ABSTRACTBackground: Prevalence of posttraumatic stress disorder (PTSD) in refugees is higher compared to the general population, and barriers in accessing mental health care are often experienced. With staggering numbers of people seeking refuge around the world, and 40% being 18 years or younger, effective trauma-focused therapies for refugee children with PTSD are highly needed.Objective: A systematic review and meta-analyses were conducted to provide an overview of, and to analyse, intervention studies using PTSD measures in young refugees, assessing treatment effectiveness and addressing efforts to mitigate barriers to mental health care.Method: Eleven databases were searched for studies evaluating trauma-focused treatments (TFT) for refugee children (0-18). Meta-analyses were conducted for all included studies grouped together; and second, per intervention type, using posttreatment measures and follow-up measures. Pooled between-group effect sizes (ESs) and pre-post ESs, using a random-effects model were calculated.Results: A total of 47 studies was retrieved, with 32 included in the meta-analyses. The narrative review highlighted positive outcomes in reducing posttraumatic stress symptoms for CBT-based interventions, EMDR therapy, KIDNET, and other treatments such as art therapy. Meta-analyses revealed medium pooled pre-post ESs for CBT-based interventions (ES = -.55) and large for EMDR therapy (ES = -1.63). RCT and CT studies using follow-up measures showed promising outcomes for KIDNET (ES = -.49). High heterogeneity of the included studies limited interpretation of several other combined effects. Results should be interpreted with caution due to the generally low quality of the included studies. All studies addressed efforts to minimize treatment barriers.Conclusion: More high-quality studies are urgently needed to inform treatment recommendations. Evidence-based therapies, such as CBT-based interventions, EMDR therapy, and KIDNET, demonstrate promising findings but need further replication. Strategies to overcome barriers to treatment may be necessary to reach this population.

Vibrio cholerae, the causative agent of cholera, can efficiently adapt its metabolic processes, including biofilm formation, in response to varying respiratory conditions- such as aerobic, microaerobic, and anaerobic- through the ArcAB system. In this study, we elucidate the activation mechanism of V. cholerae ArcB and ArcA and identify ArcB residues H292, D577, and H722, along with ArcA residue D54 as key phosphorylation sites. Furthermore, we demonstrate that the ArcAB system plays a crucial role in regulating biofilm formation under both aerobic and anaerobic conditions. Our findings reveal that the positive regulation of biofilm formation by the ArcAB systems involves the high cell density (HCD) quorum sensing (QS) regulator HapR. Specifically, phosphorylated ArcA represses hapR transcription, thereby promoting biofilm formation under anaerobic condition. This study also highlights an epistatic relationship between ArcA and HapR in biofilm regulation. Overall, our results underscore the critical role of the ArcAB system in the biofilm formation of pathogenic V. cholerae under oxygen-limiting conditions.

The relationship between dissociation features, maladaptive regulation strategies, and emotional dysregulation is a controversial issue. This meta-analytic review provides a comprehensive and multidimensional overview of the association between aspects of dissociation and emotional (dys)regulation.

We conducted systematic research on the main databases (Psycinfo, PsycARTICLES, Pubmed, MEDLINE, Scopus), collecting the literature of the last 20 years. A total of 120 studies were included in the meta-analytic review. The analyses were based on the Pearson coefficient as a measure of the size of the effect, using the random effect model and performing moderation analysis.

Results showed significant relationships between emotion (dys)regulation and the different facets of dissociation. Overall, we observed stronger associations between deficits in emotion regulation/maladaptive regulating strategies, rather than alexithymia, and dissociation, supporting the prior involvement of emotional dimensions in dissociative experiences.

This work confirms the connection between emotion (dys)regulation and dissociation, revealing differential patterns according to the specific assessed dimensions and, thus, providing a systematization of the associations between specific aspects of the examined constructs.

Despite the international incentives and the worldwide development of recovery-oriented policies, it has proven challenging to establish recovery-oriented mental health services that take into account users' subjectivity and perspectives (Slade et al., World Psychiatry 13(1):12-20, 2014. https://doi.org/10.1002/wps.20084 ). The objective of this study was to identify individual beliefs that are correlated with six recovery-oriented practices in schizophrenia among mental health professionals. Seven individual beliefs were examined for their association with each of the aforementioned practices: belief in recovery possibilities, biological beliefs, desire for social distance, perceived similarities, professional utility beliefs, continuum beliefs, and categorical beliefs. The results indicated that belief in the possibility of recovery from schizophrenia and professional efficacy beliefs were the most strongly associated with the six recovery-oriented practices examined. Conversely, there was a negative association between stigma score (desire for social distance) and the six recovery-oriented practices. The remaining four beliefs-biological, perceived similarity, categorical, and continuum-were found to be more weakly associated with recovery-oriented practices. In light of these findings, it is evident that mental health professionals' individual beliefs warrant further consideration in research endeavors aimed at fostering and facilitating the implementation of recovery-oriented practices.

It is our view that the color of teeth and gingiva needs to be analyzed conjointly, given their close anatomical interrelation and the lack of research on perceptions of this chromatic combination.

To determine aesthetic preferences concerning the chromatic combination of ceramic gingival specimens and acrylic teeth and analyze the influence of age and sex.

A sample of 120 participants responded to a survey, in which each participant first selected the three "ad hoc" ceramic gingival specimens whose color they considered the most attractive from seven Vita Lumex AC Gingiva colors (231-237). Each participant then allocated a score from 1 to 10 for the chromatic combination of each of the three ceramic gingival specimens chosen in combination with each of the three acrylic teeth (maxillary central incisor, maxillary lateral incisor, and maxillary canine) in the three most frequent colors in the reference population (1M1, 3M1, and 2L1.5). The questionnaire also collected data on age and sex. Statistical analysis of the results was conducted using SPSS (v.28) software.

Participants most frequently chose gingival shade 232 as their first preference (80.8%), shade 233 was most frequently placed in second position (75%), and most participants selected shade 235 as their third preference (58.3%). The highest rated gingiva-tooth shade combination was 232-1M1 (mean score 7.9), followed by 232-3M1 (mean score 7.3). The only significant difference (p < 0.05) between men and women was between the mean scores allocated for the 232-3M1 combination, which was rated higher by women than men. Statistically significant differences were found between the mean scores allocated by different age groups for the 233-3M1, 233-2L1.5, and 235-1M1 combinations. Younger participants scored the first two shade combinations lower, while the opposite was true for the last combination.

When establishing aesthetic preferences, gingival color takes priority over dental color when both structures are visible in combination. Preferences regarding the most attractive gingival shades are focused on only two colors (232 and 233). A substantial majority of participants rated the 232-1M1 gingival-dental shade combination most highly. Practically no significant differences were identified between the mean scores allocated for gingival-dental color combinations according to sex. Age made a greater difference to results, although both variables had only a modest impact.

Producing a combined gingival-dental shade guide would be useful, enabling the patient to provide their complete aesthetic vision, particularly in clinical situations where gingival tissue needs to be restored in patients with high smile lines. Manufacturers need to improve their gingival shade ranges, due to the limited number available, their disparity with natural gingival color, and the fact that patients do not like most shades on offer. A large percentage of aesthetic preferences focused on a limited number of gingival-dental color combinations, with lighter dental shades combined with the gingival shades that best approximate natural gingival color considered the most aesthetic. Age has more influence on gingival-dental color preferences than sex, although both factors have only a modest impact. For high smile lines, patients prioritize gingival color within the gingival-dental chromatic combination, since the preference for a certain shade of gingival specimen is maintained, irrespective of tooth color, indicating a stable chromatic hierarchy.

Obesity has been associated with lower muscle strength-to-body mass ratio. Here, we evaluated the effects of diet-induced obesity on the mechano-structural properties of isolated muscles and tendons. Thirty 10-week-old male C57BL/6 J mice were randomly assigned to either an obesogenic high-fat diet group (OB) for 24 weeks or a control group (CN) maintained on a standard chow diet. Soleus muscle (SOL) and Achilles tendon (AT) specimens were isolated and subjected either to failure testing, 300 cycles of passive stretch-destretch, or isometric twitch contractions. Morpho-structural and protein expression analyses were conducted to assess collagen and adipose tissue accumulation, concentrations of cross-linking factors, and any alterations in the POSTN-TGFβ1-Akt signaling pathway. OB SOL and AT tissues were more fragile than those from CN (p < 0.05). A piecewise linear regression model revealed a tendency for OB tissues to exhibit steeper mechanical property changes within the first 20 cycles compared to CN, followed by a similar plateau phase in both groups. OB SOL-AT complexes showed a slower twitch-contraction-relaxation pattern than CN (p < 0.05). OB tendons and muscles were larger than those of the CN, with muscles featuring bigger fibers, and higher collagen area fraction (p < 0.05). Elevated TGFβ1 and POSTN concentrations were observed in OB tissues (p < 0.05), alongside increased P-Akt and P-4EBP1 expression (p < 0.05). These findings highlight the detrimental effects of obesity on the structural integrity of muscle and tendon tissues and suggest a significant role of POSTN-TGFβ1-Akt signaling in obesity-associated musculotendinous remodeling.

