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There was an overall significant effect of time, Wilks' λ=.843, F(8, 114)=2.65, p=.010, partial η 2 =.157, a significant overall effect of training group, Wilks' λ=.770, F(16, 228)=1.99, p=.015, partial η 2 =.123, and an overall significant group x time interaction, Wilks' λ=.728, F(16, 226)=2.44, p=.002, partial η 2 =.147. Significant effects of time were found for expected psychological outcomes and self-efficacy. Post-training, participants more strongly agreed that training was enjoyable and increased their sense of accomplishment. Changes in self-efficacy for cognitive training varied by program, improvingfor Dakim- and declining for the more challenging Brain Fitness- and InSight participants. Nobiletin purchase These newly devised scales may be useful for examining cognitive training behaviors. However, more work is needed to understand factors that influence older adults' enrollment in and adherence to cognitive training.This review examines longitudinal studies of changes in components of attention following mindfulness training. A total of 57 retreat studies, non-randomized trials, and randomized controlled trials were identified. Employing the classical taxonomy proposed by Posner and Petersen (1990), outcome measures were broadly categorized based on whether they involved maintenance of an aroused state (alerting), selective prioritization of attention to target items (orienting), or assessed conflict monitoring (executive attention). Although many non-randomized and retreat studies provide promising evidence of gains in both alerting and conflict monitoring following mindfulness training, evidence from randomized controlled trials, especially those involving active control comparison groups, is more mixed. This review calls attention to the urgent need in our field of contemplative sciences to adopt the methodological rigor necessary for establishing mindfulness meditation as an effective cognitive rehabilitation tool. Although studies including wait-listed control comparisons were fruitful in providing initial feasibility data and pre-post effect sizes, there is a pressing need to employ standards that have been heavily advocated for in the broader cognitive and physical training literatures. Critically, inclusion of active comparison groups and explicit attention to the reduction of demand characteristics are needed to disentangle the effects of placebo from treatment. Further, detailed protocols for mindfulness and control groups and examination of theoretically guided outcome variables with established metrics for reliability and validity are key ingredients in the systematic study of mindfulness meditation. Adoption of such methodological rigor will allow for causal claims supporting mindfulness training as an efficacious treatment modality for cognitive rehabilitation and enhancement.The study of transpiration, water, and nutrient uptake during abiotic stress in the root zone is hindered because of the hidden nature of the root zone. In this study, a modified aeroponic system was used to evaluate whole plant transpiration, nitrate and water uptake in the growth and development of tomato plants in response to salinity. Tomato seedlings were exposed to three levels of salinity (1.5, 4.5, and 9 dSm-1) and three levels of nitrate (1, 4, and 8 mM NO3) in a separate experiments conducted concurrently. Whole plant transpiration, water and nitrate uptake were estimated. Our study revealed that ~30 to 35 days after treatment (DAT), water uptake rate per plant increased from a common initial rate of about 0.05 to 1.1, 0.6, and 0.4 kg/day at 1.5, 4.5, and 9 dSm-1 respectively. The NO3 uptake rates in tomatoes grown in 1 and 4 mM NO3 were 5.5 and 22% respectively, of the uptake of tomatoes grown in 8 mM NO3. The estimation of nitrate uptake and lower sensitivity to salinity stress in the aeroponic showed the effectiveness and cost efficiency of the system in the cultivation of vegetables during abiotic stresses. The novelty of the system described is the continuous estimation of root and nutrient uptake by the whole plant at any given time.The aim of this study was to explore the feasibility of measuring a postprandial increase in energy expenditure (ΔEE) using a state-of-the-art whole-body calorimetry unit (WBCU) in children and youth with Prader-Willi syndrome (PWS). link2 Five participants (aged 10-25 y) received both a standard and a high-protein diet in a random order (crossover design). Resting energy expenditure, postprandial ΔEE 6 h after intake of a standard [15% of total energy (TE)] and a high-protein (30% TE) meal, and respiratory exchange ratio (RER) were measured in a WBCU. No differences were observed in ΔEE comparing the 2 meals. Mean RER was lower following the high-protein meal (0.80 ± 0.01) compared with the standard meal (0.87 ± 0.02) (P = 0.009). Despite the high participant burden, it was feasible to conduct this metabolic test in children and youth with PWS. This study paves the way for further studies targeting EE in this patient population.

The role of genetic determinants in mediating iron status in Africans is not fully understood. link3 Genome-wide association studies in non-African populations have revealed genetic variants in the transmembrane protease serine 6 gene (

) that are associated with the risk of anemia.

To investigate the effects of risk alleles for low iron status, namely

rs2235321, rs855791, and rs4820268, on responses to oral iron in healthy Gambian adults.

Using a recall-by-genotype design, participants were selected from a pregenotype cohort of 3000 individuals in the Keneba Biobank (Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine). Participants were invited to participate in the study based on 9 genotype combinations obtained from 3

single nucleotide polymorphisms (SNPs) rs2235321, rs855791, and rs4820268. The participants fasted overnight and then ingested a single oral dose of ferrous sulfate (130mg elemental iron). Blood samples were collected prior to iron ingestiobutors to variations in iron status in Africans.This study was registered at clinicaltrials.gov (# NCT03341338).

