Rest Period Research Articles

Real-Time Prediction of Multi-Degree-of-Freedom Ship Motion and Resting Periods Using LSTM Networks

This study presents a novel real-time prediction technique for multi-degree-of-freedom ship motion and resting periods utilizing Long Short-Term Memory (LSTM) networks. The primary objective is to enhance the safety and efficiency of shipborne helicopter landings by accurately predicting heave, pitch, and roll data over an 8 s forecast horizon. The proposed method utilizes the LSTM network’s capability to model complex nonlinear time series while employing the User Datagram Protocol (UDP) to ensure efficient data transmission. The model’s performance was validated using real-world ship motion data collected across various sea states, achieving a maximum prediction error of less than 15%. The findings indicate that the LSTM-based model provides reliable predictions of ship resting periods, which are crucial for safe helicopter operations in adverse sea conditions. This method’s capability to provide real-time predictions with minimal computational overhead highlights its potential for broader applications in marine engineering. Future research should explore integrating multi-model fusion techniques to enhance the model’s adaptability to rapidly changing sea conditions and improve the prediction accuracy.

Effect of Nesting and Swaddling on Sleep Duration of Preterm Neonate Hospitalized at Tertiary Care Centre of Eastern Nepal

Background: All preterm neonates’ sleep is disturbed during hospitalization period due to various stressful environmental factors and human error and without focusing in individual developmental care. This impacts neonatal neurological development as well as normal growth resulting lifelong disabilities. Thus, modification of the environment by intervening developmental care could minimize the iatrogenic effect and neuro-developmental delay by decreasing stressful environment. This study was conducted to assess the effect of nesting and swaddling on sleep duration of preterm neonates during hospitalization at B.P.Koirala Instituted of Health sciences (BPKIHS). Methods: True experimental (post-test control design) study conducted among 36 preterm neonates, admitted in Nursery and Neonatal Unit of BPKIHS. The objective of this study was to assess the effect of nesting and swaddling on sleep duration. Consecutive sampling technique was used for total sample size then after random allocation is applied for creates the samples into two groups: experimental and control. Performa was used to collect socio-demographic characteristics. Sleep duration was recorded in self-administer observation form base on the observational behavior characteristics scoring of neonatal sleep by AASM (American Academy of sleep Medicine). As intervention, nesting and swaddling were performed in experimental group, then the sleep was video-recorded for 2 hours for each neonate. Finally, data were analyzed using descriptive and inferential statistics. Results: Among the enrolled neonates, there were 23 male (63.9%) and 13 female (36.1%) preterm. There was significant difference in sleep duration between experimental and control group. The mean ± SD of sleep duration was 59.22 ± 22.61 minute in experimental group and 39.50 ± 8.06 minute in control with p-value 0.001. The mean sleep duration was not associated with other selected study variables except the performed intervention. Conclusions: Nesting and Swaddling can be used as convenient and effective method to increase neonatal sleep duration or rest period.

Abstract P329: Mycophenolate Mofetil Enhances Short-Term Blood Pressure Variability During Recovery in Salt-Sensitive Hypertensive African Americans

