Towards a clinical staging for bipolar disorder: defining patient subtypes based on functional outcome.

BACKGROUND: The functional outcome of Bipolar Disorder (BD) is highly variable. This variability has been attributed to multiple demographic, clinical and cognitive factors. The critical next step is to identify combinations of predictors that can be used to specify prognostic subtypes, thus providing a basis for a staging classification in BD. METHODS: Latent Class Analysis was applied to multiple predictors of functional outcome in a sample of 106 remitted adults with BD. RESULTS: We identified two subtypes of patients presenting "good" (n=50; 47.6%) and "poor" (n=56; 52.4%) outcome. Episode density, level of residual depressive symptoms, estimated verbal intelligence and inhibitory control emerged as the most significant predictors of subtype membership at the p<0.05 level. Their odds ratio (OR) and confidence interval (CI) with reference to the "good" outcome group were: episode density (OR=4.622, CI 1.592-13.418), level of residual depressive symptoms (OR=1.543, CI 1.210-1.969), estimated verbal intelligence (OR=0.969; CI 0.945-0.995), and inhibitory control (OR=0.771, CI 0.656-0.907). Age, age of onset and duration of illness were comparable between prognostic groups. LIMITATIONS: The longitudinal stability or evolution of the subtypes was not tested. CONCLUSIONS: Our findings provide the first empirically derived staging classification of BD based on two underlying dimensions, one for illness severity and another for cognitive function. This approach can be further developed by expanding the dimensions included and testing the reproducibility and prospective prognostic value of the emerging classes. Developing a disease staging system for BD will allow individualised treatment planning for patients and selection of more homogeneous patient groups for research purposes

