Uncinate fasciculus microstructural organisation and emotion recognition in schizophrenia: controlling for hit rate bias.

Introduction: Schizophrenia (SCZ) is a complex neurodevelopmental disorder characterised by functional and structural brain dysconnectivity and disturbances in perception, cognition, emotion, and social functioning. In the present study, we investigated whether the microstructural organisation of the uncinate fasciculus (UF) was associated with emotion recognition (ER) performance. Additionally, we investigated the usefulness of an unbiased hit rate (UHR) score to control for response biases (i.e., participant guessing) during an emotion recognition task (ERT). Methods: Fifty-eight individuals diagnosed with SCZ were included. The CANTAB ERT was used to measure social cognition. Specific ROI manual tract segmentation was completed using ExploreDTI and followed the protocol previously outlined by Coad et al. (2020). Results: We found that the microstructural organisation of the UF was significantly correlated with physical neglect and ER outcomes. Furthermore, we found that the UHR score was more sensitive to ERT subscale emotion items than the standard HR score. Finally, given the association between childhood trauma (in particular childhood neglect) and social cognition in SCZ, a mediation analysis found evidence that microstructural alterations of the UF mediated an association between childhood trauma and social cognitive performance. Discussion: The mediating role of microstructural alterations in the UF on the association between childhood trauma and social cognitive performance suggests that early life adversity impacts both brain development and social cognitive outcomes for people with SCZ. Limitations of the present study include the restricted ability of the tensor model to correctly assess multi-directionality at regions where fibre populations intersect.

A 20-Year Systematic Review of the 'Reading the Mind in the Eyes' Test across Neurodegenerative Conditions.

Social cognition has a broad theoretical definition, which includes the ability to mentalise, i.e., recognise and infer mental states to explain and predict another's behaviour. There is growing recognition of the clinical, diagnostic, and prognostic value of assessing a person's ability to perform social cognitive tasks, particularly aspects of theory of mind, such as mentalising. One such measure of mentalising is the 'Reading the Mind in the Eyes' test (RMET). This systematic review and meta-analysis consider performance on the RMET, applied to people with neurodegenerative conditions in matched control studies, since its publication in 2001. Overall, this review includes 22 papers with data from N = 800 participants with neurodegenerative conditions: Alzheimer's disease, n = 31; Parkinson's disease, n = 221; Lewy body dementia, n = 33; motor neuron disease, n = 218; Huntington's disease n = 80; multiple sclerosis, n = 217; and N = 601 matched typical controls. Our meta-analyses show that deficits in mentalising, as measured by the RMET, are consistently reported across neurodegenerative conditions, with participants in both early and late disease stages being affected. Social cognition is an emerging field of cognitive neuroscience requiring specific and sensitive measurement across each subdomain. Adult-based meta-normative data feature, for which future groups or individuals could be compared against, and hypotheses relating to the source of these mentalising deficits are further discussed. This review was registered with PROSPERO (CRD42020182874).

The impact of phonological relatedness on semantic congruency judgements in readers with dyslexia: Evidence from behavioural judgements, event related potentials and pupillometry.

Readers with developmental dyslexia are known to be impaired in representing and accessing phonology, but their ability to process meaning is generally considered to be intact. However, neurocognitive studies show evidence of a subtle semantic processing deficit in dyslexic readers, relative to their typically-developing peers. Here, we compared dyslexic and typical adult readers on their ability to judge semantic congruency (congruent vs. inconcongruent) in short, two-word phrases, which were further manipulated for phonological relatedness (alliterating vs. non-alliterating); "dazzling-diamond"; "sparkling-diamond"; "dangerous-diamond"; and "creepy-diamond". At the level of behavioural judgement, all readers were less accurate when evaluating incongruent alliterating items compared with incongruent non-aliterating, suggesting that phonological patterning creates the illusion of semantic congruency (as per Egan et al., 2020). Dyslexic readers showed a similar propensity for this form-meaning relationship despite a phonological processing impairment as evidenced in the cognitive and literacy indicative assessments. Dyslexic readers also showed an overall reduction in the ability to accurately judge semantic congruency, suggestive of a subtle semantic impairment. Whilst no group differences emerged in the electrophysiological measures, our pupil dilation measurements revealed a global tendency for dyslexic readers to manifest a reduced attentional response to these word stimuli, compared with typical readers. Our results show a broad manifestation of neurocognitive differences in adult dyslexic and typical readers' processing of print, at the level of autonomic arousal as well as in higher level semantic judgements.

As clear as glass: How figurativeness and familiarity impact simile processing in readers with and without dyslexia.

