Early life phenobarbital exposure dysregulates the hippocampal transcriptome.

Introduction: Phenobarbital (PB) and levetiracetam (LEV) are the first-line therapies for neonates with diagnosed seizures, however, a growing body of evidence shows that these drugs given during critical developmental windows trigger lasting molecular changes in the brain. While the targets and mechanism of action of these drugs are well understood-what is not known is how these drugs alter the transcriptomic landscape, and therefore molecular profile/gene expression during these critical windows of neurodevelopment. PB is associated with a range of neurotoxic effects in developing animals, from cell death to altered synaptic development to lasting behavioral impairment. LEV does not produce these effects. Methods: Here we evaluated the effects of PB and Lev on the hippocampal transcriptome by RNA sequencing. Neonatal rat pups were given a single dose of PB, Lev or vehicle and sacrificed 72 h later-at time at which drug is expected to be cleared. Results: We found PB induces broad changes in the transcriptomic profile (124 differentially expressed transcripts), as compared to relatively small changes in LEV-treated animals (15 transcripts). PB exposure decreased GABAergic and oligodendrocyte markers pvalb and opalin, and increased the marker of activated microglia, cd68 and the astrocyte- associated gene vegfa. These data are consistent with the existing literature showing developmental neurotoxicity associated with PB, but not LEV. Discussion: The widespread change in gene expression after PB, which affected transcripts reflective of multiple cell types, may provide a link between acute drug administration and lasting drug toxicity.

Pharmacological inhibition of the nucleus accumbens increases dyadic social interaction in macaques.

The nucleus accumbens (NAc) is a central component of the brain circuitry that mediates motivated behavior, including reward processing. Since the rewarding properties of social stimuli have a vital role in guiding behavior (both in humans and nonhuman animals), the nucleus accumbens is likely to contribute to the brain circuitry controlling social behavior. In rodents, prior studies have found that focal pharmacological inhibition of NAc and/or elevation of dopamine in NAc increases social interactions. However, the role of the NAc in social behavior in nonhuman primates remains unknown. We measured the social behavior of eight dyads of male macaques following (1) pharmacological inhibition of the nucleus accumbens using the GABAA agonist muscimol and (2) focal application of quinpirole, an agonist at the D2 family of dopamine receptors. Transient inhibition of the NAc with muscimol increased social behavior when drug was infused in submissive, but not dominant partners of the dyad. Focal application of quinpirole was without effect on social behavior when infused into the NAc of either dominant or submissive subjects. Our data demonstrate that the NAc contributes to social interactions in non-human primates.Significance statement A range of neuropsychiatric disorders present with altered reward processing and social behavior. The nucleus accumbens is a critical brain region for reward processing and motivated behavior. While prior studies in rodents have suggested a role for the nucleus accumbens in social behaviors, no studies have examined this role in the primate brain. Here, we bridge this gap and demonstrate that focal modulation of activity within the primate nucleus accumbens alters social behavior and that this effect is modulated by the social status of the infused animal.

The strength of conspiracy beliefs versus scientific information: the case of COVID 19 preventive behaviours.

Controlling the spread of COVID-19 requires individuals to adopt preventive behaviours, but conspiracy beliefs about its origin are spreading. The aim of this paper is to better comprehend the strength of conspiracy beliefs versus objective COVID-19 information to predict people's adherence to protective behaviours (getting vaccinated, being tracked through APPs, and keeping social distance from infected people). Study 1 shows that COVID-19 implicit theories detected in the Pre-study were activated as independent factors that constitute people's interpretations of the virus origin. These beliefs were related to a lesser intention to engage in preventive behaviours and a higher level of mistrust in institutional information, although some beliefs generate positive expectations about COVID-19 consequences. In Study 2, conducted with a different sample, official COVID-19 information was included as an independent variable, but this new variable did not further explain results. Lastly, Study 3 consisting of both previous samples confirmed that conspiracy beliefs had a direct effect on a lesser willingness to engage in preventive actions, a higher mistrust, and positive expectations about COVID-19 consequences. We conclude that objective COVID-19 information did not buffer the effect of conspiracy beliefs; they interfere with actions to prevent it by taking institutions as scapegoats or complicit with secret powers.

