Comprehensive Assessment Tool Research Articles

High-resolution regional climate–CFD integrated modelling to inform climate responsive design of northern buildings in a changing climate

In permafrost regions, where climate change poses significant challenges to infrastructure stability, understanding the thermal behaviour of buildings is crucial. This study conducts a detailed investigation into the thermal performance of elevated buildings in permafrost regions within the context of a changing climate. High-resolution regional climate simulation-informed computational fluid dynamics (CFD) models were developed for northern buildings. The findings indicate that the presence of elevated buildings can disrupt the permafrost’s natural thermal equilibrium in the future. This disturbance can extend vertically and horizontally, potentially leading to altered ground temperature gradients and increased air and ground temperatures by 4.25% and 3.85%, respectively. The research findings also highlight a 12.75% reduction in wind speed beneath the study building when transitioning from the local scale (i.e., single-building) to the neighbourhood scale (i.e. with surrounding buildings). These results underscore the critical significance of exploring the neighbourhood scale in building design and planning within permafrost regions, emphasizing the need for comprehensive assessment tools to inform effective strategies and decisions. The holistic approach adopted in this study, sets out a clear vision to guide northern adaptation initiatives that address some of the climate change issues in the buildings’ design by utilizing integrated climate system-built environment modelling.

Navigating the Fourth Industrial Revolution: SBRI - A Comprehensive Digital Maturity Assessment Tool and Road to Industry 4.0 for Small Manufacturing Enterprises

Navigating the Fourth Industrial Revolution: SBRI - A Comprehensive Digital Maturity Assessment Tool and Road to Industry 4.0 for Small Manufacturing Enterprises

Development and validation of the Oral Lichen Planus-Disease Activity Scale: a novel tool for comprehensive clinical assessment.

To develop and validate the Oral Lichen Planus-Disease Activity Scale (OLP-DAS) for assessing overall disease activity of OLP. The OLP-DAS was created by refining the Thongprasom criteria, incorporating inputs from the literature and expert review, and integrating pain assessment. Content validity was evaluated in a virtual meeting with 8 Oral Medicine specialists. Reliability and validity of the final version were examined. Seventeen OLP subjects were assessed for disease activity by 10 investigators using the OLP-DAS, Oral Disease Severity Score (ODSS), OLP-Investigator Global Assessment (OLP-IGA), and Reticular-Erythema-Ulcerative (REU) scale. Convergent validity was assessed by rating 160 OLP subjects using the OLP-DAS, ODSS, and OLP-IGA. Inter-rater and intra-rater reliability, along with convergent validity, were analyzed using intraclass correlation coefficients (ICCs) and Spearman's rank correlation coefficients (rs). The final OLP-DAS achieved excellent content validity indices. Inter-rater and intra-rater ICCs for total OLP-DAS scores were 0.93 and 0.96, respectively. Total OLP-DAS scores exhibited strong positive correlations with the ODSS and OLP-IGA (rs = 0.94 and rs = 0.76; P < 0.001, respectively). The OLP Severity Index (OLP-SI), a component of the OLP-DAS, showed very strong positive correlations with OLP disease activity parameters of the ODSS (rs = 0.90; P < 0.001). The OLP-DAS is a valid and reliable clinician-reported outcome measure (CROM) for evaluating OLP disease activity. The OLP-DAS, as a standardized CROM for OLP, is valuable for both routine clinical assessments and research applications.

Young Adults' Daily Participation Scale: A measure of objective and subjective participation.

