Within-subject Analysis Research Articles

An online grief intervention to improve well-being and reduce clinical symptoms: a randomized controlled trial

The COVID-19 pandemic amplified the emotional impact of losing a loved one, deteriorating well-being, and increasing dysphoric symptoms in mourners. This study evaluated the efficacy of COVID Grief, a self-applied online cognitive-behavioral intervention for Mexican adults facing grief during the pandemic. We conducted a randomized clinical trial, enrolling 1,109 participants, 45 of whom completed the full intervention, and 69 of whom completed the waiting list control (WLC). Between-subject analysis showed that intervention group (IG) participants reported significantly higher satisfaction with life and quality of life and a reduction in depression, anxiety and stress levels compared to those in the WLC. Within-subjects analysis showed that IG presented no significant changes in satisfaction with life, whereas the quality of life was increased, and levels of depression, anxiety, and stress were reduced after treatment. For WLC, satisfaction with life and quality of life were significantly decreased, and symptoms of depression and anxiety -but not stress symptoms- increased after the waitlist. Completer’s opinions of the treatment were highly positive, although they only represent 5% of participants who accessed the intervention. High dropout rates should be addressed in future studies.

Recovery patterns of low-frequency fatigue in elite youth soccer players after official match

This study aimed to analyze the associations between recovery of low-frequency fatigue, jump height and perceptual responses following official soccer matches. Forty-two male youth elite soccer players (age: 17.13±0.70 years; height: 179.17±5.94 cm; weight: 69.74±4.91 kg) participated in this study. Low-frequency fatigue, countermovement jump, perceived fatigue, muscle soreness and perceived recovery were assessed at -2h, +30 min, +24h and +48h relative to the match. Linear mixed models analysis showed that low-frequency fatigue was reduced at the match-end (ES=-0.679 [95% CI = -1.01; -0.34]; p<.001) but returned to baseline after 24h (ES=0.149 [95% CI = -0.26; 0.56]; p=1.00). Perceptual responses were impaired for up to 48 hours following the match (ES=-0.868–1.174; p<.001). Countermovement jump did not differ between any time point (ES=-0.204–0.216; p>0.05). Additionally, the within-subject correlation analysis showed that low-frequency fatigue pre- to post-match changes presented moderate to large associations with perceived fatigue (rm[57]=-0.43; p<.001), muscle soreness (rm[57]=-0.52; p<.001) and perceived recovery (rm[57]=0.38; p=.003). The assessment of low-frequency fatigue could serve as an additional objective measurement for monitoring post-match fatigue, as findings suggest that young elite soccer players experience transient reductions following match-play, which are strongly correlated with subjective markers of recovery.

Acute effects of Mozart K.448 on interictal epileptiform discharges in adult patients with drug-resistant focal epilepsy: A crossover randomized controlled trial

BackgroundThis study aimed to validly assess the efficacy of Mozart K.448 on reducing interictal epileptiform discharges (IEDs) in adult patients with drug-resistant focal epilepsy (DRE). MethodsThis is a crossover RCT study. Adults with DRE were included. Stratified 1:1 randomization by epileptic foci i.e., temporal versus extratemporal foci, was performed. Intervention consisted of two study arms i.e., “Mozart arm” and “Control arm”. Study period encompassed 2 consecutive nights, each night consisted of baseline and intervention period. Outcomes were IED number and proportion of patients with significant IED reduction i.e., reduction ≥ 25 %. Within-group, within-subject and between-group analyses were used to test differences of IED number when listened to the Mozart piece as compared with baseline or with Control. ResultsTwenty-six patients were randomized; 13 in Mozart and 13 in Control arm. Overall, 16 (61.54 %) out of 26 patients had significant IED reduction when listening to the Mozart piece, as compared with only 7 (26.92 %) when continuing sleep (silence). Between-group analysis showed that IED number during intervention period i.e., listening to the Mozart piece in Mozart arm and silence in Control arm was significantly different, with a lower number in Mozart arm, 39.5 (IQR 89) vs 56.5 (IQR 114); p = 0.007. ConclusionsOur study demonstrates an acute effect of the Mozart K.448 on reducing IEDs in adult patients with DRE. Patients with temporal rather than extratemporal lobe epilepsy better responded to the Mozart piece. Mozart K.448 is safe and feasible in real practice. Further RCT study assessing its long-term effect is warranted. Trial registrationThai Clinical Trials Registry, TCTR20231019005, 19 October 2023, “retrospectively registered”

