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1.
J Environ Qual ; 2024 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-39086210

RESUMO

The Eastern Corn Belt (ECB) Long-Term Agroecosystem Research (LTAR) network site is one of the most agriculturally productive areas in the United States; however, nutrient and sediment losses from this region directly contribute to water quality impairment in both the Gulf of Mexico and Lake Erie. One of the largest challenges facing agricultural production in the ECB is water management, especially under a changing climate. Shifting precipitation patterns in combination with evolving infrastructure (i.e., tile drainage, irrigation) and management (i.e., crops planted; 4R nutrient management: source, timing, rate, and placement) in response to changing climate are likely to alter water quantity and quality and agricultural productivity. Through plot- and field-scale research, the ECB Common Experiment (CE) is focused on crop, soil, and water management to support sustainable agricultural intensification, with the goal of maximizing profitability, minimizing agriculture's environmental footprint, and enhancing ecosystem services. At both spatial scales, the CE aims to examine differences in water quantity and quality between the primary prevailing crop production system in the ECB (i.e., corn [Zea mays L.]-soybean [Glycine max L.] rotation, tillage prior to corn planting, free drainage, and fertility management consistent with tri-state recommendations) and an alternative system (e.g., adding small grains into the crop rotation, cover crops, limited phosphorus fertilizer, and drainage water management). Aligning producer and stakeholders needs with research objectives and long-term data collection, the ECB CE will tackle both ongoing and newly emerging research priorities and explore the effectiveness of conservation strategies to decrease nutrient and sediment losses from agricultural land.

2.
Artigo em Inglês | MEDLINE | ID: mdl-39089513

RESUMO

BACKGROUND & AIMS: Noninvasive variceal risk stratification systems have not been validated in patients with hepatocellular carcinoma (HCC), which presents logistical barriers for patients in the setting of systemic HCC therapy. We aimed to develop and validate a noninvasive algorithm for the prediction of varices in patients with unresectable HCC. METHODS: We performed a retrospective cohort study in 21 centers in the United States including adult patients with unresectable HCC and Child-Pugh A5-B7 cirrhosis diagnosed between 2007 and 2019. We included patients who completed an esophagogastroduodonoscopy (EGD) within 12 months of index imaging but before HCC treatment. We divided the cohort into a 70:30 training set and validation set, with the goal of maximizing negative predictive value (NPV) to avoid EGD in low-risk patients. RESULTS: We included 707 patients (median age, 64.6 years; 80.6% male; 74.0% White). Median time from HCC diagnosis to EGD was 47 (interquartile range, 114) days, with 25.0% of patients having high-risk varices. A model using clinical variables alone achieved an NPV of 86.3% in the validation cohort, whereas a model integrating clinical and imaging variables had an NPV 97.4% in validation. The clinical and imaging model would avoid EGDs in more than half of low-risk patients while misclassifying 7.7% of high-risk patients. CONCLUSIONS: A model incorporating clinical and imaging data can accurately predict the absence of high-risk varices in patients with HCC and avoid EGD in many low-risk patients before the initiation of systemic therapy, thus expediting their care and avoiding treatment delays.

