'Life Minus Illness = Recovery': A Phenomenological Study About Experiences and Meanings of Recovery Among Individuals with Serious Mental Illness from Southern India.

Traditional medical models have given way to recovery-oriented approaches over the years in the management of individuals with serious mental illnesses. However, very little is known about such recovery-based models in the Indian context. This qualitative study used a phenomenological approach to explore the experiences and meanings of recovery among individuals with serious mental illness in southern India. Purposive sampling with maximum variation was used to recruit participants. In-depth interviews were conducted with ten participants, using a semi-structured interview guide. Thematic analysis resulted in three themes: "The illness journey," "Life minus illness = Recovery," and "It takes a village to recover,". Illness and recovery seemed to be two sides of the same coin with the context playing an influential role in the perceptions of recovery. The term "recovery" seemed to be a misnomer giving the impression that one is expected to return to an illness free state.

Genome-wide Methylation Dynamics and Context-dependent Gene Expression Variability in Differentiating Preadipocytes.

Obesity, characterized by the accumulation of excess fat, is a complex condition resulting from the combination of genetic and epigenetic factors. Recent studies have found correspondence between DNA methylation and cell differentiation, suggesting a role of the former in cell fate determination. There is a lack of comprehensive understanding concerning the underpinnings of preadipocyte differentiation, specifically when cells are undergoing terminal differentiation (TD). To gain insight into dynamic genome-wide methylation, 3T3 L1 preadipocyte cells were differentiated by a hormone cocktail. The genomic DNA was isolated from undifferentiated cells and 4 hours, 2 days postdifferentiated cells, and 15 days TD cells. We employed whole-genome bisulfite sequencing (WGBS) to ascertain global genomic DNA methylation alterations at single base resolution as preadipocyte cells differentiate. The genome-wide distribution of DNA methylation showed similar overall patterns in pre-, post-, and terminally differentiated adipocytes, according to WGBS analysis. DNA methylation decreases at 4 hours after differentiation initiation, followed by methylation gain as cells approach TD. Studies revealed novel differentially methylated regions (DMRs) associated with adipogenesis. DMR analysis suggested that though DNA methylation is global, noticeable changes are observed at specific sites known as "hotspots." Hotspots are genomic regions rich in transcription factor (TF) binding sites and exhibit methylation-dependent TF binding. Subsequent analysis indicated hotspots as part of DMRs. The gene expression profile of key adipogenic genes in differentiating adipocytes is context-dependent, as we found a direct and inverse relationship between promoter DNA methylation and gene expression.

Variation in encoding context benefits item recognition.

The current study assesses whether varying the encoding context of a repeated event is a potential strategy to improve recognition memory across retrieval contexts. Context variability, also known as encoding variability, has historically been investigated primarily using recall and cued recall tasks, with the consensus being that encoding variability is not necessarily beneficial for episodic retrieval. However, recent studies (see text) suggest that test type may determine the strategy's effectiveness. Aligned with these recent findings, we found consistent benefits to simple item recognition when a word was studied in more variable contexts compared to less variable contexts across four experiments. This main effect of context variability occurred when crossed with a manipulation of repetition spacing and when crossed with a manipulation of encoding-retrieval context match. Variation in encoding contexts beyond the future retrieval context led to better item recognition than repeated study exposures within the future retrieval context. We argue that the current study and other recent findings indicate a need to re-evaluate the historical consensus on encoding variability as a beneficial strategy for learning.

Spatial distribution pattern of immune cells is associated with patient prognosis in colorectal cancer.

BACKGROUND: The spatial context of tumor-infiltrating immune cells (TIICs) is important in predicting colorectal cancer (CRC) patients' clinical outcomes. However, the prognostic value of the TIIC spatial distribution is unknown. Thus, we aimed to investigate the association between TIICs in situ and patient prognosis in a large CRC sample. METHODS: We implemented multiplex immunohistochemistry staining technology in 190 CRC samples to quantify 14 TIIC subgroups in situ. To delineate the spatial relationship of TIICs to tumor cells, tissue slides were segmented into tumor cell and microenvironment compartments based on image recognition technology, and the distance between immune and tumor cells was calculated by implementing the computational pipeline phenoptr. RESULTS: MPO+ neutrophils and CD68+IDO1+ tumor-associated macrophages (TAMs) were enriched in the epithelial compartment, and myeloid lineage cells were located nearest to tumor cells. Except for CD68+CD163+ TAMs, other cells were all positively associated with favorable prognosis. The prognostic predictive power of TIICs was highly related to their distance to tumor cells. Unsupervised clustering analysis divided colorectal cancer into three subtypes with distinct prognostic outcomes, and correlation analysis revealed the synergy among B cells, CD68+IDO1+TAMs, and T lineage cells in producing an effective immune response. CONCLUSIONS: Our study suggests that the integration of spatial localization with TIIC abundance is important for comprehensive prognostic assessment.