Anisotropic mass density by two-dimensional acoustic metamaterials

We show that specially designed two-dimensional arrangements of full elastic cylinders embedded in a nonviscous fluid or gas define ( in the homogenization limit) a new class of acoustic metamaterials characterized by a dynamical effective mass density that is anisotropic. Here, analytic expressions for the dynamical mass density and the effective sound velocity tensors are derived in the long wavelength limit. Both show an explicit dependence on the lattice filling fraction, the elastic properties of cylinders relative to the background, their positions in the unit cell, and their multiple scattering interactions. Several examples of these metamaterials are reported and discussed.Torrent Martí, D.; Sánchez-Dehesa Moreno-Cid, J. (2008). Anisotropic mass density by two-dimensional acoustic metamaterials. New Journal of Physics. 10. doi:10.1088/1367-2630/10/2/023004S10Sánchez-Pérez, J. V., Caballero, D., Mártinez-Sala, R., Rubio, C., Sánchez-Dehesa, J., Meseguer, F., … Gálvez, F. (1998). Sound Attenuation by a Two-Dimensional Array of Rigid Cylinders. Physical Review Letters, 80(24), 5325-5328. doi:10.1103/physrevlett.80.5325Cervera, F., Sanchis, L., Sánchez-Pérez, J. V., Martínez-Sala, R., Rubio, C., Meseguer, F., … Sánchez-Dehesa, J. (2001). Refractive Acoustic Devices for Airborne Sound. Physical Review Letters, 88(2). doi:10.1103/physrevlett.88.023902Krokhin, A. A., Arriaga, J., & Gumen, L. N. (2003). Speed of Sound in Periodic Elastic Composites. Physical Review Letters, 91(26). doi:10.1103/physrevlett.91.264302Sanchis, L., Håkansson, A., Cervera, F., & Sánchez-Dehesa, J. (2003). Acoustic interferometers based on two-dimensional arrays of rigid cylinders in air. Physical Review B, 67(3). doi:10.1103/physrevb.67.035422Gupta, B. C., & Ye, Z. (2003). Theoretical analysis of the focusing of acoustic waves by two-dimensional sonic crystals. Physical Review E, 67(3). doi:10.1103/physreve.67.036603Garcia, N., Nieto-Vesperinas, M., Ponizovskaya, E. V., & Torres, M. (2003). Theory for tailoring sonic devices: Diffraction dominates over refraction. Physical Review E, 67(4). doi:10.1103/physreve.67.046606Li, J., & Chan, C. T. (2004). Double-negative acoustic metamaterial. Physical Review E, 70(5). doi:10.1103/physreve.70.055602Håkansson, A., Sánchez-Dehesa, J., Cervera, F., Meseguer, F., Sanchis, L., & Llinares, J. (2005). Comment on «Theory of tailoring sonic devices: Diffraction dominates over refraction». Physical Review E, 71(1). doi:10.1103/physreve.71.018601Hou, Z., Wu, F., Fu, X., & Liu, Y. (2005). Effective elastic parameters of the two-dimensional phononic crystal. Physical Review E, 71(3). doi:10.1103/physreve.71.037604Mei, J., Liu, Z., Wen, W., & Sheng, P. (2006). Effective Mass Density of Fluid-Solid Composites. Physical Review Letters, 96(2). doi:10.1103/physrevlett.96.024301Torrent, D., Håkansson, A., Cervera, F., & Sánchez-Dehesa, J. (2006). Homogenization of Two-Dimensional Clusters of Rigid Rods in Air. Physical Review Letters, 96(20). doi:10.1103/physrevlett.96.204302Torrent, D., & Sánchez-Dehesa, J. (2006). Effective parameters of clusters of cylinders embedded in a nonviscous fluid or gas. Physical Review B, 74(22). doi:10.1103/physrevb.74.224305Li, S., George, T. F., Chen, L.-S., Sun, X., & Kuo, C.-H. (2006). Disorder effect on the focus image of sonic crystals in air. Physical Review E, 73(5). doi:10.1103/physreve.73.056615Torrent, D., Sánchez-Dehesa, J., & Cervera, F. (2007). Evidence of two-dimensional magic clusters in the scattering of sound. Physical Review B, 75(24). doi:10.1103/physrevb.75.241404Torrent, D., & Sánchez-Dehesa, J. (2007). Acoustic metamaterials for new two-dimensional sonic devices. New Journal of Physics, 9(9), 323-323. doi:10.1088/1367-2630/9/9/323Berryman, J. G. (1992). Single‐scattering approximations for coefficients in Biot’s equations of poroelasticity. The Journal of the Acoustical Society of America, 91(2), 551-571. doi:10.1121/1.402518Cummer, S. A., & Schurig, D. (2007). One path to acoustic cloaking. New Journal of Physics, 9(3), 45-45. doi:10.1088/1367-2630/9/3/045Leonhardt, U. (2006). Optical Conformal Mapping. Science, 312(5781), 1777-1780. doi:10.1126/science.1126493Pendry, J. B. (2006). Controlling Electromagnetic Fields. Science, 312(5781), 1780-1782. doi:10.1126/science.1125907Twersky, V. (1952). Multiple Scattering of Radiation by an Arbitrary Configuration of Parallel Cylinders. The Journal of the Acoustical Society of America, 24(1), 42-46. doi:10.1121/1.1906845Chen, Y.-Y., & Ye, Z. (2001). Acoustic Attenuation by Two-Dimensional Arrays of Rigid Cylinders. Physical Review Letters, 87(18). doi:10.1103/physrevlett.87.184301Waterman, P. C. (1969). New Formulation of Acoustic Scattering. The Journal of the Acoustical Society of America, 45(6), 1417-1429. doi:10.1121/1.1911619Faran, J. J. (1951). Sound Scattering by Solid Cylinders and Spheres. The Journal of the Acoustical Society of America, 23(4), 405-418. doi:10.1121/1.1906780Chin, S. K., Nicorovici, N. A., & McPhedran, R. C. (1994). Green’s function and lattice sums for electromagnetic scattering by a square array of cylinders. Physical Review E, 49(5), 4590-4602. doi:10.1103/physreve.49.4590Monzon, J., & Damaskos, N. (1986). Two-dimensional scattering by a homogeneous anisotropic rod. IEEE Transactions on Antennas and Propagation, 34(10), 1243-1249. doi:10.1109/tap.1986.114373

Fatal encephalitis associated with novel influenza A (H1N1) virus infection in a child

A 4-year-old girl presented with fever, coughing, and vomiting; followed by unconsciousness. Magnetic resonance imaging showed hyperintense changes in the thalami bilaterally, brain stem, cerebellum, and subcortical cortex. Novel influenza A (H1N1) virus was identified by polymerase chain reaction in patient’s nasopharyngeal swab specimen. We reported a rare case of clinically severe, novel influenza A-associated encephalitis. Novel influenza A should be considered in the differential diagnosis in patients with seizures and mental status changes, especially during an influenza outbreak

