Restraint Group Research Articles

Preclinical investigation of the effect of stress on the binding of [18F]F13640, a 5-HT1A radiopharmaceutical

Background[18F]F13640 is a new PET radiopharmaceutical for brain molecular imaging of serotonin 5-HT1A receptors. Since we intend to use this radiopharmaceutical in psychiatric studies, it is crucial to establish possible sensitivity modification of 5-HT1A receptors availability during an acute stress exposure. In this study, we first assessed the cerebrometabolic effects of a new animal model of stress with [18F]FDG and then proceeded to test for effects of this model on the cerebral binding of [18F]F13640, a 5-HT1A receptors PET radiopharmaceutical. MethodsFour groups of male Sprague-Dawley were used to identify the optimal model: “stressed group” (n = 10), “post-traumatic stress disorder (PTSD) group” (n = 9) and “restraint group” (n = 8), compared with a control group (n = 8). All rats performed neuroimaging [18F]FDG μPET-CT to decipher which model was the most appropriate to test effects of stress on radiotracer binding. Subsequently, a group of rats (n = 10) underwent two PET imaging acquisitions (baseline and PTSD condition) using the PET radiopharmaceutical [18F]F13640 to assess influence of stress on its binding. Voxel-based analysis was performed to assess [18F]FDG or [18F]F13640 changes. ResultsIn [18F]FDG experiments, the PTSD group showed a pattern of cerebrometabolic activation in various brain regions previously implicated in stress (amygdala, perirhinal cortex, olfactory bulb and caudate). [18F]F13640 PET scans showed increased radiotracer binding in the PTSD condition in caudate nucleus and brainstem. ConclusionsThe present study demonstrated stress-induced cerebrometabolic activation or inhibition of various brain regions involved in stress model. Applying this model to our radiotracer, [18F]F13640 showed few influence of stress on its binding. This will enable to rule out any confounding effect of stress during imaging studies.

Physical restraint and associated agitation.

Physical restraint of patients in intensive care units (ICUs) has an estimated prevalence of 50%. Many medical centres do not have specific protocols for physical restraint, and the decision of whether to physically restrain a patient is up to the nursing staff. Disadvantages of physical restraint include injuries, exacerbation of agitation and an increased risk of developing post-traumatic stress disorder (PTSD). To report prevalence and outcomes in terms of morbidity and mortality of physical restraint in general ICU patients in an 800-bed secondary medical centre. This retrospective study included 647 patients admitted to a general ICU in an 800-bed secondary medical centre in Kfar Saba, Israel, between January and December 2020. Data included demographics, medical history, length of stay, need for mechanical ventilation, number of ventilation days, 28-day mortality, reason for admission, agitation rate assessed by Richmond Agitation and Sedation Scale (RASS) score, need for physical restraint and need for anti-psychotics. Among the patients, 40% (256 of 647) required physical restraint. Older adult patients had a greater likelihood of being physically restrained along with those admitted because of sepsis or acute respiratory failure. Among the study sample, 11% (71 of 647) required anti-psychotics. Patients who were restrained had longer duration of ventilation (5.9 ± 8.2 vs. 0.36 ± 1.4 days; p < .001) and higher 28-day mortality (0.26 ± 0.45 vs. 0.07 ± 0.25, Z = 6.86, p < .001). There was no difference in medical history, except for chronic drug abuse, which was more frequent in the restraint group (18 [6.9%] vs. 11 [2.8%], respectively; p = .019), as well as the use of anti-psychotic medications (24 [9.3%] vs. 19 [4.8%], respectively; p = .034) and anti-depressants (55 [21.2%] vs. 59 [14.8%], respectively; p = .042). The restraint group had higher disease severity scores, as reflected in requirements for vasopressor support (174 [67.2%] vs. 69 [17.3%], respectively; p < .001) and need for dialysis (39 [15.1%] vs. 19 [4.8%], respectively; p < .001); higher frequency of in-hospital anti-psychotic treatment (60 [23.2%] vs. 11 [2.8%], respectively; p < .001); a greater tendency for agitation events and more severe agitation scores (episodes of RASS above zero [1.7 ± 4.0 vs. 0.04 ± 0.27, respectively; p < .001] and maximum RASS score [0.19 ± 1.6 vs. 0.01 ± 0.54, respectively; p < .001]). Overall, advanced age, number of ventilation days and need for dialysis were associated with increased 28-day mortality. In the restraint group, advanced age, chronic use of diuretics and the use of dialysis during ICU admission were associated with increased mortality risk. Restrained patients tended to have higher morbidity and mortality during ICU and hospital stays, as well as a greater tendency for agitation events and more severe agitation scores, with an increased need for in-hospital anti-psychotic treatment. These findings regarding patient characteristics might be used to formulate treatment plans to reduce the rate of physical restraint in the ICU. Because restrained ICU patients tend to have higher morbidity and mortality, treatment plans should be formulated to reduce the rate of physical restraint in the ICU. NCT04771793.

