One-way Analysis Of Covariance Research Articles

Abstract PO4-19-12: Trial in progress: An Observational Study to Examine Changes in Metabolic Syndrome Components in Patients With Breast Cancer Receiving (Neo)Adjuvant Aromatase Inhibitors

Abstract Background: (Neo) adjuvant systemic therapy has been shown to adversely impact metabolic health manifested as weight gain, dyslipidemia, and insulin resistance, which ultimately lead to the development of metabolic syndrome (MetS). MetS increases the risk of development for type 2 diabetes mellitus and cardiovascular disease and is associated with an increased risk of breast cancer recurrence, death due to breast cancer, and all-cause mortality. We have previously reported that 76% of metabolically healthy women receiving (neo) adjuvant chemotherapy will develop MetS at a median of 15 weeks. The impact of aromatase inhibitors (AIs) on metabolic health has not been systematically assessed in a longitudinal study. We hypothesize that AIs in the (neo) adjuvant setting will alter metabolic parameters and have embarked on a clinical trial to study this. Methods: This is a prospective observational study that will include: postmenopausal patients with newly diagnosed, early-stage hormone receptor (HR)-positive breast cancer with planned (neo)adjuvant treatment with an AI. Participants will be excluded if they have received or have planned treatment with (neo)adjuvant chemotherapy or are currently receiving antidiabetic medications or cholesterol-lowering agents. All patients will undergo a baseline assessment that includes: BMI, physical exam inclusive of blood pressure, waist circumference, assessment of body fat, lipid profile, insulin, metabolic biomarkers, and completion of the Functional Assessment of Cancer Therapy – Endocrine Symptoms (FACT-ES). Following institution of an AI, reassessment of the aforementioned tests will be repeated after 4 months and 12 months of therapy. The primary endpoint is the change in insulin resistance (as measured by HOMA-IR, homeostatic model assessment for insulin resistance) at 4 months. Secondary endpoints include the change in HOMA-IR at 12 months and the change in individual MetS components, metabolic biomarkers, anthropometric measurements, as well as FACT-ES scores from baseline to 4- and 12-months of AI treatment. The mean paired differences will be calculated for HOMA-IR measurements as well as for the secondary endpoints, and the 1-sided paired t-test will be used to test for statistical significance. One-way analysis of covariance will be used to compare means while adjusting for age, race/ethnicity, and BMI. Using a 1-sided paired t-test for the mean difference in HOMA-IR measurements from baseline to 4 months, we will have 80% power to detect an effect size of 0.405 with 40 patients (α = 0.05). Enrollment began in April 2023 and is ongoing. Contact alevee@coh.org for more information. Given the increased recognition of the importance of metabolic health in breast cancer outcomes, this data will inform future trials that focus on maintaining metabolic health in breast cancer survivors. Citation Format: Alexis LeVee, Nora Ruel, Victoria Seewaldt, Joanne Mortimer. Trial in progress: An Observational Study to Examine Changes in Metabolic Syndrome Components in Patients With Breast Cancer Receiving (Neo)Adjuvant Aromatase Inhibitors [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-19-12.

Inflammation and weight change related to neurocognitive and functional impairment in diabetes and psychiatric disorders

