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Participant
We used the Harvard calculator (
PMC10586320
Experimental design
fatigue
BLOOD
Qualified 14 male and 14 female subjects were included and randomly assigned to two groups with gender parity (seven male and seven female per group): (1) no EMS group, (2) daily EMS group (quadriceps, abdominal muscles, biceps, twice a day, 30 min each time). The mean age (no EMS group: 21.6 ± 1.7; daily EMS group: 21...
PMC10586320
Electric muscle stimulator (EMS)
The electric muscle stimulator (EMS) used in this study was from Funcare (Funcare Co., Ltd., Taichung, Taiwan). EMS electrodes were attached to the biceps of both hands, the abdomen, and the quadriceps of both legs sequentially. We refer to previously studies and modify the protocol (
PMC10586320
The EMS training protocol.
PMC10586320
Resistance training (RT)
Torsion
TORSION
All subjects performed resistance training three times a week to strengthen their upper limbs, back, abdomen, and legs, respectively, using a pneumatic resistance training machine including Abs/Abduction 3520-HI5, Push-up/Pulldown 3120, Ab/Back 5310, Torsion Rehab 5340, Leg Extension/Curl 3530, and Leg Press 5540 (AB H...
PMC10586320
Body composition
The InBody 570 device (In-body, Seoul, South Korea) is a bioelectrical impedance analyzer (BIA) that measures impedance at 1, 5, 50, 260, 500, and 1,000 kHz by the multi-frequency principle and was used in this study to measure body composition. After fasting for at least 8 h, the subject held the induction handle with...
PMC10586320
Maximal oxygen consumption
As previoulsy described (
PMC10586320
Fatigue-associated and clinical biochemical variables
To assess fatigue-related indicators, subjects fasted for at least 8 h and underwent a fixed-intensity exercise challenge (60% VO
PMC10586320
Maximum handgrip strength test
fatigue
Each participant’s maximum grip strength for both hands was measured using a Takei digital grip strength meter (T.K.K.5401; Takei Scientific Instruments Co., Ltd., Niigata, Japan). Before the actual test, participants were instructed to apply minimal force to the grip to ensure a comfortable and standardized gripping d...
PMC10586320
Countermovement jump assessment
The countermovement jump (CMJ) test is widely used to assess lower body speed, strength, and explosiveness (
PMC10586320
Statistical analysis
All the data are expressed as mean ± SD. Statistical analyses were performed using SAS 9.0 (SAS Inst., Cary, NC, USA). Multi-group comparisons were analyzed using one-way analysis of variance (ANOVA). Differences between before and after intervention were analyzed using two-way repeated-measures ANOVA with Bonferroni
PMC10586320
Results
PMC10586320
Effect of 8 weeks EMS combined with RT on body composition.
Data are presented as mean ± SD. Different superscript letters (a, b) indicate significant difference between groups at The intervention efficacy between pre- and post-intervention within the same group was statistically significant at a significance level of Additionally, the changes in body composition were assessed...
PMC10586320
Biochemical characteristics of subjects before, 4-week and after 8-week EMS intervention.
Data are presented as mean ± SD. AST, aspartate aminotransferase; ALT, alanine transaminase; BUN, blood urea nitrogen; CREA, creatinine; UA, uric acid; FFA, free fatty acid.
PMC10586320
Effect of 8 weeks EMS combined with RT on physiological adaptation and biochemical indices
As shown in
PMC10586320
Effect of 8 weeks EMS combined with RT on physiological adaptation and biochemical indices.
Data are presented as mean ± SD.
PMC10586320
Effect of 8 weeks EMS combined with RT on maximum handgrip strength
After 8 weeks of intervention, both the no-EMS group and the daily EMS group showed a significant increase in left-hand (no-EMS group, 1.03-fold (
PMC10586320
Effect of 8 weeks EMS combined with RT on maximum handgrip strength.
Data are presented as mean ± SD. Different superscript letters (a, b) indicate significant difference between groups at The intervention efficacy between pre- and post-intervention within the same group was statistically significant at a significance level of
PMC10586320
Effect of 8 weeks EMS combined with RT on muscle strength and jumping force
The improvements in lower body strength and power were assessed using the CMJ test. As shown in
PMC10586320
Effect of 8 weeks EMS combined with RT on muscle strength and jumping force.