8607 Gender Affirming Hormone Therapy: Influence of Brain Network Connectivity Changes on Affect

Abstract Disclosure: J. Andreano: None. A. Lopez: None. M. Misra: None. Background: Previous research indicates that acute gonadal treatments and fluctuations in ovarian hormone levels over the course of the menstrual cycle can alter patterns of communication between brain regions, as well as producing significant changes in self-reported affect. Recent research from our laboratory indicates changes in both brain connectivity and affect with gender affirming hormone therapy (GAHT). However, the relationship between these changes with GAHT are not well understood. Additionally, it is difficult to separate influences of GAHT and transgender identity in understanding differences in connectvity and affect from cisgender controls. A better understanding of the influence of GAHT on intrinsic network connectivity could point the way towards improved GAHT treatment regimens that minimize affective side effects. Objective: To assess relationships between changes in brain network connectivity and affective changes following GAHT, identifying regions in which changes of connectivity are associated with changes in self-reported affect, and to examine differences in brain network connectivity between transgender participants and cisgender controls. Methods: 14 transgender individuals receiving GAHT (estradiol n =7, testosterone n = 7)) were scanned using functional magnetic imaging (fMRI) at rest at two timepoints: baseline, prior to treatment, and 6 months into GAHT. Additionally, 20 cisgender controls (10 male, 10 female) were scanned once each. The time course of neural activity was computed for each voxel in the brain, then tested for correlation with each other voxel to develop a whole-brain connectome for each participant. Maps of average connectivity to two seeds known to associate with two major networks in the brain (posterior cingulate cortex for Default Mode Network, and anterior insula for Salience Network) were then generated for each participant. Within transgender participants, these maps were then compared between the baseline and 6 month timepoints. Additionally, baseline scans were also compared to scans from cisgender controls corresponding to biological sex. Results: Within-subjects analyses of transgender participants showed diverse associations between changes in seed-based connectivity and changes in self-reported anxiety and depression following GAHT in both the default mode and salience networks. Between subjects comparisons showed significantly higher connectivity within the salience network in trans men relative to cis women, as well as greater inter-network connectivity in this group. In contrast, cis men showed greater connectivity within both default mode and salience networks relative to trans women. Conclusions: Changes in affect following GAHT appear related to GAHT-induced changes in network connectivity; these influences appear independent of differences between cis and transgender individuals. Presentation: 6/2/2024

Longitudinal relationship between posttraumatic cognitions and internalising symptoms in children and adolescents

ABSTRACT Background: Little is known about the naturalistic course of posttraumatic cognitions (PTCs) after exposure to a potentially traumatic event (PTE) in children and adolescents. Moreover, previous studies on the longitudinal associations of PTCs with internalising symptoms yielded mixed results. Objective: To explore the naturalistic courses and longitudinal associations of dysfunctional PTCs and functional PTCs with posttraumatic stress symptoms (PTSS), depression, and anxiety. Method: A total of 115 children and adolescents, aged 7–15 years, were assessed within 1 month, 3 months, and 6 months after exposure to an acute accidental PTE. Repeated measures analyses of variance were conducted to capture the naturalistic courses of PTCs and internalising symptoms. Cross-lagged panel analyses were applied to explore the longitudinal relationship between dysfunctional and functional PTCs, along with their longitudinal associations with PTSS, depression, and anxiety. Results: Dysfunctional PTCs and internalising symptoms decreased, whereas functional PTCs increased over time. Dysfunctional and functional PTCs were moderately inversely related, but no significant cross-lagged paths emerged among them. Dysfunctional PTCs were moderately to strongly associated with internalising symptoms, while functional PTCs were weakly to moderately inversely associated with internalising symptoms. Initial PTSS predicted later dysfunctional PTCs (β = .31, p < .05), but not vice versa. Conclusions: Dysfunctional PTCs, functional PTCs, and internalising symptoms were entangled over time. Our findings support the cognitive scar model with initial PTSS predicting later dysfunctional PTCs. Future research complementing between-subject with within-subject analyses could offer additional insights into the longitudinal relationship between dysfunctional PTCs, functional PTCs, and psychological symptoms.

