Search

Background: Parkinson's disease (PD) induces progressive deficits in motor and cognitive functions as well as impaired dual-task performance requiring both motor and cognitive functions. This systematic review and meta-analysis evaluated the effects of non-invasive brain stimulation (NIBS) on dual-task performance in patients with PD. Methods: 11 studies met the following inclusion criteria: (a) patients with PD, (b) NIBS intervention, (c) comparison with the sham stimulation group, (d) motor and cognitive performance outcomes during dual tasks, and (e) randomized controlled trials with parallel or crossover designs. Individual effect size (i.e., comparison) was quantified by comparing motor and cognitive performances changes during dual tasks between active NIBS and sham stimulation conditions. Thus, higher values of the overall effect size indicate more improvements in either motor or cognitive performances after NIBS. Moreover, moderator variable analyses determined whether NIBS effects on dual-task performances differed depending on targeted brain regions. Finally, meta-regression analyses determined whether NIBS effects on dual-task performances were associated with demographic characteristics. Results: The random-effects model meta-analysis revealed that NIBS significantly improved motor (73 comparisons from 11 studies) and cognitive (12 comparisons from four studies) performances during dual tasks in patients with PD. Specifically, anodal transcranial direct current stimulation protocols on the dorsolateral prefrontal cortex were effective. Moreover, greater improvements in motor performance during dual tasks significantly correlated with decreased age and increased proportion of females, respectively. Conclusion: This meta-analysis suggests that excitatory stimulation on the dorsolateral prefrontal cortex may be effective for improving dual-task performance in patients with PD. [ABSTRACT FROM AUTHOR]

Despite the pervasive influence of humor in society, comprehensive quantitative studies exploring its dimensions and societal reception are scarce. This study advances the field by analyzing stand-up comedy specials, linking linguistic elements to humor theories and audience ratings, using the Linguistic Inquiry and Word Count (LIWC-22). The analysis explored the presence and association of Affect, Social, and Cognitive dimensions with ratings of standup comedy shows. Statistical analyses entailed using linear mixed models, incorporating comedians as random effects. Female comedians consistently received lower ratings than males, reflecting historical gender biases, while recent shows received lower ratings than older ones, suggesting the challenge of surpassing pioneering works. Negative emotion positively influenced ratings, while negative mood words had a detrimental effect, highlighting the delicate balance in comedic narratives. Social markers significantly predicted ratings, with moralization negatively impacting them, while the use of social referents, particularly female pronouns, improved ratings. These findings offer valuable insights into the linguistic dynamics of stand-up comedy, informing future research and practice in the comedy industry. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety are common psychological issues among international medical students in universities, which have serious negative impacts on their learning and life. The present study aimed to evaluate the efficacy of positive emotional writing in alleviating symptoms of anxiety and depression, as well as enhancing subjective well-being among this population. Method: This study was conducted at an international college of a comprehensive university in central China. A total of ninety-two participants who met the inclusion criteria were recruited to participate in a single-blind randomized controlled trial, in which participants were not aware that there was an experimental group and a control group. Participants in control received daily psychological care weekly for 8 weeks (n = 46). Correspondingly, participants in experimental group received the positive emotional writing intervention on the basis of daily psychological care. Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and General Well-being Scale (GWB) were used to evaluate the effect of the intervention. Data from 89 students who completed the entire study (experimental group, n = 44; control group, n = 45) were analyzed. Results: After the intervention, the scores of SDS and SAS in the experimental group significantly decreased, while the subjective well-being score significantly increased. Although the SAS score of the control group after intervention was significantly lower than before, the decrease in SDS and SAS scores, as well as the increase in GWB score, were significantly greater in the experimental group than in the control group. Conclusion: The findings suggest that positive emotional writing can effectively reduce the depression and anxiety of international medical students, and significantly enhance their subjective well-being, providing ideas for management to solve the psychological problems of international medical students. Trial registration number: ChiCTR2400087815. Registered at Chinese Clinical Trial Registry. [ABSTRACT FROM AUTHOR]

This study aims to identify the conceptualisation of overall well-being used for well-being assessment through a review of the characteristics and key components and/or dimensions of well-being scales as presented in current literature. Scopus and Web of Science were searched, and thematic analysis was conducted inductively to analyse the identified components within scales, as well as the types of well-being these scales measure. 107 peer-reviewed articles from 2003 to 2022 were included, and 69 well-being scales were identified covering nine areas of well-being. Four final themes were identified as the foundational dimensions of overall well-being: hedonic; eudaimonic; physical health; and generic happiness. Notably, these 69 scales are mainly validated and adopted in the Western context. '4 + N' frameworks of overall well-being are recommended for assessing overall well-being. This review provides researchers with a synthesis of what types of well-being have been measured and which measures have been used to assess these types of well-being for which research participants. Non-Western-based well-being research is called for that incorporates a broader range of research participants and cultural contexts in contributing to a more inclusive understanding of well-being. [ABSTRACT FROM AUTHOR]

Classification of pathogenic E. coli has been focused either in mammalian host or infection site, which offers limited resolution. This review presents a comprehensive framework for classifying all E. coli branches within a single, unifying figure. This approach integrates established methods based on virulence factors, serotypes and clinical syndromes, offering a more nuanced and informative perspective on E. coli pathogenicity. The presence of the LEE island in pathogenic E. coli is a key genetic marker differentiating EHEC from STEC strains. The coexistence of stx and eae genes within the bacterial genome is a primary characteristic used to distinguish STEC from other pathogenic E. coli strains. The presence of the inv plasmid, Afa/Dr adhesins, CFA-CS-LT-ST and EAST1 are key distinguishing features for identifying pathogenic E. coli strains belonging to EIEC, DAEC, ETEC and EAEC pathotypes respectively. Food microbiological criteria differentiate pathogenic E. coli in food matrices. 'Zero-tolerance' applies to most ready-to-eat (RTE) foods due to high illness risk. Non-RTE foods' roles may allow limited E. coli presence, which expose consumers to potential risk; particularly from the concerning Shiga toxin-producing E. coli (STEC) strains, which can lead to life-threatening complications in humans, including haemolytic uremic syndrome (HUS) and even death in susceptible individuals. These findings suggest that decision-makers should consider incorporating the separate detection of STEC serotypes into food microbiological criteria, in addition to existing enumeration methods. Contamination of STEC is mainly linked to food consumption, therefore, outbreaks of E. coli STEC has been reviewed here and showed a link also to water as a potential contamination route. Since their discovery in 1982, over 39,787 STEC cases associated with 1,343 outbreaks have been documented. The majority of these outbreaks occurred in the Americas, followed by Europe, Asia and Africa. The most common serotypes identified among the outbreaks were O157, the 'Big Six' (O26, O45, O103, O111, O121, and O145), and other serotypes such as O55, O80, O101, O104, O116, O165, O174 and O183. This review provides valuable insights into the most prevalent serotypes implicated in STEC outbreaks and identifies gaps in microbiological criteria, particularly for E. coli non-O157 and non-Big Six serotypes. [ABSTRACT FROM AUTHOR]

Background: Cannabis use can generate potential avoidable harms, hence the need for effective preventive measures and treatment. Studies show the efficacy of harm reduction (HR) in minimizing undesirable consequences associated with this use. Despite its proven efficacy, HR in cannabis use remains poorly applied by many health and social services (HSS) practitioners, especially with young people. However, knowledge regarding the underlying reasons for this is limited. To fill this gap, we aimed to identify facilitators of and obstacles to HSS practitioners' adoption of HR in cannabis use across OECD countries. Methods: We conducted a scoping review, guided by Arksey and O'Malley's model. The search strategy, executed on health databases and in the grey literature, captured 1804 studies, of which 35 were retained. Data from these studies were extracted in summary sheets for qualitative and numerical analysis. Results: Facilitators and obstacles were grouped into four themes: stakeholders' characteristics (e.g., education, practice experience); clients' characteristics (e.g., personal, medical); factors related to HR (e.g., perceived efficacy, misconceptions); factors related to the workplace (e.g., type of workplace). Data were also extracted to describe the populations recruited in the selected studies: type of population, clientele, workplace. Conclusion: Several factors might facilitate or hinder HSS practitioners' adoption of HR in cannabis use. Taking these into consideration when translating knowledge about HR can improve its acceptability and applicability. Future research and action should focus on this when addressing practitioners' adoption of HR. [ABSTRACT FROM AUTHOR]

Assessing the prognosis of patients with aggressive non-Hodgkin B cell lymphoma mainly relies on a clinical risk score (IPI). Standard first-line therapies are based on a chemo-immunotherapy with rituximab, which mediates CD16-dependent antibody-dependent cellular cytotoxicity (ADCC). We phenotypically and functionally analyzed blood samples from 46 patients focusing on CD16+ NK cells, CD16+ T cells and CD16+ monocytes. Kaplan-Meier survival curves show a superior progression-free survival (PFS) for patients having more than 1.6% CD16+ T cells (p = 0.02; HR = 0.13 (0.007–0.67)) but an inferior PFS having more than 10.0% CD16+ monocytes (p = 0.0003; HR = 16.0 (3.1-291.9)) at diagnosis. Surprisingly, no correlation with NK cells was found. The increased risk of relapse in the presence of > 10.0% CD16+ monocytes is reversed by the simultaneous occurrence of > 1.6% CD16+ T cells. The unexpectedly strong protective function of CD16+ T cells could be explained by their high antibody-dependent cellular cytotoxicity as quantified by real-time killing assays and single-cell imaging. The combined analysis of CD16+ monocytes (> 10%) and CD16+ T cells (< 1.6%) provided a strong model with a Harrell's C index of 0.80 and a very strong power of 0.996 even with our sample size of 46 patients. CD16 assessment in the initial blood analysis is thus a precise marker for early relapse prediction. Highlights: High CD16+ T cell counts have a positive correlation with PFS in aggressive NHL/DLBCL patients (p = 0.02; HR = 0.13, 0.01–0.7). High CD16+ monocyte counts have a negative correlation with PFS in aggressive NHL/DLBCL patients (p = 0.0003; HR = 16.0, 3-292). The combined assessment of CD16+ T cells and CD16+ monocytes accurately predicts PFS in aggressive NHL/DLBCL patients. The strong protective function of CD16+ T cells could be explained by their high antibody-dependent cellular cytotoxicity. [ABSTRACT FROM AUTHOR]

