Multivariate Analysis Of Covariance Research Articles

Enhancing Critical Thinking and Argumentation Skills in Colombian Undergraduate Diplomacy Students: ChatGPT-Assisted and Traditional Debate Methods

This study tests the effectiveness of integrating ChatGPT into debate sessions to strengthen critical thinking and argumentation skills among undergraduate diplomacy students in Colombia. One hundred and sixty-two participants were randomly assigned to an experimental group using ChatGPT during debates and a control group engaging in traditional debates. Pretest and post-test assessments measured participants’ skills using adapted versions of the Watson-Glaser Critical Thinking Appraisal and a custom argumentation rubric. Multivariate analysis of covariance (MANCOVA) found higher scores in the experimental group for combined learning outcomes. Univariate analyses of covariance (ANCOVAs) showed improvements in understanding complex concepts, critical thinking, and argumentation skills for the experimental group. Structural equation modeling (SEM) noted direct and indirect effects of ChatGPT on these skills. The study also analyzed participants’ perceptions through qualitative data from post-test open-ended questions. These findings highlight ChatGPT’s potential in fostering essential skills in resource-constrained educational settings, while noting implementation challenges in developing nations. This research adds to the growing literature on AI-powered tools in education, particularly in economically emerging regions.

Comparison of the Effects of Acceptance and Commitment Therapy and Emotion-Focused Therapy on Mental Vitality in Caregivers of Elderly Parents

Introduction: Caregiving burden for older adults can impose significant physical and emotional demands, leading to a reduction in mental vitality among caregiver children. Effective psychological interventions are crucial to enhance their well-being. Methods: This quasi-experimental study included two psychological interventions: Acceptance and Commitment Therapy (ACT) and Emotion-Focused Therapy (EFT), with baseline, post-test, and follow-up phases, along with a control group for comparison. The research population comprised female caregivers who accompanied their older adults to health centers in Tehran. From a total of 169 individuals, 45 participants were selected through convenience sampling and were randomly assigned to three groups of 15 participants each, forming two experimental groups and one control group. Data were collected using the Ryan and Frederick Mental Vitality Questionnaire, and multivariate covariance analysis was applied for data analysis to assess the effectiveness of the interventions. Results: The analysis showed that both ACT and EFT interventions significantly improved the mental vitality of caregiver children in the post-test and follow-up stages compared to the control group (p = 0.001). Additionally, EFT demonstrated a greater impact on enhancing mental vitality compared to ACT. Conclusion: Emotion-focused interventions, such as EFT, can be considered a more effective approach for improving the mental vitality of caregiver children of older adults. This highlights the importance of incorporating tailored emotional support strategies in caregiver assistance programs.

Strengthening children's sibling relationships using an online preventive intervention program for parents

AbstractObjectiveThe purpose was to test a new evidence‐based online preventive intervention designed to help parents improve the sibling relationships of their 4‐ to 8‐year‐old children.BackgroundFew evidence‐based resources exist to address parents' concerns about fostering positive sibling relationships. To address this need, the emotion‐focused online program placed parents in the role of educator, preparing them to teach their children social and emotional competencies shown in previous research to promote prosocial sibling interaction.MethodEighty‐six mothers provided assessments of children's sibling relationship quality, child and parent emotion regulation abilities, and coparenting quality prior to and following completion of four online lessons. A randomly assigned wait‐list control group of mothers (n = 49) provided comparable assessments.ResultsRepeated measures multivariate analyses of covariance revealed that, following program completion, participants perceived their children to demonstrate greater sibling warmth and less agonism and rivalry. Effects were sustained at 3 months. Mothers also reported increased abilities to regulate their own emotions as well as greater collaboration and support in their coparenting relationship.ConclusionResults support the effectiveness of the online More Fun with Sisters and Brothers Program for Parents for enabling mothers from diverse international communities to support positive sibling relationships.ImplicationsIncreasing access to evidence‐based tools for strengthening sibling relationships can enable parents to support these vital lifelong bonds.

