Background
Consolidated memories can undergo enduring modification through retrieval-dependent treatments that modulate reconsolidation. This represents a potentially transformative strategy for ...weakening or overwriting the maladaptive memories that underlie substance use and anxiety/trauma-related disorders. However, modulation of
naturalistic
maladaptive memories may be limited by ‘boundary conditions’ imposed on the reconsolidation process by the nature of these memories.
Methods
We conducted a systematic review and meta-analyses of behavioural and pharmacological studies examining retrieval-dependent modulation of reward- and threat-related memories in (sub) clinical substance use and anxiety/trauma, respectively.
Results
Of 4938 publications assessed for eligibility, 8 studies of substance use and 10 of anxiety (phobia)- and trauma-related symptoms were included in the meta-analyses. Overall, the findings were in the predicted direction, with most studies favouring the ‘retrieval + treatment’ condition. However, the magnitude of effects was dependent upon the nature of treatment, with pharmacological interventions showing a medium-sized effect (
g
= 0.59,
p
= 0.03) and behavioural treatments, a relatively small effect (
g
= 0.32,
p
= 0.10) in studies of phobia/trauma. Among studies of substance use, post-retrieval behavioural interventions yielded a larger effect (
g
= 0.60,
p
< 0.001) relative to pharmacological treatments (
g
= − 0.03,
p
= 0.91), with treatment type being a statistically significant moderator (
χ
2
(1) = 4.20,
p
= 0.04).
Conclusion
Modification of naturalistic maladaptive memories during reconsolidation appears to be a viable treatment strategy for substance use and phobias/trauma disorders. However, high levels of heterogeneity and methodological variation limit the strength of conclusions that can be drawn from the reviewed studies at this stage.
This paper analyses one British woman's everyday practices of belonging as she negotiates expatriate life in Dubai, United Arab Emirates. In doing so, it responds to widespread calls to ground ...research on processes of transnationalism and diaspora by drawing on 18 months of ethnographic research and adopting a three-stranded analytical framework to reflect on the significance of domesticity, intimacy and foreignness in expatriate belonging. The author focuses on a single research subject to draw attention to a particular British expatriate experience otherwise neglected in migration research and the paper resonates with theoretical literatures aiming to challenge the binary divisions of geographies of belonging, including attachment/detachment.
Aims
Zero- and near-zero-fluoroscopic ablation techniques reduce the harmful effects of ionizing radiation during invasive electrophysiology procedures. We aimed to test the feasibility and safety of ...a zero-fluoroscopic strategy using a novel integrated magnetic and impedance-based electroanatomical mapping system for radiofrequency ablation (RFA) of supraventricular tachycardias (SVTs).
Methods
We retrospectively studied 92 consecutive patients undergoing electrophysiology studies with/without RFA for supraventricular tachycardia (SVT) performed by a single operator at a single center. The first 42 (Group 1) underwent a conventional fluoroscopic-guided approach and the second 50 (Group 2) underwent a zero-fluoroscopic approach using the Ensite Precision
™
3-D magnetic and impedance-based mapping system (Abbott Inc).
Results
Group 1 comprised 14 AV-nodal re-entrant tachycardia (AVNRT), 12 typical atrial flutter, 4 accessory pathway (AP), 2 atrial tachycardia (AT), and 9 diagnostic EP studies (EPS). Group 2 comprised 16 AVNRT, 17 atrial flutter, 6 AP, 3 AT, 2 AV-nodal ablations, and 7 EPS. A complete zero-fluoroscopic approach was achieved in 94% of Group 2 patients. All procedures were acutely successful, and no complications occurred. There was a significant reduction in fluoroscopy dose, dose area product, and time (
p
< 0.0001, for all), with no difference in procedure times. Ablation time for typical atrial flutter was shorter in Group 2 (
p
= 0.006).
Conclusions
A zero-fluoroscopic strategy for diagnosis and treatment of SVTs using this novel 3D-electroanatomical mapping system is feasible in majority of patients, is safe, reduces ionizing radiation exposure, and does not compromise procedural times, success rates, or complication rates.