Background: The loss of gait automaticity is a key cause of motor deficits in Parkinson's disease (PD) patients, even at the early stage of the disease. Action observation training (AOT) shows promise in enhancing gait automaticity. However, effective assessment methods are lacking. We aimed to propose a novel gait normalcy index based on dual task cost (NIDTC) and evaluate its validity and responsiveness for early-stage PD rehabilitation. Methods: Thirty early-stage PD patients were recruited and randomly assigned to the AOT or active control (CON) group. The proposed NIDTC during straight walking and turning tasks and clinical scale scores were measured before and after 12 weeks of rehabilitation. The correlations between the NIDTCs and clinical scores were analyzed with Pearson correlation coefficient analysis to evaluate the construct validity. The rehabilitative changes were assessed using repeated-measures ANOVA, while the responsiveness of NIDTC was further compared by t tests. Results: The turning-based NIDTC was significantly correlated with multiple clinical scales. Significant group-time interactions were observed for the turning-based NIDTC (F = 4.669, p = 0.042), BBS (F = 6.050, p = 0.022) and PDQ-39 (F = 7.772, p = 0.011) tests. The turning-based NIDTC reflected different rehabilitation effects between the AOT and CON groups, with the largest effect size (p = 0.020, Cohen's d = 0.933). Conclusion: The turning-based NIDTC exhibited the highest responsiveness for identifying gait automaticity improvement by providing a comprehensive representation of motor ability during dual tasks. It has great potential as a valid measure for early-stage PD diagnosis and rehabilitation assessment. Trial registration Chinese Clinical Trial Registry: ChiCTR2300067657 [ABSTRACT FROM AUTHOR]

Gulf War Illness (GWI) is a chronic multisymptom disorder that affects approximately 25–32% of Gulf War veterans and is characterized by a number of symptoms such as cognitive impairment, psychiatric disturbances, chronic fatigue and gastrointestinal distress, among others. While the exact etiology of GWI is unknown, it is believed to have been caused by toxic exposures encountered during deployment in combination with other factors such as stress. In the present study we sought to evaluate the hypothesis that exposure to the toxin permethrin could prime neuroinflammatory stress response and elicit psychiatric symptoms associated with GWI. Specifically, we developed a mouse model of GWI, to evaluate the effects of chronic permethrin exposure followed by unpredictable stress. We found that subjecting mice to 14 days of chronic permethrin exposure followed by 7 days of unpredictable stress resulted in the development of depression-like behavior. This behavioral change coincided with distinct alterations in the microglia phenotype, indicating microglial activation in the hippocampus. We revealed that blocking microglial activation through Gi inhibitory DREADD receptors in microglia effectively prevented the behavioral change associated with permethrin and stress exposure. To elucidate the transcriptional networks impacted within distinct microglia populations linked to depression-like behavior in mice exposed to both permethrin and stress, we conducted a single-cell RNA sequencing analysis using 21,566 single nuclei collected from the hippocampus of mice. For bioinformatics, UniCell Deconvolve was a pre-trained, interpretable, deep learning model used to deconvolve cell type fractions and predict cell identity across spatial datasets. Our bioinformatics analysis identified significant alterations in permethrin exposure followed by stress-associated microglia population, notably pathways related to neuronal development, neuronal communication, and neuronal morphogenesis, all of which are associated with neural synaptic plasticity. Additionally, we observed permethrin exposure followed by stress-mediated changes in signal transduction, including modulation of chemical synaptic transmission, regulation of neurotransmitter receptors, and regulation of postsynaptic neurotransmitter receptor activity, a known contributor to the pathophysiology of depression in a subset of the hippocampal pyramidal neurons in CA3 subregions. Our findings tentatively suggest that permethrin may prime microglia towards a state of inflammatory activation that can be triggered by psychological stressors, resulting in depression-like behavior and alterations of neural plasticity. These findings underscore the significance of synergistic interactions between multi-causal factors associated with GWI. [ABSTRACT FROM AUTHOR]

Background: Perceived Stress has been shown as a key contributor to sleep quality, but the underlying mechanism between perceived stress and sleep quality remains unknown. This study aimed to investigate the impact of perceived stress on sleep quality of college students and the chain mediating roles of presence of meaning in life (PML) and depression, as well as the moderating role of search for meaning in life (SML). Methods: Participants were 8178 college students (4599 boys and 3579 girls; Mage = 19.10 years, SD = 1.08) who completed self-report questionnaire, including the Perceived Stress Scale (PSS), the Pittsburgh Sleep Quality Index (PSQI), the Meaning in Life Questionnaire (MLQ), and the Patient Health Questionnaire-9 (PHQ-9). Results: The results showed that higher perceived stress was directly related to poorer sleep quality. This negative impact on sleep quality was mediated through the chained roles of PML and depression. Additionally, the study found that SML moderates the influence of perceived stress, PML and depression on sleep quality. Specifically, for individuals actively search for meaning, the adverse effects of perceived stress and depression on sleep quality are diminished. Concurrently, the positive influence of PML on sleep quality is enhanced. Conclusion: This study revealed that the PML and depression mediate the effect of perceived stress on sleep quality, with SML playing a significant protective role. These results emphasize the necessity of integrating strategies to enhance PML and SML into interventions designed to improve emotion management and sleep quality among college students. [ABSTRACT FROM AUTHOR]

CD8+ T cells are the workhorses executing adaptive anti-tumour response, and targets of various cancer immunotherapies. Latest advances have unearthed the sheer heterogeneity of CD8+ tumour infiltrating lymphocytes, and made it increasingly clear that the bulk of the endogenous and therapeutically induced tumour-suppressive momentum hinges on a particular selection of CD8+ T cells with advantageous attributes, namely the memory and stem-like exhausted subsets. A scrutiny of the contemporary perception of CD8+ T cells in cancer and the subgroups of interest along with the factors arbitrating their infiltration contextures, presented herein, may serve as the groundwork for future endeavours to probe further into the regulatory networks underlying their differentiation and migration, and optimise T cell-based immunotherapies accordingly. [ABSTRACT FROM AUTHOR]

Background: Depressive symptoms among nurses have been a significant public health concern. Although many studies have demonstrated the potential relationship between interpersonal conflict at work and depressive symptoms, the mechanisms underlying this relationship among nurses remain unclear. Based on the theoretical and empirical research, this study aimed to investigate the multiple mediating effects of negative emotion at work and meaning in life on the relationship between interpersonal conflict at work and depressive symptoms among nurses. Methods: An online multicenter cross-sectional study was conducted in 15 hospitals from different geographical areas of Hunan Province, China, from December 2021 to February 2022. A total of 1754 nurses completed validated self-reported questionnaires, including their sociodemographic information, interpersonal conflict at work, negative emotions at work, meaning in life, and depressive symptoms. Descriptive statistics analysis, Spearman's correlation analysis, multiple linear regression analysis, and chain mediation analysis were performed using IBM SPSS software (version 29) and Mplus software (version 8). Results: There were significant correlations between interpersonal conflict at work, negative emotions at work, meaning in life, and depressive symptoms (r = -0.206 ~ 0.518, all p < 0.01). Interpersonal conflict at work had a statistically significantly direct effect on depressive symptoms (β = 0.061; 95% confidence interval, CI: 0.011 ~ 0.126, p = 0.039). Analysis of mediating effects revealed that interpersonal conflict at work also influenced depressive symptoms through two statistically significantly indirect pathways: (a) the mediating effect of negative emotions at work (β = 0.167; 95% CI: 0.138 ~ 0.195, p < 0.001) and (b) the chain mediating effect between negative emotions at work and meaning in life (β = 0.008; 95% CI: 0.003 ~ 0.013, p = 0.005). Conclusion: Interpersonal conflict at work has a direct positive effect on depressive symptoms among nurses. Meanwhile, interpersonal conflict at work can influence depressive symptoms among nurses through the mediating effect of negative emotions at work and the chain mediating effect between negative emotions at work and meaning in life. [ABSTRACT FROM AUTHOR]

Background: Teachers are recognized as 'key agents' for the delivery of physical activity programs and policies in schools. The aim of our study was to develop and evaluate a tool to assess teachers' capability, opportunity, and motivation to deliver school-based physical activity interventions. Methods: The development and evaluation of the Capability, Opportunity, and Motivation to deliver Physical Activity in School Scale (COM-PASS) involved three phases. In Phase 1, we invited academic experts to participate in a Delphi study to rate, provide recommendations, and achieve consensus on questionnaire items that were based on the Capability, Opportunity, and Motivation Behavior (COM-B) model. Each item was ranked on the degree to which it matched the content of the COM-B model, using a 5-point scale ranging from '1 = Poor match' to '5 = Excellent match'. In Phase 2, we interviewed primary and secondary school teachers using a 'think-aloud' approach to assess their understanding of the items. In Phase 3, teachers (n = 196) completed the COM-PASS to assess structural validity using confirmatory factor analysis (CFA). Results: Thirty-eight academic experts from 14 countries completed three rounds of the Delphi study. In the first round, items had an average rating score of 4.04, in the second round 4.51, and in the third (final) round 4.78. The final tool included 14 items, which related to the six constructs of the COM-B model: physical capability, psychological capability, physical opportunity, social opportunity, reflective motivation, and automatic motivation. In Phase 2, ten teachers shared their interpretation of COM-PASS via a 20-min interview, which resulted in minor changes. In Phase 3, CFA of the 3-factor model (i.e., capability, opportunity, and motivation) revealed an adequate fit to the data (χ2 = 122.6, p <.001, CFI =.945, TLI =.924, RMSEA =.066). The internal consistencies of the three subscale scores were acceptable (i.e., capability: α =.75, opportunity: α =.75, motivation: α =.81). Conclusion: COM-PASS is a valid and reliable tool for assessing teachers' capability, opportunity, and motivation to deliver physical activity interventions in schools. Further studies examining additional psychometric properties of the COM-PASS are warranted. [ABSTRACT FROM AUTHOR]

