Risk factors for suicide in bipolar disorder: a systematic review

BACKGROUND

Bipolar disorder confers the highest risk of suicide among major psychological disorders. The risk factors associated with bipolar disorder and suicide exist and are relevant to clinicians and researchers.

OBJECTIVE

The aim of the present study was to conduct a systematic review of articles regarding the suicide risk factors in bipolar disorder.

METHODS

A systematic review of articles on suicide risk factors in bipolar disorder, published from January 1, 2010 to April 05, 2014, on SCOPUS and PUBMED databases was carried out. Search terms were "Suicide" (medical subject headings [MeSH]), "Risk factors" (MeSH), and "Bipolar" (keyword). Of the 220 retrieved studies, 42 met the eligibility criteria.

RESULTS

Bipolar disorder is associated with an increased rate death by suicide which contributes to overall mortality rates. Studies covered a wide range of aspects regarding suicide risk factors in bipolar disorder, such as risk factors associated to Sociodemographic conditions, Biological characteristics, Drugs Relationships, Psychological Factors, Genetic Compound, Religious and Spirituals conditions. Recent scientific literature regarding the suicide risk factors in bipolar disorder converge to, directly or indirectly, highlight the negative impacts of risk factors to the affected population quality of life.

CONCLUSION

This review demonstrated that Bipolar disorders commonly leads to other psychiatric disorders and co-morbidities involving risk of suicide. Thus the risk factors are relevant to have a better diagnosis and prognosis of BD cases involving risk of suicide.

Early-onset dementias: diagnostic and etiological considerations

This paper summarizes the body of literature about early-onset dementia (EOD) that led to recommendations from the Fourth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia. A broader differential diagnosis is required for EOD compared with late-onset dementia. Delays in diagnosis are common, and the social impact of EOD requires special care teams. The etiologies underlying EOD syndromes should take into account family history and comorbid diseases, such as cerebrovascular risk factors, that may influence the clinical presentation and age at onset. For example, although many EODs are more likely to have Mendelian genetic and/or metabolic causes, the presence of comorbidities may drive the individual at risk for late-onset dementia to manifest the symptoms at an earlier age, which contributes further to the observed heterogeneity and may confound diagnostic investigation. A personalized medicine approach to diagnosis should therefore be considered depending on the age at onset, clinical presentation, and comorbidities. Genetic counseling and testing as well as specialized biochemical screening are often required, especially in those under the age of 40 and in those with a family history of autosomal dominant or recessive disease. Novel treatments in the drug development pipeline for EOD, such as genetic forms of Alzheimer's disease, should target the specific pathogenic cascade implicated by the mutation or biochemical defect.

Integrated Design Fabrication and Control of a Bioinspired Multimaterial Soft Robotic Hand

Machines that mimic humans have inspired scientists for centuries. Bioinspired soft robotic hands are a good example of such an endeavor, featuring intrinsic material compliance and continuous motion to deal with uncertainty and adapt to unstructured environments. Recent research led to impactful achievements in functional designs, modeling, fabrication, and control of soft robots. Nevertheless, the full realization of life-like movements is still challenging to achieve, often based on trial-and-error considerations from design to fabrication, consuming time and resources. In this study, a soft robotic hand is proposed, composed of soft actuator cores and an exoskeleton, featuring a multimaterial design aided by finite element analysis (FEA) to define the hand geometry and promote finger's bendability. The actuators are fabricated using molding, and the exoskeleton is 3D-printed in a single step. An ON-OFF controller keeps the set fingers' inner pressures related to specific bending angles, even in the presence of leaks. The FEA numerical results were validated by experimental tests, as well as the ability of the hand to grasp objects with different shapes, weights, and sizes. This integrated solution will make soft robotic hands more available to people, at a reduced cost, avoiding the time-consuming design-fabrication trial-and-error processes.

