We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.
The First Large Absorption Survey in H i (FLASH) is a large-area radio survey for neutral hydrogen in and around galaxies in the intermediate redshift range 0.4 < z < 1.0, using the 21-cm H i absorption line as a probe of cold neutral gas. The survey uses the ASKAP radio telescope and will cover 24,000 deg2 of sky over the next five years. FLASH breaks new ground in two ways – it is the first large H i absorption survey to be carried out without any optical preselection of targets, and we use an automated Bayesian line-finding tool to search through large datasets and assign a statistical significance to potential line detections. Two Pilot Surveys, covering around 3000 deg2 of sky, were carried out in 2019-22 to test and verify the strategy for the full FLASH survey. The processed data products from these Pilot Surveys (spectral-line cubes, continuum images, and catalogues) are public and available online. In this paper, we describe the FLASH spectral-line and continuum data products and discuss the quality of the H i spectra and the completeness of our automated line search. Finally, we present a set of 30 new H i absorption lines that were robustly detected in the Pilot Surveys, almost doubling the number of known H i absorption systems at 0.4 < z < 1. The detected lines span a wide range in H i optical depth, including three lines with a peak optical depth τ > 1, and appear to be a mixture of intervening and associated systems. Interestingly, around two-thirds of the lines found in this untargeted sample are detected against sources with a peaked-spectrum radio continuum, which are only a minor (5-20%) fraction of the overall radio-source population. The detection rate for H i absorption lines in the Pilot Surveys (0.3 to 0.5 lines per 40 deg2 ASKAP field) is a factor of two below the expected value. One possible reason for this is the presence of a range of spectral-line artefacts in the Pilot Survey data that have now been mitigated and are not expected to recur in the full FLASH survey. A future paper in this series will discuss the host galaxies of the H i absorption systems identified here.
Subjective cognitive concerns (SCCs) refer to individuals’ self-identified cognitive limitations, irrespective of objective neurocognitive performance. Previous literature has overwhelmingly found that psychiatric factors, not neurocognitive dysfunction, are a primary correlate of elevated SCCs across a wide range of clinical populations. However, the relationship between SCCs and objective neurocognitive performance is complex and may further be influenced by underlying mechanisms of various impairments or etiologies. Moreover, much of the extant literature has under-utilized performance validity tests (PVTs) when analyzing objective neuropsychological outcomes.
Methods
As such, this study examined the associations between SCCs, performance validity, neurocognitive performance, and psychiatric distress among adult clinical patients with primary medical/neurologic (n = 127) and psychiatric (n = 106) etiologies.
Results
Results showed that elevated SCCs are associated with greater degrees of performance invalidity and psychiatric distress, but not neurocognitive performance, among both groups.
Conclusions
Findings support the utility of PVTs in clinical research and further highlight the impact of psychiatric factors on SCCs, regardless of medical/neurologic or psychiatric etiology.
Paediatric ventricular assist device patients, including those with single ventricle anatomy, are increasingly managed outside of the ICU. We used retrospective chart review of our single centre experience to quantify adverse event rates and ICU readmissions for 22 complex paediatric patients on ventricular assist device support (15 two ventricles, 7 single ventricle) after floor transfer. The median age was 1.65 years. The majority utilised the Berlin EXCOR (17, 77.3%). There were 9 ICU readmissions with median length of stay of 2 days. Adverse events were noted in 9 patients (41%), with infection being most common (1.8 events per patient year). There were no deaths. Single ventricle patients had a higher proportion of ICU readmission and adverse events. ICU readmission rates were low, and adverse event rates were comparable to published rates suggesting ventricular assist device patients can be safely managed on the floor.
