Functional and Structural Substrates of Neural Modulation in Older Adults After Executive Control Training

The fronto-parietal control network (FPCN) and dorsal attention network (DAN) are critical for goal-directed cognition (GDC), which is known to decline with advancing age. Here, we investigated whether a strategy-based executive control training intervention (GOALS) would alter recruitment of the FPCN and DAN in healthy older adults. We also investigated whether functional brain changes would be associated with improvements in GDC and structural integrity of frontal-posterior white matter tracts. Thirteen participants were randomly assigned to the five-week long GOALS training and 12 were randomly assigned to a time and intensity matched control intervention group. Both groups were tested before and after intervention on a goal-directed cognitive task while undergoing fMRI scanning. We observed post-training increases in activation within the FPCN during a selective working memory task requiring GDC in the GOALS training group as compared to the control group, p < .001. These increases were positively correlated with the integrity of white matter pathways connecting frontal and posterior brain regions in the GOALS group, p < .001. In conclusion, this study is the first to our knowledge to report changes in functional neural networks known to subserve GDC in older adults after training and relate these changes to the integrity of underlying white matter tracts

Creative Aging: Functional Neural Networks Associated with Creativity in Aging

Creativity is the ability to generate novel associations and has been linked to better problem-solving and real-world functional abilities. Creative ability has been implicated in successful aging including psychological, social, spiritual and, cognitive functioning (Duhamel, 2016). Creative thinking is associated with connectivity between default and executive control regions in the young brain. In aging, this pattern of functional coupling is observed across multiple tasks, and associated with better performance on tasks that closely mirror real-world functioning, where prior knowledge is congruent with task goals. This has been described as the Default-Executive Coupling Hypothesis of Aging (Turner & Spreng, 2015), and proposes that this changing neural architecture reflects greater reliance on internally stored representations and knowledge. This shift towards greater semanticized cognition in later stages of life reflected in changes in network connectivity and interactivity may also support creative cognition into older adulthood. However, age-differences in brain networks of creativity have yet to be directly investigated. This dissertation explored age-related functional connectivity patterns of creative thought among default and executive control networks using task-based and intrinsic functional connectivity methods. In study one, old and young participants completed a divergent thinking task measuring creative thinking, while undergoing fMRI scanning. Consistent with predictions, analyses demonstrated that default and executive networks are more functionally coupled during creative thinking for older than younger adults. Critically, despite similar performance on an in-scanner creativity task, increased global network efficiency of default-executive nodes was associated with creative ability for older adults only. These findings provide novel evidence of default-executive coupling as a putative mechanism supporting creative ability in later life. Next, we investigated whether this pattern of default-executive coupling supporting creative thinking is reflected in the intrinsic architecture of the aging brain. Younger and older adults underwent fMRI scanning at rest and completed a divergent thinking task to assess creative ability outside the scanner. Results indicated that both younger and older adults have equivalent performance on offline measures of creativity. However, relative to the younger adults, older adults showed a pattern of greater between-network intrinsic functional connectivity among default-executive networks associated with creative ability. Results from both study one and two provide evidence for a greater reliance of the aging brain on default-executive coupling to support creative cognition. In study three, we investigated whether creativity is associated with fluid or crystallized intelligence in young and older adults, as further, albeit preliminary, evidence in support of a semanticization of cognition hypothesis of creative cognition in later life. Results showed that fluid intelligence was reliable predictor of creativity across both young and older adults. Contrary to the semanticization hypothesis, crystallized intelligence was not a significant predictor of creativity in older adults. However, this may reflect the limited sample size for an individual difference analysis and the narrow assessment of crystalized knowledge. Taken together, the dissertation findings presented here extend previous research in aging and creative thinking by demonstrating that creativity is preserved in normal aging, yet relies on a different functional network architecture than has been reported in young. These functional brain changes may reflect a cognitive shift towards greater reliance on semantic knowledge that has important implications for understanding and predicting functional capacity in later life. Future investigations of creative ability in aging may provide a novel lens through which we can better understand the implications of creative thought in aspects of successful aging including maintenance of an agentic self-view, independence and a positive personal self-view that is key for mental health (Duhamel, 2016; Runco, 2004)

