Pairwise Comparisons Research Articles

Inducing Coproduction: Policy Implementation and Teachers’ Unions in Mexico

Cooperation with supportive societal organizations has been shown to help states implement policies. This article demonstrates that opposed organizations can also play this role, lending their resources in exchange for inducements (induced coproduction). Whether these organizations accept those inducements is a function of their preferences regarding the policy’s goals and implementation process. Inducements can overcome opposition to the latter but are less likely to respond to concerns about the former. Examining the subnational implementation of an education reform in Mexico, I show that opposition to goals predicts which teachers’ union locals rejected offered inducements. A paired comparison of two most similar Mexican states illustrates how opposition to goals results in a rejection of inducements (Oaxaca), as well as how induced coproduction results in implementation (Coahuila).

Fuzzy Analytic Hierarchy Process (FAHP) Based Performance Assessment of Textile Industry in Tirupur

Abstract: This study explores the use of Fuzzy Analytic Hierarchy Process (FAHP) to evaluate and prioritize criteria in supply chain management within the textile industry of Tirupur district. Utilizing a detailed questionnaire reviewed by experts with over 30 years of industry experience, the study conducted pairwise comparisons of key criteria: cost (C1), quality (C2), time delivery (C3), and management and organization (C4). By applying FAHP, which effectively handles uncertainties in decision-making, the study determines the relative importance of these criteria. The findings provide a structured method for improving decisionmaking in textile supply chain operations, integrating fuzzy logic with the traditional AHP framework to enhance the management and optimization of supply chain processes.

Enhancing Student Performance through Fuzzy MCDM: Evaluating Family Concern, Study Environment, and other Key Factors

Abstract: In this study, the Fuzzy Analytic Hierarchy Process (FAHP) was utilized to evaluate factors affecting student wellbeing and performance. The criteria assessed included C1 - Family Concern, C2 - Environment of Study, C3 - Resources, C4 - Time Management, and C5 - Lecturer Concern. A survey was administered to students at United College of Arts and Science in Coimbatore, Tamil Nadu, India, to gather numerical data. Pairwise comparison matrices were created based on the survey responses to assess the relative importance of each criterion. The FAHP analysis revealed that Family Concern (C1) has the greatest impact on student outcomes, highlighting the crucial role of family support in student success and well-being. The findings suggest that educators and parents should prioritize addressing family-related issues and consider implementing additional supportive measures, such as yoga and sports activities, to further improve student performance and overall wellbeing

Abstract C157: Unraveling Early Onset Disparities and Determinants: A Two-decade Analysis of Colorectal Cancer Trends in Texas

Abstract Background: Colorectal cancer (CRC) remains a significant public health concern in the United States, with substantial disparities observed in survival rates and age at diagnosis among different racial and ethnic groups. In Texas counties bordering Mexico, which have predominantly Hispanic populations, show higher CRC diagnoses. Hispanic patients generally exhibit lower screening rates, higher mortality, and late-stage diagnosis compared to non- Hispanic counterparts. Understanding the factors behind these disparities is crucial for developing targeted interventions to improve outcomes and reduce the burden of CRC. Methods: Using data from the Texas Cancer Registry, a retrospective study examined CRC survival rates and age at diagnosis among 235,076 patients of various racial and ethnic groups in Texas from 1995 to 2016. The association between Race and ethnicity and survival time over two periods (1995-2005 and 2006-2016) was analyzed using Kaplan-Meier survival analysis and pairwise comparisons. Additionally, the effects of Race and ethnicity on age at diagnosis were examined for the same periods using Welch ANOVA and posthoc comparisons. Results: Persistent survival disparities were observed, with Black patients facing the lowest median survival times across both periods (1995-2005 and 2006-2016). Hispanic patients showed significantly lower median survival rates compared to their non-Hispanic counterparts. Comparisons between races showed significant differences in median survival time between the two periods (1995-2005 and 2006-2016). Black: Hispanic patients showed no significant improvement in survival time between the periods. Significant improvements in survival time were observed in Black: non-Hispanic, White: Hispanic, and White: non-Hispanic patients. Lastly, the mean age at diagnosis depended on the ethnicity of the patient, with Hispanic patients displaying an earlier onset of CRC compared to non-Hispanic equivalents. Hispanic ethnicity was associated with an earlier onset of CRC compared to non-Hispanic counterparts. Conclusion: Geographic and ethnic disparities significantly influence CRC outcomes in Texas. Hispanic populations in border counties face increased risks due to lower screening and socioeconomic challenges. The rising incidence of early-onset CRC, particularly among younger, socioeconomically disadvantaged, and minority populations, necessitates targeted public health interventions to improve screening, early detection, and treatment access. Addressing these disparities is crucial to enhancing CRC survival rates and reducing mortality across diverse demographic groups. Citation Format: Tyler J Torres, Elias Arellano Villanueva, Yossef Alsabawi, Manish Tripathi. Unraveling Early Onset Disparities and Determinants: A Two-decade Analysis of Colorectal Cancer Trends in Texas [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C157.

