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Objectives/Goals: Cognitive decline is a known sequalae of intracranial radiation in the treatment of brain metastases. In this study, we investigate global structural changes in the brain akin to accelerated aging and compare aging kinetics between patients treated with whole-brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS). Methods/Study Population: This retrospective study consists of patients with brain metastases treated with WBRT and SRS at our institution. Brain MRI images collected prior to radiation therapy and at approximately three and six months following radiation will be analyzed, excluding patients with evidence of worsening disease burden in the brain. Surface morphology of the cerebral cortex and sub-cortical structures will be extracted using Freesurfer and converted to graphs. Data will then be input into a validated graph convolutional neural network model to estimate brain age at each time point. A generalized linear model will be used to estimate the aging pace between baseline and follow-up for each subject within the whole brain as well as the sub-cortical structures, which will be compared between WBRT and SRS treatment groups. Results/Anticipated Results: We anticipate that intracranial radiation will accelerate brain aging to a greater extent following WBRT compared to SRS. Additionally, this accelerated aging will occur globally in the whole brain as well as within individual substructures, including the cerebral cortex, nucleus accumbens, amygdala, caudate, hippocampus, pallidum, putamen, and thalamus. Discussion/Significance of Impact: This study will demonstrate structural changes in the brain analogous to accelerated aging, supporting its potential use as an imaging biomarker to monitor cognitive decline after radiation therapy. Future work will explore the relationship between structural brain aging and assessments of neurocognitive function.
Objectives/Goals: The goal of the RC2 Systems Marketing Analysis for Research Translation (SMART) special innovation program is to develop and test a structured approach for working with research teams and communities to accelerate the translation of clinical and community innovations to address health inequities by integrating social marketing with community-based system dynamics. Methods/Study Population: The SMART program is a consultancy service for CTS teams focused on selecting and tailoring implementation strategies for advancing equity. We use social marketing for understanding the alignment of practice innovation feature sets with community priorities for advancing health equity; and community-based system dynamics to understand and refine the dynamics of scaling up and sustaining the implementation of innovations with sufficient reach to address regional health inequities. The program is implemented as community-engaged group model-building workshops with research teams, with follow-up marketing analyses and computer simulation of implementation strategies of innovations and development of implementation roadmaps. We use developmental program evaluation to revise the SMART program. Results/Anticipated Results: Anticipated results from piloting the SMART innovation program with four research teams include (1) design matrices pre and post-workshop for each innovation; (2) system dynamics simulation models and analyses of implementation and scale-up of innovations; (3) analysis of the SMART program for highest impact, with priors for estimating subsequent SMART program performance; and (4) a revised SMART program based on results from the developmental program evaluation. Discussion/Significance of Impact: This work highlights the feasibility and benefits of combining methods that have been cited in implementation science for understanding the complexity of implementation to accelerate the translation of innovations into clinical and community settings for advancing health equity.
Vaccines have revolutionised the field of medicine, eradicating and controlling many diseases. Recent pandemic vaccine successes have highlighted the accelerated pace of vaccine development and deployment. Leveraging this momentum, attention has shifted to cancer vaccines and personalised cancer vaccines, aimed at targeting individual tumour-specific abnormalities. The UK, now regarded for its vaccine capabilities, is an ideal nation for pioneering cancer vaccine trials. This article convened experts to share insights and approaches to navigate the challenges of cancer vaccine development with personalised or precision cancer vaccines, as well as fixed vaccines. Emphasising partnership and proactive strategies, this article outlines the ambition to harness national and local system capabilities in the UK; to work in collaboration with potential pharmaceutic partners; and to seize the opportunity to deliver the pace for rapid advances in cancer vaccine technology.
This paper presents a simple random procedure for selecting subsets of stimulus pairs for presentation to subjects. The resulting set of ratings from the group of subjects allows the construction of a group (average) space through the use of the computer program TORSCA-9 or equivalent programs. The procedure is applied to both real and simulated data. It is found that subjects need only make between 20% and 50% of the usual judgements to reconstruct a reasonably accurate group space.
Trace amine-associated receptor 1 (TAAR1) agonists offer a new approach, but there is uncertainty regarding their effects, exact mechanism of action and potential role in treating psychosis.
Aims
To evaluate the available evidence on TAAR1 agonists in psychosis, using triangulation of the output of living systematic reviews (LSRs) of animal and human studies, and provide recommendations for future research prioritisation.