Introduction: Obesity is a global pandemic associated with various cardio-metabolic and psychiatric disorders. Neurocognitive and functional deficits have been associated with several somatic and psychiatric disorders. Adiposity-related inflammation has recently emerged as a key risk factor for neurocognitive and functional impairments. This prospective transdiagnostic study aimed to investigate the role of adiposity-related inflammatory markers in neurocognitive and functional outcomes associated with weight changes.Methods: Peripheral blood inflammatory and oxidative stress biomarkers and neurocognitive and functional performance were assessed twice over 1 year in 165 individuals, including 30 with schizophrenia, 42 with bipolar disorder, 35 with major depressive disorder, 30 with type 2 diabetes mellitus (T2DM), and 28 healthy controls. Participants were stratified by body mass index into categories of type 2 obesity (T2OB; n=30), type 1 obesity (T1OB; n=42), overweight (OW; n=53), and average weight (NW; n=40). Mixed one-way analysis of covariance and linear and binary logistic regression analyses were performed.Results: Compared with NW, T2OB and T1OB were significantly associated with impaired neurocognitive and functional performance (p<0.01; η²p=0.06–0.12) and higher levels of C-reactive protein and platelets (PLT) (p<0.01; η²p= 0.08–0.16), with small-to-moderate effect sizes. IL-6, IL-10, and PLT were key factors for detecting significant weight changes in T1OB and T2OB over time. Regression models revealed that inflammatory and oxidative stress biomarkers and cellular adhesion molecules were significantly associated with neurocognitive and functional performance (p<0.05).Discussion: Obesity is characterised by neurocognitive and functional impairments alongside low-grade systemic inflammation. Adiposity-related inflammatory biomarkers may contribute to neurocognitive and functional decline in individuals with T2DM and psychiatric disorders. Our data suggest that these biomarkers facilitate the identification of specific subgroups of individuals at higher risk of developing obesity.

Gender differences in diet quality and the association between diet quality and BMI: an analysis in young Australian adults who completed the Healthy Eating Quiz.

Many young adults report poor diet quality. However, research evaluating whether young adult males and females differ in diet quality is limited. Additionally, although diet quality has a known inverse association with body mass index (BMI), it is unclear whether this association is observed in young adults and whether it varies by gender. The present study aimed to evaluate gender differences in diet quality in young adults, as well as the associations between diet quality and BMI. Data collected via the Healthy Eating Quiz (HEQ) in respondents aged 18-35 years between July 2019 and December 2021 were analysed, including demographics, and diet quality calculated using the Australian Recommended Food Score (ARFS). Differences in characteristics were analysed using a two-sample t-test, chi-squared and one-way analysis of covariance. Linear regressions were performed to estimate associations between diet quality and BMI. An interaction term was included in the model to test differences between genders. The respondents (n = 28,969) were predominantly female (70.8%) with a mean ± SD age of 25.9 ± 5.0 years and BMI of 24.6 ± 5.2 kg/m2. The mean ± SD ARFS was significantly different between females and males (33.1 ± 8.6 vs. 31.4 ± 9.3 points out of 70; p < 0.001). Diet quality had a small, significant inverse association with BMI in both genders. The interaction effect between diet quality score and gender in predicting BMI was significant (p < 0.001), suggesting the impact of diet quality on BMI varies by gender, with lower diet quality more strongly associated with higher BMI in females compared to males. Interventions that target young adults are needed to improve diet quality and its potential contribution to BMI status. As a result of the small observed effect sizes, caution should be applied in interpreting these findings.

The effect of selenium supplementation on oxidative stress, clinical symptoms and mental health status in patients with migraine: a study protocol for a double-blinded randomized clinical trial

BackgroundDespite a number of recommended strategies, effective treatment of migraine remains elusive. Given the role of oxidative stress in the pathogenesis of migraine, selenium, as an antioxidant nutrient, may have a beneficial effect on migraine outcomes. However, no study has explored the effects of selenium supplementation on migraine symptoms, oxidative stress biomarkers, and mental health. Therefore, this randomized, double-blinded, placebo-controlled clinical trial aims to examine the effects of selenium supplementation among migraine patients.MethodsSeventy-two migraine patients will receive either 200 µg/day selenium supplement (n = 36) or placebo (n = 36) for 12 weeks in a randomized, double-blinded, placebo-controlled study. The severity, frequency, and duration of headaches, mental health indices including depression, anxiety, and distress, and quality of life, as well as biomarkers of oxidative stress such as nitric oxide (NO), malondialdehyde (MDA), total antioxidant capacity (TAC), and total oxidant status (TOS), will be measured at the baseline and end of the study. The intention-to-treat (ITT) approach will be used to estimate missing values. One-way analysis of covariance (ANCOVA) will be performed to detect the effect of selenium supplementation on outcome variables.DiscussionOxidative stress is recognized as a key contributor to migraine pathogenesis. Selenium is an essential trace element with antioxidant properties, capable of crossing the blood–brain barrier (BBB), holding promise to alleviate the oxidative stress and neurotoxicity. Thus, selenium may beneficially affect clinical symptoms and oxidative stress as well as the quality of life in migraine patients.Trial registrationThis trial was registered in the Iranian Registry of Clinical Trials (https://www.irct.ir/) on 27 May 2023 with the code number IRCT20121216011763N60.

