Complementary Assessment Research Articles

Clinical Validation of the Preterm Oral Feeding Readiness Assessment Scale in Taiwan

PurposeA successful transition from gavage to full oral feeding is a decisive indicator for discharging premature infants from the neonatal intensive care unit. A clinically useful measure of oral feeding readiness would help nurses initiate implementation of the cue-based feeding model in Taiwan. The study aimed to assess the validity and reliability of the Traditional Chinese Preterm Oral Feeding Readiness Assessment Scale (TC-POFRAS). Design and methods81 preterm infants were enrolled and assessed by TC-POFRAS regarding their oral feeding readiness. This study included two phases. Phase 1 conducted a cross language validation procedure and item-level content validity indices (I-CVIs) for content validity were estimated. In phase 2, Cronbach's alpha for internal consistency at each category and total scale levels were estimated. A receiver operating characteristic (ROC) curve was estimated to explore the scale's performance. The optimal cut-off value of TC-POFRAS was identified by the best Youden's Index [maximum (sensitivity + specificity − 1)]. ResultsAll of the I-CVIs were 1.00. The whole Cronbach's alpha for internal consistency was 0.804 (95% CI = 0.736–0.862), and Cronbach's alpha values were between 0.538 (95% = 0.332–0.689) and 0.687 (95%CI = 0.572–0.781) for categories. The area under ROC was 92.2%, and an optimal cut-off value of TC-POFRAS was 29 (sensitivity: 0.938, specificity: 0.941). ConclusionsThe TC-POFRAS has been verified to be an effective and accurate instrument to determine the initiation of oral feeding in preterm infants. Practice implicationsThe TC-POFRAS is an appropriate and complementary assessment instrument for professionals to conveniently use in clinical practice.

Material flow analysis of forest biomass in Portugal to support a circular bioeconomy

A comprehensive understanding of how resources are utilized is required to support a circular bioeconomy. This article presents the first systematic assessment of forest biomass flows and stocks in Portugal and analyzes circularity and resource efficiency through a comprehensive set of indicators, while providing recommendations for their use and improvement in different contexts. A Material Flow Analysis was developed for 2015, including paper, wood panels, furniture, carpentry, packaging, other woodwork, and energy (firewood, pellets, charcoal, electricity, heat), addressing uncertainty. Material flow analysis indicators (e.g., domestic material consumption) and circularity/resource efficiency indicators (cascade factor, material circularity indicator, recycled input, recovery rate) were assessed. In 2015, 49% of forest biomass was used for energy and 51% for material production. The wood sector in Portugal is heterogeneous regarding circularity. Paper and wood packaging were the most recycled products (highest material circularity indicator: 0.49 and recovery rate: 54%), while the panels sector used the most industrial residues (highest cascade factor: 3.78). The indicators analyzed provided a complementary assessment of circularity, giving both system wide (cascade factor) and sector- (cascade factor, recycled input rate, recovery rate) or product-based (material circularity indicator) views. Cascade factor permits an analysis of the whole system and of separate sectors, and an assessment of post-consumer and industrial residues, and both material and energy use. Material circularity indicator considers closed- and open-loop recycling of post-consumer residues, being complementary to the cascade factor. Indicators providing complementary perspectives are important to capture multiple types of resource use and valorization within the bioeconomy system.

Complementary assessment of γ-irradiated polyurethane-POSS hybrids by chemiluminescence and differential scanning calorimetry

A series of segmental polyurethane organic inorganic hybrids with polyhedral oligomeric silsesquioxanes (POSS) incorporated along the chain contour on the hard segments is irradiated by γ radiation at doses up to 100 kGy. The effects of this treatment on the morphology of the materials and the low temperature stability to oxidation are assessed complementary by non-isothermal and isothermal chemiluminescence experiments as well as with differential scanning calorimetry. From the methodological point of view, it was found that both physical and chemical processes have a footprint on both methods, but the physical ones manifest themselves more intensely in the thermal method, whereas chemical ones in chemiluminescence. Due to γ-exposure the onset oxidation temperatures decrease by several degrees, but POSS seems to protect the material to some extent. γ-Irradiation damage has also a negative effect on the development of phase separation, which is further enhanced by the presence of POSS. The crystallinity of the soft segments in the matrix is completely suppressed by irradiation, however, even a small amount of POSS preserves the phenomenon.

