Fluorine-free nanoparticle coatings on cotton fabric: comparing the UV-protective and hydrophobic capabilities of silica vs. silica-ZnO nanostructures.

Robust, hydrophobic woven cotton fabrics were obtained through the sol-gel dip coating of two different nanoparticle (NP) architectures; silica and silica-ZnO. Water repellency values as high as 148° and relatively low tilt angles for fibrous fabrics (12°) were observed, without the need for fluorinated components. In all cases, this enhanced functionality was achieved with the broad retention of water vapor permeability characteristics, i.e., less than 10% decrease. NP formation routes indicated direct bonding interactions in both the silica and silica-ZnO structures. The physico-chemical effects of NP-compatibilizer (i.e., polydimethoxysilane (PDMS) and n-octyltriethoxysilane (OTES) at different ratios) coatings on cotton fibres indicate that compatibilizer-NP interactions are predominantly physical. Whenever photoactive ZnO-containing additives were used, there was a minor decrease in hydrophobic character, but order of magnitude increases in UV-protective capability (i.e., UPF > 384); properties which were absent in non-ZnO-containing samples. Such water repellency and UPF capabilities were stable to both laundering and UV-exposure, resisting the commonly encountered UV-induced wettability transitions associated with photoactive ZnO. These results suggest that ZnO-containing silica NP coatings on cotton can confer both excellent and persistent surface hydrophobicity as well as UV-protective capability, with potential uses in wearables and functional textiles applications.

Evaluating strengths and opportunities for a co-created climate change curriculum: Medical student perspectives.

Introduction: Medical trainees are front-line workers in our worsening climate and health crisis. A movement is underway to teach medical students essential climate change and health content. Few evaluations of climate and health curricula exist to support ongoing curricular development, innovation, and improvement. This study explores student perspectives on climate change and health content and delivery post-implementation of a climate change and health curriculum that was co-created by students and faculty and integrated across 16 months of pre-clinical coursework at Emory University School of Medicine. Methods: The authors conducted focus groups with the inaugural cohort of students to receive the climate and health education content at the conclusion of their preclinical curriculum. The focus groups elicited student perspectives across four domains: (i) prior perceptions of climate change and health, (ii) current attitudes about climate change and health, (iii) reflections on the existing curriculum, and (iv) opportunities for the curriculum. In this qualitative evaluation, the authors coded focus group transcripts using an inductive content analysis approach. Results: Out of 137 eligible students in the cohort, 13 (9.5%) participated in the focus groups. Implementation strategies that students valued included contextualization and integration of climate content within existing topics and student representation through the co-creation process. Students recommended bolstering small group sessions and case-based learning to build relevant history and physical examination skills as well as creating interprofessional and community-based opportunities. Discussion: This evaluation offers in-depth student perspectives of our climate and health curriculum. Opportunities exist to synergize climate and health education with broader transformations in medicine toward health promotion and sustainable, climate-ready healthcare. From the input of focus groups, the authors derive a framework for strengthening and extending curricular content.

Classification of performance validity and symptom validity using the Trauma Symptom Inventory-2.

The Trauma Symptom Inventory-Second Edition (TSI-2) is garnering research interest as a symptom validity test in the evaluation of trauma-related disorders. However, there has been limited empirical validation of its validity scales in clinical and forensic real-world settings. This study evaluated the ability of the TSI-2 Atypical Response (ATR) scale to discriminate response bias in cognitive performance and symptom reporting in a large sample of disability and compensation-seeking claimants. This retrospective chart review included 296 adults with a known history of trauma exposure or claimed trauma-related psychological injury who underwent neuropsychological and/or comprehensive psychological assessment in a private neuropsychology clinic. The discriminability of the ATR scale to classify credible versus non-credible cognitive profiles and symptom reporting were analyzed by AUC-ROCs. Overall, the ATR scale demonstrated poor discriminability of assessment validity based on the Word Memory Test, Victoria Symptom Validity Test, and Minnesota Multiphasic Personality Inventory-2-Restructured Form. The ATR scale had fair discriminatory ability of only one of the over-reporting scales (F-r), with an ROC area of .73, p = .001. However, the test publisher's proposed ATR cut-offs of ≥8 for screening, research, and normal groups, and ≥15 in forensic and clinical settings revealed significant issues with sensitivity and specificity. These results suggest that the TSI-2 should be paired with other established performance validity and symptom validity tests in clinical assessments and not be used as the primary or sole indicator of assessment validity.