May anti-seizure medications alter brain structure in temporal lobe epilepsy? A prospective study.

Mild mesial temporal lobe epilepsy (MTLE) patients may remain untreated for a considerable time after disease onset or achieve seizure control with a single anti-seizures medication (ASM). Thus, they represent an optimal population to investigate whether ASMs might have influence on brain structure. We consecutively enrolled 56 mild MTLE patients (22/56 untreated, 34/56 on-monotherapy) and 58 healthy controls, matched for age and gender. All subjects underwent 3T-brain MRI, using FreeSurfer for automated morphometry. Differences in gray matter were assessed using one-way Analysis of Covariance (ANCOVA), adjusting for age, disease duration and intracranial volume. No significant change was observed between treated and untreated patients. We observed a significant reduction in cortical thickness of left inferior parietal, inferior temporal, middle temporal gyri, and right inferior parietal gyrus, temporal pole in monotherapy patients compared to healthy controls, as well as an increase in left isthmus of cingulate gyrus in untreated MTLE subjects compared to controls. Surface and subcortical volumes analysis revealed no differences among groups. Our study demonstrated no substantial morphological abnormalities between untreated mild MTLE patients and those undergoing monotherapy. Although exploratory, these results may reassure about safety of commonly used drugs and their marginal role in influencing neuroimaging results. PLAIN LANGUAGE SUMMARY: This study investigated the following question: can medications against epileptic seizures have an effect on brain structure in mild mesial temporal lobe? Preliminary results from our analyses suggest not, as we did not find any difference in brain gray matter between untreated patients and those treated with a single anti-seizures medication. On the other hand, epilepsy patients presented cortical thinning compared to healthy controls in several regions of the temporal and parietal lobes, in line with previous studies investigating the disease.

Optimising Students’ Enjoyment and Engagement in Learning via Scaffolding-fused Digital Game-based Learning

Objective: To determine how a scaffolding-fused digital game impacted primary school students' enjoyment and engagement in Mathematics. Method: This experimental study was carried out with two groups of primary students. The experimental group was taught using the scaffolding fused digital game-based learning, whereas the control group was taught with the conventional method. The instruments used in this study were pre and post-interviews, and, pre and post-observations. The data were analysed using independent t-tests, matched pair t-tests and a One-way Analysis of Covariance. Findings: The results revealed statistically significant differences concerning enjoyment (F = 34.373, P &lt; .05) and engagement (F = 6.498, P &lt; .05) in mathematics learning at 0.01. The enjoyment and engagement of students in the experimental group were much higher than that of the control group. Novelty: As a result of technological advancement, games play an essential role in mathematics education today. Affective factors, precisely emotions, have been widely recognised as influential elements contributing to enjoyment engagement and achievement in the learning process. Engaged learners are motivated, inspired, and eager to put effort into their learning. Keywords: Scaffolding, Enjoyment, Engagemen, Digital game based learning

The Effectiveness of the Jigsaw and Traditional Teaching Methods on Math Anxiety, Attitude and Performance

