Background and Aim: In healthy aging, there is a decline of cognitive functions such as episodic memory, i.e., long-term memories of events in one’s life. This process is exacerbated in neurodegenerative diseases such as Alzheimer’s disease. Therefore, developing interventions to maintain memory functions in old age is essential, but requires the identification of the underlying neuronal processes of this decline. However, the neuronal processes underlying age-related memory decline have been inconclusively investigated, particularly regarding the temporal dynamics of memory content integration within brain networks. Here, electroencephalography (EEG) and transcranial alternating current stimulation (tACS) provide methods for investigating and modulating brain oscillations and their association with memory. However, methodological advancements are still required for more practicable and better-tolerated assessments of the neuronal mechanisms of memory impairments and their effective neuromodulation, e.g., in clinical populations. Therefore, this dissertation aims to provide a comprehensive picture of oscillatory processes during memory performance, their age-related changes, and new methods for investigation and potential intervention in healthy older adults and patients. Methods: To this end, I investigated and compared the neuronal correlates of episodic memory in young and older adults using EEG in paper 1. Paper 2 is a Stage 1 Registered Report aiming to investigate the effect of tACS on memory performance and oscillatory activity in healthy older adults. Here, I used EEG, functional magnetic resonance imaging (fMRI) and computational modeling of electric fields of older adults to determine the appropriate stimulation frequency, the exact stimulation sites, and the appropriate electrode set-up to target the identified regions. Paper 2 also includes a pilot study with young adults to ensure the feasibility of the stimulation protocol and involvement of subcortical activity in stimulation effects. In paper 3, I compared memory-relevant measures between conventional and newer dry electrodes (dry EEG) to test whether dry EEG provides a reliable method for investigations in groups or environments where conventional EEG would not be possible, e.g., patient populations in their home. Results: Analyses showed disturbed oscillatory processes in healthy older adults, compared to younger adults, related to age-related memory impairments (paper 1). To target the disturbed memory network in older adults, I developed a multimodal, data-driven approach analyzing EEG, fMRI and electric field modeling pilot data of healthy older adults to identify suitable tACS parameters for modulation of memory and network functioning. An additional pilot study showed the feasibility of the protocol. It also showed that despite the lack of effect on memory performance in a small, high-performing sample of young adults, the stimulation changed this group’s oscillatory processes in cortical and subcortical regions of the memory network (paper 2). The memory-relevant processes investigated in papers 1 and 2 could also be detected with dry EEG, especially using global network measures (paper 3). Conclusion: Together, this dissertation presents a comprehensive account of oscillatory processes during memory performance and the changes they undergo in healthy aging. It introduces novel methods for investigation and possible intervention in healthy older adults and patients. In future work, these findings could be extended to investigate memory- relevant EEG signatures and their modulation in patient groups to develop effective interventions in memory-impaired populations in a home-based setting.

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Although variation in effect sizes and predicted values among studies of similar phenomena is inevitable, such variation far exceeds what might be produced by sampling error alone. One possible explanation for variation among results is differences among researchers in the decisions they make regarding statistical analyses. A growing array of studies has explored this analytical variability in different fields and has found substantial variability among results despite analysts having the same data and research question. Many of these studies have been in the social sciences, but one small “many analyst” study found similar variability in ecology. We expanded the scope of this prior work by implementing a large-scale empirical exploration of the variation in effect sizes and model predictions generated by the analytical decisions of different researchers in ecology and evolutionary biology. We used two unpublished datasets, one from evolutionary ecology (blue tit, Cyanistes caeruleus, to compare sibling number and nestling growth) and one from conservation ecology (Eucalyptus, to compare grass cover and tree seedling recruitment). The project leaders recruited 174 analyst teams, comprising 246 analysts, to investigate the answers to prespecified research questions. Analyses conducted by these teams yielded 141 usable effects (compatible with our meta-analyses and with all necessary information provided) for the blue tit dataset, and 85 usable effects for the Eucalyptus dataset. We found substantial heterogeneity among results for both datasets, although the patterns of variation differed between them. For the blue tit analyses, the average effect was convincingly negative, with less growth for nestlings living with more siblings, but there was near continuous variation in effect size from large negative effects to effects near zero, and even effects crossing the traditional threshold of statistical significance in the opposite direction. In contrast, the average relationship between grass cover and Eucalyptus seedling number was only slightly negative and not convincingly different from zero, and most effects ranged from weakly negative to weakly positive, with about a third of effects crossing the traditional threshold of significance in one direction or the other. However, there were also several striking outliers in the Eucalyptus dataset, with effects far from zero. For both datasets, we found substantial variation in the variable selection and random effects structures among analyses, as well as in the ratings of the analytical methods by peer reviewers, but we found no strong relationship between any of these and deviation from the meta-analytic mean. In other words, analyses with results that were far from the mean were no more or less likely to have dissimilar variable sets, use random effects in their models, or receive poor peer reviews than those analyses that found results that were close to the mean. The existence of substantial variability among analysis outcomes raises important questions about how ecologists and evolutionary biologists should interpret published results, and how they should conduct analyses in the future.

Antidepressant medication (ADM) and psychotherapy are effective treatments for major depressive disorder (MDD). It is unclear, however, if treatments differ in their effectiveness at the symptom level and whether symptom information can be utilised to inform treatment allocation. The present study synthesises comparative effectiveness information from randomised controlled trials (RCTs) of ADM versus psychotherapy for MDD at the symptom level and develops and tests the Symptom-Oriented Therapy (SOrT) metric for precision treatment allocation.

