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New research has found that people with Attention Deficit/Hyperactivity Disorder (ADHD) are significantly more likely to also exhibit hoarding behaviours, which can have a serious impact on their quality of life.
The study, published in the Journal of Psychiatric Research and funded by theBritish Academy and the Leverhulme Trust, found that almost one in five people with ADHD exhibited clinically significant levels of hoarding, indicating there could be a hidden population of adults struggling with hoarding and its consequences.
Hoarding Disorder is a recognised condition that involves excessive accumulation, difficulties discarding and excessive clutter. The disorder can lead to distress or difficulties in everyday life and can contribute to depression and anxiety.
Previous research into Hoarding Disorder has mainly focused on older females who self-identify as hoarders and have sought help later in life. This new study, led by Dr Sharon Morein of Anglia Ruskin University (ARU), recruited 88 participants from an adult ADHD clinic run by the Cambridge and Peterborough NHS Foundation Trust.
The study found that 19% of this ADHD group displayed clinically significant hoarding symptoms, were on average in their 30s, and there was an equal gender split. Amongst the remaining 81%, the researchers found greater hoarding severity, but not to a degree that significantly impaired their lives, compared to the study’s control group.
The researchers asked the same questions, about ADHD symptoms and impulsivity, levels of hoarding and clutter, obsessive compulsive severity, perfectionism, depression and anxiety, and everyday function, on a closely-matched group of 90 adults from the general population, without an ADHD diagnosis, and found only 2% of this control group exhibited clinically significant hoarding symptoms.
They then replicated this with a larger online sample of 220 UK adults to see if similar patterns were found, and similarly only 3% of this group exhibited symptoms.
Dr Morein, Associate Professor in Psychology at Anglia Ruskin University (ARU), said: “Hoarding Disorder is much more than simply collecting too many possessions. People with diagnosed Hoarding Disorder have filled their living areas with so many items and clutter that it impacts their day-to-day functioning leading to a poorer quality of life, anxiety, and depression.
“Overall, we found that people who had been diagnosed with ADHD had a higher likelihood of also having hoarding symptoms. This is important because it demonstrates that hoarding doesn’t just affect people later in life, who are typically the focus of much of the research so far into Hoarding Disorder.
“Our findings also indicate that Hoarding Disorder should be routinely assessed in individuals with ADHD, as they do not typically disclose associated difficulties despite these potentially impairing their everyday lives. Likewise, it is possible that many people who are currently being treated for Hoarding Disorder might also have undiagnosed ADHD.
“Greater awareness amongst clinicians and people with ADHD about the link between ADHD and hoarding could also lead to more effective long-term management, as hoarding often gradually worsens with time.”
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In humans, virtually every cell stores fat. However, patients with a rare condition called congenital lipodystrophy, which is often diagnosed in childhood, cannot properly store fat, which accumulates in the body’s organs and increases the risk of early death from heart or liver disease. In 2001, a transmembrane protein called seipin was identified as a molecule essential for proper fat storage, although its mechanism has remained unknown.
An international study published in Nature Structural & Molecular Biology is the first to solve and model virtually the entire structure of seipin, revealing it exists in two conformations and pointing to the mechanism for birthing the lipid droplets used for fat storage in healthy cells.
“Lipid droplets (LDs) have been described since the invention of microscopes that could show the inside of cells. For about a century, they’ve been known to store lipids, or fats, but they were considered inactive. During the past 20 years, lipid droplets have been shown to be very dynamic,” said Joel M. Goodman, Ph.D., Professor of Pharmacology at UT Southwestern, a Distinguished Teaching Professor, and one of the study’s three corresponding authors.
Dr. Goodman has played a key role in seipin biology, discovering in 2007 that seipin is responsible for packaging fat into LDs and that the same mechanism occurs in animals, plants, and fungi. In 2010, the Goodman lab was the first to purify seipin and reported that it was composed of about nine identical subunits that resembled a donut.
