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Negative symptoms are often found in youth at clinical high risk (CHR) for psychosis. The present study explored the feasibility of using tDCS in conjunction with CBT in the treatment of negative symptoms in 5 youths at CHR. We sought to determine whether the protocol was feasible given the requirement for repeated visits over a three-week period, and to determine if measures of neurobiological change could be included, both acutely and following three weeks of stimulation. The results from this study suggest that the protocol is feasible for these youth, and the inclusion of MRI scanning sessions yielded good quality data., Competing Interests: Declaration of competing interest P.D.M., M.M.D., K.B., S.B., F.M., A.H., and J.A. have nothing to declare. A.M. is founder and shareholder of MCGRx Corp., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Aim: To harmonize two ascertainment and severity rating instruments commonly used for the clinical high risk syndrome for psychosis (CHR-P): the Structured Interview for Psychosis-risk Syndromes (SIPS) and the Comprehensive Assessment of At-Risk Mental States (CAARMS)., Methods: The initial workshop is described in the companion report from Addington et al. After the workshop, lead experts for each instrument continued harmonizing attenuated positive symptoms and criteria for psychosis and CHR-P through an intensive series of joint videoconferences., Results: Full harmonization was achieved for attenuated positive symptom ratings and psychosis criteria, and modest harmonization for CHR-P criteria. The semi-structured interview, named Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS (PSYCHS), generates CHR-P criteria and severity scores for both CAARMS and SIPS., Conclusions: Using the PSYCHS for CHR-P ascertainment, conversion determination, and attenuated positive symptom severity rating will help in comparing findings across studies and in meta-analyses., (© 2023 The Authors. Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd.)

Aim: Difficulties in social functioning have been observed in youth at clinical high-risk (CHR) of psychosis even in those who do not go on to develop a psychotic illness. Few treatment studies have attempted to improve social functioning in this population. The aim of this study was to conduct a randomized trial comparing the effects of Cognitive-Behavioral Social Skills Training (CBSST) with a supportive therapy (ST)., Methods: Both CBSST and ST were weekly group therapies, delivered over 18 weeks. This was a 2-arm trial with single-blinded ratings and intention-to-treat analyses. Assessments occurred at baseline, end-of-treatment, and 12 months after the baseline assessment. The primary outcome was social and role functioning and defeatist performance attitudes were the secondary outcome. Attenuated positive and negative symptoms, anxiety, depression, self-efficacy, and beliefs about self and others were examined as exploratory outcomes., Results: There were no significant differences between the 2 groups at baseline or either of the 2 follow-ups. However, at follow-ups, in each group there were significant improvements in clinical symptoms. These could not be attributed to group treatment since there was no control or wait-list group., Conclusions: Since poor social functioning is one of the most observed difficulties in CHR individuals, and a decline in social functioning may be a significant predictor of later transition to psychosis, future work will be needed to find effective treatments for this decline in functioning for CHR youth., (© The Author(s) 2023. Published by Oxford University Press on behalf of the University of Maryland's school of medicine, Maryland Psychiatric Research Center.)

Aim: To harmonize two ascertainment and severity rating instruments commonly used for the clinical high risk syndrome for psychosis (CHR-P): the Structured Interview for Psychosis-risk Syndromes (SIPS) and the Comprehensive Assessment of At-Risk Mental States (CAARMS)., Methods: The initial workshop is described in the companion report from Addington et al. After the workshop, lead experts for each instrument continued harmonizing attenuated positive symptoms and criteria for psychosis and CHR-P through an intensive series of joint videoconferences., Results: Full harmonization was achieved for attenuated positive symptom ratings and psychosis criteria, and partial harmonization for CHR-P criteria. The semi-structured interview, named P ositive SY mptoms and Diagnostic Criteria for the C AARMS H armonized with the S IPS (PSYCHS), generates CHR-P criteria and severity scores for both CAARMS and SIPS., Conclusion: Using the PSYCHS for CHR-P ascertainment, conversion determination, and attenuated positive symptom severity rating will help in comparing findings across studies and in meta-analyses.

