Aging is a major risk factor for developing postoperative cognitive dysfunction. Neuroinflammatory processes, which can play a causal role in the etiology of postoperative cognitive dysfunction, are ...potentiated or primed as a function of aging. Here we explored whether exposure to a microorganism with immunoregulatory and anti-inflammatory properties, Mycobacterium vaccae NCTC 11659 (M. vaccae), could ameliorate age-associated neuroinflammatory priming. Aged (24 months) and adult (3 months) male F344XBN rats were immunized with heat-killed M. vaccae (3 injections, once per week) before undergoing a laparotomy or anesthesia control procedure. Aged, but not young rats, showed postoperative learning/memory deficits in a fear-conditioning paradigm. Importantly, M. vaccae immunization protected aged rats from these surgery-induced cognitive impairments. M. vaccae immunization also shifted the aged proinflammatory hippocampal microenvironment toward an anti-inflammatory phenotype. Furthermore, M. vaccae immunization reduced age-related hyperinflammatory responses in isolated hippocampal microglia. Overall, our novel data suggest that M. vaccae can induce an anti-inflammatory milieu in the aged brain and thus mitigate the neuroinflammatory and cognitive impairments induced by surgery.
Pay-to-play fees in public schools place more support for sport participation in the hands of parents; this may disproportionately affect the ability of girls to garner the benefits of sports. Using ...an online survey of a national sample of parents (N = 814), we examined the relationship between parents’ gender role beliefs, parents’ beliefs about the benefits and monetary value of sports, and the types of sports their daughters play. The results indicate that parents placed somewhat greater value on sport for sons, than for daughters, both ideologically and financially. Gender role beliefs played a small, but significant role, in shaping parents’ beliefs about their daughters’ involvement in sport, and the types of sports their daughters play.
•Drug use disorder (DUD) is common in this population, many involving >1 drugs (22 %).•Several factors explained differences in DUD—some within- and some between-person.•Within-person changes in ...alcohol use quantity correspond to changes in DUD.•Peer behaviors and related factors affect DUD through between-person effects.•Parent support, violence exposure, and mental health show within-person effects.
The distinction between within- and between-person associations with drug use disorder (DUD) has implications for intervention targets and content. We used longitudinal data from youth entering an urban emergency department (ED) to identify factors related to changes in DUD diagnosis, with particular emphasis on alcohol use.
Research staff recruited youth age 14–24 (n = 599) reporting any past six-month drug use from a Level-1 ED; participants were assessed at baseline and four biannual follow-ups. Participants self-reported validated measurements of peer/parental behaviors, violence/crime exposure, drug use self-efficacy, and alcohol use. Research staff performed diagnostic interviews for DUD with nine substances, post-traumatic stress disorder (PTSD), and major depressive disorder (MDD). We used repeated measures logistic regression models with person-level covariate means, and person-mean-centered covariates, as separate variables, to separate within- and between-person covariate effects.
Among 2,630 assessments, 1,128 (42.9 %) were DUD diagnoses; 21.7 % were co-diagnoses with multiple drugs. Positive (aOR = 0.81, 95 %CI:0.70, 0.94) and negative (aOR = 1.73, 95 %CI:1.45, 2.07) peer behaviors related to DUD, primarily through between-person effects. Parental support (aOR = 0.92, 95 %CI:0.83, 0.99), community violence/crime (aOR = 1.28, 95 %CI:1.14, 1.44), PTSD/MDD diagnosis (aOR = 1.36, 95 %CI:1.04, 1.79), and alcohol use quantity (aOR = 1.06, 95 %CI:1.02, 1.11) were associated with DUD, showing primarily within-person effects. Other factors, such as interpersonal violence involvement (aOR = 1.47, 95 %CI:1.21, 1.78), showed both within- and between-person effects.
DUD is prevalent in this population, and within-person changes in DUD are predictable. Within-person effects suggest the importance of addressing escalating alcohol use, enhancing parental support, crime/violence exposure, and other mental health diagnoses as part of DUD intervention.
•Longer-term physical activity improves mental health and cognition in youth.•Improvements coincide with altered fMRI and EEG parameters in frontal brain areas.•Physical activity is related to BDNF ...increases; associations with cortisol are more complex.•Physical activity interventions shall target lower fit and vulnerable youth.
To investigate putative neurobiological mechanisms that link longer-term physical activity interventions to mental health and cognitive outcomes using randomised controlled trials in children, adolescents and young adults.
A range of medical and psychological science electronic databases were searched (MEDLINE, EMBASE, Scopus, Web of Science, PsychINFO).
Original research studies were selected, data were extracted and quality was appraised.
Sixteen primary papers were included, ranging from healthy and community samples to subclinical and clinical populations across a variety of age ranges and using different neurobiological measures (e.g. magnetic resonance imaging, electroencephalography, cortisol, brain-derived neurotropic factor).
The majority of studies report improvement in mental health and cognition outcomes following longer-term physical activity interventions which coincide with neurobiological alterations, especially neuroimaging alterations in activation and electrophysiological parameters in frontal areas. Future research should include measures of pre-existing fitness and target those who would benefit the most from this type of intervention (e.g. those with a lower level of fitness and at risk for or with mental health problems).
