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Context: To stabilize the humeral head within the glenoid fossa during arm elevation, the rotator cuff muscles may contribute through internal and external rotation. The main purpose of the current study was to compare the acromiohumeral distance between athletes with primary subacromial impingement syndrome who received progressive resistance exercises consisting of either shoulder internal or external rotation. Design: A randomized and controlled clinical study. Methods: Thirty athletes with primary subacromial impingement syndrome were enrolled and randomly divided into 2 experimental groups. The progressive resistance exercise protocol in experimental group I comprised shoulder internal rotation, while in experimental group II consisted of shoulder external rotation. The experimental groups worked out 3 days a week for 6 weeks. The experimental groups were compared with the control group consisting of 15 healthy athletes. The acromiohumeral distance was measured before and after the intervention using an ultrasound machine under the passive and active across no arm elevation and 45°of arm elevation. Results: The acromiohumeral distance significantly increased in both experimental groups under the passive and active arm positions following the intervention (P <.001), with no significant differences detected between the experimental groups (P >.665). The paired comparisons of the acromiohumeral distance discrepancy indicated a significant difference between the control group and each experimental group under the active and passive arm positions (P <.001), while no significant difference was observed between the experimental groups (P >.999). Conclusions: The present study revealed, for the first time, that both progressive resistance exercise protocols involving either the shoulder internal or the external rotation increased the acromiohumeral distance in individuals with primary subacromial impingement syndrome and improved associated pain and disabilities. [ABSTRACT FROM AUTHOR]

This study investigated the test–retest reliability of running economy (RE) and metabolic and cardiorespiratory parameters related to endurance running performance using a multistage incremental treadmill test. On two occasions separated by 21–28 days, 12 male middle- and long-distance runners ran at 10, 11, 12, 13, and 14 km/hr for 8 min each stage, immediately followed by a ramp test to volitional exhaustion. Carbohydrate (10% maltodextrin solution) was consumed before and during the test to provide ∼1 g/min of exercise. RE, minute ventilation ( V ˙ E), oxygen consumption ( V ˙ O 2 ), carbon dioxide production ( V ˙ CO 2 ), respiratory exchange ratio (RER), heart rate (HR), ratings of perceived exertion (RPE), and blood glucose and lactate concentrations were recorded for each stage and at volitional exhaustion. Time-to-exhaustion (TTE) and peak oxygen consumption ( V ˙ O 2 peak) during the ramp test were also recorded. Absolute reliability, calculated as the coefficient of variation (CV) between repeated measures, ranged from 2.3% to 3.1% for RE, whereas relative reliability, calculated as the intraclass correlation coefficient (ICC), ranged from.42 to.79. V ˙ E , V ˙ O 2 , V ˙ O 2 peak , V ˙ CO 2 , RER, and HR had a CV of 1.1%–4.3% across all stages. TTE and RPE had a CV of 7.2% and 2.3%–10.8%, respectively, while glucose and lactate had a CV of 4.0%–17.8%. All other parameters, except for blood glucose, were demonstrated to have good-to-excellent relative reliability assessed by ICC. Measures of RE, V ˙ O 2 peak , and TTE were reliable during this two-phase multistage incremental treadmill test in a cohort of trained and highly trained male middle- and long-distance runners. [ABSTRACT FROM AUTHOR]

Match-related performance analysis in judo Para athletes with visual impairments is important to coaches and staff to identify technical–tactical profiles of their athletes and opponents but also to identify whether there are similar characteristics in each visual class. Thus, this study explores the match-related performance in judo Para athletes and verifies the relationship between performance using the old and new classification systems. The match-derived variables were analyzed using different statistical methods considering a total of 182 matches from the Tokyo 2020 Paralympic Games. The results indicated that performance was affected by sex and degree of impairment. The new classification system seems suitable for grouping Para judo athletes, as it differentiates performance between the two proposed classes (J1 and J2), since athletes from each group compete separately. Furthermore, different variability index measures were correlated with competitive performance, demonstrating a specific performance profile for each sport class in judo. [ABSTRACT FROM AUTHOR]

There has been an increase in the use of commercially available multi-ingredient preworkout supplements (MIPS); however, there are inconsistencies regarding the efficacy of MIPS in resistance-trained women. Purpose: To determine the effect of varying doses of MIPS compared with caffeine only (C) and a placebo (PL) on resistance-training performance in trained women. Methods: Ten women (21.5 [2.3] y) completed 1-repetition-maximum tests at baseline for leg press and bench press. A within-group, double-blind, and randomized design was used to assign supplement drinks (ie, PL, C, MIPS half scoop [MIPS-H], and MIPS full scoop [MIPS-F]). Repetitions to failure were assessed at 75% and 80% to 85% of 1-repetition maximum for bench and leg press, respectively. Total performance volume was calculated as load × sets × repetitions for each session. Data were analyzed using a 1-way repeated-measures analysis of variance and reported as means and SDs. Results: There were no differences in repetitions to failure for bench press (PL: 14.4 [3.2] repetitions, C: 14.4 [2.9] repetitions, MIPS-H: 14.2 [2.6] repetitions, MIPS-F: 15.1 [3.1] repetitions; P =.54) or leg press (PL: 13.9 [7.8] repetitions, C: 10.8 [5.9] repetitions, MIPS-H: 13.1 [7.1] repetitions, MIPS-F: 12.4 [10.7] repetitions; P =.44). Furthermore, there were no differences in total performance volume across supplements for bench press (PL: 911.2 [212.8] kg, C: 910.7 [205.5] kg, MIPS-H: 913.6 [249.3] kg, MIPS-F: 951.6 [289.6] kg; P =.39) or leg press (PL: 4318.4 [1633.6] kg, C: 3730.0 [1032.5] kg, MIPS-H: 4223.0 [1630.0] kg, MIPS-F: 4085.5 [2098.3] kg; P =.34). Conclusions: Overall, our findings suggest that caffeine and MIPS do not provide ergogenic benefits for resistance-trained women in delaying muscular failure. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the microgap changes between hybrid-abutment crowns made of two materials and three internal taper connec9on implants with different connec9on designs before and a;er thermodynamic loading. Materials and Methods: A total of 30 implants--10 each of Straumann Bone Level Implant-RC (STR); GC AADVA Implant (AAD); and Astra-Tech OsseoSpeed EV (AST)--were included in this laboratory study. Each implant had an internal taper connec9on, but their designs were slightly different. Five hybrid-abutment crowns were fabricated using a lithium disilicate ceramic (LD), and five were fabricated using polymethylmethacrylate (PMMA) with CAD/CAM technologies for each implant system, providing six sample groups STR-LD, AAD-LD, AST-LD, STR-PMMA, AAD-PMMA, and ASTPMMA. The microgap volume was measured using micro-CT images obtained before and a;er thermodynamic loading equivalent to 4 months of clinical use. Student t test, one-way ANOVA, and Tukey test were used for comparisons. Results: The greatest microgap volume increase was recorded (3.405% ± 1.567%) in the AST-LD group, and the lowest increase (0.45% ± 0.373%) was in the STR-PMMA group. A sta9s9cally significant difference in microgap increase was not detected among PMMA and LD groups: for STR-LD/STR-PMMA (t test: P = .273); for AAD-LD/AAD-PMMA (t test: P = .374); and for AST-LD/AST-PMMA (t test: P = .268). However, the difference in the microgap increase between the different implant systems was sta9s9cally significant. Conclusions: The microgap between hybrid-abutment crowns and implants increased a;er short-term thermodynamic cycling. Hybrid-abutment crowns with different elas9c modulus showed similar microgap increase. The geometric shape of the connec9on influenced the microgap increase. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of combined therapy of teriparatide and raloxifene on the osseointegration of titanium dental implants in a rabbit model of osteoporotic bone. Materials and Methods: Sixty female rabbits were randomly divided into six groups. The sham ovariectomy group (control) consisted of animals that received no medication. Animals in the ovariectomy group (OVX) underwent ovariectomy and received no medication. The combined group consisted of ovariectomized animals that received combined teriparatide (10 mg/kg) for 12 weeks and raloxifene (10 mg/kg) for 12 weeks. The sequential group (SEQ) consisted of ovariectomized animals that received teriparatide (10 mg/kg) for the first 6 weeks and raloxifene therapy (10 mg/kg) for the following 6 weeks sequentially. The parathormone (PTH) and raloxifene (RAL) groups consisted of ovariectomized animals that received only teriparatide (10 mg/kg) for 12 weeks or raloxifene (10 mg/kg) for 12 weeks, respectively. Dental implants (Bilimplant) were placed in the proximal metaphysis of both tibias in all rabbits. Histomorphometric and microCT studies were performed on the specimens obtained from the right tibia bone. Removal torque (RTQ) and implant stability quotient (ISQ) tests were performed on the specimens obtained from the left tibia bone. The results were compared and evaluated statistically. Results: RTQ analysis revealed a statistically significant difference between the mean values of the combined group (93.01 ± 27.19 Ncm) and the OVX group (49.6 ± 12.5 Ncm) (P = .015). The highest mean T0 (implantation day) value was obtained in the control group (67.1 ± 3.4 Ncm), and the lowest mean value was obtained in the OVX group (61.4 ± 3.8 Ncm). The highest T1 mean (3 months after implantation) was obtained by the combined group (76.6 ± 3.8 Ncm), and the lowest mean was obtained by the OVX group (68.9 ± 6.2 Ncm). Histomorphometric analyses showed that the mean percentage of bone-to-implant contact (BIC%) of the combined group (51.2%) was significantly higher than that of the OVX group (28.6%) (P =.006). In the microCT examinations, it was found that the mean BIC% value of the combined group (41.1%) was significantly higher than that of the OVX group (24.1%) (P < .001). Conclusions: According to the results of the current study, combined therapy of teriparatide and raloxifene improves the BIC and osseointegration of titanium dental implants in osteoporotic bone compared with sequential or independent therapy with these agents. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine whether subgroups of disability-sport athletes exist on morality- and norm-based doping cognitions and whether these groups differ in anticipated guilt or doping intentions. A survey was completed by 186 athletes (Mage = 37.5 years, 78.0% male, 45.1% wheelchair basketball) assessing norms, doping moral disengagement, anticipated guilt, and intentions to dope. Cluster analysis revealed four distinct subgroups of athletes, including one potentially high-risk subgroup characterized by relatively high scores on doping moral disengagement, subjective norms, and descriptive norms. One-way analysis of variance revealed significantly lower anticipated guilt in two athlete subgroups characterized by relatively higher doping moral disengagement than the other two subgroups. Moreover, the potentially high-risk group had a greater proportion of athletes showing some presence of intention to dope. This study suggests there is a small subgroup of disability-sport athletes at elevated risk of doping who might benefit from targeted antidoping interventions. [ABSTRACT FROM AUTHOR]

