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Abstract Background Computational modeling is an increasingly common practice for disciplinary experts and therefore necessitates integration into science curricula. Computational models afford an opportunity for students to investigate the dynamics of biological systems, but there is significant gap in our knowledge of how these activities impact student knowledge of the structures, relationships, and dynamics of the system. We investigated how a computational modeling activity affected introductory biology students’ mental models of a prokaryotic gene regulatory system (lac operon) by analyzing conceptual models created before and after the activity. Results Students’ pre-lesson conceptual models consisted of provided, system-general structures (e.g., activator, repressor) connected with predominantly incorrect relationships, representing an incomplete mental model of gene regulation. Students’ post-lesson conceptual models included more context-specific structures (e.g., cAMP, lac repressor) and increased in total number of structures and relationships. Student conceptual models also included higher quality relationships among structures, indicating they learned about these context-specific structures through integration with their expanding mental model rather than in isolation. Conclusions Student mental models meshed structures in a manner indicative of knowledge accretion while they were productively re-constructing their understanding of gene regulation. Conceptual models can inform instructors about how students are relating system structures and whether students are developing more sophisticated models of system-general and system-specific dynamics.

Bodily resizing illusions typically use visual and/or tactile inputs to produce a vivid experience of one's body changing size. Naturalistic auditory input (an input that reflects the natural sounds of a stimulus) has been used to increase illusory experience during the rubber hand illusion, whilst non-naturalistic auditory input can influence estimations of finger length. We aimed to use a non-naturalistic auditory input during a hand-based resizing illusion using augmented reality, to assess whether the addition of an auditory input would increase both subjective illusion strength and measures of performance-based tasks. Forty-four participants completed the following three conditions: no finger stretching, finger stretching without tactile feedback and finger stretching with tactile feedback. Half of the participants had an auditory input throughout all the conditions, whilst the other half did not. After each condition, the participants were given one of the following three performance tasks: stimulated (right) hand dot touch task, non-stimulated (left) hand dot touch task, and a ruler judgement task. Dot tasks involved participants reaching for the location of a virtual dot, whereas the ruler task concerned estimates of the participant's own finger on a ruler whilst the hand was hidden from view. After all trials, the participants completed a questionnaire capturing subjective illusion strength. The addition of auditory input increased subjective illusion strength for manipulations without tactile feedback but not those with tactile feedback. No facilitatory effects of audio were found for any performance task. We conclude that adding auditory input to illusory finger stretching increased subjective illusory experience in the absence of tactile feedback but did not affect performance-based measures., (© 2023. The Author(s).)

Illusory body resizing typically uses multisensory integration to change the perceived size of a body part. Previous studies associate these multisensory body illusions with frontal theta oscillations and parietal gamma oscillations for dis-integration and integration of multisensory signals, respectively. However, recent studies also support illusory changes of embodiment from unimodal visual stimuli. This preregistered study (N = 48) investigated differences between multisensory visuo-tactile and unimodal visual resizing illusions using EEG, to gain a more comprehensive understanding of the neural underpinnings of resizing illusions in a healthy population. We hypothesised (1) stronger illusion in multisensory compared to unimodal, and unimodal compared to incongruent (dis-integration) conditions, (2) greater parietal gamma during multisensory compared to unimodal, and (3) greater frontal theta during incongruent compared to baseline conditions. Subjective Illusory results partially support Hypothesis 1, showing a stronger illusion in multisensory compared to unimodal conditions, but finding no significant difference comparing unimodal to incongruent conditions. Results partially supported EEG hypotheses, finding increased parietal gamma activity comparing multisensory to unimodal visual conditions, happening at a later stage of the illusion when compared to previous rubber hand illusion EEG findings, whilst also finding increased parietal theta activity when comparing incongruent to non-illusion conditions. While results demonstrated that only 27% of participants experienced the stretching illusion with unimodal visual stimuli compared to 73% of participants experiencing the stretching illusion in the multisensory condition, further analysis suggested that those who experience visual-only illusions exhibit a different neural signature to those who do not, with activity focussed around frontal and parietal regions early on in the illusory manipulation, compared to activity focussed more over parietal regions and at a later point in the illusory manipulation for the full sample of participants. Our results replicate previous subjective experience findings and support the importance of multisensory integration for illusory changes in perceived body size, whilst adding to our understanding of the temporal onset of multisensory integration within resizing illusions, differing from that of rubber hand illusions., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Co-regulation is a relatively new theoretical framework for interventions that connects developmental science to adolescent needs and provides strategies that can be applied across contexts. It also has value in shifting the focus of interventions to the role of relationships and interactions with caring adults, as well as supportive environments. This framework may be particularly salient for older youth with foster care experience whose relationships with adults and availability of developmental supports are disrupted. To understand how co-regulation aligns with current understanding of needs and supports for this population, we conducted a scoping review that involved systematically searching four databases, coding and charting relevant information, and actively engaging expert consultants and other stakeholders. Across 46 primarily descriptive articles, co-regulation was discussed most often in relation to relationships, as expected (89% of articles). Despite theoretical and empirical evidence of the benefits of supportive environments and intentional day-to-day interactions in promoting developmental skills and competencies, these two domains of co-regulation were referenced much less (39% and 28%, respectively). Results highlight opportunities for co-regulation supports that can be provided to older youth with foster care experience by caring adults and near-aged peers in a wide range of roles. Notable limitations in the literature were identified in applying co-regulation within the context of employment and career readiness, healthy relationships, and teen parenting. Also under-researched is the role of adult self-regulation skills and co-regulation approaches for youth from diverse backgrounds, including those who identify as LGBTQ or have disabilities. Considerations for practice and future research are provided., (© 2023. The Author(s).)

