Optimization of percutaneous biopsy for diagnosis and pretreatment risk assessment of neuroblastoma.

BACKGROUND: Image-guided percutaneous core needle biopsy (PCNB) is increasingly utilized to diagnose solid tumors. The objective of this study is to determine whether PCNB is adequate for modern biologic characterization of neuroblastoma. PROCEDURE: A multi-institutional retrospective study was performed by the Pediatric Surgical Oncology Research Collaborative on children with neuroblastoma at 12 institutions over a 3-year period. Data collected included demographics, clinical details, biopsy technique, complications, and adequacy of biopsies for cytogenetic markers utilized by the Children's Oncology Group for risk stratification. RESULTS: A total of 243 children were identified with a diagnosis of neuroblastoma: 79 (32.5%) tumor excision at diagnosis, 94 (38.7%) open incisional biopsy (IB), and 70 (28.8%) PCNB. Compared to IB, there was no significant difference in ability to accurately obtain a primary diagnosis by PCNB (95.7% vs 98.9%, P = .314) or determine MYCN copy number (92.4% vs 97.8%, P = .111). The yield for loss of heterozygosity and tumor ploidy was lower with PCNB versus IB (56.1% vs 90.9%, P < .05; and 58.0% vs. 88.5%, P < .05). Complications did not differ between groups (2.9 % vs 3.3%, P = 1.000), though the PCNB group had fewer blood transfusions and lower opioid usage. Efficacy of PCNB was improved for loss of heterozygosity when a pediatric pathologist evaluated the fresh specimen for adequacy. CONCLUSIONS: PCNB is a less invasive alternative to open biopsy for primary diagnosis and MYCN oncogene status in patients with neuroblastoma. Our data suggest that PCNB could be optimized for complete genetic analysis by standardized protocols and real-time pathology assessment of specimen quality.

Cross-cultural variation in the development of folk ecological reasoning.

Two studies examined children's reasoning about biological kinds in populations that vary in formal education and direct experience with the natural world, a Western (urban U.S.) and a Non-Western population (Tanna, Vanuatu). Study 1 examined children's concepts of ecological relatedness between species (N = 97, 5-13- year-olds). U.S. children provided more taxonomic explanations than Ni-Vanuatu children, who provided more ecological, physiological, and utility explanations than U.S. children. Ecological explanations were most common overall and more common among older than younger children across cultures. In Study 2, children (N=106, 6-11-year-olds) sorted pictures of natural kinds into groups. U.S. children were more likely than Ni-Vanuatu children to categorize a human as an animal and the tendency to group a human with other animals increased with age in the U.S. Despite substantial differences in cultural, educational, and ecological input, children in both populations privileged ecological reasoning. In contrast, taxonomic reasoning was more variable between populations, which may reflect differences in experience with formal education.

Evidence from hunter-gatherer and subsistence agricultural populations for the universality of contagion sensitivity.

The phenomenon of magical contagion - the unobserved passage of properties between entities that come into physical contact - was described by anthropologists over a century ago, yet questions remain about its origin, function, and universality. Contagion sensitivity, along with the emotion of disgust, has been proposed to be part of a biologically-evolved system designed to reduce exposure to pathogens by increasing the avoidance of "contaminated" objects. Yet this phenomenon has not been studied using systematic psychological comparison outside of industrialized populations. Here we document contagion sensitivity in two culturally, geographically, and economically distinct populations with little exposure to Western biomedicine and formal education: the Hadza hunter-gatherers of Tanzania and Tannese subsistence-agriculturalists of Vanuatu. In both populations, a majority of individuals rejected familiar and palatable foods when contaminating items touched the food but were subsequently removed. The Tannese children in our study showed a similar response, consistent with previous research with Western children. Our data support the proposal that contagion sensitivity is universal in human populations.

The social functions of shamanism.

Cultural evolutionary accounts of shamanism must explain the cross-cultural recurrence and variation in associated practices. We suggest that Singh's account of shamanism would be strengthened by considering the social functions of shamanism in groups. Shamanism increases social group cohesion, making it distinct from other magico-religious practices.

Central venous catheter salvage in children with Staphylococcus aureus central line-associated bloodstream infection.

