Search Results (289)

Background/Objectives: Heart transplantation is a life-saving procedure for patients with end-stage heart failure, yet it involves significant psychological and emotional challenges throughout its various stages. International guidelines recommend a multi-professional approach to the care of these patients and a psycho-social assessment for listing. The recommendations focus on content aspects, but not on the psychometric measure to be administered to patients as part of the assessment. Therefore, the purpose of this study is to provide the preliminary results of administering the protocol used by our center, measuring coping strategies, cognitive functioning, quality of life, and psychological distress in a sample of patients who are candidates for and undergo cardiac transplantation, and to observe any variations after the procedure. Methods: We conducted a comprehensive psychological-clinical assessment involving 40 patients, focusing on psychosocial functioning, cognitive reserves, mental health, and coping strategies. Tools such as the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Beck Depression Inventory-II (BDI-II), Montreal Cognitive Assessment (MoCA), General Anxiety Disorder 7 (GAD-7), and Medical Outcomes Survey Short Form 36 (SF-36) were employed to evaluate readiness for transplantation and post-transplant adaptation. Results: Results showed high levels of clinical anxiety (52.5%) and low perceived physical health (98%) before the transplant, while post-operative evaluations indicated reduced anxiety (13.51%) and depressive symptoms (10.81%), along with improved psychological well-being and reintegration into daily life. Conclusions: These results show improvement in physical and cognitive levels, accompanied by a state of enhanced psychological well-being after transplantation. A longitudinal psychological approach, from pre-transplant screening to post-discharge follow-up, is needed to address distress, improve coping mechanisms, and promote treatment adherence. This integrative strategy is critical to improving the quality of life and long-term outcomes for heart transplant recipients. Full article

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by restricted social communication and repetitive behaviors. Prenatal stress is critical in neurodevelopment and increases risk for ASD, particularly in those with greater genetic susceptibility to stress. Docosahexaenoic acid (DHA) is one of the most abundant ω-3 fatty acids in the membrane phospholipids of the mammalian brain, and dietary DHA plays an important role in brain development and maintenance of brain structure. In this study, we investigated whether peri-natal supplementation of DHA can alleviate autistic-like behaviors in a genetic risk/stress mouse model and how it alters lipid peroxidation activity and GABAergic system gene expression in the forebrain. Pregnant heterozygous serotonin transporter knockout (SERT-KO) and wild-type (WT) dams were placed in either non-stressed control conditions or chronic variable stress (CVS) conditions and fed either a control diet or a DHA-rich (1% by weight) diet. Offspring of each group were assessed for anxiety and autism-associated behavior at post-natal day 60 using an open field test, elevated plus maze test, repetitive behavior, and the 3-chamber social approach test. A liquid chromatography-mass spectrometry (LC-MS)-based method was used to follow changes in levels of lipid peroxidation products in the cerebral cortex. Male offspring of prenatally stressed SERT-het KO dams exhibited decreased social preference behaviors and increased repetitive grooming behaviors compared to WT control offspring. Moreover, DHA supplementation in male SERT-het mice decreased frequency of grooming behaviors albeit showing no associated effects on social behaviors. Regardless of stress conditions, supplementation of DHA to the WT mice did not result in alterations in grooming nor social interaction in the offspring. Furthermore, no apparent changes were observed in the lipid peroxidation products comparing the stressed and non-stressed brains. Gad2 was downregulated in the cortex of female offspring of prenatally stressed SERT-KO dams, and this change appeared to be rescued by DHA supplementation in offspring. Gad2 was upregulated in the striatum of male offspring of prenatally stressed SERT-KO dams, but DHA did not significantly alter the expression compared to the control diet condition. Full article

Breast cancer (BC) is the leading cancer diagnosis among women in Puerto Rico. Psychological distress is prevalent in this population, and social determinants may exacerbate this risk. This study examines whether sociodemographic characteristics, financial burden, and social support levels are associated with symptoms of anxiety and depression in Puerto Rican women with BC. A quantitative secondary analysis was conducted on a sample of 208 Hispanic women with BC, utilizing the Patient Health Questionnaire (PHQ-8) and the Generalized Anxiety Disorder (GAD-7) questionnaire. These scores were compared with sociodemographic values and Interpersonal Support Evaluation List (ISEL-12) scores, establishing statistical significance through association, parametric, and non-parametric tests, and regression models. 38.5% and 26.4% of participants showed clinically significant symptoms of depression and anxiety, respectively. Age and perceived income showed significant associations with psychological outcomes. However, regression analysis revealed perceived income as the only significant predictor for both depression and anxiety. Tangible and belonging support were significantly lower in participants with symptoms of depression, while appraisal support was significantly lower in participants with symptoms of anxiety. Findings highlight the influence of perceived financial stress on mental health and the need for psychosocial interventions tailored to the patients’ economic context. Full article