The use of text-based responses to improve our understanding and prediction of suicide risk.

Text-based responses may provide significant contributions to suicide risk prediction, yet research including text data is limited. This may be due to a lack of exposure and familiarity with statistical analyses for this data structure. The current study provides an overview of data processing and statistical algorithms for text data, guided by an empirical example of 947 online participants who completed both open-ended items and traditional self-report measures. We give an introduction to a number of text-based statistical approaches, including dictionary-based methods, topic modeling, word embeddings, and deep learning. We analyze responses from the open-ended question "How do you feel today?", detailing characteristics of the responses, as well as predicting past-year suicidal ideation. We see the analysis of text from social media, open-ended questions, and other text sources (i.e., medical records) as an important form of complementary assessment to traditional scales, shedding insight on what we are missing in our current set of questionnaires, which may ultimately serve to improve both our understanding and prediction of suicide.

Total diffusion volume in MRI vs. total lesion glycolysis in PET/CT for tumor volume evaluation of multiple myeloma.

This study compared the tumor burden and prognostic impact of total diffusion volume (tDV) and total lesion glycolysis (TLG) in the same patients with newly diagnosed multiple myeloma (NDMM) simultaneously. We also examined the relationship between these imaging tumor volumes (TVs) and plasma cell (PC) TV in bone marrow (BM) specimens. We retrospectively reviewed the data of 63 patients with newly diagnosed multiple myeloma (NDMM) from April 2016 to March 2018. tDV was calculated from whole-body diffusion-weighted imaging and TLG was calculated from the average standard uptake value and the metabolic tumor volume, respectively. Cellularity of BM hematopoietic tissue and the percentage of BM PCs were used as a reference of PC volume in the BM. The Spearman correlation coefficient between tDV and TLG was moderate (ɤs = 0.588, p < 0.001) when PET false-negative patients were excluded. There were positive correlations between the BM plasma cell volume (BMPCV) and the imaging TVs (ɤs = 0.505, vs. tDV; and 0.464, vs. TLG). Patients with high tDV and high TLG, as determined by the receiver operating characteristic curve, had worse survival; moreover, patients with both high tDV and high TLG showed the worst prognosis (median progression-free and overall survival: 13.2 and 28.9 months, respectively). Although tDV and TLG each reflected the total TV, in several cases, tDV and TLG were discrepant due to the biological features of each MM. It is important to use both modalities for complementary assessment of total tumor burden and biological characteristics in MM. • Total diffusion volume (tDV) and total lesion glycolysis (TLG) reflect the total tumor volume and have prognostic value in patients with multiple myeloma (MM). • tDV and TLG could assess MM from different biological perspectives and should be considered for each patient individually.

Conceptual Thinking in Statistics and Data Science Education: Interactive Formative Assessment with Meaning Equivalence Reusable Learning Objects (MERLO)

Computer age statistics, machine learning, data science and in general, data analytics, are having an ubiquitous impact on industry, business and services. Deploying a data transformation strategy requires a workforce which is up to the job in terms of knowledge, experience and capabilities. The application of analytics needs to address organizational needs, invoke proper methods, build on adequate infrastructures and ensure availability of the right skills to the right people. such upskilling requires a focus on conceptual understanding affecting both the pedagogical approach and the complementary learning assessment tools, This paper is about the application of advanced educational concepts to the teaching and evaluation of statistical and data science related concepts. Two educational elements will be included in the discussion: i) the use of simulations to facilitate problem based experiential learning and ii) an emphasis on information quality, as the overall objective of statistics and data science activity. We begin with an introduction to conceptual thinking and meaning equivalence and the application of Meaning Equivalence Reusable Learning Objects (MERLO) in the classroom. We then describe how MERLO and concept science can be applied in the domain of Statistics and Data Science. Section 3 is about the use of simulations in statistical education. In section 4 we discuss practical aspects of an education program focused on conceptual understanding. Section 5 is on the conceptual mapping of information quality as a MERLO infrastructure. The paper concludes with a discussion.

