Separate One-way Analyses Of Variance Research Articles

Capability of intravoxel incoherent motion and diffusion tensor imaging to detect early kidney injury in type 2 diabetes.

To prospectively investigate the capability of intravoxel incoherent motion (IVIM) and conventional diffusion tensor imaging (DTI) to identify early kidney function injury in type 2 diabetes. Forty-one diabetes patients (normoalbuminuria: n = 27; microalbuminuria: n = 14) and 28 volunteers were recruited. All participants were examined using DTI and IVIM with 3.0-T MRI. DTI parameters (mean diffusivity [MD], fractional anisotropy [FA]), and IVIM parameters (true diffusion coefficient [D], pseudo-diffusion coefficient [D*], and pseudo-diffusion component fraction [f]) were measured in the renal parenchyma (cortex and medulla) by two experienced radiologists independently. Image features were compared among the groups using separate one-way analyses of variance. Diagnostic performances of various diffusion parameters for predicting diabetic renal damage were compared. The medullary D and FA values were significantly different among the microalbuminuria subgroup, normoalbuminuria subgroup, and control group (all p < 0.001). In medulla, area under the curve (AUC) values for combined FA and D were significantly higher than single FA (AUC = 0.938, 0.769, respectively; p = 0.003), and the combined AUC of FA and D was numerically higher than that of single D (0.938 vs 0.878, p > 0.05). AUC of combined FA and D was 0.985, not significantly different from individual AUC for FA and D (AUC = 0.909 and 0.952, respectively; all p > 0.05) in differentiating the microalbuminuria subgroup from the control group. IVIM-derived D and DTI-derived FA values were better than other parameters for evaluating early kidney impairment of diabetes. The single indicator FA and D performed as well as the combined diagnostic indicator in the medulla for differentiating the microalbuminuria subgroup from the control group. • We speculated that early renal progression in type 2 diabetes result from restricted tubular flow and kidney tubule dysregulation may precede or at least accompany abnormal glomerular changes. • In medulla, the AUC values of FA and D and the combination of FA and D obtained by comparing the microalbuminuria subgroup with the control group were 0.909, 0.952, and 0.985, respectively. • IVIM-derived D and DTI-derived FA are effective MR biomarkers to evaluate early alterations of the renal function in patients with diabetes.

S1443 The Effects of Proton Pump Inhibitor Therapy Usage and Dosing on Hospitalization Rates and Critical Care Outcomes of COVID-19 Patients

Introduction: Proton Pump Inhibitors (PPI) are one of the most prescribed medications in the United States, but their use is associated with risk of infection due to disruption in gut flora. This has led many to question the relationship between COVID-19 and PPI use as the virus has been shown to be transmitted through both the respiratory and gastrointestinal tract. Our aim is to investigate the correlation between PPI use and COVID-19 severity. Methods: We conducted a retrospective chart review to identify patients within our network who tested positive for SARS-CoV-2 with RT-PCR testing from March to August 2020. Patients were subdivided into groups: active, past, or no PPI use. Active users included patients prescribed PPIs within the last 30 days prior to admission. Past users included those with a history of use within the last 31 to 365 days. No PPI use included all additional patients. The strength of PPI dosing, demographic and clinical variables, comorbid conditions, and critical care outcomes were also recorded. Direct multivariable logistic regression models were created to determine primary outcomes and chi square and Kruskal Wallis tests were used in analysis of secondary outcomes. Results: 2,594 patients met inclusion criteria (Active use, n=448 (17.3%); past use n=98 (3.8%); no use, n=2,048 (78.9%)). Majority were female (50.5%) and White (57.7%) and the mean age was 52.6 years with mean BMI of 30.7. mg/m2. Subgroup analysis showed that active and past PPI users had significantly higher rates of comorbid conditions. PPI use was not associated with increased hospital admission or 30-day mortality in the regression model; however, age, male gender, diabetes, COPD, cardiovascular disease, kidney disease, and obesity were independently and significantly associated. Active PPI users had higher median length of hospital stay (p=0.02) and a higher percentage of ICU admissions (P = 0.03). No secondary outcomes for active PPI users based on PPI dosage were statistically significant. Conclusion: Our results show that neither active nor past PPI use predict need for hospital admission or 30-day mortality. Admitted patients with active PPI use had higher median length of stay but higher frequency of comorbid conditions. Our data suggests descalation and discontinuation of PPI therapy when appropriate although no association was seen in our study. Ultimately in order to substantiate findings, more clinical data is necessary to determine the association between PPI use and COVID-19 susceptibility.Table 1.: Unadjusted Comparisons for Hospital Admission within Two Weeks of COVID Testing and for Overall 30-Day Mortality * Denominators differ for some variables due to missing data. ** PPI: proton pump inhibitor; SD: standard deviation; COPD: chronic obstructive pulmonary disease *** Cardiovascular disease is a composite of cardiomyopathy, congestive heart failure, and coronary artery disease. **** Defined as BMI > 30 kg/m2.***** Based on separate one-way analysis of variance or chi square tests, as appropriate.

