Repeated Measures Analysis Of Variance Research Articles

Ankle Biomechanics During Multidirectional Landings in Athletes With Chronic Ankle Instability.

Assessing and understanding the control of the ankle during multidirectional jump landings in athletes with chronic ankle instability (CAI) would help health professionals develop interventions to reduce the risk of recurrent injuries. The aim of this study was to investigate the angle, angular velocity, and movements of the ankle joint, and the muscle activity of peroneus longus (PL), tibialis anterior (TA), and gastrocnemius (GAS) muscles during multidirectional landings in athletes with CAI. Nineteen athletes with CAI (≤25 Cumberland Ankle Instability Tool-Thai Score) participated. A Vicon Nexus motion analysis system synchronously collected data with an AMTI force plate and surface electromyography (EMG) to capture kinematics, kinetics, and muscle activity, respectively. Participants were asked to perform single-leg jump-landing tests in forward (0°), 30° diagonal, 60° diagonal, and lateral (90°) directions. Ankle joint kinematics, kinetics, and muscle activity of PL, TA, and GAS were analyzed. Repeated measure ANOVA (analysis of variance) and Friedman tests were used to analyze the main effects of the jump-landing direction. Athletes with CAI exhibited significant differences in ankle angles, angular velocities, ankle movements, and average muscle activity of GAS between directions. Greatest average EMG of GAS muscle was observed during landing in the lateral direction compared with the forward and 30° diagonal directions. Lateral and diagonal direction movements showed the greatest risks associated with recurrent ankle sprains. Impairments of neuromuscular control in both pre-landing and landing phases were observed in athletes with CAI when considered alongside previously published data. Laboratory-based observational study.

Postural Control Behavior in a Virtual Moving Room Paradigm

Background: Taking inspiration from the classical 1974, “moving room experiment” by Lee and Aronson, a “virtual moving room paradigm (Vroom)” was designed using virtual reality (VR) to assess postural control behavior. Methods: Thirty healthy adults (age: 21 ± 1 years; height: 166.5 ± 7.3 cm; mass: 71.7 ± 16.2 kg) were tested for postural stability in a virtual moving room paradigm (Vroom). The Vroom consisted of randomized virtual and visual perturbations of the virtual room moving toward and away from the individual, during both unexpected and expected trials. Objective postural sway variables and subjective experiences to VR using the simulator sickness questionnaire as well as balance confidence scale were also assessed and analyzed using a two way (2 × 2 [2 moving room direction (Toward vs. Away) and 2 knowledge of moving room (unexpected vs. expected)] repeated measures analysis of variance (ANOVA), and a one-way repeated measures ANOVA and paired sample t-test, respectively at an alpha level of 0.05. Results: Significantly greater postural sway was observed when the virtual room moved toward the participant than when moving away, and when it moved unexpectedly, compared with the expected moving room. Significantly improved balance confidence with realistic immersion and without simulator sickness was also observed. Conclusions: Our findings provide evidence indicating that the virtual moving room induces postural perturbations that challenge the postural control system, especially when the moving room is unexpected and moves toward the individual. Additionally, increased balance confidence and realistic immersion in the virtual environment with no adverse effects of simulator sickness were observed, providing evidence for the beneficial effects of the Vroom. Thus, the Vroom can be an easy and cost-effective method to expose individuals to realistic, virtual, and visual perturbations that challenge the postural control system and increase balance confidence, with realistic immersion and without adverse effects.

Ambroxol as a disease-modifying treatment to reduce the risk of cognitive impairment in GBA-associated Parkinson’s disease: a multicentre, randomised, double-blind, placebo-controlled, phase II trial. The AMBITIOUS study protocol

BackgroundHeterozygous mutations in the GBA gene, encoding the lysosomal enzyme β-glucocerebrosidase (GCase), are the most frequent genetic risk factor for Parkinson’s disease (PD). GBA-related PD (GBA-PD) patients have higher risk...

Telomere Length Associates With Symptom Severity After Mild Traumatic Brain Injury in Older Adults.

