Significant Group Differences Research Articles

A pilot randomized controlled trial of transcranial direct current stimulation adjunct to moderate-intensity aerobic exercise in hypertensive individuals.

Hypertension is a global issue that is projected to worsen with increasingly obese populations. The central nervous system including the parts of the cortex plays a key role in hemodynamic stability and homeostatic control of blood pressure (BP), making them critical components in understanding and investigating the neural control of BP. This study investigated the effects of anodal transcranial direct current stimulation (tDCS) associated with aerobic physical exercise on BP and heart rate variability in hypertensive patients. Twenty hypertensive patients were randomized into two groups: active tDCS associated with aerobic exercise or sham tDCS associated with aerobic exercise. BP and heart rate variability were analyzed before (baseline) and after twelve non-consecutive sessions. After each tDCS session (2 mA for 20 min), moderate-intensity aerobic exercise was carried out on a treadmill for 40 min. A total of 20 patients were enrolled (53.9 ± 10.6 years, 30.1 ± 3.7 Kg/m2). There were no significant interactions between time and groups on diastolic BP during wake, sleep, over 24 and 3 h after the last intervention. Heart rate variability variables showed no significant difference for time, groups and interaction analysis, except for HF (ms2) between groups (p < 0.05). Anodal tDCS over the temporal cortex associated with aerobic exercise did not induce improvements in BP and heart rate variability. https://ensaiosclinicos.gov.br/rg/RBR-56jg3n/1, identifier: RBR-56jg3n.

Who benefits from indirect prevention and treatment of depression using an online intervention for insomnia? Results from an individual-participant data meta-analysis.

Major depressive disorder (MDD) is highly prevalent and burdensome for individuals and society. While there are psychological interventions able to prevent and treat MDD, uptake remains low. To overcome structural and attitudinal barriers, an indirect approach of using online insomnia interventions seems promising because insomnia is less stigmatized, predicts MDD onset, is often comorbid and can outlast MDD treatment. This individual-participant-data meta-analysis evaluated the potential of the online insomnia intervention GET.ON Recovery as an indirect treatment to reduce depressive symptom severity (DSS) and potential MDD onset across a range of participant characteristics. Efficacy on depressive symptom outcomes was evaluated using multilevel regression models controlling for baseline severity. To identify potential effect moderators, clinical, sociodemographic, and work-related variables were investigated using univariable moderation and random-forest methodology before developing a multivariable decision tree. IPD were obtained from four of seven eligible studies (N = 561); concentrating on workers with high work-stress. DSS was significantly lower in the intervention group both at post-assessment (d = -0.71 [95% CI-0.92 to -0.51]) and at follow-up (d = -0.84 [95% CI -1.11 to -0.57]). In the subsample (n = 121) without potential MDD at baseline, there were no significant group differences in onset of potential MDD. Moderation analyses revealed that effects on DSS differed significantly across baseline severity groups with effect sizes between d = -0.48 and -0.87 (post) and d = - 0.66 to -0.99 (follow-up), while no other sociodemographic, clinical, or work-related characteristics were significant moderators. An online insomnia intervention is a promising approach to effectively reduce DSS in a preventive and treatment setting.

Recent Stressful Experiences and Electronic Nicotine Product Use Among Young Adults

Background and Objective: The goal of the current study was to examine how specific recent stressors are related to electronic nicotine product use among young adults. Despite increases in electronic nicotine product use among adults, stressors shaping the use of these products remain largely unknown. The current study examined the types and average severity of stressors endorsed between young adults with past 30-day electronic nicotine product use and young adults with no lifetime use, as well as the association between frequency of recent electronic nicotine product use and average severity of stressors. Methods: 175 current electronic nicotine product users and 333 lifetime abstainers of electronic nicotine products and cigarettes reported recent stressful experiences that occurred in the past six months, as well as lifetime and past 30-day substance use. Chi-square, independent samples t-test, and regression analyses were performed. Results: There were no significant group differences in the primary type of stressor experienced (p = 0.320) or average stress of the three recent stressful experiences reported (p = 0.246). There was no significant relationship between electronic nicotine product use and average stress of the three recent stressful experiences, controlling for demographic and substance use covariates (p = 0.150). Both current electronic nicotine product users and lifetime abstainers endorsed school, family, and romantic relationship stressors most frequently as their top stressors. Conclusion: To our knowledge, this is the first study to examine group differences in specific stressor categories and perceived stress between current electronic nicotine product users and lifetime abstainers of these products. Given the novel assessment of stressor types, the current study provides a critical starting point for research on this timely topic. In addition, due to the high overlap between stress and nicotine use, future studies should investigate different populations of electronic nicotine product users and other methods to assess stressful experiences.

