Pairing transcutaneous vagus nerve stimulation with an intensive bimanual training in children and adolescents with cerebral palsy: study protocol of a randomized sham-controlled trial.

Background: Gross motor function impairments and manual dexterity deficits are frequently observed in children and adolescents with Cerebral Palsy (CP), having a major impact on their activity level and autonomy. Improving manual dexterity and activity level of patients with CP is often the focus of rehabilitation. Novel and adjuvant treatment methods that could support the standard training also in chronic conditions are a research priority. The transcutaneous Vagus Nerve Stimulation (tVNS) is a non-invasive brain stimulation technique, which provides a bottom-up stimulation of subcortical and cortical brain structures, enhancing brain GABA and Noradrenaline levels. This technique may play a pivotal role in brain plasticity, which has not been tested in CP patients before. Methods: 44 children and adolescents with CP will be involved, treated in pairs in a randomized, double-blind, pre-post test study. The two groups will undergo the Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) for 2 consecutive weeks, with 3 h daily sessions for 5 days per week, for an overall time interval of 30 h; the training will be combined with the application for 75 min/day of active or sham tVNS, in separate, randomly allocated groups. The primary outcome measure will include the scores at the Assisting Hand Assessment and Box and Block Test, and at an ad-hoc visuomotor task evaluating manual visuomotor control. Secondary outcomes will include the scores at the Children's Hand Experience Questionnaire, Canadian Occupational Performance Measure, Melbourne Assessment of Unilateral Upper Limb Function, Gross Motor Function Measure, Vineland, Pediatric quality of life inventory. The evaluation points will include pre (T0), post (T1) and 3-month follow up (T2) assessments. Safety and tolerability will also be assessed. Results: The results of this trial will assess whether tVNS can effectively boost the effects of an intensive two-week bimanual training, in improving manual dexterity in children and adolescents with cerebral palsy, ensuring safety and tolerability throughout the intervention period.Clinical trial registration: ClinicalTrials.gov, NCT06372028.

Confirming the Causal Role of Consistent Contexts in Developing a Walking Habit: A Randomized Comparison With Varied Contexts.

BACKGROUND: Physical activity interventions using habit development may help people increase and then maintain physical activity increases over time. Enacting behavior in consistent contexts is a central component of habit development, yet its causal role in habit development in health behaviors has not been confirmed. PURPOSE: This study tests the causal role of consistent context in habit development in health behavior, using a randomized control trial of a planning intervention to develop a walking habit in 127 insufficiently active, working, midlife adults in a real-world setting. METHODS: We compare participants who plan walking in consistent contexts with controls who plan walking in varied contexts and with controls not required to plan on a change in average daily steps (measured using an accelerometer) and inhabit automaticity during a 4-week intervention and at a 4-week follow-up. RESULTS: As expected, consistent and varied context planners increased walking during the intervention, but only consistent context planners developed (and maintained) habit automaticity. Counter to expectations, consistent context planners did not show walking maintenance. However, across conditions, participants who developed more habit automaticity during the intervention also maintained walking more (decreased less). Having a routine daily schedule moderated some effects. Notably, no-plan controls with greater routine developed more habit automaticity, mediated by walking in more consistent contexts. CONCLUSIONS: This study confirms the causal role of consistent contexts in developing a walking habit, in a real-world setting, with an important but challenging population for physical activity interventions and identifies a facilitating condition common for many: a routine schedule.

Developing an exercise habit may help people increase and then maintain physical activity. This study tests and confirms the role of exercising in consistent contexts as a cause of forming a daily walking habit. We use a randomized control trial of a 4-week planning intervention, with a follow-up 4 weeks after the intervention. Participants were 127 insufficiently active, working, midlife adults. We compared participants asked to plan their daily walks in consistent contexts from day-to-day, with participants asked to plan their walks in varied contexts and with participants not required to plan. As expected, consistent and varied context planners increased their daily walking steps (measured using an accelerometer) during the intervention compared to participants not required to plan. However, only consistent context planners developed (and then maintained) a daily walking habit, that is, where taking daily walks felt relatively automatic. Unexpectedly, consistent context planners did not show walking maintenance. However, across all participants, those who developed a stronger walking habit during the intervention maintained their walking more after the intervention ended. Lastly, having an existing routine daily schedule helped some participants. Those who were not asked to plan and had a more routine daily schedule also developed a daily walking habit.