Participation in occupations is considered essential for individuals' health and wellbeing. Participation is a multidimensional construct that encompasses objective and subjective dimensions that transform over the course of life. Nonetheless, there is a lack of comprehensive measures that examine young adults' participation in age-appropriate activities. Therefore, we developed the Young Adults' Daily Participation Scale (YADAPS) and aimed to explore its psychometric properties. In Study 1, the content validity of the YADAPS was established based on nine experts. Its internal consistency, criterion, convergent, and construct validity were explored among 115 typical young adults (21-35 years). Using a different sample, Study 2 examined YADAPS discriminant validity among 33 young adults with developmental coordination disorder (DCD) and 52 typical peers. No consumer and community involvement was included in these studies. The relevance of YADAPS items was sufficient. Internal consistency was acceptable to excellent in most scales (.74 ≤α≤ .89). Criterion validity was supported by correlations between the subjective participation scales and a wellbeing measure. Convergent validity was found for all scales. No gender effect was observed (p≥ .05). However, significant differences (p≤ .05) were found between individuals with and without DCD. The YADAPS appears to be a promising measure of objective and subjective dimensions of participation in young adults. The results support the importance of examining various participation dimensions, including occupational experience. Thus, it may be used for clinical purposes among young adults as well as for occupational science research, to broaden our understanding on the interplay between participation dimensions in various life situations in young adulthood. However, further research is needed on psychometric properties, the most suited scoring method, and to consolidate their robustness among diverse populations of young adults. Participation, or how one engages in daily life activities, greatly affects wellbeing. The activities in one's routine change over the lifespan, in accordance with one's developmental phase. Existing assessments of participation have limitations, like not considering young adults' concerns or only focussing on certain aspects of participation. By focussing on both the objective-observable and subjective-experiential aspects of participation, the Young Adults' Daily Participation Scale (YADAPS) strives to be a comprehensive assessment tool designed specifically for reflecting activities relevant in young adulthood. This manuscript provides preliminary validity and reliability for the YADAPS, a new questionnaire that assesses objective and subjective aspects of participation in activities relevant for individuals in young adulthood. Furthermore, the questionnaire is able to distinguish between young adults with and without participation difficulties; therefore, it is suitable for research and clinical use.

Epidemiological Study on Developmental Coordination Disorder in School Going Children

Introduction: Developmental coordination disorder (DCD) has garnered significant attention in recent years, with rapid advancements in our understanding of this condition. Despite this progress, DCD often goes undiagnosed, making it challenging for children, parents, and educators to access essential resources. The motor difficulties associated with DCD can lead to social exclusion, as peers may be reluctant to invite these children to participate in play activities. Consequently, children with DCD may withdraw from leisure pursuits, perceiving themselves as lacking the necessary skills to engage fully. Objective: The primary objective of this study was to identify DCD in non-referred school-aged children. Early identification enables these individuals to access crucial resources, such as physiotherapy interventions, which can maximize their functional, academic, and psychosocial performance, and overall quality of life. Materials and Methods: The study involved 200 non-referred school-going children aged 4-12 years from Bangalore, selected through random sampling. The Movement Assessment Battery for Children (M-ABC), consisting of 32 organized tasks across four sets covering manual dexterity, ball skills, and dynamic balance, was administered. Additionally, the Test of Gross Motor Development (TGMD), comprising 12 tasks that assess a child’s ability to accomplish various motor skills, and the Child Behavior Checklist (CBCL), a 113-item inventory describing children’s psychosocial behavior, were utilized to evaluate overall development. Results: Multivariate analysis identified a significant prevalence of DCD among the study participants. The findings underscore the imperative nature of early identification using comprehensive assessment tools for the well-being and psychosocial adaptation of school-aged children. Conclusions: These findings indicate that children with movement problems are at risk for difficulties in attention, learning, and psychosocial adjustment. Regardless of the kind or intensity, a child’s assessment for movement issues should cover a broad variety of functions in addition to motor skills. This comprehensive approach will enable access to essential resources, such as physiotherapeutic interventions, crucial for their overall development.

