Self-report Bias Research Articles

Longitudinal Monitoring of Electric Vehicle Travel Trends Using Connected Vehicle Data

Historically, practitioners and researchers have used selected count station data and survey-based methods along with demand modeling to forecast vehicle miles traveled (VMT). While these methods may suffer from self-reporting bias or spatial and temporal constraints, the widely available connected vehicle (CV) data at 3 s fidelity, independent of any fixed sensor constraints, present a unique opportunity to complement traditional VMT estimation processes with real-world data in near real-time. This study developed scalable methodologies and analyzed 238 billion records representing 16 months of connected vehicle data from January 2022 through April 2023 for Indiana, classified as internal combustion engine (ICE), hybrid (HVs) or electric vehicles (EVs). Year-over-year comparisons showed a significant increase in EVMT (+156%) with minor growth in ICEVMT (+2%). A route-level analysis enables stakeholders to evaluate the impact of their charging infrastructure investments at the federal, state, and even local level, unbound by jurisdictional constraints. Mean and median EV trip lengths on the six longest interstate corridors showed a 7.1 and 11.5 mile increase, respectively, from April 2022 to April 2023. Although the current CV dataset does not randomly sample the full fleet of ICE, HVs, and EVs, the methodologies and visuals in this study present a framework for future evaluations of the return on charging infrastructure investments on a regular basis using real-world data from electric vehicles traversing U.S. roads. This study presents novel contributions in utilizing CV data to compute performance measures such as VMT and trip lengths by vehicle type—EV, HV, or ICE, unattainable using traditional data collection practices that cannot differentiate among vehicle types due to inherent limitations. We believe the analysis presented in this paper can serve as a framework to support dialogue between agencies and automotive Original Equipment Manufacturers in developing an unbiased framework for deriving anonymized performance measures for agencies to make informed data-driven infrastructure investment decisions to equitably serve ICE, HV, and EV users.

Strategies to Facilitate Service Utilization Among Youth at Risk for HIV: A Randomized Controlled Trial (ATN 149).

Sexual and gender minority youth (SGMY) are vulnerable to acquiring HIV and need HIV prevention and health services, but may have competing needs. A prior analysis found that PrEP use reports increased in a combination intervention study arm with coaching, peer support, and automated text-messages. This paper examines ancillary support and healthcare services utilization as secondary intervention objectives. SGMY (N = 895, 40% Black, 29% Latino) in Los Angeles and New Orleans were recruited from May, 2017 to August, 2019 and randomized to four intervention conditions: (a) automated text-messaging and monitoring intervention (AMMI), (b) AMMI plus peer support online (AMMI+PS), (c) AMMI plus strengths-based coaching by near-peer paraprofessionals (AMMI+C), or (d) all three (AMMI+PS+C). Intent-to-treat multivariate regression analyses evaluated the interventions' efficacy on past 4-month reports of ancillary support services use, having a regular healthcare provider, receiving care from doctor's office or clinic and mental health specialists, and participation in mental health support groups and HIV prevention programs. Ancillary services utilization reports declined from 40% of youth reporting an average of 4.4 services at baseline to 22.6% reporting 2.5 services by 24months. Food, housing, transportation, and other basic services were utilized most frequently. Youth in the two coaching interventions maintained higher reports of services use over time compared to AMMI-only (both OR 1.23, 95%CI 1.12-1.35) and to AMMI+PS (both OR 1.20 95%CI 1.08-1.33). Our coaching intervention may support SGMY to stay engaged in support services. Results may be limited by self-report biases. It is unclear if these services are related to better long-term outcomes.

Evaluating Risk Factors and the Burden of Silent Myocardial Ischemia Among Diabetic Patients.

