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Investigating shared cognitive traits of autism spectrum disorder and picky eating
No full textObjective: Picky eating is common among children with autism spectrum disorder (ASD) and can lead to nutritional deficiencies with negative health consequences. Because ASD traits and picky eating often co-occur, it remains unclear whether similar cognitive mechanisms underlie picky eating in typically developing children. This study examined whether cognitive traits associated with ASD are also linked to picky eating in typically developing children. It was hypothesized that higher levels of picky eating would be associated with lower cognitive flexibility, less developed theory of mind (ToM), a local processing bias, and higher parent-reported ASD traits. Methods: A cross-sectional study was conducted with 198 children aged 4-6. The children completed three tasks to measure cognitive flexibility (Dimensional Change Card Sort), ToM, and global-local processing preferences. Receptive vocabulary was measured to control for general cognitive ability. Parents completed the Autism Spectrum Quotient (AQ-10) and Child Food Rejection Scale (CFRS) to assess ASD traits and picky eating, respectively. Results: Contrary to expectations, no significant relationship was found between picky eating and the cognitive traits studied. However, a small negative correlation was found between ToM and the picky eating subscale, suggesting that higher picky eating levels may be related to lower ToM abilities. Conclusion: These findings suggest that in typically developing children, ASD-related traits are probably not strongly associated with picky eating, with the exception of ToM. Future research is needed to examine if social factors appear to play a more crucial role in picky eating
Symptom over- and underreporting are relatively stable behavioral opposites in forensic patients and undergraduates
No full textThe phenomena of symptom overreporting, underreporting, and inattentive responding have often been linked to traits using cross-sectional designs. The preliminary question - the temporal stability of these phenomena - has remained largely unexamined. We conducted a test-retest study in forensic inpatients and students (all ns >= 64), who twice - across a six- to ten-week interval - completed stand-alone measures of symptom overreporting, symptom underreporting, inattentive responding, and Big Five personality domains. Symptom overreporting rates were similar in patients and students (+5 %). The same was true for symptom underreporting in patients (+15-20 %) and students (+5-10 %), whereas inattentive responding was non-trivial in patients (+15 %), but low in students (+0-5 %). In both groups, symptom overreporting and underreporting were relatively stable behavioral opposites. Trait scores of those who engaged in symptom overreporting and underreporting deviated +0.75 SD from those who passed all validity indices, and in a patterned rather than arbitrary way. The shared variance may reflect a common underlying mechanism. In patients, borderline personality disorder was linked to symptom overreporting, whereas narcissistic personality disorder was associated with symptom underreporting. Overall, our findings suggest that both traits and contextual factors shape how accurately people report their symptoms
Brain development and musical skills:A longitudinal twin study on brain developmental trajectories and sensorimotor synchronization
No full textThere are individual differences in brain developmental patterns, yet it is unknown to what extent these may be driven by enriched experiences. Moreover, it is not well known whether enriched experiences may result in attenuated or accelerated brain development. Studying the relation between music performance and the brain using a large longitudinal twin study provides a framework for better understanding the genetic and environmental effects on brain development in childhood. The present region-of-interest study tested whether individual differences in sensorimotor synchronization with an auditorily cued finger tapping task are related to individual differences in developmental brain trajectories and if this relation was genetically or environmentally driven. The present study included a longitudinal twin design with up to 3 MRI waves of data (7–14 years old; N<inf>t1</inf> = 418, N<inf>T2</inf> = 367, N<inf>T3</inf> = 228). In line with our preregistered hypotheses, results showed that attenuated patterns of brain development in 27 % of motor and affective ROIs were associated with SMS performance independent of socio-economic status effects. Furthermore, brain-behavior associations were at least partly driven by shared and unique environmental/measurement error effects, in addition to genetic influences. Possibly, attenuated brain development may be indicative of prolonged brain plasticity related to enriched environmental experiences, such as musical training, in addition to predisposing genetic factors
Housing in progress:Caring for and living in unfinished remittance houses
No full textEmpty, unfinished, or ‘ghost’ houses are common sights around the world, where aspirational investment in housing outpaces the potential to physically occupy it. While these structures may be only partially completed, this does not mean they are unoccupied. In fact, their state of incompleteness can prompt owners to find an occupant, in order to prevent incursion, protect the existing investment in construction, and enable incremental progress towards completion. This paper explores one configuration of housing investment – ‘remittance houses’, constructed by migrants – and the dynamics of caretaking and guardianship that arise to protect these housing structures while they are in-process over an unpredictable, multiple-year timeline. Building on two case studies, in Morocco and Ghana, we investigate both the lives of the houses in-progress and the accommodations and adaptations made by live-in caretakers to make them into dwell-able homes. These simultaneous and interwoven timelines involve uncertain futures for both the house and its occupants, as the more ‘complete’ the house becomes, the more uncertain the caretaker's tenure. We bring into question how the framework of ‘care’ as mutually transformative development can help to understand the affective and embodied investments made by the migrant who is building the home and the caretaker occupying and adapting it, in relation to the material responsiveness of the house itself. We take these mutual transformations as resonant not just for these houses which are markedly ‘unfinished’, but as a way to consider how much housing is somehow ‘in progress’ and complexly constituted through care
