Rest Trial Research Articles

Global motor dynamics - Invariant neural representations of motor behavior in distributed brain-wide recordings

Objective.Motor-related neural activity is more widespread than previously thought, as pervasive brain-wide neural correlates of motor behavior have been reported in various animal species. Brain-wide movement-related neural activity have been observed in individual brain areas in humans as well, but it is unknown to what extent global patterns exist.Approach.Here, we use a decoding approach to capture and characterize brain-wide neural correlates of movement. We recorded invasive electrophysiological data from stereotactic electroencephalographic electrodes implanted in eight epilepsy patients who performed both an executed and imagined grasping task. Combined, these electrodes cover the whole brain, including deeper structures such as the hippocampus, insula and basal ganglia. We extract a low-dimensional representation and classify movement from rest trials using a Riemannian decoder.Main results.We reveal global neural dynamics that are predictive across tasks and participants. Using an ablation analysis, we demonstrate that these dynamics remain remarkably stable under loss of information. Similarly, the dynamics remain stable across participants, as we were able to predict movement across participants using transfer learning.Significance.Our results show that decodable global motor-related neural dynamics exist within a low-dimensional space. The dynamics are predictive of movement, nearly brain-wide and present in all our participants. The results broaden the scope to brain-wide investigations, and may allow combining datasets of multiple participants with varying electrode locations or calibrationless neural decoder.

A mixed-method randomised controlled feasibility trial of digital CBT and emotion regulation skills training for employees in the workplace (REST)

Background and aimDigital interventions for depression and anxiety can be as effective as face-to-face therapy. One in six workers experience some form of mental health problems, making the workplace a potential avenue to deliver mental health interventions as part of a stepped care model. This study aimed to assess the acceptability, feasibility, and preliminary efficacy of a digital cognitive behavioural therapy (dCBT) on depression and anxiety for employees in the workplace.MethodsA mixed-methods evaluation of employees allocated to dCBT (n=25), or a waitlist control group (n=27) was used to assess five feasibility objectives related to recruitment of employers and employees, engagement, study procedure and preliminary efficacy of the intervention. Quantitative outcome measures and qualitative interviews at 8 weeks post-randomisation were used. Quantitative outcomes were also assessed within subject at 3-, 6-, and 12-month follow-up. Qualitative data was analysed using thematic and framework analysis in Nvivo, whilst quantitative outcomes were analysed using mixed effect linear models between and within subject in R and SPSS.ResultsThirty-Three businesses agreed to facilitate the delivery of three trials run by the University of Warwick in their workplaces. 52 participants consented into the REST trial. Adherence/usage of participants of the treatment platform was just over 50% across the whole sample. There was a reduction in depression and anxiety symptoms post-intervention and at follow-up timepoints across all participants and over time although there were no statistically significant between group differences. High acceptability and satisfaction of the intervention were reported by participants based on qualitative interview data at post-intervention.ConclusionsResults from this feasibility study suggests that the dCBT programme (REST) was acceptable and shows improvement in depression and anxiety symptoms, albeit not over and above the treatment effects in the control group. Recruitment of participants and engagement with the intervention made the feasibility of the delivery somewhat challenging. With better recruitment promotion and engagement strategies, as well as implementing the learnings from the feasibility trial, a fully powered study can inform the efficacy of the REST intervention.Trial registrationThe study is registered in the BMC Springer Nature ISRCTN registry ISRCTN31161020 (registered on 08/06/2021).

Auditory gamma-band entrainment enhances default mode network connectivity in dementia patients

Dementia, and in particular Alzheimer’s disease (AD), can be characterized by disrupted functional connectivity in the brain caused by beta-amyloid deposition in neural links. Non-pharmaceutical treatments for dementia have recently explored interventions involving the stimulation of neuronal populations in the gamma band. These interventions aim to restore brain network functionality by synchronizing rhythmic energy through various stimulation modalities. Entrainment, a newly proposed non-invasive sensory stimulation method, has shown promise in improving cognitive functions in dementia patients. This study investigates the effectiveness of entrainment in terms of promoting neural synchrony and spatial connectivity across the cortex. EEG signals were recorded during a 40 Hz auditory entrainment session conducted with a group of elderly participants with dementia. Phase locking value (PLV) between different intraregional and interregional sites was examined as an attribute of network synchronization, and connectivity of local and distant links were compared during the stimulation and rest trials. Our findings demonstrate enhanced neural synchrony between the frontal and parietal regions, which are key components of the brain’s default mode network (DMN). The DMN operation is known to be impacted by dementia’s progression, leading to reduced functional connectivity across the parieto-frontal pathways. Notably, entrainment alone significantly improves synchrony between these DMN components, suggesting its potential for restoring functional connectivity.