The objectives were to compare differences in telomere length (TL) among younger (21-54 years) and older adults (≥55) with mild traumatic brain injury (mTBI) to non-injured controls and to examine the association between TL and the severity of post-concussive symptoms over time. We performed a quantitative polymerase chain reaction to determine the TL (Kb/genome) of peripheral blood mononuclear cell samples (day 0, 3 months, and 6 months) from 31 subjects. The Rivermead Post-Concussion Symptoms Questionnaire was used to assess symptoms. Group-by-time comparisons of TL and symptom severity were evaluated with repeated-measures analysis of variance. Multiple linear regression examined the relationship between TL, group (mTBI and non-injured controls), and symptom severity total and subscale scores. Significant aging-related differences in TL were found within mTBI groups by time (day 0, 3 months, and 6 months; p = 0.025). Older adults with mTBI experienced significant worsening of changes in total symptom severity scores over time (day 0, 3 months, and 6 months; p = 0.016). Shorter TLs were associated with higher total symptom burden among each of the four groups at day 0 (baseline; p = 0.035) and 3 months (p = 0.038). Shorter TL was also associated with higher cognitive symptom burden among the four groups at day 0 (p = 0.008) and 3 months (p = 0.008). Shorter TL was associated with higher post-injury symptom burden to 3 months in both older and younger persons with mTBI. Large-scale, longitudinal studies of factors associated with TL may be useful to delineate the mechanistic underpinnings of higher symptom burden in adults with mTBI.

27 Neuropsychiatric Sequela of COVID-19 Among Persons with MS

Objective:To evaluate changes in neuropsychiatric symptoms among patients with multiple sclerosis (MS) following coronavirus disease of 2019 (COVID-19) infection using the National COVID Cohort Collaborative (N3C). The N3C represents the largest cohort of COVID-19 cases, through the unification of electronic health records from over 60 medical centers.Participants and Methods:Out of 5,631,225 COVID-19 confirmed positive patients, we identified a cohort of patients with MS who were diagnosed with COVID-19. Conditions were searched using terms denoting common neuropsychiatric comorbid diagnoses, including anxiety, depression, pain, sleep disorders, fatigue, and cognitive disorders. We examined descriptively the percentages of patients who were newly diagnosed with each comorbid condition after COVID-19 infection. Additionally, we searched for various patient-reported outcome measures in the N3C dataset; only the Patient Health Questionnaire-9 (PHQ-9) had an adequate sample size in our cohort for analysis. To control for variability due to non-COVID-19 factors, we only included PHQ-9 scores that were reported one year before and after COVID-19 infection. A repeated-measures analysis of variance (ANOVA) was conducted to analyze the difference between PHQ-9 scores before and after COVID-19 diagnosis among MS patients.Results:In our final dataset, there were 40,690 patients who were diagnosed with MS and COVID-19. Among patients without pre-existing anxiety conditions, 9.18% were diagnosed with an anxiety disorder after COVID-19 infection. Among those who did not have a pre-existing cognitive disorder, 1.73% had such diagnoses after COVID-19 infection. Among those without previous depressive disorders, 8.89% were diagnosed with a depressive disorder after COVID-19 infection. Of those without fatigue conditions prior to COVID-19 in their medical records, 8.81% had documented fatigue in their records after contracting COVID-19. Of those without pain conditions in their medical records, 11.37% had documented pain in their records after COVID-19 infection. Finally, among patients without pre-existing sleep disorders, 8.71% were diagnosed with sleep disorders after COVID-19 infection. Regarding PHQ-9 scores, 50 patients had documented scores before their COVID-19 diagnosis and 50 after COVID-19 diagnosis (17 had scores for both before and after COVID-19 diagnosis). There was no significant difference in PHQ-9 scores before and after COVID-19 diagnosis (F(df) = 0.326, p = 0.572; meanbefore = 8.77, meanafter = 9.32).Conclusions:Approximately 2-11% of MS patients developed new neuropsychiatric conditions after COVID-19 infection, with pain being the most common, followed by anxiety, fatigue, depression, and sleep disorders. Cognitive disorders were the least prevalent new onset neuropsychiatric sequelae of COVID-19 in this cohort. Additionally, there was a non-significant increase in severity of depressive symptoms, as indicated by a 1.36-point increase in PHQ-9 scores. These results suggest that patients with MS who have also been diagnosed with COVID-19 may be at risk for developing newly onset neuropsychiatric symptoms.

