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Parent-Roberge H, Fontvieille A, Poirier L, Tai LH, Pavic M, Fülöp T, Riesco E. Acute natural killer cells response to a continuous moderate intensity and a work-matched high intensity interval exercise session in metastatic cancer patients treated with chemotherapy. Brain Behav Immun Health 2024; 40:100825. [PMID: 39155952 PMCID: PMC11327397 DOI: 10.1016/j.bbih.2024.100825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 07/02/2024] [Accepted: 07/15/2024] [Indexed: 08/20/2024] Open
Abstract
Background It has been suggested that the acute natural killer (NK) cell response to aerobic exercise might contribute to the tumor suppressor effect of regular exercise observed in preclinical studies. Moreover, because this response is modulated by exercise intensity, high-intensity intervals exercise (HIIE) might represent an interesting therapeutic approach in cancer patients. However, this immune response remains unstudied in cancer patients currently undergoing chemotherapy. Objective To characterize the acute NK cell response following a moderate-intensity continuous aerobic exercise session (MOD), and a HIIE session in metastatic cancer patients treated with chemotherapy. Methods Twelve cancer patients (45-65 years old) underwent a MOD and a duration and work-matched HIIE trial, in a block-randomized order. Peripheral blood mononuclear cells (PBMC) were isolated before, after and 1h after each trial. NK cell subsets were enumerated using flow cytometry and complete blood counts. The surface expression of the cytotoxic NK cell (cNK; CD56dimCD16+) subset was evaluated for its expression of the differentiation markers CD57 and CD158a, the activating receptor NKG2D, the immune checkpoints TIM-3 and PD-1, and the chemokine receptors CXCR3, CXCR4 and CCR2. Results cNK cell blood counts increased immediately following MOD (p < 0.001) and decreased back to pre-exercise values 1 h after exercise cessation (p < 0.001). The most responsive cNK cell subsets were expressing CD57, CD158a, NKG2D, TIM-3 and CXCR3. The HIIE trial elicited a similar biphasic response, without any difference between trials (all p ≥ 0.38). However, significant changes in the MFI values of CXCR4 and NKG2D were observed in the cNK cell subset following HIIE (all p ≤ 0.038), but not MOD. Conclusion In metastatic cancer patients undergoing chemotherapy, both MOD and HIIE can elicit an acute mobilisation and egress of NK cells exhibiting phenotypic characteristics associated with high cytotoxicity and tumor homing. Future longitudinal trials are needed to determine if combining aerobic exercise training and chemotherapy will translate towards favorable immune and clinical outcomes.
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Affiliation(s)
- Hugo Parent-Roberge
- University of Sherbrooke, Faculty of Physical Activity Sciences, 2500, boul. de l’Université, Sherbrooke, Qc, J1K 2R1, Canada
- Research Centre on Aging, affiliated with CIUSSS de l’Estrie - CHUS, 1036, rue Belvédère sud, Sherbrooke, Qc, J1H 4C4, Canada
| | - Adeline Fontvieille
- University of Sherbrooke, Faculty of Physical Activity Sciences, 2500, boul. de l’Université, Sherbrooke, Qc, J1K 2R1, Canada
- Research Centre on Aging, affiliated with CIUSSS de l’Estrie - CHUS, 1036, rue Belvédère sud, Sherbrooke, Qc, J1H 4C4, Canada
| | - Laurence Poirier
- University of Sherbrooke, Faculty of Physical Activity Sciences, 2500, boul. de l’Université, Sherbrooke, Qc, J1K 2R1, Canada
- Research Centre on Aging, affiliated with CIUSSS de l’Estrie - CHUS, 1036, rue Belvédère sud, Sherbrooke, Qc, J1H 4C4, Canada
| | - Lee-Hwa Tai
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, J1H 5N4, Canada
- University of Sherbrooke, Department of Immunology and Cell Biology, 3201 rue Jean-Mignault, J1E 4K8, Canada
| | - Michel Pavic
- University of Sherbrooke, Faculty of Medicine and Health Sciences, 3001, 12e avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, J1H 5N4, Canada
- Institut de recherche sur le cancer de l’Université de Sherbrooke, Sherbrooke, Qc, Canada, J1H5N4
| | - Tamàs Fülöp
- Research Centre on Aging, affiliated with CIUSSS de l’Estrie - CHUS, 1036, rue Belvédère sud, Sherbrooke, Qc, J1H 4C4, Canada
- University of Sherbrooke, Faculty of Medicine and Health Sciences, 3001, 12e avenue Nord, Sherbrooke, QC, J1H 5N4, Canada
- Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Qc, J1H 5N4, Canada
| | - Eléonor Riesco
- University of Sherbrooke, Faculty of Physical Activity Sciences, 2500, boul. de l’Université, Sherbrooke, Qc, J1K 2R1, Canada
- Research Centre on Aging, affiliated with CIUSSS de l’Estrie - CHUS, 1036, rue Belvédère sud, Sherbrooke, Qc, J1H 4C4, Canada
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Silva JKTNF, Menêses AL, Silva GO, O'Driscoll JM, Ritti-Dias RM, Correia MA, Farah BQ. Acute Effects of Breaking up Sitting Time With Isometric Wall Squat Exercise on Vascular Function and Blood Pressure in Sedentary Adults: Randomized Crossover Trial. J Cardiopulm Rehabil Prev 2024; 44:369-376. [PMID: 38885063 DOI: 10.1097/hcr.0000000000000877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
PURPOSE The World Health Organization has recommended breaking up sitting time to improve cardiovascular health. However, whether isometric exercise can be effectively used as a strategy to break up sitting time remains unclear. Thus, the aim of this study was to analyze the acute effects of breaking up prolonged sitting with isometric wall squat exercise (IWSE) on vascular function and blood pressure (BP) in sedentary adults. METHODS This randomized crossover trial included 17 adults (53% male, 26 ± 6 yr, 22.4 ± 3.6 kg/m 2 ) with high sedentary behavior (≥ 6 hr/d). The participants completed 2 experimental sessions in a randomized order, both sharing a common sitting period of 180 min: Breaks (2-min breaks were incorporated into the IWSE, with participants maintaining their knees at the angle determined by the incremental test, which occurred every 30 min) and Control (sitting for 180 min continuously). Popliteal artery flow-mediated dilation (FMD) and brachial BP were measured before and at 10 and 30 min after the experimental sessions. RESULTS The results did not indicate significant session vs time interaction effects on popliteal FMD and brachial BP ( P > .05). A subanalysis including only participants with popliteal FMD reduction after the Control session (n = 11) revealed that Breaks enhanced popliteal FMD after 10 min (1.38 ± 6.45% vs -4.87 ± 2.95%, P = .002) and 30 min (-0.43 ± 2.48% vs -2.11 ± 5.22%, P = .047). CONCLUSION Breaking up prolonged sitting with IWSE mitigates impaired vascular function resulting from prolonged sitting but has no effect on BP in sedentary adults.
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Affiliation(s)
- Jéssika K T N F Silva
- Author Affiliations: Department of Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, São Paulo, Brazil (Ms Silva, Mr O. Silva, and Drs Ritti-Dias, Correia, and Farah); Graduate Program in Physical Education, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil (Ms Silva and Dr Farah); University of Pernambuco (UPE), Recife, Pernambuco, Brazil (Dr Menêses); School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, United Kingdom (Dr O'Driscoll); Department of Physical Education, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil (Dr Farah)
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Lim TW, Burrow MF, McGrath C. Efficacy of ultrasonic home-care denture cleaning versus conventional denture cleaning: A randomised crossover clinical trial. J Dent 2024; 148:105215. [PMID: 38944265 DOI: 10.1016/j.jdent.2024.105215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/01/2024] Open
Abstract
OBJECTIVE To compare the efficacy of test (ultrasonic cleaner combined with immersion in denture cleanser solution) and control (immersion in denture cleanser solution followed by conventional brushing) denture cleaning interventions in enhancing denture cleanliness, reducing denture stomatitis, and improving patient satisfaction. METHODS A prospective, single-blind, block-randomised, two-period crossover, superiority-controlled clinical trial was conducted of a 3-month intervention. The study design included a pre-intervention period (2 weeks), intervention period one (3 months), washout period (2 weeks), and intervention period two (3 months). A total of 56 community-dwelling elders were block-randomized into either sequence Test/Control or sequence Control/Test. The intervention, period, and carryover effects for the changes in the cleanliness of extensive partial and complete acrylic dentures, denture stomatitis, and changes in patient satisfaction were estimated using Generalized Estimating Equations models. RESULTS Percentage plaque area coverage, patient satisfaction, and denture stomatitis were significantly improved for both intervention and control arms after 3 months (P < 0.05). The intervention arm was found to significantly improve denture cleanliness (P < 0.001) and patient satisfaction (P = 0.002) more than the control arm. Denture-wearing habits and denture age were also significantly associated with the changes in denture plaque coverage (P < 0.05). However, the effect of the test intervention on denture stomatitis was not significantly different compared to the control arm (P = 0.284). CONCLUSION This study revealed that the test intervention group was significantly more effective than the control group in improving denture cleanliness and patient satisfaction among community-dwelling elders. This test intervention is recommended for maintaining optimum denture hygiene among older adults. CLINICAL SIGNIFICANCE Removable dentures can harbor opportunistic pathogens, emphasizing the need for effective denture hygiene intervention using ultrasonic cleaner combined with immersion in denture cleanser solution to eliminate denture biofilm in community-dwelling elders.
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Affiliation(s)
- Tong Wah Lim
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR
| | - Michael Francis Burrow
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR
| | - Colman McGrath
- Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR.
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Hoffmann SW, Schierbauer J, Zimmermann P, Voit T, Grothoff A, Wachsmuth N, Rössler A, Lackner HK, Moser O. Effects of light-intensity physical activity on cardiometabolic parameters in young adults with overweight and obesity: The SED-ACT randomized controlled crossover trial. Diabetes Obes Metab 2024; 26:3849-3859. [PMID: 38923193 DOI: 10.1111/dom.15732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024]
Abstract
AIMS To investigate how a change in body position with light-intensity physical activity (PA) 'snacks' (LIPAS, alternate sitting and standing, walking or standing continuously) compared with uninterrupted prolonged sitting affects glucose metabolism and heart rate variability (HRV) parameters in young adults with overweight and obesity. MATERIALS AND METHODS We conducted a four-arm randomized controlled crossover trial. The following conditions were tested during an 8-h simulated workday: uninterrupted prolonged sitting (SIT), alternate sitting and standing (SIT-STAND; 2.5 h total), continuous standing (STAND), and continuous walking (1.0 mph; WALK). The primary outcome was to investigate how a change in body position (alternate sitting and standing, walking or standing continuously) compared with uninterrupted sitting affects mean 8-h glucose metabolism. Secondary outcomes included the effects on 2-h postprandial glucose concentrations, as well as on 8-h/24-h heart rate and HRV parameters, in the respective study arms. Capillary blood samples were drawn from an hyperemised earlobe in the fasted state and once every hour during each trial intervention by puncturing the earlobe with a lancet and collecting 20 μL of blood (Biosen S-Line Lab+; EKF diagnostics, Barleben, Germany). HRV was assessed for 24 h including the 8-h intervention phase, and a home phase by means of a Holter electrocardiogram. All participants received the same standardized non-relativised breakfast and lunch during the four trial visits. RESULTS Seventeen individuals (eight women, mean age 23.4 ± 3.3 years, body mass index 29.7 ± 3.8 kg/m2, glycated haemoglobin level 34.8 ± 3.1 mmol/mol [5.4 ± 0.3%], body fat 31.8 ± 8.2%) completed all four trial arms. Compared with SIT (89.4 ± 6.8 mg/dL), 8-h mean glucose was lower in all other conditions (p < 0.05) and this was statistically significant compared with WALK (86.3 ± 5.2 mg/dL; p = 0.034). Two-hour postprandial glucose after breakfast was approximately 7% lower for WALK compared with SIT (p = 0.002). Furthermore, significant time × condition effects on HRV parameters favouring light-intensity walking were observed (p < 0.001). CONCLUSIONS Replacement and interruption of prolonged sitting with light-intensity walking showed a significant blood glucose-lowering effect and improved HRV during an 8-h work environment in young adults with overweight and obesity.
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Affiliation(s)
- Sascha W Hoffmann
- Division of Theory and Practice of Sports and Fields of Physical Activity, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
| | - Janis Schierbauer
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
| | - Paul Zimmermann
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
| | - Thomas Voit
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
| | - Auguste Grothoff
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
| | - Nadine Wachsmuth
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
| | - Andreas Rössler
- Department of Physiology and Pathophysiology, Medical University of Graz, Graz, Austria
| | - Helmut K Lackner
- Department of Physiology and Pathophysiology, Medical University of Graz, Graz, Austria
| | - Othmar Moser
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, Bayreuth, Germany
- Interdisciplinary Metabolic Medicine Trials Unit, Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
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Capili B, Anastasi JK. An Introduction to the Crossover Trial Design. Am J Nurs 2024; 124:40-43. [PMID: 39185982 DOI: 10.1097/01.naj.0001050812.23977.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Editor's note: This is the 23rd article in a series on clinical research by nurses. The series is designed to be used as a resource for nurses to understand the concepts and principles essential to research. Each column will present the concepts that underpin evidence-based practice-from research design to data interpretation. To see all the articles in the series, go to https://links.lww.com/AJN/A204.
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Affiliation(s)
- Bernadette Capili
- Bernadette Capili is director of the Heilbrunn Family Center for Research Nursing at Rockefeller University, New York City, and Joyce K. Anastasi is the Independence Foundation Professor of Nursing and founding director of Special Studies in Symptom Management at New York University. This manuscript was supported in part by grant No. UL1TR001866 from the National Institutes of Health's National Center for Advancing Translational Sciences Clinical and Translational Science Awards Program. Contact author and column coordinator: Bernadette Capili, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Feter N, Ligeza TS, Bashir N, Shanmugam RJ, Montero Herrera B, Aldabbagh T, Usman AF, Yonezawa A, McCarthy S, Herrera D, Vargas D, Mir EM, Syed T, Desai S, Shi H, Kim W, Puhar N, Gowda K, Nowak O, Kuang J, Quiroz F, Caputo EL, Yu Q, Pionke JJ, Zou L, Raine LB, Gratton G, Fabiani M, Lubans DR, Hallal PC, Pindus DM. Effects of reducing sedentary behaviour by increasing physical activity, on cognitive function, brain function and structure across the lifespan: a systematic review and meta-analysis. Br J Sports Med 2024:bjsports-2024-108444. [PMID: 39197948 DOI: 10.1136/bjsports-2024-108444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 09/01/2024]
Abstract
OBJECTIVE To examine the acute and chronic effects of reducing prolonged sedentary time (ST) with physical activity (PA) on cognitive and brain health. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Scopus, CINAHL, PsycINFO, SPORTDiscus, Web of Science, and ProQuest Dissertation and Theses. ELIGIBILITY CRITERIA Randomised controlled trials (RCTs) published from inception to 17 June 2024, with healthy participants without cognitive impairment or neurological conditions that affect cognitive functioning, aged ≥4 years, testing acute and chronic effects of reducing ST and/or prolonged ST by reallocating ST to PA on cognitive function, brain function, and structure. RESULTS We included 25 RCTs (n=1289) investigating acute (21 studies) and chronic (4 studies) effects on cognitive function (acute: n=20, chronic: n=4) and brain function (acute: n=7, chronic: n=1); there were no studies on brain structure. Acutely interrupting continuous ST with either multiple or a single PA bout improved cognitive function measured from 3 hours to three consecutive days based on 91 effect sizes (g=0.17, 95% CI: 0.05 to 0.29, p=0.005, I 2=45.5%). When comparing single versus multiple PA bouts, only multiple PA bouts yielded a positive effect on cognitive function based on 72 effect sizes (g=0.20, 95% CI: 0.06 to 0.35, p=0.006; I 2=48.8%). Chronic studies reported null findings on cognitive function (n=4), with some evidence of improved neural efficiency of the hippocampus (n=1). CONCLUSION Interrupting ST with PA acutely improves cognitive function. The evidence from chronic studies remains inconclusive. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020200998.
