Dichotic turncoats: Lateralization of auditory processing in two dichotic listening tasks using melodies and syllables

by Simon Knobloch, Philipp Haul, Saskia Rusche, Heiko Paland, Darius Zokai, Moritz Haaf, Jonas Rauh, Christoph Mulert, Gregor Leicht

When confronted with dichotically presented syllables, right-handed healthy individuals tend to consciously perceive syllables presented to the right ear more often. This phenomenon, known as the right-ear advantage, is driven by delayed processing of information from the left ear in left temporal auditory cortex due to its indirect relay through the corpus callosum. In contrast, less is known about about the corresponding mechanisms for stimuli processed in the right temporal hemisphere. In this study, we developed a melody-based dichotic listening paradigm designed to induce a left-ear advantage. This novel paradigm, alongside a classical syllable-based paradigm was tested in 40 healthy right-handed participants. We also examined the influence of musical education on lateralization of auditory processing. Our results revealed a significant left-ear advantage for the perception of dichotically presented melodies and replicated established findings of a right-ear advantage for syllables. No group differences emerged between participants with or without current or past musical practice. However, among those with musical training, a greater number of years of practice was associated with a reduced right-ear advantage for syllables and an increased report of melodies presented to the left-ear. These findings suggest that the left-ear advantage in dichotic perception of melodies reflects right hemispheric processing of musical stimuli. Moreover, monitoring of the left ear seems to be altered by musical practice. Future research using neuroimaging techniques will be necessary to confirm this finding.

Perceived stress and allostatic load: Results from the <i>All of Us</i> Research Program

by Faith Morley, Lauren Mount, Anjile An, Erica Phillips, Rulla M. Tamimi, Kevin H. Kensler

The rising prevalence of individuals reporting extreme stress has major public health implications as it increases vulnerability to accelerated premature biological aging, thus increasing risk of chronic disease. To examine the impact of stress on premature biological aging, we assessed the association between exposure to increased stress, quantified by the Perceived Stress Scale, and odds of high allostatic load (AL). To illuminate previously unexplored socio-contextual factors, we controlled for self-reported individual and neighborhood social determinants of health that included discrimination, loneliness, food insecurity, neighborhood disorder, and neighborhood social cohesion. We utilized a cross-sectional design to examine the association between perceived stress and AL among 7,415 participants ages 18–65 in the All of Us Research Program, who enrolled from 2017–2022. We used logistic regression to evaluate the association between stress and high AL, controlling for sociodemographic factors and self-reported social determinants of health. Participants who were younger, receiving Medicaid, or Hispanic had increased prevalence of high stress. High stress was associated with elevated odds of high AL in age and sex-adjusted models (OR=2.18, 95%CI = 1.78, 2.66, high stress vs. low), an association which remained significant after adjusting for social determinants of health (OR=1.29, 95%CI = 1.01, 1.65). Using restricted cubic splines, high stress was significantly associated with increased odds of high AL, even after controlling for upstream individual and neighborhood-level determinants of health. While individuals living below the medium poverty-to-income ratio demonstrated little appreciable association between high stress and increased odds of high allostatic load, those living above the median poverty-to-income ratio reporting increased stress appeared to have increased odds of high allostatic load. Through addressing the upstream factors causing undue burdens of stress, which particularly affect marginalized communities and younger generations, we can begin to address premature biological aging and the comorbid conditions it accompanies.

Assessment of change and persistence of youth psychosocial status reported by youth and their guardians during the COVID-19 pandemic: A MyHEARTSMAP study

by Melissa L. Woodward, Morgan W. Wolsey, Sophia Shalchy-Tabrizi, Jeffrey N. Bone, Tyler Black, Quynh Doan

Background

The pediatric mental health crisis pre-dated the COVID 19 pandemic with rates of mental health visits to pediatric emergency departments steadily increasing for the last decade. The COVID-19 pandemic has profoundly impacted children and adolescents and understanding the trajectory of their psychosocial status is important for appropriate resource allocation and policy planning.

