The role of the amygdala in dreaming

Includes bibliographical references.Neuro-imaging studies have strongly implicated the basolateral amygdala in dreaming (e.g. Maquet et al., 1996). Various neuropsychological dream theorists (Domhoff, 2001; Hobson, Pace-Schott & Stickgold, 2000; Revonsuo, 2000) propose central roles for the amygdala in dreaming (particularly in the generation of dream affect); however, little empirical research on its function in dreaming exists. Urbach-Wiethe Disease (UWD) is a very rare genetic condition that can lead to calcifications in the medial temporal lobes. This study analysed 26 dream reports collected from eight adult UWD patients with fully calcified basolateral amygdalae bilaterally, and compared them to 58 dream reports collected from 17 matched controls. Dream affect and various other dream characteristics were examined. A number of significant results of small to moderate effect size were found. Notably, UWD patients’ dream reports had a significantly higher mean intensity of positive affect than controls’ dream reports, a significantly lower mean intensity of negative affect, a significantly higher mean intensity of PLAY, and a significantly lower mean intensity of RAGE. The UWD patients’ dream reports were also significantly more wish-fulfilling than the controls’ dream reports, were significantly less likely to be classified as nightmares, and had a significantly lower word count and narrative item count. These results are consistent with an extensive literature that implicates the basolateral amygdala in fear conditioning, emotional appraisal and in similar affective processes in waking life (e.g. LeDoux, 2003; Pessoa, 2010). The dream reports were also analysed for instances of threat and escape, as well as for approach and avoidance behaviour, in order to test some of the hypotheses central to Revonsuo’s (2000) threat simulation theory (TST) of dreaming. These analyses produced no significant results. Given that the amygdala is essential to Revonsuo’s (2000) conceptualisation of dreaming as an evolutionarily adaptive mechanism to safely simulate threat avoidance, these findings contradict some of TST’s central predictions. In general, these findings suggest that the average dream of persons with bilateral basolateral amygdalae damage is significantly simpler, more pleasant, less unpleasant, more wish-fulfilling and less likely to be a nightmare than the average control dream. As such, the dream reports of the UWD patients seem strikingly similar to the dreams of young children

The treatment in a child guidance clinic of emotionally disturbed children showing speech defects

No abstract available

Complete intracranial response to talimogene laherparepvec (T-Vec), pembrolizumab and whole brain radiotherapy in a patient with melanoma brain metastases refractory to dual checkpoint-inhibition

Background Immunotherapy, in particular checkpoint blockade, has changed the clinical landscape of metastatic melanoma. Nonetheless, the majority of patients will either be primary refractory or progress over follow up. Management of patients progressing on first-line immunotherapy remains challenging. Expanded treatment options with combination immunotherapy has demonstrated efficacy in patients previously unresponsive to single agent or alternative combination therapy. Case presentation We describe the case of a patient with diffusely metastatic melanoma, including brain metastases, who, despite being treated with stereotactic radiosurgery and dual CTLA-4/PD-1 blockade (ipilimumab/nivolumab), developed systemic disease progression and innumerable brain metastases. This patient achieved a complete CNS response and partial systemic response with standard whole brain radiation therapy (WBRT) combined with Talimogene laherparepvec (T-Vec) and pembrolizumab. Conclusion Patients who do not respond to one immunotherapy combination may respond during treatment with an alternate combination, even in the presence of multiple brain metastases. Biomarkers are needed to assist clinicians in evidence based clinical decision making after progression on first line immunotherapy to determine whether response can be achieved with second line immunotherapy

Furthering alternative cultures of valuation in higher education research

The value of higher education is often implicit or assumed in educational research. The underlying and antecedent premises that shape and influence debates about value remain unchallenged which perpetuates the dominant, but limiting, terms of the debate and fosters reductionism. I proceed on the premise that analyses of value are not self–supporting or self-referential but are embedded within prevailing cultures of valuation. I contend that challenging, and providing alternatives to, dominant narratives of higher education requires an appreciation of those cultures. I therefore highlight some of the existing cultures of valuation and their influence. I then propose Sayer’s concept of lay normativity as a culture of valuation and discuss how it translates into the practices of research into higher education, specifically the practice of analysis. I animate the discussion by detecting the presence of lay normativity in the evaluative space of the capability approach

Disrupted prevention: condom and contraception access and use among young people during the initial months of the COVID-19 pandemic

No abstract available

Disrupted prevention: Condom and contraception access and use among young adults during the initial months of the COVID-19 pandemic. An online survey

