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Original Poster3 points · 2 hours ago

Journal reference:

Real‐time strategy video game experience and structural connectivity – A diffusion tensor imaging study

Natalia Kowalczyk Feng Shi Mikolaj Magnuski Maciek Skorko et al

Human Brain Mapping 2018

DOI: https://doi.org/10.1002/hbm.24208

Link: https://onlinelibrary.wiley.com/doi/abs/10.1002/hbm.24208

Abstract

Experienced video game players exhibit superior performance in visuospatial cognition when compared to non‐players. However, very little is known about the relation between video game experience and structural brain plasticity. To address this issue, a direct comparison of the white matter brain structure in RTS (real time strategy) video game players (VGPs) and non‐players (NVGPs) was performed. We hypothesized that RTS experience can enhance connectivity within and between occipital and parietal regions, as these regions are likely to be involved in the spatial and visual abilities that are trained while playing RTS games. The possible influence of long‐term RTS game play experience on brain structural connections was investigated using diffusion tensor imaging (DTI) and a region of interest (ROI) approach in order to describe the experience‐related plasticity of white matter. Our results revealed significantly more total white matter connections between occipital and parietal areas and within occipital areas in RTS players compared to NVGPs. Additionally, the RTS group had an altered topological organization of their structural network, expressed in local efficiency within the occipito‐parietal subnetwork. Furthermore, the positive association between network metrics and time spent playing RTS games suggests a close relationship between extensive, long‐term RTS game play and neuroplastic changes. These results indicate that long‐term and extensive RTS game experience induces alterations along axons that link structures of the occipito‐parietal loop involved in spatial and visual processing.

Original Poster8 points · 12 hours ago

The title of the post is a copy and paste from the first paragraph of the linked academic press release here :

On average, patients get about 11 seconds to explain the reasons for their visit before they are interrupted by their doctors. Also, only one in three doctors provides their patients with adequate opportunity to describe their situation. The pressure to rush consultations affects specialists more than primary care doctors says Naykky Singh Ospina of the University of Florida, Gainesville and the Mayo Clinic in the US.

Journal Reference:

Naykky Singh Ospina, Kari A. Phillips, Rene Rodriguez-Gutierrez, Ana Castaneda-Guarderas, Michael R. Gionfriddo, Megan E. Branda, Victor M. Montori.

Eliciting the Patient’s Agenda- Secondary Analysis of Recorded Clinical Encounters.

Journal of General Internal Medicine, 2018;

DOI: 10.1007/s11606-018-4540-5

Link: https://link.springer.com/article/10.1007%2Fs11606-018-4540-5

Abstract

Background

Eliciting patient concerns and listening carefully to them contributes to patient-centered care. Yet, clinicians often fail to elicit the patient’s agenda and, when they do, they interrupt the patient’s discourse.

Objective

We aimed to describe the extent to which patients’ concerns are elicited across different clinical settings and how shared decision-making tools impact agenda elicitation.

Design and Participants

We performed a secondary analysis of a random sample of 112 clinical encounters recorded during trials testing the efficacy of shared decision-making tools.

Main Measures

Two reviewers, working independently, characterized the elicitation of the patient agenda and the time to interruption or to complete statement; we analyzed the distribution of agenda elicitation according to setting and use of shared decision-making tools.

Key Results

Clinicians elicited the patient’s agenda in 40 of 112 (36%) encounters. Agendas were elicited more often in primary care (30/61 encounters, 49%) than in specialty care (10/51 encounters, 20%); p = .058. Shared decision-making tools did not affect the likelihood of eliciting the patient’s agenda (34 vs. 37% in encounters with and without these tools; p = .09). In 27 of the 40 (67%) encounters in which clinicians elicited patient concerns, the clinician interrupted the patient after a median of 11 seconds (interquartile range 7–22; range 3 to 234 s). Uninterrupted patients took a median of 6 s (interquartile range 3–19; range 2 to 108 s) to state their concern.

Conclusions

Clinicians seldom elicit the patient’s agenda; when they do, they interrupt patients sooner than previously reported. Physicians in specialty care elicited the patient’s agenda less often compared to physicians in primary care. Failure to elicit the patient’s agenda reduces the chance that clinicians will orient the priorities of a clinical encounter toward specific aspects that matter to each patient.