Quantifying urban spatial resilience using multi-criteria decision analysis (MCDA) and back propagation neural network (BPNN)

In the face of rapid urbanization and increasing environmental risks, building resilient cities has become a global priority. This study introduces a novel methodology for quantifying urban spatial resilience by integrating multi-criteria decision analysis (MCDA) and back propagation neural network (BPNN). The urban spatial resilience assessment system encompasses five critical criteria layers (urban spatial scale, structure, form, function, and network resilience) and 29 indicator layers. An empirical study of Yinchuan City, China, demonstrates the effectiveness of the MCDA-BPNN model in quantifying urban spatial resilience. The models identified significant disparities in resilience between central and peripheral urban zones, with central areas showing higher resilience scores compared to peripheral areas. This spatial pattern was most pronounced in structure, functional and network resilience. These results contribute to the field of urban environmental science by advancing the fundamental understanding of urban spatial resilience mechanisms and their spatial distribution. The study has significant implications for urban planners, policymakers, and risk management authorities, enabling data-driven decision-making and the development of targeted, resilience-oriented urban policies and strategies. The MCDA-BPNN approach offers a promising tool for comprehensive urban resilience assessment in diverse urban contexts.

Data Literacy and Data Science Literacy for Nurses: State of the Art Literature Review.

In the rapidly evolving landscape of modern healthcare, nurses must proficiently navigate data utilization and grasp the principles of data science. Despite this urgency, nursing stakeholders currently do not fully understand the extent of data literacy or data science literacy they need to acquire. This paper aims to elucidate the distinctions between data literacy and data science literacy, offering insights into strategies for nurturing these competencies within nursing education, research, and practice. Through a state-of-the-art review of 22 articles and six healthcare industry resources, we identified a notable absence of comprehensive frameworks and assessment tools, highlighting key areas for future development.

Microcirculatory dysfunction in hypertrophic cardiomyopathy with chest pain assessed by angiography-derived microcirculatory resistance

Chest pain, a common initial symptom in hypertrophic cardiomyopathy (HCM) patients, is closely linked to myocardial ischemia, despite the absence of significant coronary artery stenosis. This study explored microvascular dysfunction in HCM patients by employing angiography-derived microcirculatory resistance (AMR) as a novel tool for comprehensive assessment. This retrospective analysis included HCM patients with chest pain as the primary symptom and control patients without cardiac hypertrophy during the same period. The AMR was computed through angiography, providing a wire-free and adenosine-free index for evaluating microcirculatory function. Propensity score matching ensured balanced demographics between groups. This study also investigated the correlation between the AMR and clinical outcomes by utilizing echocardiography and follow-up data. After matching, 76 HCM patients and 152 controls were analyzed. While there was no significant difference in the incidence of epicardial coronary stenosis, the AMR of three epicardial coronary arteries was markedly greater in HCM patients. The criterion of an AMR ≥ 250 mmHg*s/m was that 65.7% of HCM patients experienced coronary microvascular dysfunction (CMD). Independent risk factors for CMD included increased left ventricular (LV) wall thickness (OR = 1.209, 95% CI 1.013–1.443, p = 0.036). Furthermore, an AMR_LAD ≥ 250 mmHg*s/m had an increased cumulative risk of the endpoint (log-rank p = 0.023) and was an independent risk factor for the endpoint (HR = 11.64, 95% CI 1.13–120.03, p = 0.039), providing valuable prognostic insights.

New test for systematic skills enhancement and improvement in maxillofacial surgery training: multicentre pilot study

We know of few studies in the international scientific literature that specifically address the evaluation of surgical and clinical progress among physicians undergoing specialist training in maxillofacial surgery. Identifying a reliable tool to accurately assess both theoretical knowledge and surgical skills of trainees is essential. The primary aim of this study therefore was to design a comprehensive assessment tool that is capable of evaluating both the theoretical and practical skills of physicians undergoing specialist training in maxillofacial surgery. The methodology employed aims to ensure fairness and effectiveness in skills development, thereby optimising training activities. To meet this need, an evaluation and self-assessment test was developed for maxillofacial surgery trainees at the Ospedali Riuniti of Ancona. Data collection involved digitally administered evaluations and self-assessment tests focused on maxillofacial traumatology, based on AO trauma surgery references. Data were processed into graphs which revealed a progressive learning trend following an initial adjustment phase, leading to optimal outcomes in both clinical and surgical domains. The evaluation and self-assessment test proved to be a valuable learning tool with which to gauge advancements in clinical and surgical skills among maxillofacial surgery residents.

