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Behavioural Brain Research Jul 2023Stressful life events can both trigger development of psychiatric disorders and promote positive behavioral changes in response to adversities. The relationship between...
BACKGROUND
Stressful life events can both trigger development of psychiatric disorders and promote positive behavioral changes in response to adversities. The relationship between stress and cognitive flexibility is complex, and conflicting effects of stress manifest in both humans and laboratory animals.
OBJECTIVE
To mirror the clinical situation where stressful life events impair mental health or promote behavioral change, we examined the post-exposure effects of stress on cognitive flexibility in mice.
METHODS
We tested female C57BL/6JOlaHsd mice in the touchscreen-based sequential reversal learning test. Corticosterone (CORT) was used as a model of stress and was administered in the drinking water for two weeks before reversal learning. Control animals received drinking water without CORT. Behaviors in supplementary tests were included to exclude non-specific confounding effects of CORT and improve interpretation of the results.
RESULTS
CORT-treated mice were similar to controls on all touchscreen parameters before reversal. During the low accuracy phase of reversal learning, CORT reduced perseveration index, a measure of perseverative responding, but did not affect acquisition of the new reward contingency. This effect was not related to non-specific deficits in chamber activity. CORT increased anxiety-like behavior in the elevated zero maze test and repetitive digging in the marble burying test, reduced locomotor activity, but did not affect spontaneous alternation behavior.
CONCLUSION
CORT improved cognitive flexibility in the reversal learning test by extinguishing prepotent responses that were no longer rewarded, an effect possibly related to a stress-mediated increase in sensitivity to negative feedback that should be confirmed in a larger study.
Topics: Humans; Mice; Animals; Female; Corticosterone; Reversal Learning; Drinking Water; Mice, Inbred C57BL; Maze Learning
PubMed: 37169127
DOI: 10.1016/j.bbr.2023.114479 -
PloS One 2023Depressive symptoms have been shown to be negatively related to academic achievement, as measured by grade point average (GPA). Grit, or the passion for and the ability...
Depressive symptoms have been shown to be negatively related to academic achievement, as measured by grade point average (GPA). Grit, or the passion for and the ability to persevere toward a goal despite adversity, has been linked to GPA. Thus, grit may potentially buffer against the negative effects of depressive symptoms in relation to academic achievement. However, social desirability may might impact the validity of grit when assessed by self-report measures, so how these constructs are all related is unknown. The current study explored the relationship between depressive symptoms, grit, social desirability, and GPA among University students (N = 520) in the United States using a cross-sectional design. We conducted a moderated-moderation model to examine how social desirability moderated the relationship between depressive symptoms, grit, and GPA. Findings replicated prior work and indicated negative relationships between depressive symptoms and social desirability with GPA and a positive relationship, albeit non-significant, between grit and GPA. However, results suggest that grit did not moderate the relationship between depressive symptoms and GPA when including social desirability in the model. Future research should investigate this relationship in a longitudinal setting to further examine how grit and depressive symptoms influence one another in academic domains.
Topics: Humans; Academic Success; Achievement; Depression; Cross-Sectional Studies; Motivation
PubMed: 37418474
DOI: 10.1371/journal.pone.0288270 -
Contemporary Clinical Trials Sep 2023Pain and depression frequently co-occur among older adults with comorbidities and can exacerbate one another. The intersection of race, gender and age puts older African...
BACKGROUND
Pain and depression frequently co-occur among older adults with comorbidities and can exacerbate one another. The intersection of race, gender and age puts older African American women at high risk of experiencing comorbid pain and depression. The purpose of this study is to test the feasibility and acceptability of a 12-week behavioral activation intervention called DAPPER (Depression and Pain Perseverance through Empowerment and Recovery) that uses non-pharmacological, tailored strategies to target pain and mood symptoms. We will measure pain intensity and depressive symptoms as outcomes, although we are not powered to test differences.
