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Background/Objectives : Identity disruption is a key feature of borderline personality disorder (BPD), characterized by disturbances in self-image. This study aimed to use the Dimensions of Identity Development Scale (DIDS) in a population aged 16-25, to assess differences in identity status and correlations with BPD features as well as whether a correlation exists between the BPD features, the scores obtained on the DIDS and the scores of the different dimensions of this disorder. Methods: We analyzed data from 132 individuals: 44 with BPD using the Diagnostic Interview for Borderline-Revised (DIB-R). Statistical analyses included quantile regression to determine the differences in the DIDS after adjusting for confounding factors identified during group comparisons and Spearman correlation between the DIDS, the BPD features and the DIB-R. Results: Results indicated significantly lower DIDS scores in the BPD group, particularly in commitment making, exploration breadth (EB), identity with commitment (IM) and ruminative exploration (RE). After adjusting, only EB differs significantly between the two groups. All dimensions of the DIDS except for the exploration in depth (ED) are correlated with BPD features. Significant correlations could be demonstrated between cognitive dimension and ED, between the total DIDS and the number of suicide attempt (SA) and between the IM and the number of SA. Conclusions: Our clinical sample showed distinct identity formation compared to controls, with a lower EB associated with BPD. RE correlated with BPD, suggesting that the individuals engage in repetitive exploratory processes. SA was negatively associated with overall identity development and commitment, indicating impulsive behaviors in BPD intersect with identity struggles.

Functions of the cerebellar cortex, from motor learning to emotion and cognition, depend on the appropriate molecular composition at diverse synapse types. Glutamate receptor distributions have been partially mapped using immunogold electron microscopy. However, information is lacking on the distribution of many other components, such as Shank2, a postsynaptic scaffolding protein whose cerebellar dysfunction is associated with autism spectrum disorders. Here, we used an adapted Magnified Analysis of the Proteome, an expansion microscopy approach, to map multiple glutamate receptors, scaffolding and signaling proteins at single synapse resolution in the cerebellar cortex. Multiple distinct synapse-selective distribution patterns were observed. For example, AMPA receptors were most concentrated at synapses on molecular layer interneurons and at climbing fiber synapses, Shank1 was most concentrated at parallel fiber synapses on Purkinje cells, and Shank2 at both climbing fiber and parallel fiber synapses on Purkinje cells but little on molecular layer interneurons. Our results are consistent with gene expression data but also reveal input-selective targeting within Purkinje cells. In specialized glomerular structures of the granule cell layer, AMPA receptors as well as most other synaptic components preferentially targeted to synapses. However, NMDA receptors and the synaptic GTPase activating protein SynGAP preferentially targeted to extrasynaptic sites. Thus, glomeruli may be considered integrative signaling units through which mossy fibers differentially activate synaptic AMPA and extrasynaptic NMDA receptor complexes. Furthermore, we observed NMDA receptors and SynGAP at adherens junctions, suggesting a role in structural plasticity of glomeruli. Altogether, these data contribute to mapping the cerebellar 'synaptome'., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Robinson, Delhaye and Craig.)

Objective: Hemin, a heme oxygenase 1 activator has shown efficacy in the prevention and treatment of acute pancreatitis in mouse models. We conducted a randomized controlled trial (RCT) to assess the protective effect of Hemin administration to prevent post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in patients at risk., Methods: In this multicenter, multinational, placebo-controlled, double-blind RCT, we assigned patients at risk for PEP to receive a single intravenous dose of Hemin (4 mg/kg) or placebo immediately after ERCP. Patients were considered to be at risk on the basis of validated patient- and/or procedure-related risk factors. Neither rectal NSAIDs nor pancreatic stent insertion were allowed in randomized patients. The primary outcome was the incidence of PEP. Secondary outcomes included lipase elevation, mortality, safety, and length of stay., Results: A total of 282 of the 294 randomized patients had complete follow-up. Groups were similar in terms of clinical, laboratory, and technical risk factors for PEP. PEP occurred in 16 of 142 patients (11.3%) in the Hemin group and in 20 of 140 patients (14.3%) in the placebo group (p = 0.48). Incidence of severe PEP reached 0.7% and 4.3% in the Hemin and placebo groups, respectively (p = 0.07). Significant lipase elevation after ERCP did not differ between groups. Length of hospital stay, mortality and severe adverse events rates were similar between groups., Conclusion: We failed to detect large improvements in PEP rate among participants at risk for PEP who received IV hemin immediately after the procedure compared to placebo., Trial Registration Number: ClinicalTrials.gov number, NCT01855841)., Competing Interests: Declaration of competing interest All the authors declare that they have no conflict of interest., (Copyright © 2024 IAP and EPC. Published by Elsevier B.V. All rights reserved.)