(086) The Capacity to Form Stable Intimate Relationships in People with Paraphilic Interests

Abstract Introduction The yearning for intimate connection with another human being lies at the core of the human experience (Mashek &amp; Aron, 2004). Thus, the ability to form stable and close bonds serves as a crucial indicator of psychological well-being (Burman &amp; Margolin, 1992). However, for some individuals with problematic sexual interests, which may lead to sexually offensive behaviors (Chan, 2020, 2021), their capacity to form such connections may be compromised (Marshal, 1993; Ward et al., 1995). In particular, sex offenders diagnosed with paraphilic disorders often experience challenges with intimacy (Stefanska et al., 2022). Objective This study aimed to investigate emotional closeness, exclusivity, and co-dependency as components of intimacy within the general population, including individuals with sexually aggressive, minors-oriented, and combined paraphilic interests. Methods The study involved a sample of 100 men randomly selected from four groups: control men without any paraphilic interests (n = 100), men with minors-oriented interests (n = 17), men interested in sexual violence (n = 27), and a combined group of men with both sexual violence and minors-oriented interests (n = 15). We collected questionnaire data as part of an online representative survey (n = 800 men) conducted in the Czech Republic, focusing on topics like love, romance, sexual relationships, and pubertal development. Specific survey items related to emotional closeness, sexual non-exclusivity/promiscuity, and co-dependency underwent confirmatory analysis to eliminate redundancy and enhance explained variance. We defined the constructs of interest based on a literature search on sexual intimacy. Subsequently, we compared the groups on these constructs using a 1-way ANOVA with four levels of grouping variables (controls, violence, minors, combined), followed by post hoc Tukey multiple comparisons tests. Results Statistical tests revealed significant group differences in emotional closeness (F(3,150) = 6.31, p = 0.0005). Post hoc comparisons indicated that the aggression group (Δ = 1.132, p = 0.0003) and the combined group (Δ = 1.117, p = 0.0254) reported significantly lower levels of perceived emotional closeness in their sexual relationships compared to the control group. However, there were no other significant group differences found. Regarding measures of sexual non-exclusivity/promiscuity, ANOVA did not show significant differences (F(3,147) = 2.37, p = 0.073, not significant). Yet, post hoc Tukey comparisons revealed that the combined group exhibited significantly higher promiscuity compared to the control group (Δ = -1.033, p = 0.039). There were no statistically significant differences between groups in the co-dependency variable. Conclusions Our findings suggest that individuals with an interest in sexual violence, and especially those with a combined interest in sexual violence and minors, perceive significantly lower levels of emotional closeness in their sexual relationships compared to individuals without any paraphilic interests. This indicates that they may struggle to feel connected and loved in their relationships. This study was funded by the grant nr. 21-31490S of the Czech Science Foundation. Disclosure No.

The effects of a retrieval cue on renewal of conditioned responses in human appetitive conditioning

Contextual renewal of reward anticipation may be one potential mechanism underlying relapse in eating and substance use disorders. We therefore tested retrieval cues, a method derived from an inhibitory retrieval-based model of extinction learning to attenuate contextual renewal using an appetitive conditioning paradigm. A pilot study was carried out in Experiment 1 to validate a differential chocolate conditioning paradigm, in which a specific tray was set up as a conditioned stimulus (CS) for eating chocolate (unconditioned stimulus, US). Using an ABA renewal design in Experiment 2, half of the participants were presented with a retrieval cue in the acquisition phase (group AC) and the other half in the extinction phase (group EC). Presentation of the retrieval cue in the EC was associated with reduced renewal of US-expectancy, while there was a clear renewal effect for US-expectancy in the AC. One limitation was the difference in cue presentations between both groups due to the number of trials in acquisition and extinction. Experiment 3 therefore aimed at replicating the results of Experiment 2, but with fewer cue presentations for the EC to match the AC. No significant group differences were observed indicating no effect of the retrieval cue. Theoretical and clinical implications in light of the differing results are discussed.