A Clinician's Guide To Effectively Transitioning and Transferring Care For Pediatric Patients With Inflammatory Bowel Diseases From The Pediatric To Adult Gastroenterologist.

Transition of care for pediatric patients with inflammatory bowel diseases (IBD) is a continuous, dynamic process that takes place over several years with a coordinated approach executed by a multidisciplinary team. We review the concepts, tools, and research in effective transitioning and transfer of care for adolescent/young adult patients with IBD. Given the constraints within the healthcare system, effective transitioning can be challenging to implement in everyday clinical practice. Different barriers include resources and expertise in effective transitioning by pediatric and adult gastroenterology healthcare providers and the impact of non-gastrointestinal issues facing young adult patients who are learning to manage and coordinate all aspects of their medical care and health maintenance. Factors that facilitate successful care transitioning and transfer include structured transitioning programs, utilization of validated transition checklists, and IBD medical summaries. Proactive transitioning by pediatric gastroenterologists in partnership with their emerging young adult patients with IBD leads to better clinical and psychosocial outcomes and ultimately, effective transfer of care to adult gastroenterology. By utilizing utilize comprehensive transition assessment tools and medical summaries in partnership with their patients, pediatric and adult gastroenterology teams can better prepare patients as they transfer to independent care and health maintenance.

Spatiotemporal Variations in Trophic Diversity of Fish Communities in a Marine Bay Ecosystem Based on Stable Isotope Analysis

Climate change has led to significant fluctuations in marine ecosystems. As a component of the food web, the trophic diversity and spatiotemporal changes of fish communities are crucial for understanding ecosystems. In recent years, stable isotope analysis has been increasingly used as a comprehensive tool for quantitative assessment of trophic diversity to explore spatiotemporal variations in fish community diversity. This study is based on carbon (δ13C) and nitrogen (δ15N) stable isotope analysis using different biomass-weighted isotope diversity indices, including isotopic divergence index (IDiv), isotopic dispersion index (IDis), isotopic evenness index (IEve), and isotopic uniqueness index (IUni). The overall results indicate that IDis, IEve, and IUni values of fish communities were relatively low, while IDiv was relatively high in the Haizhou Bay ecosystem. IDiv, IDis, IEve, and IUni were lower in autumn than in spring; IDiv and IDis were relatively higher in offshore waters, while IEve and IUni were relatively higher in inshore waters. The changes in species composition and intensive pelagic–benthic coupling in Haizhou Bay may lead to significant spatiotemporal variations in the trophic diversity of fish communities in the area. These findings highlight the importance of incorporating trophic relationships into ecosystem models, which will help to enhance our understanding of the complexity of the trophic structure of fish communities.

Assessment of the Relationship between Antero-Posterior Dental Malocclusions, Body Posture Abnormalities and Selected Static Foot Parameters in Adults.

