Early mucosal events promote distinct mucosal and systemic antibody responses to live attenuated influenza vaccine.

Compared to intramuscular vaccines, nasally administered vaccines have the advantage of inducing local mucosal immune responses that may block infection and interrupt transmission of respiratory pathogens. Live attenuated influenza vaccine (LAIV) is effective in preventing influenza in children, but a correlate of protection for LAIV remains unclear. Studying young adult volunteers, we observe that LAIV induces distinct, compartmentalized, antibody responses in the mucosa and blood. Seeking immunologic correlates of these distinct antibody responses we find associations with mucosal IL-33 release in the first 8 hours post-inoculation and divergent CD8+ and circulating T follicular helper (cTfh) T cell responses 7 days post-inoculation. Mucosal antibodies are induced separately from blood antibodies, are associated with distinct immune responses early post-inoculation, and may provide a correlate of protection for mucosal vaccination. This study was registered as NCT04110366 and reports primary (mucosal antibody) and secondary (blood antibody, and nasal viral load and cytokine) endpoint data.

The Synchrony-Prosociality Link Cannot Be Explained Away as Expectancy Effect: Response to Atwood et al. ().

Moving in time to others, as is often observed in dance, music, sports and much of children's play cross-culturally, is thought to make people feel and act more prosocially towards each other. In a recent paper, Atwood et al. (2022) argued that the inferential validity of this link found between synchronous behaviour and prosociality might be mainly due to "expectancy effects generated by a combination of (1) experimenter expectancy, leading to experimenter bias; and (2) participant expectancy (i.e., placebo effects)". Here, we counter these arguments with (1) examples of studies devoid of experimenter expectancy effects that nevertheless demonstrate a positive link between synchrony and prosociality, and (2) insights from the developmental literature that address participant expectancy by showing how expectations formed through lived experiences of synchronous interactions do not necessarily threaten inferential validity. In conclusion, there is already sufficient good-quality evidence showing the positive effects of synchronous behaviours on prosociality beyond what can be explained by experimenter or participant expectation effects.

Gods are watching and so what? Moralistic supernatural punishment across 15 cultures.

Psychological and cultural evolutionary accounts of human sociality propose that beliefs in punitive and monitoring gods that care about moral norms facilitate cooperation. While there is some evidence to suggest that belief in supernatural punishment and monitoring generally induce cooperative behaviour, the effect of a deity's explicitly postulated moral concerns on cooperation remains unclear. Here, we report a pre-registered set of analyses to assess whether perceiving a locally relevant deity as moralistic predicts cooperative play in two permutations of two economic games using data from up to 15 diverse field sites. Across games, results suggest that gods' moral concerns do not play a direct, cross-culturally reliable role in motivating cooperative behaviour. The study contributes substantially to the current literature by testing a central hypothesis in the evolutionary and cognitive science of religion with a large and culturally diverse dataset using behavioural and ethnographically rich methods.

Nasal IL-13 production identifies patients with late-phase allergic responses.

BACKGROUND: There is limited knowledge on how local cytokine secretion patterns after nasal allergen challenge correlate with clinical symptoms especially with regard to the "late allergic response," which occurs in approximately 40% to 50% of patients with allergy. OBJECTIVE: We sought to characterize the immunologic and clinical nasal responses to birch pollen allergen challenge with a special focus on the late allergic response. METHODS: In this randomized, double-blind, placebo-controlled trial, birch pollen-allergic participants were challenged with birch pollen extract (n = 20) or placebo (n = 10) on 3 consecutive days. On days 1 and 3, nasal secretions were collected at selected time points over a 24-hour time course for the measurement of 33 inflammatory mediators. Clinical responses were determined through subjective symptom scores and objective nasal airflow measurements. RESULTS: Provoked participants had significantly greater clinical responses and showed significant increases in tryptase and the soluble IL-33 receptor serum stimulation 2 (sST2) in nasal secretions within minutes compared with the placebo group. Eight of 20 provoked participants displayed high IL-13 levels 2 to 8 hours after allergen provocation. This group also showed significant changes in clinical parameters, with a secondary drop in nasal airflow measured by peak nasal inspiratory flow and increased symptoms of nasal obstruction, which significantly differed from IL-13 nonresponders after 6 hours. CONCLUSIONS: IL-13 response status correlates with clinical responses and type 2 cytokine responses in the late phase after allergen provocation.

