A Mixed Methods Evaluation of the Effectiveness of a Group Yoga Intervention as an Adjunctive Trauma Therapy for Adolescent Girls

Neuroscience findings support the need for trauma treatments that work from the lowest levels of the brain up to the highest levels of the brain (Perry, 2009) due to evidence that the inverse relationship between amygdala and medial prefrontal cortex is not as strong in individuals who have experienced trauma, leading to difficulty in inhibiting fear responses through cognition (McRae, Ochsner, & Gross 2011). Difficulties associating language with traumatic events have also been found (van der Kolk, 2006). The integration of mindfulness practices and the popularization of yoga in the West have led to use of yoga to address trauma as a mind-body intervention capable of downregulating the bod\u27s stress response (Mitchell et al., 2014). Van der Kolk and colleagues (2014) found 52% of women assigned to a yoga group no longer met PTSD criteria. Limited data is currently available in the literature regarding yoga treatment of PTSD with youth. This embedded mixed methods study expands the literature by evaluating group data regarding a yoga psychotherapy group based on the Healing Childhood Sexual Abuse with Yoga (HCSAY; Lilly & Hedlund, 2010) curriculum as an adjunctive treatment for trauma conducted at two outpatient programs. Data were collected at pretest and post-test through questionnaires. Qualitatively, data were collected through a weekly Yoga Experience Form completed during the group, follow-up interviews, and the author\u27s field notes. The Yoga Experiences Form was designed to help participants reflect on the themes and awareness gained in the group. The quantitative questionnaires measured both general symptoms through the Youth Outcomes Questionnaire-Self Report (YOQ-SR; Wells, Burlingame, & Lambert, 2005) and trauma-related symptoms through the Child PTSD Symptom Scale (CPSS; Foa, Johnson, Feeny, & Treadwell, 2001). In addition, participants\u27 beliefs in the group\u27s themes were assessed through the Affirmation Questionnaire developed by the author. Outcomes were evaluated using repeated measures ANOVA and content analysis. Findings indicated that yoga was helpful in decreasing behavioral, mood, and avoidance symptoms associated with trauma. Similar gains were seen in two samples with differing levels of symptom severity across mental health symptoms, though the group with higher initial symptom severity demonstrated a smaller decrease in trauma-specific symptoms. While the physical postures were discussed most frequently as respondents\u27 focus about what was helpful and difficult about the group, over half the group members also noted that components of the breath work were helpful and 39% noted that the meditative and mindfulness components were helpful. Themes related to safety, strength, trust, and community had the most impact for participants. Overall, while trauma presents differently in youth than in adults, the findings from the current study are similar to recent findings from studies with adult female survivors of trauma that suggest yoga is a helpful adjunct to talk therapy

Single-Dose Mucosal Immunization with a Candidate Universal Influenza Vaccine Provides Rapid Protection from Virulent H5N1, H3N2 and H1N1 Viruses

The sudden emergence of novel influenza viruses is a global public health concern. Conventional influenza vaccines targeting the highly variable surface glycoproteins hemagglutinin and neuraminidase must antigenically match the emerging strain to be effective. In contrast, "universal" vaccines targeting conserved viral components could be used regardless of viral strain or subtype. Previous approaches to universal vaccination have required protracted multi-dose immunizations. Here we evaluate a single dose universal vaccine strategy using recombinant adenoviruses (rAd) expressing the conserved influenza virus antigens matrix 2 and nucleoprotein.In BALB/c mice, administration of rAd via the intranasal route was superior to intramuscular immunization for induction of mucosal responses and for protection against highly virulent H1N1, H3N2, or H5N1 influenza virus challenge. Mucosally vaccinated mice not only survived, but had little morbidity and reduced lung virus titers. Protection was observed as early as 2 weeks post-immunization, and lasted at least 10 months, as did antibodies and lung T cells with activated phenotypes. Virus-specific IgA correlated with but was not essential for protection, as demonstrated in studies with IgA-deficient animals.Mucosal administration of NP and M2-expressing rAd vectors provided rapid and lasting protection from influenza viruses in a subtype-independent manner. Such vaccines could be used in the interval between emergence of a new virus strain and availability of strain-matched vaccines against it. This strikingly effective single-dose vaccination thus represents a candidate off-the-shelf vaccine for emergency use during an influenza pandemic

Securing Our Economic Future

The American economy is in the midst of a wrenching crisis, one caused by the COVID-19 pandemic and aggravated further by a series of climate-driven natural disasters. While the economy has made some steps towards recovery, the pandemic has laid bare the reality that too many Americans are unable to meet many of their urgent and basic needs. At the same time, it has become painfully clear that American society is not equipped to deal with the risks emerging from our changing climate. This book is a contribution towards policy options for addressing these challenges. Although it was largely written before the pandemic crises beset our country, the analyses, diagnoses, and prescriptions contained within all shed new light on the underlying fragilities that have since been exposed. The volume is composed of nine commissioned chapters and is divided into three sections, covering the 'Economics of the American Middle Class'; the 'Geographic Disparities in Economic Opportunity'; and the 'Geopolitics of the Climate and Energy Challenge and the US Policy Response.' Part I focuses on the economic wellbeing of the American middle class and the chapters in this section evaluate the prevailing narrative of its decline. The chapters in part II investigate the large variation in income and economic opportunities across places, and include a specific policy proposal for emergency rental assistance. Part III is devoted to the global climate crisis. The chapters in this final section emphasize the mounting social and economic costs of inaction and discuss potential policy approaches for tackling the climate challenge

Snow Ensemble Uncertainty Project (SEUP): quantification of snow water equivalent uncertainty across North America via ensemble land surface modeling