3.
JAMA Netw Open ; 7(8): e2429661, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39186273

RESUMO

Importance: The global refugee crisis disproportionately affects the Muslim world. Forced displacement often results in trauma-related mental health issues. Effective psychotherapy exists, but there are barriers to uptake by refugee groups as well as a lack of culturally appropriate interventions. Objective: To examine the efficacy of a brief, lay-led, mosque-based intervention, Islamic Trauma Healing (ITH), adapting empirically supported cognitive behavioral principles to improve mental health and well-being. Design, Setting, and Participants: In a randomized clinical trial, 101 participants received ITH or active assessment but delayed intervention (waiting list [WL]) in mosques and virtually in Seattle, Washington, and Columbus, Ohio, and were assessed through 12-week follow-up. Data were collected from July 14, 2018, through July 14, 2022, and data analysis was conducted from March 13 to July 31, 2023. United States-based refugees from Somalia who experienced a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Criterion A trauma exposure and posttraumatic stress disorder (PTSD) reexperiencing or avoidance. Analyses were intention-to-treat, using full information likelihood for missing data. Intervention: Islamic Trauma Healing included psychoeducation, discussion of the lives of prophets who had undergone trauma, and informal prayer turning to Allah about the trauma, incorporating cognitive restructuring and imaginal exposure. Lay-leader training is purposely brief: two 4-hour sessions with weekly supervision. Main Outcomes and Measures: The primary outcome was PTSD severity (measured with the Posttraumatic Diagnostic Scale for DSM-5 [PDS-5]). Secondary outcomes included depression (Patient Health Questionnaire-9), somatic symptoms (Somatic Symptoms Severity-8), and quality of well-being (World Health Organization Five Well-Being Index). Analyses were intention-to-treat. Results: Analyses were based on all 101 randomized participants (92 [91.1%] women; 9 [8.9%] men; mean [SD] age, 46.5 [12.02] years) with baseline mean (SD) PDS-5 score of 31.62 (16.55) points. There were significant differences in PTSD severity (d = -0.67), depression (d = -0.66), and well-being (d = 0.71), comparing ITH vs WL after the intervention. Gains were maintained through 12-week follow-up. Islamic Trauma Healing was consistent with religious and cultural practices (mean [SD], 3.8 [0.43]) and promoted community reconciliation (mean [SD], 3.8 [0.42]). Conclusions and Relevance: In this randomized clinical trial of a brief, lay-led mental health intervention, ITH proved superior to WL. The findings suggest that ITH has the potential to provide an easily trainable and scalable intervention, incorporating Islam and empirically supported principles, that addresses the psychological wounds of war and refugee trauma. Trial Registration: ClinicalTrials.gov Identifier: NCT03502278.


Assuntos
Islamismo , Refugiados , Transtornos de Estresse Pós-Traumáticos , Humanos , Refugiados/psicologia , Feminino , Masculino , Adulto , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia , Islamismo/psicologia , Pessoa de Meia-Idade , Somália/etnologia , Terapia Cognitivo-Comportamental/métodos
4.
Oncotarget ; 15: 444-458, 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38985143

RESUMO

OBJECTIVE: Patients with relapsed or metastatic head and neck squamous cell carcinoma (HNSCC) after primary local therapy have low response rates with cetuximab, systemic chemotherapy or check point inhibitor therapy. Novel combination therapies with the potential to improve outcomes for patients with HNSCC is an area of high unmet need. METHODS: This is a phase II single-arm clinical trial of locally advanced or metastatic HNSCC patients treated with a combination of soluble EphB4-human serum albumin (sEphB4-HSA) fusion protein and pembrolizumab after platinum-based chemotherapy with up to 2 prior lines of treatment. The primary endpoints were safety and tolerability and the primary efficacy endpoint was overall response rate (ORR). Secondary endpoints included progression free survival (PFS) and overall survival (OS). HPV status and EphrinB2 expression were evaluated for outcome. RESULTS: Twenty-five patients were enrolled. Median follow up was 40.4 months (range 9.8 - 40.4). There were 6 responders (ORR 24%). There were 5 responders in the 11 HPV-negative and EphrinB2 positive patients, (ORR 45%) with 2 of these patients achieving a complete response (CR). The median PFS in HPV-negative/EphrinB2 positive patients was 3.2 months (95% CI 1.1, 7.3). Median OS in HPV-negative/EphrinB2 positive patients was 10.9 months (95% CI 2.0, 13.7). Hypertension, transaminitis and fatigue were the most common toxicities. DISCUSSION: The combination of sEphB4-HSA and pembrolizumab has a favorable toxicity profile and favorable activity particularly among HPV-negative EphrinB2 positive patients with HNSCC.


