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Previous research suggests that individuals with isolated Agenesis of the Corpus Callosum (AgCC) have cognitive and psychosocial deficiencies that include impaired recognition of the emotions of others (Symington et al., 2010) and a diminished ability to infer and describe the emotions of others (Paul et al., 2021; Turk et al., 2010). In addition, galvanic skin responses effectively discriminated between emotional images despite atypical emotion ratings (Paul et al, 2006), supporting a dissociation between cognitive and affective empathy in AgCC. Likewise, atypical patterns of visual attention to faces corresponded with impaired emotion recognition in AgCC (Bridgman et al, 2014), suggesting that atypical visual attention in AgCC negatively impacts the ability to identify others’ emotions. This study used the Multifaceted Empathy Test [MET] (Foell et al., 2018) to examine the impact of visual aesthetics (photo composition) on empathetic feelings (affective empathy) and situational emotion recognition (cognitive empathy) in persons with AgCC. Both cognitive and affective empathy scores are typically higher on MET stimuli composed according to the “Golden Spiral” (Callaway, 2022).
Participants and Methods:
Results from 50 control participants recruited from Cloud Research were compared to responses from 19 participants with AgCC and normal-range FSIQ (>80). Data was gathered through an online version of the MET, which uses a series of photographs of individuals displaying an emotion, half of which adhere to the compositional technique known as “The Golden Spiral.” To measure cognitive empathy, the participants are asked to pick the correct emotion being displayed with three distractors for each item. To measure affective empathy, they are then asked on a sliding scale, “how much do you empathize with the person shown” (1 = Not at all, 7 = Very much).
Results:
Repeated measures mixed ANOVAs revealed no difference between AgCC and control groups on affective empathy, and as expected on the MET, both groups had significantly higher ratings for photos composed according to the Golden Spiral (AgCC, np2 = .071; control, np2 = .136). In contrast, the AgCC group scored significantly lower than controls overall on cognitive empathy, np2 =.065. Exploratory post-hoc found a significant group difference in cognitive empathy only on photos composed according to the Golden Spiral, np2 = .090, with the scores in the AgCC group unimpacted by composition type while the control group exhibiting significantly higher scores Golden Spiral images, np2 = .254.
Conclusions:
Empathic deficits in AgCC were restricted to the cognitive component, while affective empathy was not impaired. Visual aesthetics of photo composition influenced affective empathy ratings in both AgCC and control groups. However, adults with AgCC had diminished ability to give cognitive labels to the emotional states of others, which was not enhanced by the formal aesthetics of stimuli. Thus the corpus callosum seems to facilitate the ability to cognitively label emotions by facilitating visual attention. It also suggests that the corpus callosum does not facilitate affective empathy, in part because it does not appear to determine whether formal aesthetics influences the processing of visual stimuli in AgCC or neurotypical controls.
Agenesis of the Corpus Callosum (AgCC) is the congenital absence of all or part of the corpus callosum. Previous research has demonstrated that isolated AgCC results in a pattern of cognitive and psychosocial deficiencies, even when FSIQ is in the normal range (FSIQ > 80; Brown & Paul, 2019). Importantly, individuals with AgCC have been shown to provide narratives containing fewer emotional words, social interactions, and mental inferences on the Thematic Apperception Test (TAT; Turk et al., 2009). Similarly, research has suggested deficits in the elaborative imagination of persons with AgCC when they are providing narrative descriptions of simple animations (Renteria-Vasquez et al., 2021). Such findings raise questions about aesthetic perception in AgCC. While previous research has demonstrated differences in aesthetic perception among other neuropsychological populations (e.g. Parkinson's Disease; Lauring et al., 2019), there is no research reported regarding aesthetic appreciations in AgCC. The present study employed the Assessment of Art Attributes (AAA; Chatterjee et al., 2010) to compare the conceptual and perceptual aspects of aesthetic perception of persons with AgCC to neurotypical control participants. Prior investigation by Bromberger and colleagues (2011) utilized the AAA to examine the aesthetic perception of persons with right hemisphere lesions, finding deviations in judgements of abstractness, symbolism, realism, and animacy– all classified as “conceptual attributes.” Based on these findings, it was predicted that individuals with AgCC would rate paintings differently than neurotypical controls on conceptual attributes, but not on perceptual attributes.
