bluuebunny/crossref_metadata_2025 huggingface dataset:
The clinical outcome and neuroimaging of acute encephalopathy after status epilepticus in Dravet syndrome
Authors: Tian Xiaojuan , Ye Jintang , Zeng Qi , Zhang Jing , Yang Xiaoling , Liu Aijie , Yang Zhixian , Liu Xiaoyan , Wu Xiru , Zhang Yuehua
Published: March 2018

Aim

To analyze the clinical outcome and neuroimaging over a long duration follow‐up in the currently largest series of acute encephalopathy after status epilepticus in patients with Dravet syndrome.

Method

Clinical and neuroimaging data of patients with Dravet syndrome with a history of acute encephalopathy (coma >24h) after status epilepticus from February 2005 to December 2016 at Peking University First Hospital were reviewed retrospectively.

Results

Thirty‐five patients (15 males, 20 females) with a history of acute encephalopathy were enrolled from a total of 624 patients with Dravet syndrome (5.6%). The median onset age of acute encephalopathy was 3 years 1 month. The duration of status epilepticus varied between 40 minutes to 12 hours. Thirty‐four patients had a high fever when status epilepticus occurred, and only one had a normal temperature. Coma lasted from 2 to 20 days. Twelve patients died and 23 survived with massive neurological regression. The median follow‐up time was 2 years 1 month. Neuroimaging of 20 out of 23 survivors during the recovery phase showed diverse degrees of cortical atrophy with or without subcortical lesions.

Interpretation

Acute encephalopathy after status epilepticus is more prone to occur in patients with Dravet syndrome who had a high fever. The mortality rate is high in severe cases. Survivors are left with severe neurological sequelae but often with either no seizure or low seizure frequency.

What this paper adds

Acute encephalopathy is more prone to occur in patients with Dravet syndrome with a high fever.

The mortality rate is high for acute encephalopathy after status epilepticus in patients with Dravet syndrome.

Survivors have neurological sequelae.
Determinants of change in home participation among critically ill children
Authors: Khetani Mary A , Albrecht Erin C , Jarvis Jessica M , Pogorzelski David , Cheng Emmy , Choong Karen
Published: March 2018

Aim

To estimate changes in home participation among critically ill children in the first 6 months after discharge from a pediatric intensive care unit (PICU), and to explore the effect of child, service, and environmental factors on change in home participation.

Method

This was a prospective bi‐center, longitudinal cohort study. Caregivers of 180 children, aged 1 to 17 years, who were admitted into the PICU for at least 48 hours were included. Patient‐reported outcomes were used to capture caregivers’ perspectives of their child's participation and environmental supports for participation in home activities. Data were collected at enrollment, and 3 and 6 months after discharge.

Results

There were no significant changes in home participation frequency or involvement, but involvement rates across time were moderated by functional status. Age significantly predicted participation frequency. Pre‐PICU functional status and capabilities were significant predictors of participation frequency and involvement, and home environmental support significantly predicted home involvement.

Interpretation

Results suggest relatively stable participation trajectories in the 6 months after PICU admission. Children with abnormal baseline function experienced a greater increase in home involvement after PICU. Rehabilitation interventions targeting functional capabilities and home environment may be viable approaches during the early phase of recovery. Environmental interventions may be more time‐efficient after PICU stay and merit further study.

What this paper adds

Children's pre‐pediatric intensive care unit (PICU) functional status and capabilities impact their participation after critical illness.

Children's trajectories of home involvement may differ over time based on their pre‐PICU functional status.

Caregiver perceptions of environmental support impact a child's home involvement after discharge from a PICU.
Minor neurological dysfunction and associations with motor function, general cognitive abilities, and behaviour in children born extremely preterm
Authors: Broström Lina , Vollmer Brigitte , Bolk Jenny , Eklöf Eva , Ådén Ulrika
Published: March 2018

Aim

To study the prevalence of minor neurological dysfunction (MND) at 6 years of age in a cohort of children born extremely preterm without cerebral palsy (CP) and to investigate associations with motor function, cognitive abilities, and behaviour.

Method

This study assessed 80 children born at less than 27 weeks of gestation and 90 children born at term age between 2004 and 2007 at a mean age of 6 years 6 months. The assessments included a simplified version of the Touwen Infant Neurological Examination, the Movement Assessment Battery for Children, Second Edition (MABC‐2), Wechsler Intelligence Scale for Children, Fourth Edition (WISC‐IV), the Strengths and Difficulties Questionnaire (SDQ), and the parent version of the Five to Fifteen questionnaire.

Results

Fifty‐one of the children born preterm had normal neurology, 23 had simple MND, and six had complex MND compared with 88 who had normal neurology and two simple MND in the term‐born group (p<0.001). There were significant differences between the children with normal neurology and MND in the preterm group in MABC‐2‐assessed motor function (p<0.001), general cognitive abilities with WISC‐IV (p=0.005), and SDQ overall behavioural problems and peer problems reported by the parents (p=0.021 and p=0.003 respectively). SDQ teacher‐reported overall behavioural and hyperactivity problems were significantly different between children with normal and simple MND (p=0.036 and p=0.019).

Interpretation

Children born extremely preterm, in the absence of CP, are at risk of MND and this is associated with motor function, cognitive ability, and behaviour.

