Cross-Course Harmonized Assignments in Neuroscience.

Neuroscience is inherently interdisciplinary. This interdisciplinarity can be lost due to the self-contained nature of each course in most undergraduate neuroscience programs, leaving students to draw these cross-course relationships on their own. We sought to address this by using short, creative research assignments on a topic of the student's choice ("Deep Dive" assignments) that provided students with the opportunity to explore common applications across two concurrently run core neuroscience courses housed in different departments. We tested whether unifying the available Deep Dive topics across the two courses improved student outcomes. Specifically, students were asked to select a topic of interest from a shortlist shared in the two courses. Our results show that harmonized, concurrent creative assignments across dissimilar neuroscience courses improved outcomes related to student interest in material, confidence in creative problem solving, content recall for the other course, and applicability to real life. To our surprise, there was no added benefit to be in the same topic for both courses. Instead, the addition of harmonized Deep Dive assignments themselves, even if assigned on different topics across the two courses, drove the outcome improvement.

Enhanced neural mechanisms of set shifting in musically trained adolescents and young adults: converging fMRI, EEG, and behavioral evidence.

Musically trained individuals have been found to outperform untrained peers in various tasks for executive functions. Here, we present longitudinal behavioral results and cross-sectional, event-related potential (ERP), and fMRI results on the maturation of executive functions in musically trained and untrained children and adolescents. The results indicate that in school-age, the musically trained children performed faster in a test for set shifting, but by late adolescence, these group differences had virtually disappeared. However, in the fMRI experiment, the musically trained adolescents showed less activity in frontal, parietal, and occipital areas of the dorsal attention network and the cerebellum during the set-shifting task than untrained peers. Also, the P3b responses of musically trained participants to incongruent target stimuli in a task for set shifting showed a more posterior scalp distribution than control group participants' responses. Together these results suggest that the musician advantage in executive functions is more pronounced at an earlier age than in late adolescence. However, it is still reflected as more efficient recruitment of neural resources in set-shifting tasks, and distinct scalp topography of ERPs related to updating and working memory after childhood.

Application of virtual reality for peritoneal dialysis exchange learning in patients with end-stage renal disease and cognitive impairment.

Cognitive impairment is not uncommon in patients with end-stage renal disease and can make it more difficult for these patients to carry out peritoneal dialysis (PD) on their own. Their attempts to do so may result in adverse consequences such as peritonitis. PD exchange is a complex procedure demanding knowledge and skill which requires close supervision and guidance by a renal nurse specialist. In this study, a non-immersive virtual reality (VR) training program using a Leap motion hand tracking device was developed to facilitate patients' understanding and learning of the PD exchange procedure before attempting real task practice. This study was a two-center single-blinded randomized controlled trial on 23 incident PD patients. Patients in the experimental group received 8 sessions of VR training, while patients in the control were provided with printed educational materials. The results showed that there were significant differences between the two groups in performance of the overall PD exchange sequence, especially on the crucial steps. VR had a patient satisfaction rate of 89%, and all patients preferred to have the VR aid incorporated in PD training. Our findings conclude VR can be a useful aid in the training and reinforcement of PD exchange procedures, with distinct merits of being free from restrictions of time, space, and manpower.

The "men in grief" phenomenon among suicide bereaved Chinese men in Hong Kong.

This qualitative study addressed the intersectionality between masculine grief and gender role expectations during the grief process among men. The sample comprised 10 Chinese men in Hong Kong who had lost their wife or child to suicide. The study found that the "men in grief" phenomenon comprised three themes: making sense of hidden grief, processing grief-related guilt, and removing the stigma of masculine grieving. Future research on the masculine grieving process can focus on the association between perceived weaknesses and expected help-seeking behaviors in men who experience multiple losses after a suicide death in the family.

Effects of temporal order and intentionality on reflective attention to words in noise.

