Emotional bias training as a treatment for anxiety and depression: evidence from experimental medicine studies in healthy and medicated samples.

BACKGROUND: Anxiety and depression are leading causes of disability worldwide, yet individuals are often unable to access appropriate treatment. There is a need to develop effective interventions that can be delivered remotely. Previous research has suggested that emotional processing biases are a potential target for intervention, and these may be altered through brief training programs. METHODS: We report two experimental medicine studies of emotional bias training in two samples: individuals from the general population (n = 522) and individuals currently taking antidepressants to treat anxiety or depression (n = 212). Participants, recruited online, completed four sessions of EBT from their own home. Mental health and cognitive functioning outcomes were assessed at baseline, immediately post-training, and at 2-week follow-up. RESULTS: In both studies, our intervention successfully trained participants to perceive ambiguous social information more positively. This persisted at a 2-week follow-up. There was no clear evidence that this change in emotional processing transferred to improvements in symptoms in the primary analyses. However, in both studies, there was weak evidence for improved quality of life following EBT amongst individuals with more depressive symptoms at baseline. No clear evidence of transfer effects was observed for self-reported daily stress, anhedonia or depressive symptoms. Exploratory analyses suggested that younger participants reported greater treatment gains. CONCLUSIONS: These studies demonstrate the effectiveness of delivering a multi-session online training program to promote lasting cognitive changes. Given the inconsistent evidence for transfer effects, EBT requires further development before it can be considered as a treatment for anxiety and depression

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Brain stimulation, mathematical, and numerical training: Contribution of core and noncore skills

Mathematical abilities that are correlated with various life outcomes vary across individuals. One approach to improve mathematical abilities is by understanding the underlying cognitive functions. Theoretical and experimental evidence suggest that mathematical abilities are subserved by "core" and "noncore" skills. Core skills are commonly regarded as the "innate" capacity to attend to and process numerical information, while noncore skills are those that are important for mathematical cognition, but are not exclusive to the mathematical domain such as executive functions, spatial skills, and attention. In recent years, mathematical training has been combined with the application of noninvasive brain stimulation to further enhance training outcomes. However, the development of more strategic training paradigms is hindered by the lack of understanding on the contributory nature of core and noncore skills and their neural underpinnings. In the current review, we will examine the effects of brain stimulation with focus on transcranial electrical stimulation on core and noncore skills, and its impact on mathematical and numerical training. We will conclude with a discussion on the theoretical and experimental implications of these studies and directions for further research

Brain stimulation, mathematical, and numerical training: Contribution of core and noncore skills

Mathematical abilities that are correlated with various life outcomes vary across individuals. One approach to improve mathematical abilities is by understanding the underlying cognitive functions. Theoretical and experimental evidence suggest that mathematical abilities are subserved by "core" and "noncore" skills. Core skills are commonly regarded as the "innate" capacity to attend to and process numerical information, while noncore skills are those that are important for mathematical cognition, but are not exclusive to the mathematical domain such as executive functions, spatial skills, and attention. In recent years, mathematical training has been combined with the application of noninvasive brain stimulation to further enhance training outcomes. However, the development of more strategic training paradigms is hindered by the lack of understanding on the contributory nature of core and noncore skills and their neural underpinnings. In the current review, we will examine the effects of brain stimulation with focus on transcranial electrical stimulation on core and noncore skills, and its impact on mathematical and numerical training. We will conclude with a discussion on the theoretical and experimental implications of these studies and directions for further research

Gallic acid attenuates dextran sulfate sodium-induced experimental colitis in BALB/c mice

Ashok Kumar Pandurangan,1,2 Nooshin Mohebali,2 Mohd Esa Norhaizan,1,3 Chung Yeng Looi2 1Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; 2Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 3Laboratory of Molecular Medicine, Institute of Bioscience, Universiti Putra Malaysia, Serdang, Selangor, MalaysiaAbstract: Gallic acid (GA) is a polyhydroxy phenolic compound that has been detected in various natural products, such as green tea, strawberries, grapes, bananas, and many other fruits. In inflammatory bowel disease, inflammation is promoted by oxidative stress. GA is a strong antioxidant; thus, we evaluated the cytoprotective and anti-inflammatory role of GA in a dextran sulfate sodium (DSS)-induced mouse colitis model. Experimental acute colitis was induced in male BALB/c mice by administering 2.5% DSS in the drinking water for 7 days. The disease activity index; colon weight/length ratio; histopathological analysis; mRNA expressions of IL-21 and IL-23; and protein expression of nuclear erythroid 2-related factor 2 (Nrf2) were compared between the control and experimental mice. The colonic content of malondialdehyde and the activities of superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase activity were examined as parameters of the redox state. We determined that GA significantly attenuated the disease activity index and colon shortening, and reduced the histopathological evidence of injury. GA also significantly (P&lt;0.05) reduced the expressions of IL-21 and IL-23. Furthermore, GA activates/upregulates the expression of Nrf2 and its downstream targets, including UDP-GT and NQO1, in DSS-induced mice. The findings of this study demonstrate the protective effect of GA on experimental colitis, which is probably due to an antioxidant nature of GA.Keywords: IL-21, NQO1, MDA, enzymic antioxidants, Nrf

The neurochemistry of mathematical genius: Reduced frontal excitation/inhibition balance in an expert calculator

Alterations in excitatory and inhibitory neurotransmitters (glutamate and GABA, respectively) have been found in various neuropsychiatric disorders, but have not been examined in individuals with prodigious cognitive abilities. Understanding exceptional brain processing is critical for developing biomedical interventions for cognitive and neurodevelopmental atypicalities. We tested the 11-fold world champion in mental calculation, G.M., and compared his right middle frontal gyrus, which has been associated with mathematical prodigy, to four healthy control expert calculators, who were not prodigies. We found substantially lower frontal glutamate/GABA compared to non-prodigy controls, but not glutamate or GABA individually, measured with magnetic resonance spectroscopy. We suggest that prefrontal glutamate/GABA is a potential marker of extraordinary cognitive skills

Soluble factors from stellate cells induce pancreatic cancer cell proliferation via Nrf2-activated metabolic reprogramming and ROS detoxification

Pancreatic stellate cells (PSC), a prominent stromal cell, contribute to the progression of pancreatic ductal adenocarcinoma (PDAC). We aim to investigate the mechanisms by which PSC promote cell proliferation in PDAC cell lines, BxPC-3 and AsPC-1. PSC-conditioned media (PSC-CM) induced proliferation of these cells in a dose- and time-dependent manner. Nrf2 protein was upregulated and subsequently, its transcriptional activity was increased with greater DNA binding activity and transcription of target genes. Downregulation of Nrf2 led to suppression of PSC-CM activity in BxPC-3, but not in AsPC-1 cells. However, overexpression of Nrf2 alone resulted in increased cell proliferation in both cell lines, and treatment with PSC-CM further enhanced this effect. Activation of Nrf2 pathway resulted in upregulation of metabolic genes involved in pentose phosphate pathway, glutaminolysis and glutathione biosynthesis. Downregulation and inhibition of glucose-6-phosphate-dehydrogenase with siRNA and chemical approaches reduced PSC-mediated cell proliferation. Among the cytokines present in PSC-CM, stromal-derived factor-1 alpha (SDF-1α) and interleukin-6 (IL-6) activated Nrf2 pathway to induce cell proliferation in both cells, as shown with neutralization antibodies, recombinant proteins and signaling inhibitors. Taken together, SDF-1α and IL-6 secreted from PSC induced PDAC cell proliferation via Nrf2-activated metabolic reprogramming and ROS detoxification