Individual Target Research Articles

Subjective well-being and attitudes toward outgroup members

There is a large body of literature on the effect of negative attitudes toward outgroup members on target individuals and groups. However, less attention was devoted to their effects on those who hold these attitudes. The current study hypothesized that there would be a bidirectional relationship between subjective well-being and attitudes toward outgroup members. In Study 1, data from the Integrated Values Surveys, the Ecology-Culture Dataset, and the World Happiness Report 2022 were used. In Study 2, a random intercept cross-lagged panel model was implemented using longitudinal data over a six-year period from the GESIS Panel (n = 6783 people living in Germany). Results of Study 1 demonstrated a significant negative relationship between subjective well-being and negative attitudes toward outgroup members both at the country level (118 countries) and at the individual level (663,965 participants in 120 countries around the world). In Study 2, a random intercept cross-lagged panel model revealed significant within-person reciprocal relations between life satisfaction and negative attitudes toward refugees. This study provides evidence for a bidirectional relationship between subjective well-being and negative attitudes toward outgroup members.

Multigeographic clinical assessment of a molecular diagnostic assay for detection of key codons to predict decreased susceptibility or resistance to cephalosporins in Neisseria gonorrhoeae.

Cephalosporin resistance in Neisseria gonorrhoeae has severely compromised the efficacy of World Health Organization (WHO)-recommended therapies. This study aimed to methodologically evaluate the optimized Six-CodonPlus assay, and additionally conducted a multicenter evaluation to assess its clinical application, especially for predicting antimicrobial resistance (AMR). For methodological evaluation, 397 sequence-known N. gonorrhoeae isolates were evaluated for specificity, 17 nongonococcal isolates were assessed for cross-reactivity, 159 uncultured urogenital swabs and urine samples were evaluated for sensitivity at the clinical level. For multicenter evaluation, 773 isolates with confirmed phenotypic data and 718 clinical urogenital swabs collected from four geographical cities were, respectively, utilized for the evaluation of AMR-prediction strategies and the clinical application of the assay. The assay accurately identified specific single-nucleotide polymorphisms in resistance-associated genes, the detection limits dropped to 10 copies/reaction for individual targets. The specificity reached 100% and no cross-reactivity occurred with double-target confirmation. The assay could be directly applied to clinical samples containing over 20 copies/reaction. Multicenter evaluation formulated two optimal strategies for decreased susceptibility prediction in specific scenarios, and one tactic for prediction of resistance and identification of FC428-like strains. High sensitivity of 86.84% (95% CI, 71.11-95.05) and specificity of 99.59% (95% CI, 98.71-99.89) for resistance prediction were demonstrated for ceftriaxone (CRO). Regarding N. gonorrhoeae identification among multicenter swabs, specificity reached 97.53% (95% CI, 95.49-98.69), and sensitivity reached 93.77% (95% CI, 90.04-96.22). The Six-CodonPlus assay exhibited excellent detection performance and formulated optimal AMR-related prediction strategy with regional adaptability, providing critical information for population screening and clinical treatment.

Investigating factors influencing AI customer service adoption: an integrated model of stimulus–organism–response (SOR) and task-technology fit (TTF) theory

PurposeArtificial intelligence (AI) customer service has grown rapidly in recent years due to the emergence of COVID-19 and the growth of the e-commerce industry. Therefore, this study employs the integration of the stimuli–organism–response (SOR) and the task-technology fit (TTF) frameworks to understand the factors that affect individuals’ intentions towards AI customer service adoption in Malaysia.Design/methodology/approachThe study utilised a survey-based research approach to investigate the factors that affect individuals’ intentions towards AI customer service adoption in Malaysia. The data were collected by conducting an online survey targeting individuals aged 18 or above who had prior customer service interaction experience with human service agents but had not yet adopted AI customer service. A sample of 339 respondents was used to evaluate the hypotheses, adopting partial least squares structural equation modelling as a symmetric analytic technique.FindingsThe PLS-SEM analysis revealed that social influence and anthropomorphism have a positive direct relationship with emotional trust. Furthermore, communicative competence, technology characteristics and perceived intelligence were positively correlated with TTF. Moreover, emotional trust significantly impacts AI customer service adoption. In addition, AI readiness positively moderates the association between task technology fit and AI customer service adoption.Practical implicationsThe study provides insights to individuals, organisations, the government and educational institutions to improve the features of AI customer service and its development in Malaysia.Originality/valueThe originality of this study is found in its adoption of the SOR theory and TTF to understand the factors affecting AI customer service adoption. Additionally, it incorporates moderating variables during the analysis, adding depth to the findings. This approach introduces a new perspective on the factors that impact the adoption of AI customer service and offers valuable insights for practitioners seeking to formulate effective strategies to promote its adoption.

