Recovery Phase Research Articles

Estrogen receptor α aggravates intestinal inflammation via promoting the activation of NLRP3 inflammasome

Activation of the NLRP3 inflammasome and estrogen receptor α (ERα) has been shown to increase the risk of inflammatory bowel diseases (IBD) or promote disease recurrence. In previous work, we demonstrated that ERα regulated the transcription of NLRP3. However, the precise mechanism by which ERα modulates NLRP3 in IBD models remains unclear. In this study, we induced IBD in wild-type mice using DSS or TNBS, followed by treatment with the ERα-specific agonist PPT. The results showed that IBD symptoms and intestinal inflammation responses were significantly exacerbated after PPT treatment. Furthermore, the activation of ERα by PPT led to a marked increase in the expression of NLRP3 and pro-inflammatory cytokines, including IL-1β and IL-18, suggesting that ERα activation exacerbated intestinal inflammation and impaired mucosal healing during the recovery phase of inflammation. In contrast, ERα-knockout mice exhibited only mild symptoms when exposed to DSS or TNBS, with a concurrent reduction in NLRP3 expression, indicating that ERα plays a role in inflammation susceptibility. Similar findings were observed in NCM-460 cells, where the inflammation response was attenuated in ERα-knockdown cells. Importantly, we demonstrated that ERα interacted with the NLRP3 inflammasome and promoted its assembly. Collectively, we propose an underlying pathogenesis of IBD, that is, ERα can interact with the NLRP3 inflammasome and promote its expression and assembly, thereby exacerbating intestinal inflammation in IBD models. Therefore, ERα could serve as a potential therapeutic target for NLRP3 inflammasome-associated intestinal inflammation.

Dengue Fever—Diagnosis, Risk Stratification, and Treatment.

Dengue fever is a common infectious disease in the tropical and subtropical zones, with more than 100 million symptomatic cases per year. Mosquitoes of the genus Aedes (Aedes aegypti, Aedes albopticus) are vectors of the disease, and their spread has led to rising case numbers around the world. Physicians in Europe, too, are increasingly being confronted by this challenge. This review is based on the findings of a selective search in international publication databases, as well as on the WHO guideline of 2009 and the current recommendations of the Robert Koch Institute. Dengue fever takes a mild course in more than 90% of cases. Severe dengue fever, up to and including shock and/or mucosal hemorrhages, is rare and carries a mortality of 1-5%. The disease characteristically takes a triphasic course (febrile phase, critical phase, recovery phase). It is diagnosed by the direct demonstration of the pathogen (e.g., with the reverse transcriptase polymerase chain reaction [RT-PCR] up to day 5 of the illness) or by serology. Patients are classified into one of three risk groups depending on their findings and comorbidities and are then treated either as outpatients or in the hospital. The treatment is symptomatic, as no treatment directed against the cause of the disease is available. The key measures are adequate volume replacement and, in patients with hemorrhage, the transfusion of blood products. Preventive steps include vaccination after a documented initial infection and the meticulous avoidance of mosquito bites. Climate change and global mobility have led to a worldwide increase in dengue fever. The disease only rarely takes a severe course. In such cases, rapid symptomatic treatment as needed is the key to the avoidance of severe complications.

Design and Testing of a Small-Scale Composting Facility for Sheep Manure Utilizing Aeration and Thermal Treatment

Inner Mongolia has the largest sheep population among China’s provinces, resulting in the production of a substantial amount of sheep manure. If left untreated, this manure can contribute to environmental pollution. However, sheep manure serves a dual purpose: it can be both a pollutant and a valuable source of organic fertilizer. Consequently, there is an urgent need to address the environmental issues arising from manure accumulation and its unused status. In this paper, a viable solution is proposed: the conversion of manure into fertilizer through a composting unit incorporating high-temperature aerobic fermentation technology. This unit, tailored for small farms and individual farmers, integrates critical functions such as ventilation, heating, and turning. Additionally, it boasts excellent thermal insulation, enhancing composting efficiency and enabling precise control over fermentation conditions. This design mitigates heat loss and accelerates maturation, addressing common challenges in traditional composting. The design process encompassed both equipment construction and control systems, with a primary focus on compost fermentation and aeration heating. The components were carefully designed or selected based on theoretical analysis and subsequently validated using simulation software, including EDEM and Fluent. The control system seamlessly integrates a touch screen interface, PLC programming, and control circuits to manage air pumps and electric heaters in response to changes in temperature and oxygen concentration. Furthermore, it controls the motors during the recovery phase. A comprehensive performance evaluation was conducted, revealing notable improvements. Under artificially heated conditions, the maximum temperature of the compost increased by approximately 20 °C, the composting cycle was reduced by roughly 4 days, and the seed germination index (GI) rose by about 9% when compared to natural fermentation. Thus, this device significantly accelerates composting and improves fertilizer quality by increasing the decomposition rate.

