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1.
J Allied Health ; 49(1): 60-66, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32128540

RESUMEN

BACKGROUND: Preliminary evidence shows the successes of student-run free clinics (SRFC) in improving patient health; however, continued research is required on the effectiveness of student-delivered occupational therapy (OT) for individuals with acquired brain injury (ABI). The purpose of this study was to evaluate the effectiveness of OT treatment on patient outcomes in a SRFC for ABI. METHODS: A single-group pre/post study examined the effect of a 12-week OT intervention for 26 individuals with ABI on seven outcome measures using Cohen's d and effect size r for non-normal samples. RESULTS: The intervention had a large effect (≥0.8) on upper extremity function, goal improvement, and functional balance, a medium effect (0.5 < x < 0.8) on self-perceived physical health and activity participation, and a small effect (0.2 < x < 0.5) on cognition and mood outcomes. CONCLUSIONS: This is the first study to show the effectiveness of an OT SRFC. Participation in this clinic had a positive effect on activity-based goals, physical, cognitive, health, and psychosocial outcomes of clients with ABI.

2.
Neuropsychol Rehabil ; : 1-23, 2020 Mar 02.
Artículo en Inglés | MEDLINE | ID: mdl-32114899

RESUMEN

Non-invasive transcranial direct current stimulation (tDCS) has been reported to facilitate working memory in normal adults. There is some evidence in people with Traumatic Brain Injury (TBI) but overall evidence is mixed. This study aimed to address shortcomings of prior study designs in TBI to examine whether a single dose of tDCS would lead to benefits in working memory. Thirty people with severe, chronic TBI were administered a single session of either anodal tDCS (2 mA for 20 min) or sham tDCS (2 mA for 30 s), in a counterbalanced order, over the left parietal cortex while performing 1-back and 2-back working memory tasks. Skin conductance levels were examined as a measure of task activated arousal, a possible functional analogue of cortical excitability. We found that tDCS led to no improvements in accuracy on the working memory tasks. A slight increase in variability and reaction time with tDCS was related to decreased task activated arousal. Overall, this study yielded no evidence that a single session of tDCS can facilitate working memory for people with TBI.

3.
Int J Health Geogr ; 19(1): 2, 2020 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-32041628

RESUMEN

BACKGROUND: Demographic and Health Survey (DHS) data are an important source of maternal, newborn, and child health as well as nutrition information for low- and middle-income countries. However, DHSs are often unavailable at the administrative unit that is most interesting or useful for program planning. In addition, the location of DHS survey clusters are geomasked within 10 km, and prior to 2009, may have crossed district boundaries. We aim to use DHS surveyed information with these geomasked coordinates to estimate district assignments for use in health program planning and evaluation. METHODS: We developed three methods to assign a district to a geomasked survey cluster in two DHS surveys from Malawi: 2000 and 2004. Method A assigns districts of origin in proportion to the likelihood that results from repeated simulated geomasking, allowing more than one possible district of origin. Method B assigns a single district of origin which contains the greatest proportion of simulated geomasked survey clusters. Method C maps the geomasked survey cluster's location to a district polygon. We used these method assignments to estimate a selection of commonly used coverage indicators for each district. We compared the district coverage estimates, confidence intervals, and concordance correlation coefficients, by each of the methods, to those which used validated district assignments in 2004, and we looked at coverage change from 2000 to 2004. RESULTS: The methods we tested each approximated the validated estimates in 2004 by confidence interval comparison and concordance correlation coefficient. Estimated agreement for method A was between .14 and .98, for method B the estimated agreement was between .97 and .99, and for method C the agreement ranged from .93 to .99 when compared with the validated district assignments. Therefore, we recommend the protocol which is the simplest to implement-method C-overlaying geomasked survey cluster within district polygon. CONCLUSIONS: Using geomasked survey clusters from DHSs to assign districts provided district level coverage rates similar to those using the validated surveyed locations. This method may be applied to data sources where survey cluster centroids are available and where district level estimates are needed for program implementation and evaluation in low- and middle-income settings. This method is of special interest to those using DHSs to study spatiotemporal trends as it allows for the utilization of historic DHS data where geomasking hinders the generation of reliable subnational estimates of health in areas smaller than the first-order administrative unit (ADM1).

