Short Survey Research Articles

Validation of the Vanderbilt Classroom Listening Assessment Short Survey for Children With Unilateral Hearing Loss.

Children with unilateral hearing loss experience difficulties in classroom listening situations. There are a limited number of validated questionnaires available for monitoring listening development and quantifying the challenges school-aged children with unilateral hearing loss experience. The purpose of this study was to evaluate a survey that describes the classroom listening challenges reported by children with unilateral hearing loss with and without the use of personal hearing devices (air conduction hearing aid, bone conduction hearing aid, cochlear implant, contralateral routing of signals system). Children aged 9 to 17 years with self-reported unilateral hearing loss completed an online survey about classroom listening difficulties when not using a personal hearing device (n = 1148) or with the use of a personal hearing device (n = 897). The survey includes 15 questions examining different situations common in modern classrooms. Each question includes a picture depicting the described listening situation. Exploratory factor analysis was used to develop subscales and the internal reliability of the subscales was evaluated. To validate the survey, the relationships between survey scores and self-reported hearing difficulties (without a personal hearing device) or type of device (with a personal hearing device) were evaluated using regression analyses. Factor analysis revealed survey scores for individual items statistically loaded onto three factors. On the basis of these factors, subscales were created, which are related to: (1) listening situations where the talker is faraway from the child, (2) listening situations where the talker is close to the child and they are inside a building, and (3) listening situations where the talker is close to the child and they are outside a building. Regression analyses revealed children reported the greatest difficulty in school settings when the sound of interest was faraway from them. Although scores were generally higher, indicating listening was easier, when children were wearing their personal hearing devices (i.e., air conduction hearing aid, bone conduction hearing aid, contralateral routing of signals system, cochlear implant), situations with faraway signals were still reported as more challenging than were situations where signals were close. This set of findings highlights the need to incorporate distance effects into laboratory evaluations that include children with unilateral hearing loss. In addition, the findings support clinical interventions that address talker-to-listener distances, such as preferential seating and remote microphone systems. Last, the results of this study validate the Vanderbilt Classroom Listening Assessment Short Survey for use with children aged 9 to 17 years of age with unilateral self-reported hearing difficulty. The subscales are empirically driven, internally reliable, and focus on three types of listening situations encountered in classrooms. It is important to note that the survey results demonstrate the expected pattern of results, with participants who have greater self-reported hearing difficulty rating classroom listening situations as more difficult than participants with less self-reported hearing difficulty.

Treatment with combined exercise in patients with resistant major depression (TRACE-RMD): study protocol for a randomised controlled trial

BackgroundAround 40% of people with major depressive disorder (MDD) experience moderate remission, with the remainder meeting the criteria for resistant major depression (RMD). It has been shown that exercise has a low-to-moderate effect on MDD, but there is a lack of evidence on exercise interventions in RMD patients. The primary purpose of the proposed study will be to investigate the effect of a 12-week supervised combined exercise program on depressive symptoms in people with RMD compared to a treatment-as-usual (TAU) group.MethodThis randomised, single-blind, controlled experimental trial will include 70 adults (≥ 18 years old) with RMD. Participants randomised to an exercise intervention, or a TAU group will be assessed at baseline and after a three-month intervention period. The primary variable will be participants’ depressive symptoms measured with the Montgomery-Asberg Depression Rating Scale. Secondary outcome variables will include cardiorespiratory fitness (peak oxygen uptake through peak cardiopulmonary exercise test), body composition (bioimpedance and anthropometric variables), physical activity level (the International Physical Activity Questionnaire), health-related quality of life (the Short Form-36 Health Survey), functional outcome (the Sheehan Disability Scale and Quality of Life in Depression Scale), overall disease severity (the Clinical Global Impression Scale-Severity of Illness), and biochemical variables (a fasting blood sample).DiscussionThis study will try to answer whether a supervised co-adjuvant combined (aerobic and resistance training) exercise program will help the prognosis of this population with RMD.Trial registrationClinicalTrials.gov NCT05136027. Last public release on 12/13/2023.

