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Context: The aim of this study was to investigate the effects of 8-week ballistic-strength-training program using a validated specific throwing device (ie, Arm/Shoulder Specific Strength Device), on isokinetic shoulders' rotation muscle-torques and ratios as well as range of motion in team handball players. Design: A repeated-measures experimental design with a randomized controlled trial was used. Methods: Twenty-six high-level competitive male U-19 team handball players were randomly assigned into training (TG, n = 15) and control (n = 11) groups. The TG undertook a twice a week for 8-week periodized throws program with an individually predetermined optimal load. The program incorporated shackled eccentric and concentric exercises using the Arm/Shoulder Specific Strength Device. Peak torques, functional, and conventional ratios for both arms at different angular velocities (60°·s−1, 180°·s−1, and 300°·s−1) were assessed over time and between groups, using an isokinetic dynamometer. Results: A significant improvement for TG (P <.01; d = 1.13 [moderate]; +20.2%) of the concentric peak torques for dominant arm in external rotation was observed at 300°·s−1. Significant (P <.05–.01) increases were also noted for nondominant arm at the 3 studied angular velocities. In addition, 300°·s−1 eccentric peak torques of the dominant arm and nondominant arm have significantly improved for both external and internal rotations (P <.05; d =.99 [moderate] and d = 1.21 [large]; +15.7% and + 17.9%, respectively) with small changes at the other angular assessed velocities. Posttraining, TG's dominant arm showed significant improvements (P <.05–.01) in functional and conventional ratios at all velocities. Notably, significant differences (P <.05–.01) were observed at 60°·s−1 and across all velocities when comparing the TG with the control group. TG showed significant increase for internal rotation and external rotation shoulder range of motions (P <.05; d = 1.22–1.27 [large]), +5.0% and +7.7%, respectively). Conclusions: The specific 8-week throwing training program on the Arm/Shoulder Specific Strength Device showed significant performance improvements in almost all assessed isokinetic concentric and eccentric peak torques as well as internal and external range of motion increase for both arms while ensuring rotator cuff torque ratios and shoulder mobility in team handball real sport-specific condition. [ABSTRACT FROM AUTHOR]

Match-related performance analysis in judo Para athletes with visual impairments is important to coaches and staff to identify technical–tactical profiles of their athletes and opponents but also to identify whether there are similar characteristics in each visual class. Thus, this study explores the match-related performance in judo Para athletes and verifies the relationship between performance using the old and new classification systems. The match-derived variables were analyzed using different statistical methods considering a total of 182 matches from the Tokyo 2020 Paralympic Games. The results indicated that performance was affected by sex and degree of impairment. The new classification system seems suitable for grouping Para judo athletes, as it differentiates performance between the two proposed classes (J1 and J2), since athletes from each group compete separately. Furthermore, different variability index measures were correlated with competitive performance, demonstrating a specific performance profile for each sport class in judo. [ABSTRACT FROM AUTHOR]

To operationalize the extent to which firms place a strategic emphasis on human capital and human resource management (HRM), we draw on the strategy field's dominant logic theory and on the emerging literature on executive compensation for the heads of major firm functions, such as HRM. Specifically, we investigate whether the pay of human resource executives (HREs) relative to other members of top management teams (TMTs) is related to firm performance. After controlling for the endogeneity of HRE status as one of the highest paid executives on the TMT, we find in a comprehensive sample of the largest US firms that HRE relative pay is positively related to firm financial performance, specifically Tobin's Q. We also find that the relationship of HRE relative pay with Tobin's Q is stronger in relatively smaller and younger firms in our sample. The findings suggest that a strategic emphasis on human capital and HRM leads to higher firm value. [ABSTRACT FROM AUTHOR]

Purpose: To explore complex system behavior and subsequent team performance in professional rugby union. Methods: Here, we present 2 studies. In the first, we used global positioning system technology to measure player clustering during stoppages in play in nearly 100 games of professional rugby union to explore team (complex system) behavior and performance. In the second, we measured stress hormones (cortisol and testosterone) prior to team meetings and analyzed these relative to amount of time and the frequency with which players looked at peer presenters, as well as subsequent training performance, to explain how stress may lead to behaviors observed in the first study and subsequent match performance. Results: No link between player clustering during stoppages of play and performance was observed. When players (complex system agents) demonstrated greater levels of stress (as indicated by greater cortisol-awakening response and a greater decline in testosterone-to-cortisol ratio across the morning), they tended to look at peer presenters more; however, training quality declined (P =.02). Correlational analysis also showed that training quality was related to testosterone-to-cortisol ratio (P =.04). Conclusions: Team behavior is complex and can be unpredictable. It is possible that under stress, complex system agents (ie, rugby union players) look at (and cluster toward) their teammates more; however, meaningful interaction may not necessarily occur. Furthermore, while complex system (team) analysis may be valuable strategically in rugby union in the context of describing behavior, without understanding "how" or "why" intrateam/interagent behaviors emerge it may have little meaning. [ABSTRACT FROM AUTHOR]

Purpose: Mental fatigue causes decreases in aspects of athletes' performance. Elite coaches commonly undertake cognitively demanding tasks and are seemingly at similar risk of subsequent performance impairment. However, elite sport coaches' experiences of mental fatigue, alongside other markers of psychobiological stress, have yet to be quantified. Methods: Three elite coaching and performance staff (2 women and 1 man) provided 100-mm visual analog scale ratings of mental fatigue, physical fatigue, readiness to perform, and salivary samples for later cortisol (sCort) and alpha-amylase (sAA) analysis. Data were obtained on the same morning each week across a 16-week preseason. Data were subset by individual coach for descriptive and repeated-measures correlational analyses. Results: Fluctuating mental fatigue was observed over the 16 weeks (min–max; coach 1 = 25–86 AU; coach 2 = 0–51 AU; and coach 3 = 15 − 76 AU). Elevated levels of mental fatigue were reported at multiple time points, with individual variability observed. sCort (in nanomoles per liter), sAA (in micromoles per liter), and sAA:sCort indicated that coaches experienced psychophysiological stress (min–max; coach 1 sCort = 8.42–17.31, sAA = 52.40–113.06, sAA:sCort = 3.20–12.80; coach 2 sCort = 4.20–9.70, sAA = 158.80–307.20, sAA:sCort = 21.10–61.70; and coach 3 sCort = 6.81−19.66, sAA = 86.55–495.85, sAA:sCort = 4.90–35.50). A significant inverse relationship between mental fatigue and readiness to perform (r = −.44 [−.64 to −.17], P =.002) was identified. Conclusions: Elite sport coaches report elevated instances of mental fatigue during a preseason training period. Those involved in elite sports should act to understand the presence and potential subsequent impacts of staff mental fatigue and consider management or mitigation strategies. Optimization of the cognitive performance of coaches and performance staff presents as a potential source of competitive advantage. [ABSTRACT FROM AUTHOR]

Purpose: To determine the optimal implant diameter under limited bone width by comparing the effects of implants with different diameters on implant stability, peri-implant bone stability, and osseointegration. In addition, to evaluate the reliability of resonance frequency analysis (RFA) in detecting osseointegration and marginal bone level (MBL). Materials and Methods: Mandibular premolars and first molars of seven beagle dogs were extracted. After 8 weeks, their mandibular models and radiographic information were collected to fabricate implant templates. Implant sites were randomly divided into three groups according to diameter: Ø3.3, Ø4.1, and Ø4.8 mm. Implant stability quotient (ISQ) measurement and radiographic evaluation were performed after surgery (baseline) and at 4, 8, and 12 weeks. Three dogs were euthanized at 4 weeks to observe osteogenesis and implant-tissue interface biology. Four dogs were euthanized at 12 weeks to observe osseointegration. Hard tissue sections were prepared to analyze osteogenesis (fluorescence double labeling) and osseointegration (methylene blue-acid fuchsin staining). Results: At baseline and at 4, 8, and 12 weeks, the ISQ values of Ø4.1- and Ø4.8-mm implants did not differ (P > .05), but both had higher values than the Ø3.3-mm implants (P < .05). The mean marginal bone resorption (MBR) associated with Ø3.3-, Ø4.1-, and Ø4.8-mm implants was 0.65 ± 0.58 mm, 0.37 ± 0.28 mm, and 0.73 ± 0.37 mm, respectively. The buccal MBR of Ø4.8-mm implants was significantly higher than that of Ø4.1-mm implants (P < .05). The bone-to-implant contact (BIC) percentage at 12 weeks did not differ for any group (P > .05). The correlation coefficients between the ISQ and MBL of the Ø3.3-, Ø4.1-, and Ø4.8-mm implants were -0.84 (P < .01), -0.90 (P < .001), and -0.93 (P < .001), respectively, while that between the ISQ and BIC was 0.15 (P > .05). Conclusions: During the early healing stage, the performance of Ø4.1- and Ø4.8-mm implants in terms of implant stability was better than that of Ø3.3-mm implants. Implant diameter may not influence BIC percentage. RFA can be used to evaluate implant stability and MBL but is not suitable to assess the degree of osseointegration. [ABSTRACT FROM AUTHOR]