BACKGROUND: Prompt central venous catheter (CVC) removal is currently recommended in children with Staphylococcus aureus central line-associated bloodstream infection (CLABSI). Our objective was to examine the outcome of attempted line salvage in children with S. aureus CLABSI and assess predictors of success. METHODS: A single-institution, retrospective cohort study was performed of all children with S. aureus CLABSI between 2012 and 2015. Patients with and without immediate CVC removal (≤ 2 days after first positive culture) were compared. The primary outcome was failed CVC salvage (removal after 3+ days). RESULTS: Seventy-seven children met criteria for S. aureus CLABSI. Immediate CVC removal was performed in 27.3% of patients. Among the 72.7% patients in whom CVC salvage was attempted, 78.6% were successful and 21.4% required delayed CVC removal. Malignancy, short gut syndrome, neutropenia, methicillin-resistant S. aureus, and line type were not associated with salvage failure. No associated morbidity or mortality occurred in patients with a failed salvage attempt. New or recurrent bacteremia occurred in five patients, but three were successfully salvaged a second time. CONCLUSIONS: CVC salvage was feasible in the majority of children with S. aureus CLABSI and was not associated with significant complications or attributable mortality as reported in adults.

In-Group Ostracism Increases High-Fidelity Imitation in Early Childhood.

The Cyberball paradigm was used to examine the hypothesis that children use high-fidelity imitation as a reinclusion behavior in response to being ostracized by in-group members. Children (N = 176; 5- to 6-year-olds) were either included or excluded by in- or out-group members and then shown a video of an in-group or an out-group member enacting a social convention. Participants who were excluded by their in-group engaged in higher-fidelity imitation than those who were included by their in-group. Children who were included by an out-group and those who were excluded by an out-group showed no difference in imitative fidelity. Children ostracized by in-group members also displayed increased anxiety relative to children ostracized by out-group members. The data are consistent with the proposal that high-fidelity imitation functions as reinclusion behavior in the context of in-group ostracism.

The functions of ritual in social groups.

Ritual cognition builds upon social learning biases that may have become specialized for affiliation within social groups. The adaptive problems of group living required a means of identifying group members, ensuring commitment to the group, facilitating cooperation, and maintaining group cohesion. We discuss how ritual serves these social functions.

Valence-partitioned learning signals drive choice behavior and phenomenal subjective experience in humans.

How the human brain generates conscious phenomenal experience is a fundamental problem. In particular, it is unknown how variable and dynamic changes in subjective affect are driven by interactions with objective phenomena. We hypothesize a neurocomputational mechanism that generates valence-specific learning signals associated with 'what it is like' to be rewarded or punished. Our hypothesized model maintains a partition between appetitive and aversive information while generating independent and parallel reward and punishment learning signals. This valence-partitioned reinforcement learning (VPRL) model and its associated learning signals are shown to predict dynamic changes in 1) human choice behavior, 2) phenomenal subjective experience, and 3) BOLD-imaging responses that implicate a network of regions that process appetitive and aversive information that converge on the ventral striatum and ventromedial prefrontal cortex during moments of introspection. Our results demonstrate the utility of valence-partitioned reinforcement learning as a neurocomputational basis for investigating mechanisms that may drive conscious experience.

Time perception reflects individual differences in motor and non-motor symptoms of Parkinson's disease.

Decreasing dopaminergic function is at the core of Parkinson's disease (PD) motor symptoms and changes in dopaminergic action are associated with many comorbid non-motor symptoms in PD. Notably, dopaminergic signaling in the striatum has been shown to play a critical role in the perception of time. We hypothesize that patients with PD perceive time differently and in accordance with their specific comorbid non-motor symptoms and clinical state. This means that individual differences in clinical symptoms may be reflected in individual differences in timing behavior. To test this hypothesis, we recruited patients with PD and compared individual differences in patients' clinical state with their ability to judge intervals of time ranging from 500 ms to 1100 ms while on and off their prescribed dopaminergic medications. We show that medication state (on vs. off medications) did not affect timing behavior, but individual differences in timing behavior are able to predict individual differences in comorbid non-motor symptoms, duration of PD diagnosis, and prescribed dopaminergic medications. We show that comorbid impulse control disorder is associated with temporal overestimation; depression is associated with decreased temporal accuracy; and increased PD duration and prescribed levodopa monotherapy are associated with reduced temporal precision and accuracy. Observed differences in time perception are consistent with hypothesized dopaminergic mechanisms thought to underlie the respective motor and non-motor symptoms in PD. In future work, time perception tasks may augment clinical diagnosis strategies, or help disentangle the neural and cognitive mechanisms underlying PD motor and non-motor symptom etiology.

Time perception reflects individual differences in motor and non-motor symptoms of Parkinson's disease.