5.
J Intensive Care Med ; : 885066619897604, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31916880

RESUMEN

BACKGROUND: Cognitive impairment after sepsis is an important clinical problem. Determinants of postseptic cognitive impairment are not well understood. We thus undertook a systems biology approach to exploring a possible role for apolipoprotein E (APOE) in postseptic cognitive impairment. DESIGN: Prospective, observational cohort. SETTING: Intermountain Medical Center, a tertiary referral center in Utah. PATIENTS/PARTICIPANTS: Patients with sepsis admitted to study intensive care units. INTERVENTIONS: None. METHODS: We obtained peripheral blood for deep sequencing of RNA and followed up survivors at 6 months with a battery of cognitive instruments. We defined cognitive impairment based on the 6-month Hayling test of executive function. In our primary analysis, we employed weighted network analysis. Secondarily, we compared variation in gene expression between patients with normal versus impaired cognition. MEASUREMENTS AND MAIN RESULTS: We enrolled 40 patients, of whom 34 were follow-up eligible and 31 (91%) completed follow-up; 1 patient's RNA sample was degraded-the final analytic cohort was 30 patients. Mean Hayling test score was 5.8 (standard deviation 1.1), which represented 20% with impaired executive function. The network module containing APOE was dominated by low-expression genes, with no association on primary analysis (P = .8). Secondary analyses suggested several potential lines of future investigation, including oxidative stress. CONCLUSIONS: In this prospective pilot cohort, executive dysfunction affected 1 in 5 survivors of sepsis. The APOE gene was sparsely transcribed in peripheral leukocytes and not associated with cognitive impairment. Future lines of research are suggested.

6.
Neuropsychology ; 34(3): 288-297, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31804103

RESUMEN

OBJECTIVE: The aim of this study was to use various measures of emotion recognition, such as sensitivity to emotional intensity, accuracy-based emotion labeling, and the ability to differentiate among emotional displays, to examine whether these abilities are associated with emotional and cognitive empathy. We also sought to determine whether these relationships differ between individuals with traumatic brain injury (TBI) and healthy adults. METHOD: TBI participants (n = 28) and healthy adults (n = 29) matched for age, biological sex, and education, were tested on an emotion intensity rating and recognition task. Self-reported emotional and cognitive empathy questionnaires, together with a neuropsychological battery, were also completed. RESULTS: Participants with TBI reported reduced emotional and cognitive empathy. TBI participants also had reduced overall accuracy in recognizing emotion, specifically for happy and sad emotions, although they had no difficulty identifying the intensity or differentiating among emotional displays. Intensity labeling and sensitivity to differentiate among emotions positively correlated with emotional empathy for healthy adults but not for TBI participants. No facet of emotion recognition correlated with cognitive empathy for healthy adults or TBI participants. CONCLUSIONS: The ability to identify the intensity and differentiate among emotions is associated with emotional empathy. Although individuals with severe TBI may be able to differentiate emotions, they may be unable to utilize this information to share and understand the emotions of others, or vice versa. These results could have implications for understanding poor interpersonal relationships and impaired social functioning following TBI. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

