Significant Group Effect Research Articles

The impact of uninterrupted sitting on central and peripheral cardiovascular function in pre-menopausal and post-menopausal women.

Independently, both prolonged uninterrupted sitting and the onset of menopause negatively impact markers of cardiovascular risk. Whether their combination augment these responses additively remains unknown. This study assessed whether prolonged uninterrupted sitting causes greater central and peripheral cardiovascular dysfunction in post-menopausal women compared to pre-menopausal women. To address this, 23 healthy women (13 pre-menopausal [43.77 ± 4.30years] and 10 post-menopausal [57.20 ± 8.55years]) sat uninterrupted for 2-h. Carotid-femoral pulse wave velocity (cf-PWV), pulse wave analysis (PWA), lower limb venous pooling (HHb), and calf circumference were assessed pre-and post-sitting using general linear mixed models, with age as a covariate. Changes in MAP over time (both between and within groups) was assessed using a two-way repeated-measures-ANOVA. There were no significant interactions for any outcome measures. However, for cf-PWV, there was a significant main effect of group (Δ = 0.854 ± 0.354m s-1; p = 0.026, ηp2 = 0.707). For PWA, only heart rate (HR) and pressure forwards (Pf) showed significant main effects 13 of time [Δ = 6 ± 1 bts-min-1, p < 0.001, ηp2 = 0.861] and group [Δ = 3.893 ± 1.450mmHg, p = 0.016, ηp2 = 0.271], respectively. Both HHb (Δ = 2.737 ± 0.952, p = 0.009, ηp2 = 0.742) and calf circumference (Δ = 0.812 ± 0.128cm, p < 0.001, ηp2 = 0.863) significantly increased over time. Whilst post-menopausal women demonstrated greater overall arterial stiffness (increased cf-PWV at baseline), there was no difference in cardiovascular response (central or peripheral) to 2-h of prolonged sitting between the pre- and post-menopausal women.

Effects of a randomized controlled trial of mobile app-based Acceptance and Commitment Therapy on depressive symptoms and process variables in college students - Focusing on the mediating effects of acceptance and cognitive defusion-

As social costs rise due to the increasing prevalence of depression, there is a growing emphasis on cost-effective and evidence-based psychotherapeutic methods. Acceptance and Commitment Therapy (ACT) for depression is an effective approach that reduces depressive symptoms and helps prevent recurrence by enhancing psychological flexibility. This study developed a mobile app-based ACT and tested its effectiveness for college students with depression. Eighty college students with depression were randomly assigned to either a treatment group (n = 41) or a control group (n = 39). The treatment group received mobile app-based ACT for 4 weeks, the control group waited without treatment. The scores from pre, post, and follow-up assessments were compared between the two groups. Significant interaction effects of time and group were found for depression and anxiety symptoms, as well as for treatment process variables such as acceptance, inflexibility, defusion, values, commitment, and mindfulness. Acceptance and cognitive defusion emerged as significant mediators in the impact of mobile app-based ACT on depression. The mobile app-based ACT effectively reduced depression and improved treatment process variables, demonstrating its cost-effectiveness. The study also discusses the implications, limitations, and directions for future research.

Effects of Muay Thai Practice on Self-Esteem, Body Perception, and Quality of Life in Adolescents with Overweight/Obesity

ABSTRACT Introduction The aim of this study was to analyze the effects of 16 wk of Muay Thai practice on body perception, self-esteem, and quality of life in adolescents with overweight/obesity. Methods The sample consisted of adolescents with overweight/obesity, aged 10–17 yr. Overweight/obesity was confirmed using body mass index (BMI) and body fat (BF). Body mass and height were measured, from which BMI was calculated. BF was assessed using dual-energy x-ray absorptiometry. Body perception was measured using the Brazilian Silhouette Scale for Children, self-esteem was measured using the Rosenberg Self-Esteem Scale, and quality of life was measured using the 36-Item Short Form Health Survey. The Muay Thai intervention lasted 16 wk, with the initial 4 wk intended for adaptation and familiarization. Sessions were held three times per week on nonconsecutive days for 1.5 h. Protective equipment and devices, such as gloves, Thai pads, gauntlets, and head and rib protectors, were used. Training intensity was maintained between moderate and high according to the rate of perceived exertion scale. The control group did not perform any type of systematic training. Results There was a statistically significant group effect for self-esteem only (P &lt; 0.01; effect size (η 2) = 0.13). When analyzing η 2, there was a group × time interaction in the pain domain of quality of life (P = 0.07; η 2 p = 0.11) considered medium to large. Furthermore, increases were observed in the prevalence of healthy self-esteem (before, 65.0%; after, 73.1%) and satisfaction with body image (before, 0%; after, 3.8%) in the Muay Thai group. Conclusion Muay Thai led to increased prevalences of individuals satisfied with their body image and with healthy self-esteem, as well as an increase in the pain domain score of quality of life in adolescents with overweight/obesity.

