Automatic detection of facial expressions during the Cyberball paradigm in Borderline Personality Disorder: a pilot study.

Borderline Personality Disorder (BPD) symptoms include inappropriate control of anger and severe emotional dysregulation after rejection in daily life. Nevertheless, when using the Cyberball paradigm, a tossing game to simulate social exclusion, the seven basic emotions (happiness, sadness, anger, surprise, fear, disgust, and contempt) have not been exhaustively tracked out. It was hypothesized that these patients would show anger, contempt, and disgust during the condition of exclusion versus the condition of inclusion. When facial emotions are automatically detected by Artificial Intelligence, "blending", -or a mixture of at least two emotions- and "masking", -or showing happiness while expressing negative emotions- may be most easily traced expecting higher percentages during exclusion rather than inclusion. Therefore, face videos of fourteen patients diagnosed with BPD (26 ± 6 years old), recorded while playing the tossing game, were analyzed by the FaceReader software. The comparison of conditions highlighted an interaction for anger: it increased during inclusion and decreased during exclusion. During exclusion, the masking of surprise; i.e., displaying happiness while feeling surprised, was significantly more expressed. Furthermore, disgust and contempt were inversely correlated with greater difficulties in emotion regulation and symptomatology, respectively. Therefore, the automatic detection of emotional expressions during both conditions could be useful in rendering diagnostic guidelines in clinical scenarios.

The Feasibility and Efficacy of a Virtual Reality Tandem Cycling Program for Persons with Parkinson's Disease and Their Care Partners.

INTRODUCTION: Persons with Parkinson's disease (PwPD) suffer from motor and non-motor symptoms which significantly affect their quality of life (QoL), and the QoL of their care partners (CP). Tandem cycling reduces PwPD motor symptoms; however, no studies have examined other benefits or included PwPD CP. We conducted an 8-week community virtual reality (VR) tandem cycling intervention to assess the feasibility and efficacy for PwPD and their CP (i.e., PD dyads). We hypothesized that dyadic tandem cycling would improve (1) PwPD motor and non-motor symptoms and (2) dimensions of PD dyads' QoL and physiologic health. METHODS: Ten PD dyads were recruited to complete 8 weeks of progressive intensity, bi-weekly tandem cycling. At pre- and post-testing, PwPD were assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-III (MDS-UPDRS-III), functional gait assessment (FGA), and 10-m gait speed test. PD dyads also completed emotional and cognitive status questionnaires [e.g., Geriatric Depression Scale-Short Form (GDS-SF)], and wore BodyGuard 2 heart rate (HR) monitors for 48 h to assess surrogate measures of heart rate variability. Statistical analyses were conducted using Student's t tests with significance set at p ≤ 0.05. RESULTS: Eight PD dyads and one PwPD completed the intervention. Retention of PwPD (90%) and CP (80%) was adequate, and PD dyad adherence ranged from 91.67 to 97.91%. PwPD demonstrated significant clinical improvements in MDS-UPDRS-III scores (- 7.38, p < 0.01), FGA scores (+ 3.50, p < 0.01), and 10-m gait speed times (+ 0.27 m/s, p < 0.01), in addition to significant self-reported improvements in mobility (- 13.61, p = 0.02), fatigue (- 5.99, p = 0.02), and social participation (+ 4.69, p < 0.01). CP depressive symptoms significantly decreased (- 0.88, p = 0.02), and PD dyads shared a significant increase in root mean square of the successive differences (RMSSD; p = 0.04). CONCLUSION: Our pilot study demonstrated feasibility and multiple areas of efficacy supporting further investigation of community VR tandem cycling as a therapeutic intervention for PD dyads.

Continuous subcutaneous foslevodopa/foscarbidopa infusion for the treatment of motor fluctuations in Parkinson's disease: Considerations for initiation and maintenance.

