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Title: Understanding the Person of the Holy Spirit Series: Living in the Spirit
Focus Scripture: Acts 2 Introduction * Acts 2 marks the fulfillment of Jesus' promise to send the Holy Spirit, empowering believers for ministry and revealing the person and work of the Spirit profoundly. This chapter serves as a foundation for understanding the Holy Spirit's role in the life of the church and the believer. * Objective:
To explore the Holy Spirit's identity, nature, and mission as revealed in Acts 2 and how this understanding transforms our daily walk with God. I. The Identity of the Holy Spirit 1. The Holy Spirit as God:     * Acts 2:4: "All of them were filled with the Holy Spirit..."
The Spirit's divine nature is evident in His ability to fill believers and empower them with supernatural gifts.     * The gifts of the Holy Spirit are an extension of the person of the Holy Spirit present within us.     * The Holy Spirit is not a force but a person of the Trinity with intellect, will, and emotions - 2. The Promise of the Father:     * Acts 2:33 33 Now he is exalted to the place of highest honor in heaven, at God's right hand. And the Father, as he had promised, gave him the Holy Spirit to pour out upon us, just as you see and hear today.     * The Spirit fulfills the Old Testament promises     * (Joel 2:28-29) - 16 And I will ask the Father, and he will give you another Advocate, who will never leave you. 17 He is the Holy Spirit, who leads into all truth. The world cannot receive him, because it isn't looking for him and doesn't recognize him. But you know him, because he lives with you now and later will be in you. II. The Work of the Holy Spirit in Acts 2 1. Empowering Believers:     * Acts 2:3-4: 3 Then, what looked like flames or tongues of fire appeared and settled on each of them. 4 And everyone present was filled with the Holy Spirit and began speaking in other languages, as the Holy Spirit gave them this ability.     * The gift of diverse tongues and interpretation manifested because people of many nations/languages were gathered.     * Application: The Spirit equips us for ministry and mission, giving gifts for service (1 Corinthians 12). 2. Revealing God's Glory:     * Acts 2:11: "We hear them declaring the wonders of God in our own tongues!"     * The Spirit's work is always centered on glorifying God and revealing His nature to the world. 3. Convicting and Drawing People to Christ:     * Acts 2:37:  Peter's words pierced their hearts, and they said to him and to the other apostles, “Brothers, what should we do?”     * The Spirit convicts hearts, leading people to repentance and faith (John 16:8). 4. Building Unity in the Church:     * Acts 2:44-47: 44 And all the believers met together in one place and shared everything they had. 45 They sold their property and possessions and shared the money with those in need. 46 They worshiped together at the Temple each day, met in homes for the Lord's Supper, and shared their meals with great joy and generosity[a]— 47 all the while praising God and enjoying the goodwill of all the people. And each day the Lord added to their fellowship those who were being saved.     * The Spirit creates a community of believers through generosity, worship, and fellowship.     * The Spirit binds believers together in one body (Ephesians 4:3) -  Make every effort to keep yourselves united in the Spirit, binding yourselves together with peace. III. Living in the Spirit Today 1. Continual Filling:     * The Spirit's presence in Acts 2 wasn't a one-time event but the beginning of ongoing empowerment (Ephesians 5:18). 18 Don't be drunk with wine, because that will ruin your life. Instead, be filled with the Holy Spirit,     * Daily surrender and openness to the Spirit are essential. God's mercies are fresh and new every day. Like the children of Israel in the wilderness, we need fresh manna daily, 2. Boldness in Witnessing:     * Acts 2:14-41: Peter's boldness in proclaiming the Gospel came from the Spirit's power.     * Application: The Spirit emboldens us to share our faith in love and truth. 3. Transformation of Lives:     * Acts 2:42-47: 42 All the believers devoted themselves to the apostles' teaching, and fellowship, and to sharing in meals (including the Lord's Supper[a]), and to prayer. 43 A deep sense of awe came over them all, and the apostles performed many miraculous signs and wonders. 44 And all the believers met together in one place and shared everything they had. 45 They sold their property and possessions and shared the money with those in need. 46 They worshiped together at the Temple each day, met in homes for the Lord's Supper, and shared their meals with great joy and generosity[b]— 47 all the while praising God and enjoying the goodwill of all the people. And each day, the Lord added those who were being saved to their fellowship.     * The Spirit transforms believers, resulting in worship, generosity, and a communal lifestyle.     * Personal Reflection: How is the person of the Holy Spirit transforming our hearts, habits, and relationships? Conclusion * Call to Action:     * Let's reflect on our relationship with the Holy Spirit. Are we yielding to His leading, seeking His filling, and walking in His power?     * Let's pray for a fresh outpouring of the Spirit in our lives, just as in Acts 2. * Encouragement:     * The same Spirit who moved powerfully at Pentecost is alive and at work today. He longs to empower, guide, and transform each of us into the likeness of Christ.

Title: Understanding the Person of the Holy Spirit Series: Living in the Spirit
Focus Scripture: Acts 2 Introduction * Acts 2 marks the fulfillment of Jesus' promise to send the Holy Spirit, empowering believers for ministry and revealing the person and work of the Spirit profoundly. This chapter serves as a foundation for understanding the Holy Spirit's role in the life of the church and the believer. * Objective:
To explore the Holy Spirit's identity, nature, and mission as revealed in Acts 2 and how this understanding transforms our daily walk with God. I. The Identity of the Holy Spirit 1. The Holy Spirit as God:     * Acts 2:4: "All of them were filled with the Holy Spirit..."
The Spirit's divine nature is evident in His ability to fill believers and empower them with supernatural gifts.     * The gifts of the Holy Spirit are an extension of the person of the Holy Spirit present within us.     * The Holy Spirit is not a force but a person of the Trinity with intellect, will, and emotions - 2. The Promise of the Father:     * Acts 2:33 33 Now he is exalted to the place of highest honor in heaven, at God's right hand. And the Father, as he had promised, gave him the Holy Spirit to pour out upon us, just as you see and hear today.     * The Spirit fulfills the Old Testament promises     * (Joel 2:28-29) - 16 And I will ask the Father, and he will give you another Advocate, who will never leave you. 17 He is the Holy Spirit, who leads into all truth. The world cannot receive him, because it isn't looking for him and doesn't recognize him. But you know him, because he lives with you now and later will be in you. II. The Work of the Holy Spirit in Acts 2 1. Empowering Believers:     * Acts 2:3-4: 3 Then, what looked like flames or tongues of fire appeared and settled on each of them. 4 And everyone present was filled with the Holy Spirit and began speaking in other languages, as the Holy Spirit gave them this ability.     * The gift of diverse tongues and interpretation manifested because people of many nations/languages were gathered.     * Application: The Spirit equips us for ministry and mission, giving gifts for service (1 Corinthians 12). 2. Revealing God's Glory:     * Acts 2:11: "We hear them declaring the wonders of God in our own tongues!"     * The Spirit's work is always centered on glorifying God and revealing His nature to the world. 3. Convicting and Drawing People to Christ:     * Acts 2:37:  Peter's words pierced their hearts, and they said to him and to the other apostles, “Brothers, what should we do?”     * The Spirit convicts hearts, leading people to repentance and faith (John 16:8). 4. Building Unity in the Church:     * Acts 2:44-47: 44 And all the believers met together in one place and shared everything they had. 45 They sold their property and possessions and shared the money with those in need. 46 They worshiped together at the Temple each day, met in homes for the Lord's Supper, and shared their meals with great joy and generosity[a]— 47 all the while praising God and enjoying the goodwill of all the people. And each day the Lord added to their fellowship those who were being saved.     * The Spirit creates a community of believers marked by generosity, worship, and fellowship.     * The Spirit binds believers together in one body (Ephesians 4:3) -  Make every effort to keep yourselves united in the Spirit, binding yourselves together with peace. III. Living in the Spirit Today 1. Continual Filling:     * The Spirit's presence in Acts 2 wasn't a one-time event but the beginning of ongoing empowerment (Ephesians 5:18). 18 Don't be drunk with wine, because that will ruin your life. Instead, be filled with the Holy Spirit,     * Daily surrender and openness to the Spirit are essential. God's mercies are fresh and new every day. Like the children of Israel in the wilderness, we need fresh manna daily, 2. Boldness in Witnessing:     * Acts 2:14-41: Peter's boldness in proclaiming the Gospel came from the Spirit's power.     * Application: The Spirit emboldens us to share our faith in love and truth. 3. Transformation of Lives:     * Acts 2:42-47: 42 All the believers devoted themselves to the apostles' teaching, and to fellowship, and to sharing in meals (including the Lord's Supper[a]), and to prayer. 43 A deep sense of awe came over them all, and the apostles performed many miraculous signs and wonders. 44 And all the believers met together in one place and shared everything they had. 45 They sold their property and possessions and shared the money with those in need. 46 They worshiped together at the Temple each day, met in homes for the Lord's Supper, and shared their meals with great joy and generosity[b]— 47 all the while praising God and enjoying the goodwill of all the people. And each day the Lord added to their fellowship those who were being saved.     * The Spirit transforms believers, resulting in worship, generosity, and a communal lifestyle.     * Personal Reflection: How is the person of the Holy Spirit transforming our hearts, habits, and relationships? Conclusion * Call to Action:     * Let's reflect on our relationship with the Holy Spirit. Are we yielding to His leading, seeking His filling, and walking in His power?     * Let's pray for a fresh outpouring of the Spirit in our lives, just as in Acts 2.     * The same Spirit who moved powerfully at Pentecost is alive and at work today. He longs to empower, guide, and transform each of us into the likeness of Christ. -- Praise Tabernacle Dr. Joshua Kennedy,  Pastor 2235 Ocean Heights  Egg Harbor Township, NJ 08234 pastorjosh@praisetabernacle.com praisetabernacle.church  (609) 927-4560(w)

**The children of Christian parents belong to a Covenant Home.**The idea of "Covenant Theology" is overused and misunderstood by many of those holding to it and by those rejecting it. A lot of the conversations quickly become unfruitful because terms are not only left undefined, but are not understood by the people using them. This is not going to be an argument for or against Covenantalism. But, I do need to define by terms to avoid more overuse and misunderstanding. I'm going to summarize what I don't mean and we can talk details later if you want.When I say "Covenant Home," I am not referring to the Covenant of Grace. As described by Covenant Theologians, the Covenant of Grace includes all of the elect for salvation, from the beginning of human history to it's end. Much of the time, when people say "Covenant Home," they do have in mind the Covenant of Grace, and they include their children from the get go as legitimate members. But the kids are able to leave the covenant - go apostate - which seems strange to me if they're elect. My "Covenant Home" does not refer to the Covenant of Grace.I'm also not referring to the New Covenant. It's often used interchangeably with the Covenant of Grace, which actually makes things more confusing. The terms, parties, and promises of the New Covenant are clear and specific in the Bible. The New Covenant does stipulate that it's members will have children, and those children are guaranteed to be believers - that is, members of the New Covenant. It's one of the promises of the New Covenant. And it's also one of the reasons why I don't mean the New Covenant when I say "Covenant Home." It's possible for Christians to have their kids go apostate today. In the fulfillment of the New Covenant, that will not be.What am I talking about?Malachi 2:14-15> But you say, “Why does he not?” Because the Lord was witness between you and the wife of your youth, to whom you have been faithless, though she is your companion and your wife by covenant. Did he not make them one, with a portion of the Spirit in their union? And what was the one God seeking? Godly offspring. So guard yourselves in your spirit, and let none of you be faithless to the wife of your youth.When I say "Covenant Home," I am referring to the marriage covenant that a Christian man made with a Christian woman, with God as their witness. In that union, God gave a portion of the Spirit in order to form a Christian Household and bring up Godly children.The context of a Christian's marital vows is with God as their witness. Man and wife covenant together in order to form a household in the presence of God. And everything that happens within that household, and everything done by that household, is done with God as witness and with a portion of God's Spirit, in order to have god-honoring fruit. It's like the Spirit of God forms a dome around the Christian family and tells them not just to be fruitful and multiply, but do so in a way and to the end that honors God. Marriage is to be fruitful. And here we see that the primary fruit of a god-honoring marriage covenant is godly children.“What was God seeking? Godly offspring.”Christian marriage forms a Christian family, into which children are born, and are to be brought up, within that context, to be Christians themselves. God is seeking godly children. Our marriage covenant speaks to that.**The children of Christian parents belong to a Covenant Home.**What does it mean to be a Covenant Kid?I will be addressing our Covenant Kids. What are your responsibilities before God in your role as a kid of Christian parents?4 main points:- The Covenant Kid's Role- The Covenant Kid's Objective - The Covenant Kid's Assignment - The Covenant Kid's RewardEphesians 6:1-4.# The Covenant Kid's RoleKids are members of their households, and future heirs of it. That is their role. When the husband and wife formed their household, they both became members of it. As kids are born into that household, they are born under that covenant umbrella as members of it.I specify that kids are future heirs, and not just members, because it's possible to be a member of a household without being an heir. I'm thinking of slaves and servants, in cultures where that makes sense. Paul, writing to the Galatians distinguishes between sons and slaves in the way that the son "is the owner of everything," and when his father says so, will inherit what is his fathers.So, kids are members of their household and future heirs of it. What are they members and future heirs of? What is a household?3 C's to define a household:- Covenant- Community- Culture## Household As CovenantA household is a covenant. The husband and wife make marriage vows - mutual promises - in the presence of God, through which God's Spirit establishes a Covenant Household. You kids, are the fruit of that covenant union, and therefore, are members of it.The kids of Christian parents, even before they profess and are baptized, from the day they're conceived, are set apart from the kids of the world by being members of a Christian household.1 Corinthians 7:14> For the unbelieving husband is made holy because of his wife, and the unbelieving wife is made holy because of her husband. Otherwise your children would be unclean, but as it is, they are holy.A household is a covenant. Kids are part of the household covenant.## Household As CommunityA household is a community. It is not a group of isolated individuals. A community is a network of relationships, that are interdependent.Because it's founded on a covenant, a household is an *inseparable* community. When a husband and wife act like individuals, the household starts to unravel. And when kids act like individuals, they are being unfaithful members of their household.Acting like an individual means that you make your decisions and perform your actions without considering how that reflects on or impacts the other people in your household.We are always simultaneously representing at least 3 identities. Ourselves (which our first name reminds us of), our family (which our last name reminds us of), and Christ (which our baptism reminds us of).We never act just as individuals. The Bible says that kids can bring shame to their parents. A foolish and lazy son makes his family look bad. And a wise and hardworking son makes his family look good.There is a wrong kind of pressure that can come with that. If we're just trying to look the part in order to not embarrass our parents, we're missing the point. The point is that whenever you act, you should consider: What is this going to do for my name? For my family's name? For Christ's name?A household is a community. Kids are part of the household community.## Household As CultureWe've set the foundation of the household as a covenant. We've built the walls and roof around the household as a community. We can now fill the household with a culture. A household is a culture.Ephesians 6:4> Fathers, do not provoke your children to anger, but bring them up in the discipline and instruction of the Lord.Paideia. This is culture. A household has a certain type of culture that it takes on as it's own - standards, traditions, acceptable and unacceptable behavior.When I tell my boys that "Kulishovs don't do that," or "our family doesn't do that," I am appealing to the standard of our household culture. Households have norms and expectations.But here, this paideia, culture, is that of the Lord. What kind of culture should the household have and the kids be trained in? God's culture. Kids in a Christian family are to be raised, trained, and molded as Christians.Our kids are held to Christian standards, being raised in a Christian culture, because they are a part of a Christian household.Our kids are to be born in and molded by a Christian culture that they can't escape. And when they are launched as men and women, ungodly culture should be detestable.The Christian Household Culture obligates it's members to worship the Lord. This goes back to Paul calling kids of Christians holy. He says there that an unbelieving spouse is "being made holy," being set apart, by the believing spouse. The light of Christ shines on them, because they're married to a believer. But the kids, he says, are holy. They are set apart for God.All men who live under the Sun are obligated to worship the Lord, and are without excuse if they don't, because they live under the light of the Sun.But kids in a Christian home, being molded by a Christian culture, are living under a magnifying glass that's burning the witness of the Sun's light onto their hearts. They can't escape it. That's what God intended.Kids, God tells your dad to train and discipline you according to God's standard. Your dad controls the path you take - either for good or for evil. His role in your life is active. When your dad is setting the ground rules for you and for your house, he is doing so in obedience to God. He's supposed to be active in your training and in your boundaries - to train you in the culture of God.The household is a culture. As part of the Christian household, kids are part of that Christian culture.Big takeaway: you kids are not just members of the household. You are it's heirs. When you inherit what belongs to your father, you inherit this Christian culture that he trained you in. The Paideia of God. It belongs to you. Own it. And carry it forward.# The Covenant Kid's ObjectiveEphesians 6:1> Children, obey your parents in the Lord, for this is right.Objective: To do what is right in the Lord.Colossians 3:20> Children, obey your parents in everything, for this pleases the Lord.To please the Lord.The Covenant Household is founded with God as witness and with a portion of God's Spirit, in order to have god-honoring fruit, namely godly children. The objective for Covenant Kid's is to honor God in all that they do.Kids are to aim to do what is right and what pleases the Lord. They are to be taught this by their parents, and are to be held to this standard from the get go. "What does God think about what you did?" should be a normal question for kids to be taught to ask themselves, whether or not they're baptized.Many Christian parents tiptoe around this objective for there kids. They wait for their kids to figure it out on their own. "We want the desire to please the Lord to be sincere and authentic. We don't want to push it onto them." Parents are to set God's pleasure as the standard for their kids.The pleasure of God is the kids' objective. To do what's right.# The Covenant Kid's Assignment Ephesians 6:1-2>Children, obey your parents in the Lord, for this is right. “Honor your father and mother” (this is the first commandment with a promise),The way that kids please the Lord in their role as kids is by obeying and honoring their parents.You're not just recipients of your father's actions towards you. You also are to act a certain way toward your dad and mom. You're accountable before the Lord for how you act toward your parents.## Obey Your ParentsDisobedience to parents is underrated. It happens so often, that we take for granted - both kids and parents - how seriously God views it.Romans chapter 1, Paul lists all the debasement of the God-haters:Romans 1.29> They were filled with all manner of unrighteousness, evil, covetousness, malice. They are full of envy, murder, strife, deceit, maliciousness. They are gossips, slanderers, haters of God, insolent, haughty, boastful, inventors of evil, disobedient to parents, foolish, faithless, heartless, ruthless.God puts "disobedient to parents" alongside murderers, haters of God, and inventors of evil.2 Timothy 3.2> For people will be lovers of self, lovers of money, proud, arrogant, abusive, disobedient to their parents, ungrateful, unholy, heartless, unappeasable, slanderous, without self-control, brutal, not loving good, treacherous, reckless, swollen with conceit, lovers of pleasure rather than lovers of God,Disobedience to parents is presented alongside the abusive, treacherous, and conceited.Covenant Kids are to obey their parents in the Lord, for this is right.## Honor Your Father and MotherThey are also to honor their parents. Honor is more encompassing then obey. Obedience is specific to instruction. Honor is overarching. It entails the overall demeanor and position. Do you hold your parents in contempt, or do you hold them in honor?When we're talking about the household as Covenant, Community, and Culture, to honor your parents means to submit to and to esteem the Household Covenant, Community, and Culture. Kids are to be happy in their respect and submission to the household standards which their parents have set. It's not just about the behavior. It's about the heart, the demeanor. Honoring your parents means the kids aren't hating and begrudging having to do what their dad is telling them.Note: "Honor your father and *mother*." Where obedience is directed toward "parents," honor looks different towards the father and the mother. Your dad might allow a stronger conversation without his honor being threatened. But your mom, even though she's your mom, is still a woman. The approach, tone, and demeanor should consider all of that.The Christian Culture that the parents are raising their kids in ought to be held in honor by the kids.The kid's Assignment: to obey and honor their parents. That's how they live out their objective to please the Lord within this specific role as members and heirs of the household.# The Covenant Kid's RewardEphesians 6.2> “Honor your father and mother” (this is the first commandment with a promise), “that it may go well with you and that you may live long in the land.”The kids receive an explicit promise as a result of fulfilling their assignment towards their objective. God uses positive reenforcement. God promises to bless them as a result of their obedience. Their reward is God's blessing upon them.Some people do argue that Paul referencing the 5th Commandment means that he's bringing the New Testament Gentiles under the weight of the Mosaic Law. Reading the text does not require that kind of interpretation. Yes, he's referencing the Mosaic Law, and even quoting it here for the Gentile church. But he's doing it because it was that good, that true. "The law also says this, and includes a promise."The reward of God's blessing for honoring your parents is stability and confident peace in your life. Unstable, anxious adults who can't hold their life together were much of the time not honoring their parents. When you're not busy uprooting what your fathers before you have planted, and fighting against the god-honoring culture that you were brought up in, but instead are furthering that effort by adding your own strength to it, God's blessing follows you as you live long and stable in the land.The kid's reward for living out their assignment to obey and honor their parents, as they aim towards the objective of doing right in the Lord, within their role as members and heirs of the covenant household is God's blessing.# Conclusion:- Role: Member & Heir of the Household Covenant, Community, and Culture- Objective: To please the Lord and do what's right- Assignment: Obey and honor your parents- Reward: God's blessing on your lifeR-O-A-RYou kids are growing up to be on the attack. You are a lion cub and a young lion under the discipline of your parents. They are training you in order to one day unleash you. Like a beast on the attack, like a weapon wielded, like arrows sprung from the bow, you will be released from under your parents authority to carry and advance Christ-honoring culture, because that is your inheritance.Young man, one day you will leave your father and mother, to start your own household with the wife of your youth, to form a covenant with your companion, with God as your witness, in order for you to beget godly children - Covenant Kids - and take further ground.Young lady, one day you will be given to a man, as you leave your father's household and create a new one under your husband's family name. You will be responsible to nurture a Christian culture in your home in order to bring up godly children - Covenant Kids - and take further ground.How can you set yourself up to play offense successfully?1. Be a faithful member of your family covenant - Live in your ROLE2. Do what is right and pleasing to the Lord - Live in light of your OBJECTIVE3. Obey and honor your parents - Live out your ASSIGNMENT4. Receive God's blessing - Live out of your REWARDGo and Roar, for the pleasure of God.

