Comparison of effectiveness between different interventions in postconcussive symptoms in adolescents and young people: a literature review

INTRODUCTION

Currently, concussion considers a problem of great magnitude, adolescents and young people being the population at risk, since it is in the process of maturation. Our goal has been to compare the effectiveness of different interventions (exercise therapy, vestibular rehabilitation and rest) in adolescents and young people with concussion.

DEVELOPMENT

A bibliographic search was carried out in the main databases. Once the inclusion/exclusion criteria and the PEDro methodological scale were applied, 6 articles were reviewed. The results support the use of exercise and vestibular rehabilitation in the initial stages to reduce post-concussion symptoms. According to most authors, therapeutic physical exercise and vestibular rehabilitation report greater benefits, although a protocol that unifies assessment scales, study variables and analysis parameters would be needed to be able to make the inference in the target population. CONCLUSIóN: From the moment of hospital discharge, the combined application of exercise and vestibular rehabilitation could be the best option to reduce post-concussion symptoms.

Sex-dependent impact of a short rest after lunch on hemodynamics as assessed by Doppler sonography

PURPOSE

Taking a short rest after lunch suppresses increases in blood flow to the digestive organs and maintains blood flow to the brain in the afternoon, possibly providing beneficial effects in preventing post-prandial drowsiness. The present study investigated sex-dependent influences on changes in hemodynamics produced by taking a short rest after lunch.

METHODS

Subjects comprised 20 healthy young adults (10 men, 10 women; mean age 21 ± 1 years). Doppler sonography was performed to measure blood flow in the superior mesenteric artery (SMA) and common carotid artery (CCA) before and after lunch every hour on each day, with and without a 15-min rest with eyes closed after lunch. Blood pressure and heart rate (HR) were also measured.

RESULTS

For both men and women, peak systolic velocity (PSV) in the SMA was suppressed by taking a rest. PSV in the CCA in men was increased at 0.5 h after lunch in the resting condition but was decreased in the non-resting condition (median 109%, interquartile range [IQR] 102-120% vs. median 98%, IQR 90-107%; P = 0.037). No such differences were observed in women. Although post-prandial increases in HR were observed in women, a similar increase was only found for men in the resting condition.

CONCLUSION

An increase in CCA blood flow was observed only in men. The present study suggests that a short rest after lunch could better promote the maintenance of blood flow to the brain in men than in women.

Fit accuracy in the rest region of RPDs fabricated by digital technologies and conventional lost-wax casting: a systematic review and meta-analysis

BACKGROUND

Digital technologies have recently been introduced into the fabrication of removable partial dentures (RPDs). However, it is still unclear whether the digitally fabricated RPDs fit better than conventionally cast ones in the rest region. The aim of this study was to evaluate the fit accuracy in the rest region of RPDs fabricated by digital technologies and compare it to those made by conventional lost-wax (CLW) technique.

METHODS

A comprehensive search was conducted in Cochrane Library, PubMed, EMbase, Web of Science and SpringerLink. Studies published up to August 2022 were collected. Two authors analyzed the studies independently and assessed the risk of bias on the modified methodological index for non-randomized studies (MINORS) scale. The mean values of gap distance between rests and corresponding rest seats of each study were extracted as outcome. A random-effects model at a significance level of P < 0.05 was used in the global comparison and subgroup analysis was carried out.

RESULTS

Overall, 11 articles out of 1214 complied with the inclusion criteria and were selected, including 2 randomized controlled trials (RCTs), 1 non-randomized clinical trial and 8 in vitro studies. Quantitative data from Meta-analysis revealed that fit accuracy in the rest region of RPDs fabricated with CLW showed no statistically significant difference with digital techniques (SMD = 0.33, 95%CI (-0.18, 0.83), P = 0.21). Subgroup analysis revealed a significantly better fit accuracy of CLW-fabricated RPDs in the rest region than either additive manufacturing (AM) groups or indirect groups (P = 0.03, P = 0.00), in which wax or resin patterns are milled or printed before conventional casting. While milled RPDs fit significantly better than cast ones in the rest region (P = 0.00). With digital relief and heat treatment, hybrid manufactured (HM) clasps obtained better fit accuracy in the rest region (P < 0.05). In addition, finishing and polishing procedure had no significant influence in the fit accuracy in all groups (P = 0.83).

CONCLUSIONS

RPDs fabricated by digital technologies exhibit comparable fit accuracy in rest region with those made by CLW. Digital technologies may be a promising alternative to CLW for the fabrication of RPDs and additional studies are recommended to provide stronger evidence.

TRIAL REGISTRATION

CRD42020201313.