Elevated blood pressure variability (BPV) is an independent risk factor for cardiovascular disease (CVD), kidney disease, dementia, and stroke. High BPV is thought to be caused by arterial stiffness, vascular remodeling, inflammatory cascades, and neurohormonal mechanisms. This study aims to investigate the potential impact of mycophenolate mofetil (MMF) on short-term BPV in the context of salt-sensitive hypertension among African Americans (AA). MMF’s anti-inflammatory properties hold promise as a potential intervention for hypertension management by modulating short-term BPV. AA participants,18-50 years, normotensive, not pregnant, and not on prescription medications were recruited. In this crossover study, 51 participants received either MMF or a placebo daily. Physiological parameters were monitored every 15 minutes during a 3-hour psychosocial stressor assessment with rest, stress, and recovery periods. BPV was assessed using coefficient of variation (CV), standard deviation (SD), and average real variability (ARV). The treatment group showed a significant decrease in SBP CV (p < 0.05) during stress. During recovery, SBP SD (p, 0.05) and SBP ARV (p < 0.05) significantly increased in individuals receiving MMF treatment. Age-stratified analysis maintained significant effects of MMF on BPV during stress. Gender did not significantly alter the observed effects of MMF on BPV. Our study highlights the effectiveness of MMF in reducing BPV during acute stress, potentially lowering adverse cardiovascular events. MMF-treated groups showed increased BPV during recovery, indicating a quicker BP recovery to baseline. While a decrease in BPV during the stress period was observed, it was supported only by CV. The significant increase in BPV in the treatment group during recovery indicates MMF's ability to expedite the inflammatory stress response. The observed decrease in BPV during stress suggests a swifter return to baseline BP, potentially offering benefits for non-stress baseline physiology. Further research is warranted to clarify the mechanisms and clinical significance of these findings, impacting hypertension assessment and management. MMF treatment induces distinct changes in BPV during recovery, suggesting that MMF may positively influence BP regulation through a variety of inflammatory pathways. The alterations in SBP BPV underscore MMF's therapeutic potential for managing BPV and reducing cardiovascular risk in salt-sensitive, hypertensive AAs.

Factors associated with sleep quality among Afghan healthcare workers.

Sleep is a complex physiological process during which the body and mind enter a period of rest. For a healthy lifestyle, different cohort groups can be affected in different ways. One such cohort is healthcare workers (HCWs)-an unexplored group in Afghanistan. Therefore, the present study examined the association between a range of sociodemographic factors including having night shift work and sleep quality among Afghan HCWs. A cross-sectional survey was administered in January 2023 among HCWs (N = 342) in the Herat province of Afghanistan. The survey examined sleep quality and its association with a range of sociodemographic factors among HCWs. Logistic regression models were used to examine the association of sleep quality with sociodemographic characteristics among HCWs. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality among HCWs. A total of 342 HCWs participated in the present study with an age range of 18 to 60 years. The mean age of the participants was 28.90 years (SD ± 8.10). Just over half of the participants were male (50.3%). Of the 342 participants, 58.5% reported poor sleep quality. Being married status, having higher number of children, not being a doctor, having low economic status, working night shifts, and having a traumatic event occur during past month were among the main variables associated with sleep quality among Afghan HCWs. Multiple regression analysis indicated that having high income [negatively] (AOR = 4.132, p = 0.002), working night shifts [positively] (AOR = 0.288, p < 0.001), and having a traumatic event occur during past month [positively] (AOR = 0.504, p = 0.007) were significantly associated with sleep quality. The study suggests the need for Afghan health employers to create a healthy work environment that prioritizes the well-being of their employees by limiting overtime hours, providing rest breaks during long shifts, and ensuring that HCWs have access to necessary resources for coping with work-related stressors. These policies would promote the overall health and well-being of the workforce and would likely lead to better patient care outcomes.

Molecular Transducers of Physical Activity Consortium (MoTrPAC): human studies design and protocol.

Physical activity, including structured exercise, is associated with favorable health-related chronic disease outcomes. Although there is evidence of various molecular pathways that affect these responses, a comprehensive molecular map of these molecular responses to exercise has not been developed. The Molecular Transducers of Physical Activity Consortium (MoTrPAC) is a multicenter study designed to isolate the effects of structured exercise training on the molecular mechanisms underlying the health benefits of exercise and physical activity. MoTrPAC contains both a preclinical and human component. The details of the human studies component of MoTrPAC that include the design and methods are presented here. The human studies contain both an adult and pediatric component. In the adult component, sedentary participants are randomized to 12 wk of Control, Endurance Exercise Training, or Resistance Exercise Training with outcomes measures completed before and following the 12 wk. The adult component also includes recruitment of highly active endurance-trained or resistance-trained participants who only complete measures once. A similar design is used for the pediatric component; however, only endurance exercise is examined. Phenotyping measures include weight, body composition, vital signs, cardiorespiratory fitness, muscular strength, physical activity and diet, and other questionnaires. Participants also complete an acute rest period (adults only) or exercise session (adults, pediatrics) with collection of biospecimens (blood only for pediatrics) to allow for examination of the molecular responses. The design and methods of MoTrPAC may inform other studies. Moreover, MoTrPAC will provide a repository of data that can be used broadly across the scientific community.NEW & NOTEWORTHY The Molecular Transducers of Physical Activity Consortium (MoTrPAC) will be the first large trial to isolate the effects of structured exercise training on the molecular mechanisms underlying the health benefits of exercise and physical activity. By generating a compendium of the molecular responses to exercise, MoTrPAC will lay the foundation for a new era of biomedical research on Precision Exercise Medicine. Presented here is the design, protocols, and procedures for the MoTrPAC human studies.