Sex emergency during a family Christmas gathering!Based on a post by HeyAll. Listen to the Podcast at Steamy Stories.No one at the university's research facility could have predicted that Dr. Ledgard’s machine would have the effects that it does. The human mind is still vastly unknown. While studying new treatments for bipolar mania, some partial successes did recreate some symptoms of certain mania behavior; hyper-sexuality, to be specific. It was a national security contractor who first suggested that this subtle wave frequency could help the CIA and other security agencies.That’s why General Hamilton requested an immediate promotion for the doctor, in hopes of turning the frequency machine into something that could potentially serve the country and its national security (& espionage) interests.On the doctor’s desk was a list of potential candidates for the new test project. They were all young adults, medical school graduates who understood the process and were interested in making some money.It was decided that the next candidate would need to be an attractive young female with an inquisitive mind, traditionally religious, tepid when it comes to sex, and had a large enough family. It would make the experiment more realistic if the subject had conflicts and barriers to becoming a nymphomaniac.“You’re doing us a great service,” General Hamilton said, after observing the research doctor at work. “We greatly appreciate your efforts.”Dr. Ledgard gave a soft sigh. “I’m always happy to be of service, but I think we should disclose all of the details. I don’t want a repeat of my previous mistakes.”“Just get it done.”With a lecherous grin, the General gave another look at the research documents and state-of-the-art equipment in the new lab. Then he left.Once alone, Dr. Ledgard looked through the pile of candidates again. After an hour, a decision had been reached and the report was started.Deviance Case File  0 0 2Sara Carter: She is our next test subject, after having signed the agreements and waivers. Sara is a 29 year old medical school graduate who is currently finishing her first year of residency. Her record is clean. Her grades are top tier. No evidence of sexual promiscuity. In her younger days, she spent a lot of time with her church, for community service.Dylan Carter: He’s the younger brother. Age 21. He attends a nearby college. He’s athletic and smart. Handsome. An ideal counterpart for Sara.Julie Carter: The matriarch of the family. 51 years old. She owns a small catering business that her late husband built. Her son still lives at their family home and Sara sleeps over during the holidays. There's been no husband/father in the picture since the cancer death of Julie's 2nd husband, so she runs the household. From the looks of things, the mother is prim and proper. A great classic role model. She remarried when Sara was 10 years old. Julie's first husband was a Navy pilot who died in an accident while testing a new jet. Julie then married a widower, whose first wife died in childbirth, when Dylan was born.Objective: To convert the primary test subject into a nymphomaniac. Originally, it was irrelevant whether the subject was aware or not. But now, for ethical reasons, she will be notified of the extreme consequences.When the message came from Dr. Ledgard’s office that she had been selected as a participant in the study, she jumped at the chance. Sara rushed home to tell her Mother the good news, who was busy in the kitchen wearing an apron.“Hi sweetie, don't forget we're caroling at the nursing home tonight, with the rest of the church choir. So, how did it go with your interview?” Mom asked, stepping out of the kitchen where she was baking homemade pizza for a family lunch.Sara beamed. “It was incredible. The lab looked like something out of a movie. Seriously. I’ve never seen anything like it before. And everyone on the research team was super nice.”“I’m so happy for you. Who knows, if they like you, maybe they’ll hire you someday.”“God, I wish,” Sara said gushingly.“Speaking of which, having you back for the holidays has had a nice effect on your brother.”“Oh yeah?” Sara  was curious about what mom meant.“He’s decided to take pre-med classes. You’ve inspired him to do some good in the world.”“Nice!” Sara celebrated.“It is. He’s a smart one, just like you.” Mom beamed with pride.Sara pondered for a moment. “You know, one of the researchers today asked me about my household. They wanted to know about my brother and home situation.”“Any reason why?” Julie seemed incredulous.“They said they’ll tell me later. It may have to do with a research project I applied for. It pays pretty good money, and right now I could use some extra cash. But it was mentioned that if Dylan wanted to be involved, then he’d be welcomed. They’ll give him a small job to make things easier. I didn’t think Dylan would be interested. If I had known, I would have said something.”Mom smiled, “He’s upstairs. You should go tell him.”“I’ll be right back.” Sara's voice trailed off as she trotted up the stairs.Sara went up to break the good news to her brother, whose room was at the end of the hall, and she knocked on the door. With approval, Sara entered the bedroom, where her brother was playing on the Xbox.“I hear you’re setting your sights on pre-med?” Sara began.“Is that what Mom told you?” he asked.“Yeah, why? Did she speak too soon?” Sara asked?“I don’t know. I’m prepared to work hard. But it’s intimidating, to be honest.”“Here, I’ll describe one morning of my residency,” she said. “So you can get an idea of what I do.”“Sure.”“I get to the hospital early, and I check on each patient’s charts, making sure their blood pressure and oxygen saturation levels are measured, then I explain all the diagnostic procedures and therapeutic plans to both supervisors and patients. It’s like that the whole day.”“Sounds tough,” he said. “But I’ve always done well in biology and science.”“Do you want to test yourself?” Sara challenged him.“How?” Dylan asked, hitting the pause on his video game.“With a mock-female-patient to practice on. You’ll be given small tasks. Some responsibilities. Recording information, that sort of thing. Plus she’s hot.”“Really? How hot is she?”Sara winked. “You’re looking at her.”“Hmm. I’m assuming this has to do with Dr. Ledgard’s experiment.” Dylan revealed his insights.“Yeah, they mentioned a small job opening. Now that I know you’re interested, we should definitely team up.” Sara offered.He smiled, “Count me in. I’m now at your service.”The lab was in a small section of an underground facility, not far from the downtown medical campus area. It was accessed through an imposing government building guarded by soldiers  who were all-business when Sara arrived at the gate. They asked for her papers when she pulled her car to the checkpoint and, after consulting a computer in the guard shack, returned them to her and waved her through.When she parked & headed into the building, a few members of the team greeted her with smiles and showed her to the procedure room. She was asked to sit on the exam table and her vital signs were taken by a woman in green scrubs. In the other corner of the procedure room, another woman calibrated a small machine for the day’s session.Dr. Ledgard appeared after a meeting with government officials and sat down across the table from Sara. They exchanged pleasantries, then Dr. Ledgard handed her a file.“Take a moment to read that over,” the doctor said. “I wrote it myself. Everything is simple and in plain English.”Sara opened the folder and saw a typed report, which she was able to skim through. The content seemed jarring. When she turned the pages, she saw sets of pictures, featuring a young man and a mature woman engaging in all sorts of lewd sexual acts in a living room and kitchen setting.“What do you think?” Dr. Ledgard asked.“Riveting,” she blushed.“Do you believe the content of the report?”Sara searched for the most polite way to phrase her language. After all, in med school, Dr. Ledgard was the talk of campus and many of the professors.“I think it’s interesting,” she said. “I’m sure there are ways of actually making this happen, psychologically speaking.”Dr. Ledgard raised an eyebrow. “But do you think that these images are real, and that a medical device could override the inherent taboo objections, causing this ordinary mother to act in this manner towards her own son?”“Yes, it seems logical that a device could do that,” she answered. “But I also think that, you know, there might have been underlying feelings. Who knows, maybe the device merely nudged them to act on latent desires. Or maybe the device never worked at all, but the subjects thought it did. Sort of like a placebo effect that caused them to act on their desires.”“Interesting,” the doctor noted before pushing on. “Ms. Carter, I’m going to be blunt with you. Have you ever fantasized about your younger brother, Dylan?”Sara was aghast. “No, never.”“How about your mother, Julie? Have you ever had deviant thoughts about her?”“No, absolutely not.” Sara blurted, with a nervous chuckle.“Do you believe that this machine can create a powerful, magnetic sexual attraction between you and a member of your family? Much like the mom/son in the photos.”With an inquisitive eye, she sifted through the photos again. The people in the photos had what appears to be passionate sex, had equally as rough oral sex, and if Sara was seeing things correctly, the male subject was ejaculating in the mother’s food, then she happily ate.“Honestly,” she said. “I’m not completely sure. I still think there was possibly mutual attraction before the experiment. But I doubt it happened out of thin air.”“I appreciate your honesty. And I enjoy your skepticism. You’re a smart and independent thinker. That’s partially why I’ve chosen you.”She blushed. “Thank you, Dr. Ledgard.”“Are you still interested in participating in the study? And what does your schedule look like for the next week or two?"Yes, of course I'm interested. And my family has a big holiday gathering in a few days, other than that, I'm just doing my residency routine and spending time with my immediate family?”“I am going to amplify the power of the frequency today,” the doctor said.“Okay.”“Then we’ll see what sorts of attractions you have for your brother, or your mother.”Sara gasped. “I’m certainly not attracted to either of them. That’s basically incest. It’s gross.”“I’m glad you feel that way. We need to test the machine to know whether the previous experiment was a fluke or not.”“What, umm; are the chances?” she asked. “That I’ll,.”“Become a nymphomaniac?” Mr. Ledgard finished her nervous concerns.Sara felt her cheeks warm. “Yes.”“That’s what we’re hoping to find out. After a week or two, we’d like to administer a polygraph test to see if you’ve committed sexual acts with any member of your home.”“Oh god.” Sara gasped at the notions.“I understand your frustration,” Dr. Ledgard said. “Which is why we’re going to increase your compensation. You’ll be rewarded even further, financially speaking. I’ll provide glowing job referrals for you. And I will personally recommend you for any internship or job opening in this department, should you wish.”It was the news Sara had been hoping for. Her future flashed before her eyes. If everything went well, she’d have a bright career ahead of her.“That sounds amazing,” she said.“It does. Who knows, the side effects might be nothing. The other experiment could have been a fluke. If you do exhibit nymphomaniac tendencies with your family, we can fix it in our lab. That should provide you with some sense of safety.”“So if anything goes wrong, assuming this machine does what you’re suggesting, then I can come right back and have it undone, right?”Dr. Ledgard paused. “It would be addressed.”A slight sense of panic was setting into Sara’s psyche. If this machine had worked the way the doctor suggested, then she could be in for a real problem. Sara never doubted her own resolve on moral conduct. But then again, it did sound outlandish and crazy, and the reward for participating was fantastic.“I can do that,” she said.“You’ve also mentioned that your brother Dylan wants a job with us, for experience. I think that’s a great idea. He’ll be tasked with keeping track of your vitals, for brain waves and heart activity. He’ll send us a daily report on the findings. Since you'll be home for the holidays with him and your mother, all of the daily monitoring can be done without leaving the house.”She smiled, ”He’s going to be thrilled.“"Then we’ll begin right away.” Dr. Ledgard said with eager resolve.With the questioning over, Dr. Ledgard stepped away from the desk and the researchers hooked wires to Sara’s face and body. A small, advanced looking device was carted over to them, and a small antenna was pointed straight toward her head. The exam room's cameras were confirmed to be recording the procedures.“Initiation in 5, 4, 3, 2, 1,” Dr. Ledgard counted. “The subject Sara Carter exposed to the device emissions on December 20, at 10:23 a.m.”The machine was activated. When it made a low, humming noise, Sara wondered if she had just made the biggest mistake of her life.An hour later, Dylan met with Dr. Ledgard's staff and accepted a research contract. He was trained on the equipment and the reporting format. Then left to meet his sister at home.At home that afternoon; Sara sat by the desk in Dylan’s bedroom and her brother recorded all the latest updates. The device was small and could attach wired pads to her body, keeping track of her vital signs and brain functions throughout the day. Dylan was completing his second status check. This family arrangement was perfect. It not only provided convenient clinical monitoring at home, but also provided the strategic opportunity for a brother & sister to interact in a private setting.“Everything seems fine,” Dylan said, jotting the numbers down in a notepad.“You’re quite the researcher now,” she smiled.He smiled back. “This is easy stuff. And there’s one thing I thought was interesting. I’ve been meaning to ask you about it.”“Yes?” Sara looked at her brother.“Your heart rate and hormones seem to change at random points. At first I assumed it was your workouts, but when I looked closer, that didn’t seem to be the case. Feel anything weird?”After a moment to think, Sara realized the device recorded her recent flairs of intense sexual thoughts. But of course, she could never tell her brother that.“Well, you know,” she said. "Women work differently than men. We have different problems and issues, if you know what I’m hinting at.”The ambiguous excuse seemed to have worked.Dylan backed off. “Oh, okay. Got it.”“I should have given you some notice about that, but it was kind of embarrassing and I didn’t think it would show up on the device.”“It’s advanced,” Dylan pointed out. “Now let’s get this thing back on you. Lift up your shirt a little.”These moments were always a roll of the dice. Sara never knew what to expect with her own feelings whenever she lifted her t-shirt. Sometimes it would be fine, since Dylan had seen her in a bikini before. Other times, there’d be internal chaos.When she lifted her t-shirt to expose her stomach and the lower side of her bra, things went haywire. She suppressed the feelings the best she could and tried to act natural, even though her heart rate was spiking.Sara’s thoughts went into a frenzy; ‘God, he’s looking at my body. I wonder if he wants to rip off my bra and suck my nipples. My cunt is getting wet. I wonder if he can smell my aromas.’Everything seemed normal on Dylan’s end, as he strapped the device to her side and taped the wired pads to her body.She looked at him attentively, staring deeply at him while he worked. Had he noticed?He lifted his gaze, looking at her. “Yes?”“Nothing,” she said, quickly looking away.When the pads touched her body, and Dylan’s fingers grazed her skin, Sara felt like she could have had an orgasm right then and there!'God, why did I have to wear a bra?’ a thought popped into her mind. 'I want him to see how hard my nipples are. I want him to suck on them. I could cum so fucking hard right now.’She glanced at her brother again, who was doing his job. Her cunt felt swollen, just like her nipples. She needed; something, anything from him.In a few more seconds, she’d have enough courage to yank her bra and say,'Just fucking suck on my tits already. Then bend me over your desk and fuck me from behind!’It was about to happen, but sadly for her, Dylan pulled her T-shirt down.“All done,” he said. “You’re free to leave my office. The next appointment is tonight at 8 pm. Don’t be late.”She played it cool. “Five stars on Yelp. Plus a good review. See you tonight.”When she got up and left Dylan’s bedroom, she wondered how she could survive the rest of the week. How she prayed Dr. Ledgard could reverse this.At the moment, there was only one other person she could confide in.Mom was in the living room preparing for the big holiday party tomorrow. She was in the middle of arranging the furniture and had already finished with the decorations.“Lovely, isn’t it?” Mom said, referring to the festive décor.Sara looked everything over. “It’s amazing. I’m excited for tomorrow.”“You should be. I received some fantastic news a moment ago. Some of your distant Aunts and Uncles had extra time freed up and they’ll be catching last minute flights.”“Oh really?” Sara smiled.“Yes, really. It’ll be a large family affair. Our home will be stuffed.”There were family pictures on the wall, which reminded Sara of how many people are coming for the big holiday party. With her current medical state, she was in even worse trouble, because she would have to spend the whole day entertaining guests, instead of tending to her urges.“I’m screwed,” Sara bemoaned, wanting to cry.“Are the feelings back again?” Julie looked concerned.“It’s only gotten worse.” Sara nearly sobbed. “I’ve had those thoughts again.”“Sweetie, I think you should end it. You’re a nervous mess.”“But I’ve already told so many people that I’m working with Dr. Ledgard. It would be humiliating if I had to back out.”“Nonsense!” Mom snapped. “Everyone knows you’re not a quitter. You’re smart and talented.”“My reputation would be ruined.”Not only that, Sara had to think about her brother. She needed to be a role model. If she quit this experiment, what kind of message would that send? Big sisters have a solemn duty to their younger brothers, she thought.“Give me a hug,” Mom said.They embraced in a tight hug. It was loving and sweet, something they often shared whenever Sara was experiencing heartache. She pressed her face into Mom’s upper chest for comfort. Sara had always been a self-disciplined and responsible person. Only her mother knew of the times Sara felt weak or insecure.Under normal circumstances, this hug is where things would end. They hug, and Sara would leave feeling better. But this was far from normal. Those deviant little thoughts had returned.Sara’s mind felt like it was spinning: 'Mom’s breasts feel so nice. So soft; so delicate; and they’re just for me.’Without thinking, her hands clenched her Mother’s lower back, with her fingers digging in. It felt like a natural thing to do. The most natural thing in the world.“Sara?” Mom asked.“Yes?”“Your hands are squeezing me.”Sara gasped and released her iron grip. “I’m sorry.”“How bad is it?”“Pretty bad. I mean, just a moment ago, I kept thinking about how aroused I’d be if Dylan saw my hard nipples. I kept thinking of it, over and over again.”“And now?”Sara gave a soft sigh. “You don’t want to know.”“Tell me.”“I thought about your breasts, from our hug. Horrible, right?”“Did you want to see them?” Mom asked. “Touch them?”Sara’s jaw nearly dropped. “Oh, jeez.”“Don’t give me that expression. You’re the one with the naughty thoughts in your mind. I’m only asking. Maybe there’s something we can do.”Sara gulped. “I wanted to,  suck on them. Oh god, I’m so sorry.”“A mother’s breasts are made for nurturing. They used to feed you. Nature’s perfect gift. If you’re suffering this badly, then I would be fine helping you.”“What do you mean?” Sara asked.“Maybe you need to get this out of your system. Spare yourself. And spare your brother. It’s much easier this way.”Mom took a step back, then undid her top to reveal a white bra. The breasts looked large and inviting, begging to be touched.Sara gulped. “Promise you won’t be mad?”“Darling, this is a medical emergency. It’s nothing to be ashamed of. These aren’t your normal thoughts. This isn’t you. Obviously, we can’t allow these medical episodes to happen during the family party, or ever. So the only thing I can do, as your mother, is help relieve this tension until Dr. Ledgard can correct the problem. Okay?”“Mom?” Sara said with a shock.“Shush, Just have a look first. Let me show you.”It was a surreal moment between them when Mom reached behind and released the fasteners of her bra. When the garment slid off her shoulders, Mom’s spectacular breasts were freed for Sara’s view.They were large, shapely globes the size of grapefruits. Age had been kind to Mom, as Sara devoured those breasts with her eyes. She noticed that the nipples were becoming larger and more erect; the areolas the size of silver dollars and an inviting pink color.Sara gulped. “Can I suck on them?”“Of course you can.” Julie beamed with maternal pride.“Will you be mad?” Sara struggled with her inner taboo standards.“Never.” Julie assured her beloved daughter.A dirty thought appeared in Sara’s mind:'How fucking delicious. I have the best Mother in the world. First Mom, then my brother. The perfect holiday for me. No one stands a chance.’She brought her lips to Mom’s left nipple and sucked. Fireworks went off in Sara’s mind when her lips made contact. She wrapped her lips tight and pulled with her mouth. She sucked so hard that Mom made a gasping sound.“No one can ever know,” Mom said, rubbing her daughter’s beautiful hair. “Get it out of your system. Enjoy this. I need you at your best tomorrow.”As Sara nursed on her Mother’s tits, she wasn’t sure if that was possible. But this was a welcomed start. Her Mother’s hands moved around, and as Sara nursed on the hard nipples, she felt her Mother reaching forward to rub her tits in return.Could it be? Was Mom enjoying this too?The PartyDespite her worries, Sara did her normal hostess duties as the party guests would expect. There was a last minute option to leave home while the party happened, but that was out of character for her.There was no way she’d ever let her family down. She loved everyone too much to hide because of a medical issue. Especially since she’d been away from everyone during her first year medical residency.The party was the same as always. Uncles, Aunts, and cousins from all over had come to visit. Mom did most of the schmoozing. Dylan was in charge of food. Sara was tasked with service, which she enjoyed doing with her beautiful smile and charm.Wearing a cute yellow dress, Sara went around the living room to make sure everyone was having a good time and was properly fed.Through it all, she had a chance to catch up with distant relatives and people she only saw a few times a year. The Aunts and Uncles showered her with the usual compliments:'You’ve become so beautiful!’ 'You remind me so much of your mother when she was your age. “A doctor? Brains and beauty. A dangerous combination.’But for all the fun, Sara’s demeanor made a drastic change when her brother stepped into the living room. Though he was just coming to socialize with family, it felt different. Sara had always been the 'good girl’ at the family functions, but as Dylan chatted and laughed, Sara’s thoughts were far from good.Crazy thoughts ran through her head: 'Take him upstairs and fuck him. Yes, even with the family party going on. Nothing will make me hotter.’She realized the thoughts were making her cunt wet as they repeated in her mind, growing more insistent with each repetition."Are you okay?” Mom whispered in Sara’s ear.Sara snapped out of her trance, and she turned her attention towards her Mother, who was dolled-up like the perfect Milf.“It’s happening,” Sara whispered. “I’m really sorry.”The only reason Sara apologized was because a few hours ago, they had engaged in another nursing session. It happened in Mom’s bedroom while Dylan was in the shower. Mom had exposed both of her luscious tits and allowed Sara to suck on them for a good 10 minutes straight. Mom’s nipples even turned red.“It’s not your fault,” Mom replied. “What are you feeling?”They both looked around. The coast was clear and the living room was loud with chatter and laughter.“I want to take Dylan upstairs to fuck him.”Mom sighed. “Will a cold shower fix it?”“Unlikely. God, I’ve never been so desperate in my entire life.”“Maybe you should handle it already,” Mom said after a long pause.“Huh?” Sara stared at the mother who instilled strong and clear moral standards in her.“I remember what it’s like being your age. Hormones are raging. Things are confusing. I’ve tried my best to help, but nothing is good enough.”“Are you suggesting that I fuck my brother?” Sara asked.“I’m not saying that either. And he's your stepbrother. I adopted him at the same time your dad adopted you, shortly after our wedding.”“Then what are you saying?”Mom looked around. “Sex is an indulgence, much like food. If I have a slice of delectable chocolate cake, my cravings are satisfied and I’ll stop thinking about it for a while. Does that make sense?”“It kind of does.” Sara wanted to convince herself.Sara thought about her brother:'Mom is a genius. I want that cock so badly. I want to fuck him while the party is happening. Everyone would be oblivious to the fact that I’m an undercover brother-fucker.’“It’s a guilty pleasure,” Mom said. “I’ll never fully condone it. But, and this is very important, you know that I have a reputation to uphold. Things have to run smoothly at my parties. The family depends on me.”“Everyone looks content right now.”“At the moment. If you and Dylan disappear for 15 minutes, then I would be okay with that. But I’d need you back immediately. Dylan too. Please be gentle with him.”Sara’s eyes widened. “Oh my god, Mom.”“Don’t give me that. Besides, isn’t this part of Dylan’s job?” Julie added.Step-Sibling IndulgencesAfter dragging her brother up the stairs, she was in complete control of the situation. She decided that Dylan’s room would be the best place. She wanted to fuck on his desk. Just like in her naughty fantasies.“Mind telling me what’s going on?” he asked.Sara locked the door. “It’s time for me to be honest. I need to fuck.”“What?”“I’ll give you the details later,” Sara told him. “The short version is that Dr. Ledgard’s experiment messed me up. Badly. I knew it was possible, I just didn’t believe it.”“Believe what?”She lifted the front of her dress. “This.”With her dress held up with one hand, she used her other hand to pull her panties aside to reveal her cunt. It was cleanly shaven and the clitoris was swollen while protruding from her labia.Sara dipped her index finger into her entrance. She held her finger out, showing her brother a thick and clear liquid consistency.“Holy shit,” he gasped. “Is that the source of those weird signals coming from your body?”“Yes, I haven’t been right for the past two days. My cunt is killing me.”So, umm; why are you showing me?“"I’ll explain the whole thing later,” she sighed. “But right now, I need you to bend me over the desk. Fuck me, like our lives depend on it.”“What the,” Dylan blurted.“Dylan, look here,” she said, rubbing her labia. “ It’s an emergency. I want you in me, I need you in me!”“But, why me?” Dylan asked, worried about the potential implications of doing something so taboo.Sara swallowed her pride. “I need your cock; yours specifically. I’ve been thinking about you like crazy. It’s freaking me out.”“You mean, because of the experiment, you’ve,” Dylan was trying to process this bizarre reality.“Are you interested or not?” she said firmly.“I, umm; sure. How should we start?”Sara brisked over to him, grabbed him by the belt, and pulled him to the desk. She yanked his pants down and his semi-erect penis was almost ready to go. The horny little bastard was quickly aroused by the sight of her wet cunt, she thought. At least she was under a spell; Dylan had no excuse.“We’ve got to be quick,” she said, stroking her brother’s cock. “Mom needs us back as soon as possible.”“Does she know?” Dylan was now even more confused.She could see the conflicting emotions play across his face, lust winning out, as she continued stroking.Her inner voice told her;'Go ahead. Tell him everything. My younger brother needs to know. It’s about time he knows what I really am.’“I’ve told Mom everything,” Sara confessed in a low purr. “Mom knows more than you do, about the research. I confide in her about everything in my life. Mom knows how badly I want to fuck you. The truth is, Dr. Ledgard’s research has already accidentally made a mother and son have sex. I didn’t believe it. Now I’m the next step in the research.”She continued,”Mom tried helping me. She thought she could alleviate these nymphomaniac tendencies by showing me her amazing set of tits. She let me suck on them. That’s right, I nursed on Mom’s tits and pulled her nipples with my mouth. I think she likes it, since she fondled my breasts as well.”He was dumbfounded with arousal. “You and Mom? Nymphomaniac?”“I know, shocking. I can explain more later, but right now I need to get fucked.”Sara was under the influence of the frequency waves and she couldn’t care less that the whole family was downstairs, having a nice, wholesome time together. Actually, the risky act was turning her on even more. These were the nymphomaniac tendencies she had been warned about, and now she was loving every second of it.To get him fully erect, she grabbed his neck and pulled him in, planting a big kiss on his lips, then into his mouth. It was gentle at first, before turning rough and slipping her tongue inside. Their tongues wrestled for a good minute. All the while, she could feel her younger brother throbbing in her hand.She pulled back and released him. “You’re ready.” Sara pulled her yellow party dress over her head and unsnapped her bra.It was amusing seeing Dylan so speechless, cock freed, and in admiration of her attractive body, knowing they were about to fuck. She had always been the leader in their sibling relationship, now it was heading in a new direction.Sara bent over her brother’s desk, presenting her rounded ass. That way, her little brother could fuck her easily while standing. Her juices were running down her long, shapely legs. Her cunt lips were swollen and inviting, begging to be filled with his achingly hard cock.“Your ass is amazing,” Dylan said, sticking his index finger into her vagina.“Just fuck me already, please.”Sara was over the edge and didn’t care that it’s wrong by society’s standards, by her moral standard. All she wanted was to be fucked by her brother. Sure, it was nice sucking on Mom’s tits, but that did little to satisfy the intense craving between her legs. Only her brother could do that, with his thick rigid penis.She felt her cunt being spread wide, while she opened her legs for him. Inch by inch, her wet cunt was being entered. Despite her tight virgin cunt, it was an easy process because of how fucking aroused she was.“Oh yes!” Sara moaned, before realizing that she needed to keep her voice down. Her hymen split and  the tingling pain just added to her arousal.Dylan pumped faster, with an unrivaled force. “Your cunt is amazing. Fuck. I can’t believe I’ve been missing out on this.”“Just keep it quiet,” she hissed.While she was being pounded from behind, her submission to her brother was now complete, with her cunt being ravished. Her brother teased her by pulling her hips and bombarding her with his thrusts, slamming his balls against her cunt lips and gliding his cock through the warm folds of her cunt walls with incredible speed. He reached up and pinched the nipples of her dangling tits.It was everything she needed.Even though Sara was lost in what her brother was doing, and doing so well, she heard noises in the hall. She knew the bedroom door was locked, but they still shouldn’t be heard.“Stop, Dylan, there’s someone in the hall,” she whispered.Dylan stopped for a second. “They’re in Mom’s room. I’ll go slow.”Sara didn’t have the willpower to stop her brother; instead she buried her face in the pile of papers they used to record her data and she pushed her hips, to encourage the fucking to continue. Dylan’s cock was gliding through her canal, slowly retreating back, leaving only the head at her entrance, then going all the way in again, filling her insides.Her inner voice re-appeared; 'Finally, I’m a happy girl. All I need is his cum. His cum inside me. Then I can reach between my legs. Scoop it. And slurp it all down.’The thought of Dylan’s cum pumping into her eager cunt had Sara licking her lips. Her body demanded more from her brother. Her body needed to be filled with his seed, to have his cum leak between her vaginal walls and stream down her legs.After a few minutes of slow, sensuous fucking, the incestuous couple heard footsteps heading down the stairs. Without a word, they sped up their lustful attack on each other and Dylan was again plowing into her with wild abandon.“They’re gone,” Dylan said, pumping harder. “You like it harder, don’t you?”“Yes, yes, yes!” she cried.He groaned,”Where can I cum?“"In my cunt,” she said. “I want to eat it right after.”“Really? Oh, fuck!”That sent Dylan over the edge as he pounded with all his might, making Sara cry. Sara’s tears increased as she approached her earth-shattering climax at the same time as her brother. They both came and she felt her cunt flooded with her brother’s load. She could feel their cum mixing and intertwining to form a cum cocktail during the family party, which would be her secret treat. She reached behind her and pulled Dylan's hips tight against her, as she stood. He reached around her tits and embraced her.“What now?” he asked, kissing her neck while still buried within her.She smiled, “A snack to recover my energy.”Their bodies separated and the still-sensitive head of the cock plopped out her clinging lips. Sara reached between her legs and inserted two fingers to scoop the cum which dripped from her well-fucked hole.Before she could complete the mission, she heard the sound of a key slipping into the knob, unlocking the bedroom door.Sara’s heart nearly stopped at the sound of the locked doorknob being twisted and turned. Then the siblings heard a key slip into the lock as the knob now turned without resistance.Only their Mother had the bedroom key, and in a flash, she entered the bedroom and shut the door, locking it once again.“You two were almost caught,” Mom fumed. “There were inquiries about strange noises in here. I told your Aunt that you had a bruised rib from a recent skiing trip.”The siblings stood frozen as Mom approached them while they were still exposed after having finished fucking.Sara pulled her dress on and stood upright. “Mom, you shouldn’t be here.”“We have a party to host,” Mom countered. “And the noises you two have been making are unacceptable.”Dylan blushed, with his penis still out. “Sorry.”“Don’t be sorry,” Mom replied. “Get cleaned up. These smells are potent and the last thing we need is for anyone to notice.”“There’s plenty of tissue,” Sara noted.Mom shook her head. “No, that won’t do. I can smell both of you. The fragrance is strong, since you’re both young. If you walk down the hall, others may smell it.”“What do you suggest?” Dylan asked, with fluids dripping from his cock.Mom sighed. “The things I do for my family.”The siblings froze in place, stunned, as Mom dropped to her knees.Sara was in awe of her Mother, who lifted her dress and went to work eating her cunt. It was her first time being eaten by another woman and it was spectacular. Sara closed her eyes and tilted her head back as the cum cocktail was being sucked out of her little hole.It was pleasure Sara never knew she needed. Mom darted her tongue inside her trembling daughter, cleaning every inch and centimeter, as deep as she could go. When she was satisfied that Sara’s cunt was cleaned, she pulled away, giving her daughter a brief visual inspection and nodded to herself.“You’re so good at that, Mom,” Sara whispered.“Not that you should have known,” Mom said, licking her lips. “Dylan, you’re next.”Dylan sat on his bed. “Whatever you say, Mom.” His cock had become rigid again, while watching the two busty women.In an instant, Mom turned her attention toward the wet cock, bending down, she was taking it into her mouth to suck the excess cum that lingered. It was more of a maternal duty than anything else. But it was just as explicit as any porn scene. Her lips wrapped around the shaft and she gave hard, powerful sucks.As she watched her Mother go down on her brother, naughty thoughts arose in Sara’s mind:'There it is. Here’s your chance. Mom deserves a little relief. And I want a taste. I bet she’s delicious.’Sara got on her knees, right behind her Mother, and lifted the back of her dress. She pulled the panties to the side and pressed her lips there, making Mom squeal for a moment. Just then Dylan blasted his load into his mother's mouth. She swallowed it all, then turned her attention to Sara.“What’s gotten into you?” Mom asked, spitting the cock out of her mouth.Sara darted her tongue in her Mom’s asshole, then brought her tongue down to get a taste of cunt, lapping her tongue inside. Mom seemed rather aroused (and tasted like it too.) When Sara rose & moved around, she kissed her Mother on the lips. Mom was hesitant at first, but went along with it and their tongues wrestled with family fluids.After a few moments, Mom broke the kiss with her daughter and touched Sara’s cheek tenderly. She kissed Dylan on the tip and stood.“Alright, my two darlings, that’s enough,” Mom said. “Get dressed. Downstairs in one minute.”The siblings dressed quickly, checking each other for any telltale signs of their incestuous coupling. Neither of them minded the saliva as they wore their clothes. It would dry soon enough. Dylan was content with just pulling his pants up. Meanwhile, the ladies shared the mirror and fixed their dresses and hair, not to mention making sure their lipstick hadn’t been smeared.Clinic ReportsDr. Ledgard put the final touches on the report while sitting in the lab. Other researchers were there, monitoring heart activities and brainwaves from the two subjects.In a glass room, which the researchers were focused on, Sara was riding her brother on a bed they had set up. The siblings were naked as they had intense sexual intercourse with lust-fueled abandon. They were bashful at first, as anyone in that situation would be, but once they got started, they were unstoppable.“You’re a true genius,” General Hamilton said, observing the vigor of the youthful coupling on the other side of the glass. “I’ve always had faith in you, this is a job well done. I’m recommending you for a promotion and a generous pay raise.”“I don’t do this for money,” Dr. Ledgard replied.“No? Then what drives you?”“Knowledge,” the doctor responded, looking at the incestuous coupling once again.The siblings finished their strenuous loving-making session and Sara collapsed onto her brother, with her breasts resting on his face. Her pink nipples were hard and the brother took it upon himself to suck on them.When the researchers called for an end to the session, Sara climbed off her brother, and a trail of thick fluids leaked from between her legs. Sara cupped her buzzing cunt, catching the fresh cum, wiping it with her fingers, then brought it to her mouth. She licked her fingers clean.Sara knelt before her brother and cleaned with her mouth and tongue. According to daily reports that Sara and her brother had submitted, this was routine for them. Foreplay, sex, and 'oral cleanup.’ Their mother, it seemed, had helped ensure that everything was under control. Mom was the glue that held this experiment together.Post Notes:What was not yet asked by the primary test subject, was if Dr. Ledgard could administer and antidote treatment. He was still working on that, and relieved that he still had more time. As of now, all he could direct is a cessation, and hope that it would taper off, and perhaps a placebo impact might strengthen the restoration of the inner resolve her moral values once had in her life. As for Dylan and Julie, Dr. Ledgard could only hope that the social dynamic in the family would restore them to their previous standards of behavior. But that depended wholly on Sara's restoration; when and if she sought it.By HeyAll for Literotica

