Early Recovery Phase Research Articles

Increasing temperature threatens post‐fire auto‐successional dynamics of a Mediterranean obligate seeder

Abstract Reproductive traits influence plant auto‐successional dynamics in post‐fire regeneration. Obligate seeding species rely on their seedbank and on the climatic conditions following the fire to ensure a successful recovery, defining the window of opportunity for seedling emergence. In the Mediterranean basin, emergence opportunities generally begin with autumnal rains. However, climate change‐induced increases in temperature and drought could jeopardise the regeneration capacity of seeding species by causing temporal shifts in emergence opportunities or by modifying wildfire seasonality. This study aimed to explore the impact of experimentally induced climate change on regeneration dynamics of Aleppo pine (Pinus halepensis), a serotinous Mediterranean obligate seeder. In March 2021, we set up an 18‐month climate change simulation experiment with 15 open‐top chambers (OTC), each paired with a control subplot (CON) on top of Aleppo pines that were naturally regenerating after a stand‐replacing wildfire in SW Catalonia (June 2019). We tagged 178 young Aleppo pine recruits in OTC and CON subplots (98 and 81 respectively), classified according to their initial size, to periodically measure height growth and survival throughout the experiment duration. Furthermore, Aleppo pine seeds were seasonally sown (7900 total seeds) in 10 subplot pairs between May 2021 and April 2022, to monthly monitor temporal patterns of seedling emergence and survival. We found that OTCs reduced overall emergence rates and caused the loss of the autumnal window of opportunity for the emergence of Aleppo pine seedlings. Furthermore, seedlings which emerged within OTCs faced higher mortality rates in all seasons, with only 1% of seedlings surviving compared with 21.1% of seedlings in control plots. The OTC‐induced conditions were also detrimental to the survival of recruited seedlings, especially those with a smaller initial size, although no significant effects of temperature increase were found on growth. Synthesis. Climate change is likely to interfere with the post‐fire regeneration dynamics of obligate seeders by shortening the temporal window of opportunities for emergence and by enhancing the bottleneck effects throughout the recruitment process in the early phases of pine demographic recovery. Altogether, it could threaten post‐fire regeneration by increasing the hazard of a demographic collapse of Aleppo pine.

Overcoming Exercise Barriers In The Early Recovery Phase Among Breast Cancer Patients

Overcoming Exercise Barriers In The Early Recovery Phase Among Breast Cancer Patients

Acute nicotine exposure attenuates neurological deficits, ischemic injury and brain inflammatory responses and restores hippocampal long-term potentiation in ischemic stroke followed by lipopolysaccharide-induced sepsis-like state

Ischemic stroke is followed by an increased susceptibility to bacterial infections, which exacerbate histological stroke outcome, neurological deficits and memory impairment due to increased neuroinflammation and neurotransmitter dysfunction. Pharmacological activation of nicotinic acetylcholine receptors was suggested to mitigate brain inflammatory responses in ischemic stroke. The functional responses associated with nicotinic acetylcholine receptor activation were unknown. In this study, male NMRI mice subjected to transient intraluminal middle cerebral artery occlusion (MCAO) were intraperitoneally exposed to vehicle treatment or Escherichia coli lipopolysaccharide (LPS; 4 mg/kg)-induced sepsis-like state 24 h post-MCAO, followed by intraperitoneal administration of vehicle or nicotine (0.5 mg/kg) 30 min later. Over 96 h, rectal temperature, neurological deficits, spontaneous locomotor activity, working memory, ischemic injury, synaptic plasticity, and brain inflammatory responses were evaluated by temperature measurement, behavioral analysis, infarct volumetry, electrophysiological recordings, and polymerase-chain reaction analysis. LPS-induced sepsis induced hypothermia, increased general and focal neurological deficits, reduced spontaneous exploration behavior, reduced working memory, and increased infarct volume post-MCAO. Additional treatment with nicotine attenuated LPS-induced hypothermia, reduced neurological deficits, restored exploration behavior, restored working memory, and reduced infarct volume. Local field potential recordings revealed that LPS-induced sepsis decreased long-term potentiation (LTP) in the dentate gyrus post-MCAO, whereas concomitant nicotine exposure restored LTP in the contralateral dentate gyrus. LPS-induced sepsis increased microglial/ macrophage Iba-1 mRNA and astrocytic GFAP mRNA levels post-MCAO, whereas add-on nicotine treatment reduced astrocytic GFAP mRNA. Taken together, these findings indicate that acute nicotine exposure enhances functional stroke recovery. Future studies will have to evaluate the effects of (1) chronic nicotine exposure, a clinically relevant vascular risk factor, and (2) the cessation of nicotine exposure, which is widely recommended post-stroke, but might have detrimental effects in the early stroke recovery phase.

