Top PDF Effect of intermittent aerobic exercise on sleep quality and sleep disturbances in patients with rheumatoid arthritis – design of a randomized controlled trial

Effect of intermittent aerobic exercise on sleep quality and sleep disturbances in patients with rheumatoid arthritis – design of a randomized controlled trial

Effect of intermittent aerobic exercise on sleep quality and sleep disturbances in patients with rheumatoid arthritis – design of a randomized controlled trial

Cross-sectional studies have shown that physical inactiv- ity increases the likelihood of reporting poor sleep, even after controlling for age, depression and pain [25,26]. Fur- thermore, it has been reported that, independent of age and sex [27], maximal aerobic capacity is lower in patients with insomnia compared to those without it. In addition, physical exercise interventions have been shown to be a feasible and effective non-pharmacological treatment mo- dality for improving sleep in healthy and in clinical popula- tions [28-31]. Exercise interventions is known to improve cardiorespiratory fitness, muscle strength and functional ability [32], as well as health-related quality of life [33], and to reduce co-morbidity [34] in patients with RA. Thus, physical exercise interventions may be a viable non- pharmacological alternative for both prevention and treat- ment of poor sleep in addition to the simultaneous benefits for numerous health parameters in the human body.
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Effect of Using Eye Mask on Sleep Quality in Cardiac Patients: A Randomized Controlled Trial

Effect of Using Eye Mask on Sleep Quality in Cardiac Patients: A Randomized Controlled Trial

The study instrument comprised two parts including a demographic questionnaire and the Pittsburgh sleep quality index (PSQI). The demographic questionnaire consisted of questions about participants’ demographic and clinical data including age, gender, marriage, em- ployment, education level, history of hospitalizations, and medical diagnosis. The PSQI is a self-report question- naire developed for evaluating sleep quality (14, 15). The PSQI consists of 7 components subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and day- time dysfunction. The score for each component ranges from 0 to 3, resulting in a total PSQI score of 0-21. Higher scores represent lower sleep quality (16, 17). In this study we used Farsi version of PSQI, which has yielded satisfac- tory validity and reliability. Cronbach’s alpha coefficient was 0.77 and corrected item-total correlations ranged from 0.30 to 0.7 for the seven components of the PSQI (14).
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The acute effects of aerobic exercise on sleep in patients with depression: study protocol for a randomized controlled trial

The acute effects of aerobic exercise on sleep in patients with depression: study protocol for a randomized controlled trial

Polysomnography is considered the gold standard of sleep assessment [121]. However, one significant draw- back of this method is the so-called first-night effect. This effect describes altered sleep patterns due to novel environments, disturbances by measurement equipment, a potential Hawthorne effect, or a combination thereof [122]. Such alterations typically represent worse sleep quality, e.g., reduced sleep efficiency, in the first com- pared to the second night [122]. Although this effect has been found in different patient groups, it is clearly atte- nuated in individuals with depression [123–125]. More- over, polysomnographic measurements are expensive and performing multiple measurements is not always feasible. Several authors argue that data from the first night (i.e., baseline) should, therefore, be used in the analyses [123, 125]. In designs where baseline and follow- up data are collected, analysis of covariance (ANCOVA) has multiple advantages. Firstly, there is less potential for bias compared to the analysis of change (i.e., pre minus post) scores or follow-up data only. Secondly, ANCOVA has higher statistical power [126, 127].
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Effect of Treatment of Obstructive Sleep Apnea by Uvulopalatoplasty on Seizure Outcomes: A Case Report

Effect of Treatment of Obstructive Sleep Apnea by Uvulopalatoplasty on Seizure Outcomes: A Case Report

