Chiral domain dynamics and transient interferences of mirrored superlattices in nonequilibrium electronic crystals

Mirror symmetry plays a major role in determining the properties of matter and is of particular interest in condensed many-body systems undergoing symmetry breaking transitions under non-equilibrium conditions. Typically, in the aftermath of such transitions, one of the two possible broken symmetry states is emergent. However, synthetic systems and those formed under non-equilibrium conditions may exhibit metastable states comprising of both left (L) and right (R) handed symmetry. Here we explore the formation of chiral charge-density wave (CDW) domains after a laser quench in 1T-TaS2 with scanning tunneling microscopy. Typically, we observed transient domains of both chiralities, separated spatially from each other by domain walls with different structure. In addition, we observe transient density of states modulations consistent with interference of L and R-handed charge density waves within the surface monolayer. Theoretical modeling of the intertwined domain structures using a classical charged lattice gas model reproduces the experimental domain wall structures. The superposition (S) state cannot be understood classically within the correlated electron model but is found to be consistent with interferences of L and R-handed charge-density waves within domains, confined by surrounding domain walls, vividly revealing an interference of Fermi electrons with opposite chirality, which is not a result of inter-layer interference, but due to the interaction between electrons within a single layer, confined by domain wall boundaries.

P85 THE SUPERPOWERS OF A REAL HEART TEAM: TAVR AND PERIOPERATIVE MANAGEMENT OF A PATIENT WITH COREA DISORDER

Aortic stenosis is the most common valve disease in over75 years old patients.Managing the preoperative assessment and the perioperative course could be problematic in frailty patients.Having a real and solid multidisciplinary heart team(MDHT)is essential.This is how we succeeded in optimizing the treatment of 82–year–old patient affected by Huntington‘s disease(HD) and severe symptomatic aortic valve stenosis.HD is an autosomal–dominant progressive neurodegenerative pathology due to an expanded CAG repeat leading to a mutant protein(huntingtin) and it‘s usually characterized by chorea, dystonia, incoordination, and cognitive decline.Life expectancy in people with a late manifestation of the disorder can be long, raising the challenge of the treatment of concomitant pathology.Surgery was not indicated in this old and frail patient, but preoperative diagnostic imaging was compulsory to explore the possibility of transcatheter valve implantation. Chorea unintentional movements and dystonia make standard CTscan and angiographic analysis impossible.At our weekly institutional MDHT, we decided to overcome the technical difficulties putting the patient under general anesthesia. As we all know, multiple or very long sedations can be detrimental in frail patients.Confident in our solid multidisciplinary collaboration, we decided on an all–in–one procedure.On the procedure day, the patient was transferred to the hybrid OR.An anesthesiologist and a dedicated nurse induced the patient to general anesthesia.Intubated and with complete vital sign monitoring, the patient was moved back and forth to radiology to perform the angioCTscan.A cardiac surgeon and an interventional cardiologist analyzed the CT images deciding on a transfemoral 34mm Medtronic Evolut Pro+ bioprosthesis. The coronary angiography was performed with no evidence of significant stenosis. We proceed to commissural alignment and release of the bioprosthesis. The patient was extubated in the OR. Stable neurological status, total anesthesia time 140min. The patient was safely discharged home on the second postoperative day. Treating complex cases require multiple skills, well–established protocol, strong communication, and routine cooperation between all the involved professional figures. Therefore, the multidisciplinary heart team is not just an overused word without real significant;it is the only way to approach cardiovascular pathology in our everyday practice permitting us to have a real patient–centered vision.

Mothers massaging their newborns with lotion versus no lotion enhances mothers' and newborns' sleep

Sleep is frequently interrupted in newborns and their mothers. Massage therapy is noted to facilitate sleep in adults and infants. Infant massage has also been more effective with oil versus no oil. In this study 76 mothers of newborns were randomly assigned to a massage with lotion versus a massage without lotion group and a non-massage control group. The mothers were then taught a simple newborn massage and were asked to massage their newborns daily for 15min at bedtime for one month. The Brief Infant Sleep Questionnaire was adapted for newborns and for mothers, and the mothers completed the questionnaires on their newborns' and their own sleep behaviors (the same behaviors for both mothers and newborns). The 3 groups were compared on the mothers' and their newborns' sleep behavior changes from birth to one month. By the last day of the study, the lotion massage group versus the other two groups showed a shorter latency to sleep and longer sleep for the mothers and fewer nightwakings and longer sleep for their infants. This may relate to the lotion group mothers massaging their infants more frequently as the number of massages was correlated with the total time sleeping and negatively correlated with nightwakings for both the mothers and the infants on the last day of the study. And, the mothers' and the infants' sleep behaviors were significantly correlated.

