Does Escalating Violence and Associated Fear of Crime Worsen Psychological Well-Being in Community Dwellers Living in a Rural Setting? Results From the Atahualpa Project Cohort.

BACKGROUND: Escalating street violence and criminal homicides have an adverse impact on psychological well-being. However, these consequences have been difficult to evaluate. Using a recently validated scale, we aimed to assess the impact of fear of crime on the psychological status of middle-aged and older adults living in a rural setting afflicted by endemic violence. METHODS: Participants were selected from Atahualpa residents included in previous studies targeting psychological distress in the population. A validated scale was used to objectively quantify fear of crime in participants. Differences in symptoms of depression and anxiety between baseline and follow-up were used as distinct dependent variables and the continuous score of the fear of crime scale was used as the independent variable. Linear regression models were fitted to assess the association between the exposure and the outcomes, after adjusting for relevant confounders. RESULTS: A total of 653 participants (mean age = 53.2 ± 11.5 years; 57% women) completed the requested tests. We found a 13% increase in symptoms of depression and anxiety during the peak of violence in the village compared with previous years. Linear regression models showed a significant association between the total score on the fear of crime questionnaire and worsening symptoms of depression (ß = .24; 95% CI = 0.14-0.35) and anxiety (ß = .31; 95% CI = 0.24-0.37), after adjustment for relevant confounders. CONCLUSIONS: This study shows a significant aggravating effect of fear of crime on pre-existing symptoms of depression and anxiety and a deleterious effect of these conditions on overall well-being.

[Virtual reality in the outpatient: reducing anxiety and fear in venous puncture]. / Realidad virtual en el paciente ambulatorio: reduciendo la ansiedad y el miedo en la punción de vías venosas.

Up to 80% of children admitted to a hospital experience pain, mainly associated with venipuncture. OBJECTIVE: To analyze whether the use of virtual reality (VR) headsets during venipuncture can modify the perception of pain, anxiety, and fear in pediatrics. PATIENTS AND METHOD: Open label, randomized clinical trial. The presence of intellectual, visual, or hearing impairment were considered exclusion criteria. Two anxiety and fear scales were administered before and after the procedure, and the Wong-Baker face pain scale at the end. The following were recorded: number of venipuncture attempts, duration of the procedure, and side effects. RESULTS: 78 patients were included, 38 males and a mean age of 9.63 years. In the intervention group, the mean pain value was 2.87, with a mean difference (MD) of -0.85 compared with the control one (95% confidence interval (CI) -2.02 to 0.33). There was a significant reduction in the level of anxiety and fear, with MDs of -2.59 (95%CI: -3.92 to -1.26) and -0.85 points (95%CI: -1.45 to -0.24), respectively. CONCLUSIONS: the use of VR headsets in venipuncture in hospital daytime care decreases the level of anxiety and fear in children and seems to reduce pain, without adverse effects. The venipuncture procedure has the same success rate and does not increase its duration.

"I have not been doing it because of my fear of something happening." Exploring perspectives on healthy dietary behaviors and physical activity in Mexican pregnant women and health care professionals: A qualitative study.

OBJECTIVES: Mexico exhibits one of the highest prevalence rates of overweight and obesity globally, accompanied by a surge in non-communicable diseases, which in turn leads to elevated mortality rates. Existing efforts to address rising obesity rates have shown limited effectiveness. Maternal weight, diet, and physical activity (PA) during pregnancy affect the mother's and offspring's health. Despite the importance of establishing and engaging in healthy behaviors during pregnancy, little is known about which factors impact these behaviors among pregnant women in Mexico. This study explored perspectives on factors impacting healthy dietary behaviors and PA in pregnancy from pregnant women and health care professionals in Mexico. METHODS: We conducted semistructured interviews with 11 pregnant women and 12 health care professionals working in prenatal care. Data were analyzed using qualitative content analysis in a stepwise inductive approach. RESULTS: Classifying factors at the 1) individual level, 2) relational level, and 3) health care system level, three overall themes emerged. At the individual level, challenges with lack of time and competing priorities as well as knowledge of healthy dietary behaviors and PA were identified. At the relational level, influencing factors encompassed financial, social, and emotional support along with descriptive norms. At the health care system level, guidelines for PA during pregnancy and the quality of care were noted. CONCLUSIONS: This study identified factors impacting healthy dietary behaviors and PA in pregnancy in Mexico. Important considerations for future interventions include addressing sociocultural norms around healthy dietary behaviors and PA in pregnancy and involving pregnant women's families, closest social networks, and health care professionals working at the prenatal care unit.