AbstractObjectiveTo review and appraise the validity and usefulness of published and preprint reports of prediction models for prognosis of patients with covid-19, and for detecting people in the ...general population at increased risk of covid-19 infection or being admitted to hospital or dying with the disease.DesignLiving systematic review and critical appraisal by the covid-PRECISE (Precise Risk Estimation to optimise covid-19 Care for Infected or Suspected patients in diverse sEttings) group.Data sourcesPubMed and Embase through Ovid, up to 17 February 2021, supplemented with arXiv, medRxiv, and bioRxiv up to 5 May 2020.Study selectionStudies that developed or validated a multivariable covid-19 related prediction model.Data extractionAt least two authors independently extracted data using the CHARMS (critical appraisal and data extraction for systematic reviews of prediction modelling studies) checklist; risk of bias was assessed using PROBAST (prediction model risk of bias assessment tool).Results126 978 titles were screened, and 412 studies describing 731 new prediction models or validations were included. Of these 731, 125 were diagnostic models (including 75 based on medical imaging) and the remaining 606 were prognostic models for either identifying those at risk of covid-19 in the general population (13 models) or predicting diverse outcomes in those individuals with confirmed covid-19 (593 models). Owing to the widespread availability of diagnostic testing capacity after the summer of 2020, this living review has now focused on the prognostic models. Of these, 29 had low risk of bias, 32 had unclear risk of bias, and 545 had high risk of bias. The most common causes for high risk of bias were inadequate sample sizes (n=408, 67%) and inappropriate or incomplete evaluation of model performance (n=338, 56%). 381 models were newly developed, and 225 were external validations of existing models. The reported C indexes varied between 0.77 and 0.93 in development studies with low risk of bias, and between 0.56 and 0.78 in external validations with low risk of bias. The Qcovid models, the PRIEST score, Carr’s model, the ISARIC4C Deterioration model, and the Xie model showed adequate predictive performance in studies at low risk of bias. Details on all reviewed models are publicly available at https://www.covprecise.org/.ConclusionPrediction models for covid-19 entered the academic literature to support medical decision making at unprecedented speed and in large numbers. Most published prediction model studies were poorly reported and at high risk of bias such that their reported predictive performances are probably optimistic. Models with low risk of bias should be validated before clinical implementation, preferably through collaborative efforts to also allow an investigation of the heterogeneity in their performance across various populations and settings. Methodological guidance, as provided in this paper, should be followed because unreliable predictions could cause more harm than benefit in guiding clinical decisions. Finally, prediction modellers should adhere to the TRIPOD (transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) reporting guideline.Systematic review registrationProtocol https://osf.io/ehc47/, registration https://osf.io/wy245.Readers’ noteThis article is the final version of a living systematic review that has been updated over the past two years to reflect emerging evidence. This version is update 4 of the original article published on 7 April 2020 (BMJ 2020;369:m1328). Previous updates can be found as data supplements (https://www.bmj.com/content/369/bmj.m1328/related#datasupp). When citing this paper please consider adding the update number and date of access for clarity.
We present the operating principle and the first observing run of a novel kind of direct detector for axions and axionlike particles in the galactic halo. Sensitive to the polarisation rotation of ...linearly polarised laser light induced by an axion field, our experiment is the first detector of its kind collecting scientific data. We discuss our peak sensitivity of 1.51×10^{-10} GeV^{-1} (95% confidence level) to the axion-photon coupling strength in the axion mass range of 1.97-2.01 neV which is, for instance, motivated by supersymmetric grand-unified theories. We also report on effects that arise in our high-finesse in-vacuum cavity at an unprecedented optical continuous-wave intensity of 4.7 MW/cm^{2}. Our detector already belongs to the most sensitive direct searches within its measurement band, and our results pave the way towards surpassing the current sensitivity limits even of astrophysical observations in the mass range from 10^{-8} down to 10^{-16} eV via quantum-enhanced laser interferometry, especially with the potential of scaling our detector up to kilometer length.
