Recent anti-infective exposure as a risk factor for first episode of suicidal thoughts and/or behaviors in pediatric patients.

Objectives: We conducted a retrospective cohort study of medical records from a large, Maryland, U.S.-based cohort of pediatric primary care patients for potential associations between antibacterial, antifungal and antiviral prescriptions and subsequent suicidal thoughts and/or behaviors. Methods: Using first suicide-related diagnosis as the outcome and prior prescription of antibacterial, antifungal, and/or antiviral use as the exposure, we employed a series of multivariate Cox proportional hazards models. These models examined the hazard of developing newly recognized suicidal thoughts and/or behaviors, controlling for age, sex, race, insurance, number of encounters during the study period, prior mood disorder diagnosis and number of chronic health conditions. We constructed the same series of models stratified by the groups with and without a prior recorded mental or behavioral health diagnosis (MBHD). Results: Suicidal thoughts and/or behaviors were associated with the previous prescription of an antibacterial, antifungal and/or antiviral medication (HR 1.31, 95 %-CI 1.05-1.64) as well as the total number of such medications prescribed (HR 1.04, 95 %-CI 1.01-1.08), with the strongest relationship among patients with three or more medications (HR 1.44, 95 %-CI 1.06-1.96). Among individual medications, the strongest association was with antibacterial medication (HR 1.28, 95 %-CI 1.03-1.60). Correlations were strongest among the subgroup of patients with no previous (MBHD). Interpretation: Infections treated with antimicrobial medications were associated with increased risks of a suicide-related diagnosis among patients who had not had a previous mental or behavioral health diagnosis. This group should be considered for increased levels of vigilance as well as interventions directed at suicide screening and prevention. Funding: National Institutes of Health, Stanley Medical Research Institute.

A Defective Disc-Like Cu1.96 S Anode Material with the Efficient Cu Vacancies for High-Performance Sodium-Ion Storage.

Due to their significant capacity and reliable reversibility, transition metal sulphides (TMSs) have received attention as potential anode materials for sodium-ion batteries (SIBs). Nonetheless, a prevalent challenge with TMSs lies in their significant volume expansion and sluggish kinetics, impeding their capacity for rapid and enduring Na+ storage. Herein, a Cu1.96 S@NC nanodisc material enriched with copper vacancies is synthesised via a hydrothermal and annealing procedure. Density functional theory (DFT) calculations reveal that the incorporation of copper vacancies significantly boosts electrical conductivity by reducing the energy barrier for ion diffusion, thereby promoting efficient electron/ion transport. Moreover, the presence of copper vacancies creates ample active sites for the integration of sodium ions, streamlines charge transfer, boosts electronic conductivity, and, ultimately, significantly enhances the overall performance of SIBs. This novel anode material, Cu1.96 S@NC, demonstrates a reversible capacity of 339 mAh g-1 after 2000 cycles at a rate of 5 A g-1 . In addition, it maintains a noteworthy reversible capacity of 314 mAh g-1 with an exceptional capacity retention of 96% even after 2000 cycles at 20 A g-1 . The results demonstrate that creating cationic vacancies is a highly effective strategy for engineering anode materials with high capacity and rapid reactivity.

COVID-19 and Youth Mental Health Disparities: Intersectional Trends in Depression, Anxiety and Suicide Risk-Related Diagnoses.

OBJECTIVES: Mental health disparities were prevalent among racially and ethnically minoritized youth prior to the COVID-19 pandemic. As complete datasets from 2022 become available, we can estimate the extent to which the pandemic further magnified existing inequities. Our objective was to quantify disparities in trajectories of depression, anxiety, and suicide risk-related diagnoses in youth before and after the start of the COVID-19 pandemic, using an intersectional lens of race, ethnicity and gender. METHODS: Using electronic medical record data from one mid-Atlantic health care system (2015-2022), we evaluated changes in annual rates of depression, anxiety and suicide risk-related diagnoses in 29,117 youths, aged 8-20 years, using graphical analysis, comparison of adjusted mean differences (AMD) and adjusted mixed multilevel logistic regression. RESULTS: Almost all racial and gender subgroups had significantly higher rates of depression and anxiety after the start of COVID-19 compared to the years prior, with the greatest changes observed in Hispanic and Asian females. Suicide risk-related diagnoses significantly increased among all female subgroups, with the largest increase among Asian females (AMD 4.8, 95% CI 0.2-9.3) and Black females (AMD 4.6, 95% CI 2.2-6.9). CONCLUSIONS: Rates of depression, anxiety, and suicidal thoughts and/or behaviors in young people continued to increase in the post-pandemic period. Many pre-existing disparities between subgroups, especially females, significantly widened, highlighting the importance of using an intersectional lens. Urgent action is warranted, including universal screening of pediatric patients for suicide risk, broadening effective treatment and support options in minoritized patients, and increasing support services to patients and families.