The Emergence of Cognitive Maps for Spatial Navigation in 7- to 10-Year-Old Children.

Although much is known about adults' ability to orient by means of cognitive maps (mental representations of the environment), it is less clear when this important ability emerges in development. In the present study, 97 seven- to 10-year-olds and 26 adults played a video game designed to investigate the ability to orient using cognitive maps. The game required participants to reach target locations as quickly as possible, necessitating the identification and use of novel shortcuts. Seven- and 8-year-olds were less effective than older children and adults in using shortcuts. These findings provide clear evidence of a distinct developmental change around 9 years of age when children begin to proficiently orient and navigate using cognitive maps.

Systematic review of MRI findings in children with developmental delay or cognitive impairment.

AIM: To summarize the reported rates of magnetic resonance imaging (MRI) abnormalities in children with isolated global developmental delay (GDD) or intellectual disability (ID). METHOD: A literature search was conducted using electronic databases for studies reporting the rate of MRI abnormalities in children with clinically diagnosed ID or GDD and no other neurological signs, symptoms, or previously determined aetiology. All investigations with participants from birth to 18years were considered. Study quality was evaluated using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI) critical appraisal checklist items. RESULTS: Eighteen cross sectional, and 11 case-controlled studies adhered to inclusion criteria. Reported rates of abnormalities ranged from 0% to 98%. When all subjects with developmental delay from all papers were considered (n=2299) the total percentage found to have abnormalities was 38%. Abnormalities led to an etiological diagnosis for delay in 7.9% of cases. INTERPRETATION: Definitions of abnormalities varied widely between studies, and drastically different rates of abnormalities are reported. Currently available evidence is not of sufficient quality to make firm recommendations on the use of neuroimaging in ID or GDD but MRI should be considered for children that do not have a diagnosis after thorough clinical evaluation.

MgCaCO3 versus CaCO3 in peritoneal dialysis patients--a cross-over pilot trial.

BACKGROUND: Despite adverse effects such as constipation, vascular calcification, and hypercalcemia, calcium-based salts are relatively affordable and effective phosphate binders that remain in widespread use in the dialysis population. We conducted a pilot study examining whether the use of a combined magnesium/calcium-based binder was as effective as calcium carbonate at lowering serum phosphate levels in peritoneal dialysis (PD) patients. METHODS: This was a cross-over, investigator-masked pilot study in which prevalent PD patients received calcium carbonate alone (200 mg calcium per tablet) or calcium magnesium carbonate (100 mg calcium, 85 mg magnesium per tablet). Primary outcome was serum phosphate level at 3 months. Analysis was as per protocol. RESULTS: Twenty patients were recruited, 17 completed the study. Mean starting dose was 11.35 ± 7.04 pills per day of MgCaCO3 and 9.00 ± 4.97 pills per day of CaCO3. Mean phosphate levels fell from 2.13 mmol/L to 2.01 mmol/L (95% confidence interval (CI): 1.76 - 2.30, p = 0.361) in the MgCaCO3 group, and 1.81 mmol/L (95% CI: 1.56 - 2.0, p = 0.026) in the CaCO3 alone group. Six (35%) patients taking MgCaCO3 and 9 (54%) taking CaCO3 alone achieved Kidney Disease Outcomes Quality Initiative (KDOQI) serum phosphate targets at 3 months. Diarrhea developed in 9 patients taking MgCaCO3 and 3 taking CaCO3. Serum magnesium exceeded 1.4 mmol/L in 5 patients taking MgCaCO3 while serum calcium exceeded 2.65 mmol/L in 3 patients receiving CaCO3. When compared to the initial dose, the prescribed dose at 3 months was reduced by 44% (to 6.41 tablets/day) in the MgCaCO3 group and by 8% (to 8.24 pills per day) in the CaCO3 alone group. CONCLUSION: Compared with CaCO3 alone, the preparation and dose of MgCaCO3 used in this pilot study was no better at lowering serum phosphate levels in PD patients, and was associated with more dose-limiting side effects.