Specific Absolute Velocity Thresholds during Male Basketball Games Using Local Positional System; Differences between Age Categories

The aim of this study was (I) to establish absolute specific velocity thresholds during basketball games using local positional system (LPS) and (II) to compare the speed profiles between various levels of competitions. The variables recorded were total distance (TD); meters per minute (m·min); real time (min); maximum speed (Km h−1), distance (m), percentage distance, and percentage duration invested in four speed zones (standing–walking; jogging; running; and high-speed running). Mean and standard deviation (±SD) were calculated, and a separate one-way analysis of variance was undertaken to identify differences between competitions. TD (3188.84 ± 808.37 m) is covered by standing–walking (43.51%), jogging (36.58%), running (14.68%), and sprinting (5.23%) activities. Overall, 75.22% of the time is invested standing–walking, jogging (18.43%), running (4.77%), and sprinting (1.89%). M·min (large effect size), % duration zone 2 (moderate effect size); distance zone 4 (large effect size), and % distance zone 4 (very large effect size) are significantly higher during junior than senior. However, % distance zone 1 (large effect size) and % duration zone 1 (large effect size) were largely higher during senior competition. The findings of this study reveal that most of the distance and play time is spent during walking and standing activities. In addition, the proportion of time spent at elevated intensities is higher during junior than in senior competition.

Peak Match Demands in Young Basketball Players: Approach and Applications.

Background: The aim of this study is to describe the peak match demands and compare them with average demands in basketball players, from an external load point of view, using different time windows. Another objective is to determine whether there are differences between positions and to provide an approach for practical applications. Methods: During this observational study, each player wore a micro technology device. We collected data from 12 male basketball players (mean ± SD: age 17.56 ± 0.67 years, height 196.17 ± 6.71 cm, body mass 90.83 ± 11.16 kg) during eight games. We analyzed intervals for different time windows using rolling averages (ROLL) to determine the peak match demands for Player Load. A separate one-way analysis of variance (ANOVA) was used to identify statistically significant differences between playing positions across different intense periods. Results: Separate one-way ANOVAs revealed statistically significant differences between 1 min, 5 min, 10 min, and full game periods for Player Load, F (3,168) = 231.80, ηp2 = 0.76, large, p < 0.001. It is worth noting that guards produced a statistically significantly higher Player Load in 5 min (p < 0.01, ηp2 = −0.69, moderate), 10 min (p < 0.001, ηp2 = −0.90, moderate), and full game (p < 0.001, ηp2 = −0.96, moderate) periods than forwards. Conclusions: The main finding is that there are significant differences between the most intense moments of a game and the average demands. This means that understanding game demands using averages drastically underestimates the peak demands of the game. This approach helps coaches and fitness coaches to prepare athletes for the most demanding periods of the game and present potential practical applications that could be implemented during training and rehabilitation sessions.

Self-reported Measures of Strength and Sport-Specific Skills Distinguish Ranking in an International Online Fitness Competition