Background: Effective person-centred interventions are needed to support people living with mental-physical multimorbidity to achieve better health and wellbeing outcomes. Depression is identified as the most common mental health condition co-occurring with a physical health condition and is the focus of this intervention development study. The aim of this study is to identify the key components needed for an effective intervention based on a clear theoretical foundation, consideration of how motivational interviewing can inform the intervention, clinical guidelines to date, and the insights of primary care nurses., Methods: A multimethod approach to intervention development involving review and integration of the theoretical principles of Theory of Planned Behavior and the patient-centred clinical skills of motivational interviewing, review of the expert consensus clinical guidelines for multimorbidity, and incorporation of a thematic analysis of group interviews with Australian nurses about their perspectives of what is needed in intervention to support people living with mental-physical multimorbidity., Results: Three mechanisms emerged from the review of theory, guidelines and practitioner perspective; the intervention needs to actively 'engage' patients through the development of a collaborative and empathic relationship, 'focus' on the patient's priorities, and 'empower' people to make behaviour change., Conclusion: The outcome of the present study is a fully described primary care intervention for people living with mental-physical multimorbidity, with a particular focus on people living with depression and a physical health condition. It builds on theory, expert consensus guidelines and clinician perspective, and is to be tested in a clinical trial.

Psychosocial acceleration theory and other frameworks adapted from life history predict a link between early life stress and accelerated maturation in several physiological systems. Those findings led researchers to suggest that the emotion-regulatory brain circuits of previously-institutionalized (PI) youth are more mature than youth raised in their biological families (non-adopted, or NA, youth) during emotion tasks. Whether this accelerated maturation is evident during resting-state fMRI has not yet been established. Resting-state fMRI data from 83 early adolescents (M age = 12.9 years, SD = 0.57 years) including 41 PI and 42 NA youth, were used to examine seed-based functional connectivity between the amygdala and ventromedial prefrontal cortex (vmPFC). Additional whole-brain analyses assessed group differences in functional connectivity and associations with cognitive performance and behavior. We found group differences in amygdala - vmPFC connectivity that may be consistent with accelerated maturation following early life stress. Further, whole-brain connectivity analyses revealed group differences associated with internalizing and externalizing symptoms. However, the majority of whole-brain results were not consistent with an accelerated maturation framework. Our results suggest early life stress in the form of institutional care is associated with circuit-specific alterations to a frontolimbic emotion-regulatory system, while revealing limited differences in more broadly distributed networks., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: To examine whether motivational interviewing is used by GPs in consultations with patients living with mental-physical multimorbidity., Methods: Secondary analysis of selected videos from an existing database of routine general practice consultations with adult patients in Glasgow, Scotland. Consultations involving patients with mental-physical multimorbidity were selected and coded using the Motivational Interviewing Treatment Integrity (MITI) coding system., Results: Sixty consultations were coded involving 32 GPs across 16 practices. Mean consultation length was 9.9 min. On average GPs asked 1.7 questions per minute and offered 1.2 pieces of information per minute. Using the MITI, five GPs met beginner proficiency for the relational global qualities of partnership and empathy; however, none of the GPs met beginner proficiency for the technical global rating of efforts made to encourage patients to discuss behaviour change. Simple reflections were observed in 67% of consultations and complex reflections in 28% of consultations. Confrontation, a technique inconsistent with motivational interviewing, was observed in 18% of consultations., Discussion: MI was not evident in these consultations with patients living with mental-physical multimorbidity. This study provides information about the baseline motivational interviewing-consistent skills of GPs working with multimorbid patients and may be helpful in informing motivational interviewing training efforts and future research.

Heterozygous missense mutations in coatomer protein subunit α, COPA, cause a syndrome overlapping clinically with type I IFN-mediated disease due to gain-of-function in STING, a key adaptor of IFN signaling. Recently, increased levels of IFN-stimulated genes (ISGs) were described in COPA syndrome. However, the link between COPA mutations and IFN signaling is unknown. We observed elevated levels of ISGs and IFN-α in blood of symptomatic COPA patients. In vitro, both overexpression of mutant COPA and silencing of COPA induced STING-dependent IFN signaling. We detected an interaction between COPA and STING, and mutant COPA was associated with an accumulation of ER-resident STING at the Golgi. Given the known role of the coatomer protein complex I, we speculate that loss of COPA function leads to enhanced type I IFN signaling due to a failure of Golgi-to-ER STING retrieval. These data highlight the importance of the ER-Golgi axis in the control of autoinflammation and inform therapeutic strategies in COPA syndrome., Competing Interests: Disclosures: M. Wislez reported personal fees from Boeringher Ingelheim, Roche, MSD, BMS, Astra Zeneca, and Amgen outside the submitted work. Y.J. Crow reported "other" from Biogen outside the submitted work. No other disclosures were reported., (© 2020 Lepelley et al.)