Does the human professor or artificial intelligence (AI) offer better explanations to students? Evidence from three within-subject experiments

ABSTRACT Three within-subject experiments were conducted by providing students with answers to content questions across different subject matters (a definition, explanation, and example) offered by a human professor (subject-matter expert) versus generative artificial intelligence (ChatGPT). In a randomized order, students read both the expert and ChatGPT’s responses (both were de-identified and declared to be “professors,” so students were not aware one was artificial intelligence), rated both explanations on teaching clarity and competence, and then reported on their affect toward the content and situational interest. Study 1 (interpersonal communication content) revealed no significant differences in repeated measure ratings comparing the expert versus ChatGPT. However, in Study 2 (business communication content) and Study 3 (instructional communication content), compared with the expert, ChatGPT (impersonating a professor) was rated by the same students as higher in teaching clarity and competence, and it generated more student affect and situational interest. In Study 2 and Study 3, a within-subjects mediation analysis revealed that ChatGPT generated more student affect toward the content through the clarity in responses it provided to students.

Effect of cognitive behavioral therapy for insomnia on sleep quality among college students: the role of hyperarousal and dysfunctional beliefs

ABSTRACT Background Although cognitive-behavioral therapy for insomnia (CBT-I) is an effective treatment for sleep disorders, little is known about the role of hyperarousal (especially trait arousal) in CBT-I interventions. Therefore, this study investigated the role of trait arousal in the maintenance of sleep problems using cross-sectional and longitudinal methods. Methods Study 1, 1209 Chinese university students (63.9% female) completed the Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16), Pre-sleep Arousal Scale (PSAS), Arousal Predisposition Scale (APS), and Pittsburgh Sleep Quality Index (PSQI). The study calculated the moderating role of trait arousal in the relationship between dysfunctional beliefs about sleep and sleep quality. In study two, 89 participants completed the questionnaire used in Study 1 during pre-and post-treatment. A within-subjects mediation analysis examined the indirect effects of dysfunctional beliefs about sleep pre-sleep arousal (cognitive and somatic) on sleep quality. A within-subjects moderation analysis was used to investigate whether baseline trait arousal moderated sleep quality. Results Cross-sectional findings indicated that pre-sleep cognitive arousal mediated the effects of dysfunctional beliefs about sleep on sleep quality and that trait arousal moderated the first half of the mediating pathway described above; longitudinal analyses indicated that changes in dysfunctional beliefs about sleep and pre-sleep cognitive arousal mediated changes in sleep quality, and that, in addition, trait arousal moderated changes in sleep quality. Conclusion Trait arousal correlates with the maintenance of sleep problems, and participants with higher trait arousal benefited less from CBT-I. Enhancement programs that incorporate mindfulness may be a direction for future research.

Impact of the VTE-PREDICT calculator on clinicians’ decision making in fictional patients with venous thromboembolism: a randomized controlled trial

BackgroundAfter 3 months of anticoagulation for venous thromboembolism (VTE), the decision needs to be made whether to stop anticoagulation or extend treatment indefinitely. The VTE-PREDICT calculator can be used to estimate individual risks of VTE recurrence and bleeding to guide this decision. ObjectivesTo evaluate the impact of predicted individual risks of recurrence and bleeding on clinicians’ decisions on anticoagulation duration and to assess usefulness of the VTE-PREDICT calculator. MethodsA randomized controlled trial and within-subject study was conducted among clinicians treating VTE patients. The clinicians were asked to complete an online survey containing 6 fictional case vignettes. Group A proposed anticoagulant duration for each case without additional information first and subsequently after seeing calculator-predicted risks (within-subject analysis). Group B was directly provided with calculator risks and proposed treatment duration for each case vignette (for comparison with group A results in a randomized controlled trial analysis). Then, group B received questions on usefulness and credibility of the calculator. ResultsForty-five clinicians were assigned to group A and 48 to B. Overall, group A did not propose different anticoagulation durations than group B. However, individual clinicians in group A changed proposed duration in 35% of the cases after seeing the calculator risks. The calculator was considered useful and credible by most clinicians. ConclusionOverall, use of the VTE-PREDICT calculator did not affect proposed anticoagulation duration. However, individual clinicians frequently changed their proposed duration after using the calculator, especially for patients with high bleeding risk.