Multi-modal neuroimaging reveals differences in alcohol-cue reactivity but not neurometabolite concentrations in adolescents who drink alcohol

BackgroundThe objective of this multi-modal neuroimaging study was to identify neuroscience-informed treatment targets for adolescent alcohol use disorder (AUD) by examining potential neural alterations associated with adolescent alcohol use. MethodsAdolescents (ages 17–19) who heavily used (n=49) or did not use alcohol (n=22) were recruited for a multi-modal neuroimaging protocol, including proton magnetic resonance spectroscopy within the dorsal anterior cingulate cortex (dACC) and an fMRI alcohol cue-reactivity task. The alcohol cue-reactivity task was analyzed across 11 a priori regions-of-interest (ROI), including the dACC, and in an exploratory whole-brain approach. Correlations were run between neurometabolite levels and alcohol cue-reactivity in the dACC. ResultsThere were no significant group differences in absolute neurometabolite concentrations. Compared to the control group, the alcohol-using group exhibited heightened alcohol cue reactivity in the left amygdala ROI (p=0.04). The whole-brain approach identified higher alcohol cue reactivity in the alcohol-using group compared to controls in the amygdala and occipital regions, and lower reactivity in the parietal lobe. Whole-brain sex effects were noted, with females displaying higher reactivity regardless of group. No significant correlations were found between neurometabolite levels and alcohol cue-reactivity in the dACC. ConclusionsThe null neurometabolic findings may be due to age, relatively low severity of alcohol use, and non-treatment-seeking status of the participants. Females showed overall higher reactivity to alcohol cues, indicating a sex effect regardless of alcohol use history. Higher amygdala reactivity in alcohol-using adolescents suggests that emotional processing related to alcohol cues may be a useful target for future adolescent AUD interventions.

Effect of Intermittent Thoracic Paravertebral Block on Postoperative Nausea and Vomiting Following Thoracoscopic Radical Resection of the Lung Cancer: A Prospective Randomized Trial.

To explore the benefits of ultrasound-guided intermittent thoracic paravertebral block (TPVB) combined with intravenous analgesia (PCIA) in alleviating postoperative nausea and vomiting (PONV) during video-assisted thoracic surgery (VATS). 120 patients with lung carcinoma undergoing VATS were included and divided into three groups: group S (single TPVB+PCIA), group I (intermittent TPVB+PCIA), and group P (PCIA). The patients' NRS scores, postoperative hydromorphone hydrochloride consumption, and intramuscular injection of bucinnazine hydrochloride were recorded. The incidence of PONV and complications were documented. Compared with the group P, both group I and group S had significantly lower static NRS scores from 1-48 hours after the operation (P <0.05), and the dynamic NRS score of group I at the 1-48 hours after the operation were significantly decreased (P <0.05). Compared with the group P, the proportion of patients with PONV in group I was significantly lower (P <0.05), while there was no significant difference in group S. Moreover, the hospitalization period of patients in group I was significantly reduced compared with the other two groups (P <0.01), and the patient satisfaction was significantly increased compared with the group P (P <0.05). Intermittent TPVB combined with PCIA can reduce the postoperative pain and the occurrence of PONV.

Guided internet-based acceptance and commitment therapy for provoked vestibulodynia: A randomized controlled trial.

Provoked vestibulodynia (PVD) causes suffering in many women's lives due to its impact on relationships, sexual functioning and functioning in other key domains. Here, we report a randomized controlled trial conducted to examine whether Acceptance and Commitment Therapy (ACT) with a focus on values-based exposure, delivered online, benefits women with PVD. Participants (n = 88) were randomized to either guided online ACT for 10 weeks or a wait-list control group. Outcomes were assessed at baseline, post treatment and 1 year later. Analyses were based on intention to treat using linear mixed models. There were significant group differences on the primary outcomes, Female Sexual Index and Female Sexual Distress Scale, in favour of online ACT with moderate effect sizes. Differences were also found on several secondary outcomes and therapeutic process measures, all in favour of ACT. No differences were found at post-treatment for depression or anxiety. At the 1-year follow-up, results were maintained and a difference between baseline and follow-up was also found for depression. In summary, a relatively brief, guided, online version of ACT appears to produce benefits for women with PVD and related impacts on daily functioning. 50% to 60% of the women who participated in the treatment reliably improved in sexual functioning and distress.

