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Abnormal effort-based decision-making represents a potential mechanism underlying motivational deficits (amotivation) in psychotic disorders. Previous research identified effort allocation impairment in chronic schizophrenia and focused mostly on physical effort modality. No study has investigated cognitive effort allocation in first-episode psychosis (FEP).
Cognitive effort allocation was examined in 40 FEP patients and 44 demographically-matched healthy controls, using Cognitive Effort-Discounting (COGED) paradigm which quantified participants’ willingness to expend cognitive effort in terms of explicit, continuous discounting of monetary rewards based on parametrically-varied cognitive demands (levels N of N-back task). Relationship between reward-discounting and amotivation was investigated. Group differences in reward-magnitude and effort-cost sensitivity, and differential associations of these sensitivity indices with amotivation were explored.
Patients displayed significantly greater reward-discounting than controls. In particular, such discounting was most pronounced in patients with high levels of amotivation even when N-back performance and reward base amount were taken into consideration. Moreover, patients exhibited reduced reward-benefit sensitivity and effort-cost sensitivity relative to controls, and that decreased sensitivity to reward-benefit but not effort-cost was correlated with diminished motivation. Reward-discounting and sensitivity indices were generally unrelated to other symptom dimensions, antipsychotic dose and cognitive deficits.
This study provides the first evidence of cognitive effort-based decision-making impairment in FEP, and indicates that decreased effort expenditure is associated with amotivation. Our findings further suggest that abnormal effort allocation and amotivation might primarily be related to blunted reward valuation. Prospective research is required to clarify the utility of effort-based measures in predicting amotivation and functional outcome in FEP.
Better understanding of interplay among symptoms, cognition and functioning in first-episode psychosis (FEP) is crucial to promoting functional recovery. Network analysis is a promising data-driven approach to elucidating complex interactions among psychopathological variables in psychosis, but has not been applied in FEP.
This study employed network analysis to examine inter-relationships among a wide array of variables encompassing psychopathology, premorbid and onset characteristics, cognition, subjective quality-of-life and psychosocial functioning in 323 adult FEP patients in Hong Kong. Graphical Least Absolute Shrinkage and Selection Operator (LASSO) combined with extended Bayesian information criterion (BIC) model selection was used for network construction. Importance of individual nodes in a generated network was quantified by centrality analyses.
Our results showed that amotivation played the most central role and had the strongest associations with other variables in the network, as indexed by node strength. Amotivation and diminished expression displayed differential relationships with other nodes, supporting the validity of two-factor negative symptom structure. Psychosocial functioning was most strongly connected with amotivation and was weakly linked to several other variables. Within cognitive domain, digit span demonstrated the highest centrality and was connected with most of the other cognitive variables. Exploratory analysis revealed no significant gender differences in network structure and global strength.
Our results suggest the pivotal role of amotivation in psychopathology network of FEP and indicate its critical association with psychosocial functioning. Further research is required to verify the clinical significance of diminished motivation on functional outcome in the early course of psychotic illness.
The aim of the study was to investigate any association between extrauterine growth restriction (EUGR) and intestinal flora of <30-week-old preterm infants. A total of 59 preterm infants were assigned to EUGR (n=23) and non-EUGR (n=36) groups. Intestinal bacteria were compared by using high-throughput sequencing of bacterial rRNA. The total abundance of bacteria in 344 genera (7568 v. 13,760; P<0.0001) and 456 species (10,032 v. 18,240; P<0.0001) was significantly decreased in the EUGR group compared with the non-EUGR group. After application of a multivariate logistic model and adjusting for potential confounding factors, as well as false-discovery rate corrections, we found four bacterial genera with higher and one bacterial genus with lower abundance in the EUGR group compared with the control group. In addition, the EUGR group showed significantly increased abundances of six species (Streptococcus parasanguinis, Bacterium RB5FF6, two Klebsiella species and Microbacterium), but decreased frequencies of three species (one Acinetobacter species, Endosymbiont_of_Sphenophorus_lev and one Enterobacter_species) compared with the non-EUGR group. Taken together, there were significant changes in the intestinal microflora of preterm infants with EUGR compared to preterm infants without EUGR.