For skilled readers, idiomatic language confers faster access to overall meaning compared with non-idiomatic language, with a processing advantage for figurative over literal interpretation. However, currently very little research exists to elucidate whether atypical readers-such as those with developmental dyslexia-show such a processing advantage for figurative interpretations of idioms, or whether their reading impairment implicates subtle differences in semantic access. We wanted to know whether an initial figurative interpretation of similes, for both typical and dyslexic readers, is dependent on familiarity. Here, we tracked typical and dyslexic readers' eye movements as they read sentences containing similes (e.g., as cold as ice), orthogonally manipulated for novelty (e.g., familiar: as cold as ice, novel: as cold as snow) and figurativeness (e.g., literal: as cold as ice [low temperature], figurative: as cold as ice [emotionally distant]), with figurativeness being defined by the sentence context. Both participant groups exhibited a processing advantage for familiar and figurative similes over novel and literal similes. However, compared with typical readers, participants with dyslexia had greater difficulty processing similes both when they were unfamiliar and when the context biased the simile meaning towards a literal rather than a figurative interpretation. Our findings suggest a semantic processing anomaly in dyslexic readers, which we discuss in light of recent literature on sentence-level semantic processing.

Effect of Increased Intra-abdominal Pressure on the Esophagogastric Junction: A Systematic Review.

With the advent of high-resolution esophageal manometry, it is recognized that the antireflux barrier receives a contribution from both the lower esophageal sphincter (intrinsic sphincter) and the muscle of the crural diaphragm (extrinsic sphincter). Further, an increased intra-abdominal pressure is a major force responsible for an adaptive response of a competent sphincter or the disruption of the esophagogastric junction resulting in gastroesophageal reflux, especially in the presence of a hiatal hernia. This review describes how the pressure dynamics in the lower esophageal sphincter were discovered and measured over time and how this has influenced the development of antireflux surgery.

Inconsistent language lateralisation - Testing the dissociable language laterality hypothesis using behaviour and lateralised cerebral blood flow.

BACKGROUND: Most people have strong left-brain lateralisation for language, with a minority showing right- or bilateral language representation. On some receptive language tasks, however, lateralisation appears to be reduced or absent. This contrasting pattern raises the question of whether and how language laterality may fractionate within individuals. Building on our prior work, we postulated (a) that there can be dissociations in lateralisation of different components of language, and (b) these would be more common in left-handers. A subsidiary hypothesis was that laterality indices will cluster according to two underlying factors corresponding to whether they involve generation of words or sentences, versus receptive language. METHODS: We tested these predictions in two stages: At Step 1 an online laterality battery (Dichotic listening, Rhyme Decision and Word Comprehension) was given to 621 individuals (56% left-handers); At Step 2, functional transcranial Doppler ultrasound (fTCD) was used with 230 of these individuals (51% left-handers). 108 left-handers and 101 right-handers gave useable data on a battery of three language generation and three receptive language tasks. RESULTS: Neither the online nor fTCD measures supported the notion of a single language laterality factor. In general, for both online and fTCD measures, tests of language generation were left-lateralised. In contrast, the receptive tasks were at best weakly left-lateralised or, in the case of Word Comprehension, slightly right-lateralised. The online measures were only weakly correlated, if at all, with fTCD measures. Most of the fTCD measures had split-half reliabilities of at least .7, and showed a distinctive pattern of intercorrelation, supporting a modified two-factor model in which Phonological Decision (generation) and Sentence Decision (reception) loaded on both factors. The same factor structure fitted data from left- and right-handers, but mean scores on the two factors were lower (less left-lateralised) in left-handers. CONCLUSIONS: There are at least two factors influencing language lateralization in individuals, but they do not correspond neatly to language generation and comprehension. Future fMRI studies could help clarify how far they reflect activity in specific brain regions.

The role of orthographic neighbourhood effects in lateralized lexical decision: a replication study and meta-analysis.

The effect of orthographic neighbourhood size (N) on lexical decision reaction time differs when words are presented in the left or right visual fields. Evidence suggests a facilitatory N effect (i.e., faster reaction times for words with larger neighbourhoods) in the left visual field. However, the N effect in the right visual field remains controversial: it may have a weaker facilitative role or it may even be inhibitory. In a pre-registered online experiment, we replicated the interaction between N and visual field and provided support for an inhibitory N effect in the right visual field. We subsequently conducted a pre-registered systematic review and meta-analysis to synthesise the available evidence and determine the direction of N effects across visual fields. Based on the evidence, it would seem the effect is inhibitory in the right visual field. Furthermore, the size of the N effect is considerably smaller in the right visual field. Both studies revealed considerable heterogeneity between participants and studies, and we consider the implications of this for future work.

Corrigendum: The Phonological Mapping (Mismatch) Negativity: History, Inconsistency, and Future Direction.

[This corrects the article DOI: 10.3389/fpsyg.2020.01967.].

How alliteration enhances conceptual-attentional interactions in reading.

