Reshaping the diagnostic borders: Historical analysis of the diagnostic changes following the introduction of the schizophrenia concept

BACKGROUND

Although the concept of schizophrenia is still widely presented as having replaced that of dementia praecox, studies have shown that the former was broader than the latter, resulting in a more complex diagnostic redistribution. However, this is poorly documented by quantitative approaches.

AIMS

We sought to test the hypothesis that the use of the concept of schizophrenia had caused a diagnostic redistribution and to quantify it.

METHOD

A retrospective study, based on admission register archives of the Strasbourg University Clinic of Psychiatry was conducted. The frequency of diagnoses given to patients were examined at two key time periods: one before (TP1) and one after (TP2) the introduction of the schizophrenia concept (established between 1926 and 1928). Eight main diagnoses related to schizophrenia were considered.

RESULTS

Patients diagnosed with schizophrenia at TP2 mainly received the diagnoses of dementia praecox but also depression, hebephrenia, manic depressive illness, hysteria, paraphrenia, catatonia and mania at TP1. Dementia praecox and hebephrenia were the most relayed by schizophrenia. Bayesian sensitivity analyses confirmed the robustness of our data against distinct scenarios challenging our hypothesis.

CONCLUSIONS

Our results confirm the broadening of the concept of schizophrenia compared to that of dementia praecox but also qualify the different concepts supposed to have been impacted. They provide unique quantitative data that define the contours of the diagnostic redistribution thus provoked. They also give relevant input in the current context where the need to rethink the DSM/ICD concept of schizophrenia is still debated.

Quantifying the impacts of posture changes on office worker productivity: an exploratory study using effective computer interactions as a real-time indicator

BACKGROUND

Working in a standing posture is considered to improve musculoskeletal comfort and can help enhance office workers' performance in the long term. However, there is a lack of a quantitative, real-time measure that reflects on whether office workers can immediately become more concentrated and work more efficiently when they switch to a standing posture.

METHODS

To tackle this problem, this study proposed that the number of effective computer interactions could be used as a real-time indicator to measure the productivity of office workers whose work is primarily computer-based. Using this metric, we conducted an exploratory study to investigate the correlation between posture and productivity changes at a 10-minute resolution for eight participants.

RESULTS

The study found that when allowed to use sit-stand desks to adjust postures, participants chose to switch to standing posture for about 47 min on average once a day; standing work was most frequent between 2:30 - 4:00 pm, followed by 10:30 - 11:30 am, during which time the number of computer interactions also became higher, showing a significant positive correlation. In addition, participants were approximately 6.5% more productive than when they could only work in a sitting posture.

CONCLUSION

This study revealed that posture changes could have an immediate improvement in productivity.

Unveiling the role of differential growth in 3D morphogenesis: An inference method to analyze area expansion rate distribution in biological systems

The three-dimensional (3D) morphologies of many organs in organisms, such as the curved shapes of leaves and flowers, the branching structure of lungs, and the exoskeletal shape of insects, are formed through surface growth. Although differential growth, a mode of surface growth, has been qualitatively identified as 3D morphogenesis, a quantitative understanding of the mechanical contribution of differential growth is lacking. To address this, we developed a quantitative inference method to analyze the distribution of the area expansion rate, which governs the growth of surfaces into 3D morphology. To validate the accuracy of our method, we tested it on a basic 3D morphology that allowed for the theoretical derivation of the area expansion rate distribution, and then assessed the difference between the predicted outcome and the theoretical solution. We also applied this method to complex 3D shapes and evaluated its accuracy through numerical experiments. The findings of the study revealed a linear decrease in error on a log-log scale with an increase in the number of meshes in both evaluations. This affirmed the reliability of the predictions for meshes that are sufficiently refined. Moreover, we employed our methodology to analyze the developmental process of the Japanese rhinoceros beetle Trypoxylus dichotomus, which is characterized by differential growth regulating 3D morphogenesis. The results indicated a notably high rate of area expansion on the left and right edges of the horn primordium, which is consistent with the experimental evidence of a higher rate of cell division in these regions. Hence, these findings confirm the efficacy of the proposed method in analyzing biological systems.

