Objective Measures Research Articles

A new look at the potential links between music practice, empathy, and prosociality

Engaging in music practice is often assumed to increase empathy and prosociality. However, data in support of this relationship are limited, leaving unclear which components of empathy (cognitive empathy, emotional contagion, and emotional disconnection) and prosocial behaviors, if any, would be affected. Here, we recruited musicians with more than 2 years of musical experience ( n = 80) and nonmusicians ( n = 89) to measure empathy (using subjective and objective measures) and prosociality (using economic games). We hypothesized that musicians would score higher than nonmusicians on empathy and prosociality, and that musicians who practice more would show greater effects. Using classical and Bayesian analyses of variance (ANOVAs), we found no difference between musicians and nonmusicians in empathy and prosociality, and no correlation with the amount of practice. Exploratory analyses revealed associations between the age of onset of music practice and empathy, suggesting that it is not music practice per se but specifically its initiation in early life that could be linked to empathy. These findings challenge the common assumption that music practice in general increases empathy and prosociality and invites to explore in which specific contexts music practice does so (e.g., particular age ranges or group-based settings).

Long-term local control and cosmesis of perioperative interstitial brachytherapy for partial breast irradiation following breast-conserving surgery.

Multicatheter interstitial brachytherapy (MIB) is an established technique of partial breast irradiation (PBI). However, postoperative catheter implant is an invasive, inconvenient, and skillful procedure. In this study, local control and cosmesis of perioperative interstitial brachytherapy (PIB) by intraoperative catheter implant were evaluated by comparing with those of whole breast irradiation (WBI) following breast-conserving surgery (BCS). Between October 2007 and August 2019, consequent patients who underwent either PIB or WBI following BCS were included. In general, additional indications for PIB to WBI included age ≥ 40years, tumor ≤ 3cm, and pN0 or pNmi. WBI was initiated with a total dose of 50Gy in 25 fractions, whereas PBI was delivered immediately following BCS at 32Gy in eight fractions. Local recurrence (LR) was the primary endpoint, and subjective and objective cosmetic outcomes at 5years using the Harvard Cosmesis Scale and BCCT.core software, respectively, were the secondary endpoints. During the 10-year follow-up, the crude rate of LR was 3.8% (95% confidence interval [CI] 2.3-5.4) in 577 patients receiving PIB and 3.3% (95% CI 1.1-5.6) in 241 patients receiving WBI (P = 0.73). The 5- and 10-year LR-free survival rates in the PBI and WBI cohorts were 97.9% versus 97.9% and 95.4% versus 96.8%, respectively (P = 0.64). Multivariate analysis selected age < 50years as an independent risk factor for LR. Excellent or good cosmesis in the PBI and WBI cohorts assessed by subjective and objective measures was 89.5% versus 84.5% (P = 0.26) and 83.7% versus 68.1% (P < 0.005), respectively. Although this study was based on a retrospective chart review in a single institution, the largest series of data with a long follow-up suggested that acceptable local tumor control and cosmesis were achieved following PIB compared with WBI.

Nurses' Perspectives and Experiences of Using a Bed-Exit Information System in an Acute Hospital Setting: Mixed Methods Study.

