Affective psychotherapy in post-traumatic reactions guided by affective neuroscience: memory reconsolidation and play

This paper reviews the affective neuroscience dealing with the effects of traumatic events. We give an overview of the normal fear reactions, the pathological fear reaction, and the character of emotional episodic memories. We find that both emotions and emotional memories are a tripartite unit of sensory information, autonomic reaction, and motor impulse (the PRM complex). We propose that emotions and movements are part and parcel of the same complex. This is our main finding from the review of affective neuroscience, and from here we focus on psychotherapy with post-trauma reactions. The finding of the process of memory reconsolidation opens up a new treatment approach: affective psychotherapy focused on reconsolidation. The meaning of reconsolidation is that an emotional memory, when retrieved and being active, will rest in a labile form, amenable to change, for a brief period of time, until it reconsolidates in the memory. This leads us to the conclusion that emotions, affects, must be evoked during the treatment session and that positive emotion must come first, because safety must be part of the new memories. In the proposed protocol of affective psychotherapy based on reconsolidation the emotional episodic memory is relived in a safe and positive setting, focused in turn on the sensory experience, the autonomic reaction, and the motor impulse. Then it is followed by a fantasy of a different positive version of the same event. All in all treatment should provide a series of new memories without fear related to the original event. With the focus on the motor program, and the actions, there is a natural link to art therapy and to the mode of play, which can rehearse and fantasize new positive actions

Neurobiology of Sleep Disturbances in PTSD Patients and Traumatized Controls: MRI and SPECT Findings

OBJECTIVE: Sleep disturbances such as insomnia and nightmares are core components of post-traumatic stress disorder (PTSD), yet their neurobiological relationship is still largely unknown. We investigated brain alterations related to sleep disturbances in PTSD patients and controls by using both structural and functional neuroimaging techniques. METHOD: Thirty-nine subjects either developing (n = 21) or not developing (n = 18) PTSD underwent magnetic resonance imaging and a symptom-provocation protocol followed by the injection of 99mTc-hexamethylpropyleneamineoxime. Subjects were also tested with diagnostic and self-rating scales on the basis of which a Sleep Disturbances Score (SDS; i.e., amount of insomnia/nightmares) was computed. RESULTS: Correlations between SDS and gray matter volume (GMV)/regional cerebral blood flow (rCBF) were computed in the whole sample and separately in the PTSD and control groups. In the whole sample, higher sleep disturbances were associated with significantly reduced GMV in amygdala, hippocampus, anterior cingulate, and insula; increased rCBF in midbrain, precuneus, and insula; and decreased rCBF in anterior cingulate. This pattern was substantially confirmed in the PTSD group, but not in controls. CONCLUSION: Sleep disturbances are associated with GMV loss in anterior limbic/paralimbic, PTSD-sensitive structures and with functional alterations in regions implicated in rapid eye movement-sleep control, supporting the existence of a link between PTSD and sleep disturbance

Siblings Diagnosed With Primary Neuroendocrine Tumor of the Left Hepatic Duct

Primary left hepatic duct neuroendocrine tumors are extremely rare. We describe 2 cases of siblings, a 51-year-old brother and a 48-year-old sister, who were both diagnosed with primary left hepatic duct neuroendocrine tumor. Both patients underwent successful left hepatectomy and are both alive with no recurrence. For this rare malignancy, while definitive diagnosis is made only by histopathology, a margin-free surgical resection remains the only curative treatment modality to date

Mapping spoken language and cognitive deficits in post-stroke aphasia

Aphasia is an acquired disorder caused by damage, most commonly due to stroke, to brain regions involved in speech and language. While language impairment is the defining symptom of aphasia, the co-occurrence of non-language cognitive deficits and their importance in predicting rehabilitation and recovery outcomes is well documented. However, people with aphasia (PWA) are rarely tested on higher-order cognitive functions, making it difficult for studies to associate these functions with a consistent lesion correlate. Broca's area is a particular brain region of interest that has long been implicated in speech and language production. Contrary to classic models of speech and language, cumulative evidence shows that Broca's area and surrounding regions in the left inferior frontal cortex (LIFC) are involved in, but not specific to, speech production. In this study we aimed to explore the brain-behaviour relationships between tests of cognitive skill and language abilities in thirty-six adults with long-term speech production deficits caused by post-stroke aphasia. Our findings suggest that non-linguistic cognitive functions, namely executive functions and verbal working memory, explain more of the behavioural variance in PWA than classical language models imply. Additionally, lesions to the LIFC, including Broca's area, were associated with non-linguistic executive (dys)function, suggesting that lesions to this area are associated with non-language-specific higher-order cognitive deficits in aphasia. Whether executive (dys)function - and its neural correlate in Broca's area - contributes directly to PWA's language production deficits or simply co-occurs with it, adding to communication difficulties, remains unclear. These findings support contemporary models of speech production that place language processing within the context of domain-general perception, action and conceptual knowledge. An understanding of the covariance between language and non-language deficits and their underlying neural correlates will inform better targeted aphasia treatment and outcomes

