Single Session Research Articles

Energetic and Neuromuscular Demands of Unresisted, Parachute- and Sled-Resisted Sprints in Youth Soccer Players: Differences Between Two Novel Determination Methods

The aim of this study was to analyze the differences in terms of (1) muscle activation patterns; (2) metabolic power (MP) and energy cost (EC) estimated via two determination methods (i.e., the Global Positioning System [GPS] and electromyography-based [EMG]); and (3) the apparent efficiency (AE) of 30-m linear sprints in seventeen elite U17 male soccer players performed under different conditions (i.e., unloaded sprint [US], parachute sprint [PS], and four incremental sled loads [SS15, SS30, SS45, SS60, corresponding to 15, 30, 45 and 60 kg of additional mass]). In a single testing session, each participant executed six trials (one attempt per sprint type). The results indicated that increasing the sled loads led to a linear increase in the relative contribution of the quadriceps (R2 = 0.98) and gluteus (R2 = 0.94) and a linear decrease in hamstring recruitment (R2 = 0.99). The MP during the US was significantly different from SS15, SS30, SS45, and SS60, as determined by the GPS and EMG approaches (p-values ranging from 0.01 to 0.001). Regarding EC, significant differences were found among the US and all sled conditions (i.e., SS15, SS30, SS45, and SS60) using the GPS and EMG methods (all p ≤ 0.001). Moreover, MP and EC determined via GPS were significantly lower in all sled conditions when compared to EMG (all p ≤ 0.001). The AE was significantly higher for the US when compared to the loaded sprinting conditions (all p ≤ 0.001). In conclusion, muscle activation patterns, MP and EC, and AE changed as a function of load in sled-resisted sprinting. Furthermore, GPS-derived MP and EC seemed to underestimate the actual neuromuscular and metabolic demands imposed on youth soccer players compared to EMG.

Efficacy of Screening and Brief Intervention for Alcohol Misuse in Opioid Agonist Maintenance Treatment: A Randomized Clinical Trial

ABSTRACT Alcohol misuse is common in persons on opioid agonist maintenance treatment (OAMT). We tested the efficacy of screening and brief intervention (SBI) for harmful/hazardous alcohol use in buprenorphine/naloxone (BNX)-assisted OAMT. It was a double-blind, parallel-group, randomized trial, where 150 participants with alcohol misuse (Alcohol Use Disorder Identification Test – AUDIT 8–19) on BNX were allocated equally to receive either a single session SBI or screening and brief advice (control). Participants were followed up at three months. The primary outcome was the change in AUDIT; other outcomes were risk transition, change in the frequency of heavy drinking, days of abstinence from alcohol, Gamma-glutamyl transferase (GGT) levels, non-prescription opioid use, and adherence to BNX. Follow-up data was gathered from 138 participants. SBI participants had a higher reduction in AUDIT scores at the follow-up (F = 129. 173, df = 1, p < .001, ηp 2 =.469). A higher proportion of participants transitioned to a low-risk category in the SBI group. The SBI group showed a higher reduction in heavy drinking and days of alcohol abstinence. Although the proportion of persons with normal serum GGT increased in both groups, the difference was not significant at the follow-up. The SBI group performed better in non-prescription opioid use and BNX adherence.

HPB SO23 - Implementation and Outcomes of Index Admission Management of Acute Gallstone Pancreatitis on a Specialist Biliary Unit

