Comparison of acid and hydrothermal pretreatments of date waste for value creation.

The production of date syrup yields a substantial amount of date press cake (DPC), fibrous and moisturising material with great potential for generating value through bioprocessing. However, the recalcitrant structure of DPC affects the yield of products in bioprocesses. To boost the accessibility of the structure as well as increase the soluble fraction of carbohydrates and facilitate further enzymatic hydrolysis, hydrothermal and dilute acid (0.5% (v/v) sulfuric acid) pretreatments as cost-effective and feasible methods were applied on DPC at relatively low temperatures (80, 100, 120 and 140 °C) and reaction times (60 and 90 min). The success in pretreatment was then evaluated by a post-enzymatic treatment using an enzyme cocktail of cellulases and hemicelluloses. Based on total accessible sugar with minimum produced inhibitors, an optimal operating condition was considered acid pretreatment at 120 °C for 90 min with a 55.02% increase in total sugar yield. To explore the potential use of pretreated DPC, an anaerobic digestion was conducted on untreated and acid-pretreated DPC at 120 °C for 90 min. The results showed that pretreatment increased the total bioproduct yield, including hydrogen, ethanol, and volatile fatty acid yields, by 59.75%. This demonstrates the significant impact of pretreatment on product yields in a bioprocess.

Rupture of Pectoralis Major Muscle: A Case Report.

Introduction: Pectoralis major (PM) muscle ruptures are uncommon injuries. 365 cases of PM injury have been reported, with 75% occurring in the past 20 years; of these, 83% were a result of indirect trauma, with 48% occurring during weight-training activities. We report a case of PM rupture in a 35-year-old gym trainer who presented to our hospital with pain and weakness in his right shoulder after injury while doing bench press treated with Primary repair using Ethibond 5-0 and endobuttons who had excellent function outcome and no evidence of complication at 2 years follow-up. Case Report: A 35-year-old gentleman presented to the emergency department after experiencing sudden pain in his right chest and a tearing sensation while bench pressing (approximately 100 kg). He is a gym trainer who exercised with a lot of weight and denied any steroid use. Upon clinical examination, he had ecchymosis and loss of shoulder contour, bulking over the right chest. The shoulder range of movement was preserved, with weakness of adduction and internal rotation. Plain radiographs of the right shoulder were obtained which was normal. A magnetic resonance imaging (MRI) scan revealed a PM rupture at the insertion site with retraction and the patient was treated with primary repair of the PM. The patient exhibited satisfactory shoulder range of movement by 3 months follow-up and achieved his pre-injury strength by 6 months follow-up. Conclusion: PM ruptures are uncommon injuries that commonly occur in young men between 20 and 40 years old. Patients usually present with shoulder pain and weakness after a strenuous activity and a diagnosis can be made with MRI. Hence, surgical treatment should be offered to all young patients with PM tear irrespective of level of activity and conservative management should be reserved for geriatric patients with low activity levels and medically unfit patients.

Robust fatigue markers obtained from muscle synergy analysis.

This study aimed to utilize the nonnegative matrix factorization (NNMF) algorithm for muscle synergy analysis, extracting synergy structures and muscle weightings and mining biomarkers reflecting changes in muscle fatigue from these synergy structures. A leg press exercise to induce fatigue was performed by 11 participants. Surface electromyography (sEMG) data from seven muscles, electrocardiography (ECG) data, Borg CR-10 scale scores, and the z-axis acceleration of the weight block were simultaneously collected. Three indices were derived from the synergy structures: activation phase difference, coactivation area, and coactivation time. The indicators were further validated for single-leg landing. Differences in heart rate (HR) and heart rate variability (HRV) were observed across different fatigue levels, with varying degrees of disparity. The median frequency (MDF) exhibited a consistent decline in the primary working muscle groups. Significant differences were noted in activation phase difference, coactivation area, and coactivation time before and after fatigue onset. Moreover, a significant correlation was found between the activation phase difference and the coactivation area with fatigue intensity. The further application of single-leg landing demonstrated the effectiveness of the coactivation area. These indices can serve as biomarkers reflecting simultaneous alterations in the central nervous system and muscle activity post-exertion.

Long Title: Short to Midterm Outcomes of 139 Pyrocarbon Monopolar Radial Arthroplasties.

