Social gating and pedagogy: Mechanisms for learning and implications for robotics

It seems self-evident that human responsiveness to social input enhances learning, yet the details of the social forces at play are only beginning to come into focus. Recent research on language and cognitive development in preschoolers and infants illuminates mechanisms such as social gating and natural pedagogy, and specific ways in which they benefit learning. We review such advances and consider implications of this research for designing robotic systems that can harness the power of social forces for learning.     

Technical recommendations and interpretation guidelines for electroencephalography for premature and full-term newborns

Electroencephalography (EEG) of neonatal patients is amongst the most valuable diagnostic and prognostic tool. EEG recordings, acquired at the bedside of infants, evaluate brain function and the maturation of premature and extremely premature infants. Strict conditions of acquisition and interpretation must be respected to guarantee the quality of the EEG and ensure its safety for fragile children. This article provides guidance for EEG acquisition including: (1) the required equipment and devices, (2) the modalities of installation and asepsis precautions, and (3) the digital signal acquisition parameters to use during the recording. The fundamental role of a well-trained technician in supervising the EEG recording is emphasized. In parallel to the acquisition recommendations, we present a guideline for EEG interpretation and reporting. The successive steps of EEG interpretation, from reading the EEG to writing the report, are described. The complexity of the EEG signal in neonates makes artefact detection difficult. Thus, we provide an overview of certain characteristic artefacts and detail the methods for eliminating them.     

Pharmacotherapy for the soul and psychotherapy for the body

The "mind-body" dualism has shaped the development of psychiatry. At the very beginning psychiatry was related to the mind and the rest of the medicine to the body. The main reasons for such division were lack of biological evidence for psychiatric disorders and wrong beliefs about demonic origins of "lunacy". But although the development of science offered more than enough biological evidence to understand brain as an organ of origin for psychiatric disorders, the dualism of mind and body remained alive even in the modern classification systems. One of the consequences was another dualism that differ biological (e.g. pharmacotherapy) from psychological therapy (e.g. psychotherapy) as completely different approaches. The purpose of this article is to offer enough evidence to reframe the existing dualisms into a different paradigm. In every illness both mind and body can be affected to a different extent. Which part of an illness is body and which part is mind is often difficult to differentiate even when we compare a person with broken leg with a person with acute stress reaction. For that reason it might be an over-simplification to differentiate sharply between biological and psychological therapies. The evidence show that psychotherapy influences biology of the brain and that pharmacotherapy influences psychological, social and developmental dimensions of the diseased person as well as overall well-being and functionality. In the era where medicine discovered psychology and psychiatry discovered biology, the debates and divisions that steam out of past dualisms should end. Every practising physician regardless of the medical discipline uses in everyday practice both biological and psychological approaches to help the patient successfully.     

Astrocyte-neuron metabolic relationships: for better and for worse

In recent years, previously unsuspected roles of astrocytes have been revealed, largely owing to the development of new tools enabling their selective study in situ. These exciting findings add to the large body of evidence demonstrating that astrocytes play a central role in brain homeostasis, in particular via the numerous cooperative metabolic processes they establish with neurons, such as the supply of energy metabolites and neurotransmitter recycling functions. Furthermore, impairments in astrocytic function are increasingly being recognized as an important contributor to neuronal dysfunction and, in particular, neurodegenerative processes. In this review, we discuss recent evidence supporting important roles for astrocytes in neuropathological conditions such as neuroinflammation, amyotrophic lateral sclerosis and Alzheimer's disease. We also explore the potential for neuroprotective therapeutics based on the modulation of astrocytic functions.     