Arterial hypertension in the era of obesity bias: the impact of obesity status on pharmacological treatment intensification in patients with diabetes

Abstract Background Obesity is recognized as a significant risk factor for several chronic conditions, such as diabetes and hypertension. Despite the growing healthcare needs of individuals with obesity, they often encounter obesity bias, potentially impacting the quality of medical care they receive. Purpose The aim of this study was to explore the impact of obesity on the appropriateness of antihypertensive treatment decisions in individuals with concurrent diabetes and hypertension. Methods In this multicenter cross-sectional study, patients with type 2 diabetes and arterial hypertension who were receiving outpatient care across four centers in Southern Brazil were enrolled. Participants were categorized into two groups based on their Body Mass Index (BMI): eutrophic (BMI <25.0 kg/m²) and patients with obesity (BMI ≥30.0 kg/m²). The primary outcome evaluated was the difference in pharmacological treatment decisions for hypertension between groups, considering individualized hypertension targets from American Diabetes Association (ADA), European Society of Hypertension (ESH), and European Society of Cardiology (ESC). Analysis was conducted on whether patients failed to receive necessary treatment intensification, comparing groups through multivariable logistic regression. Results The study comprised 204 individuals with type 2 diabetes and arterial hypertension, including 53 eutrophic and 151 patients with obesity. It was observed that patients with obesity more frequently fail to receive appropriate treatment intensification when compared to eutrophic individuals. This finding was statistically significant across the hypertension targets set by the ESH (adjusted Odds Ratio [OR] 2.03 [95% Confidence Interval [CI] 1.08-3.83], p = 0.022), ESC (adjusted OR 1.94 [95% CI 1.03-3.65], p = 0.035), and ADA (adjusted OR 2.01 [95% CI 1.07-3.79], p = 0.021). Conclusion The study indicates that obesity may contribute to disparities in the management of hypertension, suggesting a link between obesity status and therapeutic inertia in treating arterial hypertension among these patients.

How do external environmental stimuli and internal psychological cultural identity affect tourists’ behavioral intentions in public cultural spaces?

The role of cities and regions is becoming increasingly crucial in the process of global localization. As vital carriers of urban activities, public spaces are receiving widespread attention; however, the substantial impact of multidimensional experiences of public cultural spaces on urban tourism and the role of cultural identity within these spaces have yet to be extensively studied. This study establishes a framework based on scenescape and stimulus-organism-response theories to explore how external stimuli influence tourists’ behavioral intentions. We developed and conducted a questionnaire survey targeting individuals who have visited the “Most Beautiful Public Cultural Spaces” in Nanjing, China. A total of 287 valid samples were collected for analysis. Four types of external environmental stimuli—physical, activity, mechanism, and virtual spaces—were found to have direct and indirect effects on tourists’ behavioral intentions with cultural identity playing an intermediary role. These new insights provide theoretical enlightenment and practical recommendations for enhancing tourism experiences in public cultural spaces.

