Supra-Threshold LS CE-Chirp Auditory Brainstem Response in the Elderly.

INTRODUCTION: Aging deteriorates peripheral and central auditory structures and functions. In elders, for an accurate audiological evaluation, it is important to explore beyond the cochlear receptor. Audiograms provide an estimation of hearing thresholds, while the amplitudes and latencies of supra-threshold auditory brainstem response (ABR) can offer noninvasive measures of the auditory pathways functioning. Regarding ABR, in young populations, level-specific chirp (LS CE-chirp) stimulus has been proposed as an alternative synchronizing method to obtain larger ABR responses than those evoked by clicks. However, the supra-threshold characteristics of chirp evoked ABR, and their association to hearing thresholds is relatively unknown in the elderly. The aim of this study was to evaluate supra-threshold LS CE-chirp ABRs in an aged population by comparing their features with click ABRs, and evaluating their relationship with audiometric hearing thresholds. METHODS: We carried out a cross-sectional study to characterize the hearing of 125 adults aged over 65 years. We determined the audiometric hearing thresholds and supra-threshold ABRs elicited by LS CE-chirp and click stimuli at 80 dB nHL. We evaluated associations by means of partial correlations and covariate adjustment. We performed specific frequencies' analysis and subgroup analysis per hearing level. RESULTS: Wave V responses had significantly shorter latencies and larger amplitudes when elicited by LS CE-chirp as compared to click-evoked responses. Audiometric hearing thresholds correlated with age, but ABR characteristics did not. We found mild correlations between hearing thresholds and ABR characteristics, predominantly at higher frequencies and with chirp. We found scarce evidence of correlation between ABR characteristics and the average of behavioral hearing thresholds between 0.5 to 4 kHz (0.5-4 kHz PTA). After subgroup analysis according to the hearing level, no stronger or more significant correlations were found between ABR characteristics and 0.5-4 kHz PTA. DISCUSSION: In this study, we found that supra-threshold LS CE-chirp ABR presented some of the previously described similitudes and differences with supra-threshold click ABR in younger populations. Although, the average amplitude and latency of wave V evoked by LS CE-chirp were larger and faster than those evoked by clicks, these results should be taken with caution at the individual level, and further studies are required to state that LS CE-chirp ABRs are better than click ABRs in elders for clinical evaluations. We did not find consistent associations between hearing thresholds and supra-threshold wave V features, suggesting that these measures should be considered independently in the elderly.

Effects of the self-perceived sensorimotor demand and immersion during video gaming on visual-attention skills.

Playing specific genres of video games (e.g., action video games) has been linked to improvements in cognitive skills mostly related to attentional phenomena. Nonetheless, do video games have features or dimensions in common that impact cognitive improvements beyond the game genre? Here, we argue that the sensorimotor demand-the amount of demand for precise coordination between movement and perception-is a key element in the improvements associated with playing video games. We conducted a two-part study to test this hypothesis: a self-report online gaming instrument development and validation and an in-lab behavioural and electrophysiological study. In the first study, data from 209 participants were used to devise the sensorimotor demand instrument (SMDI). The SMDI was split into three dimensions of video game playing: sensorimotor contingency, immersion and unfocused gaming. Criterion validity related to video gamers' characteristics supported that the SMDI is sensitive to the input device (e.g., keyboard or touchscreens), and the most recent experience gained during gaming sessions while not being sensitive to the game genre. In the second study, data from 20 participants who performed four visual-attentional tasks previously reported in the literature showed that the SMDI's dimensions were associated with behavioural performance measures and the latency and amplitude of event-related potentials (N1, P2 and P3). Despite the challenge of studying the video gamer population, our study remarks on the relevance of sensorimotor demands in the performance of attentional tasks and its potential use as a dimension to characterize the experience of playing video games beyond the game genre.

[Phenomenology of moral distress: implications for the humanization of medical education and practice]. / Fenomenología de la angustia moral: implicancias para la humanización de la educación y la práctica médica.