Growing evidence suggests a remarkable diversity and complexity in the molecular composition of synapses, forming the basis for the brain to execute complex behaviors. Hence, there is considerable interest in visualizing the spatial distribution of such molecular diversity at individual synapses within intact brain circuits. Yet this task presents significant technical challenges. Expansion microscopy approaches have revolutionized our view of molecular anatomy. However, their use to study synapse-related questions outside of the labs developing them has been limited. Here we independently adapted a version of Magnified Analysis of the Proteome (MAP) and present a step-by-step protocol for visualizing over 40 synaptic proteins in brain circuits. Surprisingly, our findings show that the advantage of MAP over conventional immunolabeling was primarily due to improved antigen recognition and secondarily physical expansion. Furthermore, we demonstrated the versatile use of MAP in brains perfused with paraformaldehyde or fresh-fixed with formalin and in formalin-fixed paraffin-embedded tissue. These tests expand the potential applications of MAP to combinations with slice electrophysiology or clinical pathology specimens. Using male and female mice expressing YFP-ChR2 exclusively in interneurons, we revealed a distinct composition of AMPA and NMDA receptors and Shank family members at synapses on hippocampal interneurons versus on pyramidal neurons. Quantitative single synapse analyses yielded comprehensive cell type distributions of synaptic proteins and their relationships. These findings exemplify the value of the versatile adapted MAP procedure presented here as an accessible tool for the broad neuroscience community to unravel the complexity of the "synaptome" across brain circuits and disease states., Competing Interests: The authors declare no competing financial interests., (Copyright © 2024 the authors.)

Introduction: Earlier studies exploring the value of executive functioning (EF) indices for assessing treatment effectiveness and predicting treatment response in attention-deficit/hyperactivity disorder (ADHD) mainly focused on pharmacological treatment options and revealed rather heterogeneous results. Envisioning the long-term goal of personalized treatment selection and intervention planning, this study comparing methylphenidate treatment (MPH) and a home-based neurofeedback intervention (NF@Home) aimed to expand previous findings by assessing objective as well as subjectively reported EF indices and by analyzing their value as treatment and predictive markers., Methods: Children and adolescents ( n  = 146 in the per protocol sample) aged 7-13 years with a formal diagnosis of an inattentive or combined presentation of ADHD were examined. We explored the EF performance profile using the Conners Continuous Performance Task (CPT) and the BRIEF self-report questionnaire within our prospective, multicenter, randomized, reference drug-controlled NEWROFEED study with sites in five European countries (France, Spain, Switzerland, Germany, and Belgium). As primary outcome for treatment response, the clinician-rated ADHD Rating Scale-IV was used. Patients participating in this non-inferiority trial were randomized to either NF@home (34-40 sessions of TBR or SMR NF depending on the pre-assessed individual alpha peak frequency) or MPH treatment (ratio: 3:2). Within a mixed-effects model framework, analyses of change were calculated to explore the predictive value of neurocognitive indices for ADHD symptom-related treatment response., Results: For a variety of neurocognitive indices, we found a significant pre-post change during treatment, mainly in the MPH group. However, the results of the current study reveal a rather limited prognostic value of neurocognitive indices for treatment response to either NF@Home or MPH treatment. Some significant effects emerged for parent-ratings only., Discussion: Current findings indicate a potential value of self-report (BRIEF global score) and some objectively measured neurocognitive indices (CPT commission errors and hit reaction time variability) as treatment markers (of change) for MPH. However, we found a rather limited prognostic value with regard to predicting treatment response not (yet) allowing recommendation for clinical use. Baseline symptom severity was revealed as the most relevant predictor, replicating robust findings from previous studies., Competing Interests: YA was employed by myBrain Technologies; AB and LM were employed by Mensia Technologies. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. DP-O reports personal fees and nonfinancial support from Medice and Shire, nonfinancial support from HAC Pharma and Boehringer Ingelsheim, outside the submitted work. HB has received lecture fees from Takeda, BIAL, laboratorios Rubio, and laboratorios Rovi. He is PI of a research of the SINCRONIA project, funded by the Start-up Bitsphi, www.bitsphi.com, and co-Founder of Haglaia Solutions. EA reports personal fees and nonfinancial support from HAC Pharma, nonfinancial support from Shire, outside the submitted work. TB served in an advisory or consultancy role for Actelion, Hexal Pharma, Lilly, Lundbeck, Medice, Novartis and Shire. He received conference support or speaker’s fees from Lilly, Medice, Novartis and Shire. He has been involved in clinical trials conducted by Shire and Viforpharma. He received royalties from Hogrefe, Kohlhammer, CIP Medien and Oxford University Press. AB reports personal fees from Mensia Technologies outside the submitted work. LM has a patent EP3181043A1 pending, a patent EP3335630A1 pending and a patent EP3217869A1 pending and was employee and shareholder of Mensia Technologies SA, a company offering class IIa certified medical device for ADHD in children and teenagers. KM has received speaker’s fees by Takeda and Medice. The present work is unrelated to these relationships. OR reports personal fees and nonfinancial support from HAC Pharma, from Shire and from Novalac outside the submitted work. SW has received in the last 5 years royalties from Thieme, Hogrefe, Kohlhammer, Springer, Beltz. In 2023 she received speakers honorary from Takeda. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Kaiser, Aggensteiner, Blasco Fontecilla, Ros, Acquaviva, Attal, Banaschewski, Baumeister, Bousquet, Bussalb, Delhaye, Delorme, Drechsler, Goujon, Häge, Mayaud, Mechler, Menache, Revol, Tagwerker, Walitza, Werling, Bioulac, Purper-Ouakil and Brandeis.)