Ever since, scientists around the world had tried to solve the structure, which proved very difficult because seipin stretches across the membrane of the endoplasmic reticulum, an organelle within the cell. That transmembrane placement made the complex resistant to X-ray crystallography, the longtime gold standard for such studies. Membrane proteins are notoriously difficult to crystallize, a requirement for that technique.
To tackle the problem, Dr. Goodman turned to cryogenic electron microscopy (cryo-EM) after discussions with Boston cell biologist Tobias C. Walther, Ph.D., at a scientific conference. Dr. Walther, a Howard Hughes Medical Institute Investigator, and his colleague, Robert V. Farese Jr., M.D., are the study’s other corresponding authors. They both have appointments at Harvard Medical School, the T.H. Chan School of Public Health, and the Broad Institute of MIT and Harvard. The study used the Harvard cryo-EM facility.
Cryo-EM uses flash-frozen samples, electron beams, and an electron detector rather than a camera to gather data on biological structures at near-atomic scale. Using cryo-EM enabled the researchers to determine that the “donut” they hypothesized was actually a 10-unit cage, a sort of incubator to create and grow lipid droplets. The second conformation showed seipin opening to release the lipid droplet onto the surface of the endoplasmic reticulum. Once on the surface, the LDs face the cell’s soupy interior (the cytoplasm), where passing enzymes can break down the LDs and free the fatty acids inside to provide energy such as during times of starvation, Dr. Goodman said.
“Getting two conformations was amazing, totally unexpected,” Dr. Goodman said, adding that previously other research teams had gotten a partial solution showing the lower layer of the seipin complex contained within the tube-like endoplasmic reticulum. The two conformations in the current investigation solve the elusive upper part of the structure, which extends across the organelle’s membrane.
“Cryo-EM made it possible,” Dr. Goodman said. “We hope that this structure will lead to a way of connecting seipin’s role in lipid-droplet creation to whatever goes wrong in lipodystrophy as well as help us better understand lipid-droplet formation in general,” he added. “There are likely several other proteins involved in the creation of lipid droplets, but seipin appears to be the main one. It seems to be a machine that generates lipid droplets.”
Current and former UTSW co-authors include Brayden Folger and Xiao Chen. The lead author is Henning Arlt of Harvard and HHMI. Researchers from the University of Washington, Seattle, and Heidelberg University, Germany, also participated.
The study received support from the National Institutes of Health (R01GM124348, R01GM084210), the German Research Foundation, the American Heart Association, and the HHMI.
Dr. Goodman holds the Jan and Bob Bullock Distinguished Chair for Science Education.

Analyzing breast-cancer tumors with artificial intelligence has the potential to improve healthcare efficiency and outcomes. But doctors should proceed cautiously, because similar technological leaps previously led to higher rates of false-positive tests and over-treatment.
That’s according to a new editorial in JAMA Health Forum co-written by Joann G. Elmore, MD, MPH, a researcher at the UCLA Jonsson Comprehensive Cancer Center, the Rosalinde and Arthur Gilbert Foundation Endowed Chair in Health Care Delivery and professor of medicine at the David Geffen School of Medicine at UCLA.
“Without a more robust approach to the evaluation and implementation of AI, given the unabated adoption of emergent technology in clinical practice, we are failing to learn from our past mistakes in mammography,” the JAMA Health Forum editorial states. The piece, posted online Friday, was co-written with Christoph I. Lee, MD, MS, MBA, a professor of radiology at the University of Washington School of Medicine.
One of those “past mistakes in mammography,” according to the authors, was adjunct computer-aided detection (CAD) tools, which grew rapidly in popularity in the field of breast cancer screening starting more than two decades ago. CAD was approved by the FDA in 1998, and by 2016 more than 92% of U.S. imaging facilities were using the technology to interpret mammograms and hunt for tumors. But the evidence showed CAD did not improve mammography accuracy. “CAD tools are associated with increased false positive rates, leading to overdiagnosis of ductal carcinoma in situ and unnecessary diagnostic testing,” the authors wrote. Medicare stopped paying for CAD in 2018, but by then the tools had racked up more than $400 million a year in unnecessary health costs.
