Recovery Window Research Articles

Non-invasive, non-pharmacological/bio-technological interventions towards neurorestoration upshot after ischemic stroke, in adults—systematic, synthetic, literature review

Considering its marked life-threatening and (not seldom: severe and/or permanent) disabling, potential, plus the overall medico-psycho-socio-economic tough burden it represents for the affected persons, their families and the community, the cerebrovascular accident (CVA)-including with the, by far more frequent, ischemic type-is subject to considerable scientific research efforts that aim (if possible) at eliminating the stroke induced lesions, and consist, as well, in ambitious-but still poorly transferable into medical practice-goals such as brain neuroregeneration and/or repair, within related corollary/upshot of neurorestoration. We have conducted, in this respect, a systematic and synthetic literature review, following the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)" concept. Accordingly, we have interrogated five internationally renowned medical data bases: Elsevier, NCBI/PubMed, NCBI/PMC, PEDro, and ISI Web of Knowledge/Science (the last one to check whether the initially identified articles are published in ISI indexed journals), based on a large (details in the body text) number of most appropriate, to our knowledge, key word combinations/"syntaxes"-used contextually-and subsequently fulfilling the related, on five steps, filtering/selection methodology. We have thereby selected 114 fully eligible (of which contributive: 83-see further) papers; at the same time, additionally, we have enhanced our documentation-basically, but not exclusively, for the introductive part of this work (see further)-with bibliographic resources, overall connected to our subject, identified in the literature within a non-standardized search. It appears that the opportunity window for morph-functional recovery after stroke is larger than previously thought, actually being considered that brain neurorestoration/repair could occur, and therefore be expected, in later stages than in earlier ones, although, in this context, the number of cases possibly benefitting (for instance after physical and/or cognitive rehabilitation-including with magnetic or direct current transcranial stimulation) is quite small and with more or less conflicting, related outcomes, in the literature. Moreover, applying especially high intense, solicitating, rehabilitation interventions, in early stages post (including ischemic) stroke could even worsen the functional evolution. Accordingly, for clarifications and validation of more unitary points of view, continuing and boosting research efforts in this complex, interdisciplinary domain, is necessary. Until finding (if ever) effective modalities to cure the lesions of the central nervous system (CNS)-including post ischemic stroke-it is reasonable and recommendable-based on rigorous methodologies-the avail of combined ways: physiatric, pharmacologic, possibly also bio-technologic. On a different note, but however connected to our subject: periodic related systematic, synthetic literature reviews reappraisals are warranted and welcome.

Condensation risk of exhaust air heat recovery window system: Assessment, key parameters, and prevention measure

The exhaust air window (EAW) can be regarded as a combination of exhaust air heat recovery unit and window system. The window can locally and directly utilize the exhaust air from each air-conditioned room to reduce the heat loss/gain through window. However, condensation may occur at the internal glazing surface of EAW in winter. To avoid the condensation risk of EAW, some prevention measures were proposed and estimated. In this study, a two-dimensional zonal model of EAW was established to calculate its temperature distribution, and to further identify whether condensation will occur under different boundary conditions. The calculated results were compared with the measured data for verifying the accuracy and reliability of model. A sensitivity analysis was conducted to identify the effects of indoor air temperature and relative humidity, exhaust airflow velocity, and adding a low-e coating on prevention of condensation in winter. The results indicated that adding a low-e coating or decreasing the indoor relative humidity can effectively reduce the critical outdoor temperature of condensation and prevent the occurrence of condensation within the EAW. It was estimated that even under the outdoor air temperature of −20 °C, condensation risk can be avoided by employing a low-e glazing.

The Head Shake Sensory Organization Test And Screening Individuals With Self-reported History Of Concussion