Cognitive clusters in first-episode psychosis

Impairments in a broad range of cognitive domains have been consistently reported in some individuals with first-episode psychosis (FEP). Cognitive deficits can be observed during the prodromal stage. However, the course of cognitive deficits is still unclear. The aim of this study was to identify cognitive subgroups over time and to compare their sociodemographic, clinical and functional profiles. A total of 114 patients with Schizophrenia Spectrum Disorders were included in the present study. We assessed subjects through psychiatric scales and eight neuropsychological tests at baseline and at two-year follow-up visit. We performed the Partition Around Medoids algorithm with all cognitive variables. Furthermore, we performed a logistic regression to identify the predictors related to the different cognitive clusters at follow-up. Two distinct subgroups were found: the first cluster characterized by cognitive impairment and a second cluster had relatively intact cognition in comparison with norms. Up to 54.7% of patients with cognitive deficits at baseline tended to improve during the first two years of treatment. Patients with intact cognition at follow-up had a higher socioeconomic status, later age of onset, lower negative symptoms and a higher cognitive reserve (CR) at baseline. CR and age of onset were the baseline variables that predicted cognitive impairment. This research allows us to obtain a better understanding of the heterogeneous profile of psychotic disorders. Identifying the characteristics of patients who will present a cognitive impairment could improve early detection and intervention. These results suggest that enhancing CR could contribute to improving the course of the illness. © 2021 Elsevier B.V

Cognitive clusters in first-episode psychosis

Impairments in a broad range of cognitive domains have been consistently reported in some individuals with first-episode psychosis (FEP). Cognitive deficits can be observed during the prodromal stage. However, the course of cognitive deficits is still unclear. The aim of this study was to identify cognitive subgroups over time and to compare their sociodemographic, clinical and functional profiles. A total of 114 patients with Schizophrenia Spectrum Disorders were included in the present study. We assessed subjects through psychiatric scales and eight neuropsychological tests at baseline and at two-year follow-up visit. We performed the Partition Around Medoids algorithm with all cognitive variables. Furthermore, we performed a logistic regression to identify the predictors related to the different cognitive clusters at follow-up. Two distinct subgroups were found: the first cluster characterized by cognitive impairment and a second cluster had relatively intact cognition in comparison with norms. Up to 54.7% of patients with cognitive deficits at baseline tended to improve during the first two years of treatment. Patients with intact cognition at follow-up had a higher socioeconomic status, later age of onset, lower negative symptoms and a higher cognitive reserve (CR) at baseline. CR and age of onset were the baseline variables that predicted cognitive impairment. This research allows us to obtain a better understanding of the heterogeneous profile of psychotic disorders. Identifying the characteristics of patients who will present a cognitive impairment could improve early detection and intervention. These results suggest that enhancing CR could contribute to improving the course of the illness

