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1.
bioRxiv ; 2024 Aug 14.
Article in English | MEDLINE | ID: mdl-39185163

ABSTRACT

Goal-directed navigation requires animals to continuously evaluate their current direction and speed of travel relative to landmarks to discern whether they are approaching or deviating from their goal. Striatal dopamine and acetylcholine are powerful modulators of goal-directed behavior, but it is unclear whether and how neuromodulator dynamics at landmarks incorporate relative motion for effective behavioral guidance. Using optical measurements in mice, we demonstrate that cue-evoked striatal dopamine release encodes bi-directional 'trajectory errors' reflecting relationships between ongoing speed and direction of locomotion and visual flow relative to optimal goal trajectories. Striatum-wide micro-fiber array recordings resolved an anatomical gradient of trajectory error signaling across the anterior-posterior axis, distinct from trajectory error independent cue signals. Dynamic regression modeling revealed that positive and negative trajectory error encoding emerges early and late respectively during learning and over different time courses in the medial and lateral striatum, enabling region specific contributions to learning. Striatal acetylcholine release also encodes trajectory errors, but encoding is more spatially restricted, opposite polarity, and delayed relative to dopamine, supporting distinct roles in modulating striatal output and behavior. Dopamine trajectory error signaling and task performance were reproduced in a reinforcement learning model incorporating a conjunctive state space representation, suggesting a potential neural substrate for trajectory error generation. Our results establish region specific neuromodulator signals positioned to guide the speed and direction of locomotion to reach goals based on environmental landmarks during navigation.

2.
JNCI Cancer Spectr ; 8(4)2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38902952

ABSTRACT

Innovative strategies to increase clinical trial accessibility and equity are needed. We conducted a retrospective review of a phase II investigator-initiated trial to determine whether the modification of clinical trial design to decentralize study treatment can improve trial accessibility among underrepresented groups. Sociodemographic characteristics, including area deprivation indices, as well as study site travel distance, time, and costs were compared between enrolled participants who received chemotherapy locally and participants who did not. Participants who received chemotherapy locally lived substantially farther from the study site (median = 95.90 vs 25.20 miles, P = .004), faced a greater time burden traveling to the study site (median = 115.00 vs 34.00 minutes, P = .002), and had higher travel-related costs for a single trip to the study site (median = $62.81 vs $16.51, P = .004). This study highlights opportunities for alleviating financial and time burdens associated with clinical trial participation, promoting equity in clinical research. Trial Registration: ClinicalTrials.gov identifier: NCT04380337.


Subject(s)
Telemedicine , Humans , Retrospective Studies , Female , Male , Telemedicine/economics , Telemedicine/statistics & numerical data , Middle Aged , Travel , Clinical Trials, Phase II as Topic , Health Services Accessibility , Time Factors , Adult , Neoplasms/therapy , Neoplasms/drug therapy , Antineoplastic Agents/economics , Antineoplastic Agents/therapeutic use , Antineoplastic Agents/administration & dosage , Aged
3.
Psychosom Med ; 86(3): 169-180, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38588495

ABSTRACT

OVERVIEW: Allostatic load represents the cumulative toll of chronic mobilization of the body's stress response systems, as indexed by biomarkers. Higher levels of stress and disadvantage predict higher levels of allostatic load, which, in turn, predict poorer physical and mental health outcomes. To maximize the efficacy of prevention efforts, screening for stress- and disadvantage-associated health conditions must occur before middle age-that is, during childhood, adolescence, and young adulthood. However, this requires that models of allostatic load display properties of measurement invariance across age groups. Because most research on allostatic load has featured older adults, it is unclear if these requirements can be met. METHODS: To address this question, we fit a series of exploratory and confirmatory analytic models to data on eight biomarkers using a nationally representative sample of N = 4260 children, adolescents, and young adults drawn from the National Health and Nutrition Examination Survey dataset. RESULTS: Exploratory and confirmatory models indicated that, consistent with allostatic load theory, a unidimensional model was a good fit to the data. However, this model did not display properties of measurement invariance; post-hoc analyses suggested that the biomarkers included in the final confirmatory model were most strongly intercorrelated among young adults and most weakly intercorrelated among adolescents. CONCLUSIONS: These results underscore the importance of testing assumptions about measurement invariance in allostatic load before drawing substantive conclusions about stress, disadvantage, and health by directly comparing levels of allostatic load across different stages of development, while underscoring the need to expand investigations of measurement invariance to samples of longitudinal data.


