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Context: Piriformis syndrome is often associated with muscle spasms and shortening of the piriformis muscle (PM). Physical therapy, including static stretching of the PM, is one of the treatments for this syndrome. However, the effective stretching position ofthe PM is unclear in vivo. This study aimed to determine the effective stretching positions of the PM using ultrasonic shear wave elastography. Design: Observational study. Methods: Twenty-one healthy young men (22.7 [2.41 y) participated in this study. The shear elastic modulus of the PM was measured at 12 stretching positions using shear wave elastography. Three of the 12 positions were tested with maximum internal rotation at 0°, 20°, or 40° hip adduction in 90° hip flexion. Nine of the 12 positions were tested with maximum external rotation at positions combined with 3 hip-flexion angles (70°, 90°, and 110°) and 3 hip-adduction angles (0°, 20°, and 40°). Results.' The shear elastic modulus of the PM was significantly higher in the order of 40°, 20°, and 0° of adduction and higher in external rotation than in internal rotation. The shear elastic modulus of the PM was significantly greater in combined 110° hip flexion and 40° adduction with maximum external rotation than in all other positions. Conclusion.- This study revealed that the position in which the PM was most stretched was maximum external rotation with 110° hip ftexion and 40° hip adduction. [ABSTRACT FROM AUTHOR]

Context: Blood flow restriction (BFR) is a rehabilitation tool which may introduce a constraint, similar to muscle fatigue, that challenge patients' sensorimotor system during balance exercises. The purpose of our study was to examine whether adding BFR to dynamic balance exercises produced a decrease in balance performance and an increase in ratings of perceived exertion and instability in individuals with chronic ankle instability (CAI) compared with dynamic balance exercises without BFR. Designs: Crossover design. Methods: Our sample included N = 25 young adults with a history of CAI. Participants completed 2 laboratory visits. At each visit, participants completed 4 sets (30×-15×-15×-15×) of dynamic balance exercises, performed similar to the modified star excursion balance test (SEBT), once with BFR and once with control (no BFR) conditions. We measured composite SEBT scores at baseline and during the final repetitions of each set of balance exercise (sets 1–4). We also measured ratings of perceived exertion and instability following each balance exercise set. Results: We observed no difference in composite SEBT scores between conditions at baseline; however, composite SEBT scores were significantly lower during all balance exercises sets 1 to 4 with the BFR condition compared with control. During the BFR condition, composite SEBT scores were significantly lower during all balance exercise sets compared with baseline. During the control condition, composite SEBT scores did not significantly change between baseline and each balance exercise set. Ratings of perceived exertion and instability scores were significantly greater in the BFR group compared with the control group during all balance exercise sets. Conclusions: Individuals with CAI demonstrated lower composite SEBT scores and greater perceived instability and exertion during dynamic balance exercise with BFR compared to without BFR. BFR introduced a novel muscle fatigue constraint during dynamic balance exercises in individuals with CAI. Additional research is needed to determine if adding BFR to balance training could improve clinical outcomes in CAI patients. [ABSTRACT FROM AUTHOR]

Context: Plantar intrinsic foot muscle strength training is difficult to master to a degree sufficient to elicit muscle hypertrophy in most individuals. It is possible that combining neuromuscular electrostimulation (NMES) and blood flow restriction (BFR) can elicit plantar intrinsic foot muscle hypertrophy regardless of the individual's technique. This study aimed to determine the effects of NMES training with BFR on acute muscle swelling in the abductor hallucis. Design: Randomized, controlled, single-blind trial design. Methods: Forty-eight participants were randomly allocated to the NMES + BFR, NMES, or Sham NMES + BFR groups. All participants received abductor hallucis NMES for 15 minutes. Participants in the NMES + BFR and Sham NMES + BFR groups received NMES with BFR. The intensity of NMES was the sensory threshold in the Sham NMES + BFR group. The cross-sectional area of the abductor hallucis was measured pretraining and posttraining using ultrasonography by a single investigator blinded to the participants' allocations. Results: After 15 minutes of training, the cross-sectional area of the abductor hallucis was significantly increased in the NMES + BFR (P<.001) and the Sham NMES + BFR (P = .004) groups. Moreover, the rate of increase was significantly higher in the NMES + BFR group than in the NMES or the Sham NMES + BFR groups (P<.001 and P = . 001, respectively). Conclusions: Since it is possible that the amount of muscle swelling immediately after training correlates with muscle hypertrophy when training is continued, the results of this study suggest that NMES training with BFR is a training method that can be expected to produce plantar intrinsic foot muscle hypertrophy. Further studies are needed to confirm the long-term effects of NMES training with BFR. [ABSTRACT FROM AUTHOR]

Context: The purpose of this study was to compare short-term clinical outcomes between meniscus procedures performed with anterior cruciate ligament reconstruction (ACLR), ACLR (ACLR-only), ACLR with meniscectomy/resection (ACLR-resect), and ACLR with meniscal repair (ACLR-repair) for bone patellar tendon bone grafts (BPTB) and hamstring tendon grafts, separately. Design: This was a cross-sectional study conducted in a controlled laboratory setting as part of a large point-of-care collaborative research program. Methods: This study included 314 participants (168 females; mean [SD]: age, 19.7 [4.8]) with primary unilateral ACLR with a BPTB or hamstring tendon. Patients were divided into 3 groups depending on meniscal procedure (ACLR-only, ACLR-resect, and ACLR-repair). Postsurgical testing included: isokinetic assessment of knee extension and flexion, single-leg hop tests, and patient-reported outcomes. Multivariate analysis of covariance compared differences between meniscal procedures on the battery of tests, and for each statistically significant variable an analysis of covariance assessed the effect of meniscal procedure within each graft type. Chi-square analysis assessed the influence of meniscal procedure on tests' pass rates defined as 90% of limb symmetry index. Results: BPTB: ACLR-only had greater hamstring strength than ACLR-resect (P = .05) and ACLR-repair (P = .005). ACLR-only had the highest proportion of participants to pass the hamstring strength test (P=.02). amstring tendon: ACLR-only (P=.03) and ACLR-resect (P=.003) had higher International Knee Documentation Committee scale scores than ACLR-repair. There was a significant difference in the proportion of participants who scored >90% limb symmetry index on the timed hop test (P = .05). Conclusions: The influence of meniscal repair on clinical outcomes is dependent on the graft choice. Following an ACLR with BPTB and a meniscal procedure, hamstring function should be more closely monitored for optimal short-term recovery. [ABSTRACT FROM AUTHOR]

This research provides a review of seated shot put alongside new data from the Tokyo 2020 Paralympic Games with the aim to understand the latest trends in equipment within a recently established rule set and how key equipment variables may impact performance for athletes in different classifications. First, a review of the literature found that the throwing pole is a key equipment aid that is not well understood, in part due to limitations in testing design. New data from the 2020 Paralympic Games showed inconsistent trends for the use of the throwing pole among athletes, particularly in transitionary classes (F33–34 and F54–55). A two-way analysis of variance found a main effect of classification on performance (p <.001), as well as an interaction effect between pole use and classification on performance (p <.05). Notably, pole users are seen to perform better than non–pole users in Class F32 (p <.05). [ABSTRACT FROM AUTHOR]

Context: Single- and dual-task walking gait assessments have been used to identify persistent movement and cognitive dysfunction among athletes with concussions. However, it is unclear whether previous ankle sprain injuries confound these outcomes during baseline testing. The purpose of this study was to determine the effects of (1) ankle sprain history and (2) time since prior ankle sprain injury on single- and dual-task spatiotemporal gait outcomes and cognitive measures. Design: Cross- sectional study. Methods: We assessed 60 college Division-I athletes (31 with ankle sprain history; 13 females and 18 males, 19.3 [0.8] y; 29 with no ankle sprain history, 14 females and 15 males, 19.7 [0.9] y) who completed injury history forms and underwent concussion baseline testing. Athletes completed single- and dual-task gait assessments by walking back and forth along an 8-m walkway for 40 seconds. Athletes wore a smartphone with an associated mobile application on their lumbar spine to record spatiotemporal gait parameters and dual-task cognitive performance. Separate multivariate analyses of variance were used to assess the effects of ankle sprain injury history on spatiotemporal measures, gait variability, and cognitive performance. We performed a multivariate regression subanalysis on athletes who reported time since injury (n = 23) to assess temporal effects on gait and cognitive performance. Results: Athletes with and without a histoiy of ankle sprains had comparable spatiotemporal and gait variability outcomes during single- (P = .42; P = .13) and dual-task (P = .75; P = .55) conditions. Additionally, ankle sprain injury history did not significantly influence cognitive performance (P = .35). Finally, time since ankle sprain did not significantly affect single- (P = .75) and dual-task gait (P = .69), nor cognitive performance (P = 19). Conclusions: Ankle sprain injury history did not significantly alter spatiotemporal gait outcomes nor cognitive performance during this common clinical assessment. Future studies may consider including athletes with ankle sprain injury history during concussion assessments. [ABSTRACT FROM AUTHOR]

