Salivary testosterone and cortisol response in acute stress modulated by seven sessions of mindfulness meditation in young males.

Stress is an established risk factor for negative health outcomes. Salivary cortisol and testosterone concentrations increase in response to acute psychosocial stress. It's crucial to reduce stress for health and well-being through evidence-based interventions. Body-mind interventions such as meditation and Tai Chi have shown reduced cortisol levels but mixed results in testosterone concentration after stress. To address this research gap, we conducted a pilot randomized controlled trial to examine the modulating effects of a short-term (seven 20-minute sessions) mindfulness meditation on testosterone and cortisol in response to acute stress. Using one form of mindfulness meditation - Integrative Body-Mind Training (IBMT) and an active control-relaxation training (RT), we assessed salivary cortisol and testosterone concentrations at three stages of stress intervention - rest, stress, and an additional 20-min IBMT or RT practice. We found increased cortisol and testosterone concentrations after acute stress in both groups, but testosterone rise was not associated with cortisol rise. Moreover, an additional practice immediately after stress produced higher testosterone concentrations in the IBMT group than the RT group, whereas cortisol concentration increased in the RT group than in the IBMT group at the same time point. These findings indicate that brief mindfulness intervention modulates a dual-hormone profile of testosterone and cortisol in response to acute stress presumably via the co-regulation of hypothalamus-pituitary-adrenal and hypothalamus-pituitary-testicular axes.

Digital mindfulness training and cognitive functions: A preregistered systematic review of neuropsychological findings.

Traditional mindfulness interventions have been frequently reported to be effective in improving cognitive functions. In recent years, however, traditional programs are being increasingly replaced by technology-enabled mindfulness training programs. The aim of the present systematic review (PROSPERO ID: CRD42021289480) is to evaluate the research evidence on their effects on cognitive functions. Empirical training studies in the realm of digital mindfulness training that fulfilled the inclusion criteria led to 19 studies and 1654 participants being included in this review from among the papers searched in PubMed, Scopus, and Web of Knowledge. Results support previous assumptions on the potential of digital mindfulness training, with the most robust effect on attention control, followed by executive regulation, memory, cognitive flexibility, and other cognitive functions. However, the number of studies that did not find significant changes at least equaled, if not exceeded, the number of studies that found increases. The heterogeneity of identified studies prompted us to discuss several aspects in order to help the future development of digital applications.

Lignan and phenolic glycosides from Viburnum betulifolium fruits and their α­amylase and α-glucosidase inhibitory activities.

The phytochemical investigation on the methanol extract of Viburnum betulifolium fruits resulted in the isolation and identification of two new lignan constituents (1 and 2) and seven known phenolic glycosides (3-9). The structures of new isolates, including their absolute configurations were elucidated by extensive spectroscopic analyses (1H and 13C NMR, HSQC, HMBC, HRESIMS, and ECD) and chemical methods. In the in vitro enzyme assays, compounds 1, 2, 6, and 8 showed potential α­amylase and α-glucosidase inhibitory activities. Among them, compound 1 exhibited stronger inhibitory effects towards α-amylase and α-glucosidase with the IC50 values of 12.68 and 15.17 µM, respectively, than those of the positive control acarbose (IC50, 29.19 and 18.15 µM, respectively). In addition, the molecular docking analyses of compound 1 with strongest inhibition against the target enzymes were also performed.

Workplace violence inflicted by patients or their family members/visitors and its relationship with suicidal ideation among undergraduate medical students during clinical training in China.

BACKGROUND: Workplace violence in healthcare settings is a significant public concern that profoundly impacts healthcare workers. However, there is a dearth of knowledge regarding the prevalence of workplace violence and its correlation with suicidal ideation among undergraduate medical students in China during their clinical training. The objective of this study was to evaluate the prevalence of workplace violence inflicted by patients or their family members/visitors and to assess its association with suicidal ideation among undergraduate medical students. METHOD: The snowballing sampling technique was used to recruit Chinese medical students. A question designed by the research team was used to ask medical students about their encounters with workplace violence. Students' basic demographic information and mental distresses (learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence, excessive daytime sleepiness and history of mental disorders) were also assessed. As appropriate, the data were analysed using descriptive statistics, chi-square tests, independent-sample t-tests and multiple logistic regression. RESULTS: Out of the 1402 undergraduate medical students who participated, 493 (35.2%) reported having experienced workplace violence inflicted by patients or their family members/visitors, of which 394 (28.1%) were verbal abuse, 14 (1.0%) were physical aggression, and 85 (6.1%) were suffered from both verbal abuse and physical aggression. Furthermore, students exposed to workplace violence were more likely to report suicidal ideation and had a higher prevalence of learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence and excessive daytime sleepiness. Depression symptoms, history of mental disorders, learning burnout and having a partner were significantly associated with suicidal ideation in this population. CONCLUSION: The prevalence of workplace violence inflicted by patients or their family members/visitors was high among undergraduate medical students in China. This may be associated with their mental distress and suicidal ideation. Consequently, it is crucial to strengthen workplace safety measures and promptly implement interventions to mitigate the potentially serious consequences.

