Statistical and machine learning approaches to predict the necessity for computed tomography in children with mild traumatic brain injury.

BackgroundMinor head trauma in children is a common reason for emergency department visits, but the risk of traumatic brain injury (TBI) in those children is very low. Therefore, physicians should consider the indication for computed tomography (CT) to avoid unnecessary radiation exposure to children. The purpose of this study was to statistically assess the differences between control and mild TBI (mTBI). In addition, we also investigate the feasibility of machine learning (ML) to predict the necessity of CT scans in children with mTBI.Methods and findingsThe study enrolled 1100 children under the age of 2 years to assess pre-verbal children. Other inclusion and exclusion criteria were per the PECARN study. Data such as demographics, injury details, medical history, and neurological assessment were used for statistical evaluation and creation of the ML algorithm. The number of children with clinically important TBI (ciTBI), mTBI on CT, and controls was 28, 30, and 1042, respectively. Statistical significance between the control group and clinically significant TBI requiring hospitalization (csTBI: ciTBI+mTBI on CT) was demonstrated for all nonparametric predictors except severity of the injury mechanism. The comparison between the three groups also showed significance for all predictors (pConclusionsThese results confirm the role and importance of each of the predictors mentioned in the PECARN study and show that ML could discriminate between children with csTBI and the control group

Dialectical Behaviour Therapy For A Woman With Borderline Personality Disorder: A Case Report

Objective: Borderline personality disorder (BPD) is often manifested by maladaptive behaviours such as self-injury. The interpersonal style characteristic of BPD makes it difficult to maintain stable therapeutic relationships, with the patient often discontinuing treatment. Although dialectical behavior therapy (DBT) has been reported to benefit patients with BPD, reports in Asian countries have been few. We herein describe a 22-year-old female with BPD and a history of attempted suicide and self-injury who underwent DBT at our hospital. Methods: Our 6-month DBT consists of 4 parts: weekly psychotherapy by a psychiatrist, weekly skills training by a clinical psychologist and nurse, emergency consultations, and supervision/consultation meetings. Individual psychotherapy and skills training sessions, respectively, were conducted for this patient 24 times. Results: After completing DBT, the number of self-injuries and frequency of suicidal ideation in our patient decreased. Conclusion: Although more costly than standard treatment for BPD, a trial of DBT might be worthwhile in Japanese patients. ASEAN Journal of Psychiatry, Vol. 14 (1): January – June 2013: XX XX

Glycosylceramides Purified from the Japanese Traditional Non-Pathogenic Fungus <i>Aspergillus</i> and <i>Koji</i> Increase the Expression of Genes Involved in Tight Junctions and Ceramide Delivery in Normal Human Epidermal Keratinocytes

Koji, which is used for manufacturing Japanese traditional fermented foods, has long been safely used as a cosmetic product. Although its cosmetic effect has been empirically established, the underlying mechanism has not been reported. We and other groups have previously elucidated that koji contains glycosylceramides, including N-2&#8242;-hydroxyoctadecanoyl-1-O-&#946;-d-glucosyl-9-methyl-4,8-sphingadienine and N-2&#8242;-hydroxyoctadecanoyl-1-O-&#946;-d-galactosyl-9-methyl-4,8-sphingadienine. This led us to hypothesise that koji exerts its cosmetic effect by acting on the keratinocytes through glycosylceramides on the gene level. Therefore, in this study, we investigated the effects of glycosylceramides from various sources on gene expression in normal human epidermal keratinocytes. The results revealed that glycosylceramides purified from white koji and the white koji-producing non-pathogenic fungus Aspergillus luchuensis and A. oryzae increased the expression of occludin (OCLN, an epidermal tight junction protein) and ATP-binding cassette sub-family A member 12 (ABCA12, a cellular membrane transporter), albeit the effect was modest relative to that of ceramides. Indeed, ceramide was increased in the keratinocytes upon koji lipid extract addition. These results indicate that glycosylceramides, which are the major sphingolipids of most natural materials, have an effect of increasing ABCA12 and OCLN expression, and suggest that koji exerts its cosmetic effect by increasing ceramide and tight junctions via glycosylceramides

Accuracy and DT score in 2 and 3 classification.

DT, decision tree.</p

Classification of the predictors based on the statistical significances.

Classification of the predictors based on the statistical significances.</p

Categorization of the predictors.

Categorization of the predictors.</p

Relationship between the risk of mTBIand days of life, showing no apparent charasteristics.

Outcome 0.0 means no risk, outcome 1.0 means mTBI. mTBI, mild traumatic brain injury.</p

Demographic features in control, mTBI on CT, ciTBI and csTBI.

Demographic features in control, mTBI on CT, ciTBI and csTBI.</p