The Polaris-LAMP multi-modal 3-D gamma-ray imager is a radiation mapping and imaging platform which uses a commercial off-the-shelf (COTS) detector integrated with a contextual sensor localization ...and mapping platform. The integration of these systems enables a free-moving radiation imaging capability with proximity mapping, coded-aperture, and Compton imaging modalities, which can create 3-D reconstruction of photon sources from tens of keV to several MeV. Gamma-ray events are recorded using a segmented cadmium zinc telluride (CZT) detector (Polaris-H Quad by H3D Inc., Ann Arbor, MI, USA), while scene data are derived from a contextual sensor and computation package developed by Lawrence Berkeley National Laboratory which includes GPS, laser ranging, and inertial measurement sensors. An onboard computer uses these inputs to create rapidly updating pose (10 Hz) and 3-D scene estimates using a simultaneous localization and mapping (SLAM) algorithm. The precise gamma-ray event location and timing resolution of the Polaris CZT sensor enables Compton imaging above several hundred keV, while photon sources at lower images are localized using coded-aperture imaging techniques. The multi-modal imaging concept enables imaging of diverse radiation sources spanning from the 59-keV emission of 241 Am to the 1.1 and 1.3 MeV lines of 60 Co. This work focuses on the description of the operational principles of the detector system and demonstrating the 3-D imaging performance in a variety of source detection and mapping scenarios. As a proof of concept, we demonstrate mapping complex environments, including both point source and distributed-source environments using proximity, coded-aperture, and Compton imaging modalities. Furthermore, we show the successful use of the system to perform measurements in high-background environments through analysis of arrays of uranium hexafluoride cylinders at the Paducah UF6 project site.
Objective: Limit-setting strategies have the potential to assist in reducing problem gambling, but there is little research on self-imposed gambling limits and factors that restrain self-regulation ...once gambling has been initiated. Using daily diary approach, we investigated individual difference and proximal factors associated with gambling limit violations. Method: Participants were 103 individuals who gambled regularly and had set a goal to limit their gambling. Participants completed a baseline measure of trait self-control and questions about gambling and limit violations over 21 days. We examined factors associated with setting and maintaining limits across episodes of gambling as well as within-person factors associated with limit violations, including the moderating role of trait self-control. Results: We found that episodes of gambling where limits were set and violated were associated with riskier gambling and more negative emotional responses. In addition, gambling limits were more likely to be violated on days when temptations to violate limits were high and by people with low trait self-control, whereas urges to gamble were associated with a reduced likelihood of limit violations. Trait self-control moderated the relationship between daily stress/tension and limit violations. Low stress/tension was associated with greater limit violations for those with lower trait self-control, but the likelihood of violating limits increased on high stress days for those with higher trait self-control. Conclusions: Individuals may benefit from greater awareness of temptations to violate gambling limits and the impact of daily stressors, particularly for those with high trait self-control who are most successful when stress/tension is low.
Public Health Significance Statement
Setting limits to gambling is an important tool for individuals who wish to reduce their gambling behavior, and it is important for individuals to be aware of situational factors that may interfere with their exercising self-control over temptations to violate these limits. Individuals who typically show high self-control and avoid situations where they are tempted to gamble may find it particularly difficult to inhibit temptations to exceed their gambling limits when exposed to gambling situations on days where they experience strong stress or tension.
Pathological Gambling (PG) has been linked to both specific personality traits and personality disorders (PDs). However, previous studies have used a wide variety of research designs that preclude ...clear conclusions about the personality features that distinguish adults with PG from other groups. The current investigation seeks to advance this research by using a sample including adults who do not gamble, who gamble socially, and who exhibit PG, using self-report, informant-report, and interview-rated measures of personality traits and disorders. A total of 245 adults completed measures of gambling behaviour and problems, as well as normative and pathological personality over two assessment visits. A multivariate ANCOVA was conducted to investigate differences between groups. Analyses supported numerous group differences including differences between all groups on the Neuroticism facet of Impulsivity, and between non-gambling/socially gambling and PG groups on the Conscientiousness facet of Self-Discipline. Adults with PG exhibited more symptoms of Borderline, Paranoid, Schizotypal, Avoidant, and Dependent PDs than adults who gamble socially or not at all. The current investigation provides a comprehensive survey of personality across a wide range of gambling involvement, using a multi-method approach. Our findings help to clarify the most pertinent personality risk factors for PG.
