Sex differences in the prospective association of excessively long reaction times and hazardous cannabis use at six months

Objective

The neurocognitive risk mechanisms predicting divergent outcomes likely differ between men and women who use cannabis recreationally. Increasingly, the use of descriptive distributions including the ex-Gaussian has been applied to draw stronger inferences about neurocognitive health in clinical populations. The current project examines whether the long tail of reaction times (RTs) in a distribution, as characterized by the ex-Gaussian parameter tau which may represent difficulty with the regulation of arousal, predicts problematic cannabis use 6 months later in those who use cannabis recreationally, and whether sex moderates these prospective associations.

Method

Young adults (ages 18-30, mean age 20.5 years, N =159, 57.2% women, 69.2% Caucasian) who recreationally used cannabis either occasionally (at least once per month) or frequently (three times or more per week) completed the Stroop Color-Word Task at baseline. Ex-Gaussian parameter tau was estimated for each participant. Self-report of hazardous cannabis use (CUDIT-R) and dysregulation of negative (DERS) and positive emotions (DERS-Positive) were obtained at baseline and 6-month follow-up.

Results

For those with larger tau at baseline, being a man (but not a woman) was associated with increased difficulty regulating positive emotions concurrently (b = -0.01, F (1,159) = 5.48, p = 0.02), and with hazardous cannabis use six months later (b = -0.007, F (1,159) = 4.42, p = 0.037) after controlling for baseline hazardous cannabis use.

Conclusions

Excessively long RTs during cognitive performance may help characterize men at risk for increased hazardous use, which contributes to understanding between-sex heterogeneity in pathways towards cannabis use disorders.

Electrophysiological auditory measures to identify potential cortical markers of tinnitus

Tinnitus, or the perception of a sound in the absence of an external acoustic stimulus, is a common condition that cannot yet be objectively diagnosed. Current diagnostic tests of tinnitus consist of case history and behavioral measures that rely on subjective responses. This study examined electrophysiological measures, specifically the auditory late response (ALR), mismatch negativity (MMN), and P300 as potential neural biomarkers of tinnitus in both a tinnitus and non-tinnitus control group while utilizing the pitch-matched tinnitus frequencies as the test stimuli. Results of this study found differences in MMN amplitudes and area under the curve, and in P300 topographic maps between tinnitus and control subjects. The differences in MMN responses across groups suggest that dysfunctional processing of acoustic stimuli located near the tinnitus frequency in individuals with tinnitus manifests as soon as 200 ms after initial onset of the stimulus. In addition, results from a global field power analysis and differences in spatial distributions on topographical maps indicate that deficits persist through higher levels of cortical processing. A secondary goal of this study was to determine if electrophysiological measures correlated with reported tinnitus severity on questionnaires. This analysis indicated that P2 latency was a significant predictor of Tinnitus Reaction Questionnaire, Tinnitus Handicap Inventory, and percent of the time participant's tinnitus was considered bothersome, suggesting that this measure could potentially be used to assess the efficacy of treatment programs for tinnitus.

Quality of life and family functioning 12 months after diagnosis of childhood brain tumour: A longitudinal cohort study

BACKGROUND

The wellbeing of a child with brain tumour is affected by several factors. We present the first investigation of quality of life and family functioning in a parent and child across the first 12 months after diagnosis, examining potential factors to guide the provision of psychosocial resources to families who most need them.

PROCEDURE

Data were collected from parents/carers in Queensland, Australia, from 2020 to 2023. Child (parent/carer-proxy reported) and carer quality of life was assessed across three timepoints (repeated measures analysis of variance [ANOVA]) and by five potential co-variates (mixed between-within ANOVA). Family functioning was assessed across two timepoints (repeated-measures t-test), and by potential co-variates (repeated measures ANOVA). Univariate relationships were explored with Pearson's correlation coefficient; significant relationships were entered into multiple regression models.

RESULTS

Ninety-six diverse families were represented. Quality of life (child, carer) and family functioning did not change across time. Children from households with lower income reported worse cognitive difficulties (p = .023) and pain and hurt (p = .013) than those from a higher income. Caregiver quality of life was poorer for those whose child had received chemotherapy and/or radiation, was aged less than 4 years at diagnosis, and had a lower household income. At 12 months, caregiver quality of life was correlated with family functioning (r = -.45, p < .001), with positive adaptation being a significant key predictor (beta = -.66, p < .005).

CONCLUSIONS

The following factors indicate a need for increased early psychosocial support: cognitive difficulties, aged <4 years at diagnosis, receiving chemotherapy and/or radiation, and low household income.

Estimating the proportions and latencies of reaction time outliers: A pooling method and case study of lexical decision tasks

A methodological problem in most reaction time (RT) studies is that some measured RTs may be outliers-that is, they may be very fast or very slow for reasons unconnected to the task-related processing of interest. Numerous ad hoc methods have been suggested to discriminate between such outliers and the valid RTs of interest, but it is extremely difficult to determine how well these methods work in practice because virtually nothing is known about the actual characteristics of outliers in real RT datasets. This article proposes a new method of pooling cumulative distribution function values for examining empirical RT distributions to assess both the proportions of outliers and their latencies relative to those of the valid RTs. As the method is developed, its strengths and weaknesses are examined using simulations based on previously suggested ad hoc models for RT outliers with particular assumed proportions and distributions of valid RTs and outliers. The method is then applied to several large RT datasets from lexical decision tasks, and the results provide the first empirically based description of outlier RTs. For these datasets, fewer than 1% of the RTs seem to be outliers, and the median outlier latency appears to be approximately 4-6 standard deviations of RT above the mean of the valid RT distribution.

A library for innovative category exemplars (ALICE) database: Streamlining research with printable 3D novel objects

This paper introduces A Library for Innovative Category Exemplars (ALICE) database, a resource that enhances research efficiency in cognitive and developmental studies by providing printable 3D objects representing 30 novel categories. Our research consists of three experiments to validate the novelty and complexity of the objects in ALICE. Experiment 1 assessed the novelty of objects through adult participants' subjective familiarity ratings and agreement on object naming and descriptions. The results confirm the general novelty of the objects. Experiment 2 employed multidimensional scaling (MDS) to analyze perceived similarities between objects, revealing a three-dimensional structure based solely on shape, indicative of their complexity. Experiment 3 used two clustering techniques to categorize objects: k-means clustering for creating nonoverlapping global categories, and hierarchical clustering for allowing global categories that overlap and have a hierarchical structure. Through stability tests, we verified the robustness of each clustering method and observed a moderate to good consensus between them, affirming the strength of our dual approach in effectively and accurately delineating meaningful object categories. By offering easy access to customizable novel stimuli, ALICE provides a practical solution to the challenges of creating novel physical objects for experimental purposes.

Association of trajectories and cumulative exposure of antenatal depression with high birth weight

BACKGROUND

Inconsistent associations between antenatal depression and fetal birth weight were reported previously, and little is known about the dynamic changes and long-term cumulative effect of antenatal depression during pregnancy.

METHODS

Participants were from the Tongji-Huaxi-Shuangliu Birth Cohort. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale in early, middle, and late pregnancy respectively. Trajectories of antenatal depression were assessed using the latent class mixed model. The percentage of days with depression (PDD) and frequency of antenatal depression were measured to assess the cumulative exposure. Multivariable logistic regression models were used to evaluate the associations of antenatal depression with macrosomia and large for gestational age (LGA).

RESULTS

We identified four distinct trajectories, including the low stable group (n = 1,327, 27.99 %), the moderate stable group (n = 2,610, 55.05 %), the peak group (n = 407, 8.58 %), and the valley group (n = 397, 8.37 %). Compared with the low stable group, the valley group showed a higher risk of macrosomia (OR, 1.98; 95 % CI, 1.17, 3.38) and LGA (OR, 1.44; 95 % CI, 1.002, 2.09); the peak group showed a higher risk of LGA (OR, 1.52; 95 % CI, 1.07, 2.16), but the association was not significant for macrosomia (OR, 1.47; 95 % CI, 0.85, 2.55). Consistently, cumulative antenatal depression was also positively associated with the risks of macrosomia and LGA.

LIMITATION

The antenatal depression was self-reported using a screening scale and information bias could not be ruled out.

CONCLUSION

Certain trajectories and cumulative exposure of antenatal depression were associated with higher risks of high birth weight.

Platelet indices as predictors of poor glucoregulation in type 2 diabetes mellitus adults at Bishoftu General Hospital, Ethiopia

BACKGROUND

Diabetes is a chronic metabolic syndrome that has become a global public health problem with significant morbidity and mortality. It is a pro-inflammatory and pro-thrombotic condition characterized by increased platelet activation and alterations in platelet indices. However, the use of platelet indices as predictors of poor glucoregulation has not been fully evaluated in this context, and evidence for their role as predictors of poor glycemic status in diabetic patients is limited.

AIM

To evaluate platelet indices and determine their prognostic significance in relation to inadequate glucoregulation among individuals diagnosed with type 2 diabetes at Bishoftu General Hospital in Ethiopia, from June 15 to August 12, 2022.

