Insufficient Recovery Research Articles

Adolescent neck pain: association with the use of mobile telephone

Introduction Neck pain has become a frequent problem in adolescents [1]. Multiple factors can be related to neck pain. The use of electronic devices has been suggested to increase the risk of neck pain, probably due to the static posture and with insufficient recovery after local muscle fatigue [2–5]. However, the data from a few studies are contradictory [1,6]. Thus, this study aimed to evaluate the prevalence of neck pain in adolescents and their association with mobile phone use. Materials and methods This is a cross-sectional study approved by Research in Education and Community Intervention (RECI) research centre. Written informed consent were obtained from all parents or guardians of the students participating in the study. The sample was comprised of 206 students, being 109 (52.9%) boys and 97 (47.1%) girls, aged between 12 and 19 years old (14.67 ± 1.51), enrolled in the 8th (n = 104; 50.5%) and 10th (n = 102; 49.5%) grades of the D. Martinho Castelo Branco, elementary school, and Poeta António Aleixo, high school, both in Portimão, south of Portugal. The measurement instruments included a self-report questionnaire of neck pain, including questions about the time spent using mobile phones, and a practical test to evaluate the posture with the use of the mobile phone during the sending of a text message (a standard posture was established). Results One hundred and fourteen (55.3%) adolescents reported neck pain at some point in their life (lifetime prevalence), 16 (7.8%) referred neck pain at the moment of evaluation and 75 (36.4%) in a 6-month period. Regarding the use time of the mobile phone per week, 8 (3.9%) students reported that they do not have a mobile phone, 18 (8.7%) use until 5 h, 32 (15.5%) between 6 and 10 h, 44 (21.4%) between 11 and 15 h, and the majority of the adolescents (n = 104; 50.5%) reported that they use the mobile phone for a period equal to or greater than 16 h per week. One hundred ninety-seven (95.6%) students used the mobile phone incorrectly with flexion of the cervical spine. The adolescents who used the mobile phone more than 10 h per week showed a 1.58 times greater risk of neck pain (95% CI: 0.59–4.23; p = .360) than those who use equal or less than 10 h, and adolescents who use the phone in a wrong way had a 1.15 times higher risk of neck pain (95% CI: 0.28–4.75; p = .845) than those who used it correctly. Discussion and Conclusions The data obtained in this study showed a high rate of neck pain in the analysed sample of adolescents. Myrtveit et al. [6] used data from the population-based study and their results showed that 1,79 (20%) of the total 8,990 adolescents reported neck pain during the last 6 months and the Shan et al. [5] showed a prevalence of 40.8% in 3016 students, in the same period. Regarding mobile phone use as a risk factor, it was observed that adolescents who use the mobile phone for many hours and those who use it with the wrong posture showed a greater probability of neck pain, however, no significant associations were observed. It is necessary to carry out more studies to expand the knowledge of neck pain associated with the time and use of screen-based activities and on their prevention.

Intratympanic Triamcinolone Acetonide as a Salvage Treatment for Idiopathic Sudden Sensorineural Hearing Loss

Introduction: Intratympanic steroid (ITS) injections represent an increasingly used salvage treatment option for patients with idiopathic sudden sensorineural hearing loss ­(ISSHL) after systemic treatment. The most effective corticosteroid for this treatment modality still remains unclear. Triamcinolone acetonide has been used for ITS treatment in various clinical settings. However, there are limited clinical data of its usage in the therapeutic management of ISSHL. The aim of this study was to determine the efficacy of intratympanic triamcinolone acetonide injections as a salvage treatment for ISSHL. Methods: We conducted a retrospective chart review on patients affected by ISSHL with insufficient hearing recovery after primary systemic corticosteroid therapy and who were treated with intratympanic triamcinolone acetonide as a salvage therapy between January 2014 and August 2019. The patients were divided into groups according to their degree of hearing recovery, and we evaluated potential predictors of hearing recovery. Audiometric results were then compared to historic studies using dexamethasone or methylprednisolone. Results: One-hundred and fifty-two patients received up to 3 intratympanic injections with triamcinolone acetonide at 1-week intervals. The mean hearing improvement due to ITS salvage treatment was 15.9 ± 18.9 dB. Complete hearing recovery was noted in 15 patients (9.9%), while 73 patients (48%) obtained partial recovery, and 64 patients (42.1%) had no recovery. Primary systemic treatment delay, hearing improvement by primary systemic treatment, and severity of initial hearing loss were identified as significant predictors of hearing improvement. The first of the 3 injections resulted in the greatest hearing improvement. Conclusion: The use of triamcinolone acetonide in ITS salvage treatment resulted in similar hearing improvements as the use of the commonly used corticosteroids, namely, dexamethasone and methylprednisolone. Longer treatment delays, lower hearing improvement by primary systemic treatment, and higher initial hearing loss are associated with poorer prognoses of hearing recovery.