Comparison of the effects of cold water immersion and percussive massage on the recovery after exhausting eccentric exercise: A three-armed randomized controlled trial.

Athletic training requires both challenging stimuli for adaptation and sufficient recovery for improved performance. While cold water immersion (CWI) is already a popular recovery method, handheld percussive massage (PM) devices have also gained popularity in recent years. This study aims to assess the effects of CWI and PM on performance recovery after strenuous eccentric exercises compared to a passive rest (PR) control condition. Thirty-four healthy physically active participants (9 females, 25 males) were randomly divided into three groups: CWI (n = 11), PM (n = 11), and passive rest (PR) (n = 12). They underwent an exhausting eccentric exercise protocol and different measurements at six time points (baseline, POST1, POST2, POST24, POST48, and POST72) over the time course of 72h. These included subjective assessments of muscle soreness and perceived stiffness as well as measures of skin temperature, leg volume, creatine kinase activity, and three different jump tests. The eccentric exercise protocol consisted of 15min downhill running (slope: 12%, speed: 10km/h) and 3 sets of successive depth jumps (dropping height: 0.5m) until individual exhaustion. After POST1 measurements, participants received 12min of either CWI (11 ± 0.5°C), PM (40Hz) or PR (supine posture). No significant group effects were found for the number of depth jumps performed during the exhaustion protocol. All jump tests displayed a significant group × time interaction effect. Post-hoc analysis indicated significant lower jump heights in ΔPOST2 between CWI and both PM and PR. No other significant group effects were observed at any time point. No significant group × time interaction effects were noted for CK, leg volume, and soreness. The perceived stiffness showed a significant group × time interaction effect. Post-hoc analysis revealed a significant decrease in stiffness for PM compared to PR at ΔPOST2. Neither CWI nor PM showed any significant improvement in performance recovery over the 72-h period following strenuous eccentric exercise compared to PR. CWI showed an immediate performance decline which may be attributed to a cold-related reduction in motor nerve conduction velocity.

Remote Microphone Systems for Autistic and Nonautistic Youth: Effects on Audiovisual Task Engagement

Objectives: A recent study has provided empirical support for the use of remote microphone (RM) systems to improve listening-in-noise performance of autistic youth. It has been proposed that RM system effects might be achieved by boosting engagement in this population. The present study used behavioral coding to test this hypothesis in autistic and nonautistic youth listening in an ecologically valid, noisy environment. Design: We drew on extant data from a recent experimental study in which 56 youth (32 autistic, 24 nonautistic) matched at the group level on age and biological sex completed listening-in-noise tasks wherein they reported their perception of audiovisual syllables, words, sentences, and passages with and without an RM system; conditions were counter-balanced across participants. As previously reported, perceptual accuracy varied with stimulus complexity and overall improved with the RM system, with improvements not significantly different between groups. Video recordings of participants completing listening-in-noise tasks in both conditions were coded via a 5-second, partial-interval coding system by naive coders for (a) engagement in the task (indexed via proportion of intervals in which participants displayed on-task behaviors) and (b) verbal, stimulus-specific protesting in the task (indexed via proportion of intervals in which participants displayed verbal, stimulus-specific protesting behaviors). Examples of on-task behaviors included attending to the screen and completing task activities. Examples of protesting behaviors included complaining about stimuli volume or the inability to hear. Chronological age, autism features, language ability, audiovisual speech integration as measured by psychophysical tasks, tactile responsiveness, and nonverbal intelligence quotient were evaluated as putative predictors and/or moderators of effects on behaviors of interest. Results: In general, participants were highly engaged in the task, and there were few protests, reflecting more than 90% and fewer than 0.5% of coded intervals, respectively. We did not detect any statistically significant effects of group or RM system use on task engagement. Nonautistic youth were engaged in the listening-in-noise task for an average of 97.45% of intervals, whereas autistic youth were engaged in the listening-in-noise task for an average of 94.25% of intervals. In contrast, verbal, stimulus-specific protesting in the listening-in-noise task was significantly reduced, on average, in the RM (0.04% of intervals) versus the No RM (0.2% of intervals) conditions. There were no effects related to group for this behaviorally coded outcome. In addition, select participant characteristics predicted engagement within conditions across participants. Greater language ability and nonverbal intelligence quotient predicted increased engagement when not using an RM system. Increased features of autism and wider temporal binding windows for audiovisual speech predicted reduced engagement while using an RM system, and greater audiovisual integration predicted increased engagement while using an RM system. Conclusions: The results of this study suggest that RM system use reduces verbal, stimulus-specific protesting, which likely reflects difficulty engaging when listening in noise. The present study extends our previous study to provide additional empirical support for RM system use in autistic and nonautistic youth.