An epileptic seizure is an episode of unusual and uncontrollable motor, intuitive, or psychological behavior caused by reduplicated, hypersynchronous electrochemical activity that emanates from the cerebrum [1]. Epilepsy can occur as a result of a mutation in the gene that controls the neural behaviors. It may cause major brain damage, stroke, infection, and malignant tumors [2]. It has been estimated that more than 50 million people worldwide are likely to have epilepsy [3]. More than one-third of the epileptic patients have obstructive sleep apnea (OSA), and this illness is more prevalent among the patients with medically refractory epilepsy [4,5]. OSA is caused by partial or complete blockage of the airways during sleep. The obstruction in the pharyngeal area results in loud snoring, hypoxia and repeated apnea; as a result, the patients have an unrestful fragmented sleep and inordinate daytime sleepiness. The disorder is associated with hypertension, cardiovascular disease, impotence and emotional problems [4,5].
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Impact of aerobic exercise on sleep and motor skills in children with autism spectrum disorders – a pilot study

Impact of aerobic exercise on sleep and motor skills in children with autism spectrum disorders – a pilot study

was executed in a highly structured manner and was based on the “Applied Behavioral Analysis” (ABA) method. ABA is based on the principles of operant conditioning with posi- tive reinforcement as the principal feature. Children were positively reinforced verbally with compliments for every successful trial (playing with ball; balancing) and every effort on the bicycle. Further, daily and weekly improvements in skills were visualized with graphs and scales at home in the child’s bedroom. Further, the training was adjusted according to the characteristics of autism present in each participant and was aimed at the important concept of errorless learning. Accordingly, the aims of MST were as follows: throwing a ball with one and two hands to the coach over a distance of 3–5 m (measurement: number of trials without interruption, that is, without losing the ball) and balancing (standing on one leg, jumping, jumping zigzag, balancing) on the beam (moderate-to-large sizes) without interruptions for at least 30 seconds (measurement: balancing time in seconds). Specific skills were assessed at the beginning and at the end of the intervention. Trials were repeated three times, and the best trial was used as baseline and as end point of the intervention.
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Effect of adjuvant sleep hygiene psychoeducation and lorazepam on depression and sleep quality in patients with major depressive disorders: results from a randomized three-arm intervention

Effect of adjuvant sleep hygiene psychoeducation and lorazepam on depression and sleep quality in patients with major depressive disorders: results from a randomized three-arm intervention

and to complete the questionnaires. Exclusion criteria were 1) not meeting the inclusion criteria; 2) presence of a pro- gressive illness (eg, cancer and dementia) directly related to the onset and course of insomnia; 3) use of medications with sleep-altering effects (eg, steroids); 4) lifetime diagnosis of any psychotic or bipolar disorder; 5) alcohol or drug abuse within the past year; 6) sleep apnea or restless legs (“Sleep-related assessment” section); and 7) night-shift work or irregular sleep pattern. All patients were treated with a standard SSRI, that is, with citalopram at a therapeutic level (20–40 mg/d).
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Rationale and design of The Delphi Trial – I(RCT)2: international randomized clinical trial of rheumatoid craniocervical treatment, an intervention prognostic trial comparing 'early' surgery with conservative treatment [ISRCTN65076841]

Rationale and design of The Delphi Trial – I(RCT)2: international randomized clinical trial of rheumatoid craniocervical treatment, an intervention prognostic trial comparing 'early' surgery with conservative treatment [ISRCTN65076841]

