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  • US Federal
    • THE IMD RULE & ADMIN. ENFORCEMENT OF DISABILITY CIVIL RIGHTS LAWS
    • Medicaid & Supportive Housing & Housing-Related Services
    • CMS' FAILURE TO COVER HOUSING FOR LTC & THE IMD RULE: WHAT THEY HAVE IN COMMON IS DISCRIMINATION
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  • Immunology & Mental Health
    • Alcoholism & the Immune System & Mental Health
    • Brain Injury, the Immune System & Mental Health
    • Celiac Disease & Sensitivities, the Immune System & Mental Illness
    • Mental Illness & The Immune System
    • Racial Discrimination & the Immune System & Mental Health
    • Trauma & the Immune System & Mental Health
    • ***Physical Health Issues, the Immune System & Mental Health Index
  • University of Chicago: Institute of Translational Medicine
  • Hot Topics
    • What We Want --- SAMHSA Grant Opportunities Due Jan. 22, 2019
    • Anti-Social Personality Disorder >
      • DECONSTRUCTING ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY: A GUIDELINES-BASED APPROACH TO PREJUDICIAL PSYCHIATRIC LABELS [Hofstra Law Review 2013]
      • Personality Disorders -- Unscientific & Vague -- Must Be Reformed
    • Executive Functioning & "Prison Brain" >
      • Job Accommodation Network on Executive Functioning Deficits
    • Medicaid & Medicare Network Adequacy >
      • OIG: STATE STANDARDS FOR ACCESS TO CARE IN MEDICAID MANAGED CARE (Sept. 2014)
      • OIG: ACCESS TO CARE: PROVIDER AVAILABILITY IN MEDICAID MANAGED CARE (Dec. 2014)
      • GAO 15-710: MEDICARE ADVANTAGE: Actions Needed to Enhance CMS Oversight of Provider Network Adequacy (Aug. 2015)
      • CMS: Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability (April 2017)
    • Medicaid Mental Health & Substance Use Disorder Parity >
      • CMS Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs [Jan. 17, 2017]
      • Frequently Asked Questions: Mental Health and Substance Use Disorder Parity Final Rule for Medicaid and CHIP [CMS October 11, 2017]
    • Olmstead Disability Rights >
      • Statement of the Department of Justice on Enforcement of the Integration Mandate of Title II of the Americans with Disabilities Act and Olmstead v. L.C. (2011)
      • Comprehensive Olmstead Planning
      • the Logical Long Term Consequences of our failure to provide Intensive Community MH Treatment
      • Olmstead Nation ---State Pages: How Far to Comply with Olmstead?
  • Take A Walk Around Orchid's Resource Block
  • Colorado Abuse & Neglect Scandals Involving People with Disabilities
  • Mental Health By The Numbers
  • New Science Is Amazing AND It Has HUGE Moral Implications for Our Society: NOW
  • Olmstead & Homelessness
  • Double V
  • " 'Defund the Police" Means 'Invest in the Resources Our Communities Need' " or Don't Cost Shift to the Police
  • VAGUE OLMSTEAD PLANS, EXPENSIVE LITIGATION
  • Updating & Reforming our Understanding & Treatment of "Anti-Social Personality Disorder" Blog
  • Reform of " Anti-Social Personality Disorder" in Criminal Justice
  • CO HB22-1278
  • New Understandings Matter
  • Mental Health, Ethics & Law
  • CO Olmstead Disability Homeless Law & Policy Project
  • Inflammation, the Immune System, Neuro-Developmental Disorders, Psychiatric Disorders, Substance Use Issues & Chronic Disease
  • Microglia and the Brain's Immune System
  • Substance Issues & the Immune System



Translational Medicine Friday

NO Competent Health Care System If We Don't Understand Developmental Neuro-Inflammation

10/20/2023

 
& We Certainly Won't Have a Competent Mental Health System If We Don't Understand Developmental Neuro-Inflammation ---
We are spending an ENORMOUS amount of money on HEALTHCARE in this Society.
  • One of the go to BROMIDES is --- WE NEED MORE PERSONAL RESPONSIBILITY
  • We have often thought that our CHRONIC DISEASE EPIDEMIC is a result in large part of people NOT TAKING PERSONAL RESPONSIBILITY.
 
  • At the same time we're coming to terms with:
    • The CONTRADICTIONS inherent in BOTH SIDES of the PRO LIFE DEBATE, and
    • The DEVELOPMENTAL ORIGINS of many BEHAVIOR ISSUES.
      • Those DEVELOPMENTAL ORIGINS are often SEX SPECIFIC and can be more obvious in males;
      • BUT the DEVELOPMENTAL ORIGINS often involve MATERNAL IMMUNE ACTIVATION (MIA)
 
  • There are probably a lot of proteins of 20,000 that are disrupted by Maternal Immune Activation ---
    • C-Reactive Protein is a protein that keeps coming up with regard to Neuro-Developmental & Psychiatric Disorders
    • Mayo Clinic --- C-Reactive Protein Test as relates to Heart Disease
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Should you be tested for inflammation? (Mar. 2022)
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C-reactive protein as a potential biomarker in psychiatric practice: Are we there yet? (2021)
Results: The accumulating evidence from large studies and meta-analyses allows us to understand the role of CRP in major psychiatric disorders and increase our understanding of specific symptoms and subtypes of disorders.