INTRODUCTION: The MoPyc radial head arthroplasty (RHA) is a monopolar implant with a pyrocarbon head that obtains rigid fixation via controlled expansion of the titanium stem. The aim of this study was to evaluate the short to midterm outcomes of MoPyc RHA. MATERIALS AND METHODS: Between 2002 and 2021, 139 MoPyc RHA were implanted in 139 patients with a RH fracture. The mean follow-up was 5.9 years ±3.5 (range 1-16). Range of motion, mean Mayo Elbow Performance score (MEPS), quick disabilities of the Arm, Shoulder and Hand (quickDASH) score, visual analog scale (VAS), radiographic outcome, and reason for failure were recorded. RESULTS: The mean MEP, QuickDASH, and VAS scores were 89.1± 2.2(range, 45-100), 17.5±16.7(range, 0-78), and 0.8±1.6(range, 0-50), respectively. Stress shielding (SS) and osteolysis around the stem (OAS) were identified in 92(66%) and 20(14%) patients. A total of 47(29%) patients experienced at least one complication; and 29(21%) of them required re-intervention. Persistent stiffness (n=12;9%) was the most common complication. No painful loosening was noted. Osteolysis around the stem, presence of an autoexpanding stem, and overstuffing were associated with a lower MEPS and an increase in VAS (p<0.05). Stress shielding (SS) was associated with an increase in MEPS (aß=6.92; p<0.001) and lower VAS (aß=-0.69; p=0.016). The auto-expending stem increased the likelihood of SS after RHA (aOR=1.49; p=0.001). CONCLUSIONS: A well-fixed MoPyc RHA provided satisfactory short to midterm outcomes, without painful loosening. However, the autoexpanding stem system was associated with poorer functional outcomes and increased the likelihood of SS.

Characterization and Techno-Functional Properties of High Protein Walnut Flour from an Oil by-Product.

A high protein walnut flour (HPWF) was obtained by defatting walnut flour (WF), which is a by-product of the oil industry. The objective of this study was the chemical and techno-functional characterization of HPWF. Composition, amino acid content, protein secondary structure, protein solubility and thermal transitions were measured. Besides, the techno-functional properties, emulsion activity and stability, and water holding and oil absorption capacities, of HPWF were evaluated. Also, the molecular mass of proteins under denaturing conditions and the microstructure of HPWF were evaluated by electrophoresis and confocal scanning laser microscopy, respectively. HPWF had 55.4% protein content and 21.5% total dietary fibre. In terms of HPWF amino acid composition, the limiting amino acids were the sulphurated cysteine and methionine. By FTIR analysis, the main secondary structures were ß-sheet (49%) followed by α-helix (24%); both structures are considered to be ordered. Likewise, HPWF soluble proteins increased at basic pH and HPWF proteins were separated in 11 bands with molecular masses ranging from 97 kDa to 18 kDa by electrophoresis. With respect to techno-functional properties, HPWF presented good emulsion activity (51%) and high thermal emulsion stability (46%). In addition, HPWF retained 571% and 242% of water and oil by weight, respectively. Finally, the micrograph showed the predominance of protein structures and fibre fragments, and the presence of few lipids mostly trapped. These results showed that HPWF is an interesting source of plant-based proteins and walnut flour can be used to obtain high protein ingredients from non-traditional sources.

Reliability of dynamic and isometric upper muscle strength testing in breast cancer survivors.

Breast cancer is the most common cancer in women worldwide, and its treatment usually involves a combination of many medical procedures, including surgery, chemotherapy, radiotherapy, and hormonal therapy. One of the detrimental effects on physical function is reduced upper limb muscle strength. This study aimed to evaluate upper body strength intra-day and inter-day (test-retest) reliability using the handgrip strength test (HGS) and the bilateral isometric bench press (BIBP) and the test-retest reliability of the one repetition maximum on the bench press (BP-1RM) in breast cancer survivors (BCS). Thirty-two (52.94 ± 8.99 yrs) BCS participated in this study. The muscle strength tests were performed in two different moments, three to seven days apart. Intraclass coefficient correlation (ICC) and coefficient of variation (CV) were used to assess the reliability. Standard error of measurement (SEM), typical error of measurement (TEM), and minimally detectable change (MDC) analyses were performed. The Bland-Altman analysis was used to assess the agreement between test-retest. We found a reliability that can be described as "high" to "very high" (ICC ≥ 0.88; CV ≤ 10%) for intra-day and test-retest. SEM% and MDC% were lower than 5% and 11%, respectively, for all intra-day testing. SEM% and TEM% ranged from 3% to 11%, and MDC% ranged from 9% to 23% in the test-retest reliability. The agreement demonstrated a systematic bias ranging from 2.3% to 6.0% for all testing, and a lower systematic bias may be presented in the non-treated side assessed by HGS and BIBP. HGS, BIBP, and BP-1RM assessments are reliable for measuring upper-body muscle strength in BCS.

