Quantitative analysis of soil potassium by near-infrared (NIR) spectroscopy combined with a three-step progressive hybrid variable selection strategy.

Soil potassium is a crucial nutrient element necessary for crop growth, and its efficient measurement has become essential for developing rational fertilization plans and optimizing crop growth benefits. At present, data mining technology based on near-infrared (NIR) spectroscopy analysis has proven to be a powerful tool for real-time monitoring of soil potassium content. However, as technology and instruments improve, the curse of the dimensionality problem also increases accordingly. Therefore, it is urgent to develop efficient variable selection methods suitable for NIR spectroscopy analysis techniques. In this study, we proposed a three-step progressive hybrid variable selection strategy, which fully leveraged the respective strengths of several high-performance variable selection methods. By sequentially equipping synergy interval partial least squares (SiPLS), the random forest variable importance measurement (RF(VIM)), and the improved mean impact value algorithm (IMIV) into a fusion framework, a soil important potassium variable selection method was proposed, termed as SiPLS-RF(VIM)-IMIV. Finally, the optimized variables were fitted into a partial least squares (PLS) model. Experimental results demonstrated that the PLS model embedded with the hybrid strategy effectively improved the prediction performance while reducing the model complexity. The RMSET and RT on the test set were 0.01181% and 0.88246, respectively, better than the RMSET and RT of the full spectrum PLS, SiPLS, and SiPLS-RF(VIM) methods. This study demonstrated that the hybrid strategy established based on the combination of NIR spectroscopy data and the SiPLS-RF(VIM)-IMIV method could quantitatively analyze soil potassium content levels and potentially solve other issues of data-driven soil dynamic monitoring.

One-year budget impact of InTandem™: a novel neurorehabilitation system for individuals with chronic stroke walking impairment.

Aim: Chronic stroke walking impairment is associated with high healthcare resource utilization (HCRU) costs. InTandem™ is a neurorehabilitation system that autonomously delivers a rhythmic auditory stimulation (RAS)-based intervention for the at-home rehabilitation of walking impairment in adults in the chronic phase of stroke recovery. This study was conducted to estimate the budget impact of InTandem in comparison with currently available intervention strategies for improvement of gait/ambulation in individuals with chronic stroke walking impairment. Methods & materials: A budget impact analysis (BIA) for InTandem was conducted based on a 1-million-member US third-party payer perspective over a 1-year time horizon. Key inputs for the budget impact model were: costs for each intervention strategy (InTandem, physical therapy, self-directed walking and no treatment), HCRU costs for persons with chronic stroke and anticipated HCRU cost offsets due to improvements in gait/ambulatory status as measured by self-selected comfortable walking speed (based on functional ability). In addition to the reference case analysis, a sensitivity analysis was conducted. Results: Based on the reference case, introduction of InTandem was projected to result in overall cost savings of $439,954 in one year. Reduction of HCRU costs (-$2,411,778) resulting from improved walking speeds with InTandem offset an increase in intervention costs (+$1,971,824). Demonstrations of cost savings associated with InTandem were robust and were consistently evident in nearly all scenarios evaluated in the sensitivity analysis (e.g., with increased/decreased patient shares, increased HCRU cost or increased InTandem rental duration). Conclusion: The InTandem system is demonstrated to improve walking and ambulation in adults in the chronic phase of stroke recovery after a five-week intervention period. The BIA predicts that introduction of InTandem will be associated with overall cost savings to the payer.

Environmental sustainability in gynecologic oncology.

Climate change is a complex, global issue that is impacting human health in various ways, with healthcare being a significant contributor to carbon emissions in the United States. This review discusses the environmental impact of important aspects of gynecologic oncology care, including surgery, anesthesia care, radiology, chemotherapy, and radiation oncology. Operating room energy and material use is highlighted, with a focus on the environmental impact of robotic surgery. The contribution of certain anesthetic gases in increasing greenhouse gas emissions is addressed. Additionally, the environmental impacts of radiologic imaging, chemotherapy, and radiation oncology are also discussed. Despite the complexity of climate change, there are multiple strategies on the individual and institutional level that can help mitigate the environmental impact of gynecologic oncology care. Individual efforts include practicing red bag stewardship, limiting single use-supplies, decreasing the use of potentially deleterious anesthetics, and supporting research into alternative dosing for chemotherapy and radiation which requires less patient travel. Institutional strategies include investing in efficient HVAC systems, utilizing reusable and reprocessed materials and devices, and purchasing renewable energy sources. Both individuals and institutions can advocate with industry and government at all levels for practices and policies that support lower carbon emissions. By recognizing our role in reducing carbon emissions, we can work towards improving the well-being of our patients and the larger community.

