Rigorous Studies Research Articles

The Efficacy of Digital Help for Divorced Danes: Randomized Controlled Trial of Cooperation After Divorce (CAD) and Sick Days

AbstractFew digital divorce interventions have undergone rigorous randomized control trial study (RCT) testing of their physical and psychological health effects. This paper describes the Cooperation after Divorce (CAD) intervention including background, target group, design and engagement strategies, intervention development, content, and theoretical cornerstones. The 17-module digital psychoeducational intervention addresses three main content areas: (1) the divorcee themselves, (2) the children, and (3) co-parenting. The content of the modules provided psychoeducation and therapeutic activities focused on the maladaptive interactional patterns between former partners and how to develop new interactional schemas, including a focus on when and how to communicate with the former partner in a way that does not escalate conflict. A randomized controlled trial (N = 778) assessed the effect of CAD in terms of number of sick days. Participants were assessed at 3-, 6- and 12-month post-divorce. Independent samples t test revealed that participants in the intervention group on average reported 5.82 fewer sick days one year post-divorce than did participants in the control condition. The results suggest that digital post-divorce interventions decrease sick days for newly divorce individuals, thereby offering long-term human, family, and public health benefits.

The Impact of Recess on Students: A Scoping Review of Developmental Outcomes and Methodological Considerations

ABSTRACT Once a hallmark of the elementary experience, recess time is now being exchanged for increased classroom time as standardized test results drive decision-making. This scoping review examined the impact of recess on school-age students, providing decision-makers valuable evidence to help determine the role recess should play in the academic day. The included studies (n = 73) examined the impact recess had on school-age students in the areas of physical activity, social-emotional learning, academic performance, injuries, and food consumption. In our review, 7% to 76% of recess time was spent in device-measured, moderate-to-vigorous physical activity; however, all children do not participate equally. Additionally, recess provides opportunities to develop social-emotional skills through problem-solving and may improve academic achievement and classroom behavior. Food consumption increased when recess occurred before lunch. Recess does, however, include a risk of injury. The majority of studies were cross-sectional designs and conducted in the United States. Thus, rigorous studies examining the causal effects of recess on multiple development outcomes for diverse students are needed to make specific recommendations on the optimal duration and scheduling of recess to optimize student learning and health.

Use of Registries and Large Databases for Toxicology Research.

The advancement of medical toxicology knowledge has traditionally relied on case reports and case series because of the ethical challenges involved in studying poisoned patients. The growing availability of several large databases and registries now allows researchers to describe and analyze patterns in poisoned patients who share a particular exposure, outcome, or condition. A large database or registry can be useful in generating hypotheses, supporting extramural funding applications, and planning more rigorous studies. Knowing how to access and interpret data in registries such as NPDS, NHAMCS, and HCUP is essential for all stakeholders engaged in medical toxicology research. This review describes the strengths and limitations of different toxicology-relevant registries and databases and how to leverage these powerful tools to advance the science in the field of medical toxicology.

A Nurse-Led Algorithm for Diagnosing Urinary Tract Infection in Homebound Older Adults.

We designed a nurse-led algorithm to standardize urinary tract infection (UTI) diagnosis for older adults receiving home-based medical care. Aims of this pilot quality improvement study were to reduce the frequency of empiric antibiotic therapy initiated without a urinalysis and urine culture (UA/UC) first being obtained, reduce antibiotic use without a concomitant increase in emergency department (ED) visits or hospital admissions, and ensure stakeholders' satisfaction with algorithm use. A nurse-led diagnostic algorithm was designed and pilot-tested to address challenges and standardize diagnosis of UTI in a population of homebound older adults. In pre/post data analysis, algorithm implementation was associated with improved frequency of obtaining UA/UC before empiric antibiotic therapy was initiated, but the overall rate of antibiotic use for UTI did not decrease. No increase in ED or hospital admissions was identified. Use of a diagnostic algorithm for UTI among homebound older adults was associated with reduced frequency of empiric antibiotic initiation for suspected UTI without a UA/UC first being obtained. More rigorous study is needed to confirm and expand on these findings. [Research in Gerontological Nursing, 17(2), 92-97.].

Node-Aligned Graph-to-Graph: Elevating Template-free Deep Learning Approaches in Single-Step Retrosynthesis.