Background: Physical activity combined with virtual reality and exergaming has emerged as a new technique to improve engagement and provide clinical benefit for gait and balance disorders in people with Parkinson's disease (PD). Objective: To investigate the effects of a training protocol using a home-based exergaming system on brain volume and resting-state functional connectivity (rs-FC) in persons with PD. Methods: A single blind randomized controlled trial was conducted in people with PD with gait and/or balance disorders. The experimental (active) group performed 18 training sessions at home by playing a custom-designed exergame with full body movements, standing in front of a RGB-D Kinect® motion sensor, while the control group played using the computer keyboard. Both groups received the same training program. Clinical scales, gait recordings, and brain MRI were performed before and after training. We assessed the effects of both training on both the grey matter volumes (GVM) and rs-FC, within and between groups. Results: Twenty-three patients were enrolled and randomly assigned to either the active (n = 11) or control (n = 12) training groups. Comparing pre- to post-training, the active group showed significant improvements in gait and balance disorders, with decreased rs-FC between the sensorimotor, attentional and basal ganglia networks, but with an increase between the cerebellar and basal ganglia networks. In contrast, the control group showed no significant changes, and rs-FC significantly decreased in the mesolimbic and visuospatial cerebellar and basal ganglia networks. Post-training, the rs-FC was greater in the active relative to the control group between the basal ganglia, motor cortical and cerebellar areas, and bilaterally between the insula and the inferior temporal lobe. Conversely, rs FC was lower in the active relative to the control group between the pedunculopontine nucleus and cerebellar areas, between the temporal inferior lobes and the right thalamus, between the left putamen and dorsolateral prefrontal cortex, and within the default mode network. Conclusions: Full-body movement training using a customized exergame induced brain rs-FC changes within the sensorimotor, attentional and cerebellar networks in people with PD. Further research is needed to comprehensively understand the neurophysiological effects of such training approaches. Trial registration ClinicalTrials.gov NCT03560089. [ABSTRACT FROM AUTHOR]

Thrombocytopenia frequently occurs in patients with sepsis. Disseminated intravascular coagulation (DIC) may be a possible cause of thrombocytopenia owing to its high prevalence and association with poor outcomes; however, it is important to keep the presence of other diseases in mind in sepsis practice. Thrombotic microangiopathy (TMA), which is characterized by thrombotic thrombocytopenic purpura, Shiga toxin-producing Escherichia coli hemolytic uremic syndrome (HUS), and complement-mediated HUS, is characterized by thrombocytopenia, microangiopathic hemolytic anemia, and organ damage. TMA has become widely recognized in recent years because of the development of specific treatments. Previous studies have reported a remarkably lower prevalence of TMA than DIC; however, its epidemiology is not well defined, and there may be cases in which TMA is not correctly diagnosed, resulting in poor outcomes. Therefore, it is important to differentiate DIC from TMA. Nevertheless, differentiating between DIC and TMA remains a challenge as indicated by previous reports that most patients with TMA can be diagnosed as DIC using the universal coagulation scoring system. Several algorithms to differentiate sepsis-related DIC from TMA have been suggested, contributing to improving the care of septic patients with thrombocytopenia; however, it may be difficult to apply these algorithms to patients with coexisting DIC and TMA, which has recently been reported. This review describes the disease characteristics, including epidemiology, pathophysiology, and treatment, of DIC, TMA, and other diseases with thrombocytopenia and proposes a novel practical approach flow, which is characterized by the initiation of the diagnosis of TMA in parallel with the diagnosis of DIC. This practical flow also refers to the longitudinal diagnosis and treatment flow with TMA in mind and real clinical timeframes. In conclusion, we aim to widely disseminate the results of this review that emphasize the importance of incorporating consideration of TMA in the management of septic DIC. We anticipate that this practical new approach for the diagnostic and treatment flow will lead to the appropriate diagnosis and treatment of complex cases, improve patient outcomes, and generate new epidemiological evidence regarding TMA. [ABSTRACT FROM AUTHOR]

Background: The promotion of daily breakfast consumption and the importance of making appropriate breakfast choices have been underscored as significant public health messages. The aim of this study was to examine the relationship between breakfast frequency and life satisfaction in large and representative samples of school-going children and adolescents aged 10–17 years from 42 different countries. Methods: This study used information from the 2017/2018 Health Behavior in School-aged Children study, comprising nationally representative samples of children and adolescents aged 10–17 years who were attending school. The total number of participants from the 42 countries included in the study was 155,451 (51.3% girls). The evaluation of breakfast consumption in this study involved a specific question: "How often do you typically have breakfast (more than a glass of milk or fruit juice)?". To measure life satisfaction, a subjective assessment scale was used in the form of a ladder, visually spanning from 0 to 10. On this scale, the topmost point (10) denotes the highest conceivable quality of life, whereas the bottom point (0) represents the worst imaginable quality of life. Results: After adjusting for several covariates, the lowest estimated marginal mean of life satisfaction was identified in those participants who skipped breakfast (mean [M] = 5.6, 95% confidence interval [CI] 5.5 to 5.8). Conversely, the highest estimated marginal mean of life satisfaction was observed in those who had breakfast every day (M = 6.5, 95% CI 6.3 to 6.6). Overall, a nearly linear relationship between higher frequency of breakfast and greater life satisfaction in children and adolescents was identified (p-for-trend < 0.001). In addition, the highest estimated marginal mean of life satisfaction score was identified in those participants from Portugal who had breakfast every day (M = 7.7; 95% CI 6.9 to 8.5 points). Conversely, the lowest estimated marginal mean of life satisfaction was observed in those participants from Romania who no breakfast (M = 3.5; 95% CI 2.6 to 4.4 points). Conclusions: There is a nearly linear relationship between higher frequency of breakfast and greater life satisfaction in children and adolescents. Considering the potential health advantages associated with breakfast during this critical age phase, these findings imply the necessity for additional global efforts to promote increased breakfast consumption among children and adolescents. [ABSTRACT FROM AUTHOR]

Background: Maintaining static balance is relevant and common in everyday life and it depends on a correct intersegmental coordination. A change or reduction in postural capacity has been linked to increased risk of falls. People with Parkinson's disease (pwPD) experience motor symptoms affecting the maintenance of a stable posture. The aim of the study is to understand the intersegmental changes in postural sway and to apply a trend change analysis to uncover different movement strategies between pwPD and healthy adults. Methods: In total, 61 healthy participants, 40 young (YO), 21 old participants (OP), and 29 pwPD (13 during medication off, PDoff; 23 during medication on, PDon) were included. Participants stood quietly for 10 s as part of the Short Physical Performance Battery. Inertial measurement units (IMU) at the head, sternum, and lumbar region were used to extract postural parameters and a trend change analysis (TCA) was performed to compare between groups. Objective: This study aims to explore the potential application of TCA for the assessment of postural stability using IMUs, and secondly, to employ this analysis within the context of neurological diseases, specifically Parkinson's disease. Results: Comparison of sensors locations revealed significant differences between head, sternum and pelvis for almost all parameters and cohorts. When comparing PDon and PDoff, the TCA revealed differences that were not seen by any other parameter. Conclusions: While all parameters could differentiate between sensor locations, no group differences could be uncovered except for the TCA that allowed to distinguish between the PD on/off. The potential of the TCA to assess disease progression, response to treatment or even the prodromal PD phase should be explored in future studies. Trial registration: The research procedure was approved by the ethical committee of the Medical Faculty of Kiel University (D438/18). The study is registered in the German Clinical Trials Register (DRKS00022998). [ABSTRACT FROM AUTHOR]

Gamma delta (γδ) T cells demonstrate strong cytotoxicity against diverse cancer cell types in an MHC-independent manner, rendering them promising contenders for cancer therapy. Although amplification and adoptive transfer of γδ T cells are being evaluated in the clinic, their therapeutic efficacy remains unsatisfactory, primarily due to the influence of the immunosuppressive tumor microenvironment (TME). Currently, the utilization of targeted therapeutic antibodies against inhibitory immune checkpoint (ICP) molecules is a viable approach to counteract the immunosuppressive consequences of the TME. Notably, PD-1/PD-L1 checkpoint inhibitors are considered primary treatment options for diverse malignancies, with the objective of preserving the response of αβ T cells. However, γδ T cells also infiltrate various human cancers and are important participants in cancer immunity, thereby influencing patient prognosis. Hence, it is imperative to comprehend the reciprocal impact of the PD-1/PD-L1 axis on γδ T cells. This understanding can serve as a therapeutic foundation for improving γδ T cells adoptive transfer therapy and may offer a novel avenue for future combined immunotherapeutic approaches. [ABSTRACT FROM AUTHOR]

Background: Methylenedioxymethamphetamine (MDMA) is a popular drug worldwide and use is prevalent in Aotearoa New Zealand. Although associated with some significant harms, including fatalities, MDMA is ultimately less harmful than other commonly consumed drugs. We aimed to expand the understanding of MDMA harm and harm reduction strategies from a consumer perspective so that national harm reduction efforts can be better informed. Methods: We conducted 14 semi-structured focus group discussions including 60 people (aged 18–67, median = 21) who use MDMA in the Southern region of Aotearoa New Zealand to explore their thoughts and experiences regarding MDMA associated harm and harm reduction. Reflexive thematic analysis was conducted from a critical realist perspective. Results: Five themes were generated; (1) Mindset and setting matters; (2) Looking after your body and mind, not overdoing it; (3) Other substances increase risk and harm; (4) Trusted friends and peers are protective; and (5) Valid information is key for healthy self-determination; and one subtheme 5.1) Drug checking is essential harm reduction. Conclusions: We discuss the implications for MDMA consumers and aim to inform national drug policy and the harm reduction practices of consumers and organisations, for the ultimate purpose of reducing MDMA-related harm in Aotearoa New Zealand. [ABSTRACT FROM AUTHOR]

Background: Meaning in life is a widely accepted aim in promoting psychosocial health in institutional care. However, how caregiver interaction and perceived control impact meaning in life among the elderly remains unclear. This study explores the effect of institutional caregiver interaction, family caregiver interaction, and perceived control on meaning in life among elderly residents in China, and the potential moderating effect of elderly-to-social worker ratio in these associations. Methods: Multistage random sampling was used to recruit a sample of 452 elderly residents from 4 elderly care homes in urban China. A structural equation model was used to test the study hypothesis. Results: Institutional caregiver interaction is positively related to meaning in life, and perceived control among elderly residents has a positive impact on meaning in life. Moreover, the elderly-to-social worker ratio moderated the relationship between institutional caregiver interaction and meaning in life, as well as between family caregiver interaction and meaning in life. Conclusions: Increase elderly's meaning in life is an important service target for the caring professions in institutional care. Social workers affect the effectiveness of interventions on elderly's meaning in life in institutional care. A higher elderly-to-social worker ratio could improve the effectiveness of interventions on meaning in life for elderly residents. [ABSTRACT FROM AUTHOR]