Technology that detects early when a patient at risk of falling leaves the bed can support nurses in acute care hospitals. To develop a better understanding of nurses' perspectives and experiences with a bed-exit information system (BES) in an acute care hospital setting. BES was implemented on 3 wards of a university medical center. Nurses completed 2 online surveys at each time point (P0 and P1) and participated in focus groups before (P0) and after (P1) implementation. Additional patient data were collected. Descriptive statistics summarized the survey results, while content analysis was applied to focus group data. Patient rates and adverse events in both phases were compared using negative binomial models. Reporting of this study adhered to the GRAMMS checklist. A total of 30 questionnaires were completed at P0 (30/72, 42%) and 24 at P1 (24/71, 33%). Of the participants, 15 completed both questionnaires (complete cases). At P1, 64% (9/14) of participants agreed that their perceived workload and strain in caring for patients with cognitive impairment was reduced by the use of the BES. The adverse event rate per patient per day was reduced by a factor of 0.61 (95% CI 0.393-0.955; P=.03). In addition, 11 nurses participated in 4 focus groups before and after the intervention. Participants found it challenging to operationalize the use of the BES due to the heterogeneity of care settings, but certain behaviors of patients with cognitive impairment were recognized as indicating a need for intervention. Negative experiences included information overload and alarm fatigue, leading to occasional removal of the system. While BES provides some support in managing patients with cognitive impairment, its impact remains limited to specific scenarios and does not significantly reduce nurses' workload or strain. Our findings highlight the need to manage expectations of BES performance to ensure alignment between expected and actual benefits. To improve BES effectiveness and long-term implementation, future research should consider both objective measures of patient care and subjective factors such as nurse experience, structural conditions, and technical specifications. Improving information mechanisms within call systems could help reduce alarm fatigue and increase perceived usefulness. Overall, successful integration of BES in acute care settings will require close collaboration with nursing staff to drive meaningful healthcare innovation and ensure that the technology meets the needs of both patients and nurses. German Register for Clinical Studies DRKS00021720; https://drks.de/search/de/trial/DRKS00021720.

The Relations Between Sensory Modulation, Hyper Arousability and Psychopathology in Adolescents with Anxiety Disorders

Background: Sensory modulation may play a significant role in psychiatric conditions, including anxiety, and explain arousability levels, behavioral disorders, and functional deficits. Yet, studies about sensory modulation in adolescents with anxiety disorders are scarce. Purpose: To profile the prevalence of sensory modulation difficulties (SMDs) in adolescents with anxiety and examine their relations to arousability and psychopathology. The study compared adolescents with anxiety disorders to healthy controls using physiological measures and self-reports that reflect daily life scenarios. Then, the study examined the relationship between SMDs, arousability, and psychopathological severity in the study group. Method: Participants were 106 adolescents, aged 10.5–18 years and their parents. The study group included 44 participants diagnosed with anxiety disorder by psychiatrists. The control group included 62 healthy participants matched by age and gender to the study group. Parents completed the demographic questionnaire and the Child Behavior Checklist (CBCL). The adolescents completed The Revised Children’s Manifest Anxiety Scale (RCMAS) and the Adolescent/Adult Sensory Profile (AASP) and underwent the electrodermal activity (EDA) and pulse rate tests while listening to extreme sensory stimuli of auditory startles. Results: Based on AASP, the study group had a higher prevalence of SMDs expressed in lower sensory seeking, difficulties in registering sensory stimuli, and higher sensory sensitivity and avoidance. The study group presented higher arousability while listening to the startles as manifested in higher heart rate and EDA responses. The physiological results correlated with SMD levels measured by the AASP self-reports. SMDs correlated with psychopathological severity. Conclusions: SMDs may characterize adolescents with anxiety disorders and impact their arousability, symptoms severity, and daily functioning. Therefore, sensory modulation should be evaluated using both self-reports (to reflect implications in real life from patients’ own voices) along with objective measures to explain daily behaviors by underlying physiological mechanisms. This may focus intervention towards better health, function, and development.

Essential components and validation of multi-specialty robotic surgical training curricula: a systematic review