Sleep During the COVID-19 Pandemic: Longitudinal Observational Study Combining Multisensor Data With Questionnaires.

BACKGROUND: The COVID-19 pandemic prompted various containment strategies, such as work-from-home policies and reduced social contact, which significantly altered people's sleep routines. While previous studies have highlighted the negative impacts of these restrictions on sleep, they often lack a comprehensive perspective that considers other factors, such as seasonal variations and physical activity (PA), which can also influence sleep. OBJECTIVE: This study aims to longitudinally examine the detailed changes in sleep patterns among working adults during the COVID-19 pandemic using a combination of repeated questionnaires and high-resolution passive measurements from wearable sensors. We investigate the association between sleep and 5 sets of variables: (1) demographics; (2) sleep-related habits; (3) PA behaviors; and external factors, including (4) pandemic-specific constraints and (5) seasonal variations during the study period. METHODS: We recruited working adults in Finland for a 1-year study (June 2021-June 2022) conducted during the late stage of the COVID-19 pandemic. We collected multisensor data from fitness trackers worn by participants, as well as work and sleep-related measures through monthly questionnaires. Additionally, we used the Stringency Index for Finland at various points in time to estimate the degree of pandemic-related lockdown restrictions during the study period. We applied linear mixed models to examine changes in sleep patterns during this late stage of the pandemic and their association with the 5 sets of variables. RESULTS: The sleep patterns of 27,350 nights from 112 working adults were analyzed. Stricter pandemic measures were associated with an increase in total sleep time (TST) (ß=.003, 95% CI 0.001-0.005; P<.001) and a delay in midsleep (MS) (ß=.02, 95% CI 0.02-0.03; P<.001). Individuals who tend to snooze exhibited greater variability in both TST (ß=.15, 95% CI 0.05-0.27; P=.006) and MS (ß=.17, 95% CI 0.03-0.31; P=.01). Occupational differences in sleep pattern were observed, with service staff experiencing longer TST (ß=.37, 95% CI 0.14-0.61; P=.004) and lower variability in TST (ß=-.15, 95% CI -0.27 to -0.05; P<.001). Engaging in PA later in the day was associated with longer TST (ß=.03, 95% CI 0.02-0.04; P<.001) and less variability in TST (ß=-.01, 95% CI -0.02 to 0.00; P=.02). Higher intradaily variability in rest activity rhythm was associated with shorter TST (ß=-.26, 95% CI -0.29 to -0.23; P<.001), earlier MS (ß=-.29, 95% CI -0.33 to -0.26; P<.001), and reduced variability in TST (ß=-.16, 95% CI -0.23 to -0.09; P<.001). CONCLUSIONS: Our study provided a comprehensive view of the factors affecting sleep patterns during the late stage of the pandemic. As we navigate the future of work after the pandemic, understanding how work arrangements, lifestyle choices, and sleep quality interact will be crucial for optimizing well-being and performance in the workforce.

Preying on cyprinid snout warts (pearl organs) as a novel and peculiar habit in the Lake Malawi cichlid Docimodus evelynae.

