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Context: Girls' high school volleyball is a popular sport with a high rate of overuse injuries and sport specialization. Health professionals perceive that high school athletes are reluctant to follow treatment plans involving sport activity reduction. This study's purpose was to describe high school girls' volleyball athletes' self-reported shoulder and knee pain, the likelihood of adhering to medical advice, and the association of factors that influence the likelihood of reporting overuse injuries and sport specialization. Study Design: Cross-sectional. Methods: Participants completed an online survey (demographics, sport participation measures, shoulder and knee pain information, medical adherence likelihood [4-point Likert: not at all likely to extremely likely], and factors influencing overuse injury reporting intentions). A 2 × 2 chi-square analysis compared factors that influence athletes' intentions to "not report an overuse injury" (eg, I thought my coach would get mad; yes/no) and sport specialization (nonhighly specialized/highly specialized athletes). Results: There were 150 participants (highly specialized = 56%, grade: ninth = 33%, 10th = 28%, 11th = 22%, 12th = 17%). At least 60% reported shoulder and knee pain related to an overuse mechanism. Most reportedly did not seek rehabilitation led by a medical provider (shoulder pain = 66%, knee pain = 60%). Only 11% of athletes reported they were "extremely likely" to rest from sporting activity during the regular season if advised by a medical professional. Highly specialized athletes were more likely to report the pursuit of a college scholarship as a factor that influences their intention to report an overuse injury compared to nonhighly specialized athletes (13% vs 3%, respectively, P =.04). Conclusions: Most girls' volleyball athletes did not treat their pain with guided rehabilitation, which may increase their risk of a worse overuse injury or even acute injury. Clinicians, athletes, parents, and coaches need to work together to create a sport culture that empowers athletes to discuss their pain and overuse injuries with medical professionals. [ABSTRACT FROM AUTHOR]

Talent transfer has enabled elite athletes to be successful in another sport, with great potential in para-sport. Previous research suggests that similarities between donor and recipient sports may facilitate talent transfer; however, this remains unclear in para-sport. This study investigated patterns between donor and recipient sports' characteristics, identifying the impact on talent transfer in para-sport. An Australian case study utilizing secondary data of 38 Australian Paralympians who competed at the Paralympic Games from 2000 through 2020 was analyzed. Results demonstrated that similarities between sports were not significantly associated with successful talent transfers between Paralympic sports. Understanding patterns associated with successful Paralympic talent transfers offers a foundation of knowledge for designing and developing future talent-transfer pathways and research. Based on this study, it is recommended that sport administrators and practitioners explore greater opportunity for talent transfer in para-sport, rather than limiting talent-transfer opportunities based on athletes' donor sports. [ABSTRACT FROM AUTHOR]

Context: Psychological difficulties can adversely affect rehabilitation outcomes and make return to sport more difficult . Identifying psychological difficulties is possible with valid and reliable measurement tools. The purpose of this study is to translate and culturally adapt the Reinjury Anxiety Inventory (RIAI), the Sport Injury Rehabilitation Adherence Scale (SIRAS), and the Athletic Injury Self-Efficacy Questionnaire (AISEQ) into Turkish and evaluate the psychometric properties of the Turkish versions. Design: Cross-sectional study . Methods.· The instruments were forward- and back-translated, culturally adapted, and validated on 248 athletes and 34 physical therapists. The physical therapists of the athletes completed the SIRAS to evaluate the athletes. Statistical analysis included reliability tests (Cronbach alpha and test-retest), exploratory factor analysis, confirmatory factor analysis, and correlational analysis . Floor and ceiling effects (< 15%) were also assessed. Results : Confirmatory factor analyses revealed a satisfactory model fit for the RIAI and the AISEQ, and exploratory factor analysis revealed the 1 -factor structure for the SIRAS as in the original. All 3 instruments displayed adequate internal consistency (Cronbach alpha coefficients ranged from .84 to .88) and test-retest reliability (coefficients ranged from .81 to .93). Convergent validity of the instruments was supported by significant correlations between the AISEQ and both the RIAI and the SIRAS. Conclusions : Our results suggest that the Turkish versions of the instruments were valid, consistent, and reliable in athletes who have serious injuries. Scores on these instruments could be useful for evaluating the contributions of psychological factors to return to sport following serious injuries. Clinicians are encouraged to use RIAI-Turkish (RIAI-TR), SIRAS-Turkish (SIRAS- TR), and AISEQ-Turkish (AISEQ-TR) together to make decisions about the treatment and rehabilitation plans of injured athletes. [ABSTRACT FROM AUTHOR]

Context: Wheelchair Power Soccer (WPS) is the only team sport that allows the participation of people with severe physical disabilities who require the daily use of motorized wheelchairs. These individuals may live with chronic pain due to the characteristics of the disabilities and treatments, interfering with their health and limiting their participation in sports. Objectives: To investigate the prevalence of musculoskeletal pain and its relationship with mood in WPS players and to analyze the incidence of traumatic injuries during a championship. Methods: A prospective, longitudinal study was carried out on 30 WPS athletes (93.33% male) with a mean (SD) (range) age of 22.37 (9.79) (47) years. Data collection was performed during a South American WPS Championship lasting 3 days, with: investigation of the presence of musculoskeletal pain and mood through a questionnaire; investigation of the occurrence of traumatic injuries through match observation; and confirmation of the occurrence of traumatic injuries through access to medical department records. Results: About 30% (n = 9/30) of the sample presented some pain on the day of evaluation, with an intensity of 5.67 (3.35) (10) points on the visual analog scale. The most common regions of pain were the lower back (13.3%, n = 4/30), thoracic (10%; n = 3/30), and cervical (10%; n = 3/30) areas of the spine. A total of 46.7% (n = 14/30) reported pain in the month before data collection but of less intensity (2.56 [4] [10] points), the most common regions being the lower limbs (20%; n = 6/30) and cervical spine (20%; n = 6/30). Among the between-group comparisons (ie, participants with pain vs without pain), no relationship was observed between mood state and pain. No traumatic injuries were identified during the competition. Conclusion: The presence of musculoskeletal pain was common in WPS players, but it was not related to mood. As no traumatic injuries were observed during the championship, this modality seems to be safe for people with physical disabilities in general. [ABSTRACT FROM AUTHOR]

Objective: To rate athletes' functional ability and return to sport (RTS) success at the end of their individual, formal, medically prescribed rehabilitation after anterior anterior cruciate ligament (ACL) reconstruction. Methods: In our prospective multicenter cohort study, 88 (42 females) adults aged 18-35 years after acute unilateral ACL rupture and subsequent hamstring grafting were included. All patients were prospectively monitored during their rehabilitation and RTS process until the end of their formal rehabilitation and RTS release. As outcome measures, functional hop and jump tests (front hop, balance hops, and drop jump screening test) and self-report outcomes (Knee Injury and Osteoarthritis Outcome Score, ACL-RTS after injury) were assessed. Literature-based cut-off values were selected to rate each performance as fulfilled or not. Results: At 7.5 months (SD 2.3 months) after surgery, the percentage of participants meeting the functional thresholds ranged from 4% (Knee Injury and Osteoarthritis Outcome Score SPORT) and over 44% (ACL-RTS after injury sum score) to 59% (Knee Injury and Osteoarthritis Outcome Score activities of all daily living) in the self-report and from 29% (Balance side hop) to 69% (normalized knee separation distance) in performance testing. Only 4% fulfilled all the cut-offs, while 45% returned to the same type and level of sport. Participants who successfully returned to their previous sport (type and level) were more likely to be "over-cut-off-performers." Conclusions: The low share of the athletes who fulfilled the functional RTS criteria highlights the importance of continuing the rehabilitation measures after the formal completion to assess the need for and success of, inter alia, secondary-preventive therapies. [ABSTRACT FROM AUTHOR]

