MicroRNAs as potential biomarkers for diagnosis of post-traumatic stress disorder

Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events.Currently,there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with and without post-traumatic stress disorder.In addition,the heterogeneity of clinical presentations of post-traumatic stress disorder and the overlap of symptoms with other conditions can lead to misdiagnosis and inappropriate treatment.Evidence suggests that this condition is a multisystem disorder that affects many biological systems,raising the possibility that peripheral markers of disease may be used to diagnose post-traumatic stress disorder.We performed a PubMed search for microRNAs(miRNAs)in post-traumatic stress disorder(PTSD)that could serve as diagnostic biomarkers and found 18 original research articles on studies performed with human patients and published January 2012 to December 2023.These included four studies with whole blood,seven with peripheral blood mononuclear cells,four with plasma extracellular vesicles/exosomes,and one with serum exosomes.One of these studies had also used whole plasma.Two studies were excluded as they did not involve microRNA biomarkers.Most of the studies had collected samples from adult male Veterans who had returned from deployment and been exposed to combat,and only two were from recently traumatized adult subjects.In measuring miRNA expression levels,many of the studies had used microarray miRNA analysis,miRNA Seq analysis,or NanoString panels.Only six studies had used real time polymerase chain reaction assay to determine/validate miRNA expression in PTSD subjects compared to controls.The miRNAs that were found/validated in these studies may be considered as potential candidate biomarkers for PTSD and include miR-3130-5p in whole blood;miR-193a-5p,-7113-5p,-125a,-181c,and-671-5p in peripheral blood mononuclear cells;miR-10b-5p,-203a-3p,-4488,-502-3p,-874-3p,-5100,and-7641 in plasma extracellular vesicles/exosomes;and miR-18a-3p and-7-1-5p in blood plasma.Several important limitations identified in the studies need to be taken into account in future studies.Further studies are warranted with war veterans and recently traumatized children,adolescents,and adults having PTSD and use of animal models subjected to various stressors and the effects of suppressing or overexpressing specific microRNAs.

Autism spectrum disorder:difficulties in diagnosis and microRNA biomarkers

We performed a PubMed search for microRNAs in autism spectrum disorder that could serve as diagnostic biomarkers in patients and selected 17 articles published from January 2008 to December 2023,of which 4 studies were performed with whole blood,4 with blood plasma,5 with blood serum,1 with serum neural cell adhesion molecule L1-captured extracellular vesicles,1 with blood cells,and 2 with peripheral blood mononuclear cells.Most of the studies involved children and the study cohorts were largely males.Many of the studies had performed microRNA sequencing or quantitative polymerase chain reaction assays to measure microRNA expression.Only five studies had used real-time polymerase chain reaction assay to validate microRNA expression in autism spectrum disorder subjects compared to controls.The microRNAs that were validated in these studies may be considered as potential candidate biomarkers for autism spectrum disorder and include miR-500a-5p,-197-5p,-424-5p,-664a-3p,-365a-3p,-619-5p,-664a-3p,-3135a,-328-3p,and-500a-5p in blood plasma and miR-151a-3p,-181b-5p,-320a,-328,-433,-489,-572,-663a,-101-3p,-106b-5p,-19b-3p,-195-5p,and-130a-3p in blood serum of children,and miR-15b-5p and-6126 in whole blood of adults.Several important limitations were identified in the studies reviewed,and need to be taken into account in future studies.Further studies are warranted with children and adults having different levels of autism spectrum disorder severity and consideration should be given to using animal models of autism spectrum disorder to investigate the effects of suppressing or overexpressing specific microRNAs as a novel therapy.