Ultrafast Optical Control of the Electronic Properties of ZrTe₅

We report on the temperature dependence of the ZrTe(5) electronic properties, studied at equilibrium and out of equilibrium, by means of time and angle resolved photoelectron spectroscopy. Our results unveil the dependence of the electronic band structure across the Fermi energy on the sample temperature. This finding is regarded as the dominant mechanism responsible for the anomalous resistivity observed at T*∼160  K along with the change of the charge carrier character from holelike to electronlike. Having addressed these long-lasting questions, we prove the possibility to control, at the ultrashort time scale, both the binding energy and the quasiparticle lifetime of the valence band. These experimental evidences pave the way for optically controlling the thermoelectric and magnetoelectric transport properties of ZrTe(5).

Knee arthritis pain is reduced and range of motion is increased following moderate pressure massage therapy

BACKGROUND

The literature on massage therapy effects on knee pain suggests that pain was reduced based on self-report, but little is known about range of motion (ROM) effects.

METHODS

Medical School staff and faculty who had knee arthritis pain were randomly assigned to a moderate pressure massage therapy or a waitlist control group (24 per group). Self-reports included the WOMAC (pain, stiffness and function) and the Pittsburgh Sleep Quality Index. ROM and ROM-related pain were assessed before and after the last sessions.

RESULTS

The massage group showed an immediate post-massage increase in ROM and a decrease in ROM-associated pain. On the last versus the first day of the study, the massage group showed greater increases in ROM and decreases in ROM-related pain as well as less self-reported pain and sleep disturbances than the waitlist control group.

DISCUSSION

These data highlight the effectiveness of moderate pressure massage therapy for increasing ROM and lessening ROM-related pain and long-term pain and sleep disturbances.

Massage therapy plus topical analgesic is more effective than massage alone for hand arthritis pain

METHODS

20 adults were randomly assigned to a massage therapy or a massage therapy plus a topical analgesic application group. Both groups received a weekly massage from a therapist and were taught self-massage (same procedure) to be done by each participant once daily over a four-week period.

RESULTS

The massage plus topical analgesic group as compared to the massage group had greater improvement in hand function as measured by a digital hand exerciser following the first session and across the four-week period. That group also had a greater increase in perceived grip strength and a greater decrease in hand pain, depressed mood and sleep disturbances over the four-week period. Massage therapy has been effective for several pain syndromes including migraine headaches (Lawle and Cameron, 2006)), lower back pain (Hsieh et al., 2004), fibromyalgia (Kalichman, 2010), neck and shoulder pain (Kong et al., 2013), carpal tunnel syndrome (Elliott and Burkett, 2013), and pain related to upper limb arthritis (Field et al., 2013). The purpose of the current study was to determine whether applying a topical analgesic following massage might be more effective than massage alone in treating pain associated with hand arthritis.

Tai chi/yoga reduces prenatal depression, anxiety and sleep disturbances

Ninety-two prenatally depressed pregnant women were randomly assigned to a tai chi/yoga or a waitlist control group at an average of 22 weeks gestation. The tai chi/yoga group participated in a 20-min group session per week for 12 weeks. At the end of the treatment period the tai chi/yoga group had lower summary depression (CES-D) scores, as well as lower negative affect and somatic/vegetative symptoms subscale scores on the CES-D, lower anxiety (STAI) scores and lower sleep disturbances scores.

Yoga and massage therapy reduce prenatal depression and prematurity

Eighty-four prenatally depressed women were randomly assigned to yoga, massage therapy or standard prenatal care control groups to determine the relative effects of yoga and massage therapy on prenatal depression and neonatal outcomes. Following 12 weeks of twice weekly yoga or massage therapy sessions (20 min each) both therapy groups versus the control group had a greater decrease on depression, anxiety and back and leg pain scales and a greater increase on a relationship scale. In addition, the yoga and massage therapy groups did not differ on neonatal outcomes including gestational age and birthweight, and those groups, in turn, had greater gestational age and birthweight than the control group.