Context: The purpose of this study was to compare short-term clinical outcomes between meniscus procedures performed with anterior cruciate ligament reconstruction (ACLR), ACLR (ACLR-only), ACLR with meniscectomy/resection (ACLR-resect), and ACLR with meniscal repair (ACLR-repair) for bone patellar tendon bone grafts (BPTB) and hamstring tendon grafts, separately. Design: This was a cross-sectional study conducted in a controlled laboratory setting as part of a large point-of-care collaborative research program. Methods: This study included 314 participants (168 females; mean [SD]: age, 19.7 [4.8]) with primary unilateral ACLR with a BPTB or hamstring tendon. Patients were divided into 3 groups depending on meniscal procedure (ACLR-only, ACLR-resect, and ACLR-repair). Postsurgical testing included: isokinetic assessment of knee extension and flexion, single-leg hop tests, and patient-reported outcomes. Multivariate analysis of covariance compared differences between meniscal procedures on the battery of tests, and for each statistically significant variable an analysis of covariance assessed the effect of meniscal procedure within each graft type. Chi-square analysis assessed the influence of meniscal procedure on tests' pass rates defined as 90% of limb symmetry index. Results: BPTB: ACLR-only had greater hamstring strength than ACLR-resect (P = .05) and ACLR-repair (P = .005). ACLR-only had the highest proportion of participants to pass the hamstring strength test (P=.02). amstring tendon: ACLR-only (P=.03) and ACLR-resect (P=.003) had higher International Knee Documentation Committee scale scores than ACLR-repair. There was a significant difference in the proportion of participants who scored >90% limb symmetry index on the timed hop test (P = .05). Conclusions: The influence of meniscal repair on clinical outcomes is dependent on the graft choice. Following an ACLR with BPTB and a meniscal procedure, hamstring function should be more closely monitored for optimal short-term recovery. [ABSTRACT FROM AUTHOR]

Context: Soft tissue mobilization is frequently employed for delayed onset muscle soreness (DOMS) management. Foam roller and percussive massage are 2 popular soft tissue mobilization methods preferred by various professionals. However, their effects on DOMS symptoms are controversial and there are no studies comparing these 2 methods. The aim of the present study was to compare the acute effects of soft tissue mobilization with a foam roller or a percussive massage device on DOMS in young male recreational athletes. Design: A parallel, single-blinded, randomized controlled trial. Methods: Thirty-six participants (median [interquartile range 25/75]; age: 20.0 [19.3/21.0] y) were randomly allocated to percussive massage group (n = 12), foam roller group (n = 12), and control group (n = 12). First, a fatigue protocol targeting quadriceps femoris was performed. Then, participants received soft tissue mobilization with foam roller/percussive massage or rested for 10 minutes according to their groups. Pain and fatigue were evaluated by a visual analog scale, and the skin surface temperature of over the quadriceps femoris was measured with thermal camera imaging. Evaluations were performed at baseline, following fatigue protocol, at 24th hour, and at 48th hour. Changes from the baseline at 24th and 48th hours were compared between groups. Results: No significant between-group differences were observed at the assessments performed at 24th or 48th hour regarding the changes from baseline in pain (P value for 24th hour = .905, P value for 48th hour = .733), fatigue (P value for 24th hour = .895, P value for 48th hour = .606), or skin surface temperature measurements (P values for 24th hour = between .300 and .925, P values for 48th hour = between .311 and .750). Conclusions: Soft tissue mobilizations applied with foam roller or percussive massage device do not seem to be superior to passive resting in alleviating DOMS symptoms in recreational athletes. [ABSTRACT FROM AUTHOR]

Context: An easy-to-administer, function-based questionnaire to assess patients with various foot problems was required for a Greek-speaking population. This study aimed to translate and cross-culturally adapt the Quick Foot and Ankle Ability Measure (Quick-FAAM) into Greek and evaluate its reliability and validity. Design: Cross-sectional study. Methods: Established international guidelines for the cross-cultural adaptation of questionnaires were followed. The face and content validity of the Greek version of the Quick-FAAM (Quick-FAAM-GR), as well as the internal consistency and test-retest reliability upon repeated administration after 5 days, were examined. In addition, the construct validity of the scale was examined via exploratory factor analysis as well as by testing for associations with the Manchester Foot Pain and Disability Index, the 12-item Short-Form Survey (version 2), and a functional balance assessment test--the Y-Balance Test. Results: Sixty participants (18 women) with self-reported chronic ankle instability symptoms, with a median (interquartile range) age of 27 (7.7) years, participated in the study. Half of the participants were included in the test-retest reliability study. The Quick-FAAM-GR demonstrated face and content validity. Excellent internal consistency (Cronbach a =.961) and intrarater test-retest reliability (intraclass correlation coefficient ICC[2,1] = .93) were demonstrated, with a comparable error margin to the original version (standard error of the measurement = 2.1, 95% minimum detectable change = 5.9). Associations of the Quick-FAAM-GR scores to other questionnaires ranged from weak to strong (Spearman rho), all being statistically significant (Manchester Foot Pain and Disability Index from -.26, P = .04, to -.67, P< .001, and 12-item Short-Form Survey, version 2, between .41 and .72, P<.001), and to the Y-Balance Test between lower-limb differences (-.35 to -.58, P< .001). The exploratory factor analysis confirmed the single- factor structure of this scale. No floor/ceiling effects were observed. Conclusions: The Greek Quick-FAAM has proven to be a valid and reliable tool for evaluating chronic ankle instability and can be used for clinical and research purposes in Greek- speaking individuals. [ABSTRACT FROM AUTHOR]

Children and adolescents with cerebral palsy (CP) show a reduced physical activity (PA) level compared with their typically developed peers. This study aimed to identify potential predictors of objectively evaluated habitual PA using data from a national clinical registry—the Cerebral Palsy Follow-Up Program (CPFP)—and proxy-reported questionnaires. Data from the CPFP database showed that female sex was associated with a lower PA level. Additional questionnaire data revealed age, popliteal angle limitation, Pediatric Outcomes Data Collection Instrument–Sports and Physical Functioning Scale score, screen time, Functional Mobility Scale score at 50 m, and fatigue as predictors. The proposed models can be used for the prediction and early detection of the PA level and consequently for the potential improvement among ambulant/semiambulant individuals with CP. Further research should investigate the predictive impact of personal, social, and environmental factors on the PA level and the gap in PA levels between girls and boys. [ABSTRACT FROM AUTHOR]

Context: The Disablement in the Physically Active Scale (DPAS) was recently developed to evaluate the disability process and health-related quality of life. The aim of this study was to investigate the validity and reliability of the Turkish version of the DPAS in physically active individuals with musculoskeletal injury. Methods: The study sample comprised 64 physically active individuals with musculoskeletal injury aged 16–40 years. The DPAS was translated into Turkish according to the guidelines for cross-cultural adaptation. Short Form-36 was used concurrently to test the construct validity. The test–retest reliability of the Turkish version of the scale assessed by intraclass correlation coefficient and Cronbach α was calculated for internal consistency. Results: Confirmatory factor analysis carried out on the Turkish version of the DPAS was confirmed. Cronbach α was calculated to be.946. The intraclass correlation coefficients ranged between.593 and.924 (P <.001). The Turkish version of the scale showed significant correlations with domains of the Short Form-36 (P <.05). When the sensitivity of the study was evaluated, the highest correlation was found between DPAS total score and impairments (r =.906, P =.001), and the lowest correlation was between DPAS total score and quality of life (r =.637, P =.001). Conclusion: The Turkish version of the DPAS is a reliable, valid, and practical tool. The Turkish version of the DPAS can be used by health professionals to understand quality of life, the disability process, and activity limitations in Turkish-speaking physically active people after musculoskeletal injuries. [ABSTRACT FROM AUTHOR]

Objective Postpartum hemorrhage (PPH) protocols improve patient safety and reduce utilization of blood products; however, few data exist on sustainability of PPH checklist use, how use affects care delivery, and variation of use among patient subgroups. This study aimed to (1) examine compliance with PPH checklist use during vaginal deliveries, (2) evaluate whether checklist use varied by patient and/or care team characteristics, and (3) evaluate whether checklist use was associated with increased use of recommended medications/interventions. Study Design This was a quality improvement study performed from April 2021 through June 2023. A multidisciplinary team developed a revised PPH checklist and used quality improvement methodology to increase checklist use following vaginal birth. Data were collected from medical records and clinician survey. Control charts were generated to track checklist use and evaluate special cause variation. Chi-square tests and logistic regression were used to evaluate variation in medications/interventions and across subgroups. Results During the study period, there were 342 cases of PPH at the time of vaginal birth. The checklist was used in 67% of PPH cases during the 20-month period after implementation in a setting where no checklist was previously being used. We found no statistically significant differences in checklist use by patient or health care team characteristics. Use of tranexamic acid, carboprost, and misoprostol were significantly associated with checklist use. Conclusion This study demonstrated successful implementation of a checklist protocol where no checklist was previously being used, with sustained use in an average of 67% of PPH cases over 20 months. Checklist use was consistent across subgroups and was associated with higher use of interventions shown to lower blood loss. Key Points Our study showed sustainability of PPH checklist use over a 20-month period. PPH checklist use was associated with increased use of interventions known to reduce blood loss. Checklist was used consistently across patient subgroups; may help address inequities in obstetric outcomes. [ABSTRACT FROM AUTHOR]

