Repeated Measures General Linear Model Research Articles

ADSTEP: Preliminary Investigation of a Multicomponent Walking Aid Program in People With Multiple Sclerosis

ObjectiveTo evaluate the effect of the Assistive Device Selection, Training and Education Program (ADSTEP) on falls and walking and sitting activity in people with multiple sclerosis (PwMS). DesignRandomized controlled trial. SettingVeterans affairs medical center. ParticipantsPwMS (N=40) using a walking aid at baseline who had fallen in the previous year. InterventionsParticipants were randomly assigned to ADSTEP or control. ADSTEP had 6 weekly, 40-minute, 1-on-1 sessions with a physical therapist, starting with walking aid selection and fitting, followed by task-oriented progressive gait training. Control was usual medical care with the option of ADSTEP after the study. Main Outcome MeasuresThe following were assessed at baseline, intervention completion, and 3 months later: falls, timed Up and Go, timed 25-foot walk, 2-minute walk, Four Square Step Test, International Physical Activity Questionnaire, Quebec User Evaluation of Satisfaction with Assistive Technologies, Multiple Sclerosis Walking Scale-12, Activities-Specific Balance Confidence Scale, and Multiple Sclerosis Impact Scale-29. Effect on these outcomes was estimated by a 2-by-2 repeated measures general linear model. ResultsFewer ADSTEP than control participants fell (χ2=3.96, P<.05. number needed to treat =3.3). Time spent sitting changed significantly differently with ADSTEP than with control from baseline to intervention completion (F=11.16, P=.002. ADSTEP: reduced 87.00±194.89min/d; control: increased 103.50±142.21min/d; d=0.88) and to 3-month follow-up (F=9.25, P=.004. ADSTEP: reduced 75.79±171.57min/d; control: increased 84.50±149.23min/d; d=0.79). ADSTEP yielded a moderate effect on time spent walking compared to control at 3-month follow-up (P>.05. ADSTEP 117.53±148.40min/d; control 46.43±58.55min/d; d=0.63). ConclusionsADSTEP prevents falls, reduces sitting, and may increase walking in PwMS.

An Evaluation Study of the “RESTART” Program—Short-Term Residential Treatment for Addiction

The syndrome model of addiction argues that addiction should be conceptualized as a syndrome with multiple opportunistic expressions. The model is built on the observation that despite the various manifestations of addictive behaviors, they share many commonalities in terms of the etiology and the associated consequences. This model proliferates the understanding of the high relapse rate in addiction after receiving solely symptom-focused treatment. For clinicians, this conceptual model emphasizes the importance of in-depth multidimensional assessment and treatment modality for the interacting underpinnings of addictions. In Hong Kong, very few residential services are currently provided for clients with addictive behaviors other than substance abuse. Against this background, we developed a pilot short-term residential treatment program namely “RESTART” based on the Acceptance Commitment Therapy and Expressive Arts Therapy for clients with various expressions of addiction. The program contained a 4-day and 3-night overnight residential treatment camp followed by three post-camp workshops, and a full-day camp. It aimed to help participants rebuild a positive lifestyle and raise self- efficacy and coping abilities. The program recruited 44 participants with various expressions of addiction including gambling disorder, sex addiction, compulsive buying, compulsive stealing, internet gaming disorder, alcohol, and cigarette addiction. The program evaluation focused on six outcomes, including health consciousness, motivation to build a healthy life, psychological distress, disclosure of distress, perceived emotional and life disturbance by addiction, and self-efficacy of urge management. Quasi-experimental design was adopted to compare the experimental group (program participants) and the control group with similar demographic and addiction backgrounds. They were surveyed in four intervals in which pretest before the commencement of the residential program was conducted to compare with posttest at the program endpoint and two follow-up tests in 3 months after the program. Repeated-measures general linear models indicated that relative to the control participants, the experimental participants yielded significant increase in willingness to disclose distress and self-efficacy over time, whereas their perceived disturbance by addiction significantly reduced over time. These results suggest that the residential treatment camp is a potentially promising complement to treatment for diverse addiction problems.

