The inhibitory control deficit of internet gaming disorder: An Event-Related Potentials(ERPs) study.

INTRODUCTION: The primary difficulty and challenge encountered by individuals with Internet Gaming Disorder (IGD) is inhibitory control deficit. Given that different types of inhibitory control have different effects on IGD patients, it is critical to investigate the neurological cognitive processes underlying various inhibitory control problems. METHODS: The IGD-20 questionnaire was used to identify Internet game disorder and healthy control group, and finally Internet game disorder in (n=25) and healthy control group (n=28) in Flanker task, Internet game disorder (n=29) and health control group (n=24) in GO/NOGO task. The Flanker task was employed to investigate distractor interference inhibition control in those with IGD, while the Go/NoGo task was used to measure their prepotent response inhibitory control. Event-related potentials (ERPs) were used to evaluate the brain mechanisms difference of both IGD and healthy participants during these different inhibitory control tasks. RESULTS: Findings indicate that compared to healthy control subjects, individuals with Internet Gaming Disorder (IGD) have deficits in inhibitory control tasks during both distraction inhibition and prepotent response inhibition tasks, and distraction inhibition occurs earlier than prepotent response inhibition. In distraction inhibition tasks, the IGD group's N2 amplitude is significantly lower than the healthy control groups. In prepotent response inhibition, the N2 amplitude provoked in the IGD group is not only significantly lower than in the healthy control group, but the P3 amplitude is also significantly larger in the IGD group. The main brain activity areas of interference inhibitory control are the frontal lobe and prefrontal lobe, while the main brain activity areas of prepotent response inhibitory control are the frontal lobe and occipital lobe. CONCLUSION: The present study concentrates on the differential neurophysiological characteristics observed in individuals with Internet gaming problems, notably the ability to avoid distractions and prepotent reactions. The current research provides foundations for the assessment and development of tailored therapy and treatment methods to address the wide variety of cognitive problems reported in individuals with Internet Gaming Disorder (IGD).

Cognitive Behavioural Therapy for Obsessive-Compulsive Disorder Related to the Fear of Internet Use: A Case Study.

Obsessive-compulsive disorder's (OCD's) symptomatology appears to evolve with modern developments, with recent reports highlighting the influence of modern technologies (e.g., the Internet); for instance, some OCD cases are characterised by an excessive fear of Internet use. Meanwhile, cognitive behavioural therapy (CBT) is a form of psychotherapy that focuses on modifying dysfunctional thoughts, behaviours, and emotions, and has proven effective for various psychological issues, including OCD; however, research on OCD related to the fear of Internet use and its treatment remains limited. The present study presents a case of a patient who had been suffering from severe OCD for approximately one year, exhibiting a fear of using the Internet due to intrusive urges to send offensive messages (e.g., death threats) when near computers. This fear led to avoidance of Internet use and compulsive checking to ensure that Internet-connected devices were turned off. The treatment involved a combination of CBT and medication (fluvoxamine). The case formulation focused on identifying thought-action-fusion-misinterpretations that exacerbate and maintain OCD (maladaptive appraisals about an increase in the probability of an unpleasant event by merely thinking about it); it also addressed cognitive and behavioural factors, including safety behaviours such as reassurance-seeking and thought suppression. To address and alter maladaptive interpretations and behaviours, CBT was implemented using various techniques, including behavioural experiments, which included the 'on duty versus off duty' tactic to relieve the patient from the responsibility of controlling aggressive thoughts, refraining from covering his computer or smartphone, intentionally looking at them frequently, and browsing various Internet forums and review sites. Through these experiments, the patient realised that his negative predictions were unfounded and that avoiding Internet use was unnecessary. The patient's self-reported OCD symptoms, measured using the Japanese versions of the Yale-Brown Obsessive-Compulsive Scale and the Obsessive-Compulsive Inventory, decreased over the course of 10 sessions. This case study demonstrates that empirically supported CBT can effectively treat OCD related to aggressive obsessions and the fear of Internet use. Its limitations included that the patient was receiving both fluvoxamine and CBT (thus making it difficult to attribute the improvement solely to CBT) and that this study focused on a single patient setting (thereby making it difficult to generalize its findings).