Automatic localization of myocardial infarction using vectorcardiography
No full textFor patients experiencing myocardial infarction (MI), localizing the affected cardiac region using electrocardiography (ECG) can reduce the time to reperfusion therapy, reducing morbidity and mortality. Extracting relevant information from ECG signals is not trivial, and computational methods have been developed aiming to assist physicians in making faster and better decisions in emergency situations. However, their clinical adoption remains limited due to the high false alarm rates consequence of the low generalizability of these methods. This research compares the performance of three machine learning techniques - Lasso, Support Vector Machine, and Gradient Boosting Machine - with varying degrees of complexity in localizing MI. Vectorcardiography-derived features were used as input to the models due to their ability to capture spatial and temporal information regarding the heart's electrical activity. An autoencoder was employed to smooth the feature space, facilitating more efficient model training and improving generalization. To further address generalizability challenges, an inter-patient validation approach was employed. Models were trained on the PTB-XL dataset and externally validated on the PTB Diagnostic dataset. Results demonstrate that Lasso, a simpler model, achieved the highest AUC of 0.74 on the external dataset, outperforming more complex models such as SVM (0.72) and GBM (0.68). Also, the combination of Lasso with the autoencoder provided superior generalization compared to other state-of-the-art methods reported in the MI localization literature. This highlights the proposed method's suitability for clinical settings, where model generalizability and reliability are critical. Furthermore, our method offers the advantage of explainability, allowing the extraction of clinical and physiological insights from the data and bridging the gap between computational methods and clinicians
Community Perspectives on Inequalities in the Provision of Basic Healthcare Services for the Most Vulnerable Populations in the Eastern Congo:A Qualitative Study
No full textBackground There is a notable lack of evidence regarding the factors that shape the provision of essential healthcare services in post-conflict settings.Purpose This study aimed to explore and describe the factors influencing the provision of basic health care services for the most vulnerable populations in the Eastern Congo.Method Employing a qualitative research approach, twenty individual interviews with community members and thirteen focus group discussions were conducted. Participants were drawn from three geographically and demographically diverse locations with a history of decades-long armed conflicts in the Congo. Inductive thematic coding used the Health System Dynamics Framework categories (i.e. goals and outcomes, values and principles; service delivery; the population; the context; leadership & governance; and the organization of resources (finances; human resources; infrastructure and supplies; knowledge and information), while allowing for additional themes.Results Our findings are presented thematically according to these ten categories. The following factors were perceived as key areas enabling or hindering healthcare provision to the community: (1) the context for organizing basic healthcare service delivery is complex and challenging; (2) the population plays a crucial role as an active producer of health and potential change agents; (3) there is a poor strategic policy framework to guide local-level communities in the provision of basic healthcare services; (4) several critical barriers and facilitators related to effective healthcare service delivery were identified; (5) the classification of basic health service delivery methods to meet the healthcare needs of the vulnerable population; (6) the healthcare system is pluralistic and consists of multiple overlapping systems and providers; and (7) service providers and potential service users still consider access to basic healthcare services challenging, potentially resulting in reduced coverage.Conclusion These findings suggest that substantial changes in the factors contributing to the provision of basic healthcare services are necessary to ensure the delivery of basic healthcare services to the most vulnerable populations in the Eastern Congo. Consequently, there is a critical need to reconsider the healthcare delivery system, specifically addressing these contributing factors in the context of the Eastern Congo
Hedonic seat arrangement problems
No full textIn this paper, we study a variant of hedonic games, called Seat Arrangement. The model is defined by a bijection from agents with preferences for each other to vertices in a graph G. The utility of an agent depends on the neighbors assigned in the graph. More precisely, it is the sum over all neighbors of the preferences that the agent has towards the agent assigned to the neighbor. We first consider the price of stability and fairness for different classes of preferences. In particular, we show that there is an instance such that the price of fairness (PoF) is unbounded in general. Moreover, we show an upper bound \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}\end{document} and an almost tight lower bound \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}\end{document} of PoF, where \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}\end{document} is the average degree of an input graph. Then we investigate the computational complexity of problems to find certain "good" seat arrangements, say Utilitarian Arrangement, Egalitarian Arrangement, Stable Arrangement, and