ObjectiveTelerehabilitation for individuals with vision impairment aims to maintain maximum physical and/or psychological functioning through remote service delivery. This review aims to describe the ...type of telerehabilitation services available to people with vision impairment and summarise evidence on health-related outcomes, well-being and cost-effectiveness.DesignScoping review.Data sourcesCINAHL Plus, MEDLINE, PsycARTICLES, PsychINFO, Embase, PubMed, HMIC and Ovid Emcare were searched, without date restrictions up to 24 May 2021. Charity and government websites, conference proceedings and clinical trial databases were also examined.Eligibility criteriaEligible studies evaluated benefits of telerehabilitation services for adults with vision impairment. Studies were excluded if they were not available in English, or focused on distance learning of visually impaired students.Data extraction and synthesisTwo independent reviewers screened articles and extracted data. A risk of bias analysis was performed.Outcome measuresMeasures of benefit included performance-based assessment, patient-reported outcomes and cost-effectiveness.ResultsOf 4472 articles, 10 eligible studies were included. Outcomes addressed patient satisfaction (n=4;33.3%), quality-of-life, activities of daily living and well-being (n=4;33.3%), objective visual function (n=2;16.6%) and knowledge relating to ocular symptoms (n=1;8.3%). Two studies addressed multiple outcomes. Cost-effectiveness was addressed in one article (8.3%). Patients were generally satisfied with their experiences, which had a range of positive benefits on functional and quality-of-life outcomes in areas relating to daily activities (eg, reading, making phone calls). Telerehabilitation allowed patients to undertake vision optimisation training to prevent vision deterioration. Grey literature indicated that there are no completed clinical trials relating to low vision telerehabilitation. Charity services had implemented digital skills training to help beneficiaries communicate remotely.ConclusionWhile acceptability of telerehabilitation was mostly high, limited real-world data are available which raises questions around the long-term desirability of this approach. Further trials are needed to evaluate telerehabilitation using a robust set of outcome measures.PROSPERO registration numberCRD42021254825.
OBJECTIVE:To quantify genetic overlap between migraine and ischemic stroke (IS) with respect to common genetic variation.
METHODS:We applied 4 different approaches to large-scale meta-analyses of ...genome-wide data on migraine (23,285 cases and 95,425 controls) and IS (12,389 cases and 62,004 controls). First, we queried known genome-wide significant loci for both disorders, looking for potential overlap of signals. We then analyzed the overall shared genetic load using polygenic scores and estimated the genetic correlation between disease subtypes using data derived from these models. We further interrogated genomic regions of shared risk using analysis of covariance patterns between the 2 phenotypes using cross-phenotype spatial mapping.
RESULTS:We found substantial genetic overlap between migraine and IS using all 4 approaches. Migraine without aura (MO) showed much stronger overlap with IS and its subtypes than migraine with aura (MA). The strongest overlap existed between MO and large artery stroke (LAS; p = 6.4 × 10 for the LAS polygenic score in MO) and between MO and cardioembolic stroke (CE; p = 2.7 × 10 for the CE score in MO).
CONCLUSIONS:Our findings indicate shared genetic susceptibility to migraine and IS, with a particularly strong overlap between MO and both LAS and CE pointing towards shared mechanisms. Our observations on MA are consistent with a limited role of common genetic variants in this subtype.
We present the observational results of an L'- and M-band adaptive optics imaging survey of 54 nearby, Sun-like stars for extrasolar planets, carried out using the Clio camera on the MMT. We have ...concentrated more strongly than all other planet-imaging surveys to date on very nearby F, G, and K stars, prioritizing stellar proximity higher than youth. Ours is also the first survey to include extensive observations in the M band, which supplement the primary L' observations. Models predict much better planet/star flux ratios at the L' and M bands than at more commonly used shorter wavelengths (i.e., the H band). We have carried out extensive blind simulations with fake planets inserted into the raw data to verify our sensitivity, and to establish a definitive relationship between source significance in {sigma} and survey completeness. We find 97% confident-detection completeness for 10{sigma} sources, but only 46% for 7{sigma} sources-raising concerns about the standard procedure of assuming high completeness at 5{sigma}, and demonstrating that blind sensitivity tests to establish the significance-completeness relation are an important analysis step for all planet-imaging surveys. We discovered a previously unknown {approx}0.15 M{sub sun} stellar companion to the F9 star GJ 3876, at a projected separation of about 80 AU. Twelve additional candidate faint companions are detected around other stars. Of these, 11 are confirmed to be background stars and one is a previously known brown dwarf. We obtained sensitivity to planetary-mass objects around almost all of our target stars, with sensitivity to objects below 3 M{sub Jup} in the best cases. Constraints on planet populations based on this null result are presented in our Modeling Results paper.
ObjectiveTo explore and analyse causes of stress among nurses in palliative and inpatient hospice care settings in Germany during the COVID-19 pandemic.DesignExplorative, qualitative study using ...problem-centred interviews. Interview data were analysed using structured qualitative content analysis.SettingTelephone interviews with nurses of different settings of palliative and inpatient hospice care.Participants16 nurses from inpatient hospice, palliative care units and specialised palliative home care were recruited.ResultsCOVID-19 infection control measures placed both physical and psychological strain on palliative care nurses. Due to changes in infection control information, workflows were being readjusted on a daily basis, preventing everyday routines and hindering relief from stress. There are reduced and limited opportunities for sharing and reflecting on daily working routines with team colleagues. Specific causes of stress in the individual settings of palliative and inpatient hospice care were identified. Overall, there is a tension between the nurses’ perceptions of proper palliative care nursing, in terms of closeness, psychosocial and emotional support and compliance with infection control measures.ConclusionsPalliative care nurses have been exposed to high levels of both physical and psychological stress during the COVID-19 pandemic. This requires rapid relief and support, with a need to ensure continuity of professional supervision and peer-support, which may be facilitated via digital technologies. The unique role of nurses in inpatient hospice and palliative care during COVID-19 ought to be recognised and valorised.
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