Differential diagnosis of autism spectrum disorder and global developmental delay based on machine learning and Children Neuropsychological and Behavioral Scale / 中国当代儿科杂志

OBJECTIVES@#To investigate the efficacy and required indicators of Children Neuropsychological and Behavioral Scale-Revision 2016 (CNBS-R2016) in the differential diagnosis of autism spectrum disorder (ASD) and global developmental delay (GDD).@*METHODS@#A total of 277 children with ASD and 415 children with GDD, aged 18-48 months, were enrolled as subjects. CNBS-R2016 was used to assess the developmental levels of six domains, i.e., gross motor, fine motor, adaptive ability, language, social behavior, and warning behavior, and a total of 13 indicators on intelligence age and developmental quotient (DQ) were obtained as the input features. Five commonly used machine learning classifiers were used for training to calculate the classification accuracy, sensitivity, and specificity of each classifier.@*RESULTS@#DQ of warning behavior was selected as the first feature in all five classifiers, and the use of this indicator alone had a classification accuracy of 78.90%. When the DQ of warning behavior was used in combination with the intelligence age of warning behavior, gross motor, and language, it had the highest classification accuracy of 86.71%.@*CONCLUSIONS@#Machine learning combined with CNBS-R2016 can effectively distinguish children with ASD from those with GDD. The DQ of warning behavior plays an important role in machine learning, and its combination with other features can improve classification accuracy, providing a basis for the efficient and accurate differential diagnosis of ASD and GDD in clinical practice.

Evaluación del uso de fármacos y conducta en pacientes con síndrome X frágil / Asessment of pharmacological freatment and behavioral changes in patients with fragile X syndrome

El Síndrome X Frágil (SXF) es la principal causa heredada de Discapacidad intelectual (DI) y Trastorno del espectro autista (TEA). Se caracteriza por presentar un fenotipo conductual asociado a hiperactividad, déficit atencional, impulsividad, ansiedad, trastornos conductuales, espectro autista y retraso global del desarrollo. No existe actualmente un tratamiento farmacológico para el trastorno genético de base. El tratamiento farmacológico se focaliza en los síntomas que interfieren con la calidad de vida y aprendizaje, entre ellos la irritabilidad e hiperactividad. OBJETIVO: Evaluar cambios conductuales a través de la escala conductual ABC, de pacientes masculinos con diagnóstico de SXF tratados con psicoestimulantes y/o antipsicóticos en comparación a controles. MÉTODO: Se evalúa a 40 pacientes hombres con diagnóstico de SXF entre los años 2014 y 2017. Se utiliza la evaluación de la conducta mediante el puntaje en la subescala de irritabilidad e hiperactividad de la encuesta ABC-C y el registro de fármacos indicados. Se compara la sintomatología conductual en pacientes que no utilizan fármacos, aquellos que utilizan antipsicóticos, los que usan psicoestimulantes y pacientes tratados con ambos fármacos. RESULTADOS: La mediana de edad fue de 15,1 (±9,3) años. Del total de pacientes, el 42,5% reportó uso de fármacos, de éstos el 35% utilizó psicoestimulantes, 35% antipsicóticos y 30% la combinación de ambos. Se observa que solo el grupo que recibe tratamiento con psicoestimulantes y antipsicóticos en forma simultánea presenta diferencias con el subgrupo sin tratamiento farmacológico. CONCLUSIONES: En más de la mitad de nuestros pacientes se decide no utilizar tratamiento farmacológico. Sin embargo, dichos pacientes igualmente presentan sintomatología de irritabilidad e hiperactividad. Los pacientes que recibieron terapia asociada de psicoestimulantes y antipsicóticos presentan puntajes significativamente más altos en la escala de irritabilidad que aquellos que no recibieron tratamiento farmacológico. Este grupo, que constituye el 12,5% del total de la muestra, presenta un fenotipo conductual que genera mayores dificultades en la calidad de vida del paciente y su entorno.