Background: Work-family enrichment refers to the extent to which experiences in one role improve the quality of life in another role, and the bidirectionality indicates that benefits derived from work can be applied to family and vice versa. Parent nurses, that is, female nurses who are raising preschool children, play a major role at work and in the family. Thus, work-family enrichment is significant for them. The Work-Family Enrichment Scale cannot be generalized to parent nurses. This study was aimed at developing and psychometrically validating a draft Work-Family Enrichment Scale for Parent Nurses. Methods: A questionnaire survey was conducted among 1,090 parent nurses who were randomly sampled from hospitals with more than 200 beds in Japan. The survey evaluated (1) a draft Work-Family Enrichment Scale for Parent Nurses, (2) the Japanese version of the Work-Family Enrichment Scale, and (3) the Positive Spillover Scale. The scales were psychometrically evaluated for internal consistency, construct validity, and criterion-related validity. Results: Data from 503 participants (age, mean ± standard deviation [range] 35.5 ± 4.96 [23–47] years) were analyzed. Results of exploratory factor analysis, the work to family enrichment direction yielded five factors for 23 items: "emotional fulfillment," "efficiency," "ability to lead," "displaying industriousness," and "self-growth." Cronbach's alpha coefficients ranged from 0.862 to 0.914. In the family-to-work enrichment direction, there were five factors for 28 items: "help-seeking," "receptiveness," "expansion of one's horizon," "efficiency," and "emotional fulfillment." Cronbach's alpha coefficients ranged from 0.790 to 0.907. Additionally, the correlation coefficients reporting criterion-related validity were 0.685 and 0.619 with regard to the Japanese version of the Work-Family Enrichment Scale and 0.596 and 0.534 with the Positive Spillover Scale for the Work-to-Family Enrichment Scale and the Family-to-Work Enrichment Scale for Parent Nurses, respectively. Conclusions: The Work-Family Enrichment Scale for Parent Nurses has adequate reliability and validity and can be used as an effective measure to assess the positive aspects of work and family roles among female parent nurses. [ABSTRACT FROM AUTHOR]

Background: Missed nursing care poses a significant challenge for healthcare staff in terms of patient safety and care quality. Objective: To evaluate presenteeism and missed care attitudes of nurses and to determine the correlation between presenteeism and missed care. Methods: This descriptive, correlational, and observational study was conducted between February and August 2023. The Stanford Presenteeism Scale-Short Form and the MISSCARE Survey were used to collect the data among nurses at two public hospitals in a city in Turkey. The study was completed with 229 nurses representing 27.4% of the total number of nurses who met the inclusion criteria. The data was analyzed using a comprehensive analytical approach, including Cronbach's alpha analysis, frequency and percentage distribution, the Shapiro–Wilk test of normality, correlation coefficient analysis, Pearson correlation coefficient, and the Bonferroni test. Results: The participants' mean age was 30.22 ± 7.14 years, and 74.2% of them were female. 53.3% of the participants reported difficulty providing patient care due to material shortages, and 62.9% experienced challenges delivering care due to the intensity of paperwork in the clinic. Nurses who felt that paperwork intensity affected patient care and were not confident in their care provision had higher levels of presenteeism (p = 0.041) and a significantly higher frequency of missed care instances (p < 0.001). Conclusions: Material shortages and high paperwork intensity are contributing factors to the difficulties experienced by nurses in their practice. These difficulties may lead to an increase in presenteeism and instances of missed nursing care. It is important to address these challenges to ensure adequate care provision and reduce the likelihood of presenteeism among nurses. The correlation between presenteeism and instances of missed nursing care highlights the impact of presenteeism behaviors on the quality of patient care. [ABSTRACT FROM AUTHOR]

Background: Despite efforts to promote guideline use, guideline adoption is often suboptimal due to failure to identify and address relevant barriers. Barriers vary not only between guidelines but also between settings, intended users, and targeted patients. Multi-professional guidelines are often used in child and adolescent mental health services (CAMHS), making the implementation process more difficult. Despite this, there is a lack of knowledge about which barriers to consider or if barriers vary by profession. The aim of this study was to address these gaps by examining barriers to adopting a multi-professional depression guideline in the context of a nationwide implementation study. Methods: 440 CAMHS clinicians across Sweden (52%) completed the Barriers and Facilitators Assessment Instrument (BFAI) ahead of an implementation endeavour. BFAI is a widely used and validated measure of guideline implementation on four scales: Innovation, Provider, Context, and Patient. Barriers were calculated at scale and at item levels. ANOVA and chi-square tests were used to analyse differences by profession and effect sizes were calculated. Results: Overall, clinicians were optimistic about guideline uptake, particularly about guideline characteristics and their own adoption ability. Barriers were related to the patient and the context domains, as well as to individual clinician knowledge and training. Perceptions differed across professions; psychiatrists were most, and counsellors were least positive about guideline embeddedness. Conclusion: This large-scale quantitative study suggests that CAMHS clinicians have an overall favourable attitude towards guideline adoption but highlights the need for adaptations to certain patient groups. Strategies to improve guideline use should primarily address these patient issues while securing proper support to the implementation. Implementation efforts, particularly those targeting staff knowledge, training, and involvement, may benefit from being tailored to different professional needs. These findings may inform implementation projects in CAMHS and future research. [ABSTRACT FROM AUTHOR]

Introduction: Over the past few decades, there has been growing concern about the concurrent trends of increasing Autism Spectrum Disorder (ASD) prevalence and declining sperm quality. These trends represent significant public health challenges that warrant thorough investigation of their underlying causes and implications. Objectives: The primary objectives of this study are to analyze trends in ASD prevalence and sperm quality parameters from 2000 to 2024, assess the statistical significance and effect size of these trends, explore potential correlations between ASD prevalence and sperm quality parameters, and identify significant predictors among sperm quality parameters that influence ASD prevalence. Methods: This study employed a longitudinal approach using multiple regression, time series analysis, ANOVA, Principal Component Analysis (PCA), hierarchical clustering, logistic regression, and cross-correlation analysis. Data on ASD prevalence were sourced from the CDC Autism and Developmental Disabilities Monitoring Network, while sperm quality data were collected from various published studies. Results: The findings reveal significant negative associations between ASD prevalence and sperm quality parameters such as sperm concentration and motility, suggesting that better sperm quality is linked to lower ASD rates. Conversely, parameters like sperm DNA fragmentation (SDF), volume of ejaculate, pH level, and semen viscosity show positive associations with ASD prevalence, indicating higher values in these parameters correlate with higher ASD rates. Conclusion: The study highlights the importance of maintaining reproductive health to potentially mitigate ASD risk and calls for further research to elucidate the underlying mechanisms driving these trends. These findings support the hypothesis that reproductive health factors play a crucial role in ASD etiology and suggest potential biological markers for assessing ASD risk. [ABSTRACT FROM AUTHOR]

Background: Various studies have shown that the type of intensity measure affects training intensity distribution (TID) computation. These conclusions arise from studies presenting data from meso- and macrocycles, while microcycles, e.g., high-intensity interval training shock microcycles (HIIT-SM) have been neglected so far. Previous literature has suggested that the time spent in the high-intensity zone, i.e., zone 3 (Z3) or the "red zone", during HIIT may be important to achieve improvements in endurance performance parameters. Therefore, this randomized controlled trial aimed to compare the TID based on running velocity (TIDV), running power (TIDP) and heart rate (TIDHR) during a 7-day HIIT-SM. Twenty-nine endurance-trained participant were allocated to a HIIT-SM consisting of 10 HIIT sessions without (HSM, n = 9) or with (HSM + LIT, n = 9) additional low-intensity training or a control group (n = 11). Moreover, we explored relationships between time spent in Z3 determined by running velocity (Z3V), running power (Z3P), heart rate (Z3HR), oxygen uptake ( Z 3 V ˙ O 2 ) and changes in endurance performance. Results: Both intervention groups revealed a polarized pattern for TIDV (HSM: Z1: 38 ± 17, Z2: 16 ± 17, Z3: 46 ± 2%; HSM + LIT: Z1: 59 ± 18, Z2: 14 ± 18, Z3: 27 ± 2%) and TIDP (Z1: 50 ± 8, Z2: 14 ± 11, Z3: 36 ± 7%; Z1: 62 ± 15, Z2: 12 ± 16, Z3: 26 ± 2%), while TIDHR (Z1: 48 ± 13, Z2: 26 ± 11, Z3: 26 ± 7%; Z1: 65 ± 17, Z2: 22 ± 18, Z3: 13 ± 4%) showed a pyramidal pattern. Time in Z3HR was significantly less compared to Z3V and Z3P in both intervention groups (all p < 0.01). There was a time x intensity measure interaction for time in Z3 across the 10 HIIT sessions for HSM + LIT (p < 0.001, pη2 = 0.30). Time in Z3V and Z3P within each single HIIT session remained stable over the training period for both intervention groups. Time in Z3HR declined in HSM from the first (47%) to the last (28%) session, which was more pronounced in HSM + LIT (45% to 16%). A moderate dose–response relationship was found for time in Z3V and changes in peak power output (rs = 0.52, p = 0.028) as well as time trial performance (rs = − 0.47, p = 0.049) with no such associations regarding time in Z3P, Z3HR, and Z 3 V ˙ O 2 . Conclusion: The present study reveals that the type of intensity measure strongly affects TID computation during a HIIT-SM. As heart rate tends to underestimate the intensity during HIIT-SM, heart rate-based training decisions should be made cautiously. In addition, time in Z3V was most closely associated with changes in endurance performance. Thus, for evaluating a HIIT-SM, we suggest integrating a comprehensive set of intensity measures. Trial Registration Trial register: Clinicaltrials.gov, registration number: NCT05067426. Key Points: Using heart rate, running velocity and running power as measures of intensity leads to different patterns of training intensity distribution during a 7-day HIIT shock microcycle. A polarized pattern was observed for velocity and power, whereas a more pyramidal distribution was found for heart rate. Additional low-intensity training volume during a HIIT shock microcycle led to a more pronounced decline in time in zone 3 measured with heart rate compared to a shock microcycle with HIIT sessions, only. A moderate dose–response relationship was observed between time in zone 3 measured by velocity and changes in peak power output as well as time-trial performance. No such correlation was found between time in zone 3 measured by power, heart rate, oxygen uptake, and changes in endurance performance parameters. [ABSTRACT FROM AUTHOR]

