Psychiatric symptoms and quality of life in patients with Idiopathic Intracranial Hypertension- A cross-sectional study.

Assessing breathing patterns in people with chronic obstructive pulmonary disease (COPD) is essential, yet assessment tools are often inaccessible outside of specialized care. The Brompton Breathing Pattern Assessment Tool (BPAT) enables quick, contactless evaluations, making it suitable for remote assessments. Although the BPAT has been shown to be reliable for remote evaluation of asthma patients, there is no evidence regarding its reliability for COPD patients. The aim of this study was to assess the reliability of the BPAT for remote assessment in patients with chronic obstructive pulmonary disease (COPD). This cross-sectional study included 18 adults with medically confirmed stable COPD (mean age 80±8.3years; 72.2% female). One physiotherapist conducted in-person BPAT evaluations, while a high-definition smartphone camera and microphone captured video of the participants' full upper bodies. Three physiotherapists participated as remote assessors, independently evaluating the same recorded breathing patterns. The main outcome measure was the total scores from the BPAT. The intraclass correlation coefficient (ICC3,1) was used to assess inter-rater reliability, and Bland-Altman analyses were conducted between the in-person assessor and each remote assessor. The reliability of the BPAT was positive and moderate between the four assessors (ICC 0.70 [0.50-0.86]) and the three remote assessors (ICC 0.70 [0.47-0.86]). The mean differences from the Bland-Altman analyses ranged from -1.17 to -0.22 points. This study demonstrates that the BPAT seems to be reliable for remote use in people with COPD and may serve as a useful screening instrument to identify individuals who could benefit from further specialist assessment of breathing pattern disorders.

Validity of the PHQ-9A as a self-report screener for major depressive disorder in youth ages 10-12years.

Moderate and severe hypoxic–ischemic encephalopathy (HIE), even when managed with therapeutic hypothermia, carries a substantial risk of neurodevelopmental impairment in early childhood. Long-term multidisciplinary follow-up is therefore essential for infants treated with hypothermia. Early identification of developmental delay is critical for timely intervention. Formal neurodevelopmental assessments—such as the Bayley Scales of Infant and Toddler Development—are considered the gold standard; however, they are resource-intensive, costly, and require in-person evaluation.. As an alternative, screening tools may be employed to identify children who require further evaluation. Screening instruments, such as the Ages and Stages Questionnaire, Third Edition (ASQ-3), offer a pragmatic alternative for initial risk stratification, demonstrating high specificity and positive predictive value for developmental delay. The Infant and Toddler Quality of Life Questionnaire (ITQOL-97) is a validated, multidimensional parent-reported instrument for assessing health-related quality of life in children aged 2 months to 5 years, encompassing physical health, behavioural and emotional functioning, and parental impact. The aim of the study was to evaluate neurodevelopmental outcomes at 2 years of age—using validated screening tools—in children with a history of moderate or severe hypoxic–ischemic encephalopathy who received whole-body surface cooling (non-device-mediated therapeutic hypothermia) in the post-asphyxial period and showed no overt adverse neonatal outcomes. Materials and methods. The study cohort comprised 18 children who underwent therapeutic hypothermia following perinatal asphyxia. The control group consisted of 22 age-matched children without evidence of birth asphyxia. Developmental status was assessed using the ASQ-3, which categorises performance as normal (white zone) or delayed (gray/black zone) across five domains: communication, gross motor, fine motor, problem solving, and personal–social skills—based on parental report. Health-related quality of life was evaluated using the ITQOL-97 (Infant and Toddler Quality of Life Questionnaire, 1997), adapted for use in children aged 2 months to 5 years. The questionnaire was completed by parents or legal guardians under researcher supervision. Scores were analysed per domain and as a composite index (mean of all domain scores). The study was conducted within the framework of the research project of the Department of Pediatrics 3 and Neonatology, Dnipro State Medical University: “Approaches to the diagnosis and treatment of childhood diseases from the perspective of patient safety” (State registration No. 0121U114304). Ethical approval was granted by the Institutional Ethics Committee. Results. No statistically significant differences were found between groups (Fisher’s exact test, p > 0.05). However, a trend toward higher rates of delay was observed in the study group for fine motor skills, problem-solving (adaptiveness), and personal–social development. Among hypothermia-treated children, 38.9% exhibited deviations from normal white zone indicators; 5.6% fell into the delayed (black) zone specifically for fine motor and personal–social domains. Significant intergroup differences (p < 0.05) were identified on the ITQOL-97 in the following domains: physical abilities and motor function, growth and development, general behaviour, and parental emotional impact and time burden. The ITQOL-97, being a subjective, parent-reported measure, may detect subtle functional impairments—such as fatigue during play, feeding difficulties, or behavioural alterations—that are not fully captured by structured developmental screening tools. Conclusions. These findings support the current understanding that although whole-body therapeutic hypothermia reduces the incidence of severe neurological sequelae, a subset of children exhibits residual functional challenges, more readily identified through combined use of developmental screening and quality-of-life assessment. Nearly 39% of children in the study group demonstrated developmental concerns, underscoring the necessity of structured, long-term neurodevelopmental surveillance and early rehabilitative support.

