Child abuse in a medical setting: Case illustrations of two variants of munchausen sindrome by proxy

Munchausen syndrome is a complex type of abuse, which is often underdiagnosed or misdiagnosed in clinical practice, and has harmful consequences for children. Its relationship with child abuse, of which it is a variety, must be recognized in clinical and forensic practice. The authors report herein two observed cases of different types of Münchausen syndrome by proxy (MSbP). The first, is the most severe form of MSbP, with induced, true illness and related pathological symptoms into victim. The second case is a moderate form, much more complex to detect, in which a perpetrator parent simulates and aggravates the childâs illness. Adequate training of health professionals and investigators is essential in revealing cases of MSbP. Diagnosis must be based on the study of the different forms of âabuseâ and the knowledge of clinical protocols used to validate any suspected behaviour which could be potentially harmful to the child. Moreover, a lack of training may lead to misleading interpretations of medical history interpretation and fallacious conclusions. Our study aims to review the features that are to be considered in a suspected case of MSbP, in accordance with a recently updated consensus statement by the Committee on Child Abuse and Neglect from the American Academy of Pediatrics

Monitoring the quality and perception of service in colombian public service companies with twitter and descriptive temporal analysis

The main goal of this research is to analyze the perception of service in public sector companies in the city of Bogota via Twitter and text mining to identify areas, problems, and topics aiming for quality service improvement. To achieve this objective, a structured method for data modeling is implemented based on the KDD methodology. Tweets from January to June 2022 related to the companies in the sector are processed, and a temporal analysis of the evolution of sentiment is performed based on the dictionaries Bing, AFINN, and NRC. Subsequently, the LDA algorithm (Latent Dirichlet Allocation algorithm) is used to visually identify the topics with the greatest negative impact reported by the users in each of the 6 months by adding the temporal dimension. The results revealed that, for Aqueduct (water supply service), the topic with the highest dissatisfaction is related to the “Water Tank Request” processes; for Enel (energy services) “Service Outages”; and for Vanti (gas services), “Case solution and request information”. Temporal patterns of tweets, sentiments, and topics are also highlighted for the three companies.Peer ReviewedPostprint (published version

The Broad Autism (Endo)Phenotype: Neurostructural and Neurofunctional Correlates in Parents of Individuals with Autism Spectrum Disorders

Autism Spectrum Disorders (ASD) are a set of neurodevelopmental disorders with an early-onset and a strong genetic component in their pathogenesis. According to genetic and epidemiological data, ASD relatives present personality traits similar to, but not as severe as the defining features of ASD, which have been indicated as the "Broader Autism Phenotype" (BAP). BAP features seem to be more prevalent in first-degree relatives of individuals with ASD than in the general population. Characterizing brain profiles of relatives of autistic probands may help to understand ASD endophenotype. The aim of this review was to provide an up-to-date overview of research findings on the neurostructural and neurofunctional substrates in parents of individuals with ASD (pASD). The primary hypothesis was that, like for the behavioral profile, the pASD express an intermediate neurobiological pattern between ASD individuals and healthy controls. The 13 reviewed studies evaluated structural magnetic resonance imaging (MRI) brain volumes, chemical signals using magnetic resonance spectroscopy (MRS), task-related functional activation by functional magnetic resonance imaging (fMRI), electroencephalography (EEG), or magnetoencephalography (MEG) in pASD.The studies showed that pASD are generally different from healthy controls at a structural and functional level despite often not behaviorally impaired. More atypicalities in neural patterns of pASD seem to be associated with higher scores at BAP assessment. Some of the observed atypicalities are the same of the ASD probands. In addition, the pattern of neural correlates in pASD resembles that of adult individuals with ASD, or it is specific, possibly due to a compensatory mechanism. Future studies should ideally include a group of pASD and HC with their ASD and non-ASD probands respectively. They should subgrouping the pASD according to the BAP scores, considering gender as a possible confounding factor, and correlating these scores to underlying brain structure and function. These types of studies may help to understand the genetic mechanisms involved in the various clinical dimension of ASD

Further characterization of NFIB-associated phenotypes: Report of two new individuals

