Repeated Measures Analysis Of Variance Research Articles

Feasibility of Simultaneous Anodal Transcranial Direct Current Stimulation During Gait Training in Chronic Stroke Patients: A Randomized Double-Blind Pilot Clinical Trial.

Transcranial direct current stimulation (tDCS) is a therapeutic tool for improving post-stroke gait disturbances, with ongoing research focusing on specific protocols for its application. We evaluated the feasibility of a rehabilitation protocol that combines tDCS with conventional gait training. This was a randomized, double-blind, single-center pilot clinical trial. Patients with unilateral hemiplegia due to ischemic stroke were randomly assigned to either the tDCS with gait training group or the sham stimulation group. The anodal tDCS electrode was placed on the tibialis anterior area of the precentral gyrus while gait training proceeded. Interventions were administered 3 times weekly for 4 weeks. Outcome assessments, using the 10-meter walk test, Timed Up and Go test, Berg Balance Scale, Functional Ambulatory Scale, Modified Barthel Index, and European Quality of Life 5 Dimensions 3 Level Version, were conducted before and after the intervention and again at the 8-week mark following its completion. Repeated-measures analysis of variance (ANOVA) was used for comparisons between and within groups. Twenty-six patients were assessed for eligibility, and 20 were enrolled and randomized. No significant differences were observed between the tDCS with gait training group and the sham stimulation group in gait speed after the intervention. However, the tDCS with gait training group showed significant improvement in balance performance in both within-group and between-group comparisons. In the subgroup analysis of patients with elicited motor-evoked potentials, comfortable pace gait speed improved in the tDCS with gait training group. No serious adverse events occurred throughout the study. Simultaneous anodal tDCS during gait training is a feasible rehabilitation protocol for chronic stroke patients with gait disturbances. URL: https://cris.nih.go.kr; Registration number: KCT0007601; Date of registration: 11 July 2022.

The Immediate Effects of a Standardized Kettlebell Swing Protocol on Lumbar Paraspinal Muscle Function: A Randomized Controlled Trial.

Hanney, WJ, Perez, A, Collado, G, Palmer, AC, Wilson, AT, Richardson, RM, and Kolber, MJ. J Strength Cond Res XX(X): 000-000, 2024-Kettlebell swings (KBSs) are commonly used to target the lumbar erector spinae and lower body musculature. This exercise exhibits distinct loading properties that requires cyclical contraction of the trunk extensors and posterior chain, potentially explaining its novel influence on muscle contractility. Tensiomyography (TMG) is a reliable, noninvasive, passive technique that may be used to examine muscular fatigue produced by exercises such as KBSs. The purpose of this randomized control trial was to determine the extent of muscle fatigue in the lumbar erector spinae musculature following the performance of a previously published high-intensity interval KBS protocol. Forty-one adults between the ages of 18 and 45 years were recruited. Inclusion criteria included subjects with no recent history of low back pain and clearance by the physical activity readiness questionnaire. Subjects were randomly allocated to either a KBS group (n = 21) or a control group (CON; n = 20) who only performed the unloaded warm-up. Subjects were assessed at baseline, postintervention, and 24-hours postintervention for bilateral erector spinae fatigue, measured by 5 TMG parameters (Dm, Tc, Tr, Td, and Ts). The results were evaluated through a 2 × 3 (group × time) repeated-measures analysis of variance. The level of significance was set at p ≤ 0.05. There was no significant difference in lumbar erector spinae fatigue, measured by the 5 TMG parameters (p ≥ 0.079), following the interval KBS protocol in comparison with the CON group at 3 assessment periods. A high-intensity interval KBS protocol failed to produce significant differences in erector spinae fatigue compared with the control group that did not perform a KBS. These findings warrant further investigation into muscle fatigue produced with higher intensity protocols and possibly suggest, depending on the programming goals, the need for an alternate KBS training parameters.

Effect of Zinc and Vitamin E on Blood Testosterone and Inflammatory Markers in Male Patients Undergoing Heart Surgery