Background: The field of traditional medicine encompasses a wide range of knowledge, skills, and practices that are deeply rooted in the theories, beliefs, and experiences of different cultures. The research aimed to identify traditional medicinal plants used in Guraferda District and assess the threats they face. Method: A total of 96 individuals, 80 males and 16 females, were interviewed to gather ethnobotanical data. Statistical tests like independent t tests, ANOVA, correlation, and regression were conducted using R software version 4.3.2 to compare informant groups. Result: The study found 81 medicinal plant species in the district from 71 genera and 38 families, with Asteraceae and Solanaceae families having the most species. Leaves were the most commonly used plant part for medicine. Significant differences in plant knowledge were observed across genders, age groups, education levels, and experiences. The highest ICF value was for Dermal and Cutaneous ailments, and Cissampelos mucronata A. Rich and Bidens pilosa L. had the highest fidelity levels. Conclusion: The study highlighted the importance of traditional medicinal plants in treating ailments but noted threats like overharvesting, habitat destruction, and climate change. Conservation efforts and sustainable harvesting practices are crucial to ensure the availability of these plants for future generations. Further research is needed to explore their potential for modern medicine and develop sustainable use strategies. [ABSTRACT FROM AUTHOR]

Introduction: Traditional, 8-week, mindfulness-based interventions can effectively treat chronic pain, but require a time and resource investment too burdensome for many patients and providers. The solution to this logistical challenge may be to distill the core, therapeutic elements of an efficacious 8-week, mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), into a 2-h, single-session intervention. Methods: In this study, the authors conducted a waitlist-controlled, randomized clinical trial to assess the impact of a 2-h, single-session adaptation of MORE (i.e., One MORE) on chronic pain patients' (N = 40) pain-related outcomes through 3-month follow-up. Results: Results indicated that One MORE significantly improved chronic pain patients' pain catastrophizing (i.e., primary outcome; F = 9.97, p = 0.002), pain intensity (F = 26.58, p < 0.001), pain interference (F = 39.43, p < 0.001), physical function (F = 16.29, p < 0.001), sleep (F = 16.66, p < 0.001), anxiety (F = 12.54, p < 0.001), and depression (F = 17.48, p < 0.001). One MORE also significantly increased theoretically indicated therapeutic mechanisms through the 3-month follow-up: mindfulness, positive reappraisal, savoring, self-transcendence. Discussion: Study results are promising, and if replicated, would suggest that One MORE is a highly scalable, low-cost (e.g., sustainable), nonpharmacologic treatment for chronic pain. Clinical Trial Registration: NCT05194241. [ABSTRACT FROM AUTHOR]

A rugby league player's ability to develop or maintain lower-body power will be significantly influenced by the resistance and field-based training loads completed. This study aimed to examine the power changes across a rugby league season and to investigate the relationship of concurrent training and training experience on power changes. Eighteen rugby league players participated in this study. Lower-body power was evaluated using a countermovement jump throughout the season. Four measures of external training loads were collected. A Friedman's test was used to assess differences in power throughout different phases of the season. A series of Spearman's rank-order correlations were conducted to assess the relationship between percentage changes in power during the training block, external training loads, and training experience. Countermovement jump peak velocity significantly decreased from the start (p = 0.006) and end of pre-season (p = 0.022) to the late competition. Correlation analysis revealed a large significant association between early competition field-based external loads (relative (rs = -0.571) and total distance (rs = -0.628)) and change in peak power. Very large significant negative relationships were also observed between mid-competition volume load with change in peak force (rs = -0.825) and peak power (rs = -0.736). Training experience was not significantly associated with changes in muscular power variables throughout this study. Coaches should seek to monitor changes in peak power when competition begins and to assist with decision-making for potential adjustments to running volume and intensity during field-based sessions. [ABSTRACT FROM AUTHOR]

Purpose: Listening effort is a broad construct, and there is no consensus on how to subdivide listening effort into dimensions. This project focuses on the subjective experience of effortful listening and tests if cognitive workload, mental fatigue, and mood are interrelated dimensions. Method: Two online studies tested young adults (n = 74 and n = 195) and measured subjective workload, fatigue (subscales of fatigue and energy), and mood (subscales of positive and negative mood) before and after a challenging listening task. In the listening effort task, participants responded to intermittent 1-kHz target tones in continuous white noise for approximately 12 min. Results: Correlations and principal component analysis showed that fatigue and mood were distinct but interrelated constructs that weakly correlated with workload. Effortful listening provoked increased fatigue and decreased energy and positive mood yet did not influence negative mood or workload. Conclusions: The findings suggest that self-reported listening effort has multiple dimensions that can have different responses to the same effortful listening episode. The results can help guide evidence-based development of clinical listening effort tests and may reveal mechanisms for how listening effort relates to quality of life in those with hearing impairment. [ABSTRACT FROM AUTHOR]

Background: As individuals living with HIV age, they often experience both physical and psychological symptoms--along with potential reductions in social support--which can significantly affect their health-related quality of life (HRQOL)--a crucial measure in HIV care. However, research exploring the potential predictive roles of social support and symptom experiences in HRQOL among older people living with HIV (PLWH) is limited. Objectives: This cross-sectional study aimed to investigate relationships between social support, symptom experiences, and HRQOL in older adults with HIV. Methods: Older adults with HIV aged ≥50 years completed surveys on demographic and HIV-related characteristics, social support, four symptoms, and HRQOL. Hierarchical multiple linear regression analyses were used to determine predictors for six HRQOL domains. Results: Among the 141 PLWH, significant associations were found between fatigue and health perceptions, physical functioning, and role functioning. Sleep disturbance was a significant predictor of health perceptions and social functioning. Anxiety displayed associations with physical functioning, role functioning, mental health, and pain. Depression was linked to health perceptions and mental health aspects of HRQOL. Notably, social support was not associated with any HRQOL domains. Discussion: These findings underscore the importance of assessing a range of common symptoms to enhance HRQOL among older adults living with HIV, necessitating tailored symptom management strategies for this growing population. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aims of this study were to describe burnout, mental health, and healthy lifestyle behaviors of nurses in a managerial role and assess associations among workplace culture factors (perceived culture, mattering, support, and staff shortages) with burnout, mental health outcomes, and healthy lifestyle behaviors. BACKGROUND: Nurse managers foster unit-based wellness cultures, yet burnout and mental health problems adversely impact the culture and well-being of staff. METHODS: A cross-sectional, descriptive correlational design was used. The Florida Organization forNursing Leadership enabled distribution of a wellness survey to nurse managers. RESULTS: There were 125 participants. Healthy lifestyle behaviors were infrequently practiced. Analysis revealed significant correlations among workplace culture factors, burnout, and mental health outcomes. When compared with nurse managers with staff shortages, those without staff shortages were 6.11 times more likely to not screen positive for burnout. CONCLUSIONS: Health systems should address workplace culture factors and staff shortages to reduce burnout, improve mental health, and enhance healthy behaviors in nurse managers. [ABSTRACT FROM AUTHOR]

Objective This study was designed to compare thiol/disulfide and ischemia-modified albumin (IMA) levels between psoriatic arthritis (PsA) and healthy controls and evaluate the correlation between these molecules and the disease activity scores used in PsA. Methods A total of 63 PsA patients and 49 healthy volunteers were included in the study. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), modified disease activity score 28 (DAS28), and Bath Ankylosing Spondylitis Functional Index (BASFI) scores were used as disease activity indices for PsA patients. Calculations of native thiol (-SH), disulfide (-SS), and total thiol (-SH+-SS) molecules were made by the automatic spectrophotometric method, and the albumin cobalt binding test was used to measure IMA levels. Results In the PsA group, -SS/-SH and -SS/(-SH+-SS) levels were higher and -SH/(-SH+-SS) levels were lower than in controls. In the linear regression analysis, a significant correlation relationship was detected between DAS28-erythrocyte sedimentation rate (ESR) and -SS/(-SH+-SS) (β = 0.795, CI 95%, 0.196-1.395; P =.010), -SH/(-SH+-SS) (β = -0.475, CI 95%, 0.114-0.836; P =.010) and IMA (β = 3.932, CI 95%, 0.859-7.005; P =.013). Additionally, a significant correlation was detected between IMA and BASDAI and BASFI. Conclusion In PsA, thiol/disulfide homeostasis has shifted in favor of disulfide as an oxidative indicator. Serum thiol/disulfide levels are correlated with PsA disease activity indices. [ABSTRACT FROM AUTHOR]

