•Motivation to engage in pleasant real-life social activities is reduced in depression.•Depressed subjects show impaired learning from social outcomes.•Impaired social learning predicts reduced ...real-life social engagement motivation.•The neural encoding of social learning signals is altered in depression.•Neural social learning signals correlate with real-life social engagement motivation.
Major depressive disorder is associated with altered social functioning and impaired learning, on both the behavioural and the neural level. These deficits are likely related, considering that successful social interactions require learning to predict other people's emotional responses. Yet, there is little research examining this relation.
Forty-three individuals with high (HD; N = 21) and low (LD; N = 22) depression scores answered questions regarding their real-life social experiences and performed a social learning task during fMRI scanning. As part of the task, subjects learned associations between name cues and rewarding (happy faces) or aversive (fearful faces) social outcomes. Using computational modelling, behavioural and neural correlates of social learning were examined and related to real-life social experiences.
HD participants reported reduced motivation to engage in real-life social activities and demonstrated elevated uncertainty about social outcomes in the task. Moreover, HD subjects displayed altered encoding of social reward predictions in the insula, temporal lobe and parietal lobe. Interestingly, across all subjects, higher task uncertainty and reduced parietal prediction encoding were associated with decreased motivation to engage in real-life social activities.
The size of the included sample was relatively small. The results should thus be regarded as preliminary and replications in larger samples are called for.
Taken together, our findings suggest that reduced learning from social outcomes may impair depressed individuals’ ability to predict other people's responses in real life, which renders social situations uncertain. This uncertainty, in turn, may contribute to reduced social engagement (motivation) in depression.
We have previously shown that individuals with high depression scores demonstrate impaired behavioral and neural responses during social learning. Given that depression is associated with altered ...dopamine (DA) and serotonin (5-HT) functioning, the current study aimed to elucidate the role of these neurotransmitters in the social learning process using a dietary depletion manipulation. In a double-blind design, 70 healthy volunteers were randomly allocated to a 5-HT depletion (N = 24), DA depletion (N = 24), or placebo (N = 22) group. Participants performed a social learning task during fMRI scanning, as part of which they learned associations between name cues and rewarding (happy faces) or aversive (fearful faces) social outcomes. Behaviorally, 5-HT depleted subjects demonstrated impaired social reward learning compared to placebo controls, with a marginal effect in the same direction in the DA depletion group. On the neural level, computational modeling-based fMRI analyses revealed that 5-HT depletion altered social reward prediction signals in the insula, temporal lobe, and prefrontal cortex, while DA depletion affected social reward prediction encoding only in the prefrontal cortex. These results indicate that 5-HT depletion impairs learning from social rewards, on both the behavioral and the neural level, while DA depletion has a less extensive effect. Interestingly, the behavioral and neural responses observed after 5-HT depletion in the current study closely resemble our previous findings in individuals with high depression scores using the same task. It may thus be the case that decreased 5-HT levels contribute to social learning deficits in depression.
To analyse the relationship between health app quality with user ratings and the number of downloads of corresponding health apps.
Utilising a dataset of 881 Android-based health apps, assessed via ...the 300-point objective Organisation for the Review of Care and Health Applications (ORCHA) assessment tool, we explored whether subjective user-level indicators of quality (user ratings and downloads) correlate with objective quality scores in the domains of user experience, data privacy and professional/clinical assurance. For this purpose, we applied spearman correlation and multiple linear regression models.
For user experience, professional/clinical assurance and data privacy scores, all models had very low adjusted R squared values (< .02). Suggesting that there is no meaningful link between subjective user ratings or the number of health app downloads and objective quality measures. Spearman correlations suggested that prior downloads only had a very weak positive correlation with user experience scores (Spearman = .084, p = .012) and data privacy scores (Spearman = .088, p = .009). There was a very weak negative correlation between downloads and professional/clinical assurance score (Spearman = -.081, p = .016). Additionally, user ratings demonstrated a very weak correlation with no statistically significant correlations observed between user ratings and the scores (all p > 0.05). For ORCHA scores multiple linear regression had adjusted R-squared = -.002.
This study highlights that widely available proxies which users may perceive to signify the quality of health apps, namely user ratings and downloads, are inaccurate predictors for estimating quality. This indicates the need for wider use of quality assurance methodologies which can accurately determine the quality, safety, and compliance of health apps. Findings suggest more should be done to enable users to recognise high-quality health apps, including digital health literacy training and the provision of nationally endorsed "libraries".