End stage renal disease: Seroprevalence of hepatitises B and C along with associated aetiology and risk factors in children

Background: End Stage Renal Disease (ESRD) normally requires dialysis or transplantation for survival. Since ESRD patients are on long term dialysis, infections such as Hepatitis B (HBV) and Hepatitis C (HCV) are commonly reported.Methods: This was a retrospective study carried out at a government hospital during a 12-month period from January 2013 to December 2013. The data was collected using a predesigned pro forma to note the etiology, gender, age, and HBsAg and anti-HCV test result of each patient.Results: 444 children suffering from ESRD were included in our analysis. The mean age of sample was 12.7 ± 4.1 years. Sixty percent (n = 262) of the children were boys. The most common etiology of ESRD was kidney stones (n = 44, 29.3%). HBV was positive in 11 children (2.5%) while HCV was positive in 13 (2.9%).Conclusion: This study asserts the need for carrying out further work to confirm these findings and expand our recommendations. It is imperative to reliably determine the burden of HBV and HCV disease and to determine the aetiology of their spread especially in children with ESRD

Impact of Thyroid Dysfunction on Red Cell Indices in a Tertiary Care Hospital

Background: The role of thyroid gland is to regulate the hematopoiesis in the bone marrow, which is carried out by inducing erythropoietin gene expression. The study aimed to compare red cell indices among different thyroid dysfunction disorders patients in our setup. Methods: This retrospective observational study was conducted in Ziauddin University Hospital, Karachi in Clifton campus from January 2018 to September 2018. To maintain confidentiality, patient’s identification was deleted. Total number of recruited patients was 485, out of which 117 were labeled as hyperthyroid, 169 were hypothyroid and 199 were euthyroid. Subjects for all three groups were between 20-60 years old. TSH level of patients were determined by VITROS® ECiQ immunoassay analyzer by Enhanced chemiluminescence technique. Data analysis was done on SPSS 20 while, mean and Standard deviation were calculated for quantitative variables. Percentages and frequencies were calculated for categorical variables and an independent t-test was applied to see significant differences among the groups. Results: Comparison between hyperthyroid and hypothyroid groups revealed a statistically significant difference in the mean hemoglobin (p=0.036) and hematocrit (p=0.022). A statistically significant difference was also found in the RBC count (p=0.043) and hematocrit (p=0.032) while comparing hyperthyroid and euthyroid groups. There was no statistical difference between hypothyroid and euthyroid patients for any of the hematological parameters. Conclusion: There was a proven association between thyroid dysfunction and erythropoiesis, which caused hematological indices to fluctuate, therefore hematological parameters, should be monitored in patients with thyroid diseases. Keywords: Red Cell Indices; Erythropoiesis; Euthyroid; Hypothyroid; Hyperthyroid; Hematocrit; Mean Corpuscular Volume; Thyroid Stimulating Hormone

Forging the path to precision medicine in Qatar: a public health perspective on pharmacogenomics initiatives

Pharmacogenomics (PGx) is an important component of precision medicine that promises tailored treatment approaches based on an individual’s genetic information. Exploring the initiatives in research that help to integrate PGx test into clinical setting, identifying the potential barriers and challenges as well as planning the future directions, are all important for fruitful PGx implementation in any population. Qatar serves as an exemplar case study for the Middle East, having a small native population compared to a diverse immigrant population, advanced healthcare system, national genome program, and several educational initiatives on PGx and precision medicine. This paper attempts to outline the current state of PGx research and implementation in Qatar within the global context, emphasizing ongoing initiatives and educational efforts. The inclusion of PGx in university curricula and healthcare provider training, alongside precision medicine conferences, showcase Qatar’s commitment to advancing this field. However, challenges persist, including the requirement for population specific implementation strategies, complex genetic data interpretation, lack of standardization, and limited awareness. The review suggests policy development for future directions in continued research investment, conducting clinical trials for the feasibility of PGx implementation, ethical considerations, technological advancements, and global collaborations to overcome these barriers

Assessing disparities in medical students’ knowledge and attitude about monkeypox: a cross-sectional study of 27 countries across three continents