Subject(s)
Allostasis , Adolescent , Child , Humans , Young Adult , Allostasis/physiology , Biomarkers , Nutrition Surveys
4.
Nat Neurosci ; 27(4): 782-792, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38491324

ABSTRACT

The interplay between excitation and inhibition determines the fidelity of cortical representations. The receptive fields of excitatory neurons are often finely tuned to encoded features, but the principles governing the tuning of inhibitory neurons remain elusive. In this study, we recorded populations of neurons in the mouse postsubiculum (PoSub), where the majority of excitatory neurons are head-direction (HD) cells. We show that the tuning of fast-spiking (FS) cells, the largest class of cortical inhibitory neurons, was broad and frequently radially symmetrical. By decomposing tuning curves using the Fourier transform, we identified an equivalence in tuning between PoSub-FS and PoSub-HD cell populations. Furthermore, recordings, optogenetic manipulations of upstream thalamic populations and computational modeling provide evidence that the tuning of PoSub-FS cells has a local origin. These findings support the notion that the equivalence of neuronal tuning between excitatory and inhibitory cell populations is an intrinsic property of local cortical networks.


Subject(s)
Neurons , Thalamus , Mice , Animals , Neurons/physiology , Neural Inhibition/physiology , Action Potentials/physiology
5.
Vet Clin Pathol ; 53(1): 136-140, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38321630

ABSTRACT

BACKGROUND: Disruption of acid-base homeostasis can lead to many clinical problems. Ammonia excretion by the kidneys is critical to maintaining acid-base homeostasis through bicarbonate production. Measurement of ammonia excretion may help determine if the kidneys are properly functioning in maintaining acid-base balance. Reference intervals are essential tools for clinical decision-making but do not currently exist for urinary ammonia-to-creatinine ratio (UACR) in feline patients. OBJECTIVE: This study aimed to generate a reference interval (RI) for UACR in healthy adult cats. METHODS: The study used samples from client-owned adult healthy cats that presented to the University of Florida Primary Care and Dentistry service (n = 92). Physical examination, serum biochemistry, urinalysis, urine ammonia, and creatinine concentrations were measured. Cats were excluded if there were significant abnormalities in their urinalysis or biochemistry panel. The RI for UACR was calculated according to the recommendation of the American Society for Veterinary Clinical Pathology. The UACR was evaluated for correlation with serum bicarbonate, weight, age, and sex. RESULTS: The RI for UACR was 3.4-20.7 with 90% confidence intervals for the lower and upper limits of (3.0-3.7) and (16.0-23.7), respectively. No significant correlation with age, sex, or weight was found. There was no discernable relationship between serum bicarbonate and UACR. CONCLUSIONS: Establishing an RI for UACR in healthy adult cats will allow further studies to determine if changes in UACR are observed during specific disease states.


Subject(s)
Ammonia , Cat Diseases , Cats , Animals , Creatinine/urine , Bicarbonates , Urinalysis/veterinary , Kidney , Albuminuria/urine , Albuminuria/veterinary
6.
Neuron ; 112(6): 909-923.e9, 2024 Mar 20.
Article in English | MEDLINE | ID: mdl-38242115

ABSTRACT

Neural population dynamics relevant to behavior vary over multiple spatial and temporal scales across three-dimensional volumes. Current optical approaches lack the spatial coverage and resolution necessary to measure and manipulate naturally occurring patterns of large-scale, distributed dynamics within and across deep brain regions such as the striatum. We designed a new micro-fiber array approach capable of chronically measuring and optogenetically manipulating local dynamics across over 100 targeted locations simultaneously in head-fixed and freely moving mice, enabling the investigation of cell-type- and neurotransmitter-specific signals over arbitrary 3D volumes at a spatial resolution and coverage previously inaccessible. We applied this method to resolve rapid dopamine release dynamics across the striatum, revealing distinct, modality-specific spatiotemporal patterns in response to salient sensory stimuli extending over millimeters of tissue. Targeted optogenetics enabled flexible control of neural signaling on multiple spatial scales, better matching endogenous signaling patterns, and the spatial localization of behavioral function across large circuits.