Method
This study is part of GALENOS (Global Alliance for Living Evidence on aNxiety, depressiOn and pSychosis). In the triangulation process, a multidisciplinary group of experts, including those with lived experience, met and appraised the first co-produced living systematic reviews from GALENOS, on TAAR1 agonists.
Results
The animal data suggested a potential antipsychotic effect, as TAAR1 agonists reduced locomotor activity induced by pro-psychotic drug treatment. Human studies showed few differences for ulotaront and ralmitaront compared with placebo in improving overall symptoms in adults with acute schizophrenia (four studies, n = 1291 participants, standardised mean difference (SMD) 0.15, 95% CI −0.05 to 0.34). Large placebo responses were seen in ulotaront phase three trials. Ralmitaront was less efficacious than risperidone (one study, n = 156 participants, SMD = −0.53, 95% CI −0.86 to −0.20). The side-effect profile of TAAR1 agonists was favourable compared with existing antipsychotics. Priorities for future studies included (a) using different animal models of psychosis with greater translational validity; (b) animal and human studies with wider outcomes including cognitive and affective symptoms and (c) mechanistic studies and investigations of other potential applications, such as adjunctive treatments and long-term outcomes. Recommendations for future iterations of the LSRs included (a) meta-analysis of individual human participant data, (b) including studies that used different methodologies and (c) assessing other disorders and symptoms.
Conclusions
This co-produced, international triangulation examined the available evidence and developed recommendations for future research and clinical applications for TAAR1 agonists in psychosis. Broader challenges included difficulties in assessing the risk of bias, reproducibility, translation and interpretability of animal models to clinical outcomes, and a lack of individual and clinical characteristics in the human data. The research will inform a separate, independent prioritisation process, led by lived experience experts, to prioritise directions for future research.
Building a successful research career often requires being adept at the methods and tools of the time. For social and behavioral scientists today, that means navigating online participant platforms and the tools used to create online studies. In this chapter, we describe how Amazon’s Mechanical Turk (MTurk) can be leveraged as a source for participant recruitment. We provide a brief history of MTurk’s usage by researchers, describe the challenges researchers have faced with the site, and summarize the status of issues like data quality, sample representativeness, and ethics in online research. Along the way, we provide tips for how researchers can use MTurk to collect high-quality data and to start and advance a research career.
This book highlights the important creative work of Belarusian theatre and filmmakers seeking to raise awareness of the Pro-democracy movement and human rights abuses in Belarus and to build communities of care and mourning following the fraudulent 2020 presidential elections in Belarus. Examining the work of the Belarus Free Theatre, Andrei Kureichik, and the Kupalautsy Theatre, it demonstrates how documentary theatre, adaptation, and digital theatre have enabled displaced, dissident artists to form international communities to support Belarusian dissidents in these fraught times.
Following the application of MCPA/MCPB at 1.7 kg ae ha−1 at a field site near Dresden, ON, Canada, poor control (<50% visible control) of green pigweed (Amaranthus powellii S. Watson) was observed. Amaranthus powellii is a common weed in Ontario crop production, and its evolution of resistance to synthetic auxin herbicides (SAHs) could pose a risk to crop yields. The suspected resistant A. powellii population (R) was used in dose–response and field experiments to determine resistance to SAHs. The objective of these studies was to determine whether this population of A. powellii is resistant to MCPA and cross-resistant to other SAHs. The GR50 (herbicide dose that causes a 50% reduction in plant aboveground biomass) values were determined by fitting plant dry weight data, obtained following application with seven SAHs, to a four-parameter log-logistic equation and were compared between the suspected-resistant (R) population and a known susceptible (S) population of A. powellii. The field trial was conducted in 2017, 2018, 2019, and 2021 in corn (Zea mays L.) and consisted of 11 postemergence SAH treatments. The GR50 values differed between the R and S populations following application with MCPA, aminocyclopyrachlor, dichlorprop-p, and mecoprop, resulting in resistance factors of 4.4, 3.0, 2.5, and 2.4, respectively. In the field study, dicamba and MCPA ester controlled A. powellii 84% and 30%, respectively, at 8 wk after treatment application (WAA). The control of Amaranthus powellii with all SAHs applied POST in corn was poor (<90% visible control) at 8 WAA. Both studies confirmed resistance to SAHs in this population of A. powellii, which will create limitations for farmers aiming to control this weed.
