What drives ‘drug-induced homicide’ prosecutions in North Carolina?

Peer-Reviewed Publication

NORTH CAROLINA STATE UNIVERSITY

A new study finds that prosecutors in North Carolina believe “drug-induced homicide” (DIH) laws are effective at both reducing drug overdoses in a community and curtailing the distribution of illicit drugs. These beliefs are worth noting because there is no evidence to support them, while there is evidence that DIH prosecutions make people in affected communities less likely to call 911 – and may actually increase the number of overdoses in a community.

DIH laws, also called “death by distribution” or “delivery resulting in death” laws, allow prosecutors to treat unlawful drug distribution as equivalent to homicide or manslaughter if someone using the drug dies of an overdose. DIH laws have been around since the 1980s, but there has been a significant increase in DIH prosecutions since the beginning of the opioid epidemic. More than two dozen states, including North Carolina, have DIH laws on the books. In North Carolina, 337 DIH cases were filed from 2015 through 2022.

“One reason we’re interested in DIH cases from a public health standpoint is because there’s strong evidence that prosecuting people under these laws reduces the likelihood that people in relevant communities will call emergency services when someone overdoses,” says Jennifer Carroll, co-author of the paper and an assistant professor of anthropology at North Carolina State University. “And there is emerging evidence – from North Carolina – that DIH prosecutions may increase the likelihood of overdoses and overdose deaths in relevant communities.”

“We wanted to know how North Carolina prosecutors view these laws in order to better understand what drives their decision making on when and whether to pursue charges under the state’s DIH law,” says Brandon Morrissey, first author of the paper and a Ph.D. student at NC State.

For the study, researchers sent surveys to district attorneys and assistant district attorneys across North Carolina. The survey was designed to collect information on factors that inform prosecutorial decisions about whether to file a DIH case, as well as the impact the prosecutors believe these cases have on affected communities. Of the more than 300 prosecutors contacted, the researchers received 24 responses, from attorneys responsible for prosecutions in 42% of North Carolina’s prosecutorial districts.

“Study participants overwhelmingly felt that DIH prosecutions reduce the likelihood of fatal overdoses in their districts, and that the prosecutions prevent or deter illicit drug distribution in their districts,” says Morrissey.

“This finding is worth highlighting because there is no evidence to support either of those beliefs, while there is evidence that the opposite is true – at least in regard to overdoses and calling 911,” says Carroll.

“We also found that the factors which are normally predictive of prosecutions for any crime don’t seem to apply when it comes to DIH prosecutions,” Carroll says. “For example, in general, the number of assistant district attorneys in a jurisdiction is normally predictive of the number of prosecutions in that jurisdiction. That doesn’t seem to be the case when it comes to DIH. The number of DIH prosecutions also doesn’t correlate to community-level variables, such as the number of overdoses or overdose deaths in a community. This creates significant uncertainty as to what drives prosecutorial decision-making regarding DIH.

“This study was exploratory, but it’s concerning that so many survey respondents are making decisions about DIH prosecutions based – at least in part – on a belief that these prosecutions improve public health and safety by preventing overdoses,” Carroll says. “The available evidence suggests this could not be further from the truth.”

“Moving forward, there would be real value in expanding this work to learn more about DIH prosecutorial decision making in other jurisdictions,” says Morrissey.

The paper, “Prosecuting overdose: An exploratory study of prosecutorial motivations for drug-induced homicide prosecutions in North Carolina,” is published in International Journal of Drug Policy. The paper was co-authored by Taleed El-Sabawi, an assistant professor of law at Florida International University.

The work was done with support from the National Institute on Drug Abuse, under grant number 1K01DA057414-01A1; and from the Justice Community Opioid Innovation Network’s Learning Experiences to Advance Practice program.

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JOURNAL

International Journal of Drug Policy

DOI

10.1016/j.drugpo.2024.104344 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Prosecuting overdose: An exploratory study of prosecutorial motivations for drug-induced homicide prosecutions in North Carolina

 

New product development shapes firms and the economy

New research from the University of California San Diego’s School of Global Policy and Strategy evaluates product life cycles and compares them to firm growth

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - SAN DIEGO

Understanding product life cycles plays an important role in the innovation arms race, helping to define firm growth and market competition.

Products experience a substantial decline in sales after an initial period of growth, a trend that is consistent across various industries and product types.