Restraint stress induces blood-brain barrier injury in rat amygdala by activating the Rho/ROCK signaling pathway

To investigate the role of Rho/ROCK signaling pathway in mediating restraint stress-induced blood-brain barrier (BBB) injury in the amygdala of rats. Sixty male SD rats were randomized equally into control group (with food and water deprivation for 6 h per day), restraint stress group (with restraint for 6 h per day), stress + fasudil treatment (administered by intraperitoneal injection at 1 mg/100 g 30 min before the 6-h restraint) group, and fasudil treatment alone group. The elevated plus-maze test was used to detect behavioral changes of the rats, serum corticosterone and S100B levels were determined with ELISA, and Evans Blue leakage in the brain tissue was examined to evaluate the changes in BBB permeability. The changes in expression levels of tight junction proteins in the amygdala were detected using immunofluorescence assay and Western blotting, and Rho/ROCK pathway activation was detected by Pull-down test and Western blotting. Ultrastructural changes of the cerebral microvascular endothelial cells were observed using transmission electron microscopy. Compared with those in the control group, the rats in restrain stress group and stress+fasudil group showed obvious anxiety-like behavior with significantly increased serum corticosterone level (P<0.001). Compared with those in the control group and stress+fasudil group, the rat models of restrain stress showed more obvious Evans Blue leakage and higher S100B expression (P<0.01) but lower expressions of tight junction proteins in the amygdala. Pull-down test and Western blotting confirmed that the expression levels of RhoA-GTP, ROCK2 and P-MLC 2 were significantly higher in stress group than in the control group and stress + fasudil group (P<0.05). Transmission electron microscopy revealed obvious ultrastructural changes in the cerebral microvascular endothelial cells in the rat models of restrain stress. Restraint stress induces BBB injury in the amygdala of rats by activating the Rho/ROCK signaling pathway.

A soy protein enzymatic digest mitigates Nrf2-related oxidative stress and attenuates depression-like behavior in a mouse model of sub-chronic restraint stress

Continuous oxidative stress conditions have been identified as a major cause of various neuropsychiatric disorders, including depression. The present study investigated the potential antidepressant-like effects of a soy protein enzymatic digest (SPD) containing soy-deprestatin, which is a soy-derived peptide with reported antidepressant-like effects, as well as its ability to mitigate oxidative stress in the brain caused by sub-chronic restraint stress. Mice were divided into two groups: a control group and restraint stress group. The restraint stress group was further divided into two groups administered water or SPD. After repeated short-time restraints over five days, we evaluated immobility times in the tail suspension test, and antioxidant enzyme activities, glutathione levels, oxidative stress maker levels, and the gene expression levels of Nrf2 and antioxidant enzymes in the brain. The results obtained showed that the oral administration of SPD reduced immobility times in mice exposed to restraint stress. In comparisons with the water-treated restraint group, the administration of SPD restored superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase activities and glutathione levels and prevented restraint stress-induced increases in malondialdehyde, carbonyl protein, and 8-OHdG levels in the restraint stress group. In addition, high expression levels of Nrf2, HO-1, NQO-1 and GCLC were observed in the SPD-treated restraint group. These results suggest that SPD attenuated repeated restraint stress-induced depression-like behaviors by mitigating oxidative stress through the activation of the Nrf2 signaling pathway.

Kısıtlama ve Soğuk Kısıtlama Stresinin Wistar Albino Sıçanlarda Pıhtılaşma Göstergeleri Üzerindeki Etkileri

The purpose of this study was to investigate the effects of two different acute stress protocols, such as restraint and cold restraint stress, on coagulation indicators in rats. The study was conducted in 18 male Wistar albino rats aged 8-10 weeks with a body weight of 180-220 g. After a one-week adaptation period, the rats were randomly divided into three groups (n=6/group). The animals in the control group were not exposed to any stress. Rats in the restraint group were housed in restrainer designed for rats, and their movement was restricted for 2 hours at room temperature. Rats in the cold restraint group were kept in the restrainer at +4°C for 2 hours. Blood samples were collected by cardiac puncture under ketamine and xylazine anesthesia in Vacutainer® tubes containing 3.2% sodium citrate (0.109 M trisodium citrate). Coagulation indicators (aPTT, PT, INR, fibrinogen, and D-dimer) were analyzed using an automated analyzer (Roche Cobas t511, Switzerland). Although acute stress (restraint and cold restraint stress) had no effect on aPTT and D-dimer levels (p&gt;0.05), it increased PT and INR values (p