Vibration of effects resulting from treatment selection in mixed-treatment comparisons: a multiverse analysis on network meta-analyses of antidepressants in major depressive disorder

ObjectiveIt is frequent to find overlapping network meta-analyses (NMAs) on the same topic with differences in terms of both treatments included and effect estimates. We aimed to evaluate the impact...

Motor variability during resistance training: Acceleration signal as intensity indicator

Analysis of variability in physiological time series has been shown to be an indicator of the state of the organism. Although there is evidence of the usefulness of analysis of the amount and/or structure of variability (complexity) in cycling actions, there is limited knowledge about its application in resistance exercise. The aim of this study is to find out whether variability in acceleration signals can be an indicator of intensity level in a squat task. For this purpose, an experimental design was developed in which the following participated seventy-two participants (age = 25.7 ± 4.4 years; height = 169.2 ± 9.8 cm; body mass = 67.7 ± 11.2 kg; ratio 1RM/body mass = 1.4 ± 0.3). They performed four repetitions of back squat at loads of 10%, 30%, 50%, 70%, and 90% of 1RM. Acceleration during the exercise was recorded using an inertial measurement unit (IMU) and a force platform. The variability of the movement was then analyzed using Standard Deviation (SD), Detrended Fluctuation Analysis (DFA), Fuzzy Entropy (FuzzyEn), and Sample Entropy (SampEn). For the IMU and for the force platform, significant effects were observed in all variables (p < 0.001). In pairwise comparisons, IMU showed a significant increase in motor complexity with increasing intensity, among most intensities, in DFA, FuzzyEn and SampEn. Differences in force platform were more limited, and only DFA detected differences between most intensities. The results suggest that measures of signal and acceleration variability may be a useful indicator of the relative intensity at which a squat exercise is performed.

Structural and Evolutionary Analysis of Proteins Endowed with a Nucleotidyltransferase, or Non-canonical Palm, Catalytic Domain

AbstractMany polymerases and other proteins are endowed with a catalytic domain belonging to the nucleotidyltransferase fold, which has also been deemed the non-canonical palm domain, in which three conserved acidic residues coordinate two divalent metal ions. Tertiary structure-based evolutionary analyses provide valuable information when the phylogenetic signal contained in the primary structure is blurry or has been lost, as is the case with these proteins. Pairwise structural comparisons of proteins with a nucleotidyltransferase fold were performed in the PDBefold web server: the RMSD, the number of superimposed residues, and the Qscore were obtained. The structural alignment score (RMSD × 100/number of superimposed residues) and the 1-Qscore were calculated, and distance matrices were constructed, from which a dendogram and a phylogenetic network were drawn for each score. The dendograms and the phylogenetic networks display well-defined clades, reflecting high levels of structural conservation within each clade, not mirrored by primary sequence. The conserved structural core between all these proteins consists of the catalytic nucleotidyltransferase fold, which is surrounded by different functional domains. Hence, many of the clades include proteins that bind different substrates or partake in non-related functions. Enzymes endowed with a nucleotidyltransferase fold are present in all domains of life, and participate in essential cellular and viral functions, which suggests that this domain is very ancient. Despite the loss of evolutionary traces in their primary structure, tertiary structure-based analyses allow us to delve into the evolution and functional diversification of the NT fold.

