Visibility Evaluation of Fundic Gland Polyp Associated With Proton Pump Inhibitor in Texture and Color Enhancement Imaging

Objectives

A 'gray color sign' (GCS) is a new endoscopic feature of fundic gland polyp associated with proton pump inhibitor (PPI-FGP). Here, we compare the ability of texture and color enhancement imaging (TXI) to white light imaging (WLI) with regard to the detection of GCS.

Methods

In this prospective study, 19 consecutive patients with PPI-FGP were enrolled at our hospital from April 2021 to October 2022. Endoscopic images of PPI-FGP using WLI, TXI mode1 (TXI-1), TXI mode2 (TXI-2), and narrow-band imaging (NBI) were collected and compared by 10 endoscopists. Visibility of GCS by each mode (Image enhancement endoscopy) was scored as follows: 5, improved; 4, somewhat improved; 3, equivalent; 2, somewhat decreased; and 1, decreased. The inter-rater reliability (intra-class correlation coefficient, ICC) was also evaluated. The images were objectively evaluated based on L* a* b* color values and the color difference (ΔE*) in the CIE LAB color space system.

Results

Improved visibility of GCS compared with WLI was achieved for: TXI-1: 82.6%, TXI-2: 86.9%, and NBI: 0% for all endoscopists. Total visibility scores were: TXI-1, 44.9; TXI-2, 42.9; NBI, 17.4 for all endoscopists. Visibility scores were significantly higher using TXI-1 and TXI-2 compared with NBI (p < 0.01). The inter-rater reliability for TXI-1 and TXI-2 was "excellent" for all endoscopists. The use of ΔE* revealed statistically significant differences between WLI and TXI-1 (p < 0.01).

Conclusions

TXI is an improvement over WLI for the visualization of GCS, and can be used by both trainee and expert endoscopists with equal efficiency and accuracy.

Estimating endurance training intensity prescription from the 6-minute stepper test in people with chronic obstructive pulmonary disease - a multicenter cross-sectional study with external validation

BACKGROUND

Home-based pulmonary rehabilitation (PR) can enhance accessibility to PR, but no at-home field exercise test has been validated for individualized endurance training prescriptions.

RESEARCH QUESTION

What is the accuracy of the six-minute stepper test (6MST) in estimating endurance training intensity as determined during cardiopulmonary exercise testing (CPET)?

STUDY DESIGN AND METHOD

This multicenter (N = 3) cross-sectional study included individuals with COPD. Participants performed CPET and two 6MSTs to evaluate the 6MST's ability to estimate endurance training intensity based on CPET-derived heart rate at the first ventilatory threshold (HRvt1), the corresponding power output (Pvt1), and peak power output (Ppeak). Predictive equations were tested for external validity using data from two prior studies.

RESULTS

105 patients were included (mean age 61 (SD 9) years; mean FEV1 61 (SD 21) %). Predictive equations moderately predicted HRvt1 (r² = 0.38), strongly predicted Pvt1 (r² = 0.63) and very strongly predicted Ppeak (r² = 0.75). External validity was small to moderate for HRvt1 and Pvt1 but was strong for 60% of Ppeak (mean absolute difference: 10W, 95% CI 5 to 10). Passing and Bablok regression confirmed interchangeability for Pvt1 and 60% of Ppeak.

INTERPRETATION

The 6MST offers a reliable method to set initial training intensity when CPET is unavailable.

CLINICAL TRIAL REGISTRATION

NCT02842463.

Validation of the academic misconduct questionnaire: exploring predictors of student misconduct

Multiple instruments have been used to assess academic misconduct, yet robust psychometric evidence has been reported only for a few. This study aims to determine the validity and dimensionality of a novel Academic Misconduct Questionnaire (AMQ) and to explore differences between students who engage in distinct misbehaviours. A diverse sample of health and non-health students replied to the AMQ. Exploratory and confirmatory factor analyses were conducted using two subsamples. Predictive models were computed for the AMQ and its dimensions. The questionnaire showed good validity and reliability, revealing eight dimensions related to Cheating during (two forms) and prior Exams, Plagiarism, Fraud in Academic Work, Impersonation (assessment), Signature Forgery in attendance sheets and Not Reporting peer misconduct. The predictors of student engagement in each form of misconduct differed, except for perceiving greater peer fraud, which increased the propensity for all misbehaviours. Perceiving higher sanctions reduced the propensity to engage in most forms, while gender played a role in half of them. First-year students were more likely to Not Reporting peer misconduct and less likely to disclose Fraud in Academic Work and Signature Forgery than those in more advanced years. Health students scored higher in most misbehaviours, especially compared to Economics/Law, Social Sciences and Arts/Humanities, while the latter two disclosed higher Signature Forgery. This study proposes a valid instrument to assess academic misconduct in university students. The predictive models helped to better understand differences between students who engaged in distinct misbehaviours, enabling more targeted interventions.

Efficacy of exposure scenario in virtual reality for the treatment of acrophobia: A randomized controlled trial

BACKGROUND AND OBJECTIVES

Individuals with acrophobia (fear of heights) can experience severe anxiety or panic attacks when they are located at height. This randomized controlled study aimed to verify the effects of a novel scalable virtual reality-based exposure (VR exposure) tool in individuals with acrophobia, by exposing them to a predefined set of situations they usually tend to avoid.

METHODS

Forty-three adults were randomly assigned to one of the two groups: the experimental group or the waitlist group. Both groups attended initial short online education. The experimental group consecutively attended three VR-based exposure therapy (VRET) intervention sessions over 3-5 weeks during which the therapist encouraged participants to enter the predefined feared situations, while the control group on the waitlist had no additional intervention.

RESULTS

The findings show that a 3-session VR exposure intervention with a standardized set of tasks effectively reduces the level of experienced height intolerance and particularly avoidance behavior compared to the control waitlist group limited to psychoeducation only. Results were maintained at the 2 months follow-up. The higher the sense of presence after the VR exposure was, the lower the avoidance level rated in the follow-up.

LIMITATIONS

Our study has some limitations, such as potential sample selection bias and tracking of only medium-term effects in the 2-month follow-up.

CONCLUSIONS

The findings show that three sessions of VR exposure intervention with a standardized set of VR-based scenarios are effective in reducing the level of height intolerance and associated avoidance behavior and led to improvement of the outcome measures two months after the procedure. The role of presence was implicated in the prolonged outcome of the VR exposure intervention.

Exploring Multimorbidity Patterns in older hospitalized Norwegian patients using Network Analysis modularity

BACKGROUND

Understanding Multimorbidity Patterns (MPs) is crucial for planning healthcare interventions, allocating resources, and improving patients' outcomes.

OBJECTIVE

We aim to demonstrate the use of Network Analysis (NA) to explore the MPs in hospitalized Norwegian older patients.

METHODS

We utilized data from the Norwegian Patient Registry (NPR) of all admissions between 2017 and 2019. The study population included patients ≥ 65 years old with two or more different conditions. Multimorbidity was defined as the co-occurrence of two or more associated chronic conditions. Chronic conditions were identified using the Chronic Condition Indicator Refined (CCIR) list. The association between chronic conditions was determined by calculating Relative Risk (RR) and Phi-correlation to detect pairs of conditions that co-occur beyond chance. A multimorbidity network was created, and MPs were detected using Louvain method for community detection. We suggested a clinical interpretation for these MPs.

RESULTS

A total of 539 chronic conditions were used to create a multimorbidity network revealing several MPs. These modules included patterns of vision and hearing disorders, cardiorenal syndrome, metabolic and cardiovascular disorders, respiratory disorders, endocrine and skin conditions, autoimmune and musculoskeletal disorders, as well as mental and behavioral disorders. Using NA centrality measures, we identified the most influential conditions in each module. An interactive network and sunburst graphs for each module are publicly available.

CONCLUSION

The study demonstrates the use of NA modularity detection in identifying MPs. The findings highlight the complex interaction of chronic conditions in the elderly and the potential of NA methodology in exploring these relationships.

Validating the depression anxiety stress scales (DASS-21) across Germany, Ghana, India, and New Zealand using Rasch methodology

Psychological distress is widespread globally, affects both mental and physical health, and has been significantly exacerbated by the COVID-19 pandemic. Reliable and valid instruments to assess psychological distress are needed so that interventions to address this condition can be directed and evaluated. We evaluated the psychometric statistics of the Depression Anxiety Stress Scales (DASS-21) using the Rasch method and a population survey sample dataset from four nations. To meet the requirements of the Rasch model, we randomly selected 500 participants (at least 110 from each country) from a total sample of 1822 individuals from Germany (n = 475), Ghana (n = 523), India (n = 411), and New Zealand (n = 413). Minor testlet modifications were necessary to achieve a satisfactory model fit for the depression (χ2 (30) = 40.32, p = 0.099), anxiety (χ2 (32) = 31.22, p = 0.510), and stress (χ2 (20) = 29.64, p = 0.076) subscales, and the full-scale (χ2 (18) = 23.93, p = 0.16). The scales were strictly unidimensional with acceptable reliability reflected by Person Separation Index (PSI) values of 0.86 for depression, 0.74 for anxiety, 0.82 for stress, and 0.87 for the total scale. The scales' items showed invariance across the countries and sociodemographic factors. The scales also demonstrated convergent, structural, and external validities. The study supported the reliability and validity of the DASS-21 for assessing psychological distress in four countries. Rasch model algorithms developed in this study enable conversion of the ordinal DASS-21 scale and its subscale scores to interval-level scores, which increases the precision of measurement. Future studies should apply Rasch methodology to the DASS-21 in various cultural contexts, incorporating subgroup analyses.

