Time Interaction Research Articles

Effects of mindfulness meditation training offered in-person and via a virtual world on self-compassion: A study with U.S. military active duty and veterans.

Mindfulness-based, in-person programs are effective at reducing stress and enhancing resilience in military and civilian samples, yet few studies have examined or compared training offered via real-time, interactive social media. Such a program would have a wider-reach and could include those unable to attend in-person. There is also interest in resolving ambiguity about the effects of mindfulness training on individual difference variables, such as self-compassion. The purpose of this research was to compare pre/post self-compassion for three interventions; Mindfulness-based Stress Reduction delivered in-person (IP), mindfulness meditation training delivered via a Virtual World (VW), and a wait-list Control Group (CG) among active duty and veteran U.S. military. A 2 (pre/post)×3 (group) factorial design was conducted with 250 active duty and veteran U.S. Military service members, with self-compassion measures as dependent variables. Self Compassion improved 10% for the IP group and 14% for the VW group, while the CG group did not improve. Combined treatment groups yielded a 10.3% improvement in self-compassion compared with no change in the CG and with a group×time interaction effect (p < 0.01). Participants with lower initial self-compassion experienced greater benefits than those with higher baseline self-compassion (p < 0.01). IP and VW Mindfulness Meditation training were equally effective in increasing self-compassion. Adding effective on-line mindfulness delivery will promote self-compassion among a more extensive audience, likely yielding improved coping, confidence, connectedness, cheerfulness, steadiness, and self-satisfaction, while lessening anxiety, fear-of-failure, and stress among participants.

Associations between readmission and patient-reported measures in acute psychiatric inpatients: a multicenter prospective longitudinal study.

This study examined whether patient-reported measures (PRMs) addressing quality of life, personal agency, functional impairment, and treatment satisfaction at hospital discharge were associated with future readmission during a 12-month follow-up period. The study also examined whether readmission influenced changes in the same measures. A multicenter prospective cohort study was conducted at 21 psychiatric hospitals in Japan. Participants completed the EuroQol-five-dimensions-five-level (EQ-5D), the Five-item Subjective Personal Agency Scale, and the Sheehan Disability Scale (SDS) at the time of index admission (T1), discharge from index admission (T2), and 6months (T3) and 12months (T4) after discharge. Inpatient treatment satisfaction was assessed at T2. Readmission and variables potentially associated with hospitalization and PRMs were evaluated using mixed-effects logistic regression models and mixed models for repeated measures. A total of 491 participants were followed for 12months (attrition rate: 19.4%), and 480 were included in the EQ-5D analysis. The most common diagnoses were schizophrenia (59%), depression (14%), and bipolar disorder (13%). No patient-reported measures were significantly associated with readmission over the follow-up period. Interaction of readmission and time did not significantly affect changes in EQ-5D. Readmission did significantly influence SDS score changes between T2 and T3 (B = 1.78, 95% CI = 0.30-3.25, p = 0.018) and between T3 and T4 (B = 1.43, 95% CI = 0.14-2.72, p = 0.029).The same influence of readmission on SDS score changes was not observed in the model which adjusted for all potential covariates. Readmission was potentially associated with changes in self-reported functional impairment. Findings highlight the potential role of intensive post-discharge services in preventing readmission, rather than relying on time-of-discharge PRMs in order to predict readmission risk. This study was registered in UMIN Clinical Trials Registry (UMIN000034220).

A Retrospective Study of Cat Hoarding Cases and Their Management Through Voluntary Spay/Neuter and Relinquishment In New York City