What this paper adds

Extremely preterm birth carries a risk of minor neurological dysfunction (MND).

MND in children born extremely preterm is associated with impaired motor function and cognitive abilities, and behavioural problems.

Male sex is associated with MND in children born extremely preterm.
Classic infantile Pompe patients approaching adulthood: a cohort study on consequences for the brain
Authors: Ebbink Berendine J , Poelman Esther , Aarsen Femke K , Plug Iris , Régal Luc , Muentjes Carsten , van der Beek Nadine A M E , Lequin Maarten H , van der Ploeg Ans T , van den Hout Johanna M P
Published: March 2018

Aim

To examine the long‐term consequences of glycogen storage in the central nervous system (CNS) for classic infantile Pompe disease using enzyme replacement therapy.

Method

Using neuropsychological tests and brain magnetic resonance imaging (MRI), we prospectively assessed a cohort of 11 classic infantile Pompe patients aged up to 17 years.

Results

From approximately age 2 years onwards, brain MRI showed involvement of the periventricular white matter and centrum semiovale. After 8 years of age, additional white‐matter abnormalities occurred in the corpus callosum, internal and external capsule, and subcortical areas. From 11 years of age, white‐matter abnormalities were also found in the brainstem. Although there seemed to be a characteristic pattern of involvement over time, there were considerable variations between patients, reflected by variations in neuropsychological development. Cognitive development ranged from stable and normal to declines that lead to intellectual disabilities.

Interpretation

As treatment enables patients with classic infantile Pompe disease to reach adulthood, white‐matter abnormalities are becoming increasingly evident, affecting the neuropsychological development. Therefore, we advise follow‐up programs are expanded to capture CNS involvement in larger, international patient cohorts, to incorporate our findings in the counselling of parents before the start of treatment, and to include the brain as an additional target in the development of next‐generation therapeutic strategies for classic infantile Pompe disease.

What this paper adds

In our long‐term survivors treated intravenously with enzyme replacement therapy, we found slowly progressive symmetric white‐matter abnormalities.

Cognitive development varied from stable and normal to declines towards intellectual disabilities.
Myelin oligodendrocyte glycoprotein and aquaporin‐4 antibodies in children with acquired demyelinating syndromes
Authors: Rostásy Kevin
Published: March 2018

This commentary is on the original article by Duignan et al. on pages 958–962 of this issue.
Balancing the benefits of intrathecal baclofen pump surgery with potential postoperative complications
Authors: Buxton Kristin
Published: March 2018

This commentary is on the original article by Lam et al. on pages 1038–1044 of this issue.
Glucose alert system improves health professional responses to adverse glycaemia and reduces the number of hyperglycaemic episodes in non‐critical care inpatients
Authors: Kyi M. , Wraight P. R. , Rowan L. M. , Marley K. A. , Colman P. G. , Fourlanos S.
Published: March 2018

Aim

To investigate the effect of a novel glucose alert system, comprising the Melbourne Glucose Alert Pathway and glucose‐alert‐capable networked blood glucose meters, on nursing and hospital medical officer responses to adverse glycaemia.

Methods

A prospective, pre‐ and post‐observational study was undertaken in non‐critical care wards of a tertiary hospital over 4 months (n=148 or 660 patient‐days). The intervention consisted of two components designed to promote a consistent staff response to blood glucose measurements: (1) a clinical escalation pathway, the Melbourne Glucose Alert Pathway, and (2) networked blood glucose meters, which provide a visual alert for out‐of‐range blood glucose measurement. All consecutive inpatients with diabetes were assessed for diabetes management and capillary blood glucose. The primary outcome was documented nursing and medical staff action in response to episodes of adverse glycaemia (blood glucose >15 mmol/l or <4 mmol/l). Secondary outcomes consisted of glycaemic measures.

Results

In response to episodes of adverse glycaemia, nursing action increased (proportion with nursing action: 45% to 73%; P<0.001), and medical action increased (proportion with medical action: 49% to 67%; P=0.011) with the glucose alert system in place. Patient‐days with hyperglycaemia (any blood glucose value >15 mmol/l: 24% vs 16%; P=0.012) and patient‐days with mean blood glucose >15 mmol/l (7.4% vs 2.6%; P=0.005) decreased. There was no difference in hypoglycaemia incidence.

Conclusions

Use of a novel glucose alert system improved health professional responses to adverse glycaemia and decreased hyperglycaemia in the hospital setting.
Impact of peer support on inpatient and outpatient payments among people with Type 2 diabetes: a prospective cohort study
Authors: Yu D. , Graffy J. , Holman D. , Robins P. , Cai Y. , Zhao Z. , Simmons D.
Published: March 2018

Aim

To investigate the impact of a low‐cost diabetes peer‐support intervention, aimed at reducing inpatient and outpatient care utilization and healthcare payments, by conducting a cohort study that followed up a randomized controlled trial.

Methods

A total of 1121 adults with Type 2 diabetes were recruited through general practices in Cambridgeshire and Hertfordshire, UK, and were followed up for 3.25 financial years after 8–12 months of one‐to‐one, group or combined diabetes peer support and usual care. Use of, and payments for inpatient and outpatient services were fully recorded in the follow‐up. Adjusted mean inpatient and outpatient payments per person were estimated using a two‐part model after adjusting for baseline characteristics.

