Magnitude Of Mean Change Research Articles

A Preliminary Investigation Into The Effect Of Nauseogenic Vection And Whole‐Body Heating On Motion Sickness Severity: A Combined And Individual Stressors Approach

INTRODUCTIONThe use of virtual reality for training, medical and recreational applications is limited by the side effects of prolonged exposure to vection. Secondary factors such as environmental temperature may be crucial in modulating the onset and severity of these side effects. To understand the role of environmental temperature in modulating nausea in virtual reality, this preliminary investigation explored the differential impacts of ambient temperature and vection on motion sickness severity using an individual and combined stressors approach.METHODSThirteen healthy individuals (eight female, five male, 24.8 ± 3.1 yrs) watched a 22 min pre‐recorded driving simulator video in four different conditions, which included: 1) Computer screen in a neutral temperature of 22°C, 50% rH; 2) Virtual reality in a neutral temperature of 22°C, 50% rH; 3) Computer screen in a hot temperature of 35°C, 50% rH; 4) Virtual reality in a hot temperature of 35°C, 50% rH. Subjective measures for visually induced motion sickness were explored using the fast motion sickness scale (FMS; 0–20 visual analogue scale) and the simulator sickness questionnaire (SSQ) both during and following exposure to each condition. To explore the effect of vection and whole‐body heating on physiological indices of motion sickness, local sweat rate (via ventilated sweat capsules), rectal temperature, skin blood flow (via laser Doppler flowmetry), skin temperature, blood pressure and heart rate were examined.RESULTSThe results from FMS ratings indicate that, when taken independently, vection significantly increased sickness severity (computer screen, 0.6 ± 0.8 vs. virtual reality, 4.3 ± 3.1; p<0.001), with an onset time of ~3.5 mins across VR trials. A significant independent influence of ambient temperature was also observed on FMS ratings (neutral conditions, 2.1 ± 2.3 vs. hot conditions, 2.8 ± 3.4; p=0.04). However, no interaction between vection and ambient temperature was observed (p=0.2), indicating an additive response between factors. The SSQ ratings immediately following each trial paralleled FMS observations, demonstrating significant independent main effects for vection (p<0.001) and ambient temperature (p=0.009) on reported motion sickness severity, yet without interaction (p=0.07). No main effects were seen in SSQ rating 2 hrs post trials. Local sweat rate, skin temperature, and heart rate each increased (p<0.03) with whole‐body heating (17.4 ± 10.5 ml.m−2.hr−1; 2.7 ± 6.5 °C; 4.1 ± 9.0 bpm), but were not affected by vection (p>0.6); furthermore, with no interactions observed (p>0.4). No main effects were observed for blood flow, mean arterial pressure or rectal temperature (p>0.1).CONCLUSIONThis preliminary study shows no interaction between ambient temperature and a mild‐moderate vection stimulus on motion sickness severity. Investigations into true motion, responders and non‐responders, as well as stimulus strength, may better highlight any interactions that may exist in this area.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

(546) Treatment of pediatric chronic pain associated with joint hypermobility in an interdisciplinary pain management program