Silent myocardial ischemia (SMI) is a significant concern for diabetic patients, often remaining undetected until severe complications arise. Prolonged hyperglycemia, poor glycemic control, and lifestyle factors contribute to its risk, with older adults and those with long-standing diabetes particularly vulnerable. To assess the prevalence and predictors of SMI in adults with diabetes, emphasizing long-term management and monitoring. A longitudinal observational study was conducted at Nishtar Medical University, Multan, from October 2020 to September 2022, involving 388 adults with diabetes for at least five years. Patients with significant cardiovascular diseases or recent medication-affecting biomarkers were excluded. Data collection included demographics, medical history, and clinical assessments such as HbA1c levels, 12-lead resting ECGs, and treadmill exercise stress tests, with myocardial perfusion imaging (MPI) for those unable to perform stress tests. Statistical analyses using IBM SPSS (version 22) incorporated univariate and multivariate logistic regression to identify predictors of SMI, adjusting for confounders such as age, sex, smoking, and blood pressure. Thresholds included microalbuminuria at 30-300 mg/24 hours and HbA1c ≥7%, with missing data addressed through multiple imputations. Among the participants, the prevalence of SMI was 48%, increasing to 58% in those with microalbuminuria. Significant predictors included the duration of diabetes (OR 1.28, 95% CI: 1.08-1.52, p=0.001), HbA1c levels (OR 1.75, 95% CI: 1.42-2.16, p<0.001), age (OR 1.05, 95% CI: 1.01-1.09, p=0.035), and smoking status (OR 1.42, 95% CI: 1.05-1.92, p=0.025). Smoking status was based on self-report. Notably, microalbuminuria showed a strong association with SMI (OR 2.89, 95% CI: 2.10-3.98, p<0.001). The distribution of participants was balanced in terms of age and gender, with a mean age of 58 years (SD 9.4), and 52% were male. No unexpected findings were observed, and the results aligned with the anticipated relationships between the variables. This study highlights a concerning prevalence of SMI among diabetic patients, emphasizing the importance of monitoring diabetes duration and glycemic control, particularly in individuals with microalbuminuria. Regular follow-up care, including routine ECGs, stress tests, and biomarker assessments, is crucial for improving cardiovascular outcomes in this high-risk population. Limitations such as the observational design and potential self-report bias in smoking status may affect the generalizability of the findings. Future research should focus on large-scale, multicenter studies to validate these findings and explore interventions that could reduce the burden of SMI in diabetic patients.

Identifying and Assessing Physiological Biomarkers for Food and Energy Intake: A Systematic Review with Meta-Analysis Protocol

Background Traditional dietary assessments are often inaccurate and prone to self-reporting biases. Tracking the physiological responses associated with eating and digestion events via wearable technologies may provide an effective approach for continuously monitoring food intake and estimating energy consumption. Eating and digestion are accompanied by a series of changes in the heart rate, skin temperature, blood oxygen saturation, and blood pressure. These changes can be tracked by wearable devices, such as smartwatches, which have been widely accepted in the market. This systematic review is the first to evaluate the effectiveness of tracking such physiological biomarkers in differentiating between high- and low-calorie meals, potentially paving the way for more accurate dietary monitoring. Methods Following the PRISMA-P guidelines, we will conduct a systematic literature search through MEDLINE, EMBASE, and PubMed for clinical trials that investigated physiological responses following meal intake in healthy subjects. Two independent reviewers will screen and select articles based on pre-defined eligibility criteria, with a third review to resolve any discrepancies. This will be followed by data extraction and quality assessment of the included studies. Statistical analyses, including meta-analyses, will be performed using R Studio software. Our primary outcome will be the comparison of physiological biomarkers before and after meal intake, while secondary outcomes will include comparisons of physiological biomarkers between high- and low-calorie meal consumption and the correlation between the caloric content of consumed meals and postprandial physiological changes. Discussion This systematic review and meta-analysis will identify physiological indicators for eating events and inform the design of wearable sensors that estimate food intake in healthy subjects. Systematic Review Registration PROSPERO Registration ID: CRD42024544353