Social network influence based on SHIR and SLPR propagation models.

The rapid progress of science and technology has revolutionized the dissemination of information, with the Internet playing a crucial role. While it has enhanced the ease of sharing information, it has also hastened the transmission of emotions on social media, sometimes resulting in unintended negative outcomes. This research seeks to tackle this issue by suggesting an innovative technique for analyzing social network influence using the Susceptible Hesitant Infected Removed (SHIR) and Susceptible Latent Propagative Removal (SLPR) propagation models. Through the development of an emotional communication model, we take into account the effects of news and public opinion on the rate of emotional communication among individuals. Furthermore, we investigate the impact of various network structures on user behavior. The findings from experiments demonstrate a notable relationship between changes in the density of emotion spreaders and hesitants and the influence of nodes in different network configurations. Specifically, the analysis reveals that the peaks of hesitators and disseminators were lower when the node influence was reduced. Additionally, we verified the precision and dependability of our model by examining data from the Baidu Index, a tool for big data analysis. The margin of error between the model and the actual data was minimal, underscoring the efficacy of our approach. In essence, the study highlights a direct correlation between the speed and extent of emotional propagation in social networks and the degree of nodes. The results showed that the density changes of emotion spreaders and hesitants were significantly correlated with the influence of nodes in different network settings. In the case of node influence of 0.86, the highest peaks of hesitator H and disseminator I were 0.101 and 0.109 lower than those of influence of 1.25. The data analysis of the Baidu Index showed that the maximum peak error of the model was only 0.04, which verified the accuracy and reliability of the model. This investigation carries significant implications for efficiently managing and steering the dissemination of emotions on social media, thereby promoting a healthier online environment.

Environmental Sustainability Initiatives in the Operating Room: A Scoping Review.

The global healthcare industry has a substantial environmental footprint and therefore has a responsibility to decrease its impact. Changes to increase sustainability will only occur if healthcare providers (HCPs) and decision-makers understand and incorporate environmentally conscious practices in the operating room (OR). This scoping review aimed to assess hospital initiatives undertaken to support environmental sustainability in the OR, with a focus on HCP and hospital decision-maker beliefs and perceptions related to sustainability. A scoping review was conducted using Embase and PubMed. Searches were performed to identify relevant studies published between January 2011 and November 2022. A total of 163 publications were included: 10 systematic literature reviews and 153 original research articles. Most studies reported department-wide sustainability measures (waste reduction, staff education, etc), which were evaluated by the reduction in generated waste and energy, emission of greenhouse gasses, and costs. Despite up to 97% of HCPs noting willingness to improve sustainability within practices, up to 80.9% of HCPs stated that they lacked the necessary training and information. In conclusion, this research highlights a recent increase in interest about sustainability initiatives in the OR and that HCPs and surgical staff are not only willing to participate but also have suggestions on how to minimize the environmental impact of the OR.

Empowering Women's Health: Examining the Impact of Human Papillomavirus (HPV) Vaccination on Cervical Cancer Treatment and Beyond.

This study aims to identify the change in the health status of women, particularly in cervical cancer treatment through HPV vaccination. Thus, the research aims to measure the reduction in the incidence of cervical cancer in vaccinated women and evaluate the impact of HPV vaccination on the overall health and well-being of women treated for cervical cancer. The paper uses a research approach that involves reviewing the literature, analysing epidemiological data, and assessing the impact of the vaccination program. Major observations suggest that many developed countries' campaigns have reduced cervical cancer and enhanced treatment. Further, the study also addresses some additional effects of the intervention, both health-related with an emphasis on the decrease in healthcare costs and an enhancement of the quality of life among women, and social with a focus on the changes in women's status as a result of vaccination. The research also focusses on the community and economic points of view on HPV vaccination programs, its problems and opportunities regarding socio-economic factors, cultural disparities, and healthcare systems. This study implies that working on those barriers by implementing effective interventions, increasing awareness, and demanding relevant changes in policies could improve vaccination levels as well as outcomes. Hence, this research supports HPV vaccination as vital to the future health status of women. Through the use of survey data and the adoption of a public health perspective, the study can fill existing gaps in the literature on preventive interventions and cervical malignancies and consequently contribute to the enhancement of women's health, particularly in developing countries.