“The premature adoption of CAD is a premonitory symptom of the wholehearted embrace of emergent technologies prior to fully understanding their impact on patient outcomes,” Elmore and Lee wrote.
The doctors suggest several safeguards to put in place to avoid “repeating past mistakes,” including tying Medicare reimbursement to “improved patient outcomes, not just improved technical performance in artificial settings.”
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Women with migraine may have a higher risk of pregnancy complications like preterm delivery, gestational high blood pressure and preeclampsia, according to a preliminary study released today, February 24, 2022, that will be presented at the American Academy of Neurology’s 74th Annual Meeting being held in person in Seattle, April 2 to 7, 2022 and virtually, April 24 to 26, 2022. Researchers also found that women with migraine with aura may have a somewhat higher risk of preeclampsia than women with migraine without aura. Auras are sensations that come before the headache, often visual disturbances such as flashing lights. Preeclampsia involves high blood pressure with additional symptoms, such as protein in the urine, during pregnancy, which can threaten the life of the mother and baby.
“Roughly 20% of women of childbearing age experience migraine, but the impact of migraine on pregnancy outcomes has not been well understood,” said study author Alexandra Purdue-Smithe, Ph.D., of Brigham and Women’s Hospital in Boston. “Our large prospective study found links between migraine and pregnancy complications that could help inform doctors and women with migraine of potential risks they should be aware of during pregnancy.”
For the study, researchers looked at more than 30,000 pregnancies in roughly 19,000 women over a 20-year period. Of those pregnancies, 11% of the women reported that they were diagnosed by a doctor with migraine before pregnancy.
Researchers examined women’s complications during pregnancy such as preterm delivery, defined as a baby born before 37 weeks gestation, gestational diabetes, gestational high blood pressure, preeclampsia, and low birthweight.
After adjusting for age, obesity, and other behavioral and health factors that could affect the risk of complications, researchers found that when compared to women without migraine, women with migraine had a 17% higher risk of preterm delivery, a 28% higher risk of gestational high blood pressure, and a 40% higher risk of preeclampsia. Of the 3,881 pregnancies among women with migraine, 10% were delivered preterm, compared to 8% of the pregnancies among women without migraine. For gestational high blood pressure, 7% of pregnancies among women with migraine developed this condition compared to 5% among pregnancies in women without migraine. For preeclampsia, 6% of pregnancies among women with migraine experienced it, compared to 3% of pregnancies among women who did not have migraine.
In addition, when looking at migraine with and without aura, women who had migraine with aura were 51% more likely to develop preeclampsia during pregnancy than women without migraine, while those who had migraine without aura were 29% more likely.
Researchers found that migraine was not associated with gestational diabetes or low birthweight.
“While the risks of these complications are still quite low overall, women with a history of migraine should be aware of and consult with their doctor on potential pregnancy risks,” said Purdue-Smithe. “More research is needed to determine exactly why migraine may be associated with higher risks of complications. In the meantime, women with migraine may benefit from closer monitoring during pregnancy so that complications like preeclampsia can be identified and managed as soon as possible.”
A limitation of the study was that although migraine history was reported prior to pregnancy, information on migraine aura was not collected until later in the study, after many of the pregnancies ended. So the findings for migraine aura may have been influenced by participants’ ability to accurately remember their experiences. Another limitation is that information on migraine attack frequency and other migraine features was not available. Additional studies will be needed to address these limitations and better inform how pregnant women with a history of migraine should be screened and monitored for potential pregnancy complications.
The study was supported by the National Institutes of Health.
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Nearly 90 percent of COVID-19 patients who qualified for, but did not receive, ECMO (extracorporeal membrane oxygenation) due to a shortage of resources during the height of the pandemic died in the hospital, despite being young with few other health issues, according to a study published in the American Journal of Respiratory and Critical Care Medicine.
