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Following a series of deadly attacks, and increasingly in recent years, incels have entered not only the public lexicon but also piqued scholarly interest, especially in terrorism research and prog...

Offloading memory to external stores (e.g., a saved file) allows us to evade the limitations of our internal memory. One cost of this strategy is that the external memory store used may be accessible to others and, thus, may be manipulated. Here we examine how reducing the perceived reliability of an external memory store and manipulating one's expectation for future access to such a store can influence participants' susceptibility to its manipulation (i.e., endorsing manipulated information as authentic). Across three pre-registered experiments, participants were able to store to-be-remembered information in an external store. On a critical trial, we surreptitiously manipulated the information in that store. Results demonstrated that an explicit notification of a previous manipulation of that store and the warning that the store will be inaccessible in the future can decrease susceptibility to manipulation of that store. Results are discussed in the context of the metacognitive monitoring and control of memory reports in situations that involve the distribution of memory demands across both internal and external spaces.

When we can offload to-be-remembered information to an external store, our ability to recall that information from internal memory can be diminished. However, previous research has suggested that associative memory processes may remain intact in the face of offloading behaviour. In the present investigation, we examine how the opportunity to offload memory demands affects the learning of categorised word lists. Across six experiments, participants studied and wrote down word lists that were either strongly associated with a semantic theme (categorised) or word lists that consisted of the same set of words but shuffled across the categorised lists (shuffled). When participants expected to have access to their written lists during the recall test (i.e., a condition that would encourage offloading) but were not given access to it, we found the typical recall advantage for categorised lists. This effect was found to be the same size or larger compared to a condition where participants did not expect to have access to their written lists during the recall test (i.e., a condition that would not allow offloading). We propose that gist memory supported by semantic associations is not substantially reduced in offloading.

Global incidence for legal and illegal substance abuse is increasing, with marginalized groups and adolescents bearing the brunt. Substance use disorders (SUDs) are linked with serious and enduring physical health consequences, persistent psychological problems, criminality, homelessness, unemployment, and diminished educational opportunities. The issue of SUD prevention and treatment is therefore considered to be of the utmost importance worldwide. Current evidence-based treatments, though effective, present with mediocre abstinence rates, leaving room for improvement in the treatment of these conditions. Newer cognitive-behavioral therapy (CBT) approaches, such as acceptance and commitment therapy (ACT), acknowledge the inevitability of attempting to control internal states, which has been shown to ameliorate abstinence rates. ACT cultivates psychological flexibility, experiential acceptance, distress tolerance, and behavior change, with the aim of living a more fulfilled, valued life. More specifically, ACT for SUDs openly aims to increase awareness of contextual and internal substance cues, while simultaneously identifying and following personally relevant, valued directions. The evidence in support of ACT, in the context of SUDs, as well as the specifics of how to apply openness, awareness, and valued activity in treatment, are detailed in this article.

There is significant uncertainty about the potential role of temperature control in the intensive care unit (ICU) in general, but more specifically in septic shock patients.1,2 Common techniques for temperature control have been limited by minimal effect (eg, paracetamol, fans or air blankets), undesirable side effects (eg, non-steroidal anti-inflammatories), or being burdensome (eg, heavy sedation, paralysis with surface cooling; intravascular cooling devices3). In contrast, the potential of newer-generation surface-cooling devices to achieve temperature control more simply has created the possibility of studying temperature modulation in the septic ICU population.

GnRH agonists have been used to halt the development of puberty in children with precocious puberty since the 1980s. Recently, drugs like Lupron DepotThe present study tested the effects of daily leuprolide treatment (50 µg/kg, postnatal day (PD) 25-50) on pubertal onset in female (i.e., vaginal opening) and male (i.e., preputial separation) Long-Evans rats. The first estrous cycle immediately after vaginal opening was also measured. Sexual behavior and sexual motivation were tested using the partner-preference paradigm. Female rats were tested during the first behavioral estrus after treatment ended (between PD 51-64). Male rats were tested weekly for four consecutive weeks starting three days after treatment ended (PD 53).Consistent with previous findings, leuprolide significantly delayed pubertal onset in both female and male rats. In addition, the first estrous cycle during the treatment period was disrupted by leuprolide, as indicated by a failure to cycle into estrus after vaginal opening until treatment ended. However, leuprolide affected neither sexual motivation nor fertility when female rats were tested within 14 days of leuprolide treatment ending. In contrast, the development of copulatory behavior and sexual motivation was significantly delayed by leuprolide in male rats; however, mature reproductive behavior was observed by the fourth week post-treatment.Taken together with previous findings, the present results indicate that male rats may be more sensitive to periadolescent leuprolide administration, taking longer to overcome the effects of leuprolide than female rats. Nevertheless, not long after leuprolide treatment is discontinued, sex-typical reproductive physiology and behavior emerge fully in female and male rats, indicating that the drug's effects are not permanent. If translatable to humans, leuprolide may be a reversible option to give adolescents more time to consider their gender identity with minimal long-term effects on sexual development.