Immersive virtual reality (VR) experienced through a head-mounted display (HMD) offers the possibility to practice real-world situations in a safe and motivating way in pediatric neurorehabilitation. As the HMD blocks the view of the physical world, patients lack visual feedback of their body parts. Foot visualization in the virtual environment could inform patients about their feet's position during walking-related activities.

How does foot visualization affect spatial gait parameters of youths with neuromotor gait impairments during everyday walking tasks with an immersive VR-HMD?

In this cross-sectional study, 15 youths with neuromotor gait impairments (mean age 12.3 years) performed four walking-related tasks wearing the VR-HMD Meta Quest 2. Walking through the virtual environment, they had to place their feet as accurately as possible on bollards, step over a plank, balance over a beam, and cross a gap. We used a Vicon motion capture system to assess spatial gait parameters when the participants could not see their feet and when a real-time virtual model of their feet was integrated into the virtual environment.

In the bollard task, foot visualization had a large positive effect (Hedges' g = 0.82) on the foot placement accuracy, with a reduction in deviation from the bollard center from 12.1 cm (IQR: 16 cm) to 6.5 cm (IQR: 5.1 cm) (p < 0.001). Further, the maximum step height of the leading foot when overstepping the plank decreased by 2.9 cm (g = 0.4, p = 0.05). Foot visualization did not influence the spatial gait parameters when balancing over a beam or crossing a gap.

Pediatric patients who practice walking-related activities with an immersive VR-HMD can benefit from foot visualization, as it increases foot placement accuracy for certain tasks. However, technical solutions have to become simpler for the clinical implementation of foot visualization.

Quantitative magnetic resonance imaging (qMRI) offers reliable biomarkers in clinic. Nevertheless, most qMRI methods are time-consuming and sensitive to motion. Single-shot multiple overlapping-echo detachment (MOLED) magnetic resonance imaging can deliver robust T2 mapping in about 100 ms with high motion tolerance. However, its spatial resolution is relatively low due to the limitations of signal-to-noise ratio (SNR) and echo-train length. At the mean time, the number of echoes with different evolution times collected is usually limited, which is not conducive to T2 mapping in high accuracy.

To propose a novel method to improve the spatial resolution and quantification accuracy of single-shot MOLED T2 mapping.

A new method called switching modulation patterns multiple overlapping-echo detachment imaging (SWP-MOLED) was designed for multi-slice information sharing via switching the k-space modulation pattern of MOLED imaging. In the SWP-MOLED pulse sequence, three different k-space modulation patterns were devised, making the 12 main echoes of any three adjacent slices symmetrically and uniformly distributed around their k-space centers to obtain diverse contrast weighting information. A multi-slice fusion three-dimensional spatial attention context-guided U-Net was trained with 3000/7000 synthetic data with geometric/brain patterns to efficiently learn the mapping relationship between SWP-MOLED signals and T2 maps. Experiments on numerical human brains, a phantom containing MnCl2 solutions with different concentrations, three healthy volunteers, and three patients diagnosed with meningioma or glioblastoma were performed. The effectiveness of the new method was quantitatively assessed using the structure similarity index measure (SSIM) and root mean square error (RMSE). Multiple statistical analyses were utilized to evaluate the accuracy and significance of the method, including linear regression, Bland-Altman analysis, Mann-Whitney test, Wilcoxon signed rank test, and Friedman test with Bonferroni correction, with the p-value significance level of 0.05.

The results from numerical human brain (The average SSIM of the reconstructed T2 maps was 0.9742/0.9782/0.9826 for MOLED/MS-MOLED/SWP-MOLED) and phantom (The slope of linear fitting of the predicted T2 values vs. reference values was 0.9934/9942/0.9972 for MOLED/MS-MOLED/SWP-MOLED) demonstrated that more accurate T2 maps were delivered by the proposed method, closely resembling the reference maps. From the Friedman test performed on the results of the test data set after the multi-comparison correction, we found that the pairwise performance differences among different reconstruction networks were all statistically significant (p < 0.001). In healthy human brain experiments, the comparison of SWP-MOLED reconstruction with reference measurements indicated no significant difference (p = 0.4504). SWP-MOLED was quite repeatable (average coefficient of variation [CV] = 4.17%) and was not corrupted by motion (average CV = 7.49%). Moreover, the proposed method exhibited clearer lesion contours in clinical cases, demonstrating the potential of the proposed method for clinical applications.

SWP-MOLED can efficiently exploit the structural similarity and parameter-weighted information diversity of adjacent slices to improve the spatial resolution and quantification accuracy of MOLED T2 mapping. It also exhibits excellent motion robustness. This technique would extend the application of MOLED imaging.

Substance use and its related disorders represent a significant global health concern. Risk propensity has been identified as a factor influencing substance use.

Multilevel meta-analysis was applied to quantitatively synthesise studies examining the associations between risk propensity and substance use and to identify potential factors that influence these relationships.

A total of 323 effect sizes, 186 independent samples, and 148 studies were included in this meta-analysis. The results showed that risk propensity was statistically positively associated with substance use (r = 0.116), as well as with all three main types of substances, including tobacco (r = 0.092), alcohol (r = 0.114), and drugs (r = 0.115). Such a link was not significantly different across substance types. Moderator analyses showed that the type of risk propensity assessments and age of the study samples moderated the association between risk propensity and one or more types of substance use.

The findings underscore the importance of considering the role of risk propensity in the initiation of substance use and developing early interventions to prevent substance use. Future interventions could consider early detection and targeted intervention for young people with a heightened risk propensity.

The cervical region is highly enriched with sensory receptors, and chronic pain in this area can disrupt afferent signals, potentially affecting motor function and balance.

To examine the effects of nonspecific chronic neck pain on balance, visuomotor reaction time, and upper extremity explosive strength in young females. The secondary objective was to investigate the relationship between neck pain intensity and the evaluated parameters.

Forty-three participants (Neck Pain Group: 21 participants; Healthy Group: 22 participants) were included. Static balance was assessed with the One-Leg Standing Test (OLST), and dynamic balance with the Lower Quarter Y Balance Test (YBT). Visuomotor reaction time was measured using the FitLight Trainer™ system, consisting of 8 RGB Laser LEDs. The Seated Medicine Ball Throw Test was employed to assess upper extremity explosive strength.

Participants in the neck pain group exhibited significantly lower scores on the eyes-closed OLST (p = 0.045) and the composite YBT (p = 0.028) for the dominant lower extremity. Visuomotor reaction time was significantly prolonged in the neck pain group (p = 0.032), while performance in the medicine ball throw test was significantly reduced (p = 0.030). Pain intensity was correlated with visuomotor reaction time (r = 0.454; p = 0.002) and the composite YBT score of the dominant lower extremity (r = -0.356; p = 0.019).

This study's findings indicate that chronic neck pain negatively impacts balance, visuomotor reaction time, and upper extremity explosive strength. Furthermore, a moderate correlation was observed between pain intensity and both visuomotor reaction time and dynamic balance, suggesting that greater pain intensity is associated with greater functional impairment.

This study compares the effects of an artificial intelligence app-based exercise program with group exercise therapy on pain intensity and neck-related disability in patients with neck pain.

84 patients with neck pain. 70 fulfilled the study requirements. 52 were in the intervention and 18 in the comparison group.

The intervention group utilized an AI-based exercise program accessible via digital devices. The AI provided 3-5 daily exercises tailored to individual feedback, pain intensity, and well-being. The exercise duration was up to 15 min per day. The comparison group attended up to two 45-min group exercise sessions weekly.

Pain intensity and neck-related disability were assessed using an 11-point numerical rating scale and the Neck Disability Index via online questionnaires at baseline, 4 weeks, and 8 weeks. The non-parametric Mann-Whitney U test was used to test for between group differences.

After 8 weeks, the intervention group showed a significantly lower pain intensity than the comparison group (U = 287, Z = -2.447, p = 0.042, r = 0.3). Compared to baseline, the intervention group showed a significant reduction in neck pain (Chi2 (2) = 15.775, p < 0.001, W = 0.15) and an improvement in neck-related disability (Chi2 (2) = 25.094, p < 0.001, W = 0.24). The comparison group showed no significant change over time.

