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Purpose: This study assessed the accuracy of linear measurements and dental implant selection performed in a smartphone application compared to a computer software. Materials and Methods: Forty-four DICOM files from the posterior mandible in partially edentulous patients were evaluated by three trained and calibrated examiners. Images were analyzed using three visualization methods: cross-sectional view (CScr) and coronal (CSco) plane using the CS 3D Imaging software, and coronal (DRco) plane using the DroidRender smartphone application. For standardization, bone width and height measurements were taken in the edentulous posterior mandible, 10 mm posterior to the mental foramen. Implants were selected according to the 2022/2023Straumann Standard implant catalog. Linear measurements were compared using repeated-measures ANOVA, and implant selection was compared using Friedman test. Statistical analysis was performed using SPSS software, with a significance level of 5%. Results: Linear measurements showed a statistically significant difference for bone width (P = .030), but not for height (P = .685). The choice of implant was not influenced by the visualization method (P = .614). Conclusions: It is possible to suggest the use of smartphone applications as an additional diagnostic tool for DICOM evaluation and implant planning in the posterior mandible. Smartphone applications allow an assessment not limited to 2D images or to static environments. Therefore, information exchange and diagnostic opinion in emergency situations may be facilitated. [ABSTRACT FROM AUTHOR]

The primary purpose of this study was to adapt selected accuracy and precision tests in table tennis to the specific skills of elite table tennis players with impairment. The study included a sample of 23 Para table tennis players with an average age of 31.8 ± 12.22 years (including 30.4% females) who belonged to the senior Polish Para table tennis team. A battery of six tests evaluating stroke accuracy and serve precision was assessed. The analysis of the reliability of these tests confirmed the legitimacy of using this battery of accuracy and precision tests to assess the skills of Para table tennis players in all three integrated sport classes: players in wheelchairs, in a standing position, and with intellectual impairment. Analysis of the data obtained from the tests could provide coaches with relevant information regarding elite Para table tennis players' level of performance and examine selected accuracy and precision elements of their individual technique. [ABSTRACT FROM AUTHOR]

Introduction: Pediatric patients have an increased risk of radiation-induced malignancies due to their ongoing development and long remaining life span. Thus, optimization of PET protocols is an important task in pediatric nuclear medicine. Long axial field-of-view (LAFOV) PET/CT has shown a significant increase in sensitivity, which provides an ideal opportunity for reduction of injected tracer activity in the pediatric population. In this study we aim to evaluate the clinical performance of a 2-[18F]FDG-tracer reduction from 3 MBq/kg to 1.5 MBq/kg on the Biograph Vision Quadra LAFOV PET/CT. Materials and methods: The first 50 pediatric patients referred for clinical whole-body PET/CT with 1.5 MBq/kg 2-[18F]FDG, were included. A standard pediatric protocol was applied. Five reconstructions were created with various time, filter and iteration settings. Image noise was computed as coefficient-of-variance (COV = SD/mean standardized-uptake-value) calculated from a spherical 20-50 mm (diameter) liver volume-of-interest. Sets of reconstructions were reviewed by one nuclear medicine physicians, who reported image lesions on a pre-defined list of sites. Paired comparison analysis was performed with significance at PB< 0.05 (Bonferroni corrected). Results: All reconstructions, except one, achieved a COVmean (0.08-0.15) equal to or lower than current clinical acceptable values (COVref ≤ 0.15). Image noise significantly improved with increasing acquisition time, lowering iterations (i) from 6i to 4i (both with five subsets) and when applying a 2 mm Gauss filter (PB< 0.001). Significant difference in lesion detection was seen from 150s to 300s and from 150s to 600s (PB = 0.006-0.007). 99% of all lesions rated as malignant could be found on the 150s reconstruction, while 100% was found on the 300s, when compared to the 600s reconstruction. Conclusion: Injected activity and scan time can be reduced to 1.5 MBq/kg 2-[18F] FDG with 5 min acquisition time on LAFOV PET/CT, while maintaining clinical performance in the pediatric population. These results can help limit radiation exposure to patients and personnel as well as shorten total scan time, which can help increase patient comfort, lessen the need for sedation and provide individually tailored scans. [ABSTRACT FROM AUTHOR]

Introduction: Pediatric patients have an increased risk of radiation-induced malignancies due to their ongoing development and long remaining life span. Thus, optimization of PET protocols is an important task in pediatric nuclear medicine. Long axial field-of-view (LAFOV) PET/CT has shown a significant increase in sensitivity, which provides an ideal opportunity for reduction of injected tracer activity in the pediatric population. In this study we aim to evaluate the clinical performance of a 2-[18F]FDG-tracer reduction from 3 MBq/kg to 1.5 MBq/kg on the Biograph Vision Quadra LAFOV PET/CT. Materials and methods: The first 50 pediatric patients referred for clinical whole-body PET/CT with 1.5 MBq/kg 2-[18F]FDG, were included. A standard pediatric protocol was applied. Five reconstructions were created with various time, filter and iteration settings. Image noise was computed as coefficient-ofvariance (COV = SD/mean standardized-uptake-value) calculated from a spherical 20-50 mm (diameter) liver volume-of-interest. Sets of reconstructions were reviewed by one nuclear medicine physicians, who reported image lesions on a pre-defined list of sites. Paired comparison analysis was performed with significance at PB < 0.05 (Bonferroni corrected). Results: All reconstructions, except one, achieved a COVmean (0.08-0.15) equal to or lower than current clinical acceptable values (COVref = 0.15). Image noise significantly improved with increasing acquisition time, lowering iterations (i) from 6i to 4i (both with five subsets) and when applying a 2 mm Gauss filter (PB < 0.001). Significant difference in lesion detection was seen from 150s to 300s and from 150s to 600s (PB = 0.006-0.007). 99% of all lesions rated as malignant could be found on the 150s reconstruction, while 100% was found on the 300s, when compared to the 600s reconstruction. Conclusion: Injected activity and scan time can be reduced to 1.5 MBq/kg 2-[18F] FDG with 5 min acquisition time on LAFOV PET/CT, while maintaining clinical performance in the pediatric population. These results can help limit radiation exposure to patients and personnel as well as shorten total scan time, which can help increase patient comfort, lessen the need for sedation and provide individually tailored scans. [ABSTRACT FROM AUTHOR]

Background: To assess marginal bone loss and soft tissue health around two-implant mandibular overdenture retained with milled versus selective laser-melted cobalt chromium (Co-Cr) bars. Method: This research was set to be a parallel, triple-blinded, randomised controlled trial. Twenty completely edentulous patients received new conventional complete dentures according to conventional techniques. Two implants were placed at mandibular canine areas bilaterally, and patients were randomly allocated into two equal groups: the milled Co-Cr bar group and the selective laser melted (SLM) Co-Cr bar group. Marginal bone loss (MBL), modified plaque index (mPI), modified gingival index (mGI), and probing depth (PD) were evaluated at 0-month (baseline), 6-month, and 12-month follow-up visits. Repeated measures ANOVA test and Bonferroni's post-hoc test were used for parametric data as PD, while for non-parametric data as MBL, mGI, and mPI, Mann-Whitney U test and Friedman's test were used. A P-value ≤ 0.05 was set as the statistical level of significance. The study protocol was approved by the Faculty Research Ethics Committee at Minia University (636 4/10/2022). Registration for the clinical trial was made retrospectively on clinicaltrials.gov with ID NCT06401200 at 04/30/2024. Results: The follow-up period (one year) was completed without a dropout. Regarding MBL, no statistically significant difference was found between the two groups throughout the study. However, the milled group showed significantly increased MBL from 0- to 6-month follow up period. In both groups, mPI increased significantly from 0- to 6-months post-loading. On the other hand, no statistically significant difference between the two groups was found regarding mPI and mGI throughout the study follow-up periods. The PD was significantly lower in the milled compared to the SLM group at the 6- and 12-month follow up period. Conclusion: Two-implant mandibular overdenture retained with milled or SLM Co-Cr bar can provide an acceptable treatment option for completely edentulous patients regarding marginal bone loss and soft tissue outcomes. [ABSTRACT FROM AUTHOR]

Objective: The article reports on an assessment of the effectiveness of the MLA Research Training Institute (RTI) for the years 2018 and 2019. The RTI is a year-long continuing education research methods training and support program for health sciences librarians. The study focuses on assessing RTI participants' research confidence after program completion and compares these results with their perceptions of workshop/program performance and learning outcomes. In addition, the authors discuss how the findings were applied to inform and improve the program. Methods: The study used a 26-item questionnaire, RTI Research Confidence Questionnaire, to gather information on participants' self-reported research confidence before the workshop, immediately after the workshop, and one year after the workshop to determine statistically significant differences. Differences in research confidence were identified by using three nonparametric statistical tests. Additional workshop and program surveys were used to corroborate the research confidence findings. Results: Post-workshop and one-year-after-workshop research confidence ratings were significantly higher than preworkshop levels for years 1 and 2. A comparison of median ratings between years 1 and 2 showed significant increases in research confidence for nine items in year 2. Participants' positive perceptions of workshop/program effectiveness and learning outcomes corroborated these findings. Conclusion: Overall assessment findings indicated that RTI training helped participants understand, use, and apply research skills to conduct research. Findings also revealed that participants' heightened research confidence persisted at least 12 months postintervention. The RTI Research Confidence Questionnaire proved effective for rigorously assessing and improving the RTI program. This study enhances the currently limited evidence on evidence-based approaches for assessing and improving research instruction for librarians. [ABSTRACT FROM AUTHOR]

