White matter tracts characteristics in habitual decision-making circuit underlie ritual behaviors in anorexia nervosa

Anorexia nervosa (AN) is a difficult to treat, pernicious psychiatric disorder that has been linked to decision-making abnormalities. We examined the structural characteristics of habitual and goal-directed decision-making circuits and their connecting white matter tracts in 32 AN and 43 healthy controls across two independent data sets of adults and adolescents as an explanatory sub-study. Total bilateral premotor/supplementary motor area-putamen tracts in the habit circuit had a significantly higher volume in adults with AN, relative to controls. Positive correlations were found between both the number of tracts and white matter volume (WMV) in the habit circuit, and the severity of ritualistic/compulsive behaviors in adults and adolescents with AN. Moreover, we found a significant influence of the habit circuit WMV on AN ritualistic/compulsive symptom severity, depending on the preoccupations symptom severity levels. These findings suggest that AN is associated with white matter plasticity alterations in the habit circuit. The association between characteristics of habit circuit white matter tracts and AN behavioral symptoms provides support for a circuit based neurobiological model of AN, and identifies the habit circuit as a focus for further investigation to aid in development of novel and more effective treatments based on brain-behavior relationships

Numerical simulations of a non-commutative theory: the scalar model on the fuzzy sphere

We address a detailed non-perturbative numerical study of the scalar theory on the fuzzy sphere. We use a novel algorithm which strongly reduces the correlation problems in the matrix update process, and allows the investigation of different regimes of the model in a precise and reliable way. We study the modes associated to different momenta and the role they play in the ``striped phase'', pointing out a consistent interpretation which is corroborated by our data, and which sheds further light on the results obtained in some previous works. Next, we test a quantitative, non-trivial theoretical prediction for this model, which has been formulated in the literature: The existence of an eigenvalue sector characterised by a precise probability density, and the emergence of the phase transition associated with the opening of a gap around the origin in the eigenvalue distribution. The theoretical predictions are confirmed by our numerical results. Finally, we propose a possible method to detect numerically the non-commutative anomaly predicted in a one-loop perturbative analysis of the model, which is expected to induce a distortion of the dispersion relation on the fuzzy sphere.Comment: 1+36 pages, 18 figures; v2: 1+55 pages, 38 figures: added the study of the eigenvalue distribution, added figures, tables and references, typos corrected; v3: 1+20 pages, 10 eps figures, new results, plots and references added, technical details about the tests at small matrix size skipped, version published in JHE

The alarm distress baby scale in a longitudinal Portuguese study reanalyzed with attachment data