METHODS
We describe the protocol for this study that uses a randomized waitlist control design to examine acceptability and feasibility of an intervention. The study population is comprised of self-identified African American women, 50 years of age or older with chronic pain and who self-report of depressive symptoms. Participants must also be pre-frail or frail and have an ADL or IADL limitation. The intervention consists of eight 1-2-h visits with a nurse interventionist via in-person or virtual telecommunication methods and two visits for non-invasive specimen collection. The primary outcomes include goal attainment, pain and depressive symptoms. Secondary outcomes include stress, frailty, and communication with providers. Follow-up qualitative interviews are conducted with participants to assess intervention acceptability.
DISCUSSION
Findings from this pilot study will provide further evidence supporting the use of non-pharmacological techniques to intervene in the cycle of pain and depression among an at-risk sub-population.
Topics: Aged; Female; Humans; Middle Aged; Affect; Black or African American; Chronic Pain; Depression; Pilot Projects; Randomized Controlled Trials as Topic; Waiting Lists
PubMed: 37478967
DOI: 10.1016/j.cct.2023.107299 -
Antibiotics (Basel, Switzerland) Aug 2023Antimicrobial resistance is one of the major global health threats. Antimicrobial stewardship (AMS) has been set as a priority within international action plans to... (Review)
Review
Antimicrobial resistance is one of the major global health threats. Antimicrobial stewardship (AMS) has been set as a priority within international action plans to combat this issue. The region of Latin America and the Caribbean are recognized for their high antimicrobial resistance rates; nevertheless, a low number of studies describing implemented interventions for this topic have been published. This review aims to provide an overview of the status of AMS in our region, focusing on the main progress achieved and describing the different published efforts made by countries towards the implementation of antimicrobial stewardship programs (ASP). Common areas of intervention included were (a) education approaches, (b) antimicrobial guideline implementation and monitoring, (c) diagnostic stewardship, (d) technological tools: electronic clinical decision support systems in AMS, (e) pharmacy-driven protocols and collaborative practice agreements, and (f) economic impact. The search demonstrated the varied interventions implemented in diverse healthcare settings; the results accentuate their influence on antimicrobial consumption, antimicrobial resistance, clinical outcomes, and direct economic impact. The integration of multiple strategies within each hospital was highlighted as an essential key to ASP success. Even though the literature found demonstrated clear progress, there is still a special need for strengthening leadership from the top down, defining goals based on needs, and gaining support through policy and financing in LAC.
PubMed: 37627762
DOI: 10.3390/antibiotics12081342 -
Journal of the American Geriatrics... Oct 2023Multiple myeloma (MM) is an incurable debilitating blood cancer associated with the lowest health related quality of life (HRQoL) of all cancers. With nearly 88% of...
BACKGROUND
Multiple myeloma (MM) is an incurable debilitating blood cancer associated with the lowest health related quality of life (HRQoL) of all cancers. With nearly 88% of adults aged ≥55 years at diagnosis, age-associated physical losses, comorbidities, and social factors contribute to worsening HRQoL. This qualitative study assessed dyadic (patient-informal caregiver) perspectives on the factors contributing to HRQoL in MM survivors.
METHODS
We recruited 21 dyads from the UNC-Chapel Hill Lineberger Comprehensive Cancer between 11/2021 and 04/2022. Participants completed a single dyadic semistructured interview capturing broad perspectives on MM. We used ATLAS. ti v 9 for project management and to facilitate data analysis using the Sort and Sift, Think and Shift approach (ResearchTalk, Inc.). This iterative approach allowed the exploration and identification of themes within and across transcripts.
RESULTS
The mean age at enrollment was 71 years (median: 71, range: 57-90) for patients and 68 years (median 67, range: 37-88) for caregivers. All dyads were racially concordant (11 Black/AA and 10 White). However, we aggregated the findings due to no consistent racial differences. Six themes related to (1) physical burden, (2) treatment challenges, (3) losses of independence, (4) caregiver burden, (5) patient and caregiver perseverance, and (6) adjustment to a new normal were identified. Dyads also experienced MM together, resulting in patients and caregivers experiencing changes in their ability to engage in physical and social activities, which further contributed to poor HRQoL. Patients' increased need for social support led to shifts in the caregiver roles, resulting in caregivers feeling burdened by their responsibilities. All dyads acknowledged the need for perseverance and adaptability to a new normal with MM.