Effect of pandemic-induced PTSD in pregnant women on infant physical growth: a prospective cohort study

BackgroundThe COVID-19 pandemic has had a profound impact on global mental health, particularly affecting vulnerable groups such as pregnant women. Post-traumatic stress disorder (PTSD) in this population may potentially hinder infant physical development, underscoring the necessity for specific interventions. This study seeks to explore the prevalence of PTSD among pregnant women during the pandemic and its implications for infant physical development, thereby providing evidence to mitigate the adverse effects of the pandemic on maternal and child health.MethodsA prospective cohort study was carried out involving 450 pregnant women from December 2022 to February 2023. Data included demographic details, PTSD evaluation using the PTSD Checklist-Civilian version (PCL-C) scale, coping mechanisms, and infant growth indicators at three months postpartum. Statistical methods included descriptive statistics, univariate analysis, and multivariate analysis of covariance (ANCOVA) to control for confounding factors.ResultsThe study enrolled a total of 450 pregnant women. Following exclusions and follow-up attrition, 422 pregnant women were analyzed. There were 72 pregnant women with PTSD and 350 without PTSD. There was no statistically significant difference in birth weight between the two groups of participants. Three months after birth, infants of PTSD-positive mothers exhibited significantly lower weight percentiles at three months (P < 0.001), adjusted for birth weight, feeding method, and coping strategies. Multivariate analysis affirmed a 9.44-point reduction in weight percentile among infants in the PTSD-positive group (95% CI: 4.01–14.87, P = 0.001). Conclusion: Pregnant women suffering from PTSD during the pandemic are at risk of giving birth to infants with impaired physical growth. These findings highlight the critical need for mental health support for pregnant women to foster optimal infant development and to guide public health policies and clinical practices.

Navigating Perceived Employment Barriers: Sociodemographic Influences and Life Satisfaction Among Older Adults.

This study delves into the complex challenges surrounding the employment of older adults, investigating perceived barriers and their interaction with sociodemographic variables and life satisfaction. Utilizing data from 153 older adults and employing a cross-sectional design and multivariate analysis of covariance, the study uncovers significant associations between gender, age, race, and perceived barriers. Female, older, and racially diverse individuals report higher perceived employment barriers, indicating disparities influenced by sociodemographic factors. Gender and race interactions on these barriers are substantial, with life satisfaction emerging as a significant covariate affecting perceived employment barriers. These findings stress the importance of targeted interventions and policy reforms to address systemic inequalities and promote age-inclusive practices. By embracing diversity, fostering inclusivity, and championing age-friendly policies, stakeholders can create a more equitable labor market, empowering older adults to contribute meaningfully to society.

Are discrete dimensions of corporate social responsibility disclosures global, regional or hybrid?

PurposeWe test whether six individual components of corporate social responsibility (CSR) disclosures in the form of environmental, employee, anticorruption, non-governmental organizations (NGOs), health and human rights are converging (global), diverging (regional) or crossverging (hybrid) on a sample of 335 multinational enterprises (MNEs) from 31 countries from three regions of the world: Europe, Anglo-Saxon cluster and Asia and the emerging markets.Design/methodology/approach We use an analysis of variance (ANOVA) and multivariate analysis of covariance (MANCOVA) analysis to test for differences between the six components of CSR on a sample of 335 MNEs from 310 countries for three regions of the world.Findings The effect of one-way ANOVA was significant for each of the six dependent variables separately on the differences between MNEs from the three regions. Taken together clearly the MANCOVA analysis indicates that there are signs of crossvergence between MNEs from Asia and the emerging markets and those from the Anglo-Saxon and European subsamples due to the hybrid nature of the findings.Research limitations/implications The results of the present study support the regional nature of CSR practices and disclosures and on many of the individual components CSR disclosures are a reflection of their home environments.Originality/valueThe study sheds light on the ongoing debate on whether CSR practices are converging, diverging or crossverging on a sample of 335 MNEs from the three regions of the world. Clear evidence of divergence was seen in that in all six dimensions of CSR, there were differences between MNEs from Europe and those from the Anglo-Saxon region reinforcing the implicit and explicit nature of the phenomena. There were significant differences between MNEs from Asia and emerging markets and Europe on four out of the six dimensions of CSR indicating mostly divergence. There were also significant differences between MNEs from Asia and emerging markets and those from the Anglo-Saxon region on three out of the six dimensions of CSR indicating the presence of divergence.