Purpose: Our study aimed to characterize and objectify the prevalence of psychiatric disorders and the use of psychotropic drugs in patients interested in undergoing aesthetic surgery. The psychiatric profile of this population is particularly interesting and is related to self-perception and the general concept of beauty., Methods: We conducted an observational, retrospective, and bicenter study of 2092 patients seen in plastic surgery departments. Data on general characteristics, pathology, psychiatric history (PH), use of psychotropic drugs, addictions, surgical requests, and surgical complications were recorded and analyzed., Results: Based on our inclusion criteria, we selected 524 patients. The prevalence of psychiatric disorders was 32.25%. The prevalence of depressive disorders (19.27%), anxiety disorders (8.21%), and sleep-wake cycle disorders (7.06%) should be noted. Comparing the population with psychiatric history (PH+) and without psychiatric history (PH-), significant differences were found in patient ethnicity, addictions (tobacco, 37.50% vs 15.00%; drugs, 3.26% vs 0.59%), and comorbidities. In the 66.86% (n = 113) of PH+ patients, the plastic surgeon did not record the presence of psychiatric disorders in the medical record., Discussion: This study offers a broad view of the prevalence and characteristics of psychiatric disorders and the use of psychotropic drugs among patients who want to undergo aesthetic surgery. The prevalence of psychiatric problems in the study population is higher than in the general population (32.25% vs 15.02%)., Conclusions: Our results suggest that plastic surgeons should be properly trained to manage these patients. A multidisciplinary approach involving plastic surgeons, psychiatrists, and psychologists is advocated., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

This paper explores the intricate relationship between teen dating violence (TDV) and mental health disorders among adolescents, a demographic particularly susceptible to such issues due to their critical developmental stage. The study underscores how mental health disorders can serve as both risk factors and consequences of TDV, with depression, suicidality, post-traumatic stress disorder (PTSD), substance use, and eating disorders being prominently associated with TDV. The profound and long-lasting repercussions of these mental health issues necessitate a comprehensive strategy to address TDV and its associated mental health implications. This paper advocates for a multi-pronged approach that includes the implementation of prevention programs to educate teenagers about healthy relationships, regular screening for TDV among adolescents for early detection, and the establishment of robust referral systems to ensure victims receive necessary support and treatment. By integrating these strategies, we aim to foster healthier relationships among teenagers, mitigate the incidence of TDV, and safeguard the mental well-being of our adolescents.