Pneumatic displacement of submacular haemorrhage secondary to neovascular age-related macular degeneration and polypoidal choroidal vasculopathy.

To compare the visual and anatomical outcomes of pneumatic displacement (PD) combined with anti-vascular endothelial growth factor (VEGF) therapy versus anti-VEGF monotherapy in treatment-naive eyes with submacular haemorrhage (SMH) secondary to neovascular age-related macular degeneration and polypoidal choroidal vasculopathy. In a retrospective comparative interventional study of 57 eyes, the changes in logMAR visual acuity (VA), and SMH height and area at baseline at months 1, 3 and 12 were compared between the PD and non-PD groups. There was no significant difference in mean VA in the PD versus non-PD group at month 12 (1.1 versus 0.7, p = 0.09). At baseline, the PD group, compared to the non-PD group, had significantly larger SMH area (35.9 versus 26.9 mm2, p = 0.04) and SMH height at the fovea (733.7 versus 503.6 µm, p < 0.01). The greatest reduction in SMH height and area occurred between baseline and month 1 in the PD group, which was faster than between month 1 and month 3 in the non-PD group, with similar findings in the matched pair analysis matched for SMH height and area. In the multivariable analysis, only baseline VA was associated with VA outcomes (month 1: β = -0.46, 95% [confidence interval] CI = -0.78 to -0.14, p = 0.006; month 3: β = -0.52, 95% CI = -0.86 to -0.18, p = 0.004; and month 12: β = -0.78, 95% CI = -1.16 to -0.39, p < 0.001). The visual outcome of SMH at month 12 in nAMD and PCV is poor regardless of whether PD is performed in addition to anti-VEGF therapy, although a more rapid resolution of SMH can be expected.

Standardized Temporary Atrial Epicardial Wire Locations Lead to Enhanced Atrial Signal Identification.

Background: Arrhythmias, common after pediatric cardiac surgery, are associated with increased morbidity and mortality. Atrial epicardial wires (AEW) improve diagnostic accuracy but have variable pacing and sensing properties based on their location. Even so, there are no longitudinal prospective pediatric studies examining ideal placement of AEW. Methods: This multicenter study compared atrial amplitudes, pacing sensitivities and thresholds via AEW placed at Bachmann's Bundle (BB) and the interatrial groove near the right pulmonary veins (IGRPV) versus the surgeons' standard locations. An AtriAmp system was used to obtain an atrial ECG to calculate atrial and ventricular amplitude from atrial electrograms on the bedside monitor. Sensitivities and thresholds via a temporary pacemaker were documented. ANOVA tests with repeated measures and post-hoc pairwise comparisons were performed to compare variables within the first 24-h postoperative hours. Mixed effects linear regression models were employed to examine daily trends. Results: In the first 24-h following cardiac surgery, AEW at BB and IGRPV showed significantly larger atrial amplitudes than the surgeons' standard locations. In addition, there was a negative trend in atrial ECG amplitude in all AEW from postoperative days 0 to 1; however, subsequent days showed a positive mean change in atrial amplitude with largest increase seen at BB. Atrial sensing as measured by the temporary pacemaker had statistically greater atrial signal amplitude from the BB-IGRPV set in both polarities (ie, with the BB as the - or + electrode pair) as compared to the surgeons' standard locations. No difference in atrial thresholds (mA) were noted in the immediate postoperative period or over time, with a relatively low atrial threshold at all sites. Conclusion: Standardization of AEW at Bachmann's Bundle can yield largest atrial amplitudes by atrial ECG and highest atrial sensing parameters without compromising atrial thresholds.