Spatial-Temporal Knowledge-Embedded Transformer for Video Scene Graph Generation.

Video scene graph generation (VidSGG) aims to identify objects in visual scenes and infer their relationships for a given video. It requires not only a comprehensive understanding of each object scattered on the whole scene but also a deep dive into their temporal motions and interactions. Inherently, object pairs and their relationships enjoy spatial co-occurrence correlations within each image and temporal consistency/transition correlations across different images, which can serve as prior knowledge to facilitate VidSGG model learning and inference. In this work, we propose a spatial-temporal knowledge-embedded transformer (STKET) that incorporates the prior spatial-temporal knowledge into the multi-head cross-attention mechanism to learn more representative relationship representations. Specifically, we first learn spatial co-occurrence and temporal transition correlations in a statistical manner. Then, we design spatial and temporal knowledge-embedded layers that introduce the multi-head cross-attention mechanism to fully explore the interaction between visual representation and the knowledge to generate spatial- and temporal-embedded representations, respectively. Finally, we aggregate these representations for each subject-object pair to predict the final semantic labels and their relationships. Extensive experiments show that STKET outperforms current competing algorithms by a large margin, e.g., improving the mR@50 by 8.1%, 4.7%, and 2.1% on different settings over current algorithms.

High chlamydia infection and its associated factors among patients seeking clinic-based STI services in Southern China: A preliminary cross-sectional study.

Objective: Chlamydia trachomatis (CT) infection is one of the most common sexually transmitted infections (STIs) worldwide. This study aimed to provide prevalence and associated factors data among patients seeking clinic-based STI services for estimating the disease burden of CT. Study design and method: A cross-sectional survey was conducted among patients attending clinics for STI services. Patients' social-demographic and behavioral information was collected and CT infection was determined by nucleic acid amplification test (NAAT) with self-collected urine specimens. Associated factors were identified using logistic regression. Results: Among the 8,324 participants, the overall prevalence was 9.0% with 10.7% for males and 8.3% for females respectively. Multivariate analysis showed that aged < 24 [adjusted odds ratio (aOR) = 1.27, 95% confidence interval (CI) = 1.01-1.59], being unmarried (aOR = 1.64, 95%CI = 1.35-2.00), having junior high school or below education level (aOR = 1.47, 95%CI = 1.13-1.91), having no access to health insurance (aOR = 1.27, 95%CI = 1.07-1.51), and being positive for Neisseria gonorrhoeae (NG, aOR = 4.49, 95%CI = 3.25-6.21) were significantly associated with CT infection. Conclusion: We found that CT infection is prevalent among patients seeking clinic-based STI services in Southern China. Targeted interventions could be implemented for patients with a higher risk of CT infection including those aged < 24, being unmarried, having junior high school or below education level, having no access to health insurance, and being positive for NG. In addition, routine CT screening could be considered a public health strategy by the government.

PAM-free loop-mediated isothermal amplification coupled with CRISPR/Cas12a cleavage (Cas-PfLAMP) for rapid detection of rice pathogens.

Pathogenic disease is an important factor affecting rice growth, yield and quality, and the development and application of rapid diagnostic methods will contribute to the prevention and control of rice disease. Herein, we developed a novel protospacer adjacent motif (PAM)-free loop-mediated isothermal amplification (LAMP) assisted CRISPR/Cas12a cleavage (Cas-PfLAMP) assay for detection of three rice pathogens; Xanthomonas oryzae pv. Oryzae (XOO), rice stripe virus (RSV), and rice black-streaked dwarf virus (RBSDV). The Cas-PfLAMP assay showed high specificity due to doubly specific recognition of LAMP primer sets and FnCas12a/sgRNA, and high sensitivity down to 9 or 3 copies due to LAMP amplification and CRISPR/Cas12a trans cleavage activity. Furthermore, a visual on-spot Cas-PfLAMP platform was established for detection of rice pathogens by combining solid-phase nucleic acid extraction and a lateral flow strip (LFS) test. Analysis of rice leaf field samples confirmed the impressive performance of the Cas-PfLAMP platform, demonstrating its suitability for rapid (∼50 min) on-spot detection of rice diseases. The assay could also be extended to detection of other plant diseases, and other nucleic acid field tests.

A delayed diagnosis of catecholaminergic polymorphic ventricular tachycardia with a mutant of RYR2 at c.7580T>G for 6 years in a 9-year-old child.