MicroRNA biogenesis machinery activation and lncRNA and REST overexpression as neuroprotective responses to fight inflammation in the hippocampus

Brain Long non-coding RNA (lncRNA) and microRNAs (miRs) play essential roles in the regulation of several important biological processes, including neuronal activity, cognitive processes, neurogenesis, angiogenesis, and neuroinflammation. In this context, the transcriptional repressor, RE1 silencing transcription factor (Rest), acts regulating the expression of neuronal genes as well as of lncRNAs and multiple miRNAs in the central nervous system. Nevertheless, its role in neuroinflammation was less explored. Here, we demonstrate, using an in vivo model of neuroinflammation induced by i.p. injection of LPS (0.33 mg/kg), that neuroinflammation increases gene expression of pro-inflammatory cytokines concomitant with the native and truncated forms of Rest and of non-coding RNAs. Additionally, the increased expression of enzymes Drosha ribonuclease III) (Drosha), Exportin 5 (Xpo5) and Endoribonuclease dicer (Dicer), associated with high expression of neuroprotective miRs 22 and 132 are indicative that the activation of biogenesis of miRs in the hippocampal region is a Central Nervous System (CNS) protective mechanism for the deleterious effects of neuroinflammation. Our results indicate that positive regulation of Rest gene expression in the hippocampal region by neuroinflammation correlates directly with the expression of miRs 22 and 132 and inversely with miR 335. In parallel, the confirmation of the possible alignment between the lncRNAs with miR 335 by bioinformatics corroborates with the sponge effect of Hottip and Hotair hybridizing and inhibiting the pro-inflammatory action of miR 335. This suggests the existence of a possible correlation between the activation of miR biogenesis machinery with increased expression of the transcription factor Rest, contributing to neuroprotection.

Will the real resource theory please stand up! Vigilance is a renewable resource and should be modeled as such

The vigilance decrement or decline in signal detection performance with time on task is one of the most reliable findings in the cognitive neuroscience and psychology literatures. The majority of theories proposed to explain the decrement are limited cognitive or attention resource based theories; the central nervous system is a limited capacity processor. The decrement in performance is then due to resource reallocation (or misallocation), resource depletion or some combination of both mechanisms. The role of resource depletion, in particular, is hotly debated. However, this may be due to a lack of understanding of the renewable nature of the vigilance resources and how this renewal process impacts performance during vigilance tasks. In the present paper, a simple quantitative model of vigilance resource depletion and renewal is described and shown to generate performance data similar to results seen in both humans and spiders. This model clarifies the role resource depletion and resource renewal may play in vigilance in both people and other animals.

Effect of Acoustic fMRI-Scanner Noise on the Human Resting State

Our knowledge about the human resting state is predominantly based on either electroencephalographic (EEG) or functional magnetic resonance imaging (fMRI) methods. While EEG recordings can be performed in seated posture in quiet conditions, the fMRI environment presents a substantial contrast with supine and restricted posture in a narrow tube that is filled with acoustic scanner noise (ASN) at a chainsaw-like volume level. However, the influence of these diverging conditions on resting-state brain activation is neither well studied nor broadly discussed. In order to promote data as a source of sharper hypotheses for future studies, we investigated alterations in EEG-frequency-band power (delta, theta, alpha, beta, gamma) and spatial power distribution as well as cortical vigilance measures in different postures and ASN surroundings over the course of time. Participants (N = 18) underwent three consecutive resting-state EEG recordings with a fixed posture and ASN setting sequence; seated, supine, and supine with ASN (supnoise) using an MRI simulator. The results showed that compared to seated, supnoise, the last instance within the posture sequence, was characterized by lower power and altered spatial power distribution in all assessed frequency bands. This might also have been an effect of time alone. In delta, theta, alpha, and beta, the power of supnoise was also reduced compared to supine, as well as the corresponding distribution maps. The vigilance analysis revealed that in supine and supnoise, the highest and lowest vigilance stages were more dominant compared to the seated and earliest posture condition within the sequence. Hence, our results demonstrate that the differences in recording settings and progress of time are related to changes in cortical arousal and vigilance regulation, findings that should be taken into account more profoundly for hypothesis generation as well as analytic strategies in future resting-state studies.

"You feel different in your body": Experiences of fatigue among children undergoing radiotherapy for cancer treatment

PURPOSE

The aim of this research is to examine the experience and impact of radiotherapy related fatigue in children diagnosed with solid tumours.

DESIGN AND METHODS

Children (n = 25) and parents (n = 19) participated in a semi-structured interview on the last week of radiotherapy treatment. The study sample included children who were 6 to 14 years of age, diagnosed with brain or solid tumour, and received radiotherapy as part of their treatment protocol over the period of 6 weeks. Interpretation of data was undertaken through the adoption of thematic analysis approach.

