Disentangling Stereotypes towards Older Age Groups: Evidence from Factorial Survey Experiments in China and the USA.

INTRODUCTION: Older adults are usually perceived as warmer but less competent than younger adults. This study examined how these stereotypes are related to domain-specific attributes and how individuals' values may moderate the association. METHODS: We recruited 560 Chinese participants (mean age [SD]: 23.14 ± 7.08 years old, ranging from 18 to 60 years old) and 479 American participants (mean age [SD]: 31.37 ± 7.19 years old, ranging from 18 to 57 years old). Participants rated perceived warmth and competence of older adults based on vignettes with varying descriptions of specific domains (i.e., three relational domains: number of friends, family relationship quality, and engagement in neighbourhood activities; and three individualistic domains: income, depression, and memory) and personal attributes (i.e., gender, age, and independence). RESULTS: Firstly, the results showed that relational domains predict warmth, whereas individualistic domains predict competence in both samples from China and the USA. Secondly, in both samples, people with higher communal values attributed more relevance to relational domains on judgement of warmth. Lastly, only in the US sample did people with higher agentic values attribute more relevance to individualistic domains on judgement of competence. DISCUSSION/CONCLUSION: The study revealed that personal values, when determined relatively, contribute to stereotypes of older adults in the two independent samples.

Psychological factors substantially contribute to biological aging: evidence from the aging rate in Chinese older adults.

We have developed a deep learning aging clock using blood test data from the China Health and Retirement Longitudinal Study, which has a mean absolute error of 5.68 years. We used the aging clock to demonstrate the connection between the physical and psychological aspects of aging. The clock detects accelerated aging in people with heart, liver, and lung conditions. We demonstrate that psychological factors, such as feeling unhappy or being lonely, add up to 1.65 years to one's biological age, and the aggregate effect exceeds the effects of biological sex, living area, marital status, and smoking status. We conclude that the psychological component should not be ignored in aging studies due to its significant impact on biological age.

Identifying risk of adverse outcomes in COVID-19 patients via artificial intelligence-powered analysis of 12-lead intake electrocardiogram.

BACKGROUND: Adverse events in COVID-19 are difficult to predict. Risk stratification is encumbered by the need to protect healthcare workers. We hypothesize that artificial intelligence (AI) can help identify subtle signs of myocardial involvement in the 12-lead electrocardiogram (ECG), which could help predict complications. OBJECTIVE: Use intake ECGs from COVID-19 patients to train AI models to predict risk of mortality or major adverse cardiovascular events (MACE). METHODS: We studied intake ECGs from 1448 COVID-19 patients (60.5% male, aged 63.4 ± 16.9 years). Records were labeled by mortality (death vs discharge) or MACE (no events vs arrhythmic, heart failure [HF], or thromboembolic [TE] events), then used to train AI models; these were compared to conventional regression models developed using demographic and comorbidity data. RESULTS: A total of 245 (17.7%) patients died (67.3% male, aged 74.5 ± 14.4 years); 352 (24.4%) experienced at least 1 MACE (119 arrhythmic, 107 HF, 130 TE). AI models predicted mortality and MACE with area under the curve (AUC) values of 0.60 ± 0.05 and 0.55 ± 0.07, respectively; these were comparable to AUC values for conventional models (0.73 ± 0.07 and 0.65 ± 0.10). There were no prominent temporal trends in mortality rate or MACE incidence in our cohort; holdout testing with data from after a cutoff date (June 9, 2020) did not degrade model performance. CONCLUSION: Using intake ECGs alone, our AI models had limited ability to predict hospitalized COVID-19 patients' risk of mortality or MACE. Our models' accuracy was comparable to that of conventional models built using more in-depth information, but translation to clinical use would require higher sensitivity and positive predictive value. In the future, we hope that mixed-input AI models utilizing both ECG and clinical data may be developed to enhance predictive accuracy.

Surgical resection of a large posttraumatic middle meningeal artery pseudoaneurysm with associated epidural hematoma.