This study was conducted to compare the effectiveness of cooperative learning on mathematics anxiety, attitudes towards mathematics, and mathematics performance of the 12th-class Private school students of Herat City by using a quasi-experimental study. The statistical population included 650 individuals who were all high school students. 40 individuals were selected in two 20-individual groups by the multistage cluster random sampling method. The Math Anxiety Scale (Baloglu &amp; Zelhart, 2007), the Mathematics Attitude Scale (Fennema-Sherman, 2000), and teacher-made tests of mathematics academic performance were used to collect data. The Jigsaw cooperative learning model was used to monitor the effectiveness of the presence or absence of cooperative learning, and the data were analyzed using SPSS software and one-way covariance analysis (ANOVA). In this study, three hypotheses were formulated, and their results indicated that there is a significant difference between the Jigsaw cooperative and traditional learning models in terms of math anxiety, attitudes towards math, and mathematics performance of the 12th-class Private school students of Herat City. It is concluded that the Jigsaw cooperative learning model can be used as one of the effective methods in schools to reduce mathematics anxiety, foster a positive attitude towards mathematics, and enhance the 12th-class Private school students’ mathematics performance.

The effects of eccentric training on hamstring flexibility and strength in young dance students

The objective of this research is to examine the impact of eccentric training on hamstring flexibility and strength in young dancers during the concluding stages of their foundational dance training program. A total of 24 female, second-year dance students from Hebei Normal University were selected as participants. They were divided into three distinct groups: Nordic hamstring exercise and single-leg deadlift group (NHE&SLD), forward bending exercises and standing leg lift group (FBE&SLL), and a control group (CG). The study was designed around a 6-week training regimen. An isokinetic dynamometer was used to measure seated knee flexor–extensor strength, while electronic goniometry was employed to measure hamstring flexibility in the supine position. Paired sample t-tests were conducted within each group, and one-way analysis of covariance (ANCOVA) was utilized for comparisons between groups. In the NHE&SLD group, significant disparities were observed in both concentric (T = − 5.687, P = 0.001) and eccentric (T = − 3.626, P = 0.008) hamstring strength pre and post-intervention. The pre-intervention dominant leg concentric strength test values significantly influenced the post-intervention outcomes (F = 5.313, P = 0.001, η2 = 0.840). Similarly, the pre-intervention dominant leg eccentric strength test values impacted the post-intervention results (F = 4.689, P = 0.043, η2 = 0.190). Following the intervention, the NHE&SLD group displayed marked changes in the active straight leg raising angle on both left (T = − 4.171, P = 0.004) and right (T = − 6.328, P = 0.001) sides. The FBE&SLL group also revealed significant changes in the active straight leg raising angle on both left (T = − 4.506, P = 0.003) and right (T = − 4.633, P = 0.002) sides following the intervention. The pre-intervention left leg concentric strength test value significantly influenced the post-intervention outcomes (F = 25.067, P = 0.001, η2 = 0.556). Likewise, the pre-intervention right leg eccentric strength test value significantly influenced the post-intervention results (F = 85.338, P = 0.01, η2 = 0.810). Eccentric training can better enhance the flexibility and strength of hamstring muscles in dance students. Traditional stretching training significantly improves the flexibility of the hamstring muscles. Eccentric training has more training benefits than traditional stretching training. It is recommended for dance students to use eccentric training when increasing hamstring flexibility and strength.

Improving psychological well-being among healthcare workers during the COVID-19 pandemic with an online mindfulness intervention: A randomised waitlist-controlled trial.

The high prevalence of psychological problems observed among healthcare workers (HCWs) during the COVID-19 pandemic called for interventions to safeguard their mental health. We assessed the effectiveness of a 6-week online mindfulness-based intervention in improving well-being and reducing stress among HCWs in Sri Lanka. Eighty HCWs were recruited and randomised into two groups: waitlist-control (WLC) and intervention groups. In the intervention, 1-hour online sessions were conducted at weekly intervals and participants were encouraged to do daily home practice. Stress and well-being were measured pre- and post-intervention using the Perceived Stress Scale and WHO-5 Well-being Index, respectively. One-way analysis of covariance was used to evaluate the effectiveness, in both intention-to-treat (ITT) and complete-case (CC) analyses. A significantly greater improvement in well-being occurred in the intervention arm compared to WLC on both ITT (p = .002) and CC analyses (p < .001), with medium-to-large effect sizes (partial η2 = .117-.278). However, the reduction in stress following the intervention was not significant compared to the WLC group on both ITT (p = .636) and CC analyses (p = .262). In the intervention arm, the median number of sessions attended by participants was 3. Low adherence to the intervention may have contributed to the apparent non-significant effect on stress.

