Composite Score Research Articles

The impact of sustainable investment on firm performance in South Africa

Purpose: This study investigates the influence of environmental, social, and governance (ESG) scores on the financial performance of firms in South Africa across industries. Motivation: In the context of the growing importance of sustainability reporting, understanding the link between ESG and firm performance is critical for informed and sustainable corporate strategies. Design/Methodology/Approach: The study employs panel data regression techniques on secondary data from 120 Johannesburg Stock Exchange-listed firms between 2015 and 2020. Main Findings: Overall, the composite ESG scores do not significantly affect the financial performance of South African companies. However, scores from social and governance pillars show a positive association with firm performance, while environmental scores have a limited effect. Practical Implications/Managerial Impact: These findings suggest that not all ESG activities are equally relevant for firm profitability. Corporate managers should prioritise industry-relevant ESG pillars to enhance firm profitability. Novelty/Contribution: The study expands empirical evidence in an emerging market context, analysing the impact of disaggregated ESG scores and providing comparative industry-specific analysis. This contributes to a nuanced understanding of the ESG-performance nexus.

Uncovering emotional and network dynamics in the speech of patients with chronic low back pain

BackgroundComputational linguistics allows an understanding of language structure and different forms of expression of patients’ perceptions. AimsThe aims of this study were (i) to carry out a descriptive analysis of the discourse of people with chronic low back pain using sentiment analysis (SA) and network analysis; (ii) to verify the correlation between patients’ profiles, pain intensity and disability levels with SA and network analysis; and (iii) to identify clusters in our sample according to language and SA using an unsupervised machine learning technique. MethodsWe performed a secondary analysis of a qualitative study including participants with chronic non-specific low back pain. We used the data related to participants’ feelings when they received the diagnosis. The SA and network analysis were performed using the Valence Aware Dictionary and sEntiment Reasoner, and the Speech Graph, respectively. Clustering was performed using the K-means algorithm. ResultsIn the SA, the mean composite score was −0.31 (Sd. = 0.58). Most participants presented a negative discourse (n = 41; 72%). Word Count (WC) and Largest Strongly connected Component (LSC) positively correlated with education. No statistically significant correlations were observed between pain intensity, disability levels, SA, and network analysis. Two clusters were identified in our sample. ConclusionThe SA showed that participants reported their feeling when describing the moment of the diagnosis using sentences with negative discourse. We did not find a statistically significant correlation between pain intensity, disability levels, SA, and network analysis. Education level presented positive correlation with WC and LSC.

Does sleep quality affect balance? The perspective from the somatosensory, vestibular, and visual systems

ObjectivePrevious studies have focused on the balance system's involvement in sleep deprivation or disorders. This study investigated how daily routine sleep quality affects the balance system of people without sleep deprivation or diagnosed sleep disorders. MethodsThe study included 45 participants with a BMI score of <25. The PSQI was used to determine sleep quality. The SOT, HS-SOT, and ADT evaluated the vestibular system's functionality. ResultsIn SOT, condition 3, 4, 5, and 6 composite scores, VIS and VEST composite balance scores, and HS-SOT 5 scores were lower in the HPSQI group. At the same time, there is a statistically significant negative correlation between these scores and PSQI scores. ConclusionPoor sleep quality may be a factor influencing the balance system. Sleep quality affects the visual and vestibular systems rather than the somatosensory system. The population should be made aware of this issue, and clinicians should consider the potential impact of sleep quality when evaluating the balance system.

Association of maternal pre-pregnancy or first trimester body mass index with neurodevelopmental impairment or death in extremely low gestational age neonates.

