Clinicaltrials.gov identifier: NCT01670747 ( www.clinicaltrials.gov ).

IMPORTANCE Adults with obsessive-compulsive disorder (OCD) display perseverative behavior in stable environments but exhibit vacillating choice when payoffs are uncertain. These findings may be associated with intolerance of uncertainty and compulsive behaviors; however, little is known about the mechanisms underlying learning and decision-making in youths with OCD because research into this population has been limited. OBJECTIVE To investigate cognitive mechanisms associated with decision-making in youths withOCD by using executive functioning tasks and computational modeling. DESIGN, SETTING, AND PARTICIPANTSIn this cross-sectional study, 50 youths with OCD (patients) and 53 healthy participants (controls) completed a probabilistic reversal learning (PRL) task between January 2014 and March 2020. A separate sample of 27 patients and 46 controls completed the Wisconsin Card Sorting Task (WCST) between January 2018 and November 2020. The study took place at the University of Cambridge in the UK. MAIN OUTCOMES AND MEASURES Decision-making mechanisms were studied by fitting hierarchical bayesian reinforcement learning models to the 2 data sets and comparing model parameters between participant groups. Model parameters included reward and punishment learning rates (feedback sensitivity), reinforcement sensitivity and decision consistency (exploitation), and stickiness (perseveration). Associations of receipt of serotonergic medication with performance were assessed. RESULTS In total, 50 patients (29 female patients [58%]; median age, 16.6 years [IQR, 15.3-18.0 years]) and 53 controls (30 female participants [57%]; median age, 16.4 years [IQR, 14.8-18.0 years]) completed the PRL task. A total of 27 patients (18 female patients [67%]; median age, 16.1 years [IQR, 15.2-17.2 years]) and 46 controls (28 female participants [61%]; median age, 17.2 [IQR, 16.3-17.6 years]) completed the WCST. During the reversal phase of the PRL task, patients made fewer correct responses (mean [SD] proportion: 0.83 [0.16] for controls and 0.61 [0.31] for patients; 95% CI, −1.31 to −0.64) and switched choices more often following false-negative feedback (mean [SD] proportion: 0.09 [0.16] for controls vs 0.27 [0.34] for patients; 95% CI, 0.60-1.26) and true-positive feedback (mean [SD] proportion: 0.93 [0.17] for controls vs 0.73 [0.34] for patients; 95% CI, −2.17 to −1.31). Computational modeling revealed that patients displayed enhanced reward learning rates (mean difference [MD], 0.21; 95% highest density interval [HDI], 0.04-0.38) but decreased punishment learning rates (MD, −0.29; 95% HDI, −0.39 to −0.18), reinforcement sensitivity (MD, −4.91; 95% HDI, −9.38 to −1.12), and stickiness (MD, −0.35; 95% HDI, −0.57 to −0.11) compared with controls. There were no group differences on standard WCST measures and computational model parameters. However, patients who received serotonergic medication showed slower response times (mean [SD], 1420.49 [279.71] milliseconds for controls, 1471.42 [212.81] milliseconds for (continued) Key Points Questio...

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The use of sexually explicit material (SEM) has become a part of adolescent sexual socialization, at least in the Western world. Adolescent and young people's SEM use has been associated with risky sexual behaviors, which has recently resulted in policy debates about restricting access to SEM. Such development seems to suggest a crisis of the preventive role of parental oversight. Based on the Differential Susceptibility to Media Effects Model, this study assessed the role of parental monitoring in the context of adolescent vulnerability to SEM-associated risky or potentially adverse outcomes (sexual activity, sexual aggressiveness, and sexting). Using an online sample of Croatian 16-year-olds (N = 1265) and structural equation modeling approach, parental monitoring was found consistently and negatively related to the problematic behavioral outcomes, regardless of participants' gender. While SEM use was related to sexual experience and sexting, higher levels of parental monitoring were associated with less frequent SEM use and lower acceptance of sexual permissiveness. Despite parents' fears about losing the ability to monitor their adolescent children's lives in the Internet era, there is evidence that parental engagement remains an important protective factor.

Purpose: Cervical traumas are frequent in emergency department and X-ray, CT, and MRI are the essential imaging modalities in the diagnosis. However, especially for pregnant and morbid obese patients and children, these techniques can be challenging. We tested the success of point-of-care ultrasound in the evaluation of cervical traumas. Methods: This is a case series of cervical vertebra imaging with ultrasound in emergency department. We used linear probe and placed it anterolaterally to the neck, parallel to cervical spine. Images were obtained by an ultrasound-certified emergency physician. The height of the anterior wall of vertebral body, irregularity in vertebral body, and intervertebral space were assessed. Results: We presented a case series of six patients. Ultrasound images of cervical vertebral bodies and intervertebral spaces were able to obtain for all the patients. Any pathology was not observed in ultrasound imaging. This finding was compatible with cervical X-ray and CT scans and all the patients were discharged. Conclusions: However, this is a case series report of minor cervical trauma, and we were able to obtain ultrasound images of cervical vertebra bodies with point-of-care ultrasound examination by an emergency physician. This technique can be important for the patients contraindicated to CT or MRI. Also, it can give additional information to X-ray and CT scans especially for soft tissues. A2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasound

Objectives. The aim of this bio-behavioral longitudinal study was to assess the association between dynamics of SEM use and risky sexual behavior among Croatian adolescents.Methods. The data were collected during 2015-2018 period (n = 577). Controlling for sensation seeking, socioeconomic status and pubertal timing, latent growth curve modeling with three observation points was used.Results. Male adolescents' initial SEM use was related to sexual risk taking growth in the following months. Among female adolescents, SEM use and sexual risk taking were related only at the initial point. Conclusions.Our findings suggest different developmental phases when addressing the target relationship.

The precision with which visual information can be recalled from working memory declines as the number of items in memory increases. This finding has been explained in terms of the distribution of a limited representational resource between items. Here we investigated how the sensory strength of memoranda affects resource allocation. We manipulated signal strength of an orientation stimulus in two ways: we varied the internal (sensory) noise by adjusting stimulus contrast, and varied the external (stimulus) noise by altering the within-stimulus variability. Both manipulations had similar effects on the precision with which the orientation could be recalled, but differed in their impact on memory for other stimuli. These results indicate that increasing internal noise released resources that could be used to store other stimuli more precisely; increasing external noise had no such effect. We show that these observations can be captured by a simple neural model of working memory encoding, in which spiking activity takes on the role of the limited resource.

The aim of this study was to show the extent of the influence of the shift work on nutritional status and physical activity of police officers. The research included 130 healthy police officers. The respondents were divided into two groups. The first group included 82 officers who were working the first shift. The second group included 48 officers who were working the 12hour shift. The study used customized questionnaire consisting of questions regarding leisure-time physical activity, self-report lifestyle activity level, body height, body mass, and derived body mass index (BMI). The ANOVA analysis showed that the first shift had significantly lower BMI (2.57 kg/m 2 , p = 0.004) than the 12-hour shift. The results showed that physical activity is strongly associated with lower values of BMI in both groups (p < 0.01). Regarding the correlation between age and years of service, only the 12-hour shift showed coherency (p < 0.01). Although there was no difference in the level of physical activity between police officers from different shifts, declines in physical activity were associated with higher values of BMI.