Participants and Methods:
Thirteen persons with AgCC and 49 neurotypical individuals completed the AAA. After completing measures of artistic experience and colorblindness, participants rated 24 paintings on 14 attributes. Balance, color saturation, color temperature, depth, simplicity, and stroke made up the “perceptual scales,” while abstractness, animacy, emotion, objective accuracy, realism, interest, and preference made up the “conceptual scales.”
Results:
Following Bromberger and colleagues (2011), average ratings from all control participants were used to rank the 24 paintings for each scale. Spearman's rank-order correlations were then conducted between the rankings of each participant and the average of the controls for each scale. Spearman's rho coefficients were then compared between AgCC and control groups using t-tests, controlling for multiple comparisons. As hypothesized, the AgCC group had significant deviations from the average of the controls (lower rho values) on several conceptual attributes: Abstractness (p = .004, d = .11), emotion (p < .001, d = .12), and interest (p < .001, d = .18), whereas individuals with AgCC deviated on only one perceptual attribute: Simplicity (p = .003, d = .12).
Conclusions:
While generally unremarkable in the sensory aspects, persons with AgCC demonstrated greatest differences in three important conceptual aspects of aesthetic perception. This outcome suggests that such higher-order aesthetic appreciations require interhemispheric interactivity. These results further support the hypothesis that decreased elaborative imagination is a fundamental component of AgCC.
Agenesis of the corpus callosum(AgCC) is a disorder in which the connection between the two brain hemispheres is congenitally absent. Previous research has suggested that the auditory system can be affected in individuals with AgCC (Demopoulos et al., 2015). However, the nature of AgCC’s effect on musical perception skills is unclear. This study investigated the impact of AgCC on the music perception skills in high-functioining adults using a brief version of the Profile of Music Perception Skills (PROMS; Zentner, M. & Strauß, H. 2017). It was hypothesized that individuals with AgCC would have diminished music perception abilities when compared to a neurotypical control group.
Participants and Methods:
Participants included 10 high-functioning adults with AgCC that had an intelligence quotation within the normal range (FSIQ>80) and 63 neurotypical controls who were recruited via Cloud Research. During the PROMS the participants were asked to listen to two different sound excerpts after which they were asked whether the second sound was the same or different from the first (correct answers= 2 points, uncertain answers= 1 point, and remaining answers not coded). The participants answered questions in four different areas of musical perception: Melody, Tuning, Accent, and Tempo.
Results:
Results indicated that there was not a significant difference between the control group and the AgCC participants on music perception skills on the overall PROMS scores F(1,72)= .365, P-value= .548. Tested individually, none of the 4 individual domains showed a significant difference: Melody F(1,72)=2.67, P-value= .107; Tuning F(1,72)= .271, P-value= .606; Accent F(1,72)= .017, P-value= .897; or Tempo F(1,72)=.106, P-value= .746.
Conclusions:
Contrary to the hypothesis of this study, the results showed that the participants with AgCC did not perform significantly differently in the PROMS total score when compared to neurotypical controls, nor were there significant differences in any of the four of the subtests (Melody, Tuning, Accent, and Tempo). Thus these high-functioning individuals with AgCC did not have deficient music perception abilities. These findings demonstrate that although the auditory system may be affected in some individuals with AgCC, we do not see differences in musical perception skills in high-functioning individuals with AgCC.
Previous research suggests that individuals with isolated Agenesis of the Corpus Callosum (AgCC) have cognitive and psychosocial deficits including that of complex processing of emotions (Anderson et al., 2017) and their ability to verbally express emotional experiences (Paul et al., 2021). Additionally, research suggests individuals with AgCC show impaired recognition of the emotions of others (Symington et al., 2010), as well as diminished ability to infer and describe the emotions of others (Renteria-Vazquez et al., 2022; Turk et al., 2010). However, the nature of the empathic abilities of individuals with AgCC remains unclear in empirical research. Capacity for empathetic feelings and situational recognition in persons with AgCC were tested using the Multifaceted Empathy Test [MET] (Foell et al., 2018). We hypothesized that individuals with AgCC would have lower abilities for both cognitive and affective empathy than neurotypical controls.