Sex emergency during a family Christmas gathering!Based on a post by HeyAll. Listen to the Podcast at Steamy Stories.No one at the university's research facility could have predicted that Dr. Ledgard’s machine would have the effects that it does. The human mind is still vastly unknown. While studying new treatments for bipolar mania, some partial successes did recreate some symptoms of certain mania behavior; hyper-sexuality, to be specific. It was a national security contractor who first suggested that this subtle wave frequency could help the CIA and other security agencies.That’s why General Hamilton requested an immediate promotion for the doctor, in hopes of turning the frequency machine into something that could potentially serve the country and its national security (& espionage) interests.On the doctor’s desk was a list of potential candidates for the new test project. They were all young adults, medical school graduates who understood the process and were interested in making some money.It was decided that the next candidate would need to be an attractive young female with an inquisitive mind, traditionally religious, tepid when it comes to sex, and had a large enough family. It would make the experiment more realistic if the subject had conflicts and barriers to becoming a nymphomaniac.“You’re doing us a great service,” General Hamilton said, after observing the research doctor at work. “We greatly appreciate your efforts.”Dr. Ledgard gave a soft sigh. “I’m always happy to be of service, but I think we should disclose all of the details. I don’t want a repeat of my previous mistakes.”“Just get it done.”With a lecherous grin, the General gave another look at the research documents and state-of-the-art equipment in the new lab. Then he left.Once alone, Dr. Ledgard looked through the pile of candidates again. After an hour, a decision had been reached and the report was started.Deviance Case File  0 0 2Sara Carter: She is our next test subject, after having signed the agreements and waivers. Sara is a 29 year old medical school graduate who is currently finishing her first year of residency. Her record is clean. Her grades are top tier. No evidence of sexual promiscuity. In her younger days, she spent a lot of time with her church, for community service.Dylan Carter: He’s the younger brother. Age 21. He attends a nearby college. He’s athletic and smart. Handsome. An ideal counterpart for Sara.Julie Carter: The matriarch of the family. 51 years old. She owns a small catering business that her late husband built. Her son still lives at their family home and Sara sleeps over during the holidays. There's been no husband/father in the picture since the cancer death of Julie's 2nd husband, so she runs the household. From the looks of things, the mother is prim and proper. A great classic role model. She remarried when Sara was 10 years old. Julie's first husband was a Navy pilot who died in an accident while testing a new jet. Julie then married a widower, whose first wife died in childbirth, when Dylan was born.Objective: To convert the primary test subject into a nymphomaniac. Originally, it was irrelevant whether the subject was aware or not. But now, for ethical reasons, she will be notified of the extreme consequences.When the message came from Dr. Ledgard’s office that she had been selected as a participant in the study, she jumped at the chance. Sara rushed home to tell her Mother the good news, who was busy in the kitchen wearing an apron.“Hi sweetie, don't forget we're caroling at the nursing home tonight, with the rest of the church choir. So, how did it go with your interview?” Mom asked, stepping out of the kitchen where she was baking homemade pizza for a family lunch.Sara beamed. “It was incredible. The lab looked like something out of a movie. Seriously. I’ve never seen anything like it before. And everyone on the research team was super nice.”“I’m so happy for you. Who knows, if they like you, maybe they’ll hire you someday.”“God, I wish,” Sara said gushingly.“Speaking of which, having you back for the holidays has had a nice effect on your brother.”“Oh yeah?” Sara  was curious about what mom meant.“He’s decided to take pre-med classes. You’ve inspired him to do some good in the world.”“Nice!” Sara celebrated.“It is. He’s a smart one, just like you.” Mom beamed with pride.Sara pondered for a moment. “You know, one of the researchers today asked me about my household. They wanted to know about my brother and home situation.”“Any reason why?” Julie seemed incredulous.“They said they’ll tell me later. It may have to do with a research project I applied for. It pays pretty good money, and right now I could use some extra cash. But it was mentioned that if Dylan wanted to be involved, then he’d be welcomed. They’ll give him a small job to make things easier. I didn’t think Dylan would be interested. If I had known, I would have said something.”Mom smiled, “He’s upstairs. You should go tell him.”“I’ll be right back.” Sara's voice trailed off as she trotted up the stairs.Sara went up to break the good news to her brother, whose room was at the end of the hall, and she knocked on the door. With approval, Sara entered the bedroom, where her brother was playing on the Xbox.“I hear you’re setting your sights on pre-med?” Sara began.“Is that what Mom told you?” he asked.“Yeah, why? Did she speak too soon?” Sara asked?“I don’t know. I’m prepared to work hard. But it’s intimidating, to be honest.”“Here, I’ll describe one morning of my residency,” she said. “So you can get an idea of what I do.”“Sure.”“I get to the hospital early, and I check on each patient’s charts, making sure their blood pressure and oxygen saturation levels are measured, then I explain all the diagnostic procedures and therapeutic plans to both supervisors and patients. It’s like that the whole day.”“Sounds tough,” he said. “But I’ve always done well in biology and science.”“Do you want to test yourself?” Sara challenged him.“How?” Dylan asked, hitting the pause on his video game.“With a mock-female-patient to practice on. You’ll be given small tasks. Some responsibilities. Recording information, that sort of thing. Plus she’s hot.”“Really? How hot is she?”Sara winked. “You’re looking at her.”“Hmm. I’m assuming this has to do with Dr. Ledgard’s experiment.” Dylan revealed his insights.“Yeah, they mentioned a small job opening. Now that I know you’re interested, we should definitely team up.” Sara offered.He smiled, “Count me in. I’m now at your service.”The lab was in a small section of an underground facility, not far from the downtown medical campus area. It was accessed through an imposing government building guarded by soldiers  who were all-business when Sara arrived at the gate. They asked for her papers when she pulled her car to the checkpoint and, after consulting a computer in the guard shack, returned them to her and waved her through.When she parked & headed into the building, a few members of the team greeted her with smiles and showed her to the procedure room. She was asked to sit on the exam table and her vital signs were taken by a woman in green scrubs. In the other corner of the procedure room, another woman calibrated a small machine for the day’s session.Dr. Ledgard appeared after a meeting with government officials and sat down across the table from Sara. They exchanged pleasantries, then Dr. Ledgard handed her a file.“Take a moment to read that over,” the doctor said. “I wrote it myself. Everything is simple and in plain English.”Sara opened the folder and saw a typed report, which she was able to skim through. The content seemed jarring. When she turned the pages, she saw sets of pictures, featuring a young man and a mature woman engaging in all sorts of lewd sexual acts in a living room and kitchen setting.“What do you think?” Dr. Ledgard asked.“Riveting,” she blushed.“Do you believe the content of the report?”Sara searched for the most polite way to phrase her language. After all, in med school, Dr. Ledgard was the talk of campus and many of the professors.“I think it’s interesting,” she said. “I’m sure there are ways of actually making this happen, psychologically speaking.”Dr. Ledgard raised an eyebrow. “But do you think that these images are real, and that a medical device could override the inherent taboo objections, causing this ordinary mother to act in this manner towards her own son?”“Yes, it seems logical that a device could do that,” she answered. “But I also think that, you know, there might have been underlying feelings. Who knows, maybe the device merely nudged them to act on latent desires. Or maybe the device never worked at all, but the subjects thought it did. Sort of like a placebo effect that caused them to act on their desires.”“Interesting,” the doctor noted before pushing on. “Ms. Carter, I’m going to be blunt with you. Have you ever fantasized about your younger brother, Dylan?”Sara was aghast. “No, never.”“How about your mother, Julie? Have you ever had deviant thoughts about her?”“No, absolutely not.” Sara blurted, with a nervous chuckle.“Do you believe that this machine can create a powerful, magnetic sexual attraction between you and a member of your family? Much like the mom/son in the photos.”With an inquisitive eye, she sifted through the photos again. The people in the photos had what appears to be passionate sex, had equally as rough oral sex, and if Sara was seeing things correctly, the male subject was ejaculating in the mother’s food, then she happily ate.“Honestly,” she said. “I’m not completely sure. I still think there was possibly mutual attraction before the experiment. But I doubt it happened out of thin air.”“I appreciate your honesty. And I enjoy your skepticism. You’re a smart and independent thinker. That’s partially why I’ve chosen you.”She blushed. “Thank you, Dr. Ledgard.”“Are you still interested in participating in the study? And what does your schedule look like for the next week or two?"Yes, of course I'm interested. And my family has a big holiday gathering in a few days, other than that, I'm just doing my residency routine and spending time with my immediate family?”“I am going to amplify the power of the frequency today,” the doctor said.“Okay.”“Then we’ll see what sorts of attractions you have for your brother, or your mother.”Sara gasped. “I’m certainly not attracted to either of them. That’s basically incest. It’s gross.”“I’m glad you feel that way. We need to test the machine to know whether the previous experiment was a fluke or not.”“What, umm; are the chances?” she asked. “That I’ll,.”“Become a nymphomaniac?” Mr. Ledgard finished her nervous concerns.Sara felt her cheeks warm. “Yes.”“That’s what we’re hoping to find out. After a week or two, we’d like to administer a polygraph test to see if you’ve committed sexual acts with any member of your home.”“Oh god.” Sara gasped at the notions.“I understand your frustration,” Dr. Ledgard said. “Which is why we’re going to increase your compensation. You’ll be rewarded even further, financially speaking. I’ll provide glowing job referrals for you. And I will personally recommend you for any internship or job opening in this department, should you wish.”It was the news Sara had been hoping for. Her future flashed before her eyes. If everything went well, she’d have a bright career ahead of her.“That sounds amazing,” she said.“It does. Who knows, the side effects might be nothing. The other experiment could have been a fluke. If you do exhibit nymphomaniac tendencies with your family, we can fix it in our lab. That should provide you with some sense of safety.”“So if anything goes wrong, assuming this machine does what you’re suggesting, then I can come right back and have it undone, right?”Dr. Ledgard paused. “It would be addressed.”A slight sense of panic was setting into Sara’s psyche. If this machine had worked the way the doctor suggested, then she could be in for a real problem. Sara never doubted her own resolve on moral conduct. But then again, it did sound outlandish and crazy, and the reward for participating was fantastic.“I can do that,” she said.“You’ve also mentioned that your brother Dylan wants a job with us, for experience. I think that’s a great idea. He’ll be tasked with keeping track of your vitals, for brain waves and heart activity. He’ll send us a daily report on the findings. Since you'll be home for the holidays with him and your mother, all of the daily monitoring can be done without leaving the house.”She smiled, ”He’s going to be thrilled.“"Then we’ll begin right away.” Dr. Ledgard said with eager resolve.With the questioning over, Dr. Ledgard stepped away from the desk and the researchers hooked wires to Sara’s face and body. A small, advanced looking device was carted over to them, and a small antenna was pointed straight toward her head. The exam room's cameras were confirmed to be recording the procedures.“Initiation in 5, 4, 3, 2, 1,” Dr. Ledgard counted. “The subject Sara Carter exposed to the device emissions on December 20, at 10:23 a.m.”The machine was activated. When it made a low, humming noise, Sara wondered if she had just made the biggest mistake of her life.An hour later, Dylan met with Dr. Ledgard's staff and accepted a research contract. He was trained on the equipment and the reporting format. Then left to meet his sister at home.At home that afternoon; Sara sat by the desk in Dylan’s bedroom and her brother recorded all the latest updates. The device was small and could attach wired pads to her body, keeping track of her vital signs and brain functions throughout the day. Dylan was completing his second status check. This family arrangement was perfect. It not only provided convenient clinical monitoring at home, but also provided the strategic opportunity for a brother & sister to interact in a private setting.“Everything seems fine,” Dylan said, jotting the numbers down in a notepad.“You’re quite the researcher now,” she smiled.He smiled back. “This is easy stuff. And there’s one thing I thought was interesting. I’ve been meaning to ask you about it.”“Yes?” Sara looked at her brother.“Your heart rate and hormones seem to change at random points. At first I assumed it was your workouts, but when I looked closer, that didn’t seem to be the case. Feel anything weird?”After a moment to think, Sara realized the device recorded her recent flairs of intense sexual thoughts. But of course, she could never tell her brother that.“Well, you know,” she said. "Women work differently than men. We have different problems and issues, if you know what I’m hinting at.”The ambiguous excuse seemed to have worked.Dylan backed off. “Oh, okay. Got it.”“I should have given you some notice about that, but it was kind of embarrassing and I didn’t think it would show up on the device.”“It’s advanced,” Dylan pointed out. “Now let’s get this thing back on you. Lift up your shirt a little.”These moments were always a roll of the dice. Sara never knew what to expect with her own feelings whenever she lifted her t-shirt. Sometimes it would be fine, since Dylan had seen her in a bikini before. Other times, there’d be internal chaos.When she lifted her t-shirt to expose her stomach and the lower side of her bra, things went haywire. She suppressed the feelings the best she could and tried to act natural, even though her heart rate was spiking.Sara’s thoughts went into a frenzy; ‘God, he’s looking at my body. I wonder if he wants to rip off my bra and suck my nipples. My cunt is getting wet. I wonder if he can smell my aromas.’Everything seemed normal on Dylan’s end, as he strapped the device to her side and taped the wired pads to her body.She looked at him attentively, staring deeply at him while he worked. Had he noticed?He lifted his gaze, looking at her. “Yes?”“Nothing,” she said, quickly looking away.When the pads touched her body, and Dylan’s fingers grazed her skin, Sara felt like she could have had an orgasm right then and there!'God, why did I have to wear a bra?’ a thought popped into her mind. 'I want him to see how hard my nipples are. I want him to suck on them. I could cum so fucking hard right now.’She glanced at her brother again, who was doing his job. Her cunt felt swollen, just like her nipples. She needed; something, anything from him.In a few more seconds, she’d have enough courage to yank her bra and say,'Just fucking suck on my tits already. Then bend me over your desk and fuck me from behind!’It was about to happen, but sadly for her, Dylan pulled her T-shirt down.“All done,” he said. “You’re free to leave my office. The next appointment is tonight at 8 pm. Don’t be late.”She played it cool. “Five stars on Yelp. Plus a good review. See you tonight.”When she got up and left Dylan’s bedroom, she wondered how she could survive the rest of the week. How she prayed Dr. Ledgard could reverse this.At the moment, there was only one other person she could confide in.Mom was in the living room preparing for the big holiday party tomorrow. She was in the middle of arranging the furniture and had already finished with the decorations.“Lovely, isn’t it?” Mom said, referring to the festive décor.Sara looked everything over. “It’s amazing. I’m excited for tomorrow.”“You should be. I received some fantastic news a moment ago. Some of your distant Aunts and Uncles had extra time freed up and they’ll be catching last minute flights.”“Oh really?” Sara smiled.“Yes, really. It’ll be a large family affair. Our home will be stuffed.”There were family pictures on the wall, which reminded Sara of how many people are coming for the big holiday party. With her current medical state, she was in even worse trouble, because she would have to spend the whole day entertaining guests, instead of tending to her urges.“I’m screwed,” Sara bemoaned, wanting to cry.“Are the feelings back again?” Julie looked concerned.“It’s only gotten worse.” Sara nearly sobbed. “I’ve had those thoughts again.”“Sweetie, I think you should end it. You’re a nervous mess.”“But I’ve already told so many people that I’m working with Dr. Ledgard. It would be humiliating if I had to back out.”“Nonsense!” Mom snapped. “Everyone knows you’re not a quitter. You’re smart and talented.”“My reputation would be ruined.”Not only that, Sara had to think about her brother. She needed to be a role model. If she quit this experiment, what kind of message would that send? Big sisters have a solemn duty to their younger brothers, she thought.“Give me a hug,” Mom said.They embraced in a tight hug. It was loving and sweet, something they often shared whenever Sara was experiencing heartache. She pressed her face into Mom’s upper chest for comfort. Sara had always been a self-disciplined and responsible person. Only her mother knew of the times Sara felt weak or insecure.Under normal circumstances, this hug is where things would end. They hug, and Sara would leave feeling better. But this was far from normal. Those deviant little thoughts had returned.Sara’s mind felt like it was spinning: 'Mom’s breasts feel so nice. So soft; so delicate; and they’re just for me.’Without thinking, her hands clenched her Mother’s lower back, with her fingers digging in. It felt like a natural thing to do. The most natural thing in the world.“Sara?” Mom asked.“Yes?”“Your hands are squeezing me.”Sara gasped and released her iron grip. “I’m sorry.”“How bad is it?”“Pretty bad. I mean, just a moment ago, I kept thinking about how aroused I’d be if Dylan saw my hard nipples. I kept thinking of it, over and over again.”“And now?”Sara gave a soft sigh. “You don’t want to know.”“Tell me.”“I thought about your breasts, from our hug. Horrible, right?”“Did you want to see them?” Mom asked. “Touch them?”Sara’s jaw nearly dropped. “Oh, jeez.”“Don’t give me that expression. You’re the one with the naughty thoughts in your mind. I’m only asking. Maybe there’s something we can do.”Sara gulped. “I wanted to,  suck on them. Oh god, I’m so sorry.”“A mother’s breasts are made for nurturing. They used to feed you. Nature’s perfect gift. If you’re suffering this badly, then I would be fine helping you.”“What do you mean?” Sara asked.“Maybe you need to get this out of your system. Spare yourself. And spare your brother. It’s much easier this way.”Mom took a step back, then undid her top to reveal a white bra. The breasts looked large and inviting, begging to be touched.Sara gulped. “Promise you won’t be mad?”“Darling, this is a medical emergency. It’s nothing to be ashamed of. These aren’t your normal thoughts. This isn’t you. Obviously, we can’t allow these medical episodes to happen during the family party, or ever. So the only thing I can do, as your mother, is help relieve this tension until Dr. Ledgard can correct the problem. Okay?”“Mom?” Sara said with a shock.“Shush, Just have a look first. Let me show you.”It was a surreal moment between them when Mom reached behind and released the fasteners of her bra. When the garment slid off her shoulders, Mom’s spectacular breasts were freed for Sara’s view.They were large, shapely globes the size of grapefruits. Age had been kind to Mom, as Sara devoured those breasts with her eyes. She noticed that the nipples were becoming larger and more erect; the areolas the size of silver dollars and an inviting pink color.Sara gulped. “Can I suck on them?”“Of course you can.” Julie beamed with maternal pride.“Will you be mad?” Sara struggled with her inner taboo standards.“Never.” Julie assured her beloved daughter.A dirty thought appeared in Sara’s mind:'How fucking delicious. I have the best Mother in the world. First Mom, then my brother. The perfect holiday for me. No one stands a chance.’She brought her lips to Mom’s left nipple and sucked. Fireworks went off in Sara’s mind when her lips made contact. She wrapped her lips tight and pulled with her mouth. She sucked so hard that Mom made a gasping sound.“No one can ever know,” Mom said, rubbing her daughter’s beautiful hair. “Get it out of your system. Enjoy this. I need you at your best tomorrow.”As Sara nursed on her Mother’s tits, she wasn’t sure if that was possible. But this was a welcomed start. Her Mother’s hands moved around, and as Sara nursed on the hard nipples, she felt her Mother reaching forward to rub her tits in return.Could it be? Was Mom enjoying this too?The PartyDespite her worries, Sara did her normal hostess duties as the party guests would expect. There was a last minute option to leave home while the party happened, but that was out of character for her.There was no way she’d ever let her family down. She loved everyone too much to hide because of a medical issue. Especially since she’d been away from everyone during her first year medical residency.The party was the same as always. Uncles, Aunts, and cousins from all over had come to visit. Mom did most of the schmoozing. Dylan was in charge of food. Sara was tasked with service, which she enjoyed doing with her beautiful smile and charm.Wearing a cute yellow dress, Sara went around the living room to make sure everyone was having a good time and was properly fed.Through it all, she had a chance to catch up with distant relatives and people she only saw a few times a year. The Aunts and Uncles showered her with the usual compliments:'You’ve become so beautiful!’ 'You remind me so much of your mother when she was your age. “A doctor? Brains and beauty. A dangerous combination.’But for all the fun, Sara’s demeanor made a drastic change when her brother stepped into the living room. Though he was just coming to socialize with family, it felt different. Sara had always been the 'good girl’ at the family functions, but as Dylan chatted and laughed, Sara’s thoughts were far from good.Crazy thoughts ran through her head: 'Take him upstairs and fuck him. Yes, even with the family party going on. Nothing will make me hotter.’She realized the thoughts were making her cunt wet as they repeated in her mind, growing more insistent with each repetition."Are you okay?” Mom whispered in Sara’s ear.Sara snapped out of her trance, and she turned her attention towards her Mother, who was dolled-up like the perfect Milf.“It’s happening,” Sara whispered. “I’m really sorry.”The only reason Sara apologized was because a few hours ago, they had engaged in another nursing session. It happened in Mom’s bedroom while Dylan was in the shower. Mom had exposed both of her luscious tits and allowed Sara to suck on them for a good 10 minutes straight. Mom’s nipples even turned red.“It’s not your fault,” Mom replied. “What are you feeling?”They both looked around. The coast was clear and the living room was loud with chatter and laughter.“I want to take Dylan upstairs to fuck him.”Mom sighed. “Will a cold shower fix it?”“Unlikely. God, I’ve never been so desperate in my entire life.”“Maybe you should handle it already,” Mom said after a long pause.“Huh?” Sara stared at the mother who instilled strong and clear moral standards in her.“I remember what it’s like being your age. Hormones are raging. Things are confusing. I’ve tried my best to help, but nothing is good enough.”“Are you suggesting that I fuck my brother?” Sara asked.“I’m not saying that either. And he's your stepbrother. I adopted him at the same time your dad adopted you, shortly after our wedding.”“Then what are you saying?”Mom looked around. “Sex is an indulgence, much like food. If I have a slice of delectable chocolate cake, my cravings are satisfied and I’ll stop thinking about it for a while. Does that make sense?”“It kind of does.” Sara wanted to convince herself.Sara thought about her brother:'Mom is a genius. I want that cock so badly. I want to fuck him while the party is happening. Everyone would be oblivious to the fact that I’m an undercover brother-fucker.’“It’s a guilty pleasure,” Mom said. “I’ll never fully condone it. But, and this is very important, you know that I have a reputation to uphold. Things have to run smoothly at my parties. The family depends on me.”“Everyone looks content right now.”“At the moment. If you and Dylan disappear for 15 minutes, then I would be okay with that. But I’d need you back immediately. Dylan too. Please be gentle with him.”Sara’s eyes widened. “Oh my god, Mom.”“Don’t give me that. Besides, isn’t this part of Dylan’s job?” Julie added.Step-Sibling IndulgencesAfter dragging her brother up the stairs, she was in complete control of the situation. She decided that Dylan’s room would be the best place. She wanted to fuck on his desk. Just like in her naughty fantasies.“Mind telling me what’s going on?” he asked.Sara locked the door. “It’s time for me to be honest. I need to fuck.”“What?”“I’ll give you the details later,” Sara told him. “The short version is that Dr. Ledgard’s experiment messed me up. Badly. I knew it was possible, I just didn’t believe it.”“Believe what?”She lifted the front of her dress. “This.”With her dress held up with one hand, she used her other hand to pull her panties aside to reveal her cunt. It was cleanly shaven and the clitoris was swollen while protruding from her labia.Sara dipped her index finger into her entrance. She held her finger out, showing her brother a thick and clear liquid consistency.“Holy shit,” he gasped. “Is that the source of those weird signals coming from your body?”“Yes, I haven’t been right for the past two days. My cunt is killing me.”So, umm; why are you showing me?“"I’ll explain the whole thing later,” she sighed. “But right now, I need you to bend me over the desk. Fuck me, like our lives depend on it.”“What the,” Dylan blurted.“Dylan, look here,” she said, rubbing her labia. “ It’s an emergency. I want you in me, I need you in me!”“But, why me?” Dylan asked, worried about the potential implications of doing something so taboo.Sara swallowed her pride. “I need your cock; yours specifically. I’ve been thinking about you like crazy. It’s freaking me out.”“You mean, because of the experiment, you’ve,” Dylan was trying to process this bizarre reality.“Are you interested or not?” she said firmly.“I, umm; sure. How should we start?”Sara brisked over to him, grabbed him by the belt, and pulled him to the desk. She yanked his pants down and his semi-erect penis was almost ready to go. The horny little bastard was quickly aroused by the sight of her wet cunt, she thought. At least she was under a spell; Dylan had no excuse.“We’ve got to be quick,” she said, stroking her brother’s cock. “Mom needs us back as soon as possible.”“Does she know?” Dylan was now even more confused.She could see the conflicting emotions play across his face, lust winning out, as she continued stroking.Her inner voice told her;'Go ahead. Tell him everything. My younger brother needs to know. It’s about time he knows what I really am.’“I’ve told Mom everything,” Sara confessed in a low purr. “Mom knows more than you do, about the research. I confide in her about everything in my life. Mom knows how badly I want to fuck you. The truth is, Dr. Ledgard’s research has already accidentally made a mother and son have sex. I didn’t believe it. Now I’m the next step in the research.”She continued,”Mom tried helping me. She thought she could alleviate these nymphomaniac tendencies by showing me her amazing set of tits. She let me suck on them. That’s right, I nursed on Mom’s tits and pulled her nipples with my mouth. I think she likes it, since she fondled my breasts as well.”He was dumbfounded with arousal. “You and Mom? Nymphomaniac?”“I know, shocking. I can explain more later, but right now I need to get fucked.”Sara was under the influence of the frequency waves and she couldn’t care less that the whole family was downstairs, having a nice, wholesome time together. Actually, the risky act was turning her on even more. These were the nymphomaniac tendencies she had been warned about, and now she was loving every second of it.To get him fully erect, she grabbed his neck and pulled him in, planting a big kiss on his lips, then into his mouth. It was gentle at first, before turning rough and slipping her tongue inside. Their tongues wrestled for a good minute. All the while, she could feel her younger brother throbbing in her hand.She pulled back and released him. “You’re ready.” Sara pulled her yellow party dress over her head and unsnapped her bra.It was amusing seeing Dylan so speechless, cock freed, and in admiration of her attractive body, knowing they were about to fuck. She had always been the leader in their sibling relationship, now it was heading in a new direction.Sara bent over her brother’s desk, presenting her rounded ass. That way, her little brother could fuck her easily while standing. Her juices were running down her long, shapely legs. Her cunt lips were swollen and inviting, begging to be filled with his achingly hard cock.“Your ass is amazing,” Dylan said, sticking his index finger into her vagina.“Just fuck me already, please.”Sara was over the edge and didn’t care that it’s wrong by society’s standards, by her moral standard. All she wanted was to be fucked by her brother. Sure, it was nice sucking on Mom’s tits, but that did little to satisfy the intense craving between her legs. Only her brother could do that, with his thick rigid penis.She felt her cunt being spread wide, while she opened her legs for him. Inch by inch, her wet cunt was being entered. Despite her tight virgin cunt, it was an easy process because of how fucking aroused she was.“Oh yes!” Sara moaned, before realizing that she needed to keep her voice down. Her hymen split and  the tingling pain just added to her arousal.Dylan pumped faster, with an unrivaled force. “Your cunt is amazing. Fuck. I can’t believe I’ve been missing out on this.”“Just keep it quiet,” she hissed.While she was being pounded from behind, her submission to her brother was now complete, with her cunt being ravished. Her brother teased her by pulling her hips and bombarding her with his thrusts, slamming his balls against her cunt lips and gliding his cock through the warm folds of her cunt walls with incredible speed. He reached up and pinched the nipples of her dangling tits.It was everything she needed.Even though Sara was lost in what her brother was doing, and doing so well, she heard noises in the hall. She knew the bedroom door was locked, but they still shouldn’t be heard.“Stop, Dylan, there’s someone in the hall,” she whispered.Dylan stopped for a second. “They’re in Mom’s room. I’ll go slow.”Sara didn’t have the willpower to stop her brother; instead she buried her face in the pile of papers they used to record her data and she pushed her hips, to encourage the fucking to continue. Dylan’s cock was gliding through her canal, slowly retreating back, leaving only the head at her entrance, then going all the way in again, filling her insides.Her inner voice re-appeared; 'Finally, I’m a happy girl. All I need is his cum. His cum inside me. Then I can reach between my legs. Scoop it. And slurp it all down.’The thought of Dylan’s cum pumping into her eager cunt had Sara licking her lips. Her body demanded more from her brother. Her body needed to be filled with his seed, to have his cum leak between her vaginal walls and stream down her legs.After a few minutes of slow, sensuous fucking, the incestuous couple heard footsteps heading down the stairs. Without a word, they sped up their lustful attack on each other and Dylan was again plowing into her with wild abandon.“They’re gone,” Dylan said, pumping harder. “You like it harder, don’t you?”“Yes, yes, yes!” she cried.He groaned,”Where can I cum?“"In my cunt,” she said. “I want to eat it right after.”“Really? Oh, fuck!”That sent Dylan over the edge as he pounded with all his might, making Sara cry. Sara’s tears increased as she approached her earth-shattering climax at the same time as her brother. They both came and she felt her cunt flooded with her brother’s load. She could feel their cum mixing and intertwining to form a cum cocktail during the family party, which would be her secret treat. She reached behind her and pulled Dylan's hips tight against her, as she stood. He reached around her tits and embraced her.“What now?” he asked, kissing her neck while still buried within her.She smiled, “A snack to recover my energy.”Their bodies separated and the still-sensitive head of the cock plopped out her clinging lips. Sara reached between her legs and inserted two fingers to scoop the cum which dripped from her well-fucked hole.Before she could complete the mission, she heard the sound of a key slipping into the knob, unlocking the bedroom door.Sara’s heart nearly stopped at the sound of the locked doorknob being twisted and turned. Then the siblings heard a key slip into the lock as the knob now turned without resistance.Only their Mother had the bedroom key, and in a flash, she entered the bedroom and shut the door, locking it once again.“You two were almost caught,” Mom fumed. “There were inquiries about strange noises in here. I told your Aunt that you had a bruised rib from a recent skiing trip.”The siblings stood frozen as Mom approached them while they were still exposed after having finished fucking.Sara pulled her dress on and stood upright. “Mom, you shouldn’t be here.”“We have a party to host,” Mom countered. “And the noises you two have been making are unacceptable.”Dylan blushed, with his penis still out. “Sorry.”“Don’t be sorry,” Mom replied. “Get cleaned up. These smells are potent and the last thing we need is for anyone to notice.”“There’s plenty of tissue,” Sara noted.Mom shook her head. “No, that won’t do. I can smell both of you. The fragrance is strong, since you’re both young. If you walk down the hall, others may smell it.”“What do you suggest?” Dylan asked, with fluids dripping from his cock.Mom sighed. “The things I do for my family.”The siblings froze in place, stunned, as Mom dropped to her knees.Sara was in awe of her Mother, who lifted her dress and went to work eating her cunt. It was her first time being eaten by another woman and it was spectacular. Sara closed her eyes and tilted her head back as the cum cocktail was being sucked out of her little hole.It was pleasure Sara never knew she needed. Mom darted her tongue inside her trembling daughter, cleaning every inch and centimeter, as deep as she could go. When she was satisfied that Sara’s cunt was cleaned, she pulled away, giving her daughter a brief visual inspection and nodded to herself.“You’re so good at that, Mom,” Sara whispered.“Not that you should have known,” Mom said, licking her lips. “Dylan, you’re next.”Dylan sat on his bed. “Whatever you say, Mom.” His cock had become rigid again, while watching the two busty women.In an instant, Mom turned her attention toward the wet cock, bending down, she was taking it into her mouth to suck the excess cum that lingered. It was more of a maternal duty than anything else. But it was just as explicit as any porn scene. Her lips wrapped around the shaft and she gave hard, powerful sucks.As she watched her Mother go down on her brother, naughty thoughts arose in Sara’s mind:'There it is. Here’s your chance. Mom deserves a little relief. And I want a taste. I bet she’s delicious.’Sara got on her knees, right behind her Mother, and lifted the back of her dress. She pulled the panties to the side and pressed her lips there, making Mom squeal for a moment. Just then Dylan blasted his load into his mother's mouth. She swallowed it all, then turned her attention to Sara.“What’s gotten into you?” Mom asked, spitting the cock out of her mouth.Sara darted her tongue in her Mom’s asshole, then brought her tongue down to get a taste of cunt, lapping her tongue inside. Mom seemed rather aroused (and tasted like it too.) When Sara rose & moved around, she kissed her Mother on the lips. Mom was hesitant at first, but went along with it and their tongues wrestled with family fluids.After a few moments, Mom broke the kiss with her daughter and touched Sara’s cheek tenderly. She kissed Dylan on the tip and stood.“Alright, my two darlings, that’s enough,” Mom said. “Get dressed. Downstairs in one minute.”The siblings dressed quickly, checking each other for any telltale signs of their incestuous coupling. Neither of them minded the saliva as they wore their clothes. It would dry soon enough. Dylan was content with just pulling his pants up. Meanwhile, the ladies shared the mirror and fixed their dresses and hair, not to mention making sure their lipstick hadn’t been smeared.Clinic ReportsDr. Ledgard put the final touches on the report while sitting in the lab. Other researchers were there, monitoring heart activities and brainwaves from the two subjects.In a glass room, which the researchers were focused on, Sara was riding her brother on a bed they had set up. The siblings were naked as they had intense sexual intercourse with lust-fueled abandon. They were bashful at first, as anyone in that situation would be, but once they got started, they were unstoppable.“You’re a true genius,” General Hamilton said, observing the vigor of the youthful coupling on the other side of the glass. “I’ve always had faith in you, this is a job well done. I’m recommending you for a promotion and a generous pay raise.”“I don’t do this for money,” Dr. Ledgard replied.“No? Then what drives you?”“Knowledge,” the doctor responded, looking at the incestuous coupling once again.The siblings finished their strenuous loving-making session and Sara collapsed onto her brother, with her breasts resting on his face. Her pink nipples were hard and the brother took it upon himself to suck on them.When the researchers called for an end to the session, Sara climbed off her brother, and a trail of thick fluids leaked from between her legs. Sara cupped her buzzing cunt, catching the fresh cum, wiping it with her fingers, then brought it to her mouth. She licked her fingers clean.Sara knelt before her brother and cleaned with her mouth and tongue. According to daily reports that Sara and her brother had submitted, this was routine for them. Foreplay, sex, and 'oral cleanup.’ Their mother, it seemed, had helped ensure that everything was under control. Mom was the glue that held this experiment together.Post Notes:What was not yet asked by the primary test subject, was if Dr. Ledgard could administer and antidote treatment. He was still working on that, and relieved that he still had more time. As of now, all he could direct is a cessation, and hope that it would taper off, and perhaps a placebo impact might strengthen the restoration of the inner resolve her moral values once had in her life. As for Dylan and Julie, Dr. Ledgard could only hope that the social dynamic in the family would restore them to their previous standards of behavior. But that depended wholly on Sara's restoration; when and if she sought it.By HeyAll for Literotica

