Stress-induced activation of the HPA axis predicts connectivity between subgenual cingulate and salience network during rest in adolescents

Background: Responses to stress vary greatly in young adolescents, and little is known about neural correlates of the stress response in youth. The purpose of this study was to examine whether variability in cortisol responsivity following a social stress test in young adolescents is associated with altered neural functional connectivity (FC) of the salience network (SN) measured during resting‐state functional magnetic resonance imaging (rs‐fMRI). Methods: Forty‐nine typically developing young adolescents participated in a social stress test during which they contributed salivary cortisol samples. Following this, they underwent rs‐fMRI scanning. We examined the association of FC of the SN [composed of anterior cingulate cortex and bilateral anterior insula regions] with cortisol responsivity. Results: Greater cortisol responsivity was significantly positively correlated with higher FC between subgenual anterior cingulate cortex (Cg25) and the SN, controlling for participant age. There were no regions of the brain that showed an inverse relation. Conclusions: Brain systems that have been implicated in autonomic arousal and that influence subjective feeling states show altered FC associated with stress responsivity in early life.     

Consensus on interprofessional collaboration in hospitals: statistical agreement of ratings from ethnographic fieldwork and measurement scales

Rationale Few methods are available for analysing psychometric properties of combined qualitative and quantitative data. While conventional reliability of measures – meaning reproducibility or consistency – may not be meaningful in small‐N research, in some health services studies agreement on perceptions arising from data generated by fieldwork and quantitative measures can be examined to good effect. Methods We studied interprofessional collaboration (IPC) in seven hospitals. An ethnographer shadowed and conducted interviews with regulated health professionals in medicine wards. Concurrently, nurses completed the nurse–doctor relations subscale of the Nursing Work Index (NWI‐NDRS) and a new measurement scale for IPC with doctors in the domains of communication, accommodation, and isolation. After fieldwork, the ethnographer rank‐ordered hospital sites on IPC from 1 to 7 based on interpretation of the qualitative data. Mean‐scale scores were calculated for hospital sites and converted to ranks similarly. The Tinsley‐Weiss T‐index (Tinsley & Weiss, 1975) for agreement among rank orderings was calculated for dyadic combinations of fieldwork and measurement ranks. Results Perfect agreement was obtained for the most liberal agreement definitions considered – differences of two rank positions – involving qualitative data agreement with IPC subscales for accommodation and isolation. Defining agreement as a difference of 1 rank at most, the T‐index was 0.77 for agreement between fieldworker and IPC accommodation and the same for NWI‐NDRS and IPC isolation. Conclusion Qualitative data from fieldwork rankings were substantially in accord with the contemporary IPC scales, less so with the NWI‐NDRS. Qualitative data appear to be useful as an additional approach to confirming the validity of quantitative scale data in measuring a complex interpersonal relational construct.     

A comparison of the perceptions and aspirations of third-year physiotherapy students trained in three educational settings in Poland

Objectives

In Poland, physiotherapy is offered at three types of school: medical universities, universities of physical education, and schools that do not specialise in either the medical sciences or physical education. This study explored the knowledge of students who were completing their physiotherapy studies about working in Poland and other countries of the European Union (EU), and about their vocational plans. Students were asked, through self-assessment, about aspects of the professional skills they had gained.

Design

Quantitative questionnaire-based study of students in three university settings.

Setting

Eleven university-level schools in Poland offering studies in physiotherapy and representing three orientations: medical sciences (MS), physical education (PE) and other universities (OU).

Participants

The study sample comprised of 954 third-year Bachelor programme students.

Results

The differences in university profiles did not influence the vocational plans of the students, with more than 70% (668/954) declaring that they would look for work outside Poland: 76% (725/954) in the UK and 69% (658/954) in Germany. Most students stated that finding work as a physiotherapist is difficult in Poland (686/954,72%) and easy in other EU countries (763/954, 80%). Differences in university profiles had an effect on the students’ assessments of their professional skills, as students from universities without a long-standing tradition of training in physiotherapy declared that they were less well prepared to work as physiotherapists; the difference was statistically significant for 12 of the 16 domains examined (P < 0.05).

