Maternal Pertussis Immunization and Immunoglobulin G Levels in Early- to Late-Term and Preterm Infants.

Importance: Maternal tetanus, diphtheria, and acellular pertussis (Tdap) vaccination protects newborns against severe pertussis. Data on transplacental antibody transfer on Tdap vaccination before 24 weeks' gestation remain scarce and are particularly relevant for preterm infants to increase the time interval for maternal antibody transfer. Objective: To assess noninferiority of anti-pertussis toxin (anti-PT) immunoglobulin G (IgG) antibody levels at age 2 months in early- to late-term infants following Tdap vaccination between 20 0/7 and 24 0/7 weeks' gestation compared with 30 0/7 and 33 0/7 weeks' gestation and compared with preterm infants. Design, Setting, and Participants: This prospective, multicenter cohort study included pregnant women aged 18 years or older in birthing centers and hospitals in the Netherlands between August 2019 and November 2021 who received Tdap vaccination between 20 0/7 and 24 0/7 weeks' gestation. Women with imminent premature birth were recruited if they had received maternal Tdap vaccination between 20 and 24 weeks' gestation. Blood samples were collected from mothers at delivery, from the umbilical cord, and from infants at age 2 months. Data from infants' blood samples at age 2 months were compared with a reference cohort (recruited between January 2014 and February 2016) of early- to late-term infants of the same age whose mothers had received Tdap vaccination between 30 0/7 and 33 0/7 weeks' gestation. Exposure: Maternal Tdap vaccination between 20 0/7 and 24 0/7 weeks' gestation or 30 0/7 and 33 0/7 weeks' gestation. Main Outcomes and Measures: The primary outcome was the geometric mean concentration (GMC) of anti-PT IgG antibodies in early- to late-term infants (≥37 0/7 weeks' gestation) at age 2 months, comparing maternal Tdap vaccination between 20 0/7 and 24 0/7 weeks' vs 30 0/7 and 33 0/7 weeks' gestation (reference cohort). Anti-PT GMC in 2-month-old infants born preterm (<35 0/7 weeks' gestation) compared with early- to late-term infants after maternal Tdap vaccination between 20 and 24 weeks' gestation was a secondary outcome. Results: In total, 221 women who delivered 239 offspring were enrolled in the study; 66 early- to late-term infants (median gestational age [GA], 40.6 weeks [IQR, 39.8-41.0 weeks]; 38 [57.6%] male) and 73 preterm infants (median GA, 32.1 weeks [IQR, 29.5-33.0 weeks]; 42 [54.5%] female) had blood samples collected at 2 months of age. Anti-PT GMC was 14.7 IU/mL (95% CI, 10.6-20.4 IU/mL) in early- to late-term infants following maternal Tdap vaccination between 20 0/7 and 24 0/7 weeks' gestation compared with 27.3 IU/mL (95% CI, 20.1-37.1 IU/mL) in 55 infants in the reference group (median GA, 40.3 [IQR, 39.1-41.0]; 33 [60.0%] female). The mean anti-PT GMC in preterm infants in the study group was 11.2 IU/mL (95% CI, 8.1-15.3 IU/mL) (P = .23 compared with early- to late-term infants). Conclusions and Relevance: In this cohort study, 2-month-old preterm and early- to late-term infants showed significantly lower anti-PT antibody levels following maternal Tdap vaccination between 20 0/7 and 24 0/7 weeks' gestation compared with 30 0/7 and 33 0/7 weeks' gestation; preterm and early- to late-term infants had similar anti-PT antibody levels, but both groups showed significantly lower antibody levels compared with the reference group. Epidemiological research should investigate whether maternal Tdap vaccination before 24 weeks' gestation provides sufficient protection against clinical pertussis, particularly in preterm infants, as long as no correlate of protection is available.

Augmenting complex and dynamic performance through mindfulness-based cognitive training: An evaluation of training adherence, trait mindfulness, personality and resting-state EEG.