The app-based exercise program demonstrated promising results for the reduction of pain intensity and neck-related disability, offering a personalized and mobile alternative to group exercise therapy for patients with neck pain.

Children with Prader-Willi Syndrome (PWS) can present with social deficits and repetitive behaviors that are also encountered in autism spectrum disorder (ASD). This study aimed at ascertaining possible differences in psychopathology between PWS and ASD, with particular attention to obsessional thinking, repetitive behaviors, and impulsivity.

Seventy-one children, aged 4-15 years: 24 with PWS, 23 with ASD, and 24 community controls, were assessed on two standardized parent-reported questionnaires: the child behavior check list (CBCL) and the autism spectrum quotient (AQ). Group differences were tested with one-way ANOVA.

ASD had higher CBCL internalizing symptom scores (67.50±9.09) than PWS (56.62±9.02, Cohen's d=1.20). On specific CBCL items, PWS had more obsessionality than ASD, which, in turn, showed more impulsivity than PWS. ASD had higher AQ scores than PWS, with small to medium effect sizes (d's ranging from 0.22 to 0.53).

The PWS phenotype was characterized by intense obsessionality, more marked than in ASD. ASD had greater psychopathology than PWS, especially of the internalizing type. Although limited by the small sample size, this study identified obsessionality as a common feature in PSW. Considering the negative impact on daily functioning, this symptom deserves clinical attention for specific treatment approaches.

People with disabilities face various barriers that hinder or prevent access to physical activity, impacting their quality of health and life. This study aimed to examine the barriers to physical activity experienced by Chilean athletes with disability. The sample consisted of 35 Chilean athletes with disability. The participants answered the Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) to assess perceptions of social ecological subdivided into four levels. Sex, the type of sport practice, the region where live, the type of disability, and the physical disability were considered. The organizational level was the main barrier according to the ecological level, with the lack of adaptation of outdoor spaces and the lack of information or inclusive advertising in the sports center being the main barriers identified. An effect of the type of disability on the social ecological barriers was observed, with differences between the non-wheelchair user and wheelchair user groups. The organizational and community context were the main perceived barriers. Thus, it is considered relevant to generate actions for specific interventions in order to promote the practice of physical activity and reduce the main barriers identified in the different contexts within the community.

High-resolution computed tomography (HRCT) is essential for evaluating interstitial lung disease (ILD). The effect of slice thickness on threshold-based quantification of individual ILD components remains underexplored. This study investigates the effect of slice thickness on ILD quantification using Lung CT Analyzer.

Retrospective analysis of 53 ILD patients (mean age 64.3 ± 14.1 years) who underwent chest CT scans with HRCT (slice thickness ≤ 1.25 mm) and conventional CT (CCT, ≥ 2.5 mm) reconstructions. Quantitative lung volumes, functional parenchyma, emphysema, ground-glass opacity (GGO), consolidation and affected parenchyma were assessed. The effects of contrast media (CM) application and ILD pattern was assessed separately.

Emphysema volume was significantly higher in HRCT compared to CCT for the whole lung (766.9 ± 568.3 mL vs. 482.6 ± 454.4 mL, p < 0.001), the right lung (431.4 ± 314.6 mL vs. 270.2 ± 251.3 mL, p < 0.001), and the left lung (337.3 ± 259.9 mL vs. 228.0 ± 221.5 mL, p < 0.001). Consolidation volumes also differed significantly between HRCT and CCT for the whole lung (271.6 ± 128.4 mL vs. 252.0 ± 126.3 mL, p < 0.001), with similar findings for the right and left lung. Functional volume was underestimated in CCT reconstructions. No significant differences were observed for GGO volumes or overall affected parenchyma. CM application and ILD pattern had no significant interaction on the measurements.

Slice thickness significantly affects the quantification of functional parenchyma, emphysema and consolidation, whereas GGO and the overall ILD extent remain unaffected.

Tactile discrimination training (TDT) and oculomotor exercises (OEs) have been widely used somatosensory-based interventions for a wide range of chronic pain conditions. There is, however, little evidence for the effectiveness of these approaches in people with chronic neck pain. This study aimed to determine the superiority of one intervention over another on pain outcomes in people with chronic neck pain.

Fifty seven participants were randomly divided into three groups: TDT, OEs, and a control group who received no intervention. TDT, OEs groups received either TDT or OEs, respectively, three times per week for four weeks. The control group received no intervention. Pain intensity, neck pain-related disability, pressure pain thresholds (PPTs), mechanical pain of temporal summation (mTSP), and conditioned pain modulation were assessed as pain outcomes. Depending on the normality, a repeated measures ANOVA or F1-LD-F1 design was used to analyse the data.

A significant group*time interaction and main effects for time were found for pain intensity (p: 0.001, p: 0.001, respectively) and pain-related disability (p < 0.019, p < 0.009; respectively). There was a significant main effect for time for mTSP at the painful side of the neck (p: 0.022). TDT and OEs resulted in a significantly higher improvement in pain intensity (p: 0.005, p < 0.001; respectively) and neck pain-related disability (p: 0.005, p: 0.007; respectively). There was a higher improvement in pain intensity in OEs group compared to TDT group (p: 0.010). A significantly higher improvement in PPT at the painful site after OEs was found (p: 0.038). The control group demonstrated a significantly higher improvement in mTSP in the painful area of the neck (p: 0.048). There were no other significant within- or between-group changes.

OEs and TDT are effective somatosensory-based interventions for improving pain intensity and pain-related disability.

This study demonstrated that sensory retraining interventions improves the subjective pain perception.

Trial Registration Number: NCT05605132, Date of trial registration: 10/29/2022, Name of trial registry: Neck Pain.

Pulmonary rehabilitation (PR) is essential for treating interstitial lung disease (ILD). The 5A nursing model enhances patients' health-promoting behaviors by improving their self-management skills. The aim of this study is to examine and analyze the effectiveness of the PR program based on the 5A nursing model concerning lung function, dyspnea, anxiety, depression, self-efficacy, quality of life, and PR compliance in patients with ILD.

64 hospitalized ILD patients were enrolled in this quasi-experimental study. Patients were randomly assigned to an intervention group (PR program based on the 5A nursing model) and a control group (conventional PR) on a ward-by-ward basis. The allocation was not concealed from the patients. A pre- and post-test design was used. An exercise training diary was utilized to evaluate PR compliance, data was gathered using the mMRC, HADS, PRAISE, and SGRQ, and lung function was assessed by a professional PR-trained nurse. SPSS 26.0 was used to analyze the data. For within/between-groups comparisons, the Wilcoxon signed-rank test, Fisher's exact test, t-test, χ²-test, and Mann-Whitney U-test were employed.

Baseline demographics were generally similar between the two groups (P > 0.05). After 10 weeks of intervention, the PR program based on the 5A nursing model group had more significant improvements in self-efficacy (P = 0.001), anxiety (P = 0.005), and depression (P = 0.018) compared to the control group, but there were no significant differences in dyspnea, lung function, or quality of life (P > 0.05). PR compliance was significantly higher in the intervention group than in the control group (P = 0.028). Further within-group comparisons showed significant improvements in DLCO%pred (P = 0.003), dyspnea (P = 0.001), anxiety (P = 0.006), self-efficacy (P < 0.001), and quality of life (P < 0.001) at post-test in patients in the intervention group compared to pre-test.

The PR program based on the 5A nursing model is an effective way to reduce anxiety, depression, and improve self-efficacy and PR compliance in patients with ILD.

Retroactive registration is underway on the Chinese Clinical Trial Registry (ChiCTR).

Breath-hold functional MRI (bh-fMRI) is able to quantify cerebrovascular reactivity. Vessel stenoses can lead to delayed hemodynamic responses. We aimed to investigate whether delay correction improves the quality of bh-fMRI compared to the diagnostic standard [15O]water PET.

The bh-fMRI data sets of 25 patients with Moyamoya Angiopathy were analyzed retrospectively without and with delay correction. Delay correction was calculated using time-to-peak (TTP) maps derived from dynamic susceptibility contrast (DSC) perfusion MRI. [15O]water PET maps and bh-fMRI maps without and with delay correction were presented blinded for delay correction to two neuroradiologists. The agreement between bh-fMRI without and with delay correction and [15O]water PET was independently and consensually rated on a 4-point-Likert scale (1 = poor, 2 = moderate, 3 = good, 4 = excellent) and compared with Wilcoxon signed-rank test.

