A Model of Trust in Online COVID-19 Information and Advice: Cross-Sectional Questionnaire Study

BACKGROUND

During the COVID-19 pandemic, many people sought information from websites and social media. Understanding the extent to which these sources were trusted is important in relation to health communication.

OBJECTIVE

This study aims to identify the key factors influencing UK citizens' trust and intention to act on advice about COVID-19 found via digital resources and to test whether an existing model of trust in eHealth provided a good fit for COVID-19-related information seeking online. We also wished to identify any differences between the evaluation of general information and information relating specifically to COVID-19 vaccines.

METHODS

In total, 525 people completed an online survey in January 2022 encompassing a general web trust questionnaire, measures of information corroboration, coping perceptions, and intention to act. Data were analyzed using principal component analysis and structural equation modeling. The evaluation responses of general information and COVID-19 vaccine information were also compared.

RESULTS

The principal component analysis revealed 5 trust factors: (1) credibility and impartiality, (2) familiarity, (3) privacy, (4) usability, and (5) personal experiences. In the final structural equation modeling model, trust had a significant direct effect on intention to act (β=.65; P<.001). Of the trust factors, credibility and impartiality had a significant positive direct effect on trust (β=.82; P<.001). People searching for vaccination information felt less at risk, less anxious, and more optimistic after reading the information. We noted that most people sought information from "official" sources. Finally, in the context of COVID-19, "credibility and impartiality" remain a key predictor of trust in eHealth resources, but in comparison with previous models of trust in online health information, checking and corroborating information did not form a significant part of trust evaluations.

CONCLUSIONS

In times of uncertainty, when faced with a global emergent health concern, people place their trust in familiar websites and rely on the perceived credibility and impartiality of those digital sources above other trust factors.

The Factors Influencing Feeding Practices of Primary Caregivers of Preschoolers: A Theory-Based Cross-Sectional Study

BACKGROUND/OBJECTIVES

Primary caregivers play a pivotal role in shaping children's dietary behaviors, which are critical in preventing childhood obesity. This study aimed to examine the extent to which demographic characteristics and caregiver factors, including dietary beliefs and intentions to provide a healthy diet, influence feeding practices among primary caregivers of preschool-aged children.

METHODS

This study included a cross-sectional dataset comprising data collected from 146 primary caregivers of preschool-aged children (3-5 years). Participants were recruited using snowball and convenience sampling from Facebook and community settings in Cincinnati, Ohio. Feeding practices were assessed using the Comprehensive Feeding Practices Questionnaire (CFPQ), while caregiver demographic characteristics, dietary beliefs, and intentions were measured through self-administered surveys. Hierarchical multiple linear regression was employed to identify predictors of feeding practices.

RESULTS

The findings reveal that primary caregivers' feeding practices were shaped by multiple factors, including dietary beliefs (behavioral, normative, and control), intentions, and demographic characteristics. Each subscale of feeding practices was predicted by different factors, highlighting the unique influence of these factors on feeding behaviors.

CONCLUSIONS

This study underscores the complex interplay between caregiver cognitive (dietary beliefs and intentions) and demographic factors in shaping feeding practices. The findings highlight the importance of targeting caregiver beliefs and intentions in interventions aimed at promoting healthier feeding practices, contributing to the prevention of childhood obesity. Importantly, future research is needed to explore these factors in more diverse populations and validate cognitive measures for broader application.

Enhanced vehicle routing for medical waste management via hybrid deep reinforcement learning and optimization algorithms

Modern technologies, particularly artificial intelligence, play a crucial role in improving medical waste management by developing intelligent systems that optimize the shortest routes for waste transport, from its generation to final disposal. Algorithms such as Q-learning and Deep Q Network enhance the efficiency of transport and disposal while reducing environmental pollution risks. In this study, artificial intelligence algorithms were trained using Homogeneous agent systems with a capacity of 3 tons to optimize routes between hospitals within the Closed Capacitated Vehicle Routing Problem framework. Integrating AI with pathfinding techniques, especially the hybrid A*-Deep Q Network approach, led to advanced results despite initial challenges. K-means clustering was used to divide hospitals into zones, allowing agents to navigate the shortest paths using the Deep Q Network. Analysis revealed that the agents' capacity was not fully utilized. This led to the application of Fractional Knapsack dynamic programming with Deep Q Network to maximize capacity utilization while achieving optimal routes. Since the criteria used to compare the algorithms' effectiveness are the number of vehicles and the utilization of the total vehicle capacity, it was found that the Fractional Knapsack with DQN stands out by requiring the fewest number of vehicles (4), achieving 0% loss in this metric as it matches the optimal value. Compared to other algorithms that require 5 or 7 vehicles, it reduces the fleet size by 20 and 42.86%, respectively. Additionally, it maximizes vehicle capacity utilization at 100%, unlike other methods, which utilize only 33 to 66% of vehicle capacity. However, this improvement comes at the cost of a 9% increase in distance, reflecting the longer routes needed to serve more hospitals per trip. Despite this trade-off, the algorithm's ability to minimize fleet size while fully utilizing vehicle capacity makes it the optimal choice in scenarios where these factors are critical. This approach not only improved performance but also enhanced environmental sustainability, making it the most effective and challenging solution among all the algorithms used in the study.

Likelihood Systems Can Improve Hit Rates in Low-Prevalence Visual Search Over Binary Systems

OBJECTIVE

To study the performance consequences of binary versus likelihood decision support systems in low-prevalence visual search.

BACKGROUND

Hit rates in visual search are often low if target prevalence is low, an issue that is relevant for numerous real-world visual search tasks (e.g., luggage screening and medical imaging). Given that binary decision support systems produce many false alarms at low prevalence, they have often been discounted as a solution to this low-prevalence problem. By offering additional information about the certainty of target-present indications through splitting these into warnings and alarms, likelihood-based systems could potentially boost hit rates without raising the number of false alarms.

METHOD

We used a simulated medical search task with low target prevalence in a paradigm where participants sequentially uncovered parts of the stimulus with their mouse. In two sessions, participants completed the task either while being supported by a binary or a likelihood system.

RESULTS

Hit rates were higher when interacting with the likelihood systems than with the binary system, at no cost of higher false alarms.

CONCLUSION

Likelihood systems are a promising way to tackle the low-prevalence problem, and might further be an effective means to make systems more transparent.

APPLICATION

Simple-to-process information about system certainty for each case might be a solution to low hit rates in domains with low target prevalence, such as radiology.

Neural mechanisms of metacognitive improvement under speed pressure

The ability to accurately monitor the quality of one's choices, or metacognition, improves under speed pressure, possibly due to changes in post-decisional evidence processing. Here, we investigate the neural processes that regulate decision-making and metacognition under speed pressure using time-resolved analyses of brain activity recorded using electroencephalography. Participants performed a motion discrimination task under short and long response deadlines and provided a metacognitive rating following each response. Behaviourally, participants were faster, less accurate, and showed superior metacognition with short deadlines. These effects were accompanied by a larger centro-parietal positivity (CPP), a neural correlate of evidence accumulation. Crucially, post-decisional CPP amplitude was more strongly associated with participants' metacognitive ratings following errors under short relative to long response deadlines. Our results suggest that superior metacognition under speed pressure may stem from enhanced metacognitive readout of post-decisional evidence.

Exploration of the relationship between primary dysmenorrhea, pain perception, and menstruation-related quality of life in young women: a cross-sectional observational study

Background

This study explores the relationship between primary dysmenorrhea (PD), pain, pain catastrophizing, and menstruation-related quality of life in young women.

Methods

A cross-sectional study was conducted involving 44 young women, both with and without PD. Various variables including pain intensity, pain catastrophizing, and menstruation-related quality of life were assessed using validated questionnaires. Correlation and regression analyses were performed to examine the relationships between the variables.

Results

Significant associations were found between the presence of PD, tendency to catastrophize pain, and decreased menstruation-related quality of life. A high correlation was observed between pain intensity and catastrophizing, indicating mutual influence between these variables. Menstruation-related quality of life was affected in terms of health perception, psychological aspect, and symptoms among women with PD. The linear regression model demonstrated that catastrophizing explained 42.8% of the variance in menstruation-related quality of life.

Conclusions

These findings underscore the importance of addressing dysmenorrhea in young women, as it significantly impacts their quality of life related to menstruation. Understanding the factors contributing to dysmenorrhea and its effects on quality of life can inform more effective, patient-centered treatment strategies.

Reproducibility of the Motor Optimality Score-Revised in infants with an increased risk of adverse neurodevelopmental outcomes

AIM

To determine reproducibility of the Motor Optimality Score-Revised (MOS-R) to assess infants at high risk of adverse neurodevelopmental outcomes, including cerebral palsy (CP), autism, and developmental delays.

