scholarly journals ONLINE-TICS: Internet-Delivered Behavioral Treatment for Patients with Chronic Tic Disorders

2022 ◽  
Vol 11 (1) ◽  
pp. 250
Author(s):  
Martina Haas ◽  
Ewgeni Jakubovski ◽  
Katja Kunert ◽  
Carolin Fremer ◽  
Nadine Buddensiek ◽  
...  
Keyword(s):  
Behavioral Treatment ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Secondary Analysis ◽  
Tic Disorders ◽  
Clear Trend ◽  
First Line Therapy ◽  
Significant Difference ◽  
Chronic Tic Disorders ◽  
The Difference

Comprehensive Behavioral Intervention for Tics (CBIT) is considered a first-line therapy for tics. However, availability of CBIT is extremely limited due to a lack of qualified therapists. This study is a multicenter (n = 5), randomized, controlled, observer-blind trial including 161 adult patients with chronic tic disorders (CTD) to provide data on efficacy and safety of an internet-delivered, completely therapist-independent CBIT intervention (iCBIT Minddistrict®) in the treatment of tics compared to placebo and face-to-face (f2f) CBIT. Using a linear mixed model with the change to baseline of Yale Global Tic Severity Scale-Total Tic Score (YGTSS-TTS) as a dependent variable, we found a clear trend towards significance for superiority of iCBIT (n = 67) over placebo (n = 70) (−1.28 (−2.58; 0.01); p = 0.053). In addition, the difference in tic reduction between iCBIT and placebo increased, resulting in a significant difference 3 (−2.25 (−3.75; −0.75), p = 0.003) and 6 months (−2.71 (−4.27; −1.16), p < 0.001) after the end of treatment. Key secondary analysis indicated non-inferiority of iCBIT in comparison to f2f CBIT (n = 24). No safety signals were detected. Although the primary endpoint was narrowly missed, it is strongly suggested that iCBIT is superior compared to placebo. Remarkably, treatment effects of iCBIT even increased over time.

Remembered preoperative Quick disabilities of the arm, shoulder and hand (QuickDASH) scores

2016 ◽  
Vol 42 (1) ◽  
pp. 78-83 ◽  
Author(s):  
A. H. Wormdal ◽  
S. H. Tallaksen ◽  
Ø. Hagen ◽  
O. A. Foss ◽  
V. Finsen
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Patient Reported Outcome ◽  
Level Of Evidence ◽  
Surgery Patient ◽  
Significant Difference ◽  
Patient Reported ◽  
Basal Joint ◽  
Tunnel Syndrome ◽  
The Difference

The Quick disabilities of the arm, shoulder and hand (QuickDASH) patient-reported outcome measure is frequently used to assess disabilities and symptoms of the upper extremity. This study compares real preoperative QuickDASH scores and remembered preoperative QuickDASH scores. Remembered preoperative QuickDASH scores were obtained 45 months (39–67) after surgery. Patient material consisted of 160 patients operated for Dupuytren’s contracture, carpal tunnel syndrome, thumb basal joint arthrosis, and shoulder pain. All patients had completed QuickDASH questionnaires before surgery. Paired T-tests, linear mixed models, and limits of agreement were used for analyses. There was a significant difference between remembered and real preoperative scores (mean 7.6, SD 15.6; SEM 1.2). Neither diagnosis, age, gender, nor time between surgery and review influenced the difference significantly. A linear mixed model was constructed to investigate the ability to retrospectively predict preoperative QuickDASH scores. Remembered preoperative QuickDASH cannot be used in individual patients because of the high inaccuracy. Level of evidence: III

scholarly journals Continuous Non-Invasive Arterial Pressure Monitoring (ClearSight System) and Ankle Blood Pressure Measurements as Alternatives to Conventional Arm Blood Pressure

2020 ◽  
Vol 9 (11) ◽  
pp. 3615
Author(s):  
Seohee Lee ◽  
Jaeyeon Chung ◽  
Jinyoung Bae ◽  
Youn Joung Cho ◽  
Karam Nam ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Blood Pressure ◽  
Least Squares ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Non Invasive ◽  
Significant Difference ◽  
The Difference