F65. The converging path of Alzheimer’s disease and epilepsy: A prospective long-term EEG study

Introduction Evidence suggests that patients with Alzheimer’s disease (AD) have a higher chance to develop epileptic seizures. However, results of prevalence studies are ambiguous and only a few studies observed the risk factors of seizures and the impact of epileptiform activity on the progression of cognitive deterioration. The appropriate neurophysiologic technique for accurate detection of dementia-related epilepsy is also questionable. Methods We selected 50 patients meeting the criteria for probable AD and followed them during 2 years. The patients underwent rigorous clinical investigation including long-term (24 h) EEG monitoring and repeated detailed neuropsychology. We analysed the prevalence of epileptic seizures and epileptiform activity, described the spatial and temporal distribution of epileptic discharges and the semiology of seizures. We also measured the sensitivity of different EEG lengths and the relation of interictal activity to different sleep stages. To analyse the risk factors of epilepsy, we compared patients with and without seizures from many epidemiology and clinical aspects with a covariance analysis. To define the effect of spike activity on the progression of cognitive decline, repeated measure general linear model was applied. Results We revealed epileptic seizures in quarter of the patients, mostly non-motor (55%), complex partial seizures with temporal lobe origin. Early onset of cognitive decline, long duration of dementia, more severe stage of AD and higher education were significant risk factors for developing seizures (p Conclusion Epilepsy is a common comorbidity of AD. Epileptic seizures predominantly occur in highly educated AD patients with early onset dementia at the severe stage of the disease. Epileptiform discharges could accelerate the progression of AD, so accurate assessment of AD-related epilepsy with long-term Holter-EEG including sleep recording is essential because antiepileptic drugs might represent a new therapeutic strategy in AD.

S170. AMYGDALA SUBNUCLEI VOLUMES IN FIRST-EPISODE PSYCHOSIS: ASSOCIATION WITH CHILDHOOD ADVERSITY

BackgroundThe amygdala volume is reduced already in the first episode of psychosis. The amygdala is a key region in emotional processing, and its volume reduction has been associated with severity of childhood adversity in psychotic patients. Since the amygdala is comprised of separate subnuclei with distinct anatomy and function we wanted to study whether these effects are present in some subnuclei more than others in first episode of psychosis.MethodsWe studied amygdala subnuclei volumes in 68 first-episode psychosis (FEP) patients (mean age = 27.1 ± 6.2, 35 females) and 65 healthy controls (mean 28.9 ± 6.5, 33 females) randomly selected from the general population. Subjects underwent a T1-weighted MRI with 1mm isotropic resolution (Philips Ingenuity 3T). The subnuclei volumes were generated with a new automated algorithm in FreeSurfer. Childhood adversity was measured using the Trauma and Distress Scale Scores (TADS). Baseline group differences in the amygdala subnuclei volumes were tested using repeated measures general linear model. The analyses were restricted to the four largest subnuclei: the lateral, basal, accessory basal, and the corticoamygdaloid transition area with volumes > 100 mm3. There were no differences between hemispheres nor group by hemisphere interactions so left and right hemispheres were averaged. All group comparisons were corrected for age, sex, and total intracranial volume. Association between the volumes and the TADS scores in the FEP group were also corrected for cumulative exposure to antipsychotic medication.ResultsWe found that amygdala subnuclei were smaller in the FEP patients than in the the controls with regional specifity (subnucleus ROI*Group p = 0.015). In the FEP, the most robust reductions were in the lateral nucleus (Bonferroni corrected p = 0.036, β = -64.15). No statistically significant difference was observed in the basal nucleus, the accessory basal nucleus or the corticoamygdaloid transition area. The FEP patients had in average higher TADS total score (19.00 ± 13.56) compared to the HC (7.68 ± 7.07) (p < 0.001, t = 5.84).We found that particularly the TADS physical abuse score (FEP(n)=63, HC(n)=59) associated significantly differently with some subnuclei in patients and control group (ROI*Group*Physical abuse p = 0.016). The difference was significant only in the lateral nucleus (Group*Physical abuse p = 0.048, β = -34.97). However, there was an overall nonsignificant trend of the negative association between lateral nucleus volume and all TADS scores in the FEP. Similar trend was not seen in the controls.DiscussionWe show that the amygdala subnuclei are differently affected already in the first episode of psychosis. Compared to the controls, the FEP patients had smaller lateral nucleus volume, but not basal, accessory basal nucleus or corticoamygdaloid transition area. The lateral nucleus volume was also negatively associated with childhood traumatic experiences, particularly physical abuse in the FEP patients. These findings suggest the involvement of the lateral nucleus of amygdala in the association between childhood traumatic experiences and psychotic disorders. This is well in agreement with studies suggesting that the lateral nucleus of the amygdala is associated with fear learning, recovery from fear and regulation of fear expression.

