Variable Recovery Research Articles

Nearshore microfossil assemblages in a Caribbean reef environment show variable rates of recovery following Hurricane Irma

AbstractModern microfossil distributions reflect site‐specific habitats and provide an opportunity to assess sediment transport pathways in the nearshore environment. When applied to overwash deposits in the geological record, they provide insight into sediment provenance and transport, factors important for understanding patterns of frequency and intensity of past storms and tsunamis. Modern distribution studies are rare and often the first established ones occur immediately after an overwash event as part of a post‐event field survey. This is problematic because it is unclear what effect overwash events have on nearshore microfossil assemblages and what time interval is necessary for them to return to pre‐event conditions. This study documents the impacts of Hurricane Irma on nearshore sediments off the coast of Anegada, British Virgin Islands, using distributions of Homotrema rubrum, an encrusting foraminifer with a defined provenance in coral reefs. At four sampling intervals spanning two years, from six months pre‐Hurricane Irma to eighteen months after, surface sediment was collected from three transects on the northern and southern shores of the island. Partitioning Around Medoids cluster analysis revealed that Hurricane Irma introduced an influx of well‐preserved fragments into the reef flat and made the sediments more uniform, limiting the foraminifer’s utility as a known sediment transport indicator. The mixing of sediments along the two northern transects (reef proximal) persisted for seven to eighteen months before returning to near pre‐hurricane conditions. However, the southern transect (absence of reef), where Homotrema rubrum concentrations are significantly less, failed to recover within the time period assessed by this study, indicating a variable recovery period between Atlantic Ocean and Caribbean Sea facing shorelines. Results from this study suggest that a waiting period of at least eighteen months after a major storm is recommended before collecting surface sediment from the nearshore environments of reef‐dominated coastlines.

Clemastine improves electrophysiologic and histomorphometric changes through promoting myelin repair in a murine model of compression neuropathy

Compression neuropathies are common and debilitating conditions that result in variable functional recovery after surgical decompression. Recent drug repurposing studies have verified that clemastine promotes functional recovery through enhancement of myelin repair in demyelinating disease. We investigated the utility of clemastine as a treatment for compression neuropathy using a validated murine model of compression neuropathy encircling the compression tube around the sciatic nerve. Mice received PBS or clemastine solution for 6 weeks of compression phase. Mice taken surgical decompression received PBS or clemastine solution for 2 weeks of decompression phase. Electrodiagnostic, histomorphometric, and Western immunoblotting analyses were performed to verify the effects of clemastine. During the compression phase, mice treated with clemastine had significantly decreased latency and increased amplitude compared to untreated mice that received PBS. Histomorphometric analyses revealed that mice treated with clemastine had significantly higher proportions of myelinated axons, thicker myelin, and a lower G-ratio. The expression levels of myelin proteins, including myelin protein zero and myelin associated glycoprotein, were higher in mice treated with clemastine. However, the electrophysiologic and histomorphometric improvements were observed regardless of clemastine treatment in mice taken surgical decompression. Mice treated with clemastine during compression of the sciatic nerve demonstrated that clemastine treatment attenuated electrophysiologic and histomorphometric changes caused by compression through promoting myelin repair.

Patient‐reported symptoms and experience following Guillain‐Barré syndrome and related conditions: Questionnaire development and validation

BackgroundGuillain‐Barré syndrome (GBS) is a rare inflammatory peripheral nerve disorder with variable recovery. Evidence is lacking on experiences of people with GBS and measurement of these experiences.ObjectiveWe aimed to develop and validate an instrument to measure experiences of people with GBS.DesignWe used a cross‐sectional design and online self‐administered questionnaire survey. Question domains, based on a previous systematic review and qualitative study, covered experiences of GBS, symptom severity at each stage, healthcare and factors supporting or hindering recovery. Descriptive, exploratory factor and reliability analyses and multivariable regression analysis were used to investigate the relationships between variables of interest, explore questionnaire reliability and validity and identify factors predicting recovery.Setting and ParticipantsPeople with a previous diagnosis of GBS were recruited through a social media advert.ResultsA total of 291 responders, of different sexes, and marital statuses, were included, with most diagnosed between 2015 and 2019. Factor analysis showed four scales: symptoms, information provided, factors affecting recovery and care received. Positive social interactions, physical activity including physiotherapy and movement, changes made at home and immunoglobulin treatment were important for recovery. Multivariable models showed that immunoglobulin and/or plasma exchange were significant predictors of recovery. Employment and recovery factors (positive interactions, work support and changes at work or home, physical activity and therapy), though associated with recovery, did not reach statistical significance.ConclusionThe questionnaire demonstrated good internal reliability of scales and subscales and construct validity for people following GBS.Patient ContributionPatients were involved in developing and piloting the questionnaire.