Content and face validity of preference-based quality of life instruments in indigenous youth experiencing mental health problems: a qualitative study.

Mainstream preference-based quality of life (QoL) measures have been traditionally based on Western principles of health. It is critical to examine whether existing preference-based QoL measures capture what is important to Indigenous people while being comprehensive and culturally acceptable. This study aims to assess the content and face validity of the EuroQol-5 dimensions 5-levels (EQ-5D-5L), 12-item short form survey (SF-12), assessment of quality of life-6 dimensions (AQoL-6D), and recovering quality of life 10-item (ReQoL-10) within the context of indigenous youth mental health. Eight individual yarns and five yarning circles were conducted with 20 indigenous young people aged 15-25 years, with a history of at least 1 mental health problem in the Perth and Bunbury regions of Western Australia. The measures were explored in random order using the yarning approach, and then ranked by relevance by participants. Data were analysed using thematic and constant comparative approaches. The face and content validity of each preference-based QoL instrument was summarised into four themes: (1) appropriateness, (2) comprehensiveness, (3) comprehensibility, and (4) layout and format. The ReQoL-10 emerged as a more suitable measure due to its mental health focus, clear response options, and well-designed layout and format. While some positive comments were made about the other measures, there were critical issues around their content and face validity. Our data revealed a clear preference for the ReQoL. The ReQoL-10 appears to be a promising measure in the context of indigenous youth mental health, and was explicitly preferred by indigenous youth.

REASONS COLLEGIATE ATHLETES FEEL UNWELL: SELF-REPORTED SLEEP, NUTRITION, AND STRESS

Introduction: Daily assessments of wellness via short quantitative surveys are becoming a mainstay across professional and collegiate sports. The data typically provide a numerical value on a scale indicating negative and positive scores across several wellness domains. However, little has been reported on why athletes indicate negative scores in wellness. Purpose: This study evaluated reasons reported for low wellness scores in sleep quality, stress, and nutrition, as well as differences in reasons for low wellness among sports and by sex. Methodology: Collegiate athletes from women’s volleyball (n=67), men’s and women’s soccer (n=119), men’s and women’s swimming (n=79), and men’s and women’s basketball (n=87) completed daily assessments of wellness. With a negative wellness score (≤ 3 on a 5-point scale), athletes were prompted to provide a reason for feeling unwell. Results: Chi-square analyses indicated a sex difference for reasons provided for poor sleep and a difference by sport for females and males (all p < .001). Reasons cited for poor sleep quality were late night (23.7%) and “other” (22.3%). For stress, analyses showed differences by sex and sport for females and males (all p < .001). Academic/work stress was the most common reason for poor stress (60.2%). For nutrition, analyses indicated differences by sex (p < .001) and by sport for females (p < .001) and males (p = .008). Consuming fewer than three meals/snacks per day (26.2%) and low fluid intake (21.9%) were the top two reasons for poor nutrition. Conclusions: These data shed light on reasons why athletes experience low wellness. Coaches and support staff can target specific reasons to enhance athlete wellness and the student-athlete experience.

Persian version of the University of Washington Quality of Life Questionnaire (UW-QOL): Reliability and Validity Study

Background: The University of Washington quality of life questionnaire (UW-QOL) is widely used to evaluate the quality of life for head and neck cancer patients. The purpose of this study is translation of the UW-QOL questionnaire's into Persian. Methods: After translation and cultural adaptation of the UW-QOL, the questionnaire was distributed among 100 head and neck cancer patients. Internal reliability of the translated UW-QOL was determined using Cronbach's alpha coefficient. The validity was determined by Spearman correlation coefficient between UW-QOL and 12-Item Short Form Survey (SF-12). The test – retest reliability was measured by Intraclass Correlation Coefficient (ICC) after one week. Results: Cronbach's alpha coefficient was more than 0.75 and ICC coefficient was more than 0.80 in all variables. The UW-QOL questionnaire composite score had a positive significant association with SF-12 questionnaire total score (Spearman's Correlation Coefficient= 0.70, P< 0.0001). Conclusion: In conclusion Persian translation of the UW-QOL questionnaire has acceptable reliability and validity and is as valid as the original English version in evaluating the quality of life for patients with head and neck cancer.