Objectives Myositis-specific and associated autoantibodies are important biomarkers in routine clinical use. We assessed local testing performance for myositis autoantibodies by comparing line immunoassay (LIA) to protein radio-immunoprecipitation and identifying clinical characteristics associated with each myositis autoantibody in the MyoCite cohort. Methods Serum samples from patients within the MyoCite cohort, a well-characterized retro-prospective dataset of adult and juvenile idiopathic inflammatory myopathy (IIM) patients in Lucknow, India (2017–2020), underwent LIA at Sanjay Gandhi Postgraduate Institute of Medical Science (SGPGIMS), Lucknow. Immunoprecipitation of 147 IIM patients' serum samples (125 adult-onset, 22 juvenile-onset) was conducted at the University of Bath, with researchers blind to LIA results. LIA performance was assessed against immunoprecipitation as the reference standard, measuring sensitivity, specificity and inter-rater agreement. Univariate and multivariate logistic regression determined clinical associations for specific myositis-specific autoantibodies. Results Immunoprecipitation identified myositis autoantibodies in 56.5% (n  = 83) of patient samples, with anti-Jo1 (n  = 16; 10.9%) as the most common, followed by anti-MDA5 (n  = 14, 9.5%). While LIA showed good agreement for anti-Jo1, anti-PL7 and anti-PL12 (Cohen's κ 0.79, 0.83 and 1, respectively), poor agreement was observed in other subgroups, notably anti-TIF1γ (Cohen's κ 0.21). Strongly positive samples, especially in myositis-specific autoantibodies, correlated more with immunoprecipitation results. Overall, 59 (40.1%) samples exhibited non-congruence on LIA and immunoprecipitation, and κ values for LIAs for anti-TIF1γ, anti-Ku, anti-PmScl, anti-Mi2 and anti-SAE ranged between 0.21 and 0.60. Conclusion While LIA reliably detected anti-Jo1, anti-PL7, anti-PL12, anti-MDA5 and anti-NXP-2, it also displayed false positives and negatives. Its effectiveness in detecting other autoantibodies, such as anti-TIF1γ, was poor. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate family resilience--defined as the capacity of a family to harness its collective strengths and resources to recover from and adapt to significant adversities or crises effectively--in primary care- givers of children who are deaf and hard of hearing (cDHH) and its association with quality of life, life satisfaction, perceived social support, and loneliness. Method: The study involved 108 primary caregivers of cDHH and 139 primary caregivers of children with normal hearing. Participants underwent psychometric evaluations including the Family Resilience Scale, World Health Organization Quality of Life Assessment--Brief Form, Satisfaction with Life Scale, UCLA Lone- liness Scale, and Multidimensional Scale of Perceived Social Support. Results: Significant differences were found in almost every scale and its subdi- mension between the two groups (p < .05). Correlation analysis revealed signifi- cant correlations between all scale total scores for both groups (p < .05, .153 < / r / < .737). Quality of life was found to be a significant predictor of family resil- ience, F(1, 139) = 41.824, R2 = .279, B = 0.495, t = 6.467, p < .001. Conclusions: Our study highlights the significant impact of having cDHH on caregivers' family resilience, quality of life, life satisfaction, feelings of loneliness, and perceived social support. The results underscore the importance of enhanc- ing caregivers' quality of life as a potential strategy to improve their family resil- ience. Further research is needed to understand the complex interplay of factors influencing these outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to determine the normative vestibulo- ocular reflex gain output values of the computerized rotational head impulse test (crHIT) with stationary visual targets (earth bound) in healthy participants in each decade age band of life: 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, and 70+ years. Method: Seventy-seven community-dwelling participants (10-85 years of age) with normal lateral semicircular canal (SCC) functioning and no symptoms or history of vestibular dysfunction were recruited through convenience sampling and assessed with the crHIT using stationary targets. These participants were assessed using two standard protocols in a randomized order. Results: Results from 77 participants (Mage = 46 years; 43 women, 34 men) were analyzed. Pearson's correlation coefficient and simple linear regression indicated a statistically significant relationship between crHIT gain output and age (p >.05) for right gain, 1030°/s², and left gain, 1005°/s². Although a statistically significant relationship was found, the slope was minor, demonstrating that the clinical effect of age on crHIT gain output was insignificant. Furthermore, no statistically significant relationship exists between crHIT gain output and gender (p > .05). Age-dependent normative data were calculated using the 2.5th and 97.5th confidence interval (CI) percentile method. The responses of angular vestibulo-ocular reflex (aVOR) gain values for crHIT are expected to occur within the range for lower limit reference interval (RI) of 0.85-0.9 and upper limit RI of 1.11-1.18 for 1030°/s² and lower limit RI of 0.86-0.92 and upper limit RI of 1.13-1.16 for 1005°/s² .It can be expected that 90% CI of the population with normal lateral SCC function- ing will have aVOR gain values that fall within this range. Conclusion: Despite a statistically significant relationship that exists with aVOR gain output and age, the changes are minor, declining by 0.0088 units per 10 years, justifying the same normative data for all decade age bands. [ABSTRACT FROM AUTHOR]

Friendship racial homophily, the tendency to form friendships with individuals who share the same racial background, is a normative developmental phenomenon that holds particular significance for youth of color in a racialized society. Yet, there exists a paucity of longitudinal research elucidating the stability and change of friendship racial composition across developmental span. This study aimed to examine the friendship racial homophily trajectories over a six-year period encompassing four time points. The sample comprised 437 Asian American youth (MAge = 16.52, SDAge = 1.36, 53% female), with 197 Filipino and 240 Korean participants. Using logistic multilevel modeling analyses, it was found that both Filipino and Korean American youth demonstrated an increase in friendship racial homophily from high school to college, but that Filipino youth overall reported lower levels of racial homophily compared to their Korean counterparts. The study findings also pinpointed several influential factors impacting these trajectories, including proficiency in heritage languages, ethnic identity, and encounters with racial discrimination from both White Americans and other People of Color. These results highlight the continuous evolution of friendship racial composition from high school to college and emphasize the crucial role of ethnic identity and experiences of discrimination in influencing these dynamics, with ethnic identity exerting more enduring effects and experiences of discrimination showing more situational impacts on the levels of racial homophily. [ABSTRACT FROM AUTHOR]

Work-related violence exposure has been identified as one of the risk factors for social workers' turnover intention, but little is known about its underlying mechanisms. This study aims to distinguish compassion satisfaction and compassion fatigue from a dual perspective and investigate the mediating effects of these two co-existing constructs in the relationship between work-related violence exposure and turnover intention. A sample of 1023 Chinese social workers in H city, China (mean age = 36.24 years, SD = 7.11) is obtained by multistage cluster random sampling. Findings demonstrate that the relationship between work-related violence exposure and turnover intention is partially mediated by compassion satisfaction (b = 0.023, 95% CI [0.007, 0.045]) and compassion fatigue (b = 0.139, 95% CI [0.093, 0.187]). The present study clarifies two influencing paths between work-related violence exposure and turnover intention, adding knowledge to the social work profession. Practical implications for reducing turnover intention are suggested in the social work setting. Practice Points: Organizations and managers are encouraged to create a safe working environment and establish a monitoring system that can respond sensitively and rapidly to violence. On the organizational level, fostering a compassionate organizational culture is especially encouraged. On the individual level, self-care programs can be introduced and implemented in China to benefit social workers. [ABSTRACT FROM AUTHOR]

Background: Excessive tension at the anastomosis contributes to anastomotic leakage (AL) in low anterior resection (LAR). However, the specific tension has not been measured. We assessed whether "Bridging," characterized by the proximal colon resembling a suspension bridge above the pelvic floor, is a significant risk factor for AL following LAR for rectal cancer. Methods: This retrospective study reviewed the medical records and laparoscopic videos of 102 patients who underwent laparoscopic LAR using the double stapling technique at Yachiyo Hospital between January 2014 and December 2023. Patients were classified based on whether they had Bridging (tight or sagging) or were in a Resting state of the proximal colon, and the association between Bridging and AL was examined. Results: AL occurred in 31.3% of the Tight Bridging group, 20% of the Sagging Bridging group, and 2.2% of the Resting group (P = 0.002). The incidence of AL was significantly higher in patients with Bridging than in those without (23.2% vs. 2.2%, P = 0.003). Multivariate analysis revealed that Bridging is an independent risk factor for AL (odds ratio = 6.97; 95% confidence interval: 1.45–33.6; P = 0.016). Conclusions: The presence of Bridging is a significant risk factor for AL following LAR for rectal cancer, suggesting the need for implementing preventive measures in patients with this condition. [ABSTRACT FROM AUTHOR]

Background: Physical restraint is applied in pediatric intensive care units to carry out certain painful procedures and to ensure the maintenance and continuity of life support devices. There is a need to analyse the factors that influence the behaviour or intention to use physical restraint. Aim: To create and test psychometrically a paediatric version of the Physical Restraint‐Theory of Planned Behaviour Questionnaire to assess paediatric critical care nurses' intention to use physical restraint. Study Design: A psychometric study. Five medical‐surgical Paeditric Intensive care Units from five hospitals in Spain. The study took place in three phases. In phase 1, the questionnaire was adapted. In phase 2, the content validity of each item was determined, and a pilot test was conducted. In phase 3, we administered the questionnaire and determined its psychometric properties. Results: The assessment of the intention to use physical restraint was extended to all critical paediatric patients, two items were eliminated from the initial questionnaire, four new items were included, and the clinical scenarios of the intention subscale were expanded from three to six. Overall content validity index for the full instrument of 0.96 out of 1. The Paediatric Physical Restraint‐Theory of Planned Behaviour Questionnaire is made up of four subscales (attitude, subjective norms (SN), perceived behavioural control (PBC), and intention) subdivided into 7 factors and 51 items. The internal consistency for the attitude subscale obtained a Cronbach's Alpha of 0.80 to 0.73, for the SN it was 0.72 to 0.89, for the PBC it was from 0.80 to 0.73 and for the intention subscale it was 0.75. Conclusions: The Paediatric Physical Restraint‐Theory of Planned Behaviour Questionnaire is an instrument composed of seven factors and 51 items that validly and reliably assesses the intention of paediatric nurses to apply PR in PICUs. Relevance for Clinical Practice: Having this instrument will help health centres move towards restraint‐free care by allowing managers to assess professionals' attitudes, beliefs, and intentions around the use of PR in PICUs. [ABSTRACT FROM AUTHOR]