Background: The gut microbiota (GM) plays a critical role in systemic health, influencing immune, metabolic, and neurological functions. Emerging evidence suggests that moxibustion, a traditional thermal therapy, may modulate GM to restore microbial homeostasis, yet its exclusive effects remain undifferentiated from combined therapies like acupuncture. Prior meta-analyses lack mechanistic specificity, necessitating a focused evaluation of moxibustion’s impact on microbial ecology. Objective: This systematic review and meta-analysis protocol aims to quantify moxibustion-induced changes in GM diversity, taxonomic composition, and functional metabolites (e.g., short-chain fatty acids [SCFAs]). Methods: We will systematically search PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP databases from inception through December 31, 2024, using keywords such as “moxibustion,” “gut microbiota,” and “intestinal flora.” Eligible preclinical (animal) and clinical (human) studies evaluating standalone moxibustion interventions on gut microbiota will be included. Primary outcomes include microbial α-diversity indices (Shannon, Simpson) and relative abundance of key taxa (e.g., Firmicutes, Bacteroidetes). Risk of bias will be assessed using SYRCLE for animal studies and modified CAMARADES criteria for human trials. Pooled effect estimates for continuous outcomes (e.g., diversity indices, taxa ratios) will be calculated using the ratio of means (ROM) with 95% confidence intervals. Statistical analyses will be conducted in RevMan 5.4 and R (metafor package), with data archived on Figshare for reproducibility. Results: As of March 2025, the literature search and screening have been completed, and 31 studies meeting the inclusion criteria have been identified. The comprehensive analysis is scheduled to be completed by October 2025, with results anticipated to be published in late 2025. The anticipated findings suggest that moxibustion may reduce pathogenic genera such as Ruminococcus while enhancing beneficial genera, effects that are expected to be associated with improved intestinal barrier integrity and anti-inflammatory responses. Conclusions: This protocol provides a rigorous framework to evaluate moxibustion’s unique role in GM modulation, bridging traditional medicine with microbiome science. Results will inform optimized, non-pharmacological strategies for managing microbiome-associated chronic diseases and guide future research priorities. Clinical Trial: Prospero CRD42025639714.

Background: Spinal cord injury (SCI) affects millions of people worldwide and often results in impaired lower limb function and reduced mobility. Transcutaneous spinal cord stimulation (tSCS) has emerged as a promising neuromodulation technique that shows potential for enhancing motor recovery and walking ability in individuals with SCI. However, the effectiveness of tSCS for lower limb rehabilitation in this population remains unclear due to limited evidence from small sample sizes, heterogeneous protocols, and lack of long-term follow-up data. Objective: The primary objective of this systematic review and meta-analysis is to determine the effectiveness of tSCS, compared to sham stimulation, no intervention, or other active interventions, for improving lower limb motor function in individuals with SCI. Secondary objectives are to evaluate the effects of tSCS on walking ability (including speed, distance, and independence), spasticity, quality of life, and safety outcomes. Methods: This systematic review will be conducted according to the Cochrane Handbook for Systematic Reviews of Interventions and reported following the PRISMA 2020 statement. We will search electronic databases (PubMed, Web of Science, Embase, CINAHL, MEDLINE, Cochrane Library, PEDro, and Scopus) from inception to August 2025, along with grey literature, trial registries, and hand-searching of key journals. We will include randomized controlled trials, quasi-RCTs, and non-randomized studies (case series with ≥5 participants) that evaluate the effects of tSCS applied over the spinal region on lower limb rehabilitation outcomes in adults with traumatic or non-traumatic SCI. The primary outcome will be lower limb motor function assessed by validated measures such as the Lower Extremity Motor Score (LEMS). Secondary outcomes will include walking ability, balance, functional independence, spasticity, quality of life, and adverse events. Two reviewers will independently screen studies, extract data, and assess risk of bias using the RoB 2 and ROBINS-I tools. Data will be synthesized using random-effects meta-analysis if appropriate, with planned subgroup analyses examining injury level (cervical vs. thoracic vs. lumbosacral), injury completeness (AIS A vs. B-D), stimulation site (cervical vs. thoracic vs. lumbosacral), and co-intervention effects (tSCS alone vs. tSCS plus training), along with sensitivity analyses to explore heterogeneity. The certainty of evidence will be evaluated using the GRADE approach (Grading of Recommendations Assessment, Development and Evaluation). Results: This is a protocol paper describing the planned methodology for the systematic review. The search strategy has been developed and the protocol has been registered with PROSPERO (CRD420250652270), with results expected by October 2025. Conclusions: This comprehensive systematic review and meta-analysis will address an important gap in the current literature by providing the first focused evaluation of tSCS effectiveness for lower limb rehabilitation in individuals with SCI. The results will inform clinical practice guidelines and guide future research directions in tSCS for SCI rehabilitation. Clinical Trial: Prospero CRD420250652270