Objectives: Fractal analysis is a numerical method that indicates the structural patterns and complexity of the trabecular bone on radiographs. The aim of this cross-sectional study was to evaluate the trabecular bone structure in systemically healthy patients and diabetes mellitus patients with periodontitis using fractal analysis. Method and materials: The study included 125 mandibular first molars of nonsmoker patients. The subjects were divided into five subgroups: diabetes mellitus patients with mild-moderate periodontitis, diabetes mellitus patients with advanced periodontitis, systemically healthy individuals with mild-moderate periodontitis, systemically healthy individuals with advanced periodontitis, and systemically healthy individuals with gingivitis (control group). Clinical periodontal parameters (pocket depth, bleeding on probing, clinical attachment loss, and bone loss) were recorded. Two specific sites located in the mesial-distal regions (n = 250) of the mandibular first molars were identified using periapical radiographs captured with a parallel technique. Fractal analysis values were calculated using the box-counting method. One-way analysis of variance (ANOVA), and Pearson correlation analysis were used forstatistical evaluation. Results: The highest fractal analysis values were observed in systemically healthy with gingivitis patients (mesial fractal analysis: 1.86 ± 0.01; distal fractal analysis: 1.85 ±0.01). Patients with periodontitis (mesial fractal analysis: 1.78 ±0.02; distal fractal analysis: 1.79 ± 0.01) exhibited lower fractal analysis values compared to the control group. There was no significant difference in mesial and distal fractal analysis values between all periodontitis groups. No correlation was found between age, sex, clinical attachment loss, bone loss, and fractal analysis (P>.05). Conclusions: Although fractal analysis values were lower in the periodontitis groups compared to the control group, fractal analysis did not demonstrate any periodontitis-associated changes of bone tra-beculationin diabetes at any stage of periodontitis. Furthermore, there was no significant association between fractal analysis values and age, sex, clinical attachment, and bone loss. [ABSTRACT FROM AUTHOR]

Context: Among many unanticipated changes, access to rehabilitation was disrupted during the onset of the COVID-19 pandemic. It is unclear how the timing of late-stage rehabilitation following anterior cruciate ligament with surgical reconstruction (ACLR) during the initial months of the pandemic affected outcomes. The purpose of this study was to compare physical performance outcome measures in patients following ACLR prior to and following COVID-19-related restrictions. Design: Retrospective cohort study. Methods: Data from patients who underwent return-to-sport testing following ACLR were analyzed based on date. December 2018 through March of 2020 (n = 66) was defined as the baseline period, and June through October 2020 (n = 27) was defined as the surveillance period. Outcome measures included single leg hop, triple hop, single leg vertical jump, and the lower-extremity functional test (LEFT). Linear mixed models were used to compare outcome measures before and after the onset of pandemic-related restrictions, clustered by sex and sport. A 1-way analysis of variance was performed to analyze the association between the number of virtual rehabilitation visits and outcome measures for subjects in the surveillance period. Results: Subjects in the surveillance period performed significantly worse in the LEFT (+7.88 s; 95% confidence interval, 1.11 to 14.66; P =.02) and single leg vertical jump on the unaffected side (−4.32 cm; 95% confidence interval, −7.44 to −1.19, P <.01), and performed better with single leg vertical jump symmetry (+6.3%; 95% confidence interval, 1.0% to 11.5%; P =.02). There were no other statistically significant differences. There was no significant association between having virtual rehabilitation visits and any of the performance outcomes. Conclusions: There was a decline in physical performance outcome measures in patients following ACLR who did not attend regular in-person physical therapy sessions in the late-stage rehabilitation due to COVID-19-related restrictions. Other factors during this unique time period, such as access to training facilities or psychosocial stressors, may have also influenced outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To study the influence of tooth mobility on the accuracy of conven6onal impressions. Materials and Methods: In total, 10 pa6ents with mobile anterior teeth and 10 healthy pa6ents were treated with conven6onal impressions and intraoral digital impressions. The digital impression group was recorded as standard data, the mobile teeth group was recorded as the experimental group, and the healthy anterior teeth group was recorded as the control group. We imported digital impression and irreversible hydrocolloid impression files into Geomagic Wrap and marked reference points to execute N-point alignment, then we recorded the coordinates. Paired-samples t test was used to analyze whether the point coordinates of mobile teeth were statistically significant (α = .05). One-way ANOVA was used to analyze whether there was a rela6onship between coordinate differences and tooth mobility in the distal, coronal, and buccal directions (α = .05). Results: In the buccal and coronal directions, the difference was statistically significant between the conven6onal and digital impression groups. In the buccal direction, the accuracy differences of I-degree and II-degree mobile teeth were 0.149 mm and 0.401 mm, respectively. In the coronal direction, the differences were 0.128 mm and 0.233 mm, respectively. Meanwhile, ANOVA analysis showed that there was a rela6onship between point coordinate difference and tooth mobility in the buccal and coronal directions. Conclusions: Conventional impressions can influence the accuracy of mobile tooth impressions. Therefore, digital impressions should be adopted for mobile teeth impressions. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare the difference in retention between implant-supported restorations with and without surface modification of the implant abutments. Materials and Methods: A total of 30 patients with singletooth implants were restored with cement-retained (Multilink N, Ivoclar) restorations using titanium base abutments (Variobase, Straumann) and randomly assigned surface modifications. Group 1 used nonmodified abutments, group 2 used sandblasted abutments, and group 3 used sandblasted abutments followed by an application of metal primer. All patients were recalled for a baseline examination 6 months after crown placement. The pull-out strength and intergroup distribution of mean pull-out strength were assessed. To assess differences between the three groups, intergroup statistical comparison of continuous variables was done using one-way ANOVA with Tukey correction for multiple group comparisons. Results: The results of the intergroup mean pull-out strength distribution revealed that the distribution of mean ± SD pull-out strength in group 1, group 2, and group 3 were 220.79 ± 94.23, 488.64 ± 84.12, and 705.46 ± 112.75 Ncm, respectively. Conclusions: Sandblasting followed by the application of metal primer produced the highest retention of porcelain-fused-to-metal (PFM) crowns to titanium base abutments, followed by sandblasting alone, with the least retention being observed with no surface treatment. [ABSTRACT FROM AUTHOR]

Purpose: This study examined performance and physiological adaptations following 3 weeks of repeated-sprint training (RST) with blood-flow restriction (BFR) or without (non-BFR). Methods: Twenty-six semiprofessional and amateur adult male team-sport players were assessed for repeated-sprint ability, anaerobic capacity, leg lean mass, neuromuscular function, and maximal aerobic capacity before and after RST. Participants completed 9 cycling RST sessions (3 sets of 5–7 × 5-s sprints, 25-s passive recovery, 3-min rest) over a 3-week period with BFR or non-BFR. Results: During RST sessions, the BFR group demonstrated lower mean power output compared with non-BFR (−14.5%; g = 1.48; P =.001). Significant improvements (P <.05) in mean and peak power output during repeated-sprint ability (+4.1%; g = 0.42, and + 2.2%; g = 0.25, respectively) and anaerobic capacity (+4.8%; g = 0.47, and + 4.7%; g = 0.32, respectively) tests, leg lean mass (+2.0%; g = 0.16), and peak aerobic power (+3.3%; g = 0.25) were observed from pretesting to posttesting without any between-groups differences. No significant changes (P >.05) were observed for maximal isometric voluntary contraction and maximal aerobic capacity. Peak rate of force development decreased (P =.003) in both groups following RST (−14.6%; g = 0.65), without any between-groups differences. Conclusions: Repeated-sprint ability, anaerobic capacity, leg lean mass, and peak aerobic power improved following 3 weeks of RST; however, the addition of BFR did not further enhance adaptations. Interestingly, comparable improvements were achieved between groups despite lower external loads experienced during RST sessions with BFR. [ABSTRACT FROM AUTHOR]