Background: This article examines the possibility that the "nightclub shots" epidemic is a "mass psychogenic disease" phenomenon, by comparing the various cases of "mass sociogenic diseases" reported in the literature. We carried out a literature review on PubMed. The keywords used were "mass hysteria", "mass sociogenic disease", "mass psychogenic disease" and "epidemic of multiple unexplained symptoms"., Results: Our review of the literature revealed several elements common to the various "mass hysterias" we identified. These phenomena generally appear in a climate of anxiety specific to the era in which they occur, in this case the fear of bioterrorism in the 21st century. Symptoms are generally benign and transient, appearing and resolving easily without the identification of an organic cause. They usually occur in a small group of individuals, and more frequently in young people and women. The media can exacerbate the phenomenon., Conclusion: The phenomenon of epidemics of nightclub shots seems to fit into the common framework of "mass psychogenic diseases" identified in the literature. This diagnosis could therefore be evoked, in the absence of any other objective somatic explanation.

Background: Multidisciplinary team (MDT) meetings aim to optimize patient management. We evaluated the impact of MDT discussions on the management and diagnosis of focal pancreatic lesions in a single tertiary center., Methods: All patients with an initial diagnosis of solid or cystic pancreatic lesion discussed in our institution's MDT meeting on pancreatic diseases between January 1, 2020, and December 31, 2021, were included. The impact of MDT discussion on patient management, defined as a modification of the initially proposed therapeutic plan after MDT discussion, as well as the criteria leading to this modification, were the primary outcomes. Impact on diagnosis was the secondary outcome., Results: A total of 522 patients were included. Of these, 185 (35.4%) and 337 (64.6%) had an initial diagnosis of cystic or solid lesion, respectively. The most common referral query was regarding the management plan (349/522; 66.9%). Endoscopy was the procedure most often proposed before MDT discussion (109/522; 20.9%). Overall, the MDT discussion led to modification of the management plan in 377/522 patients (72.2%), with a statistically significant difference between cystic and solid lesions (63.2% vs. 77.2%; P<0.001). Management modifications were mainly driven by revision of cross-sectional radiological images. MDT discussion led to modification of the diagnosis in 92/522 patients (17.6%), with a significant difference regarding cystic lesions (35.7% vs. 7.7%; P<0.001)., Conclusion: MDT discussion impacts the management of patients with cystic and solid pancreatic lesions, leading to a modification of the initially proposed management in two-thirds of them, mainly through revision of cross-sectional imaging., Competing Interests: Conflict of Interest: None, (Copyright: © Hellenic Society of Gastroenterology.)

Background: The demand for aesthetic surgery presents a continuously growing trend over the years. The population wishing to undergo this type of surgery presents unique characteristics that are profoundly different in motivational, demographic, and clinical features from patients in other specialties., Objectives: The aim of our multicenter study is to objectively define the surgical demand and the demographic characteristics of our patients comparing them with general population. We try to better define who are our patients., Methods: We conducted an observational, multicenter, retrospective study analyzing 3329 consultations involving a total of 2092 patients between January 2019 and June 2019. Based on the inclusion criteria, we selected 524 patients whose demographic characteristics, body mass index, addictions, comorbidities, and aesthetic surgery demand were analyzed., Results: The mean age of our population is 38.58 years (female-to-male ratio, 9:1). The mean body mass index is 27.50 (5.23). A total of 22.90% of the sample have smoking habits, 3.63% have alcohol addiction, 1.53% have drugs addiction, and 53.63% of the population have relevant comorbidities.The 56.68% of the patients have already undergone surgery. The conversion rate of our first consultations to surgery is 49.05%. The most requested operation is abdominoplasty (36.45%), followed by liposuction (22.90%), breast reduction (17.56%), mastopexy (14.79%), and rhinoplasty (7.63%)., Conclusions: This topic is downplayed and seldom studied in the literature; our effort is to make patient profiling crucial and evidence-based in aesthetic surgery., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Pancreatic tumours are frequently associated with obstructive jaundice requiring preoperative biliary drainage (PBD) before pancreatoduodenectomy (PD), exposing patients to infectious complications. This study aims to compare postoperative complications after PD with or without PBD and to analyse bile bacteriology and antibiotic susceptibility., Methods: All patients undergoing PD between 2014 and 2019 were retrospectively evaluated, and postoperative outcomes were compared according to PBD use. Prophylactic narrow-spectrum antibiotic therapy was given for 24 h, then adapted according to bacteriologic profile. Intraoperative bile cultures and antibiograms were collected., Results: Among 164 patients with intraoperative bile culture during PD (75 PBD+, 89 PBD-), an infected bile was observed in 95% and 70% of PBD + and PBD- groups, respectively ( p  < 0.001). Postoperative mortality and severe morbidity including infectious complications were similar between groups (5% and 15%). The median duration of antibiotherapy was longer in PBD + compared to PBD- groups (9 vs. 2 days, p  = 0.009). Malignant indication and PBD were associated with bile contamination using univariate analysis, and PBD was significantly relevant at multivariate analysis. Most common pathogens identified in bile cultures were Escherichia coli , Klebsiella spp . and Enterobacter spp . Overall antibiotic susceptibility to commonly used antibiotics was decreased, including those used in our local guidelines., Conclusions: PBD exposes nearly 100% of patients undergoing PD to bile infection and an increased duration of postoperative antimicrobial therapy, without increasing infectious complications in this study. Adaptation of antimicrobial prophylaxis should be further evaluated according to performance of PBD and local epidemiology, in order to avoid overuse of antibiotics.