Background: Multiple neurodegenerative diseases are induced by the formation and deposition of protein aggregates. In particular, the microtubule-associated protein Tau leads to the development of so-called tauopathies characterized by the aggregation of hyperphosphorylated Tau within neurons. We recently showed that the constitutive activity of the serotonin receptor 7 (5-HT7R) is required for Tau hyperphosphorylation and aggregation through activation of the cyclin-dependent kinase 5 (CDK5). We also demonstrated physical interaction between 5-HT7R and CDK5 at the plasma membrane suggesting that the 5-HT7R/CDK5 complex is an integral part of the signaling network involved in Tau-mediated pathology. Methods: Using biochemical, microscopic, molecular biological, computational and AI-based approaches, we investigated structural requirements for the formation of 5-HT7R/CDK5 complex. Results: We demonstrated that 5-HT7R domains responsible for coupling to Gs proteins are not involved in receptor interaction with CDK5. We also created a structural model of the 5-HT7R/CDK5 complex and refined the interaction interface. The model predicted two conserved phenylalanine residues, F278 and F281, within the third intracellular loop of 5-HT7R to be potentially important for complex formation. While site-directed mutagenesis of these residues did not influence Gs protein-mediated receptor signaling, replacement of both phenylalanines by alanine residues significantly reduced 5-HT7R/CDK5 interaction and receptor-mediated CDK5 activation, leading to reduced Tau hyperphosphorylation and aggregation. Molecular dynamics simulations of 5-HT7R/CDK5 complex for wild-type and receptor mutants confirmed binding interface stability of the initial model. Conclusions: Our results provide a structural basis for the development of novel drugs targeting the 5-HT7R/CDK5 interaction interface for the selective treatment of Tau-related disorders, including frontotemporal dementia and Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Background: There is a lack of measures and data on interpersonal mindfulness from non-Western cultures, which can hinder advances in our understanding of the construct, its conceptual representation, and its effects on human connection and relationships within different cultural settings. To fill this gap and help spark future research in this area in the Arab world, the current study aimed to examine the psychometric properties of an Arabic translation of the 27-item and the 13-item versions of the interpersonal Mindfulness Scale (IMS) in a sample of Arabic-speaking adolescents from the general population. Methods: A web-based survey was conducted in a sample of 527 Lebanese community adolescents (Mean age = 15.73 ± 1.81 years; 56% females). The IMS was translated from English into Arabic using the forward-backward translation method. Participants completed the long and short forms of the IMS, as well as the Buss–Perry Aggression Questionnaire-Short Form (BPAQ-SF), and the 5-item Brief Irritability Test. Results: Confirmatory factor analyses provided support to the four-factor structure of both the 27-item and the 13-item IMS (i.e., Presence, Awareness of Self and Others, Nonjudgmental Acceptance, and Nonreactivity). The original and the short form versions of the IMS yielded excellent internal consistency in our sample, with a Cronbach's α coefficients of 0.95 and 0.90, and McDonald's omega coefficients of 0.95 and 0.90, respectively. Multigroup comparisons suggested the factorial invariance of the Arabic 27-item and 13-item IMS between male and female participants at the metric, configural, and scalar levels. Finally, the concurrent validity of both full-length and short form of the IMS appeared to be good and comparable, as attested by patterns of correlations in expected directions with outcome variables (i.e., aggression, anger, hostility, and irritability). Conclusion: The present findings provide support for the good psychometric qualities of the Arabic translation of the IMS in both long and short forms, suggesting that these scales are suitable for use to measure interpersonal mindfulness in Arabic-speaking youth, at least in Lebanon. We expect that the IMS, in particular its shortest form, will prompt more systematic investigation of interpersonal mindfulness in the Arabic-speaking populations, especially with regard to enhancing healthy communications with others and building effective social relationships. [ABSTRACT FROM AUTHOR]

Background: Clinical guidelines for people with Parkinson's disease (pwPD) stress that, complementary to pharmacological treatment, exercise and physiotherapy should be given a central role in disease management. Adhering to regular exercise of the right type, and with high repetition, remains a challenge for pwPD. Exergaming has the potential to increase adherence through play and personalised interventions, both in clinic and at home. Reality DTx® is an augmented-reality (AR) home-based gait-and-balance exergaming intervention specifically designed for pwPD as an extension of supervised physiotherapy. The primary objective of this study is to evaluate the feasibility and potential efficacy of Reality DTx®. Methods: Twenty-four pwPD (Hoehn and Yahr stages 2–4) with self-reported gait and/or balance impairments will participate in this study. The study comprises a 6-week waitlist-controlled AR home-based therapeutic gait-and-balance exergaming intervention. Reality DTx® will initially be prescribed remotely for a minimum of 5 days a week for 30 min per day. We will remotely set and adjust the frequency, difficulty, type of games, and/or duration weekly, based on objective and subjective data from the AR glasses and participant, respectively. In addition to the home-based gait-and-balance exergaming intervention, the study comprises three laboratory visits: before the 6-week waitlist period (t0; baseline), before the 6-week intervention period (t1; pre-intervention), and after the 6-week intervention period (t2; post-intervention). The primary study parameters are feasibility (in terms of safety, adherence, and user experience) and potential efficacy for improving gait and balance (using standard clinical gait-and-balance tests and a targeted walking-related fall-risk assessment). Recruitment started in December 2022 and the final post-intervention assessment will be according to planning in July 2023. Conclusions: This clinical feasibility trial is the first remotely prescribed and monitored home-based AR gait-and-balance exergaming intervention for pwPD. The results in terms of clinical feasibility (i.e. safety, adherence, and user experience) and potential efficacy (gait, balance, and fall-risk outcomes) form the basis for future randomised controlled studies on the effectiveness of home-based AR gait-and-balance exergaming interventions for pwPD. Trial registration: ClinicalTrials.gov, NCT05605249. Registered on 4 November 2022. [ABSTRACT FROM AUTHOR]

Background Globally, economically developed countries face similar ageing demographics and the challenge of a ‘care gap’, yet they vary due to different care and formal support systems, and different cultural and societal norms around illness and care. The aim of this exploratory study was to examine cross-country variations in caregiver motivations, willingness, values, meaning in life, illness beliefs, and experiences of wellbeing, gain, health-related quality of life, burden and depression, across 6 European countries and Israel. Cross-country differences in the abovementioned informal caregiver experiences are rarely described. Methods An online survey (ENTWINE-iCohort) was conducted using validated measures wherever possible. This paper utilises data from 879 caregivers and seven countries (Greece, Italy, the Netherlands, Poland, Sweden, the UK, and Israel). Results No consistent finding supporting the concurrent relationship between caregiver support policies/ country culture and caregiver motivations/willingness was found. Caregivers in countries typically characterised by individualist cultures reported lower familism, higher self-enhancement values, and greater perceived illness threat compared to more collectivist countries. Search for meaning was higher in poorer countries than in wealthier countries. Higher negative caregiver experiences (e.g., burden) and lower positive experiences (e.g., wellbeing) were generally observed in countries with underdeveloped caregiver support as compared to countries with more developed formal support systems. Conclusions Cross-country variations can be explained to varying degrees by national policies around care (or their absence) and country cultural contexts. The results emphasise the importance of formal support services for achieving positive caregiver experiences, and help inform the development of policies and measures to support caregivers in Europe and Israel. [ABSTRACT FROM AUTHOR]

Background: 3,4-Methylenedioxymethamphetamine (MDMA) is drug of high prevalence in Aotearoa New Zealand and is the primary drug analysed by legal drug checking services. We aimed to address the gap in literature pertaining to MDMA-related harm reduction behaviour and harm experiences within the country. Methods: An online survey was used to assess the harm reduction behaviours (e.g., limiting consumption, planning use, seeking information) of people who use MDMA, in addition to their use of reagent testing and the major national drug checking and harm reduction service, KnowYourStuffNZ. Results: In total, 915 people completed the survey (60.7% females, aged 18–65, median = 24, IQR = 20–28). Frequency of various MDMA-related harm reduction behaviours differed, although these were carried out relatively frequently by most participants. Those who reported experiencing harm (physical, psychological, spiritual, social) from MDMA, or another drug presumed to be MDMA, reported less frequent harm reduction behaviours than non-harmed consumers. Reagent testing of MDMA had been conducted by 42.3% of the sample. Approximately 27% of the sample had used KnowYourStuffNZ services. Of KnowYourStuffNZ clients, 95.9% reported learning about harm reduction, and 53.3% reported changing their behaviour because of the service. Reasons for not using the KnowYourStuffNZ service were primarily lack of availability in local area (32.8%) or at relevant events (51.8%), and lack of concern with substance quality (29.8%). MDMA harm was reported by 14.4% of the sample, whilst reported harm was more common from consumption of presumably non-MDMA substances, self-reported as being mistaken for MDMA. Harm was primarily physical or psychological. Potential MDMA dependence was apparent in 6.9% of the sample. Conclusions: The findings highlight potential targets for harm reduction education and interventions and emphasize the need for greater availability of readily accessible drug checking services in Aotearoa New Zealand. [ABSTRACT FROM AUTHOR]

Individuals exhibiting restrained eating behaviors demonstrate increased inhibitory control when exposed to food-related stimuli, indicating the presence of an automatic food-inhibition association. Existing literature proposes that this association contributes to the devaluation of food within this population. Efforts to disrupt this association by promoting the complete elimination of the inhibition of food responses have resulted in increased food consumption but have also led to heightened food-related anxiety in individuals with restrained eating behaviors. In the current investigation, we investigated whether a novel flexible food response/inhibition computerized task could yield favorable changes in attitudes toward food in individuals with restrained eating. We randomly assigned 78 females who engage in restrained eating to one of three training groups. In the flexible response/inhibition group, participants were instructed to equally inhibit or respond to food stimuli. In the response group, participants consistently responded to food stimuli, while in the inhibition group, participants consistently inhibited their response to food cues. Implicit attitudes toward food were assessed both before and after the manipulation. To examine the stability of the effect of the training, participants also engaged in a seemingly unrelated bogus taste test. Our results revealed that only the flexible response/inhibition group demonstrated a significant improvement in positive attitudes toward high-calorie foods after eating, while there were no observable changes in negative attitudes among the other two groups. These findings suggest that promoting a balance between the responding and inhibiting responses to food stimuli can increase positive attitudes toward food amongst individuals with restrained eating.Plain English Summary: Restrained eaters are individuals who chronically avoid eating to reduce their weight. Researchers have found that these individuals also hold negative attitudes toward food. This may be because of the association created between food and inhibition, our ability to stop an urge or behavior. Researchers attempted to promote healthy eating by training individuals to associate food with disinhibition. This resulted in higher food consumption but it also increased negative attitudes toward food in those individuals. We propose that this is because disinhibition of food is not consistent with the internal goals of these individuals. The current study tested whether training individuals who restrict their eating to respond more flexibly to food would increase positive attitudes toward food. Therefore, we recruited 78 females who restrict their eating into three groups: one where participants were asked to either respond or inhibit their response to images of food in a computerized task, one where participants were asked to respond to all food images, and one where participants were asked to inhibit their response to all food images. We found that only the flexible group showed more positive attitudes toward food. There were no noticeable changes in the attitudes of the other two groups. These findings suggest that encouraging flexible responses/inhibition to food enhances positive attitudes toward food in individuals who restrict their eating. [ABSTRACT FROM AUTHOR]