PREDICTORS OF SELF-REPORTED GAINS IN A RELATIONSHIP-BASED HOME-VISITING PROJECT FOR MOTHERS AFTER CHILDBIRTH.

We assessed mothers' self-reported gains from a postpartum home-visiting (HV) project in which home visitors are volunteer mothers from the community. Hypotheses were that gains are positively related to (a) mothers' felt-closeness with their home visitor, (b) mothers' level of sociodemographic risk, and (c) the home visitors' preproject training in support services for families or children (Professionalism). One hundred sixty-four clients returned written evaluations of the HV project. Items assessing gains were reduced to two factors: Improved Well-Being ("Self") and Improved Infant Care ("Infant"). Repeated measures general linear models, with Gains (Self, Infant) as the repeated measure, and multiple regression analyses evaluated the hypotheses. Across the sample, gains on both factors were moderate, although gain scores were higher regarding Self than for Infant. Results show that (a) Mothers' felt-closeness with their volunteer was strongly related to mothers' gains; (b) high-risk mothers gained more from the project than did mothers of lower risk, particularly regarding Infant Care; and (c) mothers visited by volunteers who were professionals reported more substantial gains than did mothers visited by volunteers who were not professionals. Findings can help explain variance in mothers' gains from such projects and could be useful in improving their efficacy.

Pre-treatment red blood cell distribution width provides prognostic information in multiple myeloma

BackgroundThe red blood cell distribution width (RDW), a credible marker for abnormal erythropoiesis, has recently been studied as a prognostic factor in oncology, but its role in multiple myeloma (MM) hasn't been thoroughly investigated. MethodsWe performed a retrospective study in 162 patients with multiple myeloma. Categorical parameters were analyzed using Pearson chi-squared test. The Mann-Whitney and Wilcoxon tests were used for group comparisons. Comparisons of repeated samples data were analyzed with the general linear model repeated-measures procedure. The Kaplan–Meier product-limit method was used to determine OS and PFS, and the differences were assessed by the log-rank test. ResultsHigh RDW baseline was significantly associated with indexes including haemoglobin, bone marrow plasma cell infiltration, and cytogenetics risk stratification. After chemotherapy, the overall response rate (ORR) decreased as RDW baseline increased. In 24 patients with high RDW baseline, it was revealed RDW value decreased when patients achieved complete remission (CR), but increased when the disease progressed. The normal-RDW baseline group showed both longer overall survival (OS) and progression-free survival (PFS) than the high-RDW baseline group. ConclusionOur study suggests pre-treatment RDW level is a prognostic factor in MM and should be regarded as an important parameter for assessment of therapeutic efficiency.

Long-Lasting Neuropsychological Effects of a Computerized Cognitive Training in Patients Affected by Early Stage Alzheimer's Disease: Are They Stable Over Time?

We investigated the stability of effects of a computerized cognitive training previously administered to a large group of early stage Alzheimer's disease (AD) patients, as compared with a control group. Eighty AD patients were randomized in two groups and underwent a computerized cognitive training, or a control intervention. A Repeated Measures General Linear Model (RM-GLM) showed a significant interaction effect for the following neuropsychological tests: the digit span forward and backward, and the two-syllable words test, as measures of short-term memory and working memory; the Rivermead Behavioural Memory Test (RBMT) story immediate and the RBMT story delayed, as measures of ecologically oriented memory; the Token test, as measure of language comprehension; and the Brixton test, as an executive functions measure. Patients in the experimental group showed a significant improvement in various neuropsychological domains due to the training, and these effects decreased after 12 months.

Hematological and Hemodynamic Responses to Acute and Short-Term Creatine Nitrate Supplementation.