Subsystems of sensory attention for skilled reaching: vision for transport and pre-shaping and somatosensation for grasping, withdrawal and release

Skilled reaching is a forelimb movement in which a subject reaches for a piece of food that is placed in the mouth for eating. It is a natural movement used by many animal species and is a routine, daily activity for humans. Its prominent features include transport of the hand to a target, shaping the digits in preparation for grasping, grasping, and withdrawal of the hand to place the food in the mouth. Studies on normal human adults show that skilled reaching is mediated by at least two sensory attention processes. Hand transport to the target and hand shaping are temporally coupled with visual fixation on the target. Grasping, withdrawal, and placing the food into the mouth are associated with visual disengagement and somatosensory guidance. Studies on nonhuman animal species illustrate that shared visual and somatosensory attention likely evolved in the primate lineage. Studies on developing infants illustrate that shared attention requires both experience and maturation. Studies on subjects with Parkinson's disease and Huntington's disease illustrate that decomposition of shared attention also features compensatory visual guidance. The evolutionary, developmental, and neural control of skilled reaching suggests that associative learning processes are importantly related to normal adult attention sharing and so can be used in remediation. The economical use of sensory attention in the different phases of skilled reaching ensures efficiency in eating, reduces sensory interference between sensory reference frames, and provides efficient neural control of the advance and withdrawal components of skilled reaching movements.     

Guidelines for collecting and maintaining archives for genetic monitoring

Rapid advances in molecular genetic techniques and the statistical analysis of genetic data have revolutionized the way that populations of animals, plants and microorganisms can be monitored. Genetic monitoring is the practice of using molecular genetic markers to track changes in the abundance, diversity or distribution of populations, species or ecosystems over time, and to follow adaptive and non-adaptive genetic responses to changing external conditions. In recent years, genetic monitoring has become a valuable tool in conservation management of biological diversity and ecological analysis, helping to illuminate and define cryptic and poorly understood species and populations. Many of the detected biodiversity declines, changes in distribution and hybridization events have helped to drive changes in policy and management. Because a time series of samples is necessary to detect trends of change in genetic diversity and species composition, archiving is a critical component of genetic monitoring. Here we discuss the collection, development, maintenance, and use of archives for genetic monitoring. This includes an overview of the genetic markers that facilitate effective monitoring, describes how tissue and DNA can be stored, and provides guidelines for proper practice.     

Parents' Preferences for School- and Community-Based Services for Children at Risk for ADHD

This study used conjoint analysis, trade-off methodology employed by marketing researchers and health economists, to examine preferences of parents for school- and community-based interventions for childhood ADHD. Participants were 29 mothers (86.2% Caucasian) of boys aged 5–13 years with or at risk of ADHD. Mothers completed a conjoint survey that examined trade-offs across 15 attributes of service content (e.g., materials, resources), process (e.g., time demand, format/delivery mode), and outcome (e.g., improvement in children's behavioral functioning). Findings suggest that parents preferred services maximizing children's behavioral and social outcomes (relative to family functioning). Parents were willing to give up services with desirable delivery features (such as daily homeschool notes and child's frequent participation in therapy) for programs optimizing outcomes. Simulation analyses, forecasting tools that predict how respondents would behave in the real world, revealed that 62.1% of parents were predicted to prefer a standard, evidence-informed school-based service involving daily teacher involvement and monthly parent involvement, while 37.9% of parents were predicted to use a standard, evidence-informed community-based service involving daily parent involvement and monthly teacher involvement. Findings from this study show that parents value improved social and behavioral outcomes more than desirable service delivery features. However, results suggest that if the treatment package includes school-based services in which there is greater teacher involvement and less parent involvement, a majority of parents prefer school services, especially if they involve children's ongoing use of self-control strategies. Results suggest ways in which the delivery of effective treatments needs to be altered to make them more palatable and acceptable by parents. Other implications for school-based practitioners are discussed.     

Upper and lower extremity robotic devices for rehabilitation and for studying motor control