Immersion Ultrasound Therapy in Combination with Manual Therapy in the Treatment of Ischemic Digital Ulcers in Systemic Sclerosis

Background and Objectives: Digital ulcers (DUs) are the most common complication in patients with Systemic Sclerosis (SSc). They cause pain with hand dysfunction and negatively impact activities of daily and working life. Our study aims to evaluate the efficacy of a combined treatment of manual therapy and ultrasound therapy in SSc patients with ischemic DU (IDU) compared to manual therapy alone. Materials and Methods: We conducted a before-and-after study (non-randomized study). We enrolled a consecutive series of IDU patients undergoing rehabilitation treatment and divided them into two groups: a treatment group consisting of patients undergoing a combination of manual therapy and US water immersion and a standard care group consisting of patients subjected to manual therapy alone. At the time of the first visit (T0) and at the end of the 4-week rehabilitation period (T1), we evaluated functional capacity, pain intensity, ulcer evolution, and quality of life. Results: In the treatment group, we observed a statistically significant improvement in the functional capacity of the hand (DHI: 28.15 11.0 vs. 19.05 8.83; p < 0.05), pain (NRS: 5.55 1.2 vs. 2.9 1.09; p < 0.05), and PSST score (24.4 4.0 vs. 16.2 2.36; p < 0.05). In the standard care group, we observed a statistically significant improvement only for the functional capacity of the hand (DHI: 28.85 9.72 vs. 22.7 7.68; p < 0.05). Finally, from the comparison between the treatment group and the standard care group, we observed statistically significant improvements in pain (2.9 1.09 vs. 4.5 1.07; p < 0.05) and in the PSST scale (16.2 2.36 vs. 20.4 4.02; p < 0.05). Furthermore, at the end of treatment in the treatment group, 15 ulcers (62.5%) were completely healed, while in the standard care group, only 3 ulcers were completely healed (14.3%). Conclusions: Combined treatment with manual therapy and ultrasound therapy appears to be useful in the management of IDU in patients with scleroderma

A system level comparison of drive topologies for high speed electrical machines

This paper presents a comprehensive comparative study among five different converter topologies all designed to drive a 8.5kW-120krpm surface permanent magnet synchronous machine. The study aims at comparing the considered systems in terms of converter complexity, control complexity and overall efficiency. The assessment of the subsystems’ efficiencies is based on a set of decoupled converter-electrical machine simulations. First the designed converters are simulated in Matlab-Simulink environment in order to estimate the converter losses and the current waveforms. Then the latter are used to supply the FE model of the electrical machine so to estimate all the loss components present in the real scenario. The results of the carried out study gives a wide understanding of the interaction between the two subsystems and some general design considerations needed to select the converter topology

‘Everybody knows’, but the rest of the world: the case of a caterpillar-borne reproductive loss syndrome in dromedary camels observed by Sahrawi pastoralists of Western Sahara