Associations of physical activity and sedentary time with health-related quality of life in patients with localized renal cell cancer: a cross-sectional analysis within the ReLife study

Abstract Purpose This study examined the associations of device-measured moderate-to-vigorous physical activity (MVPA) and sedentary time as well as self-reported MVPA with health-related quality of life (HRQoL) in patients with localized renal cell cancer (RCC) in the recovery phase after surgery. Methods At 3 months post-surgery, 341 patients with stage I-III RCC participating in the ReLife study wore an ActivPAL3 device to determine MVPA and sedentary time. The SQUASH questionnaire was used for assessing self-reported MVPA, and the EORTC QLQ-C30 for assessing HRQoL (range 0–100). Multivariable linear regression models were used to examine the cross-sectional associations of MVPA and sedentary time with HRQoL. Results The highest (≥ 6.7 h/week) versus lowest (≤ 2.7 h/week) quartile of MVPA was associated with a better global health status (β, 10.2; 95% CI, 5.1, 15.3), summary score (β, 4.6; 95% CI, 1.1, 8.1), physical (β, 7.7; 95% CI, 3.8, 11.6), role (β, 12.4; 95% CI, 4.7, 20.2), and social functioning (β, 7.3; 95% CI, 0.2, 14.4), and lower fatigue (β, − 11.2; 95% CI, − 18.1, − 4.2). Results for self-reported MVPA were in the same direction but weaker. The lowest (≤ 8.8 h/day) versus highest (≥ 11.5 h/day) quartile of sedentary time was associated with better physical functioning (β, 4.6; 95% CI, 0.8, 8.5). Conclusions In patients with localized RCC, higher MVPA 3 months post-surgery was associated with better HRQoL outcomes including less fatigue whereas lower sedentary time was only associated with better physical functioning. This information can contribute to the development of physical activity guidelines and interventions to improve HRQoL.

Sympathetic nerve activity and response to physiological stress in Takotsubo syndrome.

The prevailing hypothesis posits that Takotsubo syndrome (TTS) is caused by massive sympathetic activation, yet supporting evidence remains inconsistent. The objectives of the present study were to determine whether sympathetic activity and reactivity are enhanced in the recovery phase of TTS, and to evaluate the effect of selective β1-receptor blockade on sympathetic reactivity. We conducted a case-control study that included 18 female patients with TTS and 13 age- and sex-matched controls. Muscle sympathetic nerve activity was measured through microneurography of the peroneal nerve at rest and during the cold pressor test. In the TTS group, recordings were repeated after randomisation to intravenous metoprolol or placebo. In 10 TTS patients, cardiac sympathetic activity was assessed using iodine123-metaiodobenzylguanidine scintigraphy. Blood samples were collected during hospitalisation. Microneurography was performed a median of 27.5days after patient admission. There were no significant differences in burst incidence, burst frequency, burst height or burst area between the TTS patients and the controls at rest, during stress or after administration of intravenous metoprolol. Iodine123-metaiodobenzylguanidine scintigraphy was performed a median of 12.5days after admission, revealing decreased early 1.54 ± 0.13 and late 1.40 ± 0.13 heart-to-mediastinum ratios, and an increased washout rate of 41.8 ± 12.1%. Catecholamine metabolites were comparable between the study groups. General sympathetic hyperactivity or hyperreactivityunlikelycontributesto TTS, as catecholamine levels and muscle sympathetic nerve activity at rest and during stress were similar between the TTS patients and the controls.As scintigraphy showed increased cardiac sympathetic activity, a pathological cardiac adrenergic response and vulnerability to sympathetic activationmay be crucial for the development of the syndrome.

Distinct Constructs Underlie Patient-Reported and Performance-Rated Outcomes after Stroke.