Developmental topographical disorientation and decreased hippocampal functional connectivity.

Developmental topographical disorientation (DTD) is a newly discovered cognitive disorder in which individuals experience a lifelong history of getting lost in both novel and familiar surroundings. Recent studies have shown that such a selective orientation defect relies primarily on the inability of the individuals to form cognitive maps, i.e., mental representations of the surrounding that allow individuals to get anywhere from any location in the environment, although other orientation skills are additionally affected. To date, the neural correlates of this developmental condition are unknown. Here, we tested the hypothesis that DTD may be related to ineffective functional connectivity between the hippocampus (HC; known to be critical for cognitive maps) and other brain regions critical for spatial orientation. A group of individuals with DTD and a group of control subjects underwent a resting-state functional magnetic resonance imaging (rsfMRI) scan. In addition, we performed voxel-based morphometry to investigate potential structural differences between individuals with DTD and controls. The results of the rsfMRI study revealed a decreased functional connectivity between the right HC and the prefrontal cortex (PFC) in individuals with DTD. No structural differences were detected between groups. These findings provide evidence that ineffective functional connectivity between HC and PFC may affect the monitoring and processing of spatial information while moving within an environment, resulting in the lifelong selective inability of individuals with DTD to form cognitive maps that are critical for orienting in both familiar and unfamiliar surroundings.

Glutamate alterations associated with transcranial magnetic stimulation in youth depression: a case series.

OBJECTIVE: We hypothesized an increase in dorsolateral prefrontal cortex (DLPFC) glutamate levels would occur after 3 weeks of repetitive transcranial magnetic stimulation (rTMS) treatment and a decrease in major depressive disorder (MDD) symptoms. METHODS: We report 6 patients (4 females) 15 to 21 years of age with treatment-resistant MDD. Participants had a mean (SD) age of 18.7 (1.95) years and a mean (SD) IQ of 102.3 (3.39). Short echo proton magnetic resonance spectroscopy (¹H-MRS) was used to quantify glutamate levels in the left DLPFC (4.5 cc) before and after rTMS treatment. Repetitive transcranial magnetic stimulation was localized to the left DLPFC and applied for 15 consecutive weekdays (120% resting motor threshold; 40 pulses over 4 seconds [10 Hz]; intertrain interval, 26 seconds; 75 trains; 3000 pulses). Treatment response was defined as a greater than 50% reduction in Hamilton Depression Rating Scale scores. Short echo proton magnetic resonance spectroscopy data were analyzed with LCModel to determine glutamate concentration. RESULTS: After rTMS, treatment responders (n = 4) showed an increase (relative to baseline) in left DLPFC glutamate levels (11%), which corresponded to an improvement in depressive symptom severity (68% Hamilton Depression Rating Scale score reduction). Treatment nonresponders (n = 2) had elevated baseline glutamate levels compared to responders in that same region, which decreased with rTMS (-10%). Procedures were generally well tolerated with no adverse events. CONCLUSIONS: Repetitive transcranial magnetic stimulation is feasible and possibly efficacious in adolescents with MDD. In responders, rTMS may act by induced elevations in elevating DFPLC glutamate levels in the left DLPFC, thereby leading to symptom improvement.

Cognitive mapping in humans and its relationship to other orientation skills.

Human orientation in novel and familiar environments is a complex skill that can involve numerous different strategies. To date, a comprehensive account of how these strategies interrelate at the behavioural level has not been documented, impeding the development of elaborate systems neuroscience models of spatial orientation. Here, we describe a virtual environment test battery designed to assess five of the core strategies used by humans to orient. Our results indicate that the ability to form a cognitive map is highly related to more basic orientation strategies, supporting previous proposals that encoding a cognitive map requires inputs from multiple domains of spatial processing. These findings provide a topology of numerous primary orientation strategies used by humans during orientation and will allow researchers to elaborate on neural models of spatial cognition that currently do not account for how different orientation strategies integrate over time based on environmental conditions.

Age and gender differences in various topographical orientation strategies.