Household preferences for improved water services in the Galápagos Islands

Like many islands worldwide, Santa Cruz, the most populated of Ecuador's Galápagos Islands, has limited resources to provide safe drinking water to an increasing number of inhabitants and tourists. Currently, households receive brackish water at their tap, which is rationed to a few hours per day. Insufficient recovery of water supply costs is an impediment to improving water services. Against this backdrop, we implemented a contingent valuation survey to investigate whether households are willing to pay for improved water services. Using split-sample scenarios that allow for scope and part-whole tests, we elicited household preferences for three improvements: 1) uninterrupted water supply, 2) drinkable tap water, and 3) combining both. Our estimation results indicate that households are willing to pay for safe drinking water. Conversely, our willingness-to-pay estimates suggest that households are indifferent about improvements of service reliability unless water quality is improved as well. The median willingness to pay for concurrent improvements of system reliability and water quality is estimated at approximately $36/month, about 2.1% of average monthly household income. This study has policy implications as it demonstrates that households deem system reliability and water quality as complementary improvements.

Les variations techniques des micro-anastomoses influencent-elles les résultats fonctionnels du transfert musculaire libre de gracilis pour la flexion du coude dans les lésions traumatiques du plexus brachial ?

IntroductionThe traumatic lesions of the brachial plexus in adults are devastating injuries causing continuous severe functional impairment for both work and daily living activities. The restoration of elbow flexion is one of the most important movements for patient recovery to previous activities. Free gracilis muscle transfer has good outcomes for cases with late presentation or as a rescue surgery to regain elbow flexion, however, bad results are present in all cohorts with insufficient recovery of muscle strength for elbow flexion. A number of hypotheses can be postulate to explain the fair results observed in some cases of free gracilis muscle transfer for elbow flexion. Most studies in the current literature compare the choice of the donor nerve used in neurotisation and nerve grafts. The aim of this study is to evaluate if technical components of microvascular anastomosis could influence the functional outcome of free functional muscle transfer for elbow flexion in adult patients with traumatic brachial plexus injury. Material and methodsIncluded all adult patients with traumatic brachial plexus injury submitted to free functional gracilis muscle transfer for elbow flexion. The complications and functional results according to British Medical Research Council (BMRC) score were recorded. ResultsWe assessed 26 patients with mean age of 32,8 years. The most common donor nerve for gracilis muscle was the accessory nerve in 18 patients. Eighteen patients presented with good result (M3/M4). The mean ischemia time was higher for patients with bad results (132minutes) comparing with patients with good results (122minutes). Patients with only one venous anastomosis had 41% of poor functional outcome compared with 22% of cases with two venous anastomoses. No statistically significant difference in the ischemia time of the cases with good or poor functional outcome was observed (p=0.657), as for the number of venous anastomoses (p=0.418). ConclusionOur study observes that patients with only one venous anastomoses for drainage of free gracilis and those with longer intraoperative ischemia time had higher incidence of poor functional outcome of free gracilis muscle transfer for elbow flexion, but not statistically significant. Level of proofII; prospective cross-sectional study.

