The Relationship between Bipolar Disorder and Cannabis Use in Daily Life: An Experience Sampling Study

ObjectivesAlthough cannabis use is common in bipolar disorder and may contribute to worse clinical outcomes, little is understood about the relationship between this drug and bipolar disorder over the course of daily life. The aim of study was to examine the effect of cannabis on affect and bipolar symptoms in a group of individuals with bipolar disorder.MethodsTwenty-four participants with bipolar disorder type I or type II completed diaries for 6 days using Experience Sampling Methodology to investigate the temporal associations between cannabis, affect and bipolar disorder symptoms.ResultsThe results indicated that higher levels of positive affect increase the odds of using cannabis (OR:1.25 ,CI:1.06–1.47, P=0.008). However, neither negative affect, manic nor depressive symptoms predicted the use of cannabis. Cannabis use was associated with subsequent increases in positive affect (β=0.35, CI:0.20-0.51, P=0.000), manic symptoms (β=0.20,CI:0.05-0.34, P=0.009) and depressive symptoms (β= 0.17,CI:0.04-0.29, P=0.008).ConclusionThe findings indicate that cannabis use is associated with a number of subsequent psychological effects. However there was no evidence that individuals with BD were using cannabis to self-medicate minor fluctuations in negative affect or bipolar disorder symptoms over the course of daily life. The findings in relation to existing literature and clinical implications are discussed.     

Evidence That a Psychopathology Interactome Has Diagnostic Value,Predicting Clinical Needs: An Experience Sampling Study

Background

For the purpose of diagnosis, psychopathology can be represented as categories of mental disorder, symptom dimensions or symptom networks. Also, psychopathology can be assessed at different levels of temporal resolution (monthly episodes, daily fluctuating symptoms, momentary fluctuating mental states). We tested the diagnostic value, in terms of prediction of treatment needs, of the combination of symptom networks and momentary assessment level.

Method

Fifty-seven patients with a psychotic disorder participated in an ESM study, capturing psychotic experiences, emotions and circumstances at 10 semi-random moments in the flow of daily life over a period of 6 days. Symptoms were assessed by interview with the Positive and Negative Syndrome Scale (PANSS); treatment needs were assessed using the Camberwell Assessment of Need (CAN).

Results

Psychotic symptoms assessed with the PANSS (Clinical Psychotic Symptoms) were strongly associated with psychotic experiences assessed with ESM (Momentary Psychotic Experiences). However, the degree to which Momentary Psychotic Experiences manifested as Clinical Psychotic Symptoms was determined by level of momentary negative affect (higher levels increasing probability of Momentary Psychotic Experiences manifesting as Clinical Psychotic Symptoms), momentary positive affect (higher levels decreasing probability of Clinical Psychotic Symptoms), greater persistence of Momentary Psychotic Experiences (persistence predicting increased probability of Clinical Psychotic Symptoms) and momentary environmental stress associated with events and activities (higher levels increasing probability of Clinical Psychotic Symptoms). Similarly, the degree to which momentary visual or auditory hallucinations manifested as Clinical Psychotic Symptoms was strongly contingent on the level of accompanying momentary paranoid delusional ideation. Momentary Psychotic Experiences were associated with CAN unmet treatment needs, over and above PANSS measures of psychopathology, similarly moderated by momentary interactions with emotions and context.

Conclusion

The results suggest that psychopathology, represented as an interactome at the momentary level of temporal resolution, is informative in diagnosing clinical needs, over and above traditional symptom measures.     

Explaining Adherence Success in Sub-Saharan Africa: An Ethnographic Study

Background

Individuals living with HIV/AIDS in sub-Saharan Africa generally take more than 90% of prescribed doses of antiretroviral therapy (ART). This number exceeds the levels of adherence observed in North America and dispels early scale-up concerns that adherence would be inadequate in settings of extreme poverty. This paper offers an explanation and theoretical model of ART adherence success based on the results of an ethnographic study in three sub-Saharan African countries.