CRP may be considered a 'psychiatric biomarker' which can alert clinicians about neuroinflammation, adverse effects of medications, cardiometabolic status, co-morbidities, and may also predict clinical outcomes and guide optimal treatment selection.
CAVEAT:  The Study is NOT saying all questions have been answered but given "ACCUMULATING EVIDENCE" C-Reactive Protein may be considered a "BIO-MARKER."
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Potential Inflammatory Biomarker in Patients with Attention Deficit Hyperactivity Disorder (Nov. 2022)
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Cytokines and C-reactive protein alterations with respect to cognitive impairment in schizophrenia and bipolar disorder: A systematic review. (2018)
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C-Reactive Protein during pregnancy is associated with different brain morphology, Autism, considered  a potential biomarker for psychiatric illness, a potential biomarker for ADHD, is associated with Schizophrenia, Bipolar Disorder and Depression.
Based on what CRP itself is, there is an obvious link between this protein and inflammation. Because of this, high CRP levels are a concern as well, primarily because they can be an indicator of chronic inflammation. This is true especially if high CRP levels remain for long periods of time without receding.

Chronic inflammation can be incredibly harmful to the body. Why is this? Inflammation signals white blood cells to release “free radicals” into the body and kill harmful stimuli.

The problem with this is that the free radicals damage the surrounding areas of where a harmful stimuli might be, harming and even killing our cells. This process, when prolonged, greatly increases the risk for cancer cells to develop.

This type of research has discovered that chronic inflammation plays a role in the development of many different diseases and health conditions. Some of these include arthritis, diabetes, heart disease, lupus, neurodegeneration like Alzheimer’s, and even Parkinson’s disease. Recent research indicates it might even be linked to depression.

Unfortunately, there is still much more research to be done in regards to actually treating and preventing chronic inflammation, and in turn keeping CRP levels low. As it stands, Johns Hopkins Medicine states that treating chronic ailments, like high CRP levels,is a challenge.
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Elevated Maternal C-Reactive Protein and Autism in a National Birth Cohort (2014)
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The long-term impact of elevated C-reactive protein levels during pregnancy on brain morphology in late childhood (July 2022)
Conclusion and relevance:Our results suggest sex-specific long-term effects in brain morphology after MIA [Maternal Immune Activation].

Categorical analyses suggest that this association might be driven by acute infections or or other sources of severe inflammation, which is of clinical relevance given that the COVID-19 pandemic is currently affecting millions of pregnant women worldwide. 
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Elevated C-Reactive Protein in Patients With Depression, Independent of Genetic, Health, and Psychosocial Factors: Results From the UK Biobank. (2021)

The Crying Need for:   Medical Integrators

10/15/2023

 
Medical Integrators
  • Integrating Information across:
    • Immunology
    • Endocrinology
    • Gastroenterology
    • Psychiatry/Psychology
    • Etc.
 
  • It is beyond frustrating to know that we have so much research BUT we don't have an effective means to integrate it in a "timely and responsible manner."
 
  • We've heard a lot about the need to re-allocate resources in the Society to address COMPLEX PROBLEMS in CRIMINAL JUSTICE.
 
  • We need to think about re-allocating resources, creating/expanding work in MEDICINE to deal with an EXPLOSION OF INFORMATION AND RESEARCH which is exposing that Medical Disciplines are not sufficiently INTEGRATED.

Understanding how SYSTEMIC DEVELOPMENTAL INFLAMMATION and INFLAMMATION ACQUIRED during the lifetime impact HEALTH OUTCOMES is critically important to many chronic diseases, neuro-developmental differences/disorders and psychiatric disorders.

I think there's a vague understanding with regard to INFLAMMATION --- but New & Growing Knowledge regarding the RAMIFICATIONS of SYSTEMIC DEVELOPMENTAL INFLAMMATION ----
  • has the potential to transform our Society and
  • it may be one of the keys to INTEGRATING various medical disciplines.
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The Impact of Systemic Inflammation on Neurodevelopment (2018)
Cytokines and neurodevelopment

In the past several decades, inflammation has been increasingly recognized as an important contributor to central nervous system (CNS) injury in both the developing and adult brain.

The brain is particularly vulnerable in utero as well as during infancy and early childhood, and insults that occur during these critical periods have the potential to cause long-term damage.