Generalized anxiety disorder (GAD) is one of the most common anxiety disorders and significantly impacts individual well-being. Early detection using a valid instrument, such as the GAD-7, is essential for effective intervention. However, evidence regarding the psychometric performance of the GAD-7 in developing countries remains fragmented, particularly across student and community populations, necessitating systematic synthesis. This study aimed to systematically review and synthesise evidence on the psychometric properties of the GAD-7, including its validity, reliability, cut-off values, and cultural adaptability, among students and general populations in developing-country contexts. A systematic review was conducted using three databases: PubMed, ScienceDirect, and SAGE Journals. The search employed the keywords “Anxiety Disorder,” “Developing Country,” “Generalized Anxiety Disorder-7,” “Mental Health,” “Psychometric,” and “Student,” using Boolean operators (AND, OR). Of the 3,255 records identified, 15 studies met the inclusion criteria after screening and eligibility assessment and were included in the final synthesis. The review demonstrates that the GAD-7 shows consistently strong construct validity, a stable unidimensional factor structure, and robust convergent validity across diverse cultural and educational settings, with positive correlations observed with related instruments such as the PHQ-9. With high internal consistency (Cronbach’s α = 0.85–0.93) and a commonly supported cut-off score of ≥10, the GAD-7 effectively identifies anxiety symptoms, although context-specific lower cut-off scores were reported in certain clinical and community populations. Overall, the findings indicate that the GAD-7 is a valid, reliable, and culturally adaptable screening instrument for anxiety assessment. By consolidating psychometric evidence across developing-country contexts, this review provides an integrated and up-to-date synthesis that supports the informed use of the GAD-7 in educational, clinical, and public mental health settings, particularly in low-resource environments.

Diabetes mellitus (DM) is a globally prevalent metabolic disorder with rising incidence. Diabetic peripheral neuropathy (DPN), the most common microvascular complication in DM, disrupts autonomic nervous system regulation of cardiac and circulatory functions, thereby increasing susceptibility to cardiovascular and cerebrovascular events. Elucidating the relationship between diabetic DPN and cardiovascular complications is critical for optimizing holistic management of diabetic patients. This study aimed to investigate the correlation between DPN and cardiovascular events in patients attending the Diabetes Clinic of Rafsanjan University of Medical Sciences, Iran. In this cross-sectional study, 260 patients with type 2 diabetes mellitus (T2DM), diagnosed per the American Diabetes Association (ADA) 2023 criteria, were enrolled via convenience sampling. The patients with cardiovascular complications group comprised 121 patients with T2DM and documented cardiovascular events, while the control group included 138 patients with T2DM and no cardiovascular history. Data on demographic characteristics, body mass index (BMI), blood pressure, clinical laboratory parameters, and neuropathy severity (assessed via the Michigan Neuropathy Screening Instrument [MNSI]) were collected. Statistical analysis was performed using SPSS version 22. The patients with cardiovascular complications had significantly higher neuropathy scores (p = 0.039), longer diabetes duration (p < 0.05), greater prevalence of hypertension (p < 0.001), and elevated serum creatinine (p = 0.020) compared to those without cardiovascular complications. In multivariable logistic regression, severe diabetic neuropathy (score > 4) was associated with increased odds of cardiovascular complications in the unadjusted model (OR = 1.73, 95% CI: 1.03-2.91) and after adjustment for demographic and lifestyle factors (adjusted OR = 2.07, 95% CI: 1.07-3.97; p = 0.030). A significant crude association was also observed for each one-unit increase in continuous neuropathy score (OR = 1.09, 95% CI: 1.01-1.18; p = 0.021). A significant association was found between peripheral neuropathy and increased odds of cardiovascular disease in T2DM patients. This underscores the potential role of neuropathy as a marker for cardiovascular risk. Further longitudinal studies are warranted to explore the mechanistic interplay between neuropathy progression and cardiovascular outcomes.