Mycoplasma pneumoniae-associated Mucositis: A Recently Described Entity

Mycoplasma pneumoniae (MP) is a common cause of respiratory infections and can be associated with extrapulmonary complications. MP mucositis has recently been described as a distinct endemic clinical entity called Mycoplasma pneumoniae-induced rash and mucositis (MIRM). The authors present the case of a 46-year-old man with atypical pneumonia associated with exuberant mucositis, conjunctival hyperaemia and positive serological assays for MP IgM. The patient was treated with azithromycin and systemic corticosteroid therapy. Supportive care including pain management, intravenous hydration and mucosal care was also given. There was complete resolution of the pneumonia and mucositis. The presence of atypical pneumonia with mucosal involvement without cutaneous lesions and a favourable clinical evolution led to the diagnosis of MIRM.

A Methodology to Compare Insulin Dosing Recommendations in Real-Life Settings

BACKGROUND

We propose a methodology to analyze complex real-life glucose data in insulin pump users.

METHODS

Patients with type 1 diabetes (T1D) on insulin pumps were recruited from an academic endocrinology practice. Glucose data, insulin bolus (IB) amounts, and self-reported alcohol consumption and exercise events were collected for 30 days. Rules were developed to retrospectively compare IB recommendations from the insulin pump bolus calculator (IPBC) against recommendations from a proposed decision aid (PDA) and for assessing the PDA's recommendation for exercise and alcohol.

RESULTS

Data from 15 participants were analyzed. When considering instances where glucose was below target, the PDA recommended a smaller dose in 14%, but a larger dose in 13% and an equivalent IB in 73%. For glucose levels at target, the PDA suggested an equivalent IB in 58% compared to the subject's IPBC, but higher doses in 20% and lower in 22%. In events where postprandial glucose was higher than target, the PDA suggested higher doses in 25%, lower doses in 13%, and equivalent doses in 62%. In 64% of all alcohol events the PDA would have provided appropriate advice. In 75% of exercise events, the PDA appropriately advised an IB, a carbohydrate snack, or neither.

CONCLUSIONS

This study provides a methodology to systematically analyze real-life data generated by insulin pumps and allowed a preliminary analysis of the performance of the PDA for insulin dosing. Further testing of the methodological approach in a broader diabetes population and prospective testing of the PDA are needed.

Bipolar disorder incidence between children and adolescents: A brief communication

BACKGROUND

Bipolar affective disorder is one of most injurious psychiatric diseases, not, rarely leading patient for suicide, and its prevalence keeps increasing worldwide, notably on low and, middle-income countries. For children living in northeast Brazil, extreme social conditions constitute, an environment of special vulnerability.

OBJECTIVE

Here we show that bipolar disorder incidence, between children and adolescents in this Brazilian region increased 34.2% from 2005 to 2014 and, in, the same area and age group, deaths provoked by self-caused injuries also became progressively, greater.

RESULTS

According to DATASUS, the Brazilian national databank for public health, information, in the last five years, we observed an increase of Bipolar Disorder incidence rates under, 19 year-old of about 34.2% in the northeast region of Brazil, while the increase for Brazilian general, population was 12.4%. If considered only patients under 10, this number is even greater, of 47.2%. Content of Table 2 shows this disproportion, while comparing the advance of bipolar disorder, morbidity indices nationwide and worldwide.

CONCLUSION

Children living in Brazil's northeast, region are in a condition of extreme social disadvantage, what can be determinant for the recent and, sequential increase of bipolar disorder prevalence and the mortality in this age-group due to suicide, one of possible reflections of untreated mood disorders. For protecting these children is important to, identify the factors which prevent these illnesses and promote resilience for these young people.

