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1.
J Am Heart Assoc ; 12(24): e030042, 2023 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-38108253

RESUMO

The United States witnessed a nearly 4-fold increase in personal health care expenditures between 1980 and 2010. Despite innovations and obvious benefits to health, participants enrolled in clinical trials still do not accurately represent the racial and ethnic composition of patients nationally or globally. This lack of diversity in cohorts limits the generalizability and significance of results among all populations and has deep repercussions for patient equity. To advance diversity in clinical trials, robust evidence for the most effective strategies for recruitment of diverse participants is needed. A major limitation of previous literature on clinical trial diversity is the lack of control or comparator groups for different strategies. To date, interventions have focused primarily on (1) community-based interventions, (2) institutional practices, and (3) digital health systems. This review article outlines prior intervention strategies across these 3 categories and considers health policy and ethical incentives for substantiation before US Food and Drug Administration approval. There are no current studies that comprehensively compare these interventions against one another. The American Heart Association Strategically Focused Research Network on the Science of Diversity in Clinical Trials represents a multicenter, collaborative network between Stanford School of Medicine and Morehouse School of Medicine created to understand the barriers to diversity in clinical trials by contemporaneous head-to-head interventional strategies accessing digital, institutional, and community-based recruitment strategies to produce informed recruitment strategies targeted to improve underrepresented patient representation in clinical trials.


Assuntos
American Heart Association , Instalações de Saúde , Estados Unidos , Humanos , Política de Saúde , Assistência Médica , Diversidade Cultural , Estudos Multicêntricos como Assunto
2.
bioRxiv ; 2023 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-37425725

RESUMO

Background: Methodological rigor is a major priority in preclinical cardiovascular research to ensure experimental reproducibility and high quality research. Lack of reproducibility results in diminished translation of preclinical discoveries into medical practice and wastes resources. In addition, lack of reproducibility fosters uncertainty in the public's acceptance of reported research results. Methods: We evaluate the reporting of rigorous methodological practices in preclinical cardiovascular research studies published in leading scientific journals by screening articles for the inclusion of the following key study design elements (SDEs): considering sex as a biological variable, randomization, blinding, and sample size power estimation. We have specifically chosen to screen for these SDEs across articles pertaining to preclinical cardiovascular research studies published between 2011 and 2021. Our study replicates and extends a study published in 2017 by Ramirez et al. We hypothesized that there would be higher SDE inclusion across preclinical studies over time, that preclinical studies that also include human and animal substudies within the same study will exhibit greater SDE inclusion than animal-only preclinical studies, and that there will be a difference in SDE usage between large and small animal models. Results: Overall, inclusion of SDEs was low. 15.2% of animal only studies included both sexes as a biological variable, 30.4% included randomization, 32.1% included blinding, and 8.2% included sample size estimation. Incorporation of SDE in preclinical studies did not significantly increase over the ten year time period in the articles we assessed. Although the inclusion of sex as a biological variable increased over the 10 year time frame, that change was not significant (p=0.411, corrected p=8.22). These trends were consistent across journals. Reporting of randomization and sample size estimation differs significantly between animal and human substudies (corrected p=3.690e-06 and corrected p=7.252e-08, respectively.) Large animal studies had a significantly greater percentage of blinding reported when compared to small animal studies (corrected p=0.01.) Additionally, overall, large animal studies tended to have higher SDE usage. Conclusions: In summary, evidence of methodological rigor varies substantially depending on the study type and model organisms used. Over the time period of 2011-2021, the reporting of SDEs within preclinical cardiovascular studies has not improved and suggests extensive evaluation of other SDEs used in cardiovascular research. Limited incorporation of SDEs within research hinders experimental reproducibility that is critical to future research.