ChatGPT as an information tool in rhinology. Can we trust each other today?

PURPOSE: ChatGPT (Chat-Generative Pre-trained Transformer) has proven to be a powerful information tool on various topics, including healthcare. This system is based on information obtained on the Internet, but this information is not always reliable. Currently, few studies analyze the validity of these responses in rhinology. Our work aims to assess the quality and reliability of the information provided by AI regarding the main rhinological pathologies. METHODS: We asked to the default ChatGPT version (GPT-3.5) 65 questions about the most prevalent pathologies in rhinology. The focus was learning about the causes, risk factors, treatments, prognosis, and outcomes. We use the Discern questionnaire and a hexagonal radar schema to evaluate the quality of the information. We use Fleiss's kappa statistical analysis to determine the consistency of agreement between different observers. RESULTS: The overall evaluation of the Discern questionnaire resulted in a score of 4.05 (± 0.6). The results in the Reliability section are worse, with an average score of 3.18. (± 1.77). This score is affected by the responses to questions about the source of the information provided. The average score for the Quality section was 3.59 (± 1.18). Fleiss's Kappa shows substantial agreement, with a K of 0.69 (p < 0.001). CONCLUSION: The ChatGPT answers are accurate and reliable. It generates a simple and understandable description of the pathology for the patient's benefit. Our team considers that ChatGPT could be a useful tool to provide information under prior supervision by a health professional.

Molecular Tumor Board Improves Outcomes for Hispanic Patients With Advanced Solid Tumors.

PURPOSE: Multidisciplinary molecular tumor boards (MTBs) decode complex genomic data into clinical recommendations. Although MTBs are well-established in the oncology practice in developed countries, this strategy needs to be better explored in developing countries. Herein, we describe the possible benefits and limitations of the first MTB established in Colombia. METHODS: Demographic, clinical, and genomic information was collected between August 2020 and November 2021. By mid-2020, an MTB strategy was created to discuss clinical cases with one or more genomic alterations identified by next-generation sequencing using an open-access virtual platform. We characterized the patient population as benefiting from the recommended treatment option. We assessed the benefits and access to available targeted therapies that have the potential to change clinical management by making recommendations to treating oncologists on the basis of genomic profiling. However, we did not assess the treatment oncologists' compliance with MTB recommendations because they were not intended to replace clinical judgment/standard of care. RESULTS: A total of 146 patients were included in the discussions of the MTB. The median age was 59 years, and 59.6% were women. Genomic results prompting a change in therapeutic decisions were obtained in 53.1% of patients (95% CI, 44.9 to 61.3). The most prevalent malignancy was non-small-cell lung cancer (51%). Other malignancies represented 60%, 50%, and 30% of patients with soft-tissue sarcomas, brain tumors, and breast cancer, respectively. CONCLUSION: Using an open-access virtual platform, MTBs were feasible in low- and middle-income countries on the basis of the capability to provide the benefits and access to available targeted therapies that are not standard of care. Furthermore, MTB recommendations were made available to the treating oncologist in different locations across Colombia, providing the option to modify clinical management in most of these patients.

Coupling of the Feammox - Anammox pathways by using a sequential discontinuous bioreactor.