Speech perception in noise is a cognitively demanding process that challenges not only the auditory sensory system, but also cognitive networks involved in attention. The predictive coding theory has been influential in characterizing the influence of prior context on processing incoming auditory stimuli, with comparatively less research dedicated to "postdictive" processes and subsequent context effects on speech perception. Effects of subsequent semantic context were evaluated while manipulating the relationship of three target words presented in noise and the temporal position of targets compared to the subsequent contextual cue, demonstrating that subsequent context benefits were present regardless of whether the targets were related to each other and did not depend on the position of the target. However, participants instructed to focus on the relation between target and cue performed worse than those who did not receive this instruction, suggesting a disruption of a natural process of continuous speech recognition. We discuss these findings in relation to lexical commitment and stimulus-driven attention to short-term memory as mechanisms of subsequent context integration.

A study on clinical outcomes of Rathke's cleft cyst in patients managed conservatively.

OBJECTIVES: The primary objective was to investigate the clinical presentation, hormonal dysfunction, imaging characteristics and natural history of RCCs that were managed conservatively. Secondary objective was to identify factors associated with cyst progression. METHODS: A retrospective review of patients with the clinical diagnosis of RCC-identified from word search from radiology reports that were followed up from January 1999 to March 2019 was performed. The demographics, clinical data, radiological features and outcomes were reviewed and analyzed. RESULTS: 105 patients were identified with a median follow up of 6 years. 68 patients (64.8%) were managed conservatively from diagnosis till last follow up while 37 patients (35.2%) underwent surgery, with 26 operated at time of diagnosis and 11 operated upon monitoring. For patients managed conservatively from diagnosis till last follow up, incidental finding was the most common presentation. 19.1% had either one or more axes of hormonal dysfunction, with hypogonadism and hypocortisolemia being the commonest ones. Imaging features were variable. 66.2% of patients had T2W hyperintensity on MRI. Pathognomonic feature of intracystic nodule was present in only 14.7% of patients. Among the 79 patients with repeated MRI imaging (68 from conservative group and 11 from surgical group), 32.9% of patients developed cyst progression while 67.1% had either static disease or regression in size of RCC. Median time to progression of cyst was 14 months. Longer median follow up duration and presence of pituitary stalk displacement at presentation were associated with cyst progression. Only one patient developed new endocrine dysfunction. CONCLUSION: 2/3 of the RCCs had static disease or even regression in the size of the cyst. They rarely gave rise to additional endocrine dysfunction by adopting observant approach. Cyst progression was demonstrated in 1/3 of patients. Conservative treatment remained a reasonable treatment for patients without significant symptoms.

Chinese Male Survivors of Intimate Partner Violence: A Three-Pillar Approach to Analyze Men's Delayed Help-Seeking Decisions.

Intimate partner violence (IPV) literature has addressed differential socialization for designing interventions, mainly helping female victims and male perpetrators. From a gender-specific perspective, this study examines the abused men's postponed decisions to disclose victimization or seek help. Through individual interviews, 10 Chinese male IPV survivors in Hong Kong described their help-seeking journey. A three-pillar approach is applied to guide the analysis in terms of psychological factors, cultural barriers, and decisional challenges when men are seeking help. Results reveal negative influences bearing on male survivors' help-seeking behaviors and support how men can rebuild positive personal strengths after experiencing the impact of abuse on oneself and the family. Service providers must identify barriers of delayed help-seeking decisions and treat IPV survivors with respect and acceptance to facilitate abuse disclosure.

Risk of cancer in patients with ankylosing spondylitis: a nationwide cohort study in Taiwan.

