Interventions For Individuals Research Articles

Tenascin-X deficiency causing classical-like Ehlers Danlos syndrome type 1 in humans is a significant risk factor for GI and tracheal ruptures.

Classical-like Ehlers Danlos Syndrome type 1 (clEDS1) is a very rare form of Ehlers Danlos Syndrome (EDS) caused by tenascin-X (TNX) deficiency, with only 56 individuals reported. TNX is an extracellular matrix protein needed for collagen stability. Previous publications propose that individuals with clEDS1 might be at risk for gastrointestinal (GI) tract perforations and/or tracheal ruptures. To characterize complications resulting from perforations of the GI tract and/or tracheal rupture in an international case series of individuals with clEDS1 due to disease-related tissue fragility. This case series includes individuals with confirmed clEDS1 and GI perforations and/or tracheal ruptures from participating centres. Researchers who previously reported such individuals were contacted for additional information. A retrospective assessment of clinical features was performed. Fifteen individuals were included. Ten had spontaneous GI perforations, seven of whom had multiple GI perforations. Almost all had severe diverticulosis. Three individuals experienced iatrogenic tracheal ruptures. Severe GI complications, such as perforation, and tracheal rupture were observed in a substantial number of individuals with clEDS1. As these features seem significantly more common in clEDS1 than in the average population, we advise vigilance during intubation and GI endoscopic interventions of individuals with clEDS1. Routine referrals to clinical geneticists are recommended for patients with symptoms indicative of clEDS1, especially with unexplained GI perforations and connective tissue symptoms. Our findings offer valuable insights for the clinical management of clEDS1 and underscore the importance of specialized care, providing a foundation for improved clinical guidelines and preventive strategies.

Protocol for a 1-year randomised, controlled, parallel group, open-label trial on the effects and feasibility of time-restricted eating in individuals with type 2 diabetes- The Restricted Eating Time in the Treatment of Type 2 Diabetes (RESET2) trial.

Time-restricted eating (TRE) limits the time for food intake to typically 6-10 h/day without other dietary restrictions. The aim of the RESET2 (the REStricted Eating Time in the treatment of type 2 diabetes) trial is to investigate the effects on glycaemic control (HbA1c) and the feasibility of a 1-year TRE intervention in individuals with overweight/obesity and type 2 diabetes. The aim of the present paper is to describe the protocol for the RESET2 trial. RESET2 is a randomised, controlled, parallel-group, open-label trial. One hundred and sixty individuals with type 2 diabetes (HbA1c >53 mmol/mol (>7.0%)), and Body Mass Index ≥25 kg/m2 will be randomised to standard care plus TRE, or to standard care and habitual living. Both the intervention and control group will follow standard diabetes care including regular clinical visits 3-4 times/year. The intervention is divided into two periods: (1) a 3-month TRE period with a fixed eating window with a self-selected timing to obtain data from the participants' experiences with TRE and (2) a 9-month individually adjusted TRE period. Participants in the TRE group will be instructed to reduce their eating window by a minimum of 3 h/day compared to the habitual eating window and with an eating window of 8-10 h/day. Test days will be scheduled at baseline, after 3 months and after 1 year. The primary outcome is HbA1c (evaluated 3 months and 1 year after randomisation) and secondary outcomes are body weight, fat mass, continuous glucose monitoring derived time-in-range and use of antidiabetic medicine (evaluated 1 year after randomisation). Additionally, we will conduct a process evaluation to assess whether the TRE intervention functioned as hypothesised.

Improving locomotor performance with motor imagery and tDCS in young adults

The study aimed to assess the feasibility and potential efficacy of a non-motor intervention utilizing motor imagery (MI) and transcranial direct current stimulation (tDCS) to enhance motor function. The research involved a double-blind, randomized, controlled trial with three groups: MIActive, MISham, and Control. Participants engaged in a cognitively demanding obstacle course, with time and prefrontal activation (ΔO2Hb and ΔHHb) measured across three-time points (Baseline, Post-test, 1-week follow-up). Following a pretest, active or sham tDCS was administered during an MI session, while the Control group did not receive this intervention. The MIActive group showed significant improvements in time-to-completion immediately after the intervention and one week later. Additionally, ΔO2Hb levels were lower in the MIActive group than in the other groups. These findings suggest that the combination of MI and tDCS could lead to motor improvements. The study outcomes support the feasibility and initial effectiveness of using MI and tDCS as a non-motor intervention to enhance motor outcomes in short and medium terms. Further research is recommended to explore the impact of this intervention in individuals with existing motor impairments. This study contributes to the growing body of evidence on the potential of non-motor interventions to induce neuroplastic changes that improve motor function. Clinical trial registration: ClinicalTrials.gov, identifier NCT06414213 16/05/2024.