A prospective, open-label,randomized clinical trial to evaluate theefficacy andsafety of remimazolam in patients undergoing EBUS-TBNA: REST trial design.

Remimazolam is safe and effective for moderate sedation during flexible bronchoscopy, but its safety and efficacy during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) remains undetermined. The REST trial (NCT06275594) will be a prospective randomized study of remimazolam in patients undergoing EBUS-TBNA with conscioussedation. The primary aim is to evaluate whether remimazolam is safe and effective for moderate sedation during EBUS-TBNA compared to real-world midazolam and on-label midazolam. The REST trial will recruit 330 patients from four university hospitals with mediastinal lesions suspected of being lung cancer who are eligible for EBUS-TBNA under moderate sedation. The participants will be randomized into groups using remimazolam, real-world midazolam, and on-label midazolam (US prescribing information dosage) to perform EBUS-TBNA for procedural sedation. The primary endpoint will be procedural success using composite measures. The REST trial will prospectively evaluate the efficacy and safety of remimazolam during EBUS-TBNA under moderate sedation. It will provide information for optimizing sedation modalities and contribute to practical benefits in patients undergoing EBUS-TBNA. ClinicalTrials.gov (NCT06275594). Prospectively registered on 15 February 2024.

Biological Sex Modestly Influences the Impact of Long Duration Bed Rest on Human Sympathetic Neurocirculatory Regulation

Our understanding regarding the impact of simulated microgravity on sympathetic neurocirculatory regulation, and the modulatory effects of biological sex, remain incomplete. Through retrospective analysis of two long-duration bed rest trials, this study investigated the impact of 60 days of -6° head-down bed rest (HDBR) on the transduction of integrated muscle sympathetic nerve activity (MSNA; peroneal microneurography) into mean arterial pressure (MAP; Finometer) in healthy females ( n = 12, 25-40 years) and males ( n = 13, 21-42 years). Signal averaging quantified sympathetic transduction for 12 cardiac cycles (ECG) following integrated MSNA bursts. The transduction of integrated MSNA bursting patterns was studied based on the overall response, temporal burst firing patterns (singlet, doublet, and triplet+), and burst amplitude (binned into quartiles: Q1-Q4). Data are reported as mean (SD) for a 5-minute baseline period pre-HDBR and post-HDBR. Statistical analysis included mixed-effect analyses with post-hoc t-tests. In the pooled analyses, HDBR reduced the overall MAP transduction response to integrated MSNA bursts (pre-HDBR: 1.4 ± 0.5 mmHg, post-HDBR: 1.1 ± 0.4 mmHg; P = 0.003). This stemmed from attenuated MAP transduction responses to small- and medium-sized bursts (i.e., Q1-Q3) but there was no effect of HDBR on the largest bursts (i.e., Q4: pre-HDBR: 2.2 ± 0.9 mmHg, post-HDBR: 2.1 ± 0.9 mmHg; P = 0.59). HDBR did not affect the transduction response to singlets (P = 0.23), but HDBR reduced the MAP transduction responses to doublets and triplets+ (both P < 0.03). HDBR did not affect the reduction in MAP during non-bursting periods (pre-HDBR: -0.5 ± 0.2 mmHg, post-HDBR: -0.4 ± 0.2 mmHg; P = 0.17). When stratifying the analyses by sex, we observed that HDBR reduced the overall MAP transduction response to integrated MSNA bursts more so in males (P < 0.01) than females (P = 0.14). Conversely, HDBR did not affect the MAP reductions following non-bursting periods in males (P = 0.53), but in females the reduction in MAP following non-bursting periods was less after HDBR, particularly for cardiac cycles 5 to 7 (pre-HDBR: -0.8 ± 0.5 mmHg, post-HDBR: -0.5 ± 0.3 mmHg; P = 0.03). These data suggest that 60 days of HDBR attenuates sympathetic neurocirculatory regulation during baseline conditions, with a modest influence of biological sex. This work was supported by the Canadian Space Agency, Centre National d'Etudes Spatiales, European Space Agency, National Aeronautics and Space Administration, Institute of Aerospace Medicine of the German Aerospace Center (DLR), Fond Européen de Développement Régional (FEDER) and the Natural Sciences and Engineering Research Council of Canada (NSERC). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Long-duration bed rest augments sympathetic neurovascular responses to simulated orthostatic stress among females