Dopamine D2-like receptors on conditioned and unconditioned fear: A systematic review of rodent pharmacological studies.

Growing evidence supports dopamine's role in aversive states, yet systematic reviews focusing on dopamine receptors in defensive behaviors are lacking. This study presents a systematic review of the literature examining the influence of drugs acting on dopamine D2-like receptors on unconditioned and conditioned fear in rodents. The review reveals a predominant use of adult male rats in the studies, with limited inclusion of female rodents. Commonly employed tests include the elevated plus maze and auditory-cued fear conditioning. The findings indicate that systemic administration of D2-like drugs has a notable impact on both innate and learned aversive states. Generally, antagonists tend to increase unconditioned fear, while agonists decrease it. Moreover, both agonists and antagonists typically reduce conditioned fear. These effects are attributed to the involvement of distinct neural circuits in these states. The observed increase in unconditioned fear induced by D2-like antagonists aligns with dopamine's role in suppressing midbrain-mediated responses. Conversely, the reduction in conditioned fear is likely a result of blocking dopamine activity in the mesolimbic pathway. The study highlights the need for future research to delve into sex differences, explore alternative testing paradigms, and identify specific neural substrates. Such investigations have the potential to advance our understanding of the neurobiology of aversive states and enhance the therapeutic application of dopaminergic agents.

The modulatory role of serotonin-1A receptors of the basolateral amygdala and dorsal periaqueductal gray on the impact of hormonal variation on the conditioned fear response.

Despite significant advances in the study of fear and fear memory formation, little is known about fear learning and expression in females. This omission has been proven surprising, as normal and pathological behaviors are highly influenced by ovarian hormones, particularly estradiol and progesterone. In the current study, we investigated the joint influence of serotonin (5-HT) neurotransmission and estrous cycle phases (low or high levels of estradiol and progesterone) on the expression of conditioned fear in a group of female rats that were previously divided according to their response to stressful stimuli into low or high anxiety-like subjects. The baseline amplitude of the unconditioned acoustic startle responses was high in high-anxiety female rats, with no effect on the estrous cycle observed. Data collected during the proestrus-estrus phase revealed that low-anxiety rats had startle amplitudes similar to those of high-anxiety rats. It is supposed that high-anxiety female rats benefit from increased estradiol and progesterone levels to achieve comparable potentiated startle amplitudes. In contrast, female rats experienced a significant decrease in hormone levels during the Diestrus phase. This decrease is believed to play a role in preventing them from displaying a heightened startle response when faced with strongly aversive stimuli. Data collected after 5-HT and 8-OH-DPAT were administered into the basolateral nuclei and dorsal periaqueductal gray suggest that 5-HT neurotransmission works with progesterone and estrogen to reduce startle potentiation, most likely by activating the serotonin-1A receptor subtype.

Reducing FKBP51 Expression in the Ventral Hippocampus Decreases Auditory Fear Conditioning in Male Rats.

Fear conditioning evokes a physiologic release of glucocorticoids that assists learning. As a cochaperone in the glucocorticoid receptor complex, FKBP51 modulates stress-induced glucocorticoid signaling and may influence conditioned fear responses. This study combines molecular and behavioral approaches to examine whether locally reducing FKBP51 expression in the ventral hippocampus is sufficient to affect fear-related behaviors. We hypothesized that reducing FKBP51 expression in the VH would increase glucocorticoid signaling to alter auditory fear conditioning. Adult male rats were injected with an adeno-associated virus (AAV) vector expressing short hairpin - RNAs (shRNA) targeting FKBP5 into the ventral hippocampus to reduce FKBP5 levels or a control AAV. Infusion of FKBP5-shRNA into the ventral hippocampus decreased auditory fear acquisition and recall. Although animals injected with FKBP5-shRNA showed less freezing during extinction recall, the difference was due to a reduced fear recall rather than improved extinction. Reducing ventral hippocampus FKBP51 did not affect exploratory behavior in either the open field test or the elevated zero maze test but did increase passive behavior in the forced swim test, suggesting that the reduction in auditory fear recall was not due to more active responses to acute stress. Furthermore, lower ventral hippocampus FKBP51 levels did not alter corticosterone release in response to restraint stress, suggesting that the reduced fear recall was not due to lower corticosterone release. Our findings suggest FKBP51 in the ventral hippocampus plays a selective role in modulating fear-learning processes and passive behavioral responses to acute stress rather than hypothalamic-pituitary-adrenal axis reactivity or exploratory responses.

