Effects of Exercise Restriction on Patients With Anomalous Aortic Origin of a Coronary Artery

2016 ◽  
Vol 8 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Matthew D. Elias ◽  
James Meza ◽  
Brian W. McCrindle ◽  
Julie A. Brothers ◽  
Stephen Paridon ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Exercise Capacity ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Multivariable Analysis ◽  
Young Patients ◽  
Significant Difference ◽  
Exercise Restriction ◽  
Over Time

Background: Management of young patients with anomalous aortic origin of a coronary artery (AAOCA) may involve exercise restriction. We sought to identify the association of exercise restriction with changes over time in body mass index (BMI) and exercise capacity in this cohort. Methods: We performed a retrospective review of patients with AAOCA seen at The Children’s Hospital of Philadelphia between January 1, 1998, and August 31, 2014. Linear mixed model repeated-measures analysis assessed changes in BMI and exercise capacity. Results: We included 72 patients with a median age at presentation of 12.6 years (interquartile range: 10.1-15.8) and mean follow-up of 3.6 ± 3.0 years. The majority had an anomalous right coronary artery (71%) and interarterial ± intramural coronary course (90%). Surgery was performed in 54%, more often in those with interarterial/intramural course ( P < .001) and symptoms ( P = .003). Most patients (82%) were exercise-restricted on presentation, and restricted patients were older than those who were not restricted ( P = .01). There was no significant difference between restricted and nonrestricted patients in initial BMI z scores, percentage of patients with BMI over 85th percentile (26%) or exercise capacity variables. In univariable analysis, exercise restriction over time was not associated with change in BMI z score ( P = .25) or change in exercise variables. Restriction was not associated with significant change in these variables in multivariable analysis. Conclusions: Although further investigation is warranted to determine the degree of adherence to exercise restriction, the recommendation of restriction alone is not associated with increasing BMI or decreasing exercise performance in the short-term.

Cerebral hemodynamics in peritoneal dialysis versus intermittent hemodialysis: A transcranial Doppler pilot study

2020 ◽  
pp. 089686082095371
Author(s):  
Shivani Ghoshal ◽  
Nathaniel O’Connell ◽  
Charles Tegeler ◽  
Barry I Freedman
Keyword(s):  
Peritoneal Dialysis ◽  
Transcranial Doppler ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Cerebral Hemodynamics ◽  
Intermittent Hemodialysis ◽  
Mean Flow ◽  
Treatment Groups ◽  
Significant Difference ◽  
Over Time

This study evaluated intradialytic cerebral hemodynamics measured by transcranial Doppler (TCD) in intermittent hemodialysis (iHD) versus nightly peritoneal dialysis (NIPD). Intradialytic TCD was serially performed in chronic dialysis patients receiving iHD ( n = 10) and NIPD ( n = 10). A linear mixed model was used to model mean flow velocity (MFV), pulsatility index (PI), and mean arterial pressure (MAP) as functions of time and treatment group. Intradialytic cerebral volatility (IDCV) was calculated using the coefficient of variation (CV) and mean absolute value of change (AVC) of each patient’s MFV, PI, and MAP values over time. Mixed model analyses found no significant difference between MFV, PI, and MAP treatment groups in change over time, though volatility differed significantly. Mean CV values for MFV, PI, and MAP were higher in iHD than NIPD (MFV 0.22 vs. 0.10, p = 0.005; PI 0.14 vs. 0.08, p = 0.003; MAP 0.057 vs. 0.032, p = 0.009). AVC values were similarly higher in iHD compared to NIPD (MFV 8.26 vs. 4.43, p = 0.04; PI 0.17 vs. 0.084, p < 0.001; MAP 6.05 vs. 2.9, p = 0.003). PI, MFV, and MAP were more stable in NIPD than iHD, as measured by intradialytic TCD monitoring. This study identifies IDCV as a unique TCD metric for intradialytic cerebral hemodynamics.