To compare the rates of death or survival with severe neurodevelopmental impairment (sNDI) at 2 years among extremely preterm infants in relation to pre-pregnancy or first-trimester maternal body mass index (BMI). This retrospective cohort study included extremely preterm infants (gestational age 220/7-266/7 weeks). The study was conducted at National Institute of Child Health and Human Development Neonatal Research Network sites. The primary outcome was death or sNDI at 2 years. Data on the primary outcome were available for 1208 children. Death or sNDI was not different among the three groups: 54.9% in normal, 56.1% in overweight, and 53.4% in obese group (p = 0.39). There was no significant difference in mortality, sNDI, moderate/severe cerebral palsy, Bayley Scales of Infant Development (BSID)-III cognitive composite score <70, BSID-III language composite score <70 in adjusted models. Neurodevelopmental outcome was not significantly associated with maternal pre-pregnancy BMI among extreme preterm infants.

Higher purpose in life and education were associated with better cognition among older adults.

With aging, some cognitive abilities change because of neurobiological processes. Cognition may also be influenced by psychosocial aspects. To describe the relationship between a measure of neuroticism, depression symptoms, purpose in life, and cognitive performance in community-dwelling older adults. This was a cross-sectional analysis based on the data from the second wave of the Frailty in Brazilian Older Adults (FIBRA) study, carried out between 2016 and 2017. The sample consisted of 419 older people (≥ 72 years old) cognitively unimpaired and mostly with low education. The variables of interest were sociodemographic, Neuroticism domain from the NEO-PI-R, Geriatric Depression Scale (GDS), Purpose in Life (PiL) scale, and a cognitive composite score which included the Mini-Mental State Examination (MMSE), and the scores for the sub-items of the Mini-Addenbrooke's Cognitive Examination (M-ACE), namely, Verbal Fluency (VF) - Animal, Clock Drawing Test (CDT), Episodic Memory (name and address). There was a greater number of women (70%), with older age (median = 80 years, IQR = 77-82), and low education (median = 4 years, IQR = 2-5). In the bivariate correlations, years of education (ρ = 0.415; p < 0.001) and PiL (ρ = 0.220; p < 0.001) were positively associated with cognition. Neuroticism (ρ = -0.175; p < 0.001) and depression symptoms (ρ = -0.185; p < 0.001) were negatively associated with cognition. In the logistic regression, after including confounding variables, the associations between cognition and PiL (OR = 2.04; p = 0.007) and education (OR = 1.32; p < 0.001) remained significant. Low PiL and low education levels were associated with worse cognition among older adults. Such results may be of relevance in programs that aim to improve cognition among older adults.

Early-life stress and the gut microbiome: A comprehensive population-based investigation

Early-life stress (ELS) has been robustly associated with a range of poor mental and physical health outcomes. Recent studies implicate the gut microbiome in stress-related mental, cardio-metabolic and immune health problems, but research on humans is scarce and thus far often based on small, selected samples, often using retrospective reports of ELS. We examined associations between ELS and the human gut microbiome in a large, population-based study of children.ELS was measured prospectively from birth to 10 years of age in 2,004 children from the Generation R Study. We studied overall ELS, as well as unique effects of five different ELS domains, including life events, contextual risk, parental risk, interpersonal risk, and direct victimization. Stool microbiome was assessed using 16S rRNA sequencing at age 10 years and data were analyzed at multiple levels (i.e. α- and β-diversity indices, individual genera and predicted functional pathways). In addition, we explored potential mediators of ELS-microbiome associations, including diet at age 8 and body mass index at 10 years.While no associations were observed between overall ELS (composite score of five domains) and the microbiome after multiple testing correction, contextual risk – a specific ELS domain related to socio-economic stress, including risk factors such as financial difficulties and low maternal education – was significantly associated with microbiome variability. This ELS domain was associated with lower α-diversity, with β-diversity, and with predicted functional pathways involved, amongst others, in tryptophan biosynthesis. These associations were in part mediated by overall diet quality, a pro-inflammatory diet, fiber intake, and body mass index (BMI).These results suggest that stress related to socio-economic adversity – but not overall early life stress – is associated with a less diverse microbiome in the general population, and that this association may in part be explained by poorer diet and higher BMI. Future research is needed to test causality and to establish whether modifiable factors such as diet could be used to mitigate the negative effects of socio-economic adversity on the microbiome and related health consequences.

Design and baseline characteristics of SALT-HF trial: hypertonic saline therapy in ambulatory heart failure.