Background: The initial response to COVID-19 in the UK involved a rapid contraction of face-to-face sexual and reproductive health (SRH) services and widespread use of remote workarounds. This study sought to illuminate young people’s experiences of accessing and using condoms and contraception in the early months of the pandemic. Methods: We analysed data, including open-text responses, from an online survey conducted in June–July 2020 with a convenience sample of 2005 16–24-year-olds living in Scotland. Results: Among those who used condoms and contraception, one quarter reported that COVID-19 mitigation measures had made a difference to their access or use. Open-text responses revealed a landscape of disrupted prevention, including changes to sexual risk-taking and preventive practices, unwanted contraceptive pathways, unmet need for sexually transmitted infection (STI) testing, and switches from freely provided to commercially sold condoms and contraception. Pandemic-related barriers to accessing free condoms and contraception included: (1) uncertainty about the legitimacy of accessing SRH care and self-censorship of need; (2) confusion about differences between SRH care and advice received from healthcare professionals during the pandemic compared with routine practice; and (3) exacerbation of existing access barriers, alongside reduced social support and resources to navigate SRH care. Conclusions: Emerging barriers to STI and pregnancy prevention within the context of COVID-19 have the potential to undermine positive SRH practices, and widen inequalities, among young people. As SRH services are restored amid evolving pandemic restrictions, messaging to support navigation of condom and contraception services should be co-created with young people

Risk Factors for Norovirus, Sapporo-like Virus, and Group A Rotavirus Gastroenteritis

Viral pathogens are the most common causes of gastroenteritis in the community. To identify modes of transmission and opportunities for prevention, a case-control study was conducted and risk factors for gastroenteritis attributable to norovirus (NV), Sapporo-like virus (SLV), and rotavirus were studied. For NV gastroenteritis, having a household member with gastroenteritis, contact with a person with gastroenteritis outside the household, and poor food-handling hygiene were associated with illness (population attributable risk fractions [PAR] of 17%, 56%, and 47%, respectively). For SLV gastroenteritis, contact with a person with gastroenteritis outside the household was associated with a higher risk (PAR 60%). For rotavirus gastroenteritis, contact with a person with gastroenteritis outside the household and food-handling hygiene were associated with a higher risk (PAR 86% and 46%, respectively). Transmission of these viral pathogens occurs primarily from person to person. However, for NV gastroenteritis, foodborne transmission seems to play an important role

Pharmacological prevention of postictal agitation after electroconvulsive therapy—A systematic review and meta-analysis

BackgroundPostictal agitation (PIA) after electroconvulsive therapy (ECT) is a serious clinical problem estimated to occur in 7–36% of patients and recur in 19–54% of patients. PIA has the potential to cause dangerous situations for the patient and staff members aside from the financial impact. To date, it is unclear which pharmacological interventions should be used in the management of PIA. This study aimed to systematically review the (preventative) pharmacological treatment options for PIA after ECT.MethodA systematic search was done in PubMed, EMBASE, PsycINFO, and Web of Science from inception until 10 November 2022. We included randomized trials with any pharmacological intervention or comparison and a predefined outcome measure on PIA. Studies that solely included patients with neurodegenerative disorders or stroke were excluded. Data quality was assessed with the RoB2 and GRADE. Meta-analysis was performed if possible. This study was registered on PROSPERO under CRD42021262323.ResultsWe screened 2,204 articles and included 14 studies. Dexmedetomidine was investigated in 10 studies. Alfentanil, lignocaine, esmolol, midazolam, propofol, ketamine, haloperidol, and diazepam were each studied in only one study. Meta-analysis revealed an OR of 0.45 (0.32–0.63), a moderate effect size, in favor of dexmedetomidine than placebo to prevent PIA with very low heterogeneity (I2 = 0%). The certainty of the evidence was moderate. The other interventions studied were all found to have low certainty of evidence.ConclusionFor clinical practice, we believe that our results indicate that dexmedetomidine should be considered for the prevention of PIA in patients that have previously experienced PIA

Alliance of Genome Resources Portal: unified model organism research platform

The Alliance of Genome Resources (Alliance) is a consortium of the major model organism databases and the Gene Ontology that is guided by the vision of facilitating exploration of related genes in human and well-studied model organisms by providing a highly integrated and comprehensive platform that enables researchers to leverage the extensive body of genetic and genomic studies in these organisms. Initiated in 2016, the Alliance is building a central portal (www.alliancegenome.org) for access to data for the primary model organisms along with gene ontology data and human data. All data types represented in the Alliance portal (e.g. genomic data and phenotype descriptions) have common data models and workflows for curation. All data are open and freely available via a variety of mechanisms. Long-term plans for the Alliance project include a focus on coverage of additional model organisms including those without dedicated curation communities, and the inclusion of new data types with a particular focus on providing data and tools for the non-model-organism researcher that support enhanced discovery about human health and disease. Here we review current progress and present immediate plans for this new bioinformatics resource