Localized and Long-Lasting Adaptation in Dragonfly Target-Detecting Neurons.

Some visual neurons in the dragonfly (Hemicordulia tau) optic lobe respond to small, moving targets, likely underlying their fast pursuit of prey and conspecifics. In response to repetitive targets presented at short intervals, the spiking activity of these "small target motion detector" (STMD) neurons diminishes over time. Previous experiments limited this adaptation by including intertrial rest periods of varying durations. However, the characteristics of this effect have never been quantified. Here, using extracellular recording techniques lasting for several hours, we quantified both the spatial and temporal properties of STMD adaptation. We found that the time course of adaptation was variable across STMD units. In any one STMD, a repeated series led to more rapid adaptation, a minor accumulative effect more akin to habituation. Following an adapting stimulus, responses recovered quickly, though the rate of recovery decreased nonlinearly over time. We found that the region of adaptation is highly localized, with targets displaced by ∼2.5° eliciting a naive response. Higher frequencies of target stimulation converged to lower levels of sustained response activity. We determined that adaptation itself is a target-tuned property, not elicited by moving bars or luminance flicker. As STMD adaptation is a localized phenomenon, dependent on recent history, it is likely to play an important role in closed-loop behavior where a target is foveated in a localized region for extended periods of the pursuit duration.

Time Spent: Toward a More Productive Hour

Abstract: This third and final installment of the author’s “Time Spent” series of articles for this column explores the amount of work that studio teachers can engage in with sustained focus before they need a break. It will then consider how many minutes of rest are necessary in order to resume work with similar levels of focus, presenting different recommended work-to-break ratios. Lastly, the article addresses how teachers can spend rest periods to maximize their benefits and remain cognitively fresh.

An intermittent recovery test for soccer players: a validation study.

Soccer is an intermittent team sport that demands high aerobic capacity. On field, soccer players' aerobic capacity, assessed through the maximal oxygen uptake (VO<inf>2</inf>max), is usually determined by an intermittent recovery test. The aim of this study was to obtain a construct validity of a new intermittent recovery test (IRT) with a fixed speed and a progressive decrement of rest period. Twenty-five male soccer players were recruited to perform an incremental continuous test (ICT) and the new IRT, to compare their physiological data. Fifteen male soccer players were involved to perform a test-retest of IRT to assess its reliability. VE<inf>peak</inf>, absolute VO<inf>2</inf>max, relative VO<inf>2</inf>max and VCO<inf>2</inf>peak registered during ICT and IRT correlated strongly (Pearson's correlation coefficient ranges from 0.75 to 0.80, with very large as magnitude of effects and with P<0.001). IRT showed reliability from good to excellent regarding VE<inf>peak</inf>, absolute VO<inf>2</inf>max, relative VO<inf>2</inf>max, VCO<inf>2</inf>peak and covered distance (ICC values ranged from 0.82 to 0.95). These findings and its underlying physiological and muscular demands, suggest that IRT can be considered as a valid and reliable test to assess aerobic capacity in soccer players during the competitive period.

