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Prehospital Cardiopulmonary Resuscitation in Patients with Suspected Severe Traumatic Brain Injury:A BRAIN PROTECT Sub-Analysis
No full text Background/Objectives: Severe traumatic brain injury (TBI) carries high mortality, and outcomes are particularly poor when prehospital cardiopulmonary resuscitation (CPR) is required. Because these patients are often excluded from research, epidemiological data and prognostic insights are limited. This study aimed to describe characteristics and outcomes of patients with suspected severe TBI who received prehospital CPR. Methods: We performed a sub-analysis of the prospectively collected multicenter BRAIN-PROTECT registry, including all patients with suspected severe TBI who underwent prehospital CPR and were transported to a participating trauma center. Results: A total of 256 patients with suspected severe TBI who received prehospital CPR were included. Early mortality was high, with 22.6% declared dead in the emergency department and an additional 28.9% within 24 h, resulting in 48.5% 24 h survival. Thirty-day mortality was 79.9%. Among survivors, 45.7% achieved moderate disability or good recovery at discharge. Outcomes, 30-day mortality, and neurological status at discharge did not differ between isolated and non-isolated TBI. Characteristics often seen in survivors included shockable initial rhythm, reactive pupils, and lack of anisocoria. All patients without prehospital return of spontaneous circulation died. Conclusions: Although overall 30-day mortality was high, survival among patients for whom resuscitation was attempted and who reached hospital care was not negligible, and a substantial proportion of the survivors achieved moderate to good neurological recovery. Prehospital ROSC and shockable rhythms were associated with better outcomes, suggesting that resuscitation may be valuable and warranted in selected patients with potentially reversible conditions. Further studies are needed to better define prognostic factors and guide management in this highly vulnerable population. </p
The effect of a familiarization critical speed testing session on critical speed determination during treadmill running
No full textBACKGROUND: The effect of familiarization with the critical speed (CS) testing process on the outcome of CS tests has yet to be determined.OBJECTIVES: The main aims of the present study were to determine whether a familiarization session prior to CS testing sessions affects time to task-failure (TTF) on subsequent tests and CS estimations, and whether individual characteristics such as sex and fitness status influence any familiarization effect.METHODS: 27 healthy adults (10 females, 25 ± 4 yrs) performed the following treadmill protocol: i) a maximal incremental test to identify peak speed; ii) a familiarization constant-intensity trial (CTfam) at the intensity of the first constant-intensity trial used for CS determination (CTCS), and iii) four randomly ordered maximal constant-intensity trials at ~ 85%, 92%, 98%, and 105% of peak speed. CS was estimated using 2-parameter hyperbolic, linear, and 1/time models including the CTfam (CS not familiarized) or the CTCS (CS familiarized). Familiarized and not-familiarized TTFs and CSs were compared using Wilcoxon tests. Sex effect was analyzed using Mann-Whitney test on the difference in the TTF between CTCS and CTfam. The correlation between peak speed and difference in the TTF between CTCS and CTfam was assessed using Spearman's rank correlation. α was set at 0.05.RESULTS: CTfam TTF (399 [299] s, median [interquartile range]) was lower (p = 0.009) than CTCS TTF (495[316] s), whereas CS familiarized and not-familiarized were not different in any model (p > 0.05). Sex did not affect the differences between familiarized and not-familiarized TTFs and CS. However, differences in the TTF between CTCS and CTfam were negatively correlated with peak speed (ρ = -0.381, p = 0.050).CONCLUSIONS: Familiarization with constant-intensity trials affected the TTF but not CS. Importantly, the familiarization effect was larger in less fit individuals, showing a negative correlation between the TTF differences (i.e., CTCS minus CTfam) and peak speed.</p
A Lifespan Perspective on Mentoring:An Examination of Age-Related Antecedents and Differences in Work Outcomes of Mentoring