Contextual fear conditioning in zebrafish: Influence of different shock frequencies, context, and pharmacological modulation on behavior.

Contextual fear conditioning is a protocol used to assess associative learning across species, including fish. Here, our goal was to expand the analysis of behavioral parameters that may reflect aversive behaviors in a contextual fear conditioning protocol using adult zebrafish (Danio rerio) and to verify how such parameters can be modulated. First, we analyzed the influence of an aversive stimulus (3 mild electric shocks for 5 s each at frequencies of 10, 100 or 1000 Hz) on fish behavior, and their ability to elicit fear responses in the absence of shock during a test session. To confirm whether the aversive responses are context-dependent, behaviors were also measured in a different experimental environment in a test session. Furthermore, we investigated the effects of dizocilpine (MK-801, 2 mg/kg, i.p.) on fear-related responses. Zebrafish showed significant changes in baseline activity immediately after shock exposure in the training session, in which 100 Hz induced robust contextual fear responses during the test session. Importantly, when introduced to a different environment, animals exposed to the aversive stimulus did not show any differences in locomotion and immobility-related parameters. MK-801 administered after the training session reduced fear responses during the test, indicating that glutamate NMDA-receptors play a key role in the consolidation of contextual fear-related memory in zebrafish. In conclusion, by further exploring fear-related behaviors in a contextual fear conditioning task, we show the effects of different shock frequencies and confirm the importance of context on aversive responses for associative learning in zebrafish. Additionally, our data support the use of zebrafish in contextual fear conditioning tasks, as well as for advancing pharmacological studies related to associative learning in translational neurobehavioral research.

Fear of the COVID-19 vaccine in a public healthcare system and university setting.

Despite the known benefits, some individuals remain apprehensive about receiving the COVID-19 vaccine, which hampers vaccination efforts and the achievement of herd immunity. Therefore, this cross-sectional study aimed to assess vaccination rates and identify factors influencing fear of the COVID-19 vaccine among individuals served by the public healthcare system (Family Health Strategy - FHS) and in a university community in Minas Gerais, Brazil. Surveys were conducted face-to-face with FHS participants and online with university members, employing a free sharing approach on social media. A total of 1896 and 312 responses were collected, respectively. The survey covered sociodemographic information, COVID-19 fear levels, and vaccination status for both individuals and their children Vaccination coverage was 83% among FHS participants and 99.1% in the university setting. Female respondents in both groups exhibited higher levels of COVID-19 fear (p<0.05), with FHS-assisted women reporting greater apprehension towards vaccination (p<0.05). Educated parents demonstrated better understanding of the importance of child vaccination, while younger parents expressed heightened concerns about vaccine side effects. Among FHS participants, women exhibited a 1.6 times higher fear of vaccination compared to men. Additionally, fear of vaccination increased by 1.10 times for each additional point on the COVID-19 Fear Scale (physiological domain). Effective communication strategies and dispelling misconceptions surrounding immunization could alleviate fear and promote vaccination acceptance.

Fear of COVID-19 associated with burnout syndrome in dentists of the Health Directorate of the National Police of Peru: a cross-sectional study at national level under multivariable regression model.