Nitrous oxide-induced myeloneuropathy.

Nitrous oxide misuse is a recognized issue worldwide. Prolonged misuse inactivates vitamin B12, causing a myeloneuropathy. Twenty patients presenting between 2016 and 2020 to tertiary hospitals in Sydney with myeloneuropathy due to nitrous oxide misuse were reviewed. The average age was 24years, and mean canister consumption was 148 per day for 9months. At presentation, paresthesias and gait unsteadiness were common, and seven patients were bedbound. Mean serum B12 was normal (258pmol/L, normal range [NR]=140-750) as was active B12 (87pmol/L, normal>35). In contrast, mean serum homocysteine was high (51μmol/L, NR=5-15). Spinal magnetic resonance imaging (MRI) showed characteristic dorsal column T2 hyperintensities in all 20 patients. Nerve conduction studies showed a predominantly axonal sensorimotor neuropathy (n=5). Patients were treated with intramuscular vitamin B12, with variable functional recovery. Three of the seven patients who were bedbound at presentation were able to walk again with an aid at discharge. Of eight patients with follow-up data, most had persistent paresthesias and/or sensory ataxia. Mobility scores at admission and discharge were not significantly correlated with the serum total and active B12 levels or cumulative nitrous oxide use. There were no significant trends between serum active B12 level and cumulative nitrous oxide use (Spearman rho = -0.331, p=0.195). Nitrous oxide misuse can cause a severe but potentially reversible subacute myeloneuropathy. Serum and active B12 can be normal, while elevated homocysteine and dorsal column high T2 signal on MRI strongly suggest the diagnosis. Neurological deficits can improve with abstinence and B12 supplementation, even in the most severely affected patients.

W' Recovery Kinetics after Exhaustion: A Two-Phase Exponential Process Influenced by Aerobic Fitness.

The aims of this study were 1) to model the temporal profile of W' recovery after exhaustion, 2) to estimate the contribution of changing V˙O2 kinetics to this recovery, and 3) to examine associations with aerobic fitness and muscle fiber type (MFT) distribution. Twenty-one men (age = 25 ± 2 yr, V˙O2peak = 54.4 ± 5.3 mL·min-1·kg-1) performed several constant load tests to determine critical power and W' followed by eight trials to quantify W' recovery. Each test consisted of two identical exhaustive work bouts (WB1 and WB2), separated by a variable recovery interval of 30, 60, 120, 180, 240, 300, 600, or 900 s. Gas exchange was measured and muscle biopsies were collected to determine MFT distribution. W' recovery was quantified as observed W' recovery (W'OBS), model-predicted W' recovery (W'BAL), and W' recovery corrected for changing V˙O2 kinetics (W'ADJ). W'OBS and W'ADJ were modeled using mono- and biexponential fitting. Root-mean-square error (RMSE) and Akaike information criterion (∆AICC) were used to evaluate the models' accuracy. The W'BAL model (τ = 524 ± 41 s) was associated with an RMSE of 18.6% in fitting W'OBS and underestimated W' recovery for all durations below 5 min (P < 0.002). Monoexponential modeling of W'OBS resulted in τ = 104 s with RMSE = 6.4%. Biexponential modeling of W'OBS resulted in τ1 = 11 s and τ2 = 256 s with RMSE = 1.7%. W'ADJ was 11% ± 1.5% lower than W'OBS (P < 0.001). ∆AICC scores favored the biexponential model for W'OBS, but not for W'ADJ. V˙O2peak (P = 0.009) but not MFT distribution (P = 0.303) was associated with W'OBS. We showed that W' recovery from exhaustion follows a two-phase exponential time course that is dependent on aerobic fitness. The appearance of a fast initial recovery phase was attributed to an enhanced aerobic energy provision resulting from changes in V˙O2 kinetics.

Understanding holmium laser enucleation of the prostate (HoLEP) recovery: Assessing patient expectations and understanding.