Deciphering the significance of p53 mutant proteins.

Mutations in the p53 gene compromise its role as guardian of genomic integrity, yielding predominantly missense p53 mutant proteins. The gain-of-function hypothesis has long suggested that these mutant proteins acquire new oncogenic properties; however, recent studies challenge this notion, indicating that targeting these mutants may not impact the fitness of cancer cells. Mounting evidence indicates that tumorigenesis involves a cooperative interplay between driver mutations and cellular state, influenced by developmental stage, external insults, and tissue damage. Consistently, the behavior and properties of p53 mutants are altered by the context. This article aims to provide a balanced summary of the evolving evidence regarding the contribution of p53 mutants in the biology of cancer while contemplating alternative frameworks to decipher the complexity of p53 mutants within their physiological contexts.

Cultural and Contextual Adaptation of Digital Health Interventions: Narrative Review.

BACKGROUND: Emerging evidence suggests that positive impacts can be generated when digital health interventions are designed to be responsive to the cultural and socioeconomic context of their intended audiences. OBJECTIVE: This narrative review aims to synthesize the literature about the cultural adaptation of digital health interventions. It examines how concepts of culture and context feature in design and development processes, including the methods, models, and content of these interventions, with the aim of helping researchers to make informed decisions about how to approach cultural adaptation in digital health. METHODS: Literature searches for this narrative review were conducted across 4 databases. Following full-text article screening by 2 authors, 16 studies of interventions predominantly focused on the self-management of health were selected based on their detailed focus on the process of cultural adaptation. Key considerations for cultural adaptation were identified and synthesized through a qualitative narrative approach, enabling an integrative and in-depth understanding of cultural adaptation. RESULTS: The literature demonstrates varying approaches and levels of cultural adaptation across stages of intervention development, involving considerations such as the research ethos orienting researchers, the methodologies and models used, and the resultant content adaptations. In relation to the latter, culturally appropriate and accessible user interface design and translation can be seen as particularly important in shaping the level of adaptation. CONCLUSIONS: Optimizing cultural adaptation involves linking culture with other contextual factors such as economic conditions and social systems to ensure accessibility and the sustained use of digital health interventions. Culturally humble approaches that use the involvement of a broad range of participants, experts, and other stakeholders are demonstrated to spark vital insights for content development, implementation, and evaluation.

Efficient context-aware computing: a systematic model for dynamic working memory updates in context-aware computing.

The expanding computer landscape leads us toward ubiquitous computing, in which smart gadgets seamlessly provide intelligent services anytime, anywhere. Smartphones and other smart devices with multiple sensors are at the vanguard of this paradigm, enabling context-aware computing. Similar setups are also known as smart spaces. Context-aware systems, primarily deployed on mobile and other resource-constrained wearable devices, use a variety of implementation approaches. Rule-based reasoning, noted for its simplicity, is based on a collection of assertions in working memory and a set of rules that regulate decision-making. However, controlling working memory capacity efficiently is a key challenge, particularly in the context of resource-constrained systems. The paper's main focus lies in addressing the dynamic working memory challenge in memory-constrained devices by introducing a systematic method for content removal. The initiative intends to improve the creation of intelligent systems for resource-constrained devices, optimize memory utilization, and enhance context-aware computing.

Retrosplenial cortex and aversive conditioning.

The retrosplenial cortex (RSC) is well-known for its contribution to episodic memory, as well as contextual and spatial learning and memory. However, two literatures have also emerged examining the role of the RSC in aversive conditioning. The purpose of this manuscript is to review, and attempt to integrate, these two literatures. We focus on studies in which discrete cues, such as tones, predict the occurrence of aversive outcomes, such as mild shocks. Using both electrophysiological recordings and lesion methods, the first literature has examined RSC contributions to discriminative avoidance conditioning. The second, and more recent literature, has focused on the role of the RSC in Pavlovian fear conditioning. We discuss both literatures in terms of the type of information processed by the RSC, the role of the RSC in memory storage, and how the aversive conditioning literature might be consistent with a role for the RSC in contextual learning and memory.

