Autocuidado digital en el manejo de los trastornos musculoesqueléticos de columna: revisión sistemática y metanálisis / Digital self-care in the management of spine musculoskeletal disorders: A systematic review and meta-analysis / Autocuidado digital no manejo de distúrbios musculoesqueléticos de coluna: revisão sistemática e metanálise

Objetivo: analizar la efectividad del autocuidado digital en el manejo del dolor y la discapacidad funcional en personas con trastornos musculoesqueléticos espinales. Método: revisión sistemática de la literatura, desarrollada con la checklist PRISMA, de ensayos clínicos aleatorizados sobre personas con trastornos musculoesqueléticos de columna e intervenciones digitales a las que se accede por computadora, smartphones u otro dispositivo portátil. Bases de datos consultadas: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Science Citation Indexes, Cummulative Index to Nursing and Allied Health Literature y Physiotherapy Evidence Database. Síntesis de resultados descriptiva y por metanálisis (modelo de efectos fijos) realizada con el software Review Manager. Calidad metodológica evaluada mediante la escala Physiotherapy Evidence Database. Resultados: se seleccionaron 25 ensayos (5142 participantes) que mostraron mejoras estadísticamente significativas (p<0,05) del 54% (12/22) en los niveles de dolor y del 47% (10/21) en la discapacidad funcional en el grupo intervención. Los metanálisis mostraron efectos moderados sobre la intensidad del dolor y efectos pequeños sobre la discapacidad funcional. Predominaron los estudios de calidad media. Conclusión: las intervenciones de atención digital demostraron resultados beneficiosos para la intensidad del dolor y la discapacidad funcional, principalmente para el dolor lumbar crónico. Se ha demostrado que la atención digital es promisoria para favorecer el automanejo de las afecciones musculoesqueléticas de columna. Registro PROSPERO CRD42021282102.

Objective: to analyze the effectiveness of digital self-care in the management of pain and functional disability among people with spine musculoskeletal disorders. Method: a systematic literature review, developed with the PRISMA checklist, of randomized clinical trials of people with spine musculoskeletal disorders and digital interventions accessed by means of computers, smartphones or other portable devices. Databases researched: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Science Citation Indexes, Cumulative Index to Nursing and Allied Health Literature and Physiotherapy Evidence Database. The descriptive synthesis of the results and by means of meta-analyses (fixed-effects model) was performed with the Review Manager software. The methodological quality was evaluated with the Physiotherapy Evidence Database scale. Results: a total of 25 trials were selected (5,142 participants), which showed statistically significant improvements (p <0.05) in 54% (12/22) in the pain levels and 47% (10/21) in functional disability in the Intervention Group. The meta-analyses showed moderate effects on pain intensity and small effects on functional disability. There was a predominance of medium quality studies. Conclusion: the digital care interventions showed a beneficial result in pain intensity and in functional disability, mainly for chronic low back pain. Digital care emerges as promising to support self-management of the spine musculoskeletal conditions. PROSPERO registry number CRD42021282102.

Objetivo: analisar a efetividade do autocuidado digital no manejo da dor e incapacidade funcional em pessoas com distúrbios musculoesqueléticos de coluna. Método: revisão sistemática da literatura, desenvolvida com o checklist PRISMA, de ensaios clínicos randomizados de pessoas com distúrbios musculoesqueléticos de coluna e intervenções digitais acessadas por computador, smartphones ou outro dispositivo portátil. Bases pesquisadas: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Science Citation Indexes, Cummulative Index to Nursing and Allied Health Literature e Physiotherapy Evidence Database. Síntese dos resultados descritiva e por metanálises (modelo de efeitos fixos) com o software Review Manager. Qualidade metodológica avaliada pela escala Physiotherapy Evidence Database. Resultados: selecionaram-se 25 ensaios (5142 participantes) que revelaram melhoras estatisticamente significativas (p<0,05) em 54% (12/22) nos níveis de dor e 47% (10/21) na incapacidade funcional no grupo intervenção. As metanálises mostraram efeitos moderados na intensidade da dor e pequenos na incapacidade funcional. Houve predominância de estudos de média qualidade. Conclusão: intervenções de cuidados digitais mostraram resultado benéfico na intensidade da dor e na incapacidade funcional principalmente para dor lombar crônica. Evidenciam-se os cuidados digitais como promissores para apoiar o autogerenciamento das condições musculoesqueléticas de coluna. Registro PROSPERO CRD42021282102.