616. POST-ESOPHAGECTOMY REHABILITATION IS ASSOCIATED WITH EARLY IMPROVEMENTS IN PHYSICAL FITNESS AND SARCOPENIA: PRELIMINARY RESULTS FROM THE FITNESS AFTER OESOPHAGECTOMY (FARO) TRIAL

Abstract Introduction Curative treatment of gastro-esophageal cancer encompasses surgery and peri-operative chemo(radio)therapy. Advancements in oncological treatment and surgical techniques have resulted in incremental prognostic gains with increasing focus on survivorship and optimising quality of life (QoL). Despite enhanced recovery pathways, patients receive no assistance to improve physical functioning and QoL in the post-esophagectomy recovery period. Post-operative rehabilitation has demonstrated improvement in physical fitness and psychosocial wellbeing among other cancer subtypes. The aim of this study was to determine the impact of a patient-directed, home-based rehabilitation programme upon physical functioning in the early recovery phase following an esophagectomy. Methods The Fitness AfteR Oesophagectomy (FARO) study was a prospective, single-centre, parallel-group, open-label, two-arm, pragmatic randomised controlled external pilot trial. Patients were randomised to receive post-operative rehabilitation (alongside routine care- REHAB) or standard clinical care (NO-REHAB) alone in a 1:1 ratio. The rehabilitation intervention encompassed a 12-week home-based programme with weekly step-count targets, completion of resistance exercises and dietary monitoring. Cardiorespiratory fitness was determined by the 6-minute walk test (6MWT) and the functional impact of sarcopenia was assessed by the hand-grip strength (HGS). Outcomes were measured at baseline and 6 weeks post-esophagectomy. Between-group differences were analysed using linear mixed effects models. Results A total of 60 patients were included and randomised to REHAB (n=31) or NO-REHAB (n=29). A total of 29 patients in the REHAB group (93.5%) completed the rehabilitation programme with a 100% adherence rate. At 6 weeks post-esophagectomy, there was statistically significant improvements in the functional impact of sarcopenia as denoted by improvements in HGS in REHAB versus the NO-REHAB cohorts (mean difference= 4.237; 95% c.i 0.80-7.70; p=0.017). Cardiopulmonary fitness, as determined by the 6MWT, was comparable between cohorts with no statistically significant intergroup differences at 6 weeks (mean difference= 62.008; 95% c.i -5.85-129.91; p=0.073). Conclusion Post-operative rehabilitative interventions result in improvements in physical functioning in the early recovery phase following an esophagectomy. Further analysis from the FARO trial will determine if rehabilitation restores and improves QoL and recovery of cardiopulmonary fitness into survivorship.

Recovery of Visuospatial Neglect With Standard Treatment: A Systematic Review and Meta-Analysis.

Visuospatial neglect is a common consequence of stroke and is characterized by impaired attention to contralesional space. Currently, the extent and time course of recovery from neglect are not clearly established. This systematic review and meta-analysis aimed to determine the recovery trajectory of poststroke neglect with standard treatment. PsycInfo, Embase, and MEDLINE were searched for articles reporting recovery rates of neglect after stroke. Time since stroke was categorized into early (0-3 months), mid (3-6 months), and late (>6 months) recovery phases. Random-effects models for pooled prevalence were generated for each phase, and potential sources of heterogeneity were explored with metaregressions. Methodological quality of each study was assessed using the Joanna Briggs Institute checklist, with low-quality studies excluded in sensitivity analyses. The search captured 4130 articles including duplicates, and 111 full-text reviews were undertaken. A total of 27 studies reporting data from 839 stroke survivors with neglect were included for review. Meta-analyses indicated a recovery rate of 42% in the early phase, which increased to 53% in the mid-recovery phase. Additional recovery in the late phase was minimal, with an estimated 56% recovery rate. Heterogeneity of studies was high (I2>75%) in all 3 phases of recovery. Estimates were robust to sensitivity analyses. Metaregressions showed significantly greater recovery in studies that included patients with left-hemisphere lesions (β=0.275, P<0.05, I2=84%). Most recovery from neglect occurs in the first 3 months, although additional gains can be expected up to 6 months poststroke. While a large proportion of patients recover from neglect, over 40% show persistent symptoms. Further research is needed on effective rehabilitation interventions, particularly focusing on patients most at risk of chronic visuospatial neglect. URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42023388763.

