The N400 elicited by homonyms in puns: Two primes are not better than one

To comprehend a pun involving a homonym (e.g., The prince with a bad tooth got a crown), both meanings of the homonym must be accessed and selected. Previous ERP studies have shown that the N400 reflects lexicosemantic processing, but none have directly investigated the N400 elicited by homonyms in the unique context of puns. Here, N400 priming effects showed that the dual context of puns (e.g., the primes prince and tooth) did not facilitate homonym processing in comparison to single dominant biasing (e.g., The prince with a bad leg got a crown) or subordinate biasing (e.g., The adult with a bad tooth got a crown) conditions. However, homonyms did elicit a less negative N400 (i.e., priming) in the pun condition in comparison to the neutral context condition (e.g., The adult with a bad leg got a crown). These findings are interpreted in terms of the dominant advantage and subordinate bias effect posited by the reordered access model of homonym processing, and in terms of N400 amplitude as an index of how consistently various sources of semantic featural information converge on one lexical item, even when two lexical items must be activated for comprehension.     

Childhood adversity and psychiatric disorder in young adulthood: An analysis of 107,704 Swedes

Childhood adversity (CA) is associated with increased risks of psychiatric disorder in young adulthood, but details in this association are less known. We aimed to explore the association of a range of CA indicators with psychiatric disorder in young adulthood, and the impact of age at exposure, disorder type and accumulation of indicators. We capitalized on Sweden's extensive and high-quality registers and analyzed a cohort of all Swedes (N = 107,704) born in Stockholm County 1987–1991. Adversities included familial death, parental substance misuse and psychiatric disorder, parental criminality, parental separation, public assistance recipiency and residential instability. Age at exposure was categorized as: 0–6.9 years (infancy and early childhood), 7–11.9 years (middle childhood), and 12–14 years (early adolescence). Psychiatric disorders after age 15 were defined from ICD codes through registers. Risks were calculated as Hazard Ratios (HR) with 95% confidence intervals (CI).Results showed that exposure to at least one CA was associated with an increased risk of psychiatric disorder (HR 1.4, 95% CI: 1.3–1.4). Risks were increased for mood, anxiety, and psychotic disorders and ADHD but not for eating disorders. The risk varied with type of disorder but was similar for all exposure periods. Individuals with multiple (3+) CAs had a two-fold risk of psychiatric disorder (HR 2.0, 95% CI: 1.9–2.1). In conclusion, our findings support the long-term negative impact of CA on mental health, regardless of developmental period of exposure. Given that experience of CA is common, efforts should be put to alleviate the burden of childhood adversities for children, particularly among the most disadvantaged.     

Cognitive flexibility correlates with gambling severity in young adults

Although gambling disorder (GD) is often characterized as a problem of impulsivity, compulsivity has recently been proposed as a potentially important feature of addictive disorders. The present analysis assessed the neurocognitive and clinical relationship between compulsivity on gambling behavior. A sample of 552 non-treatment seeking gamblers age 18–29 was recruited from the community for a study on gambling in young adults. Gambling severity levels included both casual and disordered gamblers. All participants completed the Intra/Extra-Dimensional Set Shift (IED) task, from which the total adjusted errors were correlated with gambling severity measures, and linear regression modeling was used to assess three error measures from the task. The present analysis found significant positive correlations between problems with cognitive flexibility and gambling severity (reflected by the number of DSM-5 criteria, gambling frequency, amount of money lost in the past year, and gambling urge/behavior severity). IED errors also showed a positive correlation with self-reported compulsive behavior scores. A significant correlation was also found between IED errors and non-planning impulsivity from the BIS. Linear regression models based on total IED errors, extra-dimensional (ED) shift errors, or pre-ED shift errors indicated that these factors accounted for a significant portion of the variance noted in several variables. These findings suggest that cognitive flexibility may be an important consideration in the assessment of gamblers. Results from correlational and linear regression analyses support this possibility, but the exact contributions of both impulsivity and cognitive flexibility remain entangled. Future studies will ideally be able to assess the longitudinal relationships between gambling, compulsivity, and impulsivity, helping to clarify the relative contributions of both impulsive and compulsive features.     