Objectives: This study aimed to find if a relationship exists between antero-posterior malocclusions and the level of musculoskeletal disorders in adults, including body posture and static foot analysis. Methods: In all, 420 participants were recruited through convenience sampling (Kraków University students and patients of a local dentist's practice). Following general medical interviews, dental examinations and consideration of inclusion and exclusion criteria, 90 healthy volunteers (ages 19-35) were enrolled and assigned to three groups (n = 30) based on occlusion type (Angle's molar Class I, II or III). The research procedure involved occlusion and temporomandibular disorder assessment conducted by a dental specialist. Comprehensive morphological measurements of body asymmetry were performed using the Videography 2D package and FreeSTEP software, which calculated the parameters determined from anterior, posterior and lateral projection photos. Foot loading distribution was analyzed using the FreeMED baropodometric platform. Results: Significant differences were demonstrated in the positioning of the head, cervical and lumbar spine in the sagittal plane among individuals with the analyzed occlusal classes (p < 0.05). Individuals with Angle's Class II exhibited significantly greater forward head positions and greater depths of cervical and lumbar lordosis compared with individuals with Class III or Class I. Those with overbites had higher forefoot loading. The Class III individuals exhibited greater L-R displacement, indicating a larger angle of displacement of the centers of the right and left feet relative to the lower edge of the measurement platform, suggesting pelvic rotation. Conclusions: An inclination for concurrent occurrences of malocclusions and posture deviations in the sagittal plane was observed. An interdisciplinary approach involving dentistry and physiotherapy specialists which utilizes tools for comprehensive posture assessment is crucial for diagnosing and treating such conditions.

Assessing and predicting water quality index with key water parameters by machine learning models in coastal cities, China

The water quality index (WQI) is a widely used tool for comprehensive assessment of river environments. However, its calculation involves numerous water quality parameters, making sample collection and laboratory analysis time-consuming and costly. This study aimed to identify key water parameters and the most reliable prediction models that could provide maximum accuracy using minimal indicators. Water quality from 2020 to 2023 were collected including nine biophysical and chemical indicators in seventeen rivers in Yancheng and Nantong, two coastal cities in Jiangsu Province, China, adjacent to the Yellow Sea. Linear regression and seven machine learning models (Artificial Neural Network (ANN), Self-Organizing Maps (SOM), K-Nearest Neighbor (KNN), Support Vector Machines (SVM), Random Forest (RF), Extreme Gradient Boosting (XGB) and Stochastic Gradient Boosting (SGB)) were developed to predict WQI using different groups of input variables based on correlation analysis. The results indicated that water quality improved from 2020 to 2022 but deteriorated in 2023, with inland stations exhibiting better conditions than coastal ones, particularly in terms of turbidity and nutrients. The water environment was comparatively better in Nantong than in Yancheng, with mean WQI values of approximately 55.3–72.0 and 56.4–67.3, respectively. The classifications "Good" and "Medium" accounted for 80 % of the records, with no instances of "Excellent" and 2 % classified as "Bad". The performance of all prediction models, except for SOM, improved with the addition of input variables, achieving R2 values higher than 0.99 in models such as SVM, RF, XGB, and SGB. The most reliable models were RF and XGB with key parameters of total phosphorus (TP), ammonia nitrogen (AN), and dissolved oxygen (DO) (R2 = 0.98 and 0.91 for training and testing phase) for predicting WQI values, and RF using TP and AN (accuracy higher than 85 %) for WQI grades. The prediction accuracy for "Medium" and "Low" water quality grades was highest at 90 %, followed by the "Good" level at 70 %. The model results could contribute to efficient water quality evaluation by identifying key water parameters and facilitating effective water quality management in river basins.

Beyond sound irritation: cross-cultural evidence on the robustness of the five aspects of misophonic experience measured by the S-Five in a Polish sample.

