Impaired Function Research Articles

Individuals With Post-Acute Sequelae Of COVID-19 Have Impaired Endothelial Function, But Combined Exercise Training Restores Endothelial Function

Individuals With Post-Acute Sequelae Of COVID-19 Have Impaired Endothelial Function, But Combined Exercise Training Restores Endothelial Function

Spine

The October 2024 Spine Roundup360 looks at: Analysis of risk factors for non-fusion of bone graft in anterior cervical discectomy and fusion: a clinical retrospective study; Does paraspinal muscle mass predict lumbar lordosis before and after decompression for degenerative spinal stenosis?; Return to work after surgery for lumbar disk herniation: a nationwide registry-based study; Can the six-minute walking test assess ambulatory function impairment in patients with cervical spondylotic myelopathy?; Complications after adult deformity surgery: losing more than sleep; Frailty limits how good we can get in adult spine deformity surgery.

Minimal change glomerular disease associated with solid neoplasms: a systematic review.

Paraneoplastic minimal change disease (MCD) has been associated with hematological malignancies, whereas solid malignancies are commonly associated with membranous glomerulonephritis. In this systematic review of the literature, we describe the clinical features, treatment and outcome of MCD associated with solid neoplasms. We performed a systematic review of the MEDLINE, COCHRANE, EMBASE and SCOPUS databases, including case reports of adult patients with biopsy-proven MCD and solid malignancy, without language or time restrictions. Sixty-seven papers were included, presenting 86 cases with a mean age of 57.8 ± 14.7years; 41.0% were women. Nephrotic syndrome was the initial presentation in 96.2% of patients; 67.2% had kidney function impairment, and 21.2% required kidney replacement therapy. The most frequent malignancies were malignant thymoma (34.9%), kidney (14.0%), lung (12.8%), and gastrointestinal tumors (12.8%). In 40.7% of cases, the neoplasm diagnosis preceded MCD by 33.8 ± 46.1months, while in 31.4%, it followed diagnosis ofMCD by 12.4 ± 22.6months. In 27.9%, the neoplasm and kidney disease were diagnosed simultaneously. Immunosuppressive therapy was started in 79.1% of cases and tumor-specific treatment in 83.7%. Remission of MCD was achieved in 80.2% of patients: 38.2% responded to immunosuppressive treatment alone and 29.6% to oncological treatment alone. The association between MCD and solid neoplasms is well-documented. Immunosuppressive therapy alone induced nephrotic syndrome remission in over one-third of cases; most others responded to tumor-specific treatment. Solid tumor screening should be considered in MCD independently of the steroid response, though more data on solid tumor-associated MCD prevalence are needed for a definitive statement. CRD42024521854.

The cumulative impact of clinical risk on brain networks and associations with executive function impairments in adolescents with congenital heart disease.

Patients with congenital heart disease (CHD) demonstrate altered structural brain network connectivity. However, there is large variability between reported results and little information is available to identify those patients at highest risk for brain alterations. Thus, we aimed to investigate if network connectivity measures were associated with the individual patient's cumulative load of clinical risk factors and with family-environmental factors in a cohort of adolescents with CHD. Further, we investigated associations with executive function impairments. In 53 adolescents with CHD who underwent open-heart surgery during infancy, and 75 healthy controls, diffusion magnetic resonance imaging and neuropsychological assessment was conducted at a mean age of 13.2 ± 1.3 years. Structural connectomes were constructed using constrained spherical deconvolution tractography. Graph theory and network-based statistics were applied to investigate network connectivity measures. A cumulative clinical risk (CCR) score was built by summing up binary risk factors (neonatal, cardiac, neurologic) based on clinically relevant thresholds. The role of family-environmental factors (parental education, parental mental health, and family function) was investigated. An age-adjusted executive function summary score was built from nine neuropsychological tests. While network integration and segregation were preserved in adolescents with CHD, they showed lower edge strength in a dense subnetwork. A higher CCR score was associated with lower network segregation, edge strength, and executive function performance. Edge strength was particularly reduced in a subnetwork including inter-frontal and fronto-parietal-thalamic connections. There was no association with family-environmental factors. Poorer executive functioning was associated with lower network integration and segregation. We demonstrated evidence for alterations of network connectivity strength in adolescents with CHD - particularly in those patients who face a cumulative exposure to multiple clinical risk factors over time. Quantifying the cumulative load of risk early in life may help to better predict trajectories of brain development in order to identify and support the most vulnerable patients as early as possible.

