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Excitotoxicity contributes to epileptogenesis after severe traumatic brain injury (sTBI). Demographic and clinical risk factors for post-traumatic seizures (PTS) have been identified, but genetic risk remains largely unknown. Thus, we investigated whether genetic variation in astroglial glutamate transporter genes is associated with accelerated epileptogenesis and PTS risk after sTBI. Adults (n = 267) 18–75 years old were assessed over a three-year period post-TBI. Single nucleotide polymorphisms (SNPs) throughout the SLC1A2 and SLC1A3 genes were assayed. Kaplan-Meier estimates and log-rank statistics were used to compare seizure frequencies by genotype. Multivariate Cox proportional hazards regression was used to estimate hazard ratios (HRs) for genotypes significant in Kaplan-Meier analyses. Thirty-nine tagging SNPs were examined (SLC1A2: n = 21, SLC1A3: n = 18). PTS developed in 57 (21.4%) individuals. Of those with PTS, n = 20 (35.7%) had an immediate/early seizure within the first seven days, and n = 36 (64.3%) had a late seizure occurring between eight days and three years post-TBI. When adjusting for multiple comparisons, rs4869682 genotypes (SLC1A3, GG vs. T-carriers) were associated with time to first seizure (p = 0.003). Median time until first seizure was 20.4 days for individuals with a GG genotype and 44.8 days for T-carriers. After adjusting for covariates, rs4869682 GG-homozygotes had a 2.05 times increased PTS risk versus T-carriers (aHR = 2.08, 95% confidence interval: 1.20, 3.62, p = 0.009). Variation within SLC1A3 is associated with accelerated epileptogenesis and clinical PTS development after sTBI. Future studies should validate these findings and examine how genetic variation at rs4869682 may be a target for PTS prevention and treatment.

Dopamine (DA) neurotransmission influences cognition and recovery after traumatic brain injury (TBI). We explored whether functional genetic variants affecting the DA transporter (DAT) and D2 receptor (DRD2) impacted in vivo dopaminergic binding with positron emission tomography (PET) using [(11)C]βCFT and [(11)C]raclopride. We examined subjects with moderate/severe TBI (N=12) ∼1 year post injury and similarly matched healthy controls (N=13). The variable number of tandem repeat polymorphism within the DAT gene and the TaqI restriction fragment length polymorphism near the DRD2 gene were assessed. TBI subjects had age-adjusted DAT-binding reductions in the caudate, putamen, and ventral striatum, and modestly increased D2 binding in ventral striatum versus controls. Despite small sample sizes, multivariate analysis showed lower caudate and putamen DAT binding among DAT 9-allele carriers and DRD2 A2/A2 homozygotes with TBI versus controls with the same genotype. Among TBI subjects, 9-allele carriers had lower caudate and putamen binding than 10/10 homozygotes. This PET study suggests a hypodopaminergic environment and altered DRD2 autoreceptor DAT interactions that may influence DA transmission after TBI. Future work will relate these findings to cognitive performance; future studies are required to determine how DRD2/DAT1 genotype and DA-ligand binding are associated with neurostimulant response and TBI recovery.