Potential underlying mechanisms for greater weight gain in massaged preterm infants

In this paper, potential underlying mechanisms for massage therapy effects on preterm infant weight gain are reviewed. Path analyses are presented suggesting that: (1) increased vagal activity was associated with (2) increased gastric motility, which, in turn, was related to (3) greater weight gain; and (4) increased IGF-1 was related to greater weight gain. The change in vagal activity during the massage explained 49% of the variance in the change in gastric activity. And, the change in vagal activity during the massage explained 62% of the variance in the change in insulin. That the change in gastric activity was not related to the change in insulin suggests two parallel pathways via which massage therapy leads to increased weight gain: (1) insulin release via the celiac branch of the vagus; and (2) increased gastric activity via the gastric branch of the vagus.

Preterm infant massage therapy research: a review

In this paper, preterm infant massage therapy studies are reviewed. Massage therapy has led to weight gain in preterm infants when moderate pressure massage was provided. In studies on passive movement of the limbs, preterm infants also gained significantly more weight, and their bone density also increased. Research on ways of delivering the massage is also explored including using mothers versus therapists and the added effects of using oils. The use of mothers as therapists was effective in at least one study. The use of oils including coconut oil and safflower oil enhanced the average weight gain, and the transcutaneous absorption of oil also increased triglycerides. In addition, the use of synthetic oil increased vagal activity, which may indirectly contribute to weight gain. The weight gain was associated with shorter hospital stays and, thereby, significant hospital cost savings. Despite these benefits, preterm infant massage is only practiced in 38% of neonatal intensive care units. This may relate to the underlying mechanisms not being well understood. The increases noted in vagal activity, gastric motility, insulin and IGF-1 levels following moderate pressure massage are potential underlying mechanisms. However, those variables combined do not explain all of the variance in weight gain, highlighting the need for additional mechanism studies.

Prenatal depression effects and interventions: a review

This review covers research on the negative effects of prenatal depression and cortisol on fetal growth, prematurity and low birthweight. Although prenatal depression and cortisol were typically measured at around 20 weeks gestation, other research suggests the stability of depression and cortisol levels across pregnancy. Women with Dysthymia as compared to Major Depression Disorder had higher cortisol levels, and their newborns had lower gestational age and birthweight. The cortisol effects in these studies were unfortunately confounded by low serotonin and low dopamine levels which in themselves could contribute to non-optimal pregnancy outcomes. The negative effects of depression and cortisol were also potentially confounded by comorbid anxiety, by demographic factors including younger age, less education and lower SES of the mothers and by the absence of a partner or a partner who was unhappy about the pregnancy or a partner who was depressed. Substance use (especially caffeine use) was still another risk factor. All of these problems including prenatal depression, elevated cortisol, prematurity and low birthweight and even postpartum depression have been reduced by prenatal massage therapy provided by the women's partners. Massage therapy combined with group interpersonal psychotherapy was also effective for reducing depression and cortisol levels. Several limitations of these studies were noted and suggestions for future research included exploring other predictor variables like progesterone/estriol ratios, immune factors and genetic determinants. Further research is needed both on the potential use of cortisol as a screening measure and the use of other therapies that might reduce prenatal depression and cortisol in the women and prematurity and low birthweight in their infants.

Depressed mothers and infants are more relaxed during breastfeeding versus bottlefeeding interactions: brief report

Depressed and non-depressed mothers and their 3-month-old infants were videotaped during breastfeeding and bottlefeeding interactions. The videotapes were subsequently coded for a number of feeding interaction behaviors as well as being rated on the Interaction Rating Scales. No differences were noted between the depressed and non-depressed mothers. Several breastfeeding versus bottlefeeding group effects were observed. The breastfeeding mothers showed less burping and less intrusive behavior during the nipple-in periods as well as during the nipple-out periods. In addition, the breastfeeding mothers and their infants received better ratings on the Interaction Rating Scales. These data suggest that the depressed mothers and their infants not unlike the non-depressed mothers and their infants were benefited by breastfeeding.

Impact of OncoType DXTM Recurrence Score and Tumor Size on Making Chemotherapy Decisions in Breast Cancer Patients