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Affiliation(s)
- Natan Feter
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tomasz S Ligeza
- Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Neha Bashir
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- The School of Cellular and Molecular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Ramiya J Shanmugam
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- The School of Cellular and Molecular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Bryan Montero Herrera
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Tamara Aldabbagh
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- School of Integrative Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Anne-Farah Usman
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- The School of Cellular and Molecular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Ayumi Yonezawa
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- The School of Cellular and Molecular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Shane McCarthy
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Physiology and Biophysics, University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Danielle Herrera
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Surgery, Ann and Robert Lurie Children's Hospital, Chicago, Illinois, USA
| | - Denise Vargas
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- The School of Cellular and Molecular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Emaad M Mir
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- The School of Cellular and Molecular Biology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Talha Syed
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Sanam Desai
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Hector Shi
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - William Kim
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Economics, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Natalie Puhar
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Kushi Gowda
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- College of Medicine Peoria, University of Illinois, Peoria, Illinois, USA
| | - Olivia Nowak
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Research & Development Solutions, IQVIA, Overland Park, Kansas, USA
| | - Jin Kuang
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- School of Psychology, Shenzhen University, Shenzhen, People's Republic of China
| | - Flor Quiroz
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Eduardo L Caputo
- School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Qian Yu
- School of Psychology, Shenzhen University, Shenzhen, People's Republic of China
| | - J J Pionke
- iSchool, Syracuse University, Syracuse, New York, USA
| | - Liye Zou
- School of Psychology, Shenzhen University, Shenzhen, People's Republic of China
| | - Lauren B Raine
- Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
- Department of Medical Sciences, Northeastern University, Boston, Massachusetts, USA
| | - Gabriele Gratton
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Monica Fabiani
- Department of Psychology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - David R Lubans
- College of Human and Social Futures, University of Newcastle Australia, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pedro C Hallal
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Dominika M Pindus
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
- Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
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Tomschi F, Ransmann P, Schmidt A, Hilberg T. Exercise induced hypoalgesia after a high intensity functional training: a randomized controlled crossover study. BMC Sports Sci Med Rehabil 2024; 16:182. [PMID: 39198898 PMCID: PMC11351546 DOI: 10.1186/s13102-024-00969-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 08/13/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND Acute physical activity often induces an acute reduction in pain sensitivity known as exercise induced hypoalgesia (EIH). The aim of this study was to investigate the effects of a high intensity functional training (HIFT) on EIH compared to a control session. METHODS 50 (age: 26.0 ± 2.7; 23 female) participants successfully conducted this study consisting of a pre-experimental test as well as a 12-minute HIFT (body-weight exercises) and a 12-minute control (supervised breathing) session in a randomized crossover design. Pre and post, pressure pain thresholds (PPT) were measured at the ankles, knees, elbows, and forehead. RESULTS The HIFT resulted in a relative maximum and average heart rate of 96.2% (± 3.6%) and 91.1% (± 4.2%), respectively, and maximum and average RPE values of 19.1 (± 1.2) and 16.2 (± 1.4), respectively. Results reveal a significant 'Intervention' × 'Time point' interaction (p < 0.001) for PPT (pooled for one average value) with hypoalgesia observed following the HIFT (p < 0.001; pre: 56.0 ± 16.8, post: 61.6 ± 19.0 [Newton]) and no change following the control (p = 0.067; pre: 56.6 ± 18.4, post: 55.3 ± 18.9 [Newton]). Further, a significant 'Time' × 'Intervention' × 'Landmark' interaction effect (p = 0.024) is observed and all landmarks showed significant hypoalgesia following HIFT (p < 0.01), except for the right elbow and forehead. Following control, no hypoalgesia was observed at any landmark. Analysing male and female participants separately, it was observed that EIH occured only in men. CONCLUSION A HIFT using bodyweight exercises reduces pain sensitivity. Hence, combining strength and aerobically demanding exercises in a short but high intensity manner, as done in HIFT, can be seen as a usable tool to induce hypoalgesia. Yet, these results were observed only in male participants, necessitating future sex-specific research. TRIAL REGISTRATION DRKS00034391, retrospectively registered on the 4th of June 2024.
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Affiliation(s)
- Fabian Tomschi
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany.
| | - Pia Ransmann
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Alexander Schmidt
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
| | - Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Wuppertal, Germany
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Zuttion GS, Juárez HAB, Lima BD, Assumpção DP, Daneris ÂP, Tuchtenhagen IH, Casarin M, Muniz FWMG. Comparison of the anti-plaque and anti-gingivitis efficacy of Chlorhexidine and Malva mouthwashes: randomized crossover clinical trial. J Dent 2024:105313. [PMID: 39173823 DOI: 10.1016/j.jdent.2024.105313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 08/12/2024] [Accepted: 08/16/2024] [Indexed: 08/24/2024] Open
Abstract
OBJECTIVES Although mechanical oral hygiene is widely practiced, it faces several challenges. Mouthwashes, such as chlorhexidine (CHX), are being explored as adjuncts to biofilm control, but their prolonged use has several side effects. Consequently, there is ongoing research into natural alternatives. This randomized crossover clinical study aimed to compare the antiplaque and antigingivitis efficacy of 0.12% CHX and a 5% Malva sylvestris METHODS: Forty-four participants were involved in two phases, each comprising three stages with variations in the mouthwash solution used only. During the study, participants refrained from mechanical plaque removal for seven days. At first day, they received whole-mouth prophylaxis and oral health assessment. After three days, gingival inflammation assessment and prophylaxis in were performed in contralateral quadrants. Participants then used a randomly assigned mouthwash solution for four days. On the 7th day, they completed a questionnaire about their perception and appreciation of the mouthwash. Additionally, gingival inflammation and plaque index were also performed by a calibrated examiner. After a minimum 21-day washout period, participants entered the second phase, repeating the three stages RESULTS: Results showed no statistically significant differences between the Malva sylvestris and CHX groups regarding inflammation and plaque formation. However, CHX demonstrated a significantly greater mean reduction (7th - 4th day) in gingival inflammation compared to Malva (p=0.02) (0.01±0.19 and 0.00±0.19, respectively). Additionally, participants using CHX reported a more pleasant taste and considered higher plaque control perception (p<0.05) CONCLUSIONS: In conclusion, both products exhibited similar antiplaque effects, but CHX outperformed Malva in controlling gingival inflammation. CLINICAL SIGNIFICANCE Mouthwashes with Malva sylvestris may be a good alternative, in a short-term period, to control biofilm. However, lower antigingivitis efficacy may be expected when compared to chlorhexidine.
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Affiliation(s)
| | | | - Betina Dutra Lima
- Undergraduate student in dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Daniele Prado Assumpção
- Master's student in Dental Clinic: Endodontics, Federal University of Pelotas, Pelotas, Brazil
| | - Ândrea Pires Daneris
- Undergraduate student in dentistry, Federal University of Pelotas, Pelotas, Brazil
| | | | - Maísa Casarin
- Department of Periodontology, Associate Professor of Periodontics, Federal University of Pelotas, Pelotas, Brazil
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9
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Hoffmann SW, Schierbauer J, Zimmermann P, Voit T, Grothoff A, Wachsmuth NB, Rössler A, Niedrist T, Lackner HK, Moser O. Effects of Interrupting Prolonged Sitting with Light-Intensity Physical Activity on Inflammatory and Cardiometabolic Risk Markers in Young Adults with Overweight and Obesity: Secondary Outcome Analyses of the SED-ACT Randomized Controlled Crossover Trial. Biomolecules 2024; 14:1029. [PMID: 39199416 PMCID: PMC11352707 DOI: 10.3390/biom14081029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/16/2024] [Accepted: 08/18/2024] [Indexed: 09/01/2024] Open
Abstract
Sedentary behavior (SB) is an essential risk factor for obesity, cardiovascular disease, and type 2 diabetes. Though certain levels of physical activity (PA) may attenuate the detrimental effects of SB, the inflammatory and cardiometabolic responses involved are still not fully understood. The focus of this secondary outcome analysis was to describe how light-intensity PA snacks (LIPASs, alternate sitting and standing, walking or standing continuously) compared with uninterrupted prolonged sitting affect inflammatory and cardiometabolic risk markers. Seventeen young adults with overweight and obesity participated in this study (eight females, 23.4 ± 3.3 years, body mass index (BMI) 29.7 ± 3.8 kg/m2, glycated hemoglobin A1C (HbA1c) 5.4 ± 0.3%, body fat 31.8 ± 8.2%). Participants were randomly assigned to the following conditions which were tested during an 8 h simulated workday: uninterrupted prolonged sitting (SIT), alternate sitting and standing (SIT-STAND, 2.5 h total standing time), continuous standing (STAND), and continuous walking (1.6 km/h; WALK). Each condition also included a standardized non-relativized breakfast and lunch. Venous blood samples were obtained in a fasted state at baseline (T0), 1 h after lunch (T1) and 8 h after baseline (T2). Inflammatory and cardiometabolic risk markers included interleukin-6 (IL-6), c-reactive protein (CRP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), visceral fat area (VFA), triglyceride-glucose (TyG) index, two lipid ratio measures, TG/HDL-C and TC/HDL-C, albumin, amylase (pancreatic), total protein, uric acid, and urea. We found significant changes in a broad range of certain inflammatory and cardiometabolic risk markers during the intervention phase for IL-6 (p = 0.014), TG (p = 0.012), TC (p = 0.017), HDL-C (p = 0.020), LDL-C (p = 0.021), albumin (p = 0.003), total protein (p = 0.021), and uric acid (p = 0.040) in favor of light-intensity walking compared with uninterrupted prolonged sitting, alternate sitting and standing, and continuous standing. We found no significant changes in CRP (p = 0.529), creatinine (p = 0.199), TyG (p = 0.331), and the lipid ratios TG/HDL-C (p = 0.793) and TC/HDL-C (p = 0.221) in response to the PA snack. During a simulated 8 h work environment replacement and interruption of prolonged sitting with light-intensity walking, significant positive effects on certain inflammatory and cardiometabolic risk markers were found in young adults with overweight and obesity.
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Affiliation(s)
- Sascha W. Hoffmann
- Division of Theory and Practice of Sports and Fields of Physical Activity, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Janis Schierbauer
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (J.S.); (P.Z.); (T.V.); (A.G.); (N.B.W.)
| | - Paul Zimmermann
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (J.S.); (P.Z.); (T.V.); (A.G.); (N.B.W.)
| | - Thomas Voit
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (J.S.); (P.Z.); (T.V.); (A.G.); (N.B.W.)
| | - Auguste Grothoff
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (J.S.); (P.Z.); (T.V.); (A.G.); (N.B.W.)
| | - Nadine B. Wachsmuth
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (J.S.); (P.Z.); (T.V.); (A.G.); (N.B.W.)
| | - Andreas Rössler
- Department of Physiology and Pathophysiology, Medical University of Graz, 8010 Graz, Austria; (A.R.); (H.K.L.)
| | - Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8010 Graz, Austria;
| | - Helmut K. Lackner
- Department of Physiology and Pathophysiology, Medical University of Graz, 8010 Graz, Austria; (A.R.); (H.K.L.)
| | - Othmar Moser
- Division of Exercise Physiology and Metabolism, BaySpo—Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (J.S.); (P.Z.); (T.V.); (A.G.); (N.B.W.)
- Interdisciplinary Metabolic Medicine Trials Unit, Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, 8010 Graz, Austria
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10
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Kuhn M, Clarenbach CF, Kläy A, Kohler M, Mayer LC, Lüchinger M, Andrist B, Radtke T, Haile SR, Sievi NA, Kohlbrenner D. Exploring immediate cardiorespiratory responses: low-intensity blood flow restricted cycling vs. moderate-intensity traditional exercise in a randomized crossover trial. BMC Sports Sci Med Rehabil 2024; 16:172. [PMID: 39148127 PMCID: PMC11325739 DOI: 10.1186/s13102-024-00951-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 07/19/2024] [Indexed: 08/17/2024]
Abstract
PURPOSE Blood-flow restriction (BFR) endurance training may increase endurance performance and muscle strength similar to traditional endurance training while requiring a lower training intensity. We aimed to compare acute cardiorespiratory responses to low-intensity interval exercise under BFR with moderate-intensity traditional interval exercise (TRA). METHODS We conducted a randomized crossover study. The protocol involved three cycling intervals interspersed with 1 min resting periods. With a 48-h washout period, individuals performed the protocol twice in random order: once as BFR-50 (i.e., 50% incremental peak power output [IPPO] and 50% limb occlusion pressure [LOP]) and once as TRA-65 (65% IPPO without occlusion). TRA-65 intervals lasted 2 min, and time-matched BFR-50 lasted 2 min and 18 s. Respiratory parameters were collected by breath-by-breath analysis. The ratings of perceived breathing and leg exertion (RPE, 0 to 10) were assessed. Linear mixed models were used for analysis. RESULTS Out of the 28 participants initially enrolled in the study, 24 healthy individuals (18 males and 6 females) completed both measurements. Compared with TRA-65, BFR-50 elicited lower minute ventilation (VE, primary outcome) (-3.1 l/min [-4.4 to -1.7]), oxygen consumption (-0.22 l/min [-0.28 to -0.16]), carbon dioxide production (-0.25 l/min [-0.29 to -0.20]) and RPE breathing (-0.9 [-1.2 to -0.6]). RPE leg was significantly greater in the BFR-50 group (1.3 [1.0 to 1.7]). CONCLUSION BFR endurance exercise at 50% IPPO and 50% LOP resulted in lower cardiorespiratory work and perceived breathing effort compared to TRA at 65% IPPO. BFR-50 could be an attractive alternative for TRA-65, eliciting less respiratory work and perceived breathing effort while augmenting perceived leg muscle effort. TRIAL REGISTRATION NCT05163600; December 20, 2021.
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Affiliation(s)
- Manuel Kuhn
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
| | - Christian F Clarenbach
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Adrian Kläy
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Malcolm Kohler
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Laura C Mayer
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Martin Lüchinger
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Belinda Andrist
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Sarah R Haile
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Noriane A Sievi
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
| | - Dario Kohlbrenner
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
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11
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Ashour AA, Elhafez SM, ElMeligie MM, Hanafy AF. Crossover effect of knee and ankle joint training on knee mechanics after ACL reconstruction: A randomized controlled trial. Gait Posture 2024; 113:512-518. [PMID: 39173441 DOI: 10.1016/j.gaitpost.2024.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 08/09/2024] [Accepted: 08/13/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Anterior cruciate ligament (ACL) rehabilitation is a common intervention after ACL reconstruction. Since different types of exercise can influence muscle and kinematic parameters in diverse ways, the training order between the knee and ankle joints may also change gait parameters. PURPOSE This study aimed to investigate whether the training sequence of the knee and ankle joints (knee followed by ankle training or vice-versa) in an ACL reconstruction (ACLR) rehabilitation program has any effects on knee extension and flexion torques. METHODS Forty-two men (aged 20-30 years) with ACLR participated in this study. They were randomly allocated to receive one of two interventions: (A) knee joint training followed by ankle training or (B) ankle joint training followed by knee training. After five weeks (four weeks of intervention and one-week washout), participants crossed from one group to another for an additional four weeks. Knee extension and flexion torques were assessed during the stance phase of the gait cycle before and after the intervention program. RESULTS Two-way Mixed-design MANOVA showed that knee extension torque improved significantly in both groups after training (p = 0.001, Cohen's D = 0.65), while the knee flexion torque increased significantly only in group B (p= 0.001, Cohen's D = 0.97). When comparing both groups, patients of group B presented significant improvements in the post-training mean values of all tested variables compared with group A. CONCLUSION Starting a post-ACLR rehabilitation program with ankle training followed by knee training is better to improve knee flexion and extension torques during the stance phase of the gait cycle than starting the program by training the knee first, followed by the ankle. Future studies using a mixed-gender sample and different types of ACLR operations are necessary to examine whether similar improvements will happen as well as to test their effects on many sports activities.
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Affiliation(s)
- Ahmed Atteya Ashour
- Department of Biomechanics, Faculty of Physical Therapy, October 6 University, Egypt.
| | | | | | - Abeer Farag Hanafy
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Egypt
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12
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Ewell TR, Bomar MC, Brown DM, Brown RL, Kwarteng BS, Thomson DP, Bell C. The Influence of Acute Oral Lactate Supplementation on Responses to Cycle Ergometer Exercise: A Randomized, Crossover Pilot Clinical Trial. Nutrients 2024; 16:2624. [PMID: 39203761 PMCID: PMC11357576 DOI: 10.3390/nu16162624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 08/05/2024] [Accepted: 08/07/2024] [Indexed: 09/03/2024] Open
Abstract
The purpose of this study was to investigate the potential ergogenic effects of an oral lactate supplement. For this double-blind, randomized, placebo-controlled crossover design, fifteen recreational exercisers (nine males, six females) ingested a placebo or a commercially available lactate supplement prior to cycle ergometer exercise. Primary outcomes included peak oxygen uptake (VO2peak; via indirect calorimetry), VO2 at the ventilatory threshold, and work rate at the lactate threshold (arterialized venous blood from a heated hand) determined during incremental exercise to fatigue, and power output during a 20-min cycling time trial. Compared with placebo, the oral lactate supplement (19 ± 1 mg/kg body mass) did not influence VO2peak (placebo: 44.3 ± 7.8 vs. oral lactate: 44.3 ± 7.1 mL/kg/min (mean ± SD); p = 0.87), VO2 at the ventilatory threshold (placebo: 1.63 ± 0.25 vs. oral lactate: 1.65 ± 0.23 L/min; p = 0.82), or work rate at the lactate threshold (placebo: 179 ± 69 vs. oral lactate: 179 ± 59 W; p = 0.41). Throughout the 20-min time trial, the work rate was slightly greater (4%) with oral lactate (204 ± 41 W) compared with placebo (197 ± 41 W; main effect of treatment p = 0.02). Collectively, these data suggest that this commercially available lactate supplement did not acutely influence the physiological responses to incremental cycle ergometer exercise but elicited a modest ergogenic effect during the short-duration time trial.
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Affiliation(s)
| | | | | | | | | | | | - Christopher Bell
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523-1582, USA; (T.R.E.)
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13
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Cheng L, Zheng Y, Weng Y, Yi Y, Zhou X, Jiang N, Xiong X. Abstracts of randomized controlled trials in splint therapy for temporomandibular disorders: Reporting quality and spin. J Oral Rehabil 2024. [PMID: 39095959 DOI: 10.1111/joor.13824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 07/13/2024] [Accepted: 07/23/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND Poor reporting quality and spin in randomized controlled trial (RCT) abstracts can lead to misinterpretation and distorted interpretation of results. OBJECTIVES This methodological study aimed to assess the reporting quality and spin among RCT abstracts on splint therapy for temporomandibular disorders (TMD) and explore the association between spin and potentially related factors. METHODS The authors searched PubMed for RCTs on splint therapy for TMD. The reporting quality of each abstract was assessed using the original 16-item CONSORT for abstracts checklist. The authors evaluated the presence and characteristics of spin only in abstracts with nonsignificant primary outcomes according to pre-determined spin strategies. Logistic regression analyses were performed to identify factors associated with the presence of spin. RESULTS A total of 148 abstracts were included in the reporting quality evaluation. The mean overall CONSORT score (OCS) was 5.86 (score range: 0-16). Only interventions, objectives and conclusions were adequately reported. Of the 61 RCT abstracts included for spin analysis, spin was identified in 38 abstracts (62.3%), among which 32 abstracts (52.3%) had spin in the Results section and 21 (34.4%) had spin in the Conclusions section. A significantly lower presence of spin was found in studies with exact p-value reporting (OR: 0.170; 95% CI: 0.032-0.887; p = .036) and a two-arm comparison design (OR: 11.777; 95% CI: 2.171-63.877; p = .004). CONCLUSIONS The reporting quality of RCT abstracts on splint therapy for TMD is suboptimal and the prevalence of spin is high. More awareness and joint efforts are needed to improve reporting quality and minimize spin.