This study explored the acute effects of different running intensities on cognitive and motor performances in individuals with intellectual disability (ID). An ID group (age, M = 15.25 years, SD = 2.76) and a control group without ID (age, M = 15.11 years, SD = 1.54) performed visual simple and choice reaction times, auditory simple reaction time, and finger tapping tests before and after running at low or moderate intensity (30% and 60% of heart rate reserve [HRR], respectively). Visual simple reaction time values decreased (p <.001) after both intensities at all time points with higher (p =.007) extend after the 60% HRR intensity for both groups. After both intensities, the VCRT decreased (p <.001) in the ID group at all time points compared with preexercise (Pre-EX) while, in the control group, these values decreased (p <.001) only immediately (IM-EX) and after 10 min (Post-10) of exercise cessation. Compared withs Pre-EX, in the ID group, the auditory simple reaction time values decreased (p <.001) at all time points after the 30% HHR intensity whereas, after the 60% HRR, these values decreased only at IM-EX (p <.001), Post-10 (p =.001) and Post-20 (p <.001). In the control group, auditory simple reaction time values decreased (p =.002) only after the 30% HRR intensity at IM-EX. The finger tapping test increased at IM-EX (p <.001) and at Post-20 (p =.001) compared to Pre-EX in both groups only after the 30% HHR intensity and for the dominant hand. The effect of physical exercise on cognitive performances in individuals with ID seems to depend on the cognitive test type as well as the exercise intensity. [ABSTRACT FROM AUTHOR]

Context: Slideboards are commonly used in exercise programs, but there is limited information about how they affect muscle activities during exercise. We aim to compare the activation levels of quadriceps and hamstring muscles and hip- and knee-flexion angles during lunge and single-leg squat exercises between normal ground and slideboard in physically active individuals. Design: Cross-sectional study. Methods: Thirty healthy individuals (age: 23.83 [2.84] y, body mass index: 21.75 [1.72] kg/m2) were included in the study. Surface electromyography was used to measure vastus medialis, vastus lateralis, biceps femoris, and semitendinosus activation levels during reaching and returning phases of the forward, lateral, and back lunges and squats that were performed on the normal ground and slideboard. Exercises were performed at a slow pace (60 beats/min). Hip- and knee-flexion angles during the exercises were evaluated by using 2-dimensional motion analysis. Repeated measures of analysis of variance were used for statistical analysis. Results: Vastus medialis and vastus lateralis activation levels were greater during reaching and returning phases of the exercises on slideboard compared with normal ground (P <.05). However, semitendinosus and biceps femoris activity were greater only during the returning phase of the forward lunge (P <.001) and the returning phase of the back squat (P =.002, P =.009, respectively). Hip-to-knee flexion ratios were closer to 1 when the forward lunge (P <.001), back lunge (P =.004), and forward squat (P =.001) exercises were performed on a slideboard. Conclusion: In exercise programs that target the quadriceps and hamstring muscles, slideboards can be effectively used in exercise progressions as they can increase muscle activity. Moreover, squat and lunge exercises on slideboard with a slow pace may also be helpful for improving the balance between hip- and knee-flexion angles. [ABSTRACT FROM AUTHOR]

Context: Aberrant movement patterns among individuals with concussion history have been reported during sport-related movement. However, the acute postconcussion kinematic and kinetic biomechanical movement patterns during a rapid acceleration–deceleration task have not been profiled and leaves their progressive trajectory unknown. Our study aimed to examine single-leg hop stabilization kinematics and kinetics between concussed and healthy-matched controls acutely (≤7 d) and when asymptomatic (≤72 h of symptom resolution). Design: Prospective, cohort laboratory study. Methods: Ten concussed (60% male; 19.2 [0.9] y; 178.7 [14.0] cm; 71.3 [18.0] kg) and 10 matched controls (60% male; 19.5 [1.2] y; 176.1 [12.6] cm; 71.0 [17.0] kg) completed the single-leg hop stabilization task under single and dual task (subtracting by 6's or 7's) at both time points. Participants stood on a 30-cm tall box set 50% of their height behind force plates while in an athletic stance. A synchronized light was illuminated randomly, queuing participants to initiate the movement as rapidly as possible. Participants then jumped forward, landed on their nondominant leg, and were instructed to reach and maintain stabilization as fast as possible upon ground contact. We used 2 (group) × 2 (time) mixed-model analyses of variance to compare single-leg hop stabilization outcomes separately during single and dual task. Results: We observed a significant main group effect for single-task ankle plantarflexion moment, with greater normalized torque (mean difference = 0.03 N·m/body weight; P =.048, g = 1.18) for concussed individuals across time points. A significant interaction effect for single-task reaction time indicated that concussed individuals had slower performance acutely relative to asymptomatic (mean difference = 0.09 s; P =.015, g = 0.64), while control group performance was stable. No other main or interaction effects for single-leg hop stabilization task metrics were present during single and dual task (P ≥.051). Conclusions: Greater ankle plantarflexion torque coupled with slower reaction time may indicate stiff, conservative single-leg hop stabilization performance acutely following concussion. Our findings shed preliminary light on the recovery trajectories of biomechanical alterations following concussion and provide specific kinematic and kinetic focal points for future research. [ABSTRACT FROM AUTHOR]

Context: Induced mental fatigue negatively impacts sport performance and neurocognition. However, it is unclear how induced mental fatigue influences landing biomechanics. The purpose of this study was to examine the influence of mental fatigue on drop landing biomechanics in individuals with and without a concussion history. Design: Crossover design. Methods: Forty-eight (24 per group) recreationally active individuals were matched on age (±3 y), sex, and body mass index (±1 kg/m²). All participants completed an experimental (30-min Stroop task) and control (30-min reading magazines) intervention on separate days separated by a minimum of 24 hours. Drop landings were performed before and after both interventions. Outcomes included peak vertical ground reaction force (vGRF), vertical loading rate (VLR), knee flexion angle, knee abduction angle, external knee flexion moment, external knee abduction moment, and initial ground contact knee flexion and knee abduction angles. Separate 2 (group) x 2 (intervention) between-within analyses of covariance compared drop landing outcomes. Each group's average pre-Stroop and premagazine outcomes were covariates. Results: There was a significant interaction for vGRF (P = .033, ηp²=.097) and VLR (P = .0497, ηp²=.083). The vGRF simple effects were not statistically significantly (P range = .052-.325). However, individuals with a concussion history displayed a medium effect size for greater vGRF post-Stroop compared with their own postmagazine vGRF (mean difference (95% confidence interval [95% CI] = 0.163 (-0.002 to 0.327) bodyweight (BW), p =.052, ηp²=.081. In contrast, the control group displayed a small effect size (mean difference [95% CI] = 0.095 [-0.069 to 0.259] BW, p =.251, ηp²=.029). Individuals with a concussion history displayed greater VLR post-Stroop compared with controls (mean difference [95% CI], 26.29 [6.19 to 46.40] BW/s, P = .012, ηp²=.134) and their own postmagazine values (mean difference [95% CI] = 32.61 [7.80 to 57.42] BW/s, p =.011, ηp²=.135). Conclusion: Mental fatigue leads to greater VLR for individuals with a concussion history. Athletic competition and activities of daily living can increase mental fatigue. Training programs may seek to teach mental fatigue reducing strategies to athletes with a concussion history. [ABSTRACT FROM AUTHOR]

Context: Measures of side-to-side asymmetry in body composition may help identify players who are predisposed to lower limb injuries (LLI) or lower back pain (LBP). This study aimed to examine (1) side-to-side asymmetry in college rugby players according to sex and position and (2) whether side-to-side asymmetry is associated with LBP or LLI. Design: Cross-sectional study. Methods: Thirty-six rugby players (61% female) underwent a dual-energy X-ray absorptiometry assessment for total and regional (appendicular, truncal) outcomes of fat mass, lean mass, and bone mass. A subsample (n = 23) of players had a second dual-energy X-ray absorptiometry assessment 2 months postbaseline. Two-way analysis of variance was used to assess the effect of position (forward and backs) and sex on body composition asymmetry. Student paired t tests were used to assess side-to-side difference in body composition and compare baseline and follow-up measures. Logistic regression was used to assess possible associations between LLI, LBP, and the degree of side-to-side asymmetry in body composition. Results: Male players had greater asymmetry in arm bone mass compared with female players (P = .026), and trunk fat mass asymmetry was greater in forwards as compared with backs (P = .017). Forwards had significantly greater fat mass (P = .004) and percentage of fat (P = .048) on the right leg compared with the left. Backs had significantly greater bone mass in the right arm compared with the left (P = .015). From baseline to postseason, forwards had a significant increase in side-to-side asymmetry in arm lean mass (P = .006) and a significant decrease in side-to-side asymmetry in leg fat mass (P = .032). In backs, side-to-side asymmetry at baseline compared with postseason was significantly different (P = .011) for trunk fat mass. There were no significant associations between body composition asymmetry, LLI, or LBP by sex or position. Conclusion: Our results revealed the presence of side-to-side asymmetries in body composition in university rugby players between sex and position. The amount of asymmetry, however, was not associated with LBP and LLI. [ABSTRACT FROM AUTHOR]