“By examining the life cycle of a wide cross-section of products, we can see the role product performance plays in shaping firm and economic growth,” said Munseob Lee, assistant professor of economics at the University of California San Diego School of Global Policy and Strategy.

Lee and his fellow researchers, Yale University’s David Argente and Northwestern University’s Sara Moreira, had a unique approach to their study. Rather than looking at durable goods like personal computers, they used a retail scanner to examine a broad range of everyday products, including nondurable goods, such as cereals and drinks, and semidurable goods, such as razors and lamps.

The team built a dynamic model highlighting the innovation-obsolescence cycle, where firms need to introduce new products to grow; otherwise, their portfolios become obsolete as rivals introduce their own new products.

Two major processes impacted this decline. “Business stealing,” where competing firms introduce similar but more enticing products, and “cannibalization,” where firms introduce new versions of their own products and reduce their sales. The interplay between these two types of innovation shapes the growth of firms and the economy.

Firms experience a smooth and moderate growth of about 2% a year. However, this decline conceals massive product reallocation. New products account for a positive contribution of 12% to this growth, and the lagging sales of existing products account for a decrease of 10%.

“The conventional view is that product sales follow a bell-shaped curve,” Lee said. “Our research shows that product sales experience a steady decline throughout the greater part of the product life cycle, declining on average 30% per year between the first and fourth year of activity.”

This debate emphasizes the critical role that nonprice strategies play in shaping the modern competitive environment. When business stealing is relatively prevalent, firms will find it more profitable to respond by introducing a new product than by reducing the prices of existing products.

The paper, “The Life Cycle of Products: Evidence and Implications” was also co-authored by Yale University’s David Argente and Northwestern University’s Sara Moreira.

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JOURNAL

Journal of Political Economy

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The Life Cycle of Products: Evidence and Implications

 

Shrinking technology, expanding horizons

Compact chips advance precision timing for communications, navigation and other applications

Peer-Reviewed Publication

NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY (NIST)

 

IMAGE: 

NIST RESEARCHERS TEST A CHIP FOR CONVERTING LIGHT INTO MICROWAVE SIGNALS. PICTURED IS THE CHIP, WHICH IS THE FLUORESCENT PANEL THAT LOOKS LIKE TWO TINY VINYL RECORDS. THE GOLD BOX TO THE LEFT OF THE CHIP IS THE SEMICONDUCTOR LASER THAT EMITS LIGHT TO THE CHIP.

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CREDIT: K. PALUBICKI/NIST

The National Institute of Standards and Technology (NIST) and its collaborators have delivered a small but mighty advancement in timing technology: compact chips that seamlessly convert light into microwaves. This chip could improve GPS, the quality of phone and internet connections, the accuracy of radar and sensing systems, and other technologies that rely on high-precision timing and communication.

This technology reduces something known as timing jitter, which is small, random changes in the timing of microwave signals. Similar to when a musician is trying to keep a steady beat in music, the timing of these signals can sometimes waver a bit. The researchers have reduced these timing wavers to a very small fraction of a second — 15 femtoseconds to be exact, a big improvement over traditional microwave sources — making the signals much more stable and precise in ways that could increase radar sensitivity, the accuracy of analog-to-digital converters and the clarity of astronomical images captured by groups of telescopes.   

The team's results were published in Nature. 

Shining a Light on Microwaves

What sets this demonstration apart is the compact design of the components that produce these signals. For the first time, researchers have taken what was once a tabletop-size system and shrunken much of it into a compact chip, about the same size as a digital camera memory card. Reducing timing jitter on a small scale reduces power usage and makes it more usable in everyday devices.

Right now, several of the components for this technology are located outside of the chip, as researchers test their effectiveness. The ultimate goal of this project is to integrate all the different parts, such as lasers, modulators, detectors and optical amplifiers, onto a single chip.  

By integrating all the components onto a single chip, the team could reduce both the size and power consumption of the system. This means it could be easily incorporated into small devices without requiring lots of energy and specialized training.

“The current technology takes several labs and many Ph.D.s to make microwave signals happen,” said Frank Quinlan, NIST physical scientist. “A lot of what this research is about is how we utilize the advantages of optical signals by shrinking the size of components and making everything more accessible.”