Quasi-two-dimensional acoustic metamaterial with negative bulk modulus

We present the experimental realization and characterization of an acoustic metamaterial with negative bulk modulus. The metamaterial consists of a two-dimensional array of cylindrical cavities, and the bulk modulus is controlled by their radius size and length. Experiments are performed in a two-dimensional waveguide where a slab of seven layers is used to extract the parameters of the metamaterial. A complete characterization of the constructed structure is reported, including the dispersion relation of the acoustic bands and the skin depth effect, which both have been measured, and the data are well supported by semianalytical models and by finite-element simulations. © 2012 American Physical Society.This work was supported by the Spanish MICINN under Contracts No. TEC2010-19751 and No. CSD2008-0066 (CONSOLIDER program), and by the USA Office of Naval Research. We acknowledge the technical help by A. Diaz-Rubio and A. Climente. J.S.-D. acknowledges useful discussions with A. Broatch and A. Krokhin. D.T. acknowledges the postdoctoral grant provided by the UPV under the program Campus de excelencia internacional.García Chocano, VM.; Graciá Salgado, R.; Torrent Martí, D.; Cervera Moreno, FS.; Sánchez-Dehesa Moreno-Cid, J. (2012). Quasi-two-dimensional acoustic metamaterial with negative bulk modulus. Physical Review B. 85(18). https://doi.org/10.1103/PhysRevB.85.184102S8518Fok, L., Ambati, M., & Zhang, X. (2008). Acoustic Metamaterials. MRS Bulletin, 33(10), 931-934. doi:10.1557/mrs2008.202Norris, A. N. (2009). Acoustic metafluids. The Journal of the Acoustical Society of America, 125(2), 839-849. doi:10.1121/1.3050288Liu, Z. (2000). Locally Resonant Sonic Materials. Science, 289(5485), 1734-1736. doi:10.1126/science.289.5485.1734Yang, Z., Mei, J., Yang, M., Chan, N. H., & Sheng, P. (2008). Membrane-Type Acoustic Metamaterial with Negative Dynamic Mass. Physical Review Letters, 101(20). doi:10.1103/physrevlett.101.204301Yao, S., Zhou, X., & Hu, G. (2008). Experimental study on negative effective mass in a 1D mass–spring system. New Journal of Physics, 10(4), 043020. doi:10.1088/1367-2630/10/4/043020Park, C. M., Park, J. J., Lee, S. H., Seo, Y. M., Kim, C. K., & Lee, S. H. (2011). Amplification of Acoustic Evanescent Waves Using Metamaterial Slabs. Physical Review Letters, 107(19). doi:10.1103/physrevlett.107.194301Fang, N., Xi, D., Xu, J., Ambati, M., Srituravanich, W., Sun, C., & Zhang, X. (2006). Ultrasonic metamaterials with negative modulus. Nature Materials, 5(6), 452-456. doi:10.1038/nmat1644Wang, Z. G., Lee, S. H., Kim, C. K., Park, C. M., Nahm, K., & Nikitov, S. A. (2008). Acoustic wave propagation in one-dimensional phononic crystals containing Helmholtz resonators. Journal of Applied Physics, 103(6), 064907. doi:10.1063/1.2894914Two-dimensional acoustic metamaterial with negative modulus. (2010). Journal of Applied Physics, 108(7), 074911. doi:10.1063/1.3493155Fey, J., & Robertson, W. M. (2011). Compact acoustic bandgap material based on a subwavelength collection of detuned Helmholtz resonators. Journal of Applied Physics, 109(11), 114903. doi:10.1063/1.3595677Li, J., & Chan, C. T. (2004). Double-negative acoustic metamaterial. Physical Review E, 70(5). doi:10.1103/physreve.70.055602Lee, S. H., Park, C. M., Seo, Y. M., Wang, Z. G., & Kim, C. K. (2010). Composite Acoustic Medium with Simultaneously Negative Density and Modulus. Physical Review Letters, 104(5). doi:10.1103/physrevlett.104.054301Torrent, D., & Sánchez-Dehesa, J. (2011). Multiple scattering formulation of two-dimensional acoustic and electromagnetic metamaterials. New Journal of Physics, 13(9), 093018. doi:10.1088/1367-2630/13/9/093018Torrent, D., & Sánchez-Dehesa, J. (2008). Anisotropic mass density by two-dimensional acoustic metamaterials. New Journal of Physics, 10(2), 023004. doi:10.1088/1367-2630/10/2/023004Pendry, J. B., & Li, J. (2008). An acoustic metafluid: realizing a broadband acoustic cloak. New Journal of Physics, 10(11), 115032. doi:10.1088/1367-2630/10/11/115032Torrent, D., & Sánchez-Dehesa, J. (2010). Anisotropic Mass Density by Radially Periodic Fluid Structures. Physical Review Letters, 105(17). doi:10.1103/physrevlett.105.174301Spiousas, I., Torrent, D., & Sánchez-Dehesa, J. (2011). Experimental realization of broadband tunable resonators based on anisotropic metafluids. Applied Physics Letters, 98(24), 244102. doi:10.1063/1.3599849Li, J., Fok, L., Yin, X., Bartal, G., & Zhang, X. (2009). Experimental demonstration of an acoustic magnifying hyperlens. Nature Materials, 8(12), 931-934. doi:10.1038/nmat2561Fokin, V., Ambati, M., Sun, C., & Zhang, X. (2007). Method for retrieving effective properties of locally resonant acoustic metamaterials. Physical Review B, 76(14). doi:10.1103/physrevb.76.144302Torrent, D., Håkansson, A., Cervera, F., & Sánchez-Dehesa, J. (2006). Homogenization of Two-Dimensional Clusters of Rigid Rods in Air. Physical Review Letters, 96(20). doi:10.1103/physrevlett.96.20430

