Comparing the Effects of Aerobic Exercise and Yoga on Stress Levels in College Students

Purpose of Study: College for many is a time of transition. This transition from adolescence to young adulthood can be very stressful. During the COVID-19 pandemic, rates of suicide, depression and anxiety increased in adolescents and young adults. Recently, Wang and colleagues (2020) found that among 2,031 students in a large US university, 48% reported having moderate-to-severe depression, 38% had moderate-to-severe anxiety, and 18% had thoughts of suicide. Effective strategies to help emerging adults cope with stress is critically needed to decrease these alarming data. The primary aim of this study was to compare the effects of aerobic exercise and yoga on college students' perceived levels of stress. A secondary aim of the study was to examine whether athlete status would moderate the effectiveness of either intervention. Methods Used: A sample of 55 college students were recruited via email during the spring of 2022. Students were randomly assigned to complete a single, 20-minute session of either yoga or aerobic exercise. Participant's current and chronic stress levels were recorded both before and after exercise. Chronic stress was measured using Cohen's Perceived Stress Scale and current stress was measured using a modified version of the same scale. To support the second research aim, participants were asked to report if they were a member of a college-affiliated athletic team during the 2021-2022 academic year. Demographic characteristics including age, gender, and ethnicity were also collected. Summary of Results: A 2 (Time) X 2 (Condition) x 2 (Athlete Status) mixed factorial ANOVA was conducted. Results indicated that both aerobic exercise and yoga led to a significant decrease in chronic stress (p=.03), although there were no meaningful differences between the two conditions (p=.075). This pattern of results held for current stress as well, with both groups experiencing an equivalent decrease in current stress (p<.001). Athlete-status did not significantly predict changes in current or chronic stress, nor did it moderate the efficacy of either intervention. Conclusion(s): Taken together, these findings indicate that a small bout of exercise, regardless of type, can help decrease reported stress for college students. They also provide preliminary evidence about the efficacy of exercise as stress reduction for college athletes. Our findings provide further support for using exercise as a practical strategy for coping with stress. (Table Presented).

Patients' referral through a Minor Ailment Service in community pharmacy

Introduction: Consultation of minor ailments and direct product request are frequent in community pharmacy in Spain, although every pharmacy offers the service following their own criteria. Standard Operational Procedures (SOP) and referral criteria agreed between community pharmacists (CPs) and general practitioners (GPs) are needed to deliver a safer service. Referral criteria set the limits of action for each healthcare professional (CPs and GPs) when managing patients. Following the positive findings of an impact study, a roll out was required to translate the evidence-based approach into usual practice. Objective(s): The aim was to characterise the referrals between CPs and GPs through a Minor Ailment Service (MAS, service offered in community pharmacy following the SOP). Method(s): A 12-month pragmatic study with hybrid effectiveness-implementation design was planned from October 2020 in Spain. The co-designed MAS service had several components: agreed SOP with GP scientific organisations, protocols for ailments divided into five groups (dermatological, digestive, related to pain, upper respiratory tract related and others) including referral criteria, information technology (IT) based consultation protocol and training before and during the study. Patients were followed up by pharmacists after ten days of the service. All data were collected through an IT system (SEFAC eXPERT) as a by-product of service delivery and implementation. Outcomes for the first fifteen months (up to December 2021) are shown. Result(s): 1246 pharmacists from 24 provinces in Spain were trained having a reach of 14083 consultations. 1858 (13.2%) patients were referred to the GP. 2193 referral criteria were detected, most patients referred had one single referral criteria (n = 965, 80.8%). Referral criteria detected were red flags such as temperature over 38degreeC, dyspnoea, etc. (n = 846, 39.5%);patients' age (n = 398, 18.6%), symptom duration (n = 361, 16.9%);patients' treatments for other health problems different than the minor ailment consulted (n = 263, 12.3%);other patients' health problems (n = 186, 8.7%) and others (n = 85, 4.0%). Minor ailments more frequently referred were joint pain (n = 190, 10.2%), cough (n = 106, 5.7%), dermatitis (n = 104, 5.6%) and heartburn (n = 63, 3.4%). Conclusion(s): High-risk patients (patients with symptoms/condition that do not appear to be minor ailments) can be assessed by CPs and referred to be evaluated and diagnosed by GPs. The use of co-designed management protocols strengthened the identification of red flags in patients suffering minor ailments to be referred when necessary. Joint pain and cough were two of the minor ailments more frequently referred, which could be a result of the study being undertaken during COVID19 pandemic. CPs can perform clinically, referring patients and acting as a triage point through MAS to increase patients' safety.

