Cocaine history and impulsiveness in professional boxers and mixed martial arts fighters.

BACKGROUND/OBJECTIVES: Impulsiveness is linked to cocaine history (CH) in the general population and greater fight exposure in professional fighters. Among fighters, no previous studies have quantified CH or investigated its relationship with impulsiveness. METHODS: Adjusted multivariable regressions were utilized to examine the relationship between CH and impulsiveness in 335 fighters from the Professional Fighters Brain Health Study. RESULTS: Twenty percent of fighters reported CH. CH was significantly associated with impulsiveness overall and on three subscales. DISCUSSION/CONCLUSION: Cocaine's prevalence and significant association with impulsiveness in fighters merit further study. SCIENTIFIC SIGNIFICANCE: We quantify CH and demonstrate its significant association with impulsiveness in professional fighters for the first time.

Increasing awareness of rare PSP-F, where rehabilitation is the primary treatment: A case report.

BACKGROUND: Progressive Supranuclear Palsy (PSP) is an incurable neurodegenerative disorder. One variant of PSP is a frontal lobe cognitive or behavioral presentation (PSP-F). Currently, the primary management of this disease is rooted in neurological rehabilitation, therefore, early, and accurate diagnosis is key. CASE REPORT: Here we present a 60-year-old man with a 2-3-year history of functional decline and behavioral changes. He was misdiagnosed with a late-onset psychiatric disorder. During his second inpatient admission, a full workup for neurodegenerative diseases was performed, and the patient was ultimately diagnosed with probable PSP-F. We describe his neurological rehabilitation plan, examining recommendations before and after diagnosis. RESULTS: After the neurodegenerative disorder diagnosis, the neurological rehabilitation plan, particularly PT and OT, changed drastically despite no change in clinical presentation emphasizing the value of an appropriate and early diagnosis. Furthermore, in an OT session, the patient demonstrated longitudinal improvement, emphasizing the importance of rehabilitation in these patient's lives. CONCLUSION: Increased recognition of PSP variants amongst healthcare providers will allow more patients to receive early and appropriate diagnoses, so that they can benefit maximally from their neurological rehabilitation plans, maintain quality of life and experience longer periods of functioning. Furthermore, developing PSP-specific rehabilitation guidelines are crucial for improved outcomes. Correct diagnosis will also reduce the use of inappropriate and potentially harmful medications in these populations.

A Magnetically Responsive Hydrogel System for Controlling the Timing of Bone Progenitor Recruitment and Differentiation Factor Deliveries.

The sequence and timing of growth factor delivery plays a crucial role in bone regeneration. While a variety of biomaterial scaffolds have been developed to provide multiple growth factor deliveries, there still exists a strong need for on-demand control over sequential delivery profiles to optimize regenerative outcomes. One particular growth factor, bone morphogenetic protein-2 (BMP-2), has established effects in the osteodifferentiation process; however, the optimal timing of its delivery is not yet known. Here, we investigate the effect of the timing of BMP-2 delivery on osteodifferentiation on both 2D and 3D cell cultures in vitro. It was shown that immediate BMP-2 delivery inhibited mouse mesenchymal stem cell (mMSC) proliferation and therefore resulted in suboptimal levels of mMSC osteodifferentiation (as measured by alkaline phosphatase activity) compared to mMSC cultures exposed to delayed BMP-2 delivery (4 day delay). Because of this, we aimed to develop a biomaterial system capable of rapidly recruiting mMSCs and exposing them to BMP-2 in a delayed manner (i.e., after a strong mMSC population has been established). This biomaterial system consisted of (i) an outer porous gelatin compartment that could be loaded with an mMSC recruitment factor (stromal cell-derived factor 1-α (SDF-1α)) for rapid establishment of a 3D mMSC culture and (ii) an inner ferrogel compartment that could deliver BMP-2 in an immediate or delayed manner, depending on when magnetic stimulation was applied. It was shown that the outer compartment was able to recruit and harbor mMSCs and that the rapidity of this recruitment could be enhanced by loading the compartment with SDF-1α. The inner ferrogel compartment enabled magnetically triggered release of BMP-2 where the timing of release could be remotely controlled from immediate to a delay of up to 11 days. This hydrogel system provides controllability over the timing between bone progenitor recruitment and osteodifferentiation factor release and can thus potentially enhance therapies that require new bone growth by optimizing the timing of these deliveries.

Pulsatile Chemotherapeutic Delivery Profiles Using Magnetically Responsive Hydrogels.

Pulsatile chemotherapeutic delivery profiles may provide a number advantages by maximizing the anticancer toxicity of chemotherapeutics, reducing off-target side effects, and combating adaptive resistance. While these temporally dynamic deliveries have shown some promise, they have yet to be clinically deployed from implantable hydrogels, whose localized deliveries could further enhance therapeutic outcomes. Here, several pulsatile chemotherapeutic delivery profiles were tested on melanoma cell survival in vitro and compared to constant (flatline) delivery profiles of the same integrated dose. Results indicated that pulsatile delivery profiles were more efficient at killing melanoma cells than flatline deliveries. Furthermore, results suggested that parameters like the duration of drug "on" periods (pulse width), delivery rates during those periods (pulse heights), and the number/frequency of pulses could be used to optimize delivery profiles. Optimization of pulsatile profiles at tumor sites in vivo would require hydrogel materials capable of producing a wide variety of pulsatile profiles (e.g., of different pulse heights, pulse widths, and pulse numbers). This work goes on to demonstrate that magnetically responsive, biphasic ferrogels are capable of producing pulsatile mitoxantrone delivery profiles similar to those tested in vitro. Pulse parameters such as the timing and rate of delivery during "on" periods could be remotely regulated through the use of simple, hand-held magnets. The timing of pulses was controlled simply by deciding when and for how long to magnetically stimulate. The rate of release during pulse "on" periods was a function of the magnetic stimulation frequency. These findings add to the growing evidence that pulsatile chemotherapeutic delivery profiles may be therapeutically beneficial and suggest that magnetically responsive hydrogels could provide useful tools for optimizing and clinically deploying pulsatile chemotherapeutic delivery profiles.