Psychosocial burden and working conditions during the COVID-19 pandemic in Germany: The VOICE survey among 3678 health care workers in hospitals

ObjectiveThe aim of this cross-sectional web-based study was to examine self-reported mental distress, psychosocial burdens, working conditions and potential risk and protective factors for depressive and anxiety symptoms during the COVID-19 pandemic in health care workers (HCW). MethodsIn the largest survey on mental health of HCW conducted during the first wave of COVID-19 in Europe (N = 8071 HCW), we investigated depressive (Patient Health Questionnaire-2, PHQ-2), and anxiety symptoms (Generalized Anxiety Disorder-2, GAD-2), working conditions, and psychosocial burden of 3678 HCW of three health care professions in hospitals: physicians (n = 1061), nurses (n = 1275), and medical technical assistants (MTA, n = 1342). ResultsThe prevalence of clinically significant levels of depressive and anxiety symptoms was 17.4% and 17.8% for physicians, 21.6% and 19.0% for nurses, and 23.0% and 20.1% for MTA, respectively. All three professions demonstrated significantly elevated PHQ-2 and GAD-2 scores, when compared with general German population before the pandemic, but lower scores in relation to that during the pandemic. Multiple linear regression analyses revealed that higher levels of depressive symptoms were associated with insufficient recovery during leisure time, increased alcohol consumption, and less trust in colleagues in difficult situations at work. In addition, elevated anxiety scores were related to increased fear of becoming infected with COVID-19. ConclusionDuring the pandemic HCW demonstrated a lower burden of mental distress compared to the general population. Nevertheless, a high percentage of HCW demonstrates psychosocial distress, so that the establishment of regular mental health screening and prevention programmes for HCW is indicated.

Graphene Oxide Substrate Promotes Neurotrophic Factor Secretion and Survival of Human Schwann-Like Adipose Mesenchymal Stromal Cells.

Mesenchymal stromal cells from adipose tissue (AD-MSCs) exhibit favorable clinical traits for autologous transplantation and can develop 'Schwann-like' phenotypes (sAD-MSCs) to improve peripheral nerve regeneration, where severe injuries yield insufficient recovery. However, sAD-MSCs regress without biochemical stimulation and detach from conduits under unfavorable transplant conditions, negating their paracrine effects. Graphene-derived materials support AD-MSC attachment, regulating cell adhesion and function through physiochemistry and topography. Graphene oxide (GO) is a suitable substrate for human sAD-MSCs incubation toward severe peripheral nerve injuries by evaluating transcriptome changes, neurotrophic factor expression over a 7-days period, and cell viability in apoptotic conditions is reported. Transcriptome changes from GO incubation across four patients are minor compared to biological variance. Nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and glial-derived neurotrophic factor (GDNF) gene expression is unchanged from sAD-MSCs on GO substrates, but NGF and GDNF protein secretion increase at day 3 and 7. Secretome changes do not improve dorsal root ganglia neuron axon regeneration in conditioned media culture models. Fewer sAD-MSCs detach from GO substrates compared to glass following phosphate buffer saline exposure, which simulates apoptotic conditions. Overall, GO substrates are compatible with sAD-MSC primed for peripheral nerve regeneration strategies and protect the cell population in harsh environments.

Abstract P806: Sirtuin1 Plays a Critical Role in Reversing Skeletal Muscle Atrophy in Cerebral Ischemic Stroke