Modelling the longitudinal dynamics of paranoia in psychosis: A temporal network analysis over 20 years.

BACKGROUND: Paranoia is a key feature of psychosis that can be highly debilitating. Theories of paranoia mostly interface with short-scale or cross-sectional data models, leaving the longitudinal course of paranoia underspecified. METHODS: We develop an empirical characterisation of two aspects of paranoia - persecutory and referential delusions - in individuals with psychosis over 20 years. We examine delusional dynamics by applying a Graphical Vector Autoregression Model to data collected from the Chicago Follow-up Study (n = 135 with a range of psychosis-spectrum diagnoses). We adjusted for age, sex, IQ, and antipsychotic use. RESULTS: We found that referential and persecutory delusions are central themes, supported by other primary delusions, and are strongly autoregressive - the presence of referential and persecutory delusions is predictive of their future occurrence. In a second analysis we demonstrate that social factors influence the severity of referential, but not persecutory, delusions. IMPLICATIONS: We suggest that persecutory delusions represent central, resistant states in the cognitive landscape, whereas referential beliefs are more flexible, offering an important window of opportunity for intervention. Our data models can be collated with prior biological, computational, and social work to contribute toward a more complete theory of paranoia and provide more time-dependent evidence for optimal treatment targets.

Orbitofrontal cortex modulates auditory cortical sensitivity and sound perception in Mongolian gerbils.

Sensory perception is dynamic, quickly adapting to sudden shifts in environmental or behavioral context. Although decades of work have established that these dynamics are mediated by rapid fluctuations in sensory cortical activity, we have a limited understanding of the brain regions and pathways that orchestrate these changes. Neurons in the orbitofrontal cortex (OFC) encode contextual information, and recent data suggest that some of these signals are transmitted to sensory cortices. Whether and how these signals shape sensory encoding and perceptual sensitivity remain uncertain. Here, we asked whether the OFC mediates context-dependent changes in auditory cortical sensitivity and sound perception by monitoring and manipulating OFC activity in freely moving Mongolian gerbils of both sexes under two behavioral contexts: passive sound exposure and engagement in an amplitude modulation (AM) detection task. We found that the majority of OFC neurons, including the specific subset that innervates the auditory cortex, were strongly modulated by task engagement. Pharmacological inactivation of the OFC prevented rapid context-dependent changes in auditory cortical firing and significantly impaired behavioral AM detection. Our findings suggest that contextual information from the OFC mediates rapid plasticity in the auditory cortex and facilitates the perception of behaviorally relevant sounds.

A new high spatial density temperature dataset in the Grenoble alpine valley (France) for urban heat island investigation and climate services dedicated to municipalities purposes.

Within the study of the urban heat island (UHI) in Echirolles and Grenoble (France, the eastern part of the alpine arc), two temperature measurement networks have been deployed. The aim is to measure the temperature gradients associated with the UHI in summer. A total of 62 measurement points has been installed in the various neighborhoods on 3-meter-high streetlights, starting in summer 2019. The preliminary classification of the different neighborhood typologies according to ``Local Climate Zone'' guided the choice of location for the temperature sensors. These urban observations respond to a dual challenge: firstly, to observe temperature located in complex topographical situations with valleys, and secondly, to observe the urban climate in neighborhoods where social considerations are important. Municipalities of Echirolles and Grenoble were involved in the investigation. The ADEME-funded (The French Agency for Ecological Transition) CASSANDRE research program analyzes and processes these observations to study the vulnerability of inhabitants to heat waves and more generally to summer heat stress.

Valuations of target items are drawn towards unavailable decoy items due to prior expectations.

When people make choices, the items they consider are often embedded in a context (of other items). How this context affects the valuation of the specific item is an important question. High-value context might make items appear less attractive because of contrast-the tendency to normalize perception of an object relative to its background-or more attractive because of assimilation-the tendency to group objects together. Alternatively, a high-value context might increase prior expectations about the item's value. Here, we investigated these possibilities. We examined how unavailable context items affect choices between two target items, as well as the willingness-to-pay for single targets. Participants viewed sets of three items for several seconds before the target(s) were highlighted. In both tasks, we found a significant assimilation-like effect where participants were more likely to choose or place a higher value on a target when it was surrounded by higher-value context. However, these context effects were only significant for participants' fastest choices. Using variants of a drift-diffusion model, we established that the unavailable context shifted participants' prior expectations towards the average values of the sets but had an inconclusive effect on their evaluations of the targets during the decision (i.e. drift rates). In summary, we find that people use context to inform their initial valuations. This can improve efficiency by allowing people to get a head start on their decision. However, it also means that the valuation of an item can change depending on the context.