COVID-19 vaccine hesitancy in Ethiopia: a latent class analysis

BackgroundDespite evidence demonstrating the effectiveness of the COVID-19 vaccine, vaccine hesitancy has emerged as a major challenge for vaccine uptake. The objective of this study was to classify latent typologies of vaccine hesitant adults in Ethiopia and identify predictors of the latent classes.MethodsWe employed a cross-sectional household survey among 1,112 individuals aged 18 and above who were partially vaccinated (one dose) or not vaccinated at the time of the survey. Data was collected in August 2022. We collected information on participant socio-demographics, COVID-19 knowledge, prevention practices, disease history, and vaccine hesitancy. Latent class analysis was used to classify individuals into categories of vaccine hesitancy. We conducted multinomial logistic regression to test the associations between latent typologies and different demographic and COVID-19 related characteristics of study participants.ResultsUsing latent class analysis we found a four-class solution for vaccine hesitancy typologies. The identified classes were strong vaccine acceptors (30%); vaccine acceptors with some concerns (7%); vaccine sceptics (13%); and vaccine rejectors (50%). In adjusted models with vaccine sceptics as the referent group, those with high COVID-19 vaccine knowledge were significantly more likely to belong to the strong vaccine acceptors class compared to those with low vaccine knowledge (adj. RRR: 17.36, 95% CI: 10.94–27.55). Better COVID-19 prevention practices were also significantly associated with belonging to the vaccine acceptors with some concerns class than the vaccine sceptics class (adj. RRR: 2.13, 95% CI: 1.09–4.16). Those who had one dose of the COVID-19 vaccine were significantly more likely to belong in the vaccine acceptors class than the vaccine sceptics class compared to those who had no dose (adj. RRR: 6.82, 95% CI: 3.06–15.21).ConclusionsHalf of the study participants were in the vaccine rejectors class. Individuals in the vaccine sceptics and rejector classes evidenced lower vaccine knowledge and worse COVD-19 prevention practices and were less likely to have been partially vaccinated. Future program interventions should focus on improving knowledge around the vaccine, decrease rumors and misconceptions, and target individuals who may be more amenable to changing their vaccination attitudes or behaviors like vaccine sceptics or acceptors with some concerns.

Epidemiology And Biological Mechanisms Of Cardiovascular Disease And Diabetes

The risk of CVDs in T2DM patients in LMICs is higher than in developed nations. It is essential to make an evaluation of the current situation of CVDs among people with T2DM. These CVDs are easily preventable through intervention especially in T2DM patients and this should be done in a comprehensive manner. The following targets and principles should be considered: individual targets of HbA1c for patients, a rigorous control of cardiovascular risk factors such as blood pressure and lipids, and incorporation of newer anti-diabetic, lipid-lowering and anti-hypertensive agents. It is, therefore, crucial to design a stepped-wedge approach that bundles a patient-level intervention, lifestyle, and pharmacological interventions to reduce the risk of CVD in LMIC T2DM populations. When selecting medications for T2DM patients with cardiovascular conditions, several key considerations must be made: When selecting medications for T2DM patients with cardiovascular conditions, several key considerations must be made: It should be noted that the choice of anti-diabetic drugs should take into consideration cardiovascular safety. SGLT2 inhibitors and GLP-1 agonists are newer agents for managing diabetes and have been found to have cardiorenal benefits. The choice of lipid-lowering should be targeted to lower LDL cholesterol and triglycerides as effectively as possible. If the intensity of statin is high; it is considered first-line therapy, and other optional medication includes ezetimibe and PCSK9 inhibitors. To maintain the best pressure level that is suitable for an individual, and as a result control hypertension, the use of antihypertensive drugs is necessary. This makes ACE inhibitors or ARBs the preferred first-line antihypertensive agents because of their cardiovascular benefits. For the purpose of secondary prevention in individuals who have experienced a cardiovascular event, the antiplatelet drug aspirin in a dosage of between 75 to 150 milligrams per day should be administered. This is to minimize the probability of such difficulties re-emerging by influencing platelet activity. In general, adequate blood pressure management and antiplatelet aggregation therapy are key interventions with specific antiplatelet medication needs in this setting.