Dividend initiators, winners during 2008 financial crisis

2016 ◽  
Vol 42 (3) ◽  
pp. 212-224 ◽  
Author(s):  
John Consler ◽  
Greg M. Lepak
Keyword(s):  
Financial Crisis ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Penalized Splines ◽  
2008 Financial Crisis ◽  
Content Type ◽  
Financial Variables ◽  
Before And After ◽  
Over Time

Purpose – The purpose of this paper is to describe and compare the mean response for selected financial variables in three dividend paying groups before and after the financial crisis of 2008. Dividend initiators are expected to be rewarded by investors over traditional dividend paying firms. Design/methodology/approach – Quarterly CRSP data from 2000 to 2012 are used to define dividend paying groups. Highly unbalanced financial data on dividend paying firms are analyzed in two truncated sample periods defined before and after the financial crisis. Fitted models describing differences in dividend paying groups are based on the linear mixed model representation of penalized splines with random effects to account for repeated measures over time. Findings – Results are presented on the important differences in selected financial variables before and after the financial crisis by dividend paying pattern group (traditional, initiators, residual/catering). Special emphasis is given to the analysis of market/book value ratio. Results demonstrate dividend initiators are rewarded over traditional dividend firms by investors. Firms with an intermittent paying pattern have no advantage. All dividend paying firms grow during the 2008 financial crisis. Traditional dividend payers have larger size than other dividend payers. The size effect explains results for several of the financial variables studied. Research limitations/implications – Future work can include an industry effect on the three dividend paying groups. Practical implications – Investors appear to prefer certainty as to when they receive a dividend over uncertainty, especially in times of economic downturn and economic recovery. Social implications – Enhanced awareness that different payment patterns exist and are rewarded differently over time on both the corporate issuer and investor sides. Originality/value – This study adds to body of knowledge of practical dividend payment patterns around a financial crisis. It also provides added support for dividend initiators.

scholarly journals Effect of Educational Intervention Based on Self-Efficacy Theory on The Caring Behavior of Mothers Having Children with Cancer

2021 ◽  
Author(s):  
Maryam Barani ◽  
Laleh Hassani ◽  
Amin Ghanbarnejad ◽  
Mohammad Ali Molavi
Keyword(s):  
Educational Intervention ◽  
Self Efficacy ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Children With Cancer ◽  
Test Analysis ◽  
Caring Behavior ◽  
Significant Difference ◽  
The Mean

Abstract Background Self-efficacy, as one of the concepts of empowerment model, plays a role in increasing the caring behavior. Accordingly, the present study aimed to evaluate the effect of educational intervention based on self-efficacy theory on the caring behavior of mothers having children with cancer. Methods This before-after clinical trial study was conducted on all mothers (N = 86) of children with cancer undergoing chemotherapy who referred to Bandar Abbas Children's Hospital. All mothers participate in four educational intervention sessions. The Shearer's self-efficacy questionnaire and "mothers caring behavior scale" were completed at the 1rst and 3rd and 6th months after intervention. Descriptive statistics, paired t-test, analysis of variance (ANOVA) with repeated measures and a linear mixed model were used to assess the effect of time and self-efficacy on the caring behavior adjusting for family size, mother’s age, mother’s job, mother’s education, and chemo-therapy session. Results The results indicated a significant difference in the mean score of mothers' self-efficacy after intervention (P < 0.001). Besides, the two-way self-efficacy score of the first and second follow-ups was p = 0.096. Furthermore, the mean score of caring behavior before and after the intervention indicated a significant difference (P < 0.001). Conclusion The results of the present study indicated that an educational program for mothers increased their caring behavior and self-efficacy with the increase of self-efficacy, mothers' caring behavior was promoted. Authorities and practitioners are suggested to pay more attention to designing educational programs based on health models and theories.

scholarly journals Skin Carotenoid Accumulation in Response to a Two-Week Sweet Potato Snack Added to the Usual Diet

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 121-121
Author(s):  
Taylor Erickson ◽  
Rui Li ◽  
Elizabeth Woods ◽  
Stephanie Dickinson ◽  
Alyce Fly
Keyword(s):  
Sweet Potato ◽  
Repeated Measures ◽  
Fixed Effects ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Least Square ◽  
Post Intervention ◽  
Change In Mean ◽  
Usual Diet ◽  
Over Time