METHOD

Thirty infants (18 males, 12 females, gestational age mean [range] = 32.5 [23-41] weeks) were randomly selected, according to 2-year outcome (typically developing; CP; or adverse neurodevelopmental outcome [ad-NDO]) from a prospective cohort. Participants had two General Movements videos between 12 weeks and 15 + 6 weeks corrected age. Six assessors, masked to history and outcomes, independently scored the MOS-R from videos. Assessors scored either one (Group 1; n = 3) or two videos for each infant (Group 2; n = 3). Intraclass correlation coefficient (ICC), Gwet's agreement coefficient, and limits of agreement were calculated.

RESULTS

Combined interassessor reliability (IRR) over six assessors for total MOS-R was 'fair' (ICC = 0.56, 95% confidence interval [CI] 0.41-0.72), and 'excellent' with consensus agreement (ICC = 0.99, 95% CI 0.98-0.99). Analyses demonstrated a mean interrater difference of 0.316 (95% limits of agreement -11.51, 12.14) over 450 comparisons (15 pairs). IRR was 'moderate' to 'almost perfect' across subcategories, with the highest reliability 'movement patterns' (Gwet's agreement coefficient = 0.73-1.00) and the lowest 'postural patterns' (0.45-0.73). Assessors who scored two videos (Group 2) demonstrated higher reproducibility. IRR for total MOS-R was 'excellent' when infants were typically developing (ICC = 0.90), and 'good' for CP (0.74) and ad-NDO (0.68).

INTERPRETATION

The MOS-R is a highly reproducible tool for assessing infants at high risk of ad-NDOs and is feasible for implementation in clinical settings. Reproducibility is best when the tool is used by experienced assessors to gain consensus agreement.

Context-dependent modulation of spatial attention: prioritizing behaviourally relevant stimuli

Human attention can be guided by semantic information conveyed by individual objects in the environment. Over time, we learn to allocate attention resources towards stimuli that are behaviourally relevant to ongoing action, leading to attention capture by meaningful peripheral stimuli. A common example includes, while driving, stimuli that imply a possibly hazardous scenario (e.g. a pedestrian about to cross the road) warrant attentional prioritization to ensure safe proceedings. In the current study, we report a novel phenomenon in which the guidance of attention is dependent on the stimuli appearing in a behaviourally relevant context. Using a driving simulator, we simulated a real-world driving task representing an overlearned behaviour for licensed drivers. While driving, participants underwent a peripheral cue-target paradigm where a roadside pedestrian avatar (target) appeared following a cylinder cue. Results revealed that, during simulated driving conditions, participants (all with driver's licenses) showed greater attentional facilitation when pedestrians were oriented towards the road compared to away. This orientation-specific selectivity was not seen if the 3-D context was removed (Experiment 1) or the same visual scene was presented, but participants' viewpoints remained stationary (Experiment 2), or an inanimate object served as a target during simulated driving (Experiment 3). This context-specific attention modulation likely reflects drivers' expertise in automatically attending to behaviourally relevant information in a context-dependent manner.

Examining the semantic relatedness effect on working memory with ad hoc categories

The semantic relatedness effect, a memory advantage of semantically related items (e.g., "penguin, giraffe, goat"), is well established in the literature on working memory (WM). Nevertheless, it remains unclear what mechanisms are responsible for this effect. Although an influential account ascribes it to the cue-dependent retrieval process (e.g., "animal" works as a cue for "penguin, giraffe, goat"), this account has not yet been fully investigated. This is partly because the influence of cues cannot be directly tested in typical studies using common categories (e.g., "animal" is likely to be generated and used by participants, but the generation and use of cues are uncontrollable for the experimenter). The present study, by introducing ad hoc categories and cueing ad hoc category labels, directly tested the influence of cues. Specifically, seemingly unrelated items (e.g., "bone, fly, car") were presented with or without the corresponding ad hoc category label (e.g., "things that dogs chase"). Four experiments demonstrated that providing ad hoc category labels affected WM performance. Importantly, providing the labels improved item memory in WM (Experiments 2 and 3). This supported the retrieval-cue account. Nevertheless, the effect was small (Experiments 2 and 3) and was not found in an experiment (Experiment 1). In contrast, providing the labels had a substantial and systematic effect on long-term memory, suggesting that the manipulation of providing the labels, per se, was successful. The current study's implications for research on WM and ad hoc categories were also discussed.

Effect of sleep quality on the severity of perimenstrual symptoms in Japanese female students: a cross-sectional, online survey

OBJECTIVES

To investigate the relationship between sleep quality and perimenstrual symptoms among Japanese female students.

DESIGN

Observational, cross-sectional, online survey SETTING: We used an online questionnaire to collate responses from Japanese female students on sleep quality and perimenstrual symptoms.

PARTICIPANTS

A total of 298 female students aged 18-25 years in Japan were included in this study.

PRIMARY AND SECONDARY OUTCOME MEASURES

The Menstrual Distress Questionnaire (MDQ) was used to assess the severity of perimenstrual symptoms for three periods-premenstrual, menstrual and postmenstrual-and the Japanese version of the Pittsburgh Sleep Quality Index was used to assess sleep quality. The MDQ scores were compared between two groups (normal-sleep quality and low-sleep quality) using Mann-Whitney U test. In addition, multiple logistic regression analysis was performed, and the MDQ subscales that showed significant differences between the groups were used as independent variables. The MDQ subscale that was strongly associated with sleep quality was calculated.

RESULTS

Of the female students, 160 were classified into the normal-sleep quality group and 138 into the low-sleep quality group. The total MDQ scores were significantly higher in the low-sleep quality group at all phases of the menstrual cycle (respectively p<0.05). Among the MDQ subscales, 'pain' during menstruation and 'concentration' in the premenstrual and postmenstrual stages were associated with sleep quality (respectively p<0.05).

CONCLUSIONS

Improving sleep quality was one possible strategy to reduce the severity of perimenstrual symptoms. These results may provide useful information for Japanese female students who suffer from perimenstrual symptoms.

Reaction time distribution analysis of bimanual movements with spatial and symbolic cues

The movement preparation of bimanual asymmetric reaching movements is longer than bimanual symmetric movements. This bimanual asymmetric cost is small for spatially cued movements and large with symbolic cues. Previous research on these bimanual asymmetric costs has relied on mean reaction time. The goal of the present study was to better understand the sensorimotor mechanisms of spatially and symbolically cued bimanual asymmetric costs by employing reaction time distribution analysis. Reaction time distributions were described with the ex-Gaussian parameters of [Formula: see text], [Formula: see text], and [Formula: see text]. Forty-eight young adults made bimanual symmetric and asymmetric reaching movements that were spatially or symbolically cued. With spatial cues, there was a small cost to [Formula: see text] for bimanual asymmetric movements compared to symmetric ones. This was depicted as a 4.8 ms rightward shift to the reaction time distribution. The bimanual asymmetric cost with spatial cues is likely caused by the temporal coupling of bimanual asymmetric movements. With symbolic cues, there was a large cost to [Formula: see text] and small costs to [Formula: see text] and [Formula: see text]. This was depicted as the Gaussian and exponential components of the distribution having longer and more disperse reaction time for asymmetric movements. The bimanual asymmetric cost with symbolic cues is likely caused by two factors: stimulus-response translation of two different symbolic cues and temporal coupling of bimanual asymmetric movements. The bimanual asymmetric cost to µ with symbolic cues is likely a combination of both factors, with stimulus-response translation contributing more than temporal coupling. The bimanual asymmetric costs to σ and τ are exclusively caused by stimulus-response translation.

Association of Quadratus Lumborum Muscle Stiffness with Chronic Low Back Pain Features: An Observational Study

Background and Objectives: Low back pain (LBP) is highly prevalent and often associated with altered muscle function, including in the quadratus lumborum (QL) muscle. While some studies have highlighted the clinical relevance of QL muscle stiffness in LBP, the findings remain inconsistent, and the role of this parameter in relation to clinical severity indicators is not well understood. Considering the high prevalence of myofascial trigger points among patients, objectively and reliably quantifying QL stiffness and its association with other clinical parameters could improve the identification of early stages of the condition before other alterations become apparent. Therefore, this study aimed to explore the association between QL stiffness and multiple indicators of LBP severity. Materials and Methods: A cross-sectional observational study was conducted involving the participation of seventy-six patients suffering from chronic LBP. An ultrasound scanner with shear-wave elastography (SWE) was used to determine the participants' QL stiffness. Additional information was collected on LBP-associated pain intensity, disability, central sensitization, and quality of life. Results: QL muscle stiffness was negatively correlated with pain intensity (p < 0.01) and central sensitization (p < 0.01), and it was positively correlated with physical quality of life (p < 0.01). Muscle stiffness influenced the variance in pain intensity along with physical quality of life, central sensitization, and chronicity (together explaining 49% of the variance) but did not explain the variance in central sensitization. Conclusions: Assessing QL muscle stiffness in patients with LBP is recommended, as greater muscle softness is linked to higher pain intensity, central sensitization, and poorer physical quality of life. Regression analyses further highlighted that QL stiffness helps explain the variance in pain intensity, physical quality of life, central sensitization, and chronicity, but it did not directly affect the central sensitization variance.

