•Brain sex differences have been extensively catalogued but have yet to identify clear neural correlates of male-female behavioral difference.•Some neuroimaging has found greater success linking ...brain to behavior using non-binary measures of “gender” as an independent variable.•Recent advances in operationalizing “gender” will enhance discovery of neural processes underlying behavior and mental health.
Despite decades of pursuit, human brain imaging has yet to uncover clear neural correlates of male-female behavioral differences. Given that such behavior does not always align with sex categories, we argue that neuroimaging research may find more success by partitioning subjects along nonbinary gender attributes in addition to sex. We review the handful of studies that have done this, several of which find as good or better association between brain measures and “gender” as they do with “sex.” Recent advances in operationalizing “gender” as a multidimensional variable should facilitate such studies, along with discovery-based approaches that mine brain imaging data for gender-associated attributes, independent of sex.
IMPORTANCE: Meta-analyses of treatments for posttraumatic stress disorder (PTSD) suggest that trauma-focused psychotherapies produce greater benefits than antidepressant medications alone. OBJECTIVE: ...To determine the relative efficacy of prolonged exposure therapy plus placebo, prolonged exposure therapy plus sertraline hydrochloride, and sertraline plus enhanced medication management in the treatment of PTSD. DESIGN, SETTING, AND PARTICIPANTS: The Prolonged Exposure and Sertraline Trial was a randomized, multisite, 24-week clinical trial conducted at the Veterans Affairs Ann Arbor Healthcare System, Veterans Affairs San Diego Healthcare System, Ralph H. Johnson Veterans Affairs Medical Center, and Massachusetts General Hospital Home Base Veterans Program between January 26, 2012, and May 9, 2016. Participants and clinicians were blinded to pill condition, and outcome evaluators were blinded to assignment. Participants completed assessments at weeks 0 (intake), 6, 12, 24, and 52 (follow-up). Participants (N = 223) were service members or veterans of the Iraq and/or Afghanistan wars with combat-related PTSD and significant impairment (Clinician-Administered PTSD Scale score, ≥50) of at least 3 months’ duration. Analyses were on an intent-to-treat basis. INTERVENTION: Participants completed up to thirteen 90-minute sessions of prolonged exposure therapy by week 24. Sertraline dosage was titrated during a 10-week period and continued until week 24; medication management was manualized. MAIN OUTCOMES AND MEASURES: The primary outcome was symptom severity of PTSD in the past month as assessed by the Clinician-Administered PTSD Scale score at week 24. RESULTS: Of 223 randomized participants, 149 completed the study at 24 weeks, and 207 (180 men and 27 women; mean SD age, 34.5 8.3 years) were included in the intent-to-treat analysis. Modified intent-to-treat analysis using a mixed model of repeated measures showed that PTSD symptoms decreased significantly during the 24 weeks (sertraline plus enhanced medication management, 33.8 points; prolonged exposure therapy plus sertraline, 32.7 points; and prolonged exposure therapy plus placebo, 29.4 points; β,–9.39; 95% CI, −11.62 to −7.16; P < .001); however, slopes did not differ by treatment group (prolonged exposure therapy plus placebo group, –9.39; sertraline plus enhanced medication management group, –10.37; and prolonged exposure therapy plus sertraline group, –9.99; P = .81). CONCLUSIONS AND RELEVANCE: No difference in change in PTSD symptoms or symptom severity at 24 weeks was found between sertraline plus enhanced medication management, prolonged exposure therapy plus placebo, and prolonged exposure therapy plus sertraline. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01524133
Leveraging technology to provide evidence‐based therapy for posttraumatic stress disorder (PTSD), such as prolonged exposure (PE), during the COVID‐19 pandemic helps ensure continued access to ...first‐line PTSD treatment. Clinical video teleconferencing (CVT) technology can be used to effectively deliver PE while reducing the risk of COVID‐19 exposure during the pandemic for both providers and patients. However, provider knowledge, experience, and comfort level with delivering mental health care services, such as PE, via CVT is critical to ensure a smooth, safe, and effective transition to virtual care. Further, some of the limitations associated with the pandemic, including stay‐at‐home orders and physical distancing, require that providers become adept at applying principles of exposure therapy with more flexibility and creativity, such as when assigning in vivo exposures. The present paper provides the rationale and guidelines for implementing PE via CVT during COVID‐19 and includes practical suggestions and clinical recommendations.
Neoadjuvant chemotherapy is becoming the standard of care for patients with locally advanced breast cancer. Conventional imaging modalities used for the assessment of tumor response to neoadjuvant ...chemotherapy rely on changes in size or morphologic characteristics and, therefore, are inherently limited.
Functional imaging technologies evaluate vascular, metabolic, biochemical, and molecular changes in cancer cells and have a unique ability to detect specific biologic tumor markers, assess therapeutic targets, predict early response to neoadjuvant chemotherapy, and guide individualized cancer therapy.
