If it Ain't Broke, Don't Fix it: Positive Versus Negative Emotion Regulation in Daily Life and Depressive Symptoms.

BACKGROUND: Despite the importance of positive emotions for affective psychopathology, prior research primarily focused on negative emotion regulation. To address this gap, this ecological momentary assessment study compared a broad set of emotion regulation strategies in the context of positive versus negative emotions regarding their effectiveness and associations with depressive symptoms. METHODS: We analyzed data from 1066 participants who were notified five times daily for seven consecutive days to complete a smartphone survey assessing their predominant emotions, strategies to regulate them, and subsequent emotional outcomes. RESULTS: Findings show that the effectiveness of most regulation strategies depended on whether the emotional context was positive or negative. While acceptance and savoring predicted improved emotional outcomes across emotional contexts, reappraisal and problem-solving were associated with deteriorated emotional outcomes and increased depressive symptoms when regulating positive but not negative emotions. LIMITATIONS: Future studies should replicate our findings in demographically and culturally diverse clinical samples to improve generalizability. CONCLUSION: These results emphasize that strategies effective for regulating negative emotions may be less helpful in the context of positive emotions. Thus, context-specific interventions may be a promising approach to improve the treatment of affective disorders.

Usability and usefulness of (electronic) patient identification systems-A cross-sectional evaluation in German-speaking radiation oncology departments.

PURPOSE: Patient misidentification in radiation oncology (RO) is a significant concern due to the potential harm to patient health and the burden on healthcare systems. Electronic patient identification systems (ePIS) are increasingly being used as an alternative or supplement to organizational systems (oPIS). The objective of this study was to assess the usability and usefulness of ePIS and oPIS in German-speaking countries. METHODS: A cross-sectional survey was designed by a group of experts from various professional backgrounds in RO. The survey consisted of 38 questions encompassing quantitative and qualitative data on usability, user experience, and usefulness of PIS. It was available between August and October 2022. RESULTS: Of 118 eligible participants, 37% had implemented some kind of ePIS. Overall, 22% of participants who use an oPIS vs. 10% of participants who use an ePIS reported adverse events in terms of patients' misidentification in the past 5 years. Frequent or very frequent drop-outs of electronic systems were reported by 31% of ePIS users. Users of ePIS significantly more often affirmed a positive cost-benefit ratio of ePIS as well as an improvement of workflow, whereas users of oPIS more frequently apprehended a decrease in staffs' attention through ePIS. The response rate was 8%. CONCLUSION: The implementation of ePIS can contribute to efficient PI and improved processes. Apprehensions by oPIS users and assessments of ePIS users differ significantly in aspects of the perceived usefulness of ePIS. However, technical problems need to be addressed to ensure the reliability of ePIS. Further research is needed to assess the impact of different PIS on patient safety in RO.

Identifying core MRI sequences for reliable automatic brain metastasis segmentation.

BACKGROUND: Many automatic approaches to brain tumor segmentation employ multiple magnetic resonance imaging (MRI) sequences. The goal of this project was to compare different combinations of input sequences to determine which MRI sequences are needed for effective automated brain metastasis (BM) segmentation. METHODS: We analyzed preoperative imaging (T1-weighted sequence ± contrast-enhancement (T1/T1-CE), T2-weighted sequence (T2), and T2 fluid-attenuated inversion recovery (T2-FLAIR) sequence) from 339 patients with BMs from seven centers. A baseline 3D U-Net with all four sequences and six U-Nets with plausible sequence combinations (T1-CE, T1, T2-FLAIR, T1-CE + T2-FLAIR, T1-CE + T1 + T2-FLAIR, T1-CE + T1) were trained on 239 patients from two centers and subsequently tested on an external cohort of 100 patients from five centers. RESULTS: The model based on T1-CE alone achieved the best segmentation performance for BM segmentation with a median Dice similarity coefficient (DSC) of 0.96. Models trained without T1-CE performed worse (T1-only: DSC = 0.70 and T2-FLAIR-only: DSC = 0.73). For edema segmentation, models that included both T1-CE and T2-FLAIR performed best (DSC = 0.93), while the remaining four models without simultaneous inclusion of these both sequences reached a median DSC of 0.81-0.89. CONCLUSIONS: A T1-CE-only protocol suffices for the segmentation of BMs. The combination of T1-CE and T2-FLAIR is important for edema segmentation. Missing either T1-CE or T2-FLAIR decreases performance. These findings may improve imaging routines by omitting unnecessary sequences, thus allowing for faster procedures in daily clinical practice while enabling optimal neural network-based target definitions.