Validity and reliability of the complementary and integrative health assessment for practitioners scale: CIHAPTR

Validity and reliability of the complementary and integrative health assessment for practitioners scale: CIHAP_TR

Contribution of MRI in Extension Assessment of Cervical Cancer in Yaound&amp;#233; (Cameroon)

Background: Cervical cancer is one of the most common cancers, requiring a precise complementary assessment. The aim of this study was to contribute to the improvement of the management of cervical cancer by describing the MRI aspects of cervical cancer according to the IFOG-MRI classification. Material and Methods: This was a cross-sectional study, conducted in patients who came for clinical suspicion, extension assessment of histologically confirmed cervical cancer, from October 2020 to March 2021, in Yaounde (Cameroon). Results: 54 patients were selected, with an average age of 50.4 years. Genital hemorrhage was the most frequent symptom (92%). The mean tumor size was 52.9 mm. According to IFOG staging, stages Ia, Ib, IIa, IIb, IIIa, IIIb, and IV accounted for 9.10%, 10.20%, 12.50%, 29.50%, 5.70%, 12.50%, and 20% respectively. No patient had known metastasis at the time of examination. Conclusion: MRI allows non-invasive, satisfactory tumor staging examination by providing information on tumor size, parametrium invasion, adjacent organ involvement, and the presence of lymph node metastasis.

Protein decomplexation and proteomics: A complementary assessment method of the physicochemical purity of antivenom

The quality of antivenom is governed by its safety and efficacy profiles. These quality characteristics are much influenced by the purity of antivenom content. Rigorous assessment and meticulous monitoring of antivenom purity at the preclinical setting is hence crucial. This study aimed to explore an integrative proteomic method to assess the physicochemical purity of four commercially available antivenoms in the region. The antivenoms were subjected to Superdex 200 HR 10/30 size-exclusion fast-protein liquid chromatography (SE-FPLC). The proteins in each fraction were trypsin-digested and analyzed by nano-ESI-liquid chromatography-tandem mass spectrometry (LC-MS/MS). SE-FPLC resolved the antivenom proteins into three major protein components of very high (>200 kDa), high (100–120 kDa) and medium (<60 kDa) molecular weights. The major components (80–95% of total proteins) in the antivenoms were proteins of 100–120 kDa consisting of mainly the light and partially digested heavy immunoglobulin chains, consistent with F(ab’)2 as the active principle of the antivenoms. However, LC-MS/MS also detected substantial quantity of large proteins (e.g. alpha-2-macroglobulins), immunoglobulin aggregates and impurities e.g. albumins in some products. The method is practical and able to unveil the quantitative and qualitative aspects of antivenom protein compositions. It is therefore a potentially useful preclinical assessment tool of antivenom purity.

Effectiveness of Concept Mapping’s Efficiency in Differential Equations

One of the existing approaches in students’ performance evaluation is to use concept mapping. There are lots of studies indicate that concept mappings can be used to evaluate the knowledge of mathematical concepts in a useful way. The best and most comprehensive way of learning is organizing study. Organizing is an expanding meaning strategy. Concept mapping is a simple way to organize and relate information, if vaguely. Lines, words, signs, and symbols are used in concept mappings. In this study, the use of concept mappings in differential equations has been investigated. To do so, a case study of understanding differential equations unit has been conducted in 90 students from Azad University. To begin with, the students went under seven sessions of differential equations of grade one, and another group was taught differential equations in a traditional way. After that, the results obtained were evaluated using SPSS software and Mann-Whitney U test to reach the conclusion. The results indicate the effectiveness of concept mappings. The students show ability to recognize the structure of differential equations that cannot be seen in the results of a traditional teaching method. In addition, the misunderstandings in misconceptions of such structures can be revealed. Therefore, it can be recommended to use the concept maps about differential equations as a complementary assessment tool along with common written tests. &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Digital health for real-time monitoring of a national immunisation campaign in Indonesia: a large-scale effectiveness evaluation

ObjectiveTo assess the contribution of a digital health real-time monitoring platform towards the achievement of coverage targets during a national immunisation campaign in Indonesia.InterventionsA digital health platform was introduced to...