Demand for student mental health services is growing, as is the complexity of presentations to university student wellbeing services. There is a need for innovative service delivery models to prevent students falling in the gaps of existing provision, where outcomes from traditional talking therapies services have been shown to be poorer for students than non-student peers. In 2018, Newcastle University established a pilot in-house cognitive behavioural therapy (CBT) service to provide high-intensity CBT for students at the university, harnessing the expertise of qualified and training staff from the psychological professions. This subsequently expanded into the Psychological Therapies Training and Research Clinic, appointing additional clinical staff. Here we present the journey of the clinic, from inception to implementation and expansion. We also present a descriptive evaluation of the first three years of operation, reporting on clinical activity, clinical outcomes and client experiences of the service. Data are presented from 605 referrals. Over 70% of referrals were assessed and over 60% transitioned into treatment. The treatment completion rate was 50%, with an overall recovery rate of 47.3% [using the same definition of recovery as NHS Talking Therapies for Anxiety and Depression (NHS TTAD)]. Satisfaction, measured by the Patient Evaluation Questionnaire, was high. These outcomes are commensurate or better than seen in NHS TTAD services for students and young adults. Overall, the clinic has been a successful addition to the wellbeing offer of the university and has provided a number of positive further opportunities for both research and the clinical training programmes.
Key learning aims
(1) To understand the process followed to establish a university-run cognitive behavioural therapy service for students and enable other institutions to replicate this model.
(2) To identify whether universities can deliver safe, effective mental health services that are fully evaluated and result in commensurate clinical outcomes to other service contexts.
(3) To reflect on key learning, challenges and ethical considerations in establishing such services.
A growing body of literature has investigated diet and mental health, however, it is often viewed through a “weight-centric” lens, where weight loss is considered a primary outcome and motivator. This review aims to shed new insights into the connections between mental health and wellbeing, and eating behaviours that focus on internal cues and regulators and do not centralise around weight. Such “weight-neutral approaches” have been associated with improved psychological health and wellbeing, however, consolidated evidence is lacking.
Objectives
To explore eating styles that do not centralise around weight, and their relationship with mental health and wellbeing and other health outcomes.
Methods
A systematic search was performed including observational studies of adult populations, with ≥1 mental health and wellbeing or physical health outcome, and ≥1 validated measure of eating behaviour reflective of a weight-neutral approach. Outcomes were characterised into four domains (mental health and wellbeing, physical health, health promoting behaviours and other eating behaviours). Risk of bias was assessed using the Newcastle-Ottawa Scale.
Results
In total 8281 records were identified with 86 studies including 75 unique datasets and 78 unique exposures included. Eating behaviours included intuitive eating (n=48), mindful eating (n=19), and eating competence (n=11). All eating behaviours incorporated biological, physiological, and social factors, with 297 outcomes categorised for mental health and wellbeing (n=122), physical health (n=116), health promoting behaviours (n=51) and other eating behaviour (n=8). Greater intuitive and mindful eating were significantly related to lower levels of disordered eating, and depressive symptoms, as well as greater body image, self-compassion, and mindfulness. Greater intuitive eating, mindful eating and eating competence were significantly related to a lower BMI, and greater diet quality and physical activity. Eating competence and intuitive eating were significantly related to higher fruit and vegetable intake, and eating competence alone was significantly related to higher fibre intake, and greater sleep quality.
Conclusions
This review provides evidence that intuitive eating, mindful eating and eating competence are positively related to a range of mental and physical health outcomes. Considered within the biopsychosocial model, these findings enhance understanding around the impact of approaches to healthy eating patterns that are not focused on weight loss, and contributes a case towards promoting health-centric eating behaviour in mental health care. Future research should focus on experimental studies and broader population groups.
The trace element selenium is known to protect against oxidative damage which is known to contribute to cognitive impairment with ageing (1,2). The aim of this study was to explore the association between selenium status (serum selenium and selenoprotein P (SELENOP)) and global cognitive performance at baseline and after 5 years in 85-year-olds living in the Northeast of England.