RESULTS

Data revealed children's experience and response to fatigue while undergoing radiotherapy. Several recurring themes arose about their experience of fatigue/tiredness while undergoing radiotherapy. Two themes and eight sub themes, namely 'Experience of Fatigue' ("You feel Different in your body", Mood and Feeling, Activity and Occurrence) and 'Response to Fatigue' (Rest and Sleep, Activity, Mood and Concentration and Eating Habit) were identified.

CONCLUSIONS

The findings illustrated significant fatigue on activity sleep, rest and mood of children undergoing radiotherapy.

PRACTICE IMPLICATIONS

Monitoring and addressing fatigue and its consequences during radiotherapy treatment are essential to improve well-being of children with cancer.

Pre-cooling with ingesting a high-carbohydrate ice slurry on thermoregulatory responses and subcutaneous interstitial fluid glucose during heat exposure

The purpose of this study was to compare the effects of ingesting ice slurries with two different carbohydrate contents on body temperatures and the subcutaneous interstitial fluid glucose level during heat exposure. Seven physically active men underwent one of three interventions: the ingestion of 7.5 g/kg of a control beverage (CON: 26°C), a normal-carbohydrate ice slurry (NCIS: −1°C), or a high-carbohydrate ice slurry (HCIS: −5°C). The participants were monitored for a 120-min period that included 10 min of rest, 25 min of exposure to the experimental cooling intervention (during which the beverage was ingested), and 85 min of seated rest in a climate chamber (36°C, 50% relative humidity). The rectal temperature in the HCIS and NCIS trials was lower than that in the CON trial from 40 to 75 min. The infrared tympanic temperature was also lower in the HCIS and NCIS trials than in the CON trial from 20 to 50 min, whereas the deep thigh or mean skin temperatures were not significantly different among the three groups. From 90 to 120 min, the subcutaneous interstitial fluid glucose level in the NCIS trial was lower than that at 65 min; however, reductions were not seen in the HCIS and CON trials. These findings suggest that both HCIS ingestion and conventional NCIS ingestion were effective cooling strategies for reducing thermal strain, while HCIS ingestion may also enable a higher subcutaneous interstitial fluid glucose level to be maintained, ensuring an adequate supply of required muscle substrates.

Real-time and Recursive Estimators for Functional MRI Quality Assessment

Real-time quality assessment (rtQA) of functional magnetic resonance imaging (fMRI) based on blood oxygen level-dependent (BOLD) signal changes is critical for neuroimaging research and clinical applications. The losses of BOLD sensitivity because of different types of technical and physiological noise remain major sources of fMRI artifacts. Due to difficulty of subjective visual perception of image distortions during data acquisitions, a comprehensive automatic rtQA is needed. To facilitate rapid rtQA of fMRI data, we applied real-time and recursive quality assessment methods to whole-brain fMRI volumes, as well as time-series of target brain areas and resting-state networks. We estimated recursive temporal signal-to-noise ratio (rtSNR) and contrast-to-noise ratio (rtCNR), and real-time head motion parameters by a framewise rigid-body transformation (translations and rotations) using the conventional current to template volume registration. In addition, we derived real-time framewise (FD) and micro (MD) displacements based on head motion parameters and evaluated the temporal derivative of root mean squared variance over voxels (DVARS). For monitoring time-series of target regions and networks, we estimated the number of spikes and amount of filtered noise by means of a modified Kalman filter. Finally, we applied the incremental general linear modeling (GLM) to evaluate real-time contributions of nuisance regressors (linear trend and head motion). Proposed rtQA was demonstrated in real-time fMRI neurofeedback runs without and with excessive head motion and real-time simulations of neurofeedback and resting-state fMRI data. The rtQA was implemented as an extension of the open-source OpenNFT software written in Python, MATLAB and C++ for neurofeedback, task-based, and resting-state paradigms. We also developed a general Python library to unify real-time fMRI data processing and neurofeedback applications. Flexible estimation and visualization of rtQA facilitates efficient rtQA of fMRI data and helps the robustness of fMRI acquisitions by means of substantiating decisions about the necessity of the interruption and re-start of the experiment and increasing the confidence in neural estimates.