Background: As Parkinson's disease (PD) advances, management is challenged by an increasingly variable and inconsistent response to oral dopaminergic therapy, requiring special considerations by the provider. Continuous 24 h/day subcutaneous infusion of foslevodopa/foscarbidopa (LDp/CDp) provides steady dopaminergic stimulation that can reduce symptom fluctuation. Objective: Our aim is to review the initiation, optimization, and maintenance of LDp/CDp therapy, identify possible challenges, and share potential mitigations. Methods: Review available LDp/CDp clinical trial data for practical considerations regarding the management of patients during LDp/CDp therapy initiation, optimization, and maintenance based on investigator clinical trial experience. Results: LDp/CDp initiation, optimization, and maintenance can be done without hospitalization in the clinic setting. Continuous 24 h/day LDp/CDp infusion can offer more precise symptom control than oral medications, showing improvements in motor fluctuations during both daytime and nighttime hours. Challenges include infusion-site adverse events for which early detection and prompt management may be required, as well as systemic adverse events (eg, hallucinations) that may require adjustment of the infusion rate or other interventions. A learning curve should be anticipated with initiation of therapy, and expectation setting with patients and care partners is key to successful initiation and maintenance of therapy. Conclusion: Continuous subcutaneous infusion of LDp/CDp represents a promising therapeutic option for individuals with PD. Individualized dose optimization during both daytime and nighttime hours, coupled with patient education, and early recognition of certain adverse events (plus their appropriate management) are required for the success of this minimally invasive and highly efficacious therapy.

Dissociation of Arousal Index Between REM and NREM Sleep in Elderly Adults with Cognitive Impairment, No Dementia: A Pilot Study.

BACKGROUND: Sleep disruption in elderly has been associated with an increased risk of cognitive impairment and its transition into Alzheimer's disease (AD). High arousal indices (AIs) during sleep may serve as an early-stage biomarker of cognitive impairment non-dementia (CIND). OBJECTIVE: Using full-night polysomnography (PSG), we investigated whether CIND is related to different AIs between NREM and REM sleep stages. METHODS: Fourteen older adults voluntarily participated in this population-based study that included Mini-Mental State Examination, Neuropsi battery, Katz Index of Independence in Activities of Daily Living, and single-night PSG. Subjects were divided into two groups (n = 7 each) according to their results in Neuropsi memory and attention subtests: cognitively unimpaired (CU), with normal results; and CIND, with -2.5 standard deviations in memory and/or attention subtests. AIs per hour of sleep during N1, N2, N3, and REM stages were obtained and correlated with Neuropsi total score (NTS). RESULTS: AI (REM)  was significantly higher in CU group than in CIND group. For the total sample, a positive correlation between AI (REM)  and NTS was found (r = 0.68, p = 0.006), which remained significant when controlling for the effect of age and education. In CIND group, the AI (N2)  was significantly higher than the AI (REM) . CONCLUSION: In CIND older adults, this attenuation of normal arousal mechanisms in REM sleep are dissociated from the relative excess of arousals observed in stage N2. We propose as probable etiology an early hypoactivity at the locus coeruleus noradrenergic system, associated to its early pathological damage, present in the AD continuum.

Adaptación de la actividad de la Red de Salud Mental de Navarra durante la pandemia de COVID-19 / Adaptation of the activity of the Network of Mental Health of Navarra during the COVID-19 pandemic

La pandemia de COVID-19 ha supuesto un desafío para los sistemas sanitarios, incluida la atención a la salud mental. Ha sido necesaria la adaptación constante de la práctica asistencial habitual según la situación epidemiológica poblacional. Se recoge la actividad asistencial prestadapor la Red de Salud Mental de Navarra durante los años 2019, 2020 y 2021. Se registra una disminución en el número de consultas ambulatorias realizadas durante 2020 y su recuperación en2021, con un incremento de la demanda en la población femenina. Se han producido variacionesen la ocupación y estancias medias de los recursos de hospitalización, así como una reestructuración funcional y estructural. En el ámbito residencial se produjo el fallecimiento del 9,8% delos usuarios debido al COVID-19. Las tasas de suicidio durante 2020 se mantuvieron similaresa 2019, incrementándose un 36% en 2021. La pandemia ha impactado en la continuidad de losplanes de tratamiento, en la evolución clínica, psicopatológica y emocional de las personasatendidas. Las repercusiones negativas pueden extenderse a lo largo de los próximos años. Porello, será fundamental el desarrollo de estrategias sanitarias, sociales y de salud pública dirigidas a la promoción de la salud y la prevención de los problemas de salud mental.(AU)

Novel adaptive law for super-twisting controller: USV tracking control under disturbances.

