24 research outputs found
Does the catechol-O-methyltransferase (COMT) Val158Met human polymorphism in influence procrastination?
Genetic studies are enlightening how the expression of several genes influences neuronal activity and all facets of human normal and abnormal behaviour. Among these, a growing body of information shows that a few key genes regulating activity of central neurotransmitters have specific roles in cognitive and/or emotional processes, as âprocrastinationâ. We investigated the association of the 5-HTTLPR and COMT Val158Met polymorphisms with studentsâ procrastination in an academic writing task. Results: showed no relationship between procrastination and the 5-HTT polymorphism but they revealed an association with the COMT Val158Met one. Particularly, the presence of the Met158 allele was found to be significantly associated with the tendency to initiate
and complete the assigned task. We hypothesize that the role of central monoamines and of dopamine already identified in impulsive behaviour, extends to procrastination. Since the 158Met allele provides neurons with significantly higher basal dopamine levels when compared to the 158Val allele, our observation suggests that under normal conditions the 158Met allele provides carriers with increased inhibitory control, resulting in an increased tendency to adhere to a planned schedule and therefore reducing procrastination. On the other hand, the Val158 allele may result more effective in increasing carriersâ performances under stress conditions, namely when the schedule deadline is approaching, and dopamine release is increased. This would result in a higher tendency to procrastinate. This hypothesis can readily be tested by applying the experimental approach here employed to various samples of subjects belonging to different categories and extending the analysis to other putative neuron-expressed gene
The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study
AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4âweeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4âweeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, PÂ =Â 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, Pâ<â0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, PÂ =Â 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, PÂ =Â 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease
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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990â2021: a systematic analysis for the Global Burden of Disease Study 2021
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56â604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100â000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100â000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100â000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100â000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100â000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation
Dendritic spine density and EphrinB2 levels of hippocampal and anterior cingulate cortex neurons increase sequentially during formation of recent and remote fear memory in the mouse
Memory consolidation is a dynamic process that involves a sequential remodeling of hippocampalâcortical circuits. Although synaptic events underlying memory consolidation are well assessed, fine molecular events controlling this process deserve further characterization.
To this aim, we challenged male C57BL/6N mice in a contextual fear conditioning (CFC) paradigm and tested their memory 24 h, 7 days or 36 days later. Mice displayed a strong fear response at all time points with an increase in dendritic spine density and protein levels of the cell adhesion factor EphrinB2 in CA1 hippocampal neurons 24 h and 7 days post conditioning (p.c.), and in anterior cingulate cortex (ACC) neurons 36 days p.c. We then investigated whether the formation of remote memory and neuronal modifications in the ACC would de- pend on p.c. protein synthesis in hippocampal neurons. Bilateral intrahippocampal infusions with the protein synthesis inhibitor anisomycin administered immediately p.c. decreased fear response, neuronal spine growth and EphrinB2 protein levels of hippocampal and ACC neurons 24 h and 36 days p.c., respectively. Anisomycin infusion 24 h p.c. had no effects on fear response, increase in spine density and in EphrinB2 protein levels in ACC neurons 36 days p.c. Our results thus confirm that early but not late p.c. hippocampal protein synthesis is necessary for the formation of remote memory and provide the first evidence of a possible involvement of EphrinB2 in neuronal plasticity in the AC
GRANULE NEURON PROLIFERATION IS REDUCED IN THE DEVELOPING CEREBELLUM OF THE NPC1-/- MOUSE, A MODEL OF HUMAN NIEMANN-PICK C1 DISEASE
Niemann Pick type C (NPC) disease is an neurodegenerative lysosomal storage disorder caused by mutations in either of two genes, Npc1 and Npc2. A prominent feature of NPC1 disease in humans is massive loss of cerebellar Purkinje cells (PCs).
Cerebellar granule neurons (GNs) have been little studied in mouse models of this disease, perhaps because their development takes place during the first three weeks of postnatal life, whereas signs of PC pathology occur in older mice. GNs are generated during the first two postnatal weeks from a progenitor layer named, external granule layer (EGL), where their proliferation is sustained by Shh and microglia-released growth factors that activate the Notch pathway.