Abstract Background While the management of acute gallstone pancreatitis (AP) has recognised guidelines, there are wide variations in compliance with these in various institutions for different reasons. The primary objective of this review was to evaluate the effects of implementing proactive management strategies on a specialist biliary firm receiving most biliary emergency admissions by protocol on the incidence of index admission laparoscopic cholecystectomy (LC) for AP. The secondary aims were to study the admission to LC interval, if such policy was safe and how it can help the optimisation of outcomes of AP. Method Analysis of prospectively collected data from AP patients treated by a specialist biliary unit dedicated to index admission LC and single session laparoscopic management of bile duct stones. Almost all patients were referred to the unit as soon as the diagnosis of AP was made. Only patients with severe pancreatitis on imaging or requiring intensive care were not included in the index admission pathway and subsequently underwent delayed surgery. Routine MRCP and ERCP were not part of the management protocol. Following clinical optimisation patients had LC with routine cholangiography (IOC). and if necessary bile duct exploration. Results 495/6140 patients were identified (8%), 70% females. Median age was 55 years. 92.3% had suspected ductal stones, half with jaundice. 11.9% had previous episodes. Only 6.2% had MRCPs and 2% ERCPs. Admission to LC interval was 5 days. 33.2% required bile duct explorations. LC difficulty grade was III to V in 37.2%. The median operative time was 62 minutes with no conversions, ductal injuries or mortality. Complications occurred in 9.2%, including 14 persistent pancreatitis/collections resulting in 6 of 25 readmissions. Two re-operations resulted from t-tube complications. Median hospital stay was 7 days, 72% having had only one admission. Conclusion Index admission LC on all AP patients fit for surgery is perfectly safe in the specialist setting. It optimises preoperative radiological investigations and endoscopic interventions and ,subsequently, a third of the patients require bile duct exploration. Implementing definitive surgical interventions during the index admission for AP offers a substantial reduction in hospital stay, re-admission rates and an overall decrease in hospital attendances. This not only yields significant cost benefits for the health service but also enhances the quality of life for patients.

HPB SO59 - How do Previous Biliary Interventions Affect the Operative and Postoperative Outcomes Of Patients Undergoing Laparoscopic Cholecystectomy (LC) and Bile Duct Exploration (LCBDE)?

Abstract Background Laparoscopic biliary surgery is perceived to be difficult in patients who had undergone previous biliary interventions; ERCP, cholecystostomy or cholecystectomy. Our objective was to evaluate the referral pattern, the preoperative characteristics and operative and postoperative outcomes in such patients. Method Analysis of prospectively collected data from patients treated by a specialist biliary unit dedicated to index admission LC and single session laparoscopic management of bile duct stones. In spite of a policy of no preoperative endoscopic clearance of bile duct stones the unit inevitably received some patients who had had previous ERCP at other hospitals prior to referral or were initially unfit when admitted to the base hospital and required ERCP. In a series of 6140 LC and LCBDE 158 patients (2.57%) had already undergone ERCP and 31 (0.5%) had undergone cholecystectomies (18), cholecystostomies (9) or attempted cholecystectomy. Results Of 158 pre-referral ERCPs, 130 (82.3%) were referred from other hospitals, 36 (22.8%) having had more than one ERCP. 83.5% had suspected CBD stones. LC difficulty grade was IV to V in 48.7%. 112 patients (70.9%) required LCBDE. There were 10.1% biliary related complications, 3 re-operations, one conversion and one mortality. of 31 patients with previous biliary interventions, 58% came from other units or hospitals. A third had already undergone ERCP. 61.3% had LC difficulty grades IV or V. The 18 un-cholecystectomised patients needed LCBDE with no conversions or bile duct injuries. There were only 2 (6.5%) biliary related complications. Conclusion While previous biliary interventions understandably increased the difficulty of LC they did not adversely affect operative and postoperative outcomes. Such surgery should be undertaken in the specialist setting as 70.9% of those with previous endoscopic and 58.1% of those with previous surgical or radiologically guided biliary interventions require LCBDE. Implementing definitive surgical interventions during the index admission can achieve a substantial reduction in re-admission rates, and overall decrease in hospital episodes without significant morbidity, re-interventions or mortality. This enhances the quality of life for patients who would otherwise be subjected to multiple repeat ERCPs and yields significant cost benefits.

The Effect of a Single Temporomandibular Joint Soft Tissue Therapy on Cervical Spine Mobility, Temporomandibular Joint Mobility, Foot Load Distribution, and Body Balance in Women with Myofascial Pain in the Temporomandibular Joint Area—A Randomized Controlled Trial