Purpose
To investigate the impact of Mindfulness-Based Stress Reduction (MBSR) on gray matter volume (GMV) in female breast cancer survivors who suffer from chronic neuropathic pain (CNP).
Methods
...Voxel-based morphometry (VBM) was used to explore differences in GMV in 13 MBSR trainees and 10 waitlisted controls, with MRI scans and self-report measures completed pre- and post-8 weeks of training.
Results
Compared to controls, the MBSR group had greater GMV in the angular gyrus and middle frontal gyrus post-training. The MBSR group’s right parahippocampal gyrus GMV increased from pre- to post-training, whereas the control group’s left parahippocampal gyrus, precuneus, middle temporal gyrus, and right cuneus GMV decreased over the same time period. Pain interference was significantly reduced and mindfulness was significantly increased following MBSR for the intervention group only.
Conclusions
MBSR was associated with increased GMV in regions where GMV is known to (1) increase with mindfulness and reorientation of attention and (2) decrease with the experience of chronic neuropathic pain. By contrast, the control group’s decreases in GMV may be due to the negative effects of CNP which potentially may be reduced with MBSR, though further research is needed.
Implications for cancer survivors
Given the poor efficiency of pharmacotherapies in a high percentage of women with neuropathic pain following breast cancer treatment, adjunct methods are required. MBSR may affect the brain to help alter attention and perception of pain, thus playing a potentially important role in the path to wellness for breast cancer survivors.
Difficulties in applying emotional regulation (ER) skills are associated with depression and anxiety symptoms, and are common targets of treatment. This meta-analysis examined whether improvements in ...ER skills were associated with psychological treatment outcomes for depression and/or anxiety in youth. A multivariate, random-effects meta-analysis was run using metafor in R. Inclusion criteria included studies that were randomized controlled trials (RCTs) of a psychological intervention for depression and/or anxiety in patients aged 14-24, were peer reviewed, were written in English, measured depression and/or anxiety symptoms as an outcome and measured ER as an outcome. Medline, Embase, APA PsycInfo, CINAHL and The Cochrane Library were searched up to 26 June 2020. Risk of bias (ROB) was assessed using the Cochrane Collaboration Risk of Bias 2.0 tool. The meta-analysis includes 385 effect sizes from 90 RCTs with total N = 11,652. Psychological treatments significantly reduced depression, anxiety, emotion dysregulation (k = 13, Hedges' g = 0.54, P < 0.001, 95% confidence interval (CI) = 0.30-0.78) and disengagement ER (k = 83, g = 0.24, 95% CI = 0.15-0.32, P < 0.001); engagement ER also increased (k = 82, g = 0.26, 95% CI = 0.15-0.32, P < 0.001). Improvements in depression and anxiety were positively associated with improved engagement ER skills, reduced emotion dysregulation and reduced disengagement ER skills. Sensitivity considered study selection and publication bias. Longer treatments, group formats and cognitive-behavioural orientations produced larger positive associations between improved ER skills and reduced symptoms. ER skill improvement is linked to depression and anxiety across a broad range of interventions for youth. Limitations of the current study include reliance on self-report measures, content overlap between variables and inability to test the directionality of associations.
The cognitive effects of cross-sex hormone therapy (CSHT) are not well understood. In cisgender individuals, sex hormone therapy can impact neurotransmitter levels and structural anatomy. Similarly, ...in gender-diverse persons, CSHT has been associated with neural adaptations, such as growth in brain structures resembling those observed in cisgender individuals of the same sex. Hormone-related changes in learning and memory, as seen in menopause, are associated with physiological hypogonadism or a decline in hormones, such as estradiol. The present study examined the effect of estradiol administration in humans on glutamate concentration in brain regions involved in semantic and working memory (i.e., the dorsolateral prefrontal cortex DLPFC, the posterior hippocampus, and the pregenual anterior cingulate cortex) and its relationship with memory.
Eighteen trans women (male biological sex assigned at birth) ceased CSHT for 30 days for a washout phase (t1) upon study enrollment to reach a hypogonadal state. Working and semantic memory, cognition, hormonal assays, and brain imaging were assessed. Participants resumed CSHT for 60 days for a replacement phase (t2), after which the same evaluations from t1 were repeated.
