Behavioral Assessment Research Articles

Behavioral problems in children with unoperated rheumatic heart disease at national referral hospital in Ethiopia: an observational study

BackgroundThe behavioral disorder is characterized by a profound abnormality in an individual’s cognition, emotion or behavior that reflects in psychological, biological or developmental dysfunction. Rheumatic heart disease (RHD) is a long-term sequel of single or recurrent acute rheumatic fever. Children with RHD are thought to be at increased risk for behavioral problems due to autoimmunity seen in pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). Behavior disorder is not well studied among children with RHD. Hence, this study aimed to assess the pattern and predictors of behavioral problems among children with RHD enrolled in chronic care at a national cardiac referral Hospital.MethodsThis cross-sectional study used a validated parental-reported Amharic Strengths and Difficulties Questionnaire (SDQ) to assess behavior problems. Children with RHD aged 6–17 years on chronic outpatient cardiac care at Tikur Anbessa Specialized Hospital, Ethiopia between February and May 2023 were included. Factors associated with behavior problems were assessed using logistic regression models.ResultsThe study included 166 children with a median age of 15 years [Interquartile range (IQR):13–17 years]. One-fourth of children, 24.7% (95% CI: 18.34–31.98), had behavioral problems. Of these, 46.4% (77) emotional, 35.5% (59) peer, 18.1% (30) conduct and 6.6% (11) hyperactivity problems were documented. Children who had good medication adherence, adjusted odds ratio AOR 0.29(95% CI: 0.09–0.94, P 0.040) and on New York Health Association (NYHA) class I, AOR 0.28(95% CI: 0.11–0.79, P 0.016) had lower odds for behavioral problems.ConclusionOne-fourth of children with RHD had behavioral abnormalities. Medication adherence and NYHA predicted behavioral abnormality. Better physical symptom control was associated with fewer behavioral problems. Behavioral abnormalities should be considered and assessed among children with RHD. Further multi-center mixed studies are recommended to uncover the unseen behavioral problem and guide health policy action on modalities of integration of behavioral problems assessment tools in clinical care.

Paracentrotus lividus sea urchin gonadal extract mitigates neurotoxicity and inflammatory signaling in a rat model of Parkinson's disease.

The present study investigates the neuroprotective effects of the sea urchin Paracentrotus lividus gonadal extract on rotenone-induced neurotoxicity in a Parkinson's disease (PD) rat model. Parkinson's disease, characterized by the progressive loss of dopaminergic neurons in the substantia nigra (SN), is exacerbated by oxidative stress and neuroinflammation. The study involved fifty Wistar rats divided into five groups: control, dimethyl sulfoxide (DMSO) control, Paracentrotus lividus gonadal extract-treated, rotenone-treated, and combined rotenone with Paracentrotus lividus gonadal extract-treated. Behavioral assessments included the rotarod and open field tests, while biochemical analyses measured oxidative stress markers (malondialdehyde (MDA), nitric oxide (NO), glutathione (GSH)), antioxidants (superoxide dismutase (SOD), catalase (CAT)), pro-inflammatory cytokines (interleukin-1 beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α)), and neurotransmitters (dopamine (DA), levodopa (L-Dopa)). Histological and immunohistochemical analyses evaluated the neuronal integrity and tyrosine hydroxylase (TH) and alpha-synuclein expression. The results showed that Paracentrotus lividus gonadal extract significantly mitigated rotenone-induced motor deficits and improved locomotor activity. Biochemically, the extract reduced oxidative stress and inflammation markers while enhancing antioxidant levels. Histologically, it restored neuronal integrity and reduced alpha-synuclein accumulation. Molecularly, it increased tyrosine hydroxylase and dopa decarboxylase gene expression, essential for dopamine synthesis. These findings suggest that Paracentrotus lividus gonadal extract exerts neuroprotective effects by modulating oxidative stress, neuroinflammation, and dopaminergic neuron integrity, highlighting its potential as a therapeutic agent for Parkinson's disease.