Examining the strategy-situation fit of emotion regulation in everyday social contexts.

The strategy-situation fit hypothesis suggests that emotion regulation strategies are only beneficial to mental health if they meet contextual demands. Previous studies support this assumption but focused on properties of the emotional stimulus and reported cross-sectional associations with mental health, thus neglecting the social context and long-term mental health outcomes. To address these limitations, we examined (1) whether reappraisal, social sharing, and suppression varied depending on the social context (i.e., being alone, among close others, or nonclose others) and (2) whether specific strategy-context associations were linked to current, and (3) long-term mental health. The study consisted of two ecological momentary assessment (EMA) periods, separated by one year, and the second period occurred during COVID-19-related governmentally imposed social restrictions. This design allowed us to examine emotion regulation following social context changes. Our results indicate that emotion regulation varied by the social context. Reappraisal was used more frequently when being alone, suppression occurred more among nonclose others, and social sharing increased with close others. Regarding current mental health, more suppression was linked to higher depressive symptoms only when used in the presence of close others. In contrast, using suppression when being alone was linked to lower depressive symptoms. Finally, analyses with long-term outcomes revealed improved mental health when participants increased their use of reappraisal when being alone, and decreased reappraisal after a higher presence of close others. These findings could reflect the unique regulatory costs and benefits of different social situations and highlight the role of context-specific reappraisal for longer-term adaptiveness. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Development and external validation of an MRI-based neural network for brain metastasis segmentation in the AURORA multicenter study.

BACKGROUND: Stereotactic radiotherapy is a standard treatment option for patients with brain metastases. The planning target volume is based on gross tumor volume (GTV) segmentation. The aim of this work is to develop and validate a neural network for automatic GTV segmentation to accelerate clinical daily routine practice and minimize interobserver variability. METHODS: We analyzed MRIs (T1-weighted sequence ± contrast-enhancement, T2-weighted sequence, and FLAIR sequence) from 348 patients with at least one brain metastasis from different cancer primaries treated in six centers. To generate reference segmentations, all GTVs and the FLAIR hyperintense edematous regions were segmented manually. A 3D-U-Net was trained on a cohort of 260 patients from two centers to segment the GTV and the surrounding FLAIR hyperintense region. During training varying degrees of data augmentation were applied. Model validation was performed using an independent international multicenter test cohort (n = 88) including four centers. RESULTS: Our proposed U-Net reached a mean overall Dice similarity coefficient (DSC) of 0.92 ± 0.08 and a mean individual metastasis-wise DSC of 0.89 ± 0.11 in the external test cohort for GTV segmentation. Data augmentation improved the segmentation performance significantly. Detection of brain metastases was effective with a mean F1-Score of 0.93 ± 0.16. The model performance was stable independent of the center (p = 0.3). There was no correlation between metastasis volume and DSC (Pearson correlation coefficient 0.07). CONCLUSION: Reliable automated segmentation of brain metastases with neural networks is possible and may support radiotherapy planning by providing more objective GTV definitions.

In-depth characterisation of a cohort of individuals with missense and loss-of-function variants disrupting FOXP2.