Correlation between glymphatic dysfunction and cranial defect in severe traumatic brain injury: a retrospective case-control study based on a diffusion tensor image analysis along the perivascular space (DTI-ALPS) investigation.

To date, limited research has been conducted on the functionality of the glymphatic system during the recovery phase of severe traumatic brain injury (sTBI). This study aimed to use a diffusion tensor image analysis along the perivascular space (DTI-ALPS) to evaluate glymphatic system function in patients recovering from sTBI who underwent unilateral decompressive craniectomy, and to examine the correlation between the ALPS index and the size of the cranial defect. We hypothesized that assessments would reveal ongoing impairments in glymphatic system function among sTBI patients during the recovery phase. A total of 23 patients with a history of sTBI who had previously undergone unilateral decompressive craniectomy at Xiangya Hospital of Central South University from January 2020 to December 2020 were enrolled in the study, along with 33 healthy control (HC) subjects. All the subjects underwent magnetic resonance imaging (MRI) with DTI scans, and the ALPS index was subsequently calculated to assess glymphatic system functionality. Additionally, the circumference and sectional area of the cranial defect were measured for each patient. An analysis of variance (ANOVA) was used to compare the ALPS index values between the sTBI patients and HC subjects, while a Pearson correlation analysis was used to examine the correlation between the ALPS index and cranial defect characteristics. The ALPS index values of both the craniectomy side (t=-9.08, P<0.001) and non-craniectomy side (t=-5.06, P<0.001) of the sTBI group were significantly lower than those of the HC group. However, no statistically significant differences were observed between the ALPS index values of the craniectomy and non-craniectomy sides. Additionally, no significant differences were observed in the ALPS index values of both the craniectomy and non-craniectomy sides among the early, intermediate, and late recovery phases. In the sTBI patients, a moderately strong negative correlation was found between the circumference of the cranial defect and the ALPS index of the craniectomy side (r=-0.62, P=0.002), and a moderately negative correlation was found between the sectional area of the cranial defect and the ALPS index of the craniectomy side (r=-0.56, P=0.005). The non-invasive DTI-ALPS technique revealed significantly reduced ALPS index values during the recovery phase of sTBI, indicating persistent impairment in glymphatic system function. A significant negative correlation was found between the ALPS index value of the craniectomy side and the size of the cranial defect. These findings suggest that the ALPS index may serve as a valuable prognostic factor in the recovery phase of sTBI.

East–West Difference in the Ionospheric Response During the Recovery Phase of May 2024 Super Geomagnetic Storm Over the East Asian

AbstractIn this study, we offer an extensive examination of the F‐region ionospheric disturbances during the May 2024 superstorm, focusing primarily on the middle‐low latitude regions of East Asia. Our analysis is grounded in a wealth of data sources including Total Electron Content (TEC), ionospheric parameters NmF2 and hmF2, Electron Density Profile (EDP) retrieved from Radio Occultation (RO) data, and ∑[O]/[N2] from the Global Ultraviolet Imager (GUVI), among others, complemented by model simulations. The observed negative ionospheric storm effect, characterized by a significant and long‐lasting reduction in electron density across the entire China, commenced immediately following the sudden storm commencement (SSC) on 10 May and continued through the main and early recovery phase of the storm on 11 May. On 11–12 May, positive ionospheric storm impacts were initially observed in a restricted geographical area from the post‐midnight to sunrise, first manifesting over the eastern regions of China and then shifting to the central regions. Subsequently, a pronounced negative storm effect persisted throughout the later stages of recovery phase. In contrast, the western regions of China experienced a positive storm effect on 12 May followed by a comparatively mild negative storm phase. This persistent extensive zonal gradient in electron density across the East Asian region resembles the scenarios depicted in prior superstorms attributed to the thermospheric circulation patterns. The disparity in the ionospheric response from east to west in this area is probably a common feature during superstorms, potentially resulting from an arch‐shaped structure of elevated ∑[O]/[N2].