Resilience building discourse in online spaces: A comparative analysis of user statements following the disclosure of a break in alcohol abstinence

This study investigates statements made by individuals who either disclose having experienced a break in alcohol abstinence or provide a first-level response to such disclosures. An average month of public Reddit data were examined, resulting in 193 posts and 1238 responses. Post statements were binarily considered according to eight a priori categories, primarily guided by the communication resilience process scale (CRPS; Wilson et al., 2021). Coded response posts were collapsed into sets corresponding to initial posts, facilitating the saturation comparison of resilience building statements between initial and response posts. Results indicate that responses were more resilience-heavy than initial posts, suggesting users looking to disclose an abstinence break have a good chance of experiencing resilience building responses. Notably, the top three resilience building categories identified in this study were identical for initial and response posts. Discussion, implications, and future research directions regarding communicating resilience and resilience building discourse follow.

Associations between physical activity trajectories and cognitive function in women 50 years and older: A nationally representative cohort study from the China Health and Retirement Longitudinal Study

OBJECTIVE

To examine the longitudinal association between physical activity trajectory changes and cognitive function in women aged 50 years and older.

METHODS

Data were obtained from the China Health and Retirement Longitudinal Study, collected between 2011 and 2020, involving 2,760 women aged 50 years and older. Group-based trajectory modeling was used to identify four physical activity trajectory groups: Low-Fluctuation Group, Moderate-Increasing Group, Moderate-Stability Group, and High-Fluctuation Group. Cognitive function was assessed based on episodic memory and mental intactness. Linear mixed-effects models were employed to examine the association between physical activity trajectories and cognitive function, including interaction effects and age-stratified analyses.

RESULTS

The Moderate-Increasing group was significantly associated with higher levels of global cognitive function (β = 0.45, 95% CI: 0.05-0.85) and episodic memory (β = 0.21, 95% CI: 0.05-0.37), particularly among women aged 50-59 years. In contrast, High-Fluctuation and Low-Fluctuation groups exhibited declining trends across cognitive outcomes. Age-stratified analysis suggested that the association between Moderate-Increasing group and cognitive function was not significant among women aged 60 years and older.

CONCLUSION

In women aged 50-59 years, the Moderate-Increasing group was significantly associated with better global cognitive function and episodic memory; however, this association was attenuated or not observed in older age groups.

Predictable object motion is extrapolated to support visual working memory for surface features

Space and time support visual working memory (VWM) by providing incidental reference frames for task-relevant information. While this has been studied with stationary items, natural scenes also contain moving objects, whose positions change over time, often in a predictable manner. We investigated if predictable item motion is leveraged to facilitate VWM for surface features. In a dynamic change-detection task, participants memorised the colours of three disks moving at constant speed in different directions before disappearing. After a retention interval, the disks reappeared (a) at the movement endpoint locations where they had disappeared (b) at positions spatiotemporally congruent with their previous motion (where they would have been had they continued their movement), (c) at positions with a temporal offset (consistent with a change in speed while out of view) or (d) at positions with a spatial offset (consistent with a change in movement direction). Performance decreased with increasing temporal or spatial offsets relative to congruent positions, indicating that the memorised items' positions were remapped to their anticipated future locations. This updating of positions in spatiotemporal reference frames, however, only occurs if motion extrapolation allows for reliable predictions of where occluded items will reappear. In a task context with unreliable motion patterns, the congruency effect diminished over time and performance instead increased at the movement endpoints. A second experiment confirmed this influence of motion reliability. Thus, predictable motion is extrapolated to update spatiotemporal reference frames in VWM, supporting memory for surface features and thereby contributing to visually guided behavior in dynamic environments.

Factor Analytic Adaptation Study of the Groningen Reflection Ability Scale (GRAS) in Senior Nursing Students

BACKGROUND AND PURPOSE

Reflection is a cyclical and iterative learning process that incorporates critically analyzing experiences, deriving lessons, establishing learning objectives, and implementing newly acquired knowledge in similar situations. This study evaluated the psychometric properties of the Turkish version of the Groningen Reflection Ability Scale (GRAS) among nursing students.

METHODS

This study is a factor analytic investigation with a nested cross-sectional design. This study included 252 fourth-year nursing students and was carried out between 10 March 2024 and 10 May 2024. Data analysis was conducted using the Content Validity Index (CVI), Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), Cronbach's alpha for internal consistency, test-retest reliability, and item-total score correlation.

RESULTS

The Turkish version of the GRAS consists of 23 items divided into three sub-dimensions: self-reflection, empathic reflection, and reflective communication. The internal consistency and reliability of the overall scale and its three sub-dimensions were acceptable. The three-factor construct validity of the Turkish version, identified through Exploratory Factor Analysis, was successfully confirmed with Confirmatory Factor Analysis.

CONCLUSION

The Turkish version of the GRAS is a valid and reliable instrument for evaluating reflective practice skills among fourth-year nursing students in Türkiye.

IMPLICATIONS

Nursing Practice: Evaluating reflective practice skills plays an important role in enhancing nursing students' critical thinking and their ability to provide patient-centered care. Policy Development and Implementation: Institutional policies should prioritize the standardized evaluation of reflective abilities within nursing education to maintain consistency and effectiveness. Education: Integrating reflection-based strategies into nursing curricula promotes self-awareness and professional growth.

FUTURE RESEARCH

Further studies should investigate the long-term influence of structured reflection on clinical competence and patient outcomes.

Exploring artificial intelligence (AI) Chatbot usage behaviors and their association with mental health outcomes in Chinese university students

Technology dependence has long been a critical public health issue, especially among young people. With the development of AI chatbots, many individuals are integrating these tools into their daily lives. However, we have limited knowledge about the issues related to AI chatbot usage and dependence. Therefore, we conducted a cross-sectional survey to investigate AI chatbot usage behaviors and their association with mental health outcomes among Chinese university students. A total of 1004 students who met the inclusion criteria were included in the analysis. Our survey revealed that 45.8 % of students reported using AI chatbots in the last month, with most using them one to three days per week (78.5 %) and showing light (38.2 %) to moderate (37.6 %) dependence. University students who use AI chatbots exhibited significantly higher levels of depression (p < 0.01) and a greater proportion scoring in the moderate to high levels of depression compared to non-users (p < 0.01). Among these users, depression was directly associated with higher AI chatbot usage and dependence (β = 0.14 to 0.20, p < 0.05). However, no direct association was found between AI chatbot-related behaviors and mental well-being or resilience (p > 0.05). Nevertheless, resilience may be indirectly linked to AI chatbot usage/dependence via depression (β = -0.077 to -0.052; p < 0.05). In conclusion, AI chatbot usage is relatively common among university students, though overuse and severe dependence are infrequent. AI chatbot usage and dependence are associated with higher levels of depression; however, the causal relationship warrants further investigation.

A Combined Interventional Approach to Train Interview Skills in Autistic Transition-Age Youth

BACKGROUND

The job interview can be challenging for autistic adolescents considering the required social communication skills. Further, having decreased awareness of personal strengths may make it difficult to advocate for oneself to a future employer. The purpose of the current pilot randomized controlled trial (RCT) is to examine the preliminary efficacy and feasibility of a combined interventional approach using: the Virtual Interview Tool for Autistic Transition-Age Youth (VIT-TAY) and Kessler Foundation Strength Identification and Expression (KF-STRIDE).

METHOD

Twenty autistic transition-age youth (TAY) were randomly assigned to two groups: an intervention group (n = 10) that received 9 h of VIT-TAY (interviewing practice with a virtual human), and three lessons of KF-STRIDE (positive psychology intervention to learn and discuss one's personal character strengths) and a services-as-usual (SAU) group (n = 10). The primary outcome was measured using a video-recorded mock job interview performed at pre- and post-test, which was rated by blinded assessors. Secondary outcomes included self-reports of job interview skill, interview anxiety, work readiness and recent job search behavior.

RESULTS

Paired samples t-tests revealed significant differences between pre- and post-test in the intervention group (but not the control group) on the mock interview total score (p = 0.02, d = 0.76) and self-reported job interview skills total score (p = 0.02, d = 0.75). The intervention group (but not the control group) had improvements in work-readiness (p = 0.06, d = 0.53) and job search behavior (p = 0.07, d = 0.52) that were characterized by medium effect sizes.

CONCLUSIONS

This pilot study suggests that combining VIT-TAY with KF-STRIDE leads to improvements in performance-based and self-reported job interview skills.