Data are presented as mean ± SD.The intervention efficacy between pre- and post-intervention within the same group was statistically significant at a significance level of
PMC10586320
Discussion
muscle mass, EMS improves, fatigue, NHAlthough, Muscle mass, muscle mass gain
In recent years, numerous studies have demonstrated the advantages of EMS as a passive exercise for muscles. However, the gains in muscle strength or mass may still be influenced by the specific protocols and frequency of use (EMS is believed to have a significant impact on reducing body fat by increasing the resting m...
PMC10586320
Conclusions
muscle mass
Our study demonstrates that 8 weeks of continuous resistance exercise training combined with daily EMS training targeting the upper body, lower body, and abdominal muscles can significantly improve muscle mass and upper body muscle strength, as well as significantly reduce body fat percentage. However, it did not show ...
PMC10586320
Supplemental Information
PMC10586320
EMS data.
Click here for additional data file.
PMC10586320
Additional Information and Declarations
PMC10586320
Competing Interests
The authors declare that they have no competing interests.
PMC10586320
Human Ethics
The following information was supplied relating to ethical approvals (Institutional Review Board of Landseed International Hospital (Taoyuan, Taiwan; LSHIRB No. 21-034-A2).
PMC10586320
Data Availability
The following information was supplied regarding data availability:All the data are available in the
PMC10586320
References
PMC10586320
Introduction
PMT
Using Protection Motivation Theory (PMT), we examined the effect of threat appraisal information (perceived vulnerability-PV and perceived severity-PS) to reduce vaping intentions, and in turn reduce vaping use. Canadian university students (Canada has one of the highest rates of vaping usage in the world, with more th...
PMC10387725
Current study
PMT
The purpose of the proposed study is to examine the effectiveness of an intervention grounded in the threat appraisal components of a PMT framework (i.e., PV and PS) that seeks to mitigate vaping intention and behaviour among Canadian university students that identify as regular vapers, vaping at least three times over...
PMC10387725
Method
PMC10387725
Participants and sample size calculation
PMT
A convenience sample of Canadian university undergraduate students ((Completed data) demographic characteristic for the two treatment conditions.Standard deviation presented in parentheses.PMT: protection motivation theory group;
PMC10387725
Design and procedure
PMT, RECRUITMENT
Study procedures were pre-registered with Clinical Trials and adheres to the requirements of the institutional registry. Data were collected in January 2021. Recruitment began in January 2021 and continued until data collection concluded in April 2021, at which point treatment effects on study outcomes were analyzed. P...
PMC10387725
Measures
PMC10387725
Threat appraisal
PMT
Perceived vulnerability (PV) perceived severity (PS) were each assessed by four 10-point items (0 = strongly disagree to 10 = strongly agree), derived from past PMT literature (
PMC10387725
Goal intention
Goal intention was assessed by three 10-point purpose-built items (0 = 
PMC10387725
Behaviour
Vaping behaviour was assessed by one 5-point purpose-built item (0 = 
PMC10387725
Statistical analyses
REGRESSION
All analyses were conducted using IBM SPSS Statistics 25 for MacOS. Presentation of statistical results and analyses methods for both completed data and imputed data (sensitivity) are illustrated separately below. Both data sets used one-way ANOVAs and chi-square procedures to ensure that there were no systematic diffe...
PMC10387725
Results (completed data)
PMC10387725
Group differences
PMT
Separate one-way factorial repeated measure ANOVAs showed that the two treatment groups differed significantly across time on PS and PV. Specifically, the PMT intervention group scored higher on both threat components than their attention control counterparts. Non-significant treatment by time group differences for int...
PMC10387725
Missing and excluded data
Multiple imputation (MI) analyses were used for all missing data points across all variables within both treatment groups. The MI process included combining five plausible imputed data sets (estimated values on other available information) and appropriately combining results obtained from each of them (
PMC10387725
Imputed group differences
PMT
Separate one-way ANOVAs showed that both treatment groups differed significantly on PS and PV across time. Significant treatment group differences across time for intention to reduce vaping behaviour and vaping use also were found. In all ANOVAS, the PMT intervention group showed higher PS, PV, and intentions as well a...