Monascus produces various bioactive compounds, including monacolin K (MK), γ-aminobutyric acid (GABA), and Monascus pigments (MPs). Studies have shown that overexpressing genes within the MK biosynthetic cluster significantly enhances MK production. Additionally, MK synthesis in Monascus is regulated by other genes. Based on previous transcriptomic analyses conducted in our laboratory, a significant positive correlation was identified between the expression level of the GAD gene and MK production in M. pilosus. In this study, the GAD gene from M. pilosus was selected for overexpression, and a series of engineered M. pilosus strains were constructed. Among the 20 PCR-positive transformants obtained, 13 strains exhibited MK production increases of 12.84–52.50% compared to the parental strain, while 17 strains showed GABA production increases of 17.47–134.14%. To elucidate the molecular mechanisms underlying the enhanced production of MK and GABA, multi-omics analyses were performed. The results indicated that GAD overexpression likely promotes MK and GABA synthesis in M. pilosus by regulating key genes (e.g., HPD, HGD, and FAH) and metabolites (e.g., α-D-ribose-1-phosphate, β-alanine) involved in pathways such as tyrosine metabolism, phenylalanine metabolism, the pentose phosphate pathway, propanoate metabolism, and β-alanine metabolism. These findings provide theoretical insights into the regulatory mechanisms of MK and GABA biosynthesis in Monascus and suggest potential strategies for enhancing their production. Full article

Exposure to fine particulate matter (PM2.5) has become an increasing public health concern, particularly in urban areas facing severe air pollution. In response, individuals are increasingly turning to real-time tracking systems and self-monitoring tools. This study aimed to examine the association between PM2.5 risk perception, self-monitoring behaviors, and anxiety levels in the general population of Thailand. A cross-sectional survey was conducted during the dry season using an online questionnaire, which included the 7-item Generalized Anxiety Disorder (GAD-7) scale. A total of 921 participants residing in Bangkok and Chiang Mai were included. Binary logistic regression analysis, adjusted for sex, age, marital status, monthly income, and years of residence, revealed a significant association between anxiety and perceived health risks of PM2.5 exposure (OR = 1.09; 95% CI: 1.06–1.13). Daily self-monitoring of air quality over the past two weeks was also significantly linked to higher anxiety levels compared to non-monitoring individuals: OR = 1.92 (95% CI: 1.11–3.33) for websites, OR = 1.65 (95% CI: 1.01–2.72) for mobile apps, OR = 1.72 (95% CI: 1.12–2.64) for air purifiers, and OR = 3.34 (95% CI: 1.77–6.31) for air quality detectors. Monitoring 4–6 days per week using apps and air detectors was similarly associated with increased anxiety (OR = 1.64 and 2.30, respectively). Heightened perception of PM2.5 health risks and frequent self-monitoring behaviors are associated with increased anxiety among urban residents in Thailand. Public health interventions should consider implementing targeted alert systems during high-pollution periods and prioritize strategies to reduce PM2.5 emissions to alleviate public anxiety. Full article

Background: The early detection of type 1 diabetes (T1D) through screening for major islet autoantibodies is receiving increasing attention as a public health strategy, exemplified by the recent implementation of a pilot pediatric screening program in Italy. The transition from research-based screening to large-scale population initiatives needs automated and standardized assays that are capable of processing extensive sample volumes. Hence, this study aimed to evaluate the analytical performance and comparability of a fully automated chemiluminescence immunoassay (CLIA) compared to a conventional enzyme-linked immunosorbent assay (ELISA) for the detection of three classes of major islet antibodies—anti-GAD (GADA), anti-IA-2 (IA-2A), and anti-ZnT8 (ZnT8A). Methods: A total of 104 serum specimens were analyzed for each autoantibody using both ELISA (RSR and Medyzim, DYNES, DSX) and CLIA (MAGLUMI 800). Assay precision and linearity were assessed through intra-assay variability studies and dilution protocols. Methods agreement was evaluated with Passing–Bablok regression, Spearman’s correlation, Bland–Altman analysis, and Cohen’s kappa statistics. Results: The CLIA showed good precision and excellent linearity across clinically relevant concentration ranges of all islet antibodies. Correlation coefficients and categorical agreement between CLIA and ELISA were high (r > 0.96 and Cohen’s kappa >0.8 for all), with ZnT8A exhibiting the highest concordance. However, proportional biases were found, as CLIA systematically underestimated GADA and ZnT8A levels, while overestimated IA-2A compared to the ELISA. Conclusions: The CLIA displayed satisfactory precision and agreement with ELISA for GADA, IA-2A, and ZnT8A detection. Our findings support the use of these automated immunoassays in large-scale population initiatives for diagnosing T1D, but we also highlight the need for further efforts to achieve better inter-assay harmonization. Full article