Several neurodevelopmental disorders have been linked to early life immune activation and inflammation, including autism spectrum disorders (ASD), schizophrenia, cerebral palsy, epilepsy, cognitive impairment, and depression .

We have been MISSING MANY VARIABLES OF THIS EQUATION ---THAT MATTERS.

9/4/2023

 
Val's Take:  So to me, the main point is that psychiatric disorders are involving MORE THAN the Central Nervous System (CNS).
Burden of Proof
The Need for A New Integrated DSM
DOJ'S 2011 Q&A on Enforcement of the Integration Mandate of the ADA
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Mayor:  Pueblo won't have 'good grasp' on homelessness until mental health treatment improves - https://goo.gl/alerts/jMQVqg #GoogleAlerts
European College of Neuropsycho-
pharmacology


Mechanistic research in immunopsychiatry: state of the art and future goals (2022)

The Respiratory System & Mental Health

8/16/2023

 
Conjecture

I remember my Art History Professor saying, "Art paints a 1,000 words --- IF you know the language."

I tend to think of things in terms of "LANGUAGES."

Human Biology which is NOT IDENTICAL to the biology of other Animals but is similar can be thought of as a kind of LANGUAGE.

The DSM 5 with its "CLUSTERS OF SYMPTOMS" is a kind of language and it's a lot about SURFACE OBSERVATION.

The underlying ASSUMPTION is that "MENTAL HEALTH" and "Mental Illness" are about "THE BRAIN."


I think "MENTAL HEALTH" is about "THE BRAIN" and the "CENTRAL NERVOUS SYSTEM" --- and those are very, very complicated.

For me personally, one of my favorite ART FORMS is FILM because it combines so many other forms of ART.

My roommate in college --- she wanted to be a Film Director and if I wasn't doing what I'm doing --- that sounds pretty cool to me too.

So what I'm trying to get at is when we think of "MENTAL HEALTH" and "MENTAL ILLNESS" we need to be bringing in "A LOT":
  • Probably ALL the SYSTEMS of the BODY
    • the Immune System
    • the Endocrine System
    • the Metabolism
    • the Cardio-Vascular System
    • the Microbiome --- this is relatively new
      • [Hey, I thought we already knew all the Systems of the Body!?]
    • etc.
  • The Social Determinants of Health
    • FOOD & HOUSING being right up there
  • The other Humans and Animals we're around
    • Cat infections have been associated with Human mental health problems
  • The Chemicals and Substances in the Environment that we're exposed to --- in the Physical and Natural Environment
    • Lead
    • Plastics
    • Pesticides
    • naturally occurring Radon
    • etc.
  • Altitude
  • Heat/Cold --- etc.

I've spent a lot of time on the Immune System, the Endocrine System, the Metabolism and the Microbiome.

One of the Systems of the BODY --- I have not spent as much time on is the RESPIRATORY SYSTEM --- although I have touched on "SLEEP APNEA."
  • Mental Health & Sleep Apnea --- When the Coping Mechanism You Need is OXYGEN --- There Really Is No Substitute

Before we have the FULL RESULTS of the US National Institute of Mental Health's RDoc Program (Research Domain Criteria Program) ---One thing we might do in addition to the traditional mental health questionnaire -- is go through an OVERVIEW of the SYSTEMS of the BODY and Concerns that often also have "PSYCHIATRIC SYMPTOMS."
The Need for a New Integrated DSM
Selected Studies on the Respiratory System & Mental Health
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Mental health problems, obstructive lung disease and lung function: findings from the general population (2011)
Affiliation

1 Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf and Schön Klinik Hamburg-Eilbek, Hamburg, Germany.

Methods: The 12-month prevalence of specific psychopathological syndromes among 1772 adults from the general population was estimated by a structured interview.

Additionally, participants underwent spirometry and were asked about obstructive lung disease in the year prior to the study.

Logistic and linear regression models were used to relate obstructive lung disease and spirometrically defined airway obstruction to mental health problems.

Results: Mental health problems were found in 35.7% of the participants. After adjusted for sociodemographic, clinical and life-style factors, asthma and chronic bronchitis were associated with almost all domains of mental health problems. In contrast, independent of its definition, spirometric airflow limitation was only related to generalized anxiety (odds ratios ranging from 2.3 to 2.7).

A reduced ratio of forced expiratory volume in one second to forced vital capacity was associated with mental health problems in general and panic and general anxiety in particular.

Conclusion: Our findings suggest an association of objective measure of airflow limitation to generalized anxiety and panic.

While the causal relationship between obstructive lung disease, airflow limitation and anxiety remains to be determined, clinicians should pay diagnostic attention to the significant overlap of these conditions.
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Screening for obstructive sleep apnoea in patients with serious mental illness. (2022)

Zhang LY, Anderson J, Higgins N, Robinson J, Francey S, Burke A, Robinson G, Curtin D, Tay G. Australas Psychiatry. 2022 Oct;30(5):615-618. doi: 10.1177/10398562221108632. Epub 2022 Jun 17. PMID: 35714679

OBJECTIVE: Patients with serious mental illness (SMI) are at increased risk of obstructive sleep apnoea (OSA). ...Of the five patients who agreed to proceed to diagnostic sleep testing, three were diagnosed with OSA.