3.
J Am Heart Assoc ; 11(8): e022380, 2022 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-35388707

RESUMO

Background To support diversity in biomedical science, the American Heart Association launched the Supporting Undergraduate Research Experiences for undergraduate students from underrepresented backgrounds to provide mentorship and high-level exposure at 5 leading medical institutions. Here we describe the initial formation of the partnership and the alteration made in response to the program to accommodate COVID-19 safety precautions. Methods and Results We outline how programming shifted from local, in-person programming in the summer of 2019 to a collaborative, mainly virtual curriculum in 2020 using students' self-reported before and after surveys from both 2019 (n=33) and 2020 (n=42). Students from both in-person (2019) and virtual programs (2020) self-reported significant gains in scientific proficiency. A qualitative-directed content analysis of student open-response questions was performed. Students reported extensive benefits from the 2020 virtual training, including Personal Gains, Research Skills, Thinking and Working Like a Scientist, and Attitudes and Behaviors. Notedly, we observed increases in the Attitudes and Behaviors category. We outline the pros and cons of in-person and virtual programming and make recommendations moving forward in a postpandemic world with hybrid work and learning systems. Conclusions Our effort informs the development of future undergraduate research training programs, significantly maximizing a hybrid training modality. The American Heart Association Supporting Undergraduate Research Experiences serves as a model for building multi-institutional partnerships and providing research experiences that overcome institutional barriers and support students' interests, commitment, and ability to persist in science, technology, engineering, and math fields.


Assuntos
American Heart Association , COVID-19 , Humanos , Mentores , Estudantes , Estados Unidos
4.
Front Neuroanat ; 14: 574130, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33328901

RESUMO

Cognitive functions such as attention and working memory are modulated by noradrenaline receptors in the prefrontal cortex (PFC). The frontal eye field (FEF) has been shown to play an important role in visual spatial attention. However, little is known about the underlying circuitry. The aim of this study was to characterize the expression of noradrenaline receptors on different pyramidal neuron and inhibitory interneuron subtypes in macaque FEF. Using immunofluorescence, we found broad expression of noradrenaline receptors across all layers of the FEF. Differences in the expression of different noradrenaline receptors were observed across different inhibitory interneuron subtypes. No significant differences were observed in the expression of noradrenaline receptors across different pyramidal neuron subtypes. However, we found that putative long-range projecting pyramidal neurons expressed all noradrenaline receptor subtypes at a much higher proportion than any of the other neuronal subtypes. Nearly all long-range projecting pyramidal neurons expressed all types of noradrenaline receptor, suggesting that there is no receptor-specific machinery acting on these long-range projecting pyramidal neurons. This pattern of expression among long-range projecting pyramidal neurons suggests a mechanism by which noradrenergic modulation of FEF activity influences attention and working memory.

5.
Cereb Cortex ; 30(1): 148-164, 2020 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-31038690

RESUMO

Dopaminergic modulation of prefrontal cortex plays an important role in numerous cognitive processes, including attention. The frontal eye field (FEF) is modulated by dopamine and has an established role in visual attention, yet the underlying circuitry upon which dopamine acts is not known. We compared the expression of D1 and D2 dopamine receptors (D1Rs and D2Rs) across different classes of FEF neurons, including those projecting to dorsal or ventral extrastriate cortex. First, we found that both D1Rs and D2Rs are more prevalent on pyramidal neurons than on several classes of interneurons and are particularly prevalent on putatively long-range projecting pyramidals. Second, higher proportions of pyramidal neurons express D1Rs than D2Rs. Third, overall a higher proportion of inhibitory neurons expresses D2Rs than D1Rs. Fourth, among inhibitory interneurons, a significantly higher proportion of parvalbumin+ neurons expresses D2Rs than D1Rs, and a significantly higher proportion of calbindin+ neurons expresses D1Rs than D2Rs. Finally, compared with D2Rs, virtually all of the neurons with identified projections to both dorsal and ventral extrastriate visual cortex expressed D1Rs. Our results demonstrate that dopamine tends to act directly on the output of the FEF and that dopaminergic modulation of top-down projections to visual cortex is achieved predominately via D1Rs.


Assuntos
Lobo Frontal/citologia , Lobo Frontal/metabolismo , Neurônios/citologia , Neurônios/metabolismo , Receptores de Dopamina D1/metabolismo , Receptores de Dopamina D2/metabolismo , Córtex Visual/citologia , Córtex Visual/metabolismo , Animais , Interneurônios/citologia , Interneurônios/metabolismo , Macaca mulatta , Masculino , Vias Neurais/citologia , Vias Neurais/metabolismo , Técnicas de Rastreamento Neuroanatômico
6.
Curr Top Behav Neurosci ; 41: 129-153, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30739308