Patient-self-reported history of restraint among 17-year-olds: a retrospective study of records by non-specialist dentists in the public dental service in Hordaland, Norway

PurposeThe primary purposes were to examine dental records of Norwegian adolescents’ with and without self-reported history of restraint for information about oral health (DMFT), total scheduled time in the Public Dental Service (PDS) (dental appointments, cancelled and missed appointments), and reluctant behaviour and/or dental fear and anxiety (DFA). Another purpose was to explore their dental records for information recorded by the dentist concerning the use of restraint.MethodsData on patient-self-reported history of restraint and DFA were collected in a population-based cross-sectional survey of 17-year-olds in the PDS in Hordaland, Norway, 2019. Patients were divided into two groups: self-reported restraint group (N1 = 26) and self-reported non-restraint group (N2 = 200). Data on oral health and dental treatment, total scheduled time of the PDS, reluctant behaviour or DFA, and information on the use of restraint were extracted from the dental records written by non-specialist dentists using a pre-set protocol covering the period from 2002 to 2019.ResultsA total of 206 dental records were analysed. Adolescents with self-reported history of restraint (n1 = 18) had higher DMFT and greater descriptions of reluctant behaviour and/or DFA, and total scheduled time compared with the self-reported non-restraint group (n2 = 188). The use of restraint was recorded in the dental records of one patient from the self-reported restraint group and in two patients from the self-reported non-restraint group.ConclusionsThe adolescents with self-reported history of restraint had higher DMFT, higher scheduled time attending the PDS, and had more descriptions of reluctant behaviour and/or signs of DFA compared with the self-reported non-restraint group. The patient records contained limited information concerning restraint, and there were significant discrepancies between patient-self-reported history of restraint and the recording of restraint by the dentist in the patients’ records.

COMPARATIVE STUDY ON THE IMPACT OF DIFFERENT IMMOBILIZATION METHODS ON MUSCLE INTEGRITY AND STRESS INDICATORS IN BROOK TROUT (SALVELINUS FONTINALIS).

Chemical sedation of fish is often used during scientific research to reduce stress and risk of injury. Electric fish handling gloves (EFHG) have been proposed as a no-residue alternative to chemical immobilization. However, the impact of handling fish with EFHG on their physiology remains relatively poorly studied. Stress markers (plasma cortisol and lactate) and the impact on muscular integrity (plasma creatine kinase and histopathology of skeletal muscles) were assessed in brook trout (Salvelinus fontinalis) subjected to one of three immobilization methods (manual restraint, EFHG [10-16 mV], and buffered 60 mg/L tricaine methanesulfonate [MS-222] immersion anesthesia) for 1- and 5-min restraints. Plasma lactate levels were significantly higher 2 h postrestraint for all experimental groups (+242%; P < 0.001), but the magnitude of these increases was significantly lower in the MS-222 groups (P ≤ 0.0002). Plasma creatine kinase concentrations significantly increased 2 h postrestraint for the EFHG groups (+92%, P ≤ 0.0061), and this increase was significantly higher than in the MS-222 group for the 1-min restraint (P = 0.0031). Although there was no significant difference between the restraining methods tested at all time points for plasma cortisol, the EFHG and manual restraint groups showed a linear and statistically significant increase after the initial 5-min restraint, whereas all other groups presented an expected bell-shaped profile with a plasma peak 1 h after the initial restraint. One fish in the manual restraint group died during the 5-min restraint, and two fish from the EFHG group were euthanized at the end of this protocol because of buoyancy anomalies. All other fish from the 5-min restraint group developed cutaneous saprolegniasis 3 wk after the experiments. The evaluation of the safety of EFHG in brook trout showed similar impacts on the variables tested compared with manual restraint for 1- and 5-min immobilizations.