The relationship between psychological resilience and hair cortisol in adolescents: The influence of family and school environments

Psychological resilience plays a crucial role in protecting individuals from mental health issues in the face of adverse life events. However, the neurobiological mechanisms through which resilience functions as a protective factor against mental disorders remain poorly understood. This study aims to investigate the neuroendocrinological mechanisms underlying psychological resilience by examining the relationship between endogenous cortisol and resilience in Chinese adolescents. Additionally, the study explores whether this relationship is moderated by parenting style, family cohesion and adaptability, school climate, and life events. A total of 270 adolescent students (mean age: 12.83 ± 0.60 years; 112 boys, 158 girls) were randomly recruited from a middle school in Jiangsu Province, China. Hair cortisol, a biomarker of chronic endogenous cortisol, was measured using liquid chromatography-tandem mass spectrometry. Resilience was assessed using a scale validated for Chinese adolescent populations, while family and school environmental factors were evaluated using questionnaires. The results showed significant negative correlations between hair cortisol levels and resilience, individual power, goal planning, family support, and positive thinking. However, no significant correlations were found between hair cortisol levels and parenting style, family cohesion and adaptability, school climate, or life events. Importantly, the associations between hair cortisol levels and resilience were stable and not significantly influenced by family or school environmental factors. In conclusion, adolescents with higher psychological resilience, greater individual power, better goal planning, stronger family support, and more positive thinking exhibited lower chronic hypothalamic-pituitary-adrenal (HPA) axis activity. These associations remained stable and were not significantly affected by family or school environments.

Primary and secondary generalization effects from Black and gay contact: Longitudinal evidence of between- and within-person effects

The contact hypothesis stipulates that contact between social groups can reduce intergroup prejudice, implying that contact changes people (i.e., within-person effects). However, recent research suggests that more intergroup contact might simply be associated with less intergroup prejudice (i.e., between-person effects). We explore primary but also secondary contact effects, whereby contact with one outgroup theoretically improves attitudes towards other uninvolved groups. White, heterosexual Americans' contact with Black and gay people was assessed at four timepoints, 3 weeks apart (T1 N = 456; 51.6% women, Mage = 46.71, SD = 15.30); multilevel modelling parsed between- from within-person contact effects on intergroup outcomes (attitudes, humanization, collective action intentions). We found consistent evidence of predicted primary contact effects, reflecting both within- and between-subjects relations. For secondary contact, between-subjects gay-to-Black associative generalization was observed: greater contact (quantity and quality) with gay people was observed among those expressing more positive Black intergroup outcomes. Within-subjects secondary effects were primarily observed in terms of assessing contact quantity, where more contact with Black people predicted more positive gay intergroup outcomes downstream (i.e., Black-to-gay process generalization). Contrary to recent concerns, the current study promisingly shows that contact with a primary outgroup can change people in ways that generate positive outcomes towards primary and (some) secondary outgroups.

In the hands of metacontrast: Investigating the dual-task structure of an unconscious priming paradigm

Our study investigated unconscious priming from a dual-task perspective by means of a metacontrast masking paradigm with trial-by-trial assessments of prime visibility. Participants responded to target stimuli via keypress. In the prime-related direct task, they responded via vocal response (cross-modal) or keypress (unimodal), using either high (four-item) or low (two-item) complexity subjective or objective visibility measures, and responded with either one or two hands. We tested how these manipulations affect response times (RTs) and error rates. In two out of three experiments, participants were unaware of the prime at the shortest stimulus-onset asynchrony (SOA), with visibility measures increasing at longer SOAs. RTs were consistently longer in dual-task than single-task conditions. Priming effects were comparable across task types in Experiments 1 and 2, but larger in dual-task conditions in Experiment 3, likely due to increased prime visibility. RTs were also prolonged in unimodal and high-complexity conditions, while two-hands responses led to faster RTs. Priming effects were larger in unimodal conditions, but unaffected by complexity. Hand usage did not affect priming in Experiment 2, but in Experiment 3 where two-hands responses led to increased priming effects. Taken together, our findings highlight the important role of task characteristics like modality, hand usage and complexity in the design of masked priming experiments. We recommend careful consideration of these factors when employing unconscious priming paradigms with trial-by-trial prime visibility judgments, as such paradigms continue to advance our understanding of unconscious cognitive processing.

Zooming In and Out: Selective Attention Modulates Color Signals in Early Visual Cortex for Narrow and Broad Ranges of Task-Relevant Features

Research on feature-based attention has shown that selecting a specific visual feature (e.g., the color red) results in enhanced processing in early visual cortex, providing the neural basis for the efficient identification of relevant features in many everyday tasks. However, many situations require the selection of entire feature ranges instead of just a single feature value, and recent accounts have proposed that broadly tuned attentional templates are often critical for guiding selection in cluttered visual scenes. To assess the neural implementation of such broad tuning of feature-based attention, we here recorded frequency-tagged potentials in human observers (male and female) while participants attended to narrow or broad ranges of colors of spatially intermingled dot fields. Our results show clear increases in the signal strength for the attended colors relative to unattended colors for both narrow and broad color ranges, though this increase was reduced for the broad-range condition, suggesting that limits in the breadth of attentional tuning arise at early processing stages. Overall, the present findings indicate that feature-selective attention can amplify multiple contiguous color values in early visual cortex, shedding light onto the neural mechanisms underlying broad search templates. More generally, they illustrate how feature-based attention can dynamically "zoom in" and "zoom out" in feature space, mirroring models of spatial attention.

The effect of emotion on prospective memory: a three-level meta-analytic review

Prospective memory (PM), or the ability to remember to perform planned actions in the future, is fundamental in daily life. As a potential influencing factor of prospective memory, emotion has garnered significant attention. However, prior studies examining the impact of emotion on PM yield mixed findings. This study systematically reviewed 37 studies examining the effects of emotion on prospective memory, extracting a total of 171 effect sizes. The main effect analysis from the three-level meta-analysis revealed that positive emotions enhance prospective memory performance, supporting the positive effect theory. However, the facilitating effect of emotion varied depending on factors such as prospective memory task type, participant age, emotion induction method, study design, and the ecological validity of the experiment. The current study represents the first comprehensive review and meta-analysis of emotion's impact on PM and proposes directions for future research on emotional effects on PM.

Delayed rewards weaken human goal directed actions

Goal-directed actions are sensitive to the causal association between actions and outcomes, as well as the value of those outcomes. Such sensitivity diminishes when actions become habitual. Based on recent findings in animals, we tested if delaying outcomes relative to actions would weaken sensitivity to outcome revaluation and reduce action rates. In three experiments (N = 290), participants made fictitious investments in companies within contexts that provided either immediate or delayed feedback. After training, participants were informed of a change in markets which affected both companies (one improved and the other worsened). Across all experiments, action rates were lower in the delayed-feedback condition, and outcome revaluation was stronger in the immediate-feedback condition. In addition, self-reported action-outcome knowledge was weaker in the delayed-feedback condition. These findings suggest that delays in reinforcement weaken the action-outcome association critical for goal-directed control. We discuss the potential mechanisms underlying this phenomenon in light of a contemporary theory of goal-directed behavior.

Distribution of attention in three-dimensional space

The distribution of spatial attention has mostly been studied for visual events presented within a two-dimensional space. In this study, we examined the distribution of spatial attention in a three-dimensional space (i.e., across the z-axis). Much previous research suggests that attention is universally biased toward stimuli appearing in near space compared to far space. However, the results of some studies suggest this 'near advantage' is task-specific, with some tasks instead producing an attention bias toward stimuli in far space. The current study investigated whether two tasks that differ in attentional priorities (i.e., target localization vs target discrimination) differentially bias attention across near and far depth. Across three experiments, we compared target localization and target discrimination tasks when a single target appeared as the stimulus (Experiment 1) and then, for a cue-target task, compared target localization (Experiment 2A) and target discrimination tasks (Experiment 2B). Our results support the proposal that the near advantage is task-specific. For target localization, reaction times (RTs) were shorter for near-targets than for far-targets, however, for target discrimination, RTs were shorter for far-targets than for near-targets. This result was revealed in both uncued and cue-target paradigms. The cue-target paradigm also showed that relative to same-depth conditions, the cueing effect pointed to greater facilitation when orienting attention from far-to-near space for target localization but from near-to-far space for target discrimination. These findings argue against a universal near advantage. Overall, the results were consistent with the notion that different task demands can differentially bias the distribution of attention across near and far depth, a proposal that has implications for the potential involvement of the dorsal and ventral visual processing streams.

Dimensions of Depressive Symptoms in Young Children: Factor Analysis of the Preschool Feelings Checklist-Scale

The current study is an investigation of the dimensionality of the Preschool Feelings Checklist-Scale (PFC-S), a caregiver-report questionnaire of early childhood depressive symptom severity. Caregivers of 450 young children, ages 3-8 years (M = 5.62, SD = 0.95; 49% female; 7% Hispanic; 66% White), completed the PFC-S and questionnaires on child emotion regulation and expression and self-reported depressive symptomatology. Confirmatory factor analyses indicated that a one-factor structure did not adequately fit the current PFC-S data. Using exploratory factor analysis, a three-factor structure emerged as interpretable and structurally sound, yielding reliable factors related to social and behavioral anhedonia, emotional and behavioral dysregulation, and excessive guilt and sadness. This factor structure showed configural and scalar invariance across preschool-aged and early middle childhood-aged children as well as children assigned male and female sex at birth. Correlations between the three factors and constructs related to depression suggested preliminary construct validity. The current study provides initial evidence for a multidimensional structure of the PFC-S and improves our understanding of early childhood depressive symptoms.

