Effects of rumination on unwanted intrusive thoughts: A replication and extension

Studies indicate that rumination might play a role in obsessive–compulsive disorder. In a previous experimental study, rumination about an unwanted intrusive thought (UIT) maintained the urge to neutralize this thought. We sought to replicate and extend these findings with measures of behavioral and mental neutralizing. Additionally, we investigated possible mechanisms that might be involved in the effects of rumination on the UIT. We activated a UIT by asking students (N = 105) to write down a sentence stating that they wished a loved person would die in a car accident. Participants were randomly allocated to rumination about the UIT, rumination about negative mood, or distraction. As predicted, rumination about the UIT maintained the urge to neutralize the UIT, relative to rumination about negative mood and distraction. In addition, rumination about the UIT also maintained distress associated with the UIT compared to rumination about negative mood and distraction. The effects of rumination did not extend to behavioral or mental neutralizing. UIT frequency and vividness were unaffected by rumination. The present findings strengthen the confidence that rumination contributes to the maintenance of UITs

Replacing performance status with a simple patient-reported outcome in palliative radiotherapy prognostic modelling

Background and purpose Prognostication is key to determining care in advanced incurable cancer. Although performance status (PS) has been shown to be a strong prognostic predictor, inter-rater reliability is limited, restricting models to specialist settings. This study assessed the extent to which a simple patient-reported outcome measure (PROM), the EQ-5D, may replace PS for prognosis of patients with bone metastases. Materials and methods Data from 1,011 patients in the Dutch Bone Metastasis Study were used. Cox proportional hazards models were developed to investigate the prognostic value of models incorporating PS alone, the EQ-5D SC dimension alone, all EQ-5D dimensions and EQ–VAS, and finally all dimensions and PS. Three prognostic groups were identified and performance assessed using the Harrell’s C-index and Altman-Royston index of separation. Results Replacing performance status (PS) with the self-care (SC) dimension of the EQ-5D provides similar model performance. In our SC-based model, three groups are identified with median survival of 86 days (95 % CI 76–101), 174 days (95 % CI 145–213), and 483 days (95 % CI 431–539). Whilst not statistically significantly different, the C-index was 0.706 for the PS-only model, 0.718 for SC-only and 0.717 in our full model, suggesting patient-report outcome models perform as well as that based on PS. Conclusion Prognostic performance was similar across all models. The SC model provides prognostic value similar to that of PS, particularly where a prognosis of<6 months is considered. Larger, more contemporaneous studies are needed to assess the extent to which PROMs may be of prognostic value, particularly where specialist assessment is less feasible

Standardized postnatal management of infants with congenital diaphragmatic hernia in Europe: The CDH EURO consortium consensus

Congenital diaphragmatic hernia (CDH) is associated with high mortality and morbidity. To date, there are no standardized protocols for the treatment of infants with this anomaly. However, protocols based on the literature and expert opinion might improve outcome. This paper is a consensus statement from the CDH EURO Consortium prepared with the aim of achieving standardized postnatal treatment in European countries. During a consensus meeting between high-volume centers with expertise in the treatment of CDH in Europe (CDH EURO Consortium), the most recent literature on CDH was discussed. Thereafter, 5 experts graded the studies according to the Scottish Intercollegiate Guidelines Network (SIGN) Criteria. Differences in opinion were discussed until full consensus was reached. The final consensus statement, therefore, represents the opinion of all consortium members. Multicenter randomized controlled trials on CDH are lacking. Use of a standardized protocol, however, may contribute to more valid comparisons of patient data in multicenter studies and identification of areas for further research

Speed Matters: Relationship between Speed of Eye Movements and Modification of Aversive Autobiographical Memories

Eye movement desensitization and reprocessing (EMDR) is an efficacious treatment for post-traumatic stress disorder. In EMDR, patients recall a distressing memory and simultaneously make eye movements (EM). Both tasks are considered to require limited working memory (WM) resources. Because this leaves fewer resources available for memory retrieval, the memory should become less vivid and less emotional during future recall. In EMDR analogue studies, a standardized procedure has been used, in which participants receive the same dual task manipulation of 1 EM cycle per second (1 Hz). From a WM perspective, the WM taxation of the dual task might be titrated to the WM taxation of the memory image. We hypothesized that highly vivid images are more affected by high WM taxation and less vivid images are more affected by low WM taxation. In study 1, 34 participants performed a reaction time task, and rated image vividness, and difficulty of retrieving an image, during five speeds of EM and no EM. Both a high WM taxing frequency (fast EM; 1.2 Hz) and a low WM taxing frequency (slow EM; 0.8 Hz) were selected. In study 2, 72 participants recalled three highly vivid aversive autobiographical memory images (n = 36) or three less vivid images (n = 36) under each of three conditions: recall + fast EM, recall + slow EM, or recall only. Multi-level modeling revealed a consistent pattern for all outcome measures: recall + fast EM led to less emotional, less vivid and more difficult to retrieve images than recall + slow EM and recall only, and the effects of recall + slow EM felt consistently in between the effects of recall + fast EM and recall only, but only differed significantly from recall + fast EM. Crucially, image vividness did not interact with condition on the decrease of emotionality over time, which was inconsistent with the prediction. Implications for understanding the mechanisms of action in memory modification and directions for future research are discussed