Usher syndrome:Genetic diagnosis and current therapeutic approaches

Usher Syndrome(USH)is the most common deaf-blind syndrome,affecting approximately 1 in 6000 people in the deaf population.This genetic condition is characterized by a combination of hearing loss(HL),retinitis pigmentosa,and,in some cases,vestibular areflexia.Among the subtypes of USH,USH type 1 is considered the most severe form,presenting profound bilateral congenital deafness,vestibular areflexia,and early onset RP.USH type 2 is the most common form,exhibiting congenital moderate to severe HL for low frequencies and severe to profound HL for high frequencies.Conversely,type 3 is the rarest,initially manifesting mild symptoms during childhood that become more prominent in the first decades of life.The dual impact of USH on both visual and auditory senses significantly impairs patients'quality of life,restricting their daily activities and interactions with society.To date,9 genes have been confirmed so far for USH:MYO7A,USH1C,CDH23,PCDH15,USH1G,USH2A,ADGRV1,WHRN and CLRN1.These genes are inherited in an autosomal recessive manner and encode proteins expressed in the inner ear and retina,leading to functional loss.Although non-genetic methods can assist in patient triage and disease extension evaluation,genetic and molecular tests play a pivotal role in providing genetic counseling,enabling appropriate gene therapy,and facilitating timely cochlear implantation(CI).The CRISPR/Cas9 system and viral-based gene replacement therapy have recently emerged as highly promising techniques for treating USH.Regarding drug therapy,PTC-124 and Nb54 have been identified as promising drug interventions for genetic HL in USH.Simultaneously,CI has proven to be critical in the restoration of hearing.This review aims to summarize the genetic and molecular diagnosis of USH and highlight the importance of early diagnosis in Cuzzuol BR et al.Diagnosis and current treatments of USH WJO https://www.wjgnet.com 2 January 19,2024 Volume 11 Issue 1 guiding appropriate treatment strategies and improving patient prognosis.

Privacy Preserved Brain Disorder Diagnosis Using Federated Learning

Federated learning has recently attracted significant attention as a cutting-edge technology that enables Artificial Intelligence(AI)algorithms to utilize global learning across the data of numerous individuals while safeguarding user data privacy.Recent advanced healthcare technologies have enabled the early diagnosis of various cognitive ailments like Parkinson’s.Adequate user data is frequently used to train machine learning models for healthcare systems to track the health status of patients.The healthcare industry faces two significant challenges:security and privacy issues and the personalization of cloud-trained AI models.This paper proposes a Deep Neural Network(DNN)based approach embedded in a federated learning framework to detect and diagnose brain disorders.We extracted the data from the database of Kay Elemetrics voice disordered and divided the data into two windows to create training models for two clients,each with different data.To lessen the over-fitting aspect,every client reviewed the outcomes in three rounds.The proposed model identifies brain disorders without jeopardizing privacy and security.The results reveal that the global model achieves an accuracy of 82.82%for detecting brain disorders while preserving privacy.

Impact of next-generation sequencing on molecular diagnosis of inherited non-syndromic hearing loss

Hearing loss is one of the most common birth defects,with inherited genetic defects play an important role,contributing to about 60%of deafness occurring in infants.However,hearing impairment is genetically heterogeneous,with both common and rare forms occurring due to mutations in estimated 500 genes.Due to the large number and presumably low mutation frequencies of those genes,it would be highly expensive and time-consuming to address this issue by conventional gene-by-gene Sanger sequencing.Next-generation sequencing is a revolutionary technology that allows the simultaneous screening of mutations in a large number of genes.It is cost effective compared to classical strategies of linkage analysis and direct sequencing when the number or size of genes is large,and thus has become a highly efficient strategy for identifying novel causative genes and mutations involved in heritable disease.In this review, we describe major NGS methodologies currently used for genetic disorders and highlight applications of these technologies in studies of molecular diagnosis and the discovery of genes implicated in non-syndromic hearing loss.