Persistent symptoms post-mild traumatic brain injury (mTBI) includes autonomic dysregulation (AD). The composite autonomic symptoms score, (COMPASS-31), was developed to quantify AD symptom severity in the last year, which limits clinical utility. The primary aim was to determine validity of a modified-COMPASS-31 measuring symptoms in the last month compared to the original, secondarily to compare both original and modified versions to the Neurobehavioral Symptom Inventory (NSI), and tertiarily to detect change post-treatment of the modified-COMPASS-31 compared to NSI and headache intensity (HI). Thirty-three military personnel with persistent headache post-mTBI. Total and domain scores for COMPASS-31 (original vs. modified) NSI and HI at baseline. Change in modified-COMPASS-31. NSI, and HI. Baseline COMPASS-31 versions were comparable and highly correlated (r = 0.72, p < 0.001), they were moderately correlated at best to the NSI (r < 0.6), which may suggest differences in measurement metrics. The mean change in modified-COMPASS-31 scores (15.4/100, effect size 0.8) was mild to moderately correlated to the change in HI (r = 0.39) score, but not to NSI (r = 0.28). The modified-COMPASS-31 appears to be valid, can measure change of AD symptom severity, and is recommended as an outcome measure. [ABSTRACT FROM AUTHOR]

Accumulating world knowledge is a major task of development and education. The productive process of self-derivation through memory integration seemingly is a valid model of the process. To test the model, we examined relations between generation and retention of new factual knowledge via self-derivation through integration and world knowledge as measured by standardised assessments. We also tested whether the productive process of self-derivation predicted world knowledge even when a measure of learning through direct instruction also was considered. Participants were 162 children ages 8–12 years (53% female; 15% Black, 6% Asian, 1% Arab, 66% White, 5% mixed race, 7% unreported; 1% Latinx). Age accounted for a maximum of 4% of variance in self-derivation and retention. In contrast, substantial individual variability related to general knowledge and content knowledge in several domains, explaining 20–40% variance. In each domain for which self-derivation performance was a unique predictor, it explained a nominally greater share of the variance than the measure of learning through direct instruction. The findings imply that individual variability in self-derivation has functional consequences for accumulation of semantic knowledge across the elementary-school years. [ABSTRACT FROM AUTHOR]

We conducted this study with 147 volunteer pregnant women to determine the effect of spousal support on the stress experienced during pregnancy during the COVID-19 pandemic period. We determined that the prenatal stress level of the pregnant women was low (15.34 ± 7.07), they were not at risk for distress, and the spousal support level was high (74.58 ± 8.78). We found that the rate of spousal support was 0.897 times higher for women who did not experience distress. Due to the stay-at-home rule during the pandemic, couples had to be together at home, which caused high spousal support, and we found that women's stress levels were lower. [ABSTRACT FROM AUTHOR]

The present study investigated the differences in movement synchrony and therapeutic alliance between solution-focused and problem-focused counseling. Thirty-four participants each attended two counseling sessions with different counselors, one with a solution-focus and one with a problem-focus, in randomized order. The sessions consisted of three consecutive parts: problem description, standardized intervention and free intervention. Movement synchrony, including leading and pacing synchrony, was measured using Motion Energy Analysis (MEA) and windowed cross-lagged correlation (WCLC) based on video recordings of the sessions. The Helping Alliance Questionnaire (HAQ) was used to assess therapeutic alliance. Results showed that movement synchrony was significantly higher in solution-focused than in problem-focused counseling, driven by differences in the problem description part. This difference may be explained by the allegiance of the counselors to the solution-focused approach, as we observed more leading synchrony during the problem description part in solution-focused sessions. There was no significant difference in therapeutic alliance between the two conditions. This study expands the understanding of counseling approaches in the field of movement synchrony and contributes valuable insights for practitioners and researchers alike. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the effect of professional and individual characteristics, practice environments and psychological empowerment perceptions of nurses on their care behaviours. Design: The study used a cross‐sectional research design following the STROBE guidelines. Methods: The sample of this descriptive and correlational study consisted of 584 nurses working in a university hospital in Turkey. The data were collected between January and June 2023 using the Nursing Information Form, the Practice Environment Scale of the Nursing Work Index (PES‐NWI), the Psychological Empowerment Scale (PES), and the Caring Behaviours Scale‐30, and analysed using descriptive statistics, Spearman's correlation and multiple linear regression. Results: It was determined that PES‐NWI, PES and Caring Behaviours Scale (CBI‐30) scores of nurses were higher than the average. The study revealed that certain professional and individual characteristics of nurses, practice environments and psychological empowerment perceptions had an effect on their care behaviours. Conclusion: The results of the study showed that nurses' PES‐NWI, PES and CBI‐30 scores were higher than the average, and that certain professional and individual characteristics of nurses, practice environments and psychological empowerment perceptions had an effect on care behaviours. Nursing service managers, in particular, are required to understand the importance of this relationship and create appropriate working conditions which are integrated with psychological empowerment to improve caring behaviours of nurses. [ABSTRACT FROM AUTHOR]

BACKGROUND: When the work load of the respiratory muscles increases and/or their capacity decreases in individuals with COPD, respiratory muscle activation increases to maintain gas exchange and respiratory mechanics, and perception of dyspnea occurs. The present study aimed to compare diaphragm and accessory respiratory muscle activation during normal breathing, pursed-lip breathing, and breathing control in different dyspnea relief positions, supine and side lying. METHODS: A cross-sectional study design was used. Sixteen individuals with COPD age between 40-75 y were included. Pulmonary function was evaluated by spirometry, muscle activation by surface electromyography, and dyspnea by the modified Borg scale. Muscle activation was measured in the diaphragm, scalene, sternocleidomastoid, and parasternal muscles. The evaluation was made in the dyspnea relief positions (sitting leaning forward, sitting leaning forward at a table, leaning forward with back against a wall, standing leaning forward, and high lying), seated erect, supine, and side lying. RESULTS: There were significant differences between the 8 positions (P < .001). There was no significant difference in muscle activation between sitting leaning forward and sitting leaning forward at a table position with analyzing post hoc test results (P > .99 for each muscle). However, muscle activation was lower in these 2 positions than in the other positions (P < .001 for each muscle). Muscle activation was greater in the supine position than in the other positions (P < .001 for each muscle). No difference was observed in muscle activation between the seated erect, leaning forward with back against a wall, standing leaning forward, high-lying, or side-lying positions (P > .05 for each muscle with a minimum P value of .09). CONCLUSIONS: The use of sitting leaning forward and sitting leaning forward at a table positions together with breathing control may help people with COPD to achieve more effective dyspnea relief and greater energy efficiency. [ABSTRACT FROM AUTHOR]

Background Sidestep cutting technique is highly individual and has been shown to influence knee joint loading. However, studies assessing whether individualized technique feedback improves technique and ACL injury-relevant knee joint loads instantly in a sport-specific task are lacking. Purpose To determine the instant effects of individualized augmented technique feedback and instructions on technique and the peak external knee abduction moment (pKAM) in a handball-specific sidestep cut. Additionally, to determine the effects of technique modifications on the resultant ground reaction force and its frontal plane moment arm to the knee joint center. Study Design Controlled laboratory cohort study Methods Three-dimensional biomechanics of 48 adolescent female handball players were recorded during a handball-specific sidestep cut. Following baseline cuts to each side, leg-specific visual and verbal technique feedback on foot strike angle, knee valgus motion, or vertical impact velocity using a hierarchically organized structure accounting for the variables' association with performance was provided. Subsequently, sidestep cuts were performed again while verbal instructions were provided to guide technique modifications. Combined effects of feedback and instructions on technique and pKAM as well as on the resultant ground reaction force and its frontal plane moment arm to the knee joint center were assessed. Results On average, each targeted technique variable improved following feedback and instructions, leading to instant reductions in pKAM of 13.4% to 17.1%. High inter-individual differences in response to feedback-instruction combinations were observed. These differences were evident in both the adherence to instructions and the impact on pKAM and its components. Conclusion Most players were able to instantly adapt their technique and decrease ACL injury-relevant knee joint loads through individualized augmented technique feedback, thereby potentially reducing the risk of injury. More research is needed to assess the retention of these adaptations and move towards on-field technique assessments using low-cost equipment. Level of Evidence: Level 3 [ABSTRACT FROM AUTHOR]

Balance assessments are an important component of rehabilitation. Considering the increasing use of telemedicine to meet rehabilitation needs, it is important to examine the feasibility of such assessments. This study aimed to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment Balance Subscale (POMA-B) when applied via synchronous and asynchronous tele-assessment. Twenty-five patients with chronic stroke were included in the study. The first physiotherapist assessed the patients on the first day in a face-to-face clinical setting. Synchronous or asynchronous tele-assessment was applied the next day. The assessments were performed in the same time zone, with an interval of one day. The synchronous tele-assessment was done online in real time by the first and second physiotherapists. A reference assessment video was sent to the patients for asynchronous tele-assessment. They were asked to make a video recording while performing the evaluation activities according to the reference video. Then the first and second physiotherapists assessed these video recordings separately. All the tests were repeated 10 days later to determine the intra-rater reliability of the tele-assessment methods. The intra-class correlation coefficients ranged from 0.96 to 0.98 for inter-rater reliability and from 0.97 to 0.98 for intra-rater reliability for both tele-assessment methods. Both asynchronous and asynchronous tele-assessment methods were medium correlated with the face-to-face versions. We demonstrated the validity and reliability of the POMA-B in chronic stroke patients with different tele-assessment methods, typically using the internet and available devices. [ABSTRACT FROM AUTHOR]