Outcomes of Concomitant Glenohumeral Stabilization After Arthroscopic Rotator Cuff Repair in Military Patients Younger Than 40 Years.

While concomitant rotator cuff and inferior labral tears are relatively uncommon in young civilians, military populations represent a unique opportunity to study this injury pattern. To (1) evaluate the long-term outcomes after combined arthroscopic rotator cuff and inferior labral repair in military patients <40 years and (2) compare functional outcomes with those after isolated arthroscopic rotator cuff repair. Cohort study; Level of evidence, 3. Military patients who underwent arthroscopic rotator cuff repair between January 2011 and December 2016 and had a minimum of 5-year follow-up data were included in this study. The patients were categorized into those who had undergone combined arthroscopic rotator cuff and inferior labral repair (RCIL cohort) and those who had isolated arthroscopic rotator cuff repair (ARCR cohort). Pre- and postoperative outcome measures-visual analog scale for pain, Single Assessment Numeric Evaluation, American Shoulder and Elbow Surgeons shoulder score, Rowe Instability Score, and range of motion-were compared between the groups. A total of 50 shoulders (27 in the RCIL cohort and 23 in the ARCR cohort) were assessed. The RCIL and ARCR groups were similar in terms of age (mean, 33.19 years [range, 21-39 years] vs 35.39 years [range, 26-39 years], respectively) and sex (% male, 88.46% vs 82.61%, respectively). All patients were active-duty military at the time of surgery. The mean final follow-up was at 106.93 ± 16.66 months for the RCIL group and 105.70 ± 7.52 months for the ARCR group (P = .75). There were no differences in preoperative outcome scores between groups. Postoperatively, both groups experienced statistically significant improvements in all outcome scores (P < .0001 for all), and there were no significant group differences in any final postoperative outcome measures. At the final follow-up, 26 (96.30%) patients in the RCIL cohort and 20 (86.96%) in the ARCR cohort had returned to unrestricted active-duty military service (P = .3223). The study findings indicate that concomitant glenohumeral stabilization does not prevent worse outcomes after arthroscopic rotator cuff repair in this military cohort. Combined repair produced statistically and clinically significant improvements in outcome scores at the long-term follow-up, indicating that simultaneous repair of combined lesions was an appropriate treatment option in this patient population.

A Comparative Study of Homoeopathic Decimal Versus Centesimal Potency Medicine in the Treatment of Cervical Spondylosis

Background: Cervical spondylosis (CS) is a degenerative condition of the cervical spine found almost universally in persons over50 years of age. It has become one of the common problems globally.Methods: An experimental study was conducted on 60 patients diagnosed with cervical spondylosis as per the inclusion and exclusion criteria. All 60 cases of cervical spondylosis were randomized into 2 groups of 30 patients each. One group was prescribed with Individualized Homoeopathic medicine in decimal scale potency and the other group was prescribed with centesimal scale potencies of Individualized Homoeopathic medicine. The Remedy Response Evaluation Form was used to assess and interpret the follow up of the patients. The improvement of the patients was assessed by the Neck Disability Index (NDI). Result: Intra-group changes in NDI score were found statistically significant (P &lt; 0.001, unpaired t test) group difference though favored centesimal against decimal. Conclusion: On statistical analysis, the p value was less than 0.001. Hence there is a significant difference between post treatment score of centesimal potency group as compared to decimal potency group. &#x0D;

Job stress and burnout affecting the mental health of Korean medical faculty members: constructing causality among latent variables.

This study aims to examine whether perceived levels of job stress, burnout, and mental health are different according to demographic characteristics and working conditions and to investigate the direct and indirect effects of job stress and burnout on the mental health of medical faculty members. The study sample consists of 855 faculty members in 40 medical schools nationwide in the 2020 Burnout of Faculty Members of Medical Schools in Korea data with a grant from the Korean Association of Medical Colleges. This study employed structural equation modeling to construct causality among latent variables in addition to t-test, analysis of variance, and correlation coefficients for bivariate analyses. Perceived job stress, burnout, and mental health levels of medical faculty members showed significant group differences by demographic characteristics and working conditions. Job stress directly affected mental health (β=0.215, p<0.01) and indirectly affected mental health via burnout (β=0.493, p<0.001). Thus burnout significantly mediated the relationship between job stress and the mental health of medical faculty members. This study found that job stress has direct and indirect effects on the mental health of medical faculty members, and burnout partially mediated this relationship. Further studies need to intervene in job stress and burnout to prevent the adverse mental health of medical faculty members and to introduce proper measures to improve working conditions affecting job stress and burnout.