This study revealed that common TMPRSS6 variants influence hepcidin concentrations, but not iron status indicators either at baseline or following a large oral dose of iron. These results suggest that genetic variations in the TMPRSS6 gene are unlikely to be important contributors to variations in iron status in Africans.This study was registered at clinicaltrials.gov (# NCT03341338).

Over the past two decades, studies have demonstrated that lung ultrasound is useful in diagnosing alveolar interstitial syndrome, which is seen in patients with decompensated congestive heart failure (CHF).

We studied medical students performing lung ultrasound on patients admitted to the hospital with a presumed diagnosis of decompensated CHF in a prospective convenience observation study. Two ultrasound fellowship-trained emergency medicine attendings independently reviewed the lung ultrasounds at a later date, blinded to the students' interpretation and other clinical information, to confirm ultrasound findings and assess for inter-rater reliability of the lung ultrasound using intraclass correlation coefficients (ICCs).

Thirty-six patients were enrolled in the study resulting in 653 unique lung zones scanned. The zones were imaged and classified as being normal (B-lines < 3) or pathologic (B-lines ≥ 3). The novice scanners' interpretation was compared to expert reviews using ICCs. The ICC was 0.88, with a 95% confidence interval of 0.87 to 0.90, for all lung zones scanned.

There was almost perfect agreement between novice practitioners and experts when determining the presence of pathologic B-lines in individual patients.

There was almost perfect agreement between novice practitioners and experts when determining the presence of pathologic B-lines in individual patients.

Despite identified inequities and disparities in lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) health, past studies have shown little or no education at the medical school or residency level for emergency physicians. With increased focus on health inequities and disparities, we sought to reexamine the status of sexual and gender minority health education in U.S. emergency medicine (EM) residencies.

Our primary objective was to determine how many EM residencies offer education on LGBTQ+ health. Secondary objectives included the number of actual versus preferred hours of LGBTQ+ training, identification of barriers to providing education, and correlation of education with program demographics. Finally, we compared our current data with past results of our 2013 study.

The initial survey that sought to examine LGBTQ+ training in 2013 was used and sent in 2020 via email to EM programs accredited by the American Council for Graduate Medical Education who had at least one full class of refer education in sexual and gender minority health, although there remains a gap between actual and preferred hours. This is a notable increase from 26% of responding programs providing education in 2013. Several barriers still exist, and the content, impact, and completeness of education remain areas for further study.

The majority of respondents offer education in sexual and gender minority health, although there remains a gap between actual and preferred hours. This is a notable increase from 26% of responding programs providing education in 2013. Several barriers still exist, and the content, impact, and completeness of education remain areas for further study.

Although primary aldosteronism (PA) reduces quality of life (QOL), there have been no reports on whether treatment with a mineralocorticoid receptor antagonist (MRA) improves QOL in Japanese PA patients.

Using the 36-Item Short-Form Health Survey (SF-36), we compared the QOL of PA patients before and after treatment and evaluated whether the effectiveness of MRAs differs by sex and serum potassium level.

In 50 patients diagnosed with PA (with or without hypokalemia) and treated with an MRA, the SF-36 scores, blood pressure, and clinical features were assessed before, and 3 and 6 months after treatment. Separate analyses were also conducted for males and females.

The normative mean SF-36 score of the healthy subjects was 50. The pretreatment Role-Physical (RP) (46.7 ± 1.8,

= .019), General Health (47.1 ± 1.3,

= .042), and Role-Emotional (47.2 ± 1.7,

= .045) SF-36 subscale scores of all PA patients were significantly lower than those of healthy subjects but were improved by MRA treatment. Females with PA had a lower RP score (45.1 ± 2.2,

= .008), which was not improved by MRA treatment (46.1 ± 2.4,

= .036). In addition, PA patients with hypokalemia had a lower Mental Health SF-36 subscale score (43.2 ± 4.4,

= .041), which was improved by treatment with an MRA.

MRAs improved the QOL of Japanese PA patients, but female PA patients may be more resistant to MRAs.

MRAs improved the QOL of Japanese PA patients, but female PA patients may be more resistant to MRAs.Generalized and partial lipodystrophy are rare and complex diseases with progressive clinical and humanistic burdens stemming from selective absence of subcutaneous adipose tissue, which causes reduced energy storage capacity and a deficiency of adipokines such as leptin. Treatment options were limited before leptin replacement therapy (metreleptin) became available. This retrospective study evaluates both clinical and humanistic consequences of the disease and treatment. Chart data were abstracted from a cohort of metreleptin-treated patients with generalized and partial lipodystrophy (n = 112) treated at the US National Institutes of Health. To quantify the quality-of-life consequences of the lipodystrophy disease attributes recorded in chart data, a discrete choice experiment was completed in 6 countries (US, n = 250; EU, n = 750). Resulting utility decrements were used to estimate the quality-adjusted life-year consequences of changes in lipodystrophy attribute prevalence before and after metreleptin. In addition to metabolic impairment, patients with generalized and partial lipodystrophy experienced a range of lipodystrophy consequences, including liver abnormality (94%), hyperphagia (79%), impaired physical appearance (77%), kidney abnormality (63%), reproductive dysfunction (80% of females of reproductive age), and pancreatitis (39%).