Alpha transcranial alternating current stimulation modulates auditory perception

BackgroundStudies using transcranial alternating current stimulation (tACS), a type of non-invasive brain stimulation, have demonstrated a relationship between the positive versus negative phase of both alpha and delta/theta oscillations with variable near-threshold auditory perception. These findings have not been directly compared before. Furthermore, as perception was better in the positive versus negative phase of two different frequencies, it is unclear whether changes in polarity (independent of a specific frequency) could also modulate auditory perception. ObjectiveWe investigated whether auditory perception depends on the phase of alpha, delta/theta, or polarity alone. MethodsWe stimulated participants with alpha, delta, and positive and negative direct current (DC) over temporal and central scalp sites while they identified near-threshold tones-in-noise. A Sham condition without tACS served as a control condition. A repeated-measures analysis of variance was used to assess differences in proportions of hits between conditions and polarities. Permutation-based circular-logistic regressions were used to assess the relationship between circular-predictors and single-trial behavioral responses. An exploratory analysis compared the full circular-logistic regression model to the intercept-only model. ResultsOverall, there were a greater proportion of hits in the Alpha condition in comparison to Delta, DC, and Sham conditions. We also found an interaction between polarity and stimulation condition; post-hoc analyses revealed a greater proportion of hits in the positive versus negative phase of Alpha tACS. In contrast, no significant differences were found in the Delta, DC, or Sham conditions. The permutation-based circular-logistic regressions did not reveal a statistically significant difference between the obtained RMS of the sine and cosine coefficients and the mean of the surrogate distribution for any of the conditions. However, our exploratory analysis revealed that circular-predictors explained the behavioral data significantly better than an intercept-only model for the Alpha condition, and not the other three conditions. ConclusionThese findings suggest that alpha tACS, and not delta nor polarity alone, modulates auditory perception.

The Effect of Intra-articular Hypertonic Dextrose Prolotherapy on Pain, Quality of Life, and Functional Outcomes Scores in Patients With Knee Osteoarthritis.

Introduction Knee osteoarthritis is a common chronic condition leading to pain and debility. Prolotherapy is a safe and cost-effective treatment option. Our team conducted a case series to examine the effect of prolotherapy on functional measures and quality of life in patients with knee osteoarthritis. Methods Our case series included 15 total patients consisting of male and female patients aged 50-85 years old with a prior diagnosis of knee osteoarthritis and moderate pain. The patients completed baseline Western Ontario and McMaster Universities Arthritis Index (WOMAC) and EuroQol-5 Dimension (EQ5D) surveys and received an ultrasound-guided intra-articular prolotherapy injection. The patients were then followed up by Telehealth at one-, two-, and three-monthpost-procedure. Results Data points for 15 patients were recorded over the duration of the three months. Results revealed significantly improved functional scores from the baseline period (M = 0.60) to the one-month (M = 0.43), two-month (M = 0.48), and three-month (M = 0.46), observed power = 0.99. Participants reported significantly lower pain scores between the baseline period (M = 0.60) compared to the one-month (M = 0.34), two-month (M = 0.35) and three-month (M = 0.39) periods. There was no statistical significance across time in participants' EQ5D scores. The repeated-measures analysis of variance (ANOVA) revealed no statistically significant differences in participants scores between the baseline (M = 64.4), one-month (M = 68.93), two-month (M = 68.47), or three-month (M = 68.33), observed power = 0.31. There were no statistically significant differences in participants WOMAC stiffness scores between the baseline (M = 0.67), one-month (M = 0.46), two-month (M = 0.57), or three-month (M = 0.56) periods, observed power = 0.73. The results revealed no significant change in participants' EQ5D and WOMAC stiffness scores. The results support a statistically significant improvement in patients' self-reported functioning and pain scores between the baseline and one-month, two-month, and three-month periods. Discussion The significant improvement in function occurred between the baseline and one-month time periods and the pain reduction was sustained throughout the two-month and three-month periods. Our study supports prolotherapy as an effective treatment option to improve pain and function in knee osteoarthritis. The study could be repeated with a large sample size to further investigate the effects of prolotherapy on quality-of-life measures.

Effects of A Single Balance Training Session on Neural Excitability in Individuals With Chronic Ankle Instability.