Objectives: To assess the effect of Community Water Fluoridation (CWF) in the prevalence of dental caries and dental fluorosis in 12-year-old children living in Israel. Considering that CWF is important in the prevention of dental caries. Between 2002 and 2014, the water in communities of at least 5,000 individuals was fluoridated. In 2014, CWF in Israel stopped. Method and materials: Data on 12-year-old children from all areas in Israel from the national cross-sectional epidemiological survey conducted in 2011 to 2012 were stratified by city water fluoridation and by city and school socioeconomic status. Two dependent variables were defined: (1) DMFT index of caries experience in the permanent dentition; (2) dental fluorosis in central incisors using the Thylstrup-Fejerskov classification of fluorosis. Results: Data from 2,181 12-year-olds were analyzed. The average DMFT was 1.17 ± 1.72, and 49% were caries-free. Based on DMFT, the caries experience was significantly higher in nonfluoridated cities (1.38 vs 0.98 in fluoridated cities) and there were more caries-free children in fluoridated cities (56.4% vs 40.6% in nonfluoridated). DMFT was higher in cities with lower socioeconomic status than high socioeconomic status (1.29 vs 1.05, respectively, P < .001) and there were fewer caries-free children in low socioeconomic status cities (44.5% vs 53.0% in high socioeconomic status cities, P < .0001). Almost all the 10.3% of children with signs of fluorosis (scoring at least 1 in the Thylstrup-Fejerskov index), had questionable to mild fluorosis (9.3%). Conclusions: CWF is a cheap, simple method of dental health protection that reaches all socioeconomic levels, and cessation of water fluoridation reduced the health of Israel's children. Clinical significance: Water fluoridation provides substantial caries prevention, by reaching a substantial number of people. The relevance of this work is for policymakers to consider CWF as clinically proven method for reducing health inequalities. [ABSTRACT FROM AUTHOR]

Purpose: A decline in youth running was observed at the start of the COVID-19 pandemic. We investigated whether the resumption of organized running after social distancing restrictions changed running habits or injury frequency in adolescent runners. Methods: Adolescents (age = 16.1 [2.1] y) who participated in long-distance running activities completed an online survey in the Spring and Fall of 2020. Participants self-reported average weekly running habits and whether they sustained an injury during the Fall 2020 season. Poisson regression models and 1-way analysis of variance compared running habits while Fisher exact test compared differences in frequencies of injuries during Fall 2020 among season statuses (full, delayed, and canceled). Results: All runners, regardless of season status, increased weekly distance during Fall 2020. Only runners with a full Fall 2020 season ran more times per week and more high-intensity runs per week compared with their Spring 2020 running habits. There were no differences in running volume or running-related injury frequency among Fall 2020 season statuses. Conclusions: There were no significant differences in running-related injury (RRI) frequency among runners, regardless of season status, following the resumption of cross-country. Health care providers may need to prepare for runners to increase running volume and intensity following the resumption of organized team activities. [ABSTRACT FROM AUTHOR]

Both men and women who violate gender stereotypes incur backlashes, or penalties, for these transgressions. However, men who engage in warm, communal behaviors occasionally receive a boost (or benefit) for this female‐stereotyped behavior. To understand how and why warmth and gender interact to predict backlashes or boosts, we integrate uncertainty reduction theory with the stereotype content model and examine warmth by gender interactions. In our first study (a field examination of job seekers), we find that men receive a boost in hireability (i.e., an increased likelihood of obtaining a job offer) for exhibiting gender incongruent (i.e., high) levels of warmth, but women do not receive a backlash in hireability for exhibiting gender incongruent (i.e., low) levels of warmth. In our second study (a laboratory experiment), we replicate and extend these findings by elucidating why they occur: warmth reduces relational uncertainty for male, but not female, applicants. In our third study (another laboratory experiment), we again replicate and extend our findings by identifying when these effects are stronger: in male‐dominated roles. Our investigation suggests that the valence of the gender stereotype violation matters when it comes to hiring decisions. Indeed, we find that displaying warmth appears to promote, rather than impede, career outcomes for men. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effects of desensitizing MI Varnish (GC America) applied before or after bleaching on the mineral component of enamel and surface topography. The coronal portions of 10 freshly extracted bovine teeth were segmented for a total of 40 specimens. Enamel specimens obtained from each tooth were randomly divided into four groups (n = 10): Group A = no bleaching; Group B = bleaching with 40% hydrogen peroxide (HP); Group C = MI Varnish applied before bleaching; and Group D = MI Varnish applied after bleaching. The calcium (Ca) and phosphorus (P) levels of the specimens in each group were determined by energy dispersive spectroscopy (EDS). Morphologic changes were observed using scanning electron microscopy (SEM). One-way ANOVA and Tukey HSD tests were used for statistical analyses (α = .05). The mean Ca content of Group B was significantly lower than those of Groups A, C, and D (P < .05). The mean Ca content of Group C was significantly lower than that of Group A (P < .05). There was no significant difference in Ca content between the other groups (P > .05). The mean P content of Group A was significantly higher than those of Groups B to D (P < .05). There was no significant difference in P content between Groups B to D (P > .05). Application of MI Varnish before or after in-office bleaching was effective in reducing mineral loss. However, applying MI Varnish after bleaching was more effective. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of fatigue loading on the internal and marginal fit of CAD/CAM-fabricated endocrowns for restoring endodontically treated molars using different machinable blocks. Materials and Methods: A total of 72 mandibular first molars were prepared using a standardized method and were divided into four groups (n = 18), each restored with a different CAD/CAM material: group V = polymerinfiltrated ceramic (Vita Enamic); group K = partially stabilized tetragonal zirconia (Katana); group E = lithium disilicate ceramic (IPS e.max CAD; and group B = polyetheretherketone (BioHPP). Endocrowns were subjected to thermomechanical fatigue loading. Internal and marginal adaptation of the endocrowns were examined at 66 points using the sectioning technique and a stereomicroscope. Data were analyzed using one-way ANOVA and Tukey post hoc test (a = .05). Results: Statistical tests showed that adhesive cementation resulted in significantly increased marginal and internal gap values in all regions in all four tested groups (P < .001). After thermomechanical fatigue loading, all regions in groups B and K showed a statistically significant difference, while no significant differences were found in the regions in group V (P > .05). In group E, the marginal (F = 71.00) and pulpal (F = 28.065) regions showed statistically significant differences (P < .001). Conclusion: Polymer-infiltrated ceramics showed the lowest gap even after thermomechanical fatigue loading and may therefore provide enhanced clinical survival of the restored tooth, favoring the use of this material for fabricating endocrown restorations. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of post length, post material, and substance loss on the fracture resistance of endodontically treated mandibular premolars. Materials and Methods: A total of 96 extracted human mandibular first premolars were endodontically treated and divided into 12 test groups (n = 8 each) based on the number of residual walls (one/two), post material (glass-fiber/titanium), and post length (5 mm, 7.5 mm, and 10 mm). After luting the posts, specimens received a composite resin core and a crown preparation with a 1.5-mm ferrule. Cast cobalt-chromium crowns were cemented using glass-ionomer cement. After 1,200,000 chewing cycles with a load of 49 N and simultaneous thermocycling (5°C to 55°C), specimens were quasi-statically loaded at 30 degrees to the longitudinal axis of the tooth until fracture. Fracture loads were analyzed using three-way, two-way, and one-way ANOVA (a = .05). Fracture modes were examined under a stereomicroscope (×25 magnification) and recorded. Results: The mean ± SD fracture loads ranged from 642 ± 190 N (one wall, glass fiber, 5 mm) to 1,170 ± 130 N (two walls, titanium, 7.5 mm). The mean fracture load of titanium posts was significantly higher than that of glass-fiber posts (P < .001), and the 7.5-mm post length exhibited significantly higher fracture loads than groups with 5-mm and 10-mm post length (P = .008). Conclusions: Teeth restored with titanium posts revealed considerably higher fracture resistance than teeth restored with glass-fiber posts, especially if 7.5-mm-length posts were used. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of bulb thickness on the weight of obturator prostheses and masticatory performance in edentulous hemimaxillectomy patients.Materials and Methods: A randomized, single-blind, three-period crossover trial was conducted with 17 edentulous patients. All patients were provided with three definitive 3D-printed obturator prostheses each. Obturators were divided into three groups: (1) group 1 (G1; 1-mm bulb); (2) group 2 (G2; 2-mm bulb); and (3) group 3 (G3; 3-mm bulb). After fabrication, the weight of each obturator was measured using a digital analytical balance. The patients used each obturator for a period of 2 weeks without a passive period (ie, they did not stop using the obturator). After using each obturator, masticatory function was evaluated with an adapted Sato questionnaire and the sieve test. Data were analyzed using one-way ANOVA and Pearson correlation analysis (α = .05).Results: According to the results of the Sato questionnaire and sieve test, G1 demonstrated the highest masticatory function scores (70.88 ± 9.39; 1.06 ± 0.06), while G3 exhibited the lowest scores (48.23 ± 7.69; 0.92 ± 0.05) (P < .001). The weight of the obturators was significantly different between groups (G1 = 31.58 ± 1.09 g; G2 = 33.99 ± 1.21 g; G3 = 36.57 ± 1.13 g) (P < .001). The correlation between masticatory function and the weight of the obturator was significant (P < .05).Conclusion: This study revealed that using 1-mm obturator bulb thickness was an effective fabrication method for improving masticatory function and reducing the weight of obturator prostheses in edentulous hemimaxillectomy patients. [ABSTRACT FROM AUTHOR]