In-depth molecular analysis of combined and co-primary pulmonary large cell neuroendocrine carcinoma and adenocarcinoma

Up to 14% of large cell neuroendocrine carcinomas (LCNECs) are diagnosed in continuity with nonsmall cell lung carcinoma. In addition to these combined lesions, 1% to 7% of lung tumors present as co-primary tumors with multiple synchronous lesions. We evaluated molecular and clinicopathological characteristics of combined and co-primary LCNEC-adenocarcinoma (ADC) tumors. Ten patients with LCNEC-ADC (combined) and five patients with multiple synchronous ipsilateral LCNEC and ADC tumors (co-primary) were included. DNA was isolated from distinct tumor parts, and 65 cancer genes were analyzed by next generation sequencing. Immunohistochemistry was performed including neuroendocrine markers, pRb, Ascl1 and Rest. Pure ADC (N = 37) and LCNEC (N = 17) cases were used for reference. At least 1 shared mutation, indicating tumor clonality, was found in LCNEC- and ADC-parts of 10/10 combined tumors but only in 1/5 co-primary tumors. A range of identical mutations was observed in both parts of combined tumors: 8/10 contained ADC-related (EGFR/KRAS/STK11 and/or KEAP1), 4/10 RB1 and 9/10 TP53 mutations. Loss of pRb IHC was observed in 6/10 LCNEC- and 4/10 ADC-parts. The number and intensity of expression of Ascl1 and neuroendocrine markers increased from pure ADC (low) to combined ADC (intermediate) and combined and pure LCNEC (high). The opposite was true for Rest expression. In conclusion, all combined LCNEC-ADC tumors were clonally related indicating a common origin. A relatively high frequency of pRb inactivation was observed in both LCNEC- and ADC-parts, suggesting an underlying role in LCNEC-ADC development. Furthermore, neuroendocrine differentiation might be modulated by Ascl1(+) and Rest(-) expression.

The Ability to Rest at Home During COVID-19 Symptom Manifestation and Depressive Symptoms: Evidence From Korea

OBJECTIVE

This study investigated the association between ability to rest at home in times of coronavirus disease 2019 (COVID-19) symptom manifestation and depressive symptoms.

METHODS

The 2020 Korea Community Health Survey data were used. The presence of depressive symptoms was determined using the Patient Health Questionnaire-9. The relationship between depressive symptoms and ability to rest at home was examined using logistic regression analysis. Additional analysis was performed on the reasons for the inability to stay at home.

RESULTS

Depressive symptoms were more common in participants who could not rest at home if symptoms manifested (4.1%) than those who could rest at home (2.7%). Participants who could not rest at home (OR 1.53, 95% CI 1.34-1.74) were more likely to have depressive symptoms, particularly when they had to report to work (OR 1.50, 95% CI 1.30-1.74) or purchase daily necessities (OR 2.40, 95% CI 1.15-5.03).

CONCLUSION

Inability to rest at home in the case of COVID-19 symptom manifestation was associated with depressive symptoms. The findings suggest the need to address the identified vulnerable groups to mitigate the mental health consequences of the pandemic.

How does the All-Star break affect injury rates in professional baseball?

Background

Injury rates in professional baseball players are increasing. It is unclear if the time of rest from the All-Star break affects injury risk.

Methods

Every professional baseball game (A-, A+, AA, AAA, and Major League Baseball) played between 2011 and 2017 was included. Each game was then classified as control game (games played in April, May, June, and September) or game within one month after the All-Star break. Incidence of injuries in games within one month of the All-Star break was compared with the control games.

Results

Our analysis included 66,642 games: 46,630 control games and 20,012 games played within one month after the All-Star break. On univariate analysis, there was a mean ± standard deviation of 0.45 ± 0.72 injuries per game in control games and 0.41 ± 0.68 injuries per game in games played within one month after the All-Star break (P<.001). On multivariate analysis, there was a significant association between games played within one month after the All-Star break and number of injuries per game (P<.001) after adjusting for the level of play and game duration. However, the effect size was 0.001, suggesting this effect is clinically insignificant.

Conclusion

There does not appear to be a clinically significant difference in injury rates per game in professional baseball players between games played in the month after the All-Star break and all other games played during the season. Although the All-Star break provides most players with a chance to rest, it does not appear to have an effect on injury rates.

Possible effects of short rest after lunch on hemodynamics in the afternoon

PURPOSE

Drowsiness is often experienced in the afternoon after lunch. Decreases in blood flow to the brain secondary to increases in blood flow to the digestive organs after food intake could represent an underlying cause. As various beneficial effects of short rests on mental activities have been reported, the present study investigated hemodynamics using Doppler sonography of the common carotid artery (CCA) and superior mesenteric artery (SMA) after lunch, comparing resting and non-resting cases.

METHODS

Subjects comprised 24 healthy young adults (10 men, 14 women; mean age 22 ± 1 years). Sonography was performed to measure blood flow before and after lunch on each day, with and without a 15-min lying rest with eyes closed after lunch in each subject.