CONCLUSION: A high proportio …

Metabolomics in Sleep, Insomnia and Sleep Apnea. (2019)

Humer E, Pieh C, Brandmayr G. Int J Mol Sci. 2020 Sep 30;21(19):7244. doi: 10.3390/ijms21197244. PMID: 33008070 Free PMC article. Review.

This review aims to summarize the status of metabolomic analyses-based knowledge on sleep disorders and to present knowledge in understanding the metabolic role of sleep in psychiatric disorders.

...In insomnia, alterations in branched-chain amino acid and glucose m …

The Intersection of Sleep Apnea and Severe Mental Illness in Veterans. (2019)

Soreca I, Tighe CA, Bramoweth AD. Psychosomatics. 2019 Sep-Oct;60(5):481-487. doi: 10.1016/j.psym.2019.01.007. Epub 2019 Jan 22. PMID: 30744999 Free PMC article.

BACKGROUND: Individuals with serious mental illness (SMI) have a high prevalence of risk factors for sleep apnea, but these risk factors often go unrecognized, partly due to the overlap among sleep apnea, somatic conditions, and symptoms …

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Afghanistan and Iraq War Veterans: Mental Health Diagnoses are Associated with Respiratory Disease Diagnoses (2018)
Affiliations
  • 1 Center to Improve Veteran Involvement in Care, VA Portland Health Care System, (R&D 66) 3710 SW US Veterans Hospital Road, Portland, OR 97239.
  • 2 Section of Pulmonary & Critical Care Medicine, VA Portland Health Care System, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239.
  • 3 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health & Science University, OHSU Division of Pulmonary and Critical Care Medicine, 3181 SW Sam Jackson Park Rd, Mail Code UHN6, Portland, OR 97239-3098.
  • 4 Department of Veterans Affairs, War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, 385 Tremont Ave, Mail Stop 129, East Orange, NJ 07018-1095.
  • 5 Rutgers Biomedical and Health Sciences, New Jersey Medical School, The State University of New Jersey, Stanley S. Bergen Building, 65 Bergen Street, Newark, NJ 07103.
  • 6 School of Public Health, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, MC: GH230, Portland, OR 97239.

The ECONOMICS & ETHICS of: A MENTAL HEALTH PROFESSION in the MIDDLE of a MAJOR PARADIGM SHIFT

8/6/2023

 
and A SHADOW HEALTHCARE SYSTEM in CRIMINAL JUSTICE
Conjecture

  • There are so many PAINFUL CHALLENGES about living in a WORLD OF INFINITE POSSIBILITY and
    • Finite Resources
    • Limited Time and
    • Energy
 
  • We are almost always of necessity leaving work for FUTURE GENERATIONS.
 
  • One of the most important things we can do is grapple with the ETHICAL ISSUES raised by PARADIGM SHIFTS in OUR OWN TIME.
    • AND how we can do this BETTER.
 
  • To me ---- A BIG PIECE OF THE PUZZLE IN DEALING with COGNITIVE DIFFERENCE/DISABILITY and RESOURCE INEQUALITY is thinking through a PRO LIFE APPROACH through the LIFE SPAN.
 
  • I often pick on Elon Musk because he is an "OUT" NEURO-DIVERSE PERSON, he is one of the RICHEST PEOPLE in the the WORLD --- and he is kind of a NUT CASE and in "some ways" is very SMART.
 
  • I also often "pick on" the Mental Health Profession and the Legal Profession ---
    • and I do think those Professions have serious problems --- and so do most professions.
 
  • So one of the ISSUES is trying to ACCURATELY DESCRIBE where we are at in our understanding of "Neuro-Developmental and Psychiatric Disorders."
    • Seemingly we know or some people (some researchers, lay people, etc) know that the current PSYCHIATRIC DIAGNOSTIC MANUAL is SERIOUSLY FLAWED and/or "INVALID" according to the National Institute of Mental Health in 2013.
    • What are the Ramifications of that?
 
  • Neuro-Developmental & Psychiatric Disorders are more and more viewed as on a "CONTINUUM."
    • What are the Ramifications of that?
 
  • Neuro-Developmental & Psychiatric Disorders are still viewed as "Brain Issues" but in addition to the Central Nervous System, we're also talking about DYSREGULATIONS of the IMMUNE SYSTEM, ENDOCRINE SYSTEM, the MICROBIOME, and the METABOLISM.
    • What are the Ramifications of that?
 