Although holmium laser enucleation of the prostate (HoLEP) is a highly effective surgery, there is a variable recovery period where patients may experience hematuria, dysuria, or urinary incontinence (UI). Despite preoperative consultation, there is a paucity of literature examining the effectiveness of physician-patient communication in preparing the patient for the postoperative recovery period. We sought to examine recovery expectations as a patient-reported outcome (PRO) metric for HoLEP. With institutional review board approval, we queried our electronic medical record and retrospective clinical registry to identify 50 consecutive patients that underwent HoLEP from November 2019 to March 2020 by two endourologists. Patients were provided questionnaires via Twistle© ≥6 months postoperatively. Patient demographics and perioperative course was examined in the context of responses. Our primary objective was determining whether patients felt they had a reasonable understanding of the recovery process. We observed a 92% (46/50) response rate, with an average patient age of 69.4 years (range 55-88). Overall, 91.3% (42/46) felt they had a reasonable understanding of the recovery. Additionally, 97.8% (45/46) were aware of temporary UI, with 87% having ≥1 episodes of UI after catheter removal. We found 47.8% (22/46) of patients expected UI to resolve within 30 days, while 8.6% expected >90 days of UI. All patients were aware of the risk of hematuria, with 93.5% (43/46) expecting resolution within 30 days (<7 days: 47.8%; 7-14 days: 28.3%; 15-30 days: 17.4%). Although surgical technique continues to improve HoLEP, ensuring adequate physician-patient communication to optimize expectations is crucial. We report patient understanding of HoLEP recovery and areas for future improvement.

Disease-driven mass mortality event leads to widespread extirpation and variable recovery potential of a marine predator across the eastern Pacific.

The prevalence of disease-driven mass mortality events is increasing, but our understanding of spatial variation in their magnitude, timing and triggers are often poorly resolved. Here, we use a novel range-wide dataset comprised 48 810 surveys to quantify how sea star wasting disease affected Pycnopodia helianthoides, the sunflower sea star, across its range from Baja California, Mexico to the Aleutian Islands, USA. We found that the outbreak occurred more rapidly, killed a greater percentage of the population and left fewer survivors in the southern half of the species's range. Pycnopodia now appears to be functionally extinct (greater than 99.2% declines) from Baja California, Mexico to Cape Flattery, Washington, USA and exhibited severe declines (greater than 87.8%) from the Salish Sea to the Gulf of Alaska. The importance of temperature in predicting Pycnopodia distribution rose more than fourfold after the outbreak, suggesting latitudinal variation in outbreak severity may stem from an interaction between disease severity and warmer waters. We found no evidence of population recovery in the years since the outbreak. Natural recovery in the southern half of the range is unlikely over the short term. Thus, assisted recovery will probably be required to restore the functional role of this predator on ecologically relevant time scales.

The Natural History of Sport-Related Concussion in Collegiate Athletes: Findings from the NCAA-DoD CARE Consortium.

Sport-related concussion is recognized as a significant injury with variable recovery rates. This study defined the acute natural history of sport concussion in male and female collegiate athletes participating in a broad array of sports. We conducted a prospective, longitudinal investigation among collegiate student athletes (n = 34,709) from 30 academic institutions. Primary outcomes included the time (days) from injury until initiation of a return to participation (RTP) protocol and time from injury until medical clearance for unrestricted RTP. Concussed athletes (n = 1751, 19.2years, 63.2% male) participating in 22 different sports began the RTP protocol in a median 6.4 (IQR 3.7-11.8) days. Time to initiate the RTP protocol was lengthened by less frequent post-injury assessments, greater initial post-injury symptom severity, limited contact sports participation, practice/training injuries, and three or more prior concussions. The median total RTP duration was 12.8 (IQR 8.7-20.1) days. Total RTP duration was shorter with ADHD medication usage, males, and greater assessment frequency; while greater initial post-injury symptom severity, practice-/training-related injuries, and three or more prior concussions had longer recoveries. Although median recovery times are consistent with previous guidelines, it was not until 1month post-injury that a preponderance of collegiate athletes were cleared to begin the RTP protocol (92%) or cleared for unrestricted sport participation (85%). Intrinsic and extrinsic factors had a small effect, altering recovery trajectories by up to 2days, suggesting a largely unified approach to post-injury monitoring and management across all athletes. These data represent a shift from previous classification parameters of normal clinical recovery.

A template for physical resilience research in older adults: Methods of the PRIME-KNEE study.