Methods

MyHEARTSMAP is a digital self-assessment mental health evaluation that examines four major psychosocial domains: psychiatry, social, function, and youth health. Children and adolescents throughout British Columbia, and their guardians, completed the baseline assessment between August 2020 and July 2021 (51.8% completed by guardian only, 40.2% youth and guardians, 7.9% youth only). Both children and their guardians repeated the MyHEARTSMAP evaluation three-months after their baseline. Patient demographics and psychosocial concerns were statistically described and compared between baseline and follow-up. A logistic regression model assessed the influence of baseline scores and demographic factors on follow-up severity.

Results

241 of 424 participants (56.8%) completed both the baseline and three-month follow-up. The majority of participants reported no change overtime across the psychosocial domains. Both improvement and decline occurred in each domain, with a greater proportion of psychosocial states improving rather than worsening, for all domains. Higher severity of psychosocial concerns reported at baseline indicated a greater likelihood of psychosocial concerns at 3-month follow-up for psychiatric, social and function concerns. Demographic, pandemic, and support service variables were not associated with psychosocial trajectories.

Conclusions

The severity of youth mental health concerns in British Columbia remained consistent through three-month follow up, despite the changing nature of the COVID-19 pandemic during this period. Greater persistence of psychosocial concerns with increased severity highlights the need for early intervention to prevent worsening mental health. Community support is needed for youth experiencing mental health concerns to address mild psychosocial concerns before presentation at the emergency department.

“<i>A PhD is just going to somehow break</i> you”: A qualitative study exploring the role of peer support for doctoral students

by Fiona Newlands, Tanvi Markan, Isabelle Pomfret, Emily Davey, Tom King, Anna Roach, Millie Wagstaff, Tom G. Osborn, Roz Shafran, Polly Livermore, Michelle de Haan, Jeanne Wolstencroft, Sophie Bennett

Doctoral (PhD) students experience high rates of mental health challenges, including high rates of anxiety, depression, loneliness, and isolation. While universities offer mental health services, these may not fully address the specific needs of doctoral students. Peer support has emerged as a promising adjunct to existing service provision, drawing on shared experiences to provide emotional and practical guidance. This study aimed to explore doctoral students’ perceptions of peer support, identifying their needs and preferences for a peer support programme tailored to the doctoral experience. Nineteen doctoral students were recruited from a university in the south of England and participated in focus groups or semi-structured interviews. Thematic analysis yielded four overarching themes: (1) Barriers to seeking support; (2) Value of peer support for doctoral students; (3) Tailored peer support needs; and (4) Diversity and accessibility. Findings indicate that doctoral students value peer support as a flexible, informal space to share experiences and gain advice from those with similar backgrounds. However, they also emphasised the need for diverse representation among peer supporters, adaptable training to meet neurodiverse needs, and formal recognition of peer supporters’ contributions. Study findings suggest that universities should consider implementing tailored peer support programmes to address the specific challenges faced by doctoral students, incorporating flexibility, cultural sensitivity, and accessibility to create a supportive academic environment. Future research should evaluate the effectiveness of such programs in improving doctoral students’ mental health and well-being.

Hypertension associated with serotonin reuptake inhibitors: A new analysis in the WHO pharmacovigilance database and examination of dose-dependency

by Basile Chrétien, Andry Rabiaza, Nishida Kazuki, Sophie Fedrizzi, Marion Sassier, Charles Dolladille, Joachim Alexandre, Xavier Humbert

Introduction

Recent literature has reported instances of drug associated with hypertension with serotonin reuptake inhibitors (SRIs). Nonetheless, the association between SRIs and hypertension development is the subject of ongoing debate. It remains uncertain whether this is indicative of a class effect, and if dose-effect exist. To investigate the potential class effect associating SRIs with hypertension reporting, we utilized real-world data from VigiBase®, the World Health Organization (WHO) pharmacovigilance database.