Electrophysiological biomarkers based on CISANET characterize illness severity and suicidal ideation among patients with major depressive disorder

Major depressive disorder (MDD) is a significant neurological disorder that imposes a substantial burden on society, characterized by its high recurrence rate and associated suicide risk. Clinical diagnosis, which relies on interviews with psychiatrists and questionnaires used as auxiliary diagnostic tools, lacks precision and objectivity in diagnosing MDD. To address these challenges, this study proposes an assessment method based on EEG. It involves calculating the phase lag index (PLI) in alpha and gamma bands to construct functional brain connectivity. This method aims to find biomarkers to assess the severity of MDD and suicidal ideation. The convolutional inception with shuffled attention network (CISANET) was introduced for this purpose. The study included 61 patients with MDD, who were classified into mild, moderate, and severe levels based on depression scales, and the presence of suicidal ideation was evaluated. Two paradigms were designed for the study, with EEG analysis focusing on 32 selected electrodes to extract alpha and gamma bands. In the gamma band, the classification accuracy reached 77.37% in the visual paradigm and 80.12% in the auditory paradigm. The average accuracy in classifying suicidal ideation was 93.60%. The findings suggest that gamma bands can be used as potential biomarkers differentiating illness severity and identifying suicidal ideation of MDD, and that objective assessment methods can effectively assess MDD The objective assessment method can effectively assess the severity of MDD and identify suicidal ideation of MDD patients, which provides a valuable theoretical basis for understanding the biological characteristics of MDD.

The General Acceptability and Use of Smartphone App-Delivered Interventions for Gambling in Australia

Smartphones can extend the reach of evidence-based gambling treatment services, yet the general acceptability of app-delivered gambling interventions remains unknown. This study examined the general acceptability and use of app-delivered gambling interventions, and predictors of both, among 173 Australian adults with a lifetime gambling problem (48.5% male, Mage = 46.4 years) recruited from an online panel. Overall, 55.5% of the sample had a positive attitude toward app-delivered gambling interventions, 8.1% had a neutral attitude, and 36.4% had a negative attitude. Furthermore, one in five participants (20.8%) reported using an app-delivered gambling intervention in their lifetime. Four dimensions of acceptability were examined, wherein 78.6% of participants endorsed confidence in the effectiveness of app-delivered gambling interventions and 66.5% perceived anonymity benefits, while 48.6% endorsed scepticism (e.g., potential to increase isolation) and 69.4% perceived technology-related threats (e.g., difficulty learning and applying app-based strategies). Positive predictors of acceptability and use included younger age, rural/regional residence, gambling expenditure, problem gambling severity, gambling harms, and use of professional support. Acceptability did not increase the likelihood of using app-delivered gambling interventions, however, which may suggest a translation gap. The findings support continued investment into the development and evaluation of app-delivered gambling interventions, with a focus on enhancing engagement and uptake. Uptake could be improved by promoting the effectiveness and anonymity of evidence-based app-delivered gambling interventions, particularly among receptive audiences (young people, rural/regional residents, those with greater problem gambling severity), while redressing scepticism and perceived technology-related threats among vulnerable subgroups (those with greater gambling expenditure and gambling-related harm).

Tiny shifts, major ripples: Unravelling micro-mechanisms in the building of mother-infant attachment and psychophysiological regulation

Parental nurturing touch plays a crucial role in early infant development by activating C-Tactile afferents, which trigger neurobiological pathways essential for parent-infant bonding and the building of attachment. This process is said to regulate the infant's parasympathetic nervous system, fostering emotional and physiological connection with the caregiver. Research has consistently shown that CT-mediated touch enhances infant parasympathetic tone, yet no clear patterns of mutual co-regulation between parent and infant have been reported. Here, we replicated our previous study design to test the impact of three minutes of maternal stroking touch on mother-infant cardiorespiratory regulation, using no-touch pre- and post-stroking baselines. To control for potential confounds, we standardised the infant's holding position, used active baselines (i.e., active group) instead of resting baselines (i.e., resting group) to account for maternal metabolic activity, and compared stroking with and without massaging oil in the active group. Electrocardiogram (ECG) and respiration were measured in 30 mother-infant dyads (active group) and 24 mother-infant dyads (resting group) (infants aged 5-14 weeks) to calculate RRI-intervals (RRI), respiration frequency (fR), and Respiratory Sinus Arrhythmia (RSA). Surprisingly, no significant changes in mother and infant cardiorespiratory measures were observed in the active contrary to the resting group and the use of massaging oil had no notable impact in the active group. We suggest that these lack of changes show that subtle experimental manipulations have an influence on maternal-infant co-regulation, emphasising the importance of using research designs that respect the individualised ecological environment of parent-infant interactions and the role of micro-processes and multisensory integration in shaping regulatory attachment dynamics.

From patterns to pathways: Latent class trajectories of self-perceptions of aging and their causal effects on multi-state functional transitions

OBJECTIVES

This study examines the heterogeneous developmental trajectories of self-perceptions of aging (SPA) and their causal effects on functional health transitions in older adults. Specifically, we aim to identify latent classes of SPA development, assess their impact on multi-state functional transitions, and quantify the loss in healthy life expectancy attributable to negative SPA.

METHODS

Drawing from the Chinese Longitudinal Healthy Longevity Survey (2008-2018; n = 14,020), we implemented latent class trajectory modeling to identify SPA developmental patterns. We then applied multi-state Markov models to examine the effects of SPA on transitions among functional states (fully independent, assistance needed, and deceased), and established a counterfactual framework to estimate the loss in multi-state life expectancy attributable to SPA.

RESULTS

Analysis revealed two distinct SPA trajectories: a high-level group (57.75 %) and a low-level group (42.25 %), both exhibiting declining trends while maintaining consistent level differences. After adjusting for demographic characteristics, negative SPA significantly increased the risk of functional impairment (HR=1.31, 95 % CI: 1.20-1.44) and diminished the probability of functional recovery (HR=0.61, 95 % CI: 0.53-0.71). At age 65, negative SPA was associated with a 2.18-year reduction in total life expectancy, with substantial disparities in healthy life expectancy (10.93 vs. 7.96 years).

DISCUSSION

This study reveals two distinct trajectories of SPA in later life and demonstrates its causal effects on health state transitions. Early interventions targeting negative aging perceptions, particularly before age 65, may effectively extend healthy life expectancy.

Interrater reliability of the modified Tinkertoy test: A validation study in schizophrenia and control groups

Aim

Divergent thinking and executive function are critical components of cognitive performance, necessitating reliable assessment tools to guide clinical decision-making and research on cognitive deficits. This study aimed to evaluate the interrater reliability of the modified Tinkertoy test (m-TTT), a neuropsychological tool designed to assess these functions, particularly in individuals with schizophrenia.

Methods

The interrater reliability of the m-TTT was assessed in a sample of 40 Japanese participants, including 20 individuals with schizophrenia (12 males, eight females; mean age = 42.4 [standard deviation, 12.6] years) and 20 healthy controls (12 males, eight females; mean age = 40.0 [standard deviation, 9.6] years). Performances were independently scored by two occupational therapists using a standardized framework. Relative reliability was evaluated using intraclass correlation coefficients (ICCs), and absolute reliability was examined using Bland-Altman analysis.

Results

In the schizophrenia group, ICC values indicated high interrater reliability for complexity (0.979), creation process (0.881), and total (0.969) scores. Similarly, in the control group, ICC values were high for complexity (0.969), creation process (0.790), and total (0.934) scores. Bland-Altman analysis demonstrated no fixed or proportional bias; however, greater variability was observed at higher creation process scores in the control group.

Conclusion

The results confirm the high interrater reliability of the m-TTT, supporting its utility as a robust tool for assessing cognitive deficits and guiding rehabilitation strategies in psychiatric contexts. However, the study's generalizability is limited by its Japanese-only sample, necessitating further validation across diverse populations and cultural settings.

Amide proton transfer weighted MRI measurements yield consistent and repeatable results in patients with gliomas: a prospective test-retest study

OBJECTIVES

Chemical exchange saturation transfer (CEST) imaging has emerged as a promising imaging biomarker, but its reliability for clinical practice remains uncertain. This study aimed to investigate the robustness of CEST parameters in healthy volunteers and patients with brain tumours.

METHODS

A total of n = 52 healthy volunteers and n = 52 patients with histologically confirmed glioma underwent two consecutive 3-T MRI scans separated by a 1-min break. The CEST measurements were reconstructed using two models: with and without fluid suppression and included the evaluation of both amide (amidePTw) and amine (aminePTw) offsets. Mean intensity values in healthy volunteers were compared from volumetric segmentations (VOI) of grey matter, white matter, and the whole brain. Mean intensity values in brain tumour patients were assessed from VOI of the contrast-enhancing, non-enhancing and whole tumour, as well as from the normal-appearing white matter. Test-retest reliability was assessed using ICC and Bland-Altman plots.

RESULTS

The amidePTw/aminePTw signal intensity distribution was significantly affected by fluid suppression (p < 0.001 for each VOI). Test-retest reliability in healthy volunteers showed fair to excellent agreement (ICC = 0.53-0.74), with the highest signal intensity values observed by amidePTw (ICC = 0.73-0.74). In patients, an excellent agreement of both amidePTw and aminePTw measurements was observed across different tumour regions (ICC = 0.76-0.89), with the highest ICC for contrast-enhancing tumour measurements. Bland-Altman analysis indicated negligible systematic bias and no proportional bias in measurement errors.