Subject(s)
Brain , Dopamine , Mice , Animals , Brain/physiology , Corpus Striatum , Neostriatum , Optogenetics/methods
7.
Clin Lung Cancer ; 25(2): 186-189, 2024 03.
Article in English | MEDLINE | ID: mdl-38040540

ABSTRACT

INTRODUCTION: Prior attempts to escalate radiation dose for non-small cell lung cancer (NSCLC) have not improved survival. Given the high risk for cardiopulmonary toxicity with treatment and heterogenous presentation of locally advanced NSCLC, it is unlikely that a single dose regimen is optimal for all patients. This phase I/II trial aims to evaluate a novel treatment approach where the level of accelerated hypofractionation is determined by the predicted toxicity from dose to organs at risk (OARs). METHODS: Patients ≥ 18 years old with lung cancer planned for fractionated radiotherapy to the lung with concurrent chemotherapy will be eligible. Radiation therapy (RT) will be delivered to a total dose of 60 to 66 Gy in 30, 25, or 20 fractions depending on the ability to meet constraints to key organs at risk including the lungs, heart, and esophagus. The primary endpoint is high grade pulmonary, esophageal, or cardiac toxicity. A Bayesian optimized design is used to determine stopping boundaries and evaluate the primary endpoint. CONCLUSION: PACER will evaluate the safety and feasibility of personalized accelerated chemoradiotherapy for lung cancer.


Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Humans , Adolescent , Lung Neoplasms/drug therapy , Carcinoma, Non-Small-Cell Lung/drug therapy , Bayes Theorem , Chemoradiotherapy/methods , Lung , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Clinical Trials, Phase II as Topic , Clinical Trials, Phase I as Topic
8.
bioRxiv ; 2023 Nov 17.
Article in English | MEDLINE | ID: mdl-38014018

ABSTRACT

Neural population dynamics relevant for behavior vary over multiple spatial and temporal scales across 3-dimensional volumes. Current optical approaches lack the spatial coverage and resolution necessary to measure and manipulate naturally occurring patterns of large-scale, distributed dynamics within and across deep brain regions such as the striatum. We designed a new micro-fiber array and imaging approach capable of chronically measuring and optogenetically manipulating local dynamics across over 100 targeted locations simultaneously in head-fixed and freely moving mice. We developed a semi-automated micro-CT based strategy to precisely localize positions of each optical fiber. This highly-customizable approach enables investigation of multi-scale spatial and temporal patterns of cell-type and neurotransmitter specific signals over arbitrary 3-D volumes at a spatial resolution and coverage previously inaccessible. We applied this method to resolve rapid dopamine release dynamics across the striatum volume which revealed distinct, modality specific spatiotemporal patterns in response to salient sensory stimuli extending over millimeters of tissue. Targeted optogenetics through our fiber arrays enabled flexible control of neural signaling on multiple spatial scales, better matching endogenous signaling patterns, and spatial localization of behavioral function across large circuits.

9.
JAMA Oncol ; 9(11): 1525-1534, 2023 Nov 01.
Article in English | MEDLINE | ID: mdl-37707820

ABSTRACT

Importance: Stereotactic ablative radiotherapy (SABR) is used for treating lung tumors but can cause toxic effects, including life-threatening damage to central structures. Retrospective data suggested that small tumors up to 10 cm3 in volume can be well controlled with a biologically effective dose less than 100 Gy. Objective: To assess whether individualizing lung SABR dose and fractionation by tumor size, location, and histological characteristics may be associated with local tumor control. Design, Setting, and Participants: This nonrandomized controlled trial (the iSABR trial, so named for individualized SABR) was a phase 2 multicenter trial enrolling participants from November 15, 2011, to December 5, 2018, at academic medical centers in the US and Japan. Data were analyzed from December 9, 2020, to May 10, 2023. Patients were enrolled in 3 groups according to cancer type: initial diagnosis of non-small cell lung cancer (NSCLC) with an American Joint Committee on Cancer 7th edition T1-3N0M0 tumor (group 1), a T1-3N0M0 new primary NSCLC with a history of prior NSCLC or multiple NSCLCs (group 2), or lung metastases from NSCLC or another solid tumor (group 3). Intervention: Up to 4 tumors were treated with once-daily SABR. The dose ranged from 25 Gy in 1 fraction for peripheral tumors with a volume of 0 to 10 cm3 to 60 Gy in 8 fractions for central tumors with a volume greater than 30 cm3. Main outcome: Per-group freedom from local recurrence (same-lobe recurrence) at 1 year, with censoring at time of distant recurrence, death, or loss to follow-up. Results: In total, 217 unique patients (median [IQR] age, 72 [64-80] years; 129 [59%] male; 150 [69%] current or former smokers) were enrolled (some multiple times). There were 240 treatment courses: 79 in group 1, 82 in group 2, and 79 in group 3. A total of 285 tumors (211 [74%] peripheral and 74 [26%] central) were treated. The most common dose was 25 Gy in 1 fraction (158 tumors). The median (range) follow-up period was 33 (2-109) months, and the median overall survival was 59 (95% CI, 49-82) months. Freedom from local recurrence at 1 year was 97% (90% CI, 91%-99%) for group 1, 94% (90% CI, 87%-97%) for group 2, and 96% (90% CI, 89%-98%) for group 3. Freedom from local recurrence at 5 years ranged from 83% to 93% in the 3 groups. The proportion of patients with grade 3 to 5 toxic effects was low, at 5% (including a single patient [1%] with grade 5 toxic effects). Conclusions and Relevance: The results of this nonrandomized controlled trial suggest that individualized SABR (iSABR) used to treat lung tumors may allow minimization of treatment dose and is associated with excellent local control. Individualized dosing should be considered for use in future trials. Trial Registration: ClinicalTrials.gov Identifier: NCT01463423.


Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Radiosurgery , Humans , Male , Aged , Female , Lung Neoplasms/pathology , Carcinoma, Non-Small-Cell Lung/pathology , Retrospective Studies , Treatment Outcome , Radiosurgery/adverse effects , Radiosurgery/methods
10.
Adv Radiat Oncol ; 8(5): 101253, 2023.
Article in English | MEDLINE | ID: mdl-37250284

ABSTRACT

Purpose: The health care sector is a major contributor of worldwide greenhouse gas (GHG) emissions. Indirect emissions, including those associated with transportation, make up 82% of the US health care sector's environmental footprint. Radiation therapy (RT) treatment regimens present an opportunity for environmental health care-based stewardship owing to the high incidence of cancer diagnosis, significant utilization of RT, and myriad treatment days required for curative regimens. Because the use of short-course RT (SCRT) in the treatment of rectal cancer has demonstrated noninferior clinical outcomes compared with conventional, long-course RT (LCRT), we investigate the environmental and health equity-related outcomes. Methods and Materials: Patients treated with curative, preoperative RT for newly diagnosed rectal cancer at our institution between 2004 and 2022 and living in-state were included. Travel distance was estimated using patients' reported home address. Associated GHG emissions were calculated and reported in carbon dioxide equivalents (CO2e). Results: Of 334 patients included, the total distance traveled for the treatment course was significantly greater in patients treated with LCRT versus SCRT (median, 1417 vs 319 miles; P < .001). Total CO2e emissions for those undergoing LCRT (n = 261) and SCRT (n = 73) were 665.3 kg CO2e and 149.9 kg CO2e, respectively, per treatment course (P < .001), with a net difference of 515.4 kg CO2e. Relatively, this suggests that LCRT is associated with 4.5 times greater GHG emissions from patient transportation. Conclusions: Using treatment of rectal cancer as proof-of-principle, we advocate for the inclusion of environmental considerations in the creation of climate-resilient oncologic RT practices, especially in the context of equivocal clinical outcomes between RT fractionation schedules.

11.
Ecol Evol ; 13(5): e10052, 2023 May.
Article in English | MEDLINE | ID: mdl-37153016

ABSTRACT

Conservation and management of biological systems involves decision-making over time, with a generic goal of sustaining systems and their capacity to function in the future. We address four persistent and difficult conservation challenges: (1) prediction of future consequences of management, (2) uncertainty about the system's structure, (3) inability to observe ecological systems fully, and (4) nonstationary system dynamics. We describe these challenges in terms of dynamic systems subject to different sources of uncertainty, and we present a basic Markovian framework that can encompass approaches to all four challenges. Finding optimal conservation strategies for each challenge requires issue-specific structural features, including adaptations of state transition models, uncertainty metrics, valuation of accumulated returns, and solution methods. Strategy valuation exhibits not only some remarkable similarities among approaches but also some important operational differences. Technical linkages among the models highlight synergies in solution approaches, as well as possibilities for combining them in particular conservation problems. As methodology and computing software advance, such an integrated conservation framework offers the potential to improve conservation outcomes with strategies to allocate management resources efficiently and avoid negative consequences.