Abnormal child behavior is a complex entity including among others disorders such as ADHD, a neuropsychiatric disorder interfering with the normal development of the child, and combining many comorbidities. There are no specific tools designed to assess abnormal child behavior, although well-known ADHD screening tools such as the CTRS-R:S go beyond the disorder itself and cover the wider construct. This can be understood as the complex system of mutually influencing entities, that is why the aim of this study was to investigate the items of the CTRS-R:S as a psychological network. We analyzed a data set of 525 children in French-speaking primary schools from Belgium, and estimated a Bayesian Gaussian Graphical Model with a Bayes Factor of 30. We identified highly connected nodes from each community of the CTRS-R:S to build an additional network of communities. In the domain network, Oppositional and Cognitive skills share the strongest connection in the network. The 28-item network was overall positively connected albeit the presence of some negative connections. The spinglass algorithm identified eight domains in the CTRS-R:S network that causally influence each other. The network approach is a useful framework to investigate the domains of abnormal child behavior as well as the interplay between individual symptoms.

Neurexin synaptic organizing proteins are central to a genetic risk pathway in neuropsychiatric disorders. Neurexins also exemplify molecular diversity in the brain, with over a thousand alternatively spliced forms and further structural heterogeneity contributed by heparan sulfate glycan modification. Yet, interactions between these modes of post-transcriptional and post-translational modification have not been studied. We reveal that these regulatory modes converge on neurexin-1 splice site 5 (S5): the S5 insert increases the number of heparan sulfate chains. This is associated with reduced neurexin-1 protein level and reduced glutamatergic neurotransmitter release. Exclusion of neurexin-1 S5 in mice boosts neurotransmission without altering the AMPA/NMDA ratio and shifts communication and repetitive behavior away from phenotypes associated with autism spectrum disorders. Thus, neurexin-1 S5 acts as a synaptic rheostat to impact behavior through the intersection of RNA processing and glycobiology. These findings position NRXN1 S5 as a potential therapeutic target to restore function in neuropsychiatric disorders., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Mpox virus (MPXV) caused a multi-country outbreak in non-endemic areas in 2022. Following historic success of smallpox vaccination with vaccinia virus (VACV)-based vaccines, the third generation modified vaccinia Ankara (MVA)-based vaccine was used as prophylaxis for MPXV, but its effectiveness remains poorly characterized. Here, we applied two assays to quantify neutralizing antibodies (NAbs) in sera from control, MPXV-infected, or MVA-vaccinated individuals. Various levels of MVA NAbs were detected after infection, historic smallpox, or recent MVA vaccination. MPXV was minimally sensitive to neutralization. However, addition of complement enhanced detection of responsive individuals and NAb levels. Anti-MVA and -MPXV NAbs were observed in 94% and 82% of infected individuals, respectively, and 92% and 56% of MVA vaccinees, respectively. NAb titers were higher in individuals born before 1980, highlighting the impact of historic smallpox vaccination on humoral immunity. Altogether, our results indicate that MPXV neutralization is complement dependent and uncover mechanisms underlying vaccine effectiveness., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Understanding psychopathology in transitional age youth (TAY) requires a complex model, incorporating familial vulnerability and environmental factors. A trans-diagnostic and dimensional approach seems the most appropriate. Transition&#95;psy study aims to assess factors playing a role in TAY psychopathology and to define predictors., Materials and Methods: This article presents part of the Transition&#95;psy study results, a case-control observational study. Youth