Application of artificial intelligence to eyewitness identification.

Artificial intelligence is already all around us, and its usage will only increase. Knowing its capabilities is critical. A facial recognition system (FRS) is a tool for law enforcement during suspect searches and when presenting photos to eyewitnesses for identification. However, there are no comparisons between eyewitness and FRS accuracy using video, so it is unknown whether FRS face matches are more accurate than eyewitness memory when identifying a perpetrator. Ours is the first application of artificial intelligence to an eyewitness experience, using a comparative psychology approach. As a first step to test system accuracy relative to eyewitness accuracy, participants and an open-source FRS (FaceNet) attempted perpetrator identification/match from lineup photos (target-present, target-absent) after exposure to real crime videos with varied clarity and perpetrator race. FRS used video probe images of each perpetrator to achieve similarity ratings for each corresponding lineup member. Using receiver operating characteristic analysis to measure discriminability, FRS performance was superior to eyewitness performance, regardless of video clarity or perpetrator race. Video clarity impacted participant performance, with the unclear videos yielding lower performance than the clear videos. Using confidence-accuracy characteristic analysis to measure reliability (i.e., the likelihood the identified suspect is the actual perpetrator), when the FRS identified faces with the highest similarity values, they were accurate. The results suggest FaceNet, or similarly performing systems, may supplement eyewitness memory for suspect searches and subsequent lineup construction and knowing the system's strengths and weaknesses is critical.

The development of working alliance in early stages of care from the perspective of patients attending a chiropractic teaching clinic.

BACKGROUND: The clinician-patient relationship has consistently been found to predict treatment success in both physical and mental health settings. This relationship has been operationalised in the literature as "Working Alliance," which consists of three key components: patient-clinician agreement on the goals of care, agreement on the tasks required to achieve those goals, and the establishment of a strong bond. While research has demonstrated the impact of working alliance in physical health settings, it often measures working alliance early in patients' care journeys. However, no primary research has investigated how early working alliance develops between patients and chiropractors. Evidence suggests that musculoskeletal practitioners may require further training to feel confident in establishing working alliance. Therefore, this study aims to explore the development of working alliance in the early stages of chiropractic care from the patients' perspective to inform evidence-based practice. METHODS: Participants for this qualitative study were recruited from a teaching clinic at a specialised healthcare professions training university in the United Kingdom between September 2022 and April 2023. A total of 25 adult patients completed semi-structured interviews during the early stages of their care. The interview transcripts were analysed using Reflexive Thematic Analysis, from a critical realist stance. RESULTS: The findings highlight that an early working alliance entails the gradual development of patients' confidence in their decision to seek help from trainee chiropractors to alleviate their symptoms. The four themes describe the impact of the clinical context on patients' expectations, the trainee chiropractors' qualities that participants considered important for early working alliance, the role of explanations, and the interplay between pain and early working alliance. CONCLUSIONS: Establishing an early trainee chiropractor-patient working alliance involves a process of building patients' confidence in the trainee chiropractors' expertise, identifying the correct goals of care, and recognising the value of the proposed treatment plan. Factors shaping this process include the context of the care journey, patients' perceptions of trainee chiropractors' qualities, their bodily sensations, their expectations, their past experiences, and their satisfaction with trainee chiropractors' explanations.

Cultural Advocacy for Indigenous Individuals With Serious Illness.

Indigenous American (I.A.) individuals with serious illness and their families have unmet needs. Often, this group is viewed as a minority within a minority. Numerous health challenges exist within the I.A. populations resulting in dire health care situations. Historical trauma and mistrust of the healthcare system impacts access to quality palliative care by this marginalized population. Given the range of social, spiritual, and cultural issues, the interprofessional team needs increased knowledge specific to the I.A. population to ensure holistic, culturally sensitive care. Utilizing a case study, this article reviews of the needs of I.A. individuals with serious illness and essential skills. The aim is empower palliative care clinicians the knowledge to provide culturally sensitive and congruent care to I.A. individuals with serious illness and their community.

