Exploratory Analysis Research Articles

Development of a short version of the perceived social support scale: based on classical test theory and ant colony optimization

BackgroundDespite the relatively small number of items on the Perceived Social Support Scale (PSSS-12), there has been a trend toward simplification of the scale in order to minimize testing time. In this situation, some researchers based on the responses of military spouses in the U.S., has simplified the PSSS-12 to develop the PSSS-M6. This study aimed to develop a short version of the PSSS-12 suitable for the Chinese general population.MethodsA multi-stage stratified cluster sampling method was employed to collect data from 10,914 residents in 120 cities across the country. After randomly dividing the data into two parts, exploratory analysis and confirmatory analysis were conducted separately. During the exploratory analysis of dataset 1, the scale was simplified using both Classical Test Theory (CTT) and the Ant Colony Optimization (ACO), resulting in one short form for each approach. Additionally, three short forms were obtained by introducing other short forms of the Multidimensional Scale of Perceived Social Support (MSPSS) scale derived from multidimensional item response theory in previous studies. The reliability and discriminant validity of the three short forms were tested. Subsequently, the reliability, validity, model fit and measurement invariance for the two short forms of the MSPSS scale were examined using dataset 2.ResultsThe 6-item short form developed based on the ACO (PSSS-A6) exhibited the best psychometric properties among all the short forms. Moreover, the 3-item short form composed of items with the highest factor loadings in each dimension also demonstrated good psychometric properties.ConclusionsIn future research, if a short form of the MSPSS scale is needed for measurement purposes, the 3-item short form is suitable for clinical settings, large-scale cross-sectional studies, or longitudinal studies, while the PSSS-A6 is more appropriate for more precise measurements.Trial registrationThis study underwent ethical review (JNUKY-2021-018) by Jinan University.

Differences in the distribution of steroids in sterol-containing liposomes: A study by liposome electrokinetic chromatography.

This study was conducted to investigate possible differences in the interactions of some selected steroids based on their distribution coefficients with cholesterol- or ergosterol-rich liposomes. Structurally cholesterol and ergosterol have very close resemblance to each other and generally it is thought that they behave in a similar manner. In this work we will show that this is not the case. Liposome electrokinetic chromatography (LEKC) was selected as the methodology for estimating the interactions between the steroids and the liposomes and for calculating the distribution coefficients. Apart from the distribution coefficients, the interactions were also studied with a response surface methodology and exploratory regression analysis. Both graphical and statistical analysis confirmed that there is an obvious difference in the interactions between the studies steroids and the cholesterol- or ergosterol-rich liposomes, and even a minute change in the sterol content had a significant impact on the interactions. The study demonstrates the flexibility and efficacy of LEKC for studying analyte-lipid membrane interactions, and for investigating taylor-made liposome systems.

Genome-wide identification of nitrate transporter 2 family in brassica rapa and brassica oleracea and exploratory analysis of BrNRT2 in response to stresses

Genome-wide identification of nitrate transporter 2 family in brassica rapa and brassica oleracea and exploratory analysis of BrNRT2 in response to stresses

Role and prognostic value of growth differentiation factor 15 in patient of heart failure with preserved ejection fraction: insights from the PURSUIT-HFpEF registry

BackgroundGrowth differentiation factor 15 (GDF15) is a cytokine responding to oxidative stress and inflammation, and it regulates appetite and energy balance. The association between GDF15 and clinical factors and its...

Effects of estradiol administration on brain activation and anhedonia in perimenopausal women: A pharmaco-fMRI study.

