Effects of local hypothermia-rewarming on physiology, metabolism and inflammation of acutely injured human spinal cord.

In five patients with acute, severe thoracic traumatic spinal cord injuries (TSCIs), American spinal injuries association Impairment Scale (AIS) grades A-C, we induced cord hypothermia (33 °C) then rewarming (37 °C). A pressure probe and a microdialysis catheter were placed intradurally at the injury site to monitor intraspinal pressure (ISP), spinal cord perfusion pressure (SCPP), tissue metabolism and inflammation. Cord hypothermia-rewarming, applied to awake patients, did not cause discomfort or neurological deterioration. Cooling did not affect cord physiology (ISP, SCPP), but markedly altered cord metabolism (increased glucose, lactate, lactate/pyruvate ratio (LPR), glutamate; decreased glycerol) and markedly reduced cord inflammation (reduced IL1β, IL8, MCP, MIP1α, MIP1β). Compared with pre-cooling baseline, rewarming was associated with significantly worse cord physiology (increased ICP, decreased SCPP), cord metabolism (increased lactate, LPR; decreased glucose, glycerol) and cord inflammation (increased IL1β, IL8, IL4, IL10, MCP, MIP1α). The study was terminated because three patients developed delayed wound infections. At 18-months, two patients improved and three stayed the same. We conclude that, after TSCI, hypothermia is potentially beneficial by reducing cord inflammation, though after rewarming these benefits are lost due to increases in cord swelling, ischemia and inflammation. We thus urge caution when using hypothermia-rewarming therapeutically in TSCI

Mild hypothermia delays the development of stone heart from untreated sustained ventricular fibrillation - a cardiovascular magnetic resonance study

<p>Abstract</p> <p>Background</p> <p>'Stone heart' resulting from ischemic contracture of the myocardium, precludes successful resuscitation from ventricular fibrillation (VF). We hypothesized that mild hypothermia might slow the progression to stone heart.</p> <p>Methods</p> <p>Fourteen swine (27 ± 1 kg) were randomized to normothermia (group I; n = 6) or hypothermia groups (group II; n = 8). Mild hypothermia (34 ± 2°C) was induced with ice packs prior to VF induction. The LV and right ventricular (RV) cross-sectional areas were followed by cardiovascular magnetic resonance until the development of stone heart. A commercial 1.5T GE Signa NV-CV/i scanner was used. Complete anatomic coverage of the heart was acquired using a steady-state free precession (SSFP) pulse sequence gated at baseline prior to VF onset. Un-gated SSFP images were obtained serially after VF induction. The ventricular endocardium was manually traced and LV and RV volumes were calculated at each time point.</p> <p>Results</p> <p>In group I, the LV was dilated compared to baseline at 5 minutes after VF and this remained for 20 minutes. Stone heart, arbitrarily defined as LV volume <1/3 of baseline at the onset of VF, occurred at 29 ± 3 minutes. In group II, there was less early dilation of the LV (p < 0.05) and the development of stone heart was delayed to 52 ± 4 minutes after onset of VF (P < 0.001).</p> <p>Conclusions</p> <p>In this closed-chest swine model of prolonged untreated VF, hypothermia reduced the early LV dilatation and importantly, delayed the onset of stone heart thereby extending a known, morphologic limit of resuscitability.</p

Systematic review and meta-analysis of therapeutic hypothermia in animal models of spinal cord injury