Lipoprotein-associated phospholipase A2 and its possible association with COPD development: a case-control study

BackgroundThe association of lipoprotein-associated phospholipase A2 (Lp-PLA2) with various cardiovascular events has been well-established. However, the exploration of its potential involvement in Chronic obstructive pulmonary disease (COPD) is currently limited. Therefore, our study aims to examine the relationship between Lp-PLA2 and pulmonary conditions, including emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction, to provide further evidence of a possible association with COPD development.MethodsUsing data from the Southwest Hospital Health Management Center, spanning January 2013 to July 2024, we analyze relationship of serum Lp-PLA2 levels with diffuse pulmonary emphysema and pulmonary functions. In univariate analysis, group differences were assessed with t-tests for numerical variables and Chi-square tests for categorical data. Variables found to be statistically significant (two-sided P < 0.05) in univariate analysis were subsequently included as covariates in multivariate analysis, performed using a binary logistic regression model. Odds ratios and 95% confidence intervals were calculated to assess the differences.ResultsWe established 2 case-control populations: the Imaging population (1056 subjects, mean age 57.666 ± 8.700 years old, 89.9% male) selected from 24,670 initial records, and the Pulmonary Function population (279 subjects, mean age 52.082 ± 11.473 years old, 71.4% male) selected from 1868 initial records. Univariate analysis revealed that serum Lp-PLA2 levels were significantly higher in patients with diffuse pulmonary emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction compared to those without (454.682 ± 141.382U/L vs. 423.330 ± 140.658U/L, P < 0.001; 475.059 ± 157.181U/L vs. 420.824 ± 142.119U/L, P = 0.006; 475.31 ± 148.980U/L vs. 439.036 ± 157.977U/L, P = 0.049, respectively). Multivariate analysis further showed higher Lp-PLA2 levels were associated with increased risks of diffuse pulmonary emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction. Using Lp-PLA2 ≤ 300 U/L as reference, odds ratios for the aforementioned conditions showed a gradually increasing trend with every 100U/L increase in Lp-PLA2 levels.ConclusionsOur preliminary study suggests that Lp-PLA2 is independently associated with diffuse pulmonary emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction, which are commonly seen in COPD development. These findings indicated a possible association between Lp-PLA2 and COPD, though further validation is needed in a large cohort of COPD patients.

The Effectiveness of Mindfulness Treatment on Emotional Self-Regulation and Its Components in Patients Suffering from Bipolar Depression

Background: Bipolar disorder is associated with chronic symptoms that impair cognitive abilities and executive functions. Objectives: The aim of this study was to investigate the effectiveness of a mindfulness intervention on elements of emotional self-regulation in patients with bipolar disorder. Methods: This research utilized a quasi-experimental design with pre-test and post-test assessments. The study population included patients with bipolar disorder who were referred to the rehabilitation and treatment center for chronic mental patients in Hayat from 2021 to 2022. A total of 30 participants were randomly selected and divided into two groups: An experimental group (15 participants) and a control group (15 participants). The experimental group underwent 8 sessions of mindfulness training, while the control group did not receive any intervention. The Emotional Self-Regulation Questionnaire (SRI-25) was administered for evaluation. Data analysis was conducted using multivariate analysis of covariance (MANOVA) in SPSS version 16. Results: The results of covariance analysis showed a statistically significant difference between the mean scores of the experimental and control groups in the components of emotional self-regulation after mindfulness training (P &lt; 0.05). Thus, the experimental group demonstrated a significant increase in emotional regulation component scores compared to the control group after the eight mindfulness sessions (P &lt; 0.05). Conclusions: Given the effectiveness of mindfulness training in enhancing the dimensions of emotional regulation, health practitioners are encouraged to use such interventions to improve emotional self-regulation in patients suffering from bipolar disorder.

