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Neurobiological Mechanisms of aggression modulated by acute threat in Mental Disorders
No full textThis project examines how acute threat modulates aggressive behavior in individuals with aggression-related mental disorders (AMD), using a translational and multimodal research approach. Aggression is a significant symptom in various psychiatric conditions, and understanding its neurobiological underpinnings is essential for developing targeted interventions. The project focuses on how the Negative Valence System (NVS), particularly threat processing, influences aggression and decision-making under provocation.
The core experimental framework combines fMRI (Functional magnetic resonance imaging) and proton magnetic resonance spectroscopy (¹H-MRS) to investigate neurofunctional and neurochemical markers of aggression. Participants will perform the anger-infused Ultimatum Game (ai-UG) under both threat and safe conditions, using the Threat-of-Shock (ToS) paradigm to simulate acute threat. The ai-UG is designed to provoke anger through unfair monetary offers, allowing assessment of aggression-related behaviors during neuroimaging.
Functional MRI will measure brain activation and connectivity, especially in regions like The ventromedial prefrontal cortex (vmPFC) and The anterior cingulate cortex (ACC), which are involved in emotion regulation and aggression. MRS will quantify glutamate and GABA concentrations in these same areas both before and after the task, providing insight into trait- and state-related neurochemical changes. The study benefits from 7T imaging, offering enhanced resolution for detecting neurotransmitter levels. Psychometric data (e.g., OAS-M, STAXI) and subjective ratings of emotional states (anger, fear, happiness, sadness) will complement the neuroimaging results.
Translationally, the study incorporates a rodent model using highly aggressive or impulsive recombinant inbred mouse lines from a parallel project. These animals will undergo 9.4T MRS in comparable brain regions to examine neurochemical parallels with human data.
Expected outcomes include a better understanding of how acute threat influences aggressive behavior across species, identification of aggression-related biosignatures (including glutamate/GABA profiles), and foundational data for developing personalized therapeutic interventions, including future neurofeedback approache
The development of emotional dynamics in emerging adulthood: a longitudinal EMA examination of change and the predictive role of psychological resources
No full textEmotion regulation continues to develop during emerging adulthood, a period marked by instability, heightened stress, identity exploration, and neurobiological maturation. Understanding the development of emotional processes during this phase, and the extent to which individual-level psychological resources facilitate the development of emotion regulation, is crucial for informing prevention efforts targeting adverse outcomes such as mental health problems.
Ecological momentary assessment (EMA) offers a powerful methodological approach for advancing our understanding of emotional development, as it provides rich, fine-grained data on emotional dynamics in daily life. Longitudinal EMA, in particular, enables the examination of both moment-to-moment fluctuations and developmental changes that are often missed by traditional, low sampling frequency longitudinal designs.
The current study has already conducted a preliminary examination of changes in negative emotional dynamics, including mean levels of negative emotion, inertia (the persistence of emotional states), and lability (reflecting emotional fluctuation) from ages 21 and 27 in a community sample who underwent a 2-week EMA protocol at each burst. These preliminary analyses suggested overall improvements in negative emotional dynamics across this developmental period (e.g., reductions in emotional lability). Building on this work, we will examine whether changes in these emotional dynamics are predicted by a set of individual-level psychological resources measured at ages 20 and 24 in a set of main cohort survey measures, including perceived adultness, hope, self-efficacy, conflict coping, stress coping, self-control, and future self-perception. These resources reflect a broader construct of psychological maturity, which is theorized to support adaptive emotion regulation during emerging adulthood. Assessing these resources at two time points allows us to examine, as an exploratory aim, whether resources measured earlier or later in emerging adulthood are differentially associated with changes in emotional dynamics. In addition, we will explore how key sociodemographic factors (including individual gender, educational status and years of education, independent living, financial-related factors, immigration background, and parents’/caregivers’ employment and educational status) relate to the changes in these emotional dynamics