South-east Asian apple snails, Pila spp., have been declining since the introduction of globally invasive, confamilial South American Pomacea spp., yet Pila ecology remains poorly studied, with most occurrence records unconfirmed. Pila scutata, a previously widespread species, presumed native to the Malay peninsula and assessed as Least Concern in the IUCN Red List, was formerly harvested for food, and may have experienced anthropogenic translocations. We surveyed the Malay peninsula (specifically Peninsular Malaysia and Singapore) to investigate the current distribution and genetic diversity of P. scutata. Six populations were found in Singapore, but only one in Peninsular Malaysia. Mitochondrial COI and 16S sequencing revealed that the Malaysian population shared a single haplotype of both genes with the Singapore populations (500 km distant). This low genetic diversity could stem from a recent anthropogenic introduction, which brings into question the true native range of P. scutata and, coupled with poorly resolved taxonomy of the genus, necessitates a reassessment of its IUCN Red List status. Introduced populations pose a dilemma, and the lack of genetic diversity is of concern in light of Pila decline throughout South-east Asia. Our results highlight that conservation management of P. scutata and its congeners must therefore be better informed by greater taxonomic resolution and more comprehensive investigations of their ecology, both in native and introduced ranges.
Better understanding of the complex interplay among key determinants of functional outcome is crucial to promoting recovery in psychotic disorders. However, this is understudied in the early course of illness. We aimed to examine the relationships among negative symptoms, neurocognition, general self-efficacy and global functioning in first-episode psychosis (FEP) patients using structural equation modeling (SEM).
Three hundred and twenty-one Chinese patients aged 26–55 years presenting with FEP to an early intervention program in Hong Kong were recruited. Assessments encompassing symptom profiles, functioning, perceived general self-efficacy and a battery of neurocognitive tests were conducted. Negative symptom measurement was subdivided into amotivation and diminished expression (DE) domain scores based on the ratings in the Scale for the Assessment of Negative Symptoms.
An initial SEM model showed no significant association between functioning and DE which was removed from further analysis. A final trimmed model yielded very good model fit (χ2 = 15.48, p = 0.63; comparative fit index = 1.00; root mean square error of approximation <0.001) and demonstrated that amotivation, neurocognition and general self-efficacy had a direct effect on global functioning. Amotivation was also found to mediate a significant indirect effect of neurocognition and general self-efficacy on functioning. Neurocognition was not significantly related to general self-efficacy.
Our results indicate a critical intermediary role of amotivation in linking neurocognitive impairment to functioning in FEP. General self-efficacy may represent a promising treatment target for improvement of motivational deficits and functional outcome in the early illness stage.
We have developed the anisotropic heat transport equation for rotating neutron stars. With a simple model of neutron star, we also model the propagation of heat pulses resulting from transient energy releases inside the star. Even in the slow rotation limit, the results with rotational effects involved could differ significantly from those obtained with a spherically symmetric metric in the timescale of the thermal afterglow.
Relapse is distressingly common after the first episode of psychosis, yet it is poorly understood and difficult to predict. Investigating changes in cognitive function preceding relapse may provide new insights into the underlying mechanism of relapse in psychosis. We hypothesized that relapse in fully remitted first-episode psychosis patients was preceded by working memory deterioration.
Visual memory and verbal working memory were monitored prospectively in a 1-year randomized controlled trial of remitted first-episode psychosis patients assigned to medication continuation (quetiapine 400 mg/day) or discontinuation (placebo). Relapse (recurrence of positive symptoms of psychosis), visual (Visual Patterns Test) and verbal (Letter–Number span test) working memory and stressful life events were assessed monthly.
Remitted first-episode patients (n = 102) participated in the study. Relapsers (n = 53) and non-relapsers (n = 49) had similar baseline demographic and clinical profiles. Logistic regression analyses indicated relapse was associated with visual working memory deterioration 2 months before relapse [odds ratio (OR) 3.07, 95% confidence interval (CI) 1.19–7.92, P = 0.02], more stressful life events 1 month before relapse (OR 2.11, 95% CI 1.20–3.72, P = 0.01) and medication discontinuation (OR 5.52, 95% CI 2.08–14.62, P = 0.001).
Visual working memory deterioration beginning 2 months before relapse in remitted first-episode psychosis patients (not baseline predictor) may reflect early brain dysfunction that heralds a psychotic relapse. The deterioration was found to be unrelated to a worsening of psychotic symptoms preceding relapse. Testable predictors offer insight into the brain processes underlying relapse in psychosis.