7.
J Clin Exp Neuropsychol ; 42(1): 28-41, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31514609

RESUMEN

Introduction: A significant proportion of people with traumatic brain injury (TBI) report low levels of empathy, yet there is a paucity of research investigating the mechanisms which underpin this. In this study, we investigated empathy after TBI through the lens of the perception-action model of empathy. Specifically, we looked at the effect of similarity of experience on self-reported empathy and skin conductance in participants with TBI and controls.Method: Thirty people with a traumatic brain injury and 30 matched healthy controls initially recounted three emotional events they had experienced in the past (one happy, one angry and one sad). Then, at a second visit, participants heard three stories which were written to be similar their own stories and three which were based on someone else's stories. We recorded skin conductance while participants listened and then collected self-reported levels of empathy for protagonists in the stories.Results: We found that self-reported empathy, but not skin conductance levels, was greater for similar compared to dissimilar stories. Further, participants with TBI were able to empathise with others despite having markedly reduced autonomic arousal and overall impairment in cognitive functioning.Conclusions: Our results suggest that the PAM has relevance with respect to explaining self-reported empathy for the experiences of others, but cannot explain the role of physiological responses associated with empathy. Further, our results suggest that intact cognitive functioning and physiological responses are not necessary for normal experiences of empathy after TBI.

8.
Transfusion ; 59(12): 3736-3745, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31710381

RESUMEN

BACKGROUND: Allogeneic adsorption (alloadsorption) involves incubating an aliquot of patient plasma with red blood cells (RBCs) of a known phenotype to facilitate removal of autoantibodies and allow for detection of remaining, potentially clinically significant alloantibodies. Alloadsorptions are routinely performed using fresh or frozen donor RBCs having particular Rh and Kidd phenotypes, and are usually enzyme or ZZAP treated before adsorptions. RBC stroma would provide a method to prepare large amounts of adsorption material that may be stored frozen and used when needed. STUDY DESIGN AND METHODS: A total of 309 samples were presented to our institutions (American Red Cross, Southwest Region Texas laboratories) with serologic positive IgG autoantibodies, had allogeneic RBC stromal adsorptions performed, and underlying alloantibodies identified. After papain treatment of RBCs from group O, K- individuals who were R1 R1 , R2 R2 , and rr where at least one individual was Jk(a+b-) and one individual Jk(a-b+), stroma was prepared using digitonin digestion of the RBC membrane. Large amounts of stroma could be obtained and were aliquoted and frozen at -18°C or less for up to 2 years. RESULTS: One hundred seventeen of 309 (38%) samples demonstrated alloantibodies following stromal alloadsorptions. Twenty-two different alloantibodies were identified in the stroma-adsorbed plasma, with an average of two stromal adsorptions resolving the autoantibody reactivity. The specificities of alloantibodies underlying the autoantibody included those in the Rh system (112), Kell system (24), Duffy system (14), Kidd system (30), MNS system (19), Lutheran system (2), and Diego system (2). CONCLUSION: Successful removal of autoantibody using RBC stromal adsorption was obtained in 308 samples and allowed for the identification of underlying alloantibodies in 117 samples. Preparation and use of RBC stroma should significantly benefit immunohematology reference laboratories in their antibody investigations.

9.
Heart Rhythm ; 2019 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-31756527

RESUMEN

BACKGROUND: Even though ethanol consumption has been associated with risk of atrial fibrillation (AF), little is known about how ethanol affects atrial electrophysiology. OBJECTIVE: The purpose of this study was to study the electrophysiological effect of ethanol on rat AF. METHODS: Atrial optical mapping was performed on male Long Evans rat hearts with escalating concentrations of ethanol (0, 1, 2, and 3 mM). In addition, patch-clamp recordings on isolated atrial myocytes were performed. In chronic ethanol study, rats were divided into control and chronic ethanol groups (20% ethanol in drinking water for 6 months). Atrial optical mapping, histology, immunohistochemistry, and reverse transcriptase polymerase chain reaction were performed in chronic rats. RESULTS: Acute ethanol perfusion increased AF vulnerability (0% at 0 mM, 0% at 1 mM, 57.1% at 2 mM, and 100% at 3 mM) in a dose-related response. Ethanol infusion decreased conduction velocities (CVs) in both atria and shortened effective refractory periods (ERP) only in the right atria with increased in dispersion of refractoriness. Action potential duration at 50% and 90% repolarization from right atrial myocytes were shortened, with corresponding increase of sustained potassium current. Chronic ethanol consumption increased AF inducibility (10% control vs 95.2% chronic ethanol). CVs in both atria were significantly decreased. ERP of the right atrium was shortened, and dispersion of ERP was increased. Expression (mRNA) of KCNQ1 and connexin40 were increased, but KCNA5 was decreased in the right atrium of rats exposed to chronic ethanol. CONCLUSION: Acute and chronic exposure to ethanol increases AF vulnerability by slowing CV, shortening right atrial ERP, and increasing dispersion of ERP.