The agreement between bh-fMRI and [15O]water PET without delay correction was good/excellent (median = 3, modus = 4), and improved significantly after delay correction with medium effect size (median = 4, modus = 4, z = -2.121, p = 0.034, r = 0.42).

Delay correction improves the quality of bh-fMRI and seems to be helpful in clinical practice.

The adoption of artificial intelligence (AI) is gaining increased interest in medical imaging. However, most medical imaging students in Ghana do not receive training on AI as part of their education. This study aimed to evaluate the effect of a tailored classroom-based medical imaging AI educational intervention in Ghana.

A pre-test/post-test study was conducted. Medical imaging students were recruited. A one-week structured lecture format was employed, integrating pre-tests at the beginning of each class, followed by theoretical presentations, discussions and post-tests. The pre-test and post-test questions were identical to assess retention and attention. The pre-test survey consisted of socio-demographic details, basic medical imaging AI concepts, applications of AI, developing AI systems and AI ethics. Descriptive, paired t-tests and multiple linear regression analyses were performed.

A total of 144 medical imaging students participated in this study, with a mean age of 21 ± 2.41 years. All the participants indicated that they have not received any previous training on medical imaging AI systems. There were significant improvements in participants' knowledge and understanding on basic concepts in medical imaging AI, applications of AI in medical imaging, developing medical imaging AI systems and AI ethics after the intervention (p < 0.001). Year of study was identified as a predictive factor to increased understanding post-test (p = 0.015).

The results of this study showed strong evidence that classroom-based intervention is an effective approach to improving students' knowledge and understanding on medical imaging AI systems.

This short medical imaging AI course can be integrated into the medical imaging curriculum in Ghana to provide students with theoretical knowledge in AI.

Here, findings from a before-after-control-impact (BACI) field experiment are presented that tested the hypothesis that bioturbation (i.e., sediment disturbance through animal activities) from an invasive population of common carp (Cyprinus carpio) degrades water quality by resuspending microplastics and microfibers in lake surface waters during the spawning season. Concentrations of total suspended solids (TSS), microplastics (MP/L), and microfibers (MF/L) were compared before, during, and after a carp spawning event to assess the magnitude and duration of disturbance effects. Concentrations of total suspended solids, microplastics, and microfibers were all similar across sampling sites prior to spawning. As spawning commenced, carp bioturbation increased concentrations of TSS, microplastics, and microfibers by 2-3 times relative to control sites. After spawning ended, TSS and microplastic fragments each returned to ambient concentrations whereas microfiber concentrations remained higher than control sites for multiple weeks. Findings from this study expand the harmful environmental effects of invasive carp to the resuspension of microplastic pollutants and the degradation of lake water quality. Given the widespread distribution of common carp and their propensity for disturbing habitats and eroding water quality, the phenomena described in this study likely extends to many other lakes, floodplain and backwater habitats, ponds, and rivers polluted with plastics and other contaminants.

Book-sharing interactions expose children to diverse language input, yet most research on parent-child book-sharing has focused on monolingual parents reading monolingual books. This study investigated how Latine bilingual parents in the U.S. share different types of books with their children. Twenty-four Latine parents and their three- to five-year-old children shared a monolingual English-only book and a bilingual English-Spanish book. Parents used a higher proportion of total words and different words in Spanish when sharing the bilingual book than the monolingual book. They also engaged in more code-switching with the bilingual book than the English monolingual book. There were no differences in the number or diversity of words in English between book types. These findings show that bilingual books increase parents' use of the home language (in this case Spanish) relative to books in the societal language, and suggest they may be one way of supporting children's dual language development.

This study investigated the impact of mental fatigue on the temporal perceptual prediction of action recognition among boxers of different skill levels.

A mixed experimental design of two (groups: Mental Fatigue Expert Group and Mental Fatigue Novice Group) × two (technique types: attack and defense) × three (time shields: -80 ms, -40 ms, and action start) was implemented. Twenty expert and novice boxers participated in this study. Mental fatigue was induced using a 45-min Stroop paradigm, and the effects were assessed using the VAS, Brog-20, BRUMS-F, and BRUMS-V. The experimental procedure for time perception was developed using E-prime 3.0, incorporating 36 videos depicting various attack and defense techniques, and reaction time and accuracy were recorded.

(1) A significant main effect on reaction time (RT) was observed (F (1,38) = 5.97, p < 0.05, η2 = 0.14) but not on accuracy (ACC), suggesting a pronounced influence of mental fatigue on novice boxers' temporal perceptual prediction in action recognition; (2) significant main effects of skill types were noted in both RT (F (1,38) = 9.03, p < 0.05, η2 = 0.19) and ACC (F (1,38) = 18.496, p < 0.05, η2 = 0.327), indicating disparities in the recognition of offensive and defensive skills under mental fatigue; (3) temporal shielding significantly influenced both RT (F (2,76) = 31.42, p < 0.05, η2 = 0.45) and ACC (F (2,76) = 125.727, p < 0.05, η2 = 0.768), with -80 ms showing a lower RT and ACC compared to -40 ms and action initiation; (4) second-order interaction effects were present in both RT (F (2,76) = 9.85, p < 0.05, η2 = 0.21) and ACC (F (2,76) = 8.773, p < 0.05, η2 = 0.188), with the RT interaction suggesting a negative impact on perceptual prediction at -80 ms and a faster offensive RT than defensive RT. The ACC interaction indicated that under mental fatigue, -40 ms approached and exceeded -80 ms in both offensive and defensive actions, with higher ACC in offense than defense; and (5) a third-order interaction effect among group, technique type, and time shielding on RT (F (2,76) = 3.92, p < 0.05, η2 = 0.09) suggests that mental fatigue more significantly affects novice defensive technique RT than offensive technique.

(1) The 45-min Stroop task effectively induced mental fatigue. (2) Mental fatigue negatively impacts both expert and novice boxers, with a more pronounced effect on experts' defensive skills. (3) The -40 ms time perception is crucial for predicting action recognition as it approaches action initiation.

The promotion of enhanced well-being among children and collaboration among families, schools, and communities is paramount and is a pressing concern in the global education sector. This necessitates that preschool teachers possess the necessary competencies for effective family-preschool partnerships (FPPs). This study explored the competencies necessary for Chinese kindergarten teachers to engage in FPP using behavioral event interviews with 30 participants. Thematic analysis identified key competency traits, and independent samples t-tests with Bonferroni correction compared collaboration competencies between outstanding and typical teachers, as well as across different career stages. Consequently, a comprehensive crisscrossing competency framework consisting of four quadrants was developed. This framework distinguishes between high-performance and general traits, as well as between stable and variable traits that may evolve across career stages. High-performance traits such as communication, expression, and relationship management should be prioritized in the training and recruitment of early childhood educators involved in FPP. In contrast, intrinsic qualities that foster successful FPP, such as child orientation, should be cultivated early and sustained throughout a teacher's career. From a developmental perspective, this framework provides a crucial foundation for evaluating and training kindergarten teachers in the competencies essential for fostering effective FPP.

Recent evidence suggests that gut microbiota has a potential role in the pathophysiology of obesity and other cardiovascular disease (CVD) risk factors, including hypertension, dyslipidemia, and type 2 diabetes. However, clinical trials evaluating the effects of probiotics supplementation on these outcomes have found inconsistent results, probably due to the wide heterogeneity in trial designs. In addition, there is a lack of studies investigating whether probiotics can enhance the beneficial effects of caloric restriction in individuals with increased risk of CVD as individuals with hypertension and excess body adiposity. Thus, the aim of this study was to evaluate the effects of multi-strain probiotics supplementation on body adiposity, glycemic homeostasis, lipid profile, and serum adipokine levels in individuals with hypertension and excess body weight following an energy restricted diet.

A randomized, double-blind, placebo controlled clinical trial was conducted for 12 weeks. Were included 66 individuals aged between 40 and 65 years; both sexes; body mass index (BMI) ≥ 25 and < 40 kg/m2 and diagnosis of hypertension. Were excluded smokers; individuals using probiotics, prebiotics, symbiotics and antibiotics in the last 3 months; presenting diabetes, chronic kidney disease or liver failure; and pregnant and lactating women. Participants were allocated into 2 groups: group with supplementation of 8 probiotic strains in capsules (3 × 1010 CFU/day) or control group (placebo capsules). Both groups followed a low-calorie diet. Participants underwent anthropometric, body composition (dual-energy radiological absorptiometry) and biochemical (glucose metabolism, lipid profile, adiponectin, and leptin) evaluation at baseline and at the end of the study.