Introduction: Animal hoarding cases are complex sources of shelter intake. Cases require significant planning, collaboration, and resources, often from multiple responding organizations. Study objectives included description of cat hoarding cases in New York City not criminally pursued, case outcomes when managed by a spay/neuter and relinquishment program utilizing a collaborative approach with caregivers, and characteristics or interventions leading to better outcomes. Methods: Data were extracted from the American Society for the Prevention of Cruelty to Animal’s Community Engagement (CE) case files. Eligible cases were retrieved using a keyword search and screened for inclusion criteria. Client demographics, case factors, and outcomes were described with descriptive statistics. Data were further analyzed using adjusted logistic regression models to investigate variables predictive of outcomes. Results: The study population included 79 cases with a median population size of 22 cats. The majority of clients were female, lived alone, and had high levels of social vulnerability. Object hoarding was reported in 29.1% of cases and unsanitary conditions in 68.4% of cases. Almost one-third (30.4%) identified as rescuers or community cat caregivers. At the time of the first interaction with CE, 88.6% of clients were interested in spay/neuter and 76.0% in surrender services. Social service agencies were involved in the initial CE intervention in 26.4% of cases. Successful outcomes were defined as cases in which clients were left with a manageable population of cats, or all cats were removed. Successful outcomes were achieved in 67.1% of cases after the first CE intervention. Recidivism occurred in 41.5% of these cases. Clients who showed an initial interest in surrender were 10 times more likely (OR 10.0, P = 0.014) to experience a successful outcome than clients not interested in surrender. Significant predictors of re-collection included clients identifying as rescuers (OR 4.8, P = 0.039) and the involvement of human service agencies during or after the CE intervention (OR 6.1, P = 0.041). Conclusion: Results demonstrate animal hoarding cases involving cooperative caregivers and rescuers can be successfully managed by programs using a collaborative approach with clients. The high rates of initial interest in spay/neuter and surrender in caregivers suggest a need to expand access to veterinary care and strategically manage case intake into shelters. Further interdisciplinary research is needed on how mental health, social service, and animal service providers can attain successful outcomes long-term and reduce recidivism in animal hoarding cases.

Rapid surface patterning to strengthen adhesive bonding of carbon fiber reinforced polymer by spatial shaping femtosecond laser

Carbon fiber reinforced polymer (CFRP) have become gradually important in the aerospace industry due to their outstanding strength-to-weight ratio. However, traditional mechanical surface treatment methods are challenging to apply to CFRP because of their anisotropic and nonhomogeneous properties. Femtosecond laser offers unique advantages for surface treatment, as it allows processing with very low thermal load due to the extremely short interaction time. This study investigates the effect of different surface structures resulting from surface treatment using a femtosecond laser on adhesive properties of CFRP. The experimental results show that: 1) beam shaping can be realized by using the plano-convex cylindrical mirror, which improves the quality of laser processing and greatly improves processing efficiency. It only takes 20 s to complete the laser processing of a 1 cm*1 cm area, which increases the work efficiency by 49 times. 2) pre-bonding surface treatment significantly enhances the tensile shear strength of the single lap joint, and the shear strength of samples with low spatial frequency LIPSS (LSFL) (14.57 ± 1.58 MPa) is 2.96 times higher than that of the untreated sample (US) (4.92 ± 1.34 MPa). 3) LSFL structure exhibits the best results, because the surface of CFRP with LSFL exhibits a relatively higher surface polarity and surface energy. This study provides an efficient, high-precision, and low-damage surface treatment method for preparing CFRP for adhesive bonding, which may promote the application of femtosecond laser technology in difficult-to-process composite materials and provide new methods and technical support for its application in aerospace, vehicle manufacturing, and other fields.

Impact of oral melatonin supplementation on urine and serum melatonin concentrations and quality-of-life measures in persons with relapsing multiple sclerosis