Workplace violence was common among Chinese undergraduate medical students during clinical training and may be associated with suicidal ideation, learning burnout, depression symptoms, anxiety symptoms, alcohol abuse/dependence and excessive daytime sleepiness.Depression symptoms, history of mental disorders, learning burnout and having a partner were significantly associated with suicidal ideation among undergraduate medical students exposed to workplace violence.

Gender differences in alcohol abuse/dependence among medical undergraduates during the post-COVID­19 pandemic period (October 20, 2020-April 5, 2021) in China.

BACKGROUND: This study aimed to assess the prevalence and the gender-specific risk factors of alcohol abuse/dependence among medical undergraduates during the post-COVID­19 pandemic period in China. METHOD: The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) was used to identify respondents with alcohol abuse/dependence. A questionnaire on basic demographics and mental distresses (learning burnout, depression symptoms, anxiety symptoms, excessive daytime sleepiness, and history of mental disorders) was used. The logistic regression model was used to explore the associations between the above characteristics and alcohol abuse/dependence. RESULTS: A total of 3,412 medical undergraduates were included in the analysis. Males showed a higher prevalence of alcohol abuse/dependence than females (16.6% vs 7.4%, p < 0.001). Alcohol abuse/dependence was associated with learning burnout (OR: 2.168, p < 0.001) and having a partner (OR: 1.788 p = 0.001) among female medical undergraduates. Among male medical undergraduates, excessive daytime sleepiness (OR: 1.788 p = 0.001) and older age (OR: 1.788, p = 0.001) were independently associated with alcohol abuse/dependence. CONCLUSION: Alcohol abuse/dependence was common among medical undergraduates during the post-COVID­19 pandemic period. Substantial gender differences in the prevalence and risk factors of alcohol abuse/dependence were found among medical undergraduates in this study, which highlighted the need for timely gender-specific screening and interventions. However, the cross-sectional design adopted in this study has limited the examination of causality, thus further longitudinal studies are warranted.

Promoting Healthy Aging: Insights on Brain and Physiological Health - A Special Issue.

This special issue focuses on healthy aging and neuroprotection, particularly in the context of brain and physiological health during normal aging and Alzheimer's disease. It highlights the importance of physical activity, nutrition, and stress management in promoting healthy aging and preventing neurodegenerative diseases. The issue explores molecular pathways, genetic factors, and lifestyle interventions that support brain and physiological health in aging populations. Overall, the findings presented in this special issue underscore the importance of healthy lifestyles in promoting brain and physiological health during the aging process.

Precision Medicine as a New Frontier in Speech-Language Pathology: How Applying Insights From Behavior Genomics Can Improve Outcomes in Communication Disorders.

PURPOSE: Precision medicine is an emerging intervention paradigm that leverages knowledge of risk factors such as genotypes, lifestyle, and environment toward proactive and personalized interventions. Regarding genetic risk factors, examples of interventions informed by the field of medical genomics are pharmacological interventions tailored to an individual's genotype and anticipatory guidance for children whose hearing impairment is predicted to be progressive. Here, we show how principles of precision medicine and insights from behavior genomics have relevance for novel management strategies of behaviorally expressed disorders, especially disorders of spoken language. METHOD: This tutorial presents an overview of precision medicine, medical genomics, and behavior genomics; case examples of improved outcomes; and strategic goals toward enhancing clinical practice. RESULTS: Speech-language pathologists (SLPs) see individuals with various communication disorders due to genetic variants. Ways of using insights from behavior genomics and implementing principles of precision medicine include recognizing early signs of undiagnosed genetic disorders in an individual's communication patterns, making appropriate referrals to genetics professionals, and incorporating genetic findings into management plans. Patients benefit from a genetics diagnosis by gaining a deeper and more prognostic understanding of their condition, obtaining more precisely targeted interventions, and learning about their recurrence risks. CONCLUSIONS: SLPs can achieve improved outcomes by expanding their purview to include genetics. To drive this new interdisciplinary framework forward, goals should include systematic training in clinical genetics for SLPs, enhanced understanding of genotype-phenotype associations, leveraging insights from animal models, optimizing interprofessional team efforts, and developing novel proactive and personalized interventions.