Human performance applications of mindfulness-based training have demonstrated its utility in enhancing cognitive functioning. Previous studies have illustrated how these interventions can improve performance on traditional cognitive tests, however, little investigation has explored the extent to which mindfulness-based training can optimise performance in more dynamic and complex contexts. Further, from a neuroscientific perspective, the underlying mechanisms responsible for performance enhancements remain largely undescribed. With this in mind, the following study aimed to investigate how a short-term mindfulness intervention (one week) augments performance on a dynamic and complex task (target motion analyst task; TMA) in young, healthy adults (n = 40, age range = 18-38). Linear mixed effect modelling revealed that increased adherence to the web-based mindfulness-based training regime (ranging from 0-21 sessions) was associated with improved performance in the second testing session of the TMA task, controlling for baseline performance. Analyses of resting-state electroencephalographic (EEG) metrics demonstrated no change across testing sessions. Investigations of additional individual factors demonstrated that enhancements associated with training adherence remained relatively consistent across varying levels of participants' resting-state EEG metrics, personality measures (i.e., trait mindfulness, neuroticism, conscientiousness), self-reported enjoyment and timing of intervention adherence. Our results thus indicate that mindfulness-based cognitive training leads to performance enhancements in distantly related tasks, irrespective of several individual differences. We also revealed nuances in the magnitude of cognitive enhancements contingent on the timing of adherence, regardless of total volume of training. Overall, our findings suggest that mindfulness-based training could be used in a myriad of settings to elicit transferable performance enhancements.

Dose-Response Effect of an Inertia Flywheel Postactivation Performance Enhancement Protocol on Countermovement Jump Performance.

The purpose of this study was to investigate the dose-response effect of a high-load, 6-repetition, maximum effort inertial flywheel (IFw) squat postactivation performance enhancement (PAPE) protocol on countermovement jump (CMJ) performance metrics. Thirteen subjects completed 5 squat testing sessions: 1 session to determine back-squat 6-repetition maximum, 1 session to determine 6-repetition maximum IFw load, and 3 sessions to investigate the dose-response effect of an IFw PAPE protocol set at the load determined in the second session. In the IFw PAPE sessions, subjects completed either 1, 2, or 3 sets of IFw squats, then performed 5 CMJs over 12 minutes (1, 3, 6, 9, and 12 min post-IFw). All CMJ tests were conducted on a force platform where CMJ performance outcomes and impulse variables were calculated. There was no main time or volume effect for jump height, contact time, reactive strength index, peak force, or any of the impulse variables. A main time effect was identified for flight time (P = .006, effect size = 0.24) and peak power (P = .001, effect size = 0.28). The lack of change in jump height may indicate that too much fatigue was generated following this near-maximal IFw squat protocol, thereby reducing the PAPE effect.

Action imagery as active inference: a commentary on Rieger et al. (2023).

Rieger et al. (Psychol Res 2023:1-10, 2023) describe action imagery as motor simulation. Inverse models encode predicted action effects and compute muscle commands, which are inhibited to prevent overt action. We welcome this conceptualization of action imagery as inherently generative and predictive. In the spirit of stimulating further theoretical discourse on action imagery, and more broadly, action control, our commentary provides a brief introduction to Active Inference to establish a contrasting perspective from which to consider what, how, and why action imagery contributes to motor learning.

Maternal and neonatal antibody levels on pertussis vaccination in pregnant women on immune-modulating therapy for rheumatic disease.