Autism spectrum disorder and personality disorders: Comorbidity and differential diagnosis

BACKGROUND Differential diagnosis,comorbidities and overlaps with other psychiatric disorders are common among adults with autism spectrum disorder(ASD),but clinical assessments often omit screening for personality disorders(PD),which are especially common in individuals with high-functioning ASD where there is less need for support.AIM To summarize the research findings on PD in adults with ASD and without intellectual disability,focusing on comorbidity and differential diagnosis.METHODS PubMed searches were performed using the key words“Asperger’s Syndrome”,“Autism”,“Personality”,“Personality disorder”and“comorbidity”in order to identify relevant articles published in English.Grey literature was identified through searching Google Scholar.The literature reviews and reference sections of selected papers were also examined for additional potential studies.The search was restricted to studies published up to April 2020.This review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method.RESULTS The search found 22 studies carried out on ASD adults without intellectual disability that met the inclusion criteria:16 evaluated personality profiles or PD in ASD(comorbidity),five compared ASD and PD(differential diagnosis)and one performed both tasks.There were significant differences in the methodological Cluster A and cluster C PD are the most frequent co-occurring PD,but overlapping features should be considered.Data on differential diagnosis were only found with cluster A and cluster B PD.CONCLUSION ASD in high-functioning adults is associated with a distinct personality profile even if variability exists.Further studies are needed to explore the complex relationship between ASD and PD.

Association between Hearing Loss and Vestibular Disorders: A Review of the Interference of Hearing in the Balance

Introduction: Dizziness is very prevalent and makes a great impact on people’s life. Because of anatomical and functional similarities of hearing and vestibular systems, it is noted that there is a big relation between hearing loss and vestibular disorders. Depending on the age onset of hearing loss, it can cause even delay on motor development. Objective: To find literature that demonstrates the relation between hearing and balance. Confirming that hearing loss or even intervention to improve quality of hearing can interfere on vestibular system. Methodology: Revision of literature was carried out, preferring recent research only in English. Conclusion: Cochlea and vestibular systems have a close relationship;changes in one of them can cause big damage in the other. So, a complete evaluation of vestibular system is recommended before ear surgeries. Video Head Impulse Test is a new procedure able to evaluate high frequency movements of the head. It was an additional exam of vestibular status and came to help detect problems that were not diagnosed before. Efforts must be directed in order to protect the balance.

Reliability of enzyme assays in dried blood spots for diagnosis of 4 lysosomal storage disorders

Introduction: Lysosomal storage disorders (LSD) are inherited diseases caused, in the majority of them, by the deficiency of lysosomal enzymatic activities. Ob-jectives: We aimed to analyze the usefulness of DBS samples for diagnosis of 4 LSDs, with the availability of a large quantity of patient samples. Design and methods: Blood samples from previously diagnosed patients with Fabry, Gaucher, Hunter, and Maro-teaux-Lamy syndromes and normal control individ-uals, were collected and dispen-sed in filter paper, and used for enzymatic activity determination. Results: Diagnosis of hemi/homo-zygous patients with Fabry, Hunter and Maroteaux-Lamy diseases using DBS samples showed ideal parameters of 100% sensitivity and specificity. DBS assay for Gaucher disease would need a posterior confirmatory step. Conclusions: Leukocyte measu-rement is the only reliable way to diagnose Gaucher disease. For Hunter, Fabry and Maroteaux-Lamy disorders discrimination between patients and controls seems adequate by DBS.

Current State and Expectation in Diagnosis and Treatment of Bleeding Disorders

Under the heading of bleeding disorders aregrouped a number of diseases which have hemorrhagicproblems. Bleeding disorders are very common, involv-ing about one third of patients in the hematological con-sultation. The hemorrhagic mechanism are complex andmay be somewhat simplistically divided into three parts:platelet deficiencies, deficiencies in the plasma coagula-

Recent Advances in HIV-Associated Neurocognitive Disorders

HIV-associated neurocognitive disorders (HAND) are chronic complications of HIV infection in the central nervous system. Clinical presentations include asymptomatic neurocognitive impairment (ANI), mild neurocognitive impairment (MND), and HIV-associated dementia (HAD). In the era of combination antiretroviral therapy (cART), the prevalence of HAD has significantly decreased, but the rates of ANI and MND have increased, impairing patients’ daily functioning, medical adherence, employment, driving abilities, risk of HIV transmission, overall quality of life, and posing challenges to society, economy, families, and public health. This article reviews the latest research findings regarding the pathogenesis, clinical diagnosis and treatment, neuroimaging, and neuropsychological assessment of HAND, aiming to provide insights into the prevention and management of HAND.

