Significant Decrease In Scores Research Articles

Real-World Retention Rate, Effectiveness, and Safety of Netakimab in the Treatment of Patients with Ankylosing Spondylitis: First Year Results of the LIBRA Post-Registration Safety Study.

: To evaluate retention rates and safety of netakimab in patients with AS in real-world clinical practice. Additionally, the efficacy of netakimab was evaluated at 1-year follow-up. : Patients were recruited for the study from August 2020 to December 2021 at 23 centers in the Russian Federation. The study included patients who were prescribed netakimab therapy before enrollment, so clinical and medical history data for the first visit were entered retrospectively, and following visits at 12, 24, and 52 weeks of therapy were collected within the study. Drug survival rate was calculated according to Kaplan-Meier analysis. : The study included 137 (93 men and 44 women) patients with AS. The average age of patients was 42.3 (11.9) years, 34.3% of patients had previously received therapy with bDMARD, mainly TNF inhibitors. At the end of the analyzed period (52 weeks of therapy), 90.4% (95% CI, 85.4-95.7) of patients continued treatment with netakimab. The BASDAI and ASDAS-CRP showed statistically significant decreases in scores from baseline at all time points. Netakimab was well tolerated by patients; AEs, related to therapy according to the investigator's opinion, were reported in 7 (5.1%) patients. Two patients stopped taking netakimab due to AEs (terminal ileitis and chronic colitis). : In real-world clinical practice, netakimab demonstrated high retention rates, a favorable safety profile, and sustained efficacy throughout the first year of therapy.

Availability of Observational Pain Assessment Tools in Hospitalized Patients with Osteoporotic Vertebral Fractures.

Background and Objectives: Osteoporotic vertebral fractures in older patients cause lower back pain and abnormal posture, resulting in impaired activities of daily living (ADLs). Assessing pain using self-reported assessment tools is difficult, especially in patients with moderate-to-severe cognitive impairment. Recently, observational assessment tools have been used when self-reported ones were difficult to administer. No studies have reported the usefulness of observational assessment tools in patients with acute-phase orthopedic disorders without complication. This study aimed to examine the availability of observational tools for pain assessment in patients with lumbar vertebral fractures. Materials and Methods: Patients admitted to our hospital with acute-phase vertebral fractures were enrolled in this prospective observational study. Pain was assessed using Japanese versions of the Abbey pain scale and Doloplus-2 observational assessment tools, and the Numerical Rating Scale, a self-reported assessment tool. To compare the pain assessment tool, we examined whether each tool correlated with ADLs and ambulatory status. ADLs were assessed using the Barthel Index. Ambulatory status was assessed using the Functional Ambulation Categories and the 10-m walking test. Results: Similar to the Numerical Rating Scale scores, assessments with the Abbey pain scale and Doloplus-2 showed significant decreases in scores over time. A significant positive correlation was observed between the self-reported and observational assessment tools. Each pain assessment tool was significantly negatively correlated with ADLs and ambulatory status. Conclusions: When self-reported assessment with the Numerical Rating Scale is difficult for patients with cognitive impairment, pain can be estimated using the Abbey pain scale and Doloplus-2 observational assessment tools.

NEUROMUSCULAR ELECTRICAL STIMULATION EFFECT ON WRIST SPASTICITY AND FUNCTION IN POST-STROKE PATIENT WITH UPPER EXTREMITY RECOVERY EXERCISE