Background: Zinc and vitamin E affect the metabolism of testosterone and inflammatory factors. We aimed to evaluate the effect of zinc and vitamin E supplementation on plasma testosterone levels and inflammatory markers in patients undergoing coronary artery bypass graft (CABG) surgery. Methods: This study was a secondary analysis of a previously published randomized controlled trial in a subsample of male patients undergoing CABG surgery. Patients in the zinc-vitamin E group (n = 27) received oral zinc (120 mg) and vitamin E (1200 international units) one day prior to surgery, followed by 30 mg of zinc and 200 units of vitamin E per day for three weeks after surgery. Patients in the control group (n = 25) received a placebo. Plasma levels of total testosterone, cortisol, interleukin-6 (IL-6), and white blood cell toll-like receptor-4 (TLR-4) gene expression were determined at three-day and three-week intervals following surgery. Changes in these markers were analyzed using a repeated-measures analysis of variance. Results: A comparison of the groups revealed no significant difference in the concentration of plasma total testosterone levels (P = 0.059) or cortisol. Three weeks following the surgical procedure, a positive correlation was observed between the change in plasma zinc concentrations and the change in plasma testosterone levels (r = 0.32; P = 0.025). The administration of zinc and vitamin E supplements resulted in a reduction in plasma IL-6 levels on postoperative day 3 (P = 0.025), while no significant effect was observed in week 3 (P = 0.091). The expression of the TLR-4 gene in WBCs was found to be lower in the zinc-vitamin E group compared to the placebo group on day 3 (P = 0.051) and week 3 (P = 0.025). Conclusions: The administration of zinc and vitamin E to patients undergoing CABG was associated with a relative improvement in postoperative inflammatory markers. Plasma zinc levels demonstrated a correlation with testosterone levels, suggesting a potential avenue for further research in these patients.

Enamel Deproteinization or Sandblasting for Enamel Reconditioning Before Acid Etching to Enhance the Shear Bond Strength of Metallic Brackets in a Third Bonding: An In Vitro Study.

Enamel conditioning with 37% phosphoric acid is the most common technique during orthodontic bracket bonding procedures. However, due to the repeated de-bonding of the orthodontic brackets during treatment, other methods were needed to condition the enamel surface and increase the bond strength. This study aimed to compare the effect of conditioning the enamel surface by sandblasting with aluminum oxide particles or 5.25% sodium hypochlorite gel in combination with acid etching compared to acid etching alone on shear bond strength (SBS). One hundred eight extracted upper premolars were randomly divided into three groups according to the conditioning enamel surface method. After the first and second bonding of metal brackets, new metal brackets were bonded with a total-etching adhesive after enamel conditioning using different methods: acid etching only (37% phosphoric acid for 30 seconds) (AE group), sodium hypochlorite associated with acid etching (5.25% NaOCl gel for 60 seconds and then acid etching for 30 seconds) (NaOCl-AE group), and sandblasting associated with acid etching (sandblasting for five seconds and then acid etching for 30 seconds) (SB-AE group). The shear bond strengths of the brackets were tested with a universal testing machine. One-way analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD) tests were used to detect significant differences in shear bond strength among groups at the third bonding. Repeated-measure ANOVA and Bonferroni's tests were used to detect significant differences in shear bond strength among the bonding attempts within each group. 5.25% sodium hypochlorite associated with the acid etching method produced significantly greater shear bond strength than sandblasting associated with acid etching and acid etching only methods at the third bonding (16.40 ± 5.80 MPa, 13.60.47 ± 6.40 MPa, and 9.90 ± 4.40 MPa, respectively; P < 0.001). However, there was no significant difference between the AE and SB-AE groups (P = 0.247). In addition, we found a significant decrease in the shear bond strength within each group after each bonding attempt. Conditioning the enamel surface with 5.25% sodium hypochlorite associated with acid etching produced greater bond strength than conditioning by sandblasting associated with acid etching and acid etching only at the third bonding. The bond strength of the metal bracket decreased with increasing bonding attempts, even with the application of enamel surface conditioning methods.

Developing Children's Motor Skills by Having Fun With Orff's Approach.

Environmental factors have a clear effect on children's motor development and can be manipulated; while biological factors are also powerfully influential, they are more resistant to intervention. Especially in restrictive environments (e.g., the recent pandemic-related shutdown), there can be increased importance to simple, fun, at-home, indoor programs. In this study, we investigated the effects on motor skill development of a movement education program based on the Orff approach, which has long been used in music education. This was an experimental research design involving 78 children, aged 6-7years old, in two groups (Control Group, n = 39; Experimental Group, n = 39). We used a simple randomization method to determine the groups. We measured the children's skill levels with the Test of Gross Motor Development-2 (TGMD-2), and we analyzed data using 2 × 2 repeated-measures analyses of variance (ANOVA). Our results revealed significantly greater improvement in the children's scores on object control (p < .001), locomotor skills (p < .001), and total TGMD-2 (p < .001) in the experimental group than in the control group. Thus, programs designed with music and rhythm can help ensure that children have fun and are better motivated to participate in activities that have a positive effect on their motor skills.

Irreversible electroporation of localised prostate cancerdownregulates immune suppression andinduces systemic anti-tumour T-cell activation - IRE-IMMUNO study.