Comparison of Traditional and Intensive Cardiac Rehabilitation on Dietary Behavior and Clinical Risk Factor Outcomes

Purpose: The objective of this study was to assess differences in dietary behavior and clinical risk factor outcomes and explore predictors of change among patients participating in traditional and Pritikin intensive cardiac rehabilitation (CR). Methods: This secondary analysis of cardiac registry data from 2015 to 2021 included patients participating in traditional CR (n = 420) or Pritikin intensive CR (n = 1005) at a single hospital site. Dietary behavior outcomes included the Rate Your Plate measure, while clinical risk factor outcomes included fasting lipids, blood pressure, anthropometrics, functional outcomes, and psychosocial assessment. Analysis of covariance examined a difference in Rate Your Plate scores between CR groups. Multivariate analysis of covariance was used to determine differences in clinical risk factor variables between CR groups. Predictors of change in dietary behavior and clinical risk factors were determined through multiple bivariate linear regression models within each CR group. Results: Both CR programs led to significant improvements though more change was observed among Pritikin intensive CR participants in dietary behavior, anthropometrics, and fasting lipids. Status as a current or recent smoker was not a significant predictor of dietary behavior. Male sex, status as a current or recent smoker, beta-blockers, and angiotensin-converting enzyme inhibitors prescribed were not significant predictors of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or non–high-density lipoprotein cholesterol for traditional and Pritikin intensive CR groups. There were not significant predictors of blood pressure, body mass, or waist circumference. Conclusion: Although participation in either CR program yielded cardiometabolic benefits, Pritikin intensive CR patients exhibited significantly greater improvements in dietary behavior and clinical risk factors.

The spectrum effect: Convergence of clinical and neuropsychological characteristics in adults referred for autism assessment

Clinical and neuropsychological profiles of adults referred for autism assessment are not thoroughly understood, and information derived from studies comparing autistic adults to neurotypical controls might not be accurate to infer on individuals in a real-world, clinical setting. 263 adults (aged 18–65 years, 70 % males) referred to our clinic with a suspected diagnosis of autism were clinically explored and administered neuropsychological investigations. The suspected diagnosis was either confirmed or rejected. We conducted multivariate and post-hoc univariate analyses of covariance (MANCOVA; ANCOVA), controlling for possible confounders, to evaluate differences between autistic and non-autistic participants and further associations. Effect sizes (partial η²) were calculated for significant results. There were no significant differences in age means and sex ratios. Both groups showed high Autism Questionnaire (AQ) scores, high schizoid, avoidant, and obsessive-compulsive scores, and mild depressive symptoms, without significant difference between groups. The effect sizes of differences ranged from negligible to small for measures of nonsocial cognition, but were large for a measure of social cognition, the emotion recognition 40 (ER40). Autistic and non-autistic participants present converging features across multiple measures. In this diagnostic setting, psychiatric and neuropsychological measures are helpful in identifying individual difficulties and strengths. However, most of them, including the AQ, are poor indicators of autism. Our results mostly aligned with previous research and showed that information derived from comparisons to neurotypical controls cannot be directly transferred to a real-world setting. Detected impairments in emotion recognition were fairly specific to autism, expanding on previous findings.

Subtle Biases Towards a New Colleague Depend on Sexual Orientation and Relationship Status

Abstract Background Allonormative beliefs entail the idea that all people desire sexual activity with other people. Single and/or asexual individuals may face social disapproval or discrimination for not being in line with allonormative beliefs. The present study investigated whether individuals offered help or were likely to befriend a new co-worker differently depending on the co-worker’s sexual orientation (i.e., heterosexual vs. asexual) and relationship status (i.e., in a relationship vs. single). Methods The online study included 1,028 participants (50.0% women and 50.0% men; Mage = 29.2, SD = 8.8) from German-speaking countries. Each participant read one of twelve short descriptions of a working situation in which they got to know a new co-worker. The description of the new colleague’s gender, sexual orientation, and relationship status varied. Participants had to indicate how likely they would share information with, befriend, gossip about, or have other-interests in the new colleague. A multivariate analysis of co-variance was calculated. Results Female participants had lower intentions to share knowledge with persons who were singles by circumstance than with persons in a relationship and male participants were more likely to befriend a single gay man by choice than a gay man in a relationship. Conclusions Bias against single persons or prejudice resulting from heteronormative beliefs might lead to subtle differences in behavior towards a co-worker. Such subtle “micro-practices” can be harmful because micro-practices accumulate over time and situations. Interventions at organizations need to help employees realize their own biases that might be based on prejudices against people with different sexual orientations and relationship statuses. Key messages • Overall women are more pressured by allonormative ideas and might therefore have lower intentions to share knowledge with persons who were singles by circumstance than with persons in a relationship. • The differing treatment of single gay men by choice and gay men in relationships may not be solely due to adherence to allonormativity, but rather could stem from heterosexist beliefs.

