Diagnosis Of Disorders Research Articles

The profile of social communication in Dravet syndrome

Dravet syndrome (DS) presents a multifaceted clinical picture marked by epilepsy, cognitive impairments and behavioral disorders that progresses throughout development. Behavioral disorders include impairments in social relationships and communication, with frequent diagnosis of autism spectrum disorder. This study focused on comprehensively evaluating and comparing social communication profiles among a group of 43 children with Dravet syndrome, 30 children with level 1 autism spectrum disorder, 36 with social (pragmatic) communication disorder, and 18 with intellectual disability. Using validated tools like the Childhood Autism Spectrum Test and Children’s Communication Checklist, distinct patterns of social communication deficits were delineated. Our findings indicate that children with Dravet syndrome experience challenges in social relationships, primarily due to difficulties in use of pragmatic language. Areas such as range of interests and social interaction are less affected compared to those with ASD, emphasizing differing profiles between the conditions. While children with DS and ID may have similar intellectual functioning, the different social communication deficits in DS indicate their role in the DS phenotype beyond ID. These results underscore the unique social communication profile of DS and emphasizes the importance of tailored interventions and deep phenotyping efforts for effective DS management.

Validation of the PCL-5 in Dutch trauma-exposed adults

BackgroundThe PTSD Checklist for DSM-5 (PCL-5) is an internationally widely used self-report questionnaire that can be used to screen for probable diagnosis of posttraumatic stress disorder (PTSD). Information on the psychometric properties of the Dutch PCL-5 is currently lacking.ObjectiveWe aimed to validate the Dutch PCL-5 in a sample of Dutch adults with prior (suspected) serious injury and establish the optimal cut-off for probable PTSD diagnosis herein.MethodsData for the current study were collected as part of a long-term follow-up measurement of the TraumaTIPS cohort, where adults admitted to an emergency department following (suspected) serious injury completed a follow-up measurement 12–15 years post-trauma. Of N = 333 eligible participants, n = 192 (57.7%) consented and completed the PCL-5 alongside self-report instruments measuring depression (QIDS), PTSD (IES-R), and quality of life (WHO-QOL and EQ-6D). In total, n = 185 participants also completed a clinician administered interview for PTSD (CAPS-5). Most participants were men (66%) and on average 54 years old (SD = 12.41). We evaluated the diagnostic utility of the PCL-5 using Youden index and tested reliability and convergent validity.ResultsThe PCL-5 demonstrated excellent diagnostic accuracy with a cut-off point of 16 resulting in an optimal Youden index (0.90) for screening purposes with a high sensitivity (1.00) and specificity (0.90). A cut-off of 22 yielded a slightly lower Youden index (0.84) but better positive predictive value (0.50 instead of 0.33) than the cut-off of 16. A cut-off of 29 resulted in the most accurate prevalence estimates. The PCL-5 showed a high internal consistency (Cronbach’s α = 0.94), excellent inter-item and item-total correlations and good convergent validity (r > .5 for CAPS-5, IES-R and QIDS).ConclusionsThe PCL-5 is a reliable and valid measurement for PTSD symptoms and probable diagnosis and shows excellent screening abilities in Dutch adults with prior (suspected) serious injury, with a lower optimal cut-off compared to previously found in clinical populations. We recommend a cut-off of 22 for screening purposes and a cut-off of 29 for prevalence estimates in Dutch trauma-exposed adults.

Language ability in 5–12-year-old children with new-onset epilepsy

Purpose This clinically based study aimed to explore and describe language ability in 5–12-year-old children with new-onset epilepsy. Participants and methods: Twenty-one consecutively recruited children (eleven boys, ten girls) with new-onset epilepsy, were assessed using Clinical Evaluation of Language Fundamentals, fourth edition (CELF-4) and additional tests for verbal fluency/word retrieval and phonology. In addition, caregivers rated their child’s speech, language, and communication in everyday context. Based on available tests and clinical observation, an overall evaluation of language ability was made to distinguish children with language disorders and children with language difficulties from those with language abilities within the normal range. Language disorder was diagnosed following the ICD-10 criteria. The cutoff for language difficulties was set at 1 standard deviation below the normative mean on the CELF-4 Core Language Score and additional indices. Results Out of twenty-one children, ten (47.5%) met the criteria for a language disorder diagnosis according to ICD-10. Another five (24%) had language difficulties but did not meet the criteria for a language disorder diagnosis according to ICD-10. Hence a total of fifteen (71.5%) children had an impaired language ability affecting different domains of language, including receptive language, language memory, and semantic processing. The remaining six (28.5%) children had average language ability. Conclusion In this group of children with new-onset epilepsy, a large over-representation of co-existing language disorder and language difficulties was found. The findings suggest that specific language assessments for children with new-onset epilepsy are needed, to ensure that adequate interventions and support can be offered.