RESULTS

The timing of the peak velocity-time integral in the SMA in resting cases was delayed to 1.5 h after lunch compared to 0.5 h in non-resting cases. Although end-diastolic velocity in the CCA decreased after lunch, this decrease was suppressed in resting cases compared to non-resting cases even 4.5 h after lunch (median 96%, interquartile range [IQR] 83-102% vs. median 87%, IQR 77-92%; P = 0.037). Mean velocity (MV) in the CCA maintained unchanged after lunch in resting cases (P = 0.318), whereas non-resting cases showed decreased MV after lunch (P < 0.001).

CONCLUSION

These findings suggest that a short lying rest with eyes closed suppresses increases in blood flow to the digestive organ and maintains blood flow to the brain after lunch. These hemodynamic changes might help explain the benefits of afternoon rests.

Different Resting Methods in Improving Laypersons Hands-Only Cardiopulmonary Resuscitation Quality and Reducing Fatigue: A Randomized Crossover Study

Objective

To determine the effects of different resting methods with various rest-start points or rest-compression ratios on improving cardiopulmonary resuscitation (CPR) quality and reducing fatigue during continuous chest compressions (CCC) in 10-min hands-only CPR scenario.

Methods

This prospective crossover study was conducted in 30 laypersons aged 18-65. Trained participants were randomized to follow different orders to perform following hands-only CPR methods: (1) CCC, 10-min CCC; (2) 4+6, 4-min CCC + 6-min of 10-s pause after 60-s compressions; (3) 2+8 (10/60), 2-min CCC + 8-min of 10-s pause after 60-s compressions; (4) 5/30, 2-min CCC + 8-min of 5-s pause after 30-s compressions; (5) 3/15, 2-min CCC + 8-min of 3-s pause after 15-s compressions. CPR quality (depth, rate, hands-off duration, chest compression fraction (CCF)) and participants’ fatigue indicators (heart rate, blood pressure, rating of perceived exertion (RPE)) were compared among methods of different rest-start points and different rest-compression ratios with CCC.

Results

Twenty-eight participants completed all methods. All resting methods reduced the trend of declining compression depth and the trend of increasing RPE while maintaining CCF of more than 86%. In methods with different rest-start points, the 2+8 method showed no difference in overall CPR quality or fatigue, but better CPR quality of every minute than 4+6 method. In methods with different rest-compression ratios, the 3/15 method showed the best CPR quality and the highest heart rate increment.

Conclusion

During prolonged hands-only CPR, appropriate transient rests were associated with higher CPR quality and lower subjectively perceived fatigue in laypersons.

Treatment of perioperative swelling by rest, ice, compression, and elevation (RICE) without and with additional application of negative pressure (RICE+) in patients with a unilateral ankle fracture: study protocol for a monocentric, evaluator-blinded randomized controlled pilot trial

Background

Edema is commonly seen after surgical fixation of ankle fractures. Rest, ice, compression, and elevation (RICE) is an established combination to prevent swelling but hardly able to stimulate lymphatic resorption. Recently, an epicutaneously applied negative pressure suction apparatus (LymphaTouch®) has been introduced to stimulate lymphatic flow. While postoperative recovery, soft tissue, and osseous healing as well as functional outcome are probably linked to the amount of postoperative swelling, estimates on this relative to prevention (RICE) or prevention + stimulated resorption (RICE⁺) of fluid are scarce.

Methods and analysis

This is a single-center, evaluator-blinded randomized pilot trial to investigate postoperative swelling in adults requiring surgical fixation of a closed unilateral ankle fracture. A total of 50 patients will be recruited and randomly assigned to RICE or RICE⁺ prior to surgery. All patients will undergo evaluator-blinded measurements of the ankle volume the day before surgery and subsequently from the evening of the 2nd postoperative day every 24 h until discharge. RICE will be initiated right after surgery and continued until discharge from the hospital in all patients. Additional application of negative pressure therapy (RICE⁺) will be initiated on the morning of the 2nd postoperative day and repeated every 24 h until the time of discharge from the hospital. Outcome measures are (i) the relative amount and the time course of the postoperative swelling, (ii) the demand for analgesic therapy (type and amount) together with the perception of pain, (iii) the rate of complications, and (iv) mobility of the ankle joint and the recovery of walking abilities during a 12-weeks follow-up period. Serum and urine samples taken prior to sugery and during postoperative recovery will allow to evaluate the ratio of naturally occurring stable calcium isotopes (δ^44/42Ca) as a marker of skeletal calcium accrual.

