Social feedback processing in borderline personality disorder.

BACKGROUND: Patients with borderline personality disorder (BPD) show negative and unstable self- and other-evaluations compared to healthy individuals. It is unclear, however, how they process self- and other-relevant social feedback. We have previously demonstrated a positive updating bias in healthy individuals: When receiving social feedback on character traits, healthy individuals integrate desirable more than undesirable feedback. Here, our aim was to test whether BPD patients exhibit a more negative pattern of social feedback processing. METHOD: We employed a character trait task in which BPD patients interacted with four healthy participants in a real-life social interaction. Afterwards, all participants rated themselves and one other participant on 80 character traits before and after receiving feedback from their interaction partners. We compared how participants updated their ratings after receiving desirable and undesirable feedback. Our analyses included 22 BPD patients and 81 healthy controls. RESULTS: Healthy controls showed a positivity bias for self- and other-relevant feedback as previously demonstrated. Importantly, this pattern was altered in BPD patients: They integrated undesirable feedback for themselves to a greater degree than healthy controls did. Other-relevant feedback processing was unaltered in BPD patients. CONCLUSIONS: Our study demonstrates an alteration in self-relevant feedback processing in BPD patients that might contribute to unstable and negative self-evaluations.

Language switching-but not foreign language use per se-reduces the framing effect.

Recent studies reported reductions of well-established biases in decision making under risk, such as the framing effect, during foreign language (FL) use. These modulations were attributed to the use of FL itself, which putatively entails an increase in emotional distance. A reduced framing effect in this setting, however, might also result from enhanced cognitive control associated with language-switching in mixed-language contexts, an account that has not been tested yet. Here we assess predictions of the 2 accounts in 2 experiments with over 1,500 participants. In Experiment 1, we tested a central prediction of the emotional distance account, namely that the framing effect would be reduced at low, but not high, FL proficiency levels. We found a strong framing effect in the native language, and surprisingly also in the foreign language, independent of proficiency. In Experiment 2, we orthogonally manipulated foreign language use and language switching to concurrently test the validity of both accounts. As in Experiment 1, foreign language use per se had no effect on framing. Crucially, the framing effect was reduced following a language switch, both when switching into the foreign and the native language. Thus, our results suggest that reduced framing effects are not mediated by increased emotional distance in a foreign language, but by transient enhancement of cognitive control, putting the interplay of bilingualism and decision making in a new light. (PsycINFO Database Record

Depression is related to an absence of optimistically biased belief updating about future life events.

BACKGROUND: When challenged with information about the future, healthy participants show an optimistically biased updating pattern, taking desirable information more into account than undesirable information. However, it is unknown how patients suffering from major depressive disorder (MDD), who express pervasive pessimistic beliefs, update their beliefs when receiving information about their future. Here we tested whether an optimistically biased information processing pattern found in healthy individuals is absent in MDD patients. METHOD: MDD patients (n = 18; 13 medicated; eight with co-morbid anxiety disorder) and healthy controls (n = 19) estimated their personal probability of experiencing 70 adverse life events. After each estimate participants were presented with the average probability of the event occurring to a person living in the same sociocultural environment. This information could be desirable (i.e. average probability better than expected) or undesirable (i.e. average probability worse than expected). To assess how desirable versus undesirable information influenced beliefs, participants estimated their personal probability of experiencing the 70 events a second time. RESULTS: Healthy controls showed an optimistic bias in updating, that is they changed their beliefs more toward desirable versus undesirable information. Overall, this optimistic bias was absent in MDD patients. Symptom severity correlated with biased updating: more severely depressed individuals showed a more pessimistic updating pattern. Furthermore, MDD patients estimated the probability of experiencing adverse life events as higher than healthy controls. CONCLUSIONS: Our findings raise the intriguing possibility that optimistically biased updating of expectations about one's personal future is associated with mental health.

Dynamic states of cells adhering in shear flow: from slipping to rolling.

Motivated by rolling adhesion of white blood cells in the vasculature, we study how cells move in linear shear flow above a wall to which they can adhere via specific receptor-ligand bonds. Our computer simulations are based on a Langevin equation accounting for hydrodynamic interactions, thermal fluctuations, and adhesive interactions. In contrast to earlier approaches, our model not only includes stochastic rules for the formation and rupture of bonds, but also fully resolves both receptor and ligand positions. We identify five different dynamic states of motion in regard to the translational and angular velocities of the cell. The transitions between the different states are mapped out in a dynamic state diagram as a function of the rates for bond formation and rupture. For example, as the cell starts to adhere under the action of bonds, its translational and angular velocities become synchronized and the dynamic state changes from slipping to rolling. We also investigate the effect of nonmolecular parameters. In particular, we find that an increase in viscosity of the medium leads to a characteristic expansion of the region of stable rolling to the expense of the region of firm adhesion, but not to the expense of the regions of free or transient motion. Our results can be used in an inverse approach to determine single bond parameters from flow chamber data on rolling adhesion.