PURPOSE: The Sensory Organization Test (SOT) assesses impairments in postural control following acute concussion. Head Shake Sensory Organization Test (HS-SOT) is a superior test that challenges the vestibular system to help detect more subtle deficits missed by SOT. The purpose of this study was to assess the accuracy of the HS-SOT in identifying residual impairments of postural control in individuals with self-reported history of concussion. METHODS: The Ohio State University-Traumatic Brain Injury Identification Method (OSU TBI-ID) determined self-reported history of concussion while NeuroCom was used to perform HS-SOT. Twenty-nine subjects were included (11 males and 18 females, mean age 25.2 ± 3.7; history of concussion: n= 14, 5 males and 9 females, mean age 25.7±3.5; no concussion: n= 15, 6 males and 9 females, mean age 24.8±4.0). Independent T-Tests were completed to determine performance differences based on history of concussion. RESULTS: HS-SOT fixed surface equilibrium ratio was similar (p = 0.988) between those without a history of concussion (0.998 ± 0.024) and those with a history of concussion (0.998 ± 0.026). Furthermore, HS-SOT sway reference surface equilibrium ratio was also similar (p = 0.431) between those without a history of concussion (0.871 ± 0.128) and those with a history of concussion (0.9136 ± 0.160). Within subjects with a history of concussion, younger subjects (23.4 ± 0.8) had a lower sway index compared to older (30.3 ± 3.6) individuals (0.85 ± 0.11 vs 1.09 ± 0.16, p=0.021). In addition, the younger group trended toward a more recent history of a concussive event (4.7 ± 4.8 vs. 8.0 ± 3.4, p=0.25). CONCLUSIONS: There was no difference in HS-SOT in subjects with or without a history of concussion demonstrating an inability to detect performance impairments. Of those with a concussion, the HS-SOT significantly identified subtle performance deficiencies in younger individuals, suggesting that time from concussion tends to normalize sub-clinical deficits. This indicates that postural control impairments initially persist but resolve over time, which may place individuals at risk for injury during this window of recovery.

Is Resting-State EEG Longitudinally Associated With Recovery of Clinical Neurological Impairments Early Poststroke? A Prospective Cohort Study

Background. The time course of cortical activation and its relation with clinical measures may elucidate mechanisms underlying spontaneous neurobiological recovery after stroke. Objective. We aimed to investigate (1) the time course of cortical activation as revealed by EEG-based spectral characteristics during awake rest and (2) the development of these spectral characteristics in relation to global neurological and upper-limb motor recovery in the first 6 months poststroke. Methods. Resting-state EEG was measured serially in 41 patients after a first-ever ischemic stroke, within 3 and at 5, 12, and 26 weeks poststroke. We computed the brain symmetry index (BSI) and directional BSI (BSIdir) over different frequency bands (1-25 Hz, delta, theta) and delta/alpha ratio (DAR). The National Institutes of Health Stroke Scale (NIHSS) and Fugl-Meyer motor assessment of the upper extremity (FM-UE) were determined as clinical reflections of spontaneous neurobiological recovery. Longitudinal changes in spectral characteristics and within- and between-subject associations with NIHSS and FM-UE were analyzed with linear mixed models. Results. Spectral characteristics showed a gradual normalization over time, within and beyond 12 weeks poststroke. Significant within- and between-subject associations with NIHSS were found for DAR of the affected hemisphere (DARAH) and BSIdirdelta. BSIdirdelta also demonstrated significant within- and between-subject associations with FM-UE. Conclusions. Changes in spectral characteristics are not restricted to the time window of recovery of clinical neurological impairments. The present study suggests that decreasing DARAH and BSIdirdelta reflect improvement of global neurological impairments, whereas BSIdirdelta was also specifically associated with upper-limb motor recovery early poststroke.

Pharmacological Interventions and Rehabilitation Approach for Enhancing Brain Self-repair and Stroke Recovery.

Neuroplasticity is a natural process occurring in the brain for the entire life. Stroke is the leading cause of long term disability and a huge medical and financial problem throughout the world. Research conducted over the past decade focused mainly on neuroprotection in the acute phase of stroke while very little studies target the chronic stage. Recovery after stroke depends on the ability of our brain to reestablish the structural and functional organization of neurovascular networks. Combining adjuvant therapies and drugs may enhance the repair processes and restore impaired brain functions. Currently, there are some drugs and rehabilitative strategies that can facilitate brain repair and improve clinical effect even years after stroke onset. Moreover, some of the compounds such as citicoline, fluoxetine, niacin, levodopa, etc. are already in clinical use or are being trialed in clinical issues. Many studies are also testing cell therapies; in our review, we focused on studies where cells have been implemented at the early stage of stroke. Next, we discuss pharmaceutical interventions. In this section, we selected methods of cognitive, behavioral, and physical rehabilitation as well as adjuvant interventions for neuroprotection including noninvasive brain stimulation and extremely low-frequency electromagnetic field. The modern rehabilitation represents a new model of physical interventions with the limited therapeutic window up to six months after stroke. However, previous studies suggest that the time window for stroke recovery is much longer than previously thought. This review attempts to present the progress in neuroprotective strategies, both pharmacological and non-pharmacological that can stimulate the endogenous neuroplasticity in post-stroke patients.