Perceptual Grouping During Binocular Rivalry in Mild Glaucoma.

Purpose: This study tested perceptual grouping during binocular rivalry to probe the strength of neural connectivity of the visual cortex involved in early visual processing in patients with mild glaucoma. Methods: Seventeen patients with mild glaucoma with no significant visual field defects and 14 healthy controls participated. Rivalry stimuli were 1.8°-diameter discs, containing horizontal or vertical sine-wave gratings, viewed dichoptically. To test the grouping, two spatially separated identical stimuli were presented eccentrically to the same or different eyes and to the same or different hemifields. The outcome measures were the time of exclusive dominance of the grouped percept (i.e., percept with synchronized orientations), the rivalry rate, and the epochs of exclusive dominance. Results: For both groups, the grouping occurred primarily for the matching orientations in the same eye/same hemifield (MO SE/SH) and for the matching orientations in the same eye/different hemifield (MO SE/DH) conditions. Time dominance of the grouped percept of the glaucoma group was similar to that of the control group in all conditions. The rivalry rates in the MO SE/SH and MO SE/DH conditions were significantly larger in the control group than in the glaucoma group. The epochs of exclusive dominance of the grouped percept in the MO SE/SH condition were a median of 48-ms longer for the control group, but a median of 116-ms shorter for the glaucoma group when compared to those in the MO SE/DH condition. Conclusion: Patients with mild glaucoma show clear impairments in binocular rivalry while evidence for deficits in perceptual grouping could be inferred only indirectly. If these deficits truly exist, they may have implications for higher levels of visual processing, such as object recognition and scene segmentation, but these predictions remain to be tested in future studies.

Development of a qualitative real-time RT-PCR assay for the detection of SARS-CoV-2: a guide and case study in setting up an emergency-use, laboratory-developed molecular microbiological assay.

Developing and deploying new diagnostic tests are difficult, but the need to do so in response to a rapidly emerging pandemic such as COVID-19 is crucially important. During a pandemic, laboratories play a key role in helping healthcare providers and public health authorities detect active infection, a task most commonly achieved using nucleic acid-based assays. While the landscape of diagnostics is rapidly evolving, PCR remains the gold-standard of nucleic acid-based diagnostic assays, in part due to its reliability, flexibility and wide deployment. To address a critical local shortage of testing capacity persisting during the COVID-19 outbreak, our hospital set up a molecular-based laboratory developed test (LDT) to accurately and safely diagnose SARS-CoV-2. We describe here the process of developing an emergency-use LDT, in the hope that our experience will be useful to other laboratories in future outbreaks and will help to lower barriers to establishing fast and accurate diagnostic testing in crisis conditions.