METHODS

A comparative cross-sectional study was conducted in 261 participants including 174 individuals with type 2 diabetes mellitus (T2DM) and 87 non-diabetic controls. The systematic random sampling technique was used to select par-ticipants. Data were collected using structured questionnaires, physical measurements, checklists, and laboratory tests. Platelet parameters and fasting blood glucose levels were determined from blood samples using Sysmex-XN550 and CobasC311 analyzers, respectively. The hematology analyzer output was checked and participants were also screened for malaria parasites using a prepared blood smear. Collected data were entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. The χ² test, Mann-Whitney U test, Kruskal-Wallis test, post hoc test, Spearman correlation, and receiver operating characteristic curve were used for analysis. A P value < 0.05 was considered statistically significant.

RESULTS

The results of our study indicate that diabetic patients have significantly higher levels of platelet distribution width (PDW), mean platelet volume (MPV), platelet large cell ratio (PLCR), and plateletcrit (PCT) compared to healthy individuals (P < 0.001). Furthermore, these indices were found to be significantly elevated in individuals with poor glycemic control in T2DM compared to those with good glycemic control and healthy controls. We also observed significant correlations between these indices and various anthropometric and clinical variables. Our findings suggest that PDW, with a cut-off value of 15.75 fL and an area under the curve (AUC) of 0.803, MPV, with a cut-off value of 12.25 fL and an AUC of 0.774, PLCR, with a cut-off value of 36.3% and an AUC of 0.775, and PCT, with a cut-off value of 0.24% and an AUC of 0.761, can serve as predictors of poor glycemic control in patients with diabetes mellitus.

CONCLUSION

The observed correlation between diabetic patients and a significant increase in platelet indices has highlighted their potential as predictors of poor glycemic control in diabetes. Therefore, regular screening and profiling of platelet indices is recommended as part of the follow-up process for individuals with diabetes mellitus.

The prospective relationship between a-priori intentions for and patterns of e-cigarette use among adults who smoke cigarettes

BACKGROUND

Electronic (e-)cigarettes may help adult cigarette smokers achieve cigarette cessation, depending on patterns of e-cigarette use. Among cigarette smokers who do not use e-cigarettes, it is unclear if and how a-priori intentions for use are related to uptake patterns. Longitudinal studies have focused on established e-cigarette users or adolescent and young adult populations exclusively.

METHODS

Within a nationwide randomized clinical trial (N = 638), adult cigarette smokers not currently using e-cigarettes were randomized (2:1) to receive (or not) one-month sampling of e-cigarettes. An exploratory factor analysis (EFA) was performed on an established 15-item measure assessing a-priori intentions for e-cigarette use to identify latent variables. Among those receiving e-cigarette products, regression models examined relationships between intentions and: 1) uptake (yes/no), 2) frequency (number of days per week), and 3) amount (puffing episodes per day) of e-cigarette use at one-month follow-up.

RESULTS

Two factors emerged from the EFA: 1) cigarette-related intentions (e.g., cigarette cessation, no smell) and 2) novel appeal of e-cigarettes (e.g., flavors). Three items remained and were treated as separate intentions: "feels like cigarette smoking", "curiosity", and "affordability". In the final multivariable models, "feel like cigarette smoking" predicted more frequent e-cigarette use (β = 0.187, SE = 0.086, p = 0.03); however, none of the five factors/intentions were significantly associated with uptake or amount of use.

CONCLUSIONS

For adult cigarette smokers not currently using e-cigarettes, a-priori intentions for using e-cigarettes might not be predictive of if or how these products will be used in the future, suggesting that motives may not drive use behavior.

"Close to My Community": A Qualitative Study of Community Health Worker-Supported Teleaudiology Hearing Aid Services

OBJECTIVES

Given well-documented disparities in rural and minority communities, alternative service delivery models that help improve access to hearing care are needed. This article reports on a study of older Latino adults with hearing loss who received hearing aid services with Community Health Workers (CHWs) providing support via teleaudiology. The present study used qualitative data to explore perceptions of this novel service delivery model.

DESIGN

Participants completed semistructured interviews related to their experiences in the intervention approximately 17 weeks after the hearing aid fitting appointment. Two coders independently coded the data, using an iterative deductive and inductive thematic analysis approach. Inter-rater reliability was good (κ = 0.80).

RESULTS

Of the 28 participants, 19 were interviewed (CHW group: n = 9, 8 females; non-CHW group: n = 10, 9 females). Both groups of participants reported experiencing barriers in access to care and reported positive experiences with teleaudiology and with hearing aids as part of the trial. CHW group participants reported interactions with patient-site facilitators that were indicative of patient-centeredness.

CONCLUSIONS

Results demonstrate the feasibility and potential effectiveness of trained CHWs as patient-site facilitators in teleaudiology-delivered hearing aid services for adults.

The Value of Amide Proton Transfer MRI in the Diagnosis of Malignant and Benign Urinary Bladder Lesions: Comparison With Diffusion-Weighted Imaging

BACKGROUND

Conventional magnetic resonance imaging (MRI) has certain limitations in distinguishing between malignant and benign urinary bladder (UB) lesions. Amide proton transfer (APT) imaging may provide more diagnostic information than diffusion-weighted imaging (DWI) to distinguish between malignant and benign UB.

PURPOSE

To investigate the potential of APT imaging in the diagnosis of malignant and benign UB lesions and to compare its diagnostic efficacy with that of conventional DWI.

STUDY TYPE

Prospective.

SUBJECTS

Eighty patients with UB lesions.

FIELD STRENGTH/SEQUENCE

A 3.0 T/turbo spin echo (TSE) T1-weighted and T2-weighted imaging, single-shot echo planar DWI, and three-dimensional TSE APT imaging.

ASSESSMENT

Patients underwent radical cystectomy or transurethral resection of the bladder lesions within 2 weeks after CT urography and MRI examination. APT signal intensity in UB lesions was quantified by the asymmetric magnetization transfer ratio (MTRasym). MTRasym and apparent diffusion coefficient (ADC) values were measured and compared between malignant and benign UB lesions.

STATISTICAL TESTS

Kolmogorov-Smirnov test, Student's t test or Mann-Whitney U test, Spearman rank correlation coefficient, area under the receiver operating characteristic (ROC) curve (AUC), Delong test, and intraclass correlation coefficient (ICC). The significance threshold was set at P < 0.05.

RESULTS

Thirty-two patients had pathologically confirmed benign UB lesions, including 2 bladder leiomyomas, 1 submucosal amyloidosis, 1 inflammatory myofibroblastic tumor, and 28 inflammatory lesions, and 48 patients had pathologically confirmed urothelial carcinoma. Urothelial carcinomas showed significantly higher MTRasym values (1.53% [0.74%] vs. 0.85% [0.23%]) and significantly lower ADC values (1.24 ± 0.34 × 10-3 mm2/s vs. 1.43 ± 0.22 × 10-3 mm2/s) than benign UB lesions. The MTRasym value (AUC = 0.928) was significantly better in differentiating urothelial carcinoma from benign UB lesions than the ADC value (AUC = 0.722).

DATA CONCLUSION

APT imaging may have value in discriminating malignant from benign UB lesions and has better diagnostic performance than DWI.

LEVEL OF EVIDENCE

3 TECHNICAL EFFICACY: Stage 2.

Quantifying accuracy on distance estimation tasks: A Monte Carlo study

An important aspect of perceptual learning involves understanding how well individuals can perceive distances, sizes, and time-to-contact. Oftentimes, the primary goal in these experiments is to assess participants' errors (i.e., how accurately participants perform these tasks). However, the manner in which researchers have quantified error, or task accuracy, has varied. The use of different measures of task accuracy, to include error scores, ratios, and raw estimates, indicates that the interpretation of findings depends on the measure of task accuracy utilized. In an effort to better understand this issue, we used a Monte Carlo simulation to evaluate five dependent measures of accuracy: raw distance judgments, a ratio of true to estimated distance judgments, relative error, signed error, and absolute error. We simulated data consistent with prior findings in the distance perception literature and evaluated how findings and interpretations vary as a function of the measure of accuracy used. We found there to be differences in both statistical findings (e.g., overall model fit, mean square error, Type I error rate) and the interpretations of those findings. The costs and benefits of utilizing each accuracy measure for quantifying accuracy in distance estimation studies are discussed.

Financial Conflicts of Interest and Industry Funding are Associated With Conclusions Favorable to New Technologies: A Review of Published Economic Analyses in Hip and Knee Arthroplasty

BACKGROUND

New technologies in hip and knee arthroplasty are commonly evaluated using cost-effectiveness analyses and similar economic assessments. There is a wide variation in the methodology of these studies, introducing the potential for bias. The purpose of this study was to evaluate associations between potential financial conflicts of interest (COI) and the outcomes of economic analyses. We hypothesized that authors' COI and industry funding would be associated with conclusions favorable to a new technology.

METHODS

Economic analyses making cost-effectiveness or economic implementation claims on patient-specific instrumentation, robotics, and implants used in hip and knee arthroplasty published from 2010 to 2022 were identified. Papers were evaluated to determine if conclusions were favorable to the new technology being studied. Fisher's exact test was utilized to determine the relationship between the presence of COI and an article's conclusions.