Purpose: To examine the feasibility and utility of the Fitbit Charge HR to estimate physical activity among ambulatory children and youth with disabilities. Method: Participants (4–17 y old) with disabilities were recruited and asked to wear a Fitbit for 28 days. Feasibility was assessed as the number of participants who adhered to the 28-day protocol. Heat maps were generated to visually examine variability in step count by age, gender, and disability group. Between-group differences for wear time and step counts by age, gender, and disability type were assessed by independent sample t tests for gender and disability group, and a 1-way analysis of variance for age group. Results: Participants (N = 157; median age = 10 y; 71% boys; 71% nonphysical disabilities) averaged 21 valid days of wear time. Wear time was higher in girls than boys (mean difference = 18.0; 95% confidence interval [CI], 6.8 to 29.1), and in preadolescents (mean difference = 27.6; 95% CI, 15.5 to 39.7) and adolescents (mean difference = −21.2; 95% CI, −33.6 to −8.7) than children. More daily steps were taken by boys than girls (mean difference = −1040; 95% CI, −1465 to −615) and individuals with a nonphysical disability than a physical disability (mean difference = −1120; 95% CI, −1474 to −765). The heat maps showed peaks in physical activity on weekdays before school, at recess, lunchtime, and after school. Conclusion: The Fitbit is a feasible tool for monitoring physical activity among ambulatory children and youth with disabilities and may be useful for population-level surveillance and intervention. [ABSTRACT FROM AUTHOR]

Background: Children with inflammatory bowel disease (IBD) experience extraintestinal side effects including altered body composition, impaired muscle strength, and aerobic capacity. Exercise training may remedy these issues. Purpose: To assess the feasibility, safety, participant satisfaction, and efficacy of a training program for youth with IBD. Methods: Children with IBD completed 16 weeks of training (2 supervised + 1 home sessions per week). Feasibility was assessed by tracking recruitment, adherence, and compliance rates. Safety was assessed by tracking symptoms and adverse events. Posttraining interviews gauged satisfaction. Circulating inflammatory markers, body composition, muscle strength, aerobic fitness, and habitual physical activity were measured at baseline, midtraining (8 wk), and posttraining. Results: Eleven youth were recruited and 10 completed the study. Participants adhered to 28 (1) of 32 prescribed supervised sessions and 8 (4) of 16 prescribed home sessions. There were no adverse events, and overall feedback on training was positive. Posttraining, we observed an increase in lean mass (+2.4 [1.1] kg), bone density (+0.0124 [0.015] g·cm−2), aerobic fitness (+2.8 [5.7] mL·kg LM−1· min−1), and vigorous physical activity levels (+13.09 [8.95] min·h−1) but no change in inflammation or muscle strength. Conclusion: Supervised exercise training is feasible, safe, and effective for youth with IBD and should be encouraged. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to examine whether cortical activity changes during exercise with increasing cognitive demands in preadolescent children. Method: Twenty healthy children (8.75 [0.91] y) performed one movement game, which was conducted with lower and higher cognitive demands. During a baseline measurement and both exercise conditions, cortical activity was recorded using a 64-channel electroencephalographic system, and heart rate was assessed. Ratings of perceived excertion and perceived cognitive engagement were examined after each condition. To analyze power spectral density in the theta, alpha-1, and alpha-2 frequency bands, an adaptive mixture independent component analysis was used to determine the spatiotemporal sources of cortical activity, and brain components were clustered to identify spatial clusters. Results: One-way repeated-measures analyses of variance revealed significant main effects for condition on theta in the prefrontal cluster, on alpha-1 in the prefrontal, central, bilateral motor, bilateral parieto-occipital, and occipital clusters, and on alpha-2 in the left motor, central, and left parieto-occipital clusters. Compared with the lower cognitive demand exercise, cortical activity was significantly higher in theta power in the prefrontal cluster and in alpha-1 power in the occipital cluster during the higher cognitive demand exercise. Conclusion: The present study shows that exercise complexity seems to influence cortical processing as it increased with increasing cognitive demands. [ABSTRACT FROM AUTHOR]

Context: Bridge exercises are extensively used in trunk-strengthening programs. The aim of this study was to investigate the effect of bridging duration on lateral abdominal muscle thickness and gluteus maximus activation. Design: Cross-sectional. Methods: Twenty-five young males participated in this study. Transversus abdominal (TrA), external and internal oblique ultrasound thickness, gluteus maximus electromyographic activation, and sacral tilt angle were simultaneously measured for every second during 30-second bridging exercise. The contraction thickness ratio and root mean squared signal (normalized to maximum isometric contraction signal) during 6 exercise durations (from 0 to 5, 10, 15, 20, 25, and 30 s) were also calculated and compared using analysis of variance designs. Results: TrA and internal oblique contraction thickness ratio and gluteus maximus root mean squared increased during the first 8 to 10 seconds and remained elevated until the end of the 30-second exercise (P <.05). External oblique contraction thickness ratio declined during exercise (P <.05). Five-second bridging showed less TrA thickness and anteroposterior and mediolateral sacral tilt angle and a lower anteroposterior tilt variability compared with bridges, which lasted more than 10 seconds (P <.05). Conclusions: Bridge exercises longer than 10 seconds may be better for promoting TrA recruitment than bridges of shorter duration. Clinicians and exercise specialists could adjust the duration of bridge exercise based on the aims of the exercise program. [ABSTRACT FROM AUTHOR]

Purpose: To compare the adaptation of single metal-ceramic crowns (MCCs) fabricated with three different methods: lost-wax metal casting (LMC), milling of hard cobalt-chromium (HCC) blanks, and milling of soft presintered cobalt-chromium (SCC) blanks. Materials and Methods: In this double-blind parallel randomized clinical trial, 60 single MCCs were fabricated using three different methods. Adaptation of the copings was evaluated radiographically, visually, and microscopically. Data were compared among the three groups using the Kruskal-Wallis test, followed by the Dunn post hoc test, one-way ANOVA, and paired t test (a = .05). Results: Radiographic data showed that the frequency of crowns with no marginal discrepancy was significantly higher in the SCC group than the LMC group. Evaluation of marginal adaptation with an explorer revealed that crowns with excellent marginal adaptation had lower frequency in the LMC group than the HCC and SCC groups. In the silicone replica technique, the recorded data revealed no significant difference. Application of porcelain veneering did not affect the adaptation of the copings. Conclusions: The SCC and HCC groups showed better clinical outcomes compared to the LMC group. However, all MCCs fabricated with the LMC method, milling of HCC blanks, and milling of SCC blanks had acceptable clinical adaptation. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the interaction between sarcopenic obesity and locomotive and nonlocomotive physical activity (PA) on the risk of depressive symptoms in community-dwelling older Japanese women. Participants were 143 community-dwelling older women aged 64–94 years. PA was measured using a three-axis accelerometer. Participants were classified according to two levels of total, locomotive, and nonlocomotive PA. Depressive symptoms were assessed by a self-administered survey consisting of the 15-item Japanese version of the Geriatric Depression Scale (GDS-15-J). The interaction between sarcopenic obesity groups and total or locomotive PA did not affect GDS-15-J scores. However, the interaction between sarcopenic obesity groups and nonlocomotive PA significantly affected GDS-15-J scores (p <.05). Moreover, sarcopenic obesity in the low PA group had significantly higher GDS-15-J scores compared with sarcopenic obesity in the high PA group (p <.05). We concluded that sarcopenic obesity combined with low nonlocomotive PA may exacerbate depressive symptoms in older women. [ABSTRACT FROM AUTHOR]

Context: The University of Wisconsin Running Injury and Recovery Index (UWRI) was developed to evaluate the key elements that runners use to self-assess their own running ability following common running-related injuries. The aim of this study was to translate and culturally adapt the UWRI and to evaluate the psychometric properties of its Turkish version (UWRI-Tr) in runners. Design: Prospective cohort study. Methods: The study included 129 runners. The UWRI-Tr, the Lower Extremity Functional Scale, the Oswestry Disability Index, the Hip Outcome Score, the International Knee Documentation Committee Subjective Knee Evaluation Form, and the Foot and Ankle Ability Measure were applied for the validation purposes. Internal consistency, reliability, construct validity, and discriminant validity of the UWRI-Tr were tested. Results: The test–retest reliability of the UWRI-Tr was excellent with an intraclass correlation coefficient of.85 and a Cronbach α value of.84. There was a small to strong correlation among the UWRI-Tr and Lower Extremity Functional Scale (r =.278), Oswestry Disability Index (r = −.744), Hip Outcome Score (r =.684), The International Knee Documentation Committee Subjective Knee Evaluation Form (r =.758), and Foot and Ankle Ability Measure (r =.498 and.767), indicating that its construct validity was appropriate for use with Turkish runners. Conclusions: The UWRI-Tr was shown to be a valid and reliable tool to use in clinical and research settings as a sport-specific measurement tool. [ABSTRACT FROM AUTHOR]