Quantitative Analysis of Myocardial Work in Gestational Diabetes Mellitus Using Noninvasive Left Ventricular Pressure-Strain Loop Measurement.

Gestational diabetes mellitus (GDM) poses a risk for cardiovascular damage during pregnancy. This study focused on evaluating changes in left ventricular myocardial performance in GDM patients using the left ventricular pressure-strain loop (LV-PSL) method and examining risk factors associated with reduced myocardial function. A prospective, randomized study involving 112 pregnant women diagnosed with GDM was conducted from June 2021 to June 2024. Additionally, 84 healthy pregnant women from the same period served as the control group. Utilizing both conventional echocardiography and two-dimensional speckle tracking echocardiography, left ventricular myocardial work metrics were assessed using LV-PSL technology. GDM patients demonstrated significantly reduced values for global longitudinal strain (GLS), global work index (GWI), global work efficiency (GWE), and global constructive work (GCW) (p < 0.05), while conventional ultrasound measures showed no significant difference between GDM and control groups. GWI, GWE, GCW, and GLS had high predictive value for cardiac function changes in GDM patients, with GWE showing the highest predictive value {Area under curve (AUC)=0.866, cutoff value=95.5%, specificity=0.77, sensitivity=0.87}. GWI, GWE, and GCW were negatively correlated with GLS (r=-0.532, -0.411, -0.425, all p < 0.001), whereas global wasted work (GWW) showed a positive correlation with GLS (r=0.325 and p < 0.001). These parameters were also correlated with HbA1c levels (r=-0.316, -0.256, -0.260, all p < 0.001 for negative correlations, and r=0.172, p < 0.05 for positive correlations). Multivariate logistic regression indicated that 1-h OGTT (mmol/L), 2-h OGTT (mmol/L), and HbA1c (%) were significant predictors of left ventricular systolic function (GWE) in GDM patients. LV-PSL is an effective tool for early detection of left ventricular systolic function impairment in GDM patients.

Neuroprotective Effect of Echinoside on MPTP-induced Parkinson's Disease Mouse Model by Activation of NRF2/HO-1 Pathway

Echinacoside, a principal active compound derived from Cistanche deserticola Ma, is recognized in traditional Chinese medicine for its anti-aging, immunomodulatory, endocrine-regulating, and neuroprotective properties. However, the specific neuroprotective mechanisms of echinacoside remain largely unclear. This study aims to investigate whether the neuroprotective effects of echinacoside in a mouse model of Parkinson's disease (PD) are mediated through the Nrf2/HO-1 signaling pathway by mitigating inflammatory responses.Mice were divided into four groups: control, model, positive control, and echinacoside-treated groups. PD mouse model was induced through intraperitoneal injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) over the course of one week, followed by three weeks of oral administration of echinacoside. The results demonstrated that echinacoside significantly improved motor function impairments caused by MPTP in PD mice. Immunohistochemical analysis revealed that echinacoside enhanced the expression of tyrosine hydroxylase in the substantia nigra of PD mice. Furthermore, assays of inflammatory cytokines indicated that echinacoside effectively reduced the levels of IL-6 and TNF-α in brain tissues.Western blot analysis further confirmed that echinacoside intervention upregulated the expression of Nrf2 and HO-1 in the brain tissues of PD mice. These findings suggest that echinacoside exerts neuroprotective effects in the PD mouse model, likely through the activation of the Nrf2/HO-1 signaling pathway. Therefore, echinacoside may be considered a potential therapeutic strategy for the treatment of PD.