Clinical and genetic characteristics of a child with Sotos syndrome and attention-deficit/hyperactivity disorder:A case report

BACKGROUND Sotos syndrome is an autosomal dominant disorder,whereas attention-deficit/hyperactivity disorder(ADHD)is a neurodevelopmental condition.This report aimed to summarize the clinical and genetic features of a pediatric case of Soros syndrome and ADHD in a child exhibiting precocious puberty.CASE SUMMARY The patient presented with accelerated growth and advanced skeletal maturation;however,she lacked any distinct facial characteristics related to specific genetic disorders.Genetic analyses revealed a paternally inherited heterozygous synonymous mutation[c.4605C>T(p.Arg1535Arg)].Functional analyses suggested that this mutation may disrupt splicing,and bioinformatics analyses predicted that this mutation was likely pathogenic.After an initial diagnosis of Sotos syndrome,the patient was diagnosed with ADHD during the follow-up period at the age of 8 years and 7 months.CONCLUSION The potential for comorbid ADHD in Sotos syndrome patients should be considered to avoid the risk of a missed diagnosis.

Understanding Behavioral Manifestations of Obsessive-Compulsive Disorder in People with Intellectual Disabilities—A Qualitative Study

Background: There is limited knowledge about obsessive-compulsive disorder (OCD) in people with intellectual disabilities (IDs). This paper describes the manifestation of compulsive behaviors associated with OCD at the behavioral level in people with ID in institutionalized settings. The aim was to gain nuanced insight into appropriate understanding and classification in this specific context, and derive implications for research and practice. Methods: Individual cases of people with ID (n = 7) were studied to assess compulsive symptoms through two days of on-site observation of the person with ID within the institution, guided group discussions (n = 28), and semi-structured interviews with key informants and caregivers of the person with ID (n = 20). Caregiver ratings of the compulsive behavior checklist were compiled. Data were analyzed using qualitative content analysis. Results: All forms of OCD were present. Characteristics of compulsive behaviors in people with ID at the behavioral level included less complex and more obvious compulsive acts, immediate responses, signs of tension, motor restlessness, facial expression changes, repetition, need for predictability, time-consuming behaviors, and aggressive reactions when these acts were interrupted. Some of the compulsive behaviors corresponded to the ICD-11 OCD code 6B20, and others to compulsions as a psychological symptom (MB23.4). Conclusions: OCD may manifest atypically at the behavioral level in people with ID, posing significant challenges for accurate classification due to symptom ambiguity. Follow-up differential diagnostic studies are needed to more accurately identify and differentiate OCD symptoms in people with ID. Further, disorder-specific guidelines for recognizing OCD in people with ID are needed for institutionalized settings without psychiatric-psychotherapeutic expertise.

Somatic disorder:diagnosis and management

Objective To enhance diagnosis and cure rate of somatic disorder.Method SCL-90,CCMD-3,HAMD,and HAMA were used to evaluate 68patients suffere d from incurable somatic unfitness.Psychotherapy and antidepression t herapy were used to treat 53patients with somatic disorder.After 12weeks,SCL-90and clinical evaluation were performed on these pat ients.Result53patients were in line with somatic disorder am ong 98with somatic indisposition.S omatic disorder was manifested as di sorder of vegetable nerve disorder and persist somatic pain.C linical symptoms and SCL-90perform ance were improved dramatically aft er psychotherapy and an-tidepression treatment.Conclusion Awareness to psychiatric knowledge,training of medical staffs about psychiatric health and appropriate psychotherapy and medicine can improve diagnosis and therapy of patient s with somatic disorder.