In linguistics, the relationship between phonological word form and meaning is mostly considered arbitrary. Why, then, do literary authors traditionally craft sound relationships between words? We set out to characterise how dynamic interactions between word form and meaning may account for this literary practice. Here, we show that alliteration influences both meaning integration and attentional engagement during reading. We presented participants with adjective-noun phrases, having manipulated semantic relatedness (congruent, incongruent) and form repetition (alliterating, non-alliterating) orthogonally, as in "dazzling-diamond"; "sparkling-diamond"; "dangerous-diamond"; and "creepy-diamond". Using simultaneous recording of event-related brain potentials and pupil dilation (PD), we establish that, whilst semantic incongruency increased N400 amplitude as expected, it reduced PD, an index of attentional engagement. Second, alliteration affected semantic evaluation of word pairs, since it reduced N400 amplitude even in the case of unrelated items (e.g., "dangerous-diamond"). Third, alliteration specifically boosted attentional engagement for related words (e.g., "dazzling-diamond"), as shown by a sustained negative correlation between N400 amplitudes and PD change after the window of lexical integration. Thus, alliteration strategically arouses attention during reading and when comprehension is challenged, phonological information helps readers link concepts beyond the level of literal semantics. Overall, our findings provide a tentative mechanism for the empowering effect of sound repetition in literary constructs.

Bilinguals apply language-specific grain sizes during sentence reading.

Languages differ in the consistency with which they map orthography to phonology, and a large body of work now shows that orthographic consistency determines the style of word decoding in monolinguals. Here, we characterise word decoding in bilinguals whose two languages differ in orthographic consistency, assessing whether they maintain two distinct reading styles or settle on a single 'compromise' reading style. In Experiment 1, Welsh-English bilinguals read cognates and pseudowords embedded in Welsh and English sentences. Eye-movements revealed that bilinguals dynamically alter their decoding strategy according to the language context, including more fixations during lexical access for cognates in the more consistent orthography (Welsh) than in the less consistent orthography (English), and these effects were specific to word (as opposed to pseudoword) processing. In Experiment 2, we compared the same bilinguals' eye movements in the English sentence reading context to those of monolinguals'. Bilinguals' eye-movement behaviour was very similar to monolinguals' when reading English, suggesting that their knowledge of the more consistent orthography (Welsh) did not alter their decoding style when reading in English. This study presents the first characterisation of bilingual decoding style in sentence reading. We discuss our findings in relation to connectionist reading models and models of bilingual visual word recognition.

Why do we need to improve monitoring of patients with inflammatory bowel disease (IBD) on biologic treatment?

Introduction: Treatment goals for IBD patients traditionally focused on symptom control. It is increasingly recognized that many patients have continued disease activity without symptoms. Subclinical inflammation increases the risk of disease flares and long-term complications. A consensus is therefore emerging on the need to treat beyond symptoms and to define clear treatment targets for IBD patients receiving biologic medicines. Areas covered: We review validated tools used in IBD for monitoring clinical and endoscopic response to therapy. We discuss the value of using non-invasive tests in assessing disease activity. We summarise the latest guidelines in IBD treatment and review recommendations regarding therapeutic drug monitoring. We examine the role of monitoring for and prevention of avoidable complications of treatment. Expert Opinion: The goals of treatment in IBD are to achieve both clinical remission and mucosal healing. Whether we adopt a top-down or more conventional treatment strategy there is now an imperative to monitor patients using a combination of endoscopic and biochemical markers to assess the degree of continuing inflammation and establish early disease control. TDM has facilitated huge improvement in the ability to personalize delivery of biologics. This has allowed for early detection and prevention of loss of response.

Matrix-associated stem cell transplantation is successful in treating talar osteochondral lesions.

PURPOSE: Osteochondral lesions (OCLs) of the talus are a challenging and increasingly recognized problem in chronic ankle pain. Many novel techniques exist to try and treat this challenging entity. Difficulties associated with treating OCLs include lesion location, size, chronicity, and problems associated with potential graft harvest sites. Matrix-associated stem cell transplantation (MAST) is one such treatment described for larger lesions > 15 mm2 or failed alternative therapies. This cohort study describes a 3 year review of the outcomes of talar lesions treated with MAST. METHODS: A review of all patients treated with MAST by a single surgeon was conducted. Pre-operative radiographs, MRIs, and FAOS outcome questionnaire scores were reviewed. Intraoperative classification was undertaken to correlate with imaging. Post-operative outcomes included FAOS scores, return to sport, revision surgery/failure of treatment, and progression to ankle fusion. RESULTS: In this study, 38 OCLs in 32 patients were identified. Median patient age was 35 years of which (68.8%) were male. Median length of follow-up was 36.7 months (range 12-64 months). (83%) returned to playing sport. Twenty-three patients underwent MAST in the setting of a failed previous operative attempt, with just nine having MAST as a first option. Nine patients out of 32 had a further procedure. Improvements were seen in all domains of the FAOS (p < 0.05). CONCLUSION: MAST has demonstrated encouraging results in lesions which prove challenging to treat, even in a "failed microfracture" cohort. LEVEL OF EVIDENCE: IV.

