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This study evaluated sleep quality, chronotype, and excessive diurnal somnolence in persons with Juvenile Myoclonic Epilepsy (JME) and their possible association with clinical variables.This cross-sectional controlled study evaluated 49 consecutive patients (65% females, mean age 27.53 years) with an electroclinical diagnosis of JME and 49 healthy controls (55% females, mean age 28.55 years). The Pittsburgh Sleep Quality Inventory (PSQI) was used to assess sleep quality and the Epworth Sleepiness Scale (ESS) to evaluate excessive daytime sleepiness. The patients' chronotype was evaluated by the Morningness-Eveningness Questionnaire (MEQ). Epilepsy-related factors gathered from the medical chart and personal interview were epilepsy duration, age at onset, frequency of myoclonic (Mcl), generalized tonic-clonic (GTC) and absence (ABS) seizures, pharmacoresponse, and current antiseizure medication (ASM).Persons with JME did not differ from the control group regarding daytime sleepiness (p=0.840); however, the JME group had worse sleep quality (p=0.01) than the controls. Persons with JME presented a more evening chronotype than controls (p = 0.003). The age at onset, epilepsy duration, frequency of Mcl seizure, frequency of GTC seizure, frequency of ABS seizure, and drug response did not predict ESS and MEQ scales. Pharmacoresponsive patients had lower PSQI scores compared with pharmacoresistant patients (p=0.036).Persons with JME have worse sleep quality and a more evening chronotype. Notably, pharmacoresistant patients present a worse sleep quality that deserves attention and special care due to the relationship between sleep deprivation and seizure worsening.

BACKGROUND Digital phenotyping is a promising methodology for capturing moment-to-moment data that can inform individually adapted and timely interventions for youth with chronic pain. OBJECTIVE The current study aimed to investigate adolescent and parent endorsement, perceived utility, and concerns related to smartphone sensor data collection for digital phenotyping for clinical and research purposes in youth with chronic pain. METHODS Through multiple-choice and open-response survey questions, we assessed participant perspectives on passive data collection from the following nine embedded smartphone sensors: Accelerometer, Applications, Bluetooth, Text/Call Log, Keyboard, Voice, Light, Screen, and GPS. RESULTS Quantitative and qualitative analyses indicated that adolescents and parent endorsement and perceived utility of digital phenotyping varied by sensor, though participants generally endorsed the use of sensor-collected data, if a certain level of utility could be provided. All participants reported primary concerns related to privacy and accuracy and validity of data collected. CONCLUSIONS Findings support the tailored use of digital phenotyping for this population and can can help refine this methodology toward an acceptable, feasible, and ethical implementation of real-time symptom monitoring for assessment and intervention in youth with chronic pain.

Purpose This study aimed to determine the presence of anxiety disorder and severity of anxiety symptoms in an extensive series of consecutive patients with JME and its association with epilepsy-related factors. In addition, we evaluated the impact of anxiety and clinical variables on social adjustment. Methods We prospectively evaluated 112 (56.2 % females, mean age 27.2 years) patients with an electroclinical diagnosis of JME and 61 (52.4 % females, mean age 29.3 years) healthy controls. Anxiety symptoms were assessed by the State and Trait Anxiety Inventory (STAI). Social functioning was addressed with Self-Report Social Adjustment Scale (SAS). The patient group was also evaluated with a psychiatric interview. Results Patients with JME presented more severe anxiety symptoms and worse social adjustment compared with controls. The presence of anxiety disorder and the severity of anxiety symptoms was associated with frequent seizures - generalized tonic-clonic seizures (p = 0.008) and drug-resistant epilepsy (p = 0.021). Regarding social adjustment, the severity of anxiety symptoms was associated with lower economic adjustment (p = 0.039), while the presence of anxiety disorder impacted family relationships (p 0.025). The presence of hard-to-control myoclonic seizure was associated with lower scores on work (p = 0.019), leisure activities (p = 0.008), family relationship (p = 0.022) and overall social adjustment (p = 0.038). Conclusion Patients with JME have severe anxiety symptoms and worse social adjustment. Anxiety disorder and symptoms were associated with frequent seizures and drug-resistant epilepsy. Epilepsy-related factors and anxiety impaired distinct aspects of social functioning.

Objective: To analyze the major outcomes comparing single versus multiple courses of antenatal corticosteroids (ACS) therapy in women at high risk of premature delivery. Methods: This systematic review analyzed 20 articles that were selected from “Biblioteca Virtual em Saúde" of Pan American Health Organization. The terms “multiple courses” and “antenatal corticosteroids” were used to search in databases: MEDLINE, LILAC, CUMED and IBECS. Another 4 relevant articles outside this search and fit our inclusion criteria were added. Results: There is no consensus in literature about whether multiple doses of ACS are beneficial or harmful for the infant and women. The majority of the reviewed articles positioned against multiple corticosteroid therapy, due to possible neurological effects to the newborn and the no outstanding results compared to single dose. Although some studies demonstrated that multiple ACS might have benefits greater than harms. Independently of those opinions, there is one major difficulty to establish the benefits of multiple ACS: insufficient long-term evaluation of these infants. For this reason, there are several neutral articles. Conclusion: The different criteria of each study (e.g. gestational age, dosage of ACS, sample size), made it difficult to analyze the articles in a standard format. There might be advantages in corticoid therapy in lower gestational age. However, there is a lack of long-term studies with exposed infants, besides insufficient studies about the best methods to administer the ACS (dosage, number of doses, rescue dose, gestational age). More long-dated follow-up and studies about methodologies are necessary to conclude this hypothesis.

A disponibilidade de recursos de processamento nos processadores atuais aliada à complexidade do software faz com que ferramentas automatizadas sejam cada vez mais importantes no processo de validação e avaliação de aplicações multithreaded. Este artigo apresenta o desenvolvimento de uma ferramenta para análise do comportamento de threads em sistemas multicore. Especificamente, a ferramenta proposta, denominada CoreTool, acompanha o escalonamento e execução das threads de uma aplicação e retorna informações precisas sobre a utilização dos núcleos de processamento assim como a execução de instruções por thread. CoreTool foi desenvolvida a partir da infraestrutura PIN para instrumentação binária dinâmica de aplicações multithreaded. Experimentos de validação e avaliação foram realizados com a ferramenta e aplicações Linux e do benchmark Splash-2. Os experimentos foram executados sobre duas configurações de processadores multicore com quatro e oito núcleos. 1.