Article first published online: 13 NOV 2013The relationship established between the infant and the caregiver is central to both parents and infants, and provides one of the most important environments in wich children develop. This study aimed to assess the effect of infant's psychophysiological functioning early in life on the quality of mother–infant interaction and on later attachment, and to explore the mediation effects of the quality of mother–infant interaction on the association between the infant's psychophysiological functioning and attachment security. A longitudinal prospective design was conducted with 94 infants and their mothers. Eight-week-old infants were assessed with the Neonatal Behavioral Assessment Scale (T.B. Brazelton & J.K. Nugent, 1995) and the Alarm Distress Baby Scale (A. Guedeney & J. Fermanian, 2001). At 8 to 12 weeks of age, cortisol levels were measured both before and after routine inoculation. Mother–infant interaction was evaluated at 12 to 16 weeks, using the Global Rating Scales (L. Murray, A. Fiori-Cowley, R. Hooper, & P. Cooper, 1996). The Strange Situation procedure (M. Ainsworth, M. Blehar, E. Waters, & S. Wall, 1978) was performed at 12 months. The overall quality of mother–infant interaction mediates the relation between infant's behavioral and physiological profile and infant attachment: The probability of been securely attached increased with good mother behavior and with good overall interaction. The co-construction of the mother–infant relationship depends on the infant characteristics and on patterns of interaction.La relación que se establece entre el infante y quien le presta cuidado es esencial tanto para los padres como los infantes y provee uno de los más importantes medios ambientales en el que los niños se desarrollan. Objetivo: evaluar el efecto del funcionamiento sicofisiológico del infante en la temprana etapa de la vida sobre la calidad de la interacción madre-infante y en la afectividad posterior. También, explorar los efectos de mediación de la calidad de la interacción madre-infante sobre la asociación entre el funcionamiento sicofisiológico del infante y la seguridad en la afectividad. Método: un diseño longitudinal de probabilidad se llevó a cabo con 94 infantes y sus madres. Se evaluaron infantes de ocho semanas de edad usando la Escala de Evaluación de la Conducta Neonatal y la Escala de Alarma de Angustia del Bebé. A la edad de 8 a 12 semanas, se midieron los niveles de cortisol tanto antes como después de una inoculación rutinaria. Las interacciones entre madre e infante fueron evaluadas entre las 12 y 16 semanas usando las Escalas de Puntajes Globales. El procedimiento de la situación extraña se llevó a cabo a los 12 meses. Resultados: La calidad general de la interacción madre-infante media la relación entre el perfil sicológico y de conducta del infante y la afectividad del infante: la probabilidad de sentirse seguro en la unión afectiva aumenta con la buena conducta de la madre y con la buena interacción en términos generales. Conclusión: la co-construcción de la relación entre madre e infante depende de las características del infante y de patrones de interacción.Le relation établie entre le bébé et la mère est centrale pour à la fois les parents et les bébés, et offre l’un des environnements les plus importants dans lesquels les enfants se développent. Objectif: évaluer l’effet du fonctionnement psychophysiologique précoc du bébé sur la qualité de l’interaction mère-bébé et sur l’attachement à venir. Explorer les effets de médiation de la qualité de l’interction mère-bébé sur le lien entre le fonctionnement psychophysiologique et la sécurité de l’attachement. Méthode: une étude longitudinale prospective a été faite avec 94 bébés et leurs mères. Des bébés de huit semaines ont été évalués à l’aide de l’Echelle d’Evaluation du Comportement Neonatal (Neonatal Behavioral Assessment Scale) et l’Echelle Alarme Détresse Bébé (Alarm Distress Baby Scale). A 8 à 12 semaines, les niveaux de cortisol ont été mesurés à la fois avant et après la vaccination de routine. L’interaction mère-bébé a été évaluée à 12–16 semaines, en utilisant les Echelles d’Evaluation Globale (Global Rating Scales). La procédure de situation étrange a été faite à 12 mois. Résultats: La qualité générale de l’interaction mère-bébé sert de d’intermédiaire à la relation entre le profil comportemental et physiologique du bébé et l’attachement du bébé: la probabilité d’être attaché de manière sécure augmentait avec le bon comportement de la mère et une bonne interaction générale. Conclusion: La co-construction de la relation mère-bébé dépend des caractéristiques du bébés et des patterns d’interaction.Die bestehende Beziehung zwischen dem Kind und der Bezugsperson ist sowohl für Eltern und Säuglinge zentral und stellt einen der wichtigsten Lebensumstände dar, in dem sich Kinder entwickeln. Ziel: Ein Ziel besteht darin, die Wirkung der frühen psychophysiologischen Funktionsfähigkeit des Säuglings auf die Qualität der Mutter-Kind-Interaktion und auf die spätere Bindung zu beurteilen. Ein weiteres Ziel ist es, die Mediationseffekte von der Qualität der Mutter-Kind-Interaktion hinsichtlich der Zusammenhänge zwischen der kindlichen psychophysiologischen Funktionsfähigkeit und Bindung zu erforschen. Methode: Es wurde ein longitudinales prospektives Design mit 94 Säuglingen und deren Müttern durchgeführt. Acht Wochen alte Säuglinge wurden mit der Neonatal Behavioral Assessment Scale und der Alarm Distress Baby Scale beurteilt. Bei 8 bis 12 Wochen alten Säuglingen, wurden die Cortisolspiegel sowohl vor als auch nach der routinemäßigen Impfung gemessen. Mutter-Kind-Interaktionen wurden zum Zeitpunkt von 12–16 Wochen mit den Global Rating Scales ausgewertet. Der Fremde-Situations-Test wurde mit 12 Monaten durchgeführt. Ergebnisse: Die allgemeine Qualität der Mutter-Kind-Interaktion mediiert die Beziehung zwischen dem behavioralen und physiologischen Profil des Säuglings und dessen Bindung: Die Wahrscheinlichkeit sicher gebunden zu sein, stieg mit gutem mütterlichen Verhalten und mit einer insgesamt guten Interaktion an. Fazit: Die Ko-Konstruktion der Mutter-Kind-Beziehung hängt von den Charakteristika des Säuglings und von den Interaktionsmustern ab.抄録：背景：乳児と養育者の間に作り上げられた関係性は、親と乳児双方にとって中心的であり、子どもが発達する最も重要な環境の一つを提供する。目的：乳児の早期の心理生理学的機能が、母親と乳児の相互交流の質、および後の愛着に与える影響を、評価すること。母親と乳児の相互交流の質が、乳児の心理生理学的機能と愛着の安定性との間の関連に与える媒介効果を探ること。方法：94人の乳児とその母親による縦断的前向き研究デザインが実施された。生後8週の乳児が新生児行動評価尺度Neonatal Behavioral Assessment Scaleと苦痛警告赤ちゃん尺度Alarm Distress Baby Scaleで評価された。8から12週で、定められた予防接種の前後両方でコルチゾールレベルが測定された。母親と乳児の相互交流は、12–16週に、全般的評価尺度Global Rating Scalesを用いて評価された。12か月時にストレンジシチュエーション法が行われた。結果：母親と乳児の相互交流の全般的な質が、乳児の行動と生理学的プロフィールと乳児の愛着の間の関係を媒介した。安定した愛着を持つ蓋然性は、母親の良い行動と良い全般的な相互交流に伴って増加した。結論：母親と乳児の関係性の共同構築co-constructionは、乳児の特性と相互交流のパターンに依存している