Abstract Objectives To evaluate changes in skin carotenoid score (SCS) from baseline, during and following a two-week sweet potato snack added to a participant's usual diet. Methods Forty participants were recruited by convenience for a 7-week longitudinal cohort study with a 1-week period to establish baseline SCS, an intervention consisting of a sweet potato snack fed 3 times/week for 2 weeks in the lab while consuming a usual diet outside of the lab, followed by a 4-week monitoring period. SCS were measured 17 times over the study with pressure-mediated reflectance spectroscopy (Veggie Meter). SCS were analyzed using a linear mixed model (LMM) with repeated measures (fixed effects) to determine whether SCS increased from baseline to the follow up points of the intervention and post-intervention periods (α = 0.05). Data were plotted with a Loess line to visualize change over time. Secondary analyses were conducted to determine if baseline SCS affected time to detect differences post-intervention. Baseline SCS tertiles were analyzed using LMM with repeated measures (fixed effects, α = 0.05). Simple differences in least square means were calculated for each tertile at each time point. Results Participants included 28 (72%) females and 11 (28%) males from 20–62 years who identified themselves as “White” (69.2%), “Asian” (23.1%), “Black/African American” (5.1%), and “Other-Latina” (2.6%). Five participants (12.8%) reported a Hispanic ethnicity. Analyses included 39 of 40 original participants, as one withdrew the first week of the study. Change in mean SCS from baseline over time was significant (P &lt; 0.001). While SCS during the intervention period were not significantly higher than baseline (P = 0.271), those at post-intervention were higher (P &lt; 0.001). The Loess line for mean change in SCS from baseline depicted a period of consistent increase from day 26 to day 36, approximately 3 weeks after the start of the intervention. Change in SCS across periods for all tertiles was significant (P &lt; 0.001). Conclusions These data suggest that 3 weeks after the beginning of a two-week intervention may be a period of interest when measuring the efficacy of such an intervention. Additionally, the difference in mean SCS between periods may depend on baseline SCS. Funding Sources This project was funded in part by Indiana University.

Longitudinal Perspectives on Children’s Physical Activity Patterns: “Do Physical Education–Related Factors Matter?”

2021 ◽  
pp. 1-8
Author(s):  
Anoek M. Adank ◽  
Dave H.H. Van Kann ◽  
Teun Remmers ◽  
Stef P.J. Kremers ◽  
Steven B. Vos
Keyword(s):  
Physical Activity ◽  
Physical Education ◽  
Sedentary Behavior ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Psychological Needs ◽  
Basic Psychological Needs ◽  
Related Factors ◽  
Over Time

Background: This study examined longitudinal associations of motor competence (MC) and physical activity (PA) enjoyment with moderate to vigorous PA and sedentary behavior among boys and girls aged 10–12 years old. In addition, this study explored the predictive strength of satisfaction of basic psychological needs in physical education (PE) and PA enjoyment. Methods: At 3 time points (baseline, +1 y, and +2 y), PA levels, MC, PA enjoyment, satisfaction of basic psychological needs in PE and height and weight of 371 children were measured. Data were analyzed using repeated-measures linear mixed model analyses stratified for gender and adjusted for relevant covariates. Results: Sedentary behavior decreased over time and was significantly predicted by PA enjoyment in boys and by PA enjoyment and MC in girls. Boys’ moderate to vigorous PA decreased over time and was predicted by MC, whereas girls’ moderate to vigorous PA remained low, yet stable over time and was predicted by PA enjoyment and MC. Furthermore, children’s need for competence and teacher relatedness (girls only) during PE significantly predicted PA enjoyment. Conclusions: Children need sufficient and well-designed opportunities to improve their MC and PA enjoyment. PE may be pivotal in advancing PA enjoyment, indicating that PE could have more beneficial effects on PA levels in children, especially in girls.

Long-term seizure outcomes after pediatric temporal lobectomy: does brain MRI lesion matter?

2019 ◽  
Vol 24 (2) ◽  
pp. 200-208
Author(s):  
Ravindra Arya ◽  
Francesco T. Mangano ◽  
Paul S. Horn ◽  
Sabrina K. Kaul ◽  
Serena K. Kaul ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Hippocampal Sclerosis ◽  
Brain Mri ◽  
Temporal Lobectomy ◽  
Seizure Freedom ◽  
Seizure Onset