Results

The mean age of the recruited adults was 65.6±11.4 years, 60.4% were male, and 16.8% were insulin‐treated. Compared with the control group, less healthcare utilization (especially non‐elective inpatient care and outpatient consultations) was observed in each of the intervention groups, particularly the combined intervention group. Over the course of 3.25 financial years, significant reductions of 41% (£909.20 per head) were observed for overall inpatient payments (P<0.0001), 51% (£514.67 per head) for non‐elective inpatient payments (P=0.005) in the combined intervention group, and 34% (£413.30 per head) and 32% (£388.99 per head) for elective inpatient payments in the one‐to‐one (P=0.029) and combined intervention (P=0.048) groups, respectively.

Conclusions

Type 2 diabetes peer support, whether delivered using a one‐to‐one, group or combined approach was associated with reduced inpatient care utilization (particularly non‐elective admissions) and payments over 3.25 years.
Effect of peer support on diabetes distress: a cluster randomized controlled trial
Authors: Ju C. , Shi R. , Yao L. , Ye X. , Jia M. , Han J. , Yang T. , Lu Q. , Jin H. , Cai X. , Yuan S. , Xie B. , Yu X. , Coufal M. M. , Fisher E. B. , Sun Z.
Published: March 2018

Aim

To investigate whether peer support would reduce diabetes distress and improve glycaemic control when added to usual diabetes education among adults with Type 2 diabetes in China.

Methods

We conducted a cluster randomized trial involving 400 adults with Type 2 diabetes from eight communities in Nanjing. All participants received usual education for an average of 2 h each month from physicians, certified diabetes educators, dieticians, psychologists and podiatric nurses. Peer support was led by trained peer leaders and included diabetes knowledge‐ and skills‐sharing at least once a month, as well as peer‐to‐peer communication. The primary outcome was diabetes distress measured using the Diabetes Distress Scale at 12 months. Secondary outcomes included fasting plasma glucose, 2‐h postprandial glucose and HbA1c concentration. Outcome data were collected from all participants at baseline, 6 months and 12 months.

Results

From 2012 to 2013, there were 200 participants in each study arm at baseline. Compared with the usual education arm, the peer support with usual education arm had greater reductions in regimen‐related distress (1.4 ± 0.6 vs 1.2 ± 0.4; P=0.004) and total distress (1.3 ± 0.4 vs 1.2 ± 0.3; P=0.038) at 6 months. At 12 months, the scores for emotional burden (1.2 ± 0.3 vs 1.4 ± 0.6; P=0.002), physician‐related distress (1.1 ± 0.3 vs 1.3 ± 0.4; P=0.001) and total scores (1.2 ± 0.3 vs 1.3 ± 0.4; P=0.002) were significantly lower in the peer support with usual education arm than in the usual education arm. Fasting plasma glucose levels were lower in the peer support with usual education arm than in the usual education arm at 6 months (7.5 ± 1.95 vs 8.0 ± 2.2; P=0.044) and 12 months (7.0 ± 2.3 vs 7.6 ± 1.5; P=0.008).

Conclusions

Beyond the benefits of usual education, peer support was effective in reducing diabetes distress for Type 2 diabetes mellitus.

(Clinical Trials Registry no: NCT02119572)
Experiential Learning for Logistics and Supply Chain Management Using an SAP ERP Software Simulation
Authors: Angolia Mark G. , Pagliari Leslie R.
Published: March 2018

This teaching brief describes a three‐echelon supply chain simulation that involves complex decision making in a dynamic environment. Using a team‐based logistics simulation operating on a live commercial‐software application (SAP ERP) as a foundation, a supplemental exercise is proposed for deeper learning of transportation and logistics aspects of supply chain management. Sales and operations planning is used during four simulated months to develop detailed procurement strategies and logistics plans to enhance the baseline supply chain management (SCM) concepts of inventory control and forecasting in a distribution network. Transportation planning and scheduling complexity is introduced as students manage freight to conform to motor carrier weight regulations. The combination of commercial software and extensive real‐world planning allows students to assimilate numerous SCM concepts in a realistic environment. Student opinion survey data shows that students are highly engaged by the detailed nature of the simulation, which they concluded aided their conceptual learning. Additionally, the inclusion of the SAP ERP commercial software becomes a competitive advantage during collegiate recruiting by potential employers.
Examining the Relationship between Math Self‐Efficacy and Statistics Motivation in the Introductory Business Statistics Course: Self‐Compassion as a Mediator
Authors: Ramos Salazar Leslie
Published: March 2018

Because business statistics students often experience a lack of statistical motivation, business educators need to understand the factors that influence students’ motivation levels in undergraduate‐level business statistics courses. The purpose of this study was to examine the role of math self‐efficacy and self‐compassion on students’ motivation levels and the gender differences among the main variables. The regression results showed that math self‐efficacy was a positive predictor of statistics motivation. Self‐compassion was also found to be a partial mediator of the relationship between math self‐efficacy and statistics motivation. Gender differences were also found in business students’ math self‐efficacy, self‐compassion, and statistics motivation.
Attitudes Towards Large Income Risk in Welfare States: An International Comparison
Authors: Schroyen Fred , Aarbu Karl Ove
Published: March 2018

