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As a strong risk factor for mortality, individual differences in loneliness are of clear public health significance. Four of the Big Five traits have emerged as cross-sectional correlates, but the etiology of these links is unclear, as are relations with more specific personality facets. Thus, we estimated phenotypic, genetic, and environmental associations between loneliness and both broader and narrower personality dimensions. Traits that indexed Negative Emotionality (e.g., Neuroticism, Stress Reactivity, Alienation) and low Positive Emotionality (e.g., low Extraversion, low Well-Being) had the strongest associations with loneliness, though low Conscientiousness, low Agreeableness, and high Aggression were also implicated. These associations were explained by both genetic (0.30|r

Background: There is a high incidence of cognitive impairment among World Trade Center (WTC) responders, comorbid with post-traumatic stress disorder (PTSD). Yet, it remains unknown whether genetic liability for Alzheimer’s disease, PTSD, educational attainment, or for a combination of these phenotypes, is associated with cognitive impairment in this high-risk population. Similarly, whether the effects of genetic liability are comparable to PTSD and indicators of exposure severity remains unknown. Objective: In a study of 3,997 WTC responders, polygenic scores for Alzheimer’s disease, PTSD, and educational attainment were used to test whether genome-wide risk for one or more of these phenotypes is associated with cognitive impairment, controlling for population stratification, while simultaneously estimating the effects of demographic factors and indicators of 9/11 exposure severity, including symptoms of PTSD. Results: Polygenic scores for Alzheimer’s disease and educational attainment were significantly associated with an increase and decrease, respectively, in the hazard rate of mild cognitive impairment. The polygenic score for Alzheimer’s disease was marginally associated with an increase in the hazard rate of severe cognitive impairment, but only age, exposure severity, and symptoms of PTSD were statistically significant predictors. Conclusion: These results add to the emerging evidence that many WTC responders are suffering from mild cognitive impairments that resemble symptoms of Alzheimer’s disease, as genetic liability for Alzheimer’s disease predicted incidence of mild cognitive impairment. However, compared to polygenic scores, effect sizes were larger for PTSD and the type of work that responders completed during rescue and recovery efforts.

Despite the strong link between borderline personality disorder (BPD) symptoms and suicide risk, little is known about the mechanisms underlying this association. Theory-driven research clarifying the pathways through which BPD symptoms increase suicide risk over time is needed and may highlight relevant treatment targets for decreasing suicide risk among individuals with heightened BPD symptoms. This study examined the prospective relations among BPD symptoms, emotion regulation (ER) difficulties, perceived burdensomeness, thwarted belongingness, and suicide risk across five assessments over a 7-month period. Consistent with the interpersonal theory of suicide, we hypothesized that greater BPD symptoms would predict greater suicide risk over time via greater ER difficulties and, subsequently, greater perceived burdensomeness.A U.S. nationwide sample of 500 adults (47 % women; mean age = 40.0 ± 11.64) completed a prospective online study, including an initial assessment and four follow-up assessments over the next seven months.Results revealed a significant indirect relation between BPD symptoms and greater suicide risk over time through greater ER difficulties and later perceived burdensomeness. Results also provided evidence for transactional relations between BPD symptoms and ER difficulties and suicide risk over time.All constructs were assessed via self-report questionnaire data. Our measure of suicide risk focuses on only suicidal ideation, plans, and impulses, and not suicide attempts or preparatory behaviors.Results highlight both ER- and interpersonal-related factors as key mechanisms underlying suicide risk among community adults with BPD symptoms.

Loneliness represents a public health threat given its central role in predicting adverse mental and physical health outcomes. Prior research has established four of the Big Five personality traits as consistent cross-sectional predictors of loneliness in largely western, White samples. However, it is not clear if the personality predictors of loneliness vary across cultures.The present study estimates associations between the Big Five traits and loneliness across distinct samples of White American, Black American, and Japanese adults (n = 6051 at T1). Confirmatory factor analysis and exploratory structural equation modeling were used to examine measurement invariance properties of the Big Five and loneliness across these groups. The factor structures were then carried forward to estimate associations between personality and loneliness across two assessments waves using structural equation modeling.While Neuroticism was a strong predictor across groups, low Extraversion was more predictive of loneliness in Japan than in the U.S., and low Conscientiousness was only a significant predictor in the U.S.Previous literature offers a framework for interpreting these findings in that loneliness may be shaped comparatively more through interconnectedness in Japanese culture, while, in the U.S., individual goals and personal romantic expectations are more salient.