Background and Purpose: Carotid artery stenting (CAS) has been, historically, an alternative to open endarterectomy (CEA) for stroke prevention in high risk patients with carotid atherosclerosis. We sought to determine the rates of periprocedural and long-term stroke or death and the risk factors for complications after CAS in our high risk patient population. Methods: Clinical and treatment variables of consecutive CAS procedures performed between 2002 and 2011 were analyzed. Using univariate and multivariate logistic regression analyses we examined how patient characteristics influenced outcomes and changes in modified Rankin Score (mRS). Results: In 152 patients, the composite total of periprocedural death, stroke, transient ischemic attack (TIA) and myocardial infarction (MI) rate was 3.95% (6/152). Chronic kidney disease (CKD) was strongly associated with periprocedural complications (p<0.001). Coronary artery disease/peripheral vascular disease (CAD/PVD) (p=0.03), dyslipidemia (p=0.02), CKD (p=0.01), and contralateral internal carotid artery stenosis (p=0.02) were non-modifiable risk factors for mRS increase. There were 25 deaths, 8 strokes, 11 TIAs, and 1 MI (mean follow-up 38.4 months, range 0-116 months). The presence of CAD/PVD (p=0.009) and dyslipidemia (p=0.002) were significantly associated with long-term complications. Conclusion: CAS was performed with low periprocedural complications in high-risk patients. Our rates compare very favorably to large-scale trials that have ideal patients. This data encourages the consideration of CAS in patients considered high risk for CEA and provides possible patient characteristics (CKD) to help with periprocedural risk stratification. Mise en place d’une endoprothèse carotidienne chez des patients à haut risque: facteurs déterminants des complications périprocédurales et des complications à long terme. Contexte et but: Historiquement, la mise en place d’une endoprothèse carotidienne (EC) était une alternative à l’endartérectomie ouverte (EO) pour la prévention de l’accident vasculaire cérébral (AVC) chez les patients à haut risque atteints d’athérosclérose carotidienne. Le but de l’étude était de déterminer les taux d’AVC ou de décès périprocéduraux et à long terme ainsi que les facteurs de risque de complications après la mise en place d’une EC dans notre population de patients à haut risque. Méthode: Nous avons analysé les variables cliniques et thérapeutiques de la mise en place d’une EC effectuée chez des patients consécutifs entre 2002 et 2011. Nous avons examiné comment les caractéristiques des patients ont influencé l’issue et les changements du score à l'échelle modifiée de Rankin (SÉMR) au moyen de l’analyse de régression logistique univariée et multivariée. Résultats: Le taux total de décès périprocéduraux, d’AVC, d’ischémie cérébrale transitoire (ICT) et d’infarctus du myocarde (IM) était de 3,95% (6/152). L’insuffisance rénale chronique (IRC) était fortement associée aux complications périprocédurales (p<0,001). La maladie coronarienne/la maladie vasculaire périphérique (MC/MVP) (p=0,03), la dyslipidémie (p=0,02), l’IRC (p=0,01) et la sténose carotidienne controlatérale (p=0,02) étaient des facteurs de risque non modifiables de l’augmentation du SÉMR. Vingt-cinq décès, 8 AVC, 11 ICT et 1 IM ont été rapportés (suivi moyen de 38,4 mois ; écart de 0 à 116 mois). La présence de MCAS/MVP (p=0,009) et de dyslipidémie (p=0,002) étaient associées de façon significative aux complications à long terme. Conclusion: La mise en place d’une EC a été effectuée avec un faible taux de complications périprocédurales chez des patients à haut risque. Nos taux se comparent très favorablement à ceux d’essais à grande échelle qui recrutent des patients idéals. Ces données incitent à envisager la mise en place d’une EC chez des patients considérés à haut risque pour l’EO et indiquent quelles sont les caractéristiques qu’on doit prendre en compte pour la stratification des risques périprocéduraux.

Purpose – The purpose of this paper is to empirically explore the underlying mechanisms through which empowerment affects organizational outcomes via a multi-dimensional model. Specifically, the paper suggests that empowerment climate (EC) is positively related to psychological empowerment (PE) and the effect of PE on the outcome variable of job satisfaction is mediated by justice perceptions and role clarity. Design/methodology/approach – In total, 765 employees at the executive level across 26 distinct groups in a large manufacturing firm participated in the survey. Multi-level analyses based on both hierarchical linear modeling and multi-level structural equation modeling techniques were utilized to test the hypotheses. Findings – This research demonstrated that EC significantly affected PE and that perceptions of justice and role clarity mediated the relationship between PE and job satisfaction. Additional analyses demonstrated that EC did not significantly affect organizational outcomes above and beyond PE, justice, and role clarity. Practical implications – The current study suggests that managers concerned with increasing employee perceptions of justice may be able to do so by increasing perceptions of employee empowerment. As only individual employee perceptions of empowerment related directly to organizational outcomes, this demonstrates the importance for managers to understand perceptions of employees. Originality/value – Exploring these mechanisms will strengthen the knowledge regarding how empowerment works to enhance organizational effectiveness. This will enable practitioners to better determine how and when empowerment will be most effective.

This study explores the use of mindfulness school-based intervention program in an elementary school. Mindfulness training is an accepted and effective didactic approach to improve the executive functions (EFs) of elementary school students. This study aimed to evaluate the effects of the Mind Yeti program on the executive functions of elementary school students. A diverse sample of third, fourth, and fifth grade elementary school students (n = 177) participated in their natural classroom setting, with six sessions per week for six weeks. Students self-reported their EFs on the Executive Function Student Questionnaire (EFSQ) pre- and posttest. Paired-sample t-tests indicated that students significantly improved on the three of the six EFs examined. Additionally, students in fifth grade responded better to Mind Yeti than students in third grade. Results were consistent with the hypothesis, suggesting that Mind Yeti is an appropriate and effective intervention for improving the EFs of students.