Background: Oncotype DXTM is a 21 gene assay that calculates recurrence score(RS) and recurrence risk(RR) over 10 years. Despite the contention that this genomic assay is more accurate than tumor size(TS) and age in predicting outcome, these factors continue to have major impact in decision-making regarding chemotherapy(CT). We analyzed the impact of TS, RS, and age on the decision to give CT.Methods: An IRB-approved chart review of 105 lymph node(LN) negative patients with ER+ T1 and T2 tumors was performed, reviewing age, RS, TS, CT history, Her-2 status, and pathology. RS was low(0-17), intermediate(18-30), or high(>30). TS was divided into T1a(0.1-0.5 cm), T1b(0.51–1.0 cm), T1c(1.1–2.0 cm), and T2(2.1-5.0 cm).Results: Mean patient age was 60.9 years(range 35-82 years). Average(AVG) RS was 20.9; AVG RR at 10 years, 13.6%. Mean TS was 1.5 cm(median 1.3 cm). Overall, 29 patients(27.6%) received CT; 76(72.4%) did not. AVG TS for CT patients was 1.8cm, AVG RS was 29.5, and AVG age was 56.4(range 35-75). Non-CT patients' AVG TS was 1.4cm; AVG RS, 17.7; AVG age, 62.6(range 44-86). 9 patients(8.5%) had T1a tumors with an AVG RS of 19.1, and no patient received CT. 25(23.8%) had T1b tumors with an AVG RS of 21.0, and 5(20.0%) received CT. 51(48.6%) had T1c tumors with an AVG RS of 20.4, and 15(29.4%) received CT. 20(19.0%) had T2 tumors with an AVG RS of 23.1; 9(45.0%) received CT. 41 patients(39.0%) had low RS: 4(9.8%) received CT; 37(90.2%) did not. AVG TS and RS were 1.6cm and 15.0 respectively for CT patients, and 1.5cm and 11.6 for no CT patients. 49 patients(46.7%) had intermediate RS: 13(26.5%) received CT; 36(73.5%) did not. AVG TS and RS were 1.9cm and 22.7 for CT patients; 1.3cm and 22.2 for no CT patients. 15 patients(14.3%) had high RS: 12(80.0%) received CT; 3(20.0%) did not. AVG TS and RS were 1.7cm and 44.7 for CT patients; 1.3cm and 39.3 for no CT patients. 10 patients were Her-2+, 5 with high, 4 with intermediate, and 1 with low RS. 7 had CT. 5 of the 15(33.3%) high RS patients were Her-2+. AVG RS for the Her-2+ patients was 36.2, and AVG TS was 1.9cm. AVG RS was 19.3 for the non-Her-2+ patients. 16 patients were <50 years old. AVG TS was 1.5cm and AVG RS was 24.2. 8 received CT and 8 did not. 89 patients were ≥50. AVG TS was 1.5cm and AVG RS was 20.3. 21(23.6%) received CT and 68 did not. Discussion: AVG RS was 20.9 for all T stages. Overall, 27.6% of patients received CT. Of the 64 with RS>18, only 25(39.1%) received CT; 4(9.8%) of low RS patients still received CT. Patients with larger tumors and younger age were more likely to receive CT. Neither RS, TS, nor age alone seemed to influence the final decision. Multiple factors are still considered by oncologists when making CT decisions, and conversely, patients may not accept CT despite high RS.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6039.

Comorbid depression and anxiety effects on pregnancy and neonatal outcome

The effects of comorbid depression and anxiety were compared to the effects of depression alone and anxiety alone on pregnancy mood states and biochemistry and on neonatal outcomes in a large multi-ethnic sample. At the prenatal period the comorbid and depressed groups had higher scores than the other groups on the depression measure. But, the comorbid group had higher anxiety, anger and daily hassles scores than the other groups, and they had lower dopamine levels. As compared to the non-depressed group, they also reported more sleep disturbances and relationship problems. The comorbid group also experienced a greater incidence of prematurity than the depressed, the high anxiety and the non-depressed groups. Although the comorbid and anxiety groups were lower birthweight than the non-depressed and depressed groups, the comorbid group did not differ from the depressed and anxiety groups on birth length. The neonates of the comorbid and depressed groups had higher cortisol and norepinephrine and lower dopamine and serotonin levels than the neonates of the anxiety and non-depressed groups as well as greater relative right frontal EEG. These data suggest that for some measures comorbidity of depression and anxiety is the worst condition (e.g., incidence of prematurity), while for others, comorbidity is no more impactful than depression alone.

Pregnancy massage reduces prematurity, low birthweight and postpartum depression

Pregnant women diagnosed with major depression were given 12 weeks of twice per week massage therapy by their significant other or only standard treatment as a control group. The massage therapy group women versus the control group women not only had reduced depression by the end of the therapy period, but they also had reduced depression and cortisol levels during the postpartum period. Their newborns were also less likely to be born prematurely and low birthweight, and they had lower cortisol levels and performed better on the Brazelton Neonatal Behavioral Assessment habituation, orientation and motor scales.

