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Objectives: Communication requires cognitive processes which are not captured by traditional speech understanding tests. Under challenging listening situations, more working memory resources are needed to process speech, leaving fewer resources available for storage. The aim of the current study was to investigate the effect of task difficulty predictability, that is, knowing versus not knowing task difficulty in advance, and the effect of noise reduction on working memory resource allocation to processing and storage of speech heard in background noise. For this purpose, an "offline" behavioral measure, the Sentence-Final Word Identification and Recall (SWIR) test, and an "online" physiological measure, pupillometry, were combined. Moreover, the outcomes of the two measures were compared to investigate whether they reflect the same processes related to resource allocation., Design: Twenty-four experienced hearing aid users with moderate to moderately severe hearing loss participated in this study. The SWIR test and pupillometry were measured simultaneously with noise reduction in the test hearing aids activated and deactivated in a background noise composed of four-talker babble. The task of the SWIR test is to listen to lists of sentences, repeat the last word immediately after each sentence and recall the repeated words when the list is finished. The sentence baseline dilation, which is defined as the mean pupil dilation before each sentence, and task-evoked peak pupil dilation (PPD) were analyzed over the course of the lists. The task difficulty predictability was manipulated by including lists of three, five, and seven sentences. The test was conducted over two sessions, one during which the participants were informed about list length before each list (predictable task difficulty) and one during which they were not (unpredictable task difficulty)., Results: The sentence baseline dilation was higher when task difficulty was unpredictable compared to predictable, except at the start of the list, where there was no difference. The PPD tended to be higher at the beginning of the list, this pattern being more prominent when task difficulty was unpredictable. Recall performance was better and sentence baseline dilation was higher when noise reduction was on, especially toward the end of longer lists. There was no effect of noise reduction on PPD., Conclusions: Task difficulty predictability did not have an effect on resource allocation, since recall performance was similar independently of whether task difficulty was predictable or unpredictable. The higher sentence baseline dilation when task difficulty was unpredictable likely reflected a difference in the recall strategy or higher degree of task engagement/alertness or arousal. Hence, pupillometry captured processes which the SWIR test does not capture. Noise reduction frees up resources to be used for storage of speech, which was reflected in the better recall performance and larger sentence baseline dilation toward the end of the list when noise reduction was on. Thus, both measures captured different temporal aspects of the same processes related to resource allocation with noise reduction on and off., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2021 The Authors. Ear & Hearing is published on behalf of the American Auditory Society, by Wolters Kluwer Health, Inc.)

A glomus tumour is a benign, small, rare tumour, primarily localised to the fingers. Literature describes a delayed diagnosis, and patients will describe a classic triad of symptoms: paroxysmal pain, hypersensitivity, and pinpoint pain at the location of the tumour. MRI can confirm the presence and the localisation of a glomus tumour, and an osseous defect can often be found by X-ray. If the patient show classic symptoms, exploratory surgery should be performed, despite negative radiology. Excision of the tumour will provide immediate pain relief and has a very low rate of recurrence.

Extracellular vesicles, including exosomes, have recently been implicated as novel mediators of immune cell communication in mammals. However, roles for endogenously produced exosomes in regulating immune cell functions in vivo are just beginning to be identified. In this article, we demonstrate that Rab27a and Rab27b double-knockout (Rab27DKO) mice that are deficient in exosome secretion have a chronic, low-grade inflammatory phenotype characterized by elevated inflammatory cytokines and myeloproliferation. Upon further investigation, we found that some of these phenotypes could be complemented by wild-type (WT) hematopoietic cells or administration of exosomes produced by GM-CSF-expanded bone marrow cells. In addition, chronically inflamed Rab27DKO mice had a blunted response to bacterial LPS, resembling endotoxin tolerance. This defect was rescued by bone marrow exosomes from WT, but not miR-155 -/- , cells, suggesting that uptake of miR-155-containing exosomes is important for a proper LPS response. Further, we found that SHIP1 and IRAK-M, direct targets of miR-155 that are known negative regulators of the LPS response, were elevated in Rab27DKO mice and decreased after treatment with WT, but not miR-155 -/- , exosomes. Together, our study finds that Rab27-dependent exosome production contributes to homeostasis within the hematopoietic system and appropriate responsiveness to inflammatory stimuli., (Copyright © 2017 by The American Association of Immunologists, Inc.)

