No relevant differences in conditioned pain modulation effects between parallel and sequential test design. A cross-sectional observational study

Background Conditioned pain modulation (CPM) is measured by comparing pain induced by a test stimulus with pain induced by the same test stimulus, either during (parallel design) or after (sequential design) the conditioning stimulus. Whether design, conditioning stimulus intensity and test stimulus selection affect CPM remains unclear. Methods CPM effects were evaluated in healthy participants (N = 89) at the neck, forearm and lower leg using the cold pressor test as the conditioning stimulus. In three separate experiments, we compared the impact of (1) design (sequential versus parallel), (2) conditioning stimulus intensity (VAS 40/100 versus VAS 60/100), and (3) test stimulus selection (single versus dual, i.e., mechanical and thermal). Statistical analyses of the main effect of design (adjusted for order) and experiment were conducted using linear mixed models with random intercepts. Results No significant differences were identified in absolute CPM data. In relative CPM data, a sequential design resulted in a slightly lower CPM effect compared to a parallel design, and only with a mechanical test stimulus at the neck (−6.1%; 95% CI [−10.1 to −2.1]) and lower leg (−5.9%; 95% CI [−11.7 to −0.1]) but not forearm (−4.5%; 95% CI [−9.0 to 0.1]). Conditioning stimulus intensity and test stimulus selection did not influence the CPM effect nor the difference in CPM effects derived from parallel versus sequential designs. Conclusions Differences in CPM effects between protocols were minimal or absent. A parallel design may lead to a minimally higher relative CPM effect when using a mechanical test stimulus. The conditioning stimulus intensities assessed in this study and performing two test stimuli did not substantially influence the differences between designs nor the magnitude of the CPM effect.

Socialising Office Space: Flexibility through a layering of multiple programs in traditional office buildings.

<p>This design-research project explores extending the flexibility of a typical 1960s open-plan office building. Through the use of cross-programming, the building now works along a 24- hour timespan. Housing a co-working office, community space and a night shelter, the building models a more efficient use of office space within our central cities. A focus on the individual allows a meaningful connection to space and to others through parallel design interventions that operate as desks and as sleeping pods.</p>

Socialising Office Space: Flexibility through a layering of multiple programs in traditional office buildings.

<p>This design-research project explores extending the flexibility of a typical 1960s open-plan office building. Through the use of cross-programming, the building now works along a 24- hour timespan. Housing a co-working office, community space and a night shelter, the building models a more efficient use of office space within our central cities. A focus on the individual allows a meaningful connection to space and to others through parallel design interventions that operate as desks and as sleeping pods.</p>

Exercise priming with transcranial direct current stimulation: a study protocol for a randomized, parallel-design, sham-controlled trial in mild cognitive impairment and Alzheimer’s disease

Background Transcranial direct current stimulation (tDCS) is a non-invasive type of brain stimulation that uses electrical currents to modulate neuronal activity. A small number of studies have investigated the effects of tDCS on cognition in patients with Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD), and have demonstrated variable effects. Emerging evidence suggests that tDCS is most effective when applied to active brain circuits. Aerobic exercise is known to increase cortical excitability and improve brain network connectivity. Exercise may therefore be an effective, yet previously unexplored primer for tDCS to improve cognition in MCI and mild AD. Methods Participants with MCI or AD will be randomized to receive 10 sessions over 2 weeks of either exercise primed tDCS, exercise primed sham tDCS, or tDCS alone in a blinded, parallel-design trial. Those randomized to an exercise intervention will receive individualized 30-min aerobic exercise prescriptions to achieve a moderate-intensity dosage, equivalent to the ventilatory anaerobic threshold determined by cardiopulmonary assessment, to sufficiently increase cortical excitability. The tDCS protocol consists of 20 min sessions at 2 mA, 5 times per week for 2 weeks applied through 35 cm2 bitemporal electrodes. Our primary aim is to assess the efficacy of exercise primed tDCS for improving global cognition using the Montreal Cognitive Assessment (MoCA). Our secondary aims are to evaluate the efficacy of exercise primed tDCS for improving specific cognitive domains using various cognitive tests (n-back, Word Recall and Word Recognition Tasks from the Alzheimer’s Disease Assessment Scale-Cognitive subscale) and neuropsychiatric symptoms (Neuropsychiatric Inventory). We will also explore whether exercise primed tDCS is associated with an increase in markers of neurogenesis, oxidative stress and angiogenesis, and if changes in these markers are correlated with cognitive improvement. Discussion We describe a novel clinical trial to investigate the effects of exercise priming before tDCS in patients with MCI or mild AD. This proof-of-concept study may identify a previously unexplored, non-invasive, non-pharmacological combination intervention that improves cognitive symptoms in patients. Findings from this study may also identify potential mechanistic actions of tDCS in MCI and mild AD. Trial registration Clinicaltrials.gov, NCT03670615. Registered on September 13, 2018.