Interdependence, bonding and support are associated with improved mental wellbeing following an outdoor team challenge.

Social relationships and mental health are functionally integrated throughout the lifespan. Although recent laboratory-based research has begun to reveal psychological pathways linking social interaction, interdependence, bonding and wellbeing, more evidence is needed to integrate and understand the potential significance of these accounts for real-world events and interventions. In a questionnaire-based, repeated measures design, we measured the wellbeing of 13- to 19-year-old participants (n = 226) in the Ten Tors Challenge (United Kingdom) 7-10 days before (T1) and after (T4) the event. Immediately before (T2) and after (T3) the event, we administered measures of team bonding, perceived and experienced interdependence, perceived and received support, physical pain and fatigue, and performance satisfaction. There was a significant increase in participants' wellbeing (pre-to-post event). Post-event social bonding and performance satisfaction positively predicted the wellbeing increase. Bonding was, in turn, positively predicted by experienced interdependence, received support, pain and fatigue, and the sense of having done better as a team than expected. Results provide novel field-based evidence on the associations between meaningful bonds of mutual reliance in a challenging team event and adolescent wellbeing. Team challenge events potentially offer effective contexts for forging social interactions, interdependencies, and bonds that can support mental and physical health.

Use of a buprenorphine-based pain management protocol is associated with reduced opioid requirements and pain on swallowing in oral mucositis: a retrospective cohort study.

OBJECTIVE: The aim of this study is to ascertain the analgesic efficacy and total oral morphine equivalent daily dose (OMEDD) effect of a buprenorphine-based analgesic protocol in the treatment of severe Oral Mucositis (OM). DESIGN: This is a retrospective cohort study. SETTING: This study was done in a single Quaternary Referral Centre, Haematology Unit. SUBJECTS: Fifty-four stem cell transplant patients suffering at least grade 3 oral mucositis (OM), 24 prior to [Pr-I] and 30 subsequent to [Po-I] a buprenorphine-based OM analgesic protocol. METHODS: We analysed data from the above subjects with the primary outcome measure of difference in total OMEDDs from all opioid types and administration routes, and secondary outcome measures of area under the curve (AUC) of 11-point Numerical Rating Scale (NRS-11) pain assessments, sedation scores and respiratory rate. RESULTS: Post-protocol patients' total OMEDD requirements were significantly reduced [Pr-I: 1961 (1365)mg; Po-I: 928 (625)mg, p = 0.02], as were total NRS-11:hours AUC on swallowing [Pr-I: 54(24) score-hours; Po-I: 41(18) score-hours, p < 0.001]. There were no significant differences in objective measures of OM severity between groups (Number of Grade 3 or 4 OM severity assessments [mean (SD)] Pr-I: 5 (6.2); Po-I: 7 (5.1) or number of days Neutrophil count 0.0 or 0.1 × 109/L; Pr-I: 13 (5.4); Po-I: 15 (4.7)). 5 Pr-I and 4 Po-I patients required ketamine infusions, with 1 Pr-I patient also requiring IV lignocaine. CONCLUSIONS: Use of Buprenorphine via transdermal, sublingual and intravenous Patient Controlled Analgesia (PCA) delivery as part of an analgesic protocol for severe post stem cell transplant oral mucositis in adult patients appears to significantly reduce opioid requirements and pain on swallowing. Further randomised prospective work is required to confirm these associations.

Finding the facts in an infodemic: framing effective COVID-19 messages to connect people to authoritative content.