Effectiveness of Innovative Ergonomic Models in Preventing Occupational Fatigue in Rice Farmers

Introduction: Ergonomic work hazards are potential hazards that can negatively affect the health of farmers. One of the ergonomic hazards that farmers often experience is fatigue. This study aims to analyze the effectiveness of innovative ergonomic models and the preparation of balanced calorie needs in preventing work fatigue in rice farmers. Methods: The type of research used is a randomized controlled trial (RCT) design, which is the most powerful design to evaluate the intervention used, namely the effectiveness of innovative ergonomic models and the preparation of balanced calorie needs in preventing occupational fatigue in rice farmers. The population in this study were all farmers in Pudak Village, Kumpeh Ulu Subdistrict, Muaro Jambi Regency, totaling 238 people. The number of research samples was 68 farmers has taken using simple random sampling technique. Data were analyzed to determine the effectiveness of innovative ergonomic models using the ANOVA test with (α = 0.05). Result: There was a difference in the effectiveness of innovative ergonomic models in preventing work fatigue between at least two groups of rice farmers. Conclusion: the provision of stretching and snacks coupled with rest periods is most effective in preventing occupational fatigue. As for occupational fatigue, the provision of stretching, snacks, and rest time and the provision of simple education on the hazards of work ergonomics are effective in preventing occupational fatigue in rice farmers.

Effect of different approaches of direct radiation on the surface structure and caries susceptibility of enamel

It is not clear whether different radiation methods have different effects on enamel. The purpose of this study was to compare the effects of single and fractionated radiation on enamel and caries susceptibility and to provide an experimental basis for further study of radiation‑related caries. Thirty-six caries-free human third molars were collected and randomly divided into three groups (n = 12). Group1 (control group) was not exposed to radiation. Group 2 received single radiation with a cumulative dose of 70 Gy. Group 3 underwent fractionated radiation, receiving 2 Gy/day for 5 days followed by a 2-day rest period, for a total of 7 weeks with a cumulative dose of 70 Gy. Changes in microhardness, roughness, surface morphology, bacterial adhesion and ability of acid resistance of each group were tested. Scanning electron microscope revealed that the enamel surface in both radiation groups exhibited unevenness and cracks. Compared with the control group, microhardness and acid resistance of enamel decreased, while roughness and bacterial adhesion increased in both the single radiation and fractionated radiation groups. Compared with the single radiation group, the enamel surface microhardness and acid resistance decreased in the fractionated radiation group, while roughness and bacterial adhesion increased. Both single radiation and fractionated radiation resulting in changes in the physical and biological properties of enamel, with these changes being more pronounced in the fractionated radiation group. Therefore, fractionated radiation is recommended as a more suitable method for constructing a radiation‑related caries model in vitro.

Comparative Effects of Neurodynamic Slider and Tensioner Mobilization Techniques on Sympathetic Nervous System Function: A Randomized Controlled Trial.

Objective: To investigate the effect of slider and tensioner neurodynamic techniques (NDTs) on the sympathetic nervous system (SNS) activity, aiming to identify which technique more effectively modulates autonomic responses in asymptomatic individuals. Materials and Methods: In this double-blind controlled trial, a total of 90 healthy participants were randomly allocated into three groups: slider, tensioner, and control. Skin conductance (SC) was continuously monitored throughout the entire 20 min experiment, while body temperature and blood pressure were measured pre- and post-intervention. Results: The SC levels significantly increased in both the slider and tensioner groups compared to the control group during the intervention and end rest period on the left leg (slider vs. control: p < 0.001, d = 1.20; tensioner vs. control: p < 0.001, d = 1.64) and on the right leg (slider vs. control: p < 0.001, d = 1.47; tensioner vs. control: p < 0.001, d = 0.73). There were no significant differences between the two NDTs on the left (p < 0.13, d = 0.89) and right legs (p < 1.00, d = 0.36). The body temperature of the slider group showed a significant increase compared to both the control group (p < 0.001, d = 0.95) and the tensioner group (p < 0.001, d = 1.48). There were no significant differences between the groups in systolic (p = 0.95) or diastolic blood pressure (p = 0.06). There were no side-specific effects on SNS activity between the left and right legs (p < 0.019) during all intervention phases. Conclusions: Significant sympathoexcitatory responses were elicited by both slider and tensioner NDTs in asymptomatic participants, demonstrating their efficacy in modulating the SNS. The differences between the two techniques were not statistically significant; however, the tensioner NDT showed a slightly more pronounced effect, suggesting that the tensioner NDT can be considered superior in terms of overall SNS effect. These findings indicate that both techniques may have the potential to enhance autonomic regulation in clinical practice; however, the tensioner NDT may be more effective. The consistent responses across participants highlight the systemic benefits of NDTs, providing a foundation for further research into their application in symptomatic populations. This study contributes to evidence-based practice by providing baseline data that support the development of theoretical frameworks and aid in clinical decision-making.