Beyond the cochlea: exploring the multifaceted nature of hearing loss in primary mitochondrial diseases.

Primary mitochondrial diseases, with diverse systemic manifestations, often present with auditory impairments due to mitochondrial dysfunction. This study provides an in-depth exploration of auditory deficits in primary mitochondrial diseases, highlighting the impact of various pathogenic variants on both cochlea and neural/central auditory functions. An observational study involving 72 adults with primary mitochondrial diseases was conducted. Participants underwent extensive audiological evaluations including pure-tone audiometry, tympanometry, acoustic reflex thresholds, quick speech-in-noise test, listening in spatialized noise-sentences test, auditory-evoked brainstem responses and distortion product otoacoustic emissions. Multivariate analysis of covariance and logistic regression analyses assessed the influence of various pathogenic DNA variants, accounting for age, cognitive status via the Montreal Cognitive Assessment and disease severity through the Newcastle Mitochondrial Disease Adult Scale. Participants with the pathogenic m.3243A>G/T variants (m.3243A>G n = 40; m.3243A>T n = 1) exhibited significant elevations in pure-tone audiometry thresholds, especially at high frequencies, suggesting cochlea involvement. Notably, the listening in spatialized noise-sentences test showed significant spatial processing deficits in the m.3243A>G/T group, possibly indicating a unique mutation-specific impact on central auditory processing. Auditory-evoked brainstem response results highlighted a higher likelihood of auditory brainstem response abnormalities in this group, further substantiating neural/central auditory pathway involvement. This study emphasizes the heterogeneous nature of hearing impairment in primary mitochondrial diseases, with a genotype-phenotype correlation, particularly in the m.3243A>G/T group. These insights advocate for personalized, genotype-specific auditory assessments and targeted management strategies. Conventional hearing aids and cochlear implants are ineffective for those with central auditory dysfunctions related to mitochondrial mutations. There is an urgent need for innovative rehabilitation strategies catering for both cochlear and neural/central auditory pathways.

Deficient functional wound closure as measured by elevated trans-epidermal water loss predicts chronic wound recurrence: An exploratory observational study

A single-center, prospective, observational pilot study was performed to evaluate wound healing endpoint and recurrence by measuring transepidermal water loss (TEWL) post-closure at the site of wound repair. Patients with clinically-defined chronic wounds (such as pressure ulcers, diabetic ulcers, and trauma wounds) who visited the Plastic Surgery outpatient department or were in-patients at the All India Institute of Medical Sciences, Rishikesh, India, and were referred for chronic wound management, were enrolled. Non-invasive point-of-care TEWL measurements were obtained, from closed wound-site and contralateral healthy skin site, starting from confirmation of closure (post-closure, V0) continuing every 2 weeks for a maximum of five visits or until the wound recurred. Statistical analyses of the data involved logistic regression and likelihood ratio chi-square tests to assess differences in TEWL at visit 0 (V0) between the closed wound site and reference skin, with the TEWL score as the sole predictor of recurrence. Of the 72 subjects that completed the study, 44 (61%) showed no recurrence and 28 (39%) had wounds that recurred over a period of 12 weeks. A significant association was found between the V0 (post-closure) TEWL score and the odds of wound recurrence, both in univariate analysis (OR [95%CI] = 1.26[1.14,1.42] (p < 0.001) and after adjusting for covariates in multivariable analysis (OR [95%CI] = 1.34[1.19,1.61] (p < 0.001). The likelihood ratio chi-square analysis demonstrated that the V0 TEWL score is a significant universal predictor of recurrence across all wound types studied. Cases of closed wounds with subsequent recurrence showed an overall higher post-closure V0 TEWL score, compared to those who did not have a wound recurrence, across visits. The TEWL score cut-off value predictive of recurrence was 24.1 g.m–2.h–1 (AUC = 0.967). The outcome of this pilot study on a wide range of chronic wounds leads to the hypothesis that post-closure TEWL at the site of wound healing is a reliable biomarker of wound recurrence. It also raises the question whether the clinical endpoint of wound closure should include re-establishment of skin barrier function as additional criterion. The current standard of care wound closure endpoint calls for re-epithelialization of the wound with no discharge for two consecutive weeks disregarding the functional parameter of restoration of skin barrier function at the wound-site.