Festivalization of business events: exploring a new strategy for designing more engaging conference experiences

Purpose This study aims to explore a potential conference experience design strategy, namely, festivalization. It investigates the potential festivalization effects on conference attendees in two formats of business conferences: virtual and in-person. Design/methodology/approach A series of two scenario-based experimental studies were conducted. A series of one-way analysis of covariance and PROCESS procedures (Model 6) were performed for data analysis. Findings The inclusion of festivalization elements significantly enhances positive responses of attendees, especially for in-person conferences. This effect is further explained by a serial mediation effect, where enhanced perceived values and conference engagement play key roles in improving attendees’ conference experience. Practical implications By incorporating festivalization elements, conference organizers can create a more engaging and satisfying event experience for attendees. This can lead to greater satisfaction, positive word-of-mouth and increased registrations. Originality/value This study represents a pioneering effort in revealing the underlining mechanisms that explain how festivalization affects attendee engagement and subsequent behaviors in business event management in both face-to-face and virtual settings.

Association Between White Matter Tract Integrity and Frontal-Executive Function in Non-Geriatric Adult Patients With Major Depressive Disorder.

This study investigated the association between white matter tract integrity and frontal executive function in adult non-geriatric patients with major depressive disorder (MDD) and healthy controls (HCs) using diffusion tensor imaging (DTI). In total, 57 patients with MDD and 115 HCs participated in this study. We calculated the integrity of the white matter tracts using the Tracts Constrained by Underlying Anatomy tool (TRACULA) from FreeSurfer. We performed cognitive function tests. Oneway analysis of covariance was used to investigate the DTI parameters as dependent variables; diagnosis of MDD as an independent variable; and age, sex, and education level as covariates. For correlation analysis between the DTI parameters and cognitive function tests, Pearson's partial correlation analyses were performed in the MDD and HC groups. The patients with MDD showed significantly decreased axial diffusivity (AD) in forceps major (FMajor), left corticospinal tract (CST), left superior longitudinal fasciculus-parietal bundle (SLFP), right anterior thalamic radiation (ATR), right CST, right inferior longitudinal fasciculus (ILF) and right superior longitudinal fasciculus-temporal bundle (SLFT) and mean diffusivity (MD) in the left CST, right CST, and right SLFT compared to HCs. We found that non-geriatric patients with MDD showed a significant negative correlation between the response time in the Stroop task and the AD value of the FMajor. Our findings suggest that impaired structural connectivity in the FMajor may be associated with cognitive dysfunction in non-geriatric patients with MDD.

Flipped classroom with collaborative learning approach in enhancing writing skills of Indonesian university students

The intention of this study was to examine how a flipped classroom with a collaborative learning approach improved the writing skills of Indonesian higher education students. To achieve the study’s aim of 48 Indonesian higher education participants, the Oxford Quick Placement Test (OQPT) was employed. They were divided into two groups: experiment and control. Following that, as a pre-test, both groups were given a written exam. The experimental class (EC) was then positioned in a flipped classroom. Students were permitted to bring smartphones to class and utilize them while learning, and the flipped classroom was equipped with an internet connection, a laptop, and a projector. The control class (CC) got standard classroom instruction. This strategy was employed until the very last session. The experimental group outperformed the control group on the post-test, according to the results of the independent samples t-test and one-way analysis of covariance (ANCOVA). Furthermore, the results revealed a significant difference in post-test performance between the EC and CC.

Altered parietal operculum cortex 2 functional connectivity in benign paroxysmal positional vertigo patients with residual dizziness: A resting-state fMRI study.