Exploring the links between type and content of virtual background use during videoconferencing and videoconference fatigue

The popularity of remote working in recent years has led to a rise in the use of videoconferencing tools. However, these communication tools have also given rise to a phenomenon known as videoconference fatigue (VF). Using the limited capacity model of motivated mediated message processing and impression management theory as the theoretical framework, this study explores how different types and content of virtual backgrounds in videoconferencing influence people’s VF and well-being. A survey of 610 users of videoconferencing tools revealed significant variations in the content and type of virtual backgrounds used during videoconferences. Our findings highlight three main points: first, there is a significant relationship between the use of virtual backgrounds and VF; second, pairwise comparisons showed that the type of virtual background significantly influences the amount of VF experienced by users; third, the content of virtual backgrounds also significantly impacts the level of VF experienced by users. These results suggest that careful selection of virtual backgrounds can mitigate VF and improve user well-being. Theoretical and practical implications are discussed.

Comparison of measurements and calculated lens power using three biometers: a Scheimpflug tomographer with partial coherence interferometry and two swept source optical coherence tomographers

PurposeTo compare the biometric measurements obtained from the Pentacam AXL Wave, IOLMaster 700, and ANTERION and calculate the recommended intraocular lens power using the Barrett Formulae.MethodsThis was a retrospective cross-sectional study of patients who underwent biometry using the Pentacam AXL Wave, IOLMaster 700, and ANTERION. Flat keratometry (K1), steep keratometry (K2), anterior chamber depth (ACD), and axial length (AL) from each device were measured and compared. These parameters were used to calculate the recommended IOL powers using the Barrett formula.ResultsThe study included 252 eyes of 153 patients. The IOLMaster had the highest acquisition rate among the two biometers. The Pentacam obtained the shortest mean AL, the IOLMaster measured the highest mean keratometry values, and the ANTERION measured the highest mean ACD. In terms of pairwise comparisons, keratometry and axial length were not significantly different between the Pentacam-IOLMaster and ANTERION-IOLMaster groups, while the rest of the pairwise comparisons were statistically significant. In nontoric and toric eyes, 35–45% of patients recommended the same sphere of IOL power. In another 30–40%, the Pentacam and ANTERION recommended an IOL power one step greater than that of the IOLMaster-derived data. 50% of the study population recommended the same toric-cylinder IOL power.ConclusionsThe Pentacam AXL Wave, IOLMaster 700, and ANTERION can reliably provide data for IOL power calculations; however, these data are not interchangeable. In nontoric and toric eyes, 35–45% of cases recommended the same sphere IOL power, and in another 30–40%, the Pentacam and ANTERION recommended one-step higher IOL power than the IOLMaster-derived data. In targeting emmetropia, selecting the first plus IOL power is advisable when using the Pentacam and ANTERION to approximate the IOL power calculations recommended by the IOLMaster 700.

Biofilm formation of Streptococcus mutans, Streptococcus sanguinis, Staphylococcus epidermidis, Staphylococcus aureus, Lactobacillus casei, and Candida Albicans on 5 thermoform and 3D printed orthodontic clear aligner and retainer materials at 3 time points: an in vitro study