Half of perimenopausal women experience depressive symptoms, including anhedonia. Anhedonia is associated with dysregulation of the frontostriatal circuit. Both the frontrostriatal circuit and depression may be regulated by the reproductive hormone estradiol (E2). Here, we present data from a pharmaco-fMRI trial investigating E2 effects on brain activation and anhedonia in those with perimenopause-onset major depression (PO-MDD). Participants with PO-MDD (n = 16) and those without depression (i.e., Controls; n = 19) received transdermal E2 for three weeks and completed two fMRI sessions (Pre- and Post-E2), and weekly anhedonia assessments. During each fMRI session, neural responses to anticipation and outcomes of monetary rewards were measured. The PO-MDD group exhibited steeper declines in anhedonia following E2 administration (t(101.95) = -8.7, pFDR < 0.001). Contrary to a priori hypotheses, there were no group differences in striatal activation at baseline nor did striatal activation significantly change with E2 administration in either group. However, exploratory whole-brain analyses revealed a significant Group∗Time interaction in a cluster spanning the right inferior, middle, and precentral gyri during reward anticipation (Z = 2.58 and pFWE < 0.05). From Pre-E2 to Post-E2, PO-MDD showed decreased activation within this cluster (t = 3.0, p < 0.009), whereas the Controls did not (t = 1.89, p = 0.08). Further, following E2 administration, both PO-MDD and Control groups exhibited reduced activation in the cerebellum, inferior and medial frontal gyri, and occipital pole during reward anticipation (Z = 2.58, pFWE < 0.05). While both anhedonia and right prefrontal activation during anticipatory reward processing were reduced in PO-MDD after three weeks of E2 administration, further research investigating the antidepressant effects of E2 is needed.

A retrospective study to understand the differences in maternal mortality among women admitted in critical and stable conditions in Malawi

IntroductionAddressing the burden of preventable maternal deaths remains a critical focus of global health efforts in countries like Malawi which still has a high maternal mortality ratio of 381 deaths...

Neighborhood-level socioeconomic disadvantage is associated with multiple cognitive domains in a community sample of older adults

ABSTRACT Greater neighborhood disadvantage is associated with poorer global cognition. However, less is known about the variation in the magnitude of neighborhood effects across individual cognitive domains and whether the strength of these associations differs by individual-level factors. The current study investigated these questions in a community sample of older adults (N = 166, mean age = 72.5 years, 51% women), who reported current addresses, linked to state-level Area Deprivation Index rankings, and completed remote and validated neuropsychological tests of verbal intelligence (North American Adult Reading Test), verbal fluency (Controlled Oral Word Association Test), attention (Digit Span Forward), and working memory (Digit Span Backward and Sequencing, Letter-Number Sequencing). Linear regressions tested associations between neighborhood disadvantage and each cognitive test, controlling for individual-level factors (age, sex, education). Exploratory analyses tested moderation by each individual-level factor. Independent of individual-level factors, greater neighborhood disadvantage was associated with lower cognitive performance across domains: verbal intelligence (β = 0.30, p < .001), verbal fluency (β = −0.19, p = .014), attention (β = −0.19, p = .024), and two of three tests of working memory (β = −0.17− −0.22, ps = .004−.039). Results were robust to correction for multiple comparisons and tests of spatial autocorrelation. In addition, higher neighborhood disadvantage was associated with lower verbal fluency for older – but not younger-older adults (p = .035) and with poorer working memory in women but not men (p < .001). Education did not moderate associations. Findings suggest that older adults living in more disadvantaged neighborhoods exhibit lower cognitive performance, particularly in the domain of verbal intelligence. Continued investigation of effect modification may be fruitful for uncovering for whom associations are strongest.

Validation of the eHealth literacy scales: comparison between the shorter and longer versions

ABSTRACT Digital service provision became necessary during and after the COVID-19 pandemic highlighting the technological disparity experienced by healthcare professionals and healthcare users. eHealth Literacy skills are mostly measured with the use of the eHeals, but recently more instruments have been developed to meet this need. The aim of the study was to validate and compare the two scales in Greek: the eHeals and the revised eHeals-Extended. In total, 401 participants replied to the eHeals, the revised eHeals-Extended, and the HLS-EU-Q16. The eHeals scales provided good psychometric properties. The validation of the eHeals confirmed the two dimensions with high internal consistency (total score α = .91, eHeals1 α = .88, eHeals2 α = .78). The revised eHeals-Extended exploratory analysis extracted five factors with satisfactory internal consistency (Cronbach’s α = .62–.89): awareness and quality of resources online, understanding online information, smart on the net, accessing and validating online information and perceived efficiency. The use of the revised eHeals-Extended and eHeals validated in Greek, could be valuable tools in clinical and research settings. The eHeals could be used as an additional tool when eHealth Literacy is not the core concept measured and the revised eHeals-Extended can be used when researchers wish to measure eHealth Literacy concept more thoroughly.