To explore the impact of a selection of contributing factors on employment in adults with cerebral palsy (CP). Eighty adults with CP (39 male, median age 31, IQ > 70) were evaluated using standardized tests and questionnaires for hand function, gross motor function, pain, depressive symptoms, fatigue, social participation, performing daily activities, supportive materials, and mobility aids. Two separate analyses were performed. Firstly, differences between three subgroups were investigated: employee (n = 43), volunteer/sheltered (n = 14), and unemployed (n = 23). Secondly, multivariable regression analysis was applied to investigate the association between functional factors and employment hours. Compared to employees, volunteer/sheltered workers performed significantly slower hand function tasks (p < 0.001). Participants in the employee group had primarily MACS I (55.8%) or MACS II (44.9%) scores. The employee group showed significantly (p < 0.001) higher social participation and performance in daily activities. Thirty-eight percent of the variance in working hours could be explained by social participation, daily activities, fatigue, and gross motor function. Employees are more likely adults with CP with better manual abilities. Sheltered/volunteer workers showed slower execution in hand function and higher limitations in fine motor skills. Social participation, performing daily activities, fatigue, and gross motor function are functional factors associated with hours of employment. Upper limb evaluation on ability and speed gives valuable information to decide whether to work on the regular labour market or choose for volunteer or sheltered work. The use of supportive materials on the work floor is low; however, they may compensate for less manual abilities of adults with cerebral palsy compared to their healthy peers. Improving social participation and daily activities, fatigue, and gross motor function may lead to higher working hours [ABSTRACT FROM AUTHOR]

The loading screen is unavoidable to smartphone users, and the waiting experience influences the success of a mobile application. Providing visual feedback during waiting time is an effective way to increase the waiting experience. This study is the first to examine the effects of interactive loading screens on the waiting experience compared to a passive loading screen on mobile phones across varying waiting times. The rotating ring, which has been used in loading screens widely, was chosen in our experiments. Participants compared a passive animation with grey-scale and colour-changed interactive animations. The results indicated that the duration of waiting time has a significant impact on the selection of the loading screen type. The studies also demonstrate that colour can act as an essential design factor to improve the waiting experience when designing the interactive loading screen. Furthermore, it was found that perceived time was shorter when an interactive loading screen was used, leading to higher user satisfaction compared to a passive loading screen, especially for the long waiting time. The findings obtained in the experiments provide a reference and guidelines for loading screen design to improve users' waiting experience. [ABSTRACT FROM AUTHOR]

This investigation aimed to assess the safety and efficacy of NeoLight's Skylife phototherapy device for the treatment of hyperbilirubinemia. A prospective, two-arm, randomized, unblinded controlled investigation compared total serum bilirubin (TSB) levels at baseline and discharge for a new phototherapy device (Skylife) with an existing phototherapy treatment in newborn infants. The repeated-measures analysis of variance (RM-ANOVA) indicated a significant main effect for the treatment condition, F (1, 54) = 4.041, P =.049. Post hoc findings showed that the Skylife group had significantly lower TSB levels following treatment (n = 28, Mean = 11.36, SD = 1.69) compared with the standard of care group (n = 28, Mean = 12.37, SD = 2.08), t (54) = 2.01, P =.049). The Skylife phototherapy device was as effective as the currently used therapy, with a shift toward a more rapid decline in bilirubin levels. Using this device may potentially decrease the length of therapy and hospitalization. Clinical Trial Registration Comparison of Phototherapy Using Neolight Skylife Versus Standardized Phototherapy for Hyperbilirubinemia in Newborns is registered at clinicaltrials.gov as NCT03599258 [ABSTRACT FROM AUTHOR]

Background: We aimed to compare the analgesic effects of intravenous ibuprofen to ketorolac after open abdominal hysterectomy. Methods: This randomized double-blinded controlled trial included adult women scheduled for elective open abdominal hysterectomy. Participants were randomized to receive either 30 mg ketorolac (n = 50) or 800 mg ibuprofen (n = 50) preoperatively, then every 8 h postoperatively for 24 h. All participants received paracetamol 1 gm/6 h. Rescue analgesic was given if the visual analogue scale (VAS) for pain assessment was > 3. The primary outcome was the mean postoperative dynamic VAS during the first 24 h. Secondary outcomes were static VAS, intraoperative fentanyl consumption, postoperative morphine consumption, time to independent movement, and patient's satisfaction. Results: Forty-six patients in the ibuprofen group and fifty patients in the ketorolac group were analyzed. The 24-h dynamic and static VAS were similar in the two groups. The median (quartiles) dynamic VAS was 1.1 (0.9, 1.9) in the ibuprofen group versus 1.0 (0.7, 1.3) in the ketorolac group, P-value = 0.116; and the median (quartiles) static VAS was 0.9 (0.6, 1.3) in the ibuprofen group versus 0.7 (0.4, 1.1) in the ketorolac group, P-value = 0.113. The intra- and postoperative analgesic requirements were also similar in the two groups. However, patient satisfaction was slightly higher in the ketorolac group than that in the ibuprofen group (median [quartiles]: 6 [5, 7] versus 5 [4, 7], respectively), P-value: 0.009. Conclusion: The two drugs, intravenous ibuprofen and ketorolac produced similar analgesic profile in patients undergoing open abdominal hysterectomy receiving multimodal analgesic regimen. NCT05610384, Date of registration: 09/11/2022 Clinical trial registration: ClinicalTrials.gov Identifier: NCT05610384. https://clinicaltrials.gov/ct2/show/NCT05610384 [ABSTRACT FROM AUTHOR]

Background: There are significant geographic inequities in COVID-19 case fatality rates (CFRs), and comprehensive understanding its country-level determinants in a global perspective is necessary. This study aims to quantify the country-specific risk of COVID-19 CFR and propose tailored response strategies, including vaccination strategies, in 156 countries. Methods: Cross-temporal and cross-country variations in COVID-19 CFR was identified using extreme gradient boosting (XGBoost) including 35 factors from seven dimensions in 156 countries from 28 January, 2020 to 31 January, 2022. SHapley Additive exPlanations (SHAP) was used to further clarify the clustering of countries by the key factors driving CFR and the effect of concurrent risk factors for each country. Increases in vaccination rates was simulated to illustrate the reduction of CFR in different classes of countries. Findings: Overall COVID-19 CFRs varied across countries from 28 Jan 2020 to 31 Jan 31 2022, ranging from 68 to 6373 per 100,000 population. During the COVID-19 pandemic, the determinants of CFRs first changed from health conditions to universal health coverage, and then to a multifactorial mixed effect dominated by vaccination. In the Omicron period, countries were divided into five classes according to risk determinants. Low vaccination-driven class (70 countries) mainly distributed in sub-Saharan Africa and Latin America, and include the majority of low-income countries (95.7%) with many concurrent risk factors. Aging-driven class (26 countries) mainly distributed in high-income European countries. High disease burden-driven class (32 countries) mainly distributed in Asia and North America. Low GDP-driven class (14 countries) are scattered across continents. Simulating a 5% increase in vaccination rate resulted in CFR reductions of 31.2% and 15.0% for the low vaccination-driven class and the high disease burden-driven class, respectively, with greater CFR reductions for countries with high overall risk (SHAP value > 0.1), but only 3.1% for the ageing-driven class. Conclusions: Evidence from this study suggests that geographic inequities in COVID-19 CFR is jointly determined by key and concurrent risks, and achieving a decreasing COVID-19 CFR requires more than increasing vaccination coverage, but rather targeted intervention strategies based on country-specific risks. [ABSTRACT FROM AUTHOR]