IntroductionMelatonin is an antioxidant and anti-inflammatory agent that modulates the immune system by scavenging free radicals, reducing the upregulation of pro-inflammatory cytokines, and reducing transendothelial cell migration. Therefore, melatonin may play a role in regulating multiple sclerosis (MS) disease activity. However, little is known about how melatonin supplementation effects individuals with MS. ObjectiveDetermine if there was a dose-dependent elevation in urine and serum melatonin concentrations. Determine if melatonin supplementation had an impact on patient reported outcomes. MethodsThis was a randomized, dose-blinded exploratory study. Adults (age 18–65) with relapsing forms of multiple sclerosis (RMS) treated with a stable dose of oral disease modifying therapy for at least 6 months were randomized into melatonin 3 mg or 5 mg daily. Urinary and serum melatonin levels and modified fatigue impact scale (MFIS), multiple sclerosis impact scale (MSIS-29), and Pittsburgh sleep quality index (PSQI), patient determined disease steps (PDDS) and performance scales (PS) were measured at baseline, 3, 6, and 12 months. Urinary and serum melatonin analyses was performed to estimate mean concentrations and their differences between treatment arms over time by a repeated measures linear mixed model. The model included treatment, assessment time, and treatment × time interaction. ResultsThirty patients, randomized 1:1, were analyzed in an intent to treat population. Twenty-three completed the study. The repeated measures linear mixed model analysis of all timepoints revealed higher melatonin concentrations in patients on 5 mg compared to 3 mg melatonin for both urinary 6-SMT (p = 0.03) and serum melatonin (p = 0.04). MFIS, MSIS-29, PSQI, and PDSS-PS scores did not significantly change from baseline to month 12. No significant differences in these measures were seen between the two doses. Five patients stopped melatonin (three on 5 mg and two on 3 mg) due to adverse events, including one patient who developed focal spongiotic dermatitis. One patient experienced three consecutive serious adverse events that were unrelated to melatonin supplementation. ConclusionsThe 5 mg melatonin supplementation group had higher concentrations of urinary 6-SMT and serum melatonin compared to the 3 mg group over 12 months of treatment. There was a correlation between 6-SMT and serum melatonin concentrations. This suggests that measuring serum melatonin is a reliable alternative to measuring urinary 6-SMT. However, no differences in clinical benefit between the two dosage groups were demonstrated in the patient reported outcomes. Trial Registration NumberNCT03498131

Phytoremediation of diclofenac and sulfamethoxazole in Arabidopsis thaliana cells and seedlings

Diclofenac (DLF), a widely recognized non-steroidal anti-inflammatory drug (NSAID), and sulfamethoxazole (SMX), a broad-spectrum sulfonamide antibiotic, are commonly prescribed medications that have raised concerns as significant contributors to pharmaceutical pollution in natural ecosystems despite their clinical effectiveness. This study investigates the potential phytoremediation pathways for these two drugs in plant systems by tracking and quantifying the fate of the parent compounds and their metabolites in Arabidopsis thaliana using cell and seedling cultures. Results indicated significant differences in the dissipation of DLF according to the treatment and time interaction within the cell cultures. Viable plant cells showed complete dissipation of DLF from an initial concentration of 2758 ng/mL in 96 h, whereas non-viable cells and blank solutions remained stable. The dissipation of SMX was comparable across viable, non-viable, and blanks, showing a minor decrease from 842 to 799 ng/mL over 120 h following the treatment of viable cells. DLF metabolites including 4′-hydroxy-diclofenac, 5-hydroxy-diclofenac, acyl-glutamatyl-diclofenac, 1-(2,6-dichlorophenyl)-5-hydroxy-2-indolinone, 5-sulfooxy-diclofenac, 5-glucopyranosyloxy-diclofenac, 1-(2,6-dichloro-4-hydroxyphenyl)-2-indolinone, and 4′-glucopyranosyloxy-diclofenac were recognized, likely formed through acylation, glutamyl conjugation, hydroxylation, dehydration, cyclization, sulfonation, and glucosidation. While for SMX, metabolites including sulfamethoxazole-glucuronide, nitroso-sulfamethoxazole, N4-acetylsulfamethoxazole, and N4-acetyl-5-OH-sulfamethoxazole were identified, potentially produced through glucuronidation, nitrosation, acetylation, and hydroxylation. Phase I metabolite concentrations of DLF and SMX peaked earlier than those of phase II metabolites. Hydroponic A. thaliana demonstrated comparable efficiencies in the phytoremediation of DLF and SMX, with concentrations varying from 1 mg/L to 10 mg/L. Detectable levels of both parent compounds and their metabolites confirmed successful absorption and metabolism within the plant system. This study provides valuable insights into the potential of phytoremediation as a sustainable approach for reducing the environmental toxicity of DLF and SMX and suggests comparable metabolic efficiency. These findings contribute to the growing body of knowledge on phytoremediation and its application in addressing pollution from pharmaceuticals and personal care products.