A novel adaptive super-twisting control algorithm, for Unmanned Surface Vehicles (USV) tracking control is presented. The proposed adaptive law is obtained using a Lyapunov approach, to analyze the system closed-loop stability. Furthermore, several conditions are given to guarantee robustness in presence of unknown bounded disturbances/uncertainties, chattering mitigation and the finite-time convergence. This adaptive control strategy has the advantage that the controller gains, which are in terms of a single control parameter, requires adjusting a small number of parameters compared with other adaptive strategies, moreover and its dynamics is smooth, improving the controller performance. To assess the proposed control methodology effectiveness, a trajectory tracking control is designed and implemented on an unmanned surface vehicle under the action of bounded unknown uncertainties and external perturbations. Numerical simulations and experimental results conducted with a vessel prototype demonstrate the performance and advantages under payload variations and external environmental conditions. Finally, a comparative study between the proposed approach with other adaptive super-twisting works has been conducted.

Adaptive sensorless control for interior permanent magnet synchronious motor based on sliding mode approach.

This paper proposes an adaptive sensorless control based on sliding mode approach for Interior Permanent Magnet Synchronous Motor (IPMSM) using the method of the angular position estimation error extraction. The proposed strategy combines a novel Adaptive Super-Twisting Controller (ASTWC) with a novel Adaptive Observer High-Order Sliding Mode (AOHOSM), where: (i) The control and observer gains are parameterized in terms of a single parameter simplifying its implementation and reducing the tuning time. (ii) By using an auxiliary system, which does not depend on machine parameters, an AOHOSM is designed for estimating the angular position, speed and acceleration in a wide speed range of the IPMSM, (iii) and these are used in an ASTWC to track a desired reference of speed and direct-axis current. (iv) Sufficient conditions are given to ensure the stability of the closed-loop system using a Lyapunov approach. Furthermore, the proposed strategy is validated throughout experimental set-up in order to show its effectiveness. Finally, a comparative study between the proposed strategy and other strategies published in the literature is addressed.

Transgenic rodents as dynamic models for the study of respiratory rhythm generation and modulation: a scoping review and a bibliometric analysis.

The pre-Bötzinger complex, situated in the ventrolateral medulla, serves as the central generator for the inspiratory phase of the respiratory rhythm. Evidence strongly supports its pivotal role in generating, and, in conjunction with the post-inspiratory complex and the lateral parafacial nucleus, in shaping the respiratory rhythm. While there remains an ongoing debate concerning the mechanisms underlying these nuclei's ability to generate and modulate breathing, transgenic rodent models have significantly contributed to our understanding of these processes. However, there is a significant knowledge gap regarding the spectrum of transgenic rodent lines developed for studying respiratory rhythm, and the methodologies employed in these models. In this study, we conducted a scoping review to identify commonly used transgenic rodent lines and techniques for studying respiratory rhythm generation and modulation. Following PRISMA guidelines, we identified relevant papers in PubMed and EBSCO on 29 March 2023, and transgenic lines in Mouse Genome Informatics and the International Mouse Phenotyping Consortium. With strict inclusion and exclusion criteria, we identified 80 publications spanning 1997-2022 using 107 rodent lines. Our findings revealed 30 lines focusing on rhythm generation, 61 on modulation, and 16 on both. The primary in vivo method was whole-body plethysmography. The main in vitro method was hypoglossal/phrenic nerve recordings using the en bloc preparation. Additionally, we identified 119 transgenic lines with the potential for investigating the intricate mechanisms underlying respiratory rhythm. Through this review, we provide insights needed to design more effective experiments with transgenic animals to unravel the mechanisms governing respiratory rhythm. The identified transgenic rodent lines and methodological approaches compile current knowledge and guide future research towards filling knowledge gaps in respiratory rhythm generation and modulation.

Liver cancer in Hidalgo State, Mexico: analysis of the status, risk factors and regional public health policy requirements: a cross-sectional correlational study