12.
Ecol Evol ; 12(9): e9197, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36172296

ABSTRACT

The actual state of ecological systems is rarely known with certainty, but management actions must often be taken regardless of imperfect measurement (partial observability). Because of the difficulties in accounting for partial observability, it is usually treated in an ad hoc fashion, or simply ignored altogether. Yet incorporating partial observability into decision processes lends a realism that has the potential to improve ecological outcomes significantly. We review frameworks for dealing with partial observability, focusing specifically on dynamic ecological systems with Markovian transitions, i.e., transitions among system states that are influenced by the current system state and management action over time. Fully observable states are represented in an observable Markov decision process (MDP), whereas obscure or hidden states are represented in a partially observable process (POMDP). POMDPs can be seen as a natural extension of observable MDPs. Management under partial observability generalizes the situation for complete observability, by recognizing uncertainty about the system's state and incorporating sequential observations associated with, but not the same as, the states themselves. Decisions that otherwise would depend on the actual state must be based instead on state probability distributions ("belief states"). Partial observability requires adaptation of the entire decision process, including the use of belief states and Bayesian updates, valuation that includes expectations over observations, and optimal strategy that identifies actions for belief states over a continuous belief space. We compare MDPs and POMDPs and highlight POMDP applications to some common ecological problems. We clarify the structure and operations, approaches for finding solutions, and analytic challenges of POMDPs for practicing ecologists. Both observable and partially observable MDPs can use an inductive approach to identify optimal strategies and values, with a considerable increase in mathematical complexity with POMDPs. Better understanding of POMDPs can help decision makers manage imperfectly measured ecological systems more effectively.

13.
Health Promot Pract ; 23(1): 25-31, 2022 01.
Article in English | MEDLINE | ID: mdl-33858267

ABSTRACT

Existing participatory research approaches have failed to identify innovative methods that overcome the persistent barriers to adolescent sexual and reproductive health service demand and access. Increasingly, programmers have turned to human-centered design (HCD), a problem-solving process that centers the needs, perspectives, and experiences of people, when developing solutions to complex SRH challenges. This article describes the application of a youth-engaged version of HCD as part of Adolescents 360, a transdisciplinary initiative to increase 15- to 19-year-old girls' use of modern contraception in Nigeria, Ethiopia, and Tanzania. Youth-adult design teams (including 111 "youth designers" trained in HCD methods) undertook formative research to inform the design and implementation of interventions. We reflect on the practical implications of using instrumental strategies of HCD with a youth-led participatory approach. Our experience indicates that (1) engaging youth as project partners in transdisciplinary teams requires planned and dedicated financial and human resources; (2) involving youth as action researchers can help identify opportunities to improve program empathy and responsiveness; (3) it is difficult to recruit "extreme users" as project partners because of the high competencies needed in HCD; (4) centering empathy and employing design standards during prototyping can drive decision-making and resolve questions raised by conflicting evidence claims in existing bodies of literature; and (5) testing tangible services and products in real-world settings continues long after the intervention design phase. Youth-adult partnership should continue throughout this iterative and adaptive phase to ensure that the adolescent experience of the intervention remains at the core of intervention delivery.


Subject(s)
Reproductive Health Services , Sexual Health , Adolescent , Adult , Female , Health Services Research , Humans , Reproductive Health , Sexual Behavior , Young Adult
14.
Front Artif Intell ; 4: 561528, 2021.
Article in English | MEDLINE | ID: mdl-34250463

ABSTRACT

Introduction: Suicidal ideation (SI) is prevalent in the general population, and is a risk factor for suicide. Predicting which patients are likely to have SI remains challenging. Deep Learning (DL) may be a useful tool in this context, as it can be used to find patterns in complex, heterogeneous, and incomplete datasets. An automated screening system for SI could help prompt clinicians to be more attentive to patients at risk for suicide. Methods: Using the Canadian Community Health Survey-Mental Health Component, we trained a DL model based on 23,859 survey responses to classify patients with and without SI. Models were created to classify both lifetime SI and SI over the last 12 months. From 582 possible parameters we produced 96- and 21-feature versions of the models. Models were trained using an undersampling procedure that balanced the training set between SI and non-SI; validation was done on held-out data. Results: For lifetime SI, the 96 feature model had an Area under the receiver operating curve (AUC) of 0.79 and the 21 feature model had an AUC of 0.77. For SI in the last 12 months the 96 feature model had an AUC of 0.71 and the 21 feature model had an AUC of 0.68. In addition, sensitivity analyses demonstrated feature relationships in line with existing literature. Discussion: Although further study is required to ensure clinical relevance and sample generalizability, this study is an initial proof of concept for the use of DL to improve identification of SI. Sensitivity analyses can help improve the interpretability of DL models. This kind of model would help start conversations with patients which could lead to improved care and a reduction in suicidal behavior.