PRENATAL MATERNAL BIOCHEMISTRY PREDICTS NEONATAL BIOCHEMISTRY

Depressed (n = 45) and nondepressed (n = 47) mothers were recruited prenatally at an ultrasound clinic. Their urine samples were assayed for cortisol, catecholamines (norepinephrine, epinephrine, dopamine) and serotonin. Their urines were assayed again at the neonatal period, and their newborns' urines were also assayed at that time. The depressed versus the nondepressed mothers showed significantly higher cortisol and norepinephrine and significantly lower dopamine levels across the pre- and postnatal assessments. At the postnatal assessment all levels had decreased except the serotonin levels for both groups. Regression analyses on the mother's postnatal biochemistry with the prenatal biochemistry entered as predictor variables showed highly significant, specific relationships between each of the catecholamines, cortisol, and serotonin. The newborn's biochemistry (except for epinephrine) was higher than the maternal biochemistry. Regression analyses on the neonatal biochemistry with the mother's prenatal biochemistry entered as predictor variables also suggested highly significant, specific relationships. The continuity between the mother's and the newborn's neurotransmitter/ neurohormone profiles and data showing that elevated norepinephrine and cortisol predict to low birthweight and prematurity, respectively, highlight the importance of assessing these levels during pregnancy.

Lavender Fragrance Cleansing Gel Effects on Relaxation

Alertness, mood, and math computations were assessed in 11 healthy adults who sniffed a cosmetic cleansing gel with lavender floral blend aroma, developed to be relaxing using Mood Mapping. EEG patterns and heart rate were also recorded before, during, and after the aroma session. The lavender fragrance blend had a significant transient effect of improving mood, making people feel more relaxed, and performing the math computation faster. The self-report and physiological data are consistent with relaxation profiles during other sensory stimuli such as massage and music, as reported in the literature. The data suggest that a specific cosmetic fragrance can have a significant role in enhancing relaxation.

Phase II study of AVR118 in the management of cancer related anorexia/cachexia

e20631

Background: AVR118 represents a new class of cytoprotective drugs in managing symptoms associated with anorexia\/ cachexia. In a previous study in patients with advanced HIV-AIDS, an improvement in appetite, strength and alertness was noted. The precise mechanism of action is not understood, but activity may be related to AVR118's adenosine based components. Other active components include guanosine and branched chain amino acids leucine and valine. Objective: To determine the effect of AVR118 on appetite, early satiety and nutritional intake in patients with advanced cancer. Secondary endpoints include changes in performance status, lean muscle mass and quality of Life (QOL). Methods: Eligible adult patients received 4.0 ml of AVR118 subcutaneous daily injections. Patients underwent bi-monthly evaluations during the 28 day initial treatment (phase A) Evaluations included Karnofsky performance status, Edmonton Symptoms Assessment Scale (ESAS), Patient Generated Subjective Global Assessment (PG-SGA), Simmonds Functional Assessment, Dyspepsia Symptom Severity Index, Weight, Lean Body Mass, skin fold thickness and grip strength. Patients who benefited from phase A could elect to continue with therapy (phase B). Results: Currently, of 16 enrolled patients 7 have completed phase A. All 7 patients chose to continue with AVR118 treatment (phase B). Improvements in anorexia and PG-SGA scores were seen in 7/7 and 6/7 patients respectively. Weight stabilization or gain was observed in 5/7 patients. All other parameters showed no significant difference. There was AVR118 has been well tolerated and no serious side effects have been reported. Conclusions: Based on these positive results, the primary endpoints have been achieved and the study will be expanded from 14 to 30 patients.

[Table: see text]

Depressed mothers' infants are less responsive to faces and voices

A review of our recent research suggests that infants of depressed mothers appeared to be less responsive to faces and voices as early as the neonatal period. At that time they have shown less orienting to the live face/voice stimulus of the Brazelton scale examiner and to their own and other infants' cry sounds. This lesser responsiveness has been attributed to higher arousal, less attentiveness and less "empathy." Their delayed heart rate decelerations to instrumental and vocal music sounds have also been ascribed to their delayed attention and/or slower processing. Later at 3-6 months they showed less negative responding to their mothers' non-contingent and still-face behavior, suggesting that they were more accustomed to this behavior in their mothers. The less responsive behavior of the depressed mothers was further compounded by their comorbid mood states of anger and anxiety and their difficult interaction styles including withdrawn or intrusive interaction styles and their later authoritarian parenting style. Pregnancy massage was effectively used to reduce prenatal depression and facilitate more optimal neonatal behavior. Interaction coaching was used during the postnatal period to help these dyads with their interactions and ultimately facilitate the infants' development.