Simple Summary: Mutation of the SMARCB1 gene can cause one of the most aggressive and lethal cancers of early childhood and infancy, malignant rhabdoid tumor (MRT). Despite the standard multimodal therapy (resection, conventional chemotherapy, and radiotherapy), the outlook for young children with MRT is poor. For infants, the disease can also preclude the use of radiotherapy. Numerous experimental treatments explore epigenetic mechanisms, but the DNA damage response has not yet been extensively evaluated as a therapeutic approach for MRT. We report a new therapeutic strategy for SMARCB1-deficient MRTs, combining PARP1 inhibition and DNA damage induction. The observed synergy between the PEGylated PARP1 inhibitor talazoparib (PEG~TLZ) and the DNA alkylating agent temozolomide (TMZ) may lead to improved therapeutic strategies for patients with this challenging cancer. We identified a new potential biomarker of response to PEG~TLZ+TMZ, O6-methylguanine methyltransferase (MGMT), and uncovered dysregulated signaling pathways involved in the response. Additionally, we elucidated the pro-survival role of SMARCB1 loss in MRT cells. Malignant rhabdoid tumors (MRTs) are among the most aggressive and treatment-resistant malignancies affecting infants, originating in the kidney, brain, liver, and soft tissues. The 5-year event-free survival rate for these cancers is a mere 20%. In nearly all cases of MRT, the SMARCB1 gene (occasionally SMARCA4)—a pivotal component of the SWI/SNF chromatin remodeling complex—is homozygously deleted, although the precise etiology of these tumors remains unknown. While young patients with localized MRT generally show improved outcomes, especially those who are older and have early-stage disease, the overall prognosis remains poor despite optimal standard treatments. This highlights the urgent need for more effective treatment strategies. We investigated the antitumor activity of a PARP1 inhibitor (talazoparib, TLZ) combined with a DNA alkylating agent (temozolomide, TMZ) in MRT xenograft models. PARP1 is a widely targeted molecule in cancer treatment and, beyond its role in DNA repair, it participates in transcriptional regulation by recruiting chromatin remodeling complexes to modulate DNA accessibility for RNA polymerases. To widen the therapeutic window of the drug combination, we employed PEGylated TLZ (PEG~TLZ), which has been reported to reduce systemic toxicity through slow drug release. Remarkably, our findings indicate that five out of six MRT xenografts exhibited an objective response to PEG~TLZ+TMZ therapy. Significantly, the loss of SMARCB1 was found to confer a protective effect, correlating with higher expression levels of DNA damage and repair proteins in SMARCB1-deficient MRT cells. Additionally, we identified MGMT as a potential biomarker indicative of in vivo MRT response to PEG~TLZ+TMZ therapy. Moreover, our analysis revealed alterations in signaling pathways associated with the observed antitumor efficacy. This study presents a novel and efficacious therapeutic approach for MRT, along with a promising candidate biomarker for predicting tumor response. [ABSTRACT FROM AUTHOR]

This study aimed to examine attachment and adult separation anxiety (ASA) among women who lost a parent in their youth. We hypothesized that insecure attachment and increased ASA from a romantic partner would be found among women who have lost a parent in youth, compared to women whose parents were both alive. Sixty women who lost one or both parents in their youth and 60 who had living parents participated in the study (mean age: 32.3, range: 18–62 years). Participants filled out the ASA and Short Attachment questionnaires. Women who lost a parent reported higher levels of anxious attachment and ASA from partner; the two groups did not differ, however, in terms of avoidant attachment. Additionally, similar effects on ASA and attachment were found among adult women who lost a father or a mother in their youth. In conclusion, the loss of a parent early in life may be associated with an insecure attachment style and increased ASA. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has determined a considerable increase in psychological distress worldwide. Compared with the general population, patients with chronic conditions experience higher stress levels due to the increased risk of worse health outcomes from COVID‐19 infection. Worries and fear of contagion could cause them to avoid going to their health facilities for medical examinations, which results in higher risks of morbidity and mortality. The present study aimed to develop and validate the Psychological Consequences of a Pandemic Event (PCPE) self‐report questionnaire, and to assess the psychological effects of exposure to a pandemic on mood and on treatment adherence appropriate for patients with chronic diseases. Data were analysed with Rasch analysis after an Exploratory Factor Analysis and a Confirmatory Factor Analysis. We identified a final set of 10 items, divided into two independent factors labelled "pandemic‐related anxiety" and "confidence in care". Finally, we transformed the raw scores of both factors into two interval scales (two rulers) that met the requirements of the fundamental measurement. The PCPE questionnaire has demonstrated to be a short and easy‐to‐administer measure, with valid and reliable psychometric properties, capable of assessing pandemic‐related anxiety and confidence in care in patients with chronic clinical conditions. [ABSTRACT FROM AUTHOR]

Purpose: There is increasing interest in the measurement of cognitive effort during listening tasks, for both research and clinical purposes. Quantification of task-evoked pupil responses (TEPRs) is a psychophysiological method that can be used to study cognitive effort. However, light level during cognitively demanding listening tasks may affect TEPRs, complicating interpretation of listening-related changes. The objective of this study was to examine the effects of light level on TEPRs during effortful listening across a range of signal-to-noise ratios (SNRs). Method: Thirty-six adults without hearing loss were asked to repeat target sentences presented in background babble noise while their pupil diameter was recorded. Light level and SNRs were manipulated in a 4 × 4 repeated-measures design. Repeated-measures analyses of variance were used to measure the effects. Results: Peak and mean dilation were typically larger in more adverse SNR conditions (except for SNR −6 dB) and smaller in higher light levels. Differences in mean and peak dilation between SNR conditions were larger in dim light than in brighter light. Conclusions: Brighter light conditions make TEPRs less sensitive to variations in listening effort across levels of SNR. Therefore, light level must be considered and reported in detail to ensure sensitivity of TEPRs and for comparisons of findings across different studies. It is recommended that TEPR testing be conducted in relatively low light conditions, considering both background illumination and screen luminance. [ABSTRACT FROM AUTHOR]

Purpose: Literature suggests a dependency of the acoustic metrics, smoothed cepstral peak prominence (CPPS) and harmonics-to-noise ratio (HNR), on human voice loudness and fundamental frequency (F0). Even though this has been explained with different oscillatory patterns of the vocal folds, so far, it has not been specifically investigated. In the present work, the influence of three elicitation levels, calibrated sound pressure level (SPL), F0 and vowel on the electroglottographic (EGG) and time-differentiated EGG (dEGG) metrics hybrid open quotient (OQ), dEGG OQ and peak dEGG, as well as on the acoustic metrics CPPS and HNR, was examined, and their suitability for voice assessment was evaluated. Method: In a retrospective study, 29 women with a mean age of 25 years (± 8.9, range: 18–53) diagnosed with structural vocal fold pathologies were examined before and after voice therapy or phonosurgery. Both acoustic and EGG signals were recorded simultaneously during the phonation of the sustained vowels /ɑ/, /i/, and /u/ at three elicited levels of loudness (soft/comfortable/loud) and unconstrained F0 conditions. Results: A linear mixed-model analysis showed a significant effect of elicitation effort levels on peak dEGG, HNR, and CPPS (all p < .01). Calibrated SPL significantly influenced HNR and CPPS (both p < .01). Furthermore, F0 had a significant effect on peak dEGG and CPPS (p < .0001). All metrics showed significant changes with regard to vowel (all p < .05). However, the treatment had no effect on the examined metrics, regardless of the treatment type (surgery vs. voice therapy). Conclusions: The value of the investigated metrics for voice assessment purposes when sampled without sufficient control of SPL and F0 is limited, in that they are significantly influenced by the phonatory context, be it speech or elicited sustained vowels. Future studies should explore the diagnostic value of new data collation approaches such as voice mapping, which take SPL and F0 effects into account. [ABSTRACT FROM AUTHOR]

Introduction: The chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) score is widely used for evaluating the health status of patients diagnosed with COPD. The aim of this study was to identify which components of the CAT are associated with exacerbations in severe COPD patients. Methods: Using data from the Korean COPD Subgroup Study (KOCOSS), we identified 3,440 COPD patients, among which 1,027 patients are classified as having severe COPD based on spirometry results. The CAT scores on 8 items were evaluated and classified into respiratory and non-respiratory categories. We analyzed the association between CAT item scores and moderate-to-severe exacerbations during study enrollment and the following years. Results: Patients with a history of moderate-to-severe exacerbations had higher scores on non-respiratory CAT components. Longitudinal CAT scores on all items after enrollment were higher in the moderate-to-severe exacerbation group. Additionally, the frequency of severe exacerbations was associated with specific CAT components related to limited activities, confidence leaving home, sleeplessness, and energy. Conclusions: This study revealed that the non-respiratory CAT component scores were statistically significant factors for predicting the moderate-to-severe exacerbation of severe COPD patients. Non-respiratory symptoms and functional limitations should be considered in patients with severe COPD. Interventions, such as pulmonary rehabilitation, may be needed to improve patients' overall well-being and prevent exacerbations. [ABSTRACT FROM AUTHOR]