An extensive review of mutualistic and similar ecological associations involving tarantulas (Araneae: Theraphosidae), with a new hypothesis on the evolution of their hirsuteness

ABSTRACT Mutualistic and similar ecological associations between tarantulas (Mygalomorphae: Theraphosidae) and other animals are reviewed. Such associations are found to occur in at least nine theraphosid subfamilies. We present 63 new cases of theraphosid–anuran associations from 10 countries, documenting these interactions for the first time in Brazil, Chile, the Dominican Republic, and the Philippines. These findings are the first documentation of such associations for 13 theraphosid and 20 anuran taxa. Additionally, we report, for the first time, associations potentially of mutualistic nature between tarantulas and snakes, whip spiders, and harvestmen. Furthermore, we provide new reports of associations with ants and termites. While some of these interactions appear to be merely tolerated cohabitations, those involving anurans and ants seem to be more prevalent and complex, clearly offering benefits for both organisms. Additionally, based on multiple observations and field experiments, we propose a new hypothesis regarding the evolution of hirsuteness in theraphosids as a defensive strategy against predatory ants. This hypothesis supports previous findings that suggest a similar function for urticating setae incorporated into egg sacs and moulting mats. We further document a unique escape strategy against ants in New World arboreal theraphosids. Finally, the possibility of a chemical defence mechanism through specialised epidermal glands in theraphosids is briefly discussed.

Short, frequent physical activity breaks improve working memory while preserving cerebral blood flow in adolescents during prolonged sitting - AbbaH teen, a randomized crossover trial

PurposePhysical activity (PA) breaks during school lessons have been suggested as a promising strategy to improve working memory performance in children and adolescents. There is a lack of studies investigating the underlying physiological mechanisms of PA on cognition, especially among adolescents. This study aimed to investigate the effects of different types of short frequent PA on adolescents’ cognitive task-related changes in cerebral blood flow in the prefrontal cortex (PFC) and working memory performance compared to prolonged sitting.MethodsIn this randomized crossover study, adolescents visited the laboratory on three different occasions for 80-minute sessions of prolonged sitting interrupted by four breaks for three minutes of simple resistance training (SRA), step-up at a pre-determined pace (STEP), or remaining seated (SOCIAL). Before and after each session, cognitive task-related changes in cerebral blood flow (oxygenated-hemoglobin, Oxy-Hb) during working memory tasks (1-, 2-, 3-back tests) were measured using functional near-infrared spectroscopy in the PFC. Accuracy and reaction time were derived from the working memory tasks. Linear mixed-effect models were used to analyze the data.ResultsA total of 17 students participated (mean age 13.6 years, 11 girls). Significant time x condition interactions were noted for Oxy-Hb in the most demanding working memory task (3-back), with a decrease following prolonged sitting in the SOCIAL condition compared to both the SRA (β 0.18, 95% CI 0.12, 0.24) and the STEP (β 0.11, 95% CI 0.05, 0.17). This was observed in parallel with improvements in reaction time following SRA (β -30.11, 95% CI -59.08, -1.13) and STEP (β -34.29, 95% CI -69.22, 0.63) although this was only significant for the SRA and no improvements in the SOCIAL condition.ConclusionWe found that short frequent PA breaks during prolonged sitting among adolescents can prevent the decrease in cognitive task-related changes in cerebral blood flow that occur following prolonged sitting. This was observed simultaneously with improvements in working memory, indicating that changes in cerebral blood flow could be one factor explaining the effects on working memory. Future studies should investigate the efficacy of implementing these PA breaks in schools.Trial registrationRetrospectively registered on 21/09/2020, ClinicalTrial (NCT04552626).

Efficacy of sequential primary motor and prefrontal cortices intermittent Theta burst stimulation in persistent somatoform PAIN disorder (TAP-PAIN): A randomized sham-controlled pilot trial