PMC10387725
Discussion
PMT
The results of the present study support the view that both threat appraisals (PV and PS) grounded in PMT are effective mechanisms to reduce vaping intentions among a sample of Canadian university students who regularly vape. With respect to vaping use, we found inconsistent and thus less convincing evidence for the ef...
PMC10387725
Conclusion
In conclusion, this is the first study to support the view that presenting isolated factual threat appraisal vaping information grounded in a Protection Motivation Theory framework concerning the possible negative health effects of vaping, may be effective at reducing vaping intentions and to a lesser extent vaping beh...
PMC10387725
Supplemental Material
PMC10387725
sj-docx-10-hpq-10.1177_13591053221144977 – Supplemental material for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial
Click here for additional data file.Supplemental material, sj-docx-10-hpq-10.1177_13591053221144977 for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial by Babac Salmani and Harry Prapavessis in Jou...
PMC10387725
sj-docx-8-hpq-10.1177_13591053221144977 – for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial
Click here for additional data file.sj-docx-8-hpq-10.1177_13591053221144977 for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial by Babac Salmani and Harry Prapavessis in Journal of Health Psycholog...
PMC10387725
sj-pdf-9-hpq-10.1177_13591053221144977 – Supplemental material for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial
Click here for additional data file.Supplemental material, sj-pdf-9-hpq-10.1177_13591053221144977 for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial by Babac Salmani and Harry Prapavessis in Journ...
PMC10387725
sj-spv-1-hpq-10.1177_13591053221144977 – for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial
Click here for additional data file.sj-spv-1-hpq-10.1177_13591053221144977 for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial by Babac Salmani and Harry Prapavessis in Journal of Health Psychology
PMC10387725
sj-spv-2-hpq-10.1177_13591053221144977 – for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial
Click here for additional data file.sj-spv-2-hpq-10.1177_13591053221144977 for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial by Babac Salmani and Harry Prapavessis in Journal of Health Psychology
PMC10387725
sj-spv-3-hpq-10.1177_13591053221144977 – for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial
Click here for additional data file.j-spv-3-hpq-10.1177_13591053221144977 for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial by Babac Salmani and Harry Prapavessis in Journal of Health Psychology
PMC10387725
sj-spv-4-hpq-10.1177_13591053221144977 – for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial
Click here for additional data file.sj-spv-4-hpq-10.1177_13591053221144977 for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial by Babac Salmani and Harry Prapavessis in Journal of Health Psychology
PMC10387725
sj-spv-5-hpq-10.1177_13591053221144977 – for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial
Click here for additional data file.sj-spv-5-hpq-10.1177_13591053221144977 for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial by Babac Salmani and Harry Prapavessis in Journal of Health Psychology
PMC10387725
sj-spv-6-hpq-10.1177_13591053221144977 – for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial
Click here for additional data file.-spv-6-hpq-10.1177_13591053221144977 for Using a protection motivation theory framework to reduce vaping intention and behaviour in Canadian university students who regularely vape: A randomized controlled trial by Babac Salmani and Harry Prapavessis in Journal of Health Psychology
PMC10387725
Appendix
RECRUITMENT
CONSORT 2010 flow diagram.Number of potential participants reached through Facebook advertisements and the Mass Email Recruitment System remains uncertain.
PMC10387725
Development of PMT and other material
PMC10387725
PMT video
PMT
The PMT present group watched an 8-minute informational video (video link:
PMC10387725
Attention control video
PMT
The PMT absent group featured an 8-minute nutritional information video (video link:
PMC10387725
Measures
PMC10387725
Demographic and modified youth vaping
Two seven-item vaping Canadian student vaping demographic and tobacco use questionnaires derived from an existing Canadian Student Tobacco, Alcohol, and Drugs Survey (CSTADS) conducted by a consortium of researchers across Canada, centralized at the University of Waterloo (2014). Excluding drugs assessment questions, t...
