Neurocognition and social cognition in youth and young adults at ultra-high-risk for psychosis and bipolar disorder.

BACKGROUND: Schizophrenia and bipolar disorder are associated with significant deficits in neurocognition and social cognition. Unlike the studies in chronic stages of these disorders, very limited information is available regarding neurocognitive and social-cognitive impairment before the onset of bipolar disorder. Our main aim was to investigate the differences in neurocognition and social cognition between individuals at ultra-high risk for psychosis (UHR-P) and bipolar disorder (UHR-BD). METHODS: This study included 152 help-seeking individuals identified as UHR-P (n = 78) and UHR-BD (n = 74), who were compared with a healthy control group (n = 43). A comprehensive neuropsychological battery was administered to all participants. RESULTS: UHR-P was associated with widespread deficits in all neurocognitive and social-cognitive domains. Effect sizes (Cohen's d) of these deficits ranged from -0.57 to -1.34. UHR-BD was associated with significant deficits in processing speed, executive functions, sustained attention and social cognition (d = -0.48 to-0.70, p < 0.05). UHR-P performed significantly worse than UHR-BD in social cognition, processing speed, verbal memory and executive function domains (d = -0.39 to-0.64, p < 0.05). Negative symptoms were associated with impaired social cognition in the UHR-P group and verbal memory deficits in the UHR-BD group. Cognitive impairment was associated with functional impairment in both groups. CONCLUSIONS: While UHR-P is associated with more widespread cognitive impairment, deficits in processing speed, executive functions, sustained attention and social cognition might be common features of both UHR groups. In early intervention services, cognition should be considered as a target for assessment and intervention not only for individuals at high risk for psychosis but also for bipolar disorder.

Risk factors for brachial plexus injury and permanent sequelae due to shoulder dystocia.

Aim: The primary aim of this study was to determine the risk factors for the occurrence of brachial plexus injury in cases of shoulder dystocia. Secondly, it was aimed to determine the factors affecting the occurrence of permanent sequelae in cases with brachial plexus injury. Subjects and Methods: ICD-10 codes were scanned from the records of patients who gave birth between 2012 and 2018, and the records of patients with brachial plexus injury and shoulder dystocia were reached. Shoulder dystocia cases with brachial plexus damage were accepted as the study group, and shoulder dystocia cases without brachial plexus damage were considered the control group. Shoulder dystocia patients with brachial plexus injury and without injury were compared for 2-year orthopedics clinic follow-up reports, surgical intervention, permanent sequelae status as well as birth data, maternal characteristics, and maneuvers applied to the management of shoulder dystocia. Results: Five hundred sixty births with shoulder dystocia were detected. Brachial plexus injury was observed in 88 of them, and permanent sequelae were detected in 12 of these patients. Maneuvers other than McRobert's (advanced maneuvers) were used more and clavicle fracture was seen more in the group with plexus injury (P < 0.05, P < 0.05, respectively). Logistic regression analysis was performed to determine the risk factors of brachial plexus injury. Brachial plexus injury was observed 4.746 times more in infants who were delivered with advanced maneuvers and 3.58 times more in infants with clavicle fractures at birth. Conclusion: In patients with shoulder dystocia, the risk of brachial plexus injury increased in deliveries in which advanced maneuvers were used and clavicle fracture occurred.

Fluctuation-dissipation and energy properties of a finite bath.

This paper expands a recent proposal by the authors to rederive the Langevin equation for a test particle in a finite-size thermal bath using a perturbation approach that yields a cascade of Langevin-type equations. Such an approach produces a different viewpoint for the fluctuation-dissipation duality by expressing them on similar scales. General properties of energy sharing between the test particle and the bath are outlined, investigating the resonant and nonresonant conditions.

A novel data-mining platform leveraging social media to monitor outcomes of Januvia.

A novel data-mining method was developed to gauge the experiences of the diabetes mellitus drug Januvia. Self-organizing maps were used to analyze forum posts numerically to infer user opinion of drug Januvia. Graph theory was used to discover influential users. The result is a word list compilation correlating positive and negative word cluster groups and a web of influential users on Januvia. The implications could open new research avenues into rapid data collection, feedback, and analysis that would enable improved solutions for public health.

Dissipation in a finite-size bath.

