Outcomes of a 12-week ecologically valid observational study of first treatment with methylphenidate in a representative clinical sample of drug naïve children with ADHD

Randomized placebo-controlled trials have reported efficacy of methylphenidate (MPH) for Attention-deficit/hyperactivity disorder (ADHD); however, selection biases due to strict entry criteria may limit the generalizability of the findings. Few ecologically valid studies have investigated effectiveness of MPH in representative clinical populations of children. This independently funded study aims to describe treatment responses and their predictors during the first 12 weeks of MPH treatment using repeated measurements of symptoms and adverse reactions (ARs) to treatment in 207 children recently diagnosed with ADHD. The children were consecutively included from the Child and Adolescent Mental Health Centre, Mental Health Services, The Capital Region of Denmark. The children (mean age, 9.6 years [range 7–12], 75.4% males) were titrated with MPH, based on weekly assessments of symptoms (18-item ADHD-rating scale scores, ADHD-RS-C) and ARs. At study-end 187 (90.8%) children reached a mean end-dose of 1.0 mg/kg/day. A normalisation/borderline normalisation on ADHD-RS-C was achieved for 168 (81.2%) children on the Inattention and/or the Hyperactivity-Impulsivity subscale in week 12, and 31 (15.0%) children were nonresponders, which was defined as absence of normalisation/borderline normalisation (n = 19) or discontinuation due to ARs (n = 12), and eight (3.8%) children dropped out from follow-up. Nonresponders were characterised by more severe symptoms of Hyperactivity-Impulsivity and global impairment before the treatment. ARs were few; the most prominent were appetite reduction and weight loss. A decrease in AR-like symptoms during the treatment period questions the validity of currently available standard instruments designed to measure ARs of MPH. This ecologically valid observational study supports prior randomized placebo-controlled trials; 81.2% of the children responded favourably in multiple domains with few harmful effects to carefully titrated MPH. Clinical trial registration: ClinicalTrials.gov with registration number NCT04366609

Romantismo e objetividade: notas sobre um panorama do Rio de Janeiro

The article deals with the great Panorama of Rio de Janeiro exhibited in Paris, 1824, and its sources - a series of watercolours which have also generated succeeding engravings produced dur-ing the 1830s. Panoramas, in their early formal conventions are shown to interplay with Romanticism's and Naturphilosophie's theses and to put in motion the legacy of 11th-century paint-ing . As this geme of visual device develops, Rio's watercoulours display symptoms of a gradual dismissal of its initial ambilions, through lhe treatment of the natural site and the city. At last the invention of the daguerreotype and vai d'oiseau urban images, among other traits, signale the changes in sensibility related to the production and consumption of those circular canvasses. From 1840/50 on panoramas conceived by the will to fuse art and science and bya reflection on nature and liberty turn essentially into a mass entertainment.Romantismo e objetividade: notas sobre um panorama do Rio de Janeiro Margarelh da Silva Pereira Enfoca O grande Panorama do Rio de Janeiro, exibido em Paris em 1824, do qual se conhece a série de aquarelas que serviram de base tanto àquela ampliação quanto às sucessivas gravuras da cena que foram produzidas na década de 1830. Busca-se mostrar como os panoramas em sua formalização inicial dialogam com as teses do romantismo e da Naturphilosophie, mobilizan-do heranças da pintura seiscentista. No desenvolvimento desta forma de exibição as aquarelas do Rio apresentam sintomas do gradual afastamento das ambições iniciais através do tratamento dispensado ao sítio natural e à cidade. Por fim, a invenção do daguerreótipo, e as vistas urbanas em võo de pássaro, enlre outros, balizariam a mudança de sensibilidade na produção e na fruição dessas telas circulares. A partir de 1840/50 os panoramas engendrados pelo desejo de fusão entre arte e ciência e pela reflexão sobre a natureza e a liberdade, tornar-se-iam, sobretudo, um divertimento de massas

Subcortical brain volume, regional cortical thickness, and cortical surface area across disorders: findings from the ENIGMA ADHD, ASD, and OCD Working Groups