We have observed that postnatal development of cerebellar GNs is defective in Npc1-/- mice. Compared to age-matched wild-type, there is an accelerated disappearance of the EGL in these mice, which is due to a premature exit from the cell cycle of GN precursors. As a consequence, the si
ENLIGHTENING MOLECULAR MECHANISMS OF ABNORMAL CEREBELLUM DEVELOPMENT IN MOUSE MODELS OF HUMAN NIEMANN-PICK C 1 DISEASE: THE EFFICACY OF HYDROXYPROPYLBETACYCLODEXTRIN IN CORRECTING THE PHENOTYPE
Protocol for a multi-situated qualitative study
UIDB/04038/2020
UIDP/04038/2020Background: Cohort studies represent a strong methodology for increasing one's understanding of human life-course development and etiological mechanisms. Retention of participants, especially during long follow-up periods, is, however, a major challenge. A better understanding of the motives for participation and attrition in cohort studies in diverse sociogeographic and cultural settings is needed, as this information is most useful in developing effective retention strategies. Objective: This study aims to improve our understanding of participation and attrition phenomena in a European cohort study of very preterm/very-low-birth-weight (VPT/VLBW) infants from various sociogeographic and cultural settings to better understand variability and ultimately contribute to developing novel and more âin-contextâ strategies to improve retention. Methods: This study uses a triangulation of multisituated methods to collect data on various cohorts in the Research on European Children and Adults Born Preterm (RECAP) network, which include focus group discussions, individual semidriven interviews, and a collaborative, reflexive visual methodology (participant-generated VideoStories) with relevant key actors involved with these cohort studies such as adult participants, parents (caregivers), cohort staff, health care professionals, and academic researchers. The methodological strategy aims to provide a shared flexible framework of various qualitatively driven methods to collect data on VPT/VLBW adult and child cohorts, from which research partners may choose and combine those most pertinent to apply in their own specific contexts. Data from all sources and sites will be submitted to a triangulation of phenomenological thematic analysis with discourse analysis. Results: As of January 2020, in this study, we enrolled 92 participants variously involved with child and adult RECAP partnering cohorts from six countries. Multisite enrollment and data collection are expected to be completed in all seven study settings by June 2020. Findings will be reported in future publications. Conclusions: Qualitative research methods are a useful complement for enriching and illuminating quantitative results. We expect that opting for a multisituated study approach addressing the interplay of the lived experience of individuals in both researcher and researched stances of particular cohort study settings will contribute to filling some gaps in the understanding of participation variability and effectiveness of different implemented strategies in context. Moreover, health research subjects have traditionally been positioned as passive objects of study rather than active participants, even though they have the greatest stake in improving health care policies and practices. Including collaborative methods allows us to counteract the âtop-downâ model by handing over some research control to the very people who are providing the data on which research findings will be based while also acknowledging the value of their involvement.publishersversionpublishe
Understanding participation in European cohort studies of preterm children:the views of parents, healthcare professionals and researchers
Abstract
Background: Retention of participants in cohort studies is a major challenge. A better understanding of all elements involved in participation and attrition phenomena in particular settings is needed to develop effective retention strategies. The study aimed to achieve an in-depth understanding of participant retention in longitudinal cohorts focusing on participantsâ and researcherâs perspectives, across three diverse socio-geographic and cultural settings.
Methods: This study used a triangulation of multi-situated methods to collect data on cohort studies of children born with less than 32âweeks of gestation in Denmark, Italy and Portugal. It included focus groups and individual semi-driven interviewing with involved key actors (i.e. parents, staff, healthcare professionals, researchers) and a collaborative visual methodology. A purposive sample of 48 key actors (nâ=â13 in Denmark; nâ=â13 in Italy; nâ=â22 in Portugal) was collected. A triangulation of phenomenological thematic analysis with discourse analysis was applied. Cross-contextual and context-specific situational elements involved in participation and attrition phenomena in these child cohorts were identified at various levels and stages.
Results: Main findings included: situational challenges affecting potential and range of possibilities for implementation strategies (geopolitical environment, societal changes, research funding models); situational elements related to particular strategies acting as deterrents (postal questionnaires) and facilitators (multiple flexible strategies, reminders, regular interaction); main motivations to enrol and participate (altruism/solidarity and gratitude/sense of duty to reciprocate); main motivational deterrents to participate to follow-up waves (lack of bonding, insufficient feedback); entanglement of clinical and research follow-up as facilitator and deterrent.