Parents, especially mothers, and young women without children, face a subtle threat in job interviews: being asked inappropriate questions about parental status. In three vignette experiments (N = 760), we compared personal (perceived likability and likelihood of being hired) and social consequences (perceived chances that the interviewer will ask the inappropriate question again) of different response strategies. Results suggest that deflection (i.e., responding with another question) is a superior strategy at the personal level, as it increases the perceived chances to be hired in comparison to truth‐telling (Study 1) and confrontation (Studies 1–3) without hurting likability (Study 1). Confrontation (i.e., saying that the question is inappropriate) is a superior strategy at the social level, decreasing the perceived probability that the interviewer will keep asking inappropriate questions in comparison to deflection (Studies 2 and 3) and truth‐telling (Study 3). No gender differences were apparent. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Providing effective health education is essential for patients with cancer-related pain. One solution is leveraging instant messaging tools for teach-back health education. OBJECTIVES: This study investigated the effects of WeChat-based teach-back health education on patients with advanced cancer who underwent patient-controlled intrathecal analgesia implantation and used hydromorphone. METHODS: This retrospective study evaluated 150 hospitalized patients with advanced cancer pain. Patients were classified into a conventional health education group (N = 50) and a teach-back group (N = 100) based on whether they received WeChatbased teach-back health education. Pain was rated using a numeric rating scale, and sleep quality was measured using the Pittsburgh Sleep Quality Index at one, two, and three months postdischarge. FINDINGS: Patients who received remote teachback health education better managed their pain. Data also demonstrated improvements in patients' sleep quality and caregiver satisfaction, and reductions in the occurrence of adverse reactions. [ABSTRACT FROM AUTHOR]

A lack of response to voices, and a great interest for music are part of the behavioral expressions, commonly (self-)reported in Autism Spectrum Disorder (ASD). These atypical interests for vocal and musical sounds could be attributable to different levels of acoustical noise, quantified in the harmonic-to-noise ratio (HNR). No previous study has investigated explicit auditory pleasantness in ASD comparing vocal and non-vocal sounds, in relation to acoustic noise level. The aim of this study is to objectively evaluate auditory pleasantness. 16 adults on the autism spectrum and 16 neuro-typical (NT) matched adults rated the likeability of vocal and non-vocal sounds, with varying harmonic-to-noise ratio levels. A group by category interaction in pleasantness judgements revealed that participants on the autism spectrum judged vocal sounds as less pleasant than non-vocal sounds; an effect not found for NT participants. A category by HNR level interaction revealed that participants of both groups rated sounds with a high HNR as more pleasant for non-vocal sounds. A significant group by HNR interaction revealed that people on the autism spectrum tended to judge as less pleasant sounds with high HNR and more pleasant those with low HNR than NT participants. Acoustical noise level of sounds alone does not appear to explain atypical interest for voices and greater interest in music in ASD. [ABSTRACT FROM AUTHOR]

Autism is associated with genomic instability, which is regulated by telomere length (TL) and index of global methylation (LINE-1). This study will determine relative TL (RTL) and LINE-1 methylation percentage for 69 patients and 33 control subjects to evaluate their potential role as biomarkers for autism. The results displayed a significant decrease of both RTL and LINE-1 methylation in autistic cases relative to controls (P < 0.001). Analysis of receiver operating characteristics curve revealed that both of RTL and LINE-1 methylation percentage have the ability to serve as autism biomarkers (area under the curve = 0.817 and 0.889, respectively). The statistical analysis revealed positive correlation between the two biomarkers (correlation coefficient = 0.439 and P < 0.001). [ABSTRACT FROM AUTHOR]

PEERS® for Young Adults is an evidence-based program aimed at teaching social skills needed to establish and maintain close relationships, including friendship and romantic relationships. The study investigated the effects of the Polish adaptation of the curriculum on the social functioning of adults on the autism spectrum. Fifteen young adults (aged 18–32, M = 23.5) were randomly allocated to an immediate or delayed (control) treatment condition. By self and parent report, individuals who participated in the PEERS® program showed significant improvements in social skills, social cognition, and social knowledge, but limited gains in social engagement. The effects were maintained over six months after the treatment. The intervention was well-accepted and deemed feasible by young adults, their parents, and peers involved in the program. [ABSTRACT FROM AUTHOR]

Purpose: The association between birth order and adverse perinatal outcomes has been well studied in twin pregnancies. However, little is known about the differences in immediate perinatal outcomes as well as long‐term hospitalization of the offspring in triplet pregnancies according to their birth order. As such, we aimed to assess the differences in immediate perinatal outcomes and long‐term hospitalizations among triplets by their birth order. Methods: In a retrospective hospital‐based cohort study, immediate perinatal outcomes and long‐term hospitalizations were compared among triplet siblings according to their birth order. Deliveries occurred between the years 1991 and 2021 in a tertiary medical center. The study groups were followed until 18 years of age for cardiovascular, respiratory, neurological, and infection‐related hospitalizations. Generalized estimation equation (GEE) models were used to control for confounders. Kaplan–Meier survival curves were used to compare cumulative long‐term hospitalization incidences and Cox proportional hazards models were performed to control for confounders. Results: The study included 117 triplet deliveries. Rates of small for gestational age (SGA) infants increased linearly by birth order (6.0%, 7.7%, and 15.4% for the first, second, and third siblings, respectively; p‐value for trends = 0.035). Using a GEE model controlling for maternal age, being born third in a triplet pregnancy was independently associated with SGA (third vs. first sibling, adjusted OR 3.0, 95% CI 1.38–6.59, p = 0.005). No significant differences in cardiovascular, respiratory, neurological, and infection‐related hospitalizations were noted among the first, second, and third siblings. Likewise, using Kaplan–Meier survival analyses, no significant differences in the cumulative incidence of long‐term pediatric hospitalizations were noted between the siblings. In Cox proportional hazards models, controlling for weight and gender, birth order in a triplet pregnancy did not exhibit an association with long‐term hospitalizations of the offspring. Conclusion: Despite the association between birth order and SGA, birth order in triplets does not seem to have an impact on the risk for long‐term offspring hospitalization. [ABSTRACT FROM AUTHOR]

Purpose: Evidence is growing that high salt intake is an independent risk factor for obesity, but the mechanisms are unknown. Our novel working hypothesis is that high salt intake drives cortisol production, which in turn, drives obesity. The current study aimed to demonstrate an acute cortisol response following a single high salt meal. Methods: Eight participants (age 30.5 ± 9.8 years [mean ± SD], 50% female), consumed high salt (3.82 g; 1529 mg sodium) and low salt (0.02 g; 9 mg sodium) meals in a randomized cross-over design. Results: Urinary and salivary cortisol and plasma adrenocorticotropic hormone (ACTH) demonstrated order effects. When high salt was given second, there was a peak above baseline for urinary cortisol (26.3%), salivary cortisol (9.4%) and plasma ACTH (4.1%) followed by a significant decline in each hormone (treatment*time, F[9, 18] = 2.641, p = 0.038, partial η2 = 0.569; treatment*time, F[12, 24] = 2.668, p = 0.020, partial η2 = 0.572; treatment*time, F[12, 24] = 2.580, p = 0.023, partial η2 = 0.563, respectively), but not when high salt was given first (p > 0.05 for all). Conclusion : These intriguing findings provide partial support for our hypothesis and support a need for further research to elucidate the role of high salt intake in cortisol production and, in turn, in the aetiology of obesity. Trial registration number: ACTRN12623000490673; date of registration 12/05/2023; retrospectively registered. [ABSTRACT FROM AUTHOR]

Our purpose in this study was to determine the effects of a virtual reality intervention delivering specific motivational motor learning manipulations of either autonomy support (AS) or enhanced expectancies (EE) on frontal plane single-leg squatting kinematics. We allocated 45 participants (21 male, 24 female) demonstrating knee, hip, and trunk frontal plane mechanics associated with elevated anterior cruciate ligament injury risk to one of three groups (control, AS, or EE). Participants mimicked an avatar performing five sets of eight repetitions of exemplary single-leg squats. AS participants were given the added option of choosing the color of their avatar. EE participants received real-time biofeedback in the form of green highlights on the avatar that remained on as long as the participant maintained pre-determined 'safe' frontal plane mechanics. We measured peak frontal plane knee, hip, and trunk angles before (baseline) and immediately following (post) the intervention. The control group demonstrated greater increases in knee abduction angle (Δ = +2.3°) than did the AS (Δ = +0.1°) and EE groups (Δ = −0.4°) (p =.003; η2p =.28). All groups demonstrated increased peak hip adduction (p =.01, ηp2 =.18) (control Δ = +1.5°; AS Δ = +3.2°; EE Δ = +0.7°). Hip adduction worsened in all groups. AS and EE motivation strategies appeared to mitigate maladaptive frontal plane knee mechanics. [ABSTRACT FROM AUTHOR]