Quantifying the Spatiotemporal Evolution of Radiation Belt Electrons Scattered by Lower Band Chorus Waves: An Integrated Model

AbstractWave particle interactions are very important to understand the intricate evolution of the Earth's radiation belt electrons. Kinetic simulations, in terms of solving the Fokker‐Planck equation based on the quasilinear theory, are usually used to simulate the radiation belt electron dynamic evolution. However, the global wave and plasma density distributions adopted in the kinetic simulations are very difficult to be directly obtained by satellites. Here we present a new model, by integrating the machine learning technique and kinetic simulations, to analyze the spatiotemporal evolution of radiation belt electrons scattered by lower band chorus (LBC). Compared to the observations, our integrated model produces effectively the global distribution of plasmapause location, plasma density, and LBC intensity, and assesses quantitatively the scattering effect driven by LBC waves at different magnetic local times (MLT), L‐shell (the Mcllwain L‐parameter), and time. Incorporating the effect of radiation electron drift, we further use the 2‐D Fokker‐Planck equation to simulate the variations of electron phase space density in different MLT sectors at a fixed L, and find that the integrated model replicates reasonably the multi‐MeV electron acceleration at L = 4.5 during the period from the main phase to the early recovery phase of the storm. Our results demonstrate that such an integrated model, on basis of a combination of the machine learning technique and kinetic simulations, provides valuable means for improved understanding of the global dynamic evolution of the Earth's radiation belt electrons.

Endovascular Embolization and Atorvastatin Therapy for Recurrent Chronic Subdural Hematoma.

Recurrent chronic subdural hematoma poses a significant clinical challenge. While craniotomy effectively removes the hematoma membrane, it is an invasive procedure associated with significant trauma. Recently, endovascular embolization of the middle meningeal artery has emerged as a promising minimally invasive alternative, demonstrating efficacy and a low recurrence rate in treating chronic subdural hematoma. Furthermore, postoperative administration of oral atorvastatin calcium may enhance hematoma absorption, thereby improving patient outcomes during the early recovery phase.

Effects of aging of radioactive fallout on timely decontamination of concrete using low and mild pressure washing

Timely decontamination will reduce the consequences of a radiological contamination event. For this purpose, pressure washing can be rapidly deployed, but its effectiveness will change if the interactions between the surface and radionuclides changes as the contamination “ages” under the influence of time and precipitation. While effects of this aging have been reported for dissolved cesium, they have not been studied for radionuclides present as particulate, e.g., fallout. This work studied the effects of aging on decontamination with low (<280 kPa/40 psi) and mild (14,000 kPa/2000 psi) pressure washing, on concrete contaminated with surrogate fallout consisting of soluble Cs-137, 0.5 μm silica particles, and 2 μm silica particles. The samples were aged up to 59 days (time between contamination and decontamination) with and without simulated precipitation. The percent removal following decontamination of the soluble cesium decreased over the first ten days of aging until the removals were less than 10 % for both low and mild pressure washing. The particle decontamination was independent of aging time but decontaminating via mild pressure washing (>80 % particle removal) significantly outperformed decontaminating by low pressure washing by flowing solution across (parallel to) the contaminated surface (<25 % particle removal). The observed changes in decontamination efficacy are explained via measurements of the penetration depth of contaminants. For soluble cesium, the results compared favorably with prior studies and theoretical treatment of cesium penetration, and they yielded additional insight into the effect of washing pressures on decontamination. There are no comparable studies for particulate contamination, so this study resulted in several novel observations which are operationally important for timely decontamination of surfaces following a radiological incident. It also suggests an evidence-based pressure washing procedure for timely decontamination of soluble and insoluble radionuclides which can be used throughout the emergency phase and into the early recovery phase.

Variability of ionospheric ionization over Eurasia according to data from a high-latitude ionosonde chain during extreme magnetic storms in 2015

. We have examined longitudinal-temporal variations in ionospheric parameters over Eurasia by analyzing data from a chain of high-latitude ionosondes along a latitude circle ~70° N (geomagnetic latitudes 58°&lt;Glat&lt;65°) in the longitudinal sector 26–171° E during severe magnetic storms of solar cycle 24 in March and June 2015. To analyze the response of ionospheric ionization to geomagnetic disturbances, we have used ionosonde data on hourly average critical frequency foF2 of the ionospheric F2 layer. Strong differences were observed between common peculiarities of temporal variations in foF2 for the analyzed periods of magnetic storms, which are likely associated with the characteristic features of the seasonal and diurnal variations in the background high-latitude ionosphere of the given geographic region. During the main and early recovery phases of magnetic storms there were periods of blackouts of ionosonde radio signals. Differences in the character of the ionospheric response to geomagnetic disturbances have been noted. This is probably due to seasonal features of the probability of occurrence of the ionospheric storm positive or negative phase in different seasons of the year. The trends of increasing ionospheric ionization over the vast region of Eastern, Western Siberia and Europe after the end of the extreme magnetic storm in March 2015, according to measurements from the chain of high-latitude ionosondes, may be associated with the formation of an area of increased [O]/[N₂] ratio over this territory. Such an increase in ionospheric ionization exceeding the background level of foF2 values can be considered as a clear manifestation of the after-effect of magnetic storms.