BACKGROUND: During the pandemic, many police dentists had the crucial responsibility of ensuring law and order while providing dental care by taking government-approved health measures to stop the spread of the coronavirus. The aim of this study was to assess the association between the fear of COVID-19 and Burnout syndrome in Peruvian dentists belonging to the Health Department of the National Police of Peru (PNP), taking into account possible confounding variables. METHODS: This cross-sectional and analytical study included 182 PNP dentists. The Fear COVID-19 Scale assessed fear of COVID-19 and the Maslach Burnout Inventory Test assessed burnout syndrome. The association between the fear of COVID-19 and Burnout syndrome (self-fulfilment) was analyzed using Spearman's Rho. A multivariable Poisson regression model with a robust variance estimation method was employed to evaluate the impact of fear of COVID-19 on the various dimensions of Burnout syndrome, considering possible confounding variables. The statistical significance level was set at p < 0.05. RESULTS: Under bivariate analysis, fear of COVID-19 was significantly linked with low direct intensity toward emotional exhaustion (Rho = 0.325, p < 0.001), very low direct intensity toward depersonalization (Rho = 0.180, p = 0.015), and very low inverse intensity toward self-fulfilment (Rho =-0.186, p = 0.012). Under multivariable analysis, it was observed that dentists who exhibited fear of COVID-19 were 3.4 and 3.7 times more likely to experience emotional exhaustion and depersonalization, respectively (APR = 3.40, 95% CI: 1.74-6.63 and APR = 3.68, 95% CI: 1.31-10.37), as compared to those who did not display fear of COVID-19. Moreover, none of the potential confounding factors were found to have a significant impact on emotional exhaustion (p > 0.05), depersonalization (p > 0.05), and self-fulfilment (p > 0.05). CONCLUSION: Fear of COVID-19 was significantly associated with emotional exhaustion and depersonalization, and inversely associated with self-fulfilment. PNP dentists who exhibited fear of COVID-19 were at greater risk for emotional exhaustion and depersonalization. In developing Burnout syndrome, no significant impact was observed from factors such as age, gender, marital status, children, hierarchy, years of service, work area, private practice, work over 40 h per week, type of service, work performed, sport practice and daily exercise time.

Social interaction-induced fear memory reduction: exploring the influence of dopamine and oxytocin receptors on memory updating.

It has been well established that a consolidated memory can be updated during the plastic state induced by reactivation. This updating process opens the possibility to modify maladaptive memory. In the present study, we evaluated whether fear memory could be updated to less-aversive level by incorporating hedonic information during reactivation. Thus, male rats were fear conditioned and, during retrieval, a female was presented as a social rewarding stimulus. We found that memory reactivation with a female (but not a male) reduces fear expression within-session and in the test, without presenting reinstatement or spontaneous recovery. Interestingly, this intervention impaired extinction. Finally, we demonstrated that this emotional remodeling to eliminate fear expression requires the activation of dopamine and oxytocin receptors during retrieval. Hence, these results shed new lights on the memory updating process and suggests that the exposure to natural rewarding information such as a female during retrieval reduces a previously consolidated fear memory.

Dual-step pharmacological intervention for traumatic-like memories: implications from D-cycloserine and cannabidiol or clonidine in male and female rats.

RATIONALE: Therapeutic approaches to mitigating traumatic memories have often faced resistance. Exploring safe reconsolidation blockers, drugs capable of reducing the emotional valence of the memory upon brief retrieval and reactivation, emerges as a promising pharmacological strategy. Towards this objective, preclinical investigations should focus on aversive memories resulting in maladaptive outcomes and consider sex-related differences to enhance their translatability. OBJECTIVES: After selecting a relatively high training magnitude leading to the formation of a more intense and generalized fear memory in adult female and male rats, we investigated whether two clinically approved drugs disrupting its reconsolidation remain effective. RESULTS: We found resistant reconsolidation impairment by the α2-adrenergic receptor agonist clonidine or cannabidiol, a major non-psychotomimetic Cannabis sativa component. However, pre-retrieval administration of D-cycloserine, a partial agonist at the glycine-binding site of the N-methyl-D-aspartate (NMDA) receptor complex, facilitated their impairing effects on reconsolidation. A similar reconsolidation blockade by clonidine or cannabidiol was achieved following exposure to a non-conditioned but generalized context after D-cycloserine administration. This suggests that sufficient memory destabilization can accompany generalized fear expression. Combining clonidine with cannabidiol without potentiating memory destabilization by D-cycloserine was ineffective. CONCLUSIONS: These findings highlight the importance of NMDA receptor signaling in memory destabilization and underscore the efficacy of a dual-step pharmacological intervention in attenuating traumatic-like memories, even in a context different from the original learning environment.

Social-Single Prolonged Stress affects contextual fear conditioning in male and female Wistar rats: Molecular insights in the amygdala.