Serafini, PR, Feito, Y, and Mangine, GT. Self-reported measures of strength and sport-specific skills distinguish ranking in an international online fitness competition. J Strength Cond Res 32(12): 3483-3493, 2018-To determine if self-reported performance measures could distinguish ranking during the 2016 CrossFit Open, data from 3,000 male (n = 1,500; 27.2 ± 8.4 years; 85.2 ± 7.9 kg; 177.0 ± 6.5 cm) and women (n = 1500, 28.7 ± 4.9 years; 63.7 ± 5.8 kg; 163.7 ± 6.6 cm) competitors was used for this study. Competitors were split by gender and grouped into quintiles (Q1-Q5) based upon their final ranking. Quintiles were compared for one-repetition maximum (1RM) squat, deadlift, clean and jerk (CJ), snatch, 400 m sprint, 5,000 m run, and benchmark workouts (Fran, Helen, Grace, Filthy-50, and Fight-Gone-Bad). Separate one-way analyses of variance revealed that all competitors in Q1 reported greater (p ≤ 0.05) 1RM loads for squat (men: 201.6 ± 19.1 kg; women: 126.1 ± 13.0 kg), deadlift (men: 232.4 ± 20.5 kg; women: 148.3 ± 14.5 kg), CJ (men: 148.9 ± 12.1 kg; women: 95.7 ± 8.4 kg), and snatch (men: 119.4 ± 10.9 kg; women 76.5 ± 7.6 kg) compared with other quintiles. In addition, men in Q1 (59.3 ± 5.9 seconds) reported faster (p ≤ 0.05) 400 m times than Q3 only (62.6 ± 7.3 seconds), but were not different from any group in the 5,000 m run. Women in Q2 (67.5 ± 8.8 seconds) reported faster (p ≤ 0.05) 400 m times than Q3-Q5 (73.5-74.8 seconds), and faster (21.3 ± 1.8 minutes, p < 0.02) 5,000 m times than Q4 (22.6 ± 2.2 minutes) and Q5 (22.6 ± 1.9 minutes). Faster (p ≤ 0.05) Fran times were reported by Q1 (men: 138.2 ± 13.3 seconds; women: 159.4 ± 28.3 seconds) compared with other groups, while the results of other workouts were variable. These data indicate that the most successful athletes excel in all areas of fitness/skill, while lower-ranking athletes should focus on developing strength and power after achieving sufficient proficiency in sport-specific skills.

Ergonomic Evaluation of Office Furniture on Team Dynamics

Office workers are at high-risk for work-related musculoskeletal disorders (WMSDs), which can inhibit productivity and perceived comfort through associated disorders (Piligian et al, 2000). An increase in WMSDs has created a demand for ergonomic office interventions. Recent ergonomic advancements have focused on dynamic office furniture that aim to promote chairs featuring structural designs (Ellegast et al, 2012). Dynamic office furniture lacking a range of specific and modifiable adjustments can lead to adverse outcomes, such as nerve compression, resulting in perceived discomfort and increased risk of musculoskeletal disorders (Groenesteijn et al, 2009; Legg et al, 2002). However, there is limited research regarding the relationship of posture changes and the effects on perceived comfort and task performance. The objective of the study was to explore the relationship between perceived comfort, productivity, postural changes, and adjustability in chairs with varying degrees of adjustability. The study consisted of 44 participants (54.5% males, 22.8 (2.89) years) attending three different days, working together in teams of 2-3, to complete a 3-hour simulated office task related to construction science. Tasks required team collaboration to evaluate construction bids, develop plan of actions, and present conclusions to each task. To determine the ergonomic impact of office furniture on team creativity and productivity on the design project, two different types of chairs were employed that varied in the level of user involvement for chair adjustments – no involvement without adjustment and high involvement with adjustment, each presented on separate days. Subjective surveys were used at the end of every session to evaluate the chair used in that session that determined individual satisfaction, usability, and perceived discomfort levels. Continuous video obtained during the sessions were analyzed to obtain the number of postural changes (e.g., bending from side to side, shoulders or back ‘drooping’), chair adjustments made, unintended jerks, and chair switches throughout each time period (for a total of 3 time periods) on each day. Performance on the simulated construction science tasks were assessed using a predetermined rubric that included components such as document completion, completed summaries, and presentations to obtain a total performance score. Reported here are preliminary findings from the video analyses and discomfort surveys. A 2-chair x 3-time repeated measures analysis of variance (ANOVA) on postural change over time revealed that postural changes on the chair associated with no involvement without adjustment was higher than that of high involvement with adjustment, however this was only seen in times 1 and 2. This implies that the benefit of adjustments are likely lost over time. Separate one-way ANOVAs were performed on discomfort scores to test the effects of the two chairs. Overall, perceived discomfort across different body regions did not differ between chairs. It is likely that more postural changes were needed to maintain initial comfort levels in the no involvement no adjustment chair studied and were necessary to minimize discomfort. Preliminary findings obtained here will help identify the extent to which postural deviations affect team productivity and responses on discomfort and strain.

