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Mindfulness-based interventions are showing increasing promise as a treatment for psychological disorders, with improvements in cognition and emotion regulation after intervention. Understanding the changes in functional brain activity and neural plasticity that underlie these benefits from mindfulness interventions is thus of interest in current neuroimaging research. Previous studies have found functional brain changes during resting and task states to be associated with mindfulness both cross-sectionally and longitudinally, particularly in the executive control, default mode and salience networks. However, limited research has combined information from rest and task to study mindfulness-related functional changes in the brain, particularly in the context of intervention studies with active controls. Recent work has found that the reconfiguration efficiency of brain activity patterns between rest and task states is behaviorally relevant in healthy young adults. Thus, we applied this measure to investigate how mindfulness intervention changed functional reconfiguration between rest and a breath-counting task in elderly participants with self-reported sleep difficulties. Improving on previous longitudinal designs, we compared the intervention effects of a mindfulness-based therapy to an active control (sleep hygiene) intervention. We found that mindfulness intervention improved self-reported mindfulness measures and brain functional reconfiguration efficiency in the executive control, default mode and salience networks, though the brain and behavioral changes were not associated with each other. Our findings suggest that neuroplasticity may be induced through regular mindfulness practice, thus bringing the intrinsic functional configuration in participants’ brains closer to a state required for mindful awareness.

The nursing role significantly changed following reforms in the nurse training process. Nowadays, nurses are increasingly trained to promote and improve the quality of clinical practice and to provide support in the assistance of patients and communities. Opportunities and threats are emerging as a consequence of the introduction of new disruptive technologies in public health, which requires the health care staff to develop new digital skills. The aim of this paper is to review and define the role of nurses and the skills they are asked to master in terms of new methodological approaches and digital knowledge in a continuously evolving health care scenario that relies increasingly more on technology and digital solutions. This scoping review was conducted using a thematic summary of previous studies. Authors collected publications through a cross-database search (PubMed, Web of Science, Google Scholar) related to new telemedicine approaches impacting the nurses' role, considering the time span of 2011-2021 and therefore including experiences and publications related to the first phase of the COVID-19 pandemic. The assessment was completed between April and July 2021. After a cross-database search, authors reviewed a selection of 60 studies. The results obtained were organized into 5 emerging macro areas: (1) leadership (nurses are expected to show leadership capabilities when introducing new technologies in health care practices, considering their pivotal role in coordinating various professional figures and the patient), (2) soft skills (new communication skills, adaptiveness, and problem solving are needed to adapt the interaction to the level of digital skills and digital knowledge of the patient), (3) training (specific subjects need to be added to nursing training to boost the adoption of new communication and technological skills, enabling health care professionals to largely and effectively use new digital tools), (4) remote management of COVID-19 or chronic patients during the pandemic (a role that has proved to be fundamental is the community and family nurse and health care systems are adopting novel assistance models to support patients at home and to enable decentralization of services from hospitals to the territory), and (5) management of interpersonal relationships with patients through telemedicine (a person-centered approach with an open and sensitive attitude seems to be even more important in the framework of telemedicine where a face-to-face session is not possible and therefore nonverbal indicators are more problematic to be noticed). Further advancing nurses' readiness in adopting telemedicine requires an integrated approach, including combination of technical knowledge, management abilities, soft skills, and communication skills. This scoping review provides a wide-ranging and general-albeit valuable-starting point to identify these core competences and better understand their implications in terms of present and future health care professionals' roles.

Magnesium plays a vital role in the body. This retrospective study aimed to evaluate dysmagnesemia incidence in hospitalized patients. Medical records of 430 dogs and 310 cats were reviewed, including patients with at least one venous blood gas analysis upon admission. Normal ionized magnesium values were considered 0.5–1 mmol/L for both species, according to the machine range. Data collected included patient demographics, hospitalization details, and outcome. In dogs, hypomagnesemia occurred in 35.5%, hypermagnesemia in 1.1%, and normomagnesemia in 62.2%. No survival differences were observed, but males showed a higher hypomagnesemia incidence. Neurological (51%), neoplastic (50%), and endocrine (42%) diseases were most associated with hypomagnesemia. In cats, hypomagnesemia was found in 6.8%, hypermagnesemia in 8%, and normomagnesemia in 85.2%. Hypermagnesemic cats had 2.3 times higher mortality. Endocrine (28.6%), systemic (13.6%), and urinary (12.9%) disorders had a higher incidence of hypermagnesemia. Dysmagnesemia was not linked to hospitalization length or blood pressure changes. In conclusion, dogs showed a high incidence of hypomagnesemia that was not associated with increased mortality. In contrast, although hypermagnesemia had a low incidence in cats, it was associated with increased mortality.