Hypertonic saline solution (HSS) plus intravenous (IV) loop diuretic appears to enhance the diuretic response in patients hospitalized for heart failure (HF). The efficacy and safety of this therapy in the ambulatory setting have not been evaluated. We aimed to describe the design and baseline characteristics of the SALT-HF trial participants. 'Efficacy of Saline Hypertonic Therapy in Ambulatory Patients with HF' (SALT-HF) trial was a multicenter, double-blinded, and randomized study involving ambulatory patients who experienced worsening heart failure (WHF) without criteria for hospitalization. Enrolled patients had to present at least two signs of volume overload, use ≥ 80mg of oral furosemide daily, and have elevated natriuretic peptides. Patients were randomized 1:1 to treatment with a 1-h infusion of IV furosemide plus HSS (2.6-3.4% NaCl depending on plasmatic sodium levels) versus a 1-h infusion of IV furosemide at the same dose (125-250mg, depending on basal loop diuretic dose). Clinical, laboratory, and imaging parameters were collected at baseline and after 7days, and a telephone visit was planned after 30days. The primary endpoint was 3-h diuresis after treatment started. Secondary endpoints included (a) 7-day changes in congestion data, (b) 7-day changes in kidney function and electrolytes, (c) 30-day clinical events (need of IV diuretic, HF hospitalization, cardiovascular mortality, all-cause mortality or HF-hospitalization). A total of 167 participants [median age, 81years; interquartile range (IQR), 73-87, 30.5% females] were randomized across 13 sites between December 2020 and March 2023. Half of the participants (n=82) had an ejection fraction >50%. Most patients showed a high burden of comorbidities, with a median Charlson index of 3 (IQR: 2-4). Common co-morbidities included diabetes mellitus (41%, n=69), atrial fibrillation (80%, n=134), and chronic kidney disease (64%, n=107). Patients exhibited a poor functional NYHA class (69% presenting NYHA III) and several signs of congestion. The mean composite congestion score was 4.3 (standard deviation: 1.7). Ninety per cent of the patients (n=151) presented oedema and jugular engorgement, and 71% (n=118) showed lung B lines assessed by ultrasound. Median inferior vena cava diameter was 23mm, (IQR: 21-25), and plasmatic levels of N-terminal-pro-B-type natriuretic peptide (NTproBNP) and antigen carbohydrate 125 (CA125) were increased (median NT-proBNP 4969pg/mL, IQR: 2508-9328; median CA125 46U/L, IQR: 20-114). SALT-HF trial randomized 167 ambulatory patients with WHF and will determine whether an infusion of hypertonic saline therapy plus furosemide increases diuresis and improves decongestion compared to equivalent furosemide administration alone.

ADSS: A Composite Score to Detect Disease Progression in Alzheimer's Disease.

Composite scores have been increasingly used in trials for Alzheimer's disease (AD) to detect disease progression, such as the AD Composite Score (ADCOMS) in the lecanemab trial. To develop a new composite score to improve the prediction of outcome change. We proposed to develop a new composite score based on the statistical model in the ADCOMS, by removing duplicated sub-scales and adding the model selection in the partial least squares (PLS) regression. The new AD composite Score with variable Selection (ADSS) includes 7 cognitive sub-scales. ADSS can increase the sensitivity to detect disease progression as compared to the existing total scores, which leads to smaller sample sizes using the ADSS in trial designs. ADSS can be utilized in AD trials to improve the success rate of drug development with a high sensitivity to detect disease progression in early stages.