Background : Stroke is still a major health problem in the world and cause disability. Spasticity is one of the disability problems in stroke patients, which is more common in the wrist muscles. Recovery of spasticity is quite difficult and there is no definitive treatment that can speed up the recovery. Electrical stimulation is one of the rehabilitation intervensions that is believed to be able to recover spasticity based on neuroplasticity theory. There has been no consensus for the method of electrical stimulation that can give rise to optimal effects in stroke patients. New studies are still needed to determine effective therapeutic programs. Objective : The study aims to determine the effectiveness of the use of Wrist Neuromuscular Electrical Stimulation (NMES) against the recovery of spasticity and functional degrees of post-stroke patients who receive upper extremity recovery exercise (URE). Methods : The study used a randomized controlled trial. The study sample was stroke patients who are treated at dr. Saiful Anwar hospital policlinic. The study involved 30 post-stroke patients who were randomized into NMES combined with URE groups (15 patients) and URE groups (15 patients). Modified Asworth Scale and Fugl-Meyer Assesment of Upper Extremity total were measured before and after interventions. Modified Asworth Scale (MAS) is a scale than use for measure spasticity degree and have very good realibility. Fugl-Meyer Assesment Scaletha (FMA) is a scale for measure fungsionality of extremities which also have good realibility. Neuromuscular Electrical Stimulation (NMES) device is BTL-5000 series. Results : NMES combined with URE can reduce the degree of spasticity and increase the functional degree of the wrist in post-stroke patients significantly (p<0.05). URE can also significantly reduce the degree of spasticity and increase the functional degree of the wrist (p<0.05). NMES compared to URE futher reduced the degree of spasticity and increased the functional degree of the wrist in post-stroke patients insignificantly (p>0.05). Conclusion : The mean decrease in the degree of spasticity and increase in functional degree in the NMES group combined with URE measured by MAS scale showing that degree of spasticity with sig 0,101 > alpha (0,05) is not significant, but the mean decrease MAS in the NMES with URE group is bigger than group URE alone. The mean decrease in the degree of spasticity and increase in functional degree in the NMES group combined with URE measured by FMA scale showing that degree of spasticity with sig 0,787 > alpha (0,05) is also not significant, but the mean decrease FMA in the NMES with URE group is bigger than URE alone. This results mean that there is a significant score decrease in spasticity and increase of fungsionality degree before and after URE grop and there is not significant different score using NMES and URE group in MAS and FMA scale.

Integration of equine assisted services and social-emotional learning: A preliminary evaluation of a life skills training program for at-risk youth

Abstract This study was a preliminary evaluation of a life skills training program conducted by the Equine Partnership Program (EPP) integrating Equine Assisted Services (EAS) with social emotional learning (SEL) competencies. SEL programs aim to foster character development, curb maladaptive behaviors, and enhance social skills in at-risk youth by promoting positive relationships and emotional regulation. Many youth still require more targeted or alternative approaches to effectively nurture these skills. EAS has the potential to enhance SEL through its experiential learning approach and use of horses as a bridge, which is believed to be effective because of the horse’s innate ability to mirror and respond to human emotion. The purpose of this study was to assess the impact of EAS on the social–emotional development of at-risk youth as measured by the Depression, Anxiety, Pain, and Stress (DAPS) visual analog tool. It was hypothesized that participants would demonstrate measurable improvements in emotional regulation post intervention. Data were collected before and after the EAS experience from 33 participants. Participants were asked to rate their levels of DAPS ranging from a high of 10 to a low of 1. Using t-test comparisons, statistically significant decreases in scores were found in depression (M = −0.67, p = 0.02), and anxiety (M = −1.18, p < 0.001). Emotional pain and stress also showed decreases, though not statistically significant. This intervention shows promise to serve as an effective modality in addressing resilience and pro-social skills necessary for improved outcomes in behavioral and emotional development, thereby improving future academic, career, and overall life success, including improved social relationships.

Effectiveness of vestibular rehabilitation therapy and yoga in the management of chronic peripheral vertigo: A randomized controlled trial.

The purpose of the study was to compare the effectiveness of yoga as a form of Vestibular Rehabilitation (VR) to standard VR for managing patients with symptoms such as dizziness, disequilibrium and gait instability. 150 participants based on 18-point difference in the DHI score were randomly assigned to group 1- Yoga, group 2- VR and group 3- control group using block randomization. The intervention was provided for 12 weeks. The participants were assessed for Dizziness Handicap Inventory (DHI) at baseline, 4 th, 8 th and 12 th week. The mean DHI for group 1(41.12±7.13) group 2 (42.96±10.54) group 3 (50.84±10.78), p<0.001 decreased significantly in group 1 and 2 when compared to baseline. There was no statistically significant difference in overall Dizziness Handicap Inventory (DHI) scores between the Yoga and Physiotherapy groups after one month; however, both groups resulted in a significant decrease in scores when compared to the control group. Similarly, by the end of the second and third months, there was no significant distinction between the Yoga and Physiotherapy groups, even though both had a considerable decrease in DHI scores when compared to the control group. Furthermore, an examination of the functional, emotional, and physical components of DHI demonstrated persistent trends of significant improvement in both the Yoga and Physiotherapy groups as compared to the control group over a three-month period. In addition to VR, Yoga and medications administered concurrently can provide effective therapeutic effects. Yoga has an advantage over VR since it offers a customized cure for giddiness in addition to symptom relief. Yoga might be a great alternative to the conventional VR because along with enhancing overall body relaxation, it is affordable and is easy to learn.