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Affiliation(s)
- Liandi Cheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yunhao Zheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yaxin Weng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yating Yi
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xueman Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xin Xiong
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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14
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Woodward A, Coleman E, Ronaldson S, Zoltie T, Bartlett P, Wilson L, Archer T, Kawalek J, Boele F, Chang B, Kalantzis G, Theaker M, El-Hindy N, Walshaw E, Gout T, Watson J. A cross-over, randomised feasibility study of digitally-printed versus hand-painted artificial eyes in adults: PERSONAL-EYE-S. Eye (Lond) 2024:10.1038/s41433-024-03273-0. [PMID: 39095468 DOI: 10.1038/s41433-024-03273-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 07/03/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND/OBJECTIVES Over 60,000 patients in the United Kingdom are estimated to have artificial eyes. Manufacturing and hand-painting of artificial eyes have not changed significantly since 1948. Delays and colour-matching issues may severely impact a patient's rehabilitation pathway. Technology advances mean alternatives are now possible. This cross-over, randomised feasibility trial aimed to determine the feasibility of conducting a full-scale trial of the effectiveness and cost-effectiveness of digitally-printed artificial eyes compared to hand-painted. SUBJECTS/METHODS Patients aged ≥18 years who were longstanding artificial eye users requiring a replacement were randomised to receive either a hand-painted or digitally-printed eye first followed by the other type of eye. Participants were asked to approach a close contact (CC) willing to participate alongside them. A subset of participants, their CCs, and staff were interviewed about their opinions on trial procedures, artificial eyes, delivery times and satisfaction. RESULTS Thirty-five participants were randomised and 10 CCs consented. Participant retention at final follow-up was 85.7%. Outcome data completion rates ranged from 91-100%. EQ-5D-5L completion ranged from 83-97%. Resource-use completion ranged from 0-94% with total costs at £347 for hand-painted and £404 for digitally-printed eye. There were two adverse events. Twelve participants, five CCs, and five staff were interviewed. There were positive and negative features of both types of eyes. We identified that social and psychological wellbeing is affected, often for many years after eye removal. Participation in the feasibility study was well accepted. CONCLUSIONS The feasibility study outcomes indicate that a full trial is achievable. TRIAL REGISTRATION NUMBER ISRCTN85921622.
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Affiliation(s)
- Amie Woodward
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Elizabeth Coleman
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Sarah Ronaldson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Tim Zoltie
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Paul Bartlett
- Maxillofacial Laboratory, Leeds Dental Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Laura Wilson
- Leeds Artificial Eye Service, Leeds Dental Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Tom Archer
- Leeds Artificial Eye Service, Leeds Dental Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Jessica Kawalek
- Leeds Institute of Medical Research at St James's, St James's University Hospital, University of Leeds, Leeds, UK
| | - Florien Boele
- Leeds Institute of Medical Research at St James's, St James's University Hospital, University of Leeds, Leeds, UK
- Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Bernard Chang
- Department of Ophthalmology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - George Kalantzis
- Department of Ophthalmology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Mike Theaker
- Patient and Public Involvement representative, Leeds, UK
| | - Nabil El-Hindy
- Department of Ophthalmology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Emma Walshaw
- Leeds Artificial Eye Service, Leeds Dental Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Taras Gout
- Leeds Artificial Eye Service, Leeds Dental Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Department of Ophthalmology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Judith Watson
- York Trials Unit, Department of Health Sciences, University of York, York, UK.
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15
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Tagiling N, Ibrahim IL, Lee YY, Udin MY, Mohamad Kamarulzaman MD, Phoa PKA, Damulira E, Mohd Rohani MF, Wan Zainon WMN, Mat Nawi N. Randomized, crossover trial: comparing the effects of standardized egg-white meal and Vital ® on global gastric emptying parameters and intragastric meal distribution in healthy Asian participants. J Gastroenterol Hepatol 2024; 39:1517-1527. [PMID: 38705971 DOI: 10.1111/jgh.16585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 02/29/2024] [Accepted: 04/11/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND AND AIM Measurements of gastric emptying and accommodation for alternative test-meal protocol during gastric emptying scintigraphy (GES), such as high-calorie nutrient drinks, are not fully established. We aimed to compare the effects of standardized egg-white meal (EWM) versus high-calorie nutrient drink (Vital®; Abbott Laboratories) on global GES parameters and intragastric meal distribution at immediate scan (IMD0h). METHODS Of 84 screened participants, 60 asymptomatic healthy Asian population (38 females; 24.0 ± 1.5 years; 23.8 ± 2.6 kg/m2) were recruited in this 2 × 2 (AB/BA) crossover trial. Participants were randomized to a 4-h GES with 99mTc-radiolabeled EWM (~255.8 kcal), followed by a 200 mL Vital® (300 kcal), or vice versa, separated by a 2-week washout period. Global meal retention (GMR), power-exponential model emptying parameters (half-emptying [T1/2], lag phases [Tlag2%, Tlag5%, Tlag10%]), and IMD0h were determined and compared. RESULTS GMRs for both test meals were within the international standard references for solid GES. Compared to EWM, Vital® exhibited significantly lower GMRs (faster emptying) from 0.5 to 3 h (all P < 0.001) but comparable at 4 h (P = 0.153). Similar observations were found for the model-based T1/2 and the different Tlag thresholds (all P < 0.001). Furthermore, IMD0h was found to be lower with Vital®, indicating lower gastric accommodation (faster antral filling) immediately post-ingestion (P < 0.001). Both test meals showed significant moderate-to-strong positive associations at the late-phase GE (GMR 2-4 h, T1/2) (all P < 0.05). CONCLUSIONS Overall, Vital® is an acceptable alternative test meal to the EWM for GES; however, exercise caution when interpreting early-phase GE. The normative values for global GES parameters and IMD0h are also established.
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Affiliation(s)
- Nashrulhaq Tagiling
- Department of Nuclear Medicine, Radiotherapy and Oncology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150, Kota Bharu, Kelantan, Malaysia
- Gastrointestinal Function and Motility (GIFM) Unit, Clinical Examination Lab, Hospital Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia
| | - Izleen Laili Ibrahim
- Medical Physics Program, School of Physics, Universiti Sains Malaysia Main Campus, 11800 Bertam, Penang, Malaysia
| | - Yeong Yeh Lee
- Gastrointestinal Function and Motility (GIFM) Unit, Clinical Examination Lab, Hospital Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia
- Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150, Kota Bharu, Kelantan, Malaysia
| | - Muhamad Yusri Udin
- Department of Nuclear Medicine, Radiotherapy and Oncology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150, Kota Bharu, Kelantan, Malaysia
- Department of Hematology and Transfusion Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150, Kota Bharu, Kelantan, Malaysia
| | - Mohamad Dzulhilmi Mohamad Kamarulzaman
- Aseptic Dispensary and Radiopharmacy Unit, Department of Pharmacy, Hospital Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia
- Department of Nuclear Medicine, Radiotherapy and Oncology, Hospital Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia
| | - Picholas Kian Ann Phoa
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, 47500, Subang Jaya, Selangor, Malaysia
| | - Edrine Damulira
- Département de physique, Complexe des sciences, Université de Montréal, 1375, Montréal, Quebec, Canada
| | - Mohd Fazrin Mohd Rohani
- Department of Nuclear Medicine, Hospital Kuala Lumpur, 50300 Wilayah Persekutuan Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Wan Mohd Nazlee Wan Zainon
- Department of Family Medicine, Hospital Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia
| | - Norazlina Mat Nawi
- Department of Nuclear Medicine, Radiotherapy and Oncology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150, Kota Bharu, Kelantan, Malaysia
- Department of Nuclear Medicine, Radiotherapy and Oncology, Hospital Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia
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Cho YJ, Mehta T, Hinton A, Sloan R, Nshimiyimana J, Tackett AP, Roberts ME, Brinkman MC, Wagener TL. E-Cigarette Nicotine Delivery Among Young Adults by Nicotine Form, Concentration, and Flavor: A Crossover Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2426702. [PMID: 39120901 PMCID: PMC11316233 DOI: 10.1001/jamanetworkopen.2024.26702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/12/2024] [Indexed: 08/10/2024] Open
Abstract
Importance Concerns have been raised about the abuse liability of modern e-cigarettes that use acidic additives to form nicotine salts, making the inhalation of nicotine smoother than freebase nicotine. Objective To examine the effects of nicotine form and concentration and e-liquid flavor on subjective effects ratings, vaping behavior, and nicotine uptake among young adults who use e-cigarettes. Design, Setting, and Participants In this single-blind, within-participant, crossover randomized clinical trial, a convenience sample of young adults aged 21 to 25 years who currently used e-cigarettes was recruited from December 2021 to August 2023, for in-person research laboratory visits in Columbus, Ohio. Interventions Participants completed up to 9 vaping sessions, starting with their usual e-cigarette brand in the first session followed by 1 of 8 laboratory-prepared e-liquids in a randomly assigned order in each subsequent session. Prepared e-liquids varied by nicotine form (salt-based vs freebase), nicotine concentration (5% vs 1% weight per weight), and flavor (menthol vs tobacco). Each session included a 5-minute, 10-puff standardized vaping period followed by 30 minutes of ad libitum vaping. Main Outcomes and Measures At 4 time points (0, 5, 10, and 35 minutes) during each vaping session, plasma samples were collected for assessing nicotine uptake, and self-reports of urges, craving, and withdrawal were collected via questionnaires. Positive subjective effects were self-reported after 35 minutes of vaping using a visual analog scale; urges and cravings were reported using the Questionnaire of Smoking Urges (QSU). Puff topography data were collected throughout each vaping session. Results Seventy-two participants (mean [SD] age, 22.4 [1.4] years; 42 [58.3%] female) who sampled at least 1 laboratory-prepared e-liquid composed the analytic sample. Salt-based (vs freebase) nicotine e-liquids increased nicotine intake, with 5% salt-based e-liquids delivering the highest mean plasma levels of nicotine (11.2 ng/mL [95% CI, 9.3-13.2 ng/mL] at 5 minutes; 17.2 ng/mL [95% CI, 14.3-20.1 ng/mL] at 35 minutes) irrespective of flavors. Higher positive subjective effect ratings (eg, for liking) were received by salt-based (42.8; 95% CI, 39.4-46.1) vs freebase (32.0; 95% CI, 28.6-35.3) nicotine, 1% (43.4; 95% CI, 40.2-46.6) vs 5% (31.2; 95% CI, 27.7-34.6) nicotine, and menthol-flavored (43.2; 95% CI, 39.7-46.7) vs tobacco-flavored (31.5; 95% CI, 28.4-34.7) e-liquids. Salt-based and 1% but not menthol-flavored nicotine elicited more intense puffing (eg, 25% [95% CI, 12%-40%] more total puffs for nicotine salts vs freebase). All study e-liquids reduced urges and cravings, with 5% vs 1% nicotine being more effective (mean [SE] QSU-Desire score at 35 minutes, 15.4 [0.5] vs 16.7 [0.5]). Conclusions and Relevance In this crossover randomized clinical trial among young adult e-cigarette users, salt-based (vs freebase) nicotine e-liquids increased nicotine intake and yielded more positive subjective effects ratings and intense puffing behaviors, suggesting higher abuse potential. Restricting the level of acidic additives and menthol flavoring may reduce the addictiveness of e-cigarettes. Trial Registration ClinicalTrials.gov Identifier: NCT05458895.
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Affiliation(s)
- Yoo Jin Cho
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus
| | - Toral Mehta
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus
| | - Alice Hinton
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus
| | - Ruth Sloan
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus
| | - Jean Nshimiyimana
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus
| | - Alayna P. Tackett
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus
| | - Megan E. Roberts
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus
- Division of Health Behavior & Health Promotion, College of Public Health, The Ohio State University, Columbus
| | - Marielle C. Brinkman
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus
| | - Theodore L. Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus
- Division of Medical Oncology, College of Medicine, The Ohio State University, Columbus
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17
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Herold F, Theobald P, Gronwald T, Kaushal N, Zou L, de Bruin ED, Bherer L, Müller NG. The Best of Two Worlds to Promote Healthy Cognitive Aging: Definition and Classification Approach of Hybrid Physical Training Interventions. JMIR Aging 2024; 7:e56433. [PMID: 39083334 PMCID: PMC11325123 DOI: 10.2196/56433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 08/02/2024] Open
Abstract
A healthy lifestyle can be an important prerequisite to prevent or at least delay the onset of dementia. However, the large number of physically inactive adults underscores the need for developing and evaluating intervention approaches aimed at improving adherence to a physically active lifestyle. In this regard, hybrid physical training, which usually combines center- and home-based physical exercise sessions and has proven successful in rehabilitative settings, could offer a promising approach to preserving cognitive health in the aging population. Despite its potential, research in this area is limited as hybrid physical training interventions have been underused in promoting healthy cognitive aging. Furthermore, the absence of a universally accepted definition or a classification framework for hybrid physical training interventions poses a challenge to future progress in this direction. To address this gap, this article informs the reader about hybrid physical training by providing a definition and classification approach of different types, discussing their specific advantages and disadvantages, and offering recommendations for future research. Specifically, we focus on applying digital technologies to deliver home-based exercises, as their use holds significant potential for reaching underserved and marginalized groups, such as older adults with mobility impairments living in rural areas.
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Affiliation(s)
- Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Paula Theobald
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, Hamburg, Germany
| | - Navin Kaushal
- Department of Health Sciences, School of Health & Human Sciences, Indiana University, Indianapolis, IN, United States
| | - Liye Zou
- Body-Brain-Mind Laboratory, Shenzhen University, Shenzhen, China
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zürich, Zürich, Switzerland
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm, Sweden
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St Gallen, Switzerland
| | - Louis Bherer
- Montreal Heart Institute, Montreal, QC, Canada
- Department of Medicine, Université de Montreal, Montreal, QC, Canada
- Centre de Recherche de l'Institut Universitaire de Geriatrie de Montreal, Montreal, QC, Canada
| | - Notger G Müller
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
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Francisco L, Francisco M, Costa R, Vasques MN, Relvas M, Rajão A, Monteiro L, Rompante P, Guerra F, Infante da Câmara M. Sinus Floor Augmentation with Synthetic Hydroxyapatite (NanoBone ®) in Combination with Platelet-Rich Fibrin: A Case Series. Biomedicines 2024; 12:1661. [PMID: 39200126 PMCID: PMC11351586 DOI: 10.3390/biomedicines12081661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/16/2024] [Accepted: 07/23/2024] [Indexed: 09/01/2024] Open
Abstract
Several techniques have been described for maxillary sinus graft augmentation, including the lateral window technique and crestal approach with osteotomes or osseodensification. Platelet-rich fibrin has been used in maxillary sinus lift procedures due to its ability to accelerate soft and hard tissue healing. The aim of this study was to evaluate the potential of PRF in combination with the synthetic hydroxyapatite NanoBone® to enhance bone regeneration in sinus floor elevation with the lateral window technique. Out of the 50 individuals screened in a preoperative assessment visit from the CESPU-Famalicão clinical unit and intervened upon between January 2023 and December 2023, only 6 patients who met the study's inclusion criteria consented to participate. In a split-mouth study, twelve sinus graft surgeries were carried out. Our observations reveal that for the test group (NanoBone®/PRF), there is a 27.5 ± 4.9% increase new vital bone, 23.0 ± 3.7% increase in inert bone particles, and 49.4 ± 2.8% increase in connective tissue. Meanwhile, for the control group (NanoBone®), there is a 19.5 ± 3.0% increase in new vital bone, 23.4 ± 5.7% increase in inert bone particles, and 57.0 ± 3.5% increase in connective tissue. The results strongly indicate that mixing liquid PRF with NanoBone® does not have a negative influence on the amount of viable bone formation, and it seems to slightly increase the amount of new bone formation and revascularization in sinus bone graft procedures with the lateral window technique compared to the single use of NanoBone®.
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Affiliation(s)
- Luís Francisco
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
| | - Manuel Francisco
- Clinical Assistant Professor Postgraduate Implant Program, Famalicão Unit, University Institute of Health Sciences (IUCS-CESPU), Av. Marechal Humberto Delgado, 14, 4760-012 Vila Nova de Famalicão, Portugal;
| | - Rosana Costa
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Miguel Nunes Vasques
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Marta Relvas
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - António Rajão
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal;
- Applied Molecular Biosciences Unit (UCIBIO), Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Luís Monteiro
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
| | - Paulo Rompante
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
| | - Fernando Guerra
- Institute of Oral Implantology and Prosthodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal;
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
- Laboratory of Hard Tissues, Dentistry Department, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Marco Infante da Câmara
- Oral Pathology and Rehabilitation Research Unit (UNIPRO), University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal; (L.F.); (R.C.); (M.N.V.); (M.R.); (L.M.); (P.R.)