OBJECTIVES: While protection against pertussis following maternal tetanus-diphtheria-and-acellular-pertussis (Tdap) vaccination was demonstrated in healthy term-born infants, no evidence is available on Tdap vaccination in combination with immune-modulating therapy during pregnancy. In this pilot study, we explored whether treatment with tumour necrosis factor alpha inhibitors (TNFis) in pregnant patients with rheumatic disease interferes with Tdap vaccine responses and affects maternal anti-pertussis IgG antibody levels in newborns. METHODS: Patients were included by a rheumatologist during pregnancy in case they received maternal Tdap vaccination in the late-second or early-third trimester of pregnancy. Blood samples were obtained from mothers during the first pregnancy trimester, 3 months after delivery and from the umbilical cord. IgG antibody levels against Tdap-included antigens were measured using a bead-based multiplex immunoassay. Findings on patients exposed to TNFis were compared with those from TNFi-unexposed patients and with data from a historical comparator study among healthy Tdap vaccinated mother-infant pairs (n=53). RESULTS: 66 patients (46 exposed and 20 unexposed to TNFIs) were enrolled. No major differences in IgG antibody levels were observed between TNFi-exposed and unexposed mothers before maternal Tdap vaccination and 3 months after delivery. In cord sera, however, antibody levels against pertussis toxin were significantly lower after TNFi-treatment (35.94 IU/mL, 95% CI 20.68 to 62.45) compared with no TNFi-treatment of mothers with rheumatic disease (94.61 IU/mL, 95% CI 48.89 to 183.07) and lower compared with a cohort of healthy mothers (125.12 IU/mL, 95% CI 90.75 to 172.50). We observed similar differences for filamentous haemagglutinin, pertactin, tetanus toxoid and diphtheria toxoid. CONCLUSION: These preliminary data indicate no major differences in IgG antibody levels on maternal Tdap vaccination in pregnant women with or without immune-modulating treatment, although our findings suggest that TNFis during pregnancy induce lower maternal anti-pertussis-specific protective antibody levels in newborns.

The Influence of Focused Attention and Open Monitoring Mindfulness Meditation States on True and False Memory.

Previous investigations into the effect of mindfulness meditation on false memory have reported mixed findings. One potential issue is that mindfulness meditation involves different styles that establish distinct cognitive control states. The present work aimed to address this issue by comparing the effects of single-session focused attention (FAM) and open monitoring (OMM) mindfulness meditation styles on true and false memory recall. Strengthened cognitive control states associated with FAM were predicted to increase true memory recall and decrease false memory recall. Conversely, weakened cognitive control established by OMM was predicted to increase false memory recall. Thirty-four meditation-naïve participants (23 females, mean age = 23.4 years, range = 18-33) first completed pre-meditation learning and recall phases of the Deese-Roediger-McDermott (DRM) task. Participants then completed a single session of FAM or OMM prior to a second, post-meditation, round of DRM task learning and recall phases with a novel word list. Finally, participants completed a recognition test with true and false memory, and distractor words. Both FAM and OMM groups demonstrated significant increase in false memory recall between pre- and post-meditation recall tests but these groups did not differ with respect to true and false memory recall and recognition. The present findings are consistent with previous reports of increased false memory arising from mindfulness meditation. Distinct cognitive control states associated with FAM and OMM states do not result in distinct true and false memory formation, at least in meditation-naïve adults.

Socio-psychological determinants of second trimester maternal pertussis vaccination acceptance in the Netherlands.

BACKGROUND: A maternal tetanus-diphtheria-and-acellular-pertussis (Tdap) vaccine is offered to all pregnant women in the Netherlands in their second trimester since December 2019. However, former studies solely investigated the socio-psychological factors that influence vaccine acceptance among pregnant women in the third trimester. We identified predicting factors for attitude, intention and acceptance of maternal Tdap vaccination during the second trimester of pregnancy. METHODS: As part of a large prospective cohort study, women early in pregnancy completed a questionnaire on determinants regarding acceptance of maternal Tdap vaccination between 20 and 24w of gestation. The vaccine was offered after completion of the questionnaire. A random forest model and Receiver Operating Characteristics (ROC) analyses were carried out to identify the factors most predictive for vaccine acceptance on the whole data set, and also in sensitivity analysis on a subset reflecting the annual nationwide 70% vaccination uptake. RESULTS: Among 1158 participants who were offered a Tdap vaccination between 20 and 24w of gestation, 1098 (94.8%) accepted and 60 (5.2%) rejected the vaccine. Random forest analyses identified intention as most predictive for acceptance, followed by attitude towards vaccination, beliefs regarding safety, risk perception of severity of side effects, moral responsibility, beliefs regarding effectiveness and risk perception of susceptibility of side effects, with a sensitivity of 100% and a specificity of 40%, for which this combination could be improved by the ROC analysis to 82% and 67%, respectively. The sensitivity analysis yielded an order of predictors that generally corresponded with the initial model. CONCLUSIONS: Intention, attitude, beliefs on safety and effectiveness, risk perception of side effects and moral responsibility were most predictive for maternal Tdap vaccine acceptance during the second trimester of pregnancy, in accordance with studies regarding third trimester vaccination. These should be discussed by healthcare professionals early in pregnancy to provide an informed choice towards vaccine acceptance.