Forensic pilot application of rehydrating solutions on human cadaveric skin: what are the effects on hemorrhagic infiltrates?

The microscopic evaluation of hemorrhagic infiltrates is crucial in forensic diagnostics, but it proves challenging in corificated and mummified cadavers. In these cases, pre-treatment with rehydrating solutions is recommended, although their effects on the hemorrhagic infiltrate are not well understood. In this pilot study, we microscopically investigated the effect of two different rehydrating solutions-Sandison's solution and fabric softener-on well-preserved human cadaveric skin samples taken from areas affected by an ecchymotic lesion, comparing them with direct fixation in formalin. Specifically, we examined the topographic distribution of the hemorrhagic infiltrate in each layer of the skin by assigning a semi-quantitative score, conducted mutual comparisons, and performed statistical analysis. Histologically, compared to direct fixation in formalin, a slight and statistically non-significant reduction in the hemorrhagic infiltrate was observed in samples pre-treated with fabric softener. On the other hand, a more pronounced and statistically significant decrease in scores was observed in samples pre-treated with Sandison's solution. This effect is likely due to the fact that Sandison's solution, due to its components, exerts an osmotic effect, partially inducing osmotic lysis of red blood cells. Overall, extensive areas of hemorrhagic infiltrates were preserved, although to a lesser extent, while smaller foci were markedly reduced, sometimes even disappearing. The findings suggest that Sandison's solution has a detrimental effect on cutaneous hemorrhagic infiltrates, emphasizing the importance of being cautious and conducting dual sampling, using both formalin and a rehydrating solution, for forensic examination of mummified or corificated skin samples.

Utilization of interactive E-book in bridging the least learned competencies in statistics and probability

This experimental study with purposive non-probability sampling focused on investigating the results before and after using interactive e-books by the Grade 12 students at Southville 1 Integrated School during the academic year 2022-2023. This study was conducted among 108 students in Grade 12 who answered the 20-item pre-test and 20-item post-test with a 5-point Likert scale survey. This study used mean, standard deviation, and mean percentage scores to determine the effectiveness of interactive e-books in bridging the least learned competency and a paired sample t-test test to analyze the significant difference between the respondents' performance before and after utilizing the interactive e-book. The study showed a significant mean difference in pre-test and post-test scores, indicating a significant decrease in scores before the intervention. However, interactive e-books resulted in a considerable performance improvement, as evidenced by the t-value and low p-value, which revealed a significant difference between the two scores. The effect size of 1.93 was likewise adequate, showing the magnitude of the observed effect. The findings indicate that interactive e-books can increase students' academic performance and learning outcomes as digital learning materials. The study finds that using interactive e-books in the classroom can increase student engagement, comprehension, and overall academic achievement.

Real-world retention rate, effectiveness, and safety of netakimab in the treatment of patients with ankylosing spondylitis: First year results of the LIBRA post-registration safety study

Background. Netakimab has shown high efficacy in controlled clinical trials in the treatment of patients with ankylosing spondylitis (AS). This article presents results of an observational study of netakimab using in routine clinical practice.Methods. Patients were recruited for the study from August 2020 to December 2021 at 23 centers in the Russian Federation. The study included patients who were prescribed netakimab therapy before enrollment, so clinical and medical history data for the first visit were entered retrospectively, and following visits at weeks 12, 24 and 52 of therapy were collected within the study. Drug survival rate has been calculated according to Kaplan – Meier analysis.Results. The study included 137 patients (93 men and 14 women) with AS. The average age of patients was 42.3 (±11.9) years, 34.3% of patients had previously received therapy with genetically engineered biologic drugs, mainly tumor necrosis factor inhibitors. At the end of the analyzed period (52 weeks of therapy), 90.4% [95% CI: 85.4–95.7] of patients continued treatment with netakimab. The BASDAI and ASDAS-CRP showed statistically significant decreases in scores from baseline at all time points. Netakimab was well tolerated by patients; adverse effects (AEs), related to therapy according to the investigator’s opinion, were reported in 7 (5.1%) patients. 2 patients stopped taking netakimab due to AEs: terminal ileitis and chronic colitis.Conclusions. In real-world clinical practice, netakimab demonstrated high retention rates, a favorable safety profile, and sustained efficacy throughout the first year of therapy.

