Digital Commons Network^™

Llm-As-A-Judge For Infection Prevention And Control And Antimicrobial Resistance Impact: Comparing Three Main Llms Vs. Human Experts' Assessment, Marcello Di Pumpo, Leonardo Villani, Maria Rosaria Gualano, Danilo Buonsenso, Francesca Raffaelli, Daniele Donà, Patrizia Laurenti, Vittorio Maio, Stefania Boccia, Walter Ricciardi

College of Population Health Faculty Papers

BACKGROUND: Large language models (LLMs) are increasingly used to generate health information, yet their reliability as evaluators remains unclear. This study investigated the feasibility of an LLM-as-a-judge methodology in the context of infection prevention and antimicrobial resistance (AMR), comparing automated ratings with human expert benchmarks.

METHODS: We performed a secondary analysis of an expert-annotated dataset of health messages. Three leading LLMs (ChatGPT, Claude, Gemini) independently evaluated the same messages using an adapted DISCERN tool across five domains: information reliability, quality, AMR impact, persuasiveness, and overall score. We utilized descriptive statistics, intra-rater reliability tests, and mixed-effects ordinal regression to analyze divergence …

Comments Re: Regulation For Federal Financial Assistance, Fred D. Ledley, Edward Zhou, Brian C. Fox

CISI Publication

This comment focuses on the proposed modifications to §200.205 “Federal Agency Merit Review of Proposals” and §200.340 “Termination and suspension” of Title 2 of the Code of Federal Regulations. We argue that the pre-issuance review, discretionary termination provisions, and other constraints of federal research support that would be established under this proposal create impediments to the scientifically-driven process of discovery and innovation that has long provided the foundation for advances in American prosperity, influence, health, and wellbeing. Our comments focus specifically on federal support for biomedical research by the National Institutes of Health (NIH) for the purpose of advancing healthcare …

Subjective Sleep Disruption, Coping, And Anxiety And Related Symptoms In The Perinatal Period: Findings From A Longitudinal Study, Rebecca C Cox, Caroline P Hoyniak, Jack Samuels, Jonathan S Abramowitz, Gerald Nestadt, Eric A Storch, Rashelle Musci, Paul Nestadt, Lauren M Osborne, Mary Kimmel

Faculty, Staff and Students Publications

Study objectives: Anxiety is common during the perinatal period and is associated with adverse maternal and infant outcomes, highlighting a need to identify predictors of perinatal anxiety. Accumulating research implicates sleep disruption in perinatal anxiety and related symptoms, including obsessive-compulsive symptoms. We examined the associations among insomnia symptoms and sleep duration with perinatal anxiety, obsessive beliefs, and obsessive-compulsive symptoms and the moderating role of coping from pregnancy through postpartum.

Methods: A sample of 231 women (agemean = 32.97 ± 4.36 years; 74% white) completed interview and self-report measures of sleep, coping, perinatal anxiety, obsessive beliefs, and obsessive-compulsive symptoms in early …

Impact Of Social Media-Driven Feeding Practices On The Gut Microbiome Of Captive Asian Elephants (Elephas Maximus) In Surin, Thailand, Pongpreecha Malaluang, Nuttapon Bangkaew, Jaruwan Chaiyakhot, Patinya Patikae, Nattaya Watwiengkam, Phimphanit Choklikitumnuey, Thanaphat Phupanna, Sudachanok Phowiset, Prim Chuesaard, Tarid Purisotayo

The Thai Journal of Veterinary Medicine

This study investigated the effects of social media-driven live-streaming dietary supplementation on the gastrointestinal microbial community of captive Asian elephants (Elephas maximus) at the Elephant Kingdom, Surin Province, Thailand. A hierarchical two-tier observational design was used: Tier 1 compared a minimal-supplementation control group (Group H, n = 6) with a frequent heterogeneous-supplementation group (Group L, n = 18); Tier 2 compared, within Group L, low-frequency (Group A, ≤ 3 sessions per week, n = 7) and high-frequency (Group B, > 3 sessions per week, n = 11) live-streaming sub-groups. Faecal microbial profiles were obtained by 16S rRNA gene (V3–V4) …

Effect Of Home Bleaching With Carbamide Peroxide And Over-The-Counter Products On Stained Supra-Nano-Filled Composite: An In-Vitro Study., Lynn Harrouk, Pascale Habre, Samar Bou Jaoude, Carina Mehanna Zogheib

International Arab Journal of Dentistry

Objective: This study evaluated the impact of home and over-the-counter (OTC) bleaching products, compliant with SCCS regulations, on color changes in tea-stained supra-nano filled composite, using the CIEDE2000 formula.

