Automatic detection of cognitive impairment with virtual reality

Cognitive impairment features in neuropsychiatric conditions and when undiagnosed can have a severe impact on the affected individual's safety and ability to perform daily tasks. Virtual Reality (VR) systems are increasingly being explored for the recognition, diagnosis and treatment of cognitive impairment. In this paper, we describe novel VR-derived measures of cognitive performance and show their correspondence with clinically-validated cognitive performance measures. We use an immersive VR environment called VStore where participants complete a simulated supermarket shopping task. People with psychosis (k=26) and non-patient controls (k=128) participated in the study, spanning ages 20-79 years. The individuals were split into two cohorts, a homogeneous non-patient cohort (k=99 non-patient participants) and a heterogeneous cohort (k=26 patients, k=29 non-patient participants). Participants' spatio-temporal behaviour in VStore is used to extract four features, namely, route optimality score, proportional distance score, execution error score, and hesitation score using the Traveling Salesman Problem and explore-exploit decision mathematics. These extracted features are mapped to seven validated cognitive performance scores, via linear regression models. The most statistically important feature is found to be the hesitation score. When combined with the remaining extracted features, the multiple linear regression model resulted in statistically significant results with R2 = 0.369, F-Stat = 7.158, p(F-Stat) = 0.000128

Realising stratified psychiatry using multidimensional signatures and trajectories

BACKGROUND: Stratified or personalised medicine targets treatments for groups of individuals with a disorder based on individual heterogeneity and shared factors that influence the likelihood of response. Psychiatry has traditionally defined diagnoses by constellations of co-occurring signs and symptoms that are assigned a categorical label (e.g. schizophrenia). Trial methodology in psychiatry has evaluated interventions targeted at these categorical entities, with diagnoses being equated to disorders. Recent insights into both the nosology and neurobiology of psychiatric disorder reveal that traditional categorical diagnoses cannot be equated with disorders. We argue that current quantitative methodology (1) inherits these categorical assumptions, (2) allows only for the discovery of average treatment response, (3) relies on composite outcome measures and (4) sacrifices valuable predictive information for stratified and personalised treatment in psychiatry. METHODS AND FINDINGS: To achieve a truly ‘stratified psychiatry’ we propose and then operationalise two necessary steps: first, a formal multi-dimensional representation of disorder definition and clinical state, and second, the similar redefinition of outcomes as multidimensional constructs that can expose within- and between-patient differences in response. We use the categorical diagnosis of schizophrenia—conceptualised as a label for heterogeneous disorders—as a means of introducing operational definitions of stratified psychiatry using principles from multivariate analysis. We demonstrate this framework by application to the Clinical Antipsychotic Trials of Intervention Effectiveness dataset, showing heterogeneity in both patient clinical states and their trajectories after treatment that are lost in the traditional categorical approach with composite outcomes. We then systematically review a decade of registered clinical trials for cognitive deficits in schizophrenia highlighting existing assumptions of categorical diagnoses and aggregate outcomes while identifying a small number of trials that could be reanalysed using our proposal. CONCLUSION: We describe quantitative methods for the development of a multi-dimensional model of clinical state, disorders and trajectories which practically realises stratified psychiatry. We highlight the potential for recovering existing trial data, the implications for stratified psychiatry in trial design and clinical treatment and finally, describe different kinds of probabilistic reasoning tools necessary to implement stratification

The Grizzly, May 2, 2000

Asbestos Mess Hits Helfferich Hard • Commencement Set for UC Seniors • Douglass Davis, UC Alumnus and Faculty Member, Dead at 81 • Annual Spring Fling a High-Flying Success • Students Selected to Speak at 2000 Ursinus Graduation Ceremonies • Letters from the Editors • Final Exam Schedule • UC Female Reflects on the Horrors of the Freshman Fifteen • The Poet-Tree Grows at Ursinus • A New Chapter in the History Books: Newmaster Hurls the First Perfect Game in Centennial Conference History • UC Track Gears Up for Last Meet • Profile: Lisa Newmaster • Bears Capture Back-to-Back CC Title • Unpredicted Ending for UC Lacrossehttps://digitalcommons.ursinus.edu/grizzlynews/1468/thumbnail.jp

