Significant Intergroup Differences Research Articles

Patient Centered, Clinical, Radiographic, and Biochemical comparative evaluation of Transgingival and Conventional Flapped Implant surgical technique: A randomized controlled trial.

A multifaceted study compared transgingival (flapless) implant placement with conventional flapped placement, which employed clinical, radiographic, biochemical, and patient-centered parameters. The study was approved by the institutional ethics committee and was conducted according to the ethical standards in the 1964 Declaration of Helsinki and its amendments. Seventy-five implants were placed, 37 by flapless method (group 1) and 38 by flapped method (group 2). The Group 1 subjects underwent flapless implant placement, while Group 2 underwent flapped implant placement. The modified plaque index was significantly higher in group 2 at 6 weeks (Mann Whitney test, z = -3.08, p = .002). Modified sulcus bleeding index was also significantly higher in group 2, up to the 12-week follow-up (Mann Whitney test, z = -4.63, p < .001). Crestal bone loss revealed no significant intergroup difference. Under biochemical evaluation, matrix metalloproteinase-8 (MMP-8) was significantly higher in flapped implants up to the 6-week follow-up. The patient-reported questionnaire-based acceptability assessment showed that the flapless technique is better regarding the perceived duration of the surgery and post-operative comfort.

A propensity score-adjusted HRV analysis of social avoidance and distress in patients with panic disorders.

Panic disorder (PD) may accompany elevated social avoidance and distress (SAD). Higher SAD in patients with PD predicts a poorer prognosis and response to treatment. As heart rate variability (HRV) reflects the self-regulatory capacity underlying SAD, applying HRV to distinguish PD heterogeneity would be clinically beneficial in formulating personalized treatment strategies. We hypothesized that HRV would be lower in patients with PD and severe SAD (PD-SAD group) than in those without SAD (PD group). A total of 288 patients met the eligibility criteria, with complete collection of variables of interest and HRV. The inverse probability of treatment weighting (IPTW) method was used to balance the groups for the baseline characteristics of patients. Following IPTW adjustment, the average treatment effects were computed using inverse propensity weighting with regression adjustment (IPW-RA). All characteristics were similar in both groups after IPTW adjustment. The PD-SAD group showed a decreased tendency in time domain parameters, including mean heart rate, SDNN, RMSSD, and pNN50 with a nonlinear domain of SD1. However, no significant intergroup differences were observed in the frequency domain. Higher SAD in PD was associated with reduced HRV, mainly in the time domain, which may be attributed to the shared neural networks between dysfunctional self-regulation statuses, as indexed by reduced HRV. As respiratory sinus arrhythmia is mainly reflected in the frequency domain, the time domain may be more reliable for identifying heterogeneity within patients with PD, who are frequently associated with respiratory pattern abnormalities.

Preoperative Analgesia Efficacy of Liposomal Bupivacaine Following Pericapsular Nerve Group (PENG) Block in Patients with Hip Fracture: A Randomized Controlled Observer-Blinded Study.

Single-injection pericapsular nerve group (PENG) block with ropivacaine provides clear analgesic effects in preoperative pain management for hip fractures. However, it suffers from insufficient duration, failing to meet the needs of most patients. This single-center, randomized controlled, observer-blinded trial utilizes a novel combination of liposomal bupivacaine (LB) single-injection PENG block to examine its efficacy, duration, and safety in preoperative analgesia for hip fractures, aiming to develop a new preoperative analgesic protocol. Sixty-six patients with hip fractures received ultrasound-guided single-injection PENG block with LB or ropivacaine after admission. The primary outcome was the static and dynamic pain scores measured at 48h post-block. Pain scores at 12, 24, 36, 60, and 72h post-block, rescue analgesia rate, time to first opioid, additional morphine consumption, and adverse events were assessed as the secondary outcomes. LB versus ropivacaine group at 48h post-block, with a median interquartile range (IQR) of 2 (1.0-2.0) versus 3 (2.0-3.0) at static pain score and 2 (1.75-3.0) versus 4 (4.0-5.0) at dynamic pain score. LB group had lower dynamic and static pain scores at other observation points except for the static pain score at 72h, lower pain intensity [sum of pain intensity difference (SPID)0-24, SPID0-48 and SPID0-72], longer time to first opioid, lower additional morphine consumption, and lower incidence of nausea and vomiting. No significant inter-group differences were detected in other secondary outcomes. For preoperative analgesia of hip fractures, LB single-injection PENG block had a similar analgesic intensity and safety as ropivacaine but provided a longer duration of analgesia, reaching 48h and even extending beyond 60h, which reduced opioid consumption and extended time to the first opioid. The protocol was registered in www.chictr.org.cn under the identifier ChiCTR2300072939.