We investigate the interaction of a particle with a finite-size bath represented by a set of independent linear oscillators with frequencies that fall within a finite bandwidth. We discover that when the oscillators have particular frequency distributions, the finite-size bath behaves much as an infinite-size bath exhibiting dissipation properties and thus allowing irreversible energy absorption from a particle immersed in it. We also present a reinterpretation of the Langevin equation using a perturbation approach in which the small parameter represents the inverse of the number of oscillators in the bath, elucidating the relationship between finite-size and infinite-size bath responses.

Vibration absorption using non-dissipative complex attachments with impacts and parametric stiffness.

Studies on prototypical systems that consist of a set of complex attachments, coupled to a primary structure characterized by a single degree of freedom system, have shown that vibratory energy can be transported away from the primary through use of complex undamped resonators. Properties and use of these subsystems as by energy absorbers have also been proposed, particularly using attachments that consist of a large set of resonators. These ideas have been originally developed for linear systems and they provided insight into energy sharing phenomenon in large structures like ships, airplanes, and cars, where interior substructures interact with a master structure, e.g., the hull, the fuselage, or the car body. This paper examines the effects of nonlinearities that develop in the attachments, making them even more complex. Specifically, two different nonlinearities are considered: (1) Those generated by impacts that develop among the attached resonators, and (2) parametric effects produced by time-varying stiffness of the resonators. Both the impacts and the parametric effects improve the results obtained using linear oscillators in terms of inhibiting transported energy from returning to the primary structure. The results are indeed comparable with those obtained using linear oscillators but with special frequency distributions, as in the findings of some recent papers by the same authors. Numerically obtained results show how energy is confined among the attached oscillators.

Wearable and mobile system to manage remotely heart failure.

Cardiovascular diseases (CVDs) account for 45% of all deaths in the western world according to the 2004 World Health Organization statistics report. Heart failure (HF), CVD's primary paradigm, mainly affects people older than 65. The European MyHeart Project's mission is to empower citizens to fight CVD by leading a preventative lifestyle and allowing early diagnosis. This paper presents the iterative design and development of the HF management system, part of MyHeart Project. The system daily measures vital body signals to assess HF. The methodology applied herein has involved stakeholders in an iterative process: concept validation, feasibility, efficiency, patients' experience, and patients' acceptance. The final solution allows patient self-management of their chronic condition.

Energy equipartition and frequency distribution in complex attachments.

As reported in several recent publications, an undamped simple oscillator with a complex attachment that consists of a set of undamped parallel resonators can exhibit unusual energy sharing properties. The conservative set of oscillators of the attachment can absorb nearly all the impulsive energy applied to the primary oscillator to which it is connected. The key factor in the ability of the attachment to absorb energy with near irreversibility correlates with the natural frequency distribution of the resonators within it. The reported results also show that a family of optimal frequency distributions can be determined on the basis of a variational approach, minimizing a certain functional related to the system response. The present paper establishes a link between these optimal frequency distributions and the energy equipartition principle: optimal frequency distributions are those that spread the injected energy as uniformly as possible over the degrees of freedom or over the modes of the system. Theoretical as well as numerical results presented support this point of view.

Pseudo-damping in undamped plates and shells.

Pseudo-damping is a counter-intuitive phenomenon observed in a special class of linear structures that exhibit an impulse response characterized by a decaying amplitude, even in the absence of any dissipation mechanism. The conserved energy remains within but designated parts of the system. Pseudo-damping develops when the natural frequency distribution of the system includes condensation points. The recently formulated theoretical foundation of this phenomenon, based on mathematical properties of special trigonometric series, makes it possible to describe a class of mechanical systems capable of displaying pseudo-damping characteristics. They include systems with discrete oscillators and one-dimensional continuous beamlike structures already reported by the authors in recent studies. This paper examines development of pseudo-damping phenomenon in two-dimensional structures, using plates and shells as examples, and shows how a preloaded plate on an elastic foundation can lead to pseudo-damping. Moreover, in the case of curved shell elements examined here, pseudo-damping can result due to the curvature of the structure, which naturally introduces condensation points in the modal density.

Theoretical foundations of apparent-damping phenomena and nearly irreversible energy exchange in linear conservative systems.

