The Role of Helicobacter Pylori Eradication on the Pathogenesis of Minimal Hepatic Encephalopathy in Egyptian Patients with Liver Cirrhosis

Background Hepatic Encephalopathy (HE) is defined as alteration of mental state in the absence of other causes of encephalopathy due to liver failure and/or abnormal shunting of blood from portal to systemic circulation often accompanied by elevated blood ammonia. Objectives The aim of this study was to determine the relation between the Helicobacter pylori infectionand minimal hepatic encephalopathy (MHE) in cirrhotic patients and to assess the outcome after treatment of H. pylori. Patients and Methods This study was can•ied out at Egyptian Railway Medical Centre at the in-patients section at Gastroenterology and Hepatology Medicine Department with chronic liver disease who agreed to participate in the study. After performing the psychometric tests the patients were allocated in one of the two groups according to test results: Group I: consisted of 30 consecutive patients who have chronic liver disease and presented with evidence of Minimal hepatic encephalopathy (MHE), as recognized by positive psychometric tests, Group Il: included 30 consecutive patients who presented with chronic liver disease and did not have Minimal hepatic encephalopathy, as confirmed by negative psychometric test. Results In this study a significant reduction was found in blood ammonia levels in MHE and non- MHE after triple-drug anti-H. pylori treatment (p < 0.001). This reduction was more marked in patients with MHE group compared to non-MHE group with % improvement in ammonia level 26.1 ± 8.36 umol/L and 17.79 ± 7.308 for MHE and non-MHE respectively. This finding indicates that H. pylori may contribute to the development of hyperammonemia in patients with liver disease and MHE. The role of H. pylori in the pathogenesis of hyperammonemia has been shown in previous studies which showed a reduction in blood ammonia levels after eradication of H.pylori infection. Conclusion Helicobacter Pylori infection was more prevalent in patients with MHE than without MHE. Serum arnrnonia levels were significantly higher in MHE patients than without MHE and even higher in H.pylori positive patients than without H.pylori infection. Helicobacter Pylori eradication treatment significantly improves ammonia levels, results of psychometric tests and improves manifestations of MHE.

Hepatic encephalopathy: modern aspects of diagnosis and treatment

A new approach to the diagnosis of PE has been the identification of latent and overt PE in recent years. The detailed assessment of the stages of PE presented in the paper actually reflects the severity of the disease. The diagnosis of latent PE is established based on the results of at least two psychometric tests repeated in dynamics, and the data of one computerized test. The diagnosis of apparent PE is often made by “excluding” other possible causes of brain dysfunction. It is shown that effective therapy of PE is based not only on the features of the pathogenesis, but is impossible without taking into account the various variants of the course of PE, the severity of the disease. Based on randomized controlled trials conducted in recent years, an effective strategy for the treatment of various forms of PE has been developed: episodic, recurrent. Recurrent, therapy-resistant, and obvious PE in the presence of hepatic insufficiency is an indication for liver transplantation.

Doble filicidio por suicidio ampliado (frustrado) de un sujeto afecto de depresión mayor psicótico y trastorno de la personalidad dependiente

Se ilustra un caso de suicido ampliado frustrado, en el que la perpetradora no logra consumar su propio suicidio, pero habiendo perpetrado el asesinato de sus propios 2 hijos a causa del sufrimiento de su trastorno depresivo mayor grave con sintomatología psicótica y rasgos de personalidad dependientes de la personalidad. Se ilustra el caso con las pruebas psicométricas administradas y se analiza la psicometría forense del caso. A case of frustrated extended suicide is illustrated, in which the perpetrator fails to consummate her own suicide, but having perpetrated the murder of her own 2 children because of the suffering of her major depressive disorder with psychotic symptomatology and personality-dependent personality traits. The case is illustrated with the psychometric tests administered and the forensic psychometrics of the case are analyzed.

Two Cheers for the Cognitive Irregulars: Intelligence’s Contributions to Ageing Well and Staying Alive

Here, intelligence is taken to mean scores from psychometric tests of cognitive functions. This essay describes how cognitive tests offer assessments of brain functioning—an otherwise difficult-to-assess organ—that have proved enduringly useful in the field of health and medicine. The two “consequential world problems” (the phrase used by the inviters of this essay) addressed in this article are (i) the ageing of modern societies (and the resulting increase in the numbers of people with ageing-related cognitive decrements and dementias) and (ii) health inequalities, including mortality. Cognitive tests have an ubiquitous place in both of these topics, i.e., the important fields of cognitive ageing and cognitive epidemiology, respectively. The cognitive tests that have sprouted in these fields are often brief and not mainstream, large psychometric test batteries; I refer to them as ‘irregulars’. These two problems are not separate, because results found with mental/cognitive/intelligence tests have produced a growing understanding that intelligence and health have a reciprocal, life-long relationship. Intelligence tests contribute to the applied research that is trying to help people to stay sharp, stay healthy, and stay alive.