Digital media and mental health in adolescent athletes.

Although digital media are increasingly important for adolescent athletes, few studies explore their influence on mental health in this population. This study aimed to examine this relationship in 591 German adolescent athletes (aged 12-19 years) from 42 different sports. Longer daily social media usage was connected to increased negative affect and dysfunctional eating patterns. Similar results were found for cognitive-behavioral symptoms of excessive media usage and mental health. Structural equation modeling revealed these relationships were mediated by social comparison and quality of sleep. Higher athletic performance level was related to increased social comparison, but not to quality of sleep, negative affect, and dysfunctional eating. The negative relationship between excessive media usage and sleep was stronger in competitive and elite than in recreational athletes. Results imply digital media should receive attention when aiming to improve mental health in athletes. Relevant targets for future intervention could be social comparison and sleep.

Interoperable IoMT Approach for Remote Diagnosis with Privacy-Preservation Perspective in Edge Systems.

The emergence of the Internet of Medical Things (IoMT) has brought together developers from the Industrial Internet of Things (IIoT) and healthcare providers to enable remote patient diagnosis and treatment using mobile-device-collected data. However, the utilization of traditional AI systems raises concerns about patient privacy. To address this issue, we present a privacy-enhanced approach for illness diagnosis within the IoMT framework. Our proposed interoperable IoMT implementation focuses on optimizing IoT network performance, including throughput, energy consumption, latency, packet delivery ratio, and network longevity. We achieve these improvements using techniques such as device authentication, energy-efficient clustering, environmental monitoring using Circular-based Hidden Markov Model (C-HMM), data verification using Awad's Entropy-based Ten-Fold Cross Entropy Verification (TCEV), and data confidentiality using Twine-LiteNet-based encryption. We employ the Search and Rescue Optimization algorithm (SRO) for optimal route selection, and the encrypted data are securely stored in a cloud server. With extensive network simulations using ns-3, our approach demonstrates substantial enhancements in the specified performance metrics compared with previous works. Specifically, we observe a 20% increase in throughput, a 15% reduction in packet drop rate (PDR), a 35% improvement in network lifetime, and a 10% decrease in energy consumption and delay. These findings underscore the efficacy of our approach in enhancing IoT network interoperability and protection, fostering improved patient care and diagnostic capabilities.

Impact of medical students' socioeconomic backgrounds on medical school application, admission and migration in Japan: a web-based survey.

OBJECTIVES: The aim of this study was to clarify and compare the socioeconomic backgrounds of medical students with those of other health professions and non-health faculty students in an era of increasing inequity in Japanese society. DESIGN: This was a quantitative nationwide study. Data were collected by a cross-sectional web-based anonymous questionnaire. SETTING: Data from years 3 and 4 medical, health professions and non-health faculty students across Japan were collected in 2021. PARTICIPANTS: Participants were 1991 students from medical schools, 224 from dental, 419 from pharmacy, 326 from nursing, 144 from other health professions and 207 from non-health faculties. RESULTS: The proportion of high-income families (>18 million yen: ca. US$140 000) among medical students was 25.6%, higher than that of pharmacy (8.7%) and nursing students (4.1%) (p<0.01). One-third of medical students had a physician parent, more common than in non-medical students (p<0.01). Students who only applied to public medical schools and a regional quota 'Chiiki-waku' students with scholarship had lower family income and physician parents compared with those who applied to private medical schools (p<0.01), but they still had higher physician parents compared with non-medical students (p<0.01). Logistic regression revealed that having a physician parent (p<0.01), aspiring to the present profession during elementary school (p<0.01) and private upper secondary school graduation (p<0.01) predicted the likelihood of studying medicine. There were regional differences of backgrounds among medical students, and 80% of medical students with urban backgrounds intended to work in urban localities after graduation. CONCLUSIONS: This study provides evidence that medical students in Japan hail from urban and higher income classes and physicians' families. This finding has implications for the health workforce maldistribution in Japan. Widening the diversity of medical students is essential for solving physician workforce issues and meeting broad healthcare needs.