The spinal column consists of vertebrae stabilized by an intricate network of ligaments. Especially in the cervical spine, rheumatoid arthritis can cause degeneration of these ligaments, causing laxity, instability and subluxa- tion of the vertebral bodies. Subsequent compression of the spinal cord and medulla oblongata can cause severe neurological deficits and even sudden death. Cervical spine involvement typically begins early in the disease process, and its progression has been closely correlated with the extent of peripheral disease activity [4-6]. Several types of subluxations have been described [3]. The first signs and symptoms of atlantoaxial instability are the result of rheumatoid synovial proliferation. Because of erosions of the transverse, apical and alar ligaments an anterior atlantoaxial subluxation (AAS) develops. Dam- age to the transverse ligament alone will allow approxi- mately 3 to 4 mm of subluxation; a greater anterior atlanto dental interval (AADI) implies damage to the alar- apical ligament complex, an incomplete odontoid peg or a resorbed dens [4]. The average duration of RA at the onset of AAS has been reported being 12.7 years (3–26 years) [7]. Many patients acquire AAS in the first 3 years of their disease, but neurological impairments develop after a mean period of 18 years (range 4–50 years) [8]. When the odontoid process erodes a posterior AAS can evolve. Vertical Translocation (VT) (Cranial settling, basilar invagination, or superior migration of the odontoid proc- ess) results from progressive destruction of the lateral mass joints (atlantoaxial and occipitoatlantal) and the lat- eral masses themselves, as a result of chronic craniocervi- cal instability [9-11]. The odontoid process moves towards and beyond the borders of the foramen magnum. Secondarily periodontoid pannus is formed in reaction to the chronic instability [3,12]. VT is observed in 4–35% of patients [13]. Because of VT the AADI can decrease, which virtually is a paradoxal improvement [9,14,15]. VT appears after a mean of 16.5 years (4–33 years) after the
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Trends in CPAP adherence over twenty years of data collection: a flattened curve

Trends in CPAP adherence over twenty years of data collection: a flattened curve

scope of this current paper, several of the papers studied in our review did investigate these interventions [79, 92], including one review [96]. The strongest intervention, cognitive-behavioral, resulted in an increase of 1.44 h per night for participants in six studies. Both supportive and educational interventions were found to increase adherence to over 4 hours per night among study partici- pants. Non-behavioral interventions for CPAP adherence, such as variants of CPAP, have also been investigated. A systematic review and meta-analysis found that patients preferred auto-CPAP over fixed pressure CPAP; however, there was no statistical difference in machine use [97]. Overall the authors did not find a difference in adherence between auto- and fixed-CPAP. Similarly, a more recent systematic review and meta-analysis found positive results associated with auto-CPAP over fixed-CPAP, including pa- tient preference and enhanced adherence [98]. However, the latter did not found significant differences between the two variants in terms of AHI and ESS scores, leading the authors to question the clinical significance of their results.
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<div>Among substance-abusing traffic offenders, poor sleep and poor general health predict lower driving skills but not slower reaction times</div>

<div>Among substance-abusing traffic offenders, poor sleep and poor general health predict lower driving skills but not slower reaction times</div>

Fourth, as already noted, it is also conceivable that further latent but unassessed neurophysiological and psychological dimensions might have biased two or more variables in the same or opposite direction. Fifth, the cross-sectional design of the study means that it is unable to shed light on the causal relationships between sleep, psychological functioning, driving behavior, and reaction time on the driving simulator. Finally, to estimate whether and to what extent the present pattern of results is unique for the present sample, it would be interesting to compare the present data with other samples such as both healthy male and female drivers without traffic violations.
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Lutein and Zeaxanthin Isomers Effect on Sleep
Quality: A Randomized Placebo-Controlled Trial

Lutein and Zeaxanthin Isomers Effect on Sleep Quality: A Randomized Placebo-Controlled Trial

Estimates from population studies indicate that the average American spends more than 10 hours per day viewing screens and this is only increasing [31]. A recent survey reported that 9 out of 10 Americans reported using a technological device in the hour before bed with among those respondents under 30 years old, smartphones were the most popular device. This has led to an alteration of this groups’ natural sleep patterns [32]. The most common complaint was a delayed bed time and shorter sleep [33]. One potential reason for this is the blue light that is emitted from these devices and the inhibitory effect it has on melatonin release.9,10 The monetary repercussions from sleeplessness are vast and are not only localized to the United States [2]. Some common foodstuffs have been shown to improve sleep when consumed. For example, the consumption of 2 kiwi fruits 1 h before bedtime daily for 4 weeks significantly increased total sleep time and sleep efficiency as measured by sleep actigraphy in adults with self-reported sleep disorders [34].
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Muscle strength, physical fitness and well-being in children and adolescents with juvenile idiopathic arthritis and the effect of an exercise programme: a randomized controlled trial