PMC10387725
References
PMC10387725
Abstract
PMC10114117
Objective
To improve problem list documentation and care quality.
PMC10114117
Materials and methods
BLOOD DISEASES
We developed algorithms to infer clinical problems a patient has that are not recorded on the coded problem list using structured data in the electronic health record (EHR) for 12 clinically significant heart, lung, and blood diseases. We also developed a clinical decision support (CDS) intervention which suggests addi...
PMC10114117
Results
There were 288 832 opportunities to add a problem in the intervention arm and the problem was added 63 777 times (acceptance rate 22.1%). The intervention arm had 4.6 times as many problems added as the control arm. There were no significant differences in any of the clinical quality measures.
PMC10114117
Discussion
The CDS intervention was highly effective at improving problem list completeness. However, the improvement in problem list utilization was not associated with improvement in the quality measures. The lack of effect on quality measures suggests that problem list documentation is not directly associated with improvements...
PMC10114117
Conclusion
An EHR-embedded CDS intervention was effective at improving problem list completeness but was not associated with improvement in quality measures.
PMC10114117
BACKGROUND AND SIGNIFICANCE
diabetes, renal insufficiency
DECAY, RENAL INSUFFICIENCY, HYPERTENSION, DISEASES, DIABETES
WeedA complete patient problem list is the cornerstone of Dr Weed’s vision of the problem-oriented medical record. It serves as a valuable tool for providers assessing a patient’s clinical status and succinctly communicates this information between providers. An accurate problem list supports problem-oriented charting ...
PMC10114117
METHODS
BLOOD, HEART, LUNG
With funding from the National Heart, Lung and Blood Institute, we developed a 4-site randomized trial of an intervention for improving problem list completeness. SitesPreviously called Partners HealthCare.Holy Spirit Hospital transitioned from the Allscripts Sunrise EHR to Epic during the intervention period and disco...
PMC10114117
System development
obstructive pulmonary disease (COPD)Congestive, CHF, heart failure, artery disease, infarction
BLOOD DISEASES, FIRES, CHF, HEART FAILURE, ARTERY DISEASE, INFARCTION
We developed and validated problem identification algorithms for 12 clinically significant heart, lung, and blood diseases:AsthmaAtrial fibrillationChronic obstructive pulmonary disease (COPD)Congestive heart failure (CHF)Coronary artery disease (CAD)HyperlipidemiaHypertensionMyocardial infarction (MI)Sickle cell anemi...
PMC10114117
Study design
CAD
REGRESSION, CAD
Each site randomized providers (physicians, physician assistants, and nurse practitioners) to the intervention or control arm, using a random number generator. Each provider had an equal probability of being assigned to either arm. Providers in the intervention arm received the alert during clinical encounters. The ale...
PMC10114117
RESULTS
PMC10114117
Alert acceptance
Proportion of missing problems added, by condition and arm
PMC10114117
Problem addition
We calculated the total number of study problems added across all conditions and all sites, by arm (Number of problems added, by arm and period.
PMC10114117
Quality measures
Finally, we evaluated the effect of the intervention on a predetermined set of HEDIS quality measures at one site (MGB). There were no differences in quality measures between the 2 groups (Clinical outcomes
PMC10114117
DISCUSSION
Our results demonstrate that the IQ-MAPLE intervention for problem list improvement had limited effectiveness at increasing problem list documentation, across conditions and at multiple sites. The overall acceptance rate (22.1%) is higher than those reported in many other published studies of CDSThe overall impact of t...
PMC10114117
Strengths and limitations
Our study has several strengths. It is the first multi-site, randomized study of problem list alerts done using a variety of EHRs and had a relatively effective intervention. It also had some important limitations. First, we did not assess whether the problems added from the alerts were accurate—we believe that they la...
PMC10114117
CONCLUSIONS
Conducting, randomized, multi-site, CDS interventions using different EHRs with different clinical workflows, upgrade cycles, patient populations, CDS governance committees, and different abilities to configure local CDS features is challenging. An EHR-embedded CDS intervention was effective at improving problem list c...
PMC10114117
Supplementary Material
Click here for additional data file.