A single 1,500 m freestyle at maximal speed decreases cognitive function in athletes.

Physical exercise can improve cognitive function, and the degree of impact on cognitive function is related to exercise modality, intensity, and duration. However, few studies have been conducted on the effects of competitive sports on cognitive function. The 1,500 m freestyle is the longest pool-based swimming event in the Olympic Games. This study explores the effects of 1,500 m freestyle at maximal speed on athletes' cognitive function and analyzes the potential mechanism of cognitive function reduction in freestyle at maximal speed from the perspective of hemoglobin oxygenation difference (Hbdiff). A total of 13 male university swimmers were required to take part in a 1,500 m freestyle competition, swimming at maximal speed. The relevant indicators, including cognitive function and freestyle at maximal speed, before and after the competition were tested and analyzed. Cognitive function was assessed using the Schulte grid test (SGT), the trail-making test (TMT), and the digit span test (DST). The neurobiological characteristics of cognitive function, such as the prefrontal cortex (PFC), response time (RT), and accuracy rate (ACC), were tested using functional near-infrared spectroscopy (fNIRS). A significant decrease in scores for SGT, TMT, and digit span test-backward (DST-B) (p < 0.01). Oxygenated hemoglobin (Oxy-Hb) concentrations in the right frontopolar area (R-FPA) of brain channels 8 (p < 0.01) and 9 (CH8, 9) (p < 0.05), the right dorsolateral prefrontal cortex (R-DLPFC) CH10 (p < 0.05), and the middle dorsolateral prefrontal cortex (M-DLPFC) CH18 (p < 0.01) were significantly altered, and the right area of the brain was activated. The total Oxy-Hb concentrations in the regions of interest (ROIs) of R-FPA, R-DLFPC, and M-DLFPC were changed significantly (p < 0.01). The exhaustive performance of a 1,500 m freestyle event resulted in both physical fatigue and a decline in cognitive function. This decline may be attributed to the activation of specific regions of interest, namely the FPA, DLPFC, and M-DLPFC, within the prefrontal cortex (PFC), as well as alterations in functional connectivity.

Ten-year incidence, predictors and impact of dizziness and vertigo in community-dwelling adults

ObjectivesWe used a cohort of community-dwelling adults to establish the 10-year incidence and predictors of dizziness/vertigo, and its impacts on health-related quality of life. Study designOf the 1152 participants aged 55 + years who did not have dizziness/vertigo at baseline, 799 and 377 participants were followed up after 5 and 10 years, respectively, and had complete data and so were included in the incidence analysis. Hearing loss was determined as the pure-tone average of audiometric hearing thresholds at 500, 1000, 2000 and 4000 Hz, and any hearing loss was defined as >25 dB hearing level. Tinnitus and migraine were assessed by a positive response to a single question. Main outcome measuresAudiologists screened participants for reported dizziness using a single question. Quality of life was measured using the Short Form 36-item Health Survey (SF-36). ResultsThe cumulative 10-year incidence of dizziness/vertigo, vestibular vertigo and non-vestibular vertigo were 39.8 %, 27.1 %, and 11.9 %, respectively. Age and presence of migraine were significant predictors of incident dizziness/vertigo: multivariable-adjusted hazard ratio (HR) 1.03 (95 % confidence interval, CI, 1.01–1.06) and HR 1.63 (95 % CI 1.13–2.35), respectively. A significant decrease in scores for the following SF-36 domains was observed over the 10 years among participants reporting baseline dizziness/vertigo: physical functioning (P-trend ≤ 0.0001), role limitation due to physical problems (P-trend ≤ 0.0001), general health (P-trend = 0.01), and vitality (P-trend = 0.01). ConclusionsDizziness/vertigo was a frequent and detrimental symptom in this population of community-dwelling adults. Our study highlights the burden imposed by dizziness, as evidenced by a significant prospective association with poorer quality of life.