In contemporary times, a significant portion of the population experiences symptoms of temporomandibular joint (TMJ) dysfunction. The objective of this study was to evaluate the effects of a single-session TMJ soft tissue therapy on the TMJ and cervical spine mobility as well as on body balance and the foot load distribution. This study was a parallel-group, randomized, controlled trial with a 1:1 allocation ratio. Fifty women aged 20–30 years diagnosed with myofascial pain in the TMJ area were included in the study and divided into two groups. The experimental group received TMJ soft tissue therapy. The following research tools were used: a Hogetex electronic caliper, a CROM Deluxe, and a FreeMed Base pedobarographic platform. In the experimental group, an increase in mobility within all assessed jaw and cervical spine movements was observed. This change was statistically significant (p &lt; 0.05) for lateral movement to the left, abduction, and protrusion of the jaw (an increase of 10.32%, 7.07%, and 20.92%, respectively) and for extension, lateral bending to the right and left, and rotation to the right and left, of the cervical spine (an increase of 7.05%, 7.89%, 10.44%, 4.65%, and 6.55%, respectively). In the control group, no significant differences were observed. No significant changes were observed in the load distribution and body balance assessment. A single session of TMJ soft tissue therapy increases jaw and cervical spine mobility but does not impact body balance or foot load distribution in static conditions in women diagnosed with myofascial pain in the TMJ area.

Utility and benefits of Camp for Children with Epilepsy: a retrospective

Objective: The aim of this study was to evaluate the benefits of educational and recreational camping programs for children with epilepsy.Method: A retrospective review of data collected from all children attending annual epilepsy camps organized by the Croatian Epilepsy Association and the Zagreb City Office for Health during 8 years was performed. Children included were between 6 and 18 years of age. The staff of the camp includes child neurologists, a psychologist, neurology nurses and trained volunteers. Educationalactivities are designed to improve children’s knowledge of epilepsy, importance of taking medication, academic choices, suggested employment, and regulations regarding driving laws. These issues were discussed in groups or in single sessions, depending on thecase. Other activities included supervised swimming, team sports, fun activities and games, arts and crafts and entertainment such as disco or movie night.Each of the participants filled out three questionnaires 1. General data questionnaire and pre-camp knowledge test; 2. Camp satisfaction questionnaire and post-camp knowledge test; 3. Questionnaire on adaptation to epilepsy in young people.Results: The analyses of surveys and tests showed that only 75% of children in camp knew that they had epilepsy. In 10% of children, friends and distant family members did not know about epilepsy. Comparing the knowledge test before and after the camp, theaverage percentage of correctly solved tasks on the first test is 65%, and on the second 87%. The answers in the questionnaire on adaptation to life with epilepsy are indicators of strong stigma in children with epilepsy.Conclusions: The main accomplishment of the camp was for children to gain confidence that they can reach their full potential in life and to feel equal to their peers in every aspect of life.

Delineating anticipatory arousal from reward consumption: evaluating fixed-intervals in cocaine seeking-taking response chains.

Anticipation is a critical antecedent to drug use, in which the prospect of imminent drug availability can potently motivate instrumental actions directed to procure it. Models that capture the behavioral dynamics that precede drug access may allow for the dissociation of key neural mechanisms underlying appetitive or consummatory processes in drug self-administration. We aimed to isolate measurements attributed to the procurement and consumption of a reward by defining distinct actions for each using a chain-schedule of reinforcement. Male Long-Evans rats were trained to self-administer cocaine or saccharin under a chained schedule of reinforcement (FI-FR) in order to dissociate appetitive ('seeking') from consummatory ('taking') behaviors. Completion of a fixed-interval (5min) was followed by 5min of continuously reinforced responding (FR1) on another lever. The FI-FR chain procedure appears to provide sensitive and dissociable dimensions of cocaine self-administration within a single experimental session. Importantly, we demonstrate that responding during the FI (i.e., seeking) link tracks with the incentive value of anticipated reward access - whereby response rates corresponded to expected reward magnitude, degree of reward-specific satiety, and general motivational state. The FI component is a sensitive and reliable index of motivational changes induced by either the extrinsic incentive value of reinforcement (i.e., anticipated dose) or intrinsic motive states (i.e., satiety or deprivation). This procedure provides a valuable tool for interrogating the neural dynamics of drug-seeking and -taking behavior, in isolation.

