Bipolar disorder

This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of bipolar disorder

A story of she: collective feminist film making at home (between Japan and Scotland).

‘Speculative Fiction: Practicing Collectively’ is the title of the ongoing collective film practice, produced between different people and places, on screen, and in homes, in Scotland and Japan. Situated in critical feminist perspectives, the authors collective approach uses digital spaces as a platform for collaboration and co-learning opportunities, meant as explicitly feminist acts of sharing knowledge and ways of knowing, and mutual learning. In this contemporary moment when COVID-19 has forced the authors to “socially” distance, the online format and cross-cultural nature of the project supports such deliberate sharing practices, and their dialogue across disparate geographies and perspectives. The film is made of three sections, each of which has been produced in different constellations of collaboration, different ways of being together. It will be shown in its entirety at an exhibition at Tokyo Arts and Space in December 2020; the first section of the film, which you can view alongside this short article, was also exhibited online, via a Japanese art and cultural support project in August 2020. This first film was created collectively in response to a theme devised by Natsumi Sakamoto and Rachel Grant: attending to everyday labour, care, and gender roles at home. Sakamoto, a member of Back and Forth Collective, a transnational feminist artist collective founded in Tokyo, invited two Japanese artists from the collective. Duffy, Clarke and McWhinney were invited as artists based in Scotland. This article is also collectively written and edited. The film is still being produced, emerging through three stages of production. The central point of departure for our collaboration was the essay ‘The Carrier Bag Theory of Fiction’ (1986) by speculative feminist writer Ursula K. Le Guin. The first film involved the authors producing short films as individuals, with explicit instructions, to create a narrative around a fictional ‘she’ and to visualise it with film, animation, and performance documentation. This was followed by a lively discussion that addressed gender issues and stereotypes in Japan and the UK, including the controversies around women breastfeeding, motherhood, housework, childcare and care work, which remain too often invisible, un-paid, and undervalued. The following section presents diverse reflections on the key idea –home– in relation to the artists’ individual practices, their work, and/or the making of the first part of our film, which was made in the Spring of 2020, under lockdown. The final section addresses the collective nature of this ongoing experiment

Deep Learning Discovery of Demographic Biomarkers in Echocardiography

Deep learning has been shown to accurately assess 'hidden' phenotypes and predict biomarkers from medical imaging beyond traditional clinician interpretation of medical imaging. Given the black box nature of artificial intelligence (AI) models, caution should be exercised in applying models to healthcare as prediction tasks might be short-cut by differences in demographics across disease and patient populations. Using large echocardiography datasets from two healthcare systems, we test whether it is possible to predict age, race, and sex from cardiac ultrasound images using deep learning algorithms and assess the impact of varying confounding variables. We trained video-based convolutional neural networks to predict age, sex, and race. We found that deep learning models were able to identify age and sex, while unable to reliably predict race. Without considering confounding differences between categories, the AI model predicted sex with an AUC of 0.85 (95% CI 0.84 - 0.86), age with a mean absolute error of 9.12 years (95% CI 9.00 - 9.25), and race with AUCs ranging from 0.63 - 0.71. When predicting race, we show that tuning the proportion of a confounding variable (sex) in the training data significantly impacts model AUC (ranging from 0.57 to 0.84), while in training a sex prediction model, tuning a confounder (race) did not substantially change AUC (0.81 - 0.83). This suggests a significant proportion of the model's performance on predicting race could come from confounding features being detected by AI. Further work remains to identify the particular imaging features that associate with demographic information and to better understand the risks of demographic identification in medical AI as it pertains to potentially perpetuating bias and disparities.Comment: 2450 words, 2 figure, 3 table

Scavenging amphipods of the Angolan deep-sea habitat, with a focus on Abyssorchomene distinctus (Birstein and Vinogradov, 1960) (Amphipoda: Lysianassoidea)

Owing to its vast natural resources and the influence of the Congo River and associated submarine canyon, the Angolan continental margin is of both socioeconomic and ecological interest. The deep-sea ecosystems of the region are nevertheless understudied, and much of the deep-sea fauna remains undescribed. Here, we document the scavenging amphipods of the Angolan deep-sea habitat, which provides valuable new insights into the ecology of Angolan deep-sea scavengers. This can be used as an ecological baseline, against which resource-extraction impacts can be measured. A total of 7996 scavenging amphipods, representing 10 species, were identified. At least four species were new to science. The relatively low scavenger diversity of the region, combined with the large sample sizes, may be indicative of abundant food falls in the region due to the presence of the submarine canyon system. The dominant species across all samples, Abyssorchomene distinctus (Birstein and Vinogradov, 1960), was the focus of a population-level study, which was used to describe the population structure of this species and identify species traits. Of the 826 individuals of A. distinctus dissected and measured, 533 were unsexed juveniles, 149 were male, and 144 were female. Females were significantly larger than males, which is indicative of non-mate-guarding pre-copulatory behaviour, but had significantly shorter antennae, which may indicate that males use chemical cues during mate searching. Two, three, and five discrete size-based cohorts were identified for juveniles, males, and females respectively. No ovigerous females were caught but brood size of A. distinctus was estimated to be 10-38 offspring based on ovary contents

Do we need a core outcome set for childbirth perineal trauma research? A systematic review of outcome reporting in randomised trials evaluating the management of childbirth trauma.

BACKGROUND: Selecting appropriate outcomes to reflect both beneficial and harmful effects is a critical step in designing childbirth trauma trials. OBJECTIVE: To evaluate the outcomes and outcome measures reported in randomised controlled trials evaluating interventions for childbirth trauma. SEARCH STRATEGY: Randomised trials were identified by searching bibliographical databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE. SELECTION CRITERIA: Randomised trials evaluating the efficacy and safety of different techniques in the management of perineal lacerations. DATA COLLECTION AND ANALYSIS: Two researchers independently assessed studies for inclusion, evaluated methodological quality, and extracted the relevant data. Spearman's ρ correlation and multivariate linear regression analysis using the backward stepwise model were used for analysis. MAIN RESULTS: Forty-eight randomised trials, reporting data from 20 308 women, were included. Seventeen different interventions were evaluated. Included trials reported 77 different outcomes and 50 different outcome measures. Commonly reported outcomes included pain (34 trials; 70%), wound healing (20 trials; 42%), and anorectal dysfunction (16 trials, 33%). In the multivariate analysis, no relationship was demonstrated between the quality of outcome reporting and year of publication (P = 0.31), journal impact factor (P = 0.49), and methodological quality (P = 0.13). CONCLUSION: Outcome reporting in childbirth trauma research is heterogeneous. Developing, disseminating, and implementing a core outcome set in future childbirth trauma research could help address these issues. TWEETABLE ABSTRACT: Developing @coreoutcomes for childbirth trauma research could help to reduce #research waste