PM2.5 Exposure Triggers Hypothalamic Oxidative and ER Stress Leading to Depressive-like Behaviors in Rats

Epidemiological studies have linked fine dust pollution to depression, yet the underlying mechanisms remain unclear. Oxidative stress and endoplasmic reticulum (ER) stress are known contributors to depression, but their induction by particulate matter (PM), particularly PM2.5, in animal models has been limited. This study aimed to establish a rat model of PM2.5-induced depression-like behaviors and elucidate the underlying molecular mechanisms. Adult male Sprague–Dawley rats received daily intranasal PM2.5 for four weeks. Behavioral assessments, including the open field test (OFT), forced swim test (FST), and light-dark box (LDB) test, were conducted weekly. PM2.5-exposed rats displayed depressive-like behaviors, particularly in the FST, reflecting decreased motivation and learned helplessness. Molecular analyses indicated a specific increase in ER stress markers (CHOP, eIF2α, GRP78, and P16) and NOX4 in the hypothalamus, while other brain regions (striatum, cortex, and hippocampus) were not as pronounced. Additionally, PM2.5 exposure reduced tyrosine hydroxylase (TH) levels in the hypothalamus, suggesting impaired dopamine synthesis. These findings indicate that PM2.5 induces depressive-like behaviors via hypothalamic ER stress and oxidative stress pathways, leading to dopaminergic dysfunction. Targeting oxidative and ER stress within the hypothalamus may offer new therapeutic strategies for treating depression associated with environmental pollutants.

Sandwich Structure Bending Analysis Using Finite Element Analysis

The research conducted1 using ANSYS software focuses1 on analyzing the flexural behavior of sandwich composite1 materials widely utilized in various industrial applications. The finite element method (FEM) employed facilitates a detailed understanding of the material's response to external forces. This study involves developing a model of the sandwich1 structure, accounting for its multiple layers1 and the specific properties of the 1materials used. Numerical analysis is performed to evaluate the structural response under defined loads and boundary conditions, enabling precise1 assessment of deformations, stresses, and layer-specific behavior. The findings1 obtained from the ANSYS1 simulations provide valuable insights1 for the design and optimization of sandwich composite1 structures, contributing to improved performance and 1durability in industrial1 applications.

Sandwich Structure Bending Analysis Using Finite Element Analysis

The research conducted1 using ANSYS software focuses1 on analyzing the flexural behavior of sandwich composite1 materials widely utilized in various industrial applications. The finite element method (FEM) employed facilitates a detailed understanding of the material's response to external forces. This study involves developing a model of the sandwich1 structure, accounting for its multiple layers1 and the specific properties of the 1materials used. Numerical analysis is performed to evaluate the structural response under defined loads and boundary conditions, enabling precise1 assessment of deformations, stresses, and layer-specific behavior. The findings1 obtained from the ANSYS1 simulations provide valuable insights1 for the design and optimization of sandwich composite1 structures, contributing to improved performance and 1durability in industrial1 applications.

Dynamic Residue Behavior and Risk Assessment of Thiamethoxam With Its Metabolite From Tea Production to Consumption

ABSTRACTThe entire fate of the widely used insecticide thiamethoxam from field cultivation, manufacturing to brewing were studied. A method to simultaneously detect thiamethoxam and its two metabolites, clothianidin and CGA265307, was developed. The field trial indicated a half‐life of thiamethoxam at 3.2 days on tea leaves, meanwhile, generation of clothianidin was observed with the maximum accumulation of 0.0152 mg/kg after 1 day of thiamethoxam application. The processing factors (PFs) during tea manufacturing ranged from 0.16 to 1.36 and 0.72 to 1.27 for thiamethoxam and clothianidin, respectively. Notably, PFs for thiamethoxam and clothianidin were higher during microwave deenzymed green tea manufacturing than pan deenzymed green tea and traditional black tea. Both thiamethoxam and clothianidin showed high infusion factors during tea brewing, whereas the risk quotient indicated an acceptable dietary risk of thiamethoxam with clothianidin through tea consumption. These findings could facilitate a more accurate assessment of safety risks and better protect the health of tea consumers.

Transformation behavior and toxicity assessment of beaytlmethodeyammonNium chbride (BAC-12) disinfectant during hospital wastewater treatment.