Purpose: The current study aimed to evaluate the telic-paratelic tendency and heart rate variability in athlete participants from different sports activities. Methods: We assigned 117 healthy participants (M age = 20, SD = 3 years) into three groups according to their training activity: power-trained (PT; n=43), endurance-trained (ET; n=36), and healthy untrained individuals (n=38). We assessed their telic-paratelic tendencies with the validated Telic Dominance Scale and their autonomic nervous system activity with heart rate variability (HRV) analyses. Results: Our findings revealed no significant differences in the telic-paratelic tendencies between ET and PT groups. However, significant differences were observed between athletes and untrained individuals (p = 0.001). Indeed, compared to untrained participants, ET and PT athletes had a greater telic tendency (both p = 0.001), were more focused on planning orientation (ET: p = 0.003; PT: p =0.001), and less often avoided arousal or activation (For ET 31% and for PT 26% of participants). The paratelic tendency was more important in untrained individuals, with most of these participants lacking in serious mindedness and planning. In addition, we found higher HRV in paratelic ET athletes (SDNN p = 0.050, LF p = 0.022, and LF/HF p = 0.031) compared to their telic peers. Conclusion: our results suggest that sport activity did not influence the telic-paratelic tendency. Nevertheless, this tendency differentiates trained from untrained participants. HRV was higher among paratelic ET athletes, potentially reflecting less stress and more training adaptability in these athletes. [ABSTRACT FROM AUTHOR]

Chronic traumatic neck pain has a high prevalence of post-traumatic stress symptoms (PTSS). However, whether PTSS moderates treatment effects is unknown. This study investigated: 1) whether PTSS was associated with patient-reported outcomes and clinical test results at baseline; 2) whether PTSS moderated the effect of a multimodal physiotherapy intervention of exercise therapy and patient education; and 3) whether adherence to the intervention differed across PTSS groups. Secondary data analysis from a randomized controlled trial on chronic neck pain with 12-month follow-up was conducted. Patients were divided into three groups (NT = non-traumatic, LT = traumatic low PTSS, HT = traumatic high PTSS) based on self-reported onset of pain and the Impact of Event Scale. The baseline data were used to analyze the association of PTSS with patient demographics and scores of physical and mental health-related quality of life, depression, neck-related disability, kinesiophobia, and clinical tests. Baseline, 4-month and 12-month follow-up data were analyzed to investigate possible moderating effects on outcomes. Data on adherence were collected at four months. 115 participants were included (NT n = 45; LT n = 46; HT n = 24). The HT group reported lower mental health scores and more depressive symptoms at baseline. PTSS did not significantly moderate the treatment effect on any outcomes. The HT group tended to have lower adherence to the multimodal physiotherapy intervention than the LT group. For patients with traumatic neck pain, high levels of PTSS are associated with poorer psychological outcomes but do not affect the outcomes of multimodal physiotherapy intervention. [ABSTRACT FROM AUTHOR]

BACKGROUND: Excess heat accrual is perhaps the body's most dangerous exercise-induced stressor. While palm cooling uses conduction to reduce body temperatures, to date the volume of heat transferred by this treatment resulting from exercise is unknown. OBJECTIVE: Asses continuous palm cooling's impact on heat transfer and physiology. METHODS: Thirty-one subjects did two workouts; one with, and one without, palm cooling. Workouts entailed consecutive stages of submaximal pedaling against prescribed workloads. Gloves were worn at workouts; for palm cooling 10.6∘C gel packs were inserted into gloves at the workout's start and conclusion. Heart rate, auditory canal and palm skin temperatures, and heat transfer across the palm were collected. Data were obtained pre-exercise, at the end of a warm-up, and at multiple times during the 25 minutes of pedaling and 30 minutes of recovery. RESULTS: Auditory canal temperatures had a significant treatment effect (palm cooling < non-palm cooling). Palm skin temperature had an interaction, with higher non-palm cooling values at multiple times. Conversely, heat transfer also produced an interaction, but palm cooling had significantly higher values at multiple times. Heat transfer was 32% higher for the palm cooling workout. CONCLUSIONS: Continuous palm cooling produced significantly higher heat transfer from submaximal exercise. [ABSTRACT FROM AUTHOR]

Introduction: Due to the COVID‐19 pandemic, the Undergraduate Medical Doctor (MD) Programme at McMaster University (Hamilton, Canada) was unable to run in‐person medical school interviews in March 2020, prompting an alternate solution that maximised admission opportunities for Indigenous applicants, prioritised admission for those rated most highly in the interview determination process, and allocated subsequent offers via lottery. Methods: A short survey was administered to applicants who had been offered an admissions interview and were subsequently impacted by the admissions adaptations. The survey elicited perceptions of the adaptation through Likert scale ratings and free‐text responses. Survey data were analysed via a sequential (quantitative to qualitative) mixed‐methods design. Results: 196 of 552 potential participants completed the survey. Across quantitative and qualitative analyses, respondents reported that the adaptation had a negative impact on their professional development and personal life. Ratings of negative perception were greater for those who did not receive an offer than for those who accepted or declined an offer. Free text responses emphasised considerable criticism for the lottery portion of the adaptation and displeasure that efforts made in constructing applications were less relevant than anticipated. Discussion: The negative responses to this unexpected change highlight the profound upstream impact admission policies have on the preapplication behaviours of aspiring medical students. The outcomes support a refined understanding of the value candidates place on the interview in appraising their own suitability for a career as a physician. [ABSTRACT FROM AUTHOR]

In 2006, Marks and Fraley published research suggesting that people remembered more information that was consistent rather than inconsistent with a sexual double standard. Despite the impact of that paper on the field, there were several caveats of that research, including a small sample. The present research, therefore, aims to replicate and extend Marks and Fraley's research. Presently, 400 participants read a vignette about a sexually active man or woman for two minutes. This vignette contained an equal amount of positive and negative information. Participants then had 5 minutes to recall the information from the vignette. In the extension portion of the research, some participants experienced an experimentally varied delay, which was used to create forgetting curves in an effort to parse apart whether any differences in recall were due to differences in the encoding process, retrieval process, or both. Recall results replicated the pattern of results from Marks and Fraley (2006), in that participants remembered more negative information about the woman than the man, and more negative than positive information about the woman. Analyses of forgetting curves were inconclusive, as the predictors explained less than 0.5% of the variance in recalled information. [ABSTRACT FROM AUTHOR]

Empathy is thought to be reduced in videoconference (VC) compared to face-to-face (F2F) therapy. To empirically test this possibility, therapist and client ratings of empathy and its correlates were examined in VC and F2F sessions. Forty-eight students in clinical training programs were randomly assigned to the role of 'therapist' or 'client', forming 24 dyads. Each dyad completed a simulated clinical session in F2F and in VC and reported on empathy and telepresence. Both therapist and client ratings of empathy were significantly lower in VC compared to F2F. Therapist empathy correlated with telepresence, particularly its physical subcomponent, and therapeutic presence, but these associations were not found for clients. The relationship between empathy and telepresence was investigated further in a real-world study. Twelve clients met with clinical psychology trainees over VC and reported on empathy and telepresence. The associations between therapist empathy, total telepresence, and the physical component of telepresence were replicated. Again, client ratings of empathy and telepresence did not correlate. These results provide the first empirical evidence that empathy is reduced in VC teletherapy compared to F2F and highlight the connection between the degree of empathy felt by therapists and their sense of telepresence during teletherapy. [ABSTRACT FROM AUTHOR]

Background: Virtual reality (VR) offers much potential for learning, but it challenges learners' orientation. Objectives: This paper investigates whether it is possible to use light or movement cues to facilitate orientation in a search task in a desktop‐VR environment so that participants can better attend to the learning content presented simultaneously. Methods: In two pre‐registered online experiments, we investigated the effects of cueing (light and movement) on search time, learning, and several evaluation variables. Participants were asked to find tools in a virtual workshop, while information about the respective tool was narrated. Experiment 1 (N = 60) used a within‐subject design, that is, the objects were alternately highlighted by light, movement or not. For Experiment 2 (N = 159) the narration was substantially shortened, and a between‐subject design was used. Cognitive load and presence were measured additionally. Results and conclusions: In Experiment 1, only the movement cue decreased search time, indicating automatic guidance of learners' attention. There was no effect of cueing on learning, which may be due to the average search time being substantially shorter than the narration, leaving sufficient time to attend to the narration exclusively. In Experiment 2 search times were significantly faster for both cueing methods, but only the light cue resulted in better learning outcomes, which could be explained by the slightly lower presence in the movement cue condition. Implications: Results imply that it is important to develop cues that automatically guide attention without reducing presence. Lay Description: What is already known about this topic: Virtual reality (VR) offers a lot of opportunities for the integration of educational scenarios.VR is challenging for learners with regard to orientation in a 360° environment.Regarding learning outcomes, research on the effects of cues to highlight important content in a 360° environment is still rare.Presence, defined as the feeling of being there in a VR environment, is an important prerequisite for learning in VR. What this paper adds: The influence of light and movement cues on search times and learning outcomes in a desktop‐VR environment was tested.Movement cues can reliably reduce search times (indicating successful orientation), whereas light cues only reduced search times in predictable scenarios.In a predictable scenario, light cues enhanced learning outcomes compared with movement cues.Movement cues reduced presence, which is one potential reason why movement cues did not improve learning. Implications for practice and/or policy: Using light cues might assist orientation and enhance overall performance in predictable scenarios (i.e., when learners know what kind of cue to expect).In an unpredictable setting with variable cues, light cues did not facilitate orientation, whereas movement cues did.However, movement cues reduced presence, which may have negatively affected learning outcomes. It is important to develop cueing methods that also work in more unpredictable settings, but that do not reduce presence. [ABSTRACT FROM AUTHOR]