Background Research suggests that symptoms of post-traumatic stress disorder (PTSD) may be common in physicians who have experienced a traumatic event, but it is unclear if medical residents suffer from similar symptoms. Objective To determine the prevalence of PTSD symptoms in the resident physician population of the University of British Columbia based on the new Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) criteria. Method A link to an online questionnaire containing 27 questions, including residency training and year, as well as the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-fifth edition (PCL-5) was e-mailed and completed by the resident physicians of the University of British Columbia. Results Forty-three residents completed the survey and 38 had complete data. Mean PCL-5 score was 10.3 for the 38 subjects. Differences between PCL-5 score and resident year yielded the following: postgraduate year (PGY)-1=8.6; PGY-2=16.5; PGY-3=3.6; PGY-4=4.0; PGY-5=7.7. With respect to the type of traumatic event and PCL-5 score, the following was observed: Death=5.3, Violence=13.8, Medical Error=8.0, Bullying=38.0, None=45.0. The Kruskal-Wallis test showed no statistically significant differences in total PCL-5 score for PGY or type of traumatic event. Regardless of post-graduate year or trauma experience, four subjects out of 38 (10.5%) had a total PCL-5 score of 33 or greater, while one subject (2.5%) had a score greater than 50. Conclusion The results from this study conclude that resident physicians do suffer from PTSD symptoms at a rate higher than the average American population. As PTSD symptoms can often be very distressing and potentially affect work ethic negatively, further studies are indicated to better understand these symptoms and hopefully lead to better care in treating PTSD symptoms in resident physicians., Competing Interests: The authors have declared that no competing interests exist.

There is now a considerable body of evidence to suggest that internal representations of the body can be meaningfully separated into at least two general levels; body image as a perceptual construct and body schema as a motor metric. However, recent studies with eating disordered individuals have suggested that there may in fact be more interaction between these two representations than first thought. We aimed to investigate how body image might act to influence body schema within a typical, healthy population. 100 healthy adult women were asked to judge the smallest gap between a pair of sliding doors that they could just pass through. We then determined whether these estimates were sufficient to predict the size of the smallest gap that they could actually pass through, or whether perceptual and attitudinal body image information was required in order to make these predictions. It was found that perceptual body image did indeed mediate performance on the egocentric (but not allocentric) motor imagery affordance task, but only for those individuals with raised body image concerns and low self-esteem; body schema was influenced by both the perceptual and attitudinal components of body image in those with more negative bodily attitudes. Furthermore, disparities between perceived versus actual size were associated with body parts that had larger variations in adipose/muscle-dependent circumference. We therefore suggest that it may be the affective salience of a distorted body representation that mediates the degree to which it is incorporated into the current body state., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective To explore the relative utility of genetic testing in contrast to placental pathology in explaining causation of death in the structurally normal stillborn population. Methods A retrospective review of a structurally normal stillborn infant cohort in South East Scotland between 2011 and 2015, defined by death at or after 24 weeks of gestation. We reviewed pathology reports and collected demographic data on cases. This information was collated with genetic test results (quantitative fluorescent polymerase chain reaction and microarray analysis) and placental pathology to create a database for analysis. Primary Results Within the structurally normal population (n = 131), there were 125 genetic tests performed and 11 abnormal results. Sixty-six microarray analyses were performed, and 2 (3%) of the results were thought likely to reflect cause of stillbirth (1 case of incomplete trisomy 4 and 1 case of deletion of chromosome Xp in a female). Analysis was significantly limited in 2 cases as parental samples were not available. The placental pathology was available in a total of 129 cases; significant findings were identified in 100 cases; 79 (61%) showed changes that were considered to have caused death (including cord "accidents"), and a further 21 (16%) showed findings likely to influence the management of subsequent pregnancies. Conclusions We reaffirm the utility of placental examination in the investigation of stillbirth. In cases of nondysmorphic stillbirth where placental pathology does not explain the cause of stillbirth, microarray analysis of fetal DNA can add further diagnostic information in 3% of cases but can add further diagnostic confusion, and it is important that parental bloods are taken to minimize this risk.

Background: Individuals with a history of maltreatment show altered amygdala reactivity to emotional stimuli, atypical frontal regulatory control, and differences in frontolimbic connectivity compared with nonmaltreated controls. However, despite early trauma, many individuals who experience maltreatment show resilience or adaptive functioning in adulthood including positive social, educational, and occupational outcomes., Methods: The present study used a psychophysiological interaction model to examine the effect of adult adaptive functioning on group differences between maltreated and nonmaltreated adults in task-based amygdala functional connectivity. The task used was a facial emotion-matching paradigm. Functional magnetic resonance imaging scans were collected from 41 adults with a history of substantiated childhood maltreatment and 39 nonmaltreated adults who were well matched on demographic variables, all of whom had been studied since childhood. Adaptive functioning was measured with a composite score of success on stage-salient developmental tasks., Results: Consistent with previous research, we found differences in task-related amygdala functional connectivity between the maltreated and nonmaltreated groups. Effects were seen in the left hippocampus, right dorsolateral prefrontal cortex, dorsomedial prefrontal cortex, and right thalamus. However, when adult functioning was included in the model, maltreatment-related differences in amygdala connectivity were observed only in the hippocampus. Adult adaptive functioning independently predicted task-related amygdala connectivity in frontal and parietal regions across the entire sample., Conclusions: These results suggest that frontolimbic functional connectivity is predicted by positive developmental adaptation in this high-risk population, regardless of maltreatment history, whereas intralimbic connectivity (amygdala and hippocampus) is more specifically associated with maltreatment history., (Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)

Background: Multimorbidity is an increasing and complex issue in Australian general practice. General practitioners (GPs) face the challenge of navigating multiple potential intervention pathways. Emerging guidelines for multimorbidity recommend patient-centred care and addressing the lifestyle factors of the patient. Motivational interviewing is a patient-centred approach that is focused on behavioural change and effective across a range of lifestyle factors., Objective: The aim of this article is to provide a practical introduction to motivational interviewing skills that may be helpful in working with patients who have multimorbidity. Key skills discussed in this article include agenda setting, giving advice, responding to resistance, and asking questions to evoke a patient’s own motivation for change., Discussion: GPs are ideally placed to assist patients with multimorbidity to navigate recommendations and identify which recommendations will work. Navigating complexity is at the heart of general practice, and multimorbidity demands more than an ‘assess-and-advise’ model of care. Motivational interviewing provides a promising and readily applicable framework to empower patients living with multimorbidity.