Solicitation and Sexualized Interactions of Minors with Adults: Prevalence, Overlap with Other Forms of Cybervictimization, and Relationship with Quality of Life / [La solicitud sexual y las interacciones sexualizadas de menores con adultos: su prevalencia, solapamiento con otras formas de cibervictimización y relación con la calidad de vida]

Sexual solicitation and sexualized interaction with minors by adults constitute one of the most pernicious risks of the Internet. Little is known about the age range in which this phenomenon is most prevalent or the relationship and overlap of this problem with other risks, such as peer-to-peer cybervictimization and cyber dating abuse. Additionally, little empirical evidence exists on whether the overlap between these types of online victimization affects health-related quality of life (HRQoL). This study aimed to: 1) analyze the prevalence of sexual solicitation and interaction according to sex and stage of adolescence; 2) relate this problem to other forms of online victimization (cybervictimization and cyber dating abuse); 3) analyze the overlap between these forms of online victimization and differences in HRQoL scores. A cross-sectional and analytical study with 3,578 adolescents (52.7% girls) aged between 10-15 years was carried out. Of the adolescents in the study sample, 12.6% (n = 448) had received sexual requests and 6.4% (n = 230) had interacted sexually with adults. Sexual solicitation was most common among girls in middle adolescence. Of the participants, 33.9% (n = 1,216) had been involved in some form of online victimization. Peer cybervictimization and cyber dating abuse were positively and significantly correlated with sexualized solicitation/interactions with adults. Victims with the overlapping of all three types of online victimization (2.7%, n = 98) presented the lowest HQRoL scores (p < .001).(AU)

La solicitación e interacción sexual con menores por parte de adultos constituyen uno de los riesgos más perniciosos de Internet. Se sabe poco sobre la franja de edad en el que es más frecuente o sobre la relación y el solapamiento de este problema con otros riesgos, como la cibervictimización entre iguales y el abuso online en la pareja. Además, existen pocas evidencias empíricas sobre si el solapamiento entre estos tipos de victimización afecta a la calidad de vida relacionada con la salud (CVRS). Los objetivos de este estudio fueron: 1) analizar la prevalencia de la solicitación/interacción sexual en función del sexo y la etapa de la adolescencia, 2) relacionar esta problemática con la cibervictimización entre iguales y el abuso online en la pareja, 3) analizar el solapamiento entre estas formas de victimización online y sus diferencias en las puntaciones de CVRS. Se trata de un estudio transversal y analítico con 3,578 adolescentes (52.7% chicas) entre 10-15 años. El 12.6% (n = 448) habían recibido solicitaciones sexuales y el 6.4% (n = 230) había interactuado sexualmente con adultos. La solicitación sexual fue más frecuente en chicas en la adolescencia media. Un 33.9% (n = 1,216) había sufrido algún tipo de victimización online. La cibervictimización entre iguales y el abuso online en la pareja correlacionaron positiva y significativamente con solicitaciones/interacciones sexualizadas con adultos. Las víctimas que solaparon los tres tipos de victimización online (2.7%, n = 98) presentaron las puntuaciones de CVRS más bajas (p < .001).(AU)

Internet of Medical Things and Healthcare 4.0: Trends, Requirements, Challenges, and Research Directions.

Healthcare 4.0 is a recent e-health paradigm associated with the concept of Industry 4.0. It provides approaches to achieving precision medicine that delivers healthcare services based on the patient's characteristics. Moreover, Healthcare 4.0 enables telemedicine, including telesurgery, early predictions, and diagnosis of diseases. This represents an important paradigm for modern societies, especially with the current situation of pandemics. The release of the fifth-generation cellular system (5G), the current advances in wearable device manufacturing, and the recent technologies, e.g., artificial intelligence (AI), edge computing, and the Internet of Things (IoT), are the main drivers of evolutions of Healthcare 4.0 systems. To this end, this work considers introducing recent advances, trends, and requirements of the Internet of Medical Things (IoMT) and Healthcare 4.0 systems. The ultimate requirements of such networks in the era of 5G and next-generation networks are discussed. Moreover, the design challenges and current research directions of these networks. The key enabling technologies of such systems, including AI and distributed edge computing, are discussed.

Chatting with ChatGPT to learn about safety of COVID-19 vaccines - A perspective.

Vaccine hesitancy is among the top 10 threats to global health, according to the World Health Organization (WHO). In this exploration, we delve into ChatGPT capacity to generate opinions on vaccine hesitancy by interrogating this AI chatbot for the 50 most prevalent counterfait messages, false and true contraindications, and myths circulating on the internet regarding vaccine safety. Our results indicate that, while the present version of ChatGPT's default responses may be incomplete, they are generally satisfactory. Although ChatGPT cannot substitute an expert or the scientific evidence itself, this form of AI has the potential to guide users toward information that aligns well with scientific evidence.