Introduction: Amanda: Welcomes listeners, reminds to rate and review the podcast. Listener Review Highlight: One Fall Gal's review praising the podcast as an easy listen with insightful content. Encouragement: Emphasizes the importance of reviews in helping others discover the podcast. Main Discussion: Topic: Addressing the experience of work dread. Objective: To offer insights and strategies to reduce work dread. Kendra's Personal Experience: Shares her struggles with balancing work and family life, and the anticipation of dread before night shifts. Brene Brown's Influence: Discusses Brown's perspective on dread and its impact on anxiety and angst. Physical and Mental Symptoms: Explores how dread can manifest physically and mentally, particularly in anticipatory scenarios. Fear vs. Dread: Differentiates between fear (present threat) and dread (future anticipation). Positive Aspects of Dread: Recognizes how dread can sometimes lead to proactive preparation. The Cycle of Dread: Discusses the repetitive nature of dread and its contribution to burnout. Being Present: Emphasizes the importance of staying present and mindful to combat dread. Strategies to Combat Work Dread: Reframing Thoughts: Encourages challenging dread-filled thoughts with more positive or neutral ones. Present Moment Focus: Tips on staying grounded in the current moment. Mel Robbins' Technique: Suggests using affirmations like "I'm okay, I'm safe, I'm loved" to calm the mind. Jill Bolte Taylor's Approach: Recommends naming different parts of the brain to manage emotions. Balancing Reality and Optimism: Encourages a balance between acknowledging potential negative outcomes and remaining hopeful. Dealing with Negative Emotions: Techniques to handle negative thoughts and feelings related to work. Conclusion: Upcoming Events: Announcement of a free class on overcoming overindulgent behaviors. Final Thoughts: Encouragement to embrace the present and the significance of one's work in medicine. Reminder: To join their email list for weekly well checks and valuable insights. Additional Resources: Website: www.thewholephysician.com Webinar Link: Overcoming Over Whatevering, December 27th, noon central Closing Message: "You are whole. You are a gift to medicine, and the work you do matters." ---

