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Impaired illness awareness or insight into illness (IIA) is a common feature of schizophrenia that contributes to medication nonadherence and poor clinical outcomes. Neuroimaging studies suggest IIA may arise from interhemispheric imbalance in frontoparietal regions, particularly in the posterior parietal area (PPA) and the dorsolateral prefrontal cortex (dlPFC). In this pilot study, we examined the effects of transcranial direct current stimulation (tDCS) on brain regions implicated in IIA.
Eleven patients with schizophrenia with IIA (≥3 PANSS G12) and 10 healthy controls were included. A crossover design was employed where all participants received single-session bi-frontal, bi-parietal, and sham stimulation in random order. For each condition, we measured (i) blood oxygen level-dependent (BOLD) response to an illness awareness task pre- and post-stimulation, (ii) regional cerebral blood-flow (rCBF) prior to and during stimulation, and (iii) changes in illness awareness.
At baseline, patients with schizophrenia showed higher BOLD-response to an illness awareness task in the left-PPA compared to healthy controls. Bi-parietal stimulation reduced the interhemispheric imbalance in the PPA compared to sham stimulation. Relatedly, bi-parietal stimulation increased rCBF beneath the anode (21% increase in the right-PPA), but not beneath the cathode (5.6% increase in the left-PPA). Bi-frontal stimulation did not induce changes in rCBF. We found no changes in illness awareness.
Although single-session tDCS did not improve illness awareness, this pilot study provides mechanistic justification for future investigations to determine if multi-session bi-parietal tDCS can induce sustained changes in brain activity in the PPA in association with improved illness awareness.
A novel laboratory experimental design is described that will investigate the processing of dust grains in astrophysical shocks. Dust is a ubiquitous ingredient in the interstellar medium (ISM) of galaxies; however, its evolutionary cycle is still poorly understood. Especially shrouded in mystery is the efficiency of grain destruction by astrophysical shocks generated by expanding supernova remnants. While the evolution of these remnants is fairly well understood, the grain destruction efficiency in these shocks is largely unknown. The experiments described herein will fill this knowledge gap by studying the dust destruction efficiencies for shock velocities in the range
), at which most of the grain destruction and processing in the ISM takes place. The experiments focus on the study of grain–grain collisions by accelerating small (
) dust particles into a large (
diameter) population; this simulates the astrophysical system well in that the more numerous, small grains impact and collide with the large population. Facilities that combine the versatility of high-power optical lasers with the diagnostic capabilities of X-ray free-electron lasers, e.g., the Matter in Extreme Conditions instrument at the SLAC National Accelerator Laboratory, provide an ideal laboratory environment to create and diagnose dust destruction by astrophysically relevant shocks at the micron scale.
Orthopedic procedures are an important focus in efforts to reduce surgical site infections (SSIs). In 2008, the Centers for Medicare and Medicaid (CMS) stopped reimbursements for additional charges associated with serious hospital-acquired conditions, including SSI following certain orthopedic procedures. We aimed to evaluate the CMS policy’s effect on rates of targeted orthopedic SSIs among the Medicare population.
We examined SSI rates following orthopedic procedures among the Medicare population before and after policy implementation compared to a similarly aged control group. Using the Nationwide Inpatient Sample database for 2000–2013, we estimated rate ratios (RRs) of orthopedic SSIs among Medicare and non-Medicare patients using a difference-in-differences approach.
Following policy implementation, SSIs significantly decreased among both the Medicare and non-Medicare populations (RR, 0.7; 95% confidence interval [CI], 0.6–0.8) and RR, 0.8l; 95% CI, 0.7–0.9), respectively. However, the estimated decrease among the Medicare population was not significantly greater than the decrease among the control population (RR, 0.9; 95% CI, 0.8–1.1).
While SSI rates decreased significantly following the implementation of the CMS nonpayment policy, this trend was not associated with policy intervention but rather larger secular trends that likely contributed to decreasing SSI rates over time.
Previous studies suggest that abnormalities in maternal immune activity during pregnancy alter the offspring's brain development and are associated with increased risk for schizophrenia (SCZ) dependent on sex.
Using a nested case–control design and prospectively collected prenatal maternal sera from which interleukin (IL)-1β, IL-8, IL-6, tumor necrosis factor (TNF)-α and IL-10 were assayed, we investigated sex-dependent associations between these cytokines and 88 psychotic cases [SCZ = 44; affective psychoses (AP) = 44] and 100 healthy controls from a pregnancy cohort followed for > 40 years. Analyses included sex-stratified non-parametric tests adjusted for multiple comparisons to screen cytokines associated with SCZ risk, followed by deviant subgroup analyses using generalized estimating equation (GEE) models.
