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Nevin Manimala Statistics

Maintenance of Aerobic or Resistance Training After an Exercise Intervention Among Breast Cancer Patients After Neoadjuvant Chemotherapy

J Phys Act Health. 2023 Oct 17:1-11. doi: 10.1123/jpah.2023-0054. Online ahead of print.

ABSTRACT

BACKGROUND: Exercise interventions have been shown to be beneficial for cancer patients regarding various treatment-related side effects and quality of life. For sustainable effects, patients should continue the training. Therefore, we investigated the maintenance of an exercise training in breast cancer patients, reasons for (dis)continuation, and explored possible influencing factors.

METHODS: The investigation is based on a 3-arm randomized intervention trial comparing aerobic and resistance training (19 [4]) during or after neoadjuvant chemotherapy among breast cancer patients. About 2 years after breast surgery, 68 patients (age 52 [11] y) provided information about training continuation, self-reported reasons of (dis)continuation, sociodemographics, employment status, age, and body mass index. Training continuation was investigated with Kaplan-Meier analyses.

RESULTS: The intervention was rated as good or very good by 88.1% of participants. Nevertheless, 52.9% discontinued the training directly, but half of them changed to different types of exercise. Reasons for discontinuation included lack of time and long travel distance to the training facility. The median continuation was 19.0 months (Q1, Q3: 5.5, 36.0) with no statistically significant difference between the intervention groups. Younger, better educated, partnered patients tended toward longer training continuation.

CONCLUSIONS: The majority of patients continued exercising after the end of intervention. However, a nonnegligible number discontinued training immediately or after few months. Practical, social, and financial support for a transition to an adequate training that is affordable and feasible in the patient’s daily life might foster training maintenance. Especially patients who are less educated, elderly, or living alone may need more support to continue exercising.

PMID:37917983 | DOI:10.1123/jpah.2023-0054

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Nevin Manimala Statistics

Test-Retest Reliability of 3 Specific Strength Tests in Professional Handball Players

J Sport Rehabil. 2023 Oct 10:1-10. doi: 10.1123/jsr.2022-0267. Online ahead of print.

ABSTRACT

CONTEXT: Current devices to assess strength performance in handball may not be sufficiently sports-specific and reliable methods. Functional electromechanical dynamometry is a new technology that allows the development of accurate strength tests in athletes.

PURPOSE: To determine the absolute and relative reliability and to compare the reliability of the right and left side, and mean and peak force of 3 specific strength tests in handball players with a functional electromechanical dynamometer: unilateral pullover, standing lift, and step forward.

METHODS: Fourteen male handball players of the first Spanish division (28.79 [4.81] y; 10.38 [4.63] y of professional experience) performed a repeated-measurement design. Three testing sessions were performed (one per week). The first measurement consisted of 4 isometric tests (right and left unilateral pullover, and right and left standing lift) to obtain isometric peak force, and in the second and third sessions, 6 incremental tests until failure (right and left unilateral pullover, and right and left standing lift, right and left step forward) were performed.

RESULTS: The tests provided high reliability or acceptable reliability for mean and peak strength of unilateral pullover, standing lift and step forward (intraclass correlation coefficient = .83-.97; coefficient of variation = 3.90-11.57). Effect side was negligible in any of the parameters, except for a small effect side in the left peak force for unilateral pullover and a small effect side on the left side for a step forward. Significant differences in reliability (coefficient of variation ratio > 1.15) were found between the right and left sides and peak and mean force in all exercises except peak force in unilateral pullover and step forward.

CONCLUSION: These results confirm that the tests could be applied to assess physical performance in handball at the same time as regular gym training. Moreover, this is an excellent opportunity to individualize the player’s weekly load.

PMID:37917982 | DOI:10.1123/jsr.2022-0267

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Six Weeks of Unilateral Flywheel Hip-Extension and Leg-Curl Training Improves Flywheel Eccentric Peak Power but Does Not Enhance Hamstring Isokinetic or Isometric Strength

Int J Sports Physiol Perform. 2023 Oct 14:1-10. doi: 10.1123/ijspp.2023-0035. Online ahead of print.

ABSTRACT

PURPOSE: This preregistered trial investigated how 6 weeks of unilateral flywheel leg-curl and hip-extension training impact isokinetic, isometric, and flywheel strength and power outcomes.