Background: Only 55% of anterior cruciate ligament-reconstructed (ACLR) athletes return to competitive sports. This brings into question the usefulness of current return to sport (RTS) criteria. High cognitive demand of sport environment clarifies the value of incorporating neurocognitive tests when making decisions regarding the time of RTS. This preliminary study aimed to compare the neurocognitive functions between healthy controls and ACLR male athletes who passed or failed RTS criteria. Methods: A total of 45 male football players, including 15 ACLR who passed RTS criteria, 15 ACLR who did not pass, and 15 healthy controls participated in this cross-sectional study. The Cambridge Neuropsychological Test Automated Battery was used to measure a battery of neurocognitive tasks, including speed of response, sustained attention, working memory, cognitive flexibility, and response inhibition. Results: The results revealed that compared with both the ACLR-passed and healthy groups, the ACLR-failed group showed greater values of 5-choice movement time (P =.02, P =.01, respectively) but lower values of stop signal reaction time (P =.03, P =.001, respectively) and proportion of successful stops variables (P =.02). In addition, compared with the healthy group, both the ACLR-failed and ACLR-passed groups indicated greater values in between errors (P <.001, P =.008, respectively) and reaction latency variables (P =.002, P =.01, respectively) but lower values of A′ (P <.001, P =.007, respectively), probability of hit (P <.001, P =.03, respectively), and percent correct trials variables (P =.006, P =.02, respectively). Conclusions: Our findings indicated deficits in neurocognitive functions in ACLR male athletes. In addition, poor performance in sustained attention, working memory, and cognitive flexibility measures observed in the ACLR-passed group highlighted the necessity for using a multimodal approach via implementation of neurocognitive measures in conjunction with the functional and muscular assessments when making RTS decisions. [ABSTRACT FROM AUTHOR]

This study explores how the motivational framing of a network training program may positively or (inadvertently) adversely impact participants' discomfort with strategic networking and motivation to network. We examine the impact of a "me‐focused" framing (i.e., on the personal career benefits that individuals can accrue through strategic networking) and a "we‐focused" framing (i.e., on the benefits to the team/organization of individuals' strategic networking) compared to a control group in two field‐based quasi‐experiments. In both studies, we found no difference between the two training frames in their effect on the two training outcomes when looking at participants' reactions, on average. However, in the second study, we find that individual differences in the way participants relate to others (i.e., the extent to which they endorse an individual or a collective self‐concept) change the impact of the framing on their discomfort with and motivation to network. The findings highlight the importance of considering the match or mismatch between training framing and self‐concept. In the we‐focused condition, a match was related to decreased networking discomfort, while a mismatch was related to increased discomfort and decreased motivation. In the me‐focused condition, a mismatch was counter‐intuitively related to decreased discomfort. These findings suggest that considering participants' reactions to training (i.e., change in discomfort and motivation), on average, may mask important differences in their response to network‐based training and that tailoring network training to participants' self‐concepts may be an important consideration for human resource management professionals. [ABSTRACT FROM AUTHOR]

Objectives: Evaluating gingival thickness is an essential factor for esthetics, function, and the maintenance of soft tissue health around natural teeth and dental implants. This study aimed to evaluate the accuracy of visual inspection procedures used to identify gingival phenotype by clinicians with different expertise and level of experience. Method and materials: The gingival phenotypes of a total of 200 cases were identified as either thick or thin via visual assessment with clinical photographs by eight clinicians. One periodontist examined the gingival phenotype of all subjects based on the translucency of the periodontal probe through the gingival sulcus. The accuracy between these two methods was evaluated using percentile agreement and k statistics. Results: The mean percentage of accurately identified cases was 75% irrespective of the clinician's experience and expertise. Almost half of the thin phenotype cases were misclassified by clinicians. Inter-examiner agreement was generally fair to moderate and intra-examiner agreement was generally moderate. Conclusion: Within the limits of this study, the present findings demonstrated that the visual inspection method misclassified the cases, especially thin gingival phenotype, compared to the probe translucency method. Therefore, there is a need to identify a universally accepted, accurate method and clearclinical definitions. [ABSTRACT FROM AUTHOR]

Context: Pulsed current and kilohertz frequency alternating current are 2 types of neuromuscular electrical stimulation (NMES) currents often used by clinicians during rehabilitation. However, the low methodological quality and the different NMES parameters and protocols used in several studies might explain their inconclusive results in terms of their effects in the evoked torque and the discomfort level. In addition, the neuromuscular efficiency (ie, the NMES current type that evokes the highest torque with the lowest current intensity) has not been established yet. Therefore, our objective was to compare the evoked torque, current intensity, neuromuscular efficiency (evoked torque/current intensity ratio), and discomfort between pulsed current and kilohertz frequency alternating current in healthy people. Design: A double-blind, randomized crossover trial. Methods: Thirty healthy men (23.2 [4.5] y) participated in the study. Each participant was randomized to 4 current settings: 2 kilohertz frequency alternating currents with 2.5 kHz of carrier frequency and similar pulse duration (0.4 ms) and burst frequency (100 Hz) but with different burst duty cycles (20% and 50%) and burst durations (2 and 5 ms); and 2 pulsed currents with similar pulse frequency (100 Hz) and different pulse duration (2 and 0.4 ms). The evoked torque, current intensity at the maximal tolerated intensity, neuromuscular efficiency, and discomfort level were evaluated. Results: Both pulsed currents generated higher evoked torque than the kilohertz frequency alternating currents, despite the similar between-currents discomfort levels. The 2 ms pulsed current showed lower current intensity and higher neuromuscular efficiency compared with both alternated currents and with the 0.4 ms pulsed current. Conclusions: The higher evoked torque, higher neuromuscular efficiency, and similar discomfort of the 2 ms pulsed current compared with 2.5-kHz frequency alternating current suggests this current as the best choice for clinicians to use in NMES-based protocols. [ABSTRACT FROM AUTHOR]

This evaluation correlates maxillary sinus 3D morphology with bone regeneration. In 39 patients with crestal bone = 2 mm, mineralized human bone allografts were used to augment the sinus floor through the crestal window sinus elevation approach. CBCT was used to measure the buccopalatal diameter (BPD), mesiodistal diameter (MDD), and hemi-ellipsoidal volume (Vh) in all sinuses. A bone core biopsy sample was taken at implant placement (4 to 5 months after sinus augmentation). Microradiographs of methacrylate-embedded sections were used to evaluate the amounts of bone, residual graft, and soft tissue. All 51 implants placed in the 39 patients successfully osseointegrated. A linear regression analysis showed that as BPD, MMD, and Vh increased, the amount of bone gain decreased and the amount of soft tissue increased (P < .05). The amount of residual graft was little affected by sinus morphology. Microradiographic data were grouped into four different sinus types (from small to great) using BPD and Vh medians. The best amount of bone formation was achieved in the narrow and short sinus type, while no great differences were found in the remaining three sinus types. Understanding of 3D sinus cavity morphology, especially the buccopalatal diameter and mesiodistal dimensions, is fundamental for achieving the best possible sinus augmentation outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the trueness of five intraoral scanners on a fully edentulous model with seven implants. Materials and Methods: The study model was created from gypsum with seven implant analogs that were placed with 2-mm gingival height and a 0-degree angle at tooth sites 47, 45, 43, 31, 33, 35, and 37 (FDI system). The study model was scanned 10 times (n = 10) with five intraoral scanners (CS 3600, Emerald S, Primescan, Trios 3, and Trios 4). The study model was digitized with a high-resolution industrial desktop scanner, and the data were imported into reverse-engineering software to be used as the reference model. The trueness assessment was performed digitally with superimposition using the software. Linear measurements were calculated as the differences between the centers of the scan bodies on the study models vs the reference model. Volumetric deviations were calculated with root mean square values. Data obtained in the study were analyzed statistically using one-way analysis of variance and Tukey tests. A value of P < .05 was accepted as statistically significant. Results: In linear measurements, Trios 4 showed the best trueness results, followed by Trios 3, Emerald S, Primescan, and CS 3600. Trios 4 showed statistically higher trueness results than CS 3600 (P = .029). However, no statistically significant differences were found between groups in volumetric measurements (P < .05). Conclusions: All of the intraoral scanners used in the study showed favorable deviation values for an edentulous model with seven implants. Trios 4 showed the best trueness values. The latest generation of intraoral scanners can be used in full-arch implant impressions. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the incorporation of liquid platelet-rich fibrin in different collagen matrices in vitro. Materials and Methods: Collagen matrices with liquid platelet-rich fibrin were used and divided into the following test groups (n = 5): Mucoderm (MD), Mucograft (MG), and Fibro-Gide (FG). After incubating the collagen matrices in liquid plateletrich fibrin, histologicl and fluid absorption capacity analysis were performed. Intergroup comparisons of cell count, blood plasma penetration area, and fluid absorption capacity were performed using one-way ANOVA and Tukey tests. Intragroup comparisons of fluid absorption capacity were made using the independent t test with a 5% significance level. Results: Descriptive qualitative analysis showed total incorporation of liquid platelet-rich fibrin in the FG group, while the MG and MD groups showed only partial and shallow incorporation, respectively. There was a statistically significant difference among the three groups regarding inflammatory cell infiltration (P = .000), with the FG group presenting the highest number of cells in the matrices (577.15 ± 54.88). The FG group showed an area of total blood plasma penetration into the matrix, followed by the MG group with partial penetration, and the MD group with minor penetration area (P = .000). Considering the fluid absorption capacity analysis, only groups FG and MG were statistically different when comparing the liquid platelet-rich fibrin absorption coefficient (P = .017), with higher absorption in group FG (14.30 ± 3.35). Conclusions: The FG collagen matrix showed a good capacity for liquid platelet-rich fibrin incorporation in vitro. [ABSTRACT FROM AUTHOR]