Objective Intrahepatic cholestasis of pregnancy is associated with adverse pregnancy outcomes including intrauterine fetal demise, spontaneous preterm labor, and meconium-stained amniotic fluid. Studies have yet to determine if patients with a history of pregnancy complicated by cholestasis had an association with more severe adverse outcomes in a subsequent pregnancy complicated by cholestasis. Study Design Retrospective cohort study of multiparous, singleton, nonanomalous live gestations complicated by cholestasis at Elmhurst Hospital Center from 2005 to 2019. We compared rates of adverse outcomes in multiparous pregnancies complicated by cholestasis with versus without prior cholestasis. Our primary outcome was rates of spontaneous preterm labor. Our secondary outcomes included rates of iatrogenic preterm birth, meconium-stained amniotic fluid, cesarean delivery for nonreassuring fetal heart tracing. Chi-square and multivariate regression tests were used to determine the strength of association. In all analyses, a p -value less than 0.05 and 95% confidence interval not crossing 1.00 indicated statistical significance. Mount Sinai Icahn School of Medicine Institutional Review Board approval was obtained for this project. Results Of the 795 multiparous pregnancies complicated by cholestasis, 618 (77.7%) had no prior history of cholestasis and 177 (23.3%) had prior history of cholestasis. Multiparous pregnancies with history of cholestasis had higher rates of prior preterm birth, earlier gestational age at diagnosis and delivery, and were more likely to receive ursodeoxycholic acid therapy. Pregnancies with history of cholestasis were not associated with spontaneous preterm labor in subsequent pregnancies with cholestasis, but history of cholestasis was associated with iatrogenic preterm birth and neonatal intensive care unit (NICU) admission. After adjusting for confounders, the association with iatrogenic preterm birth and NICU admission were no longer statistically significant. There was no significant association between history of cholestasis and other adverse obstetric outcomes. Conclusion Findings suggests that history of prior cholestasis is not associated with worsening outcomes in subsequent pregnancies complicated by cholestasis. Key Points Prior cholestasis may not alter risk in subsequent pregnancies. Unclear relationship between cholestasis and hepatobiliary disease. Studies needed to develop cholestasis screening protocol. [ABSTRACT FROM AUTHOR]

Objective Resilience is associated with mental and somatic health benefits. Given the social, physical, and mental health toll of the coronavirus disease 2019 (COVID-19) pandemic, we examined whether the COVID-19 pandemic was associated with population-level changes in resilience among pregnant people. Study Design Secondary analysis of a prospective cohort of nulliparous pregnant people <20 weeks' gestation from a single hospital. Participants completed baseline assessments of resilience characteristics, including dispositional optimism (DO), mindfulness, and proactive coping. For this analysis, participants recruited before the COVID-19 pandemic were compared with those recruited during the pandemic. The primary outcome was DO, assessed as a continuous score on the validated Revised Life Orientation Test. Secondary outcomes included continuous scores on mindfulness and proactive coping assessments. Bivariable analyses were completed using chi-squared and Mann–Whitney U tests. Multivariable linear regression compared resilience scores by recruitment time frame, controlling for confounders selected a priori: maternal age, education, and marital status. Results Of the 300 participants, 152 (50.7%) were recruited prior to the pandemic. Demographic and pregnancy characteristics differed between groups: the during-pandemic group was older, had higher levels of education, and were more likely to be married/partnered. There were no significant differences in any of the resilience characteristics before versus during the pandemic in bivariable or multivariable analyses. Conclusion In this cohort, there were no differences in early pregnancy resilience characteristics before versus during the COVID-19 pandemic. This affirms that on a population level, resilience is a stable metric, even in the setting of a global pandemic. Key Points Resilience is associated with mental and somatic health benefits. No difference in early-pregnancy resilience in those recruited before versus during the pandemic. Consistent with conceptualization of resilience as an innate characteristic. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of previous occupational noise exposure in older adults with hearing loss on (1) audiometric configuration and acoustic reflex (AR) thresholds and (2) self-reported hearing abilities and hearing aid (HA) effectiveness. Design: A prospective observational study. Study sample: The study included 1176 adults (≥60 years) with bilateral sensorineural hearing loss. Pure-tone audiometry, AR thresholds, and responses to the abbreviated version of the Speech, Spatial, and Qualities of Hearing Scale (SSQ12) and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire were obtained, along with information about previous occupational noise exposure. Results: Greater occupational noise exposure was associated with a higher prevalence of steeply sloping audiograms in men and women and a 0.32 (95% CI: −0.57; −0.06) scale points lower mean SSQ12 total score among noise-exposed men. AR thresholds did not show a significant relation to noise-exposure status, but hearing thresholds at a given frequency were related to elevated AR thresholds at the same frequency. Conclusions: A noise exposure history is linked to steeper audiograms in older adults with hearing loss as well as to poorer self-reported hearing abilities in noise-exposed men. More attention to older adults with previous noise exposure is warranted in hearing rehabilitation. [ABSTRACT FROM AUTHOR]

Background Most women experience breastfeeding problems and need changes due to postpartum physical symptoms and low breastfeeding self-efficacy. Methods Postpartum home care and e-mobile training/consultancy has been introduced to address this issue. This study was conducted as a randomized controlled interventional study. The sample of the study consisted of 75 (home care group = 25, control group = 25, e-mobile training/consultancy group = 25) women who met the sample selection criteria, agreed to participate in the study, and were hospitalized in the postpartum ward of a City Hospital. Data were collected through the Personal Information Form, the Postpartum Physical Symptom Severity Scale and the Breastfeeding Self-Efficacy Scale (BSES). Results In all postpartum stages, a statistically significant difference was detected between the home care, e-mobile training/consultancy and control group women in terms of the Postpartum Physical Symptoms Severity Scale and BSES total mean scores (P  < .05). Interviews showed that the home care group had the lowest Postpartum Physical Symptom Severity Scale total mean scores and the highest BSES total mean scores (P  < .05). Postpartum home visits and e-mobile training/consultancy should be considered a routine part of postpartum care. It is effective in reducing postpartum physical symptoms and increasing breastfeeding self-efficacy. Conclusıon In line with the results of this study, the use of home care and e-mobile training/consultancy is recommended to decrease physical symptoms and increase breastfeeding self-efficacy. [ABSTRACT FROM AUTHOR]

Background Non-pharmaceutical interventions (NPIs) decrease COVID-19 transmission. Reliability and validity of adherence to NPIs in accordance with normalization process theory (NPT) in coherent and convenient social subgroups using reflective measurement model assessment has not been evaluated. Methods In February 2021, a sample of medical students and people with substance use disorders in treatment as coherent (based on continuous probability distribution) vs. convenient groups (based on convenience, not equal probability) composed of travellers and COVID-19 suspected persons from Split-Dalmatia County (SDC) (n  = 656) in the Mediterranean completed self-administered surveys. Partial least squares structural equation modelling (PLS-SEM) was used to measure reflective model assessment of adherence to NPIs according to NPT. Results PLS-SEM reflective model assessment provided two-group specific factors in inverse relationships which determined adherence to NPIs with excellent goodness-of-fit [ χ 2 = 1.292, df = 1; P  = 0.297, CFI = 1, TLI = 0.997, RMSEA = 0.011 (90% CI 0–0.105), RMSEA P  = 0.604, SRMR = 0.008, Hoelter CN (α = 0.05) = 2322.757]. Significant negative factors covariance estimate (−0.716) revealed an inverse relationship between first (adherence to NPIs and internal locus of control (LoC) (0.640)) and second factor; young adulthood age (≤25) and highest level of education (1362). As the first factor increased the second tended to decrease. LoC is expected potential mechanism by which sex (MLsex = −0.017, SE = 0.007, P  < 0.016) and belonging to coherent subgroups (MLgroup = −0.008, SE = 0.003, P  = 0.015) can produce indirect effect of adherence to NPIs. Conclusions Coherent subgroups had a more pronounced tendency toward integration of NPIs in everyday life. Group factors that facilitate the normalization were higher educated younger adults with a tendency toward external LoC. [ABSTRACT FROM AUTHOR]