Hypoxic postconditioning modulates neuroprotective glial reactivity in a 3D cortical ischemic-hypoxic injury model

Stroke remains one of the major health challenges due to its high rates of mortality and long-term disability, necessitating the development of effective therapeutic treatment. This study aims to explore the neuroprotective effects of hypoxic postconditioning (HPC) using a cell-based 3D cortical ischemic-hypoxic injury model. Our model employs murine cells to investigate HPC-induced modulation of glial cell reactivity and intercommunication post-oxygen-glucose deprivation-reoxygenation (OGD-R) injury. We found that a single HPC session (1HPC) provided the most significant neuroprotection post-OGD-R compared to multiple intermittent hypoxic treatments, evidenced by improved spheroidal structure, enhanced cell survival and reduced apoptosis, optimal modulation of neuronal phenotypes, dampened ischemic responses, and augmented neurite outgrowth of spheroids. Furthermore, 1HPC suppressed both pro-inflammatory A1 and anti-inflammatory A2 astrocyte phenotypes despite the induction of astrocyte activation while reducing microglial activation with inhibited M1 and M2 reactive states. This was accompanied by a decrease in gene expression of the pro-inflammatory cytokines essential to microglia-astrocyte signaling, collectively suggesting a shift of glial cells away from their traditional reactive states for neuroprotection. This study highlights the potential of 1HPC as a novel therapeutic intervention for ischemic injury via the modulation of neuroprotective glial reactivity. Moreover, the 3D cortical ischemic-hypoxic injury model employed here holds enormous potential serving as a disease model to further elucidate the underlying mechanism of HPC, which can also extend to the applications in brain regeneration, drug development, and the modeling of neural diseases.

Tryptophan-immunoadsorption plasmapheresis regulates polymorphonuclear-myeloid-derived suppressor cells and pro-inflammatory cytokines.

Immunoadsorption plasmapheresis (IA) has been reported to have immunoregulatory effects, in addition to the removal of autoantibodies. This study aimed to investigate the effects of IA on the proportion of myeloid-derived suppressor cells (MDSCs) that potentially suppress autoimmune responses and regulate immunity. The study included 21 patients with autoimmune neurological diseases and 8 healthy participants. We measured polymorphonuclear (PMN)-MDSCs (CD14-CD11b+CD33+) and inflammation-related mediators before and after a single session of tryptophan-IA. We also investigated whether an increase in PMN-MDSCs after initial IA was a predictor of clinical efficacy in nine patients with myasthenia gravis based on the Quantitative Myasthenia Gravis score. For a total of 36 times of IA procedures, the number of PMN-MDSCs significantly increased after IA. Interleukin-10, monocyte chemoattractant protein-1 and macrophage inflammatory protein-1β levels showed significant increases after IA. Despite similar severity at admission, the Quantitative Myasthenia Gravis scores at discharge were significantly lower in the group in which IA increased PMN-MDSCs to a level of 20% of peripheral blood mononuclear cells or more. Tryptophan-IA regulates PMN-MDSCs and pro-inflammatory cytokines, possibly leading to suppression of autoimmune responses and tissue damage in neuroimmunological disorders.

Effect of Alternate Nostril Breathing Exercise on Cardiorespiratory Functions in Hypertensive Adults: A Systematic Review

Background: Cardiovascular diseases (CVDs), primarily driven by hypertension (HTN), are a leading global health concern. While medication is commonly used to manage HTN, non-pharmacological approaches like ANB are gaining interest. ANB is a yogic breathing technique believed to modulate the autonomic nervous system, influencing heart rate and blood pressure. Methods: A systematic review adhering to PRISMA guidelines assessed studies published between 2015 and 2022 that investigated the effects of ANB on blood pressure in human subjects. Results: Six studies were included, with findings suggesting a potential benefit of ANB for reducing blood pressure. All studies, except one, reported significant reductions in systolic and/or diastolic blood pressure after ANB practice. Intervention duration varied across studies, ranging from single sessions to six weeks of daily practice. Some studies also observed a decrease in heart rate and improved vascular function following ANB. However, limitations exist: unclear control groups in some studies and varying intervention protocols. Discussion: Despite promising preliminary evidence, further well-designed, randomized controlled trials with larger sample sizes and standardized protocols are needed. Future research should compare ANB with sham interventions or standard medical management, and explore the underlying mechanisms of how ANB might influence blood pressure. Conclusion: While the current evidence requires further confirmation, ANB appears to be a safe and potentially beneficial non-pharmacological intervention for managing blood pressure, potentially as an adjunct to medication. Healthcare professionals may consider suggesting ANB to hypertensive patients, alongside lifestyle modifications and medication, but emphasize the importance of consulting a healthcare provider before starting any new practice.