The North American Prodrome Longitudinal Study (NAPLS) is a consortium of nine programs focusing on youth at clinical high risk (CHR) for psychosis. Funded by the National Institute of Mental Health (NIMH), the sites are located at Emory University, Harvard University, University of Calgary, University of California at Los Angeles, at San Diego, and at San Francisco, University of North Carolina Chapel Hill, Yale University, and Zucker Hillside Hospital. There have been two previous endeavors completed by this consortium, known as NAPLS-1 and NAPLS-2. This paper first offers an overview of the methodology of the third phase of the NAPLS consortium, the second five-year prospective study NAPLS-3, which aims to determine mechanisms of the development of psychosis. In addition, we report on the ascertainment and demographics of the 710 CHR participants in NAPLS-3., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Aim: Poor functioning has become a hallmark of many youth at clinical high-risk (CHR) of psychosis. Even for those who do not make the transition to psychosis remain troubled by functional deficits and a decline in functioning increases the odds of transitioning to psychosis. There are very few treatment studies that have attempted to improve social and role functioning. The aim of this paper is to describe the methods of a treatment study to address social and role functioning in CHR., Methods: This was a randomized controlled trial of cognitive-behavioural social skills training (CBSST) versus a supportive therapy. CBSST combines elements of cognitive behaviour therapy (CBT) and social skills training (SST), two evidence-based treatments for schizophrenia. By adding CBT to SST to target functioning outcomes, SST can be used to train new social skills, and thoughts that interfere with skilled performance in the real world can be addressed using CBT. We developed an adapted version of CBSST, more appropriate for the age range and illness severity of typical CHR individuals, to attempt to show improvements in social and role functioning for these young people., Results: Two hundred and three participants were recruited for this study. Results include initial baseline data., Conclusion: This article describes the baseline methodology of a CHR youth who have difficulties in social and/or role functioning. It is one of the first clinical trials to address this significant problem., (© 2021 John Wiley & Sons Australia, Ltd.)

Impairments in social functioning are a core impairment in psychosis and are associated with poor outcomes. These deficits are found in those at clinical high-risk (CHR) for psychosis, and can persist even in the absence of transition. However, the neurobiological underpinnings of social functioning remain unclear, therefore we conducted a systematic review of brain metrics that have been associated with social functioning in youth at CHR for psychosis. Five databases (MEDLINE, CINAHL, EBM reviews, Embase, and PsycINFO) were searched from inception to May 5, 2020. Studies were selected if they examined brain imaging, and social functioning in youth at CHR for psychosis. Of the 9629 citations found through online database searching, 12 studies with 696 CHR participants met inclusion criteria. Too few studies were focused on the same brain region using the same methodology to perform a meta-analysis, however, loci within the prefrontal cortex were most often associated with social functioning. Few studies have linked social functioning to brain imaging metrics, suggesting that future work should focus on this relationship., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Aim: To investigate sleep behaviours of youth at-risk for serious mental illness (SMI)., Methods: This study included 243 youth, ages 12 to 25:42 healthy controls, 41 asymptomatic youth at-risk for mental illness (stage 0); 53 help-seeking youth experiencing distress (stage 1a) and 107 youth with attenuated syndromes (stage 1b). The Pittsburgh Sleep Quality Index was used to assess sleep dysfunction., Results: Stage 1b individuals indicated the greatest deficit in global sleep dysfunction (F = 26.18, P < .0001). Stages 1a and 1b reported significantly worse subjective sleep quality, a longer sleep latency, increased use of sleep medications as well as greater daytime dysfunction compared to the asymptomatic groups., Conclusion: Research investigating sleep behaviours of youth considered to be at-risk for SMI is limited. This study provides early evidence that sleep disturbances are worse for individuals considered to be at higher risk of illness development., (© 2019 John Wiley & Sons Australia, Ltd.)