- Department of Medicine and Oral Surgery, University Institute of Health Sciences (IUCS-CESPU), 4585-116 Gandra, Portugal
- Coordinator of the Postgraduate Implant Program, Famalicão Unit, University Institute of Health Sciences (IUCS-CESPU), Av. Marechal Humberto Delgado, 14, 4760-012 Vila Nova de Famalicão, Portugal
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Gong CM, Huang HC, Liu JH, Yu SS, Chen YT. Auricular Acupressure Improve Constipation of Patients With Schizophrenia: A Pilot Randomized Controlled Study. Biol Res Nurs 2024; 26:418-428. [PMID: 38439651 DOI: 10.1177/10998004241236947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Background. Constipation is a common distressing problem in patients with schizophrenia that can cause complications and impair quality of life. Objective. The objective of this study was to investigate the efficacy of applying auricular acupressure (AA) treatment in improving constipation in patients with schizophrenia. Methods. A crossover randomized controlled trial design was performed from April 2022 to December 2023 at four psychiatric rehabilitation care centers. A total of 23 patients with schizophrenia received an AA intervention or usual care according to the designated treatment sequences. Measurements comprised subjective assessment of constipation by the Patient Assessment of Constipation-Symptoms (PAC-SYM) questionnaire, an objective assessment of the stool pattern rated by a Bristol stool form scale, and heart rate variability. A generalized estimating equation model was used for data analyses. Results. After completing an 8-week AA intervention stimulating the Shenmen, San Jiao, Large intestine and Rectum, the AA group exhibited lower scores in the PAC-SYM total score (difference = -12.66, ,0.001), and the subscales: abdominal (difference = -3.36, p < .001), rectal (difference = -3.51, p < .001), and stool (difference = -5.79, p < .001), compared to those receiving usual care. The cases of constipation indicated by type 1 and type 2 of the BSF scale significantly decreased after the 8-week AA intervention. Moreover, the AA group displayed more parasympathetic dominance compared to the usual care group, with a low frequency to high frequency ratio of -1.15. Conclusion. AA is an effective non-pharmacological method for improving subjective constipation symptoms and objective stool pattern in patients with schizophrenia.
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Affiliation(s)
- Ciao-Min Gong
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ju-Han Liu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- School of Medicine, Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shiou-Shiun Yu
- Yilan Yuanshan Medical Foundation, Yilan Yuanshan Hospital, Yilan, Taiwan
| | - Yu-Ting Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Psychiatry, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan
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Rolfsen T, Vestergaard M, Hansen MF, Boisen EB, Dambæk MR. Body Fit With a Pouching System With Concave Contour for People With an Outward Peristomal Body Profile: Effects on Leakage, Wear Time, and Quality of Life: A Randomized Controlled Cross-Over Trial. J Wound Ostomy Continence Nurs 2024; 51:303-311. [PMID: 39037163 DOI: 10.1097/won.0000000000001088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
PURPOSE The purpose of the study was to investigate the fit of a two-piece pouching system with a concave-shaped skin barrier on people with an outward peristomal body profile and its effect on leakage, wear time, and quality of life (QoL) related to using an ostomy product. DESIGN Randomized, controlled, open-label, cross-over trial. SUBJECTS AND SETTINGS The sample comprised 53 subjects with outward peristomal body profiles and problems with leakage of ostomy effluent from their pouching system. Participants were randomized to the concave two-piece pouching system or a comparator (two-piece pouching system with a flat skin barrier) for 3 weeks. Subjects were then crossed over to the opposite skin barrier for an additional 3 weeks. The study was conducted in Denmark, Norway, Germany, and the Netherlands; data were collected in multiple ambulatory clinics or during home visits. METHODS The primary end point was the ability of the skin barrier to fit body contours; secondary outcomes were leakage of effluent from the pouching system, wear time, and QoL related to using an ostomy product via the validated Ostomy-Q questionnaire. Primary comparisons between concave and comparator pouching systems were evaluated using proportional odds models and mixed models taking test period into account. RESULTS Analysis included randomized subjects who had been exposed to at least one product and with information on at least one end point (full-analysis-set, n = 52). The concave pouching system provided a better fit to body contours than the comparator (P< .001) and reduced the degree of leakage underneath the skin barrier (LS mean difference = -1.84, 95% CI -3.31 to -0.37; P = .016). Participants experienced fewer episodes of leakage outside the skin barrier when using concave versus comparator pouching system (13.0% vs. 26.7%, respectively). Participants reported significant improvements in QoL (LS mean difference = 14.3; 95% CI 9.4 to 19.2; P < .001). No significant difference in wear time between skin barrier shapes was reported. CONCLUSIONS Study findings indicate that a pouching system with a concave skin barrier achieved a better body fit on people with an outward peristomal body profile and resulted in fewer leakage incidents and higher QoL compared to using a pouching system with a flat skin barrier.
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Affiliation(s)
- Thomas Rolfsen
- Thomas Rolfsen, MD, Sykepleierklinikken A/S, Larvik, Norway. Current address: Helse Nordbyen, Larvik, Norway
- Martin Vestergaard, PhD, Coloplast A/S, Humlebæk, Denmark
- Mads Fuglesang Hansen, MSc, Coloplast A/S, Humlebæk, Denmark
- Esben Bo Boisen, MSc, Coloplast A/S, Humlebæk, Denmark
- Marianne Raff Dambæk, PhD, Coloplast A/S, Humlebæk, Denmark
| | - Martin Vestergaard
- Thomas Rolfsen, MD, Sykepleierklinikken A/S, Larvik, Norway. Current address: Helse Nordbyen, Larvik, Norway
- Martin Vestergaard, PhD, Coloplast A/S, Humlebæk, Denmark
- Mads Fuglesang Hansen, MSc, Coloplast A/S, Humlebæk, Denmark
- Esben Bo Boisen, MSc, Coloplast A/S, Humlebæk, Denmark
- Marianne Raff Dambæk, PhD, Coloplast A/S, Humlebæk, Denmark
| | - Mads Fuglesang Hansen
- Thomas Rolfsen, MD, Sykepleierklinikken A/S, Larvik, Norway. Current address: Helse Nordbyen, Larvik, Norway
- Martin Vestergaard, PhD, Coloplast A/S, Humlebæk, Denmark
- Mads Fuglesang Hansen, MSc, Coloplast A/S, Humlebæk, Denmark
- Esben Bo Boisen, MSc, Coloplast A/S, Humlebæk, Denmark
- Marianne Raff Dambæk, PhD, Coloplast A/S, Humlebæk, Denmark
| | - Esben Bo Boisen
- Thomas Rolfsen, MD, Sykepleierklinikken A/S, Larvik, Norway. Current address: Helse Nordbyen, Larvik, Norway
- Martin Vestergaard, PhD, Coloplast A/S, Humlebæk, Denmark
- Mads Fuglesang Hansen, MSc, Coloplast A/S, Humlebæk, Denmark
- Esben Bo Boisen, MSc, Coloplast A/S, Humlebæk, Denmark
- Marianne Raff Dambæk, PhD, Coloplast A/S, Humlebæk, Denmark
| | - Marianne Raff Dambæk
- Thomas Rolfsen, MD, Sykepleierklinikken A/S, Larvik, Norway. Current address: Helse Nordbyen, Larvik, Norway
- Martin Vestergaard, PhD, Coloplast A/S, Humlebæk, Denmark
- Mads Fuglesang Hansen, MSc, Coloplast A/S, Humlebæk, Denmark
- Esben Bo Boisen, MSc, Coloplast A/S, Humlebæk, Denmark
- Marianne Raff Dambæk, PhD, Coloplast A/S, Humlebæk, Denmark
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Arruda MP, Lima RV, Hira S, Moreira JLML, Barbosa LIT, Zinher MT, Souza CL, Valle GSD. A Comprehensive Meta-Analysis on the Role of Analgesics and Anti-Inflammatories in Pan-Retinal Photocoagulation. Am J Ophthalmol 2024; 267:112-121. [PMID: 38942228 DOI: 10.1016/j.ajo.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/10/2024] [Accepted: 06/17/2024] [Indexed: 06/30/2024]
Abstract
PURPOSE Pan-retinal photocoagulation (PRP) is the mainstay of treatment for proliferative diabetic retinopathy (PDR), reducing the risk of severe vision loss. Pain poses a potential obstacle to effective laser delivery and patient compliance. Therefore, implementing pain relief strategies can enhance both treatment efficacy and patient comfort. DESIGN A systematic review and meta-analysis. METHODS We conducted a systematic review and meta-analysis according to PRISMA guidelines. The PubMed, Embase and Cochrane Central Register of Controlled Trials databases were searched for randomized controlled trials (RCTs) that enrolled patients undergoing PRP due to DR and compared analgesics or non-steroidal anti-inflammatory drugs (NSAID) to placebo. Pain was evaluated with the visual analogue scale. The version 2 of the Cochrane Collaboration's Risk of Bias in Randomized Controlled Trials tool and its version for crossover trials were used to assess the risk of bias. The Grading of Recommendations, Assessment, Development, and Evaluation tool was used to measure the certainty of evidence. RESULTS A total of 13 studies were included, comprising 1404 eyes from RCTs, nine of which were crossover. Patients who were administered analgesia reported a significantly lower pain sensitivity compared to those who received placebo (Standardized mean difference [SMD] -0.38; 95% confidence interval [CI] -0.58, -0.17; P < .01; I2 = 69%). Subgroup analysis of systemic administration of analgesics/NSAIDs (metamizole, Entonox, acetaminophen, ibuprofen, caffeine, mefenamic acid, intramuscular ketorolac tromethamine, and potassium diclofenac) also showed a statistically significant reduction in pain when compared to placebo (SMD -0.28; 95% CI -0.50, -0.07; P < .01; I2 = 43%). Exclusive eye drops administration (ketorolac tromethamine 0.5% and sodium diclofenac 0.1%) also showed a significant difference in pain sensitivity (SMD -0.46; 95% CI -0.88, -0.05; I2 = 83%), however with a more significant heterogeneity. CONCLUSIONS The results of this meta-analysis including over 1000 patients demonstrated that the use of analgesics significantly reduced pain sensitivity during PRP, and systemic analgesia is potentially better than topical administration when compared to placebo.
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Affiliation(s)
- Mateus P Arruda
- From the Department of Ophthalmology (M.P.A.), Instituto Penido Burnier, São Paulo, Brazil.
| | - Rian V Lima
- Universidade de Fortaleza (R.V.L.), Fortaleza, Ceará, Brazil
| | - Sara Hira
- FMH College of Medicine & Dentistry (S.H.), Lahore, Punjab, Pakistan
| | - João L M L Moreira
- Universidade Estadual de Feira de Santana (J.L.M.L.M.), Feira de Santana, Bahia, Brazil
| | | | - Mariana T Zinher
- Hospital Infantil Joana de Gusmão (M.T.Z.), Florianópolis, Santa Catarina, Brazil
| | - Camila L Souza
- Pontifícia Universidade Católica de Campinas (C.L.S.), São Paulo, Brazil
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Kaewkungwal J, Roobsoong W, Lawpoolsri S, Nguitragool W, Thammapalo S, Prikchoo P, Khamsiriwatchara A, Pawarana R, Jarujareet P, Parker DM, Sripoorote P, Kengganpanich M, Ngamjarus C, Sattabongkot J, Cui L. Effectiveness, Safety, and Acceptability of Primaquine Mass Drug Administration in Low-Endemicity Areas in Southern Thailand: Proof-of-Concept Study. JMIR Public Health Surveill 2024; 10:e51993. [PMID: 38922648 PMCID: PMC11237773 DOI: 10.2196/51993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/28/2024] [Accepted: 05/14/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND A challenge in achieving the malaria-elimination target in the Greater Mekong Subregion, including Thailand, is the predominance of Plasmodium vivax malaria, which has shown extreme resilience to control measures. OBJECTIVE This proof-of-concept study aimed to provide evidence for implementing primaquine mass drug administration (pMDA) as a strategy for P. vivax elimination in low-endemicity settings. METHODS The study employed a mixed-methods trial to thoroughly evaluate the effectiveness, safety, acceptability, and community engagement of pMDA. The quantitative part was designed as a 2-period cluster-crossover randomized controlled trial. The intervention was pMDA augmented to the national prevention and control standards with directly observed treatment (DOT) by village health volunteers. The qualitative part employed in-depth interviews and brainstorming discussions. The study involved 7 clusters in 2 districts of 2 southern provinces in Thailand with persistently low P. vivax transmission. In the quantitative part, 5 cross-sectional blood surveys were conducted in both the pMDA and control groups before and 3 months after pMDA. The effectiveness of pMDA was determined by comparing the proportions of P. vivax infections per 1000 population between the 2 groups, with a multilevel zero-inflated negative binomial model adjusted for cluster and time as covariates and the interaction. The safety data comprised adverse events after drug administration. Thematic content analysis was used to assess the acceptability and engagement of stakeholders. RESULTS In the pre-pMDA period, the proportions of P. vivax infections in the pMDA (n=1536) and control (n=1577) groups were 13.0 (95% CI 8.2-20.4) and 12.0 (95% CI 7.5-19.1), respectively. At month 3 post-pMDA, these proportions in the pMDA (n=1430) and control (n=1420) groups were 8.4 (95% CI 4.6-15.1) and 5.6 (95% CI 2.6-11.5), respectively. No statistically significant differences were found between the groups. The number of malaria cases reduced in all clusters in both groups, and thus, the impact of pMDA was inconclusive. There were no major safety concerns. Acceptance among the study participants and public health care providers at local and national levels was high, and they believed that pMDA had boosted awareness in the community. CONCLUSIONS pMDA was associated with high adherence, safety, and tolerability, but it may not significantly impact P. vivax transmission. As this was a proof-of-concept study, we decided not to scale up the intervention with larger clusters and samples. An alternative approach involving a targeted primaquine treatment strategy with primaquine and DOT is currently being implemented. We experienced success regarding effective health care workforces at point-of-care centers, effective collaborations in the community, and commitment from authorities at local and national levels. Our efforts boosted the acceptability of the malaria-elimination initiative. Community engagement is recommended to achieve elimination targets. TRIAL REGISTRATION Thai Clinical Trials Registry TCTR20190806004; https://www.thaiclinicaltrials.org/show/TCTR20190806004.
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Affiliation(s)
| | - Wanlapa Roobsoong
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Wang Nguitragool
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | | | - Amnat Khamsiriwatchara
- Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Rungrawee Pawarana
- Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Pawinee Jarujareet
- Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Daniel M Parker
- Department of Population Health and Disease Prevention, University of California, Irvine, Irvine, CA, United States
- Department of Epidemiology and Biostatistics, University of California, Irvine, Irvine, CA, United States
| | - Piyarat Sripoorote
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Mondha Kengganpanich
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Chetta Ngamjarus
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Jetsumon Sattabongkot
- Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Liwang Cui
- Division of Infectious Diseases and Internal Medicine, Department of Internal Medicine, University of South Florida, Tampa, FL, United States
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Arribas-Romano A, Fernández-Carnero J, Rodríguez-Lagos L, Molina-Álvarez M, Zabala-Zambrano J, Lezaun-Hernández L, Contreras-Padilla L, Mercado F. CPM-Related Mechanisms Could Play a Key Role in the Effects on Pain Sensitivity Induced by Manual Therapy: Three Crossover Trials Investigating the Effects of Manual Pressure. J Clin Med 2024; 13:3648. [PMID: 38999214 PMCID: PMC11242484 DOI: 10.3390/jcm13133648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/15/2024] [Accepted: 06/19/2024] [Indexed: 07/14/2024] Open
Abstract
Objective: The aim of this study is to assess whether pain-inducing manual pressure (PIMP) leads to effects on pressure pain threshold (PPT) mediated by conditioned pain modulation (CPM) and whether these effects are influenced by the intensity and repetition of the stimulus. Additionally, the influence of psychological factors and physical activity on the response to PIMP was explored. Methods: A total of 72 pain-free students were randomly assigned to three crossover trials. Trial 1 compared the effects of PIMP with the cold pressor task and pain-inducing electrostimulation. Trial 2 compared the effects of manual pressure that elicited moderate pain, mild pain, and no pain. Trial 3 compared a single PIMP stimulation with four stimuli applied at the same site or at different sites. Results: PIMP produced a lower increase in PPT than cold pressor task and no difference with electrostimulation. Manual pressure that caused moderate pain led to a greater increase in PPT compared to mild pain and pain-free application. Repetition of PIMP stimulus, whether at the same or different sites, did not significantly increase PPT compared to a single stimulation. No association with psychological factors or physical activity was found. Conclusions: PIMP produces an increase in PPT, suggesting the involvement of CPM-related mechanisms.
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Affiliation(s)
- Alberto Arribas-Romano
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (A.A.-R.); (L.R.-L.)
- Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; (M.M.-Á.); (F.M.)
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28922 Madrid, Spain
| | - Josué Fernández-Carnero
- Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; (M.M.-Á.); (F.M.)
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28922 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autonoma de Madrid, 28049 Madrid, Spain; (J.Z.-Z.); (L.L.-H.)
- La Paz Hospital Institute for Health Research, IdiPAZ, 28029 Madrid, Spain
| | - Leonardo Rodríguez-Lagos
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28933 Madrid, Spain; (A.A.-R.); (L.R.-L.)
- Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; (M.M.-Á.); (F.M.)
| | - Miguel Molina-Álvarez
- Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; (M.M.-Á.); (F.M.)
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Rey Juan Carlos University, Unidad Asociada I+D+i Instituto de Química Médica (IQM) CSIC-URJC, 28922 Alcorcón, Spain
| | - Jesús Zabala-Zambrano
- Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autonoma de Madrid, 28049 Madrid, Spain; (J.Z.-Z.); (L.L.-H.)
- Advance Rehabilitation Center Sanitas, 28046 Madrid, Spain
| | - Lucas Lezaun-Hernández
- Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autonoma de Madrid, 28049 Madrid, Spain; (J.Z.-Z.); (L.L.-H.)
- Edurne Esquide Fisioterapia, 31200 Estella, Spain
| | - Lucía Contreras-Padilla
- iCentro Fix You, 28009 Madrid, Spain;
- School of Physiotherapy ONCE, Universidad Autónoma de Madrid, 28022 Madrid, Spain
| | - Francisco Mercado
- Cognitive Neuroscience, Pain and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; (M.M.-Á.); (F.M.)