Evaluation of a Palliative Care Longitudinal Curriculum for Medical Students Using the Context-Input-Process-Product Model.

Palliative care (PC) longitudinal curricula are increasingly being recognized as important in Undergraduate Medical Education (UME). They are however, not yet commonplace, and where they do exist may be implemented without a systematic, prospective approach to curriculum evaluation. This paper describes an implementation of a new longitudinal curriculum at the Perelman School of Medicine (PSOM) at the University of Pennsylvania. We used the Context Input Process Product (CIPP) model, a holistic evaluation model, to assess the local environment, design the curriculum, guide the improvement process, and evaluate outcomes. Comprehensive models such as CIPP provide a more robust approach to curriculum evaluation than outcomes-only models and may be of use to other programs who are implementing new curricula or improving upon existing programs.

Spatial and Environmental Correlates of Prevalence of Treatment for Substance Use Disorders, Retention, and SUD Services Utilization in South Sardinia.

This study explored the economic, social, and spatial correlates of treatment prevalence, retention, and service utilization for substance use disorder (SUD) in South Sardinia. Data from 1,667 patients with an ICD-10 diagnosis of SUD were extracted from the medical records of individuals assisted by three public addiction services in 2019. We used a spatial autoregressive model, a parametric proportional hazard model, and Poisson regression to examine the associations of spatial factors and residents' socioeconomic status with the prevalence of treatment at the census block level, treatment retention, and SUD service utilization at the individual level. The prevalence was higher among residents of areas closer to competent treatment centers, with the worst building conservation status, a lower percentage of high school and university graduates, and a higher percentage of unemployed, divorced, separated, or widowed residents. Men who were older at the time of their first treatment access; primary users of cocaine, cannabis, and alcohol; had higher education level; and who lived far from competent treatment centers and closer to drug trafficking centers interrupted their treatment earlier. Primary heroin users experienced more SUD treatment encounters. Living in economically and socially disadvantaged areas and near treatment facilities was associated with a higher prevalence, whereas living near drug-dealing centers and far from competent treatment centers was associated with a decrease in treatment retention.

Atuação de psicólogos(as) escolares nas falas de professoras do ensino fundamental do sudoeste da Bahia: uma análise discursiva / Role of Educational Psychologists from primary school teachers' point of view in Southwest Bahia State, Brazil: a discursive analysis / Le rôle des psychologues de l'éducation du point de vue des enseignants du primaire dans le sud-ouest d'État de Bahia, au Brésil: une analyse discursive / El rol del psicólogo educativo según las maestras de la primaria en el sudoeste de Bahía, Brasil: una mirada discursiva

No contexto educacional brasileiro, a promulgação da Lei n. 13.935, de 11 de dezembro de 2019, formalizou a contratação de psicólogos escolares. Esta pesquisa investigou as expectativas de professoras do Ensino Fundamental do sudoeste da Bahia sobre a contratação de profissionais de psicologia escolar para atuar na rede de ensino. Para entender a promulgação da Lei, realizou-se um resgate histórico do campo da psicologia escolar no Brasil. Filiadas à perspectiva psicanalítica e da análise do discurso de Pêcheux, foram realizadas e analisadas cinco entrevistas semiestruturadas, que indicaram duas formações discursivas (FD) antagônicas. Além disso, as FD - nomeadas "detecção e encaminhamento" (FD1) e "professoras trabalhadoras" (FD2) - estão filiadas a uma formação ideológica denominada "médica-higienista-normativa". Os resultados demonstram que as respostas das participantes veiculam a FD1, que reproduz o modelo médico classificatório, mas não impede que na FD2 haja formas de resistência, por meio das denúncias de más condições de trabalho das professoras

