Estimating the risk of PTSD in recent trauma survivors: results of the International Consortium to Predict PTSD (ICPP)

A timely determination of the risk of post‐traumatic stress disorder (PTSD) is a prerequisite for efficient service delivery and prevention. We provide a risk estimate tool allowing a calculation of individuals’ PTSD likelihood from early predictors. Members of the International Consortium to Predict PTSD (ICPP) shared individual participants’ item‐level data from ten longitudinal studies of civilian trauma survivors admitted to acute care centers in six countries. Eligible participants (N=2,473) completed an initial clinical assessment within 60 days of trauma exposure, and at least one follow‐up assessment 4‐15 months later. The Clinician‐Administered PTSD Scale for DSM‐IV (CAPS) evaluated PTSD symptom severity and diagnostic status at each assessment. Participants’ education, prior lifetime trauma exposure, marital status and socio‐economic status were assessed and harmonized across studies. The study's main outcome was the likelihood of a follow‐up PTSD given early predictors. The prevalence of follow‐up PTSD was 11.8% (9.2% for male participants and 16.4% for females). A logistic model using early PTSD symptom severity (initial CAPS total score) as a predictor produced remarkably accurate estimates of follow‐up PTSD (predicted vs. raw probabilities: r=0.976). Adding respondents’ female gender, lower education, and exposure to prior interpersonal trauma to the model yielded higher PTSD likelihood estimates, with similar model accuracy (predicted vs. raw probabilities: r=0.941). The current model could be adjusted for other traumatic circumstances and accommodate risk factors not captured by the ICPP (e.g., biological, social). In line with their use in general medicine, risk estimate models can inform clinical choices in psychiatry. It is hoped that quantifying individuals’ PTSD risk will be a first step towards systematic prevention of the disorder.     

Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges

Post‐traumatic stress disorder (PTSD) is arguably the most common psychiatric disorder to arise after exposure to a traumatic event. Since its formal introduction in the DSM‐III in 1980, knowledge has grown significantly regarding its causes, maintaining mechanisms and treatments. Despite this increased understanding, however, the actual definition of the disorder remains controversial. The DSM‐5 and ICD‐11 define the disorder differently, reflecting disagreements in the field about whether the construct of PTSD should encompass a broad array of psychological manifestations that arise after trauma or should be focused more specifically on trauma memory phenomena. This controversy over clarifying the phenotype of PTSD has limited the capacity to identify biomarkers and specific mechanisms of traumatic stress. This review provides an up‐to‐date outline of the current definitions of PTSD, its known prevalence and risk factors, the main models to explain the disorder, and evidence‐supported treatments. A major conclusion is that, although trauma‐focused cognitive behavior therapy is the best‐validated treatment for PTSD, it has stagnated over recent decades, and only two‐thirds of PTSD patients respond adequately to this intervention. Moreover, most people with PTSD do not access evidence‐based treatment, and this situation is much worse in low‐ and middle‐income countries. Identifying processes that can overcome these major barriers to better management of people with PTSD remains an outstanding challenge.     

Comparative study on floristic diversity of protected and unprotected Forests of Sathan Gali,District Mansehra,KP, Pakistan

This first ever study was carried out to explore the floristic composition of protected and unprotected forests of Sathan Gali, District Mansehra, KP, Pakistan. The study area being the part of the Western Himalayas harbours rich floristic diversity. In the current investigation, an effort was made to record primary data about floral diversity of the area. The study area was visited recurrently during 2013 and 2014. Plants were collected from different sampling sites, identified, preserved and deposited in Herbarium of Hazara University, Mansehra. A total of 127 plants species including 59 common and 68 different were found in 13 stands of reserved forest. The different species were only confined with this forest whereas common plant species were distributed in both forests. The dominant family was Asteraceae (13 species, 10.7%) followed by Labiateae (10 species, 7.75%), Poaceae and Rosaceae (8 species, 6.2%) each, Polygonaceae and Pteridaceae by (5 species, 3.87%) each. Angiosperms were represented by 118 (92.91%), plant species, Pteridophytes 5(3.93%) species and Gymnosperms 4 (3.14%) species were recorded in reserved forest. Only single species of climber was documented. The number of herbs, shrubs and trees species recorded were 73.64%, 13.17% and 10.07% respectively. A total of 103 plant species of 55 families including 61 common in both forest types and 42 species different to guzara Forest. These plant species were recorded from 22 sampling stands. Angiosperms by (92.3%) plant species, Gymnosperms (2.88%) and Pteridophytes (4.8%) were recorded. The dominant family was Poaceae by 11 plant species followed by Asteraceae and Rosaceae each represented by 10 species and Pteridaceae by 5 plant species. Habit wise 69.23% were herbs, 14.42% shrubs and 16.34% species of tree were reported. This study will assist ecologists, botanists, taxonomist, conservationists and policy makers to mend, and manage the current vegetation status and sustainability for upcoming generations. The present investigation will also serves as base line for future researches on the Himalaya regions.     

