Differences In Average Scores Research Articles

Endoscopic-Assisted Cochlear Implantation in Far Advanced Otosclerosis.

To evaluate the effectiveness of cochlear implantation (CI) in case of far advanced otosclerosis and to evaluate the value of using intraoperative otoendoscopy to facilitate the identification of the round window membrane and the scala tympani without the need to remove the posterior canal wall or to perform a subtotal petrosectomy. Retrospective case-series study. Tertiary academic CI center. This study was conducted on patients with far advanced otosclerosis who underwent endoscopic-assisted CI between January 2010 and June 2020 at the same CI center. The minimum follow-up period was 2 years after surgery. Fourteen patients were included in the study. Ten patients had undergone a previous stapedotomy. Electrode insertion in the scala tympani was successfully accomplished in all cases included in the study. There was a statistically significant improvement in pure-tone average and speech discrimination scores in all cases of the study group (p < 0.0001). There were no statistically significant differences in postoperative pure-tone average or speech discrimination scores between cases with and without cochlear ossification or between cases with and without a previous stapedotomy (p > 0.05). Endoscopic-assisted CI is an effective option for hearing restoration in patients with far advanced otosclerosis. Otoendoscopy can facilitate visualization and access to the scala tympani without the need to remove the posterior canal wall or to perform a subtotal petrosectomy.

Exploring relational aggression and gender dynamics: a global and Indonesian perspective

Girls generally use less physical aggression than boys. However, does this mean that girls are more likely to use relational aggression. With this question in mind, our study aims to analyze the relational aggression of students in Indonesia based on gender. This type of research used is comparative research. The sample in this study was 510 respondents consisting of 19.6% male and 80.4% female. The relational aggression scale (RAS) was used to collect data on student relational aggression in various regions in Indonesia. The analysis technique used is descriptive and differences with the Welch test. The results show that there are significant differences in male and female relational aggression, with an average score difference of -0.30 logit between men and women. In addition, there are fluctuations in the level of relational aggression in the context of gender from year to year in some countries, such as the United States, China, Australia, and others. Recommendations for future research are to integrate a more in-depth social and cultural analysis in Indonesia.

Changes in mental health stigma among healthcare professionals and community representatives in Northern Sri Lanka during an mhGAP intervention study.

Research indicates that exposure to conflict, natural disasters, and internal displacement can increase mental health conditions. Since the end of the civil conflict within Sri Lanka, the country has worked to increase access to mental health services to meet the needs of conflict-affected populations, however, gaps remain. To address this, integration of mental health services into primary care can reduce the strain on growing specialized care. As part of a larger study primary care practitioners (doctors), public health professionals (nurses, midwives), and community representatives (teachers, social workers) were trained to deliver mental health services in primary care across the heavily impacted Northern Province. The aim was to reduce mental health stigma among enrolled healthcare workers and community representatives by 50%. Stigma was measured across all participant groups at six time points: pre- and post- initial training at baseline, pre- and post- refresher training 3-months after initial training, and pre- and post- refresher training 6-months after initial training. Results indicate a small improvement in average stigma scores at the 6-month refresher point for primary care practitioners, and no meaningful difference in average scores across time points for public health professionals or community representatives. World Health Organization mhGAP training appears to reduce stigma among primary care practitioners and could be an effective strategy to counteract mental health stigma in low resource settings. Future research should investigate underlying mechanisms of stigma reduction to improve delivery of mental health services in primary care and community settings.

A Pilot Randomized Controlled Trial of Augmented Reality Just-in-Time Guidance for the Performance of Rugged Field Procedures.