No full textConsidering the aging workforce, organizations are increasingly seeking human resources practices that leverage older workers’ skills and knowledge while keeping them engaged at work. Mentoring, defined as a developmental relationship in which a more experienced person supports the professional and personal development of a less experienced person, is widely regarded as a promising HR practice in this context. However, age-based assumptions about mentoring have remained largely unexamined, and both theoretical and empirical research have rarely explored how age-related changes influence mentoring processes and outcomes.This dissertation introduces a lifespan model of workplace mentoring, proposing that older workers may be particularly effective mentors due to well-developed emotional competencies and higher levels of generativity (the motive and behavior to support and guide the next generation). It further suggests that providing mentoring may be especially engaging for older workers because of age-related shifts toward prioritizing emotionally meaningful goals, such as generativity. Paths of the proposed model were tested using different research designs, including a systematic literature review, a meta-analysis, and a dyadic study of supervisors and employees.Overall, the findings provided only limited support for the model. A systematic review indicated that older workers may have well-developed emotional competencies, although effect sizes were generally small. The meta-analysis showed a small positive association between age and generativity. Finally, a study with 154 supervisor–employee dyads revealed no age differences in the associations between mentoring and work engagement, suggesting that both mentors and protégés may benefit from mentoring, independent of age
Mild traumatic brain injury at the emergency department:From one-size-fits-all to a patient-centered approach
No full textMild traumatic brain injury (mTBI) is one of the most common injuries seen at the emergency department (ED). Although most patients recover fully, a considerable proportion develop persistent symptoms such as headache, concentration problems, and fatigue, which impact daily functioning and societal participation. Nevertheless, limited evidence exists regarding early interventions aimed at preventing these symptoms.This thesis describes the consequences of mTBI across different patient groups. Older adults are more vulnerable: they more often experience complications such as intracranial hemorrhages and deteriorate more frequently during hospital admission, while their symptoms at the ED are less evident. Therefore, we recommend that, for the time being, older patients with mTBI routinely undergo a head CT scan in the ED.Furthermore, not all patients with mTBI experience the same symptoms or outcomes. Patients presenting with acute neck pain represent a distinct subgroup with more frequent and persistent complaints like dizziness, headache, and neck pain. In addition, patients with a head injury discharged home directly after their ED visit also often report long-term complaints. Risk factors include higher age, acute headache, and physical or mood-related symptoms two weeks after the injury.Interestingly, despite persistent symptoms, both older adults and children often report good long-term quality of life after (m)TBI, a phenomenon known as the ‘disability paradox’.The main conclusion of this thesis is that mTBI is not a uniform condition. Different subgroups have specific risk factors and treatment needs. Future research should therefore focus on subgroup-specific, symptom-oriented interventions rather than a one-size-fits-all approach
Indigenous Language Revitalisation in Central and Southern Chile, and New South Wales, Australia:Language Attitudes, Ideologies, and Digital Technologies
No full textMost Indigenous languages of the world are at risk of disappearing. In many cases, this threat has its origins in the violence of colonisation, which meant Indigenous communities were forcibly uprooted from their lands, impeding the continuity of their cultural traditions, and severely affecting the strength of their languages. Over the last few decades, communities have taken concrete actions to bring their languages back. These efforts can be referred to as Language Revitalisation (LR), a process characterised by actions that promote the use of threatened languages. Within these contexts, Indigenous peoples have taken up digital technologies as part of the resources that can support their LR processes and strengthen their cultural identity.This thesis focuses on the sociolinguistic context of Indigenous communities in central and southern Chile and New South Wales, Australia, to understand their perspectives in relation to their languages, LR processes, and the role digital technologies play. The findings showed that Indigenous communities conceive their language as a shared entity to be taken care of by the entire community. Their LR processes develop as a matter of cultural recovery, and within that process, digital technologies are generally viewed positively as supportive tools for learning, representation, and community connection, though concerns about the misuse of Indigenous cultural knowledge emerge. The discussion offered in this thesis aims to provide insights into how we can best contribute to the future of Indigenous languages in and outside the digital world, and counter the risk of losing such valuable knowledge