The influence of miscentering on radiation dose during computed tomography head examinations and the role of localiser orientation: A phantom study

IntroductionComputed Tomography (CT) chest, abdomen and pelvis research demonstrates a relationship between vertical phantom positioning and radiation dose. Moving the phantom closer or further from the x-ray source results in magnification or minimisation of the localiser. As automatic tube current modulation (ATCM) algorithms use localisers to estimate patient size and calculate required tube current, magnification or minimisation results in the incorrect provision of radiation dose. Radiation dose changes also depend on localiser orientation, changes with anteroposterior (AP) and posteroanterior (PA) localisers demonstrating an inverse relationship. However, within CT head literature often attributes radiation dose changes on impaired function of the bow-tie filter instead. The current study investigated the role of miscentering on ATCM function within CT head, paying particular attention to localiser orientation. MethodsHead scanning was performed with an anthropomorphic phantom at the isocentre, alongside ten vertically miscentered positions. This was performed three times, with an AP, PA and lateral localiser. CT dose index values at each miscentered level were compared across conditions. ResultsVertical miscentering altered radiation dose in both AP and PA conditions, radiation dose linearly increasing (up to 17.05%) when positioning the phantom closer to the x-ray source and decreasing when positioning away (up to −13.13%). Changes across AP and PA conditions demonstrated an inverse relationship. Radiation dose was unaffected in the lateral condition. ConclusionsMiscentering during CT head alters ATCM function due to magnification/minimisation of the localiser image, causing ATCM algorithms to misinterpret patient size and miscalculate required tube current. Implications for practiceRadiographers should be accurate when centering for CT head, avoiding any potential radiation dose changes. Further research into vertical miscentering and image quality during CT head is recommended.

CD151 identifies a NK cell subset that is enriched in COVID-19 patients and correlates with disease severity

Severe coronavirus disease 2019 (COVID-19) often lead to acute respiratory distress syndrome and multi-organ dysfunction, driven by a dysregulated immune response, including a cytokine storm with elevated proinflammatory cytokine levels. Natural killer (NK) cells are part of the innate immune system with a fundamental role in the defense against viral infections. However, during COVID-19 acute infection, they exhibit an altered phenotype and impaired functionality contributing to the immunopathogenesis of the disease. In this work, we have studied a cohort of patients with COVID-19 (ranging from mild to severe) by analyzing IL-15, TGF-β, PlGF and GDF-15 plasma levels and performing multiparametric flow cytometry studies. Our results revealed that severe COVID-19 patients exhibited high levels of IL-15, PlGF and GDF-15, along with an enrichment of a NK cell subset expressing the CD151 tetraspanin, which correlated with IL-15 plasma levels and disease severity. In patients, these CD151+ NK cells displayed a more activated phenotype characterized by an increased expression of HLA-DR, CD38 and granzyme B, a distinct receptor repertoire, with lower levels of CD160 and CD31 and higher levels of CD55 and, remarkably, a higher expression of tissue-resident markers CD103 and the NK cell decidual marker CD9. Last of all, in individuals with severe disease, we identified an expansion of a CD151brightCD9+ NK cell subset, suggesting that these cells play a specific role in COVID-19. Altogether, our findings suggest that CD151+ NK cells may have a relevant role in COVID-19 immunopathogenesis.

Study of correlation between arches of foot and lower back pain in Eastern India

Background: Low back pain is one of the most common disorders of the musculoskeletal system, leading to impaired function and decreased quality of life in many patients. Foot arch alterations may lead to structural changes and/or affect its load distribution. It should be noted that even slight elevations of the foot’s medial longitudinal arch above the norm may lead to changes in load and pressure distribution. Hence, it becomes important to find the relationship between low back pain and altered foot arch indices leading to improper body balance. Aims and Objectives: The aims and objectives of the study are to find any correlation between lower back pain and an altered foot arch index in the Eastern Indian population. Materials and Methods: A total of 60 subjects aged 20–40 years with varying degrees of low back pain were selected. Low back pain scores of the subjects were found using modified oswestry low back pain disability questionnaire. Footprints in standing position using ink were taken on graph paper and the foot arch indices were calculated. Results: 54.16% of the male and 36.11% of female participants had low arched feet, 20.83% of male and 52.78% of female participants had normal arched feet, and 25% of male and 11.11% of female participants had high arched feet with varying degrees of low back pain. 77.42% of the participants with minimal disability due to low back pain were having normal arched feet, 71.43% of the participants with moderate disability due to low back pain were having low arched feet, and 100% of the participants with severe disability due to low back pain were having either high or low arched feet. Conclusion: This study showed that people having either low or high arched feet are at an increased risk of developing acute or chronic low back pain at some stage in their lives. Knowledge of this risk factor might even help people to choose appropriate occupations in the future.

