Interpretability of Spatiotemporal Dynamics of the Brain Processes Followed by Mindfulness Intervention in a Brain-Inspired Spiking Neural Network Architecture.

Mindfulness training is associated with improvements in psychological wellbeing and cognition, yet the specific underlying neurophysiological mechanisms underpinning these changes are uncertain. This study uses a novel brain-inspired artificial neural network to investigate the effect of mindfulness training on electroencephalographic function. Participants completed a 4-tone auditory oddball task (that included targets and physically similar distractors) at three assessment time points. In Group A (n = 10), these tasks were given immediately prior to 6-week mindfulness training, immediately after training and at a 3-week follow-up; in Group B (n = 10), these were during an intervention waitlist period (3 weeks prior to training), pre-mindfulness training and post-mindfulness training. Using a spiking neural network (SNN) model, we evaluated concurrent neural patterns generated across space and time from features of electroencephalographic data capturing the neural dynamics associated with the event-related potential (ERP). This technique capitalises on the temporal dynamics of the shifts in polarity throughout the ERP and spatially across electrodes. Findings support anteriorisation of connection weights in response to distractors relative to target stimuli. Right frontal connection weights to distractors were associated with trait mindfulness (positively) and depression (inversely). Moreover, mindfulness training was associated with an increase in connection weights to targets (bilateral frontal, left frontocentral, and temporal regions only) and distractors. SNN models were superior to other machine learning methods in the classification of brain states as a function of mindfulness training. Findings suggest SNN models can provide useful information that differentiates brain states based on distinct task demands and stimuli, as well as changes in brain states as a function of psychological intervention.

Associations between immunological function and memory recall in healthy adults.

Studies in clinical and aging populations support associations between immunological function, cognition and mood, although these are not always in line with animal models. Moreover, very little is known about the relationship between immunological measures and cognition in healthy young adults. The present study tested associations between the state of immune system and memory recall in a group of relatively healthy adults. Immediate and delayed memory recall was assessed in 30 participants using the computerised cognitive battery. CD4, CD8 and CD69 subpopulations of lymphocytes, Interleukin-6 (IL-6) and cortisol were assessed with blood assays. Correlation analysis showed significant negative relationships between CD4 and the short and long delay memory measures. IL-6 showed a significant positive correlation with long-delay recall. Generalized linear models found associations between differences in all recall challenges and CD4. A multivariate generalized linear model including CD4 and IL-6 exhibited a stronger association. Results highlight the interactions between CD4 and IL-6 in relation to memory function. Further study is necessary to determine the underlying mechanisms of the associations between the state of immune system and cognitive performance.

Empowering Pacific Patients on the Weight Loss Surgery Pathway: A Co-designed Evaluation Study.

PURPOSE: Despite having the highest medical needs by population for weight loss treatment, Pacific patients in Aotearoa New Zealand face substantial levels of attrition in publicly funded weight loss surgery programs. In collaboration with the Auckland City Hospital bariatric surgery team, a Pacific-led preoperative weight loss surgery program was co-designed, delivered, and evaluated between 2020 and 2023. MATERIALS AND METHODS: This was a single-arm, prospective co-designed evaluation study that took place at Auckland City Hospital in Aotearoa New Zealand. Participants were Pacific patients (n = 14) referred to the weight loss surgery program. Survey and video diaries were analyzed to determine if the program had the potential to increase Pacific patient retention through the preoperative stage of weight loss surgery, increase surgery completion rates, and improve the quality of treatment experiences. RESULTS: Nine out of 14 participants attended all preoperative sessions. Six participants subsequently underwent weight loss surgery. Program components that had positive impacts on patient success and satisfaction were accessibility, information quality, having Pacific role models, cultural safety, and the group support system. The patients found the program to be culturally anchored and there was support for the implementation of the program going forward. CONCLUSION: This study demonstrated how a culturally anchored intervention can increase patient retention for those patients who may not respond to mainstream treatment. Adjusting existing preoperative weight loss surgery programs to integrate Pacific-led models of healthcare has the potential to increase Pacific patient resiliency to follow through with surgery.