Background: γ-Aminobutyric acid (GABA) is a non-proteinogenic amino acid with key roles in plant metabolism, stress responses, and fruit nutritional quality. In tomato (Solanum lycopersicum), GABA levels are dynamically regulated during fruit development but decline in the late ripening stages. Methods: To enhance GABA accumulation, we used CRISPR/Cas9 to edit the calmodulin-binding domain (CaMBD) of SlGAD2 and SlGAD3, which encode glutamate decarboxylases (GADs). The resulting truncated enzymes were expected to be constitutively active. We quantified GABA content in leaves and fruits and performed transcriptomic analysis on edited lines at the BR+7 fruit stage. Results: CaMBD truncation significantly increased GABA levels in both leaves and fruits. In gad2 sg1 lines, GABA levels increased by 3.5-fold in leaves and 3.2-fold in BR+10 fruits; in gad3 sg3 lines, increases of 2.8- and 2.5-fold were observed, respectively. RNA-seq analysis identified 1383 DEGs in gad2 #1−5 and 808 DEGs in gad3 #3−8, with 434 DEGs shared across both lines. These shared DEGs showed upregulation of GAD, GABA-T, and SSADH, and downregulation of stress-responsive transcription factors including WRKY46, ERF, and NAC. Notably, total free amino acid content and fruit morphology remained unchanged despite elevated GABA. Conclusions: CRISPR/Cas9-mediated editing of the CaMBD in SlGAD genes selectively enhances GABA biosynthesis in tomato without adverse effects on development or fruit quality. These lines offer a useful platform for GABA-centered metabolic engineering and provide insights into GABA’s role in transcriptional regulation during ripening. Full article

Background: Psychological impacts of the coronavirus disease 2019 (COVID-19) pandemic on individuals with chronic medical conditions remain understudied. Chronic kidney disease (CKD) is one of the chronic conditions associated with an increased risk of severe COVID-19 outcomes. The aim of this study was to define the psychological burden of individuals with CKD during the COVID-19 pandemic. Methods: In this cross-sectional study, 219 individuals with CKD were recruited from the Nephrology Outpatient Unit at the University Hospital Essen, Germany, and completed anonymous surveys incorporating validated psychological assessment tools for generalized anxiety (GAD-7) and depressive symptoms (PHQ-2), along with self-generated items addressing COVID-19-specific concerns and behavioral changes. These participants were propensity score matched with controls from the general German population. Results: Individuals with CKD exhibited lower levels of generalized anxiety and depressive symptoms compared to the general population. However, they reported significantly greater risk perceptions regarding the likelihood of experiencing symptoms, a severe disease course, and death from COVID-19. COVID-19-related fear and associated behavioral changes were more frequently reported among CKD patients. Adherent and dysfunctional safety behaviors predominated among the CKD cohort. Conclusions: This study underscores psychological challenges faced by individuals with CKD during the COVID-19 pandemic. The increased risk perceptions and fears of severe disease and mortality from COVID-19 emphasize the need for mental health interventions aimed at improving coping strategies alongside physical health management in this vulnerable population. Full article

Physical activity, sedentary behaviour, sleep quality, and anxiety are interrelated factors that play a critical role in physical and mental health. However, limited evidence exists on their associations within the Saudi Arabian context. This study aimed to investigate the relationships between physical activity, sedentary behaviour, sleep quality, and anxiety symptoms among healthy, pain-free adults in Saudi Arabia. A cross-sectional online survey was conducted between December 2024 and April 2025 using validated Arabic versions of the Global Physical Activity Questionnaire (GPAQ), the Brief Pittsburgh Sleep Quality Index (B-PSQI), and the Generalised Anxiety Disorder-7 (GAD-7). The data were analysed using descriptive statistics and multivariable linear regression models. A total of 185 participants (mean age = 33.99 ± 12.57 years; 69.73% female) were included. The average total physical activity was 1730.02 ± 2109.24 MET min/week, and the mean sedentary time was 6.77 ± 4.69 h/day. No significant associations were found between physical activity and either sleep quality or anxiety symptoms. Similarly, sedentary behaviour time was not significantly associated with sleep quality or anxiety symptoms. However, poorer sleep quality was significantly associated with higher anxiety levels. These findings highlight the importance of sleep quality in mental health strategies for healthy adults in Saudi Arabia. Full article