BACKGROUND: Middle meningeal artery (MMA) pseudoaneurysms are rare but can occur secondary to trauma with an associated skull fracture and can present with a variety of hemorrhage patterns. Epidural, subdural, subarachnoid, and intraparenchymal hematomas have all been reported. Given the wide range of clinical presentations and radiographic findings, multiple treatment strategies have been employed, including surgical removal, endovascular intervention, and conservative treatment. MMA pseudoaneurysms typically range from 2 to 5 mm in size and have been shown to have unpredictable growth patterns. CASE DESCRIPTION: A 54-year-old male identifying as a Jehovah's Witness presented after a fall and was found to have an epidural hematoma with an accompanying temporal bone fracture. Imaging demonstrated a traumatic pseudoaneurysm of the MMA. Given the patient's religious preferences, the emphasis was made during surgical planning for the minimization of blood loss. The epidural hematoma was evacuated, and the MMA pseudoaneurysm was directly visualized and surgically excised after ligation of its tributaries. The patient tolerated the procedure well without significant blood loss and made a complete neurological recovery. CONCLUSION: A well-circumscribed hypodensity on CT within a surrounding hyperintense collection should raise suspicion of MMA pseudoaneurysm in the setting of overlying temporal bone fracture as supported by previous imaging findings of large MMA pseudoaneurysms. The early detection of MMA pseudoaneurysm is imperative, as the presence may dictate more urgent intervention and changes in operative technique. Although not much is known about the nature and progression of these lesions, surgical excision has remained a safe, reliable method of treatment.

Factors Associated With Pregnancy and Perinatal Outcomes in Female Neurosurgeons: A Cross-Sectional Study.

Neurosurgery is male dominated with women representing only 12% of residents and 5% of practicing neurosurgeons. The conflicting demands of training versus pregnancy and motherhood are significant deterrents to women entering the field. We examined pregnancy incidence and timing, perinatal complications, and the perceived career impact of motherhood on female neurosurgeons using an anonymous survey of 643 training, practicing, and retired female neurosurgeons from the United States. Among 260 respondents, 50.8% (132/260) reported pregnancies, with an average age at first pregnancy that was significantly higher than the national average (32.1 vs 26.3 yr). In all, 40.1% (53/132) of respondents reported perinatal complications in at least one of their pregnancies. Only 25% (33/132) of respondents noted designated program maternity allowances. The most significant challenges associated with being a mother and neurosurgeon reported were issues relating to work/life balance, "mommy guilt," and sleep deprivation. A majority of respondents, 70.1% (82/116), reported fear of backlash from co-residents, partners, and staff, as well as hindered career advancement related to childbearing. Female neurosurgeons face challenges surrounding family planning different from those faced by male practitioners. Higher perinatal and fetal complications, backlash from colleagues, and demanding workload are significant issues. Progress requires institutional support and mentorship for women to create a more diverse field of practitioners.

Contrasting the Effects of Mortality Salience and Future Time Limitation on Goal Prioritization in Older and Younger Adults.

OBJECTIVES: This study aims at contrasting the effects of limited future time perspective and mortality salience on goal prioritization across adulthood. Socioemotional selectivity theory (SST) argues that people increasingly prioritize emotionally meaningful goals when they perceive future time as more limited. Terror management theory (TMT) suggests that mortality salience (i.e., the awareness of one's mortality) drives people to prioritize the goal of perpetuating own existence through affirming cultural worldview. METHOD: In this study, participants (N = 438) were randomly assigned to six conditions that primed (a) limited future time, (b) mortality salience, (c) death reflection, (d) both limited future time and mortality salience, (e) both limited future time, and death reflection, or (f) none. RESULTS: Results showed that older adults allocated significantly more resources to emotionally close recipients who supported their cultural worldviews in conditions involving future time limitation and death reflection. They also allocated less resources to emotionally not close recipients who did not support their cultural worldviews in conditions involving future time limitation. Younger adults did not show these differences. Nor did mortality salience have any effect. DISCUSSION: These results suggest that future time perspective and death reflection shift age-related goals more than mortality salience.

Corticofugal Augmentation of the Auditory Brainstem Response With Respect to Cortical Preference.