Motor skills in children with ADHD: overlap with developmental coordination disorder

Individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) often have overlooked motor difficulties which can be at least partially attributed to co-occurring conditions such as Developmental Coordination Disorder (DCD). Understanding the influence of DCD and motor difficulties is important to detect in children for early support. Accordingly, the present study examined the prevalence of DCD diagnoses, cases of probable DCD, and related impairments among German-speaking parents of children with ADHD. A total of N = 168 parents completed an online study about their child’s potential for co-occurring DCD via the Developmental Coordination Disorder Questionnaire (DCD-Q). Even after children with DCD diagnoses were removed from the sample (n = 46), a majority still remained below threshold for probable DCD (55.9%) according to parent-reports. Via exploratory analyses, we also found that a majority of parents in the sample had not heard of DCD before (64.9%) and that many parents did not deem DCD as relevant to their children, even when their DCD-Q scores were in the range of probable DCD. The results align with a high prevalence of DCD in children with ADHD despite a simultaneous lack of awareness of DCD. Furthermore, findings in our sample align with frequently estimated global co-occurrence rates of 50% between ADHD and DCD. Broadly, the results support that motor difficulties should be considered in ADHD assessment and intervention.

The response to pericapsular soft tissue and pelvic realignment therapy may be partially predicted by the relevant factors influencing the program’s response of the candidates with hip osteoarthritis for joint replacement

Objective To explore the risk factors for discontinuation of pericapsular soft tissue and pelvic realignment (PSTP-R) therapy derived from Shiatsu in the candidates with osteoarthritis for total hip replacement (THR) (i.e., candidates for total hip replacement) treated from 2017 to 2020, and to identify the effect modifiers of PSTP-R therapy for patients who continued therapy for 6 months. Methods Exploratory analyses of data from the clinical trial for PSTP-R therapy in a prospective observational study in which the PSTR exercises for 6 months improved Harris Hip Score (HHS) in 193 patients with an HHS below 60 points in two study centers, even in 130 patients with complete loss of cartilage on radiography among those 193 ones. The risk factors for the discontinuation of PSTP-R therapy and the effect modifiers for PSTP-R therapy were explored statistically. Results The risk of discontinuation of PSTP-R therapy increased as the frequency of buttock pain at baseline increased, and was mitigated as the baseline opening angle of the hip according to the modified Patrick’s test increased. Cartilage loss on radiography was not a risk factor for withdrawal from PSPT-R therapy. Among patients who continued PSTP-R therapy for 6 months, a lower Kellgren-Lawrence grade at baseline was associated with an increase in the total score of HHS. Conclusion Buttock pain at baseline was most associated with discontinuation of PSPT-R therapy. The patients that can improve with PSPT-R therapy should be selected to avoid inappropriate surgery by the detailed analysis of relevant clinical factors influencing the response for this program as well as image findings such as cartilage loss on radiography at baseline. Trial registration Registered in the Clinical Trials Registry on 20th July 2017 (UMIN000028277).