Objectives Our aim was to introduce a standardized system for assessing the extent of GCA on MRI, i.e. the Magnetic Resonance Vasculitis Activity Score (MRVAS). To obtain a comprehensive view, we used an extensive MRI protocol including cranial vessels and the aorta with its branches. To test reliability, MRI was assessed by four readers with different levels of experience. Methods A total of 80 patients with suspected GCA underwent MRI of the cranial arteries and the aorta and its branches (20 vessel segments). Every vessel was rated dichotomous [inflamed (coded as 1) or not (coded as 0)], providing a summed score of 0–20. Blinded readers [two experienced radiologists (ExR) and two inexperienced radiologists (InR)] applied the MRVAS on an individual vessel and an overall level (defined as the highest score of any of the individual vessel scores). To determine interrater agreement, Cohen's κ was calculated for pairwise comparison of each reader for individual vessel segments. Intraclass correlation coefficients (ICCs) were used for the MRVAS. Results Concordance rates were excellent for both subcohorts on an individual vessel-based (GCA: ICC 0.95; non-GCA: ICC 0.96) and overall MRVAS level (GCA: ICC 0.96; non-GCA: ICC 1.0). Interrater agreement yielded significant concordance (P  < 0.001) for all pairs (κ range 0.78–0.98). No significant differences between ExRs and InRs were observed (P  = 0.38). Conclusion The proposed MRVAS allows standardized scoring of inflammation in GCA and achieved high agreement rates in a prospective setting. [ABSTRACT FROM AUTHOR]

Background: The objective of this animal study was to evaluate the hemodynamic performance of a new centrifugal pump for extra-corporeal membrane oxygenation (ECMO) support in neonates. Methods: Six healthy swines were supported with veno-venous ECMO with the New Born ECMOLife centrifugal pump (Eurosets, Medolla, Italy) at different flow rates: 0.25, 0.5, 0.6, and 0.8 L/min; three animals were evaluated at low-flows (0.25 and 0.5 L/min) and three at high-flows (0.6 and 0.8 L/min). Each flow was maintained for 4 hours. Blood samples were collected at different time-points. Hematological and biochemical parameters and ECMO parameters [flow, revolutions per minute (RPM), drainage pressure, and the oxygenator pressure drop] were evaluated. Results: The increase of the pump flow from 0.25 to 0.5 L/min or from 0.6 to 0.8 L/min required significantly higher RPM and produced significantly higher pump pressures [from 0.25 to 0.5 L/min: 1470 (1253–1569) versus 2652 (2589–2750) RPM and 40 (26–57) versus 125 (113–139) mmHg, respectively; p <.0001 for both - from 0.60 to 0.8 L/min: 1950 (1901–2271) versus 2428 (2400–2518) RPM and 66 (62–86) versus 106 (101–113) mmHg, respectively; p <.0001 for both]. Median drainage pressure significantly decreased from −18 (−22; −16) mmHg to −55 (−63; −48) mmHg when the pump flow was increased from 0.25 to 0.5 L/min (p <.0001). When pump flow increased from 0.6 to 0.8 L/min, drainage pressure decreased from −32 (−39; −24) mmHg to −50 (−52; −43) mmHg, (p <.0001). Compared to pre-ECMO values, the median levels of lactate dehydrogenase, d-dimer, hematocrit, and platelet count decreased after ECMO start at all flow rates, probably due to hemodilution. Plasma-free hemoglobin, instead, showed a modest increase compared to pre-ECMO values during all experiments at different pump flow rates. However, these changes were not clinically relevant. Conclusions: In this animal study, the "New Born ECMOLife" centrifugal pump showed good hemodynamic performance. Long-term studies are needed to evaluate biocompatibility of this new ECMO pump. [ABSTRACT FROM AUTHOR]

Purpose: Wheelchair users and people with disabilities have limited access to physical exercise due to various factors, including medical follow-up and training facilities. Although tele-exercise guided by experts has become a viable option, there is limited knowledge about the acute performance decrement (APD) resulting from remote training methods. The current cross-sectional study aimed to: (1) assess the APD of muscle resistance strength after three synchronous tele-exercise training methods in wheelchair users and (2) compare the training loads associated with each training method. Materials and methods: Eighteen male and female wheelchair users who participated in tele-exercise strength practices were recruited. The participants performed a maximum resistance strength test by synchronous tele-assessment (push-up test, PUT) at baseline and immediately after three training methods: high-intensity interval training (HIIT), moderate-intensity continuous training (MICT) and sprint interval training (SIT). The primary outcome was the APD, which was measured by the percentage decrease in the number of repetitions of the PUT immediately after the training methods. Results: APD was observed for all three training methods, with no significant differences between them (–34.8%, −29.9% and −38.0% for MICT, SIT and HII, respectively), and presented a non-significant correlation with the training loads. HIIT had a significantly higher training load than MICT and SIT. Conclusions: APD occurred in all training sessions, but did not correlate with training load, indicating that it is not an appropriate metric for comparison. Findings provide insight into APD response and highlight the need to consider multiple metrics when comparing training protocols. Implications for Rehabilitation: Synchronous moderate-intensity continuous training (MICT), sprint interval training (SIT) and high-intensity interval training tele-exercises provided similar acute performance decrement in wheelchair users and people with disabilities. High-intensity interval training showed a higher training load compared to MICT and SIT performed remotely. Acute performance decrement did not correlate with the training load. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the effectiveness of the bladder stimulation technique (BST) to collect urine samples from newborns and its effects on physiological parameters and comfort of the newborn. Design: This was a randomized controlled trial conducted in a NICU. A total of 64 newborns were divided into 2 groups: 32 newborns in the experimental group and 32 newborns in the control group. Methods: Newborns in the experimental group (EG) were subjected to the BST, and in the control group (CG), urine collection was via sterile urine bags, which is routine practice. Procedural success was defined as the collection of urine samples within 3 min of beginning the stimulation technique in the experimental group and of placing the sterile urine bag in the control group. Results: The success rate of the procedure in 3 min was 62.5% in the EG and 28% in the CG (P = 0.006, absolute difference: 35%, 95% confidence interval 27% to 42%, NNT: 3). According to the comparison of the overall mean COMFORTneo scale and pain and distress subscale scores at the 1‐ and 3‐min marks, there was a significant difference between the EG and CG (p < 0.05). The mean scores in the EG were higher than those in the CG. The mean oxygen‐saturation was significantly lower in the EG than in the CG (p < 0.05), and the increase in heart rate was significantly higher in the EG (p = 0.018). Conclusions: BST is a more successful method within 3 min for collecting urine samples from newborns compared to sterile urine bags. However, the newborns' comfort levels minimally decreased at 3 min, and they had moderate pain and distress, while the BST was being implemented. This increase in physiologic parameters was statistically significant but not clinically significant. Summary statement: What is already known about this topic? Urinary tract infection is a commonly diagnosed bacterial infection in young infants with fever. However, the symptoms of this infection are non‐specific, so urine samples are needed to accurately diagnose and exclude it.There are multiple methods available for collecting urine samples, each with its own advantages and disadvantages.The bladder stimulation technique is a noninvasive and efficient method for collecting urine samples. However, few studies have examined the pain and distress effects of this technique, and these studies have reported varying results. What this paper adds? This study found that bladder stimulation techniques were more effective than sterile urine bags in collecting urine samples within 3 min from newborns.The bladder stimulation technique led to decreased saturation and comfort levels, increased heart rate, and increased pain and distress in the newborns during urine sampling; these increases in physiologic parameters were statistically significant but not clinically significant. The implications of this paper: The bladder stimulation technique is an effective noninvasive method for quickly collecting urine samples.Considering the pain and distress‐increasing properties of the technique, it may be recommended before invasive interventions (bladder catheterization and suprapubic aspiration) when urine sample collection with urine bags is not possible; it can be used in cases where urgent urine collection is required. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the impact of combining transcranial direct current stimulation with end-effector robot-assisted treatment on upper limb function, spasticity, and hand dexterity in chronic stroke patients. Design: This was a prospective, double-blind randomized trial with 20 equally allocated stroke patients. The experimental group received dual transcranial direct current stimulation (anode over affected M1, cathode over contralateral M1) alongside robot-assisted treatment, while the control group received sham transcranial direct current stimulation with the same electrode placement + robot-assisted treatment. Each patient underwent 20 combined transcranial direct current stimulation and robot-assisted treatment sessions. The primary outcome measure was the Fugl-Meyer Upper Limb motor score, with secondary outcomes including AMADEO kinematic measures, Action Research Arm Test, and Functional Independence Measure. Assessments were conducted at baseline, after rehabilitation, and 3 mos later. Results: Combining bilateral transcranial direct current stimulation with robot-assisted treatment did not yield additional improvements in Fugl Meyer Upper Limb motor score, Functional Independence Measure, or Action Research Arm Test scores among stroke patients. However, the real transcranial direct current stimulation group showed enhanced finger flexion in the affected hand based on AMADEO kinematic measures. Conclusions: The addition of transcranial direct current stimulation to robot-assisted treatment did not result in significant overall functional improvements in chronic stroke patients. However, a benefit was observed in finger flexion of the affected hand. [ABSTRACT FROM AUTHOR]