To investigate changes in functional connectivity (FC) focusing on parietal operculum cortex 2 (OP2) in benign paroxysmal positional vertigo (BPPV) patients with residual dizziness (RD) after successful canalith repositioning procedure (CRP). High-resolution three-dimensional T1 and resting-state functional magnetic resonance imaging (fMRI) were performed on 55 healthy controls (HCs), 55 BPPV patients with RD, and 55 patients without RD after successful CRP. Seed-based (bilateral OP2) FC was calculated to investigate the changes in FC among the three groups. Additionally, we further explored the associations between abnormal FC and clinical symptoms. One-way analysis of covariance showed significant FC differences among the three groups. Post-hoc analysis showed that patients with RD exhibited decreased FC between left OP2 and regions of left angular gyrus (AG), thalamus, precuneus, middle frontal gyrus (MFG), and right cerebellum posterior lobe (CPL) in comparison with HCs. In addition, compared with patients without RD, patients with RD showed decreased FC between left OP2 and regions of left MFG, AG, middle temporal gyrus, and right CPL. Moreover, in patients with RD, the FC between left thalamus and OP2 was negatively correlated with duration of RD, and the FC between left AG and OP2 was negatively correlated with duration of BPPV. BPPV patients with RD showed reduced FC between brain regions involved in vestibular processing and spatial cognition; These results suggested that BPPV patients with RD might have diminished central processing of vestibular information and impaired spatial cognition.

Physical Impact of Traditional and Virtual Physical Exercise Programs on Health Outcomes among Corporate Employees

Background: Technology-based exercise programs have the potential to reduce chronic disease prevalence and obesity-related risks. This research focuses on the impact of both traditional and virtual exercise programs on the health metrics of corporate employees. Methods: The study involved 30 corporate employees (16 females, average age ± SD = 37.8 ± 8.8 years) from Nigeria, who were divided into two experimental groups (one experiencing traditional exercises with an on-site trainer, and the other participating in live, virtual classes via Zoom) and a control group continuing usual practices. The 6-week intervention measured several health outcomes, including resting heart rate, blood pressure (both diastolic and systolic), body mass index (BMI), waist circumference, and waist-hip ratio, both before and after the intervention. Results: One-way analysis of covariance yielded significantly greater decreases in the diastolic blood pressure, F(2,27) = 3.7, p &lt; 0.04; systolic blood pressure F(2,27) = 3.5, p &lt; 0.04, body mass index, F(2,26) = 7.8, p &lt; 0.01, and waist circumference, F(2,27) = 39.1, p &lt; 0.01. Conclusions: The study concludes that virtual-based exercise programs are as effective as traditional ones. Offering a virtual exercise option provides flexibility, potentially increasing adherence to exercise routines among corporate workers.

The Effect of Music on Anxiety, Pain Levels, and Physiological Parameters in Women Undergoing Brachytherapy: A Randomized Controlled Trial

ObjectivesThis study was conducted to investigate the effect of music on anxiety, pain, and physiologic parameters in women undergoing brachytherapy. Data SourcesThe study was conducted with a randomized controlled design between June and December 2022. Music intervention was practiced to the patients in the experimental group (n = 30), while no practice was given to the control group (n = 25). In the study, the data were collected using the Descriptive Information Form, Hospital Anxiety and Depression Scale, visual analog scale, and vital signs (temperature, pulse rate, blood pressure, respiratory rate, SpO2) recording form. Intergroup and intragroup averages were evaluated by the mixed-design analysis of variance. Variables with pre-post intervention designs were evaluated with the one-way analysis of covariance. There was no significant difference in physiological parameters between the groups (P > . 05). Although the mean anxiety scores decreased in the music group and increased in the control group, there was no statistically significant difference (P > .05). A significant difference was found in the pain levels of the patients in repeated measurements made in intragroup evaluations (P < .001). The depression mean of the music intervention group was significantly lower than the control group (P ≤ .05). ConclusionIt was concluded that the music played during the brachytherapy process had positive effects on feeling less pain and management of depressive symptoms but did not affect anxiety and physiological parameters. Since each patient is different, the effects of music therapy can vary individually. Implications for Nursing PracticeNurses should apply different strategies to investigate session frequencies and durations for different patient groups and treatment stages in cancer care.