The public's need for timely and trusted COVID-19 information remains high. Governments and global health agencies such as the WHO have sought to disseminate accurate and timely information to counteract misinformation and disinformation that has arisen as part of an 'infodemic'-the overabundance of information on COVID-19-some accurate and some not. In early 2020, WHO began a collaboration with Google to run online public service announcements on COVID-19, in the form of search ads displayed above results of Google Search queries. Web-based text ads can drive online searchers of COVID-19 information to authoritative COVID-19 content but determining what message is most effective is a challenge. WHO wanted to understand which message framing, that is, the way in which ad information is worded for the public, leads searchers to click through to WHO content. WHO tested 71 text ads in English across four COVID-19 topics using a mix of message frames: descriptive, collective, gain, loss, appeals to values and emphasising reasons. Between 11 September 2020 and 23 November 2020, there were 13 million views of the experimental WHO text ads leading to 1.4 million click-throughs to the WHO website. Within the set of 71 ads, there was a large spread between the most effective and least effective messages; for messages on COVID-19, the best performing framings were more than twice as effective as the worst performing framings (18.7% vs 8.5% engagement rate). Health practitioners can apply the messaging tactics WHO found to be successful to rapidly optimise messages for their own public health campaigns and better reach the public with authoritative information. Similar collaboration between big technology companies and governments and global health agencies has the potential to advance public health.

Sputum biomarkers during acute severe asthma attacks in children-a case-control study.

AIM: To study sputum mediator profiles pattern in children with acute severe asthma, compared with stable asthma and healthy controls. The mechanisms of acute severe asthma attacks, such as biomarkers cascades and immunological responses, are poorly understood. METHODS: We conducted a prospective observational case-control study of children aged 5 to 17 years, who presented to hospital with an asthma attack. Children with stable asthma were recruited during outpatient asthma clinic visits. Control children without an asthma diagnosis were recruited from surgical wards. Sputum mediator profiles were measured, and sputum leukocyte differential cell counts were generated. RESULTS: Sputum data were available in 48 children (acute asthma; n = 18, stable asthma; n = 17, healthy controls; n = 13). Acute-phase biomarkers and neutrophil attractants such as IL-6 and its receptor, IL-8 and cytokines linked with bacterial signals, including TNF-R1 and TNF-R2, were elevated in asthma attacks versus stable asthma and healthy controls. T-cell attractant cytokines, associated with viral infections, such as CCL-5, CXCL-10 and CXCL-11, and CXCL-9 (secreted from eosinophils after a viral trigger) were also raised. CONCLUSION: Mediator profiles consistent with bacterial and viral respiratory infections, and T2 inflammation markers co-exist in the sputum of children with acute severe asthma attacks.

Social reward and support effects on exercise experiences and performance: Evidence from parkrun.

There is growing academic, civic and policy interest in the public health benefits of community-based exercise events. Shifting the emphasis from competitive sport to communal activity, these events have wide appeal. In addition to physical health benefits, regular participation can reduce social isolation and loneliness through opportunities for social connection. Taking a broad evolutionary and social psychological perspective, we suggest that social factors warrant more attention in current approaches to physical (in)activity and exercise behavior. We develop and test the hypothesis that social reward and support in exercise are associated with positive exercise experiences and greater performance outputs. Using a repeated-measures design, we examine the influence of social perceptions and behavior on subjective enjoyment, energy, fatigue, effort, and objective performance (run times) among a UK sample of parkrun participants. Social factors were associated with greater subjective enjoyment and energy. Higher subjective energy, in turn, was associated with faster run times, without any corresponding increase in perceived effort. No significant main effects of social factors on fatigue, performance or effort were detected. The role of social structural factors has long been recognized in public health approaches to physical activity. Our results indicate that there should be greater research attention on how positive and rewarding social behaviors and experiences-particularly subjective enjoyment and energy, and perceptions of community social support and belonging-influence exercise-related behavior, psychology and physiology, and promote health through collective physical activity. The research also supplements traditional emphases on social facilitation and team sport that have dominated sport and exercise psychology and offers new avenues for understanding the deep connections among psychological, social and physical function in everyday health.

Effects of social support on performance outputs and perceived difficulty during physical exercise.