We present the first results from a new backend on the Australian Square Kilometre Array Pathfinder, the Commensal Realtime ASKAP Fast Transient COherent (CRACO) upgrade. CRACO records millisecond time resolution visibility data, and searches for dispersed fast transient signals including fast radio bursts (FRB), pulsars, and ultra-long period objects (ULPO). With the visibility data, CRACO can localise the transient events to arcsecond-level precision after the detection. Here, we describe the CRACO system and report the result from a sky survey carried out by CRACO at 110-ms resolution during its commissioning phase. During the survey, CRACO detected two FRBs (including one discovered solely with CRACO, FRB 20231027A), reported more precise localisations for four pulsars, discovered two new RRATs, and detected one known ULPO, GPM J1839 $-$10, through its sub-pulse structure. We present a sensitivity calibration of CRACO, finding that it achieves the expected sensitivity of 11.6 Jy ms to bursts of 110 ms duration or less. CRACO is currently running at a 13.8 ms time resolution and aims at a 1.7 ms time resolution before the end of 2024. The planned CRACO has an expected sensitivity of 1.5 Jy ms to bursts of 1.7 ms duration or less and can detect $10\times$ more FRBs than the current CRAFT incoherent sum system (i.e. 0.5 $-$2 localised FRBs per day), enabling us to better constrain the models for FRBs and use them as cosmological probes.
Several neural networks have been proposed in the general literature for pattern recognition and clustering, but little empirical comparison with traditional methods has been done. The results reported here compare neural networks using Kohonen learning with a traditional clustering method (K-means) in an experimental design using simulated data with known cluster solutions. Two types of neural networks were examined, both of which used unsupervised learning to perform the clustering. One used Kohonen learning with a conscience and the other used Kohonen learning without a conscience mechanism. The performance of these nets was examined with respect to changes in the number of attributes, the number of clusters, and the amount of error in the data. Generally, the K-means procedure had fewer points misclassified while the classification accuracy of neural networks worsened as the number of clusters in the data increased from two to five.
Previous studies investigating behavioural health screening processes have focused on selected diagnoses within paediatric cardiology and focused on a smaller number of potential concerns. We developed and administered a brief survey in our paediatric heart centre to assess the presence of a wider variety of behavioural health concerns and to connect patients with resources. A cohort of 305 patients aged 2–29 years (M = 11.97 years; SD = 6.00 years; 50.49% female), representing a variety of indications for a cardiology clinic visit, or a parent, completed a survey of 14 common behavioural health concerns. Behavioural health concerns were included based on practice patterns within paediatric psychology. Respondents indicated if they were currently receiving behavioural health services and if they were interested in behavioural health follow-up. Surveys were administered during check in and collected by clinic staff. A behavioural health provider attempted to reach all those who indicated interest by phone. Approximately 45% of the sample endorsed one or more behavioural health concerns and 30.16% of the sample endorsed at least one concern but were not already connected to services. Only 27.17% of this group requested follow-up. Most commonly endorsed concerns were anxiety, sleep problems, depressed/irritable mood, and somatic complaints. Survey results converge with existing literature to indicate that behavioural health concerns are common among youth seen in a paediatric cardiology clinic but most patients are not connected to appropriate services. Screening programmes can help meet this need but challenges remain. Clinical implications and future directions are discussed.
This study investigated the relationship between various intrapersonal factors and the discrepancy between subjective and objective cognitive difficulties in adults with attention-deficit hyperactivity disorder (ADHD). The first aim was to examine these associations in patients with valid cognitive symptom reporting. The next aim was to investigate the same associations in patients with invalid scores on tests of cognitive symptom overreporting.
Method:
The sample comprised 154 adults who underwent a neuropsychological evaluation for ADHD. Patients were divided into groups based on whether they had valid cognitive symptom reporting and valid test performance (n = 117) or invalid cognitive symptom overreporting but valid test performance (n = 37). Scores from multiple symptom and performance validity tests were used to group patients. Using patients’ scores from a cognitive concerns self-report measure and composite index of objective performance tests, we created a subjective-objective discrepancy index to quantify the extent of cognitive concerns that exceeded difficulties on objective testing. Various measures were used to assess intrapersonal factors thought to influence the subjective-objective cognitive discrepancy, including demographics, estimated premorbid intellectual ability, internalizing symptoms, somatic symptoms, and perceived social support.