In the Brazilian educational context, issuance of Law no. 13935, on December 11, 2019, authorized the hiring of psychologists by public schools. This research investigated primary teachers' expectations regarding psychologist intervention in public schools from Southwest Bahia State. To understand the law's enactment we conducted a historical overview on the role of Educational Psychology in the country. Based on psychoanalysis and Pêcheux's discourse analysis, we conducted and analyzed five semi-structured interviews and identified two opposite discursive formations (DFs). These DFs-named "detection and referral" (DF1) and "working teachers" (DF2)-are affiliated to a "medical-hygienist-normative" ideology. Results show that the participants' statements emphasize the classificatory medical paradigm (DF1), which does not exclude possible resistance in DF2 by denouncing poor working conditions

Dans le contexte éducatif brésilien, la publication de la loi 13935, le 11 décembre 2019, a autorisé l'embouche de psychologues par les écoles publiques. Cette recherche a étudié les attentes des enseignants du primaire concernant l'intervention d'un psychologue dans le réseau d'éducation publique. Pour comprendre cette promulgation, nous avons effectué un survol historique du rôle de la psychologie de l'éducation dans le pays. Basé sur la psychanalyse et de l'analyse du discours de Pêcheux, nous avons mené et analysé cinq entretiens semi-structurés et identifié deux formations discursives (FD) opposées. Ces formations discursives - appelées « détection et orientation ¼ (FD1) et « enseignants en activité ¼ (FD2) - sont affiliées à une idéologie "médicale-hygiéniste-normative ¼. Les résultats montrent que leur réponses mettent l'accent sur le paradigme médical classificatoire (FD1), ce qui n'exclut pas une résistance dans FD2 en dénonçant les mauvaises conditions de travail

En el contexto educativo brasileño, se promulgó la Ley N.º 13.935, de 11 de diciembre de 2019, por la cual autoriza la contratación de psicólogos educativos. Esta investigación buscó identificar las expectativas de las maestras del sudoeste de estado de Bahía (Brasil) sobre la contratación de los profesionales de psicología educativa para trabajar en la red de enseñanza. Para comprender esta promulgación, se realizó un rescate histórico del campo de la psicología escolar en Brasil. A partir de la perspectiva psicoanalítica y de análisis del discurso de Pêcheux, se analizaron cinco entrevistas semiestructuradas que señalaron dos formaciones discursivas (FD) antagónicas. Además, las FD denominadas "detección y derivación de casos" (FD1) y "maestras trabajadoras" (FD2) se vinculan a una formación ideológica denominada "médico-higienista-normativa". Los resultados muestran que las respuestas de las participantes expresan FD1, que reproduce el modelo de clasificación médica; pero no evita formas de resistencia en FD2 mediante denuncias de malas condiciones laborales para los docentes

High School Teachers' Experiences of Consumer Technologies for Stress Management During the COVID-19 Pandemic: Qualitative Study.

BACKGROUND: Stress in education is an adverse reaction that teachers have to excessive pressures or other types of demands placed on them. Consumer digital technologies are already being used by teachers for stress management, albeit not in a systematic way. Understanding teachers' experiences and the long-term use of technologies to support stress self-management in the educational context is essential for meaningful insight into the value, opportunity, and benefits of use. OBJECTIVE: The aim of this study was first to understand teachers' experiences of consumer technologies for stress management. They were chosen by teachers from a taxonomy tailored to their stress management. The second aim was to explore whether their experiences of use evolved over time as teachers transitioned from working at home during lockdown to working full time on school premises. METHODS: A longitudinal study intended for 6 weeks in the summer term (2020) was extended because of COVID-19 into the autumn term, lasting up to 27 weeks. Teachers chose to use a Withings smartwatch or the Wysa, Daylio, or Teacher Tapp apps. In total, 2 semistructured interviews and web-based surveys were conducted with 8 teachers in South London in the summer term, and 6 (75%) of them took part in a third interview in the autumn term. The interviews were analyzed by creating case studies and conducting cross-case analysis. RESULTS: The teachers described that the data captured or shared by the technology powerfully illustrated the physical and psychosocial toll of their work. This insight gave teachers permission to destress and self-care. The social-emotional confidence generated also led to empathy toward colleagues, and a virtuous cycle of knowledge, self-compassion, permission, and stress management action was demonstrated. Although the COVID-19 pandemic added a new source of stress, it also meant that teachers' stress management experiences could be contrasted between working from home and then back in school. More intentional self-care was demonstrated when back in school, sometimes without the need to refer to the data or technology. CONCLUSIONS: The findings of this study demonstrate that taking a situated approach to understand the real-world, existential significance and value of data generates contextually informed insights. Where a strategic personal choice of consumer technology is enabled for high school heads of year, the data generated are perceived as holistic, with personal and professional salience, and are motivational in the educational context. Technology adoption was aided by the pandemic conditions of home working, and this flexibility would otherwise need workplace facilitation. These findings add to the value proposition of technologies for individual stress management and workforce health outcomes pertinent to educators, policy makers, and designers.