This study examined the associations of the experience and tolerance of shame-related emotions to suicide risk, as well as the moderating role of sexual minority status.Community adults (N = 360) were recruited via MTurk and completed self-report questionnaires. Hierarchical regression analyses examined the main and interactive associations of sexual minority status and shame-related variables to suicide risk.Results revealed significant positive associations between self-disgust and suicide risk for sexual minority and heterosexual participants, although the magnitude was greater for sexual minority participants. Additionally, tolerance of shame was significantly negatively related to suicide risk only among sexual minority participants. Finally, exploratory analyses examining the three-way interaction of self-disgust, shame tolerance, and sexual minority status revealed a significant negative association between shame tolerance and suicide risk only among sexual minority participants with high levels of self-disgust.Results highlight the relevance of shame-related experiences to suicide risk among sexual minorities.

The creation of developmentally appropriate and meaningfully complex clinical reasoning exercises in the pre-clerkship curriculum is a common challenge for many medical schools. We provide an overview of one component of the pre-clerkship clinical reasoning curriculum at Case Western Reserve University School of Medicine, and present evidence that inclusion of Health Systems Science in this exercise facilitates integrated thinking in a Problem-Based Learning curriculum.

HighlightsHumans who supervise autonomous agricultural machines require some type of warning to perceive abnormal conditions in the machine or its environment.Visual and tactile warnings were the most suitable warning methods for in-field and close-to-field remote supervision.This study will help improve the performance of remote supervisors and minimize unexpected incidents or liabilities during operation of autonomous machines.Abstract. As agricultural machinery moves toward full autonomy, human supervisors will need to monitor the autonomous machines during operation and minimize system failures or malfunctions. However, to intervene in an emergency, the supervisor must first recognize the emergency in a timely manner. Existing warning devices rely on the human visual, auditory, and tactile senses. However, these warning methods vary in their ability to attract attention. Hence, it is important to determine which warning method is best suited to draw the attention of a remote supervisor of an autonomous machine in an emergency. To achieve this objective, participants were recruited and asked to interact with a simulation of an autonomous sprayer. Seven warning methods (presented alone or in combinations of visual, auditory, and tactile sensory cues) and four remote supervision scenarios (in-field, close-to-field, farm office, outside the farmland) were considered in this study. The findings revealed that a combination of tactile and visual methods was most suitable for in-field and close-to-field remote supervision, in comparison to the other warning methods. However, there was insufficient evidence to recommend the best warning methods for supervisors at the farm office or outside the farmland. This study will help improve the performance of remote supervisors and minimize unexpected incidents during field operations with autonomous agricultural machines. Keywords: Agricultural machines, Remote supervision, User-centered design, Warning system.

Background Borderline personality disorder (BPD) pathology is common among patients with substance use disorders (SUDs) and associated with a variety of negative outcomes, including worse SUD outcomes. One particularly relevant outcome with links to substance use problems that is likely to be elevated among SUD patients with BPD symptoms is ineffective conflict resolution strategies in romantic relationships. However, no research to date has examined the relation of BPD pathology to strategies for managing conflict in romantic relationships among patients with SUDs, or the factors that may increase the use of ineffective strategies within this population. Thus, this study examined the relations of BPD symptoms to ineffective responses to romantic relationship conflict surrounding substance use among residential patients with SUDs, as well as the explanatory roles of fear of compassion from and for others in these relations. Methods Patients in a community-based correctional SUD residential treatment facility (N = 93) completed questionnaires, including a measure of BPD symptoms, fear of compassion from and for others, and strategies for responding to conflict surrounding substance use in romantic relationships. Results Fear of compassion from others accounted for significant variance in the relations of BPD symptoms to the ineffective conflict resolution strategies of reactivity, domination, and submission, whereas fear of compassion for others only accounted for significant variance in the relation between BPD symptoms and the strategy of separation (which is not always ineffective). Conclusions Together, findings suggest that it is fear of compassion from others (vs. fear of compassion for others) that explains the relation between BPD symptoms and ineffective responses to romantic relationship conflict surrounding substance use among SUD patients. Findings highlight the potential utility of interventions aimed at reducing fears of compassion and increasing comfort with and tolerance of compassion from both others and oneself among SUD patients with BPD symptoms in order to strengthen relationships and reduce risk for relapse.