Stroke is a leading cause of mortality and long-term disability in patients worldwide. Skeletal muscle is the primary systemic target organ of stroke that severely induces muscle wasting and weakness, which contributes more to the long-term functional disability in stroke patients than any other disease. Currently, no approved pharmacological drug is available to treat stroke-induced muscle loss. Rehabilitative therapy is the only available option to improve muscle function in stroke patients. However, higher muscle fatigability and lower muscle strength from extensive muscle wasting in post-stroke patients provide poor rehabilitative outcomes. As a result, about two-thirds of stroke survivors persist in a state of insufficient recovery and experience physical disability that drastically reduces their health and quality of life. The major challenge in the drug discovery effort for treating post-stroke muscle wasting is the lack of our understanding of the molecular and/or cellular mechanisms that underlie the muscle wasting in stroke. To understand the molecular origin of stroke-induced muscle atrophy, gene expression profiling and associated biological pathway enrichment studies were performed in a mouse model of cerebral ischemic stroke using high-throughput RNA sequencing and extensive bioinformatic analyses. RNA-seq data revealed that the elevated atrophy in skeletal muscle observed in response to stroke was primairly associated with the altered expression of genes involved in the muscle protein degradation pathway. Further analysis of RNA-seq data identified Sirtuin1 (SirT1) as a critical protein that plays a significant role in regulating post-stroke muscle mass. SirT1 gain-of-function in skeletal muscle significantly reversed stroke-induced muscle atrophy via inhibiting the activation of the ubiquitin proteasomal pathway and restoring autophagy function. Collectively, this study identified suppression of SirT1as a novel mechanism by which stroke induces muscle atrophy.

Construction Waste Audit in the Framework of Sustainable Waste Management in Construction Projects—Case Study

The issue of sustainability has long been the subject of interest in architecture engineering and the construction sector. All three aspects of sustainability—economic, environmental, and social—can be affected through appropriate construction waste management. Construction and demolition waste (CDW) is one of the largest worldwide waste streams, therefore, it is given great attention by all stakeholders (investors, contractors, authorities, etc.). Research studies show that one of the main barriers to insufficient CDW recovery is inadequate policies and legal frameworks to manage CDW. It is also one of European Union’s (EU) environmental priorities. The aim of the article was to confirm the economic potential of construction and demolition waste audit processing through a case study. A pre-demolition waste audit was processed for an unused shopping center building in the town Snina in Slovakia. Subsequently, a comparison of economic parameters (waste disposal costs and transport costs) of the recommended CDW management was performed. This comparison confirmed the economic benefits of environmentally friendly construction waste management methods according to the waste audit results, which would also increase the sustainability of construction projects. Additionally, the cost parameters of selected waste disposal methods could be another dimension of building information modeling.

Effects of sleep restriction on the sleep electroencephalogram of adolescents.

This report describes findings from an ongoing longitudinal study of the effects of varied sleep durations on wake and sleep electroencephalogram (EEG) and daytime function in adolescents. Here, we focus on the effects of age and time in bed (TIB) on total sleep time (TST) and nonrapid eye movement (NREM) and rapid eye movement (REM) EEG. We studied 77 participants (41 male) ranging in age from 9.9 to 16.2 years over the 3 years of this study. Each year, participants adhered to each of three different sleep schedules: four consecutive nights of 7, 8.5, or 10 h TIB. Altering TIB successfully modified TST, which averaged 406, 472 and 530 min on the fourth night of 7, 8.5, and 10 h TIB, respectively. As predicted by homeostatic models, shorter sleep durations produced higher delta power in both NREM and REM although these effects were small. Restricted sleep more substantially reduced alpha power in both NREM and REM sleep. In NREM but not REM sleep, sleep restriction strongly reduced both the all-night accumulation of sigma EEG activity (11-15 Hz energy) and the rate of sigma production (11-15 Hz power). The EEG changes in response to TIB reduction are evidence of insufficient sleep recovery. The decrease in sigma activity presumably reflects depressed sleep spindle activity and suggests a manner by which sleep restriction reduces waking cognitive function in adolescents. Our results thus far demonstrate that relatively modest TIB manipulations provide a useful tool for investigating adolescent sleep biology.

Do technical components of microanastomoses influence the functional outcome of free gracilis muscle transfer for elbow flexion in traumatic brachial plexus injury?