Objective: To estimate the incidence of cancer among patients with ankylosing spondylitis (AS) and compare this risk with that of the general population.Method: We obtained data from Taiwan's National Health Insurance database on 19 289 patients with a first diagnosis of AS registered between 2000 and 2012 with no history of cancer before the diagnosis of AS. Standardized incidence ratios (SIRs) for all cancers and for site-specific cancers were used to assess whether AS was associated with an increased risk of cancer.Results: During the follow-up period, 485 patients developed cancer. The incidence rate was therefore 256.3 per 100 000 person-years. Compared with the general population, patients with AS had an increased risk of cancer [SIR 1.33, 95% confidence interval (CI) 1.20-1.47]. The SIR of cancer was higher in older patients; the risk increased from 8 years after initial diagnosis. Among solid tumours, the risk of melanoma was the highest (SIR 4.64, 95% CI 1.93-11.15), followed by prostate (SIR 2.53, 95% CI 2.01-3.19), thyroid (SIR 2.09, 95% CI 1.45-3.00), and bone cancer (SIR 2.00, 95% CI 1.01-3.99). Among haematological cancers, the risk of leukaemia was the highest (SIR 1.94, 95% CI 1.21-3.12). By contrast, the risks of oesophageal and oral cancers decreased in patients with AS.Conclusion: This nationwide population-based cohort study demonstrated that patients with AS in Taiwan are at an increased risk of cancer, particularly melanoma; prostate, thyroid, and bone cancers; and haematological malignancies.

Brain indices associated with semantic cues prior to and after a word in noise.

It is well established that identification of words in noise improves when it is preceded by a semantically related word, but comparatively little is known about the effect of subsequent context in guiding word in noise identification. We build on the findings of a previous behavioural study (Chan & Alain, 2019) by measuring neuro-electric brain activity while manipulating the semantic content of a cue that either preceded or followed a word in noise. Participants were more accurate in identifying the word in noise when it was preceded or followed by a cue that was semantically related. This gain in accuracy coincided with a late positive component, which was time-locked to the word in noise when preceded by a cue and time-locked to the cue when it followed the word in noise. Distributed source analyses of this positive component revealed different patterns in source activity between the two temporal conditions. The effects of relatedness also generated an event-related potential modulation around 400 ms (N400) that was present at cue presentation when it followed the word in noise, but not for the word in noise when preceded by the cue, consistent with findings regarding its sensitivity to signal degradation. Exploratory analyses examined a subset of data based on participants' subjective perceived clarity, which revealed a posterior deflection over the left hemisphere that showed a relatedness effect. We discuss these findings in light of research on prediction as well as a reflective attention framework.

Nicotine-induced enhancement of a sensory reinforcer in adult rats: antagonist pretreatment effects.

RATIONALE AND OBJECTIVES: The reinforcement-enhancing effect (REE) of nicotine refers to the drug's ability to enhance the strength of other primary and conditioned reinforcers. The main aim was to investigate neuropharmacological mechanisms underlying nicotine's strengthening of a primary visual reinforcer (i.e., a light cue), using a subcutaneous (SC) dose previously shown to provide plasma nicotine levels associated with habitual smoking. METHODS: Adult male rats pressed an "active" lever to illuminate a brief cue light during daily 60-min sessions. Rats that showed a clear REE were tested with systemically administered pretreatment drugs followed by nicotine (0.1 mg/kg SC) or saline challenge, in within-subject counterbalanced designs. Pretreatments were mecamylamine (nicotinic, 0.1-1 mg/kg SC), SCH 39166 (D1-like dopaminergic, 0.003-0.2 mg/kg SC), naloxone (opioid, 1 and 5 mg/kg SC), prazosin (alpha1-adrenergic antagonist, 1 and 2 mg/kg IP), rimonabant (CB1 cannabinoid inverse agonist, 3 mg/kg IP), sulpiride (D2-like dopaminergic antagonist, 40 mg/kg SC), or propranolol (beta-adrenergic antagonist, 10 mg/kg IP). RESULTS: The nicotine REE was abolished by three antagonists at doses that did not impact motor output, i.e., mecamylamine (1 mg/kg), SCH 39166 (0.01 and 0.03 mg/kg), and naloxone (5 mg/kg). Prazosin and rimonabant both attenuated the nicotine REE, but rimonabant also suppressed responding more generally. The nicotine REE was not significantly altered by sulpiride or propranolol. CONCLUSIONS: In adult male rats, the reinforcement-enhancing effect of low-dose nicotine depends on nicotinic receptor stimulation and on neurotransmission via D1/D5 dopaminergic, opioid, alpha1-adrenergic, and CB1 cannabinoid receptors.