Introduction: The rapid adoption of robotic surgical systems has overtook the development of standardised training and competency assessment for surgeons, resulting in an unmet educational need in this field. This systematic review aims to identify the essential components and evaluate the validity of current robotic training curricula across all surgical specialties. Methods: A systematic search of MEDLINE, EMBASE, Emcare, and CINAHL databases was conducted to identify studies reporting on multi-specialty or specialty-specific surgical robotic training curricula, between January 2000 and January 2024. We extracted data according to Kirkpatrick’s curriculum evaluation model and Messick’s concept of validity. The quality of studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Results: From the 3,687 studies retrieved, 66 articles were included. The majority of studies were single-centre (n = 52, 78.8%) and observational (n = 58, 87.9%) in nature. The most commonly reported curriculum components included didactic teaching (n = 48, 72.7%), dry laboratory skills (n = 46, 69.7%), and virtual reality (VR) simulation (n = 44, 66.7%). Curricula assessment methods varied, including direct observation (n = 44, 66.7%), video assessment (n = 26, 39.4%), and self-assessment (6.1%). Objective outcome measures were used in 44 studies (66.7%). None of the studies were fully evaluated according to Kirkpatrick’s model, and five studies (7.6%) were fully evaluated according to Messick’s framework. The studies were generally found to have moderate methodological quality with a median MERSQI of 11. Conclusions: Essential components in robotic training curricula identified include didactic teaching, dry laboratory skills, and VR simulation. However, variability in assessment methods used and notable gaps in curricula validation remain evident. This highlights the need for standardised, evidence-based development, evaluation, and reporting of robotic curricula to ensure the effective and safe adoption of robotic surgical systems.

Cognition and objective sleep quality in post-COVID-19 patients

In the current study, we aimed (i) to evaluate sleep quality via wrist actigraphy monitoring of nonhospitalized and hospitalized post-COVID-19 condition (PCC) participants; (ii) to correlate actigraphy measures with subjective measures of sleep quality, such as the Pittsburgh Sleep Quality Index (PSQI); and (iii) to investigate whether total sleep time or sleep efficiency could affect PCC cognitive performance. We included 49 individuals with PCC from the NAUTILUS Project (NCT05307549 and NCT05307575) who were monitored for 1 week via actigraphy and who were also assessed with a comprehensive neuropsychological battery and the PSQI. We found that there were significant differences between nonhospitalized PCCs and hospitalized PCCs in the number of awakenings. We also found a correlation between the total sleep time of both measures (actigraphy and PSQI), but we did not observe correlations between objective and subjective parameters of latency and sleep efficiency. Regarding cognition and actigraphy measures, there was a trend of statistical significance in the performance of immediate visual memory, attention span and social cognition according to sleep efficiency. In conclusion, results indicate that although the PSQI provides clinically relevant indicators of sleep, there are divergent results between self-reported and objective sleep measures (actigraphy). Furthermore, we found a tendency toward statistical significance in cognitive performance in PCC participants according to their sleep efficiency which could indicate that is more important for cognitive function of post-COVID-19 patients than total sleep time.

CB1 Receptor Antagonist Selonabant (ANEB-001) Blocks Acute THC Effects in Healthy Volunteers: A Phase II Randomized Controlled Trial.

Emergency department visits due to cannabinoid-induced toxicity, including acute cannabinoid intoxication (ACI) have increased worldwide as more states have liberalized cannabis policy. ACI symptoms include anxiety, panic attacks, tachycardia, and psychosis, primarily mediated through cannabinoid type 1 receptor (CB1) agonism by Δ9-tetrahydrocannabinol (THC). This phase II randomized, double-blind, placebo-controlled study assessed the potential of CB1 receptor antagonist selonabant (ANEB-001) to block THC-induced effects in healthy adults. In Part A of the study, 10.5 mg of THC was coadministered with 50 mg (N = 20) or 100 mg (N = 20) selonabant, or matching placebo (N = 20). In Part B, 21-mg THC was coadministered with 30 mg (N = 9) or 10 mg (N = 7) selonabant, or matching placebo (N = 9). THC-related effects were assessed using visual analogue scales (VAS) for feeling high and alertness, objective measures of postural stability, and heart rate and analyzed using a mixed effects model. Selonabant significantly reduced VAS "Feeling High" (up to -82.8% (95% CI: -91.0%, -67.2%, P < 0.0001) at 30-mg selonabant) and increased VAS "Alertness" (up to 10.8 mm (95% CI: 4.7, 16.8 mm, P = 0.001) at 30-mg selonabant) vs. placebo. Selonabant 10 and 30 mg significantly reduced body sway (up to -30.6% (95% CI: -44.1%, -13.9%, P = 0.002) at 30 mg selonabant) vs. placebo. Effects on heart rate were not significant. Selonabant was generally safe and no clinically meaningful changes in mood occurred. Nausea and vomiting occurred more frequently at high selonabant doses; 10-mg selonabant was both well tolerated and efficacious. Present results support further development of selonabant for emergency treatment of ACI.

