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Auditory verbal hallucinations (AVHs) in schizophrenia have been suggested to arise from failure of corollary discharge mechanisms to correctly predict and suppress self-initiated inner speech. However, it is unclear whether such dysfunction is related to motor preparation of inner speech during which sensorimotor predictions are formed. The contingent negative variation (CNV) is a slow-going negative event-related potential that occurs prior to executing an action. A recent meta-analysis has revealed a large effect for CNV blunting in schizophrenia. Given that inner speech, similar to overt speech, has been shown to be preceded by a CNV, the present study tested the notion that AVHs are associated with inner speech-specific motor preparation deficits.
Objectives
The present study aimed to provide a useful framework for directly testing the long-held idea that AVHs may be related to inner speech-specific CNV blunting in patients with schizophrenia. This may hold promise for a reliable biomarker of AVHs.
Methods
Hallucinating (n=52) and non-hallucinating (n=45) patients with schizophrenia, along with matched healthy controls (n=42), participated in a novel electroencephalographic (EEG) paradigm. In the Active condition, they were asked to imagine a single phoneme at a cue moment while, precisely at the same time, being presented with an auditory probe. In the Passive condition, they were asked to passively listen to the auditory probes. The amplitude of the CNV preceding the production of inner speech was examined.
Results
Healthy controls showed a larger CNV amplitude (p = .002, d = .50) in the Active compared to the Passive condition, replicating previous results of a CNV preceding inner speech. However, both patient groups did not show a difference between the two conditions (p > .05). Importantly, a repeated measure ANOVA revealed a significant interaction effect (p = .007, ηp2 = .05). Follow-up contrasts showed that healthy controls exhibited a larger CNV amplitude in the Active condition than both the hallucinating (p = .013, d = .52) and non-hallucinating patients (p < .001, d = .88). No difference was found between the two patient groups (p = .320, d = .20).
Conclusions
The results indicated that motor preparation of inner speech in schizophrenia was disrupted. While the production of inner speech resulted in a larger CNV than passive listening in healthy controls, which was indicative of the involvement of motor planning, patients exhibited markedly blunted motor preparatory activity to inner speech. This may reflect dysfunction in the formation of corollary discharges. Interestingly, the deficits did not differ between hallucinating and non-hallucinating patients. Future work is needed to elucidate the specificity of inner speech-specific motor preparation deficits with AVHs. Overall, this study provides evidence in support of atypical inner speech monitoring in schizophrenia.
The period of the crusades and the Latin settlement of the eastern Mediterranean was an important one for medieval historical writing. Indeed, it has been recently suggested that the chroniclers of the First Crusade (1095–99), faced with the need to couch events in a more overtly exegetical register, ‘pioneered a new way of writing about the recent past’. Whether or not one accepts the notion that such writers adopted a fundamentally new mode of composition, there can be little doubt that this initial expedition left a significant imprint on medieval literary cultures. For a start, the vast number of extant narratives is unusual by medieval standards. More than this, though, the enterprise is renowned for popularising the medieval monograph format, with many writers electing to compose standalone histories characterised by a narrow focus on the crusade. As the crusading movement progressed, some embedded crusade accounts into works with wider chronological and geographical scopes, but the free-standing ‘crusade’ history was an outcome of nearly all subsequent expeditions (or at least the major ‘numbered’ ones). It is perhaps a by-product of this textual tradition – among other factors, such as modern historians’ propensity to compartmentalise evidence to facilitate historical analysis and the hangover of nineteenth-century scholarly conventions – that crusading expeditions are often treated in isolation: a discrete series of holy wars related to, but somehow distinct from, the Latin Christian settlements established in the wake of the First Crusade, known collectively as the crusader states, the Latin East or, when viewed from the West, Outremer (‘the land across the sea’). One need only cast an eye over the many modern general histories of the crusades to appreciate that most devote comparatively little space to the crusader states. Instead, the history of those polities on the fringes of Latin Christendom has usually been detailed separately, so much so that even the validity of the long-standing descriptor ‘crusader states’ has been disputed.
Consequently, the historiography of the crusades and the crusader states has developed along slightly different contours. For the purposes of this volume, the most significant difference, to be discussed in greater detail below, is that whereas texts – especially historical narratives – pertaining to the crusades have been subjected to an unparalleled degree of literary scrutiny in recent years, the textual evidence for the Latin East has less frequently been examined through the same interpretative lens.
The three-dimensional (3-D) transition of the leading-edge vortex (LEV) and the force characteristics of the plunging airfoil are investigated in the chord-based Strouhal number $St_c$ range of 0.10 to 1.0 by means of experimental measurements, numerical simulations and linear stability analysis in order to understand the spanwise instabilities and the effects on the force. We find that the interaction pattern of the LEV, the LEV from a previous cycle (pLEV) and the trailing-edge vortex (TEV) is the primary mechanism that affects the 3-D transition and associated force characteristics. For $St_c \leq 0.16$, the 3-D transition is dominated by the LEV–TEV interaction. For $0.16 < St_c \leq 0.44$, the TEV lies in the middle of the LEV and the pLEV and therefore vortex interaction between them is relatively weak; as a result, the LEV remains two-dimensional up to a relatively high Reynolds number of $Re = 4000$ at $St_c = 0.32$. For $0.44 < St_{c} \leq 0.54$, and at relatively low Reynolds numbers, the pLEV and the TEV tend to form a clockwise vortex pair, which is beneficial for the high lift and stability of the LEV. For $0.49 \leq St_c$, the pLEV and TEV tend to form an anticlockwise vortex pair, which is detrimental to the lift and flow stability. In the last $St_c$ range, vortex interaction involving the LEV, the TEV and the pLEV results in an unstable period-doubling mode which has a wavelength of about two chord-lengths and the 3-D transition enhances the lift.