Background: Choline is an essential micronutrient crucial for fetal neurodevelopment. Numerous rodent studies reveal that compared to maternal consumption of standard chow, maternal prenatal choline deficiency produces lifelong offspring cognitive deficits, and maternal choline supplementation produces lifelong improvements in offspring cognition. Few studies have evaluated this question in humans, with mixed results. Nonetheless, the available data raise concerns about the low choline intakes of pregnant women and highlight the need for knowledge of the functional consequences of various choline intakes during pregnancy. Objective: This study will evaluate the cognitive and affective functioning of adolescents born to women who participated in a randomized controlled trial (RCT) of 2 levels of choline intake during pregnancy, with the primary aim of assessing offspring attention and spatial memory. Methods: In a double-blind, randomized controlled choline feeding trial 26 women beginning their third trimester of pregnancy were randomly assigned to 2 groups: daily choline consumption at 480 or 930 mg/day. In this 14-year follow-up, the offspring (n=21) of these women will complete cognitive tests proctored over videoconferencing software. Cognitive function domains will be assessed using web-based software from the Cambridge Neuropsychological Test Automated Battery (CANTAB Connect). We will also assess facets of mental health using the Achenbach System of Empirically Based Assessment (ASEBA). These assessments will test the hypothesis that third-trimester maternal choline intake exerts lasting effects on offspring attention, memory, executive function, and mental health. Results: Between January 2009 and October 2010, 26 women beginning their third trimester of pregnancy from the Ithaca area were enrolled in the original controlled feeding study. We successfully re-recruited 21 (80%) of the original 26 offspring to this 14-year remote follow-up study. Recruitment started in August 2023 and was concluded in October 2023. Analysis is ongoing, and the first results are expected to be submitted for publication in the fall of 2025. We hypothesize that adolescent offspring born to women in the 930 mg/day group will perform better in domains of attention, memory, executive function, and mental health than offspring of women in the 480 mg/day group. This study is unique because the total maternal choline intake is precisely known, and the offspring are followed into adolescence, a time when group differences are indicative of lifelong effects of prenatal intervention. Conclusions: The findings will provide important new information concerning the lasting functional consequences of maternal choline intake during pregnancy for offspring neurobehavioral health, thereby informing dietary recommendations and supplementation policies for pregnant women. Clinical Trial: ClinicalTrials.gov: NCT05859126; https://clinicaltrials.gov/study/NCT05859126

, There is still no clear understanding of the relationship between sibship size and child outcomes. Research from across disciplines, and across settings, reports conflicting results suggesting that the relationship is complex and ecologically dependent. Evolutionary models predict that parents will make reproductive decisions based on their ability to invest in each child, but that this is not necessarily equal across children. Here we use data from the Next Steps study linked to National Pupil Database to examine the relationship between sibship size and Key Stage 4 (GCSE) maths and English grades in England for children born in 1989/1990. We were interested to further examine if and how associations might differ at the ends of the socioeconomic spectrum and we also tested if direct measures of parental investment could mitigate any negative impact of larger families. Multilevel ordinary least squares regression models with a random effect for school show that sibship sizes are associated with school grades, as is socioeconomic status. Moreover, the association between sibship size and grades holds true across the socioeconomic spectrum. Birth order was only weakly associated with school results, and only significant in some models. Parental investment is important, however, and might offset the some of the negative impact of larger families, for both maths and English attainment.

Living animals reach their end-of-life through a stereotypic set of fascinating but poorly understood processes. The discovery, first in flies and later in nematodes and zebrafish, of the “Smurf phenotype” has provided a valuable tool to investigate ageing and its associated physiological changes. Using the Smurfs, we have shown an evolutionarily conserved end-of-life transition across Drosophilids, nematodes, and zebrafish. This tool has been key to identify the discontinuous nature of ageing and predict impending death from natural causes as well as from environmental stresses. This phenotype led us to propose a two-phase perspective of ageing: a first phase where individuals are apparently healthy and have low risk of mortality, but show an age-dependent and increasing risk of entering a second phase, marked by more pronounced hallmarks of ageing and a markedly increased risk of death. Here, we test whether these two consecutive phases of ageing separated by the Smurf transition are a conserved feature of ageing in the mammals using Mus musculus as a model. We performed a longitudinal longevity study using both males and females from two different mouse genetic backgrounds and by integrating physiological, metabolic, and molecular measurements with the life history of approximately 150 mice. We show the existence of a phenotypic signature typical of the last phase of life, observable at any chronological age. Validating the two-phase ageing model in a mammalian organism allows better characterization of the high risk of imminent death and would extend its implications to a broader range of species for ageing research. The Stage 1 version of this Registered Report was submitted on 19th January 2022.

The effects of gender stereotype threat on mathematical test performance in the classroom have been extensively studied in several cultural contexts. Theory predicts that stereotype threat lowers girls’ performance on mathematics tests, while leaving boys’ math performance unaffected. We conducted a large-scale stereotype threat experiment in Dutch high schools (N = 2064) to study the generalizability of the effect. In this registered report, we set out to replicate the overall effect among female high school students and to study four core theoretical moderators, namely domain identification, gender identification, math anxiety, and test difficulty. Among the girls, we found neither an overall effect of stereotype threat on math performance, nor any moderated stereotype threat effects. Most variance in math performance was explained by gender, domain identification, and math identification. We discuss several theoretical and statistical explanations for these findings. Our results are limited to the studied population (i.e. Dutch high school students, age 13–14) and the studied domain (mathematics).