Patient-reported outcome measures (PROMs), which capture patients' perspectives on the consequences of health and disease, are widely used in neurological care and research. However, it is unclear how PROMs relate to performance-rated impairments. Sociodemographic factors are known to affect PROMs. Direct damage to brain regions critical for self-awareness (i.e., parietal regions and the salience/ventral-attention network) may also impair self-report outcomes. This study examined the relationship between PROMs and performance-based measures in stroke survivors with arm motor impairments. We hypothesized that PROMs would be distinct from performance-based outcomes, influenced by sociodemographic factors, and linked to damage in brain circuits involved in self-perception. We longitudinally assessed 54 stroke survivors using patient-reported and performance-rated measures at 4 timepoints. We used factor analysis to reveal the outcome battery's factorial structure. Linear regression examined the association between classes of measures and sociodemographics. Voxel-lesion-symptom-mapping, region-of-interest-based analysis, and voxel-lesion-network-mapping investigated the relationship between classes of outcomes and stroke-related injury. Performance-based and patient-reported measures formed distinct factors, consistent across recovery phases. Higher education (β1 = 0.36, p = 0.02) and income adequacy (β2 = 0.48, p = 0.05) were associated with patient-reported, but not performance-rated outcomes. Greater parietal lobe injury, irrespective of hemisphere, was associated with worse patient-reported outcomes; greater corticospinal tract injury related to worse performance-rated outcomes. Lesions with greater functional connectivity to the salience/ventral-attention network were associated with worse patient-reported outcomes (r = -0.35, p = 0.009). Our findings reveal important differences between performance-rated and patient-reported outcomes, each with specific associated factors and anatomy post-stroke. Incorporating sociodemographic and neuroanatomic characteristics into neurorehabilitation strategies may inform and optimize patient outcomes. ANN NEUROL 2024.

Convective Heat Transfer in Uniformly Accelerated and Decelerated Turbulent Pipe Flows

This study presents a detailed investigation of the temporal evolution of the Nusselt number (Nu) in uniformly accelerated and decelerated turbulent pipe flows under a constant heat flux using direct numerical simulations. The influence of different acceleration and deceleration rates on heat transfer is systematically studied, addressing a gap in the previous research. The simulations confirm several key experimental findings, including the presence of three distinct phases in the Nusselt number temporal response—delay, recovery, and quasi-steady phases—as well as the characteristics of thermal structures in unsteady pipe flow. In accelerated flows, the delay in the turbulence response to changes in velocity results in reduced heat transfer, with average Nu values up to 48% lower than those for steady-flow conditions at the same mean Reynolds number. Conversely, decelerated flows exhibit enhanced heat transfer, with average Nu exceeding steady values by up to 42% due to the onset of secondary instabilities that amplify turbulence. To characterize the Nu response across the full range of acceleration and deceleration rates, a new model based on a hyperbolic tangent function is proposed, which provides a more accurate description of the heat transfer response than previous models. The results suggest the potential to design unsteady periodic cycles, combining slow acceleration and rapid deceleration, to enhance heat transfer compared to steady flows.

A qualitative study exploring the experiences and needs of fear of disease progression in patients after open-heart surgery.

Open-heart surgery (OHS) is a stressful event for patients, all of whom experience varying levels of worry and fear, leading to fear of disease progression (FoP). An in-depth understanding of the experiences and needs of FoP in patients after OHS is beneficial for healthcare providers to make optimal decisions, but this has not been reported. We aimed to explore the experiences and needs of FoP in patients after OHS by adopting a qualitative interview method. A qualitative study was performed to recruit 18 qualified patients through purposive sampling and then conduct face-to-face, semi-structured interviews. The research setting was the cardiovascular surgery ward of a tertiary hospital in Guangdong, China, in 2024. The data were analyzed and extracted using conventional content analysis. In the study, four themes emerged: a) sources of FoP; b) effects of FoP; c) attitudes towards FoP; d) supportive service needs. The desire to obtain meaningful assistance and the profound experiences of FoP in patients after OHS gave rise to these themes. FoP following OHS is a subjective feeling characterized by fear and discomfort. Care workers must completely grasp the patients' fear and provide personalized interventions to support them through the difficult recovery phase, which will also be the focus of future efforts in this area.

Automated assessment of EEG background for neurodevelopmental prediction in neonatal encephalopathy.