Shared Accountability Shaping the Destinies of Individual and Groups of Nonhuman Primates

At the California National Primate Research Center (CNPRC), the preferred housing for rhesus macaques involves maintaining them in complex social groups outdoors, primarily for breeding purposes. This functionally appropriate environment promotes effective coping through the expression of species-typical behaviors and important aspects of species-typical social structure, thus enabling normal animal development, higher reproductive success, and the production of high-quality biological models. Despite the benefits, social housing introduces challenges like trauma from aggressive interactions. These challenges necessitate a delicate balance between tolerating some aggression and preventing repeated targeting of individuals. Therefore, the CNPRC has established a multidisciplinary working group of behavioral management experts, veterinarians, animal care, and researchers that meets regularly to review cases of animals that may need to be removed from their social group. We discuss the criteria and decision-making processes employed to manage and mitigate aggression. We describe the systematic approach to identifying at-risk individuals and the comprehensive evaluation process that guides whether to relocate an animal from their groups or not. Considerations include the welfare of the individual and the group’s social stability. This paper provides case studies demonstrating how the working group applies these criteria and processes in practical scenarios, highlighting the complexities and challenges of such decisions.

The perceptual and mnemonic effects of ensemble representation on individual size representation.

Our visual world consists of multiple objects, necessitating the identification of individual objects. Nevertheless, the representation of visual objects often exerts influence on each other. Even when we selectively attend to a subset of visual objects, the representations of surrounding items are encoded and influence the processing of the attended item(s). However, it remains unclear whether the effect of group ensemble representation on individual item representation occurs at the perceptual encoding phase, during the memory maintenance period, or both. Therefore, the current study conducted visual psychophysics experiments to investigate the contributions of perceptual and mnemonic bias on the observed effect of ensemble representation on individual size representation. Across five experiments, we found a consistent pattern of repulsive ensemble bias, such that the size of an individual target circle was consistently reported to be smaller than it actually was when presented alongside other circles with larger mean size, and vice versa. There was a perceptual component to the bias, but mnemonic factors also influenced its magnitude. Specifically, the repulsion bias was strongest with a short retention period (0-50 ms), then reduced within a second to a weaker magnitude that remained stable for a longer retention period (5,000 ms). Such patterns of results persisted when we facilitated the processing of ensemble representation by increasing the set size (Experiment 1B) or post-cueing the target circle so that attention was distributed across all items (Experiment 2B).

СУЧАСНІ МЕТОДИ ІНТЕРНЕТ-ПРОСУВАННЯ НА РИНКУ ДВЕРЕЙ

This article highlights current strategies and effective methods of promoting products in the door market via the Internet in the competitive struggle for sales markets. Analyzing a highly competitive industry, the authors examine various aspects of an effective online presence to increase store traffic and sales. The article focuses on the analysis and comparison of various modern methods of Internet promotion in the context of the door market, with an emphasis on determining the most effective approaches to their application, in particular, such as: social networks, search engine optimization, e-commerce, video marketing, cooperation with influencers, retargeting, content -marketing and adaptive web design. The authors examine each of these methods in detail, evaluating their cost, complexity of setup, and potential effectiveness for different target audiences. Special attention is paid to analyzing the needs of different market segments, such as: young professionals, married couples, older generations, eco-conscious buyers, developers, owners of commercial premises and real estate investors. The article examines exactly how strategies can help increase competitiveness and effectively attract the attention of the target audience. The authors emphasize the importance of a comprehensive approach and individual targeting of each segment, taking into account their unique needs and preferences. The article also includes recommendations for the optimal combination of various Internet marketing methods to maximize the effectiveness of marketing efforts in the door market. Conclusions and proposals are based on a deep analysis of modern trends in digital marketing, as well as on the experience of the author team in this field. The article contains practical recommendations for companies specializing in the sale of doors, which seek to successfully market their products via the Internet. In particular, modern trends and innovative approaches for optimizing electronic business in the field of door production and their implementation are considered. This work can be useful for marketers, door manufacturers, and anyone interested in developing effective Internet marketing strategies in specific markets.

