Linear Mixed-effects Regression Analysis Research Articles

C-reactive Protein Elevation Is Associated With QTc Interval Prolongation in Patients Hospitalized With COVID-19.

BackgroundThe relationship between inflammation and corrected QT (QTc) interval prolongation is currently not well defined in patients with COVID-19.ObjectiveThis study aimed to assess the effect of marked interval changes in the inflammatory marker C-reactive protein (CRP) on QTc interval in patients hospitalized with COVID-19.MethodsIn this retrospective cohort study of hospitalized adult patients admitted with COVID-19 infection, we identified 85 patients who had markedly elevated CRP levels and serial measurements of an ECG and CRP during the same admission. We compared mean QTc interval duration, and other clinical and ECG characteristics between times when CRP values were high and low. We performed mixed-effects linear regression analysis to identify associations between CRP levels and QTc interval in univariable and adjusted models.ResultsMean age was 58 ± 16 years, of which 39% were women, 41% were Black, and 25% were White. On average, the QTc interval calculated via the Bazett formula was 15 ms higher when the CRP values were “high” vs. “low” [447 ms (IQR 427–472 ms) and 432 ms (IQR 412–452 ms), respectively]. A 100 mg/L increase in CRP was associated with a 1.5 ms increase in QTc interval [β coefficient 0.15, 95% CI (0.06–0.24). In a fully adjusted model for sociodemographic, ECG, and clinical factors, the association remained significant (β coefficient 0.14, 95% CI 0.05–0.23).ConclusionAn interval QTc interval prolongation is observed with a marked elevation in CRP levels in patients with COVID-19.

An Exploratory Study of Strategy Use on Elicited Imitation Tasks

Elicited imitation (EI) has gained popularity with recent interests in the quest for efficient and flexible measures of second language (L2) proficiency. Despite the surge of interests, questions remain as to what specific linguistic knowledge, skills, and strategies EI measures. To contribute to this line of inquiry, this study explored the nature of strategy use and its effect on EI performance to elucidate the constructs of EI. Twenty-four L2 learners and eight native speakers of Chinese completed an EI test of Chinese and a strategy use questionnaire after the test. Qualitative analyses of the questionnaire responses revealed that participants mainly employed five types of strategies, including approach strategies, cognitive strategies, metacognitive strategies, communication strategies, and test-wiseness strategies. While native speakers reported the least number of strategies, higher-proficiency L2 learners reported more strategies than lower-proficiency L2 learners. We further subjected strategy use, along with participant proficiency level, item length, and item complexity level, to linear mixed-effects regression analyses. The results showed that participant proficiency level, item length, and item complexity level explained the largest test score variance; in contrast, strategy use of different types only accounted for a smaller proportion. The total number of cognitive strategies had a significant, positive effect on EI performance whereas the total number of metacognitive strategies had a significant, negative effect. These findings offer some insights into the nature of speech comprehension and production on EI and provide validity evidence for the use of EI as a language proficiency measure.

0232 An Intraindividual Variability of Sleep Health and Perceived Stress in College Students During the COVID-19 Pandemic

Abstract Introduction Pandemic-related societal response and uncertainty have generated marked changes in sleep-wake patterns and psycho-social well-being especially among first year college students. The current study sough to describe the changes in the sleep health domains determined from Actigraph and self-report, and examine the associations between the repeated-measure and intraindividual variability (IIV) of these domains and perceived stress in young college students over the course of a semester in the midst of an on-going COVID-19 pandemic (i.e., Fall, 2020). Methods A repeated measure design at 1-month interval across a 3-month period was conducted among a group of diverse racial and ethnic groups of college students (N=23, 78.3% female, age range 17-18). Participants completed a 7-days of wrist Actigraph, daily sleep diaries, and other surveys at each interval. A multidimensional sleep health was determined using Actigraph and daily sleep diary measures of sleep duration, efficiency, timing and regularity, and self-reported surveys of sleep satisfaction and alertness during daytime. Participants also completed the Perceived Stress Scale. Non-parametric tests were used to assess the changes in sleep health across 3 intervals, and a series of linear mixed effects model and regression analysis were conducted to assess associations between stress and subjective sleep health, adjusting for sex. Results Actigraph-determined sleep timing and regularity, and sleep diary-determined sleep timing and alertness during daytime demonstrated statistically significant changes between given timepoints. Among the sleep diary-determined sleep health domains, greater perceived stress was associated with more irregular (B=2.25 [.87–3.62], p<.001), more dissatisfied (B=.04 [.02–.19], p<.01), and sleepier during daytime (B=.18 [.05–.31], p<.001), across 3 timepoints. Moreover, greater perceived stress was associated with greater IIV (i.e., fluctuations) in sleep satisfaction, but no significance was found among IIV of other domains. Conclusion This study aids understanding of the relationship between stress and sleep health in this population, and offers insight to future research questions that can facilitate intervention development to promote both mental and sleep health among young college students. Support (If Any)