Determinants of nursing students’ satisfaction with blended learning

BackgroundBlended learning, a pedagogical approach combining traditional classroom instruction with online components, has gained prominence in nursing education. While offering numerous benefits, student satisfaction with blended learning remains a critical concern. This study contributes to the existing literature by providing a comprehensive evaluation of the determinants influencing nursing students’ satisfaction with this innovative educational modality. By examining a wide range of factors, including sociodemographic characteristics, academic factors, and environmental influences, this research offers valuable insights for educators to optimize blended learning experiences in nursing education.MethodsA descriptive cross-sectional research design was conducted. This study investigates the factors influencing nursing students’ satisfaction with blended learning at Alexandria University, Egypt, where blended learning programs have been integrated into the curriculum primarily through the Microsoft Teams platform. A convenient sample of 1266 nursing students from both bachelor and technical educational institutions participated in the study from September 2023 to the end of December 2023. Data were collected using an online survey containing two measurement tools: the Blended Learning Satisfaction Scale and the Environmental Facilitators and Barriers to Student Persistence in Online Courses scale. Statistical analyses, including descriptive statistics and backward multiple linear regression, were conducted to identify factors that are associated with the satisfaction of nursing students’ with blended learning.ResultsFindings indicate that factors such as age, gender, income, employment status, access to suitable internet sources, academic year, computer literacy, preferred learning method, and perceptions of environmental facilitators significantly influence satisfaction scores (all p < 0.001). The overall regression model, with an adjusted R² of 0.31, signifies that 31% of the variance in satisfaction scores is explained collectively by the previously mentioned variables (F = 21.21, p < 0.001).ConclusionStudents’ sociodemographic variables, preference for blended learning, and perception of environmental facilitators such as encouragement to enroll in the course significantly influence nursing students’ satisfaction levels with blended learning. However, limitations in the current study such as self-report bias, convenient sampling, and cross-sectional design limit the generalizability and causal inferences of these findings.

The Future Museum: Integrating Augmented Reality (AR) and Virtual-text with AI-enhanced Information Systems

This study examines how AR, virtual text, and AI in future museums affect visitor engagement, knowledge acquisition, emotional response, and social interaction. The study uses econometrics equations, text analysis, thematic qualitative data analysis, and agent-based modelling. The economic models show that virtual text type, depth of knowledge, personalization, accessibility options, and AR museum experiences increase visitor engagement, knowledge, emotional response, and social interaction. Thematic analysis displays visitor viewpoints such as AR curiosity, personalization, and cultural significance, while correlation matrices indicate their relationships. Bayesian econometrics, text analysis, thematic qualitative data analysis, and agent-based modelling are used to explore museum visitors' interactions with augmented reality, virtual text, and AI-enhanced information systems. These devices improve visitor engagement, social connection, emotional response, and information collection. Self-reported data biases, context biases, and rapid technological advancement limit the study. Museums can benefit from user-centric technology, AR, personalization, and cultural knowledge. The main findings reveal that these technologies significantly increase museum visitors, emphasizing that future museum administration and design must carefully adopt new technology. The findings may affect museum staff, designers, and decision-makers. Learning important technology factors improves AR, virtual text, and AI-enhanced information system design and deployment decisions. UX design prioritizes visitor choices, while immersive and integrated displays connect museum experiences. These practical implications force museums to actively and practically integrate technology to stay relevant. The project's findings, practical insights, and visitor experiences will improve future technological and cultural organisation research. The whole process contributes to the discussion on how emerging technologies affect museum experiences and innovation and decision-making in the ever-changing cultural heritage context.

Association of continuous BMI with health-related quality of life in the United States by age and sex.

The objective of this study is to estimate health-related quality of life (HRQoL) by continuous BMI by age, sex, and demographic group in the United States. We estimated HRQoL (overall and by domain) by continuous BMI using SF-6D (Short-Form Six-Dimension) data from 182,778 respondents ages 18 years and older from the repeated cross-sectional Medical Expenditure Panel Survey (MEPS) 2008 to 2016. We adjusted for BMI self-report bias and for potential confounding between BMI and HRQoL. We found an inverse J-shaped curve of HRQoL by BMI, with lower values for female individuals and the highest health utilities occurring at BMI of 20.4 kg/m2 (95% CI: 20.32-20.48) for female individuals and 26.5 kg/m2 (95% CI: 26.45-26.55) for male individuals. By BMI category, excess weight contributed to HRQoL loss of 0.0349 for obesity overall, rising to 0.0724 for class III obesity. By domain, pain was the largest cause of HRQoL loss for obesity (26%), followed by role limitations (22%). HRQoL is lower for people with excess body weight across a broad range of ages and BMI levels, especially at high levels of BMI, with pain being the largest driver of HRQoL loss. These findings highlight the importance of promoting a healthy weight for the entire population while also targeting efforts to prevent extreme weight gain over the life course.