BACKGROUND: It is extremely important for nursing students to be professionally motivated to train qualified future professional nurses. Students' vocational motivation is affected by their experiences in clinical and academic learning environments. OBJECTIVE: The aim of this study was to investigate the correlation between the vocational motivation levels of nursing students and their attitudes toward clinical practice. METHODS: 292 nursing students participated in the cross-sectional, descriptive study. The Student Information Form, Nursing Students' Attitudes Towards Clinical Practices Scale, Motivation Sources and Problems Scale (MSPS) were used to gather the data. RESULTS: The average score for students' attitudes toward clinical practice was 107.08±18.13, while the total score for MSPS stood at 3.80±0.63. A positive correlation was identified between the attitude toward clinical practice and vocational motivation levels (r = 0.367; p < 0.001). There were positive correlations between the intrinsic motivation (r = 0.572; p < 0.001) and extrinsic motivation (r = 0.58; p < 0.001), and negative correlations were observed between the negative motivation (r = -0.324; p < 0.001) and the attitude toward clinical practice scale. There were positive correlations between belief and expectation (r = 0.492; p < 0.001) and positive approach (r = 0.532; p < 0.001) with the MSPS. In the multiple regression analysis, intrinsic motivation, extrinsic motivation, satisfaction with studying nursing, and participation in vocational courses were determined as effective predictors of attitudes towards clinical practice and explained 60.4% of the variance. CONCLUSIONS: The study concluded that nursing students' attitudes toward clinical practices affect vocational motivation. Clinical learning environments should be arranged in a way to increase the motivation level of students towards professional learning. [ABSTRACT FROM AUTHOR]

Background & Objective: There is disagreement about the correlation between serum 25-OH vitamin D (25OH-D) concentrations and ovarian reserve. The aim of this study was to evaluate the correlation between serum levels of 25OH-D and ovarian reserve parameters, including Anti-mullerian hormone (AMH), Follicle stimulating hormone (FSH), and Antral follicular count (AFC) in the tropical zone. Materials & Methods: In this cross-sectional study, 148 infertile women were enrolled. On the third day of their cycles, vitamin D3, FSH, and AMH were measured. An ultrasound scan was done for the measurement of the ovaries AFC. Participants were divided into women with normal ovarian reserve (NOR) and women with diminished ovarian reserve (DOR). Then two groups were compared based on the levels of vitamin D. Results: Our findings showed that there were significant differences in vitamin D levels between the DOR and NOR groups (11.52±12.24 and 22.74±12.7, respectively), (P value <0.001). The partial Spearman correlation test depicted an inverse relationship between vitamin D and FSH (rho=-0.21, P =0.009). Also, there was a positive relationship between vitamin D and AMH and AFC, (rho=0.27, P=0.001) and (rho=0.39, P< 0.001) respectively. Conclusion: This study demonstrated that there was an inverse relationship between levels of vitamin D and FSH and a positive relationship with AMH and AFC. It appears that the level of vitamin D is important in DOR. [ABSTRACT FROM AUTHOR]

Purpose: Musculoskeletal disorders (MSDs) are common worldwide and gender differences exist in terms of prevalence and disability. MSDs are a leading cause of sick leave and physical work exposures. To assess the association between physical exposures assessed by the gender-specific CONSTANCES Job-Exposure Matrix (JEM) and musculoskeletal pain in six areas: neck pain, shoulder pain, elbow/arm pain, hand/wrist pain, low back pain, knee/leg pain; and to compare the results with those obtained using the non-gendered CONSTANCES JEM and with individual self-report exposures. Methods: We included 48,736 male and 63,326 female workers from the CONSTANCES cohort (France). The association between 27 physical exposures and musculoskeletal self-reported pain in six body areas was assessed using logistic regression. We conducted the analysis with three types of exposures: (1) individual self-reported exposures; (2) gender-specific CONSTANCES JEM; (3) non-gendered CONSTANCES JEM, and adjusted for age and Body Mass Index (BMI). Analyses were stratified by gender. Results: The associations to the gender-specific and non-gendered JEM were similar. The odds ratios using individual self-reported exposures were comparable to the JEM-based associations, with the exceptions of the exposures 'change tasks', 'rest eyes' and 'reach behind'. In some comparisons, there were differences in the direction and/or significance of effects between genders (regardless of whether the JEM used was gender-specific or not). Conclusion: The gender-specific and non-gendered JEMs gave similar results, hence, developing physical work exposures JEMs that are gender-specific may not be essential. However, when predicting musculoskeletal pain, it seems relevant to stratify the analysis by gender. [ABSTRACT FROM AUTHOR]

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Introduction: Chronic graft-versus-host disease (GVHD) following hematopoietic stem cell transplantation (HSCT) is associated with poor health-related quality of life (HRQoL) and functional status. However, few studies have evaluated chronic GVHD–related disability and specific activity limitations from a patient perspective. The objective of this analysis was to assess physical, cognitive, and work disability, and describe factors predictive of disability in patients with chronic GVHD in the potentially employable general workforce. Methods: The cross-sectional, online, Living With Chronic GVHD Patient Survey was administered in 2020 to adult US patients who reported an active chronic GVHD diagnosis (i.e., within the previous 5 years) following HSCT. Data included demographics, diagnosis, work status, chronic GVHD symptoms per the Lee Symptom Scale (LSS), and effects on daily living activities. Descriptive and correlational analyses informed composite disability definitions: (1) severe cognitive disability, (2) severe physical disability, and (3) work disability. Results: Of 137 respondents with GVHD included in this analysis, 47.0% reported severe cognitive disability, and approximately two-thirds each reported severe physical disability (67.4%) and work disability (62.8%). Chronic GVHD severity/duration, symptoms (Lee Symptom Scale), and number of transplant specialists consulted were associated with all types of disability (univariable analyses). Severe cognitive disability was associated with the number of transplant specialists consulted, severe physical disability with female sex, and work disability with nonwhite race. Conclusions: In this analysis, we found that the presence of specific symptoms and the number of transplant specialists consulted were associated with all types of severe disability; female sex was predictive of severe physical disability and nonwhite race of work disability. These findings add to the understanding of chronic GVHD-associated disability, suggest a need for improved social support for patients, and highlight potential indicators for those most in need. Plain Language Summary: Chronic graft-versus-host disease (GVHD) is a possible serious complication that can occur after someone has received a bone marrow or stem cell transplant from another person. Symptoms of chronic GVHD can be severe and can affect quality of life. To better understand exactly how chronic GVHD affects quality of life, we asked adults in the USA with chronic GVHD to fill out a survey. The objective of this research was to find out how chronic GVHD affects daily activities and work. The survey asked about physical activities including personal hygiene, eating, shopping, and ability to use the restroom, and the survey asked about mental tasks including managing personal finances and interactions with other people. The survey also asked questions about work, such as the need to take disability leave or to leave a job due to chronic GVHD. Many people with chronic GVHD who completed the survey said they had severe difficulty with mental and/or physical tasks, and many had work-related disability. People with more severe chronic GVHD who had met with many transplant specialists were more likely to have difficulty with mental and physical tasks and also to have work disability. Women who completed the survey were more likely to report severe physical disability than men, and nonwhite participants were more likely to report work disability. The results of this survey highlight a need for improved social support for patients with chronic GVHD. [ABSTRACT FROM AUTHOR]

Dolutegravir, an integrase strand inhibitor, has been linked to an increase in body mass index among adults. However, little is known about its effect on adolescents. The study assessed the effect of a dolutegravir-based regimen on adolescents' body weight and emphasized the gender-specific differences in weight gain, if any. This prospective cohort study was conducted among 182 treatment-experienced adolescents living with HIV at a tertiary hospital in Southeast Nigeria. The body mass index measurements were calculated before transitioning to dolutegravir and after six months of being on the dolutegravir regimen. A comparison of the difference in mean body mass index before and after dolutegravir-based therapy was determined using a paired t-test. At the end of the six-month follow-up, there was a significant increase in the respondents' overall body mass index z-score (t = −10.00, p < 0.001). There was a significant increase in the body mass index z-score of both genders (male; t = −7.49, p < 0.001, female; t = −6.91, p < 0.001). The dolutegravir-based therapy (β-coefficient = −0.17, t = − 2.09, p < 0.001) and baseline body mass index z-score (β-coefficient = 0.76, t = 15.86, p < 0.001) were significant predictors of body mass index z-score at six months. In adolescents living with HIV, the transition to dolutegravir is associated with increased body weight. Female adolescents tend to gain more weight compared to males. Therefore, there is a need for regular monitoring of body weight for early detection of obesity and prompt intervention. [ABSTRACT FROM AUTHOR]