S2B-1 A Study of Diagnosis and Early Efficacy Prediction Biomarkers for Major Depressive Disorder

Background:Currently,diagnosis of major depressive disorder(MDD)still relies on symptoms.There are some problems for the diagnostic criteria,like low diagnostic consistency and difficulty in differentiation of MDD and bipolar depression(BD)in the early stage.In terms of treatment,there are also many problems,such as low overall efficiency,slow onset effect,and large differences between individuals.At present,there are a lot of researches on MDD biomarkers,most focus on genomics,transcriptomics,proteomics and brain imaging both from domestic and foreign counterparts,but the main research focuses are genetics and imaging.This study is mainly combine genetics and imaging to conduct the discussions of MDD diagnosis and efficacy prediction biomarkers.Methods:Proteomics mainly included patients who met the diagnostic criteria.Blood samples were taken from the participants.Serum was collected after centrifugation for serum protein concentration detection.Receiver operation curve(ROC)analysis was used to test the diagnostic and differential powers of the single serum proteins or combined serum proteins.In the imageology groups,the 3.0T cranial magnetic resonance imaging(MRI)scan was performed on the subjects meeting the inclusion criteria,and the methods based on the deep learning of the resting-state fMRI data was used.The biological marker spectrums from molecular levels(genotyping or measuring genetic products)to clinical levels(depicting cognitive and motivational areas or clinical symptoms)to predict the outcome of the treatment.Results:In the diagnosis of MDD,accord to the results of previous animal experiments and clinical studies,we developed a highly accurate MDD diagnostic platform based on the serum levels of proteins in the P11-tPA-BDNF pathway.The sensitivity of the MDD diagnostic platform was 88.1%,specificity was 92.7%,and accuracy was as high as 90.6%.Based on the above findings,we further studied the diagnosis and differential diagnosis efficacy of serum proteins levels in this pathway for five common psychiatric diseases:schizophrenia(SZ),MDD,bipolar mania(BM),BD,and panic disorder(PD).The results suggest that the combination of serum proteins levels(tPA,PAI-1,BDNF,proBDNF,TrkB,p75NTR)in this pathway has a high accuracy not only in the diagnosis and differential diagnosis of MDD,but also in the diagnosis and identification of SZ,BM,BD and PD,which can be used as a diagnostic platform for common mental diseases.After that,we further studied serum VGF and BICC1 proteins upstream or downstream of this pathway.We found that serum VGF levels decreased in MDD while increased in BD patients compared with healthy controls(HC),had a significant ability for identifying MDD and BD,and its sensitivity is 95%,specificity is 100%,and the accuracy is up to 95%.Similarly,BICC1 also has a good diagnostic and differential efficacy in MDD,BM,and BD.We also found that facial expressions also contribute to the diagnosis and severity of MDD.In addition,imaging studies also showed that MDD patients have characteristics of small-world networks that are different from other populations,showing an increase in the characteristic path length(Lp)and a decrease in network efficiency(E),which is beneficial to the diagnosis and differential diagnosis of MDD.In the efficacy of MDD,we found that CMHC differences are existed in the precuneus and infraorbital gyrus between responsive depression(RD)group and non-responding depression(NRD)group,and the precuneus VMHC values of RD group were significantly negatively associated with the baseline scores of Hamilton depression rating scale(HAMD).ROC analysis showed that combining the VMHC values of above-mentioned brain regions can distinguish NRD more effectively.Similarly,imaging studies also found that the left ORBsup node was lower than that of the HC group,while the right ORBinf was increased;right dorsolateral superior frontal gyrus(SFGdor)nodes are lower when compare to NRD that may be the basis for different therapeutic effects.The combined ROC analysis showed that the degree of right SFGdor node and the characteristic path length can predict NRD well.We also found that there are significant correlations between bilateral NAcc network connectivity property and the severity as well as early efficacy of MDD,and the temporal variability between different efficacy MDD groups is different.The bimodal analysis based on CBF+ALFF showed that ALFF values of the bilateral occipital gyrus(MOG),left lentiform nuclear(lentiform),right superior temporal gyrus,and CBF and ALFF of right calcarine gyrus(Calcarine)and left caudate nucleus(Caudate)are significantly correlated with the severity or early efficacy of MDD at baseline.Including CBF of left Caudate and right middle frontal gyrus as well as ALFF of right inferior temporal gyrus can predict NRD better.Conclusion:Both proteomics and imaging have the feasibility of developing an objective tool for the diagnosis and efficacy evaluation of MDD.In the future,larger samples of clinical studies are needed to obtain repeatable,scientific,and reliable specific biomarkers for the differential diagnosis of MDD and BD,and the precise clinical diagnosis and treatment of MDD.