Edinburgh postpartum depression scores are associated with vaginal and gut microbiota in pregnancy

BackgroundPrenatal and postpartum depression may be influenced by the composition of host associated microbiomes. As such, the objective of this study was to elucidate the relationship between the human gut or vaginal microbiomes in pregnancy with prenatal or postpartum depression. Methods140 female participants were recruited at their first prenatal visit and completed the Edinburgh Postnatal Depression Scale (EPDS) to screen for depression and anxiety, in addition the EPDS was completed one month postpartum. Vaginal and stool biospecimens were collected in the third trimester, analyzed using 16S rRNA gene sequencing, and assessed for alpha and beta diversity. Individual taxa differences and clustering using the k-medoids algorithm enabled community state type classification. ResultsParticipants with higher postpartum EPDS scores had higher species richness and lower abundance of L. crispatus in the vaginal microbiota compared to those with lower EPDS scores. Participants with a higher prenatal EPDS score had lower species richness of the gut microbiome. Participants with a vaginal community state type dominated by L. iners had the highest mean prenatal EPDS scores, whereas postpartum EPDS scores were similar regardless of prenatal vaginal state type. LimitationsOur small sample size and participant's self-report bias limits generalizability of results. ConclusionsDepression in the prenatal and postpartum period is associated with the composition and diversity of the gut and vaginal microbiomes in the third trimester of pregnancy. These results provide a foundational understanding of the microbial relationships between maternal health and depression for identifying potential therapeutic treatments.

The Future Museum: Integrating Augmented Reality (AR) and Virtual-text with AI-enhanced Information Systems

This study examines how AR, virtual text, and AI in future museums affect visitor engagement, knowledge acquisition, emotional response, and social interaction. The study uses econometrics equations, text analysis, thematic qualitative data analysis, and agent-based modelling. The economic models show that virtual text type, depth of knowledge, personalization, accessibility options, and AR museum experiences increase visitor engagement, knowledge, emotional response, and social interaction. Thematic analysis displays visitor viewpoints such as AR curiosity, personalization, and cultural significance, while correlation matrices indicate their relationships. Bayesian econometrics, text analysis, thematic qualitative data analysis, and agent-based modelling are used to explore museum visitors' interactions with augmented reality, virtual text, and AI-enhanced information systems. These devices improve visitor engagement, social connection, emotional response, and information collection. Self-reported data biases, context biases, and rapid technological advancement limit the study. Museums can benefit from user-centric technology, AR, personalization, and cultural knowledge. The main findings reveal that these technologies significantly increase museum visitors, emphasizing that future museum administration and design must carefully adopt new technology. The findings may affect museum staff, designers, and decision-makers. Learning important technology factors improves AR, virtual text, and AI-enhanced information system design and deployment decisions. UX design prioritizes visitor choices, while immersive and integrated displays connect museum experiences. These practical implications force museums to actively and practically integrate technology to stay relevant. The project's findings, practical insights, and visitor experiences will improve future technological and cultural organisation research. The whole process contributes to the discussion on how emerging technologies affect museum experiences and innovation and decision-making in the ever-changing cultural heritage context.

Hatha yoga reduces momentary stress but does not impact diurnal profiles of salivary cortisol and alpha-amylase: A randomized controlled trial