Infant growth and body composition from birth to 24 months: are infants developing the same?

Given the importance of infancy for establishing growth trajectories, with later-life health consequences, we investigated longitudinal body composition among infants from six economically and ethnically diverse countries. We recruited mother-infant dyads using the WHO Multicenter Growth Reference Study criteria. We measured fat-free mass (FFM) in 1393 (49% female) infants from birth to 6 months of age (Australia, India, and South Africa; n = 468), 3-24 months of age (Brazil, Pakistan, South Africa, and Sri Lanka; n = 925), and derived fat mass (FM), fat mass index (FMI), and fat-free mass index (FFMI). Height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length (WHZ) Z-scores were computed. Sex differences were assessed using a t-test, and country differences using a one-way analysis of covariance. We further compared subsamples of children with average (-0.25 > HAZ < +0.25), below-average (≤-0.25) and above-average (≥+0.25) HAZ. HAZ performed well between 0 and 6 months, but less so between 3 and 24 months. The stunting prevalence peaked at 10.3% for boys and 7.8% for girls, at 24 months. By 24 months, girls had greater FMI (10%) than boys. There were significant differences in FFM (both sexes in all countries) and FM (Brazilian boys, Pakistani and South African girls) by 24 months of age between infants with average, above-average, and below-average HAZ. In a multi-country sample representing more ideal maternal conditions, body composition was heterogeneous even among infants who exhibited ideal length. Having a mean HAZ close to the median of the WHO standard for length reduced FFM between-country heterogeneity but not FM, suggesting that other factors may influence adiposity.

Comparison of the Effectiveness of Mindfulness-Based Stress Reduction Program with Transcranial Direct Current Stimulation on Stress and Rumination in Adolescents with Cancer

Objective: Considering the necessity to identify effective interventions to improve stress and rumination in students, the current study aimed to compare the effectiveness of a mindfulness-based stress reduction program with transcranial direct current stimulation (tDCS) on stress and rumination in adolescents with cancer. Methods and Materials: The research method was a quasi-experimental pre-test and post-test with a control group design. The research population included all adolescents with cancer at Mahak Hospital in Tehran, from which 40 individuals were selected through purposive sampling and randomly assigned to three groups (1- Mindfulness-based stress reduction training; 2- Transcranial direct current stimulation intervention; 3- A combined method of mindfulness-based stress reduction with transcranial direct current stimulation) and one control group. The instruments for data collection included the Lovibond and Lovibond's (1995) Depression, Anxiety, and Stress Scale and the Ruminative Response Scale about an interpersonal upset (2008). For data analysis, one-way analysis of covariance, repeated measures analysis of variance, and the least significant difference post-hoc test were used. Findings: The results of the covariance analysis along with the post-hoc tests showed that there is no significant difference between the mindfulness-based stress reduction method and tDCS in reducing stress levels (P&gt;0.05), and only the difference between these methods compared to the control group was significant (P&lt;0.05). In terms of the effectiveness of the interventions under study on stress levels, the combined method was more effective than using each method separately. Regarding the rumination variable, there was no significant difference between the mindfulness-based stress reduction method and the tDCS method in reducing the level of rumination (P&gt;0.05), and only the difference of this mindfulness method compared to the control group was significant (P&lt;0.05). The results of the repeated measures analysis of variance along with the post-hoc tests indicated that there were no significant differences between the post-test and follow-up stages for stress and rumination variables (P&gt;0.05); hence, the results were stable. Conclusion: Based on the results of the current study, counseling and psychology units established in hospitals and oncology clinics need to be more aware of the mental health of adolescents with cancer and should use the combined method of mindfulness-based stress reduction with tDCS to improve stress and rumination in adolescents with cancer.