Mean first passage times for bond formation for a Brownian particle in linear shear flow above a wall.

Motivated by cell adhesion in hydrodynamic flow, here the authors study bond formation between a spherical Brownian particle in linear shear flow carrying receptors for ligands covering the boundary wall. They derive the appropriate Langevin equation which includes multiplicative noise due to position-dependent mobility functions resulting from the Stokes equation. They present a numerical scheme which allows to simulate it with high accuracy for all model parameters, including shear rate and three parameters describing receptor geometry (distance, size, and height of the receptor patches). In the case of homogeneous coating, the mean first passage time problem can be solved exactly. In the case of position-resolved receptor-ligand binding, they identify different scaling regimes and discuss their biological relevance.

Efficiency of initiating cell adhesion in hydrodynamic flow.

We theoretically investigate the efficiency of initial binding between a receptor-coated sphere and a ligand-coated wall in linear shear flow. The mean first passage time for binding decreases monotonically with increasing shear rate. Above a saturation threshold of the order of a few 100 receptor patches, the binding efficiency is enhanced only weakly by increasing their number and size, but strongly by increasing their height. This explains why white blood cells in the blood flow adhere through receptor patches localized to the tips of microvilli, and why malaria-infected red blood cells form elevated receptor patches (knobs).

Identification of functionally relevant histidine residues in the apoptotic nuclease CAD.

The caspase-activated DNase CAD (DFF40/CPAN) degrades chromosomal DNA during apoptosis. Chemical modification with DEPC inactivates the enzyme, suggesting that histidine residues play a decisive role in the catalytic mechanism of this nuclease. Sequence alignment of murine CAD with four homologous apoptotic nucleases reveals four completely (His242, His263, His304 and His308) and two partially (His127 and His313) conserved histidine residues in the catalytic domain of the enzyme. We have changed these residues to asparagine and characterised the variant enzymes with respect to their DNA cleavage activity, structural integrity and oligomeric state. All variants show a decrease in activity compared to the wild-type nuclease as measured by a plasmid DNA cleavage assay. H242N, H263N and H313N exhibit DNA cleavage activities below 5% and H308N displays a drastically altered DNA cleavage pattern compared to wild-type CAD. Whereas all variants but one have the same secondary structure composition and oligomeric state, H242N does not, suggesting that His242 has an important structural role. On the basis of these results, possible roles for His127, His263, His304, His308 and His313 in DNA binding and cleavage are discussed for murine CAD.

IDEA: a large-scale project on electronic identification of livestock.

The aim of the IDEA (Identification électronique des animaux) project is to collect information on the feasibility of the introduction into the European Union (EU) of an animal electronic identification system, as referred to in Directive 92/102 and Regulation 1760/2000. The project will run for a period of four years (1998-2001) and will include one million animals in six countries (France, Germany, Italy, The Netherlands, Portugal and Spain). The Joint Research Centre, as technical co-ordinator of the project, provides technical support in terms of testing and certification of electronic identification devices, establishment of the central database, transmission and recording of data and evaluation of results. Identification has been undertaken in cattle, sheep, goats and buffalo using three types of electronic tags (ruminal bolus, ear tag and injectable transponder). The performance of these tags is checked at defined intervals until recovery in the slaughterhouse. The evaluation of the results in terms of the performance of the device and the necessary organisational support structures will lead to recommendations for a system to trace animals from birth to slaughterhouse, including the appropriate technology to be applied in any generalised system for the livestock sector in the EU.

Type and crossmatch of the trauma patient.