Impact of Modifiable Factors Associated with Physical Frailty and Cognitive Impairment Trajectory of Older Adults: Using the Korean Longitudinal Study of Aging 2006-2018

Background/Objectives: To identify joint trajectories of physical frailty and cognitive impairment among community-dwelling older adults and to determine modifiable factors for each trajectory. Methods: Data were utilized from the Korean Longitudinal Study of Aging, which was conducted between 2006 and 2018. Physical frailty was assessed using the Fried phenotype, and cognitive impairment was evaluated using the Korean version of the Mini-Mental State Examination. Group-based trajectory modeling and logistic regression were employed for the analyses. Results: Based on longitudinal data, 415 participants averaging 72.2 years of age were analyzed. Three trajectories of physical frailty were identified: mild physical frailty, moderate physical frailty, and improving frailty. Two trajectories of cognitive impairment were identified: stable cognitive impairment and improving cognitive impairment. Factors influencing physical frailty trajectories included the number of medications taken, being overweight or obese, and depression. Education level was found to be associated with cognitive impairment trajectories. Conclusions: This study provides evidence for the distinct identification of joint trajectories of physical frailty and cognitive impairment, which can inform the target groups for intervention. It offers a basis for including modifiable physical and mental factors in intervention components for physical frailty trajectories.

Mothers' Knowledge of and Practices Toward Oral Hygiene of Children Aged 5-9 Years in Bangladesh: Cross-Sectional Study

Background

Healthy oral hygiene is crucial for overall health and well-being. Parents' dental care knowledge and practices affect their children's oral health.

Objective

This study examined mothers' knowledge and practices regarding their children's oral hygiene through a cross-sectional survey.

Methods

This cross-sectional survey was conducted from January 1 to December 31, 2022, in Dhaka, Bangladesh. Mothers' knowledge and practices regarding their children's oral hygiene were assessed through a semistructured questionnaire. Statistical analyses, including the χ2 test and Pearson correlation test, were performed. The Mann-Whitney U and Kruskal-Wallis 1-way ANOVA tests were also used to show the average variations in knowledge and practices among different sociodemographic groups.

Results

Of 400 participants, the mean age of mothers was 30.94 (SD 5.15) years, and 388 (97%) were of the Muslim faith, 347 (86.8%) were housewives, and 272 (68%) came from nuclear families. A total of 165 (41.3%) participants showed good knowledge of their children's oral hygiene, followed by 86 (21.5%) showing moderately average knowledge, 75 (18.8%) showing average knowledge, and 74 (18.5%) showing poor knowledge. A total of 182 (45.5%) mothers had children with good oral hygiene practices, followed by mothers with children who had average (n=78, 19.5%), moderately average (n=75, 18.8%), and poor (n=65, 16.3%) oral hygiene practices. The mother's knowledge level was significantly associated with age (P=.01), education (P<.001), family size (P=.03), and monthly income (P<.001). On the other hand, educational status (P=.002) and income (P=.04) were significantly associated with the mother's practices regarding their children's oral hygiene. Nonparametric analysis revealed that mothers who were older (mean knowledge score: 12.13, 95% CI 10.73-13.54 vs 11.21, 95% CI 10.85-11.58; P=.01), with a bachelor's degree or higher (mean knowledge score: 12.93, 95% CI 12.55-13.31 vs 9.66, 95% CI 8.95-10.37; P<.001), who were working mothers (mean knowledge score: 12.30, 95% CI 11.72-12.89 vs 11.45, 95% CI 11.17-11.73; P=.03), and who had a higher family income (mean knowledge score: 12.49, 95% CI 12.0-12.98 vs 10.92, 95% CI 10.48-11.36; P<.001) demonstrated significantly higher levels of oral health knowledge. Conversely, good oral hygiene practices were significantly associated with higher maternal education (mean practice score: 6.88, 95% CI 6.54-7.22 vs 6.01, 95% CI 5.63-6.40; P<.001) and family income (mean practice score: 6.77, 95% CI 6.40-7.14 vs 5.96, 95% CI 5.68-6.24; P=.002). The mother's knowledge was also significantly and positively correlated (Pearson correlation coefficient r=0.301; P<.001) with their children's oral hygiene practices, shown by both the Pearson chi-square (χ2=25.2; P<.001) test and correlation coefficient.

Conclusions

The mothers' knowledge and their children's oral hygiene practices were inadequate. The mother's age, education level, family size, and monthly income significantly influenced their knowledge level. Children's oral hygiene habits were significantly associated with family income and the mother's educational status. This underscores the need for educational programs, accessible dental care services, oral health education in the curriculum, media and technology involvement in oral health educational campaigns, and proper research and monitoring.

The impact of action descriptions on attribution of moral responsibility towards robots

In the era of renewed fascination with AI and robotics, one needs to address questions related to their societal impact, particularly in terms of moral responsibility and intentionality. In seven vignette-based experiments we investigated whether the consequences of a robot or human's actions, influenced participant's intentionality and moral responsibility ratings. For the robot, when the vignettes contained mentalistic descriptions, moral responsibility ratings were higher for negative actions consequences than positive action consequences, however, there was no difference in intentionality ratings. Whereas, for the human, both moral responsibility and intentionality ratings were higher for negative action consequences. Once the mentalistic descriptions were removed from the vignettes and the moral responsibility question was clarified, we found a reversed asymmetry. For both robots and humans, participants attributed more intentionality and praise, for positive action consequences than negative action consequences. We suggest that this reversal could be due to people defaulting to charitable explanations, when explicit references to culpable mental states are removed from the vignettes.

Metabolic control and its associated factors in type 1 diabetic people: longitudinal trajectory modeling

BACKGROUND

Diabetes is a chronic disease, and hyperglycemia can increase the risk of diabetic complications and the need for more inpatient services. Therefore, the prevention and control of diabetes are important. This study aimed to identify the trajectories of metabolic control and its correlates in people with type 1 diabetes.

METHOD

This is a longitudinal study with 2020 type 1 diabetic individuals aged 18 to 59 years. The participants' glycosylated hemoglobin (HbA1c) was measured three times with a six-month interval between each measurement. The data were analyzed using group-based trajectory modeling. Multinomial logistic regression was used to determine the factors related to these groups.

RESULTS

The results showed four trajectories of safe controlled (46.2%), moderate stable risk (28.7%), moderate increasing risk (12.5%), and high decreasing risk trajectory (12.6%) (entropy = 0.70). The results of multinomial logistic regression showed dyslipidemia could increase the odds of being in the three risk trajectories. Education, physical inactivity, and poor psychological status could also increase the odds of being in the moderate stable and high decreasing trajectories. Moreover, sex, job, and BMI could increase the odds of being in the high decreasing risk group (p < 0.05).

CONCLUSION

Since there are different trajectories of metabolic control of diabetes, it is necessary for healthcare providers and health experts to plan behavioral interventions based on the location of individuals in different trajectories and the related significant risk factors. In this way, appropriate prevention, care, and treatment programs can be provided for the people in each group.

Interrater Reliability for Interdependent Social Network Data: A Generalizability Theory Approach

We propose interrater reliability coefficients for observational interdependent social network data, which are dyadic data from a network of interacting subjects that are observed by external raters. Using the social relations model, dyadic scores of subjects' behaviors during these interactions can be decomposed into actor, partner, and relationship effects. These effects constitute different facets of theoretical interest about which researchers formulate research questions. Based on generalizability theory, we extended the social relations model with rater effects, resulting in a model that decomposes the variance of dyadic observational data into effects of actors, partners, relationships, raters, and their statistical interactions. We used the variances of these effects to define intraclass correlation coefficients (ICCs) that indicate the extent the actor, partner, and relationship effects can be generalized across external raters. We proposed Markov chain Monte Carlo estimation of a Bayesian hierarchical linear model to estimate the ICCs, and tested their bias and coverage in a simulation study. The method is illustrated using data on social mimicry.