Multiple Roles of HIV-1 Capsid during the Virus Replication Cycle

Human immunodeficiency virus-1 capsid(HIV-1 CA) is involved in different stages of the viral replication cycle. During virion assembly, CA drives the formation of the hexameric lattice in immature viral particles, while in mature virions CA monomers assemble in cone-shaped cores surrounding the viral RNA genome and associated proteins. In addition to its functions in late stages of the viral replication cycle, CA plays key roles in a number of processes during early phases of HIV-1 infection including trafficking, uncoating, recognition by host cellular proteins and nuclear import of the viral preintegration complex. As a result of efficient cooperation of CA with other viral and cellular proteins, integration of the viral genetic material into the host genome, which is an essential step for productive viral infection, successfully occurs. In this review, we will summarize available data on CA functions in HIV-1 replication, describing in detail its roles in late and early phases of the viral replication cycle.     

Clinical Management of Patients Presenting with Non-Adjustable Gastric Band (NAGB) Complications

Background: A number of bariatric surgical procedures have been developed to manage morbid obesity and related co-morbidities. The non-adjustable gastric band (NAGB) was one such procedure that created restriction to food intake by gastric segmentation. Benefits of the procedure included a low risk of perioperative complications and substantial early weight loss. Unfortunately, the long term results of NAGB include a high incidence of complications and failure to maintain weight loss. The purpose of this study was to examine the presentation, workup, and treatment of patients presenting with complications following NAGB placement.Methods: A retrospective review of the diagnosis and management of 11 patients who presented with complications related to NAGB placement.Results: All patients presented with some degree of proximal gastric outlet obstruction. The majority of patients (8/11) presented with vomiting as the main complaint. Other complaints included intolerance to solids, liquids, and reflux. Only 2/11 patients presented with weight loss since undergoing NAGB placement, while the remainder had weight regain to their pre-NAGB level and above. Depending on clinical presentation, desire for additional weight loss and co-morbid conditions, patients underwent a variety of treatments. This included NAGB removal (endoscopic, laparo-endoscopic, and laparoscopic) as well as conversion to another bariatric procedure (sleeve gastrectomy, Roux-en-Y gastric bypass).Conclusion: Patients with NAGB complications present with symptoms related to a proximal gastric outlet obstruction, related to constriction imposed by the band. This may result in severe food and liquid intolerance and subsequent weight loss, but more likely results in maladaptive eating and subsequent weight gain. Optimal therapy involves removal of the NAGB. Laparoscopic conversion to another bariatric procedure, optimally a Roux-en-Y gastric bypass, is warranted to treat morbid obesity and associated co-morbidities.     

Genetic variants of TNFα, IL10, IL1β, CTLA4 and TGFβ1 modulate the indices of alcohol-induced liver injury in East Indian population