Immune Training of the Interleukin 6 Gene in Airway Epithelial Cells is Central to Asthma Exacerbations
No full textQuestion: Epidemiological studies suggest that respiratory viral infections are major triggers of asthma exacerbations, and clinical studies have suggested the involvement of an increased interleukin-6 (IL-6) release. What is the pathophysiological role of IL-6 in asthma exacerbation, and which mechanisms lead to enhanced IL-6 release?.Materials and Methods: Exacerbations of ovalbumin-induced experimental allergic asthma were elicited in wild-type and IL-6-deficient mice by intranasal (i.n.) application of poly(I:C). Airway inflammation, cytokine expression and release, mucus production and airway hyperresponsiveness were measured. IL-6 was neutralised by i.n. anti-IL-6 antibody application. The human bronchial epithelial cell line, BEAS-2B, was stimulated with poly(I:C) and infected with human rhinovirus-16 in vitro, followed by quantification of IL6 gene expression and DNA methylation. Genome-wide DNA methylation was assessed in bronchial epithelial cells from adults with asthma (cohort I, n = 54) and in nasal epithelial cells from children and adults in the All-Age-Asthma cohort (ALLIANCE, n = 53 and n = 108 respectively).Results: Poly(I:C)-induced experimental exacerbations in mice were preceded and paralleled by exaggerated IL-6 release in the airway epithelium, with IL-6 neutralisation completely preventing experimental exacerbations. Repetitive infection/stimulation with RV16 or poly(I:C) resulted in training of the IL-6 release in human respiratory epithelial cells. In patients, hypomethylation at the IL6 gene methylation was associated with high IL6 expression and future exacerbations.Answer: An exaggerated IL-6 release is required for exacerbation of experimental asthma, potentially the result of viral PAMP-induced immune training of airway epithelial cells. Additionally, patients with asthma carrying the epigenetic signature of a trained IL-6 response exacerbate more frequently. These findings open new avenues to identify and treat exacerbation-prone patients.</p
Daily life stress measurement strategies:A scoping review
No full textAim. This scoping review of daily momentary stress measurement studies synthesizes a booming but fragmented field of stress research and introduces the stress MEasurement StrategieS (StressMess) database. Methods. Systematic searches in Web of Science, MEDLINE, and PsycINFO identified studies of (a) stress and psychopathology (e.g., anxiety/depression) using (b) time series or ambulatory assessment designs where (c) stress was measured at least daily on two consecutive days. Results. We identified 12,846 articles and included 721 studies into the StressMess database, of which half in the past five years, typically with larger samples and more frequent measurements than older studies. Most participants were young adults (aged 18-24, M=67% women), from general populations in the US (55%), Germany (7%), and the Netherlands (5%). Stress was often operationalized as a stressor (27%) or stress response to adverse events (33%), and measured as characteristics of events (e.g., type, frequency, predictability, stressfulness, unpleasantness), or general momentaneous or daily stress score (27%), or as stress response via emotions (5%), or physiology (<1%). Some studies (13%) used multiple stress operationalizations. Conclusion. Stress is currently not a useful scientific concept because of the large heterogeneity in definitions, terminology, measurement strategies (instruments), and study design. We provide directions to improve conceptualizations and design for future studies focusing on measuring stress. TheStressMess database is open source (www.stressmess.nl) to improve the understanding, prevention, and treatment of adverse (mental) health effects of stress. Stress measurement influences what stress research can identify and thereby clinical practice
Perceived realism, place attachment, and residents' support and involvement:Towards resident-centric film tourism development
No full textThis study introduces the concept of perceived realism to (film) tourism studies and examines its effect in combination with place attachment on residents' support for and involvement in film tourism development. Partial least squares structural equation modelling (PLS-SEM) and fuzzy-set Qualitative Comparative Analysis (fsQCA) were applied to a sample of 401 Barcelona residents to explore both symmetrical and asymmetrical relationships among the research constructs. The PLS-SEM revealed that events-focused external realism affects residents' support for film tourism development, while narrative realism affects their involvement in film tourism development. In addition, place attachment directly affects residents' support for and involvement in film tourism development. The fsQCA identified asymmetrical configurations among different perceived realism dimensions and place attachment in explaining residents' support for and involvement in film tourism development. The study offers practical implications for local institutional stakeholders, such as the creation of a cultural consultation film hub to get local residents involved