Opposite asymmetry in visual perception of humans and macaques

In human adults, visual perception varies throughout the visual field. Performance decreases with eccentricity1,2 and varies around polar angle. At isoeccentric locations, performance is typically higher along the horizontal than vertical meridian (horizontal-vertical asymmetry [HVA]) and along the lower than the upper vertical meridian (vertical meridian asymmetry [VMA]).3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23 It is unknown whether the macaque visual system, the leading animal model for understanding human vision,24,25 also exhibits these performance asymmetries. Here, we investigated whether and how visual field asymmetries differ between these two groups. Human adults and adult macaque monkeys (Macaca nemestrina) performed a two-alternative forced choice (2AFC) motion direction discrimination task for a target presented among distractors at isoeccentric locations. Both groups showed heterogeneous visual sensitivity around the visual field, but there were striking differences between them. Human observers showed a large VMA-their sensitivity was poorest at the upper vertical meridian-a weak horizontal-vertical asymmetry, and lower sensitivity at intercardinal locations. Macaque performance revealed an inverted VMA-their sensitivity was poorest in the lower vertical meridian. The opposite pattern of VMA in macaques and humans revealed in this study may reflect adaptive behavior by increasing discriminability at locations with greater relevance for visuomotor integration. This study reveals that performance also varies as a function of polar angle for monkeys, but in a different manner than in humans, and highlights the need to investigate species-specific similarities and differences in brain and behavior to constrain models of vision and brain function.

Examining the influence of list composition on the mnemonic benefit of errorful generation

ABSTRACTDespite literature showing that errorful generation with corrective feedback enhances retention better than mere studying, it is unclear if this benefit depends on the composition of the learning list (pure error generation/read versus mixed). Here, we investigated whether the mnemonic advantage and metamnemonic evaluation of errorful generation generalise beyond mixed-list designs. Experiment 1 used a free-recall test, while Experiments 2 and 3 used a cued-recall test, with Experiment 3 also including a judgment of learning (JOL) assessment. Only when memory was tested via free recall did the benefit of errorful generation depend on experimental design, with the effect being most robust in mixed lists. Replicating past research, we too found that despite a clear mnemonic benefit for error generation in cued-recall tests, participants predicted better memory following read-only trials, and that this effect was not contingent on list composition. At the practical level, these findings demonstrate instances in which errorful generation is beneficial for memory and learning. At the theoretical level, the results fit nicely within the item-order framework in accounting for commonly observed design effects in free recall.

Course and trajectories of insulin resistance, incident heart failure and all-cause mortality in nondiabetic people

BACKGROUND

In nondiabetic people, the long-term effects of insulin resistance (IR) on heart failure (HF) and all-cause mortality have not been studied.

OBJECTIVES

To examine the association between IR trajectories and incident HF and all-cause mortality in a nondiabetic population.

METHODS

We studied 7835 nondiabetic participants from the Atherosclerosis Risk in Communities (ARIC) Study. We estimated IR with several methods: Homeostatic Model Assessment-Insulin Resistance (HOMA-IR), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), triglyceride glucose Index (TyG Index), and metabolic score for insulin resistance (METS-IR). The latent class analysis identified two trajectories for HOMA-IR ('low level' and 'high level'), and three trajectories for TG/HDL-C, TyG index, and METS-IR ('low level', 'moderate level', and 'high level'). Cox proportional hazard models were employed to examine the association.

RESULTS

Participants in the 'high level' group of HOMA-IR trajectory patterns were more likely to have incident HF and all-cause mortality with HRs (95% CIs) of 1.29 (1.11-1.50) and 1.31(1.19-1.44), respectively, compared to the 'low level' group. Similarly, participants in the 'moderate level' and 'high level' groups of TG/HDL-C, TyG index, and METS-IR trajectories had elevated risks of incident HF and all-cause mortality. However, no increased risk was found for all-cause mortality for men in the 'moderate level' and 'high level' group of TG/HDL-C, TyG index, and METS-IR relative to the 'low level' group.

CONCLUSIONS

Long-term moderate and high IR levels were positively associated with increased risks of incident HF for both males and females. For all-cause mortality, however, consistent associations were found only in women.

ChatGPT and retinal disease: a cross-sectional study on AI comprehension of clinical guidelines

OBJECTIVE

To evaluate the performance of an artificial intelligence (AI) large language model, ChatGPT (version 4.0), for common retinal diseases, in accordance with the American Academy of Ophthalmology (AAO) Preferred Practice Pattern (PPP) guidelines.

DESIGN

A cross-sectional survey study design was employed to compare the responses made by ChatGPT to established clinical guidelines.

PARTICIPANTS

Responses by the AI were reviewed by a panel of three vitreoretinal specialists for evaluation.

METHODS

To investigate ChatGPT's comprehension of clinical guidelines, we designed 130 questions covering a broad spectrum of topics within 12 AAO PPP domains of retinal disease These questions were crafted to encompass diagnostic criteria, treatment guidelines, and management strategies, including both medical and surgical aspects of retinal care. A panel of 3 retinal specialists independently evaluated responses on a Likert scale from 1 to 5 based on their relevance, accuracy, and adherence to AAO PPP guidelines. Response readability was evaluated using Flesch Readability Ease and Flesch-Kincaid grade level scores.

RESULTS

ChatGPT achieved an overall average score of 4.9/5.0, suggesting high alignment with the AAO PPP guidelines. Scores varied across domains, with the lowest in the surgical management of disease. The responses had a low reading ease score and required a college-to-graduate level of comprehension. Identified errors were related to diagnostic criteria, treatment options, and methodological procedures.

CONCLUSION

ChatGPT 4.0 demonstrated significant potential in generating guideline-concordant responses, particularly for common medical retinal diseases. However, its performance slightly decreased in surgical retina, highlighting the ongoing need for clinician input, further model refinement, and improved comprehensibility.

Contribution of physiological dynamics in predicting major depressive disorder severity

This study aimed to explore the physiological dynamics of cognitive stress in patients with Major Depressive Disorder (MDD) and design a multiparametric model for objectively measuring severity of depression. Physiological signal recordings from 40 MDD patients and 40 healthy controls were collected in a baseline stage, in a stress-inducing stage using two cognitive tests, and in the recovery period. Several features were extracted from electrocardiography, photoplethysmography, electrodermal activity, respiration, and temperature. Differences between values of these features under different conditions were used as indexes of autonomic reactivity and recovery. Finally, a linear model was designed to assess MDD severity, using the Beck Depression Inventory scores as the outcome variable. The performance of this model was assessed using the MDD condition as the response variable. General physiological hyporeactivity and poor recovery from stress predict depression severity across all physiological signals except for respiration. The model to predict depression severity included gender, body mass index, cognitive scores, and mean heart rate recovery, and achieved an accuracy of 78%, a sensitivity of 97% and a specificity of 59%. There is an observed correlation between the behavior of the autonomic nervous system, assessed through physiological signals analysis, and depression severity. Our findings demonstrated that decreased autonomic reactivity and recovery are linked with an increased level of depression. Quantifying the stress response together with a cognitive evaluation and personalization variables may facilitate a more precise diagnosis and monitoring of depression, enabling the tailoring of therapeutic interventions to individual patient needs.

Trajectory Analysis in FBG and the Incidence of Chronic Kidney Disease: A Nationwide Population-Based Study

OBJECTIVES

This study aimed to classify fasting blood glucose (FBG) trajectories by sex and examine their associations with the risk of chronic kidney disease (CKD).

METHODS

Using data from the National Health Insurance Service-National Sample Cohort in Korea, participants aged 40 years and above, without CKD or diabetes mellitus (DM), were followed from 2002 to 2009. Based on their FBG trajectories, participants were categorized into two classes and stratified by sex. CKD incidence rates were analyzed according to these FBG trajectories, and the impact of additional risk factors on CKD incidence was assessed.

RESULTS

A total of 91,131 participants were analyzed. Among individuals classified in Class 1, FBG levels gradually increased from 90.7 (men) and 88.7 (women) in 2002 to 96.6 (men) and 93.2 (women) in 2009. In contrast, participants classified as Class 2 exhibited a rapid increase in FBG levels, rising from 106 (men) and 106 (women) in 2002 to 144 (men) and 132 (women) in 2009. The incidence of CKD increased over time in both men and women classified as Class 2 compared to Class 1, with respective hazard ratios (HR) of 1.35 for men and 1.53 for women. Additionally, increased age, hypertension, and body mass index (BMI) were independently associated with an elevated risk of CKD.