Using survey data and the instrument developed by Barsky et al. (), we estimate the distribution of attitudes towards income risk in a country where many employment and health‐related risks are generously covered by a tax‐financed social insurance system (Norway in 2006). Under a constant relative risk aversion assumption, the sample average for the coefficient of relative risk aversion is 3.8 with standard deviation 2.3. This number is then contrasted to that for five other OECD countries where risk attitudes have been measured using the same instrument and also prior to the financial crisis: Chile, France, Italy, the Netherlands and the USA. When we relate this distribution for stated relative risk aversion to that for generosity of social insurance and the risks related to employment and health expenditure, a picture emerges suggesting that more extensive welfare states induce higher risk tolerance for foreground risks—a relationship that is in line with the theory on risk vulnerability.
FOSTERING THE BEST EXECUTION REGIME: AN EXPERIMENT ABOUT PECUNIARY SANCTIONS AND ACCOUNTABILITY IN FIDUCIARY MONEY MANAGEMENT
Authors: Casal Sandro , Ploner Matteo , Sproten Alec N.
Published: March 2018

Asset management often involves a conflict of interests between investors and fund managers. A main goal of financial regulators is to identify and mitigate this conflict. This article focuses on measures that may foster protection of investors' interests. In an experiment capturing the essential elements of asset management, we find that managers' accountability does not prevent their opportunistic behavior if not backed by a threat of punishment. Further, investors inefficiently sanction managers if not completely aware of managers' choices. To effectively protect investors in financial intermediations, financial regulators should ensure both managers' accountability and a credible sanctioning system.
Public–private wage differential in a post‐transition economy
Authors: Grotkowska Gabriela , Wincenciak Leszek , Gajderowicz Tomasz
Published: March 2018

In this study, we estimate the public sector wage premium in a post‐transition economy, a quarter of a century since the collapse of the old regime. Our methodology uses a copula method to estimate the switching regression model, which allows for the relaxation of the restrictive assumption of joint normality. We control for employment selection into both sectors using an instrument based on information regarding learned professions. We use data from the Polish Survey of Earnings by Occupations (2012). Contrary to earlier results for Poland, we found positive selection into employment in both sectors, with positive average treatment effect on the treated and negative average treatment effect on the untreated. The results suggest that both private and public sector employees select themselves into the sector in which they earn more than they would in a counterfactual scenario.
Global capital markets, housing prices, and partisan fiscal policies
Authors: Ansell Ben W. , Broz J. Lawrence , Flaherty Thomas
Published: March 2018

In recent years, global imbalances have channeled the excess savings of surplus countries toward the real estate markets of deficit countries. By consequence, the deficit countries that attracted lots of foreign capital experienced large run‐ups in house prices, whereas most surplus countries that exported capital exhibited flat or slow house price growth. We first use new house price data and a novel instrumental variable design to show the causal relationship between housing prices and capital inflows, particularly through debt bonanzas. We then argue that international capital flows affect the fiscal policy preferences of both voters and political parties by way of their impact on housing prices. Where capital inflows are large and housing prices are rising, we expect voters to respond by demanding both lower taxes and less publicly‐provided social insurance because rising house prices allow homeowners to self‐insure against income loss. In contrast, declining house prices produce greater demands for social insurance, particularly among those most exposed to housing market risk. We present evidence from two cross‐national surveys that supports these claims, as well as a “before and after” analysis of the housing crash in Eastern Europe. We also show that the connection between house prices and social policy also manifests itself in government spending outcomes, mediated by partisan control.
Physiological and behavioural responses to hypoxia in an invasive freshwater fish species and a native competitor
Authors: Nati Julie J.H. , Lindström Jan , Yeomans William , Killen Shaun S.
Published: March 2018

The spread of invasive species is one of the major environmental concerns which can have negative effects on biodiversity. While several life history traits have been identified as being important for increasing the invasiveness of introduced species, the physiological factors that allow certain species to become successful invaders remain poorly understood. It has been speculated that good invaders are thriving in disturbed environments. In unfavourable conditions, as during hypoxic events, invasive species might be better adapted in their physiological and behavioural responses towards this stressor. We compared physiological and behavioural traits between two freshwater fish species: the European bullhead (Cottus gobio), an invasive fish species in Scotland, and its native competitor the stone loach (Barbatula barbatula) over different dissolved oxygen concentrations (DO). Contrary to expectations, bullhead displayed a reduced hypoxia tolerance as compared to stone loach, indicated by a higher threshold (Pcrit) for the maintenance of standard metabolism. Avoidance behaviour during progressive hypoxia was similar between bullhead and stone loach. When given a choice between an open normoxic zone and a shelter located in hypoxia, both species spent most of their time hiding under the shelter in hypoxic conditions (bullhead: 100%; stone loach: 93.93%–99.73%), although stone loach showed brief excursions into normoxic conditions under 25% DO level. These results suggest that stone loach might be more resistant to hypoxia as compared to bullhead, and thus that increased hypoxia tolerance is likely not a trait by which bullhead have been able to expand their range within the United Kingdom.
On the species status of Laimaphelenchus hyrcanus and L. belgradiensis
Authors: Maleita C. M. N. , Abrantes I. M. O.
Published: March 2018

