Mindfulness-based stress reduction or aerobics exercise for reducing burnout in medical residents- a study protocol for a phase III, open-label, multi-center, randomized controlled trial: The MINDER Collaborative group study

Background and objectives: Burnout results from chronic workplace stress leading to emotional exhaustion, negativity, and decreased professional efficiency. In the healthcare system, this can have consequences like increased medical errors, absenteeism, substance abuse, depression, and suicide among health professionals, adversely affecting patient care. Various individual-directed measures like the mindfulness-based stress reduction program (MBSR), one of the most studied and widely adopted techniques, and physical activity, like aerobics or sports, have shown to be effective against burnout. With this study, we intend to increase awareness regarding this public health issue among the residents and the faculty. Our aim is to define a successful intervention that can be incorporated as a yearly requirement for the completion of residency programs. Methodology: This study will be a phase III, multicentric, open-label, placebo (waiting list) controlled trial. Our sample size will be 720 residents sampled from 6 university hospitals from across the world, randomized into 3 parallel arms (1:1:1 ratio stratified according to site and specialty). Residents, diagnosed with burnout based on baseline Maslach Burnout Inventory score (MBI) and having no prior physical or mental health issues, will be included. The first group will undergo the MBSR program for 8 weeks, the second group will undergo a supervised aerobics program for 8 weeks, and the third group will be put into a waiting list for any of the interventions. The primary outcome will be the change in MBI scores after the intervention. The secondary outcomes will be the change in MBI score 3 months after the intervention, and changes in measures like heart rate, blood pressure, glycated hemoglobin, cortisol levels, quality of sleep and quality of life after the intervention and 3 months later. We also plan to do a subgroup analysis to see the difference based on specialty and gender. Study impact: The residency training period is considered one of the most stressful phases in medical education. Higher rates of burnout are noted in the residents, and this can negatively impact patient care and the progression of their careers. This trial will look at multiple interventions to combat burnout recruiting residents of different specialties in different work environments across the world. We hope to remove the stigma surrounding burnout in the healthcare system. This study will show the short and long term benefits of these interventions and would help us recommend their inclusion in various residency programs

Time-resolved effective connectivity in task fMRI: Psychophysiological interactions of Co-Activation patterns

Investigating context-dependent modulations of Functional Connectivity (FC) with functional magnetic resonance imaging is crucial to reveal the neurological underpinnings of cognitive processing. Most current analysis methods hypothesise sustained FC within the duration of a task, but this assumption has been shown too limiting by recent imaging studies. While several methods have been proposed to study functional dynamics during rest, task-based studies are yet to fully disentangle network modulations. Here, we propose a seed-based method to probe task-dependent modulations of brain activity by revealing Psychophysiological Interactions of Co-activation Patterns (PPI-CAPs). This point process-based approach temporally decomposes task-modulated connectivity into dynamic building blocks which cannot be captured by current methods, such as PPI or Dynamic Causal Modelling. Additionally, it identifies the occurrence of co-activation patterns at single frame resolution as opposed to window-based methods. In a naturalistic setting where participants watched a TV program, we retrieved several patterns of co-activation with a posterior cingulate cortex seed whose occurrence rates and polarity varied depending on the context; on the seed activity; or on an interaction between the two. Moreover, our method exposed the consistency in effective connectivity patterns across subjects and time, allowing us to uncover links between PPI-CAPs and specific stimuli contained in the video. Our study reveals that explicitly tracking connectivity pattern transients is paramount to advance our understanding of how different brain areas dynamically communicate when presented with a set of cues

Get real: Orbitofrontal cortex mediates the ability to sense reality in early adolescents

Introduction Orbitofrontal reality filtering (ORFi) is a memory mechanism that distinguishes whether a thought is relevant to present reality or not. In adults, it is mediated by the orbitofrontal cortex (OFC). This region is still not fully developed in preteenagers, but ORFi is already active from age 7. Here, we probe the neural correlates of ORFi in early adolescents, hypothesizing that OFC mediates the sense of reality in this population.Methods Functional magnetic resonance images (fMRI) were acquired in 22 early adolescents during a task composed of two runs: run 1 measuring recognition capacity; run 2 measuring ORFi; each containing two types of images (conditions): distractors (D: images seen for the first time in the current run) and targets (T: images seen for the second time in the current run). Group region of interest (ROI) analysis was performed in a flexible factorial design with two factors (run and condition) using SPM12.Results We found significant main effects for the experimental run and condition. The bilateral OFC activation was higher during ORFi than during the first run. Additionally, the OFC was more active while processing distractors than targets.Conclusion These results confirm, for the first time, the role of OFC in reality filtering in early adolescents

Vital statistics of triatominae (Hemiptera: Reduviidae) under laboratory conditions: III. Rhodnius neglectus

