Low-dose naltrexone reduced anxiety in persons with multiple sclerosis during the COVID-19 pandemic.

Persons with multiple sclerosis (PwMS) have been considered at high risk for vaccination and/or acquisition of COVID-19 related to their reduced immune systems and daily regimen of immune suppressing therapy. Substantiated and unsubstantiated reports on these unknown circumstances increased anxiety and depression. Low-dose naltrexone (LDN) is a potentially effective off-label therapy shown to be effective at controlling fatigue for several autoimmune disorders including MS. This study utilized a small population of PwMS from central Pennsylvania in order to determine whether LDN therapy altered their perceived anxiety or depression during the early months of COVID-19. Utilizing mailed surveys, self-reported anxiety and depression scores were found to be significantly lower for PwMS who were prescribed LDN either alone or as an adjuvant to a standard disease modifying therapy (DMT) in comparison to those on oral disease-modifying therapies (DMTs). The data suggest that the non-toxic, inexpensive biotherapeutic may be beneficial in lessening anxiety.

Abnormalities in the copper transporter CTR1 in postmortem hippocampus in schizophrenia: A subregion and laminar analysis.

Dysbindin-1 modulates copper transport, which is crucial for cellular homeostasis. Several brain regions implicated in schizophrenia exhibit decreased levels of dysbindin-1, which may affect copper homeostasis therein. Our recent study showed decreased levels of dysbindin-1, the copper transporter-1 (CTR1) and copper in the substantia nigra in schizophrenia, providing the first evidence of disrupted copper transport in schizophrenia. In the present study, we hypothesized that there would be lower levels of dysbindin-1 and CTR1 in the hippocampus in schizophrenia versus a comparison group. Using semi-quantitative immunohistochemistry for dysbindin1 and CTR1, we measured the optical density in a layer specific fashion in the hippocampus and entorhinal cortex in ten subjects with schizophrenia and ten comparison subjects. Both regions were richly immunolabeled for CTR1 and dysbindin1 in both groups. In the superficial layers of the entorhinal cortex, CTR1 immunolabeled neuropil and cells showed lower optical density values in patients versus the comparison group. In the molecular layer of the dentate gyrus, patients had higher optical density values of CTR1 versus the comparison group. The density and distribution of dysbindin-1 immunolabeling was similar between groups. These laminar specific alterations of CTR1 in schizophrenia suggest abnormal copper transport in those locations.

Using a Systems Engineering Approach to Design an Interactive Mobile Health Application for Improving Asthma Self-management.

Mobile health applications are in demand. According to the Grand Review Research group, there were US $12.4 billion in mobile health app sales in 2018. Increasingly, providers are seeking new ways to engage their pediatric patients. One approach is through mobile health apps. Nearly 10 000 mobile health apps target youth and teens, especially for children with conditions that require complex treatment and self-management. One such chronic illness is asthma. Children with asthma who lack social support are particularly vulnerable to exacerbations because they often are not focused on self-care. For this reason, successful asthma programs for children engage family members, encouraging them to play an active role on the healthcare team. The Just-in-Time Asthma Self-management Intervention is unique in several ways compared to other asthma management mobile applications. The app uses gold standard, evidence-based asthma care practices and extends the support infrastructure beyond family and healthcare providers to engage the child, their peers, and school personnel. Further, the app was built using a systems engineering approach. This article reviews the basis for developing an asthma care mobile application including the conceptual framework supporting a systems model, how the Just-in-Time Asthma Self-management Intervention is unique, and how it was built using a systems engineering design.

There is an "app" for that: Designing mobile phone technology to improve asthma action plan use in adolescent patients.

PURPOSE: Asthma burden affects mortality, morbidity, quality of life, and the economy. Written asthma action plans are standard of care according to national guidelines, but these plans are often not prescribed. The purpose of this project was to develop an asthma action plan application for smartphones. DATA SOURCES: A development studio was consulted for support in developing a smartphone application to code the software for the asthma action plan and assist in the design process. During development of the application, a survey was conducted to assist in design of the application and functionality. CONCLUSIONS: All survey participants agreed that the application was easy to use, could be used without written instruction, and was designed for adolescents with asthma of any severity. Patients and providers mostly agreed that the app would help provide information about what to do in the event of an asthma exacerbation, and the application would be used frequently. IMPLICATIONS FOR PRACTICE: There was consensus from both patients and providers that this application is not only functional but also helpful in the event of an asthma exacerbation. The project met the goal of designing a mobile phone application that would improve patient access to asthma action plans.