Modulation of corticomotor excitability in response to distal focal cooling

Background Thermal stimulation has been proposed as a modality to facilitate motor recovery in neurological populations, such as stroke. Recently (Ansari, Remaud & Tremblay, 2018), we showed that application of cold or warm stimuli distally to a single digit produced a variable and short lasting modulation in corticomotor excitability. Here, our goal was to extend these observations to determine whether an increase in stimulation area could elicit more consistent modulation. Methods Participants (n = 22) consisted of a subset who participated in our initial study. Participants were asked to come for a second testing session where the thermal protocol was repeated but with extending the stimulation area from single-digit (SD) to multi-digits (MD, four fingers, no thumb). As in the first session, skin temperature and motor evoked potentials (MEPs) elicited with transcranial magnetic stimulation were measured at baseline (BL, neutral gel pack at 22 °C), at 1 min during the cooling application (pre-cooled 10 °C gel pack) and 5 and 10 min post-cooling (PC5 and PC10). The analysis combined the data obtained previously with single-SD cooling (Ansari, Remaud & Tremblay, 2018) with those obtained here for MD cooling. Results At BL, participants exhibited comparable measures of resting corticomotor excitability between testing sessions. MD cooling induced similar reductions in skin temperature as those recorded with SD cooling with a peak decline at C1 of respectively, −11.0 and −10.3 °C. For MEPs, the primary analysis revealed no main effect attributable to the stimulation area. A secondary analysis of individual responses to MD cooling revealed that half of the participants exhibited delayed MEP facilitation (11/22), while the other half showed delayed inhibition (10/22); which was sustained in the post-cooling phase. More importantly, a correlation between variations in MEP amplitude recorded during the SD cooling session with those recorded in the second session with MD cooling, revealed a very good degree of correspondence between the two at the individual level. Conclusion These results indicate that increasing the cooling area in the distal hand, while still eliciting variable responses, did produce more sustained modulation in MEP amplitude in the post-cooling phase. Our results also highlight that responses to cooling in terms of either depression or facilitation of corticomotor excitability tend to be fairly consistent in a given individual with repeated applications.

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An individualized treatment rule to optimize probability of remission by continuation, switching, or combining antidepressant medications after failing a first-line antidepressant in a two-stage randomized trial

Psychological Medicine ◽

10.1017/s0033291721000027 ◽

2021 ◽

pp. 1-10

Author(s):

Ronald C. Kessler ◽

Toshi A. Furukawa ◽

Tadashi Kato ◽

Alex Luedtke ◽

Maria Petukhova ◽

...

Keyword(s):

Pragmatic Trial ◽

Secondary Analysis ◽

Individualized Treatment ◽

Second Line ◽

Open Label ◽

Individual Level ◽

Ensemble Machine Learning ◽

Medication Selection ◽

The Individual ◽

Optimized Treatment

Abstract Background There is growing interest in using composite individualized treatment rules (ITRs) to guide depression treatment selection, but best approaches for doing this are not widely known. We develop an ITR for depression remission based on secondary analysis of a recently published trial for second-line antidepression medication selection using a cutting-edge ensemble machine learning method. Methods Data come from the SUN(^_^)D trial, an open-label, assessor blinded pragmatic trial of previously-untreated patients with major depressive disorder from 48 clinics in Japan. Initial clinic-level randomization assigned patients to 50 or 100 mg/day sertraline. We focus on the 1549 patients who failed to remit within 3 weeks and were then rerandomized at the individual-level to continuation with sertraline, switching to mirtazapine, or combining mirtazapine with sertraline. The outcome was remission 9 weeks post-baseline. Predictors included socio-demographics, clinical characteristics, baseline symptoms, changes in symptoms between baseline and week 3, and week 3 side effects. Results Optimized treatment was associated with significantly increased cross-validated week 9 remission rates in both samples [5.3% (2.4%), p = 0.016 50 mg/day sample; 5.1% (2.7%), p = 0.031 100 mg/day sample] compared to randomization (30.1–30.8%). Optimization was also associated with significantly increased remission in both samples compared to continuation [24.7% in both: 11.2% (3.8%), p = 0.002 50 mg/day sample; 11.7% (3.9%), p = 0.001 100 mg/day sample]. Non-significant gains were found for optimization compared to switching or combining. Conclusions An ITR can be developed to improve second-line antidepressant selection, but replication in a larger study with more comprehensive baseline predictors might produce stronger and more stable results.