In the healthcare context, moral distress (MD) refers to the negative emotions that arise when a person knows the correct course of action in a given situation but is not able to follow it due to personal, hierarchical or institutional impediments. MD has been related to various professional problems, such as vocational disorientation, low work motivation, depersonalized treatment of patients, abandonment of duties, and changes of specialty or profession. Although this phenomenon has not been sufficiently studied in Chile, it presumably exists and would have even increased during the COVID-19 pandemic, leaving its repercussions unknown. Accordingly, this article has the objectives, firstly, to promote the phenomenological study of MD in our country, considering the importance of preventing its potential adverse impact on the mental health of future professionals, and, secondly, to highlight the need to include narrative approaches in medical education, in order to develop a more holistic approach to understanding patients and their condition of vulnerability. Ultimately, it is expected that addressing the implications of MD in medical education and practice will contribute to its humanization, optimizing the quality of healthcare.

Extending the integrate-and-fire model to account for metabolic dependencies.

It is widely accepted that the brain, like any other physical system, is subjected to physical constraints that restrict its operation. The brain's metabolic demands are particularly critical for proper neuronal function, but the impact of these constraints continues to remain poorly understood. Detailed single-neuron models are recently integrating metabolic constraints, but these models' computational resources make it challenging to explore the dynamics of extended neural networks, which are governed by such constraints. Thus, there is a need for a simplified neuron model that incorporates metabolic activity and allows us to explore the dynamics of neural networks. This work introduces an energy-dependent leaky integrate-and-fire (EDLIF) neuronal model extension to account for the effects of metabolic constraints on the single-neuron behavior. This simple, energy-dependent model could describe the relationship between the average firing rate and the Adenosine triphosphate (ATP) cost as well as replicate a neuron's behavior under a clinical setting such as amyotrophic lateral sclerosis (ALS). Additionally, EDLIF model showed better performance in predicting real spike trains - in the sense of spike coincidence measure - than the classical leaky integrate-and-fire (LIF) model. The simplicity of the energy-dependent model presented here makes it computationally efficient and, thus, suitable for studying the dynamics of large neural networks.

Neural links between facial emotion recognition and cognitive impairment in presbycusis.

OBJECTIVES: Facial emotion recognition (FER) is impaired in people with dementia and with severe to profound hearing loss, probably reflecting common neural changes. Here, we aim to study the association between brain structures and FER impairment in mild to moderate age-related hearing loss participants. METHODS: We evaluated FER in a cross-sectional cohort of 111 Chilean nondemented elderly participants. They were assessed for FER in seven different categories using 35 facial stimuli. We collected pure-tone average (PTA) audiometric thresholds, cognitive and neuropsychiatric assessments, and morphometric brain imaging using a 3-Tesla MRI. RESULTS: According to PTA threshold levels, participants were classified as controls (≤25 dB, n = 56) or presbycusis (>25 dB, n = 55), with an average PTA of 17.08 ± 4.8 dB HL and 36.27 ± 9.5 dB HL respectively. Poorer total FER score was correlated with worse hearing thresholds (r = -0.23, p < 0.05) in participants with presbycusis. Multiple regression models explained 57 % of the variability of FER in presbycusis and 10% in controls. In both groups, the main determinant of FER was cognitive performance. In the brain structure of presbycusis participants, FER was correlated with the atrophy of the right insula, right hippocampus, bilateral cingulate cortex and multiple areas of the temporal cortex. In controls, FER was only associated with bilateral middle temporal cortex volume. CONCLUSIONS: FER impairment in presbycusis is distinctively associated with atrophy of neural structures engaged in the perceptual and conceptual level of face emotion processing.

Victimization, polyvictimization, and depression symptoms among immigrants and native children and youth in Chile.

BACKGROUND: Migration exposes children and youth to vulnerabilities, including uprooting, lack of protection, limited access to services, and violence. Previous studies have shown that victimization experiences impact the mental health of migrant children, including depression, anxiety, and post-traumatic stress disorder. This study aims to examine the co-occurrence of multiple forms of maltreatment (polyvictimization) among migrant and Chilean children and youth and its association with depressive symptoms, addressing a research gap in Latin America. METHODS: Secondary data from the National Polyvictimization Survey (NPS) conducted by the Chilean Ministry of the Interior were analyzed. Measures assessing polyvictimization and depressive symptoms were administered to a sample of 1362 participants, with equal group sizes for migrants and Chilean-born individuals. Data analysis included descriptive statistics, group comparisons, correlation analyses, and multiple regression analyses. RESULTS: The study revealed marked differences in experiences of conventional crime victimization and polyvictimization between migrant and Chilean-born participants, with migrants facing slightly higher incidences. Correlational analysis indicated variable strengths of association between victimization types and depressive symptoms across groups, with Chilean-born individuals showing stronger correlations for certain victimization forms. Multiple regression analysis highlighted gender, polyvictimization, child maltreatment, internet victimization, sexual victimization, and peer/sibling victimization as significant predictors of depressive symptoms across the sample. Notably, an interaction was observed between child maltreatment and migrant status, indicating a mitigated impact of maltreatment on depressive symptoms among migrant adolescents. This suggests the potential for unique resilience or coping mechanisms in this group. CONCLUSIONS: This study elucidates the varied victimization experiences of migrant children and youth in Chile, with a notable emphasis on the mitigating effect of migrant status on the relationship between child maltreatment and depressive symptoms. It highlights the resilience and potential adaptive strategies of migrant minors facing adversity. The findings underscore the necessity of developing support and intervention strategies that recognize the specific needs and strengths of migrant children and youth, advocating for policies that protect and empower this vulnerable demographic amidst new environmental challenges.