Delusional disorder (DD) is thought to be distinct from schizophrenia (SZ). However, few systematic investigations have been conducted on DD because of the difficulty in ascertaining a representative sample size. Existing knowledge has been mostly generated from inpatient cohorts, which may be biased towards a more severe sample.
We compared the demographic, clinical and cognitive differences between 71 patients with first-episode DD and 71 age-matched patients with first-episode SZ. Participants were consecutively recruited from a population-based territory-wide study of early psychosis in Hong Kong targeting first-episode psychosis. Basic demographic information, premorbid functioning, duration of untreated psychosis, pathways to care, symptomatology, social, occupational, and cognitive functioning were comprehensively assessed using standardized measurements.
Patients with DD had less premorbid schizoid and schizotypal traits compared to patients with SZ. More patients with DD were married compared to patients with SZ. However, at first episode, there were no significant differences between the two groups in regards to the duration of untreated psychosis, pathways to care, symptom severity, neurocognitive performance, treatment, and functioning.
Our findings challenge previous thinking that patients with DD had better functioning than patients with SZ. This study not only provides an updated perspective into conceptualizing the clinical differences between DD and SZ, but also expands the descriptive account of the two disorders to include the neurocognitive dimension.
Despite evidence on the short-term benefits of early intervention (EI) service for psychosis, long-term outcome studies are limited by inconsistent results. This study examined the 10-year outcomes of patients with first-episode psychosis who received 2-year territory-wide EI service compared to those who received standard care (SC) in Hong Kong using an historical control design.
Consecutive patients who received the EI service between 1 July 2001 and 30 June 2002, and with diagnosis of schizophrenia-spectrum disorders, were identified and matched with patients who received SC first presented to the public psychiatric service from 1 July 2000 to 30 June 2001. In total, 148 matched pairs of patients were identified. Cross-sectional information on symptomatology and functioning was obtained through semi-structured interview; longitudinal information on hospitalization, functioning, suicide attempts, mortality and relapse over 10 years was obtained from clinical database. There were 70.3% (N = 104) of SC and 74.3% (N = 110) of EI patients interviewed.
Results suggested that EI patients had reduced suicide rate (χ2(1) = 4.35, p = 0.037), fewer number [odds ratio (OR) 1.56, χ2 = 15.64, p < 0.0001] and shorter duration of hospitalization (OR 1.29, χ2 = 4.06, p = 0.04), longer employment periods (OR −0.28, χ2 = 14.64, p < 0.0001) and fewer suicide attempts (χ2 = 11.47, df = 1, p = 0.001) over 10 years. At 10 years, no difference was found in psychotic symptoms, symptomatic remission and functional recovery.
The short-term benefits of the EI service on number of hospitalizations and employment was sustained after service termination, but the differences narrowed down. This suggests the need to evaluate the optimal duration of the EI service.
Cognitive impairment is a core feature of schizophrenia. Its relationship with duration of untreated psychosis (DUP), a potentially malleable prognostic factor, has been less studied, with inconsistent findings being observed in the literature. Previous research investigating such a relationship was mostly cross-sectional and none of those prospective studies had a follow-up duration beyond 2 years.
A total of 93 Hong Kong Chinese aged 18 to 55 years presenting with first-episode schizophrenia-spectrum disorder were studied. DUP and pre-morbid adjustment were measured using a structured interview incorporating multiple sources of information. Psychopathological evaluation was administered at intake, after clinical stabilization of the first psychotic episode, and at 12, 24 and 36 months. Cognitive functions were measured at clinical stabilization, and at 12, 24 and 36 months.
DUP exerted differential effects on various cognitive domains, with memory deficits being the most related to DUP even when potential confounders including pre-morbid adjustment and sex were adjusted. Prolonged DUP was associated with more severe impairment in visual memory at clinical stabilization and verbal memory at 24 and 36 months. Further, patients with a long DUP were found to have worse outcomes on negative symptoms at 36 months. The effects of DUP on verbal memory remained significant even when negative symptoms were taken into consideration.
Our findings provided further supportive evidence that delayed treatment to first-episode psychosis is associated with poorer cognitive and clinical outcomes. In addition, DUP may specifically affect memory function and its adverse impact on verbal memory may only become evident at a later stage of the recovery process.