Most anti-cancer modalities are designed to directly kill cancer cells deploying mechanisms of action (MOAs) centered on the presence of a precise target on cancer cells. The efficacy of these approaches is limited because the rapidly evolving genetics of neoplasia swiftly circumvents the MOA generating therapy-resistant cancer cell clones. Other modalities engage endogenous anti-cancer mechanisms by activating the multi-cellular network (MCN) surrounding neoplastic cells in the tumor microenvironment (TME). These modalities hold a better chance of success because they activate numerous types of immune effector cells that deploy distinct cytotoxic MOAs. This in turn decreases the chance of developing treatment-resistance. Engagement of the MCN can be attained through activation of immune effector cells that in turn kill cancer cells or when direct cancer killing is complemented by the production of proinflammatory factors that secondarily recruit and activate immune effector cells. For instance, adoptive cell therapy (ACT) supplements cancer cell killing with the release of homeostatic and pro-inflammatory cytokines by the immune cells and damage associated molecular patterns (DAMPs) by dying cancer cells. The latter phenomenon, referred to as immunogenic cell death (ICD), results in an exponential escalation of anti-cancer MOAs at the tumor site. Other approaches can also induce exponential cancer killing by engaging the MCN of the TME through the release of DAMPs and additional pro-inflammatory factors by dying cancer cells. In this commentary, we will review the basic principles that support emerging paradigms likely to significantly improve the efficacy of anti-cancer therapy. [ABSTRACT FROM AUTHOR]

Background: Mounting evidence suggests that the effectiveness of positive psychology interventions is influenced by a variety of factors, including cultural context. Identifying intervention targets that can effectively contribute to improving individual well-being under these boundary conditions is a crucial step when developing viable interventions. To this end, we examined how gratitude disposition, self-esteem, and optimism relate to the subjective well-being (SWB) and psychological well-being (PWB) of Japanese individuals. Methods: Multivariate regression analysis was employed to quantify the unique relationships between the three potential intervention targets and both SWB and PWB, while accounting for the influence of other variables. Participants (N = 71) also engaged in a 4-week experience sampling study to explore how gratitude, self-esteem and optimism shape the link between momentary affective states in everyday life and evaluations of day satisfaction. Results: Multivariate regression analysis revealed that self-esteem was predominantly more strongly associated with SWB compared to gratitude disposition, whereas gratitude disposition was more strongly associated with the PWB dimensions, particularly personal growth, positive relations with others and purpose in life. Experience sampling data indicated that while both gratitude disposition and self-esteem moderated the association between momentary positive affect and day satisfaction evaluations, they did so in opposite ways; greater gratitude disposition strengthened the association, while greater self-esteem weakened it. Conclusions: Overall, the current results suggest that while gratitude, self-esteem, and optimism influence individual well-being as a whole, they likely play distinct roles in facilitating SWB and PWB in the studied cohort. [ABSTRACT FROM AUTHOR]

Background: This study focuses on college students as research subjects, exploring the relationship between fear of evaluation, ambivalence over emotional expression, and self-care, as well as the moderating effect of self-care on the prediction of ambivalence over emotional expression by fear of evaluation. Methods: This study selected physical education college students in Sichuan Province as the research participants. Convenience sampling was used to recruit participants through public recruitment information and questionnaire links on online platforms commonly used by college students. The questionnaire was distributed at two different time points to reduce the effect of common method bias. A total of 858 questionnaires were distributed, after excluding duplicate responses, a total of 743 valid questionnaires were obtained. Results: The result as following: (1) College students exhibit a moderate to high level of negative fear of evaluation, ambivalence over emotional expression, and self-care, with female students having higher negative fear of evaluation; (2) There are significant correlations between fear of evaluation, ambivalence over emotional expression, and self-care; (3) Fear of evaluation and self-care can predict ambivalence over emotional expression, but self-care does not have a moderating effect on the prediction of ambivalence over emotional expression by fear of evaluation; (4) Self-care and negative self-care both have a moderating effect on the prediction of emotion rumination by positive fear of evaluation. Conclusions: In the past, rumination has often been considered a manifestation of excessive rumination and anxiety. However, this study found that self-compassion's modulation on fear of positive evaluation intensifies its impact on emotional rumination. Research suggests that moderate emotional rumination may not necessarily be a negative outcome and reflects a positive emotional adjustment process to some extent. Therefore, future studies can further explore the growth and decline of internal rumination processes in self-compassion or counseling, and potentially gain a better understanding of key elements of personal growth. [ABSTRACT FROM AUTHOR]

Background: In diabetic retinopathy (DR), hypoxia-inducible factor (HIF-1α) induces oxidative stress by upregulating glycolysis. This process leads to neurodegeneration, particularly photoreceptor cell damage, which further contributes to retinal microvascular deterioration. Further, the regulation of Wnt-inhibitory factor 1 (WIF1), a secreted Wnt signaling antagonist, has not been fully characterized in neurodegenerative eye diseases. We aimed to explore the impact of WIF1 on photoreceptor function within the context of DR. Method: Twelve-week-old C57BL/KsJ-db/db mice were intravitreally injected with WIF1 overexpression lentivirus. After 4 weeks, optical coherence tomography (OCT), transmission electron microscopy (TEM), H&E staining, and electroretinography (ERG) were used to assess the retinal tissue and function. The potential mechanism of action of WIF1 in photoreceptor cells was explored using single-cell RNA sequencing. Under high-glucose conditions, 661 W cells were used as an in vitro DR model. WIF1-mediated signaling pathway components were assessed using quantitative real-time PCR, immunostaining, and western blotting. Result: Typical diabetic manifestations were observed in db/db mice. Notably, the expression of WIF1 was decreased at the mRNA and protein levels. These pathological manifestations and visual function improved after WIF1 overexpression in db/db mice. TEM demonstrated that WIF1 restored damaged mitochondria, the Golgi apparatus, and photoreceptor outer segments. Moreover, ERG indicated the recovery of a-wave potential amplitude. Single-cell RNA sequencing and in vitro experiments suggested that WIF1 overexpression prevented the expression of glycolytic enzymes and lactate production by inhibiting the canonical Wnt signaling pathway, HIF-1α, and Glut1, thereby reducing retinal and cellular reactive oxygen species levels and maintaining 661 W cell viability. Conclusions: WIF1 exerts an inhibitory effect on the Wnt/β-catenin-HIF-1α-Glut1 glycolytic pathway, thereby alleviating oxidative stress levels and mitigating pathological structural characteristics in retinal photoreceptor cells. This mechanism helps preserve the function of photoreceptor cells in DR and indicates that WIF1 holds promise as a potential therapeutic candidate for DR and other neurodegenerative ocular disorders. Highlights: WIF1 inhibits HIF-1α-Glut1 glycolytic pathway in photoreceptor cells Improves oxidative stress and ameliorates pathological structural characteristics. Helps preserve the function of photoreceptor cells in diabetic retinopathy WIF1 is an excellent candidate for targeted therapy against diabetic retinopathy. [ABSTRACT FROM AUTHOR]

Improving mental wellbeing is often targeted with behavioral interventions, while mindset interventions might be more appealing as they require less time and effort. In addition to recent experimental studies demonstrating that attributional beliefs can be changed to improve emotional wellbeing and performance, the current study examines whether a positive change in people's beliefs about stress and life philosophy enhances emotional, social and psychological wellbeing using brief educational interventions. Two parallel double-blind randomized controlled trials were conducted. Study 1 (N = 106; 62.3% female, mean age 36.0) compared an educational video about the benefits of a stress-is-enhancing mindset versus an active control video. In Study 2 (N = 136; 57.4% female, mean age 35.7), educational texts about the benefits of a stress-is-enhancing mindset and holding a life-is-long-and-easy mindset were compared to an active control text. Results of multilevel growth curve modeling showed that a stress mindset could be significantly changed using an educational video or text, while the change in the philosophies of life mindset did not significantly differ between conditions. Furthermore, none of the manipulations were able to sustain the positive change in mindset which might explain why there was no significant increase in mental wellbeing compared to control. To have a lasting effect on people's mental wellbeing, a change in mindset might need to be embodied in everyday life. Future research should investigate simple versus intensive interventions with longer follow-up time to examine whether and how a mindset can be sustainably changed to promote flourishing mental health in the general population. [ABSTRACT FROM AUTHOR]

Background: Access to palliative care is often limited for challenging and vulnerable groups, including persons with substance use disorders. However, with optimized healthcare options and liberal substitution policies, this patient group is likely to increase over the upcoming years, and comorbidities will also influence the need for palliative support. Here, we aim at analyzing characteristics and specific challenges associated with substance use disorders (SUD) in palliative care. Methods: We retrospectively reviewed all patients diagnosed with substance use disorder that were treated at our Competence Center Palliative Care within the University Hospital Zurich, Switzerland between 2015 and 2021. Patient characteristics, including age, gender, duration of hospitalization, as well as specific metrics like body mass index, distinct palliative care assessment scores, and in-hospital opioid consumption were retrieved from the electronic patient files. Demographics and clinical data were analyzed by descriptive statistics, and compared to those of a control group of palliative care patients without SUD. An opioid calculator was used to standardize opioid intake based on morphine equivalents for meaningful comparisons. Results: The primary characteristics revealed that the majority of individuals were single (56%), had no children (83%), lived alone (39%), and were either unemployed or recipients of a disability pension (in total 50%). Nicotine (89%), opioids (67%), and alcohol (67%) were the most used substances. We identified various comorbidities including psychiatric illnesses alongside SUD (56%), hepatitis A, B, or C (33%), and HIV infection (17%). Patients with SUD were significantly younger (p < 0.5), predominantly male (p < 0.05), and reported a higher prevalence of pain (p < 0.5) compared to the standard cohort of palliative patients. Regarding the challenges most frequently reported by healthcare practitioners, non-compliance, multimorbidity, challenging communication, biographical trauma, lack of social support, and unstable housing situations played a key role. Conclusion: Patients with SUD represent a complex and vulnerable group dealing with multiple comorbidities that profoundly affect both their physical and psychological well-being. Understanding their unique characteristics is pivotal in providing precise and suitable palliative care. [ABSTRACT FROM AUTHOR]