Особенности деонтологии в сексологической практике

Описаны основные принципы врачебной этики в сексологической практике. Рассмотрены особенности взаимоотношений врача−сексолога и пациента. Подчеркивается, что выполнение врачом деонтологических принципов будет способствовать гармонизации семейно−сексуальных отношений.Basic principles of medical ethics in sexological practice are presented. The peculiarities of mutual relations of the doctor sexologist and the patient are discussed. It is emphasized that adherence of the doctor−sexologist of ethical principles will promote harmonization of family sexual relations

Risk Factors for Chronic Lung Disease and Mortality in Newborns with Congenital Diaphragmatic Hernia

Background: Congenital diaphragmatic hernia (CDH) is associated with a mortality rate of 10-35% in live-born infants. Moreover, CDH survivors have a substantial risk of developing long-term pulmonary sequelae, such as bronchopulmonary dysplasia (BPD). Objectives: This study aims to evaluate risk factors associated with BPD and mortality in neonates with CDH, with particular focus on the initial ventilation mode. Methods: Eligible for inclusion were live-born infants with CDH born from 2001 through 2006 at the centers participating in the CDH Study Group. BPD (defined as oxygen dependency at day 30) and/or mortality by day 30 served as the primary endpoint. Results: A total of 2,078 neonates were included in the analysis. At day 30, 56% of the patients had either died or met the criteria for BPD. In infants who survived until day 30, the prevalence of BPD was 41%. The overall mortality rate was 31%. High-frequency oscillatory ventilation as initial ventilation mode, a right-sided defect, a prenatal diagnosis, a lower Apgar score at 5 min, a cardiac anomaly, a chromosomal anomaly and a lower gestational age were all associated with BPD and/or mortality by day 30. Conclusions: Despite improvements in neonatal care, the rates of BPD and early mortality in newborns with CDH are still considerable. Several important risk factors for a worse outcome are reported in this nonrandomized prospe

Revisiting Efficient Multi-Step Nonlinearity Compensation with Machine Learning: An Experimental Demonstration

Efficient nonlinearity compensation in fiber-optic communication systems is considered a key element to go beyond the "capacity crunch''. One guiding principle for previous work on the design of practical nonlinearity compensation schemes is that fewer steps lead to better systems. In this paper, we challenge this assumption and show how to carefully design multi-step approaches that provide better performance--complexity trade-offs than their few-step counterparts. We consider the recently proposed learned digital backpropagation (LDBP) approach, where the linear steps in the split-step method are re-interpreted as general linear functions, similar to the weight matrices in a deep neural network. Our main contribution lies in an experimental demonstration of this approach for a 25 Gbaud single-channel optical transmission system. It is shown how LDBP can be integrated into a coherent receiver DSP chain and successfully trained in the presence of various hardware impairments. Our results show that LDBP with limited complexity can achieve better performance than standard DBP by using very short, but jointly optimized, finite-impulse response filters in each step. This paper also provides an overview of recently proposed extensions of LDBP and we comment on potentially interesting avenues for future work.Comment: 10 pages, 5 figures. Author version of a paper published in the Journal of Lightwave Technology. OSA/IEEE copyright may appl

Prospective longitudinal evaluation of lung function during the first year of life after repair of congenital diaphragmatic hernia

OBJECTIVE: To evaluate lung function and respiratory morbidity prospectively during the first year of life in patients with congenital diaphragmatic hernia and to study the effect of extracorporeal membrane oxygenation therapy. DESIGN: Prospective longitudinal cohort study. SETTING: Outpatient clinic of a tertiary-level pediatric hospital. PATIENTS: The cohort of 43 infants included 12 patients treated with extracorporeal membrane oxygenation. Evaluation was at 6 and 12 months; 33 infants were evaluated at both time points. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Maximal expiratory flow at functional residual capacity and functional residual capacity were measured with Masterscreen Babybody. Z-scores were calculated for maximal expiratory flow at functional residual capacity. Mean maximal expiratory flow at functional residual capacity values at 6 and 12 months were significantly below the expected values (mean z-score -1.4 and -1.5, respectively) without a significant change between both time points. Values did not significantly differ between extracorporeal membrane oxygenation and nonextracorporeal membrane oxygenation-treated patients. Functional residual capacity values were generally high, 47% were above the suggested normal range, and did not change significantly over time. Mean functional residual capacity values in extracorporeal membrane oxygenation-treated patients were significantly higher than in nonextracorporeal membrane oxygenation-treated patients (p = .006). The difference (5.1 mL/kg ± 1.8 SE) did not change significantly between the two time points. Higher mean airway pressure and longer duration of ventilation were associated with higher functional residual capacity. None of the perinatal characteristics was associated with maximal expiratory flow at functional residual capacity. Mean weight z-scores were significantly below zero at both time points (p < .001). Mean weight z-score in extracorporeal membrane oxygenation-treated patients were lower than in nonextracorporeal membrane oxygenation-treated patients (p = .046). CONCLUSIONS: Infants with congenital diaphragmatic hernia have decreased expiratory flows and increased functional residual capacity within the first year of life. Extracorporeal membrane oxygenation-treated patients with congenital diaphragmatic hernia may have more respiratory morbidity and concomitant growth impairment. Close follow-up beyond the neonatal period is therefore required. Copyrigh