Chronic pain is common in individuals with joint hypermobility syndromes, but effective treatment options are poorly described. Intensive interdisciplinary pain management programs, incorporating medication management, pain psychology, biofeedback, physical and occupational therapy are effective for the treatment of multiple chronic pain conditions. We aimed to determine if such a program can improve pain and function in pediatric patients with chronic pain related to joint hypermobility. This retrospective cohort study included patients less than 18 years of age diagnosed with a joint hypermobility syndrome and chronic pain, who were treated in an intensive 6-week program at an interdisciplinary pain management center. Outcomes measured included Numeric Rating Scale (NRS) pain scores, Bath Adolescent Pain Questionnaire (BAPQ), Child Functional Disability Index (C-FDI) and Parent Functional Disability Index (P-FDI). Changes from admission to discharge were compared by Wilcoxon rank-sum test and assessed for clinical significance according to Cochrane Review criteria for treatment of chronic pain. Eleven female patients, mean age of 14.6, standard deviation (SD) 2.2 years (ranging 9-17), were included. From admission to discharge, average NRS scores significantly decreased for typical pain (p = 0.08) and greatest daily pain (p = 0.03). Patients showed significant improvement in the daily functioning as measured by the BAPQ (p = 0.04). The mean magnitude of change was 2.6 (SD 2.2), 2.5 (SD 3.0), and 4.5 (SD 6.6) for the decrease in typical pain, decrease in greatest pain, and improvement in daily functioning, respectively, representing clinically improvement for each of these outcome measures. Improvements on the C-FDI, P-FDI, and the emotion domain of the BAP-Q were nonsignificant (p’s >.05). Our findings suggest that an intensive interdisciplinary pain management program results in improvements in pain and functional scores that are both statistically and clinically significant. Chronic pain is common in individuals with joint hypermobility syndromes, but effective treatment options are poorly described. Intensive interdisciplinary pain management programs, incorporating medication management, pain psychology, biofeedback, physical and occupational therapy are effective for the treatment of multiple chronic pain conditions. We aimed to determine if such a program can improve pain and function in pediatric patients with chronic pain related to joint hypermobility. This retrospective cohort study included patients less than 18 years of age diagnosed with a joint hypermobility syndrome and chronic pain, who were treated in an intensive 6-week program at an interdisciplinary pain management center. Outcomes measured included Numeric Rating Scale (NRS) pain scores, Bath Adolescent Pain Questionnaire (BAPQ), Child Functional Disability Index (C-FDI) and Parent Functional Disability Index (P-FDI). Changes from admission to discharge were compared by Wilcoxon rank-sum test and assessed for clinical significance according to Cochrane Review criteria for treatment of chronic pain. Eleven female patients, mean age of 14.6, standard deviation (SD) 2.2 years (ranging 9-17), were included. From admission to discharge, average NRS scores significantly decreased for typical pain (p = 0.08) and greatest daily pain (p = 0.03). Patients showed significant improvement in the daily functioning as measured by the BAPQ (p = 0.04). The mean magnitude of change was 2.6 (SD 2.2), 2.5 (SD 3.0), and 4.5 (SD 6.6) for the decrease in typical pain, decrease in greatest pain, and improvement in daily functioning, respectively, representing clinically improvement for each of these outcome measures. Improvements on the C-FDI, P-FDI, and the emotion domain of the BAP-Q were nonsignificant (p’s >.05). Our findings suggest that an intensive interdisciplinary pain management program results in improvements in pain and functional scores that are both statistically and clinically significant.

IS 33. NBS in schizophrenia

Background Working memory represents a core cognitive domain that is impaired in schizophrenia for which there are currently no satisfactory treatments. Repetitive transcranial magnetic stimulation (TMS) targeted over the dorsolateral prefrontal cortex (DLPFC) has been shown to modulate neurophysiological mechanisms linked to working memory in schizophrenia and improves working memory performance in healthy subjects, and may therefore represent a treatment modality for schizophrenia patients. Objectives To evaluate the effects of rTMS on working memory performance in schizophrenia patients; and evaluate if rTMS normalizes performance to healthy subject levels. Design 4-week randomized double-blind sham-controlled pilot study design. Setting Centre for Addiction and Mental Health (a university teaching hospital that provides psychiatric care to a large urban catchment area and serves as a tertiary referral centre for the province of Ontario). Participants 27 medicated schizophrenia patients performed the verbal working memory N-back task before and after rTMS. Intervention rTMS was targeted bilaterally sequentially to left and right DLPFC 750 pulses per side at 20 Hz for 20 treatments using MRI-targeted methods. Main outcome measures Mean magnitude of change in the N-back accuracy for target responses with active (n = 13) or sham (n = 12) rTMS treatment course. Results rTMS significantly improved 3-back accuracy for targets compared to placebo sham. The improvement in 3-back accuracy was also found to be at a level comparable to healthy subjects. Conclusions These pilot data suggest that bilateral rTMS may be a novel, efficacious, and safe treatment for working memory deficits in patients with schizophrenia. rTMS for the treatment on neurophysiology and non-cognitive symptoms for schizophrenia will also be reviewed in the context of this trial.

Changes in axial length and choroidal thickness after intraocular pressure reduction resulting from trabeculectomy

PurposeTo evaluate changes in axial length and choroidal thickness after trabeculectomy.Patients and methodsFourteen patients under 80 years of age with glaucoma, were enrolled. The choroid was imaged using prototypical high-penetration optic coherence tomography (OCT) and the thickness was measured. Axial length, choroidal thickness, and intraocular pressure (IOP) were measured bilaterally at 3 pm 1 day before and 6 days after trabeculectomy. The choroidal thickness was measured at the fovea and four other locations (2 mm superior, temporal, inferior, and nasal to the center of the optic nerve head).ResultsThe IOP and axial length significantly decreased in eyes that underwent trabeculectomy (P < 0.0001 for the IOP; P < 0.001 for axial length comparisons). The mean choroidal thicknesses significantly increased in eyes that underwent trabeculectomy compared to preoperatively (P < 0.0001 for the fovea; P < 0.01 for four locations around the optic disc). The mean magnitude of change in IOP was correlated positively with the mean magnitude of change in axial length, but not correlated with the mean magnitude of change in choroidal thickness at the fovea that underwent trabeculectomy. The sum of the axial length and subfoveal choroidal thickness in eyes decreased significantly postoperatively (P < 0.05).ConclusionThe axial length shortened, the choroid thickened, and the sum of the axial length and subfoveal choroidal thickness decreased with IOP reduction early after trabeculectomy.