An ecological momentary assessment study of age effects on perceptive and non-perceptive clinical high-risk symptoms of psychosis

Among individuals with clinical high risk for psychosis (CHR), perceptive symptoms are more frequent but have less clinical significance in children/adolescents compared to adults. However, findings are based on clinical interviews relying on patient’s recall capacity. Ecological momentary assessment (EMA) can be used to explore experiences in real-time in the subject’s daily life. The aim of this study was to assess frequency and stability of (perceptive and non-perceptive) CHR symptoms and to explore potential age effects. EMA was used in a sample of an early detection for psychosis service in Bern, Switzerland (N = 66; 11–36 years). CHR symptoms were recorded in random time intervals for seven days: eight assessments per day per subject, minimum time between prompts set at 25 min. CHR symptoms were additionally assessed with semi-structured interviews including the ‘Structured Interview for Psychosis-Risk Syndromes’ and the ‘Schizophrenia Proneness Instruments’. Mixed-effects linear regression analysis on the frequency of CHR symptoms revealed a significant effect of age group, and the interaction CHR symptoms x age group for both perceptive and non-perceptive symptoms. Further, regarding stability of CHR symptoms, there was a significant effect of the interaction CHR symptoms x age group for perceptive symptoms only. Based on EMA, perceptive CHR symptoms were more frequently reported but less stable in children/adolescents compared with adults. Together with previous findings, our finding of higher instability/variability of perceptive symptoms in younger persons might suggest that with advancing age and more stability of CHR symptoms, clinical relevance (reduced psychosocial functioning) may increase.

Effect of Ground and Raised Poles on Kinematics of the Walk

Walking over poles is a commonly employed training and rehabilitation tool and it is crucial to understand its effect on equine locomotion, particularly joint range of motion (ROM). The study aimed to compare the effect of ground poles (GP) and raised poles (RP) on limb kinematics and poll, wither and pelvic ROM at walk. It was hypothesized that walking over poles would increase joint ROM but have no effect on poll, wither and pelvic ROM compared to no poles (NP). Forty-one horses were walked in-hand over NP, GP (10 cm) and RP (26 cm) in a crossover design. Limb kinematics were determined via two-dimensional motion capture (240 Hz). Poll, wither, tubera sacrale, and left/right tuber coxae ROM were determined by inertial motion units (100 Hz). Multivariable mixed effects linear regression analyses were carried out. Walking over poles increased limb joint ROM, through increased swing flexion, compared to NP. There was a greater effect over RP compared to GP. Significant reductions in craniocaudal ROM of the wither, tuber coxae and tuber sacrale were observed over GP and RP. Mediolateral ROM of tuber coxae and tuber sacrale increased over GP and RP and was greatest over RP. Wither ROM was increased over RP only. Set-up and height of the poles used here may not extrapolate to other scenarios. Walking over poles appears to be effective at increasing joint ROM via an increase in mid swing flexion, without vertical excursion of the trunk, compared to normal locomotion, which supports the use of poles for rehabilitation.

Effect of Fatiguing Wheelchair Propulsion and Weight Relief Lifts on Subacromial Space in Wheelchair Users.