Adolescence is a peak period for risk-taking, but research has largely overlooked positive manifestations of adolescent risk-taking due to ambiguity regarding operationalization and measurement of positive risk-taking. We address this limitation using a mixed-methods approach. We elicited free responses from contemporary college students (N = 74, M

Procedural sedation has a long and often fraught history in oromaxillofacial surgery and dentistry. When performed correctly, it improves patient comfort, reduces anxiety, and facilitates medical interventions and procedures to be performed without the need for general anaesthesia. There is a growing demand for procedural sedation across specialties, which is being met by anaesthetists and non-anaesthetists. There is a significant heterogeneity of sedation practice—in part due to the variety of sedative agents and modes of delivery available, but also the level of training of the individual sedation practitioner and the nature of the procedures. Complications arise from the changeability of the language used to describe sedation states, inconsistency in the standards of monitoring, and variation in the abilities of staff to rescue patients from a deeper-than-intended level of sedation. Sedation in oromaxillofacial surgery presents additional risk due to the nature and site of the procedures, where access to the airway may be restricted. Sedation agents and techniques appropriate to these procedures are outlined in this chapter. Procedural sedation warrants the application of minimum standards to ensure safety by adopting recognized guidelines. There is a need to assimilate and collect data on the incidence of adverse events and outcomes to help guide future practice and promote patient safety. Whether this is achieved on a voluntary self-reporting basis or via a national audit project remains to be seen. Future agents and devices will hopefully confer a safety advantage, but better application of existing knowledge and skills would confer an enormous safety benefit.

Background The factors associated with estimated glomerular filtrate rate (eGFR) decline in low risk adults remain relatively unknown. We hypothesized that a polygenic risk score (PRS) will be associated with eGFR decline. Methods We analyzed genetic data from 1,601 adult participants with European ancestry in the World Trade Center Health Program (baseline age 49.68 ± 8.79 years, 93% male, 23% hypertensive, 7% diabetic and 1% with cardiovascular disease) with ≥ three serial measures of serum creatinine. PRSs were calculated from an aggregation of single nucleotide polymorphisms (SNPs) from a recent, large-scale genome-wide association study (GWAS) of rapid eGFR decline. Generalized linear models were used to evaluate the association of PRS with renal outcomes: baseline eGFR and CKD stage, rate of change in eGFR, stable versus declining eGFR over a 3–5-year observation period. eGFR decline was defined in separate analyses as “clinical” (> -1.0 ml/min/1.73 m2/year) or “empirical” (lower most quartile of eGFR slopes). Results The mean baseline eGFR was ~ 86 ml/min/1.73 m2. Subjects with decline in eGFR were more likely to be diabetic. PRS was significantly associated with lower baseline eGFR (B = -0.96, p = 0.002), higher CKD stage (OR = 1.17, p = 0.010), decline in eGFR (OR = 1.14, p = 0.036) relative to stable eGFR, and the lower quartile of eGFR slopes (OR = 1.21, p = 0.008), after adjusting for established risk factors for CKD. Conclusion Common genetic variants are associated with eGFR decline in middle-aged adults with relatively low comorbidity burdens.

Background/Introduction Sacubitril/valsartan was compared to ramipril in patients with acute myocardial infarction in the PARADISE-MI trial. In the whole trial population sacubitril/valsartan did not reduce the composite primary outcome of CV death or incident heart failure compared to ramipril. Whether or not event rates and/or treatment effects vary in patients with different baseline characteristics is unknown. Purpose To investigate a) event rates b) the treatment effect of sacubitril/valsartan compared to ramipril and c) safety by the presence or absence of transient pulmonary congestion and/or left ventricular ejection fraction (LVEF) ≤40%. Methods PARADISE-MI was a double-blind, randomised clinical trial that compared sacubitril/valsartan to ramipril in 5661 patients with an acute myocardial infarction with either LVEF ≤40% and/or transient pulmonary congestion. 3 groups were investigated: 1) LVEF ≤40% with pulmonary congestion (n=2012) and 2) LVEF ≤40% without pulmonary congestion (n=2596) and 3) LVEF not ≤40% with pulmonary congestion (n=1044). Results Patients with pulmonary congestion (with and without LVEF ≤40%) were more likely to have had a prior MI, prior CABG or PCI, had more atrial fibrillation and were more often treated with mineralocorticoid receptor antagonists and diuretics than patients with no pulmonary congestion and LVEF ≤40%. Patients with LVEF ≤40% and pulmonary congestion had more than twice the rate of the primary composite outcome compared to those with LVEF ≤40% without pulmonary congestion: 10.2 (95% CI 9.2–11.3) vs. 4.8 (4.3–5.5) events per 100 patient-years, respectively). Patients with pulmonary congestion and LVEF not ≤40% had an intermediate event rate (6.6, 5.5–7.9, events per 100 patient-years). A similar pattern of event rates was seen for the components of the primary outcome and for all secondary outcomes whether Clinical Events Committee or investigator-reported events were analysed. The treatment effect of sacubitril/ valsartan versus ramipril did not vary between the 3 congestion/ LVEF subgroups. The safety of sacubitril/valsartan compared to ramipril did not vary between congestion/LVEF subgroups. Conclusion Patients with pulmonary congestion with or without LVEF ≤40% had higher rates of primary and all secondary outcomes than those without pulmonary congestion and LVEF ≤40%. The treatment effect, and safety, of sacubitril/valsartan compared to ramipril was consistent in patients with or without pulmonary congestion and with or without LVEF ≤40%. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Novartis