RATIONALE: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare but potentially lethal inherited arrhythmia syndrome induced by adrenergic stress. Due to the atypical clinical manifestations in early age, limited recognition and experience of pediatric cardiologists, and low awareness of the significance of genetic diagnosis in some underdeveloped areas in China, a delayed or missed diagnosis of CPVT in children is common and concerning. PATIENT CONCERNS: A 9-year and 3-month male child with recurrent exercise-induced syncope accompanied by convulsion was initially misdiagnosed as epilepsy since the first manifestation at the age of 3 years. Due to the identification of polymorphic ventricular premature beats, nonsustained ventricular tachycardia (VT), and supraventricular tachycardia, a cardiogenic etiology was established. The patient received a successive treatment by propafenone, amiodarone, a combination of amiodarone with metoprolol, and metoprolol alone for up to 6 years. DIAGNOSES: Given the poor response to conventional antiarrhythmics, excise-induced syncope, QRS morphology and a structurally normal heart, the diagnosis of CPVT was suspected, and ultimately confirmed by detection of polymorphic and bidirectional VT with degeneration into ventricular fibrillation during exercise testing. In addition, a heterozygous mutant of RYR2 at c.7580T > G was identified by genetic testing. INTERVENTIONS: Due to the unavailability of flecainide in China and the refusal of implantable cardioverter defibrillator implantation by his parents, this patient continued to be treated with oral metoprolol. OUTCOMES: Unfortunately, the effect was unfavorable during 4 months outpatient follow-up. LESSONS: CPVT should be suspected in young patients with a normal baseline electrocardiogram (EKG), a structurally normal heart and polymorphic and/or bidirectional ventricular tachycardia induced by exercise or emotional stress. Exercise and genetic testing is essential and significant for a timely and accurate diagnosis of CPVT. The current study firstly reported a case with CPVT associated with a mutant of RYR2 at c.7580T > G in children.

[Changes in electrocardiographic parameters in children with complete left bundle branch block early after transcatheter closure of ventricular septal defect].

OBJECTIVE: To observe the changes in electrocardiographic parameters in children with complete left bundle branch block (CLBBB) after the transcatheter closure of simple ventricular septal defect (VSD). METHODS: A total of 21 children with CLBBB early after transcatheter closure of perimembranous VSD were recruited. Another 21 children without any type of arrhythmia after transcatheter closure of perimembranous VSD were enrolled as the control group. The sex, age, and the size of occluder were matched between the two groups. The changes in the following indices were compared between the two groups: left ventricular voltage, QT interval, corrected QT interval (QTc), QT dispersion (QTd), corrected QT dispersion (QTcd), JT dispersion (JTd), and corrected JT dispersion (JTcd) on the electrocardiogram before transcatheter closure and at 1, 3, 5, 30 days after transcatheter closure. RESULTS: Left ventricular voltage and JTcd changed with operation time in the CLBBB and control groups (P<0.05). There were interaction effects between time and grouping in the changes in left ventricular voltage and QTd (P<0.05). There was a significant difference in JTcd between the CLBBB and control groups (P<0.05). There was also a significant difference in left ventricular voltage between the CLBBB and control groups at 3 and 5 days after the transcatheter closure (P<0.05). CONCLUSIONS: There are significant differences in electrocardiographic left ventricular voltage and JTcd between VSD children with and without CLBBB early after transcatheter closure. JTcd might be useful in predicting the development of CLBBB early after transcatheter closure of VSD.

Detection-Free Multiobject Tracking by Reconfigurable Inference With Bundle Representations.

This paper presents a conceptually simple but effective approach to track multiobject in videos without requiring elaborate supervision (i.e., training object detectors or templates offline). Our framework performs a bi-layer inference of spatio-temporal grouping to exploit rich appearance and motion information in the observed sequence. First, we generate a robust middle-level video representation based on clustered point tracks, namely video bundles. Each bundle encapsulates a chunk of point tracks satisfying both spatial proximity and temporal coherency. Taking the video bundles as vertices, we build a spatio-temporal graph that incorporates both competitive and compatible relations among vertices. The multiobject tracking can be then phrased as a graph partition problem under the Bayesian framework, and we solve it by developing a reconfigurable belief propagation (BP) algorithm. This algorithm improves the traditional BP method by allowing a converged solution to be reconfigured during optimization, so that the inference can be reactivated once it gets stuck in local minima and thus conduct more reliable results. In the experiments, we demonstrate the superior performances of our approach on the challenging benchmarks compared with other state-of-the-art methods.

Glycoprotein Ia C807T: Polymorphisms and Their Association with Platelet Function in Patients with the Acute Coronary Syndrome.