Real-world implications of aphantasia: episodic recall of eyewitnesses with aphantasia is less complete but no less accurate than typical imagers.

Individuals with aphantasia report an inability to voluntarily visually image and reduced episodic memory, yet episodic accounts provided by witnesses and victims are fundamental for criminal justice. Using the mock-witness paradigm, we investigated eyewitness memory of individuals with aphantasia versus typical imagers. Participants viewed a mock crime and 48 hours later were interviewed about the event, randomly allocated to one of three conditions. Two interview conditions included techniques designed to support episodic retrieval mode, namely (i) Mental Reinstatement of Context (MRC) and (ii) Sketch Reinstatement of Context (Sketch-RC). A third Control condition did not include retrieval support. Aphantasic mock-eyewitnesses recalled 30% less correct information and accounts were less complete, but they made no more errors and were as accurate as typical imagers. Interaction effects revealed reduced correct recall and less complete accounts for aphantasic participants in MRC interviews versus Sketch-RC and Control. Aphantaisic participants in the Control outperformed those in both the Sketch-RC and MRC, although Sketch-RC improved completeness by 15% versus MRC. Our pattern of results indicates reduced mental imagery ability might be compensated for by alternative self-initiated cognitive strategies. Findings offer novel insights into episodic recall performance in information gathering interviews when ability to voluntarily visualize is impoverished.

Direct cortical inputs to hippocampal area CA1 transmit complementary signals for goal-directed navigation.

The subregions of the entorhinal cortex (EC) are conventionally thought to compute dichotomous representations for spatial processing, with the medial EC (MEC) providing a global spatial map and the lateral EC (LEC) encoding specific sensory details of experience. Yet, little is known about the specific types of information EC transmits downstream to the hippocampus. Here, we exploit in vivo sub-cellular imaging to record from EC axons in CA1 while mice perform navigational tasks in virtual reality (VR). We uncover distinct yet overlapping representations of task, location, and context in both MEC and LEC axons. MEC transmitted highly location- and context-specific codes; LEC inputs were biased by ongoing navigational goals. However, during tasks with reliable reward locations, the animals' position could be accurately decoded from either subregion. Our results revise the prevailing dogma about EC information processing, revealing novel ways spatial and non-spatial information is routed and combined upstream of the hippocampus.

Patterns in bottlenecks for implementation of health promotion interventions: a cross-sectional observational study on intervention-context interactions in the Netherlands.