- Department of Psychology, Faculty of Health Sciences, Universidad Rey Juan Carlos, 28922 Madrid, Spain
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Farrell G, Chapple C, Kennedy E, Reily-Bell M, Sampath K, Gisselman AS, Cook C, Katare R, Tumilty S. Autonomic nervous system and endocrine system response to upper or lower cervical spine mobilization in males with persistent post-concussion symptoms: a proof-of-concept trial. J Man Manip Ther 2024:1-17. [PMID: 38904298 DOI: 10.1080/10669817.2024.2363018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 05/29/2024] [Indexed: 06/22/2024] Open
Abstract
INTRODUCTION The peripheral stress response, consisting of the autonomic nervous system (ANS) and hypothalamic pituitary adrenal-axis (HPA-axis), functions to maintain homeostasis in response to stressors. Cervical spine manual therapy has been shown to differentially modulate the stress response in healthy populations. No study has investigated whether cervical spine mobilizations can differentially modulate the stress response in individuals with persistent post-concussion symptoms (PPCS), a population characterized by a dysfunctional stress response. METHODS A randomized, controlled, parallel design trial was performed to investigate whether upper or lower cervical spine mobilization can differentially modulate components of the stress response in individuals with PPCS. The outcomes were salivary cortisol (sCOR) concentration (primary) and the HRV metric, rMSSD, measured with a smartphone application (secondary). Nineteen males diagnosed with PPCS, aged 19-35, were included. Participants were randomly assigned into either intervention group, upper (n = 10) or lower (n = 9) cervical spine mobilization. Each outcome was collected at different time points, pre- and post-intervention. Statistical analyses were performed using the Friedman's Two-Way ANOVA, Mann-Whitney U test, and Wilcoxon Signed Rank Test. RESULTS There was a statistically significant within-group reduction in sCOR concentration 30 minutes following lower cervical spine mobilizations and statistically significant within-group increase in rMSSD 30 minutes following upper cervical spine mobilizations. CONCLUSION The results of this trial provide preliminary evidence for cervical spine mobilizations to differentially modulate components of the stress response at specific time points. Understanding the mechanisms of the effect of cervical spine mobilizations on the stress response provides a novel rationale for selecting cervical spine mobilizations to rehabilitate individuals with PPCS.
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Affiliation(s)
- Gerard Farrell
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand
| | - Cathy Chapple
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand
| | - Ewan Kennedy
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand
| | - Matthew Reily-Bell
- Department of Physiology, HeartOtago, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Kesava Sampath
- Centre for Health and Social Practice, Waikato Institute of Technology-Rotokauri Campus, Hamilton, Waikato, New Zealand
| | | | - Chad Cook
- Doctor of Physical Therapy Program, Duke University, Durham, NC, USA
| | - Rajesh Katare
- Department of Physiology, HeartOtago, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Steve Tumilty
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand
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Hébert-Losier K, Fernandez MR, Athens J, Kubo M, O'Neill S. A randomised crossover trial on the effects of foot starting position on calf raise test outcomes: Position does matter. Foot (Edinb) 2024; 60:102112. [PMID: 38905944 DOI: 10.1016/j.foot.2024.102112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 06/12/2024] [Accepted: 06/15/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND This randomised crossover study with repeated measures examined the influence of the three most common foot starting positions used in conducting the calf raise test (CRT) on test outcomes. This study also accounted for the potential influence of gender, age, body mass index (BMI), and level of physical activity on test outcomes. METHODS Forty-nine healthy individuals (59 % female, 21 ± 4 years) performed single-leg calf raise repetitions in a human movement laboratory in three randomised foot starting positions: flat, 10° incline, and step. The validated Calf Raise application was used to track the vertical displacement of a marker placed on the foot using computer vision. The application extracted the following CRT outcomes from the vertical displacement curve: number of repetitions, peak vertical height, total vertical displacement, and total positive work. Data were analysed using mixed-effects models and stepwise regression. RESULTS There was a significant main effect (P < 0.001) of foot starting position on all outcomes, with all paired comparisons being statistically significant (P ≤ 0.023). Repetitions, total vertical displacement, and total positive work were greatest in flat and lowest in step, whereas peak vertical height was greatest in incline and lowest in step. Gender (P = 0.021; males>females) and BMI (P = 0.002; lower BMI>higher BMI) significantly influenced the number of repetitions. Gender (P < 0.001; males>females) also influenced total positive work. Age and physical activity levels did not significantly influence CRT outcomes. CONCLUSIONS CRT foot starting position mattered and significantly affected all CRT outcomes. CRT foot starting position needs consideration when contrasting data in research and practice.
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Affiliation(s)
- Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand.
| | - Ma Roxanne Fernandez
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand; Department of Physical Therapy, College of Rehabilitation Sciences, University of Santo Tomas, Philippines.
| | - Josie Athens
- Systems Biology Enabling Platform, AgResearch Ltd, Invermay Agricultural Centre, 176 Puddle Alley, Mosgiel 9022, New Zealand
| | - Masayoshi Kubo
- Department of Physical Therapy, Niigata University of Health and Welfare, Japan
| | - Seth O'Neill
- School of Healthcare, Life Sciences, University of Leicester, United Kingdom
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Ignatova-Mishutina T, Khoury-Ribas L, Flores-Orozco EI, Rovira-Lastra B, Martinez-Gomis J. Influence of masticatory side switch frequency on masticatory mixing ability and sensory perception in adults with healthy dentitions: A randomized crossover trial. J Prosthet Dent 2024; 131:1093-1103. [PMID: 37062609 DOI: 10.1016/j.prosdent.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 04/18/2023]
Abstract
STATEMENT OF PROBLEM The advantages and disadvantages of frequently changing sides while masticating remain unclear. PURPOSE The purpose of this clinical study was to determine the effect of varying the frequency of masticatory side switches on masticatory mixing ability and sensory perception in dentate adults. MATERIAL AND METHODS This nonblinded, randomized 12-period crossover study, conducted at Barcelona Dental School from January to March 2022, included 36 healthy adults with natural dentitions (median age, 23.5 years; 26 women). Participants were randomly allocated to 12 sequences and performed 12 masticatory assays masticating a 2-colored gum for 40 cycles each using the following masticatory styles as interventions: freestyle, unilateral right, unilateral left, and switching sides 5%, 15%, and 25%. The primary outcome was the mixing ability index (MAI), defined as the standard deviation of the red channel intensity of the masticated gum in the color-histogram plugin of the ImageJ software program. Participants also rated the perceived flavor intensity and salivary flow on a visual analog scale. Data were analyzed by repeated measures analysis of variance (α=.05). RESULTS The MAI was similar for all masticatory styles (P=.63). Participants perceived greater flavor intensity (mean difference: 8%, 95% CI: 1% to 15%) and salivary flow (mean difference: 11%, 95% CI: 0% to 21%) with 25% side switching compared with freestyle or unilateral mastication. CONCLUSIONS Frequently switching the masticatory side while masticating gum does not alter the mixing ability, but it appears to enhance salivary flow and flavor intensity.
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Affiliation(s)
- Tatiana Ignatova-Mishutina
- PhD Student, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Catalonia, Spain
| | - Laura Khoury-Ribas
- Assistant Professor, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Catalonia, Spain
| | - Elan Ignacio Flores-Orozco
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Autonomous University of Nayarit, Tepic, Mexico
| | - Bernat Rovira-Lastra
- Assistant Professor, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Catalonia, Spain
| | - Jordi Martinez-Gomis
- Associate Professor, Serra Hunter Fellow, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona, Catalonia, Spain; and Researcher, Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain.
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27
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Doğan Ö, Sönmez H, Doğan SSA. Comfort and wearability properties of custom-made and boil-and-bite mouthguards among basketball players: A randomized parallel arm clinical trial. Dent Traumatol 2024; 40:251-265. [PMID: 38234013 DOI: 10.1111/edt.12918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND/AIM Thermoplastic mouthguards have been a reliable means of protection against impacts and shocks for a century. Although orofacial injuries are prevalent among basketball players, many athletes still avoid using mouthguards due to concerns regarding impaired breathing, speech interference, and nausea. This study aims to compare basketball players' subjective assessments of two different thicknesses of custom-made mouthguards (MGs) with boil-and-bite MGs (B&B MG). MATERIAL AND METHODS A total of 60 systematically healthy male professional basketball players, without active orthodontic treatment, were enrolled and randomly assigned to three groups: Group 1 (received B&B MGs; n = 20), Group 2 (received custom-made MGs with a 3 mm thickness [ethyl vinyl asetat]; n = 20), and Group 3 (received custom-made MGs with a 5 mm thickness; n = 20). To evaluate MG comfort and usability, 12 key factors, including comfort, fit, stability, tiredness, thirsting, oral dryness, nausea, speaking, breathing, drinking, ease of wear and removal, and inclination to chew, were assessed. The athletes were made to rate these factors using a 10 cm-long Visual Analog Scale, measured at three-time intervals, and the values for both inter-group and intra-group were compared. RESULTS Data from 48 basketball players were retrieved, and data analysis revealed that B&B MGs had the least favorable parameter values. Among the B&B MG group, stability was reported to be poorer during the initial measurement (p < .05). In the second measurement, B&B MGs showed significantly lower values for comfort, stability, tiredness, speaking, and inclination to chew (p < .05). During the third measurement, the B&B MG group exhibited significantly reduced values for comfort, breathing, drinking, and speaking (p < .05). In contrast, no statistically significant difference was observed between 3 and 5 mm thickness MGs in these measurements. CONCLUSIONS Custom-made MGs with different thicknesses consistently outperformed B&B MGs in all measurements, indicating the potential to tailor MG thickness based on sport, age, professional level of athlete, and presence of other protective equipment. While custom-made mouthguards are considered the gold standard, dentists who provide B&B MGs can lead to cost savings while maintaining protection and encouraging athletes to use higher-quality custom-made mouthguards.
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Affiliation(s)
- Özgür Doğan
- Department of Pediatric Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Türkiye
| | - Hayriye Sönmez
- Department of Pediatric Dentistry, Altınbaş University, İstanbul, Türkiye
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28
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Dutil C, Podinic I, Featherstone RB, Eaton A, Sadler CM, Goldfield GS, Hadjiyannakis S, Gruber R, Tremblay MS, Prud’homme D, Chaput JP. Sleep and insulin sensitivity in adolescents at risk of type 2 diabetes: the Sleep Manipulation in Adolescents at Risk of Type 2 Diabetes randomized crossover study. Sleep 2024; 47:zsad313. [PMID: 38070132 PMCID: PMC11082473 DOI: 10.1093/sleep/zsad313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/01/2023] [Indexed: 01/21/2024] Open
Abstract
STUDY OBJECTIVES To investigate the effect of increasing sleep duration for 1 week, compared to a week of habitual and decreased sleep, on insulin sensitivity (IS) in adolescents at risk for type 2 diabetes (T2D). METHODS Adolescents, 13-18 years old, at risk for T2D, with obesity and other risk factors, were recruited for a randomized (1:1), open-label, sex-stratified crossover study, that manipulated time-in-bed to modify sleep duration (measured by actigraphy). Following a week of habitual (HB) sleep, time-in-bed was increased (IN) and decreased (DE) by 1 hour 30 min/night for 1 week, counterbalanced across participants (HBINDE or HBDEIN), and separated by a week of washout sleep. The main outcome measure was IS, obtained via 2-hour oral-glucose-tolerance-test conducted after each sleep week. RESULTS Of the 43 participants recruited, 36 (84%) completed all sleep interventions (52.8% female, age = 15.1 years, body mass index = 99.9th percentile, order: HBINDE = 18 and HBDEIN = 18). On average, during the HB week, participants slept 7 hours 31 min/night; sleep duration was 1 hour 02 min/night higher during the IN week and 1 hour 19 min/night lower during the DE week. We found a significant effect of sleep week on IS with a large effect size. Following the IN sleep week, IS was 20% higher compared to after the HB and DE sleep weeks, but there was no significant difference in IS following HB versus DE sleep weeks. CONCLUSIONS Whenever possible, clinicians should empower youth at risk of T2D to improve their sleep duration, since even a modest increase in sleep duration of 1 h/night for 1 week can have a positive impact on IS in this population. CLINICAL TRIALS Sleep Extension and IS in Adolescents, https://clinicaltrials.gov/study/NCT03754036, November 23rd, 2018. TRIAL REGISTRATION ClinicalTrials.gov (ID:NCT03754036).
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Affiliation(s)
- Caroline Dutil
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Irina Podinic
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Ryan B Featherstone
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Centre for Healthy Active Living (CHAL), Children’s Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - Amelia Eaton
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Christin M Sadler
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Gary S Goldfield
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Stasia Hadjiyannakis
- Centre for Healthy Active Living (CHAL), Children’s Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Reut Gruber
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Attention, Behaviour and Sleep Lab, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
| | - Denis Prud’homme
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Université de Moncton, Moncton, NB, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
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Mbuli C, Vuchas C, Konso J, Adamou Mana Z, Ngangue YR, Esther N, Nyah Ndi N, Wandji IAG, Fundoh M, Ganava M, Malama T, Denis N, Teyim P, Bisso A, Snijders R, Mitchell EM, Hasker E, Soma I, Sander M, Mitarai S. Use of the Lung Flute ECO to assist in sputum collection for tuberculosis testing: a randomised crossover trial. ERJ Open Res 2024; 10:00902-2023. [PMID: 38803415 PMCID: PMC11129641 DOI: 10.1183/23120541.00902-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/22/2023] [Indexed: 05/29/2024] Open
Abstract
The Lung Flute ECO, a self-powered, low-cost oscillatory positive expiratory pressure device, assisted people with presumptive tuberculosis to produce an adequate sputum volume for diagnostic testing and was well tolerated https://bit.ly/47sDq8W.
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Affiliation(s)
- Cyrille Mbuli
- Center for Health Promotion and Research, Bamenda, Cameroon
| | - Comfort Vuchas
- Center for Health Promotion and Research, Bamenda, Cameroon
| | - Joceline Konso
- Center for Health Promotion and Research, Bamenda, Cameroon
| | | | | | - Neba Esther
- Bamenda Regional Hospital, Bamenda, Cameroon
| | - Norah Nyah Ndi
- Cameroon Baptist Convention Health Services and Baptist Institute of Health Sciences, Bamenda, Cameroon
| | | | - Mercy Fundoh
- National TB Program – Northwest Region, Bamenda, Cameroon
| | - Maurice Ganava
- National TB Program – Far North Region, Maroua, Cameroon
| | | | - Nsame Denis
- Bamenda Regional Hospital, Bamenda, Cameroon
| | - Pride Teyim
- Tuberculosis Reference Laboratory Douala, Douala, Cameroon
| | | | | | | | - Epco Hasker
- Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Melissa Sander
- Center for Health Promotion and Research, Bamenda, Cameroon
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Peek K, Franchi M, Lemmink K, Balsom P, Meyer T. Quality Criteria for Studies Assessing the Acute Effects of Heading: Results from a UEFA Expert Panel. Sports Med 2024; 54:1089-1095. [PMID: 38150166 PMCID: PMC11127840 DOI: 10.1007/s40279-023-01977-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 12/28/2023]
Abstract
There is increasing concern regarding the effects of heading in football on brain health including cognitive, behavioural and neuromotor function, with research suggesting an association between repeated ball-head impacts and neurodegenerative disease. While longitudinal studies to determine the long-term consequences of heading are challenging, there have been short-term 'acute' studies conducted, with some studies lacking appropriate methodology to ensure valid results. The Union of European Football Associations (UEFA) established a panel of experts to determine methodological recommendations for the conduct of studies that explore the acute effects of heading (defined as a single session of heading conducted either in a laboratory setting or following match play or a training session). The aim of this panel was to create quality criteria for acute heading studies that will form part of the eligibility assessment when applying for UEFA research funding (although the criteria can be applied to the conduct of acute heading research more widely). This process was deemed necessary to counter studies with poor methodological quality that used heading trials that did not accurately represent player exposure to ball-head impacts through football practice and match play (such as small sample sizes, unrealistically high heading exposure, and a lack of consideration of confounding variables). The panel identified core design decisions that authors should consider when designing and conducting acute heading research, with key methodological requirements for each domain pertaining to participants, heading trials, confounding variables, statistics and dependent/target variables and their measurement. After two rounds of reviews, the final list of quality criteria was agreed by the panel and will be applied to the next round of UEFA grant applications.
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Affiliation(s)
- Kerry Peek
- Discipline of Physiotherapy, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Martino Franchi
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Koen Lemmink
- Department of Human Movement Sciences, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Paul Balsom
- Swedish Football Association, Solna, Stockholm, Sweden
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarland, Germany
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Tunn R, Boutron I, Chan AW, Collins GS, Hróbjartsson A, Moher D, Schulz KF, de Beyer JA, Hansen Nejstgaard C, Østengaard L, Hopewell S. Methods used to develop the SPIRIT 2024 and CONSORT 2024 Statements. J Clin Epidemiol 2024; 169:111309. [PMID: 38428538 DOI: 10.1016/j.jclinepi.2024.111309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVES To describe, and explain the rationale for, the methods used and decisions made during development of the updated SPIRIT 2024 and CONSORT 2024 reporting guidelines. METHODS We developed SPIRIT 2024 and CONSORT 2024 together to facilitate harmonization of the two guidelines, and incorporated content from key extensions. We conducted a scoping review of comments suggesting changes to SPIRIT 2013 and CONSORT 2010, and compiled a list of other possible revisions based on existing SPIRIT and CONSORT extensions, other reporting guidelines, and personal communications. From this, we generated a list of potential modifications or additions to SPIRIT and CONSORT, which we presented to stakeholders for feedback in an international online Delphi survey. The Delphi survey results were discussed at an online expert consensus meeting attended by 30 invited international participants. We then drafted the updated SPIRIT and CONSORT checklists and revised them based on further feedback from meeting attendees. RESULTS We compiled 83 suggestions for revisions or additions to SPIRIT and/or CONSORT from the scoping review and 85 from other sources, from which we generated 33 potential changes to SPIRIT (n = 5) or CONSORT (n = 28). Of 463 participants invited to take part in the Delphi survey, 317 (68%) responded to Round 1, 303 (65%) to Round 2 and 290 (63%) to Round 3. Two additional potential checklist changes were added to the Delphi survey based on Round 1 comments. Overall, 14/35 (SPIRIT n = 0; CONSORT n = 14) proposed changes reached the predefined consensus threshold (≥80% agreement), and participants provided 3580 free-text comments. The consensus meeting participants agreed with implementing 11/14 of the proposed changes that reached consensus in the Delphi and supported implementing a further 4/21 changes (SPIRIT n = 2; CONSORT n = 2) that had not reached the Delphi threshold. They also recommended further changes to refine key concepts and for clarity. CONCLUSION The forthcoming SPIRIT 2024 and CONSORT 2024 Statements will provide updated, harmonized guidance for reporting randomized controlled trial protocols and results, respectively. The simultaneous development of the SPIRIT and CONSORT checklists has been informed by current empirical evidence and extensive input from stakeholders. We hope that this report of the methods used will be helpful for developers of future reporting guidelines.
