Impairments in choosing optimally between immediate and delayed rewards are associated with numerous psychiatric disorders. Such ‘intertemporal’ choice is influenced by genetic and experiential factors; however, the contributions of biological sex are understudied and data to date are largely inconclusive. Rats were used to determine how sex and gonadal hormones influence choices between small, immediate and large, delayed rewards. Females showed markedly greater preference than males for small, immediate over large, delayed rewards (greater impulsive choice). This difference was neither due to differences in food motivation or reward magnitude perception, nor was it affected by estrous cycle. Ovariectomies did not affect choice in females, whereas orchiectomies increased impulsive choice in males. These data show that male rats exhibit less impulsive choice than females and that this difference is at least partly maintained by testicular hormones. These differences in impulsive choice could be linked to gender differences across multiple neuropsychiatric conditions.

Across species, aging is associated with an increased ability to choose delayed over immediate gratification. These experiments used young and aged rats to test the role of the basolateral amygdala (BLA) in intertemporal decision making. An optogenetic approach was used to inactivate the BLA in young and aged rats at discrete time points during choices between levers that yielded a small, immediate vs. a large, delayed food reward. BLA inactivation just prior to decisions attenuated impulsive choice in both young and aged rats. In contrast, inactivation during receipt of the small, immediate reward increased impulsive choice in young rats but had no effect in aged rats. BLA inactivation during the delay or intertrial interval had no effect at either age. These data demonstrate that the BLA plays multiple, temporally distinct roles during intertemporal choice, and show that the contribution of BLA to choice behavior changes across the lifespan.

Introduction COVID-19 has disrupted how ophthalmic practice is conducted worldwide. One patient population that may suffer from poor outcomes during the pandemic are those with age-related macular degeneration (AMD). Many practices are performing some form of teleophthalmology services for their patients, and guidance is needed on how to maintain continuity of care amongst patients with AMD using teleophthalmology. Methods A literature search was conducted, ending 1 August 2020, to identify AMD outcomes and telecare management strategies that could be used during the COVID-19 pandemic Results 237 total articles were retrieved, 56 of which were included for analysis. Four American Academy of Ophthalmology and Center for Disease Control web resources were also included. Discussion Risk-stratification models have been developed that let providers readily screen existing patients for their future risk of neovascular AMD (nAMD). When used with at-home monitoring devices to detect nAMD, providers may be able to determine who should be contacted via teleophthalmology for screening. Telemedicine triage can be used for new complaints of vision loss to determine who should be referred to a retinal specialist for management of suspected nAMD. To increase access and provider flexibility, smartphone fundus photography images sent to a centralized teleophthalmology service can aid in the detection of nAMD. Considerations should also be made for COVID-19 transmission, and teleophthalmology can be used to screen patients for the presence of COVID-19 prior to in-person office visits. Teleophthalmology has additional utility in connecting with nursing home, rural, and socioeconomically disadvantaged patients in the post-pandemic period.

BackgroundTraumatic brain injuries (TBIs), specifically concussions, affect many athletes and have dangerous immediate and long-term sequelae. Lack of awareness surrounding concussion impedes prevention, identification, and treatment. This study aims to assess parental knowledge and attitudes regarding concussions in youth baseball before and after administering an educational intervention called PitchSafe. PitchSafe is a short video that contains examples of baseball-related head injuries such as collisions, falls, and direct hits by baseballs; the signs and symptoms of a concussion; testimony from a former baseball player who sustained a TBI playing baseball; and a brochure detailing the potential signs, symptoms, and treatment plans associated with concussions. MethodologyThe Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) was used to assess three indices of parental understanding of concussion: Concussion Knowledge Index (CKI), Concussion Attitudes Index (CAI), and signs and symptoms of concussions (SS). The RoCKAS was administered at baseline and after the PitchSafe tool was administered. Parents were re-assessed one year following the initial distribution of survey materials utilizing the long-term follow-up (LTFU) RoCKAS. A paired sample t-test was conducted to compare the baseline, post-intervention (PI), and LTFU CKI, CAI, and SS among participants. ResultsThe mean scores for CKI were 68% ± 12%, 76% ± 4%, and 76% ± 5% for baseline, PI, and LTFU, respectively. The mean scores for SS were 46% ± 20%, 62% ± 14%, and 64% ± 16% for baseline, PI, and LTFU, respectively. The mean scores for CAI were 87% ± 6%, 91% ± 5%, and 92% ± 4% for baseline, PI, and LTFU, respectively. ConclusionsPitchSafe increased youth baseball parents' long-term knowledge of concussions, ability to identify signs and symptoms of concussions, and may promote safer attitudes toward concussions. These findings support more widespread use of educational tools through social media and in clinical settings.

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