OBJECTIVE: To identify a population of trauma patients in the emergency department (ED) that do not require emergent blood transfusion via a combination of clinical risk factors that are readily accessible and easily obtained. METHOD: A review of trauma patients was conducted for a 6-month period. Crossmatched patients were identified and examined for clinical characteristics and whether transfusion was performed. Risk factors for transfusion were identified and a model was developed for predicting likelihood of transfusion. RESULTS: Six hundred fifty-four patients were crossmatched, with emergent transfusion occurring in 81 (12.4%). Four risk factors were identified: systolic blood pressure < 90 mm Hg, Glasgow Coma Scale score < 9, pulse > 120 beats/min, and high-risk injury (trauma to the chest between the midclavicular lines, abdominal injury with diffuse tenderness, survival of a fatal vehicular crash, ejection from a vehicle, or stab or gunshot wound to the trunk). Patients with no risk factors were shown to have a 2.2% incidence of transfusion with no emergent transfusions occurring in the ED. CONCLUSION: Trauma patients with no risk factors at presentation were less likely to require emergent blood transfusion, especially in the setting of the ED.

Genetic engineering of Escherichia coli to produce a 1:1 complex of the anabaena sp. PCC 7120 nuclease NucA and its inhibitor NuiA.

A series of T7-promoter based bicistronic expression vectors was constructed in order to produce the complex of the Anabaena sp. PCC 7120 DNA/RNA non-specific nuclease NucA and its inhibitor NuiA. With all constructs, tandem expression of nucA and nuiA results in aggregation and inclusion body formation of NucA, independent of the order of the genes, the relative expression of the two proteins and the temperature applied during expression. Two constructs in which nuiA is the first and nucA the second cistron lead to an approximately one order of magnitude higher expression of nuiA compared with nucA. In these cells inclusion bodies are formed which contain NucA and NuiA in a 1:1 molar ratio. The complex can be solubilized with 6M urea after disruption of the cells by sonication, renatured by dialysis and purified to homogeneity. 2mg of the complex are obtained from 1l Escherichia coli culture. As shown by gel filtration and analytical ultracentrifugation, our system leads to a highly pure and homogeneous complex preparation, as required for biophysical and structural studies. Thus, our new method is a superior alternative for the production of the NucA/NuiA complex in which separately produced nuclease and inhibitor are mixed, and an excess of one or the other component, as well as aggregates of NucA, have to be removed from the preparation.

"Medical clearance" of psychiatric patients without medical complaints in the Emergency Department.

This study was conducted to evaluate the benefit of comprehensive "medical clearance" (history, physical examination, vital signs, laboratory, radiography) in patients presenting to the Emergency Department (ED) with isolated psychiatric complaints. All patients 16 years and older who presented with a psychiatric complaint and required a psychiatric evaluation before discharge from the ED were included in the study. Data, obtained in a 5-month consecutive, retrospective chart review, included patient age, sex, initial complaint, past medical and psychiatric history, initial vital sign measurement, physical examination findings, laboratory analysis (electrolytes, complete blood count, toxicology screen), chest X-ray study results, and final disposition. The number of patients who could have been referred to a psychiatric unit after a history, physical examination, and stable vital signs, without additional laboratory or radiographic studies, was determined. There were 212 patients who met the inclusion criteria, and all their charts were available for review. Eighty patients (38%) presented with isolated psychiatric complaints coupled with a documented past psychiatric history. All received a comprehensive "medical clearance" in the ED followed by a psychiatric consultation. None of the patients had positive screening laboratory or radiographic results. All were either dispositioned home or to the psychiatric ED. The remaining 132 patients (62%) presented to the ED with medically based chief complaints or past medical history requiring further evaluation in the ED before discharge. The initial complaints of these patients correlated directly with the need for laboratory and radiographic "medical clearance" in the ED. Patients with a primary psychiatric complaint coupled with a documented past psychiatric history, negative physical findings, and stable vital signs who deny current medical problems may be referred to psychiatric services without the use of ancillary testing in the ED.

Use of heliox-driven nebulizer therapy in the treatment of acute asthma.

STUDY OBJECTIVE: To compare the effectiveness of a helium-oxygen mixture with that of oxygen alone as an aerosolizing gas for beta-agonist therapy in patients with mild to moderate exacerbation of asthma. METHODS: A prospective, single-blinded study was performed in an urban teaching hospital over a period of 5 months. A convenience sample of 205 patients with mild to moderate exacerbation of asthma were enrolled. The participants were randomly assigned to 1 of 2 groups. The first group received 3 doses of albuterol, 5.0 mg aerosolized in 10 L/min of oxygen, 15 minutes apart. The second group received 3 doses of albuterol, 5.0 mg aerosolized in 10 L/min of a 70:30 helium-oxygen mixture (heliox), 15 minutes apart. Peak expiratory flow rate (PEFR), forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1 ) were measured before and after each treatment. Only PEFR and FEV1 were used in data analysis. RESULTS: Although both the heliox and the oxygen group showed significant improvement in PEFR from baseline after 45 minutes (72% and 70%, respectively), the difference between the 2 groups was clinically and statistically insignificant (P =.56). Similar findings were observed for FEV1. There was no difference in rate of admission or rate of complications between the 2 groups. CONCLUSION: Despite its ability to decrease the turbulent flow in airways and to reach distal pulmonary tissues, heliox had no clinically significant advantage over standard therapy in the treatment of mild to moderate asthma. Further large-scale studies are necessary to determine the clinical efficacy of heliox in this setting.

