A recent meta-analysis concluded that the badge of status hypothesis is the most parsimonious explanation for an observed association between measures of aggression and the degree or area of coloration across animals. We argue that the premise for the conclusion that aggression and coloration are positively associated relies on a biased, largely incomplete and heterogeneous representation of the available evidence. In addition, we identified severe problems with the calculation and interpretation of the correlations and the heterogeneity, as well as with data extraction and the publication bias tests. Our re-analyses challenge the original conclusions. Once heterogeneity-which, in contrast to the original study, our re-analysis shows to be high-and publication bias are properly assessed and accounted for, we find low generality of the relationship between aggression and coloration across animals. In addition, our analyses suggest that evidence changes dramatically depending on the source of the effect size, with evidence obtained directly from correlations and mean group comparisons being statistically nonsignificant and largely different from evidence obtained by transforming inferential statistics (t, F, and χ 2), which raises strong methodological concerns. Furthermore, by re-extracting 11 out the 74 studies included in the original meta-analysis (15%), we found errors and inconsistencies that raise further concerns about the validity of the full dataset. We give directions to guide future meta-analytic efforts in this and other topics, showcasing common misunderstandings in systematic reviews and meta-analyses, including effect size calculation and transformation. We conclude that after 50 years since its conception, the jury is still out regarding the validity and generality of the badge of status hypothesis to explain individual differences in coloration traits across animals.
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Social connection is essential for well-being, yet people often avoid interacting with strangers due to concerns about conversation quality or a lack of shared interests. This study investigates whether the Happy to Chat badge can act as a behavioural nudge to promote social connectedness. Using a nationally representative online sample of 1,738 adults in England (via YouGov), we tested whether wearing the badge influences perceptions of friendliness, trustworthiness, and interest in conversation, as well as social behaviours such as smiling, eye contact, nodding, and willingness to initiate a chat. Results show that badge wearers are perceived as significantly more friendly, trustworthy, and open to conversation, and are more likely to receive social acknowledgements, although wearing the badge did not significantly increase others' intention to initiate conversation. Age and gender effects were also observed, with older and female targets generally receiving more favourable social responses. These findings suggest that while the badge effectively promotes social recognition, it may be insufficient on its own to overcome deeper psychological barriers to initiating conversations with strangers. This paper confirms the effectiveness of the Happy to Chat badge as a nudge to promote social connectedness within communities and highlights its practical implications.
Assembly quality is frequently assessed using independent measures of assembly span, contiguity, sequence composition, and completeness. Among contiguity metrics, contig, and scaffold N50 have perhaps gained the most traction, despite well-known limitations. Several authors have suggested considering the complete Nx curve rather than just the N50 value, but while using N90 values or considering the area under the Nx curve with auN statistics provide more complete measures of contiguity, they share the limitation of being unsuited to direct comparison across a range of genome sizes. We introduced snail plots to provide a genome-size-independent way to summarize a range of commonly used assembly metrics. Here, we demonstrate that easily learnt visual differences between snail plots allow simultaneous consideration of metrics across several key areas of assembly quality to rapidly identify high- and low-quality assemblies. We show that prominent features in snail plots of high-quality assemblies effectively highlight N50, N90, and auN contiguity statistics. As the presentation is scaled to the longest scaffold, we also show that plots can be compared effectively across a wide range of taxa and assembly sizes. We use the core features of a snail plot to derive a proportional measure of assembly quality based on auN, adjusted for non-ATGC bases and scaled to the length of the longest scaffold. We show that this "snail score" value corresponds closely to a qualitative assessment of overall assembly quality from visual interpretation of a snail plot and supports corrections for expected genome size.
Gamification has emerged as a transformative pedagogical strategy in health sciences education, offering innovative ways to enhance student engagement, motivation and competency development. This state-of-the-art commentary explores the integration of digital badges into the third-year Medicine and Surgery course for occupational therapy and physiotherapy students at a public university in South Africa. Originally introduced to address contextual and educational challenges, digital badges acted as engagement tools aligned with specific learning outcomes and professional competencies. The inclusion of badges was organically developed by lecturers in response to contextual challenges, including inconsistent face-to-face teaching, low engagement, limited interdisciplinary interaction in an online learning environment, and the need to prepare students for clinical practice in resource-constrained settings. Gamification elements were embedded in Moodle, the learning management system, to scaffold learning progression and support the core competencies outlined by the Health Professions Council of South Africa (HPCSA), including therapeutic and professional relationships, professionalism, communication and ethical practice. The introduction of gamification and badges may improve clinical, interdisciplinary, and communication skills among undergraduate students. Contextual relevance, inclusive design, and ongoing evaluation incorporating the students' voices are recommended in sound instructional design through active engagement with gamification practices in health sciences education.