Joy and humanity in communication: A design-based research approach to developing and understanding the impact of a novel education programme on hospital staff, co-designed and facilitated by clown doctors.

Clown doctors have a unique skill set and role, particularly in paediatric settings. Yet, there is limited research on whether clown doctors themselves could play a role in sharing these skills with health professionals. Acknowledging uncertainty in what our intervention should be, we used a design-based research (DBR) approach with the aim of (i) shaping the educational design and content of communication skills-based workshops for clinicians and (ii) understanding the educational impact on participants. Data were collected from initial key stakeholder consultations, then through the delivery of evolving iterations of the workshop in the form of post-workshop group discussions, follow-up short participant surveys and observations of the workshops themselves. Reflexive thematic analysis of group discussions and short survey responses was undertaken to understand the impact. Forty participants participated in five workshops, including staff from medical, nursing, allied health and administrative backgrounds. Five educational principles emerged: self-awareness, curiosity, play, spirit and self-reflection. Four central themes regarding educational impact were generated: creating joy and breaking barriers; the heart, not the science of communication; workplace tensions challenge change; and communication training but not as we know it. A novel education programme facilitated by clown doctors at a hospital offered unique communication skill learnings, while bringing joy and connection to the workplace through education. The DBR approach enabled this programme to be shaped, implemented, and evaluated, with the results attesting to the value of more novel approaches to communication training. The challenge remains to embed, sustain, and potentially scale the programme to other settings.

Radiographers’ perspectives on immobilisation and restraint mechanisms in paediatric radiography

IntroductionThe utilisation of immobilisation or restraint during paediatric radiography is a multifactorial issue with associated legal and ethical considerations. Current practice regularly presents challenges for radiographers, with a notable absence of any professional best-practice guidance. This study investigated radiographers’ perspectives in Ireland on the use of immobilisation or restraint methods and the factors influencing these choices and aimed to fill the 20-year gap in European radiographers’ perspectives gaining an up-to-date understanding and contribute to the global conversation in this regard. MethodsAn anonymous online survey design was constructed using the Google Forms platform and distributed to hospital radiology departments across the Southern region of Ireland. Additionally, a short survey was send to the head of the nine radiology departments to audit the existing availability of immobilisation and/or restraint devices for paediatric radiography. Descriptive statistics (frequencies and percentages) were undertaken. Bar charts were utilised where appropriate to display trends. ResultsOne hundered and three responses were received. The majority of radiographers reported using immobilisation (95 %) or restraint (89 %) techniques during paediatric radiography, although 70 % acknowledged the lack of training regarding restraint techniques. However, 93 % reported trying alternative techniques such as distraction and negotiation to avoid immobilisation or restraint. A desire for further guidance and training was reported, with 80 % of respondents noting training as essential or potentially beneficial. ConclusionsAmbiguity remains surrounding the distinction between the terms “restraint” and “immobilisation” in paediatric radiography. Radiographers' use of restraint and immobilisation during paediatric radiography is influenced by the child's age, distress level, radiation protection and safety, and the ability of the child to understand instructions. Appropriate up-to-date guidelines and training would be recommended to clarify terminology and promote the safe practice of restraint and immobilisation during paediatric radiography.

Non-absorbable surgical sutures versus autologous tendons in the reconstruction of medial patellofemoral ligaments: a randomised controlled trial protocol

IntroductionArthroscopic-assisted medial patellofemoral ligament reconstruction (MPFLR) is a common surgical procedure for patellar dislocation. We present the protocol of a randomised controlled clinical trial to compare postoperative pain, knee function...