CONCLUSION

Measurements from amide/aminePTw imaging obtained from an adequately powered test-retest study yield consistent and reproducible results in glioma patients, as a prerequisite for robust imaging biomarker discovery in neuro-oncology.

KEY POINTS

Question The clinical reliability of chemical exchange saturation transfer imaging remains uncertain, necessitating further investigation to establish its robustness as a biomarker in neuro-oncology. Findings This study demonstrates that amide/amine proton transfer imaging provides repeatable, high-agreement measurements in glioma patients, particularly in contrast-enhancing tumour regions. Clinical relevance This test-retest study demonstrates that chemical exchange saturation transfer imaging using two models and assessing amide and amine offsets yield consistent and repeatable results in glioma patients, as a prerequisite for robust imaging biomarker discovery for neuro-oncology studies and clinical practice.

The Dyadic Relationship of Illness Perception and Fear of Progression in Patients With Digestive System Cancers and Their Caregivers: An Actor-Partner Interdependence Model Analysis

This study employs a dyadic analysis approach to explore the relationship between illness perception and fear of progression among digestive system cancer patients and caregivers using the Actor-Partner Interdependence Model (APIM). We selected 242 pairs of digestive system cancer patients and their primary caregivers from two tertiary hospitals in Guangdong Province using convenient sampling method. Participants completed the Brief Illness Perception Questionnaire and Fear of Progression Questionnaire. Structural equation modelling based on the APIM framework was used to assess both actor effects (individuals' illness perception on their own fear of progression) and partner effects (individuals' illness perception on the other member's fear of progression). This study included a total of 242 sets of participants, with patients having an average age of 55.97 (SD = 14.19) years and caregivers having an average age of 49.40 (SD = 13.18) years. The study revealed that the paired patterns of illness perception and fear of progression among patients and caregivers were couple patterns. Specifically, in terms of actor effects, illness perception among digestive system cancer patients and their caregivers was able to influence their own fear of progression (β = 0.238, 0.163; 95% CI = 0.167-0.310, 0.094-0.233; both p < 0.001). Regarding the partner effects, the illness perception of digestive system cancer patients and their caregivers positively influenced each other's fear of progression (β = 0.238, 0.163; 95% CI = 0.167-0.310, 0.094-0.233; both p < 0.001). This study confirms the existence of the actor-partner relationships between illness perception and fear of progression among digestive system cancer patients and their caregivers. These interdependent effects highlight the importance of adopting dyad-centred interventions in psycho-oncology care, where clinicians should address both patients and caregivers as an emotionally connected unit rather than isolated individuals.

Trajectories of body fatness in adulthood and the risk of ovarian cancer

BACKGROUND

While excess body fatness in older adulthood has been linked to ovarian cancer, the influence of changes in body fatness over time is unclear. This study examined the association between adulthood trajectories of body mass index (BMI), a proxy for body fatness, and ovarian cancer.

METHODS

In a population-based case-control study (440 cases, 820 controls), we used a group-based trajectory approach to identify BMI trajectories from age 20-70. Using unconditional logistic regression, we estimated adjusted odds ratios (aOR) and 95 % confidence intervals (95 % CI) for the associations between the estimated trajectories and ovarian cancer.

RESULTS

We identified three distinct BMI trajectories: a normal-stable trajectory, a normal-to-overweight trajectory and an overweight-to-obese trajectory, which included 63.2 %, 31.0 % and 6.8 % of the population, respectively. Multivariable aORs suggested that participants with normal weight at the onset of adulthood who became overweight over their adulthood time did not differ in their risk of ovarian cancer compared to those who maintained a normal weight throughout adulthood (aOR (95 %CI): 0.89 (0.69-1.16)). Among those in the overweight-to-obese trajectory, the aOR (95 %CI) was 1.45 (0.87-2.43), and thus in the direction of an increased ovarian cancer risk compared to those who maintained a normal weight.

CONCLUSION

Our findings underscore the need for further research to clarify the role of body fatness across the lifetime in the etiology of ovarian cancer.

Physiological modeling of autonomic regulation of cardiac system under graded exercise

BACKGROUND AND OBJECTIVE

Dysfunction of the autonomic nervous system (ANS) plays a critical role in the progression and assessment of cardiovascular diseases, neurological disorders, and various other pathologies. Therefore, a quantitative assessment of ANS function is vital for personalized medicine in these diseases. However, direct measurements of ANS activity can be costly and invasive, prompting researchers to adopt indirect methods for quantitative evaluation. These methods typically involve mathematical techniques, such as statistical analysis and mathematical modeling, to interpret cardiovascular fluctuations in response to external stimuli.The purpose of this study is to develop a non-invasive mathematical method that quantitatively assesses ANS function during graded exercise.

METHODS

In this study, we present a physiological mathematical model for autonomic regulation of the cardiac system under graded exercise, which recognizes the crucial role of the ANS in controlling heart rate during physical activity. The model utilizes the metabolic equivalent of walking as the input and heart rate as the output, with model parameters serving as quantitative measures of personalized ANS function. Experimental data were collected from groups with different health statuses and genders. Mann-Whitney U non-parametric tests were conducted on the model parameters to assess performance between individuals who frequently engage in aerobic exercise (15 participants, aerobic exercise frequency of more than 4 times/week) and those who barely exercise (15 participants, aerobic exercise frequency of 1 time per week or less), as well as between male and female participants.

RESULTS

The experimental results indicate that our model effectively quantitatively assesses ANS function across groups with different health statuses and genders (P < 0.05). Additionally, the model provides precise estimations of heart rate, yielding a Root Mean Square Error of 2.79 beats per minute, a Mean Absolute Error of 2.18 beats per minute, and an R-squared value of 0.93.

CONCLUSION

Our findings suggest that the proposed physiological mathematical model offers a non-invasive and user-friendly tool for measuring ANS function and monitoring cardiovascular health. This approach is feasible for home application, thereby reducing the need for professional supervision, and supports the early detection and personalized management of cardiovascular diseases. As a result, it enhances clinical decision-making and improves patient outcomes.

Ex-Gaussian vector metric and similarity index applied to reaction time analysis

In psychology and cognitive neuroscience, reaction time (RT) series and their ex-Gaussian distributions are commonly used as scalar quantities to explore the time course of attentional processes. However, we propose that such attentional processes can also be analyzed using an "ex-Gaussian vector", defined by successive triads of ex-Gaussian sigma, tau, and mu parameters from RT series. This geometrical object may help characterize interindividual differences between congruent and incongruent stimuli in the attentional Stroop task within a group of participants. To test these hypotheses, we calculated the similarity index of these geometrical objects in young adults without detectable neurological disorders. Our findings show that during two weeks of continuous Stroop task application, each participant displayed distinct ex-Gaussian RT vectors in a Cartesian 3D plot. Furthermore, our study found that the similarity index between ex-Gaussian RT vectors was significantly higher for incongruent stimuli than for congruent stimuli.

Some common statistical methods for assessing rater agreement in radiological studies

Rater agreement is commonly assessed in radiologic studies concerning image quality. There are several methods of measuring rater agreement. To choose the appropriate method, the researcher needs to consider the scale of the outcome variable and the design of the study. This article provides a brief overview of available methods, focusing on the most practical and commonly used, including intraclass correlation, the Svensson method, variants of the kappa statistic, the agreement coefficient by Gwet (AC1/AC2), and Krippendorff's alpha. Additional methods that are not primarily intended for rater agreement analysis but are applied in some cases are also discussed.

Providing an alternative explanation improves misinformation rejection and alters event-related potentials during veracity judgements

The continued influence effect of misinformation (CIE) occurs when misinformation affects memory and decision making even after correction. Here, we examined the neurocognitive processes underlying the correction and subsequent veracity judgements of misinformation. Employing electroencephalography (EEG), we examined event-related potentials (ERPs): the P300 during encoding of corrections, and the P300 and FN400 during subsequent veracity judgement. We compared ERPs between three conditions: misinformation that was retracted (retraction only), misinformation that was retracted with a correct alternative cause provided (retraction + alternative), and true information that was later confirmed (confirmation). Results showed that alternatives reduced the CIE significantly. During veracity judgements, the retraction + alternative condition exhibited a higher P300 than the retraction only condition, suggesting enriched recollection processes when re-encountering misinformation if an alternative explanation existed. In contrast, both retraction only and retraction + alternative conditions elicited a less negative FN400 compared to the confirmation condition, suggesting higher conceptual processing fluency of misinformation. Moreover, we found that greater levels of P300 when encoding retraction and alternative causes in the retraction + alternative condition were associated with improved veracity judgement accuracy. Together, these findings suggested that when providing an alternative cause in correcting misinformation, both recollection and encoding processes contributed to reduced CIE.