Assuntos
Anticorpos Monoclonais Humanizados , Efrina-B2 , Neoplasias de Cabeça e Pescoço , Receptor EphB4 , Carcinoma de Células Escamosas de Cabeça e Pescoço , Humanos , Anticorpos Monoclonais Humanizados/uso terapêutico , Feminino , Masculino , Pessoa de Meia-Idade , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/metabolismo , Neoplasias de Cabeça e Pescoço/patologia , Idoso , Efrina-B2/metabolismo , Adulto , Carcinoma de Células Escamosas de Cabeça e Pescoço/tratamento farmacológico , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Receptor EphB4/metabolismo , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Infecções por Papillomavirus/virologia , Resultado do Tratamento , Proteínas Recombinantes de Fusão/uso terapêutico , Idoso de 80 Anos ou mais
5.
J Pers ; 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39015055

RESUMO

OBJECTIVE: Test whether global self-reports of urgency moderated the within-person associations of affect and impulsive behaviors. BACKGROUND: Negative urgency is a personality trait that is a risk factor for a range of psychopathology. Although it is assumed that global self-reports of urgency measure individual tendencies to act more impulsively in the face of negative emotions, evidence from ecological momentary assessment studies is mixed. METHOD: In this Registered Report, we used ecological momentary assessment data from a large sample of young adults (n = 496, age 18-22, 5 surveys per day for 40 days). RESULTS: All forms of momentary impulsivity were impaired in moments when people reported more intense negative emotions, but global self-reports of urgency did not explain individual differences in this association. Moreover, averaged affective states, rather than specific dimensions, affective circumplex, or appraisals, best predicted impulsive states. CONCLUSIONS: Results suggest that face-valid interpretations of global self-report of urgency are inaccurate, and it may be important to understand how some people come to understand themselves as high on urgency rather than assuming that people's self-reports of their motivations are accurate. Momentary experiences of emotions globally impact multiple weakly to moderately associated impulsive behaviors, and future research should seek to understand both when and for whom these associations are strongest.

6.
J Affect Disord ; 360: 376-386, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-38823593

RESUMO

Evidence suggests that loneliness causes people to feel more depressed. It is unknown, however, why this association occurs and whether momentary versus chronic experiences of loneliness are implicated. Theoretical accounts suggest that momentary feelings of loneliness produce two competing motivations: social reaffiliation and social withdrawal. Social affiliation is protective against depression; social withdrawal, in contrast, is a risk factor. Thus, engaging in frequent and high-quality interactions following experiences of loneliness may protect against subsequent depression. We tested this hypothesis using a random-interval experience sampling design (5x/day/day, 14 days; Nobs = 6568) with a racially/ethnically diverse sample of adults with elevated depression symptoms (N = 102). Momentary loneliness was associated with depressed mood at the same time point and âˆ¼2.5h and âˆ¼5h later. Frequency and quality of social interaction did not moderate these associations. Findings suggest that momentary feelings of loneliness may be an important target for clinical intervention.


Assuntos
Depressão , Avaliação Momentânea Ecológica , Solidão , Interação Social , Humanos , Solidão/psicologia , Feminino , Masculino , Adulto , Depressão/psicologia , Pessoa de Meia-Idade , Adulto Jovem
7.
Compr Psychiatry ; 133: 152495, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38728844

RESUMO

INTRODUCTION: Recent technology has enabled researchers to collect ecological momentary assessments (EMA) to examine within-person correlates of suicidal thoughts. Prior studies examined generalized temporal dynamics of emotions and suicidal thinking over brief periods, but it is not yet known how variable these processes are across people. METHOD: We use data EMA data delivered over two weeks with youth/young adults (N = 60) who reported past year self-injurious thoughts/behaviors. We used group iterative multiple model estimation (GIMME) to model group- and person-specific associations of negative emotions (i.e., fear, sadness, shame, guilt, and anger) and suicidal thoughts. RESULTS: 29 participants (48.33%) reported at least one instance of a suicidal thought and were included in GIMME models. In group level models, we consistently observed autoregressive effects for suicidal thoughts (e.g., earlier thoughts predicting later thoughts), although the magnitude and direction of this link varied from person-to-person. Among emotions, sadness was most frequently associated with contemporaneous suicidal thoughts, but this was evident for less than half of the sample, while other emotional correlates of suicidal thoughts broadly differed across people. No emotion variable was linked to future suicidal thoughts in >14% of the sample, CONCLUSIONS: Emotion-based correlates of suicidal thoughts are heterogeneous across people. Better understanding of the individual-level pathways maintaining suicidal thoughts/behaviors may lead to more effective, personalized interventions.


