Attention Shaping: a Reward-Based Learning Method to Enhance Skills Training Outcomes in Schizophrenia

Disturbances in sustained attention commonly interfere with the ability of persons with schizophrenia to benefit from evidence-based psychosocial treatments. Cognitive remediation interventions have thus far demonstrated minimal effects on attention, as have medications. There is thus a gap between the existence of effective psychosocial treatments and patients’ ability to effectively engage in and benefit from them. We report on the results of a multisite study of attention shaping (AS), a behavioral intervention for improving attentiveness and learning of social skills among highly distractible schizophrenia patients. Patients with chronic schizophrenia who were refractory to skills training were assigned to receive either the UCLA Basic Conversation Skills Module (BCSM) augmented with AS (n = 47) or in the standard format (n = 35). AS, a reward-based learning procedure, was employed to facilitate patients’ meeting clearly defined and individualized attentiveness and participation goals during each session of a social skills training group. Primary outcome measures were observational ratings of attentiveness in each session and pre- and post-BCSM ratings of social skill and symptoms. Patients receiving social skills training augmented with AS demonstrated significantly more attentiveness in group sessions and higher levels of skill acquisition; moreover, significant relationships were found between changes in attentiveness and amount of skills acquired. Changes in attentiveness were unrelated to level or change in antipsychotic medication dose. AS is an effective example of supported cognition, in that cognitive abilities are improved within the environmental context where the patient is experiencing difficulty, leading to gains in both attention and functional outcome

Attention Shaping: a Reward-Based Learning Method to Enhance Skills Training Outcomes in Schizophrenia

Disturbances in sustained attention commonly interfere with the ability of persons with schizophrenia to benefit from evidence-based psychosocial treatments. Cognitive remediation interventions have thus far demonstrated minimal effects on attention, as have medications. There is thus a gap between the existence of effective psychosocial treatments and patients’ ability to effectively engage in and benefit from them. We report on the results of a multisite study of attention shaping (AS), a behavioral intervention for improving attentiveness and learning of social skills among highly distractible schizophrenia patients. Patients with chronic schizophrenia who were refractory to skills training were assigned to receive either the UCLA Basic Conversation Skills Module (BCSM) augmented with AS (n = 47) or in the standard format (n = 35). AS, a reward-based learning procedure, was employed to facilitate patients’ meeting clearly defined and individualized attentiveness and participation goals during each session of a social skills training group. Primary outcome measures were observational ratings of attentiveness in each session and pre- and post-BCSM ratings of social skill and symptoms. Patients receiving social skills training augmented with AS demonstrated significantly more attentiveness in group sessions and higher levels of skill acquisition; moreover, significant relationships were found between changes in attentiveness and amount of skills acquired. Changes in attentiveness were unrelated to level or change in antipsychotic medication dose. AS is an effective example of supported cognition, in that cognitive abilities are improved within the environmental context where the patient is experiencing difficulty, leading to gains in both attention and functional outcome