Effects of a Long-Term Supervised Schroth Exercise Program on the Severity of Scoliosis and Quality of Life in Individuals with Adolescent Idiopathic Scoliosis: A Randomized Clinical Trial Study.

Background and Objectives: Adolescent Idiopathic Scoliosis (AIS) affects individuals aged 10-18 years and is characterized by spinal deformity, three-dimensional axis deformation, and vertebral rotation. Schroth method exercises and braces have been shown to reduce the Cobb angle and halt spinal deformity progression. The aim of this study was to investigate the impact of a 12-month, supervised Schroth exercise program on scoliosis severity and quality of life in adolescents with AIS. Materials and Methods: Eighty adolescents with AIS (aged 10-17 years) were prescribed a brace and were divided into two groups. The intervention group followed a supervised Schroth exercise program three times a week for 12 months in addition to wearing a brace. The control group used only the brace. Outcomes included the Cobb angle of the main curvature and the sum of curves using radiography, the maximum angle of trunk rotation (ATR maximum, using a scoliometer), and quality of life with the Scoliosis Research Society-22 (SRS-22) questionnaire. Evaluations were conducted at baseline, after 12 months, and 6 months post-intervention. A multivariate analysis of covariance (MANCOVA) was used for statistical analysis (p-Value < 0.05). Results: The intervention group showed statistically significant improvement compared to the control group in the 12th month in Cobb angle (mean differences, 95% CI: -3.65 (-5.81, -1.53), p-Value < 0.001, Cohen's d = 0.30), ATR maximum (mean differences, 95% CI: -3.05 (-3.86, -2.23), p-Value < 0.001, Cohen's d = 0.74), and SRS-22 score (mean differences, 95% CI: 0.87 (0.60, 1.13), p-Value < 0.001, Cohen's d = 0.58). Differences in ATR maximum and SRS-22 score remained significant at the 18-month measurement. No significant differences were found between groups in the sum of curves (p-Value > 0.05). Conclusions: A 12-month supervised Schroth exercise program in AIS patients undergoing brace treatment significantly improves scoliosis severity (Cobb angle and ATR maximum) and quality of life. Improvements were greater than those in shorter-duration studies, suggesting a linear dose-response relationship. Further clinical studies are needed to clarify the impact of long-term Schroth programs.

Examining relationships among NODDI indices of white matter structure in prefrontal cortical-thalamic-striatal circuitry and OCD symptomatology

Obsessive-compulsive disorder is a psychiatric disorder characterized by intrusive thoughts and repetitive behaviors. There are two prominent features: Harm Avoidance (HA) and Incompleteness (INC). Previous resting-state studies reported abnormally elevated connectivity between prefrontal cortical (PFC) and subcortical regions (thalamus, striatum) in OCD participants. Yet, little is known about the white matter (WM) structural abnormalities in these connections. Using brain parcellation and segmentation, whole brain tractography, and Neurite Orientation Dispersion and Density Imaging (NODDI), we aimed to characterize WM structural abnormalities in OCD vs. healthy controls and determine the extent to which NODDI indices of these connections were associated with subthreshold-threshold HA, INC and overall OCD symptom severity across all participants. Four PFC regions were segmented: ventral medial (vmPFC), ventrolateral (vlPFC), dorsomedial (dmPFC), and dorsolateral (dlPFC). NODDI Neurite Density (NDI) and Orientation Dispersion (ODI) indices of WM structure were extracted from connections between these PFC regions and the thalamus (42 OCD, 44 healthy controls, mean age[SD] = 23.65[4.25]y, 63.9% female) and striatum (38 OCD, 41 healthy controls, mean age[SD] = 23.59[4.27]y, 64.5% female). Multivariate analyses of covariance revealed no between-group differences in these indices. Multivariate regression models revealed that greater NDI in vmPFC-thalamus, greater NDI and ODI in vmPFC-striatum, and greater NDI in dmPFC-thalamus connections were associated with greater INC severity (Q ≤ 0.032). These findings highlight the utility of NODDI in the examination of WM structure in OCD, provide valuable insights into specific WM alterations underlying dimensional INC, and can facilitate the development of customized treatments for OCD individuals with treatment-resistant symptoms.

