Molecular and brain volume changes following aerobic exercise, cognitive and combined training in physically inactive healthy Late-Middle-Aged Adults: The Projecte Moviment Randomized Controlled Trial

Behavioral interventions have shown promising neuroprotective effects, but the cascade of molecular, brain and behavioral changes involved in these benefits remains poorly understood. Projecte Moviment is a 12-week (5 days per week—45 min per day) multi-domain, single-blind, proof-of-concept randomized controlled trial examining the cognitive effect and underlying mechanisms of an aerobic exercise (AE), computerized cognitive training (CCT) and a combined (COMB) groups compared to a waitlist control group. Adherence was > 80% for 82/109 participants recruited (62% female; age = 58.38 ± 5.47). In this study we report intervention-related changes in plasma biomarkers (BDNF, TNF-α, HGF, ICAM-1, SDF1-α) and structural-MRI (brain volume) and how they related to changes in physical activity and individual variables (age and sex) and their potential role as mediators in the cognitive changes. Our results show that although there were no significant changes in molecular biomarker concentrations in any intervention group, changes in ICAM-1 and SDF1-α were negatively associated with changes in physical activity outcomes in AE and COMB groups. Brain volume changes were found in the CCT showing a significant increase in precuneus volume. Sex moderated the brain volume change in the AE and COMB groups, suggesting that men may benefit more than women. Changes in molecular biomarkers and brain volumes did not significantly mediate the cognitive-related benefits found previously for any group. This study shows crucial initial molecular and brain volume changes related to lifestyle interventions at early stages and highlights the value of examining activity parameters, individual difference characteristics and using a multi-level analysis approach to address these questions

Restes humains dans des structures néolithiques du nord-est de la péninsule Ibérique: dépôts ou sépultures?

[EN] One aspect that defines the Neolithic of the northeast of the Iberian Peninsula is its funeral register. The graves are so numerous that already in the early twentieth century culture of « Sepulcres de Fossa ». Many studies have been conducted on the funerary practices of this group, but atypical graves or human remains deposits are generally unnoticed, whereas they exist. In this paper we present some of these structures and propose a first series of reflections on these non-normative deposits.[FR] Le Néolithique du nord-est de la péninsule Ibérique est en grande partie défini par son registre funéraire. Les sépultures sont tellement nombreuses que, déjà au début du xxe siècle, le professeur P. Bosch Gimpera considérait qu’elles devaient appartenir à une même culture relativement homogène : la culture des «Sepulcres de Fossa». De nombreuses études ont été menées sur les pratiques funéraires de ce groupe, mais les sépultures atypiques ou les dépôts de restes humains sont généralement passés inaperçus, alors qu’ils existent. Dans cet article, nous présentons certaines de ces structures et proposons une première série de réflexions sur ces ensembles hors normes.Peer reviewe

Clinical features and outcomes of tuberculosis in transplant recipients as compared with the general population: a retrospective matched cohort study

AbstractThere are no previous studies comparing tuberculosis in transplant recipients (TRs) with other hosts. We compared the characteristics and outcomes of tuberculosis in TRs and patients from the general population. Twenty-two TRs who developed tuberculosis from 1996 through 2010 at a tertiary hospital were included. Each TR was matched by age, gender and year of diagnosis with four controls selected from among non-TR non-human immunodeficiency virus patients with tuberculosis. TRs (21 patients, 96%) had more factors predisposing to tuberculosis than non-TRs (33, 38%) (p <0.001). Pulmonary tuberculosis was more common in non-TRs (77 (88%) vs. 12 TRs (55%); p 0.001); disseminated tuberculosis was more frequent in TRs (five (23%) vs. four non-TRs (5%); p 0.005). Time from clinical suspicion of tuberculosis to definitive diagnosis was longer in TRs (median of 14 days) than in non-TRs (median of 0 days) (p <0.001), and invasive procedures were more often required (12 (55%) TRs and 15 (17%) non-TRs, respectively; p 0.001). Tuberculosis was diagnosed post-mortem in three TRs (14%) and in no non-TRs (p <0.001). Rates of toxicity associated with antituberculous therapy were 38% in TRs (six patients) and 10% (seven patients) in non-TRs (p 0.014). Tuberculosis-related mortality rates in TRs and non-TRs were 18% and 6%, respectively (p 0.057). The adjusted Cox regression analysis showed that the only predictor of tuberculosis-related mortality was a higher number of organs with tuberculosis involvement (adjusted hazard ratio 8.6; 95% CI 1.2–63). In conclusion, manifestations of tuberculosis in TRs differ from those in normal hosts. Post-transplant tuberculosis resists timely diagnosis, and is associated with a higher risk of death before a diagnosis can be made