aged 17 years old were recruited between June 2020 and December 2021, from both clinical [clinical population (CP) group] and non-clinical settings [non-clinical population (NCP) group]. Participants completed self-report questionnaires. The primary outcome to assess TAY psychopathology was the Youth-Self Report (YSR). We evaluated care needs with the Health of The Nation Outcome Scales For Children And Adolescents (HoNOSCA-SR) and quality of life with the World Health Organization Quality of Life - BREF (WHOQoL-BREF). Exposure factors included familial vulnerability, childhood, and present environmental factors, such as first-degree family history of psychopathology, the Childhood Trauma Questionnaire (CTQ) and the Family Assessment Device (FAD). YSR scores were compared, between groups, according to exposure factors with ANOVA and linear regression. We performed best subsets selection of multivariable analyses based on the Akaike Information Criterion. This study was registered with ClinicalTrials.gov (Identifier: NCT04333797)., Results: A total of 220 TAY (CP = 106, NCP = 114) were included in the study. Participants were aged 17 years old. The majority were female (69.1%), single (96.8%), and born in Belgium (82.3%). Clinical data were all significantly different between CP and NCP groups. YSR scores were found statistically different according to group ( p < 0.001), first-degree family history of psychopathology ( p < 0.001), CTQ ( p < 0.001), and FAD ( p < 0.001). Predictive dimensional model suggested that TAY psychopathology can be predicted by group, CTQ and FAD. Significant positive correlation was found between YSR and HoNOSCA (rho = 0.81) and negative correlation between YSR and physical and psychological health (rho = -0.69 and -0.71, respectively)., Conclusion: This study findings allowed to present a predictive dimensional model on TAY psychopathology, including belonging to a clinical population at transitional age, childhood trauma, and family dysfunction. Further research is needed to replicate Transition&#95;psy study results in other samples. The proposed model could be used in clinical practice to improve assessment of TAY psychopathology., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Marchini, Reis, Ben-Shaool, Delhaye, Kornreich, Nicolis, Slama, Leys and Delvenne.)

Background and Aims: Fully covered self-expandable metal stents (FCSEMSs) may offer a treatment option for pain associated with a dilated pancreatic duct (PD) in chronic pancreatitis (CP), but optimal patient selection and FCSEMS design, efficacy, and safety remain uncertain. We studied an investigational pancreatic FCSEMS for treatment of CP-associated pain., Methods: Patients with painful CP, a dominant distal PD stricture, and PD dilation upstream were enrolled in a prospective, multicenter, single-arm trial studying 6-month indwell of a 4- to 6-cm-long soft pancreatic FCSEMS. Primary efficacy and safety endpoints were pain reduction 6 months after FCSEMS indwell (performance goal ≥53%) and PD stenting-related serious adverse events (SAEs), respectively (performance goal <32%). The primary efficacy endpoint was assessed in patients with sufficiently severe and frequent pain at FCSEMS placement as a first stent or in exchange of a plastic stent., Results: Among 67 patients (mean age, 52.7 ± 12.5 years; mean time since CP diagnosis, 6.4 ± 6.4 years), 34 (50.7%) had plastic stent placement within 90 days of FCSEMS placement, and 46 patients were eligible for the primary efficacy endpoint analysis. Technical success was 97.0% (65/67). The observed primary efficacy (26.1%, 12/46) and safety endpoints (31.3%, 21/67) failed to meet the a priori study hypotheses. Study stent migration occurred in 47.7% of patients (31/65)., Conclusions: Six-month treatment with an FCSEMS did not lead to an expected degree of pain reduction, and migrations and SAEs were common. Further study is needed to clarify optimal decompressive strategy, FCSEMS design, and patient selection. (Clinical trial registration number: NCT02802020.)., (Copyright © 2023 American Society for Gastrointestinal Endoscopy. All rights reserved.)