Long-term medical and quality of life outcomes among voluntary liver donors

BackgroundLong-term medical and quality of life outcomes in voluntary liver donors remain under investigated. The objective of the current study was to report long-term medical outcomes and re-evaluate quality of life in living liver donors. MethodsThis was a single center retrospective cohort study of donors who underwent donor hepatectomy between 2012 and 2018. We investigated long-term outcomes in seven domains. These include medical problems, surgical procedures, work related issues, pregnancy outcomes, psychiatric interventions, willingness to donate again, and long-term mortality. Quality of life was evaluated using short-form 36. ResultsThe median follow-up time was 61.4(53.3-83.7) months. Among 698 donors, 80 (11.5%) experienced medical problems, four (0.6%) had work related issues, and 20(2.9%) needed psychiatric assistance. Surgery was performed in 49(7%) donors, and females were more likely to have undergone incisional hernia repair (5.8% vs. 1.9%, P=0.006). There were 79 post-donation pregnancies including 41(51.9%) normal vaginal deliveries, 35(44.3%) cesarean sections, and three (3.8%) miscarriages. Willingness to donate again was reported by 658(94.3%) donors. Donors whose recipients were alive were more likely to donate again (95.5% vs. 90.5%, P=0.01). There were three (0.4%) deaths in the long-term. The mean physical composite score at initial and follow-up evaluation was 86.7±13.9 and 76.5± 20.9(P=0.001), and the mean mental composite score at initial and follow-up evaluation was 92.1± 13.5 and 80.7 ±16 (P=0.001). ConclusionThe overall long-term outlook in living liver donors looks promising. Quality of life parameters might deteriorate over time and frequent re-evaluation might be considered.

Technological entrepreneurship readiness

Technological entrepreneurship presents opportunities for accelerated growth during the Fourth Industrial Revolution and assessing the readiness for such entrepreneurship would be important to investors (interested in profit) and governments (interested in economic growth). The aim was to assess and rank the BRICS (Brazil, Russia, India, China, and South Africa) countries on their level of technological entrepreneurship readiness, as to direct investor funding or alternatively guide government initiatives. Data which was collected in Brazil, Russia, India, China, and South Africa, for the World Values Survey, was used in the study (N=13 895). Mean and composite scores linked to entrepreneurship as well as the embracement of technology were compared across countries. These were combined to generate a score used to rank the countries. With each of the individual, as well as the composite variables, significant differences were found across the BRICS countries. China was rated the highest on attitudes towards science while South Africa was rated highest on the openness to entrepreneurship. On the composite score, technology entrepreneurship readiness, China scored the highest. China was ranked as the BRICS countries most viable for technology entrepreneurship. Technology investors should thus consider directing their venture capital eastward. The governments of the other countries should take note of their shortcomings and the results could inform policies to enhance readiness. The results, at a theoretical level, provided some insights into the conceptualisation of technology-related entrepreneurship.&#x0D;

Development and validation of serological dynamic risk score to predict outcome in gastric cancer with adjuvant chemotherapy: a multicentre, longitudinal, cohort study.

Baseline serological biomarkers have the potential to predict the benefits of adjuvant chemotherapy in patients with gastric cancer. However, the fluctuating nature of postoperative recurrence risk makes precise treatment challenging. We aimed to develop a risk score in real-time predicting outcomes for postoperative GC patients using blood chemistry tests. This was a retrospective, multicentre, longitudinal cohort study from three cancer centres in China, with a total of 2737 GC patients in the pTNM stage Ib to III. Among them, 1651 patients with at least two serological records were assigned to the training cohort. Model validation was carried out using separate testing data with area under curve (AUC). The least absolute shrinkage and selection operator (LASSO) and random forest-recursive feature elimination (RF-RFE) algorithm were used to select the parameters. The Cox regression model derived six risk factors to construct a composite score (low-risk: 0-2 score; high risk: 3-6 score), including CEA, CA125, CA199, haemoglobin, albumin, and neutrophil to lymphocyte ratio. The risk score accurately predicted mortality in 1000-time bootstrap (AUROCs:0.658; 95% CI: 0.645, 0.670), with the highest AUROC (0.767; 95% CI: 0.743, 0.791) after 1 year since the gastrectomy. In validation dataset, the risk score had an AUROC of 0.586 (95% CI 0.544, 0.628). Furthermore, patients with high risk at 1 month derived significant clinical benefits from adjuvant chemotherapy (P for interaction <0.0001). Compared with the low-low-low risk group, the low-low-high risk group of the long-term state chain (risk state at baseline, 6 months, 1 year) had the worse OS (HR, 6.91; 95%CI: 4.27, 11.19) and DFS (HR, 7.27; 95%CI: 4.55, 11.63). The dynamic risk score is an accurate and user-friendly serological risk assessment tool for predicting outcomes and assisting clinical decisions after gastrectomy.