Muscle strength, physical fitness and well-being in children and adolescents with juvenile idiopathic arthritis and the effect of an exercise programme: a randomized controlled trial

Results of CHAQ and CHQ are shown in Tables 1 and 7. Fifty-three children completed the CHAQ and CHQ at baseline. There were no differences between the exer- cise and the control group. The CHQ was only used in scientific studies such as the study of Norrby [38]. The CHQ was used for all the participants in this study. The adolescents even the one 20.6 years of age and those older than 16 years were considered adolescents as the participants still were patients at the Children´s hospital. Our subjects showed low values in the domain “bodily pain” and also in the domains “general health” and “mental health” at baseline. 35 children fulfilled the CHAQ and 39 the CHQ at all test occasions. There was no increase in pain during the study. There were only small changes in both of the questionnaires. In the con- trol group there was a statistically significant increase in CHQ domain “role physical” at the end of the study period. There was a tendency to improved “mental Table 2 Distribution of gender, age, height, weight,
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Relationship between Sleep Disorders, Pain and Quality of Life in Patients with Rheumatoid Arthritis

Relationship between Sleep Disorders, Pain and Quality of Life in Patients with Rheumatoid Arthritis

On the other hand pain due to illness, is one of the factors influencing sleep pattern and rest which is significantly effective on people’s QOL. This results are consistent with Lee and et al., findings on assessing the role of sleep problems in central pain processing in rheumatoid arthritis. 33 Also a study on sleep and its relationship to pain and disease activity in juvenile idiopathic arthritis indicated meaningful correlation between sleep apnea and insomnia with pain. 34 Night sleep deprivation and pain could be playing a role in reducing the QOL as a factor with interaction effects. In a survey on the relationship between RA activity, sleep, psychiatric distress and pain sensitivity indicated no significant relation between pains with QOL but the sleep disorders had direct and significant relation with pain. 16
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Randomized controlled trial design in rheumatoid arthritis: the past decade

Randomized controlled trial design in rheumatoid arthritis: the past decade

There remains an important value of limited use of placebo as there exists a ‘placebo response’ that can be characterized. Patient-reported measures such as HAQ, pain, and patient global assessment of disease activity best differentiated responders and nonresponders in US301 [45], combined anakinra trials [46], and ATTRACT [47]. Nonetheless, there are a small number of subjects who receive placebo who are ‘responders’ by signs and symptoms, including physical function and radiographic outcomes [48]. These individuals have documented RA and cannot be characterized by differ- ences in demographics or baseline disease activity, but they are few in number and responses generally wane over time. Of interest, placebo responses appear to be higher with ‘milder’ active comparators, as Paulus and colleagues [49] demonstrated in early CSSRD (Cooperative Systematic Studies of Rheumatic Diseases Group) studies. This may be due, in part, to ‘equipoise’ as extensive discussions about risks and benefits of a new therapy may prime expectations of a very powerful intervention. Many other factors may also affect the placebo response and these are related to parenteral administration, including rapid onset of effect, infusion, and injection site reactions, which may result in expectation bias as well as unblinding. Most importantly, placebo has been necessary to prove inefficacy of many ‘promising’ agents [41], including anti-CD4 and anti-CD5 monoclonal anti- bodies. To miss this effect permitted by direct comparison to placebo would expose patients to a potentially toxic therapy lacking in efficacy.
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The effects of using cognitive behavioural therapy to improve sleep for patients with delusions and hallucinations (the BEST study): study protocol for a randomized controlled trial

The effects of using cognitive behavioural therapy to improve sleep for patients with delusions and hallucinations (the BEST study): study protocol for a randomized controlled trial

