Automatic detection of cognitive impairment with virtual reality

Cognitive impairment features in neuropsychiatric conditions and when undiagnosed can have a severe impact on the affected individual's safety and ability to perform daily tasks. Virtual Reality (VR) systems are increasingly being explored for the recognition, diagnosis and treatment of cognitive impairment. In this paper, we describe novel VR-derived measures of cognitive performance and show their correspondence with clinically-validated cognitive performance measures. We use an immersive VR environment called VStore where participants complete a simulated supermarket shopping task. People with psychosis (k=26) and non-patient controls (k=128) participated in the study, spanning ages 20-79 years. The individuals were split into two cohorts, a homogeneous non-patient cohort (k=99 non-patient participants) and a heterogeneous cohort (k=26 patients, k=29 non-patient participants). Participants' spatio-temporal behaviour in VStore is used to extract four features, namely, route optimality score, proportional distance score, execution error score, and hesitation score using the Traveling Salesman Problem and explore-exploit decision mathematics. These extracted features are mapped to seven validated cognitive performance scores, via linear regression models. The most statistically important feature is found to be the hesitation score. When combined with the remaining extracted features, the multiple linear regression model resulted in statistically significant results with R2 = 0.369, F-Stat = 7.158, p(F-Stat) = 0.000128

Realising stratified psychiatry using multidimensional signatures and trajectories

BACKGROUND: Stratified or personalised medicine targets treatments for groups of individuals with a disorder based on individual heterogeneity and shared factors that influence the likelihood of response. Psychiatry has traditionally defined diagnoses by constellations of co-occurring signs and symptoms that are assigned a categorical label (e.g. schizophrenia). Trial methodology in psychiatry has evaluated interventions targeted at these categorical entities, with diagnoses being equated to disorders. Recent insights into both the nosology and neurobiology of psychiatric disorder reveal that traditional categorical diagnoses cannot be equated with disorders. We argue that current quantitative methodology (1) inherits these categorical assumptions, (2) allows only for the discovery of average treatment response, (3) relies on composite outcome measures and (4) sacrifices valuable predictive information for stratified and personalised treatment in psychiatry. METHODS AND FINDINGS: To achieve a truly ‘stratified psychiatry’ we propose and then operationalise two necessary steps: first, a formal multi-dimensional representation of disorder definition and clinical state, and second, the similar redefinition of outcomes as multidimensional constructs that can expose within- and between-patient differences in response. We use the categorical diagnosis of schizophrenia—conceptualised as a label for heterogeneous disorders—as a means of introducing operational definitions of stratified psychiatry using principles from multivariate analysis. We demonstrate this framework by application to the Clinical Antipsychotic Trials of Intervention Effectiveness dataset, showing heterogeneity in both patient clinical states and their trajectories after treatment that are lost in the traditional categorical approach with composite outcomes. We then systematically review a decade of registered clinical trials for cognitive deficits in schizophrenia highlighting existing assumptions of categorical diagnoses and aggregate outcomes while identifying a small number of trials that could be reanalysed using our proposal. CONCLUSION: We describe quantitative methods for the development of a multi-dimensional model of clinical state, disorders and trajectories which practically realises stratified psychiatry. We highlight the potential for recovering existing trial data, the implications for stratified psychiatry in trial design and clinical treatment and finally, describe different kinds of probabilistic reasoning tools necessary to implement stratification

Defining acceptable data collection and reuse standards for queer artificial intelligence research in mental health: protocol for the online PARQAIR-MH Delphi study.