Nuclear Factor I B (NFIB) haploinsufficiency has recently been identified as a cause of intellectual disability (ID) and macrocephaly. Here we report on two new individuals carrying a microdeletion in the chromosomal region 9p23-p22.3 containing NFIB. The first is a 7-year 9-month old boy with developmental delays, ID, definite facial anomalies, and brain and spinal cord magnetic resonance imaging findings including periventricular nodular heterotopia, hypoplasia of the corpus callosum, arachnoid cyst in the left middle cranial fossa, syringomyelia in the thoracic spinal cord and distal tract of the conus medullaris, and a stretched appearance of the filum terminale. The second is a 32-year-old lady (the proband' mother) with dysmorphic features, and a history of learning disability, hypothyroidism, poor growth, left inguinal hernia, and panic attacks. Her brain magnetic resonance imaging findings include a dysmorphic corpus callosum, and a small cyst in the left choroidal fissure that marks the hippocampal head. Array-based comparative genomic hybridization identified, in both, a 232 Kb interstitial deletion at 9p23p22.3 including several exons of NFIB and no other known genes. Our two individuals add to the knowledge of this rare disorder through the addition of new brain and spinal cord MRI findings and dysmorphic features. We propose that NFIB haploinsufficiency causes a clinically recognizable malformation-ID syndrome

Uso de la tierra y ambiente local de descomposición en el Chaco Semiárido de Córdoba, Argentina

El cambio en el uso de la tierra es un proceso clave debido a sus efectos directos sobre la identidady la estructura de la vegetación. En el Chaco Semiárido se conoce poco acerca del impacto de los cambios en lavegetación sobre los procesos relacionados con el ciclado de nutrientes (e.g., la descomposición). En este trabajoanalizamos si las modificaciones en la vegetación, producto de distintas intensidades en el uso de la tierra,producen cambios en las condiciones del ambiente local, y si estos cambios afectan el patrón de descomposiciónde dos materiales comunes. En las configuraciones vegetales analizadas encontramos que el cambio en el usode la tierra tiene un impacto evidente sobre la cobertura vegetal, aunque no se traduce en cambios consistentesen el ambiente local de descomposición. Específicamente, encontramos que el incremento en la intensidad deuso se asoció a la disminución de la cobertura vegetal, de la altura de esa cobertura y de la cantidad de brozadepositada sobre el suelo. Estas modificaciones estuvieron vinculadas a una disminución del contenido totalde C y N en el suelo. Sin embargo, los cambios en la estructura de la vegetación no se relacionaron con loscambios en las condiciones ambientales locales (temperatura y humedad), pese a que se detectaron diferenciasen esas variables ambientales entre las distintas configuraciones vegetales. Por su parte, la descomposiciónfue mayor en aquellos sitios con menor cobertura vegetal, que a su vez, presentaron menor temperatura delaire. Estos resultados sugieren que el cambio en el uso de la tierra tiene un impacto muy evidente sobre lacobertura de la vegetación, pero este impacto no se traduce en cambios consistentes en el ambiente local dedescomposición. En estudios futuros será interesante evaluar la contribución de los procesos de degradaciónabiótica (fotodegradación y fragmentación física) sobre la descomposición y el ciclado de nutrientes.Land use and local decomposition environment in the Semiarid Chaco of Córdoba, Argentina. Land use change is a key process due to its direct effects on the identity and structure of vegetation. In semiarid Argentinean Chaco, there is scarse information about the consequences of vegetation changes on processes related to nutrient cycling (e.g., decomposition). In this work, we analyse if changes in local climatic conditions due to changes in vegetation structure, related to different land use types, affect decomposition pattern of two common materials. We found that land use change has a clear impact on vegetation cover, but this impact is not reflected into a consistent change in local decomposition environment. Specifically, we found that more intensive land use types were related to a decrease in vegetation cover and height and also to less litter quantity. These changes were associated with lower soil C and N. However, changes in vegetation structure were not related with changes of local climatic conditions, despite the differences of climatic conditions between vegetal configurations. Decomposition of common materials was faster in vegetal configurations with lower vegetation cover and air temperature. These results suggest that land use change has an evident impact on vegetation cover, but this impact is not transferred on changes of local decomposition environment. In future studies is important to evaluate the contribution of abiotic deterioration processes (photodegradation and physical fragmentation) on decomposition and nutrient cycling.Fil: Cuchietti, Anibal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Marcotti, Eugenia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Conti, Georgina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Casanoves, Fernando. Centro Agronómico Tropical de Investigación y Enseñanza; Costa RicaFil: Mazzarino, Maria Julia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones en Biodiversidad y Medioambiente. Universidad Nacional del Comahue. Centro Regional Universidad Bariloche. Instituto de Investigaciones en Biodiversidad y Medioambiente; ArgentinaFil: Vaieretti, Maria Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Díaz, Sandra Myrna. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Pérez Harguindeguy, Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; Argentin

