Controlled Design Research Articles

Formulation-based cognitive behavioral therapy compared to an active control and a waitlist in adult inmates with ADHD: study protocol for a randomized controlled trial

BackgroundRecent literature suggests that ADHD is a risk factor for the development of antisocial behavior that is more severe and persistent than in community and other psychiatric populations. The combination of stimulant medication and psychotherapy (particularly cognitive behavioral therapy, CBT) is considered an evidence-based intervention for adults with ADHD. In contrast, few studies have evaluated the efficacy of medication in adult prisoners with ADHD, and the literature on the efficacy of psychotherapy is virtually nonexistent. Therefore, this article presents the protocol of a trial that will assess the efficacy of a formulation-based CBT program for inmates with ADHD.MethodsThe study has a multicenter randomized controlled trial design. After screening and recruitment, participants will be randomly assigned to the CBT intervention, a general offender treatment program, or a waitlist. Pre- and post-treatment self-report and clinician-report assessments, as well as 6- and 12-month follow-up assessments will be conducted. These will include both clinical (e.g., ADHD symptoms, depression and anxiety symptoms, self-esteem, alcohol/drug abuse, treatment adherence, quality of life) and criminological (e.g., recidivism and risk of recidivism) measures. Linear mixed models will be used to assess differences between groups.DiscussionThis study may be the first to evaluate the efficacy of a psychotherapy intervention in adult inmates with ADHD. It is expected that addressing the specific needs of ADHD would not only result in the previously reported clinical improvements (e.g., reduction in ADHD and comorbidity symptoms), but also reduce the risk and rate of recidivism compared to the general intervention or no intervention. However, the design may be limited by the difficulties inherent in the prison setting and in following up the sample after release.Trial registrationClinicalTrials.gov NCT06080373. Registered on October 12, 2023.

Mobile phone call reminders to improve oral rehydration salt and zinc adherence for acute diarrhea in children: a single-center, randomized controlled trial

BackgroundLow-osmolarity oral rehydration salt (ORS) and zinc therapy effectively manage diarrhea in children under five years of age, offering both short- and long-term benefits. Despite this, caregivers’ adherence to ORS and zinc is often unsatisfactory due to factors such as forgetfulness, resolution of symptoms, and underestimation of the disease’s severity. This study assessed the effect of mobile call reminders on ORS and zinc tablet adherence among children with acute diarrhea in a secondary-level health facility in Kwara State, Nigeria.MethodsUsing an open-label, randomized controlled trial design, this study compared caregiver-child pairs with acute diarrhea aged 6–59 months who received standard instructions (SI) alone (control group) and an intervention group (IG) who received SI plus phone call reminders on days three and seven of zinc sulfate therapy. All participants used a pictorial diary to track loose/watery stools and ORS and zinc tablet treatments for ten days. The primary outcome measures were independent and combined adherence to ORS and zinc therapy. The secondary outcomes were independent and combined adherence scores, defined as the percentage of times the ORS was given post-diarrhea and the percentage of prescribed zinc tablets administered out of ten.ResultsA total of 364/400 mother–child pairs completed the study. The percentage of mothers with full adherence in the intervention group was 82.5% for ORS, 72.1% for zinc, and 58.5% for combined use, compared to 78.8%, 60.8%, and 43.6%, respectively, in the control group. The odds of full adherence to ORS and zinc were 1.6 and 1.7 times higher among intervention mothers [ORS: OR = 1.561, 95% CI = 0.939–2.598, P = 0.085; zinc: OR = 1.671, 95% CI = 1.076–2.593, P = 0.022], and 1.8 times higher for combined use according to WHO guidelines [OR = 1.818, 95% CI = 1.200–2.754, P = 0.005]. The mean adherence scores for the intervention group were higher than those for the control group by 4.1% (95% CI = 0.60–7.60) for ORS, 7.3% (95% CI = 3.74–10.86) for zinc, and 5.7% (95% CI = 3.23–8.17) for the combined treatment.ConclusionPhone reminders can effectively improve consistency of home treatment administered by caregivers for children under five years old.Trial RegistrationThe study was registered retrospectively (17/3/2023) with the Pan African Clinical Trial Registry (PACTR202301560735856).

Mixed Reality in Clinical Settings for Pediatric Patients and Their Families: A Literature Review.