The impact of physical activity on mental health

This article critically evaluates the interconnectedness of physical activity and mental health, drawing on a diverse body of evidence from observational studies, controlled trials, and emerging neuroscientific research. We explore how engaging in regular exercise is associated with improved mood regulation, reductions in anxiety and depressive symptoms, and better coping strategies under stress. By examining a range of exercise modalities, intensities, and durations across various age groups and demographic contexts, we shed light on the differential impacts of physical activity on mental well-being. Neuroscientific findings including those from neuroimaging and biomarker analyses offer insights into the biological mechanisms behind these improvements, revealing alterations in neural circuits and neurotransmitter systems that underpin emotional resilience and cognitive functioning. We further consider the psychological and social benefits that accompany regular physical activity, such as enhanced self-esteem, feelings of belonging, and the establishment of positive routines. Finally, we identify gaps in existing research, including the need for more tailored, evidence-based exercise prescriptions and an improved understanding of how to optimize interventions for individuals with specific mental health profiles. Overall, this review underscores the imperative of incorporating strategic physical activity programs into mental health prevention, treatment, and policy initiatives.

Explanatory models of common mental disorders among South Asians in high-income countries: A systematic review.

Mental health service use by individuals of South Asian origin living outside of South Asia is influenced by cultural factors such as endorsing psycho-social-spiritual over biological explanations, somatisation, and stigma. The aim of this review is to synthesise the evidence about (a) explanatory models of common mental disorders (CMDs) among people of South Asian origin residing in high-income countries, and (b) their help-seeking for CMDs, including formal and informal care. The systematic review protocol was registered a priori on Prospero (registration number CRD42021287583). We ran extensive searches on explanatory models and help-seeking of people of South Asian origin across five databases (MEDLINE, Embase, Cumulated Index to Nursing and Allied Health (CINAHL), PsycINFO, and Global Health). We extracted the data and conducted a narrative synthesis. We included 33 reports and 29 studies (9,030 participants). The participants in the included studies viewed CMDs through a psychosocial rather than a biological lens (e.g., resulting from family issues vs. neurotransmitters). Causal attributions included life stressors and attitudinal and religious/spiritual factors. Commonly used help-seeking strategies included private coping (i.e., crying or praying), speaking to friends and family, and visiting their General Practitioner. We can conclude that cultural factors play an important role in how South Asian individuals experience and understand CMDs. To cope, they use pluralistic help-seeking strategies. Implications for clinical practice and policy include increasing research on the explanatory models of CMDs, involving family in services, and developing community-based interventions for individuals who do not engage with formal care.

Evaluating the effectiveness of a clinical decision support system (AI-Antidelirium) to improve Nurses' adherence to delirium guidelines in the intensive care unit.

To evaluate the impact of Artificial Intelligence Assisted Prevention and Management for Delirium (AI-AntiDelirium) on improving adherence to delirium guidelines among nurses in the intensive care unit (ICU). Between November 2022 and June 2023, A cluster randomized controlled trial was undertaken. A total of 38 nurses were enrolled in the interventional arm, whereas 42 nurses were recruited for the control arm in six ICUs across two hospitals in Beijing, comparing nurses' adherence and cognitive load in units that use AI-AntiDelirium or the control group. The AI-AntiDelirium tailored delirium preventive or treated interventions to address patients' specific risk factors. The adherence rate of delirium interventions was the primary endpoint. The other endpoints were adherence to risk factors assessment, ICU delirium assessment, and nurses' cognitive load. The repeated measures analysis of variance was utilized to explore the influence of time, group, and time×group interaction on the repeated measurement variable (e.g., adherence, cognitive load). A cumulative total of 1040 nurse days were analyzed for this study. The adherence to delirium intervention of nurses in AI-AntiDelirium groups was higher than control units (75% vs. 58%, P<0.01). When compared to control groups, AI-AntiDelirium was found to be significantly effective in both decreasing extraneous cognitive load (P<0.01) and improving germane cognitive load (P<0.01). This study supports the effectiveness of AI-AntiDelirium in enhancing nurses' adherence to evidence-based, individualized delirium intervention and also reducing extraneous cognitive load. A nurse-led systemshould be applied by nursing administrators to improve compliance with nursing interventions among ICU nurses.

