Differentiation between bipolar disorder and major depressive disorder in adolescents: from clinical to biological biomarkers.

Background: Mood disorders are very common among adolescents and include mainly bipolar disorder (BD) and major depressive disorder (MDD), with overlapping depressive symptoms that pose a significant challenge to realizing a rapid and accurate differential diagnosis in clinical practice. Misdiagnosis of BD as MDD can lead to inappropriate treatment and detrimental outcomes, including a poorer ultimate clinical and functional prognosis and even an increased risk of suicide. Therefore, it is of great significance for clinical management to identify clinical symptoms or features and biological markers that can accurately distinguish BD from MDD. With the aid of bibliometric analysis, we explore, visualize, and conclude the important directions of differential diagnostic studies of BD and MDD in adolescents. Materials and methods: A literature search was performed for studies on differential diagnostic studies of BD and MDD among adolescents in the Web of Science Core Collection database. All studies considered for this article were published between 2004 and 2023. Bibliometric analysis and visualization were performed using the VOSviewer and CiteSpace software. Results: In total, 148 publications were retrieved. The number of publications on differential diagnostic studies of BD and MDD among adolescents has been generally increasing since 2012, with the United States being an emerging hub with a growing influence in the field. Boris Birmaher is the top author in terms of the number of publications, and the Journal of Affective Disorders is the most published journal in the field. Co-occurrence analysis of keywords showed that clinical characteristics, genetic factors, and neuroimaging are current research hotspots. Ultimately, we comprehensively sorted out the current state of research in this area and proposed possible research directions in future. Conclusion: This is the first-ever study of bibliometric and visual analyses of differential diagnostic studies of BD and MDD in adolescents to reveal the current research status and important directions in the field. Our research and analysis results might provide some practical sources for academic scholars and clinical practice.

Pleiotropic Association of CACNA1C Variants With Neuropsychiatric Disorders.

BACKGROUND: Neuropsychiatric disorders are highly heritable and have overlapping genetic underpinnings. Single nucleotide polymorphisms (SNPs) in the gene CACNA1C have been associated with several neuropsychiatric disorders, across multiple genome-wide association studies. METHOD: A total of 70,711 subjects from 37 independent cohorts with 13 different neuropsychiatric disorders were meta-analyzed to identify overlap of disorder-associated SNPs within CACNA1C. The differential expression of CACNA1C mRNA in five independent postmortem brain cohorts was examined. Finally, the associations of disease-sharing risk alleles with total intracranial volume (ICV), gray matter volumes (GMVs) of subcortical structures, cortical surface area (SA), and average cortical thickness (TH) were tested. RESULTS: Eighteen SNPs within CACNA1C were nominally associated with more than one neuropsychiatric disorder (P < .05); the associations shared among schizophrenia, bipolar disorder, and alcohol use disorder survived false discovery rate correction (five SNPs with P < 7.3 × 10-4 and q < 0.05). CACNA1C mRNA was differentially expressed in brains from individuals with schizophrenia, bipolar disorder, and Parkinson's disease, relative to controls (three SNPs with P < .01). Risk alleles shared by schizophrenia, bipolar disorder, substance dependence, and Parkinson's disease were significantly associated with ICV, GMVs, SA, or TH (one SNP with P ≤ 7.1 × 10-3 and q < 0.05). CONCLUSION: Integrating multiple levels of analyses, we identified CACNA1C variants associated with multiple psychiatric disorders, and schizophrenia and bipolar disorder were most strongly implicated. CACNA1C variants may contribute to shared risk and pathophysiology in these conditions.

Design and Simulated Electrical Properties of a Proposed Implanted-Epi Silicon 3D-Spherical Electrode Detector.

A new type of 3D electrode detector, named here as the Implanted-Epi Silicon 3D-Spherical Electrode Detector, is proposed in this work. Epitaxial and ion implantation processes can be used in this new detector, allowing bowl-shaped electrodes to penetrate the silicon completely. The distance between the bowl cathode and the central collection electrode is basically the same, thus the total depletion voltage of Implanted-Epi Silicon 3D-Spherical Electrode Detectors is no longer directively correlated with the thickness of the silicon wafer, but only related to the electrode spacing. In this work, we model the device physics of this new structure and use a simulation program to conduct a systematic 3D simulation of its electrical characteristics, including electric potential and electric field distributions, electron concentration profile, leakage current, and capacitance, and compare it to the traditional 3D detectors. The theoretical and simulation study found that the internal electric potential of the new detector was smooth and no potential saddle point was found. The electric field is also uniform, and there is no zero field and a low electric field area. Compared with the traditional silicon 3D electrode detectors, the full depletion voltage is greatly reduced and the charge collection efficiency is improved. As a large electrode spacing (up to 500 µm) can be realized in the Implanted-Epi Silicon 3D-Spherical Electrode Detector thanks to their advantage of a greatly reduced full depletion voltage, detectors with large pixel cells (and thus small dead volume) can be developed for applications in photon science (X-ray, among others).

