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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 COVID-19 pandemic accelerated the development of decentralized clinical trials (DCT). DCT’s are an important and pragmatic method for assessing health outcomes yet comprise only a minority of clinical trials, and few published methodologies exist. In this report, we detail the operational components of COVID-OUT, a decentralized, multicenter, quadruple-blinded, randomized trial that rapidly delivered study drugs nation-wide. The trial examined three medications (metformin, ivermectin, and fluvoxamine) as outpatient treatment of SARS-CoV-2 for their effectiveness in preventing severe or long COVID-19. Decentralized strategies included HIPAA-compliant electronic screening and consenting, prepacking investigational product to accelerate delivery after randomization, and remotely confirming participant-reported outcomes. Of the 1417 individuals with the intention-to-treat sample, the remote nature of the study caused an additional 94 participants to not take any doses of study drug. Therefore, 1323 participants were in the modified intention-to-treat sample, which was the a priori primary study sample. Only 1.4% of participants were lost to follow-up. Decentralized strategies facilitated the successful completion of the COVID-OUT trial without any in-person contact by expediting intervention delivery, expanding trial access geographically, limiting contagion exposure, and making it easy for participants to complete follow-up visits. Remotely completed consent and follow-up facilitated enrollment.
Invasive species can have disastrous effects on the ecosystems they invade, requiring costly, labour-intensive mitigation. Public awareness campaigns are often used as a tool to reduce these species’ impacts. While heralded as useful and cost-effective, little evidence suggests that these campaigns contribute to meaningful biological outcomes. Furthermore, awareness campaigns are relatively understudied despite their usage as a common approach to mitigating invasive species. We conducted a literature review to assess publications that evaluated the efficacy of public awareness campaigns for managing invasive species. Out of 4382 papers initially extracted for analysis, we determined that 24 of them included studies conducted on awareness campaigns for invasive species. Four public awareness campaigns were deemed a ‘success’, and the other campaigns’ success was indeterminable due to study design. Our study revealed that inconsistencies in defined end points, unclear procedures and variability of campaigns contribute to there being insufficient evidence to determine the efficacy of public awareness campaigns. To evaluate the true efficacy of public awareness campaigns, we recommend that organizations conducting such campaigns implement rigorous and standardized assessments (e.g., Before–After Control–Impact designs or Bayesian analyses) that include measures of not just changes in the knowledge and behaviour of target audiences, but also relevant biological outcomes.
The coronavirus disease 2019 (COVID-19) pandemic has challenged the ability of Emergency Medical Services (EMS) providers to maintain personal safety during the treatment and transport of patients potentially infected. Increased rates of COVID-19 infection in EMS providers after patient care exposure, and notably after performing aerosol-generating procedures (AGPs), have been reported. With an already strained workforce seeing rising call volumes and increased risk for AGP-requiring patient presentations, development of novel devices for the protection of EMS providers is of great importance.
Based on the concept of a negative pressure room, the AerosolVE BioDome is designed to encapsulate the patient and contain aerosolized infectious particles produced during AGPs, making the cabin of an EMS vehicle safer for providers. The objective of this study was to determine the efficacy and safety of the tent in mitigating simulated infectious particle spread in varied EMS transport platforms during AGP utilization.
Methods:
Fifteen healthy volunteers were enrolled and distributed amongst three EMS vehicles: a ground ambulance, an aeromedical-configured helicopter, and an aeromedical-configured jet. Sodium chloride particles were used to simulate infectious particles and particle counts were obtained in numerous locations close to the tent and around the patient compartment. Counts near the tent were compared to ambient air with and without use of AGPs (non-rebreather mask, continuous positive airway pressure [CPAP] mask, and high-flow nasal cannula [HFNC]).
Results:
For all transport platforms, with the tent fan off, the particle generator alone, and with all AGPs produced particle counts inside the tent significantly higher than ambient particle counts (P <.0001). With the tent fan powered on, particle counts near the tent, where EMS providers are expected to be located, showed no significant elevation compared to baseline ambient particle counts during the use of the particle generator alone or with use of any of the AGPs across all transport platforms.