Obesity Combined with Chronic Restraint Stress-Induced Hypertension in Mice Is Associated with the Damage of Noradrenergic Neurons in Nucleus Tractus Solitarii

To investigate whether obesity combined with chronic restraint stress (CRS) can increase blood pressure in mice and its relationship with the damage of the intermediate part of the nucleus tractus solitarius (iNTS). The CRS mouse model was constructed, and 51 mice were assigned to four groups, low-fat diet non-restraint group (LF group), low-fat diet restraint group (LS group), high-fat diet non-restraint group (HF group), and high-fat diet restraint group (HS group). Interventions were carried out in four cycles (over the course of 40 consecutive days), with each cycle consisting of 7 days of restraint and 3 days of free movement. The body weight and the arterial systolic blood pressure of the mice were measured on the day 9 of every cycle. The mice were sacrificed on day 40 and the brain tissues of the mice were collected afterwards in order to perform immunohistochemical staining and Western blot to examine the expression of glial fibrillary acidic protein (GFAP) and tyrosine hydroxylase (TH). The protein expression of vascular endothelial growth factor A (VEGFA) was examined with Western blot on epididymal fat pad to assess the vascular density of lipid tissue. On day 40, the arterial systolic pressure of mice in HS group was significantly higher than that of mice in the three other groups. Body mass of high-fat diet group (HF group and HS group) increased significantly. Mice in the four groups did not present significant difference in VEGFA protein expression. INTS astrocytes were activated in the brain of mice in the restraint groups (LS group and HS group), and iNTS TH expression was decreased in HS group. Mice in HF group and LS group did not show abnormal changes in their blood pressure. Blood pressure of mice in the HS group generally rose, and hypertension (arterial systolic blood pressure ≥140 mmHg, 1 mmHg=0.133 kPa) was observed in 37.5% of the mice in this group. Obesity combined with CRS may cause an increase in arterial blood pressure in mice, the mechanism of which may be related to the damage of noradrenergic neurons in the nucleus tractus solitarius.

The Effect of Trunk Stability Training Based on Visual Feedback on Trunk Stability, Balance, and Upper Limb Function in Stroke Patients: A Randomized Control Trial.

This study aimed to investigate the effects of trunk stability training based on visual feedback on trunk stability, balance, and upper limb function in patients with stroke. Twenty-eight patients with chronic stroke were randomly assigned to either a trunk support group (n = 14) or a trunk restraint group (n = 14) that practiced upper limb training with trunk support and trunk restraint, respectively, based on visual feedback for 30 min per day, three times per week, for 4 weeks. The postural assessment scale for stroke (PASS) was used to assess the stability of patients, and the functional reaching test (FRT) was performed to assess balance. To assess upper extremity function, a range of motion (ROM) test, manual muscle testing (MMT), and Fugl–Meyer assessment-upper limb (FMA-upper limb) were performed. Consequently, both groups showed significant differences before and after training in the PASS, FRT, shoulder flexion ROM, triceps brachii MMT, and FMA-upper limb (p < 0.05), while the trunk support group showed more significant improvements than the trunk restraint group in the PASS, FRT, and FMA-upper limb (p < 0.05). Trunk support-based upper limb training effectively improved trunk stability, balance, and upper limb function and is beneficial as an upper limb training method. Providing trunk support is more effective than restricting the trunk; trunk support-based upper limb training is expected to promote voluntary participation when combined with visual feedback.

Efficacy and Safety of Inhalation Sedation during Office Probing for Congenital Nasolacrimal Duct Obstruction.

We compared the effectiveness of inhaled sevoflurane versus physical restraint during probing in children with congenital nasolacrimal duct obstruction (CNLDO). We performed a retrospective review of children with CNLDO who underwent office probing procedures by a single surgeon under sedation or restraint. Patients’ characteristics at the time of probing, including age, sex, laterality, previous non-surgical treatment, presence of dacryocystitis, outcomes of probing, and complications were compared between the sedation and restraint groups. A multivariable logistic regression analysis was performed to investigate the prognostic factors associated with the success of probing. A subgroup analysis by 12 months of age was also conducted. The overall success rate was 88.6% in 202 eyes of 180 consecutive children (mean age, 15.1 ± 7.7 months). The sedation group had a marginally higher success rates than the restraint group (93.8% vs. 85.1%, p = 0.056). The success rate was not significantly different between the two groups in children aged <12 months (90.9% vs. 93.1%, p = 0.739), but it was significantly higher in the sedation group (94.7% vs. 77.8%. p = 0.006) in children aged ≥12 months. Inhalation sedation was the most potent factor associated with success (adjusted odds ratio = 5.56, 95% confidence interval = 1.33–23.13, p = 0.018) in children aged ≥12 months. There were no surgical or sedation-related complications intra- and postoperatively. Inhaled sevoflurane sedation resulted in more successful, controlled, painless probing, particularly in children aged ≥12 months. It represents a safe, efficient alternative to general anesthesia.