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Validation of new ICD-10-based patient safety indicators for identification of in-hospital complications in surgical patients: a study of diagnostic accuracy

BMJ Quality & Safety ◽

10.1136/bmjqs-2018-008852 ◽

2019 ◽

Vol 29 (3) ◽

pp. 209-216 ◽

Cited By ~ 8

Author(s):

Daniel I McIsaac ◽

Gavin M Hamilton ◽

Karim Abdulla ◽

Luke T Lavallée ◽

Husien Moloo ◽

...

Keyword(s):

Patient Safety ◽

Secondary Analysis ◽

Data Systems ◽

Reference Standard ◽

Likelihood Ratios ◽

Primary Analysis ◽

Predictive Values ◽

Individual Level ◽

Patient Safety Indicators ◽

Icd 10

ObjectiveAdministrative data systems are used to identify hospital-based patient safety events; few studies evaluate their accuracy. We assessed the accuracy of a new set of patient safety indicators (PSIs; designed to identify in hospital complications).Study designProspectively defined analysis of registry data (1 April 2010–29 February 2016) in a Canadian hospital network. Assignment of complications was by two methods independently. The National Surgical Quality Improvement Programme (NSQIP) database was the clinical reference standard (primary outcome=any in-hospital NSQIP complication); PSI clusters were assigned using International Classification of Disease (ICD-10) codes in the discharge abstract. Our primary analysis assessed the accuracy of any PSI condition compared with any complication in the NSQIP; secondary analysis evaluated accuracy of complication-specific PSIs.PatientsAll inpatient surgical cases captured in NSQIP data.AnalysisWe assessed the accuracy of PSIs (with NSQIP as reference standard) using positive and negative predictive values (PPV/NPV), as well as positive and negative likelihood ratios (±LR).ResultsWe identified 12 898 linked episodes of care. Complications were identified by PSIs and NSQIP in 2415 (18.7%) and 2885 (22.4%) episodes, respectively. The presence of any PSI code had a PPV of 0.55 (95% CI 0.53 to 0.57) and NPV of 0.93 (95% CI 0.92 to 0.93); +LR 6.41 (95% CI 6.01 to 6.84) and −LR 0.40 (95% CI 0.37 to 0.42). Subgroup analyses (by surgery type and urgency) showed similar performance. Complication-specific PSIs had high NPVs (95% CI 0.92 to 0.99), but low to moderate PPVs (0.13–0.61).ConclusionValidation of the ICD-10 PSI system suggests applicability as a first screening step, integrated with data from other sources, to produce an adverse event detection pathway that informs learning healthcare systems. However, accuracy was insufficient to directly identify or rule out individual-level complications.

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Individual-level characteristics associated with oral HIV test acceptability among Peruvian men who have sex with men and transgender women: a cross-sectional study

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053388 ◽

2018 ◽

Vol 94 (7) ◽

pp. 528-533 ◽

Cited By ~ 4

Author(s):

Juan A Flores ◽

Brandon Brown ◽

Segundo R León ◽

Hugo Sánchez ◽

Jerome T Galea

Keyword(s):

Health Centre ◽

Secondary Analysis ◽

Prevalence Ratio ◽

Transgender Women ◽

Cross Sectional ◽

Individual Level ◽

Factors Associated ◽

Hiv Test ◽

Sex With Men ◽

The Individual

ObjectivesPeruvian men who have sex with men (MSM) and transgender women (TGW) are highly vulnerable to HIV infection (HIV), but stigma, access issues and fear of venipuncture hamper testing. The oral HIV test—which uses oral fluids and provides results in 20 minutes—could reduce these barriers. The objective of this study was to determine the acceptability of the oral HIV test and the individual-level factors associated with its acceptability among MSM and TGW.MethodsWe conducted a cross-sectional secondary analysis among Peruvian MSM and TGW attending a community-based health centre between February 2012 and February 2013 to determine the individual-level factors associated with oral HIV test acceptability.ResultsOf 334 participants, 88% were MSM and 12% TGW. Overall, 85% of participants indicated their acceptability of the oral HIV test. Acceptability was higher in MSM than TGW (85.7% vs 80.0%) but this difference was not significant. Factors associated with acceptability in MSM were: tertiary or higher education (prevalence ratio (PR)=1.18, 95% CI 1.06 to 1.32 and PR=1.16, 95% CI 1.03 to 1.30, respectively); sex with drug use (PR=1.19, 95% CI 1.05 to 1.36); believing that HIV is transmitted by saliva (PR=1.20, 95% CI 1.08 to 1.33); and potential use of the oral test at home (PR=1.56, 95% CI 1.32 to 1.85). The only factor associated with lower acceptability was having had first anal intercourse between 14 and 19 years of age (PR=0.89, 95% CI 0.80 to 0.98).ConclusionsWe identified the individual factors associated with oral HIV test acceptability among Peruvian MSM and TGW. Expanded use of the oral HIV test to increase testing rates among Peruvian MSM and TGW is recommended.Trial registration numberNCT01387412, post-results.