Economic Evaluation of a Novel Treatment of Attention-Deficit/Hyperactivity Disorder in US Motor Vehicle Drivers.

Background: Attention-deficit/hyperactivity disorder (ADHD) affects approximately 4.4% of US adults. ADHD is associated with high-risk driving behavior and costly motor vehicle accidents. DYANAVEL XR (DXR) (Tris Pharma, Inc.) is a once-daily fast-acting amphetamine developed for ADHD treatment. A randomized controlled trial showed that DXR patients were 43% less likely to crash during a driving simulation than individuals taking placebo. Study outcomes suggest a DXR crash rate similar to that of a driver without ADHD, while patients treated with the current standard of care (SOC) have a 52% higher crash risk than non-ADHD drivers. Objective: The aim was to evaluate the economic benefits attributable to improved driving abilities and avoided crashes in DXR patients compared with patients treated with the SOC or those who are untreated. Methods: A cost-impact model estimated 1-year crash-related cost outcomes for DXR-treated patients compared with SOC-treated and untreated ADHD patients. SOC was assumed to consist of a combination of short-, intermediate-, and long-acting ADHD stimulant and non-stimulant medications. DXR crash risk was assumed equivalent to the non-ADHD population risk, as supported by trial data. Crash risk for untreated and SOC-treated ADHD patients were assumed to be 99% and 52% higher than the general US population, respectively. Model outcomes included the cost impact (medication- and crash-related costs) and the number of crashes, injuries, and fatalities avoided with DXR. Results: Treatment with DXR would avoid 0.82 crashes, 0.016 injuries, and 0.036 fatalities per year compared with untreated patients, and 0.036 crashes, 0.007 injuries, and 0.0001 fatalities per year compared with SOC-treated patients. Compared with a population of 25% SOC-treated patients and 75% untreated patients, DXR use would save an average of 4581 p e r p e r s o n p e r y e a r a c r o s s a l l a g e g r o u p s w h e n p r i c e d a t 80 per month, assuming all SOC-treated and untreated patients utilized DXR. When the value of quality-of-life improvement is considered, savings increase over 7-fold. Discussion: Outcomes suggest that DXR may be an economically beneficial treatment compared with SOC for ADHD patients. Conclusions: The economic model showed that DXR is cost-saving compared with no treatment and SOC by reducing the number of motor vehicle crashes in the ADHD population.

Towards policy impact - an exploration of Clinical Toxicology research cited in policy documents and patents.

INTRODUCTION: Individual researcher impact through scientific citations is carefully monitored, with little attention to the impact of individual journals through policy and patent mentions. We aimed to describe policy and patent mentions for articles published in Clinical Toxicology. METHODS: Using Altmetric Explorer, we extracted mentions from 1 January 2013 to 31 December 2023, noting the citing source, Clinical Toxicology article title, and author-generated keywords. We used descriptive statistics to analyse the data. RESULTS: We identified 165 individual policy documents (n = 139) and patents (n = 26), citing 146 articles with median of 6.4 years between publication and mention. The highest number of citing documents were by the World Health Organization (n = 45), European Monitoring Centre for Drugs and Drug Addiction (n = 22), and United States Centers for Disease Control and Prevention (n = 16). Most patents were registered in the United States (n = 17) and by the European Patent Office (n = 10), with the main classification of human necessities (n = 23). The commonest subjects of papers cited in policy and patents, from keywords, related to medical conditions and symptoms (26%) and recreational drugs (22%). The most cited article was "A systematic review of adverse events arising from the use of synthetic cannabinoids and their associated treatment." DISCUSSION: Clinical Toxicology articles are cited in policy documents and patents, with a comparable number of mentions to the top-ranked journals in the field. This likely contributes to policy impact, but further work is needed to understand how cited articles are used and ripple effects through onwards citations of policy documents. CONCLUSIONS: Clinical Toxicology is a toxicology journal for which published research gets recognised within influential policy sources. The Journal can play a key role in guiding public health policy through its selection and development of submitted publications.