Shortening sow restraint period during lactation improves production and decreases hair cortisol concentrations in sows and their piglets

Food animal welfare is an issue of great concern, as society has a responsibility for animals under human care. Pork is the most consumed meat worldwide, with more than a billion pigs being slaughtered globally every year. Still, in most countries, sows are restrained in farrowing crates throughout lactation. In these crates, sows are confined with bars to an area that is just slightly larger than their body. Thus, moving and turning around, grooming, or expressing other natural behaviors are typically impossible. In this study, we utilized a simple and practical modification of conventional farrowing crates to designed farrowing pens, by removable confinement bars, which provide the flexibility to change the housing system from one to another. Our objective was to examine the parameters of production and hair cortisol concentrations after different restraint periods during lactation. Analyses included data from 77 sows and their 997 piglets. Sows were housed in farrowing crates, but the confinement bars were removed after different periods, from 3 days post-farrowing to full restraint. For certain analyses, sows were grouped into Short or Long Restraint groups (3–10 days vs 13–24 days, respectively). Multiple linear regression revealed that for any additional day in restraint of the sows, piglets' weaning rate decreases by 0.4% (P < 0.05). Moreover, the total number of weaned piglets per litter was higher in the Short Restraint group as compared to the Long Restraint group (10.4 ± 0.3 vs 9.7 ± 0.3, respectively; P < 0.05). Accordingly, total litter weight on the weaning day tended to be higher in the Short Restraint group (68.8 ± 2.2 vs 64.9 ± 1.8 kg; P = 0.1210). The requirement for medical treatments during lactation (e.g., antibiotics, NSAID) tended to be less frequent in the Short Restraint group (Sows: 21.9% vs 40%; P = 0.1219. Piglets: 2.4% vs 17.1%; P = 0.0609). Hair cortisol as a marker for chronic stress during lactation decreased when the restraint period was shortened in both sows and piglets. Our analysis revealed that sows' hair cortisol is a significant mediator between the restraint of the sow and its piglets' hair cortisol (Sobel test; P < 0.05). For every day of sows' restraint, sows' hair cortisol increased by 0.5 pg/mg, and for any additional unit of sows' hair cortisol, piglets' hair cortisol increased by 0.36 pg/mg. In conclusion, sustainable swine farming management can be beneficial for both animals and farmers; limiting sow restraint during lactation is expected to reduce stress, enhance welfare and production, and potentially improve the economics of swine operations.

Cognitive dietary restraint score is associated with lower energy, carbohydrate, fat, and grain intake among female adolescent endurance runners

This cross-sectional study investigated associations between cognitive dietary restraint (CDR), energy, macronutrient and food group intake, menstrual function, and bone density in female adolescent endurance runners. Participants were forty female adolescent endurance runners. The independent variable was CDR, as assessed by the Three Factor Eating Questionnaire (TFEQ). Runners with CDR subscale scores ≥11 were classified with elevated CDR. The main outcomes measured were dietary intake measured by 24-hour recall for 7 days, menstrual history, and bone mineral density (BMD). Twelve of 40 participants (30.0%) met criteria for elevated CDR. Compared to runners with normal CDR, runners with elevated CDR scores reported consuming lower energy (kcal/kg/day) (37.5 ± 8.6 vs. 44.0 ± 9.6, p = 0.052), lower carbohydrate (g/kg/day) (5.3 ± 1.3 vs. 6.3 ± 1.3, p = 0.042), more fiber (g/day) (24.9 ± 6.7 vs. 20.0 ± 5.3, p = 0.018), more servings of fruit (3.3 ± 1.4 vs. 1.9 ± 1.2, p = 0.003), more servings of vegetables (2.7 ± 1.4 vs. 1.7 ± 0.7, p = 0.004), and fewer servings of grain (7.6 ± 2.4 vs. 9.8 ± 2.4, p = 0.009) per day. Runners with elevated CDR exhibited significantly lower lumbar spine BMD Z-scores (adjusting for BMI) (−0.78 ± 0.19 vs. −0.22 ± 0.12, p = 0.016) than runners with normal CDR. Menstrual history did not significantly differ based on CDR status. Elevated CDR may increase risk of dietary patterns associated with consuming inadequate levels of energy, key nutrients, and developing low BMD in endurance runners.Trial Registration:ClinicalTrials.gov Identifier: NCT01059968