M & L Jaargang 9/6

GeneriekMichel Asperges en Robert Berten De storten van steenkoolmijnen en hun vegetaties. [Coal-mining waste dumps and their vegetation.]Tot de merkwaardige familie van natuurwetenschappelijk waardevolle residuele sites horen naast de klei- en grindgroeven of afgedane spoorwegbeddingen intussen ook de mijnterrils. Reeds langer een bevoorrechte verzamelplaats van fossiele plantenresten bieden ze aan eigentijdse soorten sinds hun op-rust-stelling een eigen, moeizaam verworven biotoop. Twee auteurs Michel Asperges en Robert Berten illustreren alvast deze aspecten van overigens nauwelijks toegankelijke reservaten.Herman van Meer en Jos Gyselinck De rehabilitatie van het huis Stellingwerff-Waerdenhof te Hasselt. Een vernieuwde dialoog. [Rehabilitation of the Stellingwerff-Waerdenhof mansion in Hasselt: a renewed dialogue.]Geconfronteerd met de eenvormige eindbestemming een Hasselts stadsmuseum en de historisch op elkaar geënte huizen Stellingwerff en Waerdenhof, aanvaardde architect Herman van Meer de dubbelbodemige uitdaging.Zijn actualisering van dit reeds lange tijd zieltogend monument bleef sedertdien geenszins onopgemerkt. Geruggensteund door Jos Gyselinck en verhelderende fotos belicht hij stapvoets een bespreekbare heropstanding.Paul Vandenbroeck De salette of pronkkamer in het 17de-eeuws Brabantse burgerhuis. Familie- en groepsportretten als iconografische bron, omstreeks 1640-1680. [The salette or stateroom in the 17th century bourgeois house in Brabant. Family and group portraits as iconographical sources, about 1640-1680.]Niet de winterse eindejaarskoude maar een vernieuwd kunsthistorisch inzicht houden Paul Vandenbrouck met een frappante portrettengalerij binnenskamers. Dat de betergestelde 17de-eeuwse burger de fraaiste ruimte van zijn woning koos tot kader van een kunstige vereeuwiging moge dan vanzelfsprekend lijken: de bij dezer aangetoonde waarheidsgetrouwe weergave blijkt daarentegen onvermoed van niet te schatten documentair belang.SummaryM&L Binnenkran

Re-annotation of 191 developmental and epileptic encephalopathy-associated genes unmasks de novo variants in SCN1A

Funder: Agency for Innovation by Science and Technology, IWTFunder: U.S. Department of Health & Human Services | NIH | National Human Genome Research Institute (NHGRI)Funder: BOF-University of Antwerp (FFB180053) and FWO (1861419N).Abstract: The developmental and epileptic encephalopathies (DEE) are a group of rare, severe neurodevelopmental disorders, where even the most thorough sequencing studies leave 60–65% of patients without a molecular diagnosis. Here, we explore the incompleteness of transcript models used for exome and genome analysis as one potential explanation for a lack of current diagnoses. Therefore, we have updated the GENCODE gene annotation for 191 epilepsy-associated genes, using human brain-derived transcriptomic libraries and other data to build 3,550 putative transcript models. Our annotations increase the transcriptional ‘footprint’ of these genes by over 674 kb. Using SCN1A as a case study, due to its close phenotype/genotype correlation with Dravet syndrome, we screened 122 people with Dravet syndrome or a similar phenotype with a panel of exon sequences representing eight established genes and identified two de novo SCN1A variants that now - through improved gene annotation - are ascribed to residing among our exons. These two (from 122 screened people, 1.6%) molecular diagnoses carry significant clinical implications. Furthermore, we identified a previously classified SCN1A intronic Dravet syndrome-associated variant that now lies within a deeply conserved exon. Our findings illustrate the potential gains of thorough gene annotation in improving diagnostic yields for genetic disorders

A sharp MLS penalty immersed finite element method for fluid-structure interaction of highly deformable slender body in turbulent flow

This paper presents a new computational approach to simulate challenging fluid-structure interactions (FSI) between fluids and slender deformable structures. Key innovations address limitations of standard immersed boundary methods, including spurious forces, stability at low density ratios, and accuracy at high Reynolds numbers. The method couples a sharp interface immersed boundary technique with detached eddy simulation turbulence modelling to enable precise FSI for high Reynolds number flows. A strong coupling partitioned algorithm stabilized by Aitken relaxation significantly enhances stability for low density ratios down to 1. A moving least square compact support domain approximation reduces spurious oscillations from moving geometries while providing second-order accuracy. Adaptive mesh refinement imposes jump conditions on slim deformable bodies and minimizes grid leakage. The proposed method is evaluated on three conventional FSI benchmarks and four experimental cases, confirming its robustness, accuracy, and stability in low and significantly high Reynolds numbers. A more complex fluids engineering case is considered last to test the solution under challenging conditions with fast moving solid boundaries and fast flowing fluid. A thin deformable membrane is forced through a submersible centrifugal pump under standard operating conditions. The solution is shown to produce a stable solution with good collision handling ability