Alcohol induced liver disease or alcoholic liver disease (ALD), a complex trait, encompasses a gamut of pathophysiological alterations in the liver due to continuous exposure to a toxic amount of alcohol (more than 80g per day). Of all chronic heavy drinkers, only 15-20% develops hepatitis or cirrhosis concomitantly or in succession. Several studies revealed that inter-individual as well as inter-ethnic genetic variation is one of the major factors that predispose to ALD. The role of genetic factors in ALD has long been sought for in ethnically distinct population groups. ALD is fast emerging as an important cause of chronic liver disease in India; even in populations such as "Bengalis" who were "culturally immune" earlier. While the genetic involvement in the pathogenesis of ALD is being sought for in different races, the complex pathophysiology of ALD as well as the knowledge of population level diversity of the relevant alcohol metabolizing and inflammatory pathways mandates the need for well designed studies of genetic factors in ethnically distinct population groups. An array of cytokines plays a critical role as mediators of injury, inflammation, fibrosis and cirrhosis in ALD. We, therefore, studied the association of polymorphisms in five relevant cytokine genes with "clinically significant" ALD in an ethnic "Bengali" population in Eastern India. Compared with "alcoholic" controls without liver disease (n=110), TNFα -238AA genotype, IL1β -511CC genotype, TGFβ1 -509CC genotype and IL10 -592AA genotype were significantly overrepresented in ALD patients (n=181; OR=2.4 and 95% CI 1.2-5.5, P(genotype)=0.042, P(allelic)=0.008; OR=2.7 and 95% CI 1.2-5.9, P(genotype)=0.018, P(allelic)=0.023; OR=4.7 and 95% CI 1.7-13.1, P(genotype)=0.003, P(allelic)=0.014; and OR=2.2 and 95% CI 1.1-4.8, P(genotype)=0.04, P(allelic)=0.039 respectively). Moreover a cumulative genetic risk analysis revealed a significant trend for developing ALD with an increase in the number of risk alleles on IL10 and TGFβ1 loci among alcoholics. The risk genotype of IL1β and TGFβ1 also influences the total bilirubin, albumin and alanine aminotransferase levels among alcoholic "Bengalis". The present study is the first case-control study from Eastern India that comprehensively identified polymorphic markers in TNFα, IL10, IL1β and TGFβ1 genes to be associated with ALD in the Bengali population, accentuating the significance of genetic factors in clinical expressions of ALD.     

Post-Covid alliance-mucormycosis,a fatal sequel to the pandemic in India

As the battle against the deadly Covid-19 pandemic is still continuing worldwide, several complications are being reported in patients who have recovered post-covid. One such lethal complication being reported in patients in India in recent times, who have tested positive for Covid-19 and are gradually recovering, is a fungal disease called Mucormycosis or the black fungus. With several hundreds of cases being reported all over the country, it has triggered an additional wave of panic among the general public. Post-Covid-19 patients who are more vulnerable to Mucormycosis are those with a history of poorly controlled diabetes mellitus and also those who are immuno-compromised and have been treated with steroids and other drugs for Covid-19. The aim of this short review is to briefly cover the epidemiology of mucormycosis, its possible pathophysiology in Post Covid scenario, the clinical presentation and its diagnosis and management.     

Phylogeography of a widespread terrestrial vertebrate in a barely-studied Palearctic region: green toads (<Emphasis Type="Italic">Bufo viridis</Emphasis> subgroup) indicate glacial refugia in Eastern Central Asia

The phylogeography of western Palearctic species is relatively well studied, but data on Eastern Central Asia are scarce. We present one of the first data sets from a widespread terrestrial vertebrate (Bufo pewzowi) inhabiting Eastern Central Asian mountains and deserts to gain knowledge on its phylogeography in this region. We applied combined phylogenetic and demographic analyses to understand the evolutionary history using mitochondrial DNA D-loop variation of toads from 37 locations. Genetic structure of Bufo pewzowi is strongly affected by landscape: we found three haplotype groups in eastern Kazakhstan, Dzungaria and Tarim Basin, divided by the Tian Shan and Dzungarian Alatau ranges. A vicariant hypothesis may explain divergence among groups. The divergence time of the three major clades was estimated about 0.9 million years ago (confidence interval 0.5–1.4), and is discussed with respect to Quaternary uplifting and glaciation in the Tian Shan. Demographic analyses provided evidence for both historical bottlenecks and population expansions and suggested Pleistocene signatures. Glacial refugia were inferred in the Tarim Basin (around the Turpan depression), in southern Dzungaria (Urumqui region), at the northern foot of the Tian Shan (Gongnaisi) and perhaps at the Altai range (Terekti). Regional Post-Last Glacial Maximum dispersal patterns are proposed. A taxonomic hypothesis is presented. This study provides a detailed history of how a widespread terrestrial vertebrate responded to geological change and Quaternary glacial events in Eastern Central Asia and may have significance for future phylogeographic research in this understudied region.     

后基因组时代生物信息学的发展趋势

介绍生物信息学产生背景、发展过程以及研究现状,讨论了后基因组时代分子生物学的主要研究领域功能基因组学、蛋白质组学、比较基因组学、药物基因组学之间的关系。在分析基因组时代和后基因组时代生物信息学所研究内容的差异基础上．说明了基于分层递阶结构的系统结构、特征分析方法以及相应的软件系统开发将成为生物信息学发展的基本趋势之一。