Common foot and ankle disorders in pregnancy: the role of diagnostic ultrasound.

Foot and ankle disorders are common during pregnancy, driven by significant physiological changes including weight distribution, hormonal fluctuations, and fluid balance. These changes often result in conditions such as varicose veins, thrombophlebitis, deep vein thrombosis (DVT), edema, overpronation, ankle sprains, metatarsalgia, stress fractures, ligament tears, synovitis, tendon tears, tenosynovitis, paratenonitis, plantar fasciitis, and Morton's neuroma. This paper emphasizes the diagnostic utility of ultrasound for these conditions, given its safety, non-invasiveness, and real-time imaging capabilities without ionizing radiation. Ultrasound is particularly effective for diagnosing venous disorders like varicose veins and thrombophlebitis, leveraging Doppler ultrasound to assess vein structure and function. It is also instrumental in identifying DVT, detecting vein dilation, reflux, and thrombosis. For conditions such as edema, ultrasound helps differentiate physiological from pathological causes, ensuring accurate diagnosis and management. In cases of musculoskeletal issues like overpronation, ankle sprains, ligament tears, and tendon pathologies, ultrasound provides detailed images of soft tissues, allowing for precise diagnosis and effective treatment planning. It is equally useful for detecting metatarsalgia, plantar fasciitis, and Morton's neuroma, offering insights into soft tissue abnormalities and guiding therapeutic interventions. Ultrasound's role extends to diagnosing foreign bodies in the foot and ankle, where it demonstrates high sensitivity and specificity. The accessibility and cost-effectiveness of ultrasound make it an invaluable tool in various healthcare settings, ensuring timely and accurate diagnosis and management of foot and ankle disorders during pregnancy, ultimately enhancing patient outcomes and quality of life.

Effect evaluation of outpatient long-term video EEGs for people with seizure disorders – study protocol of the ALVEEG project: a randomized controlled trial in Germany

BackgroundEpilepsy and other seizure disorders account for a high disease burden in Germany. As a timely diagnosis and accurate treatment are crucial, improving the management of these disorders is important. Outside of Germany, outpatient long-term video EEGs (ALVEEGs) have demonstrated the potential to support the diagnosis and management of epilepsy and other seizure disorders. This study aims to evaluate the implementation of ALVEEGs as a new diagnostic pathway in eastern parts of Germany to diagnose epilepsy and other seizure disorders and to assess if ALVEEGs are equally effective as the current inpatient-monitoring gold standard, which is currently only available at a limited number of specialized centers in Germany.MethodsALVEEG is a prospective, multicenter, randomized controlled equivalence trial, involving five epilepsy centers in the eastern states of Germany. Patients will be randomized into either intervention (IG) or control group (CG), using a permuted block randomization. The sample size targeted is 688 patients, continuously recruited over the trial. The IG will complete an ALVEEG in a home setting, including getting access to a smartphone app to document seizure activity. The CG will receive care as usual, i.e., inpatient long-term video-EEG monitoring. The primary outcome is the proportion of clinical questions being solved in the IG compared to the CG. Secondary outcomes include hospital stays, time until video EEG, time until diagnosis and result discussion, patients’ health status, quality of life and health competence, and number and form of epilepsy-related events and epileptiform activity. Alongside the trial, a process implementation and health economic evaluation will be conducted.DiscussionThe extensive evaluation of this study, including an implementation and health economic evaluation, will provide valuable information for health policy decision-makers to optimize future delivery of neurological care to patients affected by epilepsy and other seizure disorders and on the uptake of ALVEEG into standard care in Germany.Trial registrationGerman Clinical Trials Register (DRKS00032220), date registered: December 11, 2023.