Cinco cohortes de 100 huevos deRhodnius neglectusLent 1954 (Hemiptera: Reduviidae) se criaron de manera simultánea en el laboratorio bajo condiciones constantes (26 1C and 60 10% HR), registrándose semanalmente la mortalidad y la fecundidad. Calculamos los tiempos de desarrollo por estadios (tiempo de desarrollo total 15 semanas), las estadísticas vitales (mortalidad y fecundidad específica por edades, mortalidad preadulta específica por estadios), y los parámetros de crecimiento poblacional (la tasa intrínseca de crecimiento natural (r0 0,21), la tasa finita de crecimiento poblacional ( 1,23),la tasa de reproducción (R0314,24), y el tiempo generacional (T21,45 semanas)).El análisis de elasticidad indica que el rasgo dominante de la historia de vida que determina es la supervivencia de la hembra adulta, y el tiempo en que las ninfas V permanecen en ese estadio. Las hembras adultas dominaron el valor reproductor específico por estadios, y la fase del huevo dominó la distribución estable de estadios (SSD). La tasa de amortiguación ( 1,11) sugiere un período relativamente rápido de recuperación a un SSD si la misma es perturbada. Se compararon las estadísticas vitales con valores de la bibliografía y se encontró una concordancia relativamente satisfactoria, tomando en consideración que las condiciones ambientales no siempre eran las mismas. En una comparación con otras dos especies delmismo género, Rhodnius neivai Lent 1953 y Rhodnius prolixus Stål 1859, R. neglectus evidencia valores más altos en la fecundidad (huevos totales/ /vida) y en la longevidad de la hembra, valores intermedios en la tasa intrínseca de crecimiento natural (r0), y valores más bajos en el tiempo de desarrollo y en la mortalidad. Se realizó un ajuste de los valores de densidad de una colonización espontánea de dos gallineros experimentales en el campo a un modelologístico de crecimiento poblacional y se pudo estimarla tasa intrínseca de crecimiento natural (r0) y la capacidad de carga, y compararla r0 con nuestros resultados de laboratorio.Five cohorts of 100 eggs of Rhodnius neglectus Lent 1954 (Hemiptera: Reduviidae) were reared simultaneously in the laboratory under constant conditions (26 ±1°Â°C and 60 ±10% RH), with mortality and fecundity data recorded weekly. We calculated stage-specific developmental times, agespecific mortality and fecundity, stage-specific and total preadult mortality, and the intrinsic rate of natural increase (ro = 0.21), the finite population growth rate (λ = 1.23), the net reproductive rate (Ro = 314.24), and the generation time (T = 21.45 wk). Elasticity analysis showed that the dominant life-history traits determining Î" were the adult female survival, and the survival of instar V nymphs (molting into adult females). Adult females dominated the stage-specific reproductive value, and the egg stage dominated the stable stage distribution (SSD). The damping ratio (p = 1.11) suggests a relatively rapid period of recovery to a disturbed SSD. Results were compared with previous values from the literature and conform relatively well, considering that environmental conditions were not always the same. Compared with two other species of the same genus, Rhodnius neivai Lent 1953 and Rhodnius prolixus Stal 1859, R. neglectus ranked higher in fecundity (total eggs/♀/life) and in female longevity, intermediate in the intrinsic rate of natural increase (ro), and lower in developmental time and mortality. By fitting a logistic model of population growth to the density field values of a spontaneous colonization of two field experimental chicken coops we estimated the intrinsic rate of natural increase and carrying capacity parameters, and compared the former with our laboratory results.Fil: Rabinovich, Jorge Eduardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Estudios Parasitológicos y de Vectores. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Centro de Estudios Parasitológicos y de Vectores; ArgentinaFil: Nieves, Eliana Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Estudios Parasitológicos y de Vectores. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Centro de Estudios Parasitológicos y de Vectores; Argentin

Exercise-linked FNDC5/irisin rescues synaptic plasticity and memory defects in Alzheimer\u27s models

Defective brain hormonal signaling has been associated with Alzheimer\u27s disease (AD), a disorder characterized by synapse and memory failure. Irisin is an exercise-induced myokine released on cleavage of the membrane-bound precursor protein fibronectin type III domain-containing protein 5 (FNDC5), also expressed in the hippocampus. Here we show that FNDC5/irisin levels are reduced in AD hippocampi and cerebrospinal fluid, and in experimental AD models. Knockdown of brain FNDC5/irisin impairs long-term potentiation and novel object recognition memory in mice. Conversely, boosting brain levels of FNDC5/irisin rescues synaptic plasticity and memory in AD mouse models. Peripheral overexpression of FNDC5/irisin rescues memory impairment, whereas blockade of either peripheral or brain FNDC5/irisin attenuates the neuroprotective actions of physical exercise on synaptic plasticity and memory in AD mice. By showing that FNDC5/irisin is an important mediator of the beneficial effects of exercise in AD models, our findings place FNDC5/irisin as a novel agent capable of opposing synapse failure and memory impairment in AD