Synergistic effects of ularitide acetate with classical bronchorelaxants on guinea-pig tracheal smooth muscle.

Ularitide (CAS 118812-69-4, urodilatin) is a member of the family of the atrial natriuretic peptides. In the present study, the relaxant effects of ularitide acetate, isoproterenol (isoprenaline) hemisulfate, aminophylline, zaprinast, and different combinations between these drugs were investigated on methacholine chloride-precontracted guinea-pig tracheal smooth muscle. Ularitide acetate was a weaker bronchorelaxant than isoproterenol hemisulfate and aminophylline. Moreover the relaxation induced by ularitide acetate was reversible, while the relaxation induced by isoproterenol hemisulfate, aminophylline, and zaprinast was irreversible. Combinations between in each case two of these substances were overadditive, if the phosphodiesterase-inhibiting component was applicated before the combination partner. Their effects were only additive, if the combination partners were applicated simultaneously. All combinations between ularitide acetate and isoproterenol hemisulfate, aminophylline, or zaprinast respectively relaxed the tracheas irreversibly. These results suggest that ularitide acetate might be a novel partner for classical bronchorelaxants in potent bronchorelaxing combinations in the therapy of asthma bronchiale.

Comparison of the effects of ularitide acetate and other bronchorelaxing substances on the thrombin-induced permeability raise of human endothelial cell monolayers.

Endothelial cell contraction plays a pivotal role in vascular leakage. It increases the extravasation of fluid and macromolecules from the lumen into the interstitium. This is also true for bronchial edema. Previous studies have indicated that an elevation of intracellular adenosine-3',5'-cyclic monophosphate (cAMP) or guanosine-3',5'-cyclic monophosphate (cGMP), respectively, can counteract this vascular leakage by improving the endothelial barrier function in analogy to the relaxation of smooth muscle cells. To investigate the potential antiedemateous effects of ularitide acetate (CAS 115966-23-9), isoproterenol hemisulfate (CAS 6078-56-4), sodium nitroprusside (CAS 13755-38-9, SNP), aminophylline (CAS 317-34-0), and combinations of these compounds, their effects on thrombin-induced macromolecular permeability raise in relation to cGMP- or cAMP-levels, respectively, in a model of human umbilical vein endothelial cells (HUVECs) were examined. Ularitide acetate, isoproterenol hemisulfate, and SNP all increased the amount of cyclic nucleotides and decreased the raise in permeability in the following order of potency: isoproterenol hemisulfate > ularitide acetate > SNP. Aminophylline raised both cGMP- and cAMP-levels in a weaker amount and was not able to decrease the thrombin-induced permeability raise on its own. By way of contrast, preincubation of HUVECs with aminophylline resulted in a more than additive potentiation of the cGMP-levels and the permeability lowering induced by ularitide-acetate. These in vitro-data indicate that ularitide-acetate, especially in combination with phosphodiesterase (PDE) inhibitors, could probably have beneficial effects in bronchial permeability edema.

Vocational outcome of aphasic patients following severe traumatic brain injury.

The incidence and course of aphasia, and its impact on vocational outcome, were determined in a group of 351 patients with severe traumatic brain injury (TBI). Aphasia was found in 11.1%, the common forms being amnestic (56%, 22/39), expressive (10.3%, 4/39) and receptive (10.5%, 8/39), as found on the first language assessment. No age difference was found between the aphasic and non-aphasic patients. Coma was more common in the aphasics than the non-aphasics (95% and 82%, respectively), although its mean duration was shorter. Aphasics had more severe locomotor deficits (p < 0.01, Fisher test) and tended towards more severe cognitive disorders (p = 0.07, Fisher test). There was no difference between the groups in incidence of behavioural disturbances or occupational outcome. Most of the aphasic patients improved after therapy, and two recovered completely. The presence of aphasia did not have negative prognostic implications for occupational outcome.