Fault‐level coverage analysis of multistate cloud‐RAID storage systems

In this paper, a multistate cloud‐RAID (redundant array of independent disks) storage system subject to fault‐level coverage (FLC) is modeled and analyzed. Most of the existing works on reliability analysis of cloud‐RAID systems have either assumed binary‐state for storage disks or failed to consider imperfect fault coverage, an inherent behavior of fault‐tolerant systems. This work advances the state of the art by proposing a combinatorial method based on multivalued decision diagrams for analyzing reliability of a multistate cloud‐RAID system with FLC. The FLC is one common type of imperfect fault coverage behaviors, where the system fault recovery capability is dependent on the number of disk faults happening within a certain recovery window. Effects of the functional dependence behavior between the RAID controller and disks are addressed. The method is illustrated through a detailed analysis of an example cloud‐RAID 5 storage system. Numerical results are provided to show the impact of different design parameters on system performance. These results also demonstrate that failure to consider FLC leads to inaccurate system state probabilities, further misleading system design activities based on these probabilities such as maintenance and optimization.

The Pillars of Stroke Victor Recovery: Lessons for Caregivers to Make the Big Difference

To give survivors and their caregiver partners the elements of a concrete roadmap to successful stroke recovery maximization, particularly after reimbursed therapy is terminated. A secondary objective is to elevate the importance of the caregiver partner so that they are taken more seriously in the stroke recovery process. Having visited several overseas countries it became clear that there is a need for a realistic, compassionate and tested approach to extending the stroke recovery window in America. That extension has the potential, depending on the survivor and caregiver partner, to achieve a fuller stroke recovery maximization. Few survivors and their key caregiver partners have information about non-mainstream opportunistic strategies and therapies which are available, because in many cases they are either not well known or are geocentric. In addition, some of these approaches to extend physical and/or mental functionality are out of the traditional mainstream.

Unmet Needs in the Evaluation, Treatment, and Recovery for 167 Children Affected by Acute Flaccid Myelitis Reported by Parents Through Social Media

BackgroundWe aimed to characterize the outcomes of 167 children affected by acute flaccid myelitis by leveraging the power of social media. MethodsMembers of a closed social media (Facebook) group were invited to participate in an anonymous online survey. Descriptive statistics were applied to quantitative responses, and free-text responses were grouped into themes using a grounded theory approach. ResultsCaregivers provided information about 167 affected children; 77% were at least 6 months since onset. Clinical features matched those of larger published case series (e.g., walking impairment in 76.7%, intravenous immunoglobulin treatment in 80.8%; 28.2% tested positive for Enterovirus D68; 17% children had asthma before acute flaccid myelitis onset). Mean duration of initial hospitalization was 49.1 (S.D., 74.0) days, and of initial inpatient rehabilitation was 42.3 (S.D., 67.6) days. Among challenges, parents frequently reported delays in diagnosis, including lack of neurological examination at initial medical evaluation for weakness. Other challenges included familial and professional impact of protracted hospitalizations, uncertainty about cause or prognosis of acute flaccid myelitis, and the dynamic nature of care needs in growing children. The social media group played a critical role not only for social support but also for dissemination of rehabilitation approaches and of networks of expert clinicians. ConclusionsChildren with acute flaccid myelitis have persistent and dynamic deficits, but many continue to show ongoing functional improvements beyond the initial expected window of recovery. In an emerging disease paralyzing young children, social media can strengthen knowledge networks and focus on rehabilitation.

Recovery From Opioid Problems in the US Population: Prevalence, Pathways, and Psychological Well-Being.