BACKGROUND: The first aim of this study was to evaluate the capacity of electrical impedance tomography (EIT) to identify the effect of PEEP on regional ventilation distribution and the regional risk of collapse, overdistention, hypoventilation, and pendelluft in mechanically ventilated patients. The second aim was to evaluate the feasibility of EIT for estimating airway opening pressure (AOP). METHODS: The EIT signal was recorded both during baseline cyclic ventilation and slow insufflation for one breath for 9 subjects with moderate-to-severe ARDS. From these data, the AOP and volumes insufflated to lung regions with or without the risk of either collapse, overdistention, hypoventilation, or pendelluft were assessed at 3 PEEP levels (5, 10, and 15 cm H2O). PEEP levels were compared by Friedman analysis of variance and the AOP measured by EIT evaluated using an F-test and the Bland and Altman method. RESULTS: The volume for which there was no specific risk significantly decreased at the highest PEEP from 55 ± 31% tidal volume (VT) at PEEP = or 82 ± 18% VT at PEEP 10 to 10 ± 30% VT at PEEP 15 (P = .038 between PEEP 5 vs PEEP 15; P = .01 between PEEP 10 vs PEEP 15). The volume associated with overdistention significantly increased with increasing PEEP, whereas that associated with atelec-trauma significantly decreased. Pendelluft significantly decreased with increasing PEEP: VT of 8.9 ± 18.6%, 3.6 ± 7.0%, and 3.2 ± 7.1% for PEEP 5, PEEP 10, and PEEP 15, respectively. The center of ventilation tended to increase in the dependent direction with higher PEEP. The AOPs assessed by EIT and from the pressure-volume curve were in good agreement (bias 0.48 cm H2O). CONCLUSIONS: Our results suggest that EIT could aid clinicians in making personalized and reasoned choices in setting the PEEP for subjects with ARDS. [ABSTRACT FROM AUTHOR]

Introduction: Following the initial outbreak of the COVID-19 pandemic, mental health clinicians rapidly shifted service delivery from in-person to digital. This pivot was instrumental in maintaining continuity of care and meeting increased mental health service demands. Many mental health services have continued to be offered via digital delivery. The long-term implications of delivering services via digital media remain unclear and need to be addressed. Objectives: This study aimed to identify current micro (i.e., clinician–patient interactions), meso (i.e., clinician–clinic manager interactions), and macro (i.e., government–policy maker interactions) level issues surrounding the use of digital mental health interventions (DMHI). Such integrated assessments are important for optimizing services to improve treatment outcomes and client satisfaction. Methods: Participants were recruited between January 2022 and April 2023. Quantitative data were collected using a survey informed by the Hexagon Tool. Qualitative data were collected from online semi-structured interviews and focus groups and analyzed using rapid thematic analysis. Results: Survey data were collected from 11 client and 11 clinician participants. Twenty-six community partner participants were interviewed for this study. Client and clinician participants expressed satisfaction with the implementation of DMHI. Community partner participants generally agreed, reporting that such services will play an integral role in mental healthcare moving forward. Community partners shared that certain issues, such as uncertainty surrounding policies and regulations related to digital delivery, must be addressed in the future. Conclusions: Participants in this study supported the use of DMHI despite difficulties implementing these programs, asserting that such services are not a temporary fix but a pivotal cornerstone in the future of mental healthcare service delivery. [ABSTRACT FROM AUTHOR]

Background/Objectives. A notable decline in physical activity from late adolescence to early adulthood affects young women especially. This study aimed to investigate adherence to an unsupervised virtual-guided high-intensity interval training (HIIT) exercise program among young women in Spain. Methods. A total of 106 participants were recruited and randomized to the Women's Involvement in Steady Exercise (WISE) trial exercise program, administered remotely via a mobile app, and a control group. The primary outcome was adherence measured through daily steps. Secondary variables were patient-reported outcomes of physical activity, quality of sleep, and quality of life, assessed with the International Physical Activity Questionnaire (IPAQ), the Pittsburgh Sleep Quality Index (PSQI), and the Health Lifestyle and Personal Control Questionnaire (HLPCQ), respectively. The assessments were performed over 6 months, before the intervention (T0), at the halfway of the program (T1), and at the end (T2). Results. Daily steps revealed a decrease from baseline to final assessment in both groups. Secondary outcomes indicated a shift in physical activity levels, showing a transition from low to moderate and high activity perception. While sleep quality deteriorated post-intervention, quality of life showed no changes. Conclusions. The WISE trial highlights the potential and challenges of an unsupervised virtual-guided HIIT program for young women. While an improvement in physical activity levels was noticed, it also led to a decrease in daily steps and poorer sleep quality. These findings suggest a complex relationship between exercise and lifestyle factors, which could potentially have the greatest impact. [ABSTRACT FROM AUTHOR]

Purpose: During the coronavirus disease 2019 pandemic, health services offered to individuals diagnosed with mental disorders were interrupted, and use of alternative methods, such as telenursing, came to the forefront. Method: Sixty-four individuals with schizophrenia participated in the current randomized controlled trial that evaluated whether a telenursing intervention affected their drug attitudes, self-efficacy, and quality of life. Pretest, posttest, and follow-up measurements were obtained for experimental and control groups from May to August 2021. Data were collected via a Personal Information Form, Drug Attitude Inventory-10, Self-Efficacy Scale, and World Health Organization Quality of Life Questionnaire–Short Form. Results: Upon comparison of scores obtained by the experimental and control groups in pretest, posttest, and follow-up measurements, it was discerned that telenursing positively affected drug attitudes of participants in the experimental group and enhanced their quality of life. Although there was an increase in self-efficacy levels of the experimental group compared to the control group, the difference was not statistically significant. Conclusion: Telenursing is an effective intervention for the improvement of drug attitudes and quality of life but is not satisfactory for the improvement of self-efficacy in individuals with schizophrenia. [Journal of Psychosocial Nursing and Mental Health Services, 62(10), 15–24.] [ABSTRACT FROM AUTHOR]

Purpose: Treatment for oral cancer has debilitating effects on speech and swallowing, however, little is known about current speech-language pathology practice. Method: An online survey of speech-language pathologists (SLPs) was disseminated via emails to speech pathology departments, social media platforms, and professional online forums. Survey questions captured demographics, service delivery, type and timing of speech and swallowing interventions, and influences and barriers to practice. Result: Forty-three SLPs working in Australia (n = 41) and New Zealand (n = 2) completed the survey. SLPs recommended speech and swallowing compensatory strategies significantly more frequently than active intervention. Swallowing outcomes measures were either instrumental (n = 31, 94%) or performance ratings (n = 25, 76%), whereas speech was measured informally with judgements of intelligibility (n = 30, 91%). SLPs used a range of supports for their decision making, particularly expert opinion (n = 81, 38.2%). They reported time and staffing limitations (n = 55, 55%) and a lack of relevant evidence (n = 35, 35%) as the largest barriers to evidence-based service delivery. Conclusion: There is variability amongst SLPs in Australia and New Zealand regarding rehabilitation of speech and swallowing for people with oral cancer. This study highlights the need for evidence-based guidelines outlining best practice for screening processes, active rehabilitation protocols, and valid outcome measures with this population. [ABSTRACT FROM AUTHOR]

Background: To verify the influence of macrogeometry with healing chambers on the osseointegration of dental implants by analyzing implant stability quotient (ISQ) and evaluate the correlation between insertion torque and ISQ insertion with different macrogeometries. Methods: In total, 26 implants were installed in the posterior mandible of eight patients with sufficient bone height for the installation of implants measuring 3.5 mm in diameter and 9.0 mm in length. The implants were categorized according to two types of macrogeometry: a test group (GT) with 13 conical implants with healing chambers and a control group (GC) with 13 conical implants with conventional threads. To insert the implants, a bone drilling protocol was used up to a diameter of 3 mm with the last helical bur. The insertion torque of the implants was evaluated, followed by the measurement of ISQ at 0 (T-0), 7 (T-7), 14 (T-14), 21 (T-21), 28 (T-28), and 42 (T-42) days. Results: The mean insertion torque was 43 Ncm in both groups, without a significant difference. Moreover, no significant difference in the ISQ values was found between the groups at different time points (p > 0.05), except at T-7 (GT = 69.87±1.89 and GC = 66.48±4.49; p = 0.01). Although there was no significant difference, ISQ median values were higher in the GT group than GC group at 28 days (GT = 67.98 and GC = 63.46; p = 0.05) and 42 days (GT = 66.12 and GC = 60.33; p = 0.09). No correlation was found between the insertion torque and ISQ insertion (p > 0.05). Conclusion: Furthermore, implants with a 3.5 mm diameter macrogeometry, with or without healing chambers, inserted with a drilling protocol up to 3 mm in diameter of the last helical bur, led to a similar secondary stability, with no difference in ISQ values. Although, implants with healing chamber demonstrates ascending values in the graph of ISQ, having a trend of faster osseointegration than implants without healing chambers. Both macrogeometries provide a similar primary stability to implants. Trial registration: This study was registered retrospectively in ReBec (brazilian registry of clinical trials) under the number RBR-96n5×69, on the date of 19/06/2023. [ABSTRACT FROM AUTHOR]