Yoga-based lifestyle intervention for antenatal depression (YOGA-D): study protocol for a pilot randomized controlled trial

Background Depression during pregnancy is associated with pre-term labor, low birthweight, post-partum depression and adverse child outcomes. There are concerns about the safety of anti-depressant medications during pregnancy. Many pregnant women with antenatal depression are neither aware about their depression nor do they have access to non-pharmacological interventions for depression. Evidence suggests that pre-natal yoga can improve antenatal depression. Yoga is native to the Indian culture and women can practice yoga as a ‘self-care’ intervention with minimal training. There is no study till date on the efficacy of yoga on antenatal depression in pregnant women in a low resource (rural) setting in India. This pilot randomized controlled trial aims to study the feasibility, acceptability, and preliminary efficacy of a YOGA -based lifestyle intervention for Antenatal D epression (YOGA-D) in Maharashtra, India. Methods We will undertake a single-blind individual randomized parallel group-controlled pilot trial with 1:1 allocation ratio. Adult women with 12–26 weeks of pregnancy, without any obstetric or medical complications will be randomly allocated to either the active intervention group (Yoga-Sanskar (YS)) or the Enhanced Usual Care (EUC) group. Trained yoga instructors will teach a pre-defined yoga sequence to the participants in the YS arm. In the EUC arm, participants will receive a single session of health education. We will assess trial feasibility using the recruitment, retention, and study completion rates. The primary outcome of depression will be measured using the translated Marathi version of the Patient Health Questionnaire-9. Assessments will be at the baseline, three-months post-randomization, and post-delivery. Discussion This study will help us to understand the barriers in implementation of a yoga-based intervention for antenatal depression in a low-resource/rural setting in Maharashtra, India. Based on the learnings of this pilot trial, we plan to undertake an explanatory randomized controlled trial in the next few months. Registration CTRI (CTRI/2024/05/067176; 10/05/2024).

Effects of high intensity interval training on serum brain-derived neurotrophic factor in individuals with PTSD

BackgroundBrain-derived neurotrophic factor (BDNF) is a protein important for synaptic plasticity and formation of memory. It is suggested to play an important role in the development of psychiatric disorders like post-traumatic stress disorder (PTSD). Individuals with PTSD usually show decreased BDNF levels in serum. Physical exercise has shown to be effective in increasing serum BDNF levels. ObjectiveAs the most beneficial form of exercise to raise serum BDNF levels in individuals with PTSD is yet to be determined, we compared two training protocols and their effects on BDNF release. We expected that a training with higher intensity increases BDNF serum levels more than a low intensity training (LIT). Method40 participants (80% female) diagnosed with PTSD were randomized to either high-intensity interval training (HIIT) or a low intensity training group (LIT). They underwent a 12-day training period. We measured serum BDNF levels pre- and post-exercise on first and last intervention day. BDNF was controlled for platelet counts. ResultsIn the HIIT group there was a significant increase in serum BDNF post-exercise on both days measured, respectively when controlled for platelets. The increase was transient. Both groups did not show an increase in serum BDNF over the course of the 12-day training period. ConclusionA single session of HIIT raised serum BDNF levels in individuals with PTSD transiently. Neither HIIT nor LIT raised serum BDNF levels over the course of 12 days.

A single-session feedback training modifies interpretation bias in individuals with high social anxiety: A randomized controlled trial.