Associations between skating mechanical capabilities and off-ice physical abilities of highly trained teenage ice hockey players.

This study examines the associations between force and velocity characteristics of forward skating and off-ice speed, agility, and power of highly trained teenage ice hockey players. Players attending the Quebec ice hockey federation's off-season evaluation camp were invited to participate in this study. Final sample consists of 107 highly trained teenage ice hockey players (Males: n=38; 13.83±0.38years; Females: n=69: 14.75±0.90years). Individual force-velocity profiles (F-V) were determined during a 44m skating sprint. Off-ice speed, agility, and power were measured using 30m sprint, 5-10-5 agility, and standing long jump. Associations between F-V mechanical capabilities and off-ice indicators were analyzed with correlational analyses and multivariate analysis of covariance (MANCOVA). Results of pooled data indicate that the three off-ice measures had moderate associations with F0 and V0 and large associations with Pmax. Associations with Rfmax, Drf, and Sfv were moderate to small. F0 had stronger associations with off-ice performance in female players while V0 was more important with male players. MANCOVA identified 5-10-5 times as the better predictor for F0 while 30m sprints times better predicted V0. To maximize physical attributes of skating ability, practitioners are encouraged to focus on a general physical preparation for highly trained teenage players. Prioritizing types of exercises that use change of direction or acceleration and linear speed should have distinct effects on F0 and V0 on the ice.

The Relationship among Pain Perception, Severity of Temporomandibular Disorders, and Spinal Health in Older Adults: Cross-sectional Study

Aim; It was aimed to determine pain perception, temporomandibular disorders (TMD) severity, and spine functionality and the relationship between them in older adults. Method; A total of 301 individuals (177 women and 124 men) with an average age of 71.57±6.30 years (range 65-95) participated in the study. Musculoskeletal pain (MP), neck pain (NP), and low back pain (LBP) were each assessed separately, along with pain perception, tolerance to discomfort, spinal functional status, and temporomandibular disorders severity. These were measured using the Numeric Rating Scale (NRS), Centrality of Pain Scale (COPS), Discomfort Intolerance Test (DIT), Spine Functional Index (SFI), and Fonseca Anamnestic Index (FAI), respectively. Relationships between parameters were analyzed with Pearson correlation analysis, and gender differences were examined using Multivariate Analysis of Covariance. Results; The relationship between MP with NP (0.518) and LBP (0.520) and between SFI with COPS (-0.593) was moderate to good. The relationship between MP with COPS (0.485), SFI (-0.372), FAI (0.332); and between NP with LBP (0.495) and FAI (0.453); between LBP with COPS (0.412), SFI (-0.409) and FAI (0.366); and between FAI with COPS (0.377) and SFI (-0.352) was low to fair. Differences were observed between female and male individuals in terms of Mini Mental Test, MP, NP, LBP, COPS, DIT, SFI, and FAI scores (p&lt; 0.05). Conclusion; It should be taken into consideration that MP may increase with the increase in NP and LBP, and spinal functionality may decrease with the increase in pain perception.

The relationship between sphingomyelin and ceramide levels and soft neurological signs in ADHD.