To accomplish this, researchers use a semiconductor laser, which acts as a very steady flashlight. They direct the light from the laser into a tiny mirror box called a reference cavity, which is like a miniature room where light bounces around. Inside this cavity, some light frequencies are matched to the size of the cavity so that the peaks and valleys of the light waves fit perfectly between the walls. This causes the light to build up power in those frequencies, which is used to keep the laser’s frequency stable. The stable light is then converted into microwaves using a device called a frequency comb, which changes high-frequency light into lower-pitched microwave signals. These precise microwaves are crucial for technologies like navigation systems, communication networks and radar because they provide accurate timing and synchronization.

“The goal is to make all these parts work together effectively on a single platform, which would greatly reduce the loss of signals and remove the need for extra technology,” said Quinlan. “Phase one of this project was to show that all these individual pieces work together. Phase two is putting them together on the chip.”

 In navigation systems such as GPS, the precise timing of signals is essential for determining location. In communication networks, such as mobile phone and internet systems, accurate timing and synchronization of multiple signals ensure that data is transmitted and received correctly. 

For example, synchronizing signals is important for busy cell networks to handle multiple phone calls. This precise alignment of signals in time enables the cell network to organize and manage the transmission and reception of data from multiple devices, like your cellphone. This ensures that multiple phone calls can be carried over the network simultaneously without experiencing significant delays or drops. 

In radar, which is used for detecting objects like airplanes and weather patterns, precise timing is crucial for accurately measuring how long it takes for signals to bounce back.

“There are all sorts of applications for this technology. For instance, astronomers who are imaging distant astronomical objects, like black holes, need really low-noise signals and clock synchronization,” said Quinlan. “And this project helps get those low noise signals out of the lab, and into the hands of radar technicians, of astronomers, of environmental scientists, of all these different fields, to increase their sensitivity and ability to measure new things.”

Working Together Toward a Shared Goal

Creating this type of technological advancement is not done alone. Researchers from the University of Colorado Boulder, the NASA Jet Propulsion Laboratory, California Institute of Technology, the University of California Santa Barbara, the University of Virginia, and Yale University came together to accomplish this shared goal: to revolutionize how we harness light and microwaves for practical applications.

“I like to compare our research to a construction project. There’s a lot of moving parts, and you need to make sure everyone is coordinated so the plumber and electrician are showing up at the right time in the project,” said Quinlan. “We all work together really well to keep things moving forward.”

This collaborative effort underscores the importance of interdisciplinary research in driving technological progress, Quinlan said.

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Paper: Igor Kudelin et al. Photonic chip-based low noise microwave oscillator. Nature. Published online March 6, 2024. DOI: 10.1038/s41586-024-07058-z

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JOURNAL

Nature

DOI

10.1038/s41586-024-07058-z 

ARTICLE TITLE

Photonic chip-based low-noise microwave oscillator

ARTICLE PUBLICATION DATE

6-Mar-2024

 

UTA educating schoolchildren about solar eclipse

NSF funds will also support space research related to once-in-a-lifetime event

Grant and Award Announcement

UNIVERSITY OF TEXAS AT ARLINGTON

 

IMAGE: 

YUE DENG, A PROFESSOR OF SPACE PHYSICS AT UTA AND THE LEAD RESEARCHER ON THE NSF GRANT

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CREDIT: COURTESY UT ARLINGTON

The University of Texas at Arlington has received a grant from the National Science Foundation (NSF) to support educational activities related to the upcoming eclipse.

UTA faculty and graduate students are visiting elementary, middle and high schools in the DFW area in March to give talks to about 4,000 students explaining the natural phenomena occurring during the eclipse and the physics behind it. UTA will also provide special eclipse glasses for students to use to avoid eye damage.

The $50,000 grant will also provide for about 1,500 students to take field trips to the UTA Planetarium, one of the three largest in Texas, to learn about the eclipse prior to the April 8 event. Schools typically cover the cost of renting of school buses, but the grant will help support districts that do not have the funds for transportation.

On April 8, Dallas-Fort Worth-Arlington will be the largest metropolitan area in the United States in the path of the “totality” of a rare total solar eclipse. During the four-minute totality (when the moon completely blocks the sun), the entire sky will go completely dark.

UTA is hosting a “Solarbration” event on campus that is open to the public. Visitors can look through UTA’s professional telescopes to see the sky although the eclipse will be viewable to the naked eye.