Does the practice of yoga impact stress? Various studies have suggested that yoga may reduce both self-reported stress and stress biomarkers, but the evidence for such claims remains inconclusive, especially for yoga styles with a focus on physical postures. In a randomized controlled trial with 98 participants, we therefore examined whether an eight-week Hatha yoga intervention (60 min, 3×/week or more) led to reduced levels of diurnal salivary cortisol (sCort), salivary alpha-amylase (sAA), and subjective momentary stress as compared to a waitlist control group. To ensure the concomitant assessment of self-report and biological measures in an ecologically valid setting, and to capture the diurnal profile of cortisol and alpha-amylase, we employed an ecological momentary assessment approach. Five times per day, participants reported their momentary stress levels on a visual analogue scale and collected saliva samples for the assessment of salivary biomarkers. The intervention led to a significant reduction of subjective momentary stress but there was no change in diurnal sCort or sAA levels. There are several potential explanations for these findings: The intervention may have helped participants to cope better with stress while leaving diurnal levels of stress biomarkers unaffected, or the change may at least not have been reflected in sCort and sAA. Alternatively, there may have been a self-report bias, insofar as a favorable disposition towards yoga may have led participants to report reductions in stress in order to indicate positive effects of the intervention. Our findings contribute to a better understanding of the effects of distinct yoga interventions, demonstrating their potential to serve as low-risk stress relief tools.

In the Realm of Uncertainty: Quantum Thinking Promotes Tolerance for Ambiguity.

According to the principles of quantum mechanics, individuals are unable to accurately predict the precise outcome of a measurement or observation. Despite the significant impact of quantum thinking on science, there is a lack of understanding regarding the psychological consequences associated with adopting such a mindset. This research investigates how engaging in quantum thinking, which accepts the universe's inherent complexities and uncertainties, influences one's tolerance for ambiguity. To test our hypothesis, we conducted three complementary studies involving diverse populations (students and community adults), multiple measures of tolerance of ambiguity (self-report data and behavioral indicators), and different priming procedures (text reading and sentence scrambling tasks). Study 1 demonstrated that university students exposed to quantum thinking principles exhibited greater tolerance for ambiguity within an English as a Foreign Language (EFL) setting. Moving beyond the educational setting, Study 2 corroborated these observations by evaluating an individual's ease with uncertainty and unpredictability across different everyday scenarios. Addressing potential self-report biases, Study 3 incorporated a behavioral measure to objectively validate the observed effect. Together, these findings suggest that the thinking mindset prevalent in physics significantly impacts individuals' cognitive flexibility and behavior, highlighting the broad relevance of quantum thinking beyond its scientific origins.

Cognitive connections in visitor loyalty towards environmental sustainability at World Expo 2020

ABSTRACT This study investigates the intricate relationship among environmental attitudes, mindfulness, behavioural intentions, and destination loyalty within the eco-friendly setting of World Expo 2020 Dubai. Examining the biophilia hypothesis and Attention Restoration Theory (ART), the research explores how visitors’ cognitive connections with ‘human-made’ natural environments impact their commitment to environmental sustainability. Through analysis of two-stage data from a diverse cohort spanning over 30 nations, the study reveals both direct and indirect effects of environmental attitudes on destination loyalty. The findings highlight the significance of fostering environments conducive to positive environmental attitudes and mindfulness practices, which can bolster visitor commitment to sustainable behaviours and loyalty to eco-conscious destinations. Tailored communication strategies and engagement initiatives are essential to address cognitive nuances among diverse visitor demographics, advancing efforts to promote environmentally sustainable behaviours. This study also offers valuable insights into the cognitive factors influencing visitor behaviour at large-scale events, with practical implications for enhancing sustainability practices and fostering enduring dedication to eco-conscious tourism experiences. Methodologically, the study emphasizes the importance of broader sampling strategies to enhance external validity and mitigate potential self-report bias.

2332 Feasibility and utility of introducing handgrip strength measurement for outpatients living with Parkinson's disease