BACKGROUND: Heterozygous disruptions of FOXP2 were the first identified molecular cause for severe speech disorder: childhood apraxia of speech (CAS), and yet few cases have been reported, limiting knowledge of the condition. METHODS: Here we phenotyped 28 individuals from 17 families with pathogenic FOXP2-only variants (12 loss-of-function, five missense variants; 14 males; aged 2 to 62 years). Health and development (cognitive, motor, social domains) were examined, including speech and language outcomes with the first cross-linguistic analysis of English and German. RESULTS: Speech disorders were prevalent (23/25, 92%) and CAS was most common (22/25, 88%), with similar speech presentations across English and German. Speech was still impaired in adulthood, and some speech sounds (eg, 'th', 'r', 'ch', 'j') were never acquired. Language impairments (21/25, 84%) ranged from mild to severe. Comorbidities included feeding difficulties in infancy (10/26, 38%), fine (13/26, 50%) and gross (13/26, 50%) motor impairment, anxiety (5/27, 19%), depression (6/27, 22%) and sleep disturbance (10/24, 42%). Physical features were common (22/27, 81%) but with no consistent pattern. Cognition ranged from average to mildly impaired and was incongruent with language ability; for example, seven participants with severe language disorder had average non-verbal cognition. CONCLUSIONS: Although we identify an increased prevalence of conditions like anxiety, depression and sleep disturbance, we confirm that the consequences of FOXP2 dysfunction remain relatively specific to speech disorder, as compared with other recently identified monogenic conditions associated with CAS. Thus, our findings reinforce that FOXP2 provides a valuable entry point for examining the neurobiological bases of speech disorder.

False memory in posttraumatic stress disorder and borderline personality disorder.

Post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD) have been associated with an increased generation of false memories. We aimed to disentangle disorder-specific false memory in individuals with PTSD and BPD using the Deese-Roediger-McDermott (DRM) paradigm. It measures the tendency to mistakenly remember stimuli that are associated with actually presented material, but have not been presented. Participants with BPD without comorbid PTSD (n = 32), participants with PTSD without comorbid BPD (n = 28), and mentally healthy controls (HC, n = 30) were given a word recognition test after hearing neutral, emotionally negative, BPD-related and PTSD-related word lists. Compared to HC, participants with PTSD showed fewer false memories for neutral word material and no other differences. Participants with BPD showed no differences in false memory formation compared to HC, only more false memories for a BPD-related and a PTSD-related word list compared to PTSD. Our results indicate, that in the absence of BPD, increased false memory in PTSD cannot be observed. In addition, our findings do not suggest that individuals with BPD and HC differ in their false memory formation. More trauma-individualized material should be used in future studies on false memory in PTSD.

Long-term follow-up and clinical evaluation of the light-adjustable intraocular lens implanted after cataract removal: 7-year results.

PURPOSE: To determine the long-term safety and effectiveness of a light-adjustable intraocular lens (LAL) over a period that is longer than reported in the literature at the time of the study. SETTING: University Eye Hospital, Bochum, Germany. DESIGN: Noninterventional observation. METHODS: In 445 patients, cataract surgery with LAL implantation was performed between April 2008 and December 2012. It was possible to contact 171 of these patients or their relatives through letter or telephone; 61 patients (103 eyes) agreed to participate in the long-term study and were examined. RESULTS: The mean time between the lock-in (final light treatment) and long-term visit was 7.2 years; 61 patients were included and examined. Corrected and uncorrected distance visual acuity was and remained good (n = 93). The refractive outcome was stable with minimal deviation. There were no significant changes in corneal thickness. In 2 patients, there were slight opacities of the IOL material without impact on visual acuity. Other eye diseases were within the normal range of the patients' age. CONCLUSION: Seven years after implantation and refractive adjustment, eyes with an LAL had stable refraction, good visual acuity, and no IOL-associated pathologies. The findings suggest that LAL technology is a safe and efficient method to achieve good visual results without long-term complications.

A cognitive control framework for understanding emotion regulation flexibility.

What are the cognitive processes that allow flexible responses to the changing demands of varying emotional contexts? Previous research suggests that higher levels of cognitive control are linked to successful emotion regulation. In particular, the implementation of emotion regulation strategies has been associated with individual differences in cognitive control, including (a) inhibiting prepotent responses, (b) updating information in working memory, and (c) shifting mental sets. Although most of this work has focused on the relationship between cognitive control and the short-term implementation of regulatory strategies, cognitive control may be even more important for understanding the dynamic adaptation to varying emotional contexts, that is, emotion regulation flexibility. However, cognitive control and emotion regulation flexibility have not been investigated in conjunction, resulting in a lack of a coherent understanding. In this article, we describe a framework outlining the importance of cognitive control for understanding three key components of emotion regulation flexibility: (a) strategy stopping or switching, (b) strategy maintenance, and (c) monitoring. We highlight the relevance of studying each of these components through the lens of cognitive control processes, particularly focusing on the tradeoff between shielding versus shifting goals and goal-directed behavior in various emotional contexts. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

RecQ Helicases Function in Development, DNA Repair, and Gene Targeting in Physcomitrella patens.