ObjectiveThis study aimed to identify targets of intervention for reducing shoulder pain in wheelchair users with spinal cord injury (SCI) by (1) examining changes in subacromial space [acromiohumeral distance (AHD) and occupation ratio (OccRatio)] with fatiguing wheelchair propulsion, and different loading conditions [unloaded position vs. weight relief lifts (WRL)]; (2) associating these changes with wheelchair user capacity, as well as (3) identifying subject characteristics associated with subacromial space, such as sex, lesion level, time since injury, body mass index and impaired shoulder range of motion.MethodsFifty manual wheelchair users with SCI [11 females, age = 50.5 (9.7) years, time since injury = 26.2 (11.4) years] participated in this quasi-experimental one-group pretest-posttest study. Ultrasound images were used to define AHD during an unloaded position, and during personal and instructed WRL before and after fatiguing wheelchair propulsion. Furthermore, supraspinatus and biceps thickness defined from ultrasound images were used to calculate OccRatios. Wheelchair user capacity was quantified as functional strength (maximum resultant force reached during maximum isometric forward push) and anaerobic work capacity (highest power output reached during 15-m sprint test). Multilevel mixed-effects linear regression analyses controlling for between subject variability and covariables were performed to address the research questions.ResultsAHD was significantly smaller during personal WRL (p < 0.001) and instructed WRL (p = 0.009, AHD both 11.5 mm) compared to the unloaded position (11.9 mm). A higher wheelchair user capacity (higher anaerobic work capacity) reduced the impact of WRL on AHD decrease. The fatiguing wheelchair propulsion had no effect on AHD (p = 0.570) and on OccRatio of supraspinatus (p = 0.404) and biceps (p = 0.448). Subject characteristics related to a larger subacromial space were lower lesion level, shorter time since injury, impaired external rotation, a lower body mass index and a higher anaerobic work capacity.ConclusionThis study showed a significant reduction in AHD during WRL with no effect of fatiguing wheelchair propulsion on the subacromial space in wheelchair users with SCI. A higher anaerobic work capacity was beneficial in stabilizing the shoulder during WRL. Our findings may assist clinicians in designing a shoulder injury prevention program.

Effect of Vascular Comorbidity on Visual and Disability Outcomes in a Secondary Progressive Multiple Sclerosis Clinical Trial Cohort.

Vascular comorbidity (VC) is associated with multiple sclerosis (MS) disease progression and visual dysfunction. The longitudinal effect of VC in people with secondary progressive MS (SPMS) is unclear. This study explored the impact of VC on standard clinical, MRI, and visual outcomes in people with SPMS enrolled in a clinical trial. Data were extracted from a 2-year randomized controlled trial (N = 51) testing the supplement lipoic acid in people with SPMS who underwent annual Expanded Disability Status Scales, Timed 25-Foot Walk tests, MRIs, visual acuity testing, and retinal nerve fiber layer (RNFL) and ganglion cell/inner plexiform layer (GCIPL) thicknesses per optical coherence tomography (OCT). Post hoc linear mixed-effects regression analysis compared baseline and annualized outcomes between participants without VC (VC-) and with 1 or more VCs (VC+) (hypertension, dyslipidemia, obesity, diabetes, peripheral or cardiovascular disease, tobacco use). The VC- (n = 19) and VC+ (n = 28) participants were similar in age, sex, and MS disease duration and had comparable MS disability, mobility, and brain atrophy at baseline and throughout the 2-year parent study. The VC+ participants had worse baseline visual acuity than those in the VC- group by 0.13 logMAR (P = .041). No significant differences were detected in RNFL or GCIPL baseline thickness or atrophy between groups. In an SPMS cohort, VC had an inconsistent effect on standard clinical, MRI, and exploratory OCT outcomes, suggesting that the effect of VC may not be evident in smaller cohort studies. Using a more refined definition of VC in future, adequately powered investigations may help effectively elucidate and account for the interaction between vascular risk burden and MS disability.

Cognition and Diabetes: Examining Sex Differences Using a Longitudinal Sample of Older Adults.