Participants and Methods:
Results from 50 neurotypical control participants recruited from MTurk Cloud were compared to responses from 19 AgCC participants with normal-range FSIQ (>80) drawn from the individuals with AgCC involved with the Human Brain and Cognition Lab at the Travis Research Institute. The research was completed through an online version of the MET. The MET uses a series of photographs of individuals displaying an emotion. To measure cognitive empathy, the participants are asked to pick the correct emotion being displayed with three distractors for each item. To measure affective empathy, they are then asked on a sliding scale, “how much do you empathize with the person shown” (1 = Not at all, 7 = Very much).
Results:
Results of a MANOVA showed a trend for a significant overall difference between individuals with AgCC and controls for empathic abilities F(1, 67) = 2.59, p-value = .082, with persons with AgCC showing less empathy overall. Follow-up one-way ANOVAs showed that individuals with AgCC scored significantly lower in cognitive empathy F(1, 67) = 4.63, p-value = .035, ηp2 = .065; however, affective empathy was not significantly different between groups F(1, 67) = .537, p-value = .466, ηp2 = .008.
Conclusions:
Results suggest that adults with AgCC have a diminished ability to give cognitive labels to the emotional states of others compared to neurotypical controls. However, contrary to our hypothesis, participants with AgCC had affective responses to the pictures of the emotional states of others which were similar to neurotypical controls. Recent research has shown that individuals with AgCC have difficulty inferring and elaborating on the more complex cognitive, social, and emotional aspects of simple animations (Renteria-Vazquez et al., 2022; Turk et al., 2010). Cognitive empathy would require this form of elaborative thinking, even when affective empathy is normal. Similarly, Paul et al. (2021) described alexithymia in persons with AgCC as difficulty in expressing emotions linguistically, but found similar endorsements of emotional experience when compared to neurotypical controls. This study provides further evidence to suggest the corpus callosum facilitates the ability to cognitively label emotions but not necessarily the ability to experience emotions affectively.
Previous research has demonstrated that individuals with Agenesis of the Corpus Callosum (AgCC), the congenital absence of all or part of the corpus callosum, exhibit a pattern of cognitive and psychosocial deficits, even with a FSIQ in the normal range (FSIQ > 80; Brown & Paul, 2019). This includes a core deficit in their complex reasoning and novel problem-solving (Brown & Paul, 2019), with secondary deficits in capacity to imagine complex emotional/cognitive consequences of potential actions involving others (Young et al, 2019), deficits in emotion
perception (Symington et at., 2010, Bridgman et al 2014), and difficulty with cognitively processing emotions within the context of social interactions (Anderson et al., 2017). This constellation of deficits is likely to also impact moral reasoning. While previous research has demonstrated differences in moral reasoning among other neuropsychological populations such as those with ventromedial prefrontal damage (Moretto et al., 2010) and frontotemporal dementia (Gleichgerrcht et al., 2011), there is no research reported regarding moral judgements in AgCC. This study employed the Moral Dilemmas Scale (Greene, 2001) to compare the moral judgements of persons with AgCC to neurotypical controls. It was predicted that individuals with AgCC would be less contextually nuanced than neurotypical controls in responding to moral dilemmas.
Participants and Methods:
Results consist of data derived from 57 neurotypical control participants (ages 23 to 64 years) recruited from MTurk Cloud and 19 AgCC participants (ages 23 to 77 years) with normal-range FSIQ (>80) drawn from the individuals with AgCC involved with the Human Brain and Cognition Lab at the Travis Research Institute. All participants completed an online version of the Moral Dilemmas Scale (Greene, 2001). The scale consists of 25 dilemmas, of which 11 are considered high-conflict, 7 low-conflict and 7 impersonal. Participants were instructed to read each dilemma and rate whether they found the action to be “appropriate” or not. The high-conflict dilemmas share a similar structure in which responses reflect either a utilitarian or deontological judgement.