In the post-pandemic context, there has been an increasing demand for technology-based interventions in education and healthcare systems, such as augmented and mixed reality technologies. Despite the promising outcomes of applying mixed reality (MR), there is limited aggregated evidence focusing on child-patient interventions in hospital-based or clinical settings. This literature review aimed to identify and synthesize existing knowledge on MR technologies applied to pediatric patients in healthcare settings. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of the Scopus and Web of Science databases was conducted to identify articles published in the last 10 years that address the application of augmented and/or MR technologies in pediatric hospital settings or clinical environments to improve patient and family outcomes. A total of 45 articles were identified, and following a rigorous screening and eligibility process, 4 review articles were selected for qualitative synthesis. From these reviews, 10 studies with relevant interventions and measured effects were extracted. The extracted studies were analyzed based on eight key attributes: country of origin, study design, characteristics of the study population, primary clinical setting, type of MR device used, nature of the intervention, variables measured, and significant effects observed in the outcome variables. The analysis revealed diverse approaches across different clinical settings, with a common focus on improving both emotional well-being and learning outcomes in pediatric patients and their families. These findings suggest that MR-based pediatric interventions generally provide children and their parents with positive emotional experiences, enhancing both learning and treatment outcomes. However, the studies reviewed were heterogeneous and varied significantly in terms of clinical settings and MR applications. Future research should focus on developing more controlled study designs that specifically target the pediatric population to strengthen the evidence base for MR interventions in healthcare.

Using a Board Game to Learn a Physical Assessment Course in Nursing Education: A Randomized Controlled Study

Objective: Nursing students are expected to acquire the skills necessary to provide competent patient care in complex healthcare settings. This study aimed to explore the effect of a physical assessment board game on nursing students’ knowledge level and determine their opinions about the game. Methods: A randomized controlled study design was used. The study was conducted from December 2019 to January 2020 among 56 nursing students (game group= 28, control group= 28) enrolled in an undergraduate nursing program in Türkiye. The data were collected using the Kolb’s Learning Styles Inventory to determine students’ learning styles, the Knowledge Evaluation Form for physical assessment, and the Student Opinion Form for students’ opinions about the game. Mean scores for the pre-test and post-tests were compared using independent and paired sample t-tests. Results: A significant difference was found between the pre-test and post-test knowledge scores of the game group (P<.05). The mean post-test knowledge score of the students in the game group was higher than that of the students in the control group, and the difference between the groups was statistically significant (P<.05). Conclusion: The game was beneficial for teaching physical assessment course. Future studies should incorporate different game samples, such as the development of a web-based game, as this study focused on a board game that supported physical assessment skills.

Efficacy of a Comprehensive and Personalised Approach for Frail Older People in Valencia (Spain): A Pre-Post Controlled Trial.

Frailty is a common condition in older adults that negatively impacts health and quality of life. This study evaluated a comprehensive, personalised, and coordinated intervention under the value-based care approach to address frailty's multidimensional nature in older people in the primary care setting. It employed a pre-post randomised controlled design involving 242 frail individuals aged over 65 years living in the community in Valencia (Spain) between 2021 and 2023. Assessments were conducted at baseline, 12 months (immediately post-intervention), and 18 months. The intervention included a personalised care plan supported by technology, with monthly motivational follow-ups and plan updates by health professionals and participants. Outcomes were measured using an assessment questionnaire that included the International Consortium for Health Outcomes Measurement dataset for the older population: physical health, physical functioning, general mental health, satisfaction with social activities and relationships, ability to carry out usual social roles and activities, pain, general quality of life, loneliness, physical frailty, psychological frailty, and social frailty. The study found significant improvements in physical frailty, quality of life, reduced health resource use and hospitalisations and lower levels of pain and depression/anxiety compared to baseline. The findings suggest further research into value-based care approaches, emphasizing the development and activation of personalised, comprehensive programs for older individuals with frailty.

The effects of acupressure, laughter yoga, and a mindfulness-based stress reduction program applied to postmenopausal women for menopause symptoms and quality of life.