Treating nitrogenous compounds in wastewater is a contemporary challenge, prompting novel approaches for ammonium (NH4+) conversion to molecular nitrogen (N2). This study explores the classic anaerobic ammonium oxidation process (Anammox) coupled to the iron-dependent anaerobic ammonium oxidation process (Feammox) in a sequential discontinuous bioreactor (SBR) for NH4+ removal. Feammox and Anammox cultures were individually enriched and combined, optimizing the coupling, and identifying key variables influencing the enrichment process. Adding sodium acetate as a carbon source significantly reduces Fe3+ to Fe2+, indicating Feammox activity. Both Anammox and Feammox processes were successfully operated in SBRs, achieving efficient NH4+ removal (Anammox: 64.6 %; Feammox: 43.4 %). Combining these pathways in a single SBR enhances the NH4+ removal capacity of 50.8 %, improving Feammox efficiency. The Feammox process coupled with Anammox may generate the nitrite (NO2-) needed for Anammox. This research contributes to biotechnological advancements for sustainable nitrogenous compound treatment in SBRs.

European value-based healthcare benchmarking: moving from theory to practice.

BACKGROUND: Value-based healthcare (VBHC) is a conceptual framework to improve the value of healthcare by health, care-process and economic outcomes. Benchmarking should provide useful information to identify best practices and therefore a good instrument to improve quality across healthcare organizations. This paper aims to provide a proof-of-concept of the feasibility of an international VBHC benchmarking in breast cancer, with the ultimate aim of being used to share best practices with a data-driven approach among healthcare organizations from different health systems. METHODS: In the VOICE community-a European healthcare centre cluster intending to address VBHC from theory to practice-information on patient-reported, clinical-related, care-process-related and economic-related outcomes were collected. Patient archetypes were identified using clustering techniques and an indicator set following a modified Delphi was defined. Benchmarking was performed using regression models controlling for patient archetypes and socio-demographic characteristics. RESULTS: Six hundred and ninety patients from six healthcare centres were included. A set of 50 health, care-process and economic indicators was distilled for benchmarking. Statistically significant differences across sites have been found in most health outcomes, half of the care-process indicators, and all economic indicators, allowing for identifying the best and worst performers. CONCLUSIONS: To the best of our knowledge, this is the first international experience providing evidence to be used with VBHC benchmarking intention. Differences in indicators across healthcare centres should be used to identify best practices and improve healthcare quality following further research. Applied methods might help to move forward with VBHC benchmarking in other medical conditions.

Urea como opción terapéutica en síndrome de antidiuresis inadecuada

El síndrome de antiduresis inadecuada (SADI) se produce por una alteración en el eje hipotálamo-neurohipófisis, por una falla en la respuesta regulatoria osmótica o por factores no osmóticos, con complicaciones en relación directa al grado de hiponatremia e impacto en la calidad de vida y mortalidad del paciente. El tratamiento consiste en la normalización de la natremia, y la búsqueda de la etiología. Presentamos el caso de un paciente adulto con el diagnóstico de SADI idiopático y trastorno neurocognitivo asociado, con respuesta favorable al tratamiento con urea.

Syndrome of Inappropriate Antidiuresis (SIAD), is produced by an alteration in the hypothalamus-neurohypophysis axis due to a failure in the osmotic regulatory response or non-osmotic factors, with complications directly related to the degree of hyponatremia and impact on quality of life and patient mortality. Management consists of normalization of natremia, and the search for the underlying etiology. We present the case of an adult patient diagnosed with idiopathic SIAD and associated neurocognitive disorder, with a favorable response to treatment with urea.

Los colirios antibióticos acortan la duración de las conjuntivitis infecciosas en niños / Antibiotic eye drops shorten the duration of infectious conjunctivitis in children

Conclusiones de los autores del estudio: el tratamiento de la conjuntivitis infecciosa aguda en niños con antibióticos tópicos se asoció con una duración significativamente menor de la sintomatología conjuntival. Comentario de los revisores: el uso de antibiótico tópico, aunque de forma modesta, beneficia al paciente, acortando la curación clínica en las conjuntivitis agudas. No obstante, dado el curso autolimitado de esta patología y la falta de estudios de coste-efectividad en este ámbito, no parece justificada su indicación generalizada desde Atención Primaria. Se necesitarían realizar dichos estudios para evaluar el impacto global en la sociedad del tratamiento en estos pacientes. (AU)

