic. We were able to determine the groups contributing to this difference and the family and genus level. Both polar regions contain a "core group" of bacteria that are present in the majority of cryoconite holes and each contribute >1% of total amplicon sequence variant (ASV) abundance. Whilst both groups contain Microbacteriaceae, the remaining members are specific to the core group of each polar region. Additionally, the microalgal communities of Arctic cryoconite holes are dominated by Chlamydomonas whereas the Antarctic cryoconite holes are dominated by Pleurastrum. Therefore cryoconite holes may be a global feature of glacier landscapes, but they are inhabited by regionally distinct microbial communities. Our results are consistent with the notion that cryoconite microbiomes are adapted to differing conditions within the cryosphere.

Leptin treatment prevents impaired hypoglycemic counterregulation induced by exposure to severe caloric restriction or exposure to recurrent hypoglycemia.

Hypoglycemia-associated autonomic failure (HAAF) is a maladaptive failure in glucose counterregulation in persons with diabetes (PWD) that is caused by recurrent exposure to hypoglycemia. The adipokine leptin is known to regulate glucose homeostasis, and leptin levels fall following exposure to recurrent hypoglycemia. Yet, little is known regarding how reduced leptin levels influence glucose counterregulation, or if low leptin levels are involved in the development of HAAF. The purpose of this study was to determine the effect of hypoleptinemia on the neuroendocrine responses to hypoglycemia. We utilized two separate experimental paradigms known to induce a hypoleptinemic state: 60% caloric restriction (CR) in mice and three days of recurrent hypoglycemia (3dRH) in rats. A sub-set of animals were also treated with leptin (0.5-1.0 µg/g) during the CR or 3dRH periods. Neuroendocrine responses to hypoglycemia were assessed 60 min following an IP insulin injection on the terminal day of the paradigms. CR mice displayed defects in hypoglycemic counterregulation, indicated by significantly lower glucagon levels relative to controls, 13.5 pmol/L (SD 10.7) versus 64.7 pmol/L (SD 45) (p = 0.002). 3dRH rats displayed reduced epinephrine levels relative to controls, 1900 pg/mL (SD 1052) versus 3670 pg/mL (SD 780) (p = 0.030). Remarkably, leptin treatment during either paradigm completely reversed this effect by normalizing glucagon levels in CR mice, 78.0 pmol/L (SD 47.3) (p = 0.764), and epinephrine levels in 3dRH rats, 2910 pg/mL (SD 1680) (p = 0.522). These findings suggest that hypoleptinemia may be a key signaling event driving the development of HAAF and that leptin treatment may prevent the development of HAAF in PWD.

Exploring the Relationship Between ADHD Symptoms and Daily Cannabis Consequences in Emerging Adulthood: The Role of Cannabis Motives.

OBJECTIVE: Research has documented the relationship between attention-deficit/hyperactivity disorder (ADHD) and increased cannabis use, but the studies largely rely on cross-sectional or longitudinal designs. Few studies have examined the impact of recent (i.e., past 6 months) ADHD symptoms on more proximal cannabis-related factors. The purpose of the current study was to examine the relationship between cannabis use motives (coping, boredom, and sleep) and consequences and the impact of ADHD symptoms on these relationships. METHOD: Participants were 62 emerging adults (ages 19-25 years; M = 22.12, SD = 2.07; 60% male) who used cannabis regularly (two or more times in the past 2 weeks) and completed a screener assessing past-6-months ADHD symptoms at baseline followed by 14 daily reports on cannabis use, consequences, and motives. RESULTS: Across the 14 days, cannabis consequences were higher for participants with greater past-6-months symptoms of ADHD. In addition, on days when participants used cannabis for boredom and on days when they used cannabis for sleep, cannabis consequences were higher. Although greater past-6-months ADHD symptoms were associated with more consequences on days when sleep motives were endorsed, contrary to hypotheses, the strength of this relationship was greater on days when sleep motives were not endorsed. Overall, greater daily consequences for those with higher ADHD symptoms may reflect exacerbation of these symptoms, and follow-up analyses revealed that the cannabis consequences associated with higher ADHD scores were indeed ones that overlap with ADHD symptoms. CONCLUSIONS: The results suggest that ADHD symptoms, along with sleep and boredom motives, contribute to increased daily cannabis consequences and should be considered in developing interventions for emerging adults.