COVID-19 outbreak: A tale of two psych units

Background: COVID infections in inpatient psychiatry units present unique challenges during the pandemic, including behavioral characteristics of the patients, structural aspect of the unit, type of therapy for the patients. We present COVID outbreaks in psychiatry units in two hospitals in our medical center in Bronx, NY, and describe our mitigation strategies. Methods: Hosp A: In the early period of the pandemic in NY, 2 patients in the inpatient psychiatry unit tested positive for SARS-CoV-2 PCR. The unit was temporarily closed to new admissions. Hosp B: On 4/1, one of the patients in a 22 bed Psych unit, admitted since 3/10/20, developed fever, cough and tested positive for COVID-19 PCR. Two of her close contacts tested positive for SARS-COV-2 PCR. Results: Hospital A: In total, 5 of the 29 patients (17.2%) in the unit were SARSCoV- 2 positive, all of whom were asymptomatic. Hospital B: Testing of the remaining patients showed positive PCR in 10/14. PCR tests of healthcare workers (HCW) were positive in 13/46. Except for the index patient, all the patients were asymptomatic but 32/46 HCW reported symptoms. One negative patient subsequently turned positive. Infection control and prevention strategies instituted in both hospitals were the same with subtle differences due to dissimilar burden of infection and structure of the units. Table 1 shows the timing of the outbreak and the rapid institution of preventive measures in each of the hospitals. There was still difficulty with patients regarding adherence. Some of the patients refused to stay in isolation and would roam. Compliance with masking and hand hygiene was problematic. Communication was of paramount importance. Multiple meetings were held between the Psychiatry staff, Infection Control and Prevention team, executive leadership of the hospital. Environmental Services and Engineering were also involved. Communications with the NY State Department of Health occurred frequently. Conclusion: Strategies for management of COVID-19 patients in inpatient psychiatric units depends on the density of infected patients in the hospital and in the community. The implementation of practice change may need to be rapidly adjusted depending on the situation and available resources. Contingency plans should be formulated early on.

A 15 year old boy with acute onset paralysis

A 15-year-old male presented with acute onset bilateral lower extremity weakness. He felt a 'pop' in the left side of his lower back while turning in bed, followed by weakness and numbness in the left lower extremity that progressed to involve his right leg. Denied sick contacts, ingestion, or significant family history. Initial exam 6 hours after symptom onset demonstrated 0/5 strength in bilateral lower extremities, lax rectal tone, and absent lower extremity muscle stretch and cremasteric reflexes. MRI thoracic and lumbar spine with/without contrast within 24 hours of symptom onset was unremarkable. Nerve conduction studies done within 12 hours of onset demonstrated absent peroneal and tibial F waves, present median F wave, and normal motor and sensory responses in upper and lower extremities. Cerebrospinal fluid cell counts, glucose, and protein were normal. Serum studies including inflammatory markers, ANA, ds-DNA, copper, vitamin B12, methylmalonic acid, NMO and MOG antibodies were unremarkable. Nasopharyngeal COVID-19 testing was negative. Patient received 2 days of IVIG and 5 days of IV methylprednisolone. He required intermittent catheterization for neurogenic bladder prior to discharge to inpatient rehabilitation. Exam 2 months after presentation showed proximal left lower extremity strength of 4/5, distal left lower extremity strength of 2/5, with normal right lower extremity strength. Exam also showed hyperreflexia in bilateral lower extremities. Repeat MRI spine revealed a short segment of T2 hyperintensity involving T12-L1, mainly affecting the central gray matter with no enhancement. MRI brain and orbits was normal. Repeat MRI performed 1.5 months later showed decreased extent of signal abnormality limited to the anterior horns, greater on the left. Previously published cases with similar MR findings suggested an etiology for the patient's acute onset paralysis. Video recordings of the patient are available.

Ophthalmology-focused publications and findings on COVID-19: A systematic review.