Frequency of internet use, economic income, and health of the population-comparative analysis of urban and rural areas based on Chinese General Social Survey.

People's health is one of the important supports for China's economic development. This study uses the 2021 Chinese General Social Survey (CGSS) data to empirically test the impact of residents' Internet use frequency and economic income on residents' health level, and analyzes the differences between urban and rural areas. The empirical test results show that, firstly, the frequency of Internet use can promote the health level of residents, and the promotion effect of Internet use frequency on the health level of rural residents is higher than that of urban residents; Secondly, economic income has a positive promoting effect on the health level of the entire sample of residents, but in urban samples, the regression between economic income and residents' health level is not significant. Third, in the heterogeneity test of region, gender and age, it is found that the impact of residents' Internet use frequency and economic income on residents' health level also has urban-rural differences. Based on this, this study suggests that the government can continue to make efforts to further promote the health level of residents by improving the Internet penetration rate, strengthening the use of Internet skills, carrying out Internet professional skills training and promoting the high-quality development of Internet content.

Abnormal Granger causal connectivity based on altered gray matter volume and associated neurotransmitters of adolescents with internet gaming disorder revealed by a multimodal neuroimaging study.

Although prior studies have revealed alterations in gray matter volume (GMV) among individuals with internet gaming disorder (IGD). The brain's multifaceted functions hinge crucially on the intricate connections and communication among distinct regions. However, the intricate interaction of information between brain regions with altered GMV and other regions, and how they synchronize with various neurotransmitter systems, remains enigmatic. Therefore, we aimed to integrate structural, functional and molecular data to explore the GMV-based Granger causal connectivity abnormalities and their correlated neurotransmitter systems in IGD adolescents. Voxel-based morphometry (VBM) analysis was firstly performed to investigate GMV differences between 37 IGD adolescents and 35 matched controls. Brain regions with altered GMV were selected as seeds for further Granger causality analysis (GCA). Two-sample t tests were performed using the SPM12 toolkit to compare the GMV and Granger causal connectivity between IGD and control groups (GRF corrected, Pvoxel<0.005, Pcluster<0.05). Then, GMV-based Granger causal connectivity was spatially correlated with PET- and SPECT-derived maps covering multifarious neurotransmitter systems. Multiple comparison correction was performed using false discovery rate (FDR). Compared with controls, IGD adolescents showed higher GMV in the caudate nucleus and lingual gyrus. For the GCA, IGD adolescents showed higher Granger causal connectivity from insula, putamen, supplementary motor area (SMA) and middle cingulum cortex (MCC) to the caudate nucleus, and lower Granger causal connectivity from superior/inferior parietal gyrus (SPG/IPG) and middle occipital gyrus (MOG) to the lingual gyrus. Besides, GMV-based Granger causal connectivity of IGD adolescents were associated with the dopaminergic, serotonergic, GABAergic and noradrenaline systems. This study revealed that the caudate nucleus and lingual gyrus may be the key sites of neuroanatomical changes in IGD adolescents, and whole-brain Granger causal connectivity abnormalities based on altered GMV involved large brain networks including reward, cognitive control, and visual attention networks, and these abnormalities are associated with a variety of neurotransmitter systems, which may be associated with higher reward sensitivity, cognitive control, and attention control dysfunction.

Sleep efficiency in community-dwelling persons living with dementia: exploratory analysis using machine learning.

STUDY OBJECTIVES: Sleep disturbances lead to negative health outcomes and caregiver burden, particularly in community settings. This study aimed to investigate a predictive model for sleep efficiency and its associated features in older adults living with dementia in their own homes. METHODS: This was an exploratory, observational study. A total of 69 older adults diagnosed with dementia were included in this study. Data were collected via actigraphy for sleep and physical activity for 14 days, a sweat patch for cytokines for 2-3 days, and a survey of diseases, medications, psychological and behavioral symptoms, functional status, and demographics at baseline. Using 730 days of actigraphy, sweat patches, and baseline data, the best prediction model for sleep efficiency was selected and further investigated to explore its associated top 10 features using machine learning analysis. RESULTS: The CatBoost model was selected as the best predictive model for sleep efficiency. In order of importance, the most important features were sleep regularity, number of medications, dementia medication, daytime activity count, instrumental activities of daily living, neuropsychiatric inventory, hypnotics, occupation, tumor necrosis factor-alpha, and waking hour lux. CONCLUSIONS: This study established the best sleep efficiency predictive model among community-dwelling older adults with dementia and its associated features using machine learning and various sources, such as the Internet of Things. This study highlights the importance of individualized sleep interventions for community-dwelling older adults with dementia based on associated features.