Effect of Prenatal Yoga versus Moderate-Intensity Walking on Cardiorespiratory Adaptation to Acute Psychological Stress: Insights from Non-Invasive Beat-to-Beat Monitoring.

We recently reported enhanced parasympathetic activation at rest throughout pregnancy associated with regular yoga practice. The present study presents a secondary analysis of data collected within a prospective cohort study of 33 pregnant women practicing yoga once weekly throughout pregnancy and 36 controls not involved in formal pregnancy exercise programs. The objective was to assess the impact of prenatal yoga on the autonomic nervous system stress response. Healthy pregnant women with singleton pregnancies were recruited in the first trimester. There was no significant difference in the maternal body mass index (BMI) between the yoga group and the controls (24.06 ± 3.55 vs. 23.74 ± 3.43 kg/m2, p = 0.693). Women practicing yoga were older (28.6 ± 3.9 vs. 31.3 ± 3.5 years, p = 0.005) and more often nulliparous (26 (79%) vs. 18 (50%), p = 0.001). We studied heart rate variability (HRV) parameters in the time domain (SDNN, standard deviation of regular R-R intervals, and RMSSD, square root of mean squared differences of successive R-R intervals) and frequency domain (ln(LF/HF), natural logarithm of low-frequency to high-frequency power), as well as synchronization indices of heart rate, blood pressure and respiration during and immediately following acute psychological stress of a standardized mental challenge test. Measurements were performed once per trimester before and after yoga or a 30 min moderate-intensity walk. Statistical comparison was performed using three-way analyses of variance (p < 0.05 significant). Time domain HRV parameters during and following mental challenge in the yoga group were significantly higher compared to the controls regardless of the trimester (F = 7.22, p = 0.009 for SDNN and F = 9.57, p = 0.003 for RMSSD, respectively). We observed no significant differences in the yoga group vs. the controls in terms of ln(LF/HF) and synchronization indices. Regular prenatal yoga practice was associated with a significantly reduced sympathetic response to mental challenge and quicker recovery after acute psychological stress. These effects persisted throughout pregnancy with regular practice.

Effects of six-week stroboscopic training program on visuomotor reaction speed in goal-directed movements in young volleyball players: a study focusing on agility performance

BackgroundIn team sports, deficits in visuomotor reaction speed are considered a significant and modifiable risk factor that can lead to decreased performance and an increased risk of injuries. Thus, identifying effective methods to enhance visuomotor abilities is crucial. The main objective of this research was to investigate the impact of a six-week stroboscopic intervention on visuomotor reaction speed in goal-directed specific movements based on agility among young volleyball players. Additionally, the study aimed to explore the impact of saccade dynamics on visuomotor reaction speed performance throughout the experiment.MethodsThere were 50 athletes (26 males and 24 females) with an average age of 16.5 years (± 0.6) who participated in this study. Over a six-week training period, athletes performed volleyball-specific training either wearing stroboscopic glasses (intervention) or under normal visual conditions (control). Prior to and after the training period, the agility tests based on change-of-direction speed (CODS) and reactive agility (RA) were used to identify visuomotor reaction speed performance. To measure agility performance a five-repetition shuttle run to gates was conducted. The REAC-INDEX, which represents visuomotor reaction speed, was analyzed as the resulting difference between the CODS test and the RA test. To elicit saccadic dynamics, a laboratory visual search task was performed.ResultsA significant GROUP×TIME interaction was observed for the REAC-INDEX (p = 0.012, ηp2 = 0.13). ANCOVA analyses revealed significant GROUP differences, indicating improved post-training REAC-INDEX results (p = 0.004, d = 0.87), regardless of gender. Training-induced modulations in saccade acceleration did not reach significance, but a significant relationship was observed between changes in saccade acceleration and changes in the REAC-INDEX (r = -0.281, p = 0.048), indicating that higher performance gains following training were associated with a stronger increase in saccade acceleration.ConclusionsThis study demonstrates that stroboscopic training effectively enhances visuomotor reaction speed in goal-directed movements based on agility. Furthermore, visuomotor reaction speed gains could potentially be mediated by saccade dynamics. These findings provide valuable insights into the effectiveness of stroboscopic eyewear for training sport-specific visuomotor skills among young volleyball players.