IntroductionThe traumatic lesions of the brachial plexus in adults are devastating injuries causing continuous severe functional impairment for both work and daily living activities. The restoration of elbow flexion is one of the most important movements for patient recovery to previous activities. Free gracilis muscle transfer has good outcomes for cases with late presentation or as a rescue surgery to regain elbow flexion, however, bad results are present in all cohorts with insufficient recovery of muscle strength for elbow flexion. A number of hypotheses can be postulate to explain the fair results observed in some cases of free gracilis muscle transfer for elbow flexion. Most studies in the current literature compare the choice of the donor nerve used in neurotization and nerve grafts. The aim of this study is to evaluate if technical components of microvascular anastomosis could influence the functional outcome of free functional muscle transfer for elbow flexion in adult patients with traumatic brachial plexus injury. Material and methodsIncluded all adult patients with traumatic brachial plexus injury submitted to free functional gracilis muscle transfer for elbow flexion. The complications and functional results according to British Medical Research Council (BMRC) score were recorded. ResultsWe assessed 26 patients with mean age of 32.8 years. The most common donor nerve for gracilis muscle was the accessory nerve in 18 patients. Eighteen patients presented with good result (M3/M4). The mean ischemia time was higher for patients with bad results (132 minutes) comparing with patients with good results (122 minutes). Patients with only one venous anastomosis had 41% of poor functional outcome compared with 22% of cases with two venous anastomoses. No statistically significant difference in the ischemia time of the cases with good or poor functional outcome was observed (p=0.657), as for the number of venous anastomoses (p=0.418). ConclusionOur study observes that patients with only one venous anastomoses for drainage of free gracilis and those with longer intraoperative ischemia time had higher incidence of poor functional outcome of free gracilis muscle transfer for elbow flexion, but not statistically significant. Level of proofII; prospective cross-sectional study.

Insufficient recovery of fractional flow reserve even after optimal implantation of drug-eluting stents: 3-year outcomes from the FUJI study

BackgroundAdequate improvement in fractional flow reserve (FFR) is not necessarily achieved in some cases of drug-eluting stent (DES) implantation, even when imaging confirms successful placement. We hypothesized that post-stent FFR may be associated with advanced diffuse atherosclerotic condition. We explored the relationships between FFR values after DES implantation (post-stent FFR). MethodsA total of 218 patients were included in this prospective, multicenter study and were divided into two groups: adequate FFR group (post-stent FFR >0.80, n=176) and inadequate FFR group (post-stent FFR ≤0.80, n=42). The primary endpoint was a major adverse cardiovascular event (MACE) including cardiac death, non-fatal myocardial infarction (MI), unplanned coronary revascularization, and hospitalization for heart failure. The secondary endpoints were event rate of all-cause death, non-fatal MI, unplanned coronary revascularization, non-fatal stroke, and hospitalization for heart failure. ResultsDuring follow-up of 31.4±8.7 months, 34 patients (16%) had cardiovascular events. Inadequate FFR group was significantly associated with higher risk of MACE (hazard ratio: 3.86; 95% confidence interval: 1.17–12.76, p=0.026; log-rank p=0.027). In particular, the incidence of unplanned coronary revascularization on non-target lesions was significantly higher in the inadequate FFR group (log-rank p=0.031). ConclusionsPost-stent FFR ≤0.80 was associated with a high incidence of non-target lesion revascularization and could be a surrogate marker for advanced atherosclerotic condition in the vessels of the entire coronary artery.

Exceptional Conditions for Favorable Neurological Recovery After Laminoplasty in Cases with Cervical Myelopathy Caused by K-line (-) Ossification of Posterior Longitudinal Ligament.