PURPOSE OF REVIEW: The successful motor rehabilitation of stroke, traumatic brain-injured and spinal cord-injured patients requires an intensive and task-specific therapy approach. Budget constraints limit a hand-to-hand therapy approach, so that intelligent machines may offer a solution to promote motor recovery and obtain a better understanding of motor control. This new field of automated or robot-assisted motor rehabilitation has emerged since the 1990s. RECENT FINDINGS: This article will present clinically viable devices for upper and lower extremity rehabilitation. The MIT-Manus and the Mirror-Image Motion Enabler robot, which enable unrestricted unilateral or bilateral shoulder and elbow movement, consistently proved superior on the motor impairment level. The ARM guide, which assisted reaching in a straight-line trajectory, and the Bi-Manu-Track, which enabled the bilateral practice of a forearm and wrist movement, are currently being tested. For gait rehabilitation after stroke, the electromechanical gait trainer, GT I, has proved effective compared with treadmill training with body weight support. The Lokomat, consisting of a treadmill and a powered exoskeleton, lessened the therapeutic effort compared with manually assisted treadmill training in spinal cord-injured patients. Future developments will see more degrees of freedom, improved man-machine interaction and the implementation of virtual reality. SUMMARY: Technical possibilities are one aspect, but multi-centre trials and a consideration of the unsubstantiated fears among therapists of being replaced by machines will decide on the successful implementation of this most promising field to the benefit of patients.     

Rationale for cigarette smoking and for mentholation preference in cocaine- and nicotine-dependent outpatients

We asked 43 cocaine- and nicotine-dependent outpatients at a substance abuse clinic their reasons for combining cocaine and cigarette use, and for preferring either mentholated or nonmentholated cigarettes. Responses to open-ended questions asked during a semistructured interview were categorized by an analysis of expressed motives for cigarette smoking. Responses that did not fit the categorization were analyzed separately in a qualitative design. Sedating, stimulating, or addictive effects were frequently stated as reasons for the combined use of cigarettes with cocaine. Sedating or calming effects of cigarette smoking included reduction of cocaine-induced paranoia. Cocaine-substituting and cocaine-enhancing effects of cigarette smoking were categorized as stimulating effects. Addictive effects included craving for cigarette smoking on its own or triggered by cocaine use. Sensorimotor or stimulating effects were frequently stated as reasons for a preference for mentholated or nonmentholated cigarettes. Sensorimotor effects of menthol included taste, anesthetic, cooling, and decongestant properties. Some responses provided by our patient sample suggest a need for research on the effect of cigarette smoking on absorption of smoked cocaine.     

精神医学中的生物统计学(15) 对观察性数据和聚类数据应用生存分析评估个体和环境的自杀危险因素(英文)

1. Introducton Survival analysis concerns the tme from a well-defnedorigin to some event of interest, such as the tme fromsurgery to death of a cancer patent, the tme fromwedding to divorce, and the tme between the frst andsecond suicide atempts. Although originated in researchon the actve lifetme of light bulbs and other electricdevices, modern applicatons of survival analysis includemany non-survival events. Thus, survival analysis may bemore appropriately called the tme-to-event analysis.     

Technique for intracranial balloon and stent-assisted angioplasty for atherosclerotic stenosis

Dilation of stenoses of the major intracranial arteries is now technically possible in many cases. Using proper precautions, most procedures can be performed without complications today, but the safety margin will likely be improved with refinement of current devices and the introduction of new devices made specifically for this indication. Early experience with these techniques is promising for lowering the risk for recurrent ischemic events in patients who have symptomatic intracranial arterial stenosis refractory to medical therapy. This article describes the steps taken to perform transluminal balloon angioplasty and stent-assisted angioplasty for intracranial atherosclerotic stenosis, from patient preparation through follow-up, including procedural steps and device selection.     

Ethical considerations for decision making for treatment and research participation

Here we review issues of patient decision-making and consent to treatment and research by persons with cognitive impairment and dementia. Clinicians and researchers must recognize their primary duty to care for the individual and must clearly distinguish their role as a clinician and/or researcher. Distinctions between standard care and research must be clearly understood by everyone, as must the clinician’s role in each. Both actual and perceived conflicts of interest must be avoided. At present there is insufficient evidence to recommend specific methods for determining competency for decision-making, but a diagnosis of cognitive impairment or dementia does not preclude such competence. Competency is not a unitary or static construct and must be considered as the ability to make an informed decision about participation in the particular context of the specific treatment or study. Clinicians and researchers should consider consent as a process involving both the patient with cognitive impairment and his or her family/caregiver, particularly given the potential that competency for decision-making will change over time. As the availability of advance directives remains limited, clinicians and researchers must make efforts to ensure that decisions made by proxies are based on the prior attitudes and values of the patient.