Critical review of partial volume correction methods in PET and SPECT imaging:benefits, pitfalls, challenges, and future outlook
No full textPurpose: Partial volume effects (PVE) remain a major challenge in quantitative single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging, often compromising both accuracy and reproducibility. While numerous Partial Volume Correction (PVC) methods have been proposed, their clinical translation is still limited. This review provides a clinically oriented evaluation of PVC methods with a particular focus on state-of-the-art applications in neurology, cardiovascular imaging, oncology, and radiopharmaceutical therapy dosimetry, highlighting where these techniques offer the greatest added value. In addition, we outline which PVC techniques have the potential to be used in clinical practice and which remain primarily suited for research purposes, along with their suitability in each of the above-mentioned clinical domains. Finally, this review addresses the central question of whether PVC is essential in clinical practice or whether its impact is context dependent.Methods: This review categorizes PVC approaches into three partially overlapping classes: reconstruction-based, post-reconstruction-based, and AI-driven or hybrid methods. Each class is further divided into anatomical and non-anatomical subcategories. We systematically compare their clinical applicability across key dimensions: quantitative accuracy, lesion detectability, robustness to noise and artifacts, anatomical dependence, generalizability across scanners and tracers, and clinical readiness.Results: PVC techniques often improve quantitative accuracy in small structures and in regions affected by spill-over from adjacent high-uptake tissues. However, these benefits can come at the cost of increased noise or edge artifacts, which may limit their robustness for routine clinical use. Post-reconstruction methods are sensitive to segmentation errors, while AI-driven models, despite their promise, require further validation using clinical benchmarks, comparison to ground truth, and testing on diverse datasets. Issues, such as generalizability and interpretability remain significant barriers.Conclusion: This review emphasizes the importance of application-tailored PVC protocols for reliable quantitative imaging in neurology, cardiology, oncology, and radiopharmaceutical therapy dosimetry. Not all PVC methods are beneficial; some may even impair interpretation in certain contexts. We provide a practical overview of which PVC approaches are most beneficial for each clinical scenario, aiming to guide both researchers and clinicians in selecting appropriate techniques for future studies and routine practice, and also outline key areas requiring further development for broader integration into research and clinical workflows.</p
Theta Transcranial Alternating Current Stimulation Over the Dorsomedial Prefrontal Cortex Does Not Enhance Long-Term Memory
No full textLong-term memory (LTM) has been associated with neural oscillation in the theta (3–8 Hz) range. Although previous studies have suggested that the dorsomedial prefrontal cortex (dmPFC) is a core region for LTM retrieval, causal evidence is sparse and mixed. Furthermore, the moderating effects of stimulus memorability have not yet been explored. In the present study, we used transcranial alternating current stimulation (tACS) to modulate theta oscillation in the dmPFC during the retrieval of visual images with varying levels of memorability. Specifically, we included n = 33 healthy volunteers who were exposed to 300 images of faces, scenes and items, which they had to memorize. Recognition accuracy was assessed 1 h later. During the retrieval phase, participants received either sham or verum (4 Hz, 2.5 mA) tACS and were asked whether they had seen the pictures before (150 new and 150 old). Contrary to our preregistered hypotheses, we found no significant effect of 4-Hz tACS applied during retrieval on LTM recognition. Furthermore, although the memorability effect was observed, it did not interact with tACS, indicating that stimulation neither improved nor worsened performance on low- and high-memorable images. Altogether, the present study does not support an active role of 4-Hz oscillations in the dmPFC for the recognition of images with varying levels of memorability, under the specific task and stimulation parameters used here. However, this null effect may be specific to the task and particular parameters used in this study.</p