Cochlear dysfunction as an early biomarker of cognitive decline in normal hearing and mild hearing loss.

INTRODUCTION: Age-related hearing loss is an important risk factor for cognitive decline. However, audiogram thresholds are not good estimators of dementia risk in subjects with normal hearing or mild hearing loss. Here we propose to use distortion product otoacoustic emissions (DPOAEs) as an objective and sensitive tool to estimate the risk of cognitive decline in older adults with normal hearing or mild hearing loss. METHODS: We assessed neuropsychological, brain magnetic resonance imaging, and auditory analyses on 94 subjects > 64 years of age. RESULTS: We found that cochlear dysfunction, measured by DPOAEs-and not by conventional audiometry-was associated with Clinical Dementia Rating Sum of Boxes (CDR-SoB) classification and brain atrophy in the group with mild hearing loss (25 to 40 dB) and normal hearing (<25 dB). DISCUSSION: Our findings suggest that DPOAEs may be a non-invasive tool for detecting neurodegeneration and cognitive decline in the older adults, potentially allowing for early intervention.

Immunogenicity and tolerability of a multicomponent meningococcal serogroup B (4CMenB) vaccine in healthy adolescents in Chile: a phase 2b/3 randomised, observer-blind, placebo-controlled study.

BACKGROUND: Effective glycoconjugate vaccines against Neisseria meningitidis serogroups A, C, W-135, and Y have been developed, but serogroup B remains a major cause of severe invasive disease in infants and adolescents worldwide. We assessed immunogenicity and tolerability of a four-component vaccine (4CMenB) in adolescents. METHODS: We did a randomised, observer-blind, placebo-controlled, study at 12 sites in Santiago and Valparaíso, Chile. Adolescents aged 11-17 years received one, two, or three doses of 4CMenB at 1 month, 2 month, or 6 month intervals. Immunogenicity was assessed as serum bactericidal activity using human complement (hSBA) against three reference strains for individual vaccine antigens, and assessed by ELISA against the fourth strain. Local and systemic reactions were recorded 7 days after each vaccination, and adverse events were monitored throughout the study. Participants were initially randomised to five groups (3:3:3:3:1) during the primary phase to receive either one dose, two doses 1 or 2 months apart, or three doses of 4CMenB, or three doses of placebo, with an additional three groups generated for the booster phase. All subjects received at least one dose of 4CMenB. Geometric mean titres, proportions of participants with serum bactericidal antibody titres of 4 or more, and Clopper-Pearson 95% CIs were calculated. The study is registered with ClinicalTrials.gov, number NCT00661713. FINDINGS: Overall, 1631 adolescents (mean age 13·8 [SD 1·9] years) received at least one dose of 4CMenB. After two or three doses, 99-100% of recipients had hSBA titres of 4 or more against test strains, compared with 92-97% after one dose (p<0·0145) and 29-50% after placebo. At 6 months 91-100% of participants still had titres of 4 or more for each strain after two or three doses, but only 73-76% after one dose; seroresponse rates reached 99-100% for each strain after second or third doses at 6 months. Local and systemic reaction rates were similar after each 4CMenB injection and did not increase with subsequent doses, but remained higher than placebo. No vaccine-related serious adverse events were reported and no significant safety signals were identified. INTERPRETATION: On the basis of immunogenicity responses this study provides evidence for an adolescent 4CMenB vaccine schedule of two doses, 1-6 months apart, to provide protection against meningococcal B infection. The extent of this protection against meningococcus B variants circulating worldwide will be determined by national surveys. FUNDING: Novartis Vaccines and Diagnostics.