Medical resuscitations in rugged prehospital settings require emergency personnel to perform high-risk procedures in low-resource conditions. Just-in-Time Guidance (JITG) utilizing augmented reality (AR) guidance may be a solution. There is little literature on the utility of AR-mediated JITG tools for facilitating the performance of emergent field care. The objective of this study was to investigate the feasibility and efficacy of a novel AR-mediated JITG tool for emergency field procedures. Emergency medical technician-basic (EMT-B) and paramedic cohorts were randomized to either video training (control) or JITG-AR guidance (intervention) groups for performing bag-valve-mask (BVM) ventilation, intraosseous (IO) line placement, and needle-decompression (Needle-d) in a medium-fidelity simulation environment. For the interventional condition, subjects used an AR technology platform to perform the tasks. The primary outcome was participant task performance; the secondary outcomes were participant-reported acceptability. Participant task score, task time, and acceptability ratings were reported descriptively and compared between the control and intervention groups using chi-square analysis for binary variables and unpaired t-testing for continuous variables. Sixty participants were enrolled (mean age 34.8 years; 72% male). In the EMT-B cohort, there was no difference in average task performance score between the control and JITG groups for the BVM and IO tasks; however, the control group had higher performance scores for the Needle-d task (mean score difference 22%; P = .01). In the paramedic cohort, there was no difference in performance scores between the control and JITG group for the BVM and Needle-d tasks, but the control group had higher task scores for the IO task (mean score difference 23%; P = .01). For all task and participant types, the control group performed tasks more quickly than in the JITG group. There was no difference in participant usability or usefulness ratings between the JITG or control conditions for any of the tasks, although paramedics reported they were less likely to use the JITG equipment again (mean difference 1.96 rating points; P = .02). This study demonstrated preliminary evidence that AR-mediated guidance for emergency medical procedures is feasible and acceptable. These observations, coupled with AR's promise for real-time interaction and on-going technological advancements, suggest the potential for this modality in training and practice that justifies future investigation.

Abstract PO3-16-03: Investigating HER2DX genomic assay concordance within HER2-positive breast cancer

Abstract Background: The HER2DX genomic assay, encompassing a 27-gene panel, provides prognostic (risk-score) and predictive (pathological complete response [pCR]-score) information while quantifying ERBB2 mRNA expression (ERBB2-score). This study aims to explore the variability of HER2DX scores within tumor samples and between paired diagnostic biopsies and surgical specimens. Methods: The standardized HER2DX assay was conducted on pretreatment FFPE biopsies from two distinct geographical areas within tumors (i.e., two different core biopsies) of patients enrolled in the 14-409 phase II study. This study assessed the impact of HER2 heterogeneity on treatment response in stage II-III HER2+ breast cancer patients treated with neoadjuvant T-DM1 and pertuzumab. Additionally, HER2DX was evaluated on paired biopsy-surgery FFPE samples from 6 patients who underwent primary surgery without pre-operative treatment. Variability and concordance of the three HER2DX groups scores were calculated, and Pearson's correlation coefficient determined the correlation between scores at different sites/time points. Paired t-tests were performed between tumor samples for the HER2DX scores. Results: The HER2DX assay was evaluated in two different diagnostic pre-treatment core biopsies from 106 patients (n=212 HER2DX assays). Intra-tumor concordance rates of the three HER2DX groups (risk-score, pCR-score, and ERBB2-score) were 94.3%, 87.7%, and 91.5%, respectively. No significant differential expression of HER2DX scores was observed across paired core biopsies (p-values=0.327 [risk-score], 0.415 [pCR-score], and 0.451 [ERBB2-score]). The average score differences (core 1 - core 2 [scale from 0 to 100]) were 0.57 (risk-score), 0.63 (pCR score), and -0.63 (ERBB2-score). Correlation coefficients across paired core biopsies were 0.96 (risk-score), 0.91 (pCR-score), and 0.90 (ERBB2-score). Additionally, intra-patient variability of the HER2DX scores was evaluated. Average variability in risk-score was 3.38% (95% CI: 2.76-4.01), in pCR-score was 3.53% (95% CI: 2.84-4.23) and in ERBB2 was 3.87% (95% CI: 2.97-4.77). In 6 patients with cT1-2 cN0 disease, HER2DX was evaluated in a diagnostic core biopsy and a surgical specimen, with an average time interval of 8.5 weeks (range 4 to 12 weeks) between time points. The intra-patient concordance rates of the three HER2DX groups were 83.3%, 83.3%, and 100% for risk-score, pCR-score, and ERBB2-score, respectively. No significant differential expression of HER2DX scores was found across paired biopsy-surgery samples (p-values=0.814 [risk-score], 0.128 [pCR-score], and 0.607 [ERBB2-score]). The average score differences (core biopsy - surgical specimen [scale from 0 to 100]) were -0.67 (risk-score), -11.5 (pCR score), and 2 (ERBB2-score). Correlation coefficients across paired HER2DX assays were 0.97 (risk-score), 0.87 (pCR-score), and 0.94 (ERBB2-score). Conclusion: The HER2DX genomic assay demonstrates low variability within HER2+ breast cancer, supporting its reliability as a consistent tool for assessing prognosis, the probability of pCR and ERBB2 quantitative expression. Citation Format: Fara Brasó-Maristany, Laia Paré, Guillermo Villacampa, Mercedes Marín-Aguilera, Paul Spellman, Adrienne Waks, Ian Krop, Esther Sanfeliu, Zhequi Li, Patricia Galván, Eva Hernández-Illán, Pedro Jares, Joan Antón Puig-Butillé, Ana Vivancos, Patricia Villagrasa, Joel S. Parker, Charles M. Perou, Sara Tolaney, Otto Metzger, Kornelia Polyak, Aleix Prat. Investigating HER2DX genomic assay concordance within HER2-positive breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-16-03.