RESULTS

Of 43 eligible articles, 76.7% were cost-effectiveness analyses, 23.2% were cost analyses, and 67.4% of articles had conclusions favorable to a technology. Of the 29 articles with favorable conclusions, 26 had an author with a financial COI (89.7%), and 14 had industry funding (48.3%). Of the 33 articles with a financial COI, 26 (78.8%) had favorable conclusions, and of the 16 articles with industry funding, 14 (87.5%) had favorable conclusions. Fisher's exact test revealed a statistically significant association between an article having favorable conclusions and the presence of an author's COI or industry funding (odds ratio, 13.5; 95% CI [confidence interval], 2.3 to 79.9; P = .003).

CONCLUSIONS

Financial COIs were present in 79.1% of lower extremity arthroplasty economic analyses on technologies and were associated with an article having conclusions favorable to the new technology. Surgeons and decision-makers should be aware of the variability and assumptions in these studies and the potential bias of the conclusions.

Interrater Reliability and Precision of a Novel Hand Strength Assessment and Treatment Device: The GripAble

IMPORTANCE

Occupational therapy practitioners need modern tools for the assessment of maximal grip strength in clinical and remote settings.

OBJECTIVE

To establish the (1) interrater reliability and (2) precision of the GripAble among three raters with different expertise in occupational therapy when testing healthy participants, and to (3) evaluate the relative reliabilities of different approaches to estimating grip strength (i.e., one trial, mean of two trials, and the mean of three trials).

DESIGN

Measurement study.

SETTING

Minnesota Translational Musculoskeletal and Occupational Performance Research Lab, University of Minnesota, Minneapolis.

PARTICIPANTS

Thirty volunteers, age ≥18 yr, without any hand problems.

OUTCOMES AND MEASURES

Using GripAble, three occupational therapy raters with varied experience measured the maximal grip strength of the dominant and nondominant hands of all participants. Using the mean of three trials when testing grip strength with GripAble adds precision.

RESULTS

GripAble has excellent interrater reliability (i.e., intraclass correlation coefficient > .75) and acceptable precision (minimal detectable change < 15%) among healthy adults.

CONCLUSIONS AND RELEVANCE

GripAble allows occupational therapy practitioners with different experiences to assess grip strength in healthy hands quickly, precisely, and with excellent reliability. Additional research is needed on its psychometrics in clinical populations and capacities in remote monitoring and exergaming. Plain-Language Summary: The results of this study show that grip strength, an important biomarker and commonly assessed construct in occupational therapy, can be evaluated reliably, precisely, and rapidly with GripAble. The use of GripAble by occupational therapy practitioners in clinical settings may help to build an infrastructure for remote measurements and exergaming interventions in the future.

"I find it hard to change poor food habits": Measuring food choice motives in an emerging economy

Food choices are driven by an array of motives that have been approached, determined and quantified in a number of ways, mainly in developed countries. The objective of this study was to better understand the motives behind food choices in an emerging economy by collecting information from urban people in South Africa in a series of four studies. (1) Items generated through focus group discussions with low, middle and high income participants by Magano et al. (2023) were checked for content and face validity and (2) 123 statements derived from them were evaluated by 621 respondents. After exploratory factor analysis (EFA), 46 statements best representing the motivational space were (3) presented to another group of respondents (n = 259). Here, the EFA resulted in a 31-item, 7-factor food choice questionnaire for emerging economies (FCQ-EE) which was (4) confirmed by a nationwide sample (n = 814) and further refined to an alternative 19-item, 7-factor solution. The emerging factors were: Healthy eating constraints (HEC), Frugality (FR), Emotional eating (EE), Meat appeal (MA), Weather (WE), Quality seeking (QS) and Cooking constraints (CC). Whether used in the 31-item or 19-item format, this set of statements highlights factors underlying food choice in an emerging economy and offers a way to study their importance in similar contexts. Further research is needed to show the extent to which these factors can predict actual food choices.

Psychometric Evaluation of the Complexity of Care in the Home Care Setting Instrument (COMID) in Italian Language

AIM

To test the psychometric properties of the complexity assessment instrument for home nursing practice (COMID) Italian version.

DESIGN

Cross-sectional study.

METHODS

Internal consistency was determined using Cronbach's alpha, whilst the two-way mixed effects, absolute agreement, single measure intraclass correlation coefficient (ICC 3.1) was calculated to evaluate the inter-rater reliability both on individual factors and the overall score. Registered Nurses enrolled at the MSc in Nursing at the University of Applied Sciences and Arts of Southern Switzerland and homecare nurses working for several home care institutions were involved in the data collection process following ad hoc training on the use of the COMID assessment instrument.

RESULTS

A total of 220 questionnaires were completed by 36 nurses. Cronbach's alpha was 0.764, in line with the original study. The inter-rater reliability ranged from good (factor 6 ICC = 0.85) to excellent (factors 1-5 ICC > 91), with the ICC assessed on the total score of the COMID also excellent (ICC = 0.95).

CONCLUSION

The COMID Italian version is a valid and reliable instrument for homecare nurses to assess complex situations according to the tests performed on a sample of older people receiving home care in Southern Switzerland.

IMPLICATIONS FOR PRACTICE

The use of such an instrument will enable the identification of the most relevant areas of complexity to be discussed by the nursing and multidisciplinary team to plan and deliver personalised caring interventions.

An Instrument to Assess the Digital Competence of Nurse Educators

BACKGROUND

The Educators and Educator Candidates' Competence in Digital Pedagogy instrument needed to be tested before using it in nursing education.

PURPOSE

This study describes the further testing of this instrument to measure nurse educators' digital competence.

METHODS

The study is reported according to the 7 steps of the MEASURE Approach. Psychometric testing was conducted with a sample of 111 Finnish nurse educators from 9 universities of applied sciences. The study was conducted during the years 2020 and 2023.

RESULTS

The exploratory factor analysis results explained 56% of the variance with 3 factors, including 20 items. The factors were labeled to describe the nurse educators' digital competence: implementing appropriate independent and community learning, acting safely and responsibly, and guiding learning based on the evidence. Cronbach α and McDonald ω coefficients showed good reliability.

CONCLUSIONS

The instrument can be used to assess digital competence and identify the development needs to facilitate educators' continuous professional development.

How users make online privacy decisions in work and personal contexts of use

With the rising usage of contactless work options since COVID-19, users increasingly share their personal data in digital tools at work. Using an experimental online vignette study (N = 93), we examined users' willingness to use a video conferencing tool, while systematically varying the context of use (personal vs. low trustworthiness work vs. high trustworthiness work) and the type of information shared (low vs. medium vs. high sensitivity). We also assessed users' perceived responsibility in work and personal contexts of use and their self-assessed digital competence. Our results highlight employer trustworthiness as an important factor in the willingness to use a third-party video conferencing tool, with increased willingness to use these tools in work contexts of use with high trustworthiness compared to those with low trustworthiness. This effect seems to be reduced when the data to be shared is of high sensitivity, compared to medium and low sensitivity data. Furthermore, despite reduced responsibility for data protection in work compared to personal contexts of use, the willingness to use a video conferencing tool did not decrease between trustworthy work and personal contexts of use. We discuss our findings and their methodological implications for future research and derive implications for privacy decisions at work.

Psychometric properties of the Farsi version of the Disaster Nursing Readiness Evaluation Index (F-DNREI)

BACKGROUND

Considering the vital role of nurses in responding to disasters, it is essential to measure their readiness with a valid and reliable tool. The present study aimed to assess the psychometric properties of the Farsi version of the Disaster Nursing Readiness Evaluation Index (F-DNREI).

METHODS

This cross-sectional study was conducted between 2023 and 2024 among 200 nurses working at educational hospitals affiliated with one of the medical universities in Tehran, Iran. The Disaster Nursing Readiness Evaluation Index was translated into Persian. The face, content, and construct validity, as well as internal consistency, were analyzed.

RESULTS

In the exploratory factor analysis, five factors were extracted: practical skills for disaster response, adaptability to stressful situations at the disaster site, communication and cooperation skills for teamwork, emergency nursing skills, and effective coping with daily stress. Together, these factors accounted for 39.7% of the total variance. The results of the confirmatory factor analysis indicated that the extracted model fit well: CMIN/DF = 1.519, CFI = 0.889, RMSEA = 0.051. The Cronbach's alpha and McDonald's omega coefficients for the entire questionnaire were 0.890 and 0.891, respectively.

CONCLUSIONS

Given that Iran is frequently exposed to disasters, it becomes essential to assess the preparedness of Iranian nurses using a valid and reliable scale. The availability of the Farsi version of the Disaster Nursing Readiness Evaluation Index (F-DNREI), which has undergone validation and reliability testing, facilitates accurate measurement of this concept.