Background: Gulf War illness (GWI)/Chronic Multisymptom Illness (CMI) is a disorder related to military service in the 1991 Gulf War (GW). Prominent symptoms of GWI/CMI include fatigue, pain, and cognitive dysfunction. Although anosmia is not a typical GWI/CMI symptom, anecdotally some GW veterans have reported losing their sense smell shortly after the war. Because olfactory deficit is a prodromal symptom of neurodegenerative diseases like Parkinson's and Alzheimer's disease, and because we previously reported suggestive evidence that deployed GW veterans may be at increased risk for Mild Cognitive Impairment (MCI) and dementia, the current study examined the relationship between olfactory and cognitive function in deployed GW veterans. Methods: Eighty deployed GW veterans (mean age: 59.9 ±7.0; 4 female) were tested remotely with the University of Pennsylvania Smell Identification Test (UPSIT) and the Montreal Cognitive Assessment (MoCA). Veterans also completed self-report questionnaires about their health and deployment-related exposures and experiences. UPSIT and MoCA data from healthy control (HC) participants from the Parkinson's Progression Markers Initiative (PPMI) study were downloaded for comparison. Results: GW veterans had a mean UPSIT score of 27.8 ± 6.3 (range 9–37) and a mean MoCA score of 25.3 ± 2.8 (range 19–30). According to age- and sex-specific normative data, 31% of GW veterans (vs. 8% PPMI HCs) had UPSIT scores below the 10th percentile. Nearly half (45%) of GW veterans (vs. 8% PPMI HCs) had MoCA scores below the cut-off for identifying MCI. Among GW veterans, but not PPMI HCs, there was a positive correlation between UPSIT and MoCA scores (Spearman's ρ = 0.39, p < 0.001). There were no significant differences in UPSIT or MoCA scores between GW veterans with and without history of COVID or between those with and without Kansas GWI exclusionary conditions. Conclusions: We found evidence of olfactory and cognitive deficits and a significant correlation between UPSIT and MoCA scores in a cohort of 80 deployed GW veterans, 99% of whom had CMI. Because impaired olfactory function has been associated with increased risk for MCI and dementia, it may be prudent to screen aging, deployed GW veterans with smell identification tests so that hypo- and anosmic veterans can be followed longitudinally and offered targeted neuroprotective therapies as they become available. [ABSTRACT FROM AUTHOR]

Background: Avoidant/restrictive food intake disorder (ARFID) is now recognized as a feeding/eating disorder that affects individuals across the lifespan, but research on ARFID in general and particularly in adults remains limited. The purpose of this study was to describe the demographic and clinical characteristics of adults with ARFID seeking treatment at a tertiary care eating disorders program, and to describe the course and outcomes of treatment at three levels of care—inpatient, intensive outpatient, and outpatient individual therapy. Method: This retrospective chart review study examined the charts of 42 patients who received treatment for ARFID between April 2020 and March 2023. Following diagnostic assessment, patients were referred to either inpatient treatment, intensive outpatient treatment, or outpatient individual therapy. All three levels of care involved individual cognitive behaviour therapy. Inpatients typically transitioned to one of the outpatient treatments as part of a continuous care plan. We examined demographic and clinical characteristics, treatment length and completion, and changes in key indicators during treatment. Results: Patients were diverse with respect to demographics (e.g., 62% cisgender women; 21% cisgender men; 17% transgender, non-binary, or other gender) and comorbid concerns (e.g., 43% had neurodevelopmental disorders; > 50% had mood and anxiety disorders; 40% had posttraumatic stress disorder [PTSD]; 35% had medical conditions impacting eating/digestion). Most patients presented with more than one ARFID maintaining mechanism (i.e., lack of appetite/interest, sensory sensitivities, and/or fear of aversive consequences of eating). Treatment completion rates and outcomes were good. On average, patients showed significant improvement in impairment related to their eating disorder, and those who were underweight significantly improved on BMI and were not underweight at end of treatment. Discussion: These findings add to the literature by indicating that ARFID patients are commonly male or have diverse gender identities, and have high rates of neurodevelopmental, mood, anxiety, and gastrointestinal disorders. We also found high rates of PTSD. The findings show promise for treatment outcomes across the continuum of care. Next steps in ARFID treatment and research include incorporating ARFID-specific assessments into routine care, and ongoing research investigating the efficacy and effectiveness of treatments such as CBT-AR. Plain English Summary: Avoidant/restrictive food intake disorder (ARFID) is now recognized as a feeding/eating disorder that affects individuals across the lifespan, but research on ARFID in general and particularly in adults remains limited. The purpose of this study was to describe the demographic and clinical characteristics of adults with ARFID seeking treatment at a tertiary care eating disorders program, and to describe the course and outcomes of treatment at three levels of care—inpatient, intensive outpatient, and outpatient individual therapy. [ABSTRACT FROM AUTHOR]

Introduction: Self-management interventions consist of multiple components to support people in the management of medical, emotional, and behavioural aspects of their condition, and aim to improve quality of life, function, and other outcomes. A systematic review of self-management interventions in Parkinson's showed no conclusive evidence for effectiveness of specific self-management approaches in Parkinson's to date but identified several potentially useful components. Aim: To identify the key required components for self-management in people with Parkinson's by synthesising evidence from a body of primary qualitative evidence and systematic reviews, and to explore which of these key components should be incorporated into trials of self-management in Parkinson's. Method: A mixed-methods synthesis was conducted. We combined data from two primary qualitative studies and a systematic review of qualitative studies that focused on self-management in Parkinson's to identify key intervention components. These were then mapped onto the results of a systematic review of Randomised Controlled Trials (RCTs) using matrices. First, data were extracted from the qualitative studies with people with Parkinson's and healthcare professionals on the key self-management components in this population. Second, a matrix table was created to map the identified Parkinson's specific self-management components against potential effectiveness from published RCTs of self-management interventions. Results: Synthesis of qualitative data identified 15 potential self-management components. These 15 components included components needed to start self-managing (e.g., information, skill acquirement) and components needed to maintain self-managing (e.g., self-motoring, increasing motivation). From 18 RCTs, interventions varied in how many components were included (range 1–10). Trials reporting significant beneficial effects of their intervention included a higher number of components (4 or more self-management components) than trials without significant findings (1–3 self-management components). Conclusion: Fifteen key self-management components were identified that should be incorporated into interventions or programs of self-management in Parkinson's. No current trial has incorporated all aspects, but a higher number of these key components appears to make trials of self-management interventions more likely to be successful. [ABSTRACT FROM AUTHOR]

Background: Young adult caregivers (YACs) are individuals aged 18–25 years who provide care to a loved one (parent, sibling) with frailty, disability, or illness. As young adults, the transition period between adolescence and adulthood can be more challenging for YACs than their peers without care responsibilities (non-YACs), as they have to integrate caregiving with other life areas (education, relationships). This study compared the perceived life balance and the psychological functioning (i.e., burnout, negative and positive affect, and life satisfaction) between YACs and non-YACs. Method: An online cross-sectional survey was conducted among 74 YACs (85.1% females, 22.0 ± 2.1 years) and 246 non-YACs (76.0% females, 21.8 ± 2.0 years) studying in the Netherlands. The survey assessed demographic characteristics, caregiving characteristics (to be filled out only by the YACs), life balance, and psychological functioning. We used Chi-square tests for categorical variables and independent T-tests for continuous variables to examine possible differences in demographic characteristics between YACs and non-YACs. In addition, we used independent T-tests to compare the perceived life balance and psychological functioning between YACs and non-YACs. Results: YACs and non-YACs were similar on all the demographic characteristics, except for living status; fewer YACs (44.6%) than non-YACs (59.3%) lived on their own, with or without other students/friends (χ2 = 16.3, p = 0.01). YACs perceived slightly less balance in life than non-YACs (d = -.29, p =.03). Both groups did not differ in experiencing burnout, affect, and life satisfaction (all p >.05). They experienced high levels of burnout and moderate levels of life satisfaction. Discussion: Although YACs perceived a little less balance in life than non-YACs, this was not reflected in their psychological functioning. Healthcare professionals and school counselors may need to recognise the critical phase of all young adults and provide the support that could, for example, help them reduce burnout and enhance their quality of life. [ABSTRACT FROM AUTHOR]

Background: Indian adolescents exhibit unhealthy food behaviours and inactive lifestyles which increase their risk of developing obesity and associated negative health consequences. The family food environment represents a vital setting to nurture healthy lifestyle behaviours in adolescents, with parents influencing their adolescents' dietary and physical activity behaviours. Yet, much of the existing evidence exploring parental influences predominantly focuses on mothers while fathers' engagement in instilling healthy dietary and physical activity behaviours is understudied, more so in the context of developing economies like India. Therefore, this qualitative study was designed to understand Indian fathers' views on instilling healthy behaviours in their children. Methods: Convenience sampling along with snowball sampling techniques were employed to recruit fathers of adolescents aged 10–19 years from Kolkata city, India. Informed by the research aim and review of literature, an interview guide was developed and pre-tested. Interviews were carried out either in person or virtually (Zoom/telephone) in English/Hindi/Bengali as per the preference of the participants. All interactions were audio recorded, transcribed verbatim, and translated to English for the purpose of data analysis. The transcripts were analysed thematically using NVivo software program. Themes were identified using both inductive and deductive approaches. Results: A total 36 fathers participated in the interviews. Seven main themes were identified: (i) Involvement of fathers in adolescent upbringing (i.e. engagement in meal preparation, food shopping, educational activities, physical activity); (ii) Family food environment (i.e. setting food rules, having meals with children, making food available); (iii) Challenges to instilling healthy behaviours in adolescents (i.e. adolescents' sedentary lifestyle and liking for unhealthy foods); (iv) Barriers to routine involvement in adolescent upbringing (i.e. time constraints due to paid employment, poor socio-economic status); (v) Adolescent nutrition education: (vi) Dual burden of malnutrition (i.e. awareness of malnutrition, no knowledge about government-led health programs for adolescents); (vii) Paternal knowledge. Conclusions: The emerging themes reveal that Indian fathers played a crucial role in instilling healthy dietary and physical activity behaviour in their adolescents through various parenting practices such as purchasing nutritious food, enforcing food rules, disseminating nutrition-related knowledge, and encouraging adolescents to participate in moderate-to-vigorous intensity outdoor sports. This provides strong support for the inclusion of fathers in sustainable family-focused lifestyle interventions to maximise the nurturing care required by adolescents as well as assist in normalising the representation of fathers in health and welfare policies designed for adolescents. [ABSTRACT FROM AUTHOR]