Background: The difficulty in understanding speech becomes worse in the presence of background noise for individuals with sensorineural hearing loss. Speech-in-noise tests help to assess this difficulty. Previously, the Tulu sentence lists have been assessed for their equivalency to measure speech recognition threshold in noise among individuals with normal hearing. The present study aimed to determine the equivalence and test–retest reliability of Tulu sentence lists for measuring speech recognition threshold in noise among individuals with sensorineural hearing loss. Results: The SNR-50 was measured for 13 sentence lists in 20 Tulu-speaking individuals with mild to moderate sensorineural hearing loss. Retesting was done by administering all lists to eight participants after an average of 25.25 days (SD = 19.44). Friedman test was administered to check for the list equivalency. Intraclass correlation coefficient was measured to assess test–retest reliability. A regression analysis was performed to understand the influence of pure-tone average on SNR-50. A Kruskal–Wallis test was administered to check the statistical significance of the SNR-50 obtained across different configurations and degrees of hearing loss. Nine of the 13 Tulu sentence lists (lists 2, 4, 5, 6, 9, 10, 11, 12, and 13) were equivalent in individuals with sensorineural hearing loss. The mean SNR-50 for these nine lists was 1.13 dB (SD = 2.04 dB). The test–retest reliability was moderate (ICC = 0.727). The regression analysis showed that a pure-tone average accounted for 24.7% of the variance in SNR-50 data (p = 0.026). Individuals with mild to moderate hearing loss obtained the worst SNR-50, followed by mild and high-frequency hearing loss. Conclusion: Nine Tulu sentence lists are equivalent and reliable and can be used to measure speech recognition threshold in noise among individuals with sensorineural hearing loss who are Tulu speakers. [ABSTRACT FROM AUTHOR]

Background: To predict the long-term performance of restorative materials in the oral environment, it is important to evaluate their resistance to chemical and mechanical degradation and to know the toxic potential of the type and amount of ions eluted from the filling material. In this study, home bleaching was applied to dental materials with different contents and it was aimed to determine the type and amount of ions released from these materials. Methods: In this study, amalgam, posterior composite resin, anterior composite resin, bulk fill composite resin, indirect composite resin, hybrid ceramic and all-ceramic were used as restorative materials. 10 specimens of each material were prepared according to the manufacturer's instructions. Each material group was divided into two subgroups as the bleached group and the control group. After bleaching, all specimens were stored in 1 ml of 75% ethanol/water solution. Solutions were renewed after 1, 14 and 28 days. The type and amount of ions released from the materials were determined using Inductively Coupled Plasma-Mass Spectrometer (ICP-MS). Data were analyzed using the Friedman, Wilcoxon Signed Ranks, and Mann-Whitney U tests (α = 0.05). Results: It was determined that the amount of ions release from the restorative materials decreased over time (p < 0.05). According to the results of the Mann-Whitney U test, there was no difference between the bleaching and control groups in most of the restorative materials (p > 0.05). Conclusion: Within the limits of this study, home bleaching system does not have a significant effect on ion release from restorative materials. [ABSTRACT FROM AUTHOR]

Background: Fentanyl is an opioid analgesic frequently used in the emergency department (ED) and is usually administered without knowing the QTC values of the patients or being monitored. However, the effect of fentanyl on QTC, prolongation or shortening, has not been elucidated. This study aimed to determine the effect of fentanyl on QTC. Methods: This is a prospective observational study in the ED of a tertiary hospital on patients who received intravenous fentanyl for procedures other than intubation. ECG was performed before and at 1, 5, 15, 30, and 60 min after the initiation of fentanyl administration, and QTC value was calculated. Primary outcomes were QTC prolongation, defined as an increase in the QTC to ≥ 500 ms or any increase in QTC by ≥ 60 ms. Results: The study included 109 patients. Of these, 60 patients were male, and the median age was 40. Compared with the baseline QTC value, statistically significant prolongation was detected at the 5th, 15th, 30th, and 60th minutes, with the maximum prolongation at 30 min, and the median was 13.08 ms. Most patients with QTC prolongation were female and over 40 years of age. Clinically, none of these patients developed malignant arrhythmias during the 60-minute monitored observation period. Conclusion: Fentanyl prolonged the QTC value statistically significantly. Although no patient developed malignant arrhythmia clinically, our results suggest that this QTC-prolonging effect should be considered when using fentanyl in patients at risk of torsades. [ABSTRACT FROM AUTHOR]

Background: Primary biliary cholangitis (PBC) is a condition affecting the liver and immune system. In this study, the impact of autologous bone marrow-derived mononuclear cell (BM-MNC) transplantation on PBC patients was investigated. Methods: Sixteen eligible PBC patients participated at the National Scientific Medical Center in Astana, Kazakhstan, between 2017 and 2022, and BM-MNCs were harvested from their anterior iliac crest. After isolating and cultivating the BM-MNCs, they were infused back into the patient's peripheral veins. Changes in BM-MNC and peripheral blood mononuclear cell (PB-MNC) phenotypes were assessed before and after a 24-hour cultivation period and 72 hours post-transplantation. We monitored liver function parameters over 6-month intervals and conducted flow cytometry analysis to assess CD markers on BM-MNCs before and after cultivation and PB-MNCs before and after transplantation. Statistical analysis included the Friedman test for liver parameters and the Wilcoxon signed-rank test for BM-MNC and PB-MNC comparisons. Results: Our findings revealed significant reductions in liver function tests after multiple transplantations. Flow cytometry analysis before and after a 24-hour culture and autologous BM-MNC infusion revealed the expansion of specific cell populations, with significant increases in CD3+, CD4+, CD16+, CD20+, CD25+, CD34+, CD105+, CD73+, CD117+, and CD34+populations, while CD4+25+, CD34+105+, and CD4+FOXP3+ populations decreased. Interestingly, a contradictory finding was observed with a decrease in bone marrow CD34+105+ cell lines (P=0.03) alongside an increase in peripheral CD34+105+ population (P=0.03). Conclusion: In summary, our study shows that BM-MNC transplantation in PBC patients leads to changes in immune cell populations and liver function. These findings suggest potential therapeutic applications of BM-MNC transplantation in managing PBC and offer insights into the dynamics of immune cells associated with this treatment approach. [ABSTRACT FROM AUTHOR]

Combat sports is a term applied to various competitive contact sports involving 2 competitors engaging in a bout or contest under a specific ruleset. Little is known about combat sports athletes' sleep and nutritional knowledge. This study aimed to assess (a) sleep behaviors, (b) alcohol and shiftwork disorders, and (c) the nutritional knowledge of combat sports athletes. Subjects completed various demographic questions and estimations of their weight management practices and validated surveys, including the Athlete Sleep Behavior Questionnaire, Shiftwork Disorder (SWD) Screening Questionnaire, Alcohol Use Disorders Identification Test, and the Abridged Nutrition for Sports Knowledge Questionnaire. A total of 844 combat sports athletes completed the survey, 79% male, height of 177 ± 10 (cm), and body mass of 79 ± 15 (kg). Subjects were categorized into their specific combat sport type (e.g., boxing or Brazilian jiu-jitsu [BJJ]) and by their level (professional or amateur). Sleep quality was average for all combat sport types and risk prevalence of shiftwork disorder at 11%. Mann-Whitney U tests revealed that amateurs, compared with professional strikers (p = 0.046, CLES = 0.80), boxers (p = 0.01, CLES = 0.78), and BJJ (p = 0.046, CLES = 0.61) athletes, consumed significantly more alcohol. A Friedman test showed significant (p < 0.001, W = 0.51) differences in weight between time points, with most combat sports athletes reducing weight for competition. An overall nutritional knowledge average of 55% was reported. This study highlights a critical gap in the knowledge and practices of combat sports athletes in relation to sleep behaviors and disorders, alcohol consumption, and nutritional knowledge, emphasizing the need for targeted educational interventions. [ABSTRACT FROM AUTHOR]

A rugby league player's ability to develop or maintain lower-body power will be significantly influenced by the resistance and field-based training loads completed. This study aimed to examine the power changes across a rugby league season and to investigate the relationship of concurrent training and training experience on power changes. Eighteen rugby league players participated in this study. Lower-body power was evaluated using a countermovement jump throughout the season. Four measures of external training loads were collected. A Friedman's test was used to assess differences in power throughout different phases of the season. A series of Spearman's rank-order correlations were conducted to assess the relationship between percentage changes in power during the training block, external training loads, and training experience. Countermovement jump peak velocity significantly decreased from the start (p = 0.006) and end of pre-season (p = 0.022) to the late competition. Correlation analysis revealed a large significant association between early competition field-based external loads (relative (rs = -0.571) and total distance (rs = -0.628)) and change in peak power. Very large significant negative relationships were also observed between mid-competition volume load with change in peak force (rs = -0.825) and peak power (rs = -0.736). Training experience was not significantly associated with changes in muscular power variables throughout this study. Coaches should seek to monitor changes in peak power when competition begins and to assist with decision-making for potential adjustments to running volume and intensity during field-based sessions. [ABSTRACT FROM AUTHOR]

