8-week Group Research Articles

Impact of a physical exercise intervention on psychological resilience and mental ill-being in medical-naïve children with attention-deficit/hyperactivity disorder: a pilot randomised controlled trial

ABSTRACT The study aimed to evaluate whether a 12-week physical exercise intervention would improve psychological resilience and mental ill-being (e.g. internalising and externalising symptoms) in medical-naïve children with Attention-Deficit/Hyperactivity Disorder (ADHD). In a parallel two-group randomised controlled trial (RCT) design, 30 children between 8–12 years (Mage = 8.62 ± 1.37) formally diagnosed with ADHD were assigned to a 12-week physical exercise intervention group (three sessions per week for 60 mins, moderate-to-vigorous physical activity [MVPA] intensity) or a control group (treatment as usual). Psychological resilience was measured by a self-reported Chinese version of the 25-item Connor-Davidson Resilience Scale, and mental ill-being was assessed by a parent-reported Chinese version of the 113-item Achenbach’s Child Behavior Checklist. The 12-week physical exercise intervention with MVPA level revealed a significant improvement in psychological resilience (F = 4.82, p = .038) and a significant reduction in internalising symptoms (e.g. anxiety/depressed, withdrawn/depressed, and somatic complaints) (F = 7.11, p = .013) and externalising symptoms (e.g. rule-breaking behaviour and aggressive behaviour) (F = 21.09, p < .001) in the intervention group but not in the control group. Moderate correlations were revealed between the changes in psychological resilience and the changes in internalizing (r = -.557, p = .031) and externalising symptoms (r = -.647, p = .009) in the intervention groups (n = 15). The findings of this study provide initial support for the efficacy of physical exercise intervention on psychological resilience and mental ill-being and for the potential mechanisms of psychological resilience under the effects of exercise-induced mental ill-being improvements in children with ADHD.

Preliminary investigation on the establishment of a new meibomian gland obstruction model and gene expression

Meibomian gland dysfunction is a chronic ocular surface disease with a complex pathogenesis, whose main clinical manifestations are meibomian gland obstruction or/and lipid abnormalities. To explore the mechanism of MGD due to meibomian gland obstruction (MGO), we established a rat model of MGO by cauterizing the meibomian gland orifice. The morphology of the lid margins and meibomian gland orifices were visualized by slit lamp. The tear production of rats was measured by phenol red cotton thread, the tear film breakup time and corneal fluorescein staining scores of rats were detected under cobalt blue light of slit lamp. Changes in the histological structure of the meibomian gland (MG) were observed by HE staining, Oil Red O staining and immunofluorescence staining (collagen IV). RNA sequencing was used to detect differentially expressed genes in MGO and normal rats, which were validated by qPCR. In the MGO group after 4, 8, and 16 weeks, the meibomian gland orifices were closed, tear film break-up time decreased and corneal fluorescein staining score increased (p < 0.05). MG acini was smaller at 8-week and 16-week MGO rats in HE staining. Oil Red O staining showed less condensed staining in the 8- and 16-week MGO groups, while more condensed staining in the 4-week MGO group. Additionally, the basement membrane was destroyed in 16-week MGO group by immunofluorescence staining of collagen IV. Meanwhile, RNA sequencing and qPCR showed that lipid peroxidation (LPO), transient receptor potential vanilloid-3 (TRPV3) and genes in PPAR signaling pathway were differentially expressed in 16-week meibomian gland obstructive rats (p < 0.05). Consequently, meibomian gland obstruction model rats were established successfully with corneal damage and lower tear film stability. Meibomian gland obstruction is a causative factor of MGD, which led to abnormal histological structure in MG, differential expression of PPAR signaling pathway and TRPV3.

Benefits of self-paced concurrent training on lung function, cardiopulmonary fitness and fatigue perception in patients with multiple sclerosis.

Aim: Studying the effects of self-paced concurrent high-intensity interval training and resistance training (HIIT-RT) on respiratory function, cardiopulmonary fitness and fatigue perception in patients with multiple sclerosis (PwMS).Methods: Twenty-three PwMS were randomized into a 12-week training group (three times per week) (TG, n=11) or a control group (CG, n=12). Lung function (spirometry), aerobic capacity (graded cardiopulmonary-exercise-testing) and perceived fatigue (Fatigue Severity Scale (FSS)) were evaluated pre- and post-intervention.Results: The forced vital capacity (p=0.036, Hedges'g (g)=0.93), forced expiratory time (p=0.045, g=0.88), peak expiratory flow (p=0.043, g=0.89) increased in TG compared with CG. The TG showed an increase in peak aerobic power (p=0.004, g=1.34) and peak oxygen uptake (p<0.001, g=2.58) compared with CG. There was a decrease in ventilatory equivalent for carbon dioxide (p=0.02, g=1.02) and FSS scores (p<0.001, g=1.72) in TG comparatively with CG.Conclusion: 12-week self-paced HIIT-RT enhanced lung function as well as aerobic fitness, and alleviated fatigue perception in PwMS.