Short-Term Pediatric Acclimatization to Adaptive Hearing Aid Technology.

Purpose This exploratory study assessed the perceptual, cognitive, and academic learning effects of an adaptive, integrated, directionality, and noise reduction hearing aid program in pediatric users. Method Fifteen pediatric hearing aid users (6-12 years old) received new bilateral, individually fitted Oticon Opn hearing aids programmed with OpenSound Navigator (OSN) processing. Word recognition in noise, sentence repetition in quiet, nonword repetition, vocabulary learning, selective attention, executive function, memory, and reading and mathematical abilities were measured within 1 week of the initial hearing aid fitting and 2 months post fit. Caregivers completed questionnaires assessing their child's listening and communication abilities prior to study enrollment and after 2 months of using the study hearing aids. Results Caregiver reporting indicated significant improvements in speech and sound perception, spatial sound awareness, and the ability to participate in conversations. However, there was no positive change in performance in any of the measured skills. Mathematical scores significantly declined after 2 months. Conclusions OSN provided a perceived improvement in functional benefit, compared to their previous hearing aids, as reported by caregivers. However, there was no positive change in listening skills, cognition, and academic success after 2 months of using OSN. Findings may have been impacted by reporter bias, limited sample size, and a relatively short trial period. This study took place during the summer when participants were out of school, which may have influenced the decline in mathematical scores. The results support further exploration with age- and audiogram-matched controls, larger sample sizes, and longer test-retest intervals that correspond to the academic school year.

Balanced Electrolyte Solutions or Normal Saline? Resuscitative Fluid Administration Practice in Swiss Pediatric Acute Care: A Cross-Sectional Study.

INTRODUCTION: The ideal asanguineous intravenous fluid for volume resuscitation in children is controversially debated and clinical practice guidelines are scarce. Administration of large amounts of normal saline has been associated with complications including hyperchloremic acidosis, dysnatremia, neurologic damage, and fatality. AIM: We examined the current practice of intravenous fluid and blood product administration in acutely ill and injured children among pediatric acute care physicians in Switzerland. METHODS: For this descriptive, cross-sectional study, pediatric emergency departments, pediatric and neonatal intensive care units were surveyed by means of an online questionnaire. RESULTS: Sixty of 66 departments and 47 of 87 participants returned the survey. Normal saline (NS) was most commonly administered (n = 42/46, 91.3%) and twice as many times as balanced electrolyte solutions (n = 20/46, 43.5%). The mean fluid volumes ranged from 7.9 to 19.1 mL/kg. Hypertonic saline/NS were selected most often for shock with severe head injury. Half of participants administered colloids (48.9%). Packed red blood cells (97.7%) and fresh frozen plasma (88.4%) were most frequently given blood products. CONCLUSION: There is a distinct practice variation in intravenous fluid and blood product administration in children in Switzerland. Although NS is most frequently given, we observed a trend toward the use of balanced electrolyte solutions. Prospective studies are warranted to compare NS with balanced electrolyte solution (BES) in the pediatric acute care setting. We suggest that pediatric fluid administration guidelines and mass transfusion protocols are implemented to standardize this frequent intervention and minimize complications.

A case of nasopharyngeal carcinoma and precious pregnancy.

Cancer during pregnancy is a rare condition. We report here a case of a lady diagnosed with nasopharyngeal carcinoma (NPC) at University of Malaya Medical Centre during her first pregnancy conceived via In Vitro Fertilisation (IVF). A multidisciplinary (MDT) meeting among Oncology, Obstetrics, Rheumatology and Otolaryngology teams was conducted to discuss her treatment options. She opted for treatment with Complementary and Alternative Medicine (CAM). This case illustrates the unique challenges in the oncological management of a patient diagnosed with NPC during pregnancy. It also serves as a reminder that the use of CAM in cancer patients is prevalent. It is important for doctors to inquire about use of CAM and to be well-informed about it. Transparent communication and taking cognizance of the goals and concerns of the patients are essential in delivering patient-centred care.