Self-Coping Strategies Among Jordanian Athletes During Ramadan Fasting: A Questionnaire Proposal

: This study aims to categorize the adaptation strategies of Muslim athletes who fast during Ramadan and proposes a self-coping strategy questionnaire as a complementary assessment tool. A total of 109 Jordanian Muslim athletes (mean age 20.0 ± 8.5 years) were surveyed by completing a self-coping questionnaire designed to classify an individual athlete’s level of adaptation. This study was conducted during the month of Ramadan 2019 and developed based on the training, nutritional, psychological, self-control, and recovery dimensions. Seventy percent of athletes found that they developed good or very good coping mechanisms. Coping strategies vary from one dimension to another, but in general, athletes often had a positive perceived coping. Athletes expressed that they are shifting the training hours with a preference for quality training rather than quantity and associated with a longer rest time. In addition, they were in favor of food hygiene associated with a strategy of sharing meals and providing water. The majority (59%) of the athletes said they were psychologically prepared for the potential effects of fasting. This research shows that athletes develop self-adjusting strategies to counter the effects of fasting. The questionnaire on the self-coping strategies provides important and precise information on the level of coping achieved by the athletes.

Performance of diagnostic ultrasound to identify causes of hydramnios.

We aimed to assess the diagnostic yield of ultrasonography in the identification of the etiology of hydramnios, and the added value of MRI or amniocentesis. We conducted a single-center retrospective study including pregnancies with confirmed hydramnios (defined as deepest pocket ≥8 cm) between January 2013 and May 2017. Twin pregnancies, secondary hydramnios discovered after the diagnosis of a causal pathology, and pregnancies of unknown outcome were excluded. All pregnancies underwent a targeted scan, and selected cases underwent MRI or amniocentesis. A total of 158 patients with confirmed hydramnios were included. Hydramnios was associated with a fetal pathology in 37 cases (23.4%), with diabetes in 39 (24.6%), isolated macrosomia in 16 (10.1%), and considered idiopathic in 66 (41.7%). Ultrasonography established a diagnosis of the underlying pathology in 73% of cases. Amniocentesis was done in 31 cases (20%) and it allowed diagnosis of chromosome anomalies, esophageal atresia, myotonic dystrophy congenital type, Prader-Willi syndrome, and Bartter syndrome. MRI was done in 15 cases (10%) and it allowed one additional diagnosis of esophageal atresia. The diagnostic yields of MRI and amniocentesis were 91.7% and 95.2%, respectively. There were five false positive diagnoses at ultrasonography, and one false positive diagnosis at MRI. Hydramnios can be associated with a wide variety of underlying pathologies. Diagnostic ultrasound can attain a diagnosis in the majority of cases. Amniocentesis offers a valuable complementary assessment.

The Assessment of Pragmatic Skills in Young Deaf and Hard of Hearing Children.

The development of pragmatic skills does not often receive attention by professionals who are recommending or undertaking assessment of deaf and hard of hearing (DHH) children, yet social communication is vital for linguistic, social, emotional, and academic development. We acknowledge the challenges that DHH children have with pragmatic skills, advocate for monitoring of pragmatic development for all DHH children by medical professionals, and provide direction for assessment of pragmatic skills in young DHH children, particularly for clinicians and teachers who are tasked with that work. Pragmatic assessment is challenging because it must involve observations of the child in interaction with a communication partner, either directly during a specific interaction or through the reflections of a familiar adult. In this article, we recommend two complementary assessment procedures for young DHH children who use spoken language. Assessment 1 recommends that a parent or caregiver completes The Pragmatic Checklist to provide a picture of the child's functional communication. In assessment 2, the information gained through the checklist is complemented by using direct observations of a child in interaction with an adult or a peer. The Pragmatic Protocol uses a video-recorded conversation sample between the child and familiar person that is analyzed by a DHH professional for 30 different pragmatic behaviors. We conclude this article with a recommendation for pediatricians and health care professionals to monitor pragmatic developmental milestones in DHH children, to refer them for pragmatic assessments, and to collaborate with researchers to develop valid, reliable tools that adequately capture the pragmatic skill strengths and needs of DHH children.