Introduction Type 2 diabetes mellitus (T2DM) is a non-communicable disease representing one of the most serious public health challenges of the twenty-first century. Its incidence continues to rise in both developed and developing countries, causing the death of 1.5 million people every year. The use of technology (e.g. smartphone application—App) in the health field has progressively increased as it has been proved to be effective in helping individuals manage their long-term diseases. Therefore, it has the potential to reduce the use of health service and its related costs. The objective of this study is to evaluate the impact of using a digital platform called “TreC Diabete” embedded into a novel organisational asset targeting poorly controlled T2DM individuals in the Autonomous Province of Trento (PAT), Italy. Methods This trial was designed as a multi-centre, open-label, randomised, superiority study with two parallel groups and a 1:1 allocation ratio. Individuals regularly attending outpatient diabetes clinics, providing informed consent, are randomised to be prescribed TreC Diabete platform as part of their personalised care plan. Healthcare staff members will remotely assess the data shared by the participants through the App by using a dedicated online medical dashboard. The primary end-point is the evaluation of the Hb1Ac level at 12-month post-randomisation. Data will be analysed on an intention-to-treat (ITT) basis. Discussion This trial is the first conducted in the PAT area for the use of an App specifically designed for individuals with poorly controlled T2DM. If the effects of introducing this specific App within a new organisational asset are positive, the digital platform will represent a possible way for people diagnosed with T2DM to better manage their health in the future. Results will be disseminated through conferences and peer-reviewed journals once the study is completed. Trial registration ClinicalTrials.gov NCT05629221. Registered on November 29, 2022, prior start of inclusion.

Functional neuroimaging studies have implicated the left lateral occipitotemporal cortex (LOTC) in both tool and hand perception but the functional role of this region is not fully known. Here, by using a task manipulation, we tested whether tool-/hand-selective LOTC contributes to the discrimination of tool-associated hand actions. Participants viewed briefly presented pictures of kitchen and garage tools while they performed one of two tasks: in the action task, they judged whether the tool is associated with a hand rotation action (e.g., screwdriver) or a hand squeeze action (e.g., garlic press), while in the location task they judged whether the tool is typically found in the kitchen (e.g., garlic press) or in the garage (e.g., screwdriver). Both tasks were performed on the same stimulus set and were matched for difficulty. Contrasting fMRI responses between these tasks showed stronger activity during the action task than the location task in both tool- and hand-selective LOTC regions, which closely overlapped. No differences were found in nearby object- and motion-selective control regions. Importantly, these findings were confirmed by a TMS study, which showed that effective TMS over the tool-/hand-selective LOTC region significantly slowed responses for tool action discriminations relative to tool location discriminations, with no such difference during sham TMS. We conclude that left LOTC contributes to the discrimination of tool-associated hand actions.

Ulotaront, a trace amine-associated receptor 1 (TAAR1) and serotonin 5-HT1A receptor agonist without antagonist activity at dopamine D2 or the serotonin 5-HT2A receptors, has demonstrated efficacy in the treatment of schizophrenia. Here we report the phase 1 translational studies that profiled the effect of ulotaront on brain responses to reward, working memory, and resting state connectivity (RSC) in individuals with low or high schizotypy (LS or HS). Participants were randomized to placebo (n = 32), ulotaront (50 mg; n = 30), or the D2 receptor antagonist amisulpride (400 mg; n = 34) 2 h prior to functional magnetic resonance imaging (fMRI) of blood oxygen level-dependent (BOLD) responses to task performance. Ulotaront increased subjective drowsiness, but reaction times were impaired by less than 10% and did not correlate with BOLD responses. In the Monetary Incentive Delay task (reward processing), ulotaront significantly modulated striatal responses to incentive cues, induced medial orbitofrontal responses, and prevented insula activation seen in HS subjects. In the N-Back working memory task, ulotaront modulated BOLD signals in brain regions associated with cognitive impairment in schizophrenia. Ulotaront did not show antidepressant-like biases in an emotion processing task. HS had significantly reduced connectivity in default, salience, and executive networks compared to LS participants and both drugs reduced this difference. Although performance impairment may have weakened or contributed to the fMRI findings, the profile of ulotaront on BOLD activations elicited by reward, memory, and resting state is compatible with an indirect modulation of dopaminergic function as indicated by preclinical studies. This phase 1 study supported the subsequent clinical proof of concept trial in people with schizophrenia.Clinical trial registration: Registry# and URL: ClinicalTrials.gov NCT01972711, https://clinicaltrials.gov/ct2/show/NCT01972711