Single-step retrosynthesis in organic chemistry increasingly benefits from deep learning (DL) techniques in computer-aided synthesis design. While template-free DL models are flexible and promising for retrosynthesis prediction, they often ignore vital 2D molecular information and struggle with atom alignment for node generation, resulting in lower performance compared to the template-based and semi-template-based methods. To address these issues, we introduce node-aligned graph-to-graph (NAG2G), a transformer-based template-free DL model. NAG2G combines 2D molecular graphs and 3D conformations to retain comprehensive molecular details and incorporates product-reactant atom mapping through node alignment, which determines the order of the node-by-node graph outputs process in an autoregressive manner. Through rigorous benchmarking and detailed case studies, we have demonstrated that NAG2G stands out with its remarkable predictive accuracy on the expansive data sets of USPTO-50k and USPTO-FULL. Moreover, the model's practical utility is underscored by its successful prediction of synthesis pathways for multiple drug candidate molecules. This proves not only NAG2G's robustness but also its potential to revolutionize the prediction of complex chemical synthesis processes for future synthetic route design tasks.

Seasonal Testing, Results, and Effect of the Pandemic on Coxsackievirus Serum Studies.

Coxsackieviruses (CVs) are common causes of infections and can be life-threatening. Unfortunately, rigorous studies guiding the clinician in interpreting CV serum antibody titer testing is lacking. To explore the epidemiology of circulating CVs and the serological test utility in aiding diagnosis of CV infections in our community, we obtained results of CV immunologic diagnostic tests between 2018 and 2022 from a regional healthcare database. For CV type A, rare individuals had positive CF (complement fixation) tests whereas all 16 individuals with IFA testing showed at least one positive serotype. For CV type B CF testing, 52.2% of 222 patients had at least one serotype positive, with B5 being most common and also the most common with higher titers (14.8% with ≥1:32). We found a significant reduction in seropositivity rate during the pandemic in 2020 compared to 2018, which continued through 2022 (OR: 0.2, 95% CI: 0.08-0.49, p-value < 0.001). During the pandemic, the seasonal pattern of positive tests varied from the pre-pandemic pattern. Testing for CVs was increased after the first year of the pandemic. Overall, the variability by month and seasonal change in our data support that CF testing can be used to identify recent CVB infection.

Detection of type-Ⅱ diabetes using graphene-based biosensors

Diabetes is a global pandemic that increases the risk of various health complications, including heart attacks, renal failure, blindness, stroke, and peripheral neuropathy. Type-2 diabetes (T2D) results from an imbalance in lipid and glucose metabolism due to hostility to insulin action and insufficient insulin production response. Valine amino acid has been identified as a potential biomarker for T2D, but there have been no rigorous studies on its interaction with branch chain amino acids. In this study, we investigated the potential of graphene/modified graphene as a valine biosensor using density functional theory to examine the electronic properties and adsorption behaviour of graphene, Si-doped graphene (SiG), and P-doped graphene (PG). The adsorption of valine over the substrates was physisorption in nature, and the adsorption energies were in the order of SiG > G > PG. Density of states (DOS) and partial DOS calculations confirmed the molecule’s adsorption over the monolayers and indicated variations in the electronic properties. We also performed recovery time calculations to examine the reusability of the nano-surfaces as potential biosensors. Ultrafast recovery times were predicted for all three systems, with SiG showing the best results. Our study suggests that SiG could be used as a biosensor for valine, providing a real-time and efficient diagnostic tool for T2D.

A multi-region and a multiphase MHD OpenFOAM solver for fusion reactor analysis

Several systems in nuclear fusion reactors utilize liquid metals as working fluids and the design of these systems cannot overlook the magnetohydrodynamics effects arising from the interaction between the electrically conductive fluid and the magnetic fields used to confine the plasma, since these effects significantly influence the flow features. In this context, rigorous studies and research activities are imperative to provide high–quality numerical data and develop precise predictive numerical tools. This work introduces two OpenFOAM magnetohydrodynamics solvers and outlines their respective validation processes. The mMRF solver can simulate single–phase, incompressible MHD flow for multiple electro–coupled domains. Meanwhile, the mIF solver is capable of simulating two–phase MHD flow involving incompressible and immiscible fluids. The mMRF solver has demonstrated outstanding results in simulating classical 2D benchmarks up to high magnetic field intensities, while the mIF solver proved its ability by estimating, with a discrepancy of less than 10%, the velocity of a bubble rising within a liquid metal under an imposed magnetic field.

Metabolomic biomarkers for (R, S)-ketamine and (S)-ketamine in treatment-resistant depression and healthy controls: A systematic review.