Financial Literacy and Retirement Readiness:A Case Study of the Namibian Police Services

Retirement preparedness is a priceless process during one’s tenure of employment because no individual can continue working during his or her lifetime. However, the low levels of financial literacy among retired Namibian police officers compromises sound retirement planning. Financial stress upon retirement is particularly problematic for police officers in Namibia, and this study examined the nexus between financial literacy and retirement planning. The research was qualitative, allowing for an in-depth exploration of the personal experiences and challenges faced by retirees. There were interviews with 26 participants, purposively selected from retired Namibian police officers. In addition, five key informants in the human resources department of the Namibian Police services then corroborated information collected. Purposive-sampling enabled the research to target individuals with direct experience of retirement from the Namibian Police Service. Thematic analysis indicated that upon retirement, police officers found themselves in dire poverty, with no sustainable income sources. The process of determining pension amounts was opaque resulting in the police officers failing to determine the income gap they would face after retirement. There were no financial literacy training programmes for the police officers resulting in their failure to make sound investments during employment period. Therefore, the study recommended that the Namibian Police Services should implement financial literacy programmes, encourage officers to make sound investment decisions, and ensure that retirement becomes an attractive part of one’s lifetime

Planning and Preparation of Cybersecurity

In today's digital environment characterized by fast-evolving adversaries, expanded attack surfaces, and complex IT environments, having a formidable plan and being prepared could create a world of difference when faced with a potential cyber-attack. Cyber threats are growing risks to everyone and any institution. Cybercriminals target individuals and companies of all sizes. Today's attacks are agile and sophisticated. Ransom demands are elevating and advancing rapidly while attackers drill down their focus to specific victims like critical infrastructure businesses, which can spend millions of dollars in losses from cyber disasters since such companies have less tolerance for downtime. The evolution of artificial intelligence technology, which is more interesting and scarier at the same time, is impacting the field of cybersecurity. The negative side of AI is that it has enabled threat actors to blend new data theft-based extortion techniques into ransomware. Attackers can steal companies' sensitive data or even encrypt the data and demand ransom for the decryption key failure, to which they threaten the company to expose the data to the public or even trade in the dark web. The intelligent techniques and tactics utilized by threat actors are a clarion call for organizations to proactively plan and prepare adequately by developing a cybersecurity strategy as a countermeasure. A cybersecurity strategy is a comprehensive plan that stipulates an organizational approach to secure its IT infrastructure against cyber threats. The common cybersecurity strategy various organizations use to plan and prepare for inevitable attacks is the incidence response plan. Incidence response is the processes and technologies organizations use to detect and respond to cyber threats, security breaches, or cyberattacks within an organization. Developing and implementing a formal incident response plan allows organizations to minimize and prevent damage. This research paper focuses on the primary goal of the incident response of preventing cyberattacks prior to occurring and reducing the cost and business disruption emanating from cyberattacks that happen. Keywords – incident response, threats, Artificial intelligence, cybersecurity, threat attacks, plan, preparation.

Advances in Cancer Therapy: A Comprehensive Review of CDK and EGFR Inhibitors.

Protein kinases have essential responsibilities in controlling several cellular processes, and their abnormal regulation is strongly related to the development of cancer. The implementation of protein kinase inhibitors has significantly transformed cancer therapy by modifying treatment strategies. These inhibitors have received substantial FDA clearance in recent decades. Protein kinases have emerged as primary objectives for therapeutic interventions, particularly in the context of cancer treatment. At present, 69 therapeutics have been approved by the FDA that target approximately 24 protein kinases, which are specifically prescribed for the treatment of neoplastic illnesses. These novel agents specifically inhibit certain protein kinases, such as receptor protein-tyrosine kinases, protein-serine/threonine kinases, dual-specificity kinases, nonreceptor protein-tyrosine kinases, and receptor protein-tyrosine kinases. This review presents a comprehensive overview of novel targets of kinase inhibitors, with a specific focus on cyclin-dependent kinases (CDKs) and epidermal growth factor receptor (EGFR). The majority of the reviewed studies commenced with an assessment of cancer cell lines and concluded with a comprehensive biological evaluation of individual kinase targets. The reviewed articles provide detailed information on the structural features of potent anticancer agents and their specific activity, which refers to their ability to selectively inhibit cancer-promoting kinases including CDKs and EGFR. Additionally, the latest FDA-approved anticancer agents targeting these enzymes were highlighted accordingly.