Objectives: This study aims to investigate sex-based differences in the diabetes status and cognition relationship using a representative sample of older Americans. Methods: Using a sample of 19,190 females and 15,580 males from the Health and Retirement Study, we conduct mixed-effects linear regression analyses to examine sex differences in the association between diabetes and cognition over a 20-year follow-up period among older adults in the United States. Main Findings: Females experience slightly steeper declines in cognition that are further exacerbated by diabetes. At age 65, females without diabetes have significantly higher cognition than males; this gap is eliminated by age 85. Among diabetics, there is no initial sex disparity, but females' cognition becomes significantly lower than males' over the following 20years. Principal Conclusions: Relative to males, females are particularly susceptible to diabetes-related declines in cognition with increasing age.

The Acoustic Voice Quality Index (AVQI) in People with Parkinson's Disease Before and After Intensive Voice and Articulation Therapies: Secondary Outcome of a Randomized Controlled Trial

The majority of individuals with Parkinson's disease (PD) experience voice and speech problems during the course of the disease. Despite the importance of voice quality in communication and the documented disordered voice quality in PD, few studies have explored the effects of speech treatment on this variable. A parallel arm, unblinded randomized controlled trial (RCT) was conducted with two active comparators, LSVT LOUD (n=23) and LSVT ARTIC (n=20), and an inactive comparator group of untreated individuals with PD (n=22). A group of 20 healthy adults was also included for pre-treatment analysis. Voice recordings were obtained pre-treatment, immediately post-treatment and at 6-month follow-up. The acoustic voice quality index (AVQI) is reported here as a secondary outcome measure of the RCT. Linear mixed-effects regression analysis was performed with AVQI and sound pressure level (SPL) as dependent variables. Pearson correlation coefficient analysis was also conducted to explore the relationship between voice quality and SPL. Statistically significant improvements in AVQI and SPL from pre-treatment to post-treatment and follow-up were only observed in the LSVT LOUD group. Voice quality significantly improved only from pre-treatment to follow-up in the LSVT ARTIC group, whilst significant improvements in SPL were observed during maximum phonation only immediately post-treatment. No significant changes were observed in the untreated group. This study investigated the effects of intensive speech treatment targeting voice or targeting articulation on voice quality, as measured by the AVQI, in individuals with PD. Findings indicate that voice-focused treatment leads to greater improvements in voice quality in this population.

Effects of Noninvasive Cervical Vagal Nerve Stimulation on Cognitive Performance But Not Brain Activation in Healthy Adults

ObjectivesWhile preliminary evidence suggests that noninvasive vagal nerve stimulation (nVNS) may enhance cognition, to our knowledge, no study has directly assessed the effects of nVNS on brain function and cognitive performance in healthy individuals. The aim of this study was therefore to assess whether nVNS enhances complex visuospatial problem solving in a normative sample. Functional magnetic resonance imaging (fMRI) was used to examine underlying neural substrates. Material and MethodsParticipants received transcutaneous cervical nVNS (N = 15) or sham (N = 15) stimulation during a 3 T fMRI scan. Stimulation lasted for 2 min at 24 V for nVNS and at 4.5 V for sham. Subjects completed a matrix reasoning (MR) task in the scanner and a forced-choice recognition task outside the scanner. An analysis of variance (ANOVA) was used to assess group differences in cognitive performance. And linear mixed effects (LMEs) regression analysis was used to assess main and interaction effects of experimental groups, level of MR task difficulty, and recall accuracy on changes in blood oxygen level-dependent (BOLD) signal. ResultsSubjects who received nVNS showed higher accuracy for both easy (p = 0.017) and hard (p = 0.013) items of the MR task, slower reaction times for hard items (p = 0.014), and fewer false negative errors during the forced-choice recognition task (p = 0.047). MR task difficulty related to increased activation in frontoparietal regions (p < 0.001). No difference between nVNS and sham stimulation was found on BOLD response during performance of the MR task. ConclusionsWe hypothesize that nVNS increased attention compared to sham, and that this effect led to enhanced executive functions, and consequently to better performance on visuospatial reasoning and recognition tasks. Results provide initial support that nVNS may be a low-risk, low-cost treatment for cognitive disorders.

Supervisors' transformational leadership style and residents' job crafting in surgical training: the residents' views.