Ketamine is increasingly used for treatment-resistant depression (TRD) while its mechanism of action is still being investigated. In this systematic review, we appraise the current evidence of metabolomic biomarkers for racemic ketamine and esketamine in patients with TRD and healthy controls (HCs). A comprehensive search of several databases (Ovid MEDLINE®, Embase, and Epub Ahead of Print) was performed from each database's inception to June 29, 2022, in any language, was conducted. We included studies wherein the metabolomic biomarkers for racemic ketamine or esketamine were investigated in TRD or HCs. Our main outcomes were to examine changes in metabolites among patients treated with ketamine/esketamine and explore the association with response to ketamine/esketamine. A total of 1859 abstracts were screened of which 11 were included for full-text review. Of these, a total of five articles were included (N = 147), including three RCTs (n = 129) and two open-label trials (n = 18). All studies used racemic ketamine; one study additionally used esketamine. The included studies evaluated patients with treatment-resistant bipolar depression (n = 22), unipolar depression (n = 91), and HCs (n = 34). The included studies reported alteration in several metabolites including acylcarnitines, lipids, kynurenine (KYN), and arginine with ketamine in TRD. Studies suggest the involvement of energy metabolism, KYN, and arginine pathways. In HCs, acetylcarnitine decreased post-infusion, whereas inconsistent findings were observed after the ketamine infusion in TRD patients. This systematic review provides preliminary evidence that ketamine may cause changes in several important pathways involved in energy metabolism and inflammation. Larger and more rigorous studies are needed.

Surgical and non-surgical interventions for primary and salvage treatment of growth hormone-secreting pituitary adenomas in adults.

Surgical and non-surgical interventions for primary and salvage treatment of growth hormone-secreting pituitary adenomas in adults.

Interactions with virtual therapists during motor rehabilitation in immersive virtual environments: a systematic review

Introduction: Virtual Reality applications for rehabilitation are increasing in popularity. In traditional as well as virtual rehabilitation, the guidance of an occupational therapist through physical and verbal interaction is often required. Several studies have attempted to implement a virtual therapist or assistant in immersive virtual environments for rehabilitation.Objective: This research aims to systematically review these studies, understanding the therapist’s role and how they are represented in the virtual environment, how the virtual therapist and patient interact and the experience of users. Our goal is to provide guidance for virtual therapist implementations into fully immersive virtual reality environments.Method: The researchers systematically reviewed the literature on virtual therapists in immersive virtual environments for motor rehabilitation (protocol prospectively registered with PROSPERO ID: CRD42022357369).Results and Conclusion: Seven studies were identified, with findings showing that virtual therapists are often human-like avatars that guide patients, requiring them to mimic the therapist’s movements. Visual, haptic, or one-direction audio feedback from the therapist to the patient was provided in five studies. The selected studies were all newly developed custom-made systems, with five systems developed using the same game engine. Studies carrying out user testing utilised several methods to understand user experience, evidencing a positive attitude from therapists and motivated and satisfied patients.Future Research: The roles of virtual therapists for motor rehabilitation needs to be explored further in rigorous empirical studies to gather data on patient and therapist user experience. Considerable potential was identified in the development of virtual therapists and therapeutic alliance in the virtual environment. Future systems should reduce manual input from therapists and include personalisation and individualised patient feedback.Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=357369], PROSPERO ID [CRD42022357369].

Prenatal incidence of cleft lip/palate and cocaine abuse in parents: a systematic review and meta-analysis.

The study aimed to investigate the association between maternal cocaine abuse during pregnancy and the prevalence of cleft lip/palate (CL/P) in offspring, synthesizing existing evidence through a systematic review and meta-analysis. CL/P is a congenital craniofacial anomaly with complex etiology, and prior research has suggested potential links between maternal cocaine use and CL/P. However, these associations remain inconclusive. A comprehensive literature search was conducted to identify relevant studies published up to the study's cutoff date in September 2021. Several databases were systematically searched using predefined search terms. Inclusion criteria were set to encompass studies reporting on the prevalence of CL/P in infants born to mothers with a history of cocaine use during pregnancy, with a comparison group of non-cocaine-using mothers. Data were extracted, and a meta-analysis was performed using a random-effects model to calculate pooled odds ratios (OR) and relative risks (RR) with their respective 95% confidence intervals (CI). The review included data from 4 studies that met the inclusion criteria. The combined OR from two studies was 0.05 (95% CI: 0.00, 4.41), which does not suggest a statistically significant association between prenatal cocaine exposure and the incidence of CL/P due to the confidence interval crossing the null value. Additionally, the combined RR was 0.17 (95% CI: 0.04, 0.66), indicating a statistically significant decrease in the risk of CL/P associated with prenatal cocaine exposure. These results, with an OR that is not statistically significant and an RR suggesting decreased risk, should be interpreted with caution due to considerable heterogeneity and variability among the included studies' findings. Further research is needed to clarify these associations. The findings from this systematic review and meta-analysis suggest that maternal cocaine use during pregnancy is not a statistically significant independent risk factor for the development of CL/P in offspring. These results underscore the multifactorial nature of CL/P etiology and emphasize the importance of considering other genetic, environmental, and nutritional factors in understanding the condition's origins. While the study provides important insights, limitations such as data heterogeneity and potential confounders should be acknowledged. Future research should adopt rigorous study designs and explore a broader range of potential risk factors to comprehensively elucidate CL/P development.