This work focused on the transformation behavior of the emerging beaytlmethodeyammonium chbride (BAC-12) disinfectant existed in the treatment of medical sewage during its disinfection treatment. The degradation ability of ozone (O3) to BAC-12 was the best, followed by UV/NaOCl, UV, and NaOCl. The enhancement of BAC-12 in UV/NaOCl system is caused by the combined effect of UV photolysis, reactive chlorine species (RCS), and •OH. The transformation products of BAC-12 in the disinfection treatment were detected, and the chemical structure of products was rationalized by frontier molecular orbital and transition state theory methodologies. According to the ecological structure-activity relationship (ECOSAR) assessment, the intermediates of BAC-12 in UV, NaOCl, and UV/NaOCl treatments had lower half lethal concentration (LC50) and chronic toxicity (ChV) values with a higher ecotoxicity than BAC-12. O3 disinfection treatment of these toxic intermediates can significantly reduce the toxicity of the BAC-12 solution. This work provides necessary information on the potential environmental risks of BAC-12 arising from different disinfection methods in the treatment of medical wastewater.

Transitions and resilience in ecological momentary assessment: A multiple single-case study

Ecological momentary assessment (EMA) of affect, cognition and behavior aims to provide a ‘window into a person’s daily life’. But what should we look for through this window? In this paper, we compare a statistical perspective, grounded in probability theory, with a dynamic pattern perspective, grounded in complexity theory, on two common phenomena in EMA data: non-stationarity and outlying values. From a statistical perspective, these phenomena are considered nuisances that should be dealt with. From a dynamic pattern perspective, in contrast, non-stationarity may signal transitions from one dynamic pattern to another (e.g., a transition from a neutral to a persistent sad mood), whereas outlying values may signal recovery from perturbations (e.g., stressful life events). We evaluated the dynamic pattern view with a triangulation study of multiple single cases that took part in the Track your Mood EMA study, where participants reported on their emotions and daily events for 60 days. We found that non-stationarity was indeed related to a pattern transition, whereas outlying values were related to recovery after perturbations. These findings show that person-oriented EMA research would benefit from a dynamic pattern perspective that can identify highly meaningful and clinically relevant phenomena that are otherwise at risk of being missed. Complementing EMA time series with contextual information and qualitative data will be essential to genuinely understand these phenomena.

Assessment of UK Heavy Goods Vehicle drivers' lifestyle behaviours: a cross-sectional study.

Heavy Goods Vehicle (HGV) drivers face difficult working conditions, promoting unhealthy lifestyle behaviours which are associated with an elevated prevalence of long-term health conditions. 109 drivers across the UK completed an online survey investigating differences in lifestyle behaviours between drivers with (N = 54) and without obesity (N = 55), including differences on work and non-workdays using an exploratory data analysis approach. Drivers with obesity (49.6%) perceived more barriers to healthy eating and being active than drivers without obesity. Drivers with obesity reported choosing more unhealthy options as snacks, ate more often at fast-food chains, and fewer fulfilled the physical activity guidelines. Additionally, the two groups differed regarding food and beverage choices on work and non-workdays. HGV drivers with obesity exhibit various dietary and physical activity behaviours associated with overnutrition and poor cardiometabolic health.

Transition to Adulthood: Executive Functions and Independent Living Skills in Autistic Young Adults

This study investigated differences in independent living skills and executive functioning skills between autistic and neurotypical young adults in addition to how executive functioning skills contribute to independent living skills in autistic young adults. Participants completed the Adaptive Behavior Assessment System as a measure of independent living skills and the Behavioral Rating Inventory of Executive Function Adult version to measure executive functioning abilities. The Weekly Calendar Planning Activity was also used as a novel measure of performance-based executive functioning skills. Results demonstrated that independent living skills and executive functioning skills were significantly lower in autistic adults (p<.001) than neurotypical young adults. The WCPA also indicated deficits in the autistic population as demonstrated by following fewer rules, utilizing fewer strategies, lower accuracy, and lower self-awareness of performance. Within autistic adults, self-reported measures of executive functioning skills robustly correlated with independent living skills. While the Weekly Calendar Planning Activity accuracy correlated strongly with self-reported measures of executive function, the accuracy did not significantly correlate with the ABAS-3 scores suggesting a discrepancy between self-report and performance-based measures of executive functioning skills. Results indicated that the Weekly Calendar Planning Activity shows promise to inform clinical practice by providing a window into how the integration of multiple executive functioning skills impact challenges with everyday living in the adult autistic population.