A multi-country study of intussusception in children under 2 years of age in Latin America: analysis of prospective surveillance data.

BACKGROUND: Intussusception (IS) is a form of acute intestinal obstruction that occurs mainly in infants and is usually of unknown cause. An association between IS and the first licensed rotavirus vaccine, a reassortant-tetravalent, rhesus-based rotavirus vaccine (RRV-TV), led to the withdrawal of the vaccine. New rotavirus vaccines have now been developed and extensively studied for their potential association with IS. This study aimed to describe the epidemiology and to estimate the incidence of IS in Latin American infants prior to new vaccine introduction. METHODS: Children under 2 years of age representing potential IS cases were enrolled in 16 centers in 11 Latin American countries from January 2003 to May 2005. IS cases were classified as definite, probable, possible or suspected as stated on the Brighton Collaboration Working Group guidelines. RESULTS: From 517 potential cases identified, 476 (92%) cases were classified as definite, 21 probable, 10 possible and 10 suspected for intussusception. Among the 476 definite IS cases, the median age at presentation was 6.4 months with 89% of cases aged <1 year. The male to female ratio was 1.5:1. The incidence of definite IS per 100,000 subject-years ranged from 1.9 in Brazil to 62.4 in Argentina for children <2 years of age, and from 3.8 in Brazil to 105.3 in Argentina for children aged <1 year. Median hospital stay was 4 days with a high prevalence of surgery as the primary treatment (65%). Most cases (88%) made a complete recovery, but 13 (3%) died. No clear seasonal pattern of IS cases emerged. CONCLUSIONS: This study describes the epidemiology and estimates the incidence of IS in Latin American infants prior to the introduction of new rotavirus vaccines. The incidence of IS was found to vary between different countries, as observed in previous studies. TRIAL REGISTRATION: Clinical study identifier 999910/204 (SERO-EPI-IS-204).

[Evaluation of the effectiveness, safety and costs of outpatient intravenous antimicrobial treatment (OPAT) vs hospitalized in urinary infection in pediatrics]. / Evaluación de la efectividad, seguridad y costos del tratamiento antimicrobiano intravenoso ambulatorio (TAIA) vs hospitalizado en infección urinaria en pediatría.

BACKGROUND: Childrens hospitalization for intravenous antibiotic treatment has been replaced in developed countries and in some Chilean centers to outpatient intravenous therapy (OPAT). AIM: To compare the effectiveness, safety and cost of OPAT versus inpatient care. PATIENTS AND METHODS: Prospective cohort study in children (2 months-5 years) with febrile urinary tract infection (UTI) attended at two public Chilean hospitals: outpatient cohort and inpatient cohort. Between November of 2009-2010, 111 children were enrolled in OPAT and between January 2010-June 2011, 81 children were hospitalized. Demographic data, costs and parental care, response to treatment, adverse events and complications were registered. RESULTS: There was no difference in the effectiveness of both treatments (100% in OPAT and 98.6% in inpatient cohort, p: 0.41). Adherence to OPAT was 100%. Prevalence of adverse events was higher in inpatient cohort (76.3% versus 16.2%, p < 0.01). The average direct cost was four times higher in inpatients, mainly due to bed-day cost. Indirect cost was similar in both groups. There were more days of absence from work and care centers in inpatients (p: 0.017, p: 0.045 respectively). CONCLUSION: OPAT for febrile UTI was equally effective, safer and significantly less expensive than inpatient care. OPAT represents a recommended intervention for pediatric services of Chilean public hospitals.

Embodied Mindfulness Questionnaire: Scale Development and Validation.

Recently developed mindfulness scales have integrated aspects of the body in measuring mindfulness unlike other established scales. However, these scales focused solely on body awareness and did not embrace all aspects of mindfulness and the body. Specifically, they did not integrate embodiment in mindfulness. The proposed Embodied Mindfulness Questionnaire (EMQ) aims to operationalize the proposed notion of "embodied mindfulness" by grounding it into five dimensions, each representing a set of skills that can be cultivated through training and practice: (a) Detachment from Automatic Thinking, (b) Attention and Awareness of Feelings and Bodily Sensations, (c) Connection with the Body, (d) Awareness of the Mind-Body Connection, and (e) Acceptance of Feelings and Bodily Sensations. The EMQ items were developed through consultations with a panel of eight graduate students and a group of 10 experts in the field. Results from a series of three studies supported the proposed five subscales of EMQ and suggested that these subscales are independent and supported by convergent and discriminant evidence. In addition, results suggested that scores of EMQ subscales are different in terms of sensitivity to mindfulness training or meditation practice and experience. Limitations, as well as theoretical and practical implications of the EMQ subscales, are thoroughly discussed.