On the challenges and opportunities facing fish biology: a discussion of five key knowledge gaps

Many fish species face increasing challenges associated with climate change and overfishing. At the same time, aquaculture is becoming vital for food security. Gaining a deeper understanding of the basic biology of fish is therefore more important than ever. Here we synthesize and summarize key questions, opportunities and challenges in fish biology highlighted during a round‐table discussion at the 50th Anniversary Symposium of The Fisheries Society of the British Isles, held at the University of Exeter, U.K., in July 2017. We identified several knowledge gaps but also key opportunities for fish biology to inform food security, for collective behaviour, evolutionary history and trait correlations to predict responses to environmental change and for novel analytical approaches to mine existing data sets. Overall, more integrative approaches through stronger collaborations across different fields are needed to advance our understanding of the basic biology of fish

Early and long-term morbidity after total laryngopharyngectomy

To determine the early and long-term morbidity of patients treated with a total laryngopharyngectomy and reconstruction using a jejunum interposition or gastric pull-up procedure. It is a retrospective study; and it is conducted in tertiairy referral center. Sixty-three patients were included in whom 70 reconstructions were performed (51 jejunum interpositions and 19 gastric pull-up procedures) between 1990 and 2007. The studied parameters were success rate of the reconstruction, early and long-term complication rate, and functional outcome including quality of life. Subjective quality of life analysis was determined by two questionnaires: the EORTC Quality of Life Questionnaire (QLQ)-C30 Dutch version 3.0, and the EORTC-Head and Neck (H & N 35). The success rates were 84 and 74%, respectively. The procedures were associated with a high complication rate (63% after jejunum interposition and 89% after gastric pull-up), and a lengthy rehabilitation. Surviving patients were found to have a good long-term quality of life. Complete oral intake was achieved in 97%, and speech rehabilitation in 95%. These procedures are associated with significant morbidity, high complication rates, lengthy rehabilitation, but a good long-term quality of life

Validity of mobile electronic data capture in clinical studies: a pilot study in a pediatric population.

BACKGROUND: Clinical studies in children are necessary yet conducting multiple visits at study centers remains challenging. The success of "care-at-home" initiatives and remote clinical trials suggests their potential to facilitate conduct of pediatric studies. This pilot aimed to study the feasibility of remotely collecting valid (i.e. complete and correct) saliva samples and clinical data utilizing mobile technology. METHODS: Single-center, prospective pilot study in children undergoing elective tonsillectomy at the University of Basel Children's Hospital. Data on pain scores and concomitant medication and saliva samples were collected by caregivers on two to four inpatient study days and on three consecutive study days at home. A tailored mobile application developed for this study supported data collection. The primary endpoint was the proportion of complete and correct caregiver-collected data (pain scale) and saliva samples in the at-home setting. Secondary endpoints included the proportion of complete and correct saliva samples in the inpatient setting, subjective feasibility for caregivers, and study cost. RESULTS: A total number of 23 children were included in the study of which 17 children, median age 6.0 years (IQR 5.0, 7.4), completed the study. During the at-home phase, 71.9% [CI = 64.4, 78.6] of all caregiver-collected pain assessments and 53.9% [CI = 44.2, 63.4] of all saliva samples were complete and correct. Overall, 64.7% [CI = 58.7, 70.4] of all data collected by caregivers at home was complete and correct. The predominant reason for incorrectness of data was adherence to the timing of predefined patient actions. Participating caregivers reported high levels of satisfaction and willingness to participate in similar trials in the future. Study costs for a potential sample size of 100 patients were calculated to be 20% lower for the at-home than for a traditional in-patient study setting. CONCLUSIONS: Mobile device supported studies conducted at home may provide a cost-effective approach to facilitate conduct of clinical studies in children. Given findings in this pilot study, data collection at home may focus on electronic data capture rather than biological sampling

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Serotonin transporter gene (SLC6A4) polymorphism and susceptibility to a home-visiting maternal-infant attachment intervention delivered by community health workers in South Africa: reanalysis of a randomized controlled trial

