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Self-injurious behaviors (SIB) are common in autistic people. SIB is mainly studied as a broad category, rather than by specific SIB types. We aimed to determine associations of distinct SIB types with common psychiatric, emotional, medical, and socio-demographic factors.
Methods
Participants included 323 autistic youth (~50% non−/minimally-speaking) with high-confidence autism diagnoses ages 4–21 years. Data were collected by the Autism Inpatient Collection during admission to a specialized psychiatric inpatient unit (www.sfari.org/resource/autism-inpatient-collection/). Caregivers completed questionnaires about their child, including SIB type and severity. The youth completed assessments with clinicians. Elastic net regressions identified associations between SIB types and factors.
Results
No single factor relates to all SIB types. SIB types have unique sets of associations. Consistent with previous work, more repetitive motor movements and lower adaptive skills are associated with most types of SIB; female sex is associated with hair/skin pulling and self-rubbing/scratching. More attention-deficit/hyperactivity disorder symptoms are associated with self-rubbing/scratching, skin picking, hair/skin pulling, and inserts finger/object. Inserts finger/object has the most medical condition associations. Self-hitting against surface/object has the most emotion dysregulation associations.
Conclusions
Specific SIB types have unique sets of associations. Future work can develop clinical likelihood scores for specific SIB types in inpatient settings, which can be tested with large community samples. Current approaches for SIB focus on the behavior functions, but there is an opportunity to further develop interventions by considering the specific SIB type in assessment and treatment. Identifying factors associated with specific SIB types may aid with screening, prevention, and treatment of these often-impairing behaviors.
Binge eating disorder (BED) is a pernicious psychiatric disorder which is linked with broad medical and psychiatric morbidity, and obesity. While BED may be characterized by altered cortical morphometry, no evidence to date examined possible sex-differences in regional gray matter characteristics among those with BED. This is especially important to consider in children, where BED symptoms often emerge coincident with rapid gray matter maturation.
Methods
Pre-adolescent, 9–10-year old boys (N = 38) and girls (N = 33) with BED were extracted from the 3.0 baseline (Year 0) release of the Adolescent Brain Cognitive Development Study. We investigated sex differences in gray matter density (GMD) via voxel-based morphometry. Control sex differences were also assessed in age and body mass index and developmentally matched control children (boys N = 36; girls N = 38). Among children with BED, we additionally assessed the association between dorsolateral prefrontal (dlPFC) GMD and parent-reported behavioral approach and inhibition tendencies.
Results
Girls with BED uniquely demonstrate diffuse clusters of greater GMD (p < 0.05, Threshold Free Cluster Enhancement corrected) in the (i) left dlPFC (p = 0.003), (ii) bilateral dmPFC (p = 0.004), (iii) bilateral primary motor and somatosensory cortex (p = 0.0003) and (iv) bilateral precuneus (p = 0.007). Brain-behavioral associations suggest a unique negative correlation between GMD in the left dlPFC and behavioral approach tendencies among girls with BED.
Conclusions
Early-onset BED may be characterized by regional sex differences in terms of its underlying gray matter morphometry.
This chapter examines to what extent and under what conditions the Sustainable Development Goals have fostered a better inclusion and support of poor and vulnerable communities within countries, and of the least developed countries internationally. We start with a conceptualization of inclusiveness as a matter of recognition, representation, and distribution. We then review the role of the Sustainable Development Goals in steering any normative, institutional or discursive changes in favour of inclusiveness within and between countries, drawing on both a Scopus search of all articles published between 2015 and 2020 in the social sciences subject area related to inclusiveness and grey literature. Although research evidence is strikingly limited, our review indicates that rhetoric and action do not match when it comes to the impacts of the Sustainable Development Goals on inclusiveness within and between countries. While vulnerable people and countries are often discursively prioritized in the implementation of the goals, such discursive prioritization has so far not resulted in creating or reshuffling norms and institutions towards inclusiveness.
