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number of DKA admissions in our population with T1D youth. However, this intervention did not reduce the health disparity in this population and African-Americans on Medicaid insurance continued to form the disproportionate majority of admissions with DKA. This study highlights the need for further research into interventions that can improve outcomes across racial and socio-economic barriers.
Individuals with insomnia are a subpopulation at high-risk of suicide. However, despite the elements in favour of an implication of anhedonia in the occurrence of current suicidal ideations (SI), no study has investigated the role played by this affective symptom in the occurrence of current SI in individuals with insomnia. The aim of this study was to investigate the risk of current SI associated with lifelong anhedonia and recent change of anhedonia in individuals with insomnia.
Demographic and polysomnographic data from 493 individuals with insomnia selected retrospectively from the clinical database of the Erasme Hospital Sleep Laboratory were analysed. Current SI were considered present if the score in item 9 of the Beck Depression Inventory (BDI-II) was ≥1 and/or if they were highlighted during the systematic psychiatric assessment conducted on admission to the Sleep Laboratory. Logistic regression analyses were used to determine the risk of current SI associated with anhedonia in individuals with insomnia.
The prevalence of current SI was 21.5% in our sample of individuals with insomnia. After adjusting for major confounding factors, multivariate logistic regression analyses demonstrated that unlike lifelong anhedonia, only recent change of anhedonia was a risk factor for current SI in individuals with insomnia.
In this study, we demonstrated that in individuals with insomnia, recent change of anhedonia is a risk factor for current SI, which seems to justify more systematic research and adequate therapeutic management of this condition to allow better prevention in this particular subpopulation at high-risk of suicide.
In this study, we demonstrated that in individuals with insomnia, recent change of anhedonia is a risk factor for current SI, which seems to justify more systematic research and adequate therapeutic management of this condition to allow better prevention in this particular subpopulation at high-risk of suicide.
Considerable evidence on general population suggests that an "Affective pathway to psychosis", involving depression and anxiety dimensions, mediates the abuse-psychosis association. However, this has never been tested in Early Psychosis (EP) patients. We aim at testing whether severity of depressive and anxiety mediates the abuse-positive symptoms dyad in an EP prospective sample.
330EP subjects aged 18-35 were assessed for psychopathology after 2, 6, 12, 18, 24, 30, and 36 months of treatment. Abuse was considered as facing at least one experience of physical, sexual, or emotional abuse before age 16. Positive psychotic symptoms and anxiety were measured with the Positive and Negative Syndrome Scale and depressive symptoms with the Montgomery-Asberg Depression Rating Scale. Mediation analyses were performed to study whether the abuse-positive symptom's link was mediated by depressive, anxiety, and a combination of anxiety/mood symptoms.
Among the 330EP patient included, 104 (31.5% of the total) were exposed to abuse. Analyses across the 36 months of follow-up showed that depression and anxiety partially mediated 26.7% of the total effect of the abuse-positive symptoms association (indirect effects (IE)=0.392 and 0.421 respectively), while the combined anxiety/mood model mediated 28.9% (IE=0.475). Subanalyses at two and 36 months revealed a consistent role of depression, while that of anxiety was only present at baseline.
Our work confirms a mediating role of mood and anxiety in the association between abuse and positive symptoms during the first three years of treatment.
Our work confirms a mediating role of mood and anxiety in the association between abuse and positive symptoms during the first three years of treatment.
Alzheimer's disease is a chronic neurodegenerative disease that destroys brain cells, causing irreversible degeneration of cognitive functions and dementia. Its causes are not yet fully understood, and there is no curative treatment. However, neuroimaging tools currently offer help in clinical diagnosis, and, recently, deep learning methods have rapidly become a key methodology applied to these tools. click here The reason is that they require little or no image preprocessing and can automatically infer an optimal representation of the data from raw images without requiring prior feature selection, resulting in a more objective and less biased process. However, training a reliable model is challenging due to the significant differences in brain image types.
We aim to contribute to the research and study of Alzheimer's disease through computer-aided diagnosis (CAD) by comparing different deep learning models. In this work, there are three main objectives i) to present a fully automated deep-ensemble approach for demeCAD systems, considering the numerous cross-dataset experiments performed. Being tested on MRIs and fMRIs, our strategy can be easily extended to other imaging techniques. In conclusion, we found that our deep-ensemble strategy could be efficiently applied for this task with a considerable potential benefit for patient management.