Misophonia is commonly associated with negative emotional or physiological responses to specific sounds. However, the consensus definition emphasizes that misophonia entails much more than that. Even in cases of subclinical misophonia, where individuals do not meet the disorder criteria, the experience can still be burdensome, despite not currently causing significant distress or impairment. The S-Five is a psychometric tool for comprehensive assessment of five aspects of misophonic experience: internalizing, externalizing, impact, threat, and outburst, and includes S-Five-T section to evaluate feelings evoked by triggering sounds and their intensity. We examined whether the five-factor structure developed in the UK could be replicated in a Polish sample, including individuals with and without self-identified misophonia. The Polish version of the S-Five was translated and tested on 288 Polish-speaking individuals. Comprehensive psychometric evaluation, including factor structure, measurement invariance, test-retest reliability, internal consistency, and concurrent validity evaluations, was conducted on the translated scale. Exploratory factor analysis suggested similar structure to the original English study, while bootstrap exploratory graph analysis showed the factor structure to be reproducible in other samples. The scale was found to be bias free with respect to gender, internally consistent and stable in time, and evidence of validity was provided using MisoQuest and Misophonia Questionnaire. These results offer support for the cross-cultural stability of the five factors and provide preliminary evidence for the suitability of the Polish version for clinical and research purposes. The study also investigated five facets of misophonia, triggering sounds, emotional responses, and their associations with symptoms of psychopathology across various cultures. It underscores the central role of anger, distress, and panic, while also highlighting the mixed role of irritation and disgust in misophonia across different cultural contexts. Mouth sounds evoked the most pronounced reactions compared to other repetitive sounds, although there were discernible cultural differences in the nature and intensity of reactions to various trigger sounds. These findings hold significant implications for future research and underscore the importance of considering cultural nuances in both research and the clinical management of misophonia.

Validation of the Health Assessment Tool (HAT) based on four aging cohorts from the Swedish National study on Aging and Care

BackgroundAs global aging accelerates, routinely assessing the functional status and morbidity burden of older patients becomes paramount. The aim of this study is to assess the validity of the comprehensive clinical and functional Health Assessment Tool (HAT) based on four cohorts of older adults (60 + years) from the Swedish National study on Aging and Care (SNAC) spanning urban, suburban, and rural areas.MethodsThe HAT integrates five health indicators (gait speed, global cognition, number of chronic diseases, and basic and instrumental activities of daily living), providing an individual-level score between 0 and 10. The tool was constructed using nominal response models, first separately for each cohort and then in a harmonized dataset. Outcomes included all-cause mortality over a maximum follow-up of 16 years and unplanned hospital admissions over a maximum of 3 years of follow-up. The predictive capacity was assessed through the area under the curve (AUC) using logistic regressions. For time to death, Cox regressions were performed, and Harrell’s C-indices were reported. Results from the four cohorts were pooled using individual participant data meta-analysis and compared with those from the harmonized dataset.ResultsThe HAT demonstrated high predictive capacity across all cohorts as well as in the harmonized dataset. In the harmonized dataset, the AUC was 0.84 (95% CI 0.81–0.87) for 1-year mortality, 0.81 (95% CI 0.80–0.83) for 3-year mortality, 0.80 (95% CI 0.79–0.82) for 5-year mortality, 0.69 (95% CI 0.67–0.70) for 1-year unplanned admissions, and 0.69 (95% CI 0.68–0.70) for 3-year unplanned admissions. The Harrell’s C for time-to-death throughout 16 years of follow-up was 0.75 (95% CI 0.74–0.75).ConclusionsThe HAT is a highly predictive, clinically intuitive, and externally valid instrument with potential for better addressing older adults’ health needs and optimizing risk stratification at the population level.

The Exploration of the Holistic and Complex Impacts of Creative Dance on Creative Potential Enhancement

ABSTRACTInterest in nurturing individuals' creative potential is rising. Yet, the potential benefits of incorporating creative embodied activities have been neglected in both applied and research settings. To address this gap, this study examined the effects of a Creative Dance program on university students' creative self‐efficacy, emotional creativity, tolerance to ambiguity, and ideation behaviors. A total of 143 undergraduate students participated, either in the Creative Dance intervention or a sport‐based control group for 15 weeks. A mixed‐method approach using questionnaires and focus groups was adopted. Linear mixed effects models showed that engaging in Creative Dance had a significant effect on ideational behaviors and tolerance to ambiguity. Specifically, students in the intervention condition improved their ideational behaviors and remained stable in their tolerance to ambiguity compared to student in the control condition who remained stable and regressed on those variables respectively. Focus group results highlighted the social effects of the intervention, which help to contextualize the quantitative findings. This study underscores the importance of integrating creative embodied activities to foster individuals' creative potential while highlighting the need to develop comprehensive assessment tools to capture the dynamic interplay between individuals and their environment throughout this process.