Purpose: Some ethnic groups have more negative contacts with health services for first-episode psychosis, likely arising from a complex interaction between ethnicity, socio-economic factors, and immigration status. Using population-based health administrative data, we sought to examine the effects of ethnic group and migrant status on patterns of health service use preceding a first diagnosis of schizophrenia or schizoaffective disorder among people aged 14-35 over a 10-year period., Methods: We compared access to care and intensity of service use for first-generation ethnic minority groups to the general population of Ontario. To control for migrant status, we restricted the sample to first-generation migrants and compared service use indicators for ethnic minority groups to the European migrant group., Results: Our cohort included 18,080 people with a first diagnosis of schizophrenia or schizoaffective disorder, of whom 14.4% (n = 2607) were the first-generation migrants. Our findings suggest that the magnitude of ethnic differences in health service use is reduced and no longer statistically significant when the sample is restricted to first-generation migrants. Of exception, nearly, all migrant groups have lower intensity of primary care use, and Caribbean migrants are consistently less likely to use psychiatric services., Conclusions: We observed fewer ethnic differences in health service use preceding the first diagnosis of psychosis when patterns are compared among first-generation migrants, rather than to the general population, suggesting that the choice of reference group influences ethnic patterning of health service use. We need a comprehensive understanding of the mechanisms behind observed differences for minority groups to adequately address disparities in access to care.

The dynamic flexibility of body representation has been highlighted through numerous lines of research that range from clinical studies reporting disorders of body ownership, to experimentally induced somatic illusions that have provided evidence for the embodiment of manipulated representations and even fake limbs. While most studies have reported that enlargement of body parts alters somatic perception, and that these can be more readily embodied, shrunken body parts have not been found to consistently alter somatic experiences, perhaps due to reduced feelings of ownership over smaller body parts. Over two experiments, we aimed to investigate the mechanisms responsible for altered somatic representations following exposure to both enlarged and shrunken body parts. Participants were given the impression that their hand and index finger were either longer or shorter than veridical length and asked to judge veridical finger length using online and offline size estimation tasks, as well as to report the degree of ownership towards the distorted finger and hand representations. Ownership was claimed over all distorted representations of the hand and finger and no differences were seen across ownership ratings, while the online and offline measurements of perceived size demonstrated differing response patterns. These findings suggest that ownership towards manipulated body representations is more bidirectional than previously thought and also suggest differences in perceived body representation with respect to the method of measurement suggesting that online and offline tasks may tap into different aspects of body representation.

Aim: To assess variability in symptom presentation and explanatory models of psychosis for people from different ethnic groups., Methods: Clients with first-episode psychosis (n = 171) who identified as black African, black Caribbean or white European were recruited from early intervention programmes in Toronto and Hamilton. We compared results by ethnic group for symptom profiles and explanatory models of illness., Results: Clients of black Caribbean origin had a lower odds of reporting that they were speaking incomprehensibly (OR = 0.36; 95% CI: 0.14-0.90) and black African clients had a greater odds of reporting persistent aches or pains (OR = 2.92; 95% CI: 1.32-6.50). Black African clients had a lower odds of attributing the cause of psychosis to hereditary factors (OR = 0.41; 95% CI: 0.19-0.89) or to substance abuse (OR = 0.29; 95% CI: 0.13-0.67) and had a lower odds of assigning responsibility for their illness to themselves (OR = 0.41; 95% CI: 0.19-0.89)., Conclusions: Understanding the differences in illness models for ethnic minority groups may help improve the cultural competence of mental health services., (© 2015 Wiley Publishing Asia Pty Ltd.)

Internationally, health systems face an increasing demand for services from people living with multimorbidity. Multimorbidity is often associated with high levels of treatment burden. Targeting lifestyle factors that impact across multiple conditions may promote quality of life and better health outcomes for people with multimorbidity. Motivational interviewing (MI) has been studied as one approach to supporting lifestyle behaviour change. A systematic review was conducted to assess the effectiveness of MI in healthcare settings and to consider its relevance for multimorbidity. Twelve meta-analyses pertinent to multimorbidity lifestyle factors were identified. As an intervention, MI has been found to have a small-to-medium statistically significant effect across a wide variety of single diseases and for a range of behavioural outcomes. This review highlights the need for specific research into the application of MI to determine if the benefits of MI seen with single diseases are also present in the context of multimorbidity., Competing Interests: K.J.M. is a member of the Motivational Interviewing Network of Trainers. There are no other conflicts of interest to declare.

Research has suggested that altering the perceived shape and size of the body image significantly affects perception of somatic events. The current study investigated how multisensory illusions applied to the body altered tactile perception using the somatic signal detection task. Thirty-one healthy volunteers were asked to report the presence or absence of near-threshold tactile stimuli delivered to the index finger under three multisensory illusion conditions: stretched finger, shrunken finger and detached finger, as well as a veridical baseline condition. Both stretching and shrinking the stimulated finger enhanced correct touch detections; however, the mechanisms underlying this increase were found to be different. In contrast, the detached appearance reduced false touch reports-possibly due to reduced tactile noise, as a result of attention being directed to the tip of the finger only. These findings suggest that distorted representations of the body could have different modulatory effects on attention to touch and provide a link between perceived body representation and somatosensory decision-making.