Individuals with chronic ankle instability (CAI) demonstrate reduced spinal reflex modulation and corticospinal excitability of the soleus, which may contribute to decreased balance performance. To determine the effects of a single session of balance training on Spinal-reflexive excitability modulation and corticospinal excitability in those with CAI. Randomized controlled trials. Research laboratory. Thirty participants with CAI were randomly assigned to the balance training (BAL) or control (CON) group. Modulation of soleus spinal-reflexive excitability was measured by calculating relative change in normalized Hoffmann reflexes (ratio of the H-reflex to the M-wave) from prone to single-leg standing. Corticospinal excitability was assessed during single-leg stance using transcranial magnetic stimulation, outcomes of which included active motor threshold (AMT), motor evoked potential, and cortical silent period (CSP). Balance performance was measured with center of pressure velocity in anterior to posterior and medial to lateral directions. Separate 2 × 2 repeated-measures analyses of variance were employed to determine the effect of group (BAL and CON) and time (baseline and posttraining) on each dependent variable. There were significant group by time interactions in the modulation of soleus spinal-reflexive excitability (F1,27 = 4.763, P = .04); CSP at 100% AMT (F1,27 = 4.727, P = .04); and CSP at 120% AMT (F1,27 = 16.057, P < .01). A large effect size suggests increased modulation of spinal-reflexive excitability (d = 0.81 [0.03 to 1.54]) of the soleus in BAL compared with CON at posttest, while CSP at 100% (d = 0.95 [0.17 to 1.70]) and 120% AMT (d = 1.10 [0.29 to 1.84]) was reduced in BAL when compared with CON at posttest. After a single session of balance training, individuals with CAI initiated increases in spinal reflex modulation and corticospinal excitability of the soleus. Thus, individuals with CAI who undergo balance training exhibit positive neural adaptations that are linked to improvements in balance performance.

Reliability and Concurrent Validity of Smartphone Clinometer Application for Measuring Scapular Rotations in Subjects With and Without Shoulder Pain.

Clinical assessment of scapular motion is obscured by a lack of clinically accessible and feasible angular measurement tools. This study evaluates the reliability and validity of the smartphone "Clinometer" app in measuring scapular upward rotation (UR) and anteroposterior tilt. Psychometric analysis. We recruited 57 participants-10 with and 47 without shoulder pain. Two physical therapists consecutively measured both scapular movements using the Clinometer app at the arm by the side (rest), 30°, 60°, 90°, and 120° of humeral elevation in the scapular plane; one therapist measured again after 2days. For evaluating concurrent validity, we compared the Clinometer scores with those measured using an electromagnetic motion capture system in 10 healthy participants. Intraclass correlation coefficients (ICC) with standard error of measurement (SEM) and minimal detectable difference at 90% confidence intervals (MDD90) were calculated. Concurrent validity was evaluated using repeated-measures analysis of variance followed by post hoc testing with Tukey-Kramer test (P < .05). We observed good intrarater reliability (ICC: UR = .76-.85, tilt = .69-.9; SEM: 2.2°-3.5°; MDD90: ∼5°-8°) and moderate to good interrater reliability (ICC: UR = .66-.78, tilt = .66-.76; SEM: 3.6°-8°; MDD90: ∼9°-18°) for both rotations. The Clinometer scores for UR were comparable to electromagnetic motion capture system at all angles except 90° (difference ∼8°); for scapular tilt, the scores were comparable only at rest and 30° elevation. The Clinometer app is reliable and valid for measuring scapular UR throughout and for scapular tilt at lower humeral elevation angles. The MDD90 values for scapular rotations computed in this study can be helpful in rehabilitation planning and future research.

Deficits of Visual Cortex Function in Acute Acquired Concomitant Esotropia Patients.

The purpose of this study was to explore the cortical deficits of patients with acquired concomitant esotropia (AACE) using the resting-state functional magnetic resonance imaging (rs-fMRI) technique. Rs-fMRI signals from 25 patients with AACE and 25 matched controls were collected. The repeated-measures analysis of variance (RM-ANOVA) test and two-sample t-test were used to investigate statistical differences of the amplitudes of low-frequency fluctuation (ALFF) signals and correlation analysis was performed to validate the relationship of signal change and clinical features. The AACE group showed decreased ALFF in both hemispheres symmetrically (t = 0.38, P = 0.71), with peak t in both middle occipital gyrus. The ALFF signal from the upper left inferior frontal gyrus was negatively correlated with the age of onset (r = 0.62, P = 0.0008), and the ALFF signal from the right superior temporal gyrus was negatively correlated with the near work hours (r = 0.63, P = 0.0008). The ALFF signal in the left fusiform gyrus was positively correlated with both near (r = 0.48, P = 0.01) and far (r = 0.44, P = 0.03) deviation, whereas it was only positively correlated with far deviation (r = 0.44, P = 0.03) in the right. Besides, the age of onset and the near work hour were independent factors of signal changes. Using the ALFF signal of rs-fMRI, we found functional deficits in the primary visual cortex and dorsal pathway in patients with AACE. There were functional changes in the fusiform gyrus, and the greater the deviation angle, the higher the changing level. These findings reveal the association of AACE and the visual center, giving us more clues about the treatment of AACE.