Differential Effects of Type 2 Diabetes Treatment Regimens on Diabetes Distress and Depressive Symptoms in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE).

We evaluated whether adding basal insulin to metformin in adults with early type 2 diabetes mellitus (T2DM) would increase emotional distress relative to other treatments. The Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) of adults with T2DM of <10 years' duration, HbA1c 6.8-8.5%, and taking metformin monotherapy randomly assigned participants to add insulin glargine U-100, sulfonylurea glimepiride, the glucagon-like peptide-1 receptor agonist liraglutide, or the dipeptidyl peptidase 4 inhibitor sitagliptin. The Emotional Distress Substudy enrolled 1,739 GRADE participants (mean [SD] age 58.0 [10.2] years, 32% female, 56% non-Hispanic White, 18% non-Hispanic Black, 17% Hispanic) and assessed diabetes distress and depressive symptoms every 6 months. Analyses examined differences at 1 year and over the 3-year follow-up. Across treatments, diabetes distress (-0.24, P < 0.0001) and depressive symptoms (-0.67, P < 0.0001) decreased over 1 year. Diabetes distress was lower at 1 year for the glargine group than for the other groups combined (-0.10, P = 0.002). Diabetes distress was also lower for liraglutide than for glimepiride or sitagliptin (-0.10, P = 0.008). Over the 3-year follow-up, there were no significant group differences in total diabetes distress; interpersonal diabetes distress remained lower for those assigned to liraglutide. No significant differences were observed for depressive symptoms. Contrary to expectations, this randomized trial found no evidence for a deleterious effect of basal insulin on emotional distress. Glargine lowered diabetes distress modestly at 1 year rather than increasing it. Liraglutide also reduced diabetes distress at 1 year. Results can inform treatment decisions for adults with early T2DM.

Mindfulness-based empathy training supported by Obese Simulation Suit: Randomized Controlled Trial

AbstractNursing serves as the foundation of patient-centered healthcare services, and the empathetic connections formed between nurses and patients are integral to delivering quality care. In this context, the mental well-being and empathy levels of nurses significantly impact the efficiency of healthcare services and patient contentment. This study investigates the impact of mindfulness-based empathy training and obese simulation suits on nursing students' attitudes and empathy levels towards obese patients. The research, conducted as a randomized controlled trial, encompassed 84 nursing students and employed the "Attitude Scale Towards Obese Patients," "Jefferson Empathy Scale for Nursing Students," and "Descriptive Information Form." Data analysis involved two-factor ANOVA for mixed measurements. The study revealed significant interaction effects between group and time concerning nursing students' attitudes towards obese individuals [F(1,70) = 43.281, p &lt; 0.05] as well as their empathy levels towards obese individuals [F(1,70) = 15.657, p &lt; 0.05]. The experimental group exhibited a noteworthy increase in both attitudes and empathy levels compared to the control group. Furthermore, Single Factor ANOVA for Repeated Measures revealed a statistically significant difference in the experimental group's attitudes and empathy scores across pretest, posttest, and follow-up assessments [p &lt; 0.01, partial η2 = 0.492 and 0.186, respectively]. These findings underscore the effectiveness of these interventions in enhancing essential nursing competencies necessary for providing comprehensive patient care. Thus, integrating these methods into the curriculum is recommended to cultivate more positive attitudes and heightened empathy among nursing students, particularly concerning obese patients, throughout their educational journey.

A multi-modal assessment of fear conditioning in adolescent anorexia nervosa.