Probabilistic prediction and context tree identification in the Goalkeeper game.

In this article we address two related issues on the learning of probabilistic sequences of events. First, which features make the sequence of events generated by a stochastic chain more difficult to predict. Second, how to model the procedures employed by different learners to identify the structure of sequences of events. Playing the role of a goalkeeper in a video game, participants were told to predict step by step the successive directions-left, center or right-to which the penalty kicker would send the ball. The sequence of kicks was driven by a stochastic chain with memory of variable length. Results showed that at least three features play a role in the first issue: (1) the shape of the context tree summarizing the dependencies between present and past directions; (2) the entropy of the stochastic chain used to generate the sequences of events; (3) the existence or not of a deterministic periodic sequence underlying the sequences of events. Moreover, evidence suggests that best learners rely less on their own past choices to identify the structure of the sequences of events.

Heterogeneity in choice models of addiction: the role of context.

RATIONALE: Theories of addiction guide scientific progress, funding priorities, and policy development and ultimately shape how people experiencing or recovering from addiction are perceived and treated. Choice theories of addiction are heterogenous, and different models have divergent implications. This breeds confusion among laypeople, scientists, practitioners, and policymakers and reduces the utility of robust findings that have the potential to reduce the global burden of addiction-associated harms. OBJECTIVE: Here we differentiate classes of choice models and articulate a novel framing for a class of addiction models, called contextual models, which share as a first principle the influence of the environment and other contextual factors on behavior within discrete choice contexts. RESULTS: These models do not assume that all choice behaviors are voluntary, but instead that both proximal and distal characteristics of the choice environment-and particularly the benefits and costs of both drug use and non-drug alternatives-can influence behavior in ways that are outside of the awareness of the individual. From this perspective, addiction is neither the individual's moral failing nor an internal uncontrollable urge but rather is the result of environmental contingencies that reinforce the behavior. CONCLUSIONS: Contextual models have implications for guiding research, practice, and policy, including identification of novel target mechanisms while also improving existing interventions.

The influence of emotion on temporal context models.

Temporal context models (TCMs) have been influential in understanding episodic memory and its neural underpinnings. Recently, TCMs have been extended to explain emotional memory effects, one of the most clinically important findings in the field of memory research. This review covers recent advances in hypotheses for the neural representation of spatiotemporal context through the lens of TCMs, including their ability to explain the influence of emotion on episodic and temporal memory. In recent years, simplifying assumptions of "classical" TCMs - with exponential trace decay and the mechanism by which temporal context is recovered - have become increasingly clear. The review also outlines how recent advances could be incorporated into a future TCM, beyond classical assumptions, to integrate emotional modulation.

Do we know our place? The role of psychoanalysis in public life.

The contributions to this Psychoanalytic Controversies section explore the question of what psychoanalysis may be able to contribute to thinking about some of the challenges currently confronting humanity and how such communications can be made effectively. This introduction to the section frames the debate with some reflections on anxieties that have been expressed about the application of psychoanalytic ideas beyond the clinical context, the risks of insularity, the need for appropriate humility, and the reality of the embeddedness of analytic practice, in particular social, cultural, and historical contexts. Contributions from Claudia Frank, Sudhir Kakar, Eli Zaretsky, Michael Rustin, Pratyusha Tummala-Narra, Magda Khouri, and Sally Weintrobe are introduced.

Extra-abdominal trocar and instrument detection for enhanced surgical workflow understanding.