Auditory cognition and perception of action video game players.

A training method to improve speech hearing in noise has proven elusive, with most methods failing to transfer to untrained tasks. One common approach to identify potentially viable training paradigms is to make use of cross-sectional designs. For instance, the consistent finding that people who chose to avidly engage with action video games as part of their normal life also show enhanced performance on non-game visual tasks has been used as a foundation to test the causal impact of such game play via true experiments (e.g., in more translational designs). However, little work has examined the association between action video game play and untrained auditory tasks, which would speak to the possible utility of using such games to improve speech hearing in noise. To examine this possibility, 80 participants with mixed action video game experience were tested on a visual reaction time task that has reliably shown superior performance in action video game players (AVGPs) compared to non-players (≤ 5 h/week across game categories) and multi-genre video game players (> 5 h/week across game categories). Auditory cognition and perception were tested using auditory reaction time and two speech-in-noise tasks. Performance of AVGPs on the visual task replicated previous positive findings. However, no significant benefit of action video game play was found on the auditory tasks. We suggest that, while AVGPs interact meaningfully with a rich visual environment during play, they may not interact with the games' auditory environment. These results suggest that far transfer learning during action video game play is modality-specific and that an acoustically relevant auditory environment may be needed to improve auditory probabilistic thinking.

Consuming a ketogenic diet leads to altered hypoglycemic counter-regulation in mice.

Ketogenic diets (KDs) are becoming increasingly popular for the treatment of diabetes, yet they are associated with increased frequency of hypoglycemia. Here we report that mice fed a KD display blunted glucagon release to hypoglycemia and neuroglucopenia, suggesting that consuming a KD may increase the risk for iatrogenic hypoglycemia.

Crocodilepox Virus Evolutionary Genomics Supports Observed Poxvirus Infection Dynamics on Saltwater Crocodile (Crocodylus porosus).

Saltwater crocodilepox virus (SwCRV), belonging to the genus Crocodylidpoxvirus, are large DNA viruses posing an economic risk to Australian saltwater crocodile (Crocodylus porosus) farms by extending production times. Although poxvirus-like particles and sequences have been confirmed, their infection dynamics, inter-farm genetic variability and evolutionary relationships remain largely unknown. In this study, a poxvirus infection dynamics study was conducted on two C. porosus farms. One farm (Farm 2) showed twice the infection rate, and more concerningly, an increase in the number of early- to late-stage poxvirus lesions as crocodiles approached harvest size, reflecting the extended production periods observed on this farm. To determine if there was a genetic basis for this difference, 14 complete SwCRV genomes were isolated from lesions sourced from five Australian farms. They encompassed all the conserved genes when compared to the two previously reported SwCRV genomes and fell within three major clades. Farm 2's SwCRV sequences were distributed across all three clades, highlighting the likely mode of inter-farm transmission. Twenty-four recombination events were detected, with one recombination event resulting in consistent fragmentation of the P4c gene in the majority of the Farm 2 SwCRV isolates. Further investigation into the evolution of poxvirus infection in farmed crocodiles may offer valuable insights in evolution of this viral family and afford the opportunity to obtain crucial information into natural viral selection processes in an in vivo setting.

Maternal Obesity during Pregnancy Alters Daily Activity and Feeding Cycles, and Hypothalamic Clock Gene Expression in Adult Male Mouse Offspring.