Changes in nitric oxide, carbon monoxide, hydrogen sulfide and male reproductive hormones in response to chronic restraint stress in rats

Gasotrasmitters are endogenously synthesized gaseous molecules that are engaged in cellular physiological and pathological processes. Stress influences various physiological aspects of an organism and amends a normal system's functions, including those of the reproductive system. This study aims to investigate the effect of long-term exposure to restraint stress on the male reproductive system as well as the possible impact of stress on the levels of nitric oxide (NO), carbon monoxide (CO) and hydrogen sulfide (H2S), and the expression of their producing-enzymes. In this study, rats were subjected to the restraint condition for 2 h per day and 7 days per week for 8 consecutive weeks. The results revealed decreases in the serum levels of kisspeptin-1(Kiss-1), gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone and dehydroepiandrosterone sulfate (DHEA-s); however, corticosterone, gonadotropin-inhibitory hormone (GnIH), estradiol (E2) and prolactin levels increased following restraint stress. The mRNA expression levels of NO synthases (NOSs); neuronal NOS (nNOS), inducible NOS (iNOS) and H2S synthases; cystathionine-γ-lyase- (CSE), 3-mercaptopyruvate-sulfurtransferase- (3MST) and CO-producing enzyme; heme oxygenase-2 (HO-2) were upregulated in the hypothalamus of restraint rats. Testicular mRNA expression levels of endothelial NOS (eNOS), nNOS, HO-1 and HO-2 were upregulated whereas cystathionine β-synthase (CBS), CSE and 3MST expression levels were downregulated following restraint stress. Concentrations of NO increased in the testes but decreased in the semen of restraint rats. On the contrary, CO levels were reduced in the testes while they were elevated in the semen, whereas H2S concentrations decreased in both testes and semen of restraint rats. Concentrations of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX), as well as total antioxidant capacity (TAC) rose in the testes, while they declined in the semen of the restraint group. Restraint stress decreases the levels of reactive oxygen species (ROS) and malondialdehyde (MDA) in the testes while increasing them in the semen. Collectively, restraint stress negatively impacts male reproductive functions and modulates gasotransmitters producing-enzymes expression in the hypothalamus and testes.

Effect of Modified Constrain Induced Movement Therapy on Fatigue and Motor Performance in Sub Acute Stroke

ObjectivesThere is a little available information about the fatigue status among people receiving modified constraint induced movement therapy. The study examined such changes. The effect of using restraint on motor performance was also evaluated in sub acute phase after stroke. Materials and methodsThe study was designed as two group pretest and post-test study. The experimental design included a pretest and post test measures of dependent variables fatigue and motor function. All patients were recruited from the Safdurjung Hospital. 20 patients in subacute phase of stroke (3-9 months), (N = 10) mean age±SD 51.90±15.27, MAS score mean ± SD 1.90±.316 and post stroke duration mean ±SD 6.45±2.26 were included in the experimental group and (N = 10) mean age ± SD 54.10±17.42, MAS score mean ±SD 1.52±0.52 and post stroke duration mean±SD score 4.55± 2.52 were included in the control group. The subjects in the experimental group were restrained for six hours every week day with task training for 2 h per day five times a week for three weeks and the subjects in the controlled group received task training for 2 h per day five times a week for three weeks with no restrain. Motor Performance and fatigue were measured on day to day basis by Wolf Motor Function Test Scores (WMFT) and 11th item of Barrow Neurological Institute (BNI) scale in both experimental and controlled group. ResultsThe restraint group exhibited significant better motor performance than the controlled group. Mean difference between Pre- WMFT scores and Post WMFT scores were (0.533±.362) as compared to controlled group (0.192±.23). No significant statistical difference was observed in the difference of mean Pre- BNI and Post – BNI scores in either of the two groups (p = .57). Difference between the experimental and controlled group in motor performance and fatigue scores were nonsignificant. ConclusionsRestraint improves motor performance in subacute therapy group and the intensive practice associated with m-CIMT may be administered without the exacerbation of fatigue.