Parents' Experiences With and Preferences for Receiving Information About Tumor Genomic Sequencing: Findings From a Qualitative Study and Implications for Practice.

The use of up-front tumor genomic sequencing (TGS) is becoming increasingly common in pediatric oncology. Despite this, little is known about how parents receive information about TGS at the time of their child's cancer diagnosis. We aimed to describe parents' experiences with and preferences for receiving information about TGS and to use these findings to inform practical guidance for pediatric oncology clinicians. We conducted semistructured interviews with English-speaking parents (older than 18 years) of patients (younger than 18 years) who had TGS for a new diagnosis of cancer. We analyzed the interviews thematically. Participants also completed a short demographic survey, and we obtained medical information about participants' children via chart review. We interviewed 20 parents (14 mothers; median age, 38 years) of children who underwent TGS for a newly diagnosed cancer (10 leukemias/lymphomas, three CNS tumors, seven other solid tumors). Children were 6 months to 17 years at diagnosis (median, 6 years). Fifteen parents and their children were White, two of whom were Hispanic and four of whose children were Hispanic. No participants identified themselves or their child as Black. We identified the following themes regarding information delivery about genomic testing from the interviews: (1) those in the parent role have some universal information needs; (2) information delivery preferences vary among parents, even within one family; and (3) parents desire standard yet tailored information delivery. Parents made suggestions consistent with elements of established high-quality communication in pediatric oncology. As genomic testing is more standardly incorporated into childhood cancer care, communication with parents may need to adapt to reflect this. Our findings highlight potential opportunities to support parents in receiving information about genomic testing.

Comparing the efficacy of intra-articular injection of Platelet Rich Plasma (PRP) with corticosteroids (CS) in patients with chronic zygapophyseal joint low back pain confirmed by double intra-articular diagnostic blocks: A triple-blinded randomized multicentric controlled trial with a 6-month follow-up

ObjectiveTo compare the safety and effectiveness in improving function and reducing pain of autologous PRP to corticosteroid (CS) zygapophyseal (Z-joint) intra-articular (IA) injections at six months for patients with chronic osteoarthritis Z-joint mediated low back pain (LBP). DesignProspective triple-blinded multicentric randomized controlled trial. MethodsFifty participants with radiological signs of Z-joint OA and chronic Z-joint mediated LBP confirmed by a ≥80 % pain improvement after two IA local anesthetic injections were randomized into PRP and CS groups, using a 1:1 ratio. Participants completed questionnaires at baseline, and at 1-, 3- and 6-month post-treatment, with adverse effect data collected at 1 month. Function (Oswestry disability index (ODI)), pain (Numeric Rating Scale (NRS)), treatment satisfaction (modified MacNab criteria), and quality of life (Short Form survey 36 (SF-36)) were assessed at each follow-up. The primary outcome was the percentage of participants improving their function (ODI score) above the minimal clinically important difference (MCID) of 17 points. The secondary outcomes were the percentage of participants with a >50 % NRS improvement, satisfaction to treatment and mean score improvement. Proportions were compared between groups using a chi-square test. Mean scores were compared using a two-way ANOVA or the nonparametric Brunner & Langer test. ResultsBoth groups were similar at baseline, no major adverse effects occurred, and no participants were lost at follow-up. The proportion of participants improving their ODI scores above the MCID, the proportion of participants with a >50 % NRS improvement, and mean ODI scores were significantly different between groups in favor of PRP at 6 months. Modified MacNab satisfaction scale, NRS and SF36 mean scores were not statistically different between groups, but all followed the same pattern: the CS groups had a greater improvement a one month, both groups were equivalent at three months and the PRP group had a greater improvement at six months. ConclusionThis first triple-blinded multicentric RCT demonstrates the safety of PRP IA Z-joint injections and its superiority in improving pain and function at six months post-treatment compared to CS for patients with chronic OA Z-joint mediated LBP. To perform a blinded control study, two intra-articular treatments were compared. However, knowing that radiofrequency neurotomy (RFN) of the medial branch diagnosed by branch blocks has been standard of care for pain originating from Z-joints, further studies comparing PRP to RFN are still needed. Clinicaltrials gov registry numberNCT05188820.