Comparison of Analgesic Efficacy between Ultrasound-guided Supra-inguinal Fascia Iliaca Block and Pericapsular Nerve Group Block following Total Hip Arthroplasty: A Randomized Controlled Trial.

The effectiveness of pericapsular nerve group (PENG) block versus suprainguinal fascia iliaca block (SFIB) for pain relief after hip arthroplasty is a topic of ongoing debate. This study aimed to examine the association of PENG block with lower consumption of opioids during the first 24 hours following surgery compared to SFIB. In this single-center, double-blind, randomized controlled trial, 60 patients scheduled for an elective posterior approach to total hip arthroplasty (THA) were randomized according to two groups: ultrasound-guided PENG block (PENG group) or SFIB (SFIB group). The 24-hour consumption of intravenous fentanyl was the primary outcome. Secondary outcomes included perioperative consumption of intravenous fentanyl, pain scores, sensorimotor function, and functional measures. No significant intergroup difference was observed in 24-hour total fentanyl consumption (SFIB group: 117.4±99.8 μg, PENG group: 145.9±122.7 μg; mean difference: 22.6 μg [95% confidence interval -36.6 to 81.8]; P=0.45). No statistically significant difference in terms of fentanyl consumption in intraoperative, post-anesthetic care unit, at 6-hour and 48-hour postoperatively was observed between the two groups. No statistically significant differences in scores for rest and dynamic pain for all aspects of hip joint and surgical incision were observed between the groups (P>0.05). Better cutaneous sensory perception in the hip region and 12-hour postoperative quadriceps muscle strength at 90° were observed in the PENG group compared with the SFIB group (P<0.05). Compared to SFIB, the addition of PENG block to multimodal analgesia did not reduce fentanyl consumption or pain scores after posterior approach THA.

Relationship between autism spectrum disorder and peripapillary intraretinal layer thickness: a pediatric retrospective cross-sectional study.

Autism spectrum disorder (ASD) often presents with atypical visual processing, prompting investigation into its connection with retinal features. This study aimed to (I) compare intraretinal layer thickness in the peripapillary region between ASD and neurotypical (NT) groups, (II) assess associations between intraretinal layer thickness and clinical parameters (social functioning and cognitive levels) in ASD subjects, and (III) evaluate the potential of intraretinal layer thickness as a biomarker for ASD. Participants were recruited through convenience sampling from the Children's Mental Health Research Center at The Affiliated Brain Hospital of Nanjing Medical University and the Department of Ophthalmology at The First Affiliated Hospital of Nanjing Medical University, Nanjing, China, between December 2019 and August 2023. Intraretinal layer thickness in peripapillary region was quantified using optic coherence tomography images with automated layer segmentation performed by OCTExplorer software on 47 individuals with ASD (aged 7-13 years) and age- and sex-matched NT controls. Inter-group comparisons were conducted using unpaired t-tests, Welch's t-tests, or Mann-Whitney U tests as appropriate. Correlations with social functioning (measured by Social Responsiveness Scale scores) and cognitive levels [measured by total intelligence quotient (IQ) scores] were examined using the Spearman correlation coefficient. Stepwise regression analysis was conducted to assess predictive power. Significant inter-group differences (P<0.05) were observed in ganglion cell layer and inner nuclear layer (INL) thickness across global and specific quadrant regions. Participants had a mean age of 9.57±1.83 years in the ASD group and 9.89±1.70 years in the age-matched NT group. While no correlation was found between retinal sublayer thickness and social functioning on ASD subjects (all P>0.05), there was a notable correlation between INL thickness in the infero-nasal quadrant and cognitive level (r=0.381, P=0.014). Stepwise regression analysis identified global INL thickness as a significant predictor of total IQ scores (β=3.986, P=0.034), with an R2 of 0.110 and a root mean square error of 21.900. This study highlights significant differences in retinal features between ASD and NT groups, with implications for understanding ASD pathogenesis and complexity. The findings suggest that easily observable retinal features hold promise as biomarkers for ASD, warranting further investigation.