15.
Child Dev ; 92(3): 1067-1082, 2021 05.
Article in English | MEDLINE | ID: mdl-33400295

ABSTRACT

This study deconstructs cumulative risk to probe unique relations to basal cortisol for family income and four distinct aspects of poverty-related instability. Participants were 288 children aged 3-5 years who attended Head Start preschool. Parents reported on poverty risks. Children provided samples of salivary cortisol at four times of day on 6 days. Results of hierarchical linear modeling with piecewise latent growth curves representing basal cortisol indicated unique relations for family income, household chaos, neighborhood risk, attachment-disruptive residential changes, and non-attachment changes. The findings support an equifinality implied by cumulative risk models in demonstrating that multiple risks relate to cortisol dysregulation yet also suggest the utility of considering unique effects of different risks for neurophysiological stress response functioning.


Subject(s)
Hydrocortisone , Poverty , Child , Child, Preschool , Family Characteristics , Humans , Parents , Residence Characteristics
16.
Am J Med Sci ; 360(5): 591-595, 2020 11.
Article in English | MEDLINE | ID: mdl-32838955

ABSTRACT

BACKGROUND: Physical activity plays an important role in the prevention of cardio-metabolic diseases. The present study evaluated the effect of habitual physical activity on body composition, peak oxygen consumption, cardiac and metabolic function. METHODS: This was a retrospective study. Data was collected between February 2014 and November 2015. Thirty-six healthy women (age 50±16 years) were stratified according to daily number of steps into low- (<7500 steps/day, n=17) or high-active group (>12500 steps/day, n=19). All participants underwent body composition assessment, oral glucose tolerance test and non-invasive gas-exchange and haemodynamic (bioreactance) measurements at rest and in response to maximal graded cardiopulmonary exercise test. RESULTS: The high active group averaged 16280±3205 steps/day and the low active group averaged 6285±943 steps/day (difference p=0.00). High-active women (vs. low active) demonstrated significantly lower body weight (62.1±12.3 vs. 71.2±9.1 kg, p=0.02), body fat (27.2±9.1 vs 37.7±6.4 %, p=0.00), but increased lean body mass (72.8±9.1 vs. 62.3±6.4 %, p=0.00). Peak oxygen consumption was significantly higher in high- versus low active women (2.0±0.5 vs. 1.5±0.2 l/min, p=0.00). There were no significant differences between the groups in fasting- and 2-hour glucose levels (4.9±0.6 vs. 4.8±0.5, p=0.45 and 4.8±1.3 vs. 5.5±1.4 mmol/L, p=0.16) haemodynamic measures of cardiac function including cardiac power output, cardiac output, stroke volume and arterial blood pressure at rest and in response to exercise stress test (p>0.05). CONCLUSIONS: Increased levels of habitual physical activity improve body composition and peak oxygen consumption but appears to have limited effect cardio-metabolic function in middle-aged women.


Subject(s)
Aging/physiology , Blood Glucose/metabolism , Cardiac Output/physiology , Exercise/physiology , Stroke Volume/physiology , Adult , Aged , Female , Humans , Middle Aged , Monitoring, Ambulatory/methods , Retrospective Studies
18.
Arch Dis Child Fetal Neonatal Ed ; 105(4): 380-386, 2020 Jul.
Article in English | MEDLINE | ID: mdl-31666311