Abstract PO2-11-04: Assessing quality of Life in breast cancer patients undergoing mHealth mobile monitoring: A descriptive Analysis

Abstract Background: Breast cancer (BC) can be associated with a significant symptom burden that can be related both to the disease and to administered therapies. In particular, protocol related toxicity has an extreme impact on patient quality of life (QoL), and can lead to lack of adherence and ultimately, compromise therapy success. There is increasing interest in adopting more effective approaches for active/continuous patient-reported symptom monitoring. Emerging evidence, (Denis et al. 2019), shows that this strategy can reduce toxicity, emergency room visits, and improve QoL. Objectives: We aimed to analyze the QoL of women with BC diagnosis who underwent mobile-based continuous monitoring, searching for possible trends and describing the population. Methods: We conducted a retrospective analysis using data from patients with BC undergoing systemic treatment and monitored by a mobile-based application between January 2022 and June 2023 at an outpatient clinic in Brazil. Thummi is a digital platform for remote monitoring of cancer patients which enables them to record symptoms, toxicities and lifestyle variables. Utilizes the data to generate personalized recommendations and advice. It is available in Brazil at no cost. Doctors indicate the use and can monitor their patients in real time. In addition to an algorithm that informs the user if there is a need to go to the emergency room or not, the medical team can exchange real-time messages with patients. Clinicians have access to patient data through a web tool, allowing them to visualize the information, address symptom alerts, and make informed clinical-therapeutic decisions. The evaluated sample is from patients who come from physicians who indicated the use, without control of their origin, indication of treatment or clinical stage. The data were extracted from the platform's total database. Participants were requested to complete the Quality of Life Questionnaire (EORTC EQ-5D) integrated into the app every month. Inclusion criteria comprised a BC diagnosis, age ≥18, and having responded to the QoL questionnaire with at least a one-month interval between scores. Patients who failed to meet these criteria were excluded from the analysis. A comparison of QoL scores was performed between two periods: T0 (the first recorded response) and T1 (the subsequent response with at least a one-month interval between scores). Descriptive statistical analyses were conducted to search for possible trends, describe the population, and comprehensively examine the differences in QoL scores between T0 and T1. Results: There were 134 active patients in the mobile-based platform with a BC diagnosis, but only 86 (64,17%) met the inclusion criteria for the final analysis. The median age of this group was 54 years old (range 22-78). The most common treatments administered were Cyclophosphamide-Doxorubicin (28 patients, 33%) and Trastuzumab-Deruxtecan (18 patients, 21%). The average QoL score in T0 was 0,70 (SD 0,1379) and 1,0 (SD 0,1560) at T1, representing an increase of 30% after using the app for one month. Conclusion: This study suggests that mobile-based monitoring has the potential to improve the QoL for women diagnosed with BC. The difference in average QoL scores between the initial and subsequent periods indicates a positive impact of utilizing the platform. Further research is needed to establish a better correlation and to explore the specific interventions that contribute to these improvements. Implementing mobile-based monitoring in clinical practice could enhance patient well-being, treatment adherence, and survival time and can potentially lessen both burden of disease and resource utilization in BC care. Citation Format: Alessandra Morelle, Carlos Barrios, Carlos Pereira, Vinicius Agibert, Pedhro Lennon Freitas, Matheus Rocha, Paulo Schulze. Assessing quality of Life in breast cancer patients undergoing mHealth mobile monitoring: A descriptive Analysis [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-11-04.