Centre for Youth Research and Practice: Social Impact Assessment Results.

Purpose: This article outlines the objective and structure of the Center for Youth Research and Practice (CYRP), its contributions toward youth research and practices, importance of the linkages that the CYRP has cultivated between research and practice, the facilitation of knowledge exchange with local and global institutions and professionals, and its role in future endeavors.Method: A social impact assessment has been implemented to address the intervention and the outcome based on the contributions of the CYRP to youth research and practices.Results: From this, the work of the CYRP on youth research and practices is concluded to have significant social impacts at the individual, social, organizational, and global levels. The work has found that the quality of life, self-esteem, involvement in society, empowerment through social capacity building, organizational development, and providing an international hub are crucial for youth development and wellbeing.Discussion: Hitherto, the CYRP has published over a hundred journal articles and held nearly 200 events including training courses, workshops, seminars and a conference. Over 6000 participants have taken part in these events and more than 60 institutions have collaborated with the CYRP to exchange knowledge on youth research and practices. The work of the CYRP as a whole has facilitated the participation of different individuals and organizations. In essence, the work of the CYRP has provided important grounds to initiate its role as an international hub as the CYRP is now considered as a center of significance in youth research and practices for Chinese societies in the East Asia region.

Lifetime cost-effectiveness analysis of first-line dialysis modalities for patients with end-stage renal disease under peritoneal dialysis first policy.

BACKGROUND: This study aimed to determine the lifetime cost-effectiveness of first-line dialysis modalities for end-stage renal disease (ESRD) patients under the "Peritoneal Dialysis First" policy. METHODS: Lifetime cost-effectiveness analyses from both healthcare provider and societal perspectives were performed using Markov modelling by simulating at age 60. Empirical data on costs and health utility scores collected from our studies were combined with published data on health state transitions and survival data to estimate the lifetime cost, quality-adjusted life-years (QALYs) and cost-effectiveness of three competing dialysis modalities: peritoneal dialysis (PD), hospital-based haemodialysis (HD) and nocturnal home HD. RESULTS: For cost-effectiveness analysis over a lifetime horizon from the perspective of healthcare provider, hospital-based HD group (lifetime cost USD$142,389; 6.58 QALYs) was dominated by the PD group (USD$76,915; 7.13 QALYs). Home-based HD had the highest effectiveness (8.37 QALYs) but with higher cost (USD$97,917) than the PD group. The incremental cost-effectiveness ratio (ICER) was USD$16,934 per QALY gained for home-based HD over PD. From the societal perspective, the results were similar and the ICER was USD$1195 per QALY gained for home-based HD over PD. Both ICERs fell within the acceptable thresholds. Changes in model parameters via sensitivity analyses had a minimal impact on ICER values. CONCLUSIONS: This study assessed the cost-effectiveness of dialysis modalities and service delivery models for ESRD patients under "Peritoneal Dialysis First" policy. For both healthcare provider and societal perspectives, PD as first-line dialysis modality was cost-saving relative to hospital-based HD, supporting the existing PD First or favoured policy. When compared with PD, Nocturnal home Home-based HD was considered a cost-effective first-line dialysis modality for ESRD patients.

Antiphospholipid antibodies in patients with lupus nephritis: clinical correlations and associations with long-term outcomes.