Financial toxicity in early-onset colorectal cancer: A National Health Interview Survey study

BackgroundFinancial toxicity is increasingly recognized as a devastating outcome of cancer treatment but is poorly characterized in patients with early-onset colorectal cancer. Young patients are particularly vulnerable to financial toxicity as they are frequently underinsured and may suffer significant disruptions to professional and financial growth. We hypothesized that financial toxicity associated with colorectal cancer treatment confers long-lasting effects on patients’ well-being and disproportionately impacts patients diagnosed at <50 years of age. MethodsA retrospective cross-sectional analysis of the National Health Interview Survey from years 2019 to 2021 was performed. Patients with a history of colorectal cancer were included and stratified by age at diagnosis. Randomly selected age-matched controls with no cancer history were used for comparison. The primary endpoint was financial toxicity, as assessed by a composite score formulated from 12 National Health Interview Survey items. The secondary endpoint was food security assessed by the United States Department of Agriculture’s food security scale, embedded in the National Health Interview Survey. ResultsWhen compared to age-matched controls, patients with colorectal cancer experienced significant financial toxicity, as reflected by a composite financial toxicity score (P = .027). Within patients with colorectal cancer, female sex (adjusted odds ratio = 1.46, P = .046) and early-onset disease (adjusted odds ratio = 2.11, P = .002) were found to significantly increase the risk of financial toxicity. Patients with early-onset colorectal cancer more frequently experienced food insecurity (P = .011), delayed necessary medical care (P = .053), mental health counseling (P = .043), and filling prescriptions (P = .007) due to cost when compared to patients with average-onset colorectal cancer. ConclusionColorectal cancer is associated with significant long-term financial toxicity, which disproportionately impacts patients diagnosed at <50 years of age. Targeted interventions are warranted to reduce financial toxicity for patients with high-risk colorectal cancer.

Lifetime Exposure to Depression and Neuroimaging Measures of Brain Structure and Function

Despite decades of neuroimaging studies reporting brain structural and functional alterations in depression, discrepancies in findings across studies and limited convergence across meta-analyses have raised questions about the consistency and robustness of the observed brain phenotypes. To investigate the associations between 6 operational criteria of lifetime exposure to depression and functional and structural neuroimaging measures. This cross-sectional study analyzed data from a UK Biobank cohort of individuals aged 45 to 80 years who were enrolled between January 1, 2014, and December 31, 2018. Participants included individuals with a lifetime exposure to depression and matched healthy controls without indications of psychosis, mental illness, behavior disorder, and disease of the nervous system. Six operational criteria of lifetime exposure to depression were evaluated: help seeking for depression; self-reported depression; antidepressant use; depression definition by Smith et al; hospital International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnosis codes F32 and F33; and Composite International Diagnostic Interview Short Form score. Six increasingly restrictive depression definitions and groups were defined based on the 6 depression criteria, ranging from meeting only 1 criterion to meeting all 6 criteria. Data were analyzed between January and October 2022. Functional measures were calculated using voxel-wise fractional amplitude of low-frequency fluctuation (fALFF), global correlation (GCOR), and local correlation (LCOR). Structural measures were calculated using gray matter volume (GMV). The study included 20 484 individuals with lifetime depression (12 645 females [61.7%]; mean [SD] age, 63.91 [7.60] years) and 25 462 healthy controls (14 078 males [55.3%]; mean [SD] age, 65.05 [7.8] years). Across all depression criteria, individuals with lifetime depression displayed regionally consistent decreases in fALFF, LCOR, and GCOR (Cohen d range, -0.53 [95% CI, -0.88 to -0.15] to -0.04 [95% CI, -0.07 to -0.01]) but not in GMV (Cohen d range, -0.47 [95 % CI, -0.75 to -0.12] to 0.26 [95% CI, 0.15-0.37]). Hospital ICD-10 diagnosis codes F32 and F33 (median [IQR] difference in effect sizes, -0.14 [-0.17 to -0.11]) and antidepressant use (median [IQR] difference in effect sizes, -0.12 [-0.16 to -0.10]) were criteria associated with the most pronounced alterations. Results of this cross-sectional study indicate that lifetime exposure to depression was associated with robust functional changes, with a more restrictive depression definition revealing more pronounced alterations. Different inclusion criteria for depression may be associated with the substantial variation in imaging findings reported in the literature.