10.
Intensive Care Med Exp ; 7(1): 57, 2019 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-31650252

RESUMEN

BACKGROUND: Septic cardiomyopathy (SCM) is common in sepsis and associated with increased morbidity and mortality. Left ventricular global longitudinal strain (LV GLS), measured by speckle tracking echocardiography, allows improved identification of impaired cardiac contractility. The peripheral blood transcriptome may be an important window into SCM pathophysiology. We therefore studied the peripheral blood transcriptome and LV GLS in a prospective cohort of patients with sepsis. RESULTS: In this single-center observational pilot study, we enrolled adult patients (age > 18) with sepsis within 48 h of admission to the ICU. SCM was defined as LV GLS > - 17% based on echocardiograms performed within 72 h of admission. We enrolled 27 patients, 24 of whom had high-quality RNA results; 18 (75%) of 24 had SCM. The group was 50% female and had a median (IQR) age of 59.5 (48.5-67.0) years and admission APACHE II score of 21.0 (16.0-32.3). Forty-six percent had septic shock. After filtering for low-expression and non-coding genes, 15,418 protein coding genes were expressed and 73 had significantly different expression between patients with vs. without SCM. In patients with SCM, 43 genes were upregulated and 30 were downregulated. Pathway analysis identified enrichment in type 1 interferon signaling (adjusted p < 10-5). CONCLUSIONS: In this hypothesis-generating study, SCM was associated with upregulation of genes in the type 1 interferon signaling pathway. Interferons are cytokines that stimulate the innate and adaptive immune response and are implicated in the early proinflammatory and delayed immunosuppression phases of sepsis. While type 1 interferons have not been implicated previously in SCM, interferon therapy (for viral hepatitis and Kaposi sarcoma) has been associated with reversible cardiomyopathy, perhaps suggesting a role for interferon signaling in SCM.

11.
Crit Care Med ; 47(11): 1497-1504, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31517693

RESUMEN

OBJECTIVES: Increasingly, patients admitted to an ICU survive to hospital discharge; many with ongoing medical needs. The full impact of an ICU admission on an individual's resource utilization and survivorship trajectory in the United States is not clear. We sought to compare healthcare utilization among ICU survivors in each year surrounding an ICU admission. DESIGN: Retrospective cohort of patients admitted to an ICU during one calendar year (2012) in a multipayer healthcare system. We assessed mortality, hospital readmissions (categorized by ambulatory care sensitive conditions and emergency department), and outpatient visits. We compared the proportion of patients with visits during the pre-ICU year versus the post-ICU year. PATIENTS: People admitted to an Intermountain healthcare ICU for greater than 48 hours in the year 2012 INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS: Among 4,074 ICU survivors, 45% had increased resource utilization. Readmission rates at 30-day, 90-day, and 1-year were 15%, 26%, and 43%. The proportion of patients with a hospital admission increased significantly in the post-ICU period (43% vs 29%; p < 0.001). Of patients with a readmission in the post-ICU period, 24% were ambulatory care sensitive condition. Patients with increased utilization differed by socioeconomic status, insurance type, and severity of illness. Sixteen percent of patients had either an emergency department or inpatient admission, but no outpatient visits during the post-ICU period. CONCLUSIONS: An ICU admission is associated with increased resource utilization including hospital readmissions, with many due to an ambulatory care sensitive condition. Lower socioeconomic status and higher severity of illness are associated with increased resource utilization. After an ICU visit patients seem to use hospital resources over outpatient resources. Interventions to improve and coordinate care after ICU discharge are needed.