Striding beyond numbness: a non-randomized controlled study of an exercise program for breast cancer patients with chemotherapy-induced peripheral neuropathy.

To investigate the effectiveness of a 13-week combined supervised and home-based exercise program in alleviating the symptoms of chemotherapy-induced peripheral neuropathy (CIPN) in patients with breast cancer (BC). In this non-randomized controlled study, 77 patients with BC selected after applying the inclusion and exclusion criteria were allocated to the intervention (n = 37) or control (n = 40) group. Patients in the intervention group underwent a 13-week exercise program consisting of health education and hand and foot exercises combined with aerobic, resistance, and balance training, while those in the control group received usual care. The symptoms of CIPN were assessed at baseline (T0), post-intervention (T1), and 3months post-intervention (T2). Physical fitness and finger flexibility were assessed at T0 and T1. A generalized estimating equation (GEE) model was used to analyze the repeated measures data. The results of GEE showed a significant group effect, indicating significant intergroup differences in the total CIPN score and the dimensions of occurrence, severity, disruption, and frequency (all P < 0.05). Moreover, the two groups showed significant differences in finger flexibility and balance at T1 (all P < 0.05). The exercise program was effective in alleviating the symptoms of CIPN and improved balance and finger dexterity in comparison with the control group. Randomized controlled trials with larger sizes are required to validate these findings.

Association between distal tibial rotation and clinical outcomes of medial open-wedge high tibial osteotomy

BackgroundThe purpose of this study was to evaluate the association between changes in knee joint geometry after medial open-wedge high tibial osteotomy (MOWHTO) and clinical outcomes. MethodsThis was a retrospective study of patients who underwent MOWHTO (101 knees) at our hospital between January 2015 and February 2022 and who were followed up for > 2 years. Radiological and functional outcomes were compared between those who were satisfied with surgery (satisfaction group) and patients who were dissatisfied with surgery (dissatisfaction group). Multiple regression analysis was performed to analyze factors affecting the radiological parameters that significantly differed between the two groups. ResultsThe average follow up period was 38.0 ± 15.4 months. There were no significant differences regarding demographic characteristics and preoperative radiological parameters between the satisfaction and dissatisfaction groups. There was a significant intergroup difference with respect to postoperative distal tibial rotation and change in distal tibial rotation (13.5 ± 4.8° and 9.5 ± 4.3°, respectively; P < 0.001). The difference in tibial rotation before and after surgery was 4.3 ± 2.3° and 1.7 ± 1.8° in the dissatisfaction and satisfaction groups (P < 0.001) Multiple regression analysis showed that the correction angle affected the distal tibial rotation in MOWHTO (R2 = 0.079, ß = 0.165, P = 0.038). ConclusionsIn MOWHTO, an increase in distal tibial rotation was associated with patient dissatisfaction. Because the increase in distal tibial rotation is associated with a large correction angle, excessive distal tibial rotation should be avoided when MOWHTO requires a large correction angle.

Psychological and Pain Factors in Microsurgical Testicular Sperm Extraction (Micro-TESE) for Non-Obstructive Azoospermia: A Comparative Study of Successful and Unsuccessful Cases.

This study aimed to assess postoperative pain, depression, and anxiety levels in infertile men who underwent microsurgical testicular sperm extraction (micro-TESE) for non-obstructive azoospermia (NOA) and compare results between patients with successful and unsuccessful sperm retrieval. A total of 105 NOA patients participated, completing preoperative Beck Depression Inventory (BDI) and Situational and Transient Anxiety Inventory (SAI and TAI) questionnaires. Postoperatively, Visual Analog Scale (VAS) scores were recorded. Patients were categorized into primary and repeated micro- TESE groups, and scale scores, operation duration, and collected tubule count were compared. The relationship between micro-TESE outcomes, VAS scores, and additional analgesia needs was also examined. Successful sperm retrieval was achieved in 55.9% of patients. While BDI, SAI, and TAI scores showed no significant intergroup differences, micro-TESE (-) patients exhibited significantly higher mean VAS scores (p < 0.001). VAS scores positively correlated with BDI score, operation duration, and tubule count, while patient age inversely correlated with micro-TESE results. Infertility, azoospermia, and unsuccessful sperm retrieval impact psychogenic status and pain levels in male patients. Additionally, a history of micro-TESE procedures and their outcomes elevate depression levels.