Ethics and dissemination

The protocol was approved by the institutional Ethics Committee (Rostock University Medical Center, Rostock, Germany) in accordance with the Declaration of Helsinki (approval number: A 2020-0092). The results of this study will be actively disseminated through scientific publications and conference presentations.

Trial registration

DRKS, DRKS00023739. Registered on 14 December 2020

Resting-State Low-Frequency Cerebellar Oscillations Can Be Abnormal in Parkinson's Disease

Recent anatomical studies have shown connections between the basal ganglia and the cerebellum. The basal ganglia and cerebellum are major subcortical structures that influence motor and cognitive functions. Recent neuroimaging and animal studies have suggested the role of the cerebellum in the pathophysiology of Parkinson's disease. However, the role of cerebellar oscillations in PD has not been studied. Here, we recruited 75 PD and 39 healthy control subjects to collect cerebellar EEG during a resting-state condition. We followed the recently published protocols to collect cerebellar oscillations. Relative spectral power was computed in the delta, theta, beta, and gamma frequency bands. Further, we performed classifier methods to differentiate PD subjects from controls. We observed significantly increased theta-band (4-7 Hz) relative power in the cerebellar electrodes in PD subjects compared to controls. We also found differences in different frequency bands between mid-cerebellar and nearby mid-occipital EEG signals. Classification analysis using mid-cerebellar theta relative power showed differentiation between PD and control groups. Our results demonstrate that in addition to established cortical and basal ganglia oscillations, abnormal cerebellar oscillations in the theta-band may also participate in the underlying pathophysiology of PD. We suggest that low-frequency cerebellar oscillations may be a potential target for non-invasive neuromodulation to improve PD symptoms.

Can the training regimen influence night time physical activity in racehorses?

Physical activity has been widely investigated in horses to elucidate locomotion characteristics and behavior. However, research in real environment of training stables is limited. The objective of this study was to evaluate the effect of training regimen on night time physical activity of racehorses. Physical activities of twenty animals were monitored during the night time using accelerometers. The animals were compared in terms of training regimen: horses subjected to training on continual days, and horses subjected to training on intermittent days; age and sex were also considered. The variables analyzed were: counts per minute, percentage of time in (sedentary, light, moderate and vigorous) physical activity. Statistical analysis was performed by the PROCGLM procedure (ANOVA) and the means were calculated by Tukey's test. The training regimen impacts the physical activity of thoroughbreds. The mean counts per minute showed a higher physical activity in the intermittent trained animals in relation with continuously trained animals. The continuously trained animals presented a greater percentage of time in sedentary physical activity than those intermittent trained. However, intermittently trained horses spent a larger percentage of time in moderate and vigorous physical activity, in comparison with continuously trained animals. In conclusion, racehorses subject to training on continual days have lower physical activity in the night time than those that train on intermittent days.

Immediate Changes and Recovery of the Supraspinatus, Long Head Biceps Tendon, and Range of Motion after Pitching in Youth Baseball Players: How Much Rest Is Needed after Pitching? Sonoelastography on the Supraspinatus Muscle-Tendon and Biceps Long Head Tendon

Backgroud

Baseball players are subjected to repeated loads on the supraspinatus and long head biceps tendon from youth, and repetitive pitching motions can cause shoulder injuries. The purpose of this study was to evaluate the immediate changes caused by pitching in the supraspinatus muscle-tendon, long head of the bicep tendon (LHBT), and shoulder range of motion (ROM) and to verify their recovery over time in youth baseball players.

Methods

Fifteen youth baseball players (mean age, 11.5 ± 1.3 years) were enrolled. The thicknesses of the supraspinatus tendon and LHBT and the strain ratios (SRs) of supraspinatus muscle and tendon were measured by sonoelastography. ROMs of shoulder joints (abduction, external rotation at 90° of abduction [ABER], and internal rotations at 90° of abduction [ABIR]) and horizontal adduction (HA) were measured using a goniometer. All measurements were performed on the throwing shoulders before and immediately after pitching (mean pitch count, 78.3 ± 13.3) and at 30 minutes, 24 hours, and 72 hours after pitching.

Results

The thickness of supraspinatus tendon (6.64–6.27 mm, p = 0.026) and that of LHBT (2.56–2.26 mm, p = 0.021) significantly decreased immediately after pitching. The SRs of supraspinatus muscle tended to decrease, whereas SRs of supraspinatus tendon tended to increase immediately after pitching. ABER increased (119.7°–127.3°, p = 0.001) and HA decreased (34.7°–29.3°, p = 0.023) immediately after pitching. All immediate changes recovered 72 hours after pitching.