Impacto del uso de fototerapia ultravioleta B de banda estrecha en la variación de la calidad de vida evaluada con la escala Skindex-29 en pacientes adultos

BackgroundThe assessment of health-related quality of life (HRQoL) is progressively gaining importance in the evaluation of the effectiveness of interventions in dermatology. The Skindex-29 is an instrument adapted and validated for Colombia that allows the assessment of HRQoL by measuring the dimensions of emotions, symptoms and functioning, in addition to providing a global concept. Narrowband ultraviolet B phototherapy (UVB-BE) is a therapeutic tool in which there is little research in our context. Material and methodsA quasi-experimental before-after study was carried out in adults who started treatment in the UVB-BE phototherapy unit, evaluating HRQoL using Skindex-29 in the first session and subsequently in session 48 and/or 4 months after the initial session. ResultsForty-nine patients participated. 39% were men and 61% women. The mean age was 52 years and 91% belonged to the contributory health system. The most frequent phototype was III (30.6%) and the 2 most prevalent diseases were vitiligo and psoriasis (65%). A statistically significant decrease in scores was observed in all dimensions assessed using the Skindex-29 scale. ConclusionsIn the context of the Colombian health system UVB-BE phototherapy represents an effective complementary intervention to decrease the impact on HRQoL in some dermatological diseases.

Experience with agomelatine therapy for non-psychotic depression with a single and recurrent course

Therapy of depression is a current problem in psychiatry. Agomelatine is not inferior to other modern drugs in terms of antidepressant efficacy (response and remission rates) and is characterized by the best tolerability.Objective: to evaluate the efficacy and safety of agomelatine in the treatment of nonpsychotic depression with a single and recurrent course.Material and methods. Patients (n=37) with a current depressive episode (DE; F32 according to ICD-10), mean age 41.2±2.07 years, were studied. Clinical psychopathological and psychometric methods were used in the study (Hamilton Hospital Depression Scale – HAMD-17; Spielberger–Khanin Anxiety Self-Assessment Scale, Sheehan Anxiety Scale, Clinical Global Impression Scale – CGI-I). A single DE was diagnosed in 62.2% of patients, and recurrent depressive disorder in 37.8%. Stress-related onset of current DE was found in 56.8% of cases, autochthonous in 43.2%.Results. 94.6% of patients were responders, including 68.6% who went into remission. A statistically significant decrease in scores on the HAMD-17 scale was noted in the remission group from the 7th day of agomelatine therapy (p&lt;0.05), in the responder group – from the 14th day of therapy (p&lt;0.05). According to the Sheehan scale, a statistically significant decrease in scores was noted at the end of the first week of therapy (p&lt;0.05), according to the Spielberger–Khanin scale – in the second week (p&lt;0.05) in all patients. According to the CGI-I scale, the condition at the end of therapy improved in 57.1% of patients, significantly in 42.9%. Clinical predictors of therapeutic response in patients with remission included significantly higher frequency of a single DE (p&lt;0.02), moderate severity of current depression (p&lt;0.02), dizziness among autonomic disorders (p&lt;0.01), a significantly lower representation of the melancholic type of depression (p&lt;0.05), a symptom of a gloomy and pessimistic vision of the future (p&lt;0.05), sleep disturbances (p&lt;0.04), a factor of personal significance in the form of a threat in patients with stress-provoked onset of the current DE (p&lt;0.05).Adverse events occurred in the first week of treatment with agomelatine in 14.3% of cases (nausea – 8.6%, headache and dizziness – 2.9% each), they were mild and did not require discontinuation of the drug. Two patients taking agomelatine at a dose of 50 mg discontinued the study: in one case persisted social phobia, increased fatigue, motor retardation, and persistent modern insomnia; in the other case – a pronounced senestoalgic syndrome with cerebral localization.Conclusion. Agomelatine therapy has been shown to be highly effective and well tolerated in nonpsychotic depression.