Laimaphelenchus belgradiensis and L. hyrcanus species, both recently described, were morphologically, morphometrically and molecularly compared based on original descriptions, including photomicrographs and drawings. Although L. belgradiensis males were not found, all female morphological and morphometric characters are comparable for the two Laimaphelenchus species. The shape and structure of the tail tip, currently considered to be one of the most important morphological character used for differentiation within the genus, does not differ between L. belgradiensis and L. hyrcanus: four pedunculated tubercles in a square position, ending in 9‐10/10‐12 finger‐like protrusions. Additionally, the D2‐D3 expansion segments of the large subunit of ribosomal RNA were also very similar, with only three differences in alignment. Thus, this study proposes the taxonomic status of L. belgradiensis as a junior synonym of L. hyrcanus.
Occurrence of Diplodia corticola, including new oak host records, in Wisconsin, USA
Authors: Smith D. R. , Stanosz G. R.
Published: March 2018

In the United States, diseased oaks (Quercus species) exhibit tip blight, branch and stem cankers, and dieback often attributed to Diplodia species or related fungi. Emergence of Diplodia corticola as a pathogen of European oaks, and reports of this fungus in the eastern and western United States, prompted re‐examination of strains from Wisconsin. These had been obtained in the late 1990s and early 2000s and previously identified only as Diplodia species. Nuclear ribosomal ITS sequences were obtained from the Wisconsin strains and analysed with other sequences from GenBank. Wisconsin strains confirmed as D. corticola were from northern red oak (Q. rubra), black oak (Q. velutina), white oak (Q. alba) and bur oak (Q. macrocarpa). Other strains from oaks in Wisconsin were D. mutila and D. seriata. Wound inoculation of northern red, white and bur oak seedlings with D. corticola in a greenhouse resulted in shoot death and stem lesions, from which the pathogen was reisolated. We conclude that D. corticola has been present in the northcentral United States for at least two decades and report two previously unrecognized hosts of this pathogen: white oak and bur oak. The roles of D. corticola, related fungi and influences of other environmental factors in deterioration of oak health in North America merit additional investigation.
The risk to Myrtaceae of Austropuccinia psidii, myrtle rust, in Mexico
Authors: Esperón‐Rodríguez M. , Baumgartner J. B. , Beaumont L. J. , Berthon K. , Carnegie A. J. , Alfonzetti M. A. , Barradas V. L. , Leishman M.
Published: March 2018

Austropuccinia psidii is a biotrophic rust fungus that affects species from the Myrtaceae family. In Mexico, Myrtaceae is widely distributed in temperate, tropical and semi‐arid ecosystems, and includes 20 genera and 192 endemic and exotic species. Austropuccinia psidii has been present in Mexico for the last four decades; however, little is known about the distribution of this rust or the vulnerability of native and exotic Myrtaceae to infection. In this study, we used global occurrence records for the pandemic biotype of myrtle rust to model its current and future suitable habitat using a species distribution model, Maxent. We identified regions that are highly suitable for myrtle rust establishment, now and in the future (2050). Additionally, we identified the Myrtaceae species known to be susceptible to rust infection and that are currently distributed in areas with high rust habitat suitability. Thirty‐six susceptible plant species and 142 untested species are distributed within areas of suitable rust habitat and are considered potentially at risk of rust infection. Current suitable habitat is mainly restricted to the east coast of Mexico, with Veracruz, Puebla, Chiapas, Tabasco and Oaxaca being the most vulnerable regions to the rust under current and future climates. We encourage monitoring within these regions by surveying locations where the rust occurs and within areas with high suitable habitat to determine the threat to native ecosystems and industries reliant on Myrtaceae. We also recommend screening to test the susceptibility of Myrtaceae species with no known susceptibility rating.
Experience of associative stigma in parents of adolescents at risk for psychosis
Authors: Baron Julia , Salvador Melina , Loewy Rachel
Published: March 2018

Aim

This qualitative study examined the lived experience of associative stigma for parents of adolescents at clinical high risk for psychosis. A central goal was to empower families to tell their stories and to use the themes that emerge from this narrative data to make recommendations that might support families coping with a loved one being diagnosed with risk for psychosis.

Methods

Twelve parents of adolescents diagnosed with the clinical high risk for psychosis syndrome were interviewed using a semi‐structured approach. The qualitative study employed Interpretative Phenomenological Analysis (IPA) to focus on experiences of associative stigma and the way parents make sense of these experiences.

Results

From these interviews, the researcher identified themes and subthemes categorized into major domains that represent topics particularly relevant to these 12 parents. Two main domains emerged as particularly salient to parents' experiences with associative stigma: perceptions of stigma and coping with stigma.