Research has enhanced our understanding of opioid misuse prevalence and consequences, but few studies have examined recovery from opioid problems. Estimating national recovery prevalence and characterizing individuals who have resolved opioid problems can inform policy and clinical approaches to address opioid misuse. We conducted a cross-sectional investigation of a nationally-representative sample of US adults who reported opioid problem resolution (OPI). For reference, OPI was compared with an alcohol problem resolution group (ALC). Analyses estimated OPI/ALC prevalence, differences in treatment/recovery service use, and psychological well-being, within 2 recovery windows: <1 year (early recovery) and 1 to 5 years (mid-recovery) since OPI/ALC problem resolution. Of those who reported alcohol or drug use problem resolution, weighted problem resolution prevalence was 5.3% for opioids (early recovery 1.2%, mid-recovery 2.2%) and 51.2% for alcohol (early recovery 7.0%, mid-recovery 11.5%). In mid-recovery, lifetime use of formal treatment, pharmacotherapy, recovery support services, mutual help, and current pharmacotherapy were more prevalent in OPI than ALC. Service utilization did not differ between early-recovery OPI and ALC. Common services used by OPI included inpatient treatment (37.8%) and state/local recovery organizations (24.4%) in mid-recovery; outpatient treatment (25.7%) and recovery community centers (27.2%) in early recovery; Narcotics Anonymous (40.2%-57.8%) and buprenorphine-naloxone (15.3%-26.7%) in both recovery cohorts. Regarding well-being, OPI reported higher self-esteem than ALC in early recovery, and lower self-esteem than ALC in mid-recovery. An estimated 1.2 million American adults report resolving an opioid problem. Given the service use outcomes and longer-term problem resolution of mid-recovery OPI, early-recovery OPI may require encouragement to utilize additional or more intensive services to achieve longer-term recovery. OPI beyond recovery-year 1 may need enhanced support to address deficient self-esteem and promote well-being.

Abiotic and biotic controls on coral recovery 16\xa0years after mass bleaching

As climate changes increase heat stress on tropical ecosystems, the long-term persistence of coral reefs requires rapid coral recovery following coral bleaching events. Using the extent of coral cover return to a pre-bleaching baseline as a benchmark, recovery of fast-growing and stress-tolerant coral growth forms suggests that reefs can bounce back between repeated disturbances if given adequate time and protection from anthropogenic disturbances.However, long-term recovery dynamics of coral communities following severe bleaching and mass mortality are limited, particularly for fringing reefs along inhabited coastlines where human stressors may compromise recovery potential. Here, we examine the dynamics and drivers of coral recovery in Seychelles, where 12 reefs returned to pre-bleaching coral cover levels after a severe bleaching event caused > 95% coral mortality. Six reefs with initially low cover ( < 25%) recovered within 7–12 yr and, after 16 yr, exceeded pre-bleaching cover levels by 132–305%. In contrast, six reefs with initially high cover (20–60%) remained at 48–93% of pre-bleaching levels, with recovery projected to take 17–29 yr. Abiotic and historic conditions constrained recovery rates, with the slowest recovery times observed on deep and wave-exposed reefs with high pre-bleaching coral cover. Reefs with high juvenile coral densities and low nitrogen levels recovered fastest, possibly due to the interplay between nutrient enrichment, algal proliferation, and coral recruitment. Our findings emphasize the importance of understanding small-scale variation in recovery potential, whereby recovery times were governed by natural limits on growth rates and modified by coral recruitment and nutrient enrichment. Ultimately, climate-impacted reefs can recover to moderate coral cover levels, but, if bleaching causes repeated high coral mortality, short recovery windows will prevent a return to historic levels of coral dominance.

Nutrition and Supplement Update for the Endurance Athlete: Review and Recommendations.

Background: Endurance events have experienced a significant increase in growth in the new millennium and are popular activities for participation globally. Sports nutrition recommendations for endurance exercise however remains a complex issue with often opposing views and advice by various health care professionals. Methods: A PubMed/Medline search on the topics of endurance, athletes, nutrition, and performance was undertaken and a review performed summarizing the current evidence concerning macronutrients, hydration, and supplements as it pertains to endurance athletes. Results: Carbohydrate and hydration recommendations have not drastically changed in years, while protein and fat intake have been traditionally underemphasized in endurance athletes. Several supplements are commercially available to athletes, of which, few may be of benefit for endurance activities, including nitrates, antioxidants, caffeine, and probiotics, and are reviewed here. The topic of “train low,” training in a low carbohydrate state is also discussed, and the post-exercise nutritional “recovery window” remains an important point to emphasize to endurance competitors. Conclusions: This review summarizes the key recommendations for macronutrients, hydration, and supplements for endurance athletes, and helps clinicians treating endurance athletes clear up misconceptions in sports nutrition research when counseling the endurance athlete.