Maternal vaccination against pertussis as part of the national immunization program: a qualitative evaluation among obstetric care providers one year after the implementation in December 2019.

BACKGROUND: Immunization of pregnant women with a tetanus-diphtheria-and-acellular-pertussis (Tdap) vaccine is an effective and safe way to protect infants from pertussis before their primary vaccinations. Vaccine uptake among pregnant women is influenced by their care providers' attitudes toward maternal vaccination. This qualitative study aimed to evaluate the implementation of the maternal Tdap vaccination under the National Immunization Program of the Netherlands from the perspective of obstetric care providers. METHODS: In this qualitative and explorative study, we conducted in-depth interviews by telephone with obstetric care providers who were selected from a pool of respondents (convenience sampling) to a questionnaire in a previous study. The interviews were based on a semi-structured interview guide that covered three aspects of the implementation strategy: providers' overall experience with the implementation of maternal Tdap vaccination in the Netherlands; implementation logistics and counseling, and pregnant women referrals to municipal Youth Healthcare Centers. The interviews were recorded, pseudonymized and transcribed verbatim. Transcripts were analyzed according to the Thematic Analysis approach by two researchers independently in two phases of iterative coding, categorizing, reviewing and redefining until ultimately, emergent themes regarding maternal Tdap vaccination implementation were identified. RESULTS: Interviews with 11 midwives and 5 OB-GYN physicians yielded 5 major themes regarding the Tdap vaccination implementation strategy: challenges throughout the implementation process, views on maternal Tdap vaccination, general versus tailored counseling, provider responsibilities in vaccine promotion, and impact of materials for information delivery. Participants indicated that to improve provider attitudes toward Tdap vaccination, its implementation requires clear and transparent information about what is entailed, i.e., what is expected from obstetric care providers, how they can obtain information, and when their actions must be initiated. Participants demanded involvement throughout the implementation planning process. They preferred tailored communication with pregnant women over a generalized approach. CONCLUSION: This study emphasized the importance of involving all relevant healthcare professionals in planning the implementation of maternal Tdap vaccination. Possible barriers perceived by these professionals should be taken into account in order to improve their attitudes toward vaccination, thus to increase uptake among pregnant women.

Neural and cognitive correlates of performance in dynamic multi-modal settings.

The endeavour to understand human cognition has largely relied upon investigation of task-related brain activity. However, resting-state brain activity can also offer insights into individual information processing and performance capabilities. Previous research has identified electroencephalographic resting-state characteristics (most prominently: the individual alpha frequency; IAF) that predict cognitive function. However, it has largely overlooked a second component of electrophysiological signals: aperiodic 1/ƒ activity. The current study examined how both oscillatory and aperiodic resting-state EEG measures, alongside traditional cognitive tests, can predict performance in a dynamic and complex, semi-naturalistic cognitive task. Participants' resting-state EEG was recorded prior to engaging in a Target Motion Analysis (TMA) task in a simulated submarine control room environment (CRUSE), which required participants to integrate dynamically changing information over time. We demonstrated that the relationship between IAF and cognitive performance extends from simple cognitive tasks (e.g., digit span) to complex, dynamic measures of information processing. Further, our results showed that individual 1/ƒ parameters (slope and intercept) differentially predicted performance across practice and testing sessions, whereby flatter slopes and higher intercepts were associated with improved performance during learning. In addition to the EEG predictors, we demonstrate a link between cognitive skills most closely related to the TMA task (i.e., spatial imagery) and subsequent performance. Overall, the current study highlights (1) how resting-state metrics - both oscillatory and aperiodic - have the potential to index higher-order cognitive capacity, while (2) emphasising the importance of examining these electrophysiological components within more dynamic settings and over time.

Reactogenicity and safety of second trimester maternal tetanus, diphtheria and acellular pertussis vaccination in the Netherlands.