Optimal control strategies for high-efficiency non-isolated DC-DC buck converters in IoT applications: A comparative study.

A DC-DC buck converter (DDBC) plays a crucial role in facilitating the rapid evolution of Internet of Things (IoT) applications across a broad spectrum of load requirements. Achieving high efficiency under diverse load conditions necessitates a meticulous exploration of modulation and control methods. This paper aims to explore literature concerning modulation and control techniques employed in buck converters for IoT applications, with the goal of achieving optimal efficiency. The most often used control methods in the DDBC for power conversion efficiently are adaptive controlled pulse skip modulation (APSM), pulse frequency modulation (PFM), digital pulse width modulation (DPWM), and adaptive on time control (AOT). Based on the major drawbacks of high quiescent current, large ripple, and low efficiency, the control methods used in IoT applications to achieve high efficiency are discussed. The structure of DDBC with the unique controlling method and their capability of suppressing the output ripple voltage and minimizing quiescent current are briefly addressed. Comparison among the methods exhibits how control methods can achieve high efficiency. This paper outlines the major challenges in power converter control for future research and development.

Association between Internet use and depression among older adults in China: the chain-mediating role of volunteer activity participation and friend network.

Background: Depression is a significant burden on individuals and society, which requires our attention and action. As the aging wave collides with digitalization, further research is needed to understand how internet use relates to depression in older adults. This study aimed to investigate whether volunteer activity participation and friend networks played a chain mediating role in this relationship from the perspective of the socioemotional selectivity theory. Method: This study's data was derived from the 2018 China Longitudinal Aging Social Survey (CLASS), comprising 5,558 samples. The study employed the OLS model for benchmark regression and multiple robust check methods, including altering variable settings and utilizing the instrumental variable model. In addition, the generalized structural equation model (GSEM) was used to analyze the mechanism. Result: Using the internet was significantly associated with reduced depression in older adults (coefficient = -0.9321, p < 0.001). The instrumental variable model confirmed this reduction (coefficient = -0.9200, p < 0.001). Moreover, we found that there were three indirect pathways of Internet use on depression among older adults: the mediating role of volunteer activity participation (all p-values <0.001), the mediating role of friend network (all p-values <0.001), and the chain mediating role of both factors (all p-values <0.001). Conclusion: Based on the research findings, we suggest mobilizing tech-savvy older adults to assist others in adopting digital technology and using the internet. We also suggest that the government could assist in creating older adult-friendly communities. Social workers could collaborate with tech-savvy older adults to organize various voluntary activities, encouraging more senior citizens to participate. In addition, we recommend that the community should consider the form of activities to help older adults make friends first rather than solely focusing on voluntary activities.

Lessons learned from a multimodal sensor-based eHealth approach for treating pediatric obsessive-compulsive disorder.

Introduction: The present study investigates the feasibility and usability of a sensor-based eHealth treatment in psychotherapy for pediatric obsessive-compulsive disorder (OCD), and explores the promises and pitfalls of this novel approach. With eHealth interventions, therapy can be delivered in a patient's home environment, leading to a more ecologically valid symptom assessment and access to experts even in rural areas. Furthermore, sensors can help indicate a patient's emotional and physical state during treatment. Finally, using sensors during exposure with response prevention (E/RP) can help individualize therapy and prevent avoidance behavior. Methods: In this study, we developed and subsequently evaluated a multimodal sensor-based eHealth intervention during 14 video sessions of cognitive-behavioral therapy (CBT) in 20 patients with OCD aged 12-18. During E/RP, we recorded eye movements and gaze direction via eye trackers, and an ECG chest strap captured heart rate (HR) to identify stress responses. Additionally, motion sensors detected approach and avoidance behavior. Results: The results indicate a promising application of sensor-supported therapy for pediatric OCD, such that the technology was well-accepted by the participants, and the therapeutic relationship was successfully established in the context of internet-based treatment. Patients, their parents, and the therapists all showed high levels of satisfaction with this form of therapy and rated the wearable approach in the home environment as helpful, with fewer OCD symptoms perceived at the end of the treatment. Discussion: The goal of this study was to gain a better understanding of the psychological and physiological processes that occur in pediatric patients during exposure-based online treatment. In addition, 10 key considerations in preparing and conducting sensor-supported CBT for children and adolescents with OCD are explored at the end of the article. This approach has the potential to overcome limitations in eHealth interventions by allowing the real-time transmission of objective data to therapists, once challenges regarding technical support and hardware and software usability are addressed. Clinical Trial Registration: www.ClinicalTrials.gov, identifier (NCT05291611).