The last decade has witnessed an exponential growth in user-generated online content featuring Non-Suicidal Self-Injury (NSSI), including photography, digital video, poems, blogging, and drawings. Although the increasing visibility of NSSI content has evoked public concern over potential health risks, little research has investigated why people are drawn to create and publish such content. This article reports the findings from a qualitative analysis of online interviews with 17 individuals who produce NSSI content. A thematic analysis of participants' narratives identified two prominent motives: self-oriented motivation (to express self and creativity, to reflect on NSSI experience, to mitigate self-destructive urges) and social motivation (to support similar others, to seek out peers, to raise social awareness). Participants also reported a double-edged impact of NSSI content both as a trigger and a deterrent to NSSI., (© The Author(s) 2015.)

Background: Evidence suggests that migrant groups have an increased risk of psychotic disorders and that the level of risk varies by country of origin and host country. Canadian evidence is lacking on the incidence of psychotic disorders among migrants. We sought to examine the incidence of schizophrenia and schizoaffective disorders in first-generation immigrants and refugees in the province of Ontario, relative to the general population., Methods: We constructed a retrospective cohort that included people aged 14-40 years residing in Ontario as of Apr. 1, 1999. Population-based administrative data from physician billings and hospital admissions were linked to data from Citizenship and Immigration Canada. We used Poisson regression models to calculate age- and sex-adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for immigrant and refugee groups over a 10-year period., Results: In our cohort (n = 4,284,694), we found higher rates of psychotic disorders among immigrants from the Caribbean and Bermuda (IRR 1.60, 95% CI 1.29-1.98). Lower rates were found among immigrants from northern Europe (IRR 0.50, 95% CI 0.28-0.91), southern Europe (IRR 0.60, 95% CI 0.41-0.90) and East Asia (IRR 0.56, 95% CI 0.41-0.78). Refugee status was an independent predictor of risk among all migrants (IRR 1.27, 95% CI 1.04-1.56), and higher rates were found specifically for refugees from East Africa (IRR 1.95, 95% CI 1.44-2.65) and South Asia (IRR 1.51, 95% CI 1.08-2.12)., Interpretation: The differential pattern of risk across ethnic subgroups in Ontario suggests that psychosocial and cultural factors associated with migration may contribute to the risk of psychotic disorders. Some groups may be more at risk, whereas others are protected., (© 2015 Canadian Medical Association or its licensors.)

Introduction: A longer duration of untreated psychosis (DUP) is associated with poor outcomes in first-episode psychosis (FEP); however, it is unclear whether this is due to the effects of psychosis on brain structure. We systematically reviewed the literature on the association between the length of untreated psychosis and brain structure in first-episode psychosis., Methods: We searched three electronic databases and conducted forward and backward citation searching to identify relevant papers. Studies were included if they: (1) included patients with a psychotic disorder who were treatment naïve or minimally treated; and (2) had correlated measures of DUP or duration of untreated illness (DUI) with structural measures., Results: We identified 48 studies that met the inclusion criteria. Forty-three examined the correlation between DUP and brain structure, and 19 examined the correlation between DUI and brain structure. There was evidence of significant associations in brain regions considered important in psychosis; however, the proportion of significant associations was low and the findings were inconsistent across studies. The majority of included studies were not primarily designed to examine whether DUP/DUI is correlated with brain structure, and there were methodological limitations in many studies that prevent drawing a strong conclusion., Conclusion: To date, there is minimal evidence of an association between untreated psychosis and brain structure in FEP. Although the body of literature is substantial, there are few hypothesis-driven studies with a primary objective to answer this question. Future studies should be specifically designed to examine whether untreated psychosis has a deleterious effect on brain structure., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Objective: Medically unexplained symptoms (MUS) are increasingly being thought of as resulting from dysfunctional modulation of interoceptive sensory signals by top-down cognitive processes. The current study investigated whether individuals with a tendency toward MUS would be more susceptible to visual illusions that suggest tactile sensation on the skin in the absence of any actual somatosensory input., Method: Participants viewed real-time-mediated reality video images of their own hand, either un-manipulated or digitally altered to display moving pixelated 'static' effect, the crawling skin illusion. The strength of various physical sensations during each condition were rated on a numeric scale and compared to standard measures of somatoform dissociation (Somatoform Dissociation Questionnaire 20)., Results: Participants reporting a higher degree of somatoform dissociation were found to be more susceptible to somatic sensations across all conditions. Interestingly, participants who reported more visually induced somatosensory sensations also felt less ownership over their digitally presented hands., Conclusion: These findings support the proposed link between MUS and disturbances in body representation, and suggest that an over-reliance on top-down knowledge may interfere with current sensory inputs, contributing to symptom formation and maintenance in susceptible individuals., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Over 100 000 solid organ transplants are performed worldwide each year and this has a significant impact on physical function and quality of life. However, the capacity for exercise in solid-organ recipients is reduced. Regular physical activity improves most of the indices of fitness in these patients but, with few exceptions, they do not reach the values seen in healthy controls. The reason for the 40-60% reduction in maximal exercise capacity is not clear; the disease process, need for life long immunosuppression and sedentary lifestyle all contribute. The interaction between exercise and immunosuppressing medication merits research as does the specifics of the exercise prescription for these patients. This paper reviews important features of this rapidly expanding group of patients and suggests clinical considerations in the application of exercise in this population., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