  • Further, this is not as SIMPLE as:
    • Challenging Genes = Neuro-Developmental and Psychiatric Disorders
    • At the very least this is often:
      • Challenging Genes + Maternal Immune Activation (during pregnancy)
      • And the impact of GREATER "DEVELOPMENTAL" and AFTER ACQUIRED INFLAMMATION OVER THE LIFE SPAN
    • Both Maternal Immune Activation and Inflammation Acquired after Birth can come from MANY SOURCES.
    • What are the RAMIFICATIONS of this COMPLEXITY?

So when it comes to ECONOMICS ---
  • We need to fund TRANSLATIONAL RESEARCH, MEDICINE
  • We need to DE-PERSONALIZE as in DE-CRIMINALIZE DYSREGULATIONS of the Body --
    • while at the same time recognizing the need for PRECISION MEDICINE and these DYSREGULATIONS can be HIGHLY IDIOSYNCRATIC.
  • Get HONEST about IMPERFECT TREATMENTS, and
  • Bring people into the PROBLEM-SOLVING PROCESS from all sides.
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Neurodevelopmental disorders—the history and future of a diagnostic concept
 (2020)
Abstract

This article describes the history of the diagnostic class of neurodevelopmental disorders (NDDs) up to DSM-5.

We further analyze how the development of genetics will transform the classification and diagnosis of NDDs. In DSM-5, NDDs include intellectual disability (ID), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD).

Physicians in German-, French- and English-speaking countries (eg, Weikard, Georget, Esquirol, Down, Asperger, and Kanner) contributed to the phenomenological definitions of these disorders throughout the 18th and 20th centuries.

These diagnostic categories show considerable comorbidity and phenotypic overlap. NDDs are one of the chapters of psychiatric nosology most likely to benefit from the approach advocated by the National Institute of Mental Health’s Research Domain Criteria project.

Genetic research supports the hypothesis that ID, ASD, ADHD, schizophrenia, and bipolar disorder lie on a neurodevelopmental continuum.

The identification of recurrently observed copy number variants and disruptive gene variants in ASD (eg, CDH8, 16p11.2, SCN2A) led to the adoption of the genotype-first approach to characterize individuals at the etiological level.


***Physical Health Issues, the Immune System, the Endocrine System & Mental Health Index
Shared Genes & Psychiatric Disorders
Maternal Immune Activation
Schizophrenia, the Immune System, the Endocrine System & the Microbiome
Psychiatric Disorders:
  • Maternal Immune Activation
  • Developmental Aspects
  • Common Genes
  • Epigenetics
  • Executive Functioning Difference/Deficits

Maternal Immune Activation, Neuro-Diversity, Auto-Immunity and Immune Issues

6/18/2023

 
[Originally posted on the Homepage on Mother's Day ---

There will be EQUAL-OPPORTUNITY for Dads on Father's Day]

 
Conjecture

The THING about INFLAMMATION is that it is CODING FOR SO MANY THINGS.

So if someone were to say this is about . . .
  • Infections, or
  • Trauma, or
  • Auto-Immunity
  • Alcohol or Drug Consumption
  • Smoking during pregnancy
  • Toxins in the Environment
THEY WOULD ALL BE RIGHT.

Although --- Some Researchers may be able to tell the difference ---


  • Pregnancy as a Time of Increased Vulnerability to Trauma, Persistent Changes in Immune Function.
 
  • Adversity in early life and pregnancy are immunologically distinct from total life adversity: macrophage-associated phenotypes in women exposed to interpersonal violence



But how that shakes out at individual times and places and for individuals --- in individual times and places in history is very complicated.

Further, it is about the INDIVIDUAL, but there are SOCIETAL ASPECTS as well as GENERATIONAL ASPECTS.
  • For example, if your grandmother smoked during pregancy --- You could be more at risk for "ADHD."
    • See Smoking During Pregnancy and the Risk of ADHD in the Third Generation

We're often talking about SHARED GENES -- which genes get turned on and off ---- and significantly EPIGENETICS.

There's been a rise in "AUTO-IMMUNITY" since the Black Death --- because those immune systems are the ones that survived.
  • See The Black Death Shaped the Evolution of Immunity Genes

Medical Science keeps expanding the role of the IMMUNE SYSTEM and I think that may continue ---

  • See from the University of Virginia School of Medicine --- The Immune System Controls Social Behavior (in Mice)
  • Low Status Can Damage the Immune System --- BBC News reporting on a study at Duke University


Currently, we recognize AUTO-IMMUNITY more in WOMEN than MEN.


Thyroid Issues are very common among women and they are "The Tallest Tree in the Forest of Poly-Auto-Immunity."

Further, more and more women and medical professionals are raising the issue that there is more going on than the current Thyroid Test measures.

Finally, Maternal Immune Activation is associated with:
  • ADHD
  • Autism
  • Bipolar Disorder
  • Depression
  • Schizophrenia
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Modulation of human endogenous retroviruses and cytokines expression in peripheral blood mononuclear cells from autistic children and their parents (2022)
Conclusion: Herein we show that autistic children and their mothers share an intrinsic responsiveness to in vitro microenvironmental changes in expressing HERVs and pro-inflammatory cytokines.