IntroductionOrthodontic clear aligners and retainers have numerous advantages that is making them ever increasingly popular. However, they might, similar to any other oral appliance, contribute to biofilm formation and finally dental caries or white spot lesions or gingival inflammations. The literature on biofilm formation on orthodontic clear appliances is very scarce and limited to a few microorganisms and materials. Therefore, this experimental study evaluated the biofilm formation on 5 thermoformed and 3D printed CAD/CAM orthodontic retainers in 3 intervals.MethodsIn this in vitro study, 345 specimens (270 test discs and 45 negative controls) were created from fabricated retainers. Retainers included a 3D printed CAD/CAM material (Detax) and four thermoformed retainers [Erkodent (polyethylene terephthalate glycol [PETG]); EasyVac (polyethylene); DB (polyester based on terephthalic acid); and Clear Tech]. They were all 1 mm thick, and all completely fabricated, i.e., heated or printed. The discs were placed in 96-well plates. Microorganisms were cultured on 270 discs for 24 h (90 discs), 72 h (90 other discs), and 5 days or 120 h (90 other discs). Biofilm formation of the strains and negative controls was measured using the microtiter plate assay by ELISA reading. The microbes’ ability to produce biofilm was categorized based on the comparison of average optical density (OD) of tests versus a cut-off point OD (ODc) calculated as the average of the OD of corresponding negative controls plus 3× its standard deviation: non-biofilm former [OD ≤ ODc], weak biofilm former [ODc < OD ≤ (2 × ODc)], moderate biofilm former [(2 × ODc) < OD ≤ (4 × ODc)], and strong biofilm former [(4 × ODc) < OD]. These were also converted to ranked scores between zero (no biofilm) and 3. The difference between ODs with control ODs were calculated. These were analyzed using 3-way ANOVA, 2-way ANOVA, and Tukey tests (α = 0.05, α = 0.008).ResultsThe 3-way ANOVA showed that the overall difference among the ΔODs of 5 retainers (all microorganisms and all intervals combined, n = 270) was not significant (F = 1.860, P = 0.119). Nevertheless, the difference among 3 intervals (F = 31.607, P = 0.0000) and the difference among the 6 microorganisms (F = 24.044, P = 0.0000) were significant. According to the Tukey test, the differences between the 1st interval with either of the other two intervals was significant (both P values = 0.000). There were significant differences between Candida albicans with all other organisms (all 5 P values = 0.0000). All other pairwise comparisons were insignificant (all 10 P values ≥ 0.1). After taking the averages of the 3 intervals, the order of the biofilm generation for different materials were as follows: Detax (average score: 1.56), Easyvac (1.67), Erkodent (1.78), Clear Tech (1.83), BD (2.28).ConclusionsAs far as these 6 microorganisms are of concern, there might not be a significant overall difference among the clear retainer materials tested in this study. A significant overall increase was observed between the first and third days, which later did not significantly increase more until day 5. The Candida albicans biofilm was more intense than the tested 5 bacteria, which themselves showed rather similar growth patterns to each other.

Comparative analysis of In vivo endothelial cell translatomes across central nervous system vascular beds

Endothelial cells (ECs) display organ- and tissue-specific heterogeneity. In the eye, the retinal and choroidal vascular beds are distinct networks with different molecular and morphological properties that serve location-specific functions, i.e., the former maintaining a tight barrier and the latter, a permeable fenestrated vasculature. Given that retinal health critically relies on the function of these vascular beds and that their dysfunction is implicated in a variety of retinal diseases, a molecular understanding of both physiological and pathophysiological characteristics of these distinct vasculatures is critical. Given their interspersed anatomic distribution among parenchymal cells, the study of EC gene expression, in vivo, has been hampered by the challenge of isolating pure populations of ocular ECs in sufficient quantities for large-scale transcriptomics. To address this challenge, we present a methodological and analytical workflow to facilitate inter-tissue comparisons of the in vivo EC translatome isolated from choroid, retina, and brain using the Cre-inducible NuTRAP flox construct and two widely-used endothelial Cre mouse lines: constitutive Tie2-Cre and tamoxifen-inducible Cdh5-CreERT2. For each Cre line, inter-tissue comparison of TRAP-RNAseq enrichment (TRAP-isolated translatome vs input transcriptome) showed tissue-specific gene enrichments with differential pathway representation. For each mouse model, inter-tissue comparison of the EC translatome (choroid vs brain, choroid vs retina, and brain vs retina) showed over 50% overlap of differentially expressed genes (DEGs) between the three paired comparisons, with differential pathway representation for each tissue. Pathway analysis of DEGs in the Cdh5-NuTRAP vs Tie2-NuTRAP comparison for retina, choroid, and brain predicted inhibition of processes related to myeloid cell function and activation, consistent with more specific targeting of ECs in the Cdh5-NuTRAP than in the Tie2-NuTRAP model which also targets hematopoietic progenitors giving rise to immune cells. Indeed, while TRAP enriches for EC transcripts in both models, myeloid transcripts were also captured in the Tie2-NuTRAP model which was confirmed using cell sorting. We suggest experimental/analytical considerations should be taken when selecting Cre-lines to target ECs.

Matched pair analysis of the effect of longer hypothermic machine perfusion time on kidney transplant outcomes.

