Sunscreen Use and Screening in College Athletes: An Evidence-Based Pilot Project

Background: Melanoma is the third most common cancer in individuals ages 15 – 29. The greatest risk for melanoma is ultraviolet (UV) radiation from the sun. Collegiate athletes are exposed to 1,000 more sun hours per year than the average adult, placing them at higher risk for melanoma. Evidence supports sunscreen education and screening to promote protective behaviors in young adults. Objective: This evidence-based pilot project implements the standardized screening of sunscreen use and sun protective behaviors in women’s soccer players ages 18 to 21 years old at the University of San Diego. Methods: The Sun Exposure and Protection Index (SEPI), reflecting both UV exposure risk and sun protective behaviors, was administered to female soccer players before and after the intervention period. Athletes were instructed to apply SPF 50 to the face, neck, and chest once daily for 7 days while practicing on the soccer field. Educational materials about sun safety were provided. Principles of the Iowa Model and Health Belief Model guided this pilot project. Outcomes: Twenty-two athletes participated in this pilot. 86.4% reported using sunscreen 5 or more days during the intervention period. 100% reported sunscreen use 3 or more days during intervention period, compared to 45.4% prior to implementation. The average score on the SEPI Part 2 prior to the pilot was 10. After intervention, there was an average reduction of 1.45 points in SEPI Part 2 scores, representing an increased propensity for sun protection and improved sun protection behaviors. Sun exposure screening should be considered as primary prevention in college athletes, who are at an elevated lifetime risk of ultraviolet radiation exposure. Furthermore, providing sunscreen and educational materials prior to sun exposure may decrease the risk of future melanoma in this high-risk population

Locus coeruleus signal intensity and emotion regulation in agitation in Alzheimer’s disease

Hyperphosphorylated tau accumulation is seen in the noradrenergic locus coeruleus from the earliest stages of Alzheimer’s disease onwards and has been associated with symptoms of agitation. It is hypothesized that compensatory locus coeruleus-noradrenaline system overactivity and impaired emotion regulation could underlie agitation propensity, but to our knowledge this has not previously been investigated. A better understanding of the neurobiological underpinnings of agitation would help the development of targeted prevention and treatment strategies. Using a sample of individuals with amnestic mild cognitive impairment and probable mild Alzheimer’s disease dementia from the German Center for Neurodegenerative Diseases (DZNE)-Longitudinal Cognitive Impairment and Dementia (DELCODE) study cohort (N=309, aged 67-96 years, 51% female), we assessed cross-sectional relationships between a latent factor representing the functional integrity of an affect-related executive regulation network and agitation point prevalence and severity scores. In a subsample of individuals with locus coeruleus MRI imaging data (N=37, aged 68-93 years, 49% female), we also investigated preliminary associations between locus coeruleus MRI contrast ratios (a measure of structural integrity, whole or divided into rostral, middle, and caudal thirds) and individual affect-related regulation network factor scores and agitation measures. Regression models controlled for effects of age and clinical disease severity and, for models including resting state functional MRI connectivity variables, grey matter volume and education years. Agitation point prevalence showed a positive relationship with a latent factor representing the functional integrity (and a negative relationship with a corresponding structural measure) of the affect-related executive regulation network. Locus coeruleus MRI contrast ratios were positively associated with agitation severity (but only for the rostral third, in N=13) and negatively associated with the functional affect-related executive regulation latent factor scores. Resting-state functional connectivity between a medial prefrontal cortex region and left amygdala was related to locus coeruleus MRI contrast ratios. These findings implicate the involvement of locus coeruleus integrity and emotion dysregulation in agitation in Alzheimer’s disease and support the presence of potential compensatory processes. At the neural level, there may be a dissociation between mechanisms underlying agitation risk per se and symptom severity. Further studies are needed to replicate and extend these findings, incorporating longitudinal designs, measures of autonomic function and non-linear modeling approaches to explore potential causal and context-dependent relationships across Alzheimer’s disease stages

Blood biomarkers confirm subjective cognitive decline (SCD) as a distinct molecular and clinical stage within the NIA-AA framework of Alzheimer´s disease