ABSTRACT

OBJECTIVE: To compare rates of necrotising enterocolitis (NEC), late-onset sepsis, and mortality in 5-year epochs before and after implementation of routine daily multistrain probiotics administration in high-risk neonates. DESIGN: Single-centre retrospective observational study over the 10-year period from 1 January 2008 to 31 December 2017. SETTING: Level 3 neonatal intensive care unit (NICU) of the Norfolk and Norwich University Hospital, UK. PATIENTS: Preterm neonates at high risk of NEC: admitted to NICU within 3 days of birth at <32 weeks' gestation or at 32-36 weeks' gestation and of birth weight <1500 g. INTERVENTION: Prior to 1 January 2013 probiotics were not used. Thereafter, dual-species Lactobacillus acidophilus and Bifidobacterium bifidum combination probiotics were routinely administered daily to high-risk neonates; from April 2016 triple-species probiotics (L. acidophilus, B. bifidum, and B. longum subspecies infantis) were used. MAIN OUTCOME MEASURES: Incidence of NEC (modified Bell's stage 2a or greater), late-onset sepsis, and mortality. RESULTS: Rates of NEC fell from 7.5% (35/469 neonates) in the pre-implementation epoch to 3.1% (16/513 neonates) in the routine probiotics epoch (adjusted sub-hazard ratio=0.44, 95% CI 0.23 to 0.85, p=0.014). The more than halving of NEC rates after probiotics introduction was independent of any measured covariates, including breast milk feeding rates. Cases of late-onset sepsis fell from 106/469 (22.6%) to 59/513 (11.5%) (p<0.0001), and there was no episode of sepsis due to Lactobacillus or Bifidobacterium. All-cause mortality also fell in the routine probiotics epoch, from 67/469 (14.3%) to 47/513 (9.2%), although this was not statistically significant after multivariable adjustment (adjusted sub-hazard ratio=0.74, 95% CI 0.49 to 1.12, p=0.155). CONCLUSIONS: Administration of multispecies Lactobacillus and Bifidobacterium probiotics has been associated with a significantly decreased risk of NEC and late-onset sepsis in our neonatal unit, and no safety issues. Our data are consistent with routine use of Lactobacillus and Bifidobacterium combination probiotics having a beneficial effect on NEC prevention in very preterm neonates.


Subject(s)
Bifidobacterium bifidum , Enterocolitis, Necrotizing , Lactobacillus acidophilus , Probiotics/therapeutic use , Enteral Nutrition , Enterocolitis, Necrotizing/epidemiology , Enterocolitis, Necrotizing/prevention & control , Female , Humans , Incidence , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases/epidemiology , Infant, Premature, Diseases/prevention & control , Intensive Care Units, Neonatal , Male , Retrospective Studies , United Kingdom/epidemiology
19.
Front Psychol ; 11: 586749, 2020.
Article in English | MEDLINE | ID: mdl-33584419

ABSTRACT

Growth mindset is an important aspect of children's socioemotional development and is subject to change due to environmental influence. Orchestral music education may function as a fertile context in which to promote growth mindset; however, this education is not widely available to children facing economic hardship. This study examined whether participation in a program of orchestral music education was associated with higher levels of overall growth mindset and greater change in levels of musical growth mindset among children placed at risk by poverty. After at least 2 years of orchestral participation, students reported significantly higher levels of overall growth mindset than their peers; participating students also reported statistically significant increases in musical growth mindset regardless of the number of years that they were enrolled in orchestral music education. These findings have implications for future research into specific pedagogical practices that may promote growth mindset in the context of orchestral music education and more generally for future studies of the extra-musical benefits of high-quality music education.

20.
J Fam Psychol ; 33(6): 629-639, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31169392

ABSTRACT

The present study investigated relations among various aspects of economic adversity and cortisol levels for young children facing economic hardship. Specifically, the study examined relations to cortisol for variables representing family income, material hardship, financial strain, economic instability, and household chaos. Participants were 374 children, ages 3-5 years, who attended a Head Start preschool, as well as their primary caregivers. Nearly all children lived in households classified as poor or low-income, defined as less than two times the federal poverty threshold. Caregivers completed interviews about family demographics and economic adversity at the beginning of the school year. Child salivary cortisol was sampled in duplicate on two weekday mornings at the end of the school year. We hypothesized that economic instability would show direct statistical effects on child cortisol as well as indirect effects via household chaos. A structural equation model that corresponded to this hypothesis showed adequate fit for the sample data and revealed a statistically significant indirect effect of economic adversity on child cortisol via economic instability and household chaos, as well as statistically significant direct effects of economic instability and chaos on child cortisol, and a significant indirect effect of economic instability on cortisol via household chaos. Implications concern understanding mechanisms of poverty risk, including the impact of instability and chaos on stress physiology, and promoting physiological regulation for children facing economic hardship. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Subject(s)
Hydrocortisone/metabolism , Poverty/psychology , Social Environment , Adult , Caregivers , Child, Preschool , Family , Family Characteristics , Female , Humans , Interviews as Topic , Male , Philadelphia , Poverty/statistics & numerical data
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