Sleep deprivation has far-reaching consequences on the brain and behavior, impacting memory, attention, and metabolism. Previous research has focused on gene expression changes in individual brain ...regions, such as the hippocampus or cortex. Therefore, it is unclear how uniformly or heterogeneously sleep loss affects the brain. Here, we use spatial transcriptomics to define the impact of a brief period of sleep deprivation across the brain in male mice. We find that sleep deprivation induced pronounced differences in gene expression across the brain, with the greatest changes in the hippocampus, neocortex, hypothalamus, and thalamus. Both the differentially expressed genes and the direction of regulation differed markedly across regions. Importantly, we developed bioinformatic tools to register tissue sections and gene expression data into a common anatomical space, allowing a brain-wide comparison of gene expression patterns between samples. Our results suggest that distinct molecular mechanisms acting in discrete brain regions underlie the biological effects of sleep deprivation.
In a randomized trial, 294 patients with advanced heart failure were assigned to receive either a new centrifugal-flow pump or an axial-flow pump. At 6 months, the centrifugal-flow pump was ...associated with better outcomes.
A scarcity of effective therapeutic options for advanced heart failure has led to the development of durable mechanical circulatory support devices. Left ventricular assist devices, more accurately known as left ventricular assist systems, increase the rate of survival and improve quality of life among patients with advanced heart failure. However, these clinical benefits are balanced by an increased risk of infection, bleeding, neurologic events, and pump malfunction that is due principally to pump thrombosis.
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As adoption of circulatory pumps has expanded, concerns about pump thrombosis have heightened. In 2013, two reports suggested that there has been an increase in . . .
In a randomized trial, 366 patients with advanced heart failure received a centrifugal- or axial-flow LVAD. At 2 years, the centrifugal-flow LVAD was superior with regard to survival free of ...disabling stroke or reoperation to replace or remove a malfunctioning device.
Objectives
To summarize and critically evaluate research on the effects of Tai Chi on cognitive function in older adults.
Design
Systematic review with meta‐analysis.
Setting
Community and ...residential care.
Participants
Individuals aged 60 and older (with the exception of one study) with and without cognitive impairment.
Measurements
Cognitive ability using a variety of neuropsychological testing.
Results
Twenty eligible studies with a total of 2,553 participants were identified that met inclusion criteria for the systematic review; 11 of the 20 eligible studies were randomized controlled trials (RCTs), one was a prospective nonrandomized controlled study, four were prospective noncontrolled observational studies, and four were cross‐sectional studies. Overall quality of RCTs was modest, with three of 11 trials categorized as high risk of bias. Meta‐analyses of outcomes related to executive function in RCTs of cognitively healthy adults indicated a large effect size when Tai Chi participants were compared with nonintervention controls (Hedges' g = 0.90; P = .04) and a moderate effect size when compared with exercise controls (Hedges' g = 0.51; P = .003). Meta‐analyses of outcomes related to global cognitive function in RCTs of cognitively impaired adults, ranging from mild cognitive impairment to dementia, showed smaller but statistically significant effects when Tai Chi was compared with nonintervention controls (Hedges' g = 0.35; P = .004) and other active interventions (Hedges' g = 0.30; P = .002). Findings from nonrandomized studies add further evidence that Tai Chi may positively affect these and other domains of cognitive function.
Conclusion
Tai Chi shows potential to enhance cognitive function in older adults, particularly in the realm of executive functioning and in individuals without significant impairment. Larger and methodologically sound trials with longer follow‐up periods are needed before more‐definitive conclusions can be drawn.
Objective
Chronic joint pain is a major cause of pain and disability. Exercise and self‐management have short‐term benefits, but few studies follow participants for more than 6 months. We ...investigated the long‐term (up to 30 months) clinical and cost effectiveness of a rehabilitation program combining self‐management and exercise: Enabling Self‐Management and Coping of Arthritic Knee Pain Through Exercise (ESCAPE‐knee pain).