Physiological studies documented highly specific corticofugal modulations making subcortical centers focus processing on sounds that the auditory cortex (AC) has experienced to be important. Here, we show the effects of focal conditioning (FC) of the primary auditory cortex (FCAI) on auditory brainstem response (ABR) amplitudes and latencies in house mice. FCAI significantly increased ABR peak amplitudes (peaks I-V), decreased thresholds, and shortened peak latencies in responses to the frequency tuned by conditioned cortical neurons. The amounts of peak amplitude increases and latency decreases were specific for each processing level up to the auditory midbrain. The data provide new insights into possible corticofugal modulation of inner hair cell synapses and new corticofugal effects as neuronal enhancement of processing in the superior olivary complex (SOC) and lateral lemniscus (LL). Thus, our comprehensive ABR approach confirms the role of the AC as instructor of lower auditory levels and extends this role specifically to the cochlea, SOC, and LL. The whole pathway from the cochlea to the inferior colliculus appears, in a common mode, instructed in a very similar way.

The onset and post-onset auditory responses of cochlear nucleus neurons are modulated differently by cortical activation.

Auditory cortex exhibit a capacity of modulating the functions of subcortical auditory nuclei and even inner ear through descending pathways. The cochlear nucleus (CN), which acts as the gateway from the auditory periphery to the central auditory system, is also subjected to corticofugal modulation. Cortical modulation of subcortical nuclei is highly specific to the frequency tunings of cortical and subcortical neurons. It is unclear whether the high frequency-specificity of the cortical modulation of CN frequency tuning is implemented in the CN, in the auditory periphery, or in both. We analyzed the corticofugal effects on the frequency tuning, constructed from both onset (OS) and post-onset (pOS) response components of CN neurons in C57 mice. We found that the focal electrical stimulation of the primary auditory cortex (ESAI) induced remarkable changes in the response magnitude, response latency and the frequency response curves of CN neurons. The changes in the pOS components were highly specific to the difference in BFs between the stimulated AI neurons and recorded CN neurons. The changes in the OS component mostly involved the augmentation of the auditory responses of CN neurons, while exhibiting far poorer frequency-specificity. Considering the large differences in the temporal response patterns and the tuning shapes between the auditory nerve (AN) and the CN, our data suggest that the CN intrinsic neural circuitry plays a critical role in the frequency specificity of corticofugal modulation. Cortical modulation of the inner ear mostly contributes to the augmentation of the AN inputs to the CN, around the BFs of stimulated AI neurons.

Hyperoxia-induced immature brain injury through the TLR4 signaling pathway in newborn mice.

Toll-like receptor 4 (TLR4), a pathogen-associated molecular pattern receptor, is known to initiate an inflammatory cascade in response to certain stimuli within the central nervous system (CNS). Although TLR4 activation is known to be a first-line response of the innate immune system, whether and how hyperoxia influences TLR4 signaling in an immature brain remains unclear. In this study, TLR4 wild-type (W) and TLR4 knock-out(M) mice were exposed to 100% oxygen (the WO2 and MO2 groups, respectively), and control groups were exposed to ambient air (the WA and MA groups, respectively) for 48 h after postnatal-day (PND) 3. Next, neuronal apoptosis was quantified, and Morris water maze assays were conducted. The WO2 mice showed increased TLR4 expression compared with the WA mice, additionally, the expression level of Tumor Necrosis Factor-α (TNF-α) in the WO2 mice was significantly increased compared with the levels in the WA, MA and MO2 mice. Electron microscopy and terminal deoxynucleotidyl transferase-mediated biotinylated UTP nick end labeling (TUNEL) assays showed a significant increase, compared to the WO2 mice, in neuronal apoptosis within the prefrontal cortex and hippocampal CA1 region in the WO2 mice. In contrast, there were no obvious differences in neuronal apoptosis between the MO2 and MA groups. The results of the Morris water maze tests demonstrated marked deficits in learning and memory in the WO2 mice but much milder deficits in the MO2 mice compared to the WA and MA groups, respectively. Moreover, cultured N9 (TLR4 wild-type, derived from ICR/CD1 mice) microglia exposed to hyperoxia showed an immediate increase in the expression of TLR4 mRNA, followed by an increase in the expression of both TNF-α and reactive oxygen species (ROS), but this increase was abrogated by the loss of TLR4 signaling in TLR4-knockout microglia (primary cells from a C3H/HeJ strain defective in TLR4). Taken together, these data suggest that 1) TLR4 signaling is involved in hyperoxia-induced immune responses in the immature brain and 2) the loss of TLR4 activation may abrogate the neuronal apoptosis and cognitive deficits following hyperoxia exposure in newborn mice.