From research to routine care: A historical review of internet-based cognitive behavioral therapy for adult mental health problems in Sweden.

This narrative historical review examines the development of internet-based cognitive behavioral therapy (ICBT) in Sweden, describing its progression within both academic and routine care settings. The review encompasses key publications, significant scientific findings, and contextual factors in real-world settings. Over 25 years ago, Sweden emerged as a pioneering force in internet-delivered treatment research for mental health. Since then, Swedish universities, in collaboration with research partners, have produced substantial research demonstrating the efficacy of ICBT across various psychological problems, including social anxiety disorder, panic disorder, generalized anxiety disorder, and depression. Although research conducted in clinical settings has been less frequent than in academic contexts, it has confirmed the effectiveness of therapist-supported ICBT programs for mild-to-moderate mental health problems in routine care. Early on, ICBT was provided as an option for patients at both the primary care level and in specialized clinics, using treatment programs developed by both public and private providers. The development of a national platform for delivering internet-based treatment and the use of procurement in selecting ICBT programs and providers are factors that have shaped the current routine care landscape. However, gaps persist in understanding how to optimize the integration of digital treatment in routine care, warranting further research and the use of specific implementation frameworks and outcomes. This historical perspective on the research and delivery of ICBT in Sweden over two decades offers insights for the international community into the development and broad dissemination of a specific digital mental health intervention within a national context.

Internet-delivered cognitive behaviour therapy for affective disorders, anxiety disorders and somatic conditions: An updated systematic umbrella review.

Background: Internet-delivered cognitive behaviour therapy (ICBT), which can involve guidance from a clinician, continues to be a way to deliver psychological treatments. A previous umbrella review identified moderate-to-large effect sizes favouring ICBT compared to control conditions when treating major depression and anxiety disorders. Given the rapid developments in the field, an updated umbrella review of available meta-analyses can show other conditions and subpopulations for which ICBT is effective. The aim of the study was to provide an expanded overview of the efficacy of ICBT for a broader range of adult psychiatric and somatic conditions. Methods: We conducted an updated search of the literature since the publication of the previous umbrella review back in 2019 and up until March 2024. Five different search engines were used (Medline (OVID), Scopus, Web of Science, Cochrane library and CINAHL). The search was expanded to include additional psychiatric conditions (e.g., suicidal ideation) and somatic conditions (e.g., tinnitus and chronic pain). Results: Of the 6509 identified articles, 39 meta-analyses met the inclusion criteria. In these meta-analyses 19 unique outcomes were represented. The most common outcome was symptoms of major depressive disorder, followed by symptoms of anxiety. Effect sizes for the comparisons against control conditions ranged between small (e.g., SMD = 0.10 for stress in employees) to large (e.g., SMD = 1.20 for depressive symptoms among older adults). Conclusions: ICBT can generally reduce symptoms of a wide range of conditions including both psychiatric and somatic conditions, as well as other mental health problems. This updated review of available meta-analyses also indicated that ICBT has been successful in treating symptoms in different subpopulations such as older adults and students. However, some knowledge gaps remain, including the use of ICBT for psychotic disorders, and the quality of the available meta-analyses' points to a need for more stringent methodological procedures.

Internet Parent-Child Interaction Therapy for Maternal Guilt in a Child Abuse Case: A Single Case Study.