PMC10114117
ACKNOWLEDGEMENTS
The authors express their gratitude to both Calvin Beidleman and Kevin Peters for their instrumental assistance with many technical details, including alert programming and randomization of participants.
PMC10114117
FUNDING
Research reported in this publication was supported by the National Library of Medicine of the National Institutes of Health under Award Number 1R01HL122225. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
PMC10114117
AUTHOR CONTRIBUTIONS
Dr A.W. and Dr D.F.S. made substantial contributions to the conception and design of the work. All authors assisted in the acquisition, analysis, and interpretation of data. Dr A.W. wrote the initial draft, and all authors revised it critically for important intellectual content. All authors had final approval of the v...
PMC10114117
SUPPLEMENTARY MATERIAL
PMC10114117
CONFLICT OF INTEREST STATEMENT
None declared.
PMC10114117
DATA AVAILABILITY
The data underlying this article will be shared on reasonable request to the corresponding author.
PMC10114117
REFERENCES
PMC10114117
Subject terms
This experimental crossover study was performed to investigate whether fenestrated surgical drapes (covering the nose and mouth but with an opening over the periorbital area) with or without patients’ surgical face masks increase periorbital bacterial dispersion during simulated intravitreal injection conditions. Each ...
PMC10279653
Introduction
endophthalmitis, diabetic macular
CORONAVIRUS INFECTION, ENDOPHTHALMITIS, NEOVASCULAR AGE-RELATED MACULAR DEGENERATION, STERILE, DISEASES
Intravitreal injections of medications, particularly anti-vascular endothelial growth factors (anti-VEGF), are currently considered as one of the most common procedures in medicine to treat diseases such as neovascular age-related macular degeneration and diabetic macular edemaDuring the COVID-19 pandemic, face mask we...
PMC10279653
Methods
PMC10279653
Subjects
allergy, fever
CHRONIC AIRWAY DISEASE, ALLERGY, OCULAR INFECTION
This experimental multiple crossover study was approved by the Siriraj Institutional Review Board, COA No. Si508/2021, and was performed in accordance with the Declaration of Helsinki. The study was registered in the Thai Clinical Trials Registry, No. TCTR20221222002 (22/12/2022). Healthy volunteers aged 18–80 years ol...
PMC10279653
Study procedures
STERILE
The study was conducted in a closed air-conditioned room, used for everyday intravitreal injections at the Intravitreal Injection Clinic, Siriraj Hospital. The room was disinfected with UVC light (Philips UVC disinfection desk lamp 24W S TC) for 30 min before each subject. There were no specialized air filtration equip...
PMC10279653
Statistical analysis
STERILE
The amount of bacteria in colony forming units (CFUs) were compared between different scenarios using Wilcoxon signed-rank test. When the CFUs were either 0 or 1 in each subject, the comparisons were made using McNemar’s test.The effect of each of the factors including: (1) the presence/absence of face masks; (2) the p...
PMC10279653
Conference presentation
The work has been presented at the 128th annual meeting of the Korean Ophthalmological Society, Seoul, Korea on 29th October, 2022.
PMC10279653
Results
STERILE
Sixteen volunteers fulfilled the inclusion and exclusion criteria and were recruited into the study. The mean ± standard deviation of age was 30 ± 5.8 years old and 63% were female. The total number of blood agar was 464 plates from 224 experiments. All 16 room control agar plates did not grow any bacteria. The distrib...
PMC10279653
Acknowledgements
The authors thank Chulaluk Komoltri, PhD, Research Group and Research Network Division, Siriraj Hospital, Mahidol University, for her assistance in statistical analyses. The study was supported by Siriraj Development Research Fund (managed by Routine to Research: R2R), Siriraj Hospital, Mahidol University # R016435062.
PMC10279653
Author contributions
N.P., S.Pr., R.J. and P.N. were involved in study conception and design. R.J., P.P., and S.Ph. collected the data. N.P., R.J. and P.P. analysed the data. N.P. and R.J. wrote the manuscript. N.P., S. Pr. and P.N. supervised the study process. All authors reviewed and approved the final version of the manuscript.
PMC10279653
Data availability
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
PMC10279653
Competing interests
The authors declare no competing interests.
PMC10279653
References
PMC10279653