StudiCare procrastination - Randomized controlled non-inferiority trial of a persuasive design-optimized internet- and mobile-based intervention with digital coach targeting procrastination in college students.

BACKGROUND: Academic procrastination is widespread among college students. Procrastination is strongly negatively correlated with psychological well-being, thus early interventions are needed. Internet- and mobile-based cognitive behavioral therapy (iCBT) could provide a low-threshold treatment option. Human guidance seems to be a decisive mechanism of change in iCBT. Persuasive design optimization of iCBT and guidance by a digital coach might represent a resource-saving alternative. The study evaluated the non-inferiority of a digital coach in comparison to human guidance with regard to the primary outcome procrastination. METHODS: The iCBT StudiCare procrastination was optimized by principles of the Persuasive System Design (PSD). A total of 233 college students were randomly assigned to either StudiCare procrastination guided by a digital coach (intervention group, IG) or by a human eCoach (control group, CG). All participants were assessed at baseline, 4-, 8- and 12-weeks post-randomization. Symptom change and between-group differences were assessed with latent growth curve models and supported by effect size levels. The non-inferiority margin was set at Cohen's d = - 0.3. RESULTS: The primary outcome procrastination measured by the Irrational Procrastination scale (IPS) significantly decreased across groups (γ = - 0.79, p < .001, Cohen's d = -0.43 to -0.89) from baseline to 12-weeks post-randomization. There were no significant differences between groups (γ = -0.03, p = .84, Cohen's d = -0.03 to 0.08). Regarding symptoms of depression, no significant time x group effect was found (γ = 0.26, p = .09; Cohen's d = -0.15 to 0.21). There was also no significant time x group effect on the improvement of symptoms of anxiety (γ = 0.25, p = .09). However, Cohen's ds were above the non-inferiority margin 8-weeks (Cohen's d = 0.51) and 12-weeks post-randomization (Cohen's d = 0.37), preferring the CG. Of the IG, 34% and of the CG, 36% completed 80% of the modules. CONCLUSIONS: The PSD optimized version of StudiCare procrastination is effective in reducing procrastination. The digital coach was not inferior to human guidance. Guidance by a digital coach in iCBT against procrastination for college students could be a resource-saving alternative to human guidance. TRIAL REGISTRATION: The trial was registered at the WHO International Clinical Trials Registry Platform via the German Clinical Trial Register (ID: DRKS00025209, 30/04/2021).

An examination of the Petroleum Industry Act 2021: prospects, challenges, and the way forward.

Background: The study examines the gaps in the provisions of the Petroleum Industry Act (PIA) that could hinder the effective application of the Act in attaining its objectives. The repealed Petroleum Act of 1969 became obsolete and largely incapable of meeting the emerging global best practices in the industry due to inadequate sanctions, failure to address the aspirations of the people of the oil-bearing states, among others. Hence, the need for the PIA of 2021 to overhaul the industry to meet global standards though some controversial provisions that pose challenges to its proper implementation. Methods: The study examines the PIA to identify its prospects, challenges, and the way forward. The methodology the study utilises is doctrinal research with reports from existing literature and tertiary data sources such as newspapers, the Internet, and websites. Pertinent data collected from these sources were theoretically analysed and argued with current literature on the subject. Results: The finding is that the PIA does not make adequate provisions for the energy transition in line with Nigeria's Nationally Determined Contributions (NDC) under the Paris agreement; the PIA was provided for weak institutions, which translates to weak implementation and enforcement of the law which further widening the gap between the law and reality. Conclusions: The study concluded that, although the Act delivered the much-needed stability in the petroleum industry in Nigeria, there is a need for an overhaul of the Act to further protect the interest of host communities and allow for co-ownership of petroleum resources by the state government.

Certificateless broadcast signcryption scheme supporting equality test in smart grid.

With the development of cloud computing and the application of Internet of Things (IoT) in the smart grid, a massive amount of sensitive data is produced by the terminal equipment. This vast amount of data is subject to various attacks during transmission, from which users must be protected. However, most of the existing schemes require a large amount of network bandwidth resources and cannot ensure the receiver's anonymity. To solve these shortcomings, we construct a broadcast signcryption scheme supporting equality test based on certificateless cryptosystem. The scheme employs a symmetric encryption algorithm to improve encryption and transmission efficiency; The Lagrange interpolation theorem is used to encrypt the user's identity to ensure the privacy preservation of terminal devices; And a trusted third party is used to eliminate duplicated ciphertext for identical messages using an equality test, resulting in efficient network bandwidth utilization. Experimental analysis shows that our work has greater advantages in the field of practical broadcast services.