Assessment of bony changes in temporomandibular joint in patients using cone beam computed tomography – a cross sectional study

Background and aimThe aim of this study is to evaluate the changes in the temporomandibular joint (TMJ) in patients with temporomandibular disorder (TMD) and the relationship between age, sex, and types of TMJ change using Cone Beam Computed Tomography (CBCT).Methods and materialCBCT records of 200 patients (123 women and 67 men) were retrieved and assessed. Right and left TMJs were evaluated separately, resulting in a total of 400 TMJs. The images were analyzed using On demand 3D Application The radiographic findings were classified as erosion, proliferative changes mainly, including flattening and osteophytes of the condyle, sclerosis, Ely cyst, hypoplasia and hyperplasia of the condyles, ankylosis, and joint cavity. Data analysis was performed using descriptive statistics, paired T-tests, and repeated measure ANOVA (Analysis of Variance) in SPSS Software.ResultsThe most prevalent types of condylar bony changes observed was osteophyte (63.5%) followed by flattening of the articular surface (42%), erosion (40%), ankylosis (10%) and sclerosis (10%). 7.5% of joints showed hyperplastic condyles but only 2% showed hypoplasia. The least prevalent change observed was Ely Cyst (1%). Osteophyte was the most prevalent change observed in all age groups and both sexes except for men aged 31 ~ 50, where flattening was more frequent. A statistically significant difference was found between sex and prevalence of erosion in the age group of 10 ~ 30 (P = 0.001); as well as between sex and condylar hyperplasia in the same age group.ConclusionBased on the findings of this research, the prevalence of bony changes of TMJ from highest to lowest is as follows: osteophyte, flattening of the articular surface, erosion, ankylosis, sclerosis, hyperplastic condyles, hypoplastic condyles and Ely Cyst. CBCT is an accurate 3 dimensional imaging modality for assessment of TMJ bony structures.

Acute Effects of Ischemic Preconditioning at Different Occlusion Pressures on Athletic Performance Indicators in Male Soccer Players

Ischemic preconditioning (IPC) has been shown to improve exercise performance, but many factors related to IPC administration are unresolved. This study evaluated the effect of IPC performed with different pressures for exercise performance. Fifteen collegiate male soccer players completed five separate sessions in randomized order. For each session, blood pressure cuffs were placed on the thigh bilaterally, and IPC was administered in 2x5 minute cycles at cuff pressures of 0%, 25%, 50%, 75%, or 100% of each participant’s limb occlusion pressure (LOP), the pressure needed to occlude arterial flow of blood to the leg. Participants then completed vertical jump, soccer passing accuracy, and 1,600 meter run tests. Repeated-measures analysis of variance was used to assess differences in outcomes across the five trials. There were no significant differences in vertical jump or passing accuracy across the five trials. However, 1,600 meter run times were significantly faster for the 50-75% trials than the 0-25% trials (mean difference 7.1-8.4 seconds). In summary, IPC pressures below LOP improved running times while not negatively influencing jumping or passing accuracy in collegiate soccer players. Improved comfort and reduced risk from using cuff pressures below LOP may facilitate more effective IPC use in field-based settings.

Impact of Using Blood Warmer During Continuous Kidney Replacement Therapy in Patients With Acute Kidney Injury.

We investigated the impact of blood warmer use on hypotensive episodes in patients with acute kidney injury (AKI) receiving continuous kidney replacement therapy (CKRT). We included patients with AKI undergoing CKRT between January 1, 2012, and January 1, 2021, at a tertiary academic hospital. Hypotensive episodes were defined as mean arterial pressure (MAP) <60 mm Hg or a decrease in MAP by ≥10 mm Hg, systolic blood pressure (SBP) < 90 mm Hg or a decrease in SBP by ≥20 mm Hg, or increased vasopressor requirement. These were analyzed by Poisson regression with repeated-measures analysis of variance using generalized estimation equation. There were 669 patients with AKI that required CKRT. Use of blood warmer on first day of CKRT was in 324 (48%) patients. Incidence rate ratio of hypotensive episodes during the first 24-h of CKRT in patients where a blood warmer was used was 1.06 (95% confidence interval [CI]: 0.98-1.13) compared to those where blood warmer was not used. This did not change in adjusted model. Overall, the within-subject effect of temperature on hypotensive episodes showed that higher temperature was associated with fewer episodes (0.94, 95% CI: 0.9-0.99 per 10 degrees increase, P = .007). Blood rewarming was not associated with hypotensive episodes during CKRT.