This single case study explored the effectiveness of Internet Parent-Child Interaction Therapy (I-PCIT) for addressing maternal guilt in a case of child abuse. I-PCIT was implemented because traditional PCIT was challenging due to the family's geographical constraints and the mother's professional commitments. The study utilized multiple assessment tools, including the Eyberg Child Behavior Inventory (ECBI) and the Beck Depression Inventory-II (BDI-II), to measure the therapy's impact on the child's behavior and the mother's depressive symptoms. The case conceptualization highlighted the mother's emotional regulation difficulties and dissociative symptoms under stress that contributed to the abusive incidents. I-PCIT sessions, conducted via videoconferencing software, focused on enhancing the mother-son relationship through Child-Directed Interaction (CDI) and Parent-Directed Interaction (PDI) phases. Through 19 sessions of I-PCIT (with one session conducted face-to-face), the mother's mastery of positive skills improved, and follow-up sessions indicated sustained positive outcomes. This case study underscores the potential of I-PCIT in preventing the recurrence of abuse, enhancing parental skills, and facilitating positive parent-child interaction. It also highlights the importance of therapist-parent collaboration in mitigating dropout risks and promoting therapy adherence.

The Population Typology of Conspiracy Beliefs About Sars-Cov-2 Origin in Russia Based on Predictive Modelling of COMET-G Study Data: Incoherent Attitude Indicator as a Predisposing Factor for Developing Mental Disturbances.

BACKGROUND: We examined the prevalence and spread of conspiracy beliefs about the origins of the COVID-19 pandemic among representatives of the Russian population. Our study aimed to identify belief clusters and develop predictive models to understand the factors that influence conspiracy beliefs, particularly in the context of how they might evolve in response to socio-political events and cause mental disturbances, thus in relation to specific pathways of the infodemic and psychodemic waves that spread among vulnerable population groups. METHODS: Data respondents to the international COMET-G study living in Russia during pandemic period (n=7,777) were analyzed using descriptive statistics, K-means clustering, and various machine learning models, including gradient boosting. We identified distinct populations depending on predominant beliefs about COVID-19 pandemic origins, and applied game theory (Shapely additive explanations) to determine the most influential variables in predicting cluster membership. RESULTS: Four distinct belief clusters emerged, which we designate as Naturalists, Conspiracists, COVID-Sceptics, and the Incoherent Attitude groups. The Incoherent Attitude cluster constituted 20.8% of the sample, and was particularly associated with mental health signs such as sleep disturbances and the use of psychotropic medications. Internet use and mental health-related factors, as well as the respondents' education level, were key predictors of mental disturbances with mediating effects of the conspiracy views across all clusters. Conspiracy beliefs about COVID-19 origin were highly fluid/variable, often being shaped by external sociopolitical factors rather than objective health data. CONCLUSIONS: The cluster with Incoherent Attitude regarding COVID-pandemic origins, which had an association with psychoticism, showed a greater predisposition for mental health problems, than did the Conspiracist, Naturalist and Sceptic clusters. We suppose that underlying psychoticism bears a relation to their sleep problems and resorting to use of psychotropic medications. These results emphasizes the global health need for implementing target-focused and selective strategies that address public misinformation and promote the adoption of critical thinking skills to mitigate the impact of conspiracy theories, considering the factors of education level and pre-existing mental disorders.

Nurses' preferences for working in Uber-style 'Internet plus' nursing services: A discrete choice experiment.