Self reported Performance Measures Of Males Are Predictive Of Overall Performance In The Crossfit Open

PURPOSE: To determine if measures of strength and skill, obtained from online athlete profiles, could distinguish overall performance in an international online fitness competition (OFC). METHODS: The highest ranking male competitors (n = 1500; 27.18 ± 8.4 y; 85.2 ± 7.88 kg; 177.01 ± 6.47 cm) were split into quintile groups (Q1 - Q5). Subsequently, quintile comparisons were made using self-reported performances for a one-repetition maximum (1RM), squat (SQ), deadlift (DL), clean and jerk (CJ), snatch (SN), 400-m sprint, 5,000-m run, and benchmark workouts (Fran, Helen, Grace, Filthy 50, and Flight-gone-bad) via separate one-way analysis of variance. RESULTS: Greater (p < 0.011) performance scores were reported by Q1 for DL (232.4 ± 20.5 kg), SQ (201.6 ± 19.1 kg), CJ (148.9 ± 12.1 kg), SN (119.4 ± 10.9 kg) and Fran (2.3 ± 0.2 min) compared to all other quintiles. For Grace, Q1 (1.7 ± 0.4 min) reported faster (p < 0.001) completion times than Q3 - Q5, while their performances in the 400-m sprint (59.3 ± 5.9 sec), Helen (7.6 ± 0.6 min) and Flight-gone-bad (430 ± 70 repetitions) were only better than Q3 (62.6 ± 7.3 sec, p = 0.022), Q4 (7.9 ± 0.7 min, p = 0.007) and Q5 (398 ± 73 repetitions, p = 0.010) respectively. No specific quintile differences were observed in 5,000-m or Filthy-50 performance. CONCLUSION: The data indicates that the most successful male athletes in this OFC possessed the greatest strength and power. Further, these athletes performed the best in a short-duration (< 3 min) sports-specific workout (i.e., Fran) that emphasized these characteristics. Lower ranking athletes should focus on emphasizing strength and power development once sufficient anaerobic, aerobic, and sports-specific proficiency has been attained.

Knee Flexion Angles Influence Hip Extensor Activity During Prone Heel Squeeze

The purpose of this study was to determine the muscle activities of the erector spinae (ES), gluteus maximus (Gmax), gluteus medius (Gmed), and the hamstring (HAM) and the ratios of Gmax/ES,Gmax/HAM, and Gmed/HAM during the prone heel squeeze (PHS) with different knee flexion angles (45°, 90°, and 135°). Fifteen young and healthy subjects (8 men, 7 women) were recruited for the study. Surface electromyography signals were collected on ES, Gmax, Gmed, and HAM during PHS. A separate one-way analysis of variance with repeated measures was used to determine the significance of the muscle activities of ES, Gmax, Gmed, and HAM and the ratios of Gmax/ES, Gmax/HAM, andGmed/HAM with different knee flexion angles during PHS. There was a significant increase in the Gmax activity at the knee flexion of 90° in comparison with that of the 45° (p=.016). There were significant increases in the Gmed activity at the knee flexion of 90° (p=.008) and 135° (p=.006) in comparison with that of the 45°. There were significant decreases in the HAM activity at the knee flexion of 90° (p=.009) and 135° (p=.004) in comparison with that of the 45°. There were significant increases in the Gmax/HAM muscle activity ratio at the knee flexion of 90° (p=.007) and 135° (p=.012) in comparison with that of the 45°. There were significant increase in the Gmed/HAM muscle activity ratio at the knee flexion of 135° in comparison with that of the 45° (p=.008). The knee flexion of 90° during PHS can induce decreasing activity of HAM and increasing activity of Gmax, and the knee flexion of 135° during PHS can induce decreasing activity of HAM and increasing activity of Gmed. Hence, PHS with different knee flexion positions could be considered for the different target muscle.

The Natural Progression of Synovial Fluid White Blood-Cell Counts and the Percentage of Polymorphonuclear Cells After Primary Total Knee Arthroplasty