Validation of the Social Reactions-Online Questionnaire Among Adults Who Disclosed Online Victimization Via #MeToo

The #MeToo movement of 2017 ushered in a wave of online disclosure of sexual victimization. The ways in which people respond to the disclosure of sexual victimization can play an important role in a survivor's recovery process. This study conducted an exploratory structural equation model (ESEM) of a questionnaire aimed at characterizing the ways in which others respond to the disclosure of sexual victimization in online spaces. Participants (N = 767) were recruited via social media to participate in a study of disclosure of unwanted sexual experiences, with 25.4% (n = 195) endorsing disclosing an unwanted sexual experience online using the hashtag #MeToo and were included in analyses. Participants completed the Online Social Reactions Questionnaire (OSRQ). The questionnaire included all 16 original items from the Short Version of the Social Reactions Questionnaire (SRQ). An additional 8 items specific to online disclosure, not covered by the SRQ were added at the end, bringing the proposed OSRQ to a total of 24 items. The updated measure included the 16 original items of the Short Version of the SRQ as well as 8 additional items, for a total of 24 items. ESEM confirmed the OSRQ as a 23-item measure with a four-factor structure: (a) Turning Against+, (b) Unsupportive Acknowledgment, (c) Positive Support+, and (d) Online Sharing; model fit: χ2(186) = 387.125, p < .001, CFI = 0.976, RMSEA = 0.074 (90% CI [0.064, 0.085]), SRMR = 0.034. The OSRQ revealed excellent Cronbach's alpha (α = .93) and McDonald's Omega (ω = .93). The OSRQ represents a new measure that can be used to characterize the way in which others respond to online disclosure of sexual victimization.

A semi-structured interview for the dimensional assessment of internalizing and externalizing symptoms in children and adolescents: Interview Version of the Symptoms and Functioning Severity Scale (SFSS-I)

BACKGROUND

This study evaluates the psychometric properties of the newly developed semi-structured interview, Interview Version of the Symptoms and Functioning Severity Scale (SFSS-I), which is designed to provide a dimensional assessment of internalizing and externalizing symptoms.

METHODS

Multi-informant baseline data from the OPTIE study was used, involving 358 children and adolescents aged 6 to 17 years (M = 11.54, SD = 3.4, n = 140 [39.1%] were female). Participants were screened for internalizing and externalizing symptoms. For validity analyses, caregiver (Child Behavior Checklist), youth (Youth Self Report), and teacher ratings (Teacher Report Form) were used. We performed Receiver Operating Characteristic (ROC) analyses to evaluate the effectiveness of the SFSS-I subscales in distinguishing between children and adolescents diagnosed with internalizing and externalizing disorders, as determined by clinical judgement in routine care.

RESULTS

Confirmatory factor analyses supported a correlated two-factor model for internalizing and externalizing symptoms. Acceptable to good internal consistencies (α = 0.76 to 0.89; ω = 0.76 to 0.90) and excellent interrater reliability on the scale level (ICC ≥ 0.91) was found. The ROC analyses showed an acceptable accuracy in identifying internalizing diagnoses (AUC = 0.76) and excellent accuracy for externalizing diagnoses (AUC = 0.84).

CONCLUSION

The SFSS-I demonstrates potential as a clinically-rated instrument for screening and routine outcome monitoring, offering utility in both clinical practice and research settings for the dimensional assessment of broad psychopathological dimensions.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS) DRKS00016737 ( https://www.drks.de/DRKS00016737 ). Registered 17 September, 2019.

Olympic team rowers and team swimmers show altered functional brain activation during working memory and action inhibition

BACKGROUND

High-level expertise in team-sports is associated with superior performance on executive functions (EFs) such as working memory (WM) and action inhibition, and with altered activation of brain areas related to these EFs. In most such studies, athletes were sampled from the domain of dynamic (i.e., open-skill) team-sports (e.g., soccer players). Whether static (i.e., closed-skill) team-sports athletes (e.g., rowers and synchronized swimmers) also show superior EFs performance and differential EF-related functional brain activation remains unknown.

METHODS

We recruited 14 elite closed-skill athletes, all national champions, and internationally competitive in various rowing disciplines, as well as 14 controls matched on gender, age, and education, and had them perform working memory and action inhibition (stop-signal) tasks during fMRI scanning.

RESULTS

Group differences in performance in either task failed to obtain statistical significance, although athletes showed a numerical trend toward higher WM capacity than controls. Importantly, task-related BOLD responses suggested that Olympic closed-skill team athletes show stronger recruitment of brain areas that emphasize relatively stable task demands and weaker engagement of brain areas that emphasize rapidly changing demands imposed by extraneous stimulation.

CONCLUSION

Functional brain imaging data suggest elite closed-skill athletes may employ different cognitive strategies.

A practical magnetic-resonance imaging score for outcome prediction in comatose cardiac arrest survivors

AIM

Magnetic Resonance Imaging (MRI) is an important prognostic tool in cardiac arrest (CA) survivors given its sensitivity for detecting hypoxic-ischemic brain injury (HIBI), however, it is limited by poorly defined objective thresholds. To address this limitation, we evaluated a qualitative MRI score for predicting neurological outcome in CA survivors.

METHODS

Adult comatose CA survivors who underwent MRI were retrospectively identified at a single academic medical center. Two blinded neurointensivists qualitatively scored HIBI amongst 12 MRI brain regions. Scores were summated to form four distinct score groups: cortex, deep grey nuclei (DGN), cortex-DGN combined, and total (cortex, DGN, brainstem, and cerebellum). Poor neurological outcome was defined as Cerebral Performance Category (CPC) score 3-5 at hospital discharge. Inter-rater reliability was tested using intra-class correlation (ICC) and discrimination of poor neurological outcome assessed using area under the receiver operating curve (AUC).

RESULTS

Our cohort included 219 patients with median time to MRI of 96 (IQR 81-110) hours. ICC (95% CI) was good to excellent across all MRI scores: cortex 0.92 (0.89-0.94), DGN 0.88 (0.80-0.92), cortex-DGN 0.94 (0.92-0.95), and total 0.93 (0.91-0.95). AUC (95% CI) for poor outcome was good across all MRI scores: cortex 0.84 (0.78-0.90), DGN 0.83 (0.77-0.89), cortex-DGN 0.83 (0.77-0.89), and total 0.83 (0.77-0.88).

CONCLUSION

A simplified, qualitative MRI score had excellent reliability and good discrimination for poor neurologic outcome. Further work is necessary to externally validate our findings in an independent, ideally prospective, cohort.

Trajectories of Treatment Burden Among Primary Care Patients with Long-Term Conditions in Southern China: A Latent Class Growth Analysis

Background

Treatment burden is a patient-centred, dynamic concept. However, longitudinal data on the changing pattern of treatment burden among patients with one or more long-term conditions (LTCs) are relatively scanty. We aimed to explore the longitudinal trajectories of treatment burden and associated risk factors in a large, patient population in primary care settings.

Methods

We analysed data from 5573 primary care patients with long-term conditions (LTCs) recruited using a multistage sampling method in Shenzhen, southern China. The treatment burden was assessed by the Mandarin Chinese version of the Treatment Burden Questionnaire (TBQ). We used latent class growth mixture modelling (LCGMM) to determine trajectories of treatment burden across four time points, ie, at baseline, and at 6, 12, and 18 months. Predictors of trajectory classes were explored using multivariable logistic regression analysis.

Results

The mean TBQ scores of patients with a single LTC (n = 2756), 2 LTCs (n = 1871), 3 LTCs (n = 699), and ≥4 LTCs (n = 247) were 18.17, 20.28, 21.32, and 26.10, respectively, at baseline. LCGMM identified three discrete classes of treatment burden trajectories over time, ie, a high-increasing class, a low-stable class, and a high-decreasing class. When controlling for individual-level factors including age, education, monthly household income per head, smoking, alcohol consumption, and attendance in health education, patients who had a clinical diagnosis of 3 LTCs (adjusted odds ratio [aOR] = 1.49, 95% CI = 1.21-1.86, P < 0.001) or ≥4 LTCs (aOR = 1.97, 95% CI = 1.44-2.72, P < 0.001) were more likely to belong to the high-increasing class. Sensitivity analysis using propensity score methods obtained similar results.

Conclusion

Our study revealed the presence of discrete patterns of treatment burden over time in Chinese primary care patients with LTCs, providing directions for tailored interventions to optimise disease management. Patients with 3 or more LTCs should receive close attention in healthcare delivery as they tend to experience a greater treatment burden.

Can transcutaneous auricular vagus nerve stimulation mitigate vigilance loss? Examining the effects of stimulation at individualized versus constant current intensity

According to the arousal model of vigilance, the locus coeruleus-norepinephrine (LC-NE) system modulates sustained attention over long periods by regulating physiological arousal. Recent research has proposed that transcutaneous auricular vagus nerve stimulation (taVNS) modulates indirect physiological markers of LC-NE activity, although its effects on vigilance have not yet been examined. Aiming to develop a safe and noninvasive procedure to prevent vigilance failures in prolonged tasks, the present study examined whether taVNS can mitigate vigilance loss while modulating indirect markers of LC-NE activity. Following a preregistered protocol (https://osf.io/tu2xy/), 50 participants completed three repeated sessions in a randomized order, in which either active taVNS at individualized intensity set by participant, active taVNS set at 0.5 mA for all participants, or sham taVNS, was delivered while performing an attentional and vigilance task (i.e., ANTI-Vea). Changes in salivary alpha-amylase and cortisol concentrations were measured as markers of LC-NE activity. Self-reports of feelings associated with stimulation and guessing rate of active/sham conditions supported the efficacy of the single-blind procedure. Contrary to our predictions, the observed vigilance decrement was not modulated by active taVNS. Pairwise comparisons showed a mitigation by active taVNS on cortisol reduction across time. Interestingly, Spearman's correlational analyses showed some interindividual effects of taVNS on indirect markers of LC-NE, evidenced by positive associations between changes in salivary alpha-amylase and cortisol in active but not sham taVNS. We highlight the relevance of replicating and extending the present outcomes, investigating further parameters of stimulation and its effects on other indirect markers of LC-NE activity.

