22 research outputs found
Relations Among Anhedonia, Reinforcement Learning, and Global Functioning in Help-seeking Youth
Dysfunction in the neural circuits underlying salience signaling is implicated in symptoms of psychosis and may predict conversion to a psychotic disorder in youth at clinical high risk (CHR) for psychosis. Additionally, negative symptom severity, including consummatory and anticipatory aspects of anhedonia, may predict functional outcome in individuals with schizophrenia-spectrum disorders. However, it is unclear whether anhedonia is related to the ability to attribute incentive salience to stimuli (through reinforcement learning [RL]) and whether measures of anhedonia and RL predict functional outcome in a younger, help-seeking population. We administered the Salience Attribution Test (SAT) to 33 participants who met criteria for either CHR or a recent-onset psychotic disorder and 29 help-seeking youth with nonpsychotic disorders. In the SAT, participants must identify relevant and irrelevant stimulus dimensions and be sensitive to different reinforcement probabilities for the 2 levels of the relevant dimension ("adaptive salience"). Adaptive salience attribution was positively related to both consummatory pleasure and functioning in the full sample. Analyses also revealed an indirect effect of adaptive salience on the relation between consummatory pleasure and both role (αÎČ = .22, 95% CI = 0.02, 0.48) and social functioning (αÎČ = .14, 95% CI = 0.02, 0.30). These findings suggest a distinct pathway to poor global functioning in help-seeking youth, via impaired reward sensitivity and RL
Review of factors resulting in systemic biases in the screening, assessment, and treatment of individuals at clinical high-risk for psychosis in the United States
BACKGROUND: Since its inception, research in the clinical high-risk (CHR) phase of psychosis has included identifying and exploring the impact of relevant socio-demographic factors. Employing a narrative review approach and highlighting work from the United States, sociocultural and contextual factors potentially affecting the screening, assessment, and service utilization of youth at CHR were reviewed from the current literature.
RESULTS: Existing literature suggests that contextual factors impact the predictive performance of widely used psychosis-risk screening tools and may introduce systemic bias and challenges to differential diagnosis in clinical assessment. Factors reviewed include racialized identity, discrimination, neighborhood context, trauma, immigration status, gender identity, sexual orientation, and age. Furthermore, racialized identity and traumatic experiences appear related to symptom severity and service utilization among this population.
CONCLUSIONS: Collectively, a growing body of research from the United States and beyond suggests that considering context in psychosis-risk assessment can provide a more accurate appraisal of the nature of risk for psychosis, render more accurate results improving the field\u27s prediction of conversion to psychosis, and enhance our understanding of psychosis-risk trajectories. More work is needed in the U.S. and across the globe to uncover how structural racism and systemic biases impact screening, assessment, treatment, and clinical and functional outcomes for those at CHR
Getting the point across: how do we know if medical students really understand the main points a lecturer is trying to get across? (and do lecturers respond to feedback?)
The perforator-free zone of the posterior communicating, artery and its relevance in approaches to the interpeduncular cistern, especially the transcavernous approach: An anatomic study
Achieving an early pregnancy following allogeneic uterine transplantation in a rabbit model
[EN] Objective: Uterine transplantation (UTx) has been proposed as a treatment option for women diagnosed
with absolute uterine factor infertility (AUFI). The goal of UTx remains achieving pregnancy and live
birth of a healthy neonate following allogeneic UTx. Our aim was to assess whether fertility was possible
following allogeneic uterine transplantation (UTx), when the recipient had demonstrated long-term
survival and had been administered immunosuppression.
Study design: Nine allogeneic UTx in New Zealand White rabbits were performed using a pre-determined
protocol. Tacrolimus was the immunosuppressant selected. Embryos were transferred into both cornua
of the sole living recipient via a mini-midline laparotomy. The pregnancy was monitored with regular
reproductive profiles and serial trans-abdominal ultrasound to measure conceptus growth (gestation sac
and crown rump length (CRL)).
Results: In the sole surviving doe a gestation sac was visualised on ultrasound from Day 9 (D9) after
embryo transfer. Gestation sac diameter and CRL increased from D9 to D16 but by D18 the gestation sac
had reduced in size. The fetus was no longer visible, suggesting fetal resorption had occurred.
Subsequent scans on D22 and D25 did not demonstrate a gestation sac. Scheduled necropsy on D27 and
histopathology confirmed evidence of a gravid uterus and presence of a gestational sac. A single episode
of acute rejection occurred on D13.
Conclusion: Pregnancy was achieved after rabbit allogeneic UTx but serial ultrasound suggested that
fetal demise occurred prior to scheduled necropsy. The study represents only the third example of
conception and pregnancy following an animal allogeneic UTx.The authors would like to thank all the staff and veterinarians at the Royal Veterinary College (London, UK) who have been with us from the beginning and have worked tirelessly at ensuring we had the best possible conditions to carry out our transplant work. ALD receives funding at UCLH/UCL via the Department of Health's NIHR Biomedical Research Centres funding scheme.Saso, S.; Petts, G.; David, AL.; Thum, M.; Chatterjee, J.; Vicente Antón, JS.; Marco Jiménez, F.... (2015). Achieving an early pregnancy following allogeneic uterine transplantation in a rabbit model. European Journal of Obstetrics and Gynecology and Reproductive Biology. (185):164-169. doi:10.1016/j.ejogrb.2014.12.017S16416918
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Review of factors resulting in systemic biases in the screening, assessment, and treatment of individuals at clinical high-risk for psychosis in the United States.
BackgroundSince its inception, research in the clinical high-risk (CHR) phase of psychosis has included identifying and exploring the impact of relevant socio-demographic factors. Employing a narrative review approach and highlighting work from the United States, sociocultural and contextual factors potentially affecting the screening, assessment, and service utilization of youth at CHR were reviewed from the current literature.ResultsExisting literature suggests that contextual factors impact the predictive performance of widely used psychosis-risk screening tools and may introduce systemic bias and challenges to differential diagnosis in clinical assessment. Factors reviewed include racialized identity, discrimination, neighborhood context, trauma, immigration status, gender identity, sexual orientation, and age. Furthermore, racialized identity and traumatic experiences appear related to symptom severity and service utilization among this population.ConclusionsCollectively, a growing body of research from the United States and beyond suggests that considering context in psychosis-risk assessment can provide a more accurate appraisal of the nature of risk for psychosis, render more accurate results improving the field's prediction of conversion to psychosis, and enhance our understanding of psychosis-risk trajectories. More work is needed in the U.S. and across the globe to uncover how structural racism and systemic biases impact screening, assessment, treatment, and clinical and functional outcomes for those at CHR