Implementation and Evaluation of a Virtual Skills-Based Dementia Caregiver Group Intervention within a VA Setting: A Pilot Study.

This study sought to design, implement, and evaluate a 6-week skills-based telehealth group for dementia caregivers within a VA setting. The protocol was designed based on a CBT skill-building approach and was evaluated using the four levels of evaluation developed by Kirkpatrick (1998). Eight spousal caregivers of individuals with MCI or dementia participated in the pilot group within a VA geriatric clinic. Methods included comparison of pre- and post-intervention outcome measures (caregiver burden, depression, anxiety, flourishing) and inductive narrative analysis of qualitative feedback from participants. Qualitatively, the intervention was well received and participants identified several areas of subjective learning and skill implementation including increased behavioral and communication skills, knowledge, and connection with resources. However, paired-sample t-tests of group outcomes revealed no significant differences on measures of caregiver burden, depression, anxiety, and flourishing pre- and post-intervention. Based on Kirkpatrick's levels of evaluation, this study revealed positive reception of a group-based intervention for dementia caregivers within a VA setting, but further investigation of intervention effectiveness is needed given the lack of significant change found on outcome measures. A virtual skills-based group may be a feasible option for dementia caregiver intervention within VA settings that warrants further investigation.

Implementing a group singing intervention for postpartum depression within the Italian health service

BackgroundIn the United Kingdom a singing intervention for Postpartum Depression (PPD) titled “Music and Motherhood” was found to be effective. The World Health Organization Regional Office for Europe coordinated a study to assess the feasibility of implementing and adapting the intervention in other countries. In Italy, recent studies have highlighted the need to promote the availability of effective interventions for PPD in primary care.AimTo describe the implementation of “Music and Motherhood” within the Italian primary care services dedicated to pregnancy and postnatal care in three different geographical locations, thus providing an example of strategies for implementing an arts and health intervention in primary care that can improve health and well-being.MethodsA 10-week group singing intervention for mothers with PPD was conducted as part of a single arm feasibility study. Data were collected through one-to-one interviews, focus groups and questionnaires from the professionals involved in the implementation and selected participating mothers. A conceptual framework including acceptability, appropriateness, feasibility, fidelity, implementation process, costs and sustainability was adopted for analysis. Number of sessions attended by mothers and implementation outcome measures for acceptability, appropriateness and feasibility, each consisting of four items rated on a 5-point Likert scale were also gathered.ResultsThe intervention was found to be inclusive of women from different socio-cultural backgrounds and appropriate to the context. The group setting and the use of an arts-based intervention helped to de-medicalise the process of care maximising resources. Singing helped mothers to express their feelings and find strategies to improve interaction with their child. Attention to mothers’ needs and the co-presence of the professional singing leader and a health professional were among the key factors. The median number of sessions attended was nine out of 10. In terms of acceptability, almost 90% of the professionals were in complete agreement that they liked and approved the intervention.ConclusionOur study adds to the evidence that an arts and health intervention proven effective in one culture and linguistic context can be adapted to another. Collaboration among health professionals and artists in the implementation process and adequate funding are instrumental in moving from project to programme level.

Acceptability, feasibility and preliminary efficacy of the Peer-led Hub-and-Spoke Community Aphasia Group program