Methods and Findings

Determinants of ART adherence for HIV-infected persons in sub-Saharan Africa were examined with ethnographic research methods. 414 in-person interviews were carried out with 252 persons taking ART, their treatment partners, and health care professionals at HIV treatment sites in Jos, Nigeria; Dar es Salaam, Tanzania; and Mbarara, Uganda. 136 field observations of clinic activities were also conducted. Data were examined using category construction and interpretive approaches to analysis. Findings indicate that individuals taking ART routinely overcome economic obstacles to ART adherence through a number of deliberate strategies aimed at prioritizing adherence: borrowing and “begging” transport funds, making “impossible choices” to allocate resources in favor of treatment, and “doing without.” Prioritization of adherence is accomplished through resources and help made available by treatment partners, other family members and friends, and health care providers. Helpers expect adherence and make their expectations known, creating a responsibility on the part of patients to adhere. Patients adhere to promote good will on the part of helpers, thereby ensuring help will be available when future needs arise.

Conclusion

Adherence success in sub-Saharan Africa can be explained as a means of fulfilling social responsibilities and thus preserving social capital in essential relationships.     

The Influence of Emotion on Keyboard Typing: An Experimental Study Using Auditory Stimuli

In recent years, a novel approach for emotion recognition has been reported, which is by keystroke dynamics. The advantages of using this approach are that the data used is rather non-intrusive and easy to obtain. However, there were only limited investigations about the phenomenon itself in previous studies. Hence, this study aimed to examine the source of variance in keyboard typing patterns caused by emotions. A controlled experiment to collect subjects’ keystroke data in different emotional states induced by International Affective Digitized Sounds (IADS) was conducted. Two-way Valence (3) x Arousal (3) ANOVAs was used to examine the collected dataset. The results of the experiment indicate that the effect of arousal is significant in keystroke duration (p < .05), keystroke latency (p < .01), but not in the accuracy rate of keyboard typing. The size of the emotional effect is small, compared to the individual variability. Our findings support the conclusion that the keystroke duration and latency are influenced by arousal. The finding about the size of the effect suggests that the accuracy rate of emotion recognition technology could be further improved if personalized models are utilized. Notably, the experiment was conducted using standard instruments and hence is expected to be highly reproducible.     

The Influence of Mark-Recapture Sampling Effort on Estimates of Rock Lobster Survival

Five annual capture-mark-recapture surveys on Jasus edwardsii were used to evaluate the effect of sample size and fishing effort on the precision of estimated survival probability. Datasets of different numbers of individual lobsters (ranging from 200 to 1,000 lobsters) were created by random subsampling from each annual survey. This process of random subsampling was also used to create 12 datasets of different levels of effort based on three levels of the number of traps (15, 30 and 50 traps per day) and four levels of the number of sampling-days (2, 4, 6 and 7 days). The most parsimonious Cormack-Jolly-Seber (CJS) model for estimating survival probability shifted from a constant model towards sex-dependent models with increasing sample size and effort. A sample of 500 lobsters or 50 traps used on four consecutive sampling-days was required for obtaining precise survival estimations for males and females, separately. Reduced sampling effort of 30 traps over four sampling days was sufficient if a survival estimate for both sexes combined was sufficient for management of the fishery.     

Sampling Techniques Influence Understory Plant Trajectories After Restoration: An Example from Ponderosa Pine Restoration

Abstract Although there is no one correct technique for sampling vegetation, the sampling design chosen may greatly influence the conclusions researchers can draw from restoration treatments. Considerations when designing vegetation sampling protocol include determining what sampling attributes to measure, the size and shape of the sampling plot, the number of replicates and their location within the study area, and the frequency of sampling. We installed 20 point‐intercept transects (50‐m long), 8 belt transects (10 × 50 m), 10 adapted Daubenmire transects (four 0.5 × 2‐m plots), and 4 modified‐Whittaker plots (20 × 50 m with smaller nested plots) in treatment and control units to measure understory herbaceous response in a forest restoration experiment that tested different treatments. Point‐intercept transects on average recorded at least twice as much plant cover as did adapted Daubenmire transects and modified‐Whittaker plots taken at the same location for all control and treatment units. Point‐intercept transects and adapted Daubenmire plots on average captured fewer rare and exotic species in the control and treatment units in comparison with the belt transects and modified‐Whittaker plots. Modified‐Whittaker plots captured the highest species richness in all units. Early successional understory response to restoration treatments was likely masked by the response of the herbaceous community to yearly climatic variation (dry vs. wet years). Species richness and abundance were higher in wet years than dry years for all control and treatment units. Our results illustrate that sampling techniques can greatly influence perceptions of understory plant trajectories and therefore the interpretation of whether restoration goals have been achieved. In addition, our results suggest that restoration monitoring needs to be conducted for a sufficient length of time so that restoration treatment responses can be detected.     