Novel method to estimate horizontal variability of shear wave velocity through multichannel analysis of surface waves

Scale of fluctuations (SOFs) of spatially variable soil properties have been regarded as one of the important parameters for performing reliability-based design in geotechnical engineering. However, the information required to estimate the SOFs in practice is limited, especially in the horizontal direction. In this study, the potential use of Multichannel Analysis of Surface Waves (MASW) to estimate the SOFs of shear wave velocity (VS) in horizontal direction is investigated through a series of numerical investigations. 2D random field models with a vertically increasing trend of VS were first simulated with different levels of variability controlled by the coefficient of variation (COV) and SOF. Afterwards, a large number of numerical MASW tests were performed using a 2D finite difference method, where the survey lines were progressively shifted. Results show that the COV of VS can be determined from the scatter of the dispersion curves, whereas the horizontal SOF of VS can be appropriately estimated from the phase velocity profile presented in the wavelength form. Additionally, in-situ MASW tests were conducted to estimate the horizontal SOF, and the obtained results align with those estimated by different methods. It is highlighted that the accuracy of the estimation depends on survey length. The interpretation using a long array reflects an averaged site condition of the survey area, thus losing the variability information. Favorable predictions are produced when survey length is shorter than 1.0 SOF. However, it should be noted that use of short survey length may limit the depth of investigation.

The Hungarian adaptation of the functional status questionnaire: Examination of validity and reliability.

In the international literature, several questionnaires measuring everyday activities are known with the aim of examining patients' quality of life. In the Hungarian language, few validated questionnaires focus on daily activities, examining both basic and moderately difficult physical activity, as well as mental health. Our goal was to translate the Functional Status Questionnaire (FSQ) into Hungarian and examine its reliability and validity.The validation of the questionnaire into Hungarian followed the six-step principle formulated in 2000. In our cross-sectional study, 376 participants took part. For convergent validity, we used the 36-Item Short Form Survey (SF-36) and the Functional Independence Measure (FIM) questionnaires. The examination of internal consistency was performed through Cronbach's alpha calculations. Test-retest reliability within the class was assessed with the intraclass correlation coefficient (ICC). We conducted discriminant validity for pain and general health. Internal consistency values demonstrated reliability. Participants' demographic data showed that the majority live in cities and have secondary education. The individuals included in the study exhibited unusually high levels of sports activity compared to the Hungarian average. Convergent validity examinations revealed significant relationships between dimensions of health-related quality of life of the different measurement tools. The validated Hungarian questionnaire is valid and reliable. Similar to the original questionnaire, it is quickly and easily completed, allowing healthcare professionals in clinical settings to assess the patient's functional status before initiating examinations.

Virtual Reality Exposure Therapy Protocol for Post-Traumatic Stress Disorder Treatment in Military Veterans: Cross-Cultural Adaptation of Virtual Exposure Therapy in Ukraine