CONCLUSIONS

The Class 2 group demonstrated a significantly higher incidence of CKD compared to the Class 1 group. This finding indicates the need for the proactive management of individuals with relatively high FBG levels featuring rapid FBG increases in order to mitigate the risk of CKD development.

Emotional state dynamics impacts temporal memory

Emotional fluctuations are ubiquitous in everyday life, but precisely how they sculpt the temporal organisation of memories remains unclear. Here, we designed a novel task - the Emotion Boundary Task - wherein participants viewed sequences of negative and neutral images surrounded by a colour border. We manipulated perceptual context (border colour), emotional-picture valence, as well as the direction of emotional-valence shifts (i.e., shifts from neutral-to-negative and negative-to-neutral events) to create events with a shared perceptual and/or emotional context. We measured memory for temporal order and temporal distances for images processed within and across events. Negative images processed within events were remembered as closer in time compared to neutral ones. In contrast, temporal distances were remembered as longer for images spanning neutral-to-negative shifts - suggesting temporal dilation in memory with the onset of a negative event following a previously-neutral state. The extent of negative-picture induced temporal dilation in memory correlated with dispositional negativity across individuals. Lastly, temporal order memory was enhanced for recently-presented negative (versus neutral) images. These findings suggest that emotional-state dynamics matters when considering emotion-temporal memory interactions: While persistent negative events may compress subjectively remembered time, dynamic shifts from neutral-to-negative events produce temporal dilation in memory, with implications for adaptive emotional functioning.

Health inequalities research involving the pharmaceutical industry globally: a scoping review

OBJECTIVE

To assess health inequalities research involving the pharmaceutical industry and to highlight key themes and potential research gaps.

METHODS

Briefly, a literature search of article titles on the Embase and MEDLINE databases was performed to identify relevant peer-reviewed literature published between 2000 and 2023. A review of gray literature sources and pharmaceutical company global websites was performed in parallel. Peer-reviewed literature and gray literature were excluded during pre-screening based on pre-defined eligibility criteria. Peer-reviewed publications that met the eligibility criteria underwent double-blind title and abstract screening to determine relevance to health inequalities research; gray literature was screened by one reviewer. All publications included after title and abstract screening underwent full-text review.

RESULTS

The peer-reviewed literature search yielded 1,377 initial results, of which 18 publications were included for data extraction; the gray literature search yielded 10 articles. Peer-reviewed publications involving the pharmaceutical industry increased over the past 5 years. North America was included as the region of research focus or study population in 61.1% (11/18) of the peer-reviewed publications. Health inequalities across race/ethnicity (66.7% [12/18]), sex/gender (44.4% [8/18]) and socioeconomic status (27.8% [5/18]) featured in the identified publications. Across the medicines and vaccines development and launch process, 71.4% (5/7) of the publications focused on increasing clinical trial participant diversity.

CONCLUSIONS

The pharmaceutical industry has contributed to the discussion on health inequalities, particularly over the past 5 years. However, industry can better take the wider determinants of health into consideration when designing strategies of evidence generation across the medicines development pathway.

Temporal dynamics of activation and suppression in a spatial Stroop task: A distribution analysis on gaze and arrow targets

Directional judgments of an arrow became slower when the direction and location were incongruent in a spatial Stroop task (i.e., a standard congruency effect). In contrast, gaze judgments were slower when they were congruent (i.e., a reversed congruency effect). This study examined the reaction time (RT) distribution of interference effects in a spatial Stroop task to clarify the temporal characteristics of the standard congruency effect, which is known to be reversed for social targets, such as gaze direction. Participants responded to laterally presented targets (i.e., arrows, gaze, fish-only, and fish with mosaic) while ignoring their location. The standard congruency effect of arrows decreased as the overall RT increased, reflecting the temporal decay of automatically activated task-irrelevant codes (i.e., location). Critically, the reversed congruency effect of gaze increased as the overall RT increased. This result supports the dual-stage hypothesis and reflects the late-arriving selective inhibition of task-irrelevant codes. Similar results were replicated in Experiment 2, in which we manipulated the complexity of the backgrounds of nonsocial targets and in the reanalysis of existing data. These findings imply that the interplay between task-irrelevant activation and subsequent inhibition is modulated by specific stimulus characteristics, influencing spatial response selection.

Predictors of schoolteachers' intention to report suspected child abuse and neglect cases in Oman: A national study

BACKGROUND

Although schoolteachers in Oman are legally mandated to report all child abuse cases, they often show reluctance to do so. This hesitancy can deprive abuse victims of necessary help, potentially leaving them to endure long-term consequences. Oman's efforts to combat child abuse and neglect align with international best practices. However, these measures might be ineffective without considering their applicability to a collective society like Oman.

AIM

This study examined the predictors of schoolteachers' intention to report child abuse and neglect in Oman, considering their demographic and professional characteristics, attitudes toward reporting, subjective norms, and perceived behavioral control.

METHODS

This cross-sectional study was conducted across 280 cycle one-basic education public schools in Oman. The Intention to Report Child Abuse Tool (IRCAT) was used to measure intention to report, perceived behavioral control, attitudes toward reporting, and subjective norms. A total of 653 schoolteachers were recruited using a convenience sampling technique.

RESULTS

The mean total score for the intention to report subscale was 24.24 out of 36 (SD = 7.44), indicating an acceptable level. A stepwise regression analysis yielded one significant model (F (1, 651) = 112.23, p = 0.001), which included perceived behavioral control, with an adjusted R2 of 0.146.

CONCLUSION

This study's findings highlight influential variables that can guide future interventions. These results provide stakeholders with directions for designing culturally sensitive interventions to enhance the reporting of suspected child abuse cases in Oman.

A Functional Magnetic Resonance Imaging Study of Phrase Structure and Subject Island Violations

In principle, functional neuroimaging provides uniquely informative data in addressing linguistic questions, because it can indicate distinct processes that are not apparent from behavioral data alone. This could involve adjudicating the source of unacceptability via the different patterns of elicited brain responses to different ungrammatical sentence types. However, it is difficult to interpret brain activations to syntactic violations. Such responses could reflect processes that have nothing intrinsically related to linguistic representations, such as domain-general executive function abilities. To facilitate the potential use of functional neuroimaging methods to identify the source of different syntactic violations, we conducted a functional magnetic resonance imaging experiment to identify the brain activation maps associated with two distinct syntactic violation types: phrase structure (created by inverting the order of two adjacent words within a sentence) and subject islands (created by extracting a wh-phrase out of an embedded subject). The comparison of these violations to control sentences surprisingly showed no indication of a generalized violation response, with almost completely divergent activation patterns. Phrase structure violations seemingly activated regions previously implicated in verbal working memory and structural complexity in sentence processing, whereas the subject islands appeared to activate regions previously implicated in conceptual-semantic processing, broadly defined. We review our findings in the context of previous research on syntactic and semantic violations using ERPs. Although our results suggest potentially distinct underlying mechanisms underlying phrase structure and subject island violations, our results are tentative and suggest important methodological considerations for future research in this area.

Nurse academics' attitudes towards technology: A mixed methods study

BACKGROUND

Technology is being increasing used in education of nursing students. Nurse academics act both as gatekeepers to technology within their classes and as an example of technology attitudes. Therefore, understanding the attitude of academics to technology from the academic's perspective is necessary to understand barriers and enablers of technology engagement.

AIM

To explore nurse academics' attitudes to technology and the influence attitude has on their use of technologies in teaching.

DESIGN

Sequential exploratory mixed method design.

PARTICIPANTS

Academics who taught into the undergraduate Bachelor of Nursing courses in higher education institutes (n = 186) based in Australia.

METHOD

Phase one data were collected with a survey based on the Technology Readiness Index 2 (TRI 2). Phase two Qualitative interviews were conducted with 18 nurse academics sampled from the phase one survey. Statistical analysis was performed on the survey to determine factors that influence attitudes to technology. Thematic analysis was performed for qualitative data.

RESULTS

The mean score of the TRI 2 was 3.28 (SD = 0.55). Segmental analysis of the TRI score resulted there being three groups representing 90 % of participants: Explorers, Sceptics, and Hesitators. Thematic analysis resulted in four themes. The focus of this paper is the theme Attitudes towards Technology with the subthemes Openness to Technology; Aversion to Technology; Pedagogy and Technology; and Nursing and Technology. Phase one and phase two were integrated to discuss three attitude groups that emerged.

CONCLUSION

From integration of the results, three groups emerged with complementary and contrasting reasons for their attitudes to technology. Additional factors were also identified such as workload and support. Common across the groups was a student-centred focus of teaching and an acknowledgement that nursing education must prepare students for technology rich work environments.