ObjectivesThis study aims to explore the effects of three supervisors’ leadership styles (transformational, transactional, and laissez-faire) on residents’ job crafting. MethodsSequential explanatory mixed-methods. First, a purposive sample of residents rated the leadership style of their supervisors and their own job crafting on the Multifactor Leadership Questionnaire and the Dutch Job Crafting Scale. The effects were tested through linear mixed effects regression analysis. Thereafter we conducted semi-structured interviews with residents and conducted a thematic analysis. ResultsA total of 116 residents participated. A transformational style had a positive effect on residents’ job crafting (b = .19, t(112) =3.76, p=. 009), whereas the transactional and laissez-faire styles did not. This could be explained by the fact that residents felt a positive influence of the supervisors with such style on the atmosphere for training, on the job resources available to them, and on their modelling function for how to handle the demands of the environment.ConclusionsA transformational style of the supervisor has a positive effect on residents’ job crafting. Future research should explore the supervisors’ perspective, as well as the effectiveness of leadership training for supervisors with a focus on resident outcomes, such as job crafting.

A Real-Time Trend Study of the Southern Vowel Shift in Kentuckiana

This article examines both the front and back shifts of the Southern Vowel Shift (SVS) in a rural Kentuckiana (south-central Indiana) community through 50 years of real time, from the middle of the twentieth century to the early twenty-first century. Euclidean distance measurements between the pair of high front vowels /i/ and /I/ and between the pair of mid front vowels /e/ and /ε/ are subjected to analyses of variance (ANOVAs). The mid front vowels are found to be involved in the SVS and increasingly so through real time; the high front vowels, in contrast, not only are not participating in the SVS but have exhibited movements in non-SVS directions. Fronting of the back vowels is analyzed through linear mixed-effects regression analyses. Except for /℧/, which remains stable over time in this community, the other back vowels, /u/, /o/, and the nucleus of the /a℧/ diphthong all show real-time changes that are consistent with the SVS. Some of the real-time developments are at odds with profiles of change through apparent time, which underscores the value of real-time data when and where it is available.

Relations Between L2 Proficiency and L1 Lexical Property Evaluations

The present study investigates the relations between L2-English proficiency and L1-Turkish lexical property evaluations. We asked whether L2 proficiency affects lexical properties, including imageability and concreteness ratings of 600 Turkish words selected from the Word Frequency Dictionary of Written Turkish. Seventy-two participants (L1-Turkish - L2-English) provided ratings of concreteness and imageability for 600 words on a 7-point scale. In order to assess their L2 proficiency, we administered Peabody Picture Vocabulary Test-IV (PPVT-IV). We divided categories into two subcategories as high and low for the frequency, concreteness, imageability, and age of acquisition (AoA). The relationship between these subcategories and imageability-concreteness was examined by mixed effects linear regression analyses. We found that L2 proficiency and imageability ratings were positively correlated and specifically, this positive association was evident for low-frequency words and later acquired words. Results are in line with the interaction of bilingual representation under the dual-coding theory which suggests that bilinguals develop an interconnected imaginal representation for two languages as opposed to separate verbal representations. As L2 proficiency increased, the imageability also increased. These findings have implications for literature investigating the relationship between L2 proficiency and linguistic outcomes. Additionally, findings point to the importance of considering the L2 proficiency of participants when lexical tasks that involve cue words or word lists are used.

An exploratory social media intervention for perception and behavior on eating away from home: A cluster randomized trial in Chongqing, China

A modern diet with high energy density is harmful to health and negatively affects the environment. Eating out is particularly prevalent among young adults and has steadily increased in many countries over the last few decades. This study aims to assess the impact of nutrition education interventions on social media on cognitive and behavioral changes in the diet of university students. A cluster-randomized trial with an intervention group (n = 853) and a no-intervention control group (n = 846) was conducted in Chongqing. A two-month educational intervention was conducted through social media (WeChat official account, Sina Weblog, and Tencent Weibo) with participants of the intervention group. Self-reported eating-out-related knowledge and behaviors were assessed at baseline and six and eight months after randomization. Multilevel mixed-effects logistic regression and linear regression analyses accessed the outcomes between the intervention and control groups. The proportion of participants in the high-level knowledge and attitude group in the intervention group increased by 13% and 8.5% compared with the control group (p < 0.05). The effects of the intervention on the outcomes significantly changed over time, as demonstrated by the achieved statistical significance for knowledge and attitude score (p for group and time interaction <0.001) in the interaction between time and randomization groups. The high-frequency eating away from home/school at weekends decreased from 29.6% to 27.3% in the intervention group. In the control group, the high-frequency eating away from home/school at weekends in the increase was increased (26.3%–27.2%). A total of 73.6% of respondents in the intervention group reported that they consciously reduced their frequency of eating away from home/school. The possibility exists for narrowing the perception and behavior disparity gap through the effective use of social media, such as WeChat and Microblog, which could be a sustainable platform to provide health education or new food policies to promote healthy eating and reduce food waste among university students.