Attention deficit hyperactivity disorder (ADHD), characterized by attention deficit, hyperactivity, and impulsivity, has recently been associated with lipid metabolism. In particular, the roles of sphingomyelin, ceramide, andgalactosylceramidase in the pathophysiology of ADHD are being investigated. This study aims to explore the relationship between sphingolipid metabolism markers and soft neurological signs (SNS) in children diagnosed with ADHD who are not undergoing medication treatment. A cross-sectional analysis was conducted on 41 children and adolescents aged 7-12 years diagnosed with ADHD and 39 neurotypically developing controls. Plasma levels of ceramide, sphingomyelin, and galactosylceramidase were measuredusing Enzyme-Linked Immunosorbent Assay (ELISA). SNS were assessed using the Physical and Neurological Examination for Soft Signs (PANESS). Statistical analyses included Student's t-tests, Mann-Whitney U tests, and Multivariate Analysis ofCovariance (MANCOVA), along with logistic regression analysis. Plasma levels of ceramide and sphingomyelin in children with ADHD showed significant differences compared to the neurotypically developing control group; however, there were no significant differences in galactosylceramidase levels between the two groups. Positive correlations were found between plasma levels of ceramide and sphingomyelin and the PANESS subscales F1 (Total Gait and Station) and F3 (Total Dysrhythmia). Additionally, logistic regression analysis indicated that high ceramide levels were positively associated with ADHD. This study underscores a significant association between alterations in sphingolipid metabolism (specifically increased levels of ceramide and sphingomyelin) and the presence of SNS in children with ADHD. These findings elucidate the potential role of sphingolipid metabolism in the pathophysiology of ADHD and provide suggestions for future therapeutic research targeting sphingolipid metabolism in the treatment of ADHD.

The Efficacy of Cognitive Behavioral Therapy on Mental Health, Self-esteem and Emotion Regulation of Medical Students with Imposter Syndrome

Background: Medical students often experience self-doubt due to the demanding nature of their coursework and numerous assignments, which may indicate Imposter Syndrome (IS). Objectives: This study aimed to evaluate the effectiveness of cognitive behavioral therapy (CBT) in improving mental health, self-esteem, and emotional regulation among medical students dealing with IS. Methods: A semi-experimental design was used, incorporating a pre-test-post-test approach with a control group. The statistical sample included medical students from Tarbiat Modares University in 2023. A total of 36 students were selected through purposeful sampling and randomly assigned to either the experimental group (n = 18) or the control group (n = 18). Data collection tools included questionnaires assessing IS, mental health, self-esteem, and emotion regulation. The experimental group received eight 90-minute CBT sessions based on the approach by Egan and Shafran (2017), while the control group received no intervention. Data were analyzed using a multivariate analysis of covariance with SPSS24 software. Results: The results showed that CBT significantly reduced expressive suppression (F = 78.04, η² = 0.72) and increased mental health (F = 37.73, η² = 0.56), self-esteem (F = 54.76, η² = 0.64), and cognitive reappraisal (F = 35.65, η² = 0.55) among students with IS (P &lt; 0.001). Conclusions: The findings suggest that CBT is an effective intervention for improving the psychological well-being of medical students experiencing IS. The significant improvements in mental health, self-esteem, and emotional regulation underscore CBT's potential as a valuable tool for this population.

Clinical Features of Typically Developing Children With and Without Prenatal Alcohol Exposure

To determine if prenatal alcohol exposure (PAE) affected physical and cognitive/behavioral outcomes in apparently typically developing, first-grade children. Three groups were compared: children with fetal alcohol spectrum disorders (FASD); children with PAE without FASD; and children without PAE. The three groups were significantly different on most physical traits and fewer neurodevelopmental traits. Two-group comparisons of exposed and unexposed, non-FASD groups were statistically different on: height, weight, head circumference (OFC), body mass index (BMI), and palpebral fissure length (PFL). Neurobehavioral outcomes were significant in three-group, but not two-group, comparisons. Few sex differences were observed; however, sex ratios indicated fewer male offspring in first grade among women who consumed 6+ drinks per occasion during pregnancy. For weight, OFC, BMI, age, rural residence, and drinking measures, mothers of exposed children without FASD were intermediaries between, and significantly different from, the other maternal groups. Adjusted for socioeconomic covariates, multivariate analysis of covariance (MANCOVA), three-group comparisons were significantly different for cognitive/behavioral variables (p<.001); however, two-group neurobehavior comparisons for children without FASD were not significant (p>.05). Physical trait MANCOVA comparisons of the non-FASD groups were significant only for weight (p<.004) when tested univariately and through stepdown analysis. Socioeconomic-adjusted trend plots were in the expected direction for nonverbal IQ, problem behaviors, attention, height, weight, OFC, vermilion, PFL, and total dysmorphology score. Even when meeting developmental norms, children with PAE exhibited trends of poorer growth and cognitive/behavioral traits than children without PAE. These findings support the notion that abstinence during pregnancy is best.