ObjectiveHigh levels of psychological distress increase the risk of a wide range of medical diseases. In this study, we investigated the association between posttraumatic stress disorder (PTSD) and kidney disease.MethodsWorld Trade Center (WTC) responders were included if they had two or more measures of estimated glomerular filtration rate (eGFR). The PTSD Checklist (PCL) was used to define no PTSD (PCL < 40), "mild" PTSD (40 ≤ PCL

BACKGROUND: Expanding on research that has identified nonsuicidal self-injury (NSSI) as a strong predictor of suicide risk, the present study examined NSSI disorder (NSSID) and borderline personality disorder (BPD) as unique contributors to lifetime suicide attempts. To our knowledge, the present study represents the first exploration of these associations among veterans. METHODS: Participants included 124 male (74%) and female (26%) veterans diagnosed with at least one mental health disorder. Posttraumatic stress disorder (93%) and major depression (86%) were the most common mental health diagnoses. Large proportions of the sample met criteria for NSSID (48%) and BPD (40%). Suicide attempts were reported by 28% of the sample. Chi-square tests determined the bivariate associations among NSSID, BPD, history of suicide attempts, and other variables. Significant diagnostic (i.e., MDD, BPD, and NSSID) and demographic (i.e., age) characteristics were included as covariates in a logistic regression model examining the associations of BPD and NSSID with suicide attempts. RESULTS: BPD, X(2)=11.1, p

ABSTRACT: Stimulation of lab-scale boreholes was studied using small explosives for improving the development of fracture networks in engineered rock surrogates. The experimental series examines the confluence of initial stress states, orientation of induced discontinuities, and their interaction with source generated fracture growth. Density and stress response to the energetic was measured using high-speed schlieren imaging through the transparent polymethyl methacrylate (PMMA) sample. Outer surfaces were instrumented with an acoustic emissions array to detect 3D location of fracture evolution between wellbores. Prior to testing, the experiments were simulated to predict the generation of a shock-induced fracture network between single and multiple wellbores in a variety of stress states. The quantification of wave arrivals, fracture growth, and development of the fracture network in transparent PMMA material is used as further validation against computational models. Understanding the conditions under which fractures propagate in the multivariate environment with small energetics results in improved modeling capability of larger scale wellbores and sources. The present work is part of a broader effort to improve the accuracy of computational models necessary to predict formation interconnectivity established with energetics in low permeability reservoirs typical of enhanced geothermal systems. 1. INTRODUCTION Acoustic emission (AE) sensing has become a pertinent technology to observe flaws in a variety of media. Investigators can use arrays of omni-directional probes to observe energy radiating in the form of compression waves released from fracture tips, voids or features as they are distorted under load. Patterns in radiated energy may be correlated to spatial-temporal formation of microfractures. This method has been applied to the field of geomechanics where fractures grow due to an induced stress state, or when energy is radiated from an existing feature such as a slip plane. In this study, stress was induced for the purposes of studying lab-scale stimulation of geothermal wellbores using energetic sources so that computational models could be further informed by the acoustic emissions of fractures driven by energetics.