Effect of sub-maximal physical fatigue on auditory and visual reaction time in healthy adults: repeated measures design

BackgroundAuditory reaction time (ART) and visual reaction time (VRT) are critical for patients with stroke, especially during balance training. According to the research, most patients with stroke are fatigued at sub-maximal levels during their stroke rehabilitation. Sub-maximal physical fatigue may affect ART and VRT and impede stroke rehabilitation. Hence, it is important to study the effect of submaximal physical fatigue on ART and VRT. A pilot study on healthy adults paves the way for further research on stroke rehabilitation. The purpose of this research is to find out if submaximal physical fatigue affects ART and VRT in healthy adults. In addition, this study also determines if ART and VRT recover to baseline after 15 min of rest post-fatigue session. Furthermore, the goal is to determine whether sub-maximal physical fatigue has a greater effect on ART or VRT.MethodsA repeated measures within-subject design was used in the study. Eighteen healthy participants (median age 24 years) completed two sessions of a sub-maximal fatigue protocol on a cycle ergometer until they reached a rating of perceived exertion (RPE) of 15 on a scale of 6–20. Two different fatigue sessions were conducted (one to study the effects of fatigue on ART and the other for VRT). ART or VRT was measured on computer software before (PRE), immediately after (POST-0), and 15 min after (POST-15) the sub-maximal physical fatigue protocol.ResultsThe value of median ART increased significantly from PRE to POST-0 (P = 0.002) and it decreased significantly at POST-15 (P = 0.010). Similarly, the value of mean VRT increased from PRE to POST-0 (P = 0.001) before decreasing significantly at POST-15 (P = 0.001). There was no significant difference between the effects of submaximal fatigue on ART and VRT (P = 0.156).ConclusionDue to submaximal physical fatigue, ART and VRT were slower, but they returned to baseline after 15 min of rest. Submaximal physical fatigue had an equal impact on ART and VRT. As balance training requires quicker ART and VRT for optimal outcomes, it may be better if the physiotherapists consider a 15-min rest period between the exercise and balance training in patients with stroke.

Rheology and Structure of Model Smectite Clay: Insights From Molecular Dynamics

AbstractThe low frictional strength of smectite minerals, such as montmorillonite, is thought to play a critical role in controlling the rheology and the stability of clay‐rich faults. In this study, we perform molecular dynamics simulations on a model clay system. Clay platelets are simplified as oblate ellipsoids interacting via the Gay‐Berne potential. We study the rheology and structural development during shear in this model system, which is sheared at constant strain rates for 10 strains after compression and equilibrium. We find that the system exhibits velocity‐strengthening behavior over a range of normal stresses from 1.68 to 56.18 MPa and a range of strain rates from 6.93 × 105 to 6.93 × 108/s. The relationship between shear stress and strain rate follows the Herschel‐Bulkley model. Shear localization is observed at lower strain rates despite the velocity‐strengthening friction, while homogeneous shear is realized at higher strain rates. The structure change due to shear is analyzed from various aspects: the porosity, particle orientation, velocity profile, and the parallel radial distribution function. We find that particle rearrangement and compaction dominate at the early stage of shear when the shear stress increases. The shear band starts to form in the later stage as the shear stress decreases and relaxes to a steady‐state value. The structural development at low strain rates is similar to previous experimental observations. The stacking structure is reduced during shear and restores logarithmically with time in the rest period.

Impact of VR-Based Cognitive Training on Working Memory and Inhibitory Control in IDD Young Adults.