IntroductionFor artificial intelligence (AI) to help improve mental healthcare, the design of data-driven technologies needs to be fair, safe, and inclusive. Participatory design can play a critical role in empowering marginalised communities to take an active role in constructing research agendas and outputs. Given the unmet needs of the LGBTQI+ (Lesbian, Gay, Bisexual, Transgender, Queer and Intersex) community in mental healthcare, there is a pressing need for participatory research to include a range of diverse queer perspectives on issues of data collection and use (in routine clinical care as well as for research) as well as AI design. Here we propose a protocol for a Delphi consensus process for the development of PARticipatory Queer AI Research for Mental Health (PARQAIR-MH) practices, aimed at informing digital health practices and policy.Methods and analysisThe development of PARQAIR-MH is comprised of four stages. In stage 1, a review of recent literature and fact-finding consultation with stakeholder organisations will be conducted to define a terms-of-reference for stage 2, the Delphi process. Our Delphi process consists of three rounds, where the first two rounds will iterate and identify items to be included in the final Delphi survey for consensus ratings. Stage 3 consists of consensus meetings to review and aggregate the Delphi survey responses, leading to stage 4 where we will produce a reusable toolkit to facilitate participatory development of future bespoke LGBTQI+-adapted data collection, harmonisation, and use for data-driven AI applications specifically in mental healthcare settings.Ethics and disseminationPARQAIR-MH aims to deliver a toolkit that will help to ensure that the specific needs of LGBTQI+ communities are accounted for in mental health applications of data-driven technologies. The study is expected to run from June 2024 through January 2025, with the final outputs delivered in mid-2025. Participants in the Delphi process will be recruited by snowball and opportunistic sampling via professional networks and social media (but not by direct approach to healthcare service users, patients, specific clinical services, or via clinicians' caseloads). Participants will not be required to share personal narratives and experiences of healthcare or treatment for any condition. Before agreeing to participate, people will be given information about the issues considered to be in-scope for the Delphi (eg, developing best practices and methods for collecting and harmonising sensitive characteristics data; developing guidelines for data use/reuse) alongside specific risks of unintended harm from participating that can be reasonably anticipated. Outputs will be made available in open-access peer-reviewed publications, blogs, social media, and on a dedicated project website for future reuse

The Grizzly, May 2, 2000

Asbestos Mess Hits Helfferich Hard • Commencement Set for UC Seniors • Douglass Davis, UC Alumnus and Faculty Member, Dead at 81 • Annual Spring Fling a High-Flying Success • Students Selected to Speak at 2000 Ursinus Graduation Ceremonies • Letters from the Editors • Final Exam Schedule • UC Female Reflects on the Horrors of the Freshman Fifteen • The Poet-Tree Grows at Ursinus • A New Chapter in the History Books: Newmaster Hurls the First Perfect Game in Centennial Conference History • UC Track Gears Up for Last Meet • Profile: Lisa Newmaster • Bears Capture Back-to-Back CC Title • Unpredicted Ending for UC Lacrossehttps://digitalcommons.ursinus.edu/grizzlynews/1468/thumbnail.jp

The Grizzly, February 22, 2000

Black History Celebrated Across Ursinus Campus • Greeks Fall Under Scrutiny • Arts Program to Expand at UC • Nobel Laureate Lecture Draws Positive Student Response • Littleton, Letterman and the South Carolina Primary • After South Carolina: Can McCain be the Man for the GOP? • Pledging Debate Continues: The Problem of Hazing • Pat McGee: Pseudo DMB? • Valentine\u27s Day Blues • Tumbling and Dancing with Words • Music Review: Dr. John • Glah, Druckenmiller Shine at CC Swimming Championships • UC Wrestling Falls Short in Centennial Championships • UC Spring Sports Preview • Gymnastics Trounces School Record at Marranca Invitational • Men\u27s Basketball Ends Stellar Season • Sports Profile: Christopher Ciuncihttps://digitalcommons.ursinus.edu/grizzlynews/1460/thumbnail.jp

The Grizzly, February 15, 2000

UC Students Debate Pros, Cons of Pledging On Campus • Feelings of Brotherhood, Sisterhood Prevalent During Pledging Process • Employment Available for Graduating Seniors • True Love: Sorrow and Devotion • Hackers, Hijackers, and the Wide World of Sports • The Greeks Agree: Pledges Have no Free Will • Pledging: What\u27s the Big Deal Anyway? • muMs Schemes at Ursinus • Pat McGee to Jam at Ursinus • Music Review: The Alligator Blues Band • Gymnastics Tops RIC with Season High Score • Intramural 3 on 3 Action: Brains vs. Brute • Indoor Track Steps Up to Eight Way Challenge • Ursinus Wrestling Battles for 4-1 • Sports Profile: Shana Goanehttps://digitalcommons.ursinus.edu/grizzlynews/1459/thumbnail.jp