Cichlid fishes in the African Great Lakes have undergone explosive speciation, acquiring markedly varying ecologies and diets. There are multiple lineages of scale-eating cichlids, and their natural history and evolutionary ecology is only partially understood. We examined the feeding habit of Docimodus evelynae, a known scale eater, in Lake Malawi. The stomach contents of young individuals mainly consisted of unknown 1 mm hard, white warts (> 30%). To clarify the origin of these warts, we conducted an X-ray fluorometer analysis, and found they were rich in sulphur but low in silicon and calcium, suggesting they were epidermal tissues. Histological and morphological analyses revealed they were multicellular and cup-shaped. These characteristics matched only those of the pearl organs of the coexisting cyprinid Labeo cylindricus. DNA was extracted from the warts found in the stomach of five D. evelynae individuals, followed by PCR using primers targeting the partial COI gene of L. cylindricus. The resulting sequences exhibited 98% similarity to those of L. cylindricus. Pearl organs, never reported as a primary food for fish, could offer a substantial nutritional source based on calorific calculations. Understanding how this peculiar diet is foraged is essential for full comprehension of the food-web structure in this lake.

Application of multivariate binary logistic regression grouped outlier statistics and geospatial logistic model to identify villages having unusual health-seeking habits for childhood malaria in Malawi.

BACKGROUND: Early diagnosis and prompt treatment of malaria in young children are crucial for preventing the serious stages of the disease. If delayed treatment-seeking habits are observed in certain areas, targeted campaigns and interventions can be implemented to improve the situation. METHODS: This study applied multivariate binary logistic regression model diagnostics and geospatial logistic model to identify traditional authorities in Malawi where caregivers have unusual health-seeking behaviour for childhood malaria. The data from the 2021 Malawi Malaria Indicator Survey were analysed using R software version 4.3.0 for regressions and STATA version 17 for data cleaning. RESULTS: Both models showed significant variability in treatment-seeking habits of caregivers between villages. The mixed-effects logit model residual identified Vuso Jere, Kampingo Sibande, Ngabu, and Dzoole as outliers in the model. Despite characteristics that promote late reporting of malaria at clinics, most mothers in these traditional authorities sought treatment within twenty-four hours of the onset of malaria symptoms in their children. On the other hand, the geospatial logit model showed that late seeking of malaria treatment was prevalent in most areas of the country, except a few traditional authorities such as Mwakaboko, Mwenemisuku, Mwabulambya, Mmbelwa, Mwadzama, Zulu, Amidu, Kasisi, and Mabuka. CONCLUSIONS: These findings suggest that using a combination of multivariate regression model residuals and geospatial statistics can help in identifying communities with distinct treatment-seeking patterns for childhood malaria within a population. Health policymakers could benefit from consulting traditional authorities who demonstrated early reporting for care in this study. This could help in understanding the best practices followed by mothers in those areas which can be replicated in regions where seeking care is delayed.

Causal association of dietary factors with five common cancers: univariate and multivariate Mendelian randomization studies.

Background: Daily dietary habits are closely related to human health, and long-term unhealthy dietary intake, such as excessive consumption of alcohol and pickled foods, may promote the development of cancers. However, comprehensive research on the causal relationship between dietary habits and cancer is lacking. Therefore, this study aimed to reveal the potential causal link between dietary risk factors and the prognosis of cancer-related to genetic susceptibility. Methods: GWAS (Genome-Wide Association Studies) summary data on dietary habits and five common types of cancer and their pathological subtypes were obtained from the UK Biobank and various cancer association consortia. A univariable two-sample Mendelian randomization (UVMR) and FDR correction analysis was conducted to explore the causal relationships between 45 dietary habits and five common types of cancer and their histopathological subtypes. In addition, multivariable Mendelian randomization analysis (MVMR) was performed to adjust for traditional risk factors for dietary habits, and the direct or indirect effects of diet on cancer were evaluated. Finally, the prognostic impact of selected instrumental variables on cancer was analyzed using an online data platform. Results: In the UVMR analysis, four dietary habits were identified as risk factors for cancer, while five dietary habits were identified as protective factors. Among the latter, one dietary habit showed a significant association with cancer even after FDR correction, indicating a potential causal relationship. The MVMR analysis revealed that weekly beer and cider intake, may act as an independent risk factor for cancer development. Other causal associations between dietary habits and cancer risk may be mediated by intermediate factors. In the prognostic analysis, the SNPs (Single Nucleotide Polymorphisms) of average weekly beer and cider intake were set as independent risk factors and were found to significantly impact overall survival (OS) and cancer-specific survival (CSS) in lung cancer. Conclusion: This causal relationship study supports the notion that adjusting daily dietary habits and specific dietary interventions may decrease the risk of cancer.