Analysing the effectiveness of cognitive behavioural therapy in university students with ADHD: A systematic review

Background: Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins in childhood and often persists into adult life. University students with ADHD frequently experience great difficulty with global academic functioning, resulting in higher drop-out rates and, consequently, higher unemployment rates. Objective: This literature review aims to analyse the effectiveness of cognitive behavioural therapy (CBT) interventions to reduce ADHD-related symptoms in university students with ADHD. Materials and methods: A literature search was conducted via EBSCO database in October 2023 using key terms: ADHD OR attention deficit hyperactivity disorder AND cogniti* intervention OR cogniti* therapy AND college student* OR university student*. The inclusion criteria were studies using cognitive behavioural therapy as their primary intervention for individuals with ADHD who are enrolled in university or college and are 18 years or above in age. Results: Seven out of 115 papers were deemed eligible and were included in this review. This review’s studies included four randomized control trials and three before and after open trials. Three key themes were identified through data extraction: intervention design, outcome measures used, and effectiveness of interventions on ADHD-related symptoms. All the studies tailored their CBT intervention toward university students. There was a statistically significant improvement in core domains of ADHD-related impairment, in particular, inattention (N=7), overall executive functions (n=5), and hyperactivity-impulsivity (N=1). Conclusion: While the current findings suggest positive results of CBT for reducing ADHD-related symptoms in university students with ADHD, further research should explore the sustainability of these gains over the long term. Due to the lack of explicit published study on this topic in the United Kingdom, further research should be conducted in the UK to assess the applicability and effectiveness of tailored CBT interventions within the British university environment.

Effects of aerobic exercise on cognitive function and quality of life in patients with Alzheimer’s disease: a systematic review and meta-analysis

ObjectivesNumerous studies have examined the effects of physical activity on cognitive performance and executive function in people with Alzheimer’s disease (AD), although the findings are not entirely consistent. There are...

Long COVID: A risk factor for anxiety, depression, and suicidality?

In many COVID-19 survivors, symptoms continue for a long time. This study aims to examine the relationship between the long-term effects of COVID-19, levels of anxiety and depression, and suicidal ideation with sociodemographic factors and symptoms. A cross-sectional study was conducted on patients who came for control at least 3 months after having COVID-19 disease, in the stable period, and still have symptoms after COVID-19. Demographic characteristics, symptoms, The Beck Depression Scale (BDS), The Beck Anxiety Scale (BAS), and suicidal ideation were assessed with face-to-face questionnaires. A total of 490 patients participated in the study. Thirty percent of patients scored positive on the BDS and 46% scored high on the BAS. Female sex was found to be a risk factor. Anxiety and depression were found to be significantly associated with long COVID symptoms. Both BAS and BDS scores were significantly higher in people with suicidality compared to others, and long-term symptoms were found to be statistically associated with this situation. Depression and anxiety are common in cases of long COVID. It is important for healthcare professionals to be aware of these potential mental health consequences, especially suicidality, and to provide appropriate support and interventions for individuals with long COVID.

Optimizing recovery in first-episode psychosis: A systematic review of psychosocial interventions.

This systematic review evaluates the efficacy of psychosocial interventions for individuals experiencing first-episode psychosis (FEP) across multiple recovery outcomes. Drawing from 35 studies, the analysis synthesizes evidence on symptom reduction, social and role functioning improvement, continuity of care, hospitalization rates, and other psychological outcomes. Regarding symptom reduction, specialized FEP programs demonstrated decreases across positive, negative, and general symptoms. Cognitive Behavioral Therapy (CBT) interventions also showed promise in improving psychiatric symptoms, while skills training interventions were effective in enhancing positive and negative symptoms. Social and role functioning improvements were observed across different interventions, including specialized FEP care and vocational support. Furthermore, specialized FEP programs generally led to reduced hospitalization rates and improved continuity of care, while CBT and other interventions improved psychological outcomes, such as enhanced coping skills and cognitive functioning. Most studies, particularly those of higher quality, reported positive outcomes across multiple domains. Future research should prioritize comparative efficacy, intervention duration and modality effects, and address disparities in access and utilization of FEP interventions across diverse contexts. By advancing our understanding of effective psychosocial interventions for FEP, this review offers valuable insights for clinicians, researchers, and policymakers aiming to optimize outcomes and mitigate the burden of psychosis-related disabilities.