BACKGROUND: Maternal tetanus-diphtheria-and-acellular-pertussis (Tdap) vaccination is offered to all pregnant women during their second trimester in the Netherlands since December 2019. We assessed second trimester Tdap vaccination reactogenicity and compared with third trimester data from a similar study. For safety assessment, adverse pregnancy outcomes were compared with national data from 2018, before Tdap vaccine-introduction. METHODS: Pregnant women were included between August 2019-December 2021 and received Tdap vaccination between 20 and 24w gestational age (GA). Participants completed a questionnaire on solicited local reactions and systemic adverse events (AEs) within one week after vaccination. Results were compared with historical data on reactogenicity from women vaccinated between 30 and 33w GA (n = 58). Regarding safety-related outcomes, each participant was matched to four unvaccinated pregnant women from the Dutch Perinatal Registry, based on living area, parity and age. RESULTS: Among 723 participants who completed the questionnaire, 488 (67.5 %) experienced ≥ 1 local reaction with pain at the injection site as most reported reaction (62.3 %), and 460 (63.6 %) experienced ≥ 1 systemic AE with stiffness in muscles/joints (38.9 %), fatigue (28.9 %), headache (14.5 %) and common cold-like symptoms (11.0 %) most frequently reported. 4 women (0.6 %) reported fever (≥38.0˚C). Symptoms were considered mild and transient within days. No difference in AEs were found between vaccination at 20-24w versus 30-33w GA. 723 participants were matched to 2,424 unvaccinated pregnant women with no increased rates of premature labor, small-for-gestational-age, or other adverse pregnancy outcomes. CONCLUSIONS: Second trimester maternal Tdap vaccination appears safe and well-tolerated. Comparison between second versus third trimester vaccination yielded no reactogenicity concerns.

Instantaneous effects of mindfulness meditation on tennis return performance in elite junior athletes completing an implicitly sequenced serve return task.

Single-session meditation augmentation of sport-specific skill performance was tested with elite junior tennis athletes. Athletes completed one of two styles of mindfulness meditation (focused-attention or open-monitoring) or a control listening condition prior to performing an implicitly sequenced tennis serve return task involving the goal of hitting a target area placed on the service court. Unbeknownst to athletes, six distinct serves followed a repeating second-order conditional sequence for two task blocks before the sequence was altered in a third transfer block. Task performance was operationalized as serve return outcome and analyzed using beta regression modeling. Models analyzed group by block differences in the proportion of returned serves (i.e., non-aces), returns placed in the service court, and target hits. Contrary to previous laboratory findings, results did not support meditation-related augmentation of performance and/or sequence learning. In fact, compared to control, meditation may have impaired performance improvements and acquisition of serve sequence information. It is possible that the effects of single-session meditation seen in laboratory research may not extend to more complex motor tasks, at least in highly-trained adolescents completing a well-learned skill. Further research is required to elucidate the participant, task, and meditation-related characteristics that might promote single-session meditation performance enhancement.

Hypohydration alters pre-frontal cortex haemodynamics, but does not impair motor learning.

It is unknown how hypohydration influences fine motor performance training and motor learning. Here, 30 participants (aged 19-46 years) were randomly assigned to a hypohydration (HYPO) or control (CON) group (both n = 15). Moderate hypohydration (~ 2.4% loss in body mass) was produced in HYPO via active dehydration before a 46 min fluid restricted rest period was undertaken. The conclusion of rest coincided with when CON attended the facilities. Both groups undertook a discrete sequence production task consisting of 6 training blocks, and returned ~ 300 min later to complete a delayed retention and transfer test while euhydrated. Bilateral pre-frontal cortex (PFC) haemodynamics were assessed using functional near-infrared spectroscopy throughout training and delayed learning assessments. Response time improved across training (P < 0.01) and was similar between the groups (both P = 0.22). Analysis of training PFC haemodynamics revealed a significant group by block interaction for oxygenated (O2Hb; P < 0.01), but not deoxygenated haemoglobin (P = 0.77). In training block 1, bilateral O2Hb was higher in HYPO (P = 0.02), while bilateral O2Hb increased in CON between blocks 2-3 and 5-6 (both P ≤ 0.03). During the delayed retention and transfer test, no group differences or interactions were found in response time, response error, or PFC haemodynamics (all P ≥ 0.27). Moderate hypohydration does increase PFC activation during motor skill learning, however, this appears to be transient and of little consequence to training or delayed retention or transfer performance.