Authors´ conclusions: topical antibiotics were associated with significantly shorter durations of conjunctival symptoms in children with acute infective conjunctivitis. Reviewers´ commentary: the use of topical antibiotics modestly benefits the patient, shortening the clinical cure in acute conjunctivitis. However, given the self-limited course of this pathology and the lack of cost-effectiveness studies in this area, its generalized prescription in primary care does not seem justified. Such studies should be carried out to assess the overall impact on society of the treatment of these patients. (AU)

Cocoa Polyphenols Prevent Age-Related Hearing Loss and Frailty in an In Vivo Model.

Age-related hearing loss (ARHL) impairs the quality of life in elderly persons. ARHL is associated with comorbidities, such as depression, falls, or frailty. Frailty syndrome is related to poor health outcomes in old age. ARHL is a potentially modifiable risk factor for frailty. Oxidative stress has been proposed as a key factor underlying the onset and/or development of ARHL and frailty. Cocoa has high levels of polyphenols and provides many health benefits due to its antioxidant properties. Male and female C57Bl/6J mice were randomly assigned to two study groups: animals receiving a cocoa-supplemented diet and the other receiving a standard diet. Then, at the ages of 6, 14, and 22 months, hearing and frailty were measured in all mice. Auditory steady-state responses (ASSR) threshold shifts were measured to different frequencies. The frailty score was based on the "Valencia Score" adapted to the experimental animals. The total antioxidant capacity and total polyphenols in urine samples were also measured. Significant improvements in hearing ability are observed in the cocoa groups at 6, 14, and 22 months compared to the no cocoa group. The cocoa diet significantly retards the development of frailty in mice. Cocoa increases the concentration of polyphenols excreted in the urine, which increases the total antioxidant capacity. In conclusion, cocoa, due to its antioxidant properties, leads to significant protection against ARHL and frailty.

Perceptions of poverty in Spain: differences in the attitudinal profiles between women and men.

Poverty is a multidimensional phenomenon that encompasses privation of education, health or housing. Women show more positive perceptions of poor people, making external attributions for the causes of poverty or the circumstances that explain it. The aim of this study is to analyse perceptions of poverty, identifying the differences in attitudinal profiles between women and men, and the influence of their political and religious beliefs. The sample consists of 278 participants (154 women and 124 men), who completed a sociodemographic questionnaire and the Scale of Attitudes and Stereotypes toward Poverty. The results showed two attitude profiles for women and men, with differences in the first profile, where women or men did not have religious beliefs, had left-wing or centre-left political ideas and favourable attitudes about poverty.

Advanced Lipoproteins and Lipidomic Profile in Plasma Determined by Nuclear Magnetic Resonance Before and After Bariatric Surgery.

BACKGROUND: Obesity is related to cardiovascular risk factors (CVRF) such as dyslipidemia, diabetes, and hypertension, which increase mortality. Basic lipid determinations could underestimate the true atherogenic risk of patients and the impact of bariatric surgery. The objective of the study is to demonstrate the change in the advanced molecular profile of lipoproteins determined by nuclear magnetic resonance spectroscopy in plasma after bariatric surgery, thus reducing the risk of cardiovascular disease. MATERIAL AND METHODS: Descriptive, observational, and prospective study in obese patients undergoing bariatric surgery. Advanced lipid profile was analyzed in plasma from the immediate preoperative period and at the 18th postoperative month by sending samples and performing plasma magnetic resonance spectroscopy in the BiosferTreslab® laboratory. RESULTS: Fifty-two patients were included. Average age of 46.3 years; 63.46% were women, 36.54% men. The average BMI was 43.57; the abdominal perimeter 133.50 cm; 32.6% were diabetics under medical treatment, 44.23% hypertensive, and 19.23% smokers; 86.53% of the patients presented alterations in at least one of the analytical parameters in the lipid study. Twenty-nine (55.7%) underwent banded gastric bypass (PGB), 19.23% underwent GBP, and 17.31% vertical gastrectomy. The rest were revision surgeries, two BPG-A and two biliopancreatic diversions after GV. All patients presented some improvement in advanced molecular profile of lipoproteins. Twenty percent of the patients normalized all the parameters. CONCLUSIONS: Bariatric surgery improves advanced molecular profile of lipoproteins, decreasing CVRF. Analysis of the characteristics of lipoprotein particles by NMR spectrometry is optimal for studying lipoprotein metabolism in patients undergoing bariatric surgery.