Effects and Mechanisms of Cognitive, Aerobic Exercise, and Combined Training on Cognition, Health, and Brain Outcomes in Physically Inactive Older Adults : The Projecte Moviment Protocol

Altres ajuts: It has also been rewarded with three pre-doctoral fellowships ( FPU014/01460, FI-2016, and FI-2018).Introduction: Age-related health, brain, and cognitive impairment is a great challenge in current society. Cognitive training, aerobic exercise and their combination have been shown to benefit health, brain, cognition and psychological status in healthy older adults. Inconsistent results across studies may be related to several variables. We need to better identify cognitive changes, individual variables that may predict the effect of these interventions, and changes in structural and functional brain outcomes as well as physiological molecular correlates that may be mediating these effects. Projecte Moviment is a multi-domain randomized trial examining the effect of these interventions applied 5 days per week for 3 months compared to a passive control group. The aim of this paper is to describe the sample, procedures and planned analyses. Methods: One hundred and forty healthy physically inactive older adults will be randomly assigned to computerized cognitive training (CCT), aerobic exercise (AE), combined training (COMB), or a control group. The intervention consists of a 3 month home-based program 5 days per week in sessions of 45 min. Data from cognitive, physical, and psychological tests, cardiovascular risk factors, structural and functional brain scans, and blood samples will be obtained before and after the intervention. Results: Effects of the interventions on cognitive outcomes will be described in intention-to-treat and per protocol analyses. We will also analyze potential genetic, demographic, brain, and physiological molecular correlates that may predict the effects of intervention, as well as the association between cognitive effects and changes in these variables using the per protocol sample. Discussion: Projecte Moviment is a multi-domain intervention trial based on prior evidence that aims to understand the effects of CCT, AE, and COMB on cognitive and psychological outcomes compared to a passive control group, and to determine related biological correlates and predictors of the intervention effects. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03123900

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Funerary practices in the Middle Neolithic necropolis of Can Gambüs-1 (Sabadell, Spain): From preparing the body to closing the grave