Supporting the investigation of health outcomes due to airborne emission by different approaches: current evidence for the waste incineration sector.

Life cycle assessment (LCA) along with a survey on epidemiologic and oxidative potential studies was used for analysing the current evidence of the impact of airborne emissions from municipal solid waste incineration (MSWI) on human health. The correspondence among investigated health outcomes and pollutants was discussed based on the Chemical Abstract Service (CAS) and the International Agency for Research on Cancer (IARC). LCA indicated the ability of MSWI in avoiding human health impact, about - 2 × 10-4 DALY/tonne together with avoided emissions of particulate matter (PM) and resource depletion, about - 2.5 × 10-3 kg Sbeq/tonne and about - 0.11 kg PM2.5 eq/tonne, respectively. Positive emissions were detected for greenhouses (about 900 kg CO2eq/tonne) and ecotoxicity (about 15,000 CTUe/tonne). Epidemiologic studies performed on population exposed to MSWI reported quite contrasting results. In some of these, hazard ratio (HR) ranging from about 0.7 to 2.2 was reported concerning the incidence of stomach, liver, breast and bladder cancer. Larger agreement was detected concerning the incidence of larynx and lung cancer with HR ranging from about 1 to about 2.6. Direct causal nexuses were not definitively identified. Oxidative potential of PM was characterized by a high Pearson correlation > 0.8 to the presence of CrVI, Cu and Zn. These heavy metals were also identified by both CAS and IARC as toxic (i.e. Cu and Zn) and cancerous (i.e. CrVI) substances affecting the organs of both respiratory and digestive apparatus. In general, even if more research is necessary, LCA, oxidative potential and the epidemiologic survey results showed a high level of accordance. This suggests their integrated exploitation for supporting the investigation of both direct and indirect consequences on environment and health related to waste incineration for both retrospective and predictive studies.

Analysis of factors affecting microbial degradation of cyanobacterial toxins based on theoretical calculations.

Cyanobacterial toxins are the most common algal toxins, which are highly toxic and can persist in the aquatic environment without easy degradation, posing risks to the ecosystem and human health that cannot be ignored. Although microbiological methods for the removal of cyanobacterial toxins from aqueous environments are highly efficient, their degradation efficiency is susceptible to many abiotic environmental factors. In this paper, Microcystin-LR (MC-LR) and its microbial degrading enzymes were selected to study the effects of common environmental factors (temperature (T), NO3-, NH4+, Cu2+, Zn2+) and their levels during microbial degradation of cyanobacterial toxins in aqueous environments by using molecular docking, molecular dynamics simulation, analytical factor design, and the combined toxicokinetics of TOPKAT (toxicity prediction). It was found that the addition of T, NO3- and Cu2+ to the aqueous environment promoted the microbial degradation of MC-LR, while the addition of NH4+ and Zn2+ inhibited the degradation; The level effect study showed that the microbial degradation of MC-LR was promoted by increasing levels of added T and NO3- in the aqueous environment, whereas it was inhibited and then promoted by increasing levels of NH4+, Cu2+ and Zn2+. In addition, the predicted toxicity of common Microcystins (MCs) showed that MC-LR, Microcystin-RR (MC-RR) and Microcystin-YR (MC-YR) were not carcinogenic, developmentally toxic, mutagenic or ocular irritants in humans. MC-LR and MC-RR are mild skin irritants and MC-YR is not a skin irritant. MC-YR has a higher chronic and acute toxicity in humans than MC-LR and MC-RR. Acute/chronic toxicity intensity for aquatic animals: MC-YR > MC-LR > MC-RR and for aquatic plants: MC-LR > MC-YR > MC-RR. This suggests that MC-YR also has a high environmental health risk. This paper provides theoretical support for optimizing the environmental conditions for microbial degradation of cyanobacterial toxins by studying the effects of common environmental factors and their level effects in the aquatic environment.

Development, calibration and validation of impact-specific cervical spine models: A novel approach using hybrid multibody and finite-element methods.