“This will be wonderful opportunity to help students appreciate more than just four minutes of darkness in the middle of the day, but also understand the space science and the celestial mechanics behind the event,” said Yue Deng, a professor of space physics at UTA and the lead researcher on the NSF grant. “Additionally, awareness of the eclipse may spark students’ curiosity in STEM when they see the dynamic change of the sun’s corona, how the wind is affected when the moon blocks the sun and how changes to the ionospheric density during the eclipse affect things they use every day, like cellphones and mapping tools.”

The grant also provides support for a two-and-a-half-day workshop for the science community to travel to Arlington for the eclipse on April 8 and stay until April 10. At the workshop, more than 100 space scientists will come together to discuss the eclipse and the various multi-scale phenomena occurring due to it.

“Solar eclipses are treated as natural laboratory experiments for ionospheric physics because of their predictive nature,” Deng said. “With UTA’s prime location to view this rare event, this workshop will be a wonderful chance to take measurements and discuss the impacts, especially as it relates to anything relying on space satellites, such as cellphones, television broadcasts and internet services.”

 

“Thank you for the excellent work you all do here"

The German Federal Minister of Health, Karl Lauterbach, visited IQWiG and thanked the staff for their commitment

Meeting Announcement

INSTITUTE FOR QUALITY AND EFFICIENCY IN HEALTH CARE

He sees new tasks ahead for the Institute.

The German Federal Minister of Health, Karl Lauterbach, addressed around 150 employees of the Institute for Quality and Efficiency in Health Care (IQWiG) who attended a meeting with him: "You all make a valuable contribution to efficient, more evidence-based health care in Germany. Without your good work, we would run the risk of new treatments being introduced into the health care system too quickly and without careful evaluation. This does not only apply to drugs. Thank you for the excellent work you all do here.”

IQWiG's future is just beginning

IQWiG will celebrate its 20th anniversary this autumn. During his visit to Cologne, Karl Lauterbach recalled that, as an advisor to the then Federal Minister of Health, Ulla Schmidt, he was directly involved in the establishment of IQWiG in 2004: "Our basic idea at the time was to build something that would act as a kind of heart chamber for evidence-based medicine in the transfer of new scientific findings into the health care of people with statutory health insurance. This has been successful. IQWiG has developed very well, but is still in its infancy. Medical progress will continue to accelerate. There will be more and more new procedures and more and more new drugs - IQWiG's future is just beginning. Those who work at IQWiG are fortunate to have a meaningful and future-proof job for society.”

Earlier in the day, Karl Lauterbach held small expert discussions on current topics, including the European health technology assessment (HTA) of newly approved drugs and medical devices, which will start in 2025. He predicted: "IQWiG will continue to play an important role at the European level in the future and will therefore continue to grow in importance, also internationally."

IQWiG's Director, Thomas Kaiser, thanked Karl Lauterbach for his visit and for his receptiveness to IQWiG's proposals: "The Minister's appreciation of IQWiG's work was very well received by all our staff. This also applies to the support for future tasks, where we will be increasingly active in the area of evidence generation and at the European level. I would like to thank the Minister for both.”

Industrious communities can create cheaters, even in bacteria

Bacterial colonies fail to reach their potential when cooperative growth creates opportunities for laziness

DUKE UNIVERSITY
:

THE COLORFUL PATTERNS ARE PROOF THAT BACTERIA AND HUMANS AREN’T ALL THAT DIFFERENT — BOTH HARBOR INDIVIDUALS THAT WILL TAKE THE EASY WAY OUT WHEN GIVEN THE CHANCE. AND THAT LIFESTYLE CAN QUICKLY SPREAD TO THE DETRIMENT OF ALL. THE BACTERIA SHOWN HERE, PSEUDOMONAS AERUGINOSA, LOST THEIR ABILITY TO GROW INTO LARGE COLONIES WHEN CULTURED ON GROWTH PLATES OVER MULTIPLE GENERATIONS. THIS WAS BECAUSE WHEN GROWN ON RELATIVELY LARGE FLAT SURFACES, OPPORTUNITIES AROSE FOR SOME OF THE CELLS TO SIMPLY LET THEIR NEIGHBORS CREATE THE SLIPPERY SURFACTANT REQUIRED TO SPREAD EXPAND. AND WHEN THE SAME SCENARIO WAS PRESENTED OVER AND OVER AGAIN, THESE SO-CALLED “CHEATERS” BECAME MORE AND MORE COMMON, UNTIL THE COLONIES NO LONGER PRODUCED ENOUGH SLIPPERY SURFACTANT TO SPREAD EFFECTIVELY