Background and aimsThe recent monkeypox (Mpox) outbreak confirmed by the World Health Organization (WHO) underscores the importance of evaluating the knowledge and attitude of medical students toward emerging diseases, given their potential roles as healthcare professionals and sources of public information during outbreaks. This study aimed to assess medical students’ knowledge and attitude about Mpox and to identify factors affecting their level of knowledge and attitude in low-income and high-income countries.MethodsA cross-sectional study was conducted on 11,919 medical students from 27 countries. A newly-developed validated questionnaire was used to collect data on knowledge (14 items), attitude (12 items), and baseline criteria. The relationship between a range of factors with knowledge and attitude was studied using univariate and multivariate analyses.Results46% of the study participants were males; 10.7% were in their sixth year; 54.6% knew about smallpox; 84% received the coronavirus disease 2019 (COVID-19) vaccine; and 12.5% had training on Mpox. 55.3% had good knowledge of Mpox and 51.7% had a positive attitude towards it. Medical students in their third, fifth, or sixth year high- income countries who obtained information on Mpox from friends, research articles, social media and scientific websites were positive predictors for good knowledge. Conversely, being male or coming from high-income countries showed a negative relation with good knowledge about Mpox. Additionally, a positive attitude was directly influenced by residing in urban areas, being in the fifth year of medical education, having knowledge about smallpox and a history of receiving the coronavirus disease 2019 (COVID-19) vaccine. Receiving information about Mpox from social media or scientific websites and possessing good knowledge about Mpox were also predictors of a positive attitude. On the other hand, being male, employed, or receiving a training program about Mpox were inversely predicting positive attitude about Mpox.ConclusionThere were differences in knowledge and attitude towards Mpox between medical students in low and high-income countries, emphasizing the need for incorporating epidemiology of re-emerging diseases like Mpox into the medical curriculum to improve disease prevention and control

Brain Changes Following Executive Control Training in Older Adults.

BackgroundWhile older adults are able to attend to goal-relevant information, the capacity to ignore irrelevant or distracting information declines with advancing age. This decline in selective attention has been associated with poor modulation of brain activity in sensory cortices by anterior brain regions implicated in cognitive control.ObjectiveHere we investigated whether participation in an executive control training program would result in improved selective attention and associated functional brain changes in a sample of healthy older adults (N = 24, age 60-85 years).MethodsParticipants were enrolled in a goal-oriented attentional self-regulation (GOALS) program (n = 11) or a brain health education workshop as an active control condition (n = 13). All participants performed a working memory task requiring attention to or suppression of visual stimuli based on goal-relevance during functional magnetic resonance imaging.ResultsWe observed a pattern of enhanced activity in right frontal, parietal and temporal brain regions from pre- to posttraining in the GOALS intervention group, which predicted the selectivity of subsequent memory for goal-relevant stimuli.ConclusionsExecutive control training in older adults alters functional activity in brain regions associated with attentional control, and selectively predicts behavioral outcome

Forging the Path to Precision Medicine in Qatar: A Public Health Perspective on Pharmacogenomics Initiatives

Pharmacogenomics (PGx) is an important component of precision medicine that promises tailored treatment approaches based on an individual’s genetic information. Exploring the initiatives in research that help to integrate PGx test into clinical setting, identifying the potential barriers and challenges as well as planning the future directions, are all important for fruitful PGx implementation in any population. Qatar serves as an exemplar case study for the Middle East, having a small native population compared to a diverse immigrant population, advanced healthcare system, national genome program, and several educational initiatives on PGx and precision medicine. This paper attempts to outline the current state of PGx research and implementation in Qatar within the global context, emphasizing ongoing initiatives and educational efforts. The inclusion of PGx in university curricula and healthcare provider training, alongside precision medicine conferences, showcase Qatar’s commitment to advancing this field. However, challenges persist, including the requirement for population specific implementation strategies, complex genetic data interpretation, lack of standardization, and limited awareness. The review suggests policy development for future directions in continued research investment, conducting clinical trials for the feasibility of PGx implementation, ethical considerations, technological advancements, and global collaborations to overcome these barriers.The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Funding from the Qatar University and Hamad Bin Khalifa University are greatly acknowledged. The funders had no role in the study design, analysis or reporting