The Grizzly, February 22, 2000

Black History Celebrated Across Ursinus Campus • Greeks Fall Under Scrutiny • Arts Program to Expand at UC • Nobel Laureate Lecture Draws Positive Student Response • Littleton, Letterman and the South Carolina Primary • After South Carolina: Can McCain be the Man for the GOP? • Pledging Debate Continues: The Problem of Hazing • Pat McGee: Pseudo DMB? • Valentine\u27s Day Blues • Tumbling and Dancing with Words • Music Review: Dr. John • Glah, Druckenmiller Shine at CC Swimming Championships • UC Wrestling Falls Short in Centennial Championships • UC Spring Sports Preview • Gymnastics Trounces School Record at Marranca Invitational • Men\u27s Basketball Ends Stellar Season • Sports Profile: Christopher Ciuncihttps://digitalcommons.ursinus.edu/grizzlynews/1460/thumbnail.jp

The Grizzly, February 15, 2000

UC Students Debate Pros, Cons of Pledging On Campus • Feelings of Brotherhood, Sisterhood Prevalent During Pledging Process • Employment Available for Graduating Seniors • True Love: Sorrow and Devotion • Hackers, Hijackers, and the Wide World of Sports • The Greeks Agree: Pledges Have no Free Will • Pledging: What\u27s the Big Deal Anyway? • muMs Schemes at Ursinus • Pat McGee to Jam at Ursinus • Music Review: The Alligator Blues Band • Gymnastics Tops RIC with Season High Score • Intramural 3 on 3 Action: Brains vs. Brute • Indoor Track Steps Up to Eight Way Challenge • Ursinus Wrestling Battles for 4-1 • Sports Profile: Shana Goanehttps://digitalcommons.ursinus.edu/grizzlynews/1459/thumbnail.jp

The Grizzly, April 11, 2000

Vandalism: Running Rampant in Reimert and the Quad • UC Gets Medieval in Annual Sport Fest • PBK Lecture Informative and Hilarious • Phi Psi Educates UC Greeks on Pledging Do\u27s and Don\u27ts • Students Take Center Stage at Airband 2000 • Service Day Calls UC Community to Action • Basket Bingo Allows Others to Make-a-Wish • Putting a Finger on Sexuality • RHA Behind the Scenes • Election Preview: CAB, RHA, USGA and Class Elections • Letters to the Editor • Thoughts from a Sophomore Chat: If Tuition Increases, Scholarships Must • UC Artists Unveil Photography Exhibit • The Voice of UC College Choir • Team Effort Puts UC in the Lead • Bears Quest for NCAA Tournament Continues • Softball Ranked 18th in Nation • Tennis Team Continues to Struggle • Golf Ties for Second with F&M • Track and Field Improves at Osprey Open • Sports Profiles: Joe Sprague; Sue Sobolewskihttps://digitalcommons.ursinus.edu/grizzlynews/1465/thumbnail.jp

Examination of the neural basis of psychotic-like experiences in adolescence during processing of emotional faces

Contemporary theories propose that dysregulation of emotional perception is involved in the aetiology of psychosis. 298 healthy adolescents were assessed at age 14- and 19-years using fMRI while performing a facial emotion task. Psychotic-like experiences (PLEs) were assessed with the CAPE-42 questionnaire at age 19. The high PLEs group at age 19 years exhibited an enhanced response in right insular cortex and decreased response in right prefrontal, right parahippocampal and left striatal regions; also, a gradient of decreasing response to emotional faces with age, from 14 to 19 years, in the right parahippocampal region and left insular cortical area. The right insula demonstrated an increasing response to emotional faces with increasing age in the low PLEs group, and a decreasing response over time in the high PLEs group. The change in parahippocampal/amygdala and insula responses during the perception of emotional faces in adolescents with high PLEs between the ages of 14 and 19 suggests a potential ‘aberrant’ neurodevelopmental trajectory for critical limbic areas. Our findings emphasize the role of the frontal and limbic areas in the aetiology of psychotic symptoms, in subjects without the illness phenotype and the confounds introduced by antipsychotic medication