Cognitive Effect Following a Blended (Face to Face and Videoconference-Delivered) Format Mindfulness Training.

While evidence supports the feasibility of online mindfulness training (MT), the effect of this approach on cognition remains unclear. The present study investigated changes in cognition following a newly developed 6-week videoconference-delivered MT program on cognitive function in two groups. The first group (n = 17) had two baseline assessments prior to MT [3 weeks after group two (n = 15)] to allow for evaluation of practice and learning effects. Four participants from each group were excluded from the final analysis due to missing data. Following MT, there was an improvement in switching of attention, working memory, executive function, and social cognition, but some of these effects were not easily accounted for by learning or practice effects. No significant changes were found on tasks measuring sustained attention, cognitive flexibility and inhibition, information processing, and sensory-motor function. Our findings suggest that domain-specific cognition might be enhanced by a brief videoconference-delivered MT, and larger, controlled studies to delineate the effects of online MT on subdomains of cognition are needed.

Preoperative bariatric surgery programme barriers facing Pacific patients in Auckland, New Zealand as perceived by health sector professionals: a qualitative study.

Minority ethnic patient groups typically have the highest bariatric surgery preoperative attrition rates and lowest surgery utilisation worldwide. Eligible patients of Pacific Island ethnicity (Pacific patients) in New Zealand (NZ) follow this wider trend. OBJECTIVES: The present study explored structural barriers contributing to Pacific patients' disproportionately high preoperative attrition rates from publicly-funded bariatric surgery in Auckland, NZ. SETTING: Publicly-funded bariatric surgery programmes based in the wider Auckland area, NZ. DESIGN: Semi-structured interviews with health sector professionals (n=21) were conducted.Data were analysed using an inductive thematic approach. RESULTS: Two primary themes were identified: (1) Confidence negotiating the medical system, which included Emotional safety in clinical settings and Relating to non-Pacific health professionals and (2) Appropriate support to achieve preoperative goals, which included Cultural considerations, Practical support and Relating health information. Clinical environments and an under-representation of Pacific staff were considered to be barriers to developing emotional safety, trust and acceptance of the surgery process with patients and their families. Additionally, economic deprivation and lower health literacy impacted preoperative goals. CONCLUSIONS: Health professionals' accounts indicated that Pacific patients face substantial levels of disconnection in bariatric surgery programmes. Increasing representation of Pacific ethnicity by employing more Pacific health professionals in bariatric teams and finding novel solutions to implement preoperative programme components have the potential to reduce this disconnect. Addressing cultural competency of staff, increasing consultancy times and working in community settings may enable staff to better support Pacific patients and their families. Programme structures could be more accommodating to practical barriers of attending appointments, managing patients' preoperative health goals and improving patients' health literacy. Given that Pacific populations, and other patients from minority ethnic backgrounds living globally, also face high rates of obesity and barriers accessing bariatric surgery, our findings are likely to have broader applicability.

Spiking Neural Network Modelling Approach Reveals How Mindfulness Training Rewires the Brain.