Modelling bluetongue and African horse sickness vector (Culicoides spp.) distribution in the Western Cape in South Africa using random forest machine learning

BACKGROUND

Culicoides biting midges exhibit a global spatial distribution and are the main vectors of several viruses of veterinary importance, including bluetongue (BT) and African horse sickness (AHS). Many environmental and anthropological factors contribute to their ability to live in a variety of habitats, which have the potential to change over the years as the climate changes. Therefore, as new habitats emerge, the risk for new introductions of these diseases of interest to occur increases. The aim of this study was to model distributions for two primary vectors for BT and AHS (Culicoides imicola and Culicoides bolitinos) using random forest (RF) machine learning and explore the relative importance of environmental and anthropological factors in a region of South Africa with frequent AHS and BT outbreaks.

METHODS

Culicoides capture data were collected between 1996 and 2022 across 171 different capture locations in the Western Cape. Predictor variables included climate-related variables (temperature, precipitation, humidity), environment-related variables (normalised difference vegetation index-NDVI, soil moisture) and farm-related variables (livestock densities). Random forest (RF) models were developed to explore the spatial distributions of C. imicola, C. bolitinos and a merged species map, where both competent vectors were combined. The maps were then compared to interpolation maps using the same capture data as well as historical locations of BT and AHS outbreaks.

RESULTS

Overall, the RF models performed well with 75.02%, 61.6% and 74.01% variance explained for C. imicola, C. bolitinos and merged species models respectively. Cattle density was the most important predictor for C. imicola and water vapour pressure the most important for C. bolitinos. Compared to interpolation maps, the RF models had higher predictive power throughout most of the year when species were modelled individually; however, when merged, the interpolation maps performed better in all seasons except winter. Finally, midge densities did not show any conclusive correlation with BT or AHS outbreaks.

CONCLUSION

This study yielded novel insight into the spatial abundance and drivers of abundance of competent vectors of BT and AHS. It also provided valuable data to inform mathematical models exploring disease outbreaks so that Culicoides-transmitted diseases in South Africa can be further analysed.

Introducing the high-context communication style interview protocol to detect deception in pairs

In four experiments, we examined whether pairs of truth tellers could be distinguished from pairs of lie tellers by taking advantage of the fact that only pairs of truth tellers can refer to shared events by using brief expressions (high-context communication style). In Experiments 1 and 2, pairs of friends and pairs of strangers pretending to be friends answered (i) questions they likely had expected to be asked (e.g., 'How did you first meet'?) and (ii) unexpected questions (e.g., 'First, describe a shared event in a few words. Then elaborate on it'). Pairs were interviewed individually (Experiment 1, N = 134 individuals) or collectively (Experiment 2, N = 130 individuals). Transcripts were coded for the verbal cues details, complications, plausibility, predictability, and overlap (Experiment 1 only) or repetitions (Experiment 2 only). In two lie detection experiments observers read the individual transcripts in Experiment 3 (N = 146) or the collective transcripts in Experiment 4 (N = 138). The verbal cues were more diagnostic of veracity and observers were better at distinguishing between truths and lies in the unexpected than in the expected questions condition, but only when the pair members were interviewed individually.

Proprioceptive intervention improves reading performance in developmental dyslexia: An eye-tracking study

Developmental dyslexia is characterized by difficulties in learning to read, affecting cognition and causing failure at school. Interventions for children with developmental dyslexia have focused on improving linguistic capabilities (phonics, orthographic and morphological instructions), but developmental dyslexia is accompanied by a wide variety of sensorimotor impairments. The goal of this study was to examine the effects of a proprioceptive intervention on reading performance and eye movement in children with developmental dyslexia. Nineteen children diagnosed with developmental dyslexia were randomly assigned to a regular Speech Therapy (ST) or to a Proprioceptive and Speech Intervention (PSI), in which they received both the usual speech therapy and a proprioceptive intervention aimed to correct their sensorimotor impairments (prism glasses, oral neurostimulation, insoles and breathing instructions). Silent reading performance and eye movements were measured pre- and post-intervention (after nine months). In the PSI group, reading performance improved and eye movements were smoother and faster, reaching values similar to those of children with typical reading performance. The recognition of written words also improved, indicating better lexical access. These results show that PSI might constitute a valuable tool for reading improvement children with developmental dyslexia.

Decisional components of motor responses are not related to online response control: Evidence from lexical decision and speed-accuracy tradeoff manipulations

Evidence suggests that decision processes can propagate to motor-response execution. However, the functional characterization of motor decisional components is not yet fully understood. By combining a classic lexical decision experiment with manipulations of speed-accuracy tradeoff (SAT), the present experiment assessed the hypothesis that decisional effects on chronometric measures of motor-response execution are related to online response control. The electromyographic (EMG) signal associated with manual button-press responses was used to dissociate the premotor component (from stimulus onset until the onset of the EMG activity) from the motor component (from EMG onset until the button-press), thus enabling the assessment of decision-related effects in terms of motor-response duration within single-trial reaction times. Other than replicating all the previously reported SAT effects, the experiment revealed hindered control processes when the instructions emphasized speed over accuracy, as indicated by measures of response control such as partial errors, fast errors, and correction likelihood. Nonetheless, the lexicality effect on motor responses, consisting of slower motor times for pseudowords compared to words, was impervious to any SAT modulation. The results suggest that SAT-induced variations in decision and response control policies may not be the prominent determinant of decision-related effects on motor times, highlighting the multiple "cognitive" components that affect peripheral response execution.

Prostate cancer: unmet supportive and palliative care needs: national survey of patients and family carers

OBJECTIVES

Men living with prostate cancer have supportive and palliative needs. However, few studies detail unmet needs (vs quality of life measurement) or include data from those with advanced disease. We aimed to identify unmet needs of people living with prostate cancer (men, family carers), including those with advanced disease.

METHODS

Mixed-methods national survey (patient Supportive Care Needs Survey; Carer Support Needs Assessment Tool) and health status (EuroQol Visual Analogue Scale). Quantitative data were explored using regression analysis. Free text data were subjected to thematic analysis.

RESULTS

216 men (mean age 65±8.5 years; active cancer 136 [63%]) and 97 carers (68 (70%) spouse/partner) provided data. 133 men (62%) reported moderate-to-high need which was more likely in advanced disease. Men's health status was worse with active vs remitted disease (mean difference -11; 95% CI -17 to -5; p<0.001). 85 (88%) carers reported at least one unmet need relating to 'enabling them to care' and 83 (86%) relating to 'their own well-being'. Carers with chronic illnesses had more unmet needs (p=0.01 to p=0.04) and patient receipt of palliative care independently predicted higher unmet carer needs (p=0.02).Free text data demonstrated widespread burden with: (1) poor communication/information, including about palliative care; (2) poorly managed symptoms/concerns and (3) poor care co-ordination. Incontinence, sexual dysfunction and hormone side-effects were serious problems, often left unaddressed.

CONCLUSIONS

Many living with prostate cancer continue with wide-ranging concerns. Lack of systematic, ongoing needs assessment and poor communication compound inadequate clinical pathways. Person-centred care, interdisciplinary working and integrated palliative care should be resourced.

The long-term effects of perceived instructional leadership on teachers' psychological well-being during COVID-19

The COVID-19 outbreak led to widespread school closures and the shift to remote teaching, potentially resulting in lasting negative impacts on teachers' psychological well-being due to increased workloads and a perceived lack of administrative support. Despite the significance of these challenges, few studies have delved into the long-term effects of perceived instructional leadership on teachers' psychological health. To bridge this research gap, we utilized longitudinal data from 927 primary and secondary school teachers surveyed in two phases: Time 1 in mid-November 2021 and Time 2 in early January 2022. Using hierarchical linear modeling (HLM), our findings revealed that perceptions of instructional leadership, especially the "perceived school neglect of teaching autonomy" at Time 1 were positively correlated with burnout levels at Time 2. Additionally, burnout at Time 2 was positively associated with psychological distress and acted as a mediator between the "perceived school neglect of teaching autonomy" and psychological distress. In light of these findings, we recommend that schools prioritize teachers' teaching autonomy and take proactive measures to mitigate burnout and psychological distress, aiming for the sustainable well-being of both teachers and students in the post-pandemic era.

Balancing exploration and exploitation? The impact of cost and inhibitory control on information gathering in early childhood

The information-seeking behaviour of adults focuses on optimizing the gathering and utilizing information to minimize search costs. In contrast, children tend to engage in information search during decision-making with less consideration for costs. This difference in behaviour is believed to be linked to the development of executive functions. Therefore, the present study aimed to investigate the relationship between executive function and cost-related information-gathering behaviour. We assessed 56 children aged 4-6 years, involving three tasks: an information-gathering task, an inhibitory control and a working memory task. In the information-gathering task, children participated in both non-cost and cost conditions, where they were given the opportunity to freely gather information or incur a cost to acquire information. The findings revealed that children with higher inhibitory control tended to gather less information when a cost was involved. This highlights the important role of inhibitory control in shaping information-seeking behaviour in early childhood.