Background Consumption of alcohol is a risk factor for non-communicable and infectious diseases, mental health problems, and can lead injuries and violence. The aim of this study was to evaluate the prevalence of alcohol-involved deaths among decedents who died of external causes and underwent autopsy in Lithuania. Methods Study includes age persons of any age (from 0 to 110 years) who died and were autopsied in Lithuania from 1 January 2017 to 31 December 2020. Data were obtained from the Lithuanian State Register of Deaths and Their Causes. Results Among external causes of death, the presence of alcohol was detected in 55.0% of cases. Male decedents had a significantly higher number of positive BAC level recorded, at 46.6%, compared with female decedents (32.1%; P  < 0.001). The highest incidence of deaths where the alcohol was detected in the deceased's blood was found when the decedent was listed as being in the victims of assault group (71.5%, 95% CI 65.4–77.2). However, the highest median BAC score was found for those in the accidents group (59.7%, 95% CI: 58.2–61.2, BAC 2.42 ‰, IQR 1.86). Conclusions The findings of this study suggest that alcohol use may be a contributing factor in a wide range of fatal incidents, including accidents, injuries, and cases of violent intent. Inequalities between males and females were identified, with a higher proportion of males with alcohol detected in blood at the time of death. [ABSTRACT FROM AUTHOR]

Background: Caprini score and D-dimer are well-recognized markers in deep vein thrombosis (DVT) assessment. However, their utility in guiding post-arthroplasty DVT risk is hampered by susceptibility to various post-operative factors, limiting their effectiveness as reminders. Conversely, these markers exhibit greater stability in the pre-operative setting. Despite this, research on the pre-operative predictive value of Caprini score and D-dimer for DVT following primary total knee arthroplasty (TKA) remains scarce. Methods: In a retrospective study, we analyzed data from patients who underwent primary TKA, between August 2015 and December 2022. Upon admission, Caprini scores were assessed, and comprehensive blood panels were obtained from fasting blood samples. For all patients, lower limb vascular Doppler ultrasonography was performed pre-operatively to exclude those with pre-existing DVT, and all patients underwent DVT examination again post-operatively. Results: Our study included 2,873 patients, averaging 67.98 ± 7.54years, including 676 men and 2,197 women. In this study, 303 (10.55%) patients developed postoperative DVT, and 57 (1.98%) cases presented with lower limb symptoms. DVT incidence in patients with pre-operative Caprini scores of 1–2 (6.50%), 3 (10.28%), and ≥ 4 (18.05%) showed significant differences (P < 0.05). DVT rates were 14.80% in patients with pre-operative D-dimer levels of ≥ 1 mg/L, higher than the 8.98% in those with levels of < 0.5 mg/L, and 10.61% in those with levels 0.5-1 mg/L (P < 0.05). In patients with Caprini scores of 1–2 and D-dimer levels ≤ 0.5 mg/L, the occurrence rate of postoperative DVT was only 5.84%. For patients with Caprini scores ≥ 4 and D-dimer levels ≥ 1.0 mg/L, the postoperative DVT occurrence rate soared to 24.81%, with the OR(odds ratio) was 4.744 compared to the former group. Conclusion: Patients with preoperative higher Caprini scores and D-dimer are more likely to develop DVT after TKA. Additionally, those with a preoperative Caprini score ≥ 4 and D-dimer level ≥ 1.0 mg/L have a significantly increased risk (24.81%) of developing DVT, identifying them as a high-risk group for DVT following TKA. These findings hold significant value for DVT risk stratification in primary TKA patients and the formulation of preoperative interventions to mitigate the risk of DVT. [ABSTRACT FROM AUTHOR]

The multidimensional forced-choice (MFC) format is an alternative to rating scales in which participants rank items according to how well the items describe them. Currently, little is known about how to detect careless responding in MFC data. The aim of this study was to adapt a number of indices used for rating scales to the MFC format and additionally develop several new indices that are unique to the MFC format. We applied these indices to a data set from an online survey (N = 1,169) that included a series of personality questionnaires in the MFC format. The correlations among the careless responding indices were somewhat lower than those published for rating scales. Results from a latent profile analysis suggested that the majority of the sample (about 76–84%) did not respond carelessly, although the ones who did were characterized by different levels of careless responding. In a simulation study, we simulated different careless responding patterns and varied the overall proportion of carelessness in the samples. With one exception, the indices worked as intended conceptually. Taken together, the results suggest that careless responding also plays an important role in the MFC format. Recommendations on how it can be addressed are discussed. [ABSTRACT FROM AUTHOR]

Accurate and timely interpretation of microcytic anemia can be diagnostically challenging in the primary care setting. We sought to develop a novel model for distinguishing iron-deficiency anemia from thalassemia trait in the modern pediatric population. Demographic history and red blood cell indices were retrospectively characterized for 76 children referred to our pediatric hematology clinic for evaluation of microcytic anemia. Statistically significant variables were sequentially added into a logistic regression model to develop the final model. The final discriminating model incorporates red cell distribution width, mean corpuscular hemoglobin concentration, and red blood cell values. Favorable predictive performance is seen in the initial (sensitivity 89.2%, specificity 92.3%) and external validation cohort (sensitivity 84.4%, specificity 88.9%). This novel tool may aid in determining the cause of hypochromic, microcytic anemia in the primary care setting. Finally, the study cohort reflects an underrepresented group in the development of screening tools, and thus offers generalizability. [ABSTRACT FROM AUTHOR]

Magnesium (Mg) is a crucial element for cardiovascular system and its deficiency results in a variety of cardiac arrhythmias. The aim of this study is to determine the effect of oral Mg supplementation on the frequency of ventricular extrasystoles (VES) in children. Magnesium supplementation was given to 42 children who had VES without structural heart disease. Clinical, electrocardiographic, and Holter monitoring studies were reviewed. The mean baseline 24 h VES burden on Holter monitoring was 10.26% ± 4.13% and it was decreased to 6.62% ± 3.88% after. There was no significant difference between the pre-treatment serum Mg levels and the decrease in the frequency of VES. In conclusion, oral Mg therapy was found to be effective at suppressing VES in children regardless of serum Mg levels. Large and randomized studies are needed to demonstrate the effect of magnesium on VES suppression. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges of transitions between healthcare teams during pediatric hospitalizations, particularly for children with medical complexity (CMC) and those transferred from the PICU to the general floor. Topics include the risks of medical errors and family anxiety during transfers, the critical role of provider communication in preventing adverse events, and the need for improved handoff processes to enhance patient safety and satisfaction.

Suppurative cervical lymphadenitis sometimes resolves with oral antibiotic treatment; however, many children are hospitalized for intravenous treatment due to lack of improvement. When there is no substantial improvement, the possibility of a liquefaction process is considered, and as a result, source control such as needle aspiration or open surgical drainage is recommended. We examined, among pediatric patients hospitalized with suppurative cervical lymphadenitis, clinical and laboratory predictors for invasive intervention that may lead to early imaging and intervention, hasten recovery, and shorten length of hospitalization. We compared laboratory and clinical characteristics of pediatric patients hospitalized with suppurative cervical lymphadenitis during 2010-2017, according to 3 treatments: needle aspiration (N = 54), open surgical drainage (N = 37), and conservative adequate antibiotic treatment only (N = 292). Physical indicators such as local erythema and fluctuation were found as predictors for invasive interventions in hospitalized pediatric patients diagnosed with suppurative cervical lymphadenitis. No significant associations were found between invasive interventions and laboratory parameters assessed in this study. Children who underwent interventions displayed a prolonged average length of hospitalization and received extended antibiotic treatment prior to hospital admission. In hospitalized pediatric patients diagnosed with suppurative cervical lymphadenitis, physical examination findings are the main predictive factors for invasive interventions. Consequently, when such straightforward clinical findings are observed in the context of insufficient improvement during antibiotic treatment, they should prompt consideration of invasive intervention. [ABSTRACT FROM AUTHOR]

Financial relationships between physicians and the health care industry sometimes lead to conflicts of interest and need to be properly managed. Using the Open Payments Database between 2013 and 2021, this cross-sectional analysis examined the industry payments made to physicians whose primary specialty was pediatrics. Descriptive analyses were performed for the payment data overall and other pediatrician demographics. Of 99 764 eligible pediatricians, 59 984 (60.1%) received a total of $297 million (12.8%) in general and $2 billion in research payments over the 9 years. Median 9-year per-physician payments were $288 (interquartile range [IQR]: $88-$958) in general and $65 343 (IQR: $16 763-$255 208) in research payments. Male pediatricians were 1.06 (95% CI: 1.05-1.09, P <.001) and 1.56 (95% CI: 1.49-1.65, P <.001) times more likely to receive general and associated research payments than female pediatricians, respectively. The number of pediatricians receiving general payments annually decreased by 1.5% (95% CI: −1.7% to −1.4%, P <.001). [ABSTRACT FROM AUTHOR]