The Potential Usefulness of Peripheral Somatosensory Stimulation in Improving Sleep Quality in Patients with Insomnia

Background Insomnia and other sleep disorders represent a major cause of disability and impaired productivity. We evaluated the impact of peripheral somatosensory stimulation (PSS) on sleep quality in 12 patients with varying degrees of insomnia. Methods Twelve adult patients underwent daily PSS therapy for a 4-week period and were evaluated using the Insomnia Severity Index at baseline (prior to initiation of therapy) and then at the conclusion of the treatments. All data were obtained through a self-reported 7-question survey evaluating overall severity of insomnia symptoms and the impact of sleep patterns on satisfaction with sleep, daily functioning, and overall quality of life. Changes from baseline insomnia scores were analyzed using cumulative link mixed models (CLMMs). Results Seven men and five women completed one month of PSS therapy. Mean age was 55.1 (range 29 to 80 years). No adverse events were described by the patients. The average total change from baseline score was -10.3 points (baseline: 16.5 vs. week 4: 6.2). Patients had statistically significant improvements for every individual survey question by week 4. The median composite score was improved from baseline, with an overall median score of 2 (IQR: 1.25 – 2.75, min-max: 1-4) at baseline compared to 0.5 (IQR: 0 – 0.25, min-max: 0-2) by week 4 (MD = -1 95% CI: , p &lt; 0.001), signaling typically moderate insomnia at baseline vs. typically minimal to no symptoms by week 4. The predicted probability of obtaining the best outcome (score=0) was 9% at baseline vs. 53% by week 4. The overall cumulative odds ratio was 11.9 (p &lt; 0.001), suggesting that on average, the odds of moving from one score to a lower (improved) score at week 4 compared to the baseline are approximately 12 times higher than moving to a neutral or worse score. Conclusions PSS stimulation appeared to have a significantly favorable effect on sleep quality in this group of patients. Symptoms related to ability to fall asleep, remain asleep, and overall quality of sleep were all improved with PSS therapy. We suggest that further investigation into the potential usefulness of PSS therapy in patients with sleep disorders is warranted.

Evaluation Method of Texture of Glutinous Rice Cakes (Niangao) and Its Key Impact Indicators.

This study aimed to find a unique method to assess the textural properties of Niangao (glutinous rice cakes), to determine the relationship between the textural properties of rice cakes and the indicators of glutinous rice, and to identify the key indicators that significantly affect the textural properties of Niangao. The study encompassed the analysis of the chemical composition and pasting characteristics of 22 glutinous rice varieties, revealing the substantial impact of variety on lipid content, straight-chain starch content, and pasting performance. Subsequently, the textural features of the resulting Niangao were subjected to principal component analysis (PCA) to derive a mathematical method for evaluating their textural attributes, with the obtained scores employed in hierarchical cluster analysis (HCA) to identify 12 key textural characteristics. Further analysis using stepwise linear regression (SLR) demonstrated that the regression model incorporating final and peak viscosities of the glutinous rice significantly predicted the composite score of the Niangao's textural properties. This highlights the importance of final and peak viscosities as key indicators for assessing the textural quality of Niangao.

Associations between metabolic profiles and incident CKD in the Chinese population aged 45-85years.