PURPOSE: Video-based intra-abdominal instrument tracking for laparoscopic surgeries is a common research area. However, the tracking can only be done with instruments that are actually visible in the laparoscopic image. By using extra-abdominal cameras to detect trocars and classify their occupancy state, additional information about the instrument location, whether an instrument is still in the abdomen or not, can be obtained. This can enhance laparoscopic workflow understanding and enrich already existing intra-abdominal solutions. METHODS: A data set of four laparoscopic surgeries recorded with two time-synchronized extra-abdominal 2D cameras was generated. The preprocessed and annotated data were used to train a deep learning-based network architecture consisting of a trocar detection, a centroid tracker and a temporal model to provide the occupancy state of all trocars during the surgery. RESULTS: The trocar detection model achieves an F1 score of 95.06 ± 0.88 % . The prediction of the occupancy state yields an F1 score of 89.29 ± 5.29 % , providing a first step towards enhanced surgical workflow understanding. CONCLUSION: The current method shows promising results for the extra-abdominal tracking of trocars and their occupancy state. Future advancements include the enlargement of the data set and incorporation of intra-abdominal imaging to facilitate accurate assignment of instruments to trocars.

The impact of the left inferior frontal gyrus on fear extinction: A transcranial direct current stimulation study.

INTRODUCTION: Fear extinction is a fundamental component of exposure-based therapies for anxiety-related disorders. The renewal of fear in a different context after extinction highlights the importance of contextual factors. In this study, we aimed to investigate the causal role of the left inferior frontal gyrus (LiFG) in the context-dependency of fear extinction learning via administration of transcranial direct current stimulation (tDCS) over this area. METHODS: 180 healthy subjects were assigned to 9 groups: 3 tDCS conditions (anodal, cathodal, and sham) × 3 context combinations (AAA, ABA, and ABB). The fear conditioning/extinction task was conducted over three consecutive days: acquisition, extinction learning, and extinction recall. tDCS (2 mA, 10min) was administered during the extinction learning phase over the LiFG via a 4-electrode montage. Skin conductance response (SCR) data and self-report assessments were collected. RESULTS: During the extinction learning phase, groups with excitability-enhancing anodal tDCS showed a significantly higher fear response to the threat cues compared to cathodal and sham stimulation conditions, irrespective of contextual factors. This effect was stable until the extinction recall phase. Additionally, excitability-reducing cathodal tDCS caused a significant decrease of the response difference between the threat and safety cues during the extinction recall phase. The self-report assessments showed no significant differences between the conditions throughout the experiment. CONCLUSION: Independent of the context, excitability enhancement of the LiFG did impair fear extinction, and led to preservation of fear memory. In contrast, excitability reduction of this area enhanced fear extinction retention. These findings imply that the LiFG plays a role in the fear extinction network, which seems to be however context-independent.

Bi-directional context-aware network for the nested named entity recognition.

The Span-based model can effectively capture the complex entity structure in the text, thus becoming the mainstream model for nested named entity recognition (Nested NER) tasks. However, traditional Span-based models decode each entity span independently. They do not consider the semantic connections between spans or the entities' positional information, which limits their performance. To address these issues, we propose a Bi-Directional Context-Aware Network (Bi-DCAN) for the Nested NER. Specifically, we first design a new span-level semantic relation model. Then, the Bi-DCAN is implemented to capture this semantic relationship. Furthermore, we incorporate Rotary Position Embedding into the bi-affine mechanism to capture the relative positional information between the head and tail tokens, enabling the model to more accurately determine the position of each entity. Experimental results show that compared to the latest model Diffusion-NER, our model reduces 20M parameters and increases the F1 scores by 0.24 and 0.09 on the ACE2005 and GENIA datasets respectively, which proves that our model has an excellent ability to recognise nested entities.

Predictors of Perceived Healthcare Professionals' Well-Being in Work Design: A Cross-Sectional Study with Multigroup PLS Structural Equation Modeling.

The growing attention paid to employee well-being in the healthcare system, along with the reinforcement of factors that drive change in the work environment, provides a strong foundation for studying the relationship between work design and its related outcomes. The aim of this study was to examine the relationship between the elements of work design and the overall well-being of healthcare professionals, particularly the differences across multiple groups of various genders and age brackets. A cross-sectional study design was employed, and a convenience sampling method was used. The study participants were healthcare professionals, and a total of 427 valid surveys were collected. The partial least squares structural equation modeling (PLS-SEM) approach was deployed to test the relationship between the determinants of work design and the perceived well-being of healthcare professionals. The results indicate a strong positive relationship between the social characteristics of work and overall well-being, as well as a positive contribution of the work context to the perceived well-being of healthcare professionals. The findings validated that knowledge characteristics had no beneficial impacts on overall well-being; nor did the task characteristics of work design. Although the mentioned associations failed to demonstrate statistical significance, the results nonetheless have significant practical consequences that are comparable to those of the relationships that demonstrated statistical significance.