This research was conducted to determine the effects of acupressure, laughter yoga, and a mindfulness-based stress reduction program applied to postmenopausal women for menopause symptoms and quality of life. A randomized controlled design was used. The study was conducted with a total of 146 women, including 41 acupressure, 31 laughter yoga, 37 mindfulness-based stress reduction, and 37 control group women. The women in the acupressure group were administered acupressure twice a week, which accounted for 16 sessions in total. Women in the laughter yoga and mindfulness-based stress reduction groups received a total of eight sessions of the related intervention, which was performed once a week. Study data were collected using a participant information form, the Menopause Rating Scale (MRS), and the Menopause-Specific Quality of Life Scale (MENQOL). Descriptive statistics, paired-samples t test, χ 2 test, analysis of variance test, and intention to treat analysis were used to analyze the data. Before the intention to treat analysis was performed, the multiple imputation method was employed to deal with missing data. In the study, it was found that there was a decrease in the MRS total score after the intervention in women in all three intervention groups compared to the control group ( P < 0.05). In the laughter yoga group, total MRS scores decreased by 3.16 points ( P < 0.05). In the acupressure group, total MRS scores decreased by 5.46 points ( P < 0.05). In the mindfulness-based stress reduction (MBSR) program group, total MRS scores decreased by 4.65 points ( P < 0.05). It was determined that the mean scores of women in the laughter yoga and acupressure groups on all subscales of the MENQOL decreased after the intervention compared to the control group ( P < 0.05). The comparison of the MBSR group and the control group showed that there was a decrease only in the psychosocial domain subdimension of the MENQOL ( P < 0.05). In conclusion, it was determined that laughter yoga, acupressure, and MBSR could be effective in reducing menopause symptoms and improving quality of life, although findings require further testing in a rigorously controlled study and in a study with only a single prespecified outcome.

The efficacy, safety, and satisfaction of telehealth-delivered hypnotic cognitive therapy for chronic pain in spinal cord injury: A pilot study with historical controls

Context/Objective In-person hypnotic cognitive therapy (HYP-CT) is a promising treatment for chronic spinal cord injury-related pain. We describe the effects of HYP-CT delivered via Zoom (Z-HYP-CT) and compare the effects to historical controls who received hypnosis, cognitive therapy, or HYP-CT in-person. Design Open pilot trial of HYP-CT versus historical controls. Setting Telehealth study that recruited people with chronic SCI. Participants Adults with moderate to severe chronic SCI-related pain. Interventions Four weekly sessions of HYP-CT delivered via Zoom. Outcome measures The primary outcome was average pain intensity on a 0–10 numerical rating scale measured at end of treatment (4 weeks) and 12 weeks. Secondary outcomes included pain interference, depression, sleep, pain catastrophizing, and pain self-efficacy. Results 23 individuals with SCI-related pain participated in the open trial and were compared to 21 historical controls. Average age was 54 years, 70% were male, and the majority were White. The participants were 11.6-13.1 years post-SCI and average pain intensity was 4.8-5.4/10. After Z-HYP-CT mixed-effects linear regressions showed that pain intensity was significantly less at 4 weeks (−1.28, P < .0001) and 12 weeks (−1.50, P < .0001) relative to baseline. Pain interference, depression, and pain catastrophizing also decreased significantly at both time points. There were no significant differences between the effects of Z-HYP-CT versus historical controls on any outcome variable. Conclusion HYP-CT delivered via telehealth was associated with reduced pain intensity and other benefits that were comparable to the effect achieved by in-person historical controls. The effects of Z-HYP-CT should be evaluated using a randomized controlled design.

Long-Term Impact of Community Psychiatric Care on Quality of Life amongst People Living with Schizophrenia: A Systematic Review.

The review examines the long-term impact of community psychiatric care on improving the quality of life of people with schizophrenia. It addresses the global burden of this disorder and the need for effective community-based care strategies. A systematic literature search was conducted in databases such as CINAHL, Medline, Web of Science, Sage and ScienceDirect, with the search lasting until March 2024 and following the PRISMA guidelines. The inclusion criteria targeted studies that addressed the long-term effects of community mental health care for people aged 18 years and older with schizophrenia and included both quantitative and qualitative research designs. Studies unrelated to the research question or with significant methodological flaws were excluded. The risk of bias was assessed using GRADE and GRADECERqual, in addition to critical appraisal using the Joanna Briggs Institute (JBI) checklists. Independent screening and data extraction was performed, with results summarised by thematic analysis. In total, 11 studies met the inclusion criteria and included cross-sectional, cohort, qualitative and randomised controlled trial designs. The results showed that community psychiatric care significantly improves the quality of life, well-being and social integration of people with schizophrenia. Effective interventions identified include psychoeducation, cognitive behavioural therapy, social skills training and individualised care plans. However, challenges such as limited resources, labour shortages and social stigma, particularly in low-income neighbourhoods, were also identified. This study highlights the importance of continuous, personalised, multidisciplinary community-based care for sustainable mental health outcomes. Further research is recommended to investigate the long-term impact and strategies to overcome implementation challenges.