[EN] While the presence of Neolithic communities is attested in the north-eastern part of the Iberian Peninsula from the middle of the sixth millennium BC, it was only a thousand years later that burials in large numbers began to appear. Their abundance and some spectacular aspects are at the origin of the name ‘Sepulcres de fossa culture’ or ‘pit grave culture’. Although more than 600 burials are associated with this period, there has not to date been any research into how the deceased were buried in the grave and how the pit may have been installed. The site of Can Gambús-1 at Sabadell, discovered in 2003, is the latest and most remarkable discovery for the Middle Neolithic in this region. No domestic structure of this period has been discovered around the graves, suggesting that the place was strictly dedicated to interment. The preservation of most of the 47 burials helped to redefine and complete prior classifications by providing new information about construction processes, roofing systems, reuse and looting. A typology of five principal categories has been proposed for the Can Gambús-1 cemetery. Simple graves (type E) are distinguished from more complex large and monumental burials (types A to D). The anthropological study of the 51 individuals has allowed the lifestyle of the Can Gambús-1 population to be understood through osteometric study, analysis of activity-induced musculoskeletal stress markers and pathologies.[FR] Dans le Néolithique de Catalogne, il faut attendre le Ve millénaire av. J.-C. pour retrouver des sépultures en grand nombre. Cette abondance est à l’origine du nom de la culture des Sepulcres de fossa, qui a livré à ce jour plus de 600 tombes. Malgré ce corpus imposant, il n’existait à ce jour aucune étude des modalités d’inhumation du défunt et des aménagements dont la fosse a pu faire l’objet. Le site de Can Gambús-1 à Sabadell, mis au jour en 2003, constitue la plus récente et la plus remarquable découverte pour le Néolithique moyen dans cette région. Le bon état de conservation de la plupart des 47 sépultures a permis de redéfinir et de compléter les classifications antérieures : une typologie composée de cinq catégories principales a été proposée. On distingue les structures complexes, monumentales et de grandes dimensions, correspondant aux types A à D, des structures simples de type E. L’absence de sujet immature parmi les 51 défunts est remarquable. La proportion de femmes et d’hommes est globalement équivalente. La quasi-totalité des tombes a fourni un mobilier riche et diversifié, caractérisé notamment par la présence d’industrie lithique en silex blond, de vases en céramique, d’outils en os et d’éléments de parure en variscite. Quatre datations absolues ont été obtenues à ce jour. La reconstitution des pratiques funéraires est fondée sur l’analyse taphonomique, qui repose sur la chronologie de la dislocation des articulations du squelette et la pesanteur.Peer reviewe

Effects of aerobic exercise, cognitive and combined training on cognition in physically inactive healthy late-middle-aged adults: The Projecte Moviment Randomized Controlled Trial

Background: Lifestyle interventions are promising strategies to promote cognitive health in aging. Projecte Moviment examines if aerobic exercise (AE), computerized cognitive training (CCT), and their combination (COMB) improves cognition, psychological health, and physical status compared to a control group. We assessed the moderating role of age and sex and the mediating effects of cardiorespiratory fitness (CRF), physical activity (PA), and psychological health on intervention-related cognitive benefits. Methods: This was a 12-week multi-domain, single-blind, proof-of-concept randomized controlled trial (RCT). 96 healthy adults aged 50–70 years were assigned to AE, CCT, COMB, and a wait-list control group. The per protocol sample, which completed the intervention with a level of adherence > 80%, consisted of 82 participants (62% female; age = 58.38 ± 5.47). We assessed cognition, psychological health, CRF, and energy expenditure in PA at baseline and after the intervention. We regressed change in each outcome on the treatment variables, baseline score, sex, age, and education. We used PROCESS Macro to perform the mediation and moderation analyses. Results: AE benefited Working Memory (SMD = 0.29, p = 0.037) and Attention (SMD = 0.33, p = 0.028) including the Attention-Speed (SMD = 0.31, p = 0.042) domain, compared to Control. COMB improved Attention (SMD = 0.30, p = 0.043), Speed (SMD = 0.30, p = 0.044), and the Attention-Speed (SMD = 0.30, p = 0.041) domain. CTT group did not show any cognitive change compared to Control. Sportive PA (S-PA) and CRF increased in AE and COMB. Age and sex did not moderate intervention-related cognitive benefits. Change in S-PA, but not in CRF, significantly mediated improvements on Attention-Speed in AE. Conclusion: A 12-week AE program improved Executive Function and Attention-Speed in healthy late-middle-aged adults. Combining it with CCT did not provide further benefits. Our results add support to the clinical relevance of even short-term AE as an intervention to enhance cognition and highlight the mediating role of change in S-PA in these benefits

Description of the tools, recipients and ornaments found in the burials of the "Sepulcros de Fosa" culture