There has been substantial interest in Mindfulness Training (MT) to understand how it can benefit healthy individuals as well as people with a broad range of health conditions. Research has begun to delineate associated changes in brain function. However, whether measures of brain function can be used to identify individuals who are more likely to respond to MT remains unclear. The present study applies a recently developed brain-inspired Spiking Neural Network (SNN) model to electroencephalography (EEG) data to provide novel insight into: i) brain function in depression; ii) the effect of MT on depressed and non-depressed individuals; and iii) neurobiological characteristics of depressed individuals who respond to mindfulness. Resting state EEG was recorded from before and after a 6 week MT programme in 18 participants. Based on self-report, 3 groups were formed: non-depressed (ND), depressed before but not after MT (responsive, D+) and depressed both before and after MT (unresponsive, D-). The proposed SNN, which utilises a standard brain-template, was used to model EEG data and assess connectivity, as indicated by activation levels across scalp regions (frontal, frontocentral, temporal, centroparietal and occipitoparietal), at baseline and follow-up. Results suggest an increase in activation following MT that was site-specific as a function of the group. Greater initial activation levels were seen in ND compared to depressed groups, and this difference was maintained at frontal and occipitoparietal regions following MT. At baseline, D+ had great activation than D-. Following MT, frontocentral and temporal activation reached ND levels in D+ but remained low in D-. Findings support the SNN approach in distinguishing brain states associated with depression and responsiveness to MT. The results also demonstrated that the SNN approach can be used to predict the effect of mindfulness on an individual basis before it is even applied.

Factors associated with preoperative attrition in bariatric surgery: a protocol for a systematic review.

BACKGROUND: Bariatric surgery results in substantial medical and economic benefits; however, independent studies typically report high patient preoperative attrition rates. Studies have identified individual characteristics and sociodemographic variables of those who complete the surgery compared to those who do not. The aim of the present protocol is to outline a systematic review focussed on identifying the sociodemographic, medical, cultural, psychological, and patient-led factors affecting preoperative attrition in clients who were enrolled in bariatric surgery programmes. METHODS/DESIGN: The databases Scopus, CINAHL, PsycINFO, Web of Science, and MEDLINE will be searched for retrospective, prospective, and cross-sectional observational studies that have identified any sociodemographic, medical, cultural, psychological, and patient-led factors affecting preoperative attrition in clients who are enrolled in a bariatric surgery programme. English-language articles published between 1997 to 2020, inclusive of adults 18 years or older, will be included in the review. This protocol has been registered in PROSPERO, registration number; CRD42017068557. DISCUSSION: Presently, there are studies and reviews investigating population-based utilisation and access to bariatric surgery; however, there is a need to review the reasons behind preoperative bariatric surgery patient attrition once selected for bariatric surgery. The results of the review will highlight potential systematic disparities in patient attrition, where gaps in knowledge remain for further investigation, and suggest areas where countermeasures may be focussed for decreasing attrition rates. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017068557.

Correction to: Attrition after Acceptance onto a Publicly Funded Bariatric Surgery Program.

Unfortunately, the original version of this article contained an error. The Methods section's first sentence and Table 1 both mistakenly contained the letters XXXX in place of the district health board and hospital city names.

Attrition after Acceptance onto a Publicly Funded Bariatric Surgery Program.

BACKGROUND: Factors such as ethnicity, gender, and socioeconomic status may play a role in both access to and attrition from bariatric programs before surgery is undertaken. New Zealand (NZ) has high rates of obesity in its Pacific population and the indigenous Maori. These groups also experience poorer health outcomes and therefore have the greatest need for surgery. METHODOLOGY: A retrospective cross-sectional study of 704 people referred for and accepted onto a publicly funded bariatric surgery from 2007 to 2016. The demographic and clinical features of two groups were compared: those that completed surgery successfully (n = 326) and those that dropped out of the program before surgery (n = 378). We also attempted to identify factors associated with attrition. RESULTS: The attrition rate was high (54%), with a significant difference according to gender (men 66% vs 45% women, p < 0.001) and ethnicity (39% in NZ Europeans, 50% in Maori, and 73% in Pacific patients, p < 0.001). Two out of three European women proceeded to surgery, but fewer than one in seven Pacific men. Attrition was associated with having a higher mean BMI and being a smoker. Logistic regression modeling showed that while employment seemed to be protective against attrition for NZ Europeans (p < 0.004), it was not for Pacific patients. CONCLUSIONS: While there was no obvious bias in rates of referral, there is clearly a need for better ways to support Maori and Pacific people, and men in particular, to complete bariatric surgery. Further research is needed to clarify the socio-economic and cultural barriers that underlie this phenomenon.