The Effects of Chronic Cigarette Smoking on Gray Matter Volume: Influence of Sex

Cigarette smoke contains nicotine and toxic chemicals and may cause significant neurochemical and anatomical brain changes. Voxel-based morphometry studies have examined the effects of smoking on the brain by comparing gray matter volume (GMV) in nicotine dependent individuals (NDs) to nonsmoking individuals with inconsistent results. Although sex differences in neural and behavioral features of nicotine dependence are reported, sex differences in regional GMV remain unknown. The current study examined sex differences in GMV in a large sample of 80 NDs (41 males) and 80 healthy controls (41 males) using voxel-based morphometry. Within NDs, we explored whether GMV was correlated with measures of cigarette use and nicotine dependence. High-resolution T1 structural scans were obtained from all participants. Segmentation and registration were performed in SPM8 using the optimized DARTEL approach. Covariates included age and an estimate of total global GMV. Differences were considered significant at p≤0.001, with a whole brain FWE-corrected cluster probability of p<0.025. Among NDs compared to Controls less GMV was observed in the thalamus and bilateral cerebellum and greater GMV was observed in the bilateral putamen and right parahippocampus. Lower thalamic GMV was observed in both female and male NDs compared to Controls. Female NDs also had lower GMV in the left cerebellum and in the ventral medial and orbitofrontal cortices with no areas of greater GMV. Male NDs had lower GMV in bilateral cerebellum and greater GMV in bilateral parahippocampus and left putamen. Within male NDs, GMV in the left putamen was correlated with number of pack years. This study, conducted in a large cohort, contributes to our knowledge of brain morphology in nicotine addiction and provides additional evidence of sex-specific effects on GMV in NDs. Identifying brain vulnerabilities with respect to sex provides a methodological framework for personalized therapies to improve relapse rates for both sexes.     

Multiple Interacting Factors Influence Adherence,and Outcomes Associated with Surgical Safety Checklists: A Qualitative Study

Objectives

The surgical safety checklist (SSC) is meant to enhance patient safety but studies of its impact conflict. This study explored factors that influenced SSC adherence to suggest how its impact could be optimized.

Methods

Participants were recruited purposively by profession, region, hospital type and time using the SSC. They were asked to describe how the SSC was adopted, associated challenges, perceived impact, and suggestions for improving its use. Grounded theory and thematic analysis were used to collect and analyse data. Findings were interpreted using an implementation fidelity conceptual framework.

Results

Fifty-one participants were interviewed (29 nurses, 13 surgeons, 9 anaesthetists; 18 small, 14 large and 19 teaching hospitals; 8 regions; 31 had used the SC for ≤12 months, 20 for 13+ months). The SSC was inconsistently reviewed, and often inaccurately documented as complete. Adherence was influenced by multiple issues. Extensive modification to accommodate existing practice patterns eliminated essential interaction at key time points to discuss patient management. Staff were often absent or not paying attention. They did not feel it was relevant to their work given limited evidence of its effectiveness, and because they were not engaged in its implementation. Organizations provided little support for implementation, training, monitoring and feedback, which are needed to overcome these, and other individual and team factors that challenged SSC adherence. Responses were similar across participants with different characteristics.

Conclusions

Multiple processes and factors influenced SSC adherence. This may explain why, in studies evaluating SSC impact, outcomes were variable. Recommendations included continuing education, time for pilot-testing, and engaging all staff in SSC review. Others may use the implementation fidelity framework to plan SSC implementation or evaluate SSC adherence. Further research is needed to establish which SSC components can be modified without compromising its effectiveness.     

The Influence of Prior Learning Experience on Pollinator Choice: An Experiment Using Bumblebees on Two Wild Floral Types of Antirrhinum majus

Understanding how pollinator behavior may influence pollen transmission across floral types is a major challenge, as pollinator decision depends on a complex range of environmental cues and prior experience. Here we report an experiment using the plant Antirrhinum majus and the bumblebee Bombus terrestris to investigate how prior learning experience may affect pollinator preferences between floral types when these are presented together. We trained naive bumblebees to forage freely on flowering individuals of either A. majus pseudomajus (magenta flowers) or A. majus striatum (yellow flowers) in a flight cage. We then used a Y-maze device to expose trained bumblebees to a dual choice between the floral types. We tested the influence of training on their choice, depending on the type of plant signals available (visual signals, olfactory signals, or both). Bumblebees had no innate preference for either subspecies. Bumblebees trained on the yellow-flowered subspecies later preferred the yellow type, even when only visual or only olfactory signals were available, and their preference was not reinforced when both signal types were available. In contrast, bumblebees trained on the magenta-flowered subspecies showed no further preference between floral types and took slightly more time to make their choice. Since pollinator constancy has been observed in wild populations of A. majus with mixed floral types, we suggest that such constancy likely relies on short-term memory rather than acquired preference through long-term memory induced by prior learning.     

