DO HIGHER DOSES OF NALOXONE INCREASE THE RISK OF PULMONARY COMPLICATIONS?

BACKGROUND: Although naloxone has proven to be an effective opioid reversal agent, concern that high doses of naloxone can cause pulmonary edema may prevent health care providers from administering it in initial high doses. OBJECTIVE: Our aim was to determine whether increased doses of naloxone are correlated with an increase in pulmonary complications in patients presenting to the emergency department (ED) after an opioid overdose. METHODS: This was a retrospective study of patients treated with naloxone by emergency medical services (EMS) or in the ED at an urban level I trauma center and three associated freestanding EDs. Data were queried from EMS run reports and the medical record and included demographic characteristics, naloxone dosing, administration route, and pulmonary complications. Patients were grouped by naloxone dose received, defined as low (≤ 2 mg), moderate (> 2 mg to ≤ 4 mg), and high (> 4 mg). RESULTS: Of the 639 patients included, 13 (2.0%) were diagnosed with a pulmonary complication. There was no difference in the development of pulmonary complications across groups (p = 0.676). There was no difference in pulmonary complications based on the route of administration (p = 0.342). The administration of higher doses of naloxone was not associated with longer hospital stays (p = 0.0327). CONCLUSIONS: Study results suggest that the reluctance of many health care providers to administer larger doses of naloxone on initial treatment may not be warranted. In this investigation, there were no poor outcomes associated with an increase in naloxone administration. Further investigation in a more diverse population is warranted.

[Acceptance, mourning of delusions and recovery]. / Acceptation, deuil des idées délirantes et rétablissement.

Recovering from a mental disorder is a process by which the affected person will develop a new life project, based on the optimal use of personal and environmental resources. This involves adapting and managing certain symptoms better, in order to be able to rebuild oneself psychologically. This may be the case for delusions, which need to be distanced and accepted in order to develop this new life stage in. In this perspective, the notions of mourning for the self and mourning for delusional beliefs seem to be necessary steps in the reconstruction of a self that is favourable to recovery.

Serial reproduction reveals the geometry of visuospatial representations.

An essential function of the human visual system is to locate objects in space and navigate the environment. Due to limited resources, the visual system achieves this by combining imperfect sensory information with a belief state about locations in a scene, resulting in systematic distortions and biases. These biases can be captured by a Bayesian model in which internal beliefs are expressed in a prior probability distribution over locations in a scene. We introduce a paradigm that enables us to measure these priors by iterating a simple memory task where the response of one participant becomes the stimulus for the next. This approach reveals an unprecedented richness and level of detail in these priors, suggesting a different way to think about biases in spatial memory. A prior distribution on locations in a visual scene can reflect the selective allocation of coding resources to different visual regions during encoding ("efficient encoding"). This selective allocation predicts that locations in the scene will be encoded with variable precision, in contrast to previous work that has assumed fixed encoding precision regardless of location. We demonstrate that perceptual biases covary with variations in discrimination accuracy, a finding that is aligned with simulations of our efficient encoding model but not the traditional fixed encoding view. This work demonstrates the promise of using nonparametric data-driven approaches that combine crowdsourcing with the careful curation of information transmission within social networks to reveal the hidden structure of shared visual representations.

Effects of Implied Motion and Facing Direction on Positional Preferences in Single-Object Pictures.

Palmer, Gardner, and Wickens studied aesthetic preferences for pictures of single objects and found a strong inward bias: Right-facing objects were preferred left-of-center and left-facing objects right-of-center. They found no effect of object motion (people and cars showed the same inward bias as chairs and teapots), but the objects were not depicted as moving. Here we measured analogous inward biases with objects depicted as moving with an implied direction and speed by having participants drag-and-drop target objects into the most aesthetically pleasing position. In Experiment 1, human figures were shown diving or falling while moving forward or backward. Aesthetic biases were evident for both inward-facing and inward-moving figures, but the motion-based bias dominated so strongly that backward divers or fallers were preferred moving inward but facing outward. Experiment 2 investigated implied speed effects using images of humans, horses, and cars moving at different speeds (e.g., standing, walking, trotting, and galloping horses). Inward motion or facing biases were again present, and differences in their magnitude due to speed were evident. Unexpectedly, faster moving objects were generally preferred closer to frame center than slower moving objects. These results are discussed in terms of the combined effects of prospective, future-oriented biases, and retrospective, past-oriented biases.

Music-to-Color Associations of Single-Line Piano Melodies in Non-synesthetes.

Prior research has shown that non-synesthetes' color associations to classical orchestral music are strongly mediated by emotion. The present study examines similar cross-modal music-to-color associations for much better controlled musical stimuli: 64 single-line piano melodies that were generated from four basic melodies by Mozart, whose global musical parameters were manipulated in tempo(slow/fast), note-density (sparse/dense), mode (major/minor) and pitch-height (low/high). Participants first chose the three colors (from 37) that they judged to be most consistent with (and, later, the three that were most inconsistent with) the music they were hearing. They later rated each melody and each color for the strength of its association along four emotional dimensions: happy/sad, agitated/calm, angry/not-angry and strong/weak. The cross-modal choices showed that faster music in the major mode was associated with lighter, more saturated, yellower (warmer) colors than slower music in the minor mode. These results replicate and extend those of Palmer et al. (2013, Proc. Natl Acad. Sci. 110, 8836-8841) with more precisely controlled musical stimuli. Further results replicated strong evidence for emotional mediation of these cross-modal associations, in that the emotional ratings of the melodies were very highly correlated with the emotional associations of the colors chosen as going best/worst with the melodies (r = 0.92, 0.85, 0.82 and 0.70 for happy/sad, strong/weak,angry/not-angry and agitated/calm, respectively). The results are discussed in terms of common emotional associations forming a cross-modal bridge between highly disparate sensory inputs.