Remarkably, the antiretroviral drug Efavirenz restores the expression of specific HERV families to values similar to those of the controls, also reducing the expression of proinflammatory cytokines but keeping the regulatory ones high.

Our findings open new perspectives to study the role of HERVs in the biological mechanisms underlying Autism.

Hyper-Connected Brains & Associational Thinking  ---Strengths and Weaknesses

5/5/2023

 
Conjecture

I think one of the things that people with Hyper-Connected Brains often have are:
  • MORE ASSOCIATIONS than the AVERAGE PERSON.
  • MORE INTENSE EMOTIONS
  • There is something to be said for going with your GUT --- BUT that's pretty fraught and maybe more complicated than we thought ---it depends on whose living down there.
  • Often a lot of Reasoning and Rationality to try to deal with all this.
  • Which can give the perception and in some senses the reality of SLOWER PROCESSING but I would say the person is also PROCESSING MORE.
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Leadership development

Learn How to Think Different(ly)
Reams of relevant research (including our own) proves Jobs right. Innovators excel at connecting the unconnected. They engage in associational thinking.

At Apple (or at any innovative company), they take a little bit of this, sprinkle in a little bit of that and that and that to churn out market-busting ideas such as iTunes, and the iPod, iPhone, and iPad (along with a few market disasters like the G4 Cube computer).
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Val's Take:  One of the reasons ART is so powerful --- ARS LONGA, VITA BREVIS
  • It's not only the ASSOCIATIONS of One or a FEW Artists
    • It can HARNESS the ASSOCIATIONS of Many People Across Many Generations and
    • It's BUILDING on the ASSOCIATIONS of the ARTIST ---often using particular SENSORY EXPERIENCE and COMBINATIONS
    • It Can open up a CONVERSATION
 
I think for people with Hyper-Connected Brains we tend to have A LOT OF ASSOCIATIONS and INTENSE EMOTIONS we're trying to manage and ultimately
to REASON THROUGH.
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Elon Musk along with others thought Jobs was a jerk.

Many think Musk is a jerk.

I think A NATURAL ABILITY IN ASSOCIATIONAL THINKING is one of many reasons why Entrepreneurship often attracts Neuro-Diverse People.

BUT there often are Executive Functioning Challenges --- Jobs and other Entrepreneurs, Artists, etc. can be MAJOR JERKS and we don't want to EMPOWER that.

I think this is more complicated than LECTURING WHOEVER --- "DON'T BE A JERK."

Further, some illegal drug operations and even some questionable activities of BIG PHARMA are major ENTREPRENEURIAL ENTERPRISES --- but we don't want people using their TALENTS for HARMFUL PURPOSES and acting in ways that are "ANTI-SOCIAL."

Generally, Substance Use & the Immune System and as related to Neuro-Developmental & Psychiatric Disorders

4/2/2023

 
My view is that Neuro-Developmental Differences/Disorders are often coming with Developmental Systemic Inflammation through Maternal Immune Activation.


When we talk about Substance Use and the Immune System or Health Aspects ---
Historically, that has been the HEALTH IMPACTS of ADDICTION
Prosecutors have often said --- WELL, DON'T START.

It is becoming more clear that some people with Neuro-Developmental Differences & Disorders (that are BLURRED) are coming "PRIMED FOR ADDICTION"

We've kinda known this for awhile BUT the evidence is growing as well as the Ethical Dilemmas for Prosecutors.
  • Drug Courts have been one response.
  • I would submit we need to go further back in the CHAIN and recognize not only the Substance Problem but also the Neuro-Developmental Difference/Disorder.
    • Further, I would submit that the Neuro-Developmental Difference/Disorder is often PRIMARY and the Substance Use and/or Psychiatric Disorder are SECONDARY.
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Neuron-Glia-Immune Triad and Cortico-Limbic System in Pathology of Pain. (2021)

Glial cells in the peripheral nervous system, astrocytes in the brain, dorsal root ganglia, and immune cells all contribute to the development, maintenance, and resolution of pain. ...Immune responses may also exacerbate pain perception by modulating t …
The Convergent Neuroscience of Affective Pain and Substance Use Disorder. (2021)

"With these tools, future research strategies targeting severe SUD (Substance Use Disorder) should focus on the common neurobiology between negative reinforcement and affective elements of pain, possibly by reducing excessive stress hormone and neurotransmitter activity within shared circuitry."
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The role of gut-immune-brain signaling in substance use disorders. (2021)

Substance use disorders (SUDs) are debilitating neuropsychiatric conditions that exact enormous costs in terms of loss of life and individual suffering. ...Accumulating evidence suggests an important role for gut-immune-brain communication in the patho …
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Contributions of neuroimmune and gut-brain signaling to vulnerability of developing substance use disorders.  (2021)