BACKGROUND: From a complex systems perspective, implementation should be understood as the introduction of an intervention in a context with which it needs to interact in order to achieve its function in terms of improved health. The presence of intervention-context interactions could mean that during implementation particular patterns of crucial interaction points might arise. We examined the presence of - and regularities in - such 'bottlenecks for implementation', as this could create opportunities to predict and intervene in potential implementation problems. METHODS: We conducted a cross-sectional observational study against the background of municipal intersectoral policymaking in the Netherlands. We asked implementers of health promotion interventions to identify bottlenecks by rating the presence and importance of conditions for implementation in a range of intervention systems. We used descriptive statistics to characterize these systems (by their behaviour change method, health theme and implementation setting) and the conditions that acted as bottlenecks. After stratifying bottlenecks by intervention system and the system's characteristics, we tested our hypotheses by comparing the number and nature of the bottlenecks that emerged. RESULTS: More than half of the possible conditions were identified as a bottleneck for implementation. Bottlenecks occurred in all categories of conditions, e.g., relating to the implementer, the intervention, and political and administrative support, and often connected with intersectoral policymaking, e.g., relating to the co-implementer and the co-implementer's organization. Both our hypotheses were supported: (1) Each intervention system came across a unique set of - a limited number of - conditions hampering implementation; (2) Most bottlenecks were associated with the characteristics of the system in which they occurred, but bottlenecks also appeared in the absence of such an association, or remained absent in the presence thereof. CONCLUSIONS: We conclude that intervention-context interactions in integrated health policymaking may lead to both regularities and variations in bottlenecks for implementation. Regularities may partly be predicted by the function of an intervention system, and may serve as the basis for building the capacity needed for the structural changes that can bring about long-lasting health improvements. Variations may point at the need for flexibility in further tailoring the implementation approach to the - mostly unpredictable - problems at individual sites.

Social Determinants of Cancer Disparities.

Cancer is a major public health issue that is associated with significant morbidity and mortality across the globe. At its root, cancer represents a genetic aberration, but socioeconomic, environmental, and geographic factors contribute to different cancer outcomes for selected population subsets. The disparities in the delivery of healthcare affect all aspects of cancer management from early prevention to end-of-life care. In an effort to address the inequality in the delivery of healthcare among socioeconomically disadvantaged populations, the World Health Organization defined social determinants of health (SDOH) as conditions in which people are born, live, work, and age. These factors play a significant role in the disproportionate cancer burden among different population groups. SDOH are associated with disparities in risk factor burden, screening modalities, diagnostic testing, treatment options, and quality of life of patients with cancer. The purpose of this article is to describe a more holistic and integrated approach to patients with cancer and address the disparities that are derived from their socioeconomic background.

Advance Care Planning in the Netherlands.

The Dutch health care system fosters a strong public health sector offering accessible generalist care including generalist palliative care. General practitioners are well positioned to conduct ACP, for example, to continue or initiate conversations after hospitalization. However, research shows that ACP conversations are often ad hoc and in frail patients, ACP is often only initiated when admitted to a nursing home by elderly care physicians who are on the staff. Tools that raise awareness of triggers to initiate ACP, screening tools, information brochures, checklists and training have been developed and implemented with funding by national programs which currently focus on implementation projects rather than or in addition to, research. The programs commonly require educational deliverables, patient and public involvement and addressing diversity in patient groups. A major challenge is how to implement ACP systematically and continuously across sectors and disciplines in a way that supports a proactive yet person-centered approach rather than an approach with an exclusive focus on medical procedures. Digital solutions can support continuity of care and communication about care plans. Solutions should fit a culture that prefers trust-based, informal deliberative approaches. This may be supported by involving disciplines other than medicine, such as nursing and spiritual caregiving, and public health approaches.

Contextual factors influencing implementation of a university-based midwifery education programme in Central Africa: A qualitative study.