Prognostic algorithm for early diagnosis of subcritical conditions as predictors of sudden cardiac death

Aim. To develop a method for early diagnosis of subcritical homeostasis disorders leading to sudden cardiac death (SCD). The basis is to improve the efficiency of predictive algorithms.Material and methods. This pilot, controlled, open-label, randomized, prospective clinical trial included 220 patients at risk of SCD and 150 patients without risk of SCD. Main and control groups was formed according to the global cardiovascular risk score. Based on the informative features proposed by specialized experts using multivariate statistics methods (discriminant analysis), two condition classes were formed. The conducted exploratory analysis confirmed the significance of diagnostic criteria in relation to SCD manifestation (manifestation of cardiac arrest — MCA), which is an integral assessment of a fatal complication. The development of decision rules was carried out on the basis of soft computing technology.Results. Taking into account the priority of clinical research, namely, the identification of subcritical stages of MCA, a classifier is proposed according to basic severity of patients — the severity of critical condition risk (SCCR). The discriminant function and intersection areas between MCA subclasses in the conditions of early SCD diagnosis determine the transition to soft computing technology. Membership functions for severe MCA are formed, followed by their iteration according to E. Shortliffe. The final decision rule, using a fuzzy classifier, differentiates the MCA into stages with different SCCR. In parallel with standard protocols for the management of severe somatic patients (chronic obstructive pulmonary disease, chronic kidney disease, hepatocellular failure), based on the proposed algorithm with an integral assessment of critical conditions, using the MCA decision rule in the main group in 30,5% of cases, subcritical stage was revealed, followed by targeted treatment and preventive support. In the first group, a subcritical condition was detected in 67 patients (30,5%); a critical condition without SCD — in 3 patients (1,4%). In all noted cases, early prevention of SCD was successfully carried out (these patients were transferred to a class with a lower SCD degree). Using conventional prognostic scores in this group, 46 patients (20,9%) were identified with a subcritical condition and 1 (0,4%) with a critical condition. In the control group, subcritical condition was determined in 35 patients (23,3%), of which 17 patients (11,3%) had a moderate risk of SCD. Using conventional prognostic scores, 23 patients (15,3%) with subcritical condition were identified.Conclusion. In the conditions of intensive care unit, general medicine departments, hemodialysis department, cardiac surgery, and organ transplantation department, an algorithm for early diagnosis and risk stratification of SCD with an integral assessment (MCA) should be used. The fuzzy classifier MCA according to SCCR makes it possible to carry out timely correction of treatment measures in addition to standard protocols.

Association of Patient and Geographic Variables in Pediatric Patients With Prediabetes Becoming Lost to Follow-up

Abstract Introduction Prediabetes (PD) is becoming more common, and management is complicated by high rates of loss to follow-up. We evaluated variables associated with lost to follow-up status for pediatric patients with PD referred to endocrinology for evaluation and management. Methods We evaluated new patients referred to Children's of Alabama Endocrinology for PD from March 2017 through March 2021. Variables included patient medical and demographics as well as county-level metrics. Comparisons of patients who returned to clinic and those who were lost to follow-up were assessed by chi-square for categorical variables and Student’s t-test/Wilcoxon rank sum test for continuous normal/skewed variables, respectively. Univariate logistic regression modeling identified risk factors for coming lost to follow-up and odds ratios with 95% confidence intervals were reported with a 2-sided P-value for significance of <.05. Results A total of 524 patients were included in the analysis. Almost one-fourth of patients were lost to follow-up (24.6%). The odds of returning to clinic were higher in patients with the Children's Health Insurance Plan, who were prescribed endocrine medications, who had a concurrent diagnosis of cholesterol disorder, who had referral to the endocrine clinic before COVID-19, and who were offered a telehealth visit. No other assessed variable was significantly associated with the likelihood of returning to clinic. Conclusion Independent of obesity severity, age, sex, race, county-level health, and economic variables, the factor most strongly associated with returning to clinic was having a telemedicine visit scheduled. Our data suggest that offering telemedicine visits may reduce lost to follow-up rates in this patient population.