Psychological Distress in Young Chilean Adults Exposed to Parental Alienating Behaviors during Childhood/Adolescence.

The aim of this study was to analyze the psychological distress of young adults exposed to alienating behaviors during childhood/adolescence. Four hundred and sixteen adults responded to the online survey. A brief sociodemographic questionnaire, the Brief Symptom Scale, and a questionnaire on adverse childhood experiences were included. The analyses revealed that individuals who experienced one or more alienating behaviors exhibited higher levels of anxiety, depression, somatization, and overall psychological distress. Furthermore, even after controlling for the effect of other adverse childhood experiences, alienating behaviors had a significant impact on psychological distress in adulthood. This highlights an understudied aspect of alienating behaviors, i.e., their conjunction or parallelism with other adverse childhood experiences.

Tri-process model of interpersonal mindfulness: theoretical framework and study protocol.

According to the Center for Disease Control and Prevention, over 14% of the US population practice mindfulness meditation. The effects of mindfulness training on physical and mental health have been consistently documented, but its effects on interpersonal relationships are not yet fully understood or investigated. Interpersonal relationships play a crucial role in the wellbeing of individuals and society, and therefore, warrants further study. The aim of this paper is to present a tri-process theoretical model of interpersonal mindfulness and a study protocol to validate the proposed model. Specifically, according to the proposed model, mindfulness meditation training increases the self-awareness, self-regulation, and prosociality of those receiving the training, which ameliorates the quality of interpersonal interactions and the socioemotional support provided to other individuals. Finally, better socioemotional support increases the support receiver's ability to regulate their emotions. Using a multiphasic longitudinal design involving 640 participants randomized into 480 dyads, the proposed protocol aims to validate the tri-process model and to investigate its mechanisms of actions. The proposed study has important theoretical and social implications and will allow devising new and more effective interpersonal mindfulness programs with applications in multiple fields.

Non-pharmacological prevention of postoperative delirium by occupational therapy teams: A randomized clinical trial.

Background: Patients who develop postoperative delirium (POD) have several clinical complications, such as increased morbidity, increased hospital stays, higher hospital costs, cognitive and functional impairment, and higher mortality. POD is a clinical condition preventable by standard non-pharmacological measures An intensive Occupational Therapy (OT) intervention has been shown to be highly effective in preventing delirium in critically ill medical patients, but it is unknown the effect in surgical patients. Thus, we designed a prospective clinical study with the aim to determine whether patients undergoing intervention by the OT team have a lower incidence of POD compared to the group treated only with standard measures. Methods: A multicenter, single-blind, randomized clinical trial was conducted between October 2018 and April 2021, in Santiago of Chile, at a university hospital and at a public hospital. Patients older than 75 years undergoing elective major surgery were eligible for the trial inclusion. Patients with cognitive impairment, severe communication disorder and cultural language limitation, delirium at admission or before surgery, and enrolled in another study were excluded. The intervention consisted of OT therapy twice a day plus standard internationally recommended non-pharmacological prevention intervention during 5 days after surgery. Our primary outcome was development of delirium and postoperative subsyndromal delirium. Results: In total 160 patients were studied. In the interventional group, treated with an intensive prevention by OT, nine patients (12.9%) developed delirium after surgery and in the control group four patients (5.5%) [p = 0.125, RR 2.34 CI 95 (0.75-7.27)]. Whereas subsyndromal POD was present in 38 patients in the control group (52.1%) and in 34 (48.6%) in the intervention group [p = 0.4, RR 0.93 CI95 (0.67-1.29)]. A post hoc analysis determined that the patient's comorbidity and cognitive status prior to hospitalization were the main risk factors to develop delirium after surgery. Discussion: Patients undergoing intervention by the OT team did not have a lower incidence of POD compared to the group treated only with standard non-pharmacological measures in adults older than 75 years who went for major surgery. Clinical trial registration: www.ClinicalTrials.gov, identifier NCT03704090.

