Bettina Winckler: Neuronal polarity on her mind

Winckler studies how endocytic processes maintain the polarity of neurons

Examination of LGBTQIA+-Inclusive Recommendations Issued by Professional Medical Associations Across Healthcare Fields

LGBTQIA+ populations persistently experience discrimination and limited access to informed, quality, and patient-centered healthcare. The gap between population needs and provider competence can be attributed to the inadequate education of healthcare professionals, suggesting the need for educational reform not just within medical schools, but also in physician assistant, nursing, and emergency medical services programs. To create the most widespread change across all these programs, it is imperative that the leading, most influential professional medical associations (PMAs) in each field take steps to make LGBTQIA+-focused healthcare education a priority, provide actionable statements and plans, and encourage educational institutions to ardently take up their recommendations. This paper provides an overview of the recent statements, recommendations, and actions published by several of the leading PMAs across multiple healthcare professions. Through narrative and content analysis, these publications are evaluated for depth, quality, and actionability. From this evaluation, a call to action is made for the leading PMAs of each healthcare profession to actively engage in the educational reform required to begin eliminating these long-standing disparities to ultimately improve the experiences and health outcomes of individuals in LGBTQIA+ populations

Resting respiratory sinus arrhythmia and posttraumatic stress disorder: A meta-analysis

Respiratory sinus arrhythmia (RSA) has been examined as a psychophysiological marker of stress vulnerability. Research indicates that low resting RSA is associated with physical and mental health problems, including posttraumatic stress disorder (PTSD). Some research suggests that people diagnosed with PTSD have lower RSA than people without PTSD, but findings have been mixed and the overall magnitude of this effect is unknown, indicating the need for a comprehensive meta-analysis. This meta-analysis examined the association between PTSD and baseline RSA in 55 studies, including 12 unpublished studies, with a total sample size of 6689. Studies were included if they used a PTSD measure, a baseline measure of RSA, and involved humans. Studies were excluded if they were not available in English, did not present quantitative data, presented duplicate data, were a case series, or did not provide results required for computing an effect size. The meta-analysis indicated there is a small but significant association between PTSD and RSA (g = -0.26; 95% CI = -0.35, -0.16) with moderate heterogeneity. Moderator analyses suggested that effects are larger for adults than for children and for DSM-5 PTSD measures than for non-DSM referenced measures. We found some evidence for publication bias among the meta-analysis findings. Overall, there is a small but reliable association between PTSD and lower resting RSA, providing support for further research examining the complex relationship between parasympathetic activity and PTSD

A New Approach to Learning How to Teach: medical students as instructional designers

As students at the David Geffen School of Medicine at UCLA, the student authors were given the opportunity to develop their own creative projects which would be used to teach future medical students. They chose their own topics, planned and researched their projects, and then implemented the projects in interactive digital Adobe Flash files. In the first project they created interactive case-based radiology teaching files. In the second project they integrated photographic images into the existing illustrative anatomy files. Students in subsequent years have learned from these files on computers both at home and in the school's anatomy lab. The experience of creating the files served as an opportunity for hands-on learning for the student authors, both of the material and of the practice of teaching. In this paper they describe why they undertook these projects, what exactly they did, and the impact their creation had on them. The projects demonstrate that student-driven educational materials are both possible and beneficial. Furthermore, their experience has allowed them to conclude that faculty at other medical schools should consider providing students with opportunities to develop their own creative projects that contribute to the curriculum

3D reconstruction and heat map of porcine recurrent laryngeal nerve anatomy: branching and spatial location

Recurrent laryngeal nerve palsy is a common post-operative complication of many head and neck surgeries. Theoretically, the best treatment to restore partial function to a damaged recurrent laryngeal nerve would be reinnervation of the posterior cricoarytenoid muscle via anastomosis of the recurrent laryngeal and phrenic nerves. The pig is an excellent model of human laryngeal anatomy and physiology but a more thorough knowledge of porcine laryngeal anatomy is necessary before the pig can be used to improve existing surgical strategies, and develop new ones. This study first identifies the three most common recurrent laryngeal nerve branching patterns in the pig. Secondly, this study presents three-dimensional renderings of the porcine larynx onto which the recurrent laryngeal nerve patterns are accurately mapped. Lastly, heat maps are presented to display the spatial variability of recurrent laryngeal nerve trunks and primary branches on each side of 15 subjects (28 specimens). We intend for this study to be useful to groups using a porcine model to study posterior cricoarytenoid muscle reinnervation techniques.