Microbial colonization dynamics of the postnatal digestive tract of Bos indicus calves.

The rumen and the jejunum of calves have distinct functional roles; the former is in the storage and fermentation of feed, and the latter is in transporting digesta to the ileum. It is unknown how nutrition changes the evolution of the microbiome of these organs after birth. We sequenced and characterized the entire microbiome of the rumen and the jejunum from Bos indicus calves of the Mexican Tropics to study their dynamics at Days 0, 7, 28, and 42 after birth. Operational taxonomic units (OTUs) belonging to 185 and 222 genera from 15 phylum were observed in the organs, respectively. The most abundant OTUs were Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes. We observed that proteobacterial species were outcompeted after the first week of life by Bacteroidetes and Firmicutes in the rumen and the jejunum, respectively. Moreover, Prevotella species were found to predominate in the rumen (36% of total OTUs), while the jejunum microbiome is composed of small proportions of several genera. Presumably, their high relative abundance assists in specialized functions and is more likely in fermentation since they are anaerobes. In summary, the rumen and the jejunum microbiomes were outcompeted by new microbiomes in a dynamic process that begins at birth.

Study of the key biotic and abiotic parameters influencing ammonium removal from wastewaters by Fe3+-mediated anaerobic ammonium oxidation (Feammox).

The release of ammonia (as NH4+) into water bodies causes serious environmental problems. Therefore, the removal of ammonia from wastewater effluents has become a worldwide concern. New autotrophic biological alternatives for ammonia removal could reduce the limitations of conventional organic carbon-dependent nitrification-denitrification methods. Here, the potential of anaerobic ammonium oxidation coupled to Fe3+ reduction (a process known as Feammox) is studied in wastewater treatment plants of the yeast and beer production industry, not related to ammonium or iron treatment. This process is presented as a viable option to improve the efficiency of ammonia removal from wastewater. The results of this study show that enrichments under Feammox conditions achieved removals of 28.19-32.25% of the total NH4+. The highest rates of ammonium removal and Fe3+ reduction were achieved using FeCl3 as iron source and pH = 7.0. Different environmental conditions for the enrichments were studied and it was found that the use of sodium acetate as a carbon source and an incubation temperature of 35 °C presented higher rates of iron reduction and higher increase in nitrate concentration, related to ammonium oxidative processes. Likewise, the presence of relevant species of the iron and nitrogen cycles as Ferrovum myxofaciens, Geobacter spp, Shewanella spp, Albidiferax ferrireducens and Anammox was verified, supporting the findings of this study. These results provide information that may be relevant to the potential applicability of Feammox to treat wastewater with high ammonia load and could help develop cost-effective and environmentally friendly methods for ammonium removal in wastewater treatment plants.

Mandibular third molar extraction: perceived surgical difficulty in relation to professional training.