Sensitivity of the hospital anxiety and depression scale HADS in stroke patients

Introduction. The validated Hospital Anxiety and Depression Scale HADS is recommended for screening symptoms of anxiety and depression in the routine practice of somatic doctors; it is also recommended by experts for use in rehabilitation medicine and frequently used in scientific research to assess the emotional state of stroke patients. At the same time, the literature provides various contradictory data on the sensitivity of this scale for stroke patients. Aim. To evaluate the detectability of emotional disorders in stroke patients using the HADS scale in comparison with the author’s computer program for studying the actual emotional state of the patient. Materials and methods. 60 stroke patients underwent inpatient rehabilitation in the National Medical Research Center for Rehabilitation and Balneology were randomly divided into 2 groups. 30 patients of Group 1 received a basic rehabilitation complex (aimed at correcting motor disorders); 30 patients of Group 2 received a basic rehabilitation complex in combination with a course of cognitive behavioral psychotherapy (CBT). To assess the emotional state at the beginning and at the end of rehabilitation, the HADS scale and the author’s computer program were used to study the actual emotional state of the patient. Statistical analysis was carried out using the Statistica-10 program. Results. The study groups were comparable in gender, age and clinical parameters. Initially, in patients of both groups, the median values of anxiety and depression on the HADS Scale corresponded to the norm, while the median values of the author’s methodology corresponded to a low level of comfort, the presence of fatigue, high levels of anxiety and depression. At the end of rehabilitation, according to the HADS Scale, significant positive dynamics was revealed in both groups, both for depression and anxiety (p 0.05), without significant intergroup differences. Whereas with the help of the author’s methodology, significant intergroup differences (p 0.05) were revealed, indicating a better positive dynamics of the emotional state in group 2, additionally receiving CBT. Conclusion. In comparison with the author’s program in stroke patients, the HADS scale is significantly less sensitive in the diagnosis of anxiety and depression, and does not reflect the established intergroup difference in the dynamics of emotional state after the use of the basic complex and its combination with CBT.

Efficacy and safety of weekly liquid alendronate in Korean postmenopausal women with osteoporosis: a 12-month, multi-center, randomized trial

SummaryThis study compared liquid and tablet forms of alendronate for osteoporosis treatment. After 12 months, both forms increased bone density to a similar degree with no significant differences in side effects. New low-volume liquid alendronate is as effective as tablets, offering an alternative treatment option for postmenopausal women with osteoporosis.Purpose/IntroductionAlendronate, despite its significant efficacy, poses challenges due to complex administration protocols and patient compliance issues, underscoring the need for various formulations. This study compared the efficacy and safety of once-weekly low-volume liquid alendronate sodium trihydrate (ALN-S), an oral solution, to once-weekly alendronate sodium (ALN-T), an oral tablet, in Korean postmenopausal women with osteoporosis.MethodsIn a 12-month, multi-center, prospective, randomized, open-labeled, parallel trial conducted at two hospitals in Korea, 170 patients were randomized to alendronate solution (ALN-S) (N = 85) or alendronate tablet (ALN-T) (N = 85) groups. The bone mineral density (BMD) of the lumbar spine (LS), femoral neck (FN), and total hip (TH) was measured at baseline and after 12 months. Bone turnover markers (BTMs) were assessed at baseline, 6, and 12 months. The primary outcome was the percentage change in BMD of the LS, evaluated for non-inferiority.ResultsAfter 12 months, both ALN-S and ALN-T groups exhibited a significant increase in LS, FN, and TH BMD, with no significant intergroup differences (ALN-S: LS 5.0 ± 0.6%, FN 1.8 ± 0.6%, TH 2.2 ± 0.5%; ALN-T: LS 5.2 ± 0.6%, FN 1.6 ± 0.6%, TH 1.8 ± 0.5%). ALN-S was found to be non-inferior to ALN-T for BMD change at LS (treatment difference: − 0.22%, 95% CI: − 1.84 to 1.40%), excluding the predefined non-inferiority margin of − 2.29%. Changes in BTMs did not differ significantly between groups. The frequency of adverse events was similar between groups.ConclusionLiquid alendronate was non-inferior to tablet alendronate in increasing BMD in Korean postmenopausal women with osteoporosis, presenting a viable alternative when the tablet form is limited in various clinical scenarios.Clinical trial registrationThe trial was registered with ClinicalTrials.gov (NCT05387200).

