Investigating the Influence of Preoperative Trans Arterial Embolization (TAE) and Predictive Potential of Circulating Tumor Cells (CTCs) in Prognosis of Hepatocellular Carcinoma.

Introduction: Circulating tumor cells are a promising biomarker in many malignancies. CTC dissemination during the operative procedure can lead to disease recurrence. The effect of preoperative transarterial embolization on the release of CTCs and miRNA panels and oncological outcomes in large hepatocellular carcinomas has been evaluated. Materials and methods: The study included non-metastatic HCC >5 cm in size, that were completely resected after TAE (n = 10). Blood was collected pre-TAE, post-TAE, postoperative (day 2,30 and 180) and analyzed for the presence of CTC and miRNA (miR-885-5p, miR-22-3p, miR-642b-5p). The samples were subjected to CTC enrichment, isolation and staining using the markers CD45, EpCAM, and cytokeratin (CK). The data was analyzed using Gene Expression Suite software. Results: The CTC enumeration resulted in three groups: Group 1- CTC present at both pre-TAE and postoperative day 30 (n = 4), Group 2- CTC present at pre-TAE and clearing at postoperative day 30 (n = 2), Group 3- No CTC detected at any stages (n = 3). Group 2 patients had better survival compared with the other groups. Downregulation of miRNA 22-3p also had favorable prognostic implications. Conclusion: Although preoperative TAE does not seem to impact CTC shedding, CTC clearance may prove to be a valuable biomarker in prognosticating HCC. A larger study to evaluate the significance of CTCs as a prognostic marker is warranted to further evaluate these findings.

Interpretations of ambiguous situations in combat veterans with and without post-traumatic stress disorder.

Deployed combat personnel are at increased risk of post-traumatic stress disorder (PTSD). People with PTSD often judge ambiguous information as negative or threatening (interpretation bias). However, this may be adaptive during deployment. The current study aimed to investigate the extent to which interpretation bias in combat personnel is associated with PTSD symptoms, rather than with appropriate situational awareness. Combat veterans with and without PTSD and civilians without PTSD generated explanations for ambiguous situations and judged the likelihood of various possible explanations. They also made judgements about future consequences of worst-case scenarios, and their coping ability. Veterans with PTSD generated more negative explanations for ambiguous situations, judged negative interpretations as more likely and felt less able to cope with the worst-case scenario than veteran and civilian controls. Veterans with versus without PTSD judged worst-case scenarios to have more severe and insurmountable consequences, although they did not differ significantly from civilians. Veteran versus civilian controls rated their coping ability as higher; this was the only difference between control groups. In summary, group differences in interpretation bias were associated with PTSD symptoms rather than combat role. Veterans without PTSD may be particularly resilient when coping with everyday adversity.

Cognitive biases in military personnel with and without PTSD: a systematic review.

BACKGROUND: Some cognitive biases, such as excessive attention to threat, are associated with PTSD. However, they may be adaptive for military personnel; attending to threat may improve safety for deployed personnel. AIMS: The extent to which military personnel with vs. without PTSD differ with respect to specific cognitive biases is currently unclear. This systematic review aimed to address this question. METHODS: PRISMA guidelines were followed. Articles were identified using a comprehensive literature search; 21 studies (with 1977 participants) were reviewed. RESULTS: All studies were of "moderate" or "strong" quality. Military personnel with vs. without PTSD used overgeneralised language when describing autobiographical memories and demonstrated impaired performance on a modified Stroop task. Studies using dot-probe paradigms conceptualised attentional response as a dynamic process, fluctuating between bias towards and away from threat; military personnel with vs. without PTSD demonstrated greater fluctuation. Studies using visual search tasks concluded that attentional bias in PTSD involves interference (difficulty disengaging from threat) rather than facilitation (enhanced threat detection). Finally, personnel with vs. without PTSD demonstrated interpretation bias, completing ambiguous sentences with negative rather than neutral endings. CONCLUSION: The implications for military populations and recommendations for further research and clinical practice are considered. PROSPERO REGISTRATION: PROSPERO 2018 CRD42018092235.

Thinking about other's mistakes: contrasting patterns of performance in groups high or low in autistic or psychopathic traits.