Estradiol increased among trans women after 60 days of resumed CSHT with significant improvements in semantic memory compared to the hypogonadal phase. Working memory recall was significantly and positively correlated to glutamate in the DLPFC during the reinstatement phase, although the relationship was not moderated by levels of estradiol.
These results may have clinical implications for the therapeutic effects of estradiol replacement, serving as a protective factor against cognitive decline and impairment for trans women post-gonadectomy.
Introduction
Recent studies have raised the question of whether last year medical students and first year residents show an adequate attitude toward their patient’s pain as reflected by prescribed ...pain medication. Underuse of analgetics could be demonstrated in several studies even after a correct diagnosis of pain was made and has led to the term “oligoanalgesia.” Our study was aimed at evaluating the potential of improving student attitudes toward pain by changing the curriculum during the last year of medical education.
Methods
The study was designed as a prospective, randomized controlled, blinded cohort study. A recent change by law (2002) in the official curriculum (“Approbationsordnung”) made it possible to compare two groups of last year medical students who were trained in different curricula during a 1-year transitional period. One group received special training on various aspects of pain and analgesic therapy (new curriculum), while the other group followed the conventional curriculum (old curriculum) without further special training. Both students and examiners were blinded toward the study target. Measurement parameters were a clinical experiment with standardized patients (OSCE) and a key features test.
Results
The study shows a considerable improvement of attitude toward pain in those students undergoing the new curriculum. This group demonstrated better OSCE results and significant improvement in key features tasks, and also outperformed the old curriculum group in the choice of analgesia.
Discussion
Our results confirm the importance of humanistic attitudes in future doctors in addition to the traditional implementation of knowledge and skills. Changes in the medical curriculum can positively influence these attitudes.
Borderline personality disorder (BPD) is a mental health condition characterized by emotion dysregulation, interpersonal impairment, and high suicidality. Dialectical behaviour therapy (DBT) is the ...most widely studied psychotherapeutic treatment for BPD. To date, the vast majority of DBT research has focused on cisgender women, with a notable lack of systematic investigation of sex and/or gender differences in treatment response. In order to encourage effective, equitable treatment of BPD, further investigation into treatment targets in this population is critical. Here, we employed a systematic strategy to delineate gaps in the DBT literature pertaining to sex and gender differences and propose directions for future research. Findings demonstrate a significant discrepancy in measurement of sex and gender, particularly among gender-diverse individuals. Exploring DBT treatment response across the full spectrum of genders will facilitate the provision of more tailored, impactful care to all individuals who suffer from BPD.
The Polaris-LAMP multi-modal 3D gamma-ray imager is a radiation mapping and imaging platform which uses a commercial-off-the-shelf detector integrated with a contextual sensor localization and ...mapping platform. The integration of these systems enables a free-moving radiation imaging capability with proximity mapping, coded aperture, and Compton imaging modalities, which can create 3D reconstruction of photon sources from tens of keV to several MeV. Gamma-ray events are recorded using a segmented cadmium zinc telluride detector (Polaris-H Quad by H3D inc.), while scene data is derived from a contextual sensor and computation package developed by Lawrence Berkeley National Laboratory which includes GPS, laser ranging and inertial measurement sensors. An onboard computer uses these inputs to create rapidly-updating pose (10 Hz) and 3D scene estimates using a simultaneous localization and mapping algorithm. The precise gamma-ray event location and timing resolution of the Polaris CZT sensor enables Compton imaging above several hundred keV, while photon sources at lower images are localized using coded aperture imaging techniques. The multi-modal imaging concept enables imaging of diverse radiation sources spanning from the 59 keV emission of 241Am to the 1.1 and 1.3 MeV lines of 60Co. This work focuses on the description of the the operational principles of the detector system and demonstrating the 3D imaging performance in a variety of source detection and mapping scenarios. As a proof of concept, we demonstrate mapping complex environments, including both point source and distributed-source environments using proximity, coded aperture, and Compton imaging modalities. Further, we show the successful use of the system to perform measurements in high-background environments through analysis of arrays of uranium hexafluoride cylinders at the Paducah UF6 project site.
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