Young people with intellectual developmental disabilities have a persistent delay in the development of executive functions. Virtual reality (VR) is increasingly being used as a cognitive intervention tool, with significant effectiveness demonstrated in different types of populations. This pilot study aims to investigate the impact of a cognitive training program utilizing VR on young adults diagnosed with intellectual developmental disabilities (IDDs). The participants (N = 15) served as their own control group and were assessed three times: weeks 0, 8, and 16, with a rest period (0-8 weeks) and an intervention period (8-16 weeks). The assessments included measures of cognitive function provided by E-Prime® (Version 3). Overall, an improvement in working memory and inhibitory control was found after the intervention, but not in sustained attention. These findings suggest that VR-based cognitive training holds promise as an effective intervention for enhancing cognitive abilities in young adults with intellectual developmental disabilities. This study provides a foundation for future investigations into VR's role in cognitive rehabilitation and its potential to support daily living skills and overall quality of life for individuals with IDDs. Further research is needed to explore the long-term effects and broader applicability of VR interventions.

Synergistic combination effect of the PCA-1/ALKBH3 inhibitor HUHS015 on prostate cancer drugs in vitro and in vivo.

Prostate cancer antigen-1/ALKBH3, a DNA/RNA demethylase of 3-methylcytosine, 1-methyladenine (1-meA), and 6-meA, was found in prostate cancer as an important prognostic factor. Additionally, 1-meA has been associated with other cancers. The ALKBH3 inhibitor HUHS015 was found to be effective against prostate cancer both in vitro and in vivo. Herein, we investigated the effect of HUHS015 in combination with drugs for prostate cancer approved in Japan (including bicalutamide, cisplatin, mitoxantrone, prednisolone, ifosfamide, tegafur/uracil, docetaxel, dacarbazine, and estramustine) by treating DU145 cells with around IC50 value concentrations of these drugs for 3 days. Additionally, the cells were observed for additional 9 days after drug removal. Combination treatment with dacarbazine, estramustine, tegafur/uracil, and HUHS015 showed a slight additive effect after 3 days. After drug washout of them and mitoxantrone, the combined effects and levels were enhanced and sustained, although the effects of each treatment alone declined. HUHS015 combined with cisplatin or docetaxel elicited synergistic and sustained effects. In vivo, combining HUHS015 and docetaxel, the first chemotherapeutic agent for castration-resistant prostate cancer, showed notable effects in the DU145 xenograft model. In conclusion, HUHS015 exhibited a synergistic effect with docetaxel and drugs acting on DNA in vitro, even after drug removal. Since cancer chemotherapy is typically administered during rest periods due to its high toxicity, combining it with an ALKBH3 inhibitor could be a promising strategy for enhancing cancer treatment, as it can elicit an additive effect during treatment, allowing dosage reduction, and synergistically sustain the effect after drug washout during rest periods.

Plasticity of the heart in response to changes in physical activity.

The human heart is very adaptable, with chamber size, wall thickness and ventricular stiffness all modified by periods of inactivity or exercise training. Herein, we summarize the cardiac adaptations induced by changes in physical activity, ranging from bed rest and spaceflight to endurance exercise training, while also highlighting how the ageing process (a long-term model of inactivity) affects cardiac plasticity. Severe inactivity during bed rest or spaceflight leads to cardiac atrophy and ventriculo-vascular stiffening. Conversely, endurance training induces eccentric hypertrophy and enhances ventricular compliance, and can be used as an effective countermeasure to prevent adverse cardiac changes during prolonged periods of bed rest or spaceflight. With sedentary ageing, the heart undergoes concentric remodelling and irreversibly stiffens at advanced age. Specifically, older adults who initiate endurance training later in life are unable to improve ventricular compliance and diastolic function, suggesting reduced cardiac plasticity with advanced age; however, lifelong exercise training prevents age-associated cardiac remodelling and maintains cardiac compliance of older adults at a level similar to those of younger healthy individuals. Nevertheless, there are still many knowledge gaps related to cardiac remodelling and changes in cardiac function induced by bed rest, exercise training and spaceflight, as well as how these different stimuli may interact with advancing age. Future studies should focus on understanding what factors (sex, age, heritability, etc.) may influence the heart's responsiveness to training or deconditioning, as well as understanding the long-term cardiac consequences of spaceflight beyond low-Earth orbit with the added stimulus of galactic cosmic radiation.