Spectro-ViT: A vision transformer model for GABA-edited MEGA-PRESS reconstruction using spectrograms.

This study investigated the use of a Vision Transformer (ViT) for reconstructing GABA-edited Magnetic Resonance Spectroscopy (MRS) data from a reduced number of transients. Transients refer to the samples collected during an MRS acquisition by repeating the experiment to generate a signal of sufficient quality. Specifically, 80 transients were used instead of the typical 320 transients, aiming to reduce scan time. The 80 transients were pre-processed and converted into a spectrogram image representation using the Short-Time Fourier Transform (STFT). A pre-trained ViT, named Spectro-ViT, was fine-tuned and then tested using in-vivo GABA-edited MEGA-PRESS data. Its performance was compared against other pipelines in the literature using quantitative quality metrics and estimated metabolite concentration values, with the typical 320-transient scans serving as the reference for comparison. The Spectro-ViT model exhibited the best overall quality metrics among all other pipelines against which it was compared. The metabolite concentrations from Spectro-ViT's reconstructions for GABA+ achieved the best average R2 value of 0.67 and the best average Mean Absolute Percentage Error (MAPE) value of 9.68%, with no significant statistical differences found compared to the 320-transient reference. The code to reproduce this research is available at https://github.com/MICLab-Unicamp/Spectro-ViT.

Comparison of corneal endothelial cell density reduction between primary open-angle glaucoma and pseudo-exfoliation glaucoma patients at 3 years after Ex-Press® surgery.

PURPOSE: We compared corneal endothelial cell (CED) loss after Ex-Press (EXP) surgery between patients with primary open-angle glaucoma (POAG) and pseudo-exfoliation glaucoma (PEX). PATIENTS AND METHODS: This was a single-facility retrospective study. We included glaucoma patients who had undergone EXP surgery and were followed up > 3 years. We measured the CED before and after (at 12, 24, and 36 months) EXP surgery by noncontact specular microscopy and compared the means of the CED values and CED survival ratios after EXP surgery by paired t-test. RESULTS: We included 119 eyes that underwent EXP surgery, including 60 POAG eyes and 59 PEX eyes. In the POAG group, the mean CED decreased from 2389 ± 321 at baseline to 2230 ± 424 cells/mm2 after 3 years. In the PEX group, the mean CED decreased from 2111 ± 510 at baseline to 1845 ± 628 cells/mm2 after 3 years. At the 3-year follow-up, the CED survival ratio was 93.3 ± 12.5% in the POAG group and significantly lower, at 85.0 ± 19.5%, in the PEX group (p = 0.0064). Two cases in the PEX group developed bullous keratopathy. CONCLUSIONS: EXP surgery decreased the corneal endothelial cell populations in PEX patients faster than POAG patients.

High or low expectations: Expected intensity of action outcome is embedded in action kinetics.

Goal-directed actions are performed in order to attain certain sensory consequences in the world. However, expected attributes of these consequences can affect the kinetics of the action. In a set of three studies (n = 120), we examined how expected attributes of stimulus outcome (intensity) shape the kinetics of the triggering action (applied force), even when the action kinetic and attribute are independent. We show that during action execution (button presses), the expected intensity of sensory outcome affects the applied force of the stimulus-producing action in an inverse fashion. Thus, participants applied more force when the expected intensity of the outcome was low (vs. high intensity outcome). In the absence of expectations or when actions were performed in response to the sensory event, no intensity-dependent force modulations were found. Thus, expectations of stimulus intensity and causality play an important role in shaping action kinetics. Finally, we examined the relationship between kinetics and perception and found no influence of applied force level on perceptual detection of low intensity (near-threshold) outcome stimuli, suggesting no causal link between the two. Taken together, our results demonstrate that action kinetics are embedded with high-level context such as the expectation of consequence intensity and the causal relationship with environmental cues.