Results:
Patients reported greater cognitive difficulties on subjective measures than observed on objective testing. The discrepancy between subjective and objective scores was most strongly associated with internalizing and somatic symptoms. These associations were observed in both validity groups.
Conclusions:
Subjective cognitive concerns may be more indicative of the extent of internalizing and somatic symptoms than actual cognitive impairment in adults with ADHD, regardless if they have valid scores on cognitive symptom overreporting tests.
Background: A key efficacy indicator in generalized myasthenia gravis (gMG) treatment is improvement in MG-ADL score. Minimal symptom expression (MSE, MG-ADL total score of 0 or 1) is explored as a novel proposed treatment target in gMG in the phase 3 study of intravenous efgartigimod, ADAPT, and its open-label extension, ADAPT+. Methods: Post hoc analyses of acetylcholine receptor antibody positive participants in ADAPT (n=129) and ADAPT+ (n=111) were performed. Results: In ADAPT, 44.6% receiving efgartigimod achieved MSE vs 10.9% of participants given placebo. Despite less frequent assessment during ADAPT+, 40.5% of participants achieved MSE. Eighty-one percent of participants treated with efgartigimod who achieved MSE in ADAPT also achieved MSE during ADAPT+; 23% who had not achieved MSE in ADAPT did in ADAPT+. Achieving MSE was associated with substantial improvements in QMG, MGC, MG-QoL15r, and EQ-5D-5L mean scores of 11.4, 16.0, 12.4, and 0.3 points, respectively, from baseline to best score (across all visits). These drastic improvements resulted in quality of life (QoL) comparable to that of healthy populations. MSE achievement also resulted in sustained improvements in these disease-specific and QoL measures. Conclusions: Participants who achieved MSE showed substantial and consistent improvements across multiple disease measures and experienced QoL comparable to that of healthy populations.
While mentors can learn general strategies for effective mentoring, existing mentorship curricula do not comprehensively address how to support marginalized mentees, including LGBTQIA+ mentees. After identifying best mentoring practices and existing evidence-based curricula, we adapted these to create the Harvard Sexual and Gender Minority Health Mentoring Program. The primary goal was to address the needs of underrepresented health professionals in two overlapping groups: (1) LGBTQIA+ mentees and (2) any mentees focused on LGBTQIA+ health. An inaugural cohort (N = 12) of early-, mid-, and late-career faculty piloted this curriculum in spring 2022 during six 90-minute sessions. We evaluated the program using confidential surveys after each session and at the program’s conclusion as well as with focus groups. Faculty were highly satisfied with the program and reported skill gains and behavioral changes. Our findings suggest this novel curriculum can effectively prepare mentors to support mentees with identities different from their own; the whole curriculum, or parts, could be integrated into other trainings to enhance inclusive mentoring. Our adaptations are also a model for how mentorship curricula can be tailored to a particular focus (i.e., LGBTQIA+ health). Ideally, such mentor trainings can help create more inclusive environments throughout academic medicine.
Social connection is associated with better health, including reduced risk of dementia. Personality traits are also linked to cognitive outcomes; neuroticism is associated with increased risk of dementia. Personality traits and social connection are also associated with each other. Taken together, evidence suggests the potential impacts of neuroticism and social connection on cognitive outcomes may be linked. However, very few studies have simultaneously examined the relationships between personality, social connection and health.
Research objective:
We tested the association between neuroticism and cognitive measures while exploring the potential mediating roles of aspects of social connection (loneliness and social isolation).