Objective: To verify the effect of fiducial marker number and configuration on target registration error (TRE) for dynamic computer-aided zygomatic implant surgery. Material and Methods: All patients who underwent zygomatic implant surgery with navigation from January 2018 to December 2021 were enrolled. For each patient, 6 to 8 miniscrews were placed intraorally as fiducial markers before the surgery. After the registration procedure, the TRE, which represents the distance between the target of the image space and the real position of the fiducial markers, was calculated. SPSS (22.0) was used for statistical analysis. Results: A total of 325 titanium miniscrews were placed in 47 patients who underwent zygomatic implant placement by navigation. The lowest TRE was 0.2 mm, compared to the highest TRE of 1.9 mm. There was no significant difference in the mean TRE value among the different titanium miniscrew groups (P = .07). A total of 8 miniscrews in 7 patients were lost in the maxillary tuberosity area prior to and during navigation surgery, which resulted in an irregular polygonal distribution of fiducial markers. However, there was no statistically significant difference in TRE between a polygonal distribution (0.62 ± 0.35 mm) and an irregular polygonal distribution (0.68 ± 0.33 mm) (P = .35). Conclusion: A scattered, polygonal distribution with of a minimum of five fiducial markers in an edentulous maxilla could achieve acceptable TRE values in registration. It seems that the registration error was not influenced by the absence of one corner in a polygon distribution. [ABSTRACT FROM AUTHOR]

Purpose: To identify differences in heart rate (HR) and concentration of blood lactate ([La]) relationships between laboratory- and field-based skate-roller-skiing tests. Methods: Fourteen world-class biathletes (8 women, 6 men) completed a laboratory- and field-based roller-skiing test using the skate technique. The laboratory-based test comprised 5 to 7 submaximal steps at a fixed incline and speed on a roller-skiing treadmill. The field-based test comprised 5 steps on a course where the final hill was designed to mimic the conditions of the laboratory test. HR and [La] were measured for each step. The HR associated with 2 mmol·L−1 (HR@2 mmol) and 4 mmol·L−1 (HR@4 mmol) of [La] was calculated using an interpolation method. A 1-way analysis of variance and Bland–Altman analyses with 95% limits of agreement (LoA) were used to determine if test type influenced HR@2 mmol or HR@4 mmol. A second-order polynomial was fitted to group-level data to highlight the HR–[La] relationships for laboratory- and field-based tests. Results: HR@2 mmol was lower for field tests than for laboratory tests (mean bias: 1.9%HRmax; 95% LoA: −4.5 to +8.3%HRmax; P <.001). HR@4 mmol was also lower for field tests compared to laboratory tests (mean bias: 2.4%HRmax; 95% LoA: −1.2 to +6.0%HRmax; P <.001). On the group level, the lactate threshold occurred at a lower HR during roller skiing in the field compared to the laboratory. Conclusions: The findings from this study confirm that for a given HR, [La] was greater in field- compared with laboratory-based conditions. These results might have implications for how coaches define training-intensity "zones" during skate roller skiing based on laboratory tests. [ABSTRACT FROM AUTHOR]

Background: Plantar sensation and ankle proprioception occur in a stage-like variance across the life span. However, changes in adolescents, young adults, middle-aged adults, and older adults remain unclear. The aim of this study was to investigate the differences of plantar sensation and ankle proprioception in adolescents to older adults. Methods: A total of 212 participants were recruited in the study and were divided into four groups, including adolescents (n = 46), young adults (n = 55), middle-aged adults (n = 47), and older adults (n = 54). Plantar tactile sensitivity/tactile acuity/vibration threshold and ankle movement threshold/joint position sense/force sense were assessed in all groups. The Kruskal–Wallis H test was used to analyze the differences in Semmes–Weinstein monofilaments between different age groups in different plantar positions. One-way analysis of variance was used to determine differences in foot vibration threshold, two-point discrimination, and ankle proprioception between different age groups. Results: Significant differences were found in the Semmes–Weinstein monofilament test (p <.001), the two-point discrimination test (p <.05), and the vibration threshold test (p <.05) in the six tested plantar positions among adolescents, young adults, middle-aged adults, and older adults. For ankle proprioception, significant differences were found in movement thresholds in ankle plantar flexion (p =.01), ankle dorsiflexion (p <.001), ankle inversion (p <.001), and ankle eversion (p <.001), as well as relative absolute errors in the ankle force senses of ankle plantar flexion (p =.02) and ankle dorsiflexion (p =.02) across the four age groups. Conclusion: Plantar sensation and ankle proprioception were sensitive in adolescents and young adults than in middle-aged adults and older adults. [ABSTRACT FROM AUTHOR]

Health disparities are ongoing challenges in the United States, with one of the underlying factors being the variation in health risk behaviors across different socioeconomic and demographic communities. In this cross-sectional ecological study, utilizing data from 26,781 US zip codes provided by the Centers for Disease Control and Prevention (CDC), we conducted generalized linear model regressions to explore the associations between race, poverty, education, and urban/rural status in areas. Our analysis indicated that areas with a higher prevalence of Black population and higher poverty levels are associated with a more significant number of unique health risk behaviors. Conversely, other racial groups were associated with fewer unique health risk behaviors, although they may still engage in higher levels of specific behaviors. These insights underscore the need for tailored public health strategies to address the disparities in health risk behaviors across different sub-populations. Additionally, we employed Finite Mixture Modeling (FMM) to identify distinct sub-populations in the United States based on health risk behaviors, specifically binge drinking, smoking, sleep deprivation, and physical inactivity, which are essential risk factors for chronic diseases such as cancer, diabetes, and cardiovascular diseases. We identified four clusters and conducted an in-depth analysis of the demographics and socioeconomic characteristics of the identified clusters. Our findings reveal that one cluster, characterized by the worst health risk behaviors, exhibited the highest poverty rate, the least favorable health insurance profile, and the lowest frequencies of post-secondary education attainment compared to the other three clusters. This cluster, therefore, warrants targeted public health interventions. [ABSTRACT FROM AUTHOR]

Background: Empathy is important in hospice nursing clinics and may influence nurses' professional quality of life (ProQOL). However, present studies ignoring each empathic dimension, and few researches have explored the correlation between empathy and ProQOL in hospice nurses in Asia. To better understand hospice nurses' empathy abilities in China and its relationship with ProQOL, the aim of this study was to identify the latent profiles and its influencing factors of hospice nurses' empathy ability, as well as differences in ProQOL across each latent profile. Methods: A cross-sectional study was conducted from October 2021 to September 2022, and a total of 725 hospice nurses were recruited from different geographic regions in China. Participants completed the Empathy Ability Scale for Hospice Nurses and the Brief Professional Quality of Life Scale. Latent profile analysis (LPA) was employed to identify latent profiles of empathy ability among hospice nurses in China. The predictors of hospice nurses' empathy ability in different latent profiles were assessed using multinomial logistic regression analysis. One-way ANOVA test and the Kruskal–Wallis test were used to compare the ProQOL scores in each latent profile of nurses' empathy ability. Results: This study identified three latent profiles of hospice nurses' empathy ability, and those profiles labelled "poor empathy ability-high surface empathy expression" (n = 216, 29.8%), "moderate empathy ability" (n = 359, 49.5%) and "high empathy ability-high deep empathy expression" (n = 150, 20.7%). Multinomial logistic regression analysis suggested that age, hospital level, whether income meets expectations, interests in hospice care work, hospice work experience, and receiving psychological counselling were predictors of hospice nurses' profile membership of empathy ability. The scores of compassion satisfaction (CS) and burnout (BO) in ProQOL were significantly different across each profile (P < 0.001), while scores of secondary traumatic stress (STS) in ProQOL were not different across each profile (P = 0.294). Conclusions: Hospice nurses' empathy ability was divided into three latent profiles, and enhancing empathy ability may be conducive to improving hospice nurses' CS, while reducing BO, thus fostering their overall quality of life. Nursing managers should identify hospice nurses at higher risk of BO and implement targeted interventions focused on enhancing nurse's empathy abilities. [ABSTRACT FROM AUTHOR]