Short-term peritoneal rest reduces peritoneal solute transport rate and increases ultrafiltration in high/high average transport peritoneal dialysis patients: a crossover randomized controlled trial

ABSTRACT Background The peritoneal solute transport rate (PSTR) tends to increase over time in some patients undergoing peritoneal dialysis (PD), potentially leading to ultrafiltration (UF) failure. Previous case reports have shown a significant decrease in PSTR and subsequent recovery of UF after discontinuing PD for a while. Therefore, we conducted a randomized controlled crossover study to evaluate the impact of short-term peritoneal rest on PSTR. Methods The study involved 14 continuous ambulatory peritoneal dialysis (CAPD) patients with high/high-average transport rate. Two groups were randomly assigned different treatment sequences: one group underwent daily intermittent peritoneal dialysis (IPD) for 4 weeks followed by CAPD, while the other group initially received CAPD treatment for 4 weeks and then switched to IPD. Peritoneal equilibration tests were performed before and after each treatment to evaluate PSTR and paired t-tests were used to compare the changes. Volume load, serum potassium and other clinical indicators were monitored at the same time. Results Short-term peritoneal rest (daily IPD) significantly reduced PSTR, with a decrease in the dialysate:plasma creatinine ratio from 0.71 ± 0.05 to 0.65 ± 0.07 (P &amp;lt; .001). Additionally, ultrafiltration significantly increased from 210 ± 165 ml to 407 ± 209 ml (P = .001). But there were no significant changes in interleukin-6 and vascular endothelial growth factor of PD effluent. No serious adverse events such as hypotension or hyperkalaemia occurred. Conclusions In PD patients with high and high-average transport, a 4-week period of short-term peritoneal rest by switching from CAPD to IPD (without long dwell) can lead to reductions in PSTR and increases in UF volumes, while maintaining clinical safety.

Randomized Crossover Trial of 2-Week Ketone Ester Treatment in Patients With Type 2 Diabetes and Heart Failure With Preserved Ejection Fraction.

Heart failure with preserved ejection fraction (HFpEF) is a major cause of morbidity and mortality in patients with type 2 diabetes (T2DM). Acute increases in circulating levels of ketone body 3-hydroxybutyrate have beneficial acute hemodynamic effects in patients without T2DM with chronic heart failure with reduced ejection fraction. However, the cardiovascular effects of prolonged oral ketone ester (KE) treatment in patients with T2DM and HFpEF remain unknown. A total of 24 patients with T2DM and HFpEF completed a 6-week randomized, double-blind crossover study. All patients received 2 weeks of KE treatment (25 g D-ß-hydroxybutyrate-(R)-1,3-butanediol × 4 daily) and isocaloric and isovolumic placebo, separated by a 2-week washout period. At the end of each treatment period, patients underwent right heart catheterization, echocardiography, and blood samples at trough levels of intervention, and then during a 4-hour resting period after a single dose. A subsequent second dose was administered, followed by an exercise test. The primary end point was cardiac output during the 4-hour rest period. During the 4-hour resting period, circulating 3-hydroxybutyrate levels were 10-fold higher after KE treatment (1010±56 µmol/L; P<0.001) compared with placebo (91±55 µmol/L). Compared with placebo, KE treatment increased cardiac output by 0.2 L/min (95% CI, 0.1 to 0.3) during the 4-hour period and decreased pulmonary capillary wedge pressure at rest by 1 mm Hg (95% CI, -2 to 0) and at peak exercise by 5 mm Hg (95% CI, -9 to -1). KE treatment decreased the pressure-flow relationship (∆ pulmonary capillary wedge pressure/∆ cardiac output) significantly during exercise (P<0.001) and increased stroke volume by 10 mL (95% CI, 0 to 20) at peak exercise. KE right-shifted the left ventricular end-diastolic pressure-volume relationship, suggestive of reduced left ventricular stiffness and improved compliance. Favorable hemodynamic responses of KE treatment were also observed in patients treated with sodium-glucose transporter-2 inhibitors and glucagon-like peptide-1 analogs. In patients with T2DM and HFpEF, a 2-week oral KE treatment increased cardiac output and reduced cardiac filling pressures and ventricular stiffness. At peak exercise, KE treatment markedly decreased pulmonary capillary wedge pressure and improved pressure-flow relationship. Modulation of circulating ketone levels is a potential new treatment modality for patients with T2DM and HFpEF. URL: https://www.clinicaltrials.gov; Unique Identifier: NCT05236335.