A Low-Tech Assistive Tool for Inclusion of Persons with Hearing Impairments in Fiji

The rapid advancements in 21st-century technology have significantly driven the development of assistive tools, which serve as transformative aids for individuals with disabilities and emerging bilingual learners. Despite the growing recognition of technology`s potential in education, equitable access to these interventions for individuals with special needs remains a pressing concern, particularly in developing countries. This study examines the challenges faced by persons who are deaf or hard of hearing in Fiji and introduces a low-tech assistive device specifically designed to address these barriers. Utilizing a two-phased survey methodology, the research explores the experiences and perceptions of individuals with hearing impairments regarding their inclusion in public spaces, government services, entertainment, and social media platforms. The second phase evaluates the efficacy of an ICT-based Sign Language Tool, developed to assist parents and educators in consistently learning and applying universal sign language. The findings reveal substantial obstacles faced by persons with hearing impairments in accessing public services, highlighting the need for tailored interventions. The study underscores the potential of simple, cost-effective, low-tech solutions to alleviate societal barriers and enhance inclusion. This baseline research lays the groundwork for the development and adaptation of targeted assistive technologies to support the inclusion of persons with disabilities in Fiji, with prospects for broader application across the South Pacific region.

Exploring the long-term impact of PNF interventions on plantar fascitis with restricted dorsiflexion using visual analogue scale and foot and ankle ability measure

Introduction. Plantar fasciitis is the inflammation of the plantar fascia, affecting both active and sedentary individuals. Limited dorsiflexion increases tension, worsening symptoms. Diagnosis involves the Windlass test, and PNF shows promise in treatment, though long-term effects need further study. Aim of the study. This prospective longitudinal study aimed to investigate the long-term effectiveness and maintenance strategies following proprioceptive neuromuscular facilitation (PNF) technique interventions in individuals with plantar fasciitis and limited dorsiflexion which is one of the conditions affecting the community. The primary objectives included quantitatively comparing pain levels, functional mobility, and patient adherence to prescribed strategies over an extended follow-up period. Materials and Methods. A cohort of 120 participants with plantar fasciitis and limited dorsiflexion, previously treated with PNF interventions, were enrolled in the study. Follow-up assessments were conducted at three-month intervals over a one-year period. Pain levels were measured using a visual analog scale (VAS), functional mobility was assessed using the foot and ankle ability measure (FAAM), and patient-reported outcomes were recorded. Qualitative insights into maintenance strategies were obtained through in-depth interviews, covering aspects such as home exercise programs, lifestyle modifications, and adherence to recommendations. Results. Statistical analysis revealed a statistically significant (p &lt; 0.05) reduction in pain levels and improved functional mobility over the study period. Recurrence rates were found lower than baseline, with only 15% of recurrence. Logistic regression analysis identified factors contributing to sustained outcomes, including consistent adherence to prescribed home exercises (p = 0.021) and proactive lifestyle modifications (p = 0.035). Conclusion. The study concluded that PNF techniques effectively reduce pain, improve mobility, and sustain outcomes in plantar fasciitis with limited dorsiflexion, highlighting the importance of adherence to exercises and lifestyle modifications.