BACKGROUND AND OBJECTIVE: Spinal cord injuries can have a severe impact on athletes' or patients' lives. High axial impact scenarios like tackling and scrummaging can cause hyperflexion and buckling of the cervical spine, which is often connected with bilateral facet dislocation. Typically, finite-element (FE) or musculoskeletal models are applied to investigate these scenarios, however, they have the drawbacks of high computational cost and lack of soft tissue information, respectively. Moreover, material properties of the involved tissues are commonly tested in quasi-static conditions, which do not accurately capture the mechanical behavior during impact scenarios. Thus, the aim of this study was to develop, calibrate and validate an approach for the creation of impact-specific hybrid, rigid body - finite-element spine models for high-dynamic axial impact scenarios. METHODS: Five porcine cervical spine models were used to replicate in-vitro experiments to calibrate stiffness and damping parameters of the intervertebral joints by matching the kinematics of the in-vitro with the in-silico experiments. Afterwards, a five-fold cross-validation was conducted. Additionally, the von Mises stress of the lumped FE-discs was investigated during impact. RESULTS: The results of the calibration and validation of our hybrid approach agree well with the in-vitro experiments. The stress maps of the lumped FE-discs showed that the highest stress of the most superior lumped disc was located anterior while the remaining lumped discs had their maximum in the posterior portion. CONCLUSION: Our hybrid method demonstrated the importance of impact-specific modeling. Overall, our hybrid modeling approach enhances the possibilities of identifying spine injury mechanisms by facilitating dynamic, impact-specific computational models.

Personnel selection systems and diversity.

Personnel selection systems affect diversity because they are the way organizations choose who is hired. Research on personnel selection systems and diversity is reviewed, with a particular focus on racial/ethnic diversity. Topics covered include the interrelated concepts of adverse impact and subgroup mean differences, research on why mean differences exist, and which selection predictors (particularly, cognitive ability tests) are most likely to cause adverse impact due to these mean differences. The historical perspective that organizations face a dilemma due to cognitive ability tests having the greatest validity and largest racial/ethnic subgroup mean differences is reviewed. Additionally, recent research is covered that suggests the validity of cognitive ability tests has been substantially overestimated, which has significant implications for the "validity-diversity dilemma."

Economic effects of next-generation sequencing diagnostics in unspecific sepsis patients - a budget impact analysis from the healthcare providers' perspective in Germany.

PURPOSE: Next-generation sequencing (NGS) tools have clinical advantages over blood culture but are more expensive. This study assesses the budget impact and break-even point of NGS testing costs from a healthcare provider's perspective in Germany. METHODS: The budget impact was calculated based on aggregated data of German post-operative surgery cases. Simulated cost savings were calculated based on a simulated reduction in hospital length of stay (LOS) of four or eight days with a positivity rate of 71% and compared to the costs of one (scenario A) or two tests (scenario B) per case. Furthermore, the break-even point of the cost of two tests compared to saved costs through shortened LOS was conducted. RESULTS: For 9,450 cases, an average budget impact for scenario A and scenario B of €1,290.41 [95% CI €1,119.64 - €1,461.19] and - €208.59 [95% CI - €379.36 - - €37.81] was identified for gastrointestinal and kidney surgery cases, and €1,355.58 [95% CI €1,049.62 - €1,661.55] and €18.72 [95% CI - €324.69 - €287.24] for vascular artery surgery cases, respectively. The break-even analysis showed that using two tests per case could achieve a minimum positive contribution margin with an average of 1.9 tests per case across the study population. CONCLUSION: The results revealed a positive budget impact for one NGS test and a slightly negative budget impact for two NGS tests per case. Findings suggest that largest cost savings are generated for more severe cases and are highly dependent on the patient population.

Agricultural and Ecological Resources Safeguarded by the Prevention of Wild Pig Population Expansion.

Wild pigs (Sus scrofa) are one of the most destructive invasive species in the US, known for causing extensive damage to agricultural commodities, natural resources, and property, and for transmitting diseases to livestock. Following the establishment of the National Feral Swine Damage Management Program (NFSDMP) in 2014, the expansion of wild pig populations has been successfully slowed. This paper combines two modeling approaches across eight separate models to characterize the expansion of wild pig populations in the absence of intervention by the NFSDMP and forecasts the value of a subset of resources safeguarded from the threat of wild pigs. The results indicate that if wild pigs had continued spreading at pre-program levels, they would have spread extensively across the US, with significant geographic variation across modeling scenarios. Further, by averting the threat of wild pigs, a substantial amount of crops, land, property, and livestock was safeguarded by the NFSDMP. Cumulatively, between 2014 and 2021, wild pig populations were prevented from spreading to an average of 724 counties and an average of USD 40.2 billion in field crops, pasture, grasses, and hay was safeguarded. The results demonstrate that intervention by the NFSDMP has delivered significant ecological and economic benefits that were not previously known.