Race to the Bottom: Competition and Quality in Science

Abstract This paper investigates how competition to publish first and thereby establish priority impacts the quality of scientific research. We begin by developing a model where scientists decide whether and how long to work on a given project. When deciding how long they should let their projects mature, scientists trade off the marginal benefit of higher quality research against the marginal risk of being preempted. Projects with the highest scientific potential are the most competitive because they induce the most entry. Therefore, the model predicts these projects are also the most rushed and lowest quality. We test the predictions of this model in the field of structural biology using data from the Protein Data Bank (PDB), a repository for structures of large macromolecules. An important feature of the PDB is that it assigns objective measures of scientific quality to each structure. As suggested by the model, we find that structures with higher ex-ante potential generate more competition, are completed faster, and are lower quality. Consistent with the model, and with a causal interpretation of our empirical results, these relationships are mitigated when we focus on structures deposited by scientists who — by nature of their employment position — are less focused on publication and priority. We estimate that the costs associated with improving these low-quality structures are between 1.5 and 8.8 billion dollars since the PDB’s founding in 1971.

ESG Policy–Practice Decoupling: A Measurement Framework and Empirical Validation

As sustainability becomes more critical to corporate strategy and performance, firms, investors, and researchers must continue to refine methods for measuring and addressing the gap between rhetoric and reality. Closing this gap is crucial to ensuring that externally oriented ESG claims are supported by genuine internal actions that benefit both the firm and society at large. To address this issue, this study introduces a theoretically driven framework to assess the alignment (or lack thereof) between firms’ ESG policies and their actual implementation. By proposing a more granular and objective measure, we address a gap in the existing literature. Additionally, we empirically validate this framework using data from ASSET4, providing insights into the extent and persistence of this phenomenon using a sample of S&amp;P 1500 firms from 2016 to 2022. Our results reveal that misalignment between internal actions and external endorsements in managing environmental and social issues is both significant and persistent across the years analyzed. Over 80% of the sample firms exhibit this misalignment, underscoring its prevalence within the sample. In more recent years, however, firms have shown a clear tendency to prioritize internal actions over initiatives aimed at externally endorsing their efforts. Building on the framework we propose to measure ESG policy–practice decoupling, along with the empirical analysis we conducted, we discuss its broader implications and outline several opportunities for future research.

Proximity to public transportation and incidence of depression risk among older adults: A three-year longitudinal analysis from the Japan Gerontological evaluation study.

Depression in older adults has been associated with environmental factors, such as green spaces and walkable neighborhoods; however, evidence on the relationship between proximity to public transportation and mental health is scarce. This multi-municipality longitudinal study examined the association between proximity to public transportation and risk of depression among older adults and considered car usage. We analyzed data from 4947 functionally independent adults, aged 65years and older who resided in 25 municipalities across Japan. Data were obtained via the Japan Gerontological Evaluation Study in 2016 and 2019. We assessed depression over three years in older adults without depression at baseline via the Geriatric Depression Scale-15. We subjectively and objectively measured their proximity to public transportation. Logistic regression analyses were performed, adjusted for covariates, with analyses stratified by car usage. Of the participants, 9.76% developed depression over a three-year period. Those without car usage and with reported lack of proximal public transport exhibited a higher incidence of depression (OR=1.60, 95%CI: 1.05-2.42) compared with those who had better access. No significant association was observed in the car user group. Furthermore, no significant association was observed in the analysis that used objective measures with Geographic Information System (GIS) data. Subjective limited access to public transport was significantly associated with the risk of depression among older adults without car usage. Hence, improving and maintaining transportation infrastructure may mitigate the risk of depression.