Conclusions: The multi-situated approach used, addressing the interplay of the lived experience of individuals, was of most value to understand participation variability under different implemented strategies in-context. Cross-contextual and context-specific situational elements that have been influential factors towards participation and attrition in the cohorts were identified.Group authorship collaboration RECAP Preterm-WP6 QS Work Group: Sandra CS Marques (CRIA, Instituto UniversitĂĄrio de Lisboa, Portugal; EPIUnit, Instituto de SaĂșde PĂșblica da Universidade do Porto, Portugal), Julia Doetsch (EPIUnit, Instituto de SaĂșde PĂșblica da Universidade do Porto, Portugal), Raquel Teixeira (EPIUnit, Instituto de SaĂșde PĂșblica da Universidade do Porto, Portugal); Georgia Abate, Grazia Colombo and Marina Cuttini (Clinical Care and Management Innovation Research Area, Bambino GesĂč Childrenâs Hospital, IRCCS, Rome, Italy); Anne BrĂždsgaard (Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Denmark; Department of Public Health, HEALTH, Aarhus University, Denmark); Elizabeth S Draper (Department of Health Sciences, College of Life Sciences, University of Leicester, United Kingdom); Sylvia van der Pal and Ilona Wildeman (TNO-Nederlandse Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek, The Netherlands); Pernille Pedersen (Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Denmark); Kari Anne I Evensen, Ann-Mari Brubakk and Marit S Indredavik (Department of Clinical and Molecular Medicine, NTNUâNorwegian University of Science and Technology, Norway); Eero Kajantie (Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki and Oulu, Finland; PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Finland; Childrenâs Hospital, Helsinki University Hospital and University of Helsinki, Finland; Department of Clinical and Molecular Medicine, NTNU-Norwegian University of Science and Technology, Norway); Eeva Virtanen (Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki and Oulu, Finland); Jo Lebeer; Vicky Hennissen; Iemke Sarrechia (Department FAMPOP Family Medicine & Population Health, Faculty of Medicine & Health Sciences University of Antwerp, Belgium) and Henrique Barros (Departamento de CiĂȘncias da SaĂșde PĂșblica e Forenses e Educação MĂ©dica, Faculdade de Medicina, Universidade do Porto, Portugal; EPIUnit, Instituto de SaĂșde PĂșblica da Universidade do Porto, Portugal). All named researchers contributed to the development of the study protocol and/or its local implementation
Improving understanding of participation and attrition Phenomena in European cohort studies: Protocol for a multi-situated qualitative study
Background: Cohort studies represent a strong methodology for increasing oneâs understanding of human life-course development and etiological mechanisms. Retention of participants, especially during long follow-up periods, is, however, a major challenge. A better understanding of the motives for participation and attrition in cohort studies in diverse sociogeographic and cultural settings is needed, as this information is most useful in developing effective retention strategies.
Objective: This study aims to improve our understanding of participation and attrition phenomena in a European cohort study of very preterm/very-low-birth-weight (VPT/VLBW) infants from various sociogeographic and cultural settings to better understand variability and ultimately contribute to developing novel and more âin-contextâ strategies to improve retention.
Methods: This study uses a triangulation of multisituated methods to collect data on various cohorts in the Research on European Children and Adults Born Preterm (RECAP) network, which include focus group discussions, individual semidriven interviews, and a collaborative, reflexive visual methodology (participant-generated VideoStories) with relevant key actors involved with these cohort studies such as adult participants, parents (caregivers), cohort staff, health care professionals, and academic researchers. The methodological strategy aims to provide a shared flexible framework of various qualitatively driven methods to collect data on VPT/VLBW adult and child cohorts, from which research partners may choose and combine those most pertinent to apply in their own specific contexts. Data from all sources and sites will be submitted to a triangulation of phenomenological thematic analysis with discourse analysis.
Results: As of January 2020, in this study, we enrolled 92 participants variously involved with child and adult RECAP partnering cohorts from six countries. Multisite enrollment and data collection are expected to be completed in all seven study settings by June 2020. Findings will be reported in future publications.
Conclusions: Qualitative research methods are a useful complement for enriching and illuminating quantitative results. We expect that opting for a multisituated study approach addressing the interplay of the lived experience of individuals in both researcher and researched stances of particular cohort study settings will contribute to filling some gaps in the understanding of participation variability and effectiveness of different implemented strategies in context. Moreover, health research subjects have traditionally been positioned as passive objects of study rather than active participants, even though they have the greatest stake in improving health care policies and practices. Including collaborative methods allows us to counteract the âtop-downâ model by handing over some research control to the very people who are providing the data on which research findings will be based while also acknowledging the value of their involvement
Increased interaction and procedural flexibility favoured participation : study across European cohorts of preterm born individuals
Objective: To understand participation and attrition phenomena variability in European cohorts of individuals born preterm through in-depth exploration of the interplay of situational elements involved. Methods: Multi-situated qualitative design, using focus groups, semi-structured interviews and collaborative visual methodology with a purposive sample of adults born preterm, parents and professionals (n = 124) from eight cohorts in seven European countries. Results: Most cohort participants were motivated by altruism/solidarity and gratitude/sense of duty to reciprocate (only absent in adults aged 19 â 21), followed by expectation of direct benefit to one's health and knowledge amongst participating adults. Common deterrents were perceived failure in reciprocity as in insufficient/inadequate interaction and information sharing, and postal questionnaires. Combining multipurpose, flexible strategies for contact and assessment, reminders, face-to-face and shorter periodicity and not simply adding retention strategies or financial incentives favoured participation. Professionalsâ main challenges entailed resources, funding and, European societal changes related to communication and geopolitical environment. Conclusion: Retention would benefit from tailoring inclusive strategies throughout the cohortsâ life cycle and consistent promotion of reciprocal altruistic research goals. Investing in regular interaction, flexibility in procedures, participant involvement and return of results can help mitigate attrition as well as considering mothers as main facilitators to participating children and impaired adults.info:eu-repo/semantics/acceptedVersio