A critical time window for recovery extends beyond one-year post-stroke.

The impact of rehabilitation on post-stroke motor recovery and its dependency on the patient’s chronicity remain unclear. The field has widely accepted the notion of a proportional recovery rule with a “critical window for recovery” within the first 3–6 mo poststroke. This hypothesis justifies the general cessation of physical therapy at chronic stages. However, the limits of this critical window have, so far, been poorly defined. In this analysis, we address this question, and we further explore the temporal structure of motor recovery using individual patient data from a homogeneous sample of 219 individuals with mild to moderate upper-limb hemiparesis. We observed that improvement in body function and structure was possible even at late chronic stages. A bootstrapping analysis revealed a gradient of enhanced sensitivity to treatment that extended beyond 12 mo poststroke. Clinical guidelines for rehabilitation should be revised in the context of this temporal structure.NEW & NOTEWORTHY Previous studies in humans suggest that there is a 3- to 6-mo “critical window” of heightened neuroplasticity poststroke. We analyze the temporal structure of recovery in patients with hemiparesis and uncover a precise gradient of enhanced sensitivity to treatment that expands far beyond the limits of the so-called critical window. These findings highlight the need for providing therapy to patients at the chronic and late chronic stages.

Priming With tDCS: Expanding the Window of Recovery in Chronic Stroke

Priming With tDCS: Expanding the Window of Recovery in Chronic Stroke

Stroke Induces a BDNF-Dependent Improvement in Cognitive Flexibility in Aged Mice.

Stroke remains a leading cause of disability worldwide. Recently, we have established an animal model of stroke that results in delayed impairment in spatial memory, allowing us to better investigate cognitive deficits. Young and aged brains show different recovery profiles after stroke; therefore, we assessed aged-related differences in poststroke cognition. As neurotrophic support diminishes with age, we also investigated the involvement of brain-derived neurotrophic factor (BDNF) in these differences. Young (3-6 months old) and aged (16-21 months old) mice were trained in operant touchscreen chambers to complete a visual pairwise discrimination (VD) task. Stroke or sham surgery was induced using the photothrombotic model to induce a bilateral prefrontal cortex stroke. Five days poststroke, an additional cohort of aged stroke animals were treated with intracerebral hydrogels loaded with the BDNF decoy, TrkB-Fc. Following treatment, animals underwent the reversal and rereversal task to identify stroke-induced cognitive deficits at days 17 and 37 poststroke, respectively. Assessment of sham animals using Cox regression and log-rank analyses showed aged mice exhibit an increased impairment on VD reversal and rereversal learning compared to young controls. Stroke to young mice revealed no impairment on either task. In contrast, stroke to aged mice facilitated a significant improvement in reversal learning, which was dampened in the presence of the BDNF decoy, TrkB-Fc. In addition, aged stroke control animals required significantly less consecutive days and correction trials to master the reversal task, relative to aged shams, an effect dampened by TrkB-Fc. Our findings support age-related differences in recovery of cognitive function after stroke. Interestingly, aged stroke animals outperformed their sham counterparts, suggesting reopening of a critical window for recovery that is being mediated by BDNF.

Chapter 22 - Traumatic brain injury and frontal lobe plasticity

Over 1.4 million people in the United States experience traumatic brain injury (TBI) each year and approximately 52,000 people die annually due to complications related to TBI. Traditionally, TBI has been viewed as a static injury with significant consequences for frontal lobe functioning that plateaus after some window of recovery, remaining relatively stable thereafter. However, over the past decade there has been growing consensus that the consequences of TBI are dynamic, with unique characteristics expressed at the individual level and over the life span. This chapter first discusses the pathophysiology of TBI in order to understand its dynamic process and then describes the behavioral changes that are the result of injury with focus on frontal lobe functions. It integrates a historical perspective on structural and functional brain-imaging approaches used to understand how TBI impacts the frontal lobes, as well as more recent approaches to examine large-scale network changes after TBI. The factors most useful for outcome prediction are surveyed, along with how the theoretical frameworks used to predict recovery have developed over time. In this chapter, the authors argue for the need to understand outcome after TBI as a dynamic process with individual trajectories, taking a network theory perspective to understand the consequences of disrupting frontal systems in TBI. Within this framework, understanding frontal lobe dysfunction within a larger coordinated neural network to study TBI may provide a novel perspective in outcome prediction and in developing individualized treatments.