CONCLUSION
The functional, psychosocial, and HRQoL of older patients with MM and their caregivers remain impacted ≥6 months after a new diagnosis highlighting clinical and research opportunities to focus on preserving or improving the health of dyads living with MM.
Topics: Humans; Caregivers; Multiple Myeloma; Patients; Quality of Life; Black or African American; White
PubMed: 37326501
DOI: 10.1111/jgs.18482 -
Social Cognitive and Affective... Oct 2023Grit is a personality trait that encapsulates the tendency to persevere and maintain consistent interest for long-term goals. While prior studies found that grit...
Grit is a personality trait that encapsulates the tendency to persevere and maintain consistent interest for long-term goals. While prior studies found that grit predicts positive behavioral outcomes, there is a paucity of work providing explanatory evidence from a neurodevelopmental perspective. Based on previous research suggesting the utility of the functional connectome (FC) as a developmental measure, we tested the idea that individual differences in grit might be, in part, rooted in brain development in adolescence and emerging adulthood (N = 64, 11-19 years of age). Our analysis showed that grit was associated with connectome stability across conditions and connectome similarity across individuals. Notably, inter-subject representational similarity analysis revealed that teenagers who were grittier shared similar FC architecture with each other, more so than those with lower grit. Our findings suggest that individuals with high levels of grit are more likely to exhibit a converging pattern of whole-brain functional connectivity, which may underpin subsequent beneficial behavioral outcomes.
Topics: Adolescent; Humans; Adult; Connectome; Brain; Individuality; Magnetic Resonance Imaging
PubMed: 37700673
DOI: 10.1093/scan/nsad047 -
Pediatric Critical Care Medicine : a... Jun 2024Identification of children with sepsis-associated multiple organ dysfunction syndrome (MODS) at risk for poor outcomes remains a challenge. We sought to the determine...
OBJECTIVES
Identification of children with sepsis-associated multiple organ dysfunction syndrome (MODS) at risk for poor outcomes remains a challenge. We sought to the determine reproducibility of the data-driven "persistent hypoxemia, encephalopathy, and shock" (PHES) phenotype and determine its association with inflammatory and endothelial biomarkers, as well as biomarker-based pediatric risk strata.
DESIGN
We retrained and validated a random forest classifier using organ dysfunction subscores in the 2012-2018 electronic health record (EHR) dataset used to derive the PHES phenotype. We used this classifier to assign phenotype membership in a test set consisting of prospectively (2003-2023) enrolled pediatric septic shock patients. We compared profiles of the PERSEVERE family of biomarkers among those with and without the PHES phenotype and determined the association with established biomarker-based mortality and MODS risk strata.
SETTING
Twenty-five PICUs across the United States.
PATIENTS
EHR data from 15,246 critically ill patients with sepsis-associated MODS split into derivation and validation sets and 1,270 pediatric septic shock patients in the test set of whom 615 had complete biomarker data.
INTERVENTIONS
None.
MEASUREMENTS AND MAIN RESULTS
The area under the receiver operator characteristic curve of the modified classifier to predict PHES phenotype membership was 0.91 (95% CI, 0.90-0.92) in the EHR validation set. In the test set, PHES phenotype membership was associated with both increased adjusted odds of complicated course (adjusted odds ratio [aOR] 4.1; 95% CI, 3.2-5.4) and 28-day mortality (aOR of 4.8; 95% CI, 3.11-7.25) after controlling for age, severity of illness, and immunocompromised status. Patients belonging to the PHES phenotype were characterized by greater degree of systemic inflammation and endothelial activation, and were more likely to be stratified as high risk based on PERSEVERE biomarkers predictive of death and persistent MODS.
CONCLUSIONS
The PHES trajectory-based phenotype is reproducible, independently associated with poor clinical outcomes, and overlapped with higher risk strata based on prospectively validated biomarker approaches.
