4,864 research outputs found
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The many roads to psychosis: recent advances in understanding risk and mechanisms.
Schizophrenia is a chronic and severe mental illness which frequently leads to substantial lifelong disability. The past five years have seen major progress in our understanding of the complex genetic architecture of this disorder. Two major barriers to understanding the core biological processes that underlie schizophrenia and developing better interventions are (1) the absence of etiologically defined biomarkers and (2) the clinical and genetic heterogeneity of the disorder. Here, we review recent advances that have led to changes in our understanding of risk factors and mechanisms involved in the development of schizophrenia. In particular, mechanistic and clinically oriented approaches have now converged on a focus on disruptions in early neurodevelopment and synaptic plasticity as being critical for both understanding trajectories and intervening to change them. Translating these new findings into treatments that substantively change the lives of patients is the next major challenge for the field
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On the magnetospheric ULF wave counterpart of substorm onset
One near‐ubiquitous signature of substorms observed on the ground is the azimuthal structuring of the onset auroral arc in the minutes prior to onset. Termed auroral beads, these optical signatures correspond to concurrent exponential increases in ground ultralow frequency (ULF) wave power and are likely the result of a plasma instability in the magnetosphere. Here, we present a case study showing the development of auroral beads from a Time History of Events and Macroscale Interactions during Substorms (THEMIS) all‐sky camera with near simultaneous exponential increases in auroral brightness, ionospheric and conjugate magnetotail ULF wave power, evidencing their intrinsic link. We further present a survey of magnetic field fluctuations in the magnetotail around substorm onset. We find remarkably similar superposed epoch analyses of ULF power around substorm onset from space and conjugate ionospheric observations. Examining periods of exponential wave growth, we find the ground‐ and space‐based observations to be consistent, with average growth rates of ∼0.01 s−1, lasting for ∼4 min. Cross‐correlation suggests that the space‐based observations lead those on the ground by approximately 1–1.5 min. Meanwhile, spacecraft located premidnight and ∼10 RE downtail are more likely to observe enhanced wave power. These combined observations lead us to conclude that there is a magnetospheric counterpart of auroral beads and exponentially increasing ground ULF wave power. This is likely the result of the linear phase of a magnetospheric instability, active in the magnetotail for several minutes prior to auroral breakup
Trouble in the gap: a bioethical and sociological analysis of informed consent for high-risk medical procedures.
Concerns are frequently raised about the extent to which formal consent procedures actually lead to “informed” consent. As part of a study of consent to high-risk medical procedures, we analyzed in-depth interviews with 16 health care professionals working in bone-marrow transplantation in Sydney, Australia. We find that these professionals recognize and act on their responsibility to inform and educate patients and that they expect patients to reciprocate these efforts by demonstrably engaging in the education process. This expectation is largely implicit, however, and when it is not met, this can give rise to trouble that can have adverse consequences for patients, physicians, and relationships within the clinic. We revisit the concept of the sick role to formalize this new role expectation, and we argue that “informed” consent is a process that is usually incomplete, despite trappings and assumptions that help to create the illusion of completeness. Keywords Informed consent; Sick role; Bioethics; Sociology, Medical; Bone marrow transplantation; Qualitative research; AustraliaNHMR
Motor deficits in schizophrenia quantified by nonlinear analysis of postural sway.
Motor dysfunction is a consistently reported but understudied aspect of schizophrenia. Postural sway area was examined in individuals with schizophrenia under four conditions with different amounts of visual and proprioceptive feedback: eyes open or closed and feet together or shoulder width apart. The nonlinear complexity of postural sway was assessed by detrended fluctuation analysis (DFA). The schizophrenia group (n = 27) exhibited greater sway area compared to controls (n = 37). Participants with schizophrenia showed increased sway area following the removal of visual input, while this pattern was absent in controls. Examination of DFA revealed decreased complexity of postural sway and abnormal changes in complexity upon removal of visual input in individuals with schizophrenia. Additionally, less complex postural sway was associated with increased symptom severity in participants with schizophrenia. Given the critical involvement of the cerebellum and related circuits in postural stability and sensorimotor integration, these results are consistent with growing evidence of motor, cerebellar, and sensory integration dysfunction in the disorder, and with theoretical models that implicate cerebellar deficits and more general disconnection of function in schizophrenia
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