RecQ DNA helicases are genome surveillance proteins found in all kingdoms of life. They are characterized best in humans, as mutations in RecQ genes lead to developmental abnormalities and diseases. To better understand RecQ functions in plants we concentrated on Arabidopsis thaliana and Physcomitrella patens, the model species predominantly used for studies on DNA repair and gene targeting. Phylogenetic analysis of the six P. patens RecQ genes revealed their orthologs in humans and plants. Because Arabidopsis and P. patens differ in their RecQ4 and RecQ6 genes, reporter and deletion moss mutants were generated and gene functions studied in reciprocal cross-species and cross-kingdom approaches. Both proteins can be found in meristematic moss tissues, although at low levels and with distinct expression patterns. PpRecQ4 is involved in embryogenesis and in subsequent development as demonstrated by sterility of ΔPpRecQ4 mutants and by morphological aberrations. Additionally, ΔPpRecQ4 displays an increased sensitivity to DNA damages and an increased rate of gene targeting. Therefore, we conclude that PpRecQ4 acts as a repressor of recombination. In contrast, PpRecQ6 is not obviously important for moss development or DNA repair but does function as a potent enhancer of gene targeting.

Phonological working memory and FOXP2.

The discovery and description of the affected members of the KE family (aKE) initiated research on how genes enable the unique human trait of speech and language. Many aspects of this genetic influence on speech-related cognitive mechanisms are still elusive, e.g. if and how cognitive processes not directly involved in speech production are affected. In the current study we investigated the effect of the FOXP2 mutation on Working Memory (WM). Half the members of the multigenerational KE family have an inherited speech-language disorder, characterised as a verbal and orofacial dyspraxia caused by a mutation of the FOXP2 gene. The core phenotype of the affected KE members (aKE) is a deficiency in repeating words, especially complex non-words, and in coordinating oromotor sequences generally. Execution of oromotor sequences and repetition of phonological sequences both require WM, but to date the aKE's memory ability in this domain has not been examined in detail. To do so we used a test series based on the Baddeley and Hitch WM model, which posits that the central executive (CE), important for planning and manipulating information, works in conjunction with two modality-specific components: The phonological loop (PL), specialized for processing speech-based information; and the visuospatial sketchpad (VSSP), dedicated to processing visual and spatial information. We compared WM performance related to CE, PL, and VSSP function in five aKE and 15 healthy controls (including three unaffected members of the KE family who do not have the FOXP2 mutation). The aKE scored significantly below this control group on the PL component, but not on the VSSP or CE components. Further, the aKE were impaired relative to the controls not only in motor (i.e. articulatory) output but also on the recognition-based PL subtest (word-list matching), which does not require speech production. These results suggest that the aKE's impaired phonological WM may be due to a defect in subvocal rehearsal of speech-based material, and that this defect may be due in turn to compromised speech-based representations.

Tobacco prevention and reduction with nursing students: A non-randomized controlled feasibility study.

BACKGROUND: Prevalence of tobacco use among nurses and nursing students is disproportionally high in Germany. However, from a public health perspective they are considered to be an important group for delivering smoking cessation interventions. As delivery of tobacco-related treatment depends on own smoking status, smoking prevention and cessation among the nursing professions is indicative for improving nurse and public health. OBJECTIVE: To evaluate the feasibility and effects of a comprehensive tobacco prevention and reduction program on psychosocial and environmental factors related to smoking behavior of nursing students. METHODS: Between 2014 and 2015, a non-randomized, controlled feasibility study was conducted in 12 schools of nursing with 397 nursing students in Germany. Students in the intervention group received a program (ASTRA) consisting of an introductory session, steering committee workshop, stress prevention lessons, evidence-based smoking cessation intervention, and action project. Six months after baseline assessment, change in smoking-related protective and risk factors was determined. Secondary endpoints included smoking behavior. RESULTS: The program was implemented in total in 5 of 7 intervention schools. About one third of smoking nursing students participated in a cessation intervention. The program seems to do better than a minimal intervention booklet in four primary outcomes: perceived descriptive, subjective, and injunctive norms towards smoking and nursing as well as perceived social support. As anticipated, there was no change in smoking behavior. CONCLUSIONS: The applied approach is feasible and able to improve important smoking-related norm perceptions of student nurses and perception of social support. However, additional context measures to influence the settings of nursing education currently rather supporting smoking seem to be necessary in order to promote smoking cessation among nursing students and to scale up implementation of the program.