RESUMO

The processes of attention and working memory are conspicuously interlinked, suggesting that they may involve overlapping neural mechanisms. Working memory (WM) is the ability to maintain information in the absence of sensory input. Attention is the process by which a specific target is selected for further processing, and neural resources directed toward that target. The content of WM can be used to direct attention, and attention can in turn determine which information is encoded into WM. Here we discuss the similarities between attention and WM and the role prefrontal cortex (PFC) plays in each. First, at the theoretical level, we describe how attention and WM can both rely on models based on attractor states. Then we review the evidence for an overlap between the areas involved in both functions, especially the frontal eye field (FEF) portion of the prefrontal cortex. We also discuss similarities between the neural changes in visual areas observed during attention and WM. At the cellular level, we review the literature on the role of prefrontal DA in both attention and WM at the behavioral and neural levels. Finally, we summarize the anatomical evidence for an overlap between prefrontal mechanisms involved in attention and WM. Altogether, a summary of pharmacological, electrophysiological, behavioral, and anatomical evidence for a contribution of the FEF part of prefrontal cortex to attention and WM is provided.


Assuntos
Atenção , Memória de Curto Prazo , Córtex Pré-Frontal , Humanos , Córtex Pré-Frontal/fisiologia
7.
Front Neural Circuits ; 12: 12, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29483863

RESUMO

Dopamine signaling in the prefrontal cortex (PFC) is important for cognitive functions, yet very little is known about the expression of the D5 class of dopamine receptors (D5Rs) in this region. To address this, we co-stained for D5Rs, pyramidal neurons (neurogranin+), putative long-range projection pyramidal neurons (SMI-32+), and several classes of inhibitory interneuron (parvalbumin+, calbindin+, calretinin+, somatostatin+) within the frontal eye field (FEF): an area within the PFC involved in the control of visual spatial attention. We then quantified the co-expression of D5Rs with markers of different cell types across different layers of the FEF. We show that: (1) D5Rs are more prevalent on pyramidal neurons than on inhibitory interneurons. (2) D5Rs are disproportionately expressed on putative long-range projecting pyramidal neurons. The disproportionately high expression of D5Rs on long-range projecting pyramidals, compared to interneurons, was particularly pronounced in layers II-III. Together these results indicate that the engagement of D5R-dependent mechanisms in the FEF varies depending on cell type and cortical layer, and suggests that non-locally projecting neurons contribute disproportionately to functions involving the D5R subtype.


Assuntos
Lobo Frontal/citologia , Lobo Frontal/metabolismo , Neurônios/citologia , Neurônios/metabolismo , Receptores de Dopamina D5/metabolismo , Animais , Imunofluorescência , Expressão Gênica , Macaca , Masculino
8.
Trends Cogn Sci ; 21(6): 474-488, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28483638

RESUMO

Attention deficit hyperactivity disorder (ADHD) is a complex condition with a heterogeneous presentation. Current diagnosis is primarily based on subjective experience and observer reports of behavioral symptoms - an approach that has significant limitations. Many studies show that individuals with ADHD exhibit poorer performance on cognitive tasks than neurotypical controls, and at least seven main functional domains appear to be implicated in ADHD. We discuss the underlying neural mechanisms of cognitive functions associated with ADHD, with emphasis on the neural basis of selective attention, demonstrating the feasibility of basic research approaches for further understanding cognitive behavioral processes as they relate to human psychopathology. The study of circuit-level mechanisms underlying executive functions in nonhuman primates holds promise for advancing our understanding, and ultimately the treatment, of ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Atenção , Cognição/fisiologia , Função Executiva/fisiologia , Animais , Humanos , Modelos Neurológicos
9.
Neural Plast ; 2016: 6021428, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26881119

RESUMO

Perineuronal nets (PNNs) are extracellular molecules that form around neurons near the end of critical periods during development. They surround neuronal cell bodies and proximal dendrites. PNNs inhibit the formation of new connections and may concentrate around rapidly firing inhibitory interneurons. Previous work characterized the important role of perineuronal nets in plasticity in the visual system, amygdala, and spinal cord of rats. In this study, we use immunohistochemistry to survey the distribution of perineuronal nets in representative areas of the primate brain. We also document changes in PNN prevalence in these areas in animals of different ages. We found that PNNs are most prevalent in the cerebellar nuclei, surrounding >90% of the neurons there. They are much less prevalent in cerebral cortex, surrounding less than 10% of neurons in every area that we examined. The incidence of perineuronal nets around parvalbumin-positive neurons (putative fast-spiking interneurons) varies considerably between different areas in the brain. Our survey indicates that the presence of PNNs may not have a simple relationship with neural plasticity and may serve multiple functions in the central nervous system.