Mood Disorder Public Stigma in Jewish Communities in the United States.

This study employed an experimental vignette design in Jewish communities in the United States (n = 243) to investigate whether public stigma toward target individuals with major depressive disorder or bipolar disorder presenting with either mania or depression was associated with their gender and symptomatology. The Mental Illness Stigma Scale (Day et al., in J Appl Soc Psychol 37(10):2191-2219, 2007) was used to measure the following dimensions of public stigma: (a) anxiety; (b) relationship disruption; (c) hygiene; (d) visibility; (e) treatability; (f) professional efficacy; and (g) recovery. The influence of characteristics of survey respondents on public stigma was also examined.In Jewish communities in the United States, mood disorder symptomatology was associated with the stigma dimensions of recovery, relationship disruption, and hygiene. Among respondents, younger and middle-aged males reported increased treatment efficacy stigma. Research implications include designing stigma reduction interventions tailored to specific diagnostic (e.g., bipolar disorder) and demographic (e.g., younger males) groups within the Jewish community.

Getting Tacrolimus Dosing Right.

Tacrolimus (TAC) dosing is typically guided by the trough concentration (C0). Yet, significant relationships between TAC C0 and clinical outcomes have seldom been reported or only with adverse events. Large retrospective studies found a moderate correlation between TAC C0 and the area under the curve (AUC), where, for any given C0 value, the AUC varied 3- to 4-fold between patients (and vice versa). However, no randomized controlled trial evaluating the dose adjustment based on TAC AUC has been conducted yet. A few observational studies have shown that the AUC is associated with efficacy and, to a lesser extent, adverse effects. Other studies showed the feasibility of reaching predefined target ranges and reducing underexposure and overexposure. TAC AUC0-12 h is now most often assessed using Bayesian estimation, but machine learning is a promising approach. Microsampling devices are well accepted by patients and represent a valuable alternative to venous blood sample collection during hospital visits, especially when a limited sampling strategy is required. As AUC monitoring cannot be proposed very frequently, C0 monitoring has to be used in the interim, which has led to fluctuating doses in patients with an AUC/C0 ratio far from the population mean, because of different dose recommendations between the 2 biomarkers. We proposed estimating the individual AUC/C0 ratio and derived individual C0 targets to be used in between or as a replacement for AUC monitoring. Existing technology and evidence are now sufficient to propose AUC monitoring interspersed with individualized-C0 monitoring for all patients with kidney transplants while collecting real-world data to strengthen the evidence.

SOCIAL ENTREPRENEURSHIP: CRACKING THE UNKNOWN PHENOMENON OF INDIVIDUALS WITH AUTISM SPECTRUM DISORDER

Despite numerous initiatives made by various organisations to increase employment opportunities for individuals with autism spectrum disorder (ASD), they remain unemployed. The unemployment rate for individuals with ASD remains high. Therefore, this study seeks to understand the employment challenges for individuals with ASD and develop innovative solutions to address them. This study selected six founders of social enterprises in Klang Valley, Malaysia, that target individuals with ASD as participants. The study uses a face-to-face interview as a means of data collection. By implementing the thematic analysis, the study will uncover key themes and patterns that can inform future initiatives and policies to promote inclusion and diversity in the Malaysian workforce. These findings will contribute to a more comprehensive understanding of the challenges faced by marginalised groups and the strategies that can be implemented to address them effectively.