Prevalence of Unhealthy Lifestyles and Its Correlates Among College-Going Students in Rishikesh, India: A Cross-Sectional Study.

Introduction Non-communicable diseases (NCDs) have a significant impact on health concerns. The transition from school to college coincides with various stressors, affecting student health. The objective was to assess the prevalence of unhealthy lifestyles among college-going students and examine the association of composite lifestyle scores with selected demographic variables. Methods All undergraduate colleges of Rishikesh were included in the study. Cluster sampling with a population proportionate to size was used to select the participants. A structured questionnaire was administered using Google Forms or pen and paper. Index values for each lifestyle activity were added together to get a lifestyle composite score. An unhealthy lifestyle was considered with a score below 40. Association with risk factors was analyzed using a chi-square test and logistic regression. Results Among 742 participants, 166 (22.4%) lived an unhealthy lifestyle with a lifestyle score of <40. The majority of participants were either underweight or above normal weight. An unhealthy lifestyle was prevalent among fourth-year professional students (7; 58.5%), medical (33; 32%), dental (27; 34.6%), hosteller (79; 36%), and BSc Nursing (21; 56.8%) students. BSc Nursing course (AOR: 11.09; 95% CI: 1.17-104.74) and favorable attitude (AOR: 0.74; 95 % CI: 0.59- 0.93) were significant correlates of unhealthy lifestyles. Conclusion The current study indicates that nearly one-fourth of college students have unhealthy lifestyles. Four factors, i.e., health science stream, advancing professional year, hosteller, and unfavorable attitude toward health, were significantly associated with unhealthy lifestyles after adjusting for covariates.

What Is Behavioral Complexity? Lay Perceptions of Characteristics of Complex Behavior.

A behavior's complexity may impact habit formation, with implications for habit-based public health and environmental intervention designs. However, there are varying conceptualizations of behavioral complexity, hindering the synthesis of findings. To develop a unified definition, the aim of this study was to explore perceptions of behavioral complexity and identify behaviors that exemplify aspects of complexity. Participants (N = 225) completed a questionnaire concerning the complexity of various health and environmental behaviors, the importance of complexity characteristics previously identified by researchers (novelty, difficulty, steps, planning, immediacy of reward, time, attention, skill, mental resources, self-efficacy, motivation for a behavior, and supportiveness of the context) and demographics. Participants considered all proposed characteristics to be important. Complex behaviors (e.g., abstaining from smoking and taking insulin shots), compared to simple behaviors (e.g., eating fruit and stretching), are more likely to be true to the previously identified characteristics. Perceived complexity is influenced by several salient characteristics. Results may contribute to a synthesized definition and underpin future research to better identify behavior change techniques to foster habitual behaviors of varying complexity. Hence, researchers, practitioners, and policymakers may identify common barriers and facilitators of behavior to target in interventions. However, further research is required to contextualize the findings.

The consequences of AI training on human decision-making.

AI is now an integral part of everyday decision-making, assisting us in both routine and high-stakes choices. These AI models often learn from human behavior, assuming this training data is unbiased. However, we report five studies that show that people change their behavior to instill desired routines into AI, indicating this assumption is invalid. To show this behavioral shift, we recruited participants to play the ultimatum game, where they were asked to decide whether to accept proposals of monetary splits made by either other human participants or AI. Some participants were informed their choices would be used to train an AI proposer, while others did not receive this information. Across five experiments, we found that people modified their behavior to train AI to make fair proposals, regardless of whether they could directly benefit from the AI training. After completing this task once, participants were invited to complete this task again but were told their responses would not be used for AI training. People who had previously trained AI persisted with this behavioral shift, indicating that the new behavioral routine had become habitual. This work demonstrates that using human behavior as training data has more consequences than previously thought since it can engender AI to perpetuate human biases and cause people to form habits that deviate from how they would normally act. Therefore, this work underscores a problem for AI algorithms that aim to learn unbiased representations of human preferences.