Moving Toward Telehealth Surveillance Services for Toddlers at Risk for Autism During the COVID-19 Pandemic

Since 2016, the project "Early Bird Diagnostic Protocol for Autism Spectrum Disorders (ASD)" funded by the Italian Ministry of Health has been operative at IRCCS Fondazione Stella Maris (FSM), Pisa (IT), with the main aim of developing early age-specific diagnostic protocols by longitudinally enrolling two different populations at risk for ASD: (i) toddlers with older siblings with ASD (FR) and (ii) toddlers referred by a child psychiatrist or pediatrician for suspected ASD (CR). On January 30, 2020, when the World Health Organization declared the outbreak of coronavirus disease 2019 (COVID-19), 136 patients (85 FR; 51 CR; 93 males; 43 females) had been enrolled in the project with 324 completed time points and 64 still missing. Considering both the huge psychological burden on families with toddlers at risk for ASD during the lockdown and the longitudinal studies reporting the positive "surveillance effect" in terms of a better outcome in at-risk toddlers, our priority has been to maintain regular contact and support to enrolled families. To do this, the research team, being authorized for smart-working research activities, has set up a detailed remote surveillance protocol (RSP). The RSP includes three online interviews and one online video registration of parent-child play. In the current community case study, the authors report the telehealth procedure and discuss possible future directions in developing remote assessment and new evaluation modalities for ecological parent-child play video recordings in at-risk populations. Hopefully, the surveillance protocol will further improve our ability to detect risk and activate early tailored intervention

Normalized compression distance to measure cortico-muscular synchronization

The neuronal functional connectivity is a complex and non-stationary phenomenon creating dynamic networks synchronization determining the brain states and needed to produce tasks. Here, as a measure that quantifies the synchronization between the neuronal electrical activity of two brain regions, we used the normalized compression distance (NCD), which is the length of the compressed file constituted by the concatenated two signals, normalized by the length of the two compressed files including each single signal. To test the NCD sensitivity to physiological properties, we used NCD to measure the cortico-muscular synchronization, a well-known mechanism to control movements, in 15 healthy volunteers during a weak handgrip. Independently of NCD compressor (Huffman or Lempel Ziv), we found out that the resulting measure is sensitive to the dominant-non dominant asymmetry when novelty management is required (p = 0.011; p = 0.007, respectively) and depends on the level of novelty when moving the nondominant hand (p = 0.012; p = 0.024). Showing lower synchronization levels for less dexterous networks, NCD seems to be a measure able to enrich the estimate of functional two-node connectivity within the neuronal networks that control the body

Bruxismo de la vigilia

El bruxismo del sueño ha sido extensamente estudiado en las últimas décadas pero aún persiste una considerable controversia científica en relación al bruxismo de la vigilia. El presente trabajo de revisión se focalizó en este tema, incluyendo 45 artículos publicados entre los años 2011 al año 2020. Los consensos internacionales plantean avances en nuevas clasificaciones diagnósticas, que contemplan herramientas como cuestionarios, examen clínico, electromiografía, polisomnografía, evaluación ecológica momentánea y métodos de muestreo de experiencias. Se considera al bruxismo de la vigilia un problema comportamental, pasible de ser tratado mediante terapias comportamentales que lo controlen. La evaluación ecológica momentánea permite capturar información comportamental en tiempo real y se presenta como una herramienta valiosa para el diagnóstico y evaluación del bruxismo de la vigilia. A pesar de numerosos avances presentados en esta revisión, aún se requieren estudios que exploren esta área del conocimiento, especialmente en los mecanismos fisiopatológicos y los posibles tratamientos