The ability to interpret facial expressions accurately is important to adaptive social functioning. Social anxiety disorder is associated with a biased interpretation of facial emotions. This study aimed to demonstrate the effects of feedback training on modifying interpretation bias in individuals with high social anxiety. A total of 451 university students were screened, and 69 participants with high social anxiety were randomly assigned to either a training (n = 37) or a control (n = 32) group. Participants completed pre-questionnaires on social anxiety and depression symptoms, then performed a single session of experiment, followed by post-questionnaires on social anxiety symptoms. In the experiment, participants viewed an ambiguous facial expression and rated the intensity on a continuous scale. The training group received feedback that presented their ratings alongside the actual intensity, allowing them to accurately assess their emotional perception bias through trial-by-trial feedback. The control group received no feedback. The training group showed a significant reduction in interpretation bias for happy and angry faces after the experiment, while the control group did not. However, although the training group's social anxiety symptoms decreased post-experiment, the difference was not statistically significant compared to the control group. These findings provide preliminary evidence that the feedback training targeting dimensional ratings of emotions may be a promising option for correcting interpretation bias in individuals with high social anxiety. Future research could implement multiple sessions of training to potentially reduce both interpretation bias and social anxiety symptoms and verify the long-term effects.

A Qualitative Service Evaluation of the Introduction of Single Session Therapy for Families in a Child and Adolescent Mental Health Service in England, United Kingdom.

This service evaluation details the process of introducing Single Session Therapy (SST) with families to a Child and Adolescent Mental Health Service in the United Kingdom. SST is a model of short-term psychotherapy intervention which can be applied to family contexts to provide timely mental health support. This service evaluation had two objectives: (1) Review the existing evidence base and literature for SST. (2) Evaluate the implementation of a new SST treatment pathway in CAMHS, including patient experiences and satisfaction with the service. SQUIRE Guidelines are used to report on this new knowledge of healthcare. This evaluation used qualitative methods to evaluate the impact of the new service. The team also used existing frameworks within the Trust, namely discharge data, which is collected routinely as part of service evaluation. This evaluation suggests positive support for this model, and that many families appreciate and value the opportunity to build on strengths and work toward their goals as families. This project outcome appears to support some of Talmon's (1990) findings that the most commonly attended number of sessions is one, and that of those who attended only one session, many perceived the session as useful. Waiting times for our service are extremely long. The pace and structure around goals and solutions could feel both galvanising, as some reported, but others felt it was an insufficient response to the severity of their difficulties. More high-quality research is needed before judgments can be made around the cost-effectiveness or efficacy of SST over existing approaches in the United Kingdom. While implementing SST should not be used to justify reduction in existing interventions, it offers a positive additional service for young people experiencing mental health difficulties and their families.

Agility Ladder Training Combined With Plyometric or Multidirectional Speed Drills: Short-Term Adaptations on Jump, Speed, and Change of Direction Performance in Young Female Volleyball Players.

The aim of this study was to investigate the effect of agility ladder training combined with plyometric or multidirection speed drills, on performance in young female volleyball players. Seventy-six young female volleyball players were randomly distributed into 3 maturity-matched groups: (1) the agility ladder + plyometric drills group, (2) the agility ladder + multidirection speed drills group, and (3) the control group. Both experimental groups followed a 6-week training program, twice weekly, in addition to the regular volleyball training sessions, while the control group participated only in the regular volleyball training sessions. Assessments pretraining and posttraining included countermovement jump, 20-m sprint, and agility T test.Results: Both experimental groups improved T-test performance (P < .005) but only agility ladder + multidirection speed drills group outperformed the control group (P < .05). Agility ladder training programs combined with either plyometric or speed drills can improve change of direction performance in young female volleyball players but only the combination of agility ladder with multidirection speed drills is more effective than volleyball training per se. The small effectiveness of these protocols may be attributed to the short training period, or to the fact that training elements were combined in a single session. This hypothesis remains to be further investigated.

Healthy nutrition and weight management for a positive pregnancy experience in the antenatal period: Comparison of responses from artificial intelligence models on nutrition during pregnancy