Plant economics spectrum governs leaf nitrogen and phosphorus resorption in subtropical transitional forests.

BACKGROUND: Leaf nitrogen (N) and phosphorus (P) resorption is a fundamental adaptation strategy for plant nutrient conservation. However, the relative roles that environmental factors and plant functional traits play in regulating N and P resorption remain largely unclear, and little is known about the underlying mechanism of plant functional traits affecting nutrient resorption. Here, we measured leaf N and P resorption and 13 plant functional traits of leaf, petiole, and twig for 101 representative broad-leaved tree species in our target subtropical transitional forests. We integrated these multiple functional traits into the plant economics spectrum (PES). We further explored whether and how elevation-related environmental factors and these functional traits collectively control leaf N and P resorption. RESULTS: We found that deciduous and evergreen trees exhibited highly diversified PES strategies, tending to be acquisitive and conservative, respectively. The effects of PES, rather than of environmental factors, dominated leaf N and P resorption patterns along the elevational gradient. Specifically, the photosynthesis and nutrient recourse utilization axis positively affected N and P resorption for both deciduous and evergreen trees, whereas the structural and functional investment axis positively affected leaf N and P resorption for evergreen species only. Specific leaf area and green leaf nutrient concentrations were the most influential traits driving leaf N and P resorption. CONCLUSIONS: Our study simultaneously elucidated the relative contributions of environmental factors and plant functional traits to leaf N and P resorption by including more representative tree species than previous studies, expanding our understanding beyond the relatively well-studied tropical and temperate forests. We highlight that prioritizing the fundamental role of traits related to leaf resource capture and defense contributes to the monitoring and modeling of leaf nutrient resorption. Therefore, we need to integrate PES effects on leaf nutrient resorption into the current nutrient cycling model framework to better advance our general understanding of the consequences of shifting tree species composition for nutrient cycles across diverse forests.

Motivated reasoning and scientific racism in compulsion theory of human addiction: Methodological framework to promote social justice.

Heinz et al. (2024) recently criticised habit/compulsion theory of human addiction but nevertheless concluded that 'habit formation plays a significant role in drug addiction'. To challenge this causal claim, the current article develops four further methodological criticisms, that publications supporting the habit/compulsion account of human addiction: (1) under-report contradictory observations; (2) exaggerate the process purity of positive observations; (3) under-emphasise the low quality of epidemiological support for a causal hypothesis; (4) recapitulate the social injustice of racial intelligence era by prematurely attributing lower task performance to drug user group membership (endophenotype) without having adequately tested social, psychological, economic and environmental inequalities. Methodological guidelines are recommended to address each concern, which should raise evidence standards, incorporate social justice and improve accuracy of estimating any specific effect of addiction history on task performance. Given that construing drug users as intellectually impaired could promote stigma and reduce their recovery potential, it is recommended that scientific discourse about habit/compulsive endophenotypes underpinning addiction is avoided until these higher evidence standards are met.

Managing the Lower Lip-Sucking Habit With a Lip Bumper Appliance: A Pediatric Case Study.

Oral habits in children are of prime concern to a pediatric dentist as the child is in an active growth phase, and it may alter the development of the orofacial area. One of the major etiological factors in the development of malocclusion and other adverse effects on orofacial structures is oral habits during and after preschool age. The habit of sucking one's lower lip is rarely examined; it appears that practitioners tend to associate it with less adverse clinical consequences. It is important to identify harmful oral habits and eliminate them as early as possible. This case report focuses on the diagnosis of the lip-sucking habit, understanding its etiology, and creating a treatment plan that will prevent unfavorable consequences. A lip bumper is an easy-to-fabricate, easy-to-place, and easily tolerated intra-oral appliance. The successful use of lip bumper in this case adds to the evidence that when used as an early intervention the habit can be intercepted appropriately.