Changes in memory and cognition during the SARS-CoV-2 human challenge study

Patient-reported outcomes and cross-sectional evidence show an association between COVID-19 and persistent cognitive problems. The causal basis, longevity and domain specificity of this association is unclear due to population variability in baseline cognitive abilities, vulnerabilities, virus variants, vaccination status and treatment. Thirty-four young, healthy, seronegative volunteers were inoculated with Wildtype SARS-CoV-2 under prospectively controlled conditions. Volunteers completed daily physiological measurements and computerised cognitive tasks during quarantine and follow-up at 30, 90, 180, 270, and 360 days. Linear modelling examined differences between 'infected' and 'inoculated but uninfected' individuals. The main cognitive endpoint was the baseline corrected global cognitive composite score across the battery of tasks administered to the volunteers. Exploratory cognitive endpoints included baseline corrected scores from individual tasks. The study was registered on ClinicalTrials.gov with the identifier NCT04865237 and took place between March 2021 and July2022. Eighteen volunteers developed infection by qPCR criteria of sustained viral load, one without symptoms and the remainder with mild illness. Infected volunteers showed statistically lower baseline-corrected global composite cognitive scores than uninfected volunteers, both acutely and during follow up (mean difference over all time points=-0.8631, 95% CI=-1.3613,-0.3766) with significant main effect of group in repeated measures ANOVA (F (1,34)=7.58, p=0.009). Sensitivity analysis replicated this cross-group difference after controlling for community upper respiratory tract infection, task-learning, remdesivir treatment, baseline reference and model structure. Memory and executive function tasks showed the largest between-group differences. No volunteers reported persistent subjective cognitive symptoms. These results support larger cross sectional findings indicating that mild Wildtype SARS-CoV-2 infection can be followed by small changes in cognition and memory that persist for at least a year. The mechanistic basis and clinical implications of these small changes remain unclear. This study was funded through the UK Vaccine Taskforce of the Department for Business, Energy and Industrial Strategy (BEIS) of Her Majesty's Government. WT was funded by the EPSRC through the CDT for Neurotechnology Imperial College London.

The impact of maturation level, not chronological age, on attentional control: implications for sports injury prevention in female adolescents

BackgroundNon-contact injuries are highly prevalent among young athletes and occur particularly in situations that require fast decision making and divided attention. Administering relevant neurocognitive tests could help identify deficiencies in these cognitive abilities and thus potentially mitigate injury risk. However, processes such as selective attention and response inhibition might depend to some extent on the athlete’s maturation stage. We aimed to examine the effect of maturation on selective visual attention and response inhibition among adolescent volleyball players.MethodsIn this cross-sectional study, 52 female adolescents (age 12.3 ± 2.1 years) performed an Eriksen Flankers task. Participants were divided into subgroups based on their estimated adult stature, using the Khamis & Roche method: Pre-pubertal (PRE; n = 13, age: 9.9 ± 1.3), early-puberty (EPUB; n = 7, age: 10.5 ± 0.6), mid-puberty (MPUB; n = 8, age: 12.6 ± 0.8) and late puberty (LPUB; n = 24, age: 14.1 ± 0.9). Analyses of covariance (ANCOVA) were performed on congruent and incongruent reaction times (RT), with corresponding success rates (% correct responses) as covariate. Flanker interference effect was tested using ANOVA. Correlations were further examined between the dependent variables and participants’ chronological age.ResultsThere was a significant group effect, with PRE demonstrating longer RT compared with LPUB (P < 0.001) for both congruent and incongruent RT. Moderate negative correlations were observed between age and RT (Rp = -0.695, Rp = -0.614 for congruent and incongruent RT, respectively) and low positive correlations between age and incongruent success rate (Rs = 0.318). Low to moderate correlations were also observed within the LPUB group for RT (Rp = -0.431–-0.532) and success rate (negative Rs = -574 for congruent and positive Rs = 0.417 for incongruent). There were no group differences nor age associations with interference effect.ConclusionsOur findings indicate that information processing and selective visual attention are superior at late maturation compared with early maturation among female adolescents. The same cannot be said for response inhibition, which did not differ between maturation groups. Similar tendencies were observed with regards to chronological age, but not entirely explained by it. Maturation level, rather than chronological age, should guide practitioners during sport participation and injury prevention programs for young athletes, whose neurocognitive abilities are not yet fully developed, placing them at risk for non-contact injuries.

Sensory Stimulation and Robot-Assisted Arm Training After Stroke: A Randomized Controlled Trial.