Localization and Registration of 2D Histological Mouse Brain Images in 3D Atlas Space

To accurately explore the anatomical organization of neural circuits in the brain, it is crucial to map the experimental brain data onto a standardized system of coordinates. Studying 2D histological mouse brain slices remains the standard procedure in many laboratories. Mapping these 2D brain slices is challenging; due to deformations, artifacts, and tilted angles introduced during the standard preparation and slicing process. In addition, analysis of experimental mouse brain slices can be highly dependent on the level of expertise of the human operator. Here we propose a computational tool for Accurate Mouse Brain Image Analysis (AMBIA), to map 2D mouse brain slices on the 3D brain model with minimal human intervention. AMBIA has a modular design that comprises a localization module and a registration module. The localization module is a deep learning-based pipeline that localizes a single 2D slice in the 3D Allen Brain Atlas and generates a corresponding atlas plane. The registration module is built upon the Ardent python package that performs deformable 2D registration between the brain slice to its corresponding atlas. By comparing AMBIA's performance in localization and registration to human ratings, we demonstrate that it performs at a human expert level. AMBIA provides an intuitive and highly efficient way for accurate registration of experimental 2D mouse brain images to 3D digital mouse brain atlas. Our tool provides a graphical user interface and it is designed to be used by researchers with minimal programming knowledge.

Music we move to: Spotify audio features and reasons for listening

Previous literature has shown that music preferences (and thus preferred musical features) differ depending on the listening context and reasons for listening (RL). Yet, to our knowledge no research has investigated how features of music that people dance or move to relate to particular RL. Consequently, in two online surveys, participants (N = 173) were asked to name songs they move to (“dance music”). Additionally, participants (N = 105) from Survey 1 provided RL for their selected songs. To investigate relationships between the two, we first extracted audio features from dance music using the Spotify API and compared those features with a baseline dataset that is considered to represent music in general. Analyses revealed that, compared to the baseline, the dance music dataset had significantly higher levels of energy, danceability, valence, and loudness, and lower speechiness, instrumentalness and acousticness. Second, to identify potential subgroups of dance music, a cluster analysis was performed on its Spotify audio features. Results of this cluster analysis suggested five subgroups of dance music with varying combinations of Spotify audio features: “fast-lyrical”, “sad-instrumental”, “soft-acoustic”, “sad-energy”, and “happy-energy”. Third, a factor analysis revealed three main RL categories: “achieving self-awareness”, “regulation of arousal and mood”, and “expression of social relatedness”. Finally, we identified variations in people’s RL ratings for each subgroup of dance music. This suggests that certain characteristics of dance music are more suitable for listeners’ particular RL, which shape their music preferences. Importantly, the highest-rated RL items for dance music belonged to the “regulation of mood and arousal” category. This might be interpreted as the main function of dance music. We hope that future research will elaborate on connections between musical qualities of dance music and particular music listening functions.

Integrated Design and Fabrication of Pneumatic Soft Robot Actuators in a Single Casting Step

Bio-inspired soft robots have already shown the ability to handle uncertainty and adapt to unstructured environments. However, their availability is partially restricted by time-consuming, costly, and highly supervised design-fabrication processes, often based on resource-intensive iterative workflows. Here, we propose an integrated approach targeting the design and fabrication of pneumatic soft actuators in a single casting step. Molds and sacrificial water-soluble hollow cores are printed using fused filament fabrication. A heated water circuit accelerates the dissolution of the core's material and guarantees its complete removal from the actuator walls, while the actuator's mechanical operability is defined through finite element analysis. This enables the fabrication of actuators with non-uniform cross-sections under minimal supervision, thereby reducing the number of iterations necessary during the design and fabrication processes. Three actuators capable of bending and linear motion were designed, fabricated, integrated, and demonstrated as 3 different bio-inspired soft robots, an earthworm-inspired robot, a 4-legged robot, and a robotic gripper. We demonstrate the availability, versatility, and effectiveness of the proposed methods, contributing to accelerating the design and fabrication of soft robots. This study represents a step toward increasing the accessibility of soft robots to people at a lower cost.