Relationships of internet gaming engagement, history, and maladaptive cognitions and adolescent internet gaming disorder: A cross-sectional study.

OBJECTIVE: This study tested the mediation effect of maladaptive cognition of internet gaming and moderation effect of internet gaming history in the relationship between internet gaming engagement and internet gaming disorder in adolescents. METHOD: A total of 2,902 secondary school students were surveyed in Hong Kong from February 2021 to December 2021. The proposed moderated mediation model was tested by PROCESS. RESULTS: Internet gaming engagement, internet gaming history and maladaptive cognition were positively associated with internet gaming disorder symptoms. Maladaptive cognition significantly mediated the association between internet gaming engagement and internet gaming disorder symptoms in both males and females. In addition, a significant interaction between internet gaming engagement and internet gaming history was detected among females but not for males, namely, the positive relationships of internet gaming engagement with maladaptive cognition and internet gaming disorder symptoms were weaker with the increased years of internet gaming. CONCLUSIONS: Our study provides a better understanding of the underlying mechanism and boundary condition in the association between internet gaming engagement and internet gaming disorder among adolescents. Preventing interventions should aim to reduce maladaptive cognition and internet gaming engagement. Interventions targeting internet gaming engagement maybe more effective among female gamers who are beginners and all male gamers.

Attention-based bidirectional-long short-term memory for abnormal human activity detection.

Abnormal human behavior must be monitored and controlled in today's technology-driven era, since it may cause damage to society in the form of assault or web-based violence, such as direct harm to a person or the propagation of hate crimes through the internet. Several authors have attempted to address this issue, but no one has yet come up with a solution that is both practical and workable. Recently, deep learning models have become popular as a means of handling massive amounts of data but their potential to categorize the aberrant human activity remains unexplored. Using a convolutional neural network (CNN), a bidirectional long short-term memory (Bi-LSTM), and an attention mechanism to pay attention to the unique spatiotemporal characteristics of raw video streams, a deep-learning approach has been implemented in the proposed framework to detect anomalous human activity. After analyzing the video, our suggested architecture can reliably assign an abnormal human behavior to its designated category. Analytic findings comparing the suggested architecture to state-of-the-art algorithms reveal an accuracy of 98.9%, 96.04%, and 61.04% using the UCF11, UCF50, and subUCF crime datasets, respectively.

"The chameleon among diseases" - an explorative view of sarcoidosis and identification of the consequences for affected patients and relatives using qualitative interviews.

INTRODUCTION: Sarcoidosis is a multisystemic disease, with the lungs being the main site of manifestation. Although the exact etiology remains unclear, both genetic and environmental factors are being discussed. Diagnostic evaluation is challenging, and the management of chronic patients and assessment of their needs proves difficult, especially in the absence of targeted therapy. Studies on sarcoidosis patients have shown that quality of life is limited even after clinically measurable parameters have resolved. The question remains how patients and their relatives perceive medical care and the diagnostic process and how these affect their well-being. METHODS: Qualitative, semi-structured interviews were conducted with patients and their relatives between September 2019 and February 2020. Interviews were recorded, transcribed verbatim, and analyzed using qualitative content analysis. Deductive hypotheses were then formed based on categories according to personal aspects, symptoms, diagnostic, daily life activity, therapy, psychological aspects and wishes. RESULTS: Fourteen patients and five relatives were included. Most patients reported subacute symptoms before the first organ-related episode. A high degree of personal initiative was required from the majority of respondents in both the diagnostic and subsequent therapeutic processes. In addition, respondents reported so-called "doctor-hopping", a lack of specialists or contacts, and a lack of medical support. The Internet and self-help groups played a fundamental role for patients and relatives in exchanging information with other affected persons and to compensate for an existing information deficit. CONCLUSION: The results provide new insights into patients' and relatives' perceptions of the sarcoidosis diagnosis and treatment process. Identification of barriers such as a lack of physicians and an information deficit highlights potential targets for strategies to optimize sarcoidosis management.

Design and Development of an Objective Evaluation System for a Web-Based Simulator for Trauma Management.