Measuring blood pressure (BP) via a pneumatic cuff placed around the arm has long been the standard method. However, in clinical situations where BP monitoring at the arm is difficult, the ankle is frequently used instead. We compared continuous non-invasive blood pressure (CNBP) measurements obtained at the finger, ankle BP and arm BP in patients undergoing breast cancer surgery. Arm BP, ankle BP (both obtained with a conventional pneumatic cuff) and CNBP measurements were obtained every 2.5 min during surgery. Correlation and Bland–Altman analyses were performed and differences among measurements were analyzed using a linear mixed model. A total of 245 sets of BP measurements were obtained from 10 patients. All systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) measurements of ankle BP and CNBP were positively correlated with the arm BP measurements (Spearman rho 0.688–0.836, p < 0.001 for each correlation). The difference between CNBP and arm SBP was significantly smaller (least squares mean (95% confidence interval): −6.03 (−11.40, −0.67)) compared to that between ankle and arm SBP (least squares mean (95% CI): −15.32 (−20.69, −9.96), p = 0.019). However, this significant difference was not observed in DBP and MBP (−1.23 vs. 1.75, p = 0.190 and −3.85 vs. −2.63, p = 0.604, respectively). Ankle SBP measurements showed larger differences from arm SBP measurements than did CNBP SBP measurements in patients undergoing breast cancer surgery. CNBP could serve as a useful alternative to ankle BP when standard arm BP measurements cannot be obtained.

scholarly journals How Perceived Sensory Dimensions of Forest Park Are Associated with Stress Restoration in Beijing?

2022 ◽  
Vol 19 (2) ◽  
pp. 883
Author(s):  
Congying An ◽  
Jinglan Liu ◽  
Qiaohui Liu ◽  
Yuqi Liu ◽  
Xiaoli Fan ◽  
...  
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Individual Characteristics ◽  
Forest Park ◽  
Positive Effects ◽  
Activity Intensity ◽  
Visit Frequency ◽  
Significant Difference ◽  
Visit Duration ◽  
Forest Parks

A growing number of studies suggest that the perceived sensory dimensions (PSDs) of green space are associated with stress restoration offered by restorative environment. However, there is little known about PSDs and stress restoration as well as their relationship to forest park. To fill this gap, an on-site questionnaire survey was conducted in three forest parks in Beijing, as a result of which a total number of 432 completed responses were collected and analyzed. The mean values of PSDs were used to represent PSDs of forest park. Using independent sample t-test and ANOVA, this study analyzed the individual characteristics that affected PSDs and stress restoration. Linear mixed model was used to identify the relationship between PSDs and stress restoration of forest park, which took into account the interactions of stress level and PSDs. The results showed that: (1) the perceived degree of PSDs in forest park from strong to weak was Serene, Space, Nature, Rich in species, Prospect, Refuge, Social and Culture, which varied with visitors’ gender, age, level of stress, visit frequency, activity intensity, visit duration and commuting time; (2) in PSDs, Refuge, Serene, Social and Prospect had significantly positive effects on the stress restoration of forest parks (3) there was no significant difference in the effect of the eight PSDs on the stress restoration between different stress groups; (4) stress restoration was influenced by visitors’ gender, age, visit frequency and visit duration. These findings can offer references for managers to improve the health benefits of forest park for visitors, and can enrich the knowledge about PSDs and stress restoration.

scholarly journals The nasopharyngeal, ruminal, and vaginal microbiota and the core taxa shared across these microbiomes in virgin yearling heifers exposed to divergent in utero nutrition during their first trimester of gestation and in pregnant beef heifers in response to mineral supplementation

2021 ◽  
Author(s):  
Samat Amat ◽  
Devin B Holman ◽  
Kaycie Schmidt ◽  
Ana Clara B Menezes ◽  
Friederike Baumgaertner ◽  
...  
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
First Trimester ◽  
Nervous System Development ◽  
Vaginal Microbiota ◽  
Rrna Gene ◽  
Beef Heifers ◽  
Mineral Supplement ◽  
Alpha And Beta Diversity ◽  
Significant Difference