Anorexia nervosa (AN) is a pernicious psychiatric disorder which is principally characterized by a fear of weight gain. Notwithstanding the centrality of fear in the psychopathology of AN, controlled assessments of negative valence systems are lacking. Herein we assess fear conditioning in adolescent females with AN. Adolescent girls (Mage = 14.6 years, ±1.57) with DSM-5 diagnoses of AN (N = 25) and age-matched control girls (Mage = 14.8 years, ±1.46) with no DSM-5 diagnoses (N = 25) completed structured clinical interviews and participated in a classical three-phase Pavlovian fear conditioning paradigm. Participants with comorbid anxiety disorders were excluded. Skin conductance response (SCR) was measured, alongside self-reported fear, valence, and fear expectancy ratings. Both groups demonstrated significant differential acquisition across all four measures. Regarding group comparisons, no differences emerged for self-reported fear, valence, and fear expectancy ratings during acquisition, although for SCR, those with AN demonstrated reduced physiological arousal relative to controls. Both groups demonstrated significant differential extinction for unconditioned stimuli (US) expectancy, self-report fear, and self-report valence. No statistically significant group differences were evident during extinction to the conditioned stimuli (CS)+, on any outcome measure. However, controls reported more positive valence to the CS- than those with AN. Contrary to our hypotheses, our preliminary assessment did not find support for elevated fear responding among adolescent girls with AN with regards to fear acquisition or extinction. These data suggest that AN in adolescent girls may not be associated with a heightened propensity to acquire fear, but conversely, may suggest that exposure treatments for AN may be helpful, since extinction learning is intact in AN. AN is characterized by fear-related symptoms, including food and weight-related fear, and behavioral avoidance, yet controlled studies assessing fear learning are limited. Our preliminary assessment of adolescent AN indicates no abnormalities in fear learning among adolescents with AN. These findings may inform existing mechanistic models of AN psychopathology, and the development of exposure-based treatments for AN.

Projection-based two-sample inference for sparsely observed multivariate functional data.

Modern longitudinal studies collect multiple outcomes as the primary endpoints to understand the complex dynamics of the diseases. Oftentimes, especially in clinical trials, the joint variation among the multidimensional responses plays a significant role in assessing the differential characteristics between two or more groups, rather than drawing inferences based on a single outcome. We develop a projection-based two-sample significance test to identify the population-level difference between the multivariate profiles observed under a sparse longitudinal design. The methodology is built upon widely adopted multivariate functional principal component analysis to reduce the dimension of the infinite-dimensional multi-modal functions while preserving the dynamic correlation between the components. The test applies to a wide class of (non-stationary) covariance structures of the response, and it detects a significant group difference based on a single p-value, thereby overcoming the issue of adjusting for multiple p-values that arise due to comparing the means in each of components separately. Finite-sample numerical studies demonstrate that the test maintains the type-I error, and is powerful to detect significant group differences, compared to the state-of-the-art testing procedures. The test is carried out on two significant longitudinal studies for Alzheimer's disease and Parkinson's disease (PD) patients, namely, TOMMORROW study of individuals at high risk of mild cognitive impairment to detect differences in the cognitive test scores between the pioglitazone and the placebo groups, and Azillect study to assess the efficacy of rasagiline as a potential treatment to slow down the progression of PD.

Neurocognitive function as outcome and predictor for prefrontal transcranial direct current stimulation in major depressive disorder: an analysis from the DepressionDC trial.

Transcranial direct current stimulation (tDCS) of the prefrontal cortex might beneficially influence neurocognitive dysfunctions associated with major depressive disorder (MDD). However, previous studies of neurocognitive effects of tDCS have been inconclusive. In the current study, we analyzed longitudinal, neurocognitive data from 101 participants of a randomized controlled multicenter trial (DepressionDC), investigating the efficacy of bifrontal tDCS (2mA, 30min/d, for 6weeks) in patients with MDD and insufficient response to selective serotonin reuptake inhibitors (SSRI). We assessed whether active tDCS compared to sham tDCS elicited beneficial effects across the domains of memory span, working memory, selective attention, sustained attention, executive process, and processing speed, assessed with a validated, digital test battery. Additionally, we explored whether baseline cognitive performance, as a proxy of fronto-parietal-network functioning, predicts the antidepressant effects of active tDCS versus sham tDCS. We found no statistically significant group differences in the change of neurocognitive performance between active and sham tDCS. Furthermore, baseline cognitive performance did not predict the clinical response to tDCS. Our findings indicate no advantage in neurocognition due to active tDCS in MDD. Additional research is required to systematically investigate the effects of tDCS protocols on neurocognitive performance in patients with MDD.

Metabolic flexibility in postmenopausal women: Hormone replacement therapy is associated with higher mitochondrial content, respiratory capacity, and lower total fat mass.

