Onset Of Physical Symptoms Research Articles

A Review of Research on Foreign Language Speaking Anxiety of Chinese College Students: Causes, Consequences and Strategies

As English has become a compulsory course for all of the students in China, that is to say, English is becoming more and more important in China. However, due to a lack of English environment, a large proportion of students have foreign language anxiety especially speaking anxiety. Therefore, this study focuses on foreign language speaking anxiety among college students to figure out the causes, and consequences of it and further explore some effective strategies to solve these problems. The data all come from literature from previous studies. After composing and analyzing those data, it can be concluded that there are three causes: fear of committing grammatical errors, low English proficiency and fear of receiving a negative evaluation, and three consequences: onset of physical symptoms, resistance to speaking English and less self-confidence among Chinese college students. Furthermore, some strategies can be applied to solve it from the perspective of instructors and students respectively.

Plasma cell‐free RNA: a new non‐invasive biomarker for Parkinson’s disease

AbstractBackgroundParkinson’s disease (PD) is the second‐most common neurodegenerative disorder, after Alzheimer disease (AD). We aimed to create a model that can predict PD with high accuracy and specificity using plasma cell‐free RNA (cfRNA) data.MethodWe extracted RNA from 172 plasma samples (92 PD cases and 80 controls; 48% female, and median age of 73) received from the Hope Center for Neurological Disorders at Washington University in Saint Louis. After library preparation, sequencing, processing, and stringent quality control data was split into training (60%) and testing (40%) populations, both of which included 53% PD cases, 48% female, and had median age of 73. We then performed differential expression analyses using DESeq2, adjusting the by age, sex, medication and other technical variables. Following data driven identification of informative transcripts using Lasso regression, we used Ridge regression to model disease status.ResultWe identified and replicated 639 significantly dysregulated genes. Through pathway analyses we found that dysregulated genes were enriched in PD terms, as well as other neurodegenerative and in known mitochondria pathways. After predictive model training, the best model for PD in the testing population included 14 genes and had an Area Under the Receiving Operating Curve (AUC) of 0.963 (0.930, 0.996). The model had low predictive power, with AUC of 0.553 (0.421, 0.686), in differentiating between controls and AD, FTD or DLB, suggesting that it is specific to PD. More evidence of its specificity was the good performance in distinguishing between PD and AD, FTD or DLB with AUC of 0.753 (0.674, 0.833) specificity.ConclusionPlasma cfRNA is a powerful tool for PD prediction, being a minimally invasive biomarker that could detect PD before onset of physical symptoms and without relying on imaging data. We are working on replicating our results in an independent dataset.

Longitudinal relationship between onset of physical symptoms and functional impairment

Patients with chronic physical symptoms (e.g., chronic pain) often have significant functional impairment (i.e., disability). The fear avoidance model is the dominant theoretical model of how the relationship between chronic physical symptoms and functional impairment develops and proposes a cyclical/bidirectional relationship. There has never been a definitive test of the proposed bi-directional relationship. The current study followed 767 Operation Enduring Freedom/Operation Iraqi Freedom soldiers from pre-deployment, when they were relatively healthy, to 1year after deployment, when it was anticipated that symptoms would increase or develop. Over the four assessment time points, physical symptom severity consistently predicted worse functional impairment at the subsequent time point. Functional impairment did not show a consistent relationship with worsening of physical symptom severity. These findings suggest that changes to functional impairment do not have a short-term impact on physical symptom severity.

Paraneoplastic Encephalopathy Presenting with Rapidly Progressive Dementia and Catatonia

Introduction: Paraneoplastic encephalopathy can present with neurological and psychiatric symptoms, and it is important to be aware of possible underlying medical etiologies of seemingly psychiatric presentations. In this case, cancer-associated limbic encephalitis presented with classical signs of catatonia, progressive cognitive decline and psychotic depression. Methods: A 68-year-old Caucasian female with past medical history of COPD, ongoing heavy tobacco use, and depression presented with rapidly worsening cognitive function over a nine months. Her cognitive symptoms were accompanied by psychotic features and delusions of ruin that her body and hair were burnt. Her medications on presentation included sertraline, trazodone, quetiapine and clonazepam. Physical examination was remarkable for classical signs of catatonia including catalepsy, gegenhalten, staring, perseveration, echolalia, echopraxia, hypophonia, and automatic obedience. MOCA scores were 19/30. Medical work-up undertaken for rapidly progressive dementia included a paraneoplastic antibody panel due to concerns of paraneoplastic limbic encephalitis. Anti-Hu antibodies were positive and further investigation revealed Stage IIIA small cell lung cancer. The patient was started on venlafaxine and mirtazapine for depression, olanzapine for psychosis and for paraneoplastic syndrome she was referred for treatment of underlying cancer and received a short course of steroids, which improved her cognitive function remarkably. Lorazepam helped improve catatonic symptoms. Results: The early detection of small cell lung cancer in limited stage (IIIA) resulted from the paraneoplastic work up prior to onset of physical symptoms and increased the possibility of curative treatment with radiation therapy and chemotherapy. Conclusions: The early detection of small cell lung cancer in limited stage (IIIA) resulted from the paraneoplastic work up prior to onset of physical symptoms and increased the possibility of curative treatment with radiation therapy and chemotherapy. Paraneoplastic syndromes should be considered on the differential for rapid cognitive decline, psychosis and personality changes especially when there is increased suspicion for malignancy.

Childhood-Onset Multiple Sclerosis and Mood Disorders: A Case Study

Multiple Sclerosis (MS) is rare in children. Little research exists regarding emotional and behavioral disorders in childhood-onset MS, despite the occurrence of such problems in adults with MS. This paper describes the cognitive and behavioral characteristics of a boy diagnosed with MS at age 9 and mood disorder at age 10. He displayed no cognitive or behavioral problems prior to the onset of physical symptoms of MS. Three years after diagnosis, this child showed persistent problems with speed of processing, visual-motor skills, and parent and teacher-reported executive functioning. In addition, he had difficulties with emotional lability, behavioral disinhibition, depression, and social interaction. As with adults, children with MS may be at increased risk for mood disorder compared to their peers. Mood disorders in children with MS are likely to be multiply determined, although the specific causal mechanisms are unknown.

Factitious Illness v Conversion Disorder

To the Editor.— The three cases of respiratory distress associated with wheezing heard loudest over the larynx and normal pulmonary function certainly point out the value of a careful physical examination and sensitivity to the patient's emotional history to avoid unnecessary treatment for asthma (1982;248:2878). However, factitious illness was not the best diagnosis in at least two of the cases (2 and 3) and probably a third (case 1). Conversion disorder, with or without a concurrent anxiety disorder, would be much more likely and helpful to consider in these cases. Conversion disorder involves a loss or alteration of physical function, often in the voluntary nervous system. The change in function is thought to be associated with channeling of anxiety about psychological conflicts into somatic outlets, which is not explained by known physiological disease and in which a temporal connection is found between the onset of physical symptoms, psychological disturbance, and