Older adults with similar health conditions often experience widely divergent outcomes following health stressors. Variable recovery after a health stressor may be due in part to differences in biological mechanisms at the molecular, cellular, or system level, that are elicited in response to stressors. We describe the PRIME-KNEE study as an example of ongoing research to validate provocative clinical tests and biomarkers that predict resilience to specific health stressors. PRIME-KNEE is an ongoing, prospective cohort study that will enroll 250 adults ≥60 years undergoing total knee arthroplasty. Data are collected at baseline (pre-surgery), during surgery, daily for 7 days after surgery, and at 1, 2, 4, and 6months post-surgery. Provocative tests include a cognition-motor dual-task walking test, cerebrovascular reactivity assessed by functional near-infrared spectroscopy, peripheral blood mononuclear cell reactivity ex vivo to lipopolysaccharide toxin and influenza vaccine, and heart rate variability during surgery. Cognitive, psychological, and physical performance batteries are collected at baseline to estimate prestressor reserve. Demographics, medications, comorbidities, and stressor characteristics are abstracted from the electronic medical record and via participant interview. Blood-based biomarkers are collected at baseline and postoperative day 1. Repeated measures after surgery include items from a delirium assessment tool and pain scales administered daily by telephone for 7 days and cognitive change index (participant and informant), lower extremity activities of daily living, pain scales, and step counts assessed by Garmin actigraphy at 1, 2, 4, and 6months after surgery. Statistical models use these measures to characterize resilience phenotypes and evaluate prestressor clinical indicators associated with poststressor resilience. If PRIME-KNEE validates feasible clinical tests and biomarkers that predict recovery trajectories in older surgical patients, these tools may inform surgical decision-making, guide pre-habilitation efforts, and elucidate mechanisms underlying resilience. This study design could motivate future geriatric research on resilience.

A Monte Carlo simulation model of epidemic problem incorporating the interplaying between the crowd panic and infectious disease

In this paper, based on a multi-layer network consisting of a social network and a physical contact network, we propose a microscopic Monte Carlo simulation model to reproduce the interaction and spread phenomena in the crowd from complex network perspective. The model mainly is used to reproduce the epidemic spread in the situation that the crowd becomes panic showing preventive control behaviors. This coupled microscopic simulation model considers variable infectious rate, recovery rate, panic heterogeneity and preventive measures suitable for studying different actual scenarios. Under the proposed framework, we can take quantitative analysis to measure the influences of various infectious rate, recovery rate, network structure and preventive measures on the spreading of diseases and panic. By comparing a large number of statistical results of the simulation experiments to study different scenarios, it is displayed that the established micro-simulation framework has certain advantages in scalability to consider more different actual scenarios and facilitating the researchers to grasp the global trend to learn what consequences the individual behavior will make.

A 5-Minute Cognitive Assessment for Safe Remote Use in Patients With COVID-19: Clinical Case Series.

BackgroundEarly clinical experience during the COVID-19 pandemic has begun to elucidate that the disease can cause brain function changes that may result in compromised cognition both acutely and during variable recovery periods. Reports on cognitive assessment of patients with COVID-19 are often limited to orientation alone. Further assessment may seem to create an inappropriate burden for patients with acute COVID-19, which is characterized by fatigue and confusion, and may also compromise examiner safety.ObjectiveThe aims of this study were to assess cognition in patients with COVID-19 as comprehensively as possible in a brief format, while observing safety precautions, and to establish a clear face value of the external validity of the assessment.MethodsWe adapted a brief cognitive assessment, previously applied to liver transplant candidates and medical/surgical inpatients, for remote use in patients hospitalized for COVID-19 treatment. Collecting quality assurance data from telephone-administered assessments, this report presents a series of 6 COVID-19 case vignettes to illustrate the use of this 5-minute assessment in the diagnosis and treatment of brain effects. Primary medical teams referred the cases for neuropsychiatric consultation.ResultsThe age of the patients varied over four decades, and none of them were able to engage meaningfully with their surroundings on admission. On follow-up examination 6 to 10 days later, 4 of the 6 patients had recovered working memory, and only 1 had recovered calculation ability. Of the 6 patients, 2 were capable of complex judgment responses, while none of the cases completed frontal executive function testing in the normal range.ConclusionsCognitive assessment in patients with COVID-19 using this remote examination reveals patterns of cognitive recovery that vary among cases and are far more complex than loss of orientation. In this series, testing of specific temporal, parietal, and frontal lobe functions suggests that calculation ability, judgment, and especially frontal executive functions may characterize the effects of COVID-19 on the brain. Used widely and serially, this examination method can potentially inform our understanding of the effects of COVID-19 on the brain and of healing from the virus.

