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Results: Psychostimulants were associated with statistically significant improvement in depressive symptoms in major depressive disorder (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.13-1.78; P = 0.003) and bipolar disorder (OR, 1.42; 95% CI, 1.13-1.78; P = 0.003). Efficacy outcomes differed across the psychostimulants evaluated as a function of response rates: ar/modafinil (OR, 1.47; 95% CI, 1.20-1.81; P = 0.0002); dextroamphetamine (OR, 7.11; 95% CI, 1.09-46.44; P = 0.04); lisdexamfetamine dimesylate (OR, 1.21; 95% CI, 0.94-1.56; P = ns); methylphenidate (OR, 1.49; 95% CI, 0.88-2.54; P = ns). Efficacy outcomes also differed between agents used as adjunctive therapy (OR, 1.39; 95% CI, 1.19-1.64) or monotherapy (OR, 2.25; 95% CI, 0.67-7.52).
BACKGROUND: Submicroscopic malaria parasitaemia is common in both high- and low-endemicity settings, but its clinical consequences are unclear. METHODS: A cohort of 364 children (0.5-10 years of age) and 106 adults was followed from 2011 to 2016 in Tororo District, Uganda using passive surveillance for malaria episodes and active surveillance for parasitaemia. Participants presented every 90 days for routine visits (n = 9075); a subset was followed every 30 days. Participants who presented with fever and a positive blood smear were treated for malaria. At all routine visits microscopy was performed and samples from subjects with a negative blood smear underwent loop-mediated isothermal amplification for detection of plasmodial DNA. RESULTS: Submicroscopic parasitaemia was common; the proportion of visits with submicroscopic parasitemia was 25.8% in children and 39.2% in adults. For children 0.5-10 years of age, but not adults, having microscopic and submicroscopic parasitaemia at routine visits was significantly associated with both fever (adjusted risk ratios [95% CI], 2.64 [2.16-3.22], 1.67 [1.37-2.03]) and non-febrile illness (aRR [CI], 1.52 [1.30-1.78], 1.26 [1.09-1.47]), compared to not having parasitaemia. After stratifying by age, significant associations were seen between submicroscopic parasitaemia and fever in children aged 2-
The Transportation Security Administration screened an average of 1.78 million people from Friday through Monday, hitting a peak of 1.96 million on Friday. Those volumes are more than six times higher than a year ago, but still 22% below Memorial Day weekend in 2019.
METHODS: Patients 15 years of age or older with diagnosis of generalized epilepsy, generalized SWD on ambulatory EEG, and no clinical seizures in the previous month were recruited through their neurologists. Patients drove for an hour in a high-fidelity driving simulator (Yale DrivSim Lab, miniSimTM) fitted for video and high-density EEG monitoring. For baseline testing (every 5 minutes), and during each SWD episode, a virtual road obstacle consisting of a round circle (similar to a stop sign) was presented in the center of the display for 100ms. Participants were instructed to pull over as safely and quickly as possible as soon as they saw the obstacle, and then to resume driving after they had safely stopped on the side of the road. We detected appropriate response to the obstacles based on changes in acceleration, brake force, and steering, and calculated reaction times. We analyzed proportion of correct responses and reaction times for each participant during the baseline tests, and for each SWD.
RESULTS: Nine patients were tested, 2 male, 7 female, median age of 20 years. Five had generalized epileptiform discharges during driving testing, with obstacles presented during a total of 55 SWD. Mean SWD duration was 2.2 ± 1.78 s (mean ± SD). The road obstacle was presented during SWD with a mean delay of 1.25 s from SWD onset. Of the 55 SWD episodes tested, 52 (95%) elicited an appropriate behavioral response and for 3 (5%) patients continued driving without pulling over. For the episodes in which patients pulled over, mean reaction time to obstacle was 0.76 ± 0.36s (mean ± SD). EEG analyses are underway and are focused on spike and wave amplitude, SWD duration and other features that may help classify SWD in relation to driving performance. 2b1af7f3a8