Orientation in the environment can draw on a variety of cognitive strategies. We asked 634 healthy volunteers to perform a comprehensive battery administered through an internet website (www.gettinglost.ca), testing different orientation strategies in virtual environments to determine the effect of age and gender upon these skills. Older participants (46-67years of age) performed worse than younger participants (18-30 or 31-45years of age) in all orientation skills assessed, including landmark recognition, integration of body-centered information, forming association between landmarks and body turns, and the formation and use of a cognitive map. Among all tests, however, the ability to form cognitive maps resulted to be the significant factor best at predicting the individuals' age group. Gender effects were stable across age and dissociated for task, with males better than females for cognitive map formation and use as well as for path reversal, an orientation task that does not require the processing of visual landmarks during navigation. We conclude that age-related declines in navigation are common across all orientation strategies and confirm gender-specific effects in different spatial domains.

The International Collaboration on Complementary Therapy Resources (ICCR): working together to improve online CAM information.

BACKGROUND: Use of the Internet to find health information is increasing dramatically but the quality of information, particularly on complementary and alternative medicine (CAM) is variable. The International Collaboration on Complementary Therapy Resources (ICCR) involves collaboration between the national CAM information centers in Australia, Denmark, Norway, the United Kingdom, and the United States, and a CAM information service in Germany. OBJECTIVES: The study objectives were to compare the services and areas of expertise offered by each of the national CAM information services, to explore common challenges encountered in practice, and to establish specific objectives for the collaboration. DESIGN: The workshop incorporated set templates for presentations, brainstorming, and analysis of notes to identify common themes. RESULTS: Differences and similarities between the various services were revealed. Common challenges were identified under the main themes of overall context, users and needs, content and processes. Based on these themes, it was possible to agree on a number of specific objectives. CONCLUSIONS: The member organizations of the ICCR serve a range of different audiences and have varied remits to fulfill. For the international collaboration to be effective, it was necessary to identify common challenges and to agree on specific objectives and potential ways of working together. Progress to date is also discussed together with plans for the future.

Improved modulation of rostrolateral prefrontal cortex using real-time fMRI training and meta-cognitive awareness.

Recent real-time fMRI (rt-fMRI) training studies have demonstrated that subjects can achieve improved control over localized brain regions by using real-time feedback about the level of fMRI signal in these regions. It has remained unknown, however, whether subjects can gain control over anterior prefrontal cortex (PFC) regions that support some of the most complex forms of human thought. In this study, we used rt-fMRI training to examine whether subjects can learn to regulate the rostrolateral prefrontal cortex (RLPFC), or the lateral part of the anterior PFC, by using a meta-cognitive awareness strategy. We show that individuals can achieve improved regulation over the level of fMRI signal in their RLPFC by turning attention towards or away from their own thoughts. The ability to achieve improved modulation was contingent on observing veridical real-time feedback about the level of RLPFC activity during training; a sham-feedback control group demonstrated no improvement in modulation ability and neither did control subjects who received no rt-fMRI feedback but underwent otherwise identical training. Prior to training, meta-cognitive awareness was associated with recruitment of anterior PFC subregions, including both RLPFC and medial PFC, as well as a number of other midline and posterior cortical regions. Following training, however, regulation improvement was specific to RLPFC and was not observed in other frontal, midline, or parietal cortical regions. These results demonstrate the feasibility of acquiring control over high-level prefrontal regions through rt-fMRI training and offer a novel view into the correspondence between observable neuroscientific measures and highly subjective mental states.

Requirement of protein phosphatase 5 in DNA-damage-induced ATM activation.

The checkpoint kinase ATM is centrally involved in the cellular response to DNA double-strand breaks. However, the mechanism of ATM activation during genotoxic stress is only partially understood. Here we report a direct regulatory linkage between the protein serine-threonine phosphatase 5 (PP5) and ATM. PP5 interacts with ATM in a DNA-damage-inducible manner. Reduced expression of PP5 attenuated DNA-damage-induced activation of ATM. Expression of a catalytically inactive PP5 mutant inhibited the phosphorylation of ATM substrates and the autophosphorylation of ATM on Ser 1981, and caused an S-phase checkpoint defect in DNA-damaged cells. Together our findings indicate that PP5 plays an essential role in the activation and checkpoint signaling functions of ATM in cells that have suffered DNA double-strand breaks.