No effect of intradialytic neuromuscular electrical stimulation on inflammation and quality of life: a randomized and parallel design clinical trial

Neuromuscular electrical stimulation (NMES) elicits muscle contraction and has been shown to improvement of quality of life. However, if NMES improvement the quality of life and attenuate the inflammation is not fully understood. Therefore, our aim sought to assess the effects of short-term of intradialytic NMES on inflammation and quality of life in patients with chronic kidney disease patients undergoing hemodialysis. A randomized clinical trial conducted with parallel design enrolled adult hemodialysis patients three times a week during 1 month. Patients were randomly assigned to two groups (control group, n = 11; 4F/7 M) or (NMES group, n = 10; 4F/6 M). Pre-and post-intervention, was measured the high-sensitivity C reactive protein, interleukin-6, interleukin-10, and TNFα by the ELISA, and quality of life was applied using the SF-36. During each hemodialysis session, NMES was applied bilaterally at thigh and calves for 40 min. There was not change in cytokines (hs-CRP, IL-6, IL-10, and TNFα) concentrations time × group interaction. In addition, no difference was found in eight domains of quality of life. In addition, the groups did not differ for muscle strength and muscle mass. In conclusion, we found that intradialytic NMES did not change inflammation neither quality of life.

Are the Learning Styles of Elementary School Students Related to Their Academic Success? A Study of Mixed Research Methods

The aim of this study is to point out the relationship between learning styles and the academic. The purpose of this study is to show the relationship between learning styles and academic achievement of 4th grade elementary students. The study was designed according to the convergent parallel design, one of the mixed research designs in which quantitative and qualitative research methods are used together. While the quantitative and qualitative data are collected together in accordance with the convergent parallel design, the data analysis is presented separately in the results section. The study group of the research consists of 163 grade 4 primary school students, 74 girls (n=74) and 89 (n=89) boys, taught in a government primary school in Istanbul Turkey. To find out whether learning styles predict academic achievement, linear regression analysis was conducted. On the other hand, descriptive analysis and content analysis were used in the qualitative data analysis. In this study, it was found that learning styles predict academic achievement. It was also found that students tend to discover their own learning methods, and depending on which method they prefer, the academic area in which they succeed differs.

A Mixed-methods Approach to Understanding the Perspectives, Experiences and Attitudes of Cognitive Behavioral Therapy for African American Patients with Type-2 Diabetes: A Randomized Parallel Design Pilot Study

BackgroundAfrican American (AA) adults are 60% more likely to be diagnosed with diabetes mellitus (DM) and experience more complications than non-Hispanic White adults. Cognitive behavioral therapy (CBT) is a technique that combines traditional care with cognitive and psychosocial techniques. We aimed to assess the effects of CBT integrated with motivational interviewing (MI) on glycemic control in AA participants and understand their perspectives, attitudes, and experiences toward CBT. MethodsUsing a randomized, parallel design pilot study (web-based group vs in-person group), 20 participants aged >18 years, identifying as AA, and having a glycosylated hemoglobin (HbA1c) > 8%, were recruited. CBT was administered in six sessions over three months. Participants completed baseline and follow-up assessments on measures for diabetes control (HbA1c), self-efficacy, generalized anxiety, depression, perceived stress, health-related quality of life and cognitive ability. Post-CBT focus groups were conducted to determine patient perspectives regarding the intervention. ResultsFourteen participants completed the study, their mean HbA1c improved from 8.5% to 7.7%. The Diabetes Distress Scale demonstrated decreased distress overall (t(26)=2.6; p- value=0.02). The Generalized Anxiety Disorder Scale demonstrated decreased generalized anxiety for all participants (t(26)=2.2; p =0.04). Themes identified in focus groups included: (1) intervention group social support through information sharing; (2) mental health and personal identities in diabetes understanding and management; (3) receptivity to CBT/MI Intervention positively impacts self-efficacy through improved health literacy. ConclusionGroup-based CBT intervention for type 2 DM care was positively received by AA participants and helped improve diabetes control, as demonstrated by the change in HbA1c. There were additional benefits of social support through group interactions and a stronger sense of self-efficacy due to health education. A comprehensive treatment plan like CBT, may be useful in promoting healthy diabetes self-management.Trial registrationThis trial is registered at ClinicalTrials.gov with the identifier NCT03562767. 70 Registered 19 June 2018, https://clinicaltrials.gov/ct2/show/NCT03562767?term=NCT03562767&draw=2&rank=1

Folium Sennae Increased the Bioavailability of Methotrexate through Modulation on MRP 2 and BCRP

Folium Sennae (FS), a popular laxative (Senna), contains polyphenolic anthranoids, whose conjugation metabolites are probable modulators of multidrug resistance-associated proteins (MRPs) and breast cancer resistance protein (BCRP). We suspected that the combined use of FS might alter the pharmacokinetics of various medicines transported by MRPs or BCRP. This study investigated the effect of FS on the pharmacokinetics of methotrexate (MTX), an anticancer drug and a probe substrate of MRPs/BCRP. Rats were orally administered MTX alone and with two dosage regimens of FS in a parallel design. The results show that 5.0 g/kg of FS significantly increased the AUC0–2880, AUC720–2880 and MRT of MTX by 45%, 102% and 42%, and the seventh dose of 2.5 g/kg of FS significantly enhanced the AUC720–2880 and MRT by 78% and 42%, respectively. Mechanism studies indicated that the metabolites of FS (FSM) inhibited MRP 2 and BCRP. In conclusion, the combined use of FS increased the systemic exposure and MRT of MTX through inhibition on MRP 2 and BCRP.