We investigated how psychological distance influences goal contagion (the extent to which people automatically adopt another person’s goals). On the basis of construal-level theory, we predicted people would be more prone to goal contagion when primed with psychological distance (vs. closeness) because they would construe the other person’s behavior in terms of its underlying goal. Alternatively, we predicted people primed with psychological closeness (vs. distance) would be more prone to goal contagion because closeness may increase the personal relevance of another’s goals – a process not mediated by construal level. In two preregistered studies, participants read about a student whose behavior implied either an academic or a social goal. We manipulated (a) participants’ level of mental construal with a mind-set task (Study 1) and (b) their social distance from another person who showed academic or social behaviors (Study 2). We measured performance on an anagram task as an indicator of academic goal contagion. For Study 1, we predicted that participants reading about academic (vs. social) behaviors would show a better anagram performance, especially when primed with an abstract mind-set. For Study 2, we predicted that construal level and relevance effects might cancel each other out, because distance triggers both high-level construal and less relevance. In contrast to the construal-level hypothesis, the mind-set manipulation did not affect goal contagion in Study 1. In accordance with the relevance hypothesis, psychological proximity increased goal contagion in Study 2. We discuss how the findings relate to previous findings on goal contagion and imitation.

While nudges have been shown to be effective and are already being implemented, there is still a debate on the ethics of nudging. This debate specifically refers to the potential of nudges negatively affecting autonomy. It has been suggested that making a nudge transparent may resolve this issue. Whereas previous research has already demonstrated that transparency does not violate nudge effectiveness, it is unknown how transparency affects autonomy and related decision satisfaction and experienced pressure. In an online study with 905 participants, we investigated whether two variations of transparency influence the decision maker’s experience of autonomy, as well as their choice satisfaction and the experienced pressure to choose the nudged option. The results show that autonomy and satisfaction were high – and pressure low – across all conditions, and were therefore not influenced by transparency. Suggesting that nudges do not negatively affect autonomy and that transparency does also not increase it.

Previous research investigated the effects of power poses at the behavioral, subjective, and neuroendocrine level. However, it is not clear whether the same effects would be obtained also by just imagining, rather than adopting, a power pose. We planned to investigate this question by asking 200 participants to either perform or imagine a constrictive or an expansive body posture during 2 min and then measure the effect on a gambling decision task and on felt power. We followed a sequential analysis procedure by running the first 100 participants in the performed posture condition in order to check the presence of the power posing effect. Because no effect of power poses on gambling decision or on felt power was found, we ran the remaining 100 participants also in the performed instead of the imagined condition. The results after running 200 participants confirmed that power poses did not affect gambling decision. However, participants felt more powerful after adopting an expansive pose compared to a constrictive pose. Exploratory analyses found that this effect was mainly driven by male participants. In addition, participants rated themselves as being more able to adopt the expansive body posture and they reported to put more effort in adopting the restrictive body posture. Overall, our results indicate that the effect of power poses on behavior might not be as widespread as previously thought of and suggest that moderators should be investigated carefully in future research.

The purpose of the current research is to explore how mode of identification (glorification versus attachment) results in either schadenfreude “with a bad conscience” (S-BC) about disadvantaged peo...

The current study attempted to replicate results by Cuddy, Wilmuth, Yap, and Carney (2015) who showed that adopting high-power poses prior to a demanding job interview improved dominant behavior an...

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and imposes a significant public health burden. In 2019, HPV was responsible for approximately 620,000 cancer cases in women, 70,000 in men, and more than 300,000 deaths globally. Despite the proven efficacy of the vaccine, vaccination rates remain alarmingly low in certain regions of France. In Réunion Island, only 16% of girls and 9% of boys under 16 years old were fully vaccinated in 2024. This underscores the need for increased awareness, education, and outreach programs. Peer learning is well-established in health education, whereas serious game–style card games are newer and require further research. Both methods have been shown to improve knowledge on specific topics. Objective: The main objective of this study is to assess the impact of 2 awareness-raising strategies on increasing HPV vaccination rates among middle school students by actively involving them in the process. Methods: This protocol describes the design of a randomized, open-label, controlled trial aimed at evaluating the effectiveness of 2 awareness-raising interventions—peer learning and a card-based serious game—in improving HPV vaccination rates among middle school students in Réunion Island. The study will span an entire school year, beginning in August. Approximately 3600 students from 24 middle schools in Réunion Island will be included, with schools randomized into 3 groups of 8 each: (1) a control group receiving the existing national vaccination campaign initiated by the French public health institute; (2) ambassador classes, whose students will receive education about the HPV vaccine and later educate other students in the same school; and (3) serious game card group, where students can play and learn about HPV during a science class. The primary outcome will be the proportion of teenagers who initiate the vaccination process, compared across the 3 groups using appropriate statistical methods. Anonymized data will be collected at the end of the school year using social security records. Teenagers’ knowledge of HPV will be assessed both before and 3 months after each intervention, and satisfaction will also be evaluated after the intervention in each group. Results: As of May 2025, a preliminary result enrolling 124 students showed an increase in vaccination coverage after students played a serious game. We expect higher vaccination rates in the intervention groups compared with the control group, although it is difficult to predict which strategy will be more effective. The estimated target vaccination coverage for groups b and c is 45%. Conclusions: This study aims to improve HPV vaccination rates among teenagers in Réunion Island by evaluating the impact of 2 awareness-raising strategies using innovative and engaging tools. If successful, this approach could be adapted and implemented in other regions of France or internationally.