Conclusions

Participants' insights demonstrated increased experience of stigma associated with psychotic‐like symptoms as compared to other psychiatric symptoms, attempts to balance fighting against stigma with the privacy needs of adolescents, and participation in research as less stigmatizing than non‐specialty care. Stigma impacted treatment‐seeking and participation in family groups that were seen as both potentially supportive and threatening. The interviews provided an opportunity for these families to voice their unique experiences, which expands the literature on the topic of caregivers of adolescents at risk for psychosis as treatment programs for the clinical high risk syndrome expand across the United States.
Subthreshold social cognitive deficits may be a key to distinguish 22q11.2DS from schizophrenia
Authors: Peyroux Elodie , Rigard Caroline , Saucourt Guillaume , Poisson Alice , Plasse Julien , Franck Nicolas , Demily Caroline
Published: March 2018

Aim

Social cognitive impairments are core features in 22q11.2 deletion syndrome (22q11.2DS) and schizophrenia (SCZ). Indeed, adults with 22q.11.2 DS often have poorer social competence as well as poorer performance on measures of social cognitive skills (emotion recognition and theory of mind, ToM) compared with typically developing people. However, studies comparing specific social cognitive components in 22q11.2DS and SCZ have not yet been widely conducted.

Methods

In this study we compared performances of 22q11.2DS and SCZ on both facial emotion recognition and ToM. Patients with 22q11.2DS (n = 18) and matched SCZ patients were recruited. After neuropsychological testing, the facial emotion recognition test assessed the patients' ability to recognize six basic, universal emotions (joy, anger, sadness, fear, disgust, and contempt). The Versailles‐situational intentional reading evaluated ToM with six scenes from movies showing characters in complex interactions (involving hints, lies, and indirect speech).

Results

We show that 22q11.2DS exhibited significantly lower performance in emotion recognition than SCZ patients did, especially for disgust, contempt, and fear. This impairment seems to be a core cognitive phenotype in 22q11.2DS, regardless of the presence of SCZ symptoms. Concerning ToM, our results may highlight the same impairment level in 22q11.2DS and SCZ but require to be replicated in a larger cohort.

Conclusion

Our results document the existence of threshold social cognitive deficits distinguishing 22q11.2DS from SCZ.
Lived experiences of negative symptoms in first‐episode psychosis: A qualitative secondary analysis
Authors: Gee Brioney , Hodgekins Jo , Lavis Anna , Notley Caitlin , Birchwood Max , Everard Linda , Freemantle Nick , Jones Peter B. , Singh Swaran P. , Amos Tim , Marshall Max , Sharma Vimal , Smith Jo , Fowler David
Published: March 2018

Aim

Exploring how negative symptoms are experienced and understood by individuals with lived experience of psychosis has the potential to offer insights into the complex psychosocial processes underlying negative symptom presentations. The aim of the current study was to investigate lived experiences of negative symptoms through secondary analysis of interviews conducted with individuals recovering from first‐episode psychosis.

Method

Transcripts of in‐depth interviews with participants (n = 24) recruited from Early Intervention in Psychosis services were analysed thematically with a focus on participants' experiences and personal understandings of features corresponding to the negative symptoms construct.

Results

Descriptions of reductions in expression, motivation and sociability were common features of participants' accounts. Several participants described the experience of having difficulty interacting as like being a “zombie”. Some participants experienced diminished capacity for emotion, thought or drive as underlying these experiences. However, participants typically attributed reductions in expression, motivation and sociability to medication side‐effects, lack of confidence or active avoidance intended to protect them from rejection or ridicule, sometimes linked to internalized stigma.

Conclusions

Personal accounts of experiences of reduced expression, motivation and sociability during first‐episode psychosis highlight the personal meaningfulness and role of agency in these features, challenging the framing of negative symptoms as passive manifestations of diminished capacity.
Individual factors influencing the duration of untreated psychosis
Authors: Souaiby Lama , Gauthier Claire , Kazes Mathilde , Mam‐Lam‐Fook Célia , Daban Claire , Plaze Marion , Gaillard Raphaël ,   the ICAAR study group, Krebs Marie‐Odile
Published: March 2018

Aim

Duration of untreated psychosis (DUP), or the time between onset of psychosis and treatment initiation, is a prognostic factor of schizophrenia. However, few studies evaluated the relative influence of individual‐related factors on this duration. The objective of this study was to evaluate the influence of socio‐demographic, clinical and cannabis use on DUP.

Methods

This study was part of a large prospective study in help‐seeking individuals referred to our specialized early detection / intervention clinic in the Service Hospitalo‐Universitaire of Sainte‐Anne Hospital in Paris (ICAAR study). We explored 33 consecutive patients who crossed the CAARMS' threshold of psychosis. The DUP and cannabis consumption history were explored during the baseline comprehensive assessment using all available sources (direct interviews of patients, parents, practitioners). Correlations between socio‐demographic, clinical and cannabis use, and DUP were studied. A multiple linear regression model was used to determine the variables that could significantly predict DUP.

Results

When considered individually, none of the socio‐demographic and disease characteristic factors was associated with DUP, with the exception of level of education. In the multivariate analysis, age at inclusion, negative symptoms and history of cannabis use significantly influenced DUP.