Purpose The purpose of the study was to address the lack of Polish diagnostic or screening instruments for dementia in adults with intellectual disabilities by developing and assessing a Polish version of the Dementia Screening Questionnaire for People with Intellectual Disabilities (DSQIID-P). Design/methodology/approach Three independent linguists translated and adapted the original DSQIID into a Polish version, which three independent assessors then reviewed. Once finalised, a preliminary psychometric evaluation was conducted. Institutions supporting adults with intellectual disabilities were approached for the recruitment of participants. The questionnaire was completed by caregivers of 107 adults with intellectual disabilities aged 40 and over. A subset of 69 caregivers also completed the Barthel index. Findings The mean total DSQIID-P score was 13.77 (SD = 9.28). Older participants showed a statistically significant higher DSQIID-P score. Individuals with physical illnesses scored statistically significantly higher than those without. The Cronbach’s alpha of 0.89 indicates satisfactory internal consistency. A statistically significant negative correlation between DSQIID-P and the Barthel index scores supported criterion validity. The early assessment of DSQIID-P looks promising for use in Polish-speaking populations. Research limitations/implications This was a preliminary assessment of the newly developed DSQIID-P with a relatively small sample size. Full psychometric validation is still needed through further research. Originality/value To the best of the authors’ knowledge, this is the first study to develop and evaluate a Polish version of a dementia screening tool specifically designed for adults with intellectual disabilities, filling a critical gap in Polish clinical practice and research.

The definition of frailty is still debated, resulting in the development of various measurement tools. Having a convenient and accurate frailty screening instrument is essential to providing appropriate care to community-dwelling older adults in terms of facilitating the delayed onset of frailty and preventing disability. This study was conducted to develop a simple, convenient, and rapid screening method for frailty classification in community-dwelling older adults that incorporates the most significant predictive factors from the Study of Osteoporotic Fractures index components and the Kihon Checklist tool domains. Convenience sampling was used to gather longitudinal data from 110 community-dwelling older adults at baseline (T0), 6 months (T1), and 1 year (T2) using three different frailty screening tools. The Fried frailty phenotype tool was used as the gold standard. Linear discriminant analysis was conducted to create an effective model for accurately classifying frailty states. The discriminant analysis generated three statistical significant functions, which respectively explained 33.6% (Rc=.58; df=3; p<.0001), 26.0% (Rc=.51; df=2; p<.0001), and 29.2% (Rc=.54; df=2; p<.0001) of the predictive power of prefrail/frail risk. The discriminant functions demonstrated sensitivities of 64.6%-69.4% for identifying the prefrail/frail group and specificities of 77.1%-90.9% for identifying the robust group. The developed method successfully classified the correct robust and prefrail/frail states for 71.6%-79.1% of participants. The findings of this longitudinal study show weight loss, reduced energy levels, physical function, activities of daily living (IADL lifestyle), and eating function to be the most significant factors at baseline for accurately classifying community-dwelling older adults into robust and prefrail/frail states over a 1-year follow-up period. Eating function was identified as the strongest factor of influence on the correct prediction of frailty status. Nurses may use the five questionnaire-based domains in initial assessments to classify frailty in community-dwelling older adults with a 1-year accuracy of at least 70%. Those identified as at-risk should be referred to physicians, nutritionists, rehabilitation specialists, and/or long-term care services to optimally delay or prevent the onset of frailty in this population.