Therapeutic hypothermia is a clinically useful neuroprotective therapy for cardiac arrest and neonatal hypoxic ischemic encephalopathy and may potentially be useful for the treatment of other neurological conditions including traumatic spinal cord injury (SCI). The pre-clinical studies evaluating the effectiveness of hypothermia in acute SCI broadly utilise either systemic hypothermia or cooling regional to the site of injury. The literature has not been uniformly positive with conflicting studies of varying quality, some performed decades previously.In this study, we systematically review and meta-analyse the literature to determine the efficacy of systemic and regional hypothermia in traumatic SCI, the experimental conditions influencing this efficacy, and the influence of study quality on outcome. Three databases were utilised; PubMed, ISI Web of Science and Embase. Our inclusion criteria consisted of the (i) reporting of efficacy of hypothermia on functional outcome (ii) number of animals and (iii) mean outcome and variance in each group.Systemic hypothermia improved behavioural outcomes by 24.5% (95% CI 10.2 to 38.8) and a similar magnitude of improvement was seen across a number of high quality studies. The overall behavioural improvement with regional hypothermia was 26.2%, but the variance was wide (95% CI -3.77 to 56.2). This result may reflect a preponderance of positive low quality data, although a preferential effect of hypothermia in ischaemic models of injury may explain some of the disparate data. Sufficient heterogeneity was present between studies of regional hypothermia to reveal a number of factors potentially influencing efficacy, including depth and duration of hypothermia, animal species, and neurobehavioural assessment. However, these factors could reflect the influence of earlier lower quality literature.Systemic hypothermia appears to be a promising potential method of treating acute SCI on the basis of meta-analysis of the pre-clinical literature and the results of high quality animal studies

Inclusion Teaching Style and Modifications in Physical Education

Many children with special educational needs are currently educated in mainstream schools. In Greece, for example, about 5% of the student population who educated in mainstream schools have dyslexia (Vlachos et al. 2013). In this article, modifications on how two Greek educators use the Inclusion teaching style to fully integrate students with dyslexia in regular PE classes are presented. © 2022 SHAPE America

Self-Regulation, Motivation and Teaching Styles in Physical Education Classes: An Intervention Study

The aim of the study was to investigate the influence of student-activated teaching styles through a specific intervention program on students' self-regulation, lesson satisfaction, and motivation. Six hundred and one 7th grade students (318 boys and 283 girls), aged 13 years were randomly assigned to an experimental group and a comparison group. The teachers who taught the students assigned to the experimental group used student-activated teaching styles, and specifically the reciprocal, self-check, inclusion, guided discovery, convergent discovery, and divergent discovery styles. Repeated measures analysis of variance revealed that the experimental group, compared with the comparison group, had higher scores in lesson satisfaction, intrinsic motivation, identified regulation, and metacognitive activities, and lower scores in external motivation, and amotivation. The study revealed that going beyond the command and/or the practice style of teaching, PE teachers can enhance students' metacognitive skills, lesson satisfaction and intrinsic motivation

A tactical-game approach and enhancement of metacognitive behaviour in elementary school students

Background: ‘Teaching games for understanding’ (TGfU) is a tactical-game approach to teaching, in which participants are learning via the processes intrinsic to the games themselves. Purpose: The aim of the study was to examine the effectiveness of a tactical-game model in promoting metacognitive behaviour in elementary-school students. Participants and settings: Seventy-one students aged 11–12 years were randomly assigned to an experimental group (13 boys and 16 girls) and a control group (19 boys and 23 girls). Research design: Teachers in the intervention classes applied the tactical-game approach (TGfU) in teaching volleyball. Within the control group, the technique-focus approach was applied. Data collection: Metacognitive behaviour was assessed pre and post-intervention via think-aloud protocols. Descriptive statistics showed that students from the experimental group made appreciable gains in metacognitive behaviour. Previous to the intervention programme 5.63% of students were categorized as high level in terms of metacognitive behaviour. After the intervention programme 22.53% were categorized at high level. Conclusions: The results imply that the tactical-game approach could improve metacognitive behaviour in physical education classes in elementary school. © 2014 Association for Physical Education

A tactical-game approach and enhancement of metacognitive behaviour in elementary school students

Background: 'Teaching games for understanding' (TGfU) is a tactical-game approach to teaching, in which participants are learning via the processes intrinsic to the games themselves. Purpose: The aim of the study was to examine the effectiveness of a tactical-game model in promoting metacognitive behaviour in elementary-school students. Participants and settings: Seventy-one students aged 11-12 years were randomly assigned to an experimental group (13 boys and 16 girls) and a control group (19 boys and 23 girls). Research design: Teachers in the intervention classes applied the tactical-game approach (TGfU) in teaching volleyball. Within the control group, the technique-focus approach was applied. Data collection: Metacognitive behaviour was assessed pre and post-intervention via think-aloud protocols. Descriptive statistics showed that students from the experimental group made appreciable gains in metacognitive behaviour. Previous to the intervention programme 5.63% of students were categorized as high level in terms of metacognitive behaviour. After the intervention programme 22.53% were categorized at high level. Conclusions: The results imply that the tactical-game approach could improve metacognitive behaviour in physical education classes in elementary school. © 2014 © 2014 Association for Physical Education