JOURNAL

Nature Microbiology

DOI

10.1038/s41564-024-01627-8

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Cells

ARTICLE TITLE

The collapse of cooperation during range expansion of Pseudomonas aeruginosa

ARTICLE PUBLICATION DATE

5-Mar-2024

 

Why some RNA drugs work better than others

Peer-Reviewed Publication

COLD SPRING HARBOR LABORATORY

Spinal muscular atrophy, or SMA, is the leading genetic cause of infant death. Less than a decade ago, Cold Spring Harbor Laboratory (CSHL) Professor Adrian Krainer showed this brutal disease can be treated by tweaking a process called RNA splicing. This breakthrough resulted in Spinraza, the first effective treatment for SMA. It also opened a new frontier in drug development. Now, CSHL research could push RNA-splicing drugs even further. CSHL Associate Professor Justin Kinney, Krainer, and postdoc Yuma Ishigami have figured out why some splicing-based drugs tend to work better than others.

RNA splicing determines which gene segments are used to build a protein. Krainer had designed Spinraza to home in on the exact spot where the drug would modify the production of a specific protein SMA patients need. Not all splice-modifying drugs are so intentionally constructed. Some have been found to change RNA splicing without scientists fully understanding how. That’s true for a recently approved SMA drug, risdiplam.

To better understand how this drug works, the Kinney and Krainer labs analyzed risdiplam’s interactions with RNA. They also examined RNA’s interaction with another drug, branaplam. The researchers measured the drugs’ effects on splicing throughout the genome and on hundreds of variations of their intended targets. From there, they modeled how each drug identifies its targets among all RNA inside a cell.

Both risdiplam and branaplam alter RNA splicing to generate the protein needed to treat SMA. However, the researchers found that risdiplam is more specific. Their quantitative models explain how. In the simplest terms, branaplam binds to RNA in two different ways—whereas risdiplam only binds in one way. This finding could help researchers alter the chemical structure of branaplam so that it might someday treat Huntington’s disease—a fatal, currently incurable neurodegenerative disorder.

The researchers also found something else. Combining splice-modifying drugs that target the same gene segment in different ways usually has a greater effect than either drug alone.

“You get synergistic interactions,” Kinney explains. “We found synergy is a general property of splice-modifying drugs. This might provide a basis for using drug cocktails instead of individual drugs.”

The finding could help researchers identify drug combinations with the potential to improve patient outcomes. And that could lead to new therapeutic strategies for SMA and other diseases. For example, the Krainer lab recently investigated RNA splicing in pancreatic cancer.

“Our new study provides insights into the action and specificity of splice-modifying drugs,” Krainer says. “This should facilitate the development of more effective drugs and drug combinations for a variety of diseases.”

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JOURNAL

Nature Communications

DOI

10.1038/s41467-024-46090-5 

 

Patience pays off

Peer-Reviewed Publication

DEUTSCHES PRIMATENZENTRUM (DPZ)/GERMAN PRIMATE CENTER

 

IMAGE: 

A RHESUS MONKEY RETRIEVES FOOD PELLETS FROM A FOOD BOX IN AN EXPERIMENTAL ROOM.

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CREDIT: NEDA SHAHIDI, XAQ PITKOW

In a new study, neuroscientists show how decision-making processes are controlled in the primate brain during foraging. The team, including a researcher from the German Primate Center (DPZ) – Leibniz Institute for Primate Research in Göttingen, trained two rhesus monkeys to search for food in an experimental room. The animals were able to move freely and receive food pellets from two food boxes by pressing a button. In the course of the experiment, the monkeys learned that the amount of pellets dispensed from the boxes increased the longer they waited until the next button was pressed. If they were not rewarded with pellets after pressing the button, the monkeys waited longer the next time or switched to the other box. During the experiment, the researchers measured the neuronal activity in the front part of the brains of the two monkeys and decomposed it with the help of a mathematical model. By decoding monkeys’ reward expectations from the neural activity, they were able to predict how long the rhesus monkeys were willing to wait for a higher reward and when they decided to choose another option. The results advance our understanding of self-paced actions, eventually contributing to a better understanding of neurological diseases such as Parkinson's (Nature Neuroscience).