An insight into pharmacokinetics and dose optimization of antimicrobials agents in elderly patients

The global elderly population is on the rise, and infections tend to have a higher mortality rate among older individuals. Aging is associated with the progressive impairment of multi-organ function, which can impact the pharmacokinetics of antimicrobials, potentially leading to the failure of anti-infective therapy. With the increasing life expectancy, a significant growth in the elderly demographic, and the escalating costs of healthcare, gaining a thorough understanding of pharmacokinetic changes in the elderly holds crucial clinical significance. This review compiles findings from published studies, offering a comprehensive overview of the pharmacokinetics of various antimicrobials in both adults and the elderly. Furthermore, it delves into advancements in pharmacokinetic methods specific to the elderly population.

Ultrasound-guided forearm selective nerve block: A bright future on the horizon

Objective: In light of the advancement of modern medicine, anesthesiologists and surgeons are increasingly prioritizing patient comfort in diagnostic and therapeutic procedures. A growing body of research revolves around the utilization of ultrasound-guided forearm selective nerve blocks for surgeries involving the distal upper limb. This review aims to provide an overview of regional anesthesia techniques in forearm, hand, and wrist surgeries, laying a theoretical foundation for the prospects of ultrasound-guided forearm selective nerve blocks in optimizing comfort during diagnostic and therapeutic procedures. Methods: A retrospective review of literature sourced from the PubMed database was conducted to comprehensively evaluate and elucidate the advantages and drawbacks of ultrasound-guided forearm selective nerve blocks, brachial plexus blocks, Bier blocks, and wrist blocks. Additionally, a summary was provided regarding the selection of local anesthetics for ultrasound-guided forearm selective nerve blocks. Results: Overall, ultrasound-guided forearm selective nerve block techniques exhibit several advantages over Bier’s block, brachial plexus block, and wrist block for the majority of forearm, wrist, and hand surgeries. These advantages include reduced anesthesia-related time, prolonged duration of analgesia, and minimal impairment of upper extremity motor function. Consequently, these techniques enhance surgical safety and facilitate postoperative recovery. Furthermore, the addition of dexmedetomidine or dexamethasone to ultrasound-guided selective nerve blocks of the forearm could extend the duration of analgesia. Conclusion: Ultrasound-guided forearm selective nerve block is a straightforward and conducive anesthesia method for distal upper limb surgeries, aligning with the principles of fast surgical recovery and enhanced patient comfort during diagnostic and therapeutic procedures. Given its manifold benefits, widespread promotion and adoption of this technique in clinical practice are warranted.

Bisphenol S decreased lifespan and healthspan via insulin/IGF-1-like signaling-against mitochondrial stress in Caenorhabditis elegans

Bisphenol S (BPS) is widely presented and affects aging with unclear mechanisms. Here, we applied C. elegans to evaluate the effects of BPS on lifespan and healthspan and to investigate the underlying mechanisms. Both early-life and whole-life exposure to BPS at environmentally relevant doses (0.6, 6, 60 μg/L) significantly decreased lifespan, and healthspan (body bend, pharyngeal pumping, and lipofuscin accumulation). BPS exposure impaired mitochondrial structure and function, which promoted ROS production to induce oxidative stress. Furthermore, BPS increased expressions of the insulin/IGF-like signaling (IIS). Also, BPS inhibited expression of the IIS transcription factor daf-16 and its downstream anti-oxidative genes. Quercetin effectively improved BPS-induced oxidative stress byreversing BPS-regulated IIS/daf-16 pathway and anti-oxidative gene expressions. In daf-2 and daf-16 mutants, the effects of BPS and quercetin on lifespan, healthspan, oxidative stress, and anti-oxidative genes expressions were reversed, demonstrating the requirement of IIS/daf-16 for aging regulation. Molecular docking and molecular dynamics simulations confirmed the stable interaction between DAF-2 and BPS mainly via three residues (VAL1260, GLU1329, and MET1395), which was attenuated by quercetin. Our results highlighted that adverse effects of BPS on impairing lifespan and healthspan by affecting IIS/daf-16 function against mitochondrial stress, which could be inhibited by quercetin treatment. Thus, we first revealed the underlying mechanisms of BPS-induced aging and the potential treatment.