Prospective randomized trial of antibiotic prophylaxis for percutaneous renal biopsy.

Infection is a rare complication of percutaneous renal biopsy (RB). However, the questionnaire included in the Kidney Biopsy Guidebook 2020 in Japan revealed that antibiotic prophylaxis (AP) was administered at about 60% of hospitals. The objective of this study was to evaluate whether it is possible to omit AP for RB. Patients aged ≥ 15years were eligible. Three hundred and sixty-four patients were recruited at 6 hospitals. The patients were randomly assigned to receive either a single dose of intravenous cefazolin or no antibiotic prophylaxis. The primary outcome was the percentage of patients that exhibited positive urine cultures 3 or 4days after the RB. The secondary outcomes were the percentage of patients who were diagnosed with pyelonephritis, puncture site infections (PSI), or an infection other than pyelonephritis or PSI within 30days, and cefazolin-induced side effects. With regard to the primary outcome, there was no statistically significant difference between the cefazolin group and the no AP group (2.9% versus 5.1%, p = 0.416). With regard to the secondary outcomes, only one patient (who belonged to no AP group) developed pyelonephritis. This patient underwent urinary catheterization. No PSI occurred. There were no significant intergroup differences in any secondary outcomes. This study revealed the incidence of post-percutaneous RB infections was minimal. Although the outcomes of this study did not lead to the conclusion that it is unnecessary to use AP for RB, the obtained data suggest that the effects of such AP may not be clinically significant.

Close correlation between sugarcane ratoon decline and rhizosphere ecological factors

Rhizosphere ecological factors that affect sugarcane ratoons are crucial components in the feedback mechanisms between the sugarcane plant and soil environment. However, systematic investigations on these dynamics are lacking. Therefore, this study investigated the relationship between sugarcane ratoon decline and rhizosphere ecological factors. In first-year sugarcane ratoons, ecological factors such as soil available potassium content, soil nitrogen fixation, and soil peroxidase activity were significantly positively correlated with sugarcane growth (P < 0.05) compared to that of third-year sugarcane ratoons. Significant intergroup disparities in the rhizosphere soil microbial community structure were observed based on different ratoon ages (P < 0.01), while highly significant intergroup differences in endophytic microbial community structure were observed based on a Jaccard distance analysis (P < 0.01). Generalised additive model analysis revealed a significant positive correlation (P < 0.05) between sugarcane growth properties and the alpha diversity of rhizosphere soil bacteria and endophytic bacteria but a predominantly negative correlation (P > 0.05) between the alpha diversity of endophytic fungi and key sugarcane growth indicators. The deterioration of mainly non-microbial ecological factors in rhizosphere soil (P < 0.05) with increasing ratoon age may represent a significant factor contributing to sugarcane ratoon decline. The fungal community significantly impacted soil enzyme activity, while the microbial community indirectly influenced sugarcane yield through its effect on soil enzyme activity. Therefore, endophytic fungi, particularly Ascomycota species, may play a crucial role in sugarcane diseases.

Pneumatic displacement and intravitreal anti-vascular endothelial growth factor, with or without intravitreal tissue plasminogen activator, injection for submacular hemorrhage

Purpose: To evaluate the outcomes of intravitreal gas and anti-vascular endothelial growth factor (VEGF), with or without tissue plasminogen activator (tPA), injection for submacular hemorrhage (SMH). Methods: We retrospectively enrolled patients with SMH treated with intravitreal gas and anti-VEGF, with or without tPA (tPA and non-tPA groups, respectively), injection between 2014 and 2021 and data were collected at the preoperative visit and at 1-, 3-, 6-, and 12-month follow-ups. The primary outcome was the final best-corrected visual acuity (BCVA), and the secondary outcomes were central subfield thickness (CST), degree of blood displacement, and incidence of vitreous hemorrhage (VH). Results: Herein, 38 eyes received intravitreal gas, anti-VEGF, and tPA injections whereas 89 received intravitreal gas and anti-VEGF injections. At 12 months, no significant intergroup difference was detected (p=0.94), except the slightly greater CST change in the non-tPA group (p=0.03). Complete SMH displacement occurred in 35 (tPA=92.1%) and 89 (non-tPA=89.9%) eyes, with higher VH incidence in the non-tPA group (OR 7.03, p=0.004). Conclusion: In pneumatic displacement combined with anti-VEGF therapy in SMH, adjunctive tPA use did not alter the visual and anatomical outcomes although the VH risk in large SMH was reduced.