PRIVATE SECURITY COMPANIES AND SECURITY PROVISIONING IN NIGERIA: LESSONS FROM OTHER CLIMES

Insecurity in the form of terrorism, kidnapping for ransom, armed banditry, cattle rustling, armed robbery, murder, rape and other violent crimes are on the increase in Nigeria in spite of government efforts to contain them. There is no gainsaying that government forces are seemingly incapacitated to tackle the upsurge of insecurity across the country as terrorists, kidnappers and armed bandits specifically operate with impunity openly as if government security forces are non-existent. Although, insecurity is a global social problem, Nigerian situation is becoming overwhelming, thereby necessitating the proliferation of private security companies into the security arena to lend support to government security force efforts. Since their emergence into the security architecture, private security companies (PSCs) are creating great impact in security provisioning across the globe thereby complementing the efforts of government law enforcement agencies. In Nigeria, they have made great inroads in security provision such that their presence is felt in all nooks and crannies of the country. This paper examined PSCs and security provisioning in Nigeria with reference to lessons from other climes. The paper utilized exploratory analysis relying largely on qualitative content analysis from secondary sources of data collection through journal articles, books, periodicals, news prints and internet materials. The situational crime prevention and problem-oriented policing theories were used as theoretical framework. The paper showed that private security companies in Nigeria have contributed immensely to checkmating crimes in their areas of operations but lack global relevance as their activities are limited to Nigeria since they are not allowed to bear firearms. PSCs in Nigeria are overburdened with regulations that dwarf their operations cum lacking legislative recognition as components of the national security architecture. The paper underscored the global relevance of private security companies and their emergence and proliferation in Nigeria and concludes that PSCs in Nigeria, though very crucial in security provisioning need to be properly positioned for relevance in the global security market. The paper recommends among others, that relevant legislations should be enacted to allow PSCs in Nigeria bear firearms to enable them participate fully in security provisioning while intra-inter agency collaboration and networking is necessary to strengthen the private security sub sector. This is in addition to allowing PSCs to participate in private detection and prosecution in Nigeria.

Psychometric Properties and Network Analysis of the Arabic Version of Reinforcement Sensitivity Theory of Personality Scale-Short Version in Patients with Anxiety Disorders.

This study aimed to examine the psychometric properties of the Arabic version of a short version of the Reinforcement Sensitivity Theory of Personality Questionnaire (RST-PQ-S) among a sample of 700 patients with anxiety disorders (53.1% were female). Participants completed the RST-PQ-S, NEO-FFI, Positive Mental Health (PMH), and Kessler Psychological Distress scale. Both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were employed to test the construct validity of the scale. This study also utilized a network perspective, incorporating Exploratory Graph Analysis (EGA) and centrality measures. As a result of the EFA and CFA, it was determined that the scale consists of 22 items and six subdimensions. These subdimensions were named as follows: "Flight Fight-Freeze System", "Behavioral Inhibition System", "Reward Interest", "Reward Reactivity", "Goal-Drive Persistence", and "Impulsivity". Additionally, the network analysis's findings confirmed the six-factor structure derived from the construct validity assessment. The results of this study demonstrated that the Arabic version of the personality scale is a valid and reliable tool for assessing personality in Arabic-speaking individuals with anxiety disorders. It has the potential to serve as an important diagnostic instrument in clinical and research settings. These findings may assist psychologists and clinicians in Arabic-speaking countries to better understand how the personality traits and anxiety disorders are related.

Estimating Earphone Level and Dose Using Real-Ear Measures and Ecological Momentary Assessment.

Prior work estimating sound exposure dose from earphone use has typically measured earphone use time with retrospective questionnaires or device-based tracking, both of which have limitations. This research note presents an exploratory analysis of sound exposure dose from earphone use among college-aged adults using real-ear measures to estimate exposure level and ecological momentary assessment (EMA) to estimate use time. Earphone levels were measured at the ear drum of 53 college students using their own devices, earphones, and preferred music and speech stimuli at their normal listening volume. Participants completed 1 week of EMA, where they reported on their minutes of earphone use every 2 hr. Based on the EMAs and their measured earphone levels, sound exposure doses from earphone use were calculated. Compliance on EMA was 73%, comparable to most studies using this method in audiology research. Earphone levels were lower than those reported by most prior literature. The average listening level across music and speech, with A-weighting and diffuse-field corrections, was 60 dBA. Earphone use time was also lower than most prior work. Most participants had doses under 1%. Using EMA to track earphone use is a potentially simple way to facilitate measurements of sound exposure from earphone use without relying on retrospective questionnaires or limiting the sample to specific devices, earphones, or apps. Evidence was also found for potentially lower sound levels and sound exposure doses from earphone use among college-aged adults than previously reported. https://doi.org/10.23641/asha.28205072.

The safety and feasibility of transcranial direct current stimulation and exercise therapy for the treatment of cervicogenic headaches: A randomized pilot trial.