Exploring Self-Compassion among Recreational Dancers: Differences Between Tango and Ballet - Dance Teaching Implications Through Somatic and Embodied Disciplines

Self-compassion is considered a protective factor that promotes positive psychology, happiness, emotional regulation and embodiment. Self-compassion offers an approach wherein individuals in dance can pursue optimal participation and performance without compromising health and well-being. The present study aimed to explore self-compassion among recreational dancers and discover possible differences between tango and ballet. More specifically the study examined: i) the levels of self-compassion in recreational tango and ballet dancers; ii) differences in self-compassion according to demographic characteristics; and iii) differences between tango and ballet dancers. The research was based on several adults from various cities in Greece who participated in tango and ballet for recreational reasons during their leisure time. One hundred and ninety-one dancers (20 men and 171 women), between the ages of 17 and 62, completed the self-compassion scale of Mantzios, Wilson and Giannou (2015), which consists of twenty-six items. The answers were given on a five-point Likert scale, while the reliability of the scale was successfully tested. In addition, the questionnaire contained the collection of other data such as demographic characteristics. According to the first aim, the high scores on self-compassion among recreational dancers showed a relationship between self-compassion and dance, and a positive influence of ballet and tango practice. The second hypothesis was partially confirmed as statistically significant differences emerged only between the age groups with those over forty years of age to show higher levels of self-compassion. Regarding the third aim of the research, differences were found between types of dance. Tango participants showed higher levels of self-compassion than ballet participants. Specific dance teaching interventions are discussed based on somatic and embodiment theory, to create healthier mental, emotional and behavioral patterns for dancers, schools, academies or companies. © 2022 Zafeiroudi et al

Comparison of iNOS inhibition by antisense and pharmacological inhibitors after spinal cord injury

Inducible nitric oxide synthase (iNOS) is a key mediator of inflammation during pathological conditions. We examined, through the use of selective iNOS inhibitors, the role of iNOS in specific pathophysiological processes after spinal cord injury (SCI), including astrogliosis, blood-spinal cord barrier (BSCB) permeability, polymorphonuclear leukocyte infiltration, and neuronal cell death. Administration of iNOS antisense oligonucleotides (ASOs) (intraspinally at 3 h) or the pharmacological inhibitors, N-[3(Aminomethyl) benzyl] acetamidine (1400 W) (i.v./i.p. 3 and 9 h) or aminoguanidine (i.p. at 3 and 9 h) after moderate contusive injury decreased the number of iNOS immunoreactive cells at the injury site by 65.6% (iNOS ASOs), 62.1% (1400 W), or 59% (aminoguanidine) 24 h postinjury. iNOS activity was reduced 81.8% (iNOS ASOs), 56.7% (1400 W), or 67.9% (aminoguanidine) at this time. All iNOS inhibitors reduced the degree of BSCB disruption (plasma leakage of rat immunoglobulins), with iNOS ASO inhibition being more effective (reduced by 58%). Neutrophil accumulation within the injury site was significantly reduced by iNOS ASOs and 1400 W by 78.8% and 20.9%, respectively. Increased astrogliosis was diminished with iNOS ASOs but enhanced following aminoguanidine. Detection of necrotic and apoptotic neuronal cell death by propidium iodide and an FITC-conjugated Annexin V antibody showed that iNOS inhibition could significantly retard neuronal cell death rostral and caudal to the injury site. These novel findings indicate that acute inhibition of iNOS is beneficial in reducing several pathophysiological processes after SCI. Furthermore, we demonstrate that the antisense inhibition of iNOS is more efficacious than currently available pharmacological agents