Изменчивость ионизации ионосферы над Евразией по данным цепи высокоширотных ионозондов во время экстремальных магнитных бурь 2015 г.

. We have examined longitudinal-temporal variations in ionospheric parameters over Eurasia by analyzing data from a chain of high-latitude ionosondes along a latitude circle ~70° N (geomagnetic latitudes 58°&lt;Glat&lt;65°) in the longitudinal sector 26–171° E during severe magnetic storms of solar cycle 24 in March and June 2015. To analyze the response of ionospheric ionization to geomagnetic disturbances, we have used ionosonde data on hourly average critical frequency foF2 of the ionospheric F2 layer. Strong differences were observed between common peculiarities of temporal variations in foF2 for the analyzed periods of magnetic storms, which are likely associated with the characteristic features of the seasonal and diurnal variations in the background high-latitude ionosphere of the given geographic region. During the main and early recovery phases of magnetic storms there were periods of blackouts of ionosonde radio signals. Differences in the character of the ionospheric response to geomagnetic disturbances have been noted. This is probably due to seasonal features of the probability of occurrence of the ionospheric storm positive or negative phase in different seasons of the year. The trends of increasing ionospheric ionization over the vast region of Eastern, Western Siberia and Europe after the end of the extreme magnetic storm in March 2015, according to measurements from the chain of high-latitude ionosondes, may be associated with the formation of an area of increased [O]/[N₂] ratio over this territory. Such an increase in ionospheric ionization exceeding the background level of foF2 values can be considered as a clear manifestation of the after-effect of magnetic storms.

QOL-08. THE LONG-TERM UTILITY OF METHYLPHENIDATE FOR THE PRESERVATION OF INTELLECTUAL DEVELOPMENT IN CHILDHOOD SURVIVORS OF BRAIN TUMOUR

Abstract BACKGROUND Enduring neurocognitive late effects are a common consequence of childhood brain tumour survivorship. Conceptual modelling of intelligence suggests initial deficits to processing speed and attention lead to the subsequent plateauing of intellectual and academic development. The utility of methylphenidate in improving attentional and processing speed deficits within the early phase of recovery has been previously reported. The longer-term contribution of methylphenidate in preserving intellectual ability through ameliorating these early deficits is yet to be evaluated. METHODS Twenty-nine childhood survivors were matched retrospectively with a no-treatment synthetic control. Intellectual assessments were conducted prior to starting methylphenidate and a minimum of 12 months thereafter. For the no-treatment control group, intellectual data were collected retrospectively from archival records, employing a similar assessment period. Linear Mixed Models were used to assess the influence of methylphenidate on intellectual trajectories between groups and fatigue scores over time. RESULTS Methylphenidate was associated with raw score improvements across all intellectual indices compared to no-treatment controls. Linear Mixed Modelling reported a borderline significant improvement in Processing Speed (t = 1.98, p =.05) for the methylphenidate group. In comparison, a borderline significant (p =.05) within-group decrease in Working Memory scores was reported for the no-treatment group. There was a significant within-group decrease in pooled PedsQL MFS scores between assessments for the treatment group (t = -4.01, p &amp;lt;.01), with the most notable decrease observed in Sleep/Rest Fatigue (t = -10.17, p &amp;lt;.01). CONCLUSIONS Methylphenidate may pose a valuable long-term rehabilitative strategy in preserving Processing Speed in childhood survivors of brain tumour. Whilst our sample size is small, there is tentative evidence for the utility of methylphenidate in alleviating fatigue experienced by childhood survivors.

The use of honey in the perioperative care of tonsillectomy patients-A narrative review.

Tonsillectomy is one of the most common surgical procedures in childhood. While generally safe, it often is associated with a difficult early recovery phase with poor oral intake, dehydration, difficult or painful swallowing, postoperative bleeding, infection and/or otalgia. Better pain management and the availability of more child friendly medications are within the top consumer priorities in perioperative medicine, highlighting the importance of alternative pain treatments. This review focuses on the potential role of honey in the postoperative setting, its effects, and mechanisms of action. While the application of honey post-tonsillectomy may offer analgesic and healing benefits, it may also reduce postoperative bleeding. A systematic search was carried out using the search terms honey, tonsillectomy. Filters were applied to human studies and English. No other search terms were used or age filters applied to yield a broader range of results. Seven pediatric, four adult, and two studies of mixed pediatric and adult patients with sample sizes ranging from 8 to 52 patients were included in this review. Effect sizes ranged from small to huge across the studies. While the application of honey post-tonsillectomy may offer analgesic and healing benefits, it may also reduce postoperative bleeding. However, while there are potential benefits based on the chemical composition of honey, the current literature is of variable quality and there is need for high quality clinical trials.