Imagine a fisherman on a boat casting fish traps into a murky lake. To be successful, he has to check the traps regularly. But when is the best time to do this? If he checks the traps too often, it is unnecessary work and he scares the fish away. If he checks too late, he has a better chance, but may be wasting time. It is also tiring to paddle from one trap to another to check them one after the other, so the fisherman has to keep deciding whether and when it is worthwhile.

For decades, neuroscientists have been trying to understand how we manage to make the best possible decisions. Due to technical limitations, researchers have so far had to rely on experiments in which monkeys perform tasks on computer screens while the activity of their brain cells is measured. The animals are trained to sit still in a chair and are therefore restricted in their natural freedom of movement. Since it is now possible to wirelessly record the activity of several individual nerve cells, decision-making in scenarios with natural movement sequences can be investigated.

For the study, a team of researchers from Germany and the USA trained two rhesus monkeys to explore an experimental room with two button-controlled food boxes. Each time the monkeys pressed a button on one of the boxes, they had the chance to receive food pellets. The two boxes were set in such a way that the time intervals between the individual food dispenses became longer and longer during an experimental run. The longer the monkeys waited until they pressed the button again, the more pellets they received.

“When we started the experiment, we expected that our monkeys would simply choose the box based on how successful they had been with that box before,” explains first author Neda Shahidi, now a junior research group leader at the Collaborative Research Center 1528 at the University of Göttingen and the German Primate Center in Göttingen. “After a while, however, they had learned to pay attention to the time since the last keystroke and also to their previous success at a box. If they had waited a while but not received any pellets, they waited even longer before pressing the next time. However, if they were not rewarded too many times in a row after pressing the button, they moved to the other box. They had apparently decided that this food box was not worth the wait and it was better to look elsewhere.”

To analyze the underlying neuronal processes, the researchers wirelessly recorded the activity of 96 neurons in the prefrontal cortex. This brain area is involved in the control of goal-directed behavior and is activated in many aspects of the foraging task, for example in the evaluation of options, the expectation of a reward, the preparation of actions, and the perception of the outcome.

“However, characterizing the activity patterns of individual neurons does not always reveal the whole story when we study complex decision-making processes,” Shahidi explains. “Complex behaviors consist of different components that are sometimes processed simultaneously in the same brain area.” To separate these components, the researchers developed a mathematical model that first identified components of neural activity, mainly consist of groups of neurons that were more strongly active when the animals waited longer before pressing a button or when the button has been more rewarding in last few presses. Since the animals cannot know in advance whether a button press will be rewarded, the researchers assume that these neurons represent the animals' subjective expectations.

The researchers also tested whether the neuronal activity could be used to predict when the animals would press the button and whether they would decide to switch between the boxes. “We were surprised at how well our model could predict what the monkeys would do in the next few seconds,” says Shahidi. “Our results show not only how the development of wireless recording technologies can improve our understanding of brain mechanisms in natural movement scenarios, but also how advances in data science are transforming neuroscience by extracting the computational components of the brain from the collective activity of neurons. We hope that in the long term, such advances will help to better understand abnormalities in cognitive processes such as self-pacing in Parkinson's or self-initiating actions in apathy” says Shahidi.

A rhesus macaque in the animal husbandry at the German Primate Center reaching out for the snow, a natural action similar to the action of the monkeys in the experiment reaching out for the food pellets.

CREDIT

Karin Tilch

JOURNAL

Nature Neuroscience

DOI

10.1038/s41593-024-01575-w 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Population coding of strategic variables during foraging in free-moving macaques

ARTICLE PUBLICATION DATE

5-Mar-2024

 

Study reveals unexpected literacy in autistic people who cannot speak

Peer-Reviewed Publication

UNIVERSITY OF VIRGINIA COLLEGE AND GRADUATE SCHOOL OF ARTS & SCIENCES

 

IMAGE: 

UNIVERSITY OF VIRGINIA PROFESSOR OF PSYCHOLOGY VIKRAM JASWAL

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CREDIT: SANJAY SUCHAK

About one-third of autistic people are unable to communicate using speech, and most are never provided an effective alternative. However, a new study from scientists at the University of Virginia suggests that many of these individuals are literate, raising the possibility that they could learn to express themselves through writing.  