A preliminary study on the effects of long-term robot suit exercise training on gait function and quality of life in patients with spinal and bulbar muscular atrophy

Spinal and bulbar muscular atrophy (SBMA) progressively impairs gait function, resulting in the need for patients to use a wheelchair approximately 20 years after onset. No reports have investigated the effects of long-term exercise training using the Hybrid Assisted Limb (HAL) in patients with multiple SBMA. This study investigated the effects of long-term exercise training using HAL in patients with SBMA and its effects on the quality of life (QoL). Six courses of HAL treatment were administered to three males with SBMA, and leuprorelin was administered to each patient. Each course had a 4–5 week duration, during which the treatment was performed nine times, with a rest period of at least 2 months between each course. A 2-minute walk test (2MWT) and a 10-m walk test (10MWT) were performed to measure gait ability, and a blood test to measure the serum creatine kinase (CK) and creatinine (CRE) levels was performed before and after each course of treatment. We evaluated QoL using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36).The average 2MWT distance improved over 2 years (p = 0.038), and the 10MWT showed neither improvement nor decline. No increase or decrease in serum CK or CRE levels was observed. There were no significant changes in the SF-36 physical, mental, or social summary scores.In combination with leuprorelin therapy, robot-assisted training using HAL maintained gait ability and QoL in patients with SBMA for 2 years.

Feasibility, Safety, and Effects of an Aerobic Training Program with Blood Flow Restriction on Functional Capacity, and Symptomatology in Women with Fibromyalgia: A Pilot Study.

Evidence suggests that aerobic training with blood flow restriction is beneficial for treating fibromyalgia. This study evaluated the feasibility, safety, and effects of an aerobic training program with blood flow restriction for women with fibromyalgia. Thirty-seven women with fibromyalgia were included, and thirteen with an average age of 59 ± 3, a BMI of 26 ± 3, and who were polymedicated started the intervention period. The intervention group performed aerobic exercise with blood flow restriction using occlusive bands placed in the upper part of the rectus femoris, with a total duration of 14 min of restriction divided into two periods of 7 min with a rest period of 3 min and a total session duration of 17 min. Pressure intensity was measured using the visual pain scale (VAS), scoring 7 out of 10 (n = 7). The non-intervention group performed aerobic exercise without restriction of blood flow for the same periods, rest periods, and total duration of the session (n = 6). The intervention included 2 weekly sessions with 72 h between aerobic walking for 9 weeks. Walking was measured individually using the rating of perceived exertion scale (RPE) with an intensity between 6 and 7 out of 10. Visual and verbal support for the VAS and RPE scale was always provided throughout the sessions supervised by the investigator. Functional capacity was assessed using tests (six-minute walk test, incremental shuttle walk test, knee extension and handgrip test by dynamometer, 30 s chair stand test, and timed up-and-go test). Symptomatology was assessed using questionnaires (Widespread Pain Index, Symptom Severity Score, Fibromyalgia Impact Questionnaire, and Multidimensional Fatigue Inventory), and blood samples were collected. There were no adverse effects, and only one participant in the intervention group withdrew. Between-group and intragroup differences showed that the intervention group obtained improvements in the functional tests; CST p = 0.005; 6MWT p = 0.011; Handgrip p = 0.002; TUGT p = 0.002 with reduced impact of the disease according to the questionnaires; FIQ Stiffness p = 0.027 compared with the nonintervention group. Biochemical results remained within normal ranges in both groups. Blood flow-restricted aerobic training may be feasible, safe, and more effective than unrestricted aerobic training as a physical exercise prescription tool to improve cardiorespiratory fitness, strength, balance, and stiffness in women with fibromyalgia.