MicroRNA-155 (miR-155) regulates antitumor immune responses. However, its specific functions within distinct immune cell types have not been delineated in conditional KO mouse models. In this study, we investigated the role of miR-155 specifically within T cells during the immune response to syngeneic tumors. We found that miR-155 expression within T cells is required to limit syngeneic tumor growth and promote IFNγ production by T cells within the tumor microenvironment. Consequently, we found that miR-155 expression by T cells is necessary for proper tumor-associated macrophage expression of IFNγ-inducible genes. We also found that immune checkpoint-blocking (ICB) antibodies against programmed cell death protein 1/programmed death ligand 1 (PD-1/PD-L1) and cytotoxic T lymphocyte-associated protein 4 (CTLA-4) restored antitumor immunity in miR-155 T cell-conditional KO mice. We noted that these ICB antibodies rescued the levels of IFNγ-expressing T cells, expression of multiple activation and effector genes expressed by tumor-infiltrating CD8 + and CD4 + T cells, and tumor-associated macrophage activation. Moreover, the ICB approach partially restored expression of several derepressed miR-155 targets in tumor-infiltrating, miR-155-deficient CD8 + T cells, suggesting that miR-155 and ICB regulate overlapping pathways to promote antitumor immunity. Taken together, our findings highlight the multifaceted role of miR-155 in T cells, in which it promotes antitumor immunity. These results suggest that the augmentation of miR-155 expression could be used to improve anticancer immunotherapies., (© 2017 by The American Society for Biochemistry and Molecular Biology, Inc.)

Purpose: Demonstrating the effectiveness of nutrition counselling is imperative, not only to promote successful patient outcomes but also to secure funding. This study therefore assessed the value and effectiveness of nutrition counselling., Methods: To measure clients' perceptions of the value of inpatient counselling, the Clients' Perceptions about Nutrition Counselling (CPNC) instrument was administered to 164 clients one week after hospital discharge. To determine if inpatient nutrition counselling is effective in promoting changes in eating behaviours, the same clients were asked to complete the Health Habits and History Questionnaire (HHHQ) before counselling and then at three and six months following discharge., Results: The majority of respondents who completed the CPNC indicated that the information provided by the dietitian was useful, that the dietitian was knowledgeable, and that they knew what to eat after speaking with the dietitian and had changed their diet according to the recommendations. From the HHHQ, respondents counselled for heart health diet modifications (n = 45) significantly lowered their intake of energy (p<0.002), fat, saturated fat, sodium, and cholesterol (all p<0.001) over time., Conclusions: These results suggest that inpatient nutrition counselling is perceived as valuable and results in positive dietary behaviours, the majority of which are sustained at six months.

Sea-Nine211 has been introduced as a new biocide in antifouling paints with an immediate degradation when it is released from ship hulls. The active component of Sea-Nine211 is 4,5-dichloro-2-n-octyl-isothiazoline-3-one (DCOI). In the present study, the toxicity of DCOI and the occurrence of Pollution Induced Community Tolerance (PICT) were tested in microcosms containing eutrophic coastal water with its natural composition of phytoplankton. The experiment was performed in closed systems with a single addition of the nominal concentrations 0, 3.2, 10, 32 and 100 nM DCOI, for a period of 16 days. Pollution induced community tolerance (PICT) was observed in the phytoplankton communities exposed to the nominal concentrations 32 and 100 nM DCOI. Chemical analysis of DCOI in the coastal water utilised in the toxicity and PICT experiment was performed by GC-MS using a solid- phase extraction method. Half-life was calculated to be 2.5 days for the nominal concentrations 32 and 100 nM DCOI. The results of the present study show that nominal concentrations of 32 and 100 nM DCOI significantly increased the community tolerance already after 2 days of exposure and that the tolerance was maintained for a period of 16 days even when DCOI was degraded during this period. The causes for the persistent tolerance are discussed in relation to the degradation of DCOI and structural changes in the phytoplankton communities.

Background: Findings from several sources suggest that depression lies on a continuum whereby mild and severe variants are thought to differ in severity (i.e., quantitatively), but not in kind (i.e., qualitatively). The current study used cluster analysis to extend this work to examination of depression symptom profiles obtained in distressed student 'analogue' samples and clinically depressed samples., Method: Patients with major depressive disorder (n = 101) provided seed points for the depressed cluster, and 176 non-distressed university students (Beck Depression Inventory score < or = 8) provided seed points for the non-depressed cluster. The symptom profiles of three levels of analogue depressed samples were then evaluated (BDI > or = 9, BDI > or = 16, and BDI > or = 21)., Results: Only 35.4% of BDI > or = 9 analogue respondents were empirically sorted to the depression cluster and the majority were assigned to the non-depressed cluster. The proportion assigned to the depression cluster increased to 70.5% and to 86.2% when higher BDI cutoffs of 16 and 21 were examined, respectively. The DSM-IV depression symptom profile of the BDI > or = 21 group was very similar to the profile defined by clinical patients., Limitations: The study relied solely on self-report to assess symptom severity., Conclusions: It is recommended that higher BDI cutoffs be utilized in analogue depression research than is currently common. On quantitative grounds, analogue subjects who were sorted to the clinically defined depression cluster seem to best represent the idea of depression continuity.