Subjective cognitive decline (SCD) is proposed as an indicator of transitional disease stage 2 in the Alzheimer's disease (AD) continuum. However, molecular and particularly longitudinal fluid biomarker data for this stage are still limited. This study aimed to determine whether blood-based biomarkers in amyloid-positive individuals with SCD (A + SCD) support the notion of stage 2 as a distinct stage between stages 1 and 3 of AD and to identify those at high risk for clinical progression. In a prospective multicenter study (DELCODE) involving 457 participants across the AD continuum, we analyzed plasma phospho-tau 181 (p181) and neurofilament light chain (NfL) and assessed their association with longitudinal cognition, hippocampal atrophy, and AD clinical stage transition. The results showed that baseline plasma p181 levels were elevated and increased more rapidly in A + SCD individuals compared to amyloid-positive cognitively unimpaired (A + CU) individuals (stage 1). NfL levels rose across A + CU, A + SCD, and amyloid-positive mild cognitive impairment (A + MCI, stage 3). In A + SCD, but not in A + CU, higher p181 levels predicted cognitive decline (PACC5) and transition to MCI. In conclusion, plasma p181 provides molecular biomarker evidence supporting A + SCD as a pre-dementia AD stage (stage 2) distinct from A + CU (stage 1) and helps identify individuals at risk for cognitive decline early in the AD continuum

Psychobiological mechanisms of gender differences in social approach behavior

By modulating social approach behavior, oxytocin critically affects the formation and maintenance of monogamous relationships. A seminal study showed that in men, oxytocin increases trust and hence approach behavior towards unfamiliar others. In women, however, oxytocin’s effects on trust are still unknown. Furthermore, the decision whether to trust a potential romantic partner or not is strongly influenced by facial features such as attractiveness and threat. The former acts as a signal of good reproductive fitness, the latter as a signal of potential trust abuse, both being highly relevant in a mating context. This dissertation thus studies largely unknown gender differences in the relevance of attractiveness and threat by using a refined trust game with interaction partners that vary in these facial features. It furthermore addresses the research gap of gender differences in oxytocin’s effects on trust by systematically comparing single men and women in the luteal phase. In Chapter 1, literature is reviewed on the psychobiological factors and gender differences in social approach behavior and trust, and on possible ways to measure trust. Chapter 2 presents a refined, incentivized trust game, which includes photos of interaction partners that vary in facial attractiveness and threat. Results from 93 participants (all singles; 46 women during their luteal phase) with romantic interest in the opposite sex show that both women and men trusted attractive and unthreatening interaction partners more often. Moreover, women’s trust behavior was more strongly affected by threat than by attractiveness, whereas men’s trust behavior was equally affected by both features. From an evolutionary perspective, it might be advantageous for women to be more vigilant towards threat cues due to a higher parental investment. For men, on the other hand, it might be more beneficial to approach women whose attractiveness signals a good reproductive fitness, as men can produce more offspring than women can. To study gender differences in oxytocin’s effects on trust, Chapter 3 first reviews the literature on oxytocin, with a focus on gender differences in oxytocin’s effects. Then, it presents data from 144 participants (all singles with romantic interest in the opposite sex; 73 women during their luteal phase) who played the trust game after intranasal administration of oxytocin or placebo in a randomized, double-blind procedure. We find that oxytocin, compared to placebo, increased trust behavior to a larger degree in men than in women. Furthermore, this gender difference in oxytocin effects was more pronounced when participants interacted with unattractive and unthreatening interaction partners. We therefore demonstrate for the first time that there are gender differences in oxytocin’s effects on trust behavior towards potential romantic partners, and that this effect is dependent on facial features. Gender differences in the oxytocin system and its interaction with gonadal hormones might explain the gender-specific oxytocin effects on social approach behavior. Finally, Chapter 4 integrates the findings from both studies and provides a general discussion of gender differences in approach behavior both with and without oxytocin, as well as limitations and implications of this dissertation. Taken together, this dissertation reveals gender differences in the importance of facial attractiveness and threat, and in oxytocin’s effects when singles approach potential romantic partners. Future studies could utilize this refined version of the trust game to investigate oxytocin’s effect on approach behavior in homosexual participants, in friends, and in clinical samples like participants with social anxiety disorder or autism. Furthermore, our findings emphasize that more research including both genders is necessary to understand the mechanisms and evolutionary purpose of oxytocin’s effects on social cognition and behavior