Neural-WDRC: A Deep Learning Wide Dynamic Range Compression Method Combined With Controllable Noise Reduction for Hearing Aids.

Wide dynamic range compression (WDRC) and noise reduction both play important roles in hearing aids. WDRC provides level-dependent amplification so that the level of sound produced by the hearing aid falls between the hearing threshold and the highest comfortable level of the listener, while noise reduction reduces ambient noise with the goal of improving intelligibility and listening comfort and reducing effort. In most current hearing aids, noise reduction and WDRC are implemented sequentially, but this may lead to distortion of the amplitude modulation patterns of both the speech and the noise. This paper describes a deep learning method, called Neural-WDRC, for implementing both noise reduction and WDRC, employing a two-stage low-complexity network. The network initially estimates the noise alone and the speech alone. Fast-acting compression is applied to the estimated speech and slow-acting compression to the estimated noise, but with a controllable residual noise level to help the user to perceive natural environmental sounds. Neural-WDRC is frame-based, and the output of the current frame is determined only by the current and preceding frames. Neural-WDRC was compared with conventional slow- and fast-acting compression and with signal-to-noise ratio (SNR)-aware compression using objective measures and listening tests based on normal-hearing participants listening to signals processed to simulate the effects of hearing loss and hearing-impaired participants. The objective measures demonstrated that Neural-WDRC effectively reduced negative interactions of speech and noise in highly non-stationary noise scenarios. The listening tests showed that Neural-WDRC was preferred over the other compression methods for speech in non-stationary noises.

Suicide Ideation Severity and Oculomotor Avoidance of Suicide-Related Stimuli.

Identifying variables linked to distinct suicide outcomes has long been among suicidology's research priorities. Cognitive theories of suicide identify attentional processes that may vary for individuals at a greater suicide risk. However, an overreliance on self-report and objective measures that are poor estimates of attention has led to mixed findings. The current study utilizes eye tracking with a novel passive viewing task to explore differences in viewing patterns for suicide- and neutral-image pairings, as a function of suicide outcomes. Young adults (N = 124, 83.9% women) were oversampled for recent suicidal thoughts and behaviors, and completed a series of self-report questionnaires specific to suicide history, as well as relevant covariates prior to completing the eye-tracking task. Multilevel modeling revealed that individuals with low-to-moderate ratings of past-year ideation displayed a significant decline in the amount of time spent viewing suicide images as compared to neutral images over the course of the task (oculomotor avoidance). However, the same pattern was not seen among individuals with high suicide ideation, specifically those with resolved plans and preparation. Furthermore, no differences were found between people with and without a suicide attempt history. These results suggest a suicide-specific disengagement bias among individuals high in suicide ideation and more specifically, resolved plans and preparation.

Deglutition preservation after swallowing (Swoars)-sparing IMRT in head and neck cancers: Definitive results of A multicenter prospective study of the italian association of radiotherapy and clinical oncology (Airo)