Noninstrumental Dysphagia Assessment and Screening: A Proposed Checklist

PURPOSE

In the field of dysphagia research, there is a need to establish a framework for the critical appraisal of methodological reporting. A working group was formed to develop a tool to aid in such critical appraisal across various domains of dysphagia research (called the FRONTIERS [Framework for RigOr aNd Transparency In REseaRch on Swallowing] Framework). The goal of the current paper is to present and describe one domain of this tool: noninstrumental assessment and screening tools.

METHOD

Methods describing the development of the FRONTIERS Framework and the associated tool are detailed in the prologue of this series.

RESULTS

A set of questions specific to the critical appraisal of transparency and rigor of research involving noninstrumental screening and assessment tools was developed. This included 13 "yes/no" questions, each of which is presented with a rationale for its inclusion and an example of its implementation.

CONCLUSIONS

The use of this framework will serve researchers and those appraising the quality of research that uses noninstrumental dysphagia assessment and screening tools. More broadly, the FRONTIERS Framework will facilitate improved rigor and transparency across dysphagia research. Special considerations and future goals are discussed.

The Relation between Parental Locus of Control and Willingness to Implement Parent Management Training Strategies

In child disruptive behavior treatment, successful parent management training (PMT) outcomes are dependent on parents' use of strategies outside of sessions. This study aimed to identify the influence of parental locus of control (PLOC) on a key treatment acceptability variable: parents' willingness to implement PMT strategies. We sought to investigate this relationship for individual strategies within PMT, given the composite nature of the intervention. In this study, 109 parents of children (ages 2-12) with disruptive behavior watched brief videos detailing three proactive PMT strategies (child-directed interaction, effective commands, positive attention) and three reactive PMT strategies (ignoring, time out, and removal of privileges) and rated their willingness to implement each strategy. Internal PLOC predicted greater overall willingness to use PMT strategies, above and beyond the influence of child age, child gender, and disruptive behavior severity. Notably, the relationship between willingness and PLOC differed across individual strategies. PLOC predicted willingness to implement proactive PMT strategies to a greater degree than willingness to implement reactive strategies. External PLOC may be a greater barrier to use of proactive strategies because of these strategies' misalignment with external PLOC-related beliefs. Results have implications for the personalization of PMT based on parent cognitions, as well as for the separate analysis of individual components of PMT in future research.

Unification of the food and alcohol disturbance literature: A systematic review

Food and alcohol disturbance (FAD) reflects the functional relationship between disordered eating and alcohol use. There are two motivations underlying FAD - to enhance the effects of alcohol and/or to compensate for alcohol-related calories. Yet, most FAD studies have failed to adequately measure the motives underlying these behaviors, leading to inconsistent and imprecise findings. The aim of the current systematic review was to thematically consolidate FAD research findings by motive, identify limitations of the existing literature, and highlight next steps for FAD researchers. Eighty-one publications, presenting data from 38,536 participants, were included in the current review. Prevalence rates for the caloric compensation and alcohol enhancement motives range from 5.6% - 88.7% and 4.7% - 81.7%, respectively. Alcohol use and disordered eating were the primary correlates of FAD for both motives, and alcohol-related consequences were positively associated with both FAD motives cross-sectionally. Major limitations of the literature include inconsistent operationalization and imprecise measurement of FAD. Primary recommendations include adopting the terminology of and operationalization of FAD presented here, ensuring attention to FAD motive in developing and testing research questions, and moving beyond cross-sectional studies. Findings from this review can be used to contribute to more rigorous and unified FAD research.

Integrated Perceptual Decisions Rely on Parallel Evidence Accumulation

The ability to make accurate and timely decisions, such as judging when it is safe to cross the road, is the foundation of adaptive behavior. While the computational and neural processes supporting simple decisions on isolated stimuli have been well characterized, decision-making in the real world often requires integration of discrete sensory events over time and space. Most previous experimental work on perceptual decision-making has focused on tasks that involve only a single, task-relevant source of sensory input. It remains unclear, therefore, how such integrative decisions are regulated computationally. Here we used psychophysics, electroencephalography, and computational modeling to understand how the human brain combines visual motion signals across space in the service of a single, integrated decision. To that purpose, we presented two random-dot kinematograms in the left and the right visual hemifields. Coherent motion signals were shown briefly and concurrently in each location, and healthy adult human participants of both sexes reported the average of the two motion signals. We directly tested competing predictions arising from influential serial and parallel accounts of visual processing. Using a biologically plausible model of motion filtering, we found evidence in favor of parallel integration as the fundamental computational mechanism regulating integrated perceptual decisions.

Exploring the Potential of Code-Free Custom GPTs in Ophthalmology: An Early Analysis of GPT Store and User-Creator Guidance

INTRODUCTION

OpenAI recently introduced the ability to create custom generative pre-trained transformers (cGPTs) using text-based instruction and/or external documents using retrieval-augmented generation (RAG) architecture without coding knowledge. This study aimed to analyze the features of ophthalmology-related cGPTs and explore their potential utilities.

METHODS

Data collection took place on January 20 and 21, 2024, and custom GPTs were found by entering ophthalmology keywords into the "Explore GPTS" section of the website. General and specific features of cGPTs were recorded, such as knowledge other than GPT-4 training data. The instruction and description sections were analyzed for compatibility using the Likert scale. We analyzed two custom GPTs with the highest Likert score in detail. We attempted to create a convincingly presented yet potentially harmful cGPT to test safety features.

RESULTS

We analyzed 22 ophthalmic cGPTs, of which 55% were for general use and the most common subspecialty was glaucoma (18%). Over half (55%) contained knowledge other than GPT-4 training data. The representation of the instructions through the description was between "Moderately representative" and "Very representative" with a median Likert score of 3.5 (IQR 3.0-4.0). The instruction word count was significantly associated with Likert scores (P = 0.03). Tested cGPTs demonstrated potential for specific conversational tone, information, retrieval and combining knowledge from an uploaded source. With these safety settings, creating a malicious GPT was possible.

CONCLUSIONS

This is the first study to our knowledge to examine the GPT store for a medical field. Our findings suggest that these cGPTs can be immediately implemented in practice and may offer more targeted and effective solutions compared to the standard GPT-4. However, further research is necessary to evaluate their capabilities and limitations comprehensively. The safety features currently appear to be rather limited. It may be helpful for the user to review the instruction section before using a cGPT.

Repeated spaced cortical paired associative stimulation promotes additive plasticity in the human parietal-motor circuit

OBJECTIVE

Repeated spaced sessions of repetitive transcranial magnetic stimulation (TMS) to the human primary motor cortex can lead to dose-dependent increases in motor cortical excitability. However, this has yet to be demonstrated in a defined cortical circuit. We aimed to examine the effects of repeated spaced cortical paired associative stimulation (cPAS) on excitability in the motor cortex.

METHODS

cPAS was delivered to the primary motor cortex (M1) and posterior parietal cortex (PPC) with two coils. In the multi-dose condition, three sessions of cPAS were delivered 50-min apart. The single-dose condition had one session of cPAS, followed by two sessions of a control cPAS protocol. Motor-evoked potentials were evaluated before and up to 40 min after each cPAS session as a measure of cortical excitability.

RESULTS

Compared to a single dose of cPAS, motor cortical excitability significantly increased after multi-dose cPAS. Increasing the number of cPAS sessions resulted in a cumulative, dose-dependent effect on excitability in the motor cortex, with each successive cPAS session leading to notable increases in potentiation.

CONCLUSION

Repeated spaced cPAS sessions summate to increase motor cortical excitability induced by single cPAS.

SIGNIFICANCE

Repeated spaced cPAS could potentially restore abilities lost due to disorders like stroke.

Development and validation of a patient-centered communication scale for nurses

BACKGROUND

Patient-centered care aims to prevent disease and promote well-being by actively involving patients in treatment and decision-making that is based on respecting the patients and their families. However, no scales have been developed to assess patient-centered care from the nurse's perspective. This study aimed to develop a scale to measure nurses' level of patient-centered communication and confirm its validity and reliability.

METHODS

A methodological cross-sectional study was adopted to develop and validate the Patient-Centered Communication Scale (PCCS). The items were developed through a literature review and online interviews with nurses. Content validity was assessed by experts and the content validity index was calculated. A pretest of the questionnaire was conducted with 10 clinical nurses. To evaluate the factor structure and internal consistency reliability, the PCCS was administered online to 325 nurses in South Korea. Data were analyzed using descriptive statistics, explanatory factor analysis (EFA), and confirmatory factor analysis (CFA).

RESULTS

The final instrument consisted of 12 items and three factors: (1) information sharing, (2) patient-as-person, and (3) therapeutic alliance. EFA revealed a distinct three-factor structure, explaining 59.0% of the total variance. CFA confirmed the adequacy of the model fit and validated the inclusion of the final items. The Cronbach's alpha values ranged from 0.60 to 0.77, indicating acceptable internal consistency. Convergent validity was evidenced by the correlation between the PCCS and a measure of interpersonal communication competence.