Results:
“Approve” responses to each of the 3 categories of dilemma were separately tallied for each individual and subjected to a 2group ANOVA. Results revealed the control group produced a significantly higher rate of “appropriate” responses to high-conflict dilemmas than did the individuals with AgCC (F=8.17, p = .006, n2 =.113). However, no significant differences were found among the two groups for results on low (n2 = .013) and impersonal (n2 = .003) dilemmas alone. Furthermore, a X2 analysis of responses to each high conflict dilemma revealed a significant difference in 5 out of the 11 such that more persons with AgCC gave a deontological judgement.
Conclusions:
Results suggested that adults with AgCC respond similarly to neurotypical controls with respect to the low conflict or
impersonal dilemmas. However, with respect to high conflict dilemmas, compared to controls they tend to respond in a more deontological than utilitarian basis - that is, based on general principles without contextual nuance. These findings are consistent with the conclusion of Renteria-Vasquez et al. (2021) that persons with AgCC have difficulty imagining the wider implications of present information.
We implemented 2 interventions to improve utilization and contamination at our institution: kits to improve appropriate sample collection and an electronic order alert displaying appropriate indications of fungal blood cultures. An electronic order alert when ordering fungal blood cultures was associated with decreased utilization without decrease in positivity rate.
It has been previously identified that levels of peripheral inflammatory proteins, such as cytokines, are altered in people with schizophrenia spectrum disorders (SSD).
Objectives
As there is considerable inconsistency in the literature with respect to how inflammatory profiles differ between acute and chronic stages of SSD, a systematic review and network meta-analysis was performed.
Methods
Records from CINAHL, the Cochrane Central Register of Controlled Trials, EMBASE, PubMed, and PsycINFO were systematically searched from inception until 31 March 2022 for published studies that had measured levels of inflammatory proteins in cases of SSD and healthy controls. Pairwise and network meta-analyses were performed to determine whether there were significant differences in mean peripheral protein concentrations between acute SSD, chronic SSD, and healthy controls.
Results
After application of the screening process, 215 articles were included for data-analysis. One group of markers were consistently elevated (p<0·05) in both acute and chronic SSD, relative to healthy controls; this group comprised interleukin (IL)-1β, IL-1 receptor antagonist (IL-1RA), soluble interleukin-2 receptor (sIL-2R), IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-α, and high sensitivity C-reactive protein (hsCRP). A second group of markers were inconsistently altered between illness stages: IL-2 and interferon (IFN)-γ were significantly elevated (p<0·05) in acute SSD, whilst IL-4, IL-12 and IFN-γ were significantly decreased (p<0·05) in chronic SSD.
Conclusions
These results indicate that a baseline level of inflammatory protein alteration occurs in SSD throughout the course of illness. This was evident from the group of markers that were consistently elevated in acute and chronic SSD (e.g., IL-6), representing possible trait markers. Moreover, superimposed immune activity may occur in acute SSD, given the group of possible state markers that were increased only in acute illness (e.g., IFN-γ). Further research is required to elucidate whether these peripheral changes are reflected within the central nervous system.
Clozapine has been well established as the most efficacious medication for treatment refractory schizophrenia. Optimising the benefit during clozapine trial is an important clinical consideration. Therapeutic drug monitoring of clozapine plasma or serum levels has formed a critical part of this. Though there is no agreed standardised therapeutic range, advice traditionally recommends a clozapine level of >350ng/mL in order to effect best response. Most studies analysing the relationship between treatment response and clozapine level are older, have small sample sizes, and do not consider whether additional factors might assist in determining optimal clozapine level for response.
Objectives
We conducted a systematic review of PubMed, PsycInfo and Embase for studies that provided individual participant level data on clozapine levels and response.
Methods
This data was analysed using Receiver Operating Characteristic (ROC) curves to determine the prediction performance of serum clozapine levels for treatment response.
Results
We were able to include data on 294 individual participants. ROC analysis yielded an area under the curve (AUC) of 0.612. The clozapine level at the optimal Youden index was 372ng/mL, and at this level there was response sensitivity of 57.3%, and specificity of 65.7%. The interquartile range for treatment response was 223ng/mL – 558ng/mL. There was no improvement in ROC performance with mixed models including patient sex, age or length of trial.