Dopaminergic signaling in the striatum has been shown to play a critical role in the perception of time. Decreasing striatal dopamine efficacy is at the core of Parkinson's disease (PD) motor symptoms and changes in dopaminergic action have been associated with many comorbid non-motor symptoms in PD. We hypothesize that patients with PD perceive time differently and in accordance with their specific comorbid non-motor symptoms and clinical state. We recruited patients with PD and compared individual differences in patients' clinical features with their ability to judge millisecond to second intervals of time (500ms-1100ms) while on or off their prescribed dopaminergic medications. We show that individual differences in comorbid non-motor symptoms, PD duration, and prescribed dopaminergic pharmacotherapeutics account for individual differences in time perception performance. We report that comorbid impulse control disorder is associated with temporal overestimation; depression is associated with decreased temporal accuracy; and PD disease duration and prescribed levodopa monotherapy are associated with reduced temporal precision and accuracy. Observed differences in time perception are consistent with hypothesized dopaminergic mechanisms thought to underlie the respective motor and non-motor symptoms in PD, but also raise questions about specific dopaminergic mechanisms. In future work, time perception tasks like the one used here, may provide translational or reverse translational utility in investigations aimed at disentangling neural and cognitive systems underlying PD symptom etiology. One Sentence Summary: Quantitative characterization of time perception behavior reflects individual differences in Parkinson's disease motor and non-motor symptom clinical presentation that are consistent with hypothesized neural and cognitive mechanisms.

Cognitive flexibility supports the development of cumulative cultural learning in children.

The scale of cumulative cultural evolution (CCE) is a defining characteristic of humans. Despite marked scientific interest in CCE, the cognitive underpinnings supporting its development remain understudied. We examined the role cognitive flexibility plays in CCE by studying U.S. children's (N = 167, 3-5-year-olds) propensity to relinquish an inefficient solution to a problem in favor of a more efficient alternative, and whether they would resist reverting to earlier versions. In contrast to previous work with chimpanzees, most children who first learned to solve a puzzlebox in an inefficient way switched to an observed, more efficient alternative. However, over multiple task interactions, 85% of children who switched reverted to the inefficient method. Moreover, almost all children in a control condition (who first learned the efficient method) switched to the inefficient method. Thus, children were keen to explore an alternative solution but, like chimpanzees, are overall conservative in reverting to their first-learned one.

Cultural Variation in the Development of Beliefs About Conservation.

Examining variation in reasoning about sustainability between diverse populations provides unique insight into how group norms surrounding resource conservation develop. Cultural institutions, such as religious organizations and formal schools, can mobilize communities to solve collective challenges associated with resource depletion. This study examined conservation beliefs in a Western industrialized (Austin, Texas, USA) and a non-Western, subsistence agricultural community (Tanna, Vanuatu) among children, adolescents, and adults (N = 171; n = 58 7-12-year-olds, n = 53 13-17-year-olds, and n = 60 18-68-year-olds). Participants endorsed or rejected four types of justifications for engaging in land and animal conservation: sustainability, moral, religious, or permissible. In both populations, participants endorsed sustainability justifications most frequently. Religious justifications increased with age in Tanna and decreased with age in Austin. Tannese participants were also more likely to endorse multiple justifications for conservation than Austin participants. Data across all justification types show a main effect of age in both communities; endorsement of conservation decreased with age in Austin, but increased with age in Tanna. Across age groups, participants were more likely to endorse the conservation of animals than land in Austin, yet equally as likely to endorse the conservation of land and animals in Tanna. Overall, these results reveal similarities and differences in the beliefs that support the conservation of natural resources across populations.

Psychometric properties of the Affect Intensity and Reactivity Measure adapted for Youth (AIR-Y).

A valid and reliable instrument for measuring affect intensity does not exist for adolescents; such a measure may help to refine understanding of emotion among youths. The purpose of the current study was to evaluate the psychometric properties and clinical relevance of a measure of affect intensity adapted for youths. Two hundred five community adolescents and 179 adolescents from a residential treatment program were recruited; both samples completed self-report questionnaires, and the community-based sample participated in positive and negative mood-eliciting laboratory tasks. Confirmatory factor analyses comparing multiple models indicated a 3-factor structure was the best fit. This Affect Intensity and Reactivity Scale for Youth (AIR-Y) evidenced good internal consistency and test-retest reliability, and the 3 factors showed incremental predictive validity for mood ratings following emotion-elicitation procedures, even after accounting for the relevant scale on the Positive and Negative Affect Scale for Children. Evidence for the clinical relevance of the AIR-Y, particularly the Negative Intensity factor, was found. Overall, the AIR-Y appears to be a psychometrically sound measure for the assessment of affect intensity among youths.