ABSTRACT Background Several programs addressing the long-term impacts of aphasia after stroke show promise. However, barriers restrict their implementation at scale. Hub-and-spoke models of care operate in several health contexts to reduce the health care costs associated with health professionals providing all direct services, and to improve the reach of services to communities at distance from the main service. We developed the Peer-led Hub-and-Spoke Community Aphasia Group (Peer-led HS CAG) program to address staff and service availability barriers. The Peer-led HS CAG organises service through a “Hub” of allied and mental health professionals, led by a speech pathologist, who provide consultative and occasional direct services to the aphasia group. The “spokes” are volunteers with and without aphasia, trained and supported by the “Hub” staff to facilitate groups in the community. Aims We aimed to investigate the feasibility, acceptability, and preliminary efficacy of the Peer-led HS CAG program to address long-term impacts of aphasia. Methods & Procedures In a Phase I, proof of concept, mixed methods design we utilised: (1) a pre-post observational quantitative design; (2) an embedded qualitative study using semi-structured in-depth interviews of group facilitators and participants. Four health professionals from speech pathology, psychology, art therapy, and music therapy formed the Hub. Four volunteers were trained as group facilitators over two, half-day sessions prior to the group programs commencing. The 12-week group programme was delivered twice in a community setting, consisting of weekly 2-hour sessions. Seven people with aphasia attended: four in programme one, three in program two. The group program consisted of four compulsory topic sessions and eight “members choice” sessions. Seven close others attended four of the twelve program sessions: two with their family members with aphasia; two with specific “hub” staff input. During the remaining eight weeks of the program close others chose whether to meet independently. Outcome measures were taken at four time points: 6 weeks pre-program; immediately pre-program; immediately after-program; 6-week follow up. Outcomes & Results Four participants showed clinically meaningful gains in communication-related quality of life and three in functional communication immediately post-program or at 6-week follow up. Qualitative interviews confirmed the feasibility and overall acceptability of the program. Close others requested additional sessions specific to their needs. Conclusions The Peer-led HS CAG program is a feasible and acceptable way to address the current lack of community aphasia groups. Future phase II and III research should explore the efficacy and costs of this model.

Matched-pair analysis of mCRPC patients receiving 177Lu-labeled PSMA-targeted radioligand therapy in a 4-week versus 6-week treatment interval

BackgroundThe optimal regimen for 177Lu-labeled prostate-specific membrane antigen-targeted radioligand therapy, including treatment intervals, remains under study, with evidence suggesting shorter intervals could benefit patients with high disease volume and rapid progression. This retrospective analysis evaluated treatment toxicity, PSA response, PSA-progression-free survival (PSA-PFS), and overall survival (OS) in matched cohorts of mCRPC patients receiving 177Lu-PSMA-RLT at 4-week versus 6-week intervals.ResultsA PSA response (PSA decline ≥ 50%) was achieved in 47.8% and 21.7% of patients in the 4-week and 6-week treatment interval groups, respectively (p = 0.12). There was a trend towards longer PSA-PFS in the 4-week group compared to the 6-week group (median PSA-PFS, 26.0 weeks vs. 18.0 weeks; HR 0.6; p = 0.2). Although not statistically significant, there was a trend towards shorter OS in the 4-week group compared to the 6-week group (median OS, 15.1 months vs. 18.4 months; HR 1.3; p = 0.5). The 4-week group had a significantly greater decrease in leucocyte and platelet counts compared to the 6-week group (38.5% vs. 18.2% and 26.7% vs. 10.7%; p = 0.047 and p = 0.02). Severe adverse events were modest in both groups.ConclusionsIntensifying treatment intervals from 6 weeks to 4 weeks showed some improvements in PSA response and PSA-PFS for mCRPC patients, but did not significantly affect OS. Additionally, bone marrow reserve was significantly reduced with the intensified regimen. Therefore, the overall benefit remains uncertain, and further prospective studies are needed to compare 4-week and 6-week intervals regarding toxicity, treatment response, and outcome.

A Short-Term Group Telehealth Cognitive Behavioral Therapy Intervention for Youth with Autism and Anxiety: A Pilot Study.

Background: Children with autism often present with comorbid anxiety disorders. Cognitive behavioral therapy (CBT) is an effective, evidence-based approach to treating anxiety, but information on youth with autism and anxiety is limited. Coping Cat is a 16-week CBT intervention for children with anxiety but its use in a group telehealth format in an urban, predominantly Hispanic population is limited. Objectives: (a) To examine the feasibility and preliminary effectiveness of a short-term CBT telehealth group for youth with autism and anxiety disorders in an urban, predominantly Hispanic population and (b) to examine satisfaction with the intervention. Methods: Single-arm pilot study that consisted of a 16-week telehealth CBT group therapy was based on a modified Coping Cat curriculum. Youth with autism and anxiety disorders who were on a waitlist for psychotherapy at an urban developmental center were invited to participate. Anxiety was assessed pre- and posttreatment using the Screen for Child Anxiety Related Emotional Disorders, parent and self-report. Results: Eighteen children were enrolled; 16 children completed the program. Mean age was 11 ± 2.5 years (8-15 years); 89% males, 61% Hispanic. There was a significant reduction in pre-post intervention in symptoms of overall anxiety (parent: 41.0 ± 18.5 to 31.0 ± 16.3 p ≤ 0.003, self: 25.9 ± 12.8 to 14.1 ± 7.8 p ≤ 0.001), panic disorder (parent: 8.1 ± 7.0 to 4.1 ± 4.2 p = 0.013, self: 5.1 ± 4.8 to 0.8 ± 0.9 p = 0.004), and separation anxiety disorder (parent: 7.5 ± 4.8 to 5.7 ± 4.4 p = 0.041, self: 5.8 ± 3.3 to 3.8 ± 2.4 p = 0.018) as per parent and self-reports. Self-report data also revealed a significant reduction in symptoms of social anxiety disorder (6.5 ± 3.5 to 3.9 ± 2.7 p ≤ 0.001). Parents and children reported satisfaction with the group. Conclusion: In this small, predominantly Hispanic population of youth with autism and anxiety disorder, 89% of families were compliant with a group telehealth CBT intervention. Parents and youth reported a significant reduction in anxiety symptoms and program satisfaction. A modified group CBT program via telehealth represents a feasible intervention for youth with autism and anxiety disorders.