Palliative care referral criteria and application in pediatric illness care: A scoping review.

BACKGROUND: Specialty pediatric palliative care services can help to address unmet care needs for children with complex and serious illness. Current guidelines support the identification of unmet palliative care needs; however, it is unknown how these guidelines or other clinical characteristics influence pediatric palliative care referral in research and practice. AIM: To evaluate the identification and application of palliative care referral criteria in pediatric illness care and research. DESIGN: A scoping review with a content analysis approach to summarize results. DATA SOURCES: Five electronic databases (PubMed, CINAHL, PsycINFO, SCOPUS, and Academic Search Premier) were used to identify peer-reviewed literature published in English between January 2010 and September 2021. RESULTS: We included 37 articles focused on the referral of pediatric patients to palliative care teams. The identified categories of referral criteria were: disease-related; symptom-related; treatment communication; psychosocial, emotional, and spiritual support; acute care needs; end-of-life care needs; care management needs; and self-referrals for pediatric palliative care services. We identified two validated instruments to facilitate palliative care referral and seven articles which described population-specific interventions to improve palliative care access. Nineteen articles implemented a retrospective health record review approach that consistently identified palliative care needs with varying rates of service use. CONCLUSIONS: The literature demonstrates inconsistent methods for identifying and referring children and adolescents with unmet palliative care needs. Prospective cohort studies and clinical trials would inform more consistent pediatric palliative care referral practices. More research is needed on palliative care referral and outcomes in community-focused pediatrics.

The capability of chloramphenicol biotransformation of Klebsiella sp. YB1 under cadmium stress and its genome analysis.

Co-contamination by antibiotics and heavy metal is common in the environment, however, there is scarce information about antibiotics biodegradation under heavy metals stress. In this study, Klebsiella sp. Strain YB1 was isolated which is capable of biodegrading chloramphenicol (CAP) with a biodegradation efficiency of 22.41% at an initial CAP of 10 mg L-1 within 2 days. CAP biodegradation which fitted well with the first-order kinetics. YB1 still degrades CAP under Cd stress, however 10 mg L-1 Cd inhibited CAP biodegradation by 15.1%. Biotransformation pathways remained the same under Cd stress, but two new products (Cmpd 19 and Cmpd 20) were identified. Five parallel metabolism pathways of CAP were proposed with/without Cd stress, including one novel pathway (pathway 5) that has not been reported before. In pathway 5, the initial reaction was oxidation of CAP by disruption of C-C bond at the side chain of C1 and C2 with the formation of 4-nitrobenzyl alcohol and CY7, then these intermediates were oxidized into p-nitrobenzoic acid and CY1, respectively. CAP acetyltransferase and nitroreductase and 2,3/4,5-dioxygenase may play an important role in CAP biodegradation through genome analysis and prediction. This study deepens our understanding of mechanism of antibiotic degradation under heavy metal stress in the environment.

Biotransformation of chloramphenicol by white-rot-fungi Trametes versicolor under cadmium stress.

The recalcitrant chloramphenicol (CAP) combined with heavy metals cadmium (Cd) commonly co-existed in the environment, posing threat to environment health. The capacity of Trametes versicolor to remove/biodegrade CAP in air-pulse fluidized-bed reactor was evaluated, even under Cd stress. T. versicolor could remove 44 % CAP of 5 mg/L in 15 days, even 51 % CAP under 1 mg/L Cd stress. Sustained Cd stress inhibited CAP biodegradation and Cd removal in a 5-batches of a 5-days cycle sequential batch reactor. Nine transformation products and two novel pathways were proposed, with initial multi-step transformation reaction into CP2 and allylic alcohol, respectively. Furthermore, the main mechanism of Cd removal by T. versicolor was extracellular surface bioadsorption and intracellular accumulation. This study filled the gap of the mechanism of simultaneous CAP removal/biodegradation and Cd removal by white-rot fungi T. versicolor, which offer a theoretical basis for future application of biological removal of CAP containing wastewater.