The Grizzly, April 11, 2000

Vandalism: Running Rampant in Reimert and the Quad • UC Gets Medieval in Annual Sport Fest • PBK Lecture Informative and Hilarious • Phi Psi Educates UC Greeks on Pledging Do\u27s and Don\u27ts • Students Take Center Stage at Airband 2000 • Service Day Calls UC Community to Action • Basket Bingo Allows Others to Make-a-Wish • Putting a Finger on Sexuality • RHA Behind the Scenes • Election Preview: CAB, RHA, USGA and Class Elections • Letters to the Editor • Thoughts from a Sophomore Chat: If Tuition Increases, Scholarships Must • UC Artists Unveil Photography Exhibit • The Voice of UC College Choir • Team Effort Puts UC in the Lead • Bears Quest for NCAA Tournament Continues • Softball Ranked 18th in Nation • Tennis Team Continues to Struggle • Golf Ties for Second with F&M • Track and Field Improves at Osprey Open • Sports Profiles: Joe Sprague; Sue Sobolewskihttps://digitalcommons.ursinus.edu/grizzlynews/1465/thumbnail.jp

Management of antipsychotics in primary care: Insights from healthcare professionals and policy makers in the United Kingdom

Introduction Antipsychotic medication is increasingly prescribed to patients with serious mental illness. Patients with serious mental illness often have cardiovascular and metabolic comorbidities, and antipsychotics independently increase the risk of cardiometabolic disease. Despite this, many patients prescribed antipsychotics are discharged to primary care without planned psychiatric review. We explore perceptions of healthcare professionals and managers/directors of policy regarding reasons for increasing prevalence and management of antipsychotics in primary care. Methods Qualitative study using semi-structured interviews with 11 general practitioners (GPs), 8 psychiatrists, and 11 managers/directors of policy in the United Kingdom. Data was analysed using thematic analysis. Results Respondents reported competency gaps that impaired ability to manage patients prescribed antipsychotic medications, arising from inadequate postgraduate training and professional development. GPs lacked confidence to manage antipsychotic medications alone; psychiatrists lacked skills to address cardiometabolic risks and did not perceive this as their role. Communication barriers, lack of integrated care records, limited psychology provision, lowered expectation towards patients with serious mental illness by professionals, and pressure to discharge from hospital resulted in patients in primary care becoming ‘trapped’ on antipsychotics, inhibiting opportunities to deprescribe. Organisational and contractual barriers between services exacerbate this risk, with socioeconomic deprivation and lack of access to non-pharmacological interventions driving overprescribing. Professionals voiced fears of censure if a catastrophic event occurred after stopping an antipsychotic. Facilitators to overcome these barriers were suggested. Conclusions People prescribed antipsychotics experience a fragmented health system and suboptimal care. Several interventions could be taken to improve care for this population, but inadequate availability of non-pharmacological interventions and socioeconomic factors increasing mental distress need policy change to improve outcomes. The role of professionals’ fear of medicolegal or regulatory censure inhibiting antipsychotic deprescribing was a new finding in this study

Examination of the neural basis of psychotic-like experiences in adolescence during processing of emotional faces

Contemporary theories propose that dysregulation of emotional perception is involved in the aetiology of psychosis. 298 healthy adolescents were assessed at age 14- and 19-years using fMRI while performing a facial emotion task. Psychotic-like experiences (PLEs) were assessed with the CAPE-42 questionnaire at age 19. The high PLEs group at age 19 years exhibited an enhanced response in right insular cortex and decreased response in right prefrontal, right parahippocampal and left striatal regions; also, a gradient of decreasing response to emotional faces with age, from 14 to 19 years, in the right parahippocampal region and left insular cortical area. The right insula demonstrated an increasing response to emotional faces with increasing age in the low PLEs group, and a decreasing response over time in the high PLEs group. The change in parahippocampal/amygdala and insula responses during the perception of emotional faces in adolescents with high PLEs between the ages of 14 and 19 suggests a potential ‘aberrant’ neurodevelopmental trajectory for critical limbic areas. Our findings emphasize the role of the frontal and limbic areas in the aetiology of psychotic symptoms, in subjects without the illness phenotype and the confounds introduced by antipsychotic medication