Donor Milk Expression Habits: Can we Favor Hindmilk Banking for Extremely Preterm Infants?

Background: Extremely preterm infants often receive donor milk. Hindmilk, which is released more than 3 minutes after letdown, could be advantageous due to its elevated levels of fat and calorie density. Donor milk expression habits may influence milk composition but have not yet been investigated. This study aims to assess the practices of milk donors and the feasibility of hindmilk expression. Methods: Active milk donors in Québec were questioned using an online survey about their milk expression habits and whether hindmilk donation would be acceptable to them. Answers were analyzed using mixed methods. Results: Of 181 donors, 126 fully completed the questionnaire (70%); 57% reported expressing donated milk between breastfeeds; 15% reported simultaneously breastfeeding while expressing donated milk from the other breast; 12% reported breastfeeding their baby on each breast, then expressing donated milk (hindmilk). The majority (66%) would be willing to change their habits most or all the time to provide hindmilk for preterm infants. The main themes invoked by respondents in open-ended answers were altruism and gratitude for being able to help others. However, 15% commented on the complexity of milk expression or that adding further complexity might discourage them from donating. Conclusions: Expression practices are variable, which may lead to variability in donor milk composition. Most donors would agree to change their expression habits in favor of giving hindmilk to help the most fragile infants. More information is needed on how changing recommendations for milk expression might impact the supply and composition of donor milk.

Impaired saltiness perception contributes to higher sodium intake among patients with chronic kidney disease: a cross-sectional two-center study.

OBJECTIVE: Dietary sodium restriction is important in the prognosis of patients with chronic kidney disease (CKD). The association between saltiness perception and sodium intake among CKD patients is unclear, and the factors that influence saltiness are also not fully understood. We evaluated saltiness perception in CKD patients employing a cost-effective saltiness perception test using sodium solutions and evaluated the association between saltiness perception, sodium intake and influencing factors. DESIGN AND METHODS: CKD outpatients not undergoing dialysis were enrolled from two medical centers and underwent saltiness perception tests together with 24-hour urine collections to measure daily sodium intake. Participants who perceived saltiness using the test solution containing 25 mM sodium were regarded to have "preserved" saltiness perception while those unable to perceive saltiness were regarded as having "impaired" saltiness perception. RESULTS: Of the total 132 participants, the median daily sodium intake was 3.36 g (range; 0.51 to 9.95 g/day), and 43 (32.6%) were ex- or current smokers. When participants were divided into 3 groups (G) according to daily sodium intake level: low (G1; 0.51 to 2.61 g/day), middle (G2; 2.62 to 3.99 g/day) and high (G3; 4.06 to 9.95 g/day), there was an obvious difference in impaired saltiness perception between three groups: 6.8% in G1, 50.0% in G2 and 86.4% in G3 (p-value = 8.035 x 10-14, Cochran-Armitage test). In a multiple regression analysis in which the saltiness perception was adopted as a subjective variable, smoking habit (ex- or current smoker) and nonadherence to dietary sodium restriction were identified as significant explanatory variables. CONCLUSION: We revealed the clear relationship between higher daily sodium intake and impaired saltiness perception that is related to nonadherence to dietary sodium restriction and smoking habit; both of which could be intervened by nutritional counselling and public health education.

University Food Environment Assessment Methods and Their Implications: Protocol for a Systematic Review.