Rome Ⅲ:The functional gastrointestinal disorders, third edition, 2006

Functional gastrointestinal disorders （FGIDs） represent a common and important class of disorders within gastroenterology. Rome Ⅰ, the first edition was published in 1994, with symptom-based diagnostic criteria for FGIDs. These criteria began to change the diagnostic approach to F-GIDs, and no longer considered ＂diagnoses of exclusion＂ but rather ＂diagnoses of inclusion＂. Rome Ⅱ, the second edition published in 2000, resulted from the continual process of analyzing new scientific and clinical evidence in the study of F-GIDs. Rome Ⅱ, diagnostic criteria for irritable bowel syndrome （IBS）, was extended with a focus on the frequency of symptoms occurring twelve weeks （not necessarily consecutive weeks） within twelve months. ROlE Ⅲ, the third edition, conservative one, was published in September 2006, with changes made only where there is good evidence to do so. Some of the differences between Rome Ⅱ and Rome Ⅲ criteria are highlighted in this issue.

Skin reactions caused by bone-anchored hearing aid(BAHA) implantation

Objective: To report a case of intractable skin reactions caused by bone-anchored hearing aid (BAHA) implantation to improve our under-standing and treatment of BAHA implantation-caused skin reactions. Methods:We reported a case of severe skin reactions caused by BAHA implantation. Related literature were also reviewed. Results:We found grade IV skin reactions, including hyperplasia around the implant, which led to the removal of the BAHA implant 10 months after implantation. The findings indicated poor skin hygiene, allergy to titanium and inadequate surgicals skills as the possible causes of the skin reaction. Conclusion: Skin adverse reactions, usually rare in BAHA implantation patients, may cause implant removal and implantation failure. We suggest to further investigate the mechanisms underlying titanium allergy. Copyright ? 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Expert consensus on the prevention and treatment of substance use and addictive behaviour-related disorders during the COVID-19 pandemic

In early 2020,the COVID-19 outbreak complicated the diagnosis,treatm ent and rehabilitation of patients with substance use disorders and increased the risks of substance abuse and addictive behaviours,such as online gaming disorders,in the general public.Substance use disorder is a chronic recurrent brain disease characterised by strong cravings,high recurrence rates,and a high proportion of comorbidity of mental and physical disorders.1 Therefore,regular long-term therapeutic interventions are critical to preventing dm g relapses while maintaining withdrawal.