Conclusion:
Development of devices to improve safety for EMS providers to allow for use of all available therapies to treat patients while reducing risk of communicable respiratory disease transmission is of paramount importance. The AerosolVE BioDome demonstrated efficacy in creating a negative pressure environment and workspace around the patient and provided significant filtration of simulated respiratory droplets, thus making the confined space of transport vehicles potentially safer for EMS personnel.
The coronavirus disease 2019 (COVID-19) pandemic has created challenges in maintaining the safety of prehospital providers caring for patients. Reports have shown increased rates of Emergency Medical Services (EMS) provider infection with COVID-19 after patient care exposure, especially while utilizing aerosol-generating procedures (AGPs). Given the increased risk and rising call volumes for AGP-necessitating complaints, development of novel devices for the protection of EMS clinicians is of great importance.
Drawn from the concept of the powered air purifying respirator (PAPR), the AerosolVE helmet creates a personal negative pressure space to contain aerosolized infectious particles produced by patients, making the cabin of an EMS vehicle safer for providers. The helmet was developed initially for use in hospitals and could be of significant use in the prehospital setting. The objective of this study was to determine the efficacy and safety of the helmet in mitigating simulated infectious particle spread in varied EMS transport platforms during AGP utilization.
Methods:
Fifteen healthy volunteers were enrolled and distributed amongst three EMS vehicles: a ground ambulance, a medical helicopter, and a medical jet. Sodium chloride particles were used to simulate infectious particles, and particle counts were obtained in numerous locations close to the helmet and around the patient compartment. Counts near the helmet were compared to ambient air with and without use of AGPs (non-rebreather mask [NRB], continuous positive airway pressure mask [CPAP], and high-flow nasal cannula [HFNC]).
Results:
Without the helmet fan on, the particle generator alone and with all AGPs produced particle counts inside the helmet significantly higher than ambient particle counts. With the fan on, there was no significant difference in particle counts around the helmet compared to baseline ambient particle counts. Particle counts at the filter exit averaged less than one despite markedly higher particle counts inside the helmet.
Conclusion:
Given the risk to EMS providers by communicable respiratory diseases, development of devices to improve safety while still enabling use of respiratory therapies is of paramount importance. The AerosolVE helmet demonstrated efficacy in creating a negative pressure environment and provided significant filtration of simulated respiratory droplets, thus making the confined space of transport vehicles potentially safer for EMS personnel.
In this study, we propose a scale-by-scale (SBS) energy budget equation for flows with homogeneity in at least one direction. This SBS budget represents a modified form of the equation first proposed by Danaila et al. (J. Fluid Mech., vol. 430, 2001, pp. 87–109) for the channel centreline – the primary difference is that, here, we consider the role of pressure along with the errors associated with the isotropic approximations of the interscale divergence and Laplacian of the squared velocity increment. The term encompassing the effects of mean shear is also characterised such that the present analysis can be extended straightforwardly to locations away from the centreline. We show, based on a detailed analysis of previously published channel flow direct numerical simulations and pipe flow experiments near the centreline, how several terms in the present SBS budget equation (including the third-order velocity structure function) behave with increasing Reynolds number. The behaviour of these terms is shown to imply a rate of emergence and subsequent growth of the 4/3 law scale subrange at the channel centreline and pipe axis. The analysis also suggests that the peak magnitude of the third-order velocity structure function occurs at a scale that is fixed in proportion to the Taylor microscale at sufficiently high Reynolds number.
Leafy spurge is a troublesome, exotic weed in the northern Great Plains of the United States. Leafy spurge produces showy yellow bracts during June that give this weed a conspicuous appearance. A study was conducted to determine the feasibility of using remote sensing techniques to detect leafy spurge in this phenological stage. Study sites were located in North Dakota and Montana. Plant canopy reflectance measurements showed that leafy spurge had higher visible (0.63- to 0.69-μm) reflectance than several associated plant species. The conspicuous yellow bracts of leafy spurge gave it distinct yellow-green and pink images on conventional color and color-infrared aerial photographs, respectively. Leafy spurge also could be distinguished on conventional color video imagery where it had a golden yellow image response. Quantitative data obtained from digitized video images showed that leafy spurge had statistically different digital values from those of associated vegetation and soil. Computer analyses of video images showed/that light reflected from leafy spurge populations could be quantified from associated vegetation. This technique permits area estimates of leafy spurge populations. Large format conventional color photographs of Theodore Roosevelt National Park near Medora, ND were digitized and integrated with a geographic information system to produce a map of leafy spurge populations within the park that can be useful to monitor the spread or decline of leafy spurge.