Patterns of Adults with Low Literacy Skills Interacting with an Intelligent Tutoring System

A common goal of Intelligent Tutoring Systems (ITS) is to provide learning environments that adapt to the varying abilities and characteristics of users. This type of adaptivity is possible only if the ITS has information that characterizes the learning behaviors of its users and can adjust its pedagogy accordingly. This study investigated an intelligent tutoring system with computer agents (AutoTutor) designed to improve comprehension skills in adults with low reading literacy. One goal of this study was to classify adults into different clusters based on their behavioral patterns (accuracy and response time to answer questions) while they interacted with AutoTutor to help them improve their reading comprehension skills. A second goal was to investigate whether adults’ behaviors were associated with different reading components. A third goal was to assess improvements in reading comprehension skills, based on psychometric tests, of different clusters of readers. Performance on AutoTutor was collected in a targeted 100-hour hybrid intervention for adult readers (n = 252) that included both human teachers and the AutoTutor system. The adults’ average accuracy and response time in AutoTutor were used to cluster the adults into four categories: higher performers (comparatively fast and accurate), conscientious readers (slow but accurate), under-engaged readers (fast at the expense of somewhat lower accuracy) and struggling readers (slow and inaccurate). Two psychometric tests of comprehension were used to assess comprehension. Gains in comprehension scores were highest for conscientious readers, lowest for struggling readers, with higher performing readers and under-engaged readers in between. The results provide guidance to enhance the adaptivity of AutoTutor.

Double filicide for extended suicide (frustrated) of a subject with major psychotic depression and dependent personality disorder

ABSTRACT: A case of frustrated extended suicide is illustrated, where the perpetrator can’t commit her own suicide, but having perpetrated the murder of her own 2 children due to suffering from a severe major depressive disorder with psychotic symptoms and dependent personality traits. The case is illustrated with the psychometric tests administered and also, the forensic psychometry of the case is analyzed. RESUMEN: Se ilustra un caso de suicidio ampliado frustrado, en el que la autora no puede suicidarse, pero ha perpetrado el asesinato de sus propios 2 hijos debido a que padece un trastorno depresivo mayor grave con síntomas psicóticos y rasgos de personalidad dependiente. El caso se ilustra con las pruebas psicométricas administradas y además, se analiza la psicometría forense del caso.

An Attention-Based Diffusion Model for Psychometric Analyses

The emergence of computer-based assessments has made response times, in addition to response accuracies, available as a source of information about test takers’ latent abilities. The development of substantively meaningful accounts of the cognitive process underlying item responses is critical to establishing the validity of psychometric tests. However, existing substantive theories such as the diffusion model have been slow to gain traction due to their unwieldy functional form and regular violations of model assumptions in psychometric contexts. In the present work, we develop an attention-based diffusion model based on process assumptions that are appropriate for psychometric applications. This model is straightforward to analyse using Gibbs sampling and can be readily extended. We demonstrate our model’s good computational and statistical properties in a comparison with two well-established psychometric models.

Assessment of Pain, Acceptance of Illness, Adjustment to Life and Strategies of Coping with the Illness in Patients with Pancreatic Cancer

Pancreatic cancer is the fourth most common cancer causing death in the world. The prognosis of patients with pancreatic cancer is relatively low, which may be reflected in the patients’ lack of acceptance of the illness and passive attitudes towards the illness. The aim of the study was to evaluate the strategy of coping with pain and its control, acceptance of the illness and adjustment to life with cancer in patients suffering from pancreatic cancer. Forty-six patients with pancreatic cancer were included in the study. They were treated as outpatients at the Center of Oncology at Maria Skłodowska-Curie’s Institute in Warsaw between 2017 and 2018. The questionnaire included four psychometric tests: BPCQ, CSQ, AIS and MiniMAC. In the BPCQ test the highest average test result was obtained by “internal factors” (M = 16.85; SD = 5.64). The most frequently chosen strategies for coping with pain are praying/hoping (M = 22.33; SD = 7.85). The average illness acceptance score was 23.13 (SD = 7.84). The most common methods of psychological adjustment to cancer for the studied group are the strategies of positive re-evaluation (M = 20.07, SD = 3.67). Patients with pancreatic cancer have a low level of acceptance of their illness.

Autistic voices from the workplace

Purpose The purpose of this paper is to give autistic employees a voice, evaluate their work-based experiences and to disseminate the relevant recommendations of the Westminster AchieveAbility Commission report. Design/methodology/approach These experiences were identified through a questionnaire answered by 600 neurodivergent employees, including 95 autistic respondents. This allowed us to compare experiences across neurodivergent categories. Findings The overwhelmingly negative work-place experience is consistent at every stage unless managers had a good understanding of neurodivergence. This deteriorated further the more categories of neurodivergence identified with, and minority ethnicity. Few reasonable adjustments were made. Psychometric tests are experienced as disabling. No statistically significant differences were found between genders. Research limitations/implications The target group are not representative of the wider autistic population and the sample is relatively small. Further research could look at how managers come to understand neurodivergence, the utilisation of reasonable adjustments and how to promote neurodivergence awareness. Practical implications There need to be wholesale changes in recruitment and reasonable adjustments in the workplace, which will require substantial changes in attitudes. Social implications The experience of neurodivergent people in the work-place, including autistic employees, was more consistently negative than expected. It was difficult to find any autistic employees without disabling experiences. This paper hopes this will alert wider society to the issues and may serve to support more solidarity amongst neurodivergent people in relation to employment. The findings have already influenced The Advisory, Conciliation and Arbitration Service. Originality/value There is very little detailed research focussed on the work-place experience and voices of autistic employees and less research that considers the implications of neurodivergent overlaps in the workplace.