Paternal Alcohol Exposure and Intergenerational Neurobehavioral Outcomes: A Scoping Review of Epigenetic Mechanisms
No full textThis scoping review will systematically map the existing evidence on how paternal alcohol exposure prior to conception influences offspring neurobehavioral outcomes through epigenetic mechanisms. It will examine the timing and patterns of paternal alcohol exposure, associated epigenetic alterations in sperm, and links to offspring stress responsivity, cognition, emotional behaviour, and alcohol sensitivity. By identifying methodological trends and key gaps, the review will inform future mechanistic and translational research on intergenerational vulnerability to alcohol use disorder
Sustainability Characteristics of Universal Newborn Hearing Screening and Early Hearing Detection and Intervention Programmes in Low-Resource Settings
No full textThis scoping review aims to identify sustainability criteria, challenges, and effective strategies for Universal Newborn Hearing Screening (UNHS) and Early Hearing Detection and Intervention (EHDI) programs in low-resource settings. The protocol follows JBI methodology and PRISMA-ScR guidelines
Impact of Virtual Standardized Patient Training on Diagnostic Exam Performance in Medical Students: A Cluster Randomized Controlled Trial
No full textTitle: Cluster Randomized Controlled Trial Evaluating the Impact of Dual-Teacher and Virtual Standardized Patient Collaborative Training on Diagnostic Performance Among Clinical Medicine Undergraduates
Background and Purpose:
Background: To address the challenges of disconnection between basic and clinical knowledge and insufficient resources for clinical reasoning training in clinical medical education, this project developed a Dual-Teacher and Virtual Standardized Patient collaborative teaching model. Currently, this model lacks high-quality empirical evidence.
Purpose: Through a rigorous randomized controlled trial, to empirically demonstrate the immediate additive effect of this model in Diagnostics teaching and explore its potential impact on long-term clinical competency.
Research Methods:
Design: A cluster randomized controlled trial based on natural classes, using a superiority test.
Subjects and Setting: All 8 natural classes of the 2023 clinical medicine major, implemented in the Diagnostics course on the main campus.
Randomization and Allocation Concealment:
This study employs a dual-executor, two-stage fully concealed lottery method. The specific standard operating procedure is as follows:
Stage 1 (Code Assignment): Independent Executor A organizes student representatives from each class to randomly draw confidential codes (A, B, C, D), forming a class-code correspondence table. After being signed by the representatives, it is sealed on the spot and handed to the supervisor for safekeeping. Executor A is unaware of the subsequent grouping rules.
Stage 2 (Lottery Grouping): Another independent Executor B (unaware of the code-class correspondence) draws lots for the codes under video recording. The first two codes drawn are designated as the intervention group.
Stage 3 (Revelation and Announcement): After the draw, the supervisor publicly opens the sealed envelope, announces the classes corresponding to the codes, and completes the group announcement. The entire process is video-recorded and archived. This procedure ensures that no one can predict the specific grouping of any class before the revelation.
Blinding: Course instructors, outcome assessors (graders), and data analysts are blinded; students and intervention implementers are not blinded.
Intervention Measures:
Intervention Group: Standard teaching plus after-class independent use of the VSP system for training.
Control Group: Receives only the identical standard teaching.
The teaching syllabus, class hours, and instructors are completely identical for both groups. The only variable is whether VSP is provided.
Observation Indicators and Measurement Time Points:
Primary Outcome: Comprehensive Diagnostics course score (theory plus practice) measured at course end.
Secondary Outcomes: Diagnostic theory score, practical skills score, VSP system usage adherence data, student satisfaction measured at course end or during.
Exploratory Outcome: National Clinical Medicine (Undergraduate) Proficiency Test score measured approximately 1 year after the Diagnostics course ends.
Sample Size: Using classes as the analysis unit, based on all available teaching units, totaling 8 classes (4 intervention clusters, 4 control clusters).
Statistical Analysis:
Primary analysis follows the intention-to-treat principle.
A multilevel model will be used to compare score differences between groups, controlling for baseline scores and other covariates.
Sensitivity analyses will be conducted for missing data (e.g., worst-case scenario analysis).