Our understanding of the impact of long-duration head-down bed rest (HDBR) on sympathetic neurovascular regulation during orthostatic stress remains incomplete. Through retrospective analysis of the WISE-2005 long-duration bed rest trial, this study aimed to investigate the impact of 60 days of -6° HDBR on the transduction of integrated muscle sympathetic nerve activity (MSNA; peroneal microneurography) into total peripheral resistance (TPR; Finometer Modelflow) responses during rest and graded lower body negative pressure (LBNP; -20, -30, and -45 mmHg). Signal averaging quantified sympathetic transduction for 12 cardiac cycles (ECG) following integrated MSNA bursts in healthy females ( n = 12; 25-40 years). Mixed-effects modeling and post-hoct-tests assessed the impact of HDBR on sympathetic transduction during rest (5-min) and graded LBNP (3-min per level). Data are presented as mean ± SD. Long-duration HDBR did not affect resting total MSNA (pre-HDBR: 909 ± 368 AU/min, post-HDBR: 910 ± 254 AU/min; p = 0.999). HDBR did not affect total MSNA responses to -20 mmHg LBNP (pre-HDBR: 1430 ± 599 AU/min, post-HDBR: 1823 ± 433 AU/min), -30 mmHg LBNP (pre-HDBR: 1574 ± 549 AU/min, post-HDBR: 1924 ± 587 AU/min), or -45 mmHg LBNP (pre-HDBR: 1950 ± 819 AU/min, post-HDBR: 2328 ± 880 AU/min; p = 0.191). HDBR did not affect resting sympathetic transduction to TPR (pre-HDBR: 0.002 ± 0.16 mmHg/L/min, post-HDBR: -0.091 ± 0.12 mmHg/L/min; p = 0.296). However, HDBR augmented TPR transduction responses to graded LBNP (HDBR-by-LBNP interaction: p = 0.050). Pre-HDBR, TPR transduction responses were unchanged with graded LBNP (all p > 0.05). In contrast, post-HDBR, TPR transduction responses increased progressively with graded LBNP (rest: -0.09 ± 0.12 mmHg/L/min, -20 mmHg: 0.22 ± 0.31 mmHg/L/min, -30 mmHg: 0.30 ± 0.34 mmHg/L/min, -45 mmHg: 0.44 ± 0.12 mmHg/L/min; all p < 0.005). The same effect of HDBR was observed when sympathetic transduction of mean arterial pressure was analyzed (data not shown). These data suggest that long-duration HDBR augments sympathetic neurovascular responses to integrated MSNA bursts during orthostatic stress among females. This work was supported by the Canadian Space Agency, the French “Centre National d’Etudes Spatiales”, the European Space Agency, and the National Aeronautics and Space Administration of the USA. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Effect of High-Intensity With Short-Duration Re-Warm-Up on Subsequent Performance in a Cold Environment.

