Emotion regulation: quantitative meta-analysis of functional activation and deactivation.

Emotion regulation is hypothesized to be a multifaceted process by which individuals willfully modulate the intensity and direction of emotional response via prefrontally mediated inhibition of subcortical response-related regions of the brain. Here we employ activation likelihood estimation (ALE) meta-analysis of functional magnetic resonance imaging studies to (1) reveal a consistent network of structures active during emotion regulation, (2) identify the target regions inactivated by the willful regulation process, and (3) investigate the consistency of activated structures associated with downregulation and upregulation. Results reveal signal change in bilateral amygdala/parahippocampal gyrus that decreased in downregulated states and increased in upregulated states, while cortical regions including superior frontal gyrus, cingulate, and premotor areas exhibited enhanced activity across all regulation conditions. These results provide consistent evidence for the role of amygdala activity in experienced emotional intensity, where intentional dampening and exaggeration are clearly expressed. However, the execution of emotional upregulation and downregulation may involve distinct subsets of frontocortical structures.

Altered Ig levels and antibody responses in mice deficient for the Fc receptor for IgM (FcµR).

Cell surface Fc receptor for IgM antibody (FcµR) is the most recently identified member among FcRs. We determined the cellular distribution of mouse FcµR and the functional consequences of Fcmr disruption. Surface FcµR expression was restricted to B-lineage cells, from immature B to plasma cells, except for a transient down-modulation during germinal center reactions. Fcmr ablation had no significant effect on overall B- and T-cell development, but led to a reduction of marginal zone B cells and an increase in splenic B1 B cells. Preimmune serum IgM in mutant mice was significantly elevated as were natural autoantibodies. When immunized with live attenuated pneumococci, mutant mice mounted robust antibody responses against phosphorylcholine, but not protein, determinants compared with wild-type mice. By contrast, upon immunization with a hapten-carrier conjugate, nitrophenyl-coupled chicken γ-globulin (NP-CGG), the mutant mice had a diminished primary IgG1 response to both NP and CGG. These findings suggest that FcµR has an important role in IgM homeostasis and regulation of humoral immune responses.

Use of levonorgestrel emergency contraception in Utah: is it more than "plan B"?

CONTEXT: It is important to understand why some women use levonorgestrel emergency contraceptive pills repeatedly, because the method is not intended for repeated use, and current evidence suggests that it is approximately 77% effective at preventing pregnancy. METHODS: An anonymous patient survey of 1,040 women aged 18-29 purchasing levonorgestrel at Planned Parenthood clinics in Utah was conducted during a 4-6-week period in 2007. Chi-square tests and analyses of variance were used to examine associations between selected characteristics and level of levonorgestrel use. Logistic regression was used to assess characteristics independently associated with repeated use. RESULTS: Twenty-nine percent of participants had used levonorgestrel more than twice in the prior year. Fifty-eight percent believed that levonorgestrel is at least 90% effective in protecting against pregnancy; 16% believed that it is 100% effective. In univariate analyses, lifetime number of partners, currently having multiple partners, substance use at last intercourse and perceived effectiveness of levonorgestrel were positively associated with repeated levonorgestrel use in the previous year. The measure most strongly associated with repeated levonorgestrel use in multivariate analyses was perceived effectiveness: Women who believed that the method is 90-99% or 100% effective in preventing pregnancy had greater odds of repeated use than those who believed it is 75-89% effective (odds ratios, 1.8 each). CONCLUSION: Women who repeatedly use levonorgestrel may have an inflated perception of its effectiveness. Future research, including qualitative research, may help clarify factors that lead to inflated perceptions of effectiveness.

Ratiometric comparison of intense field ionization of atoms and diatomic molecules.

Intense-laser ionization rates for rare gas atoms and diatomic molecules have been precisely compared by making simultaneous measurements of ionization yield vs laser intensity for mixed atomic and molecular targets. At a given laser intensity, the N (2) and F (2) ionization yields are slightly greater than that of Ar. Conversely, comparison of O (2) and S (2) with Xe indicates significant ionization suppression in these molecules. Recent molecular ionization models that successfully describe ionization suppression in O (2) and its absence in N (2) fail to explain our observations in F (2) and S (2).

Defining dimensions of pregnancy intendedness.