In a double-blind, crossover, randomized and placebo-controlled trial; 28 men and women ingested a placebo (PLA), 3 g of creatine nitrate (CNL), and 6 g of creatine nitrate (CNH) for 6 days. Participants repeated the experiment with the alternate supplements after a 7-day washout. Hemodynamic responses to a postural challenge, fasting blood samples, and bench press, leg press, and cycling time trial performance and recovery were assessed. Data were analyzed by univariate, multivariate, and repeated measures general linear models (GLM). No significant differences were found among treatments for hemodynamic responses, clinical blood markers or self-reported side effects. After 5 days of supplementation, one repetition maximum (1RM) bench press improved significantly for CNH (mean change, 95% CI; 6.1 [3.5, 8.7] kg) but not PLA (0.7 [−1.6, 3.0] kg or CNL (2.0 [−0.9, 4.9] kg, CNH, p = 0.01). CNH participants also tended to experience an attenuated loss in 1RM strength during the recovery performance tests following supplementation on day 5 (PLA: −9.3 [−13.5, −5.0], CNL: −9.3 [−13.5, −5.1], CNH: −3.9 [−6.6, −1.2] kg, p = 0.07). After 5 days, pre-supplementation 1RM leg press values increased significantly, only with CNH (24.7 [8.8, 40.6] kg, but not PLA (13.9 [−15.7, 43.5] or CNL (14.6 [−0.5, 29.7]). Further, post-supplementation 1RM leg press recovery did not decrease significantly for CNH (−13.3 [−31.9, 5.3], but did for PLA (−30.5 [−53.4, −7.7] and CNL (−29.0 [−49.5, −8.4]). CNL treatment promoted an increase in bench press repetitions at 70% of 1RM during recovery on day 5 (PLA: 0.4 [−0.8, 1.6], CNL: 0.9 [0.35, 1.5], CNH: 0.5 [−0.2, 0.3], p = 0.56), greater leg press endurance prior to supplementation on day 5 (PLA: −0.2 [−1.6, 1.2], CNL: 0.9 [0.2, 1.6], CNH: 0.2 [−0.5, 0.9], p = 0.25) and greater leg press endurance during recovery on day 5 (PLA: −0.03 [−1.2, 1.1], CNL: 1.1 [0.3, 1.9], CNH: 0.4 [−0.4, 1.2], p = 0.23). Cycling time trial performance (4 km) was not affected. Results indicate that creatine nitrate supplementation, up to a 6 g dose, for 6 days, appears to be safe and provide some ergogenic benefit.

Cold-Water Immersion Cooling Rates in Football Linemen and Cross-Country Runners With Exercise-Induced Hyperthermia.

Ideal and acceptable cooling rates in hyperthermic athletes have been established in average-sized participants. Football linemen (FBs) have a small body surface area (BSA)-to-mass ratio compared with smaller athletes, which hinders heat dissipation. To determine cooling rates using cold-water immersion in hyperthermic FBs and cross-country runners (CCs). Cohort study. Controlled university laboratory. Nine FBs (age = 21.7 ± 1.7 years, height = 188.7 ± 4 cm, mass = 128.1 ± 18 kg, body fat = 28.9% ± 7.1%, lean body mass [LBM] = 86.9 ± 19 kg, BSA = 2.54 ± 0.13 m2, BSA/mass = 201 ± 21.3 cm2/kg, and BSA/LBM = 276.4 ± 19.7 cm2/kg) and 7 CCs (age = 20 ± 1.8 years, height = 176 ± 4.1 cm, mass = 68.7 ± 6.5 kg, body fat = 10.2% ± 1.6%, LBM = 61.7 ± 5.3 kg, BSA = 1.84 ± 0.1 m2, BSA/mass = 268.3 ± 11.7 cm2/kg, and BSA/LBM = 298.4 ± 11.7 cm2/kg). Participants ingested an intestinal sensor, exercised in a climatic chamber (39°C, 40% relative humidity) until either target core temperature (Tgi) was 39.5°C or volitional exhaustion was reached, and were immediately immersed in a 10°C circulated bath until Tgi declined to 37.5°C. A general linear model repeated-measures analysis of variance and independent t tests were calculated, with P < .05. Physical characteristics, maximal Tgi, time to reach 37.5°C, and cooling rate. Physical characteristics were different between groups. No differences existed in environmental measures or maximal Tgi (FBs = 39.12°C ± 0.39°C, CCs = 39.38°C ± 0.19°C; P = .12). Cooling times required to reach 37.5°C (FBs = 11.4 ± 4 minutes, CCs = 7.7 ± 0.06 minutes; P < .002) and therefore cooling rates (FBs = 0.156°C·min-1 ± 0.06°C·min-1, CCs = .255°C·min-1 ± 0.05°C·min-1; P < .002) were different. Strong correlations were found between cooling rate and body mass (r = -0.76, P < .001), total BSA (r = -0.74, P < .001), BSA/mass (r = 0.73, P < .001), LBM/mass (r = 0.72, P < .002), and LBM (r = -0.72, P < .002). With cold-water immersion, the cooling rate in CCs (0.255°C·min-1) was greater than in FBs (0.156°C·min-1); however, both were considered ideal (≥0.155°C·min-1). Athletic trainers should realize that it likely takes considerably longer to cool large hyperthermic American-football players (>11 minutes) than smaller, leaner athletes (7.7 minutes). Cooling rates varied widely from 0.332°C·min-1 in a small runner to only 0.101°C·min-1 in a lineman, supporting the use of rectal temperature for monitoring during cooling.