Our primary objective was to evaluate the safety and feasibility of transcranial direct current stimulation combined with exercise therapy for the treatment of cervicogenic headache. Our exploratory objectives compared symptoms of headache, mood, pain, and quality of life between active and sham transcranial direct stimulation combined with exercise therapy. Cervicogenic headache arises from injury to the cervical spine or degenerative diseases impacting cervical spine structure resulting in pain, reduced quality of life, and impaired function. Current standard-of-care treatments such as radiofrequency ablation, pharmacotherapy, manual therapy, and exercise therapy lack efficacy for some patients. Transcranial direct current stimulation is a neuromodulation technique that has shown promise in treating chronic pain conditions by positively altering neuronal activity but has not been evaluated as treatment for cervicogenic headache. This double-blind, sham-controlled, randomized, feasibility trial recruited 32 participants between the ages of 18 and 65 years that met the International Classification of Headache Disorders third edition criteria for cervicogenic headache. Participants were randomized to receive either active or sham transcranial direct current stimulation both combined with daily exercise therapy over 6 weeks. Transcranial direct current stimulation was applied over the primary motor cortex ipsilateral to worse pain for 20 min at 2 mA with a 30 s ramp up/down period. Recruitment, retention, and adherence were evaluated for feasibility. Safety was assessed through serious and minor adverse events and an adverse effect questionnaire. Clinical outcome measures assessed headache, pain, quality of life, and mood symptoms at pre-treatment, post-treatment, and 6- and 12-weeks post-treatment. A total of 97 participants were contacted to participate with 32 recruited, 16 randomized into each group, and 14 completing the treatment protocol in both groups. Within each group 12 (active) and nine (sham) completed treatment within the proposed 6 weeks (three sessions per week), others received 18 sessions but took longer. Exercise therapy was completed on an average of 87% of days for both groups. Transcranial direct current stimulation was safe, with no serious adverse events and one minor adverse event in the active group. Itching was a more common post-intervention complaint in the active group (64% active vs. 43% sham). Exploratory analysis revealed significant group × time interactions for average headache pain from pre- to post-treatment (β = -1.012, 95% confidence interval [CI] -1.751 to -0.273; p = 0.008), 6-weeks (β = -1.370, 95% CI -2.109 to -0.631; p < 0.001), and 12-weeks (β = -1.842, 95% CI -2.600 to -1.085; p < 0.001) post-treatment, and for neck pain from pre- to post-treatment (β = -1.184, 95% CI -2.076 to -0.292; p = 0.010) and 12-weeks (β = -1.029, 95% CI -1.944 to -0.114; p = 0.028) post-treatment favoring active vs. sham. There were no significant group × time interactions for quality of life or mood. The combination of transcranial direct stimulation and exercise therapy is safe and feasible for treating cervicogenic headache. While some promise has been shown for reducing headache and neck pain, larger scale trials with adequate power are needed to confirm these findings.

Genome-wide and phenome-wide studies provided insights into brain glymphatic system function and its clinical associations.

We applied an MRI technique diffusion tensor imaging along the perivascular space (DTI-ALPS) for assessing glymphatic system (GS) in a genome-wide association study (GWAS) and phenome-wide association study (PheWAS) of 40,486 European individuals. Exploratory analysis revealed 17 genetic loci significantly associating with the regional DTI-ALPS index. We found 58 genes, including SPPL2C and EFCAB5, which prioritized in the DTI-ALPS index subtypes and associated with neurodegenerative diseases. PheWAS of 241 traits suggested that body mass index and blood pressure phenotypes closely related to GS function. Moreover, we detected disrupted GS function in 44 of 625 predefined disease conditions. Notably, Mendelian randomization and mediation analysis indicated that lower DTI-ALPS index was a risk factor for ischemic stroke (odds ratio = 1.56, P = 0.028) by partly mediating the risk factor of obesity. Results provide insights into the genetic architecture and mechanism for the DIT-ALPS index and highlight its great clinical value, especially in cerebral stroke.