The mechanism of phosphate solubilizing of Pseudomonas sp. TC952 and its solubilizing process on TC removal.

Antibiotics undergo a series of complex transport and transformation route after entering the environment; however, there is scarce information about the effects of the bacterial phosphate-solubilizing process on tetracycline (TC) transformation. In this study, Pseudomonas sp. TC952 was identified as phosphate-solubilizing bacterium with high phosphate-solubilizing ability even under TC stress; it could solubilize maximum phosphate with a production of 400 mg/L soluble phosphate in 2 days. TC did not affect phosphate solubilizing in a short time incubation, but slightly promoted in a long incubation time. TC was adsorbed by inorganic phosphate with high efficiency of 53.09% within 1 day. Four tetracycline antibiotic resistance and sixteen inorganic phosphate-solubilizing-related genes were identified in the genome, which revealed the phosphate-solubilizing mechanism was that strain TC952 secrete organic acid to resolve inorganic phosphate and also secrete siderophore to chelate inorganic phosphate. So, during the inorganic phosphate-solubilizing process of strain TC952, TC was de-adsorbed from inorganic phosphate, and the solution was acidified into pH 4.3 through secreting organic acid to dissolve inorganic phosphorus, which resulted in Ca2+ and PO43- releasing into the solution. Finally, the acidic condition and PO43- enhanced TC hydrolysis. The mechanism of phosphate-solubilizing process on TC removal and genome analysis provides us new insight of the TC migration and transformation route in the environment.

Novel Spiral Silicon Drift Detector with Equal Cathode Ring Gap and Given Surface Electric Fields.

Since the advent of semiconductor detectors, they have been developed for several generations, and their performance has been continuously improved. In this paper, we propose a new silicon drift detector structure that is different from the traditional spiral SDD structure that has a gap between the cathode ring and the width of cathode ring, increasing gradually with the increase of the radius of the cathode ring. Our new structure of spiral SDD structure has equal cathode ring gap and a given surface electric field, which has many advantages compared with the traditional structure. The novel SDD structure controllably reduces the area of silicon oxide between the spiral rings, which in turn reduces the surface leakage current due to the reduction of total oxide charge in the silicon oxide and electronic states on the silicon/silicon oxide interface. Moreover, it has better controllability to adjust this spiral ring cathode gap to achieve better surface electric field distribution, thus realizing the optimal carrier drift electric field and achieving the optimal detector performance. In order to verify this theory, we have modeled this new structure and simulated its electrical properties using the Sentaurus TCAD tool. We have also analyzed and compared different spiral ring cathode gap structures (from 10 µm to 25 µm for the gap). According to the simulation results of potential, electric field, and electron concentration, we have obtained that a spiral ring cathode gap of 10 µm has the best electrical characteristics, more uniform distribution of potential and surface electric field, and a more smooth and straight electron drift channel.

Induction of zincophore pseudopaline secretion by Cr(VI) and intracellular formation of granules from nanocrystal aggregation by Cr(III) in Pseudomonas aeruginosa.

When microorganisms are challenged with toxic metals, intracellular granules are commonly observed, however, the exact nature of these granules is poorly understood. Here we show that when Pseudomonas aeruginosa CCTCC AB93066 were exposed to Cr(VI), Cr can enter the cell in the form of both Cr(VI) and Cr(III), and intracellular granules of several hundred nanometers were formed in the nucleoid region and were built up by aggregation of nanocrystals. We suggested that these nanocrystals are organic crystals. Transcriptomic profiles and liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis indicated that pseudopaline (a metallophore that can complex with Zn2+) production and pseudopaline-Zn2+ import into bacterial cells were enhanced upon Cr(VI) exposure. It was proposed that pseudopaline can scavenge Zn2+ which is essential for transcription alteration and DNA repair. Excessive pseudopaline might precipitate as nanospheres in the nuclear region that are further agglomerated by Cr(III) to form larger granules. During this process, Cr(III) is sequestered and immobilized. Hence we revealed pseudopaline production and zinc acquisition is crucial for alleviation of Cr(VI) toxicity and intracellular granules are composed of organic nanospheres which are aggregated by Cr(III).

