Are Autistic and Alexithymic Traits Distinct? A Factor-Analytic and Network Approach

Despite the heterogeneity in autism, socioemotional difficulties are often framed as universal. Increasing evidence, however, suggests that socioemotional difficulties may be explained by alexithymia, a distinct yet frequently co-occurring condition. If, as some propose, autistic traits are responsible for socioemotional impairments, then alexithymia may itself be a symptom of autism. We aimed to determine whether alexithymia should be considered a product of autism or regarded as a separate condition. Using factor-analytic and network approaches, we provide evidence that alexithymic and autistic traits are distinct. We argue that: (1) models of socioemotional processing in autism should conceptualise difficulties as intrinsic to alexithymia; and (2) assessment of alexithymia is crucial for diagnosis and personalised interventions.

Are Autistic and Alexithymic Traits Distinct? A Factor-Analytic and Network Approach

Despite the heterogeneity in autism, socioemotional difficulties are often framed as universal. Increasing evidence, however, suggests socioemotional difficulties may be explained by alexithymia, a distinct yet frequently co-occurring condition. If, as some propose, autistic traits are responsible for socioemotional impairments, then alexithymia may itself be a symptom of autism. We aimed to determine whether alexithymia should be considered a product of autism or regarded as a separate condition. Using factor-analytic and network approaches, we provide evidence that alexithymic and autistic traits are distinct. We argue that: 1) models of socioemotional processing in autism should conceptualise difficulties as intrinsic to alexithymia; and 2) assessment of alexithymia is crucial for diagnosis and personalised interventions.

Demak Kingdom: Study of Environmental Condition and Geographical

Many experts have written about the history of the Demak kingdom, therefore the role of this kingdom in politics, economics and especially in the spread of Islam in Indonesia in the past. With the geophysiographical, historical and archaeological approach used in this study, it can be revealed about the environmental conditions and the location of the palace and the royal city of Demak. The research methods used in this research are observation, geophysiographical (drilling, geoelectrical measurement), historical (reading of documents) and archaeological (test pit excavations) methods, to obtain credible conclusions. The result is that the kingdom, which has a fairly large influence in the archipelago, is located on the island of Demak between Java and the Muria peninsula, which is still in a separate condition, which is surrounded by swamps, rivers and the sea. the tombs of kings, the names of places/villages (toponyms), have proven that the existence of the central city of the kingdom is concentrically arranged and the settlement patterns are grouped according to position, profession, ethnicity and religion.

A Bayesian approach to analysing cortico-cortical associative stimulation induced increases in the excitability of corticospinal projections in humans

Repeated pairing of transcranial magnetic stimulation (TMS) over left and right primary motor cortex (M1), at intensities sufficient to generate descending volleys, produces sustained increases in corticospinal excitability. In other paired associative stimulation (PAS) protocols, in which peripheral afferent stimulation is the first element, changes in corticospinal excitability achieved when the second stimulus consists of brief bursts of transcranial alternating current stimulation (tACS), are comparable to those obtained if TMS is used instead (McNickle and Carson 2015). The present aim was to determine whether associative effects are induced when the first stimulus of a cortico-cortical pair is tACS, or alternatively subthreshold TMS. Bursts of tACS (500 ms; 140 Hz; 1 mA) were associated (180 stimulus pairs) with single magnetic stimuli (120% resting motor threshold rMT) delivered over the opposite (left) M1. The tACS ended 6 ms prior to the TMS. In a separate condition, TMS (55% rMT) was delivered to right M1 6 ms before (120% rMT) TMS was applied over left M1. In a sham condition, TMS (120% rMT) was delivered to left M1 only. The limitations of null hypothesis significance testing are well documented. We therefore employed Bayes factors to assess evidence in support of experimental hypotheses—defined precisely in terms of predicted effect sizes, that these two novel variants of PAS increase corticospinal excitability. Although both interventions induced sustained (~ 20–30 min) increases in corticospinal excitability, the evidence in support of the experimental hypotheses (over specified alternatives) was generally greater for the paired TMS-TMS than the tACS-TMS conditions.

Can the Lateralized Readiness Potential Detect Suppressed Manual Responses to Pure Tones?

Willfully not responding to auditory stimuli hampers accurate behavioral measurements. An objective measure of covert manual suppression recorded during response tasks may be useful to assess the veracity of responses to stimuli.To investigate whether the lateralized readiness potential (LRP), an electrophysiological measure of corticomotor response and suppression, may be of use in determining when participants hear but do not respond to pure tones.Within-subject repeated measures with a Go–NoGo paradigm.Five males and five females (mean age = 38.8 years, standard deviation = 8.8) underwent electrophysiology testing. All had normal hearing, except one.Participants were tested in a condition where they consistently responded to tonal stimuli, and in a condition where intensity cued whether they should respond or not. Scalp-recorded cortical potentials and behavioral responses were recorded, along with a question that probed the perceived effort required to suppress responses to the stimuli.Electrophysiology data were processed with independent component analysis and epoch-based artifact rejection. Averaged group and individual LRPs were calculated.Group averaged waveforms show that suppressed responses, cued by NoGo stimuli, diverge positively at approximately 300 msec poststimulus, when compared with performed (Go) responses. LRPs were comparable when Go responses were recorded in a separate condition in which participants responded to all stimuli, and when Go and NoGo trials were included in the same condition. The LRP was not observed in one participant.Subsequent to further investigation, the LRP may prove suitable in assessing the suppression of responses to audiometric stimuli, and, thereby, useful in cases where functional hearing loss is suspected.