Assuntos
Avaliação Momentânea Ecológica , Emoções , Ideação Suicida , Humanos , Feminino , Masculino , Adulto Jovem , Adolescente , Adulto , Tristeza/psicologia , Ira , Vergonha , Medo/psicologia , Culpa
8.
Implement Sci ; 19(1): 36, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38802827

RESUMO

BACKGROUND: Integrated care involves care provided by a team of professionals, often in non-traditional settings. A common example worldwide is integrated school-based mental health (SBMH), which involves externally employed clinicians providing care at schools. Integrated mental healthcare can improve the accessibility and efficiency of evidence-based practices (EBPs) for vulnerable populations suffering from fragmented traditional care. However, integration can complicate EBP implementation due to overlapping organizational contexts, diminishing the public health impact. Emerging literature suggests that EBP implementation may benefit from the similarities in the implementation context factors between the different organizations in integrated care, which we termed inter-organizational alignment (IOA). This study quantitatively explored whether and how IOA in general and implementation context factors are associated with implementation outcomes in integrated SBMH. METHODS: SBMH clinicians from community-based organizations (CBOs; nclinician = 27) and their proximal student-support school staff (nschool = 99) rated their schools and CBOs (clinician only) regarding general (organizational culture and molar climate) and implementation context factors (Implementation Climate and Leadership), and nine common implementation outcomes (e.g., treatment integrity, service access, acceptability). The levels of IOA were estimated by intra-class correlations (ICCs). We fitted multilevel models to estimate the standalone effects of context factors from CBOs and schools on implementation outcomes. We also estimated the 2-way interaction effects between CBO and school context factors (i.e., between-setting interdependence) on implementation outcomes. RESULTS: The IOA in general context factors exceeded those of implementation context factors. The standalone effects of implementation context factors on most implementation outcomes were larger than those of general context factors. Similarly, implementation context factors between CBOs and schools showed larger 2-way interaction effects on implementation outcomes than general context factors. CONCLUSIONS: This study preliminarily supported the importance of IOA in context factors for integrated SBMH. The findings shed light on how IOA in implementation and general context factors may be differentially associated with implementation outcomes across a broad array of integrated mental healthcare settings.


Assuntos
Prestação Integrada de Cuidados de Saúde , Cultura Organizacional , Humanos , Adolescente , Estudos Transversais , Criança , Prestação Integrada de Cuidados de Saúde/organização & administração , Feminino , Masculino , Liderança , Prática Clínica Baseada em Evidências/organização & administração , Ciência da Implementação , Serviços de Saúde Mental/organização & administração , Serviços de Saúde Mental Escolar/organização & administração , Adulto , Serviços de Saúde Escolar/organização & administração
9.
Pathogens ; 13(4)2024 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-38668285

RESUMO

To date, there have been no DNA-based metabarcoding studies into airborne fungi in tropical Sub-Saharan Africa. In this initial study, 10 air samples were collected onto Vaseline-coated acrylic rods mounted on drones flown at heights of 15-50 meters above ground for 10-15 min at three sites in Ghana. Purified DNA was extracted from air samples, the internal transcribed spacer (ITS) region was amplified using fungal-specific primers, and MinION third-generation amplicon sequencing was undertaken with downstream bioinformatics analyses utilizing GAIA cloud-based software (at genus taxonomic level). Principal coordinate analyses based on Bray-Curtis beta diversity dissimilarity values found no clear evidence for the structuring of fungal air communities, nor were there significant differences in alpha diversity, based on geographic location (east vs. central Ghana), underlying vegetation type (cocoa vs. non-cocoa), or height above ground level (15-23 m vs. 25-50 m), and despite the short flight times (10-15 min), ~90 operational taxonomic units (OTUs) were identified in each sample. In Ghanaian air, fungal assemblages were skewed at the phylum taxonomic level towards the ascomycetes (53.7%) as opposed to basidiomycetes (24.6%); at the class level, the Dothideomycetes were predominant (29.8%) followed by the Agaricomycetes (21.8%). The most common fungal genus in Ghanaian air was cosmopolitan and globally ubiquitous Cladosporium (9.9% of reads). Interestingly, many fungal genera containing economically important phytopathogens of tropical crops were also identified in Ghanaian air, including Corynespora, Fusarium, and Lasiodiplodia. Consequently, a novel loop-mediated isothermal amplification (LAMP) assay, based on translation elongation factor-1α sequences, was developed and tested for rapid, sensitive, and specific detection of the fungal phytopathogenic genus Lasiodiplodia. Potential applications for improved tropical disease management are considered.