Effect of vortioxetine versus venlafaxine on cognitive functions in adults with major depressive disorder: A randomized-controlled trial.

Vortioxetine and venlafaxine are antidepressants which have shown established efficacy to treat major depressive disorder (MDD). There are no studies that compared them for their efficacy in cognitive symptoms of depression. The study aimed to compare the effect of vortioxetine and venlafaxine on the change in cognitive scores in adults with MDD. The present study was an open-label, active-controlled parallel design randomized clinical trial. After randomization, baseline clinical evaluations by Montgomery-Asberg Depression Rating Scale (MADRS) and Social and Occupational Functioning Assessment Scale (SOFAS) were done and coding (subset of WAIS-IV), WCST, TMT, Stroop test, PGI memory were used to assess cognition in 100 unmedicated MDD patients. They were reassessed after eight weeks of monotherapy with vortioxetine or venlafaxine. Primary cognitive measure (coding score) was found to be significantly higher (Mean Difference = 0.680; 95% CI:.202 to 1.158; P = 0.006) in vortioxetine in comparison with venlafaxine. Stroop test scores (word score, color score, color-word score) were also found to be significantly higher with vortioxetine. In other cognitive measures (WCST scores: total trials, total errors score, total perseverative responses score, total perseverative errors scores; TMT-A and B scores), a significant decrease in scores with vortioxetine in comparison with venlafaxine were observed. A significant decrease in MADRS and increase in SOFAS scores were observed with vortioxetine in comparison with venlafaxine. Both the drugs alleviated the symptoms of depression but vortioxetine was better tolerated. Our study findings suggest that improvement in cognitive scores is significantly higher with vortioxetine than venlafaxine over the eight weeks of monotherapy. CTRI/2020/07/026819 (Registered with Clinical Trials Registry- India).

Opening Treatment Windows for Treatment-Resistant Schizophrenia: Improving Emotion Regulation Strategies Using the Unified Protocol in a Case Study in Spain

Approximately 30%-50% of people with schizophrenia worldwide have treatment-resistant schizophrenia (TRS). Currently available standard psychopharmacological and psychological treatments have proven insufficient to achieve full recovery in these patients. Alternative psychological interventions focused on improving emotion regulation, such as the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), could potentially improve treatment outcomes in this difficult to treat population. The aim of the present case study is to demonstrate how the UP can be adapted for the treatment of TRS. We decided to use UP to treat this particular patient due to the presence of intense unpleasant emotions, aversive reactions, and emotional avoidance strategies. After completing the full treatment protocol, the patient showed significant decreases in scores on the Difficulties in Emotion Regulation Scale (DERS), including total and emotional rejection, life interference, and emotional lack of control. A significant reduction was also observed in anxiety (OASIS) and depressive symptoms (ODSIS). The intervention had a positive impact on auditory hallucinations, with decreased severity, less intense anxiety, and less interference in life. The treatment led to greater control over voices and the patient reported feeling more confident in her relationship with those voices. These results provide preliminary support for the use of UP for the treatment of TRS.

THE EFFECTIVENESS OF TEACHERS’ CORRECTIVE FEEDBACK (CF) AND SPEAKING PRACTICE ON UNDERGRADUATE LANGUAGE LEARNERS’ SPEAKING ANXIETY (SA)

The number of the English Language users is expanding quickly around the globe due to the irrefutable importance of the English language. This is because of a number of educational and economic benefits associated with it contributing a great deal to World Englishes. Despite English has been taught, till degree level, as a compulsory subject, learners face difficulties in the basic four-fold language skills such as listening, reading, writing and speaking. The present study focuses speaking anxiety of English learners. Investigating the impact of speaking practice and corrective feedback on listening anxiety, it measures levels of speaking anxiety of Pakistani undergraduate students before and after the speaking practice and corrective feedback. One hundred and fifty undergraduate students of a public college participated in this study. Foreign Language Speaking Anxiety Scale (FLSAS)) developed from (Horwitz et al., 1986) by Zulfiqar (2022) was adopted to answer the research questions. Mean scores and effect size were also calculated. Pearson correlation was run to check the correlation of pre and post-speaking data. There was a statistically significant decrease in scores of speaking anxiety (before speaking practice and corrective feedback (M= 3.0762, SD=0.45947) and after practice (M= 2.1885, SD=.41059; t (149) = 19.276. p=.000 (two-tailed). The mean decrease in speaking anxiety score was 0.88.77% with a 90% confidence interval ranging from 0.78 to 0.95. The eta squared statistic 0.69 indicated a large effect size