This manuscript summarizes current primary resistance of Helicobacter pylori to antibiotics in Brussels in 2021. Resistance rates were estimated at 18% for clarithromycin, 24% for levofloxacin, 52% for metronidazole, and 0% for amoxicillin and tetracycline. When compared to 2016, resistance rates remain stable, except an increase of 30% for metronidazole., Competing Interests: Declaration of competing interest None to declare., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder interfering with the normal development of the child. The disorder can be screened at school with the Conners Teacher Rating Scale Revised Short (CTRS-R:S). This scale goes beyond the disorder itself and covers a wider construct, that of abnormal child behavior. This can be understood as a complex system of mutually influencing entities. We analyzed a data set of 525 children in French-speaking primary schools from Belgium, and estimated a network structure, as well as to determine the local dependence of items through Unique Variable Analysis. A reduced network was computed including 15 non-locally dependent items. The structural consistency of the network was not affected by redundant items and was structurally sound. The reduction of the number of variables in network studies is important to improve the investigation of network structures as well as better interpret results from inference measures.

Background: Although anorexia nervosa might delay puberty, a structured assessment at its onset remains crucial in excluding congenital delayed puberty diseases., Case Presentation: During the follow-up of a 15-year-old girl suffering from anorexia nervosa, a change of treatment has led to a thorough medical history revealing the absence of the olfactory bulb. Kallmann syndrome diagnosis was made on a blood analysis and the patient was treated with a multidisciplinary approach., Conclusion: After the diagnosis, our patient was relieved as it has clarified some of her symptoms including anosmia, poor height and maturational delay. Too often a delayed puberty is attributed to anorexia nervosa itself without considering medical history. This case definitely shows the importance of performing a case history and early diagnosis in pre-pubertal AN to rule out other rare diseases and avoid mid- and long-term sequelae., Level of Evidence: IV (case study)., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Neurofeedback is considered a promising intervention for the treatment of attention-deficit hyperactivity disorder (ADHD). NEWROFEED is a prospective, multicentre, randomized (3:2), reference drug-controlled trial in children with ADHD aged between 7 and 13 years. The main objective of NEWROFEED was to demonstrate the noninferiority of personalized at-home neurofeedback (NF) training versus methylphenidate in the treatment of children with ADHD., Methods: The NF group (n = 111) underwent eight visits and two treatment phases of 16 to 20 at-home sessions with down-training of the theta/beta ratio (TBR) for children with high TBR and enhancing the sensorimotor rhythm (SMR) for the others. The control group (n = 67) received optimally titrated long-acting methylphenidate. The primary endpoint was the change between baseline and endpoint in the Clinician ADHD-RS-IV total score in the per-protocol population (90 NF/59 controls)., Trial Registration: US National Institute of Health, ClinicalTrials.gov #NCT02778360., Results: Our study failed to demonstrate noninferiority of NF versus methylphenidate (mean between-group difference 8.09 90% CI [8.09; 10.56]). However, both treatment groups showed significant pre-post improvements in core ADHD symptoms and in a broader range of problems. Reduction in the Clinician ADHD-RS-IV total score between baseline and final visit (D90) was 26.7% (SMD = 0.89) in the NF and 46.9% (SMD = 2.03) in the control group. NF effects increased whereas those of methylphenidate were stable between intermediate and final visit., Conclusions: Based on clinicians' reports, the effects of at-home NF were inferior to those of methylphenidate as a stand-alone treatment., (© 2021 Association for Child and Adolescent Mental Health.)