12.
Am J Phys Anthropol ; 170(2): 308-318, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31369685

RESUMEN

At the establishment of the American Association of Physical Anthropologists in 1930, women comprised 2.4% of the total membership, and 9.7% a decade later. By 2014 ~70% of members were women. Despite these numbers, there are continued gender disparities within the discipline. While there is considerable interest in promoting equity, there is little documentation of the historical experiences of female anthropologists. This article introduces the women active in the discipline during the first decade of the Association, compiles descriptions of their experiences related to their treatment based on gender, and examines these historical perspectives in conjunction with documented trends of continuing gender disparities. A pattern is evident for these early anthropologists of receiving personal and financial discouragement during their education; experiencing discrimination in hiring, promotion, and pay; studying women and children as entrée into professional work; working within the federal government or military; leaving anthropology early in their careers; having their work credited to their male colleagues; experiencing additional limitations if they married; and outwardly downplaying their own experiences of sexism. This pattern is echoed in the experiences of female anthropologists today.

13.
J Matern Fetal Neonatal Med ; : 1-8, 2019 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-31362572

RESUMEN

Objective: Group B streptococcus (GBS) vaginal/rectal colonization in pregnancy has been associated with early-onset GBS disease (EOGBSD), a leading cause of neonatal morbidity and mortality. In Canada, universal screening for GBS colonization is offered to pregnant people at 35-37 weeks' gestation and those who test positive are offered intrapartum antibiotic prophylaxis (IAP). Universal screening and treatment with IAP have not eradicated all cases of EOGBSD, and IAP has documented side effects. Probiotic supplements have been proposed as a possible way to reduce GBS colonization. Materials and methods: Pregnant midwifery clients >18 years of age and <45 years of age and with a gestational age of <25 weeks at the time of enrolment were randomly assigned to receive two capsules of probiotics (Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14) or placebo orally daily for 12 weeks at 23-25 weeks' gestation. The primary aim was to determine the feasibility of a larger study. The rate of GBS vaginal/rectal colonization at 35-37 weeks' gestation was also assessed in both groups. Results: In total, 139 pregnant midwifery clients were randomized (probiotic group [N = 73] and placebo group [N = 66]). Of these, 113 were included in the final analysis (probiotic group [N = 57] and placebo group [N = 56]). Baseline characteristics between groups were similar with the exception of gestational age (p < .01). The recruitment rate was low at 12%, but the mean compliance rate was 87%. The eligibility/ineligibility criteria were too strict and changes to the study design will be required for the larger proposed study. The rates of vaginal/rectal GBS colonization did not differ significantly between groups (15.8 versus 21.43%; p = .48). No adverse effects were documented in the probiotic group. Conclusion: This was the first midwifery-led trial involving a natural health product in the province of Ontario. Although treatment with oral probiotics is feasible, the results were not superior to placebo in reducing the rate of GBS colonization. An adequately powered, randomly controlled trial is required to assess the effectiveness of the two probiotic strains.