Dispositional Mindfulness May Have Protected Athletes from Psychological Distress During COVID-19 in Australia.

Promoting athlete wellbeing has become a priority in elite sport, and the COVID-19 pandemic has accentuated the need for a comprehensive understanding of risk and protective factors. Existing sport research has not yet considered whether specific cognitive factors such as dispositional mindfulness and executive function may protect athletes against psychological distress. In a sample of high-performance Australian football athletes (n = 27), we administered measures of dispositional mindfulness (MAAS), executive function (AOSPAN; eStroop), and psychological distress (APSQ) at pre-season, coinciding with the initial (2020) COVID-19-related sport shutdown in Australia. Measures of executive function and psychological distress were re-administered at the end of the COVID-19 affected competitive season in 2020. Athletes reported significantly elevated psychological distress relative to previous estimates of distress among high-performance athletes established in prior studies. Executive functions, including working memory and inhibitory control were not significantly associated with psychological distress or dispositional mindfulness at either timepoint. However, baseline mindfulness was associated with reduced distress at both pre-season (r = -0.48, p = .03) and end of season (r = -0.56, p = .004), suggesting that dispositional mindfulness may have afforded protective buffering against symptoms of distress. Correlation data alone does not establish a directional connection from mindfulness to reduced distress, and future research is required to elucidate this association and/or establish the mechanism/s by which dispositional mindfulness may protect against psychological distress in this population.

A multi-representation approach to the contextual interference effect: effects of sequence length and practice.

The present study investigated the long-term benefit of Random-Practice (RP) over Blocked-Practice (BP) within the contextual interference (CI) effect for motor learning. We addressed the extent to which motor sequence length and practice amount factors moderate the CI effect given that previous reports, often in applied research, have reported no long-term advantage from RP. Based on predictions arising from the Cognitive framework of Sequential Motor Behavior (C-SMB) and using the Discrete Sequence Production (DSP) task, two experiments were conducted to compare limited and extended practice amounts of 4- and 7-key sequences under RP and BP schedules. Twenty-four-hour delayed retention performance confirmed the C-SMB prediction that the CI-effect occurs only with short sequences that receive little practice. The benefit of RP with limited practice was associated with overnight motor memory consolidation. Further testing with single-stimulus as well as novel and unstructured (i.e., random) sequences indicated that limited practice under RP schedules enhances both reaction and chunking modes of sequence execution with the latter mode benefitting from the development of implicit and explicit forms of sequence representation. In the case of 7-key sequences, extended practice with RP and BP schedules provided for equivalent development of sequence representations. Higher explicit awareness of sequence structures was associated with faster completion of practiced but also of novel and unstructured sequences.

EEG and behavioral correlates of attentional processing while walking and navigating naturalistic environments.

The capacity to regulate one's attention in accordance with fluctuating task demands and environmental contexts is an essential feature of adaptive behavior. Although the electrophysiological correlates of attentional processing have been extensively studied in the laboratory, relatively little is known about the way they unfold under more variable, ecologically-valid conditions. Accordingly, this study employed a 'real-world' EEG design to investigate how attentional processing varies under increasing cognitive, motor, and environmental demands. Forty-four participants were exposed to an auditory oddball task while (1) sitting in a quiet room inside the lab, (2) walking around a sports field, and (3) wayfinding across a university campus. In each condition, participants were instructed to either count or ignore oddball stimuli. While behavioral performance was similar across the lab and field conditions, oddball count accuracy was significantly reduced in the campus condition. Moreover, event-related potential components (mismatch negativity and P3) elicited in both 'real-world' settings differed significantly from those obtained under laboratory conditions. These findings demonstrate the impact of environmental factors on attentional processing during simultaneously-performed motor and cognitive tasks, highlighting the value of incorporating dynamic and unpredictable contexts within naturalistic designs.

Study protocol of the PIMPI-project, a cohort study on acceptance, tolerability and immunogenicity of second trimester maternal pertussis immunization in relation to term and preterm infants.

