Resilienz, Progredienzangst und psychische Belastungen bei Patientinnen mit Brustkrebs und gynäkologischen Tumoren, die eine ärztliche Zweitmeinung einholen

Purpose: The objective of the study was to investigate psychological distress, fear of progression, and resilience levels in patients with breast cancer and gynecological tumors asking for a second opinion concerning their oncological treatment. Methods: 158 female cancer patients were assessed for those parameters in a questionnaire survey comprising SOC-13, FoP-Q-SF, and the NCCN distress thermometer. Results: 16.2 % of the breast cancer patients and 20.5 % of the patients with gynecological tumors suffered from dysfunctional fear of progression, 70.4 % of the breast cancer patients and 80.6 % of the patients with gynecological tumors were highly distressed. The patients did not differ significantly in their resilience levels from a representative sample of the general population. Discussion: Strong disease-related fear and distress were found in participating patients seeking a second medical opinion. Conclusions: Further study of the connection between psychological variables and the decision for a second oncological opinion seems crucial concerning implications for doctor-patient- communication.Einleitung: Das Ziel der Studie war es zu erfassen, wie psychische Belastungen, Progredienzangst und Resilienz bei Patientinnen mit einem Mamma- oder gynäkologischem Malignom, die eine Zweitmeinung bezüglich ihrer onkologischen Behandlung einholen, ausgeprägt sind. Methode: Bei 158 Patientinnen wurden psychische Belastungen (NCCN Distress Thermometer) Kohärenzgefühl (SOC-13) und Progredienzangst (PA-F-KF) erhoben. Ergebnisse: 16,2% der Brustkrebspatientinnen und 20,5% der Patientinnen mit gynäkologischen Tumoren litten unter dysfunktionaler Progredienzangst, 70,4% der Brustkrebspatientinnen und 80,6% der Patientinnen mit gynäkologischen Tumoren unter hohem Distress. Die Patientinnen unterschieden sich hinsichtlich ihrer Resilienz jedoch nicht signifikant von einer bevölkerungsrepräsentativen Stichprobe. 15 Diskussion: In der untersuchten Gruppe der Zweitmeinungs-Patientinnen waren krankheitsbezogene Ängste und psychische Belastungen stark ausgeprägt. Schlussfolgerung: Im Hinblick auf Implikationen für die Arzt-Patienten-Kommunikation erscheint eine weitere wissenschaftliche Beschäftigung mit der Bedeutung psychologischer Variablen beim Einholen onkologischer Zweitmeinungen angezeigt

Beauty, Vanity, and Perception in the Sonnets of Shakespeare

https://digitalcommons.usu.edu/english_3315/1005/thumbnail.jp

The moderating effects of sex, age, and education on the outcome of combined cognitive training and transcranial electrical stimulation in older adults.

Computerized cognitive training (CCT) has been shown to improve cognition in older adults via targeted exercises for single or multiple cognitive domains. Combining CCT with non-invasive brain stimulation is thought to be even more effective due to synergistic effects in the targeted brain areas and networks. However, little is known about the moderating effects of sex, age, and education on cognitive outcomes. Here, we investigated these factors in a randomized, double-blind study in which we administered CCT either combined with transcranial direct (tDCS), alternating (tACS) current stimulation or sham stimulation. 59 healthy older participants (mean age 71.7 ± 6.1) received either tDCS (2 mA), tACS (5 Hz), or sham stimulation over the left dorsolateral prefrontal cortex during the first 20 min of a CCT (10 sessions, 50 min, twice weekly). Before and after the complete cognitive intervention, a neuropsychological assessment was performed, and the test scores were summarized in a composite score. Our results showed a significant three-way interaction between age, years of education, and stimulation technique (F(6,52) = 5.53, p = 0.007), indicating that the oldest participants with more years of education particularly benefitted from tDCS compared to the sham group, while in the tACS group the youngest participants with less years of education benefit more from the stimulation. These results emphasize the importance of further investigating and taking into account sex, age, and education as moderating factors in the development of individualized stimulation protocols. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, identifier NCT03475446