BACKGROUND: The classification scheme used by the National Survey of Family Growth (NSFG) is a well-established system for defining the intendedness of pregnancy, but its clinical relevance is uncertain. The purpose of this study was to explore how women conceptualize the intention status of their pregnancies and how their concepts relate to the classification scheme used by the NSFG. METHODS: This qualitative study used in-depth, semistructured, open-ended interviews with 27 pregnant women seeking prenatal care or abortion. Sampling was based on ethnicity (Caucasian or Hispanic), education, religiosity, and NSFG intention status (intended, mistimed, or unwanted). RESULTS: Five qualitative dimensions of pregnancy intendedness emerged: preconception desire for pregnancy, steps taken to prepare for pregnancy, fertility behavior and expectations, postconception desire for pregnancy, and adaptation to pregnancy and baby. The relationship of these qualitative dimensions to the NSFG categories was varied and complex, particularly for the NSFG mistimed category. Women indicated that their partners had a strong influence on preconception and postconception desire for pregnancy. CONCLUSION: Further research is needed to develop measures of pregnancy intendedness that accurately reflect the needs and priorities of women. Research that addresses male perspectives and influence is of particular importance.

Exploring the concepts of intended, planned, and wanted pregnancy.

BACKGROUND: A variety of terms have been used to define the intention status of pregnancies. The purpose of this study was to explore how women relate to these terms and how they define the intention status of their pregnancies. Improved understanding of how women use these terms may enhance communication between physicians, patients, and families. METHODS: This qualitative study used in-depth semistructured interviews to explore how women defined the intention status of current, past, and hypothetical pregnancies. Eighteen women who were seeking prenatal care, elective abortion, or pregnancy testing were interviewed. Most of the subjects were interviewed in the first trimester of a current pregnancy. Four researchers independently reviewed the interview transcripts and summarized the points made by each subject. RESULTS: Three major themes emerged from the interviews: (1) definitions of terms related to pregnancy varied substantially among women and seemed to be highly correlated to social and cultural influences; (2) the concepts of wanted and unwanted pregnancy were qualitatively distinct from the concepts of planned and unplanned pregnancies and seemed to be more relevant to the decision to continue or abort the pregnancy; and (3) attitudes of the male partners toward the pregnancies were very influential in how women defined their pregnancies. CONCLUSIONS: Physicians should explore the attitudes and circumstances of pregnant women, rather than focusing on whether the pregnancy was planned. Support from the significant other and the woman's underlying values about parenthood seem to be of particular importance. Our results also suggest that further studies are needed to determine the best method for measuring the intention status of pregnancy for research and policy.

PIP: This qualitative study using in-depth semistructured interviews determined how women define the intention status of current, past, and hypothetical pregnancies. The study population included 18 women, primarily in their first trimester, seeking prenatal care, elective abortion, or pregnancy testing. Findings demonstrated three major themes emerging from the interviews: 1) definition of terms related to pregnancy varied substantially among women and seemed to be highly correlated to social and cultural influences; 2) the concepts of wanted and unwanted pregnancy were qualitatively distinct from the concepts of planned and unplanned pregnancy and seemed to be more relevant to the decision to continue or abort the pregnancy; and 3) attitudes of male partners toward the pregnancies were very influential in how women defined their pregnancies.

Evaluating medication response in ADHD: cognitive, behavioral, and single-subject methodology.

Although evidence supports the use of double-blind placebo medication trials to evaluate methylphenidate (MPH) effects on the core behavioral symptoms of attention-deficit/hyperactivity disorder (ADHD), few studies have demonstrated their utility in examining MPH effects on the cognitive deficits associated with ADHD. This article presents a technique for evaluating behavioral and cognitive dose-response relationships at the single-subject level of analysis. Case study results and multivariate analyses suggest that systematic evaluation of behavioral and cognitive MPH dose-response relationships could lead to more accurate MPH titration and greater long-term multimodal treatment efficacy.

Relationship of nutritional status to length of stay, hospital costs, and discharge status of patients hospitalized in the medicine service.