14.
Res Pract Thromb Haemost ; 3(3): 340-348, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31294320

RESUMEN

Background: Upper extremity deep vein thrombosis (UEDVT) constitutes approximately 10% of all deep vein thromboses (DVTs). The incidence of UEDVT is increasing in association with use of peripherally inserted central venous catheters. Treatment for UEDVT is derived largely from evidence for treatment of lower extremity DVT. Limited evidence exists for the use of a direct oral anticoagulant for the treatment of UEDVT. Population: Sequential patients identified within the Intermountain Healthcare System and University of Utah Healthcare system with symptomatic UEDVT defined as the formation of thrombus within the internal jugular, subclavian, axillary, brachial, ulnar, or radial veins of the arm. Intervention: Apixaban 10 mg PO twice daily for 7 days followed by apixaban 5 mg twice daily for 11 weeks. Comparison: The historical literature review rate of venous thrombosis reported for recurrent clinically overt objective venous thromboembolism (VTE) and VTE-related death. If the confidence interval for the observed rate excludes the threshold event rate of 4%, we will conclude that treatment with apixaban is noninferior and therefore a clinically valid approach to treat UEDVT. Sample Size: We elected a sample size of 375 patients so that an exact 95% confidence interval would exclude an event rate of VTE in the observation cohort of 4%. Outcome: Ninety-day rate of new or recurrent objectively confirmed symptomatic venous thrombosis and VTE-related death. The primary safety outcome is the composite of major and clinically relevant nonmajor bleeding.

15.
Neuropsychology ; 33(8): 1151-1162, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31343236

RESUMEN

OBJECTIVE: Although the presence of empathy deficits following traumatic brain injury (TBI) is well established, there is a paucity of research investigating the underpinning mechanisms. This study investigated whether feedback from posed emotional expressions and psychophysiological responsivity, thought to play a role in emotional empathy, are impaired after TBI. METHOD: Thirty adults with TBI and 30 demographically matched healthy controls completed 2 feedback tasks while skin conductance and heart rate were recorded. In Feedback Task 1, participants assumed different emotional postures and rated how this made them feel. In Feedback Task 2, participants held a smile or frown while viewing neutral images and rated the pleasantness of each image. RESULTS: Participants with TBI did not differ from controls in their subjective ratings in response to posed emotional expressions. However, we found reduced skin conductance responses to rapid facial manipulations and some evidence of altered physiological arousal to sad emotional postures in participants with TBI. Finally, there was no relationship between emotional empathy and facial feedback or physiological responsivity. CONCLUSIONS: We failed to replicate past research that demonstrated an impairment in the feedback effect in people with TBI. These normal subjective responses, though, were in the context of reduced psychophysiological responding to the posed expressions, suggesting that another mechanism can contribute to normal feedback effects after TBI. Finally, we did not find the expected relationship between the feedback effect and emotional empathy but may have been limited by the lower than expected rates of low emotional empathy in our sample. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Lesiones Traumáticas del Encéfalo/fisiopatología , Emociones/fisiología , Empatía/fisiología , Respuesta Galvánica de la Piel/fisiología , Frecuencia Cardíaca/fisiología , Adulto , Anciano , Expresión Facial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
16.
Chest ; 156(5): 878-886, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31201784

RESUMEN

BACKGROUND: In addition to hyperglycemia, hypoglycemia, and glycemic variability, reduced time in targeted blood glucose range (TIR) is associated with increased risk of death in critically ill patients. This relation between TIR and mortality may be confounded by diabetic status and antecedent glycemic control. METHODS: This study retrospectively analyzed critically ill patients managed with the same IV insulin protocol at multiple centers. The percentage of TIR between 70 and 139 mg/dL was calculated. Patients with diabetic ketoacidosis, patients who had < 10 blood glucose readings, and patients with repeat admissions were excluded. The highest recorded glycosylated hemoglobin value in the preceding 3 months or up to 1 month following admission were used as a surrogate for the patient's preexisting glucose control. Stratified regression analyses were performed for 30-day mortality, with covariates of age, sex, TIR ≥ 80%, Acute Physiology Score, and Charlson Comorbidity Index. RESULTS: A total of 9,028 patients, 53.2% of whom had diabetes, were studied. Median TIR was 84.1% for nondiabetic patients and 64.5% for patients with diabetes. Mortality was lower in those with TIR > 80% compared with those with TIR ≤ 80% (12.4% vs 19.2%; P < .001). TIR > 80% was independently associated with reduced mortality in nondiabetic patients (OR, 0.52; P < .001), patients with diabetes (OR, 0.69; P = .001), and patients with well-controlled disease (OR, 0.50; P < .001) but not in patients with poorly controlled disease (OR, 0.86; P = .40). CONCLUSIONS: TIR was independently associated with mortality in critically ill patients, particularly those with good antecedent glucose control.