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Abstract 244: Racial Disparities In Cardiopulmonary Training Status in the United States

Circulation ◽

10.1161/circ.138.suppl_2.244 ◽

2018 ◽

Vol 138 (Suppl_2) ◽

Author(s):

Shaun K McGovern ◽

Andrew Murray ◽

Benjamin S Abella ◽

Marion Leary ◽

Audrey L Blewer

Keyword(s):

Secondary Analysis ◽

The United States ◽

Training Status ◽

Individual Level ◽

Significant Difference ◽

Chi Squared ◽

Random Digit Dial ◽

Nationally Representative ◽

The Individual ◽

Cpr Training

Background: Survival from out-of-hospital cardiac arrest varies by race, possibly due to poor penetration of CPR training in minority communities. Targeted trainings and campaigns to increase access to CPR education have sought to address these gaps, yet it is unknown if these initiatives have equalized training rates. Objectives: We sought to examine racial variation of CPR training status on the individual-level by assessing current CPR training and ever CPR trained status. We hypothesized that whites would be more likely to hold current CPR training and be ever trained in CPR compared to minorities. Methods: As a secondary analysis to a previous random digit dial survey of a nationally-representative adult sample, we defined CPR training status of individuals as currently trained (only ≤2 years) and ever trained. Chi-squared test and multivariate logistic regression were used to determine variation by race. Results: From 09/2015-11/2015, 9,022 individuals completed the national survey. Of those, 65% had been CPR trained at some point in time, while 18% reported being currently trained. Minorities were significantly less likely to ever be trained in CPR compared to whites (54.9% vs 70.8%, p<0.01). However, minorities and whites were equally as likely to be currently CPR trained (18.2% vs. 18.2%, p=0.99); no significant difference was found when adjusting for age, sex, and education (p=ns). Probability of training status by age displayed variation between groups (Figure 1). Conclusions: Significant disparities by race were observed in those ever trained in CPR, however no significant difference exists in attainment of current CPR training. Increased access to CPR education and targeted training campaigns may have closed the gap in current CPR training status disparities. Continued surveillance of CPR training rates is needed to monitor these findings over time.

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Professional mathematicians do not differ from others in the symbolic numerical distance and size effects

10.31234/osf.io/evzpa ◽

2020 ◽

Author(s):

Mateusz Hohol ◽

Klaus Willmes ◽

Edward Nęcka ◽

Bartosz Brożek ◽

Hans-Christoph Nuerk ◽

...

Keyword(s):

Size Effect ◽

Size Effects ◽

Reference Group ◽

Distance Effect ◽

Numerical Distance ◽

Single Digit ◽

Mathematical Skills ◽

Numerical Distance Effect ◽

Individual Level ◽

The Individual

The numerical distance effect (it is easier to compare numbers that are further apart) and size effect (for a constant distance, it is easier to compare smaller numbers) characterize symbolic number processing. However, evidence for a relationship between these two basic phenomena and more complex mathematical skills is mixed. Previously this relationship has only been studied in participants with normal or poor mathematical skills, not in mathematicians. Furthermore, the prevalence of these effects at the individual level is not known. Here we compared professional mathematicians, engineers, social scientists, and a reference group using the symbolic magnitude classification task with single-digit Arabic numbers. The groups did not differ with respect to symbolic numerical distance and size effects in either frequentist or Bayesian analyses. Moreover, we looked at their prevalence at the individual level using the bootstrapping method: while a reliable numerical distance effect was present in almost all participants, the prevalence of a reliable numerical size effect was much lower. Again, prevalence did not differ between groups. In summary, the phenomena were neither more pronounced nor more prevalent in mathematicians, suggesting that extremely high mathematical skills neither rely on nor have special consequences for analogue processing of symbolic numerical magnitudes.

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Effect modification of FADS2 polymorphisms on the association between breastfeeding and intelligence: results from a collaborative meta-analysis

10.1101/184234 ◽

2017 ◽

Author(s):

Fernando Pires Hartwig ◽

Neil Martin Davies ◽

Bernardo Lessa Horta ◽

Tarunveer S. Ahluwalia ◽

Hans Bisgaard ◽

...