Conclusions
Clozapine dose should be optimised based on clozapine therapeutic levels. We found that a range between 250 – 550ng/mL could be recommended, while noting that a level of >350ng/mL is most optimal for response.
The National Science Foundation (NSF) Daniel K. Inouye Solar Telescope (DKIST) has started operations at the summit of Haleakalā (Hawai’i). DKIST joins the nominal science phases of the NASA and ESA Parker Solar Probe and Solar Orbiter encounter missions. By combining in-situ measurements of the near-Sun plasma environment and detailed remote observations of multiple layers of the Sun, the three observatories form an unprecedented multi-messenger constellation to study the magnetic connectivity in the solar system. This work outlines the synergistic science that this multi-messenger suite enables.
Decumulation Pathways are proposed to help achieve better retirement outcomes for those with Defined Contribution (DC) pensions. The DC fund is split into two parts, in proportions of the consumer’s choice. Most is allocated to the Pension Fund to provide a lifetime income, while the rest is placed in the Flexible Fund for flexible access and/or to leave as a legacy. The Flexible Fund is invested in flexi-access drawdown. The Pension Fund is invested in a guaranteed annuity, Collective Defined Contribution, or a Pooled Pension Fund which maintains individual DC funds but pools longevity risk between participants. An illustrative standard Decumulation Pathway is intended as a default solution, or can be tailored by the consumer. It uses the Pooled Pension Fund, an automated withdrawal strategy which ensures a lifetime income is provided and one that aims to increase in line with inflation, and a moderate risk investment strategy. The standard approach is evaluated using various metrics, indicating that it has as a strong chance of providing a higher income than could be obtained from an annuity or drawdown, with limited downside risk.
The absence of quantitative in vitro cell–extracellular matrix models represents an important bottleneck for basic research and human health. Randomness of cellular distributions provides an opportunity for the development of a quantitative in vitro model. However, quantification of the randomness of random cell distributions is still lacking. In this paper, we have imaged cellular distributions in an alginate matrix using a multiview light sheet microscope and developed quantification metrics of randomness by modeling it as a Poisson process, a process that has constant probability of occurring in space or time. We imaged fluorescently labeled human mesenchymal stem cells embedded in an alginate matrix of thickness greater than 5 mm with $\sim\! {\rm 2}{\rm. 9} \pm {\rm 0}{\rm. 4}\,\mu {\rm m}$ axial resolution, the mean full width at half maximum of the axial intensity profiles of fluorescent particles. Simulated randomness agrees well with the experiments. Quantification of distributions and validation by simulations will enable quantitative study of cell–matrix interactions in tissue models.
To evaluate the impact of changes to urine testing orderables in computerized physician order entry (CPOE) system on urine culturing practices.
Design:
Retrospective before-and-after study.
Setting:
A 1,250-bed academic tertiary-care referral center.
Patients:
Hospitalized adults who had ≥1 urine culture performed during their stay.
Intervention:
The intervention (implemented in April 2017) consisted of notifications to providers, changes to order sets, and inclusion of the new urine culture reflex tests in commonly used order sets. We compared the urine culture rates before the intervention (January 2015 to April 2016) and after the intervention (May 2016 to August 2017), adjusting for temporal trends.
Results:
During the study period, 18,954 inpatients (median age, 62 years; 68.8% white and 52.3% female) had 24,569 urine cultures ordered. Overall, 6,662 urine cultures (27%) were positive. The urine culturing rate decreased significantly in the postintervention period for any specimen type (38.1 per 1,000 patient days preintervention vs 20.9 per 1,000 patient days postintervention; P < .001), clean catch (30.0 vs 18.7; P < .001) and catheterized urine (7.8 vs 1.9; P < .001). Using an interrupted time series model, urine culture rates decreased for all specimen types (P < .05).
Conclusions:
Our intervention of changes to order sets and inclusion of the new urine culture reflex tests resulted in a 45% reduction in the urine cultures ordered. CPOE system format plays a vital role in reducing the burden of unnecessary urine cultures and should be implemented in combination with other efforts.