Dose-response association of an accelerometer-measured physical activity with all-cause mortality and cardiovascular disease incidence: Prospective cohort with 76,074 participants

ObjectiveTo investigate the prospective dose-response association of accelerometer-measured moderate-to-vigorous physical activity (PA;MVPA) with all-cause mortality and cardiovascular disease (CVD) incidence. MethodsThis prospective cohort of 76,074 participants from the UK Biobank study contained one week of individual accelerometer-based PA data collected between June 1, 2013 and December 23, 2015. Using restricted cubic splines to allow for potential non-linearity, we examined dose-response associations of MVPA with all-cause mortality and incident CVD, respectively. ResultsThe median follow-up time was 8.0 years (IQR 7.5–8.5). The dose-response association of MVPA with all-cause mortality and CVD showed a similar L-shaped association, with significant risk reductions already from 10 min of MVPA per week for all-cause mortality (hazard ratio [HR], 0.98 [95 % CI,0.98–0.99]) and 15 min per week for CVD incidence (HR, 0.99 [95 % CI,0.98–0.99]). Doing more MVPA was associated with further risk reduction, but beyond around 500 min per week the benefits levelled off at HR's around 0.6 to 0.7. The highest additional benefit of adding more minutes per week for all-cause mortality and CVD incidence were observed between 100 and 250 weekly minutes of MVPA. From this point forward, the mean risk reduction rates decreased and were close to 0 beyond 500 weekly minutes. ConclusionsSignificant, but small, risk reductions in all-cause mortality and CVD incidence can be achieved with as little as 10 and 15 min of MVPA per week, respectively. However, public health organizations should promote the attainment of 250 min of MVPA per week (with 100 min as a possible first target for inactive individuals), as these thresholds are associated with the greatest efficiency. Beyond that, less pronounced risk reductions can be achieved by accumulating additional MVPA, with hardly any additional benefits beyond 500 weekly minutes.

Factors associated with acquiring exercise habits through health guidance for metabolic syndrome among middle-aged Japanese workers: A machine learning approach

ObjectivePhysical inactivity increases the risk of mortality and chronic morbidity. Therefore, it is crucial to establish strategies to encourage individuals to increase their physical activity and develop exercise habits. The objective of this study was to explore factors associated with acquiring exercise habits using machine learning algorithms. MethodsThe analyzed dataset was obtained from the Specific Health Guidance for metabolic syndrome systematically implemented by the Japanese Ministry of Health, Labor, and Welfare. We selected target individuals for health guidance without exercise habits in 2017 and assessed whether the participants acquired exercise habits through health guidance in 2018. We applied ten machine learning algorithms to build prediction models for acquiring exercise habits. ResultsThis study included 16,471 middle-aged Japanese workers (age, 49.5 ± 6.2 years). Among the machine learning algorithms, the Boosted Generalized Linear Model was the best for predicting the acquisition of exercise habits based on the receiver operating characteristic curve on the test set (ROC-AUCtest, 0.68). According to the analyses, the following factors were associated with the acquisition of exercise habits: being in the maintenance or action stage of changing exercise and eating behaviors based on the transtheoretical model; regular physical activity or walking; normal high-density lipoprotein cholesterol; and high alcohol consumption. ConclusionsOur findings can be used to establish an efficient strategy for encouraging individuals to acquire exercise habits through Specific Health Guidance or other health guidance. However, the lower ROC-AUCtest suggests that additional variables are necessary to enhance the prediction model.

An SMS-Guided Basal Insulin Titration in People with Type 2 Diabetes New on Insulin.