The potential of cognitive remediation therapy for improving the communication capabilities of adults with schizophrenia and other psychotic spectrum disorders.

Impairment in aspects of communication is a core diagnostic feature of schizophrenia and other psychotic spectrum disorders. These communication difficulties inhibit participation in a range of daily activities and affect relationships and quality of life. There has been little research focussed on communication outcomes in relation to cognitive remediation therapy within this population. Data collected as part of an implementation trial of the Computerised Interactive Remediation of Cognition and Thinking Skills (CIRCuiTS) program provided an opportunity to examine the potential for changes in communication capability to support activities of daily living. To survey changes in ratings of aspects of communication capability of adults with schizophrenia who completed the CIRCuiTS cognitive remediation therapy program. Thirty adults with schizophrenia and other psychotic spectrum disorders completed the CIRCuiTS therapy program as part of an implementation trial in 2018 and 2019. Most participants were male (93%) and inpatients at Bloomfield Hospital (73%) in Orange, New South Wales. Ratings on the Adaptive Behaviour Assessment System, Third Edition (ABAS3) were returned before and after completion of the CIRCuiTS program. The magnitude of changes in ABAS3 indices, the Communication scale and Functional academics scales were assessed between time points. Participants' mean adaptive functioning indices prior to the CIRCuiTS program were in the extremely low range (∼second percentile) and increased to the low range (∼seventh percentile) following this therapy, achieving large mean effect sizes (Cohen's d = 0.92-1.24). Significant improvements in functioning were observed on the ABAS3 Communication and Functional Academics scales, with large mean effect sizes on both scales (Cohen's d = 1.09 and 0.99 respectively). Improvements in ratings occurred on items including initiating conversations, talking and listening over longer periods, explaining more complex information, using lists and reminders and a schedule or diary, completing written forms and personal money management. Most participants were observed to make gains in aspects of communication. The results point to these aspects of communication as potential future targets for therapy with people with schizophrenia and other psychotic spectrum disorders. This study highlights the value and role of Speech and Language Therapists in cognitive remediation therapy. Further research seems warranted with participants with a broader range of demographic, clinical and functional capabilities, that controls for the effects of medications and other therapeutic interventions and utilises a more comprehensive assessment of communication. What is already known on the subject People with schizophrenia and other psychotic spectrum disorders experience impairment in cognitive functioning as well as communication capability that affects their daily functioning and quality of life. Cognitive remediation therapy has been shown to improve aspects of the daily functioning of people with schizophrenia and other psychotic spectrum disorders and is recommended in international treatment guidelines. However, very little research has been conducted to investigate the effectiveness of this therapy in addressing communication difficulties. What this paper adds to existing knowledge The present study found participants with schizophrenia and other psychotic spectrum disorders made significant improvements in important aspects of communication after completing the Computerised Interactive Remediation of Cognition and Thinking Skills cognitive remediation therapy program. The results point to the potential of cognitive remediation therapy as a therapeutic approach that is likely to improve communication capability. What are the potential or actual clinical implications of this work? Cognitive remediation therapy is likely to be an important treatment for improving the communication capabilities of people with severe mental illness. This relatively new area of clinical practice and research highlights the value and potential of speech and language therapy in improving the communication capabilities of people with schizophrenia and other psychotic spectrum disorders.

Behavioral Alterations in Mice Exposed to Manganese via Drinking Water: Effects of Sex and a Lipopolysaccharide Challenge.