[Rotavirus genotypes in children with gastroenteritis assisted in two public hospitals from Chile: viral strains circulating in a country without a universal vaccination against rotavirus]. / Genotipos de rotavirus aislados de niños chilenos con gastroenteritis atendidos en dos hospitales públicos: variantes virales circulantes en un país con uso limitado de vacunas anti-rotavirus.

BACKGROUND: Rotavirus is the main cause of severe gastroenteritis (GE) in children. Two vaccines currently available have proven efficacy against the predominant genotypes. Rotavirus genotypes vary both geographically and/or temporally. Genotype surveillance is important to monitor trends associated or not with vaccine use. AIM: To update information on rotavirus genotypes circulating in two main cities of Chile. METHODOLOGY: Between May 2009-March 2010, children < 5y of age receiving medical care for GE in two large hospitals were recruited; none of these children had received rotavirus vaccine previously. Epidemiological information was recorded in an ad-hoc form and stool samples were collected for rotavirus detection by a commercial ELISA. Genotyping was performed by semi-nested RT-PCR. RESULTS: A total of 296/967 samples (31%) were positive for rotavirus, with a peak in November/ December mostly in children 7-24 months old (67%). G9P[8] was the predominant genotype (76%), followed for G1P[8] (6%) and G2P[4] (6%) in both cities. CONCLUSIONS: Rotavirus caused one third of GE requiring emergency room care and/or hospitalization, mostly in children within an age range susceptible to benefit from rotavirus vaccines. G9P[8], a genotype against which rotavirus vaccines have demonstrated high efficacy, was by far the most frequent rotavirus variant. Continued surveillance in Chile is crucial for providing background information on disease burden and strain diversity before the introduction of rotavirus vaccines.

Interpersonal Mindfulness Questionnaire: Scale Development and Validation.

Objectives: Previously developed mindfulness measures focused on its intrapersonal dimensions and did not measure the interpersonal aspects of mindfulness. Furthermore, recently developed interpersonal mindfulness measures were either specific to a certain context (e.g., parenting, conjugal, teaching) or omitted/minimized the role of the body in the interpersonal dynamic. The proposed Interpersonal Mindfulness Questionnaire (IMQ) aims to operationalize the theoretical notion of embodied and embedded mindfulness by grounding it into four dimensions, each representing a set of skills that can be cultivated through training and practice: (1) Detachment from the Mind, (2) Body-Anchored Presence, (3) Attention to and Awareness of the Other Person, and (4) Mindful Responding. Methods: The IMQ subscales were developed through consultations with a panel of eight graduate students and ten experts in the field. Three studies were conducted to evaluate the construct, internal consistency, reliability, convergent validity, and utility of the IMQ. Results: Findings from the three studies supported the proposed four subscales of IMQ and suggested that these four subscales are independent and supported by convergent evidence. In addition, results suggested that IMQ subscales' scores are sensitive to meditation experience and are associated with better intrapersonal and interpersonal outcomes. Conclusions: IMQ subscales are valid and are consistent with the proposed embodied and embedded conception of interpersonal mindfulness. IMQ subscales are associated with intrapersonal mindfulness, but not strongly enough to be conceived as the same phenomenon. Limitations, as well as theoretical and practical implications of IMQ subscales, are thoroughly discussed. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-022-01855-1.

Voluntary self-initiation of the stimuli onset improves working memory and accelerates visual and attentional processing.

The ability of an organism to voluntarily control the stimuli onset modulates perceptual and attentional functions. Since stimulus encoding is an essential component of working memory (WM), we conjectured that controlling the initiation of the perceptual process would positively modulate WM. To corroborate this proposition, we tested twenty-five healthy subjects in a modified-Sternberg WM task under three stimuli presentation conditions: an automatic presentation of the stimuli, a self-initiated presentation of the stimuli (through a button press), and a self-initiated presentation with random-delay stimuli onset. Concurrently, we recorded the subjects' electroencephalographic signals during WM encoding. We found that the self-initiated condition was associated with better WM accuracy, and earlier latencies of N1, P2 and P3 evoked potential components representing visual, attentional and mental review of the stimuli processes, respectively. Our work demonstrates that self-initiated stimuli enhance WM performance and accelerate early visual and attentional processes deployed during WM encoding. We also found that self-initiated stimuli correlate with an increased attentional state compared to the other two conditions, suggesting a role for temporal stimuli predictability. Our study remarks on the relevance of self-control of the stimuli onset in sensory, attentional and memory updating processing for WM.