BACKGROUND: Trauma injuries are one of the main leading causes of death in the world. Training with guidelines and protocols is adequate to provide a fast and efficient treatment to patients that suffer a trauma injury. OBJECTIVES: This study aimed to evaluate deviations from a set protocol, a new set of metrics has been proposed and tested in a pilot study. METHODS: The participants were final-year students from the Universidad Autónoma de Madrid and first-year medical residents from the Hospital Universitario La Paz. They were asked to train four trauma scenarios with a web-based simulator for 2 weeks. A test was performed pre-training and another one post-training to evaluate the evolution of the treatment to those four trauma scenarios considering a predefined trauma protocol and based on the new set of metrics. The scenarios were pelvic and lower limb traumas in a hospital and in a prehospital setting, which allow them to learn and assess different trauma protocols. RESULTS: The results show that, in general, there is an improvement of the new metrics after training with the simulator. CONCLUSION: These new metrics provide comprehensive information for both trainers and trainees. For trainers, the evaluation of the simulation is automated and contains all relevant information to assess the performance of the trainee. And for trainees, it provides valuable real-time information that could support the trauma management learning process.

The Current Status of the Use of Internet Hospitals for Outpatients With Pain: Retrospective Study.

BACKGROUND: The national "Internet +" policies and the emergence of internet hospitals have created a new direction for the management of pain outside of the hospital. Nevertheless, there are no consolidated studies conducted by pain physicians on the current state of internet hospital-based online medical services used by patients with pain outside of a hospital setting. OBJECTIVE: In this retrospective study, we aimed to examine the status of the use of internet hospitals by patients who experience pain. Moreover, we identified the factors that influenced patients' decisions to make an online visit through the internet hospital. METHODS: Detailed information was collected online and offline from outpatients with pain at the information technology center of West China Hospital of Sichuan University from February 2020 to April 2022. Binary logistic regression analysis was conducted to identify the determinants that influenced patients' decisions to make an online visit to the internet hospital. RESULTS: Over a 2-year period, 85,266 pain-related clinic visits were recorded. Ultimately, 39,260 patients were enrolled for the analysis, with 12.9% (5088/39,260) having online visits. Both online and offline clinics had a greater number of visits by women than men. The average age of patients attending the online clinic was 46.85 (SD 16.56) years, whereas the average age of patients attending the offline clinic was 51.48 (SD 16.12) years. The majority of online clinic visitors (3059/5088, 60.1%) were employed, and one of the most common occupations was farming (721/5088, 14.2%). In addition, 51.8% (2635/5088) of patients who participated in the online clinics lived outside the hospital vicinity. Young (odds ratio [OR] 1.35, 95% CI 1.01-1.81; P=.045) and middle-aged (OR 1.98, 95% CI 1.81-2.16; P<.001) patients, employed patients (OR 1.11, 95% CI 1.04-1.18; P=.002), nonlocal patients (OR 1.57, 95% CI 1.48-1.67; P<.001), and the ordinary staff (OR 1.19, 95%CI 1.01-1.39; P=.03) were more likely to have the intention to choose online visits through the internet hospitals. CONCLUSIONS: Internet hospitals are flourishing as a more efficient and promising method of pain management and follow-up for patients with pain outside the hospital. People with pain who are young, working, and not in the vicinity of hospitals are more likely to visit internet hospitals.

Identification of a visualized web-based nomogram for overall survival prediction in patients with limited stage small cell lung cancer.

Small-cell lung cancer (SCLC) is an aggressive lung cancer subtype with an extremely poor prognosis. The 5-year survival rate for limited-stage (LS)-SCLC cancer is 10-13%, while the rate for extensive-stage SCLC cancer is only 1-2%. Given the crucial role of the tumor stage in the disease course, a well-constructed prognostic model is warranted for patients with LS-SCLC. The LS-SCLC patients' clinical data extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2018 were reviewed. A multivariable Cox regression approach was utilized to identify and integrate significant prognostic factors. Bootstrap resampling was used to validate the model internally. The Area Under Curve (AUC) and calibration curve evaluated the model's performance. A total of 5463 LS-SCLC patients' clinical data was collected from the database. Eight clinical parameters were identified as significant prognostic factors for LS-SCLC patients' OS. The predictive model achieved satisfactory discrimination capacity, with 1-, 2-, and 3-year AUC values of 0.91, 0.88, and 0.87 in the training cohort; and 0.87, 0.87, and 0.85 in the validation cohort. The calibration curve showed a good agreement with actual observations in survival rate probability. Further, substantial differences between survival curves of the different risk groups stratified by prognostic scores were observed. The nomogram was then deployed into a website server for ease of access. This study developed a nomogram and a web-based predictor for predicting the overall survival of patients with LS-SCLC, which may help physicians make personalized clinical decisions and treatment strategies.