This paper discusses a class of unexpected irreversible phenomena that can develop in linear conservative systems and provides a theoretical foundation that explains the underlying principles. Recent studies have shown that energy can be introduced to a linear system with near irreversibility, or energy within a system can migrate to a subsystem nearly irreversibly, even in the absence of dissipation, provided that the system has a particular natural frequency distribution. The present work introduces a general theory that provides a mathematical foundation and a physical explanation for the near irreversibility phenomena observed and reported in previous publications. Inspired by the properties of probability distribution functions, the general formulation developed here is based on particular properties of harmonic series, which form the common basis of linear dynamic system models. The results demonstrate the existence of a special class of linear nondissipative dynamic systems that exhibit nearly irreversible energy exchange and possess a decaying impulse response. In addition to uncovering a new class of dynamic system properties, the results have far-reaching implications in engineering applications where classical vibration damping or absorption techniques may not be effective. Furthermore, the results also support the notion of nearly irreversible energy transfer in conservative linear systems, which until now has been a concept associated exclusively with nonlinear systems.

Gunshot injuries of the ureter: one centre's 15-year experience.

PURPOSE: Ureteral injury is a rare condition. It is difficult to identify the best diagnostic methods and treatment. We report our experience with penetrating ureteral injuries secondary to gunshot wounds. The methods of diagnosis and treatment options of these cases are described and discussed. MATERIALS AND METHODS: A retrospective review of ureteral injuries due to penetrating trauma between January 1990 and December 2005, in the Urology and General Surgery departments of our hospital. Ureteral injures were graded according to the AAST-OIS. We evaluated mechanism of injury, initial urinalysis, radiologic and operative procedure, associated injuries, and postoperative complications. RESULTS: A total of twenty-one (sixteen male, five female) cases of gunshot ureteral injuries were evaluated retrospectively. The median patient age was 27.85 years (16-48 years). All patients had signs and symptoms of an acute abdomen and only nine patients were evaluated radiologically. Haematuria was absent in 71.4% of patients (15 of 21). All patients had associated injuries and were evaluated from grade I to V. Grade I had none, grade II had 1 (4.76%), grade III had 3 (14.29%), grade IV had 14 (66.6%), grade V had 3 (14.29%). Ureteral stent or nephrostomy tubes were used in all primarily repaired patients. Two patients developed urinary leakage, which resolved spontaneously. CONCLUSIONS: Ureteral injury should always be borne in mind and, when suspected, the surgeon should dissect and visualize the ureter during exploration. Adequate debridment, and ureteral stenting or nephrostomy drainage are good techniques for successful treatment.

Near-irreversibility in a conservative linear structure with singularity points in its modal density.

Through two complementary approaches, using modal response and wave propagation, the analyses presented here show the conditions under which a decaying impulse response, or a nearly irreversible energy trapping, takes place in a linear conservative continuous system. The results show that the basic foundation of near-irreversibility or apparent damping rests upon the presence of singularity points in the modal density of dynamic systems or, analogously, in the wave-stopping properties associated with these singularities. To illustrate the concept of apparent damping in detail, a simple undamped beam is modified to introduce a singularity point in its modal density distribution. Simulations show that a suitable application of a compressive axial force to an undamped beam placed on an elastic foundation attenuates its impulse response with time and develops the characteristics of a nearly irreversible energy trap.

Effects of extracorporeal shock-wave lithotripsy on intrarenal resistive index.

OBJECTIVE: This prospective study was performed to determine whether extracorporeal shock-wave lithotripsy (ESWL), widely used for treating renal and ureteral stones, affects the kidney interlobar artery resistive index (RI). MATERIAL AND METHODS: A total of 43 patients (30 with renal and 13 with ureteral stones) underwent color Doppler examination before and 30 min and 3 h after ESWL. Seventeen patients with renal and nine with ureteral stones underwent Doppler examination 2 weeks later. Measurements were made near the stones (nearby region), at least 2 cm from the stones (remote region) and in the contralateral kidney for renal stones, and in the ipsilateral and contralateral kidneys for ureteral stones. RESULTS: In patients with renal stones, the RI was increased 30 min and 3 h after ESWL in the nearby and remote regions, and more markedly in the former. In the contralateral kidney, there was an increase in RI only at 3 h, which was less than that in the ipsilateral kidney. The RI at 2 weeks post-ESWL in the nearby region and contralateral kidney did not differ from the pre-ESWL values. ESWL performed for ureteral stones caused no increase in RI in the ipsilateral kidney. CONCLUSION: Patients with renal stones had a temporary increase in RI in the hours following ESWL in both the ipsilateral and contralateral kidneys, which was highest in the region near the stones and lowest in the contralateral kidney. Two weeks later, the RI in both areas had returned to pre-ESWL levels.