Aim: There is a need to elucidate intermittent Theta burst stimulation (iTBS) as a novel treatment in persistent somatoform pain disorder (PSPD). Methods: Twenty patients were randomly allocated to active iTBS (n = 11) and sham iTBS (n = 9) and received 10 iTBS sessions, 2 sessions per day, sequentially to primary motor and dorsolateral prefrontal cortices for 5 days in a week. Each iTBS session comprised of 2 sec. per train of 10 bursts (3 pulses per burst at 50 Hz; total 30 pulses) and were given with a gap of 5 Hz, total of 20 trains, and 600 pulses. Visual Analogue Scale, Brief Pain Inventory and Global Pain Scale (GPS), Montgomery and Asberg Depression Rating Scale, Hamilton Anxiety Rating Scale - Anxiety, World Health Organization Quality-of-Life Scale-brief, and Pittsburgh Sleep Quality Index were applied at baseline, after last session, and at 2 weeks after last TBS session. Intention to treat analysis was conducted. Results: Both groups were comparable for baseline psychopathology scores including clinical variables like age (t = 0.865; P = 0.398), duration of illness (t = 1.600; P = 0.127), and motor threshold (t = 0.304; P = 0.765). On repeated measures ANOVA, a significant within-group time effect for VAS, BPI-Severity, BPI-Interference, BDI – II, MADRS, HAM-A, and WHOQOL- BREF was found for active and sham TBS groups, respectively. GPS scores had significant within-group (active) * time interaction (F = 11.651; P = .001; ηp2 = 0.538) and between-group * time interaction (F = 3.407; P = 0.044; ηp2 = 0.159). However, between-group * time effect interaction was lost after covariance (F = 1.726; P = 0.196; ηp2 = 0.110). Conclusion: No major adverse effects were reported. Our pilot trial concludes that safe therapeutic efficacy of iTBS in PSPD is inconclusive. Lower total number of sessions along with small sample size may limit the study findings.

РАЗРАБОТКА МОДЕЛИ ФИЗИЧЕСКОГО ПРИНЦИПА ДЕЙСТВИЯ СИСТЕМЫ АВТОМАТИЧЕСКОГО РЕГУЛИРОВАНИЯ ПОДАЧИ ТОПЛИВА ДИЗЕЛЬНОГО ДВИГАТЕЛЯ

The article discusses the use of an engineering-physical method for automatically regulating fuel supply in a diesel engine at the stage of constructing a model of the physical principle of operation. The resulting model of the system allows us to display the movement of the working fluid in space and its physical interaction in time.

Impact of Pilates Exercise on Quality of Life, Functional Capacity, Cancer-related Fatigue, Depression and Salivary Cortisol of Colorectal Cancer Survivors: A Quasi-Experimental Study.

This study aimed to investigate the effect of Pilates exercise on the quality of life, functional capacity, cancer-related fatigue, depression and salivary cortisol of colorectal cancer survivors. This is a quasi-experimental study which was conducted at Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia (UKM), and Hospital Al-Sultan Abdullah, Universiti Teknologi MARA (UiTM), Malaysia. The intervention group performed Pilates exercises with a certified Pilates instructor for eight weeks via online streaming from the participants' homes. Meanwhile, the control group participants received the usual care as stipulated by their oncologists. The primary outcome was the quality of life. The secondary outcomes were functional capacity, cancer-related fatigue, depression and salivary cortisol. Data was collected at baseline and eight weeks after the exercise intervention. The effects of the intervention were analyzed using Repeated Measures Analysis of Covariance (ANCOVA) statistical test. Thirty-six (36) colorectal cancer survivors were allocated into either a Pilates exercise intervention group (N= 18) or a control group (N= 18). Over eight weeks, the Pilates exercise group revealed significant group x time interactions in terms of quality of life (p = 0.003), role functioning (p = 0.012), functional capacity (p = 0.048), and stool frequency (p = 0.021). However, only the stool frequency symptom (p = 0.008) remained significant after controlling for the confounders of age, gender and stage of cancer. No significant changes in cancer-related fatigue, depression and salivary cortisol levels between the groups were observed after the intervention. Pilates exercise had positive impacts on role functioning, bowel function, and functional capacity among colorectal cancer survivors, ultimately contributing to an improvement in quality of life.

Effectiveness of Initial and Repeat Drug-Coated Balloon Angioplasty of Restenotic Arteriovenous Fistulae Compared with That of Plain Angioplasty