IpsiHand Brain-Computer Interface Therapy Induces Broad Upper Extremity Motor Rehabilitation in Chronic Stroke.

Chronic hemiparetic stroke patients have very limited benefits from current therapies. Brain-computer interface (BCI) engaging the unaffected hemisphere has emerged as a promising novel therapeutic approach for chronic stroke rehabilitation. This study investigated the effectiveness of contralesionally-controlled BCI therapy in chronic stroke patients with impaired upper extremity motor function. We further explored neurophysiological features of motor recovery driven by BCI. We hypothesized that BCI therapy would induce a broad motor recovery in the upper extremity, and there would be corresponding changes in baseline theta and gamma oscillations, which have been shown to be associated with motor recovery. Twenty-six prospectively enrolled chronic hemiparetic stroke patients performed a therapeutic BCI task for 12 weeks. Motor function assessment data and resting state electroencephalogram signals were acquired before initiating BCI therapy and across BCI therapy sessions. The Upper Extremity Fugl-Meyer assessment served as a primary motor outcome assessment tool. Theta-gamma cross-frequency coupling (CFC) was computed and correlated with motor recovery. Chronic stroke patients achieved significant motor improvement in both proximal and distal upper extremity with BCI therapy. Motor function improvement was independent of Botox application. Theta-gamma CFC enhanced bilaterally over the C3/C4 motor electrodes and positively correlated with motor recovery across BCI therapy sessions. BCI therapy resulted in significant motor function improvement across the proximal and distal upper extremities of patients, which significantly correlated with theta-gamma CFC increases in the motor regions. This may represent rhythm-specific cortical oscillatory mechanism for BCI-driven rehabilitation in chronic stroke patients. Advarra Study: https://classic.clinicaltrials.gov/ct2/show/NCT04338971 and Washington University Study: https://classic.clinicaltrials.gov/ct2/show/NCT03611855.

Hypertension toxicity of VEGFR-TKIs in cancer treatment: incidence, mechanisms, and management strategies.

Vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) are a class of targeted anticancer agents that include pazopanib, sunitinib, axitinib, and others. Currently, VEGFR-TKIs are widely used in the clinical treatment of various tumors, which can prolong patients' survival and even cure tumors. However, the use of VEGFR-TKIs is frequently associated with the occurrence of cardiovascular adverse events, with hypertension being the most prevalent. Hypertension and its complications can significantly impact the prognosis of patients, potentially jeopardizing their lives and resulting in the reduction or even cessation of treatment in severe cases. This review addresses the incidence of hypertension due to VEGFR-TKIs, mechanisms of toxicity, management strategies, and future research directions. In addition, hypertension due to VEGFR-TKIs may be associated with salt sensitivity, and possible mechanisms of hypertensive side effects are vasodilator imbalance, decreased capillary density, renal injury, impaired endothelial function due to oxidative stress, decreased lymphatic vascular density, and "off-target effect". A comprehensive understanding of hypertension toxicity due to cancer treatment with VEGFR-TKIs, can enhance clinical practice, thereby improving the prognostic outcomes of VEGFR-TKIs in oncology patients.

Diabetes and Dietary Proteins-Protein Supplement Intake

Diabetes is a growing global health issue, with diet playing a crucial role in prevention and management. Protein, an essential nutrient for growth, repair, and metabolism, can significantly influence diabetes risk and control. High-protein diets, especially those rich in animal proteins, have been linked to increased risk of type 2 diabetes, while plant-based proteins may offer protective benefits. Studies suggest that excessive animal protein intake, particularly from red and processed meats, can increase diabetes risk due to higher saturated fat content. Conversely, plant-based proteins, such as soy, tofu, and nuts, are associated with improved insulin sensitivity and reduced inflammation. Protein supplements—especially whey and soy proteins—are known to help maintain muscle mass and improve metabolic indicators. However, the evidence supporting these benefits remains limited, and excessive protein intake may increase risks of other negative effects, such as impaired kidney function. Therefore, caution is advised when using these supplements. A balanced approach that emphasizes plant-based proteins while moderating animal protein intake is recommended for diabetes prevention and management. Future research should focus on personalized dietary strategies for optimal health outcomes.