BackgroundTo investigate changes of objective instrumental measures and correlate with patient reported outcomes (PROs) of radiation-induced dysphagia (RID) after swallowing organs at risk (SWOARs)-sparing IMRT. MethodsPatients (pts) underwent Fiberoptic Endoscopic Evaluation of Swallowing (FEES), Videofluoroscopy (VFS) and M.D. Anderson Dysphagia Inventory (MDADI) questionnaire at baseline, 6 and 12 months after treatment. They were categorized in two groups: MDADI-C ≥ 80 and MDADI-C < 80. Pharyngeal residue (PR) and penetration (P) or aspiration (A) were considered as surrogate of RID. ResultsBetween 2016 and 2022 we enrolled 75 pts, 40 (53 %) MDADI-C ≥ 80 and 35 (47 %) MDADI-C < 80 at baseline.Among MDADI-C ≥ 80 the mean baseline PR score at FEES was 0,42 rising to 1,36 at 6 months (p = 0,001) and stabilizing to 1,15 at 12 months (p = 0,21); indeed, the mean baseline PR score at VFS was 0,55 rising to 1 at 6 months (p = 0,069) and slightly dropping to 0,7 at 12 months (p = 0,069). Among MDADI-C < 80 the mean baseline PR score at FEES was 0,56 rising to 1,07 at 6 months (p = 0,012) and stabilizing to 1,07 at 12 months (p = 0,99); indeed the mean baseline PR score at VFS was 0,67 rising to 1,19 at 6 months (p = 0,04) and dropping to 0,78 at 12 months (p = 0,04). No correlation was found between PROs and objective measures. ConclusionOur results show optimal acceptable deglutition preservation from major complications after SWOARs-sparing IMRT by means of low objective scores in both MDADI-C groups. Lack of correlation between PROs and objective measures suggest that referred RID is likely associated to persistence of SWOARs inflammation rather than to a real impairment of function.

Co-occurring mental health problems in adolescents with ADHD and sleep problems.

Sleep problems are highly prevalent and impairing in adolescents with ADHD. However, their relation with co-occurring mental health problems is still unclear. This study assessed whether adolescents with ADHD, with and without self-reported sleep problems, differ from each other in co-occurring mental health problems, and whether they differ from adolescents without ADHD. Furthermore, we examined whether the adolescents with ADHD and self-reported sleep problems do indeed have more disturbed sleep than the other two groups and lastly, whether these sleep differences are moderated by co-occurring mental health problems. Three groups of adolescents (13-17 years): 1) with ADHD and comorbid self-reported sleep problems (N=56), 2) with ADHD but without self-reported sleep problems (N=25), and 3) without ADHD (N=56) were assessed. Group comparisons were done for symptoms of co-occurring mental health problems, self- and parent-reported sleep problems, and objective and subjective sleep parameters. Exploratively, moderating effects of co-occurring mental health problems on sleep differences between groups are examined. Compared to those without self-reported sleep problems, adolescents with ADHD and comorbid self-reported sleep problems experienced significantly more co-occurring symptoms of mental health problems, especially depression. They also scored higher on all sleep problems, and had a longer sleep onset latency and lower sleep efficiency based on subjective and objective sleep measures. Depression and anxiety moderated objectively measured sleep differences. Co-occurring mental health problems, especially depressive symptoms, are more prevalent in adolescents with ADHD and sleep problems and partially moderate the relation with sleep. This indicates that when adolescents with ADHD present with sleep problems in clinical practice, it is essential to also assess symptoms and other mental health problems and vice-versa.

Patient-reported outcomes in sarcopenia: An ICFSR task force report.

The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force convened in March 2024 to address patient-reported outcomes measures (PROMs) in the field of sarcopenia. PROMs are crucial to enhance healthcare services at both individual and societal levels. PROMs complement objective outcome measures by capturing insights that patients are best suited to judge. In recent years, there has been an increase in the recognition of PROMs' importance within clinical trials by pharmaceutical industries and regulatory agencies. Consequently, it has become imperative to develop valid and reliable tools tailored to capture various aspects of patient's experience and health status. This report aims to present the state-of-the-art available and validated PROMs for sarcopenia that can be used within clinical settings by various stakeholders, and to highlight several research gaps and barriers that need to be addressed to expedite and improve the use of these outcome measures within the context of clinical trials.