Can Repetitive Magnetic Stimulation Improve Cognition in Schizophrenia? Pilot Data from a Randomized Controlled Trial

Working memory represents a core cognitive domain that is impaired in schizophrenia for which there are currently no satisfactory treatments. Repetitive transcranial magnetic stimulation (rTMS) targeted over the dorsolateral prefrontal cortex has been shown to modulate neurophysiological mechanisms linked to working memory in schizophrenia and improves working memory performance in healthy subjects and might therefore represent a treatment modality for schizophrenia patients. The objectives were to evaluate the effects of rTMS on working memory performance in schizophrenia patients and evaluate whether rTMS normalizes performance to healthy subject levels. In a 4-week randomized double-blind sham-controlled pilot study design, 27 medicated schizophrenia patients were tested at the Centre for Addiction and Mental Health (a university teaching hospital that provides psychiatric care to a large urban catchment area and serves as a tertiary referral center for the province of Ontario). Patients performed the verbal working memory n-back task before and after rTMS magnetic resonance image targeted bilaterally sequentially to left and right dorsolateral prefrontal cortex 750 pulses/side at 20 Hz for 20 treatments. The main outcome measure was mean magnitude of change in the n-back accuracy for target responses with active (n = 13) or sham (n = 12) rTMS treatment course. The rTMS significantly improved 3-back accuracy for targets compared with placebo sham (Cohen's d = .92). The improvement in 3-back accuracy was also found to be at a level comparable to healthy subjects. These pilot data suggest that bilateral rTMS might be a novel, efficacious, and safe treatment for working memory deficits in patients with schizophrenia.

Cumulative sum method in nonzero fixed action level setup correction strategy: An application of statistical process control for targeted prostate radiotherapy

This study aims to incorporate a statistical process control tool, the cumulative sum (CUSUM) method, in the nonzero fixed action level setup correction strategy for the detection and correction of systematic shifts in prostate position during prostate image-guided radiotherapy. A daily nonzero action level setup correction strategy using CUSUM chart was proposed and tested retrospectively on 34 nonrandomized patients with prostate-implanted fiducial markers in situ plus daily localization via stereoscopic electronic portal imaging. A cumulative error index, which monitors a cumulative process index over time, was implemented in parallel with the localization offsets of the prostate. A value of this index exceeding a decision interval H indicated that a systematic change in the mean value of localization had occurred. When a value of the index exceeding H was recorded, the magnitude of the systematic shift was estimated and the subsequent prescribed offsets were corrected to account for the new setup positions. With the new protocol, the authors produced simulated treatment histories in which the detection of systematic shifts and the frequency of localization offset exceeding action level were evaluated. The protocol was examined against three levels of mean systematic shifts of localization for detection (μ(1)) of 3, 5, and 7 mm. The overall rates of detection of systematic shifts using this algorithm were relatively high. The level μ(1) = 3 mm resulted in the highest rate of detection of systematic offset change, in 42% of the charts. For larger values of μ(1), the overall detection numbers fell to 18% and 12% of the charts for μ(1) = 5 and 7 mm, respectively. The mean magnitude of change in systematic offset at time of detection was 3.1, 4.4, and 5.2 mm for μ(1) = 3, 5, and 7 mm, respectively. By adapting the setup position for any change in systematic localization offset over a course of treatment using the new protocol, it has been shown that the frequency of localization offsets exceeding action levels was reduced. For the optimal choice of intervention levels for correction and μ(1), the number of localization offsets exceeding action levels has been reduced by approximately half. The nonzero fixed action level setup correction strategy incorporating CUSUM charts has been shown to provide an objective method for (i) detecting a systematic shift of a patient localization offset, (ii) quantifying the magnitude of a systematic change based on previous observations, and (iii) correcting the prescribed offset by accounting for the systematic shift(s) in patient setup position.