Perceptions of social support influence adaptive self-regulatory processes that maintain health, produce feelings, and motivate behavior. Although associations between sociality and health are increasingly well-understood, there is little systematic research into the effects of social support on fatigue, physical discomfort, exertion, and output regulation in physical activity. We conducted an experimental study to investigate the effect of social support on performance and perceived difficulty in a handgrip force task while controlling for audience and reputational factors. Effects were compared with those of another established psychogenic performance enhancer (a placebo ergogenic supplement). During handgrip trials over varying levels of objective difficulty, participants viewed photographs of a support figure or stranger while in a placebo or control condition. Results revealed a significant main effect of the social support cue on handgrip performance outputs, and a significant interaction with objective trial difficulty - relative to the stranger cue, the support-figure cue significantly increased handgrip performance outputs and the effect was larger in more objectively difficult trials. Moreover, despite producing greater handgrip outputs, participants perceived trials to be significantly less difficult in the social support condition. Though there was a non-significant main effect of placebo (vs. control) on performance outputs, participants perceived trials in the placebo condition to be significantly less difficult. The research contributes new evidence and theory on the role of perceived social support - an important (energetic) resource - in human performance and motivates further enquiry into how cues to support alter perceived effort and performance outputs in strenuous physical challenges.

Intuitive Dualism and Afterlife Beliefs: A Cross-Cultural Study.

It is widely held that intuitive dualism-an implicit default mode of thought that takes minds to be separable from bodies and capable of independent existence-is a human universal. Among the findings taken to support universal intuitive dualism is a pattern of evidence in which "psychological" traits (knowledge, desires) are judged more likely to continue after death than bodily or "biological" traits (perceptual, physiological, and bodily states). Here, we present cross-cultural evidence from six study populations, including non-Western societies with diverse belief systems, that shows that while this pattern exists, the overall pattern of responses nonetheless does not support intuitive dualism in afterlife beliefs. Most responses of most participants across all cultures tested were not dualist. While our sample is in no way intended to capture the full range of human societies and afterlife beliefs, it captures a far broader range of cultures than in any prior study, and thus puts the case for afterlife beliefs as evidence for universal intuitive dualism to a strong test. Based on these findings, we suggest that while dualist thinking is a possible mode of thought enabled by evolved human psychology, such thinking does not constitute a default mode of thought. Rather, our data support what we will call intuitive materialism-the view that the underlying intuitive systems for reasoning about minds and death produce as a default judgment that mental states cease to exist with bodily death.

Circadian Clock, Time-Restricted Feeding and Reproduction.

The goal of this review was to seek a better understanding of the function and differential expression of circadian clock genes during the reproductive process. Through a discussion of how the circadian clock is involved in these steps, the identification of new clinical targets for sleep disorder-related diseases, such as reproductive failure, will be elucidated. Here, we focus on recent research findings regarding circadian clock regulation within the reproductive system, shedding new light on circadian rhythm-related problems in women. Discussions on the roles that circadian clock plays in these reproductive processes will help identify new clinical targets for such sleep disorder-related diseases.

Nurse-initiated pre-prescribed antibiotic orders to facilitate prompt and appropriate antibiotic administration in febrile neutropenia.

PURPOSE: To assess the impact of a pathway allowing nurse initiation of first dose intravenous (IV) antibiotics on time to antibiotic administration (TTA) in adult inpatients with febrile neutropenia (FN). METHODS: This study evaluated the impact on TTA of a clinical pathway (November 2017 to April 2018) allowing nurse initiation of pre-prescribed antibiotics in adult haematology patients with FN, compared with a prior cohort (November 2016 to April 2017) in which antibiotics were only prescribed and administered after medical review. The primary endpoint for comparison was TTA, calculated as the time between the first recorded fever and IV antibiotic administration. Secondary endpoints included appropriateness of initial antibiotic choice, 30-day all-cause mortality and admission to intensive care unit (ICU). RESULTS: Forty-seven eligible FN episodes in 40 patients and 61 episodes in 52 patients were evaluated in the pre- and post-implementation groups, respectively. Baseline characteristics were comparable between groups. Median (IQR) TTA, in the pre-implementation group [66 min (40-100 min)] was significantly prolonged versus post-implementation group [29 min (20-41 min); p < 0.001]. A significantly higher proportion of episodes were administered appropriate initial antibiotics in the post-versus pre-implementation groups (100% vs. 89%, p = 0.03). There was no significant change in 30-day all-cause mortality (0% vs. 5%, p = 0.3) or ICU admission within 48 h of fever (0% vs. 2%, p > 0.99) between pre- and post-implementation groups, respectively. CONCLUSIONS: A pathway allowing nurse initiation of pre-prescribed antibiotic orders for FN significantly reduced TTA from first recorded fever and increased the proportion of appropriate initial antibiotic choices without significantly impacting on patient outcomes.