To prospectively compare systemic anti-tumour immune responses induced by irreversible electroporation (IRE) and robot-assisted radical prostatectomy (RARP) in patients with localised intermediate-risk prostate cancer (PCa). Between February 2021 and June 2022, before and after treatment (at 5, 14 and 30 days) peripheral blood samples of 30 patients with localised PCa were prospectively collected. Patient inclusion criteria were: International Society of Urological Pathologists Grade 2-3, clinical cancer stage ≤T2c, prostate-specific antigen level <20 ng/mL). Patients were treated with IRE (n = 20) or RARP (n = 10). Frequency and activation status of lymphocytic and myeloid immune cell subsets were determined using flow cytometry. PCa-specific T-cell responses to prostatic acid phosphatase(PSAP) and cancer testis antigen (New York oesophageal squamous cell carcinoma 1 [NY-ESO-1]) were determined by interferon-γ enzyme-linked immunospot assay (ELISpot). Repeated-measures analysis of variance and two-sided Student's t-tests were used to compare immune responses over time and between treatment cohorts. Patient and tumour characteristics were similar between the cohorts except for age (median 68 years [IRE] and 62 years [RARP], P = 0.01). IRE induced depletion of systemic regulatory Tcells (P = 0.0001) and a simultaneous increase in activated cytotoxic T-lymphocyte antigen 4 (CTLA-4)+ cluster of differentiation (CD)4+ (P < 0.001) and CD8+ (P = 0.032) Tcells, consistent with reduction of systemic immune suppression allowing for effector T-cell activation, peaking 14 days after IRE. Effects were positively correlated with tumour volume/ablation size. Accordingly, IRE induced expansion of PSAP and/or NY-ESO-1 specific T-cell responses in four of the eight immune competent patients. Temporarily increased activated myeloid derived suppressor cell frequencies (P = 0.047) were consistent with transient immunosuppression after RARP. Irreversible electroporation induces a PCa-specific systemic immune response in patients with localised PCa, aiding conversion of the tumour microenvironment into a more immune permissive state. Therapeutic efficacy might be further enhanced by combination with CTLA-4 checkpoint inhibition, potentially opening up a new synergistic treatment paradigm for high-risk localised or (oligo)metastatic disease.

MRI versus Two- and Three-Dimensional CT Scans for Assessment of Glenoid Inclination and Version

IntroductionAccurate glenoid component placement is crucial for anatomic (TSA) or reverse (RSA) total shoulder arthroplasty. Preoperative glenoid assessment by using CT scans with or without planning software seems to be the established method to plan implant positions. MRI scans can also display the glenoid bone for preoperative assessment while reducing radiation exposure. Therefore, the objective of this study was to manually assess the glenoid version and inclination in 2D MRI and CT scans in cases with degenerative shoulder pathologies. The results were compared to those of an automated 3D planning software to validate the imaging modality for preoperative glenoid assessment. MethodsMRI and CT scans of 146 patients (n=41 aTSA; n=105 RSA) were included in this retrospective, single-center study. Glenoid version and inclination were measured manually according to Friedman et al and Maurer et al on CT and MRI scans by two observers. Subsequently, the results were compared to the automated measurements performed by a planning software. A repeated-measures analysis of variance (ANOVA) was performed to compare the measured angles and interobserver and intraobserver reliability was calculated using the intraclass correlation coefficients. The level of significance was set p<0.05. ResultsThe average glenoid inclination measured in CT scans was 7.94°±7.33°, in MRI scans 8.56°±7.34° and in automated planning software 7.87°±7.60°. The ANOVA analysis revealed significant differences in mean inclination between 2D MRI and 2D CT (p<0.0005) and between MRI and automated software (p=0.011). No significant difference was found between 2D CT scans and automated planning software (p=1.000). Mean glenoid version measured in 2D CT scans was -7.94°±10.86°, in 2D MRI scans it was -8.04°±10.80° and -8.32°±11.53° by the automated planning software. There was no significant difference in between measurement methods (p = 0.339). Interobserver error analysis showed no statistical differences between the two observers. All measurements had excellent intraobserver reliability. ConclusionPreoperative assessment of glenoid version and inclination is crucial in ensuring precise implant positioning and orientation in TSA and RSA. This study observed a significant level of concordance between manual and automated measuring techniques utilizing MRI and CT scans. Mean glenoid inclination exhibited a statistically significant difference of less than 1° across the assessment modalities and no difference for glenoid version was noted. It seems to be questionable if this finding is clinically relevant. MRI may serve as a viable and safe option for assessing glenoid morphology, version and inclination if CT scans are not available.

Influence of Carotid Artery Stenting on the Retina and Choroid.