Towards the quantitative characterisation of piglets’ robustness to weaning: a modelling approach

Weaning is a critical transition phase in swine production in which piglets must cope with different stressors that may affect their health. During this period, the prophylactic use of antibiotics is still frequent to limit piglet morbidity, which raises both economic and public health concerns such as the appearance of antimicrobial-resistant microbes. With the interest of developing tools for assisting health and management decisions around weaning, it is key to provide robustness indexes that inform on the animals’ capacity to endure the challenges associated with weaning. This work aimed at developing a modelling approach for facilitating the quantification of piglet resilience to weaning. A total of 325 Large White pigs weaned at 28 days of age were monitored and further housed and fed conventionally during the post-weaning period without antibiotic administration. Body weight and diarrhoea scores were recorded before and after weaning, and blood was sampled at weaning and 1 week later for collecting haematological data. A dynamic model was constructed based on the Gompertz–Makeham law to describe live weight trajectories during the first 75 days after weaning, following the rationale that the animal response is partitioned in two time windows (a perturbation and a recovery window). Model calibration was performed for each animal. Our results show that the transition time between the two time windows, as well as the weight trajectories are characteristic for each individual. The model captured the weight dynamics of animals at different degrees of perturbation, with an average coefficient of determination of 0.99, and a concordance correlation coefficient of 0.99. The utility of the model is that it provides biologically meaningful parameters that inform on the amplitude and length of perturbation, and the rate of animal recovery. Our rationale is that the dynamics of weight inform on the capability of the animal to cope with the weaning disturbance. Indeed, there were significant correlations between model parameters and individual diarrhoea scores and haematological traits. Overall, the parameters of our model can be useful for constructing weaning robustness indexes by using exclusively the growth curves. We foresee that this modelling approach will provide a step forward in the quantitative characterisation of robustness.

Improvement of visual acuity after cranioplasty: a new window for functional recovery of post-traumatic visual loss?

The association between cranioplasty and improvement in visual function is not well established. A 27-year-old man presented to the emergency department of a different hospital with severe traumatic brain injury in July 2016. He was treated with a bifrontal approach to a frontal contusion, and on the third post-operative day developed a hemispheric brain edema for which he underwent a decompressive craniectomy. After 5 weeks of neurointensive care, he was discharged with significant visual acuity impairment and referred to us for cranioplasty. On admission, the patient was awake and aware with no motor strength impairments. Visual acuity in the left eye: ability to count fingers at 30 cm; in the right eye: sensation of light perception. He subsequently underwent a cranioplasty with no post-operative complications. At the 1-month follow-up post-surgery, he was evaluated ophthalmologically and showed visual improvement. Visual acuity in the left eye was 20/30, while the right eye exhibited mere sensation of light perception. No additional clinical or surgical treatment was performed. No previous reports of improvement of visual acuity after cranioplasty were found, except in cases of optic nerve decompression. We believe that the improvement of the patient was due to the normalization of the intracranial pressure, taking into account that the massive bone damage could have caused alterations in the cerebral circulation of the cerebral blood flow and in the intracranial pressure. With this report, we intend to stimulate new investigations in this field and to draw the attention of the medical community to the importance of cranioplasty as a functional surgery.

The long arm of the job – work characteristics and recovery windows in social welfare work

PurposeSocial welfare work contains elements that may be difficult for employees to put out of their minds when the working day ends, which may affect the recovery. The purpose of this paper is to analyze the length of recovery in relation to different work characteristics and to two types of welfare work.Design/methodology/approachAll 1,365 employees, excluding managers, of two municipality administrations were invited to a survey study. Of these, 673 (49 percent) responded. After adjusting for partial missing, the effective sample included 580 employees (43 percent). Retrospective ratings of four recovery windows were analyzed: recovery after one night’s sleep, weekends, shorter holidays and vacations.FindingsEmployees with a university education were less recovered than those with a shorter education. For those with a university education, the long arm of the job mainly involved failures regarding qualitative job demands (task difficulty). For those with a shorter education, quantitative job demands (too much to do) were most prominent for their prolonged recovery. Feedback from managers had consistent and positive associations with all four recovery windows among employees with a university education, but not among those with a shorter education for whom instead having too much to do and social support had significant spillover effects.Originality/valueThe identified differences may relate to employees with a university education having more problem-solving tasks, which may result in a higher need of work-related feedback but also in difficulties detaching from work. Thus, education and job characteristics have differential associations with self-rated recovery.