Common and distinct drug cue reactivity patterns associated with cocaine and heroin: An fMRI meta-analysis

Abstract Substance use and substance use disorders represent ongoing major public health crises. Specifically, the use of substances such as cocaine and heroin are responsible for over 50,000 drug-related deaths combined annually. We used a comparative meta-analysis procedure to contrast activation patterns associated with cocaine and heroin cue reactivity, which may reflect substance use risk for these substances. PubMed and Google Scholar were searched for studies with within-subject whole brain analyses comparing drug to neutral cues for users of cocaine and heroin published between 1995 and 2022. A total of 18 studies were included, 9 in each subgroup. Voxel-based meta-analyses were performed using seed-based d mapping with permuted subject images (SDM-PSI) for subgroup mean analyses and a contrast meta-regression comparing the two substances. Results from our mean analysis indicated that users of heroin showed more widespread activation in the nucleus accumbens, right inferior and left middle temporal gyrus, right thalamus, and right cerebellum. Cocaine use was associated with recruitment of dorsolateral prefrontal cortex during cue reactivity. Direct comparison of cue reactivity studies in heroin relative to cocaine users revealed greater activation in dopaminergic targets for users of heroin compared to users of cocaine. Differential activation patterns between substances may underlie differences in the clinical characteristics observed in users of cocaine and heroin, including seeking emotional blunting in users of heroin. More consistent research methodology is needed to provide adequate studies for stringent meta-analyses examining common and distinct neural activation patterns across substances and moderation by clinically relevant factors.

Vaccine preparation time, errors, satisfaction, and preference of prefilled syringes versus RSV vaccines requiring reconstitution: randomized, time and motion study

Aim The current study compared preparation time, errors, satisfaction, and preference for a prefilled syringe (PFS) versus two RSV vaccines requiring reconstitution (VRR1 and VRR2) in a randomized, single-blinded time and motion study. Methods Pharmacists, nurses, and pharmacy technicians were randomized to a preparation sequence of the three vaccines. Participants read instructions, then consecutively prepared the three vaccines with a 3–5-min washout period in between. Preparations were video recorded and reviewed by a trained pharmacist for preparation time and errors using predefined, vaccine-specific checklists. Participant demographics, satisfaction with vaccine preparation, and vaccine preference were recorded. Within-subjects analysis of variance was used to compare preparation time. Mixed-effects Poisson and ordered logistic regression models were used to compare the number of preparation errors and satisfaction scores, respectively. Results Sixty-three pharmacists (60%), nurses (35%), and pharmacy technicians (5%) participated at four sites in the United States. The least squares mean preparation time per dose for PFS was 141.8 s (95% CI = 156.8–126.7; p <.0001) faster than for VRR1, 103.6 s (95% CI = 118.7–88.5; p <.0001) faster than for VRR2, and 122.7 s (95% CI = 134.2–111.2; p <.0001) faster than the pooled VRRs. Overall satisfaction (combined “Very” and “Extremely”) was 87.3% for PFS, 28.6% for VRR1, and 47.6% for VRR2. Most participants (81.0%) preferred the PFS vaccine. Limitations The study is limited by the inability to completely blind observers. To minimize the effects of order, we utilized a 3-sequence block design; however, the order in which the vaccines were prepared may have affected outcomes. Participants were assessed once, whereas if repeated preparations were performed there may have been trained efficiencies gained for each vaccine. Conclusion PFS vaccines can greatly simplify the vaccine preparation process, allowing administrators to prepare almost four times more doses per hour than with vial and syringe systems.