Yamashita, Y and Umemura, Y. Effect of high-intensity with short-duration re-warm up on subsequent performance in a cold environment. J Strength Cond Res 38(6): e280-e287, 2024-The aim of this study was to investigate the effect of high-intensity, short-duration re-warm-up (RW) during half time (HT) on subsequent performance in a cold environment. Eleven male subjects (age, 21 ± 2 years; height, 172.4 ± 4.5 cm; body mass, 65.6 ± 7.1 kg; V̇ o2 max, 47.5 ± 4.8 ml·kg -1 ·min -1 ) performed 2 experimental trials comprising 40 minutes of intermittent cycling exercise, which consisted of 15-second rest, 25-second unloading cycling, 10-second high-intensity cycling, and 70-second moderate-intensity cycling as the first half. In the second half, a cycling intermittent-sprint protocol (CISP) was performed, separated by a 15-minute HT period in cold conditions (5 °C, 50% relative humidity). Two experimental trials were included in a random order: (a) approximately 1 minute of high-intensity, short-duration RW (3 sets of 3-second maximal pedaling [body weight × 0.075 kp]) trial high-intensity intermittent cycling trials (HII); (b) 15 minutes of seated rest trial (CON). Cycling intermittent-sprint protocol consisted of 10 sets of a 2-minute exercise protocol, and each set consisted of 10-second rest, 5-second maximal pedaling (body weight × 0.075 kp), and 105-second active recovery at 50% maximum oxygen uptake (V̇ o2 max). Peak power output of 5-second maximal pedaling during CISP was higher in HII trials than in CON trials (HII: 807 ± 81 W, CON: 791 ± 78 W, p < 0.05). There was no significant difference in rectal temperature between trial types ( p > 0.05). These results suggest that high-intensity, short-duration RW may be a useful HT strategy for improving subsequent performance in cold environments.

The Effect of Lower Tidal Volume Ventilation Facilitated by Extracorporeal Carbon Dioxide Removal Compared With Conventional Lung Protective Ventilation on Cardiac Function.

Lower tidal volume ventilation (targeting 3 mL/kg predicted body weight, PBW) facilitated by extracorporeal carbon dioxide removal (ECCO2R) has been investigated as a potential therapy for acute hypoxemic respiratory failure (AHRF) in the pRotective vEntilation with veno-venouS lung assisT in respiratory failure (REST) trial. We investigated the effect of this strategy on cardiac function, and in particular the right ventricle. Substudy of the REST trial. Nine U.K. ICUs. Patients with AHRF (Pao2/Fio2 < 150 mm Hg [20 kPa]). Transthoracic echocardiography and N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurements were collected at baseline and postrandomization in patients randomized to ECCO2R or usual care. The primary outcome measures were a difference in tricuspid annular plane systolic excursion (TAPSE) on postrandomization echocardiogram and difference in NT-proBNP postrandomization. There were 21 patients included in the echocardiography cohort (ECCO2R, n = 13; usual care, n = 8). Patient characteristics were similar in both groups at baseline. Median (interquartile range) tidal volumes were lower in the ECCO2R group compared with the usual care group postrandomization; 3.6 (3.1-4.2) mL/kg PBW versus 5.2 (4.9-5.7) mL/kg PBW, respectively (p = 0.01). There was no difference in the primary outcome measure of mean (sd) TAPSE in the ECCO2R and usual care groups postrandomization; 21.3 (5.4) mm versus 20.1 (3.2) mm, respectively (p = 0.60). There were 75 patients included in the NT-proBNP cohort (ECCO2R, n = 36; usual care, n = 39). Patient characteristics were similar in both groups at baseline. Median (interquartile range [IQR]) tidal volumes were lower in the ECCO2R group than the usual care group postrandomization; 3.8 (3.3-4.2) mL/kg PBW versus 6.7 (5.8-8.1) mL/kg PBW, respectively (p < 0.0001). There was no difference in median (IQR) NT-proBNP postrandomization; 1121 (241-5370) pg/mL versus 1393 (723-4332) pg/mL in the ECCO2R and usual care groups, respectively (p = 0.30). In patients with AHRF, a reduction in tidal volume facilitated by ECCO2R, did not modify cardiac function.

Muscle Blood Flow and Vasodilation are Blunted at the Onset of Exercise Following an Acute Bout of Ischemia-Reperfusion.