What are the social signals of emotional tears? This question has fascinated scholars ever since Darwin. Studies have suggested several interpersonal effects of emotional tears. A recent article presented evidence in three studies that tearful individuals are not only perceived as warmer but also less competent than their non-tearful counterparts. However, the competence effect was relatively small, and a recent replication failed to find such an effect in two different populations while the warmth effect was replicated. This questions the generalizability of the effect of tears on perceived competence. To test whether individuals expressing emotional tears are really perceived as less competent and what boundary conditions such an effect might have, we specified a decision tree of three different studies in which we test differences between the original reference study and the replication. We replicated previous findings of the perceived (in)competence in Study 1 (n = 531) but observed a considerably smaller nonsignificant effect when proceeding to Study 2 (n = 471), which increased the number of stimuli. The earlier and now repeated replication failure can therefore likely be attributed to an increased variation in stimulus material. We conclude that there is not enough evidence to argue that one social outcome of tears signals a relative lack of competence as the effect seems to depend on the specific stimuli used.

Earlier work found that – compared to participants who adopted constrictive body postures – participants who adopted expansive body postures reported feeling more powerful, showed an increase in testosterone and a decrease in cortisol, and displayed an increased tolerance for risk. However, these power pose effects have recently come under considerable scrutiny. Here, we present a Bayesian meta-analysis of six preregistered studies from this special issue, focusing on the effect of power posing on felt power. Our analysis improves on standard classical meta-analyses in several ways. First and foremost, we considered only preregistered studies, eliminating concerns about publication bias. Second, the Bayesian approach enables us to quantify evidence for both the alternative and the null hypothesis. Third, we use Bayesian model-averaging to account for the uncertainty with respect to the choice for a fixed-effect model or a random-effect model. Fourth, based on a literature review, we obtained an empirically informed prior distribution for the between-study heterogeneity of effect sizes. This empirically informed prior can serve as a default choice not only for the investigation of the power pose effect but for effects in the field of psychology more generally. For effect size, we considered a default and an informed prior. Our meta-analysis yields very strong evidence for an effect of power posing on felt power. However, when the analysis is restricted to participants unfamiliar with the effect, the meta-analysis yields evidence that is only moderate.

How do people assess the likelihood of personal risk in online activity? In three pilot experiments and one preregistered experiment, we tested the motivational and cognitive mechanisms that shape self and social judgments of cyber security. In Pilot Studies 1–3, we probed for evidence of differential use of base rate information in forecasting the likelihood oneself or another person would engage in a risky behavior. In the preregistered experiment, we gathered direct evidence of differential use of base rate information through covert eye-tracking. Data suggest people self-enhance when assessing risk, believing they are less likely than others to engage in actions that pose a threat to their cyber security, particularly because they rely less on base rate information when predicting their own behavior compared to others’ behavior. Self and social judgments were not different when scenarios posed no risk. We discuss implications for self-insight and interventions to curb risky behavior in online activity.

Background: The family plays a critical role in shaping children’s health behaviors during early childhood. Family-based interventions are a cornerstone of childhood obesity prevention but often yield modest effects and have several limitations, including a focus on a single caregiver and insufficient attention to coparenting dynamics. Mobile health (mHealth) interventions that include multiple caregivers and target coparenting practices are rare, but have the potential to amplify parenting intervention effects, leading to stronger child health outcomes. Objective: This protocol aims to describe a randomized controlled trial designed to evaluate the efficacy of the Good Start Matters mHealth Parenting Program in improving parenting and coparenting practices (primary outcomes) and child health behaviors (secondary outcomes) among 2.5- to 6-year-olds. Methods: This randomized controlled trial will recruit 118 two-parent families (ie, families with 2 caregivers participating in the trial) from childcare centers across British Columbia, Canada. To promote inclusivity, one-parent families (ie, only one parent participating) will also be eligible but will not count toward the target sample size for recruitment purposes. Eligibility criteria include at least one parent having primary custody of a child aged 2.5-6 years, both parents being fluent in English, and each caregiver owning a smartphone device. In addition, children must not have severe limitations that prevent adherence to general nutritional and 24-hour Movement Guidelines, nor can they be undergoing weight management treatment. After baseline data collection, families will be randomized into either the intervention group, which will receive immediate access to the app, or a waitlist control group, which will gain access to the app after the follow-up assessment, approximately 2 months later. Baseline and follow-up assessments will collect data on food, physical activity, and media parenting practices, coparenting agreement, and child eating, active play, and screen time behaviors. To analyze the data while accounting for its nested structure, multilevel mixed-effects models, integrating intention-to-treat principles and imputation techniques when deemed necessary, will be used. Sensitivity dose-response analyses will assess the extent to which differential adherence/exposure to the intervention influences the study’s outcomes. Results: The trial was registered in March 2023. Recruitment took place from November 2023 to January 2025, with 121 two-parent families and 62 one-parent families recruited. Data collection took place between November 2023 and April 2025. Data cleaning and analyses started in May 2025. Results are expected to be published in 2026. Conclusions: This study will provide critical insights into the efficacy of mHealth interventions to improve parenting and coparenting practices while promoting healthier child behaviors during early childhood. The Good Start Matters mHealth Parenting Program has the potential to strengthen the foundation of family-centered interventions and set a new standard for systemic approaches to early childhood obesity prevention. Trial Registration: ClinicalTrials.gov NCT05802160; https://clinicaltrials.gov/study/NCT05802160