There were higher prenatal IL-6 levels among male SCZ than male controls, and lower TNF-α levels among female SCZ than female controls. The results were supported by deviant subgroup analyses with significantly more SCZ males with high IL-6 levels (>highest quartile) compared with controls [odd ratio (OR)75 = 3.33, 95% confidence interval (CI) 1.13–9.82], and greater prevalence of low TNF-α levels (<lowest quartile) among SCZ females compared with their controls (OR25 = 6.30, 95% CI 1.20–33.04) and SCZ males. Higher levels of IL-6 were only found among SCZ compared with AP cases. Lower TNF-α levels (non-significant) also characterized female AP cases versus controls, although the prevalence of the lowest levels was higher in SCZ than AP females (70% v. 40%), with no effect in SCZ or AP males.
The results underscore the importance of immunologic processes affecting fetal brain development and differential risk for psychoses depending on psychosis subtype and offspring sex.
The generation of referring expressions is a central topic in computational linguistics. Natural referring expressions – both definite references like ‘the baseball cap’ and pronouns like ‘it’ – are dependent on discourse context. We examine the practical implications of context-dependent referring expression generation for the design of spoken systems. Currently, not all spoken systems have the goal of generating natural referring expressions. Many researchers believe that the context-dependency of natural referring expressions actually makes systems less usable. Using the dual-task paradigm, we demonstrate that generating natural referring expressions that are dependent on discourse context reduces cognitive load. Somewhat surprisingly, we also demonstrate that practice does not improve cognitive load in systems that generate consistent (context-independent) referring expressions. We discuss practical implications for spoken systems as well as other areas of referring expression generation.
Map-based cloning has been considered problematic for isolating quantitative trait loci (QTLs) due to the confounding phenotypic effects of environment and other QTLs. However, five recent studies, all in plants, have succeeded in cloning QTLs using map-based methods. We review the important features of these studies and evaluate the prospects for broader application of the techniques. Successful map-based cloning requires that QTLs represent single genes that can be isolated in near-isogenic lines, and that genotypes can be unambiguously inferred by progeny testing. In plants or animals for which map-based cloning of genes with discrete phenotypes is feasible, the modified procedures required for QTLs should not be limiting in most cases. The choice between map-based cloning and alternative methods will depend on details of the species and traits being studied.
Modeling plus simulations using the one-dimensional Lagrangian
radiation-hydrodynamics code HYADES are compared with data
from classical and ablative Rayleigh–Taylor experiments
conducted on the Nova laser. Comparisons between the experiments
and modeling for both the gross hydrodynamic motion and
the perturbation evolution are made and show good agreement.
A third order perturbation analysis is applied to demonstrate
the onset of nonlinearity. A simple, physically intuitive
saturation model is used to describe the growth further
into the nonlinear regime. Finally, we present the first
comparison of the Betti ablation front theory with indirect-drive
RT data and obtain good agreement.
We report on the results of a UV-Optical spectral monitoring of the bright Seyfert 1 galactic nuclei Mkn 335. This campaign began in June, 1989, and ended in June, 1991. Ultraviolet spectra of fourteen epochs at nearly uniform sampling of 30-day intervals, except when the object was inaccessible from the IUE satellite, have been obtained, of which twelve were coordinated with quasi-simultaneous ground-based optical observations made at Lick Observatory.
New psychiatric out-patients with depressive, phobic, and anxiety neurosis were randomly allocated to out-patient care or to one of two types of day hospital treatment one specialising in psychotherapy and the other offering all forms of day care. Of 106 patients who entered the study, 78 had assessments of psychiatric symptomatology and social adjustment both before treatment and after 4, 8 and 24 months. There was no significant difference in outcome between depressive, phobic, and anxiety neurosis, and no overall difference in response to treatment between the three types of care. Suicidal symptoms were significantly less common in out-patients. In many respects, neurotic disorder can be regarded as a single syndrome.
Seven Magnavox MX1502 satellite receivers were used during the summers of 1980 and 1981 to obtain the coordinates of 22 stations in three locations on the Greenland ice sheet. Two of the receivers were located at stationary sites on the west coast of Greenland for both seasons. This allowed the short-arc method to be used to obtain relative coordinates with high precision. The stations were located at about 65° N, and positions on the ice sheet were obtained with formal accuracies of better than 0.20 m. From the coordinates, the station velocities, ice-sheet slopes, baseline lengths (between the stations) and strain-rates were calculated. Our results show that the two stations just to the east of the ice crest are not moving in the expected direction (north-east) but are moving in a direction slightly west of north. Hence, the positions of the ice crest and the ice divide do not coincide. The other stations are moving approximately as expected. No major velocity differences between, neighboring flow lines are apparent. The magnitudes of the maximum strain and the velocities increase away from the ice divide and with increasing slope.
The inter-situational, inter-rater and temporal reliability of a schedule for rating personality disorders is described. In an initial study with a simplified form of the schedule in patients from different wards of a psychiatric hospital inter-situational reliability between raters was higher for patients with personality disorders than with no personality disorder. Using the full schedule, inter-rater reliability, using audiotaped and separate interviews, and temporal reliability at interviews conducted a mean of 12.5 months apart all reached a satisfactory level, suggesting that the schedule may be a useful instrument for measuring deviant personality traits. The interview may be used with a subject or an informant but agreement between ratings made with informants and psychiatric patients during illness was low, and the schedule is not recommended for use with patients alone during acute episodes of illness.
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