Analysis of the evidence of related factors,associated conditions and at-risk populations of the NANDA-I nursing diagnosis insomnia

Objectives:To summarize evidence in the literature on the predictors of insomnia in adults and to determine correspondences with diagnostic indicators of the NANDA-I diagnosis Insomnia.Methods:An integrative review performed in Pubmed,Virtual Health Library and CINAHL.Forty-eight articles published in Portuguese,English or Spanish from 2011 to 2018 were included.An analysis of correspondence between the predictors and the NANDA-I related factors and associated conditions for Insomnia was performed.Results:There was a correspondence of the predictors found in this review with NANDA-I related factors and associated conditions,except for grieving and frequent naps during the day.Smoking,caffeine intake,dysfunctional sleep beliefs,obesity and caregiver role strain are possible new related factors;chronic illness is a possible new associated condition and individuals going through changes in marital status,economically disadvantaged,female gender,increasing age and night shift worker are possible new at-risk populations.Conclusion:The predictors of insomnia that had a correspondence with the NANDA-I elements can support the evidence base of the nursing diagnosis.The predictors found without a correspondence with the diagnosis can be considered for inclusion in the NANDA-I classification,thereby supporting the clinical reasoning of nurses and students.

Multi-Scale Attention-Based Deep Neural Network for Brain Disease Diagnosis

Whole brain functional connectivity(FC)patterns obtained from resting-state functional magnetic resonance imaging(rs-fMRI)have been widely used in the diagnosis of brain disorders such as autism spectrum disorder(ASD).Recently,an increasing number of studies have focused on employing deep learning techniques to analyze FC patterns for brain disease classification.However,the high dimensionality of the FC features and the interpretation of deep learning results are issues that need to be addressed in the FC-based brain disease classification.In this paper,we proposed a multi-scale attention-based deep neural network(MSA-DNN)model to classify FC patterns for the ASD diagnosis.The model was implemented by adding a flexible multi-scale attention(MSA)module to the auto-encoder based backbone DNN,which can extract multi-scale features of the FC patterns and change the level of attention for different FCs by continuous learning.Our model will reinforce the weights of important FC features while suppress the unimportant FCs to ensure the sparsity of the model weights and enhance the model interpretability.We performed systematic experiments on the large multi-sites ASD dataset with both ten-fold and leaveone-site-out cross-validations.Results showed that our model outperformed classical methods in brain disease classification and revealed robust intersite prediction performance.We also localized important FC features and brain regions associated with ASD classification.Overall,our study further promotes the biomarker detection and computer-aided classification for ASD diagnosis,and the proposed MSA module is flexible and easy to implement in other classification networks.

Classification,prevalence and integrated care for neurodevelopmental and child mental health disorders:A brief overview for paediatricians

‘Neurodevelopmental disorders’comprise a group of congenital or acquired longterm conditions that are attributed to disturbance of the brain and or neuromuscular system and create functional limitations,including autism spectrum disorder,attention deficit/hyperactivity disorder,tic disorder/Tourette’s syndrome,developmental language disorders and intellectual disability.Cerebral palsy and epilepsy are often associated with these conditions within the broader framework of paediatric neurodisability.Co-occurrence with each other and with other mental health disorders including anxiety and mood disorders and behavioural disturbance is often the norm.Together these are referred to as neurodevelopmental,emotional,behavioural,and intellectual disorders(NDEBIDs)in this paper.Varying prevalence rates for NDEBID have been reported in developed countries,up to 15%,based on varying methodologies and definitions.NDEBIDs are commonly managed by either child health paediatricians or child/adolescent mental health(CAMH)professionals,working within multidisciplinary teams alongside social care,education,allied healthcare practitioners and voluntary sector.Fragmented services are common problems for children and young people with multi-morbidity,and often complicated by subthreshold diagnoses.Despite repeated reviews,limited consensus among clinicians about classification of the various NDEBIDs may hamper service improvement based upon research.The recently developed“Mental,Behavioural and Neurodevelopmental disorder”chapter of the International Classification of Diseases-11 offers a way forward.In this narrative review we search the extant literature and discussed a brief overview of the aetiology and prevalence of NDEBID,enumerate common problems associated with current classification systems and provide recommendations for a more integrated approach to the nosology and clinical care of these related conditions.