The Ultima TPS MoM THR was designed and developed as a 2nd generation MoM THR specifically aimed at younger more active patients due to the anticipated low wear rates and increased longevity of MoM THRs. In 2010, published clinical data highlighted the early failure of the Ultima TPS MoM due to fretting-crevice corrosion at the stem-cement interface. Since 2010 similar observations have been reported by other clinical centres implicating competitor products as well as the Ultima TPS MoM THR. In an attempt to replicate the electrochemical reaction and interactions established across MoM THR systems, fretting-crevice corrosion tests subjected to galvanic coupling were conducted. Galvanic coupling was seen to significantly increase the rates of corrosion under static and dynamic conditions. This was due to the large potential differences developed across the system between active and passive areas, increasing the rates of corrosion and metallic ion release from the stem-cement interface., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

This study presents the characterisation of the surface topography, tomography and chemistry of fretting corrosion product found on retrieved polished femoral stems. Scanning Electron Microscopy (SEM), X-ray Photoelectron Spectroscopy (XPS), Transmission Electron Microscopy (TEM) and Fourier Transform Infrared Spectroscopy (FI-IR) were utilised in order to assess the surface morphology of retrieved Metal-on-Metal Total Hip Replacements and surface chemistry of the films found on the surface. Gross slip, plastic deformation and directionality of the surface were extensively seen on the proximal surfaces of the retrievals. A more corrosive phenomenon was observed in the distal regions of the stem, demonstrating a seemingly intergranular attack. Tribochemical reactions were seen to occur within the stem-cement interfaces with tribofilms being observed on the femoral stem and counterpart PMMA bone cement. XPS, TEM-EDX and FT-IR analyses demonstrated that the films present in the stem surfaces were a complex mixture of chromium oxide and amorphous organic material. A comparison between current experimental and clinical literature has been conducted and findings from this study demonstrate that the formation and chemistry of films are drastically influenced by the type of wear or degradation mechanism. Films formed in the stem-cement interface are thought to further influence the biological environment outside the stem-cement interface due to the formation of Cr and O rich films within the interface whilst Co is free to migrate away., (© 2013 Elsevier Ltd. All rights reserved.)

In this study, five commercially available poly(methyl methacrylate) PMMA bone cements were tested to investigate the effects of antibiotics on the severity of crevice corrosion. Bone cements with varying chemistry were also tested. A test method was developed in part reference to ASTM F746-04. Cylindrical specimens were fitted with a bone cement tapered collar, creating consistent crevice conditions. Crevice corrosion was then studied using potentiodynamic polarization techniques in 0.9% NaCl solution (pH7.4) at 37°C. Surface analyses using a light microscope and scanning electron microscopy were also conducted to investigate the surface morphology after accelerated electrochemical testing. Initial testing of commercially available bone cements indicated that different PMMA bone cements can affect the initiation and propagation mechanism of crevice corrosion. Further studies, utilising electrochemical and mass spectroscopy techniques, have identified that the addition of radiopaque agent and antibiotics affect the initiation mechanisms of 316L stainless steel, whilst significantly increasing the extent of propagation in CoCrMo alloys., (Copyright © 2013 Wiley Periodicals, Inc.)

Aim: The purpose of this study was to undertake a first step in trying to understand the types of treatments young people at clinical high risk of psychosis are interested in pursuing., Methods: The sample consisted of 30 young people who were current participants in the ongoing North American Prodrome Longitudinal Study (NAPLS 2) and who met criteria for being at clinical high risk for psychosis. Participants were administered a questionnaire that asked them to identify the types of mental health problems they were currently getting help with or would like to get help with and the types of treatments they thought would be helpful and may be interested in receiving., Results: Results showed that when individuals first began participation in NAPLS, almost half had no expectations for treatment. They wanted help but they did not really know what kind of help to be asking for. Participants had a wide range of concerns for which they wanted help. Although a majority endorsed attenuated positive symptoms as a concern, many other issues such a family and social problems were often identified. For those who were already receiving help, the general opinion was that it was beneficial., Conclusions: The findings suggest that this population sees many different interventions as being potentially helpful. Furthermore, they are open to participating in a variety of treatments, including psychotherapeutic and psychiatric interventions as well as more general treatments addressing a range of possible deficits or difficulties., (© 2012 Wiley Publishing Asia Pty Ltd.)