Does a dedicated program for young breast cancer patients affect the likelihood of fertility preservation discussion and referral?

PurposeTo assess whether a dedicated program for young breast cancer patients, including a nurse navigator, improves the frequency of: a) fertility discussion documentation and b) fertility preservation (FP) referrals.MethodsA retrospective chart review and prospective survey were undertaken of breast cancer patients diagnosed at age 40 or younger between 2011 and 2013 who received adjuvant or neo-adjuvant chemotherapy at two academic cancer centers in Toronto, Canada. The Odette Cancer Centre (OCC) has a dedicated program for young breast cancer patients while Princess Margaret Cancer Centre (PM) does not. Patient demographics, tumor pathology, treatment and fertility discussion documentation prior to systemic chemotherapy administration were extracted from patient records. Prospective surveys were administered to the same cohort to corroborate data collected.ResultsEighty-one patient charts were reviewed at both OCC and PM. Forty-seven and 49 at OCC and PM returned surveys for a response rate of 58% and 60% respectively. Chart reviews demonstrated no difference in the frequency of fertility discussion documentation (78% versus 75% for OCC and PM, p = 0.71); however, surveys demonstrated higher rates of recall of fertility discussion at OCC (96% versus 80%, p = 0.02). A greater proportion of women were offered FP referrals at OCC, as observed in chart reviews (56% versus 41%, p = 0.09), and surveys (73% versus 51%, p = 0.04). Time to initiation of chemotherapy did not differ between women who underwent FP and those who did not.ConclusionA dedicated program for young breast cancer patients is associated with a higher frequency of FP referrals without delaying systemic therapy.     

High enhancer,downer, withdrawal helper: Multifunctional nonmedical benzodiazepine use among young adult opioid users in New York City

BackgroundBenzodiazepines are a widely prescribed psychoactive drug; in the U.S., both medical and nonmedical use of benzodiazepines has increased markedly in the past 15 years. Long-term use can lead to tolerance and dependence, and abrupt withdrawal can cause seizures or other life-threatening symptoms. Benzodiazepines are often used nonmedically in conjunction with other drugs, and with opioids in particular—a combination that can increase the risk for fatal and non-fatal overdose. This mixed-methods study examines nonmedical use of benzodiazepines among young adults in New York City and its relationship with opioid use.MethodsFor qualitative analysis, 46 90-minute semi-structured interviews were conducted with young adult opioid users (ages 18–32). Interviews were transcribed and coded for key themes. For quantitative analysis, 464 young adult opioid users (ages 18–29) were recruited using Respondent-Driven Sampling and completed structured interviews. Benzodiazepine use was assessed via a self-report questionnaire that included measures related to nonmedical benzodiazepine and opioid use.ResultsParticipants reported using benzodiazepines nonmedically for a wide variety of reasons, including: to increase the high of other drugs; to lessen withdrawal symptoms; and to come down from other drugs. Benzodiazepines were described as readily available and cheap. There was a high prevalence (93%) of nonmedical benzodiazepine use among nonmedical opioid users, with 57% reporting regular nonmedical use. In bivariate analyses, drug-related risk behaviours such as polysubstance use, drug binging, heroin injection and overdose were strongly associated with regular nonmedical benzodiazepine use. In multivariate analysis, growing up in a middle-income household (earning between $51,000 and $100,000 annually), lifetime overdose experience, having ever used cocaine regularly, having ever been prescribed benzodiazepines, recent drug binging, and encouraging fellow drug users to use benzodiazepines to cope with opioid withdrawal were consistently strong predictors of regular nonmedical benzodiazepine use.ConclusionNonmedical benzodiazepine use may be common among nonmedical opioid users due to its drug-related multi-functionality. Harm reduction messages should account for the multiple functions benzodiazepines serve in a drug-using context, and encourage drug users to tailor their endorsement of benzodiazepines to peers to include safer alternatives.     