Continuous right thoracic paravertebral block following bolus initiation reduced postoperative pain after right-lobe hepatectomy: a randomized, double-blind, placebo-controlled trial.

BACKGROUND AND OBJECTIVES: We hypothesized that continuous right thoracic paravertebral block, following bolus initiation, decreases opioid consumption after right-lobe hepatectomy in patients receiving patient-controlled intravenous analgesia with sufentanil. METHODS: Patients undergoing right-lobe hepatectomy with a right thoracic paravertebral catheter placed at T7 30 minutes before surgery were randomly assigned to receive through this catheter either a 10-mL bolus of 0.2% ropivacaine before emergence, followed by a continuous infusion of 6 mL/h for 24 hours (PVB group), or saline at the same scheme of administration (control group). All patients were started on patient-controlled intravenous analgesia with sufentanil in the postanesthesia care unit. The primary outcome measure was total sufentanil consumption during the first 24 postoperative hours. P = 0.05 was considered as significant. For the multiple comparisons of data at 5 different time points, the P value for the 0.05 level of significance was adjusted to 0.01. RESULTS: Sixty-six patients were assessed for eligibility, and a PVB catheter was successfully placed for 48 patients. Data were analyzed on 22 patients in group PVB and 22 patients in the control group. The cumulative sufentanil consumption in the PVB group (54.3 ± 12.1 µg) at 24 postoperative hours was more than 20% less than that of the control group (68.1 ± 9.9 µg) (P < 0.001). There was also a significant difference in pain scores (numerical rating scale) between groups, where the PVB group had lower scores than did the control group at rest and with coughing for the first 24 hours (P < 0.001). CONCLUSIONS: Continuous right thoracic paravertebral block, following bolus initiation, has an opioid-sparing effect on sufentanil patient-controlled intravenous analgesia for right-lobe hepatectomy patients and reduces numerical rating scale pain scores at rest and with coughing in the first 24 postoperative hours.

Cancer prevention by tocopherols and tea polyphenols.

Tocopherols (vitamin E) and tea polyphenols have been reported to have cancer preventive activities. Large-scale human trials with high doses of alpha-tocopherol, however, have produced disappointing results. This review presents data showing that - and -tocopherols inhibit colon, lung, mammary and prostate carcinogenesis in animal models, whereas -tocopherol is ineffective in animal and human studies. Possible mechanisms of action are discussed. A broad cancer preventive activity of green tea polyphenols has been demonstrated in animal models, and many mechanisms have been proposed. The cancer preventive activity of green tea in humans, however, has not been conclusively demonstrated and remains to be further investigated.

Derivation and out-of-sample validation of a modeling system to predict length of surgery.

BACKGROUND: We performed a retrospective study to compare the precision of a regression model (RM) system with the precision of the standard method of surgical length prediction using historical means (HM). METHODS: Data were collected on patients who underwent carotid endarterectomy and lower-extremity bypass. Multiple linear regression was used to model the operative time length (OTL). The precision of the RM versus HM in predicting case length then was compared in a validation dataset. RESULTS: With respect to carotid endarterectomy, surgeon, surgical experience, and cardiac surgical risk were significant predictors of OTL. For lower-extremity bypass, surgeon, use of prosthetic conduit, and performance of a sequential bypass or hybrid procedure were significant predictors of OTL. The precision of out-of-sample prediction was greater for the RM system compared with HM for both procedures. CONCLUSIONS: A regression methodology to predict case length appears promising in decreasing uncertainty about surgical case length.