OBJECTIVEThere is emerging data that adults with temporal lobe epilepsy (TLE) without a discrete lesion on brain MRI have surgical outcomes comparable to those with hippocampal sclerosis (HS). However, pediatric TLE is different from its adult counterpart. In this study, the authors investigated if the presence of a potentially epileptogenic lesion on presurgical brain MRI influences the long-term seizure outcomes after pediatric temporal lobectomy.METHODSChildren who underwent temporal lobectomy between 2007 and 2015 and had at least 1 year of seizure outcomes data were identified. These were classified into lesional and MRI-negative groups based on whether an epilepsy-protocol brain MRI showed a lesion sufficiently specific to guide surgical decisions. These patients were also categorized into pure TLE and temporal plus epilepsies based on the neurophysiological localization of the seizure-onset zone. Seizure outcomes at each follow-up visit were incorporated into a repeated-measures generalized linear mixed model (GLMM) with MRI status as a grouping variable. Clinical variables were incorporated into GLMM as covariates.RESULTSOne hundred nine patients (44 females) were included, aged 5 to 21 years, and were classified as lesional (73%), MRI negative (27%), pure TLE (56%), and temporal plus (44%). After a mean follow-up of 3.2 years (range 1.2–8.8 years), 66% of the patients were seizure free for ≥ 1 year at last follow-up. GLMM analysis revealed that lesional patients were more likely to be seizure free over the long term compared to MRI-negative patients for the overall cohort (OR 2.58, p < 0.0001) and for temporal plus epilepsies (OR 1.85, p = 0.0052). The effect of MRI lesion was not significant for pure TLE (OR 2.64, p = 0.0635). Concordance of ictal electroencephalography (OR 3.46, p < 0.0001), magnetoencephalography (OR 4.26, p < 0.0001), and later age of seizure onset (OR 1.05, p = 0.0091) were associated with a higher likelihood of seizure freedom. The most common histological findings included cortical dysplasia types 1B and 2A, HS (40% with dual pathology), and tuberous sclerosis.CONCLUSIONSA lesion on presurgical brain MRI is an important determinant of long-term seizure freedom after pediatric temporal lobectomy. Pediatric TLE is heterogeneous regarding etiologies and organization of seizure-onset zones with many patients qualifying for temporal plus nosology. The presence of an MRI lesion determined seizure outcomes in patients with temporal plus epilepsies. However, pure TLE had comparable surgical seizure outcomes for lesional and MRI-negative groups.

scholarly journals Factors associated with professional identity formation within psychiatry residency training: A longitudinal study

2021 ◽  
Author(s):  
Qian Hui Chew ◽  
Yvonne Steinert ◽  
Kang Sim
Keyword(s):  
Professional Identity ◽  
Identity Formation ◽  
Psychiatry Residency ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Developmental Stages ◽  
Rate Of Change ◽  
Psychiatry Residents ◽  
Factors Associated ◽  
Over Time

Abstract Introduction Conceptual frameworks for professional identity (PI) formation highlight the importance of developmental stages and socialization as the learner progresses from legitimate peripheral to full participation. Based on extant literature and clinical impressions, the authors aimed to explore factors associated with PI formation in psychiatry residents over time, and hypothesized that time in training, seniority status, and duration of exposure to psychiatry prior to residency would be associated with PI formation. Methods Eighty out of 96 psychiatry residents (response rate, 83.3%) from the National Psychiatry Residency Program in Singapore participated and rated their PI development using the Professional Self Identity Questionnaire (PSIQ) across four timepoints from January 2016–December 2019. The residents were classified as junior (first 3 years) or senior residents (years 4–5). Linear mixed model analyses were conducted, with time in training, seniority status (junior versus senior residents), duration of psychiatry postings prior to residency, and their interaction as associated factors with PI over time. Results Time in training, seniority, and duration of psychiatry postings before residency (all p < 0.01) were significantly associated with higher PSIQ scores at baseline. Over time, although all residents had increases in PSIQ scores, this rate of change did not differ significantly between junior and senior residents. Discussion Exposure to psychiatry postings before residency, time in learning, and seniority are factors which influence PI development in residents. This has implications for psychiatry residency selection and training, adequate clinical exposure during training rotations, and continual support for new and senior residents to foster PI formation over time.

Combining Microfractures, Autologous Bone Graft, and Autologous Matrix-Induced Chondrogenesis for the Treatment of Juvenile Osteochondral Talar Lesions

2017 ◽  
Vol 38 (5) ◽  
pp. 485-495 ◽  
Author(s):  
Riccardo D’Ambrosi ◽  
Camilla Maccario ◽  
Chiara Ursino ◽  
Nicola Serra ◽  
Federico Giuseppe Usuelli
Keyword(s):  
Bone Graft ◽  
Repeated Measures ◽  
Osteochondral Lesion ◽  
Young Patients ◽  
Case Series ◽  
Autologous Bone Graft ◽  
Lesion Size ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Autologous Bone