17.
Int J Psychophysiol ; 141: 76-83, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31054275

RESUMEN

The ability to regulate emotional reactions is a complex process that incorporates both physiological and psychological components. Anxiety sensitivity is a construct associated with the negative and often misinterpretation of bodily sensations, with previous findings suggesting that anxiety sensitivity may regulate an individual's physiological response to an acute stress response. The aim of the current study, therefore, was to identify whether anxiety sensitivity moderates the physiological and subjective experience of acute psychosocial stress. Fifty-eight undergraduate students high and low on anxiety sensitivity (as indexed by the Anxiety Sensitivity Index - Third Edition) had their physiology recorded during a widely-used psychosocial stress induction procedure; the Trier Social Stress Test (TSST). Heart rate and skin conductance, together with self-reported anger and tension on the Profile of Mood States questionnaire, significantly increased in response to the TSST. Conversely, high-frequency heart rate variability (HF-HRV) decreased in response to the TSST. We found that anxiety sensitivity moderated the subjective experience of the TSST, such that those who had greater anxiety sensitivity self-reported elevated tension in response to the TSST compared to those with low anxiety sensitivity. Anxiety sensitivity did not moderate any of the physiological outcomes of the TSST. Consequently, this study provides a physiological profile on how the autonomic nervous system responds to stress. Additionally, these findings suggest that beliefs about body sensations specifically affects the interpretation of stressful experiences rather than augmenting physiological reactions themselves. This may provide insights into how biases subserve the development and maintenance of dysregulated emotional experience.

18.
Biochemistry ; 58(21): 2524-2533, 2019 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-31058493

RESUMEN

Sunflower trypsin inhibitor (SFTI-1) is a 14 amino acid serine protease inhibitor. The dual antiparallel ß-sheet arrangement of SFTI-1 is stabilized by an N-terminal-C-terminal backbone cyclization and a further disulfide bridge to form a final bicyclic structure. This constrained structure is further rigidified by an extensive network of internal hydrogen bonds. Thus, the structure of SFTI-1 in solution resembles the protease-bound structure, reducing the entropic penalty upon protease binding. When cleaved at the scissile bond, it is thought that the rigidifying features of SFTI-1 maintain its structure, allowing the scissile bond to be reformed. The lack of structural plasticity for SFTI-1 is proposed to favor initial protease binding and continued occupancy in the protease active site, resulting in an equilibrium between the cleaved and uncleaved inhibitor in the presence of a protease. We have determined, at 1.15 Å resolution, the X-ray crystal structures of complexes between human kallikrein-related peptidase 4 (KLK4) and SFTI-FCQR(Asn14) and between KLK4 and an acyclic form of the same inhibitor, SFTI-FCQR(Asn14)[1,14], with the latter displaying a cleaved scissile bond. Structural analysis and MD simulations together reveal the roles of the altered contact sequence, intramolecular hydrogen bonding network, and backbone cyclization in altering the state of SFTI's scissile bond ligation at the protease active site. Taken together, the data presented reveal insights into the role of dynamics in the standard-mechanism inhibition and suggest that modifications on the non-contact strand may be a useful, underexplored approach for generating further potent or selective SFTI-based inhibitors against members of the serine protease family.