The Vanderbilt University Medical Center (VUMC) study, led by Whitney Gannon, MSN, director of Quality and Education for the Vanderbilt Extracorporeal Life Support Program (ECLS), analyzed the total number of patients referred for ECMO in one referral region between Jan. 1, 2021, and Aug. 31, 2021.
Approximately 90% of patients for whom health system capacity to provide ECMO was unavailable died in the hospital, compared to 43% mortality for patients who received ECMO, despite both groups having young age and limited comorbidities.
“Even when saving ECMO for the youngest, healthiest and sickest patients, we could only provide it to a fraction of patients who qualified for it,” Gannon said. “I hope these data encourage hospitals and federal authorities to invest in the capacity to provide ECMO to more patients.”
Once a patient was determined to be medically eligible to receive ECMO, a separate assessment was performed of the health system’s resources to provide ECMO.
When health system resources — equipment, personnel and intensive care unit beds — were not available, the patient was not transferred to an ECMO center and did not receive ECMO.

In an opinion article appearing online Feb. 25 in the Journal of the American Medical Association, authors from University Hospitals and Case Western Reserve University write about the unexpected patient safety benefit resulting from remote monitoring of patients during the COVID-19 pandemic.
Peter Pronovost, MD, PhD, Melissa Cole, MSN, and Robert Hughes, DO, discuss that although COVID-19 placed excessive psychological and moral stress and work demands on patients, clinicians, health care organizations and society, the pandemic also advanced patient safety in an unexpected way.
Prior to the pandemic, routine monitoring of patients with continuous pulse oximetry and heart rate devices was dependent on the patient’s location within a hospital, usually the intensive care unit (ICU). Pulse oximeters are small electronic devices that clip onto a finger and measure the saturation of oxygen carried in red blood cells. Studies have shown that monitoring with these devices is associated with reduced death rates.
As the pandemic flooded hospitals with patients and filled ICUs, many patients received care outside of the ICU in emergency departments or general medical and surgical units. And, some medical centers advised patients with milder symptoms to stay home.
“One of the major lessons gained from the pandemic was that patients could now be monitored based on risks and needs rather than location in the hospital,” said Dr. Pronovost, Chief Quality and Clinical Transformation Officer at UH and Clinical Professor of Anesthesiology and Perioperative Medicine at Case Western Reserve School of Medicine. “Home monitoring and hospital at-home models offer the potential to transform care and potentially allow a substantial proportion of hospitalized patients to receive care from home.”
In their paper, the authors review benefits of remote monitoring in the hospital and at home, explore the technology advances that made it possible, describe how government payment policy changes made home monitoring sustainable, and discuss what health systems could do to launch a home monitoring program.

In the field of scientific research, details matter. The minutia of processes and structures are explained with specificity, data points are reported to the most precise decimal and seeing is believing.
Now, University of Cincinnati cancer biologists have developed a new piece of technology and a new imaging technique that will help researchers glean more detailed data points and see cells in more precise detail when studying the development of cancer and neurodegenerative diseases.
Jiajie Diao, PhD, associate professor in the Department of Cancer Biology in UC’s College of Medicine, recently published an article detailing the progress in the journal Advanced Healthcare Materials.
New probe
Some of Diao’s research focuses on a tiny part inside cells, called a lysosome, that is involved in cell processes. A lysosome is an “organelle,” or a specialized structure that performs various jobs inside cells. In the same way organs, such as the heart, liver, stomach and kidneys, serve specific functions to keep an organism alive, organelles serve specific functions to keep a cell alive. Diao’s research centers on the lysosomes that act as the “recycling center” within cells, helping the cell reuse broken or malfunctioning building blocks for different purposes.
To accomplish its job, lysosomes need to be in an acidic environment and generally have a low pH value. However, abnormal pH levels within lysosomes have been associated with cellular malfunctions that can lead to diseases like cancer and Alzheimer’s disease.