Conclusion

The determinants of DUP are multi‐factorial and include individual centred factors, such as age, cannabis and negative symptoms. The identification of factors resulting in delayed access to care may promote the development of effective strategies to reduce DUP in early psychosis and target effective early intervention.
Providing culturally informed mental health services to Aboriginal youth: The YouthLink model in Western Australia
Authors: Sabbioni Daniela , Feehan Steven , Nicholls Craig , Soong Wei , Rigoli Daniela , Follett Denise , Carastathis Geoff , Gomes Alison , Griffiths Jennifer , Curtis Kerry , Smith Warwick , Waters Flavie
Published: March 2018

Aim

Aboriginal young people are more likely to experience mental health issues and to access mental health services than other young Australians, yet there are few culturally informed mental health programs and services available. This study describes and documents the effectiveness of the culturally sensitive model within YouthLink, a state‐wide mental health service program in Western Australia for young people aged 13 to 24 years of age.

Methods

A mixed‐method design including a descriptive approach reporting on the YouthLink framework and an empirical research design where 40 Aboriginal clients completed client feedback monitoring measures between 2014 and 2016.

Results

The YouthLink culturally informed conceptual framework adheres to best practice principles relevant to work with Indigenous people, family and communities. Aboriginal young people indicated improvement across the treatment period as shown by within‐group differences between the first and last session scores on feedback measures. Therapeutic alliance (together with lower baseline acuity and female gender) also contributed significantly to positive treatment outcomes.

Conclusions

Through a strong role of Aboriginal practitioners, relationships with Aboriginal communities, and greater service flexibility that embraces cultural meaning and knowledge, YouthLink has sought to enhance its response to the needs of Aboriginal youth.
Potentially traumatic events in youth with and at clinical high risk for psychosis
Authors: Morelli Nicholas , Fogler Jason , Tembulkar Sahil , Graber Kelsey , Lincoln Sarah H. , Bosquet Enlow Michelle , Gonzalez‐Heydrich Joseph , D'Angelo Eugene J.
Published: March 2018

Aim

Previous research has demonstrated a strong association between early trauma exposure and the development of psychotic symptoms. However, few of these studies have included young adolescents and children. This study investigated rates and number of potentially traumatic experiences (PTEs) among typically developing youth (TD; n = 21), youth at clinical high risk for psychosis (CHR; n = 38), and youth with a psychotic disorder (PD; n = 28) between 7 and 18 years of age. CHR participants were further evaluated to determine whether a history of PTEs was associated with prodromal symptom severity.

Methods

Study group inclusion was determined by structured interviews. Trauma history was assessed using the post‐traumatic stress disorder module of the Schedule for Affective Disorders and Schizophrenia for School‐Age Children—Present and Lifetime Version. CHR participants with vs without a history of PTEs were compared on severity of prodromal symptoms.

Results

CHR and PD participants reported significantly higher rates and numbers of PTEs than TD participants. Contrary to expectations and prior research, CHR participants with vs without a history of PTEs did not differ in prodromal symptom severity. Explanations and implications for the findings are discussed.

Conclusions

These findings suggest that the relationship between trauma and the development of psychotic symptoms extends to children and adolescents as young as 7 years of age. This study underscores the importance of screening for trauma exposure among youth seeking treatment for psychotic symptoms.
Comparison of a prepCheck‐supported self‐assessment concept with conventional faculty supervision in a pre‐clinical simulation environment
Authors: Wolgin M. , Grabowski S. , Elhadad S. , Frank W. , Kielbassa A. M.
Published: March 2018

Objectives

This study aimed to evaluate the educational outcome of a digitally based self‐assessment concept (prepCheck; DentsplySirona, Wals, Austria) for pre‐clinical undergraduates in the context of a regular phantom‐laboratory course.

Materials and Methods

A sample of 47 third‐year dental students participated in the course. Students were randomly divided into a prepCheck‐supervised (self‐assessment) intervention group (IG; n = 24); conventionally supervised students constituted the control group (CG; n = 23). During the preparation of three‐surface (MOD) classIIamalgam cavities, eachIGparticipant could analyse a superimposed 3D image of his/her preparation against the “master preparation” using the prepCheck software. In theCG, several course instructors performed the evaluations according to pre‐defined assessment criteria. After completing the course, a mandatory (blinded) practical examination was taken by all course participants (bothIGandCGstudents), and this assessment involved the preparation of aMODamalgam cavity. Then, optical impressions by means of aCEREC‐Omnicam were taken to digitalize all examination preparations, followed by surveying and assessing the latter using prepCheck.

Results

The statistical analysis of the digitalized samples (Mann‐WhitneyUtest) revealed no significant differences between the cavity dimensions achieved in theIGandCG(P = .406). Additionally, the sum score of the degree of conformity with the “master preparation” (maximum permissible 10% of plus or minus deviation) was comparable in both groups (P = .259).

Conclusion

The implemented interactive digitally based, self‐assessment learning tool for undergraduates appears to be equivalent to the conventional form of supervision. Therefore, such digital learning tools could significantly address the ever‐increasing student to faculty ratio.
Outcome after high‐dose chemotherapy and autologous stem cell transplantation in patients with aggressive B‐cell non‐Hodgkin's lymphoma
Authors: Kriegsmann Katharina , Rieger Michael , Schwarzbich Mark‐Alexander , Sitter Sören , Kriegsmann Mark , Bruckner Thomas , Hensel Manfred , Ho Anthony Dick , Witzens‐Harig Mathias , Wuchter Patrick
Published: March 2018

Objective

For more than two decades, high‐dose chemotherapy (HDT) and autologous blood stem cell transplantation (ABSCT) were treatment options for patients with aggressive B‐cell non‐Hodgkin's lymphoma (B‐NHL). However, the ideal timing and the collective patient benefits are still being debated.