10.
J Environ Qual ; 53(2): 241-252, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38409568

RESUMO

Agricultural phosphorus (P) losses are harmful to water quality, but knowledge gaps about the importance of fertilizer management practices on new (recently applied) sources of P may limit P loss mitigation efforts. Weighted regression models applied to subsurface tile drainage water quality data enabled estimating the new P losses associated with 155 P applications in Ohio and Indiana, USA. Daily discharge and dissolved reactive P (DRP) and total P (TP) loads were used to detect increases in P loss following each application which was considered new P. The magnitude of new P losses was small relative to fertilizer application rates, averaging 79.3 g DRP ha-1 and 96.1 g TP ha-1 , or <3% of P applied. The eight largest new P losses surpassed 330 g DRP ha-1 or 575 g TP ha-1 . New P loss mitigation strategies should focus on broadcast liquid manure applications; on average, manure applications caused greater new P losses than inorganic fertilizers, and surface broadcast applications were associated with greater new P losses than injected or incorporated applications. Late fall applications risked having large new P losses applications. On an annual basis, new P contributed an average of 14% of DRP and 5% of TP losses from tile drains, which is much less than previous studies that included surface runoff, suggesting that tile drainage is relatively buffered with regard to new P losses. Therefore old (preexisting soil P) P sources dominated tile drain P losses, and P loss reduction efforts will need to address this source.


Assuntos
Fertilizantes , Fósforo , Esterco , Movimentos da Água , Chuva , Agricultura
11.
Psychol Addict Behav ; 38(4): 409-423, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38190199

RESUMO

OBJECTIVE: It is hypothesized that alcohol use is reinforcing when used as a strategy to cope with negative affect. Although the evidence for this hypothesis in observational data is weak, some experimental evidence suggests that the behavioral economic demand for alcohol increases immediately following a negative emotional event. We hypothesized that people show a higher demand for alcohol following negative (vs. neutral) mood inductions and that this effect is stronger in people who report heavier drinking compared to people who report lighter drinking as well as stronger on days characterized by higher coping motives and negative urgency. METHOD: 309 college students who reported recent alcohol consumption (MAUDIT = 6.86) completed the alcohol purchase task after being subjected to 12 mood inductions (six negative, six neutral, order randomized) on 12 separate days. RESULTS: In our preregistered analyses, we found no evidence that the behavioral economic demand for alcohol was elevated following negative mood inductions. The mood inductions in our study were not as strong as has been reported in previous research, weakening the preregistered inferences. In exploratory analyses performed on a subset of the data in which the mood inductions worked as intended, demand was higher following negative mood inductions. CONCLUSIONS: The results of this study are not conclusive. In light of previous research, we consider these data to slightly increase our confidence that demand for alcohol is increased immediately following a negative emotional event. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Afeto , Economia Comportamental , Humanos , Feminino , Masculino , Adulto Jovem , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Estudantes/psicologia , Motivação , Consumo de Álcool na Faculdade/psicologia , Adaptação Psicológica , Adolescente
12.
Res Sq ; 2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38260462