Ostracism is a common social occurrence with severe psychological and behavioral consequences. Whereas many studies have focused on the perspective of ostracized individuals, our research explores observers’ perceptions of another’s ostracism, when the reason for ostracism is unclear. We investigated whether group membership affects observers’ causal attributions and evaluations of observed ostracism. Based on previous research and theory (Black Sheep Effect Ultimate Attribution Error), we hypothesized that when ostracism is observed in an out-group, the sources (i.e. the ostracizing group members) will be evaluated more negatively than the target (i.e. the ostracized individual), as the exclusion will be perceived as a violation of social norms. However, when ostracism is observed in the in-group, we hypothesized that observers would evaluate targets more negatively than the sources of ostracism. We further assumed that an intergroup bias in evaluation would be mediated by in-group-serving causal attributions. Results of an online experiment (N = 398) revealed that group membership influenced neither the attribution of responsibility nor the general evaluation of the ostracism sources and targets. Regardless of group membership, participants attributed responsibility for ostracism more to the sources than to the targets and rated targets as more likable. Though questions regarding the influence of group membership on observed ostracism remain open, the current study provided further insight into the impact of attributions on evaluation of ostracism sources and targets.

In the current study, we sought to replicate the finding that adopting an open/expansive body posture increases subjective feelings of power, while also investigating how these body postures influe...

Background: The recent increase in the incidence of type 1 diabetes (T1D) over the past few decades has been too rapid to be explained solely by genetic factors. It is likely influenced by environmental factors as well. Understanding these environmental factors, the exposome, is essential for identifying new disease prevention and management strategies. Objective: This paper aims to present a protocol for a scoping review to gather current knowledge on the various dimensions of the exposome relevant to the development and outcomes of T1D, highlight existing knowledge gaps, and provide a foundation for future research. Methods: We will follow principles from the Joanna Briggs Institute (JBI) methodology for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. We will search for relevant publications in 5 databases: PubMed, Embase (Elsevier), CINAHL (EBSCO), Web of Science (Clarivate), and Google Scholar. All studies on the impact of environmental exposures on T1D development or acute (hypoglycemia or hyperglycemia) and chronic (cardiovascular disease, retinopathy, neuropathy, and others) T1D complications will be collected. Two independent reviewers will then use the CADIMA (Client-Server Application for Documentation and Integrated Management of All Steps of a Systematic Review) web tool to screen records for titles, abstracts, and full texts. Data will be extracted from eligible studies by 2 independent reviewers by using a data extraction sheet, including relevant information from the eligible studies helping to answer the research question. The data extraction sheet will be completed together with a quality assessment by using JBI and other relevant tools before the synthesis of all the relevant results. Numerical and visual results will be presented using descriptive summaries to organize, describe, and interpret the findings. We will also provide a narrative synthesis of the main results focused on our objectives. This scoping review is registered with the Open Science Framework. Results: The scoping review started in November 2024. The analysis is expected to be completed and the results submitted for publication in November 2025. The final review will report on all the studies identified and synthesized in accordance with the predefined protocol. Concerning all types of exposure, we expect to find more aspects of the specific external exposome (eg, pollutants, diet, infectious agents), particularly in young populations (children, adolescents) and possibly in utero exposition, linked to the trigger of the disease rather than in developing diabetes complications. Conclusions: By covering the different aspects and stages of the disease, this literature review aims to provide a comprehensive overview of the different effects of the components from the exposome in relation to T1D. This scoping review will help the scientific community understand the various aspects of the exposome in the development of T1D and its consequences. The results will be released as a peer-reviewed open-access publication and during congresses and conferences to reach the scientific community and the general public. Clinical Trial: OSF Registries 10.17605/OSF.IO/UJ5KM; https://osf.io/uj5km

Objectives: This systematic review aims to evaluate the effectiveness of automated methods using artificial intelligence (AI) in conducting systematic reviews, with a focus on both performance and resource utilization compared to human reviewers. Study Design and Setting: This systematic review and meta-analysis protocol follows the Cochrane Methodology protocol and review guidance. We searched five bibliographic databases to identify potential studies published in English from 2005. Two independent reviewers will screen the titles and abstracts, followed by a full-text review of the included articles. Any discrepancies will be resolved through discussion and, if necessary, referral to a third reviewer. The risk of bias (RoB) in included studies will be assessed at the outcome level using the revised Cochrane risk-of-bias tool for randomized trials and the RoB In Non-randomized Studies - of Interventions for nonrandomized studies. Where appropriate, we plan to conduct meta-analysis using random-effects models to obtain pooled estimates. We will explore the sources of heterogeneity and conduct sensitivity analyses based on prespecified characteristics. Where meta-analysis is not feasible, a narrative synthesis will be performed. Results: We will present the results of this review, focusing on performance and resource utilization metrics. Conclusion: This systematic review will evaluate the effectiveness of automated methods, especially AI tools in systematic reviews, aiming to synthesize current evidence on their performance, resource utilization, and impact on review quality. The findings will inform evidence-based recommendations for systematic review authors and developers on implementing automation tools to optimize review efficiency while maintaining methodological rigor. In addition, we will identify key research gaps to guide future development of AI-assisted systematic review methods. Ó 2025 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Defaults (i.e. preselected options that become effective without active choice) are becoming increasingly popular as the idea of nudging enters the political arena. Their interplay with individual ...

