730 research outputs found
UBC's Humanities 101 Program - Interview with Sandra Delorme
No full textChildhood educational shortcomings didn't stop Sandra Delorme from becoming a published author later in life. She credits UBC's Humanities 101 program (but deserves most of the credit herself)
Metformin for weight gain associated with second generation antipsychotics in children and adolescents: a systematic review and meta-analysis
No full textBackground:
Weight gain is a potentially concerning side effect of second-generation antipsychotics (SGAs). Metformin, a biguanide with antihyperglycemic effects, is used to manage weight gain in adults treated with SGAs.
Objective:
The objective of this study was to perform the first systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effects of metformin on weight gain in children and adolescents treated with SGAs.
Methods:
Based on a pre-registered protocol (PROSPERO–CRD42017074839), we searched the PubMed, EMBASE, PsychoINFO, BIOSIS, Science Direct, Cochrane Central, and ClinicalTrials.gov electronic databases through March 2018 (with no restrictions on language, date, or type of publication) for RCTs that assessed the effect of metformin or placebo on body weight in children or adolescents (< 18 years of age) treated with selected SGAs (risperidone, aripiprazole, olanzapine, and clozapine) for any psychiatric disorder. We also contacted relevant drug manufacturers for possible additional pertinent studies/data. A random effects model was used and the quality of the included RCTs was assessed using the Cochrane Risk of Bias tool.
Results:
Five RCTs (205 participants in total) were included in the meta-analysis. We found a significant weight decrease in the metformin group compared with placebo after 4, 12, and 16 weeks of treatment {mean difference − 0.98 kg (95% confidence interval [CI] − 1.26, − 0.69); − 1.83 kg (95% CI − 2.47, − 1.18); and − 3.23 kg (95% CI − 5.59, − 0.86), respectively}. A weight decrease at weeks 2 and 8 did not reach statistical significance. The decrease in body mass index (BMI) paralleled that of weight, with a significant effect at weeks 4, 12, and 16. Overall, four studies were rated as unclear, and one study was rated as high, risk of bias.
Conclusion:
Meta-analytical evidence shows that metformin might decrease weight in children/adolescents treated with SGAs but additional high-quality evidence is needed. Clinicians need to be aware that this use of metformin is currently off-label
Influence of the Month of Birth and Persistence of ADHD in Prospective Studies: Protocol for an Individual Patient Data Meta-Analysis
No full textIntroduction: attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with symptoms, especially the hyperactive ones, that tend to decrease in severity with age. Interestingly, children born just before the school-entry cut-off date (i.e., the youngest pupils of a classroom) are at higher risk of being diagnosed with ADHD compared to children born just after the cut-off date. Noteworthy, this month-of-birth effect tends to disappear with increasing absolute age. Therefore, it is possible that young children erroneously diagnosed with ADHD due to their month of birth present a lower chance to have their diagnosis confirmed at later age, artificially reinforcing the low persistence of ADHD across the lifespan. This protocol outlines an individual patient data (IPD) meta-analysis of prospective observational studies to explore the role of month of birth in the low persistence of ADHD across the lifespan. Methods and analysis: five databases will be systematically searched in order to find prospective observational studies where the presence of ADHD is assessed both at baseline and at a follow-up of at least four years. We will use a two-stage IPD meta-analytic approach to estimate the role of month of birth in the persistence of ADHD. Various sensitivity analyses will be performed to assess the robustness of the results. Ethics and dissemination: no additional data will be collected and no deidentified raw data will be used. Ethics approval is thus not required for the present study. Results of this IPD meta-analysis will be submitted for publication in a peer-reviewed journal
Association between suicidal spectrum behaviors and Attention-Deficit/Hyperactivity Disorder: a systematic review and meta-analysis
No full textThe relationship between ADHD and suicidal spectrum behaviors (SSBs) remains uncertain. We conducted the first meta-analysis on the association between ADHD and SSBs taking possible confounders into account. Based on a pre-registered protocol (PROSPERO-CRD42018093003), we searched Pubmed, Ovid and Web of Knowledge databases through April 6th, 2018, with no language/publication type restrictions, and contacted study authors for unpublished data/information. From a pool of 2798 references, we retained 57 studies. Random-effects models were performed. Study quality was rated using the Newcastle-Ottawa Scale. After pooling crude ORs, we found a significant association between ADHD and suicidal attempts (2.37, 95% CI = 1.64–3.43; I2 = 98.21), suicidal ideations (3.53, 2.94–4.25; I2 = 73.73), suicidal plans (4.54, 2.46–8.37; I2 = 0), and completed suicide (6.69, 3.24–17.39; I2 = 87.53). Results did not substantially change when pooling adjusted ORs. Findings were also in general robust to sensitivity analyses to assess possible moderators. Awareness of the association between ADHD and SSBs should contribute to more effectively prevent SSBs