Method

We retrospectively analyzed the data of 163 patients with B‐NHL who received an HDT protocol followed by ABSCT between 2001 and 2007. Patients were analyzed according to the time point of HDT/ABSCT to compare upfront (directly after induction, n = 72, 44%) versus secondary transplantation (at first relapse, n = 91, 56%).

Results

The overall response rate was 100% and 94% after upfront and secondary HDT/ABSCT, respectively. No significant differences were found for hematopoietic recovery and toxicity profile. The progression‐free survival (PFS) and overall survival (OS) probability were found to be significantly higher in the upfront HDT/ABSCT treatment group (P = .018 and P = .004). In multivariate analysis, upfront HDT/ABSCT and low IPI risk score had a significant beneficial effect on OS (P = .031 and P = .019).

Conclusion

HDT and ABSCT directly after induction chemotherapy were confirmed to be feasible with high PFS and OS rates. In addition, for patients with relapse after first‐line therapy and consecutively poor prognosis, HDT/ABSCT also offers an effective treatment strategy.
Atypical audiovisual temporal function in autism and schizophrenia: similar phenotype, different cause
Authors: Noel Jean‐Paul , Stevenson Ryan A. , Wallace Mark T.
Published: March 2018

Binding across sensory modalities yields substantial perceptual benefits, including enhanced speech intelligibility. The coincidence of sensory inputs across time is a fundamental cue for this integration process. Recent work has suggested that individuals with diagnoses of schizophrenia (SZ) and autism spectrum disorder (ASD) will characterize auditory and visual events as synchronous over larger temporal disparities than their neurotypical counterparts. Namely, these clinical populations possess an enlarged temporal binding window (TBW). Although patients with SZ and ASD share aspects of their symptomatology, phenotypic similarities may result from distinct etiologies. To examine similarities and variances in audiovisual temporal function in these two populations, individuals diagnosed with ASD (n = 46; controls n = 40) and SZ (n = 16, controls = 16) completed an audiovisual simultaneity judgment task. In addition to standard psychometric analyses, synchrony judgments were assessed using Bayesian causal inference modeling. This approach permits distinguishing between distinct causes of an enlarged TBW: an a priori bias to bind sensory information and poor fidelity in the sensory representation. Findings indicate that both ASD and SZ populations show deficits in multisensory temporal acuity. Importantly, results suggest that while the wider TBWs in ASD most prominently results from atypical priors, the wider TBWs in SZ results from a trend toward changes in prior and weaknesses in the sensory representations. Results are discussed in light of current ASD and SZ theories and highlight that different perceptual training paradigms focused on improving multisensory integration may be most effective in these two clinical populations and emphasize that similar phenotypes may emanate from distinct mechanistic causes.
Synaptic organization of the dorsal lateral geniculate nucleus
Authors: Bickford Martha E.
Published: March 2018

A half century after Ray Guillery's classic descriptions of cell types, axon types, and synaptic architecture of the dorsal lateral geniculate nucleus, the functional organization of this nucleus, as well as all other thalamic nuclei, is still of enormous interest. This review will focus on two classic papers written by Ray Guillery: ‘A study of Golgi preparations from the dorsal lateral geniculate nucleus of the adult cat’, and ‘The organization of synaptic interconnections in the laminae of the dorsal lateral geniculate nucleus of the cat’, as well as the studies that most directly followed from the insights these landmark manuscripts provided. It is hoped that this review will honor Ray Guillery by encouraging further investigations of the synaptic organization of the dorsal thalamus.
A unified hierarchical oscillatory network model of head direction cells, spatially periodic cells, and place cells
Authors: Soman Karthik , Muralidharan Vignesh , Chakravarthy Vaddadi Srinivasa
Published: March 2018

Spatial cells in the hippocampal complex play a pivotal role in the navigation of an animal. Exact neural principles behind these spatial cell responses have not been completely unraveled yet. Here we present two models for spatial cells, namely the Velocity Driven Oscillatory Network (VDON) and Locomotor Driven Oscillatory Network. Both models have basically three stages in common such as direction encoding stage, path integration (PI) stage, and a stage of unsupervised learning of PI values. In the first model, the following three stages are implemented: head direction layer, frequency modulation by a layer of oscillatory neurons, and an unsupervised stage that extracts the principal components from the oscillator outputs. In the second model, a refined version of the first model, the stages are extraction of velocity representation from the locomotor input, frequency modulation by a layer of oscillators, and two cascaded unsupervised stages consisting of the lateral anti‐hebbian network. The principal component stage of VDON exhibits grid cell‐like spatially periodic responses including hexagonal firing fields. Locomotor Driven Oscillatory Network shows the emergence of spatially periodic grid cells and periodically active border‐like cells in its lower layer; place cell responses are found in its higher layer. This model shows the inheritance of phase precession from grid cell to place cell in both one‐ and two‐dimensional spaces. It also shows a novel result on the influence of locomotion rhythms on the grid cell activity. The study thus presents a comprehensive, unifying hierarchical model for hippocampal spatial cells.