Serum selenium and SELENOP concentrations were measured at baseline by total reflection X-ray fluorescence (TXRF) and enzyme-linked immunosorbent assay (ELISA), respectively, in 757 participants from the Newcastle 85+ study. Global cognitive performance was assessed using the Standardized Mini-Mental State Examination (SMMSE) where scores ≤25 out of 30 indicated cognitive impairment. Logistic regressions explored the associations between selenium status and global cognition at baseline. Linear mixed models explored associations between selenium status and global cognition prospectively after 5 years. Covariates included sex, body mass index, physical activity, high sensitivity C-reactive protein, alcohol intake, self-rated health, medications and smoking status.
At baseline, in fully adjusted models, there was no increase in odds of cognitive impairment with serum selenium (OR 1.004, 95% CI 0.993-1.015, p = 0.512) or between SELENOP (OR 1.006, 95% CI 0.881-1.149, p = 0.930). Likewise, over 5 years, in fully adjusted models there was no association between serum selenium and cognitive impairment (β 7.20E-4 ± 5.57E-4, p = 0.197), or between SELENOP and cognitive impairment (β 3.50E-3 ± 6.85E-3, p = 0.610).
In this UK cohort of very old adults, serum selenium or SELENOP was not associated with cognitive impairment at baseline and 5 years. This was an unexpected finding despite SELENOP’s key role in the brain and the observed associations in other studies. Further research is needed to explore the effect of selenium on global cognition in very old adults.
OBJECTIVES/GOALS: Renal vascular resistance (RVR) is the opposition to blood flow by renal arteries. At the population level, dietary salt increases RVR and blood pressure (BP), which are associated with cardiovascular disease. Recent data indicate exogenous ketones may offset adverse cardiorenal effects of salt. METHODS/STUDY POPULATION: Our registered clinical trial (NCT05545501) is a double-blinded, placebo-controlled, crossover study. Participants are being randomized to three 10-day conditions: A) control; B) high salt; C) high salt and ketone supplementation. Ten participants are enrolled (target 30 participants). Renal blood velocity (RBV) in the renal and segmental arteries will be measured in the decubitus position using Doppler ultrasound during a 3-minute baseline and 3-minute cold pressor test. We will measure brachial BP with an automated oscillometric BP monitor. RVR will be calculated as mean BP divided by RBV. Statistical analyses will include ANOVA and correlations with α set at ≤ 0.05. RESULTS/ANTICIPATED RESULTS: We anticipate attenuated RBV and increased BP during the cold pressor test, particularly following high salt loading, leading to greater RVR. We hypothesize ketone supplementation will attenuate the high salt induced increase in RVR during the cold pressor test. In addition to RVR we will examine renal vascular conductance which is the ease with which blood flows through arteries, calculated as RBV divided by mean BP. Additional hemodynamics such as heart rate and systolic and diastolic BP will be reported and correlated with primary outcomes. DISCUSSION/SIGNIFICANCE: Dietary salt plays a role in hypertension, cardiovascular disease, and chronic kidney disease, which are leading causes of death. Ketone supplementation may be a promising approach to counteract the detrimental effects of high dietary salt and improve cardiovascular health in adults.
We, the actors of the Yanka Kupala Theatre, watch with pain and horror, what is happening in our country. We respect the law and human rights, but every night we live as if we are on the front lines.[…] We are against the terror and violence. We are against the bloodshed in our country.
Actors of the Yanka Kupala Theatre, August 12, 2020
We do not have the opportunity to meet you today in our house, on our stage to fully celebrate this historic day. So fate determined. This is our way. The way of truth. The way of Belarus.
The Free Kupalautsy, September 14, 2020
When the massive protests erupted in Belarus in August 2020, as we have seen, many cultural figures and theatre workers joined their fellow protestors— demanding change: fair elections, the release of political prisoners, and an end to the violent, oppressive rule of the regime. Kureichik, members of the Belarus Free Theatre, the Contemporary Art Theatre, the Belarusian Army Drama Theatre, and many others across Belarus looked for various ways to express their opposition.3 Members of the elite, state-funded Yanka Kupala National Academic Theatre in Minsk also showed solidarity with the protesters, in spite of strict policies against political activity in their employment contracts and a decades-long culture of self-censorship.4 Like so many of their counterparts, most of the company members who stood up against the regime ended up in exile. Their stature could not shield them from the regime's reckless reaction to the growing opposition and near-total shutdown of civil society, independent media, and the arts. In spite of the loss of their jobs, their stage, and eventually their homes, members of the Kupala reformed as the “Free Kupalautsy,” using the digital space as their new creative home. Over the next few years, the company members who left the theatre regrouped, reclaiming their identity as “the national theatre” and found new ways to form a community, promote Belarusian culture and language, agitate for political prisoners, remember, and mourn. Although most of their productions have been adaptations rather than documentary or verbatim plays, by depicting the act of filming, the use of parallel texts and everyday actions like letter writing, and the use of costumes and props to signal the representation of contemporary events in Belarus acted in a similar manner.