Neuronal Remodelling as a Predictor of Autism Spectrum Disorder Diagnosis

People with Autism Spectrum Disorder (ASD) are a neurodevelopmental symptom group characterized by significant deficits in information connectivity, mainly caused by specific genetic mutations affecting the fluency of the gamma-aminobutyric acid (GABAergic) system. This disruption, to a greater or lesser degree, hinders the interactive process of incoming stimuli with previously stored information, preventing working memory from fulfilling its role of facilitating access to information in permanent memory and later recovery. In addition to the genetic components, environmental processes occurring, above all, in early childhood, related to specific organic and severe psycho-emotional diseases can produce the same effects in the brain system as the genetic karyotypic component through the concept of neuronal remodelling. In this sense, this research aims to empirically show the influence of neuronal remodelling on the GABAergic pathway leading to the traits of autism spectrum behaviour. A total of 175 participants from the three levels of ASD intensity have participated in this study. Data have been analysed through Linear Logistic Regression, which shows that both components, the genetic process and the environmental process, significantly influence the neural connective pathway that relates information, unlike other operationalized covariates, such as gender or age of the participants. Likewise, as shown by the Chi-Square Test, the interactions between genetic and environmental variables showed no differences in their interaction regarding the connectivity level that would explain the different levels of disorder. However, when there is a combination of genetic mutations in the diagnostic karyotype, there are significant differences between the genetic group and the environmental process over the neural network.

Diagnostic challenges in patients with Castleman disease, a single center experience from Hungary.

Castleman disease is a rare and atypical lymphoproliferative disorder characterized by diverse clinical manifestations. It has both unicentric and multicentric forms, the latter with further subdivisions, i.e., human herpesvirus 8-associated and idiopathic forms. The diagnosis of Castleman disease is often delayed, as it is rare, and because it shares clinical features with different autoimmune, inflammatory, and malignant lymphoproliferative disorders. The first-line treatment in unicentric form is mainly surgical, while in idiopathic Castleman disease, anti-interleukin-6 treatment is the therapy of choice. In virus-associated diseases, antiretroviral therapy and rituximab are recommended. In Hungary, only a few cases of Castleman disease have been published. This report presents our twodecades of experience in the challenging diagnosis and management of this rare disorder, most properly underdiagnosed in Hungary. We provide insights into seven unicentric and five idiopathic multicentric Castleman disease cases, the latter ones especially highlighting the diagnostic and therapeutic challenges due to the variable and unique clinical features both of patients and diseases, e.g., bronchiolitis obliterans, stage IV diabetic renal failure, anti-HBc positivity, siltuximab treatment period, respectively.

Gamma-Band Auditory Steady-State Response and Attention: A Systemic Review

Auditory steady-state response (ASSR) is the result of the brain’s ability to follow and entrain its oscillatory activity to the phase and frequency of periodic auditory stimulation. Gamma-band ASSR has been increasingly investigated with intentions to apply it in neuropsychiatric disorders diagnosis as well as in brain–computer interface technologies. However, it is still debatable whether attention can influence ASSR, as the results of the attention effects of ASSR are equivocal. In our study, we aimed to systemically review all known articles related to the attentional modulation of gamma-band ASSRs. The initial literature search resulted in 1283 papers. After the removal of duplicates and ineligible articles, 49 original studies were included in the final analysis. Most analyzed studies demonstrated ASSR modulation with differing attention levels; however, studies providing mixed or non-significant results were also identified. The high versatility of methodological approaches including the utilized stimulus type and ASSR recording modality, as well as tasks employed to modulate attention, were detected and emphasized as the main causality of result inconsistencies across studies. Also, the impact of training, inter-individual variability, and time of focus was addressed.

Understanding Trauma in IPV: Distinguishing Complex PTSD, PTSD, and BPD in Victims and Offenders