Evaluating the efficacy of functional electrical stimulation therapy assisted walking after chronic motor incomplete spinal cord injury: effects on bone biomarkers and bone strength

Objectives: To determine the efficacy of functional electrical stimulation therapy assisted walking (FES-T) compared to a conventional aerobic and resistance training (CONV) with respect to bone biomarkers and lower extremity bone strength outcomes among adults with chronic motor incomplete spinal cord injury (SCI). Design: Parallel group randomized controlled trial (www.clinicaltrials.gov - NCT0020196819). Site: Tertiary academic rehabilitation centre in Canada. Methods: Adults with chronic (≥18 months) motor incomplete SCI (C2-T12 AIS C-D) were consented and randomized to FES-T or CONV training for 45 minutes thrice-weekly for 4 months. Osteocalcin (OC), β-cross laps (CTX) and sclerostin were assessed at baseline, and 4 months. Similarly, total hip, distal femur and proximal tibia region bone mineral density (BMD) via DXA (4500A, Hologic Inc. Waltham, MA, USA) and tibia bone quality via pQCT (Stratec XCT-2000, Mezintecknik, Pforzheim, Germany) were assessed at baseline, 4, and 12 months. Between group differences were analyzed using repeated measures general linear models. Results: Thirty-four participants (17 FES-T, 17 CONV) consented and were randomized, 27 participants completed the 4-month intervention and 12-month outcome assessments. Participants in the FES-T arm had a decrease in CTX and a significant increase in OC at intervention completion (P<0.05). Significant biomarker changes were not observed in the CONV group. No within or between group differences from baseline were observed in sclerostin or bone strength. Conclusions: Four months of FES-T improved bone turnover (increase in OC and decrease in CTX) but not bone strength among individuals with chronic SCI. Future, long term FES-T may augment lower extremity bone strength.

A comparison of bite size and BMI in a cafeteria setting

Our study investigated the relationship between BMI and bite size in a cafeteria setting. Two hundred and seventy one participants consumed one meal each. Participants were free to select any food provided by the cafeteria and could return for additional food as desired. Bite weights were measured with a table embedded scale. Data were analyzed with ANOVAs, regressions, Kolmogorov-Smirnov tests, and a repeated measures general linear model for quartile analysis. Obese participants were found to take larger bites than both normal (p=0.002) and overweight participants (p=0.017). Average bite size increased by 0.20g per point increase in BMI. Food bites and drink bites were analyzed individually, showing 0.11g/BMI and 0.23g/BMI slopes, respectively. Quartiles of bites were also analyzed, and a significant interaction was found between normal and obese participants (p=0.034) such that the lower two quartiles were similar, but the upper two quartiles showed an increase in bite size for obese participants. The source of these effects could be the result of a combination of several uncontrolled factors.

In-vivo measurement of tri-axial loading at the head during the rugby tackle

ABSTRACTTo investigate the anatomical distribution of linear and rotational forces during the tackle scenario, male rugby players performed a total of 48 trials, as ball carrier or tackler. Participants wore headgear accommodating three global positioning system units measuring uniaxial acceleration at the occipital region (OR), left tempero-parietal (LT-PR) and right tempero-parietal region (RT-PR). An additional unit was located at the cervico-thoracic spinal region in a custom vest. There was a significant main effect for tackle condition (P < 0.001), with the tackler exposed to significantly greater load than the ball carrier, supporting epidemiological observations. A repeated measure general linear model also revealed a significant (P < 0.001) main effect for unit location upon 3D load, with significantly higher load at the CSR (1.63 ± 0.54 a.u.) and OR (1.67 ± 0.94 a.u.) units when compared to the LT-PR (1.23 ± 0.39 a.u.) and RT-PR (1.21 ± 0.44 a.u.) units. The anatomical specificity in loading supports epidemiological observations and provides an insight into potential concussion aetiology.