OBJECTIVES: In the current study, we explored the relationship between glycoprotein Ia (GPIa) C807T polymorphisms and platelet function, and the sensitivity to dual antiplatelet treatment after percutaneous coronary intervention. MATERIALS AND METHODS: We conducted a case-control study in 220 patients diagnosed with acute coronary syndrome (ACS) and 220 healthy controls. The platelet GPIa C807T genotypes of patients and controls were determined, and platelet aggregation and plasma concentrations of α-granule membrane protein (GMP-140) were assessed following stimulation with arachidonic acid and adenosine diphosphate. RESULTS: The frequency of the GPIa T allele was higher in the ACS group than in controls. In the ACS group, platelet aggregation was significantly higher in individuals with the T allele than in those with the C allele. Dual antiplatelet treatment reduced platelet aggregation in all three genotypes, and patients carrying the CC genotype were more sensitive to antiplatelet treatment than those with the T allele, particularly the ones with the TT genotype. There were no differences in plasma GMP-140 levels. CONCLUSIONS: The GPIa C807T polymorphism might be a risk factor for the development and relapse of ACS. The GP Ia T allele may help to identify a group of patients who need more aggressive antithrombotic treatment.

[Significance of Tp-Te interval for risk stratification of ventricular premature contractions in children].

OBJECTIVE: To investigate the significance of Tp-Te interval for risk stratification of ventricular premature contractions (VPC) in children. METHODS: A total of 120 children with VPC were divided into benign VPC (n=40), organic disease (n=40) and ventricular parasystole groups (n=40) according to the etiology of VPC; another 40 children who underwent physical examination were selected as the normal control group. The four groups were compared in terms of Tp-Te intervals and Tp-Te/QT ratios in leads V3, V4 and V5. RESULTS: The Tp-Te interval in lead V3 was significantly longer in the organic disease group than in the other groups (P<0.05), the benign VPC group had a significantly shorter Tp-Te interval in lead V4 than the normal control and organic disease groups (P<0.05), and the organic disease group had a significantly longer Tp-Te interval in lead V5 than the benign VPC group (P<0.05). The Tp-Te/QT ratios in leads V3-V5 were significantly higher in the organic disease group than in the other groups (P<0.05). The Tp-Te/QT ratios in leads V4 and V5 showed significant differences between the ventricular parasystole and benign VPC groups (P<0.05). CONCLUSIONS: Tp-Te interval is susceptible to changes in heart rate, and it is of little value for the risk stratification of VPC in children. Tp-Te/QT ratio, however, may be used as an important non-invasive index for clinical risk stratification of VPC in children and is worthy of further study.

[Risk factors for accelerated junctional escape rhythm in children early after percutaneous ventricular septal defect closure].

OBJECTIVE: To identify the risk factors for accelerated junctional escape rhythm (AJER) in children early after percutaneous ventricular septal defect (VSD) closure. METHODS: A retrospective controlled study was conducted on 42 children who had AJER within one week after percutaneous VSD closure between January 2008 and October 2012. These subjects were compared with controls without AJER after VSD closure in terms of age, sex, diameter of VSD, occluder size, difference between occluder size and diameter of VSD, and distance between VSD and aortic valve ring. Risk factors for AJER were identified by logistic regression analysis. RESULTS: Compared with the control group, the AJER group had a longer distance betweenVSD and aortic valve ring, a larger diameter of VSD (basal diameter), a larger occluder size (waist diameter) , and a bigger difference between the waist diameter of occluder and diameter of VSD (P<0.05). Logistic regression analysis showed that distance between VSD and aortic valve ring (OR=1.813, P<0.05) and occluder size (OR=1.671, P<0.05) are primary risk factors for AJER. CONCLUSIONS: AJER early after percutaneous VSD closure is related to diameter of VSD, occluder size, difference between the waist diameter of occluder and diameter of VSD, and distance between VSD and aortic valve ring. The distance between VSD and aortic valve ring and occluder size are primary risk factors for AJER.

Integrating graph partitioning and matching for trajectory analysis in video surveillance.

In order to track moving objects in long range against occlusion, interruption, and background clutter, this paper proposes a unified approach for global trajectory analysis. Instead of the traditional frame-by-frame tracking, our method recovers target trajectories based on a short sequence of video frames, e.g., 15 frames. We initially calculate a foreground map at each frame obtained from a state-of-the-art background model. An attribute graph is then extracted from the foreground map, where the graph vertices are image primitives represented by the composite features. With this graph representation, we pose trajectory analysis as a joint task of spatial graph partitioning and temporal graph matching. The task can be formulated by maximizing a posteriori under the Bayesian framework, in which we integrate the spatio-temporal contexts and the appearance models. The probabilistic inference is achieved by a data-driven Markov chain Monte Carlo algorithm. Given a period of observed frames, the algorithm simulates an ergodic and aperiodic Markov chain, and it visits a sequence of solution states in the joint space of spatial graph partitioning and temporal graph matching. In the experiments, our method is tested on several challenging videos from the public datasets of visual surveillance, and it outperforms the state-of-the-art methods.