Pinning Asymptotic Observability of Distributed Boolean Networks.

Asymptotic observability of distributed Boolean networks (DBNs) is studied in this article. Via a parallel extension method, asymptotic observability of the original system is converted to reachability at a fixed point of the extended system. Based on the structure matrix of the extended system, a necessary and sufficient condition is presented for asymptotic observability. Further, for unobservable systems, mode-dependent pinning control is first introduced and applied to achieve asymptotic observability, including the selections of pinning nodes, the design of output feedback controls, and the adding approaches. Then, a set of matrices is defined for the construction of the desired structure matrix. Based on it, a necessary condition is given to guarantee the solvability of the corresponding output feedback controls and the adding approaches. Finally, a numerical example is presented to show the effectiveness of the obtained results.

A Review of Studies on the Treatment of Premature Ejaculation with Traditional Chinese Medicine

By combing the literature and analyzing the current status of traditional Chinese medicine (TCM) treatment for premature ejaculation (PE), the strengths and shortcomings of the existing studies were identified. Building upon this assessment, we put forward a prospect for the establishment of TCM-specific strategies for PE, including more targeted and individualized comprehensive diagnosis and treatment approaches for PE, the establishment of a TCM hierarchical management program, and the exploration of the most effective entry points for collaborative treatment of PE using both TCM and Western medicine. Indeed, integrating therapeutical strategies from the two perspectives in a multifaceted and complex symptom such as PE, would enhance the possibility of success, possibly also reducing side effects. Moreover, with the help of well-established and new scientific and technological tools, we can explore the key links and targets in treating PE by TCM. At the same time, the mechanism of TCM treatment for PE could and should be examined in depth to lay the foundation for widespread clinical application. Finally, we suggest conducting multicenter, nationwide standardized clinical studies on treating PE with TCM. These studies should employ high-quality randomized controlled trial designs to obtain robust evidence-based medical data.

Effects of Tactile Massage in Improving Older Residents' Psychological Health in Long-Term Care Facilities: A Randomised Controlled Trial.

Loneliness, anxiety and depressive symptoms are common among older residents in long-term care facilities (LTCFs), which can negatively impact their quality of life and increase mortality rates. Addressing these psychological health issues is an important task for nursing staff. There is a need for easy and accessible interventions to improve older residents' negative emotions. Tactile massage (TM) is a form of touch therapy that induces oxytocin, which can help individuals feel relaxed, experience pleasure and reduce anxiety. TM can also provide a sense of security and care for individuals. This study aimed to evaluate the effects of TM in improving older residents' psychological health in LTCFs. In this study, we applied a two-arm randomised controlled trial research design. We used convenience sampling to enrol 55 older residents in three long-term care facilities who were randomly assigned to an intervention group and a comparison group. The intervention group received TM by research assistants on both hands for 15 min per time, twice a week for 4 weeks and the comparison group received regular care. Data were collected before and after the intervention. Generalised estimating equations (GEEs) were used to evaluate the effectiveness of the intervention. There were no significant differences in loneliness, anxiety, depressive symptoms, happiness, ear temperature, heart rate or diastolic blood pressure between the two groups after the intervention. However, the intervention group had significant improvements in comfort (B = 0.86, p < 0.001), relaxation (B = 1.00, p < 0.001), respiratory rate (B = -0.16, p = 0.021) and systolic blood pressure (B = - 4.17, p = 0.002) compared to the control group. TM can help older residents who live in LTCFs feel relaxed and comfortable. TM can be easily implemented as it requires no tools. We recommend that nursing staff and healthcare professionals incorporate TM as part of their care routines. They also can encourage family members to perform TM on residents during their visits to enhance residents' comfort and relaxation. The Consolidated Standards of Reporting Trials (CONSORT) checklist was used for this paper. ClinicalTrials.gov (NCT05052138).

CLigOpt: controllable ligand design through target-specific optimization.