Efficacy of Direct Acting Antivirals (DAA) therapy in patients with recurrent hepatitis C after liver and kidney transplantation: a cross-sectional study.

Direct-acting antiviral (DAA) agents are now widely used to treat patients with hepatitis C infection (HCV) and effectively increase their sustained virologic response (SVR). However, the literature seems to lack or deficient evidence of DAA efficacy in more complicated patients, especially those with HCV reinfection after liver transplantation (LT) or liver-kidney (hepatorenal) transplantation (LKT). This study aimed to retrospectively evaluate the effectiveness of two different DAA regimens in LT and LKT patients with HCV reinfection. This cross-sectional study was conducted at three hospitals in Tehran, Iran, from 2014 to 2020, enrolling 53 patients with recurrent HCV infection after LT (n = 35) or LKT (n = 18). Patients were treated for 12 weeks with one of two DAA regimens: 37 patients (70%) received Daclatasvir and Sofosbuvir (SOF + DCV), while 16 patients (30%) received Sofosbuvir and Ledipasvir (SOF + LDV). Ribavirin (RBV) was added as an adjunct antiviral in 28 patients (52.8%). To assess the SVR, all patients were followed for 12 weeks after treatment. Both DAA regimens were well-tolerated and effective, with 94.6% (35 of 37) achieving SVR-12 in the SOF + DCV group and 93.8% (15 of 16) in the SOF + LDV group. Additionally, SVR-12 rates were promising across treatment durations, with 93.9% (31 of 33) in the 12-week group and 95% (19 of 20) in the 24-week group achieving undetectable HCV RNA. No significant difference in SVR was observed between the two regimens (p = 0.439). The DAA-based therapeutic regimen was well tolerated and showed significant effectiveness in achieving the virologic response in patients with HCV reinfection after LT or LKT.

Comparison of 4-week versus 8-week dietitian-led FODMAP diet group education sessions in tertiary care clinical practice for irritable bowel syndrome: A service evaluation.

The implementation of the fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet for irritable bowel syndrome (IBS) can be effectively delivered by dietitians in group settings. The initial FODMAP restriction phase is recommended to be followed for 4 weeks; however, limited efficacy data exist for 4-week FODMAP restriction in group education clinical practice. We aimed to compare 4-week versus 8-week FODMAP group treatment pathways on clinical outcomes using a prospective service evaluation design of IBS patients attending FODMAP restriction (baseline) and reintroduction (follow-up) group sessions (between 2015 and 2019). Clinical outcomes included global symptom question (GSQ) measuring satisfactory relief, gastrointestinal symptom rating scale (GSRS), stool frequency (SF), stool consistency using Bristol stool form scale (BSFS), diet acceptability, patient satisfaction with group sessions and dietary adherence. Logistic regression was used to test for differences in treatment effects when clinical outcomes were compared between groups. Patients (n = 284) included were aged 18 to 86 years (mean ± SD [standard deviation], 44.6 ± 15.5), 80% female, and were split into 4-week (41%, 117/284) versus 8-week (59%, 167/284) pathways with no differences in baseline characteristics. Mean ± SD time gap between baseline and follow-up was 4.6 ± 0.9 weeks in the 4-week pathway and 9.6 ± 3.3 weeks in the 8-week pathway. When groups were compared at follow-up, no statistical differences were observed in any measures (GSQ, GSRS, SF, BSFS, dietary adherence, diet acceptability and patient satisfaction). A 4-week dietitian-led group FODMAP treatment pathway is as clinically effective and maintains patient acceptability when compared to 8-weeks and should be considered as part of routine clinical practice.