Assessments of the synovial fluid white blood-cell (WBC) count and percentage of polymorphonuclear cells (PMNs) have been reported to be useful in the diagnosis of periprosthetic joint infection. The purpose of this multicenter retrospective study was to evaluate the natural progression of the synovial fluid WBC count, PMN percentage, and total neutrophil count in patients who underwent knee aspiration during the first two years after primary total knee arthroplasty and had no evidence of periprosthetic joint infection. From April 1999 to March 2012, 571 patients who presented within the first two years after primary total knee arthroplasty underwent knee aspiration as part of an evaluation for periprosthetic joint infection. Patients were categorized into four groups on the basis of the number of days between surgery and arthrocentesis. The synovial fluid WBC count, PMN percentage, and total neutrophil count were compared among the four time periods with use of separate one-way analyses of variance and Tamhane post-hoc analyses. Four hundred and fifty-two samples not associated with a periprosthetic joint infection were adequate for analysis. The synovial fluid WBC count, PMN percentage, and total neutrophil count all decreased after the first ninety postoperative days. The synovial fluid WBC count showed an earlier return to a level similar to the two-year time point than the PMN percentage did. The mean total neutrophil count decreased from 2533.2 cells/μL during the first forty-five days to 649.0 cells/μL from forty-six to ninety days, 269.5 cells/μL from three months to one year, and 240.8 cells/μL from one to two years. The synovial fluid WBC count and PMN percentage changed at different rates over the first two years after total knee arthroplasty, with the WBC count exhibiting an initially more rapid decrease and the PMN percentage demonstrating a more linear decrease. Hence, the total neutrophil count, which combines these two parameters, may provide a better method to identify patients with a periprosthetic joint infection. Values for the synovial fluid WBC count, PMN percentage, and total neutrophil count were all significantly elevated in the early postoperative period, and the use of standard cutoff values for the diagnosis of periprosthetic joint infection can lead to false-positive results.

Posted Emergency Department Wait Times Are Not Always Accurate

Hospitals around the United States are advertising emergency department (ED) wait times. The objective was to measure the difference between publicly posted and actual ED wait times and to compare these between ED site volumes. This study was a retrospective consecutive sample of ED patients at one hospital system with four EDs. The wait times of 8,889 patients were included in this analysis. One ED was in a large teaching hospital with 5,000 ED patients per month; the other three were freestanding or community EDs without teaching and with fewer than 2,000 ED patients per month each. The publicly posted ED wait times at the time of patient arrival were recorded and compared to the actual wait times as retrieved from the ED tracking system. The difference between posted and actual wait times for each site was calculated. Separate one-way analysis of variance (ANOVA) tests with post hoc testing were conducted to assess actual wait time and wait time difference between ED sites. Mean and standard deviation (SD) wait time difference at the main ED with a volume of 5,000 patients per month was 31.5 (±61.2) minutes. At the facilities with fewer than 2,000 ED patients per month each, the differences in wait times were 4.2 (±21.8), 8.6 (±23.8), and 1.3 (±11.9) minutes. ANOVA results revealed that the main ED had significantly different actual wait time and wait time differences (p < 0.05) when compared to the other three EDs. In one hospital system, publicly posted ED wait times show better accuracy in EDs that see 2,000 or fewer patients per month and less accuracy for an ED that sees 5,000 patients per month, likely due to flow confounders.

Interstitial cystitis patients’ use and rating of complementary and alternative medicine therapies

The purpose of this study was to describe the use of complementary and alternative medicine (CAM) therapies among interstitial cystitis (IC) patients, patients' perception of CAM therapies' effectiveness, and the association of time since diagnosis with perceived effectiveness of these therapies. In April 2009, the Interstitial Cystitis Association (ICA) initiated an Internet-based survey on CAM. Respondents indicated whether they received an IC diagnosis and how long ago, whether they tried CAM, and who recommended it. On a 5-point scale, respondents rated 49 therapies. For respondents confirming a diagnosis, we used a chi-square goodness-of-fit test to assess which therapies were rated positively or negatively by a majority of patients who tried them. Using separate one-way analyses of variance, we assessed differences in mean perceived effectiveness among groups based on time since diagnosis and conducted post hoc tests, if necessary. Using chi-square tests, we explored the association of time since diagnosis with the use of CAM and the number of therapies tried. A total of 2,101 subjects responded to the survey; 1,982 confirmed an IC diagnosis. Most (84.2 %) had tried CAM, and 55 % said physicians had recommended CAM. Of those trying CAM, 82.8 % had tried diet or physical therapy and 69.2 % other therapies. Of the therapies, 22 were rated positively and 20 negatively; 7 were inconclusive. Therapies patients perceived to be helpful included dietary management and pain management adjuncts such as physical therapy, heat and cold, meditation and relaxation, acupuncture, stress reduction, exercise, and sleep hygiene. Many therapies worked better for those diagnosed recently than for those diagnosed long before. Randomized, placebo-controlled studies are needed to demonstrate which therapies may indeed control IC symptoms and help send research in new and productive directions.