Description, Neuroserpin preferentially inhibits amyloid formation; a 14-mer region in neuroserpin is implicated in binding to amyloid., Neuroserpin is a secreted protease inhibitor known to inhibit amyloid formation by the Alzheimer’s beta peptide (Aβ). To test whether this effect was constrained to Aβ, we used a range of in vitro assays to demonstrate that neuroserpin inhibits amyloid formation by several different proteins and protects against the associated cytotoxicity but, unlike other known chaperones, has a poor ability to inhibit amorphous protein aggregation. Collectively, these results suggest that neuroserpin has an unusual chaperone selectivity for intermediates on the amyloid-forming pathway. Bioinformatics analyses identified a highly conserved 14-residue region containing an α helix shared between neuroserpin and the thyroxine-transport protein transthyretin, and we subsequently demonstrated that transthyretin also preferentially inhibits amyloid formation. Last, we used rationally designed neuroserpin mutants to demonstrate a direct involvement of the conserved 14-mer region in its chaperone activity. Identification of this conserved region may prove useful in the future design of anti-amyloid reagents.

Offloading is a widespread and vital strategy for remembering. Yet, we lack a deep understanding of the mechanisms involved during the offloading of to-be-remembered information. One hypothesis is that offloading information is associated with a reduced engagement of top-down mnemonic strategies. A resulting prediction is that phenomena not solely by-products of such mechanisms should remain during offloading. We tested this prediction using the isolation effect (when recall is better for distinct items relative to nondistinct items). Participants had to remember lists of items (words) and, in most cases, were told that they could rely on an external store. On one trial, this expectation was violated, and participants had to unexpectedly rely on their internal/biological memory. Consistent with the prediction, results demonstrate a robust isolation effect irrespective of whether individuals could offload. The findings suggest that memory for distinct events is less susceptible to the typical cost of offloading to-be-remembered information.

Despite the long history and pervasiveness of cognitive offloading as a memory strategy, the memorial fate of offloaded information is not well understood. Recent work has suggested that offloading information may engage similar mechanisms as instructions to forget (e.g., directed forgetting). In the present investigation, we test this prediction by examining the serial position effect for offloaded information. Previous research has demonstrated that "forget" instructions can eliminate the primacy effect while leaving an intact recency effect. Across two experiments, participants completed a number of free recall trials using an external aid and then a final recall trial without the external aid. We compared a group that was expecting to use the aid for the final trial (offloading) with a group that was not (no-offloading). We found a memory impairment for offloaded items that was characterized by a reduced primacy effect but a typical recency effect, similar to what has been reported in research on intentional/directed forgetting.

The present study examined the long-term effects of suppressing puberty with a GnRH agonist on reproductive physiology and behavior in female rats. We have recently reported that administration of the GnRH agonist leuprolide acetate (25 µg/kg) daily between postnatal day (PD) 25-50 delayed puberty and disrupted the development of copulatory behavior and sexual motivation in male rats. However, pilot data from our lab suggest that this low dose of leuprolide acetate (25 µg/kg) was not high enough to significantly delay puberty in female rats. Therefore, we injected female Long-Evans rats with leuprolide acetate at a higher dose (50 µg/kg) or 0.9% sterile saline, daily , starting on PD 25 and ending on PD 50. Vaginal opening was monitored daily starting on PD 30 for signs of pubertal onset and first estrous cycle. In addition, we measured estrous cyclicity starting approximately 2 weeks after the last injection of leuprolide (∼PD 64). Immediately after monitoring estrous cyclicity, the female rats were mated on their first day in behavioral estrus using the partner-preference paradigm, with and without physical contact (PD 95-110). We found that this dose of leuprolide (50 µg/kg) significantly delayed puberty; however, neither estrous cyclicity nor sexual motivation was significantly affected by periadolescent exposure to leuprolide. Together with our findings in male rats, these results add to our understanding of the developmental effects of chemically suppressing puberty in rats.