Methods
In this pragmatic, cluster randomized, controlled trial, 418 people with chronic knee pain (recruited from 54 primary care surgeries) were randomized to usual care (pragmatic control) or the ESCAPE‐knee pain program. The primary outcome was physical function (Western Ontario and McMaster Universities Osteoarthritis Index WOMAC function), with a clinically meaningful improvement in physical function defined as a ≥15% change from baseline. Secondary outcomes included pain, psychosocial and physiologic variables, costs, and cost effectiveness.
Results
Compared to usual care, ESCAPE‐knee pain participants had large initial improvements in function (mean difference in WOMAC function −5.5; 95% confidence interval 95% CI −7.8, −3.2). These improvements declined over time, but 30 months after completing the program, ESCAPE‐knee pain participants still had better physical function (difference in WOMAC function −2.8; 95% CI −5.3, −0.2); lower community‐based health care costs (£−47; 95% CI £−94, £−7), medication costs (£−16; 95% CI £−29, £−3), and total health and social care costs (£−1,118; 95% CI £−2,566, £−221); and a high probability (80–100%) of being cost effective.
Conclusion
Clinical and cost benefits of ESCAPE‐knee pain were still evident 30 months after completing the program. ESCAPE‐knee pain is a more effective and efficient model of care that could substantially improve the health, well‐being, and independence of many people, while reducing health care costs.
A mood-congruent sensitivity towards negative stimuli has been associated with development and maintenance of major depressive disorder (MDD). The emotional Stroop task assesses interference effects ...arising from the conflict of emotional expressions consistent with disorder-specific self-schemata and cognitive colour-naming instructions. Functional neuroimaging studies of the emotional Stroop effect advocate a critical involvement of the anterior cingulate cortex (ACC) during these processes.
Subjects were 17 medication-free individuals with unipolar MDD in an acute depressive episode (mean age 39 years), and 17 age-, gender- and IQ-matched healthy volunteers. In an emotional Stroop task, sad and neutral words were presented in various colours, and subjects were required to name the colour of words whilst undergoing functional magnetic resonance imaging (fMRI). Overt verbal responses were acquired with a clustered fMRI acquisition sequence.
Individuals with depression showed greater increases in response time from neutral to sad words relative to controls. fMRI data showed a significant engagement of left rostral ACC (BA 32) and right precuneus during sad words in patients relative to controls. Additionally, rostral ACC activation was positively correlated with latencies of negative words in MDD patients. Healthy controls did not have any regions of increased activation compared to MDD patients.
These findings provide evidence for a behavioural and neural emotional Stroop effect in MDD and highlight the importance of the ACC during monitoring of conflicting cognitive processes and mood-congruent processing in depression.
PurposeWhile service scholars see modularisation as balancing the efficiency of standardisation with the value added through customisation the relationships between these concepts are ...under-theorised. In addition, although information and communication technologies can facilitate all three service strategies, the degree to which they codify service knowledge is not explicitly considered in the extant literature. The purpose of this paper is to develop and validate a model that examines service strategy trajectories by specifically considering the ICTs used and the degree of knowledge codification employed.Design/methodology/approachThis study draws on three qualitative case studies of service departments of firms involved in cardiovascular applications, orthopaedic, spinal and neuroscience product development and information technology support. Data collection involved semi-structured interviews, document analysis and non-participant observation.FindingsFindings show that ICTs were increasingly used to codify both standardised and customised services, though in different ways. For standardised services ICTs codified the service process, making them even more rigid. Due to the dynamic nature of customised services, drawing on experts' tacit knowledge, ICTs codified the possessors of knowledge rather than the service process they undertook. This study also identified a duality between the tacit development of customised services and modular service codification.Research limitations/implicationsThe model is validated using case studies from three companies in the medical and information technology sectors limiting its generalisability.Practical implicationsThe importance of considering the degree of tacitness or explicitness of service knowledge is important for service codification. The paper provides managers with empirical examples of how ICTs are used to support all three strategies, allows them to identify their current position and indicates possible future trajectories.Originality/valueThe papers main contribution is the development of a model that integrates the literature on service strategies with knowledge management strategies to classify service standardisation, customisation and modularisation in terms of both service orientation and degree of ICT codification.
