Do cognitive impairments limit treatment gains in a standalone digital intervention for psychosis? A test of the digital divide

Digital mental health interventions, such as those provided by smartphone applications (apps), show promise as cost-effective approaches to increasing access to evidence-based psychosocial interventions for psychosis. Although it is well known that limited financial resources can reduce the benefits of digital approaches to mental healthcare, the extent to which cognitive functioning in this population could impact capacity to engage in and benefit from these interventions is less studied. In the current study we examined the extent to which cognitive functioning (premorbid cognitive abilities and social cognition) were related to treatment engagement and outcome in a standalone digital intervention for social functioning. Premorbid cognitive abilities generally showed no association with aggregated treatment engagement markers, including proportion of notifications responded to and degree of interest in working on app content, though there was a small positive association with improvements in social functioning. Social cognition, as measured using facial affect recognition ability, was unrelated to treatment engagement or outcome. These preliminary findings suggest that cognitive functioning is generally not associated with engagement or outcomes in a standalone digital intervention designed for and with people with schizophrenia spectrum disorders.Accepted manuscrip

Oral iron acutely elevates bacterial growth in human serum.

Iron deficiency is the most common nutrient deficiency worldwide and routine supplementation is standard policy for pregnant mothers and children in most low-income countries. However, iron lies at the center of host-pathogen competition for nutritional resources and recent trials of iron administration in African and Asian children have resulted in significant excesses of serious adverse events including hospitalizations and deaths. Increased rates of malaria, respiratory infections, severe diarrhea and febrile illnesses of unknown origin have all been reported, but the mechanisms are unclear. We here investigated the ex vivo growth characteristics of exemplar sentinel bacteria in adult sera collected before and 4 h after oral supplementation with 2 mg/kg iron as ferrous sulfate. Escherichia coli, Yersinia enterocolitica and Salmonella enterica serovar Typhimurium (all gram-negative bacteria) and Staphylococcus epidermidis (gram-positive) showed markedly elevated growth in serum collected after iron supplementation. Growth rates were very strongly correlated with transferrin saturation (p < 0.0001 in all cases). Growth of Staphylococcus aureus, which preferentially scavenges heme iron, was unaffected. These data suggest that even modest oral supplements with highly soluble (non-physiological) iron, as typically used in low-income settings, could promote bacteremia by accelerating early phase bacterial growth prior to the induction of immune defenses

Why the idea of framework propositions cannot contribute to an understanding of delusions

One of the tasks that recent philosophy of psychiatry has taken upon itself is to extend the range of understanding to some of those aspects of psychopathology that Jaspers deemed beyond its limits. Given the fundamental difficulties of offering a literal interpretation of the contents of primary delusions, a number of alternative strategies have been put forward including regarding them as abnormal versions of framework propositions described by Wittgenstein in On Certainty. But although framework propositions share some of the apparent epistemic features of primary delusions, their role in partially constituting the sense of inquiry rules out their role in helping to understand delusions

The Multidimensional Study of Viral Campaigns as Branching Processes

Viral campaigns on the Internet may follow variety of models, depending on the content, incentives, personal attitudes of sender and recipient to the content and other factors. Due to the fact that the knowledge of the campaign specifics is essential for the campaign managers, researchers are constantly evaluating models and real-world data. The goal of this article is to present the new knowledge obtained from studying two viral campaigns that took place in a virtual world which followed the branching process. The results show that it is possible to reduce the time needed to estimate the model parameters of the campaign and, moreover, some important aspects of time-generations relationship are presented.Comment: In proceedings of the 4th International Conference on Social Informatics, SocInfo 201

Expression of Growth Factors and Growth Factor Receptor in Non-healing and Healing Ischaemic Ulceration

AbstractObjectivesTo characterise the histological and cytokinetic characteristics of purely ischaemic ulcers and the processes that underpin healing following successful revascularisation.DesignProspective observational study.Materials and methodsBiopsies were taken immediately pre- and 6 weeks following successful revascularisation of solely ischaemic ulceration. They were evaluated for morphological differences using H&E staining for the platelet derived growth factor receptor (PDGFR), epidermal growth factor receptor (EGFR), TGFβreceptorIII (TGFβRIII), transforming growth factor beta 1 and 3 (TGFβ1 and TGFβ3) and von Willebrand factor (vWF) expression using immunohistochemistry. Localisation and quantification of these growth factors and receptors was assessed systematically by three independent investigators who were blinded to the timing of biopsy.ResultsPre-operatively, small vessel vasculitis, necrosis and infection with a profuse neutrophil and macrophage infiltrate was observed in all samples. Post-operative biopsies revealed a proliferation of new capillaries in and around the ulcer edge and base. vWF staining confirmed an endothelial layer within these new vessels. Following successful revascularisation there was less infection and inflammation with minimal vasculitis. These newly formed capillaries had increased staining for TGFβ3, PDGFR and TGFβRIII with staining for PDGFR also localised to dermal fibroblasts which were larger and more numerous. Accelerated epithelial cell proliferation was observed with detachment from the underlying dermis.ConclusionsHealing of purely ischaemic ulcers is characterised by vasculogenesis associated with increased presence of the proangiogenic cytokines PDGF and TGFβ3. These findings show promise for the use of growth factor manipulation to aid healing in ischaemic ulcers

Contralateral fatigue during severe-intensity single-leg exercise: influence of acute acetaminophen ingestion

Exhaustive single-leg exercise has been suggested to reduce time to task failure (Tlim) during subsequent exercise in the contralateral leg by exacerbating central fatigue development. We investigated the influence of acetaminophen (ACT), an analgesic which may blunt central fatigue development, on Tlim during single-leg exercise completed both with, and without, prior fatiguing exercise of the contralateral leg. Fourteen recreationally-active men performed single-leg, severe-intensity knee extensor exercise to Tlim on the left (Leg1) and right (Leg2) legs without prior contralateral fatigue, and on Leg2 immediately following Leg1 (Leg2- CONTRA). The tests were completed following ingestion of 1 g ACT or maltodextrin (placebo) capsules. Intramuscular phosphorous-containing metabolites and substrates, and muscle activation, were assessed using 31 P-MRS and electromyography, respectively. Tlim was not different between the Leg1ACT and Leg1PL conditions (402 ± 101 vs. 390 ± 106 s; P=0.11). There was also no difference in Tlim between Leg2ACT-CONTRA and Leg2PL-CONTRA (324 ± 85 vs. 311 ± 92 s; P=0.10), but Tlim was shorter in these tests compared to Leg2CON (385 ± 104 s; both P<0.05). There were no differences in intramuscular phosphorous-containing metabolites and substrates, or muscle activation, between the Leg1ACT and Leg1PL or the Leg2ACT-CONTRA and Leg2PL-CONTRA conditions (all P>0.05). These findings suggest that levels of metabolic perturbation and muscle activation are not different at task failure during single leg severe-intensity knee extensor exercise completed with or without prior fatiguing exercise of the contralateral leg. Despite the existence of contralateral fatigue, ACT ingestion did not alter neuromuscular responses or exercise performance