Patient preference after switching guselkumab from prefilled syringe to an autoinjection pen in psoriasis and psoriatic arthritis patients.

BACKGROUND: We assessed pain, acceptability, patient preference, and tolerability of patients with psoriasis and psoriatic arthritis after switching guselkumab from a prefilled syringe to One-Press autoinjector pen. METHODS: Patients with psoriasis and psoriatic arthritis treated for at least 6 months with guselkumab syringe were recruited from Jan 2019 to Dec 2022. Gender, age, diagnosis, self-administration, and pain perception of guselkumab prefilled syringe were recorded. At the first visit, patients completed a post-auto-injection syringe questionnaire before starting auto-injection pen administration. After 2 and 6 months of guselkumab self-injection using the One-Press autoinjector pen, patient experience, adherence, preference, pain, and safety of each administration were assessed using post-guselkumab by One-Press autoinjector pen questionnaire. RESULTS: 40 patients [psoriasis n=34, psoriatic arthritis n=6] were included. All patients self-administered guselkumab by One-Press autoinjector pen. Pain at the injection site was significantly reduced with the use of the One-Press autoinjector pen. All patients considered that using One-Press autoinjector pen was easier than the syringe, 98% chose the pen as their preferred delivery system. CONCLUSION: The One-Press autoinjector pen for guselkumab administration is presented as a preferred option, with a high satisfaction and less painful compared to the administration of guselkumab in a prefilled syringe.

Evaluation of the qualitative properties of the oil extracted from the mixture of Helianthus annuus and Nigella sativa seeds during heating.

The oil obtained from black cumin (Nigella sativa) seeds has many health-effective properties, which is used in food applications and in traditional medicine. One practical method to extract its oil is mixing with other seeds such as sunflower (Helianthus anuus) seeds before oil extraction by press. The effectiveness of the cold-press oil obtained from the mixture of black cumin seeds (BS) and sunflower seeds (SF) in different proportions 100:0, 95:5, 90:10, 85:15 and 0:100 (w/w) was studied to evaluate their qualitative properties including peroxide value (PV), acid value, p-anisidine value (AnV), pigments (carotenoid and chlorophyll) content, polyphenols, and profile of fatty acids during heating process (30-150 min at 180 °C). The results revealed that the acid and p-anisidine value of the all samples enhanced with the extension of the heating time, and the peroxide value increased at the beginning of the heating and then decreased with the prolongation of the heating time (p < .05). With the increase of temperature and heating time, the peroxide of sunflower oil increased with a higher slope and speed than that of black seed and blends oil. Changes in the PV and AnV were the fastest in sunflower oil. Blending and heating caused considerable changes in the fatty acid composition of oils, especially myristic, palmitic, and stearic acids. Moreover, the levels of certain unsaturated fatty acids, namely linoleic, oleic, and linolenic acids declined after heating. The carotenoids, chlorophyll and total phenol content decreased gradually during heating treatments. Among extracted oils, SF:BS (15%) had the good potential for stability, with total phenol content of 95.92 (Caffeic acid equivalents/100 g), PV of 2.16 (meq O2/kg), AV of 2.59 (mg KOH/g oil), and AnV of 8.08 after the heating. In conclusion, oil extracted from the mixture of SF and BS can be used as salad and cooking oils with a high content of bioactive components and positive nutritional properties.

Effects of extrusion conditions on the morphological, functional, and sensory properties of soy press cake extrudates.