Objective Respiratory syncytial virus (RSV) is the most common viral respiratory infection in infants. This study aimed to establish the potential changes in the clinical course of RSV in the neonatal period with the onset of the coronavirus disease 2019(COVID-19) pandemic. Study Design During the observational study period, newborns diagnosed with community-acquired RSV infection and admitted to the neonatal intensive care unit (NICU) were evaluated. RSV-infected neonates before the COVID-19 pandemic were classified as Group 1 , those during the strict isolation period as Group 2 , and RSV-infected newborns after the removal of restrictions were classified as Group 3. Results A total of 208 community-acquired RSV-infected neonates were analyzed. The median age at admission to the NICU was 26 days, and the mean gestational week was 37.2 ± 2.7. The ratio of hospitalized babies with RSV infection to all hospitalized newborns rose after the pandemic significantly (1.9, 1.6, and 5.2%; p < 0.001). Following the pandemic, there was an increase in full-term, early-term, and late-preterm cases. Nevertheless, no change was observed in the number of preterm cases (p > 0.05). There was also a statistically significant increase in the need for intubation, noninvasive ventilation (NIV), supplemental oxygen, inhaled bronchodilator drugs, and length of hospital stay in Group 3 after the pandemic (p < 0.001). All these parameters related to more severe RSV infection when the precautions were removed, while there was a milder disease with restrictions during the pandemic in Group 2 (p < 0.001). However, none died due to RSV infection during the study because of timely supportive care. Conclusion Following the COVID-19 pandemic, the frequency and severity of RSV infection in newborns have increased, and it can result in a serious clinical picture even in full-term babies with no comorbidities. Attention to strict contact precautions, particularly in newborns, who are a more vulnerable population after the pandemic, may play an important role in any future outbreak. Key Points The course of neonatal RSV infection has changed after the pandemic. A statistically significant increase was observed in the need of intubation in newborns with RSV. The strict precautions during the pandemic also helped to prevent the transmission of RSV. [ABSTRACT FROM AUTHOR]

Background: Different materials have been used as wound dressings after vital pulp therapies. Some of them have limitations such as delayed setting, difficult administration, slight degree of cytotoxicity, crown discoloration and high cost. Therefore, to overcome these disadvantages, composite scaffolds have been used in regenerative dentistry. This study aims to construct and characterize the physicochemical behavior of a novel injectable alginate hydrogel loaded with different bioactive glass nanoparticles in various concentrations as a regenerative pulpotomy filling material. Methods: Alginate hydrogels were prepared by dissolving alginate powder in alcoholic distilled water containing mesoporous bioactive glass nanoparticles (MBG NPs) or boron-doped MBG NPs (BMBG NPs) at 10 and 20 wt% concentrations. The mixture was stirred and incubated overnight in a water bath at 50 0 C to ensure complete solubility. A sterile dual-syringe system was used to mix the alginate solution with 20 wt% calcium chloride solution, forming the hydrogel upon extrusion. Then, constructed hydrogel specimens from all groups were characterized by FTIR, SEM, water uptake percentage (WA%), bioactivity and ion release, and cytotoxicity. Statistical analysis was done using One-Way ANOVA test for comparisons between groups, followed by multiple pairwise comparisons using Bonferroni adjusted significance level (p < 0.05). Results: Alginate/BMBG loaded groups exhibited remarkable increase in porosity and pore size diameter [IIB1 (168), IIB2 (183) (µm)]. Similarly, WA% increased (~ 800%) which was statistically significant (p < 0.05). Alginate/BMBG loaded groups exhibited the strongest bioactive capability displaying prominent clusters of hydroxyapatite precipitates on hydrogel surfaces. Ca/P ratio of precipitates in IIA2 and IIB1 (1.6) were like Ca/P ratio for stoichiometric pure hydroxyapatite (1.67). MTT assay data revealed that the cell viability % of human gingival fibroblast cells have declined with increasing the concentration of both powders and hydrogel extracts in all groups after 24 and 48 h but still higher than the accepted cell viability % of (˃70%). Conclusions: The outstanding laboratory performance of the injectable alginate/BMBGNPs (20 wt%) composite hydrogel suggested it as promising candidate for pulpotomy filling material potentially enhancing dentin regeneration in clinical applications. [ABSTRACT FROM AUTHOR]

Background: Decreased salivary flow can make the patients uncomfortable with their complete dentures and affects the retention of the dentures. Milling and 3D printing have become an alternative to conventional denture construction techniques. The goal of this study was to evaluate the effect of conventional and digital techniques of the complete denture construction on the denture surface wettability with distilled water and saliva substitute before and after thermocycling. Methods: A total of 30 specimens were utilized in the present study. Specimens were divided according to the construction techniques into 3 groups (n = 10 each). Group I: Heat-polymerized polymethylmethacrylate (PMMA) group, group II: Milled group, and group III: 3-dimensional (3D)-printed group. All the specimens were subjected to 2000 cycles of thermal aging in a thermocycler. The wettability of all specimens to water and saliva substitute was measured via a contact angle goniometer (Olympus TGHM, Rame-hart Inc, USA) before and after thermocycling. Descriptive statistical analysis, plots, and the Shapiro-Wilk test were used to verify normality for each variable. One-way ANOVA was used to compare the 3 study groups, while paired samples t-test was used to compare the differences within each group (P <.05). Results: The smallest contact angle of drop of water to the denture base specimens before and after thermocycling were recorded in the milled group (53.0 ± 4.77 and 50.27 ± 2.30, respectively), followed by the heat polymerized PMMA group (85.65 ± 4.71 and 65.06 ± 2.27, respectively), and the 3D-printed group (91.34 ± 6.74 and 90.86 ± 8.57, respectively). While the smallest contact angle of drop of saliva substitute to denture base specimens was recorded in the milled group (56.82 ± 2.29 and 34.85 ± 7.51, respectively), followed by the 3D-printed group (72.87 ± 4.83 and 58.14 ± 9.58, respectively) and the heat polymerized PMMA group (83.62 ± 4.12 and 67.82 ± 4.93, respectively). There was statistically significant difference between the groups (P <.05). A significant decline in the average contact angle of drop of saliva has been reported in all groups after thermocycling. The contact angle values differed significantly between saliva substitute and distilled water in both 3D-printed and milled groups after thermocycling (P <.001). Conclusions: The milled denture base material presented the best wettability to water and saliva substitute than the 3D-printed and the heat-polymerized PMMA materials. Saliva substitutes improve the wetting ability of denture base materials manufactured by CAD/CAM compared with water. [ABSTRACT FROM AUTHOR]

Background: Missed nursing care poses a significant challenge for healthcare staff in terms of patient safety and care quality. Objective: To evaluate presenteeism and missed care attitudes of nurses and to determine the correlation between presenteeism and missed care. Methods: This descriptive, correlational, and observational study was conducted between February and August 2023. The Stanford Presenteeism Scale-Short Form and the MISSCARE Survey were used to collect the data among nurses at two public hospitals in a city in Turkey. The study was completed with 229 nurses representing 27.4% of the total number of nurses who met the inclusion criteria. The data was analyzed using a comprehensive analytical approach, including Cronbach's alpha analysis, frequency and percentage distribution, the Shapiro–Wilk test of normality, correlation coefficient analysis, Pearson correlation coefficient, and the Bonferroni test. Results: The participants' mean age was 30.22 ± 7.14 years, and 74.2% of them were female. 53.3% of the participants reported difficulty providing patient care due to material shortages, and 62.9% experienced challenges delivering care due to the intensity of paperwork in the clinic. Nurses who felt that paperwork intensity affected patient care and were not confident in their care provision had higher levels of presenteeism (p = 0.041) and a significantly higher frequency of missed care instances (p < 0.001). Conclusions: Material shortages and high paperwork intensity are contributing factors to the difficulties experienced by nurses in their practice. These difficulties may lead to an increase in presenteeism and instances of missed nursing care. It is important to address these challenges to ensure adequate care provision and reduce the likelihood of presenteeism among nurses. The correlation between presenteeism and instances of missed nursing care highlights the impact of presenteeism behaviors on the quality of patient care. [ABSTRACT FROM AUTHOR]

Background: Swine flu might serve as a model for challenges that primary care faces during pandemics. This study examined changes in the numbers and diagnoses of general practitioner (GP) visits during and after the Swine flu pandemic in Vantaa, a Finnish city, and how GP activities recovered after the pandemic. Putative sex and age group differences were also evaluated. Methods: The study was an observational retrospective study. The monthly number of patient visits to primary care GPs by women and men in age groups 0–19, 20–64 and 65 + years was recorded before, during and two years after the Swine flu pandemic. The recorded diagnoses were also examined. The investigation period was from 2008 to 2012. Results: The numbers of monthly visits to primary care decreased from 12 324 (mean) to 10 817 in women and from 8563 to 7612 in men during the first six months of the Swine flu, returning to the original level afterwards. This decrease was thus slightly more prominent in women. However, as the size of the population increased during the follow-up period, the actual number of GP visits adjusted for the size of population remained at a decreased level for two years after the Swine flu. This decrease was observed especially in office-hours visits of men (from 3692 to 3260) and women (from 6301 to 5428) of 20–64 years. Swine flu did not alter the number of visits to the primary care Emergency Department. The proportion of visits with diagnostic recordings of common infectious diseases mostly decreased during the Swine flu. Only a minor impact on the distribution of recordings of chronic diagnoses was found. Conclusion: A pandemic, such as Swine flu, may decrease office-hours visits to primary care GPs. This in turn may lead to activities of primary care being adjusted downward for a long time following the pandemic. Especially the age group 20–64 years may be affected. This risk should be considered when recovery from the COVID-19 pandemic begins. Swine flu did not affect the proportion of consultations of chronic diseases, but the number of diagnoses of common infectious diseases had diminished. [ABSTRACT FROM AUTHOR]