Protocol for the implementation of a stepped-care model to address fear of cancer recurrence in patients previously diagnosed with early-stage (0–II) melanoma

IntroductionFear of cancer recurrence (FCR) is commonly reported by patients diagnosed with early-stage (0–II) melanoma and can have a significant impact on daily functioning. This study will pilot the implementation...

Impact of reimbursement restriction on drug market sales under the National Health Insurance in Japan

Aim National health care expenditures have been increasing each year, although the Japanese government has annually revised official drug prices. Managing the health care system to pay for expensive drugs is a major concern. The reimbursement restriction, which is the only way that a drug can be implemented before market entry in Japan, is crucial for managing expenditures. Therefore, this study identifies the impact of the reimbursement restriction on drug market sales in Japan, particularly in the situation where health technology assessment or other market access regulations are not applicable before market entry. Method All new drugs listed in fiscal years 2011–2019, along with their market size forecast, were identified using the materials from the Central Social Insurance Medical Council. We then calculated the percentage rate of reimbursement amounts based on the National Database of Health Insurance Claims relative to the predicted market size as a dependent variable. Using the reimbursement restriction for each drug as an independent variable, we performed descriptive and univariate analyses on each variable, followed by generalized linear mixed-effects model regression analysis. Results We identified 211 drugs. The mean rates of drugs that required physicians, facilities, and patients to meet criteria for use were 30.85% (n = 2), 31.42% (n = 2), and 72.11% (n = 6), respectively. The mean rate of drugs that required diagnostic testing was 22.99% (n = 7), which was 3.7 times lower than the rate of drugs that did not require such testing (p < .05). Conclusion Our results indicate that the reimbursement restriction requiring diagnostic testing has a substantial impact on decreasing market sales. As the number of cases for each requirement is small, further study is needed to measure the impact of the other reimbursement restrictions.

The Use of Different Components of Brain Oxygenation for the Assessment of Cerebral Haemodynamics: A Prospective Observational Study on COVID-19 Patients.

Introduction: The role of near-infrared spectroscopy (NIRS) for the evaluation of cerebral haemodynamics is gaining increasing popularity because of its noninvasive nature. The aim of this study was to evaluate the role of the integral components of regional cerebral oxygenation (rSO2) measured by NIRS [i.e., arterial-oxyhemoglobin (O2Hbi) and venous-deoxyhemoglobin (HHbi)-components], as indirect surrogates of cerebral blood flow (CBF) in a cohort of critically ill patients with coronavirus disease 2019 (COVID-19). We compared these findings to the gold standard technique for noninvasive CBF assessment, Transcranial Doppler (TCD).Methods: Mechanically ventilated patients with COVID-19 admitted to the Intensive Care Unit (ICU) of Policlinico San Martino Hospital, Genova, Italy, who underwent multimodal neuromonitoring (including NIRS and TCD), were included. rSO2 and its components [relative changes in O2Hbi, HHbi, and total haemoglobin (cHbi)] were compared with TCD (cerebral blood flow velocity, CBFV). Changes (Δ) in CBFV and rSO2, ΔO2Hbi, ΔHHbi, and ΔcHbi after systemic arterial blood pressure (MAP) modifications induced by different manoeuvres (e.g., rescue therapies and haemodynamic manipulation) were assessed using mixed-effect linear regression analysis and repeated measures correlation coefficients. All values were normalised as percentage changes from the baseline (Δ%).Results: One hundred and four measurements from 25 patients were included. Significant effects of Δ%MAP on Δ%CBF were observed after rescue manoeuvres for CBFV, ΔcHbi, and ΔO2Hbi. The highest correlation was found between ΔCBFV and ΔΔO2Hbi (R = 0.88, p < 0.0001), and the poorest between ΔCBFV and ΔΔHHbi (R = 0.34, p = 0.002).Conclusions: ΔO2Hbi had the highest accuracy to assess CBF changes, reflecting its role as the main component for vasomotor response after changes in MAP. The use of indexes derived from the different components of rSO2 can be useful for the bedside evaluation of cerebral haemodynamics in mechanically ventilated patients with COVID-19.