The Effects of Acute Dopamine Precursor Depletion on the Cognitive Control Functions of Performance Monitoring and Conflict Processing: An Event-Related Potential (ERP) Study

Studies using medications and psychiatric populations implicate dopamine in cognitive control and performance monitoring processes. However, side effects associated with medication or studying psychiatric groups may confound the relationship between dopamine and cognitive control. To circumvent such possibilities, we utilized a randomized, double-blind, placebo-controlled, within-subjects design wherein participants were administered a nutritionally-balanced amino acid mixture (BAL) and an amino acid mixture deficient in the dopamine precursors tyrosine (TYR) and phenylalanine (PHE) on two separate occasions. Order of sessions was randomly assigned. Cognitive control and performance monitoring were assessed using response times (RT), error rates, the N450, an event-related potential (ERP) index of conflict monitoring, the conflict slow potential (conflict SP), an ERP index of conflict resolution, and the error-related negativity (ERN) and error positivity (Pe), ERPs associated with performance monitoring. Participants were twelve males who completed a Stroop color-word task while ERPs were collected four hours following acute PHE and TYR depletion (APTD) or balanced (BAL) mixture ingestion in two separate sessions. N450 and conflict SP ERP amplitudes significantly differentiated congruent from incongruent trials, but did not differ as a function of APTD or BAL mixture ingestion. Similarly, ERN and Pe amplitudes showed significant differences between error and correct trials that were not different between APTD and BAL conditions. Findings indicate that acute dopamine precursor depletion does not significantly alter cognitive control and performance monitoring ERPs. Current results do not preclude the role of dopamine in these processes, but suggest that multiple methods for dopamine-related hypothesis testing are needed.     

The Influence of Previous Experience and Starvation on Aphid Feeding Behavior

It was hypothesized that (1) previous experience of aphids on a host plant leads to differences in their feeding behavior relative to aphids without previous experience on it and that (2) a change in the physiological state of the aphid modifies their experience-induced behavior. Using electronic recording, the feeding behavior of the aphid Sitobion fragariae (Walker) on wheat Triticum aestivum L. and oat Avena sativa L. was examined, comparing aphids with or without previous experience on a given host and with or without a period of starvation before assessing probing behavior. All comparisons were performed within a single aphid clone to minimize the effect of genetic variation. Feeding behavior on wheat was significantly affected by previous experience and starvation. The effect of previous experience interacted with the host plant where feeding behavior was tested. Aphids feeding on wheat following previous experience on wheat showed a longer time and a higher number of pathway activities and less time in waveform F (i.e., mechanical stylet work and penetration difficulties) than did aphids feeding on wheat after a previous experience on oat. No differences in the time from the beginning of the recording until the first salivation into the sieve elements were found. When aphids were subjected to a period of starvation, the time devoted to xylem ingestion increased compared with that of nonconstrained aphids. These results are discussed in terms of factors affecting foraging decisions.     

The Influence of Chronic and Situational Social Status on Stereotype Susceptibility

We tested whether stereotypical situations would affect low-status group members'' performance more strongly than high-status group members''. Experiment 1 and 2 tested this hypothesis using gender as a proxy of chronic social status and a gender-neutral task that has been randomly presented to favor boys (men superiority condition), favor girls (women superiority condition), or show no gender preference (control condition). Both experiments found that women’s (Experiment 1) and girls’ performance (Experiment 2) suffered more from the evoked stereotypes than did men''s and boys’ ones. This result was replicated in Experiment 3, indicating that short men (low-status group) were more affected compared to tall men (high-status group). Additionally, men were more affected compared to women when they perceived height as a threat. Hence, individuals are more or less vulnerable to identity threats as a function of the chronic social status at play; enjoying a high status provides protection and endorsing a low one weakens individual performance in stereotypical situations.     