Background/Objectives: Mental health conditions represent a growing global health concern, disproportionately impacting populations in low- and middle-income countries like Pakistan. Limited epidemiological data, coupled with recent socioeconomic and environmental disruptions, has intensified the need for current insights into psychological burden and coping capacities in the Pakistani population. Methods: A descriptive, cross-sectional survey was conducted from January to May 2023 among 400 community-dwelling adults attending outpatient departments in Islamabad and Rawalpindi. A structured 75-item questionnaire incorporating validated tools (PHQ-9, GAD-7, WHO-5, CSES, and SRQ-20) was used to assess depression, anxiety, well-being, coping self-efficacy, and mental distress. Descriptive statistics, χ² and Fisher’s exact tests, and Spearman’s rank correlation (r_s) analyses were performed using IBM SPSS 22.0. Results: Most respondents were male (73.0%), aged 25–34 (60.0%), and urban-dwelling (80.0%). Clinically relevant depression and anxiety were observed in 57.0% and 19.5% of participants, respectively; 38.0% reported mental distress. Conversely, 76.5% demonstrated fair-to-good coping efficacy and 51.0% had high well-being scores. Younger age (≤34 years), higher income, urban residence, and male gender were associated with significantly better mental health outcomes. Strong positive correlation was found between PHQ-9 and GAD-7 scores (r_s = 0.672), and moderate negative correlations were found between GAD-7 and WHO-5 (r_s = −0.496), and PHQ-9 and WHO-5 (r_s = −0.310). Conclusions: Our findings highlight the significant psychological burden among urban Pakistani adults, alongside promising levels of resilience and coping self-efficacy. These results emphasize the urgent need for early, culturally adapted mental health screening and intervention programs in outpatient settings. Integrating such strategies into primary care, particularly for vulnerable subgroups like women, older adults, and those with lower income could facilitate timely diagnosis, improve outcomes, and reduce stigma surrounding mental health. Full article

Previous studies have demonstrated that slightly acidic electrolyzed water (SAEW) treatment can enhance rice seed growth and promote the accumulation of γ-aminobutyric acid (GABA), a bioactive compound. However, the underlying mechanisms remain unexplored. This study systematically investigated the effects of pH and available chlorine concentration (ACC) of SAEW on rice seed germination and GABA biosynthesis. The changing trends were monitored within 7 days. The results revealed that the treatment group with moderate pH (S2, pH 5.74 ± 0.04) showed significantly higher GABA accumulation (71.27 ± 0.45 mg/100 g) compared with S1 (pH 5.04 ± 0.03) and S3 (pH 6.38 ± 0.04) (p < 0.05). Furthermore, a positive correlation was observed between ACC levels and GABA accumulation, suggesting that ACC plays a crucial regulatory role in rice seed germination. These findings were further substantiated by monitoring the enzymatic activity of glutamate decarboxylase (GAD) throughout the germination process. Notably, while higher ACCs negatively impacted rice seed growth, pH variations within the tested range showed no adverse effects on seed development. The results show that optimal SAEW parameters, considering both pH and ACC, should be carefully determined for practical applications in rice seed production. Full article