A plausible mechanism underlying flavonoid-associated cognitive effects is increased cerebral blood flow (CBF). However, behavioural and CBF effects following flavanone-rich juice consumption have not been explored. The aim of this study was to investigate whether consumption of flavanone-rich juice is associated with acute cognitive benefits and increased regional CBF in healthy, young adults. An acute, single-blind, randomised, cross-over design was applied with two 500-ml drink conditions – high-flavanone (HF; 70·5 mg) drink and an energy-, and vitamin C- matched, zero-flavanone control. A total of twenty-four healthy young adults aged 18–30 years underwent cognitive testing at baseline and 2-h after drink consumption. A further sixteen, healthy, young adults were recruited for functional MRI assessment, whereby CBF was measured with arterial spin labelling during conscious resting state at baseline as well as 2 and 5 h after drink consumption. The HF drink was associated with significantly increased regional perfusion in the inferior and middle right frontal gyrus at 2 h relative to baseline and the control drink. In addition, the HF drink was associated with significantly improved performance on the Digit Symbol Substitution Test at 2 h relative to baseline and the control drink, but no effects were observed on any other behavioural cognitive tests. These results demonstrate that consumption of flavanone-rich citrus juice in quantities commonly consumed can acutely enhance blood flow to the brain in healthy, young adults. However, further studies are required to establish a direct causal link between increased CBF and enhanced behavioural outcomes following citrus juice ingestion.
Effects of a marine oil-based n-3 LCPUFA supplement (mLCPUFA) fed from weaning until the end of the next lactation to sows with a predicted low litter birth weight (LBW) phenotype on growth performance and carcass quality of litters born to these sows were studied, based on the hypothesis that LBW litters would benefit most from mLCPUFA supplementation. Sows were allocated to be fed either standard corn/soybean meal-based gestation and lactation diets (CON), or the same diets enriched with 0.5% of the mLCPUFA supplement at the expense of corn. The growth performance from birth until slaughter of the litters with the lowest average birth weight in each treatment (n=24 per treatment) is reported in this paper. At weaning, each litter was split between two nursery pens with three to six pigs per pen. At the end of the 5-week nursery period, two barrows and two gilts from each litter that had individual birth weights closest to their litter average birth weight, were moved to experimental grow–finish pens (barn A), where they were housed as two pigs per pen, sorted by sex within litter. Remaining pigs in each litter were moved to another grow–finish barn (barn B) and kept in mixed-sex pens of up to 10 littermates. After 8 weeks, one of the two pigs in each pen in barn A was relocated to the pens holding their respective littermates in barn B. The remaining barrows and gilts were individually housed in the pens in barn A until slaughter. Maternal mLCPUFA supplementation increased docosahexaenoic acid (DHA) concentration in the brain, liver and Semitendinosus muscle of stillborn pigs (P<0.01), did not affect eicosapentaenoic acid and DHA concentrations in sow serum at the end of lactation, and did not affect average daily gain, average daily feed intake or feed utilization efficiency of the offspring. BW was higher (P<0.01) in the second half of the grow–finish phase in pigs from mLCPUFA sows compared with controls in barn A, where space and competition for feed was minimal, but not barn B. Carcass quality was not affected by treatment for pigs from barn A, but maternal mLCPUFA supplementation negatively affected carcass quality in pigs from barn B. Collectively, these results suggest that nutritional supplementation of sows can have lasting effects on litter development, but that feeding mLCPUFA to sows during gestation and lactation was not effective in improving growth rates or carcass quality of LBW litters.