EFL (English as a Foreign Language) learners' engagement is a crucial determinant influencing learning outcomes in English vocabulary learning. In recent years, gamification elements such as points, badges, and leaderboard have been increasingly used in mobile-assisted language learning to promote EFL learners' engagement. However, empirical evidence comparing learners' engagement in multi-element and points-only gamified mobile apps remains limited, particularly across multiple engagement dimensions. To address this gap, the present study employed a quasi-experimental design with pretest, posttest and delayed posttest measures to compare the immediate and delayed effects of multi-element versus points-only gamified mobile apps on EFL learners' overall engagement and its dimensions (cognitive, emotional, and behavioural engagement) in English vocabulary learning. In this study, the experimental group (n = 35) used a gamified mobile app incorporating points, badges, and leaderboard, while the comparison group (n = 31) used a points-only gamified mobile app. The results indicated that EFL learners using the multi-element gamified mobile app reported significantly higher overall engagement and all three engagement dimensions immediately after the intervention. However, these positive effects were not maintained at the delayed posttest, suggesting that the initial effects may weaken over time. These findings provide cautious quasi-experimental evidence of the immediate and delayed effects of multi-element and points-only gamified mobile apps on EFL learners' engagement in English vocabulary learning.
BACKGROUND: The cluster randomized controlled trial interprof ACT evaluated the effects of a complex intervention designed to improve collaboration between general practitioners (GPs) and registered nurses (RNs) in nursing homes (NHs). The intervention includes six components (“Name badges”, “Mandatory availability rules”, “Designated contact persons”, “Standardized GPs’ home visits”, “Pro re nata medication”, “Shared goal setting”). The findings showed a nonsignificant reduction in hospital admissions in the intervention group (IG) compared to the control group (CG) within twelve months. The aims of this process evaluation were to describe (1) the dose, reach and fidelity of implementation (“implementation performance”), (2) the effects on the quality of RN-GP collaboration, and (3) potential moderating factors. METHODS: Process evaluation with a mixed-methods triangulation design involving all clusters (17 NHs per IG and CG) and 323 nursing home residents (NHRs) (n = 166 IG, n = 157 CG): We collected quantitative and qualitative data from multiple perspectives (e.g., RNs, GPs, NHRs) at several measurement points. We quantitatively compared groups by means of medians, interquartile ranges, proportions (all outcome domains) or Mann‒Whitney U tests (implementation performance) and analyzed qualitative data inductively via content analysis. The key findings were triangulated narratively and via a joint display. RESULTS: Compared to those in the CG, we noted relevant improvements in the implementation of “Name badges”, “Mandatory availability rules”, “Designated contact persons” and “Pro re nata medication” in ≥50% of the IG clusters, of which the group difference for “Mandatory availability rules” reached statistical significance. The implementation performance of IG clusters was moderated by resource-related and other organizational attributes of NHs and GP offices and attributes of involved professionals, especially their attitudes and awareness. Implementation of the components induced greater standardization of care processes together with positive changes in interprofessional communication and coordination among GPs and RNs. CONCLUSIONS: Implementation of the interprof ACT components varied between components and NHs but showed potential for improving RN-GP collaboration. The standardization of shared care procedures emerged as a key mediator for improvement. For larger and more sustainable implementation we recommend a stronger focus on locally available resources and communication of potential benefits for all involved parties. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03426475; registered 07 February 2018, https://www.clinicaltrials.gov/study/NCT03426475?lead=NCT03426475%26;rank=1 .