Manganese (Mn) is an essential and important metal; however, overexposures lead to adverse neurological outcomes. Nonoccupational Mn overexposure occurs primarily through consumption of Mn-contaminated drinking water (DW). Sex differences in terms of nervous and immune systems' responsiveness to excessive Mn in the DW are understudied. Thus, this study investigated behavioral and sex differences in response to Mn DW treatment (0.4 g Mn/L for up to 8 weeks) and a lipopolysaccharide (LPS) challenge of adult C57BL/6 mice with GFP-tagged monocytes/microglia. After 6 weeks, in motor function tests, Mn exposure resulted in decreased activity and gait deficits. In two different mood tests (open field test [OFT]/elevated zero maze), Mn-exposed mice exhibited decreased fear/anxiety-like behavior. Two weeks after behavioral assessment, when mice were challenged with LPS, circulating inflammatory cytokines, and acute phase proteins increased in both sexes. After 8 weeks of Mn exposure, liver and brain Mn levels were increased, but Mn alone did not affect circulating cytokines in either sex. Notably, Mn-exposed/LPS-challenged males had potentiated plasma cytokine output, whereas the reverse was seen in females. Males, but not females, continued to exhibit increased fearlessness (i.e., increased OFT center time), even when challenged with LPS. Overall, our results show that Mn DW exposure increases brain Mn levels and it leads to behavioral alterations in both sexes. However, males might be more susceptible to the effect of Mn on mood, and this effect is recalcitrant to an inflammagen challenge. Mn augmented post-LPS cytokine production only in males, further indicating that important Mn effects are sex-biased.

Effects of Patient Gender on Clinicians’ Diagnostic Assessment of Youth Disruptive Mood and Behavior

ABSTRACT Objective Youth disruptive behavior disorders (DBDs) have a male preponderance, but the extent to which gender biases in clinical assessment influence this imbalance remains unclear. The present study investigates whether a child patient’s gender affects clinicians’ diagnostic decision-making regarding Oppositional Defiant Disorder (ODD), Conduct Dissocial Disorder (CDD), and Intermittent Explosive Disorder (IED). Method Clinicians (N = 403; 57.1% male; M age = 48.96 years, SD = 11.09) participated in a global ICD-11 field study. Following an experimental design, participants were asked to use ICD-10 or ICD-11 diagnostic guidelines to evaluate two clinical case vignettes, randomly manipulating the patients’ gender (boy, girl) and symptom presentation (ODD-Defiant, ODD-Irritable, CDD, IED). Analyses tested whether clinicians’ diagnostic accuracy and perceptions of impairment and severity were affected by the patient’s gender. Results Overall, clinicians identified the correct diagnosis 64.7% of the time. Patient gender was not associated with clinicians’ diagnostic accuracy (ps= .090–.895, |φs| = 0.01–0.18) or severity or impairment ratings (ps = .079–.404, |ds| = 0.04–0.19). This pattern of nonsignificant differences and negligible/small effect sizes was consistent across all clinical presentations and analyses. Conclusions We found no evidence of an association between patient gender, diagnostic accuracy, or perceived severity or impairment when assessing youth DBDs in the present study. Results suggest that diagnostic judgments may be driven by clinical presentation rather than gender and that the male DBD preponderance may not be due to gender diagnostic biases. Further research is needed to replicate these findings among youths in clinical settings, with diverse gender identities, and with other mental health conditions.

The Relationship Between Manual Dexterity and Toothbrushing Efficiency in Preschool Children: A Crossover Study

Aim: The aim of this study was to evaluate the relationship between oral hygiene (OH) efficiency and manual dexterity skills in Spanish five-year-old children using two fine motor tests. Methods: A cross-sectional study with a pre–post evaluation was designed. The children’s OH was measured according to the Silness and Löe plaque index (PI) before toothbrushing upon arrival at school (pre) and after supervised toothbrushing (post). Motor skills (children’s dexterity) were determined with the Visual Motor Skills and Resistance to Fatigue test (VMSRF test) and the scale for the Behavioural Assessment of Preschool Skills (BAPS scale). Data were analysed with the SPSS® statistics software with a 95% confidence interval and bilateral significance. Results: One hundred and twenty-nine children were evaluated. The mean PI was 2.5, indicating generally poor OH in the sample. No difference in OH was observed between genders or in the brushing frequency categories. No significant differences in OH or the PI were found between right- and left-handed children either (p &gt; 0.05). Significant differences were found between the OH category pre and post toothbrushing in the total sample, as well as in the various sextants and surfaces evaluated. The results of the VMSRF and BAPS tests indicate moderate visuomotor skills and fatigue resistance and a poor average skill level. A statistically significant improvement in the PI was found in children with higher scores in the VMSRF and BAPS tests. Conclusions: A significantly higher OH efficacy was found in children with better motor skills, although five-year-old children showed moderate visuomotor skills and fatigue resistance and a poor average preschool skill level.