Topics: Humans; Biomarkers; Female; Male; Child; Child, Preschool; Phenotype; Infant; Shock, Septic; Hypoxia; Intensive Care Units, Pediatric; Multiple Organ Failure; Adolescent; Sepsis; Reproducibility of Results; Risk Assessment; Prospective Studies; Sepsis-Associated Encephalopathy; ROC Curve; Organ Dysfunction Scores
PubMed: 38465952
DOI: 10.1097/PCC.0000000000003499 -
Journal of Human Kinetics Oct 2023This study analyzed the effects of psychological responses (impulsivity, self-esteem, self-confidence, and anxiety) in baseline and pre-competitive contexts of national...
This study analyzed the effects of psychological responses (impulsivity, self-esteem, self-confidence, and anxiety) in baseline and pre-competitive contexts of national soccer referees (SRs), their control of the game (yellow and red cards), and physical performance (PP) according to the role (assistant or main referee), and experience in the category. Twenty-seven national SRs from Spain participated in this study. Baseline and pre-competitive psychological data were collected through the Competitive State Anxiety Inventory-2 (CSAI-2 test), Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency, Impulsive Behavior Scale (UPPS-P test), and Rosenberg tests. Furthermore, WIMU PRO™ inertial devices were used to monitor PP. The results indicated that a lack of perseverance and self-esteem were higher in the main SRs and somatic anxiety in assistant SRs. Experience of SRs was related to anxiety, self-confidence, self-esteem, impulsivity dimensions, and PP metrics (p < 0.05). Finally, red cards were related to positive and negative urgency (r = 0.38 and r = 0.35, p < 0.05, respectively). In conclusion, the main SRs and SRs with more experience had better psychological characteristics and PP in a competitive context. However, yellow and red cards were not associated with these factors, although red cards were related with urgency. Based on these data, specific training programs could be incorporated to enhance emotional control in SRs with less experience to achieve greater performance and professional development.
PubMed: 38053965
DOI: 10.5114/jhk/169174 -
Molecular Biotechnology Jun 2024Myocardial ischemia-reperfusion injury (MIRI) is fatal to patients, leading to cardiomyocyte death and myocardial remodeling. Reactive oxygen species (ROS) and oxidative... (Review)
Review
Myocardial ischemia-reperfusion injury (MIRI) is fatal to patients, leading to cardiomyocyte death and myocardial remodeling. Reactive oxygen species (ROS) and oxidative stress play important roles in MIRI. There is a complex crosstalk between ROS and regulatory cell deaths (RCD) in cardiomyocytes, such as apoptosis, pyroptosis, autophagy, and ferroptosis. ROS is a double-edged sword. A reasonable level of ROS maintains the normal physiological activity of myocardial cells. However, during myocardial ischemia-reperfusion, excessive ROS generation accelerates myocardial damage through a variety of biological pathways. ROS regulates cardiomyocyte RCD through various molecular mechanisms. Targeting the removal of excess ROS has been considered an effective way to reverse myocardial damage. Many studies have applied antioxidant drugs or new advanced materials to reduce ROS levels to alleviate MIRI. Although the road from laboratory to clinic has been difficult, many scholars still persevere. This article reviews the molecular mechanisms of ROS inhibition to regulate cardiomyocyte RCD, with a view to providing new insights into prevention and treatment strategies for MIRI.
PubMed: 38852121
DOI: 10.1007/s12033-024-01173-y -
Pathogens (Basel, Switzerland) Apr 2024As the Global Polio Eradication Initiative (GPEI) strategizes towards the final steps of eradication, routine immunization schedules evolve, and high-quality vaccination... (Review)
Review
As the Global Polio Eradication Initiative (GPEI) strategizes towards the final steps of eradication, routine immunization schedules evolve, and high-quality vaccination campaigns and surveillance systems remain essential. New tools are consistently being developed, such as the novel oral poliovirus vaccine to combat outbreaks more sustainably, as well as non-infectiously manufactured vaccines such as virus-like particle vaccines to eliminate the risk of resurgence of polio on the eve of a polio-free world. As the GPEI inches towards eradication, re-strategizing in the face of evolving challenges and preparing for unknown risks in the post-certification era are critical.
PubMed: 38668278
DOI: 10.3390/pathogens13040323