After 12 weeks of intervention, the probiotics group presented: a) reduction of body weight, BMI, circumferences of waist, hip and neck and waist-to-height ratio; b) decrease in total fat mass (kg); and c) reduction of glycated hemoglobin (HbA1c). In the control group, it was observed: a) significant reduction in all anthropometric variables; b) significant reduction in total fat mass (kg and %), trunk fat mass (kg), visceral fat and load capacity index. In the comparison between groups, there was a higher decrease in HbA1c in the probiotics group (p < 0.05).

Multi-strain probiotics supplementation associated with energy restriction in individuals with excess body weight and hypertension promoted a significant improvement in glucose homeostasis assessed by HbA1c. The clinical trial was registered at www.ensaiosclinicos.gov.br: RBR-7jw4ry.

We compared maximum voluntary isometric action (MVIA), electromyographic (EMG) amplitude, and hypertrophy of rectus femoris (RF) and vastus lateralis (VL) between groups training in different ranges of motion (ROM). Fifty untrained women were randomised into control group (CON) or to perform knee extension exercise in one of the following groups (0°=extended knee): Full ROM (FULLROM:100°-30°), Initial ROM (INITIALROM:100°-65°), Final ROM (FINALROM:65°-30°), and Varied ROM (VARROM: alternating between INITIALROM and FINALROM). Pre- and post-training assessments included MVIA at 30º, 65º and 100º of knee flexion, during which EMG amplitude of RF and VL was recorded. Summed changes in cross-sectional area, assessed via ultrasound, were measured at four locations along muscles. Results showed greater improvements in INITIALROM and VARROM for MVIA at 100º (20.63%-25.5%) and FINALROM and VARROM for MVIA at 30º (17.28%-17.97%) compared to other groups (-2.92%-9.83% and 0.84%-3.31%, respectively). EMG response was larger in INITIALROM than FINALROM and CON at 100º (15.84% vs -6.61%-1.16%). FINALROM had a higher EMG response than INITIALROM at 30º (4.52% vs -14.95%). For hypertrophy, INITIALROM, FULLROM, and VARROM showed greatest increases (13.20%-17%). Greater MVIA gains aligned with trained ROM, leading to better VARROM results. INITIALROM, FULLROM, and VARROM were more effective than FINALROM in hypertrophy.

Psychomotor intervention mediated by creative dance is emerging as an enjoyable practice that stimulates balance, coordination, and rhythm, benefiting physical function, cognition, and overall health in older adults. Despite the relevance of this practice, validated tests for assessing motor coordination and rhythm in older adults-essential parameters for motor control and movement regulation-are still needed. Thus, this study assessed the effects of a psychomotor intervention using creative dance in global motor coordination, rhythm, and balance in community dwellings. For this intent, one test to assess older adults' global motor coordination and one test to assess rhythm were developed and tested.

This 12-week non-randomized clinical trial study included 38 participants (73.4 ± 5.7 years), allocated into two groups. The experimental group (EG; n = 19) attended the psychomotor intervention (3x/week; 50 min/session), while the control group (CG; n = 19) maintained their daily activities. Previous, global motor coordination and rhythm tests were developed based on the underlying literature and expert consultation. Their reliability and validity were determined. Fullerton Advances Balance Secale assessed Balance.

The test's intra and inter-rater reliability was excellent, ranging 0.962-1.00. There were positive correlations between the test variables and theoretically-related parameters, p < 0.05. Within-group comparison revealed significant improvements after the intervention in the EG global motor coordination, rhythm, and balance, p < 0.05. Significant differences between groups concerning change (pre-post-intervention) in the previous variables were found, p < 0.05, with an effect size ranging 0.40-0.74.

The current study supports the reliability and validity of the developed global motor coordination and rhythm tests in community dwellings. Nonetheless, further research is recommended to substantiate these findings in men. The psychomotor intervention mediated by creative dance induced large beneficial effects in global motor coordination, rhythm, and balance. These findings suggest that this practice is beneficial for promoting community-dwelling older adults' healthy aging.

ClinicalTrials.gov Identifier: NCT04311931. Date of registration: March 17, 2020.

The Working Alliance Inventory-Short Revised (WAI-SR) is a self-report measure of therapeutic alliance from the patient's perspective. This study aimed to examine the factor structure of the WAI-SR and evaluate its measurement invariance across in-person and videoconferencing psychotherapy sessions.

The study sample consisted of 1043 adult patients. Exploratory and confirmatory factor analyses were conducted to evaluate the WAI-SR dimensions and structure. Measurement invariance was tested using multi-group confirmatory factor analysis, multiple indicator multiple causes model analysis, and item bias analysis.

The findings supported a three-factor structure of the WAI-SR, encompassing goal, task, and bond dimensions. Results demonstrated configural, metric, scalar, and residual invariance across in-person and videoconferencing formats. The factor structure remained consistent after accounting for patient age and gender. Additionally, no differential item functioning or bias was observed between groups. The WAI-SR exhibited excellent internal consistency and composite reliability.

The WAI-SR is a reliable and valid tool for assessing therapeutic alliance across both in-person and videoconferencing sessions. The equivalence in measurement properties and mean scores across modalities highlights the adaptability of therapeutic alliance to virtual environments, supporting the broader use of telehealth in psychotherapy.

Objectives: This study aimed to analyze the effect of a multimodal prehabilitation program for colorectal cancer patients in body composition, physical and cardiorespiratory fitness as well as its ability to reduce postoperative complications. Methods: A longitudinal observational study evaluated the efficacy of a prehabilitation intervention based on four components: (a) health education and self-care, (b) nutritional counseling, (c) psychological support, and (d) supervised physical exercise. Body composition was determined through bioelectrical impedance analysis; physical fitness variables such as strength was measured by a handgrip dynamometer for upper limbs, and a squat-jump test, countermovement jump test using a contact platform, and a chair-stand test for lower limbs. Flexibility was assessed with the sit-and-reach test. Cardiorespiratory fitness was assessed with the 6 min walking test (6MWT). Moreover, we measured lifestyles related to the amount of physical exercise by accelerometry. Results: The final cohort included 30 patients. Patients completed an average of 9.90 ± 5.26 exercise sessions. Statistically significant changes with varying effect sizes were observed in the following outcomes: SJ values in cm and W for both sexes (p = 0.021/d = 0.14 and p = 0.043/d = 0.10, respectively), SJ in W for women (p = 0.023/d = 0.21), all chair-stand test values (p = 0.021/d = 0.65 for men, p = 0.004/d = 2.08 for women, and p = 0.000/d = 0.84 for both sexes), and sit-and-reach for both sexes (p = 0.005/d = 0.12) and for men (p = 0.044/d = 0.08). All 6MWT values had statistically significant changes (p = 0.001/0.46). Women reduced the weekly minutes spent in sedentary behavior (p = 0.037/d = 0.65) and increased the minutes spent performing light physical activity (p = 0.037/d = 0.63). With regard to surgical outcomes, there was a tendency towards a decrease in postoperative complications and hospitalization days, as well as minutes in postoperative REA (p = 0.009/d = 0.69) in relation to the control group. Conclusions: Participation in a multimodal prehabilitation program improves several aspects of physical condition and lifestyles related to the amount of physical exercise and reduces both days of hospitalization and several complications post-surgery.

Previous studies have proposed that socioeconomic status (SES) can affect postpartum depression (PPD) through the mediators of satisfaction with material needs, healthcare, maternity leave, and postpartum social support. However, empirical data to validate these propositions has been lacking. This study aims to examine if all the four mediators can significantly mediate the effects of SES on PPD, as well as to compare the effect sizes of these mediators using a parallel mediation model.

A total of 328 mothers within 1 year after childbirth completed the Socioeconomic Status Questionnaire, Met Material Needs Questionnaire, Inpatient Satisfaction with Care Questionnaire, Self-care Ability Scale for Puerperal Women, Maternity Leave Questionnaire, Questionnaire for Social Support during the Postpartum Period, and Beck Depression Inventory.

The level of depression in lower-SES mothers (M = 18.38, SD = 6.88) was significantly higher than that in medium-SES mothers (M = 14.54, SD = 8.58), which was significantly higher than that in higher-SES mothers (M = 10.61, SD = 8.25). SES significantly affected satisfaction with material needs, healthcare, maternity leave, and postpartum social support. Satisfaction with material needs and postpartum social support had a significant impact on PPD, and played a significant mediating role in the relationship between SES and PPD, with mediating effect sizes of 40.0% and 30.3%, respectively. In contrast, healthcare and maternity leave did not significantly influence PPD, nor did they significantly mediate the effect of SES on PPD.

Postpartum social support and satisfaction with material needs are two important mediators between SES and PPD, whereas healthcare and maternity leave are two insignificant mediators in this relationship. More actions should be taken to reduce PPD in postpartum mothers, particularly those lower-SES mothers.