Background: The purpose of this study was to evaluate the clinical and radiologic outcomes of patients younger than 20 years, treated with the arthroscopic-talus autologous matrix-induced chondrogenesis (AT-AMIC) technique and autologous bone graft for osteochondral lesion of the talus (OLT). Methods: Eleven patients under 20 years (range 13.3-20.0) underwent the AT-AMIC procedure and autologous bone graft for OLTs. Patients were evaluated preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively, using the American Orthopaedic Foot & Ankle Society Ankle and Hindfoot (AOFAS) score, the visual analog scale and the SF-12 respectively in its Mental and Physical Component Scores. Radiologic assessment included computed tomographic (CT) scan, magnetic resonance imaging (MRI) and intraoperative measurement of the lesion. A multivariate statistical analysis was performed. Results: Mean lesion size measured during surgery was 1.1 cm3 ± 0.5 cm3. We found a significant difference in clinical and radiologic parameters with analysis of variance for repeated measures ( P < .001). All clinical scores significantly improved ( P < .05) from T0 to T3. Lesion area significantly reduced from 119.1 ± 29.1 mm2 preoperatively to 77.9 ± 15.8 mm2 ( P < .05) at final follow-up as assessed by CT, and from 132.2 ± 31.3 mm2 to 85.3 ± 14.5 mm2 ( P < .05) as assessed by MRI. Moreover, we noted an important correlation between intraoperative size of the lesion and body mass index (BMI) ( P = .011). Conclusions: The technique can be considered safe and effective with early good results in young patients. Moreover, we demonstrated a significant correlation between BMI and lesion size and a significant impact of OLTs on quality of life. Level of Evidence: Level IV, retrospective case series.

scholarly journals Decline of ovarian function in patients with rheumatoid arthritis: serum anti-Müllerian hormone levels in a longitudinal cohort

RMD Open ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e001307
Author(s):  
Jenny Brouwer ◽  
Radboud J E M Dolhain ◽  
Johanna M W Hazes ◽  
Nicole S Erler ◽  
Jenny A Visser ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Ovarian Function ◽  
Reproductive Function ◽  
Related Factors ◽  
Original Cohort ◽  
Primordial Follicles ◽  
Age At Menopause ◽  
Over Time

ObjectiveRheumatoid arthritis (RA) often affects women in their fertile age, and is known to compromise female fertility. Serum anti-Müllerian hormone (AMH) levels are a proxy for the total number of primordial follicles, and a reliable predictor of the age at menopause. Our objective was to study the longitudinal intra-individual decline of serum AMH levels in female RA patients.MethodsFemale RA patients from a nationwide prospective cohort (2002–2008) were re-assessed in 2015–2016. Serum AMH levels were measured using the picoAMH assay and compared with healthy controls. A linear mixed model (LMM) was built to assess the effect of RA-related clinical factors on the decline of AMH levels.ResultsA group of 128 women were re-assessed at an age of 42.6±4.4 years, with a median disease duration of 15.8 (IQR 12.7–21.5) years. The time between first and last AMH assessments was 10.7±1.8 (range 6.4–13.7) years. Participants represented a more fertile selection of the original cohort. At follow-up, 39% of patients had AMH levels below the 10th percentile of controls (95% CI 31% to 48%), compared with 16% (95% CI 9.3% to 22%) at baseline. The LMM showed a significant decline of AMH with increasing age, but no significant effect of RA-related factors on AMH.ConclusionAMH levels in RA patients showed a more pronounced decline over time than expected, supporting the idea that in chronic inflammatory conditions, reproductive function is compromised, resulting in a faster decline of ovarian function over time and probably an earlier age at menopause.

scholarly journals Acute Comparative Effect of Foam Rolling and Static Stretching on Range of Motion in Rowers

2021 ◽  
Vol 13 (7) ◽  
pp. 3631
Author(s):  
Alfonso Penichet-Tomas ◽  
Basilio Pueo ◽  
Marta Abad-Lopez ◽  
Jose M. Jimenez-Olmedo
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Static Stretching ◽  
Foam Rolling ◽  
Significant Difference ◽  
Post Test ◽  
Alternating Treatment Design ◽  
Stroke Amplitude ◽  
Treatment Design ◽  
Over Time

Rowers’ anthropometric characteristics and flexibility are fundamental to increase stroke amplitude and optimize power transfer. The aim of the present study was to analyze the effect of foam rolling and static stretching on the range of motion over time. Eight university rowers (24.8 ± 3.4 yrs., height 182.3 ± 6.5 cm, body mass 79.3 ± 4.6 kg) participated in an alternating treatment design study with two-way repeated measures ANOVA. The sit and reach test was used to measure the range of motion. Both in the foam rolling and in the static stretching method, a pre-test (T0), a post-test (T1), and a post-15-min test (T2) were performed. A significant effect was observed on the range of motion over time (p < 0.001), but not for time x method interaction (p = 0.680). Significant differences were found between T0 and T1 with foam rolling and static stretching (p < 0.001, d = 0.4); p < 0.001, d = 0.6). The differences between T0 and T2 were also significant with both methods (p = 0.001, d = 0.4; p < 0.001, d = 0.4). However, no significant difference was observed between T1 and T2 (p = 1.000, d = 0.1; p = 0.089, d = 0.2). Foam roller and static stretching seem to be effective methods to improve the range of motion but there seems to be no differences between them.

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