Background: Research into enhancing the effectiveness of information delivery in asynchronous video lectures remains sparse. This study analyzes the nonverbal teaching behaviours in asynchronous online videos, drawing comparisons between pre‐service and in‐service teachers (ITs). Objectives: This research primarily aims to juxtapose the nonverbal teaching behaviours, such as arm extensions and body orientation, utilized by pre‐service teachers (PTs) and ITs within asynchronous online videos. Methods: Asynchronous video lectures from four pre‐service and four ITs across four diverse subject topics were scrutinized. Leveraging deep learning technology, teachers' poses during their instruction towards a video camera were quantified, with a particular focus on arm stretch range and body orientation in relation to the subject being taught. Results: The findings revealed that PTs were deficient in effectively employing pointing gestures. Their arm stretches and body orientation towards the board were not differentiated across subjects. Conversely, ITs demonstrated subject‐specific variations in their arm extension and body orientation, signalling their effective strategies for knowledge dissemination. Conclusions and Discussion: This study emphasizes the importance of assessing nonverbal teaching behaviours in the development of effective instructional training. It accentuates the need for nonverbal communication and subject‐specific teaching strategy training in PTs. Future investigations could broaden their scope to include larger sample sizes and expanded subject areas to discern more comprehensive trends in nonverbal teaching behaviours. Lay Description: What is already known about this topic: The proliferation of online and distance learning has been largely driven by the widespread utilization of asynchronous video lectures.However, the focus of video analysis regarding teaching practices has predominantly been on in‐class activities. This has resulted in the underdevelopment of methods for delivering knowledge through asynchronous video lectures.Research into enhancing the effectiveness of information delivery within asynchronous video lectures remains sparse. What this paper adds: This study contributes to the development of teaching techniques for asynchronous online lectures through a comparative analysis of nonverbal teaching behaviours between pre‐service and in‐service teachers within asynchronous lecture videos.The findings suggest that pre‐service teachers have a deficiency in knowledge regarding the effective use of demonstrative gestures. Implications for practice and/or policy: Considering the widespread use of asynchronous video lectures – including flipped and blend learning, the training of pre‐school teachers using video analysis is requiredThe creation of a robust metric for developing knowledge delivery methods is feasible and advisable, potentially by leveraging state‐of‐the‐art technology such as deep learning. [ABSTRACT FROM AUTHOR]

Objective: There is a need to characterize exposures associated with the pathogenesis of systemic lupus erythematosus (SLE). In this pilot study, we explore a hypothesis‐free approach that can measure thousands of exogenous chemicals in blood ("exposome") in patients with SLE and unaffected controls. Methods: This cross‐sectional study analyzed a cohort of patients with prevalent SLE (n = 285) and controls (n = 106). Plasma was analyzed by liquid chromatography–quadrupole time‐of‐flight mass spectrometry (LC‐QTOF/MS). Mass spectrometry features present in at least 25% of all samples were selected for association analysis (n = 2,737). Features were matched to potential chemicals using available databases. Association analysis of abundances of features with SLE status was performed, adjusting for age and sex. We also explored features associated with SLE phenotypes, sociodemographic factors, and current medication use. Results: We found 30 features significantly associated with SLE status (Bonferroni P < 0.05). Of these, seven matched chemical names based on databases. These seven features included phthalate metabolites, a formetanate metabolite, and eugenol. The abundance of acid pesticides differed between patients with SLE and controls (Bonferroni P < 0.05). Two unmatched features were associated with a history of lupus nephritis, and one with anti–double‐stranded DNA antibody production (Bonferroni P < 0.05). Seventeen features varied by self‐reported race and ethnicity, including a polyfluoroalkyl substance (analysis of variance P < 1.69 × 10−5). Eleven features correlated with antimalarials, 6 with mycophenolate mofetil, and 29 with prednisone use. Conclusion: This proof‐of‐concept study demonstrates that LC‐QTOF/MS is a powerful tool that agnostically detects circulating exogenous compounds. These analyses can generate hypotheses of disease‐related exposures for future prospective, longitudinal studies. [ABSTRACT FROM AUTHOR]

Based on the ERG (Existence, Relatedness and Growth) theory, a scale was developed to evaluate the professional needs of psychological counsellors in China and its related factors were explored. A total of 209 counsellors participated in the study and completed two online questionnaires. The majority of participants were female (n = 163, 78%). The average age of participants is 41.00 (SD = 8.66). The results showed that the existence needs ($\bar{x}$ x ¯ = 4.49, SD = 0.60), relatedness needs ($\bar{x}$ x ¯ = 4.20, SD = 0.65) and growth needs ($\bar{x}$ x ¯ = 4.66, SD = 0.50) of counsellors were all at a high level. Work setting, marital status and regular supervision had a significant influence on the professional needs of counsellors. Counsellors working in private practice had more existence and growth needs compared to those working in institutions. Counsellors, who were married, had more existence and relatedness needs than those who were single. Counsellors without regular supervision had more existence, relatedness and growth needs. [ABSTRACT FROM AUTHOR]

Prior research on autistic sibling relationship quality largely ignored autistic sibling perspectives. Researchers continue to prioritize allistic (non-autistic) siblings' notions of relationship quality, preventing clinicians from faithfully measuring and supporting the relational well-being of autistic clients. The present study aims to understand adult autistic sibling relationship quality from both the perspective of autistic and allistic siblings, and how the combination of sibling neurocognitive functioning styles in sibling pairs impacts these results. Our sample (N = 211) is from a larger study of college students asked about their sibling relationships, with the following subgroups: 15 autistic participant and sibling pairs (both autistic), 51 allistic participants with autistic siblings (participant allistic, sibling autistic), and 145 allistic participants and sibling pairs (both allistic). We operationalized sibling relationship quality as intimacy using the Intimacy Scale (IS), and warmth using the Adult Sibling Relationship Questionnaire (ASRQ). We conducted analyses with ANOVA and post hoc tests. Results indicate that both sibling warmth (F = 15.24, p < 0.001) and sibling intimacy (F = 18.33, p < 0.001) differ significantly by sibling neurocognitive style combination. Sibling neurocognitive style combination still independently predicted sibling warmth (F = 6.64, p < 0.01) and intimacy (F = 3.66, p < 0.01) when controlling for demographics. We consider the implications of these findings, including the risks of perpetuating discrimination and a clinical ideology of cure when attempting to measure and operationalize relationship quality with autistic people. [ABSTRACT FROM AUTHOR]

Purpose: Muscle mechanics is paramount in our understanding of motor performance. However, little is known regarding the sensitivity of fascicle dynamics and connective tissues stiffness to exercise duration and ambient temperature during running, both increasing muscle temperature. This study aimed to determine gastrocnemius medialis (GM) fascicle dynamics in vivo during running in temperate and hot conditions, as well as muscle-tendon unit responses. Methods: Using ultrafast ultrasound, 15 participants (8 men, 7 women; 26 ± 3 yr) were tested before, during (2 and 40 min), and after a running task (40 min at 10 km⋅h-1) in temperate (TEMP; ~23°C) and hot (HOT: ~38°C) conditions. Results: Although core, skin temperatures, and heart rate increased from the beginning to the end of the exercise and in a larger extent in HOT than TEMP (P < 0.001), the physiological stress elicited did not alter running temporal parameters and GM fascicle operating lengths, with similar behavior of the fascicles on their force-length relationship, over time (2 vs 40 min) or across condition (TEMP vs HOT; P ≥ 0.248). Maximal voluntary force production did not reported statistical changes after exercise (P = 0.060), and the connective tissues stiffness measured (i.e., passive muscle and stiffness of the series-elastic elements) did not show neither time (P ≥ 0.281), condition (P ≥ 0.256) nor time-condition interaction (P ≥ 0.465) effect. Conclusions: This study revealed that prolonged running exercise does not alter muscle-tendon unit properties and interplay, which are not influenced by ambient temperature. These findings may rule out potential detrimental effects of heat on muscle properties and encourage further investigations on longer and more intense running exercise. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: There is a well-established association between preexisting depression/anxiety and greater postconcussion symptom burden, but the potential impact of antidepressant medications has not been fully explored. The primary objective of this study was to compare preinjury/baseline and postinjury concussion symptomscores and neurocognitive performance of athletes on antidepressant medications, both with healthy controls and with those with depression/anxiety not on antidepressants. Methods: This is a cross-sectional study using data collected from 49,270 junior and high school athletes from computerized neurocognitive assessments (Immediate Post-Concussion Assessment and Cognitive Test [ImPACT]) administered between 2009 and 2018 held by the Massachusetts Concussion Management Coalition. The main outcome measures were symptom scores and neurocognitive performance measures, all of which were assessed both at baseline and postinjury. Statistical analysis included analysis of variance and Tukey pairwise comparisons for continuous variables and Fisher's exact test for categorical variables. Multivariate regression models were used to adjust for potential confounding variables. Results: Both at baseline and postinjury, athletes with depression/anxiety had mean total symptom scores that were more than double that of healthy controls regardless of antidepressant use. Although there were no significant differences in neurocognitive performance at baseline, depression/anxiety was associated with small but significant decreases in postinjury visual memory and visual motor scores. Conclusions: Both at baseline and after sustaining a concussion, young athletes with depression/anxiety experience significantly greater symptom burden compared with healthy controls regardless of antidepressant use. [ABSTRACT FROM AUTHOR]