Effect of dural puncture epidural technique combined with programmed intermittent epidural bolus on labor analgesia: A randomized, double-blind, parallel-group, controlled clinical trial.

Labor analgesia can be achieved by different approaches. The efficacy and safety of combined dural puncture epidural (DPE) with program intermittent epidural bolus (PIEB) are not well characterized. This study aimed to compare the efficacy and safety of DPE combined with PIEB vs epidural (EP) combined with PIEB for labor analgesia. We performed a prospective, randomized, double-blind, parallel-group, controlled clinical trial. Eligible pregnant nulliparous women received either DPE combined with PIEB (group D) or epidural combined with PIEB (group E) for labor analgesia. Analgesia was initiated with 0.1% ropivacaine + 0.3 µg/mL sufentanil and maintained with PIEB at 12 mL/h. Primary outcome was the proportion of women with adequate analgesia within 10 minutes after the initiation of analgesics. Secondary outcomes (time to achieve analgesia, time to first request for additional analgesic, proportion of women required additional analgesic or epidural catheter adjustment and resetting, total labor duration, total analgesic consumption, level of anesthesia, and motor block), side effects, and patient satisfaction were also documented. Out of 174 enrolled women, 160 were included in the analysis. Baseline characteristics were comparable. The proportion of women who achieved adequate analgesia in group D was significantly greater than that in group E (38.8% vs 20.0%, P < .05). Compared with group E, group D also showed advantages in faster adequate analgesic achievement, more likely to reach adequate analgesia, a longer time to maintain analgesia, lesser requirements for additional analgesic, and better sensory blocks. There were no significant inter-group differences in other outcome measures. Compared with epidural and PIEB mode, DPE and PIEB mode achieved better analgesia without increasing maternal or neonatal side-effects during labor.

Shape of the Sagittal Curvatures of the Spine in Young Female Volleyball Players

Background: The issue of the relation betweeen training loads on the shape of the spine of young players is of significant importance, as with the advancement of training seniority, unfavorable changes may be perpetuated resulting in possible consequences in the next stages of ontogenesis. The aim of this study was to assess the formation of the sagittal curvatures of the spine in girls practicing volleyball versus their nonpractising peers. Methods: We examined 60 girls aged 10–13 years, including 30 volleyball players and 30 untrained peers. The Baseline Bubble inclinometer was applied as a research. The data were analyzed based on Mann–Whitney U test and Pearson Chi-square test. Results. There were statistically significant intergroup differences in lumbar lordosis curvature values (Z = −2.67; p = 0.007). The prevalence of correctness values of the thoracic kyphosis curvature, was group-dependent (χ2(1) = 4.34; p = 0.037). Group also determined the prevalence of lumbar lordosis normalities (χ2(1) = 5.41; p = 0.020). Conclusions. Volleyball has a beneficial effect on the formation of the thoracic kyphosis, while the lumbar lordosis is shallowed under the influence of training. This indicates the need for a holistic approach to player training and the need to supplement the technique and tactics training with exercises to strengthen the muscles that stabilize the lumbar spine, improve spinal mobility, learn how to control the anterior tilt of the pelvis and train the fascia.