On The Use of a Sticky Bone Substitute in the Presence of a Ruptured Schneider Membrane During Sinus Lift Procedures - An Experimental Within-Rabbit Study.

To assess the efficacy and safety of a sticky dual-phase porcine-derived bone substitute, compared to a similar non-adhesive graft, in addressing induced perforations of the Schneider membrane during sinus lift using a within-subject design rabbit model. Bilateral sinus floor elevations were performed in 12 rabbits. The sinus mucosa was intentionally perforated using a blade on both sides and randomly filled with either a cortico-cancellous bone embedded in a 20% thermosensitive gel (GTO sticky bone test) or a cortical cancellous bone and 10% collagen (mp3 control). Healing progress was evaluated after 2 and 10 weeks in 6 animals at each time-point, with cone-beam computed tomography (CBCT), micro-computed tomography (microCT) and histological assessments. One animal of the 2-week group died but was substituted. No other complications were observed. At 2-week, on CBCTs, biomaterials particles were observed in the vicinity of the Schneider membrane in two out of six sinuses of each group, but never dispersed into the sinus. MicroCT and histology consistently revealed few granules beyond the elevated region. Histologically, five sinuses in the mp3 group and two sinuses in the GTO group exhibited granules outside the elevated region but in the vicinity of the perforations. In the 10-week groups, the number of affected sinuses decreased to one in the mp3 group and two in the GTO group. Throughout all observations, the graft granules consistently resided proximate to the elevated region. Micro-CT demonstrated a reduction in the volume of the elevated region by approximately 12% after 2 weeks and 50-54% after 10 weeks. The use of both sticky and non-sticky bone substitutes seems to prevent a substantial amount of particles from extruding through an induced perforation of the Schneiderian membrane. This suggests that it could be possible to use a sticky bone as an alternative to a barrier membrane to avoid the extrusion of bone granules in the presence of accidental perforation of the sinus membrane in clinical practice. After 10 weeks of healing, the volume of the elevated region decreased by approximately 50%, possibly due to biomaterial resorption and loss through the surgically created perforation.

Abstract B062: Physical Activity in African American Prostate Cancer Survivors and a Comparison of Self-report versus Accelerometer-Derived Measurement

Abstract Authors: Shannon Reed, Margaret Tovar, MPH, Paula Papanek, PhD, Patricia Sheean, Deepak Kilari, MD, Katie Bylow, MD, PhD, Whitney Morelli, PhD, Melinda Stolley, PhD Background: The Men Moving Forward intervention examines a lifestyle intervention's effects on body composition among Black/African American prostate cancer survivors (AAPCS). AAPCS. To assess PA, self-report and objective measures are being used. Studies use self-report measurements due to their simplicity and low cost, however, the congruent validity of self-report PA is often questioned. This study describes PA and strength training and also compares self- report PA to accelerometry-derived PA among AAPCS at baseline. Methods: AA men with non-metastatic PC were recruited to participate in a randomized, waitlist control trial testing the efficacy of a lifestyle intervention. The 16-week group and community-based intervention was developed with and for AAPCS and is grounded in the ACS Nutrition and Physical Activity Guidelines for Cancer Survivors. Participants completed the Godin Leisure Time Physical Activity Questionnaire (GLTPAQ) which queries about moderate and vigorous activities. The study added a question about the frequency of strength training. Participants also wore a GT3X accelerometer (Actigraph) for 7 days. Only men who wore the actigraph for at least 10 hours across 4 days were included in this analysis. Troiano 2008 cut points were used to measure moderate-vigorous PA (MVPA). Pearson’s correlation was used to assess linear correlation between objectively measured and self-reported MVPA. Statistical significance was set at p&amp;lt;0.05. Results: 73 AAPCS with a mean age of 65.8 years ± 6.9 were included in the analyses. Mean Godin score was 23.32 +16.80 (insufficient activity) with 45.2% classified as active (Godin score &amp;gt;24) and 54.8% as insufficiently active (Godin score&amp;lt;23). 30.2% strength trained at least twice weekly. Actigraph data showed a mean of 101.19 minutes per day of MVPA and that 73.68% of participants did not meet the guideline for 150 minutes per week of MVPA. The analysis revealed a weak positive correlation (r = 0.274, p = 0.019) between actigraph-recorded MVPA and self-reported MVPA. Conclusion: Study results suggest AAPCS overestimate their MVPA using the GLTPAQ when compared to accelerometry. Notably, a significant proportion did not meet the recommended level of physical activity. These findings underscore the importance of including objective measures of PA and the value of programming that is intentionally inclusive of AAPCS. To better support validity and reliability, participant perceptions of PA time and intensity may require improved clarification and description in studies relying solely on SR questionnaires. Citation Format: Shannon Reed, Margaret Tovar, Paula Papanek, Patricia Sheean, Deepak Kilari, Whitney Morelli, Katie Bylow, Melinda Stolley. Physical Activity in African American Prostate Cancer Survivors and a Comparison of Self-report versus Accelerometer-Derived Measurement [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B062.