Functional recovery after stroke is often limited, despite various treatment methods such as robot-assisted therapy. Repetitive sensory stimulation (RSS) might be a promising add-on therapy that is thought to directly drive plasticity processes. First positive effects on sensorimotor function have been shown. However, clinical studies are scarce, and the effect of RSS combined with robot-assisted training has not been evaluated yet. Therefore, our objective was to investigate the feasibility and sensorimotor effects of RSS (compared to a control group receiving sham stimulation) followed by robot-assisted arm therapy. Forty participants in the subacute phase (4.4-23.9weeks) after stroke with a moderate to severe arm paresis were randomized to RSS or control group. Participants received 12 sessions of (sham-) stimulation within 3weeks. Stimulation of the fingertips and the robot-assisted therapy were each applied in 45-min sessions. Motor and sensory outcome assessments (e.g. Fugl-Meyer-Assessment, grip strength) were measured at baseline, post intervention and at a 3-week follow-up. Participants in both groups improved their sensorimotor function from baseline to post and follow-up measurements, as illustrated by most motor and sensory outcome assessments. However, no significant group effects were found for any measures at any time ( P >0.058). Stimulations were well accepted, no safety issues arose. Feasibility of robot-assisted therapy with preceding RSS in persons with moderate to severe paresis was demonstrated. However, RSS preceding robot-assisted training failed to show a preliminary effect compared to the control intervention. Participants might have been too severely affected to identify changes driven by the RSS, or these might have been diluted or more difficult to identify because of the additional robotic training and neurorehabilitation. for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A478 ).

Preventing fixation: Evidence of item-method directed forgetting protecting against mental impasses in creative problem-solving.

Creative problem-solving can be impeded by mental impasses which are caused by fixation on associated but misguiding ideas. Recently, research has focused on the question of which processes might be involved in overcoming fixation and how it can be prevented from occurring altogether. In the present study, we investigated whether initially encoded fixation words can be forgotten by means of item-method directed forgetting, a procedure in which participants are presented with a series of items that are each followed by a remember cue or forget cue. Here, the series of items partly consisted of words that were misleadingly associated with compound remote associate problems that had to be solved later on. Two groups were compared: For one group, fixation words were followed by forget cues (fixation-F), whereas for the other group, they were followed by a remember cue (fixation-R). Results revealed three major findings: (1) The fixation-R group showed typical detrimental effects of fixation (i.e., impaired problem-solving performance), whereas there was no significant fixation effect in the fixation-F group, and (2) the magnitude of fixation was positively related to memory for fixation words. The present findings add to existing literature about how fixation negatively affects creative problem-solving and how it can be prevented by reducing the activation level of misleading thoughts.

P-tau217 and other blood biomarkers of dementia: variation with time of day

Plasma biomarkers of dementia, including phosphorylated tau (p-tau217), offer promise as tools for diagnosis, stratification for clinical trials, monitoring disease progression, and assessing the success of interventions in those living with Alzheimer’s disease. However, currently, it is unknown whether these dementia biomarker levels vary with the time of day, which could have implications for their clinical value. In two protocols, we studied 38 participants (70.8 ± 7.6 years; mean ± SD) in a 27-h laboratory protocol with either two samples taken 12 h apart or 3-hourly blood sampling for 24 h in the presence of a sleep–wake cycle. The study population comprised people living with mild Alzheimer’s disease (PLWA, n = 8), partners/caregivers of PLWA (n = 6) and cognitively intact older adults (n = 24). Single-molecule array technology was used to measure phosphorylated tau (p-tau217) (ALZpath), amyloid-beta 40 (Aβ40), amyloid-beta 42 (Aβ42), glial fibrillary acidic protein, and neurofilament light (NfL) (Neuro 4-Plex E). Analysis with a linear mixed model (SAS, PROC MIXED) revealed a significant effect of time of day for p-tau217, Aβ40, Aβ42, and NfL, and a significant effect of participant group for p-tau217. For p-tau217, the lowest levels were observed in the morning upon waking and the highest values in the afternoon/early evening. The magnitude of the diurnal variation for p-tau217 was similar to the reported increase in p-tau217 over one year in amyloid-β-positive mild cognitively impaired people. Currently, the factors driving this diurnal variation are unknown and could be related to sleep, circadian mechanisms, activity, posture, or meals. Overall, this work implies that the time of day of sample collection may be relevant in the implementation and interpretation of plasma biomarkers in dementia research and care.

Effects of Heart Rate Variability (HRV) Biofeedback in Pulmonary Indicators and HRV Indices Among Patients with Chronic Obstructive Pulmonary Disease.