Aims Data on mitral annular disjunction (MAD) in children with Marfan syndrome (MFS) are sparse. To investigate the diagnostic yield of MAD by echocardiography and cardiac magnetic resonance imaging (CMR), its prevalence and progression during childhood. Methods and results We included patients <21 years old with MFS, defined by 2010 Ghent criteria and a pathogenic FBN1 variant or ectopia lentis. Two readers measured systolic separation between the mitral valve (MV) posterior hinge point and left ventricular (LV) myocardium on initial and subsequent imaging. MAD was defined as MV-LV separation ≥2 mm, MV prolapse (MVP) as atrial displacement ≥2 mm. Kappa coefficients evaluated echocardiogram–CMR agreement. Bland–Altman and intraclass correlation coefficients (ICCs) assessed inter-rater and inter-modality reliability. Univariable mixed-effects linear regression was used to evaluate longitudinal changes of MAD. MAD was detected in 60% (110/185) eligible patients. MVP was present in 48% (53/110) of MAD and MAD in 90% (53/59) of MVP. MAD detection by CMR and echocardiography had 96% overall agreement (Kappa = 0.89, P < 0.001) and a 0.32 mm estimate bias (95% CI 0.00, 0.65). ICC by echocardiography, CMR, and between modalities were 0.97 (95% CI 0.93, 0.98), 0.92 (95% CI 0.79, 0.97), and 0.91 (95% CI 0.85, 0.94), respectively. MAD was associated with aortic root dilation (P < 0.001). MAD was found in children of all ages, increased +0.18 mm/year (95% CI +0.14, +0.22) during a median duration of 5.5 years (IQR 3.1, 7.5 years). MAD indexed by height yielded a constant value +0.0002 mm/m/year (95% CI −0.0002, +0.0005 mm/m/year). Conclusion MAD was common in pediatric MFS and was associated with aortic root dilation. MAD detection by echocardiography and CMR was highly reliable, suggesting that routine assessment in MFS is feasible. MAD was present in neonates and progressed over time but remained constant when indexing by height. Further studies are needed to evaluate MAD as a biomarker for clinical outcomes in pediatric MFS. [ABSTRACT FROM AUTHOR]

Introduction: Health literacy (HL) is correlated with the risk of mortality and readmission during cardiac rehabilitation. However, the correlation between HL and utility-based health-related quality of life (HRQOL) scores has been poorly documented. Therefore, we examined the correlation between HL and utility-based HRQOL scores in participants undergoing cardiac rehabilitation. Methods: The data of 448 participants undergoing cardiac rehabilitation from the Kobe-Cardiac Rehabilitation Project for People Around the World (K-CREW) clinical trial were analyzed. Participants were divided into low and high HL cohorts. We used the 14-item Health Literacy Scale (HLS-14) to assess HL and the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire to assess HRQOL at discharge. The utility scores of the EQ-5D-5L questionnaire were calculated. The median age was 71.0 [61.0–78.0] years, 75.7% of participants were male, and 60% had a low HL. Results: Median utility score was 0.88 [0.75–1.00]. Regarding the dimensions of the EQ-5D-5L questionnaire, more than 60% of participants responded positively to the severity level of "no problem." In the comparative analysis, the low HL cohort had a statistically significantly lower utility score than that of the high HL cohort (p-value = 0.03). The multivariate analysis revealed that the HLS-14 scores were not statistically significantly correlated with the utility scores. Conclusion: Participants with low HL had lower HRQOL in the comparative analysis. However, multivariate analysis revealed that HL was not statistically significantly correlated with utility-based HRQOL scores. Future studies should explore the influence of confounding or intermediate variables on the correlation between HL and HRQOL. [ABSTRACT FROM AUTHOR]

Background: Magnetic resonance spectroscopy (MRS) studies have indicated that the imbalance between gamma-aminobutyric acid (GABA) and glutamate/glutamine (Glx) levels was the potential cause of migraine development. However, the changes in the GABA and Glx levels in patients with New daily persistent headache (NDPH) remain unclear. This study aimed to investigate the changes in GABA and Glx levels in the periaqueductal gray (PAG) and dentate nucleus (DN) in patients with NDPH using the MEGA-PRESS sequence. Methods: Twenty-one NDPH patients and 22 age- and sex-matched healthy controls (HCs) were included and underwent a 3.0T MRI examination, using the MEGA-PRESS sequence to analyze GABA and Glx levels of PAG and DN. The correlations between these neurotransmitter levels and clinical characteristics were also analyzed. Results: There were no significant differences in the GABA+/Water, GABA+/Cr, Glx/Water, and Glx/Cr levels in both PAG and DN between the two groups (all p > 0.05). Moderate-severe NDPH patients had lower levels of Glx/Water (p = 0.034) and Glx/Cr (p = 0.012) in DN than minimal-mild NDPH patients. In patients with NDPH, higher Glx/Water levels in the PAG (r=-0.471, p = 0.031, n = 21) and DN (r=-0.501, p = 0.021, n = 21) and higher Glx/Cr levels in DN (r=-0.483, p = 0.026, n = 21) were found to be correlated with lower Visual Analogue Scale scores. Additionally, a positive correlation was observed between the GABA+/Cr levels in the DN and the Generalized Anxiety Disorder-7 scores (r = 0.519, p = 0.039, n = 16). Conclusions: The results of this study indicated that the GABA and Glx levels in the PAG and DN may not be the primary contributor to the development of NDPH. The correlations between certain clinical scales and the neurotransmitter levels may be derived from the NDPH related symptoms. [ABSTRACT FROM AUTHOR]

Background: The significance of CXCL5 in pancreatic cancer is unclear, although it has been implicated in the malignant process of many different types of cancer. Research on the impact of CXCL5 on immune cell infiltration and the malignant phenotype of pancreatic cancer is needed. This study aimed to examine the connection between CXCL5 expression and immune cell infiltration and the malignant phenotype of pancreatic cancer. Methods: Tissue samples and clinical information were collected from 90 patients with pancreatic cancer. Tumour tissues and adjacent tissues were made into a tissue microarray and stained for immunohistochemistry analysis. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and Western blot analysis were performed to measure the expression level of CXCL5. CXCL5-overexpressing/CXCL5-knockdown cell lines were constructed via transfection for cytological experiments. CCK-8, cell apoptosis, cell cycle, cell invasion, and cell colony formation assays were used to detect the effect of CXCL5 on the malignant phenotype of pancreatic cancer cells. Finally, a mouse model of pancreatic cancer was constructed for in vivo verification. Results: Compared with control cells, pancreatic cancer cells overexpressing CXCL5 exhibited increased proliferation, migration, and invasion but decreased apoptosis. Conversely, knockdown of CXCL5 did not enhance the malignant phenotype of pancreatic cancer cells. Spearman correlation analysis indicated that there was a significant negative correlation between CXCL5 levels and the CD8 IRS. However, there was a significant positive correlation between FOXP3 IRS and CXCL5 levels. Conclusions: CXCL5 is highly expressed in pancreatic cancer and promotes the malignant phenotype of pancreatic cancer cells. CXCL5 is associated with immunosuppressive FOXP3 + T-cell infiltration, which facilitates the formation of an immunosuppressive microenvironment (with low CD8 + T-cell infiltration). [ABSTRACT FROM AUTHOR]

Background: Evidence from animal and human studies suggests glutamatergic dysfunction in posttraumatic stress disorder (PTSD). The purpose of this study was to investigate glutamate abnormalities in the dorsolateral prefrontal cortex (DLFPC) of individuals with PTSD using 7T MRS, which has better spectral resolution and signal-to-noise ratio than lower field strengths, thus allowing for better spectral quality and higher sensitivity. We hypothesized that individuals with PTSD would have lower glutamate levels compared to trauma-exposed individuals without PTSD and individuals without trauma exposure. Additionally, we explored potential alterations in other neurometabolites and the relationship between glutamate and psychiatric symptoms. Methods: Individuals with PTSD (n = 27), trauma-exposed individuals without PTSD (n = 27), and individuals without trauma exposure (n = 26) underwent 7T MRS to measure glutamate and other neurometabolites in the left DLPFC. The severities of PTSD, depression, anxiety, and dissociation symptoms were assessed. Results: We found that glutamate was lower in the PTSD and trauma-exposed groups compared to the group without trauma exposure. Furthermore, N -acetylaspartate (NAA) was lower and lactate was higher in the PTSD group compared to the group without trauma exposure. Glutamate was negatively correlated with depression symptom severity in the PTSD group. Glutamate was not correlated with PTSD symptom severity. Conclusion: In this first 7T MRS study of PTSD, we observed altered concentrations of glutamate, NAA, and lactate. Our findings provide evidence for multiple possible pathological processes in individuals with PTSD. High-field MRS offers insight into the neurometabolic alterations associated with PTSD and is a powerful tool to probe trauma- and stress-related neurotransmission and metabolism in vivo. [ABSTRACT FROM AUTHOR]

Aims: It was conducted to investigate digital gaming addiction among nursing students and the associated factors of such addiction. Methods: The descriptive and relationship-seeking study's universe included 1665 nursing students in three universities' nursing faculties and departments. The sample size was determined to be 774 based on a power analysis with a type I error rate of 0.05, a power of the test of 0.80 (α = 0.05, 1-β = 0.80), and an effect size of d = 0.10. Student Information Form, The Digital Game Addiction Scale (DGAS-7), and the Digital Game Playing Motivation Scale (DGPMS) were used to collect student information. Data analysis was performed using the Mann–Whitney U test, Kruskal–Wallis H test, Spearman correlation, and Binary Logistic Regression Model. Results: It was found that 83.7% of the students were female, and the mean age and BMI were 20.03 ± 1.72 years and 21.98 ± 2.90 kg/m2, respectively. A statistically significant positive correlation was found between the students' Digital Game Addiction Scale and Digital Game Playing Motivation Scale Achievement and Energizing (r = 0.717), Curiosity and Social Acceptance (r = 0.612), and Uncertainty in Game Desire (r = -0.110) sub-dimensions mean scores (p < 0.001). Conclusions: The relationship between nursing students' digital game addiction, game playing motivation, and several individual characteristics affecting digital games was found. The study's results call for further research to focus on developing and testing interventions that could effectively reduce gaming addiction while enhancing positive aspects of digital engagement among nursing students. [ABSTRACT FROM AUTHOR]