We report on Chandra observations of the black widow pulsar, PSR B1957+20. Evidence for a binary-phase dependence of the X-ray emission from the pulsar is found with a deep observation. The binary-phase resolved spectral analysis reveals non-thermal X-ray emission of PSR B1957+20, confirming the results of previous studies. This suggests that the X-rays are mostly due to intra-binary shock emission which is strongest when the pulsar wind interacts with the ablated material from the companion star. The geometry of the peak emission is determined in our study. The marginal softening of the spectrum of the non-thermal X-ray tail may indicate that particles injected at the termination shock is dominated by synchrotron cooling.
We present a short Chandra observation that confirms a previous unidentified extended X-ray source, G308.3-1.4, as a new supernova remnant (SNR) in the Milky Way. Apart from identifying its SNR nature, a bright X-ray point source has also been discovered at the geometrical center. Its X-ray spectral properties are similar to those of a particular class of neutron star known as central compact objects (CCOs). On the other hand, the optical properties of this counterpart suggests it to be a late-type star. Together with the interesting ~ 1.4 hours X-ray periodicity found by Chandra, this system can possibly provide the first direct evidence of a compact binary survived in a supernova explosion.
Anomalous X-ray pulsars (AXPs) are thought to be magnetars which are young isolated neutron stars with extremely strong magnetic fields of >1014 Gauss. Their tremendous magnetic fields inferred from the spin parameters provide a huge energy reservoir to power the observed X-ray emission. High-energy emission above 0.3 MeV has never been detected despite intensive search. Here, we present the possible Fermi Large Area Telescope (LAT) detection of γ-ray pulsations above 200 MeV from the AXP, 1E 2259+586, which puts the current theoretical models of γ-ray emission mechanisms of magnetars into challenge. We speculate that the high-energy γ-rays originate from the outer magnetosphere of the magnetar.
We report on XMM-Newton observations of the Galactic supernova remnant G296.7–0.9. A detailed spectro-imaging X-ray study of G296.7–0.9 was performed. We detected an incomplete shell-like X-ray structure which is located near the boundary of the radio emission at a frequency of 843 MHz. The X-ray spectrum can be best described by an absorbed ionization plasma model accompanied with metallic emission lines, which suggests the plasma is shock heated. No promising compact stellar remnant associated with G296.7–0.9 was found. No Gamma-ray emission of G296.7–0.9 from Fermi-LAT telescope was detected in our study.
We report a synthetic method for shifting the pKa for the deprotonaton of polyaniline by the formation of non-covalent complexes between polyaniline and a polyanion. Depending on the choice of the polyanion and the condition of the synthesis, we can control the pKa value for the dedoping reaction to spread the pH range from 5.5 to 9.0. From a systematic study of the structural influence on the pKa values, we have verified that the electrostatic stabilization of the polaron is the origin for this unusually large pKa shift.
Thermally-induced metastable phenomena in amorphous silicon-germanium alloys were studied by conductivity and ESR measurements. Fast cooling from 250 °C reduced both dark- and photo-conductivities by a factor of 3–4 while the neutral defect density remained unchanged. Thermally-induced change in conductivity relaxed towards equilibrium with a stretched exponential form. The thermal equilibrium temperature was found to be roughly proportional to the optical gap for a–Si:H, a–Sii−xCx:H, a–Si1−xNx:H and a–Si1−xGex:H:F.
Stepwise transmetalation of the neutral molecular target (µ4-O)N4 Cu4 C16(N is a monodentate pyridine) with M(NS)n transmealators (NS is a monanionic S-methyl hydrazinecarbodithioate ligand, M is Co (n = 2 or 3), Ni or Zn (n = 2)) in aprotic solvents gives a large family of heteropolymetallic products (µ4 - O)N4 (Co,Ni,Cu,Zn)4 C16 that contain from one to four different metals. Thermolysis of these solid products in flowing O2 at 220 - 250°C gives uniform, highly dispersed mixtures of the respective metal oxides. For example, thermolysis of bulk precursor (µ4 -O)N4 CoNiCuZnCl6 gives a uniform mixture of 1 - 2° particles of Co3 O4, NiO, CuO and ZnO.