AIM: To investigate contextual factors and their influence on implementing a 90-credit midwifery education programme for nurses at a university in the eastern DRC. BACKGROUND: To improve maternal and neonatal health, there is a government policy in the Democratic Republic of Congo (DRC) to educate midwives at a higher education level according to international norms. This study investigates contextual factors and their influence on the implementation of a midwifery education programme which is based on national curriculum and has a profile of person-centred care, simulation-based learning pedagogy and information and communication technology. METHOD: A qualitative study was conducted with data collected through semi-structured interviews with 22 participants who were directly or indirectly involved in establishing the midwifery education programme. Transcribed interviews were analysed using content analysis. RESULTS: The factors influencing the implementation of the new midwifery education programme comprise facilitating and hindering factors. Facilitating factors were: (i) awareness that midwives educated at a higher education level can deliver higher-quality health care, (ii) women are motivated to seek care from well-educated midwives, (iii) the planned programme is attractive and (iv) the university has a stable academic administration and established collaborations. Hindering factors were: (i) Students' lack of prerequisites for study; (ii) objections to educating midwives at a higher education level; (iii) inadequate teaching resources; and (iv) inadequate working conditions for midwives. CONCLUSION: The facilitating factors strengthen the belief that it is possible to implement this midwifery education programme, while the hindering factors need to be addressed to run the programme successfully. The findings can guide higher education institutions starting similar midwifery education programmes in the DRC and elsewhere, although it is crucial to conduct a context study in those specific contexts.

Narrative simulation of social experiences in naturalistic context - A neurocinematic approach.

Narratives may be regarded as simulations of everyday social situations. They are key to studying the human mind in socio-culturally determined contexts as they allow anchoring to the common ground of embodied and environmentally-engaged cognition. Here we review recent findings from naturalistic neuroscience on neural functions in conditions that mimic lifelike situations. We will focus particularly on neurocinematics, a research field that applies mediated narratives as stimuli for neuroimaging experiments. During the last two decades, this paradigm has contributed to an accumulation of insights about the neural underpinnings of behavior and sense-making in various narratively contextualized situations particularly pertaining to socio-emotional encounters. One of the key questions in neurocinematics is, how do intersubjectively synchronized brain activations relate to subjective experiences? Another question we address is how to bring natural contexts into experimental studies. Seeking to respond to both questions, we suggest neurocinematic studies to examine three manifestations of the same phenomenon side-by-side: subjective experiences of narrative situations, unfolding of narrative stimulus structure, and neural processes that co-constitute the experience. This approach facilitates identifying experientially meaningful activity patterns in the brain and points out what they may mean in relation to shared and communicable contents. Via rich-featured and temporally contextualized narrative stimuli, neurocinematics attempts to contribute to emerging holistic theories of neural dynamics and connectomics explaining typical and atypical interindividual variability.

Causal involvement of medial inferior frontal gyrus of non-dominant hemisphere in higher order auditory perception: A single case study.

The medial side of the operculum is invisible from the lateral surface of cerebral cortex, and its functions remain largely unexplored using direct evidence. Non-invasive and invasive studies have proved functions on peri-sylvian area including the inferior frontal gyrus (IFG) and superior temporal gyrus within the language-dominant hemisphere for semantic processing during verbal communication. However, within the non-dominant hemisphere, there was less evidence of its functions except for pitch or prosody processing. Here we add direct evidence for the functions of the non-dominant hemisphere, the causal involvement of the medial IFG for subjective auditory perception, which is affected by the context of the condition, regarded as a contribution in higher order auditory perception. The phenomenon was clearly distinguished from absolute and invariant pitch perception which is regarded as lower order auditory perception. Electrical stimulation of the medial surface of pars triangularis of IFG in non-dominant hemisphere via depth electrode in an epilepsy patient rapidly and reproducibly elicited perception of pitch changes of auditory input. Pitches were perceived as either higher or lower than those given without stimulation and there was no selectivity for sound type. The patient perceived sounds as higher when she had greater control over the situation when her eyes were open and there were self-cues, and as lower when her eyes were closed and there were investigator-cues. Time-frequency analysis of electrocorticography signals during auditory naming demonstrated medial IFG activation, characterized by low-gamma band augmentation during her own vocal response. The overall evidence provides a neural substrate for altered perception of other vocal tones according to the condition context.

[Severe injury type procedures-Influence of the cipher 11 "complications" and the COVID-19 pandemic on a center for maximum care of severe injuries]. / Schwerstverletzungsartenverfahren ­ Einfluss der Ziffer 11 "Komplikationen" sowie der COVID-19-Pandemie auf ein Haus der traumatologischen Maximalversorgung.