 

The study published in the journal Autism, reports that five times more nonspeaking autistic teenagers and adults demonstrated knowledge of written language conventions than would be expected from previous estimates of their abilities. The finding has important implications for the millions of autistic people around the world who have little or no speech and who are often assumed to be incapable of acquiring literacy.  

 

“If we assume that someone who can’t speak doesn’t understand, it limits the doors we open for them – we may not even try to figure out what they understand,” said Vikram Jaswal, Professor of Psychology at the University of Virginia and the lead author of the study. “Our study shows that nonspeaking autistic people’s capacity for language, for learning, and for literacy has been seriously underestimated.”  

 

The investigators addressed a fundamental question about literacy: whether or not nonspeaking autistic people react to letters, words and sentences in the same way as literate, non-autistic individuals. Jaswal’s team developed a method similar to the arcade game Whac-a-Mole which required participants to tap letters displayed on a tablet as soon as those letters lit up. In some instances, the letters lit up in sequences that spelled out sentences that participants had earlier heard spoken aloud, and in other instances the letters lit up in meaningless sequences. The research team, which included Ph.D. candidate Kayden Stockwell and recent graduate Andrew Lampi made the assumption that a literate individual – who knows how to spell and can convert speech into its written form – can predict the next letter in a sentence they have heard spoken aloud even before seeing that letter light up. Consequently, they could be expected to respond faster to the sentences than to meaningless sequences. Jaswal’s team found that over half of the sample group of 31 nonspeaking autistic participants responded in the same way a literate individual would.  

 

According to Jaswal, the results are striking because they show that even though most participants in the study had not received formal instruction in literacy, many had developed an understanding of how written language works.  

 

“Society has traditionally assumed that people who can’t speak are unable to understand language or to learn to read or write,” Jaswal said. “But our findings suggest that many nonspeaking autistic people have foundational literacy skills. With appropriate instruction and support, it might be possible to harness these skills to provide access to written forms of communication as an alternative to speech. Learning to express themselves through writing would open up educational, employment and social opportunities that nonspeaking autistic people have historically not been given access to.”  

 

“This is cutting-edge research with enormous potential for impact,” said Christa Acampora, dean of the College and Graduate School of Arts & Sciences. “We are truly fortunate to have professor Jaswal and outstanding graduate students like Kayden Stockwell and Andrew Lampi in the College's research community. Together, they're asking important questions, and their discovery will have life-changing consequences for many.”  

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JOURNAL

Autism

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Literacy in nonspeaking autistic people

 

Virtual reality exposure plus electric brain stimulation offers a promising treatment for PTSD

Results from a clinical trial show that an innovative combination of two treatments can be an effective, efficient and enduring way to treat post-traumatic stress disorder in military veterans

Peer-Reviewed Publication

BROWN UNIVERSITY

PROVIDENCE, R.I. [Brown University] — Combining two treatments could be a promising option for people, especially military veterans, whose lives are negatively affected by post-traumatic stress disorder, a new study shows.

In a clinical trial conducted among U.S. military veterans at the Providence Veterans Affairs Medical Center, participants who received brain stimulation with a low electrical current during sessions of virtual reality exposure reported a significant reduction in PTSD symptom severity. The results were reported on March 6 in JAMA Psychiatry.

Study author Noah Philip, a professor of psychiatry and human behavior at Brown University’s Warren Alpert Medical School, said the findings are exciting considering existing challenges in treating patients with PTSD.

“This is a different and innovative way of approaching treatment where we’re combining the best aspects of psychotherapy, neuroscience and brain stimulation to help people get better,” said Philip, who leads mental health research at the Providence V.A. Center for Neurorestoration and Neurotechnology. “There's a lot of promise here, and that offers hope.”

PTSD is a common psychiatric disorder characterized by intrusive thoughts and recollections, avoidance of trauma-related stimuli, hyperarousal and disturbed mood, the study noted. Initial PTSD treatments often include trauma-focused exposure therapy and medication.

Yet PTSD is particularly difficult to treat in military veterans, Philip said. Medications have significant adverse effects, and exposure therapy can be difficult to tolerate, since it involves describing highly traumatic experiences repeatedly. Up to 50% of patients drop out of traditional exposure therapy, and others decline to even start it.