Detecting lies in investigative interviews through the analysis of response latencies and error rates to unexpected questions

In this study, we propose an approach to detect deception during investigative interviews by integrating response latency and error analysis with the unexpected question technique. Sixty participants were assigned to an honest (n = 30) or deceptive group (n = 30). The deceptive group was instructed to memorize the false biographical details of a fictitious identity. Throughout the interviews, participants were presented with a randomized sequence of control, expected, and unexpected open-ended questions about identity. Responses were audio recorded for detailed examination. Our findings indicate that deceptive participants showed markedly longer latencies and higher error rates when answering expected (requiring deception) and unexpected questions (for which premeditated deception was not possible). Longer response latencies were also observed in participants attempting deception when answering control questions (which necessitated truthful answers). Moreover, a within-subject analysis highlighted that responding to unexpected questions significantly impaired individuals’ performance compared to answering control and expected questions. Leveraging machine-learning algorithms, our approach attained a classification accuracy of 98% in distinguishing deceptive and honest participants. Additionally, a classification analysis on single response levels was conducted. Our findings underscore the effectiveness of merging response latency metrics and error rates with unexpected questioning as a robust method for identity deception detection in investigative interviews. We also discuss significant implications for enhancing interview strategies.

Real-world effectiveness of antidepressants, antipsychotics and their combinations in the maintenance treatment of psychotic depression. Evidence from within-subject analyses of two nationwide cohorts.

Psychotic depression (PD) is a severe mental disorder leading to functional disability and high risk of suicide, but very little is known about the comparative effectiveness of medications used in its maintenance treatment. The objective of this study was to investigate the comparative effectiveness of specific antipsychotics and antidepressants, and their combinations, on the risk of psychiatric hospitalization among persons with PD in routine care. Persons aged 16-65 years with a first-time diagnosis of PD were identified from Finnish (years 2000-2018) and Swedish (years 2006-2021) nationwide registers of inpatient care, specialized outpatient care, sickness absence, and disability pension. The main exposures were specific antipsychotics and antidepressants, and the main outcome measure was psychiatric hospitalization as a marker of severe relapse. The risk of hospitalization associated with periods of use vs. non-use of medications (expressed as adjusted hazard ratio, aHR) was assessed by a within-individual design, using each individual as his/her own control, and analyzed with stratified Cox models. The two national cohorts were first analyzed separately, and then combined using a fixed-effect meta-analysis. The Finnish cohort included 19,330 persons (mean age: 39.8±14.7 years; 57.9% women) and the Swedish cohort 13,684 persons (mean age: 41.3±14.0 years; 53.5% women). Individual antidepressants associated with a decreased risk of relapse vs. non-use of antidepressants were bupropion (aHR=0.73, 95% CI: 0.63-0.85), vortioxetine (aHR=0.78, 95% CI: 0.63-0.96) and venlafaxine (aHR=0.92, 95% CI: 0.86-0.98). Any long-acting injectable antipsychotic (LAI) (aHR=0.60, 95% CI: 0.45-0.80) and clozapine (aHR=0.72, 95% CI: 0.57-0.91) were associated with a decreased risk of relapse vs. non-use of antipsychotics. Among monotherapies, only vortioxetine (aHR=0.67, 95% CI: 0.47-0.95) and bupropion (aHR=0.71, 95% CI: 0.56-0.89) were associated with a significantly decreased risk of relapse vs. non-use of both antidepressants and antipsychotics. In an exploratory analysis of antidepressant-antipsychotic combinations, a decreased relapse risk was found for amitriptyline-olanzapine (aHR=0.45, 95% CI: 0.28-0.71), sertraline-quetiapine (aHR=0.79, 95% CI: 0.67-0.93) and venlafaxine-quetiapine (aHR=0.82, 95% CI: 0.73-0.91) vs. non-use of antidepressants and antipsychotics. Benzodiazepines and related drugs (aHR=1.29, 95% CI: 1.24-1.34) and mirtazapine (aHR=1.17, 95% CI: 1.07-1.29) were associated with an increased risk of relapse. These data indicate that, in the maintenance treatment of PD, bupropion, vortioxetine, venlafaxine, any LAI, clozapine, and only few specific antidepressant-antipsychotic combinations areassociated with a decreased risk of relapse. These findings challenge the current recommendation by treatment guidelines to combine an antipsychotic with an antidepressant (without further specification) as standard treatment in PD.