We apply the Rigid Unit Mode model, which was initially developed for crystalline silicates, to the study of the flexibility of silica glass. Using a density-of-states approach we show that silica glass has the same flexibility against infinitesimal displacements of crystalline phases. Molecular dynamics simulations also show that parts of the silica structure are able to undergo large spontaneous changes through reorientations of the SiO4 tetrahedra with no energy cost.
The northern New England region includes the states of Vermont, New Hampshire, and Maine and encompasses a large degree of climate and edaphic variation across a relatively small spatial area, making it ideal for studying climate change impacts on agricultural weed communities. We sampled weed seedbanks and measured soil physical and chemical characteristics on 77 organic farms across the region and analyzed the relationships between weed community parameters and select geographic, climatic, and edaphic variables using multivariate procedures. Temperature-related variables (latitude, longitude, mean maximum and minimum temperature) were the strongest and most consistent correlates with weed seedbank composition. Edaphic variables were, for the most part, relatively weaker and inconsistent correlates with weed seedbanks. Our analyses also indicate that a number of agriculturally important weed species are associated with specific U.S. Department of Agriculture plant hardiness zones, implying that future changes in climate factors that result in geographic shifts in these zones will likely be accompanied by changes in the composition of weed communities and therefore new management challenges for farmers.
Background: Instrumentation failure (IF) such proximal junctional kyphosis/failure or distal junctional failure (PJK/PJF/DJF), rod fracture and screw-loosening can cause morbidity in patients with spinal deformity correction. Factors such as bone mineral density (BMD) or region of deformity correction may play a role in postoperative IF. Methods: We reviewed the relationship between IF and BMD or extent of spinal deformity. IF includes PJK/PJF/DJF, fractured rod, screw-looseing, radiculopathy, and non-union. BMD groups included Normal, osteopenia/osteoporosis, and Unknown. The extent of correction included Lumbar, Short Thoracolumbar (5-8 levels), Long Thoracolumbar (8 to 12 levels), and Cervical-thoracic. Results: 60 patients (41:19 F:M) were included, with average age of 65. Total IF=29 patients (48.3%). Normal BMD in N=14, with half of them (50.0%) developing IF; Low BMD in N=15, with one-third of them (33.3%) developing IF. Lumbar correction was performed in N=19, with IF in 36.8%; Short Thoracolumbar correction was performed in N=28, with IF in 46.4%; Long Thoracolumbar correction was performed in N=11, with IF in 81.8%; and Cervical correction in N=2, with no postoperative IF. Conclusions: Patients that received long-segment thoracolumbar had the highest rates of postoperative morbidity. We did not demonstrate an association between abnormal BMD and postoperative IF. A larger study would be needed for further investigations.
Background: Morbidity can be high in the management of adult spinal deformity patients. Complications include blood loss (EBL), durotomy, radicular pain, and postoperative hardware failure. Utilization of one versus two spinal surgeons in spinal deformity correction reduces overall perioperative morbidity is unclear. Methods: All procedures were performed by surgeons at a single institution between January 2012-2015. Patients were followed for a minimum of one year and maximum of four years. We retrospectively reviewed 60 cases of adult spinal deformity. Our cohort was divided into 1 versus 2 surgeons (12 vs 48 cases). We analyzed these cases for estimated blood loss and peri-operative complications. Results: Cases involving long thoracic to pelvis correction (T3-T6) was 20.8% in the 2 surgeons group and 8.3% in the 1 surgeon group. The EBL >3.0 L for 1 versus 2 surgeon groups were 25% and 41.6% respectively. Major complications in the 1 versus 2 surgeon group were 25% and 47.9% and the revision rates were 25% versus 37.5%. The percentage of minor complications in the 1 versus 2 surgeon group was 33.3% versus 14.6%. Conclusions: Utilizing two surgeons did not reduce complication rates. Procedures performed by two surgeons were more extensive deformity corrections. The extent of correction is the likely explanation for differing complication rates.
Quality measures are increasingly reported by hospitals to the Centers for Medicare and Medicaid Services (CMS), yet there may be tradeoffs in performance between infection control (IC) and other quality measures. Hospitals that performed best on IC measures did not perform well on most CMS non–IC quality measures.