PurposeTo evaluate the effect of drug-coated balloon (DCB) with high-dose paclitaxel for the treatment of restenotic dysfunctional arteriovenous fistulae (AVFs). Materials and MethodsIn this single-arm, multicenter, prospective, observational study, 334 patients using IN.PACT AV DCB (Medtronic, Plymouth, Minnesota) for the first time in the restenotic lesion of dysfunctional AVF between April 2021 and March 2022 were registered. ResultsProcedural success, defined as <30% residual stenosis, was achieved in 96.7% of cases. During a median follow-up of 7.4 months, 179 target lesion reinterventions (TLRs) were observed, and the 6-month freedom from TLR was 73.2% (68.2%–78.2%). When compared with the previous plain percutaneous transluminal angioplasty, the median time to reintervention was significantly longer with DCB (9.1 [8.0–10.6] vs 3.2 [3.0–3.4] months; P < .001). Baseline characteristics that were independently associated with TLR were as follows: months from the last intervention (adjusted hazard ratio, 0.50 [95% confidence interval, 0.40−0.62] per doubling; P < .001), partial lesion coverage by DCB (2.13 [1.10−4.12]; P = .024), and residual stenosis after DCB (2.19 [1.53−3.12] per 15% increase; P < .001) with its time interaction (0.91 [0.86−0.97] per month; P = .003). Of the 179 TLRs, 84 used DCB once again. The median time to reintervention was significantly longer for TLR using DCB (7.1 [6.2–9.7] vs 3.3 [3.1–4.0] months; P < .001). ConclusionsDCB with high-dose paclitaxel is effective at both the initial treatment in the restenotic lesion of dysfunctional AVF and during TLR after DCB use. However, partial lesion coverage by DCB and residual stenosis should be avoided.

Effects of Combined Aerobic and Breathing Exercises on Asthma Control: An RCT

Breathing and aerobic exercises are the most recommended nonpharmacological treatments to improve asthma control and quality of life in patients with asthma. However, the benefits of combining both interventions in these outcomes have never been tested. We aimed to evaluate the effects of the combination of aerobic and breathing exercises on asthma control in individuals with moderate-to-severe asthma. Individuals with moderate-to-severe asthma were randomly assigned to the aerobic + muscle-stretching group (Control group (CG), n=25) or aerobic + breathing exercises group (Experimental group (EG), n=26). The aerobic exercise was performed using constant-load training and breathing exercises using the Buteyko technique. The training program lasted 20 sessions. All individuals were blindly assessed before and after the interventions for asthma control, health-related quality of life, anxiety and depression symptoms, sleep quality, hyperventilation, exercise capacity, lung function, levels of physical activity, and thoracoabdominal kinematics. Group x time interactions were tested using a two-way repeated measures analysis of variance. Pearson's correlation test was used to test the association between outcomes. The groups were similar at baseline (all p>0.05). After the intervention, there were no between-group differences for all outcomes comparing EG and CG. These results suggest that a combination of aerobic and breathing exercises did not improve asthma control, psychosocial symptoms, sleep quality, hyperventilation, exercise capacity, lung function, levels of daily physical or thoracoabdominal kinematics compared with aerobic exercise alone in individuals with moderate-to-severe asthma. ClinicalTrials.gov, NCT04412720.

CMAS corrosion resistance of YSZ thermal barrier coatings with Al2O3 and YSZ-Al2O3 protective layers

Molten calcium-magnesium-alumina-silicate (CMAS) corrosion has become a major constraint for the application of YSZ thermal barrier coatings (TBCs). In this paper, Al2O3 and YSZ-Al2O3 protective layers with a thickness of 50 μm were prepared on the surface of 8YSZ TBCs using air plasma spraying technology, and the progressive damage modes of the different TBCs under CMAS exposure were investigated, and the effects of the composition and microstructure of the protective layers on the infiltration and wetting behaviour of CMAS were compared. When the exposure time was shorter, the dense YSZ-Al2O3 had a better impermeability barrier effect. As the interaction time between CMAS and the coating was prolonged, the structure and phase stability of YSZ-Al2O3 were damaged, the thickness was thinned, and Al2O3 had better stability and showed better protective effect. CMAS wettability was mainly related to the roughness of the coating surface, and the wettability was poorer on rough surfaces.