White matter development during adolescents is crucial for a mature integration of neural networks in the brain. Autism spectrum condition (ASC), characterized by social and communication difficulties and rigid behaviour may interact with white matter development observed during adolescence. Changes in white matter development may link autistic symptoms to its genetic underpinnings and explain a 10-fold increase in susceptibility to ASC among siblings of individuals with ASC.
We used diffusion tensor imaging to study an association between age and white matter integrity measures, fractional anisotropy (FA) and mean diffusivity (MD), in adolescents with ASC, their siblings and age-matched healthy controls. Diffusion-weighted data were acquired with 64-direction protocol with 3mm slices and TR of 6600ms and tract-based spatial statistics analysis was performed.
The control subjects showed robust signs of increase in white matter integrity correlated with age. In contrast, individuals with ASC showed significantly lower negative correlation between MD and age in a broad area centred in the right superior longitudinal fasciculus (rSLF). When the three eigenvalues constituting a tensor ellipsoid were considered separately, siblings of individuals with ASC showed a diminished negative correlation between the second eigenvalue and age also centred in the rSLF.
Adolescents with ASC and their siblings experience alterations in white matter development in comparison to age-matched healthy controls, which are similar in direction yet different in scale for the two affected groups. The alterations are observed in the area associated with flexibility of behaviour and may explain both symptoms of ASC and increased susceptibility to ASC.
Analysis of human remains and a copper band found in the center of a Late Archaic (ca. 5000–3000 cal BP) shell ring demonstrate an exchange network between the Great Lakes and the coastal southeast United States. Similarities in mortuary practices suggest that the movement of objects between these two regions was more direct and unmediated than archaeologists previously assumed based on “down-the-line” models of exchange. These findings challenge prevalent notions that view preagricultural Native American communities as relatively isolated from one another and suggest instead that wide social networks spanned much of North America thousands of years before the advent of domestication.
The WAIS (West Antarctic Ice Sheet) Divide deep ice core was recently completed to a total depth of 3405 m, ending 50 m above the bed. Investigation of the visual stratigraphy and grain characteristics indicates that the ice column at the drilling location is undisturbed by any large-scale overturning or discontinuity. The climate record developed from this core is therefore likely to be continuous and robust. Measured grain-growth rates, recrystallization characteristics, and grain-size response at climate transitions fit within current understanding. Significant impurity control on grain size is indicated from correlation analysis between impurity loading and grain size. Bubble-number densities and bubble sizes and shapes are presented through the full extent of the bubbly ice. Where bubble elongation is observed, the direction of elongation is preferentially parallel to the trace of the basal (0001) plane. Preferred crystallographic orientation of grains is present in the shallowest samples measured, and increases with depth, progressing to a vertical-girdle pattern that tightens to a vertical single-maximum fabric. This single-maximum fabric switches into multiple maxima as the grain size increases rapidly in the deepest, warmest ice. A strong dependence of the fabric on the impurity-mediated grain size is apparent in the deepest samples.
Vapor pressures of technical-grade triallate [S-(2,3,3-trichloroallyl)diisopropylthiocarbamate] were calculated from the vapor density measurements determined at seven different temperatures, using a gas-saturation technique and solid adsorbent traps. The equation Log10P = 11.05 – (4401/T) delineated the relationship between the apparent vapor pressure and temperature, giving the triallate vapor pressure values from 1.083 × 10−4 to 16.371 × 10−4 mm Hg over the temperature range of 20 to 45 C. The vapor flux of triallate from glass surfaces was of the order of 5.7 μg cm−2 h−1 at 25 C.
Surgical site infections (SSIs) are responsible for significant morbidity and mortality. Preadmission skin antisepsis, while controversial, has gained acceptance as a strategy for reducing the risk of SSI. In this study, we analyze the benefit of an electronic alert system for enhancing compliance to preadmission application of 2% chlorhexidine gluconate (CHG).
DESIGN, SETTING, AND PARTICIPANTS
Following informed consent, 100 healthy volunteers in an academic, tertiary care medical center were randomized to 5 chlorhexidine gluconate (CHG) skin application groups: 1, 2, 3, 4, or 5 consecutive applications. Participants were further randomized into 2 subgroups: with or without electronic alert. Skin surface concentrations of CHG (μg/mL) were analyzed using a colorimetric assay at 5 separate anatomic sites.
INTERVENTION
Preadmission application of chlorhexidine gluconate, 2%
RESULTS
Mean composite skin surface CHG concentrations in volunteer participants receiving EA following 1, 2, 3, 4, and 5 applications were 1,040.5, 1,334.4, 1,278.2, 1,643.9, and 1,803.1 µg/mL, respectively, while composite skin surface concentrations in the no-EA group were 913.8, 1,240.0, 1,249.8, 1,194.4, and 1,364.2 µg/mL, respectively (ANOVA, P<.001). Composite ratios (CHG concentration/minimum inhibitory concentration required to inhibit the growth of 90% of organisms [MIC90]) for 1, 2, 3, 4, or 5 applications using the 2% CHG cloth were 208.1, 266.8, 255.6, 328.8, and 360.6, respectively, representing CHG skin concentrations effective against staphylococcal surgical pathogens. The use of an electronic alert system resulted in significant increase in skin concentrations of CHG in the 4- and 5-application groups (P<.04 and P<.007, respectively).
CONCLUSION
The findings of this study suggest an evidence-based standardized process that includes use of an Internet-based electronic alert system to improve patient compliance while maximizing skin surface concentrations effective against MRSA and other staphylococcal surgical pathogens.
Infect. Control Hosp. Epidemiol. 2016;37(3):254–259