This pre-registered report tries to investigate whether and how cybersecurity legislation affects corporate AI adoption. Drawing on textual analysis to construct firm-level AI adoption measures, we are going to use the implementation of the Cybersecurity Law as a quasi-natural experiment and conduct a difference-in-differences (DID) analysis. We further explore potential mechanisms, including cost driven channel, risk mitigation channel, and managerial adaptation channel. We also assess heterogeneity across firm characteristics and regional law enforcement. This study contributes to the emerging literature on the institutional determinants of AI adoption and offers new insights into how data governance frameworks shape firm-level technology decisions in emerging economies.

Background: Living guidelines are an emerging approach to ensuring guideline recommendations remain relevant to the needs of stakeholders and frontline clinical care. However, development and maintenance remain manual. Single-database workflows involving an overarching search and triage of articles by a single-guideline development team have emerged in this context to improve the efficiency of evidence synthesis. However, there has been limited investigation in how technological enablers such as machine learning (ML)-prioritized screening may be integrated to further compound work savings. This stage I registered report details the protocol for a retrospective simulation study aiming to simulate and evaluate 90 ML-prioritized screening system configurations to streamline the title and abstract screening phase of living guideline development. Methods: A total of five feature extraction techniques (Term frequency inverse document frequency, Word2Vec, SentenceBERT, Specter2, and BioLinkBERT), two classification algorithms (logistic regression, support vector machines), three training strategies (no retraining, adaptive retraining, and incremental retraining) and three stopping rules (data driven, time-driven, and statistical base criteria) will be simulated and evaluated. Each combination will be evaluated based on capacity to save work over sampling, at a target recall of 95%. Computation bottlenecks within the system that may adversely affect user experience and limit adoption by guideline development teams will also be investigated. Lastly, risk-calibrated threshold values targeting recall of 95% for various stopping rules will be investigated. The study will be conducted on a dataset generated from the International 2023 Polycystic Ovary Syndrome (PCOS) guidelines, and the simulation will be conducted on consumer level hardware to better simulate real world scenarios. Conclusion: This study will inform ongoing work transitioning the International 2023 PCOS guidelines into a living format. The results will also provide guideline development teams at large with empirically derived guidance for adopting pragmatic, single database MLprioritized screening into their own guideline maintenance or development workflows. It will also provide a realistic estimate for potential work savings. With these insights, the study will advance both the theoretical understanding and practical implementation of ML-assisted evidence synthesis, informing how living guidelines can remain sustainable into the future. � 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

This study investigates how the development of digital finance influences the geographical distribution of corporate supply chains using data from Chinese A-share listed companies from 2010 to 2023. We examine whether digital finance enables firms to overcome traditional geographical constraints and adopt different supply chain distribution strategies. The analysis identifies two primary mechanisms through which digital finance influences supply chain geography: governance effects, which operate through enhanced risk management and information transparency, and financing effects, which function through alleviated capital constraints and trade credit provision. We further explore heterogeneous impacts across four dimensions: regional economic development, regional digital infrastructure, industry market competition, and enterprise lifecycle stages. By examining the geographical distribution of supply chains as an outcome of digital finance development, this study provides novel evidence on the micro-governance implications of digital finance. Our findings contribute to understanding how digital finance fundamentally changes the geographical constraints that have historically shaped supplier selection decisions and enables firms to develop more flexible supply chain configurations.

Background: Many mental health professionals face work-related stress due to high job demands, limited control, and inadequate institutional support. Connected mental health (CMH) technologies such as mobile apps and teletherapy platforms are increasingly being proposed as tools to alleviate these job demands. However, their actual influence on clinicians’ work environments—here understood as the organizational, social, and psychological conditions that shape their workload, job demands, autonomy, and overall well-being—remains underexplored. Existing reviews have primarily focused on traditional organizational interventions, leaving a critical gap in understanding how CMH technologies specifically influence the work environment of mental health clinicians. Objective: This systematic literature review aims to identify and summarize knowledge about the impact of CMH on the work environment of mental health clinicians. Methods: A systematic literature review will be performed. The review follows PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and has been registered in PROSPERO on April 23, 2025. A comprehensive search strategy was developed using the population, intervention, comparison, and outcome (PICO) framework in collaboration with an academic librarian. Studies will be sourced from the PubMed, Scopus, IEEE Xplore, and ACM Digital Library databases. Inclusion criteria are limited to empirical studies involving mental health clinicians using CMH tools, where outcomes explicitly relate to the work environment (eg, job demands, workload, autonomy, stress, or well-being). Eligible studies must be published in English. Data extraction will include publication trends, study methods, and types of CMH technologies. Additionally, the extraction will capture the study results, including qualitative and quantitative findings, along with the measurement instruments used. Two reviewers will independently select articles for review and extract data. Conflicts will be discussed, and a third reviewer will be consulted if a consensus cannot be reached. Descriptive statistics and thematic analysis (via NVivo) will be used to synthesize the findings. Results: This systematic literature review seeks to explore and synthesize existing research on how CMH technologies affect clinicians’ work environments and is expected to be completed by December 2025. Conclusions: This review will offer a comprehensive overview of how CMH technologies affect the professional work environment of clinicians. Trial Registration: PROSPERO CRD420251018685; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251018685 International Registered Report Identifier (IRRID): PRR1-10.2196/76668

Researchers have argued that power poses are an effective way for individuals to empower themselves to achieve personal goals. However, in laboratory studies, individuals are often unaware of the f...