Investigating the dynamics of the brain response to music: A central role of the ventral striatum/nucleus accumbens.

Ventral striatal activity has been previously shown to correspond well to reward value mediated by music. Here, we investigate the dynamic brain response to music and manipulated counterparts using functional magnetic resonance imaging (fMRI). Counterparts of musical excerpts were produced by either manipulating the consonance/dissonance of the musical fragments or playing them backwards (or both). Results show a greater involvement of the ventral striatum/nucleus accumbens both when contrasting listening to music that is perceived as pleasant and listening to a manipulated version perceived as unpleasant (backward dissonant), as well as in a parametric analysis for increasing pleasantness. Notably, both analyses yielded a ventral striatal response that was strongest during an early phase of stimulus presentation. A hippocampal response to the musical stimuli was also observed, and was largely mediated by processing differences between listening to forward and backward music. This hippocampal involvement was again strongest during the early response to the music. Auditory cortex activity was more strongly evoked by the original (pleasant) music compared to its manipulated counterparts, but did not display a similar decline of activation over time as subcortical activity. These findings rather suggest that the ventral striatal/nucleus accumbens response during music listening is strongest in the first seconds and then declines.

Participation of the classical speech areas in auditory long-term memory.

Accumulating evidence suggests that storing speech sounds requires transposing rapidly fluctuating sound waves into more easily encoded oromotor sequences. If so, then the classical speech areas in the caudalmost portion of the temporal gyrus (pSTG) and in the inferior frontal gyrus (IFG) may be critical for performing this acoustic-oromotor transposition. We tested this proposal by applying repetitive transcranial magnetic stimulation (rTMS) to each of these left-hemisphere loci, as well as to a nonspeech locus, while participants listened to pseudowords. After 5 minutes these stimuli were re-presented together with new ones in a recognition test. Compared to control-site stimulation, pSTG stimulation produced a highly significant increase in recognition error rate, without affecting reaction time. By contrast, IFG stimulation led only to a weak, non-significant, trend toward recognition memory impairment. Importantly, the impairment after pSTG stimulation was not due to interference with perception, since the same stimulation failed to affect pseudoword discrimination examined with short interstimulus intervals. Our findings suggest that pSTG is essential for transforming speech sounds into stored motor plans for reproducing the sound. Whether or not the IFG also plays a role in speech-sound recognition could not be determined from the present results.

In-situ spin labeling of his-tagged proteins: distance measurements under in-cell conditions.

New spin labeling strategies have immense potential in studying protein structure and dynamics under physiological conditions with electron paramagnetic resonance (EPR) spectroscopy. Here, a new spin-labeled chemical recognition unit for switchable and concomitantly high affinity binding to His-tagged proteins was synthesized. In combination with an orthogonal site-directed spin label, this novel spin probe, Proxyl-trisNTA (P-trisNTA) allows the extraction of structural constraints within proteins and macromolecular complexes by EPR. By using the multisubunit maltose import system of E. coli: 1) the topology of the substrate-binding protein, 2) its substrate-dependent conformational change, and 3) the formation of the membrane multiprotein complex can be extracted. Notably, the same distance information was retrieved both in vitro and in situ allowing for site-specific spin labeling in cell lysates under in-cell conditions. This approach will open new avenues towards in-cell EPR.

Does tonality boost short-term memory in congenital amusia?