RESUMO

Background: Integrated care involves care provided by a team of professionals, often in non-traditional settings. A common example worldwide is integrated school-based mental health (SBMH), which involves externally employed clinicians providing care at schools. Integrated mental healthcare can improve the accessibility and efficiency of evidence-based practices (EBPs) for vulnerable populations suffering from fragmented traditional care. However, integration can complicate EBP implementation due to overlapping organizational contexts, diminishing the public health impact. Emerging literature suggests that EBP implementation may benefit from the similarities in the implementation context factors between the different organizations in integrated care, which we termed inter-organizational alignment (IOA). This study quantitatively explored whether and how IOAs in general and implementation context factors are associated with implementation outcomes in integrated SBMH. Methods: SBMH clinicians from community-based organizations (CBOs; nclinician=27) and their proximal student-support school staff (nschool=99) rated their schools and CBOs (clinician only) regarding general (organizational culture and molar climate) and implementation context factors (Implementation Climate and Leadership), and nine common implementation outcomes (e.g., treatment integrity, service access, acceptability). The levels of IOA were estimated by intra-class correlations (ICCs). We fitted multilevel models to estimate the standalone effects of context factors from CBOs and schools on implementation outcomes. We also estimated the 2-way interaction effects between CBO and school context factors (i.e., between-setting interdependence) on implementation outcomes. Results: The IOA in general context factors exceeded those of implementation context factors. The standalone effects of implementation context factors on most implementation outcomes were larger than those of general context factors. Similarly, implementation context factors between CBOs and schools showed larger 2-way interaction effects on implementation outcomes than general context factors. Conclusions: This study preliminarily supported the importance of IOA in context factors for integrated SBMH. The findings shed light on how IOA in implementation and general context factors may be differentially associated with implementation outcomes across a broad array of integrated mental healthcare settings.

13.
Pest Manag Sci ; 80(5): 2453-2460, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-37759372

RESUMO

BACKGROUND: Detection of the inoculum of phytopathogens greatly assists in the management of diseases, but is difficult for pathogens with airborne fungal propagules. Here, we present experiments to determine the abundance and distribution frequencies of the ascospores of Leptosphaeria (Plenodomus) species that were collected on the tapes of volumetric Hirst-type traps near oilseed rape fields in Poznan, Poland and Harpenden, UK. Fungal detection and species discrimination were achieved using a SYBR-Green quantitative polymerase chain reaction (qPCR) with two different pairs of primers previously reported to differentiate Leptosphaeria maculans (Plenodomus lingam) or L. biglobosa (P. biglobosus). RESULTS: Detection was successful even at fewer than five spores per m3 of air. The primer pairs differed in the correlation coefficients obtained between DNA yields and the daily abundance of ascospores that were quantified by microscopy on duplicate halves of the spore trap tapes. Important differences in the specificity and sensitivity of the published SYBR-Green assays were also found, indicating that the Liu primers did not detect L. biglobosa subclade 'canadensis', whereas the Mahuku primers detected L. biglobosa subclade 'canadensis' and also the closely related Plenodomus dezfulensis. CONCLUSIONS: Comparisons confirmed that application of qPCR assays to spore trap samples can be used for the early detection, discrimination and quantification of aerially dispersed L. maculans and L. biglobosa propagules before leaf spot symptoms are visible in winter oilseed rape fields. The specificity of the primers must be taken into consideration because the final result will greatly depend on the local population of the pathogen. © 2023 Society of Chemical Industry.


Assuntos
Brassica napus , Leptosphaeria , Phoma , Doenças das Plantas/microbiologia , Esporos Fúngicos
15.
Pract Radiat Oncol ; 14(2): e132-e140, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37923137

RESUMO

PURPOSE: This trial's purpose was to determine the late toxicity associated with dose escalation to Prostate Imaging Reporting and Data System (PI-RADS) III-V lesions on multiparametric magnetic resonance imaging (MRI) with an image guided combined IMRT-stereotactic body radiation therapy (SBRT) approach in men with localized prostate cancer. METHODS AND MATERIALS: In this phase 2 trial patients with localized prostate cancer with clinical tumor stage T1-T3bN0 and at least one PIRADS III-V lesion were recruited to receive 45 Gy in 25 fractions to the prostate and seminal vesicles followed by a boost of 18 Gy in 3 fractions to the prostate with a simultaneous integrated boost 21 Gy in 3 fractions to the PI-RADS lesion(s). The primary endpoint was the cumulative incidence of late grade ≥3 genitourinary and gastrointestinal toxicity by 18 months (National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0). RESULTS: Overall, 50 patients were enrolled in this study, and 43 patients completed at least 18 months of follow-up. The cumulative incidence of grade 1, 2, and 3 late genitourinary toxicity at 18 months was 18%, 53%, and 2%. One patient was noted to have grade 3 hematuria and needed cystoscopy-guided cauterization. No acute grade 3 gastrointestinal or genitourinary toxicities were observed. The cumulative incidence of grade 1, 2, and 3 late gastrointestinal toxicity at 18 months was 31%, 4%, and 0%, respectively. At a median follow-up of 43.5 months, 3 patients developed biochemical recurrence, each with distant bone metastases without local or nodal recurrence. At 3 years, freedom from biochemical failure rate was 95.3% (95% CI, 89.2%-100%). CONCLUSIONS: Multiparametric MRI-guided dose escalation to PI-RADS III-V lesions using a combined image guided IMRT-SBRT approach is associated with an acceptable risk of late gastrointestinal and genitourinary toxicity. The results should be interpreted with caution considering their single institutional nature, small sample size, and short follow-up and should be validated in a larger study.