A psychosocial bouldering intervention improves the well-being of young refugees and adolescents from the host community in Lebanon: results from a pragmatic controlled trial

BackgroundMental health and psychosocial support (MHPSS) is increasingly considered vital for addressing the needs of displaced communities. The mental health of young people in Lebanon, including members of the host community and refugees, has been severely affected by multiple crises. Physical activity (PA) is an effective means for enhancing mental health, but evidence of PA’s impact on mental health among forcibly displaced populations is still emerging and often varies widely across studies.MethodIn this waitlist-controlled study, we examined the effectiveness of an 8-week psychosocial bouldering group intervention offered by the nonprofit organization ClimbAID on psychological well-being, distress, self-efficacy, and social cohesion in a group of mostly Syrian refugee adolescents residing in the Bekaa Valley, Lebanon. The intervention consisted of 8 sessions and took place once a week for 2 h in a group of up to 12 adolescents with 2 trained facilitators and up to 2 volunteers, supervised by a climbing instructor and a social worker. Multilevel analyses were performed for all outcomes.Results233 people were included in the study. The dropout rate was approximately 33%. The IG improved significantly more than the waitlist group in terms of overall mental well-being and psychological distress. Group allocation was a significant predictor of improvements in mental well-being and psychological distress and showed a trend toward predicting self-efficacy. There was no positive impact of the intervention on social cohesion.ConclusionsEven in complex humanitarian settings of forced displacement, a psychosocial bouldering intervention reduces psychological distress and increases well-being in a mixed group of host and refugee youth in Bekaa, Lebanon.Trial registrationProspectively registered with ISRCTN 13005983, registered April 1st, 2022.

Regulation of targeted blocking cannabinoid receptor 1 on spleen immune function and inflammatory response in mice under chronic intermittent hypoxia

Objective: To observe the effects of targeting and blocking cannabinoid receptor 1 (CB1R) on mouse spleen immune function and inflammatory response under chronic intermittent hypoxia (CIH) conditions, and to explore its regulatory effort. Methods: Forty SPF male C57BL/6 mice aged 4 to 5 weeks,from May 2021 to August 2021 in Experimental Animal Center of the Second Hospital of Shanxi Medical University, were randomly divided into normal oxygen control group (NC), 6-week CIH group (6w CIH), 10-week CIH group (10w CIH), 6-week CIH+CB1R group (6w CIH+AM251) and 10-week CIH+CB1R group (10w CIH+AM251) according to the method of random number table. The advanced programmable intermittent low oxygen chamber was used to prepare the CIH mouse model. The morphological structure of spleen tissue of CIH mice was stained by hematoxylin-eosin (HE) staining. The expression levels of M1 and M2 macrophage surface markers CD86, CD206 were determined by immunofluorescence. The mRNA expression levels of CB1R, CD86, CD206 and the relative expression levels of RORγt and Foxp3,which are characteristic transcriptional regulators of T helper 17(Th17) and Treg cells were detected by quantitative reverse transcriptase PCR(qRT-PCR). The expression of inflammatory factors IL-6 and IL-10 was determined by ELISA. SPSS 26.0 and Graphpad prism 8.3 were used to analyze the data. Results: (1) Compared with NC group, spleen tissue structure was disordered, fibrous tissue hyperplasia, lymphocyte proliferation and disordered arrangement in periarteriole lymphatic sheath in CIH group. The expression of CB1R in CIH group was higher than that in NC group (P<0.05), and with the prolongation of CIH time, the expression of 10w CIH group was higher than that in 6w CIH group(P<0.05). The expression of CB1R in CIH+AM251 group was lower than that in the corresponding CIH group(all P<0.05). (2) Compared with NC group, the expression level of CD86 in macrophages in CIH group was higher than that in NC group(all P<0.05). The relative expression of RORγt in 6w and 10w CIH groups was 0.76±0.03 and 0.91±0.04, respectively, which was higher than that in NC group (0.65±0.06)(all P<0.05). The relative expression levels of inflammatory factor IL-6 were 10.80±1.73 and 14.86±0.01, respectively, which were higher than 6.69±0.23 in the NC group (all P<0.05). The expression level of CD206 in macrophages in the CIH+AM251 group was higher than that in the CIH group(all P<0.05). The relative expression levels of Foxp3 in 6w and 10w CIH+AM251 groups were 0.62±0.05 and 0.32±0.21, respectively, which were higher than those in 6w CIH group (0.28±0.02) and 10w CIH group (0.02±0.01)(P<0.05). The relative expression levels of anti-inflammatory factor IL-10 were 668.45±15.71 and 379.15±56.84, respectively, which were higher than those in CIH group (all P<0.05). Conclusion: Targeted sealing of CB1R may alleviate inflammatory response of mouse spleen under CIH conditions by regulating macrophage polarization and the expression of inflammatory factors, and may have some protective effect.

