Cohort Profile:Stratifying Resilience and Depression Longitudinally (STRADL): a questionnaire follow-up of Generation Scotland: Scottish Family Health Study (GS:SFHS)

Funding: STRADL is supported by the Wellcome Trust through a Strategic Award (reference 104036/Z/14/Z). The Chief Scientist Office of the Scottish Government Health Department (CZD/16/6) and the Scottish Funding Council (HR03006) provided core support for Generation Scotland. A.M.M. is supported by the Dr Mortimer and Theresa Sackler Foundation. D.J.M. is supported by an NRS Fellowship, funded by the CSO. J.S., J.M.W., K.L.E., D.J.P., I.J.D. and A.M.M. are members of the Centre for Cognitive Ageing and Cognitive Epidemiology which also supports I.J.D.; funding from the Medical Research Council and Biotechnology and Biological Sciences Research Council is gratefully acknowledged (MR/K026992/1). Acknowledgments: We would like to express gratitude to all individuals who have taken part in both GS:SFHS and STRADL, and the entire project team including academic researchers, administrative staff, research managers and statisticians. Conflict of interest: The authors declare that they have no conflicting interests.Peer reviewedPublisher PD

HPV sensitizes OPSCC cells to cisplatin-induced apoptosis by inhibiting autophagy through E7-mediated degradation of AMBRA1

Oropharyngeal squamous cell carcinoma (OPSCC) is an increasing world health problem with a more favorable prognosis for patients with human papillomavirus (HPV)-positive tumors compared to those with HPV-negative OPSCC. How HPV confers a less aggressive phenotype, however, remains undefined. We demonstrated that HPV-positive OPSCC cells display reduced macroautophagy/autophagy activity, mediated by the ability of HPV-E7 to interact with AMBRA1, to compete with its binding to BECN1 and to trigger its calpain-dependent degradation. Moreover, we have shown that AMBRA1 downregulation and pharmacological inhibition of autophagy sensitized HPV-negative OPSCC cells to the cytotoxic effects of cisplatin. Importantly, semi-quantitative immunohistochemical analysis in primary OPSCCs confirmed that AMBRA1 expression is reduced in HPV-positive compared to HPV-negative tumors. Collectively, these data identify AMBRA1 as a key target of HPV to impair autophagy and propose the targeting of autophagy as a viable therapeutic strategy to improve treatment response of HPV-negative OPSCC. Abbreviations: AMBRA1: autophagy and beclin 1 regulator 1; CDDP: cisplatin (CDDP); FFPE: formalin-fixed paraffin-embedded (FFPE); HNC: head and neck cancers (HNC); HPV: human papillomavirus (HPV); hrHPV: high risk human papillomavirus (hrHPV); OCSCC: oral cavity squamous carcinomas (OCSSC); OPSCC: oropharyngeal squamous cell carcinoma (OPSCC); OS: overall survival (OS); qPCR: quantitative polymerase chain reaction; RB1: RB transcriptional corepressor 1; ROC: receiver operating characteristic curve (ROC)

Theories of schizophrenia: a genetic-inflammatory-vascular synthesis

BACKGROUND: Schizophrenia, a relatively common psychiatric syndrome, affects virtually all brain functions yet has eluded explanation for more than 100 years. Whether by developmental and/or degenerative processes, abnormalities of neurons and their synaptic connections have been the recent focus of attention. However, our inability to fathom the pathophysiology of schizophrenia forces us to challenge our theoretical models and beliefs. A search for a more satisfying model to explain aspects of schizophrenia uncovers clues pointing to genetically mediated CNS microvascular inflammatory disease. DISCUSSION: A vascular component to a theory of schizophrenia posits that the physiologic abnormalities leading to illness involve disruption of the exquisitely precise regulation of the delivery of energy and oxygen required for normal brain function. The theory further proposes that abnormalities of CNS metabolism arise because genetically modulated inflammatory reactions damage the microvascular system of the brain in reaction to environmental agents, including infections, hypoxia, and physical trauma. Damage may accumulate with repeated exposure to triggering agents resulting in exacerbation and deterioration, or healing with their removal. There are clear examples of genetic polymorphisms in inflammatory regulators leading to exaggerated inflammatory responses. There is also ample evidence that inflammatory vascular disease of the brain can lead to psychosis, often waxing and waning, and exhibiting a fluctuating course, as seen in schizophrenia. Disturbances of CNS blood flow have repeatedly been observed in people with schizophrenia using old and new technologies. To account for the myriad of behavioral and other curious findings in schizophrenia such as minor physical anomalies, or reported decreased rates of rheumatoid arthritis and highly visible nail fold capillaries, we would have to evoke a process that is systemic such as the vascular and immune/inflammatory systems. SUMMARY: A vascular-inflammatory theory of schizophrenia brings together environmental and genetic factors in a way that can explain the diversity of symptoms and outcomes observed. If these ideas are confirmed, they would lead in new directions for treatments or preventions by avoiding inducers of inflammation or by way of inflammatory modulating agents, thus preventing exaggerated inflammation and consequent triggering of a psychotic episode in genetically predisposed persons