We developed and applied 4 extrusion regimens (moisture content between 30 % and 60 % and temperature from 110 °C to 120 °C) with twin-screw extruder for valorising soy press cakes, byproduct of soy drink (Soyd) and tofu (Soyt) manufacturing processes, by varying physical conditions of extrusion for improving their morphological, functional, and sensory parameters. The valorised soy press cakes were compared to their respective control samples (Soyd or Soyt) both before and after extrusion. Two quantities (3%-6%) of untreated and extruded soy press cakes were utilised to develop meat analogues. Extrusion introduced striations and reduced flakiness on the surface of extruded press cake samples. Press cakes extruded at higher moisture indicated improved water holding and oil holding capacity. Interestingly, the same press cake samples also scored higher for positive indicators (e.g., juiciness) during sensory assessment. Compared with meat analogue control matrix, all meat analogue samples containing varying amounts of extruded press cake exhibited reduced chewiness, with other parameters relatively unchanged. Our results indicate that extrusion of soy press cakes of both Soyd and Soyt origin at 120 °C with 60 % moisture results in improving the morphological, functional, and sensory properties of press cakes, making them suitable for development of meat analogues.

Impact analysis of dust evolution pattern and determination of key ventilation parameters in highland highway construction tunnels.

In order to study the influence of ventilation parameters on the ventilation of plateau highway construction tunnels, a highway tunnel construction section in Yunnan is taken as the research background, and Fluent software is used for simulation. The results of the study show that: under the conditions of press-in ventilation, the wind speed in the center of the vortex area in the wind flow field is smaller than the wind speed in the surrounding area, and with the diffusion of the flow field, the average wind speed in the tunnel section gradually decreases, and ultimately stabilizes at the level of 0.5 m/s. After blasting, the dust mass concentration on the return side of the tunnel is higher than that on the duct side. Dust with a particle size of 30 µm or more settled rapidly within 100 m from the boring face, while dust with a particle size of 30 µm or less gradually diffused outward under the action of the wind flow. In the vicinity of the tunnel boring face, reducing the distance from the air outlet to the boring face and increasing the air velocity can improve the dust removal effect. This conclusion can provide theoretical basis and certain guidance for the evolution of dust and dust prevention in the tunnel construction process in plateau area.

Effects of bench press technique variations on musculoskeletal shoulder loads and potential injury risk.

While shoulder injuries resulting from the bench press exercise are commonly reported, no biomechanical evidence for lowering injury risk is currently available. Therefore, the aim of the present study was to compare musculoskeletal shoulder loads and potential injury risk during several bench press variations. Ten experienced strength athletes performed 21 technical variations of the barbell bench press, including variations in grip width of 1,1.5 and 2 bi-acromial widths (BAW), shoulder abduction angles of 45°, 70° and 90°, and scapula poses including neutral, retracted, and released conditions. Motions and forces were recorded by an opto-electronic measurement system and an instrumented barbell. An OpenSim musculoskeletal shoulder model was employed to estimate joint reaction forces in the glenohumeral and acromioclavicular joints. Time-series of joint reaction forces were compared between techniques by statistical non-parametric mapping. Results showed that narrower grip widths of < 1.5 BAW decreased acromioclavicular compression (p < 0.05), which may decrease the risk for distal clavicular osteolysis. Moreover, scapula retraction, as well as a grip width of < 1.5 BAW (p < 0.05), decreased glenohumeral posterior shear force components and rotator cuff activity and may decrease the risk for glenohumeral instability and rotator cuff injuries. Furthermore, results showed that mediolaterally exerted barbell force components varied considerably between athletes and largely affected shoulder reaction forces. It can be concluded that the grip width, scapula pose and mediolateral exerted barbell forces during the bench press influence musculoskeletal shoulder loads and the potential injury risk. Results of this study can contribute to safer bench press training guidelines.

Acute Hormonal and Inflammatory Responses following Lower and Upper Body Resistance Exercises Performed to Volitional Failure.

This study aimed to investigate the effects of a single bench press (BP) vs. leg press (LP) resistance training sessions on testosterone, cortisol, C-reactive protein (CRP) interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) concentrations, and creatine kinase (CK) activity in strength-trained males. Eleven strength-trained males participated in a cross-over randomized trial, undergoing two experimental sessions each consisting of five sets of the BP or the LP exercise to volitional failure with a load corresponding to 50% of one-repetition maximum. Blood samples were taken at baseline (BA), immediately post (POST), and 1 h after the cessation of exercise (POST-1). A significant increase in IL-6 concentration from BA to POST-1 was observed during the LP condition (p = 0.004; effect size [ES] = 0.64). Additionally, a significant main effect of time was found for increasing testosterone concentrations from BA to POST exercise (p = 0.014; ES = 0.25). A significantly lower cortisol concentration at POST-1 compared to POST (p = 0.001; ES = 1.02) was noted in the BP condition. Furthermore, a significantly lower cortisol concentration was found at POST-1 in the BP compared to the LP condition (p = 0.022; ES = 1.3). A significant increase in CK activity was reported from BA to POST (p = 0.024; ES = 0.69) and POST-1 (p = 0.045; ES = 0.55) during the LP condition, and from BA to POST-1 (p = 0.014; ES = 0.96) during the BP condition. No significant differences were found in the CRP (p = 0.659) and TNF-α concentrations (p = 0.487). These results suggest that the amount of muscle mass engaged during the resistance exercise may influence the changes in IL-6 and cortisol concentrations. Larger muscle groups, as engaged in the LP, more likely lead to elevated concentrations of IL-6 myokine.