Assessing diastolic function using CMR as an alternative to echocardiography: age- and gender-related normal reference values.

Impaired diastolic function is associated with a variety of diseases such as myocarditis or dilated cardiomyopathy. Currently, echocardiography is the standard method for assessing diastolic function. Recently, it has been postulated that cardiovascular magnetic resonance (CMR) is an at least equivalent or superior alternative to echocardiography. To assess CMR-based age- and gender-dependent diastolic functional normal reference values, pulmonary venous and transmitral blood-flow parameters were examined in heart-healthy test persons. Flow-sensitive phase-contrast CMR imaging was performed in the right upper pulmonary vein (RUPV) and at the level of the mitral valve (MV) in 183 healthy subjects (age 10-70years; 97 women, 86 men). The data wasdistributed as evenly as possible across all groups. Strong age-dependence was observed for PV S/D; r = 0.718, p < 0.001 (Pearson product-moment correlation) and for transmitral MV E/A; ρ = -0.736, p < 0.001 (Spearman's Rho correlation). Moderate age-dependence was found for PV slope D-wave; r = 0.394, p < 0.001. Except for MV slope E-wave (male -292cm/s2 interquartile range (IQR) {-338; -243} vs. female -319 ± 82cm/s2; p = 0.047), no gender-related differences were observed. In a subgroup (N = 100), CMR data were compared with echocardiographic data. Strong correlation was found between CMR and echocardiography for PV S/D; r = 0.545, p < 0.001 and MV E/A; ρ = 0.692, p < 0.001. Diastolic functional parameters change with age, while gender-differences are small. CMR and echocardiography showed similar PV S/D and MV E/A ratios, making CMR a promising alternative for assessing diastolic function.

Urodynamic study and its correlation with cardiac meta-iodobenzylguanidine (MIBG) in body-first and brain-first subtypes of Parkinson's disease.

Lower urinary tract symptoms (LUTS) are frequently observed in patients with Parkinson's disease (PD), but the underlying mechanism remains elusive. The concept of "body-first" and "brain-first" subtypes in PD has been proposed, but the correlation of PD subtype with LUTS remains unclear. We aimed to investigate the disparities in urological dysfunctions between body-first and brain-first subtypes of PD using urodynamic studies (UDS). We reviewed patients with PD (disease duration <3 years) who had undergone UDS and completed urological questionnaires (Overactive Bladder Symptom Score [OABSS] and International Prostate Symptom Score [IPSS]) and a voiding diary. Patients were categorized as having body-first or brain-first PD based on cardiac sympathetic denervation (CSD) using cardiac meta-iodobenzylguanidine (MIBG) uptake and the presence of rapid eye movement sleep behavior disorder (RBD), assessed using a questionnaire (PD with CSD and RBD indicating the body-first subtype). A total of 55 patients with PD were categorized into body-first PD (n = 37) and brain-first PD (n = 18) groups. The body-first PD group exhibited smaller voiding volume and first desire volume (FDV) than the brain-first PD group (p < 0.05 in both). Also, the body-first PD group had higher OABSS and IPSS scores, and higher prevalence of overactive bladder diagnosed by OABSS, compared to the brain-first PD group. In multiple linear regression, cardiac MIBG uptake was positively correlated with FDV and voiding volume andnegatively correlated with OABSS and IPSS (p < 0.05 in all). Patients with the body-first PD subtype exhibited more pronounced overactive bladder symptoms and impaired storage function in the early stage of disease. Additionally, cardiac MIBG was significantly associated with urological dysfunction.

Monocyte-driven inflamm-aging reduces intestinal barrier function in females.