As a clinician at the University of Missouri Thompson Center for Autism and Neurodevelopmental Disorders, David Beversdorf helps patients with autism spectrum disorder (ASD), many of whom may also be struggling with gastrointestinal or digestive issues, including constipation and diarrhea. These symptoms are experienced by children with ASD at a higher rate than their neurotypical peers, although some individuals might not respond favorably to traditional treatments, such as laxatives.
In a recent study, Beversdorf collaborated with a researcher at Penn State University to identify specific RNA biomarkers linked with gastrointestinal issues in children with autism. The findings could help one day lead to individualized treatments aimed at easing the pain of these individuals.
Saliva samples were collected from nearly 900 children, some of whom had autism and experienced gastrointestinal disturbances, at several academic medical centers across the country. After analyzing the samples, the researchers identified specific RNA biomarkers linked to children who had autism and experienced gastrointestinal symptoms.
“We wanted to understand how a child’s body responds to the various bacteria living in the mouth and determine if these interactions contribute to gastrointestinal symptoms,” said Steve Hicks, an associate professor of pediatrics at the Penn State College of Medicine, who collaborated with Beversdorf on the study. “By identifying these specific microRNAs in the saliva of children with autism, these molecules may serve as future targets for developing novel treatments or tracking medication effectiveness in children with autism-related gastrointestinal conditions.”
Beversdorf added that RNA have regulatory properties throughout the human body, and the specific RNA identified in the study may have regulatory effects on biological pathways related to metabolism, digestion, depression and addiction.
“It’s one of those ‘chicken or the egg’ cases where we still don’t know if it is the RNA potentially contributing to the gastrointestinal issues, or if the gastrointestinal issues are causing the RNA to be expressed differently, but we have identified a relationship, which will be useful to further explore going forward,” said Beversdorf, who also has appointments in the MU College of Arts and Science and MU School of Medicine. “This research can potentially help contribute to precision medicine one day, where we can follow children with autism and gastrointestinal symptoms over an extended period of time and assess how they might respond to personalized treatments, with the ultimate goal of reducing their symptoms and improving their quality of life.”
“Saliva RNA biomarkers of gastrointestinal dysfunction in children with autism and neurodevelopmental disorders: Potential implications for precision medicine” was recently published in Frontiers in Psychiatry. Funding for the study was provided by the National Institutes of Health. Co-authors on the study include Kristin Sohl, David Levitskiy, Priscilla Tennant, Robin Goin-Kochel, Rebecca Shaffer, Alexandra Confair and Frank Middleton.
Highlighting the promise of personalized health care and the impact of large-scale interdisciplinary collaboration, the NextGen Precision Health initiative is bringing together innovators from across the University of Missouri and the UM System’s three other research universities in pursuit of life-changing precision health advancements. It’s a collaborative effort to leverage the research strengths of Mizzou toward a better future for Missouri’s health. An important part of the initiative is its anchoring facility, the Roy Blunt NextGen Precision Health building, opened in October 2021, which expands collaboration between researchers, clinicians and industry leaders in a state-of-the-art research facility.