BackgroundNeurocognitive symptoms are among the most debilitating features of long COVID (persistent, ongoing symptoms and conditions following SARS‐CoV‐2 infection). Traditional neurocognitive screening instruments have been found to be non‐sensitive to post‐COVID cognitive impairments, often described as ‘brain fog’, that disrupt performance of complex daily routines. Accurate screening and diagnosis of cognitive impairment is therefore a critical area of clinical research for people with long COVID. We examined whether self‐reported or neuropsychological cognitive function tests were more strongly associated with long COVID.MethodsIn a sample from a community‐engaged cross‐sectional cohort study, we fitted a binary logistic regression model for the outcome of long COVID status (having history of COVID illness, plus a Post‐COVID Functional Status Scale (PCFS) score >=2), classified by MoCA cut score weighted for race/ethnicity, and associated with the Patient‐Reported Outcomes Measurement Information System (PROMIS) 8‐item Cognitive Functioning t‐scores, controlling for age.ResultsWe analyzed data from N = 174 participants (n = 67 cases, n = 107 controls). Our final model was fitted with 5‐knot natural cubic splines for age and PROMIS Cognition scores. At a “Non‐impaired” score on the MoCA, a PROMIS t‐score at the lower quartile of 36.67 increased the odds of having long COVID by over seven times at age 25 (1.0,56.89, p = 0.01), over five times at ages 45 (1.4,18.6, p = 0.001) and 55 (1.4,20.4, p = 0.002), and six times at ages 65 (0.9,51.2, p = 0.02) and 75 (0.8,48.9, p = 0.03). By contrast, scores above and below race/ethnicity‐weighted MoCA cut score did not significantly affect the odds of having long COVID at any age (p value ranges 0.22‐0.25 and 0.19‐0.22, respectively) adjusted for mean PROMIS score.ConclusionAcross ages, low PROMIS Cognitive Function scores showed between five‐ and six‐fold increases in odds of long COVID, adjusted for age and MoCA score. This self‐rated cognitive function scale was the best predictor of functional status changes attributed to post‐COVID‐19 health changes in our sample.

BackgroundThe Impact of Genetic Susceptibility Testing for Alzheimer's Disease (IGT‐AD) instrument, developed to assess the psychological effects of learning genetic information specific to Alzheimer's disease (AD), has been widely used in the literature. Identifying a cutoff score for this screening instrument is crucial for rapidly and efficiently identifying individuals in need of psychological intervention, including those learning the results of non‐genetic AD biomarker testing. This study aims to explore the optimal cutoff score and evaluate the predictive powers of an adapted IGT‐AD Distress subscale for identifying distress in cognitively symptomatic older adults learning the results of amyloid PET testing.MethodWe adapted the IGT‐AD instrument by replacing reference to genetic testing with reference to biomarker testing. A total of 96 cognitively symptomatic research participants were assessed for psychological impact using this adapted instrument and the Impact of Event Scale (IES) as a gold standard comparison diagnostic tool. The optimal cutoff point for the modified IGT‐AD in detecting distress was determined by evaluating the sensitivity and specificity of various cutoff scores, with an IES cutoff of 26 used as the gold standard. Receiver Operating Characteristic (ROC) analysis was performed, and the area under the curve (AUC) was calculated to evaluate the predictive accuracy of the IGT‐AD. The Youden index was used to identify the cutoff point that maximized sensitivity and specificity.ResultThe mean age of participants was 72.4 years, 40.6% were male, 71.6% were White race, 21% were Black race, and 20% were Hispanic ethnicity. Most (55.2%) held bachelor's or post‐bachelor's degrees and 71.9% were married or cohabiting. The optimal cutoff point for the modified IGT‐AD Distress subscale was determined to be 22, with a sensitivity of 77.1% and specificity of 82.0%. The AUC for distress was 0.86 (95% CI: 0.78–0.94), indicating excellent predictive power.ConclusionThe findings suggest that an adapted IGT‐AD Distress subscale score above the identified cutoff of 22 is effective in detecting psychological distress in cognitively symptomatic persons learning their AD biomarker status. This cutoff may have practical applications in clinical and research settings for screening and early intervention.