Method:
We conducted a cross-sectional study with a secondary analysis of the Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort, a sample of Canadians aged 45 to 85 years at baseline. We used only self-reported data collected at the first follow-up, between 2015 and 2018 (n= 27,765). We used structural equation modelling to assess the association between neuroticism (exposure) and six cognitive measures (Rey Auditory Verbal Learning Test immediate recall and delayed recall, Animal Fluency Test, Mental Alternation Test, Controlled Oral Word Association Test and Stroop Test interference ratio), with direct and indirect effects (through social isolation and loneliness). We included age, education and hearing in the models and stratified all analyses by sex, females (n= 14,133) and males (n=13,632).
Preliminary results of the ongoing study:
We found positive, statistically significant associations between neuroticism and social isolation (p<0.05) and loneliness (p<0.05), for both males and females. We also found inverse, statistically significant associations between neuroticism and all cognitive measures (p<0.05), except the Stroop Test interference ratio. In these models, there was consistent evidence of indirect effects (through social isolation and loneliness) and, in some cases, evidence of direct effects. We found sex differences in the model results.
Conclusion:
Our findings suggest that the association between neuroticism and cognitive outcomes may be mediated by aspects of social connection and differ by sex. Understanding if and how modifiable risk factors mediate the association between personality and cognitive outcomes would help develop and target intervention strategies that improve social connection and brain health.
The Jamaican flower bat Phyllonycteris aphylla is categorized as Critically Endangered on the IUCN Red List. It is endemic to Jamaica and formerly known only from Stony Hill Cave, where there are an estimated c. 500 individuals. Previously declared extinct twice, its rediscovery in 2010 at Stony Hill Cave marked new hope for the conservation of this important species. Although little is known about its ecology, the species is presumed to be a cave-obligate rooster and to rely exclusively on so-called hot caves, which are defined by high ambient temperatures and low air quality. In March–April 2023, we surveyed bats at seven caves throughout Jamaica. At two of these, Green Grotto Caves, St. Ann, and Rock Spring Caverns, St. Mary, we captured both male and pregnant female P. aphylla. At Green Grotto Caves, we captured 24 P. aphylla, and 66 at Rock Spring Caverns. We believe Rock Spring Caverns to be one of the largest known roosts of P. aphylla. Neither of these sites are hot caves as both are moderated by flowing water, although warmer chambers may be more important to this bat than to other species. Further monitoring of these populations and continued exploration of other potential roosts are vital for the protection of this species.
The COVID-19 pandemic disrupted many areas of life, including culturally accepted practices at end-of-life care, funeral rites, and access to social, community, and professional support. This survey investigated the mental health outcomes of Australians bereaved during this time to determine how these factors might have impacted bereavement outcomes.
Methods
An online survey indexing pandemic and bereavement experiences, levels of grief, depression, anxiety, and health, work, and social impairment. Latent class analysis (LCA) was used to identify groups of individuals who shared similar symptom patterns. Multinomial regressions identified pandemic-related, loss-related, and sociodemographic correlates of class membership.
Results
1911 Australian adults completed the survey. The LCA identified four classes: low symptoms (46.8%), grief (17.3%), depression/anxiety (17.7%), and grief/depression/anxiety (18.2%). The latter group reported the highest levels of health, work, and social impairment. The death of a child or partner and an inability to care for the deceased due to COVID-19 public health measures were correlated with grief symptoms (with or without depression and anxiety). Preparedness for the person's death and levels of pandemic-related loneliness and social isolation differentiated all four classes. Unemployment was associated with depression/anxiety (with or without grief).
Conclusions
COVID-19 had profound impacts for the way we lived and died, with effects that are likely to ricochet through society into the foreseeable future. These lessons learned must inform policymakers and healthcare professionals to improve bereavement care and ensure preparedness during and following future predicted pandemics to prevent negative impacts.