New findings on retinal microvascular changes in patients with primary COVID-19 infection: a longitudinal study.

To investigate the longitudinal alterations of retinal microvasculature in patients with primary coronavirus disease 2019 (COVID-19) infection. A cohort of participants, who had never been infected with COVID-19, was recruited between December 2022 and May 2023 at Peking Union Medical College Hospital in Beijing, China. Participants underwent comprehensive ophthalmologic examinations and fundus imaging, which included color fundus photography, autofluorescence photography, swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography (SS-OCTA). If participants were infected with COVID-19 during the study, follow-ups with consistent imaging modality were conducted within one week and two months after recovery from the infection. 31 patients (61 eyes), with a mean age of 31.0 ± 7.2 years old, were eligible for this study. All participants contracted mild COVID-19 infection within one month of baseline data collection. The average period was 10.9 ± 2.0 days post-infection for the first follow-up and 61.0 ± 3.5 days for the second follow-up. No clinical retinal microvasculopathy features were observed during the follow-ups. However, SS-OCTA analysis showed a significant increase in macular vessel density (MVD) from 60.76 ± 2.88% at baseline to 61.59 ± 3.72%(p=0.015) at the first follow-up, which subsequently returned to the baseline level of 60.23 ± 3.33% (p=0.162) at the two-month follow-up. The foveal avascular zone (FAZ) remained stable during the follow-ups with areas of 0.339 ± 0.097mm2, 0.342 ± 0.093mm2, and 0.344 ± 0.098mm2 at the baseline, first follow-up (p=0.09) and second follow-up (p=0.052), respectively. Central macular thickness, cube volume and ganglion cell-inner plexiform layer showed a transient decrease at the first follow-up(p<0.001, p=0.039, p=0.002, respectively), and increased to baseline level at the two-month follow-up(p=0.401, p=0.368, p=0.438, respectively). Mild COVID-19 infection may temporarily and reversibly impact retinal microvasculature, characterized by a transient increase in retinal blood flow during the early recovery phase, which returns to the pre-infection level two months post-infection.

Ice cooling challenge as a means to probe skin microvascular function

Skin microvasculature provides a window to study both systemic and local physiology. In vascular medicine, various challengers such reactive hyperemia, hypoxia or hyperoxia, and heat, have been used to study function and search for potential clinical biomarkers. A positive relationship between increased skin temperature and skin perfusion has been suggested, but skin cooling as a challenger has not been well explored. In the present study, the adaptive cardiovascular and hemodynamic impacts of single hand cooling were examined in a group of ten healthy women, 27.3±7.9 years old, of normal body mass index and ankle-brachial index, normotensive, non-smoking, and free from any medication and supplements. The study followed all principles of good clinical practice and ethics commission approval. After complete stabilization, a participant’s palm, randomly chosen, was placed in contact with a frozen surface covered by a plasticized cotton cloth. Blood perfusion was measured using a laser Doppler flowmetry (LDF) instrument, and temperature were continuously registered in both hands, before, during, and after (early and late recovery) the ice cooling challenge. Nominal values for blood perfusion and temperature were considered, as well as their wavelet transform (WT) components, translating endothelial [0.0095; 0.021] Hz, autonomic [0.021; 0.052] Hz, myogenic [0.052; 0.015] Hz, respiratory [0.15; 0.6] Hz, and cardiac [0.6; 2] Hz activities. No significant differences were observed between limbs regarding nominal LDF values for each experimental phase. Nonetheless, significant differences were observed for nominal temperature signals between limbs during the challenge (Wilcoxon’s signed rank test; p=0.047), and for early (p=0.028) and late (p=0.028) recovery phases. Significant differences were observed for ipsi- and contralateral LDF signals (Friedmann’s test, p&lt;0.001, and p=0.012, respectively), and also for ipsi- and contralateral temperature signals (Friedmann’s test, p&lt;0.001, and p=0.004, respectively). These contralateral responses have been previously described with other challengers applied only in the ipsilateral limb, whilst it is known that local cooling stimulates cutaneous thermoreceptors, sympathetic nerve activity and cutaneous vascular resistance. However, our findings also show that temperature may be more sensitive than LDF for studying the ice cooling challenge, and that the WT analysis approach can provide potential physiological interpretations. Nonetheless, a strong positive correlation (Spearman’s rs = 0.820, p&lt;0.001) was observed between temperature and LDF signals overall for both limbs. In conclusion, this preliminary study suggests that this cooling challenger is effective to elicit vascular physiological changes in both limbs, indicating a putative centrally-mediated adaptive process that might be quantified by changes in cardiac and respiratory activities, as shown from WT analysis. Additionally, temperature signals and the use of WT analysis seem to provide more sensitive and explanatory insights than the use of LDF signals and nominal values alone. Suported by COFAC/ALIES. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Effects of Low-Level Light Therapy on Resting-State Connectivity Following Moderate Traumatic Brain Injury: Secondary Analyses of a Double-blinded Placebo-controlled Study.