The first clinical trials of gene therapy in the 1990s offered the promise of a new paradigm for the treatment of genetic diseases. Over the decades that followed the challenges and setbacks which gene therapy faced often overshadowed any successes. Despite this, recent years have seen cause for renewed optimism. In 2012 Glybera™, an adeno-associated viral vector expressing lipoprotein lipase, became the first gene therapy product to receive marketing authorisation in Europe, with a licence to treat familial lipoprotein lipase deficiency. This followed the earlier licensing in China of two gene therapies: Gendicine™ for head and neck squamous cell carcinoma and Oncorine™ for late-stage nasopharyngeal cancer. By this stage over 1800 clinical trials had been, or were being, conducted worldwide, and the therapeutic targets had expanded far beyond purely genetic disorders. So far no trials of gene therapy have been carried out in pregnancy, but an increasing understanding of the molecular mechanisms underlying obstetric diseases means that it is likely to have a role to play in the future. This review will discuss how gene therapy works, its potential application in obstetric conditions and the risks and limitations associated with its use in this setting. It will also address the ethical and regulatory issues that will be faced by any potential clinical trial of gene therapy during pregnancy.
The effects of a marine oil-based n-3 long-chain polyunsaturated fatty acid (mLCPUFA) supplement fed to the sow from weaning, through the rebreeding period, during gestation and until end of lactation on litter characteristics from birth until weaning were studied in sows with known litter birth weight phenotypes. It was hypothesized that low birth weight (LBW) litters would benefit more from mLCPUFA supplementation than high birth weight litters. A total of 163 sows (mean parity=4.9±0.9) were rebred after weaning. Sows were pair-matched by parity and litter average birth weight of the previous three litters. Within pairs, sows were allocated to be fed either standard corn/soyabean meal-based gestation and lactation diets (CON), or the same diets enriched with 0.5% of the mLCPUFA supplement at the expense of corn. Each litter between 9 and 16 total pigs born was classified as LBW or medium/high average birth weight (MHBW) litter and there was a significant correlation (P<0.001) between litter average birth weight of the current and previous litters within sows (r=0.49). Sow serum was harvested at day 113 of gestation for determination of immunoglobulin G (IgG) concentrations. The number of pigs born total and alive were lower (P=0.01) in mLCPUFA than CON sows, whereas the number of stillborn and mummified pigs were similar between treatments. Number of stillborns (trend) and mummies (P<0.01) were higher in LBW than MHBW litters. Tissue weights and brain : tissue weight ratios were similar between treatments, but LBW litters had decreased tissue weights and increased brain : tissue weight ratios compared with MHBW litters. Placental weight was lower (P=0.01) in LBW than MHBW litters, but was not different between treatments. Average and total litter weight at day 1 was similar between treatments. mLCPUFA increased weaning weight (P=0.08) and average daily gain (P<0.05) in MHBW litters, but not in LBW litters. Pre-weaning mortality was similar between treatments, but was higher (P<0.01) in LBW than MHBW litters. IgG concentration in sow serum was similar between treatments and litter birth weight categories. In conclusion, litter birth weight phenotype was repeatable within sows and LBW litters showed the benchmarks of intra-uterine growth retardation (lower placental weight and brain sparing effects). As maternal mLCPUFA supplementation decreased litter size overall, only improved litter growth rate until weaning in MHBW litters, and did not affect pre-weaning mortality, maternal mLCPUFA supplementation was not an effective strategy in our study for mitigating negative effects of a LBW litter phenotype.
Anti-black prejudice affects how some citizens evaluate black candidates. What does it take to reduce the role of prejudice in these evaluations? Using logical implications of relevant psychological phenomena, this article shows that repeated exposure to counter-stereotypical information is insufficient to reduce evaluative prejudice. Instead, citizens must associate this prejudice with adverse effects for themselves in contexts that induce them to rethink their existing racial beliefs. These findings explain important disagreements in empirical prejudice research, as only some empirical research designs supply the conditions for prejudice reduction predicted here. This study also clarifies why similarly situated citizens react so differently to counter-stereotypical information. In sum, we find that prejudice change is possible, but in a far narrower set of circumstances than many scholars claim.
Compare the severity of illnesses associated with influenza and noninfluenza acute respiratory illness (ARI) in healthcare personnel (HCP).
Design.
Prospective observational cohort.
Participants.