The roles of metabolic indices in predicting chronic kidney disease (CKD) were lacking. This study aimed to examine the concomitant impact of metabolic and novel anthropometric indices on incident CKD in the Chinese populations. This prospective cohort study included 1825 males and 2218 females aged between 45 and 85years, derived from the ongoing prospectively cohort of China Health and Retirement Longitudinal Study (CHARLS), from 2011 to 2015. The outcome was defined as an estimated glomerular filtration rate (eGFR) < 60mL/min/1.73 m2. During the 5-years follow-up period, 3.0% (55/1825) of males and 4.1% (90/2218) of the females developed CKD. After multivariable adjustment, elevated triglyceride (TG), low high-density lipoprotein cholesterol (HDL-C), serum uric acid (sUA), elevated visceral fat index (VFI), elevated body shape index (BSI) and elevated body roundness index (BRI) in males, and sUA, and BRI in females were the independent predictors for CKD. Composite scores, composed of sUA, history of cardiovascular disease (CVD), waist circumstance (WC), HDL-C, and BRI in males and sUA, hypertension, and BRI in females were constructed that could accurately predict CKD. Our study found that elevated levels of TG, sUA, BSI, BRI, and diminished HDL in males and elevated levels of sUA, and BRI in females, are indicative of the incident CKD. The composite score, integrating a history of disease, metabolic indices, and noval anthropometric indices, could accurately differentiate individuals with and without incident CKD, proving useful for CKD care and management.

The association between fetal intracranial hemorrhages detected on MRI and neurodevelopment

PurposeFetal intracranial hemorrhage is rarely identified in prenatal imaging. When identified, sparse data regarding neurodevelopmental outcomes worsens prenatal dilemmas. This MRI-based study aimed to assess prenatal characteristics and neurodevelopmental outcomes of fetal intracranial hemorrhage. MethodsA historical cohort study which identified fetal intracranial hemorrhage in 22 individual fetal MRI scans, as part of the assessment of abnormal prenatal sonographic findings. Severity was graded by the grading system commonly used in neonates, with modifications. Prenatal data was collected. Neurodevelopmental outcome was assessed clinically by Vineland-II Adaptive Behavior Scales. ResultsEight fetuses had intraventricular hemorrhage grade I-II, twelve had intraventricular hemorrhage grade III-IV, and two had infratentorial hemorrhage. The most prevalent risk factors were maternal chronic diseases and chronic use of medications. There was male predominance. Pregnancy was terminated in eleven cases. No surviving child who participated in the Vineland assessment had a grade IV hemorrhage. Vineland scores were normal in 9/11 children and moderately low in 2/11. The mean composite score of the cohort was not different from the mean score expected for age. Clinically, one child had hypotonia. ConclusionsPrognosis for fetuses with ICH without parenchymal involvement is potentially more favorable than expected from the intraventricular hemorrhage grading-scale adopted from the preterm neonates. Parenchymal involvement may predict a worse outcome, but it is not the sole predicting feature. This information may be valuable during prenatal counseling.

Stress Appraisals and Coping across and within Academic, Parent, and Peer Stressors: The Roles of Adolescents’ Emotional Problems, Coping Flexibility, and Age

The aim of this study was to determine whether adolescents’ emotional problems, coping flexibility, age, and stress appraisals account for ways of coping, which include engagement and disengagement coping, with academic-, parent-, and peer-related stressful events. Stress appraisals were defined as perceived threats to the psychological needs of relatedness, competence, and autonomy. Models were fit at a higher order level, indicated by adolescents’ appraisals and intended ways of coping with stress in three domains (i.e., academic, parent, and peer) and tested at the lower level within each domain. Adolescents (N = 410; age 10–15; Mage = 12.5; 50% girls) reported their emotional problems (combined depressive and anxiety symptoms) and coping flexibility six months prior to completing an analogue task. The task involved viewing six short film clips portraying stressful events (e.g., obtaining a worse than expected exam grade or arguing with a parent) and reporting three stress appraisals and eight ways of coping after each stressor. The ways of coping were analyzed as four composite scores reflecting engagement coping (active coping, self-reliance) or disengagement coping (withdrawal coping, helplessness). In structural equation models, adolescents who appraised more threat reported more withdrawal coping and helplessness but also more active coping and self-reliance. Adolescents with more emotional problems appraised more threat and anticipated using less constructive ways of coping, whereas adolescents higher in coping flexibility intended to use more constructive ways of coping, with these associations sufficiently modeled at the general (across stress domains) level. Improvement in the model fit was found when appraised threat–coping associations were modeled at the lower (specific stressor domain) level, suggesting differences by stressor domain. Age was associated with more self-reliance and helplessness, with self-reliance being specific to parent stressors and helplessness specific to peer stressors.