Suicide ideation in emerging adulthood: Contributions of depressive symptoms, religiosity, parenting styles and social support

Suicide, especially among emerging adults, has continued to be a global phenomenon, demanding more in-depth empirical attention. Emerging adulthood is a probable suicidal ideation predisposing period that has received less scholarly attention. We examined the contributions of depression, religiosity, parenting styles, and social support to suicidal ideation among emerging adults. We conveniently sampled 1007 undergraduates comprising 496 (49.2 %) males and 511 (50.8 %) females whose ages ranged from 18 to 30 years with a mean age of 24 years (SD = 2.18). Results of the hierarchical multiple regression analysis showed that while depression significantly predicted suicidal ideation, preoccupation and conviction for religiosity did not; guidance and emotional involvement negatively predicted suicidal ideation. Parenting styles (mother and father) were not significant predictors of suicidal ideation. However, support from family, friends, and significant others negatively predicted suicidal ideation. We adopted the Three-Step Theory (3ST) to explain our findings that illustrate the need for government and educational institutions to make governance and educational curriculum less stressful and depressive such that the complimentary religious knowledge, parental teachings, and support from other family members, friends, and significant others can help improve abilities to achieve important (academic) life goals that promote quality of life and healthy living.

Is There a Curvilinear Trajectory of Motor Competence Across Different Weight Status? Exploring the Non-Linear Hypothesis in Adolescents

Background: Evidence supports that motor competence is inversely associated with weight status, yet less is known about this relationship among young people who are underweight. We hypothesized that there is a non-linear trajectory of motor competence across weight status categories (from underweight to obesity). Purpose: To check whether a non-liner relationship exists between motor competence and weight status in adolescents. Research Design: Cross-sectional study. Study sample: we assessed the motor competence of 310 participants (44.8% boys), aged 12-15 years. Data Collection: Motor competence was assessed the Korperkoordinationstest für Kinder (KTK). Weight status (underweight, normal weight, overweight and obesity) was determined using body mass index (BMI). Results: Motor competence was inversely associated with BMI in normal weight (rho = -.222, p = .001), overweight (rho = -.309, p = .028) and obesity (rho = -.663, p < .001), but not in underweight (rho = .193, p = .508). Adolescents with normal weight presented higher motor competence than those with overweight (mean difference = 17.198, p = .001) and obesity (mean difference = 31.686, p < .001). There was no significant difference in motor competence between normal weight and underweight categories. In addition, boys showed a curvilinear trajectory of motor competence, being ascendant from underweight to normal weight and then downward with increasing BMI. Polynomial regressions, fitting a non-linear model, confirmed a non-linear relationship between motor competence and BMI in boys (B = -3.534, p < .001). Conclusions: Our findings suggest that the inverse relationship between motor competence and BMI does not occur in adolescents who are underweight. Furthermore, our results supported the non-linear hypothesis about the relationship between motor competence and weight status in boys.

Farmer-veterinarian communication during herd health visits on dairy farms in Flanders, Belgium

Well-developed clinical communication is crucial for dairy practitioners in providing effective herd health and production management (HHPM) advisory services, as they have potential to enhance farmer satisfaction and adherence to veterinary advice. However, there is limited knowledge regarding specific communication skills veterinarians use during HHPM visits. Understanding veterinarians' communication is essential for developing targeted educational interventions to enhance veterinarian-farmer interactions during HHPM visits. The objective of the study was, therefore, to investigate veterinarians' communication during HHPM visits on Flemish dairy farms. Dairy veterinarians audio-recorded HHPM visits on dairy farms in Flanders, Belgium. Composite communication processes were assessed using the Calgary-Cambridge Guide (CCG), and global scores and specific behavior counts were assessed with a modified Motivational Interviewing Treatment Integrity code (MITI). Twenty-seven participating veterinarians recorded 127 visits with 120 unique dairy farmers. The CCG communication processes "History taking," "Presenting information," and "Safety net and follow-up" were most prevalent. Veterinarians with ≤10 years practice experience provided the farmer with a "Safety net and a follow-up" more often than veterinarians with >10 years of experience. Other CCG processes such as "Agenda setting" and "Needs determination" were often lacking. However, veterinarians who had previously participated in communication skills training determined the needs of the farmer more often than participants who had not. Veterinarians who conducted ≥15 HHPM visits per month more fully performed "History taking" and "Creating a plan" than veterinarians with <15 HHPM visits per month. Participants displayed inconsistent efforts to incorporate "Partnership" and "Empathy." In modified MITI coded audio segments of 20 min, on average, veterinarians gave information 12 times, made a persuasive statement 3 times, asked 3 open questions, and 6 closed questions. This study indicated areas for improvement in dairy veterinarians' communication and highlighted the need for ongoing education and research in this area to enhance veterinary practice and animal health.

Adolescents' next-day perceptions of their sleep quality, quantity, sleepiness and sleepiness-related symptoms relative to actigraphy metrics

BACKGROUND

Next-day perceptions of sleep and related symptoms are frequently collected in research and clinical practice, but how they correlate with objective sleep measures in adolescents has received little attention.

METHODS

Participants were aged 16-17 years and without a sleep disorder, anxiety or depression diagnosis. Seven-day wrist actigraphy was collected alongside daily survey ratings of sleep quality, sufficiency, morning and daytime sleepiness, and sleepiness-related mood and concentration. Within-person associations between daily actigraphic sleep metrics (6 variables representing quantity, quality and timing) and subjective ratings were estimated using mixed effects regression models with participant included as a random effect.

RESULTS

The sample comprised 71 adolescents (49 % female, 51 % male). No actigraphy metrics linked to sleep sufficiency ratings. Sleep onset was the strongest correlate of sleep quality and morning sleepiness in the expected direction e.g. every 10 min later onset led to a -1.4 point (95 % CI: -2.1, -0.7) drop in the sleep quality score (5-point scale, higher worse), but significant relationships were only in females. While actigraphic sleep quantity metrics were linked to several ratings, all effect sizes were marginal. Sleep quality metrics in the overall sample were not correlated to any ratings. Unexpectedly, timing and quantity metrics linked to sleepiness-related mood ratings, but in the opposite direction hypothesized.

CONCLUSIONS

The lack of correlation between objective and subjective sleep quality add to the complexity of defining sleep quality accurately. Sleep onset timing, rarely explored in these types of studies emerged as an important correlate of sleep quality perception and other subjective ratings.

"They still deserve for their pain to be controlled": healthcare providers' and community-level stakeholders' perceptions of pain management among cancer survivors with an opioid use disorder

PURPOSE

To explore healthcare providers' and community-level stakeholders' perceptions of opioid pain management among cancer survivors with a history of opioid use disorder living with cancer-related pain.

METHODS

Using a qualitative methodological approach, healthcare providers and community-level stakeholders providing care to cancer survivors with an opioid use disorder (OUD) were recruited by purposive sampling methods. Data was collected through semi-structured interviews that was subsequently transcribed verbatim and analyzed using thematic analysis.

RESULTS

Participants were healthcare providers (n = 24) and community-level stakeholders (n = 6). Four themes emerged from the data: (1) cancer survivors with an OUD deserve the right to adequate pain management, (2) healthcare professionals are uncomfortable providing pain management for cancer patients with OUD, (3) cancer survivors with cancer-related pain may suffer unnecessary pain for fear of violating their sobriety, and (4) perspectives on aberrant opioid-related behaviors among cancer survivors.

CONCLUSION

As opioid use disorder is becoming an increasing and co-present condition among patients with cancer, this study contributes important implications for improving care by understanding the views of healthcare providers and community-level stakeholders.

Space-time interference between the length and duration of static lines

The present study investigated space-time interference with static lines. In three preregistered online experiments, participants were presented with lines of different lengths and durations and asked to provide length or duration estimates after each trial on a visual analogue scale. Results showed bidirectional space-time interference in all experiments, with a slight asymmetry toward larger space-on-time than time-on-space interference when the target dimension was indicated only after stimulus presentation. Overall, the present findings add to a growing body of evidence demonstrating that space-time interference is more flexible than previously assumed.

First Experience Using a New Minimally Invasive Screw-Rod System for Completely Percutaneous Pedicle Screw Fixation of the Cervical Spine

In contrast to the thoracolumbar spine, where pedicle screws can be inserted via a minimally invasive, percutaneous technique through small skin incisions, all previously available cervical instrumentation systems required a larger midline incision, especially for rod insertion. Screw placement via small incisions reduces the risk of wound healing disorders and blood loss, and patients can be mobilized more quickly and with less pain. In 2022, a cervical, minimally invasive stabilization system became available for the complete percutaneous insertion of both cervical pedicle screws and rods. We report on the first results and experiences with this new technology.In this retrospective case series, we included patients with cervical instability treated by minimally invasive percutaneous cervical and upper thoracic spine pedicle screw and rod insertion between August 2022 and August 2023. Intra- and postoperative complications as well as revision surgeries were recorded. The screw position was evaluated by three examiners in the postoperative computed tomography (CT) using the Bredow classification.Our series includes six male patients (age = 56.9 ± 12.9 years; body mass index [BMI] = 29.8 ± 9.6 kg/m2). The indication for surgery was trauma, tumor, and degenerative stenosis in two patients each. An excellent/good screw position (Bredow 1 and 2) was found in 84.4% of the screws (n = 27/32). None of the screws rated as Bredow 3 (n = 2/32) or Bredow 4 (n = 3/32) resulted in a neurological deficit or radicular pain and none had to be repositioned. No neurologic complication or revision surgery occurred. As a complication not directly related to the surgery technique, one patient died of a pulmonary lung embolism on the seventh postoperative day.The results of this study indicate that minimally invasive percutaneous implantation of a pedicle screw-rod system is also possible in the cervical spine with sufficient accuracy using intraoperative navigation. However, technical details, possible pitfalls and finally careful patient selection must be taken into account.