BACKGROUND: China's 'Internet Plus' nursing services, which are Uber-style home care services with an 'online application, offline service' approach, have been evolving over the past five years. Registered nurses' preference for these Uber-style Internet Plus nursing services are crucial for improving human resource management and service efficiency, yet research in this area remains scarce. OBJECTIVE: This study aimed to explore registered nurses' preferences for Uber-style Internet Plus nursing services and provide optimization recommendations from a supply-side perspective. DESIGN: A cross-sectional study utilising a discrete choice experiment. SETTING(S): Two public tertiary hospitals located in Tianjin, China, which have implemented Internet Plus nursing services. PARTICIPANTS: 211 registered nurses who participated in Internet Plus nursing services. METHODS: The survey was conducted anonymously using an online survey platform. Respondents were presented with choices between two alternatives, based on five key attributes: income, safety and security, patient and family cooperation, commute time, and service type. Mixed logit models estimated the stated preferences for attributes. Relative importance scores, willingness-to-pay estimates, and simulations of service-type uptake rates were calculated. Subgroup analysis and seemingly unrelated regression estimation were performed to examine heterogeneity in preferences. RESULTS: A total of 3202 choice observations were generated. When sorted by the strength of preference, the five attributes related to registered nurses' choice of Uber-style Internet Plus nursing services, measured by their relative importance scores, are as follows: safety and security (30.89 %), income (27.41 %), patient and family cooperation (18.47 %), service type (11.96 %), and commuting time (11.27 %). Elevating safety and security from low to high levels has the same utility as a 31.81 % increase in monthly income, equivalent to 2586.14 yuan. Subgroup analysis showed that senior nurses place more value on safety and security than junior nurses (ß = 1.421 vs.ß = 0.725; P = 0.011), and unmarried nurses had a stronger preference for family and caregiver cooperation (ß = 1.105 vs.ß = 0.314; P = 0.023). CONCLUSIONS: The strength and heterogeneity of registered nurses' preferences should be highlighted in the dispatch algorithms model of Uber-style Internet Plus nursing services, thereby enhancing the efficiency and humanity of Uber-style Internet Plus nursing services. TWEETABLE ABSTRACT: Registered nurses prioritise safety and security, acknowledging heterogeneous preferences in Uber-style Internet Plus nursing services.

Evaluating challenges of circular economy and Internet of Things in renewable energy supply chain through a hybrid decision-making framework.

Due to industrial development, expansion of communities, and attention to sustainable development, sustainable energy supply has become a big challenge for communities. In this regard, the development and use of Renewable Energy (RE) are considered due to reducing the harmful environmental effects of fossil fuels. Improving the efficiency of the Renewable Energy Supply Chain (RESC) is important for using RE. To improve the performance and efficiency of RESC, it is necessary to use emerging technologies such as the Internet of Things (IoT) and its integration with the principles of the Circular Economy (CE). Therefore, this study proposes integrating IoT and CE for sustainable development and resource management in RESC. Also, this research provides a hybrid decision framework to assess the challenges of IoT and CE in the RESC of Iran. The CRiteria Importance Through Intercriteria Correlation (CRITIC) technique is used to specify the importance of the criteria. The Fuzzy Evaluation Based on Distance from Average Solution (FEDAS) technique ranks the challenges. The findings indicated that considering the cost of investment, the rate of return on investment, and the productivity rate were the most important sub-criteria with values of 0.149, 0.129, and 0.106 respectively. Then, the sensitivity of the results is examined and the validation of the findings is analyzed with decision-making methods. The results indicate the high priority of the challenge related to transparency in the implementation procedures of IoT and RE projects and information dissemination protocols, the development of guidelines for the integration of IoT in other systems in the information network, and the amount of investment and lack of access to financial resources. This study provided practical insights for RE development based on IoT and CE capabilities for energy planning.

Content analysis of fluoride-related posts on Instagram.

BACKGROUND: The Internet and social media have become many people's primary sources of health information. Instagram is one of the most popular social media platforms, and users spend a significant amount of time daily on the platform. Therefore, analyzing oral health-related information shared online can help to identify the requirements of specific groups, assisting in the planning and execution of educational public health actions. As a result, this study was carried out to conduct a qualitative evaluation of fluoride-related content on Instagram in 2022-2023. METHODS: Using hashtags associated with fluoride, a search was conducted on the Instagram application in the Persian language. All fluoride-containing posts were saved, and data was collected thrice at two-month intervals. MAXQDA software version 2020 was used to categorize the collected data content based on type, quality, and quantity. RESULTS: The qualitative analysis included 1565 (9.45%) posts with fluoride-related content out of 16,475 total posts. After removing the duplicates, 400 posts remained, among which 282 posts (70.5%) and 118 posts (29.5%) were pro- and anti-fluoride, respectively. After qualitative analysis, 270 codes were examined and categorized into three main themes and eight subthemes: "fluoride sources," "The advantages and disadvantages of fluoride," and "Invalid beliefs about fluoride." CONCLUSION: The frequency of pro-fluoride use was higher than anti-fluoride posts. However, due to the high prevalence of posts containing false information on fluoride toxicity for health, ineffectiveness on caries prevention, and conspiracy theories, there is a need to improve the quality of information on fluoride by providing scientific and unbiased explanations by professionals online or during dental visits and supervising social media content.