The effect of carotid artery stenting in patients with unilateral carotid artery stenosis on the retina and choroid was evaluated using swept-source optical coherence tomography angiography (SS-OCTA). SS-OCTA examination was conducted before stenting and 4days and 3months after stenting. The retinal nerve fiber layer, ganglion cell-inner plexiform layer (GCIPL), inner nuclear layer, superficial vascular complex (SVC), deep vascular complex (DVC), choroidal vascular volume (CVV), and choroidal vascular index were measured. Repeated-measures analysis of variance was performed to assess the impact of carotid artery stenting on optical coherence tomography angiography (OCTA) metrics. At baseline, 303 eyes from 160 patients (61.82 ± 9.98years; 85.29% males) were enrolled. SVC and DVC densities and CVV were lower in ipsilateral eyes (stenosed side) compared to contralateral eyes (all P < 0.05). Four days after stenting, a significant increase was seen in SVC density in ipsilateral eyes (P < 0.05) while a significant increase was seen in CVV in ipsilateral eyes and contralateral eyes (both P < 0.05). Three months after stenting (63 patients with 114 eyes), a significant decrease was seen in the GCIPL thickness of ipsilateral and contralateral eyes (all P < 0.001). Short term after carotid artery stenting, ipsilateral eyes showed a rapid and significant increase in SVC density and CVV. Optical coherence tomography (OCT)/OCTA measurements may have the potential to detect retinal and choroidal changes after stenting. Future research on the long-term effect of stenting on the retina and choroid will be guided by these findings.

Trajectory of Pelvic Floor Muscle Training Adherence in Chinese Women with Postpartum Stress Urinary Incontinence and Its Related Factors: A Longitudinal Study

ObjectiveNumerous studies have shown that pelvic floor muscle training (PFMT) adherence in women with postpartum stress urinary incontinence is low and influenced by many factors. However, most previous studies have been cross-sectional studies on PFMT adherence. Neglecting physiological and psychological recovery after childbirth may lead to changes in the adherence to PFMT. This longitudinal study investigated the developmental trajectory of PFMT adherence at 8, 10, and 12 weeks postpartum and the associated factors in China. MethodsA total of 213 women with postnatal stress urinary incontinence who visited the obstetric pelvic floor clinic of a Grade A tertiary specialist maternity hospital in Beijing, China between January 2018 and January 2019 were selected. Compliance levels were measured using PFMT compliance questionnaires at 8, 10, and 12 weeks postpartum. Data on self-efficacy, postpartum social support, and other influencing factors were collected at 12 weeks postpartum. Differences in PFMT compliance scores were analyzed using repeated-measures analysis of variance. Multiple stepwise linear regression analyses were used for multivariate analysis. ResultsThe PFMT compliance scores at 8, 10, and 12 weeks postpartum were 13.47 ± 4.42, 10.76 ± 4.46, and 7.95 ± 5.54, which were at a moderate level and showed a decreasing trend over time. Multiple stepwise line regression analysis showed that the factors influencing compliance with PFMT in women with postpartum stress urinary incontinence were knowledge, belief, and practice of pelvic floor function training (t=4.251, P<0.001), postpartum social support level (t=4.304, P<0.001), and self-efficacy level of PFMT (t=8.577, P<0.001). ConclusionThe PFMT compliance of Chinese women with postpartum stress urinary incontinence was moderate, with a downward trend. More effective methods should be chosen to improve women’s PFMT compliance based on their situation, such as improving patient self-efficacy, social support, and knowledge.

Effects of peer tutoring-based simulation education on caring for children with respiratory infections among nursing students: A mixed-methods study

BackgroundRespiratory infections are common in children and can quickly deteriorate, necessitating vigilant nursing care. Simulation training provides a valuable tool for nursing students to learn how to manage children with respiratory infections. Peer tutoring has demonstrated benefits, including the creation of a safe, supportive learning environment and the perception of peer tutors as beneficial role models. This study aimed to develop a simulation education program for the care of children with respiratory infections, involving peer tutoring among nursing students, and to assess its effectiveness. MethodsThis mixed-methods study, conducted between July and December 2022, utilized surveys to gather both quantitative and qualitative data. A peer tutoring-based simulation education program for providing care to children with respiratory infections was developed specifically for nursing students. The study was implemented with 49 nursing students from a South Korean university (25 in the experimental group and 24 in the control group). The students' self-efficacy, disposition towards critical thinking, problem-solving ability, and satisfaction with practice were evaluated and analyzed using the unpaired t-test, the chi-square test, and repeated-measures analysis of variance. The learning experiences of the students in the experimental group were further examined using qualitative content analysis. ResultsThe experimental group demonstrated greater growth in self-efficacy and satisfaction with practice than the control group. However, no significant difference was observed between the experimental and control groups in terms of changes in disposition towards critical thinking and problem-solving ability. From the nursing students who participated in the implementation, three categories were identified: “enhancement of learning,” “psychologically secure environment,” and “novel experience.” ConclusionsThe peer tutoring-based simulation education focused on caring for children with respiratory infections effectively improved the self-efficacy and satisfaction of nursing students. This method will be utilized to enhance the learning experience of nursing students in the field of pediatric respiratory care.