Purpose: Communication can be chronically impacted by severe traumatic brain injury (TBI), yet there is a critical lack of research investigating communication recovery beyond 12 months postinjury with discourse measures. This longitudinal study aimed to investigate quantitative and qualitative changes in important event recounts produced by a group of people with severe TBI up to 2 years postinjury. Method: A prospective observational design with an inception cohort was adopted. Thirty-four participants with severe TBI were asked to produce an important event recount at 6, 12, and 24 months postinjury. A mixed-methods approach comprised a quantitative analysis of microlinguistic and macrostructural measures, using the automated discourse command EVAL in Computerized Language Analysis (CLAN) and the CLAN Collaborative Commentary tool, respectively. Statistical analysis included a repeated-measures analysis of variance and the Friedman test. An independent qualitative content analysis was also conducted. Results: The measures revealed significant differences between 6 and 24 months, indicating a protracted recovery trajectory. The microlinguistic analysis showed increased use of revision and repetition over time. The macrostructural analysis indicated changes with orientation to recount characters, evaluative comments, and the number of events or complexity of the recount. The content analysis revealed categories of (a) childhood events, (b) family and relationships, (c) career and education, and (d) grief and loss. Topics at 6 months focused on childhood events and holidays, whereas career and education predominated at 24 months. Conclusions: This is the first study to explore important event recounts told by people with severe TBI as they recovered. Participants showed discourse recovery beyond 12 months, highlighting the need for equivalent timing of service provision. The important event recount shows good potential as an ecologically valid assessment tool to evaluate communication recovery that can also be integrated with advances in computerized analysis. Analyses additionally provided insights into potential therapy targets and content categories for chronic discourse impairments. [ABSTRACT FROM AUTHOR]

Autonomous exercise within nonspecific low back pain rehabilitation is a necessary tool to treat low back pain. The purpose of this study was to quantify adherence and compliance during two different 6-week home-exercise programs. Forty adults were randomly allocated to a gamified and packet group. Adherence, compliance, and system usability assessments occurred after 3 and 6 weeks. Packet group adherence was similar at 3 weeks and at 6 weeks. System usability was significantly greater at 6 weeks than at 3 weeks in the packet group. Adherence or compliance was not influenced. The usability of the intervention methodology was considered great by both groups. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate conversation hearing with an adaptive beamforming hearing aid that supports adaptive tracking of multiple talkers in an ecologically valid, real-world food court environment in a busy mall. Method: Twenty older adult experienced hearing aid wearers with sensorineural hearing loss were fitted in the lab with binaural receiver-in-the-canal style hearing aids set with two programs, each having a different beamforming strategy. The participant and two researchers then met in a moderately noisy and reverberant food court at a local mall where the participant was asked to listen to a conversation between the two researchers. Participants rated the extent of their agreement with 10 positively worded statements specific to the conversation twice, once for each program. Participants then provided program-preference ratings for seven different aspects of a conversation during which the programs were switched back and forth by the researcher, so that participants were unaware of the condition to which they were listening. Results: Real-world subjective ratings for all domains resulted in positive values on average for both programs. Pairwise comparisons indicated that the intervention algorithm had higher absolute ratings on five of the 10 criteria including understanding, clarity, focus, listening effort, and background noise. Ratings for preference between programs indicated a significant preference for the intervention algorithm for all seven criteria. Conclusions: In a real-world setting, the use of hearing aids with separate processing of sounds from the front and back hemisphere provided positive subjective ratings. However, following a group conversation with multiple conversation partners, improvements in the algorithm to account for the locations of interlocutors and the natural head turning of the hearing aid wearer that occurs during a conversation by adding and controlling multiple adaptive beams in the front hemisphere significantly influenced preference for all aspects rated. [ABSTRACT FROM AUTHOR]

The study objective is to test general- and sport-specific adaption during a single training on the Flexibility Trainer. The device is designed to trigger residual muscle tone decreases of the hip-joint muscles by providing (nearly) isokinetic resistance during a full range of motion strength training in adduction/abduction and flexion/extension direction. Static hip flexion and abduction as well as kinematics of double side kicks were analysed on 15 participants before and after training (or rest for controls) to assess general flexibility and sport-specific movement range. Tests were recorded by a Vicon® motion capturing system. Static hip flexion and abduction as well as leg vector spreading angles (VSA) at different nodes of the kick were selected to determine adaptions of active and passive flexibility. Normalised hip joint moments, movement velocities and VSA were calculated to evaluate the training with the device. ANOVAs with 4-repeated measures and Friedman tests were performed to identify time differences and Bonferroni post-hoc test to identify between-subject effects. Significant differences were found for both static flexibility tests (Flexion = 13.65%; Abduction = 9.94%) and the VSA at specific action phases (≤15.15%). Results indicate that short-term adaptions when training with the Flexibility Trainer are exceeding comparable literature showing improved flexibility and sport-specific performance. [ABSTRACT FROM AUTHOR]

The aim was to test the use of eye-tracking methodology for the early detection of ASD in a task of association between unfamiliar objects and pseudowords. Significant differences were found between ASD (n = 57) and TD (n = 57) Spanish speaking toddlers in the number and time of fixation. The TD children showed more and longer fixations on eyes and mouth while the ASD children attended almost exclusively to objects, making it difficult to integrate lexical and phonological information. Moreover, the TD toddlers looked at the mouth when the pseudoword was produced while the ASD toddlers did not. Gaze fixation on eyes and mouth during word learning recorded by eye-tracking may be used as a biomarker for the early diagnosis of ASD. [ABSTRACT FROM AUTHOR]

In the field of human-computer interaction, deformable user interfaces are gaining more attention. Gestures performed by bending the deformable device are commonly investigated in the literature. These bend gestures' inherent tactile and kinaesthetic feedback and their association with spatial directions benefit both blind and low vision (BLV) and sighted users. Bend gestures are naturally associated with two descriptors of bend, which are location and direction. One potential opportunity to extend this gesture space is to investigate additional descriptors of bend gestures without introducing new locations. In this context, size and angle are the two common additional descriptors of bend gestures. In this work, we conducted two (preliminary and main) studies to investigate BLV and sighted users' performance and preference for multiple magnitude levels of size and angle of bend on a smartphone-sized deformable prototype. Finally, we discuss the results and propose user group-specific design recommendations. [ABSTRACT FROM AUTHOR]

This trial was carried out to investigate the effect of forced air warming in various body areas of women on hypothermia during cesarean delivery. The patients in the study groups (n = 76) were assigned to the full-body warming group, upper-extremity warming group, lower-extremity warming group, and control groups. The intervention groups received forced-air warming 30 min before the surgery and continued until 30 min after surgery. The incidence of hypothermia was significantly higher in the control group than in the other groups at the 60th minute of the operation (p < 0.01). The intervention and control groups showed significant differences in the frequency of shivering at the entrance to the PACU (p = 0.001). Thermal comfort scores have significant difference between the control group and all of the intervention groups (p<.001). It is said that the full-body forced-air warming technique prevents hypothermia, shivering, and thermal discomfort in women Cesarean Section (CS). [ABSTRACT FROM AUTHOR]

Evaluate changes in two-wheel cycling skills and biking participation goals for children with neurodevelopmental disorders (ND) receiving a home visit and email following iCan Bike camp. Participants: 11 children with ND, 9–16 years, and one of their parents. A cycling skills checklist, two-wheel riding Goal Attainment Scaling (GAS), and biking participation GAS were completed before camp (T1), at support visit after camp (T2), and three months following camp (T3). Parents completed biking practice logs. Participants received a support visit to provide instruction, coaching, and address questions, and an email to check progress. Significant changes were made in two-wheel riding GAS T1 to T2 (p = 0.01), biking participation GAS T2 to T3 (p = 0.02), and cycling skills T1 to T2 (p = 0.01) and T2 to T3 (p = 0.02). Practice frequency was related to cycling skills (0.72, p = 0.01) and biking participation (0.86, p < 0.001); cycling skills were related to biking participation (0.81, p = 0.003). Children improved cycling skills and biking participation following camp, support visit, and email check-in. Children who practiced more had greater cycling skills and biking participation. Encouraging weekly bicycling and providing support may promote cycling skills and participation following camp. [ABSTRACT FROM AUTHOR]