There remains a persistent need for mental health services among youth, with the majority of youth untreated. Digital mental health interventions (DMHIs) have the potential to revolutionize mental health care for adolescents. DMHIs are digital tools aiding in detection, prevention, and treatment of mental health problems for adolescents. DMHIs provide interventions and services that are accessible, low-cost, and available to adolescents. This chapter discusses barriers to mental health care among adolescents, followed by a discussion of how DMHIs can address these barriers to improve access to and quality of adolescent mental health services. It reviews research on DMHIs and digital frameworks used to collect and deliver psychoeducation, assessment, and interventions across hardware (e.g., smartphones, computers) and modalities (e.g., online, text, apps). It concludes with a discussion of current limitations of DMHIs and directions for the field to improve the development, dissemination, and implementation of adolescent mental health care using DMHIs.
Behavioral features of binge eating disorder (BED) suggest abnormalities in reward and inhibitory control. Studies of adult populations suggest functional abnormalities in reward and inhibitory control networks. Despite behavioral markers often developing in children, the neurobiology of pediatric BED remains unstudied.
Methods
58 pre-adolescent children (aged 9–10-years) with BED (mBMI = 25.05; s.d. = 5.40) and 66 age, BMI and developmentally matched control children (mBMI = 25.78; s.d. = 0.33) were extracted from the 3.0 baseline (Year 0) release of the Adolescent Brain Cognitive Development (ABCD) Study. We investigated group differences in resting-state functional MRI functional connectivity (FC) within and between reward and inhibitory control networks. A seed-based approach was employed to assess nodes in the reward [orbitofrontal cortex (OFC), nucleus accumbens, amygdala] and inhibitory control [dorsolateral prefrontal cortex, anterior cingulate cortex (ACC)] networks via hypothesis-driven seed-to-seed analyses, and secondary seed-to-voxel analyses.
Results
Findings revealed reduced FC between the dlPFC and amygdala, and between the ACC and OFC in pre-adolescent children with BED, relative to controls. These findings indicating aberrant connectivity between nodes of inhibitory control and reward networks were corroborated by the whole-brain FC analyses.
Conclusions
Early-onset BED may be characterized by diffuse abnormalities in the functional synergy between reward and cognitive control networks, without perturbations within reward and inhibitory control networks, respectively. The decreased capacity to regulate a reward-driven pursuit of hedonic foods, which is characteristic of BED, may in part, rest on this dysconnectivity between reward and inhibitory control networks.
ABSTRACT IMPACT: We seek to determine which lymph nodes drain the human brain. OBJECTIVES/GOALS: Lymphatic vessels train lymphatic fluid from the central nervous system (CNS), but the specific lymph nodes that these vessels drain to remains unknown in humans. We intend on using technetium tilmanocept (TcTM)to map the draining lymph nodes of the CNSin humans. METHODS/STUDY POPULATION: Patients having a tumor resected are eligible for the trial. All patients will have TcTM injected intracranially after tumor resection. Six patients will be enrolled in Cohort 1 to define the time course of drainage to the lymph nodes. Patients in Cohort 1 will be imaged with planar LS within 7 hours of injection and the following day. Either 12 or 24 patients will be enrolled into Cohort 2 to localize the draining lymph nodes with SPECT-CT. The optimal imaging timepoint from Cohort 1 will be used for Cohort 2. Patients in Cohort 2 will be stratified depending on if their tumor is in the frontal, parietal, occipital, or temporal lobe. RESULTS/ANTICIPATED RESULTS: We anticipate that we will detect TcTMin the deep cervical lymph nodes after injection into the brain. It is unclear exactly which lymph nodes the tracer will go to. We hypothesize that the results among patients will be similar, but interindividual variation is a possibility. Furthermore, patients with disease in different lobes of the brain may have different lymph drainage patterns. DISCUSSION/SIGNIFICANCE OF FINDINGS: We seek to answer a fundamental question of human anatomy: what lymph nodes drain the human brain? Additionally, knowing which nodes drain the human brain could shape future research of immunotherapy in patients with brain cancer or autoimmune disease such as multiple sclerosis.