ABSTRACT BACKGROUND: In Latin America, liver cancer is one of the top causes of cancer mortality. It is the fifth most common cause of death among malignant tumors in Mexico and is the leading cause in Hidalgo State (43.8% of the population living in poverty). OBJECTIVE: To conduct a correlational analysis on the main risk factors for liver cancer in Hidalgo State, Mexico, including municipal disaggregation and comparison with the national level. DESIGN AND SETTING: Cross-sectional, correlational, descriptive and comparative epidemiological study using Mexican governmental databases covering 1990-2019. METHODS: A comprehensive review of the databases of the General Directorate of Health Information (DGIS) was performed to analyze official death figures, hospital discharges and national and municipal population projections, using specific search criteria defined in the Global Burden of Disease classification, based on the risk factors for liver cancer. RESULTS: Liver cancer rates showed an evident rise in Hidalgo (183%), moving from 21st place in Mexico in 1990 to 9th place in 2019. This increase was correlated with alcoholism. An increasing trend for liver cancer deaths, of 133.89%, is projected for 2030. Females and the population over 60 years of age are more affected. There are some critical regions with liver cancer death rates twice the national rate or more. CONCLUSION: Targeted effective public health strategies should be structured by identifying, characterizing and regionalizing critical marginalized municipalities that are vulnerable to alcoholism and other risk factors for liver cancer. This approach may be helpful for other states in Mexico or similar countries.

Liver cancer in Hidalgo State, Mexico: analysis of the status, risk factors and regional public health policy requirements: a cross-sectional correlational study.

BACKGROUND: In Latin America, liver cancer is one of the top causes of cancer mortality. It is the fifth most common cause of death among malignant tumors in Mexico and is the leading cause in Hidalgo State (43.8% of the population living in poverty). OBJECTIVE: To conduct a correlational analysis on the main risk factors for liver cancer in Hidalgo State, Mexico, including municipal disaggregation and comparison with the national level. DESIGN AND SETTING: Cross-sectional, correlational, descriptive and comparative epidemiological study using Mexican governmental databases covering 1990-2019. METHODS: A comprehensive review of the databases of the General Directorate of Health Information (DGIS) was performed to analyze official death figures, hospital discharges and national and municipal population projections, using specific search criteria defined in the Global Burden of Disease classification, based on the risk factors for liver cancer. RESULTS: Liver cancer rates showed an evident rise in Hidalgo (183%), moving from 21st place in Mexico in 1990 to 9th place in 2019. This increase was correlated with alcoholism. An increasing trend for liver cancer deaths, of 133.89%, is projected for 2030. Females and the population over 60 years of age are more affected. There are some critical regions with liver cancer death rates twice the national rate or more. CONCLUSION: Targeted effective public health strategies should be structured by identifying, characterizing and regionalizing critical marginalized municipalities that are vulnerable to alcoholism and other risk factors for liver cancer. This approach may be helpful for other states in Mexico or similar countries.

Importancia de la ruta de señalización JAK/STAT en la sepsis / Importance of the JAK/STAT signaling pathway in sepsis

RESUMEN El transductor de señal Janus-Kinasa y la vía de activación de la transcripción conocida como JAK/STAT es una ruta de señalización principal para la transducción de información en muchas citocinas inflamatorias implicadas durante la sepsis. Se ha demostrado que la vía JAK/STAT está fuertemente relacionada con el fallo multiorgánico, además que muchas citocinas pueden ejercer sus efectos biológicos a través de esta ruta. En los últimos años, se ha logrado un progreso significativo en la comprensión de las funciones de este complejo, sin embargo, su rol en la sepsis como objetivo terapéutico permanece en experimentación. En esta revisión se describen las funciones específicas de la vía JAK/STAT, su rol en la sepsis y presentamos un enfoque traslacional respecto a la perspectiva terapéutica para inhibir esta ruta de señalización durante la sepsis y su interacción con enfermedades inflamatorias como la COVID-19.

ABSTRACT The Janus-Kinase signal transducer and the transcription activation pathway known as JAK /STAT is a major signaling pathway for the transduction of information in many inflammatory cytokines involved during sepsis. The JAK /STAT pathway has been shown to be strongly related to multiorgan failure, and many cytokines can exert their biological effects through this pathway. In recent years, considerable progress has been made in understanding functions of this complex; however, its role in sepsis as a therapeutic target remains under experimentation. This review describes the specific functions of the JAK /STAT pathway, its role in sepsis, and presents a translational approach to the therapeutic perspective aiming to inhibit this signaling pathway during sepsis and its interaction with inflammatory diseases such as COVID-19.

Opsoclonus-Myoclonus-Ataxia Syndrome (OMAS) Associated with SARS-CoV-2 Infection: Post-Infectious Neurological Complication with Benign Prognosis.

The novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) is the cause of the COVID-19 pandemic [5]. SARS-Cov-2 demonstrates partial resemblance to SARS-CoV and MERS-CoV in phylogenetic analysis, clinical manifestations, and pathological findings [6, 7]. Reports emerging from China have described ataxia as a neurological symptom of the SARS-CoV-2 infection [5]. Opsoclonus consists of back-to-back multidirectional conjugate saccades without an inter-saccadic interval [8]. Myoclonus is defined as a sudden, brief, "shock-like", nonepileptic involuntary movement [9], which has been described as a symptom of SARS-CoV-2 infection [10]. Opsoclonus-Myoclonus-Ataxia syndrome (OMAS) associated COVID-19 infection has been reported recently [1112].

State and parameter estimation for a class of Nonlinear Systems based on Sliding Mode Approach.

In this paper, simultaneous state estimation and parameters identification for a class of nonlinear systems are addressed. With the aim of solving this problem, an adaptive observer based on the sliding mode (AOSM) approach is designed. The main advantage of the proposed adaptive observer design is that it combines the robustness and finite time convergence of the sliding mode observers, with the simplicity of tuning of high-gain observers, reducing tuning effort. The finite time convergence of the proposed adaptive observer is established using a Lyapunov approach. Furthermore, a comparative study of the proposed adaptive observer against schemes from literature is presented, in order to show the advantages of the proposed approach. Finally, numerical results are provided to demonstrate the effectiveness and performance of the proposed approach under noise and external disturbances.

Chronic Undernutrition Differentially Changes Muscle Fiber Types Organization and Distribution in the EDL Muscle Fascicles.

Fiber type composition, organization, and distribution are key elements in muscle functioning. These properties can be modified by intrinsic and/or extrinsic factors, such as undernutrition and injuries. Currently, there is no methodology to quantitatively analyze such modifications. On one hand, we propose a fractal approach to determine fiber type organization, using the fractal correlation method in software Fractalyse. On the other hand, we applied the kernel methodology from machine learning to build radial-basis functions for the spatial distribution of fibers (distribution functions), by dividing into square cells a two-dimensional binary image for the spatial distribution of fibers from a muscle fascicle and mounting on each cell a radial-basis function in such a way that the sum of all cell functions creates a smooth version of the fiber histogram on the cell grid. The distribution functions thus created belong in a reproducing kernel Hilbert space which permits us to regard them as vectors and measure distances and angles between them. In the present study, we analyze fiber type organization and distribution in fascicles (F2, F3, F4, and F5) of the extensor digitorum longus muscle (EDLm) from control and undernourished male rats. Fibers were classified according to the ATPase activity in slow, intermediate, and fast. Then, (x, y) coordinates of fibers were used to build binary images and distribution functions for each fiber type and both conditions. The fractal organization analysis showed that fast and intermediate fibers, from both groups, had a fractal organization within the four fascicles, i.e., the fiber assembly is distributed in clusters. We also show that chronic undernutrition altered the organization of fast fibers in the F3, although it still is considered a fractal organization. Distribution function analysis showed that each fiber type (slow, intermediate, and fast) has a unique distribution within the fascicles, in both conditions. However, chronic undernutrition modified the intra-fascicular fiber type distributions, except in the F2. Altogether, these results showed that the methodology herein proposed allows for analyzing fiber type organization and distribution modifications. On the other side, we show that chronic undernutrition alters not only the fiber type composition but also the organization and distribution, which could affect the muscle functioning, and ultimately, its behavior (e.g., locomotion).

Characterization and Classification of Electrophysiological Signals Represented as Visibility Graphs Using the Maxclique Graph.

Detection, characterization and classification of patterns within time series from electrophysiological signals have been a challenge for neuroscientists due to their complexity and variability. Here, we aimed to use graph theory to characterize and classify waveforms within biological signals using maxcliques as a feature for a deep learning method. We implemented a compact and easy to visualize algorithm and interface in Python. This software uses time series as input. We applied the maxclique graph operator in order to obtain further graph parameters. We extracted features of the time series by processing all graph parameters through K-means, one of the simplest unsupervised machine learning algorithms. As proof of principle, we analyzed integrated electrical activity of XII nerve to identify waveforms. Our results show that the use of maxcliques allows identification of two distinct types of waveforms that match expert classification. We propose that our method can be a useful tool to characterize and classify other electrophysiological signals in a short time and objectively. Reducing the classification time improves efficiency for further analysis in order to compare between treatments or conditions, e.g., pharmacological trials, injuries, or neurodegenerative diseases.