Risk Factors for Pericardiocentesis After Paediatric Cardiac Surgery

Background

Pericardial effusions are common after paediatric cardiac surgery and can lead to cardiac tamponade in a small minority. However, it is difficult to predict which patients with an effusion will require pericardiocentesis. Therefore, among children with a postoperative effusion, we sought to identify risk factors for requiring pericardiocentesis.

Methods

We conducted a case-control study including paediatric patients who underwent cardiac surgery between January 1, 2005, and July 1, 2020, at the Stollery Children's Hospital. Cases were defined as those who underwent pericardiocentesis within 2 months of cardiac surgery and were compared with controls who had an effusion but did not require pericardiocentesis. Controls were matched 2:1 to cases based on age and year of surgery.

Results

There were 42 cases and 84 controls. The median age at surgery was 3.0 years (interquartile range [IQR]: 0.5-6.4 years) among cases and 2.2 years (IQR: 0.4-5.8 years) among controls. The median weight at surgery was 13.5 kg (IQR: 6.4-18.0 kg) among cases and 13.5 kg (IQR: 4.9-23.1 kg) among controls. The use of anticoagulation or antiplatelet agents (odds ratio [OR]: 3.6, 95% confidence interval [CI]: 1.5-8.2, P < 0.01) in the postoperative period was independently associated with effusions requiring drainage. The use of prednisone postoperatively (OR: 3.3, 95% CI: 0.8-14.0, P = 0.10) and a history of previous pericardial effusion (OR: 4.7, 95% CI: 0.9-25.6, P = 0.08) were associated with a higher odds of pericardiocentesis but did not reach statistical significance.

Conclusions

The use of postoperative anticoagulation was independently associated with the need for pericardiocentesis. Type of surgical procedure was not associated with the need for drainage.

EthoWatcher OS: improving the reproducibility and quality of categorical and morphologic/kinematic data from behavioral recordings in laboratory animals

Behavioral recordings annotated by human observers (HOs) from video recordings are a fundamental component of preclinical animal behavioral models of neurobiological diseases. These models are often criticized for their vulnerability to reproducibility issues. Here, we present the EthoWatcher-Open Source (EW-OS), with tools and procedures for the use of blind-to-condition categorical transcriptions that are simultaneous with tracking, for the assessment of HOs intra- and interobserver reliability during training and data collection, for producing video clips of samples of behavioral categories that are useful for observer training. The use of these tools can inform and optimize the performance of observers, thus favoring the reproducibility of the data obtained. Categorical and machine vision-derived outputs are presented in an open data format for increased interoperability with other applications, where behavioral categories are associated frame-by-frame with tracking, morphological and kinematic attributes of an animal's image. The center of mass (X and Y pixel coordinates), the animal's area in square millimeters, the length and width in millimeters, and the angle in degrees were recorded. It also assesses the variation in each morphological descriptor to produce kinematic descriptors. While the initial measurements are in pixels, they are later converted to millimeters using the scale calibrated by the user via the graphical user interfaces. This process enables the creation of databases suitable for machine learning processing and behavioral pharmacology studies. EW-OS is constructed for continued collaborative development, available through an open-source platform, to support initiatives toward the adoption of good scientific practices in behavioral analysis, including tools for evaluating the quality of the data that can alleviate problems associated with low reproducibility in the behavioral sciences.

Long-Term Follow-Up of Persons Living with Perinatally Acquired HIV Infection at a Large HIV Treatment Clinic in Trinidad

Data on persons with perinatally acquired HIV infection in the Caribbean are limited; thus, a chart review was conducted among these clients at an adult HIV treatment clinic in Trinidad over the period January 01, 2011-June 30, 2023. Sociodemographic, clinical, and laboratory data were extracted and analyzed using RStudio version 2021.09.0. Fifty-four study participants were followed up, age range 18-29 years, and there were 27 (50%) males. Eighteen participants (33.3%) were institutionalized until the age of 18 years, while 36 (66.7%) lived with caregivers/relatives and attended outpatient pediatric clinic. The transition from the sheltered environment of pediatric care to the adult HIV clinic was turbulent for some participants as they experienced HIV-related stigma, which may result in poor HIV outcomes. At the initial clinic visit, 28 (51.9%) study participants were virally suppressed (HIV viral load <1,000 copies/mL), which included 12 (66.7%) of 18 who were institutionalized as compared to 16 (44.4%) of 38 who lived with caregivers/relatives (p = 0.387). Data from their last clinic visit showed 31 (57.4%) participants were virally suppressed; 13 (24.1%) were lost to follow-up from care, and there were 6 (11.1%) deaths; 29 (53.7%) were on antiretroviral therapy single-tablet regimens (STRs) and 25 (46.3%) on complex multiple-tablet regimens (MTRs). Institutionalized clients and those on STRs were more likely to be virally suppressed than those living with relatives (p = 0.043) and those on MTR (p < 0.001), respectively. Reported deaths were higher among clients who lived with caregivers/relatives and those on MTR. Participants of younger age were less likely to achieve viral suppression (p = 0.02). Comprehensive programs that include STRs, the engagement of caregivers/relatives and health workers, life skills, and enhanced psychosocial interventions for youths living with perinatally acquired HIV are important to support the transition to adult care and reduce the complex challenges of living with a stigmatizing disease.

The Detection of Porphyromonas Gingivalis in Geriatrics and Its Associated Periodontal and Clinical Factors

BACKGROUND

Porphyromonas gingivalis is one of the important pathogens in the initiation and progression of periodontitis. The findings regarding the bacterium and periodontal status in geriatric subjects are not widely reported. Bacterial analysis is needed to provide more insight regarding the severity of the disease. This study evaluated the presence of P. gingivalis in the oral cavity of geriatric patients and found a significant association between P. gingivalis infection and medical illness.

METHODS

Periodontal pocket samples were obtained from 32 geriatrics who were chosen randomly from health clinics. Clinical periodontal parameters were recorded during the oral examination. Samples were subjected to DNA extraction and polymerase chain reaction (PCR) amplification. The identification of P. gingivalis by PCR assay was determined based on the P. gingivalis 16S rRNA subunit amplification. Medical illnesses of patients were recorded. Mild cognitive impairment was diagnosed according to cognitive score assessment and daily function.

RESULTS

Approximately 90.63% (n=29) of geriatric patients had periodontitis. The presence of P. gingivalis was significantly associated with periodontal depth and clinical attachment loss (p = 0.037). The extension of periodontal disease, cognitive impairment status, and diabetes status are highly associated with P. gingivalis. Conclusion: Due to asymptomatic periodontal disease in the early phase, early screening of bacterial detection and oral public health awareness is crucial, especially among elderly groups who are smokers and diabetics. P. gingivalis infection is associated with worsening geriatric periodontitis. Adequate oral care and comorbidity control among geriatrics are indeed crucial to preventing disease progression. It is important to improve and modify the local diabetic checklist protocol for geriatric diabetic patients by incorporating oral health and oral microbiome assessments, as well as cognitive assessments.

Blocking mobile internet on smartphones improves sustained attention, mental health, and subjective well-being

Smartphones enable people to access the online world from anywhere at any time. Despite the benefits of this technology, there is growing concern that smartphone use could adversely impact cognitive functioning and mental health. Correlational and anecdotal evidence suggests that these concerns may be well-founded, but causal evidence remains scarce. We conducted a month-long randomized controlled trial to investigate how removing constant access to the internet through smartphones might impact psychological functioning. We used a mobile phone application to block all mobile internet access from participants' smartphones for 2 weeks and objectively track compliance. This intervention specifically targeted the feature that makes smartphones "smart" (mobile internet) while allowing participants to maintain mobile connection (through texts and calls) and nonmobile access to the internet (e.g. through desktop computers). The intervention improved mental health, subjective well-being, and objectively measured ability to sustain attention; 91% of participants improved on at least one of these outcomes. Mediation analyses suggest that these improvements can be partially explained by the intervention's impact on how people spent their time; when people did not have access to mobile internet, they spent more time socializing in person, exercising, and being in nature. These results provide causal evidence that blocking mobile internet can improve important psychological outcomes, and suggest that maintaining the status quo of constant connection to the internet may be detrimental to time use, cognitive functioning, and well-being.