Speaker: Dr. Victoria Brown Scripture: 2 Kings 16:20—20:21 Objective: To help the Christian Disciple understand that God sees the good, the bad and the ugly in all of us and will use it all to accomplish His purpose.

Brain activation changes following motor training in children with unilateral cerebral palsy: An fMRI studyRodrigo Araneda, Laurance Dricot, Daniela Ebner-Karestinos, Julie Paradis, Andrew M Gordon, Kathleen M Friel, Yannick BleyenheuftFree articleAbstractBackground: Intensive motor-learning-based interventions have demonstrated efficacy for improving motor function in children with unilateral spastic cerebral palsy (USCP). Although this improvement has been associated mainly with neuroplastic changes in the primary sensori-motor cortices, this plasticity may also involve a wider fronto-parietal network for motor learning.Objective: To determine whether hand-arm bimanual intensive therapy including lower extremities (HABIT-ILE) induces brain activation changes in an extensive network for motor skill learning and whether these changes are related to functional changes observed after HABIT-ILE.Methods: In total, 25 children with USCP were behaviourally assessed in manual dexterity and everyday activities before and after HABIT-ILE. Functional imagery monitored brain activity while participants manipulated objects using their less-affected, more-affected or both hands. Two random-effects-group analyses performed at the whole-brain level assessed the brain activity network before and after therapy. Three other random-effects-group analyses assessed brain activity changes after therapy. Spearman's correlations were used to evaluate the correlation between behavioural and brain activity changes.Results: The same fronto-parietal network was identified before and after therapy. After the intervention, the more-affected hand manipulation elicited a decrease in activity on the motor cortex of the non-lesional hemisphere and an increase in activity on motor areas of the lesional hemisphere. The less-affected hand manipulation generated a decrease in activity of sensorimotor areas in the non-lesional hemisphere. Both-hands manipulation elicited an increase in activity of both hemispheres. Furthermore, we observed an association between brain activity changes and changes in everyday activity assessments.Conclusion: Brain activation changes were observed in a fronto-parietal network underlying motor skill learning with HABIT-ILE in children with USCP. Two different patterns were observed, probably related to different phases of motor skill learning, representing an increased practice-dependent brain recruitment or a brain activation refinement by more efficient means. CLINICALTRIALS.GOV: NCT01700777 &NCT02667613.Keywords: Cerebral palsy; FMRI; HABIT-ILE; Intensive therapy; Neuroplasticity.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.07.18.549548v1?rss=1 Authors: Agurto, C., Cecchi, G., King, S. G., Eyigoz, E. K., Parvaz, M., Alia-Klein, N., Goldstein, R. Z. Abstract: Importance: Valid biomarkers that can predict longitudinal clinical outcomes at low cost are a holy grail in psychiatric research, promising to ultimately be used to optimize and tailor intervention and prevention efforts. Objective: To determine if baseline linguistic markers in natural speech, as compared to non-speech clinical and demographic measures, can predict drug use severity measures at future sessions in initially abstinent individuals with cocaine use disorder (iCUD). Design: A longitudinal cohort study (August 2017 - March 2020), where baseline measures were used to predict outcomes collected at three-month intervals for up to one year of follow-up. Participants: Eighty-eight initially abstinent iCUD were studied at baseline; 57 (46 male, age 50.7+/-7.9 years) came back for at least another session. Main Outcomes and Measures: Outcomes were self-reported symptoms of withdrawal, craving, abstinence duration and frequency of cocaine use in the past 90 days at each study session. The predictors were derived from 5-min recordings of vocal descriptions of the positive consequences of abstinence and the negative consequences of using cocaine; the baseline cocaine and other common drug use measures, demographic and neuropsychological variables were used for comparison. Results: Models using the non-speech variables showed the best predictive performance at three(r greater than 0.45, P less than 2E-3) and six months follow-up (r greater than 0.37, P less than 3E-2). At 12 months, the natural language processing-based model showed significant correlations with withdrawal (r=0.43, P=3E-2), craving (r=0.72, P=5E-5), days of abstinence (r=0.76, P=1E-5), and cocaine use in the past 90 days (r=0.61, P=2E-3), significantly outperforming the other models for abstinence prediction. Conclusions and Relevance: At short time intervals, maximal predictive power was obtained with models that used baseline drug use (in addition to demographic and neuropsychological) measures, potentially reflecting a slow rate of change in these measures, which could be estimated by linear functions. In contrast, short speech samples predicted longer-term changes in drug use, implying deeper penetrance by potentially capturing non-linear dynamics over longer intervals. Results suggest that, compared to the common outcome measures used in clinical trials, speech-based measures could be leveraged as better predictors of longitudinal drug use outcomes in initially abstinent iCUD, as potentially generalizable to other substance use disorders and related comorbidity. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Objective: To know about SuperAgers, aging well, maintaining and improving brain health and cognition. Aging is a natural process, but that doesn't mean we have to let it get the best of us. There are many things we can do to age well and keep our brains healthy. In this episode of our podcast, listen to Dr. Onuoha, a health expert who shares her insights on the latest research on aging, and offers practical tips on how we can all age well. Listen to how SuperAgers stay sharp and healthy as they age. If you're interested in learning more about how to age well, this is the episode for you. We cover a lot of ground in this episode, including: The latest research on aging Practical tips for aging well The secrets of brain health SuperAgers Tune in to our podcast on your favorite platform, and be sure to share this episode with your friends who are passionate about aging well and optimizing their brain health. Together, let's unleash the power of our minds and create a life full of vitality!  We hope you enjoy this episode of our podcast. And if you do, please leave us a rating and review on Spotify. Thanks for listening! #PodcastEpisode #AgingWell #BrainHealth #Superagers #CognitiveLongevity #BrainPower  #LifestyleTips #HealthyAging #SuperBrain #PhysicianPodcast [Disclaimer: This post contains affiliate links. We may earn a commission from purchases made through these links, which helps support our podcast and website. Thank you for your continued support!] Our notebooks are designed to help you cultivate a positive mindset and achieve your wellness goals. Start your day with gratitude! Check out my new gratitude journal, with prompts to help you focus on the good in your life. Get your copy today at our author page. https://www.amazon.com/author/health4naija "Get inspired with our latest newsletter! Each week, we'll share stories, tips, and insights to help you live a more fulfilling life. Sign up today and never miss an issue." Subscribe to our Newsletter  https://health4naija.substack.com/ Our designs are made on Canva. Canva makes it easy to create professional looking designs: To start your own Canva designs, visit https://partner.canva.com/2rvLO7

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.07.11.548638v1?rss=1 Authors: Kasanga, E. A., Soto, I., Centner, A., McManus, R., Shifflet, M. K., Navarrete, W., Han, Y., Lisk, J., Wheeler, K., Mhatre-Winters, I., Richardson, J. R., Bishop, C., Nejtek, V. A., Salvatore, M. F. Abstract: Background: Alleviation of motor impairment by aerobic exercise (AE) in Parkinsons disease (PD) points to a CNS response that could be targeted by therapeutic approaches, but recovery of striatal dopamine (DA) or tyrosine hydroxylase (TH) has been inconsistent in rodent studies. Objective: To increase translation of AE, 3 components were implemented into AE design to determine if recovery of established motor impairment, concomitant with greater than 80% striatal DA and TH loss, was possible. We also evaluated if serum levels of neurofilament light (NfL) and glial fibrillary acidic protein (GFAP), blood-based biomarkers of disease severity in human PD, were affected. Methods: We used a 6-OHDA hemiparkinson rat model featuring progressive nigrostriatal neuron loss over 28 days, with impaired forelimb use 7 days post-lesion, and hypokinesia onset 21 days post-lesion. After establishing forelimb use deficits, moderate intensity AE began 1-3 days later, 3x per week, for 40 min/session. Motor assessments were conducted weekly for 3 wks, followed by determination of striatal DA, TH protein and mRNA, and NfL and GFAP serum levels. Results: Seven days after 6-OHDA lesion, recovery of depolarization-stimulated extracellular DA and DA tissue content was less than 10%, representing severity of DA loss in human PD, concomitant with 50% reduction in forelimb use. Despite severe DA loss, recovery of forelimb use deficits and alleviation of hypokinesia progression began after 2 weeks of AE and was maintained. Increased NfLand GFAP levels from lesion were reduced by AE. Despite these AE-driven changes, striatal DA tissue and TH protein levels were unaffected. Conclusions: This proof-of-concept study shows AE, using exercise parameters within the capabilities most PD patients, promotes recovery of established motor deficits in a rodent PD model, concomitant with reduced levels of blood-based biomarkers associated with PD severity, without commensurate increase in striatal DA or TH protein. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.06.22.546126v1?rss=1 Authors: Hwang, Y.-C. E., Long, L., Filho, J. S., Genov, R., Zariffa, J. Abstract: Background: Discriminating recorded afferent neural information can provide sensory feedback for closed-loop control of functional electrical stimulation, which restores movement to paralyzed limbs. Previous work achieved state-of-the-art off-line classification of electrical activity in different neural pathways recorded by a multi-contact nerve cuff electrode, by applying deep learning to spatiotemporal neural patterns. Objective: To incorporate this approach into closed-loop stimulation. Methods: Acute in vivo experiments were conducted on 11 Long Evans rats to demonstrate closed-loop stimulation. A 64-channel (8 x 8) nerve cuff electrode was implanted on each rat's sciatic nerve for recording and stimulation. A convolutional neural network (CNN) was trained with spatiotemporal signal recordings associated with 3 different states of the hindpaw (dorsiflexion, plantarflexion, and pricking of the heel). After training, firing rates were reconstructed from the classifier outputs for each of the three target classes. A rule-based closed-loop controller was implemented to produce ankle movement trajectories using neural stimulation, based on the classified nerve recordings. Closed-loop stimulation was initiated by the detection of a heel prick, and induced dorsiflexion. The detection of dorsiflexion triggered stimulation to induce plantarflexion, and vice versa. A single trial began with a heel prick and ended when an incorrect state transition occurred or when a second heel prick was detected. Results: Closed-loop stimulation was successfully demonstrated in 6 subjects. Number of successful trials per subject ranged from 1-17 and number of correct state transitions per trial ranged from 3-53. Conclusion: This work demonstrates that a CNN applied to multi-contact nerve cuff recordings can be used for closed-loop control of functional electrical stimulation. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.03.12.532316v1?rss=1 Authors: Ullah, K., Ai, L., Li, Y., Liu, L., Zhang, Q., Pan, K., Humayun, Z., Sitikov, A., Su, Q., Zhao, Q., Sharp, W. W., Fang, Y., Wu, D., Liao, J. K., Wu, R. Abstract: Rationale: Cardiac microvascular leakage and inflammation are triggered during myocardial infarction (MI) and contribute to heart failure. Hypoxia-inducible factor 2 (Hif2) is highly expressed in endothelial cells (ECs) and rapidly activated by myocardial ischemia, but whether it has a role in endothelial barrier function during MI is unclear. Objective: To test our hypothesis that the expression of Hif2 and its binding partner aryl hydrocarbon nuclear translocator (ARNT) in ECs regulate cardiac microvascular permeability in infarcted hearts. Methods and Results: Experiments were conducted with mice carrying an inducible EC-specific Hif2-knockout (ecHif2-/-) mutation, with mouse cardiac microvascular endothelial cells (CMVECs) isolated from the hearts of ecHif2-/- mice after the mutation was induced, and with human CMVECs and umbilical-vein endothelial cells transfected with ecHif2 siRNA. After MI induction, echocardiographic assessments of cardiac function were significantly lower, while measures of cardiac microvascular leakage (Evans blue assay), plasma IL6 levels, and cardiac neutrophil accumulation and fibrosis (histology) were significantly greater, in ecHif2-/- mice than in control mice, and RNA-sequencing analysis of heart tissues from both groups indicated that the expression of genes involved in vascular permeability and collagen synthesis was enriched in ecHif2-/- hearts. In cultured ECs, ecHif2 deficiency was associated with declines in endothelial barrier function (electrical cell impedance assay) and the reduced abundance of tight-junction proteins, as well as an increase in the expression of inflammatory markers, all of which were largely reversed by the overexpression of ARNT. We also found that ARNT, but not Hif2, binds directly to the IL6 promoter and suppresses IL6 expression. Conclusions: EC-specific deficiencies in Hif2 expression significantly increase cardiac microvascular permeability, promote inflammation, and reduce cardiac function in infarcted mouse hearts, and ARNT overexpression can reverse the upregulation of inflammatory genes and restore endothelial-barrier function in Hif2-deficient ECs. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.03.06.531158v1?rss=1 Authors: Wendt, K., Memarian Sorkhabi, M., Stagg, C. J., Fleming, M. K., Denison, T., O'Shea, J. Abstract: Background: Intermittent theta-burst stimulation (iTBS) is a transcranial magnetic stimulation (TMS) protocol which can temporarily modulate the corticospinal excitability. Conventionally, TBS is only applied using biphasic pulses due to hardware limitations. However, monophasic pulses are hypothesised to more selectively recruit cortical neurons than biphasic pulses which may improve the effect of iTBS. A custom-made pulse-width modulation-based TMS device with improved energy recovery and pulse-shaping capabilities allows the generation of monophasic iTBS. Objective: To compare the effects of monophasic and biphasic iTBS on motor corticospinal excitability in healthy volunteers. Methods: Thirty volunteers participated in three separate sessions, where monophasic and biphasic iTBS were applied to the primary motor cortex (active condition) or the vertex (control condition) using a custom-made TMS device. Changes in corticospinal excitability were quantified using the peak-to-peak amplitude of motor evoked potentials (MEP) with single-pulse TMS collected at baseline and at 5 - 60 minutes after the application of TBS. Results: Both monophasic and biphasic active iTBS led to significant increases in MEP amplitude compared to baseline, with monophasic iTBS showing significantly larger effects (linear mixed effect model analysis: ({chi}2(1) = 8.48, p = 0.004)), even after subtracting the control condition from the active conditions ({chi}2(1) = 6.21, p = 0.013). Conclusions: This study demonstrates that the pulse shape affects the extent to which TBS can modulate corticospinal excitability. Monophasic intermittent TBS has the potential to increase the efficacy of clinical treatment protocols in the future. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.02.24.529867v1?rss=1 Authors: Zurrer, W. E., Cannon, A. E., Ewing, E., Rosso, M., Ineichen, B. V. Abstract: Background: Systematic reviews, i.e., research summaries that address focused questions in a structured and reproducible manner, are a cornerstone of evidence-based medicine and research. However, certain systematic review steps such as data extraction are labour-intensive which hampers their applicability, not least with the rapidly expanding body of biomedical literature. Objective: To bridge this gap, we aimed at developing a data mining tool in the R programming environment to automate data extraction from neuroscience in vivo publications. The function was trained on a literature corpus (n=45 publications) of animal motor neuron disease studies and tested in two validation corpora (motor neuron diseases, n=31 publications; multiple sclerosis, n=244 publications). Results: Our data mining tool Auto-STEED (Automated and STructured Extraction of Experimental Data) was able to extract key experimental parameters such as animal models and species as well as risk of bias items such as randomization or blinding from in vivo studies. Sensitivity and specificity were over 85 and 80%, respectively, for most items in both validation corpora. Accuracy and F-scores were above 90% and 0.9 for most items in the validation corpora. Time savings were above 99%. Conclusions: Our developed text mining tool Auto-STEED is able to extract key experimental parameters and risk of bias items from the neuroscience in vivo literature. With this, the tool can be deployed to probe a field in a research improvement context or to replace one human reader during data extraction resulting in substantial time-savings and contribute towards automation of systematic reviews. The function is available on Github. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Way 10: Synopsis, Outline, or Treatment You've made it through the big day of structuring and you're into the home stretch of developing your concept into a tangible and entertaining drama for the big screen. OBJECTIVE: To piece everything together to create your outline, synopsis, or treatment. ADVICE: No one writing process is the answer for everyone. Different writers will take different approaches. Some prefer to go in with no preparation at all, relying on their instincts to lead them. Others do as much preparation as they can with character backgrounds, detailed story maps, outlines, treatments, etc. EXERCISE: Gather all of your materials and form one, two, or all of these three documents, depending upon how much or how little you want to prepare — outline, extended synopsis, treatment. ASSIGNMENT: Choose what type of document you would like to create — outline, extended synopsis, or treatment. You have the freedom of doing just one, two, or all three of them. You can also decide how much detail you want to put into each, depending on your own writing process. Burning America: In the Best Interest of the Children?Mick, The Doctor of Digital, Smith mick.smith@wsiworld.comBurning America: In the Best Interest of the Children?https://burning-america.comAmazon: https://www.amazon.com/G-Mick-Smith/e/B0B59X5R79Also at Barnes & Noble, Walmart, and TargetLeave a message for The Doctor of Digital:https://podinbox.com/thedoctorofdigitalpodcastInstagram: burningamericacommunityPatreon burningamericacommunity:https://www.patreon.com/SmithConsultingWSITheDoctorofDigitalPodcastListen, subscribe, share, and positively review The Aftermath:https://podcasts.apple.com/us/podcast/the-aftermath-the-epidemic-of-divorce-custody-and-healing/id1647001828Substack:https://micksmith.substack.com/Commercials Voice Talent ||https://www.spreaker.com/user/7768747/track-1-commercialsNarratives Voice Talenthttps://www.spreaker.com/user/7768747/track-2-narrativesDo you want a free competitive analysis for your business?https://marketing.wsiworld.com/free-competitive-analysis?utm_campaign=Mick_Smith_Podcast&utm_source=SpreakerMake an Appointment:https://app.hubspot.com/meetings/mick-smithBe sure to subscribe, like, & review The Doctor of Digital™ PodcastSign up for the Doctor Up Your Life courseFacebook || Instagram || Twitter || LinkedIn || YouTubehttps://www.linkedin.com/in/gmicksmith/