Perfil genético del trastorno bipolar en Panamá: análisis de genes relacionados y otros factores determinantes en una región de alta prevalencia de episodios maníacos en la República de Panamá / Genetic profile of bipolar disorder in Panama: related gene analysis and other determi­ning factors in a high prevalence region of manic episodes in the Republic of Panama

Introducción El Trastorno Bipolar es una enfermedad que causa discapacidad física y cognitiva, afectando tanto a hombres como mujeres, con edad de inicio temprano y con un alto componente hereditario. Objetivo Estimar el comportamiento del Trastorno Bi­polar, variables sociodemográficas, antecedentes y su relación con los genes CACNA1­C (12p13.3) y DAOA (13q34) entre personas de 18 años y más en áreas específicas de la Región de Azuero de Panamá. Metodología La muestra calculada fue de 267 perso­nas de 18 años y más (IC 95%) utilizando un muestreo aleatorio, de distribución propor­cional según sexo. Se utilizaron las variables: "trastorno bipolar" medido a través del cuestionario de trastornos del estado de ánimo (Mood Disorder Questionnaire, MDQ por sus siglas en inglés); "genes asociados a la bipolaridad" (genes CACNA1­C (12p13.3) y DAOA (13q34)); y un cuestionario de datos sociodemográficos y antecedentes persona­les ­ familiares. El análisis genético se realizó con PCR (tiempo real). Se utilizaron por­centajes como medida de frecuencia relativa y se consideró significancia estadística para un valor de p ≤ 0.05. Resultados La prevalencia de bipolaridad en la muestra es­tudiada fue 3.7% (IC 95% 3.5 ­ 4.1), siendo mayor en mujeres, 6.0% (IC 95% 5.9 ­ 6.3). El 74.2% (IC 95% 73.9 ­ 74.4) de los participantes tenía presente el polimorfismo del gen CACNA1­C (12p13.3), y 19.1% (IC 95% 18.9 ­ 19.4) el del gen DAOA (13q34). Para todas las variables de estudio, la presencia del gen CACNA1­C (12p13.3) fue mayor que la del gen DAOA (13q34). De los 10 casos con MDQ+, 3 presentaron el gen CAC­NA1­C. Conclusión Esta es la primera investigación sobre bipolaridad, genes y otros factores asociados en Panamá. El gen CACNA1­C fue más prevalente que el DAOA y se asoció más al MDQ +.

Introduction Bipolar disorder is a disease that causes physical and cognitive disability, affecting both men and women, with an early onset age and a high hereditary compo­nent. Objective To estimate Bipolar Disorder demeanor, sociodemographic variables, antecedents and its relationship with CACNA1­C (12p13.3) and DAOA (13q34) genes among people aged 18 years and over in specific areas of the Azuero Region of Pana­ma. Methodology The calculated sample was 267 people aged 18 and over (95% CI) using random sampling, proportional distribution according to sex. The variables were used: "bipolar disorder" measured through the Mood Disorder Questionnaire (MDQ); "genes associated with bipolarity" (CACNA1­C (12p13.3) and DAOA (13q34) genes); and a sociodemographic data questionnaire and personal ­ family background. The ge­netic analysis was performed with PCR (real time). Percentages were used as a re of relative frequency and statistical significance was considered for a value of p ≤ 0.05. Results The prevalence of bipolarity in the studied sample was 3.7% (CI 95% 3.5 ­ 4.1), being higher in women, 6.0% (CI 95% 5.9 ­ 6.3). 74.2% (CI 95% 73.9 ­ 74.4) of the participants were aware of the polymorphism of the CACNA1­C gene (12p13.3), and 19.1% (CI 95% 18.9 ­ 19.4) of the DAOA gene (13q34). For all study variables, the pre­sence of the CACNA1­C gene (12p13.3) was greater than that of the DAOA gene (13q34). Of the 10 cases with MDQ +, 3 presented the CACNA1­C gene. ConclusionThis is the first research on bipolarity, genes and other associated factors in Panama. The CACNA1­C gene was more prevalent than DAOA and was more associated with MDQ +.