Here we will review the rapidly growing body of literature that examines the importance of interactions between the peripheral immune system, the gut microbiome, and the central nervous system (CNS) in mediating the transition to pathological drug use. While …

The immune system and autism spectrum disorder: association and therapeutic challenges. (2021)

This study provides a review of the autoimmune involvement in the pathogenesis of ASD. The\r\nmicrobiome, the representative of the innate immune system in the central nervous system (CNS), plays a critical role in triggering inflammation. ...Moreover, the hi …
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Val's Take:  We tend to view ADHD as more associated with Substance Use Disorders --- but ADHD and Autism are BLURRED.

Further, what is "LEGAL" or "ILLEGAL" in this society is often much more a matter of POLITICS than it is SCIENCE.

Alcohol is very damaging and we've struggled to turn it into a HEALTH FOOD (especially wine) --- but the RESEARCH keeps coming back that even small amounts generally aren't good for us.

ADHD and Substance Use Disorders in Young People: Considerations for Evaluation, Diagnosis, and Pharmacotherapy. (2022)

Co-occurring ADHD and substance use disorder (SUD) is a common clinical presentation associated with significant impairment requiring careful evaluation, diagnosis, and treatment. Treatment with medication, along with cognitive behavioral therapy, is g …

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Glial mechanisms underlying substance use disorders. (2019)

Addiction is a devastating disorder that produces persistent maladaptive changes to the central nervous system, including glial cells. Although there is an extensive body of literature examining the neuronal mechanisms of substance use disorders, effec …
Glial Cells: Types and Functions - Verywell Health (2022)

Oct 25, 2022 · Microglia are tiny glial cells ("micro" means small). They act as the brain's own
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Drug addiction: a curable mental disorder? (2018)

Drug addiction is a chronic, relapsing brain disorder. Multiple neural networks in the brain including the reward system (e.g., the mesocorticolimbic system), the anti-reward/stress system (e.g., the extended amygdala), and the central immune system …

Grace & Mercy For A Society that is Facing a Much BIGGER Problem than It Realizes

3/31/2023

 
SOME HOPE
  • When it comes to some of our most difficult health problems --- Medical Researchers do seem to be on the cusp of if not a THEORY of EVERYTHING --- A THEORY of MANY SOURCES of DISEASE and DYSREGULATION.
  • INFLAMMATION has been a big buzz word for a few years ---
    • I think that can lead to a kind of misguided religious zealotry if we don't understand that for many people much of this INFLAMMATION is DEVELOPMENTAL.
 
  • Further, INFLAMMATION is a kind of UNIVERSAL LANGUAGE that is also being acquired during the lifetime.
    • Mental Health Problems are often involving MULTIPLE DYSREGULATIONS of the BODY
      • For some people there may be some relationship between even a MINI STROKE and PSYCHOSIS.
 
  • " 'Mini-strokes' lead to PTSD and other psychiatric disorders Transient ischemic attacks are commonly referred to as “mini-strokes,” but this does not make them any less serious than major strokes."

www.medicalnewstoday.com/articles/283383
'Mini-strokes' lead to PTSD and other psychiatric disorder



www.texaschildrens.org
Pediatric Stroke Clinic - Stroke in Newborns and Kids
Our Expert Neurology Team Treats Common and Rare Conditions with Compassion. Learn More. Experience the Comprehensive Evaluation and Treatment of Strokes at Texas Children's.

www.self.com/story/what-is-a-mini-stroke
Causes, Symptoms, and Signs of a Mini Stroke | SELF

"There are a few reasons why young people might have mini strokes, and they’re pretty similar to why people have regular strokes. Stroke risk factors include smoking, high blood pressure, diabetes, poor diet, physical inactivity, obesity, high cholesterol, and a history of artery or heart disease, per the American Stroke Association."



Maternal immune activation and neuroinflammation in human neurodevelopmental disorders (2021)
Immune Cells in the BBB (Blood Brain Barrier) Disruption After Acute Ischemic Stroke: Targets for Immune Therapy? (2021)
Comorbidity between neurological illness and psychiatric

...
Psychiatric disorders are common in many neurological disorders, including epilepsy, migraine, Alzheimer's disease, Parkinson's disease, essential tremor, and stroke.

These comorbidities increase disease burden and may complicate the treatment of the combined disorders.

PBS NewsHour
"Pennsylvania Sen. John Fetterman announced Thursday that he is in the hospital after voluntarily seeking treatment for clinical depression. Millions of Americans struggle with depression but few politicians ever share their stories publicly.

"Geoff Bennett discussed this with Jason Kander. He stepped away from a mayoral campaign in 2018 after acknowledging struggles with depression and PTSD.
"

Estimates are that 50% of US Population has experienced some type of Mental Health Problem --- and Some Estimate Higher.