Assuntos
Imageamento por Ressonância Magnética Multiparamétrica , Neoplasias da Próstata , Masculino , Humanos , Neoplasias da Próstata/radioterapia , Neoplasias da Próstata/patologia , Imageamento por Ressonância Magnética , Estudos Prospectivos , Fracionamento da Dose de Radiação
17.
Neurobiol Aging ; 132: 1-12, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37708739

RESUMO

In older adults with abnormal levels of Alzheimer's disease neuropathology, lower cerebrospinal fluid (CSF) vascular endothelial growth factor (VEGF) levels are associated with lower [¹8F]-fluorodeoxyglucose positron emission tomography (FDG-PET) signal, but whether this association is (1) specific to VEGF or broadly driven by vascular inflammation, or (2) modified by vascular risk (e.g., white matter hyperintensities [WMHs]) remains unknown. To address this and build upon our past work, we evaluated whether 5 CSF vascular inflammation biomarkers (vascular cell adhesion molecule 1, VEGF, C-reactive protein, fibrinogen, and von Willebrand factor)-previously associated with CSF amyloid levels-were related to FDG-PET signal and whether WMH volume modified these associations in 158 Alzheimer's Disease Neuroimaging Initiative participants (55-90 years old, 39 cognitively normal, 80 mild cognitive impairment, 39 Alzheimer's disease). We defined regions both by cortical boundary and by the 3 major vascular territories: anterior, middle, and posterior cerebral arteries. We found that WMH volume had interactive effects with CSF biomarkers (VEGF and C-reactive protein) on FDG-PET throughout the cortex in both vascular territories and conventionally defined regions of interest.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Substância Branca , Humanos , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/metabolismo , Fluordesoxiglucose F18/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Substância Branca/patologia , Proteína C-Reativa , Encéfalo/metabolismo , Tomografia por Emissão de Pósitrons/métodos , Biomarcadores/líquido cefalorraquidiano , Disfunção Cognitiva/metabolismo , Inflamação/metabolismo , Peptídeos beta-Amiloides/metabolismo , Imageamento por Ressonância Magnética
18.
Am J Physiol Heart Circ Physiol ; 325(5): H1193-H1209, 2023 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-37712923

RESUMO

Age-related changes in aortic biomechanics can impact the brain by reducing blood flow and increasing pulsatile energy transmission. Clinical studies have shown that impaired cardiac function in patients with heart failure is associated with cognitive impairment. Although previous studies have attempted to elucidate the complex relationship between age-associated aortic stiffening and pulsatility transmission to the cerebral network, they have not adequately addressed the effect of interactions between aortic stiffness and left ventricle (LV) contractility (neither on energy transmission nor on brain perfusion). In this study, we use a well-established and validated one-dimensional blood flow and pulse wave computational model of the circulatory system to address how age-related changes in cardiac function and vasculature affect the underlying mechanisms involved in the LV-aorta-brain hemodynamic coupling. Our results reveal how LV contractility affects pulsatile energy transmission to the brain, even with preserved cardiac output. Our model demonstrates the existence of an optimal heart rate (near the normal human heart rate) that minimizes pulsatile energy transmission to the brain at different contractility levels. Our findings further suggest that the reduction in cerebral blood flow at low levels of LV contractility is more prominent in the setting of age-related aortic stiffening. Maintaining optimal blood flow to the brain requires either an increase in contractility or an increase in heart rate. The former consistently leads to higher pulsatile power transmission, and the latter can either increase or decrease subsequent pulsatile power transmission to the brain.NEW & NOTEWORTHY We investigated the impact of major aging mechanisms of the arterial system and cardiac function on brain hemodynamics. Our findings suggest that aging has a significant impact on heart-aorta-brain coupling through changes in both arterial stiffening and left ventricle (LV) contractility. Understanding the underlying physical mechanisms involved here can potentially be a key step for developing more effective therapeutic strategies that can mitigate the contributions of abnormal LV-arterial coupling toward neurodegenerative diseases and dementia.