The effect of progressive muscle relaxation exercises on postmenopausal sleep quality and fatigue: a single-blind randomized controlled study.

This single-blind, randomized controlled study aimed to determine the effect of progressive muscle relaxation exercises on sleep quality and fatigue in the postmenopausal period. Progressive muscle relaxation aims to relax the muscles in the body and includes breathing techniques. This study was carried out between January 2022 and July 2022 with 63 postmenopausal women who applied to a district state hospital and had poor sleep quality. The women assigned to the experimental group (EG) (n = 31) applied progressive muscle relaxation exercises every day for 8 weeks. In contrast, the women in the control group (CG) (n = 32) continued their routine coping habits related to sleep problems and fatigue in the postmenopausal period. The EG and CG were reevaluated using the Piper Fatigue Scale and the Pittsburg Sleep Quality Index in the fourth and eighth weeks. The women applied progressive muscle relaxation exercises with a guide prepared by the researchers and the compact disc of the Turkish Psychologists Association. In the data analysis, the independent-samples t test, Fisher's exact test, and χ2 test were used to compare individual, obstetric, and medical characteristics between the groups. The difference between dependent groups at different times was evaluated by repeated-measures analysis of variance. There was an improvement in fatigue symptoms in the progressive muscle relaxation exercises-performing EG at the end of 8 weeks compared with the CG, and fatigue symptoms increased in the CG (P < 0.001). There was a greater improvement in the sleep quality of the progressive muscle relaxation exercises-performing EG at the end of 8 weeks compared with the CG (P < 0.001). In our study, it was determined that progressive muscle relaxation exercises had an improving effect on sleep quality and fatigue.

Kinetics and Kinematics of the Push Press, Push Jerk, and Split Jerk.

Abstract Soriano, MA, Jiménez-Ormeño, E, Lake, JP, McMahon, JJ, Gallo-Salazar, C, Mundy, P, and Comfort, P. Kinetics and kinematics of the push press, push jerk, and split jerk. J Strength Cond Res 38(8): 1359–1365, 2024—The aim of this study was to explore the kinetics and kinematics across incremental loads with the push press (PP), push jerk (PJ), and split jerk (SJ). Eighteen resistance-trained men performed the 1 repetition maximum (1RM) tests (visit 1) 3–7 days before an incremental loading protocol (60, 75, and 90% 1RM) of the 3 exercises (visit 2). Kinetics and kinematics were derived from force-time data and compared using a repeated-measures analysis of variance with load and exercise as within-subject factors. Dependent variables for the biomechanics assessment were categorized as output (power and impulse), driver (force and work), and strategy (displacement and duration) metrics. The interrepetition reliability was assessed using the intraclass correlation coefficient and coefficient of variation. The PP, PJ, and SJ 1RM performance were 89.7 ± 15.4, 95.6 ± 14.4, and 103.0 ± 16.9 kg, respectively. Driver, strategy, and outcome metrics displayed moderate-to-excellent (intraclass correlation coefficient: 0.58–0.98) reliability with acceptable variability (% coefficient of variation: 2.02–10.00). Increased load resulted in significantly large increases in force, work, displacement, duration, power, and impulse (p &lt; 0.001, = 0.534–0.903). Exercise selection had a significant and large effect on power, impulse, work, and force (p &lt; 0.016, = 0.387–0.534). There was a significant and large effect of load × exercise interaction on work, displacement, and duration (p &lt; 0.019, = 0.158–0.220). Practitioners are encouraged to use heavier loads (90 &gt; 75 &gt; 60% 1RM) during the SJ exercise to maximize output, driver, and strategy kinetics and kinematics.