Abstract Background Patients living with Parkinson’s disease (PD) who are sarcopenic are at significantly higher risk of falling (Cai et al., Frontiers in Neurology,2021,12,598,035). Handgrip strength is a useful tool to assess for sarcopenia but is not commonly measured in clinical practice, despite the consequences that sarcopenia poses. This study aims to incorporate handgrip strength into the assessment of outpatients living with PD. Secondary objectives are to increase the understanding of whether exercise is associated with increased handgrip strength and to implement interventions for patients who are identified as sarcopenic; to improve their health outcomes. Methods Questionnaires were designed to gather quantitative data about patients’ demographics, how frequently they fall, disease severity and their weekly exercise. These were given to patients attending the movement disorders clinic at Crawley hospital, between February and October 2023. Patients without a diagnosis of PD were excluded. Their grip strength was measured using a standardised technique with a calibrated manometer. Data was input to Microsoft Excel and analysed using Spearman’s rank and Kruskal-Wallis test. Results Handgrip strength was obtained for 125 of 271 patients (46%) attending clinic over this period. Initially healthcare workers took 9.2 minutes to complete the questionnaire, but this improved to 4.3 minutes after updating the form. Sixteen patients were excluded, leaving 51 females and 58 males; both with a mean age of 80. Grip strength reduced with PD severity when adjusted for gender; this was significant in males (H = 51.9, p = 0.00) but not females (H = 4.8,p = 0.31). Grip strength was weakly correlated with exercise, although not significant (r2 = 0.15,p = 0.15) but did not appear to be related to frequency of falls (r2 = 0.01,p = 0.92). Conclusions Handgrip measurement can be successfully implemented into outpatient assessment. Handgrip strength could be used to monitor the effect of lifestyle change in individuals. Limitations include self-reporting bias; which activities each individual classifies as exercise.

Measuring vaccination coverage and concerns of vaccine holdouts from web search logs

To design effective vaccine policies, policymakers need detailed data about who has been vaccinated, who is holding out, and why. However, existing data in the US are insufficient: reported vaccination rates are often delayed or not granular enough, and surveys of vaccine hesitancy are limited by high-level questions and self-report biases. Here we show how search engine logs and machine learning can help to fill these gaps, using anonymized Bing data from February to August 2021. First, we develop a vaccine intent classifier that accurately detects when a user is seeking the COVID-19 vaccine on Bing. Our classifier demonstrates strong agreement with CDC vaccination rates, while preceding CDC reporting by 1–2 weeks, and estimates more granular ZIP-level rates, revealing local heterogeneity in vaccine seeking. To study vaccine hesitancy, we use our classifier to identify two groups, vaccine early adopters and vaccine holdouts. We find that holdouts, compared to early adopters matched on covariates, are 67% likelier to click on untrusted news sites, and are much more concerned about vaccine requirements, development, and vaccine myths. Even within holdouts, clusters emerge with different concerns and openness to the vaccine. Finally, we explore the temporal dynamics of vaccine concerns and vaccine seeking, and find that key indicators predict when individuals convert from holding out to seeking the vaccine.

Political Party Affiliation and COVID-19 Vaccination Status in Japan, 2022.

An association has been reported between political affiliations and vaccination worldwide. In Japan, a significant proportion of the population are non-partisans, and major political parties advocate COVID-19 vaccination. The association between supporting political parties and COVID-19 vaccination coverage in Japan remains unclear.This study aims to investigate the relationship between political party affiliation and COVID-19 vaccination status in Japan. Methods: This study utilized data from large-scale nationwide internet surveys conducted in Japan in 2022, with a sample size of 21,162 participants. The surveys collected information on participants' COVID-19 vaccination status and political party affiliation. The political parties included in the analysis were the Liberal Democratic Party, the Constitutional Democratic Party, the Komeito, the Japanese Communist Party, the Japan Innovation Party (Nippon Ishin no Kai), and the Reiwa Shinsengumi, as well as non-partisans. Logistic regression analysis was performed to examine the relationship between political partisanship and COVID-19 vaccine status. The analysis controlled for potential confounding variables such as age, gender, socioeconomic status, and geographic location. The odds of being unvaccinated were lower for supporters of large political groups (e.g. Liberal Democratic Party {OR 0.6; 95% CI, 0.5-0.7}), while higher for small political groups (e.g. Reiwa Shinsengumi {OR 2.6; 95% CI, 1.9-3.6}), in comparison with non-partisan. Political affiliation may be associated with vaccination disparities in Japan. Supporters of minor parties were more likely to be unvaccinated than those of the larger parties.However, this study has several limitations, including self-reporting bias andselection bias due to the Internet survey methodology.