19.
Undersea Hyperb Med ; 46(2): 117-124, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31051056

RESUMEN

Objectives: Hyperbaric oxygen (HBO2) exposure may enhance cardiorespiratory fitness. Exercise training and HBO2 exposure stimulate mitochondrial biogenesis, increase capillary density, and induce adaptive antioxidant mechanisms. We hypothesized that an exercise regimen of sprint interval training (SIT) while breathing HBO2 would lead to a greater improvement in exercise performance compared to the same training breathing ambient air. Methods: Healthy long-term intermediate-altitude residents, ages 20-39 years, with normal spirometry and cardiorespiratory fitness were randomized to two groups: one performing six sessions of a SIT regimen over two weeks in a hyperbaric chamber (1.4 ATA [141.9 kPa], FiO2=1.0); the other performing under ambient pressure conditions (0.85 ATA [86.1 kPa], FiO2=0.21). Training effect was evaluated by comparing incremental cycle ergometry cardiopulmonary exercise testing before and after the training regimen. The primary outcome measure was peak oxygen consumption (V̇O2), while secondary outcomes included additional exercise parameters. The effect of study group on exercise parameters was assessed using two-factor repeated measures ANOVA. Results: Of 58 participants randomized, 49 completed the training program and all cardiopulmonary exercise tests (n=23 HBO2, n=26 ambient). Both groups experienced an increase in peak V̇O2: 8.1% HBO2 and 7.1% ambient; the differences were not significant (p=0.50). Secondary parameters of peak work rate and peak V̇E experienced a significantly higher change in the HBO2 group compared to the ambient group (p=0.05 and p=0.03, respectively). Conclusion: Cardiorespiratory fitness improved after a two-week SIT regimen, but improvement in peak V̇O2 was not significantly different between ambient and HBO2 groups.


Asunto(s)
Capacidad Cardiovascular , Entrenamiento de Intervalos de Alta Intensidad/métodos , Oxigenación Hiperbárica/métodos , Consumo de Oxígeno , Adulto , Análisis de Varianza , Presión Atmosférica , Prueba de Esfuerzo/métodos , Femenino , Humanos , Masculino , Valores de Referencia , Factores Sexuales , Adulto Joven
20.
Neuropsychology ; 33(6): 872-882, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31021106

RESUMEN

OBJECTIVE: Emotional empathy is critical to successful social interactions and is often compromised after traumatic brain injury (TBI). Using the Emostroop task, we investigated whether adults with moderate to severe TBI (N = 26) have problems with rapid conceptual processing of emotional stimuli compared with controls (N = 30). Further, we investigated whether rapid conceptual processing of emotions relates to emotion recognition and emotional empathy. METHOD: In the Emostroop task, participants categorize emotional words (e.g., joyous, furious, and woeful) into three emotion categories: happy, sad, and angry. Each word is superimposed onto an image of a face, which expresses an emotion that is congruent to the word (congruent condition), incongruent to the word (incongruent condition), or is neutral (neutral condition). Slowed responding in the incongruent condition (interference) and speeded responding in the congruent condition (facilitation) indicates rapid conceptual processing of the faces. Participants also completed an emotion perception task, an empathy questionnaire (the BEES) and neuropsychological tests measuring processing speed, working memory, and executive function. RESULTS: Contrary to our hypotheses, we found that rapid conceptual processing of emotional faces was preserved in people with TBI, despite diminished neuropsychological performance, emotion recognition, emotional empathy, and slowed responding. Further, the Emostroop effect was not correlated with self-reported emotional empathy or with emotion recognition. CONCLUSIONS: We conclude that in people with TBI, reduced empathy may be explained by processes downstream of the initial rapid conceptual processing of emotional information, such as flexibly attending and responding to this information in a goal-directed manner in complex environments. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Lesiones Traumáticas del Encéfalo/fisiopatología , Emociones , Empatía , Expresión Facial , Reconocimiento Facial/fisiología , Adulto , Anciano , Ira , Lesiones Traumáticas del Encéfalo/psicología , Función Ejecutiva , Femenino , Felicidad , Humanos , Relaciones Interpersonales , Masculino , Memoria a Corto Plazo , Persona de Mediana Edad , Pruebas Neuropsicológicas , Tristeza , Test de Stroop , Adulto Joven
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