Purpose The study purpose was to capture the clinical practice patterns of speech-language pathologists (SLPs) treating mild traumatic brain injury (mTBI; concussion). Study aims were to (a) characterize expert SLP practice patterns for the management of mTBI and (b) use qualitative content analysis to explore areas of quantitative variability within participants' responses. Method Using a modified Delphi approach, SLPs completed an online survey, with Round 1 responses shaping questions for Round 2. Round 2 results were analyzed using a concurrent partially mixed-methods approach with quantitative and qualitative items. Quantitative consensus agreement levels were set prestudy at 75% agreement or higher. Topic-level items that did not reach consensus were analyzed using qualitative content analysis. Participants SLPs engaging in a specialty mTBI-SLP networking group were invited to participate. Round 1 had nine participants (United States: 4, Canada: 5). Round 2 had 18 participants (United States: 12, Canada: 6), with a mean of 15.7 years of experience in mTBI (range: 3-33) and a mean of 7.6 clients with mTBI seen weekly (range: 1-25). Results Nearly all topic-level practice items met quantitative consensus (42/45). Consensus areas included using conceptual frameworks, interprofessional teaming, assessment and intervention practices, goal setting, and outcomes. Functional, collaborative, and client-centered care anchored clinical practice. Areas lacking consensus included SLP roles in mTBI mental and somatic health symptoms, specific measurement tools, and intervention dosages. Qualitative themes that emerged included limited interprofessional awareness for the role of SLPs in mTBI and challenges in measurement selection. Conclusions Study aims were met with clear consensus on clinical patterns implemented by SLPs specializing in mTBI. Results will inform both current clinical practices and future practice guidelines. High-level guidance and advocacy are needed to clarify SLP practice concerns and advance interprofessional education. Future work should address identified gaps, including targeted assessment tools and consensus on intervention methods.

To determine the association between relationship distress and menopausal symptoms.A retrospective analysis was conducted of questionnaires completed by women 40-65 years of age seeking menopause or sexual health consultation between May, 2015 and May, 2017.Associations between menopausal symptoms assessed using the Menopause Rating Scale (MRS) and relationship distress measured on the Kansas Marital Satisfaction Scale (KMSS) were evaluated with two-sample t-tests. Linear regression was used to assess associations after adjusting for potential confounders.The sample of 1884 women averaged 53 years of age (SD = 6.1); most were white (95%), employed (66%), married (90%), and well-educated (≥ college graduate, 64%). Women reporting no relationship distress (KMSS ≥ 17) had less severe menopausal symptoms overall compared with women reporting relationship distress (total MRS score 13.1 vs 16.0, P 0.001), with similar findings in each MRS domain. In multivariable analyses, this relationship persisted for total MRS scores and for psychological symptoms among women with no relationship distress, who scored an estimated 1.15 points (95% CI 0.52-1.78) lower on the total MRS and 0.82 points (95% CI 0.53-1.10) lower in the psychological symptom.The absence of relationship distress was associated with less severe menopausal symptoms, particularly in the psychological domain, in women presenting to a women's health clinic. Given the cross = sectional design, the direction of the relationship is unknown.

Background & Aims Patients with cirrhosis are growing older. The overlap between minimal hepatic encephalopathy (MHE) and predementia mild cognitive impairment (MCI) could affect quality of life (QOL). We investigated the performance of elderly patients with cirrhosis on tests for MHE and MCI and their effects on QOL. Methods We recruited outpatients with cirrhosis (n = 109) and without cirrhosis (controls, n = 100), 65 years or older, at 4 centers (derivation cohort). All study participants were assessed for psychometric hepatic encephalopathy score (PHES), EncephalApp score, and QOL. MCI was tested in patients with cirrhosis using the repeatable battery for assessment of neuropsychological status and assigned to the following groups: unimpaired, MCI only, MHE only, and MCI+MHE. We created adjusted norms to detect MHE using PHES and EncephalApp scores from the controls. Findings were validated using data from a separate cohort of 77 patients with cirrhosis (mean age, 69.49 ± 4.36 y; 72% men) at the same study sites. Results Controls were older but were more educated, performed better cognitively, and had better QOL. Among patients with cirrhosis, age, education, model for end-stage liver disease score, EncephalApp score, and QOL were similar, but PHES and repeatable battery for assessment of neuropsychological status differed among sites. In the derivation cohort, the presence of MHE, with or without MCI, was associated with poor QOL, which was lowest in the MCI+MHE group. When we adjusted for age, sex, and education, 49% of patients with cirrhosis had MHE based on the EncephalApp and 8% had MHE based on the PHES. A similar pattern (49% MHE based on EncephalApp and 6% MHE based on PHES) was found in a validation cohort. Conclusions In a multicenter study of patients with cirrhosis (>65 y) and controls, the presence of MHE, regardless of MCI, was associated with poor cognition and QOL. We created adjusted norms that defined the high sensitivity of EncephalApp for the detection of MHE in older individuals and validated it in a separate cohort.