山羊体外受精胚性别鉴定不同取样方法的研究

为了不断完善山羊早期胚胎性别鉴定技术,实现奶山羊雌性胚胎的体外生产与商业化,本研究对胚胎性别鉴定的两种采样方法进行比较。结果表明,两种取样方法性别鉴定结果的准确性没有差异,桑椹胚经打孔法采样后胚胎妊娠率(36．84％)明显高于切割法(31．25％),囊胚经切割法采样后胚胎妊娠率(31．58％)明显高于打孔法(23．53％),综合比较,胚胎性别鉴定应以打孔法采集早期桑椹胚为宜。     

The Influence of the Family on Adolescent Sexual Experience: A Comparison between Baltimore and Johannesburg

The main objective of this paper is to understand the role of the family on the sexual experiences of adolescents from urban, disadvantaged settings in Baltimore and Johannesburg. Data were collected as part of the WAVE study, a global study of disadvantaged youth in five cities. Qualitative data were based on key informant interviews, a Photovoice exercise, community mapping, focus groups and in-depth interviews with adolescents. Quantitative data were gathered from an ACASI survey that was administered to approximately 450–500 adolescents per site. Results from the qualitative data revealed that while parents were viewed as important sources of information for sexual and reproductive health, they were often not present in the adolescents’ lives. This lack of parental presence was perceived to result in adolescents feeling an overall lack of adult support and guidance. The impact of parental presence and support on adolescent sexual experience was further examined from the quantitative data and revealed a complex picture. In both Baltimore and Johannesburg, female adolescents who were raised by other relatives were less likely to report having had sex compared to those raised by two biological parents, which was not observed for males. In Johannesburg, female adolescents who were paternal orphans were less likely to have had sex compared to non-orphans; the opposite was true among males. Finally, in both sites, female adolescents who had been exposed to violence were more likely to have had sex compared to those who had not; for males, there was no significant relationship. The study demonstrates the powerful influence of both context and gender for understanding the influences of the family on adolescent sexual behaviors. Programs aiming to reduce adolescent sexual risk behaviors the need to understand the complex influences on risk behaviors in different settings and in particular, the role of mothers and fathers. Prevention strategies need to also understand and incorporate gender-specific messages and interventions in order to address the high risk of sexual behaviors among adolescents in these settings.     

Overlapping Clusters of Tuberculosis Contacts: An Improved Sampling Strategy

A two stage without replacement strategy is proposed for estimating the population mean of overlapping clusters of contacts of tuberculosis cases. This sampling strategy is an improvement over the two sampling strategies proposed by SINGH (1988). A numerical illustration is provided by taking two populations of tuberculosis contacts from New York City; the percentage gain in efficiency varies from 3.70 to 24.99. The proposed improved sampling strategy may be useful to other contagious diseases in the different fields of biomedical sciences or similar situations in other fields.     

The Influence of Chronic Wound Extracts on Inflammatory Cytokine and Histatin Stability

Chronic ulcers represent a major health burden in our society. Despite many available therapies, a large number of ulcers do not heal. Protein based therapies fail in part due to proteolytic activity in the chronic wound bed. The aim of this in vitro study was to determine whether typical inflammatory cytokines and human salivary histatins remain stable when incubated with chronic wound extracts. Furthermore we determined whether a short exposure of histatins or cytokines was sufficient to exert long term effects on fibroblast migration. Stability of human recombinant cytokines IL-6 and CXCL8, and histatin variants (Hst1, Hst2, cyclic Hst1, minimal active domain of Hst1) in the presence of chronic wound extracts isolated from non-healing ulcers, was monitored by capillary zone electrophoresis. Migration-stimulating activity was assessed using a dermal fibroblast wound healing scratch assay. Histatins and cytokines stayed stable in saline for > 24h at 37°C, making them ideal as an off-the-shelf product. However, incubation with chronic wound extracts resulted in serious breakdown of Hst1 and Hst2 (~50% in 8h) and to lesser extent cyclic Hst1 and the minimal active domain of Hst1 (~20% in 8h). The cytokines IL-6 and CXCL8 were more stable in chronic wound extracts (~40% degradation in 96h). An initial 8-hour pulse of histatins or cytokines during a 96-hour study period was sufficient to stimulate fibroblast migration equally well as a continuous 96-hour exposure, indicating that they may possibly be used as novel bioactive therapeutics, exerting their activity for up to four days after a single exposure.