Abstract Background The traditional knowledge of local communities throughout the world is a valuable source of novel ideas and information to science. In this study, the ethnoveterinary knowledge of Sahrawi pastoralists of Western Sahara has been used in order to put forward a scientific hypothesis regarding the competitive interactions between camels and caterpillars in the Sahara ecosystem. Methods Between 2005 and 2009, 44 semi-structured interviews were conducted with Sahrawi pastoralists in the territories administered by the Sahrawi Arab Democratic Republic, Western Sahara, using a snow-ball sampling design. Results Sahrawi pastoralists reported the existence of a caterpillar-borne reproductive loss syndrome, known locally as duda, affecting their camels. On the basis of Sahrawi knowledge about duda and of a thorough literature review, we built the hypothesis that: 1) caterpillars of the family Lasiocampidae (genera Lasiocampa, Psilogaster, or Streblote) have sudden and rare outbreaks on Acacia treetops in the Western Sahara ecosystem after heavy rainfall; 2) during these outbreaks, camels ingest the caterpillars while browsing; 3) as a consequence of this ingestion, pregnant camels have sudden abortions or give birth to weaklings. This hypothesis was supported by inductive reasoning built on circumstantiated evidence and analogical reasoning with similar syndromes reported in mares in the United States and Australia. Conclusions The possible existence of a caterpillar-borne reproductive loss syndrome among camels has been reported for the first time, suggesting that such syndromes might be more widespread than what is currently known. Further research is warranted to validate the reported hypothesis. Finally, the importance of studying folk livestock diseases is reinforced in light of its usefulness in revealing as yet unknown biological phenomena that would deserve further investigation. Resumen ‘Todos lo saben’, menos el resto del mundo: el caso de un síndrome de pérdida reproductiva en dromedarios transmitido por orugas y observado por pastores nómadas saharauis del Sáhara Occidental. Antecedentes Los conocimientos tradicionales de las comunidades locales de todo el mundo son una valiosa fuente de nuevas ideas e información para la ciencia. En este estudio, se utilizaron los conocimientos de etnoveterinaria de pastores saharauis del Sáhara Occidental con el fin de proponer una hipótesis científica sobre las interacciones competitivas entre los camellos y las orugas en el ecosistema del Sáhara. Métodos Entre los años 2005 y 2009, se realizaron 44 entrevistas semi-estructuradas a los pastores saharauis en los territorios administrados por la República Árabe Saharaui Democrática, Sáhara Occidental, mediante un diseño de muestreo por bola de nieve. Resultados Los pastores nómadas saharauis describieron un síndrome reproductivo transmitido por orugas, llamado duda, entre sus camellas. Sobre la base de los conocimientos saharauis sobre el duda y una revisión literaria exhaustiva, se propuso la siguiente hipótesis: 1) brotes esporádico de orugas de la familia Lasiocampidae (géneros Lasiocampa, Psilogaster o Streblote) en árboles de Acacia se pueden presentar después de fuertes lluvias en el ecosistema del Sáhara Occidental; 2) durante estos brotes, los camellos ingieren las orugas durante el pastoreo; 3) como consecuencia de esta ingestión, se producen abortos repentinos o partos de crías debilitadas. Apoyamos esta hipótesis mediante razonamiento inductivo basado en evidencia circunstancial y razonamiento analógico con síndromes similares en yeguas de los Estados Unidos y Australia. Conclusiones Este es el primer reporte de la posible existencia de un síndrome de pérdida reproductiva en camellos, transmitido por orugas. Se insinúa que estos síndromes son más comunes que lo que actualmente se conoce. Se sugieren investigaciones adicionales para poner a prueba nuestra hipótesis. Finalmente, se destaca la importancia de estudios de las enfermedades del ganado en pueblos de pastores nómadas porque pueden revelar fenómenos biológicos aún desconocidos y merecen ser investigados.</p

Standard model anomalies: Lepton flavour non-universality and lepton g-2

We critically analyze the body of results that hints to the existence of New Physics from possible violations of lepton universality observed by the LHCb experiment in the $\mu/e$ ratios $R_{K}$ and $R_{K^*}$ to the $g-2$ lepton anomalies. The analysis begins with a theoretical, in depth, study of the $\mu/e$ ratios $R_{K}$ and $R_{K^*}$ as well as the process $B_s \rightarrow \mu^+ \mu^-$. Here we consider the impact of complex Wilson coefficients and derive constraints on their imaginary and real parts. We then move to a comprehensive comparison with experimental results. We show that, by fitting a single Wilson coefficient, the deviations from the Standard Model are at the $4.7\sigma$ level when including only the hadronic insensitive observables while it increases to $6.1\sigma$ when including also the hadronic sensitive ones. When switching on all relevant Wilson coefficients and combining both hadronic sensitive and insensitive data into the fit, the deviation from the Standard Model peaks at 7.2$\sigma$ and decreases at the $4.9\sigma$ level if we assume that the central values of $R_K$ and $R_K^{\ast}$ are taken to be unity. We further estimate the non-perturbative long distance hadronic contributions and show that their inclusion still requires New Physics to fit the data. We then introduce the $g-2$ lepton anomalies results. Different theoretical models are considered that can explain the discrepancies from the Standard Model. In the final part of our work we estimate the impact of the forthcoming data from LHCb (coming from LHC Run3) and Belle II, when it will have accumulated about $5~ab^{-1}$