Assess the capacity of brain state of the newborn (BSN) to predict neurodevelopment outcomes in neonatal encephalopathy. Trends of BSN, a deep learning-based measure translating EEG background to a continuous trend, were studied from a three-channel montage long-term EEG monitoring from a prospective cohort of 92 infants with neonatal encephalopathy and neurodevelopmental outcomes assessed by Bayley Scales of Infant Development, 3rd edition (Bayley-III) at 18 months. Outcome prediction used categories "Severe impairment" (Bayley-III composite score ≤70 or death) or "Any impairment" (score ≤85 or death). "Severe impairment" was predicted best for motor outcomes (24 h area under the curve (AUC) = 0.97), followed by cognitive (36 h AUC = 0.90), overall (24 h AUC = 0.84), and language (24 h AUC = 0.82). "Any impairment" was best predicted for motor outcomes (12 h AUC = 0.95), followed by cognitive (24 h AUC = 0.85), overall (12 h AUC = 0.75), and language (12 and 24 h AUC = 0.68). Optimal BSN cutoffs for outcome predictions evolved with the postnatal age. Low BSN scores reached a 100% positive prediction of poor outcomes at 24 h of age. BSN is an excellent predictor of adverse neurodevelopmental outcomes in survivors of neonatal encephalopathy after therapeutic hypothermia, even at 24 h of life. The trend provides a fully automated, objective, quantified, and reliable interpretation of EEG background. The high temporal resolution supports continuous bedside brain assessment and early prognostication during the initial dynamic recovery phase.

A Synoptic‐Dynamic View of the Millennium Drought (2001–2009) in Southeastern Australia

AbstractAustralia has had several severe droughts in its recent history. Most studies have linked these droughts to large‐scale modes of variability, whereas few studies have investigated droughts from the perspective of weather systems. The current study examines a wide range of weather systems focusing especially on heavy rainfall events, which are important to meteorological drought. Two distinct phases (development and recovery) are identified for the Millennium Drought based on the cumulative standardized precipitation index. Differences in precipitation from heavy rainfall events between the two drought phases are most pronounced in autumn and summer. The pronounced reduction in precipitation from autumn heavy rainfall events during the development phase is due to fewer, less intense, faster‐moving warm conveyor belts. In contrast, increased precipitation from autumn heavy rainfall events in the recovery phase is explained by an interaction between warm conveyor belts and upper‐level anticyclonic potential vorticity with a persistent anticyclonic circulation over the Tasman Sea acting to slow the eastward propagation of rainfall‐producing weather systems. In summer, however, the difference in precipitation from heavy rainfall events in the two drought phases is due to changed moisture content within warm conveyor belts. In the recovery phase, the higher moisture content is associated with greater moisture transport over the Tasman Sea between Australia and New Zealand.

Assessing Project Resilience Through Reference Class Forecasting and Radial Basis Function Neural Network

A project needs to be able to anticipate potential threats, respond effectively to adverse events, and adapt to environmental changes. This overall capability is known as project resilience. In order to make efficient project decisions when the project is subjected to disruption, such as adjusting the project budget, reformulating the work plan, and rationalizing the allocation of resources, it is necessary to quantitatively understand the level of project resilience. Therefore, this paper develops a novel approach for forecasting project performance, illustrating the changes in performance levels during the disruption and recovery phases of a project and thus quantitatively assessing project resilience. While there are several methods for assessing project resilience in existing research, the majority of assessment approaches originate from within projects and are highly subjective, which makes it difficult to objectively reflect the level of project resilience. Moreover, the availability of project samples is limited, which makes it difficult to forecast the level of project performance. In view of the fact that the Reference Class Forecasting (RCF) technique avoids subjectivity and the Radial Basis Function (RBF) neural network is known to be better at forecasting small sample datasets, this paper therefore combines the RCF technique and the RBF neural network to construct a model that forecasts the project performance of the current project after experiencing a disruption, further assessing the level of the project resilience. Specifically, this paper first presents a conceptual model of project resilience assessment; subsequently, an RBF neural network model that takes into account project budget, duration, risk level of disruption, and performance before disruption based on the RCF technique is developed to forecast project performance after experiencing disruption; and finally, the level of project resilience is assessed through calculating the ratio of recovery to loss of project performance. The model is trained and validated using 64 completed construction projects with disruptions as the datasets. The results show that the average relative errors between the forecast results of schedule performance index (SPI) and the real values are less than 5%, and the R2 of the training set and the testing set is 0.991 and 0.964, respectively, and the discrepancy between the forecasted and real values of project resilience is less than 10%. These illustrate that the model performs well and is feasible for quantifying the level of project resilience, clarifying its impact on project disruption and recovery situations, and facilitating the decision-makers of the project to make reasonable decisions.