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.02.08.527578v1?rss=1 Authors: Shibusawa, S., Kawashima, T., Amano, K. Abstract: Background: The aftereffects of transcranial alternating current stimulation (tACS), especially targeting occipital alpha oscillations, have been reported to show large individual differences in behavioural effects and neural responsiveness. We predicted that this variance at least partly originates from the fact that multiple alpha components are affected differently by alpha-tACS. Objective: To test the above prediction, we decomposed several alpha components from the data and evaluated the aftereffects separately for each component and participant. More specifically, we tested how the difference between the stimulation frequency and peak frequency influences the aftereffects of tACS on each alpha component. Methods: Eighteen participants received 20-min tACS or sham stimulation on separate days. Ten minutes of magnetoencephalography data were collected before and after stimulation, and spectral analysis was performed with a high-frequency resolution (0.1 Hz) to disentangle different alpha components based on the difference in peak frequencies and spatial patterns. Results: The results revealed three alpha components with slightly different frequencies. tACS increased or decreased the power of these alpha components depending on the relative frequency difference from electrical stimulation. Furthermore, observable components differed among participants, possibly because of anatomical differences in each alpha source. Conclusion: When each alpha component is not analysed separately, the change in overall alpha power will be a combination of decreased or increased components, and inter-individual differences will become larger. Our study highlights the importance of noting the presence of multiple alpha components with relatively small differences in the peak frequency for experimental design and analysis. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Way 5: The Perfect Title It's time to name your baby. One of the most underrated aspects of a screenwriter's arsenal is their ability to create titles that jump off the page. OBJECTIVE: To find the perfect titles for your drama screenplays. ADVICE: One of the most underrated aspects of a screenwriter's arsenal is their ability to create titles that jump off the page and further entice the powers that be in Hollywood to take notice.What are the factors to consider? What makes a title good or bad — and better yet, what makes a title stand out in strong and compelling fashion?Avoid ClickbaitClickbait is a contemporary internet reference that also harkens back to the tools employed by print journalism — creating headlines that force readers to “need” to explore further.Focus on the Core ConceptThe idea isn't to deceive. It's to entice. It's to showcase the strongest and most specific core element of your screenplay. The best titles often wrap the genre and overall concept together in as few words as possible. Because the title is your first marketing tool that Hollywood sees, you want to find those words and terms that best encapsulate your whole screenplay.The Unique CharacterSome screenplays have characters that are the focal point of the overall concept, which is to say that the whole film centers primarily on a unique character. If you take them out of the story, there is no story. You can't replace them with a stock protagonist.The Unique Character TypeIn this context, character “type” is referring to a certain character that has a unique power, position, or occupation.Capture the GenreStudios and producers will want and need to know the genre of your script before they even read it — the title is the best and fastest way to do that.Explore Titles with Dual MeaningsA screenplay's title comes into play twice — before the reader reads the script, and then after they've read it. When you've paid extra attention to crafting a title, you can often come up with two meanings. This offers extra significance to the title and also manages to give the reader an extra punch when they're done.Ensure That the Titles Make Sense to the StoryGoogle Any and All TitlesASSIGNMENT: With these nine directives in mind, take some time to think of 10 or more possible titles for your script. Do some research online and look up the subjects, themes, and types of characters that your screenplay has. Be creative, but also think in marketing terms as well. Creating an excellent title before you begin to write is often important as it gives your premise some identity. You can always change it. Have fun!Burning America: In the Best Interest of the Children?Mick, The Doctor of Digital, Smith mick.smith@wsiworld.comBurning America: In the Best Interest of the Children?https://burning-america.comAmazon: https://www.amazon.com/G-Mick-Smith/e/B0B59X5R79Also at Barnes & Noble, Walmart, and TargetLeave a message for The Doctor of Digital:https://podinbox.com/thedoctorofdigitalpodcastInstagram: burningamericacommunityPatreon burningamericacommunity:https://www.patreon.com/SmithConsultingWSITheDoctorofDigitalPodcastListen, subscribe, share, and positively review The Aftermath:https://podcasts.apple.com/us/podcast/the-aftermath-the-epidemic-of-divorce-custody-and-healing/id1647001828Substack:https://micksmith.substack.com/Commercials Voice Talent ||https://www.spreaker.com/user/7768747/track-1-commercialsNarratives Voice Talenthttps://www.spreaker.com/user/7768747/track-2-narrativesDo you want a free competitive analysis for your business?https://marketing.wsiworld.com/free-competitive-analysis?utm_campaign=Mick_Smith_Podcast&utm_source=SpreakerMake an Appointment:https://app.hubspot.com/meetings/mick-smithBe sure to subscribe, like, & review The Doctor of Digital™ PodcastSign up for the Doctor Up Your Life courseFacebook || Instagram || Twitter || LinkedIn || YouTubehttps://www.linkedin.com/in/gmicksmith/

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.12.21.521411v1?rss=1 Authors: Lin, C.-P., Knoop, L. E., Frigerio, I., Bol, J. G., Rozemuller, A. J., Berendse, H. W., Pouwels, P. J., van de Berg, W. D., Jonkman, L. E. Abstract: Background Motor and cognitive impairment in Parkinson's disease (PD) is associated with dopaminergic dysfunction that stems from substantia nigra (SN) degeneration and concomitant -synuclein accumulation. Diffusion MRI can detect microstructural alterations of the SN and its tracts to (sub)cortical regions, but their pathological sensitivity is still poorly understood. Objective To unravel the pathological substrate underlying microstructural alterations of the SN, and its tracts to the dorsal striatum and dorsolateral prefrontal cortex (DLPFC) in PD. Methods Combining post-mortem in-situ MRI and histopathology, T1-weighted and diffusion MRI of 9 PD, 6 PD with dementia (PDD), 5 dementia with Lewy bodies (DLB), and 10 control donors were collected. From MRI, mean diffusivity (MD) and fractional anisotropy (FA) were derived from the SN, and tracts between the SN and caudate nucleus, putamen, and DLPFC. Phosphorylated-Ser129--synuclein and tyrosine hydroxylase immunohistochemistry was included to quantify nigral Lewy pathology and dopaminergic degeneration, respectively. Results Compared to controls, PD and PDD/DLB showed increased MD of the SN and SN-DLPFC tract, as well as increased FA of the SN-caudate nucleus tract. Both PD and PDD/DLB showed nigral Lewy pathology and dopaminergic loss compared to controls. Increased FA of the SN and SN-caudate nucleus tract was associated with SN dopaminergic loss, while increased MD of the SN-DLPFC tract was associated with increased SN Lewy neurite load. Conclusions In PD and PDD/DLB, diffusion MRI captures microstructural alterations of the SN and tracts to the dorsal striatum and DLPFC, which differentially associates with SN dopaminergic degeneration and Lewy neurite pathology. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.12.14.520457v1?rss=1 Authors: Hoffman, J. L., Faccidomo, S., Taylor, S. M., DeMiceli, K. G., May, A. M., Smith, E. N., Whindleton, C. M., Hodge, C. W. Abstract: Rationale: The development and progression of alcohol use disorder (AUD) is widely viewed as maladaptive neuroplasticity. The transmembrane alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR) regulatory protein 8 (TARP {gamma}-8) is a molecular mechanism of neuroplasticity that has not been evaluated in AUD or other addictions. Objective: To address this gap in knowledge, we evaluated the mechanistic role of TARP {gamma}-8 bound AMPAR activity in the basolateral amygdala (BLA) and ventral CA3 hippocampus (vHPC) in the positive reinforcing effects of alcohol, which drive repetitive alcohol use throughout the course of AUD, in C57BL/6J mice. These brain regions were selected because they exhibit high levels of TARP {gamma}-8 expression and send glutamate projections to the nucleus accumbens (NAc), which is a key nucleus in the brain reward pathway. Methods and Results: Site-specific pharmacological inhibition of AMPARs bound to TARP {gamma}-8 in the BLA via bilateral infusion of the selective negative modulator JNJ-55511118 significantly decreased operant alcohol self-administration with no effect on sucrose self-administration in behavior-matched controls. Temporal analysis showed that reduction of alcohol-reinforced responding occurred greater than 25 min after the onset of responding, consistent with a blunting of the positive reinforcing effects of alcohol in the absence of nonspecific behavioral effects. In contrast, inhibition of TARP {gamma}-8 bound AMPARs in the vHPC selectively decreased sucrose self-administration with no effect on alcohol. Conclusions: This study reveals a novel brain region-specific role of TARP {gamma}-8 bound AMPARs as a molecular mechanism of the positive reinforcing effects of alcohol and non-drug rewards. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.12.06.519361v1?rss=1 Authors: Broeren, B. O., Hundepool, C. A., Kumas, A. H., Duraku, L. S., Walbeehm, E. T., Hooijmans, C. R., Power, D. M., Zuidam, J. M., De Jong, T. Abstract: Background: Treatment of nerve injuries proves to be a worldwide clinical challenge. Acellular nerve allografts are suggested to be a promising alternative for bridging a nerve gap to the current gold standard, an autologous nerve graft. Objective: To systematically review the efficacy of the acellular nerve allograft, its difference from the gold standard (the nerve autograft) and to discuss its possible indications. Material and methods: PubMed, Embase and Web of Science were systematically searched until the 4th of January 2022. Original peer reviewed paper that presented 1) distinctive data; 2) a clear comparison between not immunologically processed acellular allografts and autologous nerve transfers; 3) was performed in laboratory animals of all species and sex. Meta analyses and subgroup analyses (for graft length and species) were conducted for muscle weight, sciatic function index, ankle angle, nerve conduction velocity, axon count diameter, tetanic contraction and amplitude using a Random effects model. Subgroup analyses were conducted on graft length and species. Results: Fifty articles were included in this review and all were included in the meta-analyses. An acellular allograft resulted in a significantly lower muscle weight, sciatic function index, ankle angle, nerve conduction velocity, axon count and smaller diameter, tetanic contraction compared to an autologous nerve graft. No difference was found in amplitude between acellular allografts and autologous nerve transfers. Post hoc subgroup analyses of graft length showed a significant reduced muscle weight in long grafts versus small and medium length grafts. All included studies showed a large variance in methodological design. Conclusion: Our review shows that the included studies, investigating the use of acellular allografts, showed a large variance in methodological design and are as a consequence difficult to compare. Nevertheless, our results indicate that treating a nerve gap with an allograft results in an inferior nerve recovery compared to an autograft in seven out of eight outcomes assessed in experimental animals. In addition, based on our preliminary post hoc subgroup analyses we suggest that when an allograft is being used an allograft in short and medium (0-1cm, greater than 1-2cm) nerve gaps is preferred over an allograft in long ( greater than 2cm) nerve gaps. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.11.22.517479v1?rss=1 Authors: Aloi, D., Jalali, R., Calzolari, S., Lafanechere, M., Miall, R. C., Fernandez-Espejo, D. Abstract: Background: Therapeutic options for patients with prolonged disorder of consciousness (PDOC) are limited. PDOC patients often exhibit a dissociation between their retained level of (covert) cognitive ability and their (overt) behavioural responses (cognitive-motor dissociation; CMD). This is linked to reduced coupling between thalamus and the primary motor cortex. Objective: To assess whether pairing tDCS with a concurrent passive mobilisation protocol (designed to be feasible in PDOC) can influence thalamo-M1 dynamics and whether these changes are enhanced after multiple stimulation sessions. Methods: We used Dynamic Causal Modelling (DCM) on functional magnetic resonance imaging (fMRI) data from 22 healthy participants to assess tDCS changes on effective connectivity within motor network areas during command-following. Results: We found that a single anodal tDCS session (paired with passive mobilisation of the thumb) decreased self-inhibition in the motor cortex, with five sessions further enhancing this effect. In addition, anodal tDCS increased thalamo-M1 excitation as compared to cathodal stimulation, with the effects maintained after 5 sessions. In turn, cathodal tDCS had opposing effects on these connections after one session but became more similar to anodal after 5. Conclusions: Together, our results suggest that pairing anodal tDCS with passive mobilisation across multiple sessions may facilitate behavioural command-following in PDOC patients with CMD. More broadly, they offer a mechanistic window into the neural underpinnings of the cumulative effects of multi-session tDCS. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.11.15.516568v1?rss=1 Authors: Sulcova, D., Salman, Y., Ivanoiu, A., Mouraux, A. Abstract: Background: The angular gyrus (AG) is involved in numerous cognitive processes, and structural alterations of the AG are reported in many neuropsychiatric diseases. Because abnormal excitability or connectivity of such cortical hubs could precede structural alterations and clinical symptoms, approaches assessing their functional state are needed. The combination of transcranial magnetic stimulation (TMS) with electroencephalography (EEG) can provide such functional readouts by probing how the cortex responds to direct stimulation. Objective: To characterize TMS-evoked potentials (TEPs) elicited by AG stimulation, determine optimal stimulation parameters, and identify TEP biomarkers of AG function. Methods: In 19 subjects, we recorded AG-TEPs using four TMS orientations and three intensities and compared their spatiotemporal features using topographic dissimilarity and microstate analyses. We also explored the link between AG-TEPs and TMS-evoked muscle activity. Results: Early AG TEP components of interest (P25, N45) showed topographic variability dependent on stimulation parameters. The P25 topography was sensitive to TMS orientation and less to intensity, whereas the N45 topography was highly dependent on both coil orientation and intensity. However, TMS-evoked muscular activity was also dependent on coil orientation and the dominant topography of N45 was strongly related to this muscular activity, indicating that the component may reflect somatosensory-evoked responses to this peripheral activation. Conclusions: The earliest AG TEP component P25 likely reflects neural processes triggered by direct AG activation and could provide an index of local excitability. N45 must be interpreted with caution as it may mostly reflect peripherally evoked activity. Coil orientation can be optimized to minimize muscular contractions. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.10.05.510983v1?rss=1 Authors: Hwang, Y.-C. E., Genov, R., Zariffa, J. Abstract: Background: Closed-loop control of functional electrical stimulation involves using recorded nerve signals to make decisions regarding nerve stimulation in real-time. Surgically implanted devices that can implement this strategy have significant potential to restore natural movement after paralysis. Previous work demonstrated the use of convolutional neural networks (CNNs) to discriminate between activity from different neural pathways recorded by a high-density multi-contact nerve cuff electrode. Despite state-of-the-art performance, that approach required too much data storage, power and computation time for a practical implementation on surgically implanted hardware. Objective: To reduce resource utilization for an implantable implementation, with a minimal performance loss for CNNs that can discriminate between neural pathways in multi-contact nerve cuff electrode recordings. Methods: Neural network (NN) architectures were evaluated on a dataset of rat sciatic nerve recordings previously collected using 56-channel (7 x 8) spiral nerve cuff electrodes to capture spatiotemporal neural activity patterns. The NNs were trained to classify individual, natural compound action potentials (nCAPs) elicited by sensory stimuli. Three architecture types were explored: the previously reported ESCAPE-NET, a fully convolutional network, and a recurrent neural network. Variations of each architecture yielded NNs with a range in the number of weights and required floating-point operations (FLOPs). Each NN was evaluated based on F1-score and resource requirements. Results: NNs were identified that, when compared to ESCAPE-NET, required 1,132-1,787x fewer weights, 389-995x less memory, and 6-11,073x fewer FLOPs, while maintaining macro F1-scores of 0.70-0.71 compared to a baseline of 0.75. Memory requirements range from 22.69 KB to 58.11 KB, falling within the range of on-chip memory sizes from several published deep learning accelerators fabricated in 65nm ASIC technology. Conclusion: Reduced versions of ESCAPE-NET require significantly fewer resources without significant accuracy loss, thus can be more easily incorporated into a surgically implantable device that performs closed-loop real-time responsive neural stimulation. Copy rights belong to original authors. Visit the link for more info Podcast created by PaperPlayer

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.09.26.508121v1?rss=1 Authors: Gale-Grant, O., Chew, A., Falconer, S., Franca, L. G. S., Fenn-Moltu, S., Hadaya, L., Harper, N., Ciarrusta, J., Charman, T., Murphy, D., Arichi, T., McAlonan, G., Nosarti, C., Edwards, D., Batalle, D. Abstract: Importance: Autism traits typically emerge between the ages of 1 and 2. It is not known if experiences which increase the likelihood of childhood autism are related to early trait emergence, or if other exposures are more important. Identifying factors linked to toddler autism traits may improve our understanding of the mechanisms underlying atypical neurodevelopment. Objective: To characterise the association between 18-month autism traits and clinical, socio-demographic, and parental factors. Design: This is a cohort study of toddlers (n=536). Clinical, socio-demographic, and parental information was collected at birth (gestational age at birth, sex, maternal body mass index, age, parental education level, parental first language, parental history of neurodevelopmental disorders) and at 18 months (parent cohabiting status, two measures of social deprivation, three measures of maternal parenting style, and a measure of maternal postnatal depression). General neurodevelopment was assessed with the Bayley Scales of Infant and Toddler Development, 3rd Edition (BSID-III), and autism traits were assessed using the Quantitative Checklist for Autism in Toddlers (Q-CHAT). Multivariable models were used to identify associations between variables and Q-CHAT. A model including BSID-III was used to identify factors associated with Q-CHAT independent of general neurodevelopment. Models were also evaluated addressing variable collinearity with principal component analysis (PCA). Setting: Single centre (London, UK). Participants: Sub-sample from the developing Human Connectome Project (dHCP). Results: A multivariable model explained 20% of Q-CHAT variance, with four individually significant variables (two measures of parenting style and two measures of socio-economic deprivation). After adding general neurodevelopment into the model 37% of Q-CHAT variance was explained, with three individually significant variables (two measures of parenting style and one measure of language development). After addressing variable collinearity with PCA, experience of early life adversity was positively correlated with Q-CHAT score via a single principal component, independently of general neurodevelopment. Neither sex nor family history of autism were associated with Q-CHAT score. Conclusions and Relevance: Our findings question whether potential autism diagnoses are being missed in more socially deprived groups, or if there are unidentified factors influencing the likelihood of transitioning from early traits at age 18 months to a clinical autism diagnosis in childhood. Copy rights belong to original authors. Visit the link for more info Podcast created by PaperPlayer

Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy: International Clinical Practice Guideline Based on Systematic ReviewsCatherine Morgan, Linda Fetters, Lars Adde, Nadia Badawi, Ada Bancale, Roslyn N Boyd, Olena Chorna, Giovanni Cioni, Diane L Damiano, Johanna Darrah, Linda S de Vries, Stacey Dusing, Christa Einspieler, Ann-Christin Eliasson, Donna Ferriero, Darcy Fehlings, Hans Forssberg, Andrew M Gordon, Susan Greaves, Andrea Guzzetta, Mijna Hadders-Algra, Regina Harbourne, Petra Karlsson, Lena Krumlinde-Sundholm, Beatrice Latal, Alison Loughran-Fowlds, Catherine Mak, Nathalie Maitre, Sarah McIntyre, Cristina Mei, Angela Morgan, Angelina Kakooza-Mwesige, Domenico M Romeo, Katherine Sanchez, Alicia Spittle, Roberta Shepherd, Marelle Thornton, Jane Valentine, Roslyn Ward, Koa Whittingham, Alieh Zamany, Iona Novak.Free articleAbstractImportance: Cerebral palsy (CP) is the most common childhood physical disability. Early intervention for children younger than 2 years with or at risk of CP is critical. Now that an evidence-based guideline for early accurate diagnosis of CP exists, there is a need to summarize effective, CP-specific early intervention and conduct new trials that harness plasticity to improve function and increase participation. Our recommendations apply primarily to children at high risk of CP or with a diagnosis of CP, aged 0 to 2 years.Objective: To systematically review the best available evidence about CP-specific early interventions across 9 domains promoting motor function, cognitive skills, communication, eating and drinking, vision, sleep, managing muscle tone, musculoskeletal health, and parental support.Evidence review: The literature was systematically searched for the best available evidence for intervention for children aged 0 to 2 years at high risk of or with CP. Databases included CINAHL, Cochrane, Embase, MEDLINE, PsycInfo, and Scopus. Systematic reviews and randomized clinical trials (RCTs) were appraised by A Measurement Tool to Assess Systematic Reviews (AMSTAR) or Cochrane Risk of Bias tools. Recommendations were formed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and reported according to the Appraisal of Guidelines, Research, and Evaluation (AGREE) II instrument.Findings: Sixteen systematic reviews and 27 RCTs met inclusion criteria. Quality varied. Three best-practice principles were supported for the 9 domains: (1) immediate referral for intervention after a diagnosis of high risk of CP, (2) building parental capacity for attachment, and (3) parental goal-setting at the commencement of intervention. Twenty-eight recommendations (24 for and 4 against) specific to the 9 domains are supported with key evidence: motor function (4 recommendations), cognitive skills (2), communication (7), eating and drinking (2), vision (4), sleep (7), tone (1), musculoskeletal health (2), and parent support (5).Conclusions and relevance: When a child meets the criteria of high risk of CP, intervention should start as soon as possible. Parents want an early diagnosis and treatment and support implementation as soon as possible. Early intervention builds on a critical developmental time for plasticity of developing systems. Referrals for intervention across the 9 domains should be specific as per recommendations in this guideline.