Background: The overlapping clinical manifestations in parkinsonian variant of multiple system atrophy (MSA-P) and Parkinson's Disease (PD) can complicate clinical diagnostic accuracy, particularly in the early stage. The study aims to uncover the patterns of brain function in the initial phase of the two conditions. Methods: We recruited 24 MSA-P patients, 34 PD patients and 27 healthy controls (HC). Voxel-wise fractional amplitude of low-frequency fluctuation (fALFF) was compared to characterize regional brain function, followed by seedbased functional connectivity (FC) analysis. Receiver operating characteristic (ROC) analyses were used to examine the diagnostic accuracy of fALFF. Results: Compared to HC, decreased fALFF was observed in the bilateral basal ganglia (BG) of MSA-P patients, while decreased fALFF was identified in the left BG of PD patients. Additionally, elevated fALFF was found in the superior cerebellum for MSA-P patients and the temporo-occipital cortex for PD patients. Furthermore, PD patients exhibited increased FC in the cortico-striatal loop compared to MSA-P patients. The fALFF of the left caudate distinguished MSA-P from HC with an area under the curve (AUC) of 0.838 (p < 0.001) and from PD with an AUC of 0.772 (p < 0.001). The fALFF of the left putamen distinguished PD from HC with an AUC of 0.736 (p = 0.002). Conclusion: Our findings indicated common and distinct abnormalities in spontaneous brain activity within BG, cerebellum, and cortices in early-stage MSA-P and PD patients. PD patients employed more compensatory mechanisms than MSA-P patients. Furthermore, fALFF may aid in early differentiation between MSA-P and PD. [ABSTRACT FROM AUTHOR]

This paper explores citizens' views regarding the application of participatory communication in the delivery of development services within the decentralised government system of Ghana. The participatory theory informed the core issues of this study. Data were obtained from 309 inhabitants selected from three administrative areas in the Central Region using the quota sampling technique. Questionnaires and researcher-administered survey were used to gather data and analysed using means, standard deviations, Kruskal Wallis test, independent samples t-test, and one-way ANOVA. The study revealed that issues of empowerment were moderately applied in development services. Again, people-centred approaches to the delivery of development services were lowly considered. Overall, participatory communication principles have not received adequate attention during the delivery of development services. The situation was the same across the three-tier decentralised government system. Despite their educational differences, respondents expressed similar opinions on the application of participatory development principles. Participatory communication faced challenges like the absence of well-trained development communicators, inadequate resources, low motivation on the part of local representatives, a low sense of ownership, and an absence of clear institutional policies on communication. The paper outlines key practical implications of the findings, including the need for governments to set up the necessary institutional framework to aid the incorporation of participatory communication techniques into the development strategies of Assemblies. [ABSTRACT FROM AUTHOR]

Background: Despite efforts to promote guideline use, guideline adoption is often suboptimal due to failure to identify and address relevant barriers. Barriers vary not only between guidelines but also between settings, intended users, and targeted patients. Multi-professional guidelines are often used in child and adolescent mental health services (CAMHS), making the implementation process more difficult. Despite this, there is a lack of knowledge about which barriers to consider or if barriers vary by profession. The aim of this study was to address these gaps by examining barriers to adopting a multi-professional depression guideline in the context of a nationwide implementation study. Methods: 440 CAMHS clinicians across Sweden (52%) completed the Barriers and Facilitators Assessment Instrument (BFAI) ahead of an implementation endeavour. BFAI is a widely used and validated measure of guideline implementation on four scales: Innovation, Provider, Context, and Patient. Barriers were calculated at scale and at item levels. ANOVA and chi-square tests were used to analyse differences by profession and effect sizes were calculated. Results: Overall, clinicians were optimistic about guideline uptake, particularly about guideline characteristics and their own adoption ability. Barriers were related to the patient and the context domains, as well as to individual clinician knowledge and training. Perceptions differed across professions; psychiatrists were most, and counsellors were least positive about guideline embeddedness. Conclusion: This large-scale quantitative study suggests that CAMHS clinicians have an overall favourable attitude towards guideline adoption but highlights the need for adaptations to certain patient groups. Strategies to improve guideline use should primarily address these patient issues while securing proper support to the implementation. Implementation efforts, particularly those targeting staff knowledge, training, and involvement, may benefit from being tailored to different professional needs. These findings may inform implementation projects in CAMHS and future research. [ABSTRACT FROM AUTHOR]

Background: In early 2020, COVID-19 pandemic has mobilized researchers in finding new remedies including repurposing of medicinal plant products focusing on direct-acting antiviral and host-directed therapies. In this study, we performed an in vitro investigation on the standardized Marantodes pumilum extract (SKF7®) focusing on anti-SARS-CoV-2 and anti-inflammatory activities. Methods: Anti-SARS-CoV-2 potential of the SKF7® was evaluated in SARS-CoV-2-infected Vero E6 cells and SARS-CoV-2-infected A549 cells by cytopathic effect-based assay and RT-qPCR, respectively. Target based assays were performed on the SKF7® against the S1-ACE2 interaction and 3CL protease activities. Anti-inflammatory activity of the SKF7® was evaluated by nitric oxide inhibitory and TLR2/TLR4 receptor blocker assays. Results: The SKF7® inhibited wild-type Wuhan (EC50 of 21.99 µg/mL) and omicron (EC50 of 16.29 µg/mL) SARS-CoV-2 infections in Vero-E6 cells. The SKF7® also inhibited the wild-type SARS-CoV-2 infection in A549 cells (EC50 value of 6.31 µg/mL). The SKF7® prominently inhibited 3CL protease activity. The SKF7® inhibited the LPS induced-TLR4 response with the EC50 of 16.19 µg/mL. Conclusions: In conclusion, our in vitro study highlighted anti-SARS-CoV-2 and anti-inflammatory potentials of the SKF7®. Future pre-clinical in vivo studies focusing on antiviral and immunomodulatory potentials of the SKF7® in affecting the COVID-19 pathogenesis are warranted. [ABSTRACT FROM AUTHOR]

In this paper we investigate the influence of cold plasma as novel method on the external otitis treatment which is a frequent cause of earache. 24 infected external auditory canals in 24 rats were categorized in four experimental groups including control, plasma exposed, ciprofloxacin drug and mixed of plasma-ciprofloxacin groups. In plasma group, dielectric barrier discharge was employed as the source of cold plasma in 5 days. All rats were observed with otoscope daily and a scoring system was used to evaluate swelling and effusion of the ear canal. Number of colonies in microbiological culture were counted in each group during the first 5 days after treatment. For the multiple group comparisons of swelling and effusion measured in the external auditory canal, Kruskal–Wallis analysis was applied and one-way anova and Kruskal–Wallis analysis was used for the statistical analysis of the results of the cultures in different days. Also, Tukey and Mann–Whitney tests was applied for multiple comparisons. Our findings show that swelling and effusion were obviously reduced in plasma group compared to control group (P < 0.01). Number of colonies in control group was statistically different from those in drug, plasma, and mixed group on the second to fifth day (p < 0.001). According to the results cold plasma can be introduced as an impressive method for external otitis treatment. Moreover, when cold plasma joined to antibiotic method, it leads to a superior performance respecting plasma or antibiotic method alone. [ABSTRACT FROM AUTHOR]

By 2050, 1 in 4 people worldwide will be living with hearing impairment. We propose a digital Speech Hearing Screener (dSHS) using short nonsense word recognition to measure speech-hearing ability. The importance of hearing screening is increasing due to the anticipated increase in individuals with hearing impairment globally. We compare dSHS outcomes with standardized pure-tone averages (PTA) and speech-recognition thresholds (SRT). Fifty participants (aged 55 or older underwent pure-tone and speech-recognition thresholding. One-way ANOVA was used to compare differences between hearing impaired and hearing not-impaired groups, by the dSHS, with a clinical threshold of moderately impaired hearing at 35 dB and severe hearing impairment at 50 dB. dSHS results significantly correlated with PTAs/SRTs. ANOVA results revealed the dSHS was significantly different (F(1,47) = 38.1, p < 0.001) between hearing impaired and unimpaired groups. Classification analysis using a 35 dB threshold, yielded accuracy of 85.7% for PTA-based impairment and 81.6% for SRT-based impairment. At a 50 dB threshold, dSHS classification accuracy was 79.6% for PTA-based impairment (Negative Predictive Value (NPV)-93%) and 83.7% (NPV-100%) for SRT-based impairment. The dSHS successfully differentiates between hearing-impaired and unimpaired individuals in under 3 min. This hearing screener offers a time-saving, in-clinic hearing screening to streamline the triage of those with likely hearing impairment to the appropriate follow-up assessment, thereby improving the quality of services. Future work will investigate the ability of the dSHS to help rule out hearing impairment as a cause or confounder in clinical and research applications. [ABSTRACT FROM AUTHOR]