BACKGROUND: Establishing the level of surgical difficulty pre-operatively is an essential step in ensuring correct treatment planning. This study set out to determine whether the knowledge and experience acquired by dentists who had received different levels of training influenced, firstly, the perceived levels of difficulty of a variety of cases of mandibular third molar (MTM) extraction and, secondly, the perceived difficulty deriving from a series of factors (patient-related factors, anatomical and radiographic factors, operative factors). METHODS: This cross-sectional, descriptive, observational study took the form of a survey. Using a visual analog scale (VAS), participants evaluated both the perceived difficulty of 30 cases of MTM extraction described by means of digital panoramic radiographs and the perceived difficulty deriving from a series of factors conditioning MTM extraction. The results underwent statistical analysis with SPSS Statistics 28.0 software. Non-parametric tests (Mann Whitney test for independent samples and the Kruskal-Wallis test) were applied. RESULTS: A total of 389 surveys were available for analysis. Dental practioners with no surgical training saw the intervention as presenting greater difficulty. Professionals with postgraduate training in oral surgery considered patient-related factors more important than operative factors, in contrast to dentists who had not received oral surgery training. CONCLUSIONS: Dental training has a signficant influence on the perceived difficulty of MTM extraction and also affects opinions about which factors have greater or lesser influence on surgical difficulty.

Comparing Decentralized Learning Methods for Health Data Models to Nondecentralized Alternatives: Protocol for a Systematic Review.

BACKGROUND: Considering the soaring health-related costs directed toward a growing, aging, and comorbid population, the health sector needs effective data-driven interventions while managing rising care costs. While health interventions using data mining have become more robust and adopted, they often demand high-quality big data. However, growing privacy concerns have hindered large-scale data sharing. In parallel, recently introduced legal instruments require complex implementations, especially when it comes to biomedical data. New privacy-preserving technologies, such as decentralized learning, make it possible to create health models without mobilizing data sets by using distributed computation principles. Several multinational partnerships, including a recent agreement between the United States and the European Union, are adopting these techniques for next-generation data science. While these approaches are promising, there is no clear and robust evidence synthesis of health care applications. OBJECTIVE: The main aim is to compare the performance among health data models (eg, automated diagnosis and mortality prediction) developed using decentralized learning approaches (eg, federated and blockchain) to those using centralized or local methods. Secondary aims are comparing the privacy compromise and resource use among model architectures. METHODS: We will conduct a systematic review using the first-ever registered research protocol for this topic following a robust search methodology, including several biomedical and computational databases. This work will compare health data models differing in development architecture, grouping them according to their clinical applications. For reporting purposes, a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 flow diagram will be presented. CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies)-based forms will be used for data extraction and to assess the risk of bias, alongside PROBAST (Prediction Model Risk of Bias Assessment Tool). All effect measures in the original studies will be reported. RESULTS: The queries and data extractions are expected to start on February 28, 2023, and end by July 31, 2023. The research protocol was registered with PROSPERO, under the number 393126, on February 3, 2023. With this protocol, we detail how we will conduct the systematic review. With that study, we aim to summarize the progress and findings from state-of-the-art decentralized learning models in health care in comparison to their local and centralized counterparts. Results are expected to clarify the consensuses and heterogeneities reported and help guide the research and development of new robust and sustainable applications to address the health data privacy problem, with applicability in real-world settings. CONCLUSIONS: We expect to clearly present the status quo of these privacy-preserving technologies in health care. With this robust synthesis of the currently available scientific evidence, the review will inform health technology assessment and evidence-based decisions, from health professionals, data scientists, and policy makers alike. Importantly, it should also guide the development and application of new tools in service of patients' privacy and future research. TRIAL REGISTRATION: PROSPERO 393126; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=393126. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/45823.

Effect of a dedicated PI-QUAL curriculum on the assessment of prostate MRI quality.