Short-Term Effects of a Ready-to-Drink Pre-Workout Beverage on Exercise Performance and Recovery.

In a double-blind, randomized and crossover manner, 25 resistance-trained participants ingested a placebo (PLA) beverage containing 12 g of dextrose and a beverage (RTD) containing caffeine (200 mg), β-alanine (2.1 g), arginine nitrate (1.3 g), niacin (65 mg), folic acid (325 mcg), and Vitamin B12 (45 mcg) for 7-days, separated by a 7–10-day. On day 1 and 6, participants donated a fasting blood sample and completed a side-effects questionnaire (SEQ), hemodynamic challenge test, 1-RM and muscular endurance tests (3 × 10 repetitions at 70% of 1-RM with the last set to failure on the bench press (BP) and leg press (LP)) followed by ingesting the assigned beverage. After 15 min, participants repeated the hemodynamic test, 1-RM tests, and performed a repetition to fatigue (RtF) test at 70% of 1-RM, followed by completing the SEQ. On day 2 and 7, participants donated a fasting blood sample, completed the SEQ, ingested the assigned beverage, rested 30 min, and performed a 4 km cycling time-trial (TT). Data were analyzed by univariate, multivariate, and repeated measures general linear models (GLM), adjusted for gender and relative caffeine intake. Data are presented as mean change (95% CI). An overall multivariate time × treatment interaction was observed on strength performance variables (p = 0.01). Acute RTD ingestion better maintained LP 1-RM (PLA: −0.285 (−0.49, −0.08); RTD: 0.23 (−0.50, 0.18) kg/kgFFM, p = 0.30); increased LP RtF (PLA: −2.60 (−6.8, 1.6); RTD: 4.00 (−0.2, 8.2) repetitions, p = 0.031); increased BP lifting volume (PLA: 0.001 (−0.13, 0.16); RTD: 0.03 (0.02, 0.04) kg/kgFFM, p = 0.007); and, increased total lifting volume (PLA: −13.12 (−36.9, 10.5); RTD: 21.06 (−2.7, 44.8) kg/kgFFM, p = 0.046). Short-term RTD ingestion maintained baseline LP 1-RM (PLA: −0.412 (−0.08, −0.07); RTD: 0.16 (−0.50, 0.18) kg/kgFFM, p = 0.30); LP RtF (PLA: 0.12 (−3.0, 3.2); RTD: 3.6 (0.5, 6.7) repetitions, p = 0.116); and, LP lifting volume (PLA: 3.64 (−8.8, 16.1); RTD: 16.25 (3.8, 28.7) kg/kgFFM, p = 0.157) to a greater degree than PLA. No significant differences were observed between treatments in cycling TT performance, hemodynamic assessment, fasting blood panels, or self-reported side effects.

The efficacy of functional supports in mediating the effects of exercise on shoulder joint position sense

BACKGROUND: Prolonged exercise and joint position sense are considered aetiological risk factors for shoulder injury in overhead sports. OBJECTIVE: To investigate the efficacy of a neoprene sleeve and kinesiology tape (KT) in mediating the effect of exercise on shoulder joint position sense. METHODS: 25 overhead sports participants (women – 10, men – 15) completed 30 maximal isokinetic repetitions at 120◦/s of three shoulder exercise protocols: 9090 (seated 90◦ shoulder abduction, 90◦ elbow flexion, modified neutral (seated 45◦ shoulder abduction, 90◦ elbow flexion in the scapular plane and diagonal (seated GHJ flexion, abduction, external rotation and extension, adduction and internal rotation. Absolute error in active reproduction of passive positioning was assessed pre- and post-exercise at 10◦/s. This was conducted for end range internal and external rotation, and mid-range. RESULTS: A repeated measures general linear model revealed no significant main effect for gender or exercise in any test position. A main effect for support condition was observed pre-exercise in the KT condition, with JPS significantly (p < 0.01) impaired (5.30 ± 2.16◦) relative to baseline control scores (4.11 ± 2.81◦) in end range external rotation at the 9090 position. CONCLUSION: Results indicated that neither neoprene nor kinesio-tape were more effective in limiting the effects of exercise on joint position sense (JPS). Healthy, un-injured overhead athletes may not need to consider taping or supportive device, indeed KT application was observed to impair JPS in specific movements.