The reading the mind in the eyes test (RMET) – which assesses the theory of mind component of social cognition – is often used to compare social cognition between patients with schizophrenia and healthy controls. There is, however, no systematic review integrating the results of these studies. We identified 198 studies published before July 2020 that administered RMET to patients with schizophrenia or healthy controls from three English-language and two Chinese-language databases. These studies included 41 separate samples of patients with schizophrenia (total n = 1836) and 197 separate samples of healthy controls (total n = 23 675). The pooled RMET score was 19.76 (95% CI 18.91–20.60) in patients and 25.53 (95% CI 25.19–25.87) in controls (z = 12.41, p < 0.001). After excluding small-sample outlier studies, this difference in RMET performance was greater in studies using non-English v. English versions of RMET (Chi [Q] = 8.54, p < 0.001). Meta-regression analyses found a negative association of age with RMET score and a positive association of years of schooling with RMET score in both patients and controls. A secondary meta-analysis using a spline construction of 180 healthy control samples identified a non-monotonic relationship between age and RMET score – RMET scores increased with age before 31 and decreased with age after 31. These results indicate that patients with schizophrenia have substantial deficits in theory of mind compared with healthy controls, supporting the construct validity of RMET as a measure of social cognition. The different results for English versus non-English versions of RMET and the non-monotonic relationship between age and RMET score highlight the importance of the language of administration of RMET and the possibility that the relationship of aging with theory of mind is different from the relationship of aging with other types of cognitive functioning.
Accurate clay mineral identification is key to understanding past aqueous activity on Mars, but martian phyllosilicates are old (>3.5 Ga) and have been heavily bombarded by meteoroid impacts. Meteoroid impacts can alter clay mineral structures and spectral signatures, making accurate remote sensing identifications challenging. This paper uses nuclear magnetic resonance (NMR) spectroscopy to examine the short-range structural deformation induced in clay mineral samples of known composition by artificial impacts and calcination. Structural changes are then related to changes in the visible-near infrared (VNIR) and mid-infrared (MIR) spectra of these clay mineral samples. The susceptibility of phyllosilicates to structural deformation after experimental impacts varies by structure. Experimental results showed that trioctahedral, Mg(II)-rich saponite was structurally resilient up to peak pressures of 39.8 GPa and its unchanged post-impact spectra reflected this. Experimental data on kaolinite showed that this Al(III)-rich, dioctahedral phyllosilicate was susceptible to structural alteration at peak pressures ⩾ 25.1 GPa. This result is similar to previously reported experimental results on the Fe(III)-rich dioctahedral smectite nontronite, suggesting that dioctahedral phyllosilicates may be more susceptible to shock-induced structural deformation than trioctahedral phyllosilicates. The octahedral vacancies present in dioctahedral phyllosilicates may drive this increased susceptibility to deformation relative to trioctahedral phyllosilicates with fully occupied octahedral sheets. Thermal alteration accompanies shock in meteoroid impacts, but shock differs from thermal alteration. NMR spectroscopy showed that structural deformation in thermally altered phyllosilicates differs from that found in shocked phyllosilicates. Similar to shock, dioctahedral phyllosilicates are also more susceptible to thermal alteration. This differential susceptibility to impact-alteration may help explain generic smectite identifications from heavily bombarded terrains on Mars.
Health numeracy is the understanding and application of information conveyed with numbers, tables and graphs, and probabilities in order to effectively manage one's own healthcare. Health numeracy is a vital aspect of communicating with healthcare providers and participating in one's own medical decision making, which is especially important in aging populations. Current literature indicates that assessing and establishing one's health numeracy abilities is among the first steps in providing necessary resources and accommodating patients' individual needs. Additionally, older adults with diffuse cognitive impairment often have issues with facets of executive functioning; however, the extant literature does not discuss the role of executive functioning in relation to health numeracy in this population. The purpose of this study was to explore the relationship between performance on tasks of executive functioning and objectively-measured health numeracy abilities in older adult patients.