INTRODUCTION: Ensuring the best treatment options for injured patients (healing process, Heilverfahren, HV) is the main goal and responsibility of the German statutory accident insurance (DGUV). The injury type catalogue is the tool to guide the HV. The development of the number of cases treated in a center for severe injury type procedures, the effects of the cipher 11 "complications" of the catalogue and the effects of the COVID-19 pandemic are presented. METHODS: A retrospective study of all patients treated in the context of the DGUV from January 2019 to December 2021 was carried out. The number of cases before and during the legal lockdown actions were compared. The case mix index, the mean number of operations, the mean time in the operating room and the hospital stay were analyzed. Additionally, the cases under the cipher 11 were classified according to the specific anatomical regions. RESULTS: Out of 2007 cases 67% were classified as severe injury type procedures (SAV). Of these cases 51% were categorized to the cipher 11 of the injury type catalogue. Complications were observed particularly in the anatomical regions of the shoulder girdle, elbow, hand, knee, ankle joint and foot. These complex cases are economically not sufficiently represented. During the governmental COVID-19 lockdown actions, the number of patients treated in the context of the DGUV significantly decreased. CONCLUSION: The injury type catalogue is used effectively in the catchment area of the present trauma center. Most of the cases treated in the present trauma center are severe injury type procedures; however, more than half of these cases are classified as complications. This development might show the need for a structural change or an adjustment of the HV. The current comments on the injury type catalogue offer important definitions and specifications; however, the conciseness of the entire catalogue should be maintained.

When Patients' Assessments of Treatment for Subjective Symptoms are At Odds with Authoritative Assessments in the Biomedical Literature: The Case of Patients Treated with Acupuncture for Low Back Pain in a Traditional Chinese Medicine Clinic in China (and Story of a Bewildered Chicken).

Assessments of treatments for 'subjective symptoms' are problematic and potentially contentious. These are symptoms without ascertainable pathophysiology, also referred to as 'medically unexplained.' Treatments of them may be assessed from different perspectives, and an assessment as seen from one perspective may be discrepant with an assessment as seen from another perspective. The observational study described in the paper represents one perspective. Patients in the study were treated with acupuncture for the subjective symptom of low back pain in a Traditional Chinese Medicine Clinic in China; acupuncture is a form of TCM, which is indigenous to China. Shortly after treatment began and six months afterward, patients reported 'clinically important improvements' on a variety of standard, cross-culturally validated outcome measures, including pain intensity, physical functioning, and emotional functioning; this assessment is consistent with numerous assessments of acupuncture in China and other Southeastern Asian countries. On the other hand, clinical trials represent another perspective from which to assess acupuncture. Although assessments based on trials are not uniform, several assessments based on them, including those published in journals such as Lancet and New England Journal of Medicine, conclude that acupuncture is not effective. These trials, however, were mainly situated in the U.S., western European countries, and other WEIRD (Western, Educated, Industrialized, Rich, Democratic) countries. This is notable, because the population of China, the indigenous context of acupuncture, is greater than populations of WEIRD countries combined. Patients' expectations of a treatment such as acupuncture and their prior familiarity with it vary among contexts, and patients' experiences of treatment outcomes may vary accordingly. In short, although clinical trials constitute a test of truth in biomedicine and inform authoritative assessments in WEIRD countries, they do not necessarily represent the truth from the perspective of those experiencing outcomes of especially indigenous treatments for subjective symptoms in non-WEIRD contexts.

The effect of schizophrenia risk factors on mismatch responses in a rat model.