Ethics and Registration:
This study has been approved by the Medical Ethics Committee of Chengde Medical College (Approval No: 2025068)
A scoping review on the Emotional Suppression in Cancer Patients
No full textThe incidence and mortality rates of cancer worldwide continue to rise annually. A cancer diagnosis constitutes a stressful event, requiring patients to cope with unpredictable psychological trauma stemming from the disease and its poor prognosis. Emotional suppression is one such coping mechanism. Emotional suppression, also known as emotion expression inhibition, is commonly defined as the tendency to consciously inhibit emotional expression when emotions are aroused. Although existing studies have employed various tools to assess emotional suppression in cancer patients, no widely accepted unified measurement standard has been established, leading to significant variability in research findings. Furthermore, existing intervention studies are scarce, and the types of interventions are incomplete. Therefore, conducting research on emotional suppression in cancer patients is particularly important. This study adheres to scoping review reporting standards, systematically reviewing the current status, influencing factors, assessment tools, and intervention measures for emotional suppression in cancer patients. It aims to provide a reference for identifying, assessing, and managing emotional suppression in this population
Adverse Childhood Experiences, Fear Learning, and the Moderating Role of Parenting: A Systematic Investigation of Functional Activity and Connectivity in Adolescence
No full textAdverse childhood experiences (ACE) are well-established risk factors for psychopathology in adolescence, with symptoms frequently characterized by maladaptive fear learning behaviors. These behaviors are thought to underlie alterations in neurocognitive processing during fear conditioning and extinction. However, the core mechanisms driving these alterations remain underexplored, reflected in inconsistent reports of fear-related brain activation and connectivity in adolescents with ACE. Therefore, this study aims to advance our understanding of the neural correlates of fear learning following ACE in adolescents using fMRI. Specifically, we will (1) analyze both activation and seed-based functional connectivity; (2) include both ROI and whole-brain analyses; (3) examine additional key regions of the fear neurocircuitry (Hippocampus; Anterior Cingulate Cortex (ACC); Insula) beyond the amygdala and ventro-medial prefrontal cortex (vmPFC).
Additionally, some mixed findings may stem from analyses that do not distinguish between different neurocognitive stages of fear learning, therefore we analyze three specific phases of fear learning separately: fear conditioning (FC), extinction learning (EL), and extinction recall (ER).
Furthermore, literature on ACE and fear learning has overlooked the role of protective factors. Given the evidence that positive parenting promotes resilience following ACE, we test parenting as a moderator of the relationship between ACE and fear learning brain activity and connectivity
Strategic voting or confounding?
No full textSurvey research yields the surprising conclusion that voters strategically abandon small parties to a similar degree in first-past-the-post (FPTP) and proportional representation (PR) systems. If true, this challenges Duverger's classic theory that strategic voting helps explain why PR systems have more parties. We argue instead that observational analyses of FPTP and PR elections produce similar patterns of apparently strategic voter behavior because they suffer from the same methodological flaw. After reproducing previous findings in a more comprehensive dataset, we show via placebo tests that the same research design would erroneously imply strategic behavior in non-strategic outcomes like party identification. We also show that a more rigorous design reduces but does not eliminate the problem. Our findings suggest that isolating the effect of party popularity on vote choice using observational data may be fundamentally more difficult than the literature has recognized, and that alternative approaches are needed
The effectiveness of immersive virtual reality simulations in improving pediatric clinical skills, diagnostic reasoning, and self-efficacy: a systematic review
No full textObjectives
The primary objective of this systematic review is to evaluate the effectiveness of Virtual Reality (VR) simulation compared to conventional teaching methods in nursing students in the pediatric setting.
Specifically, the review aims to address the following questions:
Clinical Skills: What is the effect of VR simulation on the acquisition and performance of pediatric clinical/procedural skills among nursing students?
Clinical Reasoning: Does VR simulation enhance clinical reasoning and decision-making abilities in pediatric care scenarios compared to traditional methods?
Self-Efficacy: What is the impact of VR simulation on the level of self-efficacy and confidence of nursing students in providing care within the pediatric domain?
Secondary objectives include assessing the impact of VR simulation on students' learning satisfaction and anxiety levels related to clinical practice.
Research Question (PICOS Format)
In nursing students in pediatric training, what is the effectiveness of Virtual Reality (VR)-based simulations in improving pediatric clinical skills, diagnostic reasoning, and self-efficacy?
Participants (Population)
Nursing students (Bachelor of Science in Nursing).