Neuropathic Pain Secondary to Multiple Sclerosis: A Narrative Review.

Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system (CNS). Neuropathic pain in MS is a debilitating symptom that significantly impairs the quality of life for a substantial proportion of MS patients. Neuropathic pain in MS stems primarily from demyelination, axonal loss, CNS inflammation, and direct damage to the myelin sheath, leading to pain manifestations such as ongoing extremity pain, Lhermitte's phenomenon, and trigeminal neuralgia (TN). The pathophysiological mechanisms behind MS-related neuropathic pain are explored in this review, highlighting central sensitization, neural dysfunction, spinal thalamic tract dysfunction, and inflammatory processes that exacerbate neuronal damage. Neuropathic pain in MS necessitates comprehensive assessment tools and neurophysiological tests to differentiate neuropathic pain from other MS symptoms accurately. Treatment strategies for MS-related neuropathic pain encompass pharmacological interventions, including anticonvulsants and antidepressants, and emerging therapies targeting specific inflammatory processes. The review advocates for a holistic approach to management, incorporating innovative treatments and multidisciplinary strategies to address both the physical symptoms and psychosocial aspects of this disorder. This comprehensive overview underscores the importance of ongoing research into targeted therapies to improve patient outcomes and enhance the quality of life for those affected by MS.

Multimodal risk stratification of non-metastatic lung adenocarcinoma using AI on histology and immunohistochemistry slides.

e20083 Background: While immunohistochemistry (IHC) slides are commonly used to assess the presence of actionable biomarkers, the recent advances in artificial intelligence (AI) focus exclusively on hematoxylin and eosin (H&amp;E) slides. Nonetheless, many IHC slides, potentially rich in prognostic information, remain underexplored for risk stratification and outcome prediction. Our study aims to assess the complementarity of H&amp;E and IHC slides through the development of a multimodal prognostic AI model for lung adenocarcinoma patients. Methods: We collected 1 H&amp;E slide, 8 IHC slides (PD-L1, FOXP3, HELA2, CD3, CD4, CD8, CD163, KI67), and 2 double-stained slides (PDL1-CD163 and CD3-CD163) from 245 resected patients with lung adenocarcinoma at two different hospitals (median OS = 54.0 months [11.3 - 138.0]). Patients underwent various adjuvant treatments (chemotherapy n=92; immunotherapy n=4; other n=36; no treatment n=152). We cross-validated 11 AI models (one model per staining) to predict overall survival in these patients. We used Harell’s C-index and the 70-month cumulative AUC to evaluate the performance of our models. To assess their stratification power, each model’s predictions were split into high-risk and low-risk populations to compute a Hazard Ratio and a log-rank test p-value. Subsequently, a Cox proportional hazards model aggregated the predictions of the 11 models to compute a final risk score. We performed a grid search to find the combination of markers yielding the highest C-index. We calculated the hazard ratios to determine each biomarker's predictive value. Results: The H&amp;E model was the best unimodal model, with a C-index of 0.69 [0.67 - 0.71]. The best-performing multivariate model was obtained by combining the risk scores from univariate models in a Cox regression using H&amp;E, CD8, PD-L1, HELA2, and FOXP3 slides, reaching a C-index of 0.71 [0.69 - 0.73] (Table). We found that the predictions from H&amp;E (HR = 1.39; P = 0.03) and PD-L1 (HR = 1.17; P = 0.04) were significantly associated with survival. Conclusions: By significantly improving patient stratification with non-metastatic lung adenocarcinoma, our multivariate model proves that some IHC markers contain complementary proteomic information to H&amp;E slides. Consequently, this study paves the way for developing more comprehensive risk assessment tools from H&amp;E and IHC stainings. [Table: see text]