Reactivation of persistent human adenoviruses (HAdVs) is associated with high morbidity and mortality in paediatric haematopoietic stem cell transplant (HSCT) recipients. Although invasive HAdV ...infections mainly arise from the gastrointestinal (GI) tract, the specific sites of HAdV persistence are not well characterised. We prospectively screened biopsies from 143 non-HSCT paediatric patients undergoing GI endoscopy and monitored serial stool specimens from 148 paediatric HSCT recipients for the presence of HAdV by real-time PCR. Persistence of HAdV in the GI tract was identified in 31% of children, with the highest prevalence in the terminal ileum. In situ hybridisation and immunohistochemistry identified HAdV persistence in lymphoid cells of the lamina propria, whereas biopsies from five transplant recipients revealed high numbers of replicating HAdV in intestinal epithelial cells. The prevalence of HAdV species, the frequencies of persistence in the GI tract and reactivations post transplant indicated a correlation of intestinal HAdV shedding pre-transplant with high risk of invasive infection. HAdV persistence in the GI tract is a likely origin of infectious complications in immunocompromised children. Intestinal lymphocytes represent a reservoir for HAdV persistence and reactivation, whereas the intestinal epithelium is the main site of viral proliferation preceding dissemination. The findings have important implications for assessing the risk of life-threatening invasive HAdV infections.
Highlights ► Studies of the human gut microbiota has increased interest in probiotic therapies. ► Standardization in probiotic trials is essential to address current conflicting data. ► Probiotic ...regulation differs greatly between countries and continents. ► Consumers and manufacturers will benefit from globally harmonized regulations.
Direct, NAD(P)H-independent regeneration of Old Yellow Enzymes represents an interesting approach for simplified reaction schemes for the stereoselective reduction of conjugated C=C-double bonds. ...Simply by illuminating the reaction mixtures with blue light in the presence of sacrificial electron donors enables to circumvent the costly and unstable nicotinamide cofactors and a corresponding regeneration system.
In the present study, we characterise the parameters determining the efficiency of this approach and outline the current limitations. Particularly, the photolability of the flavin photocatalyst and the (flavin-containing) biocatalyst represent the major limitation en route to preparative application.
•Nicotinamide cofactor-independent regeneration of Old Yellow Enzymes is possible using a photochemical approach.•A biochemical characterisation of the photochemical reaction system is provided.•The photoinstability of the flavin cofactor poses the most important challenge to robust reaction schemes.
We present the discovery of two z > 6 quasars, selected as i-band dropouts in the Very Large Telescope Survey Telescope ATLAS survey. Our first quasar has redshift, z = 6.31 ± 0.03, z-band magnitude, ...z
AB
= 19.63 ± 0.08 and rest frame 1450 Å absolute magnitude, M
1450 = −27.8 ± 0.2, making it the joint second most luminous quasar known at z > 6. The second quasar has z = 6.02 ± 0.03, z
AB
= 19.54 ± 0.08 and M
1450 = −27.0 ± 0.1. We also recover a z = 5.86 quasar discovered by Venemans et al., in preparation. To select our quasars, we use a new 3D colour space, combining the atlas optical colours with mid-infrared data from the Wide-field Infrared Survey Explorer. We use i
AB
− z
AB
colour to exclude main-sequence stars, galaxies and lower redshift quasars, W1 − W2 to exclude L dwarfs and z
AB
− W2 to exclude T dwarfs. A restrictive set of colour cuts returns only our three high redshift quasars and no contaminants, albeit with a sample completeness of ∼50 per cent. We discuss how our 3D colour space can be used to reject the majority of contaminants from samples of bright 5.7 < z < 6.3 quasars, replacing follow-up near-infrared photometry, whilst retaining high completeness.
Additive manufacturing (AM) is a rising technology bringing new opportunities for design and cost of manufacturing, compared to standard processes like casting and machining. Among the AM techniques, ...direct energy deposition (DED) processes are dedicated to manufacture functional metallic parts. Despite of their promising perspectives, the industrial implementation of DED processes is inhibited by the lack of structural health control. Consequently, non-destructive testing (NDT) techniques can be investigated to inspect DED-manufactured parts, in an online or offline manner. To date, most ultrasonic NDT applications to metallic AM concerned the selective laser melting process; existing studies tackling DED processes mainly compare various ultrasonic techniques and do not propose a comprehensive control method for such processes. Current researches in the GeM laboratory focus on a multi-sensor monitoring method dedicated to DED processes, with a structural health control loop included, in order to track defect formation during manufacturing. In this way, this paper aims to be a proof of concept and proposes a comprehensive control method that opens the way to in situ ultrasonic control for DED. In this paper, a control method using the phased array ultrasonic testing (PAUT) technique is particularly illustrated on wire-arc additive manufacturing (WAAM) components, and its applicability to laser metal deposition (LMD) is also demonstrated. A specific attention is given to the calibration method, towards a quantitative prediction of the size of the detected flaws. PAUT predictions are cross-checked thanks to X-ray radiography, which demonstrates that the PAUT method enables to detect and dimension defects from 0.6 to 1 mm for WAAM aluminum alloy parts. Then, an applicable scenario of inspection of a WAAM industrial and large-scale part is presented. Finally, perspectives for in situ and real-time application of the chosen method are given. This paper shows that real-time monitoring of the WAAM process is possible, as the PAUT method can be integrated in the manufacturing environment, provides relevant in situ data, and runs with computing times compatible with real-time applications.
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