Enhancing scabies knowledge among Indonesian boarding school students through a &lt;i&gt;Wayang&lt;/i&gt; video

Skin diseases, such as scabies, present a significant global health concern, particularly among Indonesian boarding school students, resulting in complications, disruptions to daily life, and academic hindrances. To effectively address this issue, a health education approach utilizing Wayang videos was implemented, leveraging cultural elements for enhanced outcomes. Our research aimed to assess the impact of a Wayang educational video on scabies knowledge among Indonesian boarding school students. This study, conducted from October 2019 to October 2020, involved 447 students. Pre- and post-tests were administered to measure knowledge levels. Our findings demonstrate a significant improvement in scabies knowledge among students following the Wayang video education intervention. The bivariate Wilcoxon test identified a significant difference (p&lt;0.05) in average scores before and after the educational intervention. Knowledge scores increased from 76.75 in the pre-test to 83.09 in the post-test, marking an 8.27% improvement. This study underscores the efficacy of Wayang educational video in augmenting scabies knowledge among Indonesian boarding school students, with a particular emphasis on the impact of a video titled "Malin and the Mite". This innovative cultural approach holds promise as a potential model for analogous regions, contributing to scabies prevention and advancing public health objectives.

Central and peripheral contrast sensitivity in thyroid eye disease.

Assessment of central and peripheral contrast sensitivity (CS) in thyroid eye disease (TED) with and without dysthyroid optic neuropathy (DON). This cross-sectional study enrolled 33 eyes of 18 treatment-naïve TED patients and 18 age- and sex-matched healthy controls for comparative analysis. A detailed ophthalmic examination included visual acuity (VA), intraocular pressure measurement, slit-lamp biomicroscopy, and CS testing (central and four peripheral regions) using Spaeth-Richman Contrast Sensitivity test was done. The average age of TED patients was 47.17 ± 13.99 years and a female preponderance was noted (66.66%, n = 12). Twenty-five eyes (75.8%) were diagnosed as TED without DON, while eight eyes (24.2%) had DON. Nine eyes (27.2%) were in the active stage of disease and 29 eyes (87.8%) had proptosis. The difference in mean logMAR visual acuities between TED patients and controls was statistically insignificant (P = 0.189), but a significant difference was noted in central and total CS score (P < 0.001, Wilcoxon-Mann-Whitney test). On CS comparison between DON and non-DON eyes, a significant difference in average scores was noted in central and all peripheral areas (P < 0.05, Wilcoxon-Mann-Whitney test). With increasing clinical activity score, a statistically significant reduction was noted in CS in three out of four peripheral regions (Spearman correlation, P < 0.05). Visual function compromise can be detected in TED in the presence of intact VA, by testing CS. Peripheral CS deteriorates with increasing inflammation and in DON. Serial monitoring of both central and peripheral CS may help in diagnosing DON early.

The Impact of Financial Education on Stress Among Orthopaedic Surgeons.

Financial stress has been an increasing area of concern for residents and attendings. The primary goal of this study was to determine the financial education level and differentiate financial outcome measures of orthopaedic surgery residents and attendings. A survey of all residents and attendings of the 201 Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic surgery programs in the United States. Total participation in the study was 118 residents (postgraduate year (PGY) 1-5), three fellows (PGY6), and 57 attending orthopaedic surgeons. A significant difference existed between average current financial stress scores between residents versus attending (2.32 vs 1.17), but not Doctor of Medicine (MD) versus Doctor of Osteopathic Medicine (DO) attendings (0.96 vs 1.67) and MD versus DO residents (2.25 vs 2.50). There was a significant difference in average future financial stress scores between residents and attendings (1.85 vs 1.44) and MD vs DO residents (1.61 vs 2.25) but no difference between MD vs DO attending (1.31 vs 1.63). Residents' confidence in financial knowledge compared to college graduates had a significantly negative Pearson coefficient with current financial stress score, while the attending group was not significant. Orthopaedic residents and attending physicians' financial stress levels are positively correlated with the amount of student debt they hold. Most residents who currently have no personal finance education offered in their residency would likely attend a personal finance course if offered. Decreasing the amount of debt held by residents, increasing their financial knowledge, and helping them develop good financial habits would likely lead to a decrease in financial stress.