Psycho-affective health, cognition and neurophysiological function following sports-related concussion in symptomatic and asymptomatic athletes

The proposed normal recovery window for a concussive-injury is 10–14 days. However, a significant portion of athletes who sustain a sports-related concussion (SRC) exhibit symptoms beyond this recovery window. Little is known about the neuropsychiatric and neurophysiologic differences within these slow-to-recover athletes, that may explain these prolonged recovery periods. The present study aimed to investigate the psycho-affective and neuropsychological profiles of symptomatic and asymptomatic athletes who recently experienced an SRC. Additionally, we compared these concussed athletes with healthy controls, without a history of concussion. Accordingly, 78 participants with a history of concussion (26 Symptomatic, 26 Asymptomatic) and 26 healthy controls completed a neuropsychiatric and neuropsychological test battery; including the Beck's Depression Index (BDI II), Profile of Mood States (POMS), and 2-Back task. Additionally, event-related brain potentials (ERPs) were recorded during an experimental oddball paradigm. The results suggest that symptomatic athletes report significantly worse levels of depressive symptoms and negatively altered mood, compared to both asymptomatic and control athletes. Additionally, symptomatic athletes demonstrated poorer performance on the 2-back test, characterized by increased commission errors and slower reaction times. Finally, ERP analyses revealed that both symptomatic and asymptomatic athletes demonstrated reduced allocation of attentional resources during the oddball task, indexed by reduced P3b amplitude. However, only asymptomatic athletes exhibited prolonged P3 latency indicative of delayed information processing. Taken together these results suggest that compared to asymptomatic and healthy athletes, athletes with persistent concussive-like symptoms not only report greater disruptions in affect and mood, but also demonstrate impaired cognitive and neurophysiologic function.

Abstract 15: Repopulation of CA1 Region in the Hippocampus is Accompanied by Increased Diameter and Reduced Glial Scarring After 20 Weeks of Survival in an 8 Min Ventricular Fibrillation Cardiac Arrest Rat Model

Background: The CA1 region of hippocampus is specifically vulnerable to global ischemia and is depopulated 14 days after 8min ventricular fibrillation cardiac arrests (VF-CA) and conventional resuscitation in a rat model. We have previously reported on the pyramidal cell repopulation of the CA1 region after long term survival after cardiac arrest in two thirds of animals. (Circulation. 2014;130:A80) The aim of this study was to investigate the distribution of microglia and astrocytes in the CA1 region of rat hippocampus after CA and to measure its diameter. Methods: After 8 min of VF-CA male Sprague-Dawley rats received mechanical chest compressions for 2 min and epinephrine 20 μg/kg. The animals were defibrillated thereafter every 2 min to achieve return of spontaneous circulation. Animals surviving with favorable neurologic recovery were sacrificed 140 days after CA (n=12, 8 with neuronal repopulation (R), 4 without R (nonR)) and compared to 14 day survivors (n=6) and control animals (n=20). Results: Microglia cells/ 75000μm 2 were 6±3 in controls, 53±9 in 14d survivors (p&lt;0.001 vs controls), 12±4 in 140d-R and 19±12 in 140d-nonR. Astrocytes/75000μm 2 were 9±2 in controls, 15±3 in 14d survivors (p&lt;0.001 vs controls), 21±4 in 140d-R and 43±13 in 140d-nonR animals (p&lt;0.001 vs 140d-R). The hippocampal diameter (μm) was 543±36 in controls, 417±36 in 14d survivors (p&lt;0.001 vs controls), 462±39 in 140d-R and 306±86 in 140d-nonR animals (p&lt;0.001 vs 140d-R). Conclusions: The repopulation of pyramid cells in the CA1 that has taken place in two thirds of animals is accompanied by a significant increase in the diameter of the hippocampus and reduced astrocyte numbers compared to nonR-animals. Numbers of microglial cells are significantly increased after 14d survival removing cell debris after neuronal damage. This lifelong potential of the hippocampus for repair due to adult neurogenesis may open an additional late phase therapeutic window for CA recovery.