Emerging evidence has indicated that microbial transmission from the bovine dam to her fetus may take place before birth, and that the maternal microbiota during pregnancy modulates programming of fetal metabolic and nervous system development, highlighting the potential and extended role of the maternal microbiome in calf health and development. In the present study, we characterized the nasopharyngeal, ruminal and vaginal microbiota from two cohorts of beef heifers managed at the same location: 1) virgin yearling heifers (9 months old) born from dams received gestational diets which resulted in low (LG, n = 22) or medium (MG, n = 23) weight gain during the first 84 days of gestation; and 2) pregnant replacement heifers that received a vitamin and mineral supplement (VTM, n = 17) or not (Control, n = 15) during the first 6 months of gestation. Nasopharyngeal and vaginal swabs as well as ruminal fluid were collected from both cohorts and the microbiota of each sample was assessed using 16S rRNA gene sequencing. In addition to the comparison between treatment groups within each cohort, the similarity of the microbiota of the three sample types were evaluated, and shared taxa amongst these communities were identified. The bacterial genera present in the rumen and vagina that can influence methanogenic archaeal genera were predicted using a stepwise-selected generalized linear mixed model. No significant difference was observed in the alpha and beta diversity in any of the nasopharyngeal, ruminal and vaginal microbiota between LG and MG offspring virgin heifers, or between the control and VTM pregnant heifers (p > 0.05). Subtle compositional changes in the vaginal microbiota in yearling heifers, and in the nasopharyngeal and ruminal microbiota of pregnant heifers were detected in response to treatments. Forty-one archaeal and bacterial OTUs were shared by over 60% of all samples from both virgin and pregnant heifers. Two taxa within the Methanobrevibacter genus were identified as core taxa and this genus was more relatively abundant in pregnant heifers compared to virgin heifers. Among the 25 top genera, Prevotella and Prevotella UCG-003 (negative) and Christensenellaceae R-7 group (positive) were predicted to have a significant effect on ruminal Methanobrevibacter spp. The results of this study indicate that there is little impact of divergent gestational nutrition during the first trimester on the calf microbiome at 9 months postnatal, and that VTM supplementation during pregnancy may not alter the maternal microbiome. This study provides evidence that there are several microbial taxa, including methanogenic archaea, that are shared across the respiratory, gastrointestinal, and reproductive tracts, suggesting the need for a holistic evaluation of the bovine microbiota when considering potential maternal sources for seeding calves with pioneer microbiota.

Abstract NS10: Patients with Mild and Moderate Stroke Have Frequent, Severe, and Persistent Impairment in Information Processing Speed

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Susan Alderman ◽  
Terri Armstrong ◽  
Geri Wood ◽  
Sean Savitz ◽  
Joshua Breier
Keyword(s):  
Information Processing ◽  
Processing Speed ◽  
Memory Impairment ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Stroke Recovery ◽  
Stroke Severity ◽  
Information Processing Speed ◽  
Significant Difference ◽  
Mild Stroke

Background: One year after stroke 50-70% of survivors have information processing speed (IPS) impairment. IPS is a complex, elemental cognitive function with close but separate relationships with memory, attention, executive function, reading, and writing. IPS impairment can be devastating, even without physical deficits. Hypothesis: The frequency and severity of IPS impairment in patients with acute stroke is unrelated to stroke severity. Methods: In a longitudinal study, 30 adults with acute mild (NIHSS <5) versus moderate stroke (NIHSS 5-12) were assessed for IPS and memory impairments at three time points (< 72 hours, Week 3, and Week 12). The Symbol Digit Modalities Test (SDMT) was the primary IPS instrument, scores below the norm (51-62 points) indicate impairment. Results: Using linear mixed model regression, no significant difference was noted between patients with mild and moderate stroke in frequency and severity of IPS impairment (p=0.2). All patients had baseline abnormal SDMT scores, improving 21% by Week 12 (p=.005) with one patient scoring as unimpaired (51 points). Patients with mild stroke (n=18) had baseline scores on average 53% lower than SDMT norm (mean score 24 (12), [95% CI] 6 [18, 30], Standard Error (SEM) 3) and 32% lower at Week 12 (mean 34 (11), [95% CI] 5 [29, 40], SEM 3). Patients with moderate stroke (n=12) had baseline SDMT scores 60% lower than norm (mean 21 (11), [95% CI] 6 [15, 27], SEM 3) and 39% lower by Week 12 (mean 31 (12), [95% CI] 7 [25, 38], SEM 3). Memory impairment at enrollment (<72 hours post stroke) was noted in 100% of patients with moderate stroke and 78% of patients with mild stroke; at Week 12 the frequency of memory impairment was equal in both groups (67%). Conclusion: IPS were critically impaired, in both mild and moderate stroke, with minimal spontaneous recovery at Week 12. IPS impairment is clinically significant during stroke recovery. IPS impairment should be considered in the planning of healthcare of stroke victims even with mild stroke.