Background: The observer-rated Hamilton depression scale (HamD) and the self-report Beck Depression Inventory (BDI) are among the most commonly used rating scales for depression, and both have well demonstrated reliability and validity. However, many depressed subjects have discrepant scores on these two assessment methods. The present study evaluated the ability of demographic, clinical and personality factors to account for the discrepancies observed between BDI and HamD ratings., Method: The study group consisted of 94 SCID-diagnosed outpatients with a current major depressive disorder. Subjects were rated with the 21-item HamD and completed the BDI and the NEO-Five Factor Inventory., Results: Younger age, higher educational attainment, and depressive subtype (atypical, non-melancholic) were predictive of higher BDI scores relative to HamD observer ratings. In addition, high neuroticism, low extraversion and low agreeableness were associated with higher endorsement of depressive symptoms on the BDI relative to the HamD. In general, these predictive variables showed a greater ability to explain discrepancies between self and observer ratings of psychological symptoms of depression compared to somatic symptoms of depression., Limitations: The study does not determine which aspects of neuroticism and extraversion contribute to the observed BDI/HamD discrepancies., Conclusions: Depression ratings obtained with the BDI and HamD are frequently discordant and a number of patient characteristics robustly predict the discrepancy between these two rating methods. The value of multi-modal assessment in the conduct of research on depressive disorders is re-affirmed.

Objective: An association between anomalous parental bonding experiences (lack of parental care, overprotection, or both) and depression during adulthood has been observed in several studies. The objective of the present study was to evaluate several different personality dimensions as possible mediators of the relationship between perceptions of parental bonding and depressive symptoms in adulthood., Methods: Outpatients with depression (n = 138) completed the Parental Bonding Instrument (PBI), the Beck Depression Inventory (BDI), and several measures of proposed personality vulnerabilities to depression. The conceptual and methodological criteria of Baron and Kenny (1986) were used to assess possible mediating effects of personality variables., Results: In men, overprotection by their fathers was significantly associated with depression; neuroticism, socially prescribed perfectionism, and concern over mistakes acted as mediators of this relationship. In women, lack of care by their mothers was significantly associated with depression; self-criticism, socially prescribed perfectionism, and concern over mistakes mediated this relationship., Conclusions: The present study provides evidence that personality factors may mediate the observed relationship between parental rearing style and depression. These potential causal mechanisms warrant longitudinal evaluation.

This study examined the prevalence of functional gastrointestinal (FGI) disorders, and the association between FGI disorders and measures of affective distress, among a sample of 127 university students. Subjects completed a questionnaire battery including Research Diagnostic Questions for Functional Gastrointestinal Disorders, the Beck Anxiety Inventory, the Anxiety Sensitivity Index, the Beck Depression Inventory, and a medical utilization questionnaire. FGI disorders were diagnosed in 51.2% of the sample. Functional dyspepsia (22.8%), dyschezia (20.5%), functional heartburn (19.7%), functional chest pain (18.1%), and globus (12.6%) were the most frequently diagnosed disorders. Participants experiencing globus, functional dyspepsia, or functional heartburn showed significant differences in terms of anxiety, anxiety sensitivity, depression, and/or physician visits, when compared with participants without these disorders. Our results suggest that FGI disorders are strikingly prevalent among young adults, and specific FGI disorders are associated with affective distress. Implications of the observed association between psychological factors and FGI disorders are discussed.

The purpose of this article is to provide a general overview of the growing literature on the relationship between panic disorder and vestibular disturbance. This relationship has been examined from two distinct perspectives, including: (a) the assessment of vestibular dysfunction in patients with panic disorder; and (b) the evaluation of panic symptomatology in patients with vestibular disturbance. Consequently, this review focuses primarily on the literature pertaining to vestibular symptoms in patients with panic disorder and panic symptomatology in patients with vestibular complaints. Subsequent to this review we discuss clinical implications suggested by the data, outline recommendations for treatment, and highlight some directions for future investigation.