Hypothermic machine perfusion (HMP) has demonstrated benefits in terms of early kidney transplant function compared to static cold storage. While longer preservation times have shown detrimental effects, a previous paired study indicated that longer pump times (the second kidney in a pair) might lead to improved outcomes. To revisit the prior paired study's somewhat unexpected results by reviewing our program's experience. A total of 61 pairs of transplant recipients who received kidneys from the same donor (2012-2021) were analyzed. Patients were divided into two groups depending on whether they were transplanted first (K1) or second (K2). Therefore, the patients in each pair had identical donor characteristics, except for time on the pump. Statistical analyses included Kaplan-Meyer analysis and paired tests, including McNemar's test, student's paired t-test, or Wilcoxon's test, as appropriate. The two groups of recipients had similar demographics (age, body mass index, diabetes, time on dialysis, sensitization and retransplants). Cold ischemic times for K1 and K2 were 8.9 (95%CI: 7.9, 9.8) and 14.7 hours (13.7, 15.8) (P < 0.0001), respectively. Overall, K2 had a higher rate of freedom from biopsy-proven acute rejection at 1 year (P = 0.015). Delayed graft function was less common in K2, 12/61 (20%) than in K1, 20/61 (33%) (P = 0.046). Finally, K2 showed a higher graft survival than K1 (P = 0.023). Our results agree with a previous study that suggested possible advantages to longer pump times. Both studies should encourage further research into HMP's potential anti-inflammatory effect.

DEVELOPMENT OF METHODOLOGY AND STUDY OF THE INFLUENCE OF TECHNICAL, ORGANIZATIONAL AND TECHNOLOGICAL FACTORS ON THE DURATION OF THE PROCESS OF LIQUIDATION AND LOCALIZATION OF THE DEVELOPMENT OF DESTRUCTIONS

Analysis of the influence of technical, organizational and technological factors on the duration of the process of liquidation and localization of the development of destruction is an important stage of research into the process of liquidation of the consequences of accidental destruction. In order to compare options for liquidation and localization of the development of destruction of an emergency building, three options for reinforcement systems were analyzed: metal typical, wooden individual and combined. The work uses the method of analysis of hierarchies - a mathematical tool of a systematic approach to complex decision-making problems. The method does not impose the "correct" option, but allows you to interactively find an alternative (rational reinforcement option) that best matches the requirements for solving optimization tasks. To reduce the subjectivity of making a justified optimization decision in the conditions of complex multi-criteria optimization problems, a solution to the local problem of finding the optimal alternative according to the duration criterion, or a group of alternatives, taking into account the ratio of advantages based on the vector criterion, is proposed. To indicate the influence of advantages in quantitative expression, a pairwise comparison scale was used, which consists in a qualitative and quantitative assessment of relative advantage: equal in importance - 1; weak advantage – 2; average degree of preference ‒ 3; preference above the average degree ‒ 4; moderately stronger advantage ‒ 5; strong advantage ‒ 6; much stronger advantage ‒ 7; the most significant advantage is 8; absolute advantage ‒ 9. Initial data for choosing a temporary reinforcement option were obtained by comparing the estimated duration of dismantling and restoration works and optimizing the sequence of their execution for three options using wooden individual, metal typical and combined temporary reinforcement systems. It was established that it is impossible to ensure complete unification of reinforcement elements using only typical elements, therefore it is effective to use combined reinforcement systems using typical metal and individual wooden elements.

The Suicide Status Form-4 (SSF-IV) as a potentially therapeutic suicide risk assessment tool.

Empirically supported suicide risk assessment and conceptualization is a central aim of the Zero Suicide model. The Suicide Status Form (SSF) is the essential document and scaffolding of the Collaborative Assessment and Management of Suicidality-Brief Intervention (CAMS-BI) and is hypothesized as an example of a psychological assessment as therapeutic intervention (PATI). However, this hypothesis has never been directly tested. N = 57 patients deemed at risk for outpatient suicidal behavior and treated as part of an inpatient psychiatric consultation and liaison service were recruited to participate in CAMS-BI at a Level 1 trauma center in the southeastern United States. During the CAMS-BI process, patients were asked to rate their subjective units of distress (SUDS) at five time points throughout the intervention (k = 285). The omnibus random intercept multilevel model revealed a significant difference in pre- to post-session ratings of SUDS across patients. Post hoc pairwise comparisons revealed no significant differences between SSF sections (e.g., Section A, Section B, and Section C) and relative reductions in SUDS; however, there was an observable trend toward a favorable effect of Section A of the SSF. The SSF may represent an example of PATI pending replication and extension of the current results.