Patients with chronic obstructive pulmonary disease (COPD) exhibit reduced cardiac autonomic activity, linked to poor prognosis and exercise intolerance. While heart rate variability biofeedback (HRVB) can enhance cardiac autonomic activity in various diseases, its use in patients with COPD is limited. This study explored the impact of the HRVB on cardiac autonomic activity and pulmonary indicators in patients with COPD. Fifty-three patients with COPD were assigned to either the HRVB (n = 26) or the control group (n = 27), with both groups receiving standard medical care. The HRVB group also underwent one-hour HRVB sessions weekly for six weeks. All participants had pre- and post-test measurements, including the Six-Minute Walking Test (6MWT), lead II electrocardiogram (ECG) recording, Modified Medical Research Council Dyspnea Scale (mMRC), body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index. ECG data were analyzed for heart rate variability (HRV) as an index of cardiac autonomic activity. A two-way mixed analysis of variances demonstrated significant interaction effects of Group × Time in pulmonary indicators and HRV indices. The HRVB group exhibited significant post-test improvements, with decreased mMRC and BODE scores and increased 6MWT distance and HRV indices, compared to pre-test results. The 6MWT distance significantly increased and mMRC significantly decreased at post-test in the HRVB group compared with the control group. This study confirmed the efficacy of HRVB as an adjunct therapy in patients with COPD, showing improvements in exercise capacity, breathing difficulties, and cardiac autonomic activity.

Improved heart rate variability in postmenopausal women following short-term combined exercise training

Imbalances in cardiac autonomic nervous systems are associated with cardiovascular risk factors and poor cardiac outcomes. Heart rate variability (HRV) is a practical and reproducible measure of cardiac autonomic nervous system function. Exercise training promotes positive adjustments in HRV. However, previous studies have reported mixed results. Therefore, this study aimed to investigate the effects of short-term combined exercise training on heart rate variability in post-menopausal women. Thirty-four women aged 50-80 years, at least 12 months post-menopause, were divided into a control (CON) group and an exercise (EX) training group. The participants in the exercise group underwent a 2-week of combined exercise program consisting of aerobic, strength, flexibility, and balance exercises. HRV was recorded using an Actiheart device, before and after the final exercise intervention in a sitting position. The significant main effects of time and group were found in the parameter of SDNN (p time = 0.039; p group = 0.026). Post-hoc analysis showed a borderline increase in SDNN in the EX group (POST: 48.79 ± 17.88 VS 44.54 ± 17.39, p = 0.055). No significant change was observed in the CON group (POST: 35.55 ± 13.51 VS 33.17 ± 8.74, p = 0.288). Statistical analysis of other HRV components revealed no significant results (all P &gt; 0.05). In conclusion, a 2-week of combined exercise training program, including aerobic, resistance, balance, and flexibility exercises improves global cardiac autonomic function in post-menopausal women. Keywords: combined exercise training, heart rate variability, blood pressure, menopause, and women

Effectiveness of a game-based high-intensity interval training on executive function and other health indicators of children with ADHD: A three-arm partially-blinded randomized controlled trial

BackgroundChildren with ADHD demand for effective intervention with minimum side effect to improve executive function (EF) and health well-being. MethodThis study used a three-arm partially-blinded randomized controlled trial to test the effects of two different kinds of 8-week game-based training programs (game-based HIIT program, GameHIIT; and game-based structured aerobic exercise program, GameSAE) on EF and other health indicators of children with ADHD, which was compared with a non-treatment control group. ResultsA total of 49 children with ADHD completed the program. Analyses of EF tests and parental survey indicated that (i) there is no significant intragroup difference among all measures between pre-/post-intervention tests for two game-based intervention groups. The only significant intergroup difference was observed in self-monitor score of parent-reported child's EF between GameSAE group and the control (large effect). Similarly, cerebral hemodynamic responses also found no significant group effect for all EF tests. However, the time effects were observed in several channels in the GameHIIT group in two EF tests (Color Words Stroop Test and Tower of London Test). No significant change of participants' overall ADHD symptoms was found in the pre-/post-tests for three groups. Nonetheless, further analyses revealed that both of two game-based training programs exhibited the significant positive effects on child's PA levels and the large effects on levels of physical fitness, when they were compared to the control. ConclusionBy this study, a significant enhancement in physical fitness and PA levels were found in both game-based PA interventions when they were compared with control group. However, the effectiveness of game-based PA interventions on improving EF or reducing ADHD symptoms remains unclear. This implies that a larger intervention dosage or a tailored intervention design may be warranted to improve the EF of children with ADHD.

Attachment Styles and Parenting Attitudes in Adults With "Pseudo-Attention-Deficit/Hyperactivity Disorder".