Stress exposure can lead to post-traumatic stress disorder (PTSD) in male and female rats. Social-Single Prolonged Stress (SPS) protocol has been considered a potential PTSD model. This study aimed to pharmacologically validate the Social-SPS as a PTSD model in male and female rats. Male and female Wistar rats (60-day-old) were exposed to Social-SPS protocol and treated with fluoxetine (10 mg/Kg) or saline solution intraperitoneally 24 h before euthanasia. Two cohorts of animals were used; for cohort 1, male and female rats were still undisturbed until day 7 post-Social-SPS exposure, underwent locomotor and conditioned fear behaviors, and were euthanized on day 9. Animals of cohort 2 were subjected to the same protocol but were re-exposed to contextual fear behavior on day 14. Results showed that fluoxetine-treated rats gained less body weight than control and Social-SPS in both sexes. Social-SPS effectively increased the freezing time in male and female rats on day eight but not on day fourteen. Fluoxetine blocked the increase of freezing in male and female rats on day 8. Different mechanisms for fear behavior were observed in males, such as Social-SPS increased levels of glucocorticoid receptors and Beclin-1 in the amygdala. Social-SPS was shown to increase the levels of NMDA2A, GluR-1, PSD-95, and CAMKII in the amygdala of female rats. No alterations were observed in the amygdala of rats on day fourteen. The study revealed that Social-SPS is a potential PTSD protocol applicable to both male and female rats.

An ethologically relevant paradigm to assess defensive response to looming visual contrast stimuli.

In the animal kingdom, threat information is perceived mainly through vision. The subcortical visual pathway plays a critical role in the rapid processing of visual information-induced fear, and triggers a response. Looming-evoked behavior in rodents, mimicking response to aerial predators, allowed identify the neural circuitry underlying instinctive defensive behaviors; however, the influence of disk/background contrast on the looming-induced behavioral response has not been examined, either in rats or mice. We studied the influence of the dark disk/gray background contrast in the type of rat and mouse defensive behavior in the looming arena, and we showed that rat and mouse response as a function of disk/background contrast adjusted to a sigmoid-like relationship. Both sex and age biased the contrast-dependent response, which was dampened in rats submitted to retinal unilateral or bilateral ischemia. Moreover, using genetically manipulated mice, we showed that the three type of photoresponsive retinal cells (i.e., cones, rods, and intrinsically photoresponsive retinal ganglion cells (ipRGCs)), participate in the contrast-dependent response, following this hierarchy: cones > > rods > > > ipRGCs. The cone and rod involvement was confirmed using a mouse model of unilateral non-exudative age-related macular degeneration, which only damages canonical photoreceptors and significantly decreased the contrast sensitivity in the looming arena.

Role of amygdala astrocytes in different phases of contextual fear memory.

Growing evidence indicates a critical role of astrocytes in learning and memory. However, little is known about the role of basolateral amygdala complex (BLA-C) astrocytes in contextual fear conditioning (CFC), a paradigm relevant to understand and generate treatments for fear- and anxiety-related disorders. To get insights on the involvement of BLA-C astrocytes in fear memory, fluorocitrate (FLC), a reversible astroglial metabolic inhibitor, was applied at critical moments of the memory processing in order to target the acquisition, consolidation, retrieval and reconsolidation process of the fear memory. Adult Wistar male rats were bilaterally cannulated in BLA-C. Ten days later they were infused with different doses of FLC (0.5 or 1 nmol/0.5 µl) or saline before or after CFC and before or after retrieval. FLC impaired fear memory expression when administered before and shortly after CFC, but not one hour later. Infusion of FLC prior and after retrieval did not affect the memory. Our findings suggest that BLA-C astrocytes are critically involved in the acquisition/early consolidation of fear memory but not in the retrieval and reconsolidation. Furthermore, the extinction process was presumably not affected (considering that peri-retrieval administration could also affect this process).

Caesarean delivery on maternal request: the perspective of the postpartum women.