Keyword(s):

De Novo ◽

Meta Analysis ◽

Secondary Analysis ◽

Breastfeeding Duration ◽

Large Individual ◽

Environment Interaction ◽

Primary Analysis ◽

Interaction Coefficients ◽

Individual Level ◽

Z Scores

AbstractBackgroundAccumulating evidence suggests that breastfeeding benefits the children’s intelligence. Long-chain polyunsaturated fatty acids (LC-PUFAs) present in breast milk may explain part of this association. Under a nutritional adequacy hypothesis, an interaction between breastfeeding and genetic variants associated with endogenous LC-PUFAs synthesis might be expected. However, the literature on this topic is controversial.Methods and FindingsWe investigated this Gene×Environment interaction in a de novo meta-analysis involving >12,000 individuals in the primary analysis, and >45,000 individuals in a secondary analysis using relaxed inclusion criteria. Our primary analysis used ever breastfeeding, FADS2 polymorphisms rs174575 and rs1535 coded assuming a recessive effect of the G allele, and intelligence quotient (IQ) in Z scores. Using random effects meta-analysis, ever breastfeeding was associated with 0.17 (95% CI: 0.03; 0.32) higher Z scores in IQ, or about 2.1 points. There was no strong evidence of interaction, with pooled covariate-adjusted interaction coefficients (i.e., difference between genetic groups of the difference in IQZ scores comparing ever with never breastfed individuals) of 0.12 (95% CI: −0.19; 0.43) and 0.06 (95% CI: −0.16; 0.27) for the rs174575 and rs1535 variants, respectively. Secondary analyses corroborated these results. In studies with >5.85 and <5.85 months of breastfeeding duration, pooled estimates for the rs174575 variant were 0.50 (95% CI: −0.06; 1.06) and 0.14 (95% CI: −0.10; 0.38), respectively, and 0.27 (95% CI: −0.28; 0.82) and −0.01 (95% CI: −0.19; 0.16) for the rs1535 variant. However, between-group comparisons were underpowered.ConclusionsOur findings do not support an interaction between ever breastfeeding and FADS2 polymorphisms. However, our subgroup analysis raises the possibility that breastfeeding supplies LC-PUFAs requirements for cognitive development (if such threshold exists) if it lasts for some (currently unknown) time. Future studies in large individual-level datasets would allow properly powered subgroup analyses and would improve our understanding on the role of breastfeeding duration in the breastfeeding×FADS2 interaction.

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Differential Effects of Competence and Morality on Self-Esteem at the Individual and the Collective Level

Social Psychology ◽

10.1027/1864-9335/a000410 ◽

2020 ◽

Vol 51 (3) ◽

pp. 183-198

Author(s):

Wiktor Soral ◽

Mirosław Kofta

Keyword(s):

Self Esteem ◽

Differential Effects ◽

Individual Level ◽

The Subject ◽

The Individual

Abstract. The importance of various trait dimensions explaining positive global self-esteem has been the subject of numerous studies. While some have provided support for the importance of agency, others have highlighted the importance of communion. This discrepancy can be explained, if one takes into account that people define and value their self both in individual and in collective terms. Two studies ( N = 367 and N = 263) examined the extent to which competence (an aspect of agency), morality, and sociability (the aspects of communion) promote high self-esteem at the individual and the collective level. In both studies, competence was the strongest predictor of self-esteem at the individual level, whereas morality was the strongest predictor of self-esteem at the collective level.

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Empirical analysis of trait models at the individual level

PsycEXTRA Dataset ◽

10.1037/e633912013-137 ◽

2004 ◽

Author(s):

James W. Grice

Keyword(s):

Empirical Analysis ◽

Individual Level ◽

The Individual

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Metonymy in Dance: Ballet Bunheads Take a Cognitive Turn

Dance Research ◽

10.3366/drs.2019.0251 ◽

2019 ◽

Vol 37 (1) ◽

pp. 18-34

Author(s):

Edward C. Warburton

Keyword(s):

Identity Formation ◽

Cognitive Science ◽

Artistic Development ◽

Individual Level ◽

Figures Of Speech ◽

Self Image ◽

Level I ◽

Dance Educators ◽

The Individual ◽

Metaphor And Metonymy

This essay considers metonymy in dance from the perspective of cognitive science. My goal is to unpack the roles of metaphor and metonymy in dance thought and action: how do they arise, how are they understood, how are they to be explained, and in what ways do they determine a person's doing of dance? The premise of this essay is that language matters at the cultural level and can be determinative at the individual level. I contend that some figures of speech, especially metonymic labels like ‘bunhead’, can not only discourage but dehumanize young dancers, treating them not as subjects who dance but as objects to be danced. The use of metonymy to sort young dancers may undermine the development of healthy self-image, impede strong identity formation, and retard creative-artistic development. The paper concludes with a discussion of the influence of metonymy in dance and implications for dance educators.

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