Ischemia-reperfusion injury (I/R) can inhibit endothelial function and impair nitric oxide bioavailability. We tested the hypothesis that I/R also blunts the rapid and steady-state hyperemic and vasodilatory response to handgrip exercise. Ten subjects (8M/2F; 24±4yr) performed handgrip exercises before and after I/R (20 min of ischemia/20 min of reperfusion) and time control (40 min supine rest) trials. Forearm blood flow (FBF) and vascular conductance (FVC) were assessed with Doppler ultrasound during single forearm contractions and 3 min of rhythmic handgrip exercise. Venous blood samples were drawn at rest and during exercise to assess plasma [nitrite]. Peak ΔFBF (from baseline) and ΔFVC following single contractions were attenuated following I/R (134±48 vs. 103±42 ml·min-1; 160±55 vs. 118±48 ml·min-1·100 mmHg-1, P<0.05 for both) but not following time control (115±63 vs. 124±57 ml·min-1; 150±80 vs. 148±64 ml·min-1·100 mmHg-1, P=0.16 and P=0.95, respectively). Steady-state ΔFBF and ΔFVC during rhythmic exercise were unchanged in both I/R (192 ± 52 vs. 190±53 ml·min-1; 208±56 vs. 193±60 ml·min-1·100 mmHg-1) and time control (188±54 vs. 196±48 ml·min-1; 206±60 vs. 207±49 ml·min-1·100 mmHg-1) trials (group x time interactions P=0.34 and 0.21, respectively). Plasma [nitrite] under resting conditions and during steady-steady state rhythmic exercise was attenuated following I/R (P<0.05 for both) but not time control (P=0.54 and 0.93). These data indicate I/R blunts hyperemia and vasodilation at the onset of muscle contractions but does not attenuate these responses during steady-state exercise.

Resting Stroop task: Evidence of task conflict in trials with no required response

In the typical Stroop task, participants are presented with color words written in different ink colors and are asked to respond to their color. It has been suggested that the Stroop task consists of two main conflicts: information conflict (color vs. word naming) and task conflict (respond to color vs. read the word). In the current study, we developed a novel task that includes both Response trials (i.e., trials in which a response is required) and Rest trials (i.e., trials in which no response is required or available) and investigated the existence of both information and task conflicts in Rest trials. We found evidence for task conflict in Response and also in Rest trials, while evidence for information conflict was only observed in Response trials. These results are in line with a model of task conflict that occurs independently of and prior to information conflict in the Stroop task.

Three-minute bench step exercise as a countermeasure for acute mental stress-induced arterial stiffening.

Acute mental stress (MS) induces a transient increase in arterial stiffness. We verified whether a single bout of bench step (BS) exercise for 3 minutes counteracts acute MS-induced arterial stiffening. Fifteen healthy young men (mean age, 21.7 ± 0.3 years) underwent two experimental trials: rest (RE) and exercise (EX) trials. Following a 5-minute MS task, the participants in the RE trial rested on a chair for 3 minutes (from 10 to 13 minutes after task cessation), whereas those in the EX trial performed the BS exercise for the same duration. The heart-brachial pulse wave velocity (PWV) (hbPWV), brachial-ankle PWV (baPWV), heart-ankle PWV (haPWV), and the cardio-ankle vascular index (CAVI) were measured at baseline and at 5 and 30 minutes after the task. In both trials, significant increases in hbPWV, haPWV, and CAVI occurred at 5 minutes after the task; these elevations persisted until 30 minutes after the task in the RE trial, but significantly decreased to baseline levels in the EX trial. baPWV was significantly elevated at 30 minutes after the task in the RE trial, but not in the EX trial. This study reveals that a 3-minute BS exercise offsets acute MS-induced arterial stiffening.