Methods: One hundred Estelite® Sigma Quick discs were fabricated, thermocycled, and tea-stained for 12 days. Samples were divided into four groups: Opalescence 15% carbamide peroxide (CP) gel, White Dental Beauty 6% hydrogen peroxide (HP) strips, Pola Luminate 6% HP brush-on gel, and a control. Color was measured at baseline, post-staining, and post-bleaching using a VITA EasyShade spectrophotometer. ΔE₀₀ values were analyzed with Kruskal-Wallis and Dunn’s post-hoc tests (p < 0.05).

Results: All bleaching …

Specific Carbohydrate Diet Versus Mediterranean Diet In Adult Patients With Mild To Moderate Ulcerative Colitis: A Randomized Controlled-Feeding Trial, Albert Sheng-Yin Chen, Long Nguyen, Brianna Gray, Katherine Williams, Jenny Gurung, Lauren Canha, Jessica Mcgoldrick, Jane Hubbard, Hamed Khalili

Student Papers, Posters & Projects

Background and aims: This pilot randomized controlled-feeding trial compared the effect of Specific Carbohydrate Diet (SCD) and Mediterranean diet (MeD) in mild to moderate ulcerative colitis (UC).

Methods: Seventeen adults were randomized to a 6-week SCD (n = 8) or MeD (n = 9) intervention. Primary outcome was change in partial Mayo Clinic score (pMCS).

Results: The study was discontinued early due to significant dropout (n = 9, 52.9%). There was no significant between-group differences observed for pMCS change (SCD, -0.8; MeD, -1.3; p = 0.499) or secondary outcomes. Exploratory metagenomic analysis revealed enrichment of Parasutterella excrementihominis …

Exploring Lifestyle Transitions And Perceptions Of Weight And Health Among College Students In Huntsville, Texas, Keyonna Nicole Thomas

Walden Dissertations and Doctoral Studies

College students aged 18–25 transitioning to independent living often experience changes in diet, physical activity, stress, and time management that increase health risks. These challenges may be amplified in semi-urban communities by limited access to healthy food, transportation barriers, and scheduling constraints. This qualitative phenomenological study explored how college students in Huntsville, Texas, perceived and interpreted these lifestyle changes and their influence on perceptions of health and weight. Guided by the social ecological model, the study included 12 participants who were 18–25 years old, enrolled in college, living independently in Huntsville, Texas, and able to describe their experiences with lifestyle …

Spontaneous Intracranial Hypotension With Negative Brain Mri Findings: A Systematic Review Of Diagnostic Strategies And Clinical Outcomes, Marina Romozzi, Giuseppe Garignano, Valid Rastegar, Francesco Onorati, Catello Vollono, Federico Tosto, Masahito Katsuki, Yasuhiko Matsumori, Francesco Signorelli

Student Papers, Posters & Projects

BACKGROUND: Spontaneous intracranial hypotension (SIH) is a debilitating syndrome typically characterized by orthostatic headache and classic brain MRI findings. However, brain MRI abnormalities are indirect manifestations of cerebrospinal fluid (CSF) volume depletion rather than direct evidence of the leak, and some patients may present with unrevealing or absent typical brain MRI findings, posing a considerable diagnostic challenge.

METHODS: A comprehensive search of PubMed/Medline, Web of Science, and Scopus was conducted to perform a systematic review, according to PRISMA guidelines, analyzing the available evidence on MRI-negative SIH (patients without typical SIH findings on their initial brain MRI), including its clinical features, …

Sfdda Newsletter Spring 2026

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Unbiased Avidity-Based Isolation Of Antigen-Specific T Cells, Amanda Montoya, Meredith L Frank, Peixin Jiang, Hui Nie, Minying Zhang, Emily Bontekoe, Jared K Slone, Ludovica L Posta, Sofia Rosy Caterina Sorice, Tina Cascone, Maura Gillison, Don L Gibbons, Jianjun Zhang, Eleonora Dondossola, Lydia Kavraki, Pamela L Wenzel, John V Heymach, Alexandre Reuben

The Brown Foundation: Institute of Molecular Medicine

Background: Cancer immunotherapies have significantly improved treatment efficacy and patient survival by exploiting antigen-specific T cells to eliminate cancer cells. However, current approaches for identifying and isolating antigen-specific T cells typically require prior knowledge of target antigens, limiting discovery, and reducing the ability to consistently detect rare tumor-reactive T cells. We therefore sought to develop an unbiased platform for the identification and enrichment of antigen-specific T cells using naturally processed and presented tumor antigens.