Novel Perspective on Sevoflurane-Induced Cognitive Dysfunction: Implications of Neuronal SIRPα and Microglial Synaptic Remodeling.

This study aims to investigate the role of neuronal SIRPα and microglial synaptic remodeling in sevoflurane-induced cognitive dysfunction in newborn mice. Newborn mice were exposed to sevoflurane, followed by behavioral assessments and single-cell transcriptome sequencing of cortical cells. Lentivirus-mediated overexpression of neuronal SIRPα and assessment of the microglial morphology and synaptic function were conducted. Sevoflurane exposure resulted in social cognitive impairments without affecting motor coordination. Transcriptomic analysis revealed no significant changes in cortical microglial cells or neurons. However, sevoflurane inhibited nonsynaptic synapse modification by microglia. Overexpression of neuronal SIRPα enhanced microglial function, promoted neuron development, and ameliorated cognitive impairments. SCENIC analysis identified a correlation between IRF8 and SIRPα expression. This study sheds light on the involvement of neuronal SIRPα and microglial synaptic remodeling in sevoflurane-induced cognitive dysfunction. Understanding these mechanisms offers new avenues for exploring cognitive impairment pathways and potential therapeutic targets.

Validity Study of the Maladaptive Behavior Assessment Checklist for Children with Developmental Disabilities (MABAC-CDD)

The MABAC-CDD was developed to address a requirement of an updated, standardized, comprehensive assessment tool in the area of maladaptive behaviors or problem behaviors for use with the Indian population. This study aimed to assess the validity of the MABAC-CDD checklist in order to standardize the tool, which is a 107-item frequency-based checklist with 14 areas or sub-domains that assess maladaptive behavior or problem behaviors for children with developmental disabilities below the age of 18 years. The study found the MABAC-CDD tool to have statistically significant criterion validity established through Pearson coefficient correlation at r=0.43 (p=&lt;.001). The results of the validity of the 14 areas or sub-domains of MABAC-CDD are also discussed. This study helps in standardizing the tool and in establishing the validity of the MABAC-CDD for assessment of maladaptive behaviors among children with developmental disabilities in India.

Rate and setting of neurodevelopmental and psychosocial encounters for children with CHD.

In North America, less than 30% of children with complex CHD receive recommended follow-up for neurodevelopmental and psychosocial care. While rates of follow-up care at surgical centres have been described, little is known about similar services outside of surgical centres. This cohort study used Maine Health Data Organization's All Payer Claims Data from 2015 to 2019 to identify developmental and psychosocial-related encounters received by children 0-18 years of age with complex CHD. Encounters were classified as developmental, psychological, and neuropsychological testing, mental health assessment interventions, and health and behaviour assessments and interventions. We analysed the association of demographic and clinical characteristics of children and the receipt of any encounter. Of 799 unique children with complex CHD (57% male, 56% Medicaid, and 64% rural), 185 (23%) had at least one developmental or psychosocial encounter. Only 13 children (1.6%) received such care at a surgical centre. Developmental testing took place at a mix of community clinics/private practices (39%), state-based programmes (31%), and hospital-affiliated clinics (28%) with most encounters billing Medicaid (86%). Health and behavioural assessments occurred exclusively at hospital-affiliated clinics, predominately with Medicaid claims (82%). Encounters for mental health interventions, however, occurred in mostly community clinics/private practices (80%) with the majority of encounters billing commercial insurance (64%). Children with complex CHD in Maine access developmental and psychosocial services in locations beyond surgical centres. To better support the neurodevelopmental outcomes of their patients, CHD centres should build partnerships with these external providers.