Rapid Changes in Cerebrovascular Compliance During Vasovagal Syncope

Background: The rapid reduction in arterial blood pressure (ABP) during vasovagal syncope (VVS) is associated with a characteristic decline in diastolic cerebral blood velocity (CBV) and maintained systolic CBV as measured by transcranial Doppler. This increased pulsatility was originally considered to be indicative of a “dysfunctional” increase in cerebrovascular resistance (CVR). Conversely, it may be due to increased cerebrovascular compliance (Ci) that partially attenuates the cerebral effects of rapid hypotension. We tested the hypothesis that Ci supports CBV during pre-syncope in VVS. Method: Finger ABP and right middle cerebral artery blood velocity (MCAv) were recorded from 15 otherwise healthy patients (n = 11 female, 40 ± 16 years, 24.9 ± 4.0 kg/m2) at rest and during head-up tilt (80°, 5 to 28 min). Individual ABP and CBV waveforms of every second heartbeat during VVS were input into a modified Windkessel model to calculate Ci and CVR. MCAv pulsatility was determined as pulse amplitude (systolic MCAv-diastolic MCAv) and Pulsatility Index (Pi; pulse amplitude/mean MCAv). Linear mixed models assessed the contribution of Ci to changes in CBV and Pi. Within-subject mediation analysis investigated the possibility of Ci mediating the relation between blood pressure (i.e., mean ABP and pulse pressure, PP) and cerebrovascular pulsatility. Results: Diastolic and systolic ABP decreased progressively during presyncope, resulting in a nadir reduction of mean ABP of Δ24 ± 9 mmHg at end-tilt (all p ≤ 0.04 vs mid-tilt). Mean MCAv decreased by 22 ± 12% prior to end-tilt (p &lt; 0.01 vs mid-tilt). CVR decreased progressively for 10s prior to end-tilt (p ≤ 0.04 vs mid-tilt). Pi increased significantly, with peak increases occurring at 4 s prior to end-tilt (77 ± 50%, p &lt; 0.01 vs mid-tilt). The increase in Ci (307 ± 223%, p &lt; 0.01 vs mid-tilt) significantly contributed to changes in MCAv (χ2 =10.6, p &lt; 0.01) and Pi (χ2 = 4.9, p = 0.03). Correlations of PP and ABP with Pi were not significant. However, PP was related to MCAv pulse amplitude (total effect: b = 1.57) and Ci ( b = -0.01, both p &lt; 0.01). Ci partially mediated (indirect effect: b = -0.78, p &lt; 0.01) the direct relation between PP and MCAv pulse amplitude ( b = 0.79, p = 0.01). Conclusion: These data provide evidence that Ci attenuates the fall in CBV under conditions of falling PP. Cerebrovascular regulation in VVS appears to be functioning as in healthy populations. However, this regulation is not suffcient to preserve flow in the presence of such extreme and rapid reductions in ABP. USRI — Western University, Natural Sciences and Engineering Research Council of Canada (NSERC, Grant No. RGPIN-2018-06255). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Assessing the Acceptance of a Mid-Air Gesture Syntax for Smart Space Interaction: An Empirical Study

Mid-gesture interfaces have become popular for specific scenarios, such as interactions with augmented reality via head-mounted displays, specific controls over smartphones, or gaming platforms. This article explores the use of a location-aware mid-air gesture-based command triplet syntax to interact with a smart space. The syntax, inspired by human language, is built as a vocative case with an imperative structure. In a sentence like “Light, please switch on!”, the object being activated is invoked via making a gesture that mimics its initial letter/acronym (vocative, coincident with the sentence’s elliptical subject). A geometrical or directional gesture then identifies the action (imperative verb) and may include an object feature or a second object with which to network (complement), which also represented by the initial or acronym letter. Technically, an interpreter relying on a trainable multidevice gesture recognition layer makes the pair/triplet syntax decoding possible. The recognition layer works on acceleration and position input signals from graspable (smartphone) and free-hand devices (smartwatch and external depth cameras), as well as a specific compiler. On a specific deployment at a Living Lab facility, the syntax has been instantiated via the use of a lexicon derived from English (with respect to the initial letters and acronyms). A within-subject analysis with twelve users has enabled the analysis of the syntax acceptance (in terms of usability, gesture agreement for actions over objects, and social acceptance) and technology preference of the gesture syntax within its three device implementations (graspable, wearable, and device-free ones). Participants express consensus regarding the simplicity of learning the syntax and its potential effectiveness in managing smart resources. Socially, participants favoured the Watch for outdoor activities and the Phone for home and work settings, underscoring the importance of social context in technology design. The Phone emerged as the preferred option for gesture recognition due to its efficiency and familiarity. The system, which can be adapted to different sensing technologies, addresses the scalability concerns (as it can be easily extended for new objects and actions) and allows for personalised interaction.