Translation, adaptation, and validation of the Malay Preschool Screening Instrument for Targeting Educational Risk (MyPra-SIFTER): a teacher-administered hearing screening tool for preschool children in Malaysia

Abstract A screening instrument is costly if it is socially wasteful and productive otherwise. A principal screens an agent with multidimensional private information and quasilinear preferences that are additively separable across two components: a onedimensional productive component and a multidimensional costly component. Can the principal improve upon simple one-dimensional mechanisms by also using the costly instruments? We show that if the agent has preferences between the two components that are positively correlated in a suitably defined sense, then simply screening the productive component is optimal. The result holds for general type and allocation spaces, and allows for nonlinear and interdependent valuations. We discuss applications to monopoly pricing, bundling, and labor market screening.

Introduction: Dysphagia significantly affects patients’ quality of life, and its early detection is crucial. The Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is limited to referral hospitals. Accordingly, the Indonesian version of the Dysphagia Handicap Index (DHI-INA) was investigated as a potential screening instrument for identifying dysphagia among patients in community-based settings with restricted access to advanced diagnostic modalities. Methods: A cross-sectional study was conducted involving patients with oropharyngeal dysphagia. Each participant completed the DHI-INA questionnaire, and FEES was conducted to assess swallowing function using the Penetration-Aspiration Scale (PAS). Data were analyzed using ROC curve analysis to determine the Area Under the Curve (AUC), sensitivity, specificity, and optimal cut-off values. Results: A total of 100 patients were enrolled in the study, with a mean age of 52.62 ± 9.61 years; with 58% male and 42% female. The primary etiologies included neurological disorders, head and neck pathologies, reflux disease, and other medical conditions. The optimal DHI-INA cut-off score of 21 yielded a sensitivity of 90.24% and specificity of 84.74%, with an AUC of 86.30%, indicating good diagnostic accuracy. A significant correlation was found between DHI-INA domain scores and PAS results (p &lt; 0.001). Conclusion: The DHI-INA demonstrated strong diagnostic performance and a significant correlation with FEES outcomes. It represents a valid and practical screening instrument for identifying patients at risk of penetration or aspiration, particularly in community settings with limited access to advanced swallowing diagnostics.

Validity of caregiver response to a developmental screening instrument was examined in 571 caregivers (51.7% identifying as ethnic minority) of infants/toddlers (48% female) assessed longitudinally from birth to 18 months. Three embedded validity scales were designed to detect: atypical (ATP), negative (NRS), and positive (PRS) response styles. Rates of responding on the ATP, NRS, and PRS scales relative to established validity measures, temporal stability including test-retest reliability of the scales, and relations between response styles and maternal education were examined. Response bias was low; however, significant differences due to maternal education were evident. More variable scores (ATP) and more advanced development (PRS) was consistently reported by caregivers with lower education. Caregivers with higher education reported their infants' development as less advanced (NRS). Base rates of uncommon responding ranged from 11.6% to 14.4% and 5.8% to 9.1% at liberal and conservative cut scores. Preliminary analysis of additional social-contextual sources of variation (e.g., caregiver mental health) in response styles suggests the need for complex modeling of multiple sources of bias in caregiver-reported developmental outcomes. These are the first embedded validity scales to be designed within a caregiver-reported instrument of infant/toddler development.