A retrospective observational study. To clarify the exceptional conditions for a favorable neurological recovery after laminoplasty (LMP) for cervical myelopathy caused by K-line (-) ossification of the posterior longitudinal ligament (OPLL). The K-line-based classification of cervical OPLL was developed to predict insufficient neurological recovery after LMP. For patients with K-line (-) OPLL, LMP generally yields the least improvement because of inadequate decompression of the spinal cord; however, there are some exceptional cases wherein LMP promotes favorable neurological recoveries. We retrospectively reviewed the medical records of 106 consecutive patients who underwent LMP for cervical OPLL to determine the demographic data, radiographic findings, and neurological recoveries of the patients as assessed preoperatively and 2 years postoperatively by their Japanese Orthopedic Association (JOA) scores. The factors associated with favorable outcomes after LMP in patients with K-line (-) were then investigated. Of 106 total patients, 31 were classified as K-line (-), of whom 21 achieved the least neurological recovery after LMP (JOA recovery rate <50%), while the remaining 10 patients achieved favorable outcomes (JOA recovery rate ≥50%). Among the K-line (-) group patients, those with ext-K-line (+), which changed to K-line (+) in the neck-extended position, and the patients with up-K-line (-), in whom the lesion responsible for myelopathy in the upper cervical spine (C3 or above), showed favorable neurological recoveries after LMP. Our data shows that, even for patients with K-line (-) OPLL, a favorable neurological recovery can be expected after LMP in cases in which the OPLL is in the upper cervical spine or the K-line changes to (+) in the neck-extended position. This means that K-line-based predictions of surgical outcomes after LMP should be indicated for patients with OPLL in the middle and lower cervical spine with limited extension mobility.Level of Evidence: 4.

Exploratory Study on Family Leisure Constraints of the Twochild Family in China

Driven by the two-child policy, there are more and more two-child families in China. The purpose of this research was to examine the leisure constraints of these families in Chinese urban areas. Based on interviews with the parents from 12 families and the leisure constraint theory, the main factors are identified. First, intrapersonal constraints, which include personal physical constraints (such as insufficient postpartum recovery) and psychological constraints(such as stress). Second, interpersonal constraints, which mainly come from family members (such as family support) and friends (such as narrowing social circles). Third, structural constraints, like family income, climate conditions, facilities, free time for leisure. Besides, the study also discovered a new type of constraint-cultural constraints, which is embodied in familism. This factor is close to the other three constraints and affects them. Based on this, the research proposed a new hierarchical model of leisure constraints. Finally, the article puts forward some suggestions for future research on family leisure under the influence of the two-child policy.

Negative Fusional Vergence Is Abnormal in Children with Symptomatic Convergence Insufficiency.

Deficits of disparity divergence found with objective eye movement recordings may not be apparent with standard clinical measures of negative fusional vergence (NFV) in children with symptomatic convergence insufficiency. This study aimed to determine whether NFV is normal in untreated children with symptomatic convergence insufficiency and whether NFV improves after vergence/accommodative therapy. This secondary analysis of NFV measures before and after office-based vergence/accommodative therapy reports changes in (1) objective eye movement recording responses to 4° disparity divergence step stimuli from 12 children with symptomatic convergence insufficiency compared with 10 children with normal binocular vision (NBV) and (2) clinical NFV measures in 580 children successfully treated in three Convergence Insufficiency Treatment Trial studies. At baseline, the Convergence Insufficiency Treatment Trial cohort's mean NFV break (14.6 ± 4.8Δ) and recovery (10.6 ± 4.2Δ) values were significantly greater (P < .001) than normative values. The post-therapy mean improvements for blur, break, and recovery of 5.2, 7.2, and 1.3Δ, respectively, were statistically significant (P < .0001). Mean pre-therapy responses to 4° disparity divergence step stimuli were worse in the convergence insufficiency group compared with the NBV group for peak velocity (P < .001), time to peak velocity (P = .01), and response amplitude (P < .001). After therapy, the convergence insufficiency group showed statistically significant improvements in mean peak velocity (11.63°/s; 95% confidence interval [CI], 6.6 to 16.62°/s), time to peak velocity (-0.12 seconds; 95% CI, -0.19 to -0.05 seconds), and response amplitude (1.47°; 95% CI, 0.83 to 2.11°), with measures no longer statistically different from the NBV cohort (P > .05). Despite clinical NFV measurements that seem greater than normal, children with symptomatic convergence insufficiency may have deficient NFV when measured with objective eye movement recordings. Both objective and clinical measures of NFV can be improved with vergence/accommodative therapy.

Dental Pulp Cell Sheets Enhance Facial Nerve Regeneration via Local Neurotrophic Factor Delivery.