Improvement in scar appearance with the usage of silicone gel containing vitamin C for pediatric Asian patients

Background Silicone gel has been introduced as a preventive measure for scarring, yet there is limited objective evidence supporting its effectiveness in the healing of pediatric traumatic scars. This study aimed to evaluate the impact of silicone gel enriched with vitamin C on facial scars in Asian pediatric patients.Methods Pediatric patients aged 3 months to 12 years who underwent debridement and primary repair for simple facial lacerations were included in this study. A topical silicone gel mixture containing vitamin C was applied from the time of stitch removal until 6 months post-operation. Scars were evaluated at baseline, 1-, 3-, and 6-month post-application using a simplified version of the Vancouver Scar Scale, which assessed vascularity, pigmentation, and height. Scar color and pigmentation were quantified using a spectrophotometer, with comparisons to the symmetrical area on the opposite side of the scar. Statistical analysis was conducted using the Student t-test and repeated-measures analysis of variance, with post hoc testing for pairwise comparisons.Results Of the participants, 33 were men, and 19 were women. By 6 months, there was a significant improvement in the scar score on the Vancouver Scar Scale across all parameters. The erythema index showed a statistically significant decrease at each timeline (P&lt;0.001). Similarly, the melanin index demonstrated a significant difference between the baseline and 6 months (P&lt;0.001).Conclusions The topical application of silicone gel containing vitamin C significantly improved the appearance of fine surgical scars on the face in Asian pediatric patients.

The color-matching ability of single-shade universal composites in extracted human teeth.

To evaluate the color-match with extracted natural teeth of three single-shade universal composites, a group-shade universal composite, and a highly translucent-shade conventional composite. Twenty extracted human teeth were divided into light- and dark-shade groups (n = 10, LSG and DSG). A preparation was restored with the 3 single-shade universal composites, OMNICHROMA (OMC), Admira Fusion x-tra U (AFU), and Essentia U (ESU); a highly translucent-shade conventional composite, Tetric EvoCeram T (TEC-T); and two shades of a group-shade universal composite-Filtek Universal Restorative (FUR A1 and A4). Composites were photopolymerized, polished, and stored in water for 24 h. The ΔE00 value between the unprepared and restored surfaces was obtained using a spectrophotometer. Composite placement and measurements were repeated three times per tooth. Color differences were statistically analyzed with the within-between-subjects t-test and repeated-measures analysis of variance (ANOVA), followed by post hoc pairwise comparisons with a Bonferroni adjustment (α = 0.05). There were no statistically significant differences between OMC and FUR (A1 and A4). AFU and ESU showed significantly higher ΔE00 values than OMC and TEC-T (p < 0.05). Single-shade composites exhibited significantly higher ΔE00 values in the DSG than in the LSG except ESU (p < 0.05). None of the composites satisfied the criteria for an acceptable match (ΔE00 >1.8). OMC showed the same color matching ability as a group-shade universal composite. A highly translucent-shade conventional composite and OMC exhibited better color matching ability than other single-shade composites. Overall, single-shade universal composites performed better in lighter-shaded teeth. Single-shade universal composites have the potential to reduce chair time by eliminating shade selection in cavities with lighter-shade teeth. Highly translucent incisal conventional composites also may be used if the appropriate shade of composite is not available.

Effect of shade and thickness on the microhardness of resin-based composite specimens at different points considering curing light beam’s inhomogeneity

BackgroundRecent studies have reported the inhomogeneity in the light emitted by dental light-curing units (LCUs). It is essential to understand how this uneven light distribution affects the physical properties of resin-based composites (RBCs) at various points across their surfaces. This study aimed to evaluate the effect of LCU beam’s inhomogeneity on the microhardness of RBCs with different shades and thicknesses.MethodsFour body (A1B, A2B, A3B, and A4B), one dentin (A3D), and one enamel shade (A3E) of RBC (Filtek Z350 XT) were examined. The specimens were fabricated in four thicknesses (1, 2, 3, and 4 mm) and subjected to a 40-second light-curing. Vickers microhardness testing was performed at the center point, and 3 mm left and right from the center at the bottom surface of each sample. The LCU beam profile was characterized using a beam profiler, while irradiance after specimen passage was measured using a spectrometer. One-way analysis of variance (ANOVA) and Tukey’s post-hoc tests were used to analyze the effects of shades and thicknesses on irradiance and microhardness, respectively. One-way repeated-measures ANOVA was used to compare the microhardness across different points. Pearson’s correlation analysis examined the relationship between irradiance and microhardness.ResultsThe beam profile of LCU revealed inhomogeneous light distribution. Light irradiance was decreased with both the increase in thickness and darker shade of the specimens (p < 0.05). Microhardness was found to decline with an increase in sample thickness (p < 0.05), and was consistently higher at the center point compared to the periphery, particularly in thicker (3 and 4 mm) and darker shades (A3B, A4B, and A3D). A positive correlation was found between the irradiance and microhardness across all evaluated points (p < 0.05).ConclusionsInhomogeneous light emission from LCU significantly influences the microhardness of RBC samples, depending on the thicknesses and shades. The findings underline the importance of considering LCU beam inhomogeneity in clinical settings to ensure optimal polymerization of RBC.

