Enhancing Agency in Posttraumatic Stress Disorder Therapies through Sensorimotor technologies.

UNSTRUCTURED: Posttraumatic stress disorder (PTSD) is a significant public health concern, with only a third of patients recovering within a year of treatment. While PTSD often disrupts the sense of body ownership and the sense of agency (SA), attention to SA in trauma has been lacking. This perspective article explores the loss of SA in PTSD and its relevance in the development of symptoms. Trauma is viewed as a breakdown of SA, related to a freeze response, with peritraumatic dissociation increasing the risk of PTSD. Drawing from embodied cognition, we propose an "enactive" perspective of PTSD, suggesting therapies that restore the SA through direct engagement with the body and environment. We discuss the potential of agency-based therapies and innovative technologies like gesture sonification (GS), which translates body movements into sounds to enhance the SA. GS offers a screen-free, non-invasive approach that could complement existing trauma-focused therapies. We emphasize the need for interdisciplinary collaboration and clinical research to further explore these approaches in preventing and treating PTSD.

Criteria for evaluating the effectiveness of psychiatric home care-mobile team: A systematic review of the literature.

AIM: To explore criteria evaluating the effectiveness of psychiatric home care-mobile team practices, that have been developed widely in the last decades. DESIGN: Systematic review of the literature. METHODS: We included 24 studies published between January 2010 and October 2023. DATA SOURCES: CINAHL, APA PsycInfo, Embase, Scopus and PubMed. RESULTS: The evaluation criteria differed according to the studies: impact on hospital stay, symptomatic clinical impact, repercussions on functioning, quality of life, analysis of profitability, safety, therapeutic alliance and finally, cooperation network. CONCLUSION: The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices shows their richness and diversity, and the absence of standardisation. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices supports a qualitative and multidisciplinary approach, with enhanced teamwork. IMPACT: Psychiatric home care-mobile team practice have widely developed in the last years and their effectiveness need to be evaluated. Our main finding is that there is a rich variety of practices and that evaluation criteria are very diverse, thus not standardised. We suggest using a mixed-method approach to capture the subjective experience of patients and caregivers. These findings also highlight the significance of institutional cooperative work and call for a redefinition of team construction. REPORTING METHOD: The authors adhered to PRISMA guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Predicting individual differences in peak emotional response.

Why does the same experience elicit strong emotional responses in some individuals while leaving others largely indifferent? Is the variance influenced by who people are (personality traits), how they feel (emotional state), where they come from (demographics), or a unique combination of these? In this 2,900+ participants study, we disentangle the factors that underlie individual variations in the universal experience of aesthetic chills, the feeling of cold and shivers down the spine during peak experiences. Here, we unravel the interplay of psychological and sociocultural dynamics influencing self-reported chills reactions. A novel technique harnessing mass data mining of social media platforms curates the first large database of ecologically sourced chills-evoking stimuli. A combination of machine learning techniques (LASSO and SVM) and multilevel modeling analysis elucidates the interacting roles of demographics, traits, and states factors in the experience of aesthetic chills. These findings highlight a tractable set of features predicting the occurrence and intensity of chills-age, sex, pre-exposure arousal, predisposition to Kama Muta (KAMF), and absorption (modified tellegen absorption scale [MODTAS]), with 73.5% accuracy in predicting the occurrence of chills and accounting for 48% of the variance in chills intensity. While traditional methods typically suffer from a lack of control over the stimuli and their effects, this approach allows for the assignment of stimuli tailored to individual biopsychosocial profiles, thereby, increasing experimental control and decreasing unexplained variability. Further, they elucidate how hidden sociocultural factors, psychological traits, and contextual states shape seemingly "subjective" phenomena.

Insights into medical students' perceptions of work culture during the COVID-19 pandemic: a mixed method study.

BACKGROUND: The COVID-19 pandemic brought about profound social changes that affected students worldwide. These changes had both psychological and economic consequences, and also led to the adoption of new teaching methods. It can also have an impact on work culture, which is the collective set of values, norms, and practices within a specific profession, shaping how individuals in that field behave, communicate, and identify with their work. The aim of the study was to examine medical students' perception of professional culture during the COVID-19 crisis when they voluntarily participated in the healthcare network established, outside of university placements, for the management of COVID patients. METHODS: A questionnaire study based on the vignette methodology was conducted among third-year medical students. Drawing from three scenarios in which students were variably engaged in crisis management, it included questions about their perceptions of the medical profession, their motivation, and their sense of belonging to the profession. RESULTS: 352 students responded to the survey. The pandemic had both a positive and a negative impact on students' perceptions of the medical profession. Cluster analysis using a k-means algorithm and principal component analysis revealed three clusters of students with different perceptions of the medical profession. The first cluster, which represented the majority of students, corresponded to a relatively positive perception of the profession that was reinforced during the pandemic. In the second cluster, students' perceptions were reinforced still further, and particular importance was attached to field experience. Students in the third cluster had the most negative perceptions, having been shaken the most by the pandemic, and they attached little importance to field experience. CONCLUSIONS: The analysis highlighted the importance of students being able to adapt and draw on a range of resources during the COVID-19 pandemic. This underscores the need for work cultures that support adaptability and coping. Further research is needed to understand its long-term effects on students' perceptions of the medical profession and to identify interventions that could support students in the aftermath of this difficult period.