Subcortical hyperintensities in the cholinergic system are associated with improvements in executive function in older adults with coronary artery disease undergoing cardiac rehabilitation.

ObjectiveCoronary artery disease (CAD) is frequently accompanied by white matter hyperintensities and executive dysfunction. Because acetylcholine is important in executive function, these symptoms may be exacerbated by subcortical hyperintensities (SH) located in cholinergic (CH) tracts. This study investigated the effects of SH on cognitive changes in CAD patients undergoing a 48‐week cardiac rehabilitation program.MethodsFifty patients (age 66.5 ± 7.1 years, 84% male) underwent the National Institute of Neurological Disorders and Stroke – Canadian Stroke Network neurocognitive battery at baseline and 48 weeks. Patients underwent a 48‐week cardiac program and completed neuroimaging at baseline. Subcortical hyperintensities in CH tracts were measured using Lesion Explorer. Repeated measures general linear models were used to examine interactions between SH and longitudinal cognitive outcomes, controlling for age, education, and max VO2 change as a measure of fitness.ResultsIn patients with SH in CH tracts, there was a significant interaction with the Trail Making Test (TMT) part A and part B over time. Patients without SH improved on average 16.6 and 15.0% on the TMT‐A and TMT‐B, respectively. Patients with SH on average showed no improvements in either TMT‐A or TMT‐B over time. There were no significant differences in other cognitive measures.ConclusionThese results suggest that CAD patients with SH in CH tracts improve less than those without SH in CH tracts, over 48 weeks of cardiac rehabilitation. Thus, SH in CH tracts may contribute to longitudinal cognitive decline following a cardiac event and may represent a vascular risk factor of cognitive decline. © 2017 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.

Effect of dalteparin administration on thrombin generation kinetics in healthy dogs.

Dalteparin is used to prevent thrombotic complications in dogs. Measurement of anti-factor Xa (anti-FXa) activity is currently used for monitoring therapy, but remains a nonfunctional test. The calibrated automated thrombogram (CAT) could be a suitable approach for functional monitoring. We hypothesized that the CAT will detect decreased endogenous thrombin potential (ETP) in healthy dogs receiving dalteparin. Twenty-four healthy adult Beagles were randomly allocated to 4 equal groups. A single subcutaneous (SC) dose of 50 U/kg, 100 U/kg, or 150 U/kg of dalteparin was given. Platelet-poor plasma (PPP) was collected over a 24-hour period and evaluated by thrombin generation (TG) via CAT, anti-FXa activity, and APTT. Analysis was performed with a repeated-measures general linear mixed model, and the treated groups were compared to a placebo group. Time, dose, and time-dose interaction significantly affected ETP (P < .0001 for all effects), peak (P < .0001 for all effects), rate index (P < .0006 for all effects), and anti-FXa activity (P < .0001 for all effects). No significant time trend was detected in the control group. Dogs receiving the 100 U/kg dalteparin SC injection showed the most homogeneous response of ETP inhibition among treated groups. The % inhibition of ETP from baseline increased nonlinearly as a function of anti-FXa activity (r2 = .8186). The CAT assay can be employed to measure the effects of dalteparin at different doses in healthy dogs, showing sensitivity to time- and dose-dependent changes in ETP and other TG variables. Further investigation of the CAT as a tool for monitoring low molecular weight heparin therapy in dogs is warranted.

Citicoline Combination Therapy for Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial.

Residual symptoms of major depressive disorder are a source of long-term morbidity. New therapeutic strategies are required to alleviate this morbidity and enhance patient quality of life. Citicoline has been used for vascular accidents and has been effective in cognitive rehabilitation. It has been used successfully to reduce craving in patients with substance abuse disorder and for mood management of bipolar disorder. Here, we test citicoline effectiveness as an adjuvant therapy in major depression. A double-blind randomized trial was designed on 50 patients with major depressive disorder who were under treatment with citalopram. Patients were allocated to 2 groups and received citicoline (100 mg twice a day) or placebo as an adjuvant treatment for 6 weeks. Depressive symptoms were assessed by the Hamilton Depression Rating Scale (HDRS) at baseline and at weeks 2, 4, and 6. Significantly greater improvement was observed in the HDRS scores of the citicoline group compared with the placebo group from baseline to weeks 2, 4, and 6 (Ps = 0.030, 0.032, and 0.021, respectively). Repeated-measures general linear model demonstrated a significant effect for time × treatment interaction on the HDRS score (F2.10,101.22 = 3.12, P = 0.04). Remission rate was significantly higher in the citicoline group compared with the placebo group (P = 0.045). Citicoline was an effective adjuvant to citalopram in the therapy of major depressive disorder.