Temperature, Hematocrit, pH, and Glucose 4-Way ANOVA of Cytochrome C Oxidase Redox Status During Systemic Cold Circulatory Arrest in Swine

Various investigators using near infrared spectroscopy (NIRS) have reported differing patterns of cytochrome C oxidase (cytochrome a,a3) redox status in similar brain oxygenation studies. We investigated whether distinctive differences could be due to combinations of variations in temperature, hematocrit, pH, and glucose. Thirty-six healthy 10 kg commercial juvenile swine on cardiopulmonary bypass underwent 2-8 sequential periods of circulatory arrest. Prior to each arrest, key physiological variables were adjusted to match a random selection of one of 81 combinations of high, normal, or low levels of hypothermia, hematocrit, pH, and serum glucose. In the course of the study, the combinations were repeated twice to yield 162 NIRS data sets. The mean rate of change in net oxidized minus reduced cytochrome a,a3 redox status in the brain following 7.5 min of ischemia was 0.49 +/- 0.26 micromol L(-1) min(-1), and, the corresponding mean magnitude of change was -1.23 +/- 0.57 micromol L(-1). The rate of change was influenced by temperature but not by hematocrit, pH, or glucose, either singly or in combination. The respiratory response in mitochondria during systemic circulatory arrest is significantly influenced by temperature.

Variability of epileptiform activity in long-term EEGs with short and long intervals in children with epilepsy

Objective: To evaluate the impact of the time factor on the amount of epileptiform activity in long-term EEG recordings in children with epilepsy.Methods: Ten children with epilepsy of different types underwent three 24h EEG examinations during two consecutive days and with a month's interval. The number of epileptiform discharges during selected corresponding periods of time was counted.Results: The number of epileptiform discharges on three repeated examination days showed no significant difference (ANOVA P=0.88) as intraindividual increases and decreases on different days counterbalanced each other within the group. However the standard deviations of the relative changes were larger between recordings with a month's interval compared to those for consecutive days (86% and 33%). The mean magnitude of change was 55% between days separated by a month compared to 24% on consecutive days. The difference was non-significant but showed a trend towards larger changes with a longer interval (P=0.07).Conclusions: The variability of epileptiform activity was larger when the interval between recordings was 1 month compared to consecutive days. The magnitude of the relative changes between intervals of 1 and 30 days showed a trend towards a difference although not statistically significant. When evaluating repeated long-term EEGs in relation to therapy in children, these variations should be considered.

Changes Over Time in the Determinants of Sport Commitment

The purpose of this study was to examine whether changes over time in the determinants of sport commitment would be related to predicted changes in commitment. Male and female (N = 103) high school soccer players completed surveys toward the middle and at the end of their regular season. A simultaneous multiple regression analysis indicated that commitment was significantly predicted by changes in involvement opportunities. Examination of the mean magnitude of changes in the determinants and corresponding changes in commitment using a series of correlated t-tests revealed significant effects for sport enjoyment and involvement opportunities. For those players whose sport enjoyment and involvement opportunities had declined, there was a corresponding decrease in their commitment. For those players whose involvement opportunities had increased, there was a corresponding increase in their commitment. Combined, these results provided support for a priori hypotheses regarding changes in the determinants of commitment over time and corresponding changes in commitment.

Effect of changes in interannual climatic variability on CERES-wheat yields: sensitivity and [formula omitted] general circulation model studies

This study concerns the investigation of how changes in climate variability could affect agricultural production. To date very few studies of this effect have been made, whereas changes in climate variability, in addition to changes in mean conditions could have serious effects on crops. Currently there is very little certainty regarding how climate variability will change in a greenhouse-gas-warmed world. In view of this uncertainty, it is desirable to perform sensitivity analyses of how crop-climate models (e.g. the CERES-Wheat model) respond to changes in climate variability. We apply the winter wheat model to two climate stations in the wheat growing region of Kansas. Goodland in the western region, and Topeka in the moister eastern region. Time series of temperature and precipitation, are simulated, systematically changing the interannual variance of the series (from one quarter to four times the actual variance), and determining how the crop climate model responds to these changes. In addition, these variability changes are combined with mean changes of both temperature and precipitation. We then also apply a GCM-derived climate change scenario. Results indicate that it is the relative magnitude of change of the mean and variance of the climate that determines their relative importance to changes in wheat yields. In general increases in variability of temperature and precipitation resulted in significant increases in yield variability and crop failures in the sensitivity experiments, but precipitation changes had a more pronounced effect. In the GCM-derived scenario, mean temperature effects dominate, resulting in increased yield variability and crop failures, because the magnitude of mean change is much greater than the magnitude of variance change. Over all experiments, the importance of considering not only mean but also variance changes of climate variables, when investigating the effect of climate change on wheat yields, is confirmed.