Background The number of individuals who experience the onset of attention-deficit/hyperactivity disorder (ADHD)-like symptoms after the age of 12 years has been growing, which does not meet the diagnostic criteria for adult ADHD. We designated this condition as "pseudo-ADHD" and investigated its psychological implications by comparing the parenting attitudes in childhood and attachment styles among individuals with "pseudo-ADHD," those with adult ADHD, and healthy controls. Methods We conducted an online cross-sectional survey of adults aged 18 years. Participants in the analysis included individuals with "pseudo-ADHD" (n = 46), adults with ADHD (n = 23), and healthy controls (n = 758). The Parental Bonding Instrument (PBI) was used to evaluate parenting attitudes, and the Experiences in Close Relationships Inventory for the Generalized Other (ECR-GO) was used to evaluate attachment styles. One-way analysis of variance was performed to compare the PBI and ECR-GO scores among the three groups. Results Regarding the PBI scores, a significant main effect of group was found for the paternal care scores (p = 0.002), and the "pseudo-ADHD" group did not differ significantly from the adult ADHD group or healthy control group (p = 0.378, p = 0.228, respectively). A significant main effect of the group was found for the maternal care scores (p < 0.001). The "pseudo-ADHD" group scored significantly lower than the adult ADHD group (p = 0.005), whereas there was no significant difference compared to the healthy control group (p = 1.000). A significant main effect of the group was also found for the paternal overprotection scores (p < 0.001). The "pseudo-ADHD" group scored significantly lower than the adult ADHD group (p = 0.002), whereas there was no significant difference compared to the healthy control group (p = 0.571). A significant main effect of group was found for the maternal overprotection scores (p < 0.001), and the "pseudo-ADHD" group did not differ significantly from either the adult ADHD group or the healthy control group (p = 0.060, p = 0.161, respectively). Regarding ECR-GO scores, a significant main effect of group was found for the fear of abandonment score (p < 0.001), and the "pseudo-ADHD" group scored significantly lower than the adult ADHD group (p < 0.001) and significantly higher than the healthy control group (p = 0.005). Conclusion This study suggested that the parenting attitudes of parents of individuals with "pseudo-ADHD" were not different from those of the healthy controls. For attachment styles, the fear of abandonment was higher in individuals with "pseudo-ADHD" than in healthy controls, but not as high as in patients with adult ADHD. This study highlights, for the first time, the importance of considering attachment styles in the diagnosis and treatment of individuals with ADHD symptoms in adulthood.

Social Desirability Bias in a Randomized Controlled Trial That Included Breastfeeding Promotion in Western Kenya

BackgroundBreastfeeding promotion is associated with improved measures of breastfeeding practice; however, most studies rely on participant-reported outcomes. ObjectivesThis study aimed to evaluate the likelihood of bias in self-reported breastfeeding outcomes. MethodsWe used data from the WASH Benefits randomized controlled trial in Kenya (clinicaltrials.gov NCT01704105), which included intervention arms that received infant and young child feeding messages (nutrition group) and arms that did not (non-nutrition group) to examine recall bias in the assessment of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) duration. Pregnant women were eligible for inclusion, but 40% of infants were born before the first visit by the health promoter. We used the random variability in the timing of the infant birth relative to the first contact with the health promoter to examine recall bias in EIBF. We used ≤5 rounds of repeated surveys to examine bias in recall of EBF duration. ResultsThere was a significant effect of the intervention group on EIBF [prevalence ratio: 1.50, 95% confidence interval (CI): 1.43, 1.57] and a significant difference in the duration of EBF [nutrition group: 6.0 mo; interquartile range (IQR): 3.0–6.0; nonnutrition group: 3.0 mo; IQR: 0.5–6.0; P < 0.001]. There was not a significant interaction with birth timing relative to the first contact with the health promoters (P = 0.915), suggesting that the observed main effect on EIBF was due to recall bias. We found that 75.9% of mothers who initially reported having ceased EBF before 6 mo in the nutrition group changed their response to 6 mo or later in subsequent surveys. Only 32.5% of mothers in the non-nutrition group followed this pattern. ConclusionsThese data provide strong evidence of bias in reporting of breastfeeding practices in this nonblinded intervention trial and should serve as a caution to researchers who rely on self-reported outcomes of behavior change interventions.This trial was registered at clinicaltrials.gov as NCT01704105.

Intra-uterine injection of amnion-derived acellular bioscaffold product in mares, a description of systemic and intra-uterine effects over 21 days

Amnion-derived acellular bioscaffold (ADABP) products demonstrate interesting anti-inflammatory and healing properties which could be beneficial for intrauterine use. The objective of this study was to evaluate the safety of intrauterine injection of ADABP on systemic and uterine health. The study design randomly assigned subjects to one of two groups, control mares (n = 3) which received 3 mL injection of sterile saline in the base of each uterine horn, and treatment mares (n = 9) which received 3 mL of ADABP in the base of one uterine horn and 3 mL injection of sterile saline in the base of the other uterine horn. The leukogram had no significant effect of group and no group by day interaction. The serum biochemistry panel had no effect of group on any of the parameters examined. There were no significant differences in uterine culture or uterine biopsy results. The data suggests intrauterine injection of ADABP has no negative systemic or uterine effects.