TILT TEST TOLERANCE AFTER TWO-WEEKS BED REST IN OLDER ADULTS IS NOT PROTECTED BY DAILY AEROBIC AND RESISTANCE EXERCISE

Abstract Bed rest is associated with increased risk of orthostatic intolerance on return to upright posture and, at least in young adults, regular exercise during bed rest is proposed as protective. 22 older adults (55-65 years, half women) participated in a randomized trial with 14-days of continuous 6-degree head-down bed rest. Half completed 60 min/day of aerobic and high-intensity interval cycling plus resistance exercises (Ex) while the other half were control (Con). A passive 80-degree head-up tilt (HUT) to a maximum of 15-min assessed orthostatic tolerance while cardio- and cerebrovascular responses were monitored to a pre-syncopal level of systolic blood pressure &amp;lt; 90 mmHg. In pre-bed rest baseline, all but 3 women (Ex) completed 15-min HUT. After 14-days bed rest, only 3 men (1 Ex) and 1 woman (Ex) completed 15-min with no differences in tolerance between men and women or Ex and Con. Vasovagal syncope presented in 5 participants (2 M-Con, 1 M-Ex, 1 F-Con, 1 F-Ex), most other non-finishers had progressive reduction in stroke volume without adequate vasoconstriction. Reductions in cerebral blood velocity measured during HUT by Doppler ultrasound revealed strong linear relationships to both end-tidal PCO2 and mean arterial pressure across all participants. These data indicate that neither older men nor older women were protected from orthostatic intolerance by 60-min per day exercise including high-intensity interval training. These data contrast with previous findings in younger adults in controlled trials of bed rest pointing to the need for greater understanding of mechanisms regulating blood pressure and brain blood flow.

The effects of collagen peptides on exercise-induced gastrointestinal stress: a randomized, controlled trial

PurposeWe examined the effects of collagen peptides (CP) supplementation on exercise-induced gastrointestinal (GI) stress.MethodsIn a randomized, crossover design, 20 volunteers (16 males: dot{V}O2max, 53.4 ± 5.9 ml·kg−1) completed 3 trials: a non-exercise rest trial, with no supplement (REST) and then an exercise trial with CP (10 g·day−1) or placebo control (CON) supplements, which were consumed for 7 days prior to, and 45 min before, a 70 min run at 70–90% of dot{V}O2max. Outcome measures included urinary lactulose and rhamnose (L/R), intestinal fatty acid binding protein (I-FABP), lipopolysaccharide (LPS), anti-LPS antibody, monocyte-chemoattractant protein-1 (MCP-1), interleukin (IL) 6 and 8, cortisol, alkaline phosphatase (ALP) (measured pre, 10 min post and 2 h post) and subjective GI symptoms.ResultsThere were no differences in heart rate, perceived exertion, thermal comfort, or core temperature during exercise in the CP and CON trials (all P > 0.05). I-FABP was higher in CP (2538 ± 1221 pg/ml) and CON (2541 ± 766 pg/ml) vs. REST 2 h post (1893 ± 1941 pg/ml) (both P < 0.05). LPS increased in CON vs. REST 2 h post (+ 71.8 pg/ml; P < 0.05). Anti-LPS antibody decreased in CON and CP vs. REST at post (both P < 0.05). There were no differences in MCP-1, IL-6, and IL-8 between the CP and CON trials (all P > 0.05), and no differences in L/R or GI symptoms between CON and CP (all P > 0.05).ConclusionCollagen peptides did not modify exercise-induced changes in inflammation, GI integrity or subjective GI symptoms but LPS was higher in CON 2 h post-exercise and thus future studies may be warranted.

Acute hypoxaemic respiratory failure after treatment with lower tidal volume ventilation facilitated by extracorporeal carbon dioxide removal: long-term outcomes from the REST randomised trial

IntroductionLower tidal volume ventilation, facilitated by veno-venous extracorporeal carbon dioxide removal (vv-ECCO2R), does not improve 90-day mortality in patients with acute hypoxaemic respiratory failure (AHRF). The aim of this analysis...

The Sleep, Cancer and Rest (SleepCaRe) Trial: Rationale and design of a randomized, controlled trial of cognitive behavioral and bright light therapy for insomnia and fatigue in women with breast cancer receiving chemotherapy

