Sjogren's syndrome related autoimmune encephalopathy presenting as depression and involuntary agitation in a 15-year-old girl: a case report.

Introduction: Sjogren's syndrome is an autoimmune disease that commonly involves exocrinopathy. Although studies have reported psychiatric manifestations resulting from Sjogren's syndrome, few studies have focused on such manifestations in pediatric patients. Herein, we present a case of an adolescent girl with depression and involuntary self-harm behaviors related to Sjogren's syndrome with central nervous system involvement. Case presentation: A 15-year-old girl, with an underlying history of epilepsy, developed depressive symptoms of a year's duration, accompanied by three seizure episodes and involuntary self-harm behaviors. The self-harm behaviors, which included head banging and arm scratching, were sudden onset, involuntary, and unable to be recalled afterwards. After admission to our ward, the patient was positive for serum antinuclear antibodies and Schirmer's test. Moreover, 24-hour electroencephalography revealed epileptiform discharges during the mood swing episodes. Positive findings for antinuclear antibodies and anti-SSA antibodies in both serum and cerebrospinal fluid, suggested central nervous system involvement in Sjogren's syndrome. After rituximab treatment, her mood became euthymic, and her involuntary self-harm behaviors ceased. Conclusion: Central nervous system involvement leading to psychiatric presentations has rarely been reported in adolescents with Sjogren's syndrome. When treating adolescent patients with involuntary self-harm behaviors and neurological symptoms, it is crucial to consider autoimmune encephalitis related to Sjogren's syndrome in the differential diagnosis.

Factors Affecting Self-Harm- or Violence-Related Urgent Psychiatric Consultation During the COVID-19 Pandemic in Taiwan.

Purpose: People's health-care-seeking behaviors considerably changed during the COVID-19 pandemic. This study evaluated the changes in self-harm- and violence-related urgent psychiatric consultation (UPC) in the emergency department (ED) during different stages of the pandemic and at different levels of hospitals. Patients and Methods: We recruited patients who received UPC during the baseline (2019), peak (2020), and slack (2021) periods of the same time window (calendar weeks 4-18) during the COVID-19 pandemic. Demographic data such as age, sex, and referral type (by the police/emergency medical system) were also recorded. Results: We found female gender and younger age associated with higher risk of self-harm-related UPCs, whereas patients visiting regional hospitals, male patients, and patients referred by the policy/emergency medical system, had a higher risk of violence-related UPCs. After adjustment, the different pandemic stages were not significantly associated with self-harm- or violence-related UPCs. Conclusion: Patient's demographic data, but not the pandemic itself, may be responsible for the changes in self-harm- and violence-related UPCs during the pandemic.

Metagenome-Assembled Genomes from Photo-Oxidized and Nonoxidized Oil-Degrading Marine Microcosms.

We performed deep metagenomic sequencing on hydrocarbon-degrading marine microcosms designed to experimentally determine the effect of photo-oxidation on oil biodegradation dynamics. Assembly, binning, and dereplication yielded 73 unique metagenome-assembled genomes (MAGs) from 6 phyla, of which 61 are predicted to be over 90% complete.