Clock monitoring is associated with age-related decline in time-based prospective memory

In laboratory time-based prospective memory tasks, older adults typically perform worse than younger adults do. It has been suggested that less frequent clock checking due to problems with executive functions may be responsible. We aimed to investigate the role of clock checking in older adults’ time-based prospective memory and to clarify whether executive functions would be associated with clock checking and consequently, with time-based prospective memory. We included 62 healthy older adults (62-85 years of age) and applied tasks of time-based prospective memory as well as of executive functions (i.e., inhibition, fluency, and working memory). We used mediation analysis to test whether time-based prospective memory declined with advancing age due to less frequent clock checking. In addition, we tested whether there would be an association between executive functions and clock checking or time-based prospective memory. Time-based prospective memory declined with advancing age due to less frequent clock checking within 30s prior to intention completion. We only found a link between executive functions and clock checking (or time-based prospective memory) when not controlling for age. Our results support the importance of clock checking for time-based prospective memory and add to the current literature that older adults’ prospective memory declines because they are less able to adapt their clock checking. Yet, the reason why older adults are less able to adapt their clock checking still remains open. Our results do not indicate that executive function deficits play a central role

Cross-modal individual recognition in wild African lions

Individual recognition is considered to have been fundamental in the evolution of complex social systems and is thought to be a widespread ability throughout the animal kingdom. Although robust evidence for individual recognition remains limited, recent experimental paradigms that examine cross-modal processing have demonstrated individual recognition in a range of captive non-human animals. It is now highly relevant to test whether cross-modal individual recognition exists within wild populations and thus examine how it is employed during natural social interactions. We address this question by testing audio–visual cross-modal individual recognition in wild African lions (Panthera leo) using an expectancy-violation paradigm. When presented with a scenario where the playback of a loud-call (roaring) broadcast from behind a visual block is incongruent with the conspecific previously seen there, subjects responded more strongly than during the congruent scenario where the call and individual matched. These findings suggest that lions are capable of audio–visual cross-modal individual recognition and provide a useful method for studying this ability in wild populations

A classical density-functional theory for describing water interfaces

We develop a classical density functional for water which combines the White Bear fundamental-measure theory (FMT) functional for the hard sphere fluid with attractive interactions based on the statistical associating fluid theory variable range (SAFT-VR). This functional reproduces the properties of water at both long and short length scales over a wide range of temperatures and is computationally efficient, comparable to the cost of FMT itself. We demonstrate our functional by applying it to systems composed of two hard rods, four hard rods arranged in a square, and hard spheres in water. (C) 2013 American Institute of Physics. [http://dx.doi.org/10.1063/1.4774155]Keywords: Associating fluid theory, Surface properties, Free energy model, Liquid vapor interface, Born model, Chain molecules, Hard spheres, Variable range, Fundamental measure theory, Directional attractive forcesKeywords: Associating fluid theory, Surface properties, Free energy model, Liquid vapor interface, Born model, Chain molecules, Hard spheres, Variable range, Fundamental measure theory, Directional attractive force

Cortical and subcortical coordination of visual spatial attention revealed by simultaneous EEG-fMRI recording

Visual spatial attention has been studied in humans with both electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) individually. However, due to the intrinsic limitations of each of these methods used alone, our understanding of the systems-level mechanisms underlying attentional control remains limited. Here, we examined trial-to-trial covariations of concurrently recorded EEG and fMRI in a cued visual spatial attention task in humans, which allowed delineation of both the generators and modulators of the cue-triggered event-related oscillatory brain activity underlying attentional control function. The fMRI activity in visual cortical regions contralateral to the cued direction of attention covaried positively with occipital gamma-band EEG, consistent with activation of cortical regions representing attended locations in space. In contrast, fMRI activity in ipsilateral visual cortical regions covaried inversely with occipital alpha-band oscillations, consistent with attention-related suppression of the irrelevant hemispace. Moreover, the pulvinar nucleus of the thalamus covaried with both of these spatially specific, attention-related, oscillatory EEG modulations. Because the pulvinar's neuroanatomical geometry makes it unlikely to be a direct generator of the scalp-recorded EEG, these covariational patterns appear to reflect the pulvinar's role as a regulatory control structure, sending spatially specific signals to modulate visual cortex excitability proactively. Together, these combined EEG/fMRI results illuminate the dynamically interacting cortical and subcortical processes underlying spatial attention, providing important insight not realizable using either method alone

Can a serious game-based cognitive training attenuate cognitive decline related to Alzheimer's disease? Protocol for a randomized controlled trial.