Assessing carbon reduction benefits of teleworking: A case study of Beijing

Teleworking can efficiently decrease the energy consumption and carbon emissions related to physical commuting. Previous studies on assessing the carbon reduction benefits of teleworking were customarily performed according to hypotheses or qualitative methods, and disregarded different potentials of different industries for teleworking implementation. In this study, a quantitative approach was proposed to assess the carbon reduction benefits of teleworking in different industries, which was illustrated via the case study of Beijing, China. The teleworking penetrations of different industries were first estimated. Then, the carbon reduction of teleworking was assessed through the decreased commuting distance using the large-scale travel survey data. Finally, the study samples were extended to a citywide scale and the uncertainty of carbon reduction benefits was evaluated with Monte Carlo simulation. The results showed that (1) teleworking can lead to an average of 1.32 (95 % confidence interval (CI): 0.70-2.05) million tons of carbon reduction, accounting for 7.05 % (95 % CI: 3.74 %-10.95 %) of the total carbon emissions by road transport in Beijing; and (2) information and communication, and professional, scientific and technical service industries had higher carbon reduction potential. Additionally, the rebound effect slightly weakened the carbon reduction benefit of teleworking, which was necessary to be considered and mitigated through relevant policies. The proposed method can be also applied to other regions worldwide, helping to exploit future work patterns and realize global carbon neutrality targets.

A robust quantitative approach for laser speckle contrast imaging perfusion analysis revealed anomalies in the brain blood flow in offspring mice of preeclampsia

Microcirculation analysis of the brain cortex is challenging because surface perfusion varies rapidly in small space-time regions and is bone protected. The laser speckle contrast imaging (LSCI) technique allows analyzing in vivo brain vascular perfusion generating a large amount of data that requires sophisticated data analytics, making researchers invest much effort in processing. Our research question was whether the reduced placental perfusion model (RUPP) of preeclampsia (PE) was associated with impaired blood perfusion in the offspring's brains. We aimed to develop a robust numerical approach that mainly consisted of applying a signal-processing tool for calculating optimal segmentation and piece-wise fits of the offspring's brain perfusion signals obtained from the LSCI technique. We combined this tool with the usual statistical analysis, implementing both in Matlab software. We performed brain perfusion measurements from offspring (five days postnatal, P5) of control pregnant dams (sham, n = 13) and of RUPP dams (RUPP, n = 7) using the Pericam® PSI-HR system at a basal condition and after thermal stimuli (warm and cold). We found that pups of RUPP mice exhibited significant differences in perfusion and vascular response to thermal stimuli compared to the sham mice. These differences were associated with high data variability in the Sham group, while in the RUPP group, perfusion looks "stiffer." Data also suggest sex-dimorphism in the vascular response since female pups in the Sham group but not male pups showed statistically significant differences in response to the warm stimulus. Again, this sex-related difference was absent in pups of RUPP mice. In conclusion, we present a robust quantitative approach for LSCI measurements that revealed anomalies in the brain blood flow in offspring of the RUPP model of PE.

The psychometrics of the Hospital Anxiety and Depression Scale supports a shorter -12 item- version

The diagnosis of patients suffering from both anxiety and depression is complex due to mixed effects of the two disorders. This complexity has hardened the task to find an adapted treatment for these patients. Consequently, several instruments, known as depression anxiety scales, have been developed and are now used internationally by physicians to determine the diagnosis of anxiety and depression and treat the patients accordingly. This study aims at testing the consistency and reliability of one of the main anxiety and depression scale which is composed of 14 items, the Hospital Anxiety and Depression Scale (HADS). We have used explanatory factor analysis (EFA) and factor extraction by principal component analysis (PCA) with orthogonal varimax (Kaiser Normalization) rotation on a cohort of 9706 French depressed patients. The relevance of the 14 items included in the HADS was also scrutinized by measuring the internal consistency and reliability of the global HADS removing each item one by one. Our conclusion is that the HADS could potentially gain in consistency in the detection of anxiety, notably through the revision of two of the anxiety items.

Reduced time from diagnosis to stone-free status in patients with ureteral calculi

Purpose - The purpose of this paper is to describe an improvement project and its effects on decreasing the time from diagnosis to treatment for patients with kidney stones and to reduce the negative effects related to untreated stones at one hospital in western Sweden. Design/methodology/approach - A quantitative descriptive study based on Nolan's improvement model was used. The quality improvement effects were evaluated using statistical process control. Findings - Extracorporeal shock wave lithotripsy treatment's positive effects within 48 hours were described as efficiency (decreased waiting time) from diagnosis to treatment, even if a re-treatment was necessary. The results also showed a reduction in the usage of percutaneous nephropyelostomies as a treatment option. Research limitations/implications - This study includes data from one department at one hospital in one country. Comparative data include the time from acute radiological examination to final treatment but not total re-treatments, complications or time to up following radiological examination. However, the study was performed over one year and analyzed data from medical records in a systematic way. Practical implications - This study may inspire measuring and developing routines from diagnosis to treatment for patients who are transferred within different departments at one hospital. Social implications - By measuring the working process, resource use within a healthcare organization could be visualized. Planning and co-operation at different managerial levels are key factors for success when improvement projects are performed. Originality/value - Studies in improvement projects considering ureteral or kidney stones are generally lacking; thus, this study is important for improving the care of patients with this diagnose.