青年缺血性卒中心理状态

目的 评估青年缺血性卒中后心理状态.方法 入选2008年3月~2011年3月期间两院90例青年缺血性卒中患者,男58例,女32例,年龄21~45岁.使用中国版SCL-90评估心理状态,测量值与常模比较.结果 和常模比较,青年缺血性卒中测量值在抑郁,焦虑,躯体化症状,恐惧,厌恶和精神症状方面差别有统计学意义(P<0.01),而在强迫、敌意和妄想方面的差异无统计学意义(P>0.05).抑郁/焦虑的发生率是43.33%,其中女性占75%,男性占25% (P<0.01).受教育程度差异无统计学意义(P> 0.05).医保患者抑郁/焦虑发生率是29.2%,低于自费患者的发生率(66.7%,P< 0.05).脑损伤部位与抑郁/焦虑发生率有关,双重大脑半球缺血者的发生率是75% (P< 0.05).结论 青年缺血性卒中伴有抑郁、焦虑、躯体化症状、人际关系敏感、恐惧和精神症状,但是强迫、敌意和妄想与常模没有明显的差异.性别、医疗费用和缺血部位影响抑郁/焦虑的发生率.     

青年人非小细胞肺癌的临床病理特征及预后研究进展

 青年人非小细胞肺癌（NSCLC）发病率呈逐年升高趋势。目前多以发病年龄≤40岁作为青年人NSCLC的年龄界定标准。其发病原因可能与青年人吸烟人数增加、遗传易感性、内外环境改变等有关。青年人NSCLC临床表现缺乏特异性，易被误诊及漏诊，确诊时间长。年轻女性发病率高于老年女性；以腺癌为多见；以分化差的进展期病例为主，手术切除率低。青年NSCLC患者表皮生长因子受体（EGFR）突变阳性率可能低于老年NSCLC患者，而棘皮动物微管相关蛋白样4-间变性淋巴瘤激酶（EML4-ALK）融合基因阳性率可能相对高于其他人群；其一线治疗肿瘤进展时间短，肿瘤进展迅速。提高对青年人NSCLC的认识，争取早期诊治，对其进行精确分子分型可能有助于改善其预后。     

Cluster analysis and food group consumption in a national sample of Australian girls

Background: Food preferences develop early in life and track into later life. There is limited information on food consumption and dietary patterns in Australian girls. The present study aimed to: (i) determine the frequency of food groups consumed over 1 day; (ii) identify dietary clusters based on food group consumption; and (iii) compare dietary intakes and activity variables between clusters. Methods: A cross‐sectional analysis of 9–16‐year‐old girls (n = 1114) from the 2007 Australian National Children’s Nutrition and Physical Activity Survey was performed. Results: Over the whole day, 30% of all girls consumed carbonated sugar drinks, 46% consumed take‐away food, 56% consumed fruit, 70% consumed at least one vegetable, and 19% and 30% consumed white and/or red meat, respectively. K‐means cluster analysis derived four clusters. Approximately one‐third of girls were identified in a Meat and vegetable cluster; these girls had the highest intakes of red meat and vegetables, and tended to have higher intakes of fruit, whole grain breads, low fat yoghurt, and lower intakes of take‐away foods and soft drinks. They also had the highest intakes of protein, fibre and micronutrients; and tended to perform more physical activity, compared to girls in the remaining clusters. Conclusions: Girls identified in the Meat and vegetable cluster, on average, consumed more lean red meat, vegetables, fruits, and low‐fat dairy products, and had a higher intakes of many nutrients. The high percentage of girls not identified in this cluster suggests the need to inform them on how to make healthy, nutrient dense food choices, and why they require increased nutrient intakes at this time.     

Development of an auditory test battery for young children: a pilot study

This article describes the development and results of a pilot study with a recently developed auditory test battery for 4-6-year-old Dutch children. The test battery consisted of a sustained auditory attention (SAA) test, a dichotic words (DW) test, a binaural masking-level difference (BMLD) test, an auditory word discrimination (AWD) test, a gap detection (GD) test and a test of phonemic awareness, the Lindamood Auditory Conceptualization (LAC) test. Our results show that this test battery can be administered successfully to children aged 4 years and older. Most tests showed a clear effect of chronological age; the strongest age effects were found for the DW test and the LAC test. The BMLD test was the only test for which no significant age effect was found in this group of children. A small, but significant right-ear advantage was found on the DW test, for the 4- and the 6-year-olds. Correlations between subtests were in general rather high, suggesting that several tests in this test battery may be tapping into similar auditory abilities.