Lateral peri-hand bias affects the horizontal but not the vertical distribution of attention

It has been demonstrated that humans exhibit an attention bias towards the lower visual field (e.g., faster target detection for targets appearing below eye level). This bias has been interpreted as reflecting the visual motor demand in near space below eye level. In this study, we examined whether this spatial bias could be affected by participants' hand position at the time of testing. Specifically, if the hand position is held at eye level at the time of target detection, whether the bias toward the lower visual field would be reduced if the bias is directly related to the motor demand at the time of testing. Using a modified spatial cueing paradigm, in Experiment 1, we found a downward bias in reaction time measures and cueing effects in a target detection task. In Experiment 2, using the same stimulus used in Experiment 1, we compared attention performance when participants' dominant (right) hand was positioned close to the right side of the visual display with the conditions where their hand was in their laps. We revealed that despite an influence on the horizontal distribution of attention (lateral peri-hand effect), the downward bias in attention remained regardless of the hand position. This revealed that lateral peri-hand manipulation is insufficient to override the attention advantage for stimuli appearing in the lower visual field.

Information perseveration in recognition memory: Examining the scope of sequential dependencies

Models of recognition memory often assume that decisions are made independently from each other. Yet there is growing evidence that consecutive recognition responses show sequential dependencies, whereby making one response increases the probability of repeating that response from one trial to the next trial. Across six experiments, we replicated this response-related carryover effect using word and nonword stimuli and further demonstrated that the content of the previous trial-both perceptual and conceptual-can also bias the response to the current test probe, with both perceptual (orthographic) and conceptual (semantic) similarity boosting the probability of consecutive "old" responses. Finally, a manipulation of attentional engagement in Experiments 3a and 3b provided little evidence these carryover effects on recognition decisions are merely a product of lapses in attention. Taken together, the current study reinforces prior findings that recognition decisions are not made independently, and that multiple forms of information perseverate across consecutive trials.

Effects of a synthetic analog of the bovine appeasing pheromone on the overall welfare of dairy calves from birth through weaning

Environmental enrichment in the form of synthetic analogs of appeasing pheromones have shown promising results in improving the welfare of domestic animals, including dogs, pigs, horses, and cattle. The main objective of this study was to determine if the use of the bovine appeasing pheromone (BAP) would improve the welfare of dairy calves; therefore, in this randomized controlled trial, 72 Holstein Friesian dairy calves were housed in individual hutches after birth and were randomly allocated to receive BAP or a placebo once every 2 wk from birth through weaning. After weaning, calves were moved to group hutches according to treatment for 4 additional weeks. It was hypothesized that dairy calves treated with BAP would display fewer signs of stress compared with calves receiving the placebo during the weaning process. To operationalize stress, calves were fitted with triaxial accelerometers on the hind leg after birth, and activity levels were monitored throughout the experiment. Data on live weight gain (ADG) and cortisol levels in saliva and hair were also obtained. Calves were fitted with heart rate monitors every week for at least 24 h to assess heart rate variability (HRV). The use of BAP had a positive effect on ADG after weaning and during group housing and resulted in increased resting time after weaning. Moreover, BAP was associated with a reduction in the activation of the neuroendocrine system evidenced by higher HRV parameters after weaning, including increased standard deviation of beat to beat of normal sinus beats and root mean squares of successive differences. These results suggest a potential welfare benefit of the use of BAP during the artificial rearing of dairy calves.

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.

Multiscale neural dynamics in sleep transition volatility across age scales: a multimodal EEG-EMG-EOG analysis of temazepam effects

Recent advances in computational modeling techniques have facilitated a more nuanced understanding of sleep neural dynamics across the lifespan. In this study, we tensorize multiscale multimodal electroencephalogram (EEG), electromyogram (EMG), and electrooculogram (EOG) signals and apply Generalized Autoregressive Conditional Heteroskedasticity (GARCH) modeling to quantify interactions between age scales and the use of pharmacological sleep aids on sleep stage transitions. Our cohort consists of 22 subjects in a crossover design study, where each subject received both a sleep aid and a placebo in different sessions. To understand these effects across the lifespan, three evenly distributed age groups were formed: 18-29, 30-49, and 50-66 years. The methodological framework implemented here employs tensor-based machine learning techniques to compute continuous wavelet transform time-frequency features and utilizes a GARCH model to quantify sleep signal volatility across age scales. Support Vector Machines are used for feature ranking, and our analysis captures interactions between signal entropy, age, and sleep aid status across frequency bands, sleep transitions, and sleep stages. GARCH model results reveal statistically significant volatility clustering in EEG, EMG, and EOG signals, particularly during transitions between REM and non-REM sleep. Notably, volatility was higher in the 50-66 age group compared to the 18-29 age group, with marked fluctuations during transitions from deep sleep to REM sleep (standard deviation of 0.35 in the older group vs. 0.30 in the 18-29 age group, p < 0.05). Statistical comparisons of volatility across frequency bands, age scales, and sleep stages highlight significant differences attributable to sleep aid use. Mean conditional volatility parameterization of the GARCH model reveals directional influences, with a causality index of 0.75 from frontal to occipital regions during REM sleep transition periods. Our methodological framework identifies distinct neural behavior patterns across age groups associated with each sleep stage and transition, offering insights into the development of targeted interventions for sleep regularity across the lifespan.

Length of Hospital Stay and Its Predictions Among Patients With Exacerbations of Chronic Respiratory Diseases

BACKGROUND

Chronic respiratory disorders such as asthma and chronic obstructive pulmonary disease (COPD) may deteriorate into acute exacerbations requiring hospitalization. Assessing the predictors of prolonged hospital stays could help identify potential interventions to reduce the burden on patients and healthcare systems.

AIM

This study aimed to identify the risk factors attributed to prolonged hospital stays among patients admitted with acute exacerbations of chronic respiratory disorders in Jordan.

METHODS

A retrospective cohort study was conducted by reviewing the demographic and clinical characteristics of hospitalized patients with asthma and COPD exacerbations between January 2017 and July 2021. The recorded variables were checked for their independence. Simple and stepwise multivariate linear regressions were then performed to identify variables associated significantly with a longer hospital length of stay (LOS).

RESULTS

A total of 896 cases were evaluated. The mean ± SD stay was 5.66 ± 3.40 days, whereas the median (IQR) was 5.00 (4.00) days. Variables associated significantly with prolonged LOS in the multivariate analysis were female gender (β = 0.089, p = 0.011), pulmonary hypertension (β = 0.093, p = 0.004), allergic rhinitis (β = 0.086, p = 0.007), ICU admission (β = 0.096, p = 0.003), requirement for mechanical ventilation (β = 0.102, p = 0.002), higher total number of medications (β = 0.281, p < 0.001) and the number of exacerbation-related medications (β = 0.200, p < 0.001). However, smoking (β = -0.091, p = 0.008) was significantly associated with a shorter LOS.

CONCLUSIONS

Gender, pulmonary hypertension, allergic rhinitis, ICU admission, mechanical ventilation, the number of medications and smoking were significantly related to LOS. These findings emphasize the importance of patients' demographics and their clinical status in determining LOS, hence providing protective interventions to shorten it.

New-generation 0.55T MRI in patients with total hip arthroplasty: a comparison with 1.5T MRI

PURPOSE

To quantitatively and qualitatively compare the magnitude of metal total hip arthroplasty-induced imaging artifacts in vivo between 1.5T and 0.55T MRI.

MATERIALS AND METHODS

15 patients (69 ± 14 years) with THA, prospectively underwent 0.55T and 1.5T MRI of the hip. Two fellowship-trained musculoskeletal radiologists qualitatively rated artifact magnitude on T1-weighted and fluid-sensitive sequences using a 5-point Likert scale (0 = severe - 5 = no artifact). Quantitative artifact magnitude was assessed by a third fellowship-trained musculoskeletal radiologist, by measuring the maximum diameter of the THA-induced signal void (mm) anteroposteriorly d(ap) and mediolaterally d(ml) at the level of the acetabulum, proximal, mid and distal stem, including the prosthesis. Additionally, the area of signal void was noted (mm2). Statistical differences between Likert scores were evaluated using the t-test or the Wilcoxon signed-rank test (P-values <.05 = significant).

RESULTS

Qualitative artifact magnitude was on average rated as moderate to small on 0.55T and as large to moderate on 1.5T by both readers. Artifacts were rated less severe on 0.55T compared with 1.5T on T1-weighted (3.7 ± 0.7 vs. 2.4 ± 1.1, p=0.004) and fluid-sensitive sequences (3.1 ± 0.5 vs. 2.2 ± 1.1, p=0.18). Overall image quality did not show any statistically significant differences between 0.55T and 1.5T MRI (each p≥0.18). Metal artifacts' areas and diameters were smaller on 0.55T when compared with 1.5T MRI for all sequences (each p>0.016).

CONCLUSIONS

Total hip arthroplasty-induced metal artifacts are perceived as less severe at new-generation 0.55T when compared with conventional 1.5T MRI with no difference in overall image quality.