Myoblast determination protein 1 (MyoD) is a master transcription factor that triggers myogenesis and drives muscle growth.

The aim was to assess acute exercise-induced MyoD mRNA expression in skeletal muscle for young and older (age > 50) adults.

A meta-analysis and systematic review was conducted.

A literature search was conducted for studies reporting MyoD mRNA changes in biopsied human muscle taken within 48 h after exercise. Fifty eligible studies with 822 participants (young 20-35 years; older 53-85 years) were included for meta-analysis.

Significant increases in MyoD mRNA expression in human skeletal muscle were observed 3-12 h post-exercise (standardized mean difference [SMD] = 1.39, p < 0.001), subsiding within 24-48 h (SMD = 0.47, p < 0.001). Older individuals showed a similar time pattern in MyoD mRNA expression post-exercise, but the response is weaker than in younger individuals. Intriguingly, resting levels of MyoD mRNA were higher in older individuals compared to younger individuals in most age-paired studies (SMD = 0.56, p < 0.01). Considering the decline in anabolic hormones during later life, this systematic review highlights age- and sex-related impacts on exercise-induced MyoD mRNA expression in human skeletal muscle, emphasizing the roles of sex hormones and insulin.

Pooled results from the eligible studies suggest a blunted exercise-induced increase in MyoD mRNA in skeletal muscle after age 50, likely due to elevated basal MyoD expression as a compensatory mechanism against persistent catabolic conditions in aging muscle.

Registration number: CRD42023471840 (PROSPERO).

The EQ Health and Wellbeing (EQ-HWB) is a new experimental measure of health and well-being, having been validated in an increasing number of countries and languages. This study aims to examine the psychometric properties of the EQ-HWB and its short version (EQ-HWB-S) in Ireland and compare them with the EQ-5D-5L and ICEpop Capability Measure for Adults (ICECAP-A).

A secondary analysis of cross-sectional data from a 2023 Irish general population survey (n = 1220). The survey included the EQ-HWB, EQ-5D-5L, ICECAP-A, and socioeconomic and health-related questions. EQ-HWB-S responses were derived from the EQ-HWB. The UK or Irish value sets were used for each measure to compute index values. Ceiling effects, convergent, divergent validity, and known-group validity were assessed and exploratory factor analysis was conducted.

Mean index values were 0.755, 0.760 to 0.830, and 0.807 for the EQ-HWB-S, EQ-5D-5L, and ICECAP-A, respectively. Ceiling effects were 3%, 7%, 23%, and 15% for EQ-HWB, EQ-HWB-S, EQ-5D-5L, and ICECAP-A. EQ-HWB-S index values correlated strongly with EQ-5D-5L (r = 0.740-0.759) and ICECAP-A (r = 0.604) index values. All measures demonstrated good known-group validity for health-related variables, with EQ-5D-5L performing best overall. Factor analysis identified 5 factors: psychosocial health, pain and discomfort, sensory and physical functioning, capability well-being, and positive psychological states. Feeling settled and secure was the only ICECAP-A item that loaded onto the same factor (psychosocial health) as any of the EQ-HWB items.

To our knowledge, this is the first study to compare the measurement performance of EQ-HWB and EQ-HWB-S with ICECAP-A. The EQ-HWB and EQ-HWB-S showed good psychometric performance in an Irish population sample. Limited overlap was observed between EQ-HWB and ICECAP-A well-being concepts.

University students often face mental health challenges, exacerbated by stigmas that hinder seeking support and treatment. We introduce a participatory arts programme, Movin' and Groovin' for Wellness (MGW), that features facilitated drumming and dancing sessions. This study aimed to investigate the impact of the MGW programme on students' mental health, social connections, and creativity.

A 10-week pilot parallel Randomised Controlled Trial (RCT) was conducted with 76 participants randomly assigned into an Experimental (MGW) group (N= 38) or a Control group (N= 38). Data were collected at baseline, midway, and post-intervention. Mental health was evaluated using the Depression, Anxiety, and Stress Scale- 21 (DASS-21), and quality of life via the WHO Quality of Life-BREF (WHOQOL-BREF) scale. The Brief Resilient Coping Scale, Lubben Social Networking scale, Experience of Creation scale, and Brief Music in Mood Regulation scale (B-MMR) were also administered. Qualitative feedback was gathered through a bespoke survey and focus group discussion (FGD), focusing on participants' subjective experiences of the programme, mood/emotion states, social connections, and creative expression.

The MGW programme led to significant improvements in mental health, quality of life, and creativity, while the Control group experienced significant declines in mental health and quality of life over the same 10-week period (coinciding with term time). The Experimental group showed significant reductions in Stress scores (DASS-21) at Week 10, whereas the Control group had significantly worse anxiety, depression, and stress at Week 5, with stress scores remaining elevated at Week 10. Improvements in the Experimental group were also observed in the Psychological (at Week 5) and Physical (at Week 10) domains of the WHOQOL-BREF. In comparison, the Control group showed a significant decrease in WHOQOL-BREF Physical scores at Week 10. The Experimental group also showed enhanced creativity (Experience of Creation scale) at Week 5 and Week 10, although no significant changes were observed in the social networking or resilient coping scales. Qualitative findings highlighted the programme's positive impacts on participants' mental health, social connections, and creativity.

The MGW programme effectively improved mental health, quality of life, social connection and creative expression among university students. These findings suggest that arts-based interventions such as MGW can support student health and well-being in a stigma-free and culturally appropriate manner.

The trial was retrospectively registered at ClinicalTrials.gov under ID: NCT06542003 (08 August 2024).

Surgical errors of orthopedics robotic are influenced by a multitude of factors. This study aims to investigate the impact of non-navigational errors on the accuracy of pedicle screw placement in orthopedic surgery.

Initially, a robot-assisted Kirschner wire (K-wire) placement simulation system was constructed, comprising a universal arm, wide-angle cameras, microscope cameras, and a vertebral base. Utilizing this system, we conducted a systematic analysis of the effects of four factors on non-navigational errors: operator habits, guide-to-bone surface distance, robotic arm stiffness, and vertebral fixation stiffness.We investigated two distinct operator habits: Habit 1 involves first positioning the K-wire against the bone surface through the guide and then inserting it using a bone drill; Habit 2 involves clamping the K-wire onto the bone drill and then inserting it together. Based on the control variable method, we designed precision measurement experiments for K-wire placement under different factors, forming 26 variable combinations to investigate the K-wire placement errors under each factor and their proportions in the overall error.

A total of 933 K-wire placements were performed in this study. The average deviation under Habit 2 conditions was 0.51 mm, compared to 0.13 mm under Habit 1 conditions; the average deviation was 0.36 mm when the guide-to-bone surface distance was 5 cm, and 0.28 mm when the distance was 1 cm; the average deviation was 0.36 mm under the 600 mm robotic arm condition, and 0.24 mm under the 500 mm robotic arm condition; the average deviation was 0.37 mm in the Plaster-Fixed Vertebra Group, and 0.85 mm in the Silicone-Fixed Vertebra Group.

Operator habits and vertebral fixation stiffness are the primary factors influencing non-navigational errors, while guide-to-bone surface distance and robotic arm stiffness are secondary factors. This study recommends adopting Habit 1 in clinical surgeries, minimizing the guide-to-bone surface distance, and enhancing the stiffness of the robotic arm and vertebral fixation to reduce non-navigational errors and improve the accuracy of robot-assisted pedicle screw placement.

Delirium manifests with comparable clinical presentations, regardless of its heterogeneous etiology. This suggests a final common pathway such as decreased electroencephalography (EEG) phase coupling. This study investigates if amplitude coupling, another mode of neural communication, is altered in delirium due to different etiologies.

We analyzed EEGs of patients from three sites with either postoperative, poststroke or medical delirium and non-delirious control patients. Amplitude envelope correlation corrected for spatial leakage (AECc) was calculated and Mann-Whitney U-tests were used to compare patients with or without delirium. AECc differences among delirium types were compared using Kruskal-Wallis tests.

AECc was significantly increased in delirious (n = 173, age 79.2±9.3 years, 46 % female) as compared to non-delirious (n = 204, age 72.9±13.1 years, 45 % female) patients in the delta (median, effect size of difference: 0.16 vs. 0.12, r = 0.28, p < 0.01) and beta band (0.11 vs. 0.09, r = 0.14, p = 0.04). These changes did not differ among delirium types (p > 0.05).

We found modestly higher delta and beta band AECc in delirium compared to non-delirious control patients, regardless of the presumed etiology.