Interprofessional competency in clinical students: validating the Clinical student version of the Japanese Self-assessment Scale of Interprofessional Competency (C-JASSIC)

ABSTRACT In this study, we developed and validated the Clinical Student Version of the Japanese Interprofessional Competency Self-Assessment Scale (C-JASSIC) for healthcare students in their clinical practice phase. Data obtained from 331 students (medical, 98; nursing, 99; pharmacy, 134) during orientation for interprofessional education (pre-IPE) and from 319 students (medical, 94; nursing, 93; pharmacy, 132) within a week following IPE (post-IPE) were analyzed. Exploratory pre-IPE and Confirmatory post-IPE factor analyses revealed a consistent 6-factor structure aligning with the Japanese Interprofessional Competency domains. The scale exhibited strong internal consistency, with Cronbach’s α values exceeding 0.8 for all factors both pre- and post-IPE. Scores for overall competency and individual domains increased post-IPE in 234 matched cases. A notable significant pre vs post difference concerned “Understanding of Others,” indicating enhanced interprofessional comprehension after clinical practice. There was a weak but significant positive correlation between IPE satisfaction and difference in pre- and post-IPE scores. However, no significant differences were observed among medical, nursing, and pharmacy students. Despite its strengths, such as its competency-based design and cultural relevance to Japan, a limitation of the study may be potential self-reporting bias. Nonetheless, C-JASSIC represents a valuable tool for seamless competency evaluations from student to professional stages, with implications for broader Asian contexts.

Recognition of online e-cigarette marketing and e-cigarette-related attitudes and behaviors among young adults.

Past research examining the relationship between exposure to online e-cigarette marketing and e-cigarette-related attitudes and behaviors has relied on unaided recall measures that may suffer from self-report bias. To date, few studies have presented participants with e-cigarette marketing stimuli and assessed recognition. This study examined the associations between recognition of online e-cigarette marketing stimuli and e-cigarette-related attitudes and behaviors among young adults in California. A non-probability representative sample of young adults (ages 18-24; N=1500) living in California completed an online survey assessing their recognition of online e-cigarette marketing stimuli, including image-based (i.e., Instagram, email) and audiovisual (i.e., YouTube, TikTok) promotions, and positive e-cigarette-related attitudes (e.g., appeal of e-cigarettes) and behaviors (e.g., e-cigarette use). Adjusted and weighted logistic regression analyses were used. 79.0% (n=1185) of young adults, including 78.1% (n=310/397) of participants under 21 years old, recognized online e-cigarette marketing. Participants who reported recognition of stimuli, compared with those who did not, had greater odds of reporting appeal of e-cigarettes (AOR=2.26, 95% CI=1.65-3.09) and e-cigarette purchase intentions (AOR=1.66, 95% CI=1.13-2.43) among all participants, and susceptibility to use e-cigarettes among never users (AOR=2.29, 95% CI=1.59-3.29). Young adults in California recognized audiovisual and image-based online e-cigarette marketing. Such recognition may lead to positive e-cigarette-related attitudes and behavioral intentions, especially among never users. Future research should examine the causal relationship between the associations found in this study. Findings may inform the development and evaluation of psychometrically valid measures of online e-cigarette marketing exposures. Recognition of online e-cigarette marketing stimuli was associated with greater odds of reporting appeal and benefits of e-cigarettes, purchase intentions, and lifetime e-cigarette use among all participants, and susceptibility to use e-cigarettes among never users. These findings may motivate the development and evaluation of psychometrically valid measures of online e-cigarette marketing exposures.

Association Between Social Determinants of Health and Cancer Treatment Delay in an Urban Population.