Association of endovascular thrombectomy volume and outcomes in acute ischemic stroke: A National Inpatient Sample Study.

Previous studies suggest a positive relationship between higher hospital endovascular thrombectomy (EVT) volume and improved outcomes. We investigated this association using the National Inpatient Sample (NIS) database from 2016 to 2020. A cross-sectional analysis of the NIS examined the relationship between hospital EVT volume and outcomes. Data on clinical and demographic variables were collected. Outcomes included favorable functional outcome (discharge home without assistance), inpatient mortality, and intracerebral hemorrhage (ICH). Hospitals in the top quintile of annual EVT volume were classified as high-volume centers. We conducted univariate, multivariate, nearest neighbor matched analysis, and an exploratory analysis to identify annual EVT volume cutoffs. Among 114,640 patients with EVT, 24,415 (21.3%) were treated at high-volume centers. High-volume centers had higher rates of favorable functional outcomes in univariate (odds ratio (OR) 1.20, p < 0.001), multivariate (adjusted OR (aOR) 1.19, p = 0.003), and matched analysis (OR 1.14, p = 0.028). Before matching, inpatient mortality was lower in high-volume centers (OR 0.83, p < 0.001), but this difference was not significant in univariate and matched analyses. No differences in ICH were observed. Functional benefit was noted at ≥ 50 EVTs annually, with centers performing ≥ 175 EVTs showing significantly higher benefits (aOR 1.42, p = 0.002). Increased hospital EVT volume is associated with modestly improved functional outcomes in patients with acute ischemic stroke. Functional improvements are evident at ≥ 50 EVTs annually and increase with higher case volumes, without associated increases in inpatient mortality or ICH.

Connecting Language Abilities and Social Competence in Children: A Meta-Analytic Review.

Research examining relations between language skills and social competence has yielded mixed findings. Three meta-analyses investigated links between language skills (overall, receptive, and expressive) and social competence in 2- to 12-year-old children. Data from 130 studies representing 62,120 children (M age at language assessment = 4.70 years; 52% male), predominantly from North America and Europe, and identifying as White (33%), Black (17%), Hispanic (14%), Asian (2%), Mixed (4%), Indigenous (1%), and Other/Unspecified (29%) were analyzed. Analyses indicated significant medium-sized associations between social competence and: overall language (r = 0.27), receptive language (r = 0.23), and expressive language (r = 0.20). Exploratory analyses indicated significant moderating effects of study design, publication status, social type, and geographic region. Results and implications are discussed.

The technology acceptance model and adopter type analysis in the context of artificial intelligence

IntroductionArtificial Intelligence (AI) is a transformative technology impacting various sectors of society and the economy. Understanding the factors influencing AI adoption is critical for both research and practice. This study focuses on two key objectives: (1) validating an extended version of the Technology Acceptance Model (TAM) in the context of AI by integrating the Big Five personality traits and AI mindset, and (2) conducting an exploratory k-prototype analysis to classify AI adopters based on demographics, AI-related attitudes, and usage patterns.MethodsA sample of N = 1,007 individuals individuals (60% female; M = 30.92; SD = 8.63 years) was collected. Psychometric data were obtained using validated scales for TAM constructs, Big Five personality traits, and AI mindset. Regression analysis was used to validate TAM, and a k-prototype clustering algorithm was applied to classify participants into adopter categories.ResultsThe psychometric analysis confirmed the validity of the extended TAM. Perceived usefulness was the strongest predictor of attitudes towards AI usage (β = 0.34, p &amp;lt; 0.001), followed by AI mindset scale growth (β = 0.28, p &amp;lt; 0.001). Additionally, openness was positively associated with perceived ease of use (β = 0.15, p &amp;lt; 0.001). The k-prototype analysis revealed four distinct adopter clusters, consistent with the diffusion of innovations model: early adopters (n = 218), early majority (n = 331), late majority (n = 293), and laggards (n = 165).DiscussionThe findings highlight the importance of perceived usefulness and AI mindset in shaping attitudes toward AI adoption. The clustering results provide a nuanced understanding of AI adopter types, aligning with established innovation diffusion theories. Implications for AI deployment strategies, policy-making, and future research directions are discussed.