Upregulation of a Small-World Brain Network Improves Inhibitory Control: An fNIRS Neurofeedback Training Study.

The aim of this study was to investigate the inner link between the small-world brain network and inhibitory control. Functional near-infrared spectroscopy (fNIRS) was used to construct a neurofeedback (NF) training system and regulate the frontal small-world brain network. The small-world network downregulation group (DOWN, n = 17) and the small-world network upregulation group (UP, n = 17) received five days of fNIRS-NF training and performed the color-word Stroop task before and after training. The behavioral and functional brain network topology results of both groups were analyzed by a repeated-measures analysis of variance (ANOVA), which showed that the upregulation training helped to improve inhibitory control. The upregulated small-world brain network exhibits an increase in the brain network regularization, links widely dispersed brain resources, and reduces the lateralization of brain functional networks between hemispheres. This suggests an inherent correlation between small-world functional brain networks and inhibitory control; moreover, dynamic optimization under cost efficiency trade-offs provides a neural basis for inhibitory control. Inhibitory control is not a simple function of a single brain region or connectivity but rather an emergent property of a broader network.

A Standardized Withania somnifera (Linn.) Root Extract with Piperine Alleviates the Symptoms of Anxiety and Depression by Increasing Serotonin Levels: A Double-Blind, Randomized, Placebo-Controlled Study.

Background: Withania somnifera (Linn) or Ashwagandha is used in Ayurveda and other traditional medicine systems as an adaptogen and a neuroprotective supplement. Objective: The effect of Ashwagandha root extract (ARE) standardized for 2.5% full-spectrum withanolides as per The United States Pharmacopeia (USP) protocol with piperine (500 mg with 5 mg of 95% piperine) once a day (12.5 mg withanolides/day) was evaluated in individuals with mild to moderate depression and anxiety. Methods: In a randomized, double-blind placebo-controlled study, for 90 days, 70 participants were randomized to ARE (n = 34) or placebo (n = 36) once daily at night. Mean change in the Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HARS), Groningen Sleep Quality Scale (GSQS), and quality of life (QOL) from screening to days 30, 60, and 90 were evaluated. Safety was evaluated by monitoring any incidence of adverse events and laboratory parameters. Two-way analysis of variance (ANOVA) and repeated-measure ANOVA were used to compare ARE and placebo, and the changes within the group at different time points. Results: Seventy individuals were randomized and all of them completed the study. The HARS, HDRS, GSQS, and QOL scores improved significantly (p < 0.001) in all the participants taking ARE compared to placebo on days 30, 60, and 90. Anxiety and depression improved from baseline to end of the study in both groups, but the quantum of improvement was significantly higher in ARE. Serum levels of serotonin increased in ARE, but showed a decrease in placebo, the difference being statically significant (p < 0.001). Biochemical and hematological parameters remained in the normal range in all participants and ARE was well tolerated during the study. Conclusion: The results of the study suggest that 500 mg of ARE standardized for 2.5% withanolides with 5 mg piperine is beneficial in improving depression, and anxiety, by increasing serum serotonin levels. The trial was registered prospectively with the Clinical Trial Registry of India (CTRI) with the registration number CTRI/2022/05/042640, on May 18, 2022.

Changes in Quadriceps Rate of Torque Development After Anterior Cruciate Ligament Reconstruction and Association to Single-Leg Hop Distance.