An Exploratory Study of Small-Group Learning Interactions in Pre-Clerkship Medical Education: Uncovering a Mismatch Between Student Perceptions and Real-Time Observations

Small-group learning is a mainstay of medical education, and group functioning can have a major influence on these learning experiences. Our objective was to explore verbal exchange patterns within small-group learning sessions and examine how different patterns related to tutor involvement, tutor expertise, and participants’ perceptions. A non-participant observer collected group interactivity data using a real-time mobile device-based system. Verbal interaction patterns were visualized and analyzed using social network analysis and correlated with participant survey data and aggregate course grades. There were 46 observations across 30 separate groups. Group interactions clustered into four patterns defined by (1) tutor involvement (high vs. low) and (2) interactivity (high vs. low). Interaction patterns were largely stable for a given group and groups with content expert facilitators were generally less interactive. Students reported objectively fewer interactive groups as more interactive and enjoyable. There were no significant intergroup differences in aggregate course grades. Paradoxically, student perceptions were not aligned with observed interactivity data, and tutor content expertise influenced group interactivity. These findings suggest the need to better manage learner expectations of small-group learning, and to explicitly reflect on and develop skills for effective collaborative learning with both faculty and students.

Strategies for constructing harmonious colour combinations by art students with autism spectrum disorders

Introduction. The survey discussed in the article represents the first experience of an empirical study of the peculiarities characterising the ways of construction and perception of colour harmony by students with autism spectrum disorders – professional art education learners. The relevance of the study is conditioned by new trends in education related to the need to create an inclusive and favourable environment for people with autism. This environment is necessary for their successful integration and professional training in art specialities that are considered a promising area for professional realisation of people with autism. Methods. The survey was carried out using the experimental method involving 21 participants with autism spectrum disorders (mean age = 20.4 years; SD = 2.4; 9 males, 12 females). The participants’ answers in the experimental group were compared with those of an age-, gender-, and education-matched control group (N=21). The participants’ task was to match two given shades with a third one in the palette, for the colour combination to be as harmonious as possible. The experimental palette allowed to change the hue, lightness and chroma of shades. Results. The participants with autism spectrum disorders were twice as likely to choose yellow (23.8% compared to 12.4% in the control group) and purple shades (16.2% compared to 9.5%); hardly used orange (1.9%) and blue (4.8%) and preferred lighter shades (the mean L value was 67.8 compared to the control group’s 63.0). The chroma of the selected shades correlated with their hue and lightness. The stimulus selection strategy depended on the distance (∆E*00) between the given (upper and lower) shades in the CIELAB colour space and was based on a specific “geometry” (a particular ratio of values characterising the angles and side lengths formed by the given and selected shades, as well as a preference for a particular triangle area and its type). Discussion. The experiment showed that the students with autism spectrum disorders differed markedly from neurotypical students in a number of indicators when constructing a colour harmony. The experimental group participants’ responses showed a “preference for sameness” characteristic of autism. The significant inter-group differences were applied more to the lightness and chroma of the chosen shades than to their hue. The shades preferred by the participants with autism spectrum disorders better matched the conditions of the habitual “chromatic diet” and the colour’s statistics in nature. The observed specificity may also reflect the reduced ability to generalise and average out colours in terms of holistic perception, specific to autism. Conclusion. The survey results make an important contribution to the improvement of the professional training methodology for art students, and for the development of scientifically based educational approaches to teaching people with autism spectrum disorders, primarily in the context of the formation of colour-related competencies; in addition, they may provide new impulses for investigating the fundamental mechanisms of cognitive processing of colour-related information.

Nonpharmacological interventions for managing postoperative pain and anxiety in children: a randomized controlled trial.

Hospitalizations and surgical procedures are unpleasant for both children and their parents. Therefore, postoperative pain assessments and management are less commonly performed in younger children than in adults. To evaluate the effect of nonpharmacological interventions on postoperative pain and anxiety in children. In this randomized controlled trial, 160 children were randomly allocated to experimental (n=80) and control (n=80) groups. The children in the experimental group received age-appropriate distraction interventions for 3 postoperative days along with standard care. Children in the control group received standard care only. Each child was assessed for pain using EVENDOL pain scale, while their anxiety was measured using the modified Yale Preoperative Anxiety Scale. The Descriptive statistics (frequency, percentage, mean, and standard deviation) and repeated-measures analysis of variance were used to analyze the data. The children in the experimental group showed significantly decreased pain, anxiety, and physiological parameters (heart rate, respiratory rate, and oxygen saturation) compared to those in the control group. Significant intergroup differences were noted in the mean and standard deviation values of the pain, anxiety, and physiological parameters. The distraction interventions provided by nurses reduced the pain and anxiety levels and improved the postoperative recovery among children.