Introduction. The integration of virtual reality technologies into PTSD treatment in Ukraine presents new opportunities for enhancing the mental health of military personnel, veterans, and individuals affected by war-related trauma. During military operations, soldiers often experience intense stress, anxiety, and intrusive memories, which can lead to PTSD. VR therapy uses fully and partially immersive technologies to create a safe virtual environment where patients can explore and process traumatic experiences under the guidance of a qualified specialist. The use of VR technologies for PTSD treatment during the ongoing conflict in Ukraine may become a crucial tool for addressing and healing trauma in both military personnel and civilians. This method provides a structured setting that fosters emotional processing and therapeutic engagement, aiming to alleviate psychological burdens and improve mental health outcomes. Purpose: To conduct a cross-cultural adaptation of the physiologically facilitated Virtual Reality Exposure Therapy (VRET) protocol with gradually increasing exposure, develop a Ukrainian version of the protocol tailored to the specific needs of Ukrainian PTSD patients, create VR technology and content that reflect the unique aspects of the Ukrainian war experience, and pilot test this protocol with a focus group of Ukrainian war veterans diagnosed with PTSD and carrying war-related traumatic memories. Methodology: For the cross-cultural adaptation of the Virtual Reality Exposure Therapy (VRET) protocol, a physiologically facilitated version with gradually increasing exposure was selected. This protocol was translated by two independent translators, followed by synthesis into a single version, back-translation, analysis, and final approval by a working group. The finalized Ukrainian version was prepared for field studies with a focus group of Ukrainian war veterans (n=50). All veterans underwent diagnostic assessments both before and after the VRET intervention, using the following standardized scales: the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) for PTSD evaluation, the Generalized Anxiety Disorder 7-item (GAD-7) scale for anxiety disorders, the Patient Health Questionnaire-9 (PHQ-9) for depression, the Columbia-Suicide Severity Rating Scale (C-SSRS) for suicidal intentions, the Short Form Survey (SF-36) for quality of life, and the Alcohol Use Disorders Identification Test (AUDIT) for alcohol dependence. A series of VR scenarios were developed specifically to address the needs of Ukrainian war PTSD patients, designed to trigger common PTSD responses. A unique administrative panel was also created for therapists to adjust the presence and intensity of various triggers in real time, allowing for personalized tuning of the VR experience throughout the session. Results: Over a 6-month period, 50 Ukrainian war veterans participated in the study to assess the effectiveness of the adapted Ukrainian version of the VRET protocol for PTSD treatment. Comparison of baseline and post-intervention assessments showed significant improvements in clinical outcomes, including reductions in PTSD symptoms, anxiety, depression, and an overall improvement in quality of life. Conclusions: The cross-cultural adaptation and testing of the Virtual Reality Exposure Therapy protocol with a focus group of Ukrainian veterans with PTSD demonstrated reductions in PTSD symptoms, anxiety, and depression, alongside improvements in quality of life. Virtual reality allowed veterans to safely re-experience traumatic events under professional supervision, with gradually increased realism, enhancing the therapy's effectiveness. This method also reduces stigma by offering a confidential setting for therapist interaction, showing substantial promise in helping veterans manage their mental health more effectively

Opportunities for the informatics community to advance learning health systems.

There is rapidly growing interest in learning health systems (LHSs) nationally and globally. While the critical role of informatics is recognized, the informatics community has been relatively slow to formalize LHS as a priority area. We compiled results from a short survey of LHS leaders and American Medical Informatics Association (AMIA) members, discussion from an LHS reception at the AMIA annual meeting, and a follow-up survey to inform priorities at the intersection of LHS and informatics. We present opportunities between informatics and LHS which fell into themes of: Understanding and Context, Shared Resources, Collaboration, Education, Data, Evaluation, and Patient Centeredness. Immediate LHS informatics priorities identified include establishing informatics LHS forum(s), case reports of LHS informatics successes and failures, LHS informatics education resources, and improved understanding of LHS principles in informatics. Increased informatics and LHS alignment is critical for advancing this transformative national priority.

Building the OAChangeMap to Improve the Service Delivery of the New South Wales Osteoarthritis Chronic Care Program: A Worked Example of Using a Codesign Framework.