Gender differences in the relationships between meaning in life, mental health status and digital media use during Covid-19.

BACKGROUND: The COVID-19 pandemic has had a significant impact on individuals' social lives, mental health status, and meaning in life (MIL). Globally, the use of different types of digital media has become a proxy for pre-COVID social lives for many people. This study investigated gender differences in the relationship between use of digital media, mental health status and MIL, during COVID-19 in Hong Kong. METHODS: This cross-sectional study surveyed 1,488 young people recruited via city-wide random sampling in 2021. Respondents completed a phone survey on digital media use, Patient Health Questionnaire (PHQ-2), Generalized Anxiety Disorder (GAD-2), COVID-19 impact, meaning in life, and demographics. Gender differences in MIL were tested with an independent sample t-test. Gender-specific multiple linear regression models tested associations between MIL and explanatory variables of age, educational level, history of diagnosis, digital media use, and mental health status. RESULTS: There was a significant gender difference in MIL (males (M = 12.90, SD = 4.12); females (M = 13.45, SD = 3.96); t (1485) = -2.656, p = .008). For males, all variables significantly associated to MIL (F (9, 759) = 15.731, p < .000, R2 = .157). However, for females, while the overall model for MIL was significant (F (9, 709) = 12.105, p < .001, R2 = .133), the only significant associated variable was mental health status. CONCLUSION: Females had significantly better MIL under COVID-19 than males. Digital media use contributed to MIL in males but not females, and there were gender-specific associated factors of MIL.

Cardiff Online Cognitive Assessment in a National Sample: Cross-Sectional Web-Based Study.

BACKGROUND: Psychiatric disorders are associated with cognitive impairment. We have developed a web-based, 9-task cognitive battery to measure the core domains affected in people with psychiatric disorders. To date, this assessment has been used to collect data on a clinical sample of participants with psychiatric disorders. OBJECTIVE: The aims of this study were (1) to establish a briefer version of the battery (called the Cardiff Online Cognitive Assessment [CONCA]) that can give a valid measure of cognitive ability ("g") and (2) to collect normative data and demonstrate CONCA's application in a health population sample. METHODS: Based on 6 criteria and data from our previous study, we selected 5 out of the original 9 tasks to include in CONCA. These included 3 core tasks that were sufficient to derive a measure of "g" and 2 optional tasks. Participants from a web-based national cohort study (HealthWise Wales) were invited to complete CONCA. Completion rates, sample characteristics, performance distributions, and associations between cognitive performance and demographic characteristics and mental health measures were examined. RESULTS: A total of 3679 participants completed at least one CONCA task, of which 3135 completed all 3 core CONCA tasks. Performance on CONCA was associated with age (B=-0.05, SE 0.002; P<.001), device (tablet computer: B=-0.26, SE 0.05; P<.001; smartphone: B=-0.46, SE 0.05; P<.001), education (degree: B=1.68, SE 0.14; P<.001), depression symptoms (B=-0.04, SE 0.01; P<.001), and anxiety symptoms (B=-0.04, SE 0.01; P<.001). CONCLUSIONS: CONCA provides a valid measure of "g," which can be derived using as few as 3 tasks that take no more than 15 minutes. Performance on CONCA showed associations with demographic characteristics in the expected direction and was associated with current depression and anxiety symptoms. The effect of device on cognitive performance is an important consideration for research using web-based assessments.

Web-Based Self-Compassion Training to Improve the Well-Being of Youth With Chronic Medical Conditions: Randomized Controlled Trial.