METHODS: The study involved 11 male university athletes (age 22 [2] y; body mass 77.2 [11.3] kg; height 1.74 [0.09] m) with one leg randomly allocated to flywheel training and one leg to control. Unilateral eccentric and isometric knee-flexion torque and flywheel unilateral leg-curl and hip-extension peak power were tested. Training intensity and volume (3-4 sets of 6 + 2 repetitions) were progressively increased.

RESULTS: The intervention enhanced hip-extension concentric (P < .01, d = 1.76, large) and eccentric (P < .01, d = 1.33, large) peak power more than the control (significant interaction effect). Similarly, eccentric (P = .023, d = 1.05, moderate) peak power was enhanced for the leg curl. No statistically significant differences between conditions were found for isokinetic eccentric (P = .086, d = 0.77, moderate) and isometric (P = .431, d = 0.36, small) knee-flexor strength or leg-curl concentric peak power (P = .339, d = 0.52, small). Statistical parametric mapping analysis of torque-angle curves also revealed no significant (P > .05) time-limb interaction effect at any joint angle.

CONCLUSION: Unilateral flywheel hamstring training improved knee-flexor eccentric peak power during unilateral flywheel exercise but not flywheel concentric, isokinetic eccentric, or isometric (long-lever) knee-flexor strength.

PMID:37917962 | DOI:10.1123/ijspp.2023-0035

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Nevin Manimala Statistics

Bulk and Compound-Specific Stable Isotope Analysis for the Authentication of Walnuts (Juglans regia) Origins

J Agric Food Chem. 2023 Nov 2. doi: 10.1021/acs.jafc.3c03770. Online ahead of print.

ABSTRACT

Walnuts are grown in various countries, and as product origin information is becoming more important to consumers, new techniques to differentiate walnut geographical authenticity are needed. We conducted bulk stable isotope analysis (BSIA) and compound-specific stable isotope analysis (CSIA) on walnuts grown in seven countries. The BSIA consisted of δ13Cbulk, δ15Nbulk, and δ34Sbulk, and CSIA covered δ2Hfatty acid, δ13Cfatty acid, δ13Camino acid, δ15Namino acid, and δ2Hamino acid. Analysis of variance (ANOVA) and linear discriminant analysis (LDA) were used for statistical analysis to compare samples from the USA and China. Parameters that yielded significant variations are δ2HC18:1n-9, δ13CC18:2n-6, δ13CC18:3n-3, δ13CGly, δ13CLeu, δ13CVal, δ2HGlu, δ2HIle, δ2HLeu, and δ2HThr. Our findings suggested that CSIA of fatty acids and amino acids can be useful to differentiate the geographical provenance of walnuts.

PMID:37917953 | DOI:10.1021/acs.jafc.3c03770

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Systematic analysis of copy number variants of uncertain significance partially overlapping with the haploinsufficient or triplosensitive genes in clinical testing

Ann Med. 2023;55(2):2276824. doi: 10.1080/07853890.2023.2276824. Epub 2023 Nov 2.

ABSTRACT

Background: Copy number variants of uncertain significance (VUS) has brought much distress for patients and great counselling challenges for clinicians. Of these, a special type of VUS (HT-VUS), harbouring one or both breakpoints within the established haploinsufficient or triplosensitive genes, were considered to be more likely to cause clinical effects compared with other types of VUS.Methods: We retrospectively evaluated the properties and clinical significance of those HT-VUS samples in clinical testing for chromosome microarray analysis (CMA).Results: A total of 7150 samples were selected for HT-VUS screening, and 75 (1.05%) subjects with 75 HT-VUS were found. The majority of these HT-VUS were heterozygous duplications and chromosome X had the most HT-VUS. The prevalence of HT-VUS was 0.90% (28/3116) for prenatal low-risk samples, 1.18% (26/2196) for prenatal high-risk samples, 1.37% (10/728) for postnatal samples and 0.99% (11/1110) for early pregnancy loss samples. However, the incidence of HT-VUS was not statistically different between different groups.Conclusions: HT-VUS (deletions or duplications) involving introns and HT-VUS (duplications) including terminal coding exons (either the first or last exons) might be clinically neutral. Our study will be helpful for both interpretation and genetic counselling in the future.

PMID:37917952 | DOI:10.1080/07853890.2023.2276824

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Representation of Women Authorship in the Top 5 Transplantation Journals in the United States

Transplantation. 2023 Nov 2. doi: 10.1097/TP.0000000000004844. Online ahead of print.