Conclusions

The immediate effects of pitching on the supraspinatus muscle-tendon, LHBT, and shoulder ROM in youth baseball players were confirmed in the current study. These changes were recovered to pre-pitch levels 72 hours after pitching. Therefore, we recommend that youth baseball players should rest for three days after pitching to minimize the risk of shoulder injury.

The role of the anterior nuclei of the thalamus in human memory processing

Extensive neuroanatomical connectivity between the anterior thalamic nuclei (ATN) and hippocampus and neocortex renders them well-placed for a role in memory processing, and animal, lesion, and neuroimaging studies support such a notion. The deep location and small size of the ATN have precluded their real-time electrophysiological investigation during human memory processing. However, ATN electrophysiological recordings from patients receiving electrodes implanted for deep brain stimulation for pharmacoresistant focal epilepsy have enabled high temporal resolution study of ATN activity. Theta frequency synchronization of ATN and neocortical oscillations during successful memory encoding, enhanced phase alignment, and coupling between ATN local gamma frequency activity and frontal neocortical and ATN theta oscillations provide evidence of an active role for the ATN in memory encoding, potentially integrating information from widespread neocortical sources. Greater coupling of a broader gamma frequency range with theta oscillations at rest than during memory encoding provides additional support for the hypothesis that the ATN play a role in selecting local, task-relevant high frequency activity associated with particular features of a memory trace.

Comparing the effect of daytime sleep and wakefulness on mnemonic discrimination

Sleep is considered the optimal state to consolidate hippocampal-dependent memories. A particular memory process is mnemonic discrimination. Mnemonic discrimination refers to the ability to differentiate between novel and previously encountered information. Previous studies have found that mnemonic discrimination is impaired by sleep deprivation, whereas nocturnal sleep seems to protect memory representations when compared to a similar period of wakefulness. In this study we tested whether a daytime nap can facilitate mnemonic discrimination as assessed by the Mnemonic Similarity Task. Thirty-eight participants performed incidental learning of 256 images of unique everyday items at about 12:00 PM. Fifteen minutes later, in a recognition test, they were presented with 192 images: 64 targets (Old), 64 foils (New) and 64 lures (Similar to targets). For each image they had to decide whether it was already presented, never presented, or similar to an image presented during the encoding session. Then participants were split into a Nap group (N=19), who had a 90-min nap opportunity in the lab, and a Wake group (N=19), who stayed in the lab playing a low-arousing game. At 3:00 PM all participants performed a delayed recognition test, similar to the immediate test but with different images. Similar memory discrimination was observed in both the Nap and Wake group. The lack of a beneficial effect of sleep could be due to the differences between diurnal and nocturnal sleep and/or the potential role of videogames in facilitating memory discrimination during wakefulness.

Serial prolactin sampling as a confirmatory test for true hyperprolactinemia

INTRODUCTION

Hyperprolactinemia may be due to physiological or pathological causes, and may be asymptomatic or induce hypogonadism, infertility, and/or galactorrhea. It is important to take prolactin samples while avoiding stress, as this may increase prolactin levels. Therefore, our aim was to assess the value of prolactin serial sampling after brachial vein cannulation.

PATIENTS AND METHODS

Sixty-six patients (34.9±11.8 years of age, 92.4% female) with an initial elevated random prolactin level were included. A prolactin sample was drawn at baseline and after a 30min rest.

RESULTS

The median referral prolactin level was 37.4ng/ml (interquartile range [IQR* 23.3), the baseline prolactin level at serial sampling was 19.5ng/ml (IQR 8), and the value after a 30min rest was 17.1ng/ml (IQR 7.9). Hyperprolactinemia was not confirmed by serial sampling in 45 patients (68.2%). There were no statistically significant differences in referral prolactin levels between patients with and without confirmed hyperprolactinemia (41.2ng/ml and 36.7ng/ml respectively, p=0.3). Galactorrhea was found in 13.6% of patients, amenorrhea or oligomenorrhea in 28.8%, infertility in 7.6%, erectile dysfunction in 4.6%, and gynecomastia in 3%, while 45.5% were asymptomatic. There were no statistical differences regarding the presence or absence of any of these symptoms and subsequent confirmed hyperprolactinemia. Fifty-seven patients (86.4%) were discharged after the results of the prolactin serial sampling were obtained.

CONCLUSIONS

Prolactin serial sampling may be a useful test to detect artefactual hyperprolactinemias, thus avoiding unnecessary additional tests and treatments.