Background: One in two ventral and incisional hernia repair (VIHR) patients have preoperative opioid prescription within a year before procedure. The study's aim was to investigate risk factors of increased postoperative prescription filling in patients with or without preoperative opioid prescription. Methods: VIHR cases from 2013 to 2017 were reviewed. State prescription drug monitoring program data were linked to patient records. The primary endpoint was cumulative opioid dose dispensed through post-discharge day 45. Morphine milligram equivalent (MME) was used for uniform comparison. Results: 205 patients were included in the study (average age 53.5 years; 50.7% female). Over 35% met criteria for preoperative opioid use. Preoperative opioid tolerance, superficial wound infection, current smoking status, and any dispensed opioids within 45 days of admission were independent predictors for increased postoperative opioid utilization (p < 0.001). Conclusion: Preoperative opioid use during 45-day pre-admission correlated strongly with postoperative prescription filling in VIHR patients, and several independent risk factors were identified. [ABSTRACT FROM AUTHOR]

Aim: To describe the expectations, acceptability, and challenges identified by nurses and key healthcare stakeholders regarding the implementation of advanced practice nursing in Gabon. Background: Advanced practice nursing presents an opportunity to address the epidemiological transition and the shortage of healthcare professionals in Africa. In anticipation of establishing a master's degree program in advanced practice nursing and its subsequent implementation, it is important to understand Gabon's specific needs and characteristics. Design: This study used a multicenter cross‐sectional mixed‐method design. Methods: From April to May 2022, a total of 187 healthcare professionals were included from two hospitals and two universities in Gabon. Data were collected through questionnaires and complemented by focus group discussions, guided by the existing literature, the PEPPA framework, and Hamric's model. Results: The implementation of advanced practice nursing was generally well accepted. Factors influencing acceptability included being female, awareness of advanced practice nursing, and supporting the role of advanced practice nurses in diagnosing chronic diseases. Barriers to implementation included the absence of a legal framework for the profession and a lack of recognition of nursing skills by both nurses and doctors. Facilitators included the establishment of a master's degree program, formalization of a legal framework, raising awareness, providing training to medical doctors and other healthcare professionals about advanced practice nursing, and the development of nursing leadership. Implications for nursing: Advanced practice nursing can play a crucial role in addressing healthcare resource shortages and the dual burden of chronic and infectious diseases in Gabon, as well as in other African countries. Implications for nursing policy: To successfully implement advanced practice nursing in Gabon and French‐speaking Africa, it is essential to regulate the nursing and advanced nursing professions by creating a legal framework and establishing nursing councils. An effective implementation strategy for advanced practice nurses should be based on the specific needs of the country. Guidelines: COREQ, STROBE [ABSTRACT FROM AUTHOR]

Economic empowerment (EE) services promote survivors' economic stability and well-being. A target for intervention and prevention, then, is to offer more effective EE services. The study purpose was to develop a clearer picture of what EE services agencies offer, and how prepared staff are to provide these services. We collected data from 154 providers. Survivors most requested, and agencies most frequently provided, housing services. EE services offered did not differ by agency location, staff size, or number of clients. Providers' confidence was greater if they completed high school; their agency offered more EE services; and they completed voluntary training. [ABSTRACT FROM AUTHOR]

Based on previous work, we developed the comic "A healthy liver will always deliver!" to raise awareness about Non-Alcoholic Fatty Liver Disease (NAFLD) and promote healthy lifestyles. An online pre-post questionnaire design demonstrated an increase in health-threat beliefs regarding NAFLD among the general public, as well as response efficacy and self-efficacy beliefs, normative and control beliefs regarding the maintenance of preventive strategies involving healthy diets and active lifestyles, after interaction with the comic's narrative. This effect was more evident in women. Furthermore, although we could not perform all the ideal controls during the COVID-19 pandemic, and the online strategy attracted mostly university education-level subjects, the comic seemed relatable and engaging. However, more work will have to be performed to ensure its usefulness in terms of acquired knowledge and behavior changes, especially in at-risk segments of the population. [ABSTRACT FROM AUTHOR]

Social norms are common in persuasive messaging. For norms trending in a positive direction, it may be beneficial to emphasize change (i.e. dynamic norm) rather than the status quo (i.e. static norm). To test this proposition, we examined college students' responses to social norm messages encouraging moderate alcohol use. Undergraduates (N = 842) were randomly assigned to view a dynamic norm ("More college students drinking in moderation"), a static descriptive norm ("Most college students drink in moderation"), or a no message control. Four mechanisms were examined as potential mediators, three of which have been examined in previous work (preconformity, perceived importance, self-efficacy) and one of which was novel (psychological reactance). Results revealed that exposure to either social norm message (dynamic or static descriptive) was associated with more favorable attitude relative to a no message control. Attitude did not differ between the dynamic norm and static descriptive norm conditions. Only psychological reactance mediated the relationship between message condition (dynamic vs. static descriptive norm) and favorable attitude. Implications and future directions are discussed. [ABSTRACT FROM AUTHOR]

This study compared the effect of traditional exercise training and game-based exercise by TRAZER© on dynamic balance activities, vestibular ocular motor sensory (VOMS), falls efficacy scale-international (FES-I), and muscular performance in healthy older adults. Twenty-two older adults (mean age: 77.59 ± 6.20 years) randomly divided into two groups (1) exercise training (ET) and (2) ET + TRAZER©. Both groups participated in one-hour exercise sessions, three days a week for 10 wk. The ET + TRAZER© group completed the three dynamic/agility balance assessments each day. The results showed the three TRAZER© assessments significantly increased in the ET + TRAZER© group. However, there was not a statistically significant difference between the groups for timed up and go (TUG), sit-to-stand (STS), and FES-I. Our findings provided evidence that game-based exercise intervention improved muscular function and VOMS, especially dynamic balance and reaction time in older adults. [ABSTRACT FROM AUTHOR]

Objective: To measure degree of conversion (DC) of a flowable composite, microtensile bond strength (MTBS) to dentine in the snow‐plow technique with/without preheating and temperature in the preheated composite. Materials and Methods: For DC, snow‐plow specimens of Filtek Ultimate Flowable (Flow) and Filtek Bulk Fill (Bulk) (3M) were prepared by light‐curing composites simultaneously in standardized molds while in control groups light‐curing was separate. DC of Flow was measured using micro‐Raman spectroscopy. For MTBS, specimens were prepared on dentine of human extracted molars by simultaneous (snow‐plow) or separate (control) light‐curing. MTBS was measured using a universal testing machine after 24 h and 6 months. Data were analyzed using ANOVA with Tukey's post hoc (α = 0.05). Results: Increased curing time significantly increased DC in snow‐plow from 13.4% ± 11.6% (10 s) to 31.8% ± 4.4% (40 s) albeit significantly lower than controls (p < 0.05). Preheated Bulk improved conversion in snow‐plow (44.3% ± 1.7%) and control (50.5% ± 2.6%) (p < 0.05). No significant differences occurred in MTBS between groups (p > 0.05). MTBS values ranged between 66.7 ± 8.4 MPa (snow‐plow group_21°C_baseline) and 54.1 ± 15.8 MPa (control_21°C_long‐term). Temperature in the preheated Bulk dropped to ~38°C after 30 s. Conclusions: Snow‐plow technique, irrespective of preheating, resulted in lower DC of Flow than separate light‐curing of composite increments. Snow‐plow, irrespective of preheating, resulted in similar initial and long‐term MTBS to dentine. Clinical Significance: Clinicians with preference for flowable composite liners in Class II restorations should be aware that the snow‐plow technique of simultaneous light‐curing of flowable and bulk‐fill composite increments affects monomer‐to‐polymer conversion, albeit no effect on immediate, and long‐term bonding to dentine was detected. Preheating sculptable bulk‐fill composite improves conversion of the flowable liner in the snow‐plow technique but has no detectable effect on bond strength to dentine. [ABSTRACT FROM AUTHOR]