PURPOSE: The Prostate Imaging Quality (PI-QUAL) score is a metric to evaluate the diagnostic quality of multiparametric magnetic resonance imaging (MRI) of the prostate. This study evaluated the impact of a prostate MRI quality training lecture on the participant's ability to assess prostate MRI image quality. METHODS: Eighteen in-training-radiologists of varying experience in reviewing diagnostic prostate MRI assessed the image quality of ten examinations. Then, they attended a dedicated lecture on MRI quality assessment using the PI-QUAL score. After the lecture, the same participants evaluated the image quality of a new set of ten scans applying the PI-QUAL score. Results were assessed using receiver operating characteristic (ROC) analysis. The reference standard was the PI-QUAL score assessed by a fellowship trained abdominal radiologist with experience in reading prostate MRI. RESULTS: There was a significant improvement in the average area under the curve (AUC) for assessment of prostate MRI image quality from baseline (0.82; [0.576 - 0.888]) to post teaching (1.0; [0.954-1]), with an improvement of 0.18 (p < 0.03). When ROC curves were computed for different cohorts stratified based on year of training, difference ranged from 0.48 for second year residents to 0.32 for fourth year residents (p < 0.001-0.01). For abdominal imaging fellows, the pre-teaching AUC was 0.9 [0.557-1] and post teaching AUC was 1 [0.957-1], a difference of 0.1 (p = 0.20). CONCLUSIONS: A dedicated lecture on PI-QUAL improved the ability of radiologists-in-training to assess prostate MRI image quality, with variable impact depending on year of training.

Optogenetic stimulation of the superior colliculus suppresses genetic absence seizures.

While anti-seizure medications are effective for many patients, nearly one-third of individuals have seizures that are refractory to pharmacotherapy. Prior studies using evoked preclinical seizure models have shown that pharmacological activation or excitatory optogenetic stimulation of the deep and intermediate layers of the superior colliculus (DLSC) display multi-potent anti-seizure effects. Here we monitored and modulated DLSC activity to suppress spontaneous seizures in the WAG/Rij genetic model of absence epilepsy. Female and male WAG/Rij adult rats were employed as study subjects. For electrophysiology studies, we recorded single unit activity from microwire arrays placed within the DLSC. For optogenetic experiments, animals were injected with virus coding for channelrhodopsin-2 or a control vector, and we compared the efficacy of continuous neuromodulation to that of closed-loop neuromodulation paradigms. For each, we compared three stimulation frequencies on a within-subject basis (5, 20, 100 Hz). For closed-loop stimulation, we detected seizures in real time based on the EEG power within the characteristic frequency band of spike-and-wave discharges (SWDs). We quantified the number and duration of each SWD during each 2 h-observation period. Following completion of the experiment, virus expression and fibre-optic placement was confirmed. We found that single-unit activity within the DLSC decreased seconds prior to SWD onset and increased during and after seizures. Nearly 40% of neurons displayed suppression of firing in response to the start of SWDs. Continuous optogenetic stimulation of the DLSC (at each of the three frequencies) resulted in a significant reduction of SWDs in males and was without effect in females. In contrast, closed-loop neuromodulation was effective in both females and males at all three frequencies. These data demonstrate that activity within the DLSC is suppressed prior to SWD onset, increases at SWD onset, and that excitatory optogenetic stimulation of the DLSC exerts anti-seizure effects against absence seizures. The striking difference between open- and closed-loop neuromodulation approaches underscores the importance of the stimulation paradigm in determining therapeutic effects.

Secur-e-Health Project: Towards Federated Learning for Smart Pediatric Care.

The application of machine learning (ML) algorithms to electronic health records (EHR) data allows the achievement of data-driven insights on various clinical problems and the development of clinical decision support (CDS) systems to improve patient care. However, data governance and privacy barriers hinder the use of data from multiple sources, especially in the medical field due to the sensitivity of data. Federated learning (FL) is an attractive data privacy-preserving solution in this context by enabling the training of ML models with data from multiple sources without any data sharing, using distributed remotely hosted datasets. The Secur-e-Health project aims at developing a solution in terms of CDS tools encompassing FL predictive models and recommendation systems. This tool may be especially useful in Pediatrics due to the increasing demands on Pediatric services, and the current scarcity of ML applications in this field compared to adult care. Herein we provide a description of the technical solution proposed in this project for three specific pediatric clinical problems: childhood obesity management, pilonidal cyst post-surgical care and retinography imaging analysis.