Prognostic model for predicting recurrence in breast cancer patients in Saudi Arabia

Breast cancer recurrence presents a significant global health challenge, and accurate prediction is crucial for effective patient management and improved outcomes. Reliable predictive tools can help tailor therapeutic approaches, provide personalized care, and enhance patient outcomes. In light of the current lack of such tools in clinical practice, our study aimed to develop predictive models for breast cancer recurrence within three years of treatment. We analyzed data from 408 breast cancer patients at the King Fahd Specialist Hospital in Dammam, Saudi Arabia and divided them into training (n = 285) and test (n = 123) cohorts. Using multivariable penalized logistic regression combined with a nested cross-validation framework and multivariate Cox regression analysis to determine time-dependent risk factors for breast cancer recurrence, we developed prognostic models that incorporated age, stage, tumor size, and treatment type. We evaluated the performance of the models using both the area under the receiver operating characteristic curve for multivariate logistic regression and C-index for multivariate Cox regression. The multivariate logistic regression model achieved an area under the curve (AUC) of 76% (95% confidence interval [CI]: 72-81%) for the training set and 76% (95% CI: 66-87%) for the test set. The Cox regression analysis yielded a C-index of 0.81 for the training set (95% CI: 0.73-0.84) and 0.84 for the test set (95% CI: 0.76-0.89). Chemotherapy was found to decrease recurrence odds by 86% (adjusted odds ratio [AOR]: 0.143, 95% CI: 0.089-0.218, p < 0.0001), and surgery resulted in a 99% reduction in recurrence probability (AOR: 0.009, 95% CI: 0.005-0.014, p < 0.0001). Increased tumor size improved the recurrence odds by 48.5% (AOR: 1.485, 95% CI: 1.128-1.918, p = 0.0043), while age did not significantly predict recurrence (AOR: 0.841, 95% CI: 0.657-1.061, p = 0.1398). The newly developed, routinely collected baseline clinical features to predict breast cancer recurrence may be a valuable tool for clinical decision-making and is freely available online. The tool can be accessed through the following link: https://iv3p9h-nurudeen-adegoke.shinyapps.io/breast_cancer .

Expectations don't protect us from emotional distractions

We often attend to irrelevant information to the detriment of our goals. Emotional stimuli, in particular, capture attention effectively. Usually, this capture is adaptive - alerting us to possible threats or rewards - but can be costly when attention is required elsewhere. Previous studies show that we are less distracted by emotional stimuli when they appear frequently, consistent with the claim that expectation of upcoming conflict encourages the use of effective proactive attentional control. An alternative explanation, however, is that better attentional control arises through greater experience with frequent distractors. To distinguish between these alternatives, we conducted three experiments that tested the effects of expectation on attentional control of emotional distractors while holding experience constant. Participants performed a simple letter identification task while emotionally neutral or negative task-irrelevant images also appeared on 25% of trials, either predictably (on every fourth trial) or unpredictably. As expected, emotional images were more distracting than neutral ones. However, predictability of upcoming emotional distractors did not improve participants' ability to ignore them; indeed, it sometimes made distraction significantly worse. Similar findings were observed even when participants received incentives to use the sequential presentation of distractors to improve performance. Our findings imply that simply expecting distraction to occur does not help to prevent it.

Cognitive Control Network and Language Reorganization in Patients with Brain Tumors

BACKGROUND AND PURPOSE

The interaction between language and other cognitive networks in patients harboring brain tumors is poorly understood. We studied the modification of the cognitive control network (CCN) induced by brain tumors and its participation in language reorganization. We hypothesized that patients with brain tumors and reorganized language would show a modification of the CCN compared with patients who remain left dominant.

MATERIALS AND METHODS

Patients were selected with the criteria: newly diagnosed, pathologically-confirmed left-hemispheric tumor; single lesions; right-handedness; task-based and resting-state fMRI; no artifacts. Age-matched healthy controls (HC) were recruited from open-source databases. Language laterality was calculated by using task-based fMRI. We obtained the CCN through ad hoc independent component analysis on resting-state fMRI. Differences in CCN between patients and HC were characterized by cosine similarity (CS) and earth mover's distance (EMD). Changes related to language reorganization and patients' speech were assessed with the t test (P < .05). Results were corrected for multiple comparisons.

RESULTS

One hundred forty-two right-handed patients (35 low-grade and 88 high-grade gliomas; 19 metastases) and 184 HC were included. Two independent components of the CCN were obtained. The t test confirmed significant effects of lateralization on the CCN (P = .004). Modification of CCN was associated with fewer speech deficits 1 week after surgery (P = .005).

CONCLUSIONS

This study provides evidence that modifications of CCN occur in the setting of language reorganization. Patients exhibiting these modifications perform better at speech evaluation after surgery, suggesting a role of cognitive control in compensating for speech deficits when language reorganizes.

Learning Modulates Early Encephalographic Responses to Distracting Stimuli: A Combined SSVEP and ERP Study

Through experience, humans can learn to suppress locations that frequently contain distracting stimuli. However, the neural mechanism underlying learned suppression remains largely unknown. In this study, we combined steady-state visually evoked potentials (SSVEPs) with event-related potentials (ERPs) to investigate the mechanism behind statistically learned spatial suppression. Twenty-four male and female human participants performed a version of the additional singleton search task in which one location contained a distractor stimulus frequently. The search stimuli constantly flickered on-and-off the screen, resulting in steady-state entrainment. Prior to search onset, no differences in the SSVEP response were found, though a post hoc analysis did reveal proactive alpha lateralization. Following search onset, clear evoked differences in both the SSVEP and ERP signals emerged at the suppressed location relative to all other locations. Crucially, the early timing of these evoked modulations suggests that learned distractor suppression occurs at the initial stages of visual processing.

Construct validity of the Brazilian QuickDASH for assessing work-related upper-limb musculoskeletal disorders

Background

Work-related musculoskeletal disorders (WRMD) may be associated with various individual, physical, biomechanical, or psychosocial/organisational risk factors. Self-report questionnaires have increasingly been used to assess patients' perceptions of injury impact. QuickDASH is a widely used outcome measurement questionnaire but is seldom applied to WRMD.

Objective

To evaluate the construct validity of the Brazilian version of the QuickDASH (QD-Br) in patients with WRMD affecting the upper limbs, hypothesising a moderate correlation with fatigue, ergonomic, and functional questionnaires.

Methods

Workers of a tertiary hospital, such as healthcare professionals and support staff employees with WRMD in the upper limbs and neck were included. The outcome measures were QD-Br, the Numerical Pain Scale (NPS), Isometric Handgrip Strength (GS), Isokinetic Force of Bilateral Shoulder Elevation in the Scapular Plane (ISOAbd), Functional Impairment Test - Hand and Neck/Shoulder/Arm (FIT-HaNSA), and: Patient-Specific Functional Scale (PSFS-Br), Neck Disability Index (NDI-Br), Work Ability Index (WAI-Br), Need for Recovery Scale (NFR-Br), and Quick Exposure Checklist (QEC-Br). Spearman's Correlation Coefficient (ρ) was calculated to determine the direction and strength of associations.

Results

The sample was 70% female, 63% reporting chronic symptoms. The shoulder was the joint most frequently reported. QD-Br showed moderate positive correlations with NDI-Br and NPS and moderate but negative correlations with WAI-Br and PSFS-Br. It presented weak and positive correlations with NFR-Br, weak and negative correlations with GS, ISOAbd, and FIT-HaNSA, and no correlation with QEC-Br.

Conclusion

QD-Br demonstrated evidence of construct validity for assessing workers with upper limb complaints, effectively reflecting their dysfunctions and symptoms.

Transcutaneous Cervical Vagus Nerve Stimulation Improves Speech Comprehension in Noise: A Crossover, Placebo-Controlled Study

BACKGROUND

Speech comprehension in noisy environments remains a significant challenge, even among individuals with clinically normal hearing and users of hearing aids and cochlear implants. Although conventional assistive hearing devices address limitations in the auditory periphery, they do not directly enhance the brain's capacity to segregate speech from background noise. Because tonic vagus nerve stimulation (VNS) has shown potential for rapidly improving central sensory processing, this study investigated whether tonic transcutaneous cervical VNS (tcVNS) can enhance speech-in-noise intelligibility.

MATERIALS AND METHODS

Two cohorts of older human adults (aged 60-84 years) participated in a placebo-controlled, crossover study. Participants completed speech-in-noise assessments using either QuickSIN or AzBio sentences while receiving tonic tcVNS to the neck, or placebo stimulation to the neck-shoulder junction. Speech-in-noise performance was assessed by measuring participants' accuracy in repeating sentences presented at varying signal-to-noise ratios (SNR) within background babble.