Quadriceps neuromuscular function is negatively affected after anterior cruciate ligament reconstruction (ACLR). The specific effect that the ACLR has on the quadriceps femoris rate of force production and its impact on functional recovery is unknown. The anterior cruciate ligament (ACL) limb would present persistent deficits in the rate of torque development (RTD), when compared with the non-ACL limb before ACLR until 9 months (9M) post-ACLR. Prospective cohort study. Level 3. Twenty-eight participants performed quadriceps maximum voluntary isometric contractions (MVICs) before (PRE), at 5 months (5M) and at 9M after ACLR. Single-leg hop distance was also assessed at 9M. Quadriceps RTD was calculated at 50, 100, and 200 ms after the onset of torque production. Maximum RTD was also calculated. A 2 (limb) × 3 (time) repeated-measures analysis of variance was used for RTD50, RTD100, RTD200, and RTDmax. Linear regressions were used to evaluate the associations of MVIC and RTD values at 5M and 9M with single-leg hop distance at 9M. The ACL limb had lower RTD values at all times compared with the non-ACL limb (P < 0.05). RTD of the ACL limb significantly decreased from PRE to 5M, and then recovered to PRE levels at 9M (P < 0.05). The non-ACL limb displayed no differences from baseline to either 5M or 9M. MVIC and RTD200 at 5M predicted (R2 = 0.313 and R2 = 0.262, respectively) single-leg hop distance at 9M, better than the strength and RTD at 9M (R2 = 0.235 and R2 = 0.128, respectively). Quadriceps RTD is negatively affected after ACLR, and deficits may persist at the time of return to activity. Strength and RTD during recovery at 5M may predict more than 25% of the variance in single-leg hop distance at 9M, independently; hence, both provide important information to monitor functional recovery post-ACLR. RTD should be measured to understand the changes in neuromuscular capacity after ACLR, and rehabilitation strategies that target quick force production, ie, quick muscle activation and functional tasks, should be implemented.

Correlation of Serum Albumin Levels With Laboratory Parameters in Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis Patients: A Prospective Cohort Study.

Background Peritoneal dialysis (PD) is a treatment option for end-stage renal disease (ESRD) patients, with automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) being the two main modalities. APD has reported benefits such as reduced peritonitis rates, improved ultrafiltration, and enhanced quality of life. However, some studies have found potential negative consequences of APD, and the impact on survival outcomes is limited and contradictory. Selecting the appropriate PD modality for ESRD patients should be individualized based on various factors, including nutritional status, demographic factors, laboratory findings, and other outcomes. PD patients are at high risk of malnutrition, and serum albumin is commonly used as a marker of nutritional status. Continuous monitoring of laboratory values may be beneficial for identifying nutritional deficiencies in a timely manner. Methodology This prospective cohort study aimed to compare APD and CAPD modalities in relation to serum albumin levels, demographic factors, and other laboratory parameters. The sample consisted of patients with ESRD treated with PD, who were divided into two groups per baseline albumin level. The study collected data on demographic, clinical, and laboratory characteristics, as well as comorbidities. The data were analyzed using SPSS version 26 (IBM Corp., Armonk, NY, USA), and statistical tests, such as the chi-square test and repeated-measures analysis of variance (ANOVA), were conducted to determine significant associations and differences between variables. Results The study included a total of 85 patients with ESRD who required PD as a treatment modality. Among them, 71 patients were undergoing APD, and 14 patients were undergoing CAPD. The study found that there were no significant differences in demographic factors, laboratory parameters, or medical history parameters between APD and CAPD patients with different albumin levels. The patients were followed up for six months and laboratory parameters were evaluated. Repeated-measures ANOVA showed that there were no significant variationsin both APD and CAPD patients. However, Spearman's rank correlation test revealed statistically important correlations between albumin and some laboratory parameters in both APD and CAPD patients at different assessment stages, including hemoglobin, sodium, transferrin, uric acid, phosphate, total protein, cholesterol, and triglycerides (p < 0.05). Conclusions Serum albumin levels appeared to be unaffected by the choice of PD modality. There were significant correlations between serum albumin levels and specific laboratory findings, including total protein, across all assessment stages for both APD and CAPD patients. These findings underscore the importance of continuous laboratory monitoring for PD patients.

Roles of Phonation Types and Decoders' Gender in Recognizing Mandarin Emotional Speech.