An obesogenic diet adversely affects the endogenous mammalian circadian clock, altering daily activity and metabolism, and resulting in obesity. We investigated whether an obese pregnancy can alter the molecular clock in the offspring hypothalamus, resulting in changes to their activity and feeding rhythms. Female mice were fed a control (C, 7% kcal fat) or high fat diet (HF, 45% kcal fat) before mating and throughout pregnancy. Male offspring were fed the C or HF diet postweaning, resulting in four offspring groups: C/C, C/HF, HF/C, and HF/HF. Daily activity and food intake were monitored, and at 15 weeks of age were killed at six time-points over 24 h. The clock genes Clock, Bmal1, Per2, and Cry2 in the suprachiasmatic nucleus (SCN) and appetite genes Npy and Pomc in the arcuate nucleus (ARC) were measured. Daily activity and feeding cycles in the HF/C, C/HF, and HF/HF offspring were altered, with increased feeding bouts and activity during the day and increased food intake but reduced activity at night. Gene expression patterns and levels of Clock, Bmal1, Per2, and Cry2 in the SCN and Npy and Pomc in the ARC were altered in HF diet-exposed offspring. The altered expression of hypothalamic molecular clock components and appetite genes, together with changes in activity and feeding rhythms, could be contributing to offspring obesity.

Visual Outcome of Preterm Infants Screened in a Tertiary Care Hospital.

OBJECTIVE: The aim of this study is to assess the incidence of retinopathy of prematurity (ROP) in preterm infants and to compare the visual outcomes in babies with and without ROP. MATERIALS AND METHODS: A consecutive cohort of 812 preterm babies were recruited with gestational age ≤32 weeks and or birth weight ≤1500 g. The outcome was assessed at the end of 15 months by determining fixation behavior, cycloplegic refraction, and vision by Cardiff cards. Incidence of visual outcomes with 95% confidence limits and relative risks were estimated. Chi-squared test and t-test were used as tests of significance. RESULTS: The incidence of ROP was 25%. The incidence of myopia, hypermetropia, astigmatism, and strabismus were 15.8% (14.3-17.3), 6% (5.1-7.1), 55.6% (53.6-57.7), and 1.8% (1.4%-2.5%), respectively, in the cohort. The most common refractive error in terms of spherical equivalence was myopia (19.8% in ROP and 14.4% in non-ROP group). The mean visual acuity measured by Cardiff Acuity cards was 0.282 and 0.27 logarithm of the minimum angle of resolution units (right eye) and 0.293 and 0.277 (left eye) in patients with and without ROP, respectively. Strabismus was present in 5% of ROP group and 0.8% of non-ROP group babies. Babies with ROP had six times (risk ratio-6.02; 95% confidence interval 2.8-12.8) higher chance of developing strabismus than those without ROP. CONCLUSIONS: Ophthalmological morbidities in premature infants such as refractive errors and strabismus are high in addition to complications like ROP. The incidence of these conditions is more in infants with ROP when compared to non-ROP group.

Extraversion modulates cortisol responses to acute social stress in chronic major depression.

BACKGROUND: Chronic Major Depressive Disorder (CMDD) is a common, disabling illness that is often complicated by high reactivity to social stress. To further elucidate the nature of this reactivity, the current study evaluated whether the personality dimensions of neuroticism and extraversion influenced cortisol responses to a social challenge in CMDD patients vs. controls. METHODS: Fifty participants with CMDD and 58 healthy controls completed the Trier Social Stress Test (TSST) using a standard protocol. Neuroticism and extraversion were measured using the Revised NEO Personality Inventory. Hierarchical linear regressions assessed associations between independent variables neuroticism and extraversion and dependent variable cortisol area-under-the-curve increase (AUCi) in response to the TSST in the two study groups. RESULTS: The extraversion-by-group interaction was a significant predictor of cortisol AUCi, while no significant findings related to neuroticism were found. Simple slopes analysis revealed a significant negative association between extraversion and AUCi in the CMDD group, but not in healthy controls. Post-hoc analysis of the raw cortisol data over time found that CMDD participants with higher extraversion scores had significantly higher pre-challenge cortisol levels than did other study participants, however this did not explain or confound the AUCi results. CONCLUSIONS: In participants with CMDD but not in controls, higher levels of extraversion were associated with higher pre-challenge cortisol levels and decreased cortisol reactivity during the TSST, however these two findings were statistically independent. These findings underline the importance of considering personality factors when studying stress biology in CMDD patients. Extraversion may prove to be an important intermediate target for both research and clinical work in this complex, heterogenous and often treatment-resistant population.