Evaluation of ChatGPT for Patient Counseling in Kidney Stone Clinic: A Prospective Study.

Introduction: The potential of large language models (LLMs) is to improve the clinical workflow and to make patient care efficient. We prospectively evaluated the performance of the LLM ChatGPT as a patient counseling tool in the urology stone clinic and validated the generated responses with those of urologists. Methods: We collected 61 questions from 12 kidney stone patients and prompted those to ChatGPT and a panel of experienced urologists (Level 1). Subsequently, the blinded responses of urologists and ChatGPT were presented to two expert urologists (Level 2) for comparative evaluation on preset domains: accuracy, relevance, empathy, completeness, and practicality. All responses were rated on a Likert scale of 1 to 10 for psychometric response evaluation. The mean difference in the scores given by the urologists (Level 2) was analyzed and interrater reliability (IRR) for the level of agreement in the responses between the urologists (Level 2) was analyzed by Cohen's kappa. Results: The mean differences in average scores between the responses from ChatGPT and urologists showed significant differences in accuracy (p < 0.001), empathy (p < 0.001), completeness (p < 0.001), and practicality (p < 0.001), except for the relevance domain (p = 0.051), with ChatGPT's responses being rated higher. The IRR analysis revealed significant agreement only in the empathy domain [k = 0.163, (0.059-0.266)]. Conclusion: We believe the introduction of ChatGPT in the clinical workflow could further optimize the information provided to patients in a busy stone clinic. In this preliminary study, ChatGPT supplemented the answers provided by the urologists, adding value to the conversation. However, in its current state, it is still not ready to be a direct source of authentic information for patients. We recommend its use as a source to build a comprehensive Frequently Asked Questions bank as a prelude to developing an LLM Chatbot for patient counseling.

Comparison of Patient Demographics and Risk of Surgical Site Infections Following Open Reduction and Internal Fixation of Trimalleolar Ankle Fractures: A Nationwide Analysis of a Private Payor

Surgical site infections (SSIs) are a notable complication following open reduction and internal fixation (ORIF) for ankle fractures. The purpose of this study was to (1) compare baseline demographics of patients who did and did not develop SSIs within 90 days following ORIF for trimalleolar ankle fractures and (2) identify risk factors associated with SSIs in this setting. A retrospective analysis from 2010 to 2020 was completed using a national administrative database. The study group consisted of patients who underwent ORIF for trimalleolar ankle fractures and developed SSIs within 90 days postoperatively. Patients without SSIs served as the comparison cohort. Baseline demographics of the two cohorts were compared utilizing Pearson's Chi-Square Analyses. A multivariate binomial logistic regression model determined the association of various comorbidities on developing SSIs in this setting. Out of a total sample of 22,118 patients, 1000 individuals (4.52%) developed SSIs. The study revealed that the SSI cohort exhibited a greater burden of comorbidities, as evidenced by significant differences in various individual comorbidities and average Elixhauser-Comorbidity Indices scores. The most strongly associated risk factors for the development of SSIs following ORIF for trimalleolar ankle fractures were peripheral vascular disease (OR: 1.53, p < .0001), diabetes mellitus (OR: 1.26, p = .0010), iron deficiency anemia (OR: 1.24, p = .0010), male sex (OR: 1.22, p = .0010), and tobacco use (OR: 1.15, p = .0010). This study identified several patient risk factors that were associated with developing SSIs after ORIF for trimalleolar ankle fractures, recognizing potential patient-directed interventions that may reduce the rate of SSIs in this setting.