CONCLUSIONS

The 12-item PCCS showed good reliability, construct validity, and convergent validity. The scale has utility for measuring the level of patient-centered communication skills in nurses.

Development and validation of a novel questionnaire to describe and assess sensations and triggers associated with refractory and unexplained chronic cough

INTRODUCTION

Refractory or unexplained chronic cough (RUCC) is a common clinical problem with no effective diagnostic tools. The Sensations and Triggers Provoking Cough questionnaire (TOPIC) was developed to characterise cough in RUCC versus cough in other conditions.

METHODS

Content analysis of participant interviews discussing the sensations and triggers of chronic cough informed TOPIC development. Participants with chronic cough completed the draft-TOPIC (a subset repeating 5-7 days later), St George's Respiratory Questionnaire (SGRQ), Cough Severity Diary (CSD) and Global Rating of Change Scale. The draft-TOPIC item list was reduced in hierarchical and Rasch analysis to refine the questionnaire to the TOPIC.

RESULTS

49 items describing the triggers and sensations of cough were generated from participant interviews (RUCC n=14, chronic obstructive pulmonary disease (COPD) n=11, interstitial lung disease (ILD) n=10, asthma n=11, bronchiectasis n=3, cystic fibrosis n=7). 140 participants (median age 60.0 (19.0-88.0), female 56.4%; RUCC n=39, ILD n=38, asthma n=45, COPD n=6, bronchiectasis n=12) completed draft-TOPIC, where items with poor 'fit' for RUCC were removed to create TOPIC (8 trigger items, 7 sensation items). Median TOPIC score was significantly higher in RUCC (37.0) vs ILD (24.5, p=0.009) and asthma (7.0, p<0.001), but not bronchiectasis (20.0, p=0.318) or COPD (18.5, p=0.238), likely due to small sample sizes. The Rasch model demonstrated excellent fit in RUCC (χ2=22.04, p=0.85; PSI=0.88); as expected. When all participant groups were included, fit was no longer demonstrated (χ2=66.43, p=0.0001, PSI=0.89) due to the increased heterogeneity (CI=0.077). TOPIC correlated positively with SGRQ (r=0.47, p<0.001) and CSD (r=0.63, p<0.001). The test-retest reliability of TOPIC (intraclass correlation coefficient) was excellent (r=0.90, p<0.001).

CONCLUSIONS

High TOPIC scores in the RUCC patients suggest their cough is characterised by specific sensations and triggers. Validation of TOPIC in cough clinics may demonstrate value as an aid to identify features of RUCC versus cough in other conditions.

Exploring educator perceptions and profiles in supporting culturally and linguistically diverse students integration in healthcare work environments - A cross-sectional study

BACKGROUND

The global shortage of healthcare workers, an ageing population, and increasing retirement within the healthcare workforce are causing social and healthcare systems to undergo significant internationalisation and cultural-linguistic diversification. Despite the crucial role educators play in imparting healthcare education and supporting the integration of professionals into these diverse environments, there is a lack of effective strategies and understanding to achieve this integration successfully.

AIM

To explore and understand how social and healthcare educators self-perceive their role in supporting the integration of culturally and linguistically diverse (CALD) students into healthcare working environments, and to identify whether these perceptions can be categorised into specific educator profiles.

METHODS

A cross-sectional survey was conducted in the spring of 2022 in Finland, collecting observational data from 59 social and healthcare educators across 15 universities of applied sciences providing nurse education to CALD students. Four instruments were developed to measure educators' perceptions of supporting students in healthcare work environment integration. K-means clustering analysis identified two distinct educator profiles, and statistically significant differences between these profiles were analysed using t-tests, Chi-square tests, and Mann-Whitney U tests.

RESULTS

Educators perceived their highest strengths as ensuring equality for students (mean 3.81), possessing suitable characteristics (mean 3.78), and being culturally sensitive and aware (mean 3.73). They felt least confident in knowing their institution's integration practices (mean score of 2.43) and personally supporting cultural diversity among students (mean 2.93). Educators were classified into two profiles: less confident educators (mean 2.27-3.66) and confident educators (mean 2.58-3.94). Confident educators, who more effectively support CALD students, have been more involved in continuous education.

CONCLUSIONS

Continuous education is critical for enhancing educators' confidence and effectiveness in supporting CALD students. Improved training and resources focused on institutional integration practices and personal support for cultural diversity are needed to address areas where educators feel less confident.

Investigating Expert-Rater Agreement and Inter/Intra-Rater Reliability of Two Fundamental Movement Skills for the Locomotor Subscale of the FG-COMPASS

The Furtado-Gallagher Children Observational Movement Pattern Assessment System (FG-COMPASS) is an observational tool using sequential decisions to assess fundamental movement skill proficiency. The current version of the test has three locomotor and five manipulative skills. Adding two more locomotor skills to the assessment tool enriches its scope, enabling a more comprehensive and nuanced evaluation of individual movement skills. We assessed expert-non-expert rater agreement and inter/intra non-expert rater reliability of two new scales for the locomotor subscale. We divided this study into two parts. In Part I, we filmed 60 children aged 5-10 years old who performed gallop and vertical jump skills. A motor behavior expert then classified the videotapes using our newly created rating scales. Next, we selected eight videos for training purposes and 24 videos for testing purposes. In Part II, 30 undergraduate students underwent rater training. Rating data were analyzed using weighted kappa (Kw) and the intra-class correlation coefficient (ICC), and these indices showed 'very good' agreement between the expert and the non-expert raters for vertical jump (Kw = .96) and gallop (Kw = .89). The ICC expert to non-expert rater values for vertical jump and gallop were .98 and .94, respectively; and mean kappa values for inter-rater reliability between non-experts were considered 'very good' for vertical jump (MKw = .92) and 'good' for gallop (MKw = .78). The ICC inter-rater values were .98 and .95 (considered 'excellent') for vertical jump and gallop, respectively; and the kappa intra-rater values were .96 and .85, respectively, with intra-rater ICC values .98 and .92. Thus, the proposed rating scales were reliable for assessing vertical jump and gallop. Future studies should focus on criterion-related validity and reliability evidence from live performances.

Cross-modal interactions in language production: evidence from word learning

Literate adults are able to produce the same word in different language modalities-for instance, through speaking and writing. Yet how speaking and writing interact is not well understood. The present study takes a new perspective on the question of the co-activation of phonological and orthographic representations in speaking and writing by examining the acquisition of novel words. We tested how novel words get integrated into modality-specific lexicons by biasing novel word acquisition toward speaking or writing and assessing cross-modal transfer at the first stages of learning. Participants learned novel words paired with pictures of novel objects and practiced them overtly through speaking or typing. At test, typed training led to higher recall accuracy than spoken training whether words were recalled through typing or speaking. Performance in typing (RT and durations) benefited more from typed than spoken training. Crucially, performance in speaking did not benefit specifically from spoken training and was similar after spoken or typed training. Results are compatible with an asymmetric integration in the phonological and orthographic lexicons according to the modality of training, with representations created in the orthographic lexicon directly transferring to the phonological lexicon, while the opposite doesn't seem to occur. Cross-modal transfer dynamics are discussed according to the level of lexical activation.

Evaluating the Impact of Seated Pilates on Functional Outcomes Among Those With Mild, Moderate, and Severe Multiple Sclerosis Impairment: A Pilot Feasibility Trial

This pilot study assessed the feasibility and functional benefits of a twice-weekly, 12-week, virtual, seated, group-based Pilates program in persons with mild to severe multiple sclerosis (MS). Participants were randomized into either a Pilates-only group or a Pilates group, which also incorporated hip and shoulder-cuff activation exercises. Process, management, and scientific-feasibility metrics were analyzed descriptively. Functional outcomes, physical activity, and MS-related outcomes (impact, fatigue, and quality of life) were measured pre- and postintervention and analyzed using mixed-effects models, analysis of variance, and cluster analysis. Twenty-two participants completed baseline testing. Sixteen completed the intervention and postintervention testing. Collapsed across groups, analyses demonstrated improvements in the Timed 25-Foot Walk (36%), Timed Up-and-Go (13%), and the Berg Balance Scale (10%, statistically significant). Neither between-groups differences nor physical activity or MS outcome changes were significant. Participants reported high satisfaction. Findings suggest that virtual, seated Pilates is feasible and may confer balance benefits to individuals with MS.

Physiotherapists' Perception of and Readiness to Use, Telerehabilitation for Musculoskeletal Disorders in Malaysia: A Cross-Sectional Study

Introduction: Musculoskeletal ailments exert a significant impact on global populations. To address challenges posed by geographical constraints and financial limitations, physiotherapists have explored and found telerehabilitation to be a viable solution. Despite its proven effectiveness in clinical practice, the integration of telerehabilitation has been sluggish. This cross-sectional survey sought to delve into the perspectives and readiness of physiotherapists in Malaysia regarding telerehabilitation for musculoskeletal disorders. Methods: A customized survey instrument was developed and evaluated for face validity and reliability. The 36-item questionnaire was distributed through the Google Form platform, targeting respondents via social media channels such as Facebook and WhatsApp. Data analysis used descriptive statistics (frequency and percentage). Results: The survey garnered responses from 271 physiotherapists. A majority (76.3%, n = 202) expressed agreement regarding the potential benefits of telerehabilitation in physiotherapy practice. About 77% of the respondents also showcased greater readiness for monitoring client progress through telerehabilitation as opposed to assessment and treatment. Notable benefits identified by respondents included preventing cross-infection (98.5%) and reducing travel time for both clients (94.0%) and physiotherapists (90.6%). Conclusion: The study reveals that physiotherapists in Malaysia exhibit positive attitudes and preparedness for implementing telerehabilitation in managing musculoskeletal conditions.