Microstructure Refinement via Nucleation of Intragranular Acicular Ferrite Stimulated by Ti-Containing Core-Shell Structured Particles in Low-Carbon Steel.

This study investigated the microstructure, mechanical properties, and nucleation mechanism of acicular ferrite (AF) present in hot-rolled Ti deoxidized steel. In our experiments, the impact toughness of Ti deoxidized steel is significantly increased to 144 J at -20 °C, while those Mn and Al deoxidized steels are only 9 J and 18 J, respectively. Interlocked AF is the primary microstructure of Ti deoxidized steel. The second-phase particles of the core-shell-type structure, in which Ti2O3 is the nucleus and TiO is the outermost shell, act as effective nucleating agents to stimulate AF nucleation. The low lattice disregistry between TiO and AF is the main factor contributing to the production of AF. It is also revealed that Ti2O3 and MnS fulfill the particular orientation relationship, contributing to the formation of an Mn-depleted zone (MDZ) adjacent to MnS, proposed to be one of the possible mechanisms for promoting AF nucleation.

Distribution, Population Dynamics, and Management of Moroccan Locust Dociostaurus maroccanus (Thunberg, 1815) (Orthoptera, Acrididae) in Tajikistan.

This study contributes to the body of knowledge on the Moroccan locust (Dociostaurus maroccanus) in Tajikistan, exploring its distribution, population dynamics, economic significance, and management. Our research covers the period from 2012 to 2023. Over this period, there has been a documented increase in the size of the infested areas, with southern Tajikistan being the most severely affected. Outbreaks of economic importance happened each year throughout the timeframe. The total area impacted by infestations reached 752,130 hectares in southern Tajikistan alone. The paper places emphasis on the necessity of cross-border and regional collaboration and the adoption of environmentally sustainable control methods, such as the use of biopesticides.

The Biology, Impact, and Management of Xyleborus Beetles: A Comprehensive Review.

Xyleborus beetles, a diverse group of ambrosia beetles, present challenges to forestry and agriculture due to their damaging burrowing behavior and symbiotic relationships with fungi. This review synthesizes current knowledge on the biology, ecology, and management of Xyleborus. We explore the beetles' life cycle, reproductive strategies, habitat preferences, and feeding habits, emphasizing their ecological and economic impacts. Control and management strategies, including preventive measures, chemical and biological control, and integrated pest management (IPM), are critically evaluated. Recent advances in molecular genetics and behavioral studies offer insights into genetic diversity, population structure, and host selection mechanisms. Despite progress, managing Xyleborus effectively remains challenging. This review identifies future research needs and highlights innovative control methods, such as biopesticides and pheromone-based trapping systems.

Impact of Child Respiratory Syncytial Virus-Confirmed Infections on Caregivers in Japan: A Web-Based Survey.

Background/Objectives: Despite being the leading cause of acute lower respiratory tract infections in infants, the impact of respiratory syncytial virus (RSV) on the caregivers of infected children remains largely unexplored. This study is the first in Japan to examine the psychological, social, and economic burdens on caregivers of infants infected with RSV. Methods: An online questionnaire survey was used to understand the circumstances surrounding RSV infection and the psychological, social, and economic burdens on caregivers. Equal numbers of infants aged either <6 or ≥6 months were enrolled. Results: A total of 606 caregivers were included in the final analysis. Notably, 36.1% of the infants were hospitalized. Most caregivers (91.4%) felt anxious about their infants' RSV infection, and more than half (55.8%) answered that their anxiety interfered with their daily lives. Caregivers whose daily routines were disrupted due to concerns about RSV infection were more likely to hospitalize infants, particularly for extended stays. Infection significantly affected family dynamics, hindering normal daily activities and escalating stress, which in turn led to conflicts and arguments among family members (30.4%). Regarding the financial burden, most caregivers incurred medical expenses (34.2%). Additionally, 76.9% of caregivers expressed interest in the hypothetical RSV vaccination. Conclusions: In Japan, caregivers of infants with RSV experience had significant psychological burden regardless of whether the treatment is outpatient or inpatient. In addition, a non-negligible proportion of caregivers suffer from societal and economic burdens. This study lays the groundwork for all stakeholders to fully comprehend the comprehensive disease burden of child RSV infections.