Fusion-negative rhabdomyosarcoma 3D organoids to predict effective drug combinations: A proof-of-concept on cell death inducers.

Rhabdomyosarcoma (RMS) is the main form of pediatric soft-tissue sarcoma. Its cure rate has not notably improved in the last 20 years following relapse, and the lack of reliable preclinical models has hampered the design of new therapies. This is particularly true for highly heterogeneous fusion-negative RMS (FNRMS). Although methods have been proposed to establish FNRMS organoids, their efficiency remains limited to date, both in terms of derivation rate and ability to accurately mimic the original tumor. Here, we present the development of a next-generation 3D organoid model derived from relapsed adult and pediatric FNRMS. This model preserves the molecular features of the patients' tumors and is expandable for several months in 3D, reinforcing its interest to drug combination screening with longitudinal efficacy monitoring. As a proof-of-concept, we demonstrate its preclinical relevance by reevaluating the therapeutic opportunities of targeting apoptosis in FNRMS from a streamlined approach based on transcriptomic data exploitation.

Association between family functioning and psychotic transition in ultra-high risk adolescents and young adults.

Background: Psychotic transition (PT) is a crucial stage in schizophrenia. The Comprehensive Assessment of At-Risk Mental States (CAARMS) scale can be used to identify individuals at ultra-high risk (UHR) for psychosis and to evaluate their risk of PT. Many environmental and genetic factors have been identified as contributing to the development and decompensation of schizophrenia. This study aimed to determine if the quality of family functioning is associated with PT risk in UHR individuals aged between 11 and 25 years after 1 year of follow-up. Methods: From January to November 2017, 45 patients aged 12 to 25 consulting for psychiatric reasons were included. Twenty-six were classified as UHR of PT at the CAARMS. Family functioning was assessed by the Family Assessment Device-Global Functioning (FAD-GF). Thirty-seven of these patients (30% men, mean age 16 ± 2.5) were reassessed at 8-14 months of recruitment. Survival analysis was used to examine the impact of family functioning on PT risk. Results: A total of 40% of UHR patients were classified as psychotic at reassessment. Survival analysis showed that better family functioning is a significant protective factor for PT in this population. Discussion: This result suggests that the global family functioning has an impact at 1 year on the risk of PT in the population of adolescents and young adults who consult the hospital for psychiatric reasons. A family intervention may be effective in reducing PT risk in this population and should be considered as a potential therapeutic option.

The obesity paradox for mid- and long-term mortality in older cancer patients: a prospective multicenter cohort study.

BACKGROUND: Overweight and obesity are associated with adverse health outcomes. However, substantial literature suggests that they are associated with longer survival among older people. This "obesity paradox" remains controversial. In the context of cancer, the association between overweight/obesity and mortality is complicated by concomitant weight loss (WL). Sex differences in the relation between BMI (in kg/m2) and survival have also been observed. OBJECTIVES: We studied whether a high BMI was associated with better survival, and whether the association differed by sex, in older patients with cancer. METHODS: We studied patients aged ≥70 y from the ELCAPA (Elderly Cancer Patients) prospective open cohort (2007-2016; 10 geriatric oncology clinics, Greater Paris urban area). The endpoints were 12- and 60-mo mortality. We created a variable combining BMI at cancer diagnosis and WL in the previous 6 mo, and considered 4 BMI categories-underweight (BMI < 22.5), normal weight (BMI = 22.5-24.9), overweight (BMI = 25-29.9), and obesity (BMI ≥ 30)-and 3 WL categories-<5% (minimal), 5% to <10% (moderate), and ≥10% (severe). Univariate and multivariate Cox proportional hazards analyses were conducted in men and women. RESULTS: A total of 2071 patients were included (mean age: 81 y; women: 48%; underweight: 30%; normal weight: 23%; overweight: 33%; obesity: 14%; predominant cancer sites: colorectal (18%) and breast (16%); patients with metastases: 49%). By multivariate analysis, obese women with WL < 5% had a lower 60-mo mortality risk than normal-weight women with WL < 5% (adjusted HR: 0.56; 95% CI: 0.37, 0.86; P = 0.012). Overweight/obese women with WL ≥ 5% did not have a lower mortality risk than normal-weight women with WL < 5%. Overweight and obese men did not have a lower mortality risk, irrespective of WL. CONCLUSIONS: By taking account of prediagnosis WL, only older obese women with cancer with minimal WL had a lower mortality risk than their counterparts with normal weight.This trial was registered at clinicaltrials.gov as NCT02884375.