Enhancing older care services: a comprehensive internet + community home indicator system.

OBJECTIVE: Constructing a demand-oriented Internet + community home care service indicator system, starting from the actual needs of the elderly, and quantifying the demand into specific service contents that can be provided, so as to realize the effective supply of services. It aims to provide a theoretical basis for the government to formulate relevant aging policies and provide a reference basis for promoting the innovation and development of the Internet + elderly care model. METHODS: Based on existence needs, relationship needs and growth needs abbreviated as "Existence, Relatedness, Growth (ERG)" demand theory, through the discussion in the group meeting, form the expert consultation questionnaire of the demand-oriented Internet + community home care service indicator system, select experts in related fields to conduct two rounds of Delphi expert consultation, summarize the experts' opinions to determine the indicator system items, and use the Analytic Hierarchy Process (AHP) method to construct the judgment matrix to derive the weighting coefficients of the indicators, and establish the ultimate demand-oriented Internet + community home care service indicator system. RESULTS: The effective recovery rates for the two rounds of expert consoulation questionnaires were 100%, with expert authority coefficients of 0.852 and 0.868, respectively. The Kendall coefficients for the second round of expert views varied from 0.226 to 0.431, with coefficients of variation for all indexes less than 0.25.The finalized demand-oriented Internet + community home care service indicator system includes 3 first-level indicators, 10 s-level indicators, and 46 third-level indicators. The consistency ratios of indicator judgment matrices at all levels are less than 0.10, suggesting that the hierarchical analysis findings are consistent, implying that the weight coefficient distribution is appropriate. CONCLUSION: The demand-oriented Internet + community home care service Indicator System, which was created through expert consultation and AHP method, has reasonable content and is more dependable as an evaluation tool for reliably assessing demand for elderly servic.

Impact of World Cerebral Palsy Day on Public Interest in Brazil: Evidence from Internet Search Data.

AIM: This study investigated the impact of the World Cerebral Palsy Day (WCPD) campaign on the public interest using Google Trends Analysis data in Brazil. METHODS: Google Trends was used to collect Relative Search Volume (RSV) data for "cerebral palsy" from 2004 to 2011 (control years) and 2012 to 2022 (WCPD years). RSV during the 4 weeks around WCPD (period of interest) was compared with the rest of the year (control period) in each timeframe. Regional RSV, search queries, and main topics were also investigated. RESULTS: RSV increased by 62.22% from pre-campaign to campaign period. During the WCPD years, a 21.36% RSV increase occurred in campaign weeks, with an average difference of 12.16 (95% CI: 1.74, 22.58); notably in in the last five years in the southeast 9.47 (95% CI: 2.93, 16.01) and south 8.66 (95% CI: 1.66, 15.66) macro-regions. CONCLUSION: The campaign has fulfilled its role, but targeting more vulnerable areas could further amplify its impact.

Digital Twin in Managing Hypertension Among People With Type 2 Diabetes: 1-Year Randomized Controlled Trial.

Background: Digital twin (DT)-guided lifestyle changes induce type 2 diabetes (T2D) remission but effects on hypertension (HTN) in this population are unknown. Objectives: The purpose of this study was to assess effects of DT vs standard of care (SC) on blood pressure (BP), anti-HTN medication, HTN remission, and microalbuminuria in participants with T2D. Methods: This is a secondary analysis of a randomized controlled trial in India of 319 participants with T2D. Participants were randomized to DT group (N = 233), which used artificial intelligence-enabled DT technology, or SC group (N = 86). A Home Blood Pressure Monitoring system guided anti-HTN medication adjustments. BP, anti-HTN medications, HTN remission rates, and microalbuminuria were compared between groups. Results: Among the 319 participants, 44 in DT and 15 in SC group were on anti-HTN medications, totaling 59 (18.4%) participants. DT group achieved significant reductions in systolic blood pressure (-7.6 vs -3.2 mm Hg; P < 0.007) and diastolic blood pressure (-4.3 vs -2.2 mm Hg; P = 0.046) after 1 year compared with SC group. 68.2% of DT group remained off anti-HTN medications compared to none in SC group. Among participants with HTN, DT subgroup achieved higher rates of normotension (40.9% vs 6.7%; P = 0.0009) and HTN remission (50% vs 0%; P < 0.0001) than SC subgroup. DT group had a higher rate of achieving normoalbuminuria (92.4% vs 83.1%; P = 0.018) at 1 year compared with SC group. Conclusions: Artificial intelligence -enabled DT technology is more effective than SC in reducing BP and anti-HTN medications and inducing HTN remission and normoalbuminuria in participants with HTN and T2D. (A Novel WholeBody Digital Twin Enabled Precision Treatment for Reversing Diabetes; CTRI/2020/08/027072).