This design research study investigates how pace-sensitive and inclusive mathematics instruction can support students who learn at slower, moderate, and faster paces in Indonesian junior high classrooms. Using the PRIME framework—Profiling, Reconstruction, Implementation, Measurement, and Engagement—the study was implemented across two iterative cycles in two comparable inclusive classes (N = 80, Grade 8). Each cycle employed contextual mathematical tasks integrating local and global themes, such as fishing tides, travel-based time zones, temperature changes, skyscraper scaling, and communal food sharing, all grounded in Realistic Mathematics Education (RME). Students’ learning-pace profiles were established through triangulated diagnostics including cognitive screening instruments, self-assessment, teacher interviews, and Level 0 contextual tasks. Within each cycle, descriptive analyses indicated clear improvements in students’ representational clarity, strategic reasoning, and movement through the RME phases, particularly among students who initially struggled with abstraction. Cycle 2 demonstrated more substantial gains than Cycle 1, with students exhibiting increased independence, reduced need for teacher prompting, and stronger transitions from model-of to model-for reasoning. Qualitative thematic analysis further showed enhanced engagement, contextual understanding, and confidence, while teachers reported more manageable routines for differentiation. The findings suggest that learning pace is malleable and responsive to purposeful instructional design. The PRIME framework offers a practical bridge between RME, differentiated instruction, Universal Design for Learning (UDL), and Multi-Tiered Systems of Support (MTSS), providing a feasible model for promoting equitable mathematics learning in resource-variable inclusive classrooms.

ABSTRACT Background: Timely identification of individuals at risk for developing PTSD following trauma is crucial for providing targeted preventive interventions. Machine learning techniques show promise for deriving accurate prognostic screening instruments. However, accurate externally validated prognostic screening instruments for broad application in trauma-exposed civilians are not yet available. Moreover, it remains unknown whether prognostic screening instrument accuracy may be improved if developed in a sex-stratified manner. Objective: We aimed to develop an externally validated prognostic PTSD screening instrument based on self-report information obtained within 2 months post-trauma in two independent cohorts of recently trauma-exposed civilians, using machine learning techniques allowing for extraction of a short screener. We examined whether separate models for males and females improved prognostic accuracy compared to sex-combined models. Methods: Prognostic machine learning models (CART and XGBoost) were developed in a longitudinal cohort of N = 327 adults (38% females) requiring evaluation of (suspected) serious injury by an emergency department. External validation was performed in another longitudinal cohort of N = 466 adults (57% females) referred for emotional, practical or legal victim support following crime or traffic accidents. PTSD status at 1 year post-trauma was based on CAPS-IV for internal and PCL-5 for external validation. Results: During internal validation, all models achieved excellent accuracy (AUC/sensitivity/specificity > 0.90). During external validation, sufficient accuracy was only achieved for the sex-combined XGBoost model (AUC = 0.73, sensitivity = 0.69, specificity = 0.68), including 22 items of demographic and health characteristics, trauma characteristics, peri-traumatic distress or dissociation, post-traumatic cognitions, PTSD symptoms and social support. Conclusion: We developed an accurate externally validated short prognostic screening instrument for PTSD based on self-report questions that is applicable to a broad population of recently trauma-exposed civilians. This novel instrument enables timely identification of individuals at risk for PTSD following trauma, and research into early targeted interventions to prevent long-term PTSD for civilians following trauma.

Diabetic peripheral neuropathy (DPN), a prevalent microvascular complication of diabetes mellitus, poses a substantial clinical burden and has a detrimental impact on quality of life. This triple-blind, randomized, placebo-controlled trial investigated the effects of an 8-week supplementation with selenium-enriched yeast on DPN symptoms, neuropathy severity, pro-oxidant-antioxidant balance (PAB), and sexual satisfaction in individuals aged 40-70 years with DPN. Fifty participants were randomized in a 1:1 ratio to receive either a daily 200 μg dose of Saccharomyces cerevisiae yeast-derived selenium (in a 500 mg capsule) or a placebo. Outcomes were assessed using validated tools: The Michigan Neuropathy Screening Instrument (MNSI) for symptoms, the Toronto Clinical Scoring System (TCSS) for severity, the Larson Sexual Satisfaction Questionnaire (LSSQ), and serum PAB levels via a specialized assay. Analyses followed a modified intention-to-treat approach, with ANCOVA and logistic regression used to adjust for confounders. Post-intervention, both groups exhibited significant reductions in neuropathy symptoms (selenium: p < 0.001; placebo: p = 0.001), though intergroup differences were non-significant [adjusted mean difference (aMD): -0.92; 95% CI: -1.9 to 0.10]. Neuropathy severity decreased significantly in the selenium group (p = 0.002) but not in the placebo group. While PAB levels declined markedly with selenium (p = 0.001), the between-group difference was non-significant (aMD: -32.1; 95% CI: -66.02 to 1.87). Sexual satisfaction scores improved significantly in the selenium group versus the placebo group (aMD: 8.51; 95% CI: 0.74 to 16.28). These findings suggest that selenium-enriched yeast supplementation may enhance biochemical markers (PAB) and quality-of-life parameters (sexual satisfaction) in DPN. However, its limited efficacy in improving neuropathy-specific outcomes underscores the need for larger trials to clarify its therapeutic potential. This trial was registered at the Iranian Registry of Clinical Trials (IRCT20131009014957N10, https://trialsearch.who.int/Trial2.aspx?TrialID=IRCT20131009014957N10).