Risk factors for substance use in pregnant women in South Africa

To study the prevalence of alcohol and substance use in a South African antenatal population and its correlates with socio-demographic factors, depression and perceived stress. A prospective self-report study on all women presenting for their first antenatal visit who consented to the study at a midwife obstetric unit (MOU) in the East Metropole district, Cape Town, using the Alcohol Use Disorders Identification Test (AUDIT), Drug Use Disorders Identification Test (DUDIT), Edinburgh Depression Scale (EDS) and Perceived Stress Scale (PSS). Statistical analyses using the chi-square test, separate one-way analyses of variance (ANOVA) and logistic regression analyses were performed as appropriate. Outcome measures were depression, alcohol use and substance use. The questionnaire was completed by 323 women. During pregnancy 36.8% of women smoked, 20.2% used alcohol and 4% used substances. Using EDS cut-off scores of 12 and 15, respectively, 48.9% and 33.6% of the sample had scores consistent with major depression. An EDS cut-off score of 12 was significantly associated with both alcohol use (25.9% v. 15.2%, p=0.019) and risky drinking (76.9% v. 36.8%, p=0.04), while an EDS cut-off score of 15 was significantly associated with substance use (8.2% v. 1.4%, p=0.004) as well as alcohol dependence (23.1% v. 3.1%). We found high rates of both alcohol abuse and antenatal depression, and a significant association between depression, substance use and alcohol abuse; EDS scores greater than 12 could be used to identify women at risk of alcohol dependence and/or substance abuse.

Clinal variation in stomatal characteristics of an Arctic sedge, Eriophorum vaginatum (Cyperaceae)

In a large reciprocal transplant experiment, Eriophorum vaginatum tussocks transplanted along a latitudinal gradient in Alaska's interior exhibited genetic differentiation and phenotypic plasticity for vegetative traits. Using the same tussocks 30 yr later, we used estimates of growing season temperature at each site to ask whether there was a climatic cline for stomatal density, size, and conductance. We created impressions of the abaxial leaf surfaces of the transplanted individuals for viewing under a microscope and measured stomatal density (SD) and length (SL) for 224 individuals. We used SD and SL to estimate stomatal conductance (C). Separate one-way analyses of variance were performed to quantify the effect of population genetic differences and latitudinal environmental variation on stomatal characteristics. Our data suggest that stomatal size was influenced by both genetics and environment and that plasticity for stomatal density produced highest densities at the coolest sites. Stomatal conductance increased with decreasing temperature of site from which the populations originated. Our results demonstrate a cline in stomatal conductance in E. vaginatum, with some ability of populations to plastically produce an appropriate phenotypic response in a new environment. Because the species is a dominant species in many arctic plant communities, its ability to produce an appropriate stomatal phenotype and to optimize water use efficiency by decreasing stomatal conductance in warmer environments could affect both community composition and total primary productivity in future, warmer climates.

Effects of raised-intensity phonation on inflammatory mediator gene expression in normal rabbit vocal fold

Objective To investigate the hypothesis that a transient episode of raised-intensity phonation causes a significant increase in vocal fold inflammatory messenger RNA (mRNA) expression in vivo. Study Design Prospective animal study. Setting Laboratory. Subjects and Methods Ten New Zealand White breeder rabbits received 30 minutes of experimentally induced modal or raised-intensity phonation, followed by a 30-minute recovery period. A separate group of five rabbits served as sham controls. Real-time polymerase chain reaction was performed to investigate the mRNA expression of interleukin 1β (IL-1β), transforming growth factor β-1 (TGFβ1), and cyclooxygenase-2 (COX-2). Separate one-way analysis of variance (ANOVA) tests were used to investigate differences in gene expression across groups, with an appropriate alpha correction of 0.016 to control for type I error. Significant main effects were further examined using Fisher's least significant difference. Results ANOVA revealed that there were differences for IL-1β, TGFβ1, and COX-2 between sham control, modal phonation, and raised-intensity phonation ( P < 0.0001). Pairwise comparisons revealed that the expression of IL-1β, COX-2, and TGFβ1 increased significantly during raised-intensity phonation, compared to modal phonation and sham control ( P < 0.0001). Conclusion Results provided support for the hypothesis that a transient episode of raised-intensity phonation causes a significant increase in vocal fold inflammatory mRNA expression. Future studies will investigate the signal transduction pathways and mechanisms regulating the vocal fold inflammatory response. The long-term goal of these studies is to advance understanding of the molecular and cellular events underlying phonation-related tissue alterations.