Simple Summary: The presented article is devoted to the study of the safety, biodistribution and absorbed doses of a new radiopharmaceutical for diagnostics and evaluation of the treatment efficiency of tumors with hyperexpression of epithelial cell adhesion molecules by single-photon emission computed tomography. The results of the study showed the safety and tolerability of [99mTc]Tc(CO)3-(HE)3-Ec1 in patients with lung tumors. The absorbed dose values for [99mTc]Tc(CO)3-(HE)3-Ec1 SPECT are also within the acceptable limits. Also, [99mTc]Tc(CO)3-(HE)3-Ec1 SPECT showed primary diagnostic efficiency in visualizing tumors with EpCAM expression and regional metastases. The promising use of [99mTc]Tc(CO)3-(HE)3-Ec1 will allow the selection of patients for targeted immunotherapy of tumors and evaluation of the efficiency of such treatment. A high level of EpCAM overexpression in lung cancer makes this protein a promising target for targeted therapy. Radionuclide visualization of EpCAM expression would facilitate the selection of patients potentially benefiting from such treatment. Single-photon computed tomography (SPECT) using 99mTc-labeled engineered scaffold protein DARPin Ec1 has shown its effectiveness in imaging tumors with overexpression of EpCAM in preclinical studies, providing high contrast just a few hours after injection. This first-in-human study aimed to evaluate the safety and distribution of [99mTc]Tc(CO)3-(HE)3-Ec1 in patients with primary lung cancer. Twelve lung cancer patients were injected with 300.7 ± 103.2 MBq of [99mTc]Tc(CO)3-(HE)3-Ec1. Whole-body planar imaging (at 2, 4, 6 and 24 h after injection) and SPECT/CT of the lung (at 2, 4, and 6 h) were performed. The patients' vital signs and possible side effects were monitored up to 7 days after injection. The patients tolerated the injection of [99mTc]Tc(CO)3-(HE)3-Ec1 well, and their somatic condition remained normal during the entire follow-up period. There were no abnormalities in blood and urine tests after injection of [99mTc]Tc(CO)3-(HE)3-Ec1. The highest absorbed doses were in the kidneys, liver, pancreas, thyroid, gallbladder wall, and adrenals. There was also a relatively high accumulation of [99mTc]Tc(CO)3-(HE)3-Ec1 in the small and large intestines, pancreas and thyroid. According to the SPECT/CT, accumulation of [99mTc]Tc(CO)3-(HE)3-Ec1 in the lung tumor was found in all patients included in the study. Intensive accumulation of [99mTc]Tc(CO)3-(HE)3-Ec1 was also noted in regional metastases. [99mTc]Tc(CO)3-(HE)3-Ec1 can potentially be considered a diagnostic tracer for imaging EpCAM expression in lung cancer patients and other tumors with overexpression of EpCAM. [ABSTRACT FROM AUTHOR]

Aims: It is extremely important to determine the relationship between COPD and self‐management (SM) in the disease process. However, the impact of symptom management (SpM) on this relationship is still unclear. The study aimed to examine the mediating role of SpM in the effect of the COPD stage on SM. Design: A predictive correlational study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Methods: This study was conducted between 15 February 2023 and 15 June 15 2023, with 306 patients. Data were collected using the Symptom Management Scale for Self‐Efficacy and the Chronic Disease Self‐Management Scale. Descriptive statistics and Process Macro Model 4 in the SPSS program were used for data analysis. Results: Most of the patients were in the moderate stage of COPD; their SM scores were at low levels; SpM scores were at moderate levels. The model was significant, and the variables explained 65% of the model. The COPD stage was significantly positively correlated with SpM and negatively correlated with SM. There was a significant positive impact between SpM and SM. The positive and significant standardised indirect effect of SpM on SM evidenced a full mediating effect. Conclusions: Symptom management has a full mediating role in the effect of the COPD stage on SM. It was revealed that the level of SM can be increased by achieving SpM. Implications for the Profession and/or Patient Care: Symptoms are vital in COPD. Progression of COPD increases symptom severity. Being successful in SpM greatly contributes to the achievement of self‐management. Therefore, nurses should definitely consider symptom control in strengthening self‐management in the care of patients with COPD. Patient or Public Contribution: Patients' COPD stage was determined by a pulmonologist involved in the study. Voluntary patients with COPD hospitalised in the pulmonology clinic were included in the study. [ABSTRACT FROM AUTHOR]

Background: The Geriatrics Health Behavior Questionnaire (GHBQ) is essential for assessing health-related behaviors among older adults populations. This study focuses on the translation, cultural adaptation, and psychometric evaluation of the Arabic version of the GHBQ to ensure its relevance and accuracy for Arabic-speaking older adults individuals. Methods: This cross-sectional study was conducted at the Cairo University Educational Hospital's outpatient clinic. The GHBQ was translated and culturally adapted through a systematic process, including initial translation, back-translation, expert review, and pilot testing. The psychometric properties of the Arabic-translated GHBQ were evaluated using a sample of 200 older adults Arabic-speaking participants. Reliability was assessed using Cronbach's alpha (α) and Intraclass Correlation Coefficient (ICC). Validity was evaluated through Content Validity Index (CVI), Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA). Results: The Arabic GHBQ demonstrated excellent reliability with Cronbach's alpha values ranging from 0.74 to 0.87 across subscales and ICC values confirming reproducibility (ICC = 0.82). The CVI indicated strong content validity (average CVI = 0.91). EFA revealed a five-factor structure, explaining 72% of the variance, with all factor loadings exceeding 0.60. CFA supported the questionnaire's structure with fit indices meeting recommended criteria: χ²/df = 2.05, NFI = 0.92, TLI = 0.94, GFI = 0.90, SRMR = 0.05, AIC = 140.35, and BIC = 160.22. Criterion validity was confirmed through significant correlations with established health behavior measures (r = 0.63, p < 0.001). Conclusions: The culturally adapted Arabic version of the GHBQ is a reliable and valid tool for assessing health behaviors in the older adults population in Egypt. This instrument can aid healthcare providers in identifying and addressing health behaviors, ultimately improving the well-being of this demographic. Future research should focus on expanding the sample and comparing the GHBQ with other similar tools used in Arabic-speaking populations. [ABSTRACT FROM AUTHOR]

Introduction: During the COVID-19 pandemic, many countries implemented restrictions, social distancing measures, and lockdowns to limit the spread of the disease. These lockdowns have affected children's screen time (ST), pain, and physical activity (PA) levels. The present study aimed to explore the relationships between ST, pain, age, and PA before, during, and after the COVID-19 pandemic. Methods: The caregivers of 329 children (median age = 8 years) filled out an online self-reported survey about the children's PA, ST, and pain before, during, and after the COVID-19 curfew. Spearman's rank correlation coefficient was used to explore the associations between these variables. Results: After the curfew, pain that existed before the pandemic had a weak negative relationship with PA intensity (−0.11, p = 0.04) and a weak positive relationship with ST (r = +0.12, p = 0.04). There was a strong positive relationship between ST in all time periods (p > 0.01). PA and ST had a weak negative relationship (p > 0.05) during the curfew and after the curfew but not before the COVID-19 pandemic. Age had a weak positive correlation with ST in all time periods (p > 0.01). In addition, ST was affected by the curfew. Conclusion: The study findings indicated that young children had longer ST during the curfew and after the curfew compared with before the curfew. Increasing PA could lessen children's ST, which could, in turn, increase the probability that their general pain would decrease. [ABSTRACT FROM AUTHOR]

Introduction. Peripheral retinal refraction plays a crucial role in myopia, but the specific mechanism is not clear. We refined the retinal partitions to explore the characteristics of peripheral retinal refraction and its role in emmetropic, low, and moderate myopic children aged 6 to 12 years. Methods. A total of 814 subjects (814 eyes) were enrolled in the study. The participants were divided into three groups according to the central spherical equivalent refraction (SER), which were emmetropia group (E), low myopia group (LM) and moderate myopia group (MM). Multispectral refractive topography (MRT) was used to measure the retinal absolute and relative refractive difference value (RDV) in different regions. The range was divided into superior, inferior, temporal, and nasal RDV (SRDV, IRDV, TRDV, and NRDV) on the basis of several concentric circles extending outward from the macular fovea (RDV15, RDV30, RDV45, RDV30–15, RDV45–30, and RDV‐45). Kruskal–Wallis test was used to analyze the differences of peripheral refraction for all the regions among the three groups. Spearman rank correlation was performed to explore correlations between SER and RDV, axial length (AL) and RDV. Results. The absolute value of RDV decreased with increasing degree of myopia in all regions (P < 0.01). Subjects with different refractive degrees had different relative value of RDV. In nasal position within 45° and temporal position within 30°, the peripheral retina exhibited significantly different relative hyperopic refractive status among Group E, Group LM, and Group MM (P < 0.05). SER was negatively correlated with NRDV within 30° (especially in the range of NRDV30–15) (r = −0.141, P < 0.01), positively correlated with TRDV within 15° (r = 0.080, P = 0.023), and not significantly correlated with SRDV and IRDV when the retina was divided into four parts. AL was positively correlated with NRDV within 30° (especially in the range of NRDV30–15) (r = 0.109, P = 0.002), negatively correlated with TRDV within 15° (r = −0.095, P = 0.007). Conclusions. The peripheral defocus has significant implications for the genesis of myopia. The peripheral defocus of the horizontal direction, especially within the range of NRDV30, has greater effect on the development of myopia in children. Higher NRDV30 is associated with lower SER and longer AL. [ABSTRACT FROM AUTHOR]