The Snow Ensemble Uncertainty Project (SEUP) is an effort to establish a baseline characterization of snow water equivalent (SWE) uncertainty across North America with the goal of informing global snow observational needs. An ensemble-based modeling approach, encompassing a suite of current operational models is used to assess the uncertainty in SWE and total snow storage (SWS) estimation over North America during the 2009–2017 period. The highest modeled SWE uncertainty is observed in mountainous regions, likely due to the relatively deep snow, forcing uncertainties, and variability between the different models in resolving the snow processes over complex terrain. This highlights a need for high-resolution observations in mountains to capture the high spatial SWE variability. The greatest SWS is found in Tundra regions where, even though the spatiotemporal variability in modeled SWE is low, there is considerable uncertainty in the SWS estimates due to the large areal extent over which those estimates are spread. This highlights the need for high accuracy in snow estimations across the Tundra. In midlatitude boreal forests, large uncertainties in both SWE and SWS indicate that vegetation–snow impacts are a critical area where focused improvements to modeled snow estimation efforts need to be made. Finally, the SEUP results indicate that SWE uncertainty is driving runoff uncertainty, and measurements may be beneficial in reducing uncertainty in SWE and runoff, during the melt season at high latitudes (e.g., Tundra and Taiga regions) and in the western mountain regions, whereas observations at (or near) peak SWE accumulation are more helpful over the midlatitudes

Multi-omics analysis of the gut microbiome and metabolites associated with the psychoneurological symptom cluster in children with cancer receiving chemotherapy

Abstract Background Children with cancer receiving chemotherapy commonly report a cluster of psychoneurological symptoms (PNS), including pain, fatigue, anxiety, depression, and cognitive dysfunction. The role of the gut microbiome and its functional metabolites in PNS is rarely studied among children with cancer. This study investigated the associations between the gut microbiome–metabolome pathways and PNS in children with cancer across chemotherapy as compared to healthy children. Methods A case–control study was conducted. Cancer cases were recruited from Children’s Healthcare of Atlanta and healthy controls were recruited via flyers. Participants reported PNS using the Pediatric Patient-Reported Outcomes Measurement Information System. Data for cases were collected pre-cycle two chemotherapy (T0) and post-chemotherapy (T1), whereas data for healthy controls were collected once. Gut microbiome and its metabolites were measured using fecal specimens. Gut microbiome profiling was performed using 16S rRNA V4 sequencing, and metabolome was performed using an untargeted liquid chromatography–mass spectrometry approach. A multi-omics network integration program analyzed microbiome–metabolome pathways of PNS. Results Cases (n = 21) and controls (n = 14) had mean ages of 13.2 and 13.1 years. For cases at T0, PNS were significantly associated with microbial genera (e.g., Ruminococcus, Megasphaera, and Prevotella), which were linked with carnitine shuttle (p = 0.0003), fatty acid metabolism (p = 0.001) and activation (p = 0.001), and tryptophan metabolism (p = 0.008). Megasphaera, clustered with aspartate and asparagine metabolism (p = 0.034), carnitine shuttle (p = 0.002), and tryptophan (p = 0.019), was associated with PNS for cases at T1. Gut bacteria with potential probiotic functions, along with fatty acid metabolism, tryptophan, and carnitine shuttle, were more clustered in cancer cases than the control network and this linkage with PNS needs further studies. Conclusions Using multi-omics approaches, this study indicated specific microbiome–metabolome pathways linked with PNS in children with cancer across chemotherapy. Due to limitations such as antibiotic use in cancer cases, these findings need to be further confirmed in a larger cohort

Bardoxolone methyl in type 2 diabetes and stage 4 chronic kidney disease

BACKGROUND: Although inhibitors of the renin-angiotensin-aldosterone system can slow the progression of diabetic kidney disease, the residual risk is high. Whether nuclear 1 factor (erythroid-derived 2)-related factor 2 activators further reduce this risk is unknown. METHODS: We randomly assigned 2185 patients with type 2 diabetes mellitus and stage 4 chronic kidney disease (estimated glomerular filtration rate [GFR], 15 to <30 ml per minute per 1.73 m(2) of body-surface area) to bardoxolone methyl, at a daily dose of 20 mg, or placebo. The primary composite outcome was end-stage renal disease (ESRD) or death from cardiovascular causes. RESULTS: The sponsor and the steering committee terminated the trial on the recommendation of the independent data and safety monitoring committee; the median follow-up was 9 months. A total of 69 of 1088 patients (6%) randomly assigned to bardoxolone methyl and 69 of 1097 (6%) randomly assigned to placebo had a primary composite outcome (hazard ratio in the bardoxolone methyl group vs. the placebo group, 0.98; 95% confidence interval [CI], 0.70 to 1.37; P=0.92). In the bardoxolone methyl group, ESRD developed in 43 patients, and 27 patients died from cardiovascular causes; in the placebo group, ESRD developed in 51 patients, and 19 patients died from cardiovascular causes. A total of 96 patients in the bardoxolone methyl group were hospitalized for heart failure or died from heart failure, as compared with 55 in the placebo group (hazard ratio, 1.83; 95% CI, 1.32 to 2.55; P<0.001). Estimated GFR, blood pressure, and the urinary albumin-to-creatinine ratio increased significantly and body weight decreased significantly in the bardoxolone methyl group, as compared with the placebo group. CONCLUSIONS: Among patients with type 2 diabetes mellitus and stage 4 chronic kidney disease, bardoxolone methyl did not reduce the risk of ESRD or death from cardiovascular causes. A higher rate of cardiovascular events with bardoxolone methyl than with placebo prompted termination of the trial. (Funded by Reata Pharmaceuticals; BEACON ClinicalTrials.gov number, NCT01351675.)