Across three preregistered experiments (total N = 1,135), we tested whether an inductive learning (IL) intervention improved participants' news veracity discernment (i.e., ability to distinguish between true and false news). IL involves learning categories by observing or classifying exemplars. Therefore, in this research, IL involved observing true and false news headlines and classifying them as either "true" or "false," with immediate feedback on accuracy. In Experiment 1 (N = 214), the IL intervention significantly improved participants' news veracity discernment compared to the control, but the Bayesian evidence was only anecdotal. In Experiment 2 (N = 483), we incorporated game-design elements into the IL intervention, including performance-contingent badges. Unexpectedly, the effect of the IL intervention decreased. We reasoned that, because the IL intervention involved easy-to-hard classification training, the provision of performance-contingent badges inadvertently made participants more aware of their declining performance. This awareness may have undermined their motivation to learn as the training progressed. Therefore, in Experiment 3 (N = 438), we implemented hard-to-easy classification training instead, and the IL intervention significantly improved participants' news veracity discernment, now with strong Bayesian evidence. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Effective translation relies on high performance teams integrating diverse disciplines to bring new drugs, medical devices, diagnostics or behavioral interventions into improved health. Despite substantial advancements informed by the Science of Team Science (SciTS), challenges remain in effective translational team (TT) operations, while limited institutional, scholarly, and practitioner legitimacy of team science expertise constrains efforts to address them. Here, we describe an essential member of the TT, the Team Science Professional (TSP). Serving as a team educator and facilitator of team interventions, the TSP plays a pivotal role in facilitating effective team performance. Current challenges faced by this nascent profession are defining career pathways and establishing competencies needed for expert performance. To address these challenges, the authors, representing a spectrum of academic universities organized as a special interest group (SIG) of the Association of Clinical and Translational Science (ACTS), propose a suite of individualized, standardized and pathway-selective micro-credentials (digital badges). Digital badges in "Team Science (TS) Fundamentals," "TS Practitioner," "TT Trainer" and "TT Intervention Expert" are described, along with preliminary feasibility and usability evaluations of the submission process. These stackable credentials provide a customizable, portable recognition of skills and help advance career pathways for TSPs. In so doing, the Digital Badge Initiative will enhance the capacity of translational science "Hubs" such as those supported by Clinical and Translational Science Awards to conduct effective and rigorous translation. Moving forward, the ACTS TSP SIG will be examining the impact of digital badging on standardization and its effect on career recognition and retention.
Background: To compare the amount of radiation exposure received by the surgeon during volar locking plate fixation for distal radius fractures using an image intensifier (II) and a flat panel detector (FPD). Methods: We included 40 patients who underwent open reduction and internal fixation using a volar locking plate for isolated distal radius fractures. Surgeons wore thermoluminescent dosimeter badges at six anatomical sites: both thumbs, thyroid, at eye level (to estimate the eye lens dose), chest (under the protector) and abdomen (under the protector). The badges were replaced monthly, and equivalent radiation doses were measured. Fluoroscopy time was recorded from operative notes. Sixteen cases operated using an II-equipped C-arm between August and October 2020 were classified as Group II. Twenty-four patients treated between September and November 2024 using an FPD-equipped system comprised Group FPD. Results: Operative time was similar between groups (57 vs. 56 minutes). Fluoroscopy time was 324 seconds in Group II and 239 seconds in Group FPD and air kerma per case was comparable (6.6 vs. 5.8 mGy). Equivalent dose per second was higher with FPD for both thumbs (right: 2.23 vs. 1.70 μSv/s; left: 9.57 vs. 2.07 μSv/s), with no significant differences in eye-lens or thyroid exposure. Conclusions: The equivalent radiation dose per second of fluoroscopy was significantly higher in Group FPD for both thumbs compared to II systems. No significant differences were observed in radiation exposure to the lens or thyroid between groups. Level of Evidence: Level IV (Therapeutic).
