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Buildings are key in supporting human activities and well-being by providing shelter and other important services to their users. Buildings are, however, also responsible for major energy use and greenhouse gas (GHG) emissions during their life cycle. Improving the quality of services provided by buildings while reaching low energy demand (LED) levels is crucial for climate and sustainability targets. Building sector models have become essential tools for decision support on strategies to reduce energy demand and GHG emissions. Yet current models have significant limitations in their ability to assess the transformations required for LED. We review building sector models ranging from the subnational to the global scale to identify best practices and critical gaps in representing transformations toward LED futures. We focus on three key dimensions of intervention (socio-behavioral, infrastructural, and technological), three megatrends (digitalization, sharing economy, and circular economy), and decent living standards. This review recommends the model developments needed to better assess LED transformations in buildings and support decision-making toward sustainability targets. [ABSTRACT FROM AUTHOR]

Background: Multiple meta-analyses of diffusion tensor imaging (DTI) studies have reported impaired white matter integrity in patients with major depressive disorder (MDD). However, owing to inclusion of medicated patients in these studies, it is difficult to conclude whether these reported alterations are associated with MDD or confounded by medication effects. A meta-analysis of DTI studies on medication-free (medication-naive and medication washout) patients with MDD would therefore be necessary to disentangle MDD-specific effects. Methods: We analyzed white matter alterations between medication-free patients with MDD and healthy controls using anisotropic effect size-signed differential mapping (AES-SDM). We used DTI query software for fibre tracking. Results: Both pooled and subgroup meta-analyses in medication washout patients showed robust fractional anisotropy (FA) reductions in white matter of the right cerebellum hemispheric lobule, body of the corpus callosum (CC) and bilateral superior longitudinal fasciculus III (SLF III), whereas FA reductions in the genu of the CC and right anterior thalamic projections were seen in only medication-naive patients. Fibre tracking showed that the main tracts with observed FA reductions included the right cerebellar tracts, body of the CC, bilateral SLF III and arcuate fascicle. Limitations: The analytic techniques, patient characteristics and clinical variables of the included studies were heterogeneous; we could not exclude the effects of nondrug therapies owing to a lack of data. Conclusion: By excluding the confounding influences of current medication status, findings from the present study may provide a better understanding of the underlying neuropathology of MDD., Introduction Major depressive disorder (MDD) is a debilitating and pervasive mental illness with a 12-month and a lifetime prevalence of 6.6% and 16.2% respectively. (1) The disorder is the third [...]

Background: More than 6 million Americans suffer from Alzheimer's disease (AD), the most common age‐associated, neurodegenerative dementia, characterized by progressive cognitive decline and the sporadic emergence of neuropsychiatric symptoms (NPS). We applied linked independent component analysis (LICA), a unsupervised learning approach for data fusion, to identify multi‐modal gray matter patterns of covariation that were predictive of dementia ratings and depression symptoms to understand the brain circuitry underlying both. Method: Publicly available data from 277 participants (177 healthy controls, 61 mild cognitive impairment, and 39 AD (aged 58 – 93) in the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset were used to conduct secondary analyses. T1‐weighted MR images were used to compute spatial maps of cortical thickness (CT) and pial surface area (PSA) using Freesurfer and grey matter (GM) density maps using FSLVBM. CT, PSA and GM maps for each modality were concatenated across participants into 4D data files that were analyzed using FSL Linked ICA to estimate 25 multi‐modal spatial components and subject loadings quantifying the strength of each component pattern per participant. Random forest regression with 5‐fold cross validation was used to predict CDR and GDS from the resulting subject loadings (with age, sex and site). Result: Two LICA components (Fig 1) had highest feature importance in predicting CDR (R2 = 0.41). The same two patterns (Fig1) plus two additional patterns (Fig 2) were most important in predicting GDS (R2 = 0.08). Conclusion: Greater CDR was predicted by larger (Fig 1A) decreased GM and CT of widespread temporal lobe regions and (Fig 1B) of reduced GM of entorhinal cortex/mesial temporal lobe with nodes of the default mode network, implicated in disease progression. Greater GDS was also predicted by these two patterns as well as a pattern (Fig 2A) reflecting decreased GM in nucleus accumbens, amygdala and a cerebellar‐thalomocortical (CTC) circuit strongly implicated in cerebellar cognitive affective syndrome (CCAS) and another (Fig 2B) comprised of CT decreases in cortex and temporal regions and GM decreases in frontoparietal regions resembling areas of the frontopariatal functional connectivity network. These multi‐modal brain‐behavior mappings could be translated to better understand dementia and neuropsychiatric symptoms of AD. [ABSTRACT FROM AUTHOR]