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Heartbreaking Footage Shows Man’s Death in Hands of CO Springs Mental Health Team

Feb 15, 2023
Neurodevelopmental disorders-the history and future of a diagnostic concept (2020)
Abstractin English, Spanish, French

This article describes the history of the diagnostic class of neurodevelopmental disorders (NDDs) up to DSM-5.

We further analyze how the development of genetics will transform the classification and diagnosis of NDDs. In DSM-5, NDDs include intellectual disability (ID), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD).

Physicians in German-, French- and English-speaking countries (eg, Weikard, Georget, Esquirol, Down, Asperger, and Kanner) contributed to the phenomenological definitions of these disorders throughout the 18th and 20th centuries.

These diagnostic categories show considerable comorbidity and phenotypic overlap.

NDDs are one of the chapters of psychiatric nosology most likely to benefit from the approach advocated by the National Institute of Mental Health's Research Domain Criteria project.

Genetic research supports the hypothesis that ID, ASD, ADHD, schizophrenia, and bipolar disorder lie on a neurodevelopmental continuum
.

The identification of recurrently observed copy number variants and disruptive gene variants in ASD (eg, CDH8, 16p11.2, SCN2A) led to the adoption of the genotype-first approach to characterize individuals at the etiological level. .

Maternal-Fetal Inflammation in the Placenta and the Developmental Origins of Health and Disease (2020)

3/22/2023

 
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Affiliations
  • 1 Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
  • 2 Department of Nutritional Sciences, College of Health and Human Development, Penn State University, University Park, PA, United States.
  • 3 Section of Allergy and Immunology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital and Northwestern University, Chicago, IL, United States.
Abstract

Events in fetal life impact long-term health outcomes. The placenta is the first organ to form and is the site of juxtaposition between the maternal and fetal circulations.

Most diseases of pregnancy are caused by, impact, or are reflected in the placenta.

The purpose of this review is to describe the main inflammatory processes in the placenta, discuss their immunology, and relate their short- and long-term disease associations.

Acute placental inflammation (API), including maternal and fetal inflammatory responses corresponds to the clinical diagnosis of chorioamnionitis and is associated with respiratory and neurodevelopmental diseases.

The chronic placental inflammatory pathologies (CPI), include chronic villitis of unknown etiology, chronic deciduitis, chronic chorionitis, eosinophilic T-cell vasculitis, and chronic histiocytic intervillositis.

These diseases are less-well studied, but have complex immunology and show mechanistic impacts on the fetal immune system.


Overall, much work remains to be done in describing the long-term impacts of placental inflammation on offspring health.

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Maternal immune activation in mice disrupts proteostasis in the fetal brain (2021)
[Proteostasis:

"A typical mammalian cell contains up to 20,000 types of protein, which must be continually regulated and maintained.

"The homeostasis of these proteins, also referred to as 'proteostasis', is a complex pathway that functions to maintain all of the proteins within and around a cell."

----News Medical Life Sciences]
ISR = Integrated Stress Response]
Affiliations
  • 1 Department of Neurobiology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.
  • 2 Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.
  • 3 Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.
  • 4 Department of Neurobiology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.
  • 5 Division of Newborn Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.
  • 6 The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, USA.
  • 7 Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.
  • 8 Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.
  • 9 Degenerative Disease Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA.
  • 10 Department of Neurobiology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA.
  • 11 Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA, USA. [email protected].
  • 12 Evergrande Center for Immunologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA.
Abstract

Maternal infection and inflammation during pregnancy are associated with neurodevelopmental disorders in offspring, but little is understood about the molecular mechanisms underlying this epidemiologic phenomenon.

Here, we leveraged single-cell RNA sequencing to profile transcriptional changes in the mouse fetal brain in response to maternal immune activation (MIA) and identified perturbations in cellular pathways associated with mRNA translation, ribosome biogenesis and stress signaling.

We found that MIA activates the integrated stress response (ISR) in male, but not female, MIA offspring in an interleukin-17a-dependent manner, which reduced global mRNA translation and altered nascent proteome synthesis.

Moreover, blockade of ISR activation prevented the behavioral abnormalities as well as increased cortical neural activity in MIA male offspring.

Our data suggest that sex-specific activation of the ISR leads to maternal inflammation-associated neurodevelopmental disorders.

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    Translational Medicine Friday

    We're riffing off NPR's Science Friday to create Translational Medicine Friday.

    We'll be collecting Research Article recommendations for Clinicians with regard to Cognitive Disability.

    ​There is much in the RESEARCH JOURNALS and we'll just be SKIMMING THE SURFACE.

    The POINT is to INCREASE FUNDING for TRANSLATIONAL RESEARCH at the Federal Level for the National Institutes of Health, the Centers for Disease Control, the Nation's Research & Teaching Hospitals and possible collaborations with Medicare and Medicaid providers.

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