[EN] The authors of this paper has been investigating for years the Neolithic funerary contexts of the culture known as «Sepulcros de Fosa», in the northeast of the lberian Península. Here we present the results obtained from the study of the grave goods usually found in the burials of this cultural group. Ceramic vessels were gene rally placed in the graves a long with the deceased, as well as lithic and bon e tooIs, ornamental elements, and to a lesser extent, faunal remains. We d iscuss their morphological characteristics, the origin of the raw materials and the technical processes involved in their production. We also try to improve our knowledge of the function of sorne of these artefacts and their possible social or symbolic signification. This research fa lls within the l+D project started in 2011 and entit led "Aproximación a las primeras comunidades neolíticas del NE peninsular a través de sus prácticas funerarias" (HAR2011-23149). AII in all, each day we learn a litt le more about these communities.[FR] Le groupe de chercheurs qui signe ce travail étudie depuis des années les contextes funéraires néolithiques de la culture dite des «Sepulcros de Fosa», au nord-est de la péninsule lbérique. Nous présentons ici les résultats obtenus a partir de l'étude des éléments du mobilier funéraire habituellement documenté dans les sépultures de cette culture. En général, des récipients en céramique accompagnent les inhumés, ainsi que des instruments en pierre et en os, des éléments de parure, et, dans une moindre mesure, des restes faun iques. Nous aborderons leurs caractéristiques morphologiques, !'origine des matériaux utilisés, les procédés techniques impliqués dans leur élaboration. Nous essa ierons également de progresser dans la connaissance de la fonction de certains de ces objets et leur possible signification sociale et/ou symbolique. Le tout s'inscrit dans le cadre d'un projet l+D débuté en 2011 et intitulé: «Aproximación a las primeras comunidades neolíticas del NE peninsular a través de sus prácticas funerarias (HAR2011-23149)». En somme, nous en apprenons chaque jour un peu plus sur ces communautés.Une partie des analyses réalisées et présentées dans ce travail a été réalisée dans fe cadre du projet «Aproximación a las primeras comunidades neolíticas del NE peninsular a través de sus prácticas funerarias (HAR2011-23149) JJ» financé par le Ministere de f'Economie et de fa Compétitivité du Gouvernement d'Espagne. Nous remercions égafement pour leur collaboration le Departament d'Arqueologia de la Generalitat de Catalunya et les différents musées que nous avons visités (Museu Diocesà i Comarcal de Solsona, Museu d'Historia de Sabadell, Museu Arqueològic de Barcelona y Girona, Vinseum de Vilafranca del Penedes, Museu de Manresa, Museu de Granollers,Patrimoni cultural d'Andorra). Patrimoni Cultural d'Andorra).Peer reviewe

Symbolism, Exchange and Differential Grave Building Efforts during the Neolithic of the North-eastern Iberian Peninsula. The Necropolis of Bòbila Madurell-Can Gambús 1-2: An Example of Unequal Objects and Grave Goods Distribution

One of the elements that defines the so-called "Pit Burial Horizon" is the presence within certain burials of a set of tools and ornaments which were made of exogenous materials or which their acquisition and processing required an enormous investment effort. Chronologically, we stand at end of the 5th and beginning of the 4th millennium cat. BC, a period that stands out due to the relevance of its funerary structures, usually burial chambers containing a single individual. In this paper, we will identify the type of raw materials that travelled long distances during this lapse of time, recognise and explain who the receivers of those instruments and ornaments were. The best known archaeological site of this period is Bòbila Madurell-Can Gambús, which will serve as an example to examine this topic. This is a context with a considerable potential, not only due to the number of burials (more than 170 in Bòbila Madurell-Can Gambús), but alsto because of the substantial number of grave goods and instruments made with exogenous rocks.Part of the debeloped analyses presented in this study was conducted within the framework of the proyects: "Approach to the first Neolithic communiyird of the peninsular NE through their funerary practices" (HAR2011-23149) and "Approach to the first Neolithic comunities of the Mediterranean Northwest: building response from paleo-anthropological and genetic analysis "(HAR2015-67323-C2-1-P and HAR2015-67323-C2-P), financed by the Spanish Ministry of economy and competitiveness. We also would like to acknowledge the collaboration of the Departament d'Arqueologia de la Generalitat de Catalunya and the various museums that we have visited to study the deposited materials of the Bòbila Madurell-Can Gambús: Museu d'Història de Sabadell, Museu Arqueològic of Barcelona and Museu d'Història de Catalunya.Peer reviewe