Burst Lacerations: A New Term for a Common Injury to the Foot.

OBJECTIVE: This case series describes four cases with a similar mechanism of injury: crush injuries to the foot from hydraulic presses/trailers. The aim of the study was to review a specific cohort of pneumatic compression injuries of the foot in terms of their soft-tissue component, and in particular relating to the burst lacerations. METHOD: The mechanism and patterns of injury were reviewed to identify common features in a case series of four crush injuries to the foot which presented to the Emergency Department of University Hospital Galway over a period of 6 months between January and July 2017. RESULTS: There were four cases of high-energy crush injuries to the feet seen in involved farmers (mean age 55). The cases presented with similar soft-tissue injuries, despite having quite varied bony injuries. All patients had lacerations of the webbed spaces, which is likely due to extrusion of the interosseous muscles as they are flattened. Three patients had lacerations along the medial side of their foot extending transversely across the plantar surface. CONCLUSION: A common pattern of soft-tissue injury was present in these cases. We feel the term "burst laceration" is an appropriate term for describing this pattern. Burst lacerations are a marker of high-energy crush injuries and should alert surgeons to the severe soft-tissue injury that likely overlies the more obvious fracture. The importance of soft-tissue management in high-energy lower limb injury cannot be overstated. We feel the presence of burst lacerations to the foot should alert the surgeon to a high-energy crush-injury type mechanism of injury, and guide both soft-issue and bony management to optimize patient outcomes.

Development of a model for teaching manipulation of a distal radial fracture.

BACKGROUND: Recent reports indicate that there is a trend toward the use of models and simulators to teach basic orthopaedic operative skills. We describe a high-fidelity model for teaching basic orthopaedic fracture manipulation. METHODS: A model of a distal radial fracture was developed and validated by orthopaedic surgeons with different levels of experience, who examined and manipulated the model and then completed a structured questionnaire. RESULTS: The participants mostly agreed (designated as 4 in the questionnaire) that the model performed well on the degree to which the manipulation represented real life. The participants agreed (designated as 5 in the questionnaire) that the model scored high on the appearance and feel of the fracture and its ability to be used as a teaching tool. There was no difference between perceptions of participants with regard to different levels of occupational experience or model use. CONCLUSIONS: We believe that this model could be used to teach the skill of closed reduction of a distal radial fracture in the preclinical setting.

Safe surgery: how accurate are we at predicting intra-operative blood loss?

INTRODUCTION: Preoperative estimation of intra-operative blood loss by both anaesthetist and operating surgeon is a criterion of the World Health Organization's surgical safety checklist. The checklist requires specific preoperative planning when anticipated blood loss is greater than 500 mL. The aim of this study was to assess the accuracy of surgeons and anaesthetists at predicting intra-operative blood loss. METHODS: A 6-week prospective study of intermediate and major operations in an academic medical centre was performed. An independent observer interviewed surgical and anaesthetic consultants and registrars, preoperatively asking each to predict expected blood loss in millilitre. Intra-operative blood loss was measured and compared with these predictions. Parameters including the use of anticoagulation and anti-platelet therapy as well as intra-operative hypothermia and hypotension were recorded. RESULTS: One hundred sixty-eight operations were included in the study, including 142 elective and 26 emergency operations. Blood loss was predicted to within 500 mL of measured blood loss in 89% of cases. Consultant surgeons tended to underestimate blood loss, doing so in 43% of all cases, while consultant anaesthetists were more likely to overestimate (60% of all operations). Twelve patients (7%) had underestimation of blood loss of more than 500 mL by both surgeon and anaesthetist. Thirty per cent (n = 6/20) of patients requiring transfusion of a blood product within 24 hours of surgery had blood loss underestimated by more than 500 mL by both surgeon and anaesthetist. There was no significant difference in prediction between patients on anti-platelet or anticoagulation therapy preoperatively and those not on the said therapies. CONCLUSION: Predicted intra-operative blood loss was within 500 mL of measured blood loss in 89% of operations. In 30% of patients who ultimately receive a blood transfusion, both the surgeon and anaesthetist significantly underestimate the risk of blood loss by greater than 500 mL. Theatre staff must be aware that 1 in 14 patients undergoing intermediate or major surgery will have an unexpected blood loss exceeding 500 mL and so robust policies to identify and manage such circumstances should be in place to improve patient safety.