Conclusions

In the light of these results, an increased influx of Polish physiotherapists, trained according to European standards, into EU countries, especially the UK and Germany, is to be expected in the near future. The physiotherapists will predominantly be graduates of medical and sports-oriented state universities. It appears advisable to launch, under the auspices of an EU programme, an integrated employment information system for physiotherapists that would offer updated information on current demand in individual EU countries.     

The neural temporal dynamics of the intensity of emotional experience

Despite the fact that emotions involve multiple time-varying components, little is known about the underlying neural basis of these temporal dynamics. In this paper, we assess these temporal dynamics by using time-varying hemodynamic response functions (HRF) to model BOLD responses to emotional stimuli. We show that these time-varying HRFs lead to a better fit to the BOLD data and yield larger areas of significant activation than do conventional gamma-based canonical HRFs. We also report for the first time that intensity of emotional experience is associated with both magnitude and duration of brain activation. Specifically, greater negative emotional intensity was associated with greater magnitude of activation in the occipital cortex and with longer duration of activation in regions along the cortical midline associated with self-referent processing: the anterior medial prefrontal cortex and the posterior cingulate cortex. These data significantly advance our understanding of how the brain processes emotion and suggest that the intensity of a negative emotional experience is due in part to elaborative self-referent processing that is captured by the duration of neural activity in cortical midline structures. These data also underscore the importance of using modeling techniques that will help elucidate the chronometry of both normal and psychopathological emotional processes.     

Selective inhibition of JAK2-driven erythroid differentiation of polycythemia vera progenitors

Polycythemia Vera (PV) is a myeloproliferative disorder (MPD) that is commonly characterized by mutant JAK2 (JAK2V617F) signaling, erythrocyte overproduction, and a propensity for thrombosis, progression to myelofibrosis, or acute leukemia. In this study, JAK2V617F expression by human hematopoietic progenitors promoted erythroid colony formation and erythroid engraftment in a bioluminescent xenogeneic immunocompromised mouse transplantation model. A selective JAK2 inhibitor, TG101348 (300 nM), significantly inhibited JAK2V617F+ progenitor-derived colony formation as well as engraftment (120 mg/kg) in xenogeneic transplantation studies. TG101348 treatment decreased GATA-1 expression, which is associated with erythroid-skewing of JAK2V617F+ progenitor differentiation, and inhibited STAT5 as well as GATA S310 phosphorylation. Thus, TG101348 may be an effective inhibitor of JAK2V617F+ MPDs in clinical trials.     

Dynamics of early phase congestion after nasal allergen provocation

BACKGROUND: It is generally accepted that congestion during the nasal provocation is most pronounced at about 15 minutes after allergen application. However, it may reach its peak at a different time. This can cause inaccurate assessment of the nasal challenge. The aim of this study was to evaluate the dynamics of early phase congestion during nasal allergen provocation (NPT) and its reproducibility. METHODS: Two nasal allergen challenges were performed in 26 allergic rhinitis volunteers. Acoustic Rhinometry measurements were recorded beJbre, and then every 5 minutes/for 30 minutes after the allergen application. The sum of cross-sectional areas at the level of the head of inferior nasal turbinate (CSA-2) of both nasal passages was analyzed. RESULTS: The mean time to the occurrence of maximum congestion was 20 minutes. The maximum congestion differed significantly from that recorded at 10, 15 and 20 minutes. The observed patterns of congestive response were not consistent, with inter- and intra-individual differences regarding the time to maximum congestion. Percentage change in airway dimension recorded at the maximum congestion was found the least variable. CONCLUSIONS: Evaluation of the maximum congestion pattern during the NPT gives more accurate data compared to a single measurement of nasal patency.