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Affiliation(s)
- Ruth Tunn
- Oxford Clinical Trials Research Unit, University of Oxford, Oxford, UK; Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Isabelle Boutron
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), F-75004 Paris, France; Centre d'Epidémiologie Clinique, AP-HP, Hôpital Hôtel Dieu, Paris, France
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Gary S Collins
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK; UK EQUATOR Centre, University of Oxford, Oxford, UK
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Kenneth F Schulz
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer A de Beyer
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK; UK EQUATOR Centre, University of Oxford, Oxford, UK
| | - Camilla Hansen Nejstgaard
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Lasse Østengaard
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, University of Oxford, Oxford, UK; Centre for Statistics in Medicine, University of Oxford, Oxford, UK.
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Gambazza S, Mariani A, Guarise R, Ferrari B, Carta F, Brivio A, Bizzarri S, Castellani C, Colombo C, Laquintana D. Short-term effects of positive expiratory pressure mask on ventilation inhomogeneity in children with cystic fibrosis: A randomized, sham-controlled crossover study. Pediatr Pulmonol 2024; 59:1354-1363. [PMID: 38362833 DOI: 10.1002/ppul.26915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/23/2023] [Accepted: 01/31/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Can physiotherapy with a positive expiratory pressure (PEP) mask improve peripheral ventilation inhomogeneity, a typical feature of children with cystic fibrosis (cwCF)? To answer this question, we used the nitrogen multiple-breath washout (N2MBW) test to measure diffusion-convection-dependent inhomogeneity arising within the intracinar compartment (Sacin*VT). METHODS For this randomized, sham-controlled crossover trial, two N2MBW tests were performed near the hospital discharge date: one before and the other after PEP mask therapy (1 min of breathing through a flow-dependent PEP device attached to a face mask, followed by three huffs and one cough repeated 10 times) by either a standard (10-15 cmH20) or a sham (<5 cmH20) procedure on two consecutive mornings. Deception entailed misinforming the subjects about the nature of the study; also the N2MBW operators were blinded to treatment allocation. Study outcomes were assessed with mixed-effect models. RESULTS The study sample was 19 cwCF (ten girls), aged 11.4 (2.7) years. The adjusted Sacin*VT mean difference between the standard and the sham procedure was -0.015 (90% confidence interval [CI]: -∞ to 0.025) L-1. There was no statistically significant difference in Scond*VT and lung clearance index between the two procedures: -0.005 (95% CI: -0.019 to 0.01) L-1 and 0.49 (95% CI: -0.05 to 1.03) turnovers, respectively. CONCLUSION Our findings do not support evidence for an immediate effect of PEP mask physiotherapy on Sacin*VT with pressure range 10-15 cmH20. Measurement with the N2MBW and the crossover design were found to be time-consuming and unsuitable for a short-term study of airway clearance techniques.
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Affiliation(s)
- Simone Gambazza
- Healthcare Professions Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Mariani
- Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Riccardo Guarise
- Cystic Fibrosis Centre, University Hospital of Verona, Verona, Italy
| | - Beatrice Ferrari
- Rehabilitation Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Federica Carta
- Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Brivio
- Healthcare Professions Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sofia Bizzarri
- Rehabilitation Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Chiara Castellani
- Rehabilitation Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Carla Colombo
- Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Dario Laquintana
- Healthcare Professions Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Tsumanuma FK, Hembecker PK, Claus CMP, Loureiro MDP, Reinert F, Abreu de Souza M. Effect of laparoscopic handle size on surgical performance: A randomized crossover trial. Med Eng Phys 2024; 127:104165. [PMID: 38692768 DOI: 10.1016/j.medengphy.2024.104165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/02/2024] [Accepted: 04/02/2024] [Indexed: 05/03/2024]
Abstract
Laparoscopic instrument handles design and dimensions are crucial to determine the configuration of surgeons' hand grip and, therefore, can have a deleterious effect on overall surgical efficiency and surgeons' comfort. The aim of this study is to investigate the impact of laparoscopic handle size and hand surface area on surgical task performance. A single-blind, randomized crossover trial was carried out with 29 novice medical students. Participants performed three simulated tasks in "black box" simulators using two scissor-type handles of different sizes. Surgical performance was assessed by the number of errors and time required to complete each task. Hand anthropometric data were measured using a 3D scanner. Execution time was significantly higher when cutting and suturing tasks were performed with the smaller handle. In addition, hand surface area was positively correlated with peg transfer task time when performed with the standard handle and was correlated with cutting task time in small and standard handle groups. We also found positive correlations between execution time and the number of errors executed by larger-handed participants. Our findings indicate that laparoscopic handle size and hand area influence surgical performance, highlighting the importance of considering hand anthropometry variances in surgical instrument design.
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Affiliation(s)
- Fernanda Keiko Tsumanuma
- Graduate Program in Health Technology, Pontifical Catholic University of Paraná (PUC-PR), Imaculada Conceição St., 1155, Curitiba, Paraná, 80215-901, Brazil
| | - Paula Karina Hembecker
- Graduate Program in Health Technology, Pontifical Catholic University of Paraná (PUC-PR), Imaculada Conceição St., 1155, Curitiba, Paraná, 80215-901, Brazil.
| | - Christiano Marlo Paggi Claus
- Department of Surgery, Nossa Senhora das Graças Hospital, Alcides Munhoz St., 433, Curitiba, Paraná, 80810-040, Brazil
| | - Marcelo de Paula Loureiro
- Graduate Program in Industrial Biotechnology, Positivo University, Prof. Pedro Viriato Parigot de Souza St., 5.300, Curitiba, Paraná, 80740-050, Brazil
| | - Fabíola Reinert
- Department of Design and Graphic Expression, Federal University of Santa Catarina (UFSC), Campus Universitário Reitor João David Ferreira Lima, s/n, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Mauren Abreu de Souza
- Graduate Program in Health Technology, Pontifical Catholic University of Paraná (PUC-PR), Imaculada Conceição St., 1155, Curitiba, Paraná, 80215-901, Brazil
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Van der Weegen W, Van Egmond JC, Geuze RE, Gosens T, Snoeker B, Poolman RW. A simplified, 2-question grading system for evaluating abstracts in orthopedic scientific meetings: a serial randomization study. Acta Orthop 2024; 95:180-185. [PMID: 38629944 PMCID: PMC11022873 DOI: 10.2340/17453674.2024.40504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND AND PURPOSE Efficient abstract scoring for congress presentation is important. Given the emergence of new study methodologies, a scoring system that accommodates all study designs is warranted. We aimed to assess the equivalence of a simplified, 2-question abstract grading system with a more complex currently used system in assessing abstracts submitted for orthopedic scientific meetings in a serial randomized study. METHODS Dutch Orthopedic Association Scientific Committee (DOASC) members were randomized to grade abstracts using either the current grading system, which includes up to 7 scoring categories, or the new grading system, which consists of only 2 questions. Pearson correlation coefficient and mean abstract score with 95% confidence intervals (CI) were calculated. RESULTS Analysis included the scoring of 195 abstracts by 12-14 DOASC members. The average score for an abstract using the current system was 60 points (CI 58-62), compared with 63 points (CI 62-64) using the new system. By using the new system, abstracts were scored higher by 3.3 points (CI 1.7-5.0). Pearson correlation was poor with coefficient 0.38 (P < 0.001). CONCLUSION The simplified abstract grading system exhibited a poor correlation with the current scoring system, while the new system offers a more inclusive evaluation of varying study designs and is preferred by almost all DOASC members.
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Affiliation(s)
| | | | - Ruth E Geuze
- Department of Orthopedics, Elisabeth-Tweesteden Ziekenhuis, Tilburg
| | - Taco Gosens
- Department of Orthopedics, Elisabeth-Tweesteden Ziekenhuis, Tilburg
| | - Barbara Snoeker
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Medical Center, University of Amsterdam
| | - Rudolf W Poolman
- Department of Orthopedics, Leiden University Medical Center, Leiden; Department of Orthopedics, Joint Research, OLVG, Amsterdam, the Netherlands
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Elma Ö, Tümkaya Yılmaz S, Nijs J, Clarys P, Coppieters I, Mertens E, Malfliet A, Deliens T. Impaired Carbohydrate Metabolism among Women with Chronic Low Back Pain and the Role of Dietary Carbohydrates: A Randomized Controlled Cross-Over Experiment. J Clin Med 2024; 13:2155. [PMID: 38610920 PMCID: PMC11012557 DOI: 10.3390/jcm13072155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/29/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Impaired glucose regulation is suggested to be related to chronic low back pain (CLBP), although it is not clear how they interact with each other. Thus, the primary aim of this study was to investigate differences in postprandial glycemic responses (PPGRs) (the first sign of impaired glucose metabolism) to high- (sucrose) and low-glycemic index (GI) (isomaltulose) beverages in normoglycemic women with CLBP and healthy controls (HCs) and explore whether any group that showed greater PPGRs to high-GI beverage intake would benefit when the high-GI beverage was replaced with a low-GI beverage. Secondly, this study aimed to explore the association between PPGR and pain in patients with CLBP. Methods: This study was registered at clinicaltrials.org (NCT04459104) before the start of the study. In this study, 53 CLBP patients and 53 HCs were recruited. After 11-12 h of fasting, each participant randomly received isomaltulose or sucrose. Blood glucose levels were measured during the fasting state and 15, 30, 45, 60, 90, and 120 min after the beverage intake, and each participant underwent experimental pain measures. Results: Compared to the HCs, the CLBP group showed significantly higher PPGRs to sucrose (p < 0.021). Additionally, the CLBP group showed a significantly higher decrease in PPGR (p = 0.045) when comparing PPGR to sucrose with PPGR to isomaltulose. Correlation analysis revealed a positive association between self-reported pain sensitivity and PPGR to sucrose, while there was no association found between any experimental pain measures and glycemic responses. Conclusions: Overall, these findings suggest that normoglycemic CLBP patients might have a higher risk of developing impaired glucose tolerance than the HCs and might benefit more when high-GI foods are replaced with low-GI ones.
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Affiliation(s)
- Ömer Elma
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (J.N.); (I.C.); (A.M.)
- Physiotherapy Unit, Department of Rehabilitation and Sport Sciences, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth BH8 8GP, UK
| | - Sevilay Tümkaya Yılmaz
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (J.N.); (I.C.); (A.M.)
| | - Jo Nijs
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (J.N.); (I.C.); (A.M.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital, 1090 Brussel, Belgium
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Peter Clarys
- Movement and Nutrition for Health and Performance (MOVE) Research Group, Department of Movement and Sport Sciences, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (P.C.); (E.M.); (T.D.)
| | - Iris Coppieters
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (J.N.); (I.C.); (A.M.)
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital, 1090 Brussel, Belgium
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
| | - Evelien Mertens
- Movement and Nutrition for Health and Performance (MOVE) Research Group, Department of Movement and Sport Sciences, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (P.C.); (E.M.); (T.D.)
- Nutrition and Dietetics Program, Department of Health Care, Design and Technology, Erasmushogeschool Brussel, 1090 Brussels, Belgium
| | - Anneleen Malfliet
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (J.N.); (I.C.); (A.M.)
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
| | - Tom Deliens
- Movement and Nutrition for Health and Performance (MOVE) Research Group, Department of Movement and Sport Sciences, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (P.C.); (E.M.); (T.D.)
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Alqaisi NN, Haddad RA, Amasha HM. Effectiveness of a low-intensity static magnetic field in accelerating upper canine retraction: a randomized controlled clinical trial. BMC Oral Health 2024; 24:424. [PMID: 38582881 PMCID: PMC10998372 DOI: 10.1186/s12903-024-04212-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/31/2024] [Indexed: 04/08/2024] Open
Abstract
INTRODUCTION Neodymium-iron-boron magnets have been suggested as a contemporary method for accelerating the process of orthodontic tooth movement (OTM). A limited number of clinical trials evaluated their effectiveness in accelerating OTM which is desirable for both orthodontists and patients. The present study aimed to investigate the effectiveness of a low-intensity static magnetic field (SMF) in accelerating upper canine retraction movement. MATERIALS AND METHODS Seventeen patients (mean age 20.76 ± 2.9 years) with their orthodontic treatment decision to extract the upper and lower first premolars due to bimaxillary protrusion malocclusion were included in this split-mouth study. Canine retraction was performed using Nickel-titanium (Ni-Ti) closed-coil springs (150 g of force on each side). The experimental side received SMF via an auxiliary wire that carried 4-neodymium iron-born magnets with an air gap of 2 mm between the magnets to produce a magnetic field density of 414 mT in the region corresponding to the lateral ligament of the upper canine. To determine the rate of upper canine retraction and upper molar drift, alginate impressions were taken once a month to create plaster casts, which were analyzed digitally via a three-dimensional method. RESULTS The rate of upper canine retraction was significantly greater (P < 0.05) on the SMF side than that on the control side during the first and second months, with an overall duration (19.16%) that was greater than that on the control side. The peak acceleration occurred during the second month (38.09%). No significant differences in upper molar drift were detected between the experimental and control sides (P > 0.05). CONCLUSION A low-intensity static magnetic field was effective at accelerating upper canine retraction. The difference between the two sides was statistically significant but may not be clinically significant. The SMF did not affect upper molar drift during the upper canine retraction phase. TRIAL REGISTRATION The trial was retrospectively registered at the ISRCTN registry ( ISRCTN59092624 ) (31/05/2022).
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Affiliation(s)
- Nataly N Alqaisi
- Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria.
| | - Rania A Haddad
- Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Hani M Amasha
- Department of Biomedical Engineering, Faculty of Electrical Engineering, Damascus University, Damascus, Syria
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Falcone V, Catic A, Heinzl F, Steinbauer P, Wagner M, Mikula F, Dorittke T, Roessler B, Farr A. Impact of a virtual reality-based simulation training for shoulder dystocia on human and technical skills among caregivers: a randomized-controlled trial. Sci Rep 2024; 14:7898. [PMID: 38570525 PMCID: PMC10991516 DOI: 10.1038/s41598-024-57785-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
This study analyzed the adherence to the modified Advanced Life Support in Obstetrics (ALSO) algorithm (HELP-RER) for handling shoulder dystocia (SD) using a virtual reality (VR) training modality. Secondary outcomes were improvements in the post-training diagnosis-to-delivery time, human skills factors (HuFSHI), and perceived task-load index (TLX). Prospective, case-control, single-blind, 1:1 randomized crossover study. Participants were shown a 360° VR video of SD management. The control group was briefed theoretically. Both groups underwent HuFSHI and HELP-RER score assessments at baseline and after the manikin-based training. The TLX questionnaire was then administered. After a washout phase of 12 weeks, we performed a crossover, and groups were switched. There were similar outcomes between groups during the first training session. However, after crossover, the control group yielded significantly higher HELP-RER scores [7 vs. 6.5; (p = 0.01)], with lower diagnosis-to-delivery-time [85.5 vs. 99 s; (p = 0.02)], and TLX scores [57 vs. 68; (p = 0.04)]. In the multivariable linear regression analysis, VR training was independently associated with improved HELP-RER scores (p = 0.003). The HuFSHI scores were comparable between groups. Our data demonstrated the feasibility of a VR simulation training of SD management for caregivers. Considering the drawbacks of common high-fidelity trainings, VR-based simulations offer new perspectives.
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Affiliation(s)
- Veronica Falcone
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Anja Catic
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Florian Heinzl
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Philipp Steinbauer
- Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Michael Wagner
- Division of Neonatology, Pediatric Intensive Care Medicine and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Fanny Mikula
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Tim Dorittke
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Bernhard Roessler
- Medical Simulation and Emergency Management Research Group, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Alex Farr
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Lönn M, Svedberg P, Nygren J, Jarbin H, Aili K, Larsson I. The efficacy of weighted blankets for sleep in children with attention-deficit/hyperactivity disorder-A randomized controlled crossover trial. J Sleep Res 2024; 33:e13990. [PMID: 37452697 DOI: 10.1111/jsr.13990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
Weighted blankets are a non-pharmacological intervention for treating sleep and anxiety problems in children with attention-deficit/hyperactivity disorder. However, research on the efficacy of weighted blankets is sparse. The aim of this randomized controlled trial with a crossover design (4 + 4 weeks) was to evaluate the efficacy of weighted blankets on sleep among children with attention-deficit/hyperactivity disorder and sleeping problems. Children diagnosed with uncomplicated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition attention-deficit/hyperactivity disorder with verified sleep problems were randomized to start with either a weighted blanket or a lighter control blanket. Data collection was performed at weeks 0, 4 and 8 using actigraphy, questionnaires and a daily sleep diary. T-tests were used to evaluate efficacy. The study included 94 children with attention-deficit/hyperactivity disorder (mean age 9.0 [sd 2.2] years; 54 [57.4%] boys). Weighted blankets had a significant effect on total sleep time (mean diff. 7.72 min, p = 0.027, Cohen's d = 0.24), sleep efficiency (mean diff. 0.82%, p = 0.038, Cohen's d = 0.23) and wake after sleep onset (mean diff. -2.79 min, p = 0.015, Cohen's d = -0.27), but not on sleep-onset latency (p = 0.432). According to our exploratory subgroup analyses, weighted blankets may be especially beneficial for improving total sleep time in children aged 11-14 years (Cohen's d = 0.53, p = 0.009) and in children with the inattentive attention-deficit/hyperactivity disorder subtype (Cohen's d = 0.58, p = 0.016). Our results suggest that weighted blankets may improve children's sleep and could be used as an alternative to pharmacological sleep interventions.