For the study, Philip, whose background is in psychiatric research of brain simulation, teamed up with Mascha van 't Wout-Frank, an associate professor of psychiatry and human behavior (research) at the Warren Alpert Medical School who studies the effect of non-invasive brain stimulation on “fear extinction,” or learning that things that are regarded as harmful can actually be safe and can therefore become tolerable. 

“Through exposure therapy, the brain is reprocessing the trauma, and learning that even though the traumatic experience was dangerous, the memories of the traumatic experience, as well as the thoughts and feelings that are conjured up by those memories, are not dangerous — they are safe,” said van 't Wout-Frank, an investigator at the V.A. Providence Center for Neurorestoration and Neurotechnology. “This results in a decline in conditioned fear response.” ”

A leading theory of PTSD posits that the effectiveness of exposure as a therapy is impaired due to ineffective top-down control of the brain’s amygdala by the ventromedial prefrontal cortex and other brain regions. Affected individuals thus have impaired safety learning and memory, which in healthy people is supported by intact brain function, van ‘t Wout-Frank said.

Transcranial direct current stimulation, which involves administering a constant, low, pain-free electrical current to a part of the brain, is well-suited to potentially augment trauma-focused exposure therapy, van ’t Wout-Frank said. The non-invasive current may boost neural activity, facilitating top-down control by the ventromedial prefrontal cortex to improve safety learning.

The research team decided to combine transcranial direct current stimulation with virtual reality exposure, which provides a highly immersive sensory experience including visual, tactile and even olfactory stimuli to simulate real-world environments.

A treatment that accelerates results

To test the combined treatment, the researchers expanded a previous pilot study to conduct a larger, more robust, double-blind study of 54 U.S. military veterans with chronic PTSD. Participants were randomly assigned to receive transcranial direct current stimulation or a sham experience that provided some sensation but not a significant amount or duration of electrical current. In the patients receiving transcranial direct current stimulation, a low (2 milliamp) amount of electricity was targeted to the ventromedial prefrontal cortex during six 25-minute sessions of standardized warzone virtual reality exposure, delivered over two to three weeks.

Participants in the active transcranial direct current stimulation group reported a superior reduction in self-reported PTSD symptom severity at one month. While all participants had meaningful reductions in PTSD symptoms (attributed to the VR procedure), active transcranial direct current stimulation significantly accelerated psychological and physiological adjustment to the virtual reality events between sessions compared with the sham treatment patients.

In the experiment, the virtual reality was generalized to include trauma-inducing elements, but didn’t replicate any one participant’s personal experience.

“It can be difficult for patients to talk about their personal trauma over and over, and that’s one common reason that participants drop out of psychotherapy,” Philip said. “This VR exposure tends to be much easier for people to handle.”

In just two weeks, the combination of electric stimulation plus VR treatment accelerated a process that happens normally during prolonged exposure therapy, but usually takes around 12 weeks to show effects.

What’s more, Philip added, the effects continued to build over time.

“What we found was that people continued to get better after they were done with the treatment, and we started seeing the biggest effects one month later,” Philip said.

The team is continuing to review the study results to better understand how the treatment caused brain changes over time. Future studies would explore a larger group of study participants, a longer follow-up time, and perhaps even the effects of re-treatment.

Other Brown researchers involved with this study included Amanda R. Arulpragasam, M. Tracie Shea and Benjamin D. Greenberg.

This study was supported by grants from the U.S. Department of Veterans Affairs (I01 RX002450, I50 RX002864)

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JOURNAL

JAMA Psychiatry

DOI

10.1001/jamapsychiatry.2023.5661 

METHOD OF RESEARCH

Randomized controlled/clinical trial

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Virtual Reality and Transcranial Direct Current Stimulation for Posttraumatic Stress Disorder A Randomized Clinical Trial

ARTICLE PUBLICATION DATE

6-Mar-2024

COI STATEMENT

Dr. van 't Wout-Frank reported receiving grants from National Institutes of Health (NIH) and personal fees from the US Department of Veterans Affairs (VA) Rehabilitation Research and Development outside the submitted work. Dr Philip reported receiving grants from the VA Clinical Science Research and Development, NIH, Wave Neuro, and Neurolief and personal fees from Motif Neurotech and Pulvinar Neuro outside the submitted work. No other disclosures were reported.