RESULTS

Tonic tcVNS improved speech-in-noise intelligibility compared with placebo. At the group level, the SNR threshold for 50% speech intelligibility (SNR-50) improved by 0.76 dB in QuickSIN (p = 0.016) and by 0.38 dB in AzBio (p = 0.045). For individual participants, 50% showed improvements that met a minimum clinically important difference (MCID) of 1 dB. Tonic tcVNS evoked progressively greater improvements as SNR increased in QuickSIN (p = 0.021) and AzBio (p = 0.00023), with the largest gains at SNRs >0 dB. In 55% of participants, tcVNS improved intelligibility beyond an MCID benchmark of 4.9% at 5 dB SNR. Although the magnitude of tcVNS-evoked improvements was inversely related to baseline speech-in-noise impairment (p = 0.028), with the individuals having the most impaired speech-in-noise intelligibility showing the largest gains, it did not correlate with hearing loss severity (p = 0.97) or age (p = 0.88).

CONCLUSIONS

Our findings indicate that tonic tcVNS can evoke immediate and clinically meaningful enhancements in speech-in-noise comprehension. This suggests tcVNS may complement conventional assistive hearing technologies and inform novel therapies for sensory processing disorders.

Parents', Teachers', and Sledders' Acceptability of a Virtual Reality Game for Sledding Safety Education: Cross-Sectional Study

Background

Sledding is a common recreational activity in the Alpine region, practiced by families, friends, and at school, but it is rarely considered to cause serious injuries. Current actions to promote safe sledding are limited to announcements at the start of dedicated tracks or to didactic sheets presented by teachers in schools. However, these actions are currently limited and do not allow the development of piloting technique skills. Virtual reality has the potential to develop piloting skills, although the development of a virtual reality for sledding safety education needs to be guided by its acceptability.

Objective

The purpose of this study was to (1) examine the acceptability of the virtual reality game for sledding safety education from the perspective of different potential user profiles (ie, parents, teachers, and sledders) based on the Unified Theory of Acceptance and Use of Technology 2 enriched by the health locus of control (HLC), and (2) understand participants' preferences and needs in terms of features to be integrated to the technology.

Methods

Three profiles of participants (ie, parents, teachers, or sledders) were recruited through email diffusion from elementary schools, university, and ski resort announcements (Tyrol, Austria). They completed a series of questionnaires measuring: (1) demographic and general information, (2) acceptability of virtual reality sledding game for safety education (named VRodel), (3) perception of HLC, and (4) preferences and needs for VRodel.

Results

A total of 122 participants (15 teachers, 43 parents or legal guardians, and 64 sledders) completed the survey. Findings reveal that the constructs of hedonic motivation (β=.43, P<.001), price sensitivity (β=.28, P<.001), and habit (β=.36, P<.001) explained 65% of the variance in behavioral intention to use VRodel. Two acceptability clusters were identified (low and high), but no differences between the acceptability clusters emerged based on age, status, gender, or previous virtual reality use. Internal HLC was positively correlated with all dimensions of acceptability except social influence and facilitating conditions. Some correlations between acceptability constructs were also shown with powerful others' HLC. Participants highlighted the need to include realistic visual details and realistic interactions in the virtual environment for development.

Conclusions

The acceptability of a virtual reality game for sledding safety education was quite high, and relationships with HLC were shown in the expected directions. Based on participants' preferences, developers are advised to promote immersion in the game.

The Prevalence of Narcissistic Vulnerability in Men in English Prisons After Criminal Conviction for Stalking

BACKGROUND

In earlier research with prisoners, we observed that convicted stalkers had skill deficits in interpreting their experiences of stalking and their motivations for it, suggesting narcissistic vulnerability.

AIMS

Our primary aim was to explore the prevalence of narcissistic vulnerability in men serving a prison sentence in England and to investigate differences in narcissistic vulnerability and attachment styles between men convicted of stalking offences and men convicted of other offences but serving similar sentences.

METHODS

Participants were from across 16 closed custodial settings in England. Everyone serving a sentence for a stalking offence was invited to participate together with a same size sample of men serving similar sentences for other offences and without a stalking history. 25%-30% of the eligible men agreed to participate. Each completed three psychometric scales, rating themselves on the Narcissistic Vulnerability Scale (NVS), the Brief-Pathological Narcissism Inventory (B-PNI) and the Experiences in Close Relationships-Revised (ECR-R) scale. A series of independent sample t-tests were used to compare the experimental group to the other-conviction control group.

RESULTS

Twenty-nine individuals sentenced for stalking offences and 25 other prisoners, all men, completed. The stalking group had significantly higher mean scores on narcissistic vulnerability according to both scales and significantly higher mean attachment style difficulties together with higher mean anxiety scores and avoidant scores.

CONCLUSIONS

Our findings add data on aspects of personality to a limited pool that supports understanding of men convicted of stalking. Although our sampling and data collection were both limited by the COVID-19 pandemic conditions, our findings further evidence the case for intervention with respect to ameliorating the personality characteristics of narcissistic vulnerability and attachment styles of such men.

Multi-trajectories of BMI, waist circumference, gut microbiota, and incident dyslipidemia: a 27-year prospective study

Evidence is insufficient to establish a longitudinal association between combined trajectories of body mass index (BMI) and waist circumference (WC) and dyslipidemia. This study investigated the associations between multi-trajectories of BMI and WC over 24 years and the subsequent risk of dyslipidemia in a large cohort of 10,678 Chinese adults from the China Health and Nutrition Survey. Utilizing a group-based trajectory model, we identified four distinct trajectories: normal, normal-increasing, overweight-increasing, and obesity-increasing. Our results indicated that ascending trajectories of BMI and WC are significantly associated with increased odds of dyslipidemia, particularly in males, with odds ratios (OR) of 2.10, 2.69, and 3.56 for the normal-increasing, overweight-increasing, and obesity-increasing groups, respectively. Among females, the normal-increasing group exhibited a significant increased risk (OR: 1.54). Furthermore, we explored the gut microbiota associated with these trajectories, identifying 3, 8, and 4 bacterial genera linked to increasing BMI and WC in males, alongside two genera in females with the normal-increasing trajectory. We identified a total of 23, 25, and 10 differential metabolites significantly associated with these genera, except for Group 2 in males. The inclusion of relevant microbiome and metabolite data improved the model's predictive capacity for the risk of dyslipidemia, with ROC values increasing from 0.655 to 0.875. Our findings underscore the critical implications of continuous weight gain on metabolic health and suggest that gut microbiota may play a pivotal role in understanding these associations.IMPORTANCEEmerging evidence suggests a close connection between the gut microbiome and both human obesity and dyslipidemia, suggesting that the gut microbiome may play an important role in the obesity-dyslipidemia relationship. In this study, we observed several characteristic genera, including Clostridium_sensu_stricto_1, Turicibacter, and CHKCI002 among males and Parabacteroides and [Eubacterium]_brachy_group among females, which were negatively associated with high-risk trajectories. They were also related to free fatty acids (FFAs) and oxidized lipid metabolites. These shared and unique gut microbial and metabolic signatures among combined trajectories of BMI and WC with a higher risk of dyslipidemia could provide important evidence for the omics mechanism pathway of long-term obesity trend leading to dyslipidemia.

Responsiveness of the Seated Postural & Reaching Control Test in Children with Cerebral Palsy: A Preliminary Study

AIMS

To examine the responsiveness of the Seated Postural & Reaching Control (SP&R-co) test in children with cerebral palsy (CP) classified at levels III to V on the Gross Motor Function Classification System (GMFCS).

METHODS

Eleven children received a motor learning-based intervention. Expert and blinded raters scored pre- and post-intervention SP&R-co test videos. Responsiveness was measured with paired t-tests, and effect sizes with Cohen's d. Minimum Clinically Important Differences (MCIDs) were estimated for SP&R-co overall and dimension scores.

RESULTS

The SP&R-co test was responsive to group improvement in sitting-related postural and reaching control (SP&R-co overall = 48.9 points, p < 0.001). It captured increases in the active (change = 2.4 points, p = 0.040), proactive: bimanual (change = 10.5 points, p = 0.001), proactive: unimanual (change = 19.8 points, p < 0.001), and reactive (change = 15.3 points, p = 0.016) dimensions. Most children showed overall score improvements exceeding the MCID value, whereas clinical improvements in dimension scores varied across children with different GMFCS levels.

CONCLUSIONS

This preliminary study shows that the SP&R-co test is responsive to clinical changes in postural and reaching control strategies in children with CP who can follow test directions and are classified as GMFCS levels III-V.

Cognitive-affective maps extended logic: Proposing tools to collect and analyze attitudes and belief systems

Cognitive-affective maps extended logic is a software package that includes three tools designed for the collection and analysis of cognitive-affective maps (CAMs). CAMs are an innovative research method used to identify, visually represent, and analyze belief systems or any semantic knowledge. By instructing participants on how to draw a CAM, they can create a visual depiction of a belief system that illustrates their attitudes, thoughts, and emotional associations regarding a specific topic. CAMs can be considered as networks enabling participants to freely draw concepts and illustrate the affective (emotional) evaluations and connections between them. To simplify the creation of CAM studies, we first developed an administrative panel for researchers which enables them to set up CAM studies without any coding. Second, to draw CAMs, a tool was developed to give participants the opportunity to create a visual depiction of their own belief system regarding a specific topic. Third, the resulting data can be analyzed using the respective data analysis app, which tracks each analysis step to make the analysis process fully transparent. As a time-efficient approach, CAMs can be used to inform exploratory research questions, like the conceptualization of surveys, or be valuable as an independent method. The tools are available under a free and open-source license. Further information, code, and comprehensive documentation are available at https://drawyourminds.de .