Introducing a new series of episodes: Topic: Standardized English tests (IELTS, TOEFL and SAT). Objective: To get students on summer holidays preparing for those tests to be familiar with the sort of questions to expect. --- Send in a voice message: https://anchor.fm/dee64/message

Follow us at Apple Podcasts if you like what you are hearing. And please subscribe to The Ankler at TheAnkler.com for more interviews and stories like these.Though the world's eyes are on Ukraine President Volodymyr Zelensky, few have spent time with the charismatic leader in recent weeks. Among the exceptions: Sean Penn and co-director/producer Aaron Kaufman, who were on the ground in Kyiv when Russia invaded Ukraine on Feb. 24. The pair had been filming a documentary for Vice centered on the comedian-voice actor-turned-politician. In the early days of the war, Zelensky shared with Kaufman one of Zelensky's plans for resisting the Russian onslaught, which Kaufman then passed on to Ankler Editor at Large and Ankler Hot Seat podcast host Tatiana Siegel in the hopes it would be shared. The campaign, conceived by Zelensky and his leadership, is called “Your Business Smells Russian” and its objective is to limit the activities of international businesses in Russia and thus financially choke and pressure Russian leader Vladimir Putin.On the podcast, Siegel talks about her text exchanges last week with Kaufman, who told her that “Zelensky was hoping to get [a series of talking points] out to the world.”Here's the memo Kaufman says Zelensky asked him to share. Kaufman delivered the memo through a series of texts:The “Your Business Smells Russian” campaignInsight: At a time when states are banding together and making significant efforts to create sanctions for Putin's Russia, most Western companies continue to do business in Russia, following business as usual policies. They continue to bring in significant revenues to the budget, perform an important public function of "universal approval" in society, while declaring the importance of values for modern life.There is a policy of double standards, instead of support by actions, they close activities in Ukraine, (Coca Cola, Uber, McDonalds) motivated by military actions, they close in Ukraine, but not in Russia.Task:1) To show that this policy, just business, does not work in the modern business, in which values should be above all.2) To show global consumers that money earned in Russia is “bloody and toxic money”.Objective:To limit the activities of businesses in Russia, the outflow of finance/capital.Campaign:Your Business Smells RussianActions:1) Use well-known celebrities (e.g. Richard Branson) who could denounce double standards. Generate a large number (assault) of inquiries to companies in different countries about the ethics of doing business in Russia;2) Consumer reactions/boycotts to goods/services in their countries.3) Requesting ethic[al behavior] through national company forums.Examples of the depth of the problem:McDo - made $2.5 billion in Ru(ssia) last year;Coke - made $2.6 billion in profits for the quarterWhile it is unclear if Hollywood power brokers also received the memo, it appears that they got the message. A number of studios announced that they are “pausing” films scheduled for release in Russia including The Batman, Lost City and the Michael Bay action pic Ambulance. Similarly, Netflix put the kibosh on four series scheduled to shoot in Russia. “We're not talking China numbers, but you can have sizable box office performances in Russia,” Siegel noted during the podcast. “For example, Joker made $37.2 million in Russia, and something like The Batman, which has been paused, would likely be comparable.”In this episode, Siegel talks with co-hosts Janice Min and Richard Rushfield about Hollywood's big reaction to the ongoing crisis and contrasts that with its continued silence on Russia's ally, China, in addition to other entertainment headlines of the day. Thanks for reading and listening. The Ankler is subscriber-supported. To receive new posts and support our work, we invite you to join our community.Also on The Ankler:On the departure of Netflix's flamboyant marketing chief, Bozoma Saint John, what it says about Netflix and Hollywood today.Entertainment Strategy Guy explains the MGM/Amazon/FTC death spiral and what it all means for the rest of entertainment.Richard Rushfield's annual State of Showbiz address.CAMERA ROLL: 20 pictures of who's where in Hollywood this week.The fight is on for the role of the decade. The Transom has the details on the battle to play Madonna in the Material Girl's self-directed biopic.Adult animation was supposed to be the streamers' secret weapon during the pandemic. But things didn't go quite as planned. Entertainment Strategy Guy breaks down the bitter numbers.On The Optionist:Q&A: What A.I. Tells Us About Debut AuthorsA highly curated list of current and backlist books, new journalism, and podcasts ready for option. This week: a real-life biopic about the greatest Wall Street manipulator, a time travel murder mystery, A Civil Action-esque courtroom drama, a fun romcom podcast, and a superhero adventure on the backlist that, incredibly, has not been spoken for yet.Subscribe during the free beta period here. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit theankler.com/subscribe

Speaker: Pastor Faith Floyd (Guest: Saltmine Ministry) Scripture: Matthew 6 24-34 NIV Keywords: Faith, worry trust Objective: To learn how to exchange worry for an increased faith in God. To learn to depend on God in all situations- small and big.

THANKSGIVING SERVICE 29.08.21 Topic: Thank At Your Will. Objective: To know the importance of knowing and submitting to the will of God as a lifestyle in the attitude of thanksgiving. Key Notes: Scripture Texts: Leviticus 22:29; Romans 12:1-2 Spiritual hunger is a result of staying away of from studying and meditating on the word of God. A believer who is hungry experiences fear, lack of love and incessant fall into temptations. God ONLY appeals to Man; not force, manipulate,or threaten Man to follow Him or do His biding. God desires for Man to thank at his own will. Which is only possible when man's will aligns with the will of God. The scripture in Romans 12 reveals that, the only way our giving to God can be pleasing and done in a proper way is when we know the will of God, submit and align our will to His. The will of God is good for man, acceptable (that is, pleasurable to God and acceptable by man) and perfect for God. Every time God presents His will to man and is accepted by man, man's will becomes intertwined with his will. This makes man thank God for His will at his his own will. Therefore, the more you submit to the will of God; the more you align to His will and the will of God becomes the will you now operate with. Until God's will becomes your will, you cannot praise as a lifestyle. in essence, those who thank God at their own will have their will dead and actually operating in/and with the will of God reigning in them. The ability to have the will of God entails pains. The sacrifice of praise endears The Father's heart towards a man; it is therefore important to die daily to your will and be more alive to accept the will of God. What is therefore the sacrifice of thanksgiving? It is ones will that has been sacrificed for God's will. It is refusing ones will and allowing God's will to reign, irrespective of the pain/cost. Listen now for full teaching. JESUS IS LORD! Kindly follow our Facebook page for more words of blessing and encouragement:@ChimdiOhahunaofficial --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/chimdi-ohahuna/message Support this podcast: https://anchor.fm/chimdi-ohahuna/support

Objective: To provide hockey players ages 13-20 an opportunity to learn about how mental performance and mental health impacts performance, and how a psychologists, strength/conditioning coaches, athletic trainers, and nutritionists view the area of mental performance and how each area plays an important role in a players on and off ice success. The aim is to first open young players up to these fields and then introduce them to helpful tools they can use to master their mental game. Meet the presenters: Sports Psychologist – Charron Sumler Sumler, who played four years of collegiate basketball, arrives at Ohio State after spending the past two years at the University of Texas, where she coordinated services and resources for university students in crisis situations. She has 10 years of counseling, leadership and case management experience and has a bachelor's degree in psychology from St. Edwards University in Austin, Texas, and a master's in counseling from Texas State University. Strength and Conditioning Coach - Austin White, CSCS, USAW. Austin White serves as the director of performance for Method Ice Hockey. He is responsible to physically prepare his athletes for the demands of their game and position including increasing their strength, power, speed, change of direction ability, and the energy demands needed to sustain high output through all 3 periods or 4 quarters. After graduating from Kutztown University in 2016, he interned at the University of Maryland for football in 2017 which then led him to become the program director for High Performance Athletic Training Center in 2018. His role with HPATC allowed him to have a seamless transition to the Director of Performance for Method Hockey in 2020. Austin is certified through the National Strength and Conditioning Association (CSCS), United States Olympic Weightlifting (USAW Level 1), and Functional Movement Screening (FMS). Physiotherapist – Matt Arnott Matt has been practicing physiotherapy for over 20 years in the field of orthopedics. He is co-owner and operator of Avenue Physiotherapy in Brantford Ontario. He has worked extensively with prep school athletes in both basketball and hockey. Nutritionist – Alex Winnicki 30 y/o from Winston Salem NC. Studied Nutrition at Appalachian State and I'm currently in my last month of Graduate school in Texas to become a Registered Dietitian. I played hockey from 5-20 y/o as a goalie, spent two years a a professional road cyclist, and will be working as a Sports Dietitian at Northwestern University in July through a Gatorade / CPSDA Fellowship

Name, email address and phone number Objective: To obtain the position of........ Summary Of Qualifications/Skills Experience pertaining to the job and Education that has been completed. tutorjack0000@gmail.com for Zoom and jack.bosma1 for Skype. Please leave a titled message response to the content so that I can promote your content. Thanks. --- Send in a voice message: https://anchor.fm/jack-bosma3/message Support this podcast: https://anchor.fm/jack-bosma3/support

Children with cerebral palsy (CP) experience a wide range of deficits and symptoms. When undergoing occupational therapy (OT) interventions, it is essential that the OT select assessments that can accurately reflect the outcome measures of the targeted domains. Objective: To identify the assessment tools most frequently reported in research studies as measures for OT interventions when treating children with CP. Method: Pubmed and Ovid databases were systematically searched by using key terms “cerebral palsy,” “assessments,” and “occupational therapy”. Assessment tools were explored and extracted from articles contingent on the following inclusion criteria: (1) children birth to 18 years diagnosed with cerebral palsy; (2) use of assessment(s) as a measure of OT intervention; (3) published in English between 2007 and 2017. In the preliminary search, Pubmed yielded 151 records and Ovid yielded 571. Out of these, only 76 met the inclusion criteria. From the remaining 76 articles, a total of 88 assessment tools were retrieved and included in this literature review. Results: Ten assessments were found to be of importance based on frequency of use. The Assisting Hand Assessment (AHA) and Pediatric Evaluation of Disability Inventory (PEDI) were the most commonly used. Conclusion: This study helps to determine which assessments are frequently used in OT practice with children with CP. The findings of this study play an important role in addressing the challenge of assessment selection faced by occupational therapists and provide a basis for future research to expand on with regards to treating children with CP.

Also ask yourself, did this study compare their treatment to the 'gold standard' and if the answer is no they compared it to a straw man, then think big Pharma, or authors that needed publication for their job. We can't treat what we don't know exist and 30-50% of the time COVID19 is asymptomatic. Combined Oral Contraception DO NOT have an increase risk of DVT and long term the risk are very minimal if a DVT does develop while on COC. Speaking of studies that should have never been done- Multicentre, prospective, randomised study comparing the diagnostic yield of colon capsule endoscopy versus CT colonography in a screening population (the TOPAZ study) | Gut (bmj.com) Diagnostic Yield of Colon Capsule Endoscopy vs CT Colonography in a Screening Population | PracticeUpdate The authors of this multicenter, prospective, randomized study compared the diagnostic yield of colon capsule endoscopy (CCE) with that of CT colonography (CTC) for colon cancer screening in an average-risk adult population. First you had either a CCE or a CTC and then the findings were confirmed with colonoscopy. The sensitivity and specificity of CCE for polyps ≥6 mm were 79.2% and 96.3%, respectively, compared with 26.8% and 98.9%, respectively, with CTC. The sensitivity and specificity of CCE for polyps ≥10 mm were 85.7% and 98.2%, respectively, compared with 50% and 99.1%, respectively, with CTC. They authors say this may work for people who refuse colonoscopy. Which is true it might but we have a fit test—it cost pennies—why in the world do we need this test?!? Its more money its more invasive its not better than FIT….. This is a study we didn’t need till I read the 30 line conflict of interest and I knew exactly why we needed this trial—to keep big pharm in business Colon cancer is scary cause most of the time we don’t know we have it and speaking of thigs we don’t know we have Asymptomatic SARS-CoV-2 Infections Among Persons Entering China From April 16 to October 12, 2020 | Global Health | JAMA | JAMA Network China controlled their cases because Beginning April 1, 2020, persons entering China via air, sea, or land have been mandatorily tested for SARS-CoV-2 infection by PCR test at border checkpoints. retrospective cohort study looked at All international entrants found to have SARS-CoV-2 infection via a positive PCR test result at China’s border checkpoints from April 16 to October 12 were included in this study. 3103 had confirmed COVID-19 cases, AMONG THOSE 1612 (51.9%) never developed symptoms through day 13 and were considered to have asymptomatic SARS-CoV-2 infection. The Proportion of SARS-CoV-2 Infections That Are Asymptomatic: A Systematic Review: Annals of Internal Medicine: Vol 0, No 0 (acpjournals.org) Purpose: To estimate the proportion of persons infected with SARS-CoV-2 who never develop symptoms. And results found- about 1/3 of people had no symptoms and if you test positive and have no symptoms then about 75% of the time you will never have symptoms. WE will never be able to stop what we don’t even know about. WE can never and I repeat NEVER flatten a curve on something that you may not even know you have 33% of the time. Efficacy and safety of antidepressants for the treatment of back pain and osteoarthritis: systematic review and meta-analysis | The BMJ Prescribe antidepressants for depression not for pain Design Systematic review and meta-analysis. Objective To investigate the efficacy and safety of antidepressants for back and osteoarthritis pain compared with placebo. Pain and disability were primary outcomes. Pain and disability scores were converted to a scale of 0 (no pain or disability) to 100 (worst pain or disability). Results 33 trials (5318 participants) were included. Back pain- serotonin-noradrenaline reuptake inhibitors (SNRIs) reduced back pain (mean difference −5.30, 95% confidence interval −7.31 to −3.30) at 3-13 weeks SNRIs reduced sciatica at two weeks or less (−18.60, −31.87 to −5.33) but not at 3-13 weeks (−17.50, −42.90 to 7.89). tricyclic antidepressants (TCAs) did not reduce sciatica at two weeks or less but did at 3-13 weeks (−15.95, −31.52 to −0.39) and 3-12 months (−27.0, −36.11 to −17.89). SNRIs reduced disability from back pain at 1-13 weeks around 1-3 points—TO WHAT SIGNIFCANT CLINCALY ON 100 point scale. osteoarthritis- SNRIs reduced osteoarthritis pain (−9.72, −12.75 to −6.69) at 3-13 weeks TCAs and other antidepressants did not reduce pain or disability from back pain. ReplyForward 8000 women from 2004-2006- to be included you could not be pregnant or postpartum and aged ≤ 50 years, without active cancer There were 220 women had either a first distal dvt, first prox dvt, or a first PE Of these women, 47.3% (n/N = 104/220) were on COC pills at the time of their VTE event. Overall, 27.6% of patients developed venous thromboembolism (VTE)