scholarly journals The northernmost haulout site of South American sea lions and fur seals in the western South Atlantic

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Natália Procksch ◽  
M. Florencia Grandi ◽  
Paulo Henrique Ott ◽  
Karina Groch ◽  
Paulo A. C. Flores ◽  
...  
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Elephant Seal ◽  
Southern Elephant Seal ◽  
South American ◽  
Mirounga Leonina ◽  
Sea Lions ◽  
Significant Difference ◽  
Northern Portion ◽  
Kernel Density Analysis

AbstractWe present estimates of the seasonal and spatial occupation by pinnipeds of the Wildlife Refuge of Ilha dos Lobos (WRIL), based on aerial photographic censuses. Twenty aerial photographic censuses were analysed between July 2010 and November 2018. To assess monthly differences in the numbers of pinnipeds in the WRIL we used a Generalized Linear Mixed Model. Spatial analysis was carried out using Kernel density analysis of the pinnipeds on a grid plotted along the WRIL. Subadult male South American sea lions (Otaria flavescens) were the most abundant pinniped in the WRIL. Potential females of this species were also recorded during half of the census. The maximum number of pinnipeds observed in the WRIL was 304 in September 2018, including an unexpected individual southern elephant seal (Mirounga leonina), and a high number of South American fur seal yearlings (Arctocephalus australis). However, there was no statistically significant difference in counts between months. In all months analysed, pinnipeds were most often found concentrated in the northern portion of the island, with the highest abundances reported in September. This study confirms the importance of the WRIL as a haulout site for pinnipeds in Brazil, recommends that land research and recreational activities occur in months when no pinnipeds are present, and encourages a regulated marine mammal-based tourism during winter and spring months.

Appetite-stimulating effect of gabapentin vs mirtazapine in healthy cats post-ovariectomy

2020 ◽  
Vol 22 (12) ◽  
pp. 1176-1183
Author(s):  
Marco Fantinati ◽  
Julien Trnka ◽  
Amélia Signor ◽  
Séverine Dumond ◽  
Géraldine Jourdan ◽  
...  
Keyword(s):  
Placebo Group ◽  
Food Intake ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Repeated Measure ◽  
Mixed Model Analysis ◽  
Treatment Groups ◽  
Significant Difference ◽  
Post Hoc ◽  
Difference Test

Objectives The aim of the study was to evaluate the appetite-stimulating effect of gabapentin by comparing it with mirtazapine in healthy cats in the first 8 h after ovariectomy surgery. Methods This double-masked, placebo-controlled, prospective clinical trial included 60 healthy cats presented to the hospital for ovariectomy: 20 received gabapentin, 21 received mirtazapine and 19 received a placebo immediately before and 6 h after surgery. Food was offered at 2, 4, 6 and 8 h post-ovariectomy. After each meal, food intake was measured. Data were analysed using repeated-measure ANOVA and a linear mixed-model analysis. Post-hoc Tukey’s honest significant difference test was performed for multiple comparisons. Results Food intake increased in both treatment groups vs placebo. No statistically significant difference was found between cats treated with gabapentin or mirtazapine. Conclusions and relevance Cats receiving gabapentin ate more than cats in the placebo group. Thirty percent of cats in the gabapentin group covered their resting energy requirements, while none of the cats in the placebo group did. Gabapentin and mirtazapine produced similar effects on food intake.