Efficacy of acupuncture and laser acupuncture in temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials

ObjectiveThe aim of this study is to perform a qualitative and quantitative analysis of the scientific literature regarding the use of acupuncture and laser acupuncture in the treatment of pain associated with temporomandibular disorders (TMDs). The aim of this article was to assess the clinical evidence for acupuncture and laser acupuncture therapies as treatment for temporomandibular joint disorder (TMD).Materials and methodsThis systematic review includes randomized clinical trials (RCTs) of acupuncture and laser acupuncture as a treatment for TMD compared to other treatments. Systematic searches were conducted in 3 electronic databases up to July 2023; PubMed, EMBASE, and SCOPUS databases. All RCTs of acupuncture for TMD were searched without language restrictions. Studies in which no clinical data and complex interventions were excluded. The Cochrane risk of bias tool (RoB 2) tool was employed to analyze randomized controlled trials. A Meta-analysis was performed in order to investigate a quantitative analysis comparing acupuncture and laser acupuncture to placebo.ResultsA total of 11 RCTs met our inclusion criteria. The findings show that acupuncture is short-term helpful for reducing the severity of TMD pain with muscle origin. Meta-analysis revealed that the Acupuncture group and Laser Acupuncture group had a higher efficacy rate than the Placebo control group, showing a high efficacy of Acupuncture and Laser Acupuncture group in the treatment of temporomandibular.ConclusionsIn conclusion, our systematic review demonstrate that the evidence for acupuncture as a symptomatic treatment of TMD is limited. Further rigorous studies are, however, required to establish beyond doubt whether acupuncture has therapeutic value for this indication. However high efficacy of Laser Acupuncture in the treatment of temporomandibular disorders was reported.

Parametric study on the assessment of the local buckling behavior of perforated square hollow sections with non-uniform wall thickness under axial compression

The aim of this rigorous parametric study is to explore the influence of perforations on the local buckling behavior of square hollow sections (SHSs) possessing non-uniform wall thickness. A finite element procedure followed in the current study has been first validated against existing test results documented for the local buckling behavior of the perforated SHS with uniform web and flange segment thickness under axial compression. The linear elastic eigenvalue buckling and elastoplastic buckling analyses have been implemented using the Abaqus engineering finite element code. The verification of the numerical procedure has been achieved by favorably comparing the finite element results with the existing test results in terms of the first local buckling mode shape and load-end shortening curves of the perforated SHS with uniform wall thickness. . The verified numerical procedure has been applied to the problem of finding the perforation effect on the local buckling response of the SHS with non-uniform thickness. Finite element analyses have been performed for four various web width-to-perforation diameter ratios ranging from 0.3 to 0.9. Finite element analysis results have revealed that the presence of perforations does not influence the local buckling mode shape of the SHS but considerably affects the critical local buckling loads. The results have put forth that increasing perforation diameter leads to a more pronounced and drastic decrease in the critical local buckling load. The outcomes of the study have also shown that the critical post-buckling load of the SHS with non-uniform wall thickness is less susceptible to perforations compared to the SHS with uniform wall thickness. The results obtained in the context of this parametric study have been made available to practical engineering for use in actual design of the perforated SHSs.