Participants and Methods:
This study included a sample of 42 older adult patients referred for neuropsychological evaluation for memory complaints who were administered the Test of Premorbid Functioning (TOPF), Trail Making Test - Part B (TMT-B), and Stroop Color and Word Test (SCWT Color Word Interference [CWI]) as part of a larger standardized battery. Patients were also administered the Numerical Understand in Medicine Instrument - Short Form (NUMI-SF). All included patients had <2 performance validity test failures. The sample was racially diverse (47.6% Black, 35.7% White, 14.3% Hispanic, 2.4% Asian) and 54.8% female. Average age was 62.95 (SD= 8.6) and average education was 14.1 (SD=2.7). Diagnostically, 47.6% of the sample were cognitively normal, 33.3% had mild cognitive impairment, and 19.0% had dementia. Average NUMI-SF score was 4.79 (SD= 1.7). Two multiple regressions were conducted to evaluate the extent to which executive functioning, as measured by the TMT-B and SCWT CWI predicted NUMI-SF, and the additive predictive power of premorbid IQ and demographics via the TOPF on the relationship between executive functioning and NUMI-SF.
Results:
The first regression, which measured the relationship between the TMT-B and SCWT CWI upon NUMI-SF scores, was not significant (p=.616). The model was significant with the addition of the TOPF (ß=.595, p<.001) and TOPF alone predicted ∼60% of the variance in NUMI-SF score, while TMT-B and SCWT CWI remained non-significant.
Conclusions:
These results indicate that common measures of executive functioning are not reliable predictors of health literacy with or without the moderating of premorbid intellectual functioning taken into consideration. This suggests that health numeracy is likely to be minimally affected by deficits in executive functioning and rather may be better accounted for by premorbid intellectual functioning and/or other sociodemographic factors (e.g. socioeconomic status, education quality, occupation). Future studies will benefit from elucidating the contributions of other social determinant factors on predicting health numeracy.
Awareness of risk factors associated with any form of impairment is critical for formulating optimal prevention and treatment planning. Millions worldwide suffer from some form of cognitive impairment, with the highest rates amongst Black and Hispanic populations. The latter have also been found to achieve lower scores on standardized neurocognitive testing than other racial/ethnic groups. Understanding the socio-demographic risk factors that lead to this discrepancy in neurocognitive functioning across racial groups is crucial. Adverse childhood experiences (ACEs), are one aspect of social determinants of health. ACES have been linked to a greater risk of future memory impairment, such as dementia. Moreover, higher instances of ACEs have been found amongst racial minorities. Considering the current literature, the purpose of this exploratory research is to better understand how social determinants, more specifically, ACEs, may play a role in the development of cognitive impairment.
Participants and Methods:
This cross-sectional study included data from an urban, public Midwestern academic medical center. There was a total of 64 adult clinical patients that were referred for a neuropsychological evaluation. All patients were administered a standardized neurocognitive battery that included the Montreal Cognitive Assessment (MoCA) as well as a 10-item ACE questionnaire, which measures levels of adverse childhood experiences. The sample was 73% Black and 27% White. The average age was 66 (SD=8.6) and average education was 12.6 years (SD=3.4). A two-way ANOVA was conducted to evaluate the interaction of racial identity (White; Black) and ACE score on MoCA total score. An ACE score >4 was categorized as “high”; ACE <4 was categorized as “low.”
Results:
There was not a significant interaction of race and ACE group on MoCA score (p=.929) nor a significant main effect of ACE score (p=.541). Interestingly, there was a significant main effect of Race on MoCA (p=.029). White patients had an average MoCA score of 21.82 (sd=4.77). Black patients had an average MoCA score of 17.54 (sd=5.91).
Conclusions:
Overall, Black patients demonstrated statistically lower scores on the MoCA than White patients. There was no significant difference on MoCA score between races when also accounting for ACE scores. Given this study’s findings, one’s level of adverse childhood experiences does not appear to impact one’s cognitive ability later in life. There is a significant difference in cognitive ability between races, specifically Black and White people, which suggests there may be social determinants other than childhood experiences to be explored that influence cognitive impairment.