Auricular laser acupuncture as an adjunct for parental anxietymanagement during children's surgery: Arandomized-controlled study.

Pediatric surgery is associated with high levels of anxiety for both children and parents/caregivers. To mitigate anxiety, auricular acupuncture has shown its potential in the perioperative setting. Accordingly, our team developed a wearable prototype auricular laser acupuncture system, AcuHealth V1.0, as a portable acupuncture device and conducted a proof-of-concept evaluation with parents of children undergoing surgery. The primary aim of this study was to conduct feasibility testing of the AcuHealth V1.0 system in delivering auricular laser acupuncture. Parents of children who were scheduled to undergo outpatient surgery were randomly assigned to one of three groups: authentic acupuncture (laser beams at known anxiolytic acupoints, n = 13), sham acupuncture (non-anxiolytic acupoints, n = 14), or a placebo control group (inactive laser, n = 14). Parent self-reported anxiety (0-10 numerical rating scale) was assessed at baseline, pre-intervention (once child was taken to the OR), post-intervention, and at 30 min after the intervention. Usability and acceptability data regarding the device were assessed after the intervention. Baseline data revealed no significant difference in anxiety between the three groups. Parent-reported anxiety level at 30-min post-intervention as compared to baseline in the authentic group was significantly decreased (delta mean ± std = -3.58 ± 2.07) compared to both the sham acupuncture (-1.35 ± 2.65) and placebo control group (0.54 ± 1.13). Evaluation of changes in parent-reported anxiety between groups over time using two-way repeated-measures analysis of variance (ANOVA) revealed a significant difference between the three groups (p = 0.001). Post hoc analysis with Scheffe test pairwise comparisons showed that at 30-min post-intervention compared to baseline, the authentic intervention group was significantly less anxious compared with both the sham group (p = 0.033) and the placebo control group (p = 0.001). Additionally, feedback regarding the usage of the device supported the acceptability and usability of the device with no adverse events. This pilot study administering laser auricular acupuncture via the AcuHealth V1.0 system decreased parental anxiety after 30 min in parents who received treatment immediately after their children were taken to the operating room with no adverse effect.

Evaluation of the effect of hearing loss on cognitive-vestibular functions in the geriatric population

BackgroundPresbycusis is known to accelerate mental decline processes and to cause secondary consequences such as social isolation and depression when not intervened. The association of presbycusis and presbyvestibulopathy disorders is likely. These changes in vestibular functions are closely related to cognitive functions. This study investigated the effect of hearing loss on cognitive and vestibular functions in a geriatric population.MethodsThis study was conducted with 200 participants over the age of 65. The study was conducted with three groups: individuals with normal hearing, moderate sensorineural hearing loss, and severe sensorineural hearing loss. The relationship between the participants’ responses to the Cognitive Vestibular Function Scale and their hearing levels was examined.ResultsOf the individuals with hearing loss in the study group, 55 had moderate SNHL, and 45 had severe SNHL. The age range of the participants was 65 to 91 years (71.06 ± 4.92). When the control (Group N) and study groups (Group M and Group S) were compared according to CVFS and subscale scores, they were found to be statistically different (p < 0.05). In pairwise comparisons, a significant difference (p < 0.05) was found in all pairwise combinations except Group N and Group M (p = 0.109) for the VSM subscale.ConclusionsIt was concluded that having a healthy hearing is the most influential factor for maintaining cognitive vestibular functions in the geriatric population. It was found that the degree of hearing loss primarily affects cognitive vestibular functions and that cognitive vestibular functions deteriorate more as hearing loss increases.