Development of mental education through sports to enhance adolescent personal resilience

Objective: Based on the problem at hand, the aim of this study was to investigate how adolescents' personal resilience is understood in the context of developing mental education through sports activities. Research Methods: This study used a quantitative research method with an experimental approach. This study used a sample of high school students (SMA) class XI which was taken by randomized sampling. The total sample of this study amounted to 50 students. Students who became the research sample were assumed to have the ability (in class XI) and the same age (average 16 years). Research results: The results show that there is an average difference between the Pre-test and Post-test physical education learning outcomes, which means that there is an average difference in students' personal resilience scores between the pre-test and post-test. These results indicate the influence of the results of mental education intervention through physical education in increasing students' personal resilience. In the implementation of the post-test, the average value is 100.3 while the average value of the post-test is 49.5, or if you look at the difference (gain) between the post-test and the pre-test of 50.4 which shows a significant result of increasing student resilience from the results of mental education interventions in sports education learning at school. Conclusion: Mental education development programs in adolescents should be tailored to the health interests of the adolescent generation. Sports clubs have the potential to be an arena for health improvement.

Polymorphisms in the CD6-ALCAM axis may modulate psoriasis risk and outcomes

The fact that CD6, along with its ligand – ALCAM, plays a role in regulating T cell activation makes the genes encoding these molecules promising candidates for research in T cell-mediated diseases such as psoriasis vulgaris (PsV). Our study aimed to determine whether CD6 (rs17824933C>G, rs11230563C>T and rs12360861G>A) and ALCAM (rs6437585C>T, rs11559013G>A) polymorphisms may affect psoriasis susceptibility and severity (assessed by Psoriasis Area and Severity Index (PASI)). Moreover, the presence of HLA-C*06:02, the strongest psoriasis risk factor in the Caucasian population, was also investigated. 273 patients diagnosed with psoriasis vulgaris and 256 blood donors with no history of PsV or other dermatoses were included in this study. Genotyping of the investigated polymorphisms was carried out using the allelic discrimination method with the application of TaqMan SNP Genotyping Assays. We observed the association of rs17824933G allele with a higher psoriasis risk in HLA-C*06:02(+) individuals (CG + GG vs CC, OR = 1.87, CI95% = 1.03; 3.37, p = 0.0350). Furthermore, we found a difference in average PASI score among groups of patients divided according to the number of CD6 and ALCAM polymorphic sites with minor alleles (F2,173 = 6.159, p = 0.0026). Collectively, our findings suggest that polymorphisms of CD6-ALCAM axis genes may modulate psoriasis risk and outcomes.

Non-medical Use of Prescription Psychostimulants and Academic Performance in Medical Students

Objective: It is well-known that healthy medical students use psychostimulants to improve their cognitive functions and reduce their need for sleep. The main motivation behind this cognitive enhancement is to increase academic performance. However, the literature is not clear enough to support this situation.&#x0D; Methods: This cross-sectional study was conducted with an online survey and 585 students participated. The grade point average number was used to assess the student' academic performance. Additionally, the scale based on self-evaluations was used to assess levels of pharmaceutical knowledge, study performance, academic success, academic anxiety, and study performance.&#x0D; Results: Out of 585 healthy students, 40 (7.3%) admitted to using psychostimulants to enhance their academic performance. However, there was no significant difference in grade point average scores and perceived academic success levels between users and non-users. Nonetheless, most of the users reported that they benefited from taking psychostimulant drugs. Risk factors for non-medical use of prescription psychostimulants included high levels of pharmacology knowledge, smoking, and poor academic performance.&#x0D; Conclusion: Although non-medical use of prescription psychostimulants did not appear to affect academic performance significantly, most students reported positive subjective experiences, which could have a motivational effect. Therefore, it is crucial to investigate the benefits and side effects of psychostimulants in healthy young individuals in more detail and to provide them with up-to-date information on this issue.

Juvenile Myasthenia Gravis in North Texas: Clinical Features, Treatment Response, and Outcomes