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.11.16.385880v1?rss=1 Authors: Klein, A., Clucas, J., Krishnakumar, A., Ghosh, S. S., Van Auken, W., Thonet, B., Sabram, I., Acuna, N., Keshavan, A., Rossiter, H., Xiao, Y., Semenuta, S., Badioli, A., Konishcheva, K., Abraham, S. A., Alexander, L. M., Merikangas, K. R., Swendsen, J., Lindner, A. B., Milham, M. P. Abstract: Background: Universal access to assessment and treatment of mental health and learning disorders remains a significant and unmet need. There is a vast number of people without access to care because of economic, geographic, and cultural barriers as well as limited availability of clinical experts who could help advance our understanding of mental health. Objective: To create an open, configurable software platform to build clinical measures, mobile assessments, tasks, and interventions without programming expertise. Specifically, our primary requirements include: an administrator interface for creating and scheduling recurring and customized questionnaires where end users receive and respond to scheduled notifications via an iOS or Android app on a mobile device. Such a platform would help relieve overwhelmed health systems, and empower remote and disadvantaged subgroups in need of accurate and effective information, assessment, and care. This platform has potential to advance scientific research by supporting the collection of data with instruments tailored to specific scientific questions from large, distributed, and diverse populations. Methods: We conducted a search for tools that satisfy the above requirements. We designed and developed a new software platform called "MindLogger" that exceeds the above requirements. To demonstrate the tool's configurability, we built multiple "applets" (collections of activities) within the MindLogger mobile application and deployed several, including a comprehensive set of assessments underway in a large-scale, longitudinal, mental health study. Results: Of the hundreds of products we researched, we found 10 that met our primary requirements above with 4 that support end-to-end encryption, 2 that enable restricted access to individual users' data, 1 that provides open source software, and none that satisfy all three. We compared features related to information presentation and data capture capabilities, privacy and security, and access to the product, code, and data. We successfully built MindLogger mobile and web applications, as well as web browser-based tools for building and editing new applets and for administering them to end users. MindLogger has end-to-end encryption, enables restricted access, is open source, and supports a variety of data collection features. One applet is currently collecting data from children and adolescents in our mental health study, and other applets are in different stages of testing and deployment for use in clinical and research settings. Conclusions: We have demonstrated the flexibility and applicability of the MindLogger platform through its deployment in a large-scale, longitudinal, mobile mental health study, and by building a variety of other mental health-related applets. With this release, we encourage a broad range of users to apply the MindLogger platform to create and test applets to advance health care and scientific research. We hope that increasing availability of applets designed to assess and administer interventions will facilitate access to health care in the general population. Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.11.16.384396v1?rss=1 Authors: Ebrahim, B. Y., Soboka, M., Getachew, Y., Alemu, B., Ahmed, G., Tesfaye, E. Abstract: Background Expressed emotion (EE) measures the emotion of the caregivers of persons with schizophrinia and is predictive of symptom levels in a range of medical and psychiatric conditions. It is worth to assess expressed emotion and associated factors among caregivers of patient with schizophrenia in Ethiopia since there is limited data on this issue in this part of the world. Objective To assess the status of expressed emotions and selecte patients clinical factors among care givers of patients with schizophrenia attending psychiatry oupatient unit of Jimma university medical center, South west, Ethiopia, 2019. Method A cross-sectional study design employed involving 422 caregivers of schizophrenic patients using consecutive sampling technique. Data was collected using structured interviewer administrated questionnaires (Family Questioners) which assess the level of expressed emotion, entered into Epidata 4.4 and analyzed by Statistical package for social science (SPSS) version 25. Descripitive statistics used to summerize data, bivariate logistic regression was done to identify candidate variables for multivariable logistic regressions and the association between expressed emotion and predictor variables was identified by using multiple logistic regression model. Results High expressed emotion was observed in 43.6% of respondents. Caring for schizophrenic patients for about 6-8 years, having 3-4 episodes of the illness was significantly associated with high expressed emotion. Conclusions This study revealed that there is high status of care givers expressed emotion compared to other studies. It also showed that number of episode of illnesses had significant association with high caregivers expressed emotion. Health care systems, which provide interventions for patients with schizophrenia, need to design proper strategy to address caregivers need as well. Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.10.27.356873v1?rss=1 Authors: Haile, B., Wolde, M., Gebregziabiher, T. Abstract: Abstract Background: Hypertension is a silent killer that requires long term management to avoid complications. It is one of major public health problem in developing counties like Ethiopia. Hypertension increases the risk of morbidity and mortality and has negative consequences on the cognitive and physical fitness of productivity in adults. Objective: To assess fasting blood glucose, serum electrolyte, albumin, creatinine, urea, and lipid profile among hypertensive patients and non-hypertensive participants at wolaita sodo teaching and referral hospital. Methods: A comparative cross-sectional study was conducted from December 2019 to February 2020. On the study a total of 156 study participants (78 cases and 78 controls) were involved. Each study participant, after signing informed consent, interviewed about the socio-demographic and anthropometric characteristic features. Then 5ml of the blood sample was collected from each 78 patients with hypertension and each 78 samples from apparently healthy subjects from WSUTRH during the period. Fasting blood glucose, serum electrolyte, albumin, creatinine, urea, and lipid profile level were measured in each group. The Data were analyzed by using Epi data version 3.1 and SPSS version 21.0 software (IBM Corporation, USA) and results were summarized using means and percentages and presented by using figures and tables. P-value < 0.05 was considered to be significant at 95% confidence level. Any abnormal laboratory results of study subjects dispatched and communicated with physicians for better management. Results: The mean age of hypertensives and control study groups were 50 {+/-} 10.0 and 51 {+/-} 11.3 years respectively. The body mass index of hypertensives and control study groups were 53.4% and 34.2% overweighed respectively. The mean {+/-} SD of fasting blood glucose, total cholesterol, LDL-C, TG, RFT were significantly increases while serum sodium, calcium, albumin, and HDL- Cholesterol significantly decreased in hypertensives when compared with non-hypertensives and serum potassium was no statistical significance among case and control groups. Conclusion: In present study, we observed that the hypertensive group was at risk for developing biochemical alteration in creatinine, urea, fasting blood glucose, lipid profile, electrolytes, and albumin test parameters with an increased period of time. Recommendation: Regular measurements of biochemical parameters strongly needed for hypertensive patients. Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.10.13.338350v1?rss=1 Authors: Fernandez, L., Biabani, M., Opie, G. M., Hill, A. T., Barham, M. P., Teo, W.-P., Byrne, L. K., Do, M., Rogasch, N. C., Enticott, P. G. Abstract: Background: Combined single-pulse transcranial magnetic stimulation (TMS) and electroencephalography (EEG) has been used to probe the features of local networks in the cerebral cortex. Here we investigate whether we can use this approach to explore long-range connections between the cerebellum and cerebral cortex. Objective: To assess the feasibility of using cerebellar TMS-EEG for the exploration of cerebellar-cerebral network dynamics. Methods: Ten healthy adults received single-pulse suprathreshold TMS to the cerebellum and an occipital/parietal control site with double-cone and figure-of-eight coils while cerebral activity was recorded. A multisensory electrical control condition was used to simulate the sensation of the double-cone coil at the cerebellar site. Two cleaning pipelines were compared, and the spatiotemporal relationships of the EEG output between conditions were examined at sensor and source levels. Results: Cerebellar stimulation with the double-cone coil resulted in large artefacts in the EEG trace. The addition of SOUND filtering to the cleaning pipeline improved the signal such that further analyses could be undertaken. The cortical potentials evoked by the active TMS conditions showed strong relationships with the responses to the multisensory control condition after ~50 ms. A distinct parietal component at ~42 ms was found following cerebellar double-cone stimulation. Conclusions: Cerebellar double-cone stimulation produces large artefacts in the EEG. Cerebellar-specific responses could not be reliably differentiated from sensory evoked potentials after ~50 ms. While evoked potentials differed across conditions at early latencies, it is unclear as to whether these represented TMS-related network activation of the cerebellarthalamocortical tract, or whether components were dominated by sensory contamination and/or coil-driven artefacts. Further work will be required to clarify the specific contribution of cerebellar-cortical connectivity to the observed early latency signals. Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.09.08.288316v1?rss=1 Authors: Schiffer, L., Bossey, A., Taylor, A. E., Akerman, I., Scheel-Toellner, D., Storbeck, K.-H., Arlt, W. Abstract: Context: Androgens are important modulators of immune cell function impacting proliferation, differentiation and cytokine production. The local generation of active androgens from circulating androgen precursors is an important mediator of androgen action in peripheral androgen target cells of tissue. Objective: To characterize the activation of classic and 11-oxygenated androgens in human peripheral blood mononuclear cells (PBMCs). Methods: PBMCs and natural killer cells were isolated from healthy male donors and incubated ex vivo with precursors and end products of the classic and 11-oxygenated androgen pathways. Steroid concentrations were quantified by liquid chromatography-tandem mass spectrometry. The expression of genes encoding steroid metabolizing enzymes was assessed by quantitative PCR. Results: The enzyme AKR1C3 is the major reductive 17{beta}-hydroxysteroid dehydrogenase in PBMCs and has higher activity for the generation of the active 11-oxygenated androgen 11-ketotestosterone than for the generation of the classic androgen testosterone from their respective precursors. Natural killer cells are the major site of AKR1C3 expression and activity within the PBMC compartment. Steroid 5-reductase type 1 catalyzes the 5-reduction of classic but not 11-oxygenated androgens in PBMCs. Lag time prior to the separation of cellular components from whole blood sample increases 11KT serum concentrations in a time-dependent fashion, with significant increases detected from two hours after blood collection. Conclusions: 11-oxygenated androgens are the preferred substrates for androgen activation by AKR1C3 in PBMCs, primarily conveyed by natural killer cell AKR1C3 activity, yielding 11KT the major active androgen in PBMCs. Androgen metabolism by PBMCs can affect the levels of 11-oxygenated androgens measured in serum samples, if samples are not separated in a timely fashion. Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.08.30.274126v1?rss=1 Authors: Liu, C., Scorr, L. M., Kilic-Berkmen, G., Cotton, A., Factor, S. A., Freeman, A., Tran, V., Liu, K., Uppal, K., Jones, D., Jinnah, H. A., Sun, Y. V. Abstract: Background: Cervical dystonia is the most common of the adult-onset focal dystonias. Most cases are idiopathic. The current view is that cervical dystonia may be caused by some combination of genetic and environmental factors. Genetic contributions have been studied extensively, but there are few studies of other factors. Objective: To conduct an exploratory metabolomics analysis of cervical dystonia to identify potentially abnormal metabolites or altered biological pathways. Methods: Plasma samples from 100 cases with idiopathic cervical dystonia and 100 controls were compared using liquid chromatography coupled with mass spectrometry-based metabolomics. Results: A total of 7,346 metabolic features remained after quality control, and 289 demonstrated significant differences between cases and controls, depending on statistical criteria chosen. Pathway analysis revealed 9 biological processes to be significantly associated at p

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.08.19.258236v1?rss=1 Authors: Stojakovic, A., Chang, S.-Y., Nesbitt, J., Pichurin, N. P., Ostroot, M., Trushina, E. Abstract: Background: Accumulation of hyperphosphorylated Tau (pTau) protein is associated with synaptic dysfunction in Alzheimers disease (AD). We previously demonstrated that neuroprotection in familial mouse models of AD could be achieved by targeting mitochondria complex I (MCI) and activating the adaptive stress response. Efficacy of this strategy on pTau-related pathology remained unknown. Objective: To investigate the effect of specific MCI inhibitor tricyclic pyrone compound CP2 on pTau levels, memory function, long term potentiation (LTP), and energy homeostasis in 18-month-old 3xTg-AD mice and explore the potential mechanisms. Methods: CP2 was administered to male and female 3xTg-AD mice from 3.5 - 18 months of age. Cognitive function was assessed using the Morris water maze test. Glucose metabolism was measured in periphery using a glucose tolerance test and in the brain using fluorodeoxyglucose F18 positron-emission tomography (FDG-PET). LTP was evaluated using electrophysiology in the hippocampus. The expression of key proteins associated with neuroprotective mechanisms were assessed by western blotting. Results: Chronic CP2 treatment restored synaptic activity and cognitive function, increased levels of synaptic proteins, improved glucose metabolism and energy homeostasis in male and female 3xTg-AD mice. Significant reduction of human pTau in the brain was associated with increased activity of protein phosphatase of type 2A (PP2A), reduced activity of cyclin-dependent kinase 5 (CDK5) and glycogen synthase kinase 3{beta} (GSK3{beta}). Conclusion: CP2 treatment protected against synaptic dysfunction and memory impairment in symptomatic 3xTg-AD mice, and reduced levels of human pTau, indicating that targeting mitochondria with small molecule specific MCI inhibitors represents a promising strategy for AD. Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.08.06.239707v1?rss=1 Authors: Mirdamadi, J. L., Block, H. J. Abstract: Background: It is well established that proprioception (position sense) is important for motor control, yet its role in motor learning and associated plasticity is not well understood. We previously demonstrated that motor skill learning is associated with enhanced proprioception and changes in sensorimotor neurophysiology. However, the neural substrates mediating these effects are unclear. Objective: To determine whether suppressing activity in the cerebellum and somatosensory cortex (S1) affects proprioceptive changes associated with motor skill learning. Methods: 54 healthy young adults practiced a skill involving visually-guided 2D reaching movements through an irregular-shaped track using a robotic manipulandum with their right hand. Proprioception was measured using a passive two-alternative choice task before and after motor practice. Continuous theta burst stimulation (cTBS), was delivered over S1 or the cerebellum (CB) at the end of training for two consecutive days. We compared group differences (S1, CB, Sham) in proprioception and motor skill, quantified by a speed-accuracy function, measured on a third consecutive day (retention). Results: As shown previously, the Sham group demonstrated enhanced proprioceptive sensitivity after training and at retention. The S1 group had impaired proprioceptive function at retention through online changes during practice, whereas the CB group demonstrated offline decrements in proprioceptive function. All groups demonstrated motor skill learning, however, the magnitude of learning differed between the CB and Sham groups, consistent with a role for the cerebellum in motor learning. Conclusion: Overall, these findings suggest that the cerebellum and S1 are important for distinct aspects of proprioceptive changes during skill learning. Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.08.04.235481v1?rss=1 Authors: Qi, C., Chen, X., Gao, X., Xu, J., Liu, S., Ge, J. Abstract: Background: Alzheimer's disease (AD) is a neurodegenerative disease characterized by progressive cognitive decline, psychiatric symptoms and behavioral disorders, resulting in disability and loss of self-sufficiency. Objective: To establish an AD mice model, investigate the behavioral performance, and explore the potential mechanism. Methods: Streptozotocin (STZ, 3 mg/kg) was microinjected bilaterally into the dorsal hippocampus of C57BL /6 mice to establish the AD model. Behavioral changes (anhedonia and despair, balance and motor coordination, locomotion, and learning and memory) were examined and the serum concentrations of insulin and nesfatin-1 were measured by ELISA. The activation of hippocampal microglia was assessed by immunohistochemistry and the protein expression of several molecular associated with the regulation of synaptic plasticity in the hippocampus and the prefrontal cortex (PFC) was detected via western blotting. Results: The STZ model mice showed a slower bodyweight gain and higher serum concentrations of insulin and nesfatin-1. Although there was no significant difference between groups with regard to the ability of balance and motor coordination, the model mice presented a decline of spontaneous movement and exploratory behavior, together with an impairment of learning and memory ability. Increased activated microglia was aggregated in the hippocampal dentate gyrus of model mice. Moreover, the protein expression of NMDAR2A, NMDAR2B, SynGAP, PSD95, BDNF, and p-{beta}-catenin/{beta}-catenin were remarkably decreased in the hippocampus and the PFC of model mice, and the expression of p-GSK-3{beta} (ser9)/GSK-3{beta} were reduced in the hippocampus. Conclusion: A bilateral hippocampal microinjection of STZ could successfully duplicate an AD mice model, as indicated by the impaired learning and memory and the alternated synaptic plasticity, together with the hyperactive inflammatory response in the hippocampus and the imbalanced abundance of serum insulin and nesfatin-1. Apart from these, the mechanism might be associated with the imbalanced expression of the key proteins of Wnt signaling pathway in the hippocampus and the PFC. Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.07.08.193359v1?rss=1 Authors: Adriane Guillaumin [Msc], Gian Pietro Serra [PhD], François Georges [PhD], Åsa Wallén-Mackenzie [PhD] Abstract: Background The subthalamic nucleus (STN) is a major regulator of intended movements. The STN is controlled by both excitatory and inhibitory inputs. Dysregulation of the STN contributes to motor deficiency in Parkinson's disease (PD). Both STN-lesioning and high-frequency electrical stimulation of the STN improve motor symptoms in PD.However, despite a pivotal clinical target, the natural role of the STN in motor regulation has remained elusive. In fact, controlled excitatory or inhibitory manipulations have been poorly explored. By controlled regulation, new functional knowledge of the STN can be reached.Objective To uncover the role of the STN in several aspects of motor function during non-pathological conditions.Methods The Pitx2-Cre mouse model has been described as a transgenic tool to direct genetic targeting events to the STN. Here, Pitx2-Cre mice were used to direct optogenetic excitation and inhibition to the STN. The impact of each type of stimulation on motor output was recorded and compared.Results Optogenetic excitation of the STN triggered action potentials in a key component of the basal ganglia. Optogenetic excitation of the STN in the freely-moving animal reduced vertical and horizontal movement, induced immediate grooming and caused loss of motor coordination. In contrast, optogenetic inhibition increased general locomotion and reduced natural grooming. Opposite rotations were observed upon unilateral excitation and inhibition of the STN.Conclusions Optogenetic excitation and inhibition of the STN give rise to opposite motor responses in several parameters relevant to voluntary motor control that are commonly disturbed in PD.Competing Interest StatementThe authors have declared no competing interest.View Full Text Copy rights belong to original authors. Visit the link for more info

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.05.13.094235v1?rss=1 Authors: Amaral, M. S. A. d., Zamberlan-Amorin, N. E., Mendes, K. D. S., Bernal, S. C., Massuda, E. T., Hyppolito, M. A., Reis, A. C. M. B. Abstract: Introduction: P300 auditory evoked potential is evoked by a long latency auditory stimulus, which provides information on neural mechanisms underlying central auditory processing, considered an objective and non-invasive technique to study the auditory central nervous system. Objective: To identify and gather scientific evidence regarding the P3 component in adult cochlear implant users. Methods: Scoping review of scientific literature, in the search of original articles in Portuguese, Spanish and English, published between 1991 and May 2018, in the following database websites: PubMed / Medline, Embase, LILACS and Web of Science. Results: A total of 87 articles were identified and exported to the search software Rayyan for study selection - 58 were from Embase, 26 from PubMed and 3 from Web of Science. There were no articles found on LILACS. From those 87 articles, 16 were excluded for being duplicated. Then 71 articles were selected for title, authors, yeas and abstract scanning, from which 50 articles were excluded. From the 21 final articles for full reading, one was excluded for not performing P300, leaving us with 20 selected articles. Conclusion: This review has contributed with evidence that indicates how important it is to include speech stimulation when measuring P300. Regardless of the stimulus being used for P300 elicitation, a pattern of results can be seen a higher latency and a lower amplitude in CI users. Copy rights belong to original authors. Visit the link for more info

This article can be reviewed for FREE on reseachgate.net at https://tinyurl.com/trzw6rj. Check out my typed summary of this episode at otovets.com/cuttingedge.  This summary is best viewed in a browser but is mobile friendly as well. Efficacy of repeatedly used CIDR device in cattle reproduction: a metaanalysis review of progesterone concentration and conception rate Published by Muhammad Furqan Asghar CHACHER, Armağan ÇOLAK, Armağan HAYIRLI Hypothesis: Considerable residual P4 concentration exists in used CIDR (U-CIDR) devices and the achieved blood P4 concentration on days 14–15 after insertion suggests that CIDR devices can be reused upon disinfection in order to minimize the cost of using such a device. Objective: To withdraw conclusions from the available literature regarding P4 concentrations in devices and animals as well as conception rate (CR) responses in cases of multiple U-CIDR devices subjected to various disinfection methods in cattle. Location:  Department of Obstetrics and Gynecology and Department of Animal Nutrition and Nutritional Disorders at Ataturk University Turkey. Methods: Two datasets were compiled from 8 and 7 research articles involving 3434 (2653 heifers + 771 lactating cows + 10 ovariectomized cows) and 7301 cattle (3879 heifers + 3422 lactating cows) to evaluate blood P4 concentration and conception rate, respectively, in response to repeatedly used CIDR devices after sanitization via autoclaving and disinfection. Outcomes: As the number of CIDR usages increased, blood P4 concentration decreased linearly (y = –0.484X + 3.135, R2 = 0.99, P < 0.001). Blood P4 concentration (1.52 vs. 2.20 ng/mL; P < 0.002) and conception rate (40.76 vs. 32.96%, P < 0.05) for lactating cows were lower than those for heifers. The sanitization method did not affect blood P4 concentration, but reused CIDR device subjected to disinfection was associated with reduced conception rate. In summary, depending upon the initial P4 load (1.38–1.90 g), the CIDR device could be used twice in lactating cows and four times in heifers after autoclaving to achieve target blood P4 concentrations.

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Hi everyone, With this episode of BFR Radio I was inspired by a recent post from a colleague who started to use a combination modality of BFR and Electrostimulation (EMS) for an athlete who was going through post ACL surgery rehab. Traditionally EMS requires a high level of intensity for it to be effective which is problematic for those who are in the acute postoperative stage. This is where the authors thought that the combination of BFR with a lower level of EMS may prove to be useful. Before you head off and listen to the podcast, a few exciting updates: This week I am at the ASCA annual conference on the Gold Coast. I will have my Sports Rehab Tourniquets there to try and I am also debuting a new strength machine that I have developed. To date I haven't not seen this machine before so potentially a world debut. I am running a Brisbane BFR workshop on Saturday 23 November. Tickets can be purchased online only through eventbrite. There are lots of links through my social media and blog post. Click on this link to purchase your ticket  Click on this link to purchase your Brisbane BFR Workshop Ticket (direct link to Eventbrite page) Hope you enjoy the podcast.   The Effects of Blood Flow Restricted Electrostimulation on Strength and Hypertrophy. Slysz JT, Burr JF. J Sport Rehabil. 2018 May 1;27(3):257-262. doi: 10.1123/jsr.2017-0002. Epub 2018 May 22. Abstract CONTEXT: The combined effect of neuromuscular electrical stimulation (NMES) and blood flow restriction (BFR) on muscle mass and strength has not been thoroughly investigated. OBJECTIVE: To examine the effects of combined and independent BFR and a low-intensity NMES on skeletal muscle adaptation.   MAIN OUTCOME MEASURES: Subjects had each leg randomly allocated to 1 of 4 possible intervention groups: (1) cyclic BFR alone, (2) NMES alone, (3) BFR + NMES, or (4) control. Each leg was stimulated in its respective intervention group for 32 minutes, 4 days per week for 6 weeks. Mean differences in size (in grams) and isometric strength (in kilograms), between week 0 and week 6, were calculated for each group.    

Background: During the reproductive age, the human brain becomes a target for gonadal steroid hormones. Estrogens influence neural function through effects on neurons and affects indirectly the oxidative stress, inflammation, the cerebral vascular and the immune system. Objective: To evaluate the effect of the traditional hormone replacement therapy (HRT) on the cognitive function in postmenopausal women. Materials and Methods: In this randomized clinical trial, 140 postmenopausal women, from November 2014 to February 2015, were included. Women were randomly divided into two groups. Each woman in the case group took traditional HRT (0.625mg conjugated equine estrogens+2.5mg medroxyprogesterone acetate daily) plus one Cal+D tablet (500 mg calcium+200 IU vitamin D) daily for four months. Women in the control group received only one Cal+D tablet (500 mg calcium+200 IU vitamin D) daily for four months period. The Montreal Cognitive Assessment (MoCA) and Green Climacteric Scale (GCS) questionnaires filled out after the intervention and compared between the two groups. Results: The mean points of the MoCA after the intervention indicate that all MoCA domains except for the orientation improved in the case group. There was a significant difference in the memory domain after the treatment between the two groups. MoCA domains and GCS were negatively correlated after the intervention (r=−0.235,p=0.006). Conclusion: The HRT has affected some of the MoCA factors. The effects of HRT on cognitive function should be studied in a large prospective study in a group of women in their early and late menopausal ages with periodic assessment of their cognitive function during these follow-up years. Moradi F, Jahanian Sadatmahalleh S, Ziaei S. The effect of hormone replacement therapy on cognitive function in postmenopausal women: An RCT. Int J Reprod Biomed (Yazd). 2019;16(12):ijrm.v16i12.3682. Published 2019 Jan 28. doi:10.18502/ijrm.v16i12.3682. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Sections of Abstract, Introduction, Materials and Methods, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600282/

Background: In order to improve interventions for problem gambling, there is a need for studies that can highlight psychological factors that support the desire to reduce gambling. Objective: To explore online problem gamblers' motivation for change by studying participants' reactions to an online treatment referral website designed to motivate at-risk gamblers to seek help. Design: A qualitative evaluation study, combining focus groups and in-depth interviews. Data were analyzed using the general inductive approach. Informants: The informants included 19 male, treatment- and non-treatment seeking, online gamblers who played a variety of games, including poker, sports betting and online casino. Results: Motivation to change emerged as two processes including (a) empathy with others, which included projection of their thoughts and feelings onto others, and (b) dissonance between gambling behavior and ideal self-image. Dissonance included two subthemes: (i) dissonance due to positive feelings towards sports and athletics, and (ii) dissonance due to gambling among family. Conclusions: The findings have implications for interventions designed to evoke motivation early in treatment of online problem gambling. Inducing problem gamblers to reflect on the thoughts and feelings of concerned significant others, real or fictional, could be a viable strategy to motivate online problem gamblers to consider change. Johansen AB, Helland PF, Wennesland DK, Henden E, Brendryen H. Exploring online problem gamblers' motivation to change. Addict Behav Rep. 2019;10:100187. Published 2019 Jun 17. doi:10.1016/j.abrep.2019.100187 This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597935/