Familial Mediterranean fever (FMF) is an autoinflammatory disease which may cause endothelial dysfunction and arterial stiffness. In this study, we evaluated patients with FMF in terms of arterial stiffness indicators and investigated whether there was any difference according to colchicine response. This is a single-center, prospective, case-control study conducted on pediatric patients with FMF. Patients were categorized into 2 groups: patients on colchicine monotherapy (group 1) and patients who used anti-interleukin-1 (IL-1) plus colchicine (group 2). Patient age, mutations in the MEFV gene, overall duration of treatments, and general characteristics of symptoms were recorded. Laboratory values in an attack-free period were noted. Pulse wave velocity (PWV) was measured in all patients. Erythrocyte sedimentation rate and C-reactive protein, nocturnal hypertension, and PWV were higher in group 2. Arterial stiffness develops due to subclinical inflammation in patients with FMF. It is more pronounced in colchicine-resistant patients. [ABSTRACT FROM AUTHOR]

Summary: We found that a standardized order set after hip fracture increased initiation of anti-osteoporosis medication and increased persistence at 1 year, but did not reduce secondary fractures. Background: A treatment gap exists after osteoporosis-related fractures. Introducing standardized care can improve treatment. We evaluated the impact of a hip fracture order set (OS) on anti-osteoporosis medication (AOM) initiation, persistence, and secondary fracture prevention. Methods: In 2015, one hospital in Manitoba, Canada, introduced a hip fracture OS including recommendations for the initiation of AOM (OS group). A control group was identified from the other hospitals in the same region. A retrospective cohort study was conducted using linked administrative health data. All individuals 50 + years with surgical treatment for low-energy hip fracture between 2010 and 2019 were included and followed for AOM initiation, medication persistence at 1 year, and secondary fractures. Between-group differences for each year were assessed using chi-square tests. Logistic regression models tested the impact of socio-demographic and clinical factors on initiation, persistence of AOM. Cox regression tested the risk of secondary fracture. Results: No baseline differences between OS group (813 patients) and control group (2150 patients) were observed in demographics, socioeconomic factors, or comorbidities. An increase in post-fracture AOM initiation was seen with OS introduction (OS group year before 16.7% versus year after 48.6%, p < 0.001). No change was seen in the control group. Persistence on AOM also increased (OS group year before 17.7% versus year after 28.4%, p < 0.001). No difference in secondary fractures was observed (OS group 19.8% versus control group 18.8%, p = 0.38). Conclusion: Introduction of a hip fracture OS significantly increased AOM initiation and persistence at 1-year post-fracture. There was no significant difference in secondary fractures. [ABSTRACT FROM AUTHOR]

Purpose: Disability in activities of daily living (ADL) is a common unmet need among people with advanced respiratory disease. Rehabilitation could help prolong independence, but indicators for timely intervention in this population are lacking. This study aimed to identify trajectories of disability in ADLs over time, and predicting factors, in advanced respiratory disease. Method: Multi-site prospective cohort study in people with advanced non-small cell lung cancer (NSCLC), chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD), recruited from hospital or community services, throughout England. Disability in basic (Barthel Index) and instrumental (Lawton–Brody IADL Scale) ADLs were assessed monthly over six months. Visual graphical analysis determined individual trajectories. Multivariate logistic regression examined predictors of increasing disability in basic and instrumental ADLs. Findings: Between March 2020 and January 2021, we recruited participants with a diagnosis of NSCLC (n = 110), COPD (n = 72), and ILD (n = 19). 151 participants completed ≥3 timepoints and were included in the longitudinal analysis. Mobility limitation was an independent predictor of increasing disability in instrumental ADLs (odds ratio, 1⋅41 [CI: 1⋅14–1⋅74], p = 0⋅002). Conclusion: Mobility limitation could be used as a simple referral criterion across people with advanced respiratory disease to ensure timely rehabilitation that targets independence in ADLs. IMPLICATION FOR REHABILITATION: To our knowledge this is the first prospective cohort study of trajectories of disability in activities of daily living (ADL) in advanced respiratory disease, including recruitment during the Covid-19 pandemic. It adds to existing evidence by identifying individual variability in trajectories of ADL disability which are undetected at group level. The identification of mobility limitation as a predictor of increasing ADL disability, while controlling for malignant or non-malignant respiratory disease, is novel and has practical utility. Our findings have implications for clinical care, as early identification of functional decline through use of mobility limitation tools could flag early referral to rehabilitation services, potentially preventing or delaying forthcoming functional decline and avoiding reactive crisis management. Mobility limitation is a predictor of increasing disability in activities of daily living in advanced disease, which could be used to flag early referral to rehabilitation services, to help prevent or delay forthcoming functional decline and avoid reactive crisis management [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effects of mirror therapy (MT) and therapeutic exercise (TE) with the unaffected hand, on pain, sensitivity and functionality in individuals with unilateral carpal tunnel syndrome (CTS). Material and methods: A randomized controlled trial was carried out. Thirty-nine adults with unilateral CTS were included and randomly allocated to a six-week training programme based on MT (n = 20) or TE (n = 19). Visual Analogue Scale, Semmes-Weinstein monofilament test, Two-point discrimination (2PD), Disabilities of the Arm, Shoulder and Hand (DASH) and Boston Carpal Tunnel Questionnaire (BCTQ) were assessed before (T0) and after the intervention (T1), and at one-month follow-up (T2). Results: At T1, MT and TE showed significant improvements in pain (p = 0.001 and p = 0.03, respectively), however, only MT maintained the achieved effects at T2 (p = 0.01). In addition, 2PD significantly improved in MT in the first (p = 0.04) and fourth fingers (p = 0.02) at T1. The DASH score decreased at T1 in MT (p < 0.001) and TE (p = 0.01). Additionally, the BCTQ score improved in MT (p < 0.001), and TE (p < 0.001) at T1. The effects were maintained at T2 for DASH and BCTQ scores. Conclusions: Training of the unaffected hand resulted in a significant improvement of the affected hand in both groups; nevertheless, MT achieved a longer duration of the effects. IMPLICATIONS FOR REHABILITATION: Training of the unaffected hand may improve pain, sensitivity and functionality in people with unilateral tunnel carpal syndrome. Mirror therapy achieved longer duration of the effects on pain and hand functionality. Our research may inform clinical decision-making and guide the development of therapeutic interventions for patients with carpal tunnel syndrome. [ABSTRACT FROM AUTHOR]

Parental phubbing refers to the phenomenon where parents ignore their children due to mobile phone use during parent-child interactions. This study examined the longitudinal mediating role of basic psychological need satisfaction in the relations between parental phubbing and adolescents' core self-evaluation. We recruited 629 adolescents (M age = 15.20 years, SD age = 1.62 years) to participate in our longitudinal survey. Longitudinal mediation analyses revealed that parental phubbing negatively predicted adolescents' core self-evaluation by diminishing their basic psychological need satisfaction. Additionally, longitudinal network analyses identified two significant parental phubbing behaviors that impact adolescents' core self-evaluation: parents keeping mobile phones in hand during interactions with their adolescents and checking mobile phone information during mealtime. Our work provides a novel understanding on how parental phubbing decreases adolescent core self-evaluation. [ABSTRACT FROM AUTHOR]

Guided by the stress process perspective, this study examined if combat exposure was indirectly associated with marital satisfaction through work performance stress. Additionally, we tested whether unit cohesion served as a moderator of this indirect effect. Data were drawn from 1,122 married Soldiers who participated in the All-Army Study component of the Army STARRS study, a probabilistic sample of Army Soldiers. Indicative of stress proliferation and spillover, our results showed that combat exposure may negatively impact marital satisfaction through work performance stress, but the pathways of this indirect effect varied as a function of unit cohesion. Consistent with the stress buffering hypothesis, unit cohesion buffered the positive association between combat exposure and work performance stress for Soldiers reporting higher levels unit cohesion, such that this association was no longer statistically significant. However, for Soldiers reporting higher levels of unit cohesion, the negative association between work performance stress and martial satisfaction was exacerbated but was not statistically significant for those reporting lower levels of unit cohesion. The results underscore the importance of understanding the contextual nature of relational resources within the stress process framework. [ABSTRACT FROM AUTHOR]