BACKGROUND: Caesarean delivery on maternal request (CDMR) is an increasing delivery option among women. As such, we aimed to understand the reasons that led pregnant women to request a caesarean delivery. METHODS: A phenomenological study was conducted with semi-structured interviews, in a convenience sample, for women who had undergone a CDMR between March and June 2023, in a public reference university hospital in Campinas, Brazil. The interviews were recorded, transcribed and subjected to thematic analysis, supported by Nvivo®, and Reshape®. RESULTS: We interviewed eighteen women between 21 and 43 years of age. The reasons for C-section as their choice were: 1) fear of labour pain, 2) fear for safety due to maternal or fetal risks, 3) traumatic previous birth experiences of the patient, family or friends 4) sense of control, and 5) lack of knowledge about the risks and benefits of C-section. CONCLUSIONS: The perception of C-section as the painless and safest way to give birth, the movement of giving voice and respecting the autonomy of pregnant women, as well as the national regulation, contribute to the increased rates of surgical abdominal delivery under request. Cultural change concerning childbirth and better counseling could support a more adequate informed decision-making about delivery mode.

Functional lateralization in the medial prefrontal cortex control of contextual conditioned emotional responses in rats.

A functional lateralization has been reported in control of emotional responses by the medial prefrontal cortex (mPFC). However, a hemisphere asymmetry in involvement of the mPFC in expression of fear conditioning responses has never been reported. Therefore, we investigated whether control by mPFC of freezing and cardiovascular responses during re-exposure to an aversively conditioned context is lateralized. For this, rats had guide cannulas directed to the mPFC implanted bilaterally or unilaterally in the right or left hemispheres. Vehicle or the non-selective synaptic inhibitor CoCl2 was microinjected into the mPFC 10 min before re-exposure to a chamber where the animals had previously received footshocks. A catheter was implanted into the femoral artery before the fear retrieval test for cardiovascular recordings. We observed that bilateral microinjection of CoCl2 into the mPFC reduced both the freezing behavior (enhancing locomotion and rearing) and arterial pressure and heart rate increases during re-exposure to the aversively conditioned context. Unilateral microinjection of CoCl2 into the right hemisphere of the mPFC also decreased the freezing behavior (enhancing locomotion and rearing), but without affecting the cardiovascular changes. Conversely, unilateral synaptic inhibition in the left mPFC did not affect either behavioral or cardiovascular responses during fear retrieval test. Taken together, these results suggest that the right hemisphere of the mPFC is necessary and sufficient for expression of freezing behavior to contextual fear conditioning. However, the control of cardiovascular responses and freezing behavior during fear retrieval test is somehow dissociated in the mPFC, being the former bilaterally processed.

Ventral Pallidum and Amygdala Cooperate to Restrain Reward Approach under Threat.

Foraging decisions involve assessing potential risks and prioritizing food sources, which can be challenging when confronted with changing and conflicting circumstances. A crucial aspect of this decision-making process is the ability to actively overcome defensive reactions to threats and focus on achieving specific goals. The ventral pallidum (VP) and basolateral amygdala (BLA) are two brain regions that play key roles in regulating behavior motivated by either rewards or threats. However, it is unclear whether these regions are necessary in decision-making processes involving competing motivational drives during conflict. Our aim was to investigate the requirements of the VP and BLA for foraging choices in conflicts involving overcoming defensive responses. Here, we used a novel foraging task and pharmacological techniques to inactivate either the VP or BLA or to disconnect these brain regions before conducting a conflict test in male rats. Our findings showed that BLA is necessary for making risky choices during conflicts, whereas VP is necessary for invigorating the drive to obtain food, regardless of the presence of conflict. Importantly, our research revealed that the connection between VP and BLA is critical in controlling risky food-seeking choices during conflict situations. This study provides a new perspective on the collaborative function of VP and BLA in driving behavior, aimed at achieving goals in the face of dangers.

Threat directionality modulates defensive reactions in humans: cardiac and electrodermal responses.

Features of threatening cues and the associated context influence the perceived imminence of threat and the defensive responses evoked. To provide additional knowledge about how the directionality of a threat (i.e. directed-towards or away from the viewer) might impact defensive responses in humans, participants were shown pictures of a man carrying a gun (threat) or nonlethal object (neutral) directed-away from or towards the participant. Cardiac and electrodermal responses were collected. Compared to neutral images, threatening images depicting a gun directed-towards the participant induced sustained bradycardia and an increased electrodermal response, interpreted as immobility under attack. This defensive immobility reaction is evoked by high perceived threat and inescapable situations and indicates intense action preparation. Pictures of guns directed-away from the participant induced shorter bradycardia and no significant modulation of the electrodermal response compared to neutral pictures, which might be consistent with the perception of a less threatening situation. The results show that the directionality of threat stimuli is a key factor that prompts different patterns of defensive responses.