Menstruation-related symptoms in young women are associated with lifestyle factors such as stress. This study aimed to examine menstrual conditions, menstruation-related symptoms, and types of stress in Japanese female students from their first to second years of university and the association between menstruation-related symptoms and stress levels. This prospective longitudinal cohort study utilized a self-reported web survey with the Menstrual Distress Questionnaire (MDQ) at three timepoints (2, 8, and 14 months) following admission and continuing into the second year. Data from 33 out of 102 students, who were followed throughout the study period, were used for analysis. Results indicated a trend towards changes in menstrual regularity, with the lowest (48.5%) at timepoint 1 and the highest (72.7%) at timepoint 3, and significant changes in perceived bleeding amount. Stress related to study and academic performance was consistently highest, with significant differences across timepoints. Intra-menstrual MDQ scores were highest at timepoint 1, with significant variations in impaired concentration severity across timepoints. Significant correlations were found between the MDQ scores and stress related to health and personality at all timepoints, and to future prospects, friendships, study, and academic performance at different timepoints. In short, stress related to academic performance, along with a strong correlation between MDQ scores and specific stress types, such as health and personality, was observed across all timepoints. This implies the need to provide new students with health education regarding menstruation and stress management before specific timepoints. [ABSTRACT FROM AUTHOR]

Background: Although there are a growing number of studies investigating the benefits of music therapy interventions with patients diagnosed with cancer, few studies have taken an approach that specifically examines indices of perceived well-being in women with breast cancer. Overcoming these challenges can be an important step in the recovery process. Purpose: The purpose of our study was to know the positive influence of responsive music therapy through gong sounds, emitted live, on different areas of well-being of women with breast cancer. Methods: Four individual sessions of responsive music therapy with live gong sounds were conducted in which three women (M = 54; SD = 5.57) participated both in the music therapy program and in the completion of the Functional Assessment of Cancer Therapy – Breast (FACT-B) and a semi-structured interview with ad hoc designed questions about perception of qualitative aspects. Results: The results showed that the music therapy sessions significantly improved, p =.043 < 0.05, various domains of perceived well-being in women with breast cancer. Discussion: This article highlights several key benefits associated with music therapy and various indices of well-being in women with breast cancer, identifies the limitations of the study, and discusses the findings. It is considered necessary to replicate this practice in future studies that include a larger sample and age range over longer follow-up periods. Translation for Health Education Practice: The text highlights the importance of considering music therapy as a complementary intervention in comprehensive cancer care programs, which may be relevant to health educators when considering intervention and support approaches for cancer patients. Health education interventions targeting the enhancement of cancer patients' well-being should incorporate music therapy techniques. [ABSTRACT FROM AUTHOR]

Background/Objectives: Rett syndrome is a rare neurodevelopmental disorder that can severely affect motor functioning, particularly walking. Previous training programs proposed treadmills as tools to increase walking endurance of patients with Rett syndrome, but these trainings did not include virtual reality (VR). The aim of this study was to assess the feasibility of a short treadmill training coupled to VR in girls with Rett syndrome. Methods: Nine patients with Rett syndrome underwent a 3-day treadmill walking program performed in semi-immersive VR. During the training, the happiness index and performance metrics were collected. At the end of the training parents filled out the Suitability Evaluation Questionnaire (SEQ) and, when feasible, patients underwent a gait assessment. Results: All the subjects recruited performed the three GRAIL sessions and parents showed a good satisfaction and considered the integration of treadmill and VR a good possibility for future rehabilitative programs. Participants showed greater satisfaction in environments requiring walking and their attention increased during training sessions, hypothesizing the feasibility of longer trainings with treadmill and VR. Data collected from gait analysis provided insights, although preliminary, concerning differences in gait pattern amongst the recruited subjects. Conclusions: Despite the small sample size and limited training duration, the paper suggests that a walking training with a treadmill combined with VR can represent a new strategy for Rett rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Inconsistent sleep schedules, frequent awakening after sleep onset (WASO), and decreased sleep efficiency (SE) are common issues among adolescent team sports athletes. Moreover, research indicates that sleep problems are enhanced across schooldays. The aim of the present study was to assess sleep patterns of adolescent athletes and compare sleep parameters between schooldays and holidays. Methods: The chronotype and sleep quality of twelve adolescent basketball players (mean age: 15.58 ± 0.67 years) were assessed. Objective sleep parameters were then analyzed using actigraphy over a 12-day period, which included six days during the school period and six days during holidays. Results: Data showed that total sleep time (TST), SE, and WASO (382.48 min, 81.81%, and 66.70 min, respectively) did not meet international recommendations for sleep quantity and quality. During school weekdays, time in bed (TIB), TST, and SE significantly decreased compared to weekends (p < 0.001, d = −1.49; p < 0.001, d = −1.64; and p = 0.01, d = −0.89, respectively). On weekdays, TIB, TST, and WASO were significantly lower on schooldays compared to holidays (p < 0.001, d = −1.83; p < 0.01, d = −1.01; and p = 0.02, d = −0.77, respectively). While no significant difference was observed in social jetlag, the mid-point of sleep was significantly later on holiday weekdays compared to school weekdays (p < 0.05, d = 0.65). Conclusions: Adolescent athletes experience insufficient sleep, especially on school weekdays, which is partially improved during weekends and holidays. Although sleep duration was longer during holidays, our results suggest that adolescent athletes' sleep was more fragmented. Consequently, it remains crucial to implement strategies to enhance their sleep health (e.g., napping). [ABSTRACT FROM AUTHOR]

Background: Medical personnel carrying out electrical cardioversion (EC) procedures must remember to have the R-wave sync mode switched on, use the correct energy and maintain personal safety. The defibrillators used by medical response teams most often switch out of cardioversion mode once a shock is delivered. Therefore, this mode must be switched on again before subsequent shocks are delivered. The main aim of the study was to assess the ability of emergency medical teams participating in emergency medicine championships to perform EC. Methods: The research was a retrospective observational study and was based on an analysis of the evaluation sheets from two tasks simulating the management of a patient with unstable tachycardia conducted during the International Winter Emergency Medicine Championships. Three-person teams consisting of paramedics and representing the Polish emergency services were included in the study. The team representing the championship organiser and the few foreign teams participating in the competition were excluded from the study. Results: The decision to conduct EC was taken by 36 teams (83.72%) in 2015 and 27 teams (87.10%) in 2019. In both editions of the championships, during consecutive shocks, the percentage of actions performed correctly decreased significantly—switching on synchronisation mode in 2015 (94.4%, 83.33%, 72.22%) and in 2019 (100%, 88.89%, 81.48%); correct energies in 2015 (91.67%, 80.56%, 77.78%) and in 2019 (92.59%, 85.19%, 81.48%); shocks in a safe manner in 2015 (94.44%, 94.44%, 91.67%) and in 2019 (100%, 96.30%, 96.30%). Conclusions: Teams participating in the assessed tasks in a significant majority of cases correctly qualified the patient for EC, and correctly carried out the actions required for this procedure. It is of particular note that with every subsequent shock, the percentage of shocks carried out without the sync mode increased significantly. [ABSTRACT FROM AUTHOR]

Chronic back pain in adults is often a cause of absenteeism from work, limitations in social interactions, and difficulties in performing daily activities. This study aimed to check whether the functioning of everyday activities in elderly patients after neurosurgery improved over time compared to their condition before the procedure and whether there is a connection between fitness, self-esteem, and pain intensity. This was a cross-sectional study carried out using an anonymous survey. This study included patients over 60 years of age from the neurosurgical ward. The following scales were used to assess cognitive functioning, depression, functional status: basic and instrumental activities of daily living (IADL), back pain disability (QBPDS), pain intensity, and self-esteem. The level of independence in terms of IADL and QBPDS increased, and the intensity of pain decreased. Surgery reduced pain intensity from 8 ± 0.8 to 6.1 ± 1.4 points. The level of self-esteem (RSES) remained at a low level. The passage of time after neurosurgical treatment has a beneficial effect on reducing pain intensity and increasing independence in life activities. Daily physical activity and rehabilitation are important factors supporting the return to independence. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the effects of two different mandibular advancement devices on the upper airway volume, polysomnographic parameters, and sleepiness scale scores in patients with obstructive sleep apnea and Temporomandibular disorders (TMD). Materials and methods: Monoblock and twinblock mandibular advancement devices were applied to patients with obstructive sleep apnea syndrome for 3 months separated by a wash-out period of 2 weeks. Research Diagnostic Criteria for TMD (RDC/TMD), Polysomnographic parameters and cone-beam computed tomography findings were recorded before and after the use of the mandibular advancement devices. A three-dimensional analysis of the airway was then performed. Results: The use of the monoblock device significantly increased the upper airway volume compared with the use of the twinblock device (p = 0.032). The polysomnographic parameters similarly improved with the use of the twin-block and monoblock devices. The significant reduction in TMD symptoms was observed. Conclusion: The use of the monoblock device increased the retropalatal airway volume. This volume increase may be attributed to the fact that the design of the monoblock device allows less mandibular movement than does that of the twinblock device. Indicates the potential benefits of MADS treatment in alleviating TMD-related issues. Clinical significance: Monoblock MADs have improved effects on respiratory parameters and upper airway dimensions in patients with OSA and mild to moderate TMD. [ABSTRACT FROM AUTHOR]