We aimed to analyze the effects of exclusive breastfeeding duration on the occurrence and course of pneumonia in infants aged up to 6 months. Prospective case-control study. This study was conducted from August 2020 to August 2022 at a maternity and child health hospital in China. A total of 218 infants up to 6 months of age with pneumonia were included in the analyses. Health data were obtained using a hospitalization information system or an interview-based questionnaire. Univariate and multivariate logistic regression analyses were performed to analyze the data. The incidence of pneumonia, hospitalization duration, and costs to participants were significantly affected by the duration of exclusive breastfeeding (p < 0.01). The incidence of pneumonia among participants with different exclusive breastfeeding durations also differed significantly (p < 0.01). The shorter the duration of exclusive breastfeeding, the higher the incidence of pneumonia among infants. We found that the longer the exclusive breastfeeding duration in infants up to 6 months of age, the lower the recurrence of pneumonia, the shorter the hospital stay, and the lower the hospital costs. The rate of exclusive breastfeeding for infants up to 6 months of age should be increased as much as possible to reduce the occurrence of pneumonia and hospital costs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to determine the effect of moderately strenuous aerobic exercise training on heart rate variability (HRV) and heart rate turbulence (HRT) in patients with an implantable cardioverter defibrillator (ICD). Methods: Patients were randomized to a 24-week home-based aerobic exercise (EX) training program (n = 84) or to usual care (UC) (n = 76). All subjects underwent 24-h Holter monitoring at baseline, 8 and 24 weeks. Generalized estimating equations were used to test the effects of exercise on HRV and HRT outcomes. Results: The study group was comprised of n = 160 patients (124 M, 36 F, age 54.9 ± 12.2 years) with an ICD for primary (43%) or secondary prevention (57%). Compared to UC, EX was associated with a significant improvement in parasympathetic HRV for root mean square of successive differences (rMSSD; p =.05) at 8 weeks and global HRV for standard deviation of all normal (N-N) intervals (SDNN; p =.05) and standard deviation of 5-min averages N-N intervals (SDANN; p =.03) at 24 weeks. When stratified by adherence, those who were ≥80% adherent (minutes/week) had significant improvements in parasympathetic HRV (rMSSD, pNN50) and global HRV (SDNN, SDANN) at 8 weeks, and a further significant improvement in global HRV (SDNN, SDANN, SDNN index) at 24 weeks. Neither HRT nor ventricular ectopy changed with exercise training. Conclusion: Moderately strenuous aerobic exercise improved parasympathetic and global HRV indices following an ICD, with greater adherence associated with greater improvements. Clinical trial registration: Clinicaltrials.gov: NCT 00522340. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the comparability of frailty assessment tools – the electronic frailty index (eFI), retrospective electronic frailty index (reFI), and clinical frailty scale (CFS) – in older residents of care facilities. Methods: Data from 813 individuals aged 65 or older, with frailty and co-morbidities, collected between 2022 and 2023, were analysed using various statistical methods. Results: The results showed significant differences in frailty classification among the tools: 78.3% were identified as moderately to severely frail by eFI, 59.6% by reFI, and 92.1% by CFS. Statistical tests confirmed significant differences (p <.05) in their assessments, indicating variability in measurement methods. Discussion: This study advances the understanding of frailty assessment within aged-care settings, highlighting the differences in the efficacy of these assessment tools. It underscores the challenges in frailty assessments and emphasizes the need for continuous refinement of assessment methods to address the diverse facets of frailty in aged care. [ABSTRACT FROM AUTHOR]

Background : In order to reduce the risk of leakage of cytotoxic agents, peripherally inserted central catheters (PICC) are widely used in patients diagnosed with malignancy before chemotherapy. While inflammation has been demonstrated to be associated with deep vein thrombosis (DVT), the connection between systemic immune inflammation indexes and the formation of PICC-DVT remains unclear. Purpose : This study aims to evaluate the association between PICC-DVT and systemic immune inflammation indexes including platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), and systemic inflammatory response index (SIRI). Methods : From August 2018 to October 2021, we enrolled consecutive patients diagnosed with malignancy who underwent PICC implantation before chemotherapy. DVT was assessed using color Doppler ultrasonography. Results : Among the 513 patients, 57 patients (11.1%) developed PICC-DVT. The optimal cutoff values for PLR, SII and SIRI were 260.1, 1318.7, and 2.7, respectively. Based on the multiple logistic regression analysis, correlations were found between PICC-DVT and elevated PLR (p =.014), SII (p =.012), and SIRI (p =.022). Patients with malignancy having higher values of PLR, SII or SIRI tended to be more likely to develop PICC-DVT. Conclusions : The systemic immune inflammation indexes increases the risk of PICC-DVT and could be used as auxiliary predictive tests for PICC-DVT. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to determine the effects of caffeine consumption and sleep on post-spinal headache after spinal anesthesia. Background: Post-spinal headache is among the most well-known and common complications of spinal anesthesia. Although caffeine consumption is recommended to prevent headache after spinal anesthesia, caffeine does not prevent headache and causes sleep-related problems. No study in the literature found a correlation between sleep and caffeine consumption after spinal anesthesia and post-spinal headache. Methods: The research is a descriptive and cross-sectional study. The study sample comprised 425 patients who underwent elective surgery in a research hospital. The research data were collected by face-to-face interviews between April 2021 and December 2023. The "Sociodemographic and Clinical Characteristics Form," "Richard-Campbell Sleep Scale," "Insomnia Severity Index," and "Visual Analog Scale" were used in data collection. Factors affecting post-spinal headache were determined using binary logistic regression analysis. Results: According to the binary logistic regression, the insomnia severity score (OR = 1.234; p <.001), sleep quality score (OR =.992; p <.01), postoperative sleep duration (OR =.619; p <.05), and not consuming coffee (OR =.035; p <.001) are statistically significant predictors of post-spinal headache and explain 57.7% of the variance. A one-unit increase in patients' insomnia severity increased the probability of experiencing a post-spinal headache by 23.4%. With a one-unit increase in sleep quality, there was an 8% decrease in the probability of experiencing spinal headache, and a 3.81% decrease in the probability of experiencing post-spinal headache with an increase in sleep duration after surgery. The probability of experiencing post-spinal headache was 0.35 times higher in individuals who did not consume caffeine after surgery than in those who consumed it. Conclusion: The present study demonstrated that insomnia severity and sleep quality were more effective than caffeine consumption in preventing post-spinal headache. Insomnia and decreased sleep quality may cause a significant burden in developing post-spinal headache in patients and may cause post-spinal headache to be observed more frequently. Therefore, the use of caffeine in preventing or reducing post-spinal headache may adversely affect the duration and quality of sleep and increase the severity of insomnia. [ABSTRACT FROM AUTHOR]

Background: This study aims to determine the effect of virtual reality glasses application on pain, anxiety, and patient satisfaction during a transrectal prostate biopsy. Materials and Methods: The study was conducted with pre-tests, post-tests, and a control group, using a randomized controlled experimental research design. A total of 70 patients (35 in the intervention group and 35 in the control group) were included in the study. The intervention group watched a video with virtual reality glasses during the biopsy process. A Descriptive Information Form, State-Trait Anxiety Inventory (STAI-I, STAI-II), Scale of Patient Perception of Hospital Experience with Nursing Care (PPHEN), and Visual Analog Scale for Pain (VAS) were used for data collection. To evaluate the data, numbers, percentages, mean, standard deviation, chi-square, paired sample t test, independent samples t test, regression analysis, and Cronbach's alpha Reliability Coefficient were used. Results: There was no significant difference between the groups in terms of descriptive and clinical characteristics (p >.05). The mean VAS and STAI post-test scores of the patients in the intervention group were lower than the control group, and the difference between them was statistically significant (p <.05). The mean PPHEN post-test scores of the patients in the intervention group were significantly higher than those in the control group (p <.05). Conclusion: The application of virtual reality glasses during a transrectal prostate biopsy significantly reduced the level of pain and anxiety and increased patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most frequent female malignancy in the UK. Around 20% of cases are linked to weight gain, excess weight and health behaviours. We designed a weight gain prevention, health behaviour intervention for young women at increased risk. Methods: The study comprised a single arm observational study over 2 months testing acceptability and usability of the intervention: online group welcome event, app and private Facebook group. Females aged 18–35 years at moderate or high risk of breast cancer (>17% lifetime risk) were recruited via invite letters and social media posts. The app included behaviour change techniques and education content. Online questionnaires were completed at baseline, as well as at 1 and 2 months. We also assessed feasibility of study procedures. Results: Both recruitment methods were successful. Thirty‐five women were recruited, 26% via social media posts. Median age was 33 (interquartile range = 28.2–34.5) years, the majority (94.1%) were of White ethnicity. Thirty‐four participants were included in the analyses, of which 94% downloaded the app. Median self‐monitoring logs per participant during the study period was 10.0 (interquartile range = 4.8–28.8). App quality mean (SD) score was 3.7 (0.6) at 1 and 2 months (scale: 1–5). Eighty‐nine per cent rated the app at average or above at 1 month and 75.0% at 2 months. Nineteen women (55.9%) joined the Facebook group and there were 61 comments and 83 reactions and votes from participants during the study period. Conclusions: This first iteration of the app and intervention was well received and is suitable to progress to the next stage of refining and further testing. Highlights: The newly developed intervention that focused on weight gain prevention and health behaviour change was tested in young women at increased risk of breast cancer and was well‐received by the target population.Both recruitment methods, by mailshot and social media, were successful.The study was unable to recruit and ethnically diverse population.Future research should retest the intervention in a larger population, after making refinements. [ABSTRACT FROM AUTHOR]