HCP at 2 healthcare organizations with direct patient contact were enrolled prior to the 2010–2011 influenza season.
Methods.
HCP who were fewer than 8 days from the start of fever/feverishness/chills and cough were eligible for real-time reverse-transcription polymerase chain reaction influenza virus testing of respiratory specimen. Illness severity was assessed by the sum of self-rated severity (0, absent; 3, severe) of 12 illness symptoms, subjective health (0, best health; 9, worst health), activities of daily living impairment (0, able to perform; 9, unable to perform), missed work, and duration of illness.
Results.
Of 1,701 HCP enrolled, 267 were tested for influenza, and 58 (22%) of these tested positive. Influenza compared with noninfluenza illnesses was associated with higher summed 12-symptom severity score (mean [standard deviation], 17.9 [5.4] vs 14.6 [4.8]; P < .001), worse subjective health (4.5 [1.8] vs 4.0 [1.8]; P < .05), greater impairment of activities of daily living (4.9 [2.5] vs 3.8 [2.5]; P < .01), and more missed work (12.1 [10.5] vs 7.8 [10.5] hours; P < .01). Differences in symptom severity, activities of daily living, and missed work remained significant after adjusting for illness and participant characteristics.
Conclusions.
Influenza had a greater negative impact on HCP than noninfluenza ARIs, indicated by higher symptom severity scores, less ability to perform activities of daily living, and more missed work. These results highlight the importance of efforts to prevent influenza infection in HCP.
Mentalizing deficits are a hallmark of the autism spectrum condition (ASC) and a potential endophenotype for atypical social cognition in ASC. Differences in performance and neural activation on the ‘Reading the Mind in the Eyes’ task (the Eyes task) have been identified in individuals with ASC in previous studies.
Method.
Performance on the Eyes task along with the associated neural activation was examined in adolescents with ASC (n = 50), their unaffected siblings (n = 40) and typically developing controls (n = 40). Based on prior literature that males and females with ASC display different cognitive and associated neural characteristics, analyses were stratified by sex. Three strategies were applied to test for endophenotypes at the level of neural activation: (1) identifying and locating conjunctions of ASC–control and sibling–control differences; (2) examining whether the sibling group is comparable to the ASC or intermediate between the ASC and control groups; and (3) examining spatial overlaps between ASC–control and sibling–control differences across multiple thresholds.
Results.
Impaired behavioural performance on the Eyes task was observed in males with ASC compared to controls, but only at trend level in females; and no difference in performance was identified between sibling and same-sex control groups in both sexes. Neural activation showed a substantial endophenotype effect in the female groups but this was only modest in the male groups.
Conclusions.
Behavioural impairment on complex emotion recognition associated with mental state attribution is a phenotypic, rather than an endophenotypic, marker of ASC. However, the neural response during the Eyes task is a potential endophenotypic marker for ASC, particularly in females.
The eighteenth century is usually considered to be a time of increasing secularization in which the primacy of theology was replaced by the authority of reason, yet this lofty intellectual endeavor played itself out in a social and political reality that was heavily impacted by religious customs and institutions. This duality is visible in the literature and culture of late eighteenth- and early nineteenth-century Germany. On the one hand, authors such as Goethe, Schiller, and Kleist are known for their distance from traditional Christianity. On the other hand, many canonical texts from the late eighteenth and early nineteenth centuries -- from Goethe's 'Faust' to Schiller's 'Die Jungfrau von Orleans' to Kleist's 'Michael Kohlhaas' -- are not only filled with references to the Bible, but invoke religious frameworks. 'Religion, Reason, and Culture in the Age of Goethe' investigates how culture in the Age of Goethe shaped and was shaped by a sustained and multifaceted debate about the place of religion and religious difference in politics, philosophy, and culture, enriching our understanding of the relationship between religion and culture during this foundational period in German history. Contributors: Frederick Amrine, Claire Baldwin, Lisa Beesley, Jane K. Brown, Jeffrey L. High, Elisabeth Krimmer, Helmut J. Schneider, Patricia Anne Simpson, John H. Smith, Tom Spencer. Elisabeth Krimmer is professor of German at the University of California, Davis. Patricia Anne Simpson is professor of German at Montana State University.