A key challenge in deep generative models for molecular design is to navigate random sampling of the vast molecular space, and produce promising molecules that strike a balance across multiple chemical criteria. Fragment-based drug design (FBDD), using fragments as starting points, is an effective way to constrain chemical space and improve generation of biologically active molecules. Furthermore, optimization approaches are often implemented with generative models to search through chemical space, and identify promising samples which satisfy specific properties. Controllable FBDD has promising potential in efficient target-specific ligand design. We propose a controllable FBDD model, CLigOpt, which can generate molecules with desired properties from a given fragment pair. CLigOpt is a variational autoencoder-based model which utilizes co-embeddings of node and edge features to fully mine information from molecular graphs, as well as a multi-objective Controllable Generation Module to generate molecules under property controls. CLigOpt achieves consistently strong performance in generating structurally and chemically valid molecules, as evaluated across six metrics. Applicability is illustrated through ligand candidates for hDHFR and it is shown that the proportion of feasible active molecules from the generated set is increased by 10%. Molecular docking and synthesizability prediction tasks are conducted to prioritize generated molecules to derive potential lead compounds. The source code is available via https://github.com/yutongLi1997/CLigOpt-Controllable-Ligand-Design-through-Target-Specific-Optimisation.

Inflammatory biomarkers in depression: scoping review.

Inflammation is increasingly recognised as a fundamental component of the pathophysiology of major depressive disorder (MDD), with a variety of inflammatory biomarkers playing pivotal roles. These markers are closely linked to both the severity of symptoms and the responsiveness to treatments in MDD. This scoping review aims to explore the scientific literature investigating the complex relationships between inflammatory biomarkers and depression, by identifying new studies and critical issues in current research. Following the PRISMA Extension for Scoping Reviews guidelines, we systematically searched databases including PubMed, Scopus, PsycINFO, Open Grey and Cochrane Library. Our search focused on articles published from 1 January 2020 to 1 May 2024. We included studies evaluating inflammatory biomarkers in adult patients with MDD, utilising observational and randomised controlled trial designs, and review studies. Our analysis examined 44 studies on the complex interplay between inflammation and its multiple effects on MDD. Significant associations between specific inflammatory biomarkers and depression severity were found, requiring cautious interpretation. We also highlight several methodological limitations in the current studies, which warrant caution in directly applying these findings to clinical practice. However, identified methodologies show potential for using these biomarkers as diagnostic tools or therapeutic targets, including anti-inflammatory interventions. The findings emphasise the need for sophisticated, integrative research to understand inflammation's role in MDD. Future studies should identify specific biomarker panels for diagnosing depression and bridging peripheral biomarker measurements with central neuroinflammatory processes, leading to better diagnostic and treatment strategies.

Abstract P397: Effects of Dietary Sodium Reduction on Systemic Inflammation: Findings from DASH-Sodium Study

Background: High sodium intake is a significant risk factor for hypertension and cardiovascular disease. Animal studies have demonstrated that high salt diet promotes tissue inflammation and increases systemic inflammation, such that it is plausible that sodium induced inflammation might be another pathway to hypertension. However, whether the link between dietary sodium intake and systematic inflammation in humans remains unclear due to limited human studies, different designs and inconsistent findings. Therefore, we tested the hypothesis that dietary sodium reduction reduces systemic inflammation in humans by leveraging the randomized controlled trial design of the DASH-Sodium study. Methods: DASH-Sodium study was a multicenter, randomized trial comparing the effects on blood pressure (BP) of three levels of sodium intake (3450 mg/d, 2300mg/d, and 1150 mg/d) in two diets (DASH vs American) among US adults. Five systematic inflammatory markers including hs-CRP, IFN-γ, IL-6, IL-10, and TNF-α were measured at each study visit in stored plasma samples from 224 participants. Two-level mixed-effects linear regression models were used to assess the effect of sodium reduction on inflammatory markers with adjustment of covariates. Results: A total of 224 participants (aged 49.4±9.5 yrs, 61% female, 62% black, and 2% other races) from the DASH-Sodium study were included in the analyses. Overall, compared to high sodium group, low sodium group had slightly elevated hs-CRP ( p =0.013), and intermediate sodium group had decreased TNF-α ( p =0.011). Both significances, however, disappeared after adjusting for multiple testing ( p adjust &gt;0.01). Conclusion: Modest dietary sodium reduction as recommended did not induce significant changes in systematic inflammation in humans.

