Universidad Europea

The objective of this study is to evaluate whether intermittent hypoxia can enhance physical recovery following the induction of delayed onset muscle soreness (DOMS). A randomized controlled trial will be conducted with male participants aged 18-35 years who engage in at least two organized training sessions per week. After a DOMS induction protocol targeting the hamstrings, participants will be randomized to receive either intermittent hypoxia, hypoxia-hyperoxia, or placebo for five consecutive days. During this period, several outcome variables will be assessed, including: cognitive function-attention and executive functions (D2 Test and Trail Making Test A and B); stress (DASS-21 questionnaire); physical performance-VO2max, countermovement jump (CMJ, My Jump App), 30-m sprint speed (MySprint App), one-repetition maximum in half-squat (Vitruve linear encoder), isometric hamstring strength (ActivForce2 dynamometer), muscle soreness (VAS scale), heart rate variability, muscle oxygen saturation, hip flexion range of motion with extended knee (Goniometer Pro App); and blood inflammatory markers: HIF-1α, PGC-1α, Klotho protein and lactate. To analyze the effects of the intervention, a repeated-measures ANOVA will be performed to assess Group × Time interactions. The study was reviewed and approved by the Medical Ethics Committee of Hospital Clínico San Carlos, Madrid, Spain (internal code 25/446-E) prior to data collection. If effective, intermittent hypoxia and hypoxia-hyperoxia could be implemented as non-pharmacological recovery strategies for athletes and physically active populations, offering a novel alternative to current methods with inconsistent results. The findings may guide future research on hypoxic conditioning, inform clinical practices for rehabilitation and performance recovery, and potentially shape policy regarding safe, evidence-based applications of hypoxia in sports medicine. https://www.anzctr.org.au/, registration code ACTRN12625001404415.

Background/Objectives: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper limb. The aim of this study was to analyze the safety and effectiveness of ultrasound-guided percutaneous needle electrolysis (PNE) and open carpal tunnel release (OCTR) in patients with moderate-to-severe CTS. Methods: A total of 185 patients with idiopathic CTS were assigned to either the electrolysis group (75 patients) or the surgery group (73 patients); 112 patients completed the final follow-up assessment 12 months after randomization. The surgical procedure consisted of OCTR. The electrolysis group received four sessions of US-guided PNE applied every seven days. Main outcomes were nights waking up due, pain, paresthesia, Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS), Functional Status Scale (BCTQ FSS) and adverse events. These variables were evaluated in the short (6 weeks), medium (3 months), and long term (6 and 12 months). Results: In the short term (6 weeks), both interventions did not show significant differences in the severity of symptoms; however, the electrolysis group had less adverse events than the surgery group (2 vs. 100). In the medium (3 months) and long term (6 and 12 months), surgery was slightly more effective regarding nocturnal awakenings, paresthesia and BCTQ-SSS (p < 0.002). Conclusions: US-guided PNE may be a safe and effective technique for patients with moderate-to-severe CTS with a sustained long-term pattern of improvement. Although both treatments were effective, OCTR showed superior long-term symptom reduction. Therefore, PNE may serve as a first-line or bridging treatment in selected clinical scenarios.

Artificial intelligence large language models (LLMs) such as ChatGPT are increasingly used in clinical settings, yet their reliability in reproducing evidence-based recommendations remains uncertain. This study aimed to evaluate the performance of ChatGPT-4o in addressing clinical practice guideline (CPG) recommendations for the surgical management of knee osteoarthritis and total knee arthroplasty (TKA). An observational cross-sectional design was conducted in September 2025. Twenty recommendations from the most recent American Academy of Orthopaedic Surgeons CPG on TKA were translated into structured clinical questions and submitted to ChatGPT-4o. Each query was entered three times in independent sessions to evaluate textual consistency. Two independent reviewers with expertise in musculoskeletal physiotherapy and orthopedics appraised the chatbot's answers, classifying them according to the CPG framework ("should do," "could do," "do not do," "uncertain"). Agreement between reviewers and alignment with CPG recommendations were assessed using Cohen's and Fleiss' Kappa coefficients. ChatGPT-4o achieved an overall concordance of 60% with the CPG recommendations, representing fair agreement (κ = 0.392, p = 0.005). Internal text consistency across repeated trials was low, with several responses showing unacceptable similarity levels (<50%). Inter-rater reliability ranged from moderate to perfect (κ = 0.547-0.946). Although ChatGPT-4o provided clinically acceptable answers in several domains, discrepancies persisted, particularly in recommendations regarding functional outcomes and rehabilitation strategies. ChatGPT-4o demonstrated moderate accuracy and heterogeneous reliability when reproducing CPG recommendations for TKA. While the model may serve as a supportive tool for education and patient communication, its variability and incomplete adherence to guidelines highlight the need for cautious integration and professional oversight in clinical decision-making.

ABSTRACT Wildlife is often referred to as antibiotic resistance (AMR) “reservoirs,” “spreaders,” or “disseminators” without a clear ecological justification for these terms, contributing to a negative image and suggesting unnecessary control measures. We (i) discuss these epidemiological concepts within the AMR context and (ii) briefly describe a standardized framework and propose key recommendations to support, or not, their use in wildlife AMR studies. Addressing these knowledge gaps and design challenges based on the correct application of these epidemiological concepts is crucial to assess the role of wildlife within the One Health AMR cycle. By evaluating the wildlife component as part of the broader human-animal-environmental interface and not as an isolated scenario, we avoid erroneous scientific interpretations and stigmatization. Wildlife must not be viewed as “threat” but as another epidemiological factor in order to assess their epidemiological role and support the development of effective future public policies and mitigation measures.

Fibrotic interstitial lung diseases (ILDs) are characterized by different degrees of inflammation and fibrosis of the lung parenchyma that are associated with progressive loss of breath, high morbidity and mortality. Current therapeutic options are limited, so there remains a significant need for effective and well-tolerated treatments. GTX-11 is an orally available small molecule in development for the treatment of fibrotic diseases. In this study, we aimed to assess the therapeutic potential of GTX-11 in different preclinical models of lung fibrotic disease. We assessed the activity of GTX-11 and its active metabolite, GTX-11m, in the bleomycin-induced pulmonary fibrosis model and in vitro in primary fibroblast cell cultures, including human normal lung fibroblasts (hNLFs) and ILD patient-derived fibroblasts. In the murine model, GTX-11 treatment improved animal survival and significantly reduced lung fibrosis as measured by Ashcroft score and collagen deposition. GTX-11 also reduced the inflammatory cell count in bronchoalveolar lavage fluid and pro-inflammatory factors in lung tissue. Additionally, GTX-11 significantly improved lung vascular dysfunction and reduced pulmonary vascular remodeling. The preclinical anti-fibrotic effects of GTX-11 were comparable to, or in some cases exceeded, those of currently approved anti-fibrotic drugs used in clinical practice. In vitro, GTX-11m demonstrated anti-fibrotic and anti-inflammatory activity in hNLFs and ILD patient-derived fibroblasts. GTX-11m inhibited TGFβ-induced expression of key fibrotic markers and reduced fibroblast-to-myofibroblast transition and inflammatory cytokine production. The effects were consistent across the different tested ILD cultures and resulted from the prevention of SMAD2 and SMAD3 activation by TGFβ. The GTX-11m anti-fibrotic and anti-inflammatory effects were comparable or better than nintedanib. Altogether, our studies reveal that GTX-11 is an effective antifibrotic both in vivo and in vitro, suggesting that GTX-11 has potential as a therapeutic option for fibrotic ILDs.