To update normative data on fluoroscopy dose indices in the United States for the first time since the RAD-IR study in the late 1990s.The DIR-Fluoro pilot collected data from March 2018 through December 2019, with 50 fluoroscopes from 10 sites submitting data. Primary radiation dose indices including fluoroscopy time (FT), cumulative air kerma (KDose indices were collected for 70,377 FGI, with 50,501 ultimately eligible for analysis. Distribution parameters are reported for 100 ACR Common IDs. FT in minutes, KThe ACR DIR-Fluoro pilot has provided state of the practice statistics for radiation dose indices from IR FGI procedures. These data can be used to prioritize procedures for radiation optimization, as demonstrated in this work.

Objective: Catheter placement for thoracic epidural analgesia (TEA) is technically challenging; however, methods for teaching this technique to anesthesia residents have not been well-studied. The present study aimed to determine optimal teaching methods for proficient TEA catheter placement by comparing video-based formal resident education with traditional bedside training by attending physicians. Design: Prospective, randomized study. Setting: Large academic hospital, single institution. Participants: The study comprised 76 postgraduate year 3 and 4 anesthesiology residents (38 intervention, 38 control). Interventions: Formal education included an instructional video on proper TEA technique. Measurements and Main Results: Measures of proficiency in TEA catheter placement included the time needed to complete the procedure successfully and the success of placement as indicated by patient confirmation. Residents who received formal video instruction had similar success in catheter placement and similar procedure times compared with the traditionally trained residents. The overall success rate was 99.2%, with faculty intervention required in only 17% of cases. More experienced residents (ie, having placed more epidural catheters) were faster at TEA catheter placement. Conclusions: Formal video education for TEA catheter placement provided no additional improvement of resident proficiency compared with traditional training at a high-volume academic center. The success rate was very high in this group of residents; however, experiences at other institutions may vary. Future studies are needed to determine optimum teaching strategies for TEA.

The present study examined the demographic correlates of gene expression in a sample of adults (n = 543) from the Study of Midlife in the United States (MIDUS). Inflammatory and antiviral gene sets were operationalized using a priori composite scores and empirically derived co-regulatory gene sets. For both composite scores and co-regulatory gene sets, White/European Americans showed lower while Black/African Americans showed higher expression of genes involved in interferon responses and antibody synthesis. The effects of chronological age on gene expression varied by sex, such that pro-inflammatory gene expression increased with age more rapidly for females than males. The difference between the average expression of inflammatory and antiviral genes also increased with age for females but not males. Results shed light on differential gene expression as a potential physiological correlate for race/ethnicity, age, and sex-related health disparities in adulthood.

A promising magnetic refrigerant, AlFe2B2, has been prepared for the first time by microwave (MW) melting of a mixture of constituent elements. For comparison, samples of AlFe2B2 have been also pre...

OBJECTIVE: Previous studies of military veterans have produced mixed findings regarding whether combat exposure is directly related to suicidal ideation or is indirectly related to suicidal ideation via its influence on other factors. The present study used a longitudinal design to test the hypothesis that posttraumatic stress disorder (PTSD) symptom severity mediates the effect of combat exposure on suicidal ideation in veterans METHOD: Participants included 319 post-9/11 Veterans (83.4% male; 42.1% White/52.1% Black; M(age) = 39.7) assessed at baseline, 6 months, and 12 months. Structural equation modeling and bootstrapped confidence intervals were employed to examine the direct and indirect relationships between combat exposure, suicidal ideation, and PTSD symptom severity. RESULTS: Results from the mediation model, in which demographic variables and non-combat trauma were included as covariates, revealed that the indirect effect of combat exposure on suicidal ideation via PTSD symptom severity was statistically significant, accounting for 64.1% of the covariance between combat exposure and suicidal ideation. CONCLUSIONS: This study provides longitudinal evidence that the effects of combat exposure on suicidal ideation are mediated by PTSD symptom severity, suggesting the importance of targeting such symptoms in treatment to mitigate suicide risk among veterans with combat exposure.

This article addresses an unusual case of annotation in an early Luther imprint. Drew University Library (Madison, NJ, USA) owns a copy of Luther’s Confitendi ratio (Wittenberg, 1520) that, accordi...