Use of Topical Anesthetics in the Management of Patients With Simple Corneal Abrasions: Consensus Guidelines From the American College of Emergency Physicians

The management of corneal abrasions has largely excluded dispensing topical local anesthetics for home use due to concern for corneal toxicity. We have reviewed and critically appraised the available literature evidence regarding the use of topical anesthetics in patients with simple corneal abrasions. Using sequential Delphi review, we have developed these clinical guidelines. Herein are evidentiary summaries and consensus recommendations for 8 specific relevant questions. Our key observation is that for only simple corneal abrasions, as diagnosed and treated in accordance with the full protocol described herein, it appears safe to prescribe or otherwise provide a commercial topical anesthetic (ie, proparacaine, tetracaine, oxybuprocaine) for use up to every 30 minutes as needed during the first 24 hours after presentation, as long as no more than 1.5 to 2 mL total (an expected 24-hour supply) is dispensed and any remainder is discarded after 24 hours. Importantly, although published findings suggest absent harm for short courses, more rigorous studies with a greater cumulative sample size and ophthalmologic follow-up are needed.

Risk factors related to surgical wound infection after caesarean section: A systematic review and meta‐analysis

AbstractSurgical site infection (SSI) is one of the common postoperative complications after caesarean section for pregnant women. Previous studies have investigated the risk factors for SSI in pregnant women undergoing caesarean delivery. Whereas big differences in research results exist, and the correlation coefficients of different research results are quite different. A meta‐analysis was conducted to examine the risk factors related to SSI in pregnant women undergoing caesarean delivery. We searched English databases to collect case–control studies or cohort studies published between 1 January 2015 and 15 November 2023, including PubMed, Web of Science and ScienceDirect. The risk of bias of the included studies was assessed via Newcastle‐Ottawa Scale. The analysis was performed using RevMan 5.4.1 tool. A total of 24 articles (n = 581, 895) were selected in this meta‐analysis. The following risk factors were presented to be significantly correlated with SSI in pregnant women following caesarean delivery: smoking (odds ratio [OR] = 1.64, 95% confidence interval [CI] [1.31, 2.04]), previous caesarean section (OR = 1.46, 95% CI [1.18, 1.82]), multiple vaginal examinations (OR = 2.92, 95% CI [1.91, 4.46]), membrane rupture (OR = 1.68, 95% CI [1.19, 2.38]), hypertensive disorders (OR = 1.85, 95% CI [1.33, 2.57]), diabetes mellitus (OR = 1.36, 95% CI [1.18, 1.57]), high body mass index (OR = 1.57, 95% CI [1.35, 1.84]). Occurrence of SSI is influenced by a variety of factors. Thus, we should pay close attention to high‐risk subjects and take crucial targeted interventions to lower the SSI risk after caesarean section. Owing to the limited quality and quantity of the included studies, more rigorous studies with adequate sample sizes are needed to verify the conclusion.

Exploring Unidentified Aerospace Phenomena Through Instrumented Field Studies: Historical Insights, Current Challenges, and Future Directions

The study of Unidentified Aerospace Phenomena (UAP) requires a shift from a historical, narrative-based approach to a scientific and technology-based study. To conduct unbiased and agnostic research on UAPs, rigorous scientific study is necessary, including the collection of hard data to support credible explanations or scientifically prove the existence of unknown phenomena. Obtaining reliable and valid data requires instrumented observations, including multi-wavelength and multi-mode sensors (e.g., optical, radar, infrared). We present herein an overview of the benefits as well as the strategic and tactical considerations of instrumented field studies, highlighting common limitations and shortcomings with the objective of contributing to the development of future projects. We provide an overview of some past and current UAP military and civilian projects and analyze a timetable of instrumented projects spanning the years 1950-2023, encompassing contributions from both citizen science and professional/academic science. In conclusion, this paper reflects on how UAP field experiments might look going forward. Newer technologies like digital cameras, scientific instruments, computing, big data analytics, artificial intelligence, and satellite imagery are becoming more advanced and cost-effective. This is leading to the growth and progress of technical field studies, complementing local projects with global-scale investigations. Researchers can enhance their chances of success by adopting a more disciplined approach and exploring innovative avenues. Collaboration, transparency, and standardization in data collection and analysis are crucial, while also acknowledging the complex nature of the UAP phenomenon.