Immune and neural response to acute social stress in adolescent humans and rodents

Studies in adults have linked stress-related activation of the immune system to the manifestation of psychiatric conditions. Using a translational design, this study aimed to examine the impact of social stress on immune activity in adolescents and on neuronal activity in a preclinical mouse model. Participants were 31 adolescents (ages 12–19), including 25 with mood and anxiety symptoms. Whole-blood samples were collected before and after the Trier Social Stress Test (TSST), a stress-inducing public speaking task, then cultured for 6 hours in the presence and absence of the inflammatory endotoxin lipopolysaccharide (LPS). Effects of TSST and LPS on 41 immune biomarkers were examined using repeated-measures analysis of variance. Separately, juvenile (8-week-old) male mice were non-stressed or exposed to reminder social defeat then intraperitoneally injected with saline or LPS (n = 6/group). Brains were perfused and collected for immunohistochemistry and confocal microscopy at 0, 1, 6, and 24 hours post-injection. The activity was determined by the density of cFos-positive neurons in the paraventricular hypothalamus, paraventricular thalamus, and basolateral amygdala, regions known to show sustained activation to immunological challenge. Analyses in the adolescent study indicated a strong effect of LPS but no effects of TSST or TSST×LPS interaction on immune biomarkers. Similarly, reminder social defeat did not induce sustained neuronal activity changes comparable to LPS immunological challenge in juvenile mice. Our convergent findings across species suggest that the acute immune response to stress documented in adults is not present in youth. Thus, aging and chronicity effects may play an important role in the inflammatory response to acute psychosocial stress.

Linking Invasive and Noninvasive Brain Stimulation in Parkinson's Disease: A Randomized Trial.

Recent imaging studies identified a brain network associated with clinical improvement following deep brain stimulation (DBS) in Parkinson's disease (PD), the PD response network. This study aimed to assess the impact of neuromodulation on PD motor symptoms by targeting this network noninvasively using multifocal transcranial direct current stimulation (tDCS). In a prospective, randomized, double-blinded, crossover trial, 21 PD patients (mean age 59.7 years, mean Hoehn & Yahr [H&Y] 2.4) received multifocal tDCS targeting the a-priorinetwork. Twenty-minute sessions of tDCS and sham were administered on 2 days in randomized order. Movement Disorder Society-Unified Parkinson's Disease Rating Scale-Part III (MDS-UPDRS-III) scores were assessed. Before intervention, MDS-UPDRS-III scores were comparable in both conditions (stimulation days: 37.38 (standard deviation [SD] = 12.50, confidence interval [CI] = 32.04, 42.73) vs. sham days: 36.95 (SD = 13.94, CI = 30.99, 42.91), P = 0.63). Active stimulation resulted in a reduction by 3.6 points (9.7%) to 33.76 (SD = 11.19, CI = 28.98, 38.55) points, whereas no relevant change was observed after sham stimulation (36.43 [SD = 14.15, CI = 30.38, 42.48], average improvement: 0.5 [1.4%]). Repeated-measures analysis of variance (ANOVA) confirmed significance (main effect of time: F(1,20)=4.35, P < 0.05). Tukey's post hoc tests indicated MDS-UPDRS-III improvement after active stimulation (t [20] = 2.9, P = 0.03) but not after sham (t [20] = 0.42, P > 0.05). In a subset of patients that underwent DBS surgery later, their DBS response correlated with tDCS effects (R = 0.55, P(1) = 0.04). Noninvasive, multifocal tDCS targeting a DBS-derived network significantly improved PD motor symptoms. Despite a small effect size, this study provides proof of principle for the successful noninvasive neuromodulation of an invasively identified network. Future studies should investigate repeated tDCS sessions and their utility for screening before DBS surgery. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

The Effect of Traditional Strength Training on Sprint and Jump Performance in 12- to 15-Year-Old Elite Soccer Players: A 12-Month Controlled Trial.