Objective This study explored the boundaries of the proposed diagnostic criteria for nonsuicidal self-injury disorder (NSSID) as outlined in the Conditions for Further Study section of the Diagnostic and Statistical Manual, Fifth Edition. We sought to falsify the exclusion of certain NSSI behaviors from a diagnosis of NSSID (Criterion D), arguing that these exclusions are inconsistent with the broader phenomenology of the disorder outlined in the other criteria. METHOD: We describe three case studies involving NSSI (Case 1: scab-picking; Case 2: nail-biting; Case 3: tattooing) that cannot be diagnosed as NSSID because the behaviors are explicitly listed in Criterion D. Results Despite exclusion as a relevant NSSI behavior per Criterion D, each examined behavior is consistent with the intentionality, functionality, and distress/impairment of NSSID that represent core features of the disorder. Conclusion The case studies presented here suggest that Criterion D should be revised or removed from the NSSID criteria.

Rationale: Unstable ventilatory control (high loop gain) is a causal factor in the development of obstructive sleep apnea. Methods for quantifying loop gain using polysomnography have been develope...

RNA editing by adenosine deaminases changes the information encoded in the mRNA from its genomic blueprint. Editing of protein-coding sequences can introduce novel, functionally distinct, protein isoforms and diversify the proteome. The functional importance of a few recoding sites has been appreciated for decades. However, systematic methods to uncover these sites perform poorly, and the full repertoire of recoding in human and other mammals is unknown. Here we present a new detection approach, and analyze 9125 GTEx RNA-seq samples, to produce a highly-accurate atlas of 1517 editing sites within the coding region and their editing levels across human tissues. Single-cell RNA-seq data shows protein recoding contributes to the variability across cell subpopulations. Most highly edited sites are evolutionary conserved in non-primate mammals, attesting for adaptation. This comprehensive set can facilitate understanding of the role of recoding in human physiology and diseases.

Adenosine-to-inosine RNA editing is essential to prevent undesired immune activation. This diverse process alters the genetic content of the RNA and may recode proteins, change splice sites and miRNA targets, and mimic genomic mutations. Recent studies have associated or implicated aberrant editing with pathological conditions, including cancer, autoimmune diseases, and neurological and psychiatric conditions. RNA editing patterns in cardiovascular tissues have not been investigated systematically so far, and little is known about its potential role in cardiac diseases. Some hints suggest robust editing in this system, including the fact that ADARB1 (ADAR2), the main coding-sequence editor, is most highly expressed in these tissues. Here we characterized RNA editing in the heart and arteries and examined a contributory role to the development of atherosclerosis and two structural heart diseases -Ischemic and Dilated Cardiomyopathies. Analyzing hundreds of RNA-seq samples taken from the heart and arteries of cardiac patients and controls, we find that global editing, alongside inflammatory gene expression, is increased in patients with atherosclerosis, cardiomyopathies, and heart failure. We describe a single recoding editing site and suggest it as a target for focused research. This recoding editing site in the IGFBP7 gene is one of the only evolutionary conserved sites between mammals, and we found it exhibits consistently increased levels of editing in these patients. Our findings reveal that RNA editing is abundant in arteries and is elevated in several key cardiovascular conditions. They thus provide a roadmap for basic and translational research of RNA as a mediator of atherosclerosis and non-genetic cardiomyopathies.

To compare radiation dose index distributions for fluoroscopically guided interventions in interventional radiology from the American College of Radiology (ACR) Fluoroscopy Dose Index Registry (DIR-Fluoro) pilot to those from the Radiation Doses in Interventional Radiology (RAD-IR) study.Individual and grouped ACR Common identification numbers (procedure types) from the DIR-Fluoro pilot were matched to procedure types in the RAD-IR study. Fifteen comparisons were made. Distribution parameters, including the 10th, 25th, 50th, 75th, and 95th percentiles, were compared for fluoroscopy time (FT), cumulative air kerma (KThe median FT was equally likely to be higher or lower in the DIR-Fluoro pilot as it was in the RAD-IR study, whereas the maximum FT was almost twice as likely to be higher in the DIR-Fluoro pilot than it was in the RAD-IR study. The median KThe median dose indices have decreased since the RAD-IR study. The typical K