Methods: We developed ATTACH (Assessment of T cells Tethered to Antigen Class I Histocompatibility), a microfluidic platform that applies controlled shear stress and leverages tumor cells …

Promoting Equity For Children And Adolescents Through Implementation Processes In Health And Social Care: A Scoping Review, Michelle Gooey, Heather Morris, Rebecca Madill, Callie Walsh-Bailey, Ahlia Griffiths, Melissa Savaglio, Claire Blewitt, Amanda O'Connor, Sara Holton, Helia Khalesi, Sofia Grage-Moore, Maria Fernandez, Echezona E Ezeanolue, Allison Metz, Ana Baumann, Helen Skouteris

Faculty, Staff and Student Publications

Background: Despite the many existing implementation methods, theories, and frameworks, implementation science is insufficiently closing the research-to-practice gap. Bridging this gap is critical to achieving healthy and thriving communities globally, and requires implementation processes that promote equity and reach diverse populations, especially those most in need. The aim of this scoping review was to identify, thematically analyse, categorise, and provide examples of implementation processes described in equity-focused literature, with a focus on health and social care interventions for children and adolescents from birth to 18 years of age.

Methods: A comprehensive search of literature was undertaken across six electronic databases …

Eating Disorders: What Utahns Need To Know, Brie Sparks, Susan R. Madsen

Marketing and Strategy Faculty Publications

Eating disorders are serious mental health conditions characterized by persistent disturbances in eating behaviors and related thoughts and emotions. They affect individuals of all ages, backgrounds, body sizes, and life stages, often occurring alongside other mental health challenges. Eating disorders can have profound impacts on physical health, emotional wellbeing, relationships, educational attainment, and workforce participation. Understanding the prevalence, risk factors, and barriers to treatment in Utah is essential for developing effective prevention, intervention, and recovery efforts.

Drivers Of Professional Satisfaction In Emergency Medicine Residency Training In The Us, Arvin Radfar Akhavan, Kirstin Woody Scott, Patrick Hewes, Erin Kinney, Boris Pavic, Josh Simmons, Michelle Lall, Michael Gottlieb, Yvette Calderon, Dave Lu

Department of Emergency Medicine Faculty Papers

BACKGROUND: Physician wellness discussions often center on burnout and negative aspects of clinical practice. Less is known about what brings professional satisfaction to physicians, particularly among emergency medicine (EM) residents. Understanding drivers of professional satisfaction is important for the future of the specialty as they may influence residents' career decisions. This study aimed to identify drivers of professional satisfaction among a national cohort of EM residents.

METHODS: We conducted a mixed methods study using a survey administered following the 2024 ABEM In-Training Examination to EM residents in ACGME-accredited programs. The single-item, free-text survey question asked: "List the top 3 drivers …

Dna-Fish Metaphase Spreads To Distinguish Extrachromosomal Dna From Homogeneously Staining Regions In Human Cancer Cell Lines, Lauren Marie Masters, Katelin Maria Hagstrom, Graham Scott Erwin

Faculty, Staff and Students Publications

Whole-genome sequencing identifies focal DNA amplifications with base-pair resolution but cannot determine whether amplified sequences reside on extrachromosomal DNA (ecDNA, also known as double minutes) or within chromosomally integrated homogeneously staining regions (HSRs). DNA fluorescence in situ hybridization (DNA-FISH) metaphase spreads remain the gold standard for distinguishing these amplification states at single-cell resolution. Here, we present a detailed protocol for DNA-FISH metaphase spreads using human cancer cell lines, encompassing cell culture, metaphase arrest, hypotonic treatment, fixation, chromosome spreading, fluorescent probe hybridization, and fluorescence imaging. The protocol incorporates intermediate quality-control steps to verify successful chromosome dispersion and optimize metaphase spread quality, …