ADVANCEMENTS IN FRAILTY INTERVENTION RESEARCH: CURRENT TRENDS AND FUTURE DIRECTIONS

Abstract Frailty, a complex, syndromic condition primarily affecting older adults, faces a lack of evidence-based management strategies due to scarce randomized controlled trials. So far, frailty interventions have employed a spectrum of strategies, including health behavior interventions (e.g., diet and exercise), pharmacological interventions targeting specific biological pathways, and personalized geriatric care models. However, the field faces significant challenges that hinder its progress. A notable issue is that there is a noticeable lack of comprehensive management strategies for frailty patients, supported by robust evidence. Moreover, trials examining the impact of physical activity and dietary interventions have largely focused on the clinical manifestations of frailty (e.g., strength) with little evidence of addressing its biological underpinnings. Further complicating these issues is the inconsistent validation of research findings across various studies and demographic groups, casting doubt on their broader relevance and efficacy. The symposium presents four talks: the first evaluates a values-based digital literacy intervention for prefrail and frail individuals with chronic disease; the next two discuss integrating technologies, including sensors with AI and voice-activated devices, for in-home frailty monitoring and intervention; the fourth considers mind-body practices’ (e.g., yoga and tai chi) potential to influence frailty’s biological underpinnings. Collectively, this symposium aims to: (a) differentiate between interventions tailored specifically to address frailty as a unique clinical entity and interventions aimed at improving care for frail older adults; (b) explore innovative approaches for tailoring frailty interventions to patient-specific goals; (c) tackle the inherent research and implementation challenges in frailty care.

A systematic review of WT-based interventions for individuals with autism spectrum disorder

A systematic review of WT-based interventions for individuals with autism spectrum disorder

IMPACT OF GROUP-BASED DIGITAL GAMING INTERVENTION AMONG INDIVIDUALS LIVING WITH EARLY TO MODERATE DEMENTIA

Abstract Slowing the progression of dementia and maintaining good behavioral and psychological symptoms are important aspects of life for individuals living with dementia and their caregivers. This study involved a group-based digital gaming system called Obie Technology as an interactive intervention for individuals living with dementia at a local adult day health center for 20 weeks, from mid-November 2023 to mid-April 2024. This gaming system promotes movement, stimulates cognitive activity, and encourages socialization. For example, colorful balloons float around the board or floor as clients try to hit as many as they can. A mixed methods approach with a pre-post design was employed to examine the effects of the intervention on cognitive function, mood, and behaviors in 24 individuals with early or moderate-level dementia. The average scores of the Montreal Cognitive Assessment (MoCA) at the baseline and midpoint (after 10 weeks) were 15.65 and 15.60, respectively, indicating no significant progression of dementia between these time periods. Participants’ depression level and neuropsychiatric symptoms presentation assessed by standardized instruments also showed no significant changes. The results from qualitative observations demonstrate that the group of people living with early-stage dementia in this study were more engaged and enjoyed the intervention compared to a group with moderate-stage dementia. They often comment that the intervention was fun, interesting, and enjoyable while actively engaging in the game with enhanced movement. In this presentation, we will present the findings based on the completed data, including the post-assessments.

Factors influencing survival outcomes in patients with stroke at three tertiary hospitals in Zimbabwe: A 12-month longitudinal study.

In this longitudinal study, we aimed to determine factors influencing survival outcomes among patients with stroke at three tertiary hospitals over a 12-month period. The investigation sought to uncover influential determinants to enhance the precision of prognostic assessments and inform targeted interventions for individuals affected by stroke. Employing a longitudinal study design, participants were observed for 12 months from baseline, censoring survivors at the endpoint. The dataset originated from a comprehensive study involving stroke patients treated at three referral hospitals in Zimbabwe: Parirenyatwa, Sally Mugabe, and Chitungwiza Central Hospitals. The primary outcome variable, the duration of survival until death, was measured in days from the initiation of stroke treatment. Gompertz parametric regression analysis was utilized for data modeling following AFT model diagnostics. In our study, 188 stroke patients were enrolled at baseline. However, 51 patients were excluded from the analysis due to either missing information or loss to follow-up. Among the remaining 137 patients who were tracked over a 12-month period, 42% were censored, and 58% were deceased. Individuals utilizing 'Free Service (older than 65/pensioners/retirees/social welfare)' hospital bill payment methods showed a decreased risk of death, (adjusted hazard ratio; aHR: 0.4, 95% CI: 0.20, 0.80), suggesting a protective effect compared to cash paying patients. Those who had attained a secondary school level education displayed a significantly lower risk of death (aHR: 0.4, 95% CI: 0.24, 0.79) compared to those with primary level education. Age was a significant risk factor, with individuals aged 45-65 and those over 65 years showing higher adjusted hazard ratios 3.4 (95% CI: 1.42, 8.36) and 3.7(95%CI:1.44, 9.36), respectively, relative to those below 45 years of age. Housing status revealed a protective effect for those residing with parents/relatives (aHR: 0.4, 95% CI: 0.20, 0.64). Total functional outcome demonstrated significantly lower hazards for individuals with mild or moderate (aHR: 0.2, 95% CI: 0.09, 0.40) and severe outcomes (aHR: 0.2, 95% CI: 0.10, 0.46) compared to those with very severe outcomes. The study findings demonstrate that hospital bill payment methods, housing status and staying with relatives, educational attainment, functional outcome, and age significantly affect survival outcomes among stroke patients. This highlights the need to consider socio-demographic and clinical variables in the development of prognostic assessments and targeted interventions for individuals recovering from stroke.