Abstract Background Social anhedonia, the decreased enjoyment of pleasant social experiences, is associated with depression. However, whether social anhedonia in depression affects prosocial ...behaviours is unclear. The current study aimed to examine how high levels of depressive symptomatology in young peopleaffect responses to usually rewarding social situations including helping behaviour. Methods We recruited 46 females, 16 scoring high on the Beck Depression Inventory (BDI scores ≥ 20; Mage = 19; HD) and 30 scoring low (BDI ≤ 10, Mage = 20; LD). In a social emotion task (SET), participants were presented with social scenarios and asked to rate their expected emotional responses. Subsequently, participants’ helping behaviour was measured by dropping a pile of papers near them and recording their responses. Lastly, participants completed the SET again. Results The SET at time 1 revealed that HD individuals reported significantly stronger negative (p <.001) and weaker positive (p <.05) emotional responses to social situations than LD subjects. Additionally, all participants showed a significant increase in positive responses (p <.05) on the SET between time 1 and time 2. Moreover, HD subjects were less likely to engage in actual helping behaviour than LD participants. Limitations Limitations of the study are that only females were tested and that no psychiatric screening interview was conducted. Conclusions Our results indicate that young females with high levels of depression symptoms expect to respond less positively to social situations and engage less in helping behaviour compared to those with low depressive symptomatology. Social anhedonia in depression may thus contribute to decreased engagement in rewarding social situations. This, in turn, may lead to social withdrawal and might maintain depression symptoms though a lack of exposure to positive social feedback.
Testing based on multiple choice questions (MCQ) is one of the most established forms of assessment, not only in the medical field. Extended matching questions (EMQ) represent a specific type of MCQ ...designed to require higher levels of cognition, such as problem-solving. The purpose of this evaluation was to assess the suitability and efficiency of EMQ as an assessment method. EMQ were incorporated into the end-of-semester examination in internal medicine, in which 154 students participated, and compared with three established MCQ types. Item and examination quality were investigated, as well as readability and processing time. EMQ were slightly more difficult to score; however, both item discrimination and discrimination index were higher when compared to other item types. EMQ were found to be significantly longer and required more processing time, but readability was improved. Students judged EMQ as clearly challenging, but attributed significantly higher clinical relevance when compared to established MCQ formats. Using the Spearman-Brown prediction, only ten EMQ items would be needed to reproduce the Cronbach's alpha value of 0.75 attained for the overall examination. EMQ proved to be both efficient and suitable when assessing medical students, demonstrating powerful characteristics of reliability. Their expanded use in favor of common MCQ could save examination time without losing out on statistical quality.
Wilms’ tumor 1 (WT1) protein is highly immunogenic and overexpressed in acute myeloid leukemia (AML), consequently ranked as a promising target for novel immunotherapeutic strategies. Here we report ...our experience of a phase I/II clinical trial (NCT01051063) of a vaccination strategy based on WT1 recombinant protein (WT1-A10) together with vaccine adjuvant AS01
B
in five elderly AML patients (median age 69 years, range 63–75) receiving a total of 62 vaccinations (median 18, range 3–20) after standard chemotherapy. Clinical benefit was observed in three patients: one patient achieved measurable residual disease clearance during WT1 vaccination therapy, another patient maintained long-term molecular remission over 59 months after the first vaccination cycle. Interestingly, in one case, we observed a complete clonal switch at AML relapse with loss of WT1 expression, proposing suppression of the original AML clone by WT1-based vaccination therapy. Detected humoral and cellular CD4
+
T cell immune responses point to efficient immune stimulation post-vaccination, complementing hints for induced conventional T cell infiltration into the bone marrow and a shift from senescent/exhausted to a more activated T cell profile. Overall, the vaccinations with WT1 recombinant protein had an acceptable safety profile and were thus well tolerated.
To conclude, our data provide evidence of potential clinical efficacy of WT1 protein-based vaccination therapy in AML patients, warranting further investigations.
Acute and chronic cardiac disorders predispose to alterations in cognitive performance, ranging from mild cognitive impairment to overt dementia. Although this association is well-established, the ...factors inducing and accelerating cognitive decline beyond ageing and the intricate causal pathways and multilateral interdependencies involved remain poorly understood. Dysregulated and persistent inflammatory processes have been implicated as potentially causal mediators of the adverse consequences on brain function in patients with cardiac disease. Recent advances in positron emission tomography disclosed an enhanced level of neuroinflammation of cortical and subcortical brain regions as an important correlate of altered cognition in these patients. In preclinical and clinical investigations, the thereby involved domains and cell types of the brain are gradually better characterized. Microglia, resident myeloid cells of the central nervous system, appear to be of particular importance, as they are extremely sensitive to even subtle pathological alterations affecting their complex interplay with neighboring astrocytes, oligodendrocytes, infiltrating myeloid cells, and lymphocytes. Here, we review the current evidence linking cognitive impairment and chronic neuroinflammation in patients with various selected cardiac disorders including the aspect of chronic neuroinflammation as a potentially druggable target.
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