Association between poor oral health and deterioration of appetite in older age: results from longitudinal analyses of two prospective cohorts from the UK and USA

ObjectiveThis study investigated the association of poor oral health with appetite loss and deterioration in appetite longitudinally in older adults.DesignCross-sectional and longitudinal observational study.SettingData came from two population-based cohorts of...

Neuromodulatory techniques in eating disorders: From electroconvulsive therapy to transcranial magnetic stimulation and beyond: A mixed method systematic meta-review.

Psychosocial and pharmacological interventions can effectively treat eating disorders (EDs), but improvements are often short-term and modest. Neuromodulation, altering nerve activity through targeted neurological stimulation, is an emerging intervention in neuropsychiatric disorders. This meta-review synthesizes evidence on neuromodulatory techniques in ED patients, identifying research gaps and future directions. PubMed/Medline, EMBASE, and PsycINFO were searched using relevant terms. Only systematic reviews or meta-analyses reporting on neuromodulatory techniques in ED patients were included. Three evaluators extracted data, resolving discrepancies with two experienced researchers. Study quality was assessed using AMSTAR-2. Defined outcomes and effect sizes were reported for systematic reviews, and pooled effect sizes and heterogeneity information for meta-analyses. Eighteen systematic reviews (five meta-analyses) were included, with minimal primary study overlap (<5%). Most focused on anorexia nervosa (AN), some on treatment-resistant cases, and others on bulimia nervosa (BN) and binge eating disorder (BED). The quality of most systematic reviews was critically low, and they often combined observational studies with randomized-controlled trials (RCTs). Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) showed promising results in RCTs, managing binge eating and craving levels more effectively than body mass index in AN. Side effects included headaches, nausea, and drowsiness for rTMS and tDCS, and rare instances of seizures and infection with deep brain stimulation. Neuromodulation holds promise for treating EDs. Future studies should prioritize RCTs, objective outcome measures, longer follow-up for stability assessment, and comprehensive adverse event monitoring.

The effect of run duration, gait variable and Lyapunov exponent algorithm on the inter-session reliability of local dynamic stability in healthy young people.

Local dynamic stability (LDS) of gait has been used to differentiate between healthy and injured populations, establishing its potential as an indicator of healthy gait and a new objective measure to assess gait function following injury. For LDS to be a reliable assessment tool of healthy gait progression during rehabilitation, it must provide consistent and sensitive inter-session measures. Methodological factors such as trial duration, gait variable, and Lyapunov Exponent (LyE) algorithm can influence LDS estimation and its reliability. Young people are a high-risk population for sport-related injuries, and running is a key activity during rehabilitation and is regularly assessed. Therefore, the effects of run duration, gait variable, and LyE algorithm choice on the reliability and sensitivity of inter-session LDS measures in young people were investigated. Sixteen healthy participants ran on a treadmill on two separate sessions (difference of 7±5days). LDS was calculated using both the Rosenstein and Wolf algorithm for durations of 1-, 2-, 3-, 4- and 5-min of knee flexion angle and medio-lateral acceleration of the pelvis and thorax from each session. The relative and absolute reliability between sessions was calculated using the intraclass correlation coefficient and standard error of measurement. The sensitivity of inter-session LDS change was quantified by the minimal detectable change. Results showed that longer run durations produced higher relative reliability and a minimum run duration of 4min is recommended to achieve moderate-to-good inter-session reliability across all gait variables and LyE algorithms. However, shorter durations of 2-3min may still be sufficient when using medio-lateral pelvis acceleration or knee flexion angle, particularly with the Rosenstein algorithm, which also improves sensitivity to change. These findings provide practical guidance for methodological choices when calculating LDS in young people during running and support their potential use as reliable tools for monitoring gait function and tracking rehabilitation progress in young people following injury.

Diminished Interoceptive Accuracy in Attention-Deficit/Hyperactivity Disorder: A Systematic Review.