Background: Individuals with poststroke hemiplegia often develop spasticity, which increases disability. Antispastic treatments such as baclofen and botulinum toxin are commonly prescribed in poststroke recovery. However, their impact on motor recovery, especially when administered within the first 2 months after stroke, remains unclear. Objective: This study aims to compare the motor recovery effects of botulinum toxin versus oral baclofen. The hypothesis is that botulinum toxin is more supportive of motor recovery than baclofen and enhances functional recovery. Methods: The study is a multicenter, controlled phase IV, comparative, prospective, randomized, double-blind, double-dummy, superiority trial to compare the toxin and baclofen, and a noninferiority trial to compare the toxin and the placebo. It focuses on the time course of the Fugl-Meyer Motor Assessment (FMA) as the primary outcome. The main inclusion criterion is patients with a single stroke in the past 2 months. Treatment comprises 1 intramuscular injection at treatment initiation and oral tablets for 4 months. Randomized patients are allocated to 3 arms: botulinum toxin with placebo baclofen, baclofen with placebo botulinum toxin, and placebo baclofen with placebo botulinum toxin. FMA scores are assessed at pretreatment, 1 month, and 3 months later. Spasticity, functional abilities, activities of daily living, pain, and quality of life are also evaluated. Adverse effects are monitored. A positive difference of 13 points in the FMA time course between the botulinum toxin and baclofen groups is considered a relevant effect. The data analysis plan involves linear regression models to compare primary and secondary outcomes, with adjustments for covariates such as age, center, and associated treatments. Subgroup analyses will examine proportional recovery profiles, and missing data in Fugl-Meyer scores will be addressed using imputation methods. Results: A total of 179 participants were randomized across 18 centers, with inclusions delayed due to the COVID-19 pandemic. As of December 2024, the data manager currently has all the data, and a review of data quality is in progress. No statistical analysis has been conducted so far, and the blind will be lifted after the analysis. Conclusions: This study identifies the most suitable spasticity treatment, considering the specificities of the stroke and constraints during the recovery phase. It will provide recommendations for the primary treatment of early spasticity post stroke. Trial Registration: ClinicalTrials.gov NCT02462317; https://clinicaltrials.gov/study/NCT02462317; European clinical trials (EudraCT) 2010-022881-28; https://www.clinicaltrialsregister.eu/ctr-search/trial/2010-022881-28/FR

Health misinformation is a significant area of concern in the context of public health. With the rapidly increasing production, propagation, and dissemination of incomplete, incorrect, or unsubstantiated information about health through the internet, the ‘Infodemic’ threatens individual and population health attitudes and behaviours. Pragmatic educational, interventions that can be implemented are imperative to address this, designed with fundamental support based on frameworks that target the characteristics of misinformation and human factors that increase susceptibility. Present literature details and recommends development of such interventions; however, there is a lack of clarity about implementation strategies and frameworks that contribute to their development. The objective of this scoping review is to identify online interventions that have been implemented to address health misinformation. We will examine 1) the target populations, 2) the methods and/or frameworks used to guide development of interventions, 3) what characteristics of misinformation are being addressed, 4) the type of intervention (i.e., online courses, videos, infographics, counter-speech, social media posts, etc.).

Vaccination is a cost-effective strategy for reducing morbidity and mortality among children under 5 years old. To be fully protected from diseases such as tuberculosis, diphtheria, pertussis, and polio, children must receive all recommended vaccinations in a timely manner. In many countries, including Tanzania, high overall vaccination rates mask substantial regional variation in vaccination coverage and low rates of vaccination timeliness. This study evaluates the efficacy of mobile phone-based (mHealth) reminders and incentives for improving vaccination timeliness in the first year of life.

Background The challenges of living with and managing type 1 diabetes during youth and emerging adulthood are well documented. The management burden may be alleviated in part using diabetes technologies including continuous glucose monitoring and hybrid closed-loop insulin pumps. However, young people's experiences of diabetes technology during this life stage are not well understood. This study aims to address that gap. Methods This study will recruit 30–40 young people living with T1D, aged 16–21 years, from paediatric, transition and adult T1D clinics. Semi-structured qualitative interviews will be conducted. The data will be analysed using framework analysis. Results TBC (registered report format).

Extensive research has demonstrated that people can intentionally forget by inhibiting the retrieval of unwanted memories, a phenomenon known as suppression-induced forgetting (SIF). Although neuroimaging studies have linked retrieval suppression to the right lateral prefrontal cortex (LPFC), direct evidence for the causal role of this region plays in supporting SIF is still lacking. In this registered report, our aim is putting to a strong empirical test such an idea by using cathodal transcranial direct current stimulation in a standard think/no-think procedure. Across two experiments, we will compare the SIF achieved by participants receiving cathodal transcranial direct current stimulation over the right LPFC—which has been shown to disrupt prefrontally mediated inhibitory control—with those receiving sham stimulation or cathodal stimulation over a control site. In addition, we will examine the lateralization of this effect by comparing stimulation of the right and left LPFC. Our results will provide novel and critical insights into the brain mechanisms of inhibitory control.