Intervention
Artificial Intelligence simulation (including virtual clinical simulation and Augmented Reality/VR).
Comparator
Not applicable to an exploratory scoping review.
Outcome
Development of specific pediatric skills, preparation of future professionals, development of critical thinking, decision making, problem solving.
Study design
Systematic reviews, quantitative and qualitative primary studies.
3. Systematic Review Methods
METHODS (PRISMA-P Items 9-18)
9. Eligibility Criteria
Inclusion: Primary studies (RCTs, quasi-experimental) evaluating the effects of simulations integrated with AI/VR/AR on the curriculum of nursing students. Pediatric-specific context. Any publication date, any language.
Exclusion: Purely theoretical studies, letters to the editor, scoping/narrative reviews, studies focused exclusively on the adult population or other health professions.
10. Sources of Information
The search will be conducted on the following databases and platforms:
PubMed/MEDLINE
Scopus
CINAHL
PsycInfo It will also be a cross-check of references from key articles included (snowballing) will also be performed.
11. Search Strategy
The strategy is developed using MeSH terms and free-text descriptors.
MeSH terms: Students, Nursing; Education, Nursing; Simulation Training; Artificial Intelligence; Virtual Reality; Pediatrics; Clinical Competence; Decision Making.
Example String (for PubMed):
("nursing student*" OR "student nurse*" OR "pre-licensure nursing student*" OR "nurse education" OR "education nursing" OR "nurse training" OR "nurse trainees" OR "nursing trainee") AND (pediatric* OR pediatric* OR child OR children OR neonatal* OR neonate*) AND (simulation* OR "virtual reality" OR "high fidelity simulation training" OR VR OR fidelity OR "reality virtuality continuum" OR immersion OR "virtual environment" OR "virtual simulation" OR "extended reality") AND ("clinical competence" OR "Clinical Competency" OR "Clinical Skill*" OR Skill OR "Professional Competence" OR "Pediatric Skill*" OR "nursing competence" OR "nurse competency" OR "clinical performance" OR "nursing skill pediatric" OR "diagnostic reasoning" OR "clinical judgment" OR "critical thinking" OR self-confidence OR "self confident")
12-13. Study Selection and Data Extraction
Study selection will be performed by two independent reviewers. The process will be documented using the PRISMA Flow Diagram. Data will be extracted into a pre-tested standardized spreadsheet, which will include: study details, PICOS characteristics, simulator/AI type, outcome measures, and main results.
14-15. Risk of Bias and Methodological Quality
The methodological quality of the included studies will be assessed by two independent reviewers:
Randomized Controlled Trials (RCTs): The Cochrane Risk of Bias tool (RoB 2.0) will be used.
Non-Randomized Studies (NRS): The ROBINS-I (Risk Of Bias In Non-randomised Studies - of Interventions) tool will be used.
16-17. Outcomes
Primary Outcome: Development and improvement of pediatric clinical skills (measured by performance scores or OSCE).
Secondary Outcomes: Improvement in decision-making skills; improvement in problem-solving and critical thinking skills; students' levels of self-efficacy and confidence; satisfaction and acceptability of AI technology.
Additional Outcomes: Long-term retention of acquired skills; cost-effectiveness of AI system implementation.
18. Data Synthesis
A formal data synthesis is planned (Yes).
Quantitative Synthesis (Meta-Analysis): This will be performed if the data are sufficiently homogeneous by type of intervention and outcome. Heterogeneity will be tested using the I2 index and the Q test. The random-effects model will be used.
Narrative Synthesis: If Meta-Analysis is not feasible due to excessive heterogeneity, a systematic narrative synthesis will be performed, grouping the results according to primary and secondary outcomes.
ADDITIONAL INFORMATION AND ETHICS (PRISMA-P Item 4, 5c)
Ethical Aspects and Algorithmic Bias
Ethical Approval: Not required for this type of study
Algorithmic Bias: The review will dedicate a section to the extraction and documentation of potential algorithmic biases reported in the literature (such as the limited representativeness of rare clinical cases in the AI training dataset) and to the planned mitigation strategies, in order to inform the future implementation of the application in the thesis project