Obtaining a Bayesian Estimate of Coefficient Alpha Using a Posterior Normal Distribution

A new alternative to obtain a Bayesian estimate of coefficient alpha through a posterior normal distribution is proposed and assessed through percentile, normal-theory-based, and highest probability density credible intervals in a simulation study. The results indicate that the proposed Bayesian method to estimate coefficient alpha has acceptable coverage probability performance across the majority of investigated simulation conditions.

Athlete-Sports Nutrition Access Questionnaire (A-SNAQ): Predictors of food insecurity among Division III Collegiate athletes

This study presents factors contributing to food insecurity (FI) in Division Three (D3) athletes. The 2014 NCAA deregulation of feeding led to growth in registered dietitians within athletic departments except at D3 institutions. Increased food security concerns for D3 athletes followed as food access and security are crucial for optimal performance. Methods: This study included 222 D3 athletes who completed a questionnaire on FI, sports nutrition knowledge, and health habits. Exploratory factor analysis was used to extract constructs and multiple regression was used to determine if constructs were predictive of FI. Results: Cost of food, lack of dietary foods, food outlet hours of operation, lack of facilities to prepare food, reliable transportation, and location of food outlets were statistically significant predictors of FI. Discussion: These findings suggest that college policies can significantly impact FI among D3 athletes, highlighting potential avenues for institutions to reduce or eliminate the issue.

Sensorimotor adaptation reveals systematic biases in 3D perception

The existence of biases in visual perception and their impact on visually guided actions has long been a fundamental yet unresolved question. Evidence revealing perceptual or visuomotor biases has typically been disregarded because such biases in spatial judgments can often be attributed to experimental measurement confounds. To resolve this controversy, we leveraged the visuomotor system's adaptation mechanism - triggered only by a discrepancy between visual estimates and sensory feedback - to directly indicate whether systematic errors in perceptual and visuomotor spatial judgments exist. To resolve this controversy, we leveraged the adaptive mechanisms of the visuomotor system to directly reveal whether systematic biases or errors in perceptual and visuomotor spatial judgments exist. In a within-subject study (N=24), participants grasped a virtual 3D object with varying numbers of depth cues (single vs. multiple) while receiving haptic feedback. The resulting visuomotor adaptations and aftereffects demonstrated that the planned grip size, determined by the visually perceived depth of the object, was consistently overestimated. This overestimation intensified when multiple cues were present, despite no actual change in physical depth. These findings conclusively confirm the presence of inherent biases in visual estimates for both perception and action, and highlight the potential use of visuomotor adaptation as a novel tool for understanding perceptual biases.

Development and validation of the gift reciprocation anxiety scale (GRAS) for youths and adults in intimate relationships

The development and validation of any scale measuring reciprocation anxiety induced from gift reciprocation contexts are yet to be addressed for intimate relationships. To this end, the present study aimed to develop and validate the gift reciprocation anxiety scale (GRAS) using modern psychometric methods for Bangladeshi youths and adults engaged in informal romantic and formal marital relationships. A total of 763 Bangladeshi youths of different public universities and adults in different professions with the ages ranged from 17 to 36 years were the study participants recruited through convenient sampling technique. Firstly, items were generated, and the content validity coefficients were determined through appropriate procedure to finalize the 7-item GRAS for administering on a large sample (n = 763). Next, the adequacy of the data for factor analysis was checked and exploratory factor analysis (EFA) was done, extracting a single factor structure which was confirmed through the same factor retention using parallel analysis (PA). Model fit indices of confirmatory factor analysis (CFA) validated the unifactorial solution of GRAS. In addition, the item response theory (IRT) analyses confirmed that the items of the GRAS had high discriminative power, satisfactory threshold parameters, and covered a wide range of the latent trait. Mean inter-item correlations, corrected item-total correlations, and internal consistency reliabilities of the newly developed GRAS fall within the suggested limits. Multi-group confirmatory factor analysis (MGCFA) revealed that the GRAS can invariably be applied across gender, age, and marital status. A moderately positive association of GRAS with reciprocity anxiety, depression, and anxiety indicated the convergent validity of the scale. Altogether, GRAS has been found to be a psychometrically sound tool to objectively measure gift reciprocation anxiety in close relationships, implicating gift reciprocation less as an obligation and more as signs of trust, commitment, security, and care for ensuring better intimate relationships.

Prefrontal dimension change-related activation differs for visual search in sparse and dense displays

Changes of the target-defining feature dimension have previously been shown to elicit anterior prefrontal activation increases. In the majority of studies, this change-related activation was observed in the left lateral frontopolar cortex. In at least one study, however, right anterior prefrontal activation was observed. Unlike previous work which typically used dense visual displays, the latter study employed sparse displays. Display density is known to affect search efficiency, such that dense displays give rise to efficient and sparse displays give rise to inefficient search. We reasoned that different neural processes might be involved in eliciting attentional dimension changes in efficient and inefficient search, so that variation of display density would change the laterality of dimension change-related activation in the anterior prefrontal cortex. We found that changes in the target-defining feature dimension selectively elicited right frontopolar activation during search in sparse displays, but not during search in dense displays, whereas the reverse pattern was observed in left frontopolar cortex. Our results demonstrate that different neural processes are at work during search in sparse and dense displays, resolving an apparent discrepancy in reported dimension change-related activation.

Cerebral Amyloid Angiopathy in Alzheimer Disease: A Comparison Between Different Versions of the Boston Criteria

OBJECTIVES

Cerebral amyloid angiopathy (CAA) is the main driver of amyloid-related imaging abnormalities (ARIAs) in Alzheimer disease (AD). We compared different versions of the Boston criteria for CAA diagnosis in AD.

METHODS

This article presents a single-center analysis (outpatient neurodegenerative clinic) of patients with AD with mild cognitive impairment (MCI) or early dementia, meeting NIA-AA criteria and having biological amyloid confirmation (CSF or imaging). Two raters analyzed hemorrhagic (cerebral microbleeds, CMBs; cortical superficial siderosis, cSS) and nonhemorrhagic (severe centrum semiovale perivascular spaces, CSO-PVSs; multispot pattern white matter hyperintensities (WMHs)) markers following the original (V1.0), modified (V1.5), and latest (V2.0) Boston criteria.

RESULTS

We included 75 patients (mean age 71.6 ± 8.1 years, 53% female, mean disease duration 2.6 ± 2.0 years, 91% MCI). White matter CAA markers were more common than hemorrhagic markers: 41 (55%) had severe CSO-PVSs, 28 (37%) had multispot WHMs, 12 (16%) had 1 lobar CMB, 9 had ≥2 lobar CMBs (12%), 1 (1.3%) had focal cSS, and 5 (6.7) had disseminated cSS. The prevalence of possible and probable CAA was lowest with V1.0 (14.7% and 9.3%) than with V1.5 (13.3% and 13.3%) and V2.0 (42.7% and 26.7%) criteria.

DISCUSSION

More than 1 in 4 patients with AD had probable CAA according to the V2.0 Boston criteria. These findings might inform future trials.

On the pursuit of reproducibility: the importance of large sample sizes in psychoimmunology

Peripheral inflammatory markers (PIMs), such as C-reactive protein (CRP) or white blood cell count (WBC), have been associated with depression severity in meta-analyses and large cohort studies. However, in typically-sized psychoimmunology studies (N < 200) that explore associations between PIMs and neurobiological/psychosocial constructs related to depression and studies that examine less-studied PIMs (e.g., interferon gamma), significant concerns about reproducibility of results exist. For the well-characterized association between PIMs (CRP/WBC) and depression severity, we examined statistical errors as a function of sample size in a large community cohort (n = 24,550). We further assessed how statistical errors varied as related to analytic decisions (e.g., number of covariates) and characteristics related to study design (e.g., relationships within subgroups of patients). Only large samples (e.g., n = 1000 to n = 10,000) were sufficiently powered to detect PIM-depression associations and minimized overestimation of effect sizes (e.g., effect size inflation), and greater sample sizes were required as more covariates were included in analytic models. Moderately sized samples (n > 500) generally ensured the correct directionality of effect sizes (e.g., low rates of sign reversal). Sample sizes required for 80% power also varied widely depending on study design characteristics (e.g., N = 350 to N = 10,000+). Typically-sized psychoimmunology studies examining PIM-depression associations (N < 200) are likely underpowered and at high risk of overestimation of effect sizes. Study design characteristics also notably influence power and statistical error rates. Use of large sample sizes (e.g., N > 7000) and consideration of analytic decisions (e.g., number/choice of covariates) will maximize reproducibility of psychoimmunology studies related to depression to enhance development of treatments for depression or to help understand pathophysiological mechanisms of depression.

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.