The International Commission on Radiation Units and Measurements (ICRU), in collaboration with the International Commission on Radiological Protection (ICRP), has introduced new operational quantities in ICRU Report 95. Among these, the personal dose Hp addresses the significant limitations of the currently used Hp (10), which can overestimate the effective dose by up to a factor of 5.5 at photon energies below 70 keV. These changes necessitate a re-estimation of dosemeter response to evaluate potential modifications in dose algorithms and detector design. In this study, the performance of CaSO4:Dy thermoluminescent dosemeter (TLD) badges was investigated for the new operational quantity Hp and compared with the existing Hp (10). The badge response was simulated over photon energy range 12.3-1250 keV using the Monte Carlo Simulation code FLUKA and benchmarked against experimental validation. To correct for energy-dependent overestimation at lower photon energies, a new dose evaluation algorithm for Hp was developed based on disc dose ratio (R12). The disc dose ratio (R12) refers to the ratio of absorbed doses measured in CaSO₄:Dy TL discs D1 and D2 positioned under different filtration conditions within the badge and serves as an energy-sensitive parameter for correcting the over-response of the dosemeter in terms of Hp. The proposed algorithm demonstrated strong compliance with IEC 62387:2020 performance criteria (acceptance range 0.71-1.67), with 95% of estimated Hp values lying within 0.9-1.3 of the delivered dose. These results confirm that CaSO4:Dy TLD badges, when combined with the improved algorithm, are fully compatible with the new operational quantities recommended in ICRU Report 95, ensuring reliable application in personnel dosimetry.
Developer discussions particularly on programming related questions answering (Q&A) sites, contain useful information, which, if mined and analysed carefully can be transformed into insightful recommendations for developers about which software to use or prefer over others, matching with one's requirements for different software development activities. However, there is a long way to go before such a system can be realized. As a first step in this direction, we empirically explored the developers' discussions on Stack Overflow, one of the most popular Q&A sites among developers, with a particular emphasis on mining software recommendations related insights. We considered the Stack Overflow data dump published in October 2025 containing complete data of the site since 2008. The data extraction process started with the conversion of the gigantic XML files to SQL Server database table records. We then applied a keywords-based filtering approach to identify potential recommendation related queries in questions, and recommendations in answers and comments related to any aspect of software development. The set of keywords comprised of 19 keywords including the term 'recommend' along with its 14 synonyms and 4 antonyms. The extracted dataset contains 73.9k (0.31%) questions containing such terms in the question title, 1.1 M (4.69%) questions containing them in the question body, 2.2 M (6.18%) answers and 1.9 M (2.08%) comments because of exact keyword matching. The results further increase in case of substring matching. When enriched with additional metadata e.g. Users, Badges, Votes and Tags (which are available in the Stack Overflow data dump), the raw dataset presented in this paper can become highly useful for the empirical software engineering and machine learning research community for training models and developing recommendation systems for software engineering. The extracted answers and comments can be mined to extract implicit developer preferences from which ratings can be inferred whereas the extracted recommendation related questions with accepted answers can be transformed into a benchmark for retrieval evaluation of software recommendation systems for developers. The dataset is hosted on Figshare using DOI 10.6084/m9.figshare.30948506 and can be accessed via https://doi.org/10.6084/m9.figshare.30948506 or the GitHub repository.
Tropical medicine students often request testing preparation materials, but existing resources are limited. We conducted a pilot study of a gamification platform developed at the University of Alabama at Birmingham to build a formative question bank for examination preparation and to teach tropical medicine concepts in two courses: an American Society of Tropical Medicine and Hygiene diploma course and a condensed military-focused tropical medicine course. National Board of Medical Examiners-style questions were delivered as formative reinforcement of lecture material. A postcourse survey assessed user satisfaction, engagement with gamification elements, and the influence of peer competition on motivation. Forty-one learners participated, and 20 provided survey feedback. Learners reported high overall satisfaction, ease of use, and perceived knowledge retention. Most engaged primarily for examination preparation and to increase general tropical medicine knowledge. Our learners were less motivated by digital reward badges and peer competition than reported in prior gamification studies. We conclude that this gamified formative question bank is well regarded and could serve as a resource for other tropical medicine programs, although further study is needed.