An effective strategy for sustained neurotrophic factor (NTF) delivery to sites of peripheral nerve injury (PNI) would accelerate healing and enhance functional recovery, addressing the major clinical challenges associated with the current standard of care. In this study, scaffold-free cell sheets were generated using human dental pulp stem/progenitor cells, that endogenously express high levels of NTFs, for use as bioactive NTF delivery systems. Additionally, the effect of fibroblast growth factor 2 (FGF2) on NTF expression by dental pulp cell (DPC) sheets was evaluated. In vitro analysis confirmed that DPC sheets express high levels of NTF messenger RNA (mRNA) and proteins, and the addition of FGF2 to DPC sheet culture increased total NTF production by significantly increasing the cellularity of sheets. Furthermore, the DPC sheet secretome stimulated neurite formation and extension in cultured neuronal cells, and these functional effects were further enhanced when DPC sheets were cultured with FGF2. These neuritogenic results were reversed by NTF inhibition substantiating that DPC sheets have a positive effect on neuronal cell activity through the production of NTFs. Further evaluation of DPC sheets in a rat facial nerve crush injury model in vivo established that in comparison with untreated controls, nerves treated with DPC sheets had greater axon regeneration through the injury site and superior functional recovery as quantitatively assessed by compound muscle action potential measurements. This study demonstrates the use of DPC sheets as vehicles for NTF delivery that could augment the current methods for treating PNIs to accelerate regeneration and enhance the functional outcome. Impact statement The major challenges associated with current treatments of peripheral nerve injuries (PNIs) are prolonged repair times and insufficient functional recovery. Dental pulp stem/progenitor cells (DPCs) are known to endogenously express high levels of neurotrophic factors (NTFs), growth factors that enhance axon regeneration. In this study, we demonstrate that scaffold-free DPC sheets can act as effective carrier systems to facilitate the delivery and retention of NTF-producing DPCs to sites of PNIs and improve functional nerve regeneration. DPC sheets have high translational feasibility and could augment the current standard of care to enhance the quality of life for patients dealing with PNIs.

Low-energy cross-sectional cathodoluminescence analysis of the depth distribution of point defects in Si-ion-implanted β-Ga2O3

Low-energy cross-sectional cathodoluminescence (CL) with a beam energy of 1 keV was applied to Si-ion-implanted β-Ga2O3 (−201) wafers to investigate implantation damage and recovery. The semi-quantitative CL-intensity depth profiles were obtained by considering nonradiative recombination at the surface. We found that the CL intensity did not fully recover, even after annealing at 1273 K. Such insufficient recovery was prominent in the Si-diffusion region, suggesting that Si-dopant activation and Si diffusion are strongly correlated through interaction with point defects generated by implantation, such as Si interstitials and Ga vacancies.

Abstract 13428: Cardiac Troponin T Level is Associated With Myocardial Recovery in Fulminant Myocarditis

Background: Fulminant myocarditis (FM) is a fatal disease that causes rapid-onset severe heart failure requiring inotropes or mechanical circulatory support (MCS). Because insufficient myocardial recovery requires durable left ventricular assist device or heart transplantation, the course of myocardial recovery should be predicted. Hypothesis: Cardiac troponins, which elevates due to myocardial damage, may associate with myocardial recovery in FM. Purpose: We aimed to investigate the relationship between cardiac troponin T (TnT) levels and myocardial recovery course in patients with FM. Method: We performed a retrospective medical record review of 19 patients with FM requiring MCS from May 2012 to January 2020. The serial changes of one-week left ventricular ejection fraction (LVEF) after MCS implantation according to TnT levels were evaluated. Results: Median age was 50 years and 10 patients were male. As for initial MCS, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) with intra-aortic balloon pumping (IABP) were used in 13 patients, IABP in 4 patients, VA-ECMO in one patient, and impella 2.5 in one patient. Median peak TnT level within one week after MCS implantation were 4.43 (2.47 - 34.6) ng/mL. The patients were divided into High-TnT group and Low-TnT group according to median peak TnT level. All patients in both groups were alive until 7 days after MCS implantation, and LVEF on day 7 was significantly lower in the High-TnT group (Fig). TnT level was highest on day 1 and gradually decreased in the High-TnT group (Fig). Six patients died during hospitalization in the High-TnT group, in contrast, only one patient died in the Low-TnT group (p=0.020). Peak TnT level in patients with LVEF ≥30% (n=8) on day 7 was significantly lower than in patients with LVEF &lt;30% (2.40 vs 13.5 ng/mL, p=0.012), however, other laboratory parameters showed no significant differences. Conclusion: Higher TnT level showed impaired myocardial recovery in patients with FM.