Delays in oncologic time to treatment initiation (TTI) independently and adversely affect disease-specific mortality. Social Determinants of Health (SDoH) are increasingly recognized as significant contributors to patients' disease management and health outcomes. Our academic center has validated a 10-item SDoH screener, and we elucidated which specific needs may be predictive of delayed TTI. This is a retrospective cohort study at an urban academic center of patients with a SDoH screening and diagnosis of breast, colorectal, endocrine/neuroendocrine, GI, genitourinary, gynecologic, head and neck, hematologic, hepatobiliary, lung, or pancreatic cancer from 2018 to 2022. Variables of interest included household income, tumor stage, and emergency department (ED) or inpatient admission 30 days before diagnosis. Factors associated with delayed TTI ≥45 days were assessed using multivariable logistic regression. Among 2,328 patients (mean [standard deviation] age, 64.0 (12.8) years; 66.6% female), having >1 unmet social need was associated with delayed TTI (odds ratio [OR], 1.68; 95% CI, 1.54 to 1.82). The disparities most associated with delay were legal help, transportation, housing stability, and needing to provide care for others. Those with ED (OR, 0.49; 95% CI, 0.44 to 0.54) or inpatient (OR, 0.54; 95% CI, 0.50 to 0.58) admission 30 days before diagnosis were less likely to experience delay. Delays in oncologic TTI ≥45 days are independently associated with unmet social needs. ED or inpatient admissions before diagnosis increase care coordination, leading to improved TTI. Although limitations included the retrospective nature of the study and self-reporting bias, these findings more precisely identify targets for intervention that may more effectively decrease delay. Patients with SDoH barriers are at higher risk of treatment delay and could especially benefit from legal, transportation, caregiver, and housing assistance.

Electrocortical activity associated with movement-related fear: a methodological exploration of a threat-conditioning paradigm involving destabilising perturbations during quiet standing

Musculoskeletal trauma often leads to lasting psychological impacts stemming from concerns of future injuries. Often referred to as kinesiophobia or re-injury anxiety, such concerns have been shown to hinder return to physical activity and are believed to increase the risk for secondary injuries. Screening for re-injury anxiety is currently restricted to subjective questionnaires, which are prone to self-report bias. We introduce a novel approach to objectively identify electrocortical activity associated with the threat of destabilising perturbations. We aimed to explore its feasibility among non-injured persons, with potential future implementation for screening of re-injury anxiety. Twenty-three participants stood blindfolded on a translational balance perturbation platform. Consecutive auditory stimuli were provided as low (neutral stimulus [CS–]) or high (conditioned stimulus [CS+]) tones. For the main experimental protocol (Protocol I), half of the high tones were followed by a perturbation in one of eight unpredictable directions. A separate validation protocol (Protocol II) requiring voluntary squatting without perturbations was performed with 12 participants. Event-related potentials (ERP) were computed from electroencephalography recordings and significant time-domain components were detected using an interval-wise testing procedure. High-amplitude early contingent negative variation (CNV) waves were significantly greater for CS+ compared with CS– trials in all channels for Protocol I (> 521-800ms), most prominently over frontal and central midline locations (P ≤ 0.001). For Protocol II, shorter frontal ERP components were observed (541-609ms). Our test paradigm revealed electrocortical activation possibly associated with movement-related fear. Exploring the discriminative validity of the paradigm among individuals with and without self-reported re-injury anxiety is warranted.

Gender differences in the association between transitions in depressive symptoms and oral health among older adults with chronic conditions

BackgroundOral health influences the quality of life of older adults. Further, depression is negatively associated with oral health. However, little is known about this relationship among older adults with chronic health conditions. Additionally, since oral health and depression differ between genders, this study aimed to investigate the effect of transitions in depressive symptoms on oral health among older adults with chronic health conditions by gender. MethodsWe used data from the Korean Longitudinal Study of Aging (2020−2022). The study sample comprised 2836 older adults (1104 men; 1732 women). We adopted multiple linear regression to examine the association between depressive symptom transitions and oral health by gender. ResultsThe new onset depression symptoms were significantly associated with the deterioration of oral health in men (β = −5.4308) and women (β = −4.8328). Our study showed a gender-specific association between new onset depressive symptoms and particular domains of oral health. For men, the association was slightly more negative in psychosocial function (β = −2.1177) while women presented lower GOHAI scores in both the physical function domain (β = −1.8800) and the psychosocial function domain (β = −1.8801). LimitationsThe data used in this study were self-reported via a survey; thus, self-report bias may be a relevant concern. ConclusionTo prevent deterioration in oral health, depressive symptoms must be detected and addressed early among older adults with chronic conditions. This study underscores the importance of interventions that consider gender differences in the association between depressive symptoms and psychosocial and physical functioning.