Serum metabolome signature response to different types of resistance training.

Pneumatic resistance training (PRT) facilitates a longer time under tension that might lead to greater changes in body composition when compared to traditional resistance training (TRT), possibly enhancing serum metabolite concentrations indicative of healthy metabolic function. To assess the impact of PRT and TRT on muscular strength, body composition and serum metabolome, sixty-nine men (age: 31.8±7.2 years, height: 179.7±5.4 cm, weight: 81.1±9.9 kg) were randomized into two 10-week intervention groups (PRT:n=24 and TRT:n=24) and one control group (CON:n=21). Serum metabolite concentrations were assessed before and after the training intervention by high-throughput nuclear magnetic resonance. Fat mass and lean mass were obtained by bioimpedance analysis. The training intervention resulted in an increase in LM for both PRT (1.85 ± 2.69%; p=0.003) and TRT (2.72 ±4.53%; p=0.004), while only PRT reduced in body fat percentage (PRT: -5.08±10.76%; p=0.019) statistically significantly. Only in PRT and TRT significant increases in small high-density lipoproteins (S-HDL-L) and small HDL particles (S-HDL-P) were observed. When controlling for fat and lean mass, the effects on S-HDL-L/S-HDL-P diminished. Network analysis may suggest that PRT and TRT result in an increase in network connectivity and robustness. It appears that the observed improvements are associated with changes in body composition.

Short-term effects of a park-based group mobility program on increasing outdoor walking in older adults with difficulty walking outdoors: the Getting Older Adults Outdoors (GO-OUT) randomized controlled trial

BackgroundWe estimated the short-term effects of an educational workshop and 10-week outdoor walk group (OWG) compared to the workshop and 10 weekly reminders (WR) on increasing outdoor walking (primary outcome) and walking capacity, health-promoting behavior, and successful aging defined by engagement in meaningful activities and well-being (secondary outcomes) in older adults with difficulty walking outdoors.MethodsIn a 4-site, parallel-group randomized controlled trial, two cohorts of community-living older adults (≥ 65 years) reporting difficulty walking outdoors participated. Following a 1-day workshop, participants were stratified and randomized to a 10-week OWG in parks or 10 telephone WR reinforcing workshop content. Masked evaluations occurred at 0, 3, and 5.5 months. We modeled minutes walked outdoors (derived from accelerometry and global positioning system data) using zero-inflated negative binomial regression with log link function, imputing for missing observations. We modeled non-imputed composite measures of walking capacity, health-promoting behavior, and successful aging using generalized linear models with general estimating equations based on a normal distribution and an unstructured correlation matrix. Analyses were adjusted for site, participation on own or with a partner, and cohort.ResultsWe randomized 190 people to the OWG (n = 98) and WR interventions (n = 92). At 0, 3, and 5.5 months, median outdoor walking minutes was 22.56, 13.04, and 0 in the OWG, and 24.00, 26.07, and 0 in the WR group, respectively. There was no difference between groups in change from baseline in minutes walked outdoors based on incidence rate ratio (IRR) and 95% confidence interval (CI) at 3 months (IRR = 0.74, 95% CI 0.47, 1.14) and 5.5 months (IRR = 0.77, 95% CI 0.44, 1.34). Greater 0 to 3-month change in walking capacity was observed in the OWG compared to the WR group (βz-scored difference = 0.14, 95% CI 0.02, 0.26) driven by significant improvement in walking self-efficacy; other comparisons were not significant.ConclusionsA group, park-based OWG was not superior to WR in increasing outdoor walking activity, health-promoting behavior or successful aging in older adults with difficulty walking outdoors; however, the OWG was superior to telephone WR in improving walking capacity through an increase in walking self-efficacy. Community implementation of the OWG is discussed.Trial registrationClinicalTrials.gov NCT03292510 Date of registration: September 25, 2017.