Age-associated cognitive impairments affect an individual's quality of life and are a growing problem in society. Therefore, therapeutic strategies to treat age-related cognitive decline are needed ...to enhance the quality of life among the elderly. Activation of the Nr4a family of transcription factors has been closely linked to memory formation and dysregulation of these transcription factors is thought to be associated with age-related cognitive decline. Previously, we have shown that Nr4a transcription can be activated by synthetic bisindole-derived compounds (C-DIM). C-DIM compounds enhance synaptic plasticity and long-term contextual fear memory in young healthy mice. In this study, we show that activation of Nr4a2 by 1,1-bis(3′-Indolyl)-1-(p-chlorophenyl) methane (C-DIM12), enhances long-term spatial memory in young mice and rescues memory deficits in aged mice. These findings suggest that C-DIM activators of Nr4a transcription may be suitable to prevent memory deficits associated with aging.
•Pharmacological activation of Nr4a using C-DIM drugs enhances long-term memory in young mice.•C-DIM drug reverses long-term memory deficits in aged mice.•Nr4a could be a potential therapeutic target to treat age-related cognitive impairment.
Diminished control of standing balance, traditionally indicated by greater postural sway magnitude and speed, is associated with falls in older adults. Tai Chi (TC) is a multisystem intervention that ...reduces fall risk, yet its impact on sway measures vary considerably. We hypothesized that TC improves the integrated function of multiple control systems influencing balance, quantifiable by the multi-scale "complexity" of postural sway fluctuations.
To evaluate both traditional and complexity-based measures of sway to characterize the short- and potential long-term effects of TC training on postural control and the relationships between sway measures and physical function in healthy older adults.
A cross-sectional comparison of standing postural sway in healthy TC-naïve and TC-expert (24.5±12 yrs experience) adults. TC-naïve participants then completed a 6-month, two-arm, wait-list randomized clinical trial of TC training. Postural sway was assessed before and after the training during standing on a force-plate with eyes-open (EO) and eyes-closed (EC). Anterior-posterior (AP) and medio-lateral (ML) sway speed, magnitude, and complexity (quantified by multiscale entropy) were calculated. Single-legged standing time and Timed-Up-and-Go tests characterized physical function.
At baseline, compared to TC-naïve adults (n = 60, age 64.5±7.5 yrs), TC-experts (n = 27, age 62.8±7.5 yrs) exhibited greater complexity of sway in the AP EC (P = 0.023), ML EO (P<0.001), and ML EC (P<0.001) conditions. Traditional measures of sway speed and magnitude were not significantly lower among TC-experts. Intention-to-treat analyses indicated no significant effects of short-term TC training; however, increases in AP EC and ML EC complexity amongst those randomized to TC were positively correlated with practice hours (P = 0.044, P = 0.018). Long- and short-term TC training were positively associated with physical function.
Multiscale entropy offers a complementary approach to traditional COP measures for characterizing sway during quiet standing, and may be more sensitive to the effects of TC in healthy adults.
ClinicalTrials.gov NCT01340365.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
ABSTRACT We report abundances of elements from 26Fe to 40Zr in the cosmic radiation measured by the SuperTIGER (Trans-Iron Galactic Element Recorder) instrument during 55 days of exposure on a ...long-duration balloon flight over Antarctica. These observations resolve elemental abundances in this charge range with single-element resolution and good statistics. These results support a model of cosmic ray origin in which the source material consists of a mixture of % material from massive stars and ∼81% normal interstellar medium material with solar system abundances. The results also show a preferential acceleration of refractory elements (found in interstellar dust grains) by a factor of ∼4 over volatile elements (found in interstellar gas) ordered by atomic mass (A). Both the refractory and volatile elements show a mass-dependent enhancement with similar slopes.
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