BACKGROUND: Maternal immunization confers passive immunity to the fetus by transplacental antibody transfer. Infants may be better protected against pertussis if the mother received a diphtheriae, tetanus and acellular pertussis (Tdap) vaccination in the second trimester of pregnancy compared to the third trimester. This study evaluates IgG antibody concentrations in term and preterm infants at birth and 2 months after birth after maternal Tdap-vaccination between 200 and 240 w of gestation vs third trimester Tdap-vaccination. Further aims are assessing the determinants that underlie acceptance of second trimester maternal Tdap-vaccination as well as the tolerability of vaccination. METHODS: This prospective cohort study consists of two parts. In the acceptance part, pregnant women complete a questionnaire on determinants that underlie acceptance of a second trimester Tdap-vaccination, which is offered subsequently between 200 and 240 w of gestation. Vaccinated women complete an additional questionnaire on vaccination tolerability. Vaccinated women may also participate in the immunogenicity part, in which blood is drawn from mother at delivery and from infant at birth and 2 months after birth. Women are also eligible for the immunogenicity part if they received a Tdap-vaccination between 200 and 240 w of gestation via the national immunization program and get hospitalized for an imminent preterm delivery. Blood sampling continues until 60 term and 60 preterm mother-infant-pairs have been included. Pertussis-specific IgG antibody concentrations are determined in serum using a fluorescent bead-based multiplex immunoassay. For term infants, non-inferiority in IgG antibody concentrations against pertussis toxin (anti-PT) will be assessed referred to a historical control group in which mothers were Tdap-vaccinated between 300 and 320 w of gestation. For preterm infants, non-inferiority of anti-PT IgG concentrations is referred to as 85% of infants having ≥ 20 international units/mL at 2 months after birth. DISCUSSION: This study investigates acceptance, tolerability and immunogenicity regarding maternal Tdap-immunization between 200 and 240 w of gestation. Its results provide insight into the effects of second trimester Tdap-vaccination on IgG antibody concentrations in term and preterm infants before primary infant vaccinations. Results on acceptance and tolerability guide antenatal care providers in communication with pregnant women and maintain the safety of second trimester Tdap-vaccination. TRIAL REGISTRATION: EU Clinical Trials Register, 2018-002976-41, retrospectively registered 24 July 2019, https://www.clinicaltrialsregister.eu/ctr-search/search?query=2018-002976-41 .

Circulation of Bordetella pertussis in the Caribbean Netherlands: a population-based seroepidemiological study.

OBJECTIVES: Pertussis is a respiratory infectious disease caused by Bordetella pertussis. In the Caribbean Netherlands (CN), comprising the islands Bonaire, St Eustatius, and Saba, registration of cases is mandatory for disease surveillance. However, insufficient laboratory facilities hamper case confirmation, and circulation persists. The aim of this seroepidemiological study was to gain insight into B. pertussis circulation in CN, and to investigate what factors contribute to the risk of infection. METHODS: Blood samples and questionnaires were collected for 1829 participants aged 0-90 years. Concentrations of B. pertussis toxin-specific IgG antibodies (anti-Pt) were determined using a bead-based immunoassay to indicate infections within the previous 12 months (based on anti-Pt ≥ 50 IU/mL) in participants without detectable vaccine-induced humoral immunity. Risk factors for recent infection were analyzed using logistic regression models. RESULTS: An estimated 8.2% (95% CI 6.6-10.1) of CN residents aged ≥ 9 years were found to have been recently infected by B. pertussis. Risk factors for a recent infection were age 12-29 years (13.8-14.6%) and Dutch Caribbean or Surinamese origin (10.7%). CONCLUSIONS: B. pertussis infections occur frequently among CN residents aged ≥ 9 years, although few clinical pertussis cases are reported. Transmission to vulnerable individuals seems likely and should be taken into account in optimizing vaccination programs.

Resting-state aperiodic neural dynamics predict individual differences in visuomotor performance and learning.