Developing a practical neurodevelopmental prediction model for targeting high-risk very preterm infants during visit after NICU: a retrospective national longitudinal cohort study

BackgroundFollow-up visits for very preterm infants (VPI) after hospital discharge is crucial for their neurodevelopmental trajectories, but ensuring their attendance before 12 months corrected age (CA) remains a challenge. Current prediction models focus on future outcomes at discharge, but post-discharge data may enhance predictions of neurodevelopmental trajectories due to brain plasticity. Few studies in this field have utilized machine learning models to achieve this potential benefit with transparency, explainability, and transportability.MethodsWe developed four prediction models for cognitive or motor function at 24 months CA separately at each follow-up visits, two for the 6-month and two for the 12-month CA visits, using hospitalized and follow-up data of VPI from the Taiwan Premature Infant Follow-up Network from 2010 to 2017. Regression models were employed at 6 months CA, defined as a decline in The Bayley Scales of Infant Development 3rd edition (BSIDIII) composite score > 1 SD between 6- and 24-month CA. The delay models were developed at 12 months CA, defined as a BSIDIII composite score < 85 at 24 months CA. We used an evolutionary-derived machine learning method (EL-NDI) to develop models and compared them to those built by lasso regression, random forest, and support vector machine.ResultsOne thousand two hundred forty-four VPI were in the developmental set and the two validation cohorts had 763 and 1347 VPI, respectively. EL-NDI used only 4–10 variables, while the others required 29 or more variables to achieve similar performance. For models at 6 months CA, the area under the receiver operating curve (AUC) of EL-NDI were 0.76–0.81(95% CI, 0.73–0.83) for cognitive regress with 4 variables and 0.79–0.83 (95% CI, 0.76–0.86) for motor regress with 4 variables. For models at 12 months CA, the AUC of EL-NDI were 0.75–0.78 (95% CI, 0.72–0.82) for cognitive delay with 10 variables and 0.73–0.82 (95% CI, 0.72–0.85) for motor delay with 4 variables.ConclusionsOur EL-NDI demonstrated good performance using simpler, transparent, explainable models for clinical purpose. Implementing these models for VPI during follow-up visits may facilitate more informed discussions between parents and physicians and identify high-risk infants more effectively for early intervention.

Evaluating the performance of ChatGPT and Perplexity AI in Business Reference

The Thomas Mahaffey Jr. Business Library conducted a study to assess the performance of two competing generative AI products, ChatGPT and Perplexity AI, in answering business reference questions. The study used a data set consisting of a sample of anonymized reference questions submitted through the library’s ServiceNow ticketing system between January 2018 and May 2022. The questions were input as prompts to each competing AI. Responses were collected and evaluated by their performance in four separate dimensions relevant to business reference: accessibility, library referral, quality, and serendipity. Each dimension was scored on a 0-5 Likert scale resulting in a final composite performance score for each AI. Results showed similar and underwhelming performance between each AI at the composite level. Analysis of scores in each individual scoring dimension showed greater variance in the score distributions between the competing AI. Through the evaluation process, key strengths, weaknesses, and trends emerged between each AI. The study provides a quantitative measure of where generative AI stands in its capabilities in a business library reference context, and it recommends, based on the results of the evaluation, making use of generative AI in its current iteration as a supplementary tool for business reference as opposed to considering it as a replacement.