[…] they were the ones who could best do the only thing left to do: preserve the face of violence for the distant future.
Milan Kundera, The Unbearable Lightness of Being, 1984
Is this not a form of deliberate exposure and persistence, the embodied demand for a livable life that shows us the simultaneity of being precarious and acting?
Judith Butler, Notes Toward a Performative Theory of Assembly, 2015
On August 9, 2020, Belarus held a presidential election. The outcome was predetermined, as usual in the post-Soviet country where Aliaksandr Lukashenka held power since being elected to the presidency in 1994. Over time, Lukashenka had slowly increased and concentrated power in the presidency and assured he would remain uncontested by controlling the information space and eliminating opposition. In 2020, Lukashenka detained or forced major political rivals into exile prior to the election. His administration oversaw the election commission and vote counting. In the evening of election day, the commission announced that Lukashenka had received 80.1% of the vote. This was not surprising. This is how the four elections between 1994 and 2020 had gone, and why Belarusians were often cynical about the potential for change. What was surprising was the mass mobilization of the opposition—the largest in the 26 years of Lukashenka's rule—and the size and duration of peaceful protests that followed the election.
The regime “responded with unjustified, disproportionate, and often arbitrary force.” For a time, this display of brute force by the State further encouraged the resistance and destabilized the notion that Lukashenka had the support of the majority of Belarusians. Eventually, with the aid of Russian authorities, dissent was suppressed through thousands of detentions and the use of torture; the closure of all independent media, arts venues, and independent nongovernmental organizations; show trials; propaganda; firings; and forced exile. Nevertheless, as Alyena Batura has written, the 2020 civic mobilization “transformed an apathetic populace into active citizens” and “led to the creation of networks of solidarity and mutual support.” This book looks at how several theatre artists and filmmakers joined the opposition and used their own precarious bodies and artforms to help mobilize communities, oppose the State's propaganda narratives, agitate for political prisoners, collectively mourn, and “preserve the face of violence for the distant future.”
On October 30, 2023, Kupalautsy actress Krystsina Drobysh posted photos on her social media accounts of a forgotten production that had taken place in 1991 and was subsequently removed from public records. The photos are of an adaptation of Nobel Prize-winning Belarusian author Sviatlana Aleksievich's oral history, Zinky Boys: Soviet Voices from the Afghanistan War, at the Yanka Kupala National Theatre in Minsk, Belarus. Due to controversy around the production, which was televised in 1992, and a lawsuit against Aleksievich by mothers who objected to the dark portrayal of their soldier sons, the production was removed from the stage and most records of it disappeared. Due to her own sleuthing and contacts, Drobysh recovered documents and memories of the production, directed by Valery Raevsky, with a cast that included most of the troupe at the time. Drobysh told Kamunikat.org, the Belarusian Internet Library, why she wanted to recuperate the historical event:
Not only the play itself, but also the fact of its existence was erased from history. In approximately the same way, the dismissal of nearly the entire troupe of the Kupala Theatre in 2020 could have been erased from memory, if it had not happened in the age of the internet. That's why it was extremely important for me to restore this gap.
Following the impulse of Belarusian theatre artists to document their experiences and work in 2020, the book aims foremost to create a public record of the performances of these artists in a time of crisis. Through historical description and dramaturgical analysis, photographs, and a vital interview with a key figure, this account attempts to capture various forms of preservation.
As we have seen, Belarusian theatre artists were key players in the resistance movement in Belarus, helping to mobilize the resistance, bringing international attention to the crisis, shaping counternarratives to the regime's propaganda, and providing spaces—both digital and physical—to mourn and grieve those who were murdered or forced into exile. Documentary theatre, film, and digital performance became a substantial way to respond to the crisis, building on historical evidence, phenomenological detail, and lived experience.