The literature indicates a substantial overlap between chronic pain and posttraumatic stress disorder (PTSD) symptoms in individuals who sustain accidental injury. To date, however, there have been no studies of PTSD symptoms in individuals who experience work-related injury. Consequently, we assessed 139 consecutive injured workers using the Modified PTSD Symptom Scale (Falsetti, Resnick, & Kirkpatrick, 1993), as well as a number of general measures of psychopathology. Most participants reported chronic pain and all were receiving workers compensation. Results indicated that 34.7% and 18.2% of the sample reported symptoms consistent with PTSD and partial PTSD, respectively. When PTSD symptom frequency and severity were considered criterion variables in multiple regression analyses, depression was found to be significantly associated with the former and anxiety sensitivity, social fears, and somatic focus with the later. Finally, these measures of general psychopathology correctly classified 78.6% of individuals with PTSD and 81.3% of those with no PTSD. These results suggest that a considerable proportion of injured workers display symptoms consistent with PTSD and that these symptoms are related to general negative affect. Implications, including the suggestion of clinical intake screening of PTSD in this population, are discussed.

Several studies have found higher resting heart rate among patients with panic disorder compared to healthy controls, whereas others have found no differences. It has been suggested that these differences may result from anticipatory anxiety. The purpose of this study was to compare the resting heart rates of 10 patients with panic disorder, 11 patients with social phobia, and 13 healthy controls during two consecutive visits to our laboratory. There were no significant differences between groups on resting heart rate on either day. However, patients with panic disorder did have significantly higher resting heart rates on day 1 versus day 2. This suggests that patients with panic disorder may experience greater anticipatory anxiety which is manifested in a higher resting heart rate than patients with social phobia or healthy controls. Implications for previous and future reports on resting heart rate measures in patients with panic disorder are discussed.

The Pain Anxiety Symptoms Scale (PASS) is a 40-item self-report measure that consists of four subscales measuring aspects of pain-related anxiety and avoidance. Despite its growing popularity, there have been few studies of its psychometric properties. The primary purpose of this study was to determine the factor structure of the PASS in a sample of 259 chronic pain patients. Principal component analysis with oblique (Oblimin) rotation provided partial support for the factorial validity of the PASS. Five factors were extracted: (1) catastrophic thoughts, (2) physiological anxiety symptoms, (3) escape/avoidance behaviours, (4) cognitive interference, and (5) coping strategies. The use of analgesic medication did not influence the factor solution. The factors were characterised by correlating them with pain-related measures, and with measures of mood state. Implications are considered for revising the PASS subscales to provide a more comprehensive and factorially valid assessment of pain-related fear and avoidance.

Objective: The authors examined the nocturnal breathing patterns of patients with panic disorder to determine whether these individuals had respiratory irregularities at a time when anxiety was not manifest., Method: Respiratory polysomnography was conducted on 14 medication-free patients with panic disorder and 14 healthy comparison subjects. Semiautomated indices of ventilatory variability were calculated for representative 3-minute, artifact-free sleep samples, and manually scored indices of irregular breathing were rated (blind to diagnosis) for the entire last 2 nights of sleep., Results: Patients with panic disorder had evidence of abnormal sleep breathing as indicated by increased irregularity in tidal volume during REM and an increased rate of microapneas (i.e., brief [5-10-second] pauses in breathing). A subgroup of patients (including some with recent sleep panic attacks) had indices of subtle disorders in breathing during sleep that were above the 95th percentile for the comparison subjects., Conclusions: These findings extend the observations in the awake state that patients with panic disorder breathe more irregularly than healthy comparison subjects. The irregularities may be attributable to altered brainstem sensitivity to CO2 or to other as yet unexplained factors. A possible relationship between irregular nocturnal breathing and sleep panic attacks is discussed.

A neuropsychological test battery designed to assess verbal learning and memory, visual memory, psychomotor speed, cognitive flexibility and concentration was administered to patients with panic disorder (N = 18) and social phobia (N = 18) and a group of healthy control subjects (N = 16). Overall, the neurocognitive performance of the panic disorder and social phobia patients was lower than that of control subjects. Analyses of the verbal test variables indicated reduced performance in panic disorder and social phobia patients, relative to control subjects, on measures of verbal learning and memory. In addition, panic disorder patients exhibited deficits on short-delay free recall. No group differences were observed on tests of visual memory, psychomotor speed, cognitive flexibility, and concentration. These results, while indicative of diminished neuropsychological test performance in patients with panic disorder and social phobia, do not suggest the presence of syndrome-specific or localized neurocognitive deficits.

Although self-reports of panic attacks are common among student populations, it is not clear that their panic experiences are actually comparable to those of patients with clinical anxiety disorders. An empirical approach was taken to this problem by using a cluster analysis procedure to identify subjects within two samples of university students who reported panic attack symptom profiles that resembled those of patients with panic disorder. Such empirically defined "clinical" panic attacks were reported by 7.0% and 8.1% of the two samples. This predominantly female group accounted for most of the increased psychopathology that has been reported in previous studies of nonclinical panic.