ABSTRACT

BACKGROUND: In the United States, only 13% of transplant surgeons are women. We evaluated gender distribution and trends of American authorship over the past 10 y in high-impact solid organ transplantation journals to gain insight into the current status of women authorship in transplantation.

METHODS: Original articles from 2012 to 2021 from the 5 highest-impact solid organ transplantation journals were extracted from Scopus. First and last author’s gender was predicted using Genderize.io. Data of first and last authors, article type and topic, location, citation, and funding metrics were analyzed. Chi-square, logistic regression, and trend tests were performed where appropriate. Statistical significance was set at <0.05.

RESULTS: Women’s first and last authorship increased over time among all journals. There was an increase in women first authors in the American Journal of Transplantation and in senior women authors in Liver Transplantation and Transplantation. Significant differences in gender authorship in lung, intestine, pancreas, general, and islet cell transplantation were found. Women’s last authorship was associated with 1.69 higher odds of having a woman first author when adjusting for year and journal. There was an increase in the rate of women’s first and last author collaborations over the years. Women last authors had 1.5 higher odds of being funded by the National Institutes of Health over the years.

CONCLUSIONS: Despite an increase in women transplant surgeons and physicians, the gap in women authorship in transplantation persists. Women’s last authorship was associated with higher odds of having a woman first author, pointing to the importance of mentorship for women joining the transplant academia.

PMID:37917944 | DOI:10.1097/TP.0000000000004844

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Intravenous Calcium to Decrease Blood Loss During Intrapartum Cesarean Delivery: A Randomized Controlled Trial

Obstet Gynecol. 2023 Nov 3. doi: 10.1097/AOG.0000000000005441. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate whether prophylactic administration of 1 g of intravenous calcium chloride after cord clamping reduces blood loss from uterine atony during intrapartum cesarean delivery.

METHODS: This single-center, block-randomized, placebo-controlled, double-blind superiority trial compared the effects of 1 g intravenous calcium chloride with those of saline placebo control on blood loss at cesarean delivery. Parturients at 34 or more weeks of gestation requiring intrapartum cesarean delivery after oxytocin exposure in labor were enrolled. Calcium or saline placebo was infused over 10 minutes beginning 1 minute after umbilical cord clamping in addition to standard care with oxytocin. The primary outcome was quantitative blood loss, analyzed by inverse Gaussian regression. Planned subgroup analysis excluded nonatonic bleeding, such as hysterotomy extension, arterial bleeding, and occult placenta accreta. We planned to enroll 120 patients to show a 200-mL reduction in quantitative blood loss in planned subgroup analysis, assuming up to 40% incidence of nonatonic bleeding (80% power, α<0.05).

RESULTS: From April 2022 through March 2023, 828 laboring parturients provided consent and 120 participants were enrolled. Median blood loss was 840 mL in patients allocated to calcium chloride (n=60) and 1,051 mL in patients allocated to placebo (n=60), which was not statistically different (mean reduction 211 mL, 95% CI -33 to 410). In the planned subgroup analysis (n=39 calcium and n=40 placebo), excluding cases of surgeon-documented nonatonic bleeding, calcium reduced quantitative blood loss by 356 mL (95% CI 159-515). Rates of reported side effects were similar between the two groups (38% calcium vs 42% placebo).

CONCLUSION: Prophylactic intravenous calcium chloride administered during intrapartum cesarean delivery after umbilical cord clamping did not significantly reduce blood loss in the primary analysis. However, in the planned subgroup analysis, calcium infusion significantly reduced blood loss by approximately 350 mL. These data suggest that this inexpensive and shelf-stable medication warrants future study as a novel treatment strategy to decrease postpartum hemorrhage, the leading global cause of maternal morbidity and mortality.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT05027048.

PMID:37917943 | DOI:10.1097/AOG.0000000000005441

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Measure of Auditory Working Memory Span Using Monosyllabic Word Recognition Test in Young Adults With Normal Hearing: A Preliminary Study

Am J Audiol. 2023 Nov 2:1-13. doi: 10.1044/2023_AJA-23-00090. Online ahead of print.

ABSTRACT

PURPOSE: Measuring working memory at hearing clinics is important. This study attempted to develop a test protocol that measures auditory working memory using a standardized monosyllabic word list in Korean Speech Audiometry (KSA).

METHOD: We included 25 young adults with normal hearing in this study. Participants conducted word recognition and word span tests concurrently using the KSA monosyllabic word lists. We designed four test conditions according to the presence or absence of background noise and word recall order: quiet-forward (QF), quiet-backward (QB), noise-forward, (NF), and noise-backward (NB). We implemented digit span tests in the Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV) to determine the validity of the working memory outcomes.