An Assessment of Risk-Taking Behavior of Individual Investors: Role of Financial Literacy and Emotions

This paper studies the impact of emotions such as locus of control, overconfidence, risk avoidance, agreeableness, and financial literacy on risk-taking behavior. Data was collected from 338 individual investors from Delhi-NCR and analyzed through PLS-SEM 4 (V.4.0.9.2) to understand the direct and inverse association among the construct and to identify what influenced their investment choices the most. According to the data interpretation, a strong association between agreeableness and risk-taking behavior was evident; the study’s findings indicate that investors were heavily impacted by their peer group while making investment decisions. It also concludes that financial literacy induces overconfidence but does not result in risk-taking behavior. General risk aversion has a direct and locus of control has an indirect influence moderated by agreeableness on the risk-taking behavior of individual investors.

Gender Differences in Dietary Patterns and Eating Behaviours in Individuals with Obesity.

Obesity is a global health problem with significant chronic disease risks. This study examined gender differences in eating behaviour, body composition, eating frequency and time of hunger in an Italian cohort with obesity (BMI ≥ 30) to inform gender-specific management strategies. A retrospective analysis of 720 adults (51.5% female, mean age 44.4 ± 13.8 years) assessed body composition and eating behaviour using principal component analysis (PCA) to classify eating profiles (structured, irregular, social and disordered/impulsive eaters). Males showed higher weight, abdominal circumference and fat mass, while females showed higher fat mass percentages (p < 0.001). Gender differences were observed in the frequency of meals (e.g., 54.7% of males and 64.7% of females consumed 4-5 meals per day, p = 0.0018) and the time of hunger (males: before dinner; females: morning hunger, p = 0.005). The PCA profiles revealed that the 'structured eaters' had a healthier body composition, whereas the 'disordered/impulsive eaters' had a higher fat mass. Irregular eaters were predominantly male (41.0%), while disordered eaters were predominantly female (39.9%) (p = 0.0016). Gender-specific eating patterns influence obesity outcomes. Structured eating was associated with healthier profiles, whereas impulsive or irregular patterns were related to higher fat mass. The retrospective design and non-validated questionnaire for dietary behaviour assessment limit generalisability, warranting further research for tailored interventions. ClinicalTrials.gov (NCT06654674).

Deep Brain Stimulation of the Nucleus Accumbens for Severe Self-Injurious Behaviour in Children: A Phase I Pilot Trial.

Self-injurious behaviours (SIB) are repetitive, non-accidental movements that result in physical damage inflicted upon oneself, without suicidal intent. SIB are prevalent among children with autism spectrum disorder and can lead to permanent disability or death. Neuromodulation at a locus of neural circuitry implicated in SIB, the nucleus accumbens (NAc), may directly influence these behaviours. We completed a phase I, open-label clinical trial of deep brain stimulation (DBS) of the NAc in children with severe, treatment-refractory SIB (ClinicalTrials.gov Identifier NCT03982888). Participants were monitored for 12 months following NAc-DBS to assess the primary outcomes of safety and feasibility. Secondary outcomes included serial assessments of SIB and SIB-associated behaviours, ambulatory actigraphy, and changes in brain glucose metabolism induced by DBS. Six children (ages 7-14 years) underwent NAc-DBS without serious adverse events. One child was found to have a delayed asymptomatic intracranial hemorrhage adjacent to a DBS electrode that did not require intervention, and three children experienced transient worsening in irritability or SIB with titration of stimulation parameters. NAc-DBS resulted in significant reductions in SIB and SIB-associated behaviours across multiple standardized scales, concurrent with clinically meaningful improvements in quality-of-life. Ambulatory actigraphy showed reductions in high-amplitude limb movements and positron emission tomography revealed treatment-induced reductions in metabolic activity within the thalamus, striatum, and temporoinsular cortex. This first-in-children phase 1 clinical trial demonstrates the safety and feasibility of NAc-DBS in children with severe, refractory SIB at high risk of physical injury and death and supports further investigations.