Objective Attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and obsessive-compulsive disorder (OCD) are common neurodevelopmental disorders that frequently co-occur. We aimed to directly compare all three disorders. The ENIGMA consortium is ideally positioned to investigate structural brain alterations across these disorders. Methods Structural T1-weighted whole-brain MRI of controls (n=5,827) and patients with ADHD (n=2,271), ASD (n=1,777), and OCD (n=2,323) from 151 cohorts worldwide were analyzed using standardized processing protocols. We examined subcortical volume, cortical thickness and surface area differences within a mega-analytical framework, pooling measures extracted from each cohort. Analyses were performed separately for children, adolescents, and adults using linear mixed-effects models adjusting for age, sex and site (and ICV for subcortical and surface area measures). Results We found no shared alterations among all three disorders, while shared alterations between any two disorders did not survive multiple comparisons correction. Children with ADHD compared to those with OCD had smaller hippocampal volumes, possibly influenced by IQ. Children and adolescents with ADHD also had smaller ICV than controls and those with OCD or ASD. Adults with ASD showed thicker frontal cortices compared to adult controls and other clinical groups. No OCD-specific alterations across different age-groups and surface area alterations among all disorders in childhood and adulthood were observed. Conclusion Our findings suggest robust but subtle alterations across different age-groups among ADHD, ASD, and OCD. ADHD-specific ICV and hippocampal alterations in children and adolescents, and ASD-specific cortical thickness alterations in the frontal cortex in adults support previous work emphasizing neurodevelopmental alterations in these disorders

Order and culture. Passages of popularization

I will try to draw a portrait of the political genesis of the museum as a popular institution for national thought and education by examining Europe's first National Museums: the British Museum, the Louvre, the Versailles Museum of the History of France and those museums characterized by an early expression of nationalist feeling before the political institution of the nation state emerged. Their influence grew from enlightened philosophy and they became, in spite of their aspiration of objectivity, major teachers of minor and later pupils.

Danser avec les chevaux

La représentation d’un carrousel marquait l’apogée des festivités d’une cour absolutiste. Les souverains européens s’y affrontaient dans des spectacles équestres à grands frais, avec des balletti a cavalli, afin d’affirmer leur pouvoir et de diffuser leur gloire et leur splendeur à travers les cours européennes.Dans ces exercices équestres représentés publiquement et faisant référence aux festivités équestres de l’Antiquité, le monarque et la noblesse donnaient la preuve de leur hardiesse, de leur adresse à cheval comme l’exigeait la guerre en tant que pratique aristocratique par excellence. Les descriptions des triomphes romains influencèrent fortement les entrées royales à la Renaissance et à l’époque baroque mais aussi les carrousels avec cavaliers, soldats à pied et musiciens, leurs costumes et leur équipement. Au XVIIe siècle, les courses de bague ou les joutes de tête « à la turc » maintinrent les cavaliers en forme physique pour la guerre. En 1776, Marie-Antoinette fit installer comme nouveau divertissement à la cour un manège dans les jardins du Grand Trianon. Les courtisans, désormais inaptes à la guerre mais installés confortablement sur des chevaux de bois, frappaient des bagues attachées à des lanternes en papier (jeu de bague à la chinoise) ; ainsi, des cérémonies équestres de haute voltige se transformèrent en chevaux tournant mécaniquement autour d’un pivot. La conséquence en fut que les carrousels survécurent après le déclin de la culture de cour à partir du XIXe siècle dans les manèges des foires populaires.The presentation of a carrousel at the court of an absolute monarch was the culminating feature of a festive occasion. European sovereigns competed to perform equestrian shows at great expense, using balletti a cavalli to assert their power, to proclaim their glory and splendour throughout the courts of Europe.In these publicly presented horse riding exercises, monarchs and nobility displayed the boldness and skillfulness on horseback necessary in war, an aristocratic exercise par excellence and one which was a reference to the equestrian festivities of Antiquity. Descriptions of Roman triumphal parades strongly influenced royal entries during the Renaissance and the Baroque period as well as the carrousels performed with horse riders, foot soldiers and musicians, their costumes and their equipment. In the 17th century, competitions of ring- or Turk’s-head jousting kept the horsemen physically fit for warfare. In 1776, as a new entertainment at court, Queen Marie-Antoinette had a manège installed in the gardens of the Grand Trianon at Versailles. Courtiers, no longer fit enough to go to war but comfortably seated on wooden horses, hit rings attached to Chinese paper lanterns (jeu de bague à la chinoise); in this way, high-level equestrian celebrations were transformed into horses turning mechanically around a pivot. The outcome was that carrousels have survived (following the decline of court culture in the 19th century) in the form of popular roundabouts at public fairs

Fine Motor Skills in Children with Tourette Syndrome and their Unaffected First-degree Siblings

The exact etiology of Tourette Syndrome (TS) remains unclear, making the search for impaired neuropsychological functions possibly connected to the underlying cause of TS as important as it is challenging. One neuropsychological domain of interest is fine motor skills