Sputum microbiomic clustering in asthma and chronic obstructive pulmonary disease reveals a Haemophilus-predominant subgroup.

BACKGROUND: Airway ecology is altered in asthma and chronic obstructive pulmonary disease (COPD). Anti-microbial interventions might have benefit in subgroups of airway disease. Differences in sputum microbial profiles at acute exacerbation of airways disease are reflected by the γProteobacteria:Firmicutes (γP:F) ratio. We hypothesized that sputum microbiomic clusters exist in stable airways disease, which can be differentiated by the sputum γP:F ratio. METHODS: Sputum samples were collected from 63 subjects with severe asthma and 78 subjects with moderate-to-severe COPD in a prospective single centre trial. Microbial profiles were obtained through 16S rRNA gene sequencing. Topological data analysis was used to visualize the data set and cluster analysis performed at genus level. Clinical characteristics and sputum inflammatory mediators were compared across the clusters. RESULTS: Two ecological clusters were identified across the combined airways disease population. The smaller cluster was predominantly COPD and was characterized by dominance of Haemophilus at genus level (n = 20), high γP:F ratio, increased H influenzae, low diversity measures and increased pro-inflammatory mediators when compared to the larger Haemophilus-low cluster (n = 121), in which Streptococcus demonstrated the highest relative abundance at the genus level. Similar clusters were identified within disease groups individually and the γP:F ratio consistently differentiated between clusters. CONCLUSION: Cluster analysis by airway ecology of asthma and COPD in stable state identified two subgroups differentiated according to dominance of Haemophilus. The γP:F ratio was able to distinguish the Haemophilus-high versus Haemophilus-low subgroups, whether the Haemophilus-high group might benefit from treatment strategies to modulate the airway ecology warrants further investigation.

Moralizing gods, impartiality and religious parochialism across 15 societies.

The emergence of large-scale cooperation during the Holocene remains a central problem in the evolutionary literature. One hypothesis points to culturally evolved beliefs in punishing, interventionist gods that facilitate the extension of cooperative behaviour toward geographically distant co-religionists. Furthermore, another hypothesis points to such mechanisms being constrained to the religious ingroup, possibly at the expense of religious outgroups. To test these hypotheses, we administered two behavioural experiments and a set of interviews to a sample of 2228 participants from 15 diverse populations. These populations included foragers, pastoralists, horticulturalists, and wage labourers, practicing Buddhism, Christianity, and Hinduism, but also forms of animism and ancestor worship. Using the Random Allocation Game (RAG) and the Dictator Game (DG) in which individuals allocated money between themselves, local and geographically distant co-religionists, and religious outgroups, we found that higher ratings of gods as monitoring and punishing predicted decreased local favouritism (RAGs) and increased resource-sharing with distant co-religionists (DGs). The effects of punishing and monitoring gods on outgroup allocations revealed between-site variability, suggesting that in the absence of intergroup hostility, moralizing gods may be implicated in cooperative behaviour toward outgroups. These results provide support for the hypothesis that beliefs in monitoring and punitive gods help expand the circle of sustainable social interaction, and open questions about the treatment of religious outgroups.

Achievement of patients' preferences for participation in oncological symptom management and its association with perceived quality of care.

PURPOSE: The subjectivity of symptom experience and the recognized role of patients in symptom management highlight the need to understand cancer patients' participation in symptom management and to identify the associations between patient participation and quality of care. However, research on patient participation has focused mostly on general healthcare activities, rather than symptom management, especially in cancer-care settings. This study aimed to compare the congruence between cancer patients' preference for and actual perceived experience of participation in symptom management and identify the relationships between preferred and actual patient participation and perceived quality of care. METHODS: This was a cross-sectional study. Patient preference and actual experience of participation in symptom management were evaluated with the modified Control Preference Scale among patients recruited from a specialized cancer hospital in China. Patients' perception of quality of care was assessed with the short-form Quality from the Patient's Perspective questionnaire. RESULTS: A total of 162 patients were recruited. Their mean age was 47.5±12.2 years, and 51.9% were females. Patients' perceived actual level of participation in symptom management substantially agreed with their preference (weighted κ-coefficient 0.61, 95% CI 0.45-0.77). There was no significant difference between patients' perception of care quality and level of preference for participation (F=0.35, P=0.722) or actual experience of participation (F=0.76, P=0.519). Higher perceptions of quality of care were found among patients whose preferred roles were achieved (P=0.007) or surpassed (P=0.045). CONCLUSION: This study identified substantial agreement between patients' preferred and actual participation, given the generally passive preference. The findings indicated that supporting patients to achieve their preferred level of participation may be more important than focusing activities on encouraging increased desire to participate for the purpose of care-quality improvement.