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Affiliation(s)
- Maria Lönn
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Psychiatry Halland, Region Halland, Halmstad, Sweden
| | - Petra Svedberg
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Jens Nygren
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Håkan Jarbin
- Department of Child and Adolescent Psychiatry, Region Halland, Halmstad, Sweden
- Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
| | - Katarina Aili
- Department of Health and Sport, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Ingrid Larsson
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Schepers L, Jans I, Pot GK, Smilde AJ, Hofstra JM, de Roos NM. The Effect of Niacinamide Supplementation on Phosphate Concentrations in Dutch Dialysis Patients: A Randomized Crossover Trial. J Ren Nutr 2024:S1051-2276(24)00036-0. [PMID: 38492684 DOI: 10.1053/j.jrn.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/19/2023] [Accepted: 02/12/2024] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE Hyperphosphatemia is a common complication in patients with kidney failure, despite the use of phosphate binders. Vitamin B3, either in the form of niacin or niacinamide (NAM), shows potential as "add-on" treatment to reduce serum phosphate concentrations in this population. NAM seems to lack many of the side effects that are observed with niacin. The aim of this study was to investigate whether NAM is an effective and acceptable treatment in reducing serum phosphate concentrations in patients with kidney failure. METHODS DiaNia was a double-blind placebo-controlled randomized crossover trial, comparing NAM (250-500 mg/day) to placebo as "add-on" treatment to an individual treatment with approved phosphate binders for 12 weeks in patients receiving hemodialysis. The primary outcome was serum phosphate concentrations, and the secondary outcomes were platelet counts as well as drop-outs due to side effects. Data were analyzed using both per-protocol and intention-to-treat analyses. RESULTS Mean age of the per-protocol population (n = 26) was 63.6 ± 17.2 years and 53.8% were men. NAM treatment significantly reduced serum phosphate with 0.59 mg/dL (p = .03). Linear mixed-effects models demonstrated superiority of 12 weeks NAM over 12 weeks placebo with a between-treatment difference of 0.77 mg/dL (95% CI 0.010, 1.43; P = .03). Similar results, although not significant, were found in the intention-to-treat population. We found no between-treatment differences in platelet counts and during the NAM treatment we observed 3 drop-outs due to side effects (8.6%). CONCLUSION NAM is effective in reducing serum phosphate concentrations in patients with kidney failure receiving hemodialysis. In addition, NAM is well-tolerated and seems not to increase the risk of thrombocytopenia. Thus, NAM can be valuable as "add-on" treatment to combat hyperphosphatemia in patients with kidney failure. However, more research in larger populations is needed to confirm this.
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Affiliation(s)
- Lara Schepers
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Inez Jans
- Department of Nutrition and Dietetics, Hospital Gelderse Vallei, Ede, the Netherlands, Nutrition & Healthcare Alliance, Ede, The Netherlands
| | - Gerda K Pot
- Nutrition & Healthcare Alliance, Ede, The Netherlands
| | - Arend-Jan Smilde
- Department of Nephrology, Hospital Gelderse Vallei, Ede, The Netherlands
| | - Julia M Hofstra
- Department of Nephrology, Hospital Gelderse Vallei, Ede, The Netherlands
| | - Nicole M de Roos
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
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Sánchez Cuesta FJ, González-Zamorano Y, Moreno-Verdú M, Vourvopoulos A, Serrano IJ, Del Castillo-Sobrino MD, Figueiredo P, Romero JP. Effects of motor imagery-based neurofeedback training after bilateral repetitive transcranial magnetic stimulation on post-stroke upper limb motor function: an exploratory crossover clinical trial. J Rehabil Med 2024; 56:jrm18253. [PMID: 38450442 PMCID: PMC10938141 DOI: 10.2340/jrm.v56.18253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVE To examine the clinical effects of combining motor imagery-based neurofeedback training with bilateral repetitive transcranial magnetic stimulation for upper limb motor function in subacute and chronic stroke. DESIGN Clinical trial following an AB/BA crossover design with counterbalanced assignment. SUBJECTS Twenty individuals with subacute (n = 4) or chronic stroke (n = 16). METHODS Ten consecutive sessions of bilateral repetitive transcranial magnetic stimulation alone (therapy A) were compared vs a combination of10 consecutive sessions of bilateral repetitive transcranial magnetic stimulation with 12 non-consecutive sessions of motor imagery-based neurofeedback training (therapy B). Patients received both therapies (1-month washout period), in sequence AB or BA. Participants were assessed before and after each therapy and at 15-days follow-up, using the Fugl-Meyer Assessment-upper limb, hand-grip strength, and the Nottingham Sensory Assessment as primary outcome measures. RESULTS Both therapies resulted in improved functionality and sensory function. Therapy B consistently exhibited superior effects compared with therapy A, according to Fugl-Meyer Assessment and tactile and kinaesthetic sensory function across multiple time-points, irrespective of treatment sequence. No statistically significant differences between therapies were found for hand-grip strength. CONCLUSION Following subacute and chronic stroke, integrating bilateral repetitive transcranial magnetic stimulation and motor imagery-based neurofeedback training has the potential to enhance functional performance compared with using bilateral repetitive transcranial magnetic stimulation alone in upper limb recovery.
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Affiliation(s)
- Francisco José Sánchez Cuesta
- Faculty of Experimental Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain
| | - Yeray González-Zamorano
- Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, King Juan Carlos University, Alcorcón, Spain; Cognitive Neuroscience, Pain, and Rehabilitation Research Group (NECODOR), Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain
| | - Marcos Moreno-Verdú
- Faculty of Experimental Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain.
| | - Athanasios Vourvopoulos
- Institute for Systems and Robotics-Lisboa, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Ignacio J Serrano
- Neural and Cognitive Engineering group, Centre for Automation and Robotics (CAR) CSIC-UPM, Arganda del Rey, Madrid, Spain
| | | | - Patrícia Figueiredo
- Institute for Systems and Robotics-Lisboa, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Juan Pablo Romero
- Faculty of Experimental Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Brain Injury and Movement Disorders Neurorehabilitation Group (GINDAT), Institute of Life Sciences, Francisco de Vitoria University, Pozuelo de Alarcón, Spain; Brain Damage Unit, Beata María Ana Hospital, Madrid, Spain.
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Numao S, Uchida R, Kurosaki T, Nakagaichi M. Carbohydrate ingestion does not suppress increases in fatty acid-binding protein 4 concentrations post-acute aerobic exercise in healthy men: a randomized crossover study. BMC Sports Sci Med Rehabil 2024; 16:63. [PMID: 38438929 PMCID: PMC10913278 DOI: 10.1186/s13102-024-00852-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 02/19/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Fatty acid-binding protein 4 (FABP4) has been associated with cardiovascular disease and diabetes. Acute aerobic exercise increases circulating FABP4 concentrations, but the underlying mechanisms remain unclear. The purpose of this study was to investigate the effects of inhibition of lipolysis by carbohydrate ingestion on circulating FABP4 concentrations during and after acute aerobic exercise in healthy men. METHODS Men aged between 20 and 40, with no exercise habits and no metabolic diseases, were recruited. In a randomized crossover design, the participants underwent a carbohydrate-ingestion exercise (CE) and a fasted exercise (FE) trial. The CE trial consisted of 40-min acute aerobic exercise with ingestion of carbohydrates and 60-min bed rest. The FE trial followed the same protocol as the CE trial but without carbohydrate ingestion. Venous blood samples were collected to measure hormones (adrenaline, noradrenaline, and insulin) metabolites (glycerol, free fatty acids, and glucose), and FABP4 concentrations. Ventilation and gas exchange were also collected to measure substrate oxidation. RESULTS Thirteen healthy men participated in and completed both the CE and FE trials. The insulin concentration was more than 4 times higher in the CE trial than in the FE trial (p < 0.004, effect size [ES] > 2.00). Free fatty acid concentrations were more than 4 times lower in the CE trial than in the FE trial (p < 0.02, ES > 2.04). However, there was no significant difference in the changes in circulating FABP4 concentrations between the CE and FE trials (p = 0.108), which did not change during aerobic exercise and significantly increased post-aerobic exercise in both trials (p < 0.002, ES > 1.212). Changes in FABP4 concentrations following aerobic exercise were not significantly correlated with changes in glycerol or free fatty acid concentrations during aerobic exercise. CONCLUSIONS The results suggest that suppression of lipolysis and elevation of insulin are not strongly involved in increases in FABP4 secretion following acute aerobic exercise.
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Affiliation(s)
- Shigeharu Numao
- National Institute of Fitness and Sports in Kanoya, 1 Shiromizu, 891-2393, Kanoya, Kagoshima, Japan.
| | - Ryota Uchida
- National Institute of Fitness and Sports in Kanoya, 1 Shiromizu, 891-2393, Kanoya, Kagoshima, Japan
| | - Takashi Kurosaki
- National Institute of Fitness and Sports in Kanoya, 1 Shiromizu, 891-2393, Kanoya, Kagoshima, Japan
| | - Masaki Nakagaichi
- National Institute of Fitness and Sports in Kanoya, 1 Shiromizu, 891-2393, Kanoya, Kagoshima, Japan
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Lem WG, Kawata KHDS, Oyama H. Exploring the impact of immersive virtual reality on depression knowledge and stigma reduction: a cross-over RCT fMRI study. Sci Rep 2024; 14:5193. [PMID: 38431655 PMCID: PMC10908822 DOI: 10.1038/s41598-024-55797-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 02/27/2024] [Indexed: 03/05/2024] Open
Abstract
The stigma of mental illness is a form of negative judgmental knowledge and is a barrier to individual seeking treatment. Contact-based educational interventions with first-person perspective (1PP) combined with immersive virtual reality (IVR) is promising as an anti-stigma intervention. This study aims to investigate the effectiveness of 1PP anti-stigma IVR intervention compared to video in enhancing depression knowledge and reducing stigma, as well as to examine the corresponding depression knowledge brain activity change using functional magnetic resonance imaging (fMRI). Participants engaged in a 1PP anti-stigma intervention using both IVR and conventional video, focusing on the daily life and recovery of a patient with mild depression. The change in depression knowledge, stigma-related behavioral, and brain activity using fMRI were measured at pre- and post-interventions. Depression knowledge improved for both interventions; however, only the IVR intervention reduced stigma. In the IVR intervention, depression knowledge score was positively associated with neural response in the right superior frontal gyrus activation, indicative of empathic concern. Conversely, the video intervention correlated with increased activity in the right anterior insula, suggesting a distress-related response. The findings demonstrate that the immersive nature of IVR can reduce stigma more effectively than video intervention. This effectiveness is underpinned by the change in depression knowledge on neural activity, with IVR fostering empathy-related behavioral responses. The results highlight the potential of IVR in enhancing empathic understanding and reducing stigma towards mental illness, emphasizing the need for further exploration into immersive technologies for mental health education.
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Affiliation(s)
- Wey Guan Lem
- Department of Clinical Information Engineering, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Kelssy Hitomi Dos Santos Kawata
- Department of Clinical Information Engineering, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Hiroshi Oyama
- Department of Clinical Information Engineering, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-0033, Japan
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Marinello F, Fraccalvieri D, Planellas P, Adell Trapé M, Gil JM, Kreisler E, Pellino G, Espín-Basany E. Sacral Neuromodulation in Patients With Low Anterior Resection Syndrome: The SANLARS Randomized Clinical Trial. Dis Colon Rectum 2024; 67:435-447. [PMID: 38084933 PMCID: PMC10846591 DOI: 10.1097/dcr.0000000000003143] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
BACKGROUND Sacral neuromodulation might be effective to palliate low anterior resection syndrome after rectal cancer surgery, but robust evidence is not available. OBJECTIVE To assess the impact of sacral neuromodulation on low anterior resection syndrome symptoms as measured by validated scores and bowel diaries. DESIGN Randomized, double-blind, 2-phased, controlled, multicenter crossover trial (NCT02517853). SETTINGS Three tertiary hospitals. PATIENTS Patients with major low anterior resection syndrome 12 months after transit reconstruction after rectal resection who had failed conservative treatment. INTERVENTIONS Patients underwent an advanced test phase by stimulation for 3 weeks and received the pulse generator implant if a 50% reduction in low anterior resection syndrome score was achieved. These patients entered the randomized phase in which the generator was left active or inactive for 4 weeks. After a 2-week washout, the sequence was changed. After the crossover, all generators were left activated. MAIN OUTCOME MEASURES The primary outcome was low anterior resection syndrome score reduction. Secondary outcomes included continence and bowel symptoms. RESULTS After testing, 35 of 46 patients (78%) had a 50% or greater reduction in low anterior resection syndrome score. During the crossover phase, all patients showed a reduction in scores and improved symptoms, with better performance if the generator was active. At 6- and 12-month follow-up, the mean reduction in low anterior resection syndrome score was -6.2 (95% CI -8.97 to -3.43; p < 0.001) and -6.97 (95% CI -9.74 to -4.2; p < 0.001), with St. Mark's continence score -7.57 (95% CI -9.19 to -5.95, p < 0.001) and -8.29 (95% CI -9.91 to -6.66; p < 0.001). Urgency, bowel emptiness sensation, and clustering episodes decreased in association with quality-of-life improvement at 6- and 12-month follow-up. LIMITATIONS The decrease in low anterior resection syndrome score with neuromodulation was underestimated because of an unspecific measuring instrument. There was a possible carryover effect in sham stimulation sequence. CONCLUSIONS Neuromodulation provides symptoms and quality-of-life amelioration, supporting its use in low anterior resection syndrome. See Video Abstract . NEUROMODULACIN SACRA EN PACIENTES CON SNDROME DE RESECCIN ANTERIOR BAJA ENSAYO CLNICO ALEATORIZADO SANLARS ANTECEDENTES:La neuromodulación sacra podría ser eficaz para paliar el síndrome de resección anterior baja después de la cirugía de cáncer de recto, pero no hay pruebas sólidas disponibles.OBJETIVO:Evaluar el impacto de la neuromodulación sacra en los síntomas del síndrome de resección anterior baja, medido mediante puntuaciones validadas y diarios intestinales.DISEÑO:Ensayo cruzado multicéntrico, controlado, aleatorizado, doble ciego, de dos fases (NCT02517853).LUGARES:Tres hospitales terciarios.PACIENTES:Pacientes con puntuación de resección anterior baja importante, 12 meses después de la reconstrucción del tránsito después de la resección rectal en quienes había fracasado el tratamiento conservador.INTERVENCIONES:Los pacientes se sometieron a una fase de prueba avanzada mediante estimulación durante tres semanas y se les implantó el generador de impulsos si se lograba una reducción del 50% en la puntuación del síndrome de resección anterior baja, ingresando a la fase aleatorizada en la que el generador se dejaba activo o inactivo durante cuatro semanas. Después de observar por 2 semanas, se cambió la secuencia. Después del cruce, todos los generadores quedaron activados.PRINCIPALES MEDIDAS DE RESULTADO:El resultado primario fue la reducción de la puntuación del síndrome de resección anterior baja. Los resultados secundarios incluyeron continencia y síntomas intestinales.RESULTADOS:Después de las pruebas, 35 de 46 pacientes (78%) tuvieron una reducción ≥50% en la puntuación del síndrome de resección anterior baja. Durante el cruce, todos los pacientes mostraron una reducción en las puntuaciones y una mejora de los síntomas, con un mejor rendimiento si el generador estaba activo. A los 6 y 12 meses de seguimiento, la reducción media en la puntuación del síndrome de resección anterior baja fue -6,2 (-8,97; -3,43; p < 0,001) y -6,97 (-9,74; -4,2; p < 0,001), con Puntuación de continencia de St. Mark's -7,57 (-9,19; -5,95, p < 0,001) y -8,29 (-9,91; -6,66; p < 0,001). La urgencia, la sensación de vacío intestinal y los episodios de agrupamiento disminuyeron en asociación con una mejora en la calidad de vida a los 6 y 12 meses de seguimiento.LIMITACIONES:La disminución en la puntuación del síndrome de resección anterior baja con neuromodulación se subestimó debido a un instrumento de medición no específico. Posible efecto de arrastre en la secuencia de estimulación simulada.CONCLUSIONES:La neuromodulación mejora los síntomas y la calidad de vida, lo que respalda su uso en el síndrome de resección anterior baja. (Traducción-Dr. Mauricio Santamaria ).