Depressed pregnant black women have a greater incidence of prematurity and low birthweight outcomes

Pregnant black depressed women were compared to pregnant black non-depressed women on self-report stress measures and cortisol levels at mid and late pregnancy and on neonatal outcomes. The depressed women had higher anxiety, anger, daily hassles, sleep disturbance scores and cortisol levels at both prenatal visits. These higher stress levels may have contributed to the greater incidence of prematurity and low birthweight neonatal outcomes noted in the depressed group, and they may partially explain the higher rate of prematurity and low birthweight among black women.

Breakup distress in university students

A sample of 192 university students who had experienced a recent breakup of a romantic relationship was divided into high versus low score groups based on the Breakup Distress Scale. Females had higher Breakup Distress Scale scores. The group who had high Breakup Distress Scale scores reported having less time since the breakup occurred, did not initiate the breakup, reported that the breakup was sudden and unexpected, felt rejected and betrayed, and had not yet found a new relationship. They also scored higher on the Intrusive Thoughts Scale, on the Difficulty Controlling Intrusive Thoughts Scale, on The Sleep Disturbance Scale, and on the depression (CES-D) and anxiety scales (STAI). In a regression analysis, the most important predictors of the Breakup Distress scores were the depression score (CES-D), the feeling of being betrayed by the breakup, shorter time since the breakup occurred, and a higher rating of the relationship prior to the breakup. This explained as much as 37% of the variance, suggesting that these factors are important contributors to relationship breakup distress.

Prenatal dysthymia versus major depression effects on early mother-infant interactions: a brief report

Maternal dysthymia and major depression effects on mother-infant interactions were assessed when the infants were 3-months-old. The dysthymia group mothers spent less time smiling, touching and imitating their infants and more time moving their infants' limbs. The infants of the dysthymia group mothers spent less time smiling and more time showing distress behaviors.

Use of Barcelona Test for cognitive assessment of patients with schizophrenia

INTRODUCTION

In recent years different neuropsychological batteries have been developed to assess cognitive performance in schizophrenia. However, no test has been validated in Spanish for this purpose. The Barcelona Test has been one of the tests used. This present article has aimed to present a specific neurocognitive battery for schizophrenia by selecting specific subtests from the Barcelona Test. Normative data for patients with schizophrenia are presented and the influence of a number of variables is taken into account.

METHODS

The sample included 209 patients. The relationship between cognitive performance and gender, age, educational level, age of onset, duration of illness and symptomatology were assessed. Symptomatology was collected with the Positive and Negative Syndrome Scale for Schizophrenia.

RESULTS

More of the 50% of the sample had cognitive impairment when compared with standardized percentile scores of the Barcelona Test. No significant relationships between cognitive performance and variables assessed were found, except for in the educational level. Thus, percentile scores for the total sample and for the sample in terms of educational level were obtained.

CONCLUSIONS

The high percentage of patients with cognitive impairment when standardized percentile scores were used reinforces the need to use normative data appropriate for the schizophrenia group. The lack of relationship between cognitive performance and the variables assessed supports the hypothesis that cognitive impairment is a core feature in schizophrenia.

Vagal activity, early growth and emotional development

A review of the research on infant vagal tone suggests that vagal activity is associated with both infant growth and infant socioemotional development. Vagal activity has been noted to increase following the stimulation of pressure receptors as in massage therapy. Vagal activity, in turn, stimulates gastric motility which mediates weight gain in infants. Vagal activity has also been notably elevated during synchronous mother-infant interactions and positive affect, providing confirmatory data for the Porges "social engagement system" model. In contrast, low vagal activity has been noted in prenatally depressed mothers (and prenatally angry and anxious mothers) and their infants, as well as in children with autism. These studies highlight the relations between vagal activity and the social behaviors of attentiveness, facial expressions and vocalizations.

Lavender bath oil reduces stress and crying and enhances sleep in very young infants

Very young infants were given a bath with or without lavender-scented bath oil. The mothers in the lavender bath oil group were more relaxed, smiled and touched their infants more during the bath. Their infants looked at them a greater percentage of the bath time and cried less and spent more time in deep sleep after bath. The cortisol levels of this group of mothers and infants significantly decreased, confirming the behavioral data showing increased relaxation of the mothers and their infants. These findings support a body of research showing the relaxing and sleep-inducing properties of lavender aroma.