Genome-wide association and HLA fine-mapping studies identify risk loci and genetic pathways underlying allergic rhinitis

Allergic rhinitis is the most common clinical presentation of allergy, affecting 400 million people worldwide, with increasing incidence in westernized countries1,2. To elucidate the genetic architecture and understand the underlying disease mechanisms, we carried out a meta-analysis of allergic rhinitis in 59,762 cases and 152,358 controls of European ancestry and identified a total of 41 risk loci for allergic rhinitis, including 20 loci not previously associated with allergic rhinitis, which were confirmed in a replication phase of 60,720 cases and 618,527 controls. Functional annotation implicated genes involved in various immune pathways, and fine mapping of the HLA region suggested amino acid variants important for antigen binding. We further performed genome-wide association study (GWAS) analyses of allergic sensitization against inhalant allergens and nonallergic rhinitis, which suggested shared genetic mechanisms across rhinitis-related traits. Future studies of the identified loci and genes might identify novel targets for treatment and prevention of allergic rhinitis

Association of Genetic Variants With Primary Open-Angle Glaucoma Among Individuals With African Ancestry.

Importance:Primary open-angle glaucoma presents with increased prevalence and a higher degree of clinical severity in populations of African ancestry compared with European or Asian ancestry. Despite this, individuals of African ancestry remain understudied in genomic research for blinding disorders. Objectives:To perform a genome-wide association study (GWAS) of African ancestry populations and evaluate potential mechanisms of pathogenesis for loci associated with primary open-angle glaucoma. Design, Settings, and Participants:A 2-stage GWAS with a discovery data set of 2320 individuals with primary open-angle glaucoma and 2121 control individuals without primary open-angle glaucoma. The validation stage included an additional 6937 affected individuals and 14 917 unaffected individuals using multicenter clinic- and population-based participant recruitment approaches. Study participants were recruited from Ghana, Nigeria, South Africa, the United States, Tanzania, Britain, Cameroon, Saudi Arabia, Brazil, the Democratic Republic of the Congo, Morocco, Peru, and Mali from 2003 to 2018. Individuals with primary open-angle glaucoma had open iridocorneal angles and displayed glaucomatous optic neuropathy with visual field defects. Elevated intraocular pressure was not included in the case definition. Control individuals had no elevated intraocular pressure and no signs of glaucoma. Exposures:Genetic variants associated with primary open-angle glaucoma. Main Outcomes and Measures:Presence of primary open-angle glaucoma. Genome-wide significance was defined as P < 5 × 10-8 in the discovery stage and in the meta-analysis of combined discovery and validation data. Results:A total of 2320 individuals with primary open-angle glaucoma (mean [interquartile range] age, 64.6 [56-74] years; 1055 [45.5%] women) and 2121 individuals without primary open-angle glaucoma (mean [interquartile range] age, 63.4 [55-71] years; 1025 [48.3%] women) were included in the discovery GWAS. The GWAS discovery meta-analysis demonstrated association of variants at amyloid-β A4 precursor protein-binding family B member 2 (APBB2; chromosome 4, rs59892895T>C) with primary open-angle glaucoma (odds ratio [OR], 1.32 [95% CI, 1.20-1.46]; P = 2 × 10-8). The association was validated in an analysis of an additional 6937 affected individuals and 14 917 unaffected individuals (OR, 1.15 [95% CI, 1.09-1.21]; P < .001). Each copy of the rs59892895*C risk allele was associated with increased risk of primary open-angle glaucoma when all data were included in a meta-analysis (OR, 1.19 [95% CI, 1.14-1.25]; P = 4 × 10-13). The rs59892895*C risk allele was present at appreciable frequency only in African ancestry populations. In contrast, the rs59892895*C risk allele had a frequency of less than 0.1% in individuals of European or Asian ancestry. Conclusions and Relevance:In this genome-wide association study, variants at the APBB2 locus demonstrated differential association with primary open-angle glaucoma by ancestry. If validated in additional populations this finding may have implications for risk assessment and therapeutic strategies