Methods

We conducted an updated disproportionality analysis within VigiBase® to identify a signal of hypertension reporting with individual SRIs by calculating adjusted reporting odds ratios (aRORs) within a multivariate case/non-case study design. Additionally, we explored the presence of a dose-effect relationship.

Results

The database contained 13,682 reports of SRI associated with hypertension (2.2%), predominantly in women (70.0%). Hypertension was most reported in the 45-64 years old age group (44.8%). A total of 3,879 cases were associated with sertraline, 2,862 with fluoxetine, 2,516 with citalopram, 2,586 with escitalopram, 2,441 with paroxetine, 201 with fluvoxamine and 8 with zimeldine.A significant ROR was observed for all SRIs in both univariate (RORs ranging from 1.39 to 1.54) and multivariable analyses (aRORs ranging from 1.16 to 1.40) after adjustments for age group, sex, concurrent antihypertensive medication and drugs knowns to induce hypertension, except for fluvoxamine and zimeldine. No dose-response relationship was identified.

Conclusion

This investigation, conducted under real life conditions, unveils a notable pharmacovigilance safety signal associating SRI usage with hypertension reporting. No dose-response effect was detectable. Further longitudinal studies are warranted.

Enhanced nitrate removal in aquatic systems using biochar immobilized with algicidal <i>Bacillus</i> sp. AK3 and denitrifying <i>Alcaligenes</i> sp. M3: A synergistic approach

by Khomsan Ruangrit, Kittiya Phinyo, Sahassawat Chailungka, Kritsana Duangjan, Apitchaya Naree, Jearanai Thasana, Wassana Kamopas, Senoch Seanpong, Jeeraporn Pekkoh, Nuttapol Noirungsee

This study investigates the effectiveness of biochar immobilized with algicidal Bacillus sp. AK3 and denitrifying Alcaligenes sp. M3 in mitigating harmful algal blooms (HABs) and reducing nitrate pollution in aquatic environments. Over a six-day period, we analyzed changes in algal bloom-forming Microcystis density, chlorophyll-a levels (indicative of algal biomass), nitrate concentration, and microbial community composition in water treated with biochar and Bacillus sp. AK3 and Alcaligenes sp. M3-immobilized biochar. In water treatment using the AK3 and M3-immobilized biochar, Microcystis density decreased from 600,000 cells/mL to 80,000 cells/mL, and chlorophyll-a concentrations also substantially reduced, from 85.7 µg/L initially to 42.8 µg/L. Nitrate concentrations in the AK3 and M3-immobilized biochar treatment significantly decreased from approximately 23 mg/L to around 14 mg/L by Day 6, demonstrating the enhanced denitrification capabilities of the immobilized Alcaligenes sp. M3 and associated bacterial communities. The results also showed significant shifts in bacterial communities, with a decrease in Microcystis, highlighting the specific algicidal activity of Bacillus sp. AK3. The study underscores the potential of biochar-based treatments as a sustainable and effective approach for improving water quality and mitigating the environmental impacts of nutrient pollution and HABs.

Creativity research in medicine and nursing: A scoping review

by Alex Thabane, Sarah Saleh, Sushmitha Pallapothu, Tyler McKechnie, Phillip Staibano, Jason W. Busse, Goran Calic, Ranil Sonnadara, Sameer Parpia, Mohit Bhandari

Background

Creativity fuels societal progress and innovation, particularly in the field of medicine. The scientific study of creativity in medicine is critical to understanding how creativity contributes to medical practice, processes, and outcomes. An appraisal of the current scientific literature on the topic, and its gaps, will expand our understanding of how creativity and medicine interact, and guide future research.

Objectives

We aimed to assess the quantity, trends, distribution, and methodological features of the peer-reviewed on creativity in medicine.

Methods

We searched the MEDLINE, EMBASE, and PsycINFO databases for peer-reviewed primary research publications on creativity in medicine. Screening, full-text review, and data extraction were performed independently and in duplicate by pairs of reviewers, with discrepancies resolved by a third reviewer. We performed descriptive analyses, graphically displaying the data using charts and maps where appropriate.