The effects of prophylactic protease supplementation on markers of muscle damage prior to and following intense eccentric exercise: preliminary findings

Methods 20 aerobically-active (50.15 ± 6.16 ml/kg/min) male participants (22.05 ± 4.72 yr, 71.63 ± 2.51 in, 182.40 ± 26.89 lbs) consumed either a proteolytic enzyme combination (N = 10) or cellulose placebo (N = 10) for a total of 24 days. Supplement compliance was monitored via supplement logs indicating how many capsules were consumed each day during the period. During the supplement period, participants also agreed to limit consumption of antioxidant containing foods. Dietary compliance was monitored by the collection of food records for each day of the supplement period. After 21 days of supplementation, participants completed a 45-minute downhill run (60% VO2max, -17.5% grade). Participants donated blood prior to, and for 48 hours following the run (total of 6 samples). Inflammation and muscle damage were assessed by whole blood analysis, serum creatine kinase (CK), ratings of perceived muscle soreness, and via muscle strength testing of the quadriceps. Whole blood and muscle strength data were analyzed using multivariate analyses of variance (MANOVA) with repeated measures, while CK and muscle soreness were analyzed using separate one-way analyses of variance (ANOVA) with repeated measures. An alpha level of ≤ 0.05 was adopted for significance throughout.

Variations in Plantar Pressure Variables across Five Cardiovascular Exercises

To quantify variations in plantar pressure variables in healthy adults across five cardiovascular exercises. Ten young (19-35 yr old) and 10 middle-aged (45-60 yr old) individuals participated. After equipment familiarization, plantar pressure data were recorded during walking, running, elliptical training, stair climbing, and recumbent biking. Separate one-way analyses of variance with repeated measures identified significant differences in pressure variables across exercises and between age groups under the forefoot, arch, and heel. Forefoot: Peak pressures were higher during walking (253 kPa), running (251 kPa), and elliptical training (213 kPa) than stair climbing (130 kPa) and recumbent biking (41 kPa; P < or = 0.001). Biking pressures were lower than all other conditions (P < 0.001). Arch: Pressures were higher during running (144 kPa) compared with all other conditions (P < or = 0.001). Intermediate-level pressures during walking (119 kPa) and elliptical training (102 kPa) exceeded those during stair climbing (80 kPa; P < or = 0.002). Pressures were lowest during recumbent biking (33 kPa; P < 0.001). Heel: Pressures were highest during walking (215 kPa) and running (188 kPa), exceeding those recorded during all other activities (P < 0.001). Moderate elliptical training pressures (94 kPa) surpassed stair climbing values (66 kPa; P = 0.014). Pressures were lowest during recumbent biking (25 kPa; P < 0.001). The only significant difference identified between age groups was a larger arch contact area in the young compared with middle-aged, when averaged across exercises (P = 0.011). When protection of the forefoot is important (e.g., diabetic foot neuropathies), biking and stair climbing offer optimal pressure reductions. If protecting the heel from high pressures and forces is warranted, recumbent biking, stair climbing, and elliptical training provide greater relief.

The Influence of Marital Status on Self-Report of Symptoms of Psychological Burnout among Nurses

This study investigated the influence of marital status on self-report of symptoms of psychological burnout among nurses. Ninety-one female nurses comprising 51 married nurses and 40 widowed nurses drawn from seven hospital units of the University of Nigeria Teaching Hospital Enugu participated in the study. They were individually administered the Nigerian adaptation of Maslach Burnout Inventory (MBI) (Ugwu, 1998) originally developed by Maslach and Jackson (1981). A one-way analysis of variance (ANOVA) was performed on the data to test the first research question of the study. In addition, a separate one-way analysis of variance and the Duncan Multiple Range Test were performed to test the second research question. Results showed that the widowed nurses reported significantly higher burn-out symptoms than the married nurses ( p &lt; .001). The analysis of variance also indicated significant differences among the hospital units on the mean burnout symptoms reported by the nursing staff ( p &lt; .001). Results of the Duncan Multiple Range Test revealed that nurses on the theatre unit had a mean burnout symptoms score that was significantly higher than nurses on the postnatal, casualty, labor, surgical and out-patient units. Nurses on the intensive care unit (ICU) had a mean burnout symptom score that was significantly higher than nurses on the postnatal unit. The results were explained within the framework of the protection/support hypothesis (Adler, 1953). It was suggested that the nursing staff should adopt adequate self-care measures such as having enough rest, vacation, and exercise to reduce the potential for burnout.