The Osteoarthritis Chronic Care Program (OACCP) has been implemented in Australian public hospitals to deliver best evidence osteoarthritis (OA) care. It is important to ensure that the OACCP continues to deliver evidence-based OA care as intended. We aimed to identify barriers and enablers to delivering the OACCP, prioritize the barriers, and generate strategies to address them. This study provides a worked example of a seven-step theory-informed codesign framework. We invited OACCP coordinators to participate in semistructured interviews (analyzed thematically) and complete a questionnaire to identify barriers and enablers to delivery of the OACCP. We then invited a broader group of stakeholders (OACCP coordinators, health managers, policy makers, consumers, and researchers) to prioritize the barriers via a short survey (survey 2). We held five codesign workshops in which we mapped the priority barriers to the Theoretical Domains Framework and developed strategies to address them. Sixteen coordinators were interviewed, and the main barriers identified were as follows: (1) patients often have beliefs that are inconsistent with best evidence care, (2) there are aspects of clinical care that are not delivered optimally, and (3) system-level factors are a barrier to optimal patient care and sustainability of the OACCP. We codesigned a plan for action with patient educational materials, shared decision-making tools, and health professional education and training. Our worked example of codesign used a theory-based, data-driven approach with key stakeholders, identified and prioritized barriers to the delivery of the OACCP, acknowledged enablers, and generated a plan for feasible strategies to improve the program.

Effect of very low-carbohydrate high-fat diet and high-intensity interval training on mental health-related indicators in individuals with excessive weight or obesity

Very low carbohydrate high fat (VLCHF) diet and high-intensity interval training (HIIT) are widely utilized for weight reduction and cardiorespiratory fitness improvement, respectively. To assess the acceptability of these approaches, it is essential to examine mental health-related indicators. This secondary analysis of a randomized controlled trial investigated the isolated and synergistic effects of VLCHF and HIIT on mental health-related indicators in individuals with excessive weight or obesity. Sixty-eight participants (age = 42 ± 10.2; 20–60 years; BMI = 29.8 ± 3.7) were analysed across four groups: HIIT (n = 15, 4 males, 11 females), VLCHF (n = 19, 4 males, 15 females), VLCHF + HIIT (n = 19, 4 males, 15 females), and control (n = 15, 4 males, 11 females). The 12-week intervention, involved VLCHF diet or HIIT sessions, depending on group affiliation and completing online questionnaires via Qualtrics software before and after the intervention. The questionnaires included the 12-item Short Form Survey (SF-12) for mental (MHS) and physical health scores (PHS), the Satisfaction with Life Scale (SWLS), and the Perceived Stress Scale (PSS). Using the Kruskal–Wallis test, we found no significant differences in mental health-related indicators between groups after 12 weeks, except for SWLS (p = 0.031; ES = 0.133; medium), which improved significantly in the VLCHF + HIIT group compared to the HIIT group. Our findings indicate that HIIT and VLCHF, alone or combined, do not significantly affect mental health-related indicators.

Comparative Effects of Spinal Anesthesia and Combined Spinal with Peripheral Nerve Blocks on Postoperative Outcomes in Anterior Cruciate Ligament Repair.

Objectives: This study aimed to compare the effectiveness of spinal anesthesia (SA) alone versus combined spinal anesthesia with adductor canal block (ACB) and sciatic nerve block (SNB) (SA + ACB + SNB) in patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction. We hypothesized that SA + ACB + SNB would provide better analgesia, greater patient satisfaction, and shorter postanesthesia recovery times than SA alone. Methods: A prospective randomized controlled trial was conducted with 60 patients aged 15-49 years scheduled for elective arthroscopic ACL reconstruction. Participants were randomly assigned to receive either SA or SA + ACB + SNB. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 4, 12, and 24 h post-operation. General health was evaluated using the 12-item Short Form Survey (SF-12) at 1 month postoperatively. Range of motion and analgesic consumption were also recorded. Results: The median VAS score at 4 h post-operation was significantly lower in the SA + ACB + SNB group compared to the SA group (0 [IQR: 0-1] vs. 2 [IQR: 1-3], p = 0.0137). No significant differences in VAS scores were found at 12 h (p = 0.9282) and 24 h (p = 0.5809). PCS-12 and MCS-12 scores did not differ significantly between groups. The SA group had a lower postoperative range of motion (ROM) compared to the SA + ACB + SNB group, with a mean active ROM of 40.67 degrees (±23.52) versus 72.17 degrees (±24.69), respectively (p < 0.0001). Analgesic consumption was similar, with 53.33% of participants in each group using postoperative analgesics (p = 1.0). The mean surgery duration was 74.6 min. The gender distribution was 83% male and 17% female, with an average age of 27.7 years. Conclusions: Adding ACB and SNB to spinal anesthesia improved immediate postoperative pain relief and preserved range of motion in patients undergoing ACL reconstruction, suggesting potential clinical benefits in pain management and functional recovery.