A Comprehensive Review on Physical Activity Interventions for Individuals with Autism Spectrum Disorder

This review synthesizes current research on the impact of physical activity interventions for individuals with Autism Spectrum Disorder (ASD). ASD is characterized by deficits in social communication and repetitive behaviours, often accompanied by challenges in motor skills and physical fitness. Physical activity is increasingly recognized as a potential therapeutic tool for addressing these challenges, but the variability in interventions and outcomes warrants a comprehensive review. The review analysed studies published over the past two decades, focusing on various types of physical activity interventions, including aerobic exercises, strength training, and motor skill development programs. The studies were evaluated based on their methodology, sample size, duration, and reported outcomes, with a particular emphasis on physical, social, and behavioural improvements. Findings indicate that physical activity interventions generally lead to significant improvements in motor skills, physical fitness, and social interactions among individuals with ASD. Additionally, several studies reported reductions in stereotypical behaviours and anxiety levels, suggesting a broader psychosocial benefit. However, the effectiveness of these interventions varies depending on factors such as the type of activity, the intensity of the program, and individual differences within the ASD population. The review concludes that while physical activity interventions hold promise as a complementary approach to traditional therapies for ASD, further research is needed to establish standardized protocols and identify the most effective intervention strategies. Future studies should focus on long-term effects, the sustainability of benefits, and the development of tailored programs that address the diverse needs of individuals with ASD.

Characterizing Nonalcoholic Fatty Liver Disease (NAFLD) in Lean Individuals at a Tertiary Care Hospital: A Cross-sectional Study.

Fat accumulation in the liver is affecting 38% of the global population. It can also occur in normal-weight individuals, termed lean non-alcoholic fatty liver disease (NAFLD). This study examines Asian and Western body mass index (BMI) criteria, as well as metabolic dysfunction-associated fatty liver disease (MAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) diagnostic guidelines, in lean fatty liver cases within a healthcare setting. This study was cross-sectional included 111 lean patients diagnosed with NAFLD using either ultrasound or VCTE from January 2023 to March 2024. Anthropometric, laboratory and non-invasive liver fibrosis evaluation parameters were used. The study assessed clinical characteristics and metabolic risk factors of patients with BMI ≤ 23 kg/m2 and BMI between 23 and ≤ 25 kg/m2 using MASLD and MAFLD diagnostic criteria. The cohort included NAFLD patients with a mean age of 43.3 years (±13.2 years). Of the participants, 33% were diagnosed through ultrasonography, whereas 67% diagnosis were made via Fibro scan. Majority were male 92 (83%), while females were 19 (17%) of the entire group. The lean NAFLD criteria for Asia and the West were satisfied by 43 (39%) persons with a BMI ≤ 23 kg/m2 and 68 (61%) individuals with a BMI between 23 and ≤ 25 kg/m2, respectively. The average body mass index (BMI) was 23.0 ± 1.5 kg/m2. Diabetes was observed in 16%, hypertension 11%, and ischemic heart disease in 2%. Out of the total individuals, 92 satisfied the MASLD-MAFLD criteria, whereas 18 did not qualify the MAFLD criteria for diagnosis and were classed as MASLD-Alone. Elevated triglycerides, insulin resistance (HOMA-IR ≥ 2), and three or more cardiometabolic risk factors (CMRF) were significant in the MASLD-MAFLD group compared to the MASLD-Alone group (p < 0.05). Comparing BMI criteria, no significant differences were found in terms of fibrosis between the Western and Asian lean NAFLD BMI criteria's (p = 0.243). Lean NAFLD is a major global health concern. Applying non-Asian BMI criteria (BMI ≤ 25 kg/m2) for lean Asians improves early detection and intervention for at-risk individuals. Accurate use of MAFLD and MASLD criteria is essential to prevent confusion in diagnosing lean NAFLD. Further multicenter investigations with larger sample numbers are required to corroborate these results in our community. Nazir S, Abbas Z, Gazder DP, et al. Characterizing Nonalcoholic Fatty Liver Disease (NAFLD) in Lean Individuals at a Tertiary Care Hospital: A Cross-sectional Study. Euroasian J Hepato-Gastroenterol 2024;14(2):198-204.