BackgroundJuvenile myasthenia gravis (JMG) is a rare autoimmune disease that causes fatigable muscle weakness in children aged <18 years. There is currently no curative treatment or internationally accepted standard of care for JMG. The objective is to investigate relationships between clinical presentation, antibody status, severity of disease onset, electrodiagnostic evaluation, and response to therapy in JMG. MethodsThis study was a retrospective chart review. Congenital myasthenic syndromes were excluded. Data on demographics, treatments, and outcomes were collected. Disease severity was evaluated using Myasthenia Gravis Foundation of America (MGFA) clinical classifications. ResultsWe identified 84 patients with JMG at Children's Medical Center Dallas between January 2014 and February 2022. It was found that 52% of patients presented with ocular JMG (median onset age 4.5 years) and 48% with generalized JMG (median onset age 11.5 years); 81% tested positive for acetylcholine receptor antibodies. Patients were 17% non-Hispanic white, 29% Hispanic, 39% black, and 12% Asian. There was a significant difference in average MGFA scores between ethnicities (P = 0.047) and age groups (P = 0.004), with postpubertal patients having higher average MGFA scores than prepubertal patients. Seventy-one percent of patients who underwent thymectomy experienced a decrease in MGFA scores postprocedure. ConclusionsOur study showed that there were significant differences in disease severity between ethnicities and age groups and that most patients who underwent thymectomy showed clinical improvement. These outcomes highlight the need for additional therapies in the treatment of JMG and the importance of extending clinical trials to the pediatric population.

Examination of Mental Resilience Levels in Veteran Tennis Players

This research aimed to explore the disparities in mental resilience levels among veteran tennis players concerning age, gender, and weekly training frequency. The survey method was employed, utilizing a survey technique as part of the screening process. The study involved 358 volunteer veteran tennis players, with 85 females and 273 males, who completed the mental resilience scale. The "Sports Mental Resilience Scale" and a researcher-prepared personal information form were used. The scale showed good reliability with Cronbach's Alpha coefficients of 0.81 for Confidence, 0.74 for Persistence, and 0.71 for Control. Statistical analysis was conducted using SPSS 26.0. Normal distribution was confirmed through Skewness, Kurtosis values, and the Levene Test. Parametric tests, such as Independent Sample T Test and One Way ANOVA, were used when significant differences emerged between groups. The Scheffe test was applied to identify the sources of differences. Results revealed no statistically significant difference in average mental resilience scores based on gender (p&gt;0.05). However, significant differences were found in Confidence and Persistence sub-dimensions based on age (p&lt;0.05), as well as in the Confidence sub-dimension and total scores based on weekly training frequency (p&lt;0.05). In summary, this study investigated the relationship between mental resilience levels and variables like gender, age, and weekly training frequency among veteran tennis players. It found that these factors indeed impact the mental resilience of veteran tennis players, contributing new insights to the field and future research.

Chat-GPT on brain tumors: An examination of Artificial Intelligence/Machine Learning’s ability to provide diagnoses and treatment plans for example neuro-oncology cases

ObjectiveAssess the capabilities of ChatGPT-3.5 and 4 to provide accurate diagnoses, treatment options, and treatment plans for brain tumors in example neuro-oncology cases. MethodsChatGPT-3.5 and 4 were provided with twenty example neuro-oncology cases of brain tumors, all selected from medical textbooks. The artificial intelligence programs were asked to give a diagnosis, treatment option, and treatment plan for each of these twenty example cases. Team members first determined in which cases ChatGPT-3.5 and 4 provided the correct diagnosis or treatment plan. Twenty neurosurgeons from the researchers’ institution then independently rated the diagnoses, treatment options, and treatment plans provided by both artificial intelligence programs for each of the twenty example cases, on a scale of one to ten, with ten being the highest score. To determine whether the difference between the scores of ChatGPT-3.5 and 4 was statistically significant, a paired t-test was conducted for the average scores given to the programs for each example case. ResultsIn the initial analysis of correct responses, ChatGPT-4 had an accuracy of 85% for its diagnoses of example brain tumors and an accuracy of 75% for its provided treatment plans, while ChatGPT-3.5 only had an accuracy of 65% and 10%, respectively. The average scores given by the twenty independent neurosurgeons to ChatGPT-4 for its accuracy of diagnosis, provided treatment options, and provided treatment plan were 8.3, 8.4, and 8.5 out of 10, respectively, while ChatGPT-3.5’s average scores for these categories of assessment were 5.9, 5.7, and 5.7. These differences in average score are statistically significant on a paired t-test, with a p-value of less than 0.001 for each difference. ConclusionsChatGPT-4 demonstrates great promise as a diagnostic tool for brain tumors in neuro-oncology, as attested to by the program’s performance in this study and its assessment by surveyed neurosurgeon reviewers.