This work aims to shed light on the differential diagnosis of complex post-traumatic stress disorder (cPTSD), post-traumatic stress disorder (PTSD), and borderline personality disorder (BPD) within the context of intimate partner violence (IPV), which represents a highly innovative field of clinical research. To this end, a critical review of the literature was conducted to identify and compare the clinical patterns and symptomatic overlaps among cPTSD, PTSD, and BPD, with an emphasis on their manifestation in both IPV victims and offenders. The results show that despite some symptomatic similarities, cPTSD, PTSD, and BPD have distinct clinical patterns of interpersonal violence. Specifically, disturbances in self-organization (DSO) are more commonly found in offenders, while the diagnosis of cPTSD seems more aligned with the psychological functioning of victims. In addition, cPTSD and specific characteristics of BPD, such as fear of rejection and instability of identity, constitute risk factors for IPV victimization. cPTSD is shown as a predisposing factor not only for IPV victims but also for offenders, while PTSD emerges as a consequential factor. The specific pathways linking PTSD, cPTSD, and BPD with IPV have significant implications for clinical practice. Further research is needed to understand these profiles and the mechanisms linking trauma-related features to IPV, which is crucial for implementing effective violence prevention programs.

Regional citrate anticoagulation with continuous renal replacement therapy as a cause of hypercalcemia.

Awareness of the causes of hypercalcemia is essential for timely diagnosis of calcium disorders and optimal treatment. Citrate is commonly used as an anticoagulant during continuous renal replacement therapy (CRRT). Accumulation of citrate in the systemic circulation during CRRT may induce several metabolic disturbances, including total hypercalcemia and ionized hypocalcemia. The aim of the present study is to increase awareness of citrate accumulation and toxicity as a cause of hypercalcemia by relating three cases and reviewing the pathophysiology and clinical implications. We utilized electronic health records to examine the clinical cases and outlined key studies to review the consequences of citrate toxicity and general approaches to management. Citrate toxicity is associated with high mortality. A safe threshold for tolerating hypercalcemia during citrate anticoagulation is not clearly defined, and whether citrate toxicity independently increases mortality has not been resolved. Greater attention to citrate toxicity as a cause of hypercalcemia may lead to earlier detection, help to optimize the management of systemic calcium levels, and foster interest in future clinical studies.

Toxoplasma gondii IgG serointensity and cognitive function in bipolar disorder

BackgroundAlongside affective episodes, cognitive dysfunction is a core symptom of bipolar disorder. The intracellular parasite T. gondii has been positively associated with both, the diagnosis of bipolar disorder and poorer cognitive performance, across diagnostic boundaries. This study aims to investigate the association between T. gondii seropositivity, serointensity, and cognitive function in an euthymic sample of bipolar disorder.MethodsA total of 76 participants with bipolar disorder in remission were tested for T. gondii-specific IgG and IgM antibodies and for cognitive performance using neuropsychological test battery. Cognitive parameters were categorized into three cognitive domains (attention and processing speed, verbal memory, and executive function). Statistical analysis of associations between continuous indicators of cognitive function as dependent variables in relationship to T. gondii, included multivariate analyses of co-variance for seropositivity, and partial correlations with IgG serointensity in IgG seropositives. All analyses were controlled for age and premorbid IQ.ResultsIn seropositives (n = 27), verbal memory showed significant inverse partial correlations with IgG antibody levels (short delay free recall (r=–0.539, p = 0.005), long delay free recall (r=–0.423, p = 0.035), and immediate recall sum trial 1–5 (r=–0.399, p = 0.048)). Cognitive function did not differ between IgG seropositive and seronegative individuals in any of the cognitive domains (F (3,70) = 0.327, p = 0.806, n = 76). IgM positives (n = 7) were too few to be analyzed.ConclusionsThis investigation is the first to show an association between T. gondii IgG serointensity and memory function in a well-diagnosed bipolar disorder sample. It adds to the existing literature on associations between latent T. gondii infection and cognition in bipolar disorder, while further research is needed to confirm and expand our findings, eliminate potential sources of bias, and establish cause-effect relationships.

Effects of intermittent lighting program and light colour on ocular health variables as welfare indicators in broiler chickens