The Electroencephalogram (EEG) Study for Estimating Endurance Sports Performance Base on Eigenvalues Extraction Method

Objectives. Brain–behavior connections are a new means to evaluate sports performance. This electroencephalogram (EEG) study aims to estimate endurance exercise performance by investigating eigenvalue trends and comparing their sensitivity and linearity. Methods. Twenty-three cross-country skiers completed endurance cycling tasks. Twenty-four-channel full-brain EEG signals were recorded in the motor phase and recovery phase continuously. Eighteen EEG eigenvalues calculation methods were collected, commonly used in previous research. Time-frequency, band power, and nonlinear analyses were used to calculate the EEG eigenvalues. Their regression coefficients and correlation coefficients were calculated and compared, with the linear regression method. Results. The time-frequency eigenvalues shift slightly throughout the test. The power eigenvalues changed significantly before and after motor and recovery, but the linearity was not satisfactory. The sensitivity and linearity of the nonlinear eigenvalues were stronger than the other eigenvalues. Of all eigenvalues, Shannon entropy showed completely non-overlapping distribution intervals in the regression coefficients of the two phases, which were −0.1474 ± 0.0806 s−1 in the motor phase and 0.2560 ± 0.1365 s−1 in the recovery phase. Shannon entropy amplitude decreased more in the F region of the brain than in the other regions. Additionally, the higher the level of sport, the slower the decline in Shannon entropy of the athlete. Conclusions. The Shannon entropy method provided more accurate estimations for endurance exercise performance compared to other eigenvalues.

Alpha‑Asarone Ameliorates Neuronal Injury After Ischemic Stroke and Hemorrhagic Transformation by Attenuating Blood-Brain Barrier Destruction, Promoting Neurogenesis, and Inhibiting Neuroinflammation.

Recombinant tissue-type plasminogen activator (rt-PA), the primary drug for acute ischemic stroke (IS), has a narrow therapeutic window and carries a potential risk of hemorrhagic transformation (HT). Without rt-PA administration, patients may suffer permanent cerebral ischemia. Alpha-asarone (ASA), a natural compound derived from Acorus tatarinowii Schott, exhibits diverse neuropharmacological effects. This study aims to investigate whether ASA could improve outcomes in IS and be used to mitigate HT induced by rt-PA. We employed models of permanent middle cerebral artery occlusion (pMCAO) and photothrombotic cortical injury (PCI) to investigate both the therapeutic efficacy and underlying mechanisms of ASA during the acute and recovery periods following IS, respectively. Additionally, Sprague-Dawley rats were subjected to rt-PA treatment at 6-h post-PCI to mimic HT (rt-PA-HT). Our results revealed three key findings: (1) ASA demonstrated therapeutic effects in the acute phase of pMCAO rats by alleviating blood-brain barrier damage through inhibition of glial cell-mediated neuroinflammation; (2) administration of ASA 24 h after stroke ameliorated the neurological damage during the recovery phase in PCI mice by promoting neurogenesis via activation of the BDNF/ERK/CREB signaling pathway; (3) ASA attenuated rt-PA-HT injury by modulating the NLRP3/Caspase1/IL-1β and IL-18 pathways. Overall, our findings suggest that ASA mitigates neuronal injury following IS and HT, positioning it as a promising candidate for treating these conditions.

Abstract 4139170: Relationship between hemodynamics and oxygen consumption in hypertrophic cardiomyopathy during maximal stress testing