Objective: Studies in estrogen deficiency states such as primary ovarian insufficiency and Turner syndrome suggest that estrogen status may be an important modulator of mood and emotions. In this study we compared depressive and anxiety symptoms between adolescent and young adult female oligo-amenorrheic athletes (AA) and eumenorrheic females (EM), and explored structural, and functional changes in related brain areas during reward processing, a behavioral construct that is altered in depression and anxiety. Methods: We included (i) 24 AA participating in ≥4 hours/week of aerobic exercise or running ≥20 miles/week for ≥6 months in the preceding year, with lack of menstrual cycles for ≥3 months within at least 6 preceding months of oligo-amenorrhea, OR in premenarchal girls, absence of menses at >15 years), and (ii) 27 EM aged 14-25 years. Participants completed the Beck Depression Inventory-II (BDI-II), State and Trait Anxiety Inventory (STAI), and Mood and Anxiety Symptoms Questionnaire (MASQ). Structural MRI and brain activation during a functional MRI (fMRI) task that probes reward and punishment processing was examined in a subset of 10 AA and 23 EM. Results: Median (IQR) age and BMI of AA and EM groups were 20.6 (19.0-22.6) vs. 20.6 (19.2-23.7) years, p=0.6 and v 20.3 (18.8-21.5) vs. 21.9 (19.6-23.5) kg/m², p=0.005, respectively. While groups did not differ for BDI-II scores, AA had higher anhedonic depression MASQ scores (p=0.04), and STAI (p=0.03) scores vs. EM. In the fMRI subset, AA had higher caudate volumes vs. EM [F(1, 29)=9.930, p=0.004]. Lower activation observed in the right caudate during reward anticipation in AA compared with EM (p=0.036) suggests blunted reward processing in the striatum in estrogen deficient states. Conclusion: Athletes with amenorrhea had higher depressive and anxiety symptomatology compared to eumenorrheic young women. Exploratory analyses demonstrated increased caudate volumes and decreased caudate activation during reward processing in athletes with amenorrhea suggesting that estrogen may play a role in reward processing. [ABSTRACT FROM AUTHOR]

Background: Depression risk increases during adolescent development, and individual differences in neural sensitivity to peer feedback (rejection vs. acceptance) may be a key diathesis in understanding stress‐related depression risk. Methods: At baseline, adolescents (12–14 years old; N = 124) completed clinical interviews and self‐report symptom measures, and the Chatroom Task while MRI data were acquired. The majority of participants provided usable MRI data (N = 90; 76% female), which included adolescents with no maternal depression history (low risk n = 64) and those with a maternal depression history (high risk n = 26). Whole‐brain regression models probed group differences in neural sensitivity following peer feedback, and whole‐brain linear mixed‐effects models examined neural sensitivity to peer feedback by peer stress interactions relating to depression symptoms at up to nine longitudinal assessments over 2 years. Results: Whole‐brain cluster‐corrected results indicated brain activation moderating the strong positive association between peer interpersonal stress and depression over time. This included activation in the anterior insula, cingulate, amygdala, and striatum during anticipation and receipt of feedback (i.e., rejection vs. acceptance). Moderation effects were stronger when examining peer interpersonal (vs. non‐interpersonal) stress and in relation to depression (vs. social anxiety) symptoms. Conclusions: Neural responses to peer feedback in key social and incentive processing brain regions may reflect core dispositional risk factors that interact with peer interpersonal stressors to predict adolescent depression symptom severity over time. [ABSTRACT FROM AUTHOR]

Byline: Selvakumar. Palaniappan, Venkatesh. Subbiah, V. Gopalan, Poornima. Kumar, R. Vinothan Background and Aims: Arteriovenous (AV) fistula surgery is commonly performed for AV access for hemodialysis. However the ideal anaesthetic [...]

This Viewpoint synthesizes data-driven and theory-driven approaches to normative modeling. [ABSTRACT FROM AUTHOR]

Introduction: Keloid is a pathological cutaneous dermal lesion resulting from aberrant wound-healing process. It mainly arises in the chest, upper back, earlobes, and shoulder region. Keloid pinna is common diagnosis in the ear, nose, and throat, for which various treatment options are available. We describe our experience with pre- and postoperative injections with triamcinolone. Materials and Methods: This is a retrospective observational study from December 2020 to April 2022. A total of 16 cases (14 females and two males) were included in the study. Triamcinolone acetonide (TAC) (40 mg/mL) was injected both preoperatively and postoperatively following surgical excision. Results: The triamcinolone injections resulted in drastic size reduction of the keloids and made the keloids softer in consistency. The main benefit of the triamcinolone injection was the soft-tissue margin reclamation making surgical excision easy. Discussion: The main advantage of preoperative intralesional TAC is size reduction, reduced vascularity and scar pliability, and better soft-tissue margin reclamation which helps in getting better operative margins for surgical excision leading to better cosmetic results. Conclusion: TAC injection perilesional in keloid pinna preoperatively improves the surgical outcomes and postoperative injection reduces the recurrence rates considerably. [ABSTRACT FROM AUTHOR]