Questions and controversies in the study of time-varying functional connectivity in resting fMRI

The brain is a complex, multiscale dynamical system composed of many interacting regions. Knowledge of the spatiotemporal organization of these interactions is critical for establishing a solid understanding of the brain's functional architecture and the relationship between neural dynamics and cognition in health and disease. The possibility of studying these dynamics through careful analysis of neuroimaging data has catalyzed substantial interest in methods that estimate time-resolved fluctuations in functional connectivity (often referred to as "dynamic" or time-varying functional connectivity; TVFC). At the same time, debates have emerged regarding the application of TVFC analyses to resting fMRI data, and about the statistical validity, physiological origins, and cognitive and behavioral relevance of resting TVFC. These and other unresolved issues complicate interpretation of resting TVFC findings and limit the insights that can be gained from this promising new research area. This article brings together scientists with a variety of perspectives on resting TVFC to review the current literature in light of these issues. We introduce core concepts, define key terms, summarize controversies and open questions, and present a forward-looking perspective on how resting TVFC analyses can be rigorously and productively applied to investigate a wide range of questions in cognitive and systems neuroscience.

Estimation of Heat Stress and Maximum Acceptable Work Time Based on Physiological and Environmental Response in Hot-Dry Climate: A Case Study in Traditional Bakers

Background:

Heat stress is common among workers in hot-dry areas. To take preventive strategies for the protection of workers against heat stress, it is important to choose a suitable index that can accurately explain environmental parameters relative to physiological responses.

Objective:

To evaluate heat stress and maximum acceptable work time (MAWT) based on physiological and environmental response in hot-dry climate among traditional bakers.

Methods:

The current study was carried out on 30 traditional bakers of 3 different bread baking systems in Ahvaz, Iran. Environmental and physiological parameters were measured simultaneously for a work shift. The work-rest time was also determined based on the relative heart rate (RHR) and the wet-bulb globe temperature (WBGT) index.

Results:

The average WBGT index was estimated to be higher than the standard limit for all baking stations. Despite the higher-than-the-recommended-limit WBGT index, there was no significant relationship between the WBGT index and physiological parameters. The results indicated a significant (p<0.05) difference between the percentages of work-rest time estimated using the WBGT and RHR index.

Conclusion:

Based on the results of environmental and physiological monitoring of this study as well as the limitations of the use of the WBGT index, it seems that using WBGT as a standard index would not suit heat stress management in hot-dry climates. A revision of this standard to adapt to hot climatic conditions should be in order.

[Experience of "Descansos activos mediante ejercicio (¡Dame 10!)" program implementation in high school.]

OBJECTIVE

Several studies show the benefits of physical activity-based breaks programs for Pre-school and Elementary School students and their effectiveness to increase the amount of physical activity done during school hours. However, these programs are not intended for High School students. The objective of this study was to implement "¡Dame10!" program with a High School group of students and to assess the results.

METHODS

"¡Dame 10!" activities were designed and enforced at first High School grade during four weeks at a private school of Preschool, Primary and Secondary Education located in San Cristóbal de la Laguna. 54 students and 9 teachers took part. Several surveys were fulfilled to determine participants' assessment about programs' benefits and opinion through the QuickTapSurvey® web application, from which the results were obtained automatically in the form of percentages.

RESULTS

The number of participants' physical activity during school hours increased by 50%. 75.8% of the students felt more active, 58.5% more motivated and 51% showed a better attitude after the activities. 87.5% of teachers considered possible the daily implementation of "¡Dame 10!".

CONCLUSIONS

"¡Dame 10!" was effective to increase the amount of physical activity students do during class schedule and provided additional benefits related to attitude and behaviour in the classroom. Likewise, both teachers and students considered possible its application in High School.

Immediate effects of rest periods on balance control in patients after stroke. A randomized controlled pilot trial

Objectives

This randomized controlled trial evaluates the effects of two different rest periods between as set of balance exercises after stroke during inpatient rehabilitation.

Results

Twenty patients after stroke [11 males; mean (SD) age 65.4 (11.5) years; duration of illness 5.3 (3.4) weeks; 16 (80%) left-sided strokes] were randomly allocated into two groups of either a full rest (FR) of 4 min (n = 10) or a short rest (SR) of 1 min between exercise sets (n = 10). Patients improved from baseline until immediately after exercises in one-leg standing time on the affected leg [SR: mean difference 5.1 s (SD 10.3) and FR: 2.0 s (2.4)] and tandem standing time (TST). [SR: 14.9 s (SD 24.6) and FR: 5.7 s (12.0)], but OLST and TST did not differ significantly between groups (p = 0.35 and p = 0.52, respectively).

Trial registration The study was registered retrospectively in the German Register of Clinical Trials with the ID: DRKS00013979

Electronic supplementary material

The online version of this article (10.1186/s13104-018-3450-2) contains supplementary material, which is available to authorized users.