Dopamine (DA) neurotransmission influences cognition and recovery after traumatic brain injury (TBI). We explored whether functional genetic variants affecting the DA transporter (DAT) and D2 receptor (DRD2) impacted in vivo dopaminergic binding with positron emission tomography (PET) using [11C]βCFT and [11C]raclopride. We examined subjects with moderate/severe TBI (N = 12) ~1 year post injury and similarly matched healthy controls (N = 13). The variable number of tandem repeat polymorphism within the DAT gene and the Taql restriction fragment length polymorphism near the DRD2 gene were assessed. TBI subjects had age-adjusted DAT-binding reductions in the caudate, putamen, and ventral striatum, and modestly increased D2 binding in ventral striatum versus controls. Despite small sample sizes, multivariate analysis showed lower caudate and putamen DAT binding among DAT 9-allele carriers and DRD2 A2/A2 homozygotes with TBI versus controls with the same genotype. Among TBI subjects, 9-allele carriers had lower caudate and putamen binding than 10/10 homozygotes. This PET study suggests a hypodopaminergic environment and altered DRD2 autoreceptor DAT interactions that may influence DA transmission after TBI. Future work will relate these findings to cognitive performance; future studies are required to determine how DRD2/DAT1 genotype and DA-ligand binding are associated with neurostimulant response and TBI recovery.

Purpose School closures have been used as part of lockdown strategies to contain the spread of SARS-CoV-2, adversely affecting children’s health and education. To ensure the accessibility of educational institutions without exposing society to the risk of increased transmissions, it is essential to establish SARS-CoV-2 testing strategies that are child-friendly, scalable and implementable in a daily school routine. Self-sampling using non-invasive saliva swabs combined with pooled RT-qPCR testing (Lolli-Method) has been proven to be a sensitive method for the detection of SARS-CoV-2. Methods We conducted a pilot project in Cologne, Germany, designed to determine the feasibility of a large-scale rollout of the Lolli-Method for testing without any additional on-site medical staff in schools. Over a period of three weeks, students from 22 schools were sampled using the Lolli-Method. At the end of the project, teachers were asked to evaluate the overall acceptance of the project. Results We analyzed a total of 757 pooled RT-qPCRs obtained from 8,287 individual swabs and detected 7 SARS-CoV-2 infected individuals. The Lolli-Method was shown to be a feasible and accepted testing strategy whose application is only slightly disruptive to the daily school routine. Conclusion Our observations suggest that the Lolli-Method in combination with pooled RT-qPCR can be implemented for SARS-CoV-2 surveillance in daily school routine, applicable on a large scale.

Given the growing challenges of healthcare, including an aging population and increasing shortages of specialized intensive care staff, this systematic review investigates the efficacy of telemedicine in intensive care compared to standard of care (SoC) or any other type or mode of telemedicine on patient-relevant outcomes for adult intensive care unit (ICU) patients. This systematic review follows Cochrane's methodological standards. Comprehensive searches for any controlled clinical studies were conducted in MEDLINE, Scopus, CINAHL, and CENTRAL (up to 18 April 2024, and an updated search for randomized controlled trials (RCTs) up to 29 September 2025). Twenty-six studies comparing telemedicine in intensive care to SoC with approximately 2,164,508 analysed patients were identified, including data from one cluster RCT (cRCT), two stepped-wedge cluster RCTs (sw-cRCTs), and 23 non-randomized studies of interventions (NRSIs). No other comparisons were identified. Due to high clinical and methodological heterogeneity among studies, no meta-analysis was conducted. For ICU mortality, one cRCT (15,230 patients) and two sw-cRCTs (5,915 patients) showed heterogeneous results: two found no evidence for a difference, while one favoured SoC (very low-certainty). One sw-cRCT (1,462 patients) reporting overall mortality at 180 days suggested no evidence for a difference between groups (very low-certainty). Data from one cRCT (15,230 patients) and one sw-cRCT (1,462 patients) on ICU length of stay (LOS) showed no evidence for a difference between groups (moderate- and very low-certainty). Quality of life from one sw-cRCT (786 patients) indicated no evidence for a difference (very low-certainty). Six NRSIs reported adjusted data on ICU mortality, two on overall mortality, and three on ICU LOS, with heterogeneous results. High risk of bias and substantial heterogeneity limited the certainty, emphasizing the need for robust, patient-centered research in clinical studies to define telemedicine's role in intensive care and optimize its implementation. Future studies should particularly ensure transparent and comprehensive reporting.