Insomnia Severity Index (ISI) is one of the most widely used screening instruments for chronic insomnia, yet limitations in prior studies leave aspects of its psychometric properties incomplete. This study aimed to validate the ISI and investigate its screening utility in a clinical and nonclinical Romanian sample (N = 326; Mage = 25.84). Results indicate good internal consistency (αT1 = .84, αT2 = .86) and good test-rest reliability (r = .82). ISI significantly correlates with depression (r = .69), anxiety (r = .52), self-esteem (r = -.42), and quality of sleep (r = .75), supporting its concurrent and convergent validity. Regression analyses confirm its predictive validity, based on neurologists' (β = .39) and clinicians' (β = .43) diagnostic ratings of chronic insomnia. A cutoff score of 13 is optimal for a good balance between sensitivity (.79) and specificity (.68). Confirmatory factor analysis supports a two-factor model. Moreover, measurement invariance analyses show that ISI functions equivalently across the clinical and nonclinical groups. Overall, ISI scores provide reliable and valid information for screening chronic insomnia in patients with or without other psychiatric and/or medical conditions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Chickenpox, measles, monkeypox, and smallpox are skin diseases that exhibit very similar signs, making accurate distinction difficult. In this study, an automated deep learning system is developed to classify pox-related skin diseases into six classes, which are Chicken_Pox, Measles, Monkey_Pox, Small_Pox, Normal, and Unknown. The system uses MobileNet to extract features efficiently using a dataset of 4099 training and 1104 evaluation images. The three tested model variants: inception-based CNN, Deep Belief Network, and MobileNet-LSTM-hybrid, Deep Belief Network (DBN) with the SGD optimizer, incurred the best classification accuracy, showing to be more effective at similar tasks to retrieve spatial and temporal features. This will ensure more efficient and quicker detection of the pox, particularly in those regions that do not have specialists in dermatology. Although it is not a replacement for clinical expertise, the system provides a potent instrument in screening and diagnosis of early diseases. The comparative evaluation of these models offers insights into the most effective approach for medical image classification of pox diseases.

ABSTRACT This study evaluated the proximal outcomes of the Sexual Communication and Consent program (SCC): a novel, tailored sexual assault (SA) prevention intervention implemented in the United States Air Force Basic Military Training from 2019 to 2020. Trainees received classroom instructor-led training and one of five tablet-delivered interventions that were tailored based on individual SA risk for perpetration, victimization, or revictimization assessed with a screening instrument. Using multilevel regression modeling, we assessed six proximal outcomes of SCC exposure in a sample of 3557 trainees with matched pretest and posttest data, analyzing results for both the overall sample and across the five SCC intervention subgroups. Within the overall sample, participation in SCC was associated with statistically significant increases in SA knowledge, consent knowledge, and self-efficacy to resist unwanted advances and statistically significant decreases in date rape attitudes and, unexpectedly, bystander intentions. Stratified analyses revealed consistent SA knowledge increases across subgroups, whereas consent knowledge and date rape attitudes were only significant in the male Healthy Relationships/Bystander Intervention subgroup. Self-efficacy to resist unwanted advances was significant in all victimization-focused subgroups except male Primary Victimization Prevention. There were no observed changes in protective dating behaviors in the overall sample or any intervention subgroup. Expanding the limited evidence-base of SA prevention programming in the US military, findings highlight the potential for tailored interventions that address SA risk factors for perpetration, victimization, or revictimization, to improve proximal outcomes known to be associated with SA incidence. Implications for future research and practice are discussed.