Active Neurodynamic Technique at Home in Patients with Knee Osteoarthritis: An Open Single Arm Clinical Trial.

Background and Objectives: Knee osteoarthritis (KO) stands as the third leading cause of disability among the elderly, causing pain, reduced quality of life, and decreased functionality. The objective of this study is to assess the effects of an active neurodynamic technique programme at home on pain, quality of life, and function among individuals with KO. Materials and Methods: Thirty-five participants (69.7% women) aged ≥50 years with KO (Kellgren-Lawrence grades I-II) performed a femoral nerve mobilization programme at home for 6-8 weeks (20 repetitions per day). Pain intensity, using the numerical rating scale (NRS), pressure pain thresholds (PPTs), central sensitization inventory (CSI), temporal assessment, pain modulation, Knee Injury and Osteoarthritis Outcome Score (KOOS), and the 12-item Short Form Survey questionnaire (SF-12) were collected before, after the intervention, and at one, three, six, and twelve months. Results: Participants improved significantly in pain (p < 0.05), with the improvement maintained throughout the follow-up in the NRS and for at least one month in the PPT. There were also statistically significant (p < 0.05) improvements in all subscales of the KOOS, which were maintained throughout the follow-up. Improvements were also found in the CSI and CPM. Conclusions: A home-based active neurodynamic programme for the femoral nerve has been demonstrated to yield positive effects on pain and function in patients with KO.

Islamic or Conventional Banking

Purpose: The purpose of this research study is to examine the banking preferences of Kuwaiti university students, their preferences between Islamic and conventional, the reasons supporting their choice and, as a measure of satisfaction, the likelihood of them recommending their bank to their friends and family. Design/methodology/approach: We conduct a short survey among undergraduates using a 4-item paper questionnaire physically distributed and collected at a Kuwaiti business school. The large response (n= 503) is analysed and descriptive statistics used to present the results Findings: Results indicate a majority prefer Islamic banking and that the main reason for this is their religion. Those students who opted for conventional banks gave social reasons such as recommendation for their choice. A higher level of satisfaction was recorded for Islamic banking customers. We conclude that Islamic banks have managed to match their ethical and religious appeal with the delivery of efficient and convenient banking services that are valued by the student segment. Practical Implications: Our results are of interest to those offering retail banking services in binary markets where conventional banks compete with Islamic banks in addition to researchers in this domain. For Islamic banks, the significance of maintaining a strong reputation with the underpinning of robust Shariah principles is emphasized. Originality: The paper contributes fresh understanding to the acceptance of and satisfaction with Islamic banks and their products and services among a strategically important segment. It provides evidence suggesting a bright future for Islamic banking in Kuwait and the wider Gulf region.

The Role of Multi-Agents in Digital Twin Implementation: Short Survey

In recent years, Digital Twin (DT) technology has emerged as a significant technological advancement. A digital twin is a digital representation of a physical asset that mirrors its data model, behaviour, and interactions with other physical assets. Digital Twin aims at achieving adaptability, seamless data integration, modelling, simulation, automation, and real-time data management. The primary goal of this article is to explore the role of agents in DT implementations, seeking to understand their predominant usage scenarios and purposes. From our perspective, agents serving as intelligent entities play a role in realising the features of DTs. This article also discusses the gaps in DT, highlights future directions, and analyses various technologies integrated with multi-agent systems technologies in DT implementations. Finally, the article briefly discusses an overview of an architecture to implement a DT for smart agriculture with multi-agents.