Results

Eighty-one studies were eligible for review, enrolling a total of 18,221 physicians, nurses and midwifes across all studies. Most research on creativity in medicine was published in the last decade, predominately in the field of nursing (75%). Researchers from Taiwan (22%) and the United States (21%) produced the most eligible publications, and the majority research was cross-sectional in nature (54%). There was substantial variability in the definitions of creativity adopted, and most studies failed to specify a definition of creativity. Forty-five different measurement tools were used to assess creativity, the most popular being divergent thinking tests such as the Torrance Test of Creative Thinking (24%) and Guilford Creativity Tests (16%).

Conclusions

Peer-reviewed scientific research on creativity in medicine, mostly conducted in the nursing profession, is sparse and performed on variable methodological grounds. Further scientific research on the topic, as well as the development of medicine-specific definitions and measurement tools, is required to uncover the utility of creativity in the medical domain.

Influence of the use of an adhesive connection on the joint strength of modular hip endoprostheses

by Ann-Kathrin Einfeldt, Beate Legutko, Philipp-Cornelius Pott, Benjamin Bergmann, Berend Denkena, Christof Hurschler, Bastian Welke

Introduction

Modular hip implants enables a more precise adaptation of the prosthesis to the patient’s anatomy. However, they also carry the risk of increased revision rates due to micromotion at the taper junction. In order to minimize this risk, one potential solution is to establish an adhesive bond between the metal taper junctions. Load-stable bonding techniques, already successfully employed in dentistry for connecting materials such as metals and ceramics or different alloys, offer a promising approach. Nevertheless, the bond strength of tapered adhesive bonds in modular hip implants has not been investigated to date.

Materials and methods

Twenty-eight tapered junctions, consisting of a taper (female taper) and a trunnion (male taper) were turned using TiAl6V4 ELI (n = 16) and CoCr28Mo6 (n = 12). The process parameters cutting speed (v_c = 50 m/min or 100 m/min) and feed (f = 0.1 mm, 0.05 mm or 0.2 mm) were varied for the trunnions. For each set of process parameters, one trunnion and one taper were additionally subjected to sandblasting. To investigate the effect of geometry, angular mismatch in the samples were measured. The taper pairs were bonded with a biocompatible adhesive, and push-out tests were subsequently performed.

Results

The push-out forces generated from the taper connections where both tapers were sandblasted showed a mean push-out force of 5.70 kN. For the samples with only the trunnion sandblasted, the mean force was 0.58 kN, while for the samples with only taper sandblasted the mean push-out force was 1.32 kN. When neither of the tapers was sandblasted the mean push-out force was 0.91 kN. No significant effect of the process parameters on the push-out force was observed. Only the reduced valley depth Svk showed a slight correlation for the CoCr28Mo6 samples (R² = 0.54). The taper pairs with taper mismatch (between trunnion and taper) greater than |0.1°| did not show lower push-out forces than the specimens with lower taper mismatch.

Conclusions

Sandblasted and adhesive-bonded tapered connections represent a viable suitable alternative for modular hip implant connections. Slight differences in taper geometry do not result in reduced push-out forces and are compensated by the adhesive. In mechanically joined tapers these differences can lead to higher wear rates. Further investigation under realistic test conditions is necessary to assess long-term suitability.