Perceptions of patient participation in symptom management: A qualitative study with cancer patients, doctors, and nurses.

AIM: To explore people with cancer, doctors', and nurses' understanding of and attitudes toward, patient participation in symptom management. BACKGROUND: In health service policies worldwide, patients are recognized as the important members of the treatment care team. The concept of patient participation can be understood from a variety of perspectives, reflecting the limited conceptual clarity and poor congruence between patients' and clinicians' understanding. DESIGN: A qualitative study conducted using individual interviews. METHODS: Forty one people with cancer, five doctors, and seven nurses were recruited from two oncological medical units of a cancer specialized hospital in Shanghai, China between November 2013 - March 2014. Individual interviews were semi-structured. Data were analysed through framework analysis. RESULTS: Patient participation was perceived as a mutual interaction requiring contribution from both patients and clinicians. Three main themes were uncovered: (a) information exchange is the key to patient participation; (b) negotiated decision-making can be achieved in various ways; and (c) patients' self-management can be a form of patient participation. Patient participation was recognized by both patients and clinicians as an important component of cancer care, however concerns relating to patients' limited knowledge and their ability to negotiate treatment decisions existed among most of the patients, doctors, and nurses. CONCLUSION: This study identified the wide range of activities where patient participation can occur in the context of cancer care. Positive recognition of patients' roles in treatment and care should be advocated among both patients and clinicians to facilitate patients' participation in their own care and enhance clinicians' skills in involving patients.

Of Promise and Penalties: How Student Racial-Cultural Markers Shape Teacher Perceptions.

Scholars document considerable disparities in teacher perceptions of students, yet absent from this literature is an examination of how race, ethnicity, and immigration status intersect to influence teacher ratings. This study extends previous research by examining variation in teachers' ratings of academic ability across four conventional racial/ethnic groups as well as thirteen racialized subgroups. Using data from the Early Childhood Longitudinal Study-Kindergarten Class of 1998-1999, we find that black first-graders receive lower ratings in language and literacy, a pattern that holds for both black Americans and black immigrants. In contrast, Asian first-graders receive higher ratings in math; however, this is primarily driven by teachers' much higher ratings of East Asian and Southeast Asian immigrants. These subgroup differences remain even after controlling for a host of background and contextual factors, as well as students' tested ability and academic growth in math and reading. Teacher perceptions of student academic behavior explain lower language and literacy ratings for black Americans and higher math ratings for Southeast Asian immigrants that are present net background and performance, but higher math ratings for East Asian immigrants remain. We conclude by discussing implications of our approach and findings.

Consensus statement on placebo effects in sports and exercise: The need for conceptual clarity, methodological rigour, and the elucidation of neurobiological mechanisms.

In June 2017 a group of experts in anthropology, biology, kinesiology, neuroscience, physiology, and psychology convened in Canterbury, UK, to address questions relating to the placebo effect in sport and exercise. The event was supported exclusively by Quality Related (QR) funding from the Higher Education Funding Council for England (HEFCE). The funder did not influence the content or conclusions of the group. No competing interests were declared by any delegate. During the meeting and in follow-up correspondence, all delegates agreed the need to communicate the outcomes of the meeting via a brief consensus statement. The two specific aims of this statement are to encourage researchers in sport and exercise science to 1. Where possible, adopt research methods that more effectively elucidate the role of the brain in mediating the effects of treatments and interventions. 2. Where possible, adopt methods that factor for and/or quantify placebo effects that could explain a percentage of inter-individual variability in response to treatments and intervention.