We report a cross-cultural study designed to investigate crossmodal correspondences between a variety of visual features (11 colors, 15 shapes, and 2 textures) and the five basic taste terms (bitter, salty, sour, sweet, and umami). A total of 452 participants from China, India, Malaysia, and the USA viewed color patches, shapes, and textures online and had to choose the taste term that best matched the image and then rate their confidence in their choice. Across the four groups of participants, the results revealed a number of crossmodal correspondences between certain colors/shapes and bitter, sour, and sweet tastes. Crossmodal correspondences were also documented between the color white and smooth/rough textures on the one hand and the salt taste on the other. Cross-cultural differences were observed in the correspondences between certain colors, shapes, and one of the textures and the taste terms. The taste-patterns shown by the participants from the four countries tested in the present study are quite different from one another, and these differences cannot easily be attributed merely to whether a country is Eastern or Western. These findings therefore highlight the impact of cultural background on crossmodal correspondences. As such, they raise a number of interesting questions regarding the neural mechanisms underlying crossmodal correspondences.

For over 20 years, studies have tried to measure the association between the duration of untreated psychosis (DUP) and changes in brain morphology. A hypothesis that untreated psychosis is neurotoxic has been postulated, but the mechanisms of that toxicity have not been described. We re-analyzed papers collected for a systematic review to extract data on the hypotheses that have been generated on the potential mechanisms by which DUP could impact brain morphology in first-episode psychosis. Dopaminergic hyperactivity, prolonged hypothalamic-pituitary-adrenal activation, and persistent activity of catecholamines have been hypothesized as mechanisms to explain these associations. However, the question remains as to whether the observed structural changes are permanent or may be reversed via antipsychotic treatment.

Colors and odors are associated; for instance, people typically match the smell of strawberries to the color pink or red. These associations are forms of crossmodal correspondences. Recently, there has been discussion about the extent to which these correspondences arise for structural reasons (i.e., an inherent mapping between color and odor), statistical reasons (i.e., covariance in experience), and/or semantically-mediated reasons (i.e., stemming from language). The present study probed this question by testing color-odor correspondences in 6 different cultural groups (Dutch, Netherlands-residing-Chinese, German, Malay, Malaysian-Chinese, and US residents), using the same set of 14 odors and asking participants to make congruent and incongruent color choices for each odor. We found consistent patterns in color choices for each odor within each culture, showing that participants were making non-random color-odor matches. We used representational dissimilarity analysis to probe for variations in the patterns of color-odor associations across cultures; we found that US and German participants had the most similar patterns of associations, followed by German and Malay participants. The largest group differences were between Malay and Netherlands-resident Chinese participants and between Dutch and Malaysian-Chinese participants. We conclude that culture plays a role in color-odor crossmodal associations, which likely arise, at least in part, through experience.

This paper is an initial attempt to collate the literature on psychiatric inpatient recovery-based care and, more broadly, to situate the inpatient care sector within a mental health reform dialogue that, to date, has focused almost exclusively on outpatient and community practices. We make the argument that until an evidence base is developed for recovery-oriented practices on hospital wards, the effort to advance recovery-oriented systems will stagnate. Our scoping review was conducted in line with the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (commonly referred to as PRISMA) guidelines. Among the 27 papers selected for review, most were descriptive or uncontrolled outcome studies. Studies addressing strategies for improving care quality provide some modest evidence for reflective dialogue with former inpatient clients, role play and mentorship, and pairing general training in recovery oriented care with training in specific interventions, such as Illness Management and Recovery. Relative to some other fields of medicine, evidence surrounding the question of recovery-oriented care on psychiatric wards and how it may be implemented is underdeveloped. Attention to mental health reform in hospitals is critical to the emergence of recovery-oriented systems of care and the realization of the mandate set forward in the Mental Health Strategy for Canada.

Background: Delirium is one of the most distressing and difficult to manage problems in advanced illness. Family caregivers have a unique view of the progression of delirium., Objective: This study examined precursors to delirium from the perspective of family caregivers., Design: This study utilized a two-stage concept mapping design that began with semistructured interviews with caregivers of patients suffering with delirium. The interview data was sorted and rated by clinicians prior to quantitative data analysis via multidimensional scaling (MDS) and cluster analysis., Subjects/settings: The subjects were 20 family caregivers of patients with a diagnosis of delirium in a hospice inpatient unit., Results: The main outcome of the study was a multidimensional model of precursors of delirium that included 99 specific items. The model included ten clusters within three general domains: Cognition, Distress, and Rest/Sleep. An exploratory analysis suggested that Rest and Sleep issues were evident to caregivers much earlier than other kinds of problems (mean=17.56 weeks prior to hospice admission, 95% CI=9.2-25.0 weeks)., Conclusions: This study provides detailed insights from family caregivers about the progression of delirium. The caregiver observations were clustered by multivariate analysis to provide a map of symptom domains. The principal finding of this study is that sleep disturbance was identified by almost all family caregivers much earlier than other more commonly recognized symptoms associated with delirium. The study highlights the importance of sleep fragmentation in the temporal progression of delirium and points toward opportunities for improved measurement, prevention, and treatment.

In this commentary the authors highlight the difficulties developed countries have had in generating effective means of addressing inequities in mental health. Limitations in research, policy, and service responses are discussed and the social entrepreneurship framework is suggested as a means of better understanding how mental health disparities might be addressed. The example of the Canadian Centre for Victims of Torture is provided to illustrate the points made.

Cognitive remediation (CR) is a treatment approach that is being increasingly examined as a means through which the cognitive impacts of schizophrenia might be ameliorated. While CR has demonstrated good outcomes when paired with supported employment, little is known regarding how it might be integrated within supported education contexts. In this study CR was examined in a supported education context with 16 individuals with psychosis. The findings indicated that CR aligned well with the academic curriculum with very low attrition, was found useful by students, and showed similar pre-post differences on cognitive measures as those found in previous work.