Operating room (OR) scheduling problems are often addressed using deterministic models that assume surgery durations are known in advance. However, such assumptions fail to reflect the uncertainty that often occurs in real surgical environments, especially during the surgery and recovery stages. This study focuses on a robust scheduling problem involving a three-stage surgical process that includes pre-surgery, surgery, and post-surgery stages. The scheduling needs to coordinate multiple resources—pre-operative holding unit (PHU) beds, ORs, and post-anesthesia care unit (PACU) beds—while following a strict no-wait rule to keep patient flow continuous without delays between stages. The main goal is to minimize the makespan and improve schedule robustness when surgery and post-surgery durations are uncertain. To solve this problem, we propose a Genetic Algorithm for Robust Scheduling (GARS), which evaluates solutions using a scenario-based robustness criterion derived from multiple sampled instances. GARS is compared with four other algorithms: a deterministic GA (GAD), a random search (BRS), a greedy randomized insertion and swap heuristic (GRIS), and an improved version of GARS with simulated annealing (GARS_SA). The results from different problem sizes and uncertainty levels show that GARS and GARS_SA consistently perform better than the other algorithms. In large-scale tests with moderate uncertainty (30 surgeries, α = 0.5), GARS achieves an average makespan of 633.85, a standard deviation of 40.81, and a worst-case performance ratio (WPR) of 1.00, while GAD reaches 673.75, 54.21, and 1.11, respectively. GARS can achieve robust performance without using any extra techniques to strengthen the search process. Its structure remains simple and easy to use, making it a practical and effective approach for creating reliable and efficient surgical schedules under uncertainty. Full article

γ-aminobutyric acid (GABA) is a four-carbon non-protein amino acid, with many regulatory effects in humans. It aids in regulating blood glucose levels and pressure and is widely recognized for its ability to promote cognitive balance through the alleviation of stress and improvements in sleep quality. The GABA content of longan pulp is higher than that of many other fruits and vegetables; however, much is still unknown about GABA’s biosynthesis in longan. In this study, we found that the GABA content of ‘Baoshi No. 1’ (BS1) pulp was significantly higher than that of ‘Chunxiang’ (CX) pulp. The GAD activity was higher in BS1 pulp than CX pulp, while there was no significant difference in the GABA-T activity. Additionally, five GAD genes were identified in longan, and an analysis of their transcriptional levels showed that only the expression level of DlGAD3 corresponded to the GABA content and GAD activity. DlGAD3 was localized in the cytoplasm, and its transient overexpression promoted an increase in the GABA content in Nicotiana benthamiana leaves. Overall, our results show that DlGAD3 is able to promote the accumulation of GABA and may play a major role in its biosynthesis in longan pulp. Full article

Epigenetic research has made notable progress in recent years, yet our ability to explore the human brain at a cellular level remains limited. One of the main obstacles has been the difficulty of isolating specific neuronal populations from postmortem tissue—particularly interneurons, which play a central role in many psychiatric disorders. In this study, we present a practical and reproducible protocol for isolating GAD-positive interneurons from human brain samples. We isolate permeabilized cell-like structures suitable for downstream epigenetic analysis. To ensure specificity, we validated the isolated cells by comparing them with interneurons derived from human iPSCs. This approach allows for high-quality DNA extraction suitable for downstream epigenetic analysis, including methylation-specific PCR. By targeting a well-defined neuronal subtype, our method provides a solid foundation for studying the molecular changes associated with disorders such as schizophrenia and autism. This protocol opens new doors for cell-specific investigations in brain tissue, a step forward in understanding how epigenetic mechanisms contribute to neuropsychiatric pathophysiology. Full article

Less socially adaptive behaviors have often been underestimated in university students, with limited research addressing their impact on academic functioning. This study aimed to identify distinct profiles of social functioning difficulties in university students and to examine their associations with academic engagement, learning difficulties, and psychological distress. A cross-sectional, web-based survey was conducted with 540 undergraduate university students (mean age = 23.06, SD = 6.53; 89.7% female). Participants completed standardized self-report assessments of social functioning (SRS-2), academic engagement (SAES), learning difficulties (Vinegrad Plus), and psychological distress (GAD-7, PHQ-9). Latent profile analysis (LPA), based on ASD-related traits, revealed two latent profiles: one reflecting non-social functioning difficulties (311 participants, 57.6%—Profile 1) and another reflecting social functioning difficulties (229 participants, 42.4%—Profile 2), while binomial regression analyses examined their associations with academic outcomes. Participants in Profile 2 scored significantly higher than those in Profile 1 across all SRS-2 variables—awareness, cognition, communication, motivation, and restricted interests and repetitive behavior (p = 0.001)—indicating greater overall functioning in these domains. Students in the Non-social functioning difficulties profile showed higher levels of academic engagement in all areas. In contrast, students in the Social functioning difficulties profile experienced more self-reported learning challenges (p = 0.001), anxiety (p = 0.001), and depression (p = 0.001), underscoring the significant differences in social, academic, and emotional outcomes between the two profiles. These findings underscore the impact of vulnerability to social functioning difficulties on academic engagement, highlighting the need for tailored support systems within higher education settings. Full article