OBJECTIVE: This study was conducted to determine the relationship, if any, between nutritional status, length of stay (LOS) in hospital, discharge placement, readmission rates, and hospital costs and charges in patients hospitalized in the medicine service. DESIGN: Data regarding medical diagnosis, LOS, hospital costs, charges, discharge destination, and readmission rates were collected prospectively from medical records and through patient interviews on patients admitted to the medical service who were classified to be at risk or not at risk for malnutrition on the basis of established criteria (weight for height < 75% ideal body weight, admission serum albumin level < 30 g/L, or > or = 10% unintentional weight loss within 1 month before admission). SUBJECTS: All patients admitted directly to any of three medicine units during December 1994 who met study criteria were included in the study. Off-service patients, transfer patients, and patients discharged before screening (usually admitted and discharged within 72 hours) were excluded. Data were collected on 173 patients. STATISTICAL ANALYSIS PERFORMED: At-risk and not at-risk patients were compared for LOS, costs and reimbursement, and discharge placement (to home, to home with home health care services, or to another facility for further care). Two sample t tests and alpha survival analysis technique were used to compare continuous variables between the two study cohorts. Nonparametric tests were used for LOS and readmission data. chi 2 Tests were used for categoric variables. An alpha level of .05 was used throughout to determine statistical significance. RESULTS: Median LOS in the not-at-risk population (n = 56) was significantly greater than in the not-at-risk population (n = 117): 6 days (25th percentile = 4 days, 75th percentile = 8 days) vs 4 days (25th percentile = 3 days, 75th percentile = 7 days) (P < .01). Mean hospitalization cost per patient was also higher in the at-risk group ($6,196 vs $4,563, P < .02). Readmission rate per month of follow-up was not significantly different. At-risk patients were significantly less likely to be discharged home with self-care (23[41%] vs 77 [66%], P < .05). At-risk patients were significantly more likely to use home health care service than not-at-risk patients (17[31%] vs 14 or [12%], P < .001). APPLICATIONS: Patients at risk for malnutrition had significantly higher LOS, costs, and home health care needs, despite the fact that 51, or 91%, received nutrition intervention while hospitalized. Further research should explore the use of nutrition screening and intervention before, during, and after hospitalization to ensure that appropriate nutrition intervention, as indicated by medical patients' clinical condition and nutritional risk status, is initiated and continued.

The dangers of jimson weed and its abuse by teenagers in the Kanawha Valley of West Virginia.

Jimson weed (Datura stramonium, a member of the Belladonna alkyloid family) is a plant growing naturally in West Virginia and has been used as a home remedy since colonial times. Due to its easy availability and strong anticholinergic properties, teens are using Jimson weed as a drug. Plant parts can be brewed as a tea or chewed, and seed pods, commonly known as "pods" or "thorn apples," can be eaten. Side effects from ingesting jimson weed include tachycardia, dry mouth, dilated pupils, blurred vision, hallucinations, confusion, combative behavior, and difficulty urinating. Severe toxicity has been associated with coma and seizures, although death is rare. Treatment consists of activated charcoal and gastric lavage. Esmolol or other beta-blocker may be indicated to reduce severe sinus tachycardia. Seizures, severe hypertension, severe hallucinations, and life-threatening arrhythmias are indicators for the use of the anticholinesterase inhibitor, Physostigmine. This article reviews the cases of nine teenagers who were treated in hospitals in the Kanawha Valley after ingesting jimson weed. We hope this article will help alert primary care physicians about the abuse of jimson weed and inform health officials about the need to educate teens about the dangers of this plant.

Attention capture by novel stimuli.

In several experiments, observers were given glimpses of 4-word arrays. Accuracy of word localization was tested after each array. Some words, called familiar, appeared many times across the series of arrays; others, called novel, appeared only once. The ratio of novel to familiar words in an array ranged from 0:4 to 4:0. When familiar and novel words were not intermixed (in 0:4 and 4:0 arrays), localization accuracy was higher for familiar words. However, when they were intermixed, especially in 1:3 arrays, accuracy tended to be higher for the novel words. This novel popout effect was the outcome of the suppressed localizability of the familiar words (relative to the 0:4 baseline) and the enhanced localizability of the novel words (relative to the 4:0 baseline). Novel popout may reflect an automatic orientation of attention away from more fluently unfolding regions of the perceptual field (familiar objects) and toward less fluently unfolding regions (novel objects).