A new perspective on transient characteristics of quiet stance postural control.

Postural control provides insight into health concerns such as fall risk but remains relatively untapped as a vital sign of health. One understudied aspect of postural control involves transient responses within center of pressure (CoP) data to events such as vision occlusion. Such responses are masked by common whole-trial analyses. We hypothesized that the transient behavior of postural control would yield unique and clinically-relevant information for quiet stance compared to traditionally calculated whole-trial CoP estimates. Three experiments were conducted to test different aspects of this central hypothesis. To test whether transient, epoch-based characteristics of CoP estimates provide different information than traditional whole-trial estimates, we investigated correlations between these estimates for a population of young adults performing three 60-second trials of quiet stance with eyes closed. Next, to test if transient behavior is a result of sensory reweighting after eye closure, we compared transient characteristics between eyes closed and eyes open conditions. Finally, to test if there was an effect of age on transient behavior, we compared transient characteristics during eyes closed stance between populations of young and older adults. Negligible correlations were found between transient characteristics and whole-trial estimates (p>0.08), demonstrating limited overlap in information between them. Additionally, transient behavior was exaggerated during eyes closed stance relative to eyes open (p<0.044). Lastly, we found that transient characteristics were able to distinguish between younger and older adults, supporting their clinical relevance (p<0.029). An epoch-based approach captured unique and potentially clinically-relevant postural control information compared to whole-trial estimates. While longer trials may improve the reliability of whole-trial estimates, including a complementary assessment of the initial transient characteristics may provide a more comprehensive characterization of postural control.

Complementary pre-operative risk assessment using coronary computed tomography angiography and nuclear myocardial perfusion imaging in non-cardiac surgery: A VISION-CTA sub-study

BackgroundThe incremental value and optimal utilization of non-invasive testing for prediction of peri-operative cardiac events during non-cardiac surgery are not clear. MethodsA sub-study of VISION-CTA was performed using patients who underwent both coronary computed tomography angiography (CCTA) and nuclear myocardial perfusion imaging (MPI) as part of their pre-operative assessment. CCTA images were compared with MPI to determine the correlation between ischemia and obstructive coronary artery disease (CAD). Patients were followed post-operatively for 30 days and primary outcomes were all-cause death and non-fatal myocardial infarction. The predictive capacity of CCTA and nuclear MPI in predicting peri-operative major adverse cardiac event (MACE) was analyzed. ResultsA total of 55 patients (mean age 68.5 ± 8.4 years, 80.0% male) were analyzed. There was a strong correlation between the degree of obstructive CAD and the severity of perfusion abnormalities. Patients with severe CAD (≥ 70% stenosis) had a higher summed stress score than those without severe CAD [4.88 ± 1.22 and 1.30 ± 0.62, respectively (P < .05)]. Similarly summed difference score was significantly higher in patients with severe CAD [1.33 ± 0.46 and 0.17 ± 0.17 (P < .05)]. At 30 days there was a total of 8 (14.5%) MACE. The rate of MACE was higher in patients with severe CAD than those without (20.7% and 7.7%, respectively). Myocardial ischemia appeared to be predictive of MACE with an unadjusted odds ratio of 14.63 (P = .003). The predictive capacity of MPI further improved when only those patients with severe CAD were included (33.00) with a sensitivity, specificity, positive predictive value, and negative predictive value of 100% (79.4-100.0), 72.7% (49.8-89.3), 50.0% (21.1-78.9), and 100% (79.4-100.0), respectively. ConclusionAlthough patients with significant obstructive disease are at risk of peri-operative MACE, the absolute event rate is low. Our data, albeit hypothesis generating, suggest that the peri-operative risk may be refined further by employing nuclear MPI in those with obstructive disease on CCTA.