We strongly believe that integrating the proposed deep-ensemble approach will result in robust and reliable CAD systems, considering the numerous cross-dataset experiments performed. Being tested on MRIs and fMRIs, our strategy can be easily extended to other imaging techniques. In conclusion, we found that our deep-ensemble strategy could be efficiently applied for this task with a considerable potential benefit for patient management.Domain adaptation (DA) tackles the problem where data from the source domain and target domain have different underlying distributions. In cross-domain (cross-subject or cross-dataset) emotion recognition based on EEG signals, traditional classification methods lack domain adaptation capabilities and have low performance. To address this problem, we proposed a novel domain adaptation strategy called adversarial discriminative-temporal convolutional networks (AD-TCNs) in this study, which can ensure the invariance of the representation of feature graphs in different domains and fill in the differences between different domains. For EEG data with specific temporal attributes, the temporal model TCN is used as the feature encoder. In the cross-subject experiment, our AD-TCN method achieved the highest accuracies of the valence and arousal dimensions in both the DREAMER and DEAP datasets. In the cross-dataset experiment, two of the eight task groups showed accuracies of 62.65% and 62.36%. Compared with the state-of-the-art performance in the same protocol, experimental results demonstrated that our method is an effective extension to realize EEG-based cross-domain emotion recognition.
The fifth metatarsal base avulsion fracture (i.e., Pseudo-Jones fracture) is one of the most common foot fractures. The management of pseudo-Jones fractures could be carried out surgically or conservatively. This systematic review and meta-analysis aimed to provide an update about the efficacy of orthotic removable support compared to short-leg casting for individuals with pseudo-Jones fracture.
We searched Embase, Medline, and Cochrane Central register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) that compared the clinical outcomes of orthotic removable support and short-leg cast for adult individuals with a fifth metatarsal base avulsion fracture. We used 95% as a confidence level and P <0.05 as a threshold. The standardized mean difference (SMD) was used for the continuous outcomes, and the risk ratio (RR) was used for the dichotomous outcomes.
A total of 6 RCTs incorporating 403 individuals out were deemed eligible. There was no significant difference between orthotic removable support and short-leg casting regarding AOFAS score (standardized mean difference (SMD)= 0.31, 95% CI -0.17 to 0.8), pain on VAS score (SMD= -0.08, 95% CI -0.39 to 0.22), VAS-FA score (SMD= 0.22, 95% CI -0.19 to 0.62) EQ-5D VAS score, and non-union rate (RR=0.37, 95% CI 0.05 to 2.74).
The current meta-analysis reveals that there is no difference between orthotic removable support and short-leg casting for the conservative management of individuals sustaining pseudo-Jones fracture.
The current meta-analysis reveals that there is no difference between orthotic removable support and short-leg casting for the conservative management of individuals sustaining pseudo-Jones fracture.Bites from animal and humans represent a very small proportion of all the patients presenting to emergency departments, However, they require prompt medical and surgical intervention in order to minimise the risk of infection, that may lead to limb and life-threatening complications. In this review article we synthesise the existing literature for treatment of human and animal bites and offer practical considerations when managing bite injuries.As the emerging technology of three-dimensional (3D) printing impacts several facets of medicine, innovative techniques and applications are increasingly being incorporated into clinical workflows. Specifically, 3D printing technology has allowed for the individualization of patient care through the creation of printed surgical guides, patient-specific anatomical models, and simulation practice models. In this paper, we review the broad applications of 3D printing in orthopaedic surgery. The purpose of this paper is to help orthopaedic trauma surgeons understand 3D printing's emerging influence on the delivery of care as well as how to directly apply this technology to their practice. We aim to illustrate these principles through a specific example of a patient who presented for malunion surgery. A 3D printed model of a very complex traumatic scapula malunion was used to not only pre-surgically plan the reconstruction, but to also facilitate provider and patient education. This paper highlights the benefits of 3D printing and how trauma surgeons are uniquely positioned to apply this technology to improve patient care.Itch is a universally experienced sensation, and chronic itch can be as diabolically debilitating as pain. Recent advances have not only identified the neuronal itch sensing circuitry, but also have uncovered the intricate interactions between skin and immune cells that work together with neurons to identify itch-inducing irritants. In this review, we will summarize the fundamental mechanisms of acute itch detection in the skin, as well as highlight the recent discoveries relating to this topic.This article describes the technical principles and indications for the most often encountered diagnostic imaging modalities in veterinary dentistry and oral surgery; with extensive coverage of intraoral (and extraoral) dental radiographic imaging and interpretation through detailed example figures of common dental and maxillofacial diseases in the dog and cat. Multidetector/multislice computed tomography (MDCT/MSCT) and emergent technologies such as cone-beam computed tomography (CBCT) are presented here in detail. Magnetic resonance imaging (MRI) and diagnostic ultrasound, which are used less frequently, are briefly discussed.
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