Immunotherapies have revolutionized the treatment paradigms of various types of cancers. However, most of these immunomodulatory strategies focus on harnessing adaptive immunity, mainly by inhibiting immunosuppressive signaling with immune checkpoint blockade, or enhancing immunostimulatory signaling with bispecific T cell engager and chimeric antigen receptor (CAR)-T cell. Although these agents have already achieved great success, only a tiny percentage of patients could benefit from immunotherapies. Actually, immunotherapy efficacy is determined by multiple components in the tumor microenvironment beyond adaptive immunity. Cells from the innate arm of the immune system, such as macrophages, dendritic cells, myeloid-derived suppressor cells, neutrophils, natural killer cells, and unconventional T cells, also participate in cancer immune evasion and surveillance. Considering that the innate arm is the cornerstone of the antitumor immune response, utilizing innate immunity provides potential therapeutic options for cancer control. Up to now, strategies exploiting innate immunity, such as agonists of stimulator of interferon genes, CAR-macrophage or -natural killer cell therapies, metabolic regulators, and novel immune checkpoint blockade, have exhibited potent antitumor activities in preclinical and clinical studies. Here, we summarize the latest insights into the potential roles of innate cells in antitumor immunity and discuss the advances in innate arm-targeted therapeutic strategies. [ABSTRACT FROM AUTHOR]

Background: Avoidant/restrictive food intake disorder (ARFID) is an eating disorder that involves restrictive or avoidant eating behaviour not related to weight or body image concerns. It was first included in the Diagnostic and Statistical Manual of Mental Disorders–fifth edition (DSM-5) in 2013. ARFID frequently begins in childhood and can have serious psychosocial impacts and detrimental health consequences when nutritional and energy needs are persistently unmet. This systematic scoping review focuses on Australasia, synthesizing the current literature landscape on ARFID, and offering recommendations for targeted, actionable research directions for both funders and researchers. Methods: Online databases and university thesis repositories were systematically searched for studies examining ARFID in the New Zealand or Australian population since 2013. Database search results were exported to Rayyan software, and two independent reviewers screened all identified sources, prior to extraction of key data. Results: Twenty-nine studies and one thesis from 138 screened sources were eligible for inclusion. Frequent study types were treatment interventions and cross-sectional studies, with populations including individuals with ARFID, ED service populations, parents/caregivers, health professionals, and non-clinical populations. ARFID presents in a range of settings and is associated with poorer quality of life and significant functional impairment. Assessment of ARFID was varied, and no specific treatment guidelines for ARFID have been written as yet. Conclusion: This review calls for more accurate prevalence estimates of ARFID in children and larger-scale studies in all ages using validated measures. It emphasizes the need for education and training of healthcare professionals, and interdisciplinary collaboration. Established interventions like behaviour analytics should be considered, and more comprehensive research is needed on interventions for ARFID, including controlled trials and longitudinal studies. Urgent research is needed to improve outcomes for those affected by ARFID. Plain English summary: This scoping review examines all published literature on Avoidant/Restrictive Food Intake Disorder (ARFID) in the Australasian region since the disorder was first recognized in 2013. ARFID is an eating disorder marked by restrictive or avoidant eating behaviour unrelated to weight or body image concerns. The disorder can have serious psychosocial impacts and detrimental health consequences when nutritional and energy needs are persistently unmet. The review identifies the methods, participants, and key findings of the studies on ARFID and suggests targeted and actionable research goals for researchers and funders. It calls for more accurate information on how common ARFID is in children, for larger-scale studies using validated measures, and emphasizes the need for education and training of healthcare professionals, and a collaborative approach to treatment. We also underscore the need for longitudinal studies to better understand the landscape of ARFID in Australasia. [ABSTRACT FROM AUTHOR]

Background: The 5th revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) construes PTSD symptoms into 4 clusters (intrusion, avoidance, negative alterations in cognitions and mood, alterations in arousal and reactivity; Model 1). However, recent literature has shown that this symptom structure does not best represent PTSD. Unfortunately, the findings of studies investigating the proposed alternative models are from consensus. Adding to the complexity of the issue of symptom-grouping models is the identification of specific and non-specific symptoms of PTSD. The present study aims to address these gaps by identifying the best-fitting PTSD model and subsequently examining what symptoms are considered specific and non-specific to PTSD in adolescent-survivors of armed political conflict and violence. Methods: The study utilized a sample of 641 adolescent victim survivors. We conducted CFA analyses and compared nested models through the scaled χ2 difference test, while comparison of non-nested models was done using the Bayesian information criterion (BIC). The best-fitted model was used in the consequent analysis, where we statistically controlled for the effect of non-specific psychological distress on PTSD by comparing the factor loadings and factor correlations before and after accounting for distress using the Aroian z-test. Results: The results provide support for the 7-factor hybrid model of PTSD over other proposed models for the current sample. Moreover, the data reveal that only 7 items could be construed as core symptoms, while the rest of the symptoms can be considered non-PTSD specific. Conclusions: Overall, the findings provide support for the validity of the hybrid PTSD model among political conflict-exposed adolescents. The results also show that the DSM-5 PTSD has both specific and non-specific features in the present sample of conflict-exposed adolescents. This has potential implications for theory, practice, and treatment of the disorder. [ABSTRACT FROM AUTHOR]

Background : During the aging process, cognitive functions and performance of the muscular and neural system show signs of decline, thus making the elderly more susceptible to disease and death. These alterations, which occur with advanced age, affect functional performance in both the lower and upper members, and consequently human motor functions. Objective measurements are important tools to help understand and characterize the dysfunctions and limitations that occur due to neuromuscular changes related to advancing age. Therefore, the objective of this study is to attest to the difference between groups of young and old individuals through manual movements and whether the combination of features can produce a linear correlation concerning the different age groups. Methods : This study counted on 99 participants, these were divided into 8 groups, which were grouped by age. The data collection was performed using inertial sensors (positioned on the back of the hand and on the back of the forearm). Firstly, the participants were divided into groups of young and elderly to verify if the groups could be distinguished through the features alone. Following this, the features were combined using the linear discriminant analysis (LDA), which gave rise to a singular feature called the LDA-value that aided in verifying the correlation between the different age ranges and the LDA-value. Results : The results demonstrated that 125 features are able to distinguish the difference between the groups of young and elderly individuals. The use of the LDA-value allows for the obtaining of a linear model of the changes that occur with aging in the performance of tasks in line with advancing age, the correlation obtained, using Pearson's coefficient, was 0.86. Conclusion : When we compare only the young and elderly groups, the results indicate that there is a difference in the way tasks are performed between young and elderly individuals. When the 8 groups were analyzed, the linear correlation obtained was strong, with the LDA-value being effective in obtaining a linear correlation of the eight groups, demonstrating that although the features alone do not demonstrate gradual changes as a function of age, their combination established these changes. [ABSTRACT FROM AUTHOR]

Background: Bipolar disorder (BD) (i.e., BD-I or BD-II) is a serious mental illness (SMI) that can cause significant life challenges, but its impact and management may be mediated by psychosocial factors. This study's primary objectives were to investigate whether adults with BD differ from those without in terms of social support, negative social interactions (NSIs), and positive mental health (PMH). Secondly, examine whether gender differences exist in terms of these variables, as well as whether specific social support subscales and NSI predict PMH for those with BD. Methods: Using data extracted from a national Canadian survey, 563 adults reporting a lifetime BD diagnosis were compared to a matched, non-BD sample using the Social Provisions Scale 10 Items (SPS-10), the NSI Scale, and the Mental Health Continuum – Short Form (MHC-SF) Scale. For the BD sample, males and females were compared based on study variables, and hierarchical regressions were subsequently performed to assess whether SPS-10 subscales and NSIs predicted PMH. Results: Respondents with BD reported significantly lower SPS-10 and PMH scores, and significantly higher NSI scores. Within the BD sample, females reported significantly higher SPS-10 and NSIs scores, and 'social integration' and 'reassurance of worth' positively predicted PMH, while NSI uniquely predicted lower PMH levels for both males and females. Conclusions: The results implicate specific psychosocial factors and gender in the degree to which adults with BD might flourish, particularly in terms negative relationships. The implications of social erosion and the bi-directionality of social support are also considered. [ABSTRACT FROM AUTHOR]

Background: Balance impairments, that lead to falls, are one of the main symptoms of Parkinson's disease (PD). Telerehabilitation is becoming more common for people with PD; however, balance is particularly challenging to assess and treat virtually. The feasibility and efficacy of virtual assessment and virtual treatment of balance in people with PD are unknown. The present study protocol has three aims: I) to determine if a virtual balance and gait assessment (instrumented L-shape mobility test) with wearable sensors can predict a gold-standard, in-person clinical assessment of balance, the Mini Balance Evaluation Systems Test (Mini-BESTest); II) to explore the effects of 12 sessions of balance telerehabilitation and unsupervised home exercises on balance, gait, executive function, and clinical scales; and III) to explore if improvements after balance telerehabilitation transfer to daily-life mobility, as measured by instrumented socks with inertial sensors worn for 7 days. Methods: The TelePD Trial is a prospective, single-center, parallel-group, single-blind, pilot, randomized, controlled trial. This trial will enroll 80 eligible people with PD. Participants will be randomized at a 1:1 ratio into receiving home-based balance exercises in either: 1) balance telerehabilitation (experimental group, n = 40) or 2) unsupervised exercises (control group, n = 40). Both groups will perform 12 sessions of exercise at home that are 60 min long. The primary outcome will be Mini-BESTest. The secondary outcomes will be upper and lower body gait metrics from a prescribed task (instrumented L-shape mobility test); daily-life mobility measures over 7 days with wearable sensors in socks, instrumented executive function tests, and clinical scales. Baseline testing and 7 days of daily-life mobility measurement will occur before and after the intervention period. Conclusion: The TelePD Trial will be the first to explore the usefulness of using wearable sensor-based measures of balance and gait remotely to assess balance, the feasibility and efficacy of balance telerehabilitation in people with PD, and the translation of balance improvements after telerehabilitation to daily-life mobility. These results will help to develop a more effective home-based balance telerehabilitation and virtual assessment that can be used remotely in people with balance impairments. Trial registration: This trial was prospectively registered on ClinicalTrials.gov (NCT05680597). [ABSTRACT FROM AUTHOR]