Monitoring emerging pathogens using negative nucleic acid test results from endemic pathogens in pig populations: Application to porcine enteric coronaviruses

by Ana Paula Serafini Poeta Silva, Guilherme Arruda Cezar, Edison Sousa Magalhães, Kinath Rupasinghe, Srijita Chandra, Gustavo S. Silva, Marcelo Almeida, Bret Crim, Eric Burrough, Phillip Gauger, Christopher Siepker, Marta Mainenti, Michael Zeller, Rodger G. Main, Mary Thurn, Paulo Fioravante, Cesar Corzo, Albert Rovira, Hemant Naikare, Rob McGaughey, Franco Matias Ferreyra, Jamie Retallick, Jordan Gebhardt, Angela Pillatzki, Jon Greseth, Darren Kersey, Travis Clement, Jane Christopher-Hennings, Melanie Prarat, Ashley Johnson, Dennis Summers, Craig Bowen, Kenitra Hendrix, Joseph Boyle, Daniel Correia Lima Linhares, Giovani Trevisan

This study evaluated the use of endemic enteric coronaviruses polymerase chain reaction (PCR)-negative testing results as an alternative approach to detect the emergence of animal health threats with similar clinical diseases presentation. This retrospective study, conducted in the United States, used PCR-negative testing results from porcine samples tested at six veterinary diagnostic laboratories. As a proof of concept, the database was first searched for transmissible gastroenteritis virus (TGEV) negative submissions between January 1^st, 2010, through April 29^th, 2013, when the first porcine epidemic diarrhea virus (PEDV) case was diagnosed. Secondly, TGEV- and PEDV-negative submissions were used to detect the porcine delta coronavirus (PDCoV) emergence in 2014. Lastly, encountered best detection algorithms were implemented to prospectively monitor the 2023 enteric coronavirus-negative submissions. Time series (weekly TGEV-negative counts) and Seasonal Autoregressive-Integrated Moving-Average (SARIMA) were used to control for outliers, trends, and seasonality. The SARIMA’s fitted and residuals were then subjected to anomaly detection algorithms (EARS, EWMA, CUSUM, Farrington) to identify alarms, defined as weeks of higher TGEV-negativity than what was predicted by models preceding the PEDV emergence. The best-performing detection algorithms had the lowest false alarms (number of alarms detected during the baseline) and highest time to detect (number of weeks between the first alarm and PEDV emergence). The best-performing detection algorithms were CUSUM, EWMA, and Farrington flexible using SARIMA fitted values, having a lower false alarm rate and identified alarms 4 to 17 weeks before PEDV and PDCoV emergences. No alarms were identified in the 2023 enteric negative testing results. The negative-based monitoring system functioned in the case of PEDV propagating epidemic and in the presence of a concurrent propagating epidemic with the PDCoV emergence. It demonstrated its applicability as an additional tool for diagnostic data monitoring of emergent pathogens having similar clinical disease as the monitored endemic pathogens.

Patient and clinician preferences for diabetes management among older adults with co-morbid HIV: A qualitative exploration

by Allison P. Pack, Mary Clare Masters, Rachel O’Conor, Kenya Alcantara, Sophia Svoboda, Reneaki Smith, Fangyu Yeh, Guisselle Wismer, Amisha Wallia, Stacy C. Bailey

Background

Older adults with HIV are at increased risk of developing certain chronic health conditions including type 2 diabetes mellitus (T2DM). As the number and complexity of conditions increases, so do treatment and health care needs. We explored patient and clinician preferences for HIV+T2DM care and perceived solutions to improving care.

Methods

We conducted an exploratory qualitative study comprised of individual in-depth interviews. Participants included English-speaking patients aged 50 and older living with HIV and T2DM and infectious disease (ID) and primary care (PC) clinicians from a large academic health center in Chicago. Thematic analysis drew from the Framework Method.

Results

A total of 19 patient and 10 clinician participants were interviewed. Many patients reported seeking HIV and T2DM care from the same clinician; they valued rapport and a ‘one-stop-shop’. Others reported having separate clinicians; they valued perceived expertise and specialty care. Nearly all clinicians reported comfort screening for T2DM and initiating first line oral therapy; ID clinicians reported placing referrals for newer, complex therapies. Patients would like educational support for T2DM management; clinicians would like to learn more about newer therapies and easier referral processes.

Conclusions

Patient-centered care includes managing T2DM from a variety of clinical settings for individuals with HIV, yet strategies are needed to better support clinicians. Future research should examine how best to implement these strategies.