Interoception is the perception of one's internal physiological state. Altered interoception may play a role in the pathogenesis of attention-deficit/hyperactivity disorder (ADHD). We reviewed the literature on interoception and ADHD symptoms (inattention, hyperactivity/impulsivity, executive function, emotional dysregulation) in individuals with and without the disorder. Studies included assessments of interoception and ADHD symptoms in (1) individuals with/without diagnoses of ADHD or (2) the general population. Interoception assessments included objective measures (heartbeat-tracking test) and self-report questionnaires. The literature search included the PubMed/MEDLINE, PsychINFO, CINAHL and Scopus databases. A protocol was prospectively registered in the PROSPERO database (CRD #42022351726); the PRISMA guidelines directed reporting. The Newcastle-Ottawa scale was adapted to evaluate study quality. Of 636 articles identified, 17 articles (based on 18 studies) met inclusion criteria. Five studies compared interoception in participants with/without ADHD, and three found that interoception was reduced in participants with ADHD. One study compared interoception between presentations of ADHD, finding no differences. Twelve studies assessed the association of ADHD symptoms and interoception in the general population. Overall, results suggested that interoception is reduced in individuals who reported higher symptoms of inattention, hyperactivity, impulsivity, emotional dysregulation, and executive dysfunction. Studies were of moderate quality; issues included small sample sizes and inadequate reporting. Individuals with ADHD may have decreased interoception compared to individuals without. Interoception is negatively associated with ADHD symptoms in the general population. Interventions focused on improving interoceptive abilities may provide an avenue for ADHD treatment. Future work should consider the role of culture in interoception.

A qualitative study of the home-based time burdens faced by persons affected by GI cancer.

822 Background: As cancer care is increasingly delivered at home, more tasks and responsibilities fall on patients and informal care partners. This is especially relevant for people with GI cancer who often have specific home-based care needs such as feeding, ostomy care, 5-fluorouracil chemotherapy, and complex medication management. Home-based time costs are undercounted in current measures of time toxicity that only include care received in formal healthcare settings. Methods: We conducted semi-structured interviews with patients with GI cancer and their care partners at a single tertiary cancer center in MN, USA from March-Oct 2023. Interviews explored cancer care tasks at home, associated time burdens, and how they compare to in-facility care. We analyzed interview transcripts using a grounded theory approach to identify themes. Results: We included 33 individuals (11 aged &gt;60y, 21 female, 25 white) including 15 patients (8 colorectal cancer, 8 ECOG 0) and 18 care partners (15 lived with the patient, 7 working at least part-time). We identified 5 themes (Table). Conclusions: This foundational work characterizes time burdens of home-based cancer care for persons affected by GI cancer. In addition to providing the first input on incorporating home-based time burdens into objective measures of time toxicity, we highlight the complexity of assessing time burden which is context and role-dependent. Theme Subtheme Quote Unexpected home-based care is time burdensome Challenge with home as a site of healthcare, difficult transition from hospital to home ‘’What they would do at the clinic behind the scenes she was doing on my kitchen table.” (Patient) Other burdens compound time burdens Logistic/administrative, emotional, symptom “The time spent on administrative things and coordinating [...] are more stressful than going to the clinic.” (Patient) Time burdens evolve over the disease course and differentially impact patients and care partners Cancer care constantly changes, discomfort with some tasks at home, less support provided if more competent, home-based care allows for connection “They’re in a season of remission and [...] we want to live as normal a life as we can. And then there are other seasons where it’s the absolute opposite.” (Care partner) Factors influencing the choice of home-based care Need to manage family duties, supportive care partners matter, value connection with nurses, decreased travel “There is a different cost when you start doing things at home, especially when you have small children because if they’re witnessing it, that’s emotional.” (Patient) Home-based care is generally perceived as less time-burdensome than similar cares provided in-facility Different opinions on whether home-based care should be included in time toxicity measure “If you’re just talking about video visits I wouldn't consider that time toxic. But if I’m going [to the clinic], I’ve pretty much lost the whole day.” (Patient)