Assuntos
Acetilgalactosamina/análise , Encéfalo/metabolismo , Matriz Extracelular/metabolismo , Plasticidade Neuronal , Neurônios/metabolismo , Animais , Encéfalo/citologia , Proteínas da Matriz Extracelular/metabolismo , Feminino , Macaca mulatta , Masculino , Neurônios/citologia , Ratos , Medula Espinal/citologia , Medula Espinal/metabolismo , Sinapses/metabolismo
10.
PLoS One ; 9(3): e86154, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24603437

RESUMO

Perineuronal nets (PNNs) accumulate around neurons near the end of developmental critical periods. PNNs are structures of the extracellular matrix which surround synaptic contacts and contain chondroitin sulfate proteoglycans. Previous studies suggest that the chondroitin sulfate chains of PNNs inhibit synaptic plasticity and thereby help end critical periods. PNNs surround a high proportion of neurons in the cerebellar nuclei. These PNNs form during approximately the same time that movements achieve normal accuracy. It is possible that PNNs in the cerebellar nuclei inhibit plasticity to maintain the synaptic organization that produces those accurate movements. We tested whether or not PNNs in a saccade-related part of the cerebellar nuclei maintain accurate saccade size by digesting a part of them in an adult monkey performing a task that changes saccade size (long term saccade adaptation). We use the enzyme Chondroitinase ABC to digest the glycosaminoglycan side chains of proteoglycans present in the majority of PNNs. We show that this manipulation does not result in faster, larger, or more persistent adaptation. Our result indicates that intact perineuronal nets around saccade-related neurons in the cerebellar nuclei are not important for maintaining long-term saccade gain.


Assuntos
Acetilgalactosamina/metabolismo , Núcleos Cerebelares/fisiologia , Rede Nervosa/fisiologia , Movimentos Sacádicos/fisiologia , Adaptação Ocular/fisiologia , Adaptação Fisiológica/fisiologia , Animais , Condroitina ABC Liase/metabolismo , Proteoglicanas de Sulfatos de Condroitina/metabolismo , Matriz Extracelular/metabolismo , Matriz Extracelular/fisiologia , Macaca mulatta , Masculino , Rede Nervosa/metabolismo , Plasticidade Neuronal/fisiologia , Neurônios/metabolismo , Neurônios/fisiologia , Fatores de Tempo
11.
Brain Res ; 1503: 33-42, 2013 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-23399683

RESUMO

The caudal part of the cerebellar fastigial nucleus (CFN) influences the horizontal component of saccades. Previous reports show that activity in the CFN contralateral to saccade direction aids saccade acceleration and that activity in the ipsilateral CFN aids saccade deceleration. Here we refine this description by characterizing how blocking CFN activity changes the distance that the eye rotates during each of 4 phases of saccades, the increasing and decreasing saccade acceleration (phases 1 and 2) and deceleration (3 and 4). We found that unilateral CFN inactivation increases total eye rotation to ∼1.8× normal. This resulted from rotation increases in all four phases of ipsiversive saccades. Rotation during phases 1 and 2 increases slightly, more during phase 3, and most during phase 4, to ∼4.4× normal. Thus, the ipsilateral CFN normally reduces eye rotation throughout a saccade but reduces it the most near saccade end. After unilateral CFN inactivation, rotation during contraversive saccades was ∼0.8× normal. This resulted from decreased rotation during phases 1-3, to ∼0.7× normal, and then normal rotation during phase 4. Thus the CFN contraversive to saccade direction normally increases eye rotation during acceleration and the first phase of deceleration. These data indicate that the influences of the CFNs on saccades overlap extensively and that there is a smooth shift from predominance of the contralateral CFN early in a saccade to the ipsilateral CFN later. The pathway from the CFN to contralateral IBNs and then to the abducens nucleus can account for these effects.


Assuntos
Núcleos Cerebelares/fisiologia , Orientação/fisiologia , Movimentos Sacádicos/fisiologia , Vias Visuais/fisiologia , Animais , Ataxia Cerebelar/fisiopatologia , Núcleos Cerebelares/efeitos dos fármacos , Lateralidade Funcional/efeitos dos fármacos , Lateralidade Funcional/fisiologia , Agonistas de Receptores de GABA-A/farmacologia , Macaca mulatta , Muscimol/farmacologia , Orientação/efeitos dos fármacos , Tempo de Reação/efeitos dos fármacos , Movimentos Sacádicos/efeitos dos fármacos , Fatores de Tempo , Vias Visuais/efeitos dos fármacos
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