Transient dynamics during kelp forest recovery from fishing across multiple trophic levels.

Outcomes of management efforts to recover or restore populations of harvested species can be highly dependent on environmental and community context. Predator-prey interactions can alter recovery trajectories, and the timing of management actions within multi-trophic level harvest scenarios may influence the dynamics of recovery and lead to management trade-offs. Recent work using a generalist predator-prey model suggests that management promoting synchronized recovery of predators and prey leads to faster and less variable recovery trajectories than sequential recovery (predator or prey first). However, more complex communities may require different management actions to minimize recovery time and variability. Here, we use a tri-trophic level rocky reef community dynamics model with size-structure and fisheries at multiple trophic levels to investigate the importance of three ecological processes to recovery of fished communities: (1) size-structured predation, (2) non-consumptive effects of predators on prey behavior, and (3) varying levels of recruitment. We also test the effects of initiating recovery from community states associated with varying degrees of fishery-induced degradation and develop a simulation in which the basal resource (kelp) is harvested. In this system, a predator-first closure generally leads to the least volatile and quickest recovery, whether from a kelp forest, urchin barren, or intermediate community state. The benefits gained by selecting this strategy are magnified when recovering from the degraded community, the urchin barren, because initial conditions in the degraded state lead to lengthy recovery times. However, the shape of the size-structured predation relationship can strongly affect recovery volatility, where the differences between alternate management strategies are negated with size-independent predation. External recruitment reduces return times by bolstering the predatory lobster population. These results show that in a tightly linked tri-trophic level food web with top-down control, a predator-first fishery closure can be the most effective strategy to reduce volatility and shorten recovery, particularly when the system is starting from the degraded community state. Given the ubiquity of top predator loss across many ecosystems, we highlight the value of incorporating insights from community ecology into ecosystem management.

Adaptability to Balance Perturbations During Walking as a Potential Marker of Falls History in Older Adults.

Given that falls most commonly occur during walking due to unexpected balance perturbations like trips and slips, walking-based balance assessment including walking stability and adaptability to such perturbations could be beneficial for fall risk assessment in older adults. This cross-sectional study reanalyzed data from two larger studies conducted with the same walking protocol. Participants completed unperturbed walking trials at speeds of 0.4 m/s up to 1.8 m/s in 0.2 m/s steps. Ten unannounced treadmill belt acceleration perturbations were then applied while participants walked at equivalent stability, assessed using the margins of stability. Retrospective (12 months) falls incidence was collected to divide participants into people with and without a history of falls. Twenty older adults (mean age 70.2 ± 2.9 years) were included in this analysis; eight people with one or more recent falls and 12 people without, closely matched by sex, age and height. No significant differences were found in unperturbed walking parameters or their variability. Overall perturbation-recovery step behavior differed slightly (not statistically significant) between the groups after the first perturbation and differences became more pronounced and significant after repetition of perturbations. The No-Falls group significantly reduced the number of recovery steps needed across the trials, whereas the Falls group did not show these improvements. People with a previous fall tended to have slightly delayed and more variable recovery responses after perturbation compared to non-fallers. Non-fallers demonstrate more signs of adaptability to repeated perturbations. Adaptability may give a broader indication of the ability of the locomotor system to respond and improve responses to sudden walking perturbations than unperturbed walking variability or recovery to a single novel perturbation. Adaptability may thus be a more useful marker of falls history in older adults and should be considered in further research.

Enhanced Variable Neighborhood Search-Based Recovery Supplier Selection for Post-Disruption Supply Networks

With the increasing reliance on global sourcing and the growth in the likelihood of disruptive incidents, today’s supply networks are more prone to unexpected natural and man-made disruptive events. In order to alleviate the losses caused by these disruptive events, when a large-scale event disrupts multiple suppliers simultaneously, a single or several critical suppliers should be selected from the disrupted ones to assist them to recover their production as soon as possible. The selection of these recovery suppliers is of great importance in the recovery process of the entire supply network. Thus, this paper proposes a recovery supplier selection method from the view of the supply network structure. Firstly, a tripartite graph-based supply model is proposed to depict a two-stage supply network, which consists of multiple manufacturers and suppliers as well as the diverse product supply-demand interdependence connecting them. To measure the impacts caused by supplier disruptions and to evaluate the effectiveness of recovery supplier decisions, two supply network performance metrics reflecting product supply availability are also given. Then, the recovery supplier selection problem is described as a combinatorial optimization problem. To solve this problem, a heuristic algorithm, with enhanced variable neighborhood search (EVNS) is designed based on the general framework of a variable neighborhood search. Finally, experiments based on a real-world supply network are conducted. The experimental results indicate that the proposed method is applicable and effective.