The distribution of eukaryotic initiation factor 4E after bouts of resistance exercise is altered by shortening of recovery periods

Insufficient duration of recovery between resistance exercise bouts reduces the effects of exercise training, but the influence on muscle anabolic responses is not fully understood. Here, we investigated the changes in the distribution of eukaryotic initiation factor (eIF) 4E, a key regulator of translation initiation, and related factors in mouse skeletal muscle after three successive bouts of resistance exercise with three durations of recovery periods (72 h: conventional, 24 h: shorter, and 8 h: excessively shorter). Bouts of resistance exercise dissociated eIF4E from eIF4E binding protein 1, with the magnitude increasing with shorter recovery. Whereas bouts of resistance exercise with 72 h recovery increased the association of eIF4E and eIF4G, those with shorter recovery did not. Similar results were observed in muscle protein synthesis. These results suggest that insufficient recovery inhibited the association of eIF4E and eIF4G, which might cause attenuation of protein synthesis activation after bouts of resistance exercise.

Planning for climate change: evaluating the changing patterns of flood vulnerability in a case study in New Taipei City, Taiwan

Global climate change has resulted in extreme events occurring with increasing intensity and frequency. Due to the limitations of traditional structural engineering measurements, vulnerability measurement has become critical in disaster mitigation according to the IPCC and UNISDR. Currently, flood vulnerability studies focus on evaluating the present state of flood vulnerability at various spatial scales. Different levels of development progress and varying environmental factors result in variations in disaster capacity in urban and rural areas. Therefore, this study explores the temporal and spatial variations of vulnerability in urban and rural built environments by using spatial autocorrelation analysis and principal component analysis. Bivariate local indicators of spatial association (LISA) results show that particular areas maintain high or low vulnerability in both examined years: 2008 and 2018. The critical differences between HH and LL might be caused by different urban development statuses and insufficient emergency or recovery facilities.

TRAINING LOAD, RECOVERY AND INJURIES IN ELITE RHYTHMIC GYMNASTS DURING MAIN COMPETITIVE PERIODS: A CASE STUDY

Competitive periods are critical periods where elite rhythmic gymnasts experience higher training loads and insufficient recovery. The aim of this short report is to describe individual training load, recovery and injuries in elite group rhythmic gymnasts during competitive periods. Six gymnasts from the Brazilian senior rhythmic gymnastics group were monitored daily over a 126-day period comprising regular training and four competitions. Training load was measured using the session rating of perceived exertion (session-RPE). Daily load, chronic load, and acute:chronic workload ratio (ACWR) were assessed. The Total Quality Recovery (TQR) scale was used to monitor recovery and a 3-day rolling average (3RA) TQR was also measured. Injuries were diagnosed and reported by the medical staff and their reports were used in the analysis. Descriptive statistics were used. The gymnasts presented distinct daily load, ACWR, and recovery patterns, as well as injuries across the competitive periods. All athletes had rapid increase (“spike”) in load. Three athletes were underrecovered more than 60% of the time. Four athletes sustained five injuries during the time of the study (all lower limb overuse injuries, two severe, two mild and one slight). Individual factors such as age and chronic load could moderate how each gymnast responds to training and tolerates spikes in load. Moreover, injuries sustained during competitive periods appear to affect the short and long-term careers of gymnasts, as well as impair training and competition organization of the team.