Feasibility, Acceptability and Preliminary Outcomes of Embracing Your Life: An Online Self-Compassion Program for Emerging Adults

Due to the psychological toll COVID-19 has had on emerging adults, as well as normative mental health challenges of this developmental period, emerging adults are struggling more than ever with depression and loneliness. The objective of this study was to assess feasibility, acceptability, and preliminary psychosocial outcomes of Embracing Your Life, a self-compassion program for emerging adults, as self-compassion is associated with better mental health. Thirty-nine emerging adults (Mage = 23.7, 67% female) enrolled in a 6-session online program from July 2020 to January 2022 participated in this study. Results indicated the program was feasible; 81% of participants attended at least five out of six sessions. Qualitative feedback indicated high acceptability, with recommended changes to make the program more interactive. Participants reported significant improvements in self-compassion, resilience, loneliness, depression, stress, and emotion regulation. Conclusions are that Embracing Your Life is a promising, accessible intervention to address the mental health of emerging adults

A School-Based Mindfulness Pilot Study for Ethnically Diverse At-Risk Adolescents

Adolescence is a critical period for intervention with at-risk youth to promote emotional well-being, deter problematic behavior, and prevent the onset of life-long challenges. Despite preliminary evidence supporting mindfulness interventions for at-risk youth, few studies have included implementation details or reported feasibility and acceptance in ethnically diverse at-risk adolescents in a school setting. We conducted a randomized pilot study of a school-based mindfulness program, Learning to BREATHE, with ethnically diverse at-risk adolescents. Twenty-seven students were randomly assigned to a mindfulness or substance abuse control class that occurred for 50 min, once a week, over one school semester. Adjustments were made to increase acceptability of the mindfulness class, including enhanced instructor engagement in school activities. Reductions in depression were seen for students in the mindfulness class compared to controls. Initially, students’ perceived credibility of the mindfulness class was lower than that of the substance abuse class. Over the semester, perceived credibility of the mindfulness class increased while that of the substance abuse class decreased. Qualitative acceptability measures revealed that the mindfulness class helped to relieve stress and that students favored continuing the class. This study provides practical knowledge about what works with this unique population in a school setting and offers suggestions for future studies

Individual and combined effects of chemical and mechanical power on postoperative pulmonary complications: a secondary analysis of the REPEAT study

Introduction: Intra-operative supplemental oxygen and mechanical ventilation expose the lungs to potentially injurious energy. This can be quantified as 'chemical power' and 'mechanical power', respectively. In this study, we sought to determine if intra-operative chemical and mechanical power, individually and/or in combination, are associated with postoperative pulmonary complications. Methods: Using an individual patient data analysis of three randomised clinical trials of intra-operative ventilation, we summarised intra-operative chemical and mechanical power using time-weighted averages. We evaluated the association between intra-operative chemical and mechanical power and a collapsed composite of postoperative pulmonary complications using multivariable logistic regression to estimate the odds ratios related to the effect of 1 J.min-1 increase in chemical or mechanical power with adjustment for demographic and intra-operative characteristics. We also included an interaction term to assess for potential synergistic effects of chemical and mechanical power on postoperative pulmonary complications. Results: Of 3837 patients recruited to three individual trials, 2492 with full datasets were included in the analysis. Intra-operative time-weighted average (SD) chemical power was 10.2 (3.9) J.min-1 and mechanical power was 10.5 (4.4) J.min-1. An increase of 1 J.min-1 in chemical power was associated with 8% higher odds of postoperative pulmonary complications (OR 1.08, 95%CI 1.05-1.10, p < 0.001), while the same increase in mechanical power raised odds by 5% (OR 1.05, 95%CI 1.02-1.08, p = 0.003). We did not find evidence of a significant interaction between chemical and mechanical power (p = 0.40), suggestive of an additive rather than synergistic effect on postoperative pulmonary complications. Discussion: Both chemical and mechanical power are independently associated with postoperative pulmonary complications. Further work is required to determine causality

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Stratospheric circulation in seasonal forecasting models: Implications for seasonal prediction

Accurate seasonal forecasts rely on the presence of low frequency, predictable signals in the climate system which have a sufficiently well understood and significant impact on the atmospheric circulation. In the Northern European region, signals associated with seasonal scale variability such as ENSO, North Atlantic SST anomalies and the North Atlantic Oscillation have not yet proven sufficient to enable satisfactorily skilful dynamical seasonal forecasts. The winter-time circulations of the stratosphere and troposphere are highly coupled. It is therefore possible that additional seasonal forecasting skill may be gained by including a realistic stratosphere in models. In this study we assess the ability of five seasonal forecasting models to simulate the Northern Hemisphere extra-tropical winter-time stratospheric circulation. Our results show that all of the models have a polar night jet which is too weak and displaced southward compared to re-analysis data. It is shown that the models underestimate the number, magnitude and duration of periods of anomalous stratospheric circulation. Despite the poor representation of the general circulation of the stratosphere, the results indicate that there may be a detectable tropospheric response following anomalous circulation events in the stratosphere. However, the models fail to exhibit any predictability in their forecasts. These results highlight some of the deficiencies of current seasonal forecasting models with a poorly resolved stratosphere. The combination of these results with other recent studies which show a tropospheric response to stratospheric variability, demonstrates a real prospect for improving the skill of seasonal forecasts. © 2009 Springer-Verlag

High PEEP with recruitment maneuvers versus Low PEEP During General Anesthesia for Surgery -a Bayesian individual patient data meta-analysis of three randomized clinical trials

Background: The influence of high positive end-expiratory pressure (PEEP) with recruitment maneuvers on the occurrence of postoperative pulmonary complications after surgery is still not definitively established. Bayesian analysis can help to gain further insights from the available data and provide a probabilistic framework that is easier to interpret. Our objective was to estimate the posterior probability that the use of high PEEP with recruitment maneuvers is associated with reduced postoperative pulmonary complications in patients with intermediate-to-high risk under neutral, pessimistic, and optimistic expectations regarding the treatment effect. Methods: Multilevel Bayesian logistic regression analysis on individual patient data from three randomized clinical trials carried out on surgical patients at Intermediate-to-High Risk for postoperative pulmonary complications. The main outcome was the occurrence of postoperative pulmonary complications in the early postoperative period. We studied the effect of high PEEP with recruitment maneuvers versus Low PEEP Ventilation. Priors were chosen to reflect neutral, pessimistic, and optimistic expectations of the treatment effect. Results: Using a neutral, pessimistic, or optimistic prior, the posterior mean odds ratio (OR) for High PEEP with recruitment maneuvers compared to Low PEEP was 0.85 (95% Credible Interval [CrI] 0.71 to 1.02), 0.87 (0.72 to 1.04), and 0.86 (0.71 to 1.02), respectively. Regardless of prior beliefs, the posterior probability of experiencing a beneficial effect exceeded 90%. Subgroup analysis indicated a more pronounced effect in patients who underwent laparoscopy (OR: 0.67 [0.50 to 0.87]) and those at high risk for PPCs (OR: 0.80 [0.53 to 1.13]). Sensitivity analysis, considering severe postoperative pulmonary complications only or applying a different heterogeneity prior, yielded consistent results. Conclusion: High PEEP with recruitment maneuvers demonstrated a moderate reduction in the probability of PPC occurrence, with a high posterior probability of benefit observed consistently across various prior beliefs, particularly among patients who underwent laparoscopy