Assuntos
Coração , Rigidez Vascular , Humanos , Frequência Cardíaca , Hemodinâmica/fisiologia , Aorta , Rigidez Vascular/fisiologia , Encéfalo/irrigação sanguínea , Pressão Sanguínea/fisiologia
19.
J Neural Eng ; 20(4)2023 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-37552980

RESUMO

Objective.Currently, there exists very few ways to isolate cognitive processes, historically defined via highly controlled laboratory studies, in more ecologically valid contexts. Specifically, it remains unclear as to what extent patterns of neural activity observed under such constraints actually manifest outside the laboratory in a manner that can be used to make accurate inferences about latent states, associated cognitive processes, or proximal behavior. Improving our understanding of when and how specific patterns of neural activity manifest in ecologically valid scenarios would provide validation for laboratory-based approaches that study similar neural phenomena in isolation and meaningful insight into the latent states that occur during complex tasks.Approach.Domain generalization methods, borrowed from the work of the brain-computer interface community, have the potential to capture high-dimensional patterns of neural activity in a way that can be reliably applied across experimental datasets in order to address this specific challenge. We previously used such an approach to decode phasic neural responses associated with visual target discrimination. Here, we extend that work to more tonic phenomena such as internal latent states. We use data from two highly controlled laboratory paradigms to train two separate domain-generalized models. We apply the trained models to an ecologically valid paradigm in which participants performed multiple, concurrent driving-related tasks while perched atop a six-degrees-of-freedom ride-motion simulator.Main Results.Using the pretrained models, we estimate latent state and the associated patterns of neural activity. As the patterns of neural activity become more similar to those patterns observed in the training data, we find changes in behavior and task performance that are consistent with the observations from the original, laboratory-based paradigms.Significance.These results lend ecological validity to the original, highly controlled, experimental designs and provide a methodology for understanding the relationship between neural activity and behavior during complex tasks.


Assuntos
Interfaces Cérebro-Computador , Percepção Visual , Humanos , Análise e Desempenho de Tarefas , Projetos de Pesquisa , Discriminação Psicológica
20.
Psychol Addict Behav ; 37(8): 1030-1038, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37471009

RESUMO

OBJECTIVE: Although there is growing evidence that alcohol use at the daily level is associated with positive but not negative affect, results are mixed when examining marijuana use and simultaneous alcohol and marijuana (SAM) use (i.e., use with overlapping effects). In addition, less is known about these daily level associations among diverse samples of adolescents and young adults. The present study will address these gaps. METHOD: Participants (N = 1,006; 57.3% female, 43.1% White, Non-Hispanic, ages 15-25; Mage = 20.0) were part of a study on substance use that consisted of a 3-week ecological momentary assessment (EMA) burst design (eight surveys per week, up to 2×/day) that was repeated quarterly over a 12-month period. RESULTS: Within-person results indicated that on days with elevated positive affect, participants reported consuming more drinks, whereas positive affect was not significant for hours high from marijuana. In addition, on days with elevated negative affect, participants reported fewer hours high from marijuana. No association was found between negative affect and number of drinks. Finally, within-person results indicated that on alcohol or marijuana days with elevated positive affect, individuals were more likely to report SAM use. There was no association found between negative affect and SAM use. CONCLUSIONS: Results have implications such that in-the-moment interventions for alcohol and SAM use may be more salient when individuals have higher positive affect than average, whereas such interventions may be more relevant for marijuana use when negative affect is lower compared to average levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Cannabis , Fumar Maconha , Uso da Maconha , Transtornos Relacionados ao Uso de Substâncias , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Masculino , Uso da Maconha/epidemiologia , Fumar Maconha/epidemiologia , Consumo de Bebidas Alcoólicas/epidemiologia , Etanol
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