Point-of-care testing preferences 2020–2022: Trends over the years

BackgroundThe use of point-of-care (POC) tests prior to the COVID-19 pandemic was relatively infrequent outside of the healthcare context. Little is known about how public opinions regarding POC tests have changed during the pandemic. MethodsWe redeployed a validated survey to uncompensated volunteers to assess preferences for point-of-care testing (POCT) benefits and concerns between June and September 2022. We received a total of 292 completed surveys. Linear regression analysis was used to compare differences in survey average response scores (ARSs) from 2020-2022. ResultsRespondent ARSs indicated agreement for all 16 POCT benefits in 2022. Of 14 POCT concerns, there were only two statements that respondents agreed with most frequently, which were that “Insurance might not cover the costs of the POC test” (ARS 0.9, +/- 1.0) and “POC tests might not provide a definitive result” ( ARS 0.1, +/- 1.0). Additionally, when comparing survey responses from 2020-2022, we observed 8 significant trends for POCT harms and benefits. ConclusionsThe public’s opinion on POC tests has become more favorable over time. However, concerns regarding the affordability and reliability of POCT results persist. We suggest that stakeholders address these concerns by developing accurate POC tests that continue to improve care and facilitate access to healthcare for all.

Klinik Anatomi Eğitimi Verilen Anesteziyoloji ve Reanimasyon Anabilim Dalı Araştırma Görevlilerinin Eğitim Hakkındaki Görüşlerinin Değerlendirilmesi: Bir Üniversite Örneği

Introduction: Anatomy is considered one of the cornerstones of medical education. In-depth understanding of anatomy is essential, especially for safe clinical practice in surgical disciplines. This study aimed to evaluate the feedback of research assistants in the department of anesthesiology and reanimation, who received clinical anatomy education.&#x0D; Methods: Clinical anatomy education was provided for research assistants at different levels in the department of anesthesiology and reanimation, with two hours per week, and the education was completed within one month. The 5-point Likert scale questionnaire consisting of 18 questions was administered to research assistants to gather their opinions about education. Participants were asked to rate the questions on a scale from 1 to 5. Additionally, data such as age, gender, duration of clinical experience, experience with neuroaxial or peripheral nerve blocks, and participation in regional anesthesia courses were recorded.&#x0D; Results: A total of 40 participants, including 15 (37.5%) males and 25 (62.5%) females, with an average age of 29.67 ± 3.94 years, were included in the study. Nearly all participants in our study reported that integrated clinical anatomy education is necessary. The majority mentioned that anatomy education would contribute to airway management and regional anesthesia applications. The participation rate in regional anesthesia courses before education was 17.5%. There was no significant difference in average questionnaire scores between those who participated in regional anesthesia courses and those who did not (p=0.06).&#x0D; Conclusion: In the process of anesthesiology and reanimation specialization training, we believe that incorporating clinical anatomy education would enhance the quality of specialization education, thereby improving safety and effectiveness in clinical applications.

A study of the impact of an interprofessional education module in Vietnam on students' readiness and competencies.

The literature puts forward a range of challenges of interprofessional education (IPE) related to its planning, initiation, implementation, and especially to IPE assessment. The present study aims to map changes in students' readiness and interprofessional collaboration competence (IPCC) in implementing an innovative IPE module. Potential differences in impact related to the health education programs and IPCC scores resulting from self-, peer-, and tutor assessments will also be analysed. A pre-post design was adopted. The student's readiness for interprofessional learning was assessed using the Readiness for Interprofessional Learning Scale, and the student's IPCC score was calculated based on self-, peer-, and tutor assessments with the interprofessional collaborator assessment rubric. Students' mean post-test readiness scores and mean post-test IPCC scores were significantly higher than the total and subscales/domain pre-test scores (p<0.01). No significant within-subject differences were observed in students' readiness total or subscale scores when comparing health educational programs. However, significant differences were observed in students' mean total IPCC scores between programs (p<0.01). Significant differences in students' average IPCC scores were found when comparing self-, peer- and tutor assessment scores in six domains (p<0.01). Also, significant correlations between peer and tutor assessment scores were observed (p<0.01). The IPE module, designed and implemented to focus on patient-centred practice within a primary care context, positively impacted students' readiness and IPCC development. These results offer insights to expand the implementation of the IPE module to all health educational programs.