Capturing phonation types such as breathy, modal, and pressed voices precisely can facilitate the recognition of human emotions. However, little is known about how exactly phonation types and decoders' gender influence the perception of emotional speech. Based on the modified Brunswikian lens model, this article aims to examine the roles of phonation types and decoders' gender in Mandarin emotional speech recognition by virtue of articulatory speech synthesis. Fifty-five participants (28 male and 27 female) completed a recognition task of Mandarin emotional speech, with 200 stimuli representing five emotional categories (happiness, anger, fear, sadness, and neutrality) and five types (original, copied, breathy, modal, and pressed). Repeated-measures analyses of variance were performed to analyze recognition accuracy and confusion data. For male and female decoders, the recognition accuracy of anger from pressed stimuli and fear from breathy stimuli was high; across all phonation-type stimuli, the recognition accuracy of sadness was also high, but that of happiness was low. The confusion data revealed that in recognizing fear from all phonation-type stimuli, female decoders chose fear responses more frequently and neutral responses less frequently than male decoders. In recognizing neutrality from breathy stimuli, female decoders significantly reduced their choice of neutral responses and misidentified neutrality as anger, while male decoders mistook neutrality from pressed stimuli for anger. This study revealed that, in Mandarin, phonation types play crucial roles in recognizing anger, fear, and neutrality, while the recognition of sadness and happiness seems not to depend heavily on phonation types. Moreover, the decoders' gender affects their recognition of neutrality and fear. These findings support the modified Brunswikian lens model and have significance for diagnosis and intervention among clinical populations with hearing impairment or gender-related psychiatric disorders. https://doi.org/10.23641/asha.24302221.

Exploring the Effect of Trataka (A Yogic Cleansing Technique) and Cold Eye Pack on Eye Strain During COVID-19 Pandemic: A Randomized Three-Arm Trial.

Objective: Computer vision syndrome is a major global public health concern affecting >60 million individuals globally. Yoga and naturopathy practices can reduce visual fatigue and strain. The present study attempted to explore the effect of trataka that is, a yogic cleansing technique and cold eye pack on visual strain and fatigue. Subjects: Three hundred volunteers from an IT company were recruited following inclusion and exclusion criteria. Intervention: The subjects were randomly distributed in three groups, that is, trataka, cold eye pack, and waitlist control group with an allocation ratio of 1:1:1. Outcome measure: Visual Fatigue Scale and Visual symptoms checklist (VSC) was administered at baseline and end of 2 weeks. Repeated measures analysis of variance (RM-ANOVA) with Bonferroni corrections was used to test the difference across the groups. Results: All the variables were similar at the baseline among the groups. Significant changes in the within-group analysis occurred in both the trataka and cold eye pack groups. The RM-ANOVA revealed significant differences in the VAS and VSC (p = 0.001) and the post hoc analysis suggested that there were significant differences in both the trataka and cold eye pack group when compared with the control group (p = 0.001); however, there was no differences between the trataka and cold eye pack group in both the scales (p = 1). Conclusions: The results of the present study suggest that a trataka and cold eye pack for 14 days improves self-rated visual strain and fatigue among IT professionals with computer vision syndrome. Clinical Trial registration number: CTRI/2020/11/029003.

The Influence of Knee Position on Ultrasound Imaging of Femoral Cartilage in Individuals with Anterior Cruciate Ligament Reconstruction.

Articular cartilage is important for knee function and can be imaged using ultrasound. The purpose was to compare femoral cartilage thickness and echo intensity (EI) measured at 90° and 140° of knee flexion and between limbs in a cohort with unilateral anterior cruciate ligament reconstruction (ACLR). We also examined associations between gait biomechanics and cartilage outcomes. Twenty-seven individuals with primary unilateral ACLR participated (12 men, 15 women; age = 22.3 ± 3.8 years; time since ACLR = 71.2 ± 47.2 months). Ultrasound was used to obtain femoral cartilage measurements. Gait outcomes included peak KFA (knee flexion angle) and peak external knee flexion moment (KFM). Cartilage outcomes were compared using a 2 (position) × 2 (limb) repeated measures ANOVA (analysis of variance). Gait and cartilage associations were assessed using linear regression. There were no position × limb interactions for any cartilage outcome (all P > 0.05). Medial (P = 0.038) and central cartilage (P < 0.001) were thicker, whereas central (P = 0.029) and lateral cartilage EI (P = 0.003) were lower when measured at 90° than those at 140° of knee flexion. Medial cartilage was thicker in the ACLR than that in the contralateral limb (P = 0.016). A larger KFM was associated with thicker medial cartilage (ΔR2 = 0.146, P = 0.021) and central cartilage (ΔR2 = 0.159, P = 0.039) measured at 140° of knee flexion in the ACLR limb but not at 90°. Findings suggest that imaging position influences cartilage thickness and EI measurements in individuals with ACLR and should be considered in study designs and clinical evaluation. A greater KFM was associated with thicker cartilage within specific portions of the distal femur.