BACKGROUND: Up to one-third of young people live with chronic physical conditions (eg, diabetes, asthma, and autoimmune disease) that frequently involve recurrent pain, fatigue, activity limitations, stigma, and isolation. These issues may be exacerbated as young people transition through adolescence. Accordingly, young people with chronic illness are at a high risk of psychological distress. Accessible, evidence-based interventions for young people with chronic illnesses are urgently needed to improve well-being, support adaptation, and enhance daily functioning. Self-compassion, which is an adaptive means of relating to oneself during times of difficulty, is a promising intervention target for this population. OBJECTIVE: This study aims to test the efficacy of a 4-week, self-guided, web-based self-compassion training program for improving well-being among young Australians (aged 16-25 years) living with a chronic medical condition. The primary outcomes were self-compassion, emotion regulation difficulties, and coping; the secondary outcomes were well-being, distress, and quality of life. We also sought to test whether changes in primary outcomes mediated changes in secondary outcomes and gather feedback about the strengths and limitations of the program. METHODS: We conducted a single-blind, parallel-group, randomized controlled trial comparing a 4-week, fully automated, web-based self-compassion training program with a waitlist control. Participants were recruited via the internet, and outcomes were self-assessed at 4 (T1) and 12 weeks (T2) after the baseline time point via a web-based survey. A mixed methods approach was used to evaluate the program feedback. RESULTS: Overall, 151 patients (age: mean 21.15, SD 2.77 years; female patients: n=132, 87.4%) were randomized to the intervention (n=76, 50.3%) and control (n=75, 49.7%) groups. The loss-to-follow-up rate was 47.4%, and program use statistics indicated that only 29% (22/76) of young people in the experimental group completed 100% of the program. The main reported barrier to completion was a lack of time. As anticipated, treatment effects were observed for self-compassion (P=.01; partial η2=0.05; small effect); well-being (P≤.001; partial η2=0.07; medium effect); and distress (P=.003; partial η2=0.054; small-medium effect) at the posttest time point and maintained at follow-up. Contrary to our hypotheses, no intervention effects were observed for emotion regulation difficulties or maladaptive coping strategies. Improvements in adaptive coping were observed at the posttest time point but were not maintained at follow-up. Self-compassion, but not emotion regulation difficulties or coping, mediated the improvements in well-being. CONCLUSIONS: Minimal-contact, web-based self-compassion training can confer mental health benefits on young people with chronic conditions. This group experiences substantial challenges to participation in mental health supports, and program engagement and retention in this trial were suboptimal. Future work should focus on refining the program content, engagement, and delivery to optimize engagement and treatment outcomes for the target group. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry 12619000572167; https://tinyurl.com/5n6hevt. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-020-8226-7.

Gender-Based Violence Narratives in Internet-Based Conversations in Nigeria: Social Listening Study.

BACKGROUND: Overcoming gender inequities is a global priority recognized as essential for improved health and human development. Gender-based violence (GBV) is an extreme manifestation of gender inequities enacted in real-world and internet-based environments. In Nigeria, GBV has come to the forefront of attention since 2020, when a state of emergency was declared due to increased reporting of sexual violence. Understanding GBV-related social narratives is important to design public health interventions. OBJECTIVE: We explore how gender-related internet-based conversations in Nigeria specifically related to sexual consent (actively agreeing to sexual behavior), lack of consent, and slut-shaming (stigmatization in the form of insults based on actual or perceived sexuality and behaviors) manifest themselves and whether they changed between 2017 and 2022. Additionally, we explore what role events or social movements have in shaping gender-related narratives in Nigeria. METHODS: Social listening was carried out on 12,031 social media posts (Twitter, Facebook, forums, and blogs) and almost 2 million public searches (Google and Yahoo search engines) between April 2017 and May 2022. The data were analyzed using natural language processing to determine the most salient conversation thematic clusters, qualitatively analyze time trends in discourse, and compare data against selected key events. RESULTS: Between 2017 and 2022, internet-based conversation about sexual consent increased 72,633%, from an average 3 to 2182 posts per month, while slut-shaming conversation (perpetrating or condemning) shrunk by 9%, from an average 3560 to 3253 posts per month. Thematic analysis shows conversation revolves around the objectification of women, poor comprehension of elements of sexual consent, and advocacy for public education about sexual consent. Additionally, posters created space for sexual empowerment and expressions of sex positivity, pushing back against others who weaponize posts in support of slut-shaming narrative. Time trend analysis shows a greater sense of empowerment in advocating for education around the legal age of consent for sexual activity, calling out double standards, and rejecting slut-shaming. However, analysis of emotions in social media posts shows anger was most prominent in sexual consent (n=1213, 73%) and slut-shaming (n=226, 64%) posts. Organic social movements and key events (#ArewaMeToo and #ChurchToo, the #SexforGrades scandal, and the #BBNaija television program) played a notable role in sparking discourse related to sexual consent and slut-shaming. CONCLUSIONS: Social media narratives are significantly impacted by popular culture events, mass media programs, social movements, and micro influencers speaking out against GBV. Hashtags, media clips, and other content can be leveraged effectively to spread awareness and spark conversation around evolving gender norms. Public health practitioners and other stakeholders including policymakers, researchers, and social advocates should be prepared to capitalize on social media events and discourse to help shape the conversation in support of a normative environment that rejects GBV in all its forms.