Uncovering multiple axonal targeting pathways in hippocampal neurons

Neuronal polarity is, at least in part, mediated by the differential sorting of membrane proteins to distinct domains, such as axons and somata/dendrites. We investigated the pathways underlying the subcellular targeting of NgCAM, a cell adhesion molecule residing on the axonal plasma membrane. Following transport of NgCAM kinetically, surprisingly we observed a transient appearance of NgCAM on the somatodendritic plasma membrane. Down-regulation of endocytosis resulted in loss of axonal accumulation of NgCAM, indicating that the axonal localization of NgCAM was dependent on endocytosis. Our data suggest the existence of a dendrite-to-axon transcytotic pathway to achieve axonal accumulation. NgCAM mutants with a point mutation in a crucial cytoplasmic tail motif (YRSL) are unable to access the transcytotic route. Instead, they were found to travel to the axon on a direct route. Therefore, our results suggest that multiple distinct pathways operate in hippocampal neurons to achieve axonal accumulation of membrane proteins

A prospective examination of health care costs associated with posttraumatic stress disorder diagnostic status and symptom severity among veterans

Posttraumatic stress disorder (PTSD) is associated with increased health care costs; however, most studies exploring this association use PTSD diagnostic data in administrative records, which can contain inaccurate diagnostic information and be confounded by the quantity of service use. We used a diagnostic interview to determine PTSD diagnostic status and examined associations between PTSD symptom severity and health care costs and utilization, extracted from Veteran Health Administration (VHA) administrative databases. Using a nationwide longitudinal sample of U.S. veterans with and without PTSD (N = 1,377) enrolled in VHA health care, we determined the costs and utilization of mental health and non–mental health outpatient, pharmacy, and inpatient services for 1 year following cohort enrollment. Relative to veterans without PTSD, those with PTSD had higher total health care, B = 0.47; mental health clinic care, B = 0.72; non–mental health clinic care, B = 0.30; and pharmacy costs, B = 0.72, ps < .001. More severe PTSD symptoms were associated with mental health clinic care costs, B = 0.12; non–mental health clinic care costs, B = 0.27; and higher odds of inpatient, B = 0.63, and emergency service use, B = 0.39, p < .001–p = .012. These findings indicate that veterans’ PTSD status, determined by a clinician-administered semistructured diagnostic interview, was associated with higher health care costs and increased use of mental health and non–mental health clinic services. The findings also suggest that more severe PTSD is associated with increased costs and utilization, including costly emergency and inpatient utilization

The narcissistic mask: An exploration of \u27the defensive grandiosity hypothesis\u27

Narcissism has been conceptualized as involving attempts to defend against negative self-schemata (implicit negative beliefs about one\u27s own self-worth). This idea has been termed the \u27mask model of narcissism\u27. This study explores the mask model, examining the association between extreme narcissistic personality traits and performance on a task purported to assess the influence of negative self-schemata. Participants (n=232) from the UK and the UAE completed the Narcissistic Personality Inventory and also performed an incidental learning task involving the surprise recall of self-referential adjectives (traits). A greater recall of negative adjectives was viewed as indicative of negative self-schemata. Looking at the sample as a whole, there were no associations between narcissistic traits and negative adjective recall. However, amongst those scoring in the upper quartile of the Narcissistic Personality Inventory, narcissism scores were positively correlated with the recall of negative adjectives even after controlling for age and memory. Narcissism may reflect self-enhancement strategies rooted in negative self-beliefs. © 2012 John Wiley & Sons, Ltd

Effects of trauma-focused rumination among trauma-exposed individuals with and without posttraumatic stress disorder: An experiment

Rumination, or thinking repetitively about one's distress, is a risk factor for posttraumatic stressdisorder (PTSD). Current theories suggest that rumination contributes to PTSD symptoms directly,by increasing negative reactions to trauma cues (i.e., symptom exacerbation), or represents a formof cognitive avoidance, if verbal ruminations are less distressing than trauma imagery. The goal ofthis study was to test the symptom exacerbation and cognitive avoidance accounts of traumafocusedrumination. We recruited 135 trauma-exposed participants (n = 60 diagnosed with PTSD)and randomly assigned them to ruminate about their trauma, distract themselves, or engage intrauma imagery. For individuals with and without PTSD, rumination led to larger increases insubjective distress (i.e., negative affect, fear, sadness, subjective arousal, valence) than distraction,?p2s = .04–.13, but there were no differences between rumination and imagery ?p2s = .001–.02.We found no evidence that rumination or imagery elicited physiological arousal, ds = 0.01–0.19,but did find that distraction reduced general physiological arousal, as measured by heart rate,relative to baseline, d = 0.84, which may be due to increases in parasympathetic nervous systemactivity (i.e., respiratory sinus arrhythmia), d = 0.33. These findings offer no support for theavoidant function of rumination in PTSD. Instead, the findings were consistent with symptomexacerbation, indicating that rumination leads directly to emotional reactivity to trauma remindersand may be a fruitful target in PTSD intervention