“I'm completely off base here on what this child is capable of”: A qualitative analysis of how medical ableism manifests in PICU clinicians' care of children with severe neurological impairment

BackgroundChildren with severe neurological impairment (SNI) are at heightened risk of experiencing medical ableism from clinicians in the pediatric intensive care unit (PICU), where barriers such as time scarcity and heavy workloads limit clinicians’ ability to provide personalized care. ObjectiveTo examine medical ableism and strategies to support PICU clinicians in understanding the lives of children with SNI and their families. MethodsThis US-based, single-center, qualitative study included PICU clinicians identified by the parents/caregivers of a child with SNI. Semi-structured 1:1 60-min interviews about the challenges of caring for children with SNI were conducted virtually. Coded data were extracted, thematically analyzed, and further conceptualized using the Dual Process Theory (DPT) bias reduction framework. ResultsNineteen PICU clinicians participated. Three major themes emerged: 1) assumptions and misconceptions about children with SNI and their families, 2) barriers to providing personalized care, and 3) clinician-suggested strategies to honor the lives of children with SNI. These themes aligned with the DPT framework. As outlined in the DPT, system 1 “fast thinking” errors occur when quick observations inform decisions (e.g., snap judgments about a child's capabilities). Second, barriers (e.g., insufficient time for meaningful interactions) may prevent clinicians from providing unbiased care. Third, system 2 “slow thinking,” where complex decision-making occurs, and can be enhanced through personalization strategies (e.g., viewing visuals of the child at baseline health). ConclusionsIncreasing clinician awareness of their potential implicit biases and utilizing bias reduction strategies to mitigate medical ableism in care are critical areas for future research.

Hematocrit and Renal Failure in Aortic Arch Surgery: A Society of Thoracic Surgeons Database Study

BackgroundThis study examined the association between cardiopulmonary bypass (CPB) hematocrit and postoperative acute renal failure (ARF) in patients undergoing aortic arch surgery with hypothermic circulatory arrest. MethodsThe Society of Thoracic Surgeons Adult Cardiac Surgery Database was queried from 2011 to 2019 for patients undergoing aortic arch surgery with hypothermic circulatory arrest. A multivariable logistic regression model estimated the adjusted odds of postoperative ARF on the basis of CPB hematocrit. Effects were stratified by preoperative kidney function and the duration of hypothermic circulatory arrest by using interaction terms. The study also investigated the association between postoperative ARF and major postoperative outcomes by using multivariable regression models. ResultsOn adjusted analysis, higher CPB hematocrit (>20%-25%, >25%-30%, >30%) was associated with lower odds of ARF as compared with lower CPB hematocrit (≤20%) (>20-25%, aOR, 0.78; 95% CI, 0.65-0.93; P = .006; >25%-30%, aOR, 0.65; 95% CI, 0.50-0.84; P = .0007; >30%, aOR, 0.45; 95% CI, 0.28-0.72; P = .0008). The predicted probability of postoperative ARF by CPB hematocrit was higher in patients with lower preoperative renal function (estimated glomerular filtration rate, <60 mL/min/1.73 m2) (interaction P = .03). The association between hematocrit and postoperative ARF was not significantly modified by hypothermic circulatory arrest time (interaction P = .74). All postoperative outcomes were significantly worse in patients with postoperative ARF (all P < .0001). ConclusionsAmong patients undergoing aortic arch surgery, a higher CPB hematocrit level is associated with reduced likelihood of postoperative ARF. Preoperative renal function, but not hypothermic circulatory arrest duration, significantly modified this association. The maintenance of higher CPB hematocrit may reduce the incidence of postoperative ARF, especially for patients with poor preoperative renal function.

Effectiveness of greater occipital nerve blockade in chronic cluster headache.

Greater occipital nerve (GON) blockade injections can be used to prevent episodic and chronic cluster headaches. In recent studies, prophylactic treatment has been used in addition to the GON blockade. In this study, we aimed to elucidate the effect of GON blockade on the attack frequency, pain intensity, and duration in patients diagnosed with chronic cluster headaches. The demographic characteristics of 30 patients who received GON blockade along with acute attack treatment, short- and long-term prophylactic treatment for cluster headache, and 24 patients who received only acute attack treatment, short- and long-term prophylactic treatment, before blockade treatment, in the 1st week and 1st month after blockade were investigated. Attack frequency, attack duration, and visual analog scale (VAS) variables were compared. We evaluated the VAS score, daily attack frequency, and duration of pain attacks after repeated GON blockade and found a statistically significant difference in the VAS score, daily attack frequency, duration of pain attacks, average values of the treatment, and time interaction of pain intensity in the group in which GON blockade was applied in the 1st week and 1st month compared to the pre-treatment period (p<0.01), (p<0.01), (p=0.044). Regarding the outcomes of this research, GON blockade provided significant improvement in pain frequency, attack duration, and VAS score in the period from attack treatment to the start of long-term prophylaxis treatment and one month after treatment, without the need to switch to different prophylaxis treatments. Therefore, GON blockade may be a preferable and reliable treatment option.