Background Low-level light therapy (LLLT) has been shown to modulate recovery in patients with traumatic brain injury (TBI). However, the impact of LLLT on the functional connectivity of the brain when at rest has not been well studied. Purpose To use functional MRI to assess the effect of LLLT on whole-brain resting-state functional connectivity (RSFC) in patients with moderate TBI at acute (within 1 week), subacute (2-3 weeks), and late-subacute (3 months) recovery phases. Materials and Methods This is a secondary analysis of a prospective single-site double-blinded sham-controlled study conducted in patients presenting to the emergency department with moderate TBI from November 2015 to July 2019. Participants were randomized for LLLT and sham treatment. The primary outcome of the study was to assess structural connectivity, and RSFC was collected as the secondary outcome. MRI was used to measure RSFC in 82 brain regions in participants during the three recovery phases. Healthy individuals who did not receive treatment were imaged at a single time point to provide control values. The Pearson correlation coefficient was estimated to assess the connectivity strength for each brain region pair, and estimates of the differences in Fisher z-transformed correlation coefficients (hereafter, z differences) were compared between recovery phases and treatment groups using a linear mixed-effects regression model. These analyses were repeated for all brain region pairs. False discovery rate (FDR)-adjusted P values were computed to account for multiple comparisons. Quantile mixed-effects models were constructed to quantify the association between the Rivermead Postconcussion Symptoms Questionnaire (RPQ) score, recovery phase, and treatment group. Results RSFC was evaluated in 17 LLLT-treated participants (median age, 50 years [IQR, 25-67 years]; nine female), 21 sham-treated participants (median age, 50 years [IQR, 43-59 years]; 11 female), and 23 healthy control participants (median age, 42 years [IQR, 32-54 years]; 13 male). Seven brain region pairs exhibited a greater change in connectivity in LLLT-treated participants than in sham-treated participants between the acute and subacute phases (range of z differences, 0.37 [95% CI: 0.20, 0.53] to 0.45 [95% CI: 0.24, 0.67]; FDR-adjusted P value range, .010-.047). Thirteen different brain region pairs showed an increase in connectivity in sham-treated participants between the subacute and late-subacute phases (range of z differences, 0.17 [95% CI: 0.09, 0.25] to 0.26 [95% CI: 0.14, 0.39]; FDR-adjusted P value range, .020-.047). There was no evidence of a difference in clinical outcomes between LLLT-treated and sham-treated participants (range of differences in medians, -3.54 [95% CI: -12.65, 5.57] to -0.59 [95% CI: -7.31, 8.49]; P value range, .44-.99), as measured according to RPQ scores. Conclusion Despite the small sample size, the change in RSFC from the acute to subacute phases of recovery was greater in LLLT-treated than sham-treated participants, suggesting that acute-phase LLLT may have an impact on resting-state neuronal circuits in the early recovery phase of moderate TBI. ClinicalTrials.gov Identifier: NCT02233413 © RSNA, 2024 Supplemental material is available for this article.

