An Emotional Bias Modification for Children With Attention-Deficit/Hyperactivity Disorder: Co-design Study.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is one of the common neurodevelopment disorders. Children with ADHD typically have difficulties with emotional regulation. Previous studies have investigated the assessment for underlying emotional biases using the visual probe task. However, one of the significant limitations of the visual probe task is that it is demanding and repetitive over time. Previous studies have examined the use of gamification methods in addressing the limitations of the emotional bias visual probe task. There has also been increased recognition of the potential of participatory action research methods and how it could help to make the conceptualized interventions more relevant. OBJECTIVE: The primary aim of this study was to collate health care professionals' perspectives on the limitations of the existing visual probe task and to determine if gamification elements were viable to be incorporated into an emotional bias modification task. METHODS: A co-design workshop was conducted. Health care professionals from the Department of Development Psychiatry, Institute of Mental Health, Singapore, were invited to participate. Considering the COVID-19 pandemic and the restrictions, a web-based workshop was conducted. There were 3 main phases in the workshops. First, participants were asked to identify limitations and suggest potential methods to overcome some of the identified limitations. Second, participants were shown examples of existing gaming interventions in published literature and commercial stores. They were also asked to comment on the advantages and limitations of these interventions. Finally, participants were asked if gamification techniques would be appropriate. RESULTS: Overall, 4 health care professionals consented and participated. Several limitations were identified regarding the conventional emotional bias intervention. These included the nature of the task parameters, included stimulus set, and factors that could have an impact on the accuracy of responding to the task. After examining the existing ADHD games, participants raised concerns about the evidence base of some of the apps. They articulated that any developed ADHD game ought to identify the specific skill set that was targeted clearly. Regarding gamification strategies, participants preferred economic and performance-based gamification approaches. CONCLUSIONS: This study has managed to elucidate health care professionals' perspectives toward refining a conventional emotional bias intervention for children with ADHD. In view of the repetitiveness of the conventional task, the suggested gamification techniques might help in influencing task adherence and reduce the attrition rates.

Unusual branching pattern of external iliac artery: case report / Patrón inusual de ramificación de la arteria ilíaca externa: reporte de caso

During the routine dissection, a rare anomaly was observed in left lower limb of a female cadaver. The external iliac artery continued as femoral artery, branched on lateral side as the lateral circumflex femoral artery and on medial side as profunda femoris artery. On tracing the lateral circumflex femoral artery, the ascending branch towards the spinous anastomosis was very thin and coursed behind the rectus femoris muscle. The transverse and descending branches were not observed, however, the artery coursed along the vastus lateralis towards the knee. The femoral artery had its normal course and continued as popliteal artery. The profunda femoris artery originated from the medial side of the external iliac artery, initially superficial to the femoral vein, coursed downwards and posteriorly, relating posteromedial to femoral artery. The medial circumflex femoral artery originated as thin branch, which further divided into two divisions. The profunda femoris gave origin of 3 perforators and continued as 4th perforator. The unusual branching pattern was observed to be novel and not reported in the literature.

Durante una disección de rutina, se observó una rara anomalía en el miembro inferior izquierdo de un cadáver de sexo femenino. La arteria ilíaca externa dio origen en el lado lateral ala arteria circunfleja femoral lateral y en el lado medial a la arteria femoral profunda. En el recorrido de la arteria circunfleja femoral lateral, la rama ascendente era muy delgada y corría detrás del músculo recto femoral. No se observaron ramas transversales y descendente, sin embargo, la arteria descendió hacia la rodilla a lo largo del músculo vasto lateral. La arteria femoral tuvo su curso normal y continuó como arteria poplítea. La arteria femoral profunda, inicialmente superficial a la vena femoral, se dirigió inferior y posteriormente colocándose posteromedial a la arteria femoral. La arteria circunfleja femoral medial se originó como una rama delgada, que otorgó dos arterias. La arteria femoral profunda dio origen a tres ramas perforantes y continuó como cuarta perforante. Este patrón de ramificación inusual es una descripción nueva no reportada en la literatura.

Morphometric analysis of superior articular facets of atlas vertebra and its clinical applications in ergonomics of atlanto-occipital joints.

AIM: The classic variants in superior articular facets of atlas such as, variability in shape, presence of notch, constrictions, partial or complete separation of facets, and presence of pressure facets, have been reported to a limited extent in relation to ergonomics of cranio-vertebral joint. OBJECTIVE: The objectives of the present study were to report the analyzed morphological features and metrical values of superior articular facets of the atlas. The morphological features which were included in this study were variability in shapes, constrictions and partial or complete separation of facets. The metrical measure included the surface area measurement of the facets. MATERIAL AND METHODS: This study was carried out on 50 (100 sides) dry atlas vertebrae from the Department of Anatomy, St John's Medical College, Bangalore, India. The superior articular facets were studied for the shape and symmetry, constrictions and partial or complete separation of facets. The surface area of the facets were measured by using Image J (Image processing and analysis in JAVA) tool, that was primarily designed to measure and analyze different metrics. RESULTS: The mean surface area on the right side was 157.3 ± 29.02, and on the left side, it was 158.5 ± 24.85. Oval, irregular, kidney and figure of eight shapes were observed either on both sides or on one side. Bilateral constrictions of facets were seen in 58 % of vertebrae. Bilateral, complete separations of facets were seen in 30% of vertebrae. CONCLUSION: The observations of the present study are important to understand the ergonomics of the cranio-vertebral joint and they are helpful for academicians, neuro-surgeons, clinicians and radiologists in day to day clinical practice.