Maladaptive reward memories (MRMs) are involved in the development and maintenance of acquired overconsumption disorders, such as harmful alcohol and drug use. The process of memory reconsolidation - ...where stored memories become briefly labile upon retrieval - may offer a means to disrupt MRMs and prevent relapse. However, reliable means for pharmacologically weakening MRMs in humans remain elusive. Here we demonstrate that the N-methyl D-aspartate (NMDA) antagonist ketamine is able to disrupt MRMs in hazardous drinkers when administered immediately after their retrieval. MRM retrieval + ketamine (RET + KET) effectively reduced the reinforcing effects of alcohol and long-term drinking levels, compared to ketamine or retrieval alone. Blood concentrations of ketamine and its metabolites during the critical 'reconsolidation window' predicted beneficial changes only following MRM reactivation. Pharmacological reconsolidation interference may provide a means to rapidly rewrite maladaptive memory and should be further pursued in alcohol and drug use disorders.
This article examines night-time bedroom soundscapes to highlight the significance of embodied geographies of home in understanding lived inequalities of housing. The article presents an analysis of ...responses (n =174) to the Mass Observation Project 'Your Bedroom' (2017) directive, in which UK panellists were asked about their bedrooms. The mundane, ordinary and frequent noise disturbance from neighbourhoods and neighbours is documented to contribute to an understanding of the sensory geographies of night-time domesticities. The article demonstrates that embodied experiences of night-time bedroom soundscapes, including sleep practices, are shaped by housing, including residential location, building type, and ownership/tenure. The article concludes by arguing that attention to soundscapes is significant in developing an embodied understanding of the inequalities of contemporary geographies of housing and home.
To present recommendations for the prevention and screening, recognition, and treatment of the most common conditions resulting in sudden death in organized sports.
Cardiac conditions, head injuries, ...neck injuries, exertional heat stroke, exertional sickling, asthma, and other factors (eg, lightning, diabetes) are the most common causes of death in athletes.
These guidelines are intended to provide relevant information on preventing sudden death in sports and to give specific recommendations for certified athletic trainers and others participating in athletic health care.
Left main coronary artery (LMCA) damage is a rare but catastrophic complication of cardiac ablation procedures.
The purpose of this study was to describe the anatomic relationships of the LMCA to its ...adjacent structures using analysis of computed tomographic coronary angiograms (CTCA).
We studied 100 patients (55 males, age 51 ± 10 years) who were investigated for chest pain with CTCA. The relationships between the LMCA and adjacent structures were described by analysis of 2-dimensional images and 3-dimensional reconstructions.
The LMCA coursed within 5 mm of the anterior left atrial endocardium and/or base of left atrial appendage in 49% (within 2 mm in 17%) and from the pulmonary artery in 90% (within 2 mm in 43%). The LMCA was within 5 mm of the right ventricular outflow tract in 1%. In 4% the LMCA coursed inferiorly, remaining within 5 mm of the left aortic sinus of Valsalva at a vertical distance >5 mm from the inferior margin of the LMCA ostium.
The LMCA is often intimately related to the anterior left atrium, left atrial appendage base, and pulmonary artery and occasionally to the inferior part of the left aortic sinus of Valsalva and thus is exposed to the risk of injury during ablation in these areas. The LMCA is rarely close to the right ventricular outflow tract.
A procedure for the selective deprotection of p-methoxybenzyl ethers using catalytic amounts of DDQ and of sodium nitrite, with oxygen as the terminal oxidant, is reported.
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As Australia's population ages, and the prevalence of dementia increases, questions regarding the powers of those who take on legal responsibility for persons recognised as mentally incapacitated ...will likely become more common. One such question recently came before the Full Court of the Supreme Court of South Australia in 'Public Advocate v C, B'. This case concerned an appeal by the Public Advocate against a declaration made by Stanley J in the Supreme Court of South Australia that the respondent, a 95-year-old man named 'BC', was unlawfully detained at a residential aged care facility by reason of the Public Advocate's exercise of guardianship over him under section 29 of the 'Guardianship and Administration Act 1993' (SA).
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