PURPOSE: To summarize COVID-19 research endeavors by ophthalmologists/researchers in terms of publication numbers, journals and author countries, and to detail key findings. METHODS: The LitCovid database was systematically reviewed for ophthalmology-focused COVID-19 articles. The quality of the evidence was assessed for articles investigating conjunctivitis in COVID-19 patients. RESULTS: There were 21,364 articles in LitCovid on June 12, 2020, of which 215 (1%) were ophthalmology-focused. Of articles on COVID-19 transmission, 3.3% were ophthalmology-focused. Ophthalmology-focused articles were published in 68 journals and originated from 25 countries. The top five countries publishing ophthalmology-focused articles (China, India, United States of America, Italy, and United Kingdom) produced 145/215 (67%) articles. A total of 16 case reports/series from eight countries reported that conjunctivitis can be the initial or the only symptom of COVID-19 infection. Conjunctivitis may occur in the middle phase of COVID-19 illness. A total of 10 hospital-based cross-sectional studies reported that between 0% and 31.6% of COVID-19 patients have conjunctivitis or other ocular conditions, with a pooled prevalence of 5.5% reported in a meta-analysis. Viral RNA was detected in conjunctival swabs of patients with and without ocular manifestations, after resolution of conjunctivitis, after nasopharyngeal swabs turned negative and in retina of deceased COVID-19 patients. CONCLUSION: Within 3 months of declaring the COVID-19 pandemic, 215 ophthalmology-focused articles were published in PubMed, concentrating on disease manifestations and transmission. The reported presence of conjunctivitis or other ocular conditions in COVID-19 patients is varied. Clinicians should be alert for ocular involvement in COVID-19 infections and possible ocular transmission even in patients without ocular symptoms.

Clinical Assessment and Validation of a Rapid and Sensitive SARS-CoV-2 Test Using Reverse Transcription Loop-Mediated Isothermal Amplification Without the Need for RNA Extraction.

BACKGROUND: Amid the enduring pandemic, there is an urgent need for expanded access to rapid, sensitive, and inexpensive coronavirus disease 2019 (COVID-19) testing worldwide without specialized equipment. We developed a simple test that uses colorimetric reverse transcription loop-mediated isothermal amplification (RT-LAMP) to detect severe acute resrpiratory syndrome coronavirus 2 (SARS-CoV-2) in 40 minutes from sample collection to result. METHODS: We tested 135 nasopharyngeal specimens from patients evaluated for COVID-19 infection at Massachusetts General Hospital. Specimens were either added directly to RT-LAMP reactions, inactivated by a combined chemical and heat treatment step, or inactivated then purified with a silica particle-based concentration method. Amplification was performed with 2 SARS-CoV-2-specific primer sets and an internal specimen control; the resulting color change was visually interpreted. RESULTS: Direct RT-LAMP testing of unprocessed specimens could only reliably detect samples with abundant SARS-CoV-2 (>3 000 000 copies/mL), with sensitivities of 50% (95% CI, 28%-72%) and 59% (95% CI, 43%-73%) in samples collected in universal transport medium and saline, respectively, compared with quantitative polymerase chain reaction (qPCR). Adding an upfront RNase inactivation step markedly improved the limit of detection to at least 25 000 copies/mL, with 87.5% (95% CI, 72%-95%) sensitivity and 100% specificity (95% CI, 87%-100%). Using both inactivation and purification increased the assay sensitivity by 10-fold, achieving a limit of detection comparable to commercial real-time PCR-based diagnostics. CONCLUSIONS: By incorporating a fast and inexpensive sample preparation step, RT-LAMP accurately detects SARS-CoV-2 with limited equipment for about US$6 per sample, making this a potentially ideal assay to increase testing capacity, especially in resource-limited settings.

Singing in a silent spring: Birds respond to a half-century soundscape reversion during the COVID-19 shutdown.

Actions taken to control the coronavirus disease 2019 (COVID-19) pandemic have conspicuously reduced motor vehicle traffic, potentially alleviating auditory pressures on animals that rely on sound for survival and reproduction. Here, by comparing soundscapes and songs across the San Francisco Bay Area before and during the recent statewide shutdown, we evaluated whether a common songbird responsively exploited newly emptied acoustic space. We show that noise levels in urban areas were substantially lower during the shutdown, characteristic of traffic in the mid-1950s. We also show that birds responded by producing higher performance songs at lower amplitudes, effectively maximizing communication distance and salience. These findings illustrate that behavioral traits can change rapidly in response to newly favorable conditions, indicating an inherent resilience to long-standing anthropogenic pressures such as noise pollution.