Effect of robotic exoskeleton gait training during acute stroke on functional ambulation.

BACKGROUND:Stroke is a leading cause of disability resulting in long-term functional ambulation deficits. Conventional therapy can improve ambulation, but may not be able to provide consistent, high dose repetition of movement, resulting in variable recovery with residual gait deviations.OBJECTIVE:The objective of this preliminary prospective investigation is to evaluate the ability of a robotic exoskeleton (RE) to provide high dose gait training, and measure the resulting therapeutic effect on functional ambulation in adults with acute stroke.METHODS:Participants (n = 14) received standard of care (SOC) and RE overground gait training during their scheduled physical therapy (PT) sessions at the same inpatient rehabilitation facility. The outcome measures included distance walked during their PT training sessions (RE and SOC), and functional ambulation measures (10-meter walk test (10MWT), 6-minute walk test (6 MWT), and timed up and go (TUG)).RESULTS:The average total distance walked during RE and the average distance per RE session was significantly higher than SOC sessions. Total walking distance during PT (RE+SOC) showed a strong positive correlation to the total number of steps during RE sessions and number of RE sessions. All functional ambulation measures showed significant improvement at follow-up compared to baseline. The improvement in functional ambulation measures showed a positive correlation with the increase in number of RE gait training sessions.CONCLUSION:The RE can be utilized for inpatient rehabilitation in conjunction with SOC gait training sessions and may result in improved functional ambulation in adults with acute stroke. This preliminary research provides information on the ability of the robotic exoskeleton to provide high dose therapy and its therapeutic effect on functional ambulation in adults with acute stroke during inpatient rehabilitation.

Optimization of the eco-friendly solvent-free microwave extraction of Limnophila aromatica essential oil

Seasonal variation can alter the profile, quantity, and bioactivity of secondary metabolites in aromatic plants. This study aimed to establish solvent-free microwave extraction (SFME) conditions for the recovery of essential oil from Limnophila aromatica (Lam.) Merr. aerial parts and investigate the influence of seasonality on this oil. The effects of key SFME variables, including the microwave power and irradiation time, on the essential oil yield were evaluated, and these variables were optimized using response surface methodology. The chemical composition and antioxidant and antiproliferative capabilities of the essential oils obtained under the selected SFME conditions during different seasons of the year were then analyzed. The optimal SFME process conditions for achieving the maximal essential oil yield were 700 W for 25 min. The most important variable influencing oil recovery was the irradiation time (p < 0.001), followed by the microwave power (p < 0.01). The applied extraction method offered essential oil yields during the different seasons ranging from 0.20 % to 0.24 % (v/w). The obtained essential oils showed the presence of forty-seven constituents, mainly limonene, perillaldehyde, (E)-4-caranone, (Z)-4-caranone, and α-pinene. Monoterpene hydrocarbons were the dominant class of compounds in the oils. Seasonality affected both the antioxidant and antiproliferative properties to different degrees. These findings are not only useful for identifying eco-friendly essential oil extraction conditions but also serve as a useful guide for informing agronomic practices during the planting and cultivation of the studied medicinal plant.

Enhancing High-Intensity Actions During a Basketball Game After a Strength Training Program With Random Recovery Times Between Sets.