The college transition is a time of great emotional lability, and sharing emotional experiences with parents can be beneficial for first-year students. Guided by the social sharing of emotions framework and the cultural theory on self-construal, this study investigated the developmental course of freshmen's emotional disclosure with parents during the first semester and the mediating role of independence-orientation in two Asian contexts—Beijing (China) and Singapore. Using experience sampling method (online diary), 205 Chinese freshmen (Mage = 19.43) and 291 Singapore freshmen (Mage = 19.44) reported on four facets of emotional disclosure with parents (frequency, intimacy, negativity, and positivity) across four timepoints and their independence–interdependence orientation (Time 1). Latent growth curve modeling comparing the two Asian samples revealed that frequency increased for Chinese students and decreased for Singapore students. Intimacy indicated upward trajectories for both Asian samples, whereas negativity and positivity showed downward trajectories but were less pronounced for Chinese students. Mediated latent growth curve modeling revealed that the cultures predicted independence-orientation, which in turn negatively predicted increase in frequency for the Singapore sample and positively predicted decrease for the Chinese sample. Independence-orientation negatively predicted increase in intimacy, positively predicted decline in negativity, and negatively predicted decline in positivity. In sum, we found complex and differentiated trajectories for the four facets of emotional disclosure in two Asian samples and the mediating role of independence-orientation in explaining cultural differences in the trajectories, which have implications for understanding emotional disclosure to parents during the developmental phase of the college transition in Asian contexts. Public Significance Statement: Chinese and Singapore freshmen's emotional disclosure with parents is a sophisticated and multifaceted developmental process. Although Beijing (China) and Singapore are traditionally interdependence-oriented Asian societies, first-year students across these two Asian cultures have varying experiences in how they manage emotions with parents during the developmentally significant phase of the college transition. Independence-orientation can account for cross-cultural differences in the trajectories of emotional disclosure with parents among first-year Asian college students. [ABSTRACT FROM AUTHOR]

Given the importance of self-esteem for promoting adolescents' social, psychological, and academic adjustment and the growing importance of social identities during adolescence, this five-wave study examined whether an identity-based self-affirmation intervention attenuated declines in adolescent self-esteem following the high school transition. A sample of ninth graders in the United States (N = 388; Mage = 14.05; 60.6% female; 35.8% male; 3.6% nonbinary, trans, or identifying with another gender; 46% White, 19% Black, 17% Asian, 6% Arab, Middle Eastern, North African, 6% Biracial/Multiethnic, 3% Latinx/Hispanic, and 3% another race/ethnicity) was recruited for the study. Following completion of a baseline online survey assessing self-esteem, participants were assigned to one of three conditions and corresponding writing exercises: identity-based self-affirmation, values-based self-affirmation, or control. Participants completed the same writing exercise during the first three waves of the study, and they completed measures of self-esteem at all five waves. Results indicated that participants in the self-affirmation conditions, but not the control condition, were protected from declining self-esteem across 1 year. Public Significance Statement: Self-esteem is a psychological phenomenon that predicts a host of important outcomes for youth but typically stagnates or even declines during adolescence. The present study developed an identity-based and values-based self-affirmation intervention to mitigate declines in ninth graders' self-esteem across 1 year. Results revealed that adolescents in the control condition exhibited declines in self-esteem, whereas those in the identity-based or values-based self-affirmation conditions were buffered from deteriorating self-esteem. The findings suggest that providing adolescents with opportunities to reflect on values and social identities of personal importance could have cascading effects on psychological adjustment following the high school transition. [ABSTRACT FROM AUTHOR]

People see some impossible events as more impossible than others. For example, walking through a solid wall seems more impossible if it is made of stone rather than wood. Across four experiments, we investigated how children and adults assess the relative impossibility of events, contrasting two kinds of information they may use: perceptual information and causal knowledge. In each experiment, participants were told about a wizard who could magically transform target objects into other things. Participants then assessed which of the two transformation spells would be easier or harder, a spell transforming a target object into a perceptual match (i.e., a similar-looking thing) or one transforming it into a causal match (e.g., an item made of similar materials). In Experiments 1–3, children aged 4–7 mainly thought that transformations into the perceptual match would be easier, though this tendency varied with age. Adults were overall split when choosing which spell would be easier. In Experiment 1, this was because of variations in their judgments across different pairs of spells; in Experiments 2 and 4, the split resulted because different subsets of adults preferred either the perceptual or causal match. Overall, these findings show that children, and many adults, use perceptual reasoning to assess relative impossibility. Public Significance Statement: Besides differentiating possible events from ones that are impossible, people see some events as more impossible than others. We investigated how children and adults make these judgments by asking them about magical transformations. One way that people might assess the relative impossibility of magic is by drawing on their causal knowledge. However, we find that young children, and even many adults, instead make these judgments using shallow perceptual information. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate nnU-net's performance in automatically segmenting and volumetrically measuring ocular adnexal lymphoma (OAL) on multi-sequence MRI. Methods: We collected T1-weighted (T1), T2-weighted and T1-weighted contrast-enhanced images with/without fat saturation (T2_FS/T2_nFS, T1c_FS/T1c_nFS) of OAL from four institutions. Two radiologists manually annotated lesions as the ground truth using ITK-SNAP. A deep learning framework, nnU-net, was developed and trained using two models. Model 1 was trained on T1, T2, and T1c, while Model 2 was trained exclusively on T1 and T2. A 5-fold cross-validation was utilized in the training process. Segmentation performance was evaluated using the Dice similarity coefficient (DSC), sensitivity, and positive prediction value (PPV). Volumetric assessment was performed using Bland-Altman plots and Lin's concordance correlation coefficient (CCC). Results: A total of 147 patients from one center were selected as training set and 33 patients from three centers were regarded as test set. For both Model 1 and 2, nnU-net demonstrated outstanding segmentation performance on T2_FS with DSC of 0.80–0.82, PPV of 84.5–86.1%, and sensitivity of 77.6–81.2%, respectively. Model 2 failed to detect 19 cases of T1c, whereas the DSC, PPV, and sensitivity for T1_nFS were 0.59, 91.2%, and 51.4%, respectively. Bland–Altman plots revealed minor tumor volume differences with 0.22–1.24 cm3 between nnU-net prediction and ground truth on T2_FS. The CCC were 0.96 and 0.93 in Model 1 and 2 for T2_FS images, respectively. Conclusion: The nnU-net offered excellent performance in automated segmentation and volumetric assessment in MRI of OAL, particularly on T2_FS images. [ABSTRACT FROM AUTHOR]

Objective: The 48‐week, phase 2 SLEek study (NCT03978520) evaluated the efficacy and safety of upadacitinib (JAK inhibitor) and elsubrutinib (BTK inhibitor) alone or in combination (ABBV‐599) in adults with moderately to severely active systemic lupus erythematosus (SLE). Methods: Patients were randomized 1:1:1:1:1 to elsubrutinib 60 mg and upadacitinib 30 mg once daily (ABBV‐599 high dose), elsubrutinib 60 mg and upadacitinib 15 mg once daily (ABBV‐599 low dose), elsubrutinib 60 mg once daily (QD), upadacitinib 30 mg QD, or placebo QD. The primary endpoint was the proportion of patients achieving both Systemic Lupus Erythematosus Responder Index 4 (SRI‐4) and glucocorticoid dose ≤10 mg QD at week 24. Additional assessments through week 48 included British Isles Lupus Assessment Group‐Based Composite Lupus Assessment (BICLA) and Lupus Low Disease Activity State (LLDAS) responses, number of flares, time to first flare, and adverse events. Results: The study enrolled 341 patients. The ABBV‐599 low dose and elsubrutinib arms were discontinued after a planned interim analysis showed lack of efficacy (no safety concerns). More patients achieved the primary endpoint with upadacitinib (54.8%; P = 0.028) and ABBV‐599 high dose (48.5%; P = 0.081) versus placebo (37.3%). SRI‐4, BICLA, and LLDAS response rates were higher for both upadacitinib and ABBV‐599 high dose versus placebo at weeks 24 and 48. Flares were reduced, and time to first flare through week 48 was substantially delayed with both upadacitinib and ABBV‐599 high dose versus placebo. No new safety signals were observed beyond those previously reported for upadacitinib or elsubrutinib. Conclusion: Upadacitinib 30 mg alone or in combination with elsubrutinib (ABBV‐599 high dose) demonstrated significant improvements in SLE disease activity and reduced flares and were well tolerated through 48 weeks. [ABSTRACT FROM AUTHOR]