Spinal cord epidural stimulation for male sexual function in spinal cord injured rats.

95% of men with spinal cord injuries exhibit difficulties with sexual function, including erectile dysfunction, anejaculation, retrograde ejaculation, poor ejaculatory force, and poor sperm quality. The primary goal is to determine if well-established interventions, such as spinal cord epidural stimulation, are a feasible treatment for sexual dysfunction and if locomotor recovery training can be used to improve ejaculatory function in a rodent model of spinal cord injury (SCI). Male Wistar rats underwent thoracic laminectomies (shams), spinal cord transections, or moderate spinal cord contusion injuries. In urethane-anesthetized rodents, terminal spinal cord epidural stimulation was performed to target the mid-lumbar level spinal generator for ejaculation (SGE) in animals with transection spinal cord injuries at 3-, 14-, or 70-days post-injury and in animals with sham surgeries and spinal cord contusions at 70days post-injury. The impact of locomotor training frequency was examined in two groups of rats with spinal cord contusion, which underwent 1-hr of assisted plantar stepping on a treadmill, training two or five times weekly for 6weeks. Terminal experiments in all groups were followed by measures of sperm concentration and post-mortem testicular weight and morphology. Spinal cord epidural stimulation consistently induced the expulsion phase of ejaculation, and occasionally the emission phase of ejaculation in rats with chronic SCI. All animals were most responsive to spinal cord epidural stimulation combined with manual stimulation to induce ejaculation, with chronic injury resulting in the most consistent responses. Locomotor training improved response rates to spinal cord epidural stimulation, with intermittent training resulting in the most consistent induction of both the emission and expulsion phases of ejaculation. Sperm concentration was impacted by injury completeness and time-post injury, which was lowest in the chronic complete transection group of rats. Locomotor training resulted in an overall increase in sperm concentration, with 2days per week of training resulting in a significant improvement of sperm motility. Spinal cord epidural stimulation combined with locomotor training is a feasible intervention for individuals with SCI who seek to regain sexual function. Although we have anecdotal reports of non-targeted L3 spinal cord epidural stimulation inducing ejaculation in humans having spinal cord injuries, the current outcomes may be underestimated as stimulation was carried out in anesthetized animals. Spinal cord epidural stimulation to target the SGE is a feasible intervention for sexual dysfunction following SCI.

Short-Term Restriction of Physical and Social Activities Effects on Brain Structure and Connectivity

Background: Prolonged confinement in enclosed environments has raised concerns about its effects on both physical and mental health. Although increased rates of depression or anxiety during COVID-19 lockdowns have been reported, the effects of short-term restrictions on social activities and physical on brain function and structure remain poorly known. Methods: This study explored longitudinal changes in brain gray matter volume (GMV) and functional connectivity (FC) immediately after and four months following a short-term lockdown in comparison to pre-lockdown conditions. MRI data were collected from 20 participants before the lockdown, from 29 participants (14 original, 15 new) two months post-lockdown, and from 27 out of the 29 participants four months post-lifting of the lockdown. Results: Results showed significant GMV reductions in the right gyrus rectus and cuneus post-lockdown, with further reductions observed four months after lifting the restrictions, affecting additional brain regions. Longitudinal FC trajectories revealed decreased connectivity between the default mode network (DMN) and sensorimotor/attention networks post-lockdown, and recovery after four months post-lifting of the lockdown. Conclusions: The observed plasticity in brain FC indicates substantial recovery potential with the potential long-term effect of structural changes. Our findings offer insights into the effects of isolation on the human brain, potentially informing rehabilitation mechanisms and interventions for individuals in similar conditions.