Transcatheter aortic valve replacement with balloon-expandable and self-expandable valves in Japanese patients with large annulus: the OCEAN-TAVI registry

Abstract Background East Asians have smaller aortic valve complexes than individuals from Western countries, and few studies have reported transcatheter aortic valve replacement (TAVR) outcomes in Asian patients with a large annulus. Purpose We aimed to compare the acute and long-term outcomes of TAVR using balloon-expandable valves (BEVs) and self-expandable valves (SEVs) in Asian patients with a large annulus. Methods We retrospectively analyzed the data from the Optimized transCathEter vAlvular interveNtion Transcatheter Aortic Valve Implantation (OCEAN-TAVI) registry. A large annulus was defined by annular area ≥ 500 mm2 and average diameter ≥ 25 mm in computed tomography scans. The primary endpoint was the 3-year all-cause mortality. Secondary endpoints were 3-year heart-failure rehospitalization (HFR) after TAVR, acute outcomes of TAVR, and changes in valve function on echocardiography 2 years after TAVR. Results Among 773 patients, 671 (86.8%) underwent BEV-TAVR. The SEV-TAVR group showed a significantly higher incidence of above-moderate perivalvular leakage (2.1% vs. 7.8%; P &amp;lt; 0.001), and included a significantly greater percentage of patients who required postoperative pacemaker implantation (6.1% vs. 11.8%; P = 0.035). The incidence of moderate-to-severe prosthesis–patient mismatch did not differ between the two groups. The Kaplan–Meier curve showed no significant intergroup differences in the 3-year all-cause mortality and HFR rates (log-rank P = 0.900), and the echocardiography-indexed effective orifice area and mean transaortic valve pressure gradient at 2 years post-TAVR did not differ significantly between the two groups. Conclusions The benefits of BEV-TAVR may outweigh those of SEV-TAVR in patients with a large annulus.

Effectiveness of Implant Therapy in Patients With and Without a History of Periodontitis: A Systematic Review With Meta-Analysis of Prospective Cohort Studies.

This systematic review investigates the effectiveness of implant therapy in patients with and without a history of periodontitis in terms of implant loss, peri-implant marginal bone loss (MBL), and occurrence of peri-implant diseases. The protocol of the present meta-analysis was registered on PROSPERO (CRD42021264980). An electronic search was conducted up to April 2024. All prospective cohort studies reporting implant loss, MBL, and occurrence of peri-implant diseases in both patients with a history of periodontitis (HP) and patients with no history of periodontitis (NHP) after at least 36-month follow-up were included. The risk of bias was evaluated using the Newcastle-Ottawa Scale and the quality of the evidence was also assessed. A meta-analysis was performed on the selected outcomes at the available follow-up time points. Subgroup analyses were conducted based on follow-up time, rate of progression and severity of periodontitis, and implant surface characteristics. Publication bias was evaluated using the Funnel plot and Egger's test. From 13 761 initial records, 14 studies (17 articles) were finally included. Eight studies had a low risk of bias level, and six had a medium risk of bias level. Meta-analysis showed that HP patients had a significantly greater risk for implant loss (HR: 1.75; 95% CI: 1.28-2.40; p = 0.0005; I2 = 0%), MBL (MD: 0.41 mm; 95% CI 0.19, 0.63; p = 0.0002; I2 = 54%), and peri-implantitis (3.24; 95% CI: 1.58-6.64; p = 0.001; I2 = 57%) compared to NHP, whereas no significant intergroup difference for peri-implant mucositis was found. Subgroup analyses revealed a particularly greater risk for implant loss for HP patients over a ≥ 10-year follow-up (HR: 2.02; 95% CI: 1.06-3.85; p = 0.03; I2 = 0%) and for patients with a history of grade C (formerly aggressive) periodontitis (HR: 6.16; 95% CI: 2.53-15.01; p < 0.0001; I2 = 0%). A greater risk for implant loss for stages III-IV (severe) periodontitis, and implants with rough surfaces was also found. Within the limits of heterogeneous case definitions and methods of assessment, a history of periodontitis has been proved to significantly increase the risk for implant loss, particularly at long follow-up (≥ 10 years) and in case of rapidly progressive forms (grade C), and for MBL and peri-implantitis.