The importance of sleep in the occurrence of psychiatric problems is becoming increasingly recognized [5,41]. The BEST study will be the first randomized controlled test of cognitive behaviour therapy for insomnia in patients with nonaffective psychosis. The trial is funded for 24 months and staff began in post in October 2012. Final outcome as- sessments will be complete by the end of August 2014. Therefore, the study results will become available in 2015. We predict that the intervention will not only improve sleep but lessen distressing positive symptoms of psych- osis. Our experience is that the intervention is popular since it focuses on a problem that the patient recognizes and hence there is a clear shared outcome goal. In the study we will be able to compare self-reported and more objective markers of sleep (for example, actigraphy, mela- tonin), while we will assess delusions and hallucinations multidimensionally (for example, frequency, preoccupa- tion, distress, and interference). If the study is successful, we anticipate that the next step will be a definitive Phase III clinical trial. We think it likely that in the future the treatment of sleep problems will be an important tool in the reduction, and perhaps prevention, of distressing psychotic experiences.
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Health-Related Benefits of Exercise Training with a Sauna Suit: A Randomized, Controlled Trial

Health-Related Benefits of Exercise Training with a Sauna Suit: A Randomized, Controlled Trial

Purpose: Worldwide, the prevalence of overweight and obesity has more than doubled in adults. This epidemic is associated with many cardiovascular and metabolic disorders. Training strategies exist for weight reduction, one of which is heat stress. Evidence has shown that exercise combined with heat therapy provides cardiovascular health benefits. Research is lacking on the use of a heat stress on health parameters for overweight or obese individuals. The purpose of this study was to quantify the effect of health-related benefits associated with exercise training using a sauna suit in a cohort of overweight and obese individuals. Methods: Overweight or obese, sedentary, but low risk men and women (n=45) were randomized to the non-exercise control group or one of the two training groups. Exercise training was five days a week for eight-weeks. Monday, Wednesday, and Friday were 45 minutes long training sessions at a moderate intensity based on an individual’s heart rate reserve (HRR). Tuesdays and Thursdays were 30 minute long spin classes at a vigorous intensity based on an individual’s HRR and were instructed by the principle investigator. Results: 45 men and women completed the study. After eight-weeks, V̇O 2 max increased significantly (p<0.05) in the sauna suit with
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Impact of earplugs and eye mask on sleep in critically ill patients: a prospective randomized study

Impact of earplugs and eye mask on sleep in critically ill patients: a prospective randomized study

This study demonstrates that sleep was severely altered in critically ill patients. Sleep alterations involved both sleep duration and architecture and were consistent with previous reports [19, 26, 27], although the time spent in N3 sleep tended to be longer in our study. The severity of sleep alterations observed in this study shows that the study was conducted in patients with poor- quality sleep who were likely to benefit from an inter- vention designed to improve sleep quality. Of note, one of the strengths of our study was the use of poly- somnography as a key outcome measure, because, to our knowledge, this study is one the largest studies including polysomnography recording in critically ill patients [4, 9, 19, 26 – 32]. However, performing poly- somnography to provide analyzable data is a challenge in the ICU, as recently reported [33]. In contrast with recent reports, we did not observe the atypical sleep stages de- scribed in ICU patients, namely pathologic wakefulness and atypical sleep [29, 34], because the EEG patterns ob- served complied with the Rechtschaffen and Kales scoring system [22]. This result could be explained by the exclu- sion of patients in whom sedation or high-dose opioids Table 1 Main characteristics of included patients
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Infant sleep hygiene counseling (sleep trial): protocol of a randomized controlled trial

Infant sleep hygiene counseling (sleep trial): protocol of a randomized controlled trial