Murre Eggs (Uria aalge and Uria lomvia) as Indicators of Mercury Contamination in the Alaskan Marine Environment

Sixty common murre (Uria aalge) and 27 thick-billed murre (Uria lomvia) eggs collected by the Seabird Tissue Archival and Monitoring Project (STAMP) in 1999-2001 from two Gulf of Alaska and three Bering Sea nesting colonies were analyzed for total mercury (Hg) using isotope dilution cold vapor inductively coupled mass spectrometry. Hg concentrations (wet mass) ranged from 0.011 microg/g to 0.357 microg/g (relative standard deviation = 76%), while conspecifics from the same colonies and years had an average relative standard deviation of 33%. Hg levels in eggs from the Gulf of Alaska (0.166 microg/g +/- 0.011 microg/g) were significantly higher (p < 0.0001) than in the Bering Sea (0.047 microg/g +/- 0.004 microg/g). Within the Bering Sea, Hg was significantly higher (p = 0.0007) in eggs from Little Diomede Island near the arctic than at the two more southern colonies. Although thick-billed and common murres are ecologicallysimilar,there were significant species differences in egg Hg concentrations within each region (p < 0.0001). In the Bering Sea, eggs from thick-billed murres had higher Hg concentrations than eggs from common murres, while in the Gulf of Alaska, common murre eggs had higher concentrations than those of thick-billed murres. A separate one-way analysis of variance on the only time-trend data currently available for a colony (St. Lazaria Island in the Gulf of Alaska) found significantly lower Hg concentrations in common murre eggs collected in 2001 compared to 1999 (p = 0.017). Results from this study indicate that murre eggs may be effective monitoring units for detecting geographic, species, and temporal patterns of Hg contamination in marine food webs. The relatively small intracolony variation in egg Hg levels and the ability to consistently obtain adequate sample sizes both within and among colonies over a large geographic range means that monitoring efforts using murre eggs will have suitable statistical power for detecting environmental patterns of Hg contamination. The potential influences of trophic effects, physical transport patterns, and biogeochemical processes on these monitoring efforts are discussed, and future plans to investigate the sources of the observed variability are presented.

Delay of Gratification and Make-Believe Play of Preschoolers

This study examined the relationship between children's ability to delay gratification and time spent in make-believe play in a sample of 39 three-to five-year-old children. Delay of gratification was determined in an experimental situation (Mischel, 1974). Children's play was assessed using a teacher questionnaire, a mother interview, a child interview, and videotaped naturalistic preschool classroom observations. Children who spent more time in make-believe play were able to delay gratification longer than children who spent less time in make-believe play (p = .025). There was a significant correlation between make-believe play at home and delay of gratification (p = .047), but no significant relationship between make-believe play at preschool and delay of gratification. Separate one-way analyses of variance found make-believe play (p = .042) was the only significant variable related to delay of gratification when age, sex, family structure, ethnicity, child care center, mother education, and make-believe play were examined. Solitary play versus social play and delay of gratification were not significantly related (p = .512) when examined by one-way analyses of variance.

The Pediatric Daytime Sleepiness Scale (PDSS): Sleep Habits and School Outcomes in Middle-school Children

To develop a measure of daytime sleepiness suitable for middle-school children and examine the relationship between daytime sleepiness and school-related outcomes. Self-report questionnaire. Four hundred fifty, 11- to 15-year-old students, from grades 6, 7, and 8 of a public middle school in Dayton, Ohio. A pediatric daytime sleepiness questionnaire was developed using factor analysis of questions regarding sleep-related behaviors. Results of the sleepiness questionnaire were then compared across other variables, including daily sleep patterns, school achievement, mood, and extracurricular activities. Factor analysis on the 13 questions related to daytime sleepiness yielded 1 primary factor ("pediatric daytime sleepiness"; 32% of variance). Only items with factor loadings above .4 were included in the final sleepiness scale. Internal consistency (Chronbach's alpha) for the final 8-item scale was .80. Separate one-way analyses of variance and trend analyses were performed comparing pediatric daytime sleepiness scores at the 5 different levels of total sleep time and academic achievement. Participants who reported low school achievement, high rates of absenteeism, low school enjoyment, low total sleep time, and frequent illness reported significantly higher levels of daytime sleepiness compared to children with better school-related outcomes. The self-report scale developed in the present work is suitable for middle-school-age children and may be useful in future research given its ease of administration and robust psychometric properties. Daytime sleepiness is related to reduced educational achievement and other negative school-related outcomes.