Envy-free Arrangement. We give dichotomies of computational complexity of four Seat Arrangement problems from the perspective of the maximum order of connected components in an input graph. For the parameterized complexity, Utilitarian Arrangement can be solved in time \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}n<^>{O(\gamma )}\end{document}, while it cannot be solved in time \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}f(\gamma )n<^>{o(\gamma )}\end{document} under ETH, where n is the number of agents and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}\end{document} is the vertex cover number of an input graph. Moreover, we show that Egalitarian Arrangement and Envy-free Arrangement are weakly NP-hard even on graphs of bounded vertex cover number.Finally, we prove that determining whether a stable arrangement can be obtained from a given arrangement by k swaps is W[1]-hard when parameterized by \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}\end{document}, whereas it can be solved in time \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}n<^>{O(k)}\end{document}
Proteomic Profiling of Urinary Large Extracellular Vesicles for the Diagnosis of Prostate Cancer
No full textDistinguishing between prostate cancer (PCa) and prostatitis poses a challenge in clinical settings, often resulting in overdiagnosis and treatment. Large extracellular vesicles (lEVs) extracted from urine samples of patients may contain information about prostate pathology and are, therefore, potential biopsies for early PCa detection. This research endeavors to create a urinary lEV-centric proteomic approach for early PCa identification. An integrated workflow utilizing functionalized magnetic beads, centrifugation, and filter membranes optimizes and expedites the analysis of urinary lEVs. To validate the stability and significance of lEV proteomic markers, the study employed multiple reaction monitoring (MRM) to assess the identified differentially expressed proteins in lEVs (lEV-DEPs) within a validation group for precise quantification. Furthermore, cell-line experiments were conducted to compare the proteomic profiles of lEVs, small EVs (sEVs), and cell membranes (CM). In total, 3549 urinary lEV proteins were captured, revealing 17 lEV-DEPs, with 12 confirmed through MRM. Notably, this isolation method reduced contaminants compared to centrifugation, facilitating the extraction of relatively large EVs. Pathway enrichment analysis of lEV-DEPs underscored their role in transitioning from inflammation to cancer, with specific post-translational modifications (PTMs) influencing PCa progression. A panel integrating four potential lEV-DEPs and prostate-specific antigen (PSA) exhibited a distinguished accuracy of 0.875, emphasizing the importance of lEV-DEPs over PSA in distinguishing PCa from prostatitis. Additionally, lEVs demonstrated significant protein content and pathway similarity with CM compared to sEVs. In conclusion, this investigation establishes a comprehensive protocol for isolating and characterizing urinary lEV proteomics, showcasing its efficacy in discriminating PCa from prostatitis. These results enhance diagnostic precision and offer fresh insights into the biological mechanisms underlying PCa, paving the way for improved diagnostic and therapeutic approaches
The effect of prophylactic clipping on delayed bleeding after proximal colonic endoscopic mucosal resection:a multicenter, randomized controlled trial (CLIPPER)
No full textBackground Delayed bleeding is the most common complication after endoscopic mucosal resection (EMR) of large colorectal polyps. Randomized controlled trials in high volume centers have suggested that prophylactic clipping of the resection defect reduces delayed bleeding in patients with a high risk for delayed bleeding. We aimed to evaluate the role of prophylactic clipping in reducing delayed bleeding in patients undergoing EMR for large, proximal, nonpedunculated polyps in daily clinical practice. Methods We performed a randomized controlled trial in 19 Dutch hospitals in patients referred for EMR of laterally spreading and sessile polyps >= 20mm in the proximal colon. Patients were randomly assigned (1:1) into groups receiving or not receiving prophylactic clipping. The primary end point was delayed bleeding, and analyses were performed according to intention-to-treat analysis. The trial was registered at ClinicalTrials.gov (NCT03309683). Results Between May 2018 and December 2021, 356 patients with a median polyp size of 30 mm (interquartile range 25-40) in the proximal colon were randomized (177 to the prophylactic clipping group and 179 to the control group). Delayed bleeding occurred in 16 patients (9.0 %) receiving prophylactic clipping and 11 control patients (6.1 %; P = 0.30). No deaths were reported. Conclusions Prophylactic clipping did not reduce delayed bleeding in patients undergoing EMR for large laterally spreading and sessile polyps in the proximal colon in daily clinical practice
De-escalation strategies with targeted therapies in non-small cell lung cancer
No full textTargeted therapies (TT) for non-small cell lung cancer (NSCLC) with actionable genomic alterations (AGA), particularly EGFR-mutant and ALK-rearranged tumors, have become the standard of care across nearly all stages of the disease. However, the arbitrarily defined dose and treatment duration of TT, as well as the financial cost of these drugs, reduce their availability worldwide. Pharmacokinetic and pharmacodynamic properties of TT suggest that doses of some TT are overestimated as there is limited evidence supporting a direct relationship between therapeutic intensity and outcomes. This can lead to overtreatment of patients, resulting in an increased risk of toxicity without enhanced efficacy. Some academic initiatives have been launched aiming to explore de-escalating strategies with TT, either reducing the dose or the duration of these drugs. These approaches can decrease the risk of adverse events positively impacting patients’ quality of life, without compromising efficacy, while reducing economic impact. In this review, we summarize current data regarding de-escalating strategies with TT, ongoing trials and challenges of this approach