Effects of Fu’s subcutaneous needling on clinical efficacy and psychological cognitive characteristics in patients with chronic non-specific low back pain: A randomized controlled trial

Background and purposeLow back pain (LBP) is a major global public health problem. Evidence shows that LBP is also related to cognitive, psychological, and lifestyle factors. Fu’s subcutaneous needling (FSN) has been used for the treatment of musculoskeletal problems for many years. This prospective randomized controlled trial aimed to evaluate the clinical efficacy and fear avoidance beliefs of FSN in the treatment of patients with chronic non-specific LBP. Material and methodsNinety participants with chronic non-specific LBP were randomly divided into the FSN and the traditional acupuncture (TA) groups (n = 45) and received either FSN or TA treatment for three consecutive days from December 2021 to March 2023. The primary outcome was pain intensity measured by the visual analogue scale (VAS). Secondary outcomes were trunk extensor endurance (TEE), lumbar range of motion (ROM), and the Fear Avoidance Beliefs Questionnaire (FABQ). Outcome measurements were made before the first treatment and after each treatment. Follow-up assessments of VAS and FABQ scores were conducted one month after treatment. ResultsThe FSN group had significantly lower VAS and FABQ scores at each time point after intervention compared to the TA group (P < 0.01). The scores of TEE and lumbar ROM were higher in the FSN group than those in the TA group (P < 0.01). Repeated measures analysis of variance (ANOVA) showed significant time effects, group effects, and interaction effects for VAS, TEE, lumbar ROM, and FABQ in both groups (P < 0.01). One month after treatment, the FSN group had significantly lower VAS and FABQ scores compared to the TA group (P < 0.05). ConclusionThis study suggested that FSN was superior to TA in terms of clinical efficacy and fear-avoidance beliefs in the treatment of chronic non-specific LBP. FSN could be used as an effective clinical treatment.

Effects of attentional focus on quiet standing balance control in individuals with non-specific chronic low back pain

Despite the widespread research about the effects of attentional focus on balance control in different populations, to the best of our knowledge, no study has yet investigated the effects of attentional focus instructions on balance control in individuals with chronic low back pain (CLBP). Therefore, this study was aimed to compare the effects of internal focus (IF) and external focus (EF) of attention on quiet standing balance control between individuals with CLBP and healthy controls. Twenty individuals with CLBP and 20 healthy controls were enrolled in this quasi-experimental study. The participants were asked to stand still with eyes open and eyes closed while performing three tasks: baseline standing with no focus instructions, internally focusing on their feet, and externally focusing on two markers were placed on the force platform. Statistical analyses showed a significant main effect of group for mean total velocity (p = 0.02), area (p = 0.01), and displacement in mediolateral (ML) direction (p = 0.003). Moreover, a significant main effect of vision was observed for mean total velocity (p < 0.001), area (p < 0.001), and displacement in anteroposterior (AP) (p < 0.001) and ML directions (p < 0.001). Also, the results revealed a significant main effect of attentional focus for mean total velocity (p < 0.001), area (p < 0.001), and displacement in AP (p < 0.001) and ML directions (p = 0.01). Our results showed that in both healthy controls and individuals with CLBP, EF led to improve quiet standing balance control compared to IF and control conditions. From a clinical perspective, it may be useful for physical therapists to consider the use of instruction cues that direct performer's attention away from the body for improving quiet standing balance control in individuals with CLBP.

Peer-Led Versus Authority-Led Video Intervention Effects on Musculoskeletal Injury Help-Seeking Intentions in Reserve Officers' Training Corps.