BackgroundInsomnia and fatigue symptoms are common in breast cancer. Active cancer treatment, such as chemotherapy, appears to be particularly disruptive to sleep. Yet, sleep complaints often go unrecognised and under treated within routine cancer care. The abbreviated delivery of cognitive behavioral therapy for Insomnia (CBTI) and bright light therapy (BLT) may offer accessible and cost-effective sleep treatments in women receiving chemotherapy for breast cancer. MethodsThe Sleep, Cancer and Rest (SleepCaRe) Trial is a 6-month multicentre, randomized, controlled, 2 × 2 factorial, superiority, parallel group trial. Women receiving cytotoxic chemotherapy for breast cancer at tertiary Australian hospitals will be randomly assigned 1:1:1:1 to one of four, non-pharmacological sleep interventions: (a) Sleep Hygiene and Education (SHE); (b) CBTI; (c) BLT; (d) CBT-I + BLT combined and simultaneously delivered. Each sleep intervention is delivered over 6 weeks, and will comprise an introductory session, a mid-point phone call, and regular emails. The primary (insomnia, fatigue) and secondary (health-related quality of life, rest activity rhythms, sleep-related impairment) outcomes will be assessed via online questionnaires at five time-points: baseline (t0, prior to intervention), mid-point intervention (t2, Week 4), post-intervention (t3, Week 7), 3-months (t4, Week 18), and 6-months follow-up (t5, Week 30). ConclusionsThis study will report novel data concerning the comparative and combined efficacy of CBT-I and BLT during chemotherapy. Findings will contribute to the development of evidence-based early sleep and fatigue intervention during chemotherapy for breast cancer.Clinical trial informationRegistered with the Australian New Zealand Clinical Trials Registry (http://anzctr.org.au/), Registration Number: ACTRN12620001133921.

Impaired Oxygenation of the Prefrontal Cortex During Verbal Fluency Task in Young Adults With Major Depressive Disorder and Suicidality: A Functional Near-Infrared Spectroscopy Study.

BackgroundFew previous studies have focused on prefrontal activation in young adults diagnosed with major depressive disorder (MDD) and suicidality via functional near-infrared spectroscopy (fNIRS).Materials and MethodsA total of 59 healthy controls (HCs), 35 patients with MDD but without suicidality, and 25 patients with MDD and suicidality, between the ages of 18–34 years, were enrolled. Changes in oxygenated hemoglobin (oxy-Hb) levels of the prefrontal cortex at baseline, 4 weeks, and 8 weeks, were evaluated using a protocol consisting of three consecutively repeated trials of rest, speech, and verbal fluency test (VFT) via fNIRS. MDD was diagnosed and suicidality was evaluated based on Mini International Neuropsychiatric Interview (MINI).ResultsOxy-Hb levels were impaired in patients with MDD compared with HCs (p = 0.018 for left prefrontal cortex; p = 0.021 for right ventromedial prefrontal cortex; p = 0.002 for left frontopolar cortex). Among the three groups including HCs, MDD without suicidality, and MDD with suicidality, prefrontal oxygenation was most decreased in MDD patients with suicidality. A significantly impaired prefrontal oxygenation in the right ventrolateral prefrontal cortex (VLPFC) was detected after adjusting for covariates in MDD patients with suicidality, compared to those without suicidality.ConclusionImpaired prefrontal oxygenation during cognitive execution may serve as a diagnostic biomarker for suicidality in young adult patients with MDD.

The effectiveness of bench step exercise for ameliorating acute mental stress-induced arterial stiffening.

PurposeThis study aimed to evaluate the effectiveness of bench step (BS) exercise for ameliorating arterial stiffening caused by acute mental stress (MS).MethodsFifteen young healthy men participated in two randomized trials: rest (RE) and exercise (EX) trials. Following a 5-min MS task (first task), the RE trial participants rested on a chair for 10 min (from 10 to 20 min after task cessation); the EX trial participants performed BS exercise for the same duration. At 40 min after the first task, the participants performed the same task (second task) again. Heart–brachial pulse wave velocity (PWV) (hbPWV), brachial–ankle PWV (baPWV), heart–ankle PWV (haPWV), and the cardio-ankle vascular index (CAVI) were measured simultaneously at 5, 30, and 50 min after the first task.ResultsBoth trials caused significant elevations in hbPWV, haPWV, and CAVI at 5 min after the first task; these changes persisted until 30 min after the task in the RE trial, while they were abolished in the EX trial. baPWV significantly increased at 30 min after the task in the RE trial, but not in the EX trial. After the second task (from 30 to 50 min after the first task), none of the parameters significantly increased in the RE trial, although the values remained above baseline levels. In the EX trial, hbPWV, haPWV, and CAVI showed significant elevations.ConclusionOur findings suggest that a 10-min BS exercise after acute MS can counteract stress-induced arterial stiffening, but has only a limited effect against subsequent acute MS.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00421-022-04962-y.