I reflect on my tenure as Editor-in-Chief of Law and Human Behavior, including my attempts to improve the scientific impact of the work published in the journal and to increase the representation of traditionally minoritized groups among those who reviewed for it. I also describe the introduction of the nascent open science movement to the field and the journal, with the journal being the first journal published by the American Psychological Association to offer open science badges. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
BACKGROUND: Digital transformation in healthcare is guided globally by digital health maturity models and accreditation-linked standards. In India, the National Accreditation Board for Hospitals & Healthcare Providers (NABH) introduced landmark Digital Health Standards (DHS) for hospitals (2025 draft). This provides a national framework, but its positioning within the complex global landscape is unclear, making it challenging for stakeholders to benchmark progress and plan strategically. OBJECTIVES: The primary objective was to map the features, domains, and assessment approaches of prominent international digital health maturity models and accreditation-linked standards. The secondary objective was to conduct a comparative analysis of these frameworks against the NABH-DHS to identify areas of convergence, divergence, and critical gaps. METHODS: A scoping review adhering to PRISMA-ScR guidelines was conducted. Peer-reviewed databases (PubMed, Embase, Scopus) and grey literature sources were searched from inception to 26 July 2025. We included sources describing national or international maturity models or accreditation standards for healthcare provider organizations. Data were charted using a customized form, synthesized narratively (SWiM), and comparatively analysed using a conceptual crosswalk matrix and thematic gap map. RESULTS: 38 sources were included, comprising systematic/scoping reviews (n = 8), official reports/standards (n = 17), and primary studies (n = 13). Key international frameworks mapped include HIMSS EMRAM, NHS England’s WGLL, WHO-PAHO IS4H, JCI, and Australian models. The NABH-DHS (structured across 8 chapters) shows strong alignment with these frameworks in core domains: Leadership, Governance, Clinical & Patient Safety, and Information & Data Management. However, the comparative analysis identified emerging gaps vis-à-vis global best practices. These include absent or minimal coverage for explicit AI governance, advanced cybersecurity maturity (e.g., alignment with NIST CSF 2.0), granular interoperability maturity assessment, a dedicated health-equity lens, and the systematic integration of Patient-Generated Health Data (PGHD). CONCLUSIONS: The NABH-DHS provide a robust and comprehensive foundation for core digital assurance in India, converging well with international best practices on foundational elements. Our mapped findings are presented as external policy guidance. We recommend that future NABH revisions incorporate pragmatic, light-weight requirements to address the identified gaps (AI governance, advanced cybersecurity, interoperability metrics, and equity). This can be achieved through annexes or tiered ‘Digital Plus’ badges that reference mature external frameworks (e.g., ISO/IEC 42001, NIST CSF 2.0), ensuring a future-proof, phased implementation that safeguards patient trust as the Indian digital health ecosystem matures.
Professional capability development in diagnostic radiography education relies heavily on clinical placement. However, these periods expose students to ionising radiation, resulting in radiophobia - an exaggerated fear characterised by actual and perceived radiation risks. This study investigates the frequency, sources, and management strategies of radiophobia among Ghanaian diagnostic radiography students. This was a mixed-methods exploratory sequential study conducted among second-, third-, and fourth-year diagnostic radiography students from seven undergraduate programs. Qualitative data analysis involved reflexive thematic analysis while quantitative analysis involved descriptive and inferential statistical analysis, considering p < 0.05 as statistically significant for differences. Results showed 63.5 % (n = 174) of participants experienced radiophobia at some point, with most initial episodes occurring during the first year of study. Primary sources included (i) misinformation regarding infertility and cancer, (ii) inadequate foundational knowledge, and (iii) systemic inefficiencies such as lack of personal dosimeters and inconsistent safety practices at clinical sites. Radiophobic students significantly prioritised the need for counselling, clinical mentorship, and improved radiation protection (RP) infrastructure. Radiophobia is a real and prevalent clinical stressor shaped by social, educational, and systematic factors. It involves mistrust in safety infrastructure and highlights significant gaps between theoretical learning and practical clinical experience. Curricula should integrate psychological support and seminars to deconstruct myths and alleviate anxieties. Clinical sites must enhance radiation safety culture by maintaining adherence to RP practices. To support this, the Allied Health Professions Council should ensure that all accredited programs provide radiation monitoring badges to students prior to clinical placements. Additionally, effective clinical mentorship is needed to facilitate student resilience, enhance professional confidence and identity formation, and ensure long-term career retention.