Preterm infants show reduced stress behaviors and activity after 5 days of massage therapy

Preterm infants residing in an NICU were randomly assigned to a massage therapy or to a control group. The preterm infants in the massage therapy group received three 15-min massages each day for 5 consecutive days, with the massages consisting of moderate pressure stroking to the head, shoulders, back, arms and legs and kinesthetic exercises consisting of flexion and extension of the limbs. Infant stress behaviors and activity were recorded on the first and last day of the study. Preterm infants receiving massage therapy showed fewer stress behaviors and less activity from the first to the last day of the study. The findings suggest that massage has pacifying or stress reducing effects on preterm infants, which is noteworthy given that they experience numerous stressors during their hospitalization.

Massage therapy reduces pain in pregnant women, alleviates prenatal depression in both parents and improves their relationships

Prenatally depressed women (N=47) were randomly assigned to a group that received massage twice weekly from their partners from 20 weeks gestation until the end of pregnancy or a control group. Self-reported leg pain, back pain, depression, anxiety and anger decreased more for the massaged pregnant women than for the control group women. In addition, the partners who massaged the pregnant women versus the control group partners reported less depressed mood, anxiety and anger across the course of the massage therapy period. Finally, scores on a relationship questionnaire improved more for both the women and the partners in the massage group. These data suggest that not only mood states but also relationships improve mutually when depressed pregnant women are massaged by their partners.

Depressed mothers' newborns show less discrimination of other newborns' cry sounds

Newborns' crying in response to the cry of another newborn has been called an empathetic response. The purpose of this study was to determine whether newborns of depressed mothers showed the same response. Newborns of depressed and non-depressed mothers were presented with cry sounds of themselves or other infants, and their sucking and heart rate were recorded. The newborns of non-depressed mothers responded to the cry sounds of other infants with reduced sucking and decreased heart rate. In contrast, the newborns of depressed mothers did not show a change in their sucking or heart rate to the cry sounds of other infants. This lesser attentiveness/responsiveness to other infants' cry sounds may predict their later lack of empathy.

Sleep disturbances in depressed pregnant women and their newborns

Pregnant women (N=253) were recruited during their second trimester of pregnancy (M=22.3 weeks gestation) and assigned to depressed (N=83) and non-depressed groups based on a SCID diagnosis of depression. They were then given self-report measures on sleep disturbance, depression, anxiety and anger, and their urine was assayed for norepinephrine and cortisol. These measures were repeated during their third trimester (M=32.4 weeks). Their newborns were then observed during sleep. During both the second and third trimesters, the depressed women had more sleep disturbances and higher depression, anxiety and anger scores. They also had higher norepinephrine and cortisol levels. The newborns of the depressed mothers also had more sleep disturbances including less time in deep sleep and more time in indeterminate (disorganized) sleep, and they were more active and cried/fussed more.

Prenatal paternal depression

Prenatal depressive symptoms, anxiety, anger and daily hassles were investigated in 156 depressed and non-depressed pregnant women and their depressed and non-depressed partners (fathers-to-be). Depressed versus non-depressed fathers had higher depression, anxiety and daily hassles scores. Although the pregnant women in general had lower anxiety, anger and daily hassles scores than the men, the scores on the measures for depressed fathers and depressed mothers did not differ. Paternal depression appeared to have less effect than maternal depression on their partners' scores. However, the similarity between the scores of depressed mothers and depressed fathers highlights the importance of screening for depression in fathers-to-be as well as mothers-to-be during pregnancy.

Instrumental and vocal music effects on EEG and EKG in neonates of depressed and non-depressed mothers

Neonates (M age=16 days) born to depressed and non-depressed mothers were randomly assigned to hear an audiotaped lullaby of instrumental music with vocals or without vocals. Neonatal EEG and EKG were recorded for 2min (baseline) of silence and for 2min of one or the other music presentation. Neonates of non-depressed mothers showed greater relative right frontal EEG asymmetry to both types of music, suggesting a withdrawal response. Neonates of depressed mothers on the other hand showed greater relative left frontal EEG asymmetry to the instrumental without vocal segment, suggesting an approach response, and greater relative right frontal EEG asymmetry to the instrumental with vocal segment, suggesting a withdrawal response. Heart rate decelerations occurred following the music onset for both groups of infants, however, compared to infants of non-depressed mothers, infants of depressed mothers showed a delayed heart rate deceleration, suggesting slower processing and/or delayed attention. These findings suggest that neonates of depressed and non-depressed mothers show different EKG and EEG responses to instrumental music with versus without vocals.