Exploring the Associations between Reading Skills and Eye Movements in Elementary Children’s Silent Sentence Reading

The purpose of this study was to investigate the associations between elementary students’ reading skills and their online reading (i.e., real-time reading) behaviors during silent sentence processing. Thirty-five students participated in this study and their eye movements were recorded during sentence reading tasks. The effects of students’ reading skills measured by traditional standardized measures were investigated for widely-used eye tracking measures such as first fixation duration, gaze duration, regression path duration, total duration, word skipping, fixation count, and regression frequency. The eye tracking measures were chosen to represent early/late cognitive processes and temporal/spatial gaze behaviors. Linear mixed-effects regression analyses revealed that children’s performances in reading skills predict most of the eye tracking measures.

Efficacy of a Toothpaste Based on Microcrystalline Hydroxyapatite on Children with Hypersensitivity Caused by MIH: A Randomised Controlled Trial.

Hypersensitivity is a frequent complaint in children with molar incisor hypomineralisation (MIH). This double-blind randomised controlled trial aimed to evaluate non-inferiority in hypersensitivity relief of a toothpaste containing microcrystalline hydroxyapatite compared to amine fluoride in children with MIH. Children were randomised into 2 groups: either hydroxyapatite (intervention) or amine fluoride toothpaste (control). The primary endpoint was pain sensation in response to tactile stimulus (Wong-Baker FACES Pain Rating Scale) 56 days after randomisation and analysed by mixed effects linear regression analysis. Non-inferiority was inferred if the upper limit of the one-sided 95% confidence interval (CI) of the difference between intervention and control group was below the non-inferiority margin of 1 in the ITT (intention-to-treat) and PP (per protocol) population. Twenty-one children were randomised and 14 children finished the study per protocol. In the ITT population, hydroxyapatite was non-inferior to amine fluoride (mean difference: -0.75 95%CI [-∞;0.49]). In the PP population, non-inferiority could not be shown (-0.62 [-∞;1.08]). Overall non-inferiority in hypersensitivity relief of a toothpaste containing hydroxyapatite compared to amine fluoride could not be shown. However, the hydroxyapatite group tended to be less hypersensitive in both populations. Attrition of the PP population due to the COVID-19 pandemic led to loss of statistical power.

Psychobiological Correlates of Aggression in Female Adolescents with Borderline Personality Disorder

Introduction: Aggressive behavior in reaction to threats, frustration, or provocation is prevalent in borderline personality disorder (BPD). This study investigated aggressive behavior and its biological correlates in adolescents with BPD. Methods: Twenty-one female adolescents with a DSM-IV BPD diagnosis and 25 sex- and age-matched healthy controls participated in the Taylor Aggression Paradigm (TAP), a laboratory-based experiment measuring aggressive behavior in the interpersonal context. Heart rate was measured and saliva samples were taken throughout the experiment. Results: Multilevel mixed-effects linear regression analyses revealed no significant group difference in aggressive behavior induced by the TAP. Additionally, the two groups did not differ in cortisol, testosterone, and heart rate responses to the aggression induction. The BPD group showed a significant cortisol increase in the time preceding the start of the TAP in contrast to the healthy control group, in whom a significant heart rate increase from baseline to the first block of the TAP was observed. Discussion: There was no evidence, either at the phenomenological or the biological level, of increased task-induced aggression in adolescents with BPD. The results may indicate that adolescents with BPD experienced fearful stress in anticipation of the experimental task in contrast to healthy controls who showed an adaptive response of the autonomic nervous system necessary to deal with the upcoming demand.