Tgf-Β Drives The Conversion Of Conventional Nk Cells Into Uterine Tissue-Resident Nk Cells To Support Murine Pregnancy, Josselyn D Barahona, Liping Yang, D Michael Nelson, Wayne M Yokoyama

2020-Current year OA Pubs

Tissue microenvironments shape lymphocyte differentiation to align immune function with local physiological demands. Uterine natural killer (NK) cells are critical for reproductive success, yet the molecular cues in the uterus that instruct their specialized identities remain incompletely understood. Here, we identify a TGF-β-dependent differentiation pathway by which circulating conventional NK cells convert into uterine tissue-resident NK cells during murine pregnancy. Loss of TGF-β receptor II expression in

Phenomenological Analysis Of Trust In Science For The Design Of Ai-Based Health And Social Policies, Kochav Koren

All Duquesne Faculty Scholarship

The promises of artificial intelligence (AI) as a solution to challenges facing health systems increasingly link technological innovation with improvements in efficiency and access. However, the legitimacy of AI-supported health policies depends not only on scientific competence but also on public trust in scientific institutions. Using data from the international Trust in Science Project (71,922 respondents across 68 countries), this study analyses multidimensional trust and communication ecologies to reconstruct relational configurations of trust, termed ‘Figures of Relevance’. Findings reveal that whilst scientific competence is widely recognised, perceptions of institutional openness vary markedly, shaping heterogeneity in trust. The study identifies four …

Sleep Disturbances Affect Sleep Quality Of Hospitalized Adults, Tonjia Hardesty

Dissertations

Abstract

Background: Sleep disturbances affect the quality of sleep hospitalized adults experience, possibly extending patient recovery time. Treatment of insomnia frequently includes pharmacological interventions exposing patients to potential side effects, leading to negative patient outcomes.  The purpose of this project was to determine if a sleep hygiene toolkit including eye masks, earplugs, advocacy cards, and removal of nicotine patches at bedtime would improve patient sleep quality without use of pharmacological interventions.

Methods: A descriptive observational design was used in this quality improvement (QI) project. A convenience sample of 37 (N =37) participants over the age of 18 years and …

Identification Of Prognostic Factors For Disease Recurrence-Free Survival (Drfs) In Breast Cancer Patients Using The Cox Proportional Hazards Model, Dwi Cahyaning Putri, Veny Prabaningrum, Samsul Arifin

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Breast cancer remains one of the most common malignancies among women worldwide, with recurrence remaining a major clinical challenge. Despite various treatment efforts, the mortality rate from breast cancer remains high, particularly among patients with worse clinical and molecular conditions. This study aims to identify factors influencing the survival of breast cancer patients using the Cox proportional hazards model. The study analyzes clinical and molecular data of breast cancer patients to identify key risk factors affecting Disease Recurrence-Free Survival (DRFS). Analysis was conducted using Kaplan-Meier, the Log Rank test, and the Cox proportional hazards model. The results showed that nodal …

Longitudinal Genomic Surveillance Of Sars-Cov-2 In A University Microcosm Reflects Global Evolutionary Trends, Sankar Prasad Chaki, Melissa M Kahl-Mcdonagh, Benjamin W Neuman, Loni A Taylor, Rebecca S B Fischer, Blake M Hanson, Marlisa S Hardy, Jo Ann Culpepper, Eric Boerwinkle, Kurt A Zuelke

Faculty, Staff and Student Publications

SARS-CoV-2 transmission has declined, yet ongoing viral evolution continues to pose public health challenges. This study conducted long-term (2020-2024) genomic surveillance within a large and globally diverse university community. Viral genomes obtained from clinical (n = 1,786) and surveillance (n = 888) testing samples were classified under clade, lineage, and variant systems, and compared with global genomic data sets. Local patterns broadly paralleled global evolutionary trends, including the phased emergence of major variants, episodic introductions of new lineages, and shifts in dominant clades. Lineage diversity peaked during fall semesters and was highest among undergraduate-aged individuals, with similar distributions …

The Impact Of Social Determinants Of Health On Alcoholism Among African American Communities Aged 65 And Older, Kymberly Williams

