OBJECTIVE: Cognitive deficits that characterize schizophrenia are present in the prodrome, worsen with illness onset, and predict functional outcome. Cognitive dysfunction is thus a critical target for early intervention in young individuals with recent onset schizophrenia. METHOD: This 2-site double-blind randomized controlled trial investigated cognitive training of auditory processing/verbal learning in 86 subjects with recent onset schizophrenia (mean age of 21 years). Subjects were given laptop computers to take home and were asked to perform 40 hours of training or 40 hours of commercial computer games over 8 weeks. We examined cognitive measures recommended by the Measurement and Treatment Research to Improve Cognition in Schizophrenia initiative (MATRICS), symptoms, and functioning. We also assessed baseline reward anticipation to index motivational system functioning and measured changes in auditory processing speed after 20 hours of training to assess target engagement. RESULTS: Auditory training subjects demonstrated significant improvements in global cognition, verbal memory, and problem solving compared with those of computer games control subjects. Both groups showed a slight but significant decrease in symptoms and no change in functional outcome measures. Training-induced cognitive gains at posttraining showed significant associations with reward anticipation at baseline and with improvement in auditory processing speed at 20 hours. CONCLUSION: Neuroscience-informed cognitive training via laptop computer represents a promising treatment approach for cognitive dysfunction in early schizophrenia. An individuals baseline motivational system functioning (reward anticipation), and ability to engage in auditory processing speed improvement, may represent important predictors of treatment outcome. Future studies must investigate whether cognitive training improves functioning and how best to integrate it into critical psychosocial interventions.

Background

Efficiency of coronary CT angiography (CCTA) in clinical practice depends on precise reporting and accurate result interpretation.

Objective

We sought to assess referring clinicians' understanding of patients' coronary artery disease (CAD) severity and to compare satisfactions of the free-form impression (FFI) with satisfactions of the structured impression (SI) section of CCTA reports.

Materials and methods

Fifty clinical CCTA reports from May 2011 to April 2012 were retrospectively selected (25 FFI and 25 SI), to include cases with the entire spectrum of CAD (6 categories encompassing normal, minimal, mild, moderate, severe stenosis, and occlusion). A survey containing only randomized blinded impressions was distributed to 4 cardiologists and 2 cardiac imaging specialists. Clinician interpretation was examined regarding (Q1) worst stenosis severity, (Q2) number of vessels with significant stenosis, and (Q3) the presence of nonevaluable segments. Agreement proportions and Cohen's kappa were evaluated between FFI versus SI. Satisfactions were measured with respect to content, clarity, and clinical effectiveness.

Results

Q1 agreement was excellent for both FFI and SI (by 6 categories: 80% versus 85%; P > .05; kappa: 0.87 versus 0.89; by no CAD versus nonsignificant versus significant CAD: 99% versus 97%; P > .05; kappa: 0.99 versus 0.94). Q2 agreement improved from fair to moderate (53% versus 68%; P = .04; kappa 0.31 versus 0.52). Q3 agreement was moderate (90% versus 87%; P > .05; kappa 0.57 versus 0.58). Satisfactions with impressions were high and similar for FFI and SI for clinicians.

Conclusion

Structured impressions were shown to improve result interpretation agreement from fair to moderate with regard to the number of vessels with significant stenosis.

Dehydration has been a key limiting factor for the operation of conductive hydrogels in practical application. Here, we report self-healable ionic skins that can self-regulate their internal moisture level by capturing extenral moistures via hygroscopic ion-coordinated polymer backbones through antipolyelectrolyte effect. Results show the ionic skin can maintain its mechanical and electrical functions over 16 months in the ambient environment with high stretchability (fracture stretch ∼2216 %) and conductivity (23.5 mS/cm). The moisture self-regulating capability is further demonstrated by repeated exposures to harsh environments such as 200°C heating, freezing, and vacuum drying with recovered conductivity and stretchability. Their reversible ionic and hydrogen bonds also enable self-healing feature as a sample with the fully cut-through damage can restore its conductivity after 24 h at 40 % relative humidity. Utilizing the ionic skin as a building block, self-healing flexible piezoelecret sensors have been constructed to monitor physiological signals. Together with a facile transfer-printing process, a self-powered sensing system with a self-healable supercapacitor and humidity sensor has been successfully demonstrated. These results illustrate broad-ranging possibilities for the ionic skins in applications such as energy storage, wearable sensors, and human-machine interfaces.

The latent reservoir is a major barrier to HIV cure. As latently infected cells cannot be phenotyped directly, the features of the in vivo reservoir have remained elusive. Here, we describe a method that leverages high-dimensional phenotyping using CyTOF to trace latently infected cells reactivated ex vivo to their original pre-activation states. Our results suggest that, contrary to common assumptions, the reservoir is not randomly distributed among cell subsets, and is remarkably conserved between individuals. However, reservoir composition differs between tissues and blood, as do cells successfully reactivated by different latency reversing agents. By selecting 8-10 of our 39 original CyTOF markers, we were able to isolate highly purified populations of unstimulated in vivo latent cells. These purified populations were highly enriched for replication-competent and intact provirus, transcribed HIV, and displayed clonal expansion. The ability to isolate unstimulated latent cells from infected individuals enables previously impossible studies on HIV persistence.