Background: Sleep problems in childhood have been found to be associated with memory and learning impairments, irritability, difficulties in mood modulation, attention and behavioral problems, hyperactivity and impulsivity. Short sleep duration has been found to be associated with overweight and obesity in childhood. This paper describes the protocol of a behavioral intervention planned to promote healthier sleep in infants. Methods: The study is a 1:1 parallel group single-blinded randomized controlled trial enrolling a total of 552 infants at 3 months of age. The main eligibility criterion is maternal report of the infant ’ s sleep lasting on average less than 15 h per 24 h (daytime and nighttime sleep). Following block randomization, trained fieldworkers conduct home visits of the intervention group mothers and provide standardized advice on general practices that promote infant ’ s self-regulated sleep. A booklet with the intervention content to aid the mother in implementing the intervention was developed and is given to the mothers in the intervention arm. In the two days following the home visit the intervention mothers receive daily telephone calls for intervention reinforcement and at day 3 the fieldworkers conduct a reinforcement visit to support mothers ’ compliance with the intervention. The main outcome assessed is the between group difference in average nighttime self-regulated sleep duration (the maximum amount of time the child stays asleep or awake without awakening the parents), at ages 6, 12 and 24 months, evaluated by means of actigraphy, activity diary records and questionnaires. The secondary outcomes are conditional linear growth between age 3 – 12 and 12 – 24 months and neurocognitive development at ages 12 and 24 months.
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<p>Frequency of sleep disorders in patients with rheumatoid arthritis</p>

<p>Frequency of sleep disorders in patients with rheumatoid arthritis</p>

population (8.4%). 17 This higher prevalence can be explained by the high risk of iron de fi ciency anemia sec- ondary to the chronic use of NSAIDs in the RA patients, 18 which was identi fi ed as the main risk factor for secondary RLS. 19 Iron de fi ciency was further con fi rmed in our study population by the presence of low serum ferritin in patients with RLS. In addition, the prevalence of RLS reported in this study was higher than that reported among RA patients in other studies. Reynolds et al 20 reported a strong link between RLS and RA disease with a prevalence of 5 – 15%; however, the previous study did not use the standard IRLSSG criteria. This discrepancy was explained by iron de fi ciency anemia and chronic in fl ammatory conditions with the secretion of multiple cytokines and in fl ammatory mediators. 21,22 Taylor-Gjevre et al 22 used the standard IRLSSG criteria to screen RA patients and found that approximately a quarter of RA patients had RLS signi fi cantly affecting their quality of life. However, most patients with RLS were underdiag- nosed due to the lack of awareness of health care professionals. 4
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Effect of low level laser therapy on pain, quality of life and sleep in patients with fibromyalgia: study protocol for a double blinded randomized controlled trial

Effect of low level laser therapy on pain, quality of life and sleep in patients with fibromyalgia: study protocol for a double blinded randomized controlled trial

Methods/design: One hundred and twenty patients with fibromyalgia will be treated at the Integrated Health Center and the Sleep Laboratory of the Post Graduate Program in Rehabilitation Sciences of the Nove de Julho University located in the city of Sao Paulo, Brazil. After fulfilling the eligibility criteria, a clinical evaluation and assessments of pain and sleep quality will be carried out and self-administered quality of life questionnaires will be applied. The 120 volunteers will be randomly allocated to an intervention group (LLLT, n = 60) or control group (CLLLT, n = 60). Patients from both groups will be treated three times per week for four weeks, totaling twelve sessions. However, only the LLLT group will receive an energy dose of 6 J per tender point. A standardized 50-minute exercise program will be performed after the laser application. The patients will be evaluated regarding the primary outcome (pain) using the following instruments: visual analog scale, McGill Pain Questionnaire and pressure algometry. The secondary outcome (quality of life and sleep) will be assessed with the following
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A randomized controlled trial of Tai chi for balance, sleep quality and cognitive performance in elderly Vietnamese

A randomized controlled trial of Tai chi for balance, sleep quality and cognitive performance in elderly Vietnamese

In a randomized, controlled trial, 102 subjects were recruited. Six subjects did not meet the exclusion criteria (Mini Mental State Examination score $ 25). Subjects were divided randomly into two groups – Tai chi group and control group. The subjects were expected to consent and volunteer. Participants in the Tai chi group (n = 48, mean age = 69.2 years, standard deviation = 5.3) were assigned 6 months’ Tai chi training. Participants in the control group (n = 48, mean age = 68.7, standard deviation = 4.9) were instructed to maintain their routine daily activities and not to begin any new exercise programs. Statistical analysis was based on previous findings, 10,11 using the standardized mean difference of the group
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