Objective: To assess the effect of gynecologists' sex on their clinical opinions of hysterectomy., Study Design: A survey presenting a case of symptomatic uterine leiomyomas was randomly mailed to the fellows of the American College of Obstetricians and Gynecologists, who were asked to choose either hysterectomy or any uterus-sparing modality for the treatment of the presented case. The effects of gynecologists' sex, age, race, type and year of training, practice type, location and region on their clinical opinions were evaluated with univariate and multivariate logistic regression analysis., Results: Among the 500 potential respondents, 245 (49.0%) responses were complete for analysis. One hundred forty-seven (60.0%) were males, and 98 (40.0%) were females. Hysterectomy choice was not significantly influenced by the gynecologist's sex (77.6% vs. 87.1%; OR 0.51; 95% CI 0.26, 1.01). Univariate logistic regression analysis indicated that only younger age and being in an academic practice significantly decreased the hysterectomy choice among the participants. In the multivariate model, both age (OR 1.66; 95% CI 1.27, 2.19) and academic practice type (OR 0.37; 95% CI 0.14, 0.94) remained independently significant., Conclusion: When presented with a case involving symptomatic leiomyomas, gynecologists' sex did not significantly affect their opinion for or against hysterectomy. Only age and practice type were independently significant in this decision making.

The results of hip simulator tests on a total of 16 total hip joints, all of them 22.25 mm Charnley designs, are presented. Wear at up to 6.75 million cycles was assessed by using a coordinate measuring machine. The results gave good agreement with clinical estimates of wear rate on the same design of joint replacement from a number of sources. Good agreement was also obtained when comparison was made with the published results from more sophisticated simulators. The major source of variation in the results was found to occur in the first million cycles where creep predominates. The results of this study support the use of this type of simplified simulator for estimating wear in a total hip prosthesis. The capability to test a significant number of joints simultaneously may make this mechanism preferable to more complex machines in many cases.

A number of total hip components explanted at revision with bearing surfaces in either cobalt-chromium-molybdenum alloy or titanium-6% aluminium-4% vanadium alloy were examined and compared to contemporaneously manufactured but unused items; particular attention was paid to the bearing surfaces which were examined visually, by low-power microscopy, scanning electron microscopy (SEM), confocal microscopy, white light interferometry, laser profilometry and conventional stylus profilometry. The cobalt alloy heads maintained their surface finish well over periods up to 12 years. The titanium implants became badly damaged over much shorter periods although even badly scratched heads continued to meet the current standards for titanium alloy heads. Analysis showed that the damage to the titanium alloy heads was not a random but a well-defined process of scarring of a consistent size created by abrasion with small particles of bone. These damaged heads had the potential to wear the matching UHMWPE components rapidly creating large amounts of polymer debris. The finding that measurement of these damaged heads is within current standards raises concerns as to whether current standards incorporate fully the requirements for clinical performance.

The wear of ultra high molecular weight polyethylene (UHMWPE) when sliding against zirconia ceramic and stainless steel counterfaces has been compared in a pin-on-plate reciprocator and in a hip joint simulator. A lower wear factor was found for the UHMWPE when sliding on the zirconia ceramic counterfaces in the pin-on-plate tests. In the hip joint simulator test, the acetabular cups articulating on zirconia heads showed consistently lower volume changes than the cups articulating on stainless steel heads. The higher volume changes found with the stainless steel heads were associated with an increased roughness of the femoral heads during the tests. This roughening was caused by the adherence of a rough polymer transfer film.