Reactivation of encoding ensembles in the prelimbic cortex supports temporal associations.

Fear conditioning is encoded by strengthening synaptic connections between the neurons activated by a conditioned stimulus (CS) and those activated by an unconditioned stimulus (US), forming a memory engram, which is reactivated during memory retrieval. In temporal associations, activity within the prelimbic cortex (PL) plays a role in sustaining a short-term, transient memory of the CS, which is associated with the US after a temporal gap. However, it is unknown whether the PL has only a temporary role, transiently representing the CS, or is part of the neuronal ensembles that support the retrieval, i.e., whether PL neurons support both transient, short-term memories and stable, long-term memories. We investigated neuronal ensembles underlying temporal associations using fear conditioning with a 5-s interval between the CS and US (CFC-5s). Controls were trained in contextual fear conditioning (CFC), in which the CS-US overlaps. We used Robust Activity Marking (RAM) to selectively manipulate PL neurons activated by CFC-5s learning and Targeted Recombination in Active Populations (TRAP2) mice to label neurons activated by CFC-5s learning and reactivated by memory retrieval in the amygdala, medial prefrontal cortex, hippocampus, perirhinal cortices (PER) and subiculum. We also computed their co-reactivation to generate correlation-based networks. The optogenetic reactivation or silencing of PL encoding ensembles either promoted or impaired the retrieval of CFC-5s but not CFC. CFC-5s retrieval reactivated encoding ensembles in the PL, PER, and basolateral amygdala. The engram network of CFC-5s had higher amygdala and PER centralities and interconnectivity. The same PL neurons support learning and stable associative memories.

Effects of different surgical treatments on pain, disability, anxiety and quality of life in lumbar disc herniation.

OBJECTIVE: This study aims to compare the effects of microscopic microdiscectomy and microendoscopic discectomy on pain, disability, fear of falling, kinesiophobia, anxiety, quality of life in patients with lumbar disc herniation (LDH). METHODS: A total of 90 patients who underwent microscopic microdiscectomy (n = 40) and microendoscopic discectomy (n = 50) for LDH were included in this study. The patients' pain, disability, fear of falling, kinesiophobia, anxiety, and quality of life were evaluated before the surgery, in the early postoperative period and three months after. RESULTS: In patients who underwent microendoscopic discectomy, the results of pain, disability, fear of falling, kinesiophobia and anxiety were statistically decreased compared with the microscopic microdiscectomy in the early postoperative period and three months later (p < 0.05). Also, a statistically higher increase was observed in the general health perception of patients who underwent microendoscopic discectomy three months after the operation (p < 0.01). CONCLUSION: Microendoscopic microdiscectomy, remains the most effective and widely applied method with advantages on pain, quality of life, and improved physical functions.

OBJETIVO: Este estudio tiene como objetivo comparar los efectos de la microdiscectomía microscópica y la discectomía microendoscópica sobre el dolor, la discapacidad, el miedo a caer, la kinesiofobia, la ansiedad y la calidad de vida en pacientes con hernia de disco lumbar (LDH). MÉTODOS: Se incluyeron en este estudio un total de 90 pacientes sometidos a microdiscectomía microscópica (n = 40) y discectomía microendoscópica (n = 50) por LDH. Se evaluó el dolor, la discapacidad, el miedo a caer, la kinesiofobia, la ansiedad y la calidad de vida de los pacientes antes de la cirugía, en el postoperatorio temprano y tres meses después. RESULTADOS: En los pacientes sometidos a discectomía microendoscópica, los resultados de dolor, discapacidad, miedo a caer, kinesiofobia y ansiedad disminuyeron estadísticamente en comparación con la microdiscectomía microscópica en el postoperatorio temprano y tres meses después (p < 0.05). Además, se observó un aumento estadísticamente mayor en la percepción de salud general de los pacientes sometidos a discectomía microendoscópica tres meses después de la operación (p < 0.01). CONCLUSIÓN: La microdiscectomía microendoscópica sigue siendo el método más eficaz y ampliamente aplicado con ventajas sobre el dolor, la calidad de vida y la mejora de las funciones físicas.