ABSTRACT 1. The objective of the present study was to examine the effect of lighting programs and light colour on ocular health variables as welfare indicators in Ross 308 broilers. 2. A total of 384, male, one-d-old broiler chickens (Ross 308) were placed in a completely randomised design with a 2 × 2 factorial arrangement of lighting program (continuous or intermittent) and light colour (white and green LED light). Ross 308 broilers under restricted lighting had 18 h of light (18 L:6D), while those under intermittent lighting had cycles of 17 L:3D:1 L:3D throughout the experimental period, which lasted 42 d. 3. At the end of the experiment, all eyes of birds (n = 96 birds) underwent a complete ophthalmic examination, which included the Schirmer tear test I, intraocular pressure and eye dimensions. In addition, 32 broilers (eight birds per trial groups) aged 42 d underwent ophthalmic examination to include assessment of ocular ultrasound biometry. 4. Light colour had a significant influence on the mean intraocular pressure (p < 0.001). The Ross 308 broilers kept with intermittent lighting had lower eye weights (2.29 g; p < 0.05), palpebral fissure length (14.39 mm; p < 0.01), eye dorsoventral diameter (17.46 mm; p < 0.05), anteroposterior size (13.70 mm; p < 0.01) and corneal dorsoventral diameter (7.81 mm; p < 0.05) compared to those reared under restricted lighting. 5. In conclusion, these values for Ross 308 broilers may be applied in poultry ophthalmology to detect early eye disease symptoms and to help the diagnosis of tear disorders that could cause economic losses and welfare issues. Intermittent lighting and green LED light may help reduce eye health problems thus contributing to improved welfare in broilers.

Experiences of attending prenatal ultrasounds during the COVID-19 pandemic in Australia: A cross-sectional survey.

Prenatal ultrasounds form an important part of routine maternity care in Australia and indeed internationally. The COVID-19 pandemic necessitated rapid changes in society and healthcare to curb transmission, with evidence demonstrating detrimental impacts on childbearing women associated with these restrictions. However, experiences with pandemic restrictions for prenatal ultrasounds in relation to distress, patient expectations, and satisfaction are largely unknown. This study aimed to explore the experiences of pregnant women attending prenatal ultrasound during the pandemic in Australia. A cross-sectional online survey of people in Australia who had undergone at least one prenatal ultrasound during the period of maternity care restrictions was performed. The survey included validated tools for assessing post-traumatic stress, satisfaction, and expectations with maternity care. A total of 1280 responses were obtained. Almost 37% of respondents returned a PCL-C score consistent with probable post-traumatic stress disorder. Unexpected ultrasound findings or a high PCL-C score were more likely to have higher expectations and lower levels of satisfaction with their maternity care experience. Having an ultrasound for pregnancy loss, fetal abnormality, and/or a prior post-traumatic stress disorder diagnosis were the strongest factors correlating with a high PCL-C score. The prevalence of post-traumatic stress symptoms in the study population is concerning and elucidates the distress experienced in association with prenatal ultrasounds during pandemic restrictions in Australia. Maternity services should acknowledge the high levels of service consumers with post-trauma symptoms and consider trauma-responsive maternity care adaptations in response to adverse perinatal outcomes for those afflicted with post-trauma and distress-related symptoms.

A Digital Clock Drawing Test on Tablet for the Diagnosis of Neurocognitive Disorders in Older Adults.

The diagnosis of neurocognitive diseases is an important health issue for patients, families and healthcare professionals. The need to develop rapid, high-performance screening tools would improve access to care. The Clock Drawing Test (CDT) is widely used and validated with the older adults, and its digital version is becoming increasingly widespread. We propose to confirm its validity in a population of old patients hospitalized in a geriatric unit, and secondly to verify its performance in comparison with the reference diagnosis made by a specialized team in a memory consultation. CDTs were collected from older hospitalized patients, both in paper form and digitally on a touchscreen tablet. The results show good agreement between the paper and digital versions (kappa coefficient = 0.81). Sensitivity and specificity of the digital CDT were 0.84 and 0.59 respectively for the diagnosis of major cognitive disorders. The corresponding values were 0.72 and 0.59 for the diagnosis of mild neurocognitive disorders. User questionnaires indicate that older participants find the digital tablet easy to use. However, they prefer to use paper, even if they are open to learning how to use the tablet.

Contribution of a Tablet-Based Tests to the Diagnosis of Neurocognitive Disorders in Older Adults: A Feasibility Study.