Background and Aims: Bilomas most frequently result from postoperative bile leaks. The endoscopic conventional treatment is sphincterotomy ± stent placement. In complex cases, such as altered anatomy or failure of conventional treatment, transpapillary/transfistulary (TP/TF) drainage or EUS-guided transmural drainage (EUS-TD) may obviate additional biliary surgery. This study reports our experience with treating biloma secondary to refractory biliary leak with TP/TF drainage or EUS-TD and evaluates the safety and outcomes associated with this approach., Methods: This observational study focused on consecutive patients managed for biliary leakage (diagnosis based on imaging and/or bile outflow from a surgical drain) at a tertiary care hospital (2007-2017). TP/TF drainage was performed by double-pigtail stent(s) placement to drain the biloma through the leak during ERCP. For EUS-TD, plastic stent(s) were placed under EUS control. Primary outcomes were a composite of clinical success (patient free of sepsis after percutaneous drain removal and, in patients with benign disease, removal of all endoscopically placed stents, without need for reintervention) and biloma regression (<3 cm) at last follow-up., Results: Thirty patients (men, 57%; median age, 55 years) were included. Most biliary leaks resulted from cholecystectomy (27%) and hepatectomy (50%). Initial EUS-TD and TP/TF drainage were performed in 14 (47%) and 16 (53%) patients, respectively. At last follow-up (median, 33.2 months), clinical success and primary outcome were achieved in 70.4% of patients (EUS-TD, 75%; TP/TF, 67%). Additional surgery was necessary in 1 patient. Rate of serious adverse events was 23% (7/30), of which 13% (4/30) were procedure related. There were 4 deaths during the course of treatment, 2 of which were related to endoscopic interventions (hemorrhage and fibrillation)., Conclusions: TP/TF drainage or EUS-TD is technically feasible with high clinical success and may avoid the need for additional surgery in complex cases or in patients with altered anatomy., (Copyright © 2022 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)

Given the limited data currently available in the literature, the aim of this study was to investigate the risk of excessive daytime sleepiness (EDS) associated with major depression in a large sample of adolescents. The clinical and polysomnographic data of 105 adolescents recruited from the database of the Erasme Hospital sleep laboratory were analysed. A score > 10 on the Epworth Sleepiness Scale was used as cut-off for the diagnosis of EDS. The status (remitted or current) and the severity (mild to moderate or severe) of major depressive episodes were determined based on the diagnostic criteria of the DSM-IV-TR during a systematic psychiatric assessment. Logistic regression analyses were performed to determine the risk of EDS associated with major depression in adolescents. The prevalence of EDS was 34.3% in our sample of adolescents. After adjusting for the main confounding factors associated with EDS, multivariate logistic regression analysis demonstrated that unlike mild to moderate major depression, remitted major depression and severe major depression were risk factors for EDS in adolescents. In our study, we have highlighted that in adolescents, the EDS could be both residual symptom and severity marker of major depression, which seems to justify a systematic psychiatric assessment in adolescents with EDS complaints in order to allow better management of this problem in this particular subpopulation., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Long-term transmural double-pigtail stent (DPS) placement is recommended for patients with disconnected pancreatic duct syndrome (DPDS) and peripancreatic fluid collections (peri-PFCs). The long-term safety and efficacy of indwelling DPSs were evaluated., Methods: Medical files of patients treated with DPS for DPDS-associated peri-PFC and with a follow-up ≥ 48 months were reviewed. Early ( < 30 days) and late complications of DPS placement were evaluated and the primary endpoint, i. e., incidence of late complications per 100 patient-years of follow-up, was calculated. Short- and long-term success rates of endoscopic treatment and rate of peri-PFC recurrence were among secondary endpoints., Results: From 2002 to 2014 we identified 116 patients, with mean (SD) follow-up of 80.6 (34.4) months. Among early complications (n = 20), 6 occurred peri-interventionally. Late complications (n = 17) were mainly pain due to DPS-induced ulcer or erosion (n = 10) and 14 of these were treated conservatively or by stent removal; 2 gastro-pancreatico-colo-cutaneous fistulas and 1 persisting bleed required surgical intervention. No DPS-related deaths were recorded. The incidence rate (95 %CI) of late complications was 2.18 (1.27-3.49) per 100 patient-years of follow-up. Short- and long-term success rates (with 95 %CI) of endoscopic treatment were 97.4 % (94.5 %-100 %) and 94 % (89.6 %-98.3 %), respectively. The peri-PFC recurrence rate was 28 % (20.1 %-35.9 %), and 92.3 % of these occurred within the first 2 years. Stent migration, chronic pancreatitis, and length of stent (> 6 cm) were independently associated with higher rates of peri-PFC recurrence., Conclusions: Long-term transmural drainage with DPS is a safe and effective treatment for DPDS-associated peri-PFCs. However, about one quarter of peri-PFCs will recur., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)