Evaluating the Impact of a Dutch Sexual Health Intervention for Adolescents: Think-Aloud and Semistructured Interview Study.

BACKGROUND: Engagement with and the potential impact of web-based interventions is often studied by tracking user behavior with web analytics. These metrics do provide insights into how users behave, but not why they behave as such. OBJECTIVE: This paper demonstrates how a mixed methods approach consisting of (1) a theoretical analysis of intended use, (2) a subsequent analysis of actual use, and (3) an exploration of user perceptions can provide insights into engagement with and potential impact of web-based interventions. This paper focuses on the exploration of user perceptions, using the chlamydia page of the Dutch sexual health intervention, Sense.info, as a demonstration case. This prevention-focused platform serves as the main source of sexual and reproductive health information (and care if needed) for young people aged 12-25 years in the Netherlands. METHODS: First, acyclic behavior change diagrams were used to theoretically analyze the intended use of the chlamydia page. Acyclic behavior change diagrams display how behavior change principles are applied in an intervention and which subbehaviors and target behaviors are (aimed to be) influenced. This analysis indicated that one of the main aims of the page is to motivate sexually transmitted infection (STI) testing. Second, the actual use of the chlamydia page was analyzed with the web analytics tool Matomo. Despite the page's aim of promoting STI testing, a relatively small percentage (n=4948, 14%) of the 35,347 transfers from this page were to the STI testing page. Based on these two phases, preliminary assumptions about use and impact were formulated. Third, to further explore these assumptions, a study combining the think-aloud method and semistructured interviews was executed with 15 young individuals aged 16-25 (mean 20, SD 2.5) years. Template analysis was used to analyze interview transcripts. RESULTS: Participants found the information on the Sense.info chlamydia page reliable and would visit it mostly for self-diagnosis purposes if they experienced potential STI symptoms. A perceived facilitator for STI testing was the possibility to learn about the symptoms and consequences of chlamydia through the page. Barriers included an easily overlooked link to the STI testing page and the use of language not meeting the needs of participants. Participants offered suggestions for lowering the threshold for STI testing. CONCLUSIONS: The mixed methods approach used provided detailed insights into the engagement with and potential impact of the Sense.info chlamydia page, as well as strategies to further engage end users and increase the potential impact of the page. We conclude that this approach, which triangulates findings from theoretical analysis with web analytics and a think-aloud study combined with semistructured interviews, may also have potential for the evaluation of web-based interventions in general.

Exploring the psychopathological profile of fibromyalgia: insights from the personality assessment inventory and its association with disease impact.

Background: Fibromyalgia (FM) is a complex rheumatic disorder characterized by chronic nociplastic pain and central sensitization. Psychopathological conditions can influence FM symptoms, which worsen their condition. However, not all patients with FM have psychopathological disorders, indicating a heterogeneous population. Objective: To investigate the psychopathological profile and personality disorders in patients with FM and its relationship impact on this disease. Methods: An observational and cross-sectional comparative study was conducted with a sample of 90 women, mean age 48.7 years (SD = 8.12), from Hospital del Mar, Barcelona. The Personality Assessment Inventory (PAI) and the Fibromyalgia Impact Questionnaire (FIQ) were used for assessment. Results: FM patients predominantly exhibited psychopathological profiles resembling affective disorders (37.7%) and Cluster C personality disorders (58.8%). The severity of FM's impact was related to affective disorder symptoms, hypervigilance, derealization, somatization, and Cluster B personality disorder (emotional instability). Different rheumatic symptoms correlated with specific psychopathological patterns. Increased somatic symptoms on the FIQ were related to an unstable and dependent personality, while heightened emotional symptoms on the FIQ were associated with avoidance, borderline traits, and passive-aggressive reactions. Conclusion: Recognizing psychopathological aspects is crucial for managing FM. The PAI is a valuable tool for establishing its psychopathological multidimensional profile, which predominantly shows an affective spectrum conditions and comorbid Cluster C personality disorder, exacerbating the disease's impact.