Environmental estrogens suppress hormones, behavior, and reproductive fitness in male fathead minnows.

This study explored the possibility that environmental estrogens in sewage effluent may reduce the reproductive fitness of adult male fish by suppressing their reproductive behaviors, including their ability to compete for nests and females. Male fathead minnows (Pimephales promelas) were exposed for three weeks to either blank control, effluent released by a sewage treatment plant (STPE), waterborne estradiol (E2), or a synthetic androgen (methyltestosterone [MT]). Afterward, fish were placed with females and a nest, and their behavior was monitored for 5 d in either the presence or the absence of a competing (unexposed control) male. Males exposed to either the STPE or E2 (approximately 50 ng/L, a level chosen to mimic the estrogenic content of the STPE) had elevated levels of circulating vitellogenin (p < 0.05) and lower levels of 11-ketotestosterone (KT; p < 0.05). Nearly all STPE- and E2-exposed males spawned successfully in the absence of a competing male, but in both cases, exposed males suffered nearly total reproductive failure when they had to compete. Conversely, males exposed to MT (approximately 50 ng/L) outcompeted control males. Behavioral observations suggested that subtle differences in agonistic behaviors, typically associated with circulating androgens (i.e., KT), were responsible. We speculate that male fish exposed to estrogenic effluent in the field are less likely to reproduce successfully within large populations of wild fish, thereby causing abnormal and potentially detrimental patterns of gene flow within those populations.

The coexistence of natural and supernatural explanations within and across domains and development.

People across highly diverse cultural contexts use both natural and supernatural explanations to explain questions of fundamental concern such as death, illness, and human origins. The present study examines the development of explanatory coexistence within and across domains of existential concern in individuals in Tanna, Vanuatu. We examined three age groups: 7- to 12-year-old children, 13- to 18-year-old adolescents, and 19- to 70-year-old adults (N = 72). Within the domain of death, biological and spontaneous explanations were most common across all ages. For illness, children showed the highest rates of explanatory coexistence, while adolescents and adults favoured biological explanations. Within the human origins domain, theistic explanations were most common across the age groups. Overall, these data show that coexistence reasoning in these domains is pervasive across cultures, yet at the same time it is deeply contextually specific, reflecting the nuanced differences in local ecologies and cultural beliefs. Statement of contribution What is already known on this subject? Individuals across highly diverse cultural contexts use both natural and supernatural explanations to understand the events that occur in their lives. Context and cultural input play a large role in determining when and how individuals incorporate natural and supernatural explanations. The development of explanatory coexistence has primarily studied explanations for isolated domains. What does this study add? We examined explanatory coexistence in a culture with recent conversion to Christianity and formal education. The current research examines how individuals reason within and across the domains of human origins, illness, and death. Developmental differences associated with explanatory coexistence are examined.

What's Important to the Patient? Informational Needs of Patients Making Decisions About Hepatitis C Treatment.

BACKGROUND AND OBJECTIVES: Multiple treatment options with direct-acting antivirals are now available for hepatitis C virus (HCV). Study aims were to understand (1) the informational topics patients want to have to make informed treatment decisions; (2) the importance patients place on each topic; and (3) the topics patients prioritize as most important. METHODS: We used a mixed-methods study of two samples recruited from an academic liver center. Participants were not currently on treatment. Sample I (n = 45) free listed all informational topics deemed important to decision making. Raw responses were coded into several broad and subcategories. Sample II (n = 38) rated the importance of the subcategories from Sample I and ranked their highest priorities on two surveys, one containing topics for which sufficient research existed to inform patients ('static'), and the other containing topics that would require additional research. RESULTS: The topics listed by Sample I fell into six broad categories with 17 total subcategories. The most oft-cited informational topics were harms of treatment (100%), treatment benefits (62%), and treatment regimen details (84%). Sample II rated 16 of 17 subcategories as "pretty important' or "extremely important". Sample II prioritized (1) viral cure, (2) long-term survival, and (3) side effects on the survey of topics requiring additional research, and (1) liver disease, (2) lifestyle changes, and (3) medication details on the second survey of the most important static topics patients needed. CONCLUSIONS: Patients weighed several informational topics to make an informed decision about HCV treatment. These findings lay the groundwork for future patient-centered outcomes research in HCV and patient-provider communication to enhance patients' informed decision making regarding direct-acting antiviral treatment options.