Full Outline of UnResponsiveness (FOUR) Scale: a Multicenter Validation Study of the Psychometric Properties of the Approved Russian Version

Assessment of the individual level of consciousness on admission of a patient with brain injury to the intensive care unit (ICU) is a priority task and a mandatory step in the overall assessment of neurological status. The Full Outline of UnResponsiveness (FOUR) scale, developed at the Mayo Clinic (USA) in 2005, is a widely used tool for comprehensive assessment of patients with altered state of consciousness. The lack of a validated Russian-language version of the FOUR scale has hindered its widespread use in clinical practice. Therefore, the official Russian version of the FOUR scale was developed and adapted for use in Russia after the first stage of the validation study (linguistic and cultural adaptation).Aim. To evaluate the psychometric properties of the Russian version of the FOUR scale for comprehensive assessment of patients in altered state of consciousness.Materials and Methods. As part of a prospective multicenter validation study, the psychometric properties of the scale (reliability, validity, and sensitivity) were evaluated in a group of 171 adult patients with altered conscious state of various etiologies, such as ischemic and hemorrhagic stroke, neuroinflammatory conditions, and traumatic brain injury. Patients’ responses were assessed on the first day of ICU stay and 2-3 days later by two ICU neurologists with at least three years of experience.Results. High levels of validity and reliability were obtained for the Russian version of the FOUR scale for comprehensive assessment of unresponsive patients, including Spearman’s rank correlation coefficient r=0.99 (P&lt;0.0001), Cohen’s κ=0.77 (P&lt;0.001), Cronbach’s α=0.87 (P&lt;0.0001). Regarding the sensitivity of the FOUR scale, no significant changes were found after comprehensive assessment of unresponsive patients on day 1 in the ICU and 2-3 days later (Wilcoxon test, P=0.906). There was a good correlation between the FOUR and Glasgow Coma Scale scores used to assess patients with altered state of consciousness, confirming the validity of the test with r=0.91 (P&lt;0.0001).Conclusion. The Russian version of the FOUR scale for comprehensive assessment of unresponsive patients is a valid, reliable, and sensitive clinical tool. Sufficiently verified level of psychometric properties allows its authorized use in Russia and other Russian-speaking countries. The scale is available for download via QR code and at the website of the International Scales and Questionnaires Validation Group at the Scientific Center of Neurology.

Assessment of chronic rhinosinusitis with nasal polyps: Development of the Nasal Polyp Patient Assessment Scoring Sheet tool.

Chronic rhinosinusitis (CRS) is a heterogeneous disorder with a wide range of validated subjective and objective assessment tools to assess disease severity. However, a comprehensive and easy-to-use tool that integrates these measures for determining disease severity and response to treatment is still obscure. The objective of this study was to develop a standardized assessment tool that facilitates diagnosis, uniform patient monitoring, and comparison of treatment outcomes between different centers both in routine clinical practice and in research. To develop this tool, published literature on assessment tools was searched on various databases. A panel of 12 steering committee members conducted an advisory board meeting to review the findings. Specific outcome measures to be included in a comprehensive assessment tool and follow-up sheet were then collated following consensus approval from the panel. The tool was further validated for content and revised with expert recommendations to arrive at the finalized Nasal Polyp Patient Assessment Scoring Sheet (N-PASS) tool. The N-PASS tool was developed by integrating the subjective and objective measures for CRS assessment. Based on expert opinions, N-PASS was revised to be used as an easy-to-use guidance tool that captures patient-reported and physician-assessed components for comprehensively assessing disease status and response to treatment. The N-PASS tool can be used to aid in the diagnosis and management of CRS cases with nasal polyps. The tool would also aid in improved monitoring of patients and pave the way for an international disease registry. Oxford Level 3.