Fragile X Syndrome (FXS) is the main inherited cause of Intellectual Disability and Autism Spectrum Disorder. It characteristically presents as a behavioral phenotype asso- ciated with hyperactivity, attention deficit, impulsivity, anxiety, behavioral disorders, autistic spectrum and global developmental delay. There is currently no pharmacological treatment for the underlying genetic disorder. Pharmacological treatment targets symptoms that interfere with quality of life and learning, including irritability and hyperactivity.OBJECTIVE: To evaluate behavioral changes through the ABC behavioral scale of male patients diagnosed with FXS treated with psychostimulants and / or antipsychotics compared to controls. METHOD: 40 male patients with a diagnosis of FXS between 2014 and 2017 were evaluated. The behavioral assessment was done by scoring the irritability and hyperactivity subscale of the ABC-C survey and by registering the prescribed drug. Behavioral symptomatology was compared in patients who do not use drugs, those who use antipsychotics, those who use psychostimulants and patients treated with both drugs. RESULTS: The median age was 15.1 (± 9.3) years. Of the total of patients, 42.5% were prescribed drugs, of these 35% used psychostimulants, 35% antipsychotics and 30% the combination of both. It was observed that the group that received treatment with both psychostimulants and antipsychotics simultaneously presented differences with the subgroup without pharmacological treatment.CONCLUSIONS: In more than half of our patients no pharmacological treatment is prescribed. However, these patients also show symptoms of irritability and hyperactivity. Patients who received associated therapy of psychostimulants and antipsychotics have significantly higher scores on the irritability scale than those who did not receive pharmacological treatment. This group, which constitutes 12.5% of the total sample, has a behavioral phenotype that generates greater difficulties in the patient's quality of life and their environment.

Reliability and validity of Chinese version of State Behavioral Scale for mechanically ventilated children / 中国实用护理杂志

Objective To test the reliability and validity of the Chinese version of State Behavioral Scale for Mechanically Ventilated Children (SBS). Methods The English version of SBS was revised and translated into Chinese version. The reliability and validity of the Chinese version of SBS was tested in 172 mechanically ventilated children. Results The Cronbach α coefficient of the Chinese SBS was 0.986. The item-level content validity index of Chinese SBS were 0.83-0.10, and the scale- level content validity index of Chinese SBS was 0.932. The correlation coefficient between the score of Chinese SBS and the Comfort Scale (CS) was 0.919 (P<0.01). Conclusions The Chinese version of SBS has been proved to be reliable and valid.It can be used to sedation assessment for mechanically ventilated children.

Comparing the Behavioral Patterns and Psychological Characteristics of Web Board Gamers and Gamblers

OBJECTIVE: In Korea, online board games, such as “flower cards,” are played using virtual money. In contrast, Internet-based gambling (ibGambling) concerns the use of real money to gamble online. We hypothesized that online board gamers using virtual money show less risky behaviors than do gamblers who use real money, and that, in regard to psychological aspects, online board gamers are less depressed and more introverted than online gamblers are. METHODS: For this study, 100 online board gamers, 100 ibGamblers, 100 offline gamblers (offGamblers), and 100 age- and sex-matched healthy controls were recruited by an online research company. Gambling behavior and self-efficacy were assessed using the Korean Gambling Behavior Scale-high/low factors (KGBS-H/L) and the Gambling Abstinence Self-efficacy Scale (GASS). Additionally, introversion, depression, and mania tendency were assessed. RESULTS: Online board gamers had good intentions gaming, as evidenced by their higher KGBS-L scores than ibGamblers and offGamblers, and they showed less risky behaviors, as evidenced by their lower KGBS-H scores than offGamblers. Additionally, online board gamers were less introverted than ibGamblers and less depressed than offGamblers. CONCLUSION: Online board gaming could be a gateway to the world of gambling (ibGambling or OffGambling). However, the higher tendency of online board gamers to engage in good intentioned gaming could help prevent online board gaming from progressing to online or offline gambling.