Detection of kinase domain mutations in BCR::ABL1 leukemia by ultra-deep sequencing of genomic DNA

The screening of the BCR::ABL1 kinase domain (KD) mutation has become a routine analysis in case of warning/failure for chronic myeloid leukemia (CML) and B-cell precursor acute lymphoblastic leukemia (ALL) Philadelphia (Ph)-positive patients. In this study, we present a novel DNA-based next-generation sequencing (NGS) methodology for KD ABL1 mutation detection and monitoring with a 1.0E−4 sensitivity. This approach was validated with a well-stablished RNA-based nested NGS method. The correlation of both techniques for the quantification of ABL1 mutations was high (Pearson r = 0.858, p < 0.001), offering DNA-DeepNGS a sensitivity of 92% and specificity of 82%. The clinical impact was studied in a cohort of 129 patients (n = 67 for CML and n = 62 for B-ALL patients). A total of 162 samples (n = 86 CML and n = 76 B-ALL) were studied. Of them, 27 out of 86 harbored mutations (6 in warning and 21 in failure) for CML, and 13 out of 76 (2 diagnostic and 11 relapse samples) did in B-ALL patients. In addition, in four cases were detected mutation despite BCR::ABL1 < 1%. In conclusion, we were able to detect KD ABL1 mutations with a 1.0E−4 sensitivity by NGS using DNA as starting material even in patients with low levels of disease.Tis project was funded in part by CRIS CANCER FOUNDATION

Obstetric–Neonatal Care during Birth and Postpartum in Symptomatic and Asymptomatic Women Infected with SARS-CoV-2: A Retrospective Multicenter Study

Data Availability Statement: Data are available upon reasonable request. All necessary data are supplied and available in the manuscript; however, the corresponding author will provide the dataset upon request. All data relevant to the study are included in the article.Copyright © 2022 by the authors. This study analyses the obstetric–neonatal outcomes of women in labour with symptomatic and asymptomatic COVID-19. A retrospective, multicenter, observational study was carried out between 1 March 2020 and 28 February 2021 in eight public hospitals in the Valencian community (Spain). The chi-squared test compared the obstetric–neonatal outcomes and general care for symptomatic and asymptomatic women. In total, 11,883 births were assisted in participating centers, with 10.9 per 1000 maternities (n = 130) infected with SARS-CoV-2. The 20.8% were symptomatic and had more complications both upon admission (p = 0.042) and during puerperium (p = 0.042), as well as transfer to the intensive care unit (ICU). The percentage of admission to the Neonatal Intensive Care Unit (NICU) was greater among offspring of symptomatic women compared to infants born of asymptomatic women (p < 0.001). Compared with asymptomatic women, those with symptoms underwent less labour companionship (p = 0.028), less early skin-to-skin contact (p = 0.029) and greater mother–infant separation (p = 0.005). The overall maternal mortality rate was 0.8%. No vertical transmission was recorded. In conclusion, symptomatic infected women are at increased risk of lack of labour companionship, mother–infant separation, and admission to the ICU, as well as to have preterm births and for NICU admissions.FISABIO grant number UGP-20-24

Opposite cannabis-cognition associations in psychotic patients depending on family history

The objective of this study is to investigate cognitive performance in a first-episode psychosis sample, when stratifying the interaction by cannabis use and familial or non-familial psychosis. Hierarchical-regression models were used to analyse this association in a sample of 268 first-episode psychosis patients and 237 controls. We found that cannabis use was associated with worse working memory, regardless of family history. However, cannabis use was clearly associated with worse cognitive performance in patients with no family history of psychosis, in cognitive domains including verbal memory, executive function and global cognitive index, whereas cannabis users with a family history of psychosis performed better in these domains. The main finding of the study is that there is an interaction between cannabis use and a family history of psychosis in the areas of verbal memory, executive function and global cognition: that is, cannabis use is associated with a better performance in patients with a family history of psychosis and a worse performance in those with no family history of psychosis. In order to confirm this hypothesis, future research should explore the actual expression of the endocannabinoid system in patients with and without a family history of psychosis