Migration-related risk factors may impact the association between coping strategies, resilience, and identity development, one of the fundamental developmental tasks in adolescence. We examined the relationship between resilience and coping strategies in immigrant and non-immigrant adolescents' identity development. On a sample of Turkish adolescents (n = 399, 50.9% girls), we conducted six hierarchical regression models to predict identity dimensions from resilience and coping strategies. For both immigrants and non-immigrants, seeking social support predicted a more mature and successful identity while avoidance predicted less reconsideration of commitment. For non-immigrants, seeking social support and avoidance was associated with in-depth exploration whereas for immigrants, only seeking social support was linked to in-depth exploration. Additionally, resilience predicted a successful identity for immigrants. Results were discussed considering migration-related difficulties [ABSTRACT FROM AUTHOR]

Multiple studies have explored the factor structure of working memory (WM) tasks, yet few have done so controlling for both the domain and category of the memory items in a single study. In the current pre-registered study, we conducted a large-scale latent variable analysis using variant forms of n-back and backward recall tasks to test whether they measured a single underlying construct, or were distinguished by stimuli-, domain-, or paradigm-specific factors. Exploratory analyses investigated how the resulting WM factor(s) were linked to fluid intelligence. Participants (N = 703) completed a fluid reasoning test and multiple n-back and backward recall tasks containing memoranda that varied across (spatial or verbal material) and within (verbal digits or letters) domain, allowing the variance specific to task content and paradigm to be assessed. Two distinct but related backward recall and n-back constructs best captured the data, in comparison to other plausible model constructions (single WM factor, two-factor domain, and three-factor materials models). Common variance associated with WM was a stronger predictor of fluid reasoning than a residual n-back factor, but the backward recall factor predicted fluid reasoning as strongly as the common WM factor. These data emphasise the distinctiveness between backward recall and n-back tasks. [ABSTRACT FROM AUTHOR]

Transgender individuals face challenges to identity as they transition from their sex assigned at birth to their affirmed gender. Memories may support a sense of self through the recall of events with more phenomenological detail than others, making them feel closer to the current self. Autobiographical memories of 90 transgender and 90 cisgender adults were compared on self-reported memory phenomenology. Memory phenomenology was more variable in transgender individuals, with a larger difference between phenomenological ratings of recent and distant memories. Memory phenomenology specifically varied in relation to the timing of coming out to a parent. High points reported after this time were rated with higher phenomenological quality and these ratings were linked to positive well-being. Results affirm the relevance of phenomenological continuity to the identity of transgender individuals, suggesting that events from before coming out are recalled with less phenomenological quality than events after coming out. [ABSTRACT FROM AUTHOR]

Purpose: To identify the qualifications, professional roles and service practices of nurses, occupational therapists (OTs) and speech-language pathologists (SLPs) in the management of adults with oropharyngeal dysphagia (OD) in the Nordic countries. Methods: A web-based survey was developed that consisted of 50 questions on respondent demographics, education, experience, roles and service practices provided for adults with OD. The survey was distributed to practicing nurses, OTs, and SLPs in five Nordic countries via professional associations, social media, online networks and snowballing. Results: Data from 396 nurses, OTs and SLPs whom provided services for adults with OD revealed that the majority of respondents worked in acute care and inpatient rehabilitation facilities. Most respondents had minimal undergraduate education and practical clinical training in OD. Notable variances in roles and service practices in OD between professions and countries were found. OTs were the primary service provider for OD management in Denmark, while SLPs had this role in the other Nordic countries. Nurses were mainly involved in screening and some compensatory treatments in most Nordic countries. Limited use of evidence-based screening, non-instrumental or instrumental clinical assessments and rehabilitative therapeutic methods was evident. Conclusions: Study results highlight challenges in education and training of professionals responsible for the management of adults with OD in the Nordic countries. Increased use of evidence-based assessment and exercise-based treatments to improve swallowing are warranted. Adherence to European and international clinical practice guidelines for the management of adults with OD is recommended. [ABSTRACT FROM AUTHOR]

Purpose: National surveys of speech-language pathologists' (SLP) practices play an important role in professional development, and previous research show that many challenges faced by the profession are similar across the globe. This study aims to describe Swedish SLP assessment practices, examine factors that may affect this practice, and discuss the results in the light of international studies. Methods: Data from 584 SLPs were collected through an online questionnaire with multiple choice and open-ended questions. A mixed-method design was deployed where a deductive qualitative analysis of free-text responses complemented quantitative data. Results: In line with previous results from English-speaking countries, both standardized discrete skill tests and contextualized assessments were used by the respondents but fewer used language sample analysis and dynamic assessment procedures, despite international recommendations. There were few differences based on experience, work setting, proportion of multilingual assessments and socio-economic status of the health catchment area. Main challenges reported were lack of time and difficulty prioritizing, and assessment and/or diagnosis of multilingual/L2 children, which is similar to challenges faced by SLPs in other countries. Swedish SLPs also reported lack of national clinical guidelines as a main challenge. Factors contributing to better assessments included experience, and the combination of many sources of information, including professional and interprofessional discussions. Conclusions: The accumulated evidence from this and previous studies show that to address challenges and build on strengths, changes on a systemic level are needed. This includes more time and resources for continuing education and implementation of recommended assessment methods, as well as professional and interprofessional collaborations. [ABSTRACT FROM AUTHOR]

This cross-cultural study examines the differences in TikTok use among users from the United States, Spain, and Chile. A survey, in English, European Spanish, and Latin American Spanish respectively, was administered to 556 TikTok users across the three countries. These users shared similar demographic characteristics, and multigroup measurement models were established to support cross-country measurement invariance. Our results show that Chilean TikTokers are the least engaged on the platform, but have more followers on average than their American and Spanish counterparts. Additionally, users' motivations for and uses of TikTok are associated with their countries' national cultural values. For instance, TikTok users in Chile and Spain, which are collectivistic societies, view the platform as a socialisation tool more than users in the individualistic United States. Lastly, Chileans, who have a high uncertainty avoidance level, tend to avoid self-expression and archiving on TikTok compared to Americans, who have a low uncertainty avoidance level. [ABSTRACT FROM AUTHOR]

'Phubbing' refers to the phenomenon where people ignore social partners in a face-to-face situation by focusing on their phones. Narcissism, a personality trait characterised by entitled self-importance, has strong influences on interpersonal relationships. As the mechanism through which narcissism may affect the development of phubbing is unclear and most relevant studies have been conducted in Western countries, we proposed and empirically tested a theoretical model that links narcissism to phubbing in China. Chinese participants (N = 322; 181 women and 141 men) completed a survey in the Chinese language. Path analyses largely confirmed the proposed hypothetical model. The main findings showed that vulnerable narcissism directly predicted more phubbing behaviour and also indirectly via increased social anxiety, preference for online social interaction (POSI), social media use (SMU) for mood regulation, and compulsive SMU. Also, grandiose narcissism indirectly predicted less phubbing behaviour via reduced social anxiety, POSI, SMU for mood regulation, and compulsive SMU. The findings, therefore, elucidate the mechanisms by which the two subtypes of narcissism differentially predispose people to phubbing in China, with vulnerable narcissism predisposing people to more phubbing and grandiose narcissism to less phubbing. Implications and limitations of the study are discussed. [ABSTRACT FROM AUTHOR]

Data visualisation software provides the ability to create highly customisable choropleth maps. This presents an abundance of design choices. The colour legend, one particular aspect of choropleth map design, has the potential to effectively convey data points' absolute magnitudes (how large or small they are). Colour legends present the mapping between a specific range of colours and a specific range of numerical values. In this experiment, we demonstrate that manipulating this range affects interpretations of the plotted values' absolute magnitudes. Participants (N = 100) judged the urgency of addressing pollution levels as greater when the colour legend's upper bound was equal to the maximum plotted value, compared to when it was significantly larger than the maximum plotted value. This provides insight into the cognitive processing of plotted data in choropleth maps that are designed to promote inferences about overall magnitude. [ABSTRACT FROM AUTHOR]