Effects of 16weeks of plyometric training on knee biomechanics during the landing phase in athletes.

This study investigated the effects of plyometric training on lower-limb muscle strength and knee biomechanical characteristics during the landing phase. Twenty-four male subjects were recruited for this study with a randomised controlled design. They were randomly divided into a plyometric training group and a traditional training group and underwent training for 16weeks. Each subject was evaluated every 8weeks for knee and hip isokinetic muscle strength as well as knee kinematics and kinetics during landing. The results indicated significant group and time interaction effects for knee extension strength (F=74.942 and p=0.001), hip extension strength (F=99.763 and p=0.000) and hip flexion strength (F=182.922 and p=0.000). For landing kinematics, there were significant group main effects for knee flexion angle range (F=4.429 and p=0.047), significant time main effects for valgus angle (F=6.502 and p=0.011) and significant group and time interaction effects for internal rotation angle range (F=5.475 and p=0.008). The group main effect for maximum knee flexion angle was significant (F=7.534 and p=0.012), and the group and time interaction effect for maximum internal rotation angle was significant (F=15.737 and p=0.001). For landing kinetics, the group main effect of the loading rate was significant (F=4.576 and p=0.044). Significant group and time interaction effects were observed for knee extension moment at the moment of maximum vertical ground reaction force (F=5.095 and p=0.010) and for abduction moment (F=8.250 and p=0.001). These findings suggest that plyometric training leads to greater improvements in hip and knee muscle strength and beneficial changes in knee biomechanics during landing compared to traditional training.

A preliminary randomized controlled study of the PEERS® program for Taiwanese autistic adolescents: The effectiveness on reducing school bullying and enhancing social function.

Individuals with autism spectrum disorder (ASD) often experience lifelong social communication challenges and are more vulnerable to school bullying. Addressing their social difficulties and school bullying requires evidence-based interventions. PEERS® (Program for the Education and Enrichment of Relational Skills) was adapted and translated for Taiwanese adolescents. This randomized controlled study aimed to examine the effectiveness of the Taiwanese version of PEERS® in reducing school bullying and enhancing social function among autistic adolescents. Twenty-one autistic adolescents (mean age 14.29 ± 1.67 years; female n = 733.33%) were randomized to a treatment group (TG, n = 10) or a delayed treatment control group (DTG, n = 11). The outcome measures (school bullying, social challenges, social skills knowledge, and social skills performance) were assessed at baseline, post-treatment, and follow-up. The group and time interaction analyses revealed greater magnitudes of reduction in general school bullying (p < 0.001), victimization (p < 0.001), perpetration (p = 0.012), social challenges (p = 0.001), and peer conflicts (p < 0.001), and improvement in social knowledge (p < 0.001) in the TG group than the DTG group. The findings suggest that the PEERS® program tailored for Taiwanese adolescents is effective in reducing school bullying, decreasing social challenges, and enhancing social skills among autistic adolescents, with very large effect sizes (Cohen's d ranging from 1.19 to 2.88). Consequently, participation in the PEERS® program is recommended for adolescents with social difficulties to improve their social communication and interactions to offset school bullying and other social challenges related to adverse outcomes.

A stochastic model of discussion

We consider the duration of discussions in face-to-face contacts and propose a stochastic model to describe it. It is based on the points of a Levy flight where the duration of each contact corresponds to the size of the clusters produced during the walk. When confronting it to the data measured from proximity sensors, we show that several datasets obtained in different environments, are precisely reproduced by the model fixing a single parameter, the Levy index, to 1.15. We analyze the dynamics of the cluster formation during the walk and compute analytically the cluster size distribution. We find that discussions are first driven by a maximum-entropy geometric distribution and then by a rich-get-richer mechanism reminiscent of preferential-attachment (the more a discussion lasts, the more it is likely to continue). In this model, conversations may be viewed as an aggregation process with a characteristic scale fixed by the mean interaction time between the two individuals.