The Flynn effect (Flynn, 1984; 1987) refers to increases in cognitive performance, for later-born cohorts. It has been documented globally, occurring for more than a century. In a meta-analysis, Pietschnig and Voracek (2015) noted that the effect may be even stronger in adults than in children, though little research has addressed this topic (or its implications) for aging adults. Similarly, overall life-time health has improved, and incidences of cognitive impairment have decreased during the last two decades (Clouston et al., 2021). Using multilevel growth curve models, we found family Flynn effects in the National Longitudinal Survey of Youth; children in families with later-born mothers, and later-born first children, had higher PIAT math scores, and steeper developmental slopes. Although the link from childhood and adolescent cognitive function to later life outcomes has been well studied, research that takes advantage of the Flynn effect to facilitate interpreting that link is lacking. Clouston et al. (2021) emphasized the value of the Flynn effect in investigating links between childhood cognitive functioning and later adult Alzheimer’s disease and related dementia (ADRD) risks. We linked our family level results to middle-age maternal health outcomes (factors that are related to ADRD risks). Canonical correlation analyses showed that mothers (at ages 40+ and 50+) from families with higher score levels and slopes tended to have better mental and physical health. Our results, showing a Flynn effect in child and adolescence scores, at the family level, with links to adult health, persisted after controlling for a known selection bias.

Introduction Circadian dysregulation is implicated in substance use and comorbid mental health problems, but is also exacerbated by these states. In addition to conventional treatment, environmental factors (light, temperature) are potential targets for improving sleep, circadian functioning, and recovery outcomes. This study explored the feasibility of objective sleep and environmental monitoring for recovering substance users in residential treatment, and also examined the relationship between objectively measured sleep-wake rhythms and mental health outcomes. Methods Fifty-two (Mage=38, SD=9.6; 56% female) individuals receiving treatment for substance use were included. Environmental light exposure, temperature, and activity data were collected via wrist-worn actigraphy, and in-room sensors for a minimum of 1-week of stay within a 6-week program. Actigraphy derived sleep-wake patterns were used to calculate Interdaily Stability (IS). Data were linked to routinely collected clinical measures of mental health. Results No individuals opted out of the environmental monitoring aspect of the study, indicating acceptability and feasibility. Environmental loggers mounted in individual rooms recorded average nightly temperatures >21 degrees for 5/8 months. Objectively measured IS (M=.79; 95%CI=.67-.73) was negatively associated with Anxiety (r=-.33, p=.024) and Depression (r=-.36, p=.012), while sleep duration was not. Relationships between participant-level light exposure and clinical outcomes were also examined. Discussion Preliminary results indicate that circadian regularity appears important for mental health outcomes in this population and setting. The structured residential environment provides opportunities for regulating sleep-wake rhythms via scheduling of activities at circadian-appropriate times. This research suggests that optimising circadian- appropriate lighting and thermal comfort may lead to improved individual outcomes.

Introduction One third of patients with OSA have high loop gain. Acetazolamide (ACZ) and supplemental oxygen (O2) individually reduce loop gain (via different mechanisms) and the apnoea-hypopnoea-index (AHI). The current study aimed to explore the efficacy of combining both ACZ and O2 to maximally lower loop gain. Method Randomised single-blind cross-over trial. Participants took ACZ (500mg orally) or placebo for 7 days. Within each arm, participants completed two polysomnograms (PSGs) during which they slept with supplemental oxygen (3L/min) or sham-air. Sleep and respiratory events were scored by a (blinded) technologist. In addition to standard scoring, respiratory events were scored without SpO2 or arousal information to calculate a ‘flow-based AHI’ (fAHI). PSG data were then imported into Matlab for loop gain analysis. Results Nine participants (5 males, Age=52.4±9.1, BMI=32.0±4.9, AHI=39.9±22.0) have so far completed the trial. Loop gain was significantly reduced by ACZ (-22%, -0.15 CI95:-0.03 to -0.26, p=0.011), O2 (-25%, -0.19 CI95:-0.08 to -0.29, p=0.001) and combination ACZ+O2 (-33%, -0.23 CI95:-0.12 to -0.34, p50% reduction in fAHI in 4/9 participants. Discussion Our preliminary data demonstrate that ACZ+O2 may be an efficacious combination therapy for some OSA patients.