Original Poster6 points · 12 hours ago

The title of the post is a copy and paste from the first paragraph of the linked academic press release here :

On average, patients get about 11 seconds to explain the reasons for their visit before they are interrupted by their doctors. Also, only one in three doctors provides their patients with adequate opportunity to describe their situation. The pressure to rush consultations affects specialists more than primary care doctors says Naykky Singh Ospina of the University of Florida, Gainesville and the Mayo Clinic in the US.

Journal Reference:

Naykky Singh Ospina, Kari A. Phillips, Rene Rodriguez-Gutierrez, Ana Castaneda-Guarderas, Michael R. Gionfriddo, Megan E. Branda, Victor M. Montori.

Eliciting the Patient’s Agenda- Secondary Analysis of Recorded Clinical Encounters.

Journal of General Internal Medicine, 2018;

DOI: 10.1007/s11606-018-4540-5

Link: https://link.springer.com/article/10.1007%2Fs11606-018-4540-5

Abstract

Background

Eliciting patient concerns and listening carefully to them contributes to patient-centered care. Yet, clinicians often fail to elicit the patient’s agenda and, when they do, they interrupt the patient’s discourse.

Objective

We aimed to describe the extent to which patients’ concerns are elicited across different clinical settings and how shared decision-making tools impact agenda elicitation.

Design and Participants

We performed a secondary analysis of a random sample of 112 clinical encounters recorded during trials testing the efficacy of shared decision-making tools.

Main Measures

Two reviewers, working independently, characterized the elicitation of the patient agenda and the time to interruption or to complete statement; we analyzed the distribution of agenda elicitation according to setting and use of shared decision-making tools.

Key Results

Clinicians elicited the patient’s agenda in 40 of 112 (36%) encounters. Agendas were elicited more often in primary care (30/61 encounters, 49%) than in specialty care (10/51 encounters, 20%); p = .058. Shared decision-making tools did not affect the likelihood of eliciting the patient’s agenda (34 vs. 37% in encounters with and without these tools; p = .09). In 27 of the 40 (67%) encounters in which clinicians elicited patient concerns, the clinician interrupted the patient after a median of 11 seconds (interquartile range 7–22; range 3 to 234 s). Uninterrupted patients took a median of 6 s (interquartile range 3–19; range 2 to 108 s) to state their concern.

Conclusions

Clinicians seldom elicit the patient’s agenda; when they do, they interrupt patients sooner than previously reported. Physicians in specialty care elicited the patient’s agenda less often compared to physicians in primary care. Failure to elicit the patient’s agenda reduces the chance that clinicians will orient the priorities of a clinical encounter toward specific aspects that matter to each patient.

Original Poster37 points · 12 hours ago

The title of the post is a copy and paste from the title and first paragraph of the linked academic press release here :

Study: Beef jerky and other processed meats associated with manic episodes

An analysis of more than 1,000 people with and without psychiatric disorders has shown that nitrates–chemicals used to cure meats such as beef jerky, salami, hot dogs and other processed meat snacks–may contribute to mania, an abnormal mood state. Mania is characterized by hyperactivity, euphoria and insomnia.

Journal Reference:

Nitrated meat products are associated with mania in humans and altered behavior and brain gene expression in rats

Seva G. Khambadkone, Zachary A. Cordner, Faith Dickerson, Emily G. Severance, Emese Prandovszky, Mikhail Pletnikov, Jianchun Xiao, Ye Li, Gretha J. Boersma, C. Conover Talbot Jr., Wayne W. Campbell, Christian S. Wright, C. Evan Siple, Timothy H. Moran, Kellie L. Tamashiro & Robert H. Yolken

Molecular Psychiatry (2018)

DOI: https://doi.org/10.1038/s41380-018-0105-6

Link: https://www.nature.com/articles/s41380-018-0105-6

Abstract

Mania is a serious neuropsychiatric condition associated with significant morbidity and mortality. Previous studies have suggested that environmental exposures can contribute to mania pathogenesis. We measured dietary exposures in a cohort of individuals with mania and other psychiatric disorders as well as in control individuals without a psychiatric disorder. We found that a history of eating nitrated dry cured meat but not other meat or fish products was strongly and independently associated with current mania (adjusted odds ratio 3.49, 95% confidence interval (CI) 2.24–5.45, p < 8.97 × 10−8). Lower odds of association were found between eating nitrated dry cured meat and other psychiatric disorders. We further found that the feeding of meat preparations with added nitrate to rats resulted in hyperactivity reminiscent of human mania, alterations in brain pathways that have been implicated in human bipolar disorder, and changes in intestinal microbiota. These findings may lead to new methods for preventing mania and for developing novel therapeutic interventions.