scholarly journals Exercise-induced hypoalgesia in women with varying levels of menstrual pain

2018 ◽  
Vol 18 (2) ◽  
pp. 303-310 ◽  
Author(s):  
Mervyn Travers ◽  
Penny Moss ◽  
William Gibson ◽  
Dana Hince ◽  
Sheree Yorke ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Random Effect ◽  
Activity Levels ◽  
Menstrual Pain ◽  
Isometric Handgrip ◽  
Pressure Pain Thresholds ◽  
Significant Difference ◽  
Exercise Induced

Abstract Background and aims: Exercise-induced hypoalgesia (EIH) is a well-established phenomenon in pain-free individuals that describes a decrease in pain sensitivity after an acute bout of exercise. The EIH response has been demonstrated to be sub-optimal in the presence of persisting pain. Menstrual pain is a common recurrent painful problem with many women experiencing high levels of pain each cycle. However, the EIH response has not been examined in a cohort of women with high levels of menstrual pain. This research aimed to examine whether EIH manifests differently in women with varying levels of menstrual pain. The primary hypothesis was that women with high levels of menstrual pain would demonstrate compromised EIH. Secondary aims were to explore relationships between EIH and emotional state, sleep quality, body mass index (BMI) or physical activity levels. Methods: Pressure pain thresholds (PPT) were measured in 64 participants using a digital handheld algometer before and after a submaximal isometric-handgrip exercise. EIH index was compared between low (VAS 0–3), moderate (VAS 4–7) and high (VAS 8–10) pain groups, using a linear mixed model analysis with participant as a random effect, and site, menstrual pain category and the interaction between the two, as fixed effects. Results: EIH was consistently induced in all groups. However, there was no statistically significant difference between the pain groups for EIH index (p=0.835) or for any co-variates (p>0.05). Conclusions: EIH was not found to differ between women who report regular low, moderate or high levels of menstrual pain, when measured at a point in their menstrual cycle when they are pain free. Implications: This study provides insight that EIH does not vary in women with differing levels of menstrual pain when they are not currently experiencing pain. The current findings indicate that, although menstrual pain can involve regular episodes of high pain levels, it may not be associated with the same central nervous system dysfunctions as seen in sustained chronic pain conditions.

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.

scholarly journals Assessment of Macular Function in Patients With Non-Vascularized Pigment Epithelial Detachment

2020 ◽  
Author(s):  
Ryo Asaoka ◽  
Tatsuya Inoue ◽  
Tatsuaki Amari ◽  
Kayoko Komatsu ◽  
Motoshi Yamamoto ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Function ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Retinal Pigment ◽  
Age Related Macular Degeneration ◽  
Retinal Sensitivity ◽  
Optical Coherence ◽  
Pigment Epithelial ◽  
Significant Difference

Abstract Non-vascularized pigment epithelial detachments (PED) are usually associated with dry age-related macular degeneration (AMD). In this study, we aimed to investigate the correlation between visual function and morphologic parameters. Seventeen eyes of eleven patients with non-vascularized AMD were enrolled. In addition to conventional optical coherence tomography (OCT), polarization-sensitive optical coherence tomography (PS-OCT) measurements were performed by evaluating the regularity of retinal pigment epithelium (RPE) entropy within the PED area. Retinal sensitivity was measured with MP-3 microperimetry, and retinal sensitivities within (RSin) and outside (RSout) the PED area were calculated. The relationship between OCT parameters and visual function was analyzed. As a result, there was a significant difference between the RSin and RSout (p < 0.001, Wilcoxon signed rank test). Moreover, RSin was significantly related to logMAR VA (p = 0.033, linear mixed model). The regularity of RPE entropy was significantly related to visual acuity and RSin (p = 0.00038, p = 0.031, linear mixed model), although neither the height nor area of PED correlated with visual function. Our results suggest that retinal sensitivity is significantly deteriorated within the PED area and RPE entropy measured with PS-OCT was closely related to visual function in eyes with non-vascularized PED.

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