Background: Hypertrophic cardiomyopathy (HCM) is a global heart disease with great variability in disease severity, which can lead to significant impairment of exercise capacity. In healthy populations, oxygen consumption is related to cardiac output and arteriovenous oxygen difference. We sought to determine the relationship between hemodynamics (cardiac output and stroke volume) and oxygen consumption in HCM compared to healthy controls during maximal stress testing. Aims: To evaluate associations between the trajectories of hemodynamic function and oxygen consumption in HCM compared to healthy controls. Methods: Twenty individuals with HCM (51±15 years old, body mass index (BMI): 28±3 kg/m 2 , females, n=4) and 16 healthy controls (66±7 years old, 27±6 kg/m 2 , females, n=6) were included in the present study. Participants completed a maximal-graded stress test coupled with non-invasive hemodynamic bioreactance (cardiac output, stroke volume) and gas exchange (oxygen consumption, VO 2 ) measurements. Data were analyzed in quartiles (exercise only) and phases (rest, pre-pedalling, exercise and recovery) of the maximal-graded stress test. Results: In HCM, cardiac output declined in the fourth quartile of the exercise phase of the stress test (-0.39 L/min, p <0.001) whilst VO 2 increased (3.86 ml/kg/min, p <0.001). There was a significant difference in the gradient of cardiac output between HCM and controls in the final quartile of the test (-1.6 vs. 18.1 L/min, p<0.001). In coherence, stroke volume declined in the fourth quartile of the test (-18.4 ml, p <0.01) in response to increasing VO 2 in HCM. The rates of recovery were faster in HCM compared to the control group for VO 2 (-4.3 vs -2.6 mL/second, p<0.001), cardiac output (-0.03 vs -0.02 L/second, p<0.001), heart rate (-0.17 vs -0.10 beats/second, p<0.001), and stroke volume (-0.18 vs -0.07 L/second, p<0.001). Conclusions: In HCM, cardiac output declined during the later stages of maximal stress testing whereas in controls it continued to rise, indicating impaired maximal cardiac output responses to exercise. These findings have implications for exercise prescription and training regimens in HCM suggesting avoidance of maximal exercise levels.

An Improved Machine Learning Framework Considering Spatiotemporal Heterogeneity for Analyzing the Relationship Between Subway Station-Level Passenger Flow Resilience and Land Use-Related Built Environment

The COVID-19 pandemic and similar public health emergencies have significantly impacted global travel patterns. Analyzing the recovery characteristics of subway station-level passenger flow during the pandemic recovery phase can offer unique insights into public transportation operations and guide practical planning efforts. This pioneering study constructs a station-level passenger flow recovery resilience (PFRR) index during the rapid recovery phase using subway AFC system swipe data. Additionally, it develops an analytical framework based on a multiscale geographically weighted regression (MGWR) model, the improved gray wolf optimization with Levy flight (LGWO), and light gradient boosting machine (LightGBM) regression to analyze passenger flow resilience on weekdays and weekends in relation to land use-related built environment types. Finally, SHAP attribution analysis is used to study the nonlinear relationships between built environment variables and PFRR index. The results show significant spatial heterogeneity in the impact of commercial, recreational, and residential land, as well as POI (points of interest) of leisure and shopping on PFRR. On weekdays, the most relevant built environment variables for PFRR are POI of enterprises and shopping numbers. In contrast, the contribution of built environment variables affecting PFRR of weekend is more balanced, reflecting the recovery of non-essential travel on weekends. Most land use-related built environment variables exhibit nonlinear associations with PFRR values. The proposed analytical framework shows significant performance advantages over other baseline models. This study provides unique insights into subway passenger flow characteristics and surrounding land use-related development layouts under the impact of public health emergencies.

Focusing on Sedentary Behavior in Comprehensive Cardiac Rehabilitation.

In recent years, the adverse effects of prolonged sedentary behavior in daily life, so-called 'sitting too much', on health have been pointed out. Sedentary behavior is defined as 'all waking behavior in which the energy expenditure in a sitting, semi-recumbent, or recumbent position is 1.5 metabolic equivalents or less'. Even if a person engages in the level of physical activity recommended in the guidelines, sitting for too long at other times may increase the risk of developing various diseases and death. For patients with cardiovascular disease, a comprehensive cardiac rehabilitation program that systematically includes not only medical treatment but also exercise therapy, patient education, and disease management is extremely important. Also, differences in sedentary behavior during the acute and recovery phases are known to affect physical function and activities of daily living at the time of hospital discharge. Here, we discuss cardiac rehabilitation that addresses sedentary behavior and review the previous related research.

Integrating physiotherapists in disaster management: A key to comprehensive recovery

Abstract Disasters, both natural and man-made, pose significant challenges, causing substantial loss of life, property damage, and environmental degradation. Physiotherapists play a crucial role in disaster management, spanning prevention, preparedness, response, and recovery phases. They provide acute care, and long-term rehabilitation, addressing physical and psychosocial recovery aspects. Case studies from the Kashmir, Nepal, and Haiti earthquakes illustrate the vital role of physiotherapists in triage, wound care, mobilization, and community reintegration. Despite barriers such as resource limitations and professional challenges, physiotherapists enhance disaster response through specialized skills and multidisciplinary collaboration. To improve disaster management, recommendations include policy support, training, capacity building, and international cooperation. Investing in physiotherapy in disaster management is essential for building resilient, inclusive communities capable of facing future challenges.