Original Poster1 point · 12 hours ago

The title of the post is a copy and paste from the title and first paragraph of the linked academic press release here :

Study: Beef jerky and other processed meats associated with manic episodes

An analysis of more than 1,000 people with and without psychiatric disorders has shown that nitrates–chemicals used to cure meats such as beef jerky, salami, hot dogs and other processed meat snacks–may contribute to mania, an abnormal mood state. Mania is characterized by hyperactivity, euphoria and insomnia.

Journal Reference:

Nitrated meat products are associated with mania in humans and altered behavior and brain gene expression in rats

Seva G. Khambadkone, Zachary A. Cordner, Faith Dickerson, Emily G. Severance, Emese Prandovszky, Mikhail Pletnikov, Jianchun Xiao, Ye Li, Gretha J. Boersma, C. Conover Talbot Jr., Wayne W. Campbell, Christian S. Wright, C. Evan Siple, Timothy H. Moran, Kellie L. Tamashiro & Robert H. Yolken

Molecular Psychiatry (2018)

DOI: https://doi.org/10.1038/s41380-018-0105-6

Link: https://www.nature.com/articles/s41380-018-0105-6

Abstract

Mania is a serious neuropsychiatric condition associated with significant morbidity and mortality. Previous studies have suggested that environmental exposures can contribute to mania pathogenesis. We measured dietary exposures in a cohort of individuals with mania and other psychiatric disorders as well as in control individuals without a psychiatric disorder. We found that a history of eating nitrated dry cured meat but not other meat or fish products was strongly and independently associated with current mania (adjusted odds ratio 3.49, 95% confidence interval (CI) 2.24–5.45, p < 8.97 × 10−8). Lower odds of association were found between eating nitrated dry cured meat and other psychiatric disorders. We further found that the feeding of meat preparations with added nitrate to rats resulted in hyperactivity reminiscent of human mania, alterations in brain pathways that have been implicated in human bipolar disorder, and changes in intestinal microbiota. These findings may lead to new methods for preventing mania and for developing novel therapeutic interventions.

Original Poster85 points · 13 hours ago

The title of the post is a copy and paste from the title and first paragraph of the linked popular press article here :

Scientists find drug that restores mice's ability to walk

Researchers at Boston Children's Hospital showed that a small-molecule compound could revive neural circuits in paralyzed mice, restoring their ability to walk, according to a study published on Thursday in the journal Cell.

Journal Reference:

Bo Chen, Yi Li, Bin Yu, Zicong Zhang, Benedikt Brommer, Philip Raymond Williams, Yuanyuan Liu, Shane Vincent Hegarty, Songlin Zhou, Junjie Zhu, Hong Guo, Yi Lu, Yiming Zhang, Xiaosong Gu, Zhigang He.

Reactivation of Dormant Relay Pathways in Injured Spinal Cord by KCC2 Manipulations.

Cell, 2018;

DOI: 10.1016/j.cell.2018.06.005

Link: https://www.cell.com/cell/fulltext/S0092-8674(18)30730-X

Highlights

•A KCC2 agonist restores stepping ability in paralyzed mice with spinal cord injuries •KCC2 expression in inhibitory neurons leads to functional recovery •Restoration of inhibition in injured spinal cord leads to functional recovery

Summary

Many human spinal cord injuries are anatomically incomplete but exhibit complete paralysis. It is unknown why spared axons fail to mediate functional recovery in these cases. To investigate this, we undertook a small-molecule screen in mice with staggered bilateral hemisections in which the lumbar spinal cord is deprived of all direct brain-derived innervation, but dormant relay circuits remain. We discovered that a KCC2 agonist restored stepping ability, which could be mimicked by selective expression of KCC2, or hyperpolarizing DREADDs, in the inhibitory interneurons between and around the staggered spinal lesions. Mechanistically, these treatments transformed this injury-induced dysfunctional spinal circuit to a functional state, facilitating the relay of brain-derived commands toward the lumbar spinal cord. Thus, our results identify spinal inhibitory interneurons as a roadblock limiting the integration of descending inputs into relay circuits after injury and suggest KCC2 agonists as promising treatments for promoting functional recovery after spinal cord injury.