Walden Dissertations and Doctoral Studies

Alcohol use disorder among African American older adults (aged ≥65) remains an underrecognized contributor to preventable morbidity and diminished quality of life. Although previous research has identified individual risk factors for alcohol misuse, little is known about how social determinants of health shape alcohol use among this population. The purpose of this descriptive phenomenological study was to explore how family support, experiences of racial discrimination, religious engagement, and economic stability influence late-life alcohol use. Cultural Resilience Theory guided the exploration of how cultural resources and structural stressors influence alcohol use. Five African American adults aged 65 years and older were …

Fostering Active Learning In Reproductive Health Classes Among Undergraduates Of A Nigerian Public University: The Role Of Cognitive Restructuring Health Education, Ndubuisi Friday Ugwu, Adewumi Segun Igbinlade, Adijat Bolanle Adams, Uchenna Anselm Anibueze, Gabriel Aderibigbe Oyegbami, Chinyere Chrysantus Onwurah, Sabina Nwakaego Igwilo, Olufemi M. Olubamise, Folasade Adediran, Oladipo Adeyeye Olubodun Phd, Jacob Kehinde Opele, Loveth Nnenna Ugwu, Amos Olorunwa Agbojo

Higher Learning Research Communications

Objective: This study examined the efficacy of the cognitive restructuring health education (CRHE) intervention in improving participatory learning in sexual and reproductive health classes among students at a Nigerian public university.

Methods: The study employed a randomized pretest/posttest control group design involving 130 undergraduates from Federal University Oye-Ekiti, Nigeria. Participants were randomly assigned to either a 2-week intensive health education–based cognitive restructuring program (n = 65) or a waitlist control group (n = 65). Interaction behavior was assessed at pretreatment, at post-treatment, and at a 6-week follow-up using the 14-item Interaction Behavior Checklist (reliability = 0.85). …

Al Kuwait Hospital Dubai, Emirates Health Services 1st Research Week 2025: Research Abstracts Of Clinical And Scientific Advances, Suad Hannawi, Linda Saf Eldin, Alaa Abuquta, Yusra Abdulrahman, Maryam Yaslam, Sabaa Saleh Al-Hemyari, Maimouneh Qazi, Noor Majed Al Mheiri, Ahmed Alamadi, Alia Aljasmi, Sondos Al Salmi, Maria Al-Salmi, Moza Aljamri, Ahmed Ibrahim Abdulrahman, Sharifa Alamadi, Haifa Hannawi

Saudi Medical Journal

No abstract provided.

The Outcome Of Thrombectomy Can Be Improved By Shortening The Door-To-Needle And The Onset-To-Door Time, Sounira Mehri, Josef Finsterer

Saudi Medical Journal

No abstract provided.

Awareness Of The Mediterranean Diet And Its Perceived Effect On Cardiovascular Health In The Western Region, Saudi Arabia, Abdullah M. Alharbi, Mohammed S. Alsaedi, Mutaz S. Alharbi, Faisal F. Almutairi, Adeeb M. Aloufi, Azzam M. Alharbi, Rakan D. Alsaedi, Hatim F. Alhejaili, Motasem M. Alyamani

Saudi Medical Journal

Objective: To increase awareness of mediterranean diet (MD) and its perceived effects on cardiovascular health, enhance knowledge and inform public health efforts aimed at improving the population's health outcomes of. The MD comprises heart-healthy eating patterns high in vegetables, legumes, nuts and seeds, and fruits. Methods: This cross-sectional study involved adult participants who were living in the Western region of the Kingdom of Saudi Arabia. The data were collected online through social media platforms, then cleaned, coded, and analyzed using Statistical Package for the Social Sciences, version 21 to generate key insights. Results: A total of 390 participants were included …

Early Initiation And Dual Patterns Of Cigarette And E-Cigarette Use Among Adults In The Eastern Province, Saudi Arabia: A Cross-Sectional Study, Haidar A. Alridha, Nora A. Alafif

Saudi Medical Journal

Objectives: To explore the early initiation of cigarette and e-cigarette use and the dual patterns of usage among adults in the Eastern Province of Saudi Arabia. Methods: A cross-sectional survey was conducted from December 2024 to February 2025 among adults living in the Eastern Province. An online self-administered questionnaire collected data on sociodemographic characteristics, smoking behaviors, age of initiation, dual-use patterns, and quit attempts. Convenience sampling was applied, and a total of 551 participants were included. Descriptive statistics summarized distributions of smoking behavior and initiation age. Pearson's Chi-square tests were used to examine associations between smoking status, age of initiation, …