Carbon source type can affect tetracycline removal by Pseudomonas sp. TC952 through regulation of extracellular polymeric substances composition and production.

The objective of this work is to elucidate the mechanism of tetracycline (TC) removal by Pseudomonas sp. TC952. The TC removal characteristics of strain TC952 under various environmental conditions were studied. Results showed that the bio-removal efficiency was significantly affected by initial TC and peptone concentration, pH values, divalent metal ion (Zn2+) and carbon source, and the strain TC952 efficiently removed approximately 72.8% of TC within 6 days with 10 g/L peptone. The best conditions for strain TC952 to remove TC are as follows: initial TC concentration is 50 mg/L, solution initial pH is 7, Zn2+ concentration is 0.1 µg/L, carbon source is peptone. And through intra- and extracellular fractions assay and extracellular polymeric substances (EPS) component analysis, TC removal by strain TC952 was mainly attributed to the adsorption by bacterial EPS and bacterial cell. Furthermore, different carbon source affected the EPS production content and component of strain TC952, so EPS produced under peptone and serine conditions could bio-adsorb TC and formed a buffer area outside the cells, thus reducing or preventing TC from entering the bacteria cells. All the results obtained showed that secretion of EPS and adsorption of TC by EPS and bacterial cell wall may be a common way for bacteria to reduce TC in the environment, which brought novel insights for better management of TC contamination by functional bacteria and for understanding the natural removal process of antibiotics by microorganisms in the environment.

Biodegradation mechanism of chloramphenicol by Aeromonas media SZW3 and genome analysis.

The overuse of chloramphenicol (CAP) due to its low price is detrimental to ecological safety and human health. An earthworm gut content dwelling bacterium, Aeromonas media SZW3, was isolated with capability of CAP biodegradation, and the CAP degradation efficiency reached 55.86% at day 1 and 67.28% at day 6. CAP biodegradation kinetics and characteristic of strain SZW3 determined the factors that affect CAP biodegradation. Thirteen possible biodegradation products were identified, including three novel biodegradation products (CP1, CP2 and CP3), and three potential biodegradation pathway were proposed. Biodegradation reactions include amide bond hydrolysis, nitro group reduction, acetylation, aminoacetylation, dechlorination and oxidation. Genome analysis suggested that the coding gene of RarD (CAP resistance permease), CAP O-acetyltransferase, nitroreductase and haloalkane dehalogenase may be responsible for CAP biodegradation. The proposed complete biodegradation pathway and genome analysis by strain SZW3 provide us new insight of the transformation route and fate of CAP in the environment.

The survival and removal mechanism of Sphingobacterium changzhouense TC931 under tetracycline stress and its' ecological safety after application.

Sphingobacterium changzhouense TC931 was isolated as a novel TC (tetracycline) removal bacterium through adsorption on extracellular polymerase substances (EPS) and cellular surface and biodegradation. TC biodegradation efficiency by strain TC931 was affected by solution initial pH and carbon source. Polysaccharides and hydrocarbons in EPS and cellular surface were responsible for TC biosorption. Eight possible biodegradation products were identified and the biodegradation pathway was proposed. Strain TC931 was rich in antibiotic resistance genes, and tetX-TC931 and antibiotics resistance genome island (GI) may be acquired via horizontal gene transfer in early evolutionary history. The GI was incomplete and may stable in strain TC931, but it could develop into an intact and transferability GI with help of other mobile genetic elements. This work offers a theoretical basis for understanding the survival and biodegradation mechanisms of S. changzhouense TC931 under TC stress, and offers an ecological safety assessment for its application in environmental bioremediation.

Neonatal Pain: Perceptions and Current Practice.

Neonates may experience more than 300 painful procedures throughout their hospitalizations. Prior to 1980, there was a longstanding misconception that neonates do not experience pain. Current studies demonstrate that not only do neonates experience pain but also, due to their immature nervous systems, they are hypersensitive to painful stimuli. Poorly treated pain may lead to negative long-term consequences. Proper assessment of neonate pain is vital. The use of nonpharmacologic treatments may be beneficial in alleviating neonate pain. Pharmacologic treatments in the neonate have been well established. Pharmacologic and nonpharmacologic interventions can be used in conjunction to increase the efficacy of analgesia.