Impact of Differing Instability Devices on Postural Sway Parameters

Single-limb balance training is integral to preventing and rehabilitating lower extremity injuries. Previous investigations have shown that when using instability devices, differences may or may not exist in the postural sway parameters during use, depending on the specific devices being assessed. Thus, this investigation sought to examine the differences between a commonly used foam pad and a novel instability device (block) in postural sway measures. Twenty-two healthy individuals with no history of lower extremity injury or neurological disorders participated in this investigation. The participants performed three single-limb static balance exercises on a force platform sampling at 120 Hz. Each condition contained three 10-s trials separated by thirty seconds. The mean CoP values of the three trials in each condition were then compared using a within-subjects repeated-measures analysis of variance. Statistically significant differences were seen in the sway area between conditions (p = 0.009), the CoP path length (p = 0.007), the peak medial–lateral CoP displacement (p = 0.004), and the average sway velocity (p = 0.007). All variables displayed similar trends whereby the control condition showed significantly lower values than both instability devices, with no differences between devices. This investigation provides supporting evidence that different instability devices may deliver similar changes to postural sway parameters compared to control conditions. The novel block instability device used in this investigation may be used similarly to the traditional foam pad in prevention and rehabilitation settings based on the absence of differences between the two devices.

Mediated pathway from e-cigarette use to internalizing and externalizing mental health via polysubstance use among young adults

ABSTRACT Objective This study examined the mediated pathways from e-cigarette use to internalizing and externalizing mental health via polysubstance use among young adults. Methods Data were drawn from the Population Assessment of Tobacco and Health, a nationally representative longitudinal study. A total of 5,042 young adults (18–24 years at baseline) who had matched data from Wave 1 to Wave 5 (2013–2019) were analyzed. Within-subject mediation analysis along with a multilevel framework assessed the mediated pathways from between time-lagged exposure (e-cigarette use at t − 1 ), time-lagged mediator (polysubstance use at t ), and outcome variables (internalizing/externalizing mental health at t + 1 ). Results Path from e-cigarette use to polysubstance use to poorer internalizing problems showed appreciable proportion of mediation (total effect: b = 0.052, 95% CI = 0.019–0.087; direct effect: b = 0.035, 95% CI = 0.001–0.070; mediated effect: b = 0.017, 95% CI = 0.011–0.025 [proportion mediated 34.0%]). Similarly, polysubstance use partially mediated the associations between e-cigarette use and externalizing problems (total effects: b = 0.050, 95% CI = 0.014–0.084; direct effect: b = 0.034, 95%CI = −0.001–0.069; mediated effects: b = 0.016, 95% CI = 0.010–0.024 [proportion mediated: 32.7%]). Conclusions Our findings imply that e-cigarette use may be detrimental to young adults’ mental health and polysubstance use patterns, underscoring the need for discouraging them from e-cigarette use.

Gratitude predicts well-being via resilience and social support in emerging adults: a daily diary study

ABSTRACT Although previous studies have established a link between daily gratitude and daily well-being, little is known about whether resilience and social support play the mediating role in the predictive effect of daily gratitude on daily well-being. To better understand how gratitude is linked to well-being, the present study adopted a daily diary method to explore the mediating roles. A sample of 153 undergraduates (M age = 20.27 years, SD age = 1.83 years) completed the daily questionnaire once a day for 21 consecutive days. Multilevel within-subject mediation analyses indicated that daily resilience and daily social support mediated the relationship between daily gratitude and daily well-being. These findings are in line with the broaden-and-build theory, emphasizing the significant mediating roles of resilience and social support in the gratitude – well-being link at the within-person level.

A school-based physical activity intervention in primary school: effects on physical activity, sleep, aerobic fitness, and motor competence.