An in vitro platform for quantifying cell cycle phase lengths in primary human intestinal epithelial cells.

The intestinal epithelium dynamically controls cell cycle, yet no experimental platform exists for directly analyzing cell cycle phases in non-immortalized human intestinal epithelial cells (IECs). Here, we present two reporters and a complete platform for analyzing cell cycle phases in live primary human IECs. We interrogate the transcriptional identity of IECs grown on soft collagen, develop two fluorescent cell cycle reporter IEC lines, design and 3D print a collagen press to make chamber slides for optimal imaging while supporting primary human IEC growth, live image cell cycle dynamics, then assemble a computational pipeline building upon free-to-use programs for semi-automated analysis of cell cycle phases. The PIP-FUCCI construct allows for assigning cell cycle phase from a single image of living cells, and our PIP-H2A construct allows for semi-automated direct quantification of cell cycle phase lengths using our publicly available computational pipeline. Treating PIP-FUCCI IECs with oligomycin demonstrates that inhibiting mitochondrial respiration lengthens G1 phase, and PIP-H2A cells allow us to measure that oligomycin differentially lengthens S and G2/M phases across heterogeneous IECs. These platforms provide opportunities for future studies on pharmaceutical effects on the intestinal epithelium, cell cycle regulation, and more.

Considerations for event-related gamma-aminobutyric acid functional magnetic resonance spectroscopy.

The use of sequential proton magnetic resonance spectroscopy (MRS) to follow glutamate and gamma-aminobutyric acid (GABA) changes during functional task-based paradigms, functional MRS (fMRS), has increased. This technique has been used to investigate GABA dynamics during both sensory and behavioural tasks, usually with long 'block design' paradigms. Recently, there has been an increase in interest in the use of short stimuli and 'event-related' tasks. While changes in glutamate can be readily followed by collecting multiple individual transients (or shots), measurement of GABA, especially at 3 T, is usually performed using editing techniques like Mescher-Garwood point-resolved spectroscopy (MEGA-PRESS), which by its nature is a dual shot approach. This poses problems when considering an event-related experiment, where it is unclear when GABA may change, or how this may affect the individual subspectra of the MEGA-PRESS acquisition. To address this issue, MEGA-PRESS data were simulated to reflect the effect of a transient change in GABA concentration due to a short event-related stimulus. The change in GABA was simulated for both the ON and OFF subspectra, and the effect of three different conditions (increase only during ON acquisition, increase during OFF acquisition and increase across both) on the corresponding edited GABA spectrum was modelled. Results show that a transient increase in GABA that only occurs during the ON subspectral acquisition, while not changing the results much from when GABA is changed across both conditions, will give a much larger change in the edited GABA spectrum than a transient increase that occurs only during the OFF subspectral acquisition. These results suggest that researchers should think carefully about the design of any event-related fMRS studies using MEGA-PRESS, as well as the analysis of other functional paradigms where transient changes in GABA may be expected. Experimental design considerations are therefore discussed, and suggestions are made.

The Influence of an Unexpected Symbolic Gift on Postoperative Arthroplasty Patients' Press Ganey Scores.