This study provides evidence for altered amplitude coupling as mode of impaired neuronal communication in delirium, the role of which should be investigated in future studies of neural network pathophysiology.

The growing adoption of social virtual reality (VR) platforms underscores the importance of safeguarding personal VR space to maintain user privacy and security. Teleportation, a prevalent instantaneous locomotion method in VR, facilitates user engagement but can also inadvertently intrude upon personal VR space, thereby raising privacy concerns. This paper introduces three innovative negotiated teleportation techniques designed to secure user-to-user teleportation and protect personal space privacy, all under a unified small-group development framework. We have designed and evaluated three types of negotiated teleportation techniques: Sector technique for directional control, Distance technique for minimum social distance control, and Area technique for defining circular permissible teleportation areas. These techniques foster a collaborative approach to selecting teleportation points that respect personal space. To evaluate the efficacy of these techniques, we conducted a user study with 20 participants who performed social tasks within a virtual campus environment. The findings demonstrate that our techniques significantly enhance privacy protection and alleviate anxiety associated with unwanted proximity in social VR.

This study investigated the impact of different breathing patterns and stroke variations on inspiratory and expiratory muscle fatigue (IMF and EMF) in front crawl swimming.

Twelve club-level swimmers (3 females) performed four maximal effort 200-m front crawl swims in a random order: breathing every two strokes (B2), every four strokes (B4), ad libitum via a snorkel (S), and legs only with a kickboard (K).

Postswim maximal inspiratory mouth pressure decreased in B2 (34±26%), B4 (41±23%), S (26±16%), and K (13±15%). The only significant difference in IMF was between B4 and K. Significant EMF was observed only in S (12±11%) and K (13±15%). IMF was greater than EMF in B2 and B4. Swim time was slower in K (217 (199-231) s) compared to B2 (139 (136-156) s), B4 (142 (138-155) s), and S (142 (138-155) s), but similar among B2, B4, and S. Postswim, pH and HCO3- levels decreased, while blood lactate levels increased in all trials. Full stroke and legs-only front crawl swimming caused IMF, regardless of breathing restrictions. However, IMF was lower when breathing was unrestricted, and the upper body was immobilized compared to full stroke and highly restricted breathing. EMF was not observed when breathing was restricted and tended to be lower than IMF.

These findings suggest that the mechanisms of IMF and EMF differ during front crawl swimming.

This study aimed to assess the effects of focal brain cooling (FBC) on human brain tissue through use of multiple sensing techniques by monitoring cerebrovascular activity and brain temperature.

Intraoperative brain activity monitoring using a multimodality probe capable of measuring brain temperature, electrocorticography (ECoG) and changes in cerebral hemoglobin concentration was performed in 13 patients with refractory epilepsy. Brain temperature and neurovascular activity were measured beneath and surrounding the FBC device. Data were categorized into three temperature ranges [low-temperature range (LTR, <18 °C), moderate-temperature range (MTR, 18 °C-28 °C), and high-temperature range (HTR, >28 °C)] for analysis.

Changes in oxyhemoglobin (ΔO2Hb) and deoxyhemoglobin (ΔHHb) across the temperature ranges showed a U-shape and inverted U-shape pattern, respectively. ΔO2Hb decreased and ΔHHb increased in the MTR, reflecting enhanced neuronal activity and increased oxygen consumption. Conversely, ΔO2Hb increased and ΔHHb decreased in the LTR, indicating suppressed neuronal activity and reduced oxygen consumption. These findings highlight the temperature-dependent modulation of neurovascular activity by FBC, driven by distinct non-linear patterns.

FBC selectively influenced brain electrical activity and hemoglobin concentration, highlighting its subtle effects on neurovascular dynamics.

These findings provide critical insights into optimizing cooling strategies for neurological disorders using multimodality probes and FBC devices.

The COVID-19 pandemic challenged social support systems leading to loneliness and social isolation, particularly for older adults and international university students. This study explored the potential of using a shared interest in pets to support intergenerational and intercultural social connections, with a hypothesis that such interactions could enhance health-related quality of life and wellbeing and reduce feelings of loneliness.

The study adopted an action research approach to co-design and pilot an Animal-Assisted Activity (AAA) group intervention (called the 'Pets and People program') across two aged care facilities in Melbourne, Australia. The 18-week program was designed to facilitate social connections through the presence of live or robotic pets, and/or animal-assisted activities. The program was evaluated using mixed methods.

Thirty older adults and 11 international students participated in the program. Six older adults, 10 international university students and three senior management staff participated in the evaluation. Both the older adult and student groups experienced a significant decrease in feelings of loneliness and a significant and clinically meaningful increase in the EQ-5D-5L utility index after program completion. The cost of implementation was $237 per person who participated in 10 weeks or more of the 18-week program. The explorative cost-utility analysis indicated a cost of $4,017 per quality adjusted life year gained, which is well below the threshold for the Australian Government's health related expenditure.

The Pets and People program holds potential to be replicated and scaled in aged care settings both in Australia and internationally.

This study explores links between anxiety and physical health among older adults (aged 45+) incarcerated in Kentucky state prisons. Using secondary data, independent sample t-tests, and hierarchical multiple linear regression, we identify disparities in anxiety and physical health among those with and without self-reported anxiety and the contribution of symptoms of anxiety to physical health in the sample. Findings show individuals with self-reported anxiety experienced increased impairment in daily activities, multimorbidity, and decreased physical health-related quality of life. Older adults are a large and growing proportion of prison populations, and addressing anxiety may improve physical health and reduce related costs.

Older veterans with multimorbidity experience physical and social vulnerabilities that complicate receipt of and adherence to physical rehabilitation services. Thus, traditional physical rehabilitation programs are insufficient to address this population's heterogenous clinical presentation.

To evaluate the feasibility and acceptability of a MultiComponent TeleRehabilitation (MCTR) program for older veterans with multimorbidity.

Randomized controlled cross-over feasibility study.

Telehealth from Veterans Affairs Medical Center to participants' homes.

Fifty U.S. military veterans, age ≥60 years (mean ± SD; 69.2 ± 6.7) with ≥3 comorbidities (6.0 ± 1.9), and impaired physical function were randomized and allocated equally to two groups.

The MCTR program consisted of high-intensity rehabilitation, coaching, social support, and technologies. Physical therapists delivered 12 individual and 20 group telerehabilitation sessions/participant. Participants in the education group started the MCTR program after 12 weeks.

The primary outcome was combined adherence (>75% of participants attending ≥80% sessions). Acceptability was measured by the Acceptability of Intervention Measure. Secondary outcomes included safety, participant surveys, and physical function. Patient-level outcomes were collected at baseline, 12 (primary time point), and 24 weeks.

Of 50 participants, 39 adhered to total session attendance (0.78 [95% confidence interval: 0.64-0.88], p = .76), 45 adhered to individual sessions (0.90 [95% confidence interval: 0.78-0.97], p = .01), and 48 rated the program as acceptable (0.96 [95% confidence interval: 0.85-0.99], p < .001). Thirty-five participants reported 78 safety events, and 12 (15%) had some degree of relatedness to the protocol. Most patient-level outcomes were similar between groups at 12-weeks.

The MCTR program was feasible based on high adherence to individual sessions and high acceptability. Adherence results were consistent with previous exercise studies in older adults. Most in-session safety events were related to underlying medical conditions and consistent with in-person physical rehabilitation safety events. These results can inform use of telerehabilitation for similar populations.

Background/Objectives: During the COVID-19 pandemic, suicide risk increased in the general population and persisted in the post-pandemic period. People with hearing impairment faced communication barriers that negatively affected their mental health. However, there is no evidence on whether they have an increased suicide risk in the post-pandemic period. This study aimed to assess the association between mental disorders, quality of life, and suicide risk in individuals with hearing impairment in the post-COVID-19 period. Methods: A cross-sectional study was conducted with 103 participants with hearing impairment from the CaViDAuCo study. Adjusted and unadjusted differences in mental disorders (depression, anxiety, and stress) and quality of life (physical and mental) were analyzed using Student's t test and ANCOVA according to suicide risk. Results: Depression, anxiety, stress, and mental quality of life in people with hearing impairment were significantly associated with suicide risk (unadjusted, models 1 and 2, p < 0.001; Cohen's d = 1.4, 1.4, 1.3, and -1.0, respectively). Due to the cross-sectional design, no causal relationships can be established. Conclusions: In the post-pandemic period, participants with hearing impairment exhibited a significant association between suicide risk, mental disorders, and poor mental quality of life. Although causality cannot be established, and the results should be interpreted with caution due to the small sample size, these findings underscore the need to improve mental health accessibility and implement inclusive communication policies. Further research is needed to better understand these associations and design effective interventions that promote the mental health and quality of life of people with hearing impairment.