Multi-Instrument Observation of the Ionospheric Irregularities and Disturbances during the 23–24 March 2023 Geomagnetic Storm

This work investigates the ionospheric response to the March 2023 geomagnetic storm over American and Asian sectors from total electron content (TEC), rate of TEC index, ionospheric heights, Swarm plasma density, radio occultation profiles of Formosat-7/Cosmic-2 (F7/C2), Fabry-Perot interferometer driven neutral winds, and E region electric field. During the storm’s main phase, post-sunset equatorial plasma bubbles (EPBs) extend to higher latitudes in the western American longitudes, showing significant longitudinal differences in the American sector. Over the Indian longitudes, suppression of post-sunset irregularities is observed, attributed to the westward prompt penetration electric field (PPEF). At the early recovery phase, the presence of post-midnight/near-sunrise EPBs till post-sunrise hours in the American sector is associated with the disturbance of dynamo-electric fields (DDEF). Additionally, a strong consistency between F7/C2 derived amplitude scintillation (S4) ≥ 0.5 and EPB occurrences is observed. Furthermore, a strong eastward electric field induced an increase in daytime TEC beyond the equatorial ionization anomaly crest in the American region, which occurred during the storm’s main phase. Both the Asian and American sectors exhibit negative ionospheric storms and inhibition of ionospheric irregularities at the recovery phase, which is dominated by the disturbance dynamo effect due to equatorward neutral winds. A slight increase in TEC in the Asian sector during the recovery phase could be explained by the combined effect of DDEF and thermospheric composition change. Overall, storm-time ionospheric variations are controlled by the combined effects of PPEF and DDEF. This study may further contribute to understanding the ionospheric responses under the influence of storm-phase and LT-dependent electric fields.

Lipid metabolic reprogramming mediated by circulating Nrg4 alleviates metabolic dysfunction-associated steatotic liver disease during the early recovery phase after sleeve gastrectomy

BackgroundThe metabolic benefits of bariatric surgery that contribute to the alleviation of metabolic dysfunction-associated steatotic liver disease (MASLD) have been reported. However, the processes and mechanisms underlying the contribution of lipid metabolic reprogramming after bariatric surgery to attenuating MASLD remain elusive.MethodsA case–control study was designed to evaluate the impact of three of the most common adipokines (Nrg4, leptin, and adiponectin) on hepatic steatosis in the early recovery phase following sleeve gastrectomy (SG). A series of rodent and cell line experiments were subsequently used to determine the role and mechanism of secreted adipokines following SG in the alleviation of MASLD.ResultsIn morbidly obese patients, an increase in circulating Nrg4 levels is associated with the alleviation of hepatic steatosis in the early recovery phase following SG before remarkable weight loss. The temporal parameters of the mice confirmed that an increase in circulating Nrg4 levels was initially stimulated by SG and contributed to the beneficial effect of SG on hepatic lipid deposition. Moreover, this occurred early following bariatric surgery. Mechanistically, gain- and loss-of-function studies in mice or cell lines revealed that circulating Nrg4 activates ErbB4, which could positively regulate fatty acid oxidation in hepatocytes to reduce intracellular lipid deposition.ConclusionsThis study demonstrated that the rapid effect of SG on hepatic lipid metabolic reprogramming mediated by circulating Nrg4 alleviates MASLD.

Acute physiological responses of blood flow restriction between high-intensity interval repetitions in trained cyclists.

Blood flow restriction (BFR) is increasingly being used to enhance aerobic performance in endurance athletes. This study examined physiological responses to BFR applied in recovery phases within a high-intensity interval training (HIIT) session in trained cyclists. Eleven competitive road cyclists (mean±SD, age: 28±7years, body mass: 69±6kg, peak oxygen uptake: 65±9mL ·kg-1· min-1) completed two randomised crossover conditions: HIIT with (BFR) and without (CON) BFR applied during recovery phases. HIIT consisted of six 30-s cycling bouts at an intensity equivalent to 85% of maximal 30-s power (523±93W), interspersed with 4.5-min recovery. BFR (200mmHg, 12cm cuff width) was applied for 2-min in the early recovery phase between each interval. Pulmonary gas exchange (V̇O2, V̇CO2, and V̇E), tissue oxygen saturation index (TSI), heart rate (HR), and serum vascular endothelial growth factor concentration (VEGF) were measured. Compared to CON, BFR increased V̇CO2 and V̇E during work bouts (both p<0.05, dz<0.5), but there was no effect on V̇O2, TSI, or HR (p>0.05). In early recovery, BFR decreased TSI, V̇O2, V̇CO2, and V̇E (all p<0.05, dz>0.8) versus CON, with no change in HR (p>0.05). In late recovery, when BFR was released, V̇O2, V̇CO2, V̇E, and HR increased, but TSI decreased versus CON (all p<0.05, dz>0.8). There was a greater increase in VEGF at 3-h post-exercise in BFR compared to CON (p<0.05, dz>0.8). Incorporating BFR into HIIT recovery phases altered physiological responses compared to exercise alone.