When attempting to detect a near-threshold signal, participants often incorrectly report the presence of a signal, particularly when a stimulus in a different modality is presented. Here we investigated the effect of prior experience of bimodal visuotactile stimuli on the rate of falsely reported touches in the presence of a light. In Experiment 1, participants made more false alarms in light-present than light-absent trials, despite having no experience of the experimental visuotactile pairing. This suggests that light-evoked false alarms are a consequence of an existing association, rather than one learned during the experiment. In Experiment 2, we sought to manipulate the strength of the association through prior training, using supra-threshold tactile stimuli that were given a high or low association with the light. Both groups still exhibited an increased number of false alarms during light-present trials, however, the low association group made significantly fewer false alarms across conditions, and there was no corresponding group difference in the number of tactile stimuli correctly identified. Thus, while training did not affect the boosting of the tactile signal by the visual stimulus, the low association training affected perceptual decision-making more generally, leading to a lower number of illusory touch reports, independent of the light., (Copyright © 2011 Elsevier B.V. All rights reserved.)

When asked to judge the presence or absence of near-threshold tactile stimuli, participants often report touch experiences when no tactile stimulation has been delivered ('false alarms'). The simultaneous presentation of a light flash during the stimulation period can increase the frequency of touch reports, both when touch is and is not present. Using fMRI, we investigated the BOLD response during both light-present and light-absent false alarms, testing predictions concerning two possible neural mechanisms underlying these illusory touch experiences: activation of a tactile representation in primary somatosensory cortex (SI) and/or activation of a tactile representation in late processing areas outside of sensory-specific cortex, such as medial prefrontal cortex (MPC). Our behavioural results showed that participants made false alarms in light-present and light-absent trials, both of which activated regions of the medial parietal and medial prefrontal cortex including precuneus, posterior cingulate and paracingulate cortex, suggesting the same underlying mechanism. However, only a non-significant increase in SI activity was measured in response to false alarm vs. correct rejection trials. We argue that our results provide evidence for the role of top-down regions in somatic misperception, consistent with findings from studies in humans and non-human primates., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Purpose: The difference in risk of mental illness in UK ethnic minorities may be related to a balance between specific risk factors such as racial discrimination and mediating factors such as social support. We investigated whether social support from friends or relatives reduces the cross-sectional association between perceived racism and the risk of mental illness in an ethnic minority group., Methods: We conducted secondary analyses of nationally representative community samples of five UK ethnic minority groups (EMPIRIC dataset; n = 4,281) using multiple regression techniques., Results: We found that the associations between perceived racism, common mental disorder and potentially psychotic symptoms were mainly independent of social support as measured by the number of close persons and their proximity to the individual., Conclusion: Social support when measured in this way does not mediate the associations between perceived racism and mental ill health in this population-based sample.

Recent studies have reported that in normal healthy individuals, the perception of illusory sensations in one modality can be induced by the presentation of a stimulus in another modality. These illusory sensations may arise from the activation of a tactile representation in memory induced by the non-target stimulus, in a process mirroring that thought to be responsible for many forms of medically unexplained symptoms. The reliability of illusory-touch reports was investigated here in two experiments with a novel perceptual paradigm designed to simulate the occurrence of somatoform symptoms in the laboratory. A concurrent light significantly increased the number of tactile stimuli reported, and resulted in a higher number of illusory-touch reports, while the modality of the trial start cue did not affect subsequent responses. In addition, a strong relationship was found between the rates of illusory sensations that participants produced in successive sessions, indicating that the tendency to report illusory sensations is a robust phenomenon.

Here we describe for the first time the electrolytic deposition of copper and copper composites from a solution of the metal chloride salt in either urea-choline chloride, or ethylene glycol-choline chloride based eutectics. We show that the deposition kinetics and thermodynamics are quite unlike those in aqueous solution under comparable conditions and that the copper ion complexation is also different. The mechanism of copper nucleation is studied using chronoamperometry and it is shown that progressive nucleation leads to a bright nano-structured deposit. In contrast, instantaneous nucleation, at lower concentrations of copper ions, leads to a dull deposit. This work also pioneers the use of the electrochemical quartz crystal microbalance (EQCM) to monitor both current efficiency and the inclusion of inert particulates into the copper coatings. This technique allows the first in situ quantification or particulate inclusion. It was found that the composition of composite material was strongly dependent on the amount of species suspended in solution. It was also shown that the majority of material was dragged onto the surface rather than settling on to it. The distribution of the composite material was found to be even throughout the coating. This technology is important because it facilitates deposition of bright copper coatings without co-ligands such as cyanide. The incorporation of micron-sized particulates into ionic liquids has resulted, in one case, in a decrease in viscosity. This observation is both unusual and surprising; we explain this here in terms of an increase in the free volume of the liquid and local solvent perturbation.