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Affiliation(s)
- Franco Marinello
- Colorectal Surgery Unit, Hospital Universitari Vall d’Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Doménico Fraccalvieri
- Colorectal Surgery Unit, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - Pere Planellas
- Colorectal Surgery Unit, Hospital Universitari Josep Trueta, Universitat de Girona, Girona, Spain
| | - Montse Adell Trapé
- Colorectal Surgery Unit, Hospital Universitari Vall d’Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Julia M. Gil
- Colorectal Surgery Unit, Hospital Universitari Josep Trueta, Universitat de Girona, Girona, Spain
| | - Esther Kreisler
- Colorectal Surgery Unit, Hospital Universitari de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - Gianluca Pellino
- Colorectal Surgery Unit, Hospital Universitari Vall d’Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eloy Espín-Basany
- Colorectal Surgery Unit, Hospital Universitari Vall d’Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain
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Trinh M, Nam J, Kumar M, Nivison-Smith L. OCTA Signal Quality Augmentation Using the Isometric Handgrip Test to Maximize Vascular Flow (SQUEEZE): A Randomized Crossover Trial. Transl Vis Sci Technol 2024; 13:22. [PMID: 38530302 PMCID: PMC10981163 DOI: 10.1167/tvst.13.3.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/07/2024] [Indexed: 03/27/2024] Open
Abstract
Purpose To determine if performing the isometric handgrip test (IHGT) can augment optical coherence tomography angiography (OCTA) vascular signal quality in eyes with macular abnormalities. Methods A randomized, single-blinded crossover trial was conducted including 36 participants with macular abnormalities, randomized to undergo OCTA with or without the IHGT, then crossed over to the alternate "intervention" after 1 minute. The primary outcome was OCTA signal quality after 1 minute of squeezing at 50% maximum grip strength. Secondary outcomes were other measures of vascular flow and systemic blood pressure (BP), also regressed against person- and eye-level covariables. Results Primary analysis of OCTA signal quality with versus without the IHGT was nonsignificant (P = 0.73). Nested analyses showed that the IHGT resulted in increased OCTA B-scan retinal vascular flow signal (2.95 [-1.64 to 7.55] Δ%, P < 0.05) and increased systolic BP, diastolic BP, pulse pressure, and mean arterial pressure (4.94 [0.41 to 9.47] to 12.38 [8.01 to 16.75] mm Hg, P < 0.05). OCTA signal quality and en face vessel density and perfusion changes were associated with sex, refraction, race/ethnicity, and right-hand IHGT use (P < 0.05). Greater increases in systolic and diastolic BP and mean arterial pressure were generally associated with right-hand IHGT use and greater maximum grip strength (P < 0.09). Conclusions The IHGT can temporarily increase OCTA B-scan retinal vascular flow signal in participants with macular abnormalities. IHGT-induced changes to systemic BP appear to be linked to absolute (rather than relative) grip strength, implying that the IHGT may be ineffective with low grip strength. Further research in larger populations is warranted. Translational Relevance This study provides early validation that the IHGT may augment OCTA output, which may lead to improved noninvasive detection of pathologic vascular changes.
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Affiliation(s)
- Matt Trinh
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Judy Nam
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Meenakshi Kumar
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Lisa Nivison-Smith
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Dietel FA, Rupprecht R, Seriyo AM, Post M, Sudhoff B, Reichart J, Berking M, Buhlmann U. Efficacy of a smartphone-based Cognitive Bias Modification program for emotion regulation: A randomized-controlled crossover trial. Internet Interv 2024; 35:100719. [PMID: 38370286 PMCID: PMC10869929 DOI: 10.1016/j.invent.2024.100719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/20/2024] Open
Abstract
Previous research has identified maladaptive emotion regulation as a key factor in psychopathology. Thus, addressing emotion regulation via scalable, low-threshold digital interventions - such as smartphone-based Cognitive Bias Modification (CBM) - holds important therapeutic potential. Using a randomized-controlled crossover trial, we tested the efficacy of an integrated CBM module within the Affect Regulation Training (ART, i.e., CBM-ART) that targeted emotion regulation through elements of appraisal-based and approach avoidance training. Undergraduate students reporting elevated stress were randomized to a one-week active intervention (Mindgames; including psychoeducation, a quiz, and CBM-ART; n = 40), active control training (Emo Shape; including placebo psychoeducation, a quiz, and a placebo swiping task; n = 36) or waitlist (n = 25). Before and after the intervention, we assessed emotion regulation, interpretation bias, stress and depression. We further tested post-training stress reactivity using an anagram task. Results indicated that the active intervention improved negative (OR = 0.35) and positive (OR = 2.40) interpretation biases and symptom measures (d = 0.52-0.87). However, active control training showed attenuated concurrent pre-post changes on interpretation biases (i.e., OR = 0.53 for negative, and OR = 1.49 for positive interpretations) and symptom measures (d = 0.26-0.91). The active intervention was rated positively in terms of acceptability and usability. These findings provide initial evidence for the efficacy and acceptability of an integrated app-based CBM intervention for emotion regulation in reducing interpretation biases and psychopathological symptoms, including stress. However, future studies should disentangle specific mechanisms underlying interventional effects.
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Ding H, Simmich J, Vaezipour A, Andrews N, Russell T. Evaluation framework for conversational agents with artificial intelligence in health interventions: a systematic scoping review. J Am Med Inform Assoc 2024; 31:746-761. [PMID: 38070173 PMCID: PMC10873847 DOI: 10.1093/jamia/ocad222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/04/2023] [Accepted: 11/24/2023] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVES Conversational agents (CAs) with emerging artificial intelligence present new opportunities to assist in health interventions but are difficult to evaluate, deterring their applications in the real world. We aimed to synthesize existing evidence and knowledge and outline an evaluation framework for CA interventions. MATERIALS AND METHODS We conducted a systematic scoping review to investigate designs and outcome measures used in the studies that evaluated CAs for health interventions. We then nested the results into an overarching digital health framework proposed by the World Health Organization (WHO). RESULTS The review included 81 studies evaluating CAs in experimental (n = 59), observational (n = 15) trials, and other research designs (n = 7). Most studies (n = 72, 89%) were published in the past 5 years. The proposed CA-evaluation framework includes 4 evaluation stages: (1) feasibility/usability, (2) efficacy, (3) effectiveness, and (4) implementation, aligning with WHO's stepwise evaluation strategy. Across these stages, this article presents the essential evidence of different study designs (n = 8), sample sizes, and main evaluation categories (n = 7) with subcategories (n = 40). The main evaluation categories included (1) functionality, (2) safety and information quality, (3) user experience, (4) clinical and health outcomes, (5) costs and cost benefits, (6) usage, adherence, and uptake, and (7) user characteristics for implementation research. Furthermore, the framework highlighted the essential evaluation areas (potential primary outcomes) and gaps across the evaluation stages. DISCUSSION AND CONCLUSION This review presents a new framework with practical design details to support the evaluation of CA interventions in healthcare research. PROTOCOL REGISTRATION The Open Science Framework (https://osf.io/9hq2v) on March 22, 2021.
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Affiliation(s)
- Hang Ding
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, QLD, Australia
| | - Joshua Simmich
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, QLD, Australia
| | - Atiyeh Vaezipour
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, QLD, Australia
| | - Nicole Andrews
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, QLD, Australia
- The Tess Cramond Pain and Research Centre, Metro North Hospital and Health Service, Brisbane, QLD, Australia
- The Occupational Therapy Department, The Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Trevor Russell
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service (STARS), The University of Queensland and Metro North Health, Brisbane, QLD, Australia
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Vicenti C, Otero PE, Briganti A, Rondelli V, Stabile M, Piemontese C, Crovace A, Lacitignola L, Staffieri F. Respiratory Effects of Continuous Positive Airway Pressure Administered during Recovery from General Anesthesia in Brachycephalic Dogs. Vet Sci 2024; 11:75. [PMID: 38393093 PMCID: PMC10893332 DOI: 10.3390/vetsci11020075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/20/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
This study aimed to evaluate the benefits of applying 5 cmH2O of CPAP using a pediatric helmet during the recovery phase from general anesthesia in brachycephalic dogs. Brachycephalic dogs undergoing various surgical procedures were included in this study, and a total of 64 subjects were randomly assigned to receive either standard oxygen supplementation (NO-CPAP group) or oxygen supplementation combined with CPAP (CPAP group). This study evaluated arterial blood pH, blood gas partial pressures of O2 and CO2, arterial blood O2 saturation, and related parameters during recovery. The dogs were monitored, and helmet tolerance was assessed using predefined criteria. Of the initially assessed 69 dogs, 64 were enrolled: 32 in the CPAP group and 32 in the NO-CPAP group. Fifteen dogs in the NO-CPAP group were excluded based on predetermined criteria. The CPAP group showed significant improvements in PaO2, PaO2/FiO2, P(A-a)O2, F-Shunt, and respiratory rate compared with the NO-CPAP group (p < 0.001). The incidence of reintubation and helmet intolerance was higher in the NO-CPAP group (18% and 15.6%, respectively) than in the CPAP group (0%). This study highlights the potential benefits of incorporating CPAP, delivered through a pediatric helmet, in the perioperative management of brachycephalic dogs.
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Affiliation(s)
- Caterina Vicenti
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
| | - Pablo E Otero
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires C1427CWN, Argentina
| | - Angela Briganti
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, 56122 Pisa, Italy
| | | | - Marzia Stabile
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
| | - Claudia Piemontese
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
| | - Antonio Crovace
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
| | - Luca Lacitignola
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
| | - Francesco Staffieri
- Section of Veterinary Clinics and Animal Production, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari, 70010 Valenzano, Italy
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Serrano-Velasco D, Martín-Vacas A, Cintora-López P, Paz-Cortés MM, Aragoneses JM. Comparative Analysis of the Comfort of Children and Adolescents in Digital and Conventional Full-Arch Impression Methods: A Crossover Randomized Trial. CHILDREN (BASEL, SWITZERLAND) 2024; 11:190. [PMID: 38397302 PMCID: PMC10886968 DOI: 10.3390/children11020190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/26/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
The aim of this study was to evaluate the comfort of children and adolescents with conventional full-arch dental impression methods compared to two intraoral scanners (iTeroTM and PrimescanTM). METHODS A monocentric, analytical, controlled crossover study was designed to compare conventional impression and digital impression with two intraoral scanners (iTeroTM and PrimescanTM) in children and teenagers. Patient comfort was evaluated using a 100 mm VAS scale adapted to Spanish and for children. A descriptive and analytical statistical method was conducted with a confidence level of 95% (p ≤ 0.05) and asymptotic or bilateral significance. RESULTS A total of 51 subjects were enrolled in the study (mean age = 12.35 years). Although the group of 10-14-year-olds was the most numerous, gender was equally distributed among the age groups. None of the variables on the VAS scale showed differences between the gender categories (p > 0.05). There were differences (p < 0.05) with respect to the age categories, as the middle adolescent group showed the worst general perception and total comfort during the conventional impression. Statistically significant differences were found between all VAS scale items and the three impression methods (p < 0.05). CONCLUSIONS The digital impression technique is superior in terms of total comfort to the conventional alginate impression in children and adolescents.
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Affiliation(s)
- Diego Serrano-Velasco
- PhD Program in Translational Medicine, Universidad San Pablo—CEU, CEU Universities, 28003 Madrid, Spain;
- Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.M.-V.); (P.C.-L.); (J.M.A.)
| | - Andrea Martín-Vacas
- Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.M.-V.); (P.C.-L.); (J.M.A.)
| | - Patricia Cintora-López
- Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.M.-V.); (P.C.-L.); (J.M.A.)
| | - Marta Macarena Paz-Cortés
- Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.M.-V.); (P.C.-L.); (J.M.A.)
| | - Juan Manuel Aragoneses
- Faculty of Dentistry, Alfonso X El Sabio University, 28691 Madrid, Spain; (A.M.-V.); (P.C.-L.); (J.M.A.)
- Department of Dental Research, Federico Henriquez y Carvajal University, Santo Domingo 10106, Dominican Republic
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49
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Nakai N, Kurogi T, Murata H. Oral health-related quality of life of conventional removable partial dentures, unilateral nonmetal clasp dentures, and shortened dental arch with 2- or 3-tooth unilateral distal extension tooth loss in the mandible: A randomized, crossover, clinical trial. J Prosthet Dent 2024; 131:220-226. [PMID: 35697550 DOI: 10.1016/j.prosdent.2021.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/19/2022]
Abstract
STATEMENT OF PROBLEM Conventional removable partial dentures with metal clasps are still a common option for patients with distal-extension tooth loss. However, unilateral nonmetal clasp dentures fabricated by using a thermoplastic denture base resin are increasingly being used. Furthermore, the shortened dental arch concept remains controversial, in spite of being advocated for many years. Nevertheless, these treatment options remain controversial, particularly in patients with the loss of a few distal teeth unilaterally. PURPOSE The purpose of this randomized, crossover, clinical trial was to investigate the oral health-related quality of life of participants who requested a new dental prosthesis (unilateral nonmetal clasp dentures or conventional removable partial dentures) at a private practice. MATERIAL AND METHODS A 3-period, randomized, crossover design was used in a within-subject, controlled, clinical trial. Twenty-four participants (mean age 59.0 years [7 men: 62.6 {45-85} years; 17 women: 57.5 {24-75} years]) were enrolled. All experimental procedures were approved by the Ethics Committee of Nagasaki University Hospital (#15022313) and registered in the International Standard Randomized Controlled Trial Number registry (ISRCTN49105064). All participants were fully dentate in the maxilla and had unilateral distal-extension loss of 2 or 3 teeth in the mandible. Participants were allocated to 1 of 6 groups and treated with prescribed options in accordance with their allocated sequences and used a dental prosthesis or nothing for 2-week periods. At the end of each intervention, the participants were asked to answer the Oral Health Impact Profile questionnaire. Differences in Oral Health Impact Profile scores among groups were estimated with a mixed-effects model (α=.05). RESULTS Total Oral Health Impact Profile scores were higher for unilateral nonmetal clasp dentures (P=.002) and shortened dental arch (P=.049) than for conventional removable partial dentures, with medium and small effects. The unilateral nonmetal clasp dentures had a similar effect compared with shortened dental arch (P>.05). unilateral nonmetal clasp dentures (P=.011) and shortened dental arch (P=.005) demonstrated medium effects in the oral function dimension compared with conventional removable partial dentures. Unilateral nonmetal clasp dentures exhibited large and medium effects in the orofacial appearance dimension compared with conventional removable partial dentures (P=.001) and shortened dental arch (P=.006). In the orofacial pain dimension, shortened dental arch showed effects similar to those of conventional removable partial dentures and unilateral nonmetal clasp dentures (P>.05), and no significant differences were observed in the psychosocial impact dimension (P>.05), but the unilateral nonmetal clasp denture score was lower than the conventional removable partial denture score, with a small effect. Men had significantly lower total Oral Health Impact Profile scores for shortened dental arch than women (P=.033). CONCLUSIONS Unilateral nonmetal clasp dentures and shortened dental arch were better than conventional removable partial dentures for the oral health-related quality of life of individuals with unilateral distal-extension tooth loss in the mandible, and sex had a significant effect on removable prosthetic planning.
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Affiliation(s)
- Nobuyuki Nakai
- Clinical Professor, Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan; Private practice, Kyoto, Japan.
| | - Tadafumi Kurogi
- Assistant Professor, Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hiroshi Murata
- Professor, Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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50
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Vaccaro MG, Innocenti B, Cione E, Gallelli L, De Sarro G, Bonilla DA, Cannataro R. Acute effects of a chewable beetroot-based supplement on cognitive performance: a double-blind randomized placebo-controlled crossover clinical trial. Eur J Nutr 2024; 63:303-321. [PMID: 37875637 PMCID: PMC10799154 DOI: 10.1007/s00394-023-03265-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/03/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Dietary nitrate (NO3-) has been shown to be useful as an ergogenic aid with potential applications in health and disease (e.g., blood pressure control). However, there is no consensus about the effects of dietary NO3- or beetroot (BR) juice supplementation on cognitive function. OBJECTIVE The aim of this study was to evaluate the effects of a single dose of a chewable BR-based supplement on cognitive performance. METHODS A double-blind randomized placebo-controlled two-period crossover clinical trial was carried out based on the extension of the CONSORT guidelines for randomized crossover trials. A total of 44 participants (24 F; 20 M; 32.7 [12.5] years; 66.3 [9.0] kg; 170 [9.2] cm; 22.8 [1.4] kg/m2) were randomly allocated to receive first either four BR-based chewable tablets (BR-CT) containing 3 g of a Beta vulgaris extract (RedNite®) or four tablets of a placebo (maltodextrin). A 4-day washout period was used before crossover. Ninety minutes after ingestion of the treatments, a neuropsychological testing battery was administered in each period. The trial was registered at clinicaltrials.gov NCT05509075. RESULTS Significant improvements with moderate effect size were found on memory consolidation at the short and long term only after BR-CT supplementation via the Rey Auditory Verbal Learning Test immediate (+ 20.69%) and delayed (+ 12.34%) recalls. Likewise, enhancement on both frontal lobe functions (+ 2.57%) and cognitive flexibility (+ 11.16%) were detected after BR-CT. There was no significant change (p < 0.05) on verbal memory of short-term digits, working memory and information processing speed. Mixed results were found on mood and anxiety through the Beck Depression Inventory-II (BDI-II) and the State-Trait Anxiety Inventory (STAI-Y1 and STAI-Y2); however, sequence and period effects were seen on STAI-Y2. CONCLUSIONS The acute administration of a chewable BR-based supplement improves certain aspects of cognitive function in healthy females and males, particularly memory capacity and frontal skills.
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Affiliation(s)
- Maria Grazia Vaccaro
- Department of Medical and Surgical Sciences, University of Magna Graecia, Catanzaro, Italy
| | | | - Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
- Galascreen Laboratories, University of Calabria, Rende, Italy
| | - Luca Gallelli
- Clinical Pharmacology and Pharmacovigilance Operative Unit, Department of Health Science, University of Magna Graecia, Mater Domini Hospital, Catanzaro, Italy
| | - Giovambattista De Sarro
- Clinical Pharmacology and Pharmacovigilance Operative Unit, Department of Health Science, University of Magna Graecia, Mater Domini Hospital, Catanzaro, Italy
| | - Diego A Bonilla
- Research Division, Dynamical Business and Science Society-DBSS International SAS, 110861, Bogotá, Colombia
- Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, 230002, Montería, Colombia
- Research Group in Biochemistry and Molecular Biology, Universidad Distrital Francisco José de Caldas, 110311, Bogotá, Colombia
| | - Roberto Cannataro
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy.
- Galascreen Laboratories, University of Calabria, Rende, Italy.
- Research Division, Dynamical Business and Science Society-DBSS International SAS, 110861, Bogotá, Colombia.
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