Cerebral white matter injury in hemodialysis patients: a cross-sectional tract-based spatial statistics and fixel-based analysis

Abstract Background End-stage renal disease (ESRD) patients with maintenance hemodialysis (HD) are often accompanied by damage to brain white matter (WM) and cognitive impairment. However, whether this damage is caused by maintenance HD or renal dysfunction is unclear. Purpose To investigate the natural progression of WM damage in patients with ESRD and the effects of HD on WM using Tract-based spatial statistics (TBSS) and fixel-based analysis (FBA). Population Eighty-one ESRD patients including 41 with no dialysis (ND) and 40 with HD and forty-six healthy controls (HCs) were enrolled in this study. Field Strength/Sequence A 3 T, single-shot spin–echo echo planar imaging (EPI). Assessment The difference of WM among the three groups (ESRD patients with HD, ESRD patients without HD and HCs) were analyzed using Tract-based spatial statistics (TBSS) and fixel-based analysis (FBA), pairwise comparison was then used to compare the difference of WM between two groups. Relationship between WM and neurocognitive assessments/clinical data were analyzed in ESRD patients with or without HD. Statistical Tests Group t-test, Chi-square Test, Kruskal–Wallis test, Mann–Whitney U-Test, Spearman’ correlation analysis, non-parametric permutation testing. Results The damage of WM in ESRD with ND and ESRD HD appeared around the lateral ventricles similarly used for TBSS while FBA reflected the changes had extended to adjacent WM in anterior hemisphere, with larger region in ESRD HD compared to ESRD ND and the brainstem was also widely affected in ESRD HD. The levels of MoCA score were lower in ESRD HD group. RD in body of corpus callosum (BCC) were negatively correlated with MoCA score in both groups. FDC in left Thalamo-prefrontal projection (T_PREFL), left and right cingulum (CGL and CGR) were positively correlated with MoCA score in both groups. Creatinine (Cr) was positively correlated with FDC in some frontal projection fibers in striatum and thalamus, CG and fronto-pontine tract (FPT), Cr was positively correlated with FD mainly in premotor projection fibers in striatum and thalamus in ESRD HD group. Cr was negatively correlated with MD and RD in regions of corona radiata ESRD ND group. Data Conclusion FBA is more sensitive in detecting differences between ESRD patients and HCs. When ESRD patients receive maintenance HD, the degree of WM damage may not be aggravated, however, the range of damaged WM can be expanded, especially in anterior hemisphere and brainstem, some of these changes in anterior hemisphere may contribute to cognitive decline.

Psychological Health and Wellness and the Impact of a Supportive Text Messaging Program (Wellness4MDs) Among Physicians and Medical Learners in Canada: Protocol for a Longitudinal Study.

Burnout, anxiety, and depression continue to affect physicians, postgraduate medical trainees, and medical students globally and in Canada particularly after the COVID-19 pandemic. The primary goal of this project is to design, implement, monitor, and evaluate a daily supportive SMS text messaging program (Wellness4MDs, Global Psychological e-Health Foundation). The program aims to reduce the prevalence and severity of burnout, anxiety, and depression symptoms among physicians, postgraduate medical trainees, and medical students in Canada. This longitudinal study represents a multistakeholder, mixed methods, multiyear implementation science project. Project evaluation will be conducted through a quantitative prospective longitudinal approach using a paired sample comparison, a naturalistic cross-sectional controlled design, and satisfaction surveys. Prevalence estimates for psychological problems would be based on baseline data from self-completed validated rating scales. Additional data will be collected at designated time points for paired comparison. Outcome measures will be assessed using standardized rating scales, including the Maslach Burnout Inventory for burnout symptoms, the 9-item Patient Health Questionnaire for depression symptoms, the 7-item Generalized Anxiety Disorder scale for anxiety symptoms, and the World Health Organization-Five Well-Being Index. The project launched in the last quarter of 2023, and program evaluation results will become available within 36 months. The Wellness4MDs program is expected to reduce the prevalence and severity of psychological problems among physicians in Canada and achieve high subscriber satisfaction. The results from the Wellness4MDs project evaluation will provide key information regarding the effectiveness of daily supportive SMS text messages and links to mental health resources on these mental health parameters in Canadian physicians, postgraduate trainees, and medical students. Information will be useful for informing policy and decision-making concerning psychological interventions for physicians in Canada. PRR1-10.2196/44368.