The Impact of Baseline Mindfulness Scores on Mindfulness-Based Intervention Outcomes: Toward Personalized Mental Health Interventions.

A growing body of evidence has portrayed mindfulness as a useful tool for dealing with a broad range of psychological problems and disorders. This has created the impression that mindfulness-based interventions (MBIs) can be used to treat nearly all psychological difficulties, in all cases. Nonetheless, little research has been done on how individual differences may contribute to intervention outcomes. The goal of this study was to evaluate the role of baseline mindfulness on participants' outcomes by examining three prior Randomized Controlled Trials that addressed the impact of MBIs on mental health and mindfulness measures. The participants were 164 people, aged between 12 and 45, from both clinical and non-clinical samples. Our findings indicate that at least two thirds of the change produced by these interventions in terms of mindfulness scores can be predicted by the baseline scores of the same variables. We also found that many trajectories are not only strongly influenced by the initial status of the participants, but also by the intervention performed, as attested to by the significant interactions found. These results stress the need to continue doing research in a way that considers the diversity of participants' trajectories, increasing the room for intervention improvements aligned with a more personalized health care model.

Population attributable fraction of modifiable risk factors for dementia in Chile.

INTRODUCTION: Projected dementia incidence in Latin America and the Caribbean for the next decades is overwhelming. Access to local data, stratified by sex, is imperative for planning precise dementia-prevention strategies. METHODS: We analyzed the individual and overall weighted population attributable fraction (PAF) of nine modifiable risk factors for dementia, in dementia-free subjects ≥45-years-old, using the 2016-2017 Chilean National Health Survey. RESULTS: The overall weighted PAF for modifiable risk factors was 45.8% (42.2% to 49.3%). Variables with the highest PAF were lower education, high blood pressure, hearing loss, and obesity. Women showed a greater overall weighted PAF: 50.7% (45.3% to -56.1%), compared to men: 40.2% (35.4% to 45.0%), driven by a higher PAF for physical inactivity and depression in women. DISCUSSION: The PAF for modifiable risk factors for dementia in Chile is higher than in previous world reports, due to a greater prevalence of cardiovascular risk factors. Women have a higher potential for dementia prevention. HIGHLIGHTS: The proportion of dementia associated to modifiable risk factors in Chile is 45.8%.The main modifiable risk factors are high blood pressure, obesity, and hearing loss.Women had a greater prevalence of physical inactivity and depression than men.Chile had a greater prevalence of metabolic risk factors than other world regions.

Cancer History Is Associated with Slower Speed of Cognitive Decline in Patients with Amnestic Cognitive Impairment.

BACKGROUND: Several epidemiological studies report a negative association between Cancer and Alzheimer's disease (AD). OBJECTIVE: To characterize the trajectories of memory loss in individuals with early amnestic cognitive impairment with and without history of previous cancer. METHODS: Cognitive deterioration was assessed using the Montreal Cognitive Assessment (MoCA) or MoCA-Memory Index Score (MoCA-MIS) biannually in subjects with early amnestic cognitive impairment followed-up retrospectively from 2007 to 2021. History of Cancer was obtained from clinical records. Simple linear regressions of MoCA-MIS scores were calculated for each subject and analyzed with K-means cluster analysis to identify subgroups with different cognitive decline trajectories. χ2 and t tests were used for descriptive categorical and continuous variables and mixed multiple linear regressions to determine cognitive decline covariates. RESULTS: Analysis of the trajectory of cognitive decline in 141 subjects with early amnestic cognitive impairment identified two subgroups: Fast (n = 60) and Slow (n = 81) progressors. At baseline Fast progressors had better MoCA-MIS (p < 0.001) and functionality (CDR p = 0.02, AD8 p = 0.05), took less anti-dementia medications (p = 0.005), and had higher depression rates (p = 0.02). Interestingly, Fast progressors slowed their speed of memory decline (from 1.6 to 1.1 MoCA-MIS points/year) and global cognitive decline (from 2.0 to 1.4 total MoCA points/year) when Cancer history was present. CONCLUSION: Two trajectories of amnestic cognitive decline were identified, possibly derived from different neurophysiopathologies or clinical stages. This study suggests that a history of previous Cancer slows down amnestic cognitive decline, specifically in a subgroup of subjects with depression at baseline and accelerated deterioration at follow-up.