BackgroundAs artificial intelligence AI-supported applications become integral to web-based information-seeking, assessing their impact on healthy nutrition and weight management during the antenatal period is crucial. ObjectiveThis study was conducted to evaluate both the quality and semantic similarity of responses created by AI models to the most frequently asked questions about healthy nutrition and weight management during the antenatal period, based on existing clinical knowledge. MethodsIn this study, a cross-sectional assessment design was used to explore data from 3 AI models (GPT-4, MedicalGPT, Med-PaLM). We directed the most frequently asked questions about nutrition during pregnancy, obtained from the American College of Obstetricians and Gynecologists (ACOG) to each model in a new and single session on October 21, 2023, without any prior conversation. Immediately after, instructions were given to the AI models to generate responses to these questions. The responses created by AI models were evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) scale. Additionally, to assess the semantic similarity between answers to 31 pregnancy nutrition-related frequently asked questions sourced from the ACOG and responses from AI models we evaluated cosine similarity using both WORD2VEC and BioLORD-2023. ResultsMed-PaLM outperformed GPT-4 and MedicalGPT in response quality (mean = 3.93), demonstrating superior clinical accuracy over both GPT-4 (p = 0.016) and MedicalGPT (p = 0.001). GPT-4 had higher quality than MedicalGPT (p = 0.027).The semantic similarity between ACOG and Med-PaLM is higher with WORD2VEC (0.92) compared to BioLORD-2023 (0.81), showing a difference of +0.11. The similarity scores for ACOG–MedicalGPT and ACOG–GPT-4 are similar across both models, with minimal differences of −0.01. Overall, WORD2VEC has a slightly higher average similarity (0.82) than BioLORD-2023 (0.79), with a difference of +0.03. ConclusionsDespite the superior performance of Med-PaLM, there is a need for further evidence-based research and improvement in the integration of AI in healthcare due to varying AI model performances.

Acute exercise boosts NAD+ metabolism of human peripheral blood mononuclear cells

Nicotinamide adenine dinucleotide (NAD+) coenzymes are the central electron carriers in biological energy metabolism. Low NAD+ levels are proposed as a hallmark of ageing and several diseases, which has given rise to therapeutic strategies that aim to tackle these conditions by boosting NAD+ levels. As a lifestyle factor with preventive and therapeutic effects, exercise increases NAD+ levels across various tissues, but so far human trials are mostly focused on skeletal muscle. Given that immune cells are mobilized and redistributed in response to acute exercise, we conducted two complementary trials to test the hypothesis that a single exercise session alters NAD+ metabolism of peripheral blood mononuclear cells (PBMCs). In a randomized crossover trial (DRKS00017686) with 24 young adults (12 female) we show that acute exercise increases gene expression and protein abundance of several key NAD+ metabolism enzymes with high conformity between high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT). In a longitudinal exercise trial (DRKS00029105) with 12 young adults (6 female) we confirm these results and reveal that – similar to skeletal muscle – NAD+ salvage is pivotal for PBMCs in response to exercise. Nicotinamide phosphoribosyltransferase (NAMPT), the rate-limiting enzyme of NAD+ salvage pathway, displayed a pronounced increase in gene expression during exercise, which was accompanied by elevated intracellular NAD+ levels and reduced serum levels of the NAD+ precursor nicotinamide. These results demonstrate that acute exercise triggers NAD+ biosynthesis of human PBMCs with potential implications for immunometabolism, immune effector function, and immunological exercise adaptions.

A Novel Method to Predict Carbohydrate and Energy Expenditure During Endurance Exercise Using Measures of Training Load.

Sports nutrition guidelines recommend carbohydrate (CHO) intake be individualized to the athlete and modulated according to changes in training load. However, there are limited methods to assess CHO utilization during training sessions. We aimed to (1) quantify bivariate relationships between both CHO and overall energy expenditure (EE) during exercise and commonly used, non-invasive measures of training load across sessions of varying duration and intensity and (2) build and evaluate prediction models to estimate CHO utilization and EE with the same training load measures and easily quantified individual factors. This study was undertaken in two parts: a primary study, where participants performed four different laboratory-based cycle training sessions, and a validation study where different participants performed a single laboratory-based training session using one of three exercise modalities (cycling, running, or kayaking). The primary study included 15 cyclists (five female; maximal oxygen consumption [ O2max], 51.9 ± 7.2mL/kg/min), the validation study included 21 cyclists (seven female; O2max 53.5 ± 11.0mL/kg/min), 20 runners (six female; O2max 57.5 ± 7.2mL/kg/min), and 18 kayakers (five female; O2max 45.6 ± 4.8mL/kg/min). Training sessions were quantified using six training load metrics: two using heart rate, three using power, and one using perceived exertion. Carbohydrate use and EE were determined separately for aerobic (gas exchange) and anaerobic (net lactate accumulation, body mass, and O2 lactate equivalent method) energy systems and summed. Repeated-measures correlations were used to examine relationships between training load and both CHO utilization and EE. General estimating equations were used to model CHO utilization and EE, using training load alongside measures of fitness and sex. Models were built in the primary study and tested in the validation study. Model performance is reported as the coefficient of determination (R2) and mean absolute error, with measures of calibration used for model evaluation and for sport-specific model re-calibration. Very-large to near-perfect within-subject correlations (r = 0.76-0.96) were evident between all training load metrics and both CHO utilization and EE. In the primary study, all models explained a large amount of variance (R2 = 0.77-0.96) and displayed good accuracy (mean absolute error; CHO = 16-21g [10-14%], EE = 53-82kcal [7-11%]). In the validation study, the mean absolute error ranged from 16-50g [15-45%] for CHO models to 53-182kcal [9-31%] for EE models. The calibrated mean absolute error ranged from 9-20g [8-18%] for CHO models to 36-72kcal [6-12%] for EE models. At the individual level, there are strong linear relationships between all measures of training load and both CHO utilization and EE during cycling. When combined with other measures of fitness, EE and CHO utilization during cycling can be estimated accurately. These models can be applied in running and kayaking when used with a calibration adjustment.