An emerging body of work has demonstrated that resting-state non-oscillatory, or aperiodic, 1/f neural activity is a functional and behaviorally relevant marker of cognitive function capacity. In the motor domain, previous work has only applied 1/f analyses to investigations of motor coordination and performance measures. The value of aperiodic resting-state neural dynamics as a marker of individual visuomotor performance capacity remains unknown. Accordingly, the aim of this work was to investigate if individual 1/f intercept and slope parameters of aperiodic resting-state neural activity predict reaction time and perceptual sensitivity in an immersive virtual reality marksmanship task. The marksmanship task required speeded selection of target stimuli and avoidance of selecting non-target stimuli. Motor and perceptual demands were incrementally increased across task blocks and participants performed the task across three training sessions spanning one week. When motor demands were high, steeper individual 1/f slope predicted shorter reaction time. This relationship did not change with practice. Increased 1/f intercept and a steeper 1/f slope were associated with higher perceptual sensitivity, measured as d'. However, this association was only observed under the highest levels of perceptual demand and only in the initial exposure to these conditions. Individuals with a lower 1/f intercept and a shallower 1/f slope demonstrated the greatest gains in perceptual sensitivity from task practice. These findings demonstrate that individual differences in motor and perceptual performance can be accounted for with resting-state aperiodic neural dynamics. The 1/f aperiodic parameters are most informative in predicting visuomotor performance under complex and demanding task conditions. In addition to predicting capacity for high visuomotor performance with a novel task, 1/f aperiodic parameters might also be useful in predicting which individuals might derive the most improvements from practice.

Prefrontal Cortex Activation During Motor Sequence Learning Under Interleaved and Repetitive Practice: A Two-Channel Near-Infrared Spectroscopy Study.

Training under high interference conditions through interleaved practice (IP) results in performance suppression during training but enhances long-term performance relative to repetitive practice (RP) involving low interference. Previous neuroimaging work addressing this contextual interference effect of motor learning has relied heavily on the blood-oxygen-level-dependent (BOLD) response using functional magnetic resonance imaging (fMRI) methodology resulting in mixed reports of prefrontal cortex (PFC) recruitment under IP and RP conditions. We sought to clarify these equivocal findings by imaging bilateral PFC recruitment using functional near-infrared spectroscopy (fNIRS) while discrete key pressing sequences were trained under IP and RP schedules and subsequently tested following a 24-h delay. An advantage of fNIRS over the fMRI BOLD response is that the former measures oxygenated and deoxygenated hemoglobin changes independently allowing for assessment of cortical hemodynamics even when there is neurovascular decoupling. Despite slower sequence performance durations under IP, bilateral PFC oxygenated and deoxygenated hemoglobin values did not differ between practice conditions. During test, however, slower performance from those previously trained under RP coincided with hemispheric asymmetry in PFC recruitment. Specifically, following RP, test deoxygenated hemoglobin values were significantly lower in the right PFC. The present findings contrast with previous behavioral demonstrations of increased cognitive demand under IP to illustrate a more complex involvement of the PFC in the contextual interference effect. IP and RP incur similar levels of bilateral PFC recruitment, but the processes underlying the recruitment are dissimilar. PFC recruitment during IP supports action reconstruction and memory elaboration while RP relies on PFC recruitment to maintain task variation information in working memory from trial to trial. While PFC recruitment under RP serves to enhance immediate performance, it does not support long-term performance.

Co-Designing a New Yoga-Based Mindfulness Intervention for Survivors of Stroke: A Formative Evaluation.

Movement-based mindfulness interventions (MBI) are complex, multi-component interventions for which the design process is rarely reported. For people with stroke, emerging evidence suggests benefits, but mainstream programs are generally unsuitable. We aimed to describe the processes involved and to conduct a formative evaluation of the development of a novel yoga-based MBI designed for survivors of stroke. We used the Medical Research Council complex interventions framework and principles of co-design. We purposefully approached health professionals and consumers to establish an advisory committee for developing the intervention. Members collaborated and iteratively reviewed the design and content of the program, formatted into a training manual. Four external yoga teachers independently reviewed the program. Formative evaluation included review of multiple data sources and documentation (e.g., formal meeting minutes, focus group discussions, researcher observations). The data were synthesized using inductive thematic analysis. Three broad themes emerged: (a) MBI content and terminology; (b) manual design and readability; and (c) barriers and enablers to deliver the intervention. Various perspectives and feedback on essential components guided finalizing the program. The design phase of a novel yoga-based MBI was strengthened by interdisciplinary, consumer contributions and peer review. The 12-week intervention is ready for testing among survivors of stroke.