Background: During deployment, veterans of the 1991 Gulf War (GW) were exposed to multiple war-related toxicants. Roughly a third of these veterans continue to exhibit neurotoxicant induced symptoms of Gulf War Illness (GWI), a multi-faceted condition that includes fatigue, pain and cognitive decrements. When studied empirically, both deployed veterans with exposures and those who meet the criteria for GWI are more likely to show deficits in the area of neuropsychological functioning. Although studies have shown cognitive impairments in small sample sizes, it is necessary to revisit these findings with larger samples and newer cohorts to see if other areas of deficit emerge with more power to detect such differences. A group of researchers and clinicians with expertise in the area of GWI have identified common data elements (CDE) for use in research samples to compare data sets. At the same time, a subgroup of researchers created a new repository to share these cognitive data and biospecimens within the GWI research community. Methods: The present study aimed to compare cognitive measures of attention, executive functioning, and verbal memory in a large sample of GWI cases and healthy GW veteran controls using neuropsychological tests recommended in the CDEs. We additionally subdivided samples based on the specific neurotoxicant exposures related to cognitive deficits and compared exposed versus non-exposed veterans regardless of case criteria status. The total sample utilized cognitive testing outcomes from the newly collated Boston, Biorepository, Recruitment, and Integrative Network (BBRAIN) for GWI. Results: Participants included 411 GW veterans, 312 GWI (cases) and 99 healthy veterans (controls). Veterans with GWI showed significantly poorer attention, executive functioning, learning, and short-and-long term verbal memory than those without GWI. Further, GW veterans with exposures to acetylcholinesterase inhibiting pesticides and nerve gas agents, had worse performance on executive function tasks. Veterans with exposure to oil well fires had worse performance on verbal memory and those with pyridostigmine bromide anti-nerve gas pill exposures had better verbal memory and worse performance on an attention task compared to unexposed veterans. Conclusions: This study replicates prior results regarding the utility of the currently recommended CDEs in determining impairments in cognitive functioning in veterans with GWI in a new widely-available repository cohort and provides further evidence of cognitive decrements in GW veterans related to war-related neurotoxicant exposures. [ABSTRACT FROM AUTHOR]

Background: Safety precautions and activity restrictions were common in the early, pre-vaccine phases of the COVID-19 pandemic. We hypothesized that higher levels of participation in potentially risky social and other activities would be associated with greater life satisfaction and perceived meaning in life. At the same time, prosocial COVID-preventive activities such as mask wearing should enhance life satisfaction. Method: We assessed the impact of COVID-preventive behaviors on psychological well-being in October 2020. A nationally representative sample of U.S. adults (n = 831) completed a demographic questionnaire, a COVID-related behaviors questionnaire, a Cantril's Ladder item, and the Multidimensional Existential Meaning Scale. Two hierarchical linear models were used to examine the potential impact of COVID-preventive behaviors on life satisfaction and meaning in life while accounting for the influence of demographic factors. Results: The study revealed significant positive relationships between COVID-preventive behaviors and subjective well-being. Wearing a mask was significantly associated with higher life satisfaction, while maintaining social distancing of six feet and avoiding large groups were significantly associated with higher perceived meaning in life. Social activities including dining at restaurants and visiting friends and family were also significantly associated with higher life satisfaction and meaning in life, respectively. Conclusion: The study's findings support the conclusion that disease prevention measures such as social distancing and mask wearing do not reduce, and may enhance, subjective well-being during a pandemic. Utilizing the unique context of the COVID-19 pandemic to examine relationships between behavior and subjective well-being, the study also indicates that shallow or medium-depth social activities are likely to be more central to life satisfaction, whereas narrower, deeper social interactions with friends and family are more important to perceived meaning in life. [ABSTRACT FROM AUTHOR]

Background: Demoralization is a clinically relevant syndrome in chronic diseases. The demoralization scale (DS-II) was recently developed as an economic screening tool in clinical populations. Main aim of this study was to provide normative data of DS-II scores in the general population. Methods: We developed a new German version, the DS-II Münster, and tested internal consistency as well as the previously proposed two-factor structure with confirmatory factor analyses. The DS-II was applied in a household survey of the general population. Associations between DS-II scores and age, gender and other sociodemographic variables were explored. Results: The final sample consisted of N = 2471 participants (mean age = 49.8 years, range: 18–96; 50.1% men, 49.8% women). The DS-II Münster showed nearly excellent internal consistency. The model fit indices of the two-factor structure were not superior to those of the one-factor model. Mean scores of the DS-II were as follows. Total score: M = 3.76 (SD = 5.56), Meaning and Purpose subscale: M = 1.65 (SD = 2.77), Distress and Coping Ability subscale: M = 2.11 (SD = 3.02). DS-II scores were increased in women with an effect size of Cohen's d = 0.19. An age-related increase was specifically found for the Meaning and Purpose subscale (d = 0.21). Conclusions: The study provides normative values of the DS-II with respect to age and gender in the general population to facilitate interpretation of DS-II scores in clinical samples. A DS-II total score > 5 is suggested as a cut-off value. The findings further our understanding of significant symptom burden that was previously suggested in young patients with cancer. [ABSTRACT FROM AUTHOR]

Background: Short-track speed skating movement involves asymmetric overloading of the lower left side of the body. The gluteus maximus fatigue limits the physical and mental athletic capacity to perform set tasks. A possible link between the presence of latent trigger points (LTrPs) and muscle fatigue development/persistence has been posited. The aim of the study was to determine whether elite short-track speed skating can result in the impairment of the musculoskeletal system of the lower limbs. Methods: Elite short-track athletes as the experimental group (EXP) = 9, 19.5 ± 1.8 years, and healthy subjects as the control group (CON) = 18, 20.8 ± 1.2 years, were tested for: (i) lower limb loading asymmetry using ground reaction force (GRF) measurements during quiet standing, (ii) gluteus maximus fatigue measured with surface electromyography (sEMG) during the Biering-Sorensen test, and (iii) LTrPs presence in the 14 examined muscles of the pelvic girdle and lower limbs. Results: There were between-group differences in the number of LTrPs, with the EXP group (left lower limb (LLL) n = 18, right lower limb (RLL) n = 9) showing more LTrPs compared to the CON group (LLL n = 2, RLL n = 1), (p < 0.001), and within-group differences in the EXP group only (p < 0.001). There were also significant differences in muscle fatigue for the left side (p < 0.001) both between the groups and within the EXP group (p ≤ 0.001). The vertical ground reaction force (GRF) measurement showed a loading rate of 2% (p = 0.013) in the athletes' LLL exclusively. Conclusions: The study confirmed an increased prevalence of LTrPs, increased muscle fatigue and left-sided limb load asymmetry in elite short-track athletes. Trial registration: The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Poznan University of Medical Sciences (Resolution No 110/22 of 10 March 2022). Trial registration: 20/07/2022, Trial Id: ACTRN12622001016729. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has had a significant impact on individuals' social lives, mental health status, and meaning in life (MIL). Globally, the use of different types of digital media has become a proxy for pre-COVID social lives for many people. This study investigated gender differences in the relationship between use of digital media, mental health status and MIL, during COVID-19 in Hong Kong. Methods: This cross-sectional study surveyed 1,488 young people recruited via city-wide random sampling in 2021. Respondents completed a phone survey on digital media use, Patient Health Questionnaire (PHQ-2), Generalized Anxiety Disorder (GAD-2), COVID-19 impact, meaning in life, and demographics. Gender differences in MIL were tested with an independent sample t-test. Gender-specific multiple linear regression models tested associations between MIL and explanatory variables of age, educational level, history of diagnosis, digital media use, and mental health status. Results: There was a significant gender difference in MIL (males (M = 12.90, SD = 4.12); females (M = 13.45, SD = 3.96); t (1485) = -2.656, p =.008). For males, all variables significantly associated to MIL (F (9, 759) = 15.731, p <.000, R2 =.157). However, for females, while the overall model for MIL was significant (F (9, 709) = 12.105, p <.001, R2 =.133), the only significant associated variable was mental health status. Conclusion: Females had significantly better MIL under COVID-19 than males. Digital media use contributed to MIL in males but not females, and there were gender-specific associated factors of MIL. [ABSTRACT FROM AUTHOR]

Objective: To compare, rank and evaluate the 24 exercise types that improve postural instability in patients with Parkinson's disease (PD). Methods: We searched the data in PubMed, MEDLINE, Embase, PsycINFO, Cochrane library, and Web of Science from their inception date to January 23, 2023. Randomized controlled trials (RCTs) that aimed at determining the effectiveness of physical activity interventions on postural instability in adults with PD. This review focused on different balance outcome categories: (a) balance test batteries (BBS); (b) static steady-state balance (sSSB); (c) dynamic steady-state balance (dSSB); (d) proactive balance (PB); (e) reactive balance (RB). Results: Among 10,474 records, 199 studies (patients = 9523) were eligible for qualitative synthesis. The random-effects NMA model revealed that the following exercise training modalities had the highest p score of being best when compared with control group: body-weight support treadmill training (BWS_TT) for BBS (p score = 0.97; pooled standardised mean difference (95% CI): 1.56 (0.72 to 2.39)) and dSSB (1.00; 1.53 (1.07 to 2.00)), aquatic exercise (AQE) for sSSB (0.85; 0.94 (0.33 to 1.54)), Pilates for PB (0.95; 1.42 (0.59 to 2.26)). Balance and gait training with the external cue or attention (BGT_ECA) and robotic assisted gait balance (RA_GT) had similar superior effects in improving RB. The confidence in evidence was often low according to Confidence in Network Meta-Analysis. Conclusions: There is low quality evidence that BWS_TT, AQE, Pilates, BGT_ECA and RA_GT are possibly the most effective treatments, pending outcome of interest, for adults with PD. [ABSTRACT FROM AUTHOR]