The enhancing effects of testosterone in exposure treatment for social anxiety disorder: a randomized proof-of-concept trial

Individuals with a social anxiety disorder (SAD) show hypofunctioning of the hypothalamus–pituitary-gonadal (HPG) axis, which is linked to social fear and avoidance behavior. As testosterone administration has been shown to facilitate social-approach behavior in this population, it may enhance the effectiveness of exposure treatment. In this proof-of-concept study, we performed a randomized clinical assay in which 55 women diagnosed with SAD received two exposure therapy sessions. Session 1 was supplemented with either testosterone (0.50 mg) or placebo. Next, transfer effects of testosterone augmentation on within-session subjective fear responses and SAD symptom severity were assessed during a second, unenhanced exposure session (session 2) and at a 1-month follow-up, respectively. The participants having received testosterone showed a more reactive fear pattern, with higher peaks and steeper reductions in fear levels in session 2. Post-hoc exploration of moderating effects of endogenous testosterone levels, revealed that this pattern was specific for women with high basal testosterone, both in the augmented and in the transfer session. In contrast, the participants with low endogenous testosterone showed reduced peak fear levels throughout session 1, again with transfer to the unenhanced session. Testosterone did not significantly affect self-reported anxiety. The effects of testosterone supplementation on fear levels show transfer to non-enhanced exposure, with effects being modulated by endogenous testosterone. These first preliminary results indicate that testosterone may act on important fear mechanisms during exposure, providing the empirical groundwork for further exploration of multi-session testosterone-enhanced exposure treatment for SAD.

Using The Rotary International´s Platform to Create Long-Term Skills Transfer and Vocational Training Opportunities for Cancer Care in Bangladesh

Background and context: Rotary International (RI) is an international service organization whose stated purpose is to bring together business and professional leaders to provide humanitarian services, encourage high ethical standards in all vocations, and to advance goodwill and peace around the world. The Rotary Club of Dhaka Mavericks, with the notion to work on cancer care has partnered with an US-based organization to bring cancer care specialists from the US. These 2 partners mainly work with the National Institute of Cancer Research and Hospital, the government-owned tertiary level cancer care and research institute in Bangladesh, to transfer the skills and provide vocational training to Bangladeshi oncologists, nurses and allied health professionals by oncologists, nurses and allied health professionals from the US. Aim: The overall aim of this project is to create a cadre of cancer care professionals - oncologists, nurses and allied health professionals - in Bangladesh who would have the vocational skills through on-the-job training and skills transfer session from experienced and skilled oncologists, nurses and allied health professionals from the US. Strategy/Tactics: The international platform of RI has been used to reach out to a US-based not-for-profit organization Partners for World Health. This US-based organization has sourced in cancer care professionals from the US and brought them to Bangladesh using the partnership of 1 rotary club in the US and another rotary club in Dhaka. Later on, these 2 Rotary Clubs and Partners for World Health collaborated with the National Institute of Cancer Research and Hospital, where this long-term skills transfer and vocational sessions are taking place. Program process: In this partnership, the Rotary Clubs and the US-based organization arranged all necessary funding and relevant permission and accreditation, while the National Institute of Cancer Research and Hospital patients - who were served - and oncologists, nurses and allied health professionals - who were trained. Outcomes: This partnership is currently for 5 years starting from October of 2017. The plan is to have 2-week vocational and skills transfer session every 6 months. The first session took place in October of 2017 and the second one on March of 2018. The third session will take place on October of 2018. In the October 2018 session, total 100 doctors and 35 nurses were trained on US standard cancer treatment protocols and chemotherapy administration. Number of complicated surgical techniques were also taught to the Bangladeshi surgeons by the US team. During the March session, the focus was on radiation oncology. A total of 100 radiation oncologists were trained on March of 2018.

The impact of cerebellar transcranial direct current stimulation (tDCS) on learning fine-motor sequences

The cerebellum has been shown to be important for skill learning, including the learning of motor sequences. We investigated whether cerebellar transcranial direct current stimulation (tDCS) would enhance learning of fine motor sequences. Because the ability to generalize or transfer to novel task variations or circumstances is a crucial goal of real world training, we also examined the effect of tDCS on performance of novel sequences after training. In Study 1, participants received either anodal, cathodal or sham stimulation while simultaneously practising three eight-element key press sequences in a non-repeating, interleaved order. Immediately after sequence practice with concurrent tDCS, a transfer session was given in which participants practised three interleaved novel sequences. No stimulation was given during transfer. An inhibitory effect of cathodal tDCS was found during practice, such that the rate of learning was slowed in comparison to the anodal and sham groups. In Study 2, participants received anodal or sham stimulation and a 24 h delay was added between the practice and transfer sessions to reduce mental fatigue. Although this consolidation period benefitted subsequent transfer for both tDCS groups, anodal tDCS enhanced transfer performance. Together, these studies demonstrate polarity-specific effects on fine motor sequence learning and generalization. This article is part of the themed issue ‘New frontiers for statistical learning in the cognitive sciences’.

Automated Data Collection with a Tecnai 12 Electron Microscope for Applications in Structural Biology

In high-resolution biological electron microscopy, the speed of collection of large numbers of micrographs of the required quality is a rate-limiting step in the overall process of structure determination. Approaches to speed up data collection can be very useful especially in “single molecule” microscopy of large multi-protein and protein-nucleic acid complexes, where many thousands of individual molecular images need to be averaged to determine the threedimensional structure.Here, we report the development of an automated low-dose image acquisition procedure on a Tecnai 12 electron microscope using the scripting functionality available on the microscope computer. The program that we have developed and implemented, AutoEM, is presently aimed at providing automation capabilities for the user familiar with normal operation of the microscope. However, the user’s participation is relatively minimal, and involves the following steps. After preparing a specimen grid and inserting it into the microscope as is normal for a cryo transfer session, the user simply downloads a Low-Dose alignment file that contains information on the relative beam shifts between the Search, Focus and Exposure modes that would normally be employed in a manual low-dose data collection experiment.

Aging and Retention of Newly Acquired Skill: Does Performance Predict Retention of Underlying Learning?

In this study, we evaluated age-related decay characteristics of the learning supporting skilled performance. We directly assessed the retention of performance and learning associated with skilled visual search. Ninety older (63 to 79 yrs.) and 90 younger (19 to 25 yrs.) adults received 6300 trials of consistent semantic category search. A transfer session assessed automatic process development. After either 2, 4, or 8 weeks participants returned for retention testing. At retention we evaluated trained performance, learning associated with strength of attention training (AARs), and optimal feature search. For young adults, the AAR declined but remained strong even after eight weeks of disuse. Older adults exhibited minimal automatic activation strength before and (not surprising) after the retention interval. However, when retention performance not supported by AARs was examined (learning due to the development of optimal search) age-related effects were minimized. Contrary to other learning domains, older adults' retention performance was less affected than young adults' by the interfering processing activity performed prior to the retention interval. Issues of instructional and system design are discussed as mechanisms to promote age-dependent retention of skilled performance.