The reliability and applicability of the Ten Test in hand injuries: A systematic review

Introduction The Ten Test (TT) is a touch threshold test that quantifies sensory discrimination by comparing an injured area with a contralateral uninjured area. It’s quick, simple, equipment-free and repeatable. However, as a subjective measure, the TT’s reliability and applicability need further investigation. This review aimed to investigate if the TT has superior inter- and intra-examiner reliability compared to the widely accepted Weinstein Enhanced Sensory Test (WEST) in a human population of all ages. Methods A systematic search was conducted on major databases from January 1997 to September 2023 and adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. Outcomes were assessed with a narrative approach. The included articles were critically appraised according to the Quality Assessment of Diagnostic Accuracy Studies two tool. Results This review included five articles. High inter-examiner reliability was demonstrated with intraclass correlation coefficient (ICC) values of 0.91 and 0.95, alongside a kappa statistic of 1, as reported by three distinct studies. Intra-examiner reliability displayed some variance, with one study reporting a significant ICC value in four out of six instances. Two studies corroborated that the TT results corresponded with the findings of WEST, each presenting a Spearman rank coefficient of −0.71. Conclusion Our findings underscore the TT’s high inter-examiner reliability, though its intra-examiner reliability exhibited some inconsistencies. Interestingly, certain studies claimed its superiority over the WEST. To validate the TT’s use in the clinical setting, more rigorous studies, particularly those comparing pre-operative TT outcomes with intraoperative nerve damage evaluations, are essential.

Spectral analysis of non-contrast fluoroscopy for evaluation of pulmonary perfusion: Feasibility and sensitivity testing with a phantom.

Oscillating x-ray attenuation in the lungs provides an opportunity to evaluate pulmonary perfusion without contrast. Recent intensity-based methods have been compared to pulmonary scintigraphy and CT angiography but lack rigorous phantom studies. A new method to quantify the periodic signal amplitude was employed using spectral analysis. Performance was characterized using a water phantom capable of creating an oscillating x-ray attenuation at physiologic amplitudes. Feasibility in detecting abnormal perfusion was performed on a volunteer with pulmonary vascular disease and compared to pulmonary angiography, the clinical gold standard. For each fluoroscopic acquisition, the normalized temporal signal from each pixel was decomposed into its frequency components using Fourier transformation, and the spectral amplitude, defined as the x-ray pulsatility index (XPI), was determined at the desired frequency using a band-pass filter. XPI was displayed as a pixel-wise parametric colormap. Based on XPI maps generated using two human volunteers, a water bath phantom was constructed with a fluctuating fluid height and a 1cm diameter pulsatility defect. Contrast-to-noise (CNR) of the defect was measured using fluoroscopy images acquired at variable fluid height fluctuation (0.1-1.9mm) and oscillation frequency (30-60bpm). Various sampling frame rates (3-30 fps) and acquisition durations (1.8-8s) using truncated datasets were reconstructed from full datasets. Fluoroscopic images were obtained in a patient just prior to pulmonary angiography in the same projection. XPI maps in human subjects showed high signal to background contrast with high central XPI measuring up to 0.5. Phantom experiments revealed CNR was linearly correlated to fluid height change (r2 =0.998). CNR is proportional to increasing sampling frame rate and increasing acquisition duration as expected with Fourier analysis. XPI map displayed multifocal perfusion defects in good agreement with pulmonary angiography. Spectral analysis is an accurate and sensitive method to detect small changes in periodic x-ray attenuation using a short fluoroscopic acquisition. This method demonstrated good agreement to pulmonary angiography and shows promise for clinical imaging of pulmonary perfusion using standard fluoroscopic methods.

Gamified Assessment of the Emotion-Regulation Abilities in Youths: Validation of the REThink Online Game-Based Assessment System.

Objective: Emotional problems in the youth population are a major issue that can have a significant negative impact for their future development as adults. Their emotion regulation (ER) abilities represent a preventive measure for those emotional problems. REThink is an online therapeutic game that was proved to be effective in rigorous studies, and is based on the rational emotive behavioral therapy, with seven levels built to train various emotional regulation skills. Each level has a section that can be used for the assessment of the targeted skills within the level. The present study aimed at investigating the reliability and validity of the evaluation modules from the REThink game regarding the assessment of ER abilities in children/adolescents. Methods: In accordance with established guidelines, 110 children and adolescents aged 8-14 years old were recruited. Following parental informed consent, the participants filled out the standard questionnaires and, subsequently, they played the evaluation module of the REThink game. The reliability aspect was investigated by evaluating internal consistency, while validity was evaluated by using concurrent and predictive validity analyses. Results: The results revealed statistically significant positive associations between the game scores obtained by the participants and the emotion regulation scale. In terms of predictive validity, there were significant negative associations between game scores and the presence of emotional and behavioral problems. Moreover, in terms of the reliability of the REThink game, an acceptable value for the internal consistency was observed. Conclusion: In conclusion, the REThink therapeutic game was proved to be a valid measure for assessing emotion regulation abilities in children and adolescents. Clinical Trial Registration No. NCT04788901.