Banquet with DeLorme, circa 1940
No full textWomen and a girl sit at a banquet table, on sign: 1926. Written on verso: Banquet incl. Class of 1926 table incl. unidentified women and Grace Holmes DeLorme (left) ca. 1940s.The Atlanta University Center Robert W. Woodruff Library acknowledges the generous support of the Council on Library and Information Resources (CLIR) in supporting the processing and digitization of a number of historic collections as part of the project: Our Story: Digitizing Publications and Photographs of the Historically Black Atlanta University Center Institutions.</em
Electroencéphalographie et interfaces cerveau-machine : nouvelles méthodes pour étudier les états mentaux
No full textAvec les avancées technologiques dans le domaine de l'imagerie cérébrale fonctionnelle et les progrès théoriques dans la connaissance des différents éléments neurophysiologiques liés à la cognition, les deux dernières décennies ont vu l'apparition d'interfaces cerveau-machine (ICM) permettant à une personne d'observer en temps réel, ou avec un décalage qui se limite à quelques secondes, sa propre activité cérébrale. Le domaine clinique en général, et plus particulièrement celui de la neuropsychologie et des pathologies conduisant à un handicap moteur lourd, pour lesquels les applications potentielles sont nombreuses qu'elles soient thérapeutiques ou en vue d'une réhabilitation fonctionnelle, a constitué un moteur important de la recherche sur ce nouveau domaine des neurosciences temps réel. Parmi ces applications, le neurofeedback, ou neurothérapie, qui vise l'acquisition par le sujet du contrôle volontaire de certains aspects de son activité cérébrale en vue de les amplifier ou au contraire les diminuer dans un but thérapeutique, voire d'optimisation cognitive, représente une technique prometteuse, alternative aux thérapies et traitements médicamenteux. Cependant, la validation de ce type d'intervention et la compréhension des mécanismes mis en jeux en sont encore à leurs balbutiements. L'entraînement par neurofeedback est souvent long, pouvant s'étaler sur plusieurs semaines. Il est donc très probable que ce type de rééducation cérébrale sollicite des phénomènes de plasticité qui s'inscrivent dans une dynamique lente, et de ce fait, requiert une durée relativement longue d'entraînement pour atteindre les effets à long terme recherchés. Cependant, à cela peuvent s'ajouter de nombreux éléments perturbateurs qui pourraient être à l'origine de la difficulté de l'apprentissage et des longs entraînements nécessaires pour obtenir les résultats attendus. Parmi eux, les perturbations qui viennent déformer le signal enregistré, ou les éléments artefactuels qui ne font pas partie du signal d'intérêt, sont une première cause potentielle. Le manque de spécificité fonctionnelle du signal retourné au sujet pourrait en constituer une deuxième. Nous avons d'une part développé des outils méthodologiques de traitement du signal en vue d'améliorer la robustesse des analyses des signaux EEG, principalement utilisés jusqu'à maintenant dans le domaine du neurofeedback et des ICM, face aux artefacts et au bruit électromagnétique. D'autre part, si l'on s'intéresse au problème de la spécificité fonctionnelle du signal présenté au sujet, des études utilisant l'IRM fonctionnelle ou des techniques de reconstruction de sources à partir du signal EEG, qui fournissent des signaux ayant une meilleure spécificité spatiale, laissent entrevoir de possibles améliorations de la vitesse d'apprentissage. Afin d'augmenter la spécificité spatiale et la contingence fonctionnelle du feedback présenté au sujet, nous avons étudié la stabilité de la décomposition de l'EEG en différentes sources d'activité électrique cérébrale par Analyse en Composantes Indépendantes à travers différentes séances d'enregistrement effectuées sur un même sujet. Nous montrons que ces décompositions sont stables et pourraient permettre d'augmenter la spécificité fonctionnelle de l'entraînement au contrôle de l'activité cérébrale pour l'utilisation d'une ICM. Nous avons également travaillé à l'implémentation d'un outil logiciel permettant l'optimisation des protocoles expérimentaux basés sur le neurofeedback afin d'utiliser ces composantes indépendantes pour rejeter les artefacts en temps réel ou extraire l'activité cérébrale à entraîner. Ces outils sont utiles dans le cadre de l'analyse et de la caractérisation des signaux EEG enregistrés, ainsi que dans l'exploitation de leurs résultats dans le cadre d'un entraînement de neurofeedback. La deuxième partie de ce travail s'intéresse à la mise en place de protocoles de neurofeedback et à l'impact de l'apprentissage. Nous décrivons tout d'abord des résultats obtenus sur une étude pilote qui cherche à évaluer chez des sujets sains l'impact d'un protocole de neurofeedback basé sur le contrôle du rythme Mu. Les changements comportementaux ont été étudiés à l'aide d'un paradigme de signal stop qui permet d'indexer les capacités attentionnelles et d'inhibition de réponse motrice sur lesquelles on s'attend à ce