BACKGROUND: Hospitals use Press Ganey surveys to evaluate patient satisfaction. The goal of our study was to evaluate whether surgeon-driven gifting to patients postoperatively affects Press Ganey Survey responses. METHODS: There were 1,468 patients undergoing arthroplasty at our institution who were randomized to receive a thank-you gift, a small bouquet of flowers, and a note from their provider after surgery, or nothing for completing their preoperative arthroplasty registry questionnaire. Press Ganey surveys were sent to patients who received and did not receive flowers immediately after their hospital stay and after the patients' first postoperative visit. Scores were reported as the mean score and the fraction of responses with a top-box rating. One-sided student t-tests and Fisher's exact tests were used to assess statistical significance. RESULTS: Hospital Discharge: Patients who received flowers had higher Press Ganey survey scores than patients who did not receive flowers. For example, for "physician's concerns for questions," they had higher scores (mean difference: 3.7 ± 1.6 points, P = .012) and a 9% higher top-box rating (P = .032). For "staff attitude toward visitors," they also had higher scores (mean difference: 2.8 ± 1.3 points, P = .019) and a 7% higher top-box rating (P = .049). First Follow-up: Patients who received flowers had a higher top-box rating for "concern provider showed for questions" and "amount of time provider spent with you" by 6% (P = .046) and 11% (P = .009), respectively. They also had higher scores for "information provider gave about medications" (mean difference: 4.0 ± 1.6 points, P = .009) and 11% higher top-box rating (P = .006). CONCLUSIONS: Press Ganey Surveys were higher in orthopaedic patients who received bouquets of flowers from their arthroplasty surgeons compared to patients who did not. At follow-up, improved Press Ganey scores persisted if the patient received flowers. The gift of flowers generates patient loyalty to their surgeon.

GABAergic imbalance in Parkinson's disease-related depression determined with MEGA-PRESS.

OBJECTIVE: The pathogenesis of depression in patients with Parkinson's disease (PD) is poorly understood. Therefore, this study aimed to explore the changes in γ-aminobutyric acid (GABA) and glutamate plus glutamine (Glx) levels in patients with PD with or without depression determined using MEscher-GArwood Point Resolved Spectroscopy (MEGA-PRESS). MATERIALS AND METHODS: A total of 83 patients with primary PD and 24 healthy controls were included. Patients with PD were categorized into depressed PD (DPD, n = 19) and nondepressed PD (NDPD, n = 64) based on the 17-item Hamilton Depression Rating Scale. All participants underwent T1-weighted imaging and MEGA-PRESS sequence to acquire GABA+ and Glx values. The MEGA-PRESS sequence was conducted using 18.48 mL voxels in the left thalamus and medial frontal cortex. The GABA+, Glx, and creatine values were quantified using Gannet 3.1 software. RESULTS: The GABA+ and Glx values were not significantly disparate between patients with PD and controls in the thalamus and medial frontal cortex. However, the levels of N-acetyl aspartate/creatine and choline/creatine in the left thalamus were significantly lower in patients with PD than in controls (P = .031, P = .009). The GABA+/Water and GABA+/Creatine in the medial frontal cortex were higher in DPD than in NDPD (P = .001, P = .004). The effects of depression on Glx or other metabolite levels were not evident, and no significant difference in metabolite values was noted in the left thalamus among all groups (P > .05). CONCLUSIONS: GABA+ levels increased in the medial frontal cortex in DPD, which may be more closely related to depressive pathology. Thus, alterations in GABAergic function in special brain structures may be related to the clinical manifestations of PD symptoms, and hence mediating this function might help in treating depression in PD.

The impact of EEG biofeedback training on the athletes' motivation and bench press performance.

The objective of this paper was to determine the impact of EEG-biofeedback training on the motivation and efficiency of powerlifters during the bench press exercise in relation to the external load and the level of training. The study included 18 trained powerlifters who were divided into the intermediate (IG) and the advanced (AG) groups. EEG-biofeedback training was conducted every three days, lasting 27 minutes each time (5 × 3-minute intervals with recovery periods - lying on a bench - between them 4 × 3 minutes), and ended with a final EEG measurement in the second cycle of research. The repeated measures ANOVA showed intra-group differences due to external loading for the FAI (Frontal Alpha Asymmetry) obtained in the EEG both before and after biofeedback training. In AG group analysis revealed significant differences between 65%1RM and 35%1RM. In the IG group between 35%1RM and 50, 65 and 80%1RM. One of the major variables influencing the efficiency of strength training, including bench press workouts, is the level of training. The more successfully an athlete uses motivation when exercising, the better their training, which translates into greater results and a lower chance of injury.