Effectiveness of Neuropsychoeducation, Intrinsic Motivation, and Metaphoric Content Integrated with Cognitive Behavioral Therapy in the Treatment of Obsessive-Compulsive Disorder: A Pilot Study.

Obsessive-compulsive disorder (OCD) is considered frequent, unnecessary thoughts that lead to repetitive actions to lessen the apprehension provoked by thoughts; this repetitive sequence may further influence trouble in one's daily activities. The remedial procedure for OCD includes medication (such as SSRIs, anxiolytics, and antidepressants) with psychotherapy [such as cognitive behavioral therapy (CBT) and exposure response prevention (ERP)]. Previous investigations indicated that regardless of the trend of adopting CBT and ERP to treat OCD, only around half of the patients experienced a full reduction in symptoms. The ERP component in CBT has been termed as a challenging treatment as it contains threatening anxiety-provoking indications, and it has been reflected that between 25-30% of OCD patients reject the ERP treatment, and the refusal and dropout rates for ERP in OCD are higher than other interventions. Thus, in the present investigation, researchers developed a proposed therapy that includes neuropsychoeducation, intrinsic motivation, and metaphoric content integrated with CBT in addition to regular pharmacological management to treat OCD patients and validated the efficacy of the proposed therapy through psychometric ratings (Y-BOCS). In this pilot study, 10 cases of OCD received a 12-week proposed therapy program. The primary outcome was the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), which was assessed at baseline and post-treatment. The present study's results revealed a significant decrease in scores on the obsessions and compulsions domains and overall total scores on Y-BOCS among OCD patients. The findings show that this proposed therapy, which includes neuropsychoeducation, intrinsic motivation, and metaphors contents integrated with CBT in combination with pharmacological management, is effective in the treatment of OCD. Therefore, the proposed therapy may be beneficial in the treatment of OCD. It has far-reaching implications in the areas of clinical, psychiatry, and mental health.

Efficacy of Fecal Microbiota Transplant on Behavioral and Gastrointestinal Symptoms in Pediatric Autism: A Systematic Review.

Background and Aims: There is a high prevalence of gastrointestinal-related (GI) symptoms among children with autism spectrum disorder (ASD), which is associated with the severity of behavioral symptoms. Fecal microbiota transplantation (FMT) is a proposed therapeutic strategy that aims to address the dysregulation of the gut microbiome among children with ASD. Our study performed the first systematic review aimed to evaluate the benefits of FMT on the behavioral and gastrointestinal symptoms of pediatric patients with autism. Methods: A literature search was performed using variations of the keywords "pediatrics" and "fecal microbiota transplantation" in PubMed, EMBASE, CINAHL, Cochrane, and Web of Science from inception to 30 June 2022. Four studies that met the eligibility criteria were included in the systematic review. The efficacy of FMT on behavioral symptoms was measured by the difference in Aberrant Behavior Checklist (ABC) and Child Autism Rating Scale (CARS) scores before and after FMT. Results: We found a statistically significant improvement (p < 0.05) in ABC and CARS scores following FMT, with a statistically significant decrease in scores observed across all studies. In addition, substantial improvements in gastrointestinal symptoms were observed across all studies. Conclusion: Our findings suggest that FMT may offer a promising intervention for treating both behavioral and gastrointestinal symptoms in pediatric patients with autism.