Approximately 50% of older adults receiving care at VA are Veterans with chronic pain (V-CP). While physical activity can reduce chronic pain and increase mobility, little is known about group exercise (GE) effects for V-CP. We hypothesized that attrition may limit GE effectiveness. In this study, we retrospectively compared program attrition and participant mobility at three-months of Gerofit GE. At baseline, Older V-CP (N=21) had lower mobility assessment scores (gait speed, 6MW, chair stands, TUG: 1.04 m/s, 443 yd, 11, 9.35s vs. 1.09 m/s, 463 yd, 12, 8.19s respectively) compared to unaffected Veterans. Three-month attrition was higher for older V-CP (54% vs 39%). For those completing three months GE, gains in mobility were similar. We conclude that Veterans with chronic pain are less likely to persist in group exercise but those who persist benefit much like those without pain. Further study is needed to understand successful exercise adherence.

We often offload memory demands onto external artefacts (e.g., smartphones). While this practice allows us to subvert the limitations of our biological memory, storing memories externally exposes them to manipulation. To examine the impact of such manipulation, we report three experiments, two of which were pre-registered. Individuals performed a memory task where they could offload to-be-recalled information to an external store and on a critical trial, we surreptitiously manipulated the information in that store. Results demonstrated that individuals rarely noticed this manipulation. In addition, when individuals had information inserted into their external memory stores, they often encoded it into their biological memory, thereby leading to the creation of a false memory. The reported results highlight one of the cognitive consequences of offloading our memory to external artefacts.

Background & Aims Inpatients with cirrhosis are prone to develop acute-on-chronic liver failure (ACLF). ACLF is associated with dysbiosis of the intestinal microbiota, which might serve as a prognostic factor. We investigated whether features of the intestinal microbiota associate organ failure, transfer to intensive care, and mortality within 30 days in patients admitted to the hospital with cirrhosis. Methods Stool samples were collected from 181 patients with cirrhosis (age 56 years; mean model for end-stage liver disease score, 21; 43% with infections) at time of admission, from multiple hospitals in North America. Patients were followed for 30 days for development of ACLF, extra-hepatic organ failures, and death or hospice care. Microbiota were analyzed by 16s rRNA sequencing for alpha diversity (within groups), beta diversity (between groups), cirrhosis dysbiosis ratio (CDR), and taxa that differed between groups with vs without negative outcomes (individual organ failures, transfer to intensive care, ACLF, death, or hospice). Regression analyses were performed using microbial and clinical variables for each outcome. Results ACLF developed in 8% of study subjects; 16% were transferred to intensive care and 21% died. Beta diversity of the intestinal microbiome was significantly different, whereas alpha diversity was similar, between subjects with vs without outcomes. The CDR was lower in subjects who developed ACLF, especially among those with renal failure. Taxa belonging to phylum Proteobacteria (Enterobacteriaceae, Campylobacteriaceae, and Pasteurellaceae) and Firmicutes (Enterococcaceae and Streptococcaceae) were associated with development of negative outcomes, whereas other Firmicutes members (Lachnospiraceae and Clostridiales) reduced risk of negative outcomes. Changes in the microbiota associated with extra-hepatic organ failure, transfer to intensive care, ACLF, and death, independently on logistic regression analyses. Conclusion In hospitalized patients with cirrhosis, dysbiosis of the intestinal microbiota on admission (particularly changes in Protebacteria constituents) associates with increased risk of extra-hepatic organ failure, ACLF, and death, independent of clinical factors. Strategies to reduce gut dysbiosis might improve outcomes of patients with cirrhosis.

Herein we describe an improved synthesis for homoleptic iridium(III) 2-phenylpyridine based photocatalysts that allows rapid access to these compounds in good to high yields which have recently become a vital component within the field of catalysis. In addition, we synthesized a number of heteroleptic iridium(III) 2-phenylpyridine photocatalysts and report their photophysical and electrochemical properties. The emission energies span the range of 473–560 nm and reduction potentials from −2.27 V to −1.23 V and oxidation potentials ranging from 1.81 V to 0.69 V. Additionally, we provide the calculated excited state properties and comment on the role of these properties in designing catalytic cycles.