Network of burnout, depression, anxiety, and dropout intention in medical undergraduates.

BACKGROUND: Burnout, depression, and anxiety are highly prevalent among medical students, which often leads to their attrition. We aim to assess the inter-relationships of depression, burnout, and anxiety symptoms with dropout intention among Chinese medical undergraduates using the network analysis. METHOD: A total of 3,648 Chinese medical undergraduates were recruited through snowball sampling. Learning burnout scale, 9-item Patient Health Questionnaire (PHQ-9), and General Anxiety Disorder Scale (GAD-7) was used to assess burnout, depression, and anxiety symptoms, respectively. We used the EBICglasso model to estimate the network. We compared the network based on gender, study phase, and clinical experience. RESULTS: After removing repeated submissions and incorrect responses to the trap question, 3,536 participants were included in the final analysis. The prevalence of burnout, depression, anxiety, and dropout intention was 38, 62.7, 38.4, and 39% respectively, which is consistent with previous findings. Network analysis suggested that anxiety and depression items clustered together and displayed several strong bridge connections, while burnout items formed another cluster. All the strongest edges were within the respective distress. Cynicism symptoms 'I am fed up with study' and 'I want to study but I feel that studying is boring' were the most central symptoms, while 'fatigue' and 'worthless' were the bridge symptoms within the burnout-depression-anxiety network. Other central symptoms included 'worthless', 'I can handle my courses', 'nervous', and 'uncontrollable worry'. Cynicism symptoms 'I am interested in my major' and 'I feel that the knowledge I have learned is useless' were mostly related to dropout intention. Gender, study phase, and clinical experience didn't affect the global strength of the burnout-depression-anxiety network. CONCLUSION: Our results indicated the predominance of cynicism symptoms within the burnout-depression-anxiety network and its substantial impact on dropout intention, suggesting that early detection and intervention for cynicism symptoms in Chinese medical students are in urgent need. Other central and bridge symptoms might also serve as potential targets for the prevention and treatment of burnout, depression, and anxiety among medical students. For example, studies suggest cognitive-behavioral therapy could quickly improve 'worthless', which might be beneficial in treating burnout, depression, and anxiety in medical students.

LC-MS guided isolation of phenolic glycosides from Viburnum luzonicum Rolfe leaves and their α­amylase and α-glucosidase inhibitory activities.

Viburnum luzonicum Rolfe is widely used in China as folk medicine. The bioactivity evaluation indicated that the n-BuOH fraction of V. luzonicum leaves (VLLB) could significantly inhibit α­amylase and α-glucosidase. In order to clarify its active constituents, the phytochemical analysis on VLLB was first performed using HPLC-QTOF-MS/MS, and three new phenolic compounds, viburosides A-C (1-3), along with seven known analogues (4-10) were isolated through preparative HPLC. The undescribed compounds were determined by extensive spectroscopic analyses (1H and 13C NMR, HSQC, HMBC, HRESIMS, and ORD) and enzymatic hydrolysis. In the in vitro enzyme assays, compounds 1-8 showed potent α­amylase and α-glucosidase inhibitory activities. The enzymatic kinetics and molecular docking of the strongest inhibitors 2 and 3 against the corresponding target enzyme were also performed.

The thalamic clustering coefficient moderates the vigor-sleep quality relationship.