"I'm still struggling with it, and it scares me": A qualitative analysis of older adults' experiences with digital health portals during and after COVID-19.

Objective: The scaling of digital health platforms, accelerated by the COVID-19 pandemic, has globally reshaped the delivery of healthcare services, presenting both opportunities and challenges. Ensuring equitable access, especially for digitally disadvantaged groups, is a critical concern, and this study explores older adults' perspectives on digital health platforms during and after the COVID-19 pandemic and examines their strategies for coping with the general challenges of the digitalization of health. Methods: A total of 77 older adults (aged at least 65), including both internet users and non-users, participated in 11 focus group sessions in Slovenia between September and December 2022. Hybrid thematic analysis was used to develop an understanding of the challenges confronted by older adults in the digital health landscape. Results: Three key themes emerged from the focus group sessions, which highlight digital inequalities that impact access to digital health platforms and their services: the challenges of digitalized health services, coping with these challenges, and the outcomes of health service digitalization. The "digital health paradox" is evident, in which opportunities are provided for some while access is limited for those unwilling or unable to use digital health platforms. Proxy users, often family or friends, help bridge this gap. Conclusions: Ensuring the availability and viability of traditional health service access is crucial for empowering older adults to choose between digital health platforms and alternatives. Recognizing the importance of traditional approaches is vital, and healthcare providers and policymakers should prioritize inclusivity to ensure a diverse and equitable healthcare system for older adults and vulnerable populations.

The mediating effect of social connectedness between internet gaming disorder and somatic symptoms in adolescents: a large sample cross-sectional study.

BACKGROUND: Previous studies have indicated that social connectedness can serve as a protective buffer against negative outcomes associated with online victimization. However, the role of social connectedness between Internet gaming disorder and somatic symptoms is still unclear. This study aims to examine the mediating effect of social connectedness on the association between Internet gaming disorder and somatic symptoms. METHODS: A cross-sectional design was utilized, using questionnaires for data collection and multi-stage stratified cluster sampling. The general demographic questionnaire, Nine-Item Internet Gaming Disorder Scale-Short Form, Social Connectedness Scale-Revised and Patient Health Questionnaire Physical Symptoms were used to collect data. We adopted Pearson's correlation analysis and the PROCESS Macro Model in regression analysis to explore the relationships among Internet gaming disorder, social connectedness and somatic symptoms. RESULTS: Internet gaming disorder was positively correlated with somatic symptoms (r = 0.20, P < 0.001), while network (r=-0.08, P < 0.001) and real-life social connectedness (r=-0.31, P < 0.001) negatively affected somatic symptoms. The network social connectedness and the real-life social connectedness played a chain mediating role in the development of Internet gaming disorder to somatic symptoms [95%CI: 0.073, 0.088], explaining 45.25% of the total effect value. The difference of real-life social connectedness and network social connectedness played a partial mediating role between Internet gaming disorder and somatic symptoms [95% CI:0.050, 0.062], accounting for 31.28% of the total effect value. CONCLUSIONS: Real-life social connectedness, network social connectedness, and their disparity all mediated the relationship between Internet gaming disorder and somatic symptoms. Real-life social connectedness acted as a protective factor, while network social connectedness served as a risk factor. Encouraging offline activities and guiding teenagers to use the internet responsibly may help prevent and reduce physical symptoms linked to Internet gaming disorder.