Benzodiazepine (BZD) prescription rates have increased over the past decade in the United States. Available literature indicates that sociodemographic factors may influence diagnostic patterns and/or prescription behaviour. Herein, the aim of this study is to determine whether the gender of the prescriber and/or patient influences BZD prescription.
Methods
Cross-sectional study using data from the Florida Medicaid Managed Medical Assistance Program from January 1, 2018 to December 31, 2018. Eligible recipients ages 18 to 64, inclusive, enrolled in the Florida Medicaid plan for at least 1 day, and were dually eligible. Recipients either had a serious mental illness (SMI), or non-SMI and anxiety.
Results
Total 125 463 cases were identified (i.e., received BZD or non-BZD prescription). Main effect of patient and prescriber gender was significant F(1, 125 459) = 0.105, P = 0 .745, partial η2 < 0.001. Relative risk (RR) of male prescribers prescribing a BZD compared to female prescribers was 1.540, 95% confidence intervals (CI) [1.513, 1.567], whereas the RR of male patients being prescribed a BZD compared to female patients was 1.16, 95% CI [1.14, 1.18]. Main effects of patient and prescriber gender were statistically significant F(1, 125 459) = 188.232, P < 0.001, partial η2 = 0.001 and F(1, 125 459) = 349.704, P < 0.001, partial η2 = 0.013, respectively.
Conclusions
Male prescribers are more likely to prescribe BZDs, and male patients are more likely to receive BZDs. Further studies are required to characterize factors that influence this gender-by-gender interaction.
The rich and innovative ideas of quantum physicist and feminist theorist Karen Barad have much to offer environmental educators in terms of practical theories for teaching and learning. This article shares insights gained from a facilitated conversation at the Australian Association for Environmental Education (AAEE) Conference Research Symposium, and offers an introduction to Barad’s theories for environmental educators. At this time of challenging planetary imperatives, environmental education is increasingly called upon to contribute to students’ understanding of connectedness, and Barad’s theory of agential realism provides a way to think about, articulate and engage with connectedness as inherent within the world rather than something we need to create. By considering entanglement as a fundamental state, we understand that separateness is not the original state of being. This shift in perspective supports a subtle yet powerful approach to knowledge, communication and collaboration, understanding difference as integral within the world’s entangled becoming. The convened conversation sought to explore Barad’s thinking by defining and discussing the concepts of agential realism, intra-action, material-discursivity, phenomena and diffraction. Barad’s ideas were used to collectively explore what it means to be intraconnected and entangled in today’s world, and specifically how these concepts and experiences relate to our work and lives as environmental educators and researchers.
Recent criticism of American legal education has focused on its being theory-driven rather than practice driven, which either produces or reinforces a divide or gap between theory and practice. Yet two features of American legal education expressly draw upon experiential learning, one directly by sending students into experiential learning situations (legal clinics) and the other indirectly by bringing instructors who are engaged full-time in active practice into the classroom (i.e. adjunct faculty). If skills development is a feature of American legal education, to what degree can, or should, this be transplanted to other systems of legal education? Are American experiential techniques of legal education meaningful elsewhere?
The motion field of the northern Larsen Ice Shelf, Antarctic Peninsula, was analyzed using radar interferometry in combination with field measurements and finite-element model calculations. The ice shelf between Jason Peninsula and Seal Nunataks has been in steady retreat since January 1995. Model calculations suggest that the ice shelf is in a stage of irreversible retreat since the last calving events in summer 1998/99. The interferometric analysis is based on synthetic-aperture radar data of the tandem mission of European remote-sensing satellites ERS-1 and –2 in austral spring 1995. The phase contributions due to tidal motion were estimated from the vertical displacement at those parts of the grounding zone where the horizontal motion is close to zero" in order to separate the vertical and horizontal motion components over the ice shelf. Satellite-derived velocities compare well with the long-term field measurements along a transverse and a longitudinal profile. The real interferograms and synthetic interferograms, calculated from model velocities, show reasonable agreement over the main parts of the ice shelf, but differ in the boundary zones where the details are not resolved by the model.