Niños, niñas y adolescentes de circuito: entre la precariedad y la frontera, México / Circuit children and adolescents: between precariousness and the border, Mexico / Meninos, meninas e adolescentes de circuito: precariedade e fronteira, México

Resumen (analítico) Analizamos los factores que promueven la incursión de menores de edad a mercados laborales ilícitos en la frontera norte de México. Se analiza el caso de los niños, niñas y adolescentes de circuito. Llevamos a cabo una revisión bibliográfica, hemerográfica, así como desarrollamos y aplicamos indicadores de desarrollo social en una de las regiones de mayor incidencia del fenómeno y realizamos entrevistas a actores clave en la atención institucional a esta población. Concluimos que este fenómeno tiene un origen multifactorial, pero con un trasfondo geográfico y de deficiencias en desarrollo social con una visión incluyente de la niñez y la adolescencia.

Abstract (analytical) In this study the authors explore the factors that promote the involvement of children and adolescences in illicit labor markets in Mexico's northern border region. The study analyses cases from the population known as circuit children and adolescents. The research includes bibliographic, hemerographic, and statistical analyses, as well as the application of social development indicators in one of the regions that has the highest concentration of cases. The study also included interviews with key informants who provide institutional assistance to this population. The authors conclude that there are multiple factors that contribute to the insertion of minors in illicit labor markets. These can be traced to geographic conditions and a lack of social development that has an inclusive vision for children and adolescents.

Resumo (analítico) Este artigo analisa a relação entre as condições de desenvolvimento social e a incursão de menores de idade em mercados de trabalho ilícitos na fronteira norte do México. Analisa-se o caso de meninos, meninas e adolescentes de circuito. Realizou-se uma revisão bibliográfica, hemerográfica, desenvolveram-se e aplicaram-se indicadores de desenvolvimento social em uma das regiões com maior incidência do fenômeno, e realizaram-se entrevistas com atores-chave no atendimento institucional dessa população. Concluiu-se que esse fenômeno tem origem geográfica e multifatorial, mas com um pano de fundo de deficiências no desenvolvimento social com visão inclusiva da infância e adolescência.

Raynaud's phenomenon of the nipple as a side-effect of labetalol: Case report and literature review.

Raynaud's phenomenon of the nipple is an unusual side-effect of labetalol use. There is one official report from the United Kingdom. The present case concerns a 30-year-old woman, gravida 1, para 0, who developed pre-eclampsia and was treated with labetalol but subsequently reported neuropathic pain of the nipple. Nifedipine was then started as part of her treatment plan for blood pressure control and she no longer reported pain, despite being given six more doses of labetalol. Nifedipine is the first-line of treatment for Raynaud's phenomenon. The concomitant use of labetalol with nifedipine by a woman with Raynaud's phenomenon of the nipple has not been discussed before. The goal of this review is to raise awareness of this drug-induced phenomenon and to add to the limited literature available on this subject.

Changes in Nonmotor Symptoms Following an 8-Week Yoga Intervention for People with Parkinson's Disease.

Parkinson's disease (PD) is a neurodegenerative disorder marked by progressive degenerative motor symptoms (e.g., tremors, impaired balance and gait) and nonmotor symptoms (e.g., fatigue, sleep disturbances, pain) that can negatively influence health-related quality of life (HRQoL). Previous studies have shown that yoga for individuals with PD improves balance, strength, and mobility. However, little research has been conducted to determine the effect of yoga on nonmotor symptoms of PD. The purpose of this study was to examine changes in nonmotor symptoms among individuals with PD following an 8-week yoga intervention. Data used for analyses were part of a larger study that researched improvements in motor function for individuals with PD. Participants (N = 27) were randomly assigned to experimental (n = 15) and control (n = 12) groups and completed pre- and postintervention quantitative measures. Within-group improvements were statistically significant for fatigue measured by the Parkinson's Fatigue Scale, balance confidence measured by the Activities Balance Confidence Scale, the belief in one's ability to manage falls measured by the Falls Management Scale, activity constraints measured by the Activities Constraint Questionnaire, and PD-specific quality of life measured by the Parkinson's Disease Questionnaire-8. Across-group changes were statistically significant for activity constraints. Findings indicate yoga may be an efficacious intervention for improving nonmotor symptoms as well as HRQoL for individuals with PD.