Poor sleep is a modifiable risk factor for multiple disorders. Frontline treatments (e.g. cognitive-behavioral therapy for insomnia) have limitations, prompting a search for alternative approaches. Here, we compare manualized Mindfulness-Based Therapy for Insomnia (MBTI) with a Sleep Hygiene, Education, and Exercise Program (SHEEP) in improving subjective and objective sleep outcomes in older adults. We conducted a single-site, parallel-arm trial, with blinded assessments collected at baseline, post-intervention and 6-months follow-up. We randomized 127 participants aged 50-80, with a Pittsburgh Sleep Quality Index (PSQI) score ⩾5, to either MBTI ( = 65) or SHEEP ( = 62), both 2 hr weekly group sessions lasting 8 weeks. Primary outcomes included PSQI and Insomnia Severity Index, and actigraphy- and polysomnography-measured sleep onset latency (SOL) and wake after sleep onset (WASO). Intention-to-treat analysis showed reductions in insomnia severity in both groups [MBTI: Cohen's effect size = -1.27, 95% confidence interval (CI) -1.61 to -0.89; SHEEP: = -0.69, 95% CI -0.96 to -0.43], with significantly greater improvement in MBTI. Sleep quality improved equivalently in both groups (MBTI: = -1.19; SHEEP: = -1.02). No significant interaction effects were observed in objective sleep measures. However, only MBTI had reduced WASO (MBTI: = -0.30; SHEEP: = 0.02), SOL (MBTI: = -0.25; SHEEP: = -0.09), and WASO (MBTI: = -0.26; SHEEP ( = -0.18). There was no change in SOL . No participants withdrew because of adverse effects. MBTI is effective at improving subjective and objective sleep quality in older adults, and could be a valid alternative for persons who have failed or do not have access to standard frontline therapies.

Abstract Background Evidence suggests that schizophrenia involves impaired functioning of fast spiking (FS) GABA interneurons and disinhibition of glutamate release. Acute ketamine disrupts interneuron-pyramidal neuron balance, increases network activity, and increases the cortical blood oxygen level dependent (BOLD) signal in magnetic resonance imaging (MRI) studies in rodents and humans. In humans, ketamine markedly increased BOLD signal in dorsal anterior cingulate (dACC) and in precuneus, which correlated with psychosis–like subjective effects of the drug. These effects were reduced by pre-treatment with lamotrigine (Deakin et al PMID:18250253). AUT00206 is a positive modulator of Kv3.1 and Kv3.2 channels that are located on fast-spiking cortical GABA interneurons. We have previously reported that AUT00206 reduced the BOLD response to acute ketamine in rodents. The present study explored the effects of AUT00206 in an acute ketamine challenge study in healthy volunteers. Methods The design was a single-centre, double-blind, placebo-controlled, crossover study for 16 healthy participants. AUT00206 (800 mg, 2000 mg) or placebo was administered 4 hours prior to the intravenous infusion of ketamine or saline during MR BOLD imaging. Saline was infused for 8 minutes (baseline), followed by ketamine (bolus of 0.26 mg/kg for 1 min, maintenance of 0.25 mg/kg/h for 30 mins) or continued saline. The BOLD signal was followed for a further 16 mins. Participants attended 4 pharmaco-MRI sessions in which they received (in random order) placebo + saline, placebo + ketamine, 2000 mg AUT00206 + ketamine, 800 mg AUT00206 + ketamine. BOLD signal was averaged within 3 ROIs (dACC, precuneus and thalamus). A mixed models ANCOVA examined the influence of Treatment (4 levels) and Time (2 levels: the average BOLD signal over the first and second 8 minutes of the active infusion). The baseline average was used as a covariate. The doses and ROIs were analysed separately. Within the model, pairwise contrasts of interest were AUT00206 + ketamine versus placebo + ketamine. Results 23 subjects were randomised and 15 completed all 4 study scanning sessions, with dropouts mainly due to scanner technical issues, intolerance to ketamine, or excessive head movement. AUT00206 was well tolerated with no serious or severe AEs attributed to study drug. Ketamine evoked rapid increases in BOLD signal in the 3 primary ROIs. In dACC, both doses of AUT00206 attenuated the effect of ketamine compared to placebo, with pairwise effects of Treatment (β= -0.72; [95% CI -1.19 to -0.25] p=0.003) for the 800mg dose and (β= -0.49; [95% CI-0.97 to -0.02] p=0.04) for the 2000mg dose. BOLD responses to ketamine in precuneus and thalamus were similar in magnitude, but shorter lasting than responses in dACC. AUT00206 did not attenuate ketamine effects in precuneus. In thalamus AUT00206 800mg lessened responses in the second 8 minutes at trend level significance (p=0.05) contributing to an overall Treatment by Time interaction (p=0.03). AUT00206 800mg attenuated ketamine effects in all 12 secondary ROIs reaching significance in insula and right prefrontal cortex, again in the last 8 minutes. Discussion This study is the first evidence of a central effect of the novel Kv3 modulator, AUT00206 in healthy humans. Based on evidence from rodent models, we suggest that the drug enhances the activity of GABA interneurons in cortical circuits, which opposes the effects of ketamine. The results are also consistent with results from the rodent ketamine-challenge model. These results are promising for the potential use of AUT00206 in the treatment of disorders associated with reduced cortical inhibitory function, such as schizophrenia.