Prebiotic and panthenol-containing dermocosmetic improves tolerance from daylight photodynamic therapy: A randomized controlled trial in patients with actinic keratosis

Introduction & ObjectivesTreatment with daylight photodynamic therapy (dPDT) of actinic keratosis (AK) is associated with local skin reactions (LSR), which may affect patients’ quality of life and treatment acceptability. This study explores the potential of a prebiotic and panthenol-containing Dermocosmetic Cream (DC) to enhance tolerance and mitigate post-dPDT induced LSR in the treatment of AKs. Materials & MethodsThis randomized controlled, intra-individual trial included 20 patients with ≥10 AKs in two symmetrical areas on their face or décolleté, treated with a single session of artificial dPDT. After treatment, the two areas were randomized to DC twice daily for 14 days or No-DC. Primary outcomes included clinical signs of LSR graded from 0=none to 3=severe, calculated as a composite score, and assessed on Days 2, 7, 14, and 30 post-treatment, along with AK clearance rate. Secondary outcomes encompassed objectively measured erythema, and clinical and objective skin photoaging assessment. ResultsTopical application of DC following dPDT significantly improved post-treatment tolerance up to two weeks. By Day 2, DC-treated skin had milder LSR (median 3.0, IQR 2.0-4.8) compared to No-DC skin (median 4.0, IQR 3.0-5.0; p=0.011). This improvement continued on Day 7 (DC median 3.0, IQR 2.0-3.8 vs. No-DC median 4.5, IQR 3.0-5.8; p<0.001) and Day 14 (DC median 1.0, IQR 0.0-1.0 vs. No-DC median 1.0, IQR 1.0-2.0; p=0.004). Objective measurements showed milder erythema in DC-treated areas on Day 2 (p=0.045) and Day 7 (p=0.005). Crusting resolved more effectively in DC-treated areas by Day 7 (40% vs. 20%; p=0.039). No significant difference in complete lesion response rate was observed between DC and No-DC skin (p=0.850). By Day 30, clinical photoaging assessment demonstrated significant improvement in dyspigmentation (p=0.004) and skin texture (p<0.001) in both locations. Moreover, objective measurements revealed reduced dyspigmentation in both DC and No-DC treated skin (p≤0.001). ConclusionApplication of a prebiotic and panthenol-containing multipurpose DC significantly enhanced tolerance from artificial dPDT and accelerated healing time up to 14 days after treatment. The use of DC cream did not affect the overall treatment efficacy of dPDT, indicating its potential to enhance patient comfort following dPDT.

Long-term Observation of Therapeutic Effect of Onabotulinumtoxin A on Short-lasting Unilateral Neuralgiform Headache Attacks with Conjunctival Injection and Tearing

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare primary headache disorder characterized by severe intractable stabbing headache and accompanying tearing and conjunctival injections. In this report, we present a case of a patient with SUNCT who achieved sustained remarkable improvement more than 6 months following successful treatment with a single session of botulinum toxin A, after being refractory or intolerant to several preventives for 4 months.