Cochlear implants (CIs) are the primary treatment for severe-to-profound hearing loss. For CI users, speech intelligibility (SI) is often excellent in quiet yet degrades dramatically in background noise. Scientific and clinical testing of the effects of noise on SI is routinely performed with speech-in-noise tests. The sensitivity of these tests to signal to noise ratio depends on the slope of their psychometric curve. This slope is not always known for CI users, and direct comparisons between typical hearing (TH) listeners and CI users are lacking.

We present a comparative study of a digit test (DIN), a Matrix sentence test, and an everyday sentence test (LIST) for a group of CI users and TH listeners, with use of word (digit) and sentence (triplet) scoring in the free field. We report descriptive statistics and effect size measures of the psychometric slope and the speech reception threshold (SRT) for each speech test.

For CI users, the slopes of the psychometric curve were significantly shallower and SRTs significantly higher than those of TH listeners. The shallowest slope was seen with the Matrix test. However, the small variances of the slope and the SRT resulted in effect size estimates that fell between those of the other two tests. The DIN test was associated with steeply sloped psychometric curves with low variance. The scoring method did not substantially affect slopes and SRTs for the DIN test and LIST sentences, but word scoring resulted in shallow slopes and substantially worse SRTs for CI users.

The DIN test stood out in this study as an attractive speech-in-noise test for CI users, with steep slopes and low variance in slopes and SRTs among participants. Digit and keyword scoring appear to be viable options for the DIN test and LIST sentences, respectively, potentially increasing the number of available test items. For the Matrix test, sentence scoring yielded shallow slopes and deteriorated SI, especially for the CI group. We recommend word scoring for the Dutch-Flemish Matrix test.

To compare cervical range of motion (ROM) between asymptomatic individuals and those with subacromial pain syndrome (SAPS), and to investigate its relationship with shoulder pain, disability, and other clinical factors.

A cross-sectional study was conducted with 50 individuals with SAPS and 50 asymptomatic controls (both sexes, aged 32-66). The Shoulder Pain and Disability Index (SPADI) assessed shoulder disability, and cervical ROM was measured using a cervical range of motion (CROM) device.

Individuals with SAPS had significantly reduced cervical ROM compared to controls, confirmed by Student's t-test or Mann-Whitney test. Large effect sizes were observed (Cohen's d = 1.08 and 1.65 for right bending and extension; Mann-Whitney effect size = -0.44 to -0.56 for other movements). Pearson correlations revealed a significant inverse relationship between cervical ROM and SPADI scores (r = -0.42 to -0.61). Chi-square analysis indicated that shoulder pain was associated with cervical ROM deficits (Χ2 = 6.83 to 27.75), with prevalence ratios ranging from 1.5 (flexion) to 4.25 (left rotation) higher in individuals with SAPS. These deficits were also associated with longer duration of shoulder pain, higher neck pain intensity, and older age.

Individuals with SAPS have reduced cervical mobility compared to asymptomatic individuals, especially for cervical rotation. Cervical ROM deficits were more prevalent in individuals with SAPS and correlated with greater shoulder disability. Clinical factors such as duration of shoulder pain, neck pain intensity, and age contribute to these deficits. These findings highlight the need to assess cervical mobility in patients with SAPS.

Test anxiety (TA) has been linked to abnormalities in attentional control not only for test-related information but also in situations where irrelevant information has to be ignored. However, the neural basis of individuals with high TA (HTA) when exposed to interference from different types of information remains limited. Twenty-two individuals with HTA and twenty-three individuals with low TA (LTA) completed a Stroop task integrating emotional-word and color-word Stroop tasks. Participants were instructed to assess the font color of neutral words, generally threatening words, test-related threatening words, color-congruent words, and color-incongruent words. Functional magnetic resonance imaging data were recorded simultaneously as the task was completed. The results indicated that compared with LTA group, HTA group exhibited higher activation in the right postcentral gyrus, left cerebellum, right calcarine gyrus, and left inferior parietal lobule when individuals were exposed to interference by test-related threatening words as opposed to neutral words. However, no clusters with significant group-related differences were found when individuals were exposed to interference by generally threatening words and color-incongruent words. These results suggested that differences in attentional control processes between high- and low-test anxiety groups were mainly limited to test-related threatening stimuli and did not extend to generally threatening and cognitively task-irrelevant stimuli.

Rehabilitation is an effective and feasible approach for post-COVID patients to improve mental health and cognitive complaints. However, knowledge regarding the long-term impact of rehabilitation on neuropsychological health of these patients is lacking.

This study aims to investigate psychological health, fatigue, and cognitive function 6 and 12 months after inpatient post-COVID rehabilitation of patients, who acquired COVID-19 in the workplace. In addition, group differences in these outcome parameters according to sex, age, acute COVID status, socioeconomic status, profession, and pre-existing diseases will be detected.

This longitudinal observational study examined the changes in mental and cognitive health of 127 patients with COVID-19 as an occupational disease or work accident. Symptoms of depression and anxiety, fatigue severity, somatic symptom severity, trauma-related symptoms, and cognitive functioning were assessed at the beginning as well as six and 12 months after rehabilitation. Group differences concerning sex, age, acute COVID status, socioeconomic status, occupational status, and existing diseases prior to COVID-19 were also analyzed.

The results showed that the improvements direct after rehabilitation in mental health and fatigue severity could not be maintained six and 12 months after rehabilitation discharge. Contrary, patients' cognitive function maintained stable during follow-up. Significant group differences were observed regarding age, sex, acute COVID status, socioeconomic status, occupational status, and pre-existing diseases.

This study highlights the importance of the aftercare process and the implementation of adequate and individualized therapeutic interventions such as psychological support and strengthen self-management skills.The study is registered in the German Clinical Trials Register with the identifier DRKS00022928.

Regular walking has been reported to improve metabolically-associated steatotic liver disease (MASLD) by altering the metabolic environment. However, no studies to date have focused on older individuals in both conditions. Therefore, this study aimed to investigate the effects of a 12-week walking intervention on metabolic syndrome risk factors, liver function indicators, and liver ultrasound findings in older adults with both metabolic syndrome and MASLD.

A total of 66 participants aged 65-85 years had average ages, heights, and weights of 75.3 ± 5.8 years, 159.3 ± 9.3 cm, and 68.6 ± 6.8 kg, respectively. The participants resided in four senior living communities, and their diets were uniform. The participants from two facilities were assigned to the control group (CON, n = 33), whereas those from the other two facilities were allocated to the treadmill walking program group (WPG, n = 33). Each group comprised 13 males and 20 females. The intervention consisted of a low- to moderate-intensity walking program, conducted for 30 min per day, 6 days per week, totaling 180 min per week. The total daily calorie expenditure was recorded based on the values calculated from the treadmill. The walking intensity was adjusted by modifying the treadmill incline according to each participant's heart rate corresponding to their maximal oxygen consumption (VO₂max). The exercise intensity was set at 50% on Mondays and Fridays, 60% on Tuesdays and Thursdays, and 70% on Wednesdays and Saturdays. Sundays were designated as rest days.

Although there were no significant differences in caloric intake between the groups, the WPG exhibited a 52.5% increase in physical activity levels (p < 0.001), resulting in significant reductions in body weight (-10.2%), fat mass (-17.2%), and abdominal fat (-4.8%). The WPG showed a 16.1% increase in VO₂max, along with significant reductions in systolic blood pressure (-9.6%) and blood glucose (-16.9%), as well as notable improvements in lipid profiles (p < 0.001). The WPG also demonstrated significant reductions in aspartate aminotransferase (-40%), alanine aminotransferase (-23.5%), total protein (-14.4%), albumin (-8.1%), bilirubin (-17.6%), and liver ultrasound scores (-31.8%), with all changes showing significant intergroup differences (p < 0.001).

Along with a consistent diet, a 12-week walk has been shown to induce significant changes in the body composition and cardiometabolic factors of older adults, as well as notable improvements in liver function markers and imaging findings.

This study was registered with the Clinical Research Information Service of the Korea Centers for Disease Control and Prevention under Clinical Trials KCT0010079 on 26/12/2024.

The adoption of protective behaviors represents a crucial measure to counter the spread of infectious diseases. The development of effective behavior change techniques therefore emerged as a public health priority during the COVID-19 pandemic, but randomized controlled trials (RCTs) testing such interventions during the pandemic were scarce. We conducted a Multiphase Optimization Strategy to develop, optimize, and evaluate a smartphone app, Soapp+, to promote hand hygiene during the COVID-19 pandemic.