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People in the United States who belong to racial and ethnic minority groups reported experiencing Covid-related discrimination far more often than white people during the pandemic, and far more often than had been estimated, according to a new study that is one of the largest to date on the issue.The study, from the National Institute on Minority Health and Health Disparities, a division of the National Institutes of Health, found that members of minority groups were more likely to report instances of being harassed or threatened and situations in which other people treated them as though they might be carrying the disease. People of Asian ethnicity, who have been victims of several high-profile bias crimes during the pandemic, reported the highest rates of being taunted by racist comments, insults, threats and name-calling related to Covid.But they weren’t alone: Members of other major racial and ethnic groups — including American Indian/Alaska Natives, Black people, Hawaiian and Pacific Islanders, Latinos and multiracial people — also said they had faced discrimination, and that they had seen people acting afraid of them.“While we expected to see that discrimination was prevalent, it was way more prevalent than previously estimated — and double the prior estimates for Asian Americans,” said Paula D. Strassle, the paper’s lead author, who is a staff scientist at the institute.While other reports estimated that 20 percent of people of Asian ethnicity had experienced Covid-related bias, the new report found that 30 percent of that group had experienced such discrimination, while 44 percent had seen people act fearful around them. American Indian/Alaska Natives and Latinos reported similar rates of discrimination and fearful behavior, while multiracial survey participants as well as Hawaiian and Pacific Islanders reported similarly high rates of fearful behavior in others. Of all minority groups, Black and multiracial people reported the lowest rates of Covid-related discrimination, though many said they perceived fearfulness.Those who spoke little or no English and less educated people also reported facing more Covid-related discrimination. And survey participants in Alabama, Kentucky, Mississippi and Tennessee reported relatively higher rates of discrimination than in other parts of the country.Overall, 22 percent of those surveyed reported experiencing Covid-related discriminatory behavior, and 43 percent said people had behaved as though they were afraid of them.The study, whose findings were published in the American Journal of Public Health on Wednesday, was based on the CURB (Covid-19’s Unequal Racial Burden) survey, an extensive survey of a nationally representative sample of 5,500 adults. The survey was conducted online from December 2020 to February 2021.The results suggest the pandemic has worsened resentment of and bias toward members of minority communities, Dr. Strassle said, adding that future analyses would examine the effects discrimination has on mental health and on people’s willingness to seek health care.“We need to be mindful of the additional effects that occur during a pandemic, beyond the infection and the health crisis,” she said.

Malaria remains one of the biggest global public health challenges. It kills a young child every two minutes, more than any other infectious disease.
Malaria parasites, of which Plasmodium falciparum is the most widespread and lethal, are transmitted by mosquitoes and have a complex life cycle. Malaria symptoms occur once the parasite’s asexual stages begin replicating inside red blood cells. However, these asexual forms must transform into male and female stages called gametocytes in order to infect the mosquitoes that spread the disease.
In a study published Jan. 27 in Nature Microbiology, investigators from Weill Cornell Medicine report they have identified a protein called HDP1 that plays a critical role in activating genes required for the development of these male and female stages. The finding provides important new insights into how the parasite controls this conversion into gametocytes.
“HDP1 is essential for the development of the parasite’s transmissible stages,” said senior author Dr. Björn Kafsack, assistant professor of microbiology and immunology at Weill Cornell Medicine.
Previous research has shown that switching between the different stages requires the master gene regulator AP2-G, which initiates the development of the transmissible stages by activating other regulators of gene expression, including HDP1.
In their new study, the researchers showed that HDP1 is required for the parasite’s maturation to the gametocyte stage, the first time such a connection has been shown. They used CRISPR/Cas9 gene-editing technology to delete the hdp1 gene in P. falciparum parasites. Using microscopy and other lab techniques, including flow cytometry and RNA sequencing and chromatin profiling, they were able to discover what was happening inside these cells at the molecular level.
They found that without HDP1, parasites were unable to turn up expression of genes that are necessary to assemble mature gametocytes and give them their characteristic sickle shape. This eventually leads to the death of these gametocytes and leaves them unable to infect mosquitoes.
“HDP1 is the first of a previously uncharacterized class of DNA-binding proteins identified in malaria,” said first author Dr. Riward Campelo Morillo, a research associate in microbiology and immunology in the Kafsack lab. “It provided us with a greater understanding of how genes are regulated in these parasites.”
The team aims to further study how these molecular changes cause the parasite to take on its sickle shape, something that is not currently known.
“By understanding the developmental program of these transmission stages, it could eventually lead to possible future drugs for blocking transmission,” Dr. Kafsack said. “We may be able to find additional components of this process that are unique to these parasites for us to target with drugs.”
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