An industry experiment on the effects of test-driven development on external quality and productivity

Existing empirical studies on test-driven development (TDD) report different conclusions about its effects on quality and productivity. Very few of those studies are experiments conducted with software professionals in industry. We aim to analyse the effects of TDD on the external quality of the work done and the productivity of developers in an industrial setting. We conducted an experiment with 24 professionals from three different sites of a software organization. We chose a repeated-measures design, and asked subjects to implement TDD and incremental test last development (ITLD) in two simple tasks and a realistic application close to real-life complexity. To analyse our findings, we applied a repeated-measures general linear model procedure and a linear mixed effects procedure. We did not observe a statistical difference between the quality of the work done by subjects in both treatments. We observed that the subjects are more productive when they implement TDD on a simple task compared to ITLD, but the productivity drops significantly when applying TDD to a complex brownfield task. So, the task complexity significantly obscured the effect of TDD. Further evidence is necessary to conclude whether TDD is better or worse than ITLD in terms of external quality and productivity in an industrial setting. We found that experimental factors such as selection of tasks could dominate the findings in TDD studies.

Correlation between salivary alpha-amylase, anxiety, and game records in the archery competition.

[Purpose]This study was aimed to investigate the relationship between psychological and physiological changes and performance in archery, which is strongly influenced by psychological factors including concentration, tension, anxiety, and stress.[Methods]A total of 19 athletes from women’s colleges who participated in the 30 m individual competition at the 34th President’s Cup National Archery Competition in July 2016 were included in this study. The anxiety levels of the participants were assessed on a 10-point Likert scale, with 1 corresponding to “not at all” and 10 to “extremely anxious.” Saliva samples were collected as follows: 10 min before the game (pre-10), 1 min before the game (pre-1), and 10 min after the game (post-10). Repeated measures general linear model ANOVA was performed to compare the mean values of salivary alpha amylase (sAA) concentrations and anxiety levels. The correlations between sAA, anxiety, and game records were analyzed using the Pearson’s correlation method.[Results]The sAA concentrations increased significantly in pre-1 and post-10, but not in pre-10 samples. Moreover, anxiety levels increased in both pre-1 and post-10 samples, but not in pre-10 samples. Anxiety and sAA were positively correlated (p < 0.01), while sAA and game records, or anxiety and game record were negatively correlated (p < 0.01).[Conclusion]During the archery competition, the level of cognitive anxiety increased, sAA concentrations increased, and performance decreased. The study findings suggest that during archery competitions, anxiety hinders performance, and this effect may be related to the increase in sAA levels.

Cognitive Decline in Relation to Psychological Wellbeing and HIV Disease- and Treatment Characteristics in HIV-Infected Patients on cART: A One-Year Follow-Up Study

The objectives of the current study were to examine cognitive decline in relation to psychological wellbeing, HIV disease and treatment characteristics and baseline variables over a one-year period of time in a group of HIV-infected patients on long term cART with undetectable viral load in comparison to a HIV-negative control group. Eighty-two of 95 patients and 43 of 55 controls who completed a baseline assessment for the Art-NeCo study underwent a follow-up neuropsychological assessment. A repeated-measure general linear model analysis was performed to compare the performance at follow-up in comparison to baseline between the patients and controls. Reliable change indices were computed as a measure of significant change in cognitive function. Compared to controls, patients overall performed worse on the domain speed of information processing. In the patient group a worse performance at follow-up was present for the verbal fluency domain compared to the controls, in the absence of a baseline group difference. For the executive function domain, no group differences were found at follow-up, but the patients performed worse than the controls at baseline. We found that cognitive decline was related to more frequent use of recreational drugs and a somewhat heightened level of irritability and more somatic complaints at baseline. However, the decliners did not differ from the non-decliners on any of the HIV-related variables.