No difference between 5 and 6 weeks of non-weight bearing after osteochondral grafts for medial osteochondral defects of the talus with medial malleolar osteotomy.

The present study aimed to compare the clinical outcomes and safety at a 1-year follow-up after 5 or 6 weeks of non-weight bearing after a Talar OsteoPeriostic grafting from the Iliac Crest (TOPIC) for a medial osteochondral lesion of the talus (OLT). A retrospective comparative case-control analysis of prospectively followed patients who underwent a TOPIC procedure with medial malleolus osteotomy was performed. Patients were matched in two groups with either 5 or 6 weeks of non-weight bearing. Clinical outcomes were evaluated using the Numeric Rating Scale (NRS) during walking, rest, running, and stairclimbing. Additionally, the Foot and Ankle Outcome Score (FAOS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were assessed. Moreover, radiology and complications were assessed. Elevenpatients were included in the 5-week non-weight bearing group and 22 in the 6-week non-weight bearing group. No significant differences were found in any of the baseline variables. The NRS during walking in the 5-week group improved by 3.5 points and 4 points for the 6-week group (p = 0.58 at 1-year post-operatively). In addition, all other NRS scores, FAOS subscalesand the AOFAS scores improved (all n.s. at 1 year follow-up). No significant differences in radiological (osteotomy union and cyst presence in the graft) were found. Moreover, no significant differences were found in terms of complications and reoperations. No statistical significant differences were found in terms of clinical, radiologicaland safety outcomes between 5 or 6 weeks of non-weight bearing following a TOPIC for a medial OLT. Level III, Therapeutic.

A Randomized Trial Evaluating Acceptance and Commitment Therapy and Smart Phone Care Management Application to Augment Buprenorphine Therapy for Opioid Use and Chronic Pain.

There is high comorbidity of opioid use disorder (OUD) and chronic pain (CP), which is often addressed by prescribing buprenorphine (BUP). While BUP is effective in preventing overdose, it does not address the psychological aspects of OUD and CP comorbidity and treatment retention rates are as low as 50%. The Virtual Opioid use disorder Integrated Chronic Pain Treatment (VOICE) study (NCT05039554) is a novel effectiveness-implementation trial to test a 12-week virtual group Acceptance and Commitment Therapy (ACT) protocol and a care management smartphone application (app; Valera Health) on pain and opioid use in patients with OUD and CP receiving BUP. Using a 2 × 2 factorial design, participants (expected N = 280) are randomized into: ACT, Valera app, ACT + Valera, or Treatment as Usual arm. This study is taking place in the Bronx, NY, a racially/ethnically diverse community that faces numerous socioeconomic stressors and is one of the nation's epicenters of the opioid epidemic. We created a culturally responsive ACT group protocol, and Valera psychoeducational material. Outcome measures include NIH HEAL Common Data Elements and ACT and Valera-specific measures. We are conducting a novel 2 × 2 trial investigating augmenting BUP treatment with ACT and Valera, with the goal that improved mental health and access to care will result in decreased and opioid use and pain interference.

The Impact of Group Art Observation on Mentalization for Mothers of Children Diagnosed With ASD

This pilot study explored meaning of shared art observations and their impact on mentalization for five mothers of children with autism spectrum disorder, who participated in a 12-week art therapy group, post-intervention reflections on their experiences and art responses designed to assess the mentalization of self and their child before and after the group. The findings suggested that group art observation promoted belonging, facilitated emotional and cognitive learning, and increased comprehension of their child’s diagnosis. The study also demonstrated a visible shift in participants’ mentalization of self and others (perception of their child/relationship). Clinical implications include the distinctive benefits of a shared community gaze for this population, as a vehicle of self-knowing, which enables more effective communication with, about and for their child.

Safety Nets: A Social Prescribing Intervention to Support Young People on CAMHS Waiting Lists

High numbers of children face mental health difficulties in the UK, leading to increased referrals to Child and Adolescent Mental Health Services (CAMHS) which face reduced capacity and increased waiting times. Children’s mental health can deteriorate significantly during this wait for treatment. Safety Nets is an 8-week group intervention for children on CAMHS waiting lists, involving psychoeducation and physical activity co-delivered by clinicians and coaches at local sports clubs. A mixed-methods feasibility study was conducted exploring the impact of Safety Nets. A fully powered trial is now needed to further test for clinical and cost-effectiveness and to support future implementation.