Elevation of C-reactive protein in adolescent bipolar disorder vs. anxiety disorders.

Bipolar disorder (BD) largely begins in adolescence, but diagnosis lags for years, causing significant morbidity and mortality, and demonstrating the need for better diagnostic tools. Suggesting an association between BD and immune activity, elevated levels of peripheral inflammatory markers, including C-reactive protein (CRP), have been found in adults with BD. As similar data are extremely limited in adolescents, this study examined CRP levels in adolescents with BD (n = 37) compared to those with anxiety disorders (ADs, n = 157) and healthy controls with no psychiatric diagnoses (HCs, n = 2760). CRP blood levels for patients aged 12-17 years were retrieved from a nationwide repository of deidentified clinical data. After excluding patients with inflammatory conditions, differences in CRP were examined using multivariate and weighted regressions (covariates: demographics and BMI). Mean CRP levels were significantly elevated in adolescents with BD relative to those with ADs and HCs. Mean CRP levels were lower in the ADs cohort versus HCs. Although CRP levels were significantly higher in males and younger patients, the significant between-cohort differences in CRP remained after controlling for multiple confounders. To our knowledge, our study is the first to compare CRP levels between adolescent BD, ADs, and HCs, comprising a novel and essential contribution. Our results suggest the presence of a unique immune process in adolescents with BD and indicate that CRP may represent a biomarker with a crucial role in the diagnostic assessment of adolescent BD.

Krankheitsreste: The residual signs of catatonia. A case series.

BACKGROUND: Catatonic signs were first described by 19th- and 20th-century researchers. An important concept known as "Krankheitsreste," or the residual signs of catatonia, was described by Kraepelin in 1896. Modern researchers describe patients who demonstrate "partial response to the treatment of catatonia with residual signs." Kraepelin observed that these signs occurred between catatonic episodes as part of the natural course of illness. Modern psychiatrists see residual signs after intervention or treatment. The determination of residual signs of catatonia is necessary to evaluate the most effective treatment approach to the patient. METHODS: In this case series, we describe 3 patients whose catatonia improved with treatment, but each exhibited continued residual signs of the syndrome. Appropriate consent was obtained from the patients and we identified the varying levels of catatonic signs using the Bush-Francis Catatonia Rating Scale (BFCRS) and the KANNER scale. RESULTS: Scores on both the BFCRS and KANNER scale decreased on followup in all 3 patients, with varying levels of success. The BFCRS score for the patient in Case 1 dropped 4 points upon follow-up, and their score on Part 2 of the KANNER scale decreased 12 points. The patient in Case 2 experienced a 5-point drop in their BFCRS score at follow-up and their score on Part 2 of the KANNER scale decreased 4 points. In Case 3, the patient's BFCRS score dropped 10 points at follow-up and their score on Part 2 of the KANNER scale decreased 20 points. CONCLUSIONS: These 3 patients demonstrate Krankheitsreste, or "partial response to the treatment of catatonia with residual signs." Each patient had a developmental disorder and 2 had autism spectrum disorder. They exhibited improved self-care and greater independence and required less restrictive living environments.

Controller-area-network bus control and monitor system for a radio astronomy interferometer.

We describe the design and implementation of a controller-area-network bus (CANbus) monitor and control system for a millimeter wave interferometer. The Combined Array for Research in Millimeter-wave Astronomy (CARMA) is a 15-antenna connected-element interferometer for astronomical imaging, created by the merger of two university observatories. Its new control system relies on a central computer supervising a variety of subsystem computers, many of which control distributed intelligent nodes over CANbus. Subsystems are located in the control building and in individual antennas and communicate with the central computer via Ethernet. Each of the CAN modules has a very specific function, such as reading an antenna encoder or tuning an oscillator. Hardware for the modules was based on a core design including a commercial CANbus-enabled single-board computer and some standard circuitry for interfacing to peripherals. Hardware elements were added or changed as necessary for the specific module types. Similarly, a base set of embedded code was implemented for essential common functions such as CAN message handling and time keeping and extended to implement the required functionality for the different hardware. Using a standard CAN messaging protocol designed to fit the requirements of CARMA and a well-defined interface to the high-level software allowed separate development of high-level code and embedded code with minimal integration problems. Over 30 module types have been implemented and successfully deployed in CARMA, which is now delivering excellent new science data.