Using the external auditory canal skin graft of the healthy side to treat unilateral congenital aural atresia: preliminary results of clinical research

Objective: To investigate whether the contralateral normal external auditory canal (EAC) skin graft can maintain the ear canal health after EAC reconstruction in unilateral congenital aural atresia (CAA) cases. Methods: A Zelen design randomized controlled study was used to collect unilateral CAA patients for EAC reconstruction prospectively (clinical trial registration number: ChiCTR2000032103). The patients were randomly divided into the control group and the trial group. The trial group used the contralateral normal EAC skin graft group (transplant part of the contralateral normal EAC skin to repair the atresia side for unilateral CAA patients), the control group all used scalp blade thick skin. We observed the EAC health and hearing results of the two groups after EAC reconstruction. Results: A total of 13 cases were enrolled from July 2020 to August 2021. There were eight patients in the trial group, including six males and two females, with an average age of 22.3 years (14-36 years). There were two patients with CAA on the left and six patients on the right. The average follow-up time was 8.8 months (4-14 months). There were five patients in the control group, all cases were male with an average age of 16.2 years (12-20 years). There were four patients with CAA on the left and one patient on the right. The average follow-up time was 7.0 months (2-14 months). In the trial group, eight cases of reconstructed EAC epithelium were healthy, one patient had cicatricial stenosis of EAC opening and lateralization of the tympanic membrane. The other patient had cicatricial stenosis of reconstructed EAC, this case also had scar hyperplasia of the contralateral EAC opening but recovered after soft packing and triamcinolone acetonide injection treatment. The healthy side EAC of the rest trial group had no scarring stenosis or local bone hyperplasia during long-term follow-up. In the control group, one patient was lost to follow-up and the other four patients had dry ears of reconstructed EAC, but easily to form crusts and needed to be cleaned repeatedly, one patient had lateralization of the tympanic membrane, the EAC epithelium was not healthy for long-term follow-up. The incidence of complications related to EAC reconstruction was lower than previous studies (χ²=5.55, P=0.018), and the average postoperative Air-Bone Gap increased (18.8±10.0)dB. Conclusion: By optimizing the EAC reconstruction technology, the health of the reconstructed EAC is improved compared with the previous study. After active intervention and treatment, there should be no scarring stenosis or local bone hyperplasia on the contralateral side EAC.

The Influence of a Competitive Field Hockey Match on Cognitive Function.

Despite the known positive effects of acute exercise on cognition, the effects of a competitive team sport match are unknown. In a randomized crossover design, 20 female and 17 male field hockey players (19.7 ± 1.2 years) completed a battery of cognitive tests (Visual Search, Stroop, Corsi Blocks, and Rapid Visual Information Processing) prior to, at half-time, and immediately following a competitive match (or control trial of seated rest); with effect sizes (ES) presented as raw ES from mixed effect models. Blood samples were collected prior to and following the match and control trial, and analyzed for adrenaline, noradrenaline, brain derived neurotrophic factor (BDNF), cathepsin B, and cortisol. The match improved response times for a simple perception task at full-time (ES = –14 ms; P < 0.01) and response times on the complex executive function task improved at half-time (ES = –44 ms; P < 0.01). Working memory declined at full-time on the match (ES = –0.6 blocks; P < 0.01). The change in working memory was negatively correlated with increases in cortisol (r = –0.314, P = 0.01; medium), as was the change in simple perception response time and the change in noradrenaline concentration (r = –0.284, P = 0.01; small to medium). This study is the first to highlight the effects a competitive hockey match can have on cognition. These findings have implications for performance optimization, as understanding the influence on specific cognitive domains across a match allows for the investigation into strategies to improve these aspects.

Is early activity resumption after paediatric concussion safe and does it reduce symptom burden at 2 weeks post injury? The Pediatric Concussion Assessment of Rest and Exertion (PedCARE) multicentre randomised clinical trial

ObjectiveInvestigate whether resuming physical activity (PA) at 72 hours post concussion is safe and reduces symptoms at 2 weeks, compared with resting until asymptomatic.MethodsReal-life conditions, multicentre, single-blinded randomised clinical trial,...