Background: A long-term assessment of stroke outcomes from the perspectives of patients and their caregivers is important for optimising long-term post-stroke care. The extended effects of stroke caregiving, particularly caregiver burden beyond 5 years since stroke, remain to be determined. Hence, this study aimed to determine caregiver burden at 10 years after stroke, compare the burden severity at 10 years with its levels at 5 years and 6 months after stroke, and identify predictors of the burden severity at 10 years post-stroke. Methods: A longitudinal follow-up study including a group of first-ever stroke patients/informal continuous caregivers pairs was followed for 10 years and interviewed face-to face at their home setting. Caregiver burden was evaluated with the Caregiver Burden Scale. Potential predictors were examined using standardised measures and identified by applying the Classification and Regression Tree. Results: A total of 40 caregiver/patient pairs participated in the study. At 10 years, 47.5% of the caregivers experienced a considerable burden. This was more than after 5 years (17.5%) and comparable to that after 6 months (37.5%), p < 0.003. Longer time spent caregiving, caregivers' weaker sense of coherence, more severe stroke, and caregivers' anxiety were the independent predictors of considerable burden 10 years after stroke. Conclusions: Caregivers' burden in the late chronic post-stroke phase is a significant problem, as nearly half of the caregivers experience a substantial burden. This problem mainly concerns individuals who spend at least 7 h daily caregiving and have a lower Sense of Coherence. The long-term evaluation of stroke consequences reported by stroke patients and their caregivers can be an important source of information for healthcare professionals in order to optimise the care and support they provide at various stages of life after stroke. [ABSTRACT FROM AUTHOR]

Background: Parkinson's disease (PD) is the most common movement disorder and the second most common neurodegenerative disease. The aim of our study was to compare gray–white matter changes (GWC) between Parkinson's disease (PD) patients and age-matched healthy control group as well as comparing GWC between different stages of PD (early and complicated). Our study was prospective cross-sectional case–control observational study with analytic component conducted on twenty patients and ten controls without any signs or symptoms of PD or any history of PD in first-degree relatives. All patients and controls were tested for history taking with stress on resting tremors, rigidity, gait abnormalities, postural instability and any symptoms of cognitive impairment, clinical examination including general examination and neurological examination. Also diffusion tensor imaging (DTI) with fiber tracking (tractography) and susceptibility-weighted MR imaging were performed for all cases. Results: As regards DTI and evaluation of fractional anisotropy (FA) and mean diffusivity (MD) values between PD cases and healthy controls, the cases group showed significant decrease in FA values at substantia nigra on both sides and left cingulum as well as significant increase in MD values at substantia nigra on both sides and corpus callosum. Also, there are significant decrease in FA values at substantia nigra on both sides and significant increase in MD values at substantia nigra on both sides and right cingulum in late parkinsonism when compared to early parkinsonism. A cutoff FA value of 0.945 at right substantia nigra and cutoff FA value of 0.585 at left substantia nigra showed significant AUC that could differentiate between cases and controls. Also cutoff MD value of 0.791 at right substantia nigra and cutoff MD value of 0.813 at left substantia nigra showed significant AUC that could differentiate between cases and controls. Conclusions: Diffusion tensor imaging showed valuable role in evaluation of gray–white matter changes in Parkinson's disease. Also, it helps to assess degree of gray–white matter changes when comparing late parkinsonism to early parkinsonism through evaluation of FA and MD values at corpus callosum, substania nigra, and cingulum. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a complex CNS demyelinating disease. Assessment of MS plaques in specific anatomic locations in the brain was challenging to detect by conventional MRI sequences. So, this study aimed to compare the diagnostic accuracy of 3D FLAIR (Fluid attenuation inversion recovery), or 3D DIR (Double inversion recovery) sequences to conventional 2D FLAIR and T2 sequences in detecting MS plaques in different anatomic sites, as well as counting the total lesion burden. Methods: A comparative cross-sectional study enrolled 30 MS patients on the basis of McDonald's criteria 2017. All participants underwent a brain MRI study including 3D FLAIR or 3D DIR sequences, conventional 2D FLAIR, and T2 sequences. Results: No statistically significant difference between the 3D DIR and 3D FLAIR in total lesion (plaque) burden results; however, when each is compared to the conventional ones, both are superior. 3D FLAIR detected the most significant number of plaques in the periventricular region, followed by 2D FLAIR and T2W sequences, with 3D DIR being the least accurate in this region. Meanwhile, 3D DIR was the most precise and can detect a statistically significant number of cortical plaques compared to the 3D FLAIR and the conventional sequences. No statistically significant results on which sequence is best in regard to infratentorial plaque detection. Conclusion: 3D FLAIR and 3D DIR were superior to 2D FLAIR and T2 sequences in detecting overall lesion burden in MS. Moreover, the 3D DIR sequence was the most precise in the detection of the cortical plaques. [ABSTRACT FROM AUTHOR]

Optimal seatbelt practices for pregnant women with twins at different gestational ages remain uncertain. To offer recommendations for a comfortable seatbelt system, this cross-sectional observational study explored seatbelt usage and driving habits among women with twins across various pregnancy stages through an online survey that explored driving conditions and comfortable seatbelts at different stages of pregnancy. Women who drove daily before their pregnancy with twins decreased their driving frequency as the pregnancy progressed. Correct seatbelt usage was lower and no seatbelt usage was higher among pregnant women with twins than those with singleton pregnancies. They adapted their seatbelt-wearing techniques to minimise pressure on the chest in the first and third trimesters and the abdomen from the second trimester onwards. The comfortable seatbelts were those that could alleviate belt pressure, featuring waist belts to reduce pressure, wider belts to avoid localised pressure, and shoulder belts resembling a backpack type. When wearing a seatbelt, avoiding pressure on the thorax and abdomen is key for pregnant women with twins. This study suggests that the suitability of driving for pregnant women with twins in their last trimester and the reliability of seatbelts designed for such women should be further examined and validated. [ABSTRACT FROM AUTHOR]

Background: Emergency medical services (EMS) are intended to provide people with immediate, effective, and safe access to the healthcare system. The effects of pandemics on emergency medical services (EMS) have not been studied sufficiently. The aim of this paper is to assess the frequency and structure of calls at an ambulance station in Kazakhstan during the period of 2019–2023. Methods: A retrospective analysis was conducted to estimate the incidence of emergency assistance cases from 2019 to 2023. Results: An analysis of the structure and number of ambulance calls before the pandemic, during the pandemic, and post-pandemic period did not reveal significant changes, except for calls in urgency category IV. Patients of urgency category IV handled by an ambulance decreased by 2 and 1.7 times in 2020 and 2021, respectively, which appears to be related to quarantine measures. In 2022 and 2023, category IV calls were 4.7 and 4.5 times higher than in 2019. Conclusions: This study's findings suggest no changes in the dynamics of ambulance calls, except urgency category IV calls. The number of category IV urgent calls decreased significantly during the COVID-19 pandemic and increased in the post-pandemic period. [ABSTRACT FROM AUTHOR]

Our mental representation of our body depends on integrating various sensory modalities, such as tactile information. In tactile distance estimation (TDE) tasks, participants must estimate the distance between two tactile tips applied to their skin. This measure of tactile perception has been linked to body representation assessments. Studies in individuals with fibromyalgia (FM), a chronic widespread pain syndrome, suggest the presence of body representation distortions and tactile alterations, but TDE has never been examined in this population. Twenty participants with FM and 24 pain-free controls performed a TDE task on three Body regions (upper limb, trunk, lower limb), in which they manually estimated the interstimuli distance on a tablet. TDE error, the absolute difference between the estimation and the interstimuli distance, was not different between the Groups, on any Body region. Drawings of their body as they felt it revealed clear and frequent distortions of body representation in the group with FM, compared to negligible perturbations in controls. This contrast between distorted body drawings and unaltered TDE suggests a preserved integration of tactile information but an altered integration of this information with other sensory modalities to generate a precise and accurate body representation. Future research should investigate the relative contribution of each sensory information and prior knowledge about the body in body representation in individuals with FM to shed light on the observed distortions. [ABSTRACT FROM AUTHOR]

Children with cochlear implants (CI) communicate in noisy environments, such as in classrooms, where multiple talkers and reverberation are present. Speakers compensate for noise via the 'Lombard effect'. The present study examined the Lombard effect on the intensity and duration of stressed vowels in the speech of children with Cochlear Implants (CIs) as compared to children with Normal Hearing (NH), focusing on the effects of speech-shaped noise (SSN) and speech-shaped noise with reverberation (SSN+Reverberation). The sample consisted of 7 children with CIs and 7 children with NH, aged 7–12 years. Regarding intensity, a) children with CIs produced stressed vowels with an overall greater intensity across acoustic conditions as compared to NH peers, b) both groups increased their stressed vowel intensity for all vowels from Quiet to both noise conditions, and c) children with NH further increased their intensity when reverberation was added to SSN, esp. for the vowel /u/. Regarding duration, longer stressed vowels were produced by children with CIs as compared to NH in Quiet and SSN conditions but the effect was retained only for the vowels /i/, /o/ and /u/ when reverberation was added to noise. The SSN+Reverberation condition induced systematic lengthening in stressed vowels for children with NH. Furthermore, although greater intensity and duration ratios of stressed/unstressed syllables were observed for children with NH as compared to CIs in Quiet condition, they diminished with noise. The differences observed across groups have implications for speaking in classroom noise. [ABSTRACT FROM AUTHOR]