que l'entraînement ICM ait une influence. Pour clore cette partie, nous présentons un nouvel outil interactif immersif pour l'entraînement cérébral, l'enseignement, l'art et le divertissement pouvant servir à évaluer l'impact de l'immersion sur l'apprentissage au cours d'un protocole de neurofeedback. Enfin, les perspectives de l'apport des méthodes et résultats présentés sont discutées dans le contexte du développement des ICMs de nouvelle génération qui prennent en compte la complexité de l'activité cérébrale. Nous présentons les dernières avancées dans l'étude de certains aspects des corrélats neuronaux liés à deux états mentaux ou classes d'états mentaux que l'on pourrait qualifier d'antagonistes par rapport au contrôle de l'attention : la méditation et la dérive attentionnelle, en vue de leur intégration à plus long terme dans un entraînement ICM par neurofeedback.With new technological advances in functional brain imaging and theoretical progress in the knowledge of the different neurophysiologic processes linked to cognition, the last two decades have seen the emergence of Brain-Machine Interfaces (BCIs) allowing a person to observe in real-time, or with a few seconds delay, his own cerebral activity. Clinical domain in general, and more particularly neuropsychology and pathologies leading to heavy motor handicaps, for which potential applications are numerous, whether therapeutic or for functional rehabilitation, has been a major driver of research on this new field of real-time neurosciences. Among these applications, neurofeedback, or neurotherapy, which aims the subject to voluntary control some aspects of his own cerebral activity in order to amplify or reduce them in a therapeutic goal, or for cognitive optimization, represents a promising technique, and an alternative to drug treatments. However, validation of this type of intervention and understanding of involved mechanisms are still in their infancy. Neurofeedback training is often long, up to several weeks. It is therefore very likely that this type of rehabilitation is seeking brain plasticity phenomena that are part of slow dynamics, and thus require a relatively long drive to achieve the desired long-term effects. However, other disturbing elements that could add up to the cause of the difficulty of learning and long training sessions required to achieve the expected results. Among them, the disturbances that come from recorded signal distortions, or artifactual elements that are not part of the signal of interest, are a first potential cause. The lack of functional specificity of the signal returned to the subject could be a second one. We have developed signal processing methodological tools to improve the robustness to artifacts and electromagnetic noise of EEG signals analysis, the main brain imaging technique used so far in the field of neurofeedback and BCIs. On the other hand, if one looks at the issue of functional specificity of the signal presented to the subject, studies using functional MRI or source reconstruction methods from the EEG signal, which both provide signals having a better spatial specificity, suggest improvements to the speed of learning. Seeing Independent Component Analysis as a potential tool to increase the spatial specificity and functional contingency of the feedback signal presented to the subject, we studied the stability of Independent Component Analysis decomposition of the EEG across different recording sessions conducted on the same subjects. We show that these decompositions are stable and could help to increase the functional specificity of BCI training. We also worked on the implementation of a software tool that allows the optimization of experimental protocols based on neurofeedback to use these independent components to reject artifacts or to extract brain activity in real-time. These tools are useful in the analysis and characterization of EEG signals recorded, and in the exploitation of their results as part of a neurofeedback training. The second part focuses on the development of neurofeedback protocols and the impact of learning. We first describe the results of a pilot study which seeks to evaluate the impact of a neurofeedback protocol based on the Mu rhythm control on healthy subjects. The behavioral changes were studied using a stop signal paradigm that indexes the attentional abilities and inhibition of motor responses on which the BCI training can possibly have influence. To conclude this section, we present a new tool for immersive interactive brain training, education, art and entertainment that can be used to assess the impact of immersion on learning during a neurofeedback protocol. Finally, prospects for methods and results presented are discussed in the context of next-generation BCI development which could take brain activity complexity into account. We present the latest advances in the study of certain aspects of the neural correlates associated with two mental states or classes of mental states that could be described as antagonistic with respect to the control of attention: meditation and mind wandering, for their integration in the longer term in an BCI training using neurofeedback
Memory for past events: movement and action chains in high-functioning autism spectrum disorders.