Introduction Precarious work is characterised with high job insecurity, low income, and reduced rights and social protections. Current evidence suggests that precarious work is a risk factor for poor mental health. The relationship between these factors, and especially the contributing role of sleep may play in poor outcomes from precarious work, is unknown. This study investigated the mediating effects of sleep quality and duration on the relationship between precarious employment and poor mental health. Methods Data were obtained from the Household, Income and Labour Dynamics in Australia (HILDA) survey (2017). A novel precarious employment score (PES) was developed capturing precarity across the following dimensions: Employment insecurity, level of income, and rights and social protections. Self-reported sleep quality and 24-hour sleep duration were included as mediators. Mediation analyses were conducted to evaluate the mediating effect of sleep duration and sleep quality on the relationship between precarious employment and mental health (SF-36 mental health subscale), after controlling for several covariates. Results The PES identified 1446 (female, n=839) workers in precarious and 7922 (female, n=3949) non-precarious employees out of 9368. There was no significant direct association between precarious employment and mental health (P=.53). We observed no significant changes due to sleep quality in the association between precarious employment and mental health (Coefficient=-0.003, 95% CI -0.01-0.00, P=0.32). However, this association was significant when considering sleep duration (Coefficient=0.34, 95% CI 0.25-0.43, P Discussion Encouraging precarious employees to prioritise and promote sleep appropriately may promote well-being. Further objective measurement of sleep is warranted in this group.

Many animals frequently transition between different media while navigating their heterogeneous environments. These media vary in compliance, moisture content, and other characteristics that affect their physical properties. As a result, animals may need to alter their kinematics to adapt to potential changes in media while maintaining performance during predator escape and foraging. Due to its fluid nature, water is highly compliant, and although usually associated with swimming, water running has evolved in a variety of animals ranging from insects to mammals. While the best studied large water runners are the bipedal basilisk lizards (Basiliscus spp.), other lizards have also been observed to run across the surface of water, namely, Hemidactylus platyurus, a house gecko, and in this study, Anolis sagrei, the brown anole. Unlike the basilisk lizard, the primarily arboreal Anolis sagrei is not adapted for water running. Moreover, water running in A. sagrei, similar to that of the house gecko, was primarily quadrupedal. Here, we tested for performance and kinematic differences between aquatic and terrestrial running and if the variance in performance and kinematic variables differed between the two media. We found no difference in average and maximum velocity between running on land and water. We also found that Anolis sagrei had higher hindlimb stride frequencies, decreased duty factor, and shorter stride lengths on water, as well as more erect postures. Finally, we found that most kinematics did not differ in variance between the two media, but of those that were different, almost all were more variable during terrestrial running. Our findings show that animals may be capable of specialized modes of locomotion, even if they are not obviously adapted for them, and that they may do this by modulating their kinematics to facilitate locomotion through novel environments.

Nonsuicidal self-injury (NSSI) is associated with significant impairment and is a robust predictor of suicidal ideation, attempts, and death by suicide; however, the present lack of a brief screening instrument for NSSI coupled with consistent underidentification of NSSI in male adults has led to concerning rates of missed identification of NSSI.The Screen for Nonsuicidal Self-Injury (SNSI) is a brief, 10-item screen designed to identify individuals currently engaging in NSSI with an emphasis on behaviors more frequently endorsed by male adults. The present study examined the development and validation of the SNSI.In a sample of veterans (N = 124) with complex psychiatric presentations, SNSI scores demonstrated good internal consistency and strong construct validity with area under the curve (AUC) estimates of 0.85-0.93 for the identification of NSSI disorder. SNSI scores also demonstrated good convergent (rs 0.59-0.90) and external validity (rs = 0.25-0.42), and excellent predictive validity identifying future NSSI Suicide and Life-Threatening Behavior disorder (AUC = 0.88) and NSSI behaviors (AUC = 0.90). Importantly, SNSI performance was not affected by participants' race, sex assigned at birth, or age.The SNSI is an efficient screen to identify patients engaging in NSSI who are likely to benefit from more comprehensive assessment and treatment programs.

The present study tested the interactive effects of childhood adversity and polygenic risk scores for waist circumference (PRS-WC) on waist circumference (WC). Consistent with a diathesis-stress model, we hypothesize that the relationship between PRS-WC and WC will be magnified by increasing levels of childhood adversity.Observational study of 7976 adults (6347 European Americans and 1629 African Americans) in the Health and Retirement Study with genotyped data. PRS-WC were calculated by the HRS administrative core using the weighted sum of risk alleles based on a genome-wide association study conducted by the Genetic Investigation of Anthropometric Traits (GIANT) consortium. Childhood adversity was operationalized using a sum score of three traumatic events that occurred before the age of 18 years.There was a statistically significant interaction between PRS-WC and childhood adversity for European Americans, whereby the magnitude of PRS-WC predicting WC increased as the number of adverse events increased.This study supports the idea of the interactive effects of genetic risks and childhood adversity on obesity. More epidemiological studies, particularly with understudied populations, are needed to better understand the roles that genetics and childhood adversity play on the development and progression of obesity.