Digital wellness interventions for preventive health, such as prediabetes management, often face high dropout rates due to insufficient personalisation and motivational support. This design science research study presents a self-determination theory (SDT)-informed gamification framework to address these challenges. Drawing on a systematic literature review, the study identifies engagement barriers, facilitators, and empirical evidence to guide design. The framework maps strategies to SDT's core constructs: autonomy (user-defined goals with structured guidance and selectable difficulty levels), competence (adaptive challenges with badges and points), and relatedness (collaboration-focused progress sharing). The framework was co-designed with 20 young adults in Australia and validated by six multidisciplinary experts. The study revealed that 60% of participants felt overwhelmed with fully open goal setting, highlighting that structured guidance is essential for autonomy support in preventive wellness applications. These findings informed the development of MiCARE, a progressive web app that operationalises the framework with user-centred, motivationally aligned features. This study offers a replicable, theory-driven approach for designing engaging preventive wellness interventions.
Adolescents and young adults with intellectual and developmental disabilities (IDs) experience disproportionately low physical activity and high sedentary time yet remain insufficiently served by scalable and cognitively accessible health-enhancing physical activity (HEPA) programmes. This study reports proof-of-concept evidence for IDHEApp, a co-designed, gamified mobile health (mHealth) intervention integrated with a wearable activity tracker to promote physical activity in cognitively diverse users. We conducted an 8-week, convergent mixed-methods pilot randomised controlled trial across two European community IDs services (Rome, Italy; Rijeka, Croatia). Sixty adolescents and young adults were randomised (1:1) to an intervention arm (IDHEApp with Fitbit-enabled feedback and gamified step challenges) or a control arm (Fitbit monitoring plus usual routines). Quantitative outcomes were derived from wearable data (primary: daily step count; secondary: activity intensity and posture-related indicators) and analysed as exploratory behavioural signals using ANCOVA adjusted for baseline values. Qualitative data were obtained through two-phase focus groups (pre-implementation formative assessment and post-implementation technology exposure) with adolescents and young adults and caregivers and examined using reflexive thematic analysis. The intervention was technically feasible to deploy in real-world service settings at both sites. The strongest between-group signal was observed for daily steps (+2068 steps/day; p < 0.001), whereas activity-intensity and posture metrics demonstrated smaller and less consistent patterns. Thematic findings suggested that simple, non-competitive gamification (step goals, points, badges) was readily understood and perceived as motivating, supporting sustained engagement; however, technical barriers (Bluetooth pairing, synchronisation, device charging) increased reliance on caregiver support. Collectively, these findings indicate that IDHEApp is a promising mobile-wearable ecosystem to support HEPA in adolescents and young adults with IDs and justify further optimisation to enhance technical robustness, reduce caregiver burden, and evaluate effectiveness over longer follow-up periods.
The global prevalence of Chronic Kidney Disease (CKD) ranges from 9.1% to 13.4%, with China having the largest number of CKD and advanced CKD patients in Asia. Most patients choose hemodialysis (HD) due to its high safety. Still, long-term treatment may cause complications such as restless legs syndrome and skin itching, which seriously affect patients' quality of life. Recently, the Internet has gradually become the main medical and health information source. As one of the largest short-video platforms in China, TikTok is an important source for spreading health information. However, the reliability of content about hemodialysis on short-video platforms varies and lacks professional evaluation. This study aims to evaluate the content, reliability, and quality of short videos related to hemodialysis on TikTok. In May 2025, a new TikTok account was created, and the keyword "hemodialysis" was used for searching. The first 100 videos were evaluated using three scales: GQS, JAMA, and the Modified DISCERN. Relevant information from the videos was extracted and analyzed. Overall, the quality of short videos about hemodialysis on TikTok was not satisfactory. Most videos had GQS scores of 2-3, JAMA scores of 2, and Modified DISCERN scores of 2. Videos posted by health professionals had higher quality and reliability than those by non-health professionals (P < 0.05). Videos with diverse presentation forms had significantly higher GQS, JAMA, and Modified DISCERN scores than monotonous presentation forms (P < 0.05). Some variables, such as likes and duration, comments, and scale scores, showed no correlation, while the rest were positively correlated (P < 0.05). This study shows that the overall quality and reliability of short videos related to hemodialysis on TikTok are low, but videos posted by medical professionals and those with diverse presentation forms are of better quality. It is recommended that when users search for relevant health information on short-video platforms, they should prioritize watching videos released by qualified healthcare professionals with verified identity badges.