Whether the presence or absence of antiphospholipid antibodies (aPL) in patients with lupus nephritis (LN) is associated with differences in clinical outcomes remains unclear. We reviewed LN patients at a single centre during 2000-2017, and compared the clinical features and long-term outcomes between patients who were seropositive or seronegative for aPL. aPL was detected in 53/149 (35.6%) patients with biopsy-proven LN, and anticardiolipin IgM, anticardiolipin IgG, anti-ß2 glycoprotein I and lupus anticoagulant was detected in 18.8%, 18.1%, 10.7% and 8.1%, respectively. Follow-up was 155.8 ± 61.0 months, and was similar between aPL-seropositive and -seronegative patients. aPL seropositivity persisted in 94.3% of patients during remission. aPL-seropositive patients showed inferior patient survival (91% and 85% at 10 and 15 years, respectively, compared to 99% and 95% in aPL-seronegative patients; p = 0.043). Nine (6.0%) patients died during follow-up, including six aPL-seropositive (four thrombotic events and two bleeding complications related to anticoagulation) and three aPL-seronegative patients. aPL seropositivity was associated with more rapid decline in estimated glomerular filtration rate (-1.44 mL/min/year compared to -0.38 mL/min/year in aPL-seronegative patients; p = 0.027) and inferior long-term renal survival (82% and 74% at 10 and 15 years, respectively, compared to 91% and 87% in aPL-seronegative patients; p = 0.034). aPL-seropositive patients also had a higher incidence of thrombotic events and miscarriage (32.1% and 13.2%, respectively, compared to 16.7% and 2.1% in the aPL-seronegative group; p = 0.030 and 0.006). We concluded that aPL seropositivity was associated with inferior long-term patient and renal survival and more frequent thrombotic events and miscarriage in LN patients.

Infectious complications in lupus nephritis treatment: a systematic review and meta-analysis.

OBJECTIVES: Infection is an important concern in lupus nephritis treatment, but few studies have focused on this complication. Available data suggest marked variation in occurrence and outcome. This meta-analysis and review aims to provide an overview of infective complications, focusing on the risk factors and outcomes. METHODS: Original articles on lupus nephritis Class III/IV/V published in the period January 1980 to December 2016 were identified from the Pubmed/Medline electronic database. Meta-analysis of randomized controlled trials was performed to investigate total and serious infections at different phases of treatment and their associated factors. A descriptive review that included all studies was also performed, providing details on the types of infection, infection-related mortality, and potential impact of different eras on infection rates. RESULTS: A total of 56 studies (32 randomized controlled trials) were included. The incidence rates of overall and serious infections were higher during the induction than maintenance phase of therapy, with serious infections occurring at 8.2-50 and 3.5 per 100 patient-years, respectively. Recent data, predominantly from Asia, suggested lower rates of overall infections with induction regimens that included tacrolimus compared with mycophenolate (risk ratio 0.50, 95% confidence interval 0.33-0.76, p = 0.001). Mycophenolate as induction treatment was associated with lower overall infection risks than cyclophosphamide in non-Asians (risk ratio 0.60, 95% confidence interval 0.48-0.75, p < 0.001). The rates of serious infections were 4.1-25% in Asian and 4.4-8.5% in non-Asian countries; with infection-related mortality rates of 0-6.7% in Asian, compared to 0-2.1% in non-Asian locations. CONCLUSIONS: Infection remains a serious complication during treatment of lupus nephritis, but the reported rates and outcomes varied markedly. Mycophenolate was associated with lower infection risk than cyclophosphamide in non-Asians. Infection-related deaths appeared more common in Asian patients.

Listening back in time: Does attention to memory facilitate word-in-noise identification?

The ephemeral nature of spoken words creates a challenge for oral communications where incoming speech sounds must be processed in relation to representations of just-perceived sounds stored in short-term memory. This can be particularly taxing in noisy environments where perception of speech is often impaired or initially incorrect. Usage of prior contextual information (e.g., a semantically related word) has been shown to improve speech in noise identification. In three experiments, we demonstrate a comparable effect of a semantically related cue word placed after an energetically masked target word in improving accuracy of target-word identification. This effect persisted irrespective of cue modality (visual or auditory cue word) and, in the case of cues after the target, lasted even when the cue word was presented up to 4 seconds after the target. The results are framed in the context of an attention to memory model that seeks to explain the cognitive and neural mechanisms behind processing of items in auditory memory.