The "Super Quinas" project evaluated the effectiveness of an intervention program to improve physical activity, aerobic fitness, sleep, and motor competence on children in primary school. The experimental group (n = 19) enrolled in a 12-week intervention program (one more extra-curricular activity class of 60 min per week) compared to the CG (n = 19), all aged 9-10 years. Physical activity (PA) and sleep were measured by accelerometry, and aerobic fitness was measured by Children's Yo-Yo test (YYIR1C) during the 1st week (PRE), the 6th week (DUR), and the 12th week (POST) of the intervention program. Motor Competence in PRE and POST intervention was also assessed by the Motor Competence Assessment (MCA) instrument. Heart rate (HR, assessed using HR monitors), and enjoyment level were recorded during all intervention program classes. A linear mixed model analysis (i.e., within-subject analyses) was performed. Comparing the EG and CG in DUR and POST, the EG spent ~18 min and ~ 34 min more time in moderate to vigorous physical activity (MVPA) per day (p < 0.001); had ~44 min and ~ 203 min less sedentary time per day (p < 0.001); performed more 44 and 128 m in the Children's Yo-Yo test compared to CG (p < 0.001) and slept more 17 and 114 min per night (p < 0.001). In POST motor competence was significantly better (27%) in the EG compared to CG (p < 0.001). The %HRmax during the extra-curricular classes ranged between 65 and 81% (i.e., light to moderate intensities), and the enjoyment between fun and great fun. Our findings suggest that adding one more extra-curricular activity class of 60 min per week for 12 weeks effectively increased the levels of physical activity, aerobic fitness, sleep duration, and motor competence in children aged 9-10 years.

Assessment of Foot Strike Angle and Forward Propulsion with Wearable Sensors in People with Stroke.

Effective retraining of foot elevation and forward propulsion is a critical aspect of gait rehabilitation therapy after stroke, but valuable feedback to enhance these functions is often absent during home-based training. To enable feedback at home, this study assesses the validity of an inertial measurement unit (IMU) to measure the foot strike angle (FSA), and explores eight different kinematic parameters as potential indicators for forward propulsion. Twelve people with stroke performed walking trials while equipped with five IMUs and markers for optical motion analysis (the gold standard). The validity of the IMU-based FSA was assessed via Bland-Altman analysis, ICC, and the repeatability coefficient. Eight different kinematic parameters were compared to the forward propulsion via Pearson correlation. Analyses were performed on a stride-by-stride level and within-subject level. On a stride-by-stride level, the mean difference between the IMU-based FSA and OMCS-based FSA was 1.4 (95% confidence: -3.0; 5.9) degrees, with ICC = 0.97, and a repeatability coefficient of 5.3 degrees. The mean difference for the within-subject analysis was 1.5 (95% confidence: -1.0; 3.9) degrees, with a mean repeatability coefficient of 3.1 (SD: 2.0) degrees. Pearson's r value for all the studied parameters with forward propulsion were below 0.75 for the within-subject analysis, while on a stride-by-stride level the foot angle upon terminal contact and maximum foot angular velocity could be indicative for the peak forward propulsion. In conclusion, the FSA can accurately be assessed with an IMU on the foot in people with stroke during regular walking. However, no suitable kinematic indicator for forward propulsion was identified based on foot and shank movement that could be used for feedback in people with stroke.

A study on the effect of music listening on people with high neurotic tendency as evidenced by negative affective scores and physiological responses.

Music listening has been found to be effective in reducing stress levels with different participant samples. Relatively little evidence has been obtained from people with high neurotic tendency (HNT), whose dispositional psychological characteristics might dampen the effect of music listening. This study therefore tried to examine the immediate effect of music listening in reducing stressful feelings of participants with either high or low neurotic tendency. Seventy-nine undergraduate participants who were identified as having either HNT or low neurotic tendency (LNT) accomplished a stressful task before listening to a comforting music piece. Negative affect (NA) scores and heart rate were measured at different phases. Results in a within-subjects analysis showed that the stressor and music listening could significantly alter the stressful feeling of both participant groups. Although the percentage changes in heart rate were similar between the groups, the changes of NA score which were measured after either the stressful task or the music listening session were consistently lower in the HNT group than the LNT group. The divergence revealed a loose connection between the subjective feelings and the bodily changes in the HNT group, which could be important for clinicians and practitioners to take into consideration in psychology when evaluating the stressful feelings for their clients with HNT.