Does the Body Survive Death? Cultural Variation in Beliefs About Life Everlasting.

Mounting evidence suggests that endorsement of psychological continuity and the afterlife increases with age. This developmental change raises questions about the cognitive biases, social representations, and cultural input that may support afterlife beliefs. To what extent is there similarity versus diversity across cultures in how people reason about what happens after death? The objective of this study was to compare beliefs about the continuation of biological and psychological functions after death in Tanna, Vanuatu (a Melanesian archipelago), and the United States (Austin, Texas). Children, adolescents, and adults were primed with a story that contained either natural (non-theistic) or supernatural (theistic) cues. Participants were then asked whether or not different biological and psychological processes continue to function after death. We predicted that across cultures individuals would be more likely to endorse the continuation of psychological processes over biological processes (dualism) and that a theistic prime would increase continuation responses regarding both types of process. Results largely supported predictions; U.S. participants provided more continuation responses for psychological than biological processes following both the theistic and non-theistic primes. Participants in Vanuatu, however, provided more continuation responses for biological than psychological processes following the theistic prime. The data provide evidence for both cultural similarity and variability in afterlife beliefs and demonstrate that individuals use both natural and supernatural explanations to interpret the same events.

Interdisciplinary and Cross-Cultural Perspectives on Explanatory Coexistence.

Natural and supernatural explanations are used to interpret the same events in a number of predictable and universal ways. Yet little is known about how variation in diverse cultural ecologies influences how people integrate natural and supernatural explanations. Here, we examine explanatory coexistence in three existentially arousing domains of human thought: illness, death, and human origins using qualitative data from interviews conducted in Tanna, Vanuatu. Vanuatu, a Melanesian archipelago, provides a cultural context ideal for examining variation in explanatory coexistence due to the lack of industrialization and the relatively recent introduction of Christianity and Western education. We argue for the integration of interdisciplinary methodologies from cognitive science and anthropology to inform research on explanatory coexistence.

Stability and change in multi-method measures of impulsivity across residential addictions treatment.

INTRODUCTION: Although the relations between constructs related to impulsivity and substance use disorders (SUDs) are well established, recent research suggests that changes in impulsivity may be an important mechanism in the recovery process. However, this evidence is primarily based on studies that have examined the relation between changes in impulsivity and substance involvement across the span of several years using self-report measures; thus, it is unclear if these changes are linked across shorter time intervals or extend to behavioral methods of assessment. METHODS: Using prospective data from 43 participants (mean age=35.06; 60% female) enrolled in residential substance abuse treatment, the extent to which seven facets of impulsivity (i.e., questionnaire-assessed delay discounting, lack of perseverance, lack of planning, negative urgency, positive urgency, sensation seeking, and behaviorally-assessed inhibitory control) changed across approximately 4 weeks of treatment was examined. RESULTS: Dependent group t-tests suggested significant reductions in negative urgency and lack of planning, and significant improvements in inhibitory control. CONCLUSIONS: Findings indicate that specific impulsivity facets show change across relatively short time frames and suggest nonspecific effects of residential treatment on levels of impulsivity. These results inform the functional relation between facets of impulsivity and substance involvement and have implications for assessment and treatment approaches for SUDs.

Interactive Effects of Anxiety Sensitivity and Difficulties in Emotion Regulation: An Examination among Individuals in Residential Substance Use Treatment with Comorbid Posttraumatic Stress Disorder.

Individuals with posttraumatic stress disorder (PTSD) exhibit deficits in cognitive and emotional processes. PTSD severity is positively associated with anxiety sensitivity (AS) and difficulties in emotion regulation, and difficulties in emotion regulation mediate the relation between AS and PTSD. However, previous research has not examined the interactive nature of these variables. Associations between PTSD, AS, and difficulties in emotion regulation were examined in patients with PTSD in a residential substance treatment program (N = 120). Conditional process analyses indicated an interactive effect of difficulties in emotion regulation and AS for predicting PTSD symptom severity. For individuals high in emotion regulation difficulties, PTSD symptom severity was high regardless of level of AS; conversely, for individuals high in AS, increased PTSD severity was observed regardless of level of emotion regulation difficulties. Results suggest directions for future research, including targeting patient specific cognitive-affective processes to enhance PTSD treatment response among substance dependent individuals.