Research Spotlight

Xu, Q., Jiang, M., Gu, S., Zhang, X., Feng, G., Ma, X., Xu, S., Wu, E., Huang, J. H. and Wang, F. (2022). “Metabolomics changes in brain-gut axis after unpredictable chronic mild stress.” Psychopharmacology (Berl) 239(3): 729-743.

Full text of this article.

BACKGROUND: Major depressive disorder is a leading cause of disability worldwide, affecting up to 17 % of the general population. The neural mechanisms of depression, however, are yet to be uncovered. Recently, attention has been drawn to the effects of dysfunctional brain-gut axis on depression, and many substances have been suggested to be involved in the communication between the gut and brain, such as ghrelin. METHODS: We herein systematically examined the changes of metabolomics after unpredictable chronic mild stress (UCMS)-induced depression-like behaviors in rats and compared the altered metabolites in the hippocampus and jejunum samples. RESULTS: Our results show that many metabolites significantly changed with UCMS both in the hippocampus and jejunum, such as L-glutamine, L-tyrosine, hydroxylamine, and 3-phosphoglyceric acid. Further studies suggested that these changes are the reasons for anxiety-like behaviors and depression-like behaviors in UCMS rats and also are the reasons for hippocampal neural plasticity. CONCLUSIONS: Coexistence of brain and gut metabolic changes in UCMS-induced depressive behavior in rats suggests a possible role of brain-gut axis in depression. This study provides insights into the neurobiology of depression.

Womble, M. N., Reynolds, E., Kissinger-Knox, A., Collins, M. W., Kontos, A. P., West, R. V., Eagle, S. and Elbin, R. J. (2022). “The Emerging Role of Telehealth for Concussion Clinical Care During the Coronavirus (COVID-19) Pandemic.” J Head Trauma Rehabil 37(2): E49-e54.

Full text of this article.

The coronavirus disease 2019 (COVID-19) pandemic has substantially altered the delivery of healthcare for providers and their patients. Patients have been reticent to seek care for many diseases and injuries including concussion due to fears of potential exposure to COVID-19. Moreover, because of social distancing recommendations and stay-at-home orders, patient screening, evaluation, and delivery of care have become less efficient or impossible to perform via in-person clinic visits. Consequently, there was a sudden need to shift healthcare delivery from primarily in-person visits to telehealth. This sudden shift in healthcare delivery brings with it both challenges and opportunities for clinical concussion care. This article is designed to discuss these challenges and opportunities and provide an experiential-based framework for providing concussion care via telehealth. We first provide an overview of a clinical concussion model utilized at concussion specialty clinics from 3 geographically disparate healthcare systems for in-person service delivery prior to COVID-19. We then discuss the creation of new clinical workflows to facilitate the continued provision of concussion specialty care using telehealth. Finally, we examine lessons learned during this healthcare delivery shift including limitations and potential barriers for telehealth for concussion care, as well as opportunities for expansion of concussion care in rural and underserved areas. We also discuss the need to empirically evaluate the comparative efficacy of telehealth and in-person concussion care moving forward.

Wilson, D. K., Sweeney, A. M., Van Horn, M. L., Kitzman, H., Law, L. H., Loncar, H., Kipp, C., Brown, A., Quattlebaum, M., McDaniel, T., St George, S. M., Prinz, R. and Resnicow, K. (2022). “The Results of the Families Improving Together (FIT) for Weight Loss Randomized Trial in Overweight African American Adolescents.” Ann Behav Med.

Full text of this article.

BACKGROUND: Few intervention studies have integrated cultural tailoring, parenting, behavioral, and motivational strategies to address African American adolescent weight loss. PURPOSE: The Families Improving Together (FIT) for Weight Loss trial was a randomized group cohort study testing the efficacy of a cultural tailoring, positive parenting, and motivational intervention for weight loss in overweight African American adolescents (N = 241 adolescent/caregiver dyads). METHODS: The trial tested an 8-week face-to-face group motivational plus family weight loss program (M + FWL) compared with a comprehensive health education control program. Participants were then rerandomized to an 8-week tailored or control online program to test the added effects of the online intervention on reducing body mass index and improving physical activity (moderate-to-vigorous physical activity [MVPA], light physical activity [LPA]), and diet. RESULTS: There were no significant intervention effects for body mass index or diet. There was a significant effect of the group M + FWL intervention on parent LPA at 16 weeks (B = 33.017, SE = 13.115, p = .012). Parents in the group M + FWL intervention showed an increase in LPA, whereas parents in the comprehensive health education group showed a decrease in LPA. Secondary analyses using complier average causal effects showed a significant intervention effect at 16 weeks for parents on MVPA and a similar trend for adolescents. CONCLUSIONS: While the intervention showed some impact on physical activity, additional strategies are needed to impact weight loss among overweight African American adolescents.

Warren, A. M., Perrin, P. B., Elliott, T. R. and Powers, M. B. (2022). “Reasons for COVID-19 vaccine hesitancy in individuals with chronic health conditions.” Health Sci Rep 5(2): e485.

Full text of this article.

Hesitancy for COVID‐19 vaccines is a concern for the population at large. Prior to the availability of COVID‐19 vaccines in early 2021, a large study of adult Americans showed approximately one‐fifth of those asked would be hesitant to take vaccines if they become available. A recent comprehensive scoping review suggests across 48 studies conducted worldwide, 60% to 93% of individuals report the intention to be vaccinated against COVID‐19. Although this trend is encouraging, vaccine hesitancy among those with chronic health conditions, including those with intellectual and/or developmental disabilities, is a concern, as these individuals are at a higher risk for COVID‐19 incidence, severity, and mortality. In an online survey of 439 individuals with disabilities, concern about the COVID‐19 vaccines, including concerns for safety and possible side effects, was the largest predictor of vaccine hesitancy among 25% of the sample. Similar findings were seen in large studies of people with developmental or intellectual disabilities and their caregivers, who expressed concerns about side effects and the speed at which vaccines were developed were the primary contributors for not getting a vaccine. Individuals with chronic health conditions are at a higher risk for COVID‐19 incidence, severity, and mortality. To further our understanding of vaccine hesitancy in this at‐risk group, the present cross‐sectional observational survey study examined predictors and reasons for COVID‐19 vaccine hesitancy in a representative sample of US adults with chronic health conditions.

Vier, D. and Irwin, T. A. (2022). “Open Ankle Arthrodesis for Deformity Correction.” Foot Ankle Clin 27(1): 199-216.

Full text of this article.

Open ankle arthrodesis remains a reliable solution for ankle arthritis, especially in the setting of deformity. Careful preoperative evaluation needs to be performed, both clinically and radiographically. The specific deformity present helps determine the approach used and the fixation choices. Deformity is most commonly seen intraarticularly, though deformity can also be present anywhere along the lower extremity, including compensatory deformity in the foot. Multiple different techniques can be used to address both the deformity and achieve a successful ankle arthrodesis. Patient outcomes reported in the literature are generally good, with high union rates and improved functional outcomes.