A well-posedness theory for the initial-value problem for hydroelastic waves in two spatial dimensions is presented. This problem, which arises in numerous applications, describes the evolution of a thin elastic membrane in a two-dimensional (2D) potential flow. We use a model for the elastic sheet that accounts for bending stresses and membrane tension, but which neglects the mass of the membrane. The analysis is based on a vortex sheet formulation and, following earlier analyses and numerical computations in 2D interfacial flow with surface tension, we use an angle–arclength representation of the problem. We prove short-time well-posedness in Sobolev spaces. The proof is based on energy estimates, and the main challenge is to find a definition of the energy and estimates on high-order non-local terms so that an a priori bound can be obtained.
Cerebral cavernous malformation (CCM) is a form of intracranial vascular disease that may arise sporadically or be dominantly inherited. Linkage studies have revealed genetic heterogeneity among the dominantly inherited forms suggesting the existence of at least three loci called CCM1, CCM2 and CCM3.
Methods:
In the present study, we screened five families with dominantly inherited CCM for CCM1 gene mutations with denaturing high performance liquid chromatography (DHPLC). Then, we performed linkage analysis and haplotyping on these five families using highly polymorphic markers at the candidate CCM loci.
Results:
None of the five families tested with DHPLC were found to have mutations in the CCM1 gene. Based on haplotyping, we identified three families segregating alleles for CCM2, while two families segregated alleles for CCM3. Using linkage analysis, we could confirm that one family (IFCAS-1) had a positive Lod score of 2.03 (p<0.0001) at the CCM2 locus using marker D7S678.
Conclusions:
The present study is the first one to replicate linkage at the CCM2 locus and provides a fifth family identified as such. It also supports the concept of genetic heterogeneity in CCM, identifying four other families that showed no mutations in the CCM1 gene.
Resonant optical rod antennas are made from aluminum using electron-beam lithography and are optically characterized by linear dark-field microscopy and nonlinear multi-photon luminescence spectroscopy. It is demonstrated that by exciting close to the interband transition of aluminum at about 1.5 eV different radiative decay channels can be addressed. Over a period of weeks, a slight spectral red-shift and a decrease in the scattering intensity are observed due to the formation of a native oxide layer at the metal-air interface. To investigate the concurrent influence of shape transformation and dielectric environment on the spectral response function we carry out numerical calculations using finite difference time domain (FDTD) methods. It is found that the induced energy shift is mainly determined by the change of the dielectric constant in the nanovicinity resulting in an overall red-shift as seen in the experiment. These findings allow for a better understanding of designing and modeling plasmonic aluminum nanostructures for e.g. UV sensing where the shift in peak resonance and linewidth are key observables.
The modern concept of stress is commonly traced to the physiologist, Hans Selye. Selye viewed stress as a physiological response to a significant or unexpected change, describing a series of stages: alarm, resistance, and exhaustion, when an organism's adaptive mechanisms finally failed. While Selye originally focused on nonspecific physiological responses to harmful agents, the stress concept has since been used to examine the relationship between a variety of environmental stressors and mental disorders and chronic organic diseases such as hypertension, gastric ulcers, arthritis, allergies, and cancer. This edited volume brings together leading scholars to explore the emergence and development of the stress concept and its ever-changing definitions. It examines how the concept has been used to connect disciplines such as ecology, physiology, psychology, psychiatry, public health, urban planning, architecture, and a range of social sciences; its application in a variety of sites such as the battlefield, workplace, clinic, hospital, and home; and the emergence of techniques of stress management in a variety of different socio-cultural and scientific locations. Contributors: Theodore M. Brown, David Cantor, Otniel E. Dror, Rhodri Hayward, Mark Jackson, Robert G. W. Kirk, Junko Kitanaka, Tulley Long, Joseph Melling, Edmund Ramsden, Elizabeth Siegel Watkins, Allan Young. David Cantor is Acting Director, Office of History, National Institutes of Health. Edmund Ramsden is Research Fellow at the Centre for History of Science, Technology and Medicine, University of Manchester.
Edited by
David Cantor, Acting Director, Office of History, National Institutes of Health,Edmund Ramsden, Research Fellow at the Centre for History of Science, Technology and Medicine, University of Manchester