Socio-technical transitions in UK electricity: part 1 – history, actors and pathways

A large interdisciplinary consortium of engineers, social scientists and policy analysts has developed three low-emissions, more-electric transition pathways for the UK. The approach is based on earlier work on understanding transitions, applying a multi-level perspective with landscape, regime and niche levels to the development of socio-technical scenarios. The pathways to 2050 focus on the power sector, including the potential for increasing the use of low-emissions electricity for heating and transport. Part 1 describes studies of historical energy and infrastructure transitions that help to understand the dynamics and timing of past transitions. The role of large-scale and small-scale actors in the electricity sector and methods used to develop the pathways are then described. In part 2, associated technologies are evaluated to determine the choices that need to be made by UK energy policymakers and stakeholders. All three pathways are appraised in terms of their environmental performance using complementary life-cycle assessment and footprinting methods. Lessons can clearly be drawn for other industrialised nations attempting to reduce the emissions from their electricity generation systems, although local circumstances will determine country- and region-specific options.

Socio-technical transitions in UK electricity: part 2 – technologies and sustainability

A large interdisciplinary consortium of engineers, social scientists and policy analysts has developed three low-emissions, more-electric transition pathways for the UK. The approach is based on earlier work on understanding transitions, applying a multi-level perspective with landscape, regime and niche levels to the development of socio-technical scenarios. The pathways to 2050 focus on the power sector, including the potential for increasing the use of low-emissions electricity for heating and transport. Part 1 described studies of historical energy and infrastructure transitions that help to understand the dynamics and timing of past transitions. The role of large-scale and small-scale actors in the electricity sector and methods used to develop the pathways were also described. In part 2, associated technologies are evaluated to determine the choices that need to be made by UK energy policymakers and stakeholders. All three pathways are appraised in terms of their environmental performance using complementary life-cycle assessment and footprinting methods. Lessons can clearly be drawn for other industrialised nations attempting to reduce the emissions of their electricity generation systems, although local circumstances will determine country- and region-specific options.

Diffusion MRI as a complementary assessment to cognition, emotion, and motor dysfunction after sports-related concussion: a systematic review and critical appraisal of the literature.

Sports-related concussion (SRC) is a complex and heterogeneous injury with psychological, cognitive and functional consequences. Advances in diffusion magnetic resonance imaging (dMRI) allow sensitive measurement of white matter pathology post-SRC and may provide insight into injury and recovery. We systematically reviewed and meta-analyzed the literature examining dMRI alongside cognitive, emotional or motor assessments to determine relationships between these analyses. Sixteen studies examining young athletes (n = 6) or retired professionals (n = 10) met the inclusion criteria, with 12 emotional, 10 cognitive and four motor assessments. Studies had heterogeneous methodology, moderate quality and modest sample sizes. Fractional anisotropy (FA) was the most frequent dMRI metric, with SRC-induced changes described most commonly in the frontal lobe and least in the cerebellum and brainstem. There is an emerging complementary role for dMRI as part of a comprehensive assessment battery for SRC. However, larger-scale studies with broader subject populations (specifically, in females and in the 30-45year age range) are needed to corroborate findings and determine the true diagnostic utility of dMRI post-SRC.

Toxicity tests in wastewater and drinking water treatment processes: A complementary assessment tool to be on your radar

Wastewater discharges from cities and industries, especially megacities, and intensive livestock can be considered as main sources of pollution of our rivers and groundwater. Water pollution, therefore, constitutes a major threat to both aquatic ecosystems and human health. Here we address the influence of chemical pollution in waste- and drinking water, their associated potential toxicological effects, as well as, the available technologies for their removal. This opinion paper provides illustrative selected examples covering a broad range for both drinking water and wastewater treatment processes, for which a battery of toxicity tests is applied for their risk assessment. The examples are classified based on five hot topics: (i) Bioassays for toxicity evaluation, (ii) Toxicity of municipal wastewaters, (iii) Toxicity of pharmaceutical residues and hospital wastewaters, (iv) Toxicity of other non-urban effluent examples, and (v) Drinking water treatment processes and toxicity evaluation. 'Chemical analysis combined with batteries of bioassays covering a broad range of endpoints: cytotoxicity, endocrine disruption, genotoxicity, and other types seem to be good way to assess performance/efficiency of the water treatment processes when removing chemical contaminants.. Altogether, while recognizing that water treatment is a cornerstone for water pollution reduction, providing safe water for both human use and its return back to the aquatic environment will be undoubtedly enhanced with the use of ecotoxicity biomonitoring.