Genetic and environmental contributions to psychological resilience and coping

Background: Twin studies indicate that genetic and environmental factors contribute to both psychological resilience and coping style, but estimates of their relative molecular and shared environmental contributions are limited. The degree of overlap in the genetic architectures of these traits is also unclear. Methods: Using data from a large population- and family-based cohort Generation Scotland (N = 8,734), we estimated the genetic and shared environmental variance components for resilience, task-, emotion-, and avoidance-oriented coping style in a linear mixed model (LMM). Bivariate LMM analyses were used to estimate the genetic correlations between these traits. Resilience and coping style were measured using the Brief Resilience Scale and Coping Inventory for Stressful Situations, respectively. Results: The greatest proportion of the phenotypic variance in resilience remained unexplained, although significant contributions from common genetic variants and family-shared environment were found. Both task- and avoidance-oriented coping had significant contributions from common genetic variants, sibling- and couple-shared environments, variance in emotion-oriented coping was attributable to common genetic variants, family- and couple-shared environments. The estimated correlation between resilience and emotion-oriented coping was high for both common-variant-associated genetic effects (rG = -0.79, se = 0.19), and for the additional genetic effects from the pedigree (rK = -0.94, se = 0.30). Genetic correlations between resilience and task- and avoidance-oriented coping did not meet statistical significance. Conclusions: Both genetics and shared environmental effects were major contributing factors to coping style, whilst the variance in resilience remains largely unexplained. Strong genetic overlap between resilience and emotion-oriented coping suggests a relationship whereby genetic factors that increase negative emotionality also lead to decreased resilience. We suggest that genome-wide family-based studies of resilience and coping may help to elucidate tractable methodologies to identify genetic architectures and modifiable environmental risk factors to protect against psychiatric illness, although further work with larger sample sizes is needed

The COVIDTrach prospective cohort study on outcomes in 1982 tracheostomised COVID-19 patients during the first and second UK pandemic waves

COVIDTrach is a UK-wide, prospective cohort study evaluating tracheostomised COVID-19 patient outcomes and operator disease transmission. Early in the pandemic controversy surrounded optimal timing of tracheostomy insertion, however meta-analyses have since addressed this uncertainty. We report on our cohort’s data and outcomes to help inform the management of this disease and compare our findings to the literature. Our inclusion criteria were COVID-19 patients aged ≥ 18 undergoing tracheostomy following invasive ventilation. We recorded relevant characteristics, clinical parameters, intra-operative details and outcome data. Predictors for mortality and time to ventilatory wean were determined. Among 1982 patients, there was a 21% post-tracheostomy mortality and median intubation to tracheostomy time of 15 days (IQR 11–21). The median time to successful ventilatory wean post-tracheostomy was 12 days (IQR 7–20). Advancing age, greater FiO2 and PEEP requirements and inotrope or anticoagulant use were associated with increased mortality (p < 0.05) and time to wean success (p < 0.01). Higher CRP predicted increased mortality (p < 0.05), while NIV use and extended pre-tracheostomy ventilation predicted prolonged wean time (p < 0.01). The death risk for tracheostomy performed ≤ 7 or ≥ 14 days of ventilation was equivocal (OR 1.01, 95% CI [0.37–2.72]) but lower between 8 and 14 days (OR = 0.64, 95% CI [0.47–0.86]) (p = 0.01). Eight operators tested positive within two weeks of performing a tracheostomy. Our mortality rates were similar to cohort studies but lower than early versus late tracheostomy designs. In contrast to the literature, we found reduced mortality when tracheostomy was performed 8–14 days post-intubation, with more favourable wean time and wean and decannulation rates

Biomarkers predicting chemotherapy response in head and neck squamous cell carcinoma: a review

AbstractBackground:Biomarkers are increasingly being used in many cancers to select patients for oncological treatment paradigms based on their inherent genetic properties. However, in head and neck cancers, there are no personalised therapies available outside the context of a clinical trial. A number of studies suggest there are intrinsic tumour properties of head and neck cancers that affect their response to chemotherapeutic agents. This paper aimed to review their evidence base.Method:A narrative review was conducted following a search of the PubMed database.Results and conclusion:The review identified a number of biomarkers predicting response to chemotherapy in head and neck cancers. The paper discusses these in detail, and explores where future research could be directed in order to deliver personalised therapies for patients with head and neck cancers.</jats:sec