No full textIn the present study, we assessed whether individuals with autism spectrum disorders (ASD) show memory impairments for previously performed actions, as previously suggested for people suffering from obsessive-compulsive disorder (OCD) (Ecker and Engelkamp in Behav Cogn Psychother 23:349-371, 1995; Merckelbach and Wessel in J Nerv Ment Dis 188(12):846-848, 2000). To test this possibility, we explored verbal memory for actions in individuals with a diagnosis of ASD, with and without co-morbidity for OCD, and in controls matched for age and gender. Participants observed or observed and enacted a number of actions while listening to the corresponding phrases being spoken. After a suitable delay, they were submitted to an old/new recognition task. Results showed that ASD individuals with OCD were less accurate and slower in responding compared to ASD individuals without OCD and controls, particularly when dealing with phrases describing simple movements. In contrast, ASD participants without OCD were more impaired when phrases described complex actions that involved pantomiming object use or coordinating movements of multiple body parts. These findings are discussed in terms of differential organization of the motor trace for simple versus complex actions in ASD individuals according to the concurrent presence of OCD. © 2013 Springer-Verlag Berlin Heidelberg
Sleep in youth with Autism Spectrum Disorders: systematic review and meta-analysis
No full textQuestions: sleep problems are common and impairing in individuals with autism spectrum disorders (ASD). Evidence synthesis including both subjective (i.e., measured with questionnaires) and objective (i.e., quantified with neurophysiologic tools) sleep alterations in youth with ASD is currently lacking. Therefore, we conducted a systematic review and meta-analysis of subjective and objective studies sleep studies in youth with ASD. Study selection and analysis: we searched the following electronic databases with no language, date, or type of document restriction, up to May 23rd, 2018: Pubmed, PsycInfo, Embase+Embase Classic, Ovid Medline, and Web of Knowledge. Random-effects models were used. Heterogeneity was assessed with Cochran's Q and I2 statistics. Publication (small studies) bias was assessed with final plots and the Egger’s test. Study quality was evaluated with the Newcastle Ottawa Scale. Analyses were conducted using Review Manager and Comprehensive meta-analysis. Findings: from a pool of 3,359 non-duplicate potentially relevant references, 47 datasets were included in the meta-analyses. Subjective and objective sleep outcome measures were extracted from 37 and 15 studies, respectively. Only five studies were based on comorbidity free, medication-naïve participants. Compared to typically developing controls, youth with ASD significantly differed in 10/14 subjective parameters and in 7/14 objective sleep parameters. The average quality score in the Newcastle-Ottawa scale was 5.9/9. CONCLUSIONS: A number of subjective and, to a less extent, objective sleep alterations might characterise youth with ASD, but future studies should assess the impact of pharmacological treatment and psychiatric comorbidities
Umbrella-Review, Evaluation, Analysis, and Communication Hub (U-REACH): a novel living umbrella review knowledge translation approach
No full textSystematic reviews and meta-analyses have become crucial for evidence-based decision-making in recent decades. However, it is common for the results of multiple reviews on the same topic to be inconsistent, and it is widely recognized that the results of the reviews are not always effectively communicated to health care professionals and the lay public. This manuscript proposes a strategy to summarize and communicate the findings of previous systematic reviews and meta-analyses to wider audiences. The proposed approach couples the findings of umbrella reviews with the creation of open-access online platforms that present the results of these umbrella reviews in an accessible way to various stakeholders. The key potential methodological avenues of this approach are presented, and specific examples from the author's own works and those from other teams are provided. An accompanying website (https://u-reach.org/) has been designed to present this U-REACH approach and to overcome the technical challenges associated with this type of project (by sharing the code used to build existing U-REACH projects). The present document is intended to serve as a methodological and technical guide for the creation of large-scale projects designed to synthesize and disseminate scientific information to a broad audience
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