Effectiveness of English Language Teaching on Aggression and Anxiety in the Elderly with Alzheimer’s Disease

Introduction: When aging starts, the human being becomes prone and vulnerable to a variety of diseases and disorders, specifically Alzheimer’s disease (AD), which is the main reason for about 80% of the cases of dementia in older adults. AD is associated with a range of challenging disorders, such as aggression and anxiety, which make the lives of patients more difficult. This study aimed at investigating the impact of English language teaching on aggression and anxiety among older people with AD.&#x0D; &#x0D; Methods: The design of this study was quasi-experimental pre-test post-test with the control group. The participants of the study included 40 Iranian (20 males and 20 females) older adults (≥ 65 years) who were suffering from AD in Kerman province, Iran, and also they were selected through convenience sampling. The exercise group participated in 20 sessions of English language teaching three times a week in 40 minutes. Then, the effect of English language teaching on both aggression and anxiety was analyzed. The required data were collected through the Persian version of the Bass-Perry Aggression Questionnaire and the Persian version of the Spielberger State‐Trait Anxiety Inventory. Data analysis was conducted by running descriptive statistics, Kolmogorov-Smirnov normality test, Leven test, and one-way Analysis of Covariance (ANCOVA).&#x0D; &#x0D; Results: English language teaching significantly affected aggression among older people with AD (F= 9.112 p &lt; 0.05, w2 = 0.178) similarly; it significantly affected anxiety (F = 9.147 p &lt; 0.05, w2 = 0.130).&#x0D; &#x0D; Conclusion: English language teaching significantly improves aggression and anxiety among older people with AD. The findings have implications for the elderly with AD and their families, psychiatrists, and English language teaching policymakers.

The Effects of Autonomic Dysfunction on Functional Outcomes in Patients with Acute Stroke.

Autonomic dysfunction is a common complication of acute stroke, which impairs functional outcomes and increases mortality. There is a lack of well-established knowledge regarding the influence of autonomic dysfunction in patients with acute stroke. This study aims to investigate the impact of the severity of autonomic dysfunction on functional outcomes in patients with acute stroke. A retrospective analysis was conducted at a single center, involving 22 patients diagnosed with acute stroke. The severity of autonomic dysfunction was evaluated based on the Composite Autonomic Scoring Scale (CASS). The modified Barthel Index, Berg Balance Scale, Functional Ambulatory Category, and modified Rankin Scale were designated as functional outcome measures. The impact of the severity of autonomic dysfunction on functional outcomes was analyzed using one-way analysis of covariance (ANCOVA). A statistically significant difference was observed between the initial and follow-up functional outcomes based on the severity of autonomic dysfunction. This study presents evidence that the severity of autonomic dysfunction influences functional prognosis in patients with acute stroke. The findings will serve as additional considerations for the rehabilitation of patients with acute stroke.

Implementing augmented reality to improve students’ biology learning outcomes: Gender-based effect

&lt;span lang="EN-US"&gt;The current study examined the difference in students’ biology learning outcomes based on gender following the implementation of Augmented reality (AR). A gender equality study is useful as a foundation for establishing gender-sensitive learning. Gender equality promotes higher productivity and development outcomes, therefore it has favorable effects on economic and technological growth, as well as social fairness. We administered a quasi-experimental non-equivalent pretest-posttest control group design. The research population is all of class X public high school in Pamekasan Regency, Indonesia. The research samples were 56 senior high school students in class X. The classes that will be used as research samples are first tested for equality. The equivalence test analysis will use analysis of variance (ANOVA) by utilizing the SPSS 23.00 for windows program. Participants’ learning outcomes were measured using an essay test. The revised Blooms taxonomy indicators were used as the reference to construct the tests. The test covered the indicators of applying (C3), analyzing (C4), and synthesizing (C5). The participants’ answered were evaluated using a 4-point scale rubric adopted from Hart. One-way ANCOVA (analysis of covariance) was performed, involving the pretest scores as the covariate. The results showed that there was no difference in biology learning outcomes between male and female students involved in this study (p&amp;gt;0.05). These findings demonstrate that the implementation of augmented reality can close the gender gap in biology education. Augmented reality can be a solution to improve the learning environment in biology classrooms and facilitate gender-based learning demands.&lt;/span&gt;