To investigate effects of hormone replacement therapy in postmenopausal women on factors associated with metabolic flexibility related to whole-body parameters including fat oxidation, resting energy expenditure, body composition and plasma concentrations of fatty acids, glucose, insulin, cortisol, and lipids, and for the mitochondrial level, including mitochondrial content, respiratory capacity, efficiency, and hydrogen peroxide emission. 22 postmenopausal women were included. 11 were undergoing estradiol and progestin treatment (HT), and 11 were matched non-treated controls (CONT). Peak oxygen consumption, maximal fat oxidation, glycated hemoglobin, body composition, and resting energy expenditure were measured. Blood samples were collected at rest and during 45 min of ergometer exercise (65% VO2peak). Muscle biopsies were obtained at rest and immediately post-exercise. Mitochondrial respiratory capacity, efficiency, and hydrogen peroxide emission in permeabilized fibers and isolated mitochondria were measured, and citrate synthase (CS) and 3-hydroxyacyl-CoA dehydrogenase (HAD) activity were assessed. HT showed higher absolute mitochondrial respiratory capacity and post-exercise hydrogen peroxide emission in permeabilized fibers and higher CS and HAD activities. All respiration normalized to CS activity showed no significant group differences in permeabilized fibers or isolated mitochondria. There were no differences in resting energy expenditure, maximal, and resting fat oxidation or plasma markers. HT had significantly lower visceral and total fat mass compared to CONT. Use of hormone therapy is associated with higher mitochondrial content and respiratory capacity and a lower visceral and total fat mass. Resting energy expenditure and fat oxidation did not differ between HT and CONT.

Comparing the impact of left bundle branch area pacing and traditional left ventricular pacing on right heart function following dual-chamber pacemaker implantation

Objective: To compare the effects of left bundle branch area pacing (LBBaP) versus traditional right ventricular pacing (RVP) on left ventricular function in patients after dual-chamber pacemaker implantation. Methods: A retrospective cohort study was conducted on patients who underwent dual-chamber pacemaker implantation from March 2017 to April 2021 in Beijing Anzhen Hospital. The patients were divided into the LBBaP group and RVP group based on the placement of the ventricular lead. Follow-up was conducted until March 2022, comparing baseline and follow-up echocardiographic parameters, pacing parameters, and the incidence and timing of complications between the two groups. The complications included ventricular electrode perforation, dislocation, pericardial effusion, tricuspid valve perforation, etc. Results: A total of 163 patients aged (68.3±13.5) years were included, including 82 (50.3%) men, with 80 patients in the LBBaP group and 83 in the RVP group. Baseline left ventricular end-diastolic diameter ((50.49±4.95) mm vs. (47.43±8.15) mm, P=0.01) and left atrium (LA) ((33.14±5.94) mm vs. (30.18±3.92) mm, P=0.001) in the LBBaP group were significantly higher than those in the RVP group. Follow-up LA diameter ((37.10±6.70) mm vs. (40.10±8.90) mm, P=0.016) showed a statistically significant difference in the LBBaP group compared to the RVP group. There was no statistically significant difference between the two groups in baseline QRS duration(P=0.490). Postoperative QRS duration in the LBBaP group was significantly lower ((110.69±24.01) ms vs. (139.65±29.85) ms, P<0.010). Intraoperative threshold in the LBBaP group was significantly higher ((0.83±0.32) V/0.48 ms vs. (0.71±0.23) V/0.48 ms, P=0.004), while impedance was lower ((754.53±205.59) Ω vs. (905.41±302.75) Ω, P<0.01). Comparing with the RVP group, postoperative ventricular pacing ratio (VP) ((87.39±20.92) % vs. (79.49±25.76) %, P=0.034), threshold ((0.90±0.38) V/0.48 ms vs. (0.69±0.27) V/0.48 ms, P<0.01) in the LBBaP group were higher, and impedance ((507.45±77.37) Ω vs. (620.52±197.29) Ω, P<0.01) in the LBBaP group was lower. Postoperative follow-up period was 5 to 51 months, with a median follow-up time of 17 months. No statistically significant difference in overall complications between the LBBaP and RVP groups was found (13.8% (11/80) vs. 7.2% (6/83), P>0.05). The median time to occurrence of complications after surgery was significantly earlier in the LBBaP group (29.74 (95%CI 27.21-32.26) months vs. 46.17 (95%CI 42.48-49.86) months, P=0.030). Conclusion: LBBaP demonstrates more stable pacing parameters, substantial improvement in clinical left ventricular function, with a relatively higher threshold compared to traditional RVP, and complications occurs relatively early.