Artificial Intelligence In Pharmaceutical Care: Transforming Drug Discovery, Development, And Patient-Care Delivery, Abdulrahman G. Alharbi, Abdulrahman A. Aljabri

Saudi Medical Journal

The integration of artificial intelligence (AI) into pharmaceutical care represents a paradigm shift in healthcare delivery, offering unprecedented opportunities to revolutionize medication management, accelerate drug development, and enhance patient outcomes. This comprehensive review synthesized evidence from global literature (2021–2025) examining AI applications across drug discovery and development, clinical trials optimization, medication therapy management, and pharmacy operations. The AI demonstrated prediction accuracies of 86–98% in drug discovery, 80% improvement in clinical trial recruitment efficiency, and 32.7% increase in medication adherence over standard care. The global AI drug discovery market, valued at \$1.5 billion (2023), is projected to reach \$11.8 billion by …

Healthcare-Associated Infection Causes And Mitigation Strategies: A Systematic Review, Mohammad Irfan, Nahed Alquwez

Saudi Medical Journal

Objective: To describe the landscape of healthcare-associated infections (HAI) and, in particular, to pay attention to the types of infection that are usually seen, the most common infectious agents involved and the effective prevention strategies. Methods: A detailed search was performed using Google and PubMed, and studies that exclusively addressed healthcare associated infections or their mitigation. Studies published since 2000 were included. Data from individual articles were extracted and categorized by study focus, type of infection, causes and contributing factors, and documented mitigation strategies. Editorials, reviews, case studies, meta-analyses, and systematic reviews were excluded. Results: The analysis showed that infections …

Computed Tomography Findings Of Normal Appendix In Pediatric Population, Thanwarat Koonthong, Teerasak Phewplung*

Chulalongkorn Medical Journal

Background: Appendicitis remains the most common indication for emergency abdominal surgery in children. Computed tomography (CT) plays a vital role in the evaluation of pediatric patients with suspected appendicitis. Yet, there is limited of literature describing the normal appendiceal diameter in the pediatric Asian population.

Objectives: To characterize the normal pediatric appendix and to identify the variables that influence its diameter in pediatric patients aged one day to 18 years who underwent abdominal CT.

Materials and Methods: The study was approved by the IRB. We conducted a retrospective study of 358 children (≤18 years of age) who underwent abdominal CT …

Global Trends In School Disaster Preparedness Research: Bibliometric Analysis Impacts On Public Health And Safety, Muhammad Farid, Muhammad Agita Hutomo, Oktomi Wijaya, Dian Ika Puspitasari

Chulalongkorn Medical Journal

Background: Disasters disrupt daily human activities, arising from natural or artificial triggers, with varying impacts based on community vulnerability and resource capacity. Effective disaster management involves a cycle of mitigation, preparedness, response, and recovery. One of the mitigation measures is to establish school disaster preparedness that integrate education and capacity building.

Objective: The aim of this research is to conduct a bibliometric analysis based on Scopus publications regarding school disaster preparedness.

Methods: A bibliometric analysis was performed on publications indexed in Scopus from 1965 to 2024. Data were processed and visualized using VOSviewer to explore trends in annual outputs, contributing …

Greater Weekly Exercise Volume Is Associated With Lower Prevalence Of Metabolic Comorbidities, Psychiatric Conditions, And Exertional Symptoms In Youth Athletes Undergoing Pre-Participation Screening: An Observational Study, Grace Qiu, Seong Kyu Kim, Douglas Corsi, Alexander G. Hajduczok, Imran Masood, Daniel Underberg, Brian Osler, Drew Johnson, David Shipon

Division of Cardiology Faculty Papers

INTRODUCTION: Physical activity has been associated with improved cardiovascular health outcomes in adults. However, the specific associations between physical activity volume and cardiovascular outcomes in youth athletes are less defined.

METHODS: This study analyzed data from the HeartBytes National Youth Database, compiled from Simon's Heart. Simon's Heart is a nonprofit organization that includes information from sports pre-participation examinations for adolescents. The dataset encompasses demographics, electrocardiogram (ECG) findings, and exercise-related symptoms. Youth athletes' self-reported weekly physical activity volume was classified into four levels: < 2 h, 2-5 h, 5-10 h, and >10 h, with less than 2 h taken as the reference group. Given the physical diMerences among athletes …