Original Poster2 points · 13 hours ago

The title of the post is a copy and paste from the title and first paragraph of the linked academic press release here :

Study finds therapy dogs effective in reducing symptoms of ADHD

In a first of its kind randomized trial, researchers from the UCI School of Medicine found therapy dogs to be effective in reducing the symptoms of attention deficit/hyperactivity disorder (ADHD) in children.

Journal Reference:

A Randomized Controlled Trial of Traditional Psychosocial and Canine-Assisted Interventions for Children with ADHD

Sabrina E.B. Schuck, Natasha A. Emmerson, Maryam M. Abdullah, Aubrey H. Fine, Annamarie Stehli, & Kimberley D. Lakes

Human-Animal Interaction Bulletin (HAIB), Vol 6, No 1, 2018

Link: https://www.apa-hai.org/human-animal-interaction/haib/a-randomized-controlled-trial-of-traditional-psychosocial-and-canine-assisted-interventions-for-children-with-adhd/

Abstract

This study provides findings on the final main outcomes from a randomized controlled trial of psychosocial intervention with and without canine assisted intervention (CAI) for children with Attention-Deficit/Hyperactivity Disorder (ADHD). Eighty-eight children, ages 7-9 with ADHD, combined subtype were randomly assigned to 12-week intervention groups (CAI or Non-CAI). Outcome measures were collected across multiple domains and time points. Main effects of group were revealed for total ADHD symptoms (p <.05), inattention (p =.01) and social skills (p =.04), indicating that the CAI group fared better than the non-CAI group. A significant interaction of group by time on ratings of problem behaviors (p =.02) and social initiation (p =.03), indicated the CAI group demonstrated a modest benefit over the non-CAI group in these domains. This manuscript describes the results and discusses the benefits and limitations of this intervention for children with ADHD.

Original Poster317 points · 13 hours ago

The title of the post is a copy and paste from the title and sixth paragraph of the linked academic press release here :

Three-week diary study: sex today increases sense of meaning in life tomorrow

They found that having sex on one day was associated with more positive mood states the following day, and also a greater feeling that life is meaningful (the converse wasn’t true – positive moods or more meaning in life one day was not associated with more sex the next).

Journal Reference:

Kashdan, T. B., Goodman, F. R., Stiksma, M., Milius, C. R., & McKnight, P. E. (2018).

Sexuality leads to boosts in mood and meaning in life with no evidence for the reverse direction: A daily diary investigation.

Emotion, 18(4), 563-576.

DOI: http://dx.doi.org/10.1037/emo0000324

Link: http://psycnet.apa.org/record/2017-25711-001

Abstract

Sex is rarely discussed in theories of well-being and rarely empirically examined using methods other than cross-sectional surveys. In the present study, a daily diary approach was used (for 21 days with 152 adults) to explore the relationship between the presence and quality of sexual episodes and well-being (positive affect, negative affect, meaning in life). Time-lagged analyses demonstrated that sexual activity on 1 day was related to greater well-being the next. As for the quality of episodes, higher reported sexual pleasure and intimacy predicted greater positive affect and lower negative affect the following day. When the reverse direction was tested, well-being did not predict next-day sexual activity, pleasure, or intimacy. These results suggest a unidirectional relationship in which the presence and quality of sexual activity lead to gains in well-being the following day. Contextual moderators (gender, relationship status, relationship closeness, and relationship length) allowed for tests of conditions altering the link between sexuality and well-being. Relationship closeness was the most robust moderator in predicting greater levels of meaning in life and positive affect following sexual episodes. These data provide evidence to support the continual consideration of sex in empirical work and theoretical models of elements that comprise healthy relationships and a good life.

As an MD yourself, may I ask what your thoughts are on ketamine in practice?

Do you feel there is a stigma to prescribing it and what is the barriers to medicating with it for anxiety, depression and pain medicine facing society today?

It's been in research at the NIH for more 10+ years (2008 is the the time I recall the initial NIH study I seen for depression), it's an older medication with a relatively good safety record. Yet it is very stigmatizing to discuss it despite well knowledge.

see more
Original Poster1 point · 20 hours ago

Thanks for the question. There’s a stigma but it’s definitely shifting as alternatives to opioids are explored. There are now clinical trials with ketamine and esketamine with promising results. Doctors are definitely interested but cautious as it’s still considered off-label for many conditions.

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