Efficacies of extracorporeal shockwave therapy and low-level laser therapy in patients with plantar fasciitis

BackgroundVarious conservative treatment methods can be administered in the early stages of plantar fasciitis (PF). The aim of the treatment is to enable the patient to return to the physical activity as soon as possible. AimIn this study it was aimed to compare efficacies of Extracorporeal Shockwave Therapy (ESWT) and Low-Level Laser Therapy (LLLT) on patients with PF. DesignA local prospective cross-sectional study SettingDepartment of Physical Medicine and Rehabilitation Outpatient Clinic of Sakarya University, Faculty of Medicine PopulationPatients aged 18–70 years, having ongoing heel pain for at least 3 months, and not using oral and/or parenteral corticosteroids in the last 6 months. MethodsA total of 40 patients with PF included in the current study. Visual Analog Scale (VAS), Roles and Maudsley Score (RMS), American Orthopedic Foot and Ankle Association Score (AOFAS) and Foot Function Index (FFI) questionnaire were performed for all patients. ESWT and LLLT groups comprised of 22 (55%) and 18 (45%) patients, respectively. ResultsWe found significant improvements in scores based on the VAS, RMS, AOFAS, FFI in patients with PF and it was sustained for 3 months (p = 0.001, for all scores). While decrease in scores based on the VAS and FFI in LLLT group was statistically more significant compared to ESWT group (p = 0.014, p = 0.013), there was statistically less significant decrease in scores on the AOFAS in LLLT group than that of ESWT group (p = 0.032). ConclusionsThe results of this study indicated significant improvements in terms of pain, functional status and daily life activities following the administration of either of the treatments. Furthermore, LLLT was found to be significantly more effective for alleviating pain than ESWT in the treatment of PF.

Changes in Eating Behaviors and Their Associations with Weight Loss in Japanese Patients Who Underwent Laparoscopic Sleeve Gastrectomy.

Metabolic and bariatric surgery (MBS) has been established to provide long-term weight loss in severe obesity. In this study, we investigated the factors that affect post-operative weight loss, with a particular focus on changes in eating behaviors. Time-course changes in body weight and eating behaviors were examined in 49 Japanese patients who underwent laparoscopic sleeve gastrectomy from the first visit to 12 months after surgery. Each eating behavior was evaluated via the questionnaire of the Japan Society for the Study of Obesity. Pre-operative weight reduction mediated by dietary and lifestyle interventions showed significant positive correlations with weight loss outcomes at 12 months after surgery. We observed significant decreases in scores for most of the eating behaviors 12 months after surgery. However, "emotional eating behavior" scores declined temporarily in the early post-operative period of one month but thereafter returned to the pre-operative level at 12 months. Furthermore, increases in the scores for "emotional eating behavior" and "sense of hunger" from 1 to 12 months post-operatively were significantly associated with poor weight loss. Our results demonstrate the beneficial effects of MBS on obesity-related eating behaviors, as well as highlighting "emotional eating behavior" as requiring particular attention.

Investigation of liver fibrosis with serum biochemical parameters before treatment with direct-acting antivirals, at the end of treatment, and in the first and third year after treatment in patients with chronic hepatitis C.

In the treatment of chronic hepatitis C, the need for non-invasive methods, other than invasive methods, is increasing for the detection of fibrosis before and after treatment. In our study, we aimed to determine the changes in histological response with post-treatment biochemical scoring in patients treated with direct-acting antivirals. Between June 1, 2016, and January 1, 2020, 125 patients followed up with a diagnosis of chronic hepatitis C, who presented to Haseki Training and Research Hospital, were enrolled in the study. Scores of APRI, Fibro Q, Fibrosis-4 (FIB-4) index, Doha score, Fibro alpha, and fibrosis-cirrhosis index were used to evaluate the liver fibrosis of the patients with examinations before treatment, at the end of treatment and at the 12th week, first year, and third year after treatment. The study was conducted as a retrospective observational case series. One hundred twenty-five patients were enrolled in the study. The mean age was 55.5 ±15.9 years. Patients were divided into two groups according to their baseline FIB-4 values: cirrhotic/noncirrhotic. Seven (5.6%) patients had compensated cirrhosis; there were no decompensated cirrhotic patients. There was a statistically significant decrease in scores of APRI, FIB-4, Fibro Q, and Doha score calculated during the end-of-treatment three-year follow-up period. It was shown that serum fibrosis scores, such as APRI, FIB-4, Fibro Q, and Doha score, could be used to detect fibrosis before treatment and to follow histological improvement after treatment with direct-acting antivirals (DAA) in chronic hepatitis C patients.