Development and applications of the SWAN rating scale for assessment of attention deficit hyperactivity disorder: a literature review

This study reviewed the use of the Strengths and Weaknesses of Attention-Deficit/Hyperactivity-symptoms and Normal-behaviors (SWAN) rating scale in diagnostic and evolutive approaches to attention deficit hyperactivity disorder (ADHD) and in correlational studies of the disorder. A review of articles published in indexed journals from electronic databases was conducted and 61 articles on the SWAN scale were analyzed. From these, 27 were selected to a) examine use of SWAN in research on attention disorders and b) verify evidence of its usefulness in the areas of genetics, neuropsychology, diagnostics, psychiatric comorbidities, neuroimaging, pharmacotherapy, and to examine its statistical reliability and validity in studies of diverse populations. This review of articles indicated a growing use of the SWAN scale for diagnostic purposes, for therapy, and in research on areas other than ADHD, especially when compared with other reliable scales. Use of the scale in ADHD diagnosis requires further statistical testing to define its psychometric properties.

Avances nosológicos de las demencias. Caracterización de los pacientes con demencia frontotemporal / Clinical characterization of the fronto-temporal dementia patients

En la última década se ha dado un marcado avance en el cono-cimiento de la enfermedad de Alzheimer (EA), pero no en otras demencias. Es así como las características clínicas y psicométri-cas de los pacientes con demencia frontotemporal (DFT) -segun-da causa de demencias degenerativas primarias-, empiezan a ser descritas en series de casos de los principales centros del mundo, donde se tiene la posibilidad de realizar diagnóstico por consenso por grupos de expertos. Por tal motivo se analizó una muestra de pacientes de la Clínica de Memoria del Hospital Universitario de San Ignacio (Bogotá, Colombia), en donde fueron evaluadas en forma protocolizada 348 personas, de las cuales 45 cumplían criterios de DFT, 259 para EA y 44 eran controles. El análisis es-tadístico se realizó con la prueba de comparación Kruskal Wallis (significación del 5 por ciento), teniendo como medida de análisis el rango intercuartílico. Todas las diferencias señaladas fueron el producto de pruebas con valores de p< 0.017. Los hallazgos que mejor definían al los pacientes con DFT eran: mayor predominio de hombres (73 por ciento vs. 31 por ciento en los que tenían EA), edad menor (mediana 65 años vs. mediana de 76 años en los que tenían EA), escala comportamental de Columbia más comprometida (mediana de 10 vs. 7 en pacientes con EA y 1 en los controles) y minimental más deteriorado en comparación con el grupo control (mediana de 24 vs. 27) pero mejor que los pacientes que tenían EA (mediana de 24 vs. 20). Estos hallazgos nos ayudan a poder definir mejor el perfil clínico y psicométrico de los pacientes con DFT, pero a su vez nos abren nuevos interrogantes que iremos despejando en la medida en que podamos hacer un seguimiento longitudinal de estas personas.[Cano CA, Ramírez CA. Avances nosológicos de las demencias. Caracterización de los pacientes con demencia frontotemporal. MedUNAB 2004; 7:84-8]

Clinical characterization of the fronto-temporal dementia patients. Thee clinical and psychometric profiles of patients with fronto-tem-poral dementia (FTD) has been recently described as cases series from the most important research centers of the world, where there is the possibility for a diagnosis by a consensus criteria. In this article, a group of patients from the Memory Clinic at the Hospital Universitario de San Ignacio, in Bogotá City has been studied. Three hundred and forty eight patients were studied by the Memory Clinic Group, of which 45 had the criteria for FTD, 259 the criteria for Alzheimer's disease (AD) and 44 were controls. The statistical analysis was realized with the best distinctions to define the FTD group were: predominance of men (73% vs. 31% in AD), younger age of onset (65 years vs. 76 years in AD) Columbia Behavioral Scale more compromised (10 vs. 7 in AD and 1 in controls) and MMS inferior to controls (24 vs. 27) but superior to AD (24 vs. 20). These distinctions aid to better define the profile of patients with FTD, but also open a new questions which we expect to answer, soon, in a longitudinal study of this persons.