432. POSTOPERATIVE SAFETY AND TOLERABILITY OF INTRAMUSCULAR OCTREOTIDE IN PATIENTS WITH GASTROESOPHAGEAL CANCER: AN OPEN-LABEL PHASE 2 PILOT STUDY

Abstract Background Dietary peptides are believed to contribute to persistent weight loss following gastrectomy or esophagectomy due to cancer. Previous studies have suggested that this effect might be partially mitigated by octreotide. This study aims to investigate the safety and tolerability of intramuscular Sandostatin® LAR depot 10mg, including the frequency and nature of adverse events. It serves as a pilot study for future research aiming to comprehensively assess its effects. Methods A prospective open-label phase-2 study was conducted from November 2021 to June 2023. Twenty patients (10 undergoing gastrectomy, 10 undergoing esophagectomy) were enrolled. Patients received three doses of intramuscular Sandostatin® LAR depot 10mg at 7 days, 1 month, and 2 months post-surgery. All patients were evaluated at 7 days, 1, 2, 3, and 6 months post-surgery. The primary endpoint was safety, determined by the incidence and nature of adverse events, with no occurrence of serious or severe events defined as successful. Tolerability was defined as at the completion of the treatment protocol by at least 90% of patients. Secondary endpoints included weight loss (percent from baseline), Health-Related Quality of Life (assessed via EORTC-QLQ-C30 and OG25 at baseline, 1, 2, 3, and 6 months post-surgery), and the proportion of subjects requiring enteral nutrition via jejunostomy. Results The study protocol was completed by 95% of participants. No serious or severe adverse events were reported. Median weight loss at 6 months was 11% (3 months: 7%, 2 months: 4%, 1 month: 5%). Mean and median Global Quality of Life (part of EORTC-QLQ-C30) remained unchanged at 6 months compared to baseline (mean: 67.6 vs. 67.2; median 66.7 [25-100] vs 70.8 [16.7-100]). The percentage of subjects requiring enteral nutrition was 40%, 30%, and 15% at 1, 2, and 3 months respectively. Conclusion This pilot study suggests that Sandostatin® LAR depot was well tolerated and safe, with no serious or severe adverse events observed. Weight loss, Health Related Quality of Life, and the proportion of subjects requiring enteral nutrition were consistent with expectations. Future studies should consider a double-blinded randomized controlled design preferably with dose-response assessment for more robust investigation.

The Utilization of Interactive Multimedia in Improving Vocabulary Knowledge of High School Students

In the current digital era, English education is becoming increasingly important. By integrating English language learning with digital learning media, it is hoped to create a more dynamic and student-centered learning environment. The goal is to facilitate students in achieving the set learning objectives. This research focuses on evaluating the effectiveness of interactive multimedia in improving English vocabulary comprehension in English subjects at the junior high school level. The research method employed is an experiment with a quasi-experimental design, involving pre and posttests in both control and experimental classes. The sample consists of 32 students from class VIII B (experimental group) and 32 students from class VIII C (control group) in SMPN 1 Jatisrono, selected using cluster random sampling from various classes. The experimental group receives treatment through learning activities using interactive multimedia, while the control group does not use interactive multimedia in the learning process. Data collection is conducted through attitude scale questionnaires filled out by junior high school students. The research findings indicate that the use of interactive multimedia significantly influences the improvement of students' English vocabulary comprehension. This is evidenced by the significant increase in students' English vocabulary knowledge after undergoing learning with interactive multimedia. Interactive multimedia is considered effective in influencing students' comprehension and helping them achieve learning objectives. Thus, interactive multimedia can be considered a suitable learning medium for English subjects at the junior high school level. The use of technology in such learning is crucial to keep up with the times and ensure that students have skills relevant to current global needs. This underscores the importance of integrating technology into education to create more effective and engaging learning experiences for students.

Pivoting Training and Coaching for an Early Numeracy Intervention During COVID-19.

Early numeracy skills are vital for kindergarten students because they provide the foundation for acquiring mathematics skills in both kindergarten and subsequent years. Teacher support to intervene with kindergarteners at risk for poor mathematics learning outcomes is a promising approach to addressing this achievement gap. The current study replicates previous work on an established early numeracy intervention, ROOTS. In this instance, ROOTS uses remote professional development as a novel format for interventionist training support during the COVID-19 pandemic. Findings indicate that interventionists receiving remote support for implementing ROOTS found training and coaching acceptable and feasible. Remote training and coaching supported strong levels of implementation fidelity. Furthermore, children who received the ROOTS intervention outperformed their control group peers on post-test measures of mathematics achievement within a randomized controlled trial research design. Outcomes and implications for using remote professional development as a format for supporting educators in their use of early numeracy intervention programs are discussed within a pandemic-response context.