Reduced mismatch negativity (MMN), a robust finding in schizophrenia, has prompted interest in MMN as a preclinical biomarker of schizophrenia. The rat brain can generate human-like mismatch responses (MMRs) which therefore enables the exploration of the neurobiology of reduced MMRs. Given epidemiological evidence that two developmental factors, maternal infection and adolescent cannabis use, increase the risk of schizophrenia, we determined the effect of these two developmental risk factors on rat MMR amplitude in different auditory contexts. MMRs were assessed in awake adult male and female Wistar rats that were offspring of pregnant dams treated with either a viral infection mimetic (poly I:C) inducing maternal immune activation (MIA) or saline control. In adolescence, subgroups of the prenatal treatment groups were exposed to either a synthetic cannabinoid (adolescent cannabinoid exposure: ACE) or vehicle. The context under which MMRs were obtained was manipulated by employing two different oddball paradigms, one that manipulated the physical difference between rare and common auditory stimuli, and another that manipulated the probability of the rare stimulus. The design of the multiple stimulus sequences across the two paradigms also allowed an investigation of context on MMRs to two identical stimulus sequences. Male offspring exposed to each of the risk factors for schizophrenia (MIA, ACE or both) showed a reduction in MMR, which was evident only in the probability paradigm, with no effects seen in the physical difference. Our findings highlight the importance of contextual factors induced by paradigm manipulations and sex for modeling schizophrenia-like MMN impairments in rats.

Soil water and nutrient availability interactively modify pollinator-mediated directional and correlational selection on floral display.

The individual and combined effects of abiotic factors on pollinator-mediated selection on floral traits are not well documented. To examine potential interactive effects of water and nutrient availability on pollinator-mediated selection on three floral display traits of Primula tibetica, we manipulated pollination and nutrient availability in a factorial experiment, conducted at two common garden sites with different soil water content (natural vs addition). We found that both water and nutrient availability affected floral trait expression in P. tibetica and that hand pollination increased seed production most when both nutrient content and water content were high, indicating joint pollen and resource limitation. We documented selection on all floral traits, and pollinators contributed to directional and correlational selection on plant height and number of flowers. Soil water and nutrient availability interactively influenced the strength of both pollinator-mediated directional and correlational selection, with significant selection observed when nutrient or water availability was high, but not when none or both were added. The results suggest that resource limitation constrains the response of P. tibetica to among-individual variation in pollen receipt, that addition of nutrients or water leads to pollinator-mediated selection and that effects of the two abiotic factors are nonadditive.

Intensity and inter-stimulus-interval effects on human middle- and long-latency auditory evoked potentials in an unpredictable auditory context.

It is not known how Auditory-Evoked Responses (AERs) comprising Middle Latency Responses (MLRs) and Long Latency Responses (LLRs) are modulated by stimulus intensity and inter-stimulus interval (ISI) in an unpredictable auditory context. Further, intensity and ISI effects on MLR and LLR have never been assessed simultaneously in the same humans. To address this important question, thirty participants passively listened to a random sequence of auditory clicks of three possible intensities (65, 75, and 85 dB) at five possible ISI ranges (0.25 to 0.5 s, 0.5 to 1 s, 1 to 2 s, 2 to 4 s, 4 to 8 s) over four to seven one-hour sessions while EEG was recorded. P0, Na, Pa, Nb, and Pb MLR peaks and N1 and P2 LLR peaks were measured. MLRs P0 (p = .005), Pa (p = .021), and Pb (p = <.001) were modulated by intensity, while only MLR Pb (p = <.001) was modulated by ISI. LLR N1 and P2 were modulated by both intensity and ISI (all p values < .001). Intensity and ISI interacted at Pb, N1, and P2 (all p values < .001), with greater intensity effects at longer ISIs and greater ISI effects at louder intensities. Together, these results provide a comprehensive picture of intensity and ISI effects on AER across the entire thalamocortical auditory pathway, while controlling for stimulus predictability. Moreover, they highlight P0 as the earliest MLR response sensitive to stimulus intensity and Pb (~50 ms) as the earliest cortical response coding for ISIs above 250 ms and showing an interdependence between intensity and ISI effects.