RESULTS: Word recognition scores of QF and QB were significantly higher than those of NF and NB. The percentages of correctly recalled words and word recall span scores were highest in QF and lowest in NB. Overall, the Pearson correlation and multiple regression statistics showed that our word span test outcomes for QB and NF were highly associated with digit span scores on the K-WAIS-IV.

CONCLUSION: Our proposed test protocol showed the possibility of measuring auditory working memory and monosyllabic word recognition simultaneously by validating the results with K-WAIS-IV outcomes.

PMID:37917922 | DOI:10.1044/2023_AJA-23-00090

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Self-Reported Symptoms of Vertigo and Imbalance Are Prevalent Among Adults With Chronic Moderate-Severe Traumatic Brain Injury: A Preliminary Analysis

Am J Audiol. 2023 Nov 2:1-6. doi: 10.1044/2023_AJA-23-00100. Online ahead of print.

ABSTRACT

PURPOSE: Dizziness and imbalance are common symptoms during the acute phase of traumatic brain injury (TBI). However, there is evidence to suggest that these symptoms persist into the chronic phase of injury. Few prospective studies have examined the frequency and type of dizziness and imbalance in adults with chronic moderate-severe TBI. The aim of this preliminary analysis was to investigate the prevalence of these symptoms in adults with chronic moderate-severe TBI.

METHOD: Twenty-four adults with chronic moderate-severe TBI and a group of 19 age-, sex-, and education-matched noninjured comparison participants were recruited. Self-reported dizziness and imbalance were measured using a modified version of a standard case history form. Significant associations between group (TBI group or noninjured comparison [NC] participants) and self-reports of dizziness, imbalance, and related symptoms (endorsed “yes” or “no”) were explored.

RESULTS: The TBI group most reported lightheadedness (75%), vertigo (38%), and imbalance and/or falling (46%). The most common related symptom reported by the TBI group was headache (63%) and nausea (46%). Significant associations revealed that the TBI group responded “yes” in higher percentages than the NC group across all categories (dizziness, imbalance, and related symptoms). There were no statistically significant relationships among dizziness, imbalance, or headache symptoms within the TBI group.

CONCLUSIONS: These preliminary findings suggest that dizziness and imbalance are prevalent in adults with chronic moderate-severe TBI. Persistent vertiginous symptoms may point to an underlying vestibular impairment. However, further research is needed to characterize vestibular function in chronic moderate-severe TBI.

PMID:37917920 | DOI:10.1044/2023_AJA-23-00100

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Hyperacusis Diagnosis and Management in the United States: Clinical Audiology Practice Patterns

Am J Audiol. 2023 Nov 2:1-12. doi: 10.1044/2023_AJA-23-00118. Online ahead of print.

ABSTRACT

PURPOSE: Hyperacusis often leads to debilitating psychosocial consequences, but there is no standard protocol for its diagnosis and management in the United States. In this study, we surveyed U.S. clinical audiologists to understand their education and clinical practices surrounding the evaluation and treatment of hyperacusis.

METHOD: An online survey was distributed to clinical audiologists across the United States. Survey responses were quantified using descriptive statistics and inductive content analysis.

RESULTS: Hyperacusis definitions and clinical practice patterns varied widely across the 102 respondents. Respondents cited a lack of education and training as the primary barrier to effective audiological diagnosis and management of hyperacusis, with most respondents reporting ≤ 5 hr of hyperacusis education. Other primary barriers to effective audiological management of hyperacusis included time constraints, reimbursement, poor sensitivity and specificity of available diagnostic tools, and poor efficacy of available treatments and management strategies. Most respondents (82.5%) agreed that audiologists are the primary professionals who are responsible for implementing hyperacusis interventions. However, 63.3% of respondents reported that their clinic does not have a hyperacusis management protocol, and 80.0% routinely recommend treatment that is outside their scope of practice to implement (cognitive behavioral therapy).

CONCLUSIONS: Clinical audiologists in the United States do not receive uniform education on hyperacusis, and they report multiple barriers to its evidence-based diagnosis and management. Effective hyperacusis management necessitates a multidisciplinary approach. The information obtained via this survey will pave the way toward the refinement of interprofessional education programs and the development of systematic, evidence-based clinical protocols for hyperacusis.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24431188.

PMID:37917915 | DOI:10.1044/2023_AJA-23-00118