Neurocognitive diseases are diagnosed in specialized centers such as memory clinics, where the waiting time can be long. The reference assessment involves a battery of tests carried out by a specialized team. Facilitating screening in primary care using new technologies could make it possible to appropriately direct care pathways towards specialist care. This work aimed to set up a battery of questionnaires, cognitive and manual dexterity tests on a digital tablet to screen people with cognitive impairment. Three groups of people are recruited from a memory consultation: people with major neurocognitive disorders, people with mild neurocognitive disorders and people with no cognitive impairment. Initial results in geriatric settings show that the digital tablet assessment test is feasible and well accepted, but that manual dexterity assessment needs to be adapted to the bodily particularities of the very old.

Mood stabilizers for treatment of bipolar disorder in pregnancy and impact on neonatal outcomes.

Untreated bipolar disorder in pregnancy is associated with adverse maternal and neonatal outcomes. Despite advances in clinical management, there is concern among obstetric providers and patients about the safety of pharmacological agents for the treatment of bipolar disorder in pregnancy. Recent studies have shown atypical antipsychotics and lamotrigine to have a favorable safety profile; however, little information is published on lurasidone. The objective of this retrospective chart review was to evaluate pregnancy and neonatal outcomes in obstetric patients with bipolar disorder who are untreated, compared to those treated with lurasidone, other atypical antipsychotics, and lamotrigine at a tertiary teaching institution. This retrospective cohort study included neonates whose mothers had a diagnosis of bipolar disorder and were referred to the Maternal & Fetal Care Clinic with two documented visits after January 1, 2014, with delivery by October 31, 2017, within an SSM health-system hospital. In this study, women with untreated bipolar disorder (not on any mood stabilizer) in pregnancy had significantly higher rates of premature delivery and low birth weight compared to women on mood stabilizers of lamotrigine, lurasidone, and other atypical antipsychotics. No difference was observed for pregnancy or neonatal outcomes between patients taking any of the mood stabilizers. This study suggests that the use of lurasidone, other atypical antipsychotics, and lamotrigine have better neonatal outcomes than untreated bipolar disorder in pregnancy.

Diet pills and deception: A content analysis of weight-loss, muscle-building, and cleanse and detox supplements videos on TikTok

The promotion of harmful dieting-related products, including weight-loss, muscle-building, and cleanse/detox supplements, is pervasive across TikTok. Use of these products has been associated with eating pathology, and in some instances, increased risk of an eating disorder diagnosis. To inform eating disorders prevention and public health intervention, a content analysis was conducted to analyze the promotional features of the most viewed videos as of June 2022 in the U.S. across popular dieting product-related hashtags (#dietpills, #preworkout, #detox) (N = 233 videos). Investigators watched and coded videos using a codebook that captured details about featured individuals, product claims and details, and other video elements (e.g., language, use of popular music). Descriptive statistics were obtained to analyze trends within and across product hashtags. A total of 78 #dietpills, 86 #preworkout, and 69 #detox videos met study criteria. Videos promoting weight-loss and cleanse/detox products overwhelmingly featured feminine-presenting (70.5 % and 71 %, respectively) and thin (35.9 % and 44.9 %) individuals, while #preworkout video subjects were mostly masculine-presenting (73.3 %) and muscular (61.6 %). Most did not disclose their credentials (93.6 %) nor identify whether the promotion of the product was sponsored by the retailer (95.7 %). The vast majority of videos (97 %) did not provide any scientific evidence to support health- and appearance-related claims. The most popular videos promoting dieting-related supplements on TikTok overwhelmingly make unsubstantiated health claims, posing substantial risks for social media users who are vulnerable to their usage and associated health risks, including engagement in disordered eating.

Unsupervised Learning of Eye State Prototypes for Semantically Rich Blinking Detection.

Blinking contributes to the health and protection of the eye and also holds potential in the context of muscle or nerve disorder diagnosis. Traditional methods of classifying eye blinking as open or closed are insufficient, as they do not capture medical-relevant aspects like closure speed, duration, or percentage. The issue could be solved by reliably detecting blinking intervals in high-temporal recordings. Our research demonstrates the reliable detection of blinking events through data-driven analysis of the eye aspect ratio. In an unsupervised manner, we establish an eye state prototype to identify blink intervals and measure inter-eye synchronicity between moments of peak closure. Additionally, our research shows that manually defined prototypes yield comparable results. Our results demonstrate inter-eye synchronicity up to 4.16 ms. We anticipate that medical professionals could utilize our methods to identify or define disease-specific prototypes as potential diagnostic tools.