BACKGROUND: While the retail food environment has been well studied, research surrounding the university food environment is still emerging. Existing research suggests that university food environments can influence behavioral outcomes such as students' dietary choices, which may be maintained long-term. Despite a growing interest in assessing university food environments, there is no standardized tool for completing this task. How researchers define "healthy" when assessing university food environments needs to be clarified. This paper describes the protocol for systematically reviewing literature involving university food environment assessments. OBJECTIVE: This paper aimed to describe the protocol for a systematic review of the assessments of university food environments. The review will summarize previously used tools or methods and their implications. METHODS: Electronic databases, including PubMed (NLM), Cochrane Library (Wiley), Web of Science (Clarivate), APA PsycINFO (EBSCO), CINAHL (Cumulative Index to Nursing & Allied Health) Complete (EBSCO), ProQuest Nursing and Allied Health, and Google Scholar were searched for papers published between 2012 and 2022 using combinations of related medical subject headings terms and keywords. The electronic databases were supplemented by reviewing the reference list for all included papers and systematic reviews returned with our search results. The review will include all study types, including randomized controlled trials, observational studies, and other pre-post designs. Papers that examine at least 1 aspect of the university food environment, such as cafeterias, campus convenience stores, and vending machines, were considered for inclusion. A total of 2 reviewers will independently screen titles and abstracts, complete a full-text review, extract data, and perform a quality assessment of included papers, with a third reviewer resolving any conflicts. The Quality Assessment for Diverse Studies (QuADS) tool was used to determine the methodological quality of selected studies. A narrative and tabular summary of the findings were presented. There will not be a meta-analysis due to the methodological heterogeneity of the included papers. RESULTS: The initial queries of 4502 records have been executed, and papers have been screened for inclusion. Data extractions were completed in December 2023. The results of the review were accepted for publication in May 2024. The systematic review generated from this protocol will offer evidence for using different assessment tools to examine the campus food environment. CONCLUSIONS: This systematic review will summarize the tools and methods used to assess university food environments where many emerging adults spend a significant part of their young adult lives. The findings will highlight variations in practice and how "healthy" has been defined globally. This review will provide an understanding of this unique organizational food environment with implications for practice and policy. TRIAL REGISTRATION: PROSPERO CRD42023398073; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=398073. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/54955.

Factors Predicting Effectiveness of Eradication Therapy for Helicobacter pylori-Associated Dyspepsia Symptoms.

Functional dyspepsia is distinguishable from Helicobacter pylori-associated dyspepsia. However, distinguishing H. pylori-associated dyspepsia from functional dyspepsia before H. pylori eradication is difficult. Therefore, in the present study, we aimed to investigate whether serum pepsinogen levels before H. pylori eradication are associated with the amelioration of dyspepsia after successful H. pylori eradication. Additionally, we examined the usefulness of serum pepsinogen levels and other factors in predicting dyspepsia outcomes. H. pylori eradication was effective in 14 patients (Responders) and ineffective in 19 patients (Non-responders). The pepsinogen I/II ratio in Responders (3.4 ± 1.2) and Non-responders (2.3 ± 1.0) differed significantly (p = 0.006). The optimal cut-off pepsinogen I/II value was 2.3. Multivariate logistic regression analysis showed that the adjusted odds ratio for Non-responders was 26.1 (95% confidence interval: 2.0-338.0, p = 0.012) for a pepsinogen I/II ratio ≤ 2.3 and 8.10 (95% confidence interval: 1.1-57.6, p = 0.037) for smoking habits. The pepsinogen I/II ratio and smoking habits were associated with the effects of H. pylori eradication on dyspeptic symptoms. Thus, the pepsinogen I/II ratio cut-off value can be used to identify patients likely to respond to H. pylori eradication after the resolution of dyspeptic symptoms.

Developing cue-behavior association for habit formation: A qualitative study to explore the role of avatar in hypertension.