Reserve Officers' Training Corps (ROTC) trainees are college students who complete military courses and participate in physical and tactical training under the direction of military Service Members assigned to ROTC programs to serve as faculty and staff at US colleges. ROTC trainees report musculoskeletal injuries (MSKIs) attributable to ROTC training in line with MSKI incidence in other training environments. However, concealment is prevalent, as 66% of MSKIs in ROTC go unreported. The current study investigated if a brief, online educational video could increase ROTC trainees' reporting intentions. In addition, we investigated if the message's source (i.e., peer or authority figure) affected reporting intentions. A repeated measures design was used to evaluate the impact of 2 MSKI educational interventions, one delivered by a high-achieving Army ROTC trainee (peer-led) and the other delivered by an Army ROTC battalion commander (authority-led), on MSKI reporting intentions, as compared to each other and a control intervention. Other than their personal introductions, both individuals had the same script addressing 4 areas: (1) MSKI prevalence in ROTC, (2) evidence of improved outcomes with early treatment, (3) encouraging injury reporting, and (4) addressing specific barriers and stigma beliefs previously identified in ROTC. The control condition consisted of a video demonstrating exercise technique with voiceover. A survey was developed to measure stigma regarding MSKI reporting and intentions to seek help for MSKI. ROTC trainees at 23 universities were invited to participate via an anonymous survey link. Participants completed the following using an online survey platform: (1) pre-intervention MSKI intentions scale, (2) randomly assigned intervention video, and (3) repeat MSKI intentions scale post-intervention. A two-way mixed, ANOVA was performed to assess interaction effects and main effects pre- and post-intervention. One-hundred ROTC trainees (39% female; age = 21 ± 2 years, ROTC experience = 2 ± 1 years) completed the study. Participants were primarily from Army ROTC programs (72 Army, 14 Air Force, and 14 Naval). Pre-intervention survey scores (possible score range 8-56 with lower scores indicating greater intention to seek help): authority-led (n = 31) 20.3 ± 9.4, peer-led (n = 32) 21.8 ± 8.7, control (n = 37) 19.1 ± 10.1, total 20.3 ± 9.4. Post-intervention scores: authority-led 20.9 ± 11.2, peer-led 20.2 ± 10.0, control 17.3 ± 7.7, total 19.7 ± 9.3. There was no significant group*time interaction (F2,97 = 0.92, P = .403, η2partial = 0.02). There were no significant main effects for time (F1,97 = 1.461, P = .230, η2partial =0.015) or group (F2,97 = 1.08, P = .342, η2partial = 0.02). Findings did not support the use of a single educational intervention video to influence MSKI help-seeking intentions of ROTC trainees. Intentions may already be ingrained such that a single intervention could not influence change. Previous research on concussion reporting indicates that concealment cultures may be systematic and indoctrination of concealment can influence one's reporting intentions. Our sample had already participated in ROTC for 2 years. Future research should evaluate if MSKI help-seeking intentions change over the course of ROTC participation, or even over a military career.

Exploring the Impact of a Sleep App on Sleep Quality in a General Population Sample: Pilot Randomized Controlled Trial.

A third of adults in Western countries have impaired sleep quality. A possible solution involves distributing sleep aids through smartphone apps, but most empirical studies are limited to small pilot trials in distinct populations (eg, soldiers) or individuals with clinical sleep disorders; therefore, general population data are required. Furthermore, recent research shows that sleep app users desire a personalized approach, offering an individually tailored choice of techniques. One such aid is Peak Sleep, a smartphone app based on scientifically validated principles for improving sleep quality, such as mindfulness meditation and cognitive behavioral therapy. We aimed to test the impact of the smartphone app Peak Sleep on sleep quality and collect user experience data to allow for future app development. This was a 2-arm pilot randomized controlled trial. Participants were general population adults in the United Kingdom (aged ≥18 years) who were interested in improving their sleep quality and were not undergoing clinical treatment for sleep disorder or using sleep medication ≥1 per week. Participants were individually randomized to receive the intervention (3 months of app use) versus a no-treatment control. The intervention involved free access to Peak Sleep, an app that offered a choice of behavioral techniques to support better sleep (mindfulness, cognitive behavioral therapy, and acceptance commitment therapy). The primary outcome was sleep quality assessed using the Insomnia Severity Index at baseline and 1-, 2-, and 3-month follow-ups. Assessments were remote using web-based questionnaires. Objective sleep data collection using the Oura Ring (Ōura Health Oy) was planned; however, because the COVID-19 pandemic lockdowns began just after recruitment started, this plan could not be realized. Participant engagement with the app was assessed using the Digital Behavior Change Intervention Engagement Scale and qualitative telephone interviews with a subsample. A total of 101 participants were enrolled in the trial, and 21 (21%) were qualitatively interviewed. Sleep quality improved in both groups over time, with Insomnia Severity Index scores of the intervention group improving by a mean of 2.5 and the control group by a mean of 1.6 (between-group mean difference 0.9, 95% CI -2.0 to 3.8), with was no significant effect of group (P=.91). App users' engagement was mixed, with qualitative interviews supporting the view of a polarized sample who either strongly liked or disliked the app. In this trial, self-reported sleep improved over time in both intervention and control arms, with no impact by group, suggesting no effect of the sleep app. Qualitative data suggested polarized views on liking or not liking the app, features that people engaged with, and areas for improvement. Future work could involve developing the app features and then testing the app using objective measures of sleep in a larger sample. ClinicalTrials.gov NCT04487483; https://www.clinicaltrials.gov/study/NCT04487483.