Background: The rising prevalence of work-related musculoskeletal disorders has numerous physical, financial, and mental repercussions for surgeons. This study aims to establish whether the use of a wearable posture device can improve the operating time spent in suboptimal, high-risk postures. Methods: Surgeons were recruited in Phase 1 of this prospective randomised study and baseline postural data was obtained. In Phase 2, participants were randomised to receive either a traditional educational workshop or intraoperative vibrations from the device to correct postural lapses. During minor elective day cases, intraoperative postural data was collected and stratified by forward flexion angle, into five risk categories (negligible to very high). Participants' experience with the sensor was also assessed. Results: A total of 100 surgical procedures (Phase 1: n = 50; Phase 2: n = 50) were performed by eight surgeons of varying seniority. Exposure to the educational intervention increased time spent in suboptimal posture (Phase 1 vs. Phase 2); 47.5% vs. 67.8%, p = 0.05. However, the vibrational intervention significantly reduced this time; 50.0% vs. 20.7%, p = 0.005. Procedure type didn't influence posture although, laparoscopic interventions spent most time in negligible-risk postures; 47.7% vs. 49.3%, compared to open procedures. Surgical consultants spent less time in suboptimal posture compared to fellow/registrars; 30.3% vs. 72.6% (Phase 1) and 33.8% vs. 65.3% (Phase 2). Conclusion: Vibrational intervention from the device significantly decreased the time spent in suboptimal, high-risk postures. As procedure type wasn't correlated with postural changes, surgeon-specific factors in regulating posture are paramount. Finally, surgeon experience was positively correlated with improved surgical ergonomics. [ABSTRACT FROM AUTHOR]

Background: The bed bath is an important part of nursing care. There are few studies evaluating the effects of traditional and dry bed baths on patients. Aim: This study was performed with the aim of investigating the effect of traditional and dry bed baths given to intensive care unit patients on the patients' hemodynamic parameters, the duration of the bathing procedure and the cost of consumable items. Methods: This was a randomized crossover clinical trial and a prospective study. The study was conducted in a General Surgery Intensive Care Unit with 22 intensive care patients aged 18 and over, who had a nursing diagnosis of bathing personal care deficiency. Each patient was given two types of bed baths at an interval of 24 h: a traditional bed bath and a dry bed bath performed with single‐use tissues. Immediately before each bath, in the 5th, 10th and 15th minute of bathing, immediately after bathing and 30 min after bathing, body temperature, heart rate, blood pressure, breathing rate and peripheral oxygen saturation measurement changes over time were compared within the group using the Friedman test. The Wilcoxon signed ranks test was used to compare the variables of bathing duration and bathing consumable item costs between the bathing procedures. Results: It was found that at the completion of traditional and dry bed bathing, the participants' body temperature, blood pressure, heart rate and breathing rate parameters were statistically significantly lower than before bathing, whereas peripheral oxygen saturation values showed a significant increase (p < 0.05). It was found that the dry bed bath took a statistically significantly shorter time than the traditional bed bath and that the cost of consumable bathing materials was less (p < 0.05). Conclusions: It was concluded that traditional and dry bed baths given to intensive care patients affected their hemodynamic parameters and that the dry bed bath was superior to the traditional bed bath in that it took less time and that it cost less. Summary statement: What is already known about this topic? Traditional and dry bed baths are personal care procedures that are frequently carried out by nurses with patients in intensive care units.Bed baths may affect the hemodynamic parameters of patients in intensive care units, but few studies have evaluated their effects.Determination of the hemodynamic parameters of patients during bed baths, the duration of bathing and the cost of consumable bathing materials may help nurses to achieve patients' body hygiene in a more reliable way and to decide on and adopt measures to minimize risks. What this paper adds? This paper contributes to the performance of personal hygiene. It is necessary to closely monitor the hemodynamic parameters of intensive care patients when they are being given bed baths.This study has direct effects in awakening nurses to the potential risk of bed baths causing a change in hemodynamic parameters in intensive care patients and in taking measures to reduce these risks to a minimum. Also, giving dry bed baths, which are superior in taking less time and having lower costs, provides advantages to nurses in terms of work load, physical difficulties and finance. The implications of this paper: This study emphasizes the positive impacts of dry bed baths carried out by nurses for patients in intensive care units.The dry bed bath can be accepted as enhancing patient safety by being easy to perform and by shortening the time when the patient is exposed to environmental risks. [ABSTRACT FROM AUTHOR]

We compared different LLMs, notably chatGPT, GPT4, and Google Bard and we tested whether their performance differs in subspeciality domains, in executing examinations from four different courses of the European Society of Neuroradiology (ESNR) notably anatomy/embryology, neuro-oncology, head and neck and pediatrics. Written exams of ESNR were used as input data, related to anatomy/embryology (30 questions), neuro-oncology (50 questions), head and neck (50 questions), and pediatrics (50 questions). All exams together, and each exam separately were introduced to the three LLMs: chatGPT 3.5, GPT4, and Google Bard. Statistical analyses included a group-wise Friedman test followed by a pair-wise Wilcoxon test with multiple comparison corrections. Overall, there was a significant difference between the 3 LLMs (p < 0.0001), with GPT4 having the highest accuracy (70%), followed by chatGPT 3.5 (54%) and Google Bard (36%). The pair-wise comparison showed significant differences between chatGPT vs GPT 4 (p < 0.0001), chatGPT vs Bard (p < 0. 0023), and GPT4 vs Bard (p < 0.0001). Analyses per subspecialty showed the highest difference between the best LLM (GPT4, 70%) versus the worst LLM (Google Bard, 24%) in the head and neck exam, while the difference was least pronounced in neuro-oncology (GPT4, 62% vs Google Bard, 48%). We observed significant differences in the performance of the three different LLMs in the running of official exams organized by ESNR. Overall GPT 4 performed best, and Google Bard performed worst. This difference varied depending on subspeciality and was most pronounced in head and neck subspeciality. [ABSTRACT FROM AUTHOR]

Aim: Hallux valgus is a common foot deformity that causes significant pain and functional impairment. This study aimed to compare the effectiveness of prolotherapy and dry needling in treating mild to moderate hallux valgus pain. Material and Methods: Patients with hallux valgus deformity experiencing refractory pain after orthotic and analgesic treatment, and treated with prolotherapy (52 patients, 68 feet) or dry needling (49 patients, 57 feet) methods were included in the study. Each group received three treatment sessions at 3-week intervals. Clinical assessments were performed using the visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) scores at baseline, in the third month, and twelfth month. Results: Both groups showed significant improvement in VAS and AOFAS scores after treatment (p<0.001). In the prolotherapy group, the VAS score decreased from 6 (range, 4-8) in the pre-treatment period to 2 (range, 1-5) both in the third and twelfth months (p<0.001). In the dry needling group, the VAS score decreased from 6 (range, 4-7) in the pre-treatment period to 4 (range, 2-7) both in the third and twelfth months (p<0.001). While the AOFAS scores improved to 75 (range, 63-85) in the third month and 76 (range, 60-80) in the twelfth month in the prolotherapy group (p<0.001), improved to 56 (range, 44-75) in the third month and 50 (range, 36-75) in the twelfth month in the dry needling group (p<0.001). Conclusion: Both prolotherapy and dry needling effectively treat hallux valgus pain and improve foot function, with prolotherapy showing superior effectiveness. [ABSTRACT FROM AUTHOR]

Importance: Stroke is a leading cause of disability worldwide and is often accompanied by complications such as spasticity. Static stretching (SS) is a common physiotherapy intervention for reducing spasticity, whereas dry needling (DN) is a novel approach. However, the combined effects of DN and SS on spasticity have not been thoroughly investigated. Given the pivotal effect of spasticity on daily activities, mitigating spasticity can significantly contribute to restoring patient independence. Objective: This study will explore the impact of DN plus SS on spasticity, alpha motor neuron excitability, overall function, and quality of life in patients with chronic stroke. Design, Setting, and Population: A double-blind, randomized, sham-controlled trial will be conducted in patients with post-stroke spasticity in the plantar flexor muscles. Twentyeight participants will be randomly assigned to either an intervention or control group. The intervention group will receive DN (60s × 3 days/week; 1 week) plus SS (20 min × 5 days/week; 1 week). The control group will undergo sham DN (60s × 3 days/week; 1 week) and SS (20 min × 5 days/week; 1 week). Exposures: DN plus SS or sham DN plus SS. Main Outcomes and Measures: Both groups will be assessed at baseline, immediately post-treatment, and after 1 week of follow-up. Outcome measures will include the Modified Modified Ashworth Scale, H-reflex latency, Hmax/Mmax ratio, active and passive ankle dorsiflexion range of motion, timed up and go test, and the EuroQol questionnaire. Results: Results from this randomized, sham-controlled study will provide evidence for the effectiveness of DN in combination with SS for spasticity. Conclusions and Relevance: The additional impact of DN in conjunction with SS, a widely used method for reducing muscle tone, remains unclear and warrants investigation. This study, with a high level of evidence, aims to address this knowledge gap. [ABSTRACT FROM AUTHOR]