Background: Testicular germ cell tumours (TGCT) are thought to originate from fetal germ cells that fail to differentiate normally, but no animal model for these events has been described. We evaluated the marmoset (Callithrix jacchus) as a model by comparing perinatal germ cell differentiation with that in humans., Methods: Immunohistochemical profiling was used to investigate germ cell differentiation (OCT4, NANOG, AP-2gamma, MAGE-A4, VASA, NANOS-1) and proliferation (Ki67) in fetal and neonatal marmoset testes in comparison with the human and, to a lesser extent, the rat., Results: In marmosets and humans, differentiation of gonocytes into spermatogonia is associated with the gradual loss of pluripotency markers such as OCT4 and NANOG, and the expression of germ cell-specific proteins such as VASA. This differentiation occurs asynchronously within individual cords during fetal and early postnatal life. This contrasts with rapid and synchronous germ cell differentiation within and between cords in the rat. Similarly, germ cell proliferation in the marmoset and human occurs throughout perinatal life, in contrast to rats in which proliferation ceases during this period., Conclusions: The marmoset provides a good model for normal human germ cell differentiation and proliferation. The perinatal marmoset may be a useful model in which to establish factors that lead to failure of normal germ cell differentiation and the origins of TGCT.

Objective: The purpose of this study was to assess the effectiveness of a low-resource-intensive lifestyle modification program incorporating resistance training and to compare a gymnasium-based with a home-based resistance training program on diabetes diagnosis status and risk., Research Design and Methods: A quasi-experimental two-group study was undertaken with 122 participants with diabetes risk factors; 36.9% had impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) at baseline. The intervention included a 6-week group self-management education program, a gymnasium-based or home-based 12-week resistance training program, and a 34-week maintenance program. Fasting plasma glucose (FPG) and 2-h plasma glucose, blood lipids, blood pressure, body composition, physical activity, and diet were assessed at baseline and week 52., Results: Mean 2-h plasma glucose and FPG fell by 0.34 mmol/l (95% CI -0.60 to -0.08) and 0.15 mmol/l (-0.23 to -0.07), respectively. The proportion of participants with IFG or IGT decreased from 36.9 to 23.0% (P = 0.006). Mean weight loss was 4.07 kg (-4.99 to -3.15). The only significant difference between resistance training groups was a greater reduction in systolic blood pressure for the gymnasium-based group (P = 0.008)., Conclusions: This intervention significantly improved diabetes diagnostic status and reduced diabetes risk to a degree comparable to that of other low-resource-intensive lifestyle modification programs and more intensive interventions applied to individuals with IGT. The effects of home-based and gymnasium-based resistance training did not differ significantly.

SoxAX cytochromes are essential for the function of the only confirmed pathway for bacterial thiosulfate oxidation, the so-called "Sox pathway," in which they catalyze the initial formation of a S-S bond between thiosulfate and the SoxYZ carrier protein. Our work using the Starkeya novella diheme SoxAX protein reveals for the first time that in addition to two active site heme groups, SoxAX contains a mononuclear Cu(II) center with a distorted tetragonal geometry and three to four nitrogen ligands, one of which is a histidine. The Cu(II) center enhanced SoxAX activity in a newly developed, glutathione-based assay system that mimics the natural reaction of SoxAX with SoxYZ. EPR spectroscopy confirmed that the SoxAX Cu(II) center is reduced by glutathione. At pH 7 a K(m) (app) of 0.19+/-0.028 mm and a k(cat) (app) of 5.7+/-0.25s(-1) were determined for glutathione. We propose that SoxAX cytochromes are a new type of heme-copper proteins, with SoxAX-mediated S-S bond formation involving both the copper and heme centers.

The electrodeposition of most of technologically important metals has been shown to be possible from a wide range of room temperature molten salts, more commonly known today as 'ionic liquids'. These liquids are currently under intense scrutiny for a wide variety of applications some of which have already been commercialized. Despite the fact that electrodeposition was the first application studied in these liquids no metal deposition processes have as yet been developed to an industrial scale. This review addresses the practical and theoretical aspects that need to be considered when choosing ionic liquids for metal deposition. It details the current understanding of the physical and chemical properties of these interesting fluids and highlights the areas that need to be considered to develop practical electroplating systems. The effect of composition and temperature on viscosity and conductivity are discussed together with the fundamental approaches required to synthesise new liquids.

We have studied the anodic dissolution (electropolishing) of various stainless steel alloys in an ionic liquid comprising a 2 : 1 stoichiometric mix of ethylene glycol (EG) and choline chloride. We have used a combination of electrochemical and spectroscopic methods together with in situ liquid probe microscopy. We discuss the role and influence of the surface oxide passivation layer, characterized here by X-ray photoelectron spectroscopy (XPS) and linear sweep voltammetry, on the polishing process. We address the question of dealloying during the polish in order to contribute to our understanding of the viability of the ionic liquid as a replacement industrial electropolishing medium; the current commercial process uses a corrosive mixture of phosphoric and sulfuric acids. Also, we present data from ex situ and in situ liquid AFM studies giving both a qualitative and quantitative insight into the nature and scale of morphological changes at the steel surface during the polishing process.

Cytochrome c is accumulated into a film of TiO(2) nanoparticles and phytate by adsorption from an aqueous solution into the mesoporous structure. Stable voltammetric responses and high concentrations of redox protein within the TiO(2) phytate layer can be achieved. Two types of electrode systems are reported with (i) the modified TiO(2) phytate film between electrode and aqueous solution phase and (ii) the modified TiO(2) phytate film buried under a porous gold electrode ('porotrode'). The electrical conductivity of TiO(2) phytate films is measured and compared in the dry and in the wet state. Although in the dry state essentially insulating, the TiO(2) phytate film turns into an electrical conductor (with approximately 4 Omega cm specific resistivity assuming ohmic behaviour) when immersed in aqueous 0.1 M phosphate buffer solution at pH 7. The redox protein cytochrome c is therefore directly connected to the electrode via diffusion and migration of electrons in the three dimensional mesoporous TiO(2) phytate host structure. Electron transfer from cytochrome c to TiO(2) is proposed to be the rate-determining step for this conduction mechanism.