Dietary Restraint in Adolescence Predicts Diet Quality in Young Adulthood

Abstract Objectives Establishing a diet that follows the Dietary Guidelines for Americans has been associated with lower risk of mortality from cardiovascular disease and cancer. Some research has shown that individuals’ desire for weight control is an important factor in determining food choices. The aims of this study were to 1) examine dietary restraint in adolescence as a predictor of overall diet quality in young adulthood and 2) compare selected dietary components by levels of restraint. Methods Data were collected from participants enrolled in a longitudinal study in NC, the Right Track Health Study (n = 112). Dietary restraint was assessed using the 21-item subscale of the Three Factor Eating Questionnaire. Three 24-hour dietary recalls were collected to estimate dietary intake and Healthy Eating Index 2015 (HEI-2015) scores were calculated to determine diet quality. Multiple linear regression tested the association between restraint and diet quality, adjusting for sex, race, Body Mass Index-for-age percentiles and disinhibition in adolescence. Using the mean value for restraint (score of 6.64), “high restraint” and “low restraint” groups were created, and the specific HEI-2015 component scores were compared using t-tests. Level of significance was set at P &amp;lt; 0.05. Results Overall, participants consumed a poor-quality diet (HEI-2015 score = 50.24 ± 13.56). Higher restraint in adolescence (mean age 16.59 ± 0.39 years) was associated with higher total HEI-2015 score in young adulthood (mean age 18.74 ± 0.51) (β = 15.39 (95% CI: 3.44, 27.34) P = 0.01). The high restraint group had significantly higher HEI-component scores for total vegetables, greens and beans, total fruit, whole fruit, seafood and plant proteins, and added sugars. There were no differences between the two groups in the remaining HEI-2015 component scores (e.g., whole grains, fatty acids, sodium). Conclusions Higher dietary restraint in adolescence predicts better overall diet quality in young adulthood. Nevertheless, young adults in our sample failed to meet the federal dietary guidelines. Interventions aimed at improving diet quality should consider an individual's level of dietary restraint to better tailor nutrition advice. Funding Sources This research was supported by funding from NIH-NICHD and NIH-NIDDK.

Simulation stress model of the undersea environment activates the central nervous, neuroendocrine and immune systems and anxiety in rats

The present study was designed to assess the stress responses to a simulation model of the undersea environment that is similar to some undersea working conditions such as submarine rescue, underwater salvage and underwater construction. Restraint, hyperbaric air and immersion were chosen to produce the simulation stress model in rats for four hours. Rats were randomized into five groups: control group, restraint (R) group, hyperbaric air (H) group, restraint plus hyperbaric air (RH) group, and restraint plus hyperbaric air plus immersion (RHI) group. The results showed that the responses to the simulation stress model of the undersea environment induced by R, H, RH and RHI involved the upregulated norepinephrine (NE), dopamine (DA) and 5-hydroxytryptamine (5-HT) of the central nervous system (CNS), upregulated adrenocorticotropic hormone (ACTH), corticosterone (CORT) and blood glucose of the neuroendocrine system, upregulated interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) of the immune system, and increased anxiety in rats. Compared with hyperbaric air, restraint tended to activate stronger stress responses. Conclusively, this work established a simulation stress model of the undersea environment induced by restraint, hyperbaric air and immersion. It further provided experimental data of such a model that showed significant activation of the CNS, neuroendocrine and immune systems and anxiety in rats. In this experiment we provided an experimental basis for undersea work such as working aboard a submarine.

The effect of adding trunk restraint to task-oriented training in improving function in stroke patients: A systematic review and meta-analysis.

The effectiveness of trunk restraint on post-stroke arm motor function and daily function remain controversial. To evaluate the effect of adding trunk restraint to task-oriented rehabilitation of arm motor function and functional ability after stroke. Nine databases were systematically searched for randomized controlled trials studying the effects of trunk restraint in post-stroke task-oriented training. Researchers assessed methodological qualities using the Physiotherapy Evidence Database scale, and extracted data related to study participants, intervention, and outcomes. The overall effectiveness was calculated using a meta-analytic method. In total, ten articles met the inclusion criteria and nine trails (n = 255 subjects) were included in quantitative analyses. Meta-analysis revealed that trunk restraint exhibited a significant improvement on the Motor Activity Log-amount of use, 0.39 (95% CI: 0.25- 0.54), the Motor Activity Log-quality of movement, 0.45 (95% CI: 0.27- 0.63), the Fugl-Meyer Assessment (upper extremity), 1.09 (95% CI: 0.67- 1.51), Action Research Arm test, 4.51 (95% CI: 2.49- 6.54) and performance of Activities of daily living, 1.70 (95% CI: 0.19- 3.21) in trunk restraint group in patients at subacute stage, compared to the non-trunk restraint group, but no significant difference was found in patients with chronic stroke. Adding trunk restraint to task-oriented training may improve function in patients with subacute stroke.