A systematic review and meta-analysis of randomized controlled trials to reduce burden, stress, and strain in informal stroke caregivers.

To understand the nature and effectiveness of interventions aimed at improving informal stroke caregiver burden, stress, and strain. In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of CENTRAL, CINAHL, MEDLINE, Embase, APA PsycInfo, and Web of Science was conducted in May 2022. Studies were eligible if they included an intervention designed for informal stroke caregivers, reported on caregiver burden, strain, or stress, were published in English, and used a randomized controlled trial design. An updated search was conducted in June 2024. The methodological quality of studies was appraised using the Cochrane risk-of-bias tool for randomized trials. The data were pooled, and a meta-analysis was completed for caregiver burden and strain outcomes. Nineteen studies met inclusion criteria and were meta-analyzed. Interventions ranged from 4 days to 12 months. Most studies incorporated educational and/or support components. Meta-analyses revealed nonsignificant effects on caregiver burden or strain. Significant between-group differences for caregiver strain and burden were, however, found in seven studies. Limited studies, small sample sizes, and conflicting results made definitive conclusions on the most effective intervention characteristics for improving caregiver outcomes difficult. Of the 19 studies, seven found significant between-group differences for caregiver outcomes postintervention, and these tended to incorporate educational components and comprised between seven and nine sessions. Further high-quality research is required to identify optimal format, duration, and frequency for improving caregiver outcomes.

Randomized Controlled Trial Assessing Vitamin D's Role in Reducing BPPV Recurrence in Older Adults.

To determine if the recurrence rates of BPPV in older adults were lower in the vitamin D-treated group as compared to placebo groups. Double-blinded randomized control placebo trial. A single-centre study. Double-blinded randomized controlled trial design with 12 months follow-up. Vitamin D3 deplete participants were randomized into treatment (Group A) or placebo groups (Group B). Treatment group received 13 weeks of 2000 IU vitamin D3 followed by 1000 IU for the next 13 weeks. Patients who were replete were allocated to a control group (Group C) for observation and follow up. All groups had dietary interventions for vitamin D3 and calcium. Results showed an 87% reduction in recurrence rates of BPPV in the treatment group (Group A), with 0.75 fewer clinical episodes per 1 person-year as compared to placebo (Group B). Time to first recurrence was also significantly longer in Group A. There was no statistically significant difference between Group A and C in both recurrence rates and dizziness handicap scores. This clinical trial has laid the foundation to expand the investigation of vitamin D as standard of care treatment in BPPV patients in future phase IIb and III studies. A reduction in BPPV episodes in older adults has implications on fall risk, as dizziness from BPPV may cause falls. With fewer BPPV episodes and longer time to recurrence, seniors may have better postural stability and hence reduced risk of falls.

Controllable Design and Synthesis of Polyurethane Elastomers Containing Polar Dangling Chains with High Mechanical Properties and Wide Damping Temperature Range.

Vibration and noise severely affect the operation of mechanical equipment and is also detrimental to human health. Therefore, the development of high performance damping materials is crucial. However, current methods to improve damping properties often come at the expense of mechanical properties, resulting in inferior mechanical performance of materials. In order to address the issue of imbalance between damping properties and mechanical properties in polyurethane damping elastomers. In this study, polyester dangling chains containing polar groups are synthesized and introduced into polyurethane. The obtained polyurethane exhibited an effective damping temperature range of 154 °C (-54 °C to 100 °C) and a tensile strength of 15.82 MPa. Furthermore, dynamic mechanical analysis and broadband dielectric relaxation spectroscopy are combined to investigate the influence of polar dangling chains on the structure and properties of polyurethane. The degree of microphase separation increases after the introduction of polar dangling chains, indicating enhances intermolecular interaction forces, facilitating the formation of hydrogen bond between the main chain and dangling chains, thereby increasing molecular chain friction and energy dissipation. This work overcomes the challenge of balancing the damping and mechanical properties of polyurethane, providing a new strategy for designing high performance polyurethane damping elastomers.