Background Clear recognition of the damaging effects of poverty on early childhood development has fueled an interest in interventions aimed at mitigating these harmful consequences. Psychosocial interventions aimed at alleviating the negative impacts of poverty on children are frequently shown to be of benefit, but effect sizes are typically small to moderate. However, averaging outcomes over an entire sample, as is typically done, could underestimate efficacy because weaker effects on less susceptible individuals would dilute estimation of effects on those more disposed to respond. This study investigates whether a genetic polymorphism of the serotonin transporter gene moderates susceptibility to a psychosocial intervention. Methods and findings We reanalyzed data from a randomized controlled trial of a home-visiting program delivered by community health workers in a black, isiXhosa-speaking population in Khayelitsha, South Africa. The intervention, designed to enhance maternal-infant attachment, began in the third trimester and continued until 6 mo postpartum. Implemented between April 1999 and February 2003, the intervention comprised 16 home visits delivered to 220 mother–infant dyads by specially trained community health workers. A control group of 229 mother–infant dyads did not receive the intervention. Security of maternal-infant attachment was the main outcome measured at infant age 18 mo. Compared to controls, infants in the intervention group were significantly more likely to be securely attached to their primary caregiver (odds ratio [OR] = 1.7, p = 0.029, 95% CI [1.06, 2.76], d = 0.29). After the trial, 162 intervention and 172 control group children were reenrolled in a follow-up study at 13 y of age (December 2012–June 2014). At this time, DNA collected from 279 children (134 intervention and 145 control) was genotyped for a common serotonin transporter polymorphism. There were both genetic data and attachment security data for 220 children (110 intervention and 110 control), of whom 40% (44 intervention and 45 control) carried at least one short allele of the serotonin transporter gene. For these 220 individuals, carrying at least one short allele of the serotonin transporter gene was associated with a 26% higher rate of attachment security relative to controls (OR = 3.86, p = 0.008, 95% CI [1.42, 10.51], d = 0.75), whereas there was a negligible (1%) difference in security between intervention and control group individuals carrying only the long allele (OR = 0.95, p = 0.89, 95% CI [0.45, 2.01], d = 0.03). Expressed in terms of absolute risk, for those with the short allele, the probability of secure attachment being observed in the intervention group was 84% (95% CI [73%, 95%]), compared to 58% (95% CI [43%, 72%]) in the control group. For those with two copies of the long allele, 70% (95% CI [59%, 81%]) were secure in the intervention group, compared to 71% (95% CI [60%, 82%]) of infants in the control group. Controlling for sex, maternal genotype, and indices of socioeconomic adversity (housing, employment, education, electricity, water) did not change these results. A limitation of this study is that we were only able to reenroll 49% of the original sample randomized to the intervention and control conditions. Attribution of the primary outcome to causal effects of intervention in the present subsample should therefore be treated with caution. Conclusions When infant genotype for serotonin transporter polymorphism was taken into account, the effect size of a maternal-infant attachment intervention targeting impoverished pregnant women increased more than 2.5-fold when only short allele carriers were considered (from d = 0.29 for all individuals irrespective of genotype to d = 0.75) and decreased 10-fold when only those carrying two copies of the long allele were considered (from d = 0.29 for all individuals to d = 0.03). Genetic differential susceptibility means that averaging across all participants is a misleading index of efficacy. The study raises questions about how policy-makers deal with the challenge of balancing equity (equal treatment for all) and efficacy (treating only those whose genes render them likely to benefit) when implementing psychosocial interventions

Optimizing the Definitions of Stroke, TIA and Infarction for Research and Application in Clinical Practice

Background and purposeUntil now, stroke and transient ischemic attack (TIA) have been clinically based terms which describe the presence and duration of characteristic neurological deficits attributable to intrinsic disorders of particular arteries supplying the brain, retina, or (sometimes) the spinal cord. Further, infarction has been pathologically defined as death of neural tissue due to reduced blood supply. Recently, it has been proposed we shift to definitions of stroke and TIA determined by neuroimaging results alone and that neuroimaging findings be equated with infarction.MethodsWe examined the scientific validity and clinical implications of these proposals using the existing published literature and our own experience in research and clinical practice.ResultsWe found that the proposals to change to imaging-dominant definitions, as published, are ambiguous and inconsistent. Therefore, they cannot provide the standardization required in research or its application in clinical practice. Further, we found that the proposals are scientifically incorrect because neuroimaging findings do not always correlate with the clinical status or the presence of infarction. In addition, we found that attempts to use the proposals are disrupting research, are otherwise clinically unhelpful and do not solve the problems they were proposed to solve.ConclusionWe advise that the proposals must not be accepted. In particular, we explain why the clinical focus of the definitions of stroke and TIA should be retained with continued sub-classification of these syndromes depending neuroimaging results (with or without other information) and that infarction should remain a pathological term. We outline ways the established clinically based definitions of stroke and TIA, and use of them, may be improved to encourage better patient outcomes in the modern era