Spinal cord injury

The term spinal cord injury (SCI) is often taken to denote damage to the spinal cord following trauma, with non-traumatic SCI treated as a separate condition in some services. The prognosis for SCI varies depending on aetiology. Often, survival for those with non-traumatic SCI is determined by the underlying diagnosis. Individuals with SCI have great capacity to maintain a good quality of life. Helping to make this a reality is one of the multiple challenges that SCI poses to the multidisciplinary team. Following inpatient rehabilitation, the key to independence and participation in previous life roles is access to good-quality information. Individuals should be kept informed of developments at all times and put in touch with the necessary range of professionals, not only with regard to their health, but also in social services, employment, and other spheres.

Boosted visual performance after eye blinks

We blink more often than required for maintaining the corneal tear film. It is unclear whether there are perceptual or cognitive consequences of blinks that may justify their high frequency. Recent findings showed that blinks occur at consistent time points and may indicate switches between large scale cortical networks, such as dorsal attention and default-mode networks. Thus, blinks may trigger a refresh of visual attention, although this has so far not been confirmed behaviourally. Here, we tested the effect of blinks on visual performance in a rapid serial visual presentation task. In Experiment 1, participants had to identify a target digit embedded in a random stream of letter distractors, presented foveally for 60 ms each. Participants blinked once during the presentation stream. In a separate condition, blinks were simulated by shutter glasses. We found enhancements of performance (up to 15% point increase in accuracy) for targets appearing up to 300 ms after blinks. This finding was replicated for object recognition with naturalistic stimuli (Experiment 2) and for spatially distributed stimuli (Experiment 4), but not in a numerosity task (Experiment 3). We also observed a later, suatained performance boost after blinks in five experiments. While the early performance boost may be partially based on retinal transients induced by blinks, the later boost signifies an attentional reset triggered by eye blinks. We conclude that eye blinks lead to attentional benefits in the period after reopening of the eyelids and may be used strategically for temporarily boosting visual performance.

The use of computer-interpretable clinical guidelines to manage care complexities of patients with multimorbid conditions: A review

Clinical practice guidelines (CPGs) document evidence-based information and recommendations on treatment and management of conditions. CPGs usually focus on management of a single condition; however, in many cases a patient will be at the centre of multiple health conditions (multimorbidity). Multiple CPGs need to be followed in parallel, each managing a separate condition, which often results in instructions that may interact with each other, such as conflicts in medication. Furthermore, the impetus to deliver customised care based on patient-specific information, results in the need to be able to offer guidelines in an integrated manner, identifying and managing their interactions. In recent years, CPGs have been formatted as computer-interpretable guidelines (CIGs). This enables developing CIG-driven clinical decision support systems (CDSSs), which allow the development of IT applications that contribute to the systematic and reliable management of multiple guidelines. This study focuses on understanding the use of CIG-based CDSSs, in order to manage care complexities of patients with multimorbidity. The literature between 2011 and 2017 is reviewed, which covers: (a) the challenges and barriers in the care of multimorbid patients, (b) the role of CIGs in CDSS augmented delivery of care, and (c) the approaches to alleviating care complexities of multimorbid patients. Generating integrated care plans, detecting and resolving adverse interactions between treatments and medications, dealing with temporal constraints in care steps, supporting patient-caregiver shared decision making and maintaining the continuity of care are some of the approaches that are enabled using a CIG-based CDSS.

An autosomal recessive DNASE1L3-related autoimmune disease with unusual clinical presentation mimicking systemic lupus erythematosus

We describe the third family in the world, after Arabian and Turkish ones, displaying an autosomal recessive autoimmune disease (AID), mimicking systemic lupus erythematosus (SLE), with unusual manifestations due to a homozygous frame-shift variant in DNASE1L3. SLE is a complex AID characterized by multiple organ involvement. Genetic risk variants identified account for only 15% of SLE heritability. Rare Mendelian forms have been reported, including DNASE1L3-related SLE. Through specific genetic tests we identified a homozygous 2 bp-deletion c.289_290delAC (NM_004944.2) in DNASE1L3, predicting frameshift and premature truncation (p.Thr97Ilefs*2). The same mutation was previously reported in three sisters, born from consanguineous parents and affected with hypocomplementemic urticarial vasculitis syndrome (HUVS). As approximately 50% of individuals affected with HUVS develop SLE, it is still unclear whether it is a SLE sub-phenotype or a separate condition.