Stress and Traditional Support: The Role of Orphans' and Vulnerable Children's Primary Caregivers in Rural Ethiopia.

Orphans' and Vulnerable Children's (OVC) primary caregivers (PCGs) in Ethiopia live with multiple social and emotional problems stemming from extreme poverty, war, environmental disasters, and the HIV pandemic. Family and community supports are strained, leaving OVC's PCGs dependent on inconsistent humanitarian aid. This aid is typically focused on OVCs and does not address PCG well-being. This study aimed to assess PCG well-being and explore their perceived stress and the traditional family and community coping mechanisms. Participants from the Oromia region of Ethiopia were recruited, and a mixed-methods design was employed. Six cases were included using a criterion sampling technique. An explanatory data analysis technique was used, and data were triangulated from interviews, focus group discussions, archival information, and surveys. A 36-item Well-being Measuring Tool (WMT) Likert scale was employed to measure well-being domains. The results indicated that none of the PCGs reported the desirable and average summative well-being domain mean scores [25 and 23]. Among the ten well-being domains, only "spirituality" and "community cohesion" were above the average score [2.3]. The "economy" domain had the lowest score, indicating a critical deficiency [1.3]. A lack of community support could exasperate perceived stress, and well-being deficiencies were linked. Lack of family and community support could exacerbate feeling overlooked, unwelcome, and lonely. A policy that promotes a supportive community environment and safeguards the most vulnerable OVCs and their PCGs should be in place. This study recommends further rigorous research examining the well-being determinants of OVCs' PCGs in Ethiopia and the role of traditional support systems in rural settings.

Artificial intelligence models using F-wave responses predict amyotrophic lateral sclerosis.

Nerve conduction F-wave studies contain critical information about subclinical motor dysfunction which may be used to diagnose patients with amyotrophic lateral sclerosis (ALS). However, F-wave responses are highly variable in morphology, making waveform interpretation challenging. Artificial Intelligence techniques can extract time-frequency features to provide new insights into ALS diagnosis and prognosis. A retrospective analysis was performed on F-wave responses from 46,802 patients. Discrete wavelet transforms were applied to time-series waveform responses after stimulating ulnar, median, fibular, and tibial nerves. Wavelet coefficient statistics, onset age, sex, and BMI were features for training a Gradient Boosting Machine model on 40,095 (5,329 diagnosed with motor neuron disease). Model performance was tested on responses from 689 ALS patients meeting Gold Coast criteria and 689 age- and sex-matched controls. An exploratory analysis examined model performance on cohorts of patients with inclusion body myositis (IBM), cervical radiculopathy, lumbar radiculopathy, or peripheral neuropathy which can mimic ALS symptoms. Factors affecting survival were estimated through cox proportional hazards regression. The model trained using wavelet-features on the full waveform had 90% recall, 87% precision, and 88% accuracy. Similar model performance was measured using features only from the M-Wave or F-Wave. Classification probabilities for ALS patients were statistically different from the diagnoses mimicking ALS symptoms (p<0.001, ANOVA, Tukey's post-hoc), Higher model classification probabilities of ALS, older age at onset, and family history of ALS alone or with frontotemporal dementia were factors decreasing survival. Longer diagnostic delay and upper limb onset site were factors increasing survival. Model scores two standard deviations below the mean had 4 months increased survival (two standard deviations below had 3 months decreased survival). Artificial intelligence techniques extracted important information from F-wave responses to estimate a patient's likelihood of ALS and their survival risks. Although the model can make predictions at specific decision threshold as presented here, the true strength of such a model lies in its ability to provide probabilities about whether a patient is likely to have ALS compared to other mimicking diagnoses such as IBM, cervical or lumbar radiculopathy, or peripheral neuropathy. These probabilities provide clinicians with additional information they can use to make the final diagnosis with greater confidence and precision. Integrating such a model into the clinical workflow could help clinicians diagnose ALS sooner and manage treatment based on estimated survival, which may improve outcomes and patients' quality of life.