Calcinosis cutis universalis.

We report the case of a 49-year-old female who complained of hardening of the skin, with onset about 1.5 years before presentation. The laboratory data showed normal biochemistry profile. Routine haematochemical examinations showed slight anaemia, an increased erythrocyte sedimentation rate and negative rheumatological markers. Calcium excretion in a 24-h urine sample was normal, but the phosphate excretion was slightly low. The clinical diagnosis was verified by soft tissue ultrasound examination showing subcutaneous calcifications. X-ray examination of bones evidenced no abnormal calcification. Mammography revealed deep seated bilateral reticular calcifications, even in the axillary region. Histological examination showed calcinosis cutis. On these grounds, the diagnosis of idiopathic universal calcinosis cutis was made. The authors describe the clinical and histological picture and discuss the laboratory findings.

Assessment of depression in subjects with psoriasis vulgaris and lichen planus.

AIM: The aim of this study was to investigate the frequency of depressive symptoms in psoriasis vulgaris and lichen planus and to evaluate the relationship between the Beck depression scores and the Psoriasis Area and Severity Index (PASI) scores of subjects with psoriasis vulgaris. SUBJECTS: The study involved 120 subjects attending the dermatology clinic of Izmir Ataturk Training Hospital (Izmir, Turkey) and comprised 50 subjects with psoriasis vulgaris, 30 with lichen planus and 40 healthy control subjects. RESULTS: Subjects with psoriasis vulgaris, lichen planus and controls had depression scores of 58%, 53% and 20%, respectively. The Beck depression scores of patients with psoriasis vulgaris were significantly higher than those of the control group. The PASI scores showed a correlation with Beck depression scores. Smoking and drinking were very common in subjects with psoriasis vulgaris. There was no correlation between the duration of illness and depressive symptoms. CONCLUSIONS: This study confirms the importance of depressive symptoms in two common dermatological diseases. It is important to recognize this association as it affects both clinical outlook and response to treatment.

The first micturition times of the newborns whose mothers were treated with magnesium sulfate.

BACKGROUND: The aim of this study was to determine whether magnesium sulfate used for the treatment of severe pre-eclampsia or eclampsia had an effect on the first micturition time of the newborn. METHODS: The first group included 20 newborns all of whose mothers had severe pre-eclampsia or eclampsia, and all mothers had been treated with magnesium sulfate according to the Parkland Memorial Hospital eclampsia regimen. The second group included 20 newborns all of whose mothers were normal pregnants, and did not receive any drug that had an effect on the contractility of smooth muscles. The first micturition times of all newborns in two groups were determined following delivery and were compared statistically. RESULTS: All newborns urinated in the first 24 hours. There were no statistically significant differences in the micturition times between the two groups (p > 0.05). There was no residual urine after the first micturition, and none of them had any urinary tract abnormality and neurological pathology. CONCLUSIONS: From the results, it was concluded that magnesium sulfate had no effect on the first micturition time of the newborns, when applied according to the Parkland Memorial Hospital eclampsia regimen in severe pre-eclamptic or eclamptic pregnants.

The effects of GnRH analogues and antiandrogenes in preventing the gonadotoxic effects of COPP chemotherapy.

BACKGROUND: In this study we aimed to discuss whether the gonadal suppression is effective or not in preventing the gonadal toxic effects of some chemotherapeutics. METHODS: Forty Sprague-Dawley adult male rats were randomised into 4 groups, each consisting of 10. No drugs were given to the first group. The second group received GnRH agonist and antiandrogen, the third group received COPP chemotherapy protocol and the last group received COPP together with GnRH agonist and antiandrogen. Ninety days after drug application we sacrificed all rats. Total body weight, testicular weight and testicular size measurements were all recorded. All testicular tissues were examined histologically for the ratio of active seminiferous tubules. RESULTS: There was no difference in total body weight. The weight and measurements of testicular tissues were decreased in-group 3 and 4 when compared with 1 and 2. The amount of active seminiferous tubules was significantly less in the third group. CONCLUSIONS: As a conclusion we think that gonadal suppression applied during chemotherapy regimen could decrease the testicular toxic effects of chemotherapeutic but more clinical investigations needed for routine application.