Arede, J, Leite, N, Tous-Fajardo, J, Bishop, C, and Gonzalo-Skok, O. Enhancing high-intensity actions during a basketball game after a strength training program with random recovery times between sets. J Strength Cond Res 36(7): 1989-1997, 2022-To examine the effects of a strength training program with random recovery times between sets in consideration of several physical parameters, high-intensity actions, and spatial exploration index during a simulated basketball game. Twenty male basketball players (age: 19.45 ± 4.36 years) were assigned randomly to either strength training group (n = 10) or control group (n = 10). The strength training included parallel back squat and bench press exercises, twice a week for the duration of 10 weeks, with 2 blocks of 5 sets × 5 repetitions interspersed with variable passive recovery (range = 15-35 seconds) between sets, and constant passive recovery (3 minutes) between blocks with the load that maximized propulsive power output. The pre- and posttest assessments included jumping (bilateral and unilateral), change of direction, straight sprinting, and a 5-on-5 full-court situation. The external training load was assessed using the local positioning system, and the internal load was recorded with the use of individual heart rate monitors. A significant interaction effect (group × time) was observed on countermovement jump, unilateral right hops, high-intensity accelerations and decelerations, and peak accelerations and decelerations in the 5-on-5 full-court situation. Relative improvements observed and recorded in the training group on unilateral right hops, accelerations, and decelerations were correlated. Similar results were observed on 0- to 25-m sprints, high-intensity decelerations, peak accelerations, and decelerations. Strength training paired with random recovery times enhanced physical and game-related aspects in the observed basketball players.

Abstract 24: Predicting Persistent Upper Extremity Impairment in Ischemic Stroke Patients

Background: Motor impairment after ischemic stroke is common and has variable recovery that depends on patient factors and stroke severity. An important challenge in rehabilitation research is enrolling patients who may benefit from interventions to improve recovery because they will not recover with standard care. Hypothesis: We can accurately predict persistent upper extremity motor impairment at 90 days after acute ischemic stroke. Methods: The primary outcome was an NIHSS arm domain score of 2-4 at 90 days in patients with a 24-hour NIHSS arm score of 1-4, which we termed persistent arm impairment. With the NINDS tPA trial dataset we used LASSO regression to select baseline demographics and 24-hour NIHSS score domains for a predictive model. We gave one point each for age ≥60 years and 24-hour NIHSS values of worst arm=4, worst leg&gt;2, facial palsy=3, and total NIHSS≥10. The optimal cutpoint for a positive Persistent UPPer extremity Impairment (PUPPI) Score was ≥3 points. We validated the PUPPI score in the ALIAS Part 2, IMS-III, and DEFUSE 3 trials. Results: We included 431, 383, 331, and 71 patients from the NINDS tPA, ALIAS Part 2, IMS-III, and DEFUSE 3 trials. PUPPI was most common in the NINDS tPA trial (62%) and least common in ALIAS (31.3%). The PUPPI Score accurately predicted PUPPI with an area under the receiver operating curve (AUC) of &gt;0.75 for all trials (Table 1). The positive predictive value was 74.6%, 90.9%, 86.1%, and 74.5% in the NINDS tPA, ALIAS Part 2, IMS-III, and DEFUSE 3 trials (Table 1). Conclusion: The PUPPI score uses readily available information to provide accurate prediction of patients who will have persistent upper extremity motor impairment at 90 days from stroke onset.

Variable Gut Function Recovery After Right vs. Left Colectomy May Be Due to Rectosigmoid Hyperactivity.

It is established that gut function recovers slower after right vs. left colectomies with higher rates of prolonged post-operative ileus (PPOI), but the reason is unclear. Development of PPOI is multifactorial. A recent manometry study in right colectomy patients showed that the distal colon becomes hyperactive after surgery with predominantly cyclic motor patterns (CMPs). In this perspective, we evaluate the hypothesis that the slower gut recovery after right hemicolectomy could be induced by a functional obstruction due to hyperactive CMPs.

Serum cytokine profiles in healthy nonhuman primates are blunted by sedation and demonstrate sexual dimorphism as detected by a validated multiplex immunoassay

Cytokine profiling is a valuable tool for monitoring immune responses associated with disease and treatment. This study assessed the impact of sex and sedation on serum cytokines in healthy nonhuman primates (NHPs). Twenty-three cytokines were measured from serum using a bead-based multiplex assay. Assay validation for precision, sensitivity, recovery, linearity, and stability was performed. Samples from male and female cynomolgus and rhesus macaques either cooperating or sedated were compared. All cytokines except TNFα demonstrated acceptable sensitivity and precision, with variable recovery and linearity. IFNγ, IL-2, IL-5, IL-6, IL-8, IL-12/23 (p40), IL-13, IL-15, MCP-1, TGFα, VEGF met acceptance criteria; G-CSF, IL-4, IL-10, MIP1α, sCD40L were marginal. Higher cytokine levels were observed in females and cytokine levels were blunted in sedated NHPs when compared to awake cooperating NHPs. Significant differences observed in cytokines related to sex, species, or imposed by handling highlight the importance of model design on translational relevance for clinical settings.