Skratek, J, Kadlubowski, B, and Keiner, M. The effect of traditional strength training on sprint and jump performance in 12- to 15-year-old elite soccer players: a 12-month controlled trial. J Strength Cond Res XX(X): 000-000, 2024-The aim of the study was to evaluate the effect of traditional strength training on maximum strength (1 repetition maximum in front squat [FS] and back squat [BS]), jump (squat and countermovement jump), and linear sprint (LS) performance (5, 10, and 30 m) in elite young soccer players. A 12-month longitudinal design was chosen, and 48 elite male youth soccer players (age: 12-15 years) were included. The subjects were divided in 2 groups (a strength training group [STG] and a control group [CG]). The intervention group trained for 1 year over a competitive soccer season with additional sessions to their regular soccer practice (4 sessions per week), while the CG did not complete any additional sessions to the regular soccer training (4 sessions per week). The additional strength training (2 sessions per week [each approximately 30 minutes]) consisted of either parallel FS or BS. The squat variants switched in each session. Data were analyzed using a 2 × 3 (group × time) repeated-measures analysis of variance. The main findings of this study were that the STG resulted in significant pretest and post-test improvements in maximum strength (d = 3.75-5.58), jump (d = 0.84-1.14), and LS performance (d = -0.25 to 0.44), while for the CG, smaller increases or performance decreases were measured (maximum strength: d = 1.64-2.7; jump: d = 0.12-0.31; sprint: d = 0.00-025). A significant interaction effect in all variables indicated significant (p < 0.05) stronger performance improvements compared with the CG. Traditional strength training in elite youth soccer players is recommended to increase strength and speed-strength (jump and sprint performance) and should be considered in long-term athletic development programs.

Soluble CD44 in oral rinses for the early detection of cancer: a prospective cohort study in high-risk individuals

BackgroundThere are 54,000 new cases of oral cavity and oropharyngeal cancer in the United States and more than 476,000 worldwide each year. Oral cavity and oropharyngeal squamous cell carcinoma make up most tumors with five-year survival rates of 50% due to prevalence of late-stage diagnoses. Improved methods of early detection in high-risk individuals are urgently needed. We aimed to assess the tumorigenic biomarkers soluble CD44 (solCD44) and total protein (TP) measured using oral rinses as affordable convenient screening tools for cancer detection.MethodsIn this prospective cohort study, we recruited 150 healthy current or former smokers through a community screening program. Baseline and four annual visits were conducted from March 2011-January 2016 with records followed until August 2020. Participants provided oral rinses, received head and neck exams, and completed questionnaires. SolCD44 and TP levels were measured and compared across groups and time. Participants were placed in the cancer group if malignancy developed in the study period, the suspicious group if physical exams were concerning for premalignant disease or cancer in the head and neck, and the healthy group if there were no suspicious findings. This analysis used two-sample t-test for comparison of means and two-sample Wilcoxon Test for comparison of medians. For subjects with follow-ups, estimated means of biomarkers were obtained from a fitted Repeated Measures Analysis of Variance (RANOVA) model including group, visit, and their interaction. Pairwise comparisons of mean solCD44 were made, including intergroup and intragroup comparison of values at different years.ResultsMost participants were males (58.7%), < 60 years of age. (90.7%), and Black (100%). Baseline mean solCD44 was elevated (2.781 ng/ml) in the cancer group compared to the suspicious group (1.849 ng/ml) and healthy group (1.779 ng/ml).ConclusionThis study supports the feasibility of a CD44-based oral rinse test as an affordable and convenient adjunctive tool for early detection of aerodigestive tract and other cancers in high-risk populations.

Influence of customer contact employees (CCEs) competencies on their service recovery performance: a moderated-mediation approach

Purpose This study aims to explore the influence of customer contact employees (CCEs) competencies (social, emotional and professional) on their service recovery performance (SRP) with mediation effect of internal marketing and moderation effect of industry/sector. Design/methodology/approach This study used survey-based dyads of 210 CCEs and their managers/supervisors in three service sectors (hotel and hospitality, automobile service centers and organized retail stores). Repeated-measures analysis of variance, confirmatory factor analysis and PROCESS macro of Hayes (2013) was used to assess reliability, validity and to test mediation, moderation and moderated-mediation. Findings CCEs competencies influenced SRP. The relationship between CCEs competencies and SRP was mediated by internal marketing. The industry/sector was found to be a significant moderator between the internal marketing and SRP. Additionally, a significant moderated-mediation effect was found between CCEs competencies and SRP. Research limitations/implications Longitudinal studies could be particularly helpful to evaluate the impact of internal marketing on SRP. The future researcher may benefit from replicating and extending the model in different industries or can study other factors as mediators or moderators for further contribution to the SRP literature. Practical implications Firms striving for consumer retention and aiming to extend their consumer life cycle can greatly benefit from the results of this study to provide effective SRP. The study also suggests that policymakers and management should adopt properly designed and well-articulated human resource management practices for excellence in SRP in their organizations. Originality/value To the best of the authors' knowledge, there is no study in the past which has addressed employee and organizational factors with the dyadic sample. In addition, it has used a moderated-mediation model in the context of SRP and also contributes to the extant literature by researching in a non-Western setting like India.