Elevated plasma progranulin levels in the acute phase are correlated with recovery of left ventricular function in the chronic phase in patients with acute myocardial infarction.

Progranulin is a secreted glycoprotein that regulates inflammation and wound healing. However, plasma progranulin levels in the acute phase and their clinical significance in patients with acute myocardial infarction (AMI) remain to be elucidated. We aimed to investigate the relationship between the increase in plasma progranulin levels in the acute phase and the recovery of left ventricular function in the chronic phase in AMI patients. Eighteen AMI patients were followed up for 6 months. Blood samples were collected from the antecubital vein on day 0 (on admission) and day 7 in the acute phase. The control group consisted of patients without significant coronary artery stenosis, as assessed by cardiac catheterization (n = 16). Plasma progranulin levels were measured by enzyme-linked immunosorbent assay. Echocardiography was performed in the acute (within 7 days) and chronic (6 months) phases of AMI to evaluate left ventricular ejection fraction using the modified Simpson's method. Plasma progranulin levels in the AMI group on day 0 (69.5 ± 24.6 ng/mL) were similar to those in the control group (84.2 ± 47.1 ng/mL). There was a significant increase in progranulin levels in the AMI group on day 7 (104.2 ± 52.0 ng/mL) compared with day 0. The increase in plasma progranulin levels in the acute phase was positively correlated with the increase in left ventricular ejection fraction between the acute and chronic phases. Among various factors, only plasma progranulin levels were favorably correlated with left ventricular functional recovery in the chronic phase. The increase in plasma progranulin levels in the acute phase may serve as a predictive biomarker and a contributer for the recovery of left ventricular function in the chronic phase in patients with AMI.

Potential Role of Soundscape and Music Interventions in post-Intensive Care Rehabilitation

Background Post Intensive Care Unit (ICU) survivors face physical, psychological, and cognitive impairments during their recovery phase, adversely affecting their quality of life. Given the scarcity and barriers to access to post-ICU care worldwide, patient-centered adjuncts are worth exploring. Although music interventions have gained recognition as non-pharmacological approaches in the acute phase of critical illness; exploration of their potential benefits in the post-ICU is scarce. Objective This paper examines the potential of sound and music interventions as an adjunct therapeutic modality to improve the well-being of adults post-ICU patients, through a narrative overview of published research evidence regarding post-ICU recovery and other relevant post-acute conditions, such as post-traumatic disorder and anxiety. Results The effectiveness of sound/ music interventions on several key outcomes including reduced anxiety, stress, pain, and PTSD, improved sleep, and enhanced mood and emotional well-being have been studied. Research indicates that music-based approaches to physical and psychological well-being reduce emotional distress, foster connectedness, and improve overall well-being. The importance of tailoring sound and music interventions to the individual needs and preferences of post-ICU patients is emphasized. Conclusion The potential benefits of sound and music interventions, both in terms of physiological and psychological well-being, encourage further investigation into their potential application and implementation into post-ICU care and rehabilitation. Ultimately, this therapeutic approach could contribute to enhancing the overall quality of life and empowerment of post-ICU patients on their path to recovery.

Quantifying the recovery process of skeletal muscle on hematoxylin and eosin stained images via learning from label proportion

Visual observing muscle tissue regeneration is used to measure experimental effect size in biological research to discover the mechanism of muscle strength decline due to illness or aging. Quantitative computer imaging analysis for support evaluating the recovery phase has not been established because of the localized nature of recovery and the difficulty in selecting image features for cells in regeneration. We constructed MyoRegenTrack for segmenting cells and classifying their regeneration phase in hematoxylin–eosin (HE) stained images. A straightforward approach to classification is supervised learning. However, obtaining detailed annotations for each fiber in a whole slide image is impractical in terms of cost and accuracy. Thus, we propose to learn individual recovery phase classification utilizing the proportions of cell class depending on the days after muscle injection to induce regeneration. We extract implicit multidimensional features from the HE-stained tissue images and train a classifier using weakly supervised learning, guided by their class proportion for elapsed time on recovery. We confirmed the effectiveness of MyoRegenTrack by comparing its results with expert annotations. A comparative study of the recovery relation between two different muscle injections shows that the analysis result using MyoRegenTrack is consistent with findings from previous studies.