[Insight, neurocognition and psychopathology in schizophrenia]

INTRODUCTION

In recent years, research has been aimed at finding variables mediating between neurocognition and psychosocial functioning in schizophrenia, proposing insight as one of these variables. Some authors have found associations between insight and functional outcome, and between insight and symptomatology, although these associations remain unclear. These different findings could be explained by the insight definition used. The current study evaluates insight unidimensionally and multidimensionally and studies its relationship with cognitive and psychopathological variables.

METHODS

The sample consisted of 94 subjects admitted to an outpatient Psychosocial Rehabilitation Program, all diagnosed of schizophrenia according to ICD-10 diagnostic criteria. A brief version of the Neuropsychology Battery Test Barcelona and the Wisconsin Card Sorting Test were used to evaluate cognitive variables. The Positive and Negative Syndrome Scale (PANSS) was used to evaluate psychopathology. Insight was assessed with the PANSS item ((lack of judgment and insight)), and with a semi-structured interview.

RESULTS

Two insight factors were found, one including more specific knowledge about the disease and its consequences (cognitive factor), that is related to executive functions, and another referring to unspecific knowledge about suffering from an illness and the need for treatment (psychotic factor). Each factor was statistically related to positive symptoms and superior cognitive functions.

CONCLUSIONS

These findings support a relationship between insight and low cognitive performance.

Prenatal depression effects on the fetus and newborn: a review

A review of research on prenatal depression effects on the fetus and newborn suggests that they experience prenatal, perinatal and postnatal complications. Fetal activity is elevated, prenatal growth is delayed, and prematurity and low birthweight occur more often. Newborns of depressed mothers then show a biochemical/physiological profile that mimics their mothers' prenatal biochemical/physiological profile including elevated cortisol, lower levels of dopamine and serotonin, greater relative right frontal EEG activation and lower vagal tone. Elevated prenatal maternal cortisol is the strongest predictor of these neonatal outcomes. Moderate pressure massage can alleviate these effects including reducing prematurity.

Greater arousal and less attentiveness to face/voice stimuli by neonates of depressed mothers on the Brazelton Neonatal Behavioral Assessment Scale

Neonates born to depressed (n=44) versus non-depressed (n=43) mothers were compared on individual items of the Brazelton Neonatal Behavioral Assessment Scale (NBAS). The neonates of depressed mothers received lower scores on orienting to the live face/voice stimulus and on the alertness items, suggesting they were less attentive. They also scored less optimally on the cuddliness and hand-to-mouth activity items, suggesting they were more aroused. These data lend support to the model that infants of depressed mothers are more aroused and less attentive.

Stability of mood states and biochemistry across pregnancy

Four hundred and thirty pregnant women were recruited during their second trimester of pregnancy (M=20 weeks). They were designated depressed (N=172) or nondepressed (N=258) on the Structured Clinical Interview of Depression (SCID) and the Center for Epidemiological Studies Depression scale (CES-D). They were given a second assessment when they were approximately 32 weeks gestational age. At both assessments they were given self-report measures (CES-D, the State Anxiety Inventory, and the State Anger Inventory) and provided urine samples for assays of cortisol, catecholamines (norepinephrine, epinephrine and dopamine) and serotonin. They were also given the VITAS scale for lower back pain and leg pain and a sleep disturbance scale. The stability of mood states and biochemistry across pregnancy (20 and 32 weeks) were assessed inasmuch as mood states, and biochemistry have been noted to predict prematurity and low birthweight. Significant correlations were noted for all variables except serotonin. Relationships between mood states and biochemistry were also noted but only between cortisol and depression, cortisol and anxiety, and epinephrine and anxiety. Significant stability was noted between the 20-week measures and the 32-week measures including depression, anxiety, anger, and cortisol. These were, in turn, correlated with each other and with, low back pain, leg pain, and sleep disturbance. These data suggest the stability of mood states and cortisol across pregnancy.

Prenatal cortisol, prematurity and low birthweight

Three hundred depressed pregnant women were recruited at approximately 20 weeks gestation. They were then divided by a median split into high and low urinary cortisol level groups. The high cortisol group had higher CES-D depression scores and higher inhibition (BIS) scores prenatally. Their fetuses had smaller head circumference, abdominal circumference, biparietal diameter and fetal weight. The high cortisol group neonates were shorter gestational age and lower birthweight and they had lower Brazelton habituation and higher Brazelton reflex scores. Discriminant function analyses suggested that cortisol levels more accurately classified short gestation and low birthweight groups than CES-D depression scores.