Congenital amusia is a neuro-developmental disorder of music perception and production. Recent findings have demonstrated that this deficit is linked to an impaired short-term memory for tone sequences. As it has been shown before that non-musicians' implicit knowledge of musical regularities can improve short-term memory for tone information, the present study investigated if this type of implicit knowledge could also influence amusics' short-term memory performance. Congenital amusics and their matched controls, who were non-musicians, had to indicate whether sequences of five tones, presented in pairs, were the same or different; half of the pairs respected musical regularities (tonal sequences) and the other half did not (atonal sequences). As previously reported for non-musician participants, the control participants showed better performance (as measured with d') for tonal sequences than for atonal ones. While this improvement was not observed in amusics, both control and amusic participants showed faster response times for tonal sequences than for atonal sequences. These findings suggest that some implicit processing of tonal structures is potentially preserved in congenital amusia. This observation is encouraging as it strengthens the perspective to exploit implicit knowledge to help reducing pitch perception and memory deficits in amusia.

Working memory for pitch, timbre, and words.

Aiming to further our understanding of fundamental mechanisms of auditory working memory (WM), the present study compared performance for three auditory materials (words, tones, timbres). In a forward recognition task (Experiment 1) participants indicated whether the order of the items in the second sequence was the same as in the first sequence. In a backward recognition task (Experiment 2) participants indicated whether the items of the second sequence were played in the correct backward order. In Experiment 3 participants performed an articulatory suppression task during the retention delay of the backward task. To investigate potential length effects the number of items per sequence was manipulated. Overall findings underline the benefit of a cross-material experimental approach and suggest that human auditory WM is not a unitary system. Whereas WM processes for timbres differed from those for tones and words, similarities and differences were observed for words and tones: Both types of stimuli appear to rely on rehearsal mechanisms, but might differ in the involved sensorimotor codes.

Auditory stroop and absolute pitch: an fMRI study.

To date, the underlying cognitive and neural mechanisms of absolute pitch (AP) have remained elusive. In the present fMRI study, we investigated verbal and tonal perception and working memory in musicians with and without absolute pitch. Stimuli were sine wave tones and syllables (names of the scale tones) presented simultaneously. Participants listened to sequences of five stimuli, and then rehearsed internally either the syllables or the tones. Finally participants indicated whether a test stimulus had been presented during the sequence. For an auditory stroop task, half of the tonal sequences were congruent (frequencies of tones corresponded to syllables which were the names of the scale tones) and half were incongruent (frequencies of tones did not correspond to syllables). Results indicate that first, verbal and tonal perception overlap strongly in the left superior temporal gyrus/sulcus (STG/STS) in AP musicians only. Second, AP is associated with the categorical perception of tones. Third, the left STG/STS is activated in AP musicians only for the detection of verbal-tonal incongruencies in the auditory stroop task. Finally, verbal labelling of tones in AP musicians seems to be automatic. Overall, a unique feature of AP appears to be the similarity between verbal and tonal perception.

Test of a motor theory of long-term auditory memory.

Monkeys can easily form lasting central representations of visual and tactile stimuli, yet they seem unable to do the same with sounds. Humans, by contrast, are highly proficient in auditory long-term memory (LTM). These mnemonic differences within and between species raise the question of whether the human ability is supported in some way by speech and language, e.g., through subvocal reproduction of speech sounds and by covert verbal labeling of environmental stimuli. If so, the explanation could be that storing rapidly fluctuating acoustic signals requires assistance from the motor system, which is uniquely organized to chain-link rapid sequences. To test this hypothesis, we compared the ability of normal participants to recognize lists of stimuli that can be easily reproduced, labeled, or both (pseudowords, nonverbal sounds, and words, respectively) versus their ability to recognize a list of stimuli that can be reproduced or labeled only with great difficulty (reversed words, i.e., words played backward). Recognition scores after 5-min delays filled with articulatory-suppression tasks were relatively high (75-80% correct) for all sound types except reversed words; the latter yielded scores that were not far above chance (58% correct), even though these stimuli were discriminated nearly perfectly when presented as reversed-word pairs at short intrapair intervals. The combined results provide preliminary support for the hypothesis that participation of the oromotor system may be essential for laying down the memory of speech sounds and, indeed, that speech and auditory memory may be so critically dependent on each other that they had to coevolve.