Sleep disorders affect more than one-quarter of the world's population, resulting in reduced daytime productivity, impaired immune function, and an increased risk of cardiovascular disease. It is important to identify the physiological and psychological factors related to sleep for the prevention and treatment of sleep disorders. In this study, we correlated measurements of emotional state, sleep quality, and some brain neural activity parameters to better understand the brain and psychological factors related to sleep. Resting-state functional magnetic resonance imaging (rs-fMRI) of 116 healthy undergraduates were analyzed using graph theory to assess regional topological characteristics. Among these, the left thalamic cluster coefficient proved to be the ablest to reflect the characteristics of the sleep neural graph index. The Profile of Mood States (POMS) was used to measure vigor, and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. The results showed that the left thalamic clustering coefficient was negatively correlated with sleep quality and vigor. Further, the left thalamic clustering coefficient moderated the relationship between vigor and sleep quality. When the left thalamic clustering coefficient was very low, there was a significant positive correlation between vigor and sleep quality. However, when the left thalamic clustering coefficient was high, the correlation between vigor and sleep quality became insignificant. The relationship between vigor and sleep quality is heterogeneous. Analyzing the function of the left thalamic neural network could help understand the variation in the relationship between vigor and sleep quality in different populations. Such observations may help in the development of personalized interventions for sleep disorders.

Correction: The thalamic clustering coefficient moderates the vigor-sleep quality relationship.

[This corrects the article DOI: 10.1007/s41105-023-00456-2.].

A network analysis of anxiety and depression symptoms among Chinese nurses in the late stage of the COVID-19 pandemic.

Background: Nurses are at high risk for depression and anxiety symptoms after the outbreak of the COVID-19 pandemic. We aimed to assess the network structure of anxiety and depression symptoms among Chinese nurses in the late stage of this pandemic. Method: A total of 6,183 nurses were recruited across China from Oct 2020 to Apr 2021 through snowball sampling. We used Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder scale-7 (GAD-7) to assess depression and anxiety, respectively. We used the Ising model to estimate the network. The index "expected influence" and "bridge expected influence" were applied to determine the central symptoms and bridge symptoms of the anxiety-depression network. We tested the stability and accuracy of the network via the case-dropping procedure and non-parametric bootstrapping procedure. Result: The network had excellent stability and accuracy. Central symptoms included "restlessness", "trouble relaxing", "sad mood", and "uncontrollable worry". "Restlessness", "nervous", and "suicidal thoughts" served as bridge symptoms. Conclusion: Restlessness emerged as the strongest central and bridge symptom in the anxiety-depression network of nurses. Intervention on depression and anxiety symptoms in nurses should prioritize this symptom.

Two new phenolic allopyranosides and their analogues from the stems of Viburnum luzonicum Rolfe guided by LC-MS.

Two new phenolic allopyranosides, named viburluzosides A and B (1, 2), together with eight known phenolic glycosides (3 - 10) were discovered from the stems of Viburnum luzonicum Rolfe under the guidance of LC-MS analyses coupled with bioactivity evaluation. They were purified through various chromatography methods and identified by extensive spectroscopic analyses (1H and 13C NMR, HSQC, HMBC, and HRESIMS) and chemical methods. The in vitro evaluation on α-glucosidase and aldose reductase (AR) inhibitory activities of isolated compounds were conducted. Compounds 1 - 4 and 6 - 9 exhibited α-glucosidase inhibitory activities with IC50 values of 5.35 - 21.34 µM and AR inhibitory activities with IC50 values of 6.21 - 40.06 µM. Moreover, the inhibitory kinetics analyses of compounds 1 and 2 were also performed.

Default mode network mediates low-frequency fluctuations in brain activity and behavior during sustained attention.

The low-frequency (<0.1 Hz) fluctuation in sustained attention attracts enormous interest in cognitive neuroscience and clinical research since it always leads to cognitive and behavioral lapses. What is the source of the spontaneous fluctuation in sustained attention in neural activity, and how does the neural fluctuation relate to behavioral fluctuation? Here, we address these questions by collecting and analyzing two independent fMRI and behavior datasets. We show that the neural (fMRI) fluctuation in a key brain network, the default-mode network (DMN), mediate behavioral (reaction time) fluctuation during sustained attention. DMN shows the increased amplitude of fluctuation, which correlates with the behavioral fluctuation in a similar frequency range (0.01-0.1 Hz) but not in the lower (<0.01 Hz) or higher (>0.1 Hz) frequency range. This was observed during both auditory and visual sustained attention and was replicable across independent datasets. These results provide a novel insight into the neural source of attention-fluctuation and extend the former concept that DMN was deactivated in cognitive tasks. More generally, our findings highlight the temporal dynamic of the brain-behavior relationship.