Cognitive correlates of psychopathology in functional/dissociative seizures and non-lesional epilepsy: An exploratory study

OBJECTIVE

To explore the relationship between cognitive functioning and psychopathological features in Functional/Dissociative Seizures (FDS), and test whether this differs from that observed in epilepsy.

METHODS

We recruited a cross-sectional sample of adults (age > 18) with a diagnosis of non-lesional epilepsy or FDS between January 2021 and July 2022 (n = 73). Participants completed a series of psychiatric questionnaires and neuropsychological measures. Spearman's Correlation Coefficient was computed between each of the psychiatric and cognitive measures in each group. Fisher's Z test of significance for independent correlation coefficients then tested the significance of the difference between correlation coefficients for the two groups.

RESULTS

There were no group differences in neuropsychological test scores. However, people with FDS reported higher seizure severity, depression levels, number of medically unexplained somatic symptoms, and exposure to traumatic events compared to epilepsy. Results of the Fisher's Z-test revealed significant differences in correlation coefficients between groups in two instances. First, in the association between the number of traumatic experiences and cognitive switching (z = 2.77, p = 0.006); the number of traumatic experiences were positively associated with cognitive switching in epilepsy but showed a non-significant negative trend in FDS. Secondly, in the association between vocabulary abilities and the number of medically unexplained symptoms (z = -2.71; p = 0.007); higher vocabulary ability was associated with fewer somatic symptoms in epilepsy, while no such correlation was observed in FDS.

SIGNIFICANCE

This study provides preliminary evidence for the complex interplay between cognitive functioning and psychopathology in FDS and epilepsy. Neurocognitive functioning such as vocabulary abilities or attentional switching may play a role in the expression or maintenance of pathological features of FDS.

Using machine learning to analyze mental health in distance education during the COVID-19 pandemic: an opinion study from university students in Mexico

In times of lockdown due to the COVID-19 pandemic, it has been detected that some students are unable to dedicate enough time to their education. They present signs of frustration and even apathy towards dropping out of school. In addition, feelings of fear, anxiety, desperation, and depression are now present because society has not yet been able to adapt to the new way of living. Therefore, this article analyzes the feelings that university students of the Instituto Tecnológico Superior de Misantla present when using long distance education tools during COVID-19 pandemic in Mexico. The results suggest that isolation, because of the pandemic situation, generated high levels of anxiety and depression. Moreover, there are connections between feelings generated by lockdown and school performance while using e-learning platforms. The findings of this research reflect the students' feelings, useful information that could lead to the development and implementation of pedagogical strategies that allow improving the students' academic performance results.

Precious2GPT: the combination of multiomics pretrained transformer and conditional diffusion for artificial multi-omics multi-species multi-tissue sample generation

Synthetic data generation in omics mimics real-world biological data, providing alternatives for training and evaluation of genomic analysis tools, controlling differential expression, and exploring data architecture. We previously developed Precious1GPT, a multimodal transformer trained on transcriptomic and methylation data, along with metadata, for predicting biological age and identifying dual-purpose therapeutic targets potentially implicated in aging and age-associated diseases. In this study, we introduce Precious2GPT, a multimodal architecture that integrates Conditional Diffusion (CDiffusion) and decoder-only Multi-omics Pretrained Transformer (MoPT) models trained on gene expression and DNA methylation data. Precious2GPT excels in synthetic data generation, outperforming Conditional Generative Adversarial Networks (CGANs), CDiffusion, and MoPT. We demonstrate that Precious2GPT is capable of generating representative synthetic data that captures tissue- and age-specific information from real transcriptomics and methylomics data. Notably, Precious2GPT surpasses other models in age prediction accuracy using the generated data, and it can generate data beyond 120 years of age. Furthermore, we showcase the potential of using this model in identifying gene signatures and potential therapeutic targets in a colorectal cancer case study.

Psychometric properties of the chinese version of the value-based stigma inventory (VASI): a translation and validation study

OBJECTIVE

This study aimed to develop a culturally adapted Chinese version of the Value-based Stigma Inventory (VASI) and to evaluate its psychometric properties, including reliability and validity, among the general Chinese population.

METHODS

This study is a cross-sectional study. Convenience sampling was used to recruit 708 general citizens from Shenyang City, Liaoning Province, China. The VASI's internal consistency, split-half reliability, and test-retest reliability were tested to assess the translated scale's reliability. Several validity tests were performed, including expert consultation, exploratory factor analysis, and confirmatory factor analysis. Data were analyzed using SPSS 25.0 (IBM Corp., Armonk, NY, United States) and AMOS 23.0 (IBM Corp., Armonk, NY, United States).

RESULTS

The Chinese version of the VASI showed good reliability, with a Cronbach's α value of 0.808, and the dimensions ranged from 0.812 to 0.850. Test-retest reliability showed good temporal stability with a value of 0.855, and the split-half reliability value was 0.845, indicating a high degree of consistency. The scale also demonstrated good content validity with a content validity index of 0.952. After conducting exploratory factor analysis, a five-factor structure was identified, including factors of self-realization, personal enrichment, reputation, meritocratic values, and security. In the confirmatory factor analysis, all recommended fit indicators were found to be within the acceptable range, including χ2/DF = 1.338, GFI = 0.960, AGFI = 0.940, RMSEA = 0.031, TLI = 0.985, CFI = 0.989, IFI = 0.989, PGFI = 0.640, and PNFI = 0.729.

CONCLUSION

The Chinese version of the VASI is valid and reliable among the Chinese general public. The five-factor structured scale effectively assessed public stigma against mental illness, including the value orientations associated with personal stigma. Given the harsh and widespread public stigma against mental illness, the findings from the questionnaire may inform the development of future public health education programs. Public health education is needed to reduce the stigma of mental illness, increase public awareness of mental health issues, and mitigate the continued stigmatization of mental illness.

Using Wearables to Study Biopsychosocial Dynamics in Couples Who Cope With a Chronic Health Condition: Ambulatory Assessment Study

BACKGROUND

Technology has become an integral part of our everyday life, and its use to manage and study health is no exception. Romantic partners play a critical role in managing chronic health conditions as they tend to be a primary source of support.

OBJECTIVE

This study tests the feasibility of using commercial wearables to monitor couples' unique way of communicating and supporting each other and documents the physiological correlates of interpersonal dynamics (ie, heart rate linkage).

METHODS

We analyzed 617 audio recordings of 5-minute duration (384 with concurrent heart rate data) and 527 brief self-reports collected from 11 couples in which 1 partner had type II diabetes during the course of their typical daily lives. Audio data were coded by trained raters for social support. The extent to which heart rate fluctuations were linked among couples was quantified using cross-correlations. Random-intercept multilevel models explored whether cross-correlations might differ by social contexts and exchanges.

RESULTS

Sixty percent of audio recordings captured speech between partners and partners reported personal contact with each other in 75% of self-reports. Based on the coding, social support was found in 6% of recordings, whereas at least 1 partner self-reported social support about half the time (53%). Couples, on average, showed small to moderate interconnections in their heart rate fluctuations (r=0.04-0.22). Couples also varied in the extent to which there was lagged linkage, that is, meaning that changes in one partner's heart rate tended to precede changes in the other partner's heart rate. Exploratory analyses showed that heart rate linkage was stronger (1) in rater-coded partner conversations (vs moments of no rater-coded partner conversations: rdiff=0.13; P=.03), (2) when partners self-reported interpersonal contact (vs moments of no self-reported interpersonal contact: rdiff=0.20; P<.001), and (3) when partners self-reported social support exchanges (vs moments of no self-reported social support exchange: rdiff=0.15; P=.004).

CONCLUSIONS

Our study provides initial evidence for the utility of using wearables to collect biopsychosocial data in couples managing a chronic health condition in daily life. Specifically, heart rate linkage might play a role in fostering chronic disease management as a couple. Insights from collecting such data could inform future technology interventions to promote healthy lifestyle engagement and adaptive chronic disease management.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/13685.

Moving beyond processing- and analysis-related variation in resting-state functional brain imaging

When fields lack consensus standard methods and accessible ground truths, reproducibility can be more of an ideal than a reality. Such has been the case for functional neuroimaging, where there exists a sprawling space of tools and processing pipelines. We provide a critical evaluation of the impact of differences across five independently developed minimal preprocessing pipelines for functional magnetic resonance imaging. We show that, even when handling identical data, interpipeline agreement was only moderate, critically shedding light on a factor that limits cross-study reproducibility. We show that low interpipeline agreement can go unrecognized until the reliability of the underlying data is high, which is increasingly the case as the field progresses. Crucially we show that, when interpipeline agreement is compromised, so too is the consistency of insights from brain-wide association studies. We highlight the importance of comparing analytic configurations, because both widely discussed and commonly overlooked decisions can lead to marked variation.