The intestinal barrier encompasses physical and immunological components that act to compartmentalize luminal contents, such as bacteria and endotoxins, from the host. It has been proposed that an age-related decline of intestinal barrier function may allow for the passage of luminal contents into the bloodstream, triggering a low-grade systemic inflammation termed inflamm-aging. Although there is mounting evidence to support this hypothesis in model species, it is unclear if this phenomenon occurs in humans. In addition, despite being well-established that biological sex impacts aging physiology, its influence on intestinal barrier function and inflamm-aging has not been explored. In this study, we observed sex differences in markers of intestinal barrier integrity, where females had increased epithelial permeability throughout life as compared to males. With age, females had an age-associated increase in circulating bacterial products and metabolites such as LPS and kynurenine, suggesting reduced barrier function. Females also had age-associated increases in established markers of inflamm-aging, including peripheral blood monocytes as well as TNF and CRP. To determine if impaired barrier function was driving inflamm-aging, we performed a mediation analysis. The results show that the loss of intestinal barrier integrity was not the mediator of inflamm-aging in humans. Instead, persistent, low-grade inflammation with age preceded the increase in circulating bacterial products, which we confirmed using animal models. We found, as in humans, that sex modified age-associated increases in circulating monocytes in mice, and that inflammation mediates the loss of intestinal barrier function. Taken together, our results suggest that higher basal intestinal permeability in combination with age-associated inflammation, increases circulating LPS in females. Thus, targeting barrier permeability in females may slow the progression of inflamm-aging, but is unlikely to prevent it.

Extract of Angelica keiskei Leaves Attenuates Spatial Memory Impairment on the D-galactose Model of Brain Aging in Mice

Aging is a complex and inexorable phenomenon, entailing several physiological changes. Impaired memory skills are associated with cell death in the hippocampus as a result of the age-related buildup of free radicals. D-galactose can artificially accelerate brain aging, causing memory impairment in mice due to neuroinflammation and oxidative stress. Numerous phytoconstituents found in Angelica keiskei possess anti-oxidant, anti-inflammatory, and memory-enhancing properties. In this study, we sought to determine the effects of an ethanol extract from the leaves of A. keiskei (EELAK) on spatial memory in mice with impaired memory functions due to D-gal. Here, we showed that administering 300 mg/kg BW/day of D-gal orally for a duration of 28 days significantly decreased spatial memory as quantified by the Morris Water Maze, and this was linked to a marked increase in hippocampal acetylcholinesterase (AChE), inflammation, and oxidative stress. The spatial memory of D-gal-induced mice was markedly enhanced by 20 mg/kg BW/day of EELAK, demonstrating its potent memory-boosting properties. The mice treated with EELAK also showed a notable decrease in hippocampal neuroinflammation (p65 NF-kB, NO, and TNF-α protein) and an increase in antioxidant activity (elevated SOD activity and reduced MDA levels), suggesting its potent neuroprotective activity. In conclusion, our results establish for the first time that by reducing oxidative stress and neuroinflammation, EELAK enhances spatial memory. Hence, for the prevention and treatment of age-related neurodegenerative illnesses like Alzheimer's disease, EELAK may be a useful therapeutic approach.

Association of history of concussion with vestibular impairment and cognitive function in sports athletes

Background: Tear production increases ocular surface health and improves visual clarity. Which facilitates the physical activity comfortably. Different dosages of glucose intake had a significantly varying impact on tear production in euglycemic, initially decreasing followed by an increase. Objective: to compare the effect of 0.5% and 1% glucose intake on tear production in euglycemic. Methodology: A quasi-experimental study was conducted with n=200 participants at Irfan Eye Care Hospital Peshawar, from September 2022 to May 2023. The participants were euglycemic without any ocular and systemic pathology and determined its effect on tear production. The participants were divided into two groups equally for 0.5% and 1% glucose intake. Tear production was measured at baseline, after 60 minutes, 90 minutes, 120 minutes, and 150 minutes with the Schirmer test. Results: There was a significant reduction of tear production from baseline to 120 minutes (p&lt;0.05) than rise in both groups. While when compared, no significant (p≥0.05) difference at each assessment level. Conclusion: there was similar effect of 0.5% and 1% glucose concentration intake on tear production Keywords: fasting blood sugar; glucose; hyperglycaemia; tear production; dry eye disease