The shortage of general practitioners (GPs) and the increasing prevalence of type 2 diabetes create significant pressure on primary healthcare services. To enable that medical services are available to allthat need it, innovative solutions are needed. One of those, a Short Message Service (SMS)-supported basal insulin titration service is investigated in this study. The primary objective was to determine the percentage of subjects who achieved stable fasting blood glucose (FBG) within their individual target range with this service after week 16. This single-arm, 16-week study aimed to enroll 111 adults diagnosed with type 2 diabetes that needed insulin. The study subjects measured their FBG 4 consecutive days to establish a baseline, then received SMS prompts for daily FBG measurements and evening insulin injections until their FBG stabilized within the target range. Adjusting the insulin based on the FBG. Once stabilization was achieved, subjects continued with their optimal insulin dose for the remainder of the study. Sixteen weeks after the baseline, subjects measured FBG for 4days before visit 4, where these values were read by the healthcare provider. Out of the planned 111 subjects, only 30 were enrolled, with one withdrawal prior to service activation. Challenges in subject recruitment were attributed to the COVID-19 outbreak, limited eligibility, competing studies, and new medications delaying insulin initiation. Subjects were on average 59.97years old, had an HbA1c of 9.29% a FBG of 205.64mg/dl, and had diabetes for 10years. Among the 29 subjects who started the service, 72% achieved successful titration at visit 4, with a median time of 49days. Notable improvements were observed in HbA1c levels (decreased by 1.58%) and FBG levels (decreased by 64mg/dl) over the 16-week study period. No adverse events or device-related issues were reported. Despite recruitment challenges, guided basal insulin titration holds promise for insulin therapy initiation in individuals. The findings emphasize the potential of tele-medical approaches, specifically through remote messaging, in managing diabetes and improving therapy adherence.

Transducer module apodization to reduce bone heating during focused ultrasound uterine fibroid ablation with phased arrays: A numerical study.

During magnetic resonance-guided focused ultrasound (MRgFUS) surgery for uterine fibroids, ablation of fibrous tissues in proximity to the hips and spine is challenging due to heating within the bone that can cause patients to experience pain and potentially damage nerves. This far-field bone heating limits the volume of fibroid tissue that is treatable viaMRgFUS. To investigate transducer module apodization for improving the ratio of focal-to-bone heating ( ) when targeting fibroid tissue close to the hips and spine, to enable MRgFUS treatments closer to thebone. Acoustic and thermal simulations were performed using 3D magnetic resonance imaging (MRI)-derived anatomies of ten patients who underwent MRgFUS ablation for uterine fibroids using a low-frequency ( ) 6144-element flat fully-populated modular phased array system (Arrayus Technologies Inc., Burlington, Canada) at our institution as part of a larger clinical trial (NCT03323905). Transducer modules ( per module) whose beams intersected with no-pass zones delineated within the field were identified, their output power levels were reduced by varying blocking percentage levels, and the resulting temperature field distributions were evaluated across multiple sonications near the hip and spine bones in each patient. Acoustic and thermal simulations took approximately ( ) and ( ) to run for a single near-spine (near-hip) target,respectively. For all simulated sonications, transducer module blocking improved compared to the no blocking case. In just over half of sonications, full module blocking maximized (increase of 82% 38% in 50% of hip targets and 49% 30% in 62% of spine targets vs. no blocking; mean±SD), at the cost of more diffuse focusing (focal heating volumes increased by 13%±13% for hip targets and 39%±27% for spine targets) and thus requiring elevated total (hip: 6%±17%, spine: 37%±17%) and peak module-wise (hip: 65%±36%, spine: 101%±56%) acoustic power levels to achieve equivalent focal heating as the no blocking control case. In the remaining sonications, partial module blocking provided further improvements in both (increased by 29%±25% in the hip and 15%±12% in the spine) and focal heating volume (decrease of 20%±10% in the hip and 34%±17% in the spine) relative to the full blocking case. The optimal blocking percentage value was dependent on the specific patient geometry and target location of interest. Although not all individual target locations saw the benefit, element-wise phase aberration corrections improved the average compared to the no correction case (increase of 52%±47% in the hip, 35%±24% in the spine) and impacted the optimal blocking percentage value. Transducer module blocking enabled ablative treatments to be carried out closer to both hip and spine without overheating or damaging the bone (no blocking: / , full blocking: / , optimal partial blocking: / for hip/spine). The proposed transducer apodization scheme shows promise for improving MRgFUS treatments of uterine fibroids, and may ultimately increase the effective treatment envelope of MRgFUS surgery in the body by enabling tissue ablation closer to bonystructures.