Ethological and Physiological Alterations in Female Albino Rat in Compact to Restraining Stress

An experiment was designed to investigate the effect of restraint stress on the behavior and physiological alterations of the female albino rat. For this purpose, 16 adult females rat average weight 150-160 gm were divided into two groups, restraint group 8 females’ restraint in a wire mesh one hours for 10 days and the served as control group. Behavior observation was assessed by observing rat day and light periods using infra-red camera by scanning observation. A blood samples were collected at the 1st, 3rd and 10 days of experiment for physiological and biochemical analysis. Results revealed that restraint stress was strong stress as it decreases significantly feeding, drinking, exploration and walking activities, while increase significantly resting both (lying and standing idle) and body care behavior(licking). However, increase significantly triglyceride, albumin, total lipids, cortisol and corticosteroids on the other hand decrease glucose and cholesterol level.

Psychiatric inpatients subjected to physical restraint have a higher risk of deep vein thrombosis and aspiration pneumonia

Physical restraint in clinical settings can lead to potentially lethal complications. Although this is a life-and-death issue, no comprehensive large-scale study relating medical complications to physical restraint has yet been performed. The 1308 psychiatric inpatients in our retrospective cohort study were categorized into two groups: a physical restraint group (those who had been subjected to physical restraint while hospitalized; n = 110) and a non-physical restraint group (those never subjected to physical restraint; n = 1198). We assessed differences between the two groups with respect to the occurrence of medical complications subsequent to restraint. To control for potentially confounding factors, linear discriminant regression analysis was used to identify whether physical restraint itself affected the occurrence of medical complications. The physical restraint group had a higher risk for deep vein thrombosis (P < .01, OR = 6.0, 95%CI: 2.4–13.9) and aspiration pneumonia (P < .01, OR = 4.1, 95%CI: 2.1–7.6) when compared with the non-physical restraint group. Even after controlling for potentially confounding factors, physical restraint substantially raised the risk of deep vein thrombosis and aspiration pneumonia (P < .01, P = .01, respectively). Although this study population was derived from a single psychiatric unit, physical restraint may lead to serious medical conditions. To avoid this unwanted consequence, the use of physical restraint should be minimized and physical therapy is highly recommended.

Esomeprazole alleviates the damage to stress ulcer in rats through not only its antisecretory effect but its antioxidant effect by inactivating the p38 MAPK and NF-κB signaling pathways.

BackgroundStress ulcer is a severe complication in critically ill patients and causes a high mortality. The proton pump inhibitor esomeprazole is widely applied in the treatment of stress ulcers because of its powerful acid suppression ability. However, the mechanism of stress ulcer and the precise gastroprotective effect of esomeprazole in stress ulcer remain unclear.PurposeIn the present study, the rats with water-immersed and restraint (WIR)-induced stress ulcer were used to further elucidate the anti-ulcerogenic capacity of esomeprazole in stress ulcer in addition to its anti-acid secreting ability.Methods and resultsThe rats were randomly divided into 5 groups: control group (NS), water-immersed and restraint group (WIR), high-dose application of esomeprazole plus stress ulcer-induced group (HE+WIR), low-dose application of esomeprazole plus stress ulcer-induced group (LE+WIR), and high-dose application of esomeprazole without stress ulcer-induced group (HE). Our study showed that the pretreatment of esomeprazole alleviated gastric tissue damage in both macroscopic and histopathological manifestations. Pretreatment of esomeprazole elevated the decline in PEG2 level affected by WIR; and it inhibited the secretion of gastric acid, gastrin and pepsin. Moreover, esomeprazole exerted its antioxidant effects by reducing malondialdehyde levels, enhancing the expressions of antioxidant factors like glutathione and superoxide dismutase (SOD) and reducing the compensatory transcriptional elevation of SOD1 gene. Esomeprazole also reduced the levels of MPO (myeloperoxidase), tumor necrosis factor (TNF)-α and interleukin (IL)-1β according to its anti-inflammatory effects. We further explored the possible mechanism of esomeprazole pretreatment on stress ulcer and demonstrated that esomeprazole attenuated the high phosphorylation levels of nuclear factor kappa B (NF-κB) p65 and p38 MAPK, and decreased the NF-κB p65 nuclear translocation induced by WIR related stress ulcer.ConclusionOur study provides some evidence that the esomeprazole pretreatment exerts gastroprotective effects in WIR-induced stress ulcer through not only its antisecretory effect but also its antioxidant effect by inactivating the p38 MAPK and NF-κB signaling pathways.