Protective fibrous structures based on cellulose fibers functionalized with metal oxide nanoparticles by electrospinning and electrospray deposition

This work aims to develop a bio-based fibrous material that is able to adsorb and degrade chemical and biological hazardous agents. Thus, cellulosic fabrics (flax) were functionalized with chitosan (CS) and poly(ethylene oxide) (PEO) electrospun nanofibers doped with titanium dioxide (TiO2) and cerium dioxide (CeO2) nanoparticles (NPs). The electrospray deposition of these NPs was also tested. The TiO2 NPs were synthesized using a very straightforward precipitation method. The successful synthesis was confirmed by Scanning Transmission Electron Microscopy (STEM) and Attenuated Total Reflectance-Fourier-Transform Infrared Spectroscopy (ATR-FTIR). The functionalization of the fabrics with the NPs and the nanofibers doped with NPs was proved by Field Emission Scanning Electron Microscopy (FESEM), ATR-FTIR, and Ground-State Diffuse Reflectance (GSDR). The developed samples presented antibacterial activity against Staphylococcus aureus (ATCC 6538) and Escherichia coli (ATCC 434), reaching values of 99.97 and 100.0 %, respectively. The degradation of methylene blue (MB) and dimethyl methylphosphonate (DMMP) was evaluated. The best samples were able to decompose 97.82 % of DMMP. The wash durability of the nanocoating was also tested. The developed fibrous structures show great potential for personal protection applications.

Electrically-driven phase transition actuators to power soft robot designs

In the quest for electrically-driven soft actuators, the focus has shifted away from liquid-gas phase transition, commonly associated with reduced strain rates and actuation delays, in favour of electrostatic and other electrothermal actuation methods. This prevented the technology from capitalizing on its unique characteristics, particularly: low voltage operation, controllability, scalability, and ease of integration into robots. Here, we introduce a liquid-gas phase transition electric soft actuator that uses water as the working fluid and is powered by a coil-type flexible heating element. It achieves strain rates of over 16%/s and pressurization rates of 100 kPa/s. Blocked forces exceeding 50 N were achieved while operating at voltages up to 24 V. We propose a method for selecting working fluids which allows for application-specific optimization, together with a nonlinear control approach that reduces both parasitic vibrations and control lag. We demonstrate the integration of this technology in soft robotic systems, including a cable-driven biomimetic hand and a quadruped robot powered by liquid-gas phase transition.

Subserous Type of Eosinophilic Colitis: A Rare Disease

Eosinophilic colitis is a rare heterogeneous inflammatory disorder. The pathogenesis is not well understood even though it seems to be multifactorial, with hypersensitivity as a major contributor. The clinical presentation depends on the eosinophilic infiltration of different sections within the gastrointestinal tract. Diagnosis is based on the presence of peripheral eosinophilia and histopathological evidence of colon wall eosinophilic infiltration. The authors present the case of a woman with a predominantly subserous pattern of eosinophilic colitis potentially triggered by intake of an Ulmus rubra-rich product.

LEARNING POINTS

Subserous eosinophilic colitis (EC) is a rare inflammatory gastrointestinal disease that should be suspected when peripheral eosinophilia is accompanied by eosinophil-rich ascites and confirmed by the presence of eosinophilic infiltration of the colon wall.Although the aetiology of EC is not fully understood, a combination of genetic predisposition, dysbiosis and environmental factors (e.g., ingested allergens) likely contribute to it.The subserous type has the best prognosis and responds well to corticosteroids, with fewer relapses than other types.

[Tarlov's cyst: definition, etiopathogenesis, propaedeutic and treatment]

Tarlov's cyst or perineurial cyst is disease on portion of the posterior nerve root in lumbo-sacral region. The lack of knowledge of physicians around the world about Tarlov's cyst as to their nature, significance and treatment also with differential diagnostics to radiculopathy in legs. With review of literature discuss about definition, etiopathogenesis, diagnostic investigation and treatment clinic and/or surgery. The pathogenesis Tarlov's cyst remains unclear; several cases have history of the trauma, old hemorrhage, congenital and iatrogenic. Cysts provoke low back pain, sacral radiculopathy, dyspareunia, urinary incontence. The magnetic resonance imaging is now the gold standard to diagnose cysts. The treatment is clinic or surgery depending neurologics finding and neuroimage.