Background: Electronic health (eHealth) has been widely adopted in chronic disease management. Prior studies focused on time-based reminders as a cue to facilitate behavior change intentions, ignoring the development of automatic cue-behavior associations via other cue types. Objective: Hence, this study utilized avatar appearance as a visual-based cue to help establish the automatic association between appearance transformation and health behavior to form habits without intention. Methods: To better understand users' attitudes and experiences toward applying changes in avatar appearance to develop cue-behavior associations for hypertensive patients. Fifteen participants were recruited in a 14-day experiment. After excluding one participant who dropped out of the experiment, others were randomly assigned to two groups. One group consisted of a visual-based cue (a virtual plant) and basic behavior change techniques (BCTs). The other group only included basic BCTs. Attitudes and experience outcomes were collected by interview, and qualitative data were analyzed using thematic analysis. Results: 57% of participants had been diagnosed with hypertension for more than five years, and more than 50% of participants have experience using mobile apps or wearables. 66% of participants did physical activity more than three times every week. The result shows that tailored time-based reminders, blood pressure monitoring, and daily dietary intake were the most attractive features. Additionally, hypertensive participants have positive attitudes toward avatar appearance as a visual-based cue to develop cue-behavior association, which enhances self-management motivation. Conclusion: This study proposes a visual-based cue design for habit formation and conducts a qualitative method to explore hypertensive patients' perceptions. The findings offer insights from user's perspectives into hypertensive patients' attitudes toward visual-based cues and perception of the connection between avatar appearance and health behavior for self-management. Subsequent discussions present eHealth design guidelines of habit formation from intention, automatic cue-behavior association, and self-management perspectives.

Interaction of smoking and spicy habits modifies the risk of erectile dysfunction.

Background: Having a spicy diet and smoking habit may be important factors causing erectile dysfunction (ED). The aim of this study is to investigate the impact of spicy diet and smoking habits on the risk of ED in men, with a focus on the interaction between these lifestyle factors. Methods: Our investigation was conducted as a retrospective analysis spanning from June 2017 to June 2023. Participants underwent interviews utilizing the Structured Interview on Erectile Dysfunction (SIEDY) to evaluate the degree of pathological factors. The International Index of Erectile Function-5 (IIEF-5) was employed as a metric for assessing ED. Additionally, the subjects were comprehensively questioned about their smoking history and dietary preferences, which included an inquiry into how often they consumed spicy meals. Results: Our research involved 373 participants, with 67.6% being individuals with ED. Among the participants, 50.7% were non-smokers and 49.3% were smokers, totaling 188 and 185, respectively. There was no significant difference in the spicy food frequency consumption among smokers with ED. However, non-smokers who consumed spicy food more frequently experienced more severe ED (P=0.02). ED patients showed significant differences in body mass index (BMI), blood glucose and testosterone, which were linked to vascular damage (P=0.03, P=0.02, P=0.04, respectively). Additionally, non-smokers who consumed more spicy food had higher scores on the SIEDY 2 scale, indicating marital factors (P=0.004). In non-smoking participant, a high spicy ratio indicated an even higher risk of ED [odds ratio 2.58, 95% confidence interval: 1.27-5.26; P=0.008], while there was no significant impact on ED in smoking participants (data not shown). Conclusions: This retrospective study suggests that a considerable consumption of spicy foods is independently correlated with an elevated risk of ED, particularly among non-smoking men.

Determination of α lamellae orientation in a ß-Ti alloy using electron backscatter diffraction.

The spatial orientation of α lamellae in a metastable ß-Ti matrix of Timetal LCB (Ti-6.8 Mo-4.5 Fe-1.5 Al in wt%) was examined and the orientation of the hexagonal close-packed α lattice in the α lamella was determined. For this purpose, a combination of methods of small-angle X-ray scattering, scanning electron microscopy and electron backscatter diffraction was used. The habit planes of α laths are close to {111}ß, which corresponds to (1320)α in the hexagonal coordinate system of the α phase. The longest α lamella direction lies approximately along one of the 〈110ã€‰ß directions which are parallel to the specific habit plane. Taking into account the average lattice parameters of the ß and α phases in aged conditions in Timetal LCB, it was possible to index all main axes and faces of an α lath not only in the cubic coordinate system of the parent ß phase but also in the hexagonal system of the α phase.