BACKGROUND Alzheimer's disease (AD) is a major public health issue. Cognitive interventions such as computerized cognitive trainings (CCT) are effective in attenuating cognitive decline in AD. However, in those at risk of dementia related to AD, results are heterogeneous. Efficacy and feasibility of CCT needs to be explored in depth. Moreover, underlying mechanisms of CCT effects on the three cognitive domains typically affected by AD (episodic memory, semantic memory and spatial abilities) remain poorly understood. METHODS In this bi-centric, randomized controlled trial (RCT) with parallel groups, participants (planned N = 162, aged 60-85 years) at risk for AD and with at least subjective cognitive decline will be randomized to one of three groups. We will compare serious game-based CCT against a passive wait list control condition and an active control condition (watching documentaries). Training will consist of daily at-home sessions for 10 weeks (50 sessions) and weekly on-site group meetings. Subsequently, the CCT group will continue at-home training for an additional twenty-weeks including monthly on-site booster sessions. Investigators conducting the cognitive assessments will be blinded. Group leaders will be aware of participants' group allocations. Primarily, we will evaluate change using a compound value derived from the comprehensive cognitive assessment for each of three cognitive domains. Secondary, longitudinal functional and structural magnetic resonance imaging (MRI) and evaluation of blood-based biomarkers will serve to investigate neuronal underpinnings of expected training benefits. DISCUSSION The present study will address several shortcomings of previous CCT studies. This entails a comparison of serious game-based CCT with both a passive and an active control condition while including social elements crucial for training success and adherence, the combination of at-home and on-site training, inclusion of booster sessions and assessment of physiological markers. Study outcomes will provide information on feasibility and efficacy of serious game-based CCT in older adults at risk for AD and will potentially generalize to treatment guidelines. Moreover, we set out to investigate physiological underpinnings of CCT induced neuronal changes to form the grounds for future individually tailored interventions and neuro-biologically informed trainings. TRIAL REGISTRATION This RCT was registered 1st of July 2020 at clinicaltrials.gov (Identifier NCT04452864)

The moderating effects of sex, age, and education on the outcome of combined cognitive training and transcranial electrical stimulation in older adults

Computerized cognitive training (CCT) has been shown to improve cognition in older adults via targeted exercises for single or multiple cognitive domains. Combining CCT with non-invasive brain stimulation is thought to be even more effective due to synergistic effects in the targeted brain areas and networks. However, little is known about the moderating effects of sex, age, and education on cognitive outcomes. Here, we investigated these factors in a randomized, double-blind study in which we administered CCT either combined with transcranial direct (tDCS), alternating (tACS) current stimulation or sham stimulation. 59 healthy older participants (mean age 71.7 ± 6.1) received either tDCS (2 mA), tACS (5 Hz), or sham stimulation over the left dorsolateral prefrontal cortex during the first 20 min of a CCT (10 sessions, 50 min, twice weekly). Before and after the complete cognitive intervention, a neuropsychological assessment was performed, and the test scores were summarized in a composite score. Our results showed a significant three-way interaction between age, years of education, and stimulation technique (F(6,52) = 5.53, p = 0.007), indicating that the oldest participants with more years of education particularly benefitted from tDCS compared to the sham group, while in the tACS group the youngest participants with less years of education benefit more from the stimulation. These results emphasize the importance of further investigating and taking into account sex, age, and education as moderating factors in the development of individualized stimulation protocols.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT03475446