Introduction: Counterfactual thinking refers to thoughts such as, "What if … ?" or "If only … " that hypothesise about how past events might have turned out differently. It is a functional process, allowing us to reflect upon and solve problems, and to evoke appropriate responses. It is thought to involve both cognitive and emotional processes, and is linked to the development of false belief and moral emotions. Methods: The present study compared responses to a novel task, "Counterfactual Judgments", in students who scored high or low on self-report measures of autistic or psychopathic traits, two conditions putatively associated with deficits in empathy. Results: Contrasting patterns of performance were revealed: those with high versus low autistic traits gave harsher ratings of blame for others' mistakes and showed reduced sensitivity to punitive counterfactual alternatives, whereas those with high versus low psychopathic traits gave lower ratings for moral judgments of regret and guilt. A self-report questionnaire measure of empathy also provided some evidence of reduced empathic processing in both the high trait groups. Conclusions: The findings are considered in the light of the possible contributions of cognitive versus emotional processes to counterfactual thinking. The possible implications for managing social dysfunction in clinical populations are also discussed.

Derailing the trolley: Everyday utilitarian judgments in groups high versus low in psychopathic traits or autistic traits.

Moral decision-making has been linked with empathy. The present study built on previous work examining the relationship between psychopathy or autism spectrum disorder (ASD), two conditions putatively associated with deficits in empathy, and utilitarian decision-making. Students scoring high on self-report measures of psychopathic or autistic traits were presented with a novel task, 'Utilitarian Judgments', and compared to low trait control groups. This study replicated the classic finding that more direct links between the agents' actions and harm to victims mitigated utilitarian decision-making. It also found that participants made more utilitarian decisions when outcomes involved extreme physical versus everyday social harm. Enhanced utilitarian decision-making was not observed in those scoring high for either psychopathic or autistic traits, although both high trait groups reported that they would experience less discomfort than their low trait counterparts. Verbal reasoning differences were observed for the high autistic trait group, but not the high psychopathic trait group. The dilemmas that have been typically used to explore utilitarian decision-making describe extreme, hypothetical events involving physical or serious emotional harm. The present findings suggest that this might limit the generalisability of the existing literature and over-emphasise the tendency to make utilitarian decisions when considering everyday dilemmas.

The influence of subclinical psychopathic traits on responding to others' awkward requests.

INTRODUCTION: Psychopathy is characterised by a postulated deficit in emotional empathy, with intact cognitive empathy. Although studies have examined performance on laboratory tasks within incarcerated populations, there is a paucity of work exploring how subclinical psychopathic traits translate into everyday social interactions. METHODS: The present study investigated this by screening 502 university students with the Psychopathic Personality Inventory and comparing 20 high-scoring (10F; mean age = 19.85 years) and 19 low-scoring (15F; mean age = 21.00 years) participants on their responses to the Social Strategy Task. This comprises social scenarios that each end with an awkward request posed by the main character. Participants provided verbal responses and rated the awkwardness of each situation. Verbal responses were classified into positive or negative social strategies, denoting the extent of compliance with requests. RESULTS: The groups were compared using analysis of variance and t-tests. The high psychopathic trait group used fewer positive social strategies than the low group was less polite in emotional tone and perceived situations as less awkward. CONCLUSIONS: The findings are considered in relation to the postulated dissociation between intact cognitive empathy and impaired emotional empathy. The potential implications for clinical interventions are briefly discussed.

Great Expectations: The Role of Rules in Guiding Pro-social Behaviour in Groups with High Versus Low Autistic Traits.

Measuring autistic traits in the general population has proven sensitive for examining cognition. The present study extended this to pro-social behaviour, investigating the influence of expectations to help others. A novel task describing characters in need of help was administered to students scoring high versus low on the Autism-Spectrum Quotient. Scenarios had two variants, describing either a 'clear-cut' or 'ambiguous' social rule. Participants with high versus low autistic traits were less pro-social and sympathetic overall towards the characters. The groups' ratings of characters' expectations were comparable, but those with high autistic traits provided more rule-based rationales in the clear-cut condition. This pattern of relatively intact knowledge in the context of reduced pro-social behaviour has implications for social skill training programmes.

Going 'above and beyond': are those high in autistic traits less pro-social?

Few studies have explored how the cognitive differences associated with autistic spectrum disorder translate into everyday social behaviour. This study investigated pro-social behaviour in students scoring high and low on the autism-spectrum quotient (AQ), using a novel scenario task: 'Above and Beyond'. Each scenario involved an opportunity to behave pro-socially, and thus required balancing the needs of a character against participants' own interests. High AQ participants both generated responses and selected courses of action that were less pro-social than those of the low AQ group. For actions of low pro-social value they gave higher self-satisfaction ratings; conversely, they gave lower self-satisfaction ratings for high pro-social actions. The implications for everyday functioning are considered for those with high autistic traits.