Effortless training of attention and self-control: mechanisms and applications.

For the past 50 years, cognitive scientists have assumed that training attention and self-control must be effortful. However, growing evidence suggests promising effects of effortless training approaches such as nature exposure, flow experience, and effortless practice on attention and self-control. This opinion article focuses on effortless training of attention and self-control. We begin by introducing our definitions of effortful and effortless training and reviewing the growing literature on these two different forms of training. We then discuss the similarities and differences in their respective behavioral outcomes and neural correlates. Finally, we propose a putative neural mechanism of effortless training. We conclude by highlighting promising directions for research, development, and application of effortless training.

Mental health conditions and academic burnout among medical and non-medical undergraduates during the mitigation of COVID-19 pandemic in China.

The outbreak of the novel coronavirus disease 2019 (COVID-19) has posed a great impact on people's mental health, especially for undergraduate students. This study aimed to compare the mental health conditions and academic burnout between medical and non-medical undergraduates in China when the COVID-19 pandemic is mitigating. A cross-sectional online survey was conducted among 4,972 undergraduates between October 2020 and April 2021, when the pandemic was basically under control. The survey included basic demographics information and standardized scales to evaluate depression, anxiety, perceived stress, daytime sleepiness, alcohol abuse/dependence, quality of life, fatigue, and academic burnout. Compared with medical undergraduates, non-medical undergraduates had higher rates of moderate to severe depression symptoms (29.1% vs. 17.9%, P < 0.001), moderate to severe anxiety symptoms (19.7% vs. 8.9%, P < 0.001), alcohol abuse/dependence (16.3% vs.10.3%, P < 0.001), excessive daytime sleepiness (47.4% vs. 43.4%, P = 0.018), high perceived stress (34.7% vs. 22.2%, P < 0.001), high level of fatigue (51.8% vs. 42.2%, P < 0.001), low QOL (35.8% vs. 21.4%, P < 0.001), and higher academic burnout score (59.4 vs. 57.5, P < 0.001). Being non-medical undergraduates, depression, alcohol abuse/dependence, excessive daytime sleepiness, and high perceived stress were positively associated with academic burnout, while high QOL was negatively associated with the burnout (all P < 0.001). Excessive daytime sleepiness was the strongest predictor for academic burnout.

High prevalence and risk factors of dropout intention among Chinese medical postgraduates.

BACKGROUND: A high attrition rate in medical students has exacerbated the physician shortage in China. However, few studies have explored the risk factors of dropout intention in medical postgraduates. This study compared the prevalence of dropout intention and mental distress between medical and non-medical postgraduates in China and investigated risk factors for dropout intention. This study also explored the impact of medical postgraduates' perception of the Chinese healthcare environment on their mental status and dropout intention. METHODS: This cross-sectional study was conducted using online questionnaires from October 2020 to April 2021. Convenience sampling was used to recruit postgraduates in different majors. Outcomes included dropout intention and potential risk factors, including mental distress, quality of life, and fatigue. Medical postgraduates were additionally assessed for healthcare environment satisfaction, burnout, career choice regret, and experiences of workplace violence. A logistic regression model was constructed to evaluate the association between dissatisfaction, mental distress, and turnover intention. RESULTS: A total of 740 medical and 670 non-medical postgraduates participated in the survey. The rates of depression symptoms (33.8% vs. 39.0%, p < 0.001), anxiety symptoms (22.2% vs. 32.4%, p < 0.001), and somatic symptoms (34.7% vs. 42.4%, p = 0.004) were lower in medical postgraduates, while more medical postgraduates (58.4% vs. 48.4%, p < 0.001) reported dropout intention. Dissatisfaction with the healthcare environment (odds ratio [OR]: 1.65; 95% confidence interval [CI]: 1.17-2.34, p = 0.005), career choice regret (OR: 6.23; 95% CI: 4.42-